Block II - Path II Flashcards
What are risk factors for RCC?
Smoking, cadmium, plastic factory
What are risk factors for TCC?
Smoking, beta-naphthylamine
What is a risk factor for a young, Middle-Eastern male for squamous cell carcinoma of the bladder?
Schistosoma hematobium
What type of growth is TCC?
Papillary, cauliflower like.
What is clear cell carcinoma of the kidney associated with, and what subset is it?
VHL, oncogene; induce HIF, Chromosome 3. Subset of RCC
What is a risk factor for HCC?
Aflatoxin; found in peanuts, inhibits TP53 (also Hepatitis B, and Hepatitis C)
What is the gene associated with cavernous hemangioma?
VHL gene; HIF, Chr 3.
What is a risk factor for cholangiocarcinoma; and what is it associated with?
Opisthorcoris, ulcerative colitis and primary sclerosing cholangitis
What is the marker for HCC?
Alpha-fetoprotein
Mode of transmission of Hep C?
Primarily blood; through IV Drug Use, and post-transfusion
Mode of transmission for Hep B?
Parenteral (blood), sexual (baby-making), perinatal (birthing)
Acute Hep B markers:
HBsAg, HBeAg, Anti-HBc of IgM
Window Hep B markers:
Anti-HBe, Anti-HBc of IgM
Chronic HBV (high infectivity):
HBsAg, HBeAg, Anti-HBc of IgG
Chronic HBV (low infectivity):
HBsAg, Anti-HBe, Anti-HBc of IgG
Recovery Hep B markers:
Anti-HBs, Anti-HBe, Anti-HBc of IgG
Immunized Hep B marker:
Anti-HBs
What is fibrinous pericarditis composed of?
Exudate; fibrinogen, PMN’s, IL-6.
Name 3 things that affect the tubules:
ATN (mainly PCT), Rhabdomyolysis, and Snake Venom
Name 2 things that affect the glomerulus:
PSGN and HUS (via MAHA, forms thrombus in glomerulus)
What does Renal Papillary Necrosis affect?
The collecting duct
If you have Renal Artery Stenosis without complete occlusion, what type of azotemia is it?
Pre-Renal
Non-neoplastic causes of hypercalcemia:
Sarcoidosis (due to increased D3), Padget, and Primary Parathyroidism
Neoplastic causes of hypercalcemia:
Renal Cell Carcinoma, Breast Carcinoma, and Squamous Cell Carcinoma
What does parathyroid hyperplasia occur in ADPKD?
Chronic Renal Failure causing a decreased Vit D3, and secondary parathyroidism
What signifies hydronephrosis?
Dilation of calyx system
Obstructive bilateral causes: Male (Adult)
BPH
Obstructive bilateral causes: Female (Adult)
Invasive cervical carcinoma
Obstructive bilateral causes: Child
Obstruction; or posterior urethral valves
What is affected in the kidney if the patient just has Diabetes?
The vessels due to hyaline arteriosclerosis; essential HTN, benign nephrosis and DM cause hyaline.
Where do drug analgesics affect the kidney?
Tubules and Interstitium
Where does tophi affect the kidney?
Mainly interstitium
Where does Amyloid affect the kidney?
Vessels
Where does pyelonephritis affect the kidney?
Pelvis, Tubules, Interstitium
What are two other causes of Renal Papillary Necrosis?
Sickle Cell Disease and Analgesic Abuse
What causes septic shock in acute pyelonephritis?
Peripheral vasodilation
Fever, Rash, Eosinophilia, and Renal Abnormality:
Drug-Induced Nephritis
Fever, Rash, PMN, and Renal Abnormality
Post-Streptococcal Glomerulonephritis
Cause of TTP:
ADAMST13 (metalloprotease that cleaves vWF for adhesion) deficiency; microthrombi with low platelets and increased bleeding time (hemolytic anemia, thrombocytopenia, ARF)
What type of necrosis is Diffuse Cortical Necrosis and what is it seen in?
Coagulative; abruptio placentae, DIC.
What could reticulocytosis be due to?
Juvenile RBCs; could be due to hemolysis or Vit B12 therapy
Iron Deficiency Anemia labs:
Decreased ferritin, increased TIBC
Anemia of Chronic Disease labs:
Increased ferritin, decreased TIBC
Features of B-thalassemia major:
“Crew-cut” appearance on X-ray; none/very low HbA, elevated HbF
What can myeloid metaplasia result in?
Hemolysis
What can paranoctornal hemoglobinuria lead to?
Gpi-linked complement deficiency (DAF= CD55/59); chronic hemolysis without dramatic hemoglobinuria; intravascular hemolysis; can cause venous thrombosis in hepatic, portal, or cerebral veins
What is MAHA caused by?
TTP, HUS, DIC, and hemolysis in a major blood vessel (such as aorta)
Where are Howell-Jolly bodies present? And what is this patient at risk for?
Autospleenectomy in sickle-cell; and recurrent infections by Strep Pneumo, Haemophilius, and Neisseria meningitidis
What is aplastic criss caused by and where would you see it?
Parvovirus B19; Sickle-Sell and B-thalassemia
Asplastic anemia presents how?
Hypoplastic bone marrow; no splenomegaly or reticulocytes; so fatty marrow
Feature of lead poisoning:
Basophilic stippling
Where is pancytopenia seen?
Pure red cell aplasia, hyperspleenism, and aplastic anemia
