can only be diagnosed if psoriasis is present (F) also if fhx of psoriasis ref K&C

EBV infection

90% of adults were infected asymptomatically in childhood with EBV but infectious mononucleosis is symptomatic EBV infection usually in adolescents.

EBV infects B-lymphocytes followed by T-Cell proliferation (mononucleosis), theses are cytotoxic to EBV infected cells.

Glandular Fever Syndrome lymphadenopathy, prominent pharangitis and spleen is palpable in 50% of cases.

Paul Bunnell/Monospot test is negative after 3 months.

Abnormal LFT’s is commom, occasionally jaundice.
77FTFTT

Mitral incompetence

All left sided murmours are heard better on expiration

LEFT EXPIRATION

RIGHT INSPIRATION

Auscultation: soft or absent S₁

S₃

pansystolic

max at apex

radiates towards axilla

A gallop rhythm= S₃ therefore MR may be associated with a gallop rhythm.

Also indirect S₃ is associated with cardiac failure and MR is associated with cardiac failure.

Causes of MR:

1- intrinsic valve disease: rheumatic heart disease

infective endocarditis

myxomatous (connective tissue tumour) degeneration