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



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tarix25.12.2016
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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




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