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Skin, Blood, Lymph > Exam 1 Pathology > Flashcards

Exam 1 Pathology Flashcards

1
Q

Layers of the Epidermis

A

Stratum… Corneum, Lucidum, Granulosum, Spinosum, Basale

Come, Let’s Get Sun Burned

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2
Q

Acanthosis vs papillomatosis

A

acanthosis: epidermal hyperplasia
papillomatosis: dermal papilla enlargement and hyperplasia

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3
Q

Lentigo

A

flat lesion

melanocyte hyperplasia

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4
Q

suborrheic keratoses

A

Flat, greasy, pigmented squamous epithelial proliferation
Benign tumor in older patients

Leser-Trelat sign: rapid onset of multiple keratoses may indicates possible malignancy (GI adenocarcinoma)

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5
Q

acanthosis nigricans

A

80% benign: diabetes, pitutary/pineal tumor

20% associated with malignacy (GI adenocarcinoma)

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6
Q

Acrochordon

A

skin tag

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7
Q

actinic keratosis

A

Premalignant skin lesion associated with sun exposure
rough brown plaques
may be horn like

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8
Q

benign fibrous histiocytoma (dermatofibroma)

A

painless scar-like lesion leftover from trauma

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9
Q

dermatofibrosarcoma protuberans

A

overexpression of PDGF-B (platelet derived growth factor)

translocation of COL1A1 (collagen) onto the PDGF gene causes upregulation

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10
Q

wheals

A

hives, aka uticaria

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11
Q

Eczema

A

atopic dermatitis

allergic skin contact

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12
Q

Erythema multiforme

A

hypersensitivity in response to infections (mycoplasma, HSV) or drugs (sulfa drugs, B-lactams, phenytoin)
Target lesions

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13
Q

Psoriasis

A

silver scaly lesions, nail pitting

+ Auspitz sign → bleed when picked

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14
Q

Seborrheic dermatitis

A

occurs in areas rich with sebaceous glands, (scalp, face, periocular, ear)
possibly caused by fungus called Malassezia.
correlated with Parkinsons and HIV

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15
Q

Lichen Planus

A

Pruritic, Purple, Polygonal, Planar Papules, and plaques
with Wickham striae and sawtooth pattern at the dermal-epidermal junction
resolve spontaneously

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16
Q

Pemphigus

A 
IgG autoantibodies against desmoglein
flaccid blisters (subcorneal or suprabasal)
type 2 hypersensitivity disorder
potentially fatal
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17
Q

Bullous pemphigoid

A 
IgG autoantibodies against hemidesmosomes (epidermal basement membrane)
tense blisters (subepidermal)
type 2 hypersensitivity
less severe than pemphigus
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18
Q

Dermatitis herpetiformis

A

IgA deposits
grouped pruritic blisters
associated with celiacs disease

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19
Q

Epidermolysis bullosa

A

defects in structural proteins

↑ blisters, trauma, rubbing

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20
Q

Porphyria cutana tarda

A

blistering in response to sunlight

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21
Q

Red marrow

A

hematopioetic

axial skeleton, hands and feet

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22
Q

yellow marrow

A

fat

long bones

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23
Q

Normal WBC ranges

A

5,000-10,000

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24
Q

Normal granuloocyte ranges

A

40-70%

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25
Normal RBC ranges
3,500,000 - 5,000,000 (higher in men)
26
Normal platelet ranges
150,000 - 450,000
27
Most numerous white blood cell
neutrophil (40-80%)
28
Leukemia
Bone marrow cancer of WBCs causes... marrow failure ↓ RBCs and mature WBCs infections hemorrhage (↓ platelets) presents with circulating malignant WBCs Metastasis to liver, spleen, lymph nodes, and skin possible
29
Acute Lymphoblastic leukemia/lymphoma (ALL)
``` Lymphoid neoplasm Children TdT+ (pre-T and pre-B cells) CD10+ (pre-B cells) t(12;21) → better prognosis May spread to CNS and testis T-cell ALL can present with mediastinal mass associated with Down Syndrome ```
30
Chonic lymphocytic leukemia/small lymphocytic lymphoma
``` lymphoid neoplasm (B-cell) age > 60 most common adult leukemia CD20+ CD23+ CD5+ smudge cells in peripheral blood smear CLL (crushed little lymphocytes) autoimmune hemolytic anemia Richter transformation → CLL/SLL can transform into an aggressive lymphoma, diffuse large B-cell lymphoma ```
31
TdT+ | CD10+
ALL
32
CD20+ CD23+ CD5+
CLL/SLL
33
Richter transformation
CLL/SLL
34
smudge cells
CLL/SLL
35
Hairy cell leukemia
Lymphoid neoplasm adult males mature B-cell tumor cells have filamentous hair-like projections marrow fibrosis → massive splenomegaly and pancytopenia TRAP+ stain BRAF mutations
36
Acute myelogenous leukemia
Myeloid neoplasm age ~ 65 Auer rods ↑↑↑ circulating myeloblasts on peripheral smear Can arise of pre-existing myelodysplastic syndromes exhibit anemia, neutropenia, thrombocytopenia
37
Chronic myelogenous leukemia
``` myeloid neoplasm age 45-85 Philadelphia chromosome (t[9;22], BCR-ABL) splenomegaly low LAP ```
38
Hodgkin vs NH lymphomas
Both present with low grade fever, night sweats, weight loss ``` Hodgkin: better prognosis localized group of nodes Reed sternberg cells EBV ``` NHL: multiple lymph nodes, extranodal involvement majority are B-cells Autoimmune disease and EBV, HIV, HTLV frequently involve waldeyer ring and mesenteric nodes
39
Hodgkin lymphomas and its subtypes
Reed sternberg cells (binucleate, owl eye cells that are CD15+ and CD30+) subtypes: Nodular sclerosis → most common Lymphocyte rich → best prognosis Mixed cellularity → eosinophilia, seen in the immunocompromised (EBV) Lymphocyte depleted → seen in the immunocompromised (EBV)
40
Burkitt lymphoma
NHL CHILDREN OR YOUNG ADULTS (all other NHL are adults) t(8;14) translocation of c-MYC(8) and heavy chain Ig (14) Starry sky appearance with interspersed tingible body macrophages jaw lesions in Africa pelvis or abdomen in sporadic form
41
Diffuse large B-cell lymphoma
NHL (most common one) older adults (80%), children (20%) BCL-2 and BCL-6 alterations
42
Follicular lymphoma
NHL adults t(14;18) translocation of heavy chain Ig (14) and BCL-2 (18) painless waxing and waning lymphadenopathy
43
Mantle cell lymphoma
NHL Adult males (MANtle) t(11;14) translocation of cyclin D1 (11) and heavy chain Ig (14) CD5+ very aggressive, patients present in late stages
44
Marginal cell lymphoma
NHL adults t(11;18) translocation of cyclin D1 (11) and BCL-2 (18) associated with chronic inflammation (sjogrens, chronic gastritis)
45
Primary central nervous system lymphoma
``` NHL adults associated with HIV/EBV considered AIDs defining illness ring enhancing mass lesion on MRI of brain ```
46
Adult T-cell lymphoma
``` NHL of T-cells adults caused by HTLV (associated with IV drug abuse) present with cutaneous lesions common in Japan, Africa, and caribbean ```
47
Mycosis fungoides
NHL of T-cells Adults skin patches and plaques characterized by atypical CD4+ cells with cerebriform nuclei and intraepidermal neoplastic cell aggregates (Pautrier microabcesses) may progress to Sezary syndrome (T-cell leukemia)
48
Sezary syndrome
T-cell leukemia | associated with mycosis fungoides
49
t(8;14)
Burkitt lymphoma (burk-8)
50
t(11;14)
mantle cell lymphoma
51
t(11;18)
marginal zone lymphoma
52
t(14;18)
follicular lymphoma
53
t(15;17)
APL (M3 type AML)
54
t(9;22)
Philadelphia chromosome | CML
55
Multiple myeloma
``` Plasma cell cancer in marrow produces large amounts of IgG or IgA ↑ susceptibility to infection Punched-out lytic bone lesions hypercalcemia and renal failure Ig light chains in urine (Bence jones protein) M spike on electrophoresis Rouleaux formation (RBC's stacked like poker chips) ```
56
Hypercalcemia Renal failure anemia bone lytic lesions / back pain
Multiple myeloma
57
M spike on electrophoresis
multiple myeloma
58
Rouleaux formation
mutliple myeloma (RBCs stack up like poker chips)
59
Elevated serum Ig and Bence Jones protein in urine
multiple myeloma
60
monoclonal gammopathy of undetermined significance
Monoclonal expansion of plasma cells which may progress to multiple myeloma asymptomatic and no other findings
61
Waldenstrom macroglobulinemia
``` hyperviscosity syndrome (blurred vision, Reynaud's) differentiate from multiple myeloma, no CRAB findings ```
62
myelodysplastic syndromes
Disorders involving ineffective hematopoiesis Risk of transforming into AML Refractory anemias.... (RA, RARS, RAEB...)
63
Polycythemia Vera
``` ↑ in all Blood cell types, but RBCs in particular intense pruritus red-blue cyanosis DVT, stroke ↓ in EPO ```
64
Essential thrombocythemia
↑↑ in platelets and megakaryocytes | thrombosis
65
myelofibrosis
obliteration of bone marrow with fibrosis from non-neoplastic fibroblasts massive splenomegaly teardrop RBCs
66
Langerhans cell histiocytosis
Group of proliferative disorders S-100 and CD1a + cells Birbeck granules (tennis racket) Presents in children as bony lytic lesions, with rash and recurrent otitis media
67
Birbeck granules
Langerhan cell histiocytosis
68
S-100 and CD1a +
Langerhan cell histiocytosis
69
Intravascular hemolysis vs Extravascular hemolysis
Intravascular → RBC destroyed in circulation Extravascular → RBC destroyed in spleen or liver intra → ↓haptoglobin, hemoglobinemia/uria extra → spherocytes, splenomegaly
70
Hereditary spherocytosis
``` Intrinsic, extravascular anemia AD sphere-shaped RBCs eliminated in spleen splenomegaly ↑ MCHC (mean cell hemoglobin conc) ↓ MCV Many patients asymptomatic aplastic crisis can occur if infected with Parvovirus ```
71
G6PD deficiency
↑ RBC susceptibility to oxidant stress (infections, drugs, fava beans) RBCs with Heinz bodies and bite cells
72
Hemoglobin C disease
Similar to Sickle Cell, but milder, confers same resistance to malaria Distinctive Crystalline bars in RBCs causes extravascular hemolysis
73
α-thalassemia
``` Microcytic, hypochromic anemia defect in α chain of hemoblobin gene deletion (vs ß which is due to point mutation) ``` (αα/α-) → minima (silent carrier) (α-/α- ;trans) or (αα,-- ;cis) → minor (mild anemia) (--/-α) Hemoglobin H disease (moderate to severe anemia) (--/--) Hemoglobin Barts disease (hydrops fetalis)
74
ß-thalassemia
Microcytic, hypochromic anemia point mutation ↓ ß-globin synthesis Heterozygote → minor (usually asymptomatic, ↑HbA) Homozygote → major (severe anemia require transfusions, "Crew-cut" marrow expansion on skull x-ray)
75
Paroxysmal nocturnal hemoglobinuria
hemolytic anemia Acquired mutation of PIGA at risk for thrombosis and leukemia
76
Autoimmune hemolytic anemia
Warm (IgG) - chronic anemia seen in SLE, CLL, and certain drugs Cold (IgM) - acute/chronic anemia triggered by cold seen in CLL, M. pneumoniae, Mononucleosis, painful blue fingers and toes Both are Coombs +
77
Direct vs Indirect Coombs test
Direct → Pt RBCs | Indirect → Pt serum
78
Microangiopathic anemia
RBCs damaged when passing through obstructd or narrowed vessel Schistocytes (helmet cells) on blood smear
79
megaloblastic anemia
Impaired DNA synthesis includes: folate deficiency, Vit B12 deficiency, orotic aciduria
80
Vit B12 defic
causes megaloblastic anemia with neurologic symptoms | ↑ homocysteine, methylmalonic acid
81
Pernicious anemia
megaloblastic anemia caused by autoimmune gastritis that impairs intrinsic factor production → vit B12 deficiency
82
Folate deficiency
megaloblastic anemia with no neurologic symptoms | ↑ homocysteine
83
Iron deficiency
``` Microcytic, hypochromic anemia ↓ iron ↓ ferritin (iron stores) ↑ TIBC (total iron binding capacity) ↑ RDW (red cell distribution width) ```
84
Anemia of chronic disease
``` Normocytic anemia Chronic infection Chronic autoimmune disease Cancer iron is not released from tissue to be used, nor absorbed in the gut ``` ↓ iron ↓ TIBC ↑ ferritin
85
Aplastic anemia
``` Normocytic anemia destruction or failure of hematopoietic cells due to... Drugs Virus (EBV, HIV, hepatitis) Fanconi syn Idiopathic (65%) ``` hypocellular marrow
86
Coagulation cascade
Intrinsic pathway: Factor 12, 11, 9, (10) Extrinsic pathway: Factor 7 Common pathway: Factor 10, 13
87
PTT vs PT
PTT → intrinsic and common (monitors heparin) | PT → extrinsic and common (monitors coumadin)
88
Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome
Triad of thrombocytopenia, hemolytic anemia, and AKI TTP → addition of neuro symptoms and fever HUS → addition of bloody diarrhea TTP → ↓ADAMTTS13 HUS → E.Coli (EHEC)
89
Bernard-Soulier syndrome
Platelet disorder, defect in adhesion
90
Glanzmann thrombasthenia
Platelet disorder, defect in aggregation
91
von Willebrand disease
Intrinsic pathway defect (↑ PTT) Platelet plug formation defect Ristocetin assay will cause no platelet aggregation

Skin, Blood, Lymph (2 decks)

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