HISTO: Systemic Pathology Flashcards
Describe the course of viral load and CD4 count in HIV.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/385/830/165/a_image_thumb.png?1641978331)
List 5 types of opportunistic infections present in HIV.
- Pneumocystis jiroveci: pneumonia
- CMV: especially retina and GIT
- Candida • Tuberculosis and atypical mycobacteria
- Cryptococcus: meningitis
- Toxoplasma gondii: encephalitis and mass lesions
- JC papovavirus: progressive multifocal leukoencepalopathy
- Herpes simplex
- Cryptosporidium, Isospora belli, microsporidia: GIT
What is shown in this patient with HIV? What is a cause?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/385/830/167/q_image_thumb.png?1641978584)
Endoscopy: Oesophageal ulcer
CMV oesophagitis
What is shown in this CMV oesophagitis?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/385/830/169/q_image_thumb.png?1641978651)
(a) CMV nuclear inclusion
(b) Immunohistochemistry for CMV
List some types of tumours and their cause in HIV.
Kaposi’s sarcoma = HHV-8
Lymphoma: systemic, CNS or body cavity based B cell lymphomas = EBV
Others: Squamous cell carcinoma; Anus and cervix = HPV
What is seen in this Kaposi’s?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/385/830/173/q_image_thumb.png?1641978745)
A. The dermis is expanded by a solid tumour.
B. Fascicles of relatively monomorphic spindled cells, with slit-like vascular channels containing erythrocytes.
C. The nuclei of the tumour cells demonstrate immunoreactivity for HHV-8.
What CNS disease can occur in HIV?
Progressive encephalopathy = AIDS dementia complex
Plus opportunistic infections and tumours e.g. CNS lymphoma as below
![](https://s3.amazonaws.com/brainscape-prod/system/cm/385/830/175/a_image_thumb.png?1641978783)
Describe mycobacterial pathology.
Caseating granulomas
Demonstration of acid fast bacilli
![](https://s3.amazonaws.com/brainscape-prod/system/cm/385/830/177/q_image_thumb.png?1641978848)
Which parts of the body can be affected by TB?
- Lung
- Lymph node
- Bone: e.g. vertebra
- Heart: e.g. pericarditis
- GIT: e.g. peritonitis
- CNS: e.g. meningitis etc.
How do you diagnose sarcoid?
Non-caseating granulomas
A diagnosis of exclusion.
What is shown here in sarcoid?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/385/830/181/q_image_thumb.png?1641978967)
Organised collection of macrophages
Giant cells are characteristic (this is several macrophages joint together)
Which parts of the body can be affected by sarcoid?
- Lung: scattered granulomas, heal with fibrosis
- Lymph nodes: usually hilar and mediastinal
- Spleen
- Liver
- Heart
- Joints
- Bone marrow
- Skin: nodules, plaques or macules
- Eyes: iritis, choroid retinitis, lacrimal glands
- CNS
- Salivary glands
![](https://s3.amazonaws.com/brainscape-prod/system/cm/385/830/183/a_image_thumb.png?1641979059)
Describe the pathology of IgG4 related disease briefly.
Inflammation caused by IgG4 antibody producing plasma cells (polyclonal but subclass specific)
Fibrosis, obliteration of veins
What is seen here in this liver slice of IgG4 related disease?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/385/830/187/q_image_thumb.png?1641979163)
A lot of plasma cells witg dark nuclei due to golgi apparatus due to IgG4 production of these cells, inflammatory infiltarte is also seen
![](https://s3.amazonaws.com/brainscape-prod/system/cm/385/830/187/a_image_thumb.png?1641979223)