mss patho

Question 1

upper limp nerve anatomy + injery ?

Answer 1

5 main nerve?
posterior
1- axilary بلف ع راس الهيمورس=deltoied paralysis loss of sensation and loss of forarm abduction
2-radial wrist+posterior arm only=wrist drop+posterior arm loss of sensation
anterior
3-musculcutanous forarm only=loss of sensation and loss of flextion supply the biceps
4-median=loss of sensation of palm anterior + loss of wrist flextion
5-ulner= loss of sensation over ulner finger + loss of ulner finger add or abd +radial deveation upon flextion

Question 2

Myasthenia gravis deffe +symp?

Answer 2

-deff:Myasthenia gravis is an autoimmune disease that causes a decreased number of functional post synaptic necotinc acetylcholine receptors within the nm junction
-sympكرينيل نيرف واطراف: patient’s fluctuating, fatigable weakness involving the eyes (eg, diplopia, ptosis), bulbar muscles (eg, chewing fatigue,
dysphagia), and proximal extremities is characteristic of myasthenia gravis (MG).

Question 3

scleroderma dxx

Answer 3

-lap:
anti- dna topoisomer
anti-rna polymerase
anti-centromer
clincal=
limted=crest
non limted بكون كريست + اشياء سيستميك رينل وريسبايرتوري ومالير راش

Question 3

Dermatomyocyts dxx

Answer 3

lap:
ck-//ana//-anti jo -// anti srp//-anti mi
clincal:

Question 4

SLE dxx

Answer 4

lap:
1-anti ss dna
2-anri dd dna
3-anti smith
4-ana+cbc
clincal:
طبقات من فوق لتحت
photosensteive
rash +renoied
nurolgical disoreder
hematology cytopenia +immune deppression
arthritis +seroitos

Question 5

RF dxx

Answer 5

ana
cbc
left kft
CRP+ESR
RF+Anti-Cyclic Citrullinated Peptide antibody (anti-ccp) اهم فحوصات بالحياه

Question 6

sugrion dxx

Answer 6

lap:
ana+ rf
anti-la +anti ra

Question 7

Seronegative spondyloarthritis sub type + symptome ?

Answer 7

Arthritis without rheumatoid factor (no anti-IgG antibody). Strong association with HLA-B27
كلهم بيجوا
back pain//perphiral arthritits//dactylitis //uvetits

Psoriatic arthritis=skin psoriasis and nail lesions.+ ductlytis

Ankylosing spondylitis= ankylosis (joint fusion), uveitis, aortic regurgitation.=Symmetric involvement of spine and sacroiliac joint

Inflammatory bowel disease= Crohn disease and ulcerative colitis

Reactive arthritis= conjectivits +urtherits+artheritis

Question 8

Polymyalgia rheumatica

Answer 8

Pain and stiffness in proximal muscles (eg, shoulders, hips), often with fever, malaise, weight loss. Does not cause muscular weakness. More common in females > 50 years old; associated with giant cell (temporal) arteritis.



ESR,  CRP, normal CK.

Question 9

Fibromyalgia

Answer 9

for female 20-50
Chronic, widespread musculoskeletal pain associated
with “tender points,” stiffness, paresthesias, poor sleep, fatigue, cognitive disturbance (“fibro fog”). Normal inflammatory markers like ESR.

Question 10

Polymyositis/ dermatomyositis dxx

Answer 10

lap= anti mi + anti jo + anti srp =الاردن بتسبب جلطه
ana+ ck

-Polymyositis=Progressive symmetric proximal muscle weakness, characterized by ((endomysial inflammation with CD8+ T cells.)) Most often involves shoulders.

-dermatomyositis=Perimysial inflammation and atrophy with CD4+ T cell

Question 11

Polymyositis/ dermatomyositis symp?

Answer 11

-Polymyositis=proximal muscle weakness,

-dermatomyositis=proximal muscle weakness, + Gottron papules A , photodistributed facial

erythema (eg, heliotrope [violaceous] edema of the eyelids B ), “shawl and face” rash C ,

Question 12

Large-vessel vasculitis patho+affected site

Answer 12

giant cell arterits = Focal granulomatous inflammation  ESR. IL-6 levels correlate with disease activity.
affected=temporal artery tenderness,+ May also cause aortitis or vertebral artery infarct.

Takayasu arteritis=Granulomatous thickening and narrowing of aortic arch and proximal great vessels  ESR.
Pulseless disease” (weak upper extremity pulses)

Question 13

Medium-vessel vasculitis patho+affected site

Answer 13

-kwakasiكورنري=May develop coronary artery aneurysms E ; thrombosis or rupture can cause death.
-polyartery nodusaرينل=Different stages of transmural inflammation with fibrinoid necrosis.
Innumerable renal microaneurysms F and spasms on arteriogram (string of pearls appearance).

PAN usually affects the SKIN: Skin, Kidneys, Intestines (GI), Nerves.

Question 14

Large-vessel vasculitis tretment?

Answer 14

poly arterits nodusa=Giant cell (temporal) arteritis= high-dose glucocorticoids prior to temporal artery biopsy to prevent blindness.

Takayasu arteritis=Conjunctivitis, Rash (polymorphous Ž desquamating), Adenopathy (cervical), Strawberry tongue (oral mucositis) D , Hand-foot changes (edema, erythema), fever.

Question 15

Medium-vessel vasculitis symp

Answer 15

Kawasaki disease=Bilateral nonexudative bulbar Conjunctivitis, Rash (polymorphous Ž desquamating), Adenopathy (cervical), Strawberry tongue (oral mucositis) D , Hand-foot changes (edema, erythema), fever.

PAN= Fever, weight loss, malaise, headache.
GI: abdominal pain, melena. Hypertension, neurologic dysfunction, cutaneous eruptions, renal damage.=PAN usually affects the SKIN: Skin, Kidneys, Intestines (GI), Nerves.

Question 16

Small-vessel vasculitis patho + affected site

Answer 16

عددهم 7
-Behçet syndrome=Immune complex vasculitis. Associated with HLA-B51.

-Cutaneous smallvessel vasculitis=Immune complex–mediated leukocytoclastic vasculitis
; late involvement indicates systemic vasculitis.

-Eosinophilic granulomatosis with polyangiitis= 1-Granulomatous, necrotizing vasculitis with eosinophilia

-Granulomatosis with polyangiitis=Focal necrotizing vasculitis ƒ 3-Necrotizing granulomas in lung and upper airway ƒ5- Necrotizing glomerulonephritis

-Immunoglobulin A vasculitis(hsp)=Vasculitis 2° to IgA immune complex deposition.=Associated with IgA nephropathy (Berger disease).
-Microscopic polyangiitis=No granulomas.

-Microscopic polyangiitis=Necrotizing vasculitis commonly involving lung, kidneys, and skin with pauci-immune glomerulonephritis
MPO-ANCA/p-ANCA (anti-myeloperoxidase

-Mixed cryoglobulinemia=Vasculitis due to mixed IgG and IgM immune complex deposition. ==Cryoglobulins are immunoglobulins that precipitate in the Cold.

Question 17

Small-vessel vasculitis symp

Question 18

Common skin disorders

Answer 18

9 احفظ تعريفهم بس
Atopic dermatitis (eczema=Pruritic eruption associated with ichthyosis vulgaris and other atopic diseases (asthma, allergic rhinitis, food allergies);  serum IgE بظهر ع الوجه بعدين ع المفاصل

Allergic contact dermatitis=Type IV hypersensitivity reaction secondary to contact allergen
Keratosis pilaris=Follicular-based papules from keratin plugging, most often on extensor surfaces of arms and thighs.
Melanocytic nevus=Common mole. Benign, but melanoma can arise in congenital or atypical moles. Intradermal nevi are papular F . Junctional nevi are flat macules G .
Pseudofolliculitis barba=Inflammatory reaction to hair penetrating the skin characterized by firm papules and pustules that are painful and pruritic.
Psoriasis =Papules and plaques with silvery scaling H , especially on knees and elbows. Acanthosis with
-parakeratotic scaling (nuclei still in stratum corneum), Munro microabscesses.  stratum spinosum,  stratum granulosum
-Rosacea=Inflammatory facial skin disorder characterized by erythematous papules and pustules J , but no comedones.
-Seborrheic keratosis=Well-demarcated, verrucous, benign squamous epithelial proliferation of immature keratinocytes with keratin-filled cysts (horn cysts) K
Warts; caused by low-risk HPV strains. Soft, tan-colored, cauliflowerlike papules M . Epidermal hyperplasia, hyperkeratosis, koilocytosis. Verrucae=Condyloma acuminatum on anus or genitals N .

Question 19

Pemphigus vulgaris vs Bullous pemphigoid parho + ?

Answer 19

Potentially fatal. Most commonly seen in older adults. Type II hypersensitivity reaction.
IgG antibodies against desmogelin 3 +/desmoglein 1 (component of desmosomes, which connect keratinocytes in the stratum spinosum).

Less severe than pemphigus vulgaris. Most commonly seen in older adults. Type II hypersensitivity reaction.

IgG antibodies against hemidesmosomes (epidermal basement membrane; antibodies are “bullow” the epidermis).

Question 20

Pemphigus vulgaris vs Bullous pemphigoid presentaion?

Answer 20

Pemphigus vulgaris=Flaccid intraepidermal bullae A caused by acantholysis (separation of keratinocytes, “row
of tombstones” on H&E stain); oral mucosa is involved. Nikolsky sign ⊕ .

Bullous pemphigoid =Tense blisters C containing eosinophils; oral mucosa spared. Nikolsky sign ⊝ .

Question 22

Pemphigus vulgaris vs Bullous pemphigoid immune flurence ?

Answer 22

Reticular pattern around epidermal cells B .

Linear pattern at epidermal-dermal junction

.

Question 23

blistering skin disorders patho

Answer 23

Dermatitis herpetiformis=Deposits of IgA at tips of dermal papillae.

Erythema multiforme=Associated with infections (eg, Mycoplasma pneumoniae, HSV), drugs (eg, sulfa drugs, β-lactams, phenytoin

Stevens-Johnson syndrome =associated with adverse drug reaction. Toxic epidermal necrolysis (TEN) D E is more severe form of SJS involving > 30% body surface area. 10–30% involvement denotes SJS-TEN.

Question 24

blistering skin disorders present?

Answer 24

Dermatitis herpetiformis=Pruritic papules, vesicles, and bullae (often found on elbows, knees, buttocks) Erythema multiforme=Presents with multiple types of lesions—macules, papules, vesicles, target lesions (look like targets with multiple rings and dusky center showing epithelial disruption) B . Stevens-Johnson syndrome=Characterized by fever, bullae formation and necrosis, sloughing of skin at dermal-epidermal junction ( ⊕ Nikolsky), high mortality rate. Typically mucous membranes are involved C . Targetoid skin lesions may appear, as seen in erythema multifo