Lorena
10-20-2004, 08:57 PM
19:59:23 Lorena enters this room
19:59:24 >[Lorena] Welcome to our chat. Please obey the net etiquette while chatting: try to be pleasant and polite.
20:01:13 hutals enters this room
20:01:58 [hutals] hey lor
20:04:04 [Lorena] hi hutals
20:04:10 [Lorena] how are you?
20:04:53 [hutals] i'm good, how bout you?
20:05:03 [Lorena] fine thanks
20:06:58 [hutals] i'm still listening to goljans heme lecture coz i didnt get a chance to go over it earlier
20:07:48 [Lorena] same here, i have guests so could not study
20:07:55 acestep1 enters this room
20:08:21 [acestep1] hey guys
20:08:33 [hutals] oh, i know how that is.....but always good to take a break
20:08:38 [hutals] hey ace
20:08:38 [Lorena] hi ace
20:08:58 [acestep1] hi lor n hutals
20:09:09 [acestep1]
20:09:38 [acestep1] same here . had a sleep prob am still v sleepy
20:09:42 ash enters this room
20:10:16 [ash] hi sorry i havent read for today
20:10:22 [acestep1] hey ash
20:10:28 [Lorena] i will just follow you guys with my book
20:10:33 [ash] hi ace
20:10:45 [Lorena] hi ash
20:10:47 [ash] thats what i was going to do
20:10:54 [ash] hi lorena
20:11:09 [hutals] hey ash
20:11:11 [ash] hi hutals
20:11:23 [acestep1] good idea lor
20:12:02 [hutals] i was still listening to the lectures cause didnt get to read too
20:12:21 [ash] if you dont mind i am keeping my book open today
20:12:27 [acestep1] ya .same here hutals but i never read up these days
20:12:42 [Lorena] lol, it seems nobody feels ready for today's chat
20:13:00 [acestep1] sure. np - ash
20:13:26 [ash] name some drugs causing aplastic anemia
20:13:46 [hutals] parvo isnt a drug, but that causes it
20:13:48 [acestep1] . no buts lets study . im sure well help out each other
20:13:48 [Lorena] chloramphenicol
20:14:08 [ash] agree with ace
20:14:21 [hutals] phenylbutazone
20:14:25 [ash] atleast i will go through the book that way
20:14:28 [Lorena] yes, even with the books open, we learn like that
20:14:32 [acestep1] antifit medication - cbz
20:14:46 [acestep1] yes agree
20:15:02 [ash] let me give you the list i have your answers are right
20:15:04 [acestep1] also antica drugs i think
20:15:19 [acestep1] k
20:15:19 [hutals] i agree, this is a good way to go through the material in the book rather than just reading....it sticks better this way
20:15:34 [Lorena] yes, and it is fun
20:15:37 ninadnashua enters this room
20:15:48 [acestep1] yes
20:15:51 [hutals] hey nina
20:16:01 [Lorena] hi ninad , nice to see you
20:16:03 [ninadnashua] hi
20:16:12 [ash] alkylating agents,antimetabolites,benzene,chloramphenicol,phe nylbutazone,sulfonamides,methylphenylhydantoin
20:16:28 [ash] hi ninad
20:16:32 [Lorena] gold
20:16:35 [ninadnashua] thanku lorena same here
20:16:48 [acestep1] hi nina
20:16:50 [ninadnashua] hi
20:16:58 [hutals] whats the most common cause (mcc) of folate def?
20:17:11 [ninadnashua] hiall
20:17:13 [ash] alcoholism
20:17:43 [ash] last cell to disappear by folate treatment?
20:17:57 [hutals] yep, alcoholics. would a beer drinking alcoholic have folate defciency?
20:18:17 [Lorena] no
20:18:28 [Lorena] beer has folate
20:18:45 [ash] wow i didnt know that
20:18:46 [hutals] yep, thats right lorena
20:19:15 [acestep1] hey i thought prep was teh mcc for folate def
20:19:29 [acestep1] imean pregnancy
20:19:45 [acestep1] hey guys brb in 5 mins
20:19:53 [Lorena] acording to <a target=new HREF=http://www.amazon.com/exec/obidos/external-search?tag=valuetheplace-20&keyword=Goljan&mode=books>Goljan</A> alcoholism is MCC
20:19:58 [Lorena] opps
20:20:08 [Lorena] sorry about that
20:20:11 [acestep1] ic
20:20:18 [ash] but anyways folate is given in pregnancy as supplement and hence we dont see the deficiency
20:20:25 [hutals] not according to golijan. i would imagine that pregnancy only includes a certain population whereas alcoholics are across the boards
20:20:54 [acestep1] k
20:21:07 [Lorena] ok
20:21:17 [hutals] what are other causes of folate def? what type of anemia
20:21:23 [acestep1] illcheck this out cuz i think in other bks they mention preg as teh mcc
20:21:42 [ash] why do we see increased serum ldh in folate deficiency?
20:21:53 [acestep1] old ppl- tea n toast diet , malabsp synd
20:22:00 [Lorena] some drugs like methrotexate , sulfas, the anemia is megaloblastic
20:22:02 [ash] macrocytic anemia
20:22:11 [acestep1] megaloblastic anemia
20:22:39 [acestep1] agree with lor
20:22:44 [ash] phenytoin and also celiac disease and malignancy
20:22:58 [hutals] otheryep, those are all causes, dont forget birth control pills too
20:23:14 [ash] also birth control pills
20:23:28 [acestep1] k
20:23:45 [ash] why raised serum LDH in folate def.?
20:23:52 [hutals] seems no way around that.....folate def seen in both preg and those trying not to get pregnant???
20:24:28 [acestep1] lol
20:24:36 [hutals] dont know ash?
20:24:37 [acestep1] brb
20:24:48 [Lorena] because destruction of RBC
20:24:53 [hutals] k
20:25:51 [Lorena] is that it ash?
20:25:56 [ash] a woman 50 yrs old,with waxy complexion ,blue eyes and premature greying of hairon vegan diet.anemia?
20:26:11 [ash] right lorena
20:26:32 [hutals] i dont see the relation?
20:26:42 [hutals]
20:26:45 [Lorena] i read it , soit means everytime you have destruction of cells you will have incresed LDH?
20:27:13 [Lorena] i guess because of the membrane contains cholesterol
20:27:40 [hutals] ok, that makes more sense. thanks
20:28:22 [ash] a man with right sided lower abdominal pain ,fever,string sign of kantor on x ray will most likely suffer from what anemia if hhis iron intake is good?
20:28:25 [Lorena] vegan diet ...megaloblastic anemia?
20:29:15 [Lorena] anemia of chronic disease
20:29:18 [ash] lorena can you be more specific?
20:29:57 [hutals] pernicious anemia?
20:30:15 [ash] right hutals
20:30:47 [ash] intrinsic factor deficiency.lorena is also right
20:31:06 [ash] as it is vegan diet it will be b12 def
20:31:20 [Lorena] ok thanx i'll try to be more specific
20:31:41 crusher enters this room
20:31:45 [hutals] where will you see howell jolly bodies?
20:31:50 [hutals] hey crush
20:31:54 [crusher] hiall.
20:32:04 [crusher] aplenic pateints
20:32:14 [acestep1] g6pd def
20:32:16 [ash] the man with abd. pain has crohns disease which involves terminal ileum and therefore b12 deficiency
20:32:26 [ash] hi crusher
20:32:46 [Lorena] post splenectomy or autosplenectomy
20:32:58 [ash] splenectomy,
20:33:00 [hutals] howell jolly bodies means spleen surgicall removed or dysfunctional spleen like in sickle cell dis. ...good
20:33:00 [ninadnashua] hi crush
20:33:01 [Lorena] hi crush
20:33:20 [Lorena] what are they howell jolly bodies?
20:33:52 [hutals] ace, heinz bodies for G6PD
20:33:54 sweta_med enters this room
20:34:00 [ash] nuclear remnants
20:34:12 [sweta_med] hi everyone
20:34:24 [Lorena] hi sweta
20:34:29 [Lorena] yes ash
20:34:32 [ash] hi sweta
20:34:36 [hutals] http://www.wadsworth.org/chemheme/heme/microscope/howelljolly.htm for pic of HJ bodies
20:34:55 [hutals] hey sweta
20:34:58 [ninadnashua] hi sweta
20:35:03 [crusher] degraded rbcs fragments??
20:35:10 [Lorena] thanks
20:35:11 [ash] why do you get b12 def. in chronic pancreatitis?
20:35:49 [hutals] problem cleaving R factor
20:36:01 [ash] good hutals
20:36:01 [sweta_med] malabsorption due to low bile salts
20:36:02 [Lorena] because you lack some of the enzymes
20:36:27 [sweta_med] ok
20:37:09 [Lorena] R factor is given by saliva and you need the ez to cleave it off
20:37:36 [sweta_med] and also intrinsic factor
20:37:51 [ash] right lorena
20:39:04 [Lorena] diferential diagnosis betweenanemia by deff folate or def B12?
20:39:08 [sweta_med] IFbinds with b12 after it is cleaved off
20:39:12 [hutals] pt with hemolytic anemia post dapson and aspirin....diagnosis?
20:39:30 [sweta_med] treatment for the two differ
20:39:42 [sweta_med] g6pd def
20:39:55 [hutals] B12 has neurological symptoms
20:40:06 [Lorena] yes G6PD def
20:40:33 [ash] also methylmalonicaciduria is seen in b12 def
20:40:36 [hutals] give both folate and B12 to make sure you cover the neurological symptoms which may become permanent if not treated
20:40:53 [sweta_med] and FIGLU in folate def]
20:41:04 [hutals] yep, G6PD def
20:41:10 [Lorena] yes and also in vit B12 def has methylmalonil aciduria
20:41:20 [hutals] dapsone is a sulfur drug used in leprosy
20:42:21 [sweta_med] what infection causes aplastic anemia
20:42:35 [hutals] the other high yield sulfa drug for boards is the TMP SMX used in HIV pts to tx PCP
20:42:36 [Lorena] PARVOVIRUS
20:42:40 [hutals] parvo
20:42:47 [crusher] parvo virus
20:43:05 [crusher] B19..
20:43:08 [sweta_med] and also nanb hepatitis
20:44:02 [Lorena] ok
20:44:11 [hutals] causes of osteomyolitis in sickle cell disease?
20:44:25 [sweta_med] salmonella
20:44:36 [Lorena] salmonella
20:45:42 [hutals] staph aureus is MCC of osteomyolitis in normal and sickle cell disease, but sicklers are prone to have salmonella causing osteomyolitis as well....good
20:45:47 [sweta_med] whatis th treatment for thalassemia
20:46:01 [ash] when do you find shift cells in the blood
20:46:02 [crusher] what kindof anemiainmalignancy?
20:46:24 [sweta_med] hypoproliferative
20:46:44 [Lorena] in maliganncy is anemia of chronic disease
20:46:52 [ash] anemia of chronic disorder
20:47:21 [hutals] severe thal requires transfusions
20:47:39 [hutals] the minor requires no treatment
20:47:56 [Lorena] agree with hutals
20:48:17 [sweta_med] yes
20:48:20 [crusher] for alpha thalasemia nothing.for beta blood trans
20:48:49 [hutals] what about B thal minor crusher?
20:48:54 [crusher] yes anemia of chronic dis in malgnacy..very good
20:49:21 [ninadnashua] cause of the sideroblastic anemia
20:49:23 acestep1 enters this room
20:49:36 [hutals] lead
20:49:39 [sweta_med] lead poisonins, alcohol
20:49:57 [hutals] working in battery factory
20:49:59 [Lorena] piridoxine deficiency
20:50:01 [sweta_med] pyridoxine def,alkylating drugs
20:50:06 [acestep1] sorry guys my comp froze
20:50:07 [ninadnashua] ya
20:50:12 mle1 enters this room
20:50:25 [hutals] no prob ace....good to have u back
20:50:30 [hutals] hey mle1\
20:50:43 [sweta_med] hi mle1
20:50:45 [acestep1] thnx hutals
20:50:47 [mle1] Hey guys
20:50:49 [Lorena] welcome back ace
20:50:59 [Lorena] hi mle
20:51:12 [ninadnashua] also b6 defeciency
20:51:17 [mle1] Hi
20:51:45 [acestep1] thnx lor
20:51:58 [sweta_med] what is the cause of bloodloss anemia in > 50yrs male
20:52:29 [Lorena] you have to suspect colon cancer
20:52:47 [ash] agree with lorena
20:52:52 hutals exits from this room
20:52:55 hutals exits from this room
20:53:03 hutals enters this room
20:53:06 [acestep1] agree with lor
20:53:14 [hutals] oops
20:53:38 [Lorena] i just saw hutals jumping to another room
20:53:46 [sweta_med] welcome back hutals
20:55:20 [hutals] don't lean on the door, i just fell through by accident
20:55:32 [Lorena] lol
20:56:08 [hutals] what is the buzz word for the cells seen in thalasemia
20:56:08 [acestep1] lol
20:56:23 [sweta_med] target cells
20:56:28 [Lorena] target cells
20:56:44 [ninadnashua] teardrop cells
20:56:50 [hutals] yep, target cells.....tear drop cells too i think
20:56:57 [sweta_med] tear drop cells are also
20:57:11 [Lorena] why a **** with sickle cell symptoms start after 6 months of age?
20:57:27 [acestep1] agree with hutals - also micrcytic anemia
20:57:31 [sweta_med] because the HBF dec
20:57:37 [acestep1] hbf
20:57:43 [crusher] cos of HbF
20:57:52 [Lorena] i didnt know that thanks sweta and hutals
20:57:53 [hutals] pic of teardrop cells here http://www.wadsworth.org/chemheme/heme/microscope/teardrop.htm
20:58:09 [sweta_med] what are the symptoms
20:58:53 [hutals] because of HbF....i agre
20:59:23 [Lorena] hemolytic anemia, infections, painful vascular oclusions
20:59:40 [crusher] low oxygen tension lead to painful vascular crisis
20:59:48 [hutals] pic of target cells here http://www.wadsworth.org/chemheme/heme/microscope/targetcells.htm
21:00:15 [sweta_med] aplastic crisis,leg ulcers, priaopism
21:00:16 [Lorena] what is the most common anemia in african americans?
21:00:31 [crusher] dactiltis,,,osteomylitis
21:00:38 [sweta_med] thalassemia
21:01:08 [ninadnashua] b
21:01:10 [crusher] G6 Ph..def..hemolytic
21:01:15 mle1 enters this room
21:01:33 [mle1] sorry guys
21:01:40 [hutals] welcome back mle1
21:01:54 [mle1] Thanks
21:01:58 [Lorena] iron deficiency .... if it says genetic anemia then it is sickle cell
21:02:23 [sweta_med] its sickle cell anemia
21:02:49 [mle1] microcytic anemia, with normal hb seen in?
21:03:13 [Lorena] iron deficiency
21:03:22 [crusher] iron defi
21:03:24 [sweta_med] siderblastic
21:04:05 [crusher] microcytic hypochromic=uiron def
21:04:27 [ninadnashua] microcytic a
21:05:41 [Lorena] patient has gastrectomy...what kind of anemia can be present?
21:05:53 [sweta_med] macrocytic
21:06:21 [hutals] iron deficiency
21:06:24 [Lorena] yes
21:06:26 [crusher] n def
21:06:41 [crusher] iron def cos fe absorb in duod
21:06:55 [sweta_med] ok
21:07:22 [crusher] while b12 in ileum
21:07:29 [ninadnashua] cause of fe defeciency in newborn
21:07:32 [crusher] n folate in jejunum
21:07:33 [Lorena] iron is reabsorbed in duodenum
21:07:56 [hutals] meckels
21:08:05 [sweta_med] iron def
21:08:05 [crusher] breast feeding??
21:08:18 [ninadnashua] ya meckels
21:08:25 [sweta_med] iroon def
21:08:35 mle1 enters this room
21:08:53 [hutals] nina, can you use a brighter color, hard to read dark text?
21:09:10 [Lorena] why meckels? because of bleeding?
21:09:32 [sweta_med] yes
21:09:52 [Lorena] ok thanx sweta
21:09:59 [ninadnashua] ok
21:10:06 [hutals] thanks nina
21:10:19 [sweta_med] what are the symptoms of intravascular hemolysis
21:10:19 [ninadnashua] np
21:10:43 [hutals] iron deficiency in elderly pt....most common cause?
21:10:55 [Lorena] where did ace go?
21:10:56 [mle1] colon cancer
21:11:03 [ninadnashua] rdwindex high in which microcytic a?
21:11:06 [sweta_med] coloncan
21:11:20 [mle1] iron def?
21:11:21 [sweta_med] iron def
21:11:25 [crusher] malignancy colon ca
21:11:38 [ninadnashua] ya iron defe
21:11:42 [hutals] yep mle and sweta, its colon cancer for elderly.
21:12:01 [Lorena] intravascular hemolysis = hemoglobinuria?
21:12:08 [crusher] iron def in less 50 year women ??
21:12:13 [hutals] ace was having connection problems
21:12:15 [sweta_med] and low haptoglobin
21:12:25 [hutals] ulcer
21:12:26 [Lorena] metrorragia
21:12:28 [sweta_med] menorrhagia
21:12:32 [mle1] hemosiderinuria after some time
21:12:36 [crusher] yes menorrahgia
21:12:54 [hutals] oops, male under 50 would be ulcers...sorry
21:13:09 [Lorena] how about bilirrubin? how is it in intravascular hemolysis?
21:13:18 [sweta_med] unconjugates
21:13:27 [crusher] gi or ulcer is mcc over all
21:13:37 [mle1] elevated&unconjugated?
21:13:58 [crusher] intravascular hemolysisfat saluble=uncongugated
21:13:58 acestep1 enters this room
21:14:12 [mle1] du more commom than gastric ulcer.
21:14:21 [sweta_med] what is the characteristic of a spherocyte
21:14:42 [Lorena] no area of central pallor
21:14:55 [sweta_med] yes lor
21:15:01 [mle1] disc like&smaller size&no cental pallor.
21:15:01 [hutals] agree with lor
21:15:02 [acestep1] agree
21:15:14 [sweta_med] and also loss of biconcave disc
21:15:33 [acestep1] yes
21:15:35 [ninadnashua] hus what r symtoms
21:16:09 [crusher] a person ask to close the eyehe fall down on closing the eye.what is that defect n test called
21:16:13 [sweta_med] anemia , jaundice and splenomegaly
21:16:21 [mle1] triad of fevr, jaundice&anemia.
21:16:28 [Lorena] anemia, splenomegaly
21:16:35 [ninadnashua] cerebral edema in children?
21:16:43 [mle1] oops splenomegaly too.
21:16:47 [acestep1] wht abt rf n neurological s/s
21:16:56 [ninadnashua] ya
21:17:02 [Lorena] cerebellar ataxia crush?
21:17:34 [Lorena] romberg sign or somthing like that
21:17:40 [acestep1] hmm i thought post col defect
21:17:43 [sweta_med] ya
21:17:45 [crusher] its post romberg test. due to loss of propioception on closing eye..b12 def
21:17:47 [ninadnashua] because of inc rease permeability of capillaries to dala
21:17:56 [hutals] Petechiae, purpura, and fever , gi bleed
21:18:10 [crusher] while in cerebellar dis there is neg rombergs test
21:18:37 [hutals] rhomberg sign...agree
21:18:49 [Lorena] ok thanx
21:19:00 [hutals] sorry i'm late on that, was looking up HUS
21:19:22 [crusher] TTP?
21:19:29 [crusher] or HUS
21:19:41 [acestep1] np hutals
21:19:46 [Lorena] HUS caused by EHEC in kids younger than 5 yo, thrombocytopenia
21:19:51 [hutals] someone asked about symptoms of HUS i think
21:20:08 [Lorena] yes ninad did
21:20:24 [acestep1] agree with lor
21:20:31 [ninadnashua] ya me
21:20:40 [Lorena] hemolytic anemia too and neurological symptoms
21:20:56 mle1 enters this room
21:21:03 [Lorena] renal failure...death
21:21:15 [hutals] this was a real one.....what type of mutation seen in CML?
21:21:33 [sweta_med] 922
21:21:43 [Lorena] philadelphia chromosome
21:21:46 [sweta_med] philadelphia chr
21:21:46 [mle1] t9,22
21:22:08 [hutals] for CML, remember the t9,22, so translocation of 9 to 22....very good!
21:22:33 [hutals] chrom 22 is the philidelphia chrom...good!
21:23:06 [Lorena] do you guys have a way to remember the other 2 translocations ?
21:23:06 [mle1] bcr-abl gene seen in all people with cml
21:23:23 [hutals] would you have greater than or less than 30% blasts in CML
21:23:47 [hutals] good point mle1
21:24:02 [Lorena] greater than huts
21:24:09 [sweta_med] less
21:24:34 [mle1] i think more than 30%blasts in blast crisis.
21:25:04 [hutals] acute (AML) has lots of blasts (>30%) whereas chronic (CML) has <30%
21:25:43 [Lorena] ok
21:26:02 [mle1] oh,o.k
21:26:14 [acestep1] agree with hutals
21:26:21 crusher exits from this room
21:26:24 [hutals] which leukemia has smudge cells?
21:26:39 [sweta_med] waht is the diagmostic enzyme
21:26:42 [Lorena] so by age , most common leukemia between 15-39 yo?
21:27:06 [hutals] AML for 15 to 39
21:27:39 [Lorena] yes
21:27:51 [hutals] smudge cells seen in CLL
21:28:26 [Lorena] what are they?
21:28:38 [hutals] pic of smudge cells http://www.wadsworth.org/chemheme/heme/microscope/smudgecell.htm
21:29:02 [Lorena] cool
21:29:54 [hutals] thats a pretty good site for path slides
21:30:15 [Lorena] fantastic
21:30:43 [hutals] sweta, diagnostic enzymes in what?
21:30:44 [Lorena] where do you see starry sky appearance , what is the sky and what are the stars?
21:31:29 [hutals] is it burkitts
21:31:47 [sweta_med] sorry i got disconnected
21:32:06 [Lorena] yes
21:32:20 [sweta_med] diagnostic enzyme for CML is leucocytealk phosphate
21:32:40 [sweta_med] phosphatase
21:33:14 [Lorena] small lymphocytes (neoplastic cells) are interpersed with larger histiocytes (normal cells-benign macrophages)
21:34:00 acestep1 enters this room
21:34:32 [hutals] only pic i could find on starry sky...will keep looking for better one.... http://www.ncl.ac.uk/pathology/teaching/lectures/lympho/bcell/sld049.htm
21:35:22 [Lorena] thank you huts
21:35:35 [sweta_med] i need to go guys
21:35:45 [sweta_med] see ya tomorrow
21:35:58 crusher enters this room
21:36:31 [mle1] lap decreased in cml?
21:36:32 [Lorena] see you tomorrow sweta
21:36:45 [hutals] http://www.fda.gov/OHRMS/DOCKETS/AC/01/slides/3743s1_07_hutchinson/sld021.htm a little better, but not great
21:37:02 [hutals] nite sweta
21:37:15 [mle1] o.k, sweta ,bye.
21:37:34 [Lorena] alkaline phosphatase
21:37:43 [hutals] didnt get the question mle?
21:38:12 [Lorena] LAP it is decreased
21:38:19 [crusher] LAp score is dec in CML and Inc in leukamoid reaction
21:39:10 [hutals] you mean the alk phos?
21:39:22 [Lorena] what bacteria can cause a leukemoid reaction?
21:39:53 [hutals] what is LAP...sorry I should probably know this
21:40:31 [Lorena] leukocyte alkaline phosphatase... nio prob huitals, it happens to me all the time
21:40:38 [crusher] leukocyte alkanine phosphate
21:40:59 [hutals] ah, ok.....thanks
21:41:16 [ninadnashua] tb whooping cough
21:42:05 [Lorena] B.pertussis
21:42:56 [ninadnashua] ya
21:43:21 [Lorena] why people with polycithemia vera have pruritus and incresed risk for ulcers?
21:45:56 [Lorena] because release of histamine by basophils , also plethora
21:45:56 [ninadnashua] because of parasites diseases
21:46:15 mle1 enters this room
21:46:25 [ninadnashua] ok
21:46:48 [mle1] sorry guys was having problems getting conected
21:46:50 acestep1 enters this room
21:47:00 [ninadnashua] ya got it
21:47:04 [Lorena] no problem mle
21:47:20 [ninadnashua] also bilesalt accumulates
21:47:56 [acestep1] ya same here . im getting dc
21:48:06 [hutals] good point, the hyperhistinema can explain the pruritis and also histamine stimulates gastric acid causing PUD
21:48:13 [mle1] in polycythemia there is histaminemia,which in turn caues pruritus.
21:48:39 [acestep1] k
21:48:47 [Lorena] how is erythropoyetin in PVera?
21:49:24 [acestep1] dec / normal
21:49:28 [hutals] low erythropoietin
21:49:49 [Lorena] yes
21:50:38 [mle1] low
21:51:07 [Lorena] auer rods, what are they and in which condition are they found?
21:51:14 [hutals] remember the 4 H's of PRV.....Hypervolume, Hypervisiscosity, hyperuricemia, histaminemia
21:51:16 [mle1] coz of increased rbc&inc oxygen content.
21:51:35 [hutals] found in AML
21:52:07 [Lorena] yes
21:53:46 [Lorena] see you tomorrow, i gotta go
21:54:06 [Lorena] is someone posting the transcript?
21:54:06 [mle1] bye lorena.
21:54:15 [acestep1] k . tc lor
21:54:30 [hutals] i gotta go too,
21:54:43 [Lorena] tc too ace , talk to you all tomorrow
21:54:47 [hutals] was anyone here from beginning who didnt lose connection?
21:54:57 [acestep1] same here
21:55:09 [acestep1] thnx lor
21:55:10 [Lorena] i do, this time for sure
21:55:10 [hutals] lorena, can you post to now?
21:55:24 [Lorena] ok hutals, i will post it now
21:55:29 [Lorena] byeeeee
21:55:44 [hutals] thanks, bye lor
21:55:54 [hutals] nite everyone
19:59:24 >[Lorena] Welcome to our chat. Please obey the net etiquette while chatting: try to be pleasant and polite.
20:01:13 hutals enters this room
20:01:58 [hutals] hey lor
20:04:04 [Lorena] hi hutals
20:04:10 [Lorena] how are you?
20:04:53 [hutals] i'm good, how bout you?
20:05:03 [Lorena] fine thanks
20:06:58 [hutals] i'm still listening to goljans heme lecture coz i didnt get a chance to go over it earlier
20:07:48 [Lorena] same here, i have guests so could not study
20:07:55 acestep1 enters this room
20:08:21 [acestep1] hey guys
20:08:33 [hutals] oh, i know how that is.....but always good to take a break
20:08:38 [hutals] hey ace
20:08:38 [Lorena] hi ace
20:08:58 [acestep1] hi lor n hutals
20:09:09 [acestep1]
20:09:38 [acestep1] same here . had a sleep prob am still v sleepy
20:09:42 ash enters this room
20:10:16 [ash] hi sorry i havent read for today
20:10:22 [acestep1] hey ash
20:10:28 [Lorena] i will just follow you guys with my book
20:10:33 [ash] hi ace
20:10:45 [Lorena] hi ash
20:10:47 [ash] thats what i was going to do
20:10:54 [ash] hi lorena
20:11:09 [hutals] hey ash
20:11:11 [ash] hi hutals
20:11:23 [acestep1] good idea lor
20:12:02 [hutals] i was still listening to the lectures cause didnt get to read too
20:12:21 [ash] if you dont mind i am keeping my book open today
20:12:27 [acestep1] ya .same here hutals but i never read up these days
20:12:42 [Lorena] lol, it seems nobody feels ready for today's chat
20:13:00 [acestep1] sure. np - ash
20:13:26 [ash] name some drugs causing aplastic anemia
20:13:46 [hutals] parvo isnt a drug, but that causes it
20:13:48 [acestep1] . no buts lets study . im sure well help out each other
20:13:48 [Lorena] chloramphenicol
20:14:08 [ash] agree with ace
20:14:21 [hutals] phenylbutazone
20:14:25 [ash] atleast i will go through the book that way
20:14:28 [Lorena] yes, even with the books open, we learn like that
20:14:32 [acestep1] antifit medication - cbz
20:14:46 [acestep1] yes agree
20:15:02 [ash] let me give you the list i have your answers are right
20:15:04 [acestep1] also antica drugs i think
20:15:19 [acestep1] k
20:15:19 [hutals] i agree, this is a good way to go through the material in the book rather than just reading....it sticks better this way
20:15:34 [Lorena] yes, and it is fun
20:15:37 ninadnashua enters this room
20:15:48 [acestep1] yes
20:15:51 [hutals] hey nina
20:16:01 [Lorena] hi ninad , nice to see you
20:16:03 [ninadnashua] hi
20:16:12 [ash] alkylating agents,antimetabolites,benzene,chloramphenicol,phe nylbutazone,sulfonamides,methylphenylhydantoin
20:16:28 [ash] hi ninad
20:16:32 [Lorena] gold
20:16:35 [ninadnashua] thanku lorena same here
20:16:48 [acestep1] hi nina
20:16:50 [ninadnashua] hi
20:16:58 [hutals] whats the most common cause (mcc) of folate def?
20:17:11 [ninadnashua] hiall
20:17:13 [ash] alcoholism
20:17:43 [ash] last cell to disappear by folate treatment?
20:17:57 [hutals] yep, alcoholics. would a beer drinking alcoholic have folate defciency?
20:18:17 [Lorena] no
20:18:28 [Lorena] beer has folate
20:18:45 [ash] wow i didnt know that
20:18:46 [hutals] yep, thats right lorena
20:19:15 [acestep1] hey i thought prep was teh mcc for folate def
20:19:29 [acestep1] imean pregnancy
20:19:45 [acestep1] hey guys brb in 5 mins
20:19:53 [Lorena] acording to <a target=new HREF=http://www.amazon.com/exec/obidos/external-search?tag=valuetheplace-20&keyword=Goljan&mode=books>Goljan</A> alcoholism is MCC
20:19:58 [Lorena] opps
20:20:08 [Lorena] sorry about that
20:20:11 [acestep1] ic
20:20:18 [ash] but anyways folate is given in pregnancy as supplement and hence we dont see the deficiency
20:20:25 [hutals] not according to golijan. i would imagine that pregnancy only includes a certain population whereas alcoholics are across the boards
20:20:54 [acestep1] k
20:21:07 [Lorena] ok
20:21:17 [hutals] what are other causes of folate def? what type of anemia
20:21:23 [acestep1] illcheck this out cuz i think in other bks they mention preg as teh mcc
20:21:42 [ash] why do we see increased serum ldh in folate deficiency?
20:21:53 [acestep1] old ppl- tea n toast diet , malabsp synd
20:22:00 [Lorena] some drugs like methrotexate , sulfas, the anemia is megaloblastic
20:22:02 [ash] macrocytic anemia
20:22:11 [acestep1] megaloblastic anemia
20:22:39 [acestep1] agree with lor
20:22:44 [ash] phenytoin and also celiac disease and malignancy
20:22:58 [hutals] otheryep, those are all causes, dont forget birth control pills too
20:23:14 [ash] also birth control pills
20:23:28 [acestep1] k
20:23:45 [ash] why raised serum LDH in folate def.?
20:23:52 [hutals] seems no way around that.....folate def seen in both preg and those trying not to get pregnant???
20:24:28 [acestep1] lol
20:24:36 [hutals] dont know ash?
20:24:37 [acestep1] brb
20:24:48 [Lorena] because destruction of RBC
20:24:53 [hutals] k
20:25:51 [Lorena] is that it ash?
20:25:56 [ash] a woman 50 yrs old,with waxy complexion ,blue eyes and premature greying of hairon vegan diet.anemia?
20:26:11 [ash] right lorena
20:26:32 [hutals] i dont see the relation?
20:26:42 [hutals]
20:26:45 [Lorena] i read it , soit means everytime you have destruction of cells you will have incresed LDH?
20:27:13 [Lorena] i guess because of the membrane contains cholesterol
20:27:40 [hutals] ok, that makes more sense. thanks
20:28:22 [ash] a man with right sided lower abdominal pain ,fever,string sign of kantor on x ray will most likely suffer from what anemia if hhis iron intake is good?
20:28:25 [Lorena] vegan diet ...megaloblastic anemia?
20:29:15 [Lorena] anemia of chronic disease
20:29:18 [ash] lorena can you be more specific?
20:29:57 [hutals] pernicious anemia?
20:30:15 [ash] right hutals
20:30:47 [ash] intrinsic factor deficiency.lorena is also right
20:31:06 [ash] as it is vegan diet it will be b12 def
20:31:20 [Lorena] ok thanx i'll try to be more specific
20:31:41 crusher enters this room
20:31:45 [hutals] where will you see howell jolly bodies?
20:31:50 [hutals] hey crush
20:31:54 [crusher] hiall.
20:32:04 [crusher] aplenic pateints
20:32:14 [acestep1] g6pd def
20:32:16 [ash] the man with abd. pain has crohns disease which involves terminal ileum and therefore b12 deficiency
20:32:26 [ash] hi crusher
20:32:46 [Lorena] post splenectomy or autosplenectomy
20:32:58 [ash] splenectomy,
20:33:00 [hutals] howell jolly bodies means spleen surgicall removed or dysfunctional spleen like in sickle cell dis. ...good
20:33:00 [ninadnashua] hi crush
20:33:01 [Lorena] hi crush
20:33:20 [Lorena] what are they howell jolly bodies?
20:33:52 [hutals] ace, heinz bodies for G6PD
20:33:54 sweta_med enters this room
20:34:00 [ash] nuclear remnants
20:34:12 [sweta_med] hi everyone
20:34:24 [Lorena] hi sweta
20:34:29 [Lorena] yes ash
20:34:32 [ash] hi sweta
20:34:36 [hutals] http://www.wadsworth.org/chemheme/heme/microscope/howelljolly.htm for pic of HJ bodies
20:34:55 [hutals] hey sweta
20:34:58 [ninadnashua] hi sweta
20:35:03 [crusher] degraded rbcs fragments??
20:35:10 [Lorena] thanks
20:35:11 [ash] why do you get b12 def. in chronic pancreatitis?
20:35:49 [hutals] problem cleaving R factor
20:36:01 [ash] good hutals
20:36:01 [sweta_med] malabsorption due to low bile salts
20:36:02 [Lorena] because you lack some of the enzymes
20:36:27 [sweta_med] ok
20:37:09 [Lorena] R factor is given by saliva and you need the ez to cleave it off
20:37:36 [sweta_med] and also intrinsic factor
20:37:51 [ash] right lorena
20:39:04 [Lorena] diferential diagnosis betweenanemia by deff folate or def B12?
20:39:08 [sweta_med] IFbinds with b12 after it is cleaved off
20:39:12 [hutals] pt with hemolytic anemia post dapson and aspirin....diagnosis?
20:39:30 [sweta_med] treatment for the two differ
20:39:42 [sweta_med] g6pd def
20:39:55 [hutals] B12 has neurological symptoms
20:40:06 [Lorena] yes G6PD def
20:40:33 [ash] also methylmalonicaciduria is seen in b12 def
20:40:36 [hutals] give both folate and B12 to make sure you cover the neurological symptoms which may become permanent if not treated
20:40:53 [sweta_med] and FIGLU in folate def]
20:41:04 [hutals] yep, G6PD def
20:41:10 [Lorena] yes and also in vit B12 def has methylmalonil aciduria
20:41:20 [hutals] dapsone is a sulfur drug used in leprosy
20:42:21 [sweta_med] what infection causes aplastic anemia
20:42:35 [hutals] the other high yield sulfa drug for boards is the TMP SMX used in HIV pts to tx PCP
20:42:36 [Lorena] PARVOVIRUS
20:42:40 [hutals] parvo
20:42:47 [crusher] parvo virus
20:43:05 [crusher] B19..
20:43:08 [sweta_med] and also nanb hepatitis
20:44:02 [Lorena] ok
20:44:11 [hutals] causes of osteomyolitis in sickle cell disease?
20:44:25 [sweta_med] salmonella
20:44:36 [Lorena] salmonella
20:45:42 [hutals] staph aureus is MCC of osteomyolitis in normal and sickle cell disease, but sicklers are prone to have salmonella causing osteomyolitis as well....good
20:45:47 [sweta_med] whatis th treatment for thalassemia
20:46:01 [ash] when do you find shift cells in the blood
20:46:02 [crusher] what kindof anemiainmalignancy?
20:46:24 [sweta_med] hypoproliferative
20:46:44 [Lorena] in maliganncy is anemia of chronic disease
20:46:52 [ash] anemia of chronic disorder
20:47:21 [hutals] severe thal requires transfusions
20:47:39 [hutals] the minor requires no treatment
20:47:56 [Lorena] agree with hutals
20:48:17 [sweta_med] yes
20:48:20 [crusher] for alpha thalasemia nothing.for beta blood trans
20:48:49 [hutals] what about B thal minor crusher?
20:48:54 [crusher] yes anemia of chronic dis in malgnacy..very good
20:49:21 [ninadnashua] cause of the sideroblastic anemia
20:49:23 acestep1 enters this room
20:49:36 [hutals] lead
20:49:39 [sweta_med] lead poisonins, alcohol
20:49:57 [hutals] working in battery factory
20:49:59 [Lorena] piridoxine deficiency
20:50:01 [sweta_med] pyridoxine def,alkylating drugs
20:50:06 [acestep1] sorry guys my comp froze
20:50:07 [ninadnashua] ya
20:50:12 mle1 enters this room
20:50:25 [hutals] no prob ace....good to have u back
20:50:30 [hutals] hey mle1\
20:50:43 [sweta_med] hi mle1
20:50:45 [acestep1] thnx hutals
20:50:47 [mle1] Hey guys
20:50:49 [Lorena] welcome back ace
20:50:59 [Lorena] hi mle
20:51:12 [ninadnashua] also b6 defeciency
20:51:17 [mle1] Hi
20:51:45 [acestep1] thnx lor
20:51:58 [sweta_med] what is the cause of bloodloss anemia in > 50yrs male
20:52:29 [Lorena] you have to suspect colon cancer
20:52:47 [ash] agree with lorena
20:52:52 hutals exits from this room
20:52:55 hutals exits from this room
20:53:03 hutals enters this room
20:53:06 [acestep1] agree with lor
20:53:14 [hutals] oops
20:53:38 [Lorena] i just saw hutals jumping to another room
20:53:46 [sweta_med] welcome back hutals
20:55:20 [hutals] don't lean on the door, i just fell through by accident
20:55:32 [Lorena] lol
20:56:08 [hutals] what is the buzz word for the cells seen in thalasemia
20:56:08 [acestep1] lol
20:56:23 [sweta_med] target cells
20:56:28 [Lorena] target cells
20:56:44 [ninadnashua] teardrop cells
20:56:50 [hutals] yep, target cells.....tear drop cells too i think
20:56:57 [sweta_med] tear drop cells are also
20:57:11 [Lorena] why a **** with sickle cell symptoms start after 6 months of age?
20:57:27 [acestep1] agree with hutals - also micrcytic anemia
20:57:31 [sweta_med] because the HBF dec
20:57:37 [acestep1] hbf
20:57:43 [crusher] cos of HbF
20:57:52 [Lorena] i didnt know that thanks sweta and hutals
20:57:53 [hutals] pic of teardrop cells here http://www.wadsworth.org/chemheme/heme/microscope/teardrop.htm
20:58:09 [sweta_med] what are the symptoms
20:58:53 [hutals] because of HbF....i agre
20:59:23 [Lorena] hemolytic anemia, infections, painful vascular oclusions
20:59:40 [crusher] low oxygen tension lead to painful vascular crisis
20:59:48 [hutals] pic of target cells here http://www.wadsworth.org/chemheme/heme/microscope/targetcells.htm
21:00:15 [sweta_med] aplastic crisis,leg ulcers, priaopism
21:00:16 [Lorena] what is the most common anemia in african americans?
21:00:31 [crusher] dactiltis,,,osteomylitis
21:00:38 [sweta_med] thalassemia
21:01:08 [ninadnashua] b
21:01:10 [crusher] G6 Ph..def..hemolytic
21:01:15 mle1 enters this room
21:01:33 [mle1] sorry guys
21:01:40 [hutals] welcome back mle1
21:01:54 [mle1] Thanks
21:01:58 [Lorena] iron deficiency .... if it says genetic anemia then it is sickle cell
21:02:23 [sweta_med] its sickle cell anemia
21:02:49 [mle1] microcytic anemia, with normal hb seen in?
21:03:13 [Lorena] iron deficiency
21:03:22 [crusher] iron defi
21:03:24 [sweta_med] siderblastic
21:04:05 [crusher] microcytic hypochromic=uiron def
21:04:27 [ninadnashua] microcytic a
21:05:41 [Lorena] patient has gastrectomy...what kind of anemia can be present?
21:05:53 [sweta_med] macrocytic
21:06:21 [hutals] iron deficiency
21:06:24 [Lorena] yes
21:06:26 [crusher] n def
21:06:41 [crusher] iron def cos fe absorb in duod
21:06:55 [sweta_med] ok
21:07:22 [crusher] while b12 in ileum
21:07:29 [ninadnashua] cause of fe defeciency in newborn
21:07:32 [crusher] n folate in jejunum
21:07:33 [Lorena] iron is reabsorbed in duodenum
21:07:56 [hutals] meckels
21:08:05 [sweta_med] iron def
21:08:05 [crusher] breast feeding??
21:08:18 [ninadnashua] ya meckels
21:08:25 [sweta_med] iroon def
21:08:35 mle1 enters this room
21:08:53 [hutals] nina, can you use a brighter color, hard to read dark text?
21:09:10 [Lorena] why meckels? because of bleeding?
21:09:32 [sweta_med] yes
21:09:52 [Lorena] ok thanx sweta
21:09:59 [ninadnashua] ok
21:10:06 [hutals] thanks nina
21:10:19 [sweta_med] what are the symptoms of intravascular hemolysis
21:10:19 [ninadnashua] np
21:10:43 [hutals] iron deficiency in elderly pt....most common cause?
21:10:55 [Lorena] where did ace go?
21:10:56 [mle1] colon cancer
21:11:03 [ninadnashua] rdwindex high in which microcytic a?
21:11:06 [sweta_med] coloncan
21:11:20 [mle1] iron def?
21:11:21 [sweta_med] iron def
21:11:25 [crusher] malignancy colon ca
21:11:38 [ninadnashua] ya iron defe
21:11:42 [hutals] yep mle and sweta, its colon cancer for elderly.
21:12:01 [Lorena] intravascular hemolysis = hemoglobinuria?
21:12:08 [crusher] iron def in less 50 year women ??
21:12:13 [hutals] ace was having connection problems
21:12:15 [sweta_med] and low haptoglobin
21:12:25 [hutals] ulcer
21:12:26 [Lorena] metrorragia
21:12:28 [sweta_med] menorrhagia
21:12:32 [mle1] hemosiderinuria after some time
21:12:36 [crusher] yes menorrahgia
21:12:54 [hutals] oops, male under 50 would be ulcers...sorry
21:13:09 [Lorena] how about bilirrubin? how is it in intravascular hemolysis?
21:13:18 [sweta_med] unconjugates
21:13:27 [crusher] gi or ulcer is mcc over all
21:13:37 [mle1] elevated&unconjugated?
21:13:58 [crusher] intravascular hemolysisfat saluble=uncongugated
21:13:58 acestep1 enters this room
21:14:12 [mle1] du more commom than gastric ulcer.
21:14:21 [sweta_med] what is the characteristic of a spherocyte
21:14:42 [Lorena] no area of central pallor
21:14:55 [sweta_med] yes lor
21:15:01 [mle1] disc like&smaller size&no cental pallor.
21:15:01 [hutals] agree with lor
21:15:02 [acestep1] agree
21:15:14 [sweta_med] and also loss of biconcave disc
21:15:33 [acestep1] yes
21:15:35 [ninadnashua] hus what r symtoms
21:16:09 [crusher] a person ask to close the eyehe fall down on closing the eye.what is that defect n test called
21:16:13 [sweta_med] anemia , jaundice and splenomegaly
21:16:21 [mle1] triad of fevr, jaundice&anemia.
21:16:28 [Lorena] anemia, splenomegaly
21:16:35 [ninadnashua] cerebral edema in children?
21:16:43 [mle1] oops splenomegaly too.
21:16:47 [acestep1] wht abt rf n neurological s/s
21:16:56 [ninadnashua] ya
21:17:02 [Lorena] cerebellar ataxia crush?
21:17:34 [Lorena] romberg sign or somthing like that
21:17:40 [acestep1] hmm i thought post col defect
21:17:43 [sweta_med] ya
21:17:45 [crusher] its post romberg test. due to loss of propioception on closing eye..b12 def
21:17:47 [ninadnashua] because of inc rease permeability of capillaries to dala
21:17:56 [hutals] Petechiae, purpura, and fever , gi bleed
21:18:10 [crusher] while in cerebellar dis there is neg rombergs test
21:18:37 [hutals] rhomberg sign...agree
21:18:49 [Lorena] ok thanx
21:19:00 [hutals] sorry i'm late on that, was looking up HUS
21:19:22 [crusher] TTP?
21:19:29 [crusher] or HUS
21:19:41 [acestep1] np hutals
21:19:46 [Lorena] HUS caused by EHEC in kids younger than 5 yo, thrombocytopenia
21:19:51 [hutals] someone asked about symptoms of HUS i think
21:20:08 [Lorena] yes ninad did
21:20:24 [acestep1] agree with lor
21:20:31 [ninadnashua] ya me
21:20:40 [Lorena] hemolytic anemia too and neurological symptoms
21:20:56 mle1 enters this room
21:21:03 [Lorena] renal failure...death
21:21:15 [hutals] this was a real one.....what type of mutation seen in CML?
21:21:33 [sweta_med] 922
21:21:43 [Lorena] philadelphia chromosome
21:21:46 [sweta_med] philadelphia chr
21:21:46 [mle1] t9,22
21:22:08 [hutals] for CML, remember the t9,22, so translocation of 9 to 22....very good!
21:22:33 [hutals] chrom 22 is the philidelphia chrom...good!
21:23:06 [Lorena] do you guys have a way to remember the other 2 translocations ?
21:23:06 [mle1] bcr-abl gene seen in all people with cml
21:23:23 [hutals] would you have greater than or less than 30% blasts in CML
21:23:47 [hutals] good point mle1
21:24:02 [Lorena] greater than huts
21:24:09 [sweta_med] less
21:24:34 [mle1] i think more than 30%blasts in blast crisis.
21:25:04 [hutals] acute (AML) has lots of blasts (>30%) whereas chronic (CML) has <30%
21:25:43 [Lorena] ok
21:26:02 [mle1] oh,o.k
21:26:14 [acestep1] agree with hutals
21:26:21 crusher exits from this room
21:26:24 [hutals] which leukemia has smudge cells?
21:26:39 [sweta_med] waht is the diagmostic enzyme
21:26:42 [Lorena] so by age , most common leukemia between 15-39 yo?
21:27:06 [hutals] AML for 15 to 39
21:27:39 [Lorena] yes
21:27:51 [hutals] smudge cells seen in CLL
21:28:26 [Lorena] what are they?
21:28:38 [hutals] pic of smudge cells http://www.wadsworth.org/chemheme/heme/microscope/smudgecell.htm
21:29:02 [Lorena] cool
21:29:54 [hutals] thats a pretty good site for path slides
21:30:15 [Lorena] fantastic
21:30:43 [hutals] sweta, diagnostic enzymes in what?
21:30:44 [Lorena] where do you see starry sky appearance , what is the sky and what are the stars?
21:31:29 [hutals] is it burkitts
21:31:47 [sweta_med] sorry i got disconnected
21:32:06 [Lorena] yes
21:32:20 [sweta_med] diagnostic enzyme for CML is leucocytealk phosphate
21:32:40 [sweta_med] phosphatase
21:33:14 [Lorena] small lymphocytes (neoplastic cells) are interpersed with larger histiocytes (normal cells-benign macrophages)
21:34:00 acestep1 enters this room
21:34:32 [hutals] only pic i could find on starry sky...will keep looking for better one.... http://www.ncl.ac.uk/pathology/teaching/lectures/lympho/bcell/sld049.htm
21:35:22 [Lorena] thank you huts
21:35:35 [sweta_med] i need to go guys
21:35:45 [sweta_med] see ya tomorrow
21:35:58 crusher enters this room
21:36:31 [mle1] lap decreased in cml?
21:36:32 [Lorena] see you tomorrow sweta
21:36:45 [hutals] http://www.fda.gov/OHRMS/DOCKETS/AC/01/slides/3743s1_07_hutchinson/sld021.htm a little better, but not great
21:37:02 [hutals] nite sweta
21:37:15 [mle1] o.k, sweta ,bye.
21:37:34 [Lorena] alkaline phosphatase
21:37:43 [hutals] didnt get the question mle?
21:38:12 [Lorena] LAP it is decreased
21:38:19 [crusher] LAp score is dec in CML and Inc in leukamoid reaction
21:39:10 [hutals] you mean the alk phos?
21:39:22 [Lorena] what bacteria can cause a leukemoid reaction?
21:39:53 [hutals] what is LAP...sorry I should probably know this
21:40:31 [Lorena] leukocyte alkaline phosphatase... nio prob huitals, it happens to me all the time
21:40:38 [crusher] leukocyte alkanine phosphate
21:40:59 [hutals] ah, ok.....thanks
21:41:16 [ninadnashua] tb whooping cough
21:42:05 [Lorena] B.pertussis
21:42:56 [ninadnashua] ya
21:43:21 [Lorena] why people with polycithemia vera have pruritus and incresed risk for ulcers?
21:45:56 [Lorena] because release of histamine by basophils , also plethora
21:45:56 [ninadnashua] because of parasites diseases
21:46:15 mle1 enters this room
21:46:25 [ninadnashua] ok
21:46:48 [mle1] sorry guys was having problems getting conected
21:46:50 acestep1 enters this room
21:47:00 [ninadnashua] ya got it
21:47:04 [Lorena] no problem mle
21:47:20 [ninadnashua] also bilesalt accumulates
21:47:56 [acestep1] ya same here . im getting dc
21:48:06 [hutals] good point, the hyperhistinema can explain the pruritis and also histamine stimulates gastric acid causing PUD
21:48:13 [mle1] in polycythemia there is histaminemia,which in turn caues pruritus.
21:48:39 [acestep1] k
21:48:47 [Lorena] how is erythropoyetin in PVera?
21:49:24 [acestep1] dec / normal
21:49:28 [hutals] low erythropoietin
21:49:49 [Lorena] yes
21:50:38 [mle1] low
21:51:07 [Lorena] auer rods, what are they and in which condition are they found?
21:51:14 [hutals] remember the 4 H's of PRV.....Hypervolume, Hypervisiscosity, hyperuricemia, histaminemia
21:51:16 [mle1] coz of increased rbc&inc oxygen content.
21:51:35 [hutals] found in AML
21:52:07 [Lorena] yes
21:53:46 [Lorena] see you tomorrow, i gotta go
21:54:06 [Lorena] is someone posting the transcript?
21:54:06 [mle1] bye lorena.
21:54:15 [acestep1] k . tc lor
21:54:30 [hutals] i gotta go too,
21:54:43 [Lorena] tc too ace , talk to you all tomorrow
21:54:47 [hutals] was anyone here from beginning who didnt lose connection?
21:54:57 [acestep1] same here
21:55:09 [acestep1] thnx lor
21:55:10 [Lorena] i do, this time for sure
21:55:10 [hutals] lorena, can you post to now?
21:55:24 [Lorena] ok hutals, i will post it now
21:55:29 [Lorena] byeeeee
21:55:44 [hutals] thanks, bye lor
21:55:54 [hutals] nite everyone