NEET MDS Lessons
General Pathology
Pyelonephritis
- A bacterial infection that affects the renal tubules, interstitium, and renal pelvis.
- One of the most common renal diseases.
- Usually caused by gram-negative, rod-shaped bacteria that are part of the normal flora of the enteric tract. Most commonly caused by Escherichia coli, followed by Proteus, Klebsiella, and Enterobacter.
- The infecting bacteria are usually from the patient’s own enteric flora an example of an endogenous infection.
- Usually associated with a urinary tract infection (acute pyelonephritis) or involved with another precipitating condition, such as obstruction (chronic pyelonephritis).
Achrondroplasia
is a major cause of dwarfism. The underlying etiology is a point mutation in the fibroblast growth factor receptor, which causes inhibition of chondrocyte proliferation, which is associated with suppression of the normal epiphyseal growth plate expansion. Thus, long bone growth is markedly shortened.
The most conspicuous changes include disproportionate shortening of the proximal extremities, bowing of the legs, and a lordotic posture.
Microscopically, the cartilage growth plates are disorganized and hypoplastic.
Bronchitis
Bronchitis is an obstructive pulmonary disease characterized by inflammation of the bronchi of the lungs
Signs and symptoms
persistent cough that produces sputum
shortness of breath (dyspnea) on exertion
hypercapnia
insufficient oxygenation of the blood hypoxemia leading to cynosis
Severe chronic bronchitis will commonly lead to cor pulmonale and heart failure.
Pathology
an increase in the number of goblet cells with mucus blocking the airway clusters of pigmented alveolar macrophages
the presence of inflammatory cells (e.g. neutrophils) scarring (fibrosis) of the walls of the bronchioles
Diagnosis
- decreased intensity of breath sounds (rhonchi) and extended expiration.
- a sputum culture has pathogenic microorganisms
- a chest x-ray that reveals hyperinflation and increased bronchovascular markings
- a pulmonary function test that shows an increase in the lung's residual volume and a decreased vital capacity
Pathophysiology
- The initiating event in developing bronchitis appears to be chronic irritation due to inhalation of certain chemicals
- earliest clinical feature of bronchitis is increased secretion of mucus by submucousal glands of the trachea and bronchi
- Damage caused by irritation of the airways leads to inflammation and infiltration of the lung tissue by neutrophils
- The neutrophils release substances that promote mucousal hypersecretion
- As bronchitis persists to become chronic bronchitis, a substantial increase in the number of goblet cells in the small airways is seen
- The role of infection in the pathogenesis of chronic bronchitis appears to be secondary.
Treatment
Quit smoking, Oxygen therapy, bronchodilator drugs
Prognosis
Pulmonary hypertension, cor pulmonale, and chronic respiratory failure are possible complications of chronic bronchitis
In severe chronic bronchitis is poor
Infectious Mononucleosis
It is an Epstein Barr virus infection in children and young adults.
Features
-Constitutional symptoms.
-Sore throat.
-Lymphnode enlargement.
-Skin rashes
-Jaundice.
-Rarely pneumonia, meningitis and encephalitis.
Blood Picture
- Total count of I0,000. 20,000 /cu.mm.
- Lymphocytosis (50-90%) with atypical forms. They are larger with more cytoplasm which may be vacuolated or basophilic. Nucleus may be indented. with nucleoli (Downy type I to III).
- Platelets may be reduced.
- Paul Bunell test (for heterophil antibody against sheep RBC) is positive
Roseola
- alias exanthem subitum; caused by Herpes virus type 6.
- children 6 months to 2 years old; spring and fall; incubation 10-15 days.
- sudden onset of a high fever with absence of physical findings; febrile convulsions are particularly common.
- fever falls by crisis on the 3rd or 4th day → 48 hours after temperature returns to normal macular or maculopapular rash starting on the trunk and spreading centrifugally.
Peutz-Jeghers syndrome
1. Lesions appear as small, melanotic, and freckle-like. They can be found on the skin, oral mucosa, lips, feet, and hands.
2. May also present with intestinal polyps, which may develop into a gastrointestinal carcinoma.
3. Genetic transmission: autosomal dominant.
Keratoses (Horny Growth)
1. Seborrheic keratosis is a common benign epidermal tumor composed of basaloid (basal cell-like) cells with increased pigmentation that produce a raised, pigmented, "stuck-on" appearance on the skin of middle-aged individuals.
- they can easily be scraped from the skin's surface.
- frequently enlarge of multiply following hormonal therapy.
- sudden appearance of large numbers of Seborrheic keratosis is a possible indication of a malignancy of the gastrointestinal tract (Leser-Trelat sign).
2. An actinic keratosis is a pre-malignant skin lesion induced by ultraviolet light damage.
- sun exposed areas.
- parakeratosis and atypia (dysplasia) of the keratinocytes.
- solar damage to underlying elastic and collagen tissue (solar elastosis).
- may progress to squamous carcinoma in situ (Bowen's disease) or invasive cancer.
3. A keratoacanthoma is characterized by the rapid growth of a crateriform lesion in 3 to 6
weeks usually on the face or upper extremity.
- it eventually regresses and involutes with scarring.
- commonly confused with a well-differentiated squamous cell carcinoma.