Path Key Points 3 Flashcards
Diffuse large B cell lymphoma
Old people
Large lymphocytes
SIADH
2 low in blood - sodium and osmolality
2 high in urine - sodium and osmolality
3 exclusions - renal/adrenal/thyroid/cardiac cause, hypovolaemia, contributing drugs
AIHA
Warm - IgG mediated - lymphoproliferative disease, drugs (penicillins), autoimmune diseases (SLE)
Cold - IgM mediated - mycoplasma/EBV
DAT +ve + spherocytes
Common variable immunodeficiency syndrome
Adults
MHC III mutation
Low B cells, Ig A & G
Also have autoimmune conditions
Chronic granulomatous disease
X-linked
Chronic inflammation with non-caseating granuloma
Niotroblue tetrazolium negative
Bare lymphocyte syndrome
Low MHC I/II
Sclerosing cholangitis + hepatomegaly + jaundice
Selective IgA deficiency
Mild respiratory and gastro infections
Linked to RA and SLE
Reticular dysgenesis
No granulocytes and lymphocytes
Sepsis few days after birth
AKA SCID
Interferon gamma deficiency
No granulomas
Mycobacterium and salmonella infections
Goodpasture’s disease
Respiratory feature - haemoptysis, dyspnoea, cough
Renal features - haematuria, AKI, nephrotic syndrome
IgG in basement membrane
Di George syndrome
22q11 deletion
Cardiac abnormalities + atresia + thymic aplasia + cleft palate + hypocalcaemia
Low CD4, CD8, IgG, gA
Rabies
Progressive encephalitis + hydrophobia + muscle spasm
Q fever
Coxiella burnetti
Inhalation of urine/faeces of infected livestock
Cat scratch disease
Bartonella species
Bites from cats
Tender and swollen lymph nodes + headache + backache
Kala azar
Visceral leishmaniasis
Fever + splenomegaly
Hepatomegaly, hyperpigmentation, dry warty skin
Cutaneous leishmaniasis
Itchy papule at bite site –> ulcer with raised edges
Brucellosis
Brucella abortis
Unsterilised milk/cheese
Fever, muscle and joint pain, weight loss, fatigue, sacroilitis, depression
Mx - amoxicillin and doxycycline for 6 weeks
Lyme disease
Borrelia burgdorferi
Local - erythema chronicum migrans (red papule/macule –> target lesion), fever, headache
Disseminated - peripheral neuropathy, erythema chronicum migrans, cranial nerve palsies, arthritis
Late - persistent arthritis, chronic encephalitis
Mx - oral doxycycline
Sporadic CJD
Rapidly progressing dementia at 65, lower motor neuron signs, akinetic mutism, myoclonus, cortical blindness
LP for 14-3-3 protein
EEG - generalised triphasic sharp complexes
Variant CJD
26 years
Initially psych feature –> ataxia, dementia, myoclonus
MRI - positive pulvinar sign
EEG - normal
