22. Systemic Pathology Flashcards
Accumulation of blood in pericardial space
Cardiac tamponade
“Beck’s triad” assoc with Cardiac tamponade
Distended neck veins
Distant muffled heart sounds
Decrease arterial BP
3 diseases assoc with RHD/RF
Scarlet fever
Impetigo
Strep throat
Disease caused by post streptococcal hypersensitivity
RHD
Strawberry tongue
Scarlet fever
Diff dx of scarlet fever (with strawberry tongue also)
Kawasaki disease
2 Histologic features of RHF
Aschoff bodies
Anitschkow giant cells
Pathognomonic granulomatous inflammed tissue of myocardium
Aschkoff bodies
“Caterpillar like” 🐛 Giant macrophages
Anitschkow giant cells
5 features of RF/RHD
Polyarthritis Pancarditis Valvular damage (mitral valve) Chorea Erythema marginatum
BQ: what Pericarditis is associated with RHD?
Fibrinoid pericarditis
Other term for fibrinoid pericarditis
“Bread and butter” pericarditis
BQ: Clinica feature of erythema multiforme
Target skin lesion/bull’s eye
Bacteria colonization of heart valves (mitral valve)
Endocarditis
Most common cause of Endocarditis (old textbook)
RHD
Accdg to WHO: High risk of Endocarditis in:
Prosthetic heart valve
Recent cardiac surgery
History of endocarditis
Treatment for pxs with high risk of having Endocarditis before Extraction or invasive procedures
Prophylactic antibiotic:
- Amoxicillin 2,000mg/2g
- 30mins to 60mins prior to invasive procedure - Clindamycin 600mg
- if allergic to amox
Side effect of clindamycin
Pseudomembranous colitis
Causative agent/bacteria of pseudomembranous colitis
Clostridium difficile
Tx for pseudomembranous colitis
Metronidazole
Vancomycin
Side effect of vancomycin
Red man syndrome
Most common type of endocarditis
Subacute endocarditis
Bacteria assoc with “endocarditis”
Streptococcus viridans
Infection of lungs esp the alveoli
Pneumonia
2 types of pneumonia
Bacterial and viral pneumonia
Causative agent of bacterial pneumonia
Strep pneumoniae
Viral pneumonia
Influenza virus (orthomyxovirus) RSV (paramyxovirus)
“Collapsed” alveoli of lungs (decrease in size/deflated) due to surfactant deficiency
Atelectasis
“Ectasis” - collapse
COPD (3)
Bronchiectasis
Emphysema
Chronic bronchitis
BQ: disease assoc with “Barrel chest appearance”
COPD* (boards)
- Emphysema
Collapsed bronchi (dilatation of respiratory tract) usually due to CYSTIC FIBROSIS!!(inc mucus prod:loss of cilia: cant breathe)
Bronchiectasis
“Pink puffer”
emPhysema
“Blue Bloaters”
Chronic Bronchitis
“Trapped air”
Emphysema
Most common chronic disease of the lungs
Emphysema
Increase in size of the air spaces (nawawalan ng elasticity ung alveoli)
Emphysema
“Barrel chest appearance”
Emphysema
Choices sa boards: COPD!
Inflammation of bronchi due to Inhalation of pollutants (smoking and pneumoconiosis)
Chronic bronchitis
Inhalation of different pollutants
Pneumoconiosis
“Stone mason’s disease”
Silicosis
Most common and most serious
Inhalation of SILICA
Assoc with TB!
Silicosis
Inhalation of ASBESTOS
Assoc with bronchogenic carcinoma
Asbestosis
“Wool sorter’s disease”
Anthrax
“Black lung or Coal worker’s disease”
Anthracosis
Inhalation of csrbon or coal dust
Anthracosis
Inhalation of beryllium
Berrylliosis
BQ: Consequences of CHRONIC BRONCHITIS
Cor pulmonale
Bronchogenic carcinoma
Enlargement of right ventricles
Cor pulmonale
Bronchial epithelium to squamous change
Assoc with asbestosis
Bronchogenic carcinoma
BQ: Most common death causing cancer in MALE(or female 2018)
Lung cancer
Most common death causing cancer in women (old statistics)
Breast cancer
Most common cancer in male
Prostate cancer
Most common cancer in females
Breast cancer
Disease due to excessive acid secretion
Peptic ulcers
Most commonly involved bacteria in peptic ulcers
Helicobacter pylori
Most common site of peptic ulcer
Duodenum (c shaped/iron)
Skin cancer of the stomach
- risk factors: smoked and raw food
Gastric carcinoma
Most common blood type assoc with gastric carcinoma
Blood type A
Carcinogen found in grilled food:well done
Benzo-a-pyrenes
Other term for gerd
Heartburn
Gastric contents moving up to the Lower esophagus
Gerd
Doc for gerd
Omeprazole (PPI)
Treatment for GERD (2)
Omeprazole H2 blockers (ranitidine/cimetidine)
Metaplastic change assoc with GERD
Barret’s esophagus
Decrease function of heart; resulting to decrease blood flow to organs
Heart failure
Most common type of CHF
Left CHF
Causes of left CHF
Hypertension
Rheumatic fever
MI
Larger type of circulation: Systemic or pulmonary?
Systemic - larger
Vessels involved in Pulmonary circulation
2 only:
Pulmo artery and vein
(the rest sa systemic na)
What ventricle supplies the systemic circulation
Left ventricle
Ventricle that is involved in pulmonary circulation
Right ventricle
Fat + Calcium =
Plaque
Sudden attack of severe shortness of breath during the night
Paroxysmal nocturnal dyspnea
Shortness of breath while lying
Two-pillow orthopnea (positional dyspnea)
Paroxysmal nocturnal dyspnea Two-pillow orthopnea Tachypnea Pleural effusion Pulmonary edema - Are characteristic of what CHF?
Left CHF - Lungs affected
Body compensation to heart failure:
- Increases heart function ➡️ Hypertrophy of Left ventricle ➡️ Congestion
- Fluid retention = ⬆️BF = ⬆️BS
- Hypertrophy
What happens if there’s congestion in the left ventricle:
- Decrease blood systemic circulation
- Back flow of blood in the lungs (kaya hirap sila huminga)
- R-CHF
BQ: Pigment carried by Heart failure cells
Hemosiderin
Dust cells: eat yung rbc sa lungs = end product: hemosiderin
Most common cause of R-CHF
Left CHF
Nutmeg liver is s characteristic feature of what disease?
Nutmeg liver : R-CHF
Nutmeg liver Portal hypertension leading to: - Splenomegaly - Ascites - Peripheral edema ( in lower ext) - Jugular venous distention - Esophageal varices \: Are associated with what CHF?
Right CHF (is body is involved)
Fluid accumulation in peritoneal cavity
Ascites
BQ: Esophageal varices is seen in what disease?
Right CHF or “CHF”
Plaque or (fat-calcium complexes) formation in the coronary artery
Coronary heart disease
Volume of blood pumped by the heart for every minute
Cardiac output
Formula for Cardiac output
CO = Stroke vol x Heart rate
Volume of blood pumped by the heart
Stroke volume
Beats per minute
Heart rate
Average stroke volume
70ml
Average heart rate
70 bpm
Average Cardiac output
4900ml/min ➡️ 5L/min!!!!
Typical range of Cardiac output
4L-7L/min
3 stages of Coronary Heart Disease
👑 Atherosclerosis
👑 Angina pectoris
👑 Myocardial infarction
Thickening and hardening of LARGE arteries like coronary artery, aorta
Atherosclerosis
Thickening and hardening of the smallest artery or arterioles
Arteriosclerosis
Chest pain due to ischemia (dec blood supply) in the heart
Angina pectoris
BQ: Chest pain without physical exertion 🙅♀️
Unstable angina
BQ: Chest pain during physical exertion 💃
Stable angina
Intermittent chest pain at rest (di matanong sa boards)
Variant or Prinzmetal’s angina
BQ: DOC for angina pectoris or chest pain
Nitroglycerin (Glycerin trinitrate)
- Sublingual
- causes vasodilation = ⬆️ Blood supply
Inhalational drug that can also be used to tx angina pectoris
Amyl nitrate
“Heart attack”
Myocardial infarction
Necrosis of myocardium due to infarction (LOSS of blood supply) in the coronary artery
Myocardial infaction
Whole process that causes Myocardial infarction is called?
Thromboembolism (formation of thrombus to EMBOLUS)
BQ: Most common site of thrombosis or Clot formation?
Deep femoral vein
Formation of clot
Thrombosis
aka “clot”
Thrombus
Any floating mass that is capable of clogging capillary walls (ex blood clot)
Embolus
Lodging of an embolus (pag na trap sa small vessel)
Embolism
Process: thrombus to embolus
Thromboembolism
Myocardial infarction has features of having:
- Severe chest pain and numbness radiating to what side of the body?
Left side of body - Numbness/Severe chest pain
Virchow’s triad - Factors that contribute to thrombosis formation : (virCHEows)
- Changes in vascular flow
- obstruction ng blood flow
- (pag nakaupo palagi) - Hypercoagulability
- Gene mutations or drugs (birth control pills) - Endothelial injury
- damage in the wall of bv (happens in any form of wound like during SURGERY = ⬆️ risk of having MI)
BQ: “Roger’s disease”
Ventricular septal defect
Most common type of Acyanotic
Ventricular septal defect
Most common type of Cyanotic type: “Bluish” 💙
Tetralogy of fallot
4 components of Tetralogy of fallot
“PROVe” Pulmonary stenosis Right ventricular hypertrophy Overriding aorta Ventricular septal defect
“Narrowing of valve” = ⬇️ blood to lungs
Pulmonary STENOSIS
stenosis - narrowing
Narrowing of the DESCENDING AORTA
Coarctation of the aorta
Blood pressure difference in Coarctation of the aorta:
Upper body =
Lower body =
Coarctation of the aorta:
Upper body = hypertension
Lower body = hypotension
BQ: Ductus arteriosus (fetus)
Ligamentum arteriosum
BQ: Ductus venosus (fetus)
Ligamentum venosum (adults)
BQ: Umbilical vein (fetus)
Ligamentum teres (joins with falciform ligament of liver)
BQ: Foramen ovale (fetus)
- loc: sphenoid and heart (bet R/L atrium)
Fossa ovalis of right atrium
In adults: 1 foramen ovale = exit of V3
BQ: Which has thicker MUSCULAR LAYER: Arteries or veins?
Arteries thicker!
BQ: Which of the ffg layers of is ABSENT in veins?
Serosa
BQ: Arteries carrying UNoxygenated blood
Pulmonary artery
Umbilical artery
BQ: Veins carrying OXYGENATED blood
Pulmonary vein
Ductus venosus
Umbilical vein
BQ: Blue baby syndrome is assoc with?
Congenital heart defects
Methemoglobinemia
Erythroblastosis fetalis
BQ: Small bv supplying Larger blood vessels
Vasa vasorum
“Vessels of the vessels”
BQ: Exchange system of arteries and veins
Capillaries
Smallest BV
Capillaries
Lining of capillaries
Simple squamous
Size or Thickness of lumen of Capillaries
1 RBC
BQ: Vessels with greatest cross sectional area?
Capillaries
But slowest blood flow: ⬆️Cross sec area = ⬇️ Blood flow
BQ: blood flow is fastest in what blood vessel?
Aorta
Rule: ⬇️ Cross sectional area: ⬆️BF
BQ: Peripheral resistance is greatest in?
Capillaries
⬇️compliance of capillaries = ⬆️ peripheral resistance
Pressure exerted by the blood towards the wall of the blood vessel or “resistance ng vessel against blood pressure”
Peripheral resistance
Example:
(Blood exerts pressure on aorta(flexible)= ⬆️compliance:magsstretch ung walls pero may limit)
RULE: ⬆️compliance = ⬇️ Peripheral resistance
Highest BP in the body
Aorta
Lowest BP in the body
Vena cava
BQ: What vessel is assoc with Sudden GREATEST DECREASE in BP? (Biglang bumagsak BP)
Arteriole
BQ: What kind of drug is 5-Fluorouracil?
Anti-metabolite
BQ: Which disease has a rx app of Sunburst or Sunray ☀️
Osteosarcoma
BQ: Hx app of FIBROSARCOMA
Herringbone pattern
Nakikita din sa xray film: pag baligtad
Malignancy of skeletal muscle
Rhabdomyosarcoma
Benign tumor of skeletal muscle
Rhabdomyoma
Malignancy of smooth muscle
Leiomyosarcoma
Benign counterpart of leiomyosarcoma (smooth muscle)
Leiomyoma
BQ: Which is SMALLER: Osteiod osteoma or Osteoblastoma?
Osteoid osteoma - <1cm
osteoblastoma - >2cm
Which is MORE PAINFUL (Constant/nocturnal) : Osteiod osteoma or Osteoblastoma?
Osteoid osteoma
BQ: Which is relieved by nsaids: Osteoid osteoma or Osteoblastoma?
Osteoblastoma - pain reliever
Hereditary accumulation of polyps in the rectum of large intestine
- (presence of POLYPS and SUPERNUMERARY TEETH)
Gardner’s syndrome
Other name for Gardner’s syndrome
Familial colorectal polyposis
BQ: Most common site of colorectal cancer?
Rectosigmoid junction
Gardner’s syndrome or Familial colorectal polyposis is assoc with what cancer
Colorectal cancer
BQ: What is the differential diagnosis of Gardner’s?
Peutz-Jeghers Syndrome
- With polyps
- normal # of teeth
- w/ freckles(ephilides)
Other name for Sjogren’s syndrome
Sicca syndrome
Autoimmune disease that damages the salivary and lacrimal glands
Sjogren’s syndrome or Sicca syndrome
Sjogren’s syndrome TRIAD
Xerostomia
Keratoconjunctivitis sicca
Rheumatoid arthritis
Treatment for Sjogren’s syndrome
- Immunosuppressants:
Cyclosporine
Corticosteroids - Cholinergic drugs - Pilocarpine (parasymp drug: inc fluids for dry mouth and eyes)
- Antiinflammatory:
NSAIDs
BQ: Drugs assoc with GINGIVAL HYPERPLASIA
Phenytoin
Cyclosporines
Nifedipine
BQ: Disease assoc with sjogren’s syndrome with ENLARGEMENT OF SALIVARY AND LACRIMAL GLANDS is called?
Mikulicz disease
“benign lymphoepithelial lymphomatosum”
( BLL - mukhang BELL)
BQ: most common tumor assoc with PAROTID GLAND
Pleomorphic adenoma
Most common BENIGN tumor of parotid gland
Pleomorphic adenoma
Most common MALIGNANT tumor of parotid gland
“Mucoepidermoid carcinoma”
ssc of salivary gland
BQ: other term for SCC
Mucoepidermoid carcinoma
BQ: “Papillary cystadenoma lymphomatosum”
Warthin’s tumor (2nd benign)
BQ: 2nd most common skin cancer of the body
SCC
BQ: most common site of SCC
Posterolateral border of tongue
Second most common MALIGNANT in PAROTID gland
Acinic cell carcinoma
Autodigestion of pancreas due to early activation of pancreatic juices - (happens only when you have gallstones : Alcoholics)
Acute pancreatitis
COD: Internal hemorrhage
Lab findings in Acute pancreatitis
Increase serum amylase and lipase (secreted by pancreas)
Liver tissues are being replaced by SCAR FIBROUS TISSUE resulting to decrease blod flow in the liver
Cirrhosis
Cirrhosis due to alcohol
Presence of mallory bodies
Alcoholic cirrhosis
“Laennec’s cirrhosis”
Cirrhosis due to obstruction of bile ducts
Biliary cirrhosis
Cirrhosis due to chronic RIGHT CHF!!!!
Cardiac cirrhosis
Inflammation of gall bladder
Cholecystitis
Gall bladder or bile duct STONES
Cholelithiasis
Chronic inflammatory bowel disease
Crohn’s disease
Clinical appearance of Crohn’s disease
Cobblestone
BQ: glomerular inflammation due to POST STREP INFECTIONS
Glomerulonephritis
BQ: Inflammatory rupture of the glomerular capillaries
- presence of HEMATURIA!!!
Nephritic syndrome
BQ: Functional impairment of kidney
Inc excretion of substances WITHOUT NEPHRITIS
- WITHOUT HEMATURIA
Nephrotic syndrome
Inflammation of renal pelvis and kidney
Pyelonephritis
Failure of PCT to reabsord impt subs like glucose and amino acids
Faconi’s syndrome
BQ: overfunctioning of the prostate gland
Inc serum acid phosphatase and Prostate specific antigen “PSA”
Prostate cancer
Accumulation of fluid in interstitial tissues
Edema
Accumulation of fluid in the peritoneal cavity
Ascites
Accumulation of fluid in the Pleural cavity
Hydrothorax/ Pleural effusion
Accumulation of fluid in the Pericardial sac
Cardiac tamponade
Generalized edema
Anasarca
Accumulation of fluid in the LUNG SPACES
Pulmonary edema
Process of “Blood efflux” from the circulatory system
Hemorrhage
Small size hemorrhage (<3mm)
Petechiae
Moderate size hemorrhage (3-10mm)
Purpura
Large size hemorrhage (>10mm)
Ecchymoses
Tumor like hemorrhage
Hematoma
Lack of blood flow to the tissues
Shock
Shock caused by hemorrhage
Hypovolemic shock or Hemorrhagic shock
Shock due to Decrease cardiac function (heart attack or cardiac tamponade)
Cardiogenic shock
Shock due to bacterial infection or SEPSIS and SEPTICEMIA
Septic shock
Shock due to excessive allergic reaction
Anaphylactic shock
Tx for anaphylactic shock
Epinephrine (1:1000 - IM)
Shock due to disruption of parasym and symp
Neurogenic shock
“Diabetic shock”
Due to abnormal body metabolism
Metabolic shock
Shock due to emotional event or traumatic event
Psychogenic shock
BQ: location of prostate gland
Neck of bladder
Decrease in erthrocyte count
Anemia
BQ: most common type of anemia
Iron deficiency anemia
BQ: “Plummer Vinson Syndrome” is assoc with what type of anemia?
Iron def anemia
Tx for iron def anemia that causes tooth discoloration
Ferrous sulfate
BQ: “Plummer’s dse” is assoc with what disease
Hyperthyroidism
Inability of red bone marrow cells to produce RBC
Aplastic anemia
Vit B12 def
Pernicious anemia
Vit B9 def
Megaloblastic anemia
BQ: “beefy tongue” is seen in
Pernicious anemia
Hemolytic anemia (“STEf”)
Sickle cell anemia
Thalassemia
Erythroblastosis fetalis
Abnormal “hemoglobin” formation
Thalassemia
Hx app: Heinz bodies
Thalassemia
2 dses with RX: Crewcut/Hair-on-end
Thalassemia
Sickle cell anemia
Type of anemia where in Glutamic acid is replaced by VALINE
Sickle cell anemia
Lifespan of rbc in sickle cell anemia
10-20 days only!
Hemolytic anemia in fetus
Erythroblastosis fetalis
Rh - mom / Rh+ father
BQ: “GRANULOCYTOPENIA”
- decrease number of granulocytes
(Nakakalito kasi misleading!!)
Agranulocytosis
Neoplastic growth of WBC
Leukemia
BQ: “not a feature of leukemia”
Features:
- Dec platelet count = thrombocytopenia
- Hemorrhage - petechiae/ecchymosis
- Decrease RBC - anemia
- Abnormal WBC
- Gingival hyperplasia
- Oral ulcerations
- Oral petechiae
BQ: Leukemia common to Down’s syndrome
Acute leukemia
BQ: Most common leukemia
CLL
BQ: Least common leukemia
AML
BQ: Most common acute leukemia in CHILDREN
ALL
BQ: Leukemia assoc with PHILADELPHIA CHROMOSOME (translocation of 22 to 9)
CML
BQ: Mutation of chr 22 to 11
Ewings sarcoma
BQ: deletion of chr 22
DiGeorge syndrome
Def thymus and parathyroid
BQ: 3 disease of HISTIOCYTOSIS
BQ: Letterer Siwe disease
BQ: Hand schuller christian disease
Eosinophilic granuloma
BQ: Letterer siwe disease is common in what age
<1 yr old
