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MRCS A: Pathology II > Infection and Inflammation II > Flashcards

Infection and Inflammation II Flashcards

1
Q

TB detection

A

Acid fast bacilli in sputum or pus smears by Ziehl-Neelson staining

Very slow growing

3 consecutive samples required

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2
Q

BCG and Mantoux tests

A

BCG-Live attenuated vaccine

Mantoux test: Intracutaneous or topical application.

Type IV hypersensitivity reaction if previous exposure

Immunosuppressed patients with TB may not be able to mount a response

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3
Q

Systemic characteristics

A

Cachexia

Caseating granulomas

Ileocaecal, IBD like presentation, RLQ mass

Adrenal: Bilateral, Addisons disease

Peritonitis

Urinary: sterile pyuria, predisposes to bladder Ca.

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4
Q

Treatment

A

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

Pyridixone to reduce isoniazide induced neuropathy

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5
Q

Syphilis

A

Vertical and horizontal sexual transmission
Increases HIV risk 3-5 fold
Teratogenic

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6
Q

Stages I: Primary

A

Chancre ulceration 2-6 weeks at mucosal sites

disappears regardless of treatment

30% risk of chronicity

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7
Q

Stages I: Secondary

A

Skin rash on palms and soles of feet (brown sores)

Fever, head ache, sore throat, lymphadenopathy

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8
Q

Stages I: Tertiary

A

Gummas (Granulomas with coagulative necrosis

Systemic damage

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9
Q

Diagnosis and treatment

A

VDRL test

Penicillin V (!)

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10
Q

Leprosy

A

Acid Fast Bacillin on skin scrapings
Disfiguring skin lesions, nerve damage
Predisposes to amyloidosis A

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11
Q

Treatment of leprosy

A

Rifampicin, dapsone and ethionamide

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12
Q

Schistosomiasis causes and sequelae

A

Schistosomiasis ova infiltrate GI and urinary systems causing reactionary granuloma formation resulting in bleeding, fibrosis and strictures

Often causes portal hypertension

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13
Q

Granulomas: immune reaction type and disease states

A

Type 4 hypersensitivity reaction

Disease states: PBC, Sarcoidosis, Wegener’s granulomatosis, Crohn’s

Tumours such as lymphoma and seminoma

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14
Q

Wegener’s granulomatosis

A

Granulomatous vasculitis-can occur anywhere

Affects respiratory system commonly and also glomerulonephritis

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15
Q

Sarcoidosis (General)

A

Non-caseating granulomatous disease predominantly affecting:

  • Young
  • Female
  • Black patients

Often seen in chest with bilateral hilar lymphadenopathy

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16
Q

Sarcoidosis (Respiratory)

A 
Bilateral hilar lymphadenopathy
Fever, cough, arthralgia, erythema nodosum
Pulmonary fibrosis (controlled by steroids)
17
Q

Sarcoidosis (CNS)

A

Uveitis
Cranial nerve palsy
meningitis

18
Q

Sarcoidosis (Renal)

A

Nephropathy

Renal calculi due to hypercalcaemia

19
Q

Sarcoidosis (Cardiac)

A

Arrhythmias
Cardiomyopathy
pericardial effusion

20
Q

ESR

A

Sign of chronic inflammation
Occurs due to increased plasma viscosity

Increased in malignancy
Increased in:
-Females
-Elderly
-Obese
-Pregnancy
-Anaemia
21
Q

CRP (actions)

A
  • Opsonin
  • Activates classical complement pathway
  • Upregulates adhesion molecules
  • Increases pro-inflammatory markers
22
Q

CRP (levels)

A

Acutely raised often in surgical trauma
Mildly raised predisposes to colon cancer and atherosclerosis
>300 independently poor prognostic sign

23
Q

Steroid side effects

A

Mineralocorticoid:
Hypertension
Fluid retention

Glucocorticoid:
Steroid diabetes
Iatrogenic Cushings
Poor wound healing
Osteoporosis
Adiposity
24
Q

NSAIDS general pharmacology

A

Absorbed in stomach and small intestine
Detectable after 30-45 mins
Mostly peripheral nerve system effect
Ceiling analgesia

25
Q

NSAIDs mode of action

A

Lipophilic at lower pH-as seen around inflamed tissue

Incorporate into cell bilayer and disrupt signals

COX-1 and COX-2 inhibited-therefore PG12 and PGE2 inhibited-antipyretic, anti-inflammatory and analgesic

26
Q

COX-1

A

COX-1 constitutive production of prostaglandin-mucin production in stomach and renal perfusion

27
Q

COX-2

A

COX-2 inducible from cytokines

28
Q

NSAID side effects

A 
GI disruption e.g. dyspepsia, gastric and duodenal ulceration
Renal toxicity
Fluid retention and hypertension
Bronchospasm
Tinnitus

MRCS A: Pathology II (15 decks)

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