31 January 2022: Textbook Updates

We have posted updates of the following topics:

Lung > Obstructive pulmonary disease > Emphysema
by Akira Yoshikawa, M.D., Andrey Bychkov, M.D., Ph.D., Sakda Sathirareuangchai, M.D.
Topic summary: Pulmonary emphysema is defined as permanent abnormal enlargement of air spaces distal to the terminal bronchioles with destruction of the alveolar septa with little or no fibrosis. Affects multiple pulmonary functions and causes chronic respiratory symptoms. Chronic obstructive pulmonary disease (COPD) is the third leading cause of global death; affects 1.4% of adults in the U.S.. Primarily diagnosed by imaging studies with compatible clinical manifestation. Treatment: Smoking cessation; medications: bronchodilators, antimuscarinic drugs, steroids, etc.

Mandible & maxilla > Non-odontogenic cysts > Oral lymphoepithelial cyst
by Abberly Lott Limbach, M.D.
Topic summary: Lymphoepithelial cysts are uncommon benign oral cavity cysts. Small, white-yellow submucosal nodule, often painless and asymptomatic. Histologic features include a squamous epithelial lined cyst filled with keratin debris and stromal lymphoid tissue. Occurs in adults: most common in fifth to sixth decade. Most common site: ventral and posterolateral tongue. Diagnosis through combination of clinical and histologic findings. Good prognosis; no recurrence after excision. Treatment is conservative surgical excision.

Microbiology & parasitology > Gram positive bacteria > C. perfringens / C. septicum
by Asad Ullah, M.D., Hasan Samra, M.D.
Topic summary: Common anaerobic, gram positive pathogen. Ubiquitous in environment, soil and human intestinal tracts. Clostridium perfringens: diabetic, immunocompromised patients and history of trauma. Clostridium septicum: strongly associated with malignancy, most commonly of colonic or hematological origin. Diagnosis is based on clinical observations, necrotizing tissue Gram stain and anaerobic bacterial culture, blood cultures (aerobic and anaerobic). Treatment: surgical debridement of traumatic injuries; wound cleansing, removal of dead tissue.

Microbiology & parasitology > Viruses > Yellow fever
by Amaro Nunes Duarte-Neto, M.D., Ph.D.
Topic summary: Yellow fever (YF) is a hemorrhagic viral disease caused by an arbovirus of the Flaviviridae family, endemic in parts of central eastern Africa and South America. Direct damage by the yellow fever virus (YFV) to hepatocytes and Kupffer cells, associated with host immune response causing hepatitis; vasculopathy and coagulopathy leading to visceral hemorrhages; multiple organ dysfunction. Markers of unfavorable prognosis: older age, renal dysfunction, shock, hypothermia, delirium, seizures, coma, hypoglycemia, metabolic acidosis, elevated neutrophil count, increased AST, high blood viral load. No specific antiviral therapy is available yet.

Placenta > Nonneoplastic placental conditions and abnormalities > Placental findings in specific conditions > Early first trimester pregnancy loss
by Chrystalle Katte Carreon, M.D., Drucilla J. Roberts, M.D.
Topic summary: Early pregnancy loss (EPL) refers to an early, spontaneous, previable pregnancy loss that occurs before 14 weeks gestation. Early first trimester pregnancy loss is a common event and may be recurrent. Affects up to 14% of pregnancies with up to as high as 66% of detectable early pregnancies terminating spontaneously. Sporadic cases are often followed by successful pregnancies. Treatment: surgical removal of products of conception by D&C, D&E or vacuum aspiration; treatment of underlying disease (etiology specific management) for recurrent EPL.

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