HIV ->CD4 TH17 (activate neutrophils/protect mucoepithelium) is depleted->decrease CD4 T-> decrease TH1->not enough CD8T = infection + no control of infections
10
Identify the antiviral therapies for HIV and describe their site of action: Dolutegravir, Abacavir, Efavirenz
Discuss the laboratory tests that guide antiretroviral drug selection: HLA-B5701 & HIV resistance tests
Haplotype test: assessing the rate of HIV progression; genotype: drug resistance+correct therapy; HLA-B5701 don't use Abacavir drug
10
use of TMP-SMX to treat Pneumocystis jirovecii; why is it an opportunistic infection in late HIV
inhibits dihydropteroate synthase+dihydrofolate reductase; PCP lacks ergosterol->antimycotic ineffective; Opportunistic infection in HIV CD4 low=AIDS defining
10
Explain the pathogenesis of EBV infection and how it relates to Hodgkin Lymphoma
EBV infects B lymphocytes->proliferate expression viral proteins->EBV-derived LMP-1->NF-kappaB & JAK/STAT->host cell proliferation/inhibit apoptosis by BCL2
10
Describe the Ann Arbor staging system used in staging Hodgkin lymphomas and the prognostic significance.
Hodgkin: contiguous lymph spread but NOT Non-Hodgkin; Ann Harbor I-IV (lymph spread increases+organ involved) + A (no b symptoms) B (yes B sympt)->IVB is worst
10
Describe the significance for PET-CT for the staging of malignancy.
Evaluate the spread of the cancer; Also see how successful the treatment is for the cancer.
10
Compare Hodgkin Lymphoma with Non-Hodgkin Lymphoma
Explain the significance of the SPEP M-spike in the evaluation of multiple myeloma
A dense narrow band that is composed of a single class of immunoglobulins secreted by an abnormally expanded clone of plasma cells
10
Discuss the indications/drug class of the VRd regimen (bortezomib, lenalidomide, and dexamethasone) for Multiple Myeloma (MM)
induction therapy for MM: Bortezomib-antineoplastic; Lenalidomide-immunomodulatory; dexamethasone-low dose gluccoctoricoid used w/ Lenalidomide
10
Explain the significance of rouleaux, pancytopenia, elevated serum protein, calcium levels, and circulating plasma cells in the presentation of multiple myeloma.
extensive monoclonal B lymphocyte proliferation->stacks RBCs together; ->overrun bone marrow->anemia; ->osteoclasts increase->hypercalcemia; M-protein spikes
10
Characterize Taenia solium, including structure, physiology, and epidemiology.
cestode, pork tapeworm; monoecious, hooklets on scolex, suckers; ingestion cysticerci in infected-undercooked pork; Latin America/Sub-Sahara Africa/India/Asia
10
Discuss the modes of transmission and life cycle of Taenia solium as they relate to cysticercosis and taeniasis.
host is man->intermediate pig->man has tapeworm->infects pig->man eats pig w/ mature larva->man ill eating eggs->inactive oncosphere->active oncosphere->cysts
10
Explain how taeniasis and cysticercosis can be prevented.
treatment of human cases harboring adult T. solium (to reduce egg transmission); controlled disposal of human feces
10
Discuss why you do not use albendazole to treat cysticerci (calcified cysts) in a patient with seizures and no cerebral edema
Do not treat calcified cysts with antihelminith or corticosteroids but treat with antiepileptic to control the seizures