Disease definitions

Question 1

Disease name

Answer 1

Pathophysiology

Question 2

Type I Diabetes

Answer 2

Caracterized by a lack in production of insulin due to autoimmune B cell destruction. There is a immune imbalance with excessive th1/th17 + CD8 and lack of treg and foxp3 regulatory t cells. People with this have antigens to glutamic acid decarboxylase, insulin, islet auto antigen IA-2 or beta cell sinc transporter (one or more of these)

Question 3

Type II Diabetes

Answer 3

Type II diabetes is characterized by a deficit in insulin secretion or insulin resistance that results in hyperglycemia and can lead to several serious macrovascular and microvascular complications.

Question 4

Other types of diabetes

Answer 4

Suggested that glucose binds to free AA residues. These form advanced glycation end-products (AGEs). AGEs accumulate in proportion to hyperglycaemias and time, leading to tissue dysfunction.

Question 5

Diabetic neuropathy

Answer 5

Most common complication of diabetes. Classified into generalized (autonomic, sensorimotor, sensory) and focal (cranial, truncal, focal limb, proximal motor) neuropathies.

Question 6

Diabetic nephropathy

Answer 6

Progressive kidney damage over about 20 years until kidney failure. Drop of GFR and rise of urine albumin and plasma creatinine and urea

Question 7

Diabetic retinopathy

Answer 7

Complication of T1 and T2DM. Small blood vessels in the retina grow mini aneurysms or haemorrage and some blood vessels get completely cut off. Microaneurysms can complicate and you can get loss of capillary endothelial cell, haemorrhage due to rupture, increased vessel permeability with leakage of proteins, exudates… Can also get vascular occlusions with blood or small infarcts within nervous fibre layer.

Question 8

HIV

Answer 8

Viral infection of the HIV virus, transmitted sexually most of the time. Virus invades and infects T-cells, which are destroyed by by body’s own immune system which causes a reduced viral load. After initial infection, a latent perdio that can last many years starts where t cell count is returned to normal.

Question 9

Varicella

Answer 9

Incubation period of 10-21 days. Varicella zoster infection that causes. After a while specific IgG & IgA antibodies + specific CD8/CD4 T-cells. It then becomes latent in sensory ganglia of specific nerves.

Question 10

Shingles

Answer 10

Reactivation and replication of varicella zoster virus in the sensory ganglia of nerves causing dermatome specific rashes

Question 11

Encephalitis

Answer 11

Inflammatory process of brain parenchyma (functional brain tissue).

Question 12

Influenza

Answer 12

Infection of respiratory tract and 2 day incubation period before symptoms.

Question 13

Viral hepatitis

Answer 13

Inflammation of the liver

Question 14

Zika Infection

Answer 14

Maternal infection -> placental infection -> fetal neural tissue. Due to progenitor neural cell damage and prolonged infection with persistant fetal and maternal viraemia

Question 15

Ebola infection

Answer 15

Infection of a broad range of cells (liver, kidney, macrophage, endothelial cells)

Question 16

Cellulitis

Answer 16

Acute spreading infection of dermis and subcutaneous tissue. Local production of inflammatory cytokines by keratinocytes.

Question 17

Gall stone disease

Answer 17

Presence of solid concretions in the gallbladder. Symptoms arrise when these masses obstruct the cystic, bile or pancreatic duct. They are usually formed of bile and cholesterol.

Question 18

Ascending cholangitis

Answer 18

Obstruction of bile ducts can aggravate and become an infection of the ascending colon. Usually gram negative bacteria (e.coli. enterobacter)

Question 19

Pancreatitis

Answer 19

Proinflmmatory mediators and activation of proenzymes cause autodigestion of the pancreas and systemic inflammatory response.

Question 20

Appendicities

Answer 20

Inflammation of the appendix

Question 21

Upper GI Bleeding

Answer 21

Blood in the upper GI tact

Question 22

Diverticular disease

Answer 22

Formation of sac like protrusions of mucosa through the muscular colonic wall. Become inflammed or infected. Associated with low fibre diet -> increase transit time -> increases intraluminal pressure)

Question 23

IBD (Crohn’s disease)

Answer 23

Chronic inflammatory autoimmune trans-mural inflammation (goes through the bowel wall, unlike UC). Characterized by presence in the ilium along to other places in the GI tract.

Question 24

IBD (Ulcerative Colitis)

Answer 24

Inflammatory autoimmune disroder of the mucosa of the colon only. Caused by an exaggerated mucosal T cell response to host microbiota. It infects the whole area equally (not in patches like crohn’s).

Question 25

Coeliac disease

Answer 25

Chronic systemic, immune mediated disorder triggered by ingesting gluten. Leads to mucosal inflammation, crypt hyperplasia, villous atrophy. Gluten accumulates in submucosal layer.

Question 26

Alcoholic hepatitis

Answer 26

Cirrhosis of liver due to alcohol intake. Toxic inflammation.

Question 27

Tuberculosis

Answer 27

Disease due to infection of mycobacterium tuberculosis. Patients catch bacteria via inhalation (droplet nuclei) and these go directly to alveolus. Can be pulmunary, cervical, meningeal,

Question 28

Meningitis

Answer 28

A serious inflammation of the meninges caused by various baecteria. It reaches the CNS either by haematogenous spread or direct extension from contiguou site. Causes an inflammatory cascade which leads to cerebral oeddema, increased intercranial pressure.

Question 29

Osteoarthritis

Answer 29

Degenerative joint disorder caused by a failure to maintain balance between cartilage synthesis and degradation. The degradation is a result of either increased degradation or decreased synthesis by the enzymes produced by the joint chondrocytes. Other structures in the joint are also damaged like synovial membrane inflammation, muscle weakness, ligament injury, bone degradation… Injury or trauma can also be an additional negative factor in osteoarthritis.

Question 30

Psoriatic arthritis

Answer 30

psoriasis affecting skin but with associated swelling of joints

Question 31

Rheumatoid arthritis

Answer 31

Type 2, 3, 4 hypersensitivity disease. Is a chronic inflammatory disease of synovial joints.

Question 32

Systemic lupus erythematosus

Answer 32

Antibodies to nuclear material (anti dsDNA, anti histone, anti extractanle nuclear antigen…) These antibodies (espcially anti-Ro and anti-La) can be present of up to 9 years before symptoms. Auto-immune haemolysis, anaemia, sepsis, vascular inflammation.

Question 33

Systemic sclerosis

Answer 33

aka sclerdoma, multisystem autoimmune disease characterised by functional and structural abnormalities in small vessels

Question 34

Raynaud’s

Answer 34

Exists as primary (symmetrical and no thumb involvement) and secondary (asymmetrical and thumb involvement)

Question 35

Antiphospholipid syndrome

Answer 35

Arterial thrombosis strokes, pregnancy morbidity. Caused by antiphospholipid antibodies (aCL, lupus anticoagulant, anti-b2 glycoprotein 1 antibodies). A subclass of lupus.

Question 36

Atopic dermatitis (Eczema)

Answer 36

Chronic relapsing skin disorder

Question 37

Glomerulonephritis (general condition)

Answer 37

Immune mediated damage to the glomerulus due to deposition of circulating or in situ immune complexes
or deposition of anti-glomerular basement membrane antibodies

Question 38

IgA nephropathy (main cause of glomerulonephritis)

Answer 38

Glomerular deposition of IgA causing inflammation in glomeruli (type of glomerulonephritis)

Question 39

Henoch Schonlein Purpura (main cause of glomerulonephritis)

Answer 39

INflammation of the small blood vossels esp in kidney, skin and gut caused by IgA deposition like IgA nephropathy

Question 40

Nephrotic syndrome

Answer 40

Condition in which you see a triad of high proteinuria, low albumin and oedema.

Question 41

Minimal change disease (cause of nephrotic syndrome)

Answer 41

Disease of the glomerulus showing characteristic changes on EM. (effacement of foot processes by electron microscope)

Question 42

focal segmental glomerular sclerosis (cause of nephrotic syndrome)

Answer 42

AKA FSGS. It is a lesion caused by a variety of diseases. Characterized by areas of mesangial collapse and sclerosis.

Question 43

Membranous nephropaty (cause of nephrotic syndrome)

Answer 43

most common cause of primary nephrotic syndrome in adults. Basement membrane thickening with little cell expansion. Associated with antiPLA2 antibody. Can also be associated with cancer, hepB, autoimmune, drugs.

Question 44

Urinary Tract Infection

Answer 44

Bacterial infection of the urine with >105 colony of urine.