22. Systemic Pathology Flashcards by Ch Mora

Accumulation of blood in pericardial space

Cardiac tamponade

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“Beck’s triad” assoc with Cardiac tamponade

Distended neck veins
Distant muffled heart sounds
Decrease arterial BP

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3 diseases assoc with RHD/RF

Scarlet fever
Impetigo
Strep throat

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Disease caused by post streptococcal hypersensitivity

RHD

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Strawberry tongue

Scarlet fever

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Diff dx of scarlet fever (with strawberry tongue also)

Kawasaki disease

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2 Histologic features of RHF

Aschoff bodies

Anitschkow giant cells

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Pathognomonic granulomatous inflammed tissue of myocardium

Aschkoff bodies

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“Caterpillar like” 🐛 Giant macrophages

Anitschkow giant cells

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5 features of RF/RHD

Polyarthritis
Pancarditis
Valvular damage (mitral valve)
Chorea
Erythema marginatum

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BQ: what Pericarditis is associated with RHD?

Fibrinoid pericarditis

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Other term for fibrinoid pericarditis

“Bread and butter” pericarditis

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BQ: Clinica feature of erythema multiforme

Target skin lesion/bull’s eye

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Bacteria colonization of heart valves (mitral valve)

Endocarditis

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Most common cause of Endocarditis (old textbook)

RHD

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Accdg to WHO: High risk of Endocarditis in:

Prosthetic heart valve
Recent cardiac surgery
History of endocarditis

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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

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Side effect of clindamycin

Pseudomembranous colitis

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Causative agent/bacteria of pseudomembranous colitis

Clostridium difficile

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Tx for pseudomembranous colitis

Metronidazole

Vancomycin

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Side effect of vancomycin

Red man syndrome

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Most common type of endocarditis

Subacute endocarditis

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Bacteria assoc with “endocarditis”

Streptococcus viridans

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Infection of lungs esp the alveoli

Pneumonia

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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:

1. Increases heart function ➡️ Hypertrophy of Left ventricle ➡️ Congestion 2. Fluid retention = ⬆️BF = ⬆️BS 3. Hypertrophy

What happens if there’s congestion in the left ventricle:

1. Decrease blood systemic circulation 2. Back flow of blood in the lungs (kaya hirap sila huminga) 3. 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)

1. Changes in vascular flow - obstruction ng blood flow - (pag nakaupo palagi) 2. Hypercoagulability - Gene mutations or drugs (birth control pills) 3. 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

1. Immunosuppressants: Cyclosporine Corticosteroids 2. Cholinergic drugs - Pilocarpine (parasymp drug: inc fluids for dry mouth and eyes) 3. 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: 1. Dec platelet count = thrombocytopenia 2. Hemorrhage - petechiae/ecchymosis 3. Decrease RBC - anemia 4. Abnormal WBC 5. Gingival hyperplasia 6. Oral ulcerations 7. 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