Other infections Flashcards
(435 cards)
1
Q
What is Leprosy known as?
A
Hansen’s disease
2
Q
Describe the disease of Leprosy
A
Bipolar
3
Q
Describe the infection of Leprosy
A
Slowly progressive
4
Q
What is this infection caused by?
A
Mycobacterium leprae
5
Q
What is the Mycobacterium leprae known as?
A
Lepra bacilli
6
Q
What does this infection affect? (2 points)
A
Skin
Peripheral nerves
7
Q
What does this infection mainly result in?
3 points
A
Deformity
Paralysis
Ulceration
8
Q
What is the incubation period of the Mycobacterium leprae?
A
5-10 years
9
Q
What is the mode of infection of Leprosy?
A
Droplet
10
Q
What does this droplet infection occur via?
A
Nasal mucosa
11
Q
What is the classification of the Leprosy bipolar disease based on?
A
Host immune responses
12
Q
What are the 2 forms of the Leprosy disease classified based on the host immune responses?
A
Nodular
Maculoanaesthetic
13
Q
What is the nodular leprosy known as?
A
Lepromatous
14
Q
What is the Maculoanaesthetic leprosy known as?
A
Tuberculoid
15
Q
What is another form of Leprosy?
A
Border line
16
Q
Describe Border line Leprosy
A
Grade between Tuberculoid and Lepromatous
17
Q
Describe the form of Nodular Leprosy
A
Severe
18
Q
What is the tissue destruction in the Leprosy known as?
A
Leproma
19
Q
Describe Leproma
A
Granuloma
20
Q
How many cells is this granuloma composed of?
A
4
21
Q
What are the 4 cells where this granuloma is composed of?
A
Macrophages
Lymphocytes
Plasma cells
Giant cells
22
Q
Describe the cytoplasm of these Macrophages
A
Foamy
23
Q
Describe the color of this cytoplasm
A
Pale
24
Q
What do these Macrophages do with the Lepra bacilli?
A
Engulfment
25
What do these Lepra bacilli rapidly do?
Multiplication
26
Where do these Lepra bacilli rapidly multiply in the Macrophages?
Cytoplasm
27
What does the Macrophages do with the Lepra bacilli then?
Lysis
28
Describe this lysis (2 points)
Partial
| Incomplete
29
What causes this incomplete lysis of the Lepra bacilli?
Defective digestion
30
What is resulted due to the partial lysis of the Lepra bacilli?
Foamy cytoplasm
31
What are the Macrophages then known as?
| 2 points
Foam cells
| Lepra cells
32
Describe the resistance of the patient in Nodular Leprosy
Very low
33
What causes this low resistance?
A defect
34
Which cells does this defect occur in causing the low resistance of the patient?
T Lymphocytes
35
What aren't the T Lymphocytes stimulated by as a result?
Lepra bacilli
36
What doesn't occur to the Macrophages as a result?
Instruction
37
What aren't the Macrophages instructed to do?
Killing
38
What aren't the Macrophages instructed to kill?
Phagocytosed Lepra bacilli
39
What also occurs in the Leproma?
Healing
40
What is healed in the Leproma?
Old lesions
41
What do the old lesion heal by?
Fibrosis
42
How many lesions occur in the Nodular Leprosy?
5
43
What are the 5 lesions that occur in the Nodular Leprosy?
```
Skin
Nasal
Neural
Trophic
Visceral
```
44
Describe the 2 forms of the skin lesion
Nodular
| Macular
45
Where is the skin lesion especially nodular in?
| 2 points
Face
| Extremities
46
Where is the skin lesion also nodular in?
Forehead
47
Describe the appearance of the nodular skin lesion in the face and in the forehead
Lenione
48
Describe the 2 forms of the macular skin lesion
Erythematous
| Hypopigmented
49
What occurs in the Nasal lesion? (3 points)
Mucosal ulceration
Nasal obstruction
Septal destruction
50
What is affected in the neural lesion?
Big peripheral nerves
51
Which big peripheral nerves are especially affected in Neural lesion?
Ulnar
52
What occurs in these big peripheral nerves?
Thickening
| Destruction
53
Describe this thickening and destruction
Diffuse
54
What causes Trophic lesion?
Loss of sensation
55
What occurs due to the Trophic lesion?
| 2 points
Traumatic ulcer
| Deformities
56
Where do these traumatic ulcer and deformities occur in?
| 2 points
Hands
| Feet
57
What are the 4 organs in which the infection occur in, in Visceral lesion?
Liver
Spleen
Testis
Eye
58
Describe the form of the Maculoanaesthetic Leprosy
Mildest
59
Describe the resistance of the patients in Maculoanaesthetic Leprosy compared to the resistance of the patients in Nodular Leprosy
Relatively higher
60
What is occurs in the tissue reaction?
Granuloma
61
Describe this granuloma
Non-caseating
62
How many cells is this non-caseating granuloma formed of?
3
63
What are the 3 cells that form this non-caseating granuloma?
Macrophages
Lymphocytes
Giant cells
64
What does this non-caseating granuloma has a marked tendency for?
Fibrosis
65
What does this granuloma differ from?
Sarcoidosis
66
What does this granuloma have which is a difference between it and sarcoidosis?
Lepra cells
67
Describe the number of these lepra cells
Few
68
Which stain may these lepra cells be found by?
Ziehl-Neelsen
69
Where does this granuloma occur along side of which is a difference between it and Sarcoidosis?
Nerves
70
What is accompanied by these nerves due to the occurrence of this granuloma along side them?
Nerve destruction
71
Describe the infection of the Maculoanaesthetic Leprosy
Mild
72
What does this infection mainly occur in? (2 points)
Skin
| Peripheral nerve
73
How many lesions occur in the Maculoanaesthetic Leprosy?
3
74
What are the 3 lesions that occur in the Maculoanaesthetic Leprosy?
Skin
Neural
Trophic
75
What occurs in the skin lesion in Maculoanaesthetic Leprosy?
Macules
76
Where exactly do these macules occur in the skin lesion in Maculoanaesthetic Leprosy?
(3 points)
Face
Trunk
Limbs
77
Describe the occurrence of these macules
Single
Or
Very few
78
What is the color of these macules?
Red
79
Describe the border of these macules
Slightly elevated
80
Describe the center of these macules
Anesthetic
81
What does anesthetic mean?
Impaired sensation
82
Describe the color of these macules center
Pale
83
What is also impaired?
Sweating
84
Describe the occurrence of the neural lesion
Early
85
What does the peripheral nerve show in the neural lesion?
Thickening
86
Describe this thickening (2 points)
Diffuse
Or
Fusiform
87
What does this thickening cause?
Muscle atrophy
88
What causes the trophic lesion
Loss of sensation
89
What occurs due to the Trophic lesion?
| 2 points
Traumatic ulcer
| Deformities
90
Where do these traumatic ulcer and deformities occur in?
| 2 points
Hand
| Feet
91
Describe the disease of the Syphilis
Venereal acquired
92
Describe the disease of the Syphilis
Venereal acquired
93
What does the Syphilis cause?
Infective granuloma
94
What is the etiological agent of the Syphilis?
Treponema pallidum
95
What is the form of the Treponema pallidum?
Spirochetes
96
What are the 2 ways of Syphilis transmission?
Sexual
| Vertical
97
What is the transmission of the Syphilis most contagious to?
Sex partners
98
During which stages of the Syphilis is the transmission most contagious to sex partners? (2 points)
Primary
| Secondary
99
What does the Treponema pallidum enter the body via?
| 2 points
Skin
| Mucous membrane
100
Through what does the Treponema pallidum enter the body via skin and mucous membrane?
Abrasions
101
When does the Treponema pallidum enter the body via skin and mucous membrane through abrasions?
During sexual contact
102
What is the other mode of infection of the Syphilis?
Transplacentally
103
How is this infection transmitted transplacentally?
From mother to fetus
104
When is this infection transmitted placentally from mother to fetus?
During pregnancy
105
What occurs in the pathogenesis of the disease?
Invasion
106
What does the Treponema pallidum directly invade?
Mucosa
107
What is this Treponema pallidum possibly aided by?
Surface abrasions
108
What are these surface abrasions resulted from?
Intercourse
109
Describe the person which has this intercourse that causes surface abrasions
Infected
110
What develops at the site of infection?
Primary lesion
111
What is this primary lesion known as?
Chancre
112
What is the usual site of infection in which the primary lesion develops in?
External genitalia
113
What are the other 2 sites of infection in which the primary lesion develops in?
Lips
| Anorectal region
114
What does the Treponema pallidum then pass to within hours?
Regional lymph nodes
115
What does the Treponema pallidum gain access to within hours?
Systemic circulations
116
What are the 5 histologic hallmarks of the Syphilis whatever the disease is that the location of the lesions are?
```
Endarteritis Obliterans
Plasma cell
Lymphocytes
Giant cells
Necrosis
```
117
Describe the occurrence of the Endarteritis Obliterans
Early
118
Which cells are mainly the histologic hallmarks of the Syphilis?
Plasma cells
119
Describe these giant cells
Relatively small
120
Describe the nuclei of these giant cells
Central
121
Which Syphilis stage does the necrosis occur in?
Tertiary
122
What is developed in the primary syphilis?
Primary lesion
123
Which site does this primary lesion develops at?
Inoculation
124
What are these 2 sites of inoculation?
Genital
| Extra genital
125
What are the 2 extra genital sites?
Lips
| Tongue
126
When does the primary lesion appear?
2-6 weeks after infection
127
What are the 3 progressions of this primary lesion?
Macule to Papule to ulcer
128
Describe this primary lesion (2 points)
Painless
| Highly infectious
129
Describe the edge of this primary lesion
| 2 points
Sharp
| Indurated
130
Describe the base of this primary lesion
Clean
131
What also occurs in the primary syphilis?
Regional lymphadenopathy
132
Describe the regional lymphadenopathy
| 2 points
Painless
| Bilateral
133
Describe the regional lymphadenopathy when touched
Classically rubbery
134
When does the secondary Syphilis occur?
2 months after the primary chancre
135
What is the most common lesion in the Secondary Syphilis?
Mucocutaneous
136
What are the 3 clinical manifestations?
Skin lesion
Hair
Lymph node
137
What occurs in the skin lesion? (3 points)
Rash
Mucous patches
Condylomata lata
138
Describe this rash
Generalized
139
What is present in this rash? (3 points)
Macule
Papule
Pastule
140
What is the percentage of the occurrence of the macule, papule and pustule?
75%-100%
141
Describe these mucous patches
Highly infectious
142
What are these mucous patches?
Ulcers
143
Describe these ulcers
Snail track
144
Where are these mucous patches found on?
| 2 points
Pharynx
| Genitalia
145
What is the Condylomata lata?
Papular lesions
146
What do these papular lesions look like?
Wart
147
Where do these papular lesions occur in?
Moist areas
148
Which 4 moist areas do these papular lesions occur in?
Axillae
Perineum
Vulva
Scrotum
149
What are these moist areas stuffed with?
Treponema pallidum
150
Describe the occurrence of these Treponema pallidum
Abundant
151
What occurs in the hair?
Spots
| Loss of eyebrows
152
Describe these spots (2 points)
Patchy
| Bald
153
What occurs in the lymph nodes?
Generalized Lymphadenopathy
154
Which lymph nodes does this Generalized Lymphadenopathy especially occur in?
Epitrochlear
| Cervical
155
What are the 5 general manifestations of Secondary Syphilis?
```
Malaise
Fever
Headache
Joint pain
Syphilis lesions
```
156
What happens to these Syphilis lesions while the person remains infected?
Resolve without treatment
157
When does the Tertiary Syphilis occur?
After 2-12 years
158
Describe the stage of this disease
Destructive
159
What are the 3 main types of the Tertiary Syphilis?
Syphilitic gummas
Cardiovascular
Neurosyphilis
160
What is the most common complication of late syphilis?
Gummas
161
What is the color of this gummas?
Gray white
162
Describe the gummas when touched
Rubbery
163
What occurs in this gummas? (2 points)
Granulomas
| Necrosis
164
Describe this necrosis (2 points)
Central
| Coagulative
165
What is infiltered in this gummas?
Plasma cell
166
What are the 5 most common sites where this gummas occur in?
```
Skin
Subcutaneous tissue
Bone
Joints
Testis
```
167
What do these gummas do in the skin?
Break down
168
What do these gummas form when broken down?
Ulcers
169
Describe these ulcers
Punched-out
170
What happens to the liver as a result of this gummas?
Scarring
171
What does this scarring cause?
Distinctive hepatic lesion
172
What is this distinctive hepatic lesion known as?
Hepar lobatum
173
What does the Cardiovascular Syphilis result in?
Weakening
174
What is weakened due to the Cardiovascular Syphilis?
Aortic wall
175
What will the weakening of this aortic wall due to the Cardiovascular Syphilis progress into?
Late syphilis vascular manifestations
176
What are the 2 late syphilis vascular manifestations of the aorta?
Aneurysm
| Dilatation
177
Which aorta do Aneurysm and the Dilatation occur in?
Ascending
178
Where does the Aneurysm also occur in?
Aortic arch
179
What is the aortic arch known as?
Thoracic aorta
180
What is resulted from the dilatation of the ascending aorta?
Stretching
181
What is stretched?
Aortic valve ring
182
What is produced due to the stretching of the aortic valve ring?
Aortic insufficiency
183
What does the Neurosyphilis cause? (4 points)
Syphilitic meningitis
Meningovascular syphilis
General insane paresis
Tabes dorsalis
184
What does the Meningovascular syphilis cause? (3 points)
Syphilitic arteritis
Thrombosis
Infraction
185
Where does the Syphilitic arteritis occur in?
Cerebral arteries
186
Which type of infraction occurs in the Meningovascular syphilis?
Liquefactive
187
What occurs in the general paresis of insane?
Loss of cortical function
188
Describe this loss
Gradually progressive
189
What does the Tabes dorsalis result in?
Loss
190
What is lost as a result of Tabes dorsalis?
Peripheral reflexes
Position sense
Ataxia
191
Describe the loss of the peripheral reflexes and ataxia
Progressive
192
What may be seen in advanced cases in Tabes dorsalis?
Chronic destructive changes
193
Where do these chronic destructive changes occur in?
Large joints
194
Which large joints do these chronic destructive changes occur in?
Of affected limbs
195
What are these large joints of affected limbs which have chronic destructive changes known as?
Charcot's joints
196
How is the Treponema pallidum transmitted in Congenital Syphilis?
From a pregnant woman to her fetus
197
What occurs due to Congenital Syphilis?
| 4 points
Spontaneous abortion
Still birth
Neonatal death
Survive
198
Describe the affection of the baby in neonatal death
Severe
199
When does this baby die in neonatal death?
Soon after birth
200
What happens when the baby survives?
Develops late manifestations
201
Which stage of Congenital Syphilis does the transmission occur in?
Any
202
Which Congenital Syphilis stages is the risk much higher in? (2 points)
Primary
| Secondary
203
When does the fetal infection of Congenital Syphilis occur?
Any trimester of pregnancy
204
What are the 3 sites in which the fetal infections of Congenital Syphilis occur in?
Bone
Teeth
Eye
205
What occurs in the bone? (2 points)
Saddle nose
| Saber shins
206
What occurs in the teeth? (2 points)
Hutchinson's teeth
| Mulberry molars
207
What occurs in the eye? (2 points)
Corneal inflammation
| Interstitial keratitis
208
What are the other 2 fetal infections of Congenital Syphilis?
Neurosyphilis
| Hutchinson's triad
209
What occurs in the Neurosyphilis of Congenital Syphilis?
Eighth nerve deafness
210
Describe Bilharziasis
Inflammation
211
What type of Inflammation is the Bilharziasis?
Chronic specific
212
Describe this chronic specific inflammation
Infective granuloma
213
Which country is the Bilharziasis present in?
Egypt
214
Describe the occurrence of the Bilharziasis in Egypt
Endemic
215
What are the 2 causative species of Bilharziasis?
S. Haematobium
| S. Mansoni
216
What does the S. Haematobium affect?
Urogenital system
217
What does the S. Mansoni affect?
Digestive system
218
What is the pathogenesis of the Bilharziasis?
Lesions
219
How many lesions caused by the Bilharziasis?
3
220
What are the 3 lesions caused by?
Cercaria
Adult worms
Ova
221
What are the 3 lesions caused by the cercaria?
Acute dermatitis
Papular
Vesicular eruption
222
Where are the papular
| and the vesicular eruption present in?
Skin
223
Which site are the papular
| and the vesicular eruption present at?
Penetration
224
Describe the nature of the adult worm that can be present which causes lesions (2 points)
Living
| Dead
225
What do the living worms produce? (2 points)
Bilharzial pigments
| Ova
226
What happens to these bilharzial pigments?
Phagocytosis
227
What are the bilharzial pigments phagocytosed by?
RES
228
What do the dead worms cause?
Inflammation
| Necrosis
229
What type of inflammation is caused by the dead worms?
Severe allergic
230
Where does the severe allergic inflammation occur?
Wall of blood vessels
231
What is this severe allergic inflammation known as?
Thrombophlebitis
232
Were do the ova pass in? (2 points)
Urine
| Stool
233
What happens when the ova pass in the urine and stool?
Bleeding
234
Where does this bleeding occur in?
Rectum
235
Describe another form of bleeding that can occur
Terminal hematuria
236
What occurs due the bleeding?
Anemia
237
Where can the ova be trapped in?
Submucosa
238
What is caused due to the trapping of the ova in the submucosa?
Bilharzial granuloma
239
Describe this bilharzial granuloma
Periovular
240
What is involved in the bilharzial granuloma?
Miracidium
241
What does this miracidium secrete? (2 points)
Antigens
| Proteolytic enzymes
242
What occurs when the miracidium secrete antigens and the proteolytic enzymes?
Sensitization
243
Which cells make this sensitization?
T-lymphocytes
244
What feature of these T-lymphocytes make this sensitization?
Lymphokines
245
What is created after the sensitization of these T-lymphocytes lymphokines?
Granulomatous reaction
246
Which cells are present in the granulomatous reaction?
Multinucleated giant cells
247
Describe the 3 passages of the granuloma
Cellular
Fibrocellular
Fibrous
248
What is involve in the cellular granuloma?
Ova
249
What are the ova surrounded by in the cellular granuloma?
Cells
250
What is involved in the fibrocellular granuloma?
Cellular granuloma
251
What is involved in the cellular granuloma?
| 2 points
Fibroblasts
| Capillaries
252
What can some ova be carried by?
Blood
253
What are these ova carried by the blood as?
Emboli
254
What are the 2 organs which these ova reach when they are carried by the blood as emboli?
Lung
| Liver
255
What is caused when the Bilharziasis occurs in the urinary bladder?
Bilharziasis cystitis
256
What occur in the early lesion during the Bilharziasis cystitis?
Hyperemia
| Petechial hemorrhage
257
What is more common in the Bilharziasis cystitis?
Sandy patches
258
Describe the shape of these sandy patches
| 2 points
Irregular
| Granular
259
What is the color of these sandy patches?
Yellow
260
What are the areas of these sandy patches covered with?
Atrophic mucosa
261
Where are the bilharzial ova deposited which cause these sandy patches?
Submucosa
262
Where could happen to these sandy patches?
Pressure atrophy
263
What is caused due to the pressure atrophy of the sandy patches?
Mucosal ischemia
264
What are less common in the Bilharzias cystitis?
Polyps
265
What occurs in the polyps?
Protrusion
266
What is protruded in the polyps? (2 points)
Mucosa
| Submucosa
267
What is accompanied with this protrusion?
Bilharzial reaction
268
What is seen microscopically in the Bilharzial cystitis?
Connective tissue core
269
What does this connective tissue core contain? (2 points)
Ova
| Granuloma
270
What is this connective tissue core covered with?
Hyperplastic mucosa
271
What is deposited in massive amounts causing these sandy patches?
Bilharzial ova
272
What is ulcerated in the Bilharzias cystitis?
Polyp
273
What causes ulceration in the polyp?
Extrusion
274
What is extruded causing this ulceration?
Ova
275
Which cases does the dense fibrosis occur in?
Long standing
276
What do these long standing cases involve?
Mucosa
277
What do these long standing cases sometimes involve?
Submucosa
278
Describe the epithelial changes of the Bilharziasis cystitis
Urothelial changes
279
What are the 6 urothelial changes?
```
Hyperplasia
Squamous metaplasia
Dysplasia
Brunn's nests
Leukoplakia
Cystitis
```
280
Which 2 epithelium does the dysplasia occur in?
Urothelial
| Squamous
281
What occurs in the Brunn's nests?
Solid buds
282
Where are these solid buds present in?
Urothelial epithelium
283
Describe the leukoplakia
Mucosal patches
284
What is the color of these mucosal patches?
White
285
Describe the thickness of these mucousal patches
Thick
286
What are the 2 types of cystitis involved in the urothelial changes?
Cystica
| Glandularis
287
What are involved in the Cystitis cystica and the Cystitis glandularis?
Cysts
288
What are these cysts lined by in Cystitis cystica?
Transitional epithelium
289
What are these cysts lined by in Cystitis glandularis?
Columnar cells
290
What do these columnar cells secrete?
Mucin
291
What are the 5 complications of Bilharziasis cystitis?
```
Bladder neck obstruction
Renal calculi
Bladder carcinoma
Terminal hematuria
Fistulous communication
```
292
What does the bladder neck obstruction cause? (7 points)
```
Diverticulum
Hydroureter
Hydronephrosis
Pyoureter
Pyonephrosis
Chronic renal failure
Urine retention
```
293
What are involved in the renal calculi?
Calcium phosphate stones
294
What does the Terminal hematuria cause?
Anemia
295
What does the fistula communicate with? (2 points)
Rectum
| Vagina
296
What are the 3 organs which the complications of the Bilharziasis cystitis occur in?
Ureter
Urethra
Genitalia
297
Which part of the ureter will be affected?
Lower 1/3
298
What occurs in the ureter as a complication?
Ureteric stricture
299
What does the ureteric stricture cause?
Black pressure
300
What occurs in the urethra as a complication (3 points)?
Sandy patches
Polyps
Ulcers
301
What occurs in the male genitalia as a complication?
Sterility
302
What causes this sterility?
Fibrosis
303
Where does this fibrosis occur around?
Vas deferens
304
What occurs in the female genitalia as a complication?
Bilharzial granuloma
305
What does the intestinal Bilharziasis cause?
Bilharzial colitis
306
What is involved in the Bilharzial colitis?
| 4 points
Hyperemia
Edema
Petechial hemorrhage
Sandy patches
307
What are the most common intestinal lesions that occur in the Bilharzial colitis?
Polyps
308
What are the 2 most common sites where the polyps occur in?
Rectum
| Sigmoid colon
309
Describe the ulcers that occur in the Bilharzial colitis
Shallow
310
Describe the shape of these ulcers
Irregular
311
Describe the edges of these ulcers
Sharp
312
Describe the floor of these ulcers
Granular
313
Which cases does the fibrosis occur in?
Long standing
314
What does this fibrosis prevent the passage of?
Ova
315
What does this fibrosis prevent the passage of the ova with?
Stool
316
Describe the Intestinal Bilharziasis caused
Closed
317
What are the 5 complications of the Bilharzial colitis?
```
Recurrent intestinal hemorrhage
Intestinal stenosis
Large polyps
Marked fibrosis
Secondary infection
```
318
What causes this intestinal stenosis?
Fibrosis
319
What do these large polyps cause?
Intestinal obstruction
320
Where does the ova pass to in the marked fibrosis?
Liver
321
What does the secondary infection lead to?
Dysentery
322
What occurs in the Bilharziasis of the liver?
Portal tract lesion
323
What is involved in this portal tract lesion?
Periportal fibrosis
324
What happens to the liver cells in the portal tract lesion?
Fatty changes
325
What are the 2 types of the Bilharzial hepatic fibrosis?
Periportal
| Mixed
326
What are the 4 types of periportal fibrosis?
Fine
Diffuse
Coarse
Pipe stem
327
What is not involved in the Bilharzial liver?
Regenerating nodule
328
What happens to the ova in the Bilharzial liver?
Impaction
| Penetration
329
Where are the ova impacted?
Portal vein branches
330
What does the impaction of these ova in the portal vein branches recult in?
Proliferation
331
What will be proliferated?
Endothelial lining
332
Where are these ova deposited in?
Portal tract
333
What do these deposited ova penetrate?
Venous wall
334
What is then caused when the ova penetrate the venous wall?
Granuloma
335
What does this granuloma cause?
Fibrosis
336
Where are the dead worms impacted in?
Large portal tract
337
What do the impacted worms cause in these large portal tract?
Thrombophlebitis
338
What does this thrombophlebitis cause?
Severe allergic necrosis
339
What does this severe allergic necrosis cause?
Dense cellular filtrate
340
Where are these dense cellular filtrate found around?
Veins
341
What also occurs in the prognosis of the Bilharzial liver?
Angiomatoids
342
Describe the angiomatoids
Dilated capillaries
343
Where are these dilated capillaries found between? (2 points)
Hepatic artery branches
| Portal veins
344
What does the Bilharzial periportal fibrosis cause? (3 points)
Portal hypertension
Portal vein thrombosis
Ammonia encephalopathy
345
What does the portal hypertension causes?
| 7 points
```
Splenomegaly
Ascites
Venous congestion
Varicosities
Esophageal
Piles
Caput medusa
```
346
What is accompanied by the Splenomegaly?
Splenic vein thrombosis
347
Where does the venous congestion occur in?
Viscera
348
Where does the varicosities occur in?
Porto-systemic anastomosis
349
Describe the portal vein thrombosis
Vascular stasis
350
What does the normal ammonia come form?
Colon
351
What is this ammonia converted to?
Urea
352
Which organ converts the ammonia to urea?
Liver
353
In ammonia encephalopathy, which organ does the ammonia?
Brain
354
What are opened so that the ammonia reaches the brain in ammonia encephalopathy?
Shunts
355
Describe the spleen in Bilharzial splenomegaly
Enlarged
356
Describe the spleen in the early and late stages of Bilharzial splenomegaly
Firm
357
Describe the capsule of the spleen in the early and late stages of Bilharzial splenomegaly
Tense
358
Describe the surface of the spleen in the early and late stages of Bilharzial splenomegaly
Smooth
359
What 2 features are increased in the spleen in the early and late stages of Bilharzial splenomegaly?
Size
| Weight
360
What occurs in the early stage of Bilharzial splenomegaly? (2 points)
Congested sinusoids
| Reticuloendothelial hyperplasia
361
What occurs in the late stage of Bilharzial splenomegaly? (2 points)
```
Portal hypertension
Chronic venous congestion
Subcapsular haemorrhage
Adhesions
Thrombosis
Atrophic lymphoid follicles
Dilated congested sinusoids
Thick capsules
```
362
What is prognosis of the Bilharzial splenomegaly in the early stage?
Reticuloendothelial hyperplasia
363
What are the 2 prognosis of the Bilharzial splenomegaly in the late stage?
Portal hypertension
| Chronic venous congestion
364
What are the 2 complications of the Bilharzial splenomegaly?
Hypersplenism
| Compression
365
What what the hypersplenism cause?
Pancytopenia
366
What does this Pancytopenia result in?
| 3 points
Anemia
Leucopenia
Thrombocytopenia
367
What is compressed as a complication?
Surrounding structure
368
What is involved in the Bilharziasis of the lung?
Emboli
369
What does this emboli contain?
S.Mansoni
370
What is rarely contained in this emboli?
S.Haematobium
371
Where is this emboli present in?
Collateral circulation
372
What is the percentage of the patients that get lung Bilharziasis?
20%
373
Describe the infection of Actinomycosis
Rare
374
Describe the disease of Actinomycosis
Bacterial
375
What causes Actinomycosis?
Actinomyces species
376
What are the 2 species of Actinomyces that cause this infection?
Actinomyces israelii
| Actinomyces gerencseriae
377
What is the percentage of infection caused by these species?
70%
378
What are the 3 most common sites where the Actinomycosis occur in?
Mouth
Lungs
Gastrointestinal tract
379
Describe the Actinomycosis in the mouth
Cervicofacial
380
Describe the Actinomycosis in the lungs
Pulmonary
381
Describe the Actinomycosis in the Gastrointestinal tract
Intestinal
382
Where does the Actinomycosis rarely occur in?
Skin
383
What is formed in Actinomycosis?
Painful abscesses
384
What happens to these abscesses when the disease progresses?
Grow larger
385
Where do these abscesses often occur over when they grow larger as the disease progresses?
Mouths
386
What are the 2 surrounding sites where these abscesses penetrate ,in severe cases?
Bone
| Muscle
387
What do these abscesses reach when they abscesses penetrate the surrounding bone and muscle?
Skin
388
What do these abscess break open and leak in the skin in large amounts?
Pus
389
What does this pus contain?
Characteristic granules
390
Describe these characteristic granules
Sulfur granules
391
What are these characteristic granules filled with?
Progeny bacteria
392
What is the feature of these granules where they are named based on?
Appearance
393
What are these granules actually not composed of?
Sulfur
394
What is seen in the microscopic picture of Actinomycosis? (2 points)
Colonies
| lesions
395
What do these colonies consist of? (2 points)
Clubs
| Filaments
396
Describe the arrangement of these clubs
Peripheral
397
Describe the position of these filaments
Central
398
What are these peripherally arranged clubs stained by?
Eosin
399
What is the color of these peripherally arranged clubs when stained by Eosin?
Red
400
What are these central filaments stained by?
Gram positive
401
What is the color of these central filaments when stained by Gram positive?
Blue
402
Which 4 cells are the colonies surrounded by?
PNLS
Macrophages
Lymphocytes
Plasma cells
403
Describe the number of these cells
Large
404
What is the lesion surrounded by?
Fibrosis
405
What is the Mycetoma known as?
Madura foot
406
Describe the disease of Mycetoma (2 points)
Chronic granulomatous
| Fungal
407
What is the Mycetoma caused by?
Mycetoma fungus
408
What is the mycetoma fungus known as?
Nocardia
409
What does this mycetoma fungus enter?
Skin
410
Describe the person where this mycetoma fungus enter his skin
Barefoot
411
What does the mycetoma fungus enter through ,in the skin of a barefoot person?
Abrasion
412
What does the Mycetoma mainly affect?
Limbs
413
What are the 2 countries where the Mycetoma infection occur in?
Africa
| India
414
Describe the infection in these 2 countries
Endemic
415
Where can the Mycetoma infection also occur in?
Egypt
416
Describe the initial lesion in the Mycetoma
Small subcutaneous swelling
417
What is this small subcutaneous swelling followed by?
Minor trauma
418
What then occurs later?
Sinuses
419
What do these sinuses discharge?
Exudates
420
What are the 2 exudates that the sinuses discharge?
Purulent
| Seropurulent
421
What do these exudates contain?
Grains
422
Describe these grains
Fungal colonies
423
What may occur in the late stages of Mycetoma in the limbs?
Destruction
Deformity
Loss of function
424
What are destructed in the late stages of Mycetoma in the limbs?
Deeper tissues
425
What is the microscopic picture of the Mycetoma the same as?
Actinomycosis
426
What is seen in the microscopic picture of the Mycetoma? (2 points)
Colonies
| Lesions
427
What does the microscopic picture of the Mycetoma contain?
Fungus colony
428
What is the center of the fungus colony?
hyphae
429
What is the color of this hyphae when stained?
Blue
430
What are these fungus colonies surrounded by?
Clubs
431
Describe the location of these clubs
Peripheral
432
What is the color of these peripheral clubs when stained?
Red
433
Which 4 cells surround these colonies?
PNLS
Macrophages
Lymphocytes
Plasma cells
434
Describe the number of these cells
Large
435
What are the lesions surrounded with?
Fibrosis
