management for transient ischemic attack(TIA)Secondary prevention of future stroke includes antiplatelet agents (eg, aspirin, clopidogrel) to prevent thrombus formation and ☆statin therapy (HMG-CoA reductase inhibitor; eg, atorvastatin, rosuvastatin) to reduce atherosclerotic plaque formation. Lifestyle modifications (eg, exercise, tobacco cessation) are also recommended. neurologyUWorld HirotoShishido
prenatal screening for group B streptococcus
characteristics of the bacteriaGBS colonization by vaginal-rectal culture at 35-37 weeks gestation is recommended to identify colonized woman who require ★intrapartum penicillin/ampicillin to prevent neonatal GBS sepsis, pneumonia and meningitis
women with heavy colnization (eg. asymptomatic bacteriuria) needs ampicillin (★)regardless of screening status or rectovaginal culture results
hypothyroidism and T3synthetic T3 (liothyronine) is not recommended for the routine treatment of hypothyroidism, as it has a short half-life and patients can experience wide fluctuations in plasma T3 levels
diffrentiate between folate and vitamin B12 deficiency↑ homocysteine in both
☆↑ methylmalonic acid only in cobalamin deficiency(cobalamin=cofacter for methylmalonyl CoA mutase)
(methylmalonyl CoA is converted to succinyl CoA with the cofactor vitamin B12. If there is not enough vitamin B12 present, methylmalonyl CoA is alternatively converted to methylmalonic acid) hematologyUWorld HirotoShishido
enters the nerve terminals through endocytosis, when it ☆prevents binding and fusion of Ach-containing synaptic vesicles with the plasma membrane through the destruction of SNARE proteins
sporothrix schenckii
transmissionspores are traumatically introduced into the skin, typically by ☆a thorn("rose gardener's disease") microbiologydermatologyUWorld HirotoShishido
picture
symptoms, transmission, diagnosis, treatmentcutaneous leishmaniasis
enlarging, pinkish papule at the site of the bites→ eventually develop into nodule or plaque and ulcerations
caused by Leishmania donovani
→can also cause(kala-azar)
(visceral protozoa infection) hepatosplenomegaly, pancytopenia
sandfly
macrophages containing ☆intracellular round oval amastigotes with rod shaped kinetoplasts
PTHrP(parathyroid hormone-related protein)→ ↑Ca (SCC of the lung)
☆Ectopicerythropoietin(EPO)→ polycythemia
(* RCC can also cause both anemia of chronic disease and iron deficiency anemia due to chronic hematuria)
