prep4usmle
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19:55:03: dxtxpx: Msg:hi niti
19:55:08: niti: Msg:hi dx
19:55:12: dxtxpx: Msg:u here for patho chat
19:55:32: niti: Msg:no,i was just checking
19:55:47: niti: Msg:when are u going to revise immuno.?
19:55:47: dxtxpx: Msg:ok u can stay, meddance and nico will be here shortly
19:55:58: dxtxpx: Msg:dont know
19:56:07: dxtxpx: Msg:we r doin this whole month of patho
19:56:20: dxtxpx: Msg:i have revised immuno coupla days ago on my own
19:56:28: niti: Msg:ok
19:56:39: dxtxpx: Msg:if u want to discuss immuno we can set a time separately
19:57:19: dxtxpx: Msg:hi nico
19:57:26: niti: Msg:yes.i set next wk for immuno..but don't know how many people are ready?
19:57:31: NicoToscani: Msg:hey dx, niti
19:57:32: dxtxpx: Msg:ok
19:57:36: niti: Msg:hi nico
19:57:54: NicoToscani: Msg:m lookn forward 2 your immuno chat
19:58:02: niti: Msg:thanks nico
19:59:21: NicoToscani: Msg:immuno chat starts the 24th right
19:59:35: niti: Msg:25 sep
19:59:38: NicoToscani: Msg:oh
19:59:46: NicoToscani: Msg:time?
19:59:58: niti: Msg:everyday...at 4pm eastern
20:00:07: NicoToscani: Msg:ok
20:00:14: niti: Msg:or whatever time suits u guys?
20:00:47: NicoToscani: Msg:im ok with 4
20:00:52: dxtxpx: Msg:its ok with me 4pm eastern althoough i will be studying more on my own
20:00:59: niti: Msg:ok then.its all set for immuno.
20:01:00: dxtxpx: Msg:hi meddancer
20:01:39: NicoToscani: Msg:hey med
20:01:42: meddancer: Msg:hi guys
20:01:47: niti: Msg:hi med
20:01:50: meddancer: Msg:hi niti
20:02:05: meddancer: Msg:hey nico
20:02:42: meddancer: Msg:did u guys start already
20:02:49: dxtxpx: Msg:no
20:02:51: niti: Msg:you are welcome in immuno. chat starting 25 sep ..4 pm eastern
20:02:52: NicoToscani: Msg:nope, but we're ready to
20:03:03: niti: Msg:ok guys.thank u so much
20:03:10: meddancer: Msg:great niti... i'll try to join
20:03:11: NicoToscani: Msg:hey, thank you for starting it
20:03:11: dxtxpx: Msg:sure niti
20:03:11: niti: Msg:i am doing bio right now
20:03:23: NicoToscani: Msg:me too
20:04:08: niti: Msg:but read your path transcript too..
20:04:27: niti: Msg:will join on 25 sep...till now....BYE
20:04:33: niti: Msg:TILL THEN...
20:04:35: NicoToscani: Msg:c ya
20:04:39: meddancer: Msg:bye niti
20:04:39: dxtxpx: Msg:later
20:04:40: niti: Msg:cia
20:04:50: dxtxpx: Msg:lets start our path discussion then
20:04:58: meddancer: Msg:difference in primary hemostasis vs secondary ( general characteristics) ?
20:05:20: NicoToscani: Msg rimary is bleeding from smaller vsls and capillaries vx larger in secondary
20:05:22: dxtxpx: Msg:defects in initial platellet plug
20:05:24: dxtxpx: Msg:for prim
20:05:33: meddancer: Msg:yes to both
20:05:36: dxtxpx: Msg:just bruising n stuff
20:05:44: dxtxpx: Msg:for secondary bleeding for large vessels
20:05:50: meddancer: Msg:yes dx
20:05:55: NicoToscani: Msgrolonged bleeding time in primary versus normal bleeding time in secondary
20:06:02: meddancer: Msg:great nico
20:06:02: dxtxpx: Msg:def of plasma clotting factors for secondary
20:06:18: meddancer: Msg:which ones dx
20:06:22: dxtxpx: Msg:secondary may have abn PT
20:06:27: NicoToscani: Msgrimary is platelet problem versus coagulation pathway problem in secondary
20:06:40: meddancer: Msg:yuo Nico
20:06:41: dxtxpx: Msg:2, 5,, 7, 9
20:07:12: dxtxpx: Msg:but all clotting factors can b involved
20:07:14: dxtxpx: Msg:exceptions
20:07:16: meddancer: Msg:i thought PT was 2 5 7 10
20:07:27: dxtxpx: Msg:yea
20:07:38: dxtxpx: Msg:TT exceptions r 7 13
20:07:48: meddancer: Msg:yup... dx
20:07:58: dxtxpx: Msg:sorry
20:08:03: dxtxpx: Msg:that was for aPTT
20:08:07: meddancer: Msg:no problem
20:08:09: dxtxpx: Msg:TT is fibrinigen defects
20:08:25: meddancer: Msg:yes thrombin time
20:08:47: dxtxpx: Msg:Christmas disease?
20:08:56: NicoToscani: Msg:factor 9 defic
20:08:57: meddancer: Msg:hemophilia B
20:09:01: dxtxpx: Msg:yes
20:09:06: meddancer: Msg:just like the classic
20:09:10: meddancer: Msg:hard to distinguish
20:09:10: dxtxpx: Msg:yes
20:09:13: dxtxpx: Msg:whats classic
20:09:20: meddancer: Msg:def in 8
20:09:20: dxtxpx: Msg:which factor
20:09:22: dxtxpx: Msg:yes
20:09:24: NicoToscani: Msg:8
20:09:27: meddancer: Msg:x-linked
20:09:27: dxtxpx: Msg:X linked
20:09:37: dxtxpx: Msg:sx for both?
20:09:41: NicoToscani: Msg:therefore increased aPTT
20:09:51: dxtxpx: Msg:yes
20:10:06: NicoToscani: Msg:bleeding into muscles, joints and subcu tissues
20:10:07: meddancer: Msg:bleeding into muscles and joints
20:10:11: dxtxpx: Msg:yes to both
20:10:21: meddancer: Msg:
20:10:27: NicoToscani: Msg:
20:10:32: NicoToscani: Msg:functions of vWF
20:10:52: meddancer: Msg:aggregant of platelets ?
20:10:53: dxtxpx: Msg:carrier protein for 8
20:11:02: dxtxpx: Msg:antihemophilic factor
20:11:12: dxtxpx: Msglatelte adhesion
20:11:19: dxtxpx: Msg:in inhury
20:11:25: dxtxpx: Msg:injury
20:11:48: dxtxpx: Msg:reacts with subendothelium and platelet surface GP1b
20:11:54: NicoToscani: Msg:good
20:12:05: NicoToscani: Msg:inheritance
20:12:17: dxtxpx: Msg:AD
20:12:19: NicoToscani: Msg:and what cells synthesize
20:12:23: meddancer: Msg:autosomal dominant
20:12:30: meddancer: Msg:endothelial
20:12:33: dxtxpx: Msg:endothelieal
20:12:40: dxtxpx: Msg:megakaryocytes
20:12:40: meddancer: Msg:and megakoryocytes
20:13:03: NicoToscani: Msg:great what times are prolonged
20:13:11: meddancer: Msgtt
20:13:20: dxtxpx: Msg:PTT
20:13:23: NicoToscani: Msg:yup and
20:13:26: dxtxpx: Msg:and BT
20:13:28: dxtxpx: Msg:bleeding
20:13:36: NicoToscani: Msg:ok
20:13:50: NicoToscani: Msg:vit k deficiency mainly due to
20:14:02: meddancer: Msg:fat malab
20:14:04: dxtxpx: Msg:malabrso
20:14:07: meddancer: Msg:absorption
20:14:15: dxtxpx: Msgancreatic and small bowel dis
20:14:23: NicoToscani: Msg:yup, and what clotting factors will be deficient
20:14:32: dxtxpx: Msg:2 7 9 10
20:14:37: meddancer: Msg:2 7 910
20:14:40: NicoToscani: Msg:ok
20:14:47: dxtxpx: Msg:vit K is given to all newborns
20:14:54: NicoToscani: Msg:thx
20:14:57: meddancer: Msg:yeah... not enough bacteria
20:15:05: dxtxpx: Msg:yeah
20:15:11: NicoToscani: Msg:factors deficient in stored blood
20:15:11: dxtxpx: Msg:deficent in breast milk
20:15:40: dxtxpx: Msg:nico?
20:15:45: meddancer: Msg:as well
20:15:51: NicoToscani: Msg:2, 5, 8
20:15:58: meddancer: Msg:any reason
20:15:58: dxtxpx: Msg:ok
20:16:02: dxtxpx: Msg:thanks
20:16:12: NicoToscani: Msg:in relation to dilutional coagulopathy
20:16:27: NicoToscani: Msg:manifested by persistent bleeding from surgical wounds
20:16:34: dxtxpx: Msg:ok
20:16:46: meddancer: Msg:oh okay
20:17:18: dxtxpx: Msg:Glanzmann;s thrombasthania?
20:17:32: meddancer: Msg:no g2b-3a
20:17:42: meddancer: Msglatelets can't aggregate
20:17:45: NicoToscani: Msg:for formation of fibrinogen bridges
20:17:46: dxtxpx: Msg:yes to both
20:17:50: dxtxpx: Msg:
20:18:07: dxtxpx: Msg:aspirin can also induce this problem
20:18:33: NicoToscani: Msg:how long do the effects of aspirin last on platelets
20:18:40: meddancer: Msg:good one
20:18:48: meddancer: Msg:i can't remember
20:19:03: dxtxpx: Msg:till they die
20:19:14: dxtxpx: Msg:whatever is platelte 's life
20:19:17: NicoToscani: Msg:remember aspirin is an irreversible inhibitor... you got it dx... 7 days
20:19:21: dxtxpx: Msg:cuz it binds irreversibly
20:19:25: meddancer: Msg:wow
20:19:26: dxtxpx: Msg:ok
20:19:51: meddancer: Msg:TTP?
20:19:51: NicoToscani: Msg:hey is Ehlers related to a specific collagen type?
20:20:00: meddancer: Msg:yes i think type IV
20:20:03: meddancer: Msg:not sure though
20:20:33: NicoToscani: Msg:i was thinkn IV too
20:20:41: dxtxpx: Msg:i think its many types
20:20:50: dxtxpx: Msg:there is this post onthe forum patho
20:20:53: dxtxpx: Msg:by meghana
20:21:04: dxtxpx: Msg:where this site shows all the diff collagen relations
20:21:16: NicoToscani: Msg:got the link?
20:21:24: dxtxpx: Msg:no i gotta look it up
20:21:40: NicoToscani: Msg:thats ok. lets move on
20:22:11: NicoToscani: Msg:back to med's TTP
20:22:50: meddancer: Msg:sorry... was away from the computer
20:23:02: NicoToscani: Msg:TTP characterized by hyaline microthrombi and microangiopathic hemolytic anemia
20:23:19: meddancer: Msg:yup
20:23:37: meddancer: Msg:what are some other features
20:23:41: NicoToscani: Msg:lesions in TTP cause damage to RBCs resulting to helmet cells
20:23:52: meddancer: Msg:and what other
20:24:01: NicoToscani: Msg:and schistocytes due to fibrin strands stripping away at the RBC membrane
20:24:31: meddancer: Msg:quick question is schistocytes seen in all hemolytic anemias
20:24:56: NicoToscani: Msg:am not sure
20:25:08: meddancer: Msg:neither am I
20:25:24: meddancer: Msg:but i think they are .... will look up
20:25:32: NicoToscani: Msg:ok
20:25:40: meddancer: Msg:what other features concern different orang systems will u see in TTP
20:26:12: NicoToscani: Msg:renal insufficiency, neurologic abnormalities
20:26:17: meddancer: Msg:yes
20:26:21: NicoToscani: Msg:and fever
20:26:27: meddancer: Msg:yup
20:27:43: meddancer: Msg:what is Bernard- Soulier disease?
20:28:01: NicoToscani: Msg:Auto-recessive
20:28:12: meddancer: Msg:yes ... AR
20:28:13: NicoToscani: Msgroblem with platelet adhesion
20:28:19: meddancer: Msg:yes
20:28:25: meddancer: Msg:why
20:28:47: NicoToscani: Msg:lack of platelet surface GPIb
20:28:56: meddancer: Msg:yes
20:29:09: NicoToscani: Msg:also shows unusually large platelets
20:29:20: meddancer: Msg:yup
20:31:05: meddancer: Msg:i wonder if dx is having problems with her computer
20:31:09: meddancer: Msg:nico are u still there
20:31:14: NicoToscani: Msg:yup
20:31:21: NicoToscani: Msg:i dont know
20:31:26: meddancer: Msg:ok
20:31:36: NicoToscani: Msg:i think we've covered the main stuff though
20:31:59: meddancer: Msg:yeah... we didn't touch on DIC though
20:32:15: NicoToscani: Msg:i was just thinking that
20:32:32: meddancer: Msg:real quick before we end
20:32:38: meddancer: Msg:what is it caused by
20:33:05: NicoToscani: Msg:widespread clotting leading to consumption of platelets and coag factors
20:33:24: meddancer: Msg:yes... what causes the widespread clotting
20:33:52: NicoToscani: Msg:tissue factor being released and activating the intrinsic pathway
20:34:28: meddancer: Msg:yes either tf is released or the intrinsic pathyway can be activated
20:34:48: meddancer: Msg:you can have secondary activation via the fibrin system
20:35:07: NicoToscani: Msg:yup, fibrinolytic system actiavation
20:35:17: meddancer: Msg:hi dx
20:36:15: meddancer: Msg:what clotting factors are produced in the liver
20:36:31: NicoToscani: Msg:everything but vWF
20:36:33: meddancer: Msg:yes
20:36:48: meddancer: Msg:what then happens to the pt and stuff
20:36:53: dxtxpx: Msg:hi
20:36:55: dxtxpx: Msg:sorry
20:37:00: NicoToscani: Msg:increased
20:37:18: meddancer: Msg:that's okay dx
20:37:37: meddancer: Msg:yes nico it is prolonged as well as ptt and thrombin time
20:37:54: meddancer: Msg:u will also see prolong bleeding time
20:38:02: dxtxpx: Msg:and deg products
20:38:15: dxtxpx: Msg:causes of DIC
20:38:17: dxtxpx: Msg:?
20:38:41: NicoToscani: Msg:infection like gram (-) sepsis
20:38:51: NicoToscani: Msg:abruptio placentae
20:38:58: NicoToscani: Msg:retained dead fetus
20:39:03: dxtxpx: Msg:yes
20:39:12: meddancer: Msg:cancer
20:39:14: dxtxpx: Msg:eclampsia lots of obst conditions
20:39:40: dxtxpx: Msg:yes ca of lung prostate pancreas stomach
20:39:51: dxtxpx: Msg:immune dis
20:40:01: dxtxpx: Msg:hemolytic transfusion
20:41:04: NicoToscani: Msg:ok im ready to call it a night
20:41:08: dxtxpx: Msg:ok
20:41:08: meddancer: Msg:in the case of coagulopathy of the liver what could u give the patient to aid
20:41:19: dxtxpx: Msg:vit K
20:41:19: NicoToscani: Msg:vit k
20:41:23: meddancer: Msg:yes
20:41:32: meddancer: Msg:well i guess we shall call it a night then
20:41:34: dxtxpx: Msg:tom is respiratory
20:41:37: meddancer: Msg:
20:41:53: NicoToscani: Msg:ok thanks for coming you two
20:42:01: meddancer: Msg:you too
20:42:01: dxtxpx: Msg:ok bye then i had some chat connection probs
20:42:08: NicoToscani: Msg:so we noticed
20:42:10: dxtxpx: Msg:hopefully it wont be the case tom
20:42:12: dxtxpx: Msg:
20:42:15: NicoToscani: Msg:
20:42:16: dxtxpx: Msg:yeah ok then
20:42:21: meddancer: Msg:night
20:42:23: NicoToscani: Msg:night
20:42:27: dxtxpx: Msg:night
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