Medical Quiz: Conjunctivitis and GI Conditions

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Questions and Answers

Which of the following is a characteristic of allergic conjunctivitis?

Discharge is thick and purulent

Affects only one eye

Discharge is clear and watery (correct)

Not associated with itching

What is a primary cause of dry eye?

Excessive blinking

Bacterial infection of the eye

Overproduction of tears

Deficiency or dysfunction of the tear film (correct)

Which of these is a predisposing factor for developing otitis externa?

Exposure to the cold

Low humidity

Dry air

Moisture (correct)

A patient presents with gradual hearing loss and ear discomfort. Which of the following conditions is MOST likely?

Excessive ear wax build-up Signup and view all the answers

How is scabies typically transmitted?

Through skin-to-skin contact or shared bedding Signup and view all the answers

A patient reports intense itching, redness, and blistering after being bitten. Which is the MOST likely cause?

Insect bite Signup and view all the answers

Which immune cells are primarily involved in the pro-inflammatory response in Inflammatory Bowel Disease (IBD)?

Th17 cells Signup and view all the answers

During the pathogenesis of Ulcerative Colitis, which interleukin is secreted by T(helper) cells leading to TH2 cell production?

IL4 Signup and view all the answers

Which of the following is characteristic of food poisoning, rather than a GI infection?

A rapid onset of symptoms with a short duration. Signup and view all the answers

Which bacterium is NOT typically associated with causing food poisoning?

Campylobacter jejuni Signup and view all the answers

Which of the following types of E. coli is typically associated with 'traveler's diarrhea'?

ETEC Signup and view all the answers

Which of these best describes the pathophysiology of antibiotic associated diarrhea?

Removal of normal microflora and proliferation of specific pathogens. Signup and view all the answers

What common characteristic differentiates primary osteoarthritis from secondary osteoarthritis?

The presence of a pre-existing condition or other cause. Signup and view all the answers

Which of the following is NOT considered a major risk factor for the development of osteoarthritis?

Infectious disease Signup and view all the answers

Which type of immune cell is primarily responsible for activating B cells in the pathogenesis of osteoarthritis?

CD4+ T cells Signup and view all the answers

Which substance, released by fibroblasts, directly activates osteoclasts, leading to bone destruction in osteoarthritis?

RANKL Signup and view all the answers

What is the primary characteristic of pannus formation in the context of joint pathology?

Hypertrophied synovial tissue growing over articular cartilage causing erosion. Signup and view all the answers

Which of the following factors can lead to the development of gout?

Elevated total body uric acid concentration. Signup and view all the answers

What is a risk factor specific to osteomyelitis?

Poor vascularity due to poorly controlled diabetes. Signup and view all the answers

Which characteristic is NOT typical of gout?

Symmetrical joint involvement. Signup and view all the answers

What is the main cause of pseudo gout (CPPD)?

Accumulation of calcium pyrophosphate crystals. Signup and view all the answers

What is a common symptom of reactive arthritis related to the digits?

Dactylitis, or 'sausage digits'. Signup and view all the answers

A patient presents with acute, intense pain, erythema, and swelling in their first metatarsophalangeal joint. Which of the following conditions is most likely?

Gout. Signup and view all the answers

Which of the following is a characteristic of ulcerative colitis?

Continuous inflammation from rectum to proximal colon Signup and view all the answers

Which of the following is a potential complication of severe untreated gout?

Kidney damage. Signup and view all the answers

What is the primary immune cell type involved in the pathogenesis of Crohn's disease?

Macrophages recruited which positively regulate Th1 cells Signup and view all the answers

Which of the following is considered a protective factor against ulcerative colitis?

Both smoking and appendectomy Signup and view all the answers

A patient presents with symptoms including diarrhea, abdominal cramping, and iron deficiency anemia. The inflammation is patchy with some areas of normal tissue in between inflamed sections of the bowel. Which condition below is the most likely cause?

Crohn's Disease Signup and view all the answers

What is the role of tissue transglutaminase 2 (TTG) in the pathogenesis of celiac disease?

It deamidates gluten peptides, making them more immunogenic Signup and view all the answers

Which of these complications is more common in Crohn's disease compared to ulcerative colitis?

Fistula formation Signup and view all the answers

What is the primary mechanism by which gluten causes inflammation in celiac disease?

Triggering an immune response via HLA-DQ2 or DQ8 presentation. Signup and view all the answers

Which of the following is a symptom that is present in all three conditions; Ulcerative Colitis, Crohn's and Coeliac disease?

Weight loss Signup and view all the answers

Which of the following is NOT an extra-articular manifestation of an inflammatory disease?

Joint pain Signup and view all the answers

What is the primary mechanism by which estrogen contributes to bone health?

By increasing osteoblast proliferation and inhibiting apoptosis. Signup and view all the answers

Which hormone primarily functions to mobilize calcium from bone and increase its reabsorption in the kidneys?

Parathyroid hormone Signup and view all the answers

Calcitonin reduces blood calcium levels by which mechanism?

Inhibiting bone resorption by osteoclasts. Signup and view all the answers

Which of the following describes the primary method of Vitamin D production in the human body?

Conversion of dietary colecalciferol into the most potent product (calcitriol), in the liver and kidneys. Signup and view all the answers

How do glucocorticoids affect bone metabolism?

They are required for osteoblast differentiation but their excess can inhibit osteoblast differentiation while stimulating osteoclast activity. Signup and view all the answers

Which of the following is a direct effect of thyroxine on bone metabolism?

It stimulates osteoclast activity, which reduces bone density. Signup and view all the answers

What does a T-score of -1.0 on a DEXA scan indicate?

Normal bone density. Signup and view all the answers

Which type of pain is characterized by an increased sensitivity to stimuli?

Hyperalgesia Signup and view all the answers

Which of the following best describes somatic pain?

Aching, deep, dull, and well-localized Signup and view all the answers

Which of these categories of pain is related to the growth and spread of tumours?

Cancer Pain Signup and view all the answers

In the process of pain, which system is responsible for determining how you should feel about that pain?

Limbic system Signup and view all the answers

Which neurotransmitters are involved in the modulation stage of pain by preventing transmission?

Endorphins and Enkephalins Signup and view all the answers

If someone feels pain from a light touch, what is this most likely an example of?

Allodynia Signup and view all the answers

Which best describes the transmission process of pain?

Neurotransmitters activate, continuing the action potential towards the brain Signup and view all the answers

What is the primary distinction between A and C fibres in the pain pathway?

A fibres are fast, whereas C fibres are slow. Signup and view all the answers

Study Notes

Inflammatory Skin Conditions

Acne (Acne vulgaris): Caused by increased sebum production and abnormal follicular keratinization. Androgens and anabolic steroids increase sebum, while estrogen decreases it. Diet and stress can also affect production. Bacteria can proliferate and cause inflammation.
Atopic Dermatitis (Eczema): A chronic allergic hypersensitivity disease and immune dysfunction, primarily mediated by TH2 cells. This condition presents with dry, red, cracked, itchy, and weeping skin and is often associated with other atopic conditions, like asthma. Acute cases are triggered by allergens entering damaged skin, leading to inflammatory mediators release. Chronic cases are driven by T-cell cytokines and keratinocyte dysfunction causing skin thickening.
Contact Dermatitis: Two types:
- Irritant contact dermatitis: Direct irritation or injury by physical or chemical agents (e.g., ammonia in urine, proteolytic enzymes in feces, friction).
- Allergic contact dermatitis: Immune response to small organic or inorganic allergens that can penetrate the skin, mediated by T-cell responses. Protein contact dermatitis is also an immune response but to large protein allergens and cannot penetrate intact skin.
Cellulitis: An acute bacterial infection of the dermis and subcutaneous fat, commonly caused by Staphylococcus aureus or Streptococcus pyogenes. It often enters through a wound and presents as ill-defined red, painful, and swollen lesions. Systemic symptoms like fever and chills can also occur.
Urticaria (Hives): Characterized by itchy wheals (hives) and/or dermal swelling (angioedema). It can be acute or chronic and results from mast cell degranulation-releasing histamine and other mediators. This leads to the characteristic weals and blisters.
Psoriasis: Excessive proliferation and differentiation of keratinocytes. Stimuli may damage keratinocytes and trigger an immune response, resulting in inflammatory mediators and excessive skin cell growth. This manifests as plaques on the skin.

Infectious Skin Conditions

Fungal Infections:
- Tinea Pedis (Athlete's foot): Caused by T. rubrum, T. mentagrophytes, or Epidermophyton floccosum. It is a chronic recurrence that is common in immune-compromised or those with poor circulation. It presents as dry, scaly, itchy lesions and even nail infections (onychomycosis).
- Tinea Corporis (Ringworm): Often zoonotic, and appears as inflamed red patches with white healing centers. It's distinguished by using a Wood's lamp (fungi will glow).
- Tinea Capitis (Scalp infection): Presents as inflamed scalp, and hair loss. It is caused by Microsporum canis. Easily transmitted via spores in hairbrushes and clothing.
Viral Infections:
- Warts (Verruca vulgaris): Caused by human papillomavirus, can be contagious and spread from person to person or auto-inoculated.
- Cold sores: Caused by Herpes simplex virus type 1 (HSV-1). It is a latent virus, with periodic reactivation and typically appears as red bumps, blisters that crust over and heal within 7 to 10 days.
- Chickenpox: Caused by Varicella-zoster virus (VZV). Highly contagious and spread via respiratory droplets. It is characterized by a characteristic itchy rash of fluid-filled blisters that rupture, resulting in scabs.
Bacterial Infections:
- Hair follicle infections: Often caused by S. aureus but can be fungal. This condition typically affects moist and warm areas.
- Folliculitis: Localized, small, inflamed pustules (often itchy and painful).
- Boils (furunculosis): More severe, deeper infection of one or more follicles with larger inflammatory areas.
- Carbuncle: A large collection of boils.

Other Skin Conditions

Impetigo: Caused by Staphylococcus aureus or Streptococcus pyogenes, a superficial infection of the epidermis. Highly contagious, without systemic symptoms, self-resolving and often occurs around the nose and mouth
Clostridial skin infections: Caused by C. tetani (tetanus) and C. perfringens.
- Tetanus: Early symptoms include progressive tissue infection, weakness, and stiffness followed by muscle spasms and seizures.
- C. perfringens: This can result in necrotizing disease with early symptoms of skin discoloration and fluid-filled blisters. Systemic symptoms (hypotension) follow.
Leprosy: Caused by Mycobacterium leprae; characterized by skin lesions and nerve damage. Two types exist: tuberculoid (less severe, less contagious) and lepromatous (more severe and more contagious).
Other: Scabies, head lice, insect bites, and insect stings.

Mouth Conditions

Cold sores: Caused by Herpes simplex virus type 1, presenting as recurrent sores (with a rash), or painful lesions.
Mouth Ulcers: Inflammatory damage to the oral epithelium, often triggered by physical injury, nutritional deficiencies, or stress.
Oral Candidiasis: Fungal infection caused by Candida albicans, often common in infants and older adults with compromised immune systems. Risk factors include: Immunocompromised, reduced saliva, uncontrolled diabetes, regular inhaled corticosteroid therapy.
Angular cheilitis: A condition affecting the corners of the mouth, marked by inflammation, often triggered by skin conditions, nutritional deficiencies, or other chronic conditions

Ear and Eye Infections

Conjunctivitis: Inflammation of the conjunctiva. Three types of bacterial, viral and allergic infections.
Dry Eye: Deficiency or dysfunction of the tear film.
Otitis Externa: Inflammation of the outer ear canal. A common cause is moisture.
Ear Wax Implications: Build-up of ear wax can cause hearing loss and be associated with other medical conditions like systemic illness or hearing aids.

GI Conditions

Inflammatory Bowel Disease: Two types, Ulcerative Colitis (affects only colon) and Crohn's disease (affects any part of GI tract). Characterized by inflammation and ulceration.
Coeliac Disease: An inflammatory disease caused by gluten, triggering an immune response in the small intestine and causing damage to the villi.
Gastric Acid Secretion Process: The phases of gastric acid secretion are triggered by stimuli in the cephalic, gastric and intestinal phases.
Peptic Ulcer Disease: An erosion of the lining of the stomach or duodenum caused by injury, usually by H. Pylori.
GORD: Chronic condition caused by reflux of gastric acid upward into the oesophagus.
Zollinger-Ellison Syndrome: Pancreatic tumor producing excessive gastric acid resulting in frequent peptic ulcers
Haemorrhoids: Occur when vascular-rich connective tissue becomes engorged or swollen, often occurring in the rectum or anus, usually (but not always) leading to pain and swelling or bleeding.
Threadworms: Small, thin worms in the bowel resulting from ingestion and self-infection. Common in people with inadequate hygiene and can cause itching.

Viral Hepatitis; Food Poisoning; GI Infections

Types of viral hepatitis with their causes and transmission.
Causes of and types of food poisoning and other GI Infections.

MSK Conditions

Osteoarthritis: A chronic joint disease, most common in elderly adults (over 55). Risk factors include age, obesity, and injury.
Rheumatoid Arthritis: A chronic inflammatory disorder that leads to joint destruction and deformity. It is more common in women, and associated with genetic factors, environmental factors and chance events.
Gout: Caused by deposition of monosodium urate crystals in the joints. Risk is higher in men than women.
Pseudo Gout: Caused by the deposition of calcium pyrophosphate crystals in the joints. More prevalent in women.

Pain

Pain Description categories: Acute, chronic, cancer, and phantom pain. Types include nociceptive and neuropathic pain, which have subtypes.

Other Specific Conditions

Osteomyelitis (bone infection)
Septic arthritis (joint infection)
Reactive arthritis (arthritis resulting from an infection elsewhere in the body)
Osteoporosis (bone loss)

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Description

Test your knowledge on various medical conditions such as allergic conjunctivitis, dry eye, and otitis externa. This quiz also covers important aspects of inflammatory bowel disease and food poisoning. Assess your understanding of pathophysiology and immune responses in these conditions.