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Pathology > Block2 > Flashcards

Block2 Flashcards

1
Q

Irreversible/uncontrolled death of cells

A

Necrosis

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2
Q

Which cell death may produce exudate (high protein with neutrophils)

A

Necrosis

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3
Q

Programmed cell death

A

Apoptosis

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4
Q

Which cell death process occurs in ganglion cells during development

A

Apoptosis

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5
Q

Cell death process critical in fine-tuning the developing retina

A

Apoptosis

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6
Q

4 types of necrosis

A

Coagulative
Liquefactive
Caseous
Fat

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7
Q

Which cell death process has inflammation

A

Necrosis

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8
Q

Structural boundary of cell is maintained, but internal proteins are denatured

A

Coagulative necrosis

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9
Q

Which type of necrosis is due to ischemia/infarction

A

Coagulative necrosis

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10
Q

Ischemia of CNS causes which type of necrosis

A

Liquefactive

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11
Q

Type of necrosis that leaves pus and fluid –> forming an abscess

A

Liquefactive

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12
Q

Necrosis type that usually has an infectious etiology

A

Liquefactive

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13
Q

Cheesy proteinaceous dead cell mass

A

Caseous necrosis

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14
Q

Most often type of necrosis observed in Tb infections

A

Caseous

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15
Q

Death in adipose tissue - small white lesion

A

Fat necrosis

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16
Q

Cell death type usually in subcutaneous tissue because of trauma

A

Fat necrosis

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17
Q

Necrosis type due to ischemia of organs in the body (NOT CNS)

A

Coagulative

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18
Q

Enzyme that initiates the arachidonic acid path

A

Phospholipase A2 (PLA2)

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19
Q

What will steroids do to the arachidonic acid path

A

They will stop the arachidonic path

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20
Q

Which enzyme to steroids inhibit

A

PLA2

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21
Q

2 pathways in arachidonic path

A

LOX and COX

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22
Q

Aspirin (NSAIDs) block which arm of the arachidonic path

A

COX

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23
Q

The 2 arms of the COX path are

A

PGI2 and TXA2

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24
Q

What does aspirin neutralize in the COX path

A

Platelets –> cannot regenerate

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25
Q

Which arm of the COX path inhibits platelet aggregation

A

PGI2

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26
Q

Which arm of the COX path promotes platelet aggregation

A

TXA2

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27
Q

Major driver in pain and fever

A

PGE2

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28
Q

PGE2 comes from which pathway in the arachidonic acid path

A

COX

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29
Q

Which arachidonic acid path plays huge role in lungs and asthma

A

LOX

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30
Q

Leukotrienes are involved in which path of the arachidonic acid path

A

LOX

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31
Q

2 inflammatory cytokines leading to fever

A

IL1 and TNFalpha

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32
Q

Primary cytokine that acts on liver to produce APR

A

IL6

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33
Q

What are 3 acute phase reactants (APRs)

A

Ferritin, fibrinogen, CRP

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34
Q

Granulomas are seen in which kind of inflammation

A

Chronic

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35
Q

Epithelium macrophages surrounded by lymphocytes

A

Granuloma

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36
Q

Chronic inflammation: Play a key role in IgE-mediated reactions

A

Basophils/mast cells

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37
Q

Chronic inflammation: can release histamine

A

Basophils/mast cells

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38
Q

Chronic inflammation: contain major basic proteins, which is toxic to parasites

A

Eosinophils

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39
Q

Cardinal signs of acute inflammation

A

Rubor/calor
Tumor
Dolor
Functio laesa

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40
Q

Latin for red

A

Rubor

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41
Q

Latin for heat

A

Calor

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42
Q

Latin for swelling

A

Tumor

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43
Q

Latin for pain

A

Dolor

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44
Q

Latin for loss of function

A

Functio laesa

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45
Q

Which of the cardinal signs of inflammation is not due to histamine

A

Dolor

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46
Q

What is dolor due to

A

PGE2 (prostaglandins)

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47
Q

Primary leukocytes in acute infection

A

Neutrophils

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48
Q

4 steps in neutrophil adhesion and margin action

A

1- IL1 and TNF increase expression of selectin molecules
2- neutrophils weakly bind to endothelial selecting and roll along surface
3- neutrophils stimulated to express ligands for cellular adhesion molecules
4- neutrophils adhere firmly to ICAMS and VCAMS
**then they emigrate, migrate, ,phagocytize, degranulate and kill what has been eaten

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49
Q

Function of IL8

A

Cleanup

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50
Q

Which molecules slow neutrophil movement

A

Selectin

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51
Q

Which molecules stop neutrophils movement

A

CAMs

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52
Q

Neutrophils often form what kind of fluid and why

A

Exudate bc of lots of cells and proteins

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53
Q

What molecules produce histamine

A

Basophils, platelets and mast cells

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54
Q

What molecules produce serotonin

A

Platelets

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55
Q

What two amines cause vasodilation and increased vascular permeability

A

Serotonin and histamine

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56
Q

What is the major effect of bradykinin

A

Pain

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57
Q

What makes aspirins affect on the COX system different than other NSAIDs

A

Aspirin neutralizes TXA2 which irreversibly prevents sticky platelets

Most NSAIDs target TXA2 as well, but are reversible

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58
Q

Cytokine in liver that helps monitor inflammation

A

IL6

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59
Q

Cytokine - PMN chemotaxis

A

IL8

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60
Q

Thelper cells are classified as ____ and TH2 cells drive a ____-mediated response

A

CD4….antibody

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61
Q

Identify the most likely type of necrosis to occur in the brain after a stroke

A

Liquefactive necrosis

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62
Q

TXA2 and PGI2 are products of which path

A

Arachidonic acid - COX path

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63
Q

Mnemonic for 4 types of hypersensitivities

A

ACID

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64
Q

Type 1 HS

A

Anaphylactic/atopic

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65
Q

Type 2 HS

A

Cytotoxic

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66
Q

Type 3 HS

A

Immune complex

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67
Q

Type 4 HS

A

Delayed (cell mediated)

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68
Q

Which HS type is IgE drive

A

Type 1

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69
Q

Type 1 HS late phase response

A

Arachidonic acid pathway

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70
Q

Potency of leukotrienes relative to histamine

A

Leukotrienes 1000x more potent

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71
Q

Cytokine driving IgM to IgE

A

IL4

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72
Q

Cytokine involved in massive IgE production

A

IL13

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73
Q

Initial phase of type 1 HS is drive by

A

Histamine

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74
Q

Late phase of type 1 HS is driven by

A

Prostaglandins and leukotrienes

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75
Q

Cytokine activating eosinophils (IgM to IgA)

A

IL5

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76
Q

IgE in parasites

A

IfE binds to worm and Fc portion is free

- Eosinophils collide with parasite, crosslink, and release MBP

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77
Q

IgE in mast cells (allergic reactions)

A

predocked onto mast cell waiting for allergen/antigen to come bind

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78
Q

Antibodies driving Type 2 HS

A

IgG and IgM

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79
Q

HS type dealing with transfusion reactions and hyperacute transplant rejection

A

Type 2 HS

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80
Q

If tissue is rejected within minutes –> preformed Abs

A

Type 2 HS

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81
Q

Classic and corneal rejection are what type of HS

A

Type 4 HS

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82
Q

Antihuman IgG is known as

A

Coombs serum

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83
Q

Detects Ab bound to RBCs

A

direct antiglobulin test (DAT)

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84
Q

Detects plasma Abs

A

Indirect antiglobulin test (IAT)

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85
Q

If you want to find out what is destroying the RBCs, which test do you do

A

DAT

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86
Q

Abs driving type 3 HS

A

IgG and IgM

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87
Q

Ab is directly bound to cells in which HS type

A

Type 2

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88
Q

Ab is not bound to cell, but instead bind to immune complexes in which HS

A

Type 3

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89
Q

Local example of type 3 HS

A

Arthus

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90
Q

Systemic example of type 3 HS

A

Serum sickness

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91
Q

Most common cause of serum sickness

A

Oral drugs

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92
Q

Only cell driven HS

A

Type 4

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93
Q

Key cells in Type 4 HS

A

T-helper cells and macrophages

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94
Q

Phlyctenular keratoconjunctivitis (PKC) is an example of what type of HS

A

Type 4 HS

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95
Q

Blister-forming keratoconjunctiviti that occurs due to a type 4 HS reaction to antigens of bacterial origin

A

PKC

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96
Q

Clinician is worried that an Rh-neg mom is going to have an Rh-pos baby. What is she worried about?

A

Type 2 HS

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97
Q

A patient is given a TB skin test. Which HS is being tested and which cells are expected to mediate a positive test result

A

Type 4….Th1 cells

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98
Q

Contact dermatitis, TB skin test, corneal transplant rejection are what type of HS

A

Type 4 HS

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99
Q

Arthus reaction and serum sickness are what HS type

A

Type 3 HS

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100
Q

Asthma and anaphylaxis are examples of which HS types

A

Type 1 HS

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101
Q

3 common triggers for type 1 HS

A

Food, drugs and stinging insects

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102
Q

Flat lesion <1cm

A

Macule

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103
Q

Example of macule

A

Freckle

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104
Q

Elevated solid skin lesion < 1cm

A

Papule

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105
Q

Example of papule

A

Mole, acne

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106
Q

Small fluid-filled blister <1cm

A

Vesicle

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107
Q

Example of vesicle

A

Shingles

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108
Q

Vesicle containing pus

A

Pustule

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109
Q

Example of pustule

A

Pustular psoriasis

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110
Q

Transient smooth papule or plaque

A

Wheal

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111
Q

Example of wheal

A

Hives

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112
Q

Flaking off of stratum corneum

A

Scale

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113
Q

Example of scale

A

Eczema

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114
Q

Dry exudate

A

Crust

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115
Q

Example of crust

A

Impetigo

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116
Q

Classic triad for lupus

A

Fever
Joint pain
Malar rash

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117
Q

Lupus is which type of HS

A

Type 3 HS

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118
Q

Is lupus more common in men or women

A

Women, but more severe in men

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119
Q

Common cause of death in lupus

A

Cardiovascular disease, renal failure, infection

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120
Q

Most common type of lupus

A

Systemic lupus erythematosis

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121
Q

Lab tests for lupus

A

ANA
Anti-dsDNA
Anti-sm

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122
Q

Is ANA specific or sensitivity for lupus

A

Sensitive

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123
Q

Are anti-dsDNA and anti-sm specific or sensitive for lupus

A

Specific

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124
Q

Which antibodies indicate a poor prognosis of lupus

A

Anti-dsDNA

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125
Q

Ocular issues will be seen in how many lupus patients

A

20%

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126
Q

Drugs associated with drug-induced lupus

A

Quinidine
Isoniazid
Hydralazine
Procainamide

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127
Q

Will drug induced lupus be confirmed by anti-dsDNA or anti-sm

A

Neither, only from transient ANA

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128
Q

How do you treat GCA

A

Steroids

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129
Q

If GCA is not treated quick enough, what could happen

A

Blindness

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130
Q

Affects large and medium arteries (ophthalmic and aorta often involved )

A

GCA

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131
Q

Lesions of small and medium arteries

A

Polyarteritis nodosum

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132
Q

Which type of lupus affects only the skin

A

Discoid lupus

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133
Q

Excessive fibrosis

A

Scleroderma

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134
Q

Leading cause of death in scleroderma pts

A

Pulmonary involvement

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135
Q

How often is ANA positive in scleroderma pts

A

95%

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136
Q

Widespread, rapid, going internal type of scleroderma

A

Diffuse

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137
Q

Limited to skin, fingers and face, benign and characterized by CREST

A

Limited scleroderma

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138
Q

C in CREST

A

Calcinosis

- calcium deposits in soft tissue

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139
Q

R in CREST

A

Raynaud phenomenon

- vasospasm in digits (white->blue->red)

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140
Q

E in CREST

A

Esophageal dysmotility

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141
Q

S in CREST

A

Sclerodactyly (claw fingers)

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142
Q

T in CREST

A

Telangiectasia

- small, dilated vessels near skin

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143
Q

CREST syndrome deals with

A

Limited scleroderma

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144
Q

Lab test for diffuse scleroderma

A

Anti-scl70 Ab

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145
Q

Lab test for limited scleroderma

A

Anti-centromere Ab

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146
Q

Destruction of exocrine glands

- attacks moisture producing glands

A

Sjogren syndrome

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147
Q

Classic triad seen in Sjogren syndrome

A

Dry mouth, dry eyes and arthritis

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148
Q

Positive lab tests in Sjogren syndrome

A

ANA and RF

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149
Q

Most common cause of arthritis

A

Osteoarthritis (OA)

- friction/overuse disease

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150
Q

Which is more systemic, osteoarthritis or rheumatoid arthritis

A

RA

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151
Q

Which will have higher ESR/CRP, RA or OA

A

RA

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152
Q

Type of HS - RA

A

Type 3

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153
Q

Inflammation of synovial membranes/joints of hands, feet, wrists

A

RA

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154
Q

RF is an autoantibody to what antibody

A

IgM/IgG

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155
Q

Used to diagnose RA

A

RF

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156
Q

How many RA pts will have ocular manifestations

A

25%

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157
Q

Keratoconjunctivitis sicca i seen in how many RA pts

A

15-25%

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158
Q

15% of all cases of scleritis are caused by

A

RA

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159
Q

Which is painful: scleritis or conjunctivitis

A

Scleritis

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160
Q

Most common form of arthritis in kids

A

JIA

Juvenile idiopathic arthritis

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161
Q

is ANA positive or negative in JIA

A

Positive

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162
Q

Is RF positive or negative in JIA

A

Negative in 50% of fcases

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163
Q

Most common cause of uveitis in children (80%)

A

JIA

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164
Q

Arthritis without having RF (RF negative)

A

Seronegative spondyloarthropathies

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165
Q

HLA-B27 is strongly associated with

A

Seronegative spondyloarthropathies

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166
Q

Examples of seronegative spondyloarthropathies (pair)

A

psoriatic arthritis
Ankylosis spondylitis
Inflammatory bowel disease
Reactive arthritis

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167
Q

Which of the spondyloarthropathies can cause a patient to develop uveitis

A

Psoriatic arthritis
Ankylosis spondylitis
Reactive arthritis

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168
Q

Bamboo spine is seen in

A

Ankylosis spondylitis

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169
Q

Classic triad of reactive arthritis

A

Conjunctivitis/uveitis, urethritis, arthritis

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170
Q

Often associated with sarcoidosis

A

Uveitis and hyeprcalcemia

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171
Q

Granulomatous skin lesions are seen in what disease

A

Sarcoidosis

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172
Q

X-ray shows bilateral adenopathy and coarse reticular opacities

A

Sarcoidosis

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173
Q

Aspirin selectively inhibits which arm of the COX path (more than it inhibts the other)

A

TXA2

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174
Q

If JIA patients are positive for RF, what does that mean

A

They will have a worse outcome

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175
Q

Buildup of atherosclerotic plaque in lumen of common carotid

A

Carotid stenosis

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176
Q

Where is the plaque buildup usually located in carotid stenosis

A

Near bifurcation of carotid or in internal carotids just distal to bifurcation

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177
Q

What does carotid stenosis do to blood flow

A

Decreases it

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178
Q

What can carotid stenosis lead to

A

Thrombosis at stenotic site or formation of emboli

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179
Q

In carotid stenosis, which arteries are most typically occluded

A

MCA
ACA
Ophthalmic A(monocular blindness)

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180
Q

What is carotid stenosis often accompanied by

A

Bruit

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181
Q

Severity of carotid stenosis is defined by

A

Degree of narrowing of lumen

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182
Q

Surgery to remove the artheroscleritic build up

A

Carotid endarterectomy

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183
Q

Is carotid endarterectomy usually done on asymptomatic pts? Why or why not?

A

No because of high risk

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184
Q

What are 2 alternatives to surgery for carotid stenosis

A

Angioplasty and stenting

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185
Q

Carotid stenosis pts may gradually develop complete filling occlusion of a long segment of internal carotid

This is called

A

Carotid occlusion

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186
Q

Trauma-induced tear in the intimate lining of vessel

A

Carotid/vertebral dissection

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187
Q

Pt’s may claim to hear a popping sound in what carotid occlusion typ

A

Carotid/vertebral dissection

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188
Q

Flap of tissue concluding the vessel

A

Carotid/vertebral dissection

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189
Q

Presentation in carotid/vertebral dissection

A

Pain in distribution areas (orbital with carotid a, neck/occipital pain with vertebral a)
Signs of transient ischemic attacks
Horner’s syndrome ipsilaterally

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190
Q

Large artery vasculitis is known as

A

Temporal arteritis (GCA)

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191
Q

Vasculitis is typically in which 3 arteries

A

Superficial temporal
Vertebral
Ophthalmic

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192
Q

What nerve is vulnerable to temporal arteritis

A

Optic nerve

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193
Q

Signs of temporal arteritis indicate an emergency to prevent what

A

Blindness

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194
Q

How to treat GCA

A

Glucocorticoids (anti-inflammatory)

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195
Q

presentation of GCA

A

Visible loss of blood perfusion to affected side of face
Fever and aches/pains
Jaw claudification (pain when chewing)

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196
Q

What demographics does GCA usually affect

A

White women over 70

197
Q

Most common origin for orbital disorder in adults

A

Graves’ disease

198
Q

Hyperthyroid syndrome

A

Graves’ disease

199
Q

Explain the mechanism of grave’s disease

A

Ab have a stimulatory effect on TSH receptors, activating T3/T4

200
Q

Presentation of grave’s disease

A

Often a goiter
Tachycardia
Fatigue, weight loss, anxiety, heat intolerance, sweating, increased appetite

201
Q

Antibodies in Graves’ disease also induce excess production of what

A

Glucosaminoglycans in orbital fat and EOMs

202
Q

Thyroid-associated ophthalmopathy

A 
Periocular swelling
Lid retraction
Eyes bulge (exophthalmos)
Diplopia and disconjugate gaze
Frequent complaints of F or pain during eye movements
203
Q

Oculomotor deficits in Graves’ disease

A

Typically impaired elevation and abduction

204
Q

What type of patients is laryngeal carcinoma more common in

A

Smokers

205
Q

Does the CNS have lymphatics

A

No

206
Q

Does lymphoma typically makes its way into the brain

A

No, not unless primary CNS lymphoma

207
Q

Is laryngeal carcinoma likely to invade CNS

A

No

208
Q

Most common form of this carcinoma originates in parotid gland

A

Salivary gland carcinoma

209
Q

Is salivary gland carcinoma likely to lead to visual system disturbances

A

No

210
Q

If it spreads to cranial sinuses, what kinds of carcinoma are likely to invade intracranially

A

Craniopharyngeal and nasopharyngeal carcinomas

211
Q

Benign form of lymphoma initiated in lymphatics or blood

A

Chronic lymphocytic lymphoma (b cell lymphoma)

212
Q

Is primary CNS lymphoma common

A

No, rare and develops from glial cells

213
Q

In what type of patients are cutaneous viral infections of greatest concern

A

Immunosuppressed patients

214
Q

Umbilicated papule typically appearing in clusters are usually dealing with what

A

Molluscum contagiosum

215
Q

What time of infection is molluscum contagiosum

A

Viral

216
Q

What is a sign of healing in Molluscum contagiosum

A

Erythema (redness) around lesions

217
Q

Can Molluscum contagiosum be transferred

A

Yes, sexual partners are at risk

218
Q

Can Molluscum contagiosum clear on its own

A

Yes, typically it clears in 6 months unless in an immunosuppressed patient

219
Q

What may Molluscum contagiosum look like in immunosuppressed patients

A

Diffuse lesion, unilateral conjunctivitis

220
Q

There are more than 150 types of this virus

A

HPV

221
Q

Virus including warts

A

HPV

222
Q

Is HPV considered pre-malignant

A

Yes, in the cervix

223
Q

Most common warts infection often seen in school aged kids and resolve spontaneously

A

Verruca vulgaris

224
Q

In what layers of the skin is verruca vulgaris

A

Confined to epidermis

225
Q

What is pahtognomonic for warts

A

Black dots, helps distinguish it from a callus

226
Q

3 main predisposing factors of Verruca vulgaris

A

Impaired immunity
Pregnancy
Occupation (handling raw meat)

227
Q

Which HPV types cause conjunctival papilloma

A

6 and 11

228
Q

Where is Conjunctival papilloma usually at and what does it look like

A

Usually in fornix or palpebral conj and it is pedunculated (not flat)

229
Q

Grouped vesicles with erythematous base

A

Herpes simplex virus (HSV)

230
Q

What percent of genital cases of HSV are absent of symptoms

A

70%

231
Q

Can HSV be transmitted, even if the pt is asymptomatic

A

Yes

232
Q

HSV1 is located in which parts of the body

A

Above neck

233
Q

HSV2 is located in which parts of the body

A

Below waist

234
Q

Is HSV always present if the pt is infected, or does it remain latent

A

Remains latent in root ganglia after primary infection

235
Q

Where does recurrence of HSV symptoms typically occur

A

An region innervated by the infected nerve

236
Q

Can you get rid of HSV

A

No, it is for life and recurrence can happen at any time

237
Q

What are some of the triggers of recurrence of HSV

A 
Irritation
Menstruation
Medication
Other infections
Immunosuppressive
238
Q

What is the lesion type in HSV

A

Erythemetous papules that rupture easily, forming erosions

239
Q

Most common sites of primary HSV infection

A

Mouth, anogenitalia, digits

240
Q

HSV1 shedding is detected in 40% of what patients

A

Herpetic facial paralysis (bell palsy)

241
Q

Ocular infections due to HSV

A

Recurrent dendritic keratitis
Disciform enotheliitis
Uveitis
Blepharoconjunctivitis

242
Q

Major cause of corneal scarring and vision loss? Which HSV can usually call this?

A

Recurrent dendritic keratitis

HSV1 unless neonate (HSV2 if get it from mom during birth)

243
Q

How is Varicella zoster virus transmitted

A

Airborne droplets and directly

244
Q

Infects mucosa of upper respiratory tract, replicates in mononuclear phagocyte system then it spreads to skin/mucous, then to sensory nerves

A

Varicella zoster virus

245
Q

What type of lesions after Varicella zoster virus reactivates

A

Pain and vesicular lesions

246
Q

Why are HSV and VZV infections similar

A

Remain latent in nerve until reactivated by stress or immunosuppression

247
Q

What dermatomes are VZV most commonly seen

A

Trigeminal, cervical, thoracic, lumbar, or sacral

248
Q

Primary VZV is seen as

A

Chickenpox, very diffuse

249
Q

After VZV remains latent for a while and reappears as herpes zoster, how does it look on the body

A

Stays dermatomal

250
Q

Ocular involvement in VZV

A

Hutchinson’s sign
Belpharoconjuncitivits
Episcleritis
Facial palsy

251
Q

What is hutchinsons sign

A

Rash at tip of nose indicating VZV

252
Q

3 acute inflammatory dermatoses

A

Urticaria
Eczema
Erythema multiforme

253
Q

3 chronic inflammatory dermatoses

A

Psoriasis
Seborrheic dermatitis
Lichen planus

254
Q

Presentation is wheals (hives) typically on trench, distal extremities and ears

A

Urticaria

255
Q

What antibody can urticaria depend on

A

IgE

256
Q

Is Urticaria always IgE dependent

A

No

257
Q

Seen as red, oozing, crusted lesions that develop into scaling plaques

A

Eczema

258
Q

Most common type of eczema marked by itching, burning or both

A

Contact dermatitis

259
Q

Most famous example of allergic contact dermatitis

A

Poison ivy

260
Q

Antigen responsible for allergic contact dermatitis (eczema)

A

Urushiol

261
Q

Skin reactions caused by psoralen in plants and exposure to UV-A sunlight

A

Phytodermatitis

262
Q

Is the skin more likely to rupture in urticaria or eczema

A

Eczema

263
Q

Known for honey-colored lesions

A

Impetigo

264
Q

Bacteria responsible for Impetigo

A

Staph. Aureus

Group a beta-hemolytic streptococci

265
Q

2 forms of Impetigo are based on

A

Size of lesions

266
Q

Lesions in Impetigo contagiosa

A

Crusty pustules

267
Q

Types of lesions in Impetigo bullosa

A

Bulla

268
Q

Most common sites of Impetigo

A

Face/nose

269
Q

Deeper infection of Impetigo, resulting in erosion to dermis

A

Ecthyma

270
Q

Staphylococcal infection of hair follicle

A

Folliculitis

271
Q

Areas of body that Folliculitis is most commonly found

A

Axilla, face and legs

272
Q

Occurs in setting of staphylococcal Folliculitis

A

Furuncule

273
Q

Firm nodule that develops an abscess, sometime with a central pustule

A

Furuncule

274
Q

Composed of multiple, coalescing furuncules

A

Carbuncle

275
Q

Contains subcutaneous abscesses, superficial pustules and draining pus

A

Carbuncle

276
Q

Beta-hemolytic strep colonize skin and sprea along superficial lymph vessels

A

Erysipelas

277
Q

Where is Erysipelas typically seen

A

Face and booty

278
Q

Usually seen with a erythematous expanding plaque

A

Erysipelas

279
Q

Associated with people with arthritis, myopathy, enteropathy and AIDS

A

Psoriasis

280
Q

Areas that Psoriasis usually affects

A

Elbows, knees, scalp, lumbosacral, intergluteal cleft, glans penis

281
Q

Lesions are well demarcated, salmon colored, covered with silver-white loose scales

A

Psoriasis

282
Q

30% of cases have nail involvement with pitting and discoloration

A

Psoriasis

283
Q

Chronic inflammatory that has acanthosis

A

Psoriasis

284
Q

What is acanthosis

A

Epidermal thickening

285
Q

What is Psoriasis mediated by

A

T cells

- strong association with HLA-C

286
Q

More common chronic inflammatory infection than Psoriasis

A

Seborrheic dermatitis

287
Q

Involved regions wth high densities of sebaceous glands

A

Seborrheic dermatitis

288
Q

Most common clinical expression of Seborrheic dermatitis

A

Dandruff

289
Q

In infants, the most common sign of Seborrheic dermatitis is

A

Cradle cap

290
Q

Early Seborrheic dermatitis is similar to

A

Eczema

291
Q

Late Seborrheic dermatitis is similar to

A

Psoriasis

292
Q

Pruritic, purple, polygonal papules with wickham striae

A

Lichen planus

293
Q

Resolve spontaneously after 1-2 years

A

Lichen planus

294
Q

Blistering disease in kids is usually

A

Impetigo

295
Q

Blistering disease in adults is usually

A

Pemphigus

296
Q

Most common variant of pemphigus

A

Pemphigus vulgaris

297
Q

80% of pemphigus cases are

A

Pemphigus vulgaris

298
Q

Pemphigus variant involving mucosa and skin in face, axial, and pressure points

A

Pemphigus vulgaris

299
Q

Lesions are superficial vesicles and bullpen that rupture easily –> dried serum, crust

A

Pemphigus vulgaris

300
Q

Pemphigus vulgaris deals with antibodies to

A

IgG

301
Q

Immunofluorescence shows IgG deposited in what kinds of pattern in Pemphigus vulgaris

A

Fishnet pattern

302
Q

Lesions are Bullae filled with clear fluid that do not rupture easily

A

Bulbous pemphigoid

303
Q

Has a subepidermal, nonacantholytic blister (no epidermal thickening)

A

Bulbous pemphigoid

304
Q

Antigens are proteins in hemidesmosomes that attach basal cells to basement membrane

A

Bulbous pemphigoid

305
Q

Immunofluorescence shows what pattern of deposits in Bulbous pemphigoid

A

Linear

306
Q

Are blackhead caused by dirt

A

No

307
Q

Do certain foods worsen acne

A

No

308
Q

Will scrubbing the face daily help clear up acne

A

No

309
Q

Will acne disappear after 20s

A

No

310
Q

Does stress exacerbate acne

A

No

311
Q

Adolescent acne

A

Acne vulgaris

312
Q

Andorgenic hormones cause abnormal keratinization of follicles
- hereditary

A

Acne vulgaris

313
Q

Disorder of sebaceous follicles

A

Acne vulgaris

314
Q

Bacteria involved in acne

A

Propionibacterium acnes

315
Q

4 stages of acne

A

Black heads (open comedones)
White heads (closed comedones)
Papules
Pustules

316
Q

Acne classification: usually just comedones

A

Mild acne

317
Q

Acne classification: more inflammatory and may heal with scars

A

Moderate acne

318
Q

Acne classification: larger, deeper and more numerous papules or pustules; occurs on trunk

A

Cystic

319
Q

Type of acne: leaving pitted scars on face or hypertrophic scars on back; tx is difficult if it the trunk is involved

A

Sequelae

320
Q

What makes Rosacea and acne different

A

Rosacea doesn’t have comedones

321
Q

Lesions appear on flush areas (nose, cheeks, forehead, chin)

A

Rosacea

322
Q

Ocular involvement of this is blepharoconjunctivits

A

Rosacea

323
Q

Precipitating factors of Rosacea

A

Sun, excessive face washing, irritating cosmetics

324
Q

Seen in middle-aged men with Rosacea

A

Rhinophyma

325
Q

What is rhinophyma and where on the body is it seen

A

Disfiguring sebaceous hyperplasia

Makes the nose look big and bubbly

326
Q

Roses-cheeked completion in Rosacea patients

A

Prereosacea

327
Q

Facial erythema and tenagiectasias

A

Prerosacea

328
Q

Do patients with prerosacea ever develop inflammatory lesions typical of Rosacea

A

No

329
Q

Loss of melanocytes/pigment

A

Vitiligo

330
Q

Loss of pigmentation in Vitiligo can be caused by

A

Infection
Dermatitis
Chemical irritation
Idiopathic

331
Q

Enhanced pigment transfer from melanocytes

A

Melasma

332
Q

Melasma is associated with

A

Pregnancy and oral contraceptives

333
Q

When will Melasma resolve

A

Spontaneously after hormone administration is discontinue

Sun can accentuate it

334
Q

Localized hyperplasia of melanocytes; oval tan-brown macule or patches

A

Lentigines (lentigo)

335
Q

Birthmarks are known as

A

Lentigines (lentigo)

336
Q

Does Lentigines (lentigo) darken in the sun

A

No

337
Q

Cafe Au lait spots

A

Lentigines (lentigo)

338
Q

Too many cafe au lait spots may signal

A

Neurofibromatosis type 1

339
Q

Develop with age and sun exposure (liver spots)

A

Solar (actinic) lentigines

340
Q

Where are scabies mites seen

A

predominantly between fingers and on the wrists

341
Q

Where are scabies rashes commonly seen

A

Axilla, trunk, genitalia, knees

342
Q

Pathognomoic lesion of scabies

A

The burrow

343
Q

Moles are known as

A

Nevocellular nevi (nevus)

344
Q

Any neoplasm of melanocytes; brown, uniformly pigmented papules with well-defined borders

A

Nevocellular Nevi

345
Q

Type of nevi: flat, can grow to form the other kind

A

Junctional nevi

346
Q

Type of nevi: contain cords of nevus cells in dermis, raised, dome-shaped

A

Compound nevi

347
Q

Larger than most acquired nevi and are abnormally shaped

- familiarly precursors of malignant melanoma

A

Dysplastic nevi

348
Q

Spotty and dark in the middle, surrounded by lighter area; no distinct borders

A

Dysplastic nevi

349
Q

Thickened hyperigmented skin; velvet like texture, affecting flexural areas

A

Acanthosis nigricans

350
Q

Most of the time, Acanthosis nigricans is: benign or malignant

A

Benign (80%)

351
Q

Clinical marker for obesity and insulin resistance

A

Acanthosis nigricans - benign

352
Q

Crater like morphology with center containing keratin mass

A

Keratoacanthoma

353
Q

Does Keratoacanthoma have a malignant risk

A

No

354
Q

Sharply demarcated plaques, in pts after 30-40 yoa

A

Seborrheic keratosis

355
Q

If singular or very few, does Seborrheic keratosis have a malignant risk

A

No

356
Q

If there are hundreds of plaques in Seborrheic keratosis, is there a malignant risk

A

Yes

357
Q

Occur on exposed skin of fair-skinned elders; from chronic overexposure to UV light (face and behind ears)

A

Actinic keratosis

358
Q

Ill-defined erythematous macule or papules with scaly surface

A

Actinic keratosis

359
Q

If left untreated, Actinic keratosis can lead to

A

Squamous cell carcinoma

360
Q

Is Actinic keratosis benign, pre-malignant or malignant

A

Pre-malignant

361
Q

Red, scaling plaques; common in men over 60yo

A

Squamous cell carcinoma

362
Q

Is Squamous cell carcinoma benign or malignant

A

Malignant

363
Q

Risk factors for Squamous cell carcinoma

A

Sun exposure
Fair complexion
Carcinogens
(Anything irritating to skin)

364
Q

Cutaneous horns are often associated with

A

Squamous cell carcinoma

365
Q

Usually discovered with small and respectable

A

Squamous cell carcinoma

366
Q

Common, slow growing, and usually curative is taken out; rarely metastasizes; pearly papules

A

Basal cell carcinoma

367
Q

Is Basal cell carcinoma benign or malignant

A

Malignant

368
Q

Where is Malignant melanoma typically seen in males

A

Upper back

369
Q

Where is Malignant melanoma typically seen in females

A

Back and legs

370
Q

Most important clinical sign of Malignant melanoma

A

Change in color, size or shape in pigmented lesion

371
Q

Rule for malignancy

A

ABCD rule

372
Q

ABCD rule: A

A

Asymmetry

373
Q

ABCD rule: B

A

Border irregularity

374
Q

ABCD rule: C

A

Color

375
Q

ABCD rule: D

A

Diameter >1 cm

376
Q

Risk factors for malignant melanoma

A

Intermittent sun exposure - BAD sunburns
Fair skin
Dysplastic nevus syndrome

377
Q

Best prognosis of malignant melanoma is with tumors that grow in which direction

A

Horizontally

378
Q

Common melanoma in Caucasians

A

Superficial spreading melanoma

379
Q

Common melanoma type in dark-skinned

A

Acral-lentiginous melanoma

380
Q

Metastasis in malignant melanoma in unlikely if the tumor is

A

< .76 mm

381
Q

Top cancer sites in men

A

Prostate
Lung
Colorectal

382
Q

Top cancer sites in women

A

Breast
Lung
Colorectal

383
Q

Leading cancer deaths in men and women

A

Lung

384
Q

New, uncoordinated growth

A

Neoplasm

385
Q

Discontinuous spread of a malignant neoplasm to distant sites

A

Metastasis

386
Q

4 primary targets of genetic damage

A
  • growth-promoting proto-oncogenes (dominant)
  • growth-inhibiting tumor suppressor genes (recessive - 2 hit required)
  • apoptosis-regulating genes
  • dna repair genes
387
Q

Most common target in human tumors

A

P53

388
Q

Function of p53

A

Cells cycle arrest and initiation of apoptosis

389
Q

Loss of p53 results in

A

Unprepared dna damage –> may lead to malignancy

390
Q

Path of neoplasia

A

Normal –> hyperplasia –> metaplasia –> dysplasia –> neoplasia –> infiltration –> metastasis

391
Q

An abnormality in cell size and appearance

A

Dysphasia

392
Q

Alteration of normal growth regulatory mechanism (lost control)

A

Neoplasia

393
Q

6 hallmarks of cancer

A 
Evading apoptosis
Self-sufficiency in growth signals
Insensitivity to anti-growth signals
Tissue invasion and metastasis
Limitless replicating potential
Sustained angiogenesis
394
Q

Slow growing:benign or malignant

A

Benign

395
Q

Encapsulated: benign or malignant

A

Benign

396
Q

Non invasive: benign or malignant

A

Benign

397
Q

Well differentiated: benign or malignant

A

Benign

398
Q

Rapidly growing: benign or malignant

A

Malignant

399
Q

Invasive: benign or malignant

A

Malignant

400
Q

Matastasis: benign or malignant

A

Malignant

401
Q

Poorly differentiated: benign or malignant

A

Malignant

402
Q

Benign tumor of glandular epithelial tissue

A

Adenoma

403
Q

Malignant tumor of glandular epithelial tissue

A

Adenocarcinoma

404
Q

2 benign types of tumors

A

Adenoma and lipoma

405
Q

Malignant tumor of epithelial tissue

A

Carcinoma

406
Q

Malignant tumor of immune system

A

Lymphoma

407
Q

Fingerlike projections growing on surface

A

Papillomas

408
Q

Malignant tumors of bone, muscle, or connective tissue

A

Sarcoma

409
Q

Tumor where muscle and bone connect

A

Osteosarcoma

410
Q

Most common tumor (aside from the eye) in retinoblastoma

A

Osteosarcoma

411
Q

Osteosarcoma usually involves which bone

A

Femur

412
Q

Most common childhood ocular cancer

A

Retinoblastoma

413
Q

60% of RB cases are: non-hereditary or hereditary

A

Non hereditary

414
Q

Which type of RB affects 1 eye: non-hereditary or hereditary

A

Non hereditary

415
Q

Which type of RB has a huge risk of osteosarcoma and sarcoma: nonhereditary or hereditary

A

Hereditary

416
Q

Type of RB affecting both eyes: nonhereditary or hereditary

A

Hereditary

417
Q

Hereditary RB mutation occurs where

A

Germ cell line

418
Q

Most common type of RB

A

Non hereditary

419
Q

Top cancer sites in men

A

Prostate
Lung
Colorectal

420
Q

Top cancer sites in women

A

Breast
Lung
Colorectal

421
Q

Leading cancer deaths in men and women

A

Lung

422
Q

New, uncoordinated growth

A

Neoplasm

423
Q

Discontinuous spread of a malignant neoplasm to distant sites

A

Metastasis

424
Q

4 primary targets of genetic damage

A
  • growth-promoting proto-oncogenes (dominant)
  • growth-inhibiting tumor suppressor genes (recessive - 2 hit required)
  • apoptosis-regulating genes
  • dna repair genes
425
Q

Most common target in humor tumors

A

P53

426
Q

Function of p53

A

Cells cycle arrest and initiation of apoptosis

427
Q

Loss of p53 results in

A

Unprepared dna damage –> may lead to malignancy

428
Q

Path of neoplasia

A

Normal –> hyperplasia –> metaplasia –> dysplasia –> neoplasia –> infiltration –> metastasis

429
Q

An abnormality in cell size and appearance

A

Dysphasia

430
Q

Alteration of normal growth regulatory mechanism (lost control)

A

Neoplasia

431
Q

6 hallmarks of cancer

A 
Evading apoptosis
Self-sufficiency in growth signals
Insensitivity to anti-growth signals
Tissue invasion and metastasis
Limitless replicating potential
Sustained angiogenesis
432
Q

Slow growing:benign or malignant

A

Benign

433
Q

Encapsulated: benign or malignant

A

Benign

434
Q

Non invasive: benign or malignant

A

Benign

435
Q

Well differentiated: benign or malignant

A

Benign

436
Q

Rapidly growing: benign or malignant

A

Malignant

437
Q

Invasive: benign or malignant

A

Malignant

438
Q

Matastasis: benign or malignant

A

Malignant

439
Q

Poorly differentiated: benign or malignant

A

Malignant

440
Q

Benign tumor of glandular epithelial tissue

A

Adenoma

441
Q

Malignant tumor of glandular epithelial tissue

A

Adenocarcinoma

442
Q

2 benign types of tumors

A

Adenoma and lipoma

443
Q

Malignant tumor of epithelial tissue

A

Carcinoma

444
Q

Malignant tumor of immune system

A

Lymphoma

445
Q

Fingerlike projections growing on surface

A

Papillomas

446
Q

Malignant tumors of bone, muscle, or connective tissue

A

Sarcoma

447
Q

Tumor where muscle and bone connect

A

Osteosarcoma

448
Q

Most common tumor (aside from the eye) in retinoblastoma

A

Osteosarcoma

449
Q

Osteosarcoma usually involves which bone

A

Femur

450
Q

Most common childhood ocular cancer

A

Retinoblastoma

451
Q

60% of RB cases are: non-hereditary or hereditary

A

Non hereditary

452
Q

Which type of RB affects 1 eye: non-hereditary or hereditary

A

Non hereditary

453
Q

Which type of RB has a huge risk of osteosarcoma and sarcoma: nonhereditary or hereditary

A

Hereditary

454
Q

Type of RB affecting both eyes: nonhereditary or hereditary

A

Hereditary

455
Q

Hereditary RB mutation occurs where

A

Germ cell line

456
Q

Most common type of RB

A

Non hereditary

457
Q

Visible whiteness in pupil

A

Leukocoria

458
Q

3 ways cancer spreads

A

Direct invasion and extension
Seeding in body cavities
Metastatic spread through blood/lymph

459
Q

Cancer enters blood vessels

A

Intravasation

460
Q

Cancer exits vessels and enters tissue

A

Extravasation

461
Q

Development of new blood vessels

A

Angiogenesis

462
Q

Cancer grading scheme uses what 3 letters

A

TNM

463
Q

Cancer grading: T

A

Primary tumor

- higher number, bigger it is

464
Q

Cancer grading: N

A

Regional lymph nodes (axillary to clavical)

465
Q

Cancer grading: Tx

A

Can’t assess primary tumor

466
Q

Cancer grading: t0

A

Breast free of tumor

467
Q

Cancer grading: t1

A

<2cm

468
Q

Cancer grading: t2

A

2-5 cm

469
Q

Cancer grading: t3

A

> 5 cm

470
Q

Cancer grading: nx

A

Cannot assess

471
Q

Cancer grading: n0

A

No lymph nodes

472
Q

Cancer grading: n1

A

1-3 axillary nodes

473
Q

Cancer grading: n2

A

4-9 axillary nodes

474
Q

Cancer grading: n3

A

10+ axillary or spread to clavical nodes

475
Q

Cancer grading: M

A

Distant metastasis

476
Q

Cancer grading: mx

A

Cannon assess

477
Q

Cancer grading: m0

A

No spread

478
Q

Cancer grading: m1

A

Distant spread present

479
Q

Mnemonic for 7 signs of cancer

A

Caution

480
Q

7 signs of cancer: C

A

Change in Bowel/bladder

481
Q

7 signs of cancer: a

A

A sore throat that wont heal

482
Q

7 signs of cancer: u

A

Unusual bleeding or discharge

483
Q

7 signs of cancer: t

A

Thickening or lump

484
Q

7 signs of cancer: i

A

Indigestion of difficulty swallowing

485
Q

7 signs of cancer: o

A

Obvious change in wart or mole

486
Q

7 signs of cancer: n

A

Nagging cough or hoarseness

487
Q

Is there usually pain associated with early stage of malignancy

A

No

488
Q

Grading a tumor deals with

A

Cellular differentiation

489
Q

Staging a tumor deals with

A

Progression/spread

Pathology (5 decks)

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