Infectious Diseasess

Question 1

Describe the organ involvement in tertiary syphilis.

Describe the histological structure
of syphilitic granuloma

Answer 1

Occurs AFTER Latent Period of SECONDARY Lesions, about 2-3 Years AFTER 1st Exposure!

LESIONS of TERTIARY Syphilis are LESS INFECTIVE and have 2 Types:

1) SYPHILITIC GUMMMA
- Solitary, Localised, RUBBERY-Lesion
- CLAY-Line NECROSIS
- Seen in Liver, Testes, Bone + Brain
- CENTRAL Coagulative Necrosis

• ## PALISADING MFs w/ Plasma Cells, Lymph, Giant Cells + Fibroblasts2) DIFFUSE LESIONS
• WIDESPREAD Dissemination of SPIROCHETES
  a) CVS Syphilis = In the THORACIC AORTA, leading to AORTIC Aneurysm

b) Neurosyphilis
- Manifests as MENINGOVASCULAR Syphilis, TABES DORSALIS or PARSES - affecting the BRAIN

Question 2

Primary complexes in tuberculosis

Answer 2

Aka GHONS COMPLEX which is a TRIAD of:

1) PULMONARY LESION = 1-2cm SOLITARY + Found in SUBPLEURAL FOCUS in UPPER PARTS of the LUNG

2) TB Lymphangitis

PROGNOSIS:
1) Healing VIA FIBROSIS of GHONS COMPLEX

2) PROGRESSIVE Primary TB, which CONTINUES to grow / spread

3) HEMATOGENOUS TB, where BACILI ENTERS Circulation

4) PROGRESSIVE Secondary TB, where HEALED LESION is RE-ACTIVATED

Question 3

List the forms of secondary tuberculosis

Answer 3

1) FIBROCASEOUS Tuberculosis:

• ORIGINAL AREA of TB, which HEALS at the PERIPHERY WITH a MASSIVE CENTRAL CASEOUS Necrosis Cavity

a) CAVITARY / OPEN = It can BREAK thru BRONCHUS + FORM a CAVITY - Showing a THICK FIBROUS Wall, with YELLOW NECROTIC Material and WIDESPREAD TUBERCLES

b) CHRONIC = Remains a SOFT CASEOUS Lesion , WITHOUT DRAINAGE into –> Bronchus

2) TB CASEOUS PNEUMONIA:

• TB that spreads to REST OF LUNG, where there’s an EXUDATIVE REACTION - Fibri, Polymporphs, Monocyhtes + Tubercle Bacilli

3) MILITARY TB

• TB Infection that LYMPHOHEMATOGENOUSLY SPREADS, either PULMONARY / EXTRAPULMONARY,
• Forming MILLET-SIZED Tubercles

4) TB PLEURITIS & EMPYEMA

• COMPLICATION of Secondary TB
• SEROUS / FIBRIN Exudate is HEALED VIA FIBROSIS
• There’s OBLITERATED Pleural Cavity WITH CASEOUS Material
• Develop EMPYEMA

Question 4

Forms of urological tuberculosis

Question 5

How do we form the names of benign and malignant mesenchymal tumours? Give at
at least three examples.

Answer 5

1) EPITHELIAL
0 Benign
- Squamous Papilloma
- Adenoma

0 Malignant:
- Squamous Cell Carcinoma
- Adenocarcinoma
———————————-
2) MESENCHYMAL
0 Benign
- Lipoma (Fat)
- Chondroma (Cartilage)
- Haemangioma (Blood Vessles)
- Leiomyoma (Muscle)

0 Malignant:
- Liposarcoma (Fat)
- Chondrosarcoma (Cartilage)
- Angiosarcoma (Blood Vessels)
- Leiomyosarcoma (Muscle)

• Leukaemia / Lymphoma (Haematolymphoid)

Question 6

Squamous intraepithelial lesions and dysplasia. Definitions

Answer 6

1) SQUAMOUS INTRAEPITHELIAL LESION = This Term is USED to INDICATE the Cells from Pap Smear may be PRE-CANCEROUS

CIN 1 = Nuclear Enlargement + Hyperchromasia in BASAL 1/3 of Cells

CIN 2 = 2/3 of EPITHELIUM show NUCLEAR Changes

2) DYSPLASIA
- ABNORMAL Organisation of Cells

• Characterised by PLEOMORPHISM, Disorderly Arrangement within Epithelium + Nuclear Changes
• Consists of Enlargement, IRREGULAR Borders, HYPERChromasia of INDIVIDUAL Nuclei + INCREASED N.O of Mitotic Figures

Question 7

What do the terms Main disease and Immediate cause of death mean?

Answer 7

MAIN DISEASE
- Disease that DIRECTLY / Via COMPLICATIONS have a GREAT Impact on Px Life

INTERMEDIATE Cause of Death
- SPECIFIC Nosological Unit (Disease Injury, Complication of Disease)

• LEADING to Cardiac / Respiratory Failure + DEATH of Px

Question 8

Svetko carcinoma - macro and microscopic