02/3/05 19:14:46 [USMLE_Step_2] sanz: hey naz and lanny
02/3/05 19:14:55 [USMLE_Step_2] lanny: hey finally you guys are here hey sanz
02/3/05 19:14:57 [USMLE_Step_2] Naz1234: Hi welcom
02/3/05 19:15:08 [USMLE_Step_2] sanz: no chat today?
02/3/05 19:15:15 [USMLE_Step_2] Naz1234: Why not ?
02/3/05 19:15:21 [USMLE_Step_2] lanny: thought for a minute we had it off today
02/3/05 19:15:33 [USMLE_Step_2] sanz: i dont know... normally there would be a lto of ppl... hehe
02/3/05 19:15:54 [USMLE_Step_2] lanny: yes lets give them a few mins
02/3/05 19:15:57 [USMLE_Step_2] Naz1234: Guess u r right
02/3/05 19:15:58 [USMLE_Step_2] sanz: what's the topic anyway?
02/3/05 19:16:22 [USMLE_Step_2] Naz1234: Ped neuro??
02/3/05 19:16:47 [USMLE_Step_2] lanny: i hought it was peds: immun allergy poison finish neuro
02/3/05 19:16:55 [USMLE_Step_2] sanz: i just checked... endo heam/onc
02/3/05 19:17:13 [USMLE_Step_2] sanz: but we can do neuro as well if you want... we hardly touched neuro yesterday...
02/3/05 19:18:24 [USMLE_Step_2] sanz: naz, did you do kaplan q bank?
02/3/05 19:18:47 [USMLE_Step_2] Naz1234: Yes I did I am doing UW now
02/3/05 19:19:01 [USMLE_Step_2] sanz: which is better?
02/3/05 19:19:14 [USMLE_Step_2] lanny: sorry stepped away whwt are we doing
02/3/05 19:19:16 [USMLE_Step_2] Naz1234: I like Uw much better
02/3/05 19:19:34 [USMLE_Step_2] Naz1234: How about you ?
02/3/05 19:19:39 [USMLE_Step_2] sanz: ok... i just finsihed UW
02/3/05 19:19:48 [USMLE_Step_2] sanz: i dont know if i should do kap Qbank...
02/3/05 19:19:48 [USMLE_Step_2] Naz1234: Score ??
02/3/05 19:19:53 [USMLE_Step_2] lanny: any diff bet q book the white and nlue one and the new yellow col one Nybody?
02/3/05 19:20:07 [USMLE_Step_2] sanz: i thought maybe i should do QBank rather than just IM Qbank...
02/3/05 19:20:21 [USMLE_Step_2] sanz: i ended up with just 62.5%... quite disappointed really
02/3/05 19:20:32 [USMLE_Step_2] Naz1234: Q book is good
02/3/05 19:20:34 [USMLE_Step_2] sanz: lanny i dont know
02/3/05 19:20:48 [USMLE_Step_2] Naz1234: 62 % is a good score
02/3/05 19:21:10 [USMLE_Step_2] lanny: as far as UW i am taking it tutorial like, will be starting kap q bank soon for testing
02/3/05 19:21:15 [USMLE_Step_2] sanz: do you know how much correlation roughly?
02/3/05 19:21:55 [USMLE_Step_2] Naz1234: I don't believe this correlation ,really !!
02/3/05 19:22:04 [USMLE_Step_2] sanz: lanny... i plan to do kap qbank maybe next week
02/3/05 19:22:07 [USMLE_Step_2] lanny: me too.
02/3/05 19:22:11 [USMLE_Step_2] sanz: naz, i know...
02/3/05 19:22:23 [USMLE_Step_2] sanz: when are you guys taking the exams? mine's on the 9th march
02/3/05 19:22:27 [USMLE_Step_2] Naz1234: Lanny do u agree with me ?
02/3/05 19:22:56 [USMLE_Step_2] lanny: yes i dont think correlation is imp,, it could give you false confidence
02/3/05 19:22:56 [USMLE_Step_2] Naz1234: Mine is in march
02/3/05 19:23:07 [USMLE_Step_2] lanny: end of march for me
02/3/05 19:23:08 dua_frank Logs in
02/3/05 19:23:09 dua_frank Joins Subroom USMLE_Step_2
02/3/05 19:23:11 [USMLE_Step_2] dua_frank: hi all
02/3/05 19:23:18 [USMLE_Step_2] lanny: hey lateeee
02/3/05 19:23:20 [USMLE_Step_2] Naz1234: hello
02/3/05 19:23:33 [USMLE_Step_2] lanny: dua whats on today
02/3/05 19:23:33 [USMLE_Step_2] sanz: hey dua
02/3/05 19:23:34 [USMLE_Step_2] dua_frank: sorry lanny, cooking dinner
02/3/05 19:23:48 [USMLE_Step_2] dua_frank: strug's missing
02/3/05 19:23:55 [USMLE_Step_2] lanny: i know i understand just kidding better late than never
02/3/05 19:24:14 [USMLE_Step_2] dua_frank: those are words to console losers but thanks anyway :P
02/3/05 19:24:27 [USMLE_Step_2] dua_frank:
02/3/05 19:24:55 [USMLE_Step_2] dua_frank: please remind me, what are the topics for today?
02/3/05 19:24:58 [USMLE_Step_2] dua_frank: neuro and?
02/3/05 19:25:00 [USMLE_Step_2] lanny: youre not a loser dua we all depend on each other its been good
02/3/05 19:25:15 [USMLE_Step_2] lanny: thought it was immuno and allergy poison
02/3/05 19:25:17 [USMLE_Step_2] dua_frank: i was just kidding lanny :P
02/3/05 19:25:19 [USMLE_Step_2] dua_frank: oh
02/3/05 19:25:23 [USMLE_Step_2] lanny: finsh neuro
02/3/05 19:25:35 [USMLE_Step_2] dua_frank: did we?
02/3/05 19:25:40 [USMLE_Step_2] dua_frank: ive lost track of topics
02/3/05 19:25:54 [USMLE_Step_2] sanz: ok... let's start with neuro?
02/3/05 19:25:59 [USMLE_Step_2] lanny: sanz said something else sanz whats today again?
02/3/05 19:26:22 [USMLE_Step_2] sanz: a kid with facial neveus upp lip... and now presenting with seizures...
02/3/05 19:26:34 [USMLE_Step_2] sanz: what is the diagnostic test?
02/3/05 19:26:38 [USMLE_Step_2] dua_frank: tuberous sclerosis?
02/3/05 19:26:45 [USMLE_Step_2] dua_frank: CT
02/3/05 19:27:10 [USMLE_Step_2] lanny: sturge weber
02/3/05 19:27:17 [USMLE_Step_2] sanz: CT is correct... but the dx is sturge weber... faial nevus
02/3/05 19:27:20 [USMLE_Step_2] dua_frank: oh yeah
02/3/05 19:27:29 [USMLE_Step_2] sanz: what do u see on CT?
02/3/05 19:27:41 [USMLE_Step_2] dua_frank: tuberous sclerosis was adenoma on face
02/3/05 19:27:43 [USMLE_Step_2] lanny: calcify
02/3/05 19:28:09 [USMLE_Step_2] lanny: intracranial calcif on CT
02/3/05 19:28:09 [USMLE_Step_2] sanz: yup
02/3/05 19:28:30 [USMLE_Step_2] sanz: the facial nevus usu involve trigeminal area
02/3/05 19:28:53 [USMLE_Step_2] sanz: what are they at risk of developing?
02/3/05 19:29:14 [USMLE_Step_2] lanny: not sure
02/3/05 19:29:18 [USMLE_Step_2] sanz: glaucoma
02/3/05 19:29:28 [USMLE_Step_2] lanny: maybe seizure
02/3/05 19:29:41 [USMLE_Step_2] sanz: yeah, and mental retardation as well
02/3/05 19:29:57 [USMLE_Step_2] lanny: seizure correct sanz
02/3/05 19:31:02 [USMLE_Step_2] sanz: we're all very quiet today... hehe
02/3/05 19:31:17 [USMLE_Step_2] lanny: ans my question sanz is yeah means seizure is correct
02/3/05 19:31:40 [USMLE_Step_2] lanny: naz where are you....
02/3/05 19:31:48 [USMLE_Step_2] sanz: lanny, correct
02/3/05 19:32:26 Naz1234 Logs Out
02/3/05 19:32:38 [USMLE_Step_2] lanny: Naz give your answer we learn from wrong ans as wlell... we correct each other if doubts
02/3/05 19:32:51 [USMLE_Step_2] lanny: oh he left
02/3/05 19:32:56 [USMLE_Step_2] sanz: she
02/3/05 19:33:19 [USMLE_Step_2] lanny: oh never knew her is this her first chat sanz
02/3/05 19:33:36 naz1234 Logs in
02/3/05 19:33:37 naz1234 Joins Subroom USMLE_Step_2
02/3/05 19:33:47 [USMLE_Step_2] lanny: guess dua is still cooking
02/3/05 19:33:56 [USMLE_Step_2] sanz: 2 yr old kid with hypotonia, no deep tendon reflex, nystagmus and slurred speech...
02/3/05 19:33:57 [USMLE_Step_2] sanz: Dx?
02/3/05 19:34:37 [USMLE_Step_2] sanz: she also has not been 'walking right' acording to mum
02/3/05 19:34:48 [USMLE_Step_2] lanny: werdnig hoffman
02/3/05 19:34:58 [USMLE_Step_2] lanny: not sure maybe wrong
02/3/05 19:35:13 [USMLE_Step_2] sanz: it's metchromic leukodystrophy
02/3/05 19:35:21 [USMLE_Step_2] sanz: defect of...?
02/3/05 19:35:24 [USMLE_Step_2] lanny: oh krabbes
02/3/05 19:36:11 [USMLE_Step_2] lanny: galactisode
02/3/05 19:36:16 edy1234 Logs in
02/3/05 19:36:25 [USMLE_Step_2] sanz: arylsulphatase...
02/3/05 19:36:36 edy1234 Joins Subroom Clinical_Skills
02/3/05 19:36:43 [USMLE_Step_2] lanny: oh is it the same as krabbes
02/3/05 19:36:44 [USMLE_Step_2] sanz: i dont do well with these white matter lesions...
02/3/05 19:36:45 edy1234 Logs Out
02/3/05 19:37:05 [USMLE_Step_2] sanz: it's not... krabbes presents very early
02/3/05 19:37:11 [USMLE_Step_2] lanny: me too i just mem them for st 1
02/3/05 19:37:17 [USMLE_Step_2] sanz: in the first few months
02/3/05 19:37:55 [USMLE_Step_2] sanz: with seizures... and it's due to galactosidase def
02/3/05 19:38:15 [USMLE_Step_2] lanny: thx
02/3/05 19:38:56 [USMLE_Step_2] dua_frank: shall we go over them once?
02/3/05 19:39:04 [USMLE_Step_2] dua_frank: i mean just to get them all right once
02/3/05 19:39:12 [USMLE_Step_2] lanny: ok
02/3/05 19:39:17 [USMLE_Step_2] sanz: sure...
02/3/05 19:39:26 [USMLE_Step_2] lanny: as much as i can remeber
02/3/05 19:39:32 [USMLE_Step_2] sanz: as far as i kow, there're 3 degenerative white matter dz
02/3/05 19:39:33 [USMLE_Step_2] lanny: did them year ago
02/3/05 19:39:57 [USMLE_Step_2] sanz: metachromic, krabbe amd adrenoleukodystrophy
02/3/05 19:40:24 [USMLE_Step_2] dua_frank: give me a minute, trying to find them
02/3/05 19:40:31 [USMLE_Step_2] sanz: krabbe has early presentation...
02/3/05 19:40:31 [USMLE_Step_2] lanny: ok
02/3/05 19:40:48 [USMLE_Step_2] sanz: and ALD is late... like 5 yr and abv
02/3/05 19:41:11 [USMLE_Step_2] sanz: MLD can be either...
02/3/05 19:41:30 [USMLE_Step_2] lanny: yes krabbe is early remeber it like sounds like creep babys creep
02/3/05 19:41:48 [USMLE_Step_2] sanz: lol lanny
02/3/05 19:42:18 [USMLE_Step_2] lanny: yea have my own silly mnemonics
02/3/05 19:42:37 [USMLE_Step_2] dua_frank: i'll never forget that now
02/3/05 19:42:58 [USMLE_Step_2] lanny: i think also krabbes dont live past infancy?
02/3/05 19:43:32 [USMLE_Step_2] lanny: mean past childhood
02/3/05 19:43:57 [USMLE_Step_2] sanz: 14 yr old girl came in with gait abn, claw hands and decreased sensation in hands and foot... dx?
02/3/05 19:44:55 [USMLE_Step_2] lanny: mental retard?any
02/3/05 19:45:11 [USMLE_Step_2] sanz: it's hereditary motor sensory neuropathy...
02/3/05 19:45:16 [USMLE_Step_2] sanz: sorry i know these are hard...
02/3/05 19:45:28 [USMLE_Step_2] sanz: no mental retardation
02/3/05 19:45:38 [USMLE_Step_2] lanny: where you get them from
02/3/05 19:45:43 [USMLE_Step_2] lanny: thanks
02/3/05 19:45:46 [USMLE_Step_2] sanz: kaplan
02/3/05 19:45:58 [USMLE_Step_2] sanz: the is also known as charco marie tooth
02/3/05 19:46:11 [USMLE_Step_2] sanz: and it's the most common genetic neuropathy
02/3/05 19:46:42 [USMLE_Step_2] lanny: oh yea
02/3/05 19:47:36 [USMLE_Step_2] lanny: which is seen inspina bifida anorld1 or 2
02/3/05 19:48:18 [USMLE_Step_2] sanz: 2
02/3/05 19:48:43 mmw Logs in
02/3/05 19:48:52 mmw Joins Subroom USMLE_Step_1
02/3/05 19:49:01 mmw Joins Subroom USMLE_Step_2
02/3/05 19:49:23 [USMLE_Step_2] lanny: infant botulism presentation
02/3/05 19:49:40 [USMLE_Step_2] sanz: descending paralysis
02/3/05 19:49:46 [USMLE_Step_2] sanz: GI constipation
02/3/05 19:49:52 [USMLE_Step_2] sanz: hypotonia and poor feeding
7:49 PM [lanny] all corecet
7:50 PM [lanny] good sanz seems like its two of us here today
7:50 PM [sanz] what nevers are most affected in charcot marie tooth?
7:50 PM [lanny] not sure feet nerves maybe tibial peroneal?
7:50 PM [sanz] yup
7:51 PM [sanz] and on biopsy what is the charc?
7:51 PM [sanz] ans is onion bulb formation...
7:51 PM [lanny] know its nerve bio[sy but dont know what is seen
7:52 PM [lanny] oh thx
7:52 PM [lanny] wanna cont neuro so boring
7:53 PM [sanz] hehe
7:53 PM [lanny] go ahead if you have more ques.sanz
7:53 PM [sanz] i dont
7:53 PM [lanny] immuno is more interst and commonly asked
7:53 PM [sanz] ok.. shoot
7:53 PM [lanny] i tinking
7:54 PM naz1234 has left the chat.
7:54 PM [lanny] ok MC humoral antib def.
7:54 PM [sanz] bruton?
7:55 PM [lanny] no
7:55 PM [lanny] try again
7:55 PM [sanz] SCID?
7:55 PM [lanny] IGA
7:55 PM mmw has joined subroom: USMLE_Step_1
7:55 PM [sanz] Ig A def?
7:55 PM [lanny] yep most comm
7:56 PM [sanz] kid with recurrent sino pulm infection... also has ataxia
7:56 PM [lanny] ataxia teleang
7:56 PM [sanz] yup!
7:56 PM [sanz] hey huli
7:56 PM [huli72] Hi, sanz
7:57 PM [lanny] what chromosome def
7:57 PM [sanz] ask us questions!
7:57 PM [sanz] i think it's 11... but not too sure
7:57 PM [lanny] right
7:57 PM [lanny] two words like two nos..mnemonic
7:57 PM [sanz] it's both humorla and cellular def
7:58 PM [lanny] yep a BandT cell def
7:58 PM [lanny] why do they screen blood for igZ
7:58 PM [lanny] sorrt IGA
7:58 PM [lanny] sorryIgA
7:59 PM [sanz] cuz they have low Ig A?
7:59 PM [lanny] and can dev antibodies can cause anaphylactic and death!!!
7:59 PM [huli72] pt can be anaphylax to IGA if deficieny
7:59 PM [sanz] oh yeah... thnx guys
7:59 PM [lanny] many people are IgA def hence Most comm
8:00 PM [huli72] and Ig G2?
8:00 PM [lanny] yes they occur together
8:00 PM [lanny] many people with Ig a def have IG G2 too
8:01 PM [lanny] which IG cross placenta
8:01 PM [huli72] igG
8:01 PM [sanz] Ig G
8:01 PM [lanny] correct which subclass
8:02 PM mmw has left the chat.
8:02 PM [sanz] Ig G 2
8:02 PM [lanny] right and 4
8:02 PM [sanz] triad of wiskott?
8:02 PM [huli72] eczema
8:02 PM [huli72] immuno deficiency
8:02 PM [lanny] wow thank god some of this is still in my head!!!
8:02 PM [huli72] log plt
8:02 PM [huli72] low plt
8:02 PM [lanny] whats this huli
8:03 PM [sanz] yup huli got it
8:03 PM [lanny] oh low plate
8:03 PM [huli72] platelet
8:03 PM [lanny] got it
8:03 PM [sanz] x linked and low ig M
8:03 PM [lanny] yep
8:04 PM [lanny] diff transit hypogamma and bruton
8:04 PM [sanz] what's that lanny?
8:04 PM [lanny] diff diag transit hypogamma and brutoin
8:04 PM [huli72] bruton: X linked, severe, without improve by 2 years old
8:05 PM [sanz] starts at 6 mth
8:05 PM [huli72] transit: occur at 6 month - 1 year, improve at later
8:05 PM [lanny] both right actually age is best diag factor < 6 mths transit .....
8:05 PM [sanz] did they improve?
8:06 PM [huli72] transit improves
8:06 PM [lanny] transit improves after 6 mths
8:06 PM [huli72] are you sure it is after 6 month?
8:06 PM [lanny] bruton need immunogob thoy
8:06 PM [huli72] I think it is too early
8:06 PM [sanz] it's usu after 6 mth when maternal IgM wears off...
8:06 PM [sanz] i mean IgG
8:07 PM [lanny] transit improves after 6 mths when the bABY IS MAKING SUFF AMTS OF IMMUNO
8:07 PM [huli72] you are right, sanz
8:07 PM [huli72] I think it is they improve later than 6 month
8:07 PM [lanny] huli after 6 mths.
8:08 PM [huli72] they begin to have symptoms of IG deficiency at 6 month
8:08 PM [lanny] around 6 mths mums ig wear off baby kicks in
8:09 PM [sanz] kis with recurrent sinusitis and diarrhoea due to cyrptosporidium... low levels of Ig G, A and E... dx?
8:09 PM [lanny] before 6 mtns
8:09 PM [sanz] lanny, i dont think the bruton kids can make Ig...
8:10 PM [sanz] they rely on mum's IgG and after 6mth when they are gone, they start to have inf...
8:10 PM [lanny] thats what i said before yes but mums start waning before 6 mths not exactly at 6 mths
8:12 PM [lanny] it cannot be after cause at that time they can now make their own Immune
8:12 PM [huli72] which chromasome problem for bruton?
8:12 PM [sanz] dont know huli
8:12 PM [lanny] X chrom
8:12 PM [huli72] 22
8:12 PM [sanz] oh ok
8:13 PM [lanny] oh short arm of 22 youre right
8:13 PM [huli72] q22 of X chroma
8:13 PM [sanz] anyway, the ans to my q was hyper IgM syndr
8:13 PM [huli72] lanny is correct
8:13 PM [huli72] sorry, my mistake
8:14 PM [huli72] what is the molecular problem with bruton?
8:14 PM [sanz] tyrosine kinase problems
8:14 PM [sanz] cannt make Ig
8:15 PM [huli72] no
8:15 PM [lanny] def in b lymphos
8:16 PM [huli72] sorry, you are right, sanz, it is tyrosine kinase problem
8:16 PM [lanny] answer huli
8:16 PM [huli72] pre-B cell failed to differentiate to B cells
8:16 PM [huli72] due to a mutation in the gene codeing for tyrosine kinase
8:17 PM [sanz] thnx huli
8:17 PM [sanz] is there any use in giving these kids vaccine?
8:18 PM [sanz] ans is no... cuz they cant mount a response since they cant make B cells
8:18 PM [lanny] ni will think so but itdepends on live or killed attenuated vaccs
8:18 PM [lanny] i will not think so
8:18 PM [sanz] how do kids with chr granulomatous dz present?
8:19 PM lanny has left the chat.
8:19 PM [huli72] chronic granuloma
8:19 PM [sanz] hehe yeah
8:20 PM [lanny] staph e coli infs
8:20 PM [sanz] ans staph aureus and ecoli inf
8:20 PM [huli72] T B lymphocytes deficiency
8:20 PM [sanz] pneumonia
8:20 PM [sanz] huli, they're defect of phagocytes... not t and b cell
8:20 PM [lanny] are you asking a ques huli?
8:20 PM [lanny] agree with sanz
8:20 PM [huli72] no, lanny, I am answering sanz's q
8:21 PM [huli72] but I got it wrong
8:21 PM [lanny] ok..
8:21 PM [sanz] is vaccine recomended fort hem?
8:21 PM [lanny] its a defect in neutrophil phagocytizind
8:21 PM [huli72] yea'
8:21 PM [huli72] yes
8:21 PM [sanz] yup, cuz they have normal B and T cell to mount a response
8:22 PM [lanny] agree
8:23 PM [huli72] presentation of Ig G sybclass deficiency?
8:23 PM [sanz] recurrent encapsulated inf
8:24 PM [huli72] and normal growth
8:24 PM [sanz] oh oke
8:24 PM [lanny] usu have sinus and pulm infs
8:24 PM [sanz] they usu have IgA def too
8:24 PM [lanny] yes
8:24 PM [huli72] yeah, sanz
8:25 PM [sanz] guys tell me more abt chediak higashi... i dont know much abt it
8:25 PM [huli72] how is the total ig G level?
8:25 PM [sanz] low huli?
8:25 PM [huli72] no
8:25 PM [sanz] normal?
8:25 PM [huli72] yes
8:25 PM [huli72] surprised?
8:25 PM [sanz] but the subclass 2 will be low
8:25 PM [huli72] yes
8:25 PM [lanny] another defect in phagocytic function
8:25 PM [sanz] huli...good one
8:26 PM [huli72] ha ha
8:26 PM [sanz] how do they present?
8:26 PM [lanny] they have pyogenic infs.
8:26 PM [lanny] staph and strep
8:26 PM [lanny] they can be albinos too
8:27 PM [huli72] chediak: deficiet in lysosome fusing to..
8:27 PM [lanny] the phagocytes have deficient lysosomes
8:28 PM usmle_guy has left the chat.
8:28 PM [sanz] ok
8:28 PM [huli72] lysosome can't fuse with bugs due to cytosckeletal problem
8:29 PM [huli72] so, bugs still inside the neutrophils and live well
8:29 PM [lanny] which of the immune def is been trted with gene thpy?
8:29 PM [sanz] SCID
8:29 PM [sanz] adenosine something...
8:29 PM [lanny] good know this!!!!!!!
8:29 PM [huli72] adenosine diamimase defici
8:29 PM [sanz] thnx huli ...
8:30 PM [lanny] its a new technique 3 yrs old
8:30 PM [sanz] huli, coming back to chediak... what is the diff then from CGD?
8:30 PM [huli72] do they still do gene treatment?
8:30 PM [lanny] in scid yes
8:31 PM [sanz] the bugs live well in neurtrophils CGD too right?
8:31 PM [huli72] CGD due to peroxidase problem
8:31 PM [sanz] ok
8:31 PM [lanny] they cant phagoctze the bugs
8:31 PM [huli72] no bleach in neutrophil
8:32 PM [lanny] yes
8:32 PM [sanz] NADP oxidase lacking..
8:32 PM [huli72] they both can phagoctze the bugs
8:32 PM [sanz] but in chediak... it's lysosomes... yeah?
8:32 PM [lanny] yes
8:32 PM [huli72] CGD can' t kill staph only
8:32 PM [lanny] nad microtubules
8:33 PM [lanny] and
8:33 PM [lanny] not only dtaph e coli too
8:33 PM [huli72] yeah, for sure, it is lysosome
8:33 PM [sanz] ok
8:33 PM [sanz] thnx
8:33 PM [lanny] child with hypocalcemia/
8:34 PM [sanz] di george
8:34 PM [lanny] cong hear defect what diag
8:34 PM [lanny] right
8:34 PM [lanny] which immuno has candida probs only
8:35 PM [sanz] di george?
8:35 PM [lanny] chronic mucocutaneous candidiasis
8:35 PM [lanny] t cell prob
8:35 PM [sanz] di george can have candidiasis right? cuz it's also t cell def
8:36 PM [lanny] yes but chr muco is specificaaly for candid
8:36 PM [sanz] oh ok
8:36 PM [huli72] no deaf in de Georgia
8:36 PM [lanny] no
8:37 PM [lanny] lets do some allergy
8:37 PM [huli72] oh
8:38 PM [lanny] also common peds quetions
8:38 PM [lanny] sanz wanna shoot
8:38 PM zoya has left the chat.
8:38 PM [sanz] what conditions are considered atopy?
8:39 PM [lanny] you mean symtoms?
8:39 PM [sanz] yup... i'll start... asthma
8:39 PM [huli72] erythematous, pruritic rash
8:39 PM [lanny] allergic rhinitis
8:39 PM [lanny] hives
8:39 PM [huli72] weepy patch
8:40 PM [sanz] yup
8:40 PM [sanz] good
8:40 PM [sanz] contact dermatitis is what type of hypersen?
8:40 PM [huli72] 4
8:40 PM [lanny] type4
8:40 PM [sanz] yup
8:40 PM [huli72] how to trt atopy dermatitis?
8:41 PM [sanz] 1% steroid cream
8:41 PM [huli72] yes
8:41 PM [lanny] temprature control
8:41 PM [huli72] and
8:41 PM [lanny] bathings
8:41 PM [sanz] distribution of atopic derm?
8:41 PM [huli72] bathing less
8:41 PM [lanny] extensors of upper arms
8:41 PM [huli72] antihistime
8:42 PM [huli72] cheeks,neck,
8:42 PM [huli72] wrist
8:42 PM [lanny] when do we use steroids in rash
8:42 PM [huli72] hand
8:42 PM [sanz] trunk, necks, arms... but sparing the nappy areas
8:42 PM [sanz] complication?
8:42 PM [lanny] nappy areas is.....?
8:42 PM [huli72] when there is rash
8:42 PM [sanz] lanny... where the nappy is! hehe
8:42 PM [sanz] i mean diapers
8:43 PM [lanny] i know ..meant what kind of allergic prob in nappy area....
8:43 PM [lanny] contact derm
8:43 PM [huli72] thanks, lanny
8:43 PM [sanz] oh ok
8:44 PM [lanny] nurse put on gloves, take off skin rash itch whatis dx
8:44 PM [dua_frank] can i ask congenital infections and other infecs in peds?
8:45 PM [dua_frank] or is that for another day?
8:45 PM [huli72] allergy to rubber
8:45 PM [sanz] shoot dua...
8:45 PM [sanz] i thought you were gone... hehe
8:45 PM [lanny] yes neonatal day is day after tom
8:45 PM [dua_frank] triad of toxo?
8:46 PM [dua_frank] i was.. ate my dinner and came back
8:46 PM [huli72] chorerenitis, periventricular calci,
8:46 PM [sanz] chorioretinitis... calification
8:46 PM [lanny] im going off to eat soon....
8:46 PM [sanz] and hepatosplenome
8:46 PM [huli72] thanks, sanz
8:46 PM [huli72] I forget
8:46 PM [dua_frank] chorioret, intracranial calcs and hydrocephalus
8:47 PM [sanz] welcome huli... we all do
8:47 PM [dua_frank] Dx of toxo?
8:47 PM [sanz] serology
8:48 PM [dua_frank] yes
8:48 PM [dua_frank] Ig G levels, PCR of WBCS
8:48 PM [dua_frank] TX?
8:49 PM [sanz] cant remember
8:49 PM [sanz] hehe
8:49 PM [huli72] erythr?
8:49 PM [sanz] TMP?
8:49 PM [dua_frank] pyrimethamine and sulfadiazine
8:49 PM [sanz] TMP-SMX
8:49 PM [sanz] oh oke
8:49 PM [dua_frank] thats for pnemocystis carinii
8:49 PM [sanz] TMP-SMX is prophylaxis for PCP and toxo
8:49 PM [dua_frank] which is more dangerous, toxo inf in first trimester or last?
8:50 PM [sanz] 1st
8:50 PM [dua_frank] yes but as second line therapy i think or first?
8:50 PM [dua_frank] yes first
8:50 PM [dua_frank] blueberry muffin rash with PDA in?
8:50 PM [sanz] rubella
8:50 PM [huli72] agree
8:50 PM [dua_frank] good girl :P
8:50 PM [dua_frank] DX?
8:51 PM [sanz] hehe... mpre qs dua i love them
8:51 PM [huli72] serology?
8:51 PM [dua_frank] huli be specific
8:51 PM [dua_frank] i'm looking for Igs
8:51 PM [sanz] IgG
8:51 PM [dua_frank] igM
8:51 PM [dua_frank] and isolation of the virus from throat, urine and csf
8:51 PM [sanz] oh yeah ... igG is mum's and chr... not acute
8:51 PM [dua_frank] yes
8:52 PM [dua_frank] so how is rubella treated?
8:52 PM [sanz] immunisation to prevent
8:52 PM [dua_frank] yes but if infected?
8:52 PM [huli72] no effective trt
8:53 PM [huli72] ig G
8:53 PM [lanny] trt is supportive
8:53 PM [sanz] symptomatic?
8:53 PM [lanny] yes
8:53 PM [dua_frank] yes passive protection can be given with immune serum globulin within 7 days after exposure
8:53 PM [sanz] and immunise mum
8:53 PM [dua_frank] after that no treatment
8:54 PM [dua_frank] there is no treatment i mean
8:54 PM [dua_frank] presentation of CMV?
8:54 PM [lanny] rubella roseola rubeola are usu supportive trts
8:54 PM [sanz] i suppose i'm wrong... mum dont need to get immunised since she's got the infection already and sh'll have natural Ab
8:55 PM [dua_frank] yes
8:55 PM [sanz] interventr calfi... chorioretinitis cataract
8:55 PM [huli72] chorenitis, hepatospemagly, intracranial calci
8:55 PM [sanz] hepatspl
8:55 PM [sanz] jaundice
8:55 PM [dua_frank] which is the most frequent manifestation of CMV infection?
8:55 PM [sanz] lung
8:55 PM [huli72] jaundice?
8:56 PM [dua_frank] microcephaly
8:56 PM [dua_frank] 70% of them have this
8:56 PM [sanz] thnx dua
8:56 PM [sanz] the thing to diff between toxo and CMV calci?
8:56 PM [dua_frank] welcome sanz, i learn a lot from you guys, i feel obliged to contribute some too
8:56 PM [dua_frank] good question, i don't know
8:56 PM [huli72] the location of calci
8:56 PM [dua_frank] oh cals
8:56 PM [sanz] appreciate it dua... the more qs the better!
8:57 PM [dua_frank] periventricular
8:57 PM [huli72] for CMV
8:57 PM [dua_frank] intracerebral in toxo
8:57 PM [sanz] CMV is perventricular
8:57 PM [dua_frank] yes
8:57 PM [sanz] toxo is more intracranial
8:57 PM [dua_frank] tx of toxo?
8:57 PM [sanz] pyri and salfa
8:57 PM [huli72] pyrimethamine salfa
8:57 PM [dua_frank] tx of cmv i mean *)
8:58 PM [sanz] acyy
8:58 PM [huli72] gancyclvir
8:58 PM [sanz] acyclovir
8:58 PM [lanny] ok guys lanny is feeling hungry, will be back and forth while i make dinner ...if i miss you see you tomorrow
8:58 PM [dua_frank] yes gan
8:58 PM [sanz] oh ok
8:58 PM [dua_frank] and if gan fails then?
8:58 PM [sanz] bye lanny
8:58 PM [sanz] foscarnet
8:58 PM [dua_frank] see you lanny bye bye
8:58 PM [dua_frank] good sanz
8:58 PM [huli72] foscarnet
8:59 PM [dua_frank] most neonatal herpes is caused by which type?
8:59 PM [sanz] 2
8:59 PM [huli72] 2
8:59 PM [dua_frank] yes
8:59 PM [dua_frank] DX?
8:59 PM [sanz] tanck smear?
9:00 PM [dua_frank] good
9:00 PM [dua_frank] what does it show?
9:00 PM [sanz] intranuclear stuff?
9:00 PM [sanz] hehe
9:00 PM [dua_frank] yes
9:00 PM [huli72] big cells
9:00 PM [dua_frank] more like inclusion bodies :P
9:00 PM [dua_frank] intranuclear though yes :P
9:00 PM [sanz] that sounds a lot more intelligent dua!
9:00 PM [dua_frank] i give you 0.5% mark :P
9:01 PM [sanz] hehe
9:01 PM [dua_frank] tx?
9:01 PM [sanz] acyclorvir
9:01 PM [dua_frank] yes
9:01 PM [dua_frank] herpetic keratitis?
9:01 PM [dua_frank] tx i mean
9:01 PM [sanz] huli and dua, what nicknames do you guys go by in usmle net forum?
9:01 PM [huli72] Mimi
9:02 PM [sanz] acyc droplets?
9:02 PM [sanz] mine is SS
9:02 PM [dua_frank] i don't write much there, i am dua and i think ive posted only two messages in 4 months there :P
9:02 PM [huli72] I don't post much now
9:02 PM [dua_frank] topical idoxuridine
9:02 PM [dua_frank] do you give steroids?
9:02 PM [huli72] ohh,
9:02 PM [sanz] no
9:03 PM [huli72] no steroids
9:03 PM [dua_frank] yes you do
9:03 PM [sanz] really? i thought contraindicated...
9:03 PM [dua_frank] in optic lesions but only after prior abs therapy
9:03 PM [huli72] why?
9:03 PM [dua_frank] never topical
9:03 PM [dua_frank] only optic lesions
9:04 PM [sanz] what is idoxuridine?
9:04 PM [dua_frank] mucocutaneous lesions, persistent rhinitis, osteochondritis disease?
9:04 PM [dua_frank] i have no idea
9:04 PM [dua_frank] i'm just reading from this book for you guys
9:04 PM [sanz] oke.. dont worry
9:04 PM [sanz] thnx dua
9:04 PM [huli72] syphilis?
9:04 PM [dua_frank] welcome
9:04 PM [dua_frank] yes
9:05 PM [dua_frank] early congenital syphilis
9:05 PM [dua_frank] appears within 2 weeks of life
9:05 PM [dua_frank] when is it late cong syphilis?
9:05 PM [huli72] >2 years
9:06 PM [dua_frank] after 4 weeks of birth and can take years
9:06 PM [dua_frank] manifestations?
9:06 PM [dua_frank] at least 3 big ones
9:06 PM [sanz] with all sorts of funny things like sabre tooth and hutchison shins ?
9:06 PM [huli72] bone lession
9:06 PM [dua_frank] yes
9:06 PM [dua_frank] hutchinson teeth, saddle nose, saber shins
9:07 PM [sanz] hehehe
9:07 PM [sanz] i got it all mixed up
9:07 PM [dua_frank] am i confusing you sanz?
9:07 PM [sanz] no...
9:07 PM [huli72] you are clear
9:07 PM [dua_frank] ok good
9:07 PM [sanz] i'm already pretty muddled up there on my own ... u're v good
9:07 PM [dua_frank] just remember that a snuffles and lymphnodes is early
9:07 PM [dua_frank] bones and teeth late
9:08 PM [dua_frank] lol
9:08 PM [dua_frank] no nerves affected in early
9:08 PM [dua_frank] what are the nerves affected in late?
9:09 PM [sanz] dont know
9:09 PM [dua_frank] eighth
9:09 PM [huli72] posterior colume
9:09 PM [sanz] i just checked the BNF... idoxuridine is an antiviral
9:09 PM [huli72] III
9:09 PM [dua_frank] deafness, vertigo and loss of high pitches
9:09 PM [dua_frank] thanks sanz
9:09 PM edy1234 has left the chat.
9:10 PM [huli72] thanks, dua
9:10 PM [dua_frank] so that for herpetic keratitis
9:10 PM [sanz] yup... too toxic for systemic use...
9:10 PM [sanz] only used as topical
9:10 PM [dua_frank] right
9:10 PM [dua_frank] IV acyclo for systemic right?
9:10 PM [dua_frank] and steroids for optic lesions
9:10 PM [dua_frank] only after antiviral therapy though
9:10 PM [dua_frank] hutchinson's triad?
9:11 PM [sanz] didnt say anything abt steriods...
9:11 PM [huli72] dunno
9:11 PM [dua_frank] oh
9:11 PM [dua_frank] deafness, interstitial keratitis and deformed teeth
9:11 PM [huli72] what cause this?
9:12 PM [huli72] dua
9:12 PM [dua_frank] syphilitic triad huli
9:12 PM [sanz] i guess it's the viral effect...
9:12 PM [huli72] thx, dua
9:12 PM [dua_frank] is hutchinson's triad in other words
9:13 PM [dua_frank] what are the dx reliable tests for syphilis?
9:13 PM [sanz] huli, you're not from the UK are you? I have a classmate called Mimi who was thinking of doing USMLE... hehe
9:13 PM [huli72] no, there are several Mimi in usmle
9:13 PM [dua_frank] huli is a girl too?
9:13 PM [huli72] yes
9:13 PM [huli72] so, we all are girls
9:14 PM [dua_frank] lanny's surrounded by girls, he must feel so special
9:14 PM [sanz] girls' power
9:14 PM [dua_frank] lol
9:14 PM [sanz] Dx for syphilis...?
9:14 PM [huli72] penicillin
9:14 PM [huli72] or cefetriaxone
9:14 PM [dua_frank] csf VDRL and RPR tests for cns syphilis
9:15 PM [sanz] oh yeah
9:15 PM [dua_frank] FTA-ABS unreliable
9:15 PM [sanz] FTPA
9:15 PM [dua_frank] whats the definitive test for syphilis?
9:15 PM [huli72] FTA _ABS
9:15 PM [sanz] isnt FTPAb more specific?
9:15 PM [sanz] dark field
9:16 PM [dua_frank] correct
9:16 PM [sanz] is the definitive test
9:16 PM [dua_frank] no mothers ABs might interfere with the test
9:16 PM [dua_frank] so thats why it's unreliable
9:16 PM [huli72] oh, I understand now, thanks, dua
9:16 PM [sanz] oh oke.. so you do dark field for definite dx...
9:17 PM [sanz] good pt dua!
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9:18 PM [dua_frank] lets just say that VDRL in baby even less than 4 months of age are more reliable than FTA
9:18 PM [dua_frank] after two years both are equally good to diagnose syphilis in a baby
9:18 PM [dua_frank] does that make sense?
9:18 PM zoya has left the chat.
9:19 PM [dua_frank] i mean in a 2 yr baby
9:19 PM [dua_frank] because mothers ABs start weaning off after 6 months
9:19 PM [sanz] yeah...
9:19 PM [dua_frank] so within 6 months VDRL more reliable
9:19 PM [dua_frank] ok
9:19 PM [dua_frank] DOC for syphilis?
9:19 PM [sanz] pen
9:19 PM [dua_frank] alternative drug?
9:19 PM [sanz] even for mum who're allergic... they have to be desensitized first
9:20 PM [dua_frank] yes
9:20 PM [dua_frank] alternative drug is erythromycin
9:20 PM usmle_guy has left the chat.
9:20 PM [sanz] ok
9:20 PM clover has left the chat.
9:21 PM mmw has left the chat.
9:21 PM [dua_frank] shall i stop?
9:21 PM [dua_frank] there are a lot more infections left though
9:21 PM [sanz] whatever you want dua...
9:21 PM [dua_frank] infections won't complete today for sure
9:21 PM [dua_frank] there are a lot more
9:21 PM [sanz] i know... so maybe some other time?
9:21 PM [dua_frank] sure, tomorrow
9:22 PM [dua_frank] thanks for today
9:22 PM [sanz] huli?
9:22 PM [huli72] yeah
9:22 PM [sanz] no, thank YOU for the qs... it makes me recall
9:22 PM [huli72] nice to study with you guys
9:22 PM [sanz] huli, i meant whether you want to cont or call it a day?
9:22 PM [dua_frank] same here, i love the study sessions, don't want this to break till the day of my exam
9:23 PM [sanz] aww dua... i guess by contributing we learn ourselves as well...
9:23 PM [dua_frank] two hours in a day is not a lot of time considering how much we cover every day in these two hours. i'm all for it
9:23 PM [huli72] it realy depend on you guys
9:23 PM [sanz] well, the TV is calling me... ER particulary... hehe
9:23 PM [lanny] hi se e you guys are still on
9:24 PM [dua_frank] lol sanz
9:24 PM [huli72] we can add another day at the end of discussion
9:24 PM [dua_frank] yeah lanny, we couldn't leave without saying good bye to you :P
9:24 PM [huli72] for infetion
9:24 PM [sanz] done with yr dinner lanny?
9:24 PM [huli72]
9:24 PM [lanny] actually preparing it..another 10 mins and will be ready
9:24 PM [dua_frank] huli sure
9:24 PM [sanz] actually today was meant for endo and hem/onc peds but we didnt do any of them
9:24 PM [dua_frank] oh?
9:24 PM [sanz] hehe
9:25 PM [huli72] oh
9:25 PM [dua_frank] i could have asked those questions
9:25 PM [huli72] that is OK
9:25 PM [dua_frank] nobody ever tells me the time table for today :P
9:25 PM [dua_frank] i'm sort of lazy to go and read myself :P
9:25 PM [lanny] acc to the schedule today was allergy immuno poisin
9:25 PM [huli72] what is for tomorrow?
9:25 PM [sanz] i never know the schedule
9:25 PM shreya has left the chat.
9:25 PM [sanz] hehehe
9:25 PM [lanny] so tom is hem, onco
9:25 PM [dua_frank] me neither
9:25 PM [dua_frank] lol
9:26 PM [huli72] ha ha ha
9:26 PM [sanz] well, we'll find out tmrw... if not, we'll talk abt whatever we want to talk abt
9:26 PM [sanz] hehe
9:26 PM [dua_frank] strug is the only one who keeps us all organised
9:26 PM [dua_frank] sanz lol
9:26 PM [dua_frank] ok guys see you all tomorrow then
9:26 PM [dua_frank] take care and have a good weekend
9:26 PM [dua_frank] bye
9:26 PM [huli72] see you tomorrow
9:26 PM [lanny] well lets final it now ie tomorrow
9:26 PM [sanz] have a nice evening
9:26 PM [dua_frank] you too
9:27 PM [huli72] have a nice dream
9:27 PM [dua_frank] bye
9:27 PM dua_frank has left the chat.
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9:28 PM lanny has left the chat.
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