virology and immuno chat transcript

[Lorena]

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 &lt;a target=new href=http://click.linksynergy.com/fs-bin/click?id=c97WUMRO5hY&offerid=47491.10002441&type=3 &subid=0 >Kaplan&lt;/a><IMG border=0 width=1 height=1 src=http://ad.linksynergy.com/fs-bin/show?id=c97WUMRO5hY&bids=47491.10002441&type=3&sub id=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 &lt;a target=new href=http://click.linksynergy.com/fs-bin/click?id=c97WUMRO5hY&offerid=47491.10002441&type=3 &subid=0 >Kaplan&lt;/a><IMG border=0 width=1 height=1 src=http://ad.linksynergy.com/fs-bin/show?id=c97WUMRO5hY&bids=47491.10002441&type=3&sub id=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 &lt;a target=new HREF=http://www.amazon.com/exec/obidos/external-search?tag=valuetheplace-20&keyword=Goljan&mode=books>Goljan&lt;/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