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Flashcards in Disease Deck (125):
1

Carpal tunnel syndrome

Tingling/numbness/pain as the median nerve is compressed

2

Paget's disease

Bone is replaces at a faster rate so they are enlarged, weak and brittle.
increased risk of fracture and causes bone pain, especially when lying down.

3

Tetanus

Caused by clostridium tetani.
Produces a toxin which interferes with feedback control, causing fused tetani.

4

Primary osteoarthritis

Wear and tear, reducing articular cartilage of the joint. Very painful as the lining is broken down.
Fluid is produced to reduce inflammation and range of movement.
Can be triggered by injury or break.
Treat with analgesia and physio at first, then will require a joint replacement.

5

Secondary osteoarthritis

Infection in a joint caused by a puncture wound.
Can cause breakdown of articular cartilage.
Joint is red and swollen with a decreased range of movement.

6

Septic arthritis of the hip

Unable to weight bear.
Fever, high wbc count and c-reactive protein.
Check with an ultrasound or a needle in the joint (look for pus)

7

Primary osteosarcoma

Seen in teens or earrly adults. Cancer in the bone.

8

Bursitis

Bursae become irritated and inflamed due to a repetitive strain injury or trauma.

9

Syndactyly

When two or more digits are fused together.
Can be joined by skin, connective tissue, or bone.

10

Polydactyly

When there are extra digits.
Autosomal recessive disorder

11

Amelia

Complete absence of a limb.

12

Meromelia

Partial absence of one or more limb structure

13

Phocomelia

Caused by thalidomide, interferes with the apical ectodermal ridge.

14

Dislocation of the glenohumeral joint

Usually caused by trauma to a fully abducted arm.
Humeral head locates anteriorly due to powerful adductors, comes to lie beneath the coracoid process.
Capsule and rotator cuff may tear with poor healing, leading to recurrent dislocation.

15

Axillary nerve injury

Likely to be injured during dislocation due to its close relation to the inferior part of the joint capsule.
Indicated by paralysis of the deltoid with loss of sensation over the regimental badge area, supplied by the lateral cutaneous nerve.
Test for injury by sensory rather than motor ability.

16

Painful arc syndrome

Supraspinatous tendon rubbing under the coracromial arch, causing irritation and inflammation of the tendon and subacromial bursa.
Leads to a spectrum of problems including subacromial bursitis and supraspinatous tendinitis (with or without calcification), and deveneration + rupture of tendons if they don't heal.

Predisposing factors:
- Repetitive overuse (sporting activities/work with overhead use of the arms)
- Degenerative changes to the tendons in older people
- Avascularity of the supraspinatous tendon making impingement more likely

Pain experienced during abduction of the arm between 50 and 130 degrees.

17

Pericardial effusion

A build up of serous fluid. Can be caused by pericarditis.
Treat by removing with a needle

18

Cardiac tamponade

Fluid accumulates too quickly for the heart to compensate.
Distended veins on the neck, quiet heart sounds and low blood pressure.

19

Valve calcification

Calcium deposits on the aortic valve, narrowing the opening and causing stenosis.
Changes the quality of the valve sounds, causing a heart murmer.

20

Aortic stenosis in the foetus

Obstruction of blood flow from the heart to the body.
Causes ventricular hypertrophy if left untreated, leading to to left-sided heart failure and abnormal heart rhythm.
May be leaking in addition to the narrowing if the aortic valve is affected.

21

Examples of atrial septal defects and consequences

Secundum fails to close
Sinous venous defect (pulmonary vein failure)
Primum atrial defect

Blood can move from left to right, causing the heart to stretch. This causes atrial arrhythmia and is a low pressure defect. Eventually causes right heart failure.

May stay unnoticed into adulthood if the defect is small

22

Ventricular septal defects

Can happen anywhere, most common in the membrane septum below the aortic valve.

If small, a murmer may be present but with no significant effects.

If significant size, increases pressure around the lungs causing damage. The left ventricle has to pump harder.

23

Atrioventricular defects

Leakage.
Associated with Down's syndrome, can be complete or partial.

Symptoms include dyspnea and cyanosis. The newborn shows signs of heart failure such as oedema, fatigue and irregular heart rate.

24

Coarction of the aorta

Narrowing at the region of the ligamentum arteriosum

Increases afterload on the left ventricle causing left ventricular hypertrophy. Vessels to the head and limbs enlarged so the blood supply to these regions isn't compromised. Blood to the rest of the body is reduced.

Extent of symptoms depends on severity of coarction

Can be very serous, causes hypertension and excess vessels. Can be removed and repaired, or a stent added.

May be seen in neonate or adult

25

Tetralogy of Fallot

Pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy and over-riding aorta.

Malalignment of the aorta pushes the pulmonary artery away, causing stenosis above and below the valve. Leads to right ventricular hypertrophy which protects against high blood pressure in the lungs. Also allows right to left shunting which causes cyanosis.
Thickened pulmonary valves.

Is survivable and treatable.

26

Tricuspid atresia

No right ventricular inlet with obstruction of the tricuspid.
Hole between atria - right to left atrial shunt.
Blood flow to the lungs via VSD/PDA.
Cyanotic
At birth, stops blood flow to the lungs.
Can have surgery to compromise on blood flow.

27

Transposition of the great arteries

Bi-directional shunting.
PDA and atrioseptal mixing in utero. When born, the right ventricle supplies the aorta and the left ventricle the pulmonary arteries.

The baby will die quickly unless the arteries are swapped, potentially including the coronary arteries.

28

Hypoplastic left heart

Extention of the aortic stenosis, left ventricle doesn't form or grow.

Atrioseptal communication means it doesn't matter in utero. Circulation stops at birth. Can reconstruct the aorta and ventricle, but still has a high mortality.

29

Univentricular heart

Can occur with or without transposition of the great arteries. Can treat after birth.
Causes Fontan circulation - one ventricle maintains both systemic and pulmonary circulation.
Blood returns from the body without a pumping chamber.

30

Reperfusion injury

Blood flow returns, worsening ischaemic damage. Oxygen is converted to superoxide, causing cell death.
Brings neutrophils which causes acute infammation and proteins which activate the complement pathway.

31

Rhabdomyolysis

Breakdown of muscle tissue, leading to the release of muscle fibre contents into the blood.
Occurs in alcohol/drug abuse.
Causes brown urine due to renal failure as it affects the kidney tubules.

32

Xanthoma

A build up of cholesterol in the skin

33

Haemosiderosis

Systemic excess of iron causing haemosiderin build up. Has a range of causes.
Can cause liver failure, diabetes and hyperpigmentation.

34

Bacterial meningitis

Pus causes vascular thrombosis and decreased cerebral perfusion.
Streptococcus meningitidis can be seen in all age groups.

35

Skin blisters

Caused by heat/sun/chemicals. Very painful with lots of exudates.
If fluid is clear, not infection.
Resolution or scarring

36

Abcess

Solid tissue with an influx of exudate, liquefactive necrosis in the centre.
May cause pressure and therefore pain.
Can lead to tissue damage if it squashes adjacent structures.

37

Hereditary angio-oedema

Non-itchy angio-oedema.
Can cause abdominal pain, high incidence of sudden death with laryngeal involvement.
Caused by a C1 esterase deficiency

38

Alpha-1 antitrypsin deficiency

Autosomal recessive.
Inhibits proteases normally, causes emphysema as inhibition lost.
Abnormal shape allows it to polymerise in the liver ER and can therefore cause liver disease.

39

Complement deficiency

Effect depends on what exactly is affected.
Hereditary angio-oedema is an example.
Also can increase susceptability to certain infections e.g. Neisseria

40

Neutropenia

Low neutrophil count, patient is immunocompromised with recurrent infections.

41

Chronic granulomatous disease

Phagocytes are unable to produce superoxide radicles so can't kill bacteria.
Causes chronic infection, granuloma and abcess.

42

Acute appendicitis

Caused by bacterial infection, can become obstructed (by faeces/calcium salts) which causes inflammation and infection.
Symptoms include sharp, localised, persistent pain, low fever, rapid heartbeat and loss of appetite.

43

Bronchopneumonia

Acute inflammation of the walls of the bronchioles.
Associated with Staphylococcus aureus and E coli.
Mainly seen in infants or the immunosuppressed. Onset is insidious.

44

Lobar pneumonia

Commonly caused by Streptococcus pneumoniae or Mycobacterium tuberculosis.

Stages -
Congestion: vascular engorgement, intra-alvelolar fluid, small number of neutrophils, numerous bacteria
Consolidation (red hepatisation): continued congestion with extravasion of RBC to alveolar spaces with high number of neutrophils and fibrin. Gross appearance of solidification of alveolar parenchyma.
Grey hepatisation: RBC disintegrate, persistence of neutrophils and fibrin, paler colour
Resolution: total recovery. Exudate digested by enzymes and cleared by macrophages.

Complications include abcess formation, emphysema, intra-alveolar scarring (causes permanent loss of ventilatory function of affected parts of the lung), bacteraemia (causes endocarditis, cerebral abcess/meningitis, septic arthritis)

45

Ascending cholangitis

Infection of the bile duct caused by bacteria ascending from the junction with the jejunum. Tends to occur if already obstructed by gall stones.

Symptoms: jaundice, fever, abdominal pain, low blood pressure, confusion (when severe)

Treat with IV fluids and antibiotics.

46

Liver abcess

A pus-filled mass inside the liver commonly caused by abdominal infections such as appendicitis which spreads through the portal vein.
Mostly pyogenic, can be due to amoebae or fungal, although these are less common.

Symptoms: fever, anorexia, sickess, weight loss, weakness, pain and jaundice (late stage)

Treat with antibiotics. May require drainage/surgery.

47

Multiple Sclerosis

Autoimmune disease which attacks the proteins holding myelin together, causing demyelination.
This disrupts the neurons ability to communicate.
Symptoms depend on location.
Action potentials fire but a large proportion fails to come through (stops propagation)

48

Thyrotoxicosis

Grave's disease.
Autoimmune hyperthyroidism.
TSH receptors are stimulated by antibodies

49

Tuberculosis

Caused by Mycobacterium tuberculosis

50

Multiple Sclerosis

Inflammatory disease which damages the insulating covers of neurons, disrupting their ability to communicate.
Multiple points have been damaged, symptoms depend on location.
Action potentials fire but a large proportion fails to come through (stops propagation)

51

Devic's disease

Recurrent and simultaneous inflammation and demyelination of the optic nerve and spinal cord.

52

Guillian-Barre syndrome

Rapid onset weakness of the limbs as a result of polyneuropathy. Normally triggered by infection.
Can be life threatening.

53

Charcot-Marie-Tooth syndrome

Group of inherited disorders characterised by progressive loss of muscle tissue and touch sensation across various parts of the body.

54

Scurvy

Vitamin C deficiency.
Defective alpha chains are formed so collagen lacks tensile strength and resistance to enzyme degradation.
Can have haemorrhage of the gums and skeletal abnormalities in young children.

55

Ehler-Danlos syndrome

Lax skin, hypermobile joints, lens detachment.
Associated with keloid scars.
Mutations which disrupt proper collagen functions

56

Osteogenesis imperfecta

Most commonly seen as a deficiency of type I collagen.
Thin, brittle bones with high risk of fracture. Can also have bluish, thin sclera.

57

Alport syndrome

Mutation to genes involved in production/assembly of type IV collagen.
Characterised by glomerulonephritis, end-stage kidney disease and hearing loss. Can also cause eye abnormalities.

58

Diverticular stricture

Sigmoid colon.
Small herniations of mucosa with paracolic abcesses.
Insult dies down and fibrous repair leads to a stricture forming.
Majorly due to stenotic colon cancers in the elderly.

59

Pressure ulcers

When a large amount of pressure occurs over a short time or a small amount over a large time, disrupting blood flow through the skin causing ischaemia.
Patients most at risk are those with health conditions that make it difficult to move, especially confined to a bed or left sitting for a long period of time. Type II diabetes can also make a person more vulnerable.
Treated with dressings, creams and gels to increase rate of healing and reduce pressure. Surgery may be recommended in the most severe cases.
Prevention through regular changing of a person's position and using equipment to protect vulnerable parts of the body.

60

Scurvy

Deficiency of vitamin C, required for vitamin C-dependent hydroxylation of procollagen.
Characterised by swelling and haemorrhage of the gums, petechial haemorrhaging of the skin and hyperkeratosis of hair follicles.

61

Ehlers-Danlos syndrome

Defect in structure/processing/production of collagen or the proteins that interact with it.
Associated with keloid formation, hyperflexible joints, unstable joints, osteoarthritis, myalgia, spinal deformity, fragile skin and sleep apnoea.

62

Osteogenesis imperfecta

Deficiency in type I collagen which creates brittle bones susceptable to fracture.
Can cause spinal curvature and blue sclera.

63

Alport syndrome

Defect to type IV collagen biosynthesis.
Causes glomerulonephritis, end-stage kidney disease and hearing loss. Can cause eye abnormalities.
X-linked

64

Liver cirrhosis

Healthy liver tissue is replaced with scar tissue.
Forms islands of hepatocytes surrounded by fibrotic tissue. Scar tissue can block blood flow and slows metabolism of hormones, drugs and toxic by-products of metabolism.

65

Coal worker's pneumoconiosis

Inhaled coal builds up in the lungs, unable to be removed.
Leads to excessive fibrosis.

66

Keloid scars

Overgrowth of granulation tissue which is slowly replaced by type I collagen.
Greater likelihood of infection.
Generally produces a scar larger than the original wound.

67

Oesophageal strictures

Webs and rings causing narrowing of the oesophagus caused by excessive fibrosis.
Causes dysphagia, food impaction, weight loss and chest pain.

68

Contractures (due to excessive fibrosis)

Excessive fibrosis over a tendon causing permanent contraction of muscles.

69

Marfan's syndrome

Defect in fibrillin-1, increasing TGF-beta, causing problems with connective tissue throughout the body.
Causes aortic enlargement, long limbs and digits, lung collapse and eye problems.

70

Tuberculosis

Caused by the bacteria Mycobacterium tuberculosis. Identify with an acid fast stain.
Symptoms are a chronic cough, blood-tinged sputum, fever, night sweats and weight loss.
Most commonly affects the lungs

71

Pott's disease

Extrapulmonary tuberculosis where the disease is seen in the spinal vertebrae. If it spreads to two disks they can't receive nutrients and collapse. Tissue dies and is broken down by caseation, leading to vertebral narrowing, collapse and spinal damage.

72

Rheumatoid arthritis

Inflammatory response around a joint capsule secondary to swelling of the synovial membrane, excess synovial fluid and development of fibrous tissue in the synovium. Autoimmune disorder.

Symptoms include swollen and stiff joints, joint deformity due to tendon tethering and destruction of the joint surface (e.g. swan neck deformity of the finegrs).
Rheumatoid nodules in the skin. Have a central area of fibrinoid necrosis surrounded by macrophages and fibroblasts.
May also lead to fibrosis of the lungs, renal amyloidosis and atherosclerosis.

Can be managed with lifestyle chanegs, disease-modifying anti-rheumatic drugs and NSAIDs

73

Chronic gastritis

Inflammation of the lining of the stomach causing upper abdominal pain, nausea, vomiting, loss of appetite and unexplained weight loss.

Can be caused by bacterial infections e.g. H. pylori, chronic bile reflux, stress and autoimmune disorders.

Can treat with antacids or proton pump inhibitors.

74

Ulcerative colitis

Intermittent disease which attacks the large intestine.
Symptoms include constant diarrhoea mixed with blood (gradual onset), abdominal pain, may have weight loss.

Endoscopy - loss of vascular appearance, erythema, friability of mucosa, superficial ulceration, pseudopolyps.

Microscopy - distortion of crypt architecture, cryptitis, frank crypt abcesses, haemorrhage/inflammatory cells in the lamina propria.

Complications:
Enteropathic arthritis, ankylosing spondylitis (spinal arthritis)
Erythremanedosum (inflammation of fat)
Piodermagangrenosum
Iritis, episcleritis
Hepatitis, cirrosis, sclerosing cholangitis

75

Crohn's diseas

Can affect any part of the GI tract from mouth to anus.
Symptoms include abdominal pain, diarrhoea (may be bloody), fever and weight loss.

Has a transmural pattern of inflammation, making the patient susceptible to fistulas. Abrupt transition between unaffected tissue and an ulcer, characteristic sign known as skip lesions. Can have stenosis and bowel obstruction.

Microscopy - mucosal inflammation with focal infiltration of neutrophils into the epithelium, cryptitis, crypt abcess (rarely), granulomas in 50% of cases, blunting of intestinal villi, atypical branching of crypts.

76

Leprosy

Mainly caused by Mycobacterium leprae.
Symptoms include skin lesions, loss of pain sensation and damage to the limbs and eyes.

Granulomas form in nerves, respiratory tract, skin and eyes.

Treat with rifampin.

77

Syphilis

Most commonly transmitted sexually.

Begins with sores on the genitals and sometimes mouth, then a skin rash and sore throat. A latent period follows which can last years, before the disease may progress and cause serious damage.

Can easily be treated with antibiotics e.g. penicillin.

78

Sarcoidosis

Rare condition which causes granulomas to form in the body, most commonly affecting the lungs and skin.

Typical symptoms include shortness of breath, persistant dry cough, tender red bumps/patches on the skin. Symptoms depend on the organs affected.

Characterised by bilateral enlarged hilar lymph nodes. Thought to be an autoimmune response which results in inflammation causing granulomas (non-caseating) with foreign body cells.

Patient will have high angiotensin converting enzyme and calcium.

Most common in young afro-caribbean women.

79

Wegener's granulomatosis

Rare form of vasculitis, thought to be an autoimmune inflammatory process affecting endothelial cells.

Most commonly presents with lesions of the upper respiratory tract (100%), lungs and kidneys.

Symptoms include fever, weakness, weight loss, cough, chest pain and wheezing.

80

Patent Foramen Ovale

Not a true atrioseptal defect.
Seen in around 20% of the population.

Generally clinically silent because the left atrial pressure causes functional closure of the flap valve.
May be a route where a venous embolism enters the systemic circulation as pressure on the right side of the heart increases transiently (paradoxial embolism)

81

Patent Ductus Arteriosus

Failure of the ductus arteriosus to close. Blood flow from the aorta to the the pulmonary artery after birth.

82

Eisenmenger Syndrome

Right to left shunting.
Chronic left to right shunting leads to vascular remodelling of the pulmonary circulation and an increase in pulmonary resistance.
Pulmonary resistance increases beyond that of systemic circulation.

83

Myasthenia Gravis

Autoimmune destruction of nAChR and degrades end-plate folding.
Causes profound weakness which increases with exercise.
Receptors become non-functional by complement mediated lysis and receptor degradation.
End plate potential decreases in amplitude.
Amount of neurotransmitter remains the same but each quantum released produces a smaller response than in normal muscle.

84

Deep vein thrombosis

Formation of a clot in a deep vein, commonly in the calf.
Risk factors include old age, surgery, immobilisation, pregnancy and the post-natal period.
Symptoms are pain, swelling and a heavy ache in the leg, but may be asymptomatic.

85

Pulmonary embolism

Emboli which travel to the lungs, usually due to DVT
Symptoms include chest pain, shortness of breath, coughing and feeling faint/dizzy
May have cyanosis, high heart rate and heavy breathing.
A saddle pulmonary embolism will block both branches of the pulmonary artery and commonly causes death before diagnosis.

86

Air embolism

When a bubble becomes trapped in a blood vessel and blocks it.
Common cause of death among divers.
Symptoms and severity depends on the area affected.

87

Fat embolism

Caused by physical trauma such as fracture of a long bone, soft tissue trauma and burns.
Small and multiple so have widespread effects.
Can have shortness of breath, neurological symptoms, petechial rash and anaemia.

88

Haemophilia

A - factor VIII deficiency, X-linked recessive
B - factor IX deficiency, X-linked recessive
C - factor XI deficiency, autosomal recessive (not totally)

89

Disseminated intravascular coagulation

Blood clots throughout the circulation.
Complication of a primary event which triggers generalised clotting (e.g. sepsis/trauma/shock)
Combination of clotting and non-clotting leading to thromboembolism and haemorrhage as clotting factors and platelets are used up by the clotting, increasing susceptability to the haemorrhage.

90

Amniotic fluid embolism

Complication of labour and caesarian section
Causes sudden respiratory distress and collapse
Amniotic fluid enters the circulation through a tear in the amniotic membranes.
Microscopic emboli of foetal origin found in the lungs
Symptoms and signs may occur secondary to disseminated intravascular coagulation.

91

Thrombocytopenia

Low platelet count
Likely to have no symptoms but may have frequent nosebleeds and/or frequent gums, and bruising/ecchymosis.
Many causes including decreased production (vitamin B12/folic acid deficiency, low thrombopoietin), increased destruction or medicine-induced.

92

Thrombophilia

Increased tendency of the blood to clot.
Causes increased risk of DVT.
Symptoms only occur if a clot has formed, then they depend on its location.
Treat with anticoagulants (e.g. warfarin/heparin)

93

Bowel infarction

Restricted blood flow to the bowel often due to bowel obstruction or occlusion of a mesenteric artery.
Causes central abdominal pain resistant to analgesia.
Extensive resection of the bowel can lead to malabsorption

94

Angina pectoris

Chest pain, pressure or squeezing due to ischaemia in the heart.
Is episodic and can be relieved by taking pressure off the chest and/or stopping the activity that caused it.

95

Transient ischaemic attack

A small embolus which causes ischaemia in the brain causing neurological symptoms which last less than 24 hours.

96

Peripheral vascular disease

Narrowing of the arteries, mainly affecting those which apply to the legs, due to atheroma.
Can cause intermittent claudication (pain in the calf on exercise) or Leriche syndrome (pain in the buttocks) if it occurs in the bifurcation of the abdominal aorta. Can progress to resting pain and gangrene of the extremities.

97

Abdominal aortic aneurysm

Caused by the formation of an atheromatous plaque which weakens the media of the artery by destroying elastic fibres, causing local dilatation.
Can often feel pulsating in the abdomen.
Isn't usually dangerous unless very large as it may rupture, or cause dissection.

98

Familial hypercholesterolaemia

Caused by mutations to LDL receptors or apoB100, leading to hypercholesterolaemia.
When homozygous, increases the likelihood of a myocardial infarction before 20 significantly.
Symptoms include:
- Corneal arcus (cholesterol deposits around the cornea)
- Xanthoma (cholesterol deposits in the skin or tendons)
- Xanthelasma (cholesterol deposits near the eye)

99

Cardiac failure

The heart is unable to pump blood around the body at the right pressure.
Atherosclerosis can cause this in the coronary arteries as the muscle doesn't have enough oxygen.
Symptoms include breathlessness, feeling tired and ankle swelling.

100

Myocardial infarction

Mostly occur due to coronary artery disease.
Occurs when blood flow to an area of the heart is cut off.
Generally causes chest pain or discomfort which can travel to the shoulder/arm/neck/jaw

101

Ischaemic colitis

Inflammation and injury of the large intestine due to inadequate blood supply.
Causes severe abdominal pain and passing of bloody stools. If very severe, fluids can leak through the abdominal lining and can lead to shock, rapid heart rate and low blood pressure.

102

Mucosal intestinal infarction

Likely to be transient as it can completely regenerate.
Release of cytokines causes influx of polymorphs which can further compromise vasculature and 'leaky' mucosa can allow toxic agents to enter the blood stream, causing shock.

103

Mural intestinal infarction

Will reach the submucosa.
Mucosa is ulcerated and may be haemorrhagic.
Necrosis involves the connective tissue so healing with granulation tissue is required. If the patient recovers this can cause stricture formation.

104

Transmural intestinal infarction

Infarct extends to the serosa, is synonymous with gangrene.
Bowel dilates and the serous aspect becomes congested and coated with fibrin. The walls become liable to perforation.
May be able to have surgical treatment but if necrosis is extensive the prognosis is very poor.

105

Chronic eczema

An inflammatory and itchy skin disorder. Pathological hyperplasia causing epidermal thickening.
Many factors are thought to cause it, including immune system dysfunction and environmental factors.
The barrier function of the skin is lost.

106

Psoriasis

Hyperplasia of epidermal cells despite lack of a stimulus or control mechanisms.
Lesions are commonest on extensor surfaces.
Treatments involve drugs which inhibit the growth of the epidermis.

107

Goitre in iodine deficiency

Iodine deficiency causes low T3/T4 production, leading to a high TSH. This causes hyperplasia of the thyroid epithelium.

108

Left ventricular hypertrophy

Thickening of the myocardium on the left of the heart.
Is a pathological reaction to cardiovascular disease or high blood pressure.
Causes of increased afterload that can lead to this include aortic stenosis, aortic insufficiency and hypertension.
Sometimes growth can regress with reduction of blood pressure and controlling excitement or emotion.

109

Benign prostatic hypertrophy

An increase in the size of the prostate gland without malignancy present. Commonly normal with advanced age.
Often causes urinary frequency, urinary urgency, hesitancy, incomplete bladder emptying and the need to push or strain.
Can treat with drugs/surgery

110

Barrett's oesophagus

Replacement of the normal squamous epithelium of the oesophagus with columnar glandular epithelium, sometimes showing overt intestinal differentiation.
Caused by chronic reflux of gastro-duodenal contents, including acid and bile, into the oesophagus.

111

Myositis ossificans

Inflammation in the muscles and ossification.
Benign lesions but can be mistaken (both clinically and histologically) for malignant lesions, resulting in clinically disastrous overtreatment.

112

Endometrial hyperplasia

Occurs in response to unopposed oestrogenic stimulation.
Can be endogenous (e.g. ovarian tumours or PCOS) or exogenous.
Obesity is an important cause due to increased peripheral conversion of androstenedione to oestrone in fat cells.

113

Atrophy of disease

Occurs with prolonged immobility of muscles, or by loss of stimulation to glands.

114

Osteoporosis of disease

Bone formation is reduced and resporption is increased due to reduction of mechanical stress.
Require a long time to recover the bone mineral density and strength.

115

Colorectal carcinoma

Non-polypoid adenomas in the mucosa are a precursor lesion.
Increased risk in patients with adenomatous polyps and long-standing ulcerative colitis.
Those in the rectum tend to present with rectal bleeding as they ulcerate, whereas if they are further up they are more likely to present with stenosis which causes obstruction.

116

Uterine leiomyoma

Common benign tumour in the female urogenital tract
Presents with an abdominal mass, urinary problems due to pressure on the bladder and abnormal uterine bleeding.
Have cystic changes or focal necrosis.

117

Osteosarcoma

An aggressive malignant tumour which usually affects adolescents. Tends to involve the distal femur, proximal tibia or humerus.
Can also be present in older people with Paget's disease due to high turnover of bone.
Characterised histologically by pleomorphic and mitotically active osteoblasts.

118

Teratoma

Tends to be benign in the ovaries but more aggressive in the testes. Can be found anywhere in the midline.
May present at any age but usually seen in younger patients.
Appears as a smooth-walled, unilateral cyst, but characteristically contain hair, teeth and sebaceous material.
Will histologically have a range of tissues indistinguishable from those seen in a normal adult.

119

Struma ovarii

A monophyletic tetaroma of the ovary which comprises of thyroid tissue.
Can be benign or malignant and can rarely cause thyrotoxicosis.

120

Chronic lymphocytic leukaemia

A neoplasm of small, mature B-lymphocytes.
Predominantly involves the bone marrow and blood.
Affected lymph nodes are enlarged and smooth-surfaced.
Have a diffuse infiltrate of monomorphic small lymphocytes which can cause nodular aggregates.
Causes anaemia

121

Small lymphocytic leukaemia

A neoplasm of small, mature B-lymphocytes.
Predominantly involves the lymph nodes.
Thought to be an earlier stage of chronic lymphocytic leukaemia

122

Myeloma

A plasma cell tumour which arises in the bone marrow and causes extensive bone erosion.
Produces excessive quantities of immunoglobin of a specific class with a uniform light chain.
The light chain forms the amyloid material which is deposited in many organs but tends to be in the connective tissue within them.

123

Lipoma

A benign tumour of adipocytes in adipose tissue.
Most common connective tissue tumour, usually subcutaneous and comprising morphologically mature adipocytes.
Usually solitary.

124

Seminoma

Malignant germ cell tumour which most commonly occurs in the testis.
Homogenous firm white solid tumour which replaces all or part of the body of the testis.

125

Angiosarcoma

Malignant vascular tumour which is rare but notoriously aggressive.
Composed of masses of interconnecting vascular channels lined by a pleomorphic endothelium.
Most commonly develop in soft tissues of the lower limbs, and the head and neck of elderly individuals.