Systemic Disease Flashcards

1
Q

Opportunistic infections in HIV

A

o Pneumocystis jiroveci  PCP pneumonia
o CMV  especially retina and GIT
 I.E. CMV oesophagitis

o Candida
o Tuberculosis and atypical mycobacteria
o Cryptococcus  meningitis
o Toxoplasma gondii  encephalitis and mass lesions

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2
Q

Tumours in HIV

A

o Kaposi’s sarcoma (HHV-8) (A) Dermis expanded by a solid tumour
 (B) Made of spindle-shaped cells – infiltrated by HHV-8
 (C) HHV-8 identified in nuclei of tumour cells
o Lymphoma

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3
Q

CNS diseases in HIV

A

o Progressive encephalopathy = AIDS dementia complex
o Plus, opportunistic infections and tumours
o CNS lymphoma

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4
Q

Characteristics of TB

A

o Caseating granulomas – in immunocompetent people

• Mycobacterial infections can affect:
Lung, Lymph nodes, Bone,Heart GIT, CNS

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5
Q

Characteristics of sarcoid

A

o NON-caseating granulomas – collection of macrophages with a cuff of lymphocytes around
o Diagnosed as a diagnosis of exclusion

Affects many organs including, lung, liver, heart, skin, spleen etc

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6
Q

IgG4 related disease characteristics

A

o Inflammation dominated by IgG4-AB producing plasma cells
o Fibrosis and obliteration of veins
 Plasma cell rich inflammatory infiltrate
 Immunohistochemistry for IgG4

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7
Q

IgG4 related diseases

A

o Salivary and lacrimal glands: Mikulicz syndrome
o Thyroid: Riedel thyroiditis
o Peritoneum: Retroperitoneal fibrosis
o Liver: Biliary obstruction

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8
Q

Conditions caused by alcohol

A

o Liver: fatty change (steatosis), steatohepatitis, cirrhosis
o GI Tract: acute gastritis, oesophageal varices
o Nervous system: peripheral neuropathy, Wernicke-Korsakoff syndrome etc
o Cardiovascular system: dilated cardiomyopathy, hypertension
o Pancreas: acute pancreatitis, chronic pancreatitis
o Cancer: oral cavity, pharynx. oesophagus, liver and breast

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9
Q

Areas affected in cystic fibrosis

A

o Pancreas: duct obstruction, exocrine atrophy

o Salivary glands: duct obstruction, atrophy

o Intestine: meconium ileus

o Liver: biliary obstruction, cirrhosis

o Lung: bronchial obstruction, superimposed infection with abscess formation (Staphylococcus aureus, Haemophilus influenzae and Pseudomonas aeruginosa)

o Male genital tract: infertility, absence of the vas

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10
Q

Amyloid pathophysiology

A
  • Deposition of an abnormal proteinaceous substance in non-branching fibrils, 7.5-10nm diameter
  • Always contains P-component
  • Beta-pleated sheet structure
  • A variety of proteins can take on this conformation
  • Resistant to enzymic degradation
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11
Q

Staining of amyloid

A

o Stains with Congo Red Dye

o Shows apple-green birefringence under polarised light

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12
Q

Classification of amyloid

A

 AA – derived from serum amyloid A (e.g. RhA, Crohn’s Disease / chronic inflammatory diseases)
 AL – derived from light chains (e.g. multiple myeloma, B cell lymphoma)

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13
Q

Clinical effects of amyloid

A

o Proteinuria, renal failure Restrictive cardiomyopathy, arrhythmias
o Autonomic neuropathy Carpal tunnel syndrome
o Macroglossia Bleeding on injury
o Also deposited in blood vessels, endocrine organs, liver, spleen

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