Histopathology 1 - systemic diseases

Question 1

Which opportunistic infections commonly occur in HIV patients?

Answer 1

Pneumocystis jirovecii --> PCP
Cryptococcus neoformans --> meningitis
CMV (oesophagitis and retinitis)
Candida
TB and atypical mycobacteria
Toxoplasma gondii
JC virus --> progressive multifocal leukoencephalopathy
Cryptosporidium
Herpes simplex

Question 2

Colour of CMV stain on immunohistochemistry in pt with CMV oesophagitis

Answer 2

Stains brown

Question 3

HIV tumours (2 main types)

Answer 3

Kaposi’s sarcoma

Lymphoma

Question 4

Location of lymphomas in HI V patients

Answer 4

Body cavities, CNS and systemic disease

Question 5

How to look for Kaposi’s sarcomi

Answer 5

Immunohistochemistry stain for hHV-8 in the nuclei of cells

Question 6

CNS system disease in HIV

Answer 6

Progressive encephalopathy = AIDS dementia complex

Question 7

Characteristics of mycobacteria in immunocompetent people

Answer 7

Caseating granulomas

Question 8

Waht does it mean by caseating granuloma?

Answer 8

The centres will be necrotic

Question 9

Where does cavitating TB have a predilection for?

Answer 9

The apices of the lung

Question 10

Characteristic finding in sarcoidosis

Answer 10

Non-caseating granulomas

Question 11

What are granulomas?

Answer 11

Collection of activated macrophages/epithelioid macrophages with a cuff of lymphocytes around them +/- giant cells

Question 12

What is IgG4 related disease?

Answer 12

Inflammation dominated by IgG4-AB producing plasma cells which results in fibrosis and obliteration of veins

Question 13

IgG4 related disease of the thyroid =

Answer 13

Riedel’s thyroiditis

Question 14

IgG4 related disease of the pancreas

Answer 14

Autoimmune pancreatitis

Question 15

Stages of liver change in long term alcohol consumption

Answer 15

Normal –> Steatosis –> steatohepatitis –> fibrosis –> cirrhosis –> HCC

Question 16

Effects of alcohol on atheroma production

Answer 16

Increases and decreases it

Question 17

Locations affected in cystic fibrosis

Answer 17

Pancreas
Liver
Males: infertility, absent vas def
Intestine 
Salivary glands
Lung

Question 18

Effect of cystic fibrosis in intestine

Answer 18

Meconium ileus in neonates and distal intestinalobstruction in adults

Question 19

Lung infections commonly seen in CF patients

Answer 19

Pseudomonas aeruginosa, S.aureus, Haemophilus influenza

Question 20

Structure of amyloid protein

Answer 20

Beta-pleated sheet structure

Question 21

First classification of amyloidosis

Answer 21

primary (AL)- immune e.g. multiple myeloma, lymphoma

Second`ry (AA) - inflammatory e.g. RA, crohn’s

Question 22

Where is amyloid derived in primary and secondary amyloidosis?

Answer 22

Primary (AL) derived from serum free light chains

Secondary (AA) Derived from serum amyloid A

Question 23

Beta2 macroglobulin + amyloid

Answer 23

Peritoneal dialysis

Question 24

AB2 protein

Answer 24

Alzheimer’s disease

Question 25

Some clinical features of amyloidosis

Answer 25

Proteinuria, renal failure
Autonomic neuropathy
Macroglossia
Restrictive cardiomyopathy
Carpal tunnel syndrome

Question 26

Causes of granulomatous inflammation in the liver

Answer 26

TB
Sarcoid
Leprosy
PBC