Tutorial title - General pathologies
38 important questions on Tutorial title - General pathologies
What are the characteristics and complications of Xerostomia?
- Dry mouth
- Decrease in production of saliva
- Altered taste
- Results as a side effect of CNS suppressants (anticholinergic)
What are the macroscopic features of squamous cell carcinoma?
- Enlarged lesions
- Ulcerated and protruding masses
- Irregular and indurated or rolled borders
What are the characteristics of Aphthous Ulcers (Canker Sores)?
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Describe the microscopic characteristics of squamous cell carcinoma.
What are the features of Pleomorphic Adenoma?
- Mixture of ductal epithelium and connective tissue (myoepithelium)
- Mixed tumor
- Slow-growing, painless, mobile discrete masses
What are the causes of acquired pyloric stenosis?
- Fibrosis due to chronic injury
- Antral gastritis
- Peptic ulcer near the pylorus
- A tumor occupying the pylorus
Describe Herpes Labialis and its cause.
What are the features of intestinal obstruction mentioned in the notes?
- Abdominal distension
- Vomiting
- Abdominal pain
- Absolute constipation
What are the clinical features of pyloric stenosis?
- Vomiting (non-bilious, projectile vomiting)
- Abdominal distension
- Malnutrition
- Failure to thrive (in children)
What causes Oral Candidiasis (Thrush) and what are its contributing factors?
What are the anatomical and congenital causes of cleft lip and cleft palate?
- CAUSES: Genetic mutations, alcohol consumption during pregnancy, folic acid deficiency.
- CLINICAL FEATURES:
- Hypernasality
- chronic cough,
- choking/gagging while feeding (Difficulty in feeding)
- weak sucking,
- wet voice,
- recurrent lung infections, and
- failure to thrive(failure to gain weight appropriately)
- Slow cognitive development
- TREATMENT: Surgery, therapy (speech).
Describe the esophageal atresia and its associated features.
- Esophageal atresia: Esophagus ends as a blind tube.
- Common anomalies:
- Tracheoesophageal fistula (abnormal connection)
- Proximal atresia & distal fistula features:
- Abdominal distension (air going into esophagus)
- Dysphagia
- Death from hypoglycemia
- Choking, coughing, and cyanosis following feeding.
How are reducible and non-reducible hernias described?
- Main worry is strangulation leading to ischemia then necrosis.
Feature
Reducible Hernia vs Non-Reducible (Incarcerated) Hernia
Tissue Position
- Can be pushed back in. (Reducible Hernia)
- Stuck outside abdominal wall. (Non-Reducible (Incarcerated) Hernia)
- Mild or none. (Reducible Hernia)
- Severe, tender, firm. (Non-Reducible (Incarcerated) Hernia)
- Disappears when lying down. (Reducible Hernia)
- Persistent bump, vomiting, constipation. (Non-Reducible (Incarcerated) Hernia)
- Low (if managed) (Reducible Hernia)
- High (risk of strangulation). (Non-Reducible (Incarcerated) Hernia)
- Planned surgery or monitoring (Reducible Hernia)
- Emergency surgery. (Non-Reducible (Incarcerated) Hernia)
How is congenital pyloric stenosis characterized?
- Hypertrophy of the pylorus
What are the characteristics of an omphalocele?
- Protective barrier
- Perfectly central right through the umbilical
- Can have multiple structures (e.g., intestines, liver)
- Less severe due to the protective barrier
What treatments are available for pyloric stenosis?
- Progressive ballooning of the area
- Surgical resection
- Gastric by-pass
What are Leukoplakia and Erythroplakia, and what are their causes?
Leukoplakia and Erythroplakia are indicative of reddish patches beneath the tongue that can't be scraped off, associated with chronic irritation.
Causes include:
- tobacco use and
- EBV infection.
There is an increased risk of malignancy (oral cancer), with a 2:1 male predominance ages 40 to 70 years.
What are the characteristics and features of diaphragmatic hernia?
- Hernia: Any state in which a tissue or organ protrudes due to a form of weakness.
- Diaphragmatic hernia:
- Clinical features:
- Dyspnea
- Compression atelectasis [Dyspnea (shortness of breath), coughing, rapid and shallow breathing (tachypnea), chest pain, and potential cyanosis in severe cases].
- Presence of bowel sounds in the chest
- Abdominal distension
- Vomiting
- Abdominal pain
- Absolute constipation
- Clinical features:
Describe gastroschisis based on the notes.
- No barrier
- Opening on the right side of the umbilical
- Intestine only protrudes
- Long term complications due to exposure to amniotic fluid
- More severe
What is megacolon and why does it occur?
Describe the morphology associated with oral lesions (simple squamous carcinoma).
Morphology of oral lesions includes forms such as:
- firm pearly plaques,
- irregular, roughened or verrucous mucosal thickening, and
- leukoplakia or erythroplakia.
These are macroscopically observable features.
What is Meckel's diverticulum and its associated features?
- A "lay-by" structure of "Pouch".
- Congenital remnant of the vitelline duct
- Just above the ileocecal valve
- Mostly clinically asymptomatic
- May be associated with gastric tissue releasing HCl, leading to ulcer (abdominal pain or obstruction).
- Painless rectal bleeding (hematochezia or melena)
What complications are associated with Meckel's diverticulum?
- Perforation leads to peritonitis → sepsis, shock (distributive shock)
- Multi-organ failure (due to peritonitis)
What are the clinical features of Hirschsprung disease?
- Feature of intestinal obstruction
- Failure to pass meconium
How is the definitive diagnosis of Hirschsprung disease made?
What are the risk factors and characteristics of Squamous Cell Carcinoma?
It is the most common cancer of the oral cavity.
Risk factors:
- HPV infection
- tobacco (carcinogens)
Clinical features:
- Erythroplakia
- Unprovoked loosening of teeth
- Oral ulcer or space-occupying lesion.
What are the characteristics of a periapical cyst?
- Has an inflammatory etiology.
- Occurs at the tooth apex.
- Necrosis of the pulpal tissue may exit the apex of the tooth into the surrounding alveolar bone and lead to a periapical abscess.
What age group is mostly affected by odontogenic keratocysts?
- Odontogenic keratocysts affect mostly individuals between 10 and 40 years.
- They are more common in males.
- These cysts are typically found within the posterior mandible.
- They are locally aggressive and have a high recurrence rate.
- The cyst is lined by a thin layer of keratinized stratified squamous epithelium with a prominent basal cell layer and a corrugated luminal epithelial surface.
What are odontogenic cysts usually derived from?
- Odontogenic cysts are usually derived from remnants of odontogenic epithelium found in the jaw.
- Dentigerous cysts originate around the crown of an unerupted tooth.
- They are thought to be the result of degeneration of the dental follicle, which is the primordial tissue that makes the enamel surface of teeth.
- These cysts are lined by a thin, stratified squamous epithelium.
What are the characteristics of fibromas in neoplastic lesions?
- Submucosal nodular fibrous tissue masses.
- Chronic irritation results in reactive connective tissue hyperplasia.
- Occur on the buccal mucosa along the bite line.
Describe the features of pyogenic granuloma in neoplastic lesions.
- Proliferative lesion typically found on the gingiva of children, young adults, and pregnant women.
- Richly vascular and typically ulcerated.
- Growth can be rapid and raise fear of a malignancy.
What are the causes and effects of dental caries?
- Dental caries result from focal demineralization of tooth structure, including enamel and dentin.
- They are caused by acids generated during the fermentation of sugars by bacteria.
- Worldwide, caries are the main cause of tooth loss before 35 years of age.
What does periodontitis affect and how is it characterized?
- Periodontitis is an inflammatory process that affects the supporting structures of the teeth, including periodontal ligaments, alveolar bone, and cementum.
- This condition involves the deeper tissues surrounding the teeth and can lead to tooth loss if untreated.
- It is a progression from gingivitis and requires professional dental care.
What is the treatment for Hirschsprung disease?
- Surgical resection of the affected part and anastomosis.
What are the clinical features of Hirschsprung disease?
- Immediate postpartum period results in failure to pass meconium.
- Obstruction/constipation occurs with visible ineffective peristalsis.
- Complications include:
- Enterocolitis
- Fluid and electrolyte imbalance
- Perforation
- Peritonitis
What are some causes of acquired megacolon?
- Chagas disease
- Obstruction by neoplasm/inflammatory stricture
- Toxic megacolon complicating ulcerative colitis
- Visceral myopathy
- Functional psychosomatic disorders
What is Hirschsprung disease and its prevalence?
- Hirschsprung disease is a congenital aganglionic megacolon.
- It occurs in 1/5000 live births and is present in 10% of Down syndrome children.
- The condition is more common in males than females.
Describe the pathogenesis of Hirschsprung disease.
- Premature arrest of neural crest cell migration from cecum to rectum.
- Premature death of ganglion cells.
- Distal intestinal segment without both Meissner and Auerbach myenteric plexus, known as Aganglionosis.
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