Cyst, Ulcer, Fistula & Sinus Quiz

b-Tubuloembryonic cysts: collection of embryonic remnants, includes ependymal cyst (thryoglossal cyst, Ependymal cyst), acquired, and parasitic cysts.

Cysts can be classified based on their origin:

• Retention cysts: result from the accumulation of secretion in glands due to obstruction of ducts (sebaceous cyst, parotid gland cyst).
• Traumatic cysts: caused by injury, such as a cystic tumor (cystic teratoma, cystadenoma).
• Degeneration cyst: degenerative changes within a cyst.
• Distension cyst: distension from the accumulation of fluid within a cyst (thyroid cyst, lymphatic cyst, hydrocele).
• Parasitic cyst: caused by parasitic infestation, such as a hydatid cyst.

Clinical features vary according to site and size of the cyst:

• Pain: enlarging cysts, secondary to haemorrhage, infection, rupture, or torsion.
• Compression symptoms: haemorrhage in thyroglossal cyst, large ovarian cyst, obstruction to pelvic veins, causing varicose veins of the lower limbs.

Diagnosis can be obvious in superficial cysts but may require ultrasound, CT scan, or MRI for deep-seated intra-abdominal or thoracic cysts.

Complications include infection, haemorrhage, torsion, obstruction, calcification, and malignancy (rare).

An ulcer is a break in the continuity of an epithelial surface, characterized by progressive destruction of the epithelium and a granulating base.

Clinical examination includes assessment of size, shape, edge, floor, base, discharge, surrounding area, and lymph nodes.

Management involves treating the cause of the ulcer, identifying and correcting comorbid factors, adequate drainage and debridement, antiseptics and topical antibiotics, and wound dressings (hydrogel, alginate, lyofoam, tegaderm, alleyn).

A fistula is a communicating track between two epithelial surfaces, commonly between a hollow viscus and the skin (external fistula) or between two hollow viscera (internal fistula). The track is lined with granulation tissue and subsequently epithelialized.

Fistulas require accurate assessment, as well as treatment of the underlying cause, drainage, and wound care with hydrogel, alginate, lyofoam, tegaderm, and alleyn.

Viruses can cause cell death through multiplication inside host cells, leading to cell death or cell explosion, resulting in additional death.

Bacteria emit specific gases (toxins) that can cause hypersensitivity reactions, resulting in inappropriate or excessive immune responses that damage tissues.

Physical or chemical agents such as irritants and corrosive substances cause tissue damage leading to inflammation, which may occur through physical trauma, ultraviolet or other ionizing radiation, burns or excessive cooling (frostbite).

Tissue necrosis, death of tissues, results from insufficient oxygen or nutrients due to inadequate blood flow, which is a potent inflammatory stimulus, often accompanied by an acute inflammatory response.

Inflammation has both systemic and local effects. Systemic effects include fever, malaise, and leukocytosis, which is the presence of an abnormally high number of circulating white blood cells, often indicating a bacterial infection in the case of increased neutrophils, or a viral infection in the case of increased lymphocytes.

Fever is a common systemic response to inflammation, often associated with infection, and is thought to enhance the efficiency of leukocyte killing and impair the replication of many invading organisms.

Persistent inflammation can lead to chronic diseases such as arthritis, atherosclerosis, and cancer, and can result in tissue damage and fibrosis.

Inflammation can also affect the central nervous system, leading to neurological disorders such as multiple sclerosis, Alzheimer's disease, and Parkinson's disease.

The immune response to inflammation plays a crucial role in the pathogenesis of many diseases and can be both protective and harmful. A balanced immune response is essential for maintaining optimal health.