Questions On Diseases: Multiple Choice! Quiz

Spherocytes (the spherical red blood cells that give spherocytosis its name) are less able to withstand hypotonic solutions and will burst, even in salinities that are relatively close to blood. This is partly because the red blood cell membranes are weaker, but also because the cells are already spherical and so can not increase their volume by changing shape, unlike the normal biconcave red blood cells. The Ham test is a test used in the diagnosis of paroxysmal nocturnal hemoglobinuria Heinz bodies are formed by damage to the hemoglobin component molecules, usually through oxidant damage, or from an inherited mutation (i.e. change of an internal amino acid residue). As a result, an electron from the hemoglobin is transferred to an oxygen molecule, which creates a Reactive Oxygen Species (ROS) that can cause severe cell damage leading to premature cell lysis. Damaged cells are cleared by macrophages in the spleen, where the precipitate and damaged membrane are removed, leading to characteristic "Bite cells". The denaturing process is irreversible and the continual elimination of damaged cells leads to Heinz body anemia.

Concept: Association of RB tumor suppressor gene with cancers

The symptoms described in the question, including failure to thrive, elevated levels of GPT, AST, ammonia, and creatinine in the blood, and a strong cabbage-like smell, are consistent with the diagnosis of Tyrosinemia I. Tyrosinemia I is a rare genetic disorder that affects the breakdown of the amino acid tyrosine. It results in the accumulation of toxic substances in the body, leading to liver and kidney damage. The elevated levels of GPT and AST indicate liver dysfunction, while the elevated ammonia and creatinine levels suggest kidney dysfunction. The strong cabbage-like smell is a characteristic odor associated with tyrosinemia.

Organ grafts between genetically identical individuals, such as identical twins, are not rejected even with no immunosuppression because their immune systems recognize the transplanted organ as "self" and do not mount an immune response against it. This is because genetically identical individuals have the same major histocompatibility complex (MHC) molecules, which are responsible for presenting antigens to the immune system. As a result, there is no need for immunosuppressive drugs to prevent rejection of the transplanted organ.

The most likely line of research for the student would be studying the mechanism of enhanced efflux transporter molecules in the plasmodial cell. This mechanism is common to tumor cells, bacteria, and fungi, and it allows the cells to pump out drugs and prevent them from accumulating inside the cell. By studying this mechanism, the student can understand how the plasmodial cell is able to resist the effects of mefloquine and develop strategies to overcome this resistance.

The most likely diagnosis in this case is systemic sclerosis. Systemic sclerosis is a chronic autoimmune disease characterized by fibrosis and vascular abnormalities. The patient's symptoms of dysphagia, diarrhea, and weight loss are consistent with gastrointestinal involvement, which is common in systemic sclerosis. The presence of antibodies against DNA topoisomerase I, also known as Scl-70, is highly specific for systemic sclerosis. The abnormal breath sounds may be indicative of pulmonary involvement, another common feature of this disease. Sjogren's syndrome, CREST syndrome, systemic lupus erythematosus, and discoid lupus are all autoimmune diseases, but they are less likely to present with the combination of symptoms and laboratory findings described in this case.

CD33 is the target of gemtuzumab ozogamicin, a monoclonal antibody-based treatment for acute myeloid leukemia. Cytochemical stains on blood and bone marrow smears are helpful in the distinction of AML from ALL, and in the subclassification of AML. The combination of a myeloperoxidase or Sudan black stain and a nonspecific esterase stain will provide the desired information in most cases. The myeloperoxidase or Sudan black reactions are most useful in establishing the identity of AML and distinguishing it from ALL. The nonspecific esterase stain is used to identify a monocytic component in AMLs and to distinguish a poorly differentiated monoblastic leukemia from ALL. The diagnosis and classification of AML can be challenging, and should be performed by a qualified hematopathologist or hematologist. In straightforward cases, the presence of certain morphologic features (such as Auer rods) or specific flow cytometry results can distinguish AML from other leukemias; however, in the absence of such features, diagnosis may be more difficult. The French–American–British (FAB) classification requires a BLAST PERCENTAGE of at least 30% in bone marrow (BM) or peripheral blood (PB) for the diagnosis of AML Myeloperoxidase (MPO) is a peroxidase enzyme that in humans is encoded by the MPO gene. Myeloperoxidase is most abundantly expressed in neutrophil granulocytes (a subtype of white blood cells). It is a lysosomal protein stored in azurophilic granules of the neutrophil. MPO has a heme pigment, which causes its green color in secretions rich in neutrophils, such as pus and some forms of mucus. PAS staining is mainly used for staining structures containing a high proportion of carbohydrate macromolecules (glycogen, glycoprotein, proteoglycans), typically found in e.g. connective tissues, mucus, the glycocalyx, and basal laminae.

Concept: Diagnosis of benign tumor based on histopathology findings Fibroadenomas of the breast, are lumps composed of fibrous and glandular tissue. Because breast cancer can also appear as a lump, doctors may recommend a tissue sample (biopsy) to rule out cancer in older patients. Unlike typical lumps from breast cancer, fibroadenomas are easy to move, with clearly defined edges. Fibroadenomas are sometimes called breast mice or a breast mouse owing to their high mobility in the breast A fibroadenoma is usually diagnosed through clinical examination, ultrasound or mammography, and often a NEEDLE BIOPSY sample of the lump Cytology: The diagnostic findings on needle biopsy consist of abundant stromal cells, which appear as bare bipolar nuclei, throughout the aspirate; sheets of fairly uniform-size epithelial cells that are typically arranged in either an antler-like pattern or a honeycomb pattern. These epithelial sheets tend to show typical metachromatic blue staining on DiffQuick staining. Foam cells and apocrine cells may also be seen, although these are less diagnostic features.

Concept: Use of serum tumor markers for monitoring hepatocellular carcinoma AFP: A level above 500 nanograms/milliliter of AFP in adults can be indicative of hepatocellular carcinoma, germ cell tumors, and metastatic cancers of the liver. Elevation of AFP is used as one factor in the diagnosis of ataxia-telangiectasia AFP is measured in pregnant women through the analysis of maternal blood or amniotic fluid, as a screening test for a subset of developmental abnormalities: it is principally increased in open neural tube defects and omphalocele and is decreased in Down syndrome. It can also be used as a biomarker to detect a subset of tumors in non-pregnant women, men, and children.

The most likely process of transformation in this case is the binding of protein E7 to Rb and bypassing cell cycle control. This is because the question mentions that the lesions in the cervix are indicative of a malignancy caused by Papillomavirus infection. The E7 protein of Papillomavirus is known to bind to the retinoblastoma protein (Rb) and inactivate it, leading to uncontrolled cell growth and proliferation. This disruption of the cell cycle control is a key step in the development of cervical cancer.

Concept: Thalassemia – Association between clinical features and laboratory findings Pt has a severe B-thalassemia. This will lead to a loss of iron, resulting in an iron def anemia. (microcytic hypochromic). the body will try to compensate with EMH. this will lead to the skeletal changes we see in this pt and the elevated HbF. Splenomegaly is from the Extravascular destruction of the RBC's. Remember also that in Sickel cell, Hydroxyurea is given to increase HbF, which helps with symptoms.

The patient's symptoms of difficulty breathing, pitting edema, and distension of the right internal jugular vein are consistent with congestive heart failure (CHF). In CHF, there is impaired pumping function of the heart, leading to increased intravascular (hydrostatic) pressure. This increased pressure causes fluid to leak out of the vessels and into the surrounding tissues, resulting in pulmonary congestion, edema, and jugular vein distension. The other options are not associated with these specific manifestations seen in CHF.

The patient in this scenario has a CYP2C9 variant with significantly reduced activity in the liver. CYP2C9 is responsible for metabolizing warfarin, a commonly used anticoagulant. With reduced CYP2C9 activity, the patient's liver is unable to efficiently metabolize warfarin, resulting in increased blood levels of the drug. Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting factors, including prothrombin. Therefore, increased blood warfarin levels would lead to an increased prothrombin time, indicating a longer time for clot formation.

Dracula "flees" from Holy "water"

This patient's symptoms and findings suggest a type II hypersensitivity reaction. Type II hypersensitivity reactions involve the formation of antibodies against specific cells or tissues. In this case, the presence of red blood cells and proteins in the urine suggests an autoimmune response targeting these cells. The hypertension, respiratory distress, and edema may be due to damage to blood vessels caused by the immune response.

The correct answer is "Knowledge". According to the given information, the study found that adequate information from the doctor on the child's fatal prognosis was the main predictor of intellectual and emotional awareness. Therefore, providing knowledge to parents about their child's illness and prognosis would reduce the chances of them being unprepared emotionally and intellectually.

Muromonab CD3 is an immunosuppressive medication that is used to treat acute rejection in renal transplant patients. The patient in this case is presenting with symptoms suggestive of graft dysfunction, such as fever, pain over the graft, and decreased urine volume. The elevated creatinine and BUN levels further support the possibility of acute rejection. Therefore, adding muromonab CD3 would be the most appropriate modification to the current course of therapy for this patient.

from concept sheet of mini 2 (jan 2012)
H_MI: Rationale for a malaria vaccine against sporozoites (Adebyi)

Scenario: they were creating a vaccine that would be most effective. And the most effective vaccine is works when the malaria mosquito first bites you, what does the vacine target?

Vaccine against the sporozites