HD EOYS4 Flashcards
Which virus has differing chronicty depending on age at infection?
EBV
Hep B
VZV
Hep C
HSV
Which virus has differing chronicty depending on age at infection?
EBV
Hep B
Hep C
HSV
Name a virus that is usually asymptomatic in early life but is typically worse in 15-25 years old
EBV
Hep B
VZV
Hep C
HSV
Name a virus that is usually asymptomatic in early life but is typically worse in 15-25 years old
EBV
Hep B
VZV
Hep C
HSV
Which of the following causes scarlet fever?
Streptococcus bovis
Streptococcus agalactiae
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus viridans
Which of the following causes scarlet fever?
Streptococcus bovis
Streptococcus agalactiae
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus viridans
Which of the following is group A strep?
Streptococcus bovis
Streptococcus agalactiae
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus viridans
Which of the following is group A strep?
Streptococcus bovis
Streptococcus agalactiae
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus viridans
Which of the following is group B strep?
Streptococcus bovis
Streptococcus agalactiae
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus viridans
Which of the following is group B strep?
Streptococcus bovis
Streptococcus agalactiae
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus viridans
Describe pathophysiology caused by Corynebacterium diphtheriae
- What process does the A-B subunit inhbit? [1]
- What are the pathological consequences for the heart [2] & nerves? [3]
- What structural change occurs in mouth? [1]
Diphtheria toxin: A and B subunits inhibits protein synthesis:
Heart implications:
- Myocarditis
- Heart block
Nerve implications:
- Difficulty swallowing
- Paralysis
- Diplopia
Get pseudomembrane in mouth
What are the four bacilli gram +ve organsims need to know? [3]
Corynebacterium
Listeria
Bacillus: cereus (food pois); anthracis (anthrax)
Clostridium: tetani botulinum, difficile
Describe the pathogenesis of meningococcal disease
Which two molecules are activated by LPS that cause inflammatory cascade for meningococcal disease? [2]
IL-6
TNF-α
Name three most common causes of septicaemia and meningitis [3]
Streptococcus pneumoniae
Neisseria meningitidis
* Group B and C
* Increase in Group W since 2009
* Teenagers, university students
Haemophilus influenzae B (HiB)
Name 4 invasive features of Streptococcus pneumoniae infection
- Meningitis
- Sepsis
- Osteomyelitis
- Septic arthritis
- Peritonitis
- Lobar pneumonia
- Empyema
Name the two most common presentations of Pneumococcal pneumonia (Streptococcus pneumoniae) [2]
- Lobar pneuomonia
- Empyema (a serious complication characterized by pus and bacteria in the pleural)
How would you manage empyema caused by pneuomococcal pneuomonia? [2]
Chest drain
Video-assisted thoracoscopic surgery (VATS)
Name two rheumatological implications of pneuomococcal pneuomonia infection
Osteomyelitis (inflammation in a bone and bone marrow, usually caused by bacterial infection)
Septic arthritis
Which pathogen cauese this symptom? [1]
Neisseria meningitidis - septic patient
What is the most common organism responsible for infective endocarditis?
Streptococcus bovis
Staphylococcus epidermis
Staphylococcus aureus
Streptococcus viridans
What is the most common organism responsible for infective endocarditis?
Streptococcus bovis
Staphylococcus epidermis
Staphylococcus aureus
Streptococcus viridans
Name this symptom [1]
What causative agent is most likely to have caused this infection?
Herpetic whitlow
Caused by HSV-1 (60% of cases, HSV-2 in 40%)
What causative agent is most likely to have caused this? [1]
Congenital CMV infection
What is this infection? [1]
Name the two most likely causative agents? [1]
Impetigo
Agents: group A Streptococcus and Staphylococcus aureus.
Name the most likely causative agent of this symptom [1]
Epstein-Barr Virus - causing infectious mononucleosis (glandular fever)
Name the most likely causative agent of this symptom [1]
Epstein-Barr Virus - causing infectious mononucleosis (glandular fever)
Which is the most severe form of malaria? [1]
Plasmodium falciparum
Explain pathophysiology of malaria life cycle
Malaria is spread by mosquitoes
Infected blood is sucked up by feeding female Anopheles mosquito.
Malaria in the blood reproduces in the gut of the mosquito producing thousands of sporozoites (malaria spores).
The mosquito bites another human or animal the sporozoites are injected by the mosquito. These sporozoites travel to the liver of the newly infected person
Sporozoites mature in the liver into merozoites which enter the blood and infect red blood cells.
merozoites reproduce over 48 hours, after which the red blood cells rupture releasing loads more merozoites into the blood and causing a haemolytic anaemia
Explain the differences in the presentations of Herpes simplex in older children and adults [3] compared to very young children [2]
Older children and adults: relatively benign
* Herpes labialis
* Herpetic whitlow
* Cold sore
Neonates: causes perncious effects via two presentations:
- Disseminated HSV
- HSV encephalitis:
Treatment of congenital CMV? [2]
How does it work agaisnt CMV [1]
How long should treatment last? [1]
IV ganciclovir
or
oral valganciclovir (pro-drug) :inhibits DNA synthesis
6 months of treatment reduces hearing loss and improves neurodevelopment
What are potential secondary bacterial infections of VZV? [1]
Name a consequence of this secondary bacterial infection [1]
Strep. infection (specifically Strep A)
Causes Necrotizing fasciitis
Name a virus that is usually asymptomatic in early life but is typically worse in 15-25 years old [1]
Epstein-Barr virus: causes infectious mononucleosis (glandular fever)
Which virus has differing chronicty depending on age at infection? [1]
Hep. B
How does Hepatitis B chronicity depend on age at infection?
Chronic HBV infection occurs in approximately 90% of newborns infected perinatally, 30% of children aged under 5 years, and <5% of immunocompetent adults.
Meningococcal disease refers to any illness caused by bacteria called []
Pneumococcal disease is a name for any infection caused by bacteria called []
Meningococcal disease refers to any illness caused by bacteria called Neisseria meningitidis.
Pneumococcal disease is a name for any infection caused by bacteria called Streptococcus pneumoniae
What pathology causes this slide from testis [1]
Explain your answer [1]
The seminiferous tubules contain Sertoli cells, but none of the characteristic cells of spermatogenesis. Abundant Leydig cells remain in the interstitium.
What is the name for this surgery? [1]
Orchiectomy
What is the name for this surgery? [1]
Orchidopexy
What is the name for this surgery? [1]
Orchidopexy
Which hormone has the following role:
inhibits the synthesis and release of the follicle-stimulating hormone in the pituitary gland and reduces the hypothalamic LH - releasing hormone content [1]
Inhibin
Which of the following type of Nonseminomatous Testicular Tumors causes high hCG
Choriocarcinoma
Teratoma
Yolk Sac Tumor
Embryonal Carcinoma
Which of the following type of Nonseminomatous Testicular Tumors causes high hCG
Choriocarcinoma
Teratoma
Yolk Sac Tumor
Embryonal Carcinoma
A 16-year-old patient presents with increasing testicular pain of 1-month duration. On exam, a left testicular mass is identified. A radical orchiectomy was performed, and the testicular mass was found to have a stroma that was infiltrated with numerous lymphocytes along with extensive hemorrhage and necrosis. Light microscopy reveals a diffuse sheet-like pattern of cells. Which of the following diagnoses is the most likely given this description?
A. Seminoma
B. Embryonal carcinoma
C. Leydig cell tumor
D. Choriocarcinoma
A. Seminoma
Seminoma is the most common pure germ cell tumor and is predominantly found in white populations.
Which two markers are rasied in non-seminoma cancers? [2]
AFP (alpha-fetoprotein) and/or beta-hCG are elevated in 80-85%
Describe the process of spermatogenesis [5]
Spermatogenesis:
* Division of spermatognia into more spermatogonia and primary spermatocytes via meiosis
* Spermatogonia remain in the basal compartment
* Primary spermatocytes migrate away from the basement membrane and cross in the adjuminal comparment towards the lumen of the ST
* Primary spermatocytes then enter meiosis (prolonged prophase) - which faciliates the exchange of genetic material between homologous chromosomes
* First division creates secondary spermatocytes with 23 pairs of chromosomes
* Secondary spermatocytes divide into haploid spermatids
Why is there no testosterone produced in prepuberty testis? [1]
No FSH produced so no testosterone produced
In which condition would you see atrophic testis? [1]
Atrophic testes occur in cryptorchidism, when testis fail to descend into the scrotum
Nodular hyperplasia of the prostate: which part of the prostate does it occur in? [1]
Transitional zone has proliferation and hypertrophy
Adenocarcinoma prostate:
Occurs in which zone of the prostate? [1]
How does is it present histopathologically/ [1]
peripheral zone w/ adenocarnioma
Note the malignant glands are generally smaller than benign glands
Benign: L; Malignant: R
Treatment of testicular torsion? [3]
Treatment
* Detorsion
* Orchidopexy (surgical procedure that moves an undescended testicle into the scrotum). Plus contralateral side check
* Orchiectomy (a surgical procedure to remove one or both testicles) 42% during surgical evaluation
What are the two types of testicular cancer & where do they originate? [2]
Which is more common? [1]
Which is more likely to metastasise? [1]
Seminomas:
* Originate in germinal epithelium of seminiferous tubules (germ cells)
* More common
Non-seminmomas
* Yolk sac, embryonal cell, choriocarcinoma and teratomas
* More likely to metastasise
Which part of the testis changes during testicular cancer and how does it present? [1]
Seminiferous tubule becomes full of proliferating spermatogonia
Label A-D out of:
BPE
Adenocarcinoma
Normal
prostatic intraepithelial (PIN)
A: adenocarcinoma
B: normal
C: PIN
D: BPH: Histological studies have demonstrated both glandular and stromal proliferation.
What does this slide depict?
A: adenocarcinoma
B: normal
C: prostatic intraepithelial (PIN)
D: BPH
A: adenocarcinoma
The malignant glands in the lower left show macronucleoli in contrast to the benign glands on the upper right side. However, one has to be cautious.
What does this slide depict?
A: adenocarcinoma
B: normal
C: prostatic intraepithelial (PIN)
D: BPH
Adenocarcinoma
This focus of prostate cancer has all the essential histologic features - small crowded glands lined by a single layer of cells, nuclear enlargement and hyperchromasia, prominent nucleoli, and intraluminal blue mucin. A benign gland is partially visible at the lower right side of the image. Contrast its nuclear size to those of adjacent malignant glands.
What does this slide depict?
A: adenocarcinoma
B: normal
C: prostatic intraepithelial (PIN)
D: BPH
A: adenocarcinoma
Glomerulations are an architectural feature that are usually associated with carcinoma in a prostate needle biopsy. Similar structures may rarely be seen in benign prostate glands. They consist of an aggregate of tumor cells that projects into the lumen of a larger malignant gland creating a superficial resemblance to a renal glomerulus.
What does this slide depict?
A: adenocarcinoma
B: normal
C: prostatic intraepithelial (PIN)
D: BPH
What does this slide depict?
A: adenocarcinoma
B: normal
C: prostatic intraepithelial (PIN)
D: BPH
What does this slide depict?
A: adenocarcinoma
B: normal
C: prostatic intraepithelial (PIN)
D: BPH
What does this slide depict?
A: adenocarcinoma
B: normal
C: prostatic intraepithelial (PIN)
D: BPH
TL: BPE
TR: Adenomcarcinoma
BL: Normal
BR: PIN
the clitoris is analagous to which part of the penis?
corpus spongiosum
corpus cavernersa
bulbospongiosus
ischiocavernosus
the clitoris is analagous to which part of the penis?
corpus spongiosum
corpus cavernersa
bulbospongiosus
ischiocavernosus
what are the 3 nerve branches of the perineum? [3] what do they supply [3]
Inferior rectal - supplies the external anal sphincter and inferior anal canal
Perineal - supplies the anterior perineum
Dorsal nerve of penis/clitoris - supplies the external genitalia
Spermatozoa are produced in the:
vas (ductus) deferens.
rete testis
epididymis
tunica albuginea
seminiferous tubules
Spermatozoa are produced in the:
vas (ductus) deferens.
rete testis
epididymis
tunica albuginea
seminiferous tubules
Which ligaments comprise the borders of the greater and lesser sciatic foramen? [2]
Acceptable responses: sacrospinous and sacrotuberous ligaments
contracts the external urethral sphincter
visceral afferents
sympathetic
parasympathetic
somatomotor
contracts the external urethral sphincter
visceral afferents
sympathetic
parasympathetic
somatomotor
contracts the detrusor muscle
visceral afferents
sympathetic
parasympathetic
somatomotor
contracts the detrusor muscle
visceral afferents
sympathetic
parasympathetic
somatomotor
Deficits in which of these fibres may cause urinary retention?
visceral afferents
sympathetic
parasympathetic
somatomotor
Deficits in which of these fibres may cause urinary retention?
visceral afferents
sympathetic
parasympathetic
somatomotor
