Uworld HY
36 yo w a skin rash, received it 2 mo ago at the beach, mild pruritius, construction worker that works in the heat - malasezzzi furfur or pytriasis versicolor - hypopigmented spots or hyperpigmented - confined to the stratum corneum - dz w KOH and spores and hypahe in sphagetti and metaball - antifungal or selenium Blasto and histo cause lung or in disseminated - Skin ***Intertrigo - well defined erythematous plaque w satellite vessicles in warm, moist areas papular or pustular - axilla and groinand skin folds - usually Candida and seen indiabetics or immunocompromised state tinea corprorus or tinea capidus is microsporum Mucor cause invasive necrotic in URI spoorotthrix causes nodular and ulcerating subq nodules
Diaper rash also in axilla
patient w exertional dyspnea annd mother died of PAH, clear breath sounds, and prominent P2/S2, Right Axis Deviation - inherited PAH bc of BMPR2 mutation that is autosomal dominant 0 smooth muscle proliferation causing increased endothelin, decreased prostacyclin and NO - also intimal thickening and increased PVR and plexiform lesions - it follows a 2 hit hypothesis - you have the susceptibility but then you develop another mutation like smoking *** can cause Cor pulmonale and RVH failure w elevated JVP, hepatic congestion Pulm HTN is also seen in systemic sclerosis, RA, and HIV that is primary 2* is COPD, Chronic lung dz, chronic pulm infection HYpoxic vasocosntictioon in COPD, OSA and interstitial lung dz chronic thromboembolisms decreases the cross sectional area - need to have a history of venous thromboembolism LV fluid overload cause decompendated HF and increased Pulm venous pressures
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