PGMEEnotes: 2006-04-02
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Monday, April 03, 2006

CD4 COUNT in AIDS & Opportunistic infections

PGMEEnotes:-- CD4 COUNT in AIDS & Opportunistic infections

1200 - 700 == normal healthy adults

<500/cmm>Tuberculosis(PTB), Oral or vaginal thrush ,Herpes zoster, Herpes simplex virus, Non-Hodgkins lymphoma

<300/cmm>Thrush (candidal infec.) & Oral Hairy leucoplakia,

250 ==

<250/cmm==Start Anti-Retroviral Therapy (ART) (> 1,00,00 RNA HIV copies) –in india

<200/cmm>Cryptococcal meningoencephalitis, pneumocystis carinii pneumonia, Candida esophagitis

150 ==

<100/cmm>Toxoplasmic encephalitis & CHORIORETINITIS, Cryptococcal meningitis, AIDS dementia, Progressive multifocal leukoencephalopathy(JC virus), Wasting syndrome -- extreme weight loss and anorexia caused by HIV

50 ==

<50 color="=">CMV Retinitis, Mycobacterium avium(MAC)

Sunday, April 02, 2006

TESTS--Part(I)

Hemoglobin A1c (HbA1c) as a diagnostic test for DM .

fFN TEST ----->FETAL FIBRONECTIN..... To assesses the risk of preterm delivery in symptomatic and asymptomatic women.

PT 20210 test ----->Prothrombin 20210 mutation test--->Factor II Mutation/Prothrombin Mutation G20210A --->causes a slight elevation in the prothrombin level-----> venous thrombosis.
Factor V Leiden and Prothrombin 20210 tests are done in hypercoagulability, to help diagnose the cause of venous thromboembolism (VTE). They are used to help determine the reason for an initial thrombotic episode, especially when it occurs in a relatively young person (under 50 years old), is unprovoked, or is in an unusual place such as the liver (hepatic), the kidneys (renal), the brain (cerebral), the pelvis, or in the eye veins. They may also be ordered to investigate multiple miscarriages, especially when they occur in the 2nd or 3rd trimester. It is thought that blood clots may affect the placental veins.

TRIPLE TEST---->best-done b/w 16-20 weeks. MS-AFP, hCG, and estriol. Generally results go as follows: in Trisomy 21, MS-AFP and estriol are decreased but hCG is increased. For Trisomy 18, all three markers are decreased. and in neural tube defects, MS-AFP is increased, the rest are decreased.

Triple + Sr. inhibin= Quadruple test

Adson's test ---a test for thoracic outlet syndrome;
The patient is seated, with head extended and turned to the side of the lesion; with deep inspiration there is a diminution or total loss of radial pulse on the affected side. Syn: Adson maneuver.

Allen’s test--- To test the integrity of palmer arch.

Ascoli's test ----a precipitin test for anthrax using a tissue extract and anthrax antiserum.

Bárány's caloric test = a test for vestibular function, made by irrigating the external auditory meatus with either hot or cold water; this normally causes stimulation of the vestibular apparatus, resulting in nystagmus and past-pointing; in vestibular disease, the response may be reduced or absent. Syn: caloric test, nystagmus tests.

Bender gestalt test = a psychological test to measure a person's ability to visually copy a set of geometric designs; useful for measuring visuospatial and visuomotor coordination to detect brain damage. Syn: Bender Visual Motor Gestalt test.

Benzidine test = a test for blood; the suspected fluid is treated with glacial acetic acid and ether, and the latter is then decanted and treated with hydrogen peroxide and a solution of benzidine in acetic acid; the presence of blood is indicated by a bluish color turning to purple. Syn: Adler's test.

Benedict's test for glucose

Bettendorff's test
a test for arsenic

Marshall test
stress urinary incontinence. Syn: Bonney test, Marshall-Marchetti test.

Breath-holding test
a rough index of cardiopulmonary reserve measured by the length of time that a subject can voluntarily stop breathing; normal duration is 30 seconds or more; diminished cardiac or pulmonary reserve is indicated by a duration of 20 seconds or less.

CAMP test
a test to identify Group B beta-streptococci based on their formation of a substance (CAMP factor) that enlarges the area of HEMOLYSIS formed by streptococcal beta-hemolysin.

Capillary fragility test
a tourniquet test used to determine presence of vitamin C deficiency or thrombocytopenia; a circle 2.5 cm in diameter, the upper edge of which is 4 cm below the crease of the elbow, is drawn on the inner aspect of the forearm, pressure midway between the systolic and diastolic blood pressure is applied above the elbow for 15 minutes, and a count of petechiae within the circle is made: 10, normal; 10 to 20, marginal zone; over 20, abnormal. See Also: Rumpel-Leede test. Syn: capillary resistance test, vitamin C test.

HOMEOBOX GENE

Genes for Regulation of Vertebrate Morphogenesis and r required for positional identity of various structures along the body axis from the branchial area to the coccyx.
Genes at the 3-prime end control the cranial region and are expressed before those at the 5-prime end, which control the caudal region.
The potent teratogen, retinoic acid, can activate these genes prematurely leading to abnormalities in the hindbrain and limb buds.

Valproic acid is believed to preferentially alter the expression of homeobox genes called Hox genes. Disregulation of Hox-gene expression by valproic acid may prevent normal closure of the posterior neuropore . Interestingly, the affected Hox genes, Hox d8, d10, and d11, all control posterior structures. This corresponds with clinical observations that most neural-tube defects caused by valproic acid are in the lumbosacral area.
A homeobox is about 180 base pairs long.
Inshort,Hox genes determine where limbs and other body segments will grow in a developing fetus or larva. Mutations in any one of these genes can lead to the growth of extra, typically non-functional body parts in invertebrates, but usually results in spontaneous abortion in vertebrates. The Hox genes were first found in the fruit fly Drosophila melanogaster .
 

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