Epidemiology

Sarcoidosis is a multisystem granulamtous disorder of unknown aetiology. It most commonly affects the lungs (>90% of cases) and lymphatic system, but can affect any organ. Many cases are asymptomatic, although some patients can have very severe disease. Treatment may involve NSAIDs and less often, steroids, but often none is required as most cases resolve spontaneously.   Epidemiology and Aetiology  

Osteoarthritis is a condition that results from the loss of cartilage at synovial joints, and is often accompanied by degeneration of the underlying bone.   Radiologically there are: osteophytes Joint space narrowing   Epidemiology most common type of arthritis 80% people >60 will have some radiographic features  

Epidemiology and Aetiology More common in women Typical presentation at age 30-50 Associated with gout, pregnancy, the pill, premenstrual state, rheumatoid arthritis, diabetes, acromegaly, obesity, amyloidosis Some believe that jobs that involve repetitive flexing of the wrist may be involved.  

Ehlers-Danlos syndrome is an inherited connective tissue disorder caused by defective collagen synthesis. Symptoms vary widely between individuals. Some may be hardly effected, whilst other live severely restricted lives.   Epidemiology and Aetiology    

Fibromyalgia is a non-specific muscular disorder of unknown origin. It primarily affects insertions of tendons and associated soft tissues and presents with dull aching pains. It is much more common in women.  Epidemiology and Aetiology Cause is unknown Affects muscles rather than joints – although can often feel like joint pain Peak age of onset: 40-50 years M:F ratio 1:9  Pathology  

Introduction Marfan Syndrome (sometime Marfan’s Syndrome) is an autosomal dominant connective tissue disorder.   Epidemiology and Aeitiology 25% of cases occur without family history Reduced life expectancy – average is around 60   Pathology  

Along with osteoporosis, this is a common degenerative bone disease   Epidemiology and Aetiology This is the second most common bone disorder (after osteoporosis), and affects >5% of the over 55’s in the UK. The prevalence varies between countries and races. The UK has the highest incidence. It is rare in Scandinavia, China and Japan. Increased incidence in Pet Owners Genetic susceptibility  

Eczema (aka Dermatitis) presents as a poorly demarcated, itchy rash. There are several causes. By far the most common is atopic eczema, but irritants and venous stasis can also cause the condition.   Atopic Eczema This results from an IgE-mediated, T-cell auto-immune response.   Epidemiology and Aetiology  

Can be divided into two types; Hodgkin’s and non-Hodgkin’s. Lymphoid leukaemias also exist, and the distinction between these and lymphomas can be difficult.   Hodgkin’s Lymphoma (HL) Epidemiology This is rare; incidence is 2.5-4 per 100 000 Male: female is 1.5:1 Peak incidence is in the 3rd decade, and there is a second peak between the ages of 50-70.  

Epidemiology and Aetiology Major health problem – 300 million carriers Incubation 1 - 4 mths Parenteral transmission – sexual, IV, perinatal 0.5% of UK population are carriers, but this is as much as 10-15% in some countries in the developing world. in some far eastern countries, 1/3 of people are carriers. E.g. in Yemen ¼ of the population have hep B PresentationAcute Hepatitis B    

Remember, although rare, men can also get breast cancer. Less than 1% of breast cancers occur in men. Benign breast masses are 15x more common than breast cancer   Epidemiology In the UK, a woman has a 1/9 chance of developing breast cancer It is the most common cause of death in women aged 35-55  

Sterilisation Can be controversial in some cultures Should only be undertaken in stable relationships where the couple is certain they do not want any more children   Epidemiology Rates falling in developed countries UK is unusual as the number of men receiving the operation is greater than the number of women 18% of men between 18-69 have had a vasectomy  

Epidemiology The most common genital tract cancer Every year, about 4500 women in the UK develop endometrial cancer The majority (93%) of cases are diagnosed in women aged over 50 years Geographical variation exists - North American: Chinese ratio of about 7: 1   Pathology  

C-section is major surgery, with real risks, and the decision to perform such an operation should not be taken lightly!   Epidemiology Incidence in increasing, mainly due to the increased diagnoses of fetal distress, as diagnosed by CTG monitoring. Also increasing used for non-longitudinal lies (e.g. breech, transverse) WHO recommends not >15% of deliveries should be via c-section  

THE most common cause of pathological vaginal discharge. Can be caused by an overgrowth of many types of bacteria, usually anaerobes. There is alos often a decrease in the number of lactobacilli. Not sexually transmitted   Epidemiology Affects 10% of women in the UK, but most cases are asymptomatic   Presentation  

The second most common cause of pathological vaginal discharge, it is not usually sexually transmitted, and is instead the result of fungal overgrowth.   Epidemiology 95% of cases the result of Candida albicans 5% of cases due to Candida Glabrata – which is more difficult to treat  

Chlamydia Trachomatis (CT) The most common bacterial STI.   Like gonorrhoea, this can also be spread vertically, and can result in aconjunctivitis in the neonate. However, unlike gonorrhoea, the conjunctivitis is not a medical emergency, and will noly very rarely result in blindness.   Epidemiology It is the most common bacterial STD  

This is a parasitic protozoan infection, the result of infection with the flagellated anaerobic trichomonas vaginalis. This is the most common protozoan infection in the developed world It is a sexually transmitted infection although men are usually asymptomatic.   Epidemiology  

Epidemiology The most common STI in the UK Estimated that 10-20% of the population have a genital HPV infection, but only 1% of the population are symptomatic at any one time   Pathology The result of HPV infection. There are >100 types of HPV, and only several cause warts. HPV types 6 and 11 account for >90% of cases   Spread  

This is localised dilation of an artery within the brain. They rarely occur in veins. They are a major risk factor for subarachnoid haemorrhage.   Epidemiology & Aetiology Occur in 5% of the population Risk factors include: Arteriosclerosis Hypertension