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BBC (MICRO (Pneumonia: Fever, Cough, Dyspnea (Bronchopneumonia
S. Aureus…
BBC
MICRO
Pneumonia: Fever, Cough, Dyspnea
Bronchopneumonia
- S. Aureus (multiple lesions)
- Haemophilus Influenzae
Lobar pneumonia
- Klebsiella: Slower
- S. Pneumoniae: Fast onset
Atypical: Bilateral infiltrates
- Mycoplasma: Mass that looks like fried egg on petri dish
- Influenzae,
- RSV
Other
- Pneumocystis: Ground glass, Bronchial levage and silver stain
- Aspergilloma
Gastroenteritis: Diarrhea, +/- Blood, +/- Stool WBC
+ Hemoccult and stool WBC
- C. difficile
- Shigella
- Salmonella
- Campylobacter
- EHEC
- Necator
- Hemoccult and stool WBC
- C. difficile
- S. Aureus
- ETEC
- Norovirus
- Rotavirus
- Cyptosporidium
- Giardia
- Taenia
- Ascaris
- Strongyloides
Infectious Rash: Rash, Fever
Virus
- Benign Viruses
- HHV-6: Roseola: Fever 1-5 days then disappears and rash appears
- Parvovirus B19: Fifth/slap cheek, bone marrow issues will make it worse, Spontaneous abortion in pregnant women
- Rubeola Virus: Very High fevers
- Rubella Virus: Faint rash, with low grade fever, bad for fetus, ok for the mother
- VZV: Reactivation --> Shingles/Herpes zoster (Dermatomes): Immunosuppression
Bacteria
- Rickettsia rickettsiae: Rocky mountain spotted fever, dog tick, vascular collapse
- Neisseria Meningitidis: endotoxin --> Factor 12 activation, Pharynx first (sore throat) --> Blood stream --> Petechia and purpura --> DIC
- S. aureus: TTST1 toxin --> Desquamation
Encephalitis: HA, Fever, Change in mental status, focal findings +/- Stiff neck
Virus
- HIV, Echovirus, Mumps, Rubeola, JC, Smallpox, HSV, VZV, CMV, EEE, WEE, St. Louis, West Nile, California, Rabies
Protozoa
- Toxoplasma Gondii
- Typanosoma Brucei
- Naegleria Fowleri
Cestodes
- Taenia solium
- Echinococcus Granulosa
- Trichinella Spiralis
Spiralchetes
- Treponema Pallidum
- B. Burgdorferi
- Nocardia Asteroides
Physiology
Face
- Facial expression/chewing
- Motor Cortex: Ipsilateral Cortex -> Medial Midbrain/pons -> CN 7
- Ipsilateral cortex: Upper face
- Contralateral: Upper and Lower face
- SK muscle contraction
- acetylCOA --> Ach --> Alpha Subunit of Nicotinic Type II on muscle end plate
- Ca-ATPase is what catalyzes the return of Ca to SR
- Botulinum Toxin, Myasthenia Gravis (anti-ach ab), Curare, Physostigmine (inhibit acetylcholinesterase)
- Tetanospasmin Toxin
- Smooth Muscle contration
- Ca released by SR --> Binds to Calmodulin --> complex binds to MLCK --> Myosin bind to actin --> cell shortens --> Myosin dephosphorylated --> smooth muscle relaxed
- Speech/Blinking/Eyes
- Speech
- Broca: be able to speak properly
- Wernickie: Comprehension of the
- CN 7: facial expression/chewing, CN 12: Tongue
- Eye: Cone-Color
- SK muscle: Obicularis Oculi, levator palpebrae superioris
- Smooth Muscle: Mueller's muscle
- Multi-unit: ANS: Na enter Cell --> vgCa CH
- Single-Unit: Hormones/NT --> Entire unit contracted (coordinated, spontaneous active: Pacemaker activity)
- Retina -> Optic Nerve -> lateral geniculate body of thalamus -> Visual cortex
- Meyer's Loop: Lower retina -> Loops around inf Lateral ventricle
- Olfaction
- Olfactory Receptor cells are NEURONS
- GOLF (Gprotein): Adenylate cyclase --> inc. cAMP --> Na + Ca ch open --> depolarization of olfactory nerve --> (Unmyelinated, slow) -> pass cribriform plate --> Olfactory bulb --> Mitral cells (neuron) depolarize and send AP to prepirifoxrm cortex
- Taste
- Not Neurons
- Ant 2/3 : Salt/sweet: CN 7 (Chorda Tympani of facial N)
- Post 1/3: Sour/Bitter: CN 9
- Pharynx/epiglottis: CN 10
- Audition
- Sound waves --> Tempanic membrane --> M --> I --> S --> Oval window --> endolymph (water inner ear) --> basilar membrane vibrate --> Organ of corti vibrates --> receptor cells bend and depolarize
- Vibration of organ of corti --> pushes on tectorial membrane --> Cilia on surface to bend/oscillate
- Hyperpolarization: K entry into cholera nerve, Opposite bend blocks K to enter
- AP goes through Lateral Lemniscus --> inferior Colliculus --> Medial geniculate nucleus of the thalamus --> auditory cortex (superior temporal gyrus)
- Cochlear damage: Unilateral hearing loss
- Damage at cortext/thalamus: Bilateral hearing loss
Chest
- Breathing
- Mostly diaphragm
- Air resistance = (nL8)/r^4
- Airflow = (Change in P) / R
- Compliance: (Change in V)/ P
- Viscosity, and length : Proportional to Resistance, Radius is INVERSE
- Surface tension: Alveolar radius is inversely proportional to collapsing pressure
- P=2T/r
- Surfacntant : Type 2! Decrease surface tension
- Lecithin = dipalmitoryl phosphatidylcholine
- Before 34wk = premature
- Gas exchange
- Amp of gas dissolved = partial pressure
- Rate of gas diffusion = partial pressure difference across the alveolar membrane
- Blood Delivery
- Cardiac muscle contraction (MUCH MORE MITOCHONDRIA): AP --> Ca enter T tubules --> Ca released from SR --> Ca bind to Troponin C --> tropomyosin moves --> myosin bind to actin
- Skeletal muscle: AP (Na) that causes T tubule to release Ca from SR
- Compliance = Capacitance = (Change in Vol)/P
- MAP = 2/3 D + 1/3 S
- CO = SV x HR
- Pulse Pressure = SBP - DBP
Abdomen
- Hormones
- Gastrin, CCK, Secretion, GIP, Somatostatin, Histamine, VIP, GRP
- GI Motility
- All smooth muscle except: pharynx, upper 1/3 of eso, external anal canal
- Slow waves: constant waves of movement
- Frequency of AP influenced by neural hormonal controls
- 3 major factors of motility
- Segmentation contraction: Mix chyme
- Peristalsis: push chyme forward
- Gastroileal reflex: Push to Lg intestine
- LG intestine motility
- Segmentation contraction (haustra), Mass movement
- Nutrient absorption
- Carbs: G and galactose -> Na dependent co-transport, F: facilitated diffusion
- Free AA -> Na dependent co-transport
- Na into bloodstream: SI - Like PCT, LI - Like DCT (stimulated by aldosterone!)
- K is absorbed in SI and secreted in colon (like LDCT and CD)
- B12 is only absorbed in Ileum + intrinsic factor
- GFR
- Blood being filtered: Best tested by inulin
- GFR = ([Inulin urine] x V) / [Inulin plasma]
- BUN and Creatinine increase with decreasing GFR
- GFR decreases with age
- GFR = K[Hydrostatic cap - hydrostatic bs] - [Onconic cap - Onconic bs]
- Hydrostatic pressure is increase by afferent arteriole vasodilation, efferent constriction
- Hydrostatic pressure of Bowman's space is increase by blockade of uterus
- Oncotic pressure of capillary is decreased by decreased albumin levels
- Onconic pressure of Bowman's space is 0 unless there is nephrotic syndrome