Histopath of systemic disease Flashcards
name the sign seen on microscopy for cmv infections?
Nuclear Inclusion bodies - owls eye inclusions
name some ivx and findings for CMV oesophagitis?
Endoscopy; oesophageal ulcers
slide; inclusion bodies
immunohistochem - cmv
name some tumours associated with HIV and their causes
• Kaposi’s sarcoma: HHV-8
• Lymphoma:
systemic,
CNS or body cavity based B cell lymphomas
EBV
• Others:
Squamous cell carcinoma
Anus and cervix
HPV
name some HIV Central Nervous System Disease
• Progressive encephalopathy = AIDS dementia complex
tumours
opportunitistic infections
what is the pathological picture with Mycobacteria infection?
- Caseating granulomas / Granuloma with caseous necrosis
* Demonstration of acid fast bacilli
which condition is characterised by:
Non-caseating granulomas
with a diagnosis of exclusion.
sarcoid
characterise a sarcoid granuloma?
lymphocytes lining outside giant cells in lymphocyte layer
epithelioid cells in the middle
characterise the extrapulmonary manifestations of sarcoid?
- Lung: scattered granulomas, heal with fibrosis
- Lymph nodes: usually hilar and mediastinal
- Skin: nodules, plaques or macules. ERYTHEMA NODOSUM
- Eyes: iritis, choroid retinitis, lacrimal glands . can cause blindness
Bones; arthritis
hepatomegaly, splenomegaly and more
what is the aetiology of sarcoid?
- genetics; hla-dr genes may be implicated if more than 1 family member has it
- infectious agents include: mycobacteria, fungi, borrelia, and rickettsia
- autoimmune
what is IgG4 Related Disease?
Inflammation dominated by IgG4 antibody producing plasma cells
Fibrosis, obliteration of veins
Name igg4 rleated disease in the different systems?
- Salivary and lacrimal glands: Mikulicz syndrome • •Thyroid: Riedel thyroiditis
- Peritoneum: Retroperitoneal fibrosis
- Liver: Biliary obstruction
- Pancreas: Autoimmune pancreatitis
- Mass lesions: Inflammatory pseudotumour
what conditions can alcohol cause in the different systems?
- Liver: fatty change (steatosis) , fatty liver hepatitis (steatohepatitis), cirrhosis, liver cell cancer (hepatocellular carcinoma)
- GI Tract: acute gastritis, oesophageal varices
- Nervous system: peripheral neuropathy, Wernicke-Korsakoff syndrome etc.
- Cardiovascular system: dilated cardiomyopathy, hypertension, atheroma (and decreases it!)
- Pancreas: acute pancreatitis, chronic pancreatitis
large consumption of alcohol is usually dangerous. list some benefits of small-moderate alcohol consumption?
lowers diabetes risk
increases insulin sensitivity
higher skeletal bone mineral density
increase hdl, increase coronary blood flow
reduced thrombosis
… so cardioprotective effects
list some benefits of alcohol consumption regardless of the amount of intake?
reduced rheumatoid arthiritis
reduced chance of getting;
- gallstones
- kidney stones
list the stages of alcoholic liver disease?
normal liver -> steatosis -> steatohepatitis ->
fibrosis -> cirrhosis -> hepatocellular carcinoma
what is the systemic impact of fizzy drinks on the body?
obesity
bones - osteoporosis and density loss (caffeine and phosphoric acid)
kidneys - increase calculi RR 2x
teeth - corrosion
lungs - increase asthma & COPD risk
heart - increased risk of CVDs
GI - worsens IBS, caffeine -> diarrhoea constipation
list the possible systemic impact of cystic fibrosis?
- Pancreas: duct obstruction, exocrine atrophy
- Salivary glands: duct obstruction, atrophy
- Intestine: meconium ileus
- Liver: biliary obstruction, cirrhosis
- Lung: bronchial obstruction, superimposed infection with abscess formation (Staphylococcus aureus, Haemophilus influenzae and Pseudomonas aeruginosa)
- Male genital tract: infertility, absence of the vas
what are the types of amyloid and which condition do they present in?
AA - derived from serum amyloid A e.g. Crohn’s Disease, Rheumatoid arthritis
• AL - derived from light chains
e.g. multiple myeloma, B Cell lymphoma
name an ivx for amyloidosis and the result?
Stains with Congo Red dye
• This shows apple green birefringence under polarised light
what is the clinical picture seen in amyloid?
- Proteinuria, renal failure
- Restrictive cardiomyopathy, arrhythmias
- Autonomic neuropathy
- Carpal tunnel syndrome
- Macroglossia
- Bleeding on injury
- Also deposited in blood vessels, endocrine organs, liver, spleen
this patient has which condition;
A 79-year-old man presents with dyspnoea on exertion for 1 year and lower extremity oedema. As part of a cardiac work-up, the echo shows concentric left ventricular hypertrophy. Cardiac catheterisation shows normal coronary arteries and he is referred for further evaluation of non-cardiac dyspnoea.
amyloidosis
this patient has which condition;
A 62-year-old man is referred for management of atypical multiple myeloma. He has a mild anaemia of 120 g/L (12 g/dL), a urinary protein loss of 2.2 g/day with a urinary immunofixation showing free lambda light chains. However, the bone marrow shows only 5% plasma cells and does not fulfil criteria for multiple myeloma.
amyloidosis
which ‘types of amyloid’ are associated with the following;
- mutation
- peritoneal dialysis
- Alzheimer’s
- endocrine tumours
- Transthyretin e.g. mutation
- Beta2-macroglobulin – peritoneal dialysis
- Abeta2 protein - Alzheimer’s
- Insulin, calcitonin – endocrine tumours
