NEET MDS Lessons
General Pathology
Q Fever
An acute disease caused by Coxiella burnetii (Rickettsia burnetii) and
characterized by sudden onset of fever, headache, malaise, and interstitial
pneumonitis.
Symptoms and Signs
The incubation period varies from 9 to 28 days and averages 18 to 21 days. Onset
is abrupt, with fever, severe headache, chills, severe malaise, myalgia, and,
often, chest pains. Fever may rise to 40° C (104° F) and persist for 1 to > 3
wk. Unlike other rickettsial diseases, Q fever is not associated with a
cutaneous exanthem. A nonproductive cough and x-ray evidence of pneumonitis
often develop during the 2nd wk of illness.
In severe cases, lobar consolidation usually occurs, and the gross appearance of
the lungs may resemble that of bacterial pneumonia
About 1/3 of patients with protracted Q fever develop hepatitis, characterized
by fever, malaise, hepatomegaly with right upper abdominal pain, and possibly
jaundice. Liver biopsy specimens show diffuse granulomatous changes, and C.
burnetii may be identified by immunofluorescence.
DYSPLASIA
It is disturbed growth or cells in regard to their size, shape arrangement. In its mild degrees it represents a reversible reaction to chronic inflammation whereas the most severe degrees warrant a labelling of intraepithelial neoplasia. Hence it includes a wide spectrum of changes ranging from a reversible disorientation to 'carcinoma-in-situ'.
Histologically it is characterized by:
o Basal cell hyperplasia.
o Variation in size and shape of cells.
o Disorderly maturation.
o Increased mitotic activity.
o Disorientation of arrangement of cells (loss of polarity)
Dysplasia is commonly seen in:
o Squamous epithelium of cervix.
o Bronchial epithelium in habitual smokers.
o Gastric and colonic mucosa in long standing inflammation
o Oral and vulval leucoplakia
Cryptococcosis
An infection acquired by inhalation of soil contaminated with the encapsulated yeast Cryptococcus neoformans, which may cause a self-limited pulmonary infection or disseminate, especially to the meninges, but sometimes to the skin, bones, viscera, or other sites.
Cryptococcosis is a defining opportunistic infection for AIDS, although patients with Hodgkin's or other lymphomas or sarcoidosis or those receiving long-term corticosteroid therapy are also at increased risk.
AIDS-associated cryptococcal infection may present with severe, progressive pneumonia with acute dyspnea and an x-ray pattern suggestive of Pneumocystis infection.
Primary lesions in the lungs are usually asymptomatic and self-limited
Pneumonia usually causes cough and other nonspecific respiratory symptoms. Rarely, pyelonephritis occurs with renal papillary necrosis development.
Most symptoms of cryptococcal meningitis are attributable to brain swelling and are usually nonspecific, including headache, blurred vision, confusion, depression, agitation, or other behavioral changes. Except for ocular or facial palsies, focal signs are rare until relatively late in the course of infections. Blindness may develop due to brain swelling or direct involvement of the optic tracts. Fever is usually low-grade and frequently absent.
Ichthyosis vulgaris is a genetic disease characterized by increased cohesiveness of the cells in the stratum corneum, resulting up in a piling up stratum corneum (scales like a fish).
TOXOPLASMOSIS
Infection with Toxoplasma gondii, causing a spectrum of manifestations ranging from asymptomatic benign lymphadenopathy to life-threatening CNS disease, chorioretinitis, and mental retardation.
Symptomatic infections may present in several ways
Acute toxoplasmosis may mimic infectious mononucleosis with lymphadenopathy, fever, malaise, myalgia, hepatosplenomegaly, and pharyngitis. Atypical lymphocytosis, mild anemia, leukopenia, and slightly abnormal liver function tests are common. The syndrome may persist for weeks or months but is almost always self-limited.
A severe disseminated form characterized by pneumonitis, myocarditis, meningoencephalitis, polymyositis, diffuse maculopapular rash, high fevers, chills, and prostration. Acute fulminating disease is uncommon.
Congenital toxoplasmosis usually results from a primary (and often asymptomatic) acute infection acquired by the mother during pregnancy. The risk of transplacental infection increases from 15% to 30 to 60% for maternal infections acquired in the 1st, 2nd, or 3rd trimester of gestation, respectively
Huntington’s disease
a. Causes dementia.
b. Genetic transmission: autosomal dominant.
c. Characterized by the degeneration of striatal neurons, affecting cortical and basal ganglia function.
d. Clinically, the disease affects both movement and cognition and is ultimately fatal.
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