Disease Flashcards
Carpal tunnel syndrome
Tingling/numbness/pain as the median nerve is compressed
Paget’s disease
Bone is replaces at a faster rate so they are enlarged, weak and brittle.
increased risk of fracture and causes bone pain, especially when lying down.
Tetanus
Caused by clostridium tetani.
Produces a toxin which interferes with feedback control, causing fused tetani.
Primary osteoarthritis
Wear and tear, reducing articular cartilage of the joint. Very painful as the lining is broken down.
Fluid is produced to reduce inflammation and range of movement.
Can be triggered by injury or break.
Treat with analgesia and physio at first, then will require a joint replacement.
Secondary osteoarthritis
Infection in a joint caused by a puncture wound.
Can cause breakdown of articular cartilage.
Joint is red and swollen with a decreased range of movement.
Septic arthritis of the hip
Unable to weight bear.
Fever, high wbc count and c-reactive protein.
Check with an ultrasound or a needle in the joint (look for pus)
Primary osteosarcoma
Seen in teens or earrly adults. Cancer in the bone.
Bursitis
Bursae become irritated and inflamed due to a repetitive strain injury or trauma.
Syndactyly
When two or more digits are fused together.
Can be joined by skin, connective tissue, or bone.
Polydactyly
When there are extra digits.
Autosomal recessive disorder
Amelia
Complete absence of a limb.
Meromelia
Partial absence of one or more limb structure
Phocomelia
Caused by thalidomide, interferes with the apical ectodermal ridge.
Dislocation of the glenohumeral joint
Usually caused by trauma to a fully abducted arm.
Humeral head locates anteriorly due to powerful adductors, comes to lie beneath the coracoid process.
Capsule and rotator cuff may tear with poor healing, leading to recurrent dislocation.
Axillary nerve injury
Likely to be injured during dislocation due to its close relation to the inferior part of the joint capsule.
Indicated by paralysis of the deltoid with loss of sensation over the regimental badge area, supplied by the lateral cutaneous nerve.
Test for injury by sensory rather than motor ability.
Painful arc syndrome
Supraspinatous tendon rubbing under the coracromial arch, causing irritation and inflammation of the tendon and subacromial bursa.
Leads to a spectrum of problems including subacromial bursitis and supraspinatous tendinitis (with or without calcification), and deveneration + rupture of tendons if they don’t heal.
Predisposing factors:
- Repetitive overuse (sporting activities/work with overhead use of the arms)
- Degenerative changes to the tendons in older people
- Avascularity of the supraspinatous tendon making impingement more likely
Pain experienced during abduction of the arm between 50 and 130 degrees.
Pericardial effusion
A build up of serous fluid. Can be caused by pericarditis.
Treat by removing with a needle
Cardiac tamponade
Fluid accumulates too quickly for the heart to compensate.
Distended veins on the neck, quiet heart sounds and low blood pressure.
Valve calcification
Calcium deposits on the aortic valve, narrowing the opening and causing stenosis.
Changes the quality of the valve sounds, causing a heart murmer.
Aortic stenosis in the foetus
Obstruction of blood flow from the heart to the body.
Causes ventricular hypertrophy if left untreated, leading to to left-sided heart failure and abnormal heart rhythm.
May be leaking in addition to the narrowing if the aortic valve is affected.
Examples of atrial septal defects and consequences
Secundum fails to close
Sinous venous defect (pulmonary vein failure)
Primum atrial defect
Blood can move from left to right, causing the heart to stretch. This causes atrial arrhythmia and is a low pressure defect. Eventually causes right heart failure.
May stay unnoticed into adulthood if the defect is small
Ventricular septal defects
Can happen anywhere, most common in the membrane septum below the aortic valve.
If small, a murmer may be present but with no significant effects.
If significant size, increases pressure around the lungs causing damage. The left ventricle has to pump harder.
Atrioventricular defects
Leakage.
Associated with Down’s syndrome, can be complete or partial.
Symptoms include dyspnea and cyanosis. The newborn shows signs of heart failure such as oedema, fatigue and irregular heart rate.
Coarction of the aorta
Narrowing at the region of the ligamentum arteriosum
Increases afterload on the left ventricle causing left ventricular hypertrophy. Vessels to the head and limbs enlarged so the blood supply to these regions isn’t compromised. Blood to the rest of the body is reduced.
Extent of symptoms depends on severity of coarction
Can be very serous, causes hypertension and excess vessels. Can be removed and repaired, or a stent added.
May be seen in neonate or adult
Tetralogy of Fallot
Pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy and over-riding aorta.
Malalignment of the aorta pushes the pulmonary artery away, causing stenosis above and below the valve. Leads to right ventricular hypertrophy which protects against high blood pressure in the lungs. Also allows right to left shunting which causes cyanosis.
Thickened pulmonary valves.
Is survivable and treatable.
Tricuspid atresia
No right ventricular inlet with obstruction of the tricuspid.
Hole between atria - right to left atrial shunt.
Blood flow to the lungs via VSD/PDA.
Cyanotic
At birth, stops blood flow to the lungs.
Can have surgery to compromise on blood flow.
Transposition of the great arteries
Bi-directional shunting.
PDA and atrioseptal mixing in utero. When born, the right ventricle supplies the aorta and the left ventricle the pulmonary arteries.
The baby will die quickly unless the arteries are swapped, potentially including the coronary arteries.
Hypoplastic left heart
Extention of the aortic stenosis, left ventricle doesn’t form or grow.
Atrioseptal communication means it doesn’t matter in utero. Circulation stops at birth. Can reconstruct the aorta and ventricle, but still has a high mortality.
Univentricular heart
Can occur with or without transposition of the great arteries. Can treat after birth.
Causes Fontan circulation - one ventricle maintains both systemic and pulmonary circulation.
Blood returns from the body without a pumping chamber.
Reperfusion injury
Blood flow returns, worsening ischaemic damage. Oxygen is converted to superoxide, causing cell death.
Brings neutrophils which causes acute infammation and proteins which activate the complement pathway.
Rhabdomyolysis
Breakdown of muscle tissue, leading to the release of muscle fibre contents into the blood.
Occurs in alcohol/drug abuse.
Causes brown urine due to renal failure as it affects the kidney tubules.
Xanthoma
A build up of cholesterol in the skin
Haemosiderosis
Systemic excess of iron causing haemosiderin build up. Has a range of causes.
Can cause liver failure, diabetes and hyperpigmentation.
Bacterial meningitis
Pus causes vascular thrombosis and decreased cerebral perfusion.
Streptococcus meningitidis can be seen in all age groups.
Skin blisters
Caused by heat/sun/chemicals. Very painful with lots of exudates.
If fluid is clear, not infection.
Resolution or scarring
Abcess
Solid tissue with an influx of exudate, liquefactive necrosis in the centre.
May cause pressure and therefore pain.
Can lead to tissue damage if it squashes adjacent structures.
Hereditary angio-oedema
Non-itchy angio-oedema.
Can cause abdominal pain, high incidence of sudden death with laryngeal involvement.
Caused by a C1 esterase deficiency
Alpha-1 antitrypsin deficiency
Autosomal recessive.
Inhibits proteases normally, causes emphysema as inhibition lost.
Abnormal shape allows it to polymerise in the liver ER and can therefore cause liver disease.
Complement deficiency
Effect depends on what exactly is affected.
Hereditary angio-oedema is an example.
Also can increase susceptability to certain infections e.g. Neisseria
Neutropenia
Low neutrophil count, patient is immunocompromised with recurrent infections.
Chronic granulomatous disease
Phagocytes are unable to produce superoxide radicles so can’t kill bacteria.
Causes chronic infection, granuloma and abcess.
Acute appendicitis
Caused by bacterial infection, can become obstructed (by faeces/calcium salts) which causes inflammation and infection.
Symptoms include sharp, localised, persistent pain, low fever, rapid heartbeat and loss of appetite.
Bronchopneumonia
Acute inflammation of the walls of the bronchioles.
Associated with Staphylococcus aureus and E coli.
Mainly seen in infants or the immunosuppressed. Onset is insidious.
Lobar pneumonia
Commonly caused by Streptococcus pneumoniae or Mycobacterium tuberculosis.
Stages -
Congestion: vascular engorgement, intra-alvelolar fluid, small number of neutrophils, numerous bacteria
Consolidation (red hepatisation): continued congestion with extravasion of RBC to alveolar spaces with high number of neutrophils and fibrin. Gross appearance of solidification of alveolar parenchyma.
Grey hepatisation: RBC disintegrate, persistence of neutrophils and fibrin, paler colour
Resolution: total recovery. Exudate digested by enzymes and cleared by macrophages.
Complications include abcess formation, emphysema, intra-alveolar scarring (causes permanent loss of ventilatory function of affected parts of the lung), bacteraemia (causes endocarditis, cerebral abcess/meningitis, septic arthritis)
Ascending cholangitis
Infection of the bile duct caused by bacteria ascending from the junction with the jejunum. Tends to occur if already obstructed by gall stones.
Symptoms: jaundice, fever, abdominal pain, low blood pressure, confusion (when severe)
Treat with IV fluids and antibiotics.
Liver abcess
A pus-filled mass inside the liver commonly caused by abdominal infections such as appendicitis which spreads through the portal vein.
Mostly pyogenic, can be due to amoebae or fungal, although these are less common.
Symptoms: fever, anorexia, sickess, weight loss, weakness, pain and jaundice (late stage)
Treat with antibiotics. May require drainage/surgery.
Multiple Sclerosis
Autoimmune disease which attacks the proteins holding myelin together, causing demyelination.
This disrupts the neurons ability to communicate.
Symptoms depend on location.
Action potentials fire but a large proportion fails to come through (stops propagation)
Thyrotoxicosis
Grave’s disease.
Autoimmune hyperthyroidism.
TSH receptors are stimulated by antibodies
Tuberculosis
Caused by Mycobacterium tuberculosis
Multiple Sclerosis
Inflammatory disease which damages the insulating covers of neurons, disrupting their ability to communicate.
Multiple points have been damaged, symptoms depend on location.
Action potentials fire but a large proportion fails to come through (stops propagation)