Lorena
08-14-2004, 11:06 PM
21:07:09 [Hmmmmmm] hi ppl
21:07:13 [Lorena] a website of south caroline university has a good explanation in bacterial and viral genetics
21:07:19 upman enters this room
21:07:22 [Lorena] hi hmmmmm
21:07:26 [ash] thanks lorena
21:07:32 [ash] hi hmmmmmm
21:07:38 abc-Al enters this room
21:07:53 [Hmmmmmm] hey buzza (buzza just joined st george) so will be joining us today
21:07:54 [ash] what does a monospot test do?
21:08:07 [Hmmmmmm] hi ash
21:08:18 [Hmmmmmm] hi lorena
21:08:22 [ash] hi upman and abc-al
21:08:31 [upman] hello everybody.....i will be here mostly as a spectator
21:08:39 [Hmmmmmm] monospot test is to detect CMV?
21:08:40 [upman] ; )
21:09:01 [ash] no
21:09:15 [Lorena] welcome buzza and upman
21:09:19 [abc-Al] hi everybody
21:09:23 [Hmmmmmm] its one of the herpes virus i know that
21:09:32 [Hmmmmmm] hi abc and upman
21:09:37 [crusher] it detect heterophil antibody
21:09:37 [ash] it is for ebstein barrr i dont think it is for cmv
21:09:57 [Hmmmmmm] oh ok thanks ash
21:10:10 [ash] but what does it detect?
21:10:18 [ash] you r welcome
21:10:19 [Lorena] i see, thanks
21:10:36 [Lorena] crusher said heterophil antibodies
21:11:04 [Hmmmmmm] yeah heterophil antibodies in sheep antigen
21:11:38 [ash] right crusher .it detects heterophile antibodies by agglutination against sheep erythrocytes
21:11:53 [ash] right hmmmmmmm
21:11:55 [Hmmmmmm] lorena is step 1 coming today?
21:12:12 [Hmmmmmm] give me 3 naked dna viruses?
21:12:21 [Lorena] i hope so, usually when he can' t he make people know
21:12:36 [crusher] what is bacterial superinfection means
21:12:38 [ash] parvo,papavo,adeno
21:12:39 [Hmmmmmm] ok thanks
21:12:48 [Lorena] adeno, papova and parvo
21:12:52 [crusher] papova parvo adeno
21:12:55 [Hmmmmmm] good lorena
21:13:01 [Hmmmmmm] good crusher
21:13:22 [Hmmmmmm] superinfection = one infection then another right after it
21:13:38 [Hmmmmmm] like hep d on hep b
21:13:49 [Lorena] agree
21:14:02 [Hmmmmmm] what does hep eAg denote?
21:14:22 [ash] viral replication
21:14:25 [crusher] life threatning condition in which bacterial infection is superimposed on already exixting viral infection
21:14:27 [Lorena] high infectivity
21:14:57 [crusher] high infectivity..hepe
21:15:18 [Hmmmmmm] very good lorena, crush, its highy infective when hep eag is inthe serum
21:15:35 [Lorena] HBeAg
21:15:39 [Hmmmmmm] what 4 viruses cross the blood-placental barrier?
21:15:49 [Hmmmmmm] thats the name heheh
21:16:07 [ash] rubella,cmv,
21:16:12 [Lorena]
21:16:14 [crusher] describe the physical and genetic characterstic of H.influenza virus
21:16:53 [crusher] CMV,,HERPES,rubella
21:17:11 [crusher] tORCHES right??
21:17:27 [Hmmmmmm] very good CMV, hSV2, HIV and rubbella
21:17:31 [ash] right crusher
21:17:39 [Lorena] belongs to orthomyxo :enveloped, segmented, RNA negative sence
21:17:46 [ash] but i dont remember all the names
21:18:14 [Hmmmmmm] lorena this is for h.flu?
21:18:38 [ash] guys h.influ is not a virus!!!!!
21:18:48 [abc-Al] hepatitis B
21:18:51 [ash] it is a bacteria
21:19:14 [Lorena] crusher asked influenza virus,,, i didnt see the H
21:19:14 [Hmmmmmm] i know thus i asked!
21:19:34 [crusher] _ssRNA ,envelop ,segmented ,prone to genetic changes
21:19:35 [ash] eenveloped,icosahedral,ds.incomplete circular
21:19:53 [crusher] i,m sorry i means Influenza virus,,A//or B
21:20:07 [ash] hehe
21:20:56 [Hmmmmmm] what is reye's syndrome?
21:20:56 [ash] hcv is commonly seen in which kind of people in usa?
21:21:05 [crusher] describe the migration of rabies within CNS
21:21:27 [crusher] blood trusfused pat
21:21:30 [Lorena] it is retrograde through axons ....
21:21:43 [Hmmmmmm] rabies = retrograde
21:22:19 [ash] reyes syndrome is seen in influenza.aspirin is used and affects liver and brain
21:22:20 [Lorena] reye syndrome is caused by given aspirin during a viral infection (in kids)
21:22:37 [Hmmmmmm] good
21:22:53 [Hmmmmmm] ash hcv?
21:23:28 [ash] i.v .drug users
21:23:40 [Hmmmmmm] thanks
21:23:40 [crusher] yes in reterograde fasion up in the CNS.very good all
21:23:42 [Lorena] thanks
21:24:13 [ash] here is a pneumonic for hep.e -enteric,expectant ,epidemic
21:24:20 [Lorena] receptor on host cell of reovirus? HIV, EBV?
21:24:52 [crusher] CD$ and CD21
21:24:57 [Hmmmmmm] reo=b adre., Hiv = gly 120 to cd4, EBV = c21
21:25:03 [crusher] CD4 for HIV
21:25:43 [Lorena] Hep D=Defective
21:26:08 [Lorena] yes, good hmmmmmm and crusher
21:26:18 [Hmmmmmm] hep c = cancer (also b thought)
21:26:40 [crusher] describe physical shape of rabiesand also duration of incubation
21:26:50 [Hmmmmmm] did u all see step 1
21:26:57 [Hmmmmmm] 's mneumoic
21:27:01 [Hmmmmmm] http://www.valuemd.com/viewtopic.php?t=20110
21:27:07 [ash] no
21:27:18 [Hmmmmmm] go to the link
21:27:41 [Lorena] RNA negative sence bullet shape, enveloped, non segm,ented
21:28:25 [ash] biopsy of this patient shows owls eye appearance in cells.diagnosis?
21:28:30 [Hmmmmmm] wow lorena how od u remember all this?
21:28:32 acestep1 enters this room
21:28:41 [Hmmmmmm] cmv?
21:28:42 [ash] lorena-rabies
21:28:55 [Hmmmmmm] hi ace
21:28:58 [acestep1] hi
21:29:02 [Lorena] i have muy own neumonics but they are in spanish
21:29:08 [acestep1] hi hmm
21:29:09 [crusher] CMv ..owl eye
21:29:21 [acestep1]
21:29:29 [Hmmmmmm]
21:29:35 [ash] hi acestep1
21:29:37 [Lorena] if you want them i can send them to you , if you know spanish
21:29:50 [ash] do you speak hindi?
21:29:52 [Lorena] ace , how nice to see you after a long time!
21:29:55 [acestep1] hi ash
21:30:09 [Hmmmmmm] only very little pukito pukito
21:30:10 [acestep1] yes. same here
21:30:19 [acestep1] long time no see
21:30:21 [crusher] yes -ve sense envelop ,non segmented ..has long incubation period weeks to 3 months
21:30:22 [ash] sorry lorena i know only one two three in spanish
21:30:24 [acestep1] how r u
21:30:30 [Lorena]>[Hmmmmmm] how cute
21:30:50 [acestep1]
21:31:00 [Hmmmmmm] Lorena> its true
21:31:01 [crusher] hi ace step1
21:31:02 [Lorena] i am fine and you?
21:31:06 [ash] i just read some of your hindi so i was asking
21:31:12 [acestep1] im good as well
21:31:21 [acestep1]
21:31:30 [acestep1] hi crusher
21:31:35 [Hmmmmmm] oh yeah i can read hindi
21:31:37 [acestep1] my hindi ash ?
21:31:48 [Lorena]>[ash] i dont speak hindi
21:31:52 [acestep1]
21:31:53 [ash] where are you from?
21:31:59 [crusher] i can understand hindi very well
21:32:06 [ash] yes ace and hmmmmmm
21:32:11 [acestep1] lol
21:32:20 [acestep1] pak
21:32:21 [ash] thats alright lorena
21:32:42 [ash] and crusher where are u from?
21:32:49 [Hmmmmmm] lol lorena i had a mneumonic, can u please translate it for me?
21:32:55 [ash] and hmmmm,?
21:33:10 [acestep1]
21:33:12 [Lorena] why DNA virus are more stable genetically than RNA?
21:33:18 [Lorena] sure hmmmmm
21:33:18 [ash] i am in usa but am basically from india
21:33:36 [acestep1] k
21:33:40 [crusher] cos they are double stranded??
21:34:00 [Hmmmmmm] ok this is in lyme disease "por favor, no pinta mi cabeza"
21:34:06 [ash] because they dont incorporate their nucleic acid in host dna?????
21:34:15 [Hmmmmmm] im from india too but in canada
21:34:21 [acestep1] or r bound 2histones ?
21:34:36 [Lorena] lol translation "please dont paint my head"
21:34:45 [ash] lorena what is the ans?
21:34:48 [Hmmmmmm] hahahhaha thanks lorena
21:35:02 [Hmmmmmm] from "medical mico made ridic. simple"
21:35:02 [ash]
21:35:13 [ash] i had no clue either
21:35:14 [acestep1] lol
21:35:34 [Hmmmmmm] Lorena> i thought cabeza meant something bad
21:35:43 [Lorena] because DNA use host polymerases which have proof reading , in contrast RNA virus use tgheir own and they dont have proof reading so mutations are seen more often
21:35:56 [crusher] what the technique and why do we do Tzank smear?
21:36:09 [Lorena]>[Hmmmmmm] no, just head ....
21:36:29 [acestep1] ic
21:36:30 [ash] oh!!! this is like human dna and rna polymerase from genetics
21:36:35 [Lorena] tzank God i dont have herpes is the neumonic
21:37:00 [acestep1]
21:37:10 [Hmmmmmm] hahaha nice one
21:37:25 [Lorena] it is in f...aid
21:37:38 [acestep1] k
21:37:42 [ash] crusher it is to detect multinucleated giant cells for herpes
21:38:30 [crusher] nice lorena....for herpes and make a smear of open herpes vesicle to detect multinucleated giant cell
21:39:49 [Lorena] a neumonic for CMV: Owl’s eyes = CMV (Sightomegalovirus
21:40:12 [acestep1] yes
21:40:12 [Hmmmmmm] a pateint has minute but very painful vescicles in the forheads and around the eye on one side of the head what is the dx and treatment?
21:40:28 [acestep1] herpes zooster
21:40:38 [acestep1] acyclovir
21:40:45 [acestep1] ?
21:40:49 [Lorena] agree
21:40:50 [ash] antigen presentation by monocytes and macrophages is defective in which viral infection?
21:41:08 [Hmmmmmm] yep very good
21:41:32 [ash] acyclovir +carbamazepine(for neuralgia)
21:41:32 [acestep1] thnx
21:41:34 [Hmmmmmm] this is a long shot but HIV?
21:41:53 [ash] good hmmmmmmmmmm
21:41:55 [crusher] hat are the common diseases (1) and routes of transmission(1) for HHV-8?
21:42:21 [Hmmmmmm] thanks ash
21:42:25 [ash] hhv causes kaposis sarcoma
21:42:43 [Lorena] cofactor for kaposi sarcoma
21:42:46 [Hmmmmmm] yup in aids patients causes kaposi
21:42:57 [crusher] -Kaposi's sarcoma (HIV pts.) -sexual contact
21:43:02 [Hmmmmmm] routes of transmissing is sexual
21:43:21 [ash] it is sexually transmitted
21:43:27 [Lorena] ok
21:43:40 [acestep1] sexual needles
21:43:50 [acestep1] oops sorry
21:43:53 [ash] what gene does hhv-8 inactivate?
21:43:56 [crusher] What are the common diseases (2) and routes of transmission(2) for EBV?
21:44:02 [acestep1] only sexm contact
21:44:32 [Hmmmmmm] what strain of HPV causes condyloma acuminata
21:44:40 [ash] hhv 8 is also transmitted by organ transplantation
21:44:54 [Lorena] infectious mononucleosis
21:45:07 [ash] 1 to 4
21:45:09 [Lorena] kissing disease
21:45:13 [Hmmmmmm] ash ans please?
21:45:22 [ash] hmmmmmm 1 to 4
21:45:35 [Hmmmmmm] agree with lor
21:45:40 [Hmmmmmm] ty ash
21:45:45 [ash] oh sorry ,it inactivates rb gene
21:45:49 [crusher] nfectious mono, Burkitt's lymphoma -resp. secretions, saliva
21:46:09 [Lorena] thanks ash
21:46:26 [ash] you are welcome
21:46:38 [crusher] What are the common diseases (2) and routes of transmission(2) for HSV-2?
21:46:55 [Lorena] diferentiate mononucleosis in EBV and CMV infections
21:46:57 [acestep1] sex
21:47:14 [ash] which strain of parvovirus causes erythema infectiosum?
21:47:19 [Hmmmmmm] strains 6 and 11 = condyloma acuminata
21:47:39 [crusher] parvo,,B19
21:47:47 [ash] crusher causes herpes genitalis and sexually transmitted
21:47:48 drkittu enters this room
21:47:53 [Lorena] B-19 causes erythema infectiosum
21:48:08 [drkittu] Sorry I am late
21:48:16 [crusher] herpes genitalis, neonatal herpes -sexual contact, perinatal
21:48:20 [Hmmmmmm] hsv2 - sexual contact, genital lesions
21:48:36 [ash] right hmmmmm 1 to 4 cause skin and plantar warts.this is so confusing
21:48:49 [Hmmmmmm] hi dr kittu
21:48:50 [ash] hi drkittu
21:48:52 [Lorena] where does HSV 2 stay latent?
21:48:59 [Lorena] hi Dr kittu
21:49:05 [drkittu] hello everyone
21:49:07 [acestep1] dorsal rt gangion
21:49:19 [acestep1] hi kittu
21:49:25 [Hmmmmmm] DRG
21:49:52 [ash] lumbar and sacral sensory ganglia
21:50:31 [ash] what kind of immunity is more important in herpes infection?
21:50:56 [acestep1] cell mediated?
21:51:11 [ash] right
21:51:16 [drkittu] cell mediated
21:51:34 [ash] what is herpetic whitlow?
21:51:36 [Lorena] it is sacral nerve ganglia for HSV 2 , and dorsal root ganglia for varicella zoster
21:51:40 [Hmmmmmm] cell and antibodi mediated (antibody very little though)
21:51:47 [ash] cell mediated is right
21:52:01 [acestep1] thnx lorena
21:52:07 [Hmmmmmm] oh
21:52:28 [acestep1] k
21:52:45 [Hmmmmmm] a 6 week kid with atypical pneumonia mc cause?
21:52:51 [ash] what is the treatment for herpes resistant to acyclovir?
21:52:55 [Lorena] herpes is an enveloped virus the immune response to them is mostly cell mediated and little ab , for naked virus is mostly antibody
21:53:11 [Hmmmmmm] ty lor
21:53:17 [Lorena] RSV?
21:53:19 [Hmmmmmm] ash gancyclovir
21:53:19 [ash] thanks lorena
21:53:32 [acestep1] thnx lorena
21:53:32 [Hmmmmmm] yes lorena rsv very good
21:53:51 [Lorena] you' re welcome
21:54:11 [Lorena] major cause of croup?
21:54:11 Step_1 enters this room
21:54:32 [Hmmmmmm] hi step 1
21:54:32 [acestep1] hey step1
21:54:39 [ash] hi step_1
21:54:40 [acestep1] rsv
21:54:45 [Lorena] hi step !
21:54:59 [ash] parainfluenza
21:55:34 [ash] treatment of herpes resistant to acyclovir?
21:55:54 [Hmmmmmm] gancyclovir
21:55:54 [Lorena] yes ash , very good
21:55:55 [acestep1] ganciclover
21:56:01 [Step_1] i'm soooo sorry i'm late, was having computer problems
21:56:21 [Lorena] no problem, we are glad to see you !
21:56:40 [ash] foscarnet
21:56:44 [acestep1] yes agree with lorena
21:56:44 [Hmmmmmm] yup
21:56:55 [Step_1] i hope someone else doesnt mind posting the transcript since i dont missed the past hour
21:57:26 [ash] i dont know how to do it
21:57:28 [Lorena] foscarnet!! i remember from pharm, thanks ash !!
21:57:37 [Lorena] i will do it
21:57:50 [acestep1]
21:57:53 [ash]
21:57:59 [Hmmmmmm] i can
21:58:04 [Step_1] thanks lorena
21:58:10 [Hmmmmmm] oh ok lorena u can
21:58:32 [ash] what is the treatment for genital herpes?
21:58:32 [Hmmmmmm] ash whats foscarnet?
21:59:07 [ash] foscarnet is for acyclovir resistant herpes
22:00:04 [drkittu] Acyclovir
22:00:09 [acestep1] hey guys i gtg
22:00:15 [ash] this patient has a pleomorphic rash.diagnosis?
22:00:17 [acestep1]
22:00:50 [Hmmmmmm] bye ace good to have u
22:00:53 [acestep1] take care all of u
22:00:59 [ash] drkittu,valacyclovir or famicyclovir
22:01:02 [acestep1] same here hmm
22:01:09 [Hmmmmmm] another shot in the dark but measles? ash?
22:01:16 [ash] bye ace nice having you here
22:01:17 [Lorena] foscarnet cklionical use identical to ganciclovyr, inhibits DNA and RNA polymerase and used for resistant HSV
22:01:18 [drkittu] Thanks ash
22:01:26 [drkittu] varicella
22:01:31 [ash] nope try again
22:01:34 [Lorena] bye ace, take care!
22:01:47 [acestep1] u2 lorena
22:01:52 [acestep1] byee
22:01:55 [ash] thanks lorena
22:01:56 [Hmmmmmm] ty lorena
22:02:23 [Hmmmmmm] patient bitten by a monkey? what virus?
22:02:41 [Lorena] you're welcome
22:03:26 [drkittu] Erythema multiformae
22:03:30 [ash] marburg?????
22:03:52 [Lorena] lassa fever?
22:03:52 [Hmmmmmm] HHV 7 (f+a has it)
22:04:10 [Hmmmmmm] pg 195
22:04:12 [ash] pleomorphic rash is pathognomonic of chicken pox
22:04:31 [Lorena] thanks hmmmmm
22:04:47 [drkittu] I varicella so its right wasn't ash?
22:04:48 [Hmmmmmm] your welcome
22:05:04 [Hmmmmmm] wow ash i didnt know that
22:05:06 [ash] thanks hmmmmmmm.i had no clue
22:05:55 [Hmmmmmm] yes dr kittu u were rite
22:06:06 [Step_1] are you all going over virology now? pos or neg sense, or virology in general?
22:06:17 erum enters this room
22:06:35 [ash] marburg virus causes infection when you come in contact with the affected monkeys
22:06:51 [Hmmmmmm] yes step 1 general virology (actually no particular order )
22:06:52 [erum] hi
22:06:53 [Lorena] virology jumping all over
22:07:08 [Step_1] thanks
22:07:13 [ash] sorry drkittu i didnt read properly i am so sorry
22:07:23 [Hmmmmmm] hi erum
22:07:35 [Hmmmmmm] ash this is in caplan?
22:07:39 [ash] hi erum
22:07:44 [Lorena] hi erum
22:07:45 [drkittu] no problem. I was confused.
22:07:53 [drkittu] hi erum
22:08:02 [ash] i think it is in javetz
22:08:10 [ash] let me check
22:08:20 [erum] hi lorena hmmmmm dr kitu
22:08:32 [Lorena] name the killed vaccines
22:08:34 [erum] ash n all
22:09:12 [Hmmmmmm] hep a?
22:09:17 [drkittu] Rabies, Influenza, Polio and Hepatitis A
22:09:21 [Step_1] Rabies, Influenza, Polio (salk), Hep A
22:09:30 [Lorena] Rest In Peace Always
22:09:35 [Lorena] very good!
22:09:52 [Hmmmmmm] wow nice one
22:10:16 [erum] good one
22:11:17 [Step_1] Name 4 herpesviruses
22:11:18 [ash] yes hmmmmmm it is given in javetz pg. 297 and there it is also given that a virus known as herpes simiae or herpes b virus is also caused by contact with monkeys
22:12:15 [ash] herpes simplex,zoster,cmv,ebstein barr
22:12:49 [erum] cmv ebv vzs hsv
22:13:03 [Step_1] good job.......mneumonic is "get herpes in a CHEVrolet." -CMV -HSV -EBV -VZV
22:13:13 [Hmmmmmm] thanks ash
22:13:21 [ash] cause of winter virus disease?
22:13:36 [ash] you r welcome
22:13:56 [Step_1] corona virus
22:14:05 [ash] sorry cause of winter vomiting disease?
22:14:38 [Lorena] what is #1 cause of common cold?
22:14:58 [ash] rhinovirus
22:15:08 [Hmmmmmm] influezne
22:15:16 [erum] rota virus
22:15:17 [Step_1] oh, ok....well winter virus that causes common cold is corona virus. rhinovirus peaks in summer and fall
22:15:17 [drkittu] rhinovirus
22:15:20 [Lorena]>[ash] winter vomiting disease?
22:15:46 [Step_1] rhinovirus more common overall
22:15:58 [ash] winter vomiting disease is caused by norwalk virus
22:16:02 [Lorena] thank you step 1
22:16:41 [Step_1] Name naked DNA viruses
22:17:07 [Hmmmmmm] PAP
22:17:12 [ash] what is the HAART combination?
22:17:29 [Lorena] papova, parvo, adeno, calci, picorna
22:17:32 [ash] parvo,papavo,adeno
22:17:33 [Hmmmmmm] papova, adeno, parvo
22:18:08 [Step_1] very good! -Parvo -Adeno -Papova . mneumonic is "You need to be naked for a PAP smear". Lorena, the last two are naked, but they're RNA....but good point
22:18:17 [Lorena] opps, sorry , i wrote all naked ones, RNA too
22:18:45 [Lorena]
22:18:56 [erum] what is lichen planus
22:19:00 [Hmmmmmm] hey thanks for writing them cuz i dont know RNA viruses
22:19:24 [Step_1] thats ok, better to cover now so that we dont need to write a separate question Lorena
22:19:37 [Lorena]
22:20:06 [Step_1] there is one more naked RNA that people often forget.....that's Reovirus
22:20:14 [Hmmmmmm] reo
22:20:23 [Lorena] thanks step
22:20:37 [erum] name viruses associated with gbs
22:20:46 [Hmmmmmm] u have to be naked for a PAP and CPR eh step 1
22:20:49 [ash] fever and severe pleuritic chest pain known as epidemic myalgia is caused by?
22:21:12 [Hmmmmmm] erum ans for ur 1st question please?
22:21:16 [erum] cocksackie
22:21:19 [ash] what is the characteristic finding of reo virus ?
22:21:29 [Lorena] what is gbs?
22:21:42 [Hmmmmmm] gullina barre syn
22:22:00 [Lorena] reo virus are naked, double stranded RNA viruses (that makes them diff from the rest RNA viruses)
22:22:08 [ash] right erum what group and do you know other names for this disease?
22:22:12 [Lorena] they are also segmented virus
22:22:21 [ash] good lorena
22:22:27 [erum] yep
22:22:51 [erum] types of gbs
22:23:57 [Lorena] also campylobacter j. , i remember from last chat is associated with GBS
22:24:07 [Lorena] thanks to ash
22:24:14 [Step_1] ROBA (sounds like "robot" for segmented) Reo, Orthomyxo, Bunya, Arena
22:25:08 [erum] its a skin disease autoimmune
22:25:29 [ash] this pt. has fever ,sore throat and tender vesicles in the oropharynx.it is not a dna virus and it is not enveloped .what is the disease and the causative agent?
22:25:33 [Hmmmmmm] ty erum
22:25:36 [Step_1] Haemophilus influenzae, parainfluenza 1 virus, influenza A virus, influenza B virus, adenovirus, and herpes simplex virus all have been demonstrated in patients with GBS
22:26:06 [ash] thanks step_1
22:26:17 [erum] mycoplasma too
22:26:27 [Step_1] nevermind that....I just read that those are not more frequently found than in controls....ooops
22:27:12 [Step_1] I think that CMV and the C jejuni are the most frequent....is that correct?
22:27:14 [Lorena] cocksackie?
22:27:37 [ash] yes lorena and what is the disease?
22:27:48 [Lorena] influenza A and B are frequent too for GBS
22:27:59 [Hmmmmmm] foot and mouth?
22:28:28 [Lorena] herpangina
22:28:29 [erum] ebv and cmv
22:28:31 [Step_1] It goes on to say "Other significant, though less frequently identified, infectious agents in GBS patients include Epstein-Barr virus (EBV), Mycoplasma pneumoniae, and varicella zoster virus."
22:29:09 [erum] c jejuni is associated with axonal type
22:29:28 [Step_1] it almost sounds like they're not really sure, so they include them all
22:29:33 [drkittu] viruses causing aseptic meningitis?
22:29:35 [ash] lorena right again .hand foot and mouth diasase has rash on hand and feet(vesicular) and ulsers in mouth
22:29:38 [Lorena] lol
22:30:34 [Step_1] coxsackieviruses and echoviruses
22:30:41 [ash] drkittu herpes
22:30:46 [drkittu] Yes
22:31:06 [drkittu] coxsaxhe and echo ......ash
22:31:37 [ash] oops sorry
22:31:49 [Lorena] so when you say aseptic it means it is caused by echo and coxackie?.....
22:32:40 [Step_1] aseptic means viral meningitis.....of which 90% is caused by echo and cosackie. but also Herpesviruses and the mumps virus can also cause viral meningitis.
22:32:44 [ash] hey i am right herpes simplex 2 does cause aseptic meningitis
22:32:46 [Lorena] i am confused , i thought when it is a virus that causes meningitis you refer to it as "aseptic"
22:33:02 [Lorena] just to make the diff of bacterial ethiology
22:33:24 [drkittu] sorry ash
22:33:27 [Lorena] thanks for clarify step !
22:33:41 [Step_1] no prob
22:34:08 erum enters this room
22:34:18 [Lorena] welcome back erum
22:34:19 [ash] thats ok
22:34:35 [Hmmmmmm] cause of infantile gastroentertis?
22:34:43 [erum] thanks
22:35:03 [Step_1] rotavirus
22:35:03 [ash] hey i just remembered another viral infection associated with monkeys-yellow fever
22:35:05 [drkittu] Rota virus, Norwalk virus
22:35:23 [Lorena] rotavirus, adenovirus
22:35:32 [Hmmmmmm] good rotavirus
22:35:43 [erum] rotavirus
22:36:07 [Step_1] i think that norwalk is more common in older children. i remember it because they can "walk", so "norWALK"
22:36:16 [ash] can we discuss some immunology now?
22:36:39 [ash] wow step_! i will always remember it now
22:36:56 [Hmmmmmm] are we doing parasites at all?
22:37:18 [ash] ok lets do parasites then
22:37:28 [erum] preterm 28 weeker with hypoxia and tachypnea in january
22:38:00 [Lorena] RSV
22:38:10 [Lorena] ?
22:38:25 [erum] right
22:39:15 [Lorena] RSV is the major cause of bronchiolitis and neumonia in <1 yo
22:39:27 [ash] which protozoal cyst has 8 nuclei?
22:39:33 [Step_1] i was trying to figure out which parasite could cause that
22:39:47 [erum] screening test for herpes simplex type2
22:39:48 [Hmmmmmm] i was thinking HMD! man im lost
22:40:25 [erum] well patient has no active lesions ofcourse
22:40:28 [Step_1] tzanck smear
22:40:51 [ash] elisa
22:40:55 [Step_1] oops, good point....you said screening
22:41:34 [erum] serum igg n igm
22:41:55 [Lorena] before start parasites we should review, HIV, very high yield if you want , or we can just post some q's later
22:42:17 [Hmmmmmm] yeah lets review HIV
22:42:35 [Hmmmmmm] we can post parasite questions
22:43:07 [ash] ok
22:43:11 [Step_1] as far as regulatory genes for HIV, which up regulate and which down regulate?
22:43:58 [ash] tat and rev upregulaie and nef downregulates
22:44:10 [drkittu] Tat for Up regulation
22:44:19 [Lorena] REV upregulates , and nef downmregulates (controversial) , VIF upregulate
22:44:30 [Step_1] tat and rev ("rev it up") are up regulatory and nef (enef which sounds like enough is down) is down.
22:44:35 [drkittu] Nef down regulates
22:44:57 [Hmmmmmm] good one
22:45:18 [Step_1] what is screening for HIV?
22:45:21 [ash] hiv has been subdivided into classes by what gene?
22:45:31 [Lorena] ELISA
22:45:45 [Hmmmmmm] elsia
22:45:47 [ash] agree with lorena
22:45:55 [ash] good sensitivity
22:46:29 [Step_1] ELISA is screening. what if positive, what next? (trick question). and here is ethics part....when do you tell pt?
22:46:47 [erum] conffirm westiorn blot
22:46:53 [Lorena] if positive western blot
22:46:54 [Hmmmmmm] if positive u do it again
22:47:20 [ash] western blot for confirmation
22:47:20 [Lorena] you tell the patient immediately........?
22:47:29 [ash] best specificity
22:47:30 [erum] sorry i meant western blot
22:47:54 [Step_1] that was kinda tricky. if elisa is positive, you repeat it. if positive again, then you confirm with western blot. do not tell pt until all the testing is done and confirmed
22:48:18 [Lorena] thank you step
22:48:18 [Step_1] i meant when to tell the pt that they have HIV
22:48:31 [erum] agree with step 1
22:48:36 [Hmmmmmm] ty step
22:48:53 [ash] thanx step_1
22:49:39 [Lorena] when do you start therapy with AZT?
22:49:57 [ash] hiv has been subdivided into classes by what gene?
22:50:14 [Lorena] sorry ash, i dont know the answer
22:50:26 [Hmmmmmm] ans please?
22:50:52 [ash] gp 120
22:51:29 [Step_1] i think when cd4 count is below 500 or with a detectable viral load over 20,000....but that is more of a step 2 question
22:51:49 [Lorena] it would be env gene then which codes for pg120
22:52:05 [Lorena] yes step 1 , right
22:52:20 [ash] the main immune response to hiv is by which cells?
22:52:24 [Lorena] gp 120 i meant to say
22:52:51 [Hmmmmmm] cell mediated
22:53:06 [ash] right lorena env gene is first gp160 it is then cleaved to gp120 and gp41
22:53:26 [ash] hmmmmmmm what cells?
22:53:51 [Hmmmmmm] nk, macrophage
22:54:14 [Lorena] agree with hmmmmmm.and B cells too?
22:54:21 [Step_1] now here is an HIV and immuno question combined...so boards love this. what percent of babies will test positive for HIV Abs? (hint: this is a trick question)
22:54:38 [ash] what cells mediate cell mediated immunity?
22:54:54 [ash] step_1 none
22:54:55 [Lorena] 100%
22:55:03 [Hmmmmmm] t helper
22:55:08 [Hmmmmmm] 0 %?
22:55:09 [Step_1] babies meaning newborns
22:55:22 [ash] none
22:55:41 [Lorena] ash what is the ans to the main immune response to hiv is by which cells?
22:55:42 [Step_1] and newborns meaning newborns to HIV moms....sorry, 1st part of question was cut off
22:55:59 [ash] the answer is cd8 t cells
22:56:06 [Hmmmmmm] oh then 100%
22:56:16 [Lorena] they get ab from mom
22:56:26 [drkittu] 100%
22:56:27 [Hmmmmmm] agree wit lorena
22:56:35 [ash] remember the main cells responsible for cell mediated immunity are cd8
22:56:38 [Lorena] thanks ash
22:56:40 [Hmmmmmm] ty ash
22:57:05 [ash] yes i think 100 %too
22:57:22 [Step_1] 100% of newborn babies from HIV infected moms will test positive for HIV Abs because the Abs are passed on via IgG.
22:57:36 [drkittu] Thatwhy PCR used to test HIV Virus in babies
22:57:46 [Lorena] cool
22:57:50 [Hmmmmmm] biggest antibody in serum?
22:58:04 [Lorena] good correlation dr kittu
22:58:30 [Step_1] or you can do PCR like drkittue said...but its expensive
22:58:31 [Lorena] IgM
22:59:09 [Hmmmmmm] macrophages attached to which portion of the antibody?
22:59:13 [Hmmmmmm] good lorena
22:59:25 [Lorena] IgM=Massive
22:59:59 [Hmmmmmm] contact dermatisis is which type hypersensitivity?
23:00:47 [ash] some hiv positive people have lived for many years without opportunistic infections and without reduction in their cd4 count.due to mutations in what gene?
23:01:11 [Step_1] type 4
23:01:19 [Lorena] type IV
23:01:34 [Hmmmmmm] the env gene ash?
23:01:39 erum enters this room
23:01:41 [Hmmmmmm] yes step1 and lorena
23:01:53 [Lorena] agree with hmmm
23:02:10 [Hmmmmmm] yes ash fc portion !
23:02:24 [Step_1] 3 main roles of Ig binding to bacteria
23:02:27 [ash] the answer is nef gene
23:03:06 [Step_1] good point ash since its the down regulator (enef or enough)
23:03:22 [Lorena] thanks ash, where did you find those q's? very good ones
23:03:29 [Hmmmmmm] opsonin
23:04:09 [ash] i picked them from the text part of j a v e t z and k a p l a n and
23:04:30 [Step_1] opsonization , neutralization, complement activation for roles of Ig binding to bact
23:04:37 [Hmmmmmm] chemotatic and complement activatio?
23:04:49 [Lorena] excellent ash!
23:05:00 [Hmmmmmm] oh i forgot neutralization
23:05:13 [Step_1] good job hmmmm
23:05:16 [Step_1] A defect in phagocytosis of neutrophils owing to lack of NADPH oxidase activity or similar enzymes is indicative of what immune deficiency disease?
23:05:18 [ash] ok guys i have to go now for i havent yet had dinner.can you telll me the topics for next discussion?
23:05:31 [Hmmmmmm] patho ash
23:05:43 [ash] cgd
23:05:53 [ash] but what topics?
23:06:04 [Lorena] agree with ash
23:06:17 [Hmmmmmm] its was fun, so sorry u have to go bye
23:06:28 [erum] ch granulomatous dis
23:06:34 [ash] hmmmmmmm what topics?
23:06:36 [Step_1] next week is gol jan path
23:06:54 [Lorena] patho i sooooo much.huge topic
23:07:01 [ash] ok which chapters?
23:07:19 [Hmmmmmm] ash> i dunno
23:07:32 [ash] pleaase someone tell me the chapters
23:07:55 [erum] k a p la npath????
23:08:01 [Lorena] yes, gol jan ........lets try until chap ....let me check the notes
23:08:16 [Hmmmmmm] how bout we finish general patho and maybe till liver in sys patho?
23:08:35 [Step_1] lets do like we did last time, which is the first chapters of his lecture notes......cell injury, inflammation, immunopath, fluids and hemodynamics, acid base, nutrition, genetics, environmental path, neoplasia....then the rest on sat....dound ok>
23:09:04 [Hmmmmmm] yes step 1 agreed
23:09:12 [ash] sounds good step_1
23:09:14 [Lorena] yes
23:09:46 [ash] thanks allhow do you communicate with eachother for the rest of the days?
23:09:56 [drkittu] sounds good
23:10:05 [Lorena] you can post or IM
23:10:06 [Step_1] we actually covered some of that already, like immunopath is tonight, genetics before, nutrition before, acid base, etc.
23:10:14 [erum] ok
23:10:58 [Step_1] we all joined the step 1 usergroup here if you want to contact us via PM. but i think its better to communicate via the step 1 forum here so everyone can join in
23:11:00 [ash] i tried to post but i cant at value md .i tried to congratulate step_1 for his result and i couldnt
23:11:37 [ash] ok i will try that.
23:11:41 [Step_1] thanks ash, but you should be able to post either as a user or guest
23:12:04 [ash] ok thanks for your help guys goodnite.see you on wednesday
23:12:10 [Hmmmmmm] bye ash
23:12:21 [ash] bye
23:12:23 [Step_1] bye ash, good night
23:12:31 [erum] bye ash
23:12:32 [Lorena] bye ash, thanks for the great q's
23:13:16 [Step_1] btw, the ans to my previous question was Chronic granulomatous disease
23:13:23 [erum] is k ap la n good 4 patho
23:13:45 [erum] sice i dont have <a target=new HREF=http://www.amazon.com/exec/obidos/external-search?tag=valuetheplace-20&keyword=Goljan&mode=books>Goljan</A>
23:13:59 [Hmmmmmm] graves disease what hyper sensti?
23:14:03 [erum] oops sorry
23:14:13 [Hmmmmmm] erum what dont u have of gol?
23:14:26 [Lorena] type 2
23:14:30 [Hmmmmmm] the 100 pgs, hy are in the download site
23:14:50 [Step_1] i used gol jan path, so i dont know how kap lan's is, but if you can get your hands on gol jans, i think its better. if not, brs path is excellent. then i think that kap lan path is the next best thing
23:14:56 [Hmmmmmm] if u want his audio u can find them in coolgoose.com
23:15:00 [erum] i vegot the hy
23:15:21 [Hmmmmmm] i can send u the audio too if u want
23:15:22 [Lorena] and you can download the gol jan audios
23:16:10 [Hmmmmmm] step1 did u find bacterial genetic hy? (sorry for sidetracking)
23:16:41 [Lorena] no problem...good q's!
23:17:12 [Hmmmmmm] yes lorena type 2 is correct just saw ur answer
23:17:15 [Step_1] i dont have them for bacterial genetics specifically, but maybe the biochem ones have them?
23:18:18 [Hmmmmmm] no no i mean in <a target=new href=http://click.linksynergy.com/fs-bin/click?id=c97WUMRO5hY&offerid=47491.10002441&type=3&subid=0 >Kaplan</a><IMG border=0 width=1 height=1 src=http://ad.linksynergy.com/fs-bin/show?id=c97WUMRO5hY&bids=47491.10002441&type=3&subid=0 > book (bacterial genetics is it hy) cuz there like 30 pgs and i dont have too much time to memorize em all
23:18:20 [Step_1] like the immuno high yields are mixed with micro and titled "micro high yields"
23:18:32 [Hmmmmmm] whoops sorry
23:18:56 [Step_1] oh, sorry i misunderstood
23:19:27 [Hmmmmmm] np
23:19:29 [Lorena] besides it is complicated , k a pl an dones explian well in that section there of bacterial genetics
23:19:38 erum enters this room
23:20:10 [Hmmmmmm] i know lorena thats my problem
23:20:24 [Hmmmmmm] i cant understand it and have no time
23:20:43 [Hmmmmmm] im giving exam sept 24
23:21:09 [Hmmmmmm] i wana save my one month starting aug 24 for only mcq and review
23:21:13 [Lorena] you know, i found a website very useful for that subject-i understiood more there then in k a pl an
23:21:13 [erum] i did kap video lectures
23:21:42 [Lorena] i will post it so you can check it out
23:22:01 [erum] hmmmmmmm thanks iwould like that
23:22:01 [Hmmmmmm] thanks you lorena ur an angel
23:22:20 [Hmmmmmm] yeah erum i did some <a target=new href=http://click.linksynergy.com/fs-bin/click?id=c97WUMRO5hY&offerid=47491.10002441&type=3&subid=0 >Kaplan</a><IMG border=0 width=1 height=1 src=http://ad.linksynergy.com/fs-bin/show?id=c97WUMRO5hY&bids=47491.10002441&type=3&subid=0 > video lecs 2
23:22:52 [Lorena] is it bacteruial genetics a High Yield topic in the exam step 1?
23:23:07 [Hmmmmmm] sure erum do u have any messenger? give me any id u dont have to give me ur personal one ill give u them one by one
23:23:15 [erum] but 4 patho im also using brs
23:24:07 [Hmmmmmm] lorena have u done vid lecs?
23:24:11 [Step_1] i think its important to know, but it depends on how much time you have. there are things that are more high yield than that, but i wouldnt ignore it altogether
23:24:11 [erum] n afraid to use any new material @this point
23:24:16 [Hmmmmmm] and whens ur exam?
23:24:43 [Lorena] yes , i did k apl an video lectures
23:24:56 [Hmmmmmm] erum i havent done <a target=new HREF=http://www.amazon.com/exec/obidos/external-search?tag=valuetheplace-20&keyword=Goljan&mode=books>Goljan</A> yet either but i heard it good after uve done all subjects cuz its intergrative
23:25:03 [Lorena]>[Step_1] thanks step good advise
23:25:18 [Hmmmmmm] ty step 1 and dam i must be whipped i keep making that stupid mistake
23:25:23 [erum] i dont have the exact date
23:26:12 [erum] but soon
23:26:16 [Hmmmmmm] oh ok what bout u lorena when ur exam?
23:26:25 [Lorena] me too..soon
23:26:52 [Lorena] i dont have the date yet, i am terrified cauze i have to pick tghe date SOON
23:26:54 [Hmmmmmm] erum my yahoo messenger is hmmm_med2004@yahoo.com i can upload them to u through there
23:27:59 [Step_1] ready for a few more immuno questions
23:27:59 [erum] ok ..what do i need
23:28:12 [Hmmmmmm] lol not half a terrified as i m i only had 3 months of study after 2 months of rotation (so means i forgot all my basic sciece)
23:28:14 [Lorena] bring them on step!
23:28:21 [Step_1] lorena, you will do fine
23:28:23 [Hmmmmmm] sure step 1
23:28:45 [Step_1] and so will the rest of you....i have all the faith in the world of your knowledge
23:28:47 [Hmmmmmm] erum> u just need to sign up for yahoo messneger and download it
23:28:55 [erum] to get the files
23:29:07 [Lorena] i had to take a "forced " break of almost a month and a half which was very frustrating
23:29:15 [Hmmmmmm] erum> well its a chat program but i can send u filez from there
23:29:26 [erum] oh thanks
23:29:42 [Hmmmmmm] ty step1 very kind words
23:29:46 [Step_1] hmmmmm, did you figure out how to upload them to the download area?
23:29:53 [Lorena] but i am happy i am studying again and you guys help me a lot withy these chats
23:30:19 [Hmmmmmm] no step 1 i asked doc he increased the upload limit but my computer isnt cooperating
23:30:44 [Hmmmmmm] same here lorena
23:31:13 [erum] me too had to take 2 months break
23:31:44 [Lorena] ok guys, lets study
23:31:45 [erum] its hard tobuild the same pace again
23:32:18 [erum] but im trying
23:32:21 [Hmmmmmm] btw do u ppl have web...pre.p?
23:32:36 [Lorena] questions questions questions
23:32:39 [Step_1] the chats helped me stay on pace. hopefully it will do the same for you erum
23:33:04 [Hmmmmmm] sorry sorry lets get on
23:33:13 [Lorena]
23:33:24 [erum] i will keep my fingers crossed
23:33:25 [Lorena] crusher..are you there?
23:33:28 [Hmmmmmm] mch1
23:33:42 [erum] i hope so step 1
23:33:50 [Hmmmmmm] dont worry erum ur smart
23:34:02 [Lorena] hutals didnt come today
23:34:52 [Step_1] hutals wrote to me and said couldnt make it and sent apology to group. said would make it on wed
23:34:53 [Hmmmmmm] mch1
23:35:06 [Step_1] thanks for reminding me
23:35:29 [Lorena] oh ok , hope everything is fine
23:35:36 [Step_1] class I MHC proteins is correct, only mature RBCs wont have them because non-nucleated
23:35:39 [Hmmmmmm] which mhc is exogenus and endogenus antigen?
23:35:51 [Hmmmmmm] and platelets rite?
23:36:29 [Step_1] MHC II is eXogenous (take the II and cross them into an X)
23:36:51 [Hmmmmmm] nice pneumonic
23:37:09 [Lorena] you are the best
23:37:34 [Step_1] yes hmmmm, PLTs have class I even though non-nucleated...its the exception
23:38:12 [erum] agree with step 1
23:38:38 [Hmmmmmm] is b-cell an apc?
23:38:55 [Hmmmmmm] is t-cell an apc?
23:40:43 [Hmmmmmm] knock knock anyone there?
23:40:50 [Lorena] sorry
23:40:59 [Lorena] b cells are
23:41:07 [Lorena] t cells aren't .?
23:41:09 [Hmmmmmm] np
23:41:27 [Hmmmmmm] yes
23:41:44 [Step_1] Macrophages. 2) Dendritic cells. 3) B cells
23:41:58 [Step_1] are the 3 types of APCs
23:42:15 [Lorena] ok
23:42:40 [Hmmmmmm] looks like ppl are sleepy ill must be off as well its late
23:43:06 [Step_1] Anaphylaxis, asthma, or local wheal and flare are possible manifestations of which type of hypersensitivity?
23:43:21 [Lorena] type 1
23:43:23 [Hmmmmmm] type 1
23:43:34 [erum] type1
23:43:39 [Step_1] Type I is correct...very good
23:43:52 [Hmmmmmm] ok ppl thanks for a very informative chat, will see you all on wednesday
23:43:59 [Step_1] Autoimmune hemolytic anemia, Rh disease (erythroblastosis fetalis), and Goodpasture's syndrome are examples of what kind of hypersensitivity reaction?
23:44:14 [Lorena] type 2
23:44:16 [Hmmmmmm] type 2?
23:44:27 [erum] 2
23:44:36 [Hmmmmmm] erum> email me whenever u want the filez
23:44:38 [Step_1] type II hypersensitivity is correct...you all are on a role
23:45:02 [Lorena] purpose of immunotherapy in allergies?
23:45:21 [erum] ok i wi ll tx again
23:45:56 [Step_1] desensitisation??
23:45:56 [Lorena] injecting the ag in small amounts results in...? regarding th1, and Th2
23:46:06 [Lorena] yes
23:46:32 [erum] desensitization
23:46:34 [Step_1] Helper T cells have CD(?) which binds to class (?) MHC on antigen-presenting cells.
23:46:54 [Lorena] the purpose is to switch Th2 to Th1 type so decrease igE production
23:47:08 [erum] 8 1
23:47:26 [Lorena] cd4 which binds to MHC 2
23:47:51 [Step_1] it always equals 8, so 4 x 2 = 8 means CD4 is MHC 2. 8 x 1 = 8 so CD8 is MHC 1 .
23:48:46 [Step_1] and the Helper T cell is CD4.
23:48:49 [erum] cytotoxic nhelper 4 1
23:49:09 [Step_1] so the answer is 4 and 1
23:49:24 [erum] i mean 8 1 cytotoxic
23:49:58 [erum] n helper 4 1
23:50:10 [Step_1] thats right erum
23:50:39 [Step_1] How does Bruton's agammaglobulinemia usually present?
23:51:17 [Lorena] recurrent pyogenic infections ,no B cells circulating
23:51:31 [erum] 6 mon old with inf
23:51:48 [Lorena] respiratory infections ,very low Ig
23:52:00 [Step_1] Brutons is the 3 ** (Boys, Brutons, B cells). presents as bacterial infections in boys after about 6 months of age, when levels of maternal IgG antibody decline. good job!
23:52:05 [erum] when moms igg is gone
23:52:50 [Step_1] In what T-cell deficiency do the thymus and parathyroids fail to develop owing to failure of development of the 3rd and 4th pharyngeal pouches?
23:53:12 [Lorena] diGeorge
23:53:30 [erum] di george
23:53:41 [Step_1] Thymic aplasia (DiGeorge syndrome)....great!
23:54:19 [erum] thymic tcell tetany
23:54:28 [erum] 3 t
23:54:31 [Step_1] sorry i'm going fast, but running out of time......stop me whenever you have question or want to stop
23:54:41 [Step_1] good one erum
23:54:55 [Step_1] Sensitized T lymphocytes encounter antigen and then release lymphokines which leads to macrophage activation' in what hypersensitivity reaction?
23:55:04 [erum] tx
23:56:01 [Step_1] that would be type 4 HS
23:56:10 [erum] delayed
23:56:16 [Lorena] i see
23:56:24 [Step_1] i think this one might be easier
23:56:25 [erum] cell mediated
23:56:27 [Step_1] TB skin test, transplant rejection, and contact dermatitis are examples of what type of hypersensitivity reaction?
23:56:29 [Lorena] thanks
23:56:40 [Lorena] type 4
23:56:42 [erum] pe 4
23:57:25 [Step_1] the T cell, lmphokine and macrophage thing was also part of actual question, so try to go over that concept
23:57:30 [Step_1] yep type 4
23:57:50 [Lorena]
23:58:04 [Step_1] The 3 kinds of MHC class I genes are…? what about The 3 kinds of MHC class II genes are…?
23:59:13 [erum] abc
23:59:23 [Lorena] class II DP, DQ DR
23:59:32 [erum] dr dq dp
00:00:01 [Step_1] A, B, and C for MHC 1 because you "learn your ABCs in 1st grade. DP, DQ, DR are MHC2 because D stands for "Dos" which is "two" in spanish.
00:00:06 [Step_1] good job
00:01:03 [Step_1] ok, i think our time is up
00:01:11 [Lorena]
00:01:36 [Step_1] sorry again for being late tonight....but it was great chatting with everyone
00:02:13 [Lorena] thank you so much step , you are our angel, thank you for being here today
00:02:15 [erum] same here step 1
00:02:25 [Lorena] see you next chat
00:02:39 [Step_1] lorena, i guess you'll post the transcript tonight?
00:02:49 [erum] thanx every one
00:02:58 [Lorena] i will step
00:03:04 [Step_1] see everyone in the next chat.....good night all
00:03:05 [erum] n see u all
00:03:08 [Lorena] byeee , take care
21:07:13 [Lorena] a website of south caroline university has a good explanation in bacterial and viral genetics
21:07:19 upman enters this room
21:07:22 [Lorena] hi hmmmmm
21:07:26 [ash] thanks lorena
21:07:32 [ash] hi hmmmmmm
21:07:38 abc-Al enters this room
21:07:53 [Hmmmmmm] hey buzza (buzza just joined st george) so will be joining us today
21:07:54 [ash] what does a monospot test do?
21:08:07 [Hmmmmmm] hi ash
21:08:18 [Hmmmmmm] hi lorena
21:08:22 [ash] hi upman and abc-al
21:08:31 [upman] hello everybody.....i will be here mostly as a spectator
21:08:39 [Hmmmmmm] monospot test is to detect CMV?
21:08:40 [upman] ; )
21:09:01 [ash] no
21:09:15 [Lorena] welcome buzza and upman
21:09:19 [abc-Al] hi everybody
21:09:23 [Hmmmmmm] its one of the herpes virus i know that
21:09:32 [Hmmmmmm] hi abc and upman
21:09:37 [crusher] it detect heterophil antibody
21:09:37 [ash] it is for ebstein barrr i dont think it is for cmv
21:09:57 [Hmmmmmm] oh ok thanks ash
21:10:10 [ash] but what does it detect?
21:10:18 [ash] you r welcome
21:10:19 [Lorena] i see, thanks
21:10:36 [Lorena] crusher said heterophil antibodies
21:11:04 [Hmmmmmm] yeah heterophil antibodies in sheep antigen
21:11:38 [ash] right crusher .it detects heterophile antibodies by agglutination against sheep erythrocytes
21:11:53 [ash] right hmmmmmmm
21:11:55 [Hmmmmmm] lorena is step 1 coming today?
21:12:12 [Hmmmmmm] give me 3 naked dna viruses?
21:12:21 [Lorena] i hope so, usually when he can' t he make people know
21:12:36 [crusher] what is bacterial superinfection means
21:12:38 [ash] parvo,papavo,adeno
21:12:39 [Hmmmmmm] ok thanks
21:12:48 [Lorena] adeno, papova and parvo
21:12:52 [crusher] papova parvo adeno
21:12:55 [Hmmmmmm] good lorena
21:13:01 [Hmmmmmm] good crusher
21:13:22 [Hmmmmmm] superinfection = one infection then another right after it
21:13:38 [Hmmmmmm] like hep d on hep b
21:13:49 [Lorena] agree
21:14:02 [Hmmmmmm] what does hep eAg denote?
21:14:22 [ash] viral replication
21:14:25 [crusher] life threatning condition in which bacterial infection is superimposed on already exixting viral infection
21:14:27 [Lorena] high infectivity
21:14:57 [crusher] high infectivity..hepe
21:15:18 [Hmmmmmm] very good lorena, crush, its highy infective when hep eag is inthe serum
21:15:35 [Lorena] HBeAg
21:15:39 [Hmmmmmm] what 4 viruses cross the blood-placental barrier?
21:15:49 [Hmmmmmm] thats the name heheh
21:16:07 [ash] rubella,cmv,
21:16:12 [Lorena]
21:16:14 [crusher] describe the physical and genetic characterstic of H.influenza virus
21:16:53 [crusher] CMV,,HERPES,rubella
21:17:11 [crusher] tORCHES right??
21:17:27 [Hmmmmmm] very good CMV, hSV2, HIV and rubbella
21:17:31 [ash] right crusher
21:17:39 [Lorena] belongs to orthomyxo :enveloped, segmented, RNA negative sence
21:17:46 [ash] but i dont remember all the names
21:18:14 [Hmmmmmm] lorena this is for h.flu?
21:18:38 [ash] guys h.influ is not a virus!!!!!
21:18:48 [abc-Al] hepatitis B
21:18:51 [ash] it is a bacteria
21:19:14 [Lorena] crusher asked influenza virus,,, i didnt see the H
21:19:14 [Hmmmmmm] i know thus i asked!
21:19:34 [crusher] _ssRNA ,envelop ,segmented ,prone to genetic changes
21:19:35 [ash] eenveloped,icosahedral,ds.incomplete circular
21:19:53 [crusher] i,m sorry i means Influenza virus,,A//or B
21:20:07 [ash] hehe
21:20:56 [Hmmmmmm] what is reye's syndrome?
21:20:56 [ash] hcv is commonly seen in which kind of people in usa?
21:21:05 [crusher] describe the migration of rabies within CNS
21:21:27 [crusher] blood trusfused pat
21:21:30 [Lorena] it is retrograde through axons ....
21:21:43 [Hmmmmmm] rabies = retrograde
21:22:19 [ash] reyes syndrome is seen in influenza.aspirin is used and affects liver and brain
21:22:20 [Lorena] reye syndrome is caused by given aspirin during a viral infection (in kids)
21:22:37 [Hmmmmmm] good
21:22:53 [Hmmmmmm] ash hcv?
21:23:28 [ash] i.v .drug users
21:23:40 [Hmmmmmm] thanks
21:23:40 [crusher] yes in reterograde fasion up in the CNS.very good all
21:23:42 [Lorena] thanks
21:24:13 [ash] here is a pneumonic for hep.e -enteric,expectant ,epidemic
21:24:20 [Lorena] receptor on host cell of reovirus? HIV, EBV?
21:24:52 [crusher] CD$ and CD21
21:24:57 [Hmmmmmm] reo=b adre., Hiv = gly 120 to cd4, EBV = c21
21:25:03 [crusher] CD4 for HIV
21:25:43 [Lorena] Hep D=Defective
21:26:08 [Lorena] yes, good hmmmmmm and crusher
21:26:18 [Hmmmmmm] hep c = cancer (also b thought)
21:26:40 [crusher] describe physical shape of rabiesand also duration of incubation
21:26:50 [Hmmmmmm] did u all see step 1
21:26:57 [Hmmmmmm] 's mneumoic
21:27:01 [Hmmmmmm] http://www.valuemd.com/viewtopic.php?t=20110
21:27:07 [ash] no
21:27:18 [Hmmmmmm] go to the link
21:27:41 [Lorena] RNA negative sence bullet shape, enveloped, non segm,ented
21:28:25 [ash] biopsy of this patient shows owls eye appearance in cells.diagnosis?
21:28:30 [Hmmmmmm] wow lorena how od u remember all this?
21:28:32 acestep1 enters this room
21:28:41 [Hmmmmmm] cmv?
21:28:42 [ash] lorena-rabies
21:28:55 [Hmmmmmm] hi ace
21:28:58 [acestep1] hi
21:29:02 [Lorena] i have muy own neumonics but they are in spanish
21:29:08 [acestep1] hi hmm
21:29:09 [crusher] CMv ..owl eye
21:29:21 [acestep1]
21:29:29 [Hmmmmmm]
21:29:35 [ash] hi acestep1
21:29:37 [Lorena] if you want them i can send them to you , if you know spanish
21:29:50 [ash] do you speak hindi?
21:29:52 [Lorena] ace , how nice to see you after a long time!
21:29:55 [acestep1] hi ash
21:30:09 [Hmmmmmm] only very little pukito pukito
21:30:10 [acestep1] yes. same here
21:30:19 [acestep1] long time no see
21:30:21 [crusher] yes -ve sense envelop ,non segmented ..has long incubation period weeks to 3 months
21:30:22 [ash] sorry lorena i know only one two three in spanish
21:30:24 [acestep1] how r u
21:30:30 [Lorena]>[Hmmmmmm] how cute
21:30:50 [acestep1]
21:31:00 [Hmmmmmm] Lorena> its true
21:31:01 [crusher] hi ace step1
21:31:02 [Lorena] i am fine and you?
21:31:06 [ash] i just read some of your hindi so i was asking
21:31:12 [acestep1] im good as well
21:31:21 [acestep1]
21:31:30 [acestep1] hi crusher
21:31:35 [Hmmmmmm] oh yeah i can read hindi
21:31:37 [acestep1] my hindi ash ?
21:31:48 [Lorena]>[ash] i dont speak hindi
21:31:52 [acestep1]
21:31:53 [ash] where are you from?
21:31:59 [crusher] i can understand hindi very well
21:32:06 [ash] yes ace and hmmmmmm
21:32:11 [acestep1] lol
21:32:20 [acestep1] pak
21:32:21 [ash] thats alright lorena
21:32:42 [ash] and crusher where are u from?
21:32:49 [Hmmmmmm] lol lorena i had a mneumonic, can u please translate it for me?
21:32:55 [ash] and hmmmm,?
21:33:10 [acestep1]
21:33:12 [Lorena] why DNA virus are more stable genetically than RNA?
21:33:18 [Lorena] sure hmmmmm
21:33:18 [ash] i am in usa but am basically from india
21:33:36 [acestep1] k
21:33:40 [crusher] cos they are double stranded??
21:34:00 [Hmmmmmm] ok this is in lyme disease "por favor, no pinta mi cabeza"
21:34:06 [ash] because they dont incorporate their nucleic acid in host dna?????
21:34:15 [Hmmmmmm] im from india too but in canada
21:34:21 [acestep1] or r bound 2histones ?
21:34:36 [Lorena] lol translation "please dont paint my head"
21:34:45 [ash] lorena what is the ans?
21:34:48 [Hmmmmmm] hahahhaha thanks lorena
21:35:02 [Hmmmmmm] from "medical mico made ridic. simple"
21:35:02 [ash]
21:35:13 [ash] i had no clue either
21:35:14 [acestep1] lol
21:35:34 [Hmmmmmm] Lorena> i thought cabeza meant something bad
21:35:43 [Lorena] because DNA use host polymerases which have proof reading , in contrast RNA virus use tgheir own and they dont have proof reading so mutations are seen more often
21:35:56 [crusher] what the technique and why do we do Tzank smear?
21:36:09 [Lorena]>[Hmmmmmm] no, just head ....
21:36:29 [acestep1] ic
21:36:30 [ash] oh!!! this is like human dna and rna polymerase from genetics
21:36:35 [Lorena] tzank God i dont have herpes is the neumonic
21:37:00 [acestep1]
21:37:10 [Hmmmmmm] hahaha nice one
21:37:25 [Lorena] it is in f...aid
21:37:38 [acestep1] k
21:37:42 [ash] crusher it is to detect multinucleated giant cells for herpes
21:38:30 [crusher] nice lorena....for herpes and make a smear of open herpes vesicle to detect multinucleated giant cell
21:39:49 [Lorena] a neumonic for CMV: Owl’s eyes = CMV (Sightomegalovirus
21:40:12 [acestep1] yes
21:40:12 [Hmmmmmm] a pateint has minute but very painful vescicles in the forheads and around the eye on one side of the head what is the dx and treatment?
21:40:28 [acestep1] herpes zooster
21:40:38 [acestep1] acyclovir
21:40:45 [acestep1] ?
21:40:49 [Lorena] agree
21:40:50 [ash] antigen presentation by monocytes and macrophages is defective in which viral infection?
21:41:08 [Hmmmmmm] yep very good
21:41:32 [ash] acyclovir +carbamazepine(for neuralgia)
21:41:32 [acestep1] thnx
21:41:34 [Hmmmmmm] this is a long shot but HIV?
21:41:53 [ash] good hmmmmmmmmmm
21:41:55 [crusher] hat are the common diseases (1) and routes of transmission(1) for HHV-8?
21:42:21 [Hmmmmmm] thanks ash
21:42:25 [ash] hhv causes kaposis sarcoma
21:42:43 [Lorena] cofactor for kaposi sarcoma
21:42:46 [Hmmmmmm] yup in aids patients causes kaposi
21:42:57 [crusher] -Kaposi's sarcoma (HIV pts.) -sexual contact
21:43:02 [Hmmmmmm] routes of transmissing is sexual
21:43:21 [ash] it is sexually transmitted
21:43:27 [Lorena] ok
21:43:40 [acestep1] sexual needles
21:43:50 [acestep1] oops sorry
21:43:53 [ash] what gene does hhv-8 inactivate?
21:43:56 [crusher] What are the common diseases (2) and routes of transmission(2) for EBV?
21:44:02 [acestep1] only sexm contact
21:44:32 [Hmmmmmm] what strain of HPV causes condyloma acuminata
21:44:40 [ash] hhv 8 is also transmitted by organ transplantation
21:44:54 [Lorena] infectious mononucleosis
21:45:07 [ash] 1 to 4
21:45:09 [Lorena] kissing disease
21:45:13 [Hmmmmmm] ash ans please?
21:45:22 [ash] hmmmmmm 1 to 4
21:45:35 [Hmmmmmm] agree with lor
21:45:40 [Hmmmmmm] ty ash
21:45:45 [ash] oh sorry ,it inactivates rb gene
21:45:49 [crusher] nfectious mono, Burkitt's lymphoma -resp. secretions, saliva
21:46:09 [Lorena] thanks ash
21:46:26 [ash] you are welcome
21:46:38 [crusher] What are the common diseases (2) and routes of transmission(2) for HSV-2?
21:46:55 [Lorena] diferentiate mononucleosis in EBV and CMV infections
21:46:57 [acestep1] sex
21:47:14 [ash] which strain of parvovirus causes erythema infectiosum?
21:47:19 [Hmmmmmm] strains 6 and 11 = condyloma acuminata
21:47:39 [crusher] parvo,,B19
21:47:47 [ash] crusher causes herpes genitalis and sexually transmitted
21:47:48 drkittu enters this room
21:47:53 [Lorena] B-19 causes erythema infectiosum
21:48:08 [drkittu] Sorry I am late
21:48:16 [crusher] herpes genitalis, neonatal herpes -sexual contact, perinatal
21:48:20 [Hmmmmmm] hsv2 - sexual contact, genital lesions
21:48:36 [ash] right hmmmmm 1 to 4 cause skin and plantar warts.this is so confusing
21:48:49 [Hmmmmmm] hi dr kittu
21:48:50 [ash] hi drkittu
21:48:52 [Lorena] where does HSV 2 stay latent?
21:48:59 [Lorena] hi Dr kittu
21:49:05 [drkittu] hello everyone
21:49:07 [acestep1] dorsal rt gangion
21:49:19 [acestep1] hi kittu
21:49:25 [Hmmmmmm] DRG
21:49:52 [ash] lumbar and sacral sensory ganglia
21:50:31 [ash] what kind of immunity is more important in herpes infection?
21:50:56 [acestep1] cell mediated?
21:51:11 [ash] right
21:51:16 [drkittu] cell mediated
21:51:34 [ash] what is herpetic whitlow?
21:51:36 [Lorena] it is sacral nerve ganglia for HSV 2 , and dorsal root ganglia for varicella zoster
21:51:40 [Hmmmmmm] cell and antibodi mediated (antibody very little though)
21:51:47 [ash] cell mediated is right
21:52:01 [acestep1] thnx lorena
21:52:07 [Hmmmmmm] oh
21:52:28 [acestep1] k
21:52:45 [Hmmmmmm] a 6 week kid with atypical pneumonia mc cause?
21:52:51 [ash] what is the treatment for herpes resistant to acyclovir?
21:52:55 [Lorena] herpes is an enveloped virus the immune response to them is mostly cell mediated and little ab , for naked virus is mostly antibody
21:53:11 [Hmmmmmm] ty lor
21:53:17 [Lorena] RSV?
21:53:19 [Hmmmmmm] ash gancyclovir
21:53:19 [ash] thanks lorena
21:53:32 [acestep1] thnx lorena
21:53:32 [Hmmmmmm] yes lorena rsv very good
21:53:51 [Lorena] you' re welcome
21:54:11 [Lorena] major cause of croup?
21:54:11 Step_1 enters this room
21:54:32 [Hmmmmmm] hi step 1
21:54:32 [acestep1] hey step1
21:54:39 [ash] hi step_1
21:54:40 [acestep1] rsv
21:54:45 [Lorena] hi step !
21:54:59 [ash] parainfluenza
21:55:34 [ash] treatment of herpes resistant to acyclovir?
21:55:54 [Hmmmmmm] gancyclovir
21:55:54 [Lorena] yes ash , very good
21:55:55 [acestep1] ganciclover
21:56:01 [Step_1] i'm soooo sorry i'm late, was having computer problems
21:56:21 [Lorena] no problem, we are glad to see you !
21:56:40 [ash] foscarnet
21:56:44 [acestep1] yes agree with lorena
21:56:44 [Hmmmmmm] yup
21:56:55 [Step_1] i hope someone else doesnt mind posting the transcript since i dont missed the past hour
21:57:26 [ash] i dont know how to do it
21:57:28 [Lorena] foscarnet!! i remember from pharm, thanks ash !!
21:57:37 [Lorena] i will do it
21:57:50 [acestep1]
21:57:53 [ash]
21:57:59 [Hmmmmmm] i can
21:58:04 [Step_1] thanks lorena
21:58:10 [Hmmmmmm] oh ok lorena u can
21:58:32 [ash] what is the treatment for genital herpes?
21:58:32 [Hmmmmmm] ash whats foscarnet?
21:59:07 [ash] foscarnet is for acyclovir resistant herpes
22:00:04 [drkittu] Acyclovir
22:00:09 [acestep1] hey guys i gtg
22:00:15 [ash] this patient has a pleomorphic rash.diagnosis?
22:00:17 [acestep1]
22:00:50 [Hmmmmmm] bye ace good to have u
22:00:53 [acestep1] take care all of u
22:00:59 [ash] drkittu,valacyclovir or famicyclovir
22:01:02 [acestep1] same here hmm
22:01:09 [Hmmmmmm] another shot in the dark but measles? ash?
22:01:16 [ash] bye ace nice having you here
22:01:17 [Lorena] foscarnet cklionical use identical to ganciclovyr, inhibits DNA and RNA polymerase and used for resistant HSV
22:01:18 [drkittu] Thanks ash
22:01:26 [drkittu] varicella
22:01:31 [ash] nope try again
22:01:34 [Lorena] bye ace, take care!
22:01:47 [acestep1] u2 lorena
22:01:52 [acestep1] byee
22:01:55 [ash] thanks lorena
22:01:56 [Hmmmmmm] ty lorena
22:02:23 [Hmmmmmm] patient bitten by a monkey? what virus?
22:02:41 [Lorena] you're welcome
22:03:26 [drkittu] Erythema multiformae
22:03:30 [ash] marburg?????
22:03:52 [Lorena] lassa fever?
22:03:52 [Hmmmmmm] HHV 7 (f+a has it)
22:04:10 [Hmmmmmm] pg 195
22:04:12 [ash] pleomorphic rash is pathognomonic of chicken pox
22:04:31 [Lorena] thanks hmmmmm
22:04:47 [drkittu] I varicella so its right wasn't ash?
22:04:48 [Hmmmmmm] your welcome
22:05:04 [Hmmmmmm] wow ash i didnt know that
22:05:06 [ash] thanks hmmmmmmm.i had no clue
22:05:55 [Hmmmmmm] yes dr kittu u were rite
22:06:06 [Step_1] are you all going over virology now? pos or neg sense, or virology in general?
22:06:17 erum enters this room
22:06:35 [ash] marburg virus causes infection when you come in contact with the affected monkeys
22:06:51 [Hmmmmmm] yes step 1 general virology (actually no particular order )
22:06:52 [erum] hi
22:06:53 [Lorena] virology jumping all over
22:07:08 [Step_1] thanks
22:07:13 [ash] sorry drkittu i didnt read properly i am so sorry
22:07:23 [Hmmmmmm] hi erum
22:07:35 [Hmmmmmm] ash this is in caplan?
22:07:39 [ash] hi erum
22:07:44 [Lorena] hi erum
22:07:45 [drkittu] no problem. I was confused.
22:07:53 [drkittu] hi erum
22:08:02 [ash] i think it is in javetz
22:08:10 [ash] let me check
22:08:20 [erum] hi lorena hmmmmm dr kitu
22:08:32 [Lorena] name the killed vaccines
22:08:34 [erum] ash n all
22:09:12 [Hmmmmmm] hep a?
22:09:17 [drkittu] Rabies, Influenza, Polio and Hepatitis A
22:09:21 [Step_1] Rabies, Influenza, Polio (salk), Hep A
22:09:30 [Lorena] Rest In Peace Always
22:09:35 [Lorena] very good!
22:09:52 [Hmmmmmm] wow nice one
22:10:16 [erum] good one
22:11:17 [Step_1] Name 4 herpesviruses
22:11:18 [ash] yes hmmmmmm it is given in javetz pg. 297 and there it is also given that a virus known as herpes simiae or herpes b virus is also caused by contact with monkeys
22:12:15 [ash] herpes simplex,zoster,cmv,ebstein barr
22:12:49 [erum] cmv ebv vzs hsv
22:13:03 [Step_1] good job.......mneumonic is "get herpes in a CHEVrolet." -CMV -HSV -EBV -VZV
22:13:13 [Hmmmmmm] thanks ash
22:13:21 [ash] cause of winter virus disease?
22:13:36 [ash] you r welcome
22:13:56 [Step_1] corona virus
22:14:05 [ash] sorry cause of winter vomiting disease?
22:14:38 [Lorena] what is #1 cause of common cold?
22:14:58 [ash] rhinovirus
22:15:08 [Hmmmmmm] influezne
22:15:16 [erum] rota virus
22:15:17 [Step_1] oh, ok....well winter virus that causes common cold is corona virus. rhinovirus peaks in summer and fall
22:15:17 [drkittu] rhinovirus
22:15:20 [Lorena]>[ash] winter vomiting disease?
22:15:46 [Step_1] rhinovirus more common overall
22:15:58 [ash] winter vomiting disease is caused by norwalk virus
22:16:02 [Lorena] thank you step 1
22:16:41 [Step_1] Name naked DNA viruses
22:17:07 [Hmmmmmm] PAP
22:17:12 [ash] what is the HAART combination?
22:17:29 [Lorena] papova, parvo, adeno, calci, picorna
22:17:32 [ash] parvo,papavo,adeno
22:17:33 [Hmmmmmm] papova, adeno, parvo
22:18:08 [Step_1] very good! -Parvo -Adeno -Papova . mneumonic is "You need to be naked for a PAP smear". Lorena, the last two are naked, but they're RNA....but good point
22:18:17 [Lorena] opps, sorry , i wrote all naked ones, RNA too
22:18:45 [Lorena]
22:18:56 [erum] what is lichen planus
22:19:00 [Hmmmmmm] hey thanks for writing them cuz i dont know RNA viruses
22:19:24 [Step_1] thats ok, better to cover now so that we dont need to write a separate question Lorena
22:19:37 [Lorena]
22:20:06 [Step_1] there is one more naked RNA that people often forget.....that's Reovirus
22:20:14 [Hmmmmmm] reo
22:20:23 [Lorena] thanks step
22:20:37 [erum] name viruses associated with gbs
22:20:46 [Hmmmmmm] u have to be naked for a PAP and CPR eh step 1
22:20:49 [ash] fever and severe pleuritic chest pain known as epidemic myalgia is caused by?
22:21:12 [Hmmmmmm] erum ans for ur 1st question please?
22:21:16 [erum] cocksackie
22:21:19 [ash] what is the characteristic finding of reo virus ?
22:21:29 [Lorena] what is gbs?
22:21:42 [Hmmmmmm] gullina barre syn
22:22:00 [Lorena] reo virus are naked, double stranded RNA viruses (that makes them diff from the rest RNA viruses)
22:22:08 [ash] right erum what group and do you know other names for this disease?
22:22:12 [Lorena] they are also segmented virus
22:22:21 [ash] good lorena
22:22:27 [erum] yep
22:22:51 [erum] types of gbs
22:23:57 [Lorena] also campylobacter j. , i remember from last chat is associated with GBS
22:24:07 [Lorena] thanks to ash
22:24:14 [Step_1] ROBA (sounds like "robot" for segmented) Reo, Orthomyxo, Bunya, Arena
22:25:08 [erum] its a skin disease autoimmune
22:25:29 [ash] this pt. has fever ,sore throat and tender vesicles in the oropharynx.it is not a dna virus and it is not enveloped .what is the disease and the causative agent?
22:25:33 [Hmmmmmm] ty erum
22:25:36 [Step_1] Haemophilus influenzae, parainfluenza 1 virus, influenza A virus, influenza B virus, adenovirus, and herpes simplex virus all have been demonstrated in patients with GBS
22:26:06 [ash] thanks step_1
22:26:17 [erum] mycoplasma too
22:26:27 [Step_1] nevermind that....I just read that those are not more frequently found than in controls....ooops
22:27:12 [Step_1] I think that CMV and the C jejuni are the most frequent....is that correct?
22:27:14 [Lorena] cocksackie?
22:27:37 [ash] yes lorena and what is the disease?
22:27:48 [Lorena] influenza A and B are frequent too for GBS
22:27:59 [Hmmmmmm] foot and mouth?
22:28:28 [Lorena] herpangina
22:28:29 [erum] ebv and cmv
22:28:31 [Step_1] It goes on to say "Other significant, though less frequently identified, infectious agents in GBS patients include Epstein-Barr virus (EBV), Mycoplasma pneumoniae, and varicella zoster virus."
22:29:09 [erum] c jejuni is associated with axonal type
22:29:28 [Step_1] it almost sounds like they're not really sure, so they include them all
22:29:33 [drkittu] viruses causing aseptic meningitis?
22:29:35 [ash] lorena right again .hand foot and mouth diasase has rash on hand and feet(vesicular) and ulsers in mouth
22:29:38 [Lorena] lol
22:30:34 [Step_1] coxsackieviruses and echoviruses
22:30:41 [ash] drkittu herpes
22:30:46 [drkittu] Yes
22:31:06 [drkittu] coxsaxhe and echo ......ash
22:31:37 [ash] oops sorry
22:31:49 [Lorena] so when you say aseptic it means it is caused by echo and coxackie?.....
22:32:40 [Step_1] aseptic means viral meningitis.....of which 90% is caused by echo and cosackie. but also Herpesviruses and the mumps virus can also cause viral meningitis.
22:32:44 [ash] hey i am right herpes simplex 2 does cause aseptic meningitis
22:32:46 [Lorena] i am confused , i thought when it is a virus that causes meningitis you refer to it as "aseptic"
22:33:02 [Lorena] just to make the diff of bacterial ethiology
22:33:24 [drkittu] sorry ash
22:33:27 [Lorena] thanks for clarify step !
22:33:41 [Step_1] no prob
22:34:08 erum enters this room
22:34:18 [Lorena] welcome back erum
22:34:19 [ash] thats ok
22:34:35 [Hmmmmmm] cause of infantile gastroentertis?
22:34:43 [erum] thanks
22:35:03 [Step_1] rotavirus
22:35:03 [ash] hey i just remembered another viral infection associated with monkeys-yellow fever
22:35:05 [drkittu] Rota virus, Norwalk virus
22:35:23 [Lorena] rotavirus, adenovirus
22:35:32 [Hmmmmmm] good rotavirus
22:35:43 [erum] rotavirus
22:36:07 [Step_1] i think that norwalk is more common in older children. i remember it because they can "walk", so "norWALK"
22:36:16 [ash] can we discuss some immunology now?
22:36:39 [ash] wow step_! i will always remember it now
22:36:56 [Hmmmmmm] are we doing parasites at all?
22:37:18 [ash] ok lets do parasites then
22:37:28 [erum] preterm 28 weeker with hypoxia and tachypnea in january
22:38:00 [Lorena] RSV
22:38:10 [Lorena] ?
22:38:25 [erum] right
22:39:15 [Lorena] RSV is the major cause of bronchiolitis and neumonia in <1 yo
22:39:27 [ash] which protozoal cyst has 8 nuclei?
22:39:33 [Step_1] i was trying to figure out which parasite could cause that
22:39:47 [erum] screening test for herpes simplex type2
22:39:48 [Hmmmmmm] i was thinking HMD! man im lost
22:40:25 [erum] well patient has no active lesions ofcourse
22:40:28 [Step_1] tzanck smear
22:40:51 [ash] elisa
22:40:55 [Step_1] oops, good point....you said screening
22:41:34 [erum] serum igg n igm
22:41:55 [Lorena] before start parasites we should review, HIV, very high yield if you want , or we can just post some q's later
22:42:17 [Hmmmmmm] yeah lets review HIV
22:42:35 [Hmmmmmm] we can post parasite questions
22:43:07 [ash] ok
22:43:11 [Step_1] as far as regulatory genes for HIV, which up regulate and which down regulate?
22:43:58 [ash] tat and rev upregulaie and nef downregulates
22:44:10 [drkittu] Tat for Up regulation
22:44:19 [Lorena] REV upregulates , and nef downmregulates (controversial) , VIF upregulate
22:44:30 [Step_1] tat and rev ("rev it up") are up regulatory and nef (enef which sounds like enough is down) is down.
22:44:35 [drkittu] Nef down regulates
22:44:57 [Hmmmmmm] good one
22:45:18 [Step_1] what is screening for HIV?
22:45:21 [ash] hiv has been subdivided into classes by what gene?
22:45:31 [Lorena] ELISA
22:45:45 [Hmmmmmm] elsia
22:45:47 [ash] agree with lorena
22:45:55 [ash] good sensitivity
22:46:29 [Step_1] ELISA is screening. what if positive, what next? (trick question). and here is ethics part....when do you tell pt?
22:46:47 [erum] conffirm westiorn blot
22:46:53 [Lorena] if positive western blot
22:46:54 [Hmmmmmm] if positive u do it again
22:47:20 [ash] western blot for confirmation
22:47:20 [Lorena] you tell the patient immediately........?
22:47:29 [ash] best specificity
22:47:30 [erum] sorry i meant western blot
22:47:54 [Step_1] that was kinda tricky. if elisa is positive, you repeat it. if positive again, then you confirm with western blot. do not tell pt until all the testing is done and confirmed
22:48:18 [Lorena] thank you step
22:48:18 [Step_1] i meant when to tell the pt that they have HIV
22:48:31 [erum] agree with step 1
22:48:36 [Hmmmmmm] ty step
22:48:53 [ash] thanx step_1
22:49:39 [Lorena] when do you start therapy with AZT?
22:49:57 [ash] hiv has been subdivided into classes by what gene?
22:50:14 [Lorena] sorry ash, i dont know the answer
22:50:26 [Hmmmmmm] ans please?
22:50:52 [ash] gp 120
22:51:29 [Step_1] i think when cd4 count is below 500 or with a detectable viral load over 20,000....but that is more of a step 2 question
22:51:49 [Lorena] it would be env gene then which codes for pg120
22:52:05 [Lorena] yes step 1 , right
22:52:20 [ash] the main immune response to hiv is by which cells?
22:52:24 [Lorena] gp 120 i meant to say
22:52:51 [Hmmmmmm] cell mediated
22:53:06 [ash] right lorena env gene is first gp160 it is then cleaved to gp120 and gp41
22:53:26 [ash] hmmmmmmm what cells?
22:53:51 [Hmmmmmm] nk, macrophage
22:54:14 [Lorena] agree with hmmmmmm.and B cells too?
22:54:21 [Step_1] now here is an HIV and immuno question combined...so boards love this. what percent of babies will test positive for HIV Abs? (hint: this is a trick question)
22:54:38 [ash] what cells mediate cell mediated immunity?
22:54:54 [ash] step_1 none
22:54:55 [Lorena] 100%
22:55:03 [Hmmmmmm] t helper
22:55:08 [Hmmmmmm] 0 %?
22:55:09 [Step_1] babies meaning newborns
22:55:22 [ash] none
22:55:41 [Lorena] ash what is the ans to the main immune response to hiv is by which cells?
22:55:42 [Step_1] and newborns meaning newborns to HIV moms....sorry, 1st part of question was cut off
22:55:59 [ash] the answer is cd8 t cells
22:56:06 [Hmmmmmm] oh then 100%
22:56:16 [Lorena] they get ab from mom
22:56:26 [drkittu] 100%
22:56:27 [Hmmmmmm] agree wit lorena
22:56:35 [ash] remember the main cells responsible for cell mediated immunity are cd8
22:56:38 [Lorena] thanks ash
22:56:40 [Hmmmmmm] ty ash
22:57:05 [ash] yes i think 100 %too
22:57:22 [Step_1] 100% of newborn babies from HIV infected moms will test positive for HIV Abs because the Abs are passed on via IgG.
22:57:36 [drkittu] Thatwhy PCR used to test HIV Virus in babies
22:57:46 [Lorena] cool
22:57:50 [Hmmmmmm] biggest antibody in serum?
22:58:04 [Lorena] good correlation dr kittu
22:58:30 [Step_1] or you can do PCR like drkittue said...but its expensive
22:58:31 [Lorena] IgM
22:59:09 [Hmmmmmm] macrophages attached to which portion of the antibody?
22:59:13 [Hmmmmmm] good lorena
22:59:25 [Lorena] IgM=Massive
22:59:59 [Hmmmmmm] contact dermatisis is which type hypersensitivity?
23:00:47 [ash] some hiv positive people have lived for many years without opportunistic infections and without reduction in their cd4 count.due to mutations in what gene?
23:01:11 [Step_1] type 4
23:01:19 [Lorena] type IV
23:01:34 [Hmmmmmm] the env gene ash?
23:01:39 erum enters this room
23:01:41 [Hmmmmmm] yes step1 and lorena
23:01:53 [Lorena] agree with hmmm
23:02:10 [Hmmmmmm] yes ash fc portion !
23:02:24 [Step_1] 3 main roles of Ig binding to bacteria
23:02:27 [ash] the answer is nef gene
23:03:06 [Step_1] good point ash since its the down regulator (enef or enough)
23:03:22 [Lorena] thanks ash, where did you find those q's? very good ones
23:03:29 [Hmmmmmm] opsonin
23:04:09 [ash] i picked them from the text part of j a v e t z and k a p l a n and
23:04:30 [Step_1] opsonization , neutralization, complement activation for roles of Ig binding to bact
23:04:37 [Hmmmmmm] chemotatic and complement activatio?
23:04:49 [Lorena] excellent ash!
23:05:00 [Hmmmmmm] oh i forgot neutralization
23:05:13 [Step_1] good job hmmmm
23:05:16 [Step_1] A defect in phagocytosis of neutrophils owing to lack of NADPH oxidase activity or similar enzymes is indicative of what immune deficiency disease?
23:05:18 [ash] ok guys i have to go now for i havent yet had dinner.can you telll me the topics for next discussion?
23:05:31 [Hmmmmmm] patho ash
23:05:43 [ash] cgd
23:05:53 [ash] but what topics?
23:06:04 [Lorena] agree with ash
23:06:17 [Hmmmmmm] its was fun, so sorry u have to go bye
23:06:28 [erum] ch granulomatous dis
23:06:34 [ash] hmmmmmmm what topics?
23:06:36 [Step_1] next week is gol jan path
23:06:54 [Lorena] patho i sooooo much.huge topic
23:07:01 [ash] ok which chapters?
23:07:19 [Hmmmmmm] ash> i dunno
23:07:32 [ash] pleaase someone tell me the chapters
23:07:55 [erum] k a p la npath????
23:08:01 [Lorena] yes, gol jan ........lets try until chap ....let me check the notes
23:08:16 [Hmmmmmm] how bout we finish general patho and maybe till liver in sys patho?
23:08:35 [Step_1] lets do like we did last time, which is the first chapters of his lecture notes......cell injury, inflammation, immunopath, fluids and hemodynamics, acid base, nutrition, genetics, environmental path, neoplasia....then the rest on sat....dound ok>
23:09:04 [Hmmmmmm] yes step 1 agreed
23:09:12 [ash] sounds good step_1
23:09:14 [Lorena] yes
23:09:46 [ash] thanks allhow do you communicate with eachother for the rest of the days?
23:09:56 [drkittu] sounds good
23:10:05 [Lorena] you can post or IM
23:10:06 [Step_1] we actually covered some of that already, like immunopath is tonight, genetics before, nutrition before, acid base, etc.
23:10:14 [erum] ok
23:10:58 [Step_1] we all joined the step 1 usergroup here if you want to contact us via PM. but i think its better to communicate via the step 1 forum here so everyone can join in
23:11:00 [ash] i tried to post but i cant at value md .i tried to congratulate step_1 for his result and i couldnt
23:11:37 [ash] ok i will try that.
23:11:41 [Step_1] thanks ash, but you should be able to post either as a user or guest
23:12:04 [ash] ok thanks for your help guys goodnite.see you on wednesday
23:12:10 [Hmmmmmm] bye ash
23:12:21 [ash] bye
23:12:23 [Step_1] bye ash, good night
23:12:31 [erum] bye ash
23:12:32 [Lorena] bye ash, thanks for the great q's
23:13:16 [Step_1] btw, the ans to my previous question was Chronic granulomatous disease
23:13:23 [erum] is k ap la n good 4 patho
23:13:45 [erum] sice i dont have <a target=new HREF=http://www.amazon.com/exec/obidos/external-search?tag=valuetheplace-20&keyword=Goljan&mode=books>Goljan</A>
23:13:59 [Hmmmmmm] graves disease what hyper sensti?
23:14:03 [erum] oops sorry
23:14:13 [Hmmmmmm] erum what dont u have of gol?
23:14:26 [Lorena] type 2
23:14:30 [Hmmmmmm] the 100 pgs, hy are in the download site
23:14:50 [Step_1] i used gol jan path, so i dont know how kap lan's is, but if you can get your hands on gol jans, i think its better. if not, brs path is excellent. then i think that kap lan path is the next best thing
23:14:56 [Hmmmmmm] if u want his audio u can find them in coolgoose.com
23:15:00 [erum] i vegot the hy
23:15:21 [Hmmmmmm] i can send u the audio too if u want
23:15:22 [Lorena] and you can download the gol jan audios
23:16:10 [Hmmmmmm] step1 did u find bacterial genetic hy? (sorry for sidetracking)
23:16:41 [Lorena] no problem...good q's!
23:17:12 [Hmmmmmm] yes lorena type 2 is correct just saw ur answer
23:17:15 [Step_1] i dont have them for bacterial genetics specifically, but maybe the biochem ones have them?
23:18:18 [Hmmmmmm] no no i mean in <a target=new href=http://click.linksynergy.com/fs-bin/click?id=c97WUMRO5hY&offerid=47491.10002441&type=3&subid=0 >Kaplan</a><IMG border=0 width=1 height=1 src=http://ad.linksynergy.com/fs-bin/show?id=c97WUMRO5hY&bids=47491.10002441&type=3&subid=0 > book (bacterial genetics is it hy) cuz there like 30 pgs and i dont have too much time to memorize em all
23:18:20 [Step_1] like the immuno high yields are mixed with micro and titled "micro high yields"
23:18:32 [Hmmmmmm] whoops sorry
23:18:56 [Step_1] oh, sorry i misunderstood
23:19:27 [Hmmmmmm] np
23:19:29 [Lorena] besides it is complicated , k a pl an dones explian well in that section there of bacterial genetics
23:19:38 erum enters this room
23:20:10 [Hmmmmmm] i know lorena thats my problem
23:20:24 [Hmmmmmm] i cant understand it and have no time
23:20:43 [Hmmmmmm] im giving exam sept 24
23:21:09 [Hmmmmmm] i wana save my one month starting aug 24 for only mcq and review
23:21:13 [Lorena] you know, i found a website very useful for that subject-i understiood more there then in k a pl an
23:21:13 [erum] i did kap video lectures
23:21:42 [Lorena] i will post it so you can check it out
23:22:01 [erum] hmmmmmmm thanks iwould like that
23:22:01 [Hmmmmmm] thanks you lorena ur an angel
23:22:20 [Hmmmmmm] yeah erum i did some <a target=new href=http://click.linksynergy.com/fs-bin/click?id=c97WUMRO5hY&offerid=47491.10002441&type=3&subid=0 >Kaplan</a><IMG border=0 width=1 height=1 src=http://ad.linksynergy.com/fs-bin/show?id=c97WUMRO5hY&bids=47491.10002441&type=3&subid=0 > video lecs 2
23:22:52 [Lorena] is it bacteruial genetics a High Yield topic in the exam step 1?
23:23:07 [Hmmmmmm] sure erum do u have any messenger? give me any id u dont have to give me ur personal one ill give u them one by one
23:23:15 [erum] but 4 patho im also using brs
23:24:07 [Hmmmmmm] lorena have u done vid lecs?
23:24:11 [Step_1] i think its important to know, but it depends on how much time you have. there are things that are more high yield than that, but i wouldnt ignore it altogether
23:24:11 [erum] n afraid to use any new material @this point
23:24:16 [Hmmmmmm] and whens ur exam?
23:24:43 [Lorena] yes , i did k apl an video lectures
23:24:56 [Hmmmmmm] erum i havent done <a target=new HREF=http://www.amazon.com/exec/obidos/external-search?tag=valuetheplace-20&keyword=Goljan&mode=books>Goljan</A> yet either but i heard it good after uve done all subjects cuz its intergrative
23:25:03 [Lorena]>[Step_1] thanks step good advise
23:25:18 [Hmmmmmm] ty step 1 and dam i must be whipped i keep making that stupid mistake
23:25:23 [erum] i dont have the exact date
23:26:12 [erum] but soon
23:26:16 [Hmmmmmm] oh ok what bout u lorena when ur exam?
23:26:25 [Lorena] me too..soon
23:26:52 [Lorena] i dont have the date yet, i am terrified cauze i have to pick tghe date SOON
23:26:54 [Hmmmmmm] erum my yahoo messenger is hmmm_med2004@yahoo.com i can upload them to u through there
23:27:59 [Step_1] ready for a few more immuno questions
23:27:59 [erum] ok ..what do i need
23:28:12 [Hmmmmmm] lol not half a terrified as i m i only had 3 months of study after 2 months of rotation (so means i forgot all my basic sciece)
23:28:14 [Lorena] bring them on step!
23:28:21 [Step_1] lorena, you will do fine
23:28:23 [Hmmmmmm] sure step 1
23:28:45 [Step_1] and so will the rest of you....i have all the faith in the world of your knowledge
23:28:47 [Hmmmmmm] erum> u just need to sign up for yahoo messneger and download it
23:28:55 [erum] to get the files
23:29:07 [Lorena] i had to take a "forced " break of almost a month and a half which was very frustrating
23:29:15 [Hmmmmmm] erum> well its a chat program but i can send u filez from there
23:29:26 [erum] oh thanks
23:29:42 [Hmmmmmm] ty step1 very kind words
23:29:46 [Step_1] hmmmmm, did you figure out how to upload them to the download area?
23:29:53 [Lorena] but i am happy i am studying again and you guys help me a lot withy these chats
23:30:19 [Hmmmmmm] no step 1 i asked doc he increased the upload limit but my computer isnt cooperating
23:30:44 [Hmmmmmm] same here lorena
23:31:13 [erum] me too had to take 2 months break
23:31:44 [Lorena] ok guys, lets study
23:31:45 [erum] its hard tobuild the same pace again
23:32:18 [erum] but im trying
23:32:21 [Hmmmmmm] btw do u ppl have web...pre.p?
23:32:36 [Lorena] questions questions questions
23:32:39 [Step_1] the chats helped me stay on pace. hopefully it will do the same for you erum
23:33:04 [Hmmmmmm] sorry sorry lets get on
23:33:13 [Lorena]
23:33:24 [erum] i will keep my fingers crossed
23:33:25 [Lorena] crusher..are you there?
23:33:28 [Hmmmmmm] mch1
23:33:42 [erum] i hope so step 1
23:33:50 [Hmmmmmm] dont worry erum ur smart
23:34:02 [Lorena] hutals didnt come today
23:34:52 [Step_1] hutals wrote to me and said couldnt make it and sent apology to group. said would make it on wed
23:34:53 [Hmmmmmm] mch1
23:35:06 [Step_1] thanks for reminding me
23:35:29 [Lorena] oh ok , hope everything is fine
23:35:36 [Step_1] class I MHC proteins is correct, only mature RBCs wont have them because non-nucleated
23:35:39 [Hmmmmmm] which mhc is exogenus and endogenus antigen?
23:35:51 [Hmmmmmm] and platelets rite?
23:36:29 [Step_1] MHC II is eXogenous (take the II and cross them into an X)
23:36:51 [Hmmmmmm] nice pneumonic
23:37:09 [Lorena] you are the best
23:37:34 [Step_1] yes hmmmm, PLTs have class I even though non-nucleated...its the exception
23:38:12 [erum] agree with step 1
23:38:38 [Hmmmmmm] is b-cell an apc?
23:38:55 [Hmmmmmm] is t-cell an apc?
23:40:43 [Hmmmmmm] knock knock anyone there?
23:40:50 [Lorena] sorry
23:40:59 [Lorena] b cells are
23:41:07 [Lorena] t cells aren't .?
23:41:09 [Hmmmmmm] np
23:41:27 [Hmmmmmm] yes
23:41:44 [Step_1] Macrophages. 2) Dendritic cells. 3) B cells
23:41:58 [Step_1] are the 3 types of APCs
23:42:15 [Lorena] ok
23:42:40 [Hmmmmmm] looks like ppl are sleepy ill must be off as well its late
23:43:06 [Step_1] Anaphylaxis, asthma, or local wheal and flare are possible manifestations of which type of hypersensitivity?
23:43:21 [Lorena] type 1
23:43:23 [Hmmmmmm] type 1
23:43:34 [erum] type1
23:43:39 [Step_1] Type I is correct...very good
23:43:52 [Hmmmmmm] ok ppl thanks for a very informative chat, will see you all on wednesday
23:43:59 [Step_1] Autoimmune hemolytic anemia, Rh disease (erythroblastosis fetalis), and Goodpasture's syndrome are examples of what kind of hypersensitivity reaction?
23:44:14 [Lorena] type 2
23:44:16 [Hmmmmmm] type 2?
23:44:27 [erum] 2
23:44:36 [Hmmmmmm] erum> email me whenever u want the filez
23:44:38 [Step_1] type II hypersensitivity is correct...you all are on a role
23:45:02 [Lorena] purpose of immunotherapy in allergies?
23:45:21 [erum] ok i wi ll tx again
23:45:56 [Step_1] desensitisation??
23:45:56 [Lorena] injecting the ag in small amounts results in...? regarding th1, and Th2
23:46:06 [Lorena] yes
23:46:32 [erum] desensitization
23:46:34 [Step_1] Helper T cells have CD(?) which binds to class (?) MHC on antigen-presenting cells.
23:46:54 [Lorena] the purpose is to switch Th2 to Th1 type so decrease igE production
23:47:08 [erum] 8 1
23:47:26 [Lorena] cd4 which binds to MHC 2
23:47:51 [Step_1] it always equals 8, so 4 x 2 = 8 means CD4 is MHC 2. 8 x 1 = 8 so CD8 is MHC 1 .
23:48:46 [Step_1] and the Helper T cell is CD4.
23:48:49 [erum] cytotoxic nhelper 4 1
23:49:09 [Step_1] so the answer is 4 and 1
23:49:24 [erum] i mean 8 1 cytotoxic
23:49:58 [erum] n helper 4 1
23:50:10 [Step_1] thats right erum
23:50:39 [Step_1] How does Bruton's agammaglobulinemia usually present?
23:51:17 [Lorena] recurrent pyogenic infections ,no B cells circulating
23:51:31 [erum] 6 mon old with inf
23:51:48 [Lorena] respiratory infections ,very low Ig
23:52:00 [Step_1] Brutons is the 3 ** (Boys, Brutons, B cells). presents as bacterial infections in boys after about 6 months of age, when levels of maternal IgG antibody decline. good job!
23:52:05 [erum] when moms igg is gone
23:52:50 [Step_1] In what T-cell deficiency do the thymus and parathyroids fail to develop owing to failure of development of the 3rd and 4th pharyngeal pouches?
23:53:12 [Lorena] diGeorge
23:53:30 [erum] di george
23:53:41 [Step_1] Thymic aplasia (DiGeorge syndrome)....great!
23:54:19 [erum] thymic tcell tetany
23:54:28 [erum] 3 t
23:54:31 [Step_1] sorry i'm going fast, but running out of time......stop me whenever you have question or want to stop
23:54:41 [Step_1] good one erum
23:54:55 [Step_1] Sensitized T lymphocytes encounter antigen and then release lymphokines which leads to macrophage activation' in what hypersensitivity reaction?
23:55:04 [erum] tx
23:56:01 [Step_1] that would be type 4 HS
23:56:10 [erum] delayed
23:56:16 [Lorena] i see
23:56:24 [Step_1] i think this one might be easier
23:56:25 [erum] cell mediated
23:56:27 [Step_1] TB skin test, transplant rejection, and contact dermatitis are examples of what type of hypersensitivity reaction?
23:56:29 [Lorena] thanks
23:56:40 [Lorena] type 4
23:56:42 [erum] pe 4
23:57:25 [Step_1] the T cell, lmphokine and macrophage thing was also part of actual question, so try to go over that concept
23:57:30 [Step_1] yep type 4
23:57:50 [Lorena]
23:58:04 [Step_1] The 3 kinds of MHC class I genes are…? what about The 3 kinds of MHC class II genes are…?
23:59:13 [erum] abc
23:59:23 [Lorena] class II DP, DQ DR
23:59:32 [erum] dr dq dp
00:00:01 [Step_1] A, B, and C for MHC 1 because you "learn your ABCs in 1st grade. DP, DQ, DR are MHC2 because D stands for "Dos" which is "two" in spanish.
00:00:06 [Step_1] good job
00:01:03 [Step_1] ok, i think our time is up
00:01:11 [Lorena]
00:01:36 [Step_1] sorry again for being late tonight....but it was great chatting with everyone
00:02:13 [Lorena] thank you so much step , you are our angel, thank you for being here today
00:02:15 [erum] same here step 1
00:02:25 [Lorena] see you next chat
00:02:39 [Step_1] lorena, i guess you'll post the transcript tonight?
00:02:49 [erum] thanx every one
00:02:58 [Lorena] i will step
00:03:04 [Step_1] see everyone in the next chat.....good night all
00:03:05 [erum] n see u all
00:03:08 [Lorena] byeee , take care