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éxito: usamos la puerta para el éxito del edificio.
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- A 48-year-old man presents with continuous right upper quadrant pain that developed after eating fried chicken. He has experienced previous episodes of less severe right upper quadrant pain that resolved spontaneously. The pain radiates to his right shoulder, accompanied by nausea, vomiting, and chills. Vital signs include BP 120/85 mm Hg, pulse 117/min, respirations 18/min, temperature 102.5°F. Physical examination is remarkable for scleral icterus and jaundice. His abdomen is slightly distended with right upper quadrant tenderness and a positive Murphy sign. CBC reveals mild leukocytosis, elevated serum aminotransferases and bilirubin, and normal lipase.What is the most likely cause of this patient's symptoms?
- - Exotoxin - necrotising and neurotoxic effectso fragment A - (action, activity) ® inhibition of protein synthesiso fragment B - (binding) i) ® entry of the toxin into the cell through receptor-mediated endocytosisTheir role in the pathogenesis of infections:- C.diphtheriae typically is not invasive (does not invade deep tissues and does not enter the bloodstream- Transmission - by air droplets or contact with respiratory secretions or contaminated skin abrasions of a symptomatic infected person- C.diphtheriae colonises mucosa or skin- Toxigenic strains (temperate bacteriophage infects C.diphtheriae) produce exotoxin with necrotising and neurotoxic effects ® Destruction of epithelium, superficial inflammation response- Grayish pseudomembrane- Regional lymph nodes in the neck enlarge, and marked oedema of the entire neck may be present- Distant toxic systemic damage (parenchymatous degeneration, fatty infiltration, necrosis) affectingo heart muscle (myocarditis)o livero kidneys (tubular necrosis)o adrenal glandso nerves (demyelination → resulting in paralysis of the soft palate, eye muscles, or extremities)- Wound or skin diphtheria Primary (pustule→ulcer covered by a pseudomembrane)- Respiratory diphtheria (Sore throat, low-grade fever- Cutaneous diphtheria (May involve any area of the skin (usually the legs)
- The three main groups of elements are metals, nonmetals, and