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USMLE Step 1 > Anatomy and Histology > Flashcards

Anatomy and Histology Flashcards

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USMLE® Step 1 flashcards
1
Q

Tay Sachs disease

A

Lysosomal dysfunction

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2
Q

Chediak-Higashi disease

A

Abnormal microtubular assembly, leading to decreased PMN phagocytosis and frequent infections

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3
Q

Kartagener syndrome

A

Dynein arm defect that causes recurrent lung infections due to decreased mucus clearing, hearing loss, and infertility.

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4
Q

Drugs that act on mictrotubules

A

Mebendazole/thiabendazole, taxol, griseofulvin, vincristine/vinblastine, colchicine

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5
Q

Principle types of cell junctions

A

Zona occludens (tight junctions), zona adherens (intermediate junctions), adherens junctions (desmosomes), hemidesmosomes, gap junctions (communicating junctions)

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6
Q

Zona occludens

A

Aka tight junctions. Determine epithelial cell polarity, separating apical from basolateral pole. Regulate passage of substances across epithelial barrier (paracellular transport)

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7
Q

Cadherins

A

Calcium-dependent adhesion proteins

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8
Q

Cells of adenocarcinomas

A

Often lose usual eptihelial cell junctions allowing them to infiltrate basal membrane of surrounding tissues, converting it from in situ to invasive leading to metastatic

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9
Q

Zona adherens

A

Located just below tight junctions, near apical surface of epithelial layer. Occurs periodically around circumference of cell

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10
Q

Hemidesmosome

A

Connects cells to underlying extracellular matrix

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11
Q

Gap junction

A

Allows adjacent cells to communicate for electric and metabolic functions. Connexon fromed from six connexin proteins.

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12
Q

Hematocrit

A

Percentage of erythrocytes in blood

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13
Q

Buffy coat

A

Leukocytes

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14
Q

Serum

A

Plasma without platelets and clotting factors

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15
Q

Erythrocytes

A

Only contain plasma membrane, cytoskeleton, Hb, glycolytic enzymes that help them survive by anaerobic respiration (90%) and hexose monophosphate shunt (10%)

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16
Q

Reticulocytes

A

Immature cells that are produced in bone marrow and replace mature erythrocytes. Still have nucleus and slightly larger diameter. Expel nucleus and mature 1-2 days after entering circulation

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17
Q

Promyelocyte lineage

A

Produces neutrophils, basophils, mast cells, eosinophils

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18
Q

Monoblast lineage

A

Produces monocytes

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19
Q

Increased reticulocyte count

A

When increased bone marrow production to replenish RBC levels in response to bleeding or hemolysis

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20
Q

RBC destruction

A

Removed by macrophages in spleen and to lesser extent, liver. Globin degraded to amino acids, iron released from heme and reused, tetrapyrrole (part of heme) converted to bilirubin which is mostly excreted in bile.

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21
Q

Neutrophils

A

Myeloid lineage. Act as acute phase granulocytes. Large spherical size, multi-lobed nuclei, azurophilic primary granules (lysosomes). Aka PMNs (polymorphonucleocytes) due to multilobed nucleus. Phagocytose via ROS.

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22
Q

Eosinophils

A

COntain azurophilic granules with myeloperoxidase. Larger than neutrophils and have cationic proteins e.g. major basic protein (antibacterial) and eosinophilic cationic protein (antiparasitic) with acidophilic granules. Once mature, possess large bilobed nucleus and sparse ER and Golgi vesicles.

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23
Q

Basophils

A

Produce peroxidase, heparin, histamine. Also release kallikrein (eosinophil chemoattractant during hypersensitivity rxns). Considered “blood-borne counterpart” of mast cell (which resides in tissues)

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24
Q

Mast cells

A

Similar to basophils but are larger and contain serotonin

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25
Q

Monocytes

A

Myeloid precursor to mononuclear phagocte (tissue macrophage). Large motile cell that marginates along vessel wall in response to expression of specific cell adhesion proteins. During inflamm response, cell adhesion proteins (esp PECAM-1) facilitate monocyte diapedesis across vessel walls into surrounding tissues. Once close to inflamm foci, differentiates into macrophage with increased phagocytic and lysosomal activity.

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26
Q

Macrophages

A

Contain large number cell surface receptors which differ based on tissue which monocyte matured in.

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27
Q

Multinucleated giant cells

A

Sites of chronic inflamm–macrophages sometimes fuse into these, Can be produced in-vitro via IFN-gamma or IL-3 stimulation

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28
Q

Dendritic cells

A

APCs, essential to adaptive immune system. Monocyte-derived phagocytic cells take up antigens, process them, and display them to MHC II cell surface marker, and travel to lymph nodes where they recruit other immune cells. Esp important in initial exposure to new antigen.

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29
Q

Kupffer cells

A

Mononuclear phagocytes-liver

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30
Q

Alveolar macrophages

A

Mononuclear phagocytes-lungs

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31
Q

Histiocytes

A

Mononuclear phagocytes in connective tissue

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32
Q

Red pulp macrophages

A

Mononuclear phagocytes in spleen

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33
Q

Lymphocytes

A

Large nucleus (90% of cell cytoplasm) whose chromatin stains deep blue or purple.

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34
Q

B cells

A

“Long range artillery” in adaptive (humoral) immune response. From lymphocyte lineage. Develop in bone marrow and then migrate to other lymphoid organs. Express IgM and IgD on surface. B-cell antigen receptor complexes allow for recognition of foriegn antigens and subsequent activation of B cell. Downstream cell signaling leads to expression of necessary genes for terminal differentiation to plasma cells that produce and secrete antibodies to aid in specific immune response.

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35
Q

T cells

A

“infantry” of adaptive immune response. Mature in thymus. Early T cells express several surface receptors simultaneously, e.g. the t cell receptor (TCR), CD4, CD8. If one of these receptors recognizes receptors of thymic APCs, either MHC I or II, then the t cell is positively selected, proliferates, and matures.

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36
Q

Helper t cells

A

Derived from CD4+ progenitor. TH1 and TH2 subtypes.
Respond when recognize foreign antigens bound to MHC II. Once activated, secrete cytokines-interleukins-which specifically attract B cells. After immune response some helper t cells become memory cells

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37
Q

TH1

A

Respond during presence of intracellular pathogens. Innate immunity and cytolytic responses.

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38
Q

TH2

A

Respond to helminthic or parasitic infections. Humoral immunity and asthma.

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39
Q

Cytotoxic t cells

A

CD8+. Also proliferate in response to cytokines, but only recognize antigens in association with class I MHC.
Rovign CD8+ cell recognizes signal and attaches to infected cell via cell adhesion molecules.
When activated, release perforin.

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40
Q

Spleen

A

Made up of two types of parenchymal tissue: red and white pulp. Red pulp removes senescent and damaged RBCs. White pulp is where activation of humoral immune system occurs

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41
Q

Acute lymphadenitis

A

Brisk germinal center expansion in response to a local bacterial infection, leading to painfully swollen lymph nodes

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42
Q

Lymph nodes

A

Contain APCs, T cells, B cells. Possess multiple afferent lymphatic channels which enter node through its capsule near cortex. Efferent lymphatics exit at hilum along with artery and vein

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43
Q

Right lymphatic duct

A

Drains R arm, R half head, R thorax

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44
Q

Thoracic duct

A

Drains all regions except R arm, R half head, R thorax

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45
Q

Major LN drainage of head and neck

A

Submental, submandibular, retroauricular, parotid, occipital, superficial, deep cervical

46
Q

Major LN drainage of lateral breast, upper limb

A

Axillary (pectoral, subscapular, humeral, apical, central)

47
Q

Major LN drainage of parasternal breast

A

Supra and infraclavicular

48
Q

Major LN drainage of stomach

A

Celiac

49
Q

Major LN drainage of duod, jej, perineum

A

Superior mesenteric

50
Q

Major LN drainage of sigmoid colon

A

Colic (drains to inferior mesenteric)

51
Q

Major LN drainage of lower rectum, anal canal above pectinate line

A

Internal iliac

52
Q

Major LN drainage of anal canal below pectinate line

A

Superficial inguinal

53
Q

Major LN drainage of testes

A

Para-aortic

54
Q

Major LN drainage of scrotum and thighs

A

Superficial inguinal

55
Q

Major LN drainage of lateral side of dorsum of foot

A

Popliteal

56
Q

Epineurium

A

Most external layer of a nerve. Dense layer of CT that covers the entire nerve, incl its vascular supply

57
Q

Perineurium

A

Deep to epineurium. Permability barrier, regulating nutrient transport from capillaries to nerve fibers underneath. Invests a number of nerve fascicles-bundles of individual nerves surrounded by endoneurium.

58
Q

Lesion to upper trunk of brachial plexus

A

Waiter’s tip (Erb’s pasly)

59
Q

Lesion to lower trunk of brachial plexus

A

Claw hand (Klumpke’s palsy)

60
Q

Lesion to post cord of brachial plexus

A

Wrist drop

61
Q

Lesion to LTN

A

Winged scapula

62
Q

Lesion to musculocutaneous nerve

A

Difficulty flexing elbow, variable sensory loss

63
Q

Damage to median nerve

A

Decreased thumb function, Pope’s blessing

64
Q

Lesion to ulnar nerve

A

Intrinsic muscles of hand, claw hand

65
Q

Epidermis

A

Made predominantly from keratinocytes. Five layers: stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, stratum basalis (“Californians Like Girls in String Bikinis”)

66
Q

Albibism

A

Deficiency in tyrosinase leading to congenital lack of melanin

67
Q

Bullous pemphigoid

A

Autoantibodies against cellular adhesion molecules

68
Q

Langerhans cells

A

Bone-marrow derived dendritic cells in skin.

69
Q

Merkel cells

A

Found in stratum basalis. Contribute to function of mechanoreceptors in epidermis.

70
Q

Ciliated epithelial cells

A

Coordinated ciliary motion –> helps expel resp secretions that have collected pathogens and debris from inspired air

71
Q

Goblet cells

A

Produce mucus and protect airway and lung tissue from inspired particles

72
Q

Basal cells

A

Provide structural support to airway

73
Q

Type II pneumocytes

A

Produce surfactant and have ability to differentiate into Type I pneumocytes

74
Q

Type I alveolar cell

A

Simple squamous epith cell. Forms first layer or blood-air barrier

75
Q

Mucosa layer of SI

A

Absorption. Polarized eptih cells specialized in transport. Plicae circularis, cilli, glands, microvilli.

76
Q

Submocosa layer of SI

A

Vascular and lymph supply. Loose CT. Lymph drainage starts as blind ended channels (lacteals) within core of villi. In duod, also has Brunner glands which secrete alkaline fluid to neutralize acidic chyme. Peyer’s patches/GALT in intestines. Also houses two neural plexuses-plexus of Meissner and myenteric plexus of Auerbach, which are extensively interconnected.

77
Q

Muscularis externa layer of SI

A

Mechanical mixing, dissociation, and propulsion.

78
Q

Serosa layer of SI

A

Protection

79
Q

Hirschsprung disease

A

Congenital absence of plexus, leading to decreased intestinal mobility

80
Q

Angiotensin II

A

Produced in lung, can trigger release of aldosterone and hypertrophy of zona glomerulosa

81
Q

Measurement of systemic catecholamine levels

A

Urine. VMA (vanillylmandelic acid) and metanephrine -both of which are breakdown products of catecholamines.

82
Q

Chromaffin cells

A

Located in adrenal medulla. Synthesizes either epinephrine (80%) or NE but not both. From tyrosine.

83
Q

Adrenal medulla-derivation

A

From neuroectoderm

84
Q

Most common tumors of adrenal gland

A

Adenomas (cortex), neuroblastomas (medullary crest cells) pheochromocytomas (medullary chromaffin cells)

85
Q

Barrett esophagus

A

Columnar

86
Q

Medulloblastoma

A

N&V, nystagmus, truncal ataxia.
Kids.
Pseudorosettes

87
Q

Burkitt lymphoma

A

Starry sky

88
Q

Heinz bodies

A

G6PD deficiency. Aka bite cells

89
Q

Ringed sideroblasts

A

Fe accumulation in mitochondria. Chronic alcoholism, B6 def, Pb poisoning

90
Q

Spherocytes

A

AD. Mutation in ankyrin or spectrin.

91
Q

Auer rods

A

AML. if sudden release, DIC.

92
Q

DIC

A

Helmet shaped cells, schistocytes

93
Q

Target cells

A

Asplenia, liver disease, thalassemia

94
Q

Teardrop cells

A

Myeloid dysplasia, myelofibrosis

95
Q

Drepanocyte

A

Sickled RBC

96
Q

Howell-jolly

A

Asplenia

97
Q

Pappenheimer bodies

A

Siderosomes. Iron bodies. In those with excess Fe.

98
Q

Sideroblastic anemia

A

Fe deposited in ring around nucleus of erythroblast. Microcytic, microchromic.

99
Q

Spherocytes

A

Small RBCs with characteristic lack central pallor.

100
Q

Multiple myeloma

A

Off center nuclei and clock faced chromatin.

Bence jones protein

101
Q

Sister Mary Joseph node

A

Umbilical nodes

102
Q

Blumers shelf node

A

Superior rectum

103
Q

Urethra-lymph

A

Deep inguinal nodes

104
Q

Bladder-lymph

A

External iliac

105
Q

Deep buttock-lymph

A

Gluteal nodes

106
Q

Scrotum-lymph

A

Superficial inguinal

107
Q

Schwannomas

A

Spindle cells palisading

108
Q

Meningiomas

A

Psammoma bodies or calcification

109
Q

Neurofibromas

A

Loosely arranged spindle cells with intervening collagen

110
Q

Oligodendriomas

A

Homogenous sheets of cells with uniformly rounded nuclei

USMLE Step 1 (15 decks)

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