ABM

Pathogen mechanisms for causing disease

Destruction of host cell, exposing host cell to toxin, interfering with host cell metabolism

Factors effecting pathogenicity

VIrulence, infectivity, toxigenicity, antigenicity, antigenic variability, pathogenic defense mechanisms, coinfection, superinfection

Types of pathogens

Obligate, faculative, bacteria, viruses, fungi, protozoa, helminths, rickettsiae, mycopalsmas, chlamydiae

Chain of infection

Infectious agen, reservoirs, protal of exit, means of transmission, portal of entry, susceptible host

Phases of acute infection

Exposure, incubation, prodrome, acute/chronic illness, convalescence

Local manifestations of infection

Heat, pain, edema, redness, lymphadenitis, purulent exudate

Systemic manifestations of infections

Fever, weakness, headache, malaise, anorexia, nausea

Spread by fecal oral route, not chronic, no carrier state

Hepatitis A and E

Spread by infected blood/body fluids, chronic, carrier state

Hepatitis B, C, D

Kernig’s sign

Cannot straighten leg when hip is flexed

Brudzinski’s sign

Hips and knees flex when neck is flexed

Measles incubation

6-21 days

Measles Prodrom and exanthem

Cough, fever, maculopapular rash

Cephalocaudal spread

Face, neck, trunk, extremeties

Mesenteric ischemia

Risk with vascular disease, Afib. Out of proportion sudden pain

Ruptured AAA

Secondary to arthersclerosis, more in men.

Tubo-ovarian abcess

Unilateral tenderness, fever, chills, extension of PID

Gastric/duodenal ulcer

May perforate/bleed, due to H.pylori

Pyloric stenosis

Narrowing of the opening between stomach and small intestine

Intussussception

Currant jelly-like stool due to intestine sliding in on itself

Intestinal malrotation

Intestines don’t coil in the abdomen like normal

Midgut volvulus

Twisting of intestines

CO2 and Bicarbonate

CO2 dissolves in blood releases H+ and forms bicarbonate

CO2 regulation

By lungs, can change quickly

Bicarb regulation

Renal system, H+ is excreted and bicarb is reabsorbed. Delayed changed

Acidosis

pH < 7.35, due to PaCO2 < 35 mmHg / HCO3 < 22 mEq/L

Alkalosis

pH > 7.45, due to PaCO2 > 45 mmHg / HCO3 > 26 mEq/L

CO2 and pH

Inverse relationship

HCO3 and pH

Direct relationship

Respiratory acidosis causes

CNS depression, pulmonary condions, heart failure/arrest, MS, myasthenia gravis

Respiratory alkalosis causes

Psychological, respiratory, fever, thryoid storm, gram-negative septicemia, pregnancy, salicylate/stimulants/nicotine poisoning

Metabolic acidosis causes

Renal failure, DKA, lactic acidosis, starvation, diarrhea, salicylate/carbonic anydrase inhibitors

Metabolic alkalosis causes

Excess bicarb/antacid, hypokalemia, hypochloremia, diuretic use, hyperaldosteronism

MUDPILES

Methanol, Uremia, DKA, Paraldehyde, Iron/Isoniazid, Lactic acid, Ethylene glycol, Salicylates

Anion gap calculation

(Na + K) - (CL + HCO3), typiclaly 10-18 mmol/L

Apraxia

Inability to perform motor tasks

Agnosia

Failure to recognize objects

Cluster A personality disorders

Odd/eccentric, social awkwardness, distorted perceptions

Cluster B personality disorders

Dramatic/erratic, unpredictable thinking and behaviour