Diseases Pt 3

Question 1

Chagas Disease

Answer 1

It is a tropical disease caused by Trypanosoma cruzi.

• Romaña’s sign is the swelling of the eyelids on the bite side is the sign of this disease
• May lead to myocardial inflammation and necrosis
• Megacolon & megaesophagus may also occur

Question 2

Berry aneurysm

Answer 2

focal weakening of the cerebral vessels, resulting in outpouching

Question 3

Buerger disease (p. 183)

Answer 3

recurrent acute and chronic inflammation of small and medium sized vessels

• Causes segmental thrombosis in the extremities.
• Most common in smokers younger than 35
• If you see gangrene in a young smoker, think of Buerger
• Also called Thromboangiitis obliterans

Question 4

Wegener Granulomatosis (p. 183)

Answer 4

A triad of necrotizing vasculitis and necrotizing granulomas (both in respiratory tract & lungs), and necrotizing glomerulitis

Question 5

Takayasu arteritis (p. 183)

Answer 5

Granulomatous inflammation of medium and large size arteries

Question 6

Kawasaki disease (p. 183)

Answer 6

Acute inflammation and necrosis of the entire vessel wall with aneurysm for no known reason. Mostly in children (Japan).

• Characterized by fever, conjunctivitis, erosion of oral mucosa, maculopapular skin rash with adenopathy. Coronary vasculitis may lead to death
• Also called mucocutaneous lymph node syndrome

Question 7

Von Hippel-Lindau disease (p. 185)

Answer 7

• Autosomal dominant
• Benign hemangiomas in the cerebellum, brain stem, liver, panceras & eyes.
• Associated with pheochromocytoma, also renal cysts & carcinoma

Question 8

Kaposi sarcoma (p. 186)

Answer 8

hemorrhagic, violaceous polypoid or nodular lesions, in mucocutaneous locations. Common in homos

• associated with herpes infection and AIDS
• There is proliferation of endothelial cells & CT cells, with RBC and leukocytes aggregation (angiosarcoma). No epithelial element
• Rarely symptomatic, but spreads fast in AIDS patients
• Treated with chemotherapy and interferon gamma

Question 9

Conn syndrome is ….

Answer 9

Primary Hyperaldosteronism, from adrenal adenoma

• Features: Na retention, K depletion, hypertension, polyuria, polydipsia, weakenss, headache
• Lab work reveals low K, low renin, metabolic alkalosis, high Na (failure to suppress Na even with Na loading)

Question 10

Bartter syndrome (p. 189)

Answer 10

Juxtaglomerular cell hyperplasia, resulting in high renin & aldosterone

• Often associated with hypotension
• Lab work shows: high Na, low K, High renin

Question 11

Myxedema (p. 191)

Answer 11

severe hypothyroidism in adults.

• Characterized by: periorbital puffiness, pale doughy skin (due to accumulation of hydrophilic mucopolysaccharides), sparse hair, pleural effusion, cardiomyopathy, poor muscle tone, swelling of tongue and pharynx
• Women (>50) are affected more than men

Question 12

Metrorrhagia

Answer 12

abnormal uterine bleeding

* May be due to hypothyroidism

Question 13

Hashimoto thyroiditis (p. 191)

Answer 13

Goitrous enlargement of the thyroid due to lymphocytic and plasma cell infiltration (Autoimmune), leading to hypothyroidism

• It is the leading cause of goitrous hypothyroidism in the U.S, more in women
• There is decreased T4, high TSH
• Early in the disease process, hyperthyroidism occurs
• There is a family predisposition

Question 14

Alkali syndrome

Answer 14

Hypercalcemia caused by repeated ingestion of calcium (milk, antacid calcium carbonate). Leads to metastatic calcification and renal failure, and subsequent hypovolemia
* Hypovolemia due to excretion of bicarbonate and Na in urine (because of high Ph)

Question 15

Kimmelstiel-Wilson disease (p.194)

Answer 15

characterized by nephrotic syndrome and diffuse glomerulosclerosis. It is due to longstanding diabetes mellitus, and is a prime indication for dialysis

Question 16

Kartagener syndrome (p. 202)

Answer 16

absence of motile pulmonary cilia which interferes with bacterial clearance

Question 17

Goodpasture syndrome (p. 203)

Answer 17

Hemorrhagic interstitial pneumonia, characterized by hemoptysis and rapidly progressive glomerulonephritis.

• Caused by an antibody against a common basement membrane antigen in the lung and kidney
• There is a heavy consolidation of the lungs
• Antibodies to Type IV collagen.
• It is a type II hypersensitivity reaction

Question 18

Myxoma

Answer 18

Primitive connective tissue tumor, usually in the right or left atria. It is pedunculated with a stalk attached to fossa ovalis of the interatrial septum

Question 19

Carcinoid syndrome

Answer 19

symptoms occurring secondary to carcinoid tumors. Include flushing, diarrhea, heart failure, broncoconstriction. The active secretions contain serotonine and kallikrein

Question 20

Superior Vena Cava syndrome

Answer 20

Obstruction of SVC by bronchiogenic tumor, causing shortness of breath, swelling of face, neck and arms. Also cough & headache & cyanosis

Question 21

Lou Gehrig disease (p.211)

Answer 21

A type of Motor system disease, a group of (muscle weakness, atrophy, spasticity)

• Caused by loss of motor neurons in the spinal cord, brainstem, cerebellum, cerebral cortex
• Also called Amyotrophic lateral sclerosis

Question 22

Tuberous sclerosis (p. 213)

Answer 22

• Autosomal dominant
• involves the brain (seizures, mental retardation), skin (ash leaf spots, shagreen patches on the nape, adenoma sebaceum). Also involve the kidney, eyes, lungs
• There are hamartomas on the mentioned organs. In the CNS, there is astrocytoma, gangliogliomas, gliomas.

Question 23

Sturge Weber syndrome (p. 214)

Answer 23

capillary-venous malformation of one cerebral hemisphere with ipsilateral nevus flammeus (port wine stain) in the trigeminal region of the face

Question 24

Multiple sclerosis (p. 214)

Answer 24

• Characterized by exacerbation and remission, F>M (age 20-40)
• Pyramidal tract dysfunction (hyperreflexia, weakness, spasticity)
• Cerebellar dysfunction
• Disturbance in visual acuity and extraocular muscles (due to MLF lesions)
• Autoimmune etiology, provoked by viral infection
• Plaques of demyelination in the white matter (composed of immune cells & glial cells)
• Characterized by nystagmus, intention tremor, scanning speech
• There is an increase in IgG level of the CSF

Question 25

Beriberi

Answer 25

peripheral neuropathy to thiamine deficiency (B1)

Question 26

Wernicke-Korsakoff encephalopathy

Answer 26

memory, gait and eye movement disorder caused by thiamine deficiency

Question 27

Progressive multifocal leukoencephalopathy (PML)

Answer 27

Caused by JC virus (aka papovavirus)

• Seen in some AIDS patients
• It infects the oligodendrocytes and astrocytes

Question 28

Lymphogranuloma venereum (LGV) p.222

Answer 28

STD caused by Chlamydia trachomatis
* There is genital or anorectal lesions with regional lymphadenopathy (which may cause obstruction and subsequent edema and elphantiasis of genitalia and lower limbs)

Question 29

Stein-Leventhal syndrome (p. 227)

Answer 29

Bilateral enlarged polycystic ovaries, with amenorrhea, obesity, hirsutism, infertility

Question 30

Gardner Syndrome (p. 251)

Answer 30

• Autosomal dominant
• Characterized by exostoses, sebaceous cysts, desmoid tumors & colonic polyps which may become cancer
• Usually first discovered by dentists as a finding in the panograph