Th differentiation: ILminus2

Th0(zero) cells become what IL minus 2 signal hits them.

IL12 take away a '2' and you get a '1' left over-->Th1

IL4-2-->Th2

See?

More neuro blah

Sorry if you thrive on neuro, but I don't like localizing lesions more than to the brain/spine/LMN since they'll get a head scan regardless. But here's study stuff anyways with stupid things to help me remember it all. Bytheway, these ideas came out of Kochar's textbook. (I met him!)

Problem in_____-results in_____(example)

Thalamus/sensory cortex-complex sensations (R/L differences in pin prick)

Spinal cord-trunk and limb (unless it is not a complete disruption, then you get Weber syndrome or the like)

Polyneuropathy-sock and glove distribution (Thank you, krispy kreme)

UMN-spastic movement & Up reflexes

LMN-fasciculation & down reflexes

Basal ganglia-RIGID ROBOT muscles

Cerebellum-pendular reflexes/movement (Nose-Finger-Nose test may cause blindness)

NMJ-fatigue

Murmurs & other heart sounds

"Come Right In so you aren't Left Out." Right-sided murmurs louder on Inspiration, Left are lounder when you breath Out.

"MTV shows wHOLesome regurg." HOLosystolic murmurs=Mitrial regurg Tricuspid regurg or VSD

"AP classes are hard to A Stupid Dude in Middle school." Midsystolic murmurs=hard(stenotic) Aortic or Pulmonic valves, ASD, and there may possibly be more.

Diastolic murmurs problems with ventricle relaxing or filling, like aortic or pulmonic regurg, mitral or tricuspid stenosis, and they are ALWAYS pathologic.

Opportunistic fungi

I was going to make this a post-a-day thing, but why limit myself? So I'm making up for Thanksgiving.

Candida-cold bud & pseudohyphae (just like Canada, a cold psuedo-America bud [j/k but it helps with memorizing]) but germ tubes when hot; cause thrush, vulvovaginitis, diaper rash, and can disseminate to any organ

Aspergillus-give someone a high five if they eat their Asparagus veggies. As seen in the picture, fruiting bodies of Aspergillus look like a high five, and their hyphae branch at 45 degrees and your thumb is typically 45 degrees from your other fingers (unless you have some sort of Median nerve problem).

Cryptococcus-a hiding/encapsulated (crypto) sphere (coccus), causes meningitis (soap bubble lesion in brain), found hiding in soil and pigeon poo (you need soap for dirt and bird poo). India ink, Sabouraud's agar, and latex agglutinaion help with Dx (think of an indian with latex gloves wielding a saber)

Mucor-dz in ketoacidotic diabetics and leukemic patients. Infarction, necrosis, frontal lobe abscesses from mucormycosis. Branches wide like my beautiful handwritten "M"

US Fungus

Ok so Thanksgiving break threw off my grove. I seriously was eating a ton (macrophaging) in Ohio, which brought to mind Histoplasmosis, since its in the oHio and mississippi river basin areas, and macrophages engorge on Histoplasmosis (I can make up something about bats or starlings to go along with this story, but I'm too lazy).

Cali has Coccidioidomycosis, states/Mexico Bordering the Atlantic have Blastomycosis (remember Goljan stuttering "blasto broad based bud") , and Panama has Paracoccidioidomycosis. The picture is supposed to help remember a road trip to Cali and Coccidioidomycosis (looks like a tire) and sailing to Panama (Paracoccidio looks like a captain's wheel).

Pesonality D/O (PD)

To be a PD, a pattern of behavior must affect cognition, affectivity, interpersonal functioning & impulse control; it must clinically cause distress and/or functional impairment and have started at adolescence or early adulthood.

Cluster A:Odd&Eccentric (Accusatory, Alone, Awkward)

Paranoid-irrational fears, jealousy; projection is defense mechanism

Schizoid-solitary, indifferent, no psychosis; fantasy is defense

Schizotypal-psychosis (ideas of refernce, magical thinking)

Cluster B:Dramatic (Borderline, Bad, Beautiful*, Babe*; *=in mind only)

Antisocial-impulsive, reckless, non-conformative; act out

Histrionic-shallow&suggestive; repress/dissociate

Narcissistic-self-important; intellectualize, distort

Borderline-mood swings, extreme avoidance of abandonment; splitting

Cluster C:Anxious (Cowardly, Controlling, Clingy)

Avoidant-"inferiority complex" but w/ desire for relation

OCPD-egosyntonic version of OCD

Dependent-exaggerated fear of loniness, low self esteem; regression, somatization

Tx=DBT if destructive, serotonin for impulses

DNA viruses Her HAPPy Pox

HERpes, Hepadna, Adeno, Papova, Parvo, Pox

APP have nucleocap, H,H&Pox have envelopes (herpes env is from nuclear env)

All double stranded except the one that "pleads the 5th" (Parvo/erythema infectiosum); all icosahedral capsid and replicate in nucleus except Pox (in a box w/ own DNAdep-RNApolymerase).

Herpesviruses-latent in-dzs

HSV1-trigem-mainly oral herpes

HSV2-sacral DRG-mainly genital herpes

VZV-thoracolumbar DRG-chicken pox, shingles

EBV-Bcells-infectious mono, Burkitt's lymphoma, nasopharyngeal CA

CMV-leukocytes(macrophages)-cytomegalic inclusion dz, heterophil- mono, NO pharyngitis

HHV6-Tcells-roseola(6th dz) Rash On Stomach & fEver (the fever comes 1st)

HHV8-unknown-8th dz j/k Kaposi sarcoma. 8-kap!

Seps in embryology: Zygote to Blastocyst

Zygote (zygo in greek means "joined" or "union") w/ Zona pellucida; divides @ 1 day

Morula ("Mor" rhymes with "four," here there are 4^2 cells), cavitation starts here

Trophoblast - cells begin secreting fluid into the morula ("Troph" means nourishment [atrophy=no nourishment]); not totipotent as trophoblast

Blastocoel=fluid cavity in trophoblast, Zona pellucida begins being "blast"ed away

Blastocyst=Trophoblast+Blastocoel+inner cell mass; pre-implantation state; ~5 days after fertilization; 70-100 cells; IVF possible from day 2 to now

According to wikipedia, toxin exposure up to 2-3 weeks results in miscarriage; after that toxin exposure causes malformations

Neuro viruses

Herpes Simplex-dorsal root/sensory neuron->localized blisters/cold sores
Herpes Zoster-dorsal root/sensory neuron->shingles (Think "Zoster-brand shingles")
Rabies-retrograde axonal transport (sensory & autonomic nerves affected--hence hypersalivation)

Polio-anterior (ventral) root/motor neuron->paralysis
Other Enteroviruses-hematogenous, cross BBB->meningitis, encephalitis (esp Coxsackie)
And Arboviruses cause encephalitis

PAIN fibers cross in the sPAINal cord; vibration, touch, pressure cross in medulla

Roseola, Rubeola, Rubella, etc

ROSEola (6th dz) from HHV-6 = Rash On Stomach ~3 days after high fEver

Rubeola (Measles) = Constable (Koplik) Measle has Ruby-red eyes w/ rash head (1st) to toe (last)

Rubella = "Little Red" mimicks RUbeola but not as high fever, not as prominent rash, and no Koplik spots despite being called "German Measles" (Koplik sounds German, right?)

Variola = small pox

Varicella = chicken pox, rash mainly on head and trunk

Molluscum contagiosum = "pox pimple"

Exanthem subitum = 6th dz aka roseola

Erythema infectiosum = 5th dz aka slapped cheek dz (don't spread infectiosum by slapping others high-five)

Erythema nodosum = rash on shins, ulcerative colitis (nod and look at your shin)

Erythema multiform = allergic reaction to infection (HSV) or medication (pencillin, sulfas, barbs)

Note: Oatmeal has been scientifically found to reduce itching.

Brachial plexus I/O & injury

C5,6,7->UPPER trunk->MUSCULOcutaneous (think upper trunk helps you show-UP your MUSCLes [supinate forearm and elbow flex--how else do you show your big guns?])

C7->middle trunk->Radial, Axillary, and Median (remember Radial injury=wRist dRop [posterior cord])

C8,T1->lower trunk->Ulnar (UL=LOW backwards and my U's look like C's for Claw hand)

Radial N injury doesn't sound Profundly Humerous (profunda brachial A near Radial N)

Nerve Injury Mnemonics! Oh yeah!

Nerve damaged-Resulting loss/problem

Radial Nerve-wRist dRop & doRsal sensation

Ulnar-Claw hand w/ pinky and palm sensation (my U's look like C's sometimes, so this works in my mind)

Median-Me Done with this post (thumbs up![no thumb opposition])