Exam 1 Review for Final

Question 1

What does the word Lentigo mean?

Answer 1

Lentigo – small, pigmented spots on the skin with a clearly-defined edge and surrounded by normal-appearing skin.

Question 2

What is meant by the word nevus?

Answer 2

Melanocytic nevi are nests of multi-layered melanocytes found in moles.

Question 3

What characteristics indicate that a nevus may be dysplastic?

Answer 3

Nevocellular nevi are benign tumors of melanocytes with sharp, well-defined borders, usually stable in shape and size; rarely transform and become malignant.

Dysplastic nevi are larger, irregular, and may have pigment variation. Things to look for: asymmetric, irregular borders, variegated color, large diameter and enlarging (ABCD’s)
Dysplastic nevus syndrome: autosomal dominant with increased risk of melanoma.

Question 4

What can Acanthosis Nigricans be an indication of?

Answer 4

hyperinsulinemia

associated with obesity but rarely with malignancy

Question 5

What is the sign of Leser-Trelat?

Answer 5

The sudden development of multiple lesions, possibly accompanying an underlying malignancy.
Seen in seborrheic keratosis where there is a “stuck-on” appearing of keratin-filled epidermal pseudocysts.

Question 6

What are the tests called you can use on physical exam to evaluate for Psoriasis and Pemphigus?

Answer 6

Ausptiz Sign: the removal of a scale that results in pinpoint bleeding used to evaluate psoriasis.
Nikolski’s Sign: breaks the layer after determining if the borders of the blister will extend out by applying manual force (blisters move under the skin). Microscopically, net-like patterns of IgG between epidermal keratinocytes create bullae. Intraepidermal acantholysis is the hallmark feature.

Question 7

What is the relationship between topical steroids and Tenia infections of the skin?

Answer 7

Topical steroids are NOT used in conjunction with antifungals. This decreases the efficacy of the antifungal because corticosteroids suppress the immune system; although provides immediate relief of symptoms for the patient.

Question 8

What is the difference between Erythema Nodosum and Erythema Multiforme?

Answer 8

Erythema multiforme: hypersensitivity skin reaction to infections or drugs. Characterized by vesicles, bullae, and “targetoid” erythematous lesions (like Lyme). Stevens - Johnson Syndrome is the most severe form, characterized by extensive involvement of skin and mucous membranes.

Erythema nodosum: causes raised, erythematous, painful nodules of subcutaneous adipose tissue. Sometimes it is associated with granulomatous diseases and strep.

Question 9

What layers are involved with the following: BCC, SCC, Melanoma?

Answer 9

Squamous Cell Carcinoma (SCC): nests of atypical keratinocytes that invade the DERMIS. Rarely metastasize; complete excision is usually curative.
Basal Cell Carcinoma (BCC): most common tumor in the western world. Typically only locally invasive and characterized by a pearly borders and papules; arises from BASAL CELLS of hair follicles.
Melanoma: depending on severity can involve epidermis, dermis and subcutaneous tissue

Question 10

Pathology

Answer 10

is the study of the essential nature and characteristic of disease (S&S, complications, pathogenesis, etc).

Question 11

Define Disease

Answer 11

Disease is the impairment of the normal states (known from distinguishing S&S, etc).

Question 12

Define Homeostasis

Answer 12

Homeostasis is the maintenance of a harmonious environment within the body.

Question 13

Define Morbidity

Answer 13

Morbidity is the sequelae/effects of a disease.

Question 14

Define Comorbidity

Answer 14

Comorbidity is the property of a disease that gives it a specific virulence/ sequelae.

Question 15

Define Iatrogenic

Answer 15

Iatrogenic is doctor-acquired.

Question 16

Define Idiopathic

Answer 16

Idiopathic is where we don’t know the cause.

Question 17

Define Symptoms

Answer 17

Symptoms are subjective and according to what the patient may feel.

Question 18

Define Signs

Answer 18

Signs are objective and what the doctor observes.

Question 19

Define Death

Answer 19

Death is when pulse is not palpatable and heart sounds aren’t able to be auscultated. Respiration is non-spontaneous.

Question 20

Define Sub-clinical

Answer 20

Sub-clinical means that the immune system is doing its job and taking care of the infection.

Question 21

Define Illness

Answer 21

Illness is an unhealthy condition of the body or mind (sickness/disease).

Question 22

Define Etiology

Answer 22

Etiology is the underlying cause of disease.

Question 23

Define Pathogenesis

Answer 23

Pathogenesis is the course that a disease takes from start to finish.

Question 24

Define Morphology

Answer 24

Morphology is the presence/conformation of damaged cells and tissues from the infection.

Question 25

Define functional disease.

Answer 25

Functional disease is what happens when we know the disease exists, but have not discovered any gross or microscopic morphologic changes at this time.

Question 26

Define syndrome.

Answer 26

Syndrome is a group of signs and symptoms that occur together and characterize a particular abnormality or condition.

Question 27

On an H&E stain, what structures turn blue, and which red?

Answer 27

Hematoxylin stains nuclei and bacteria to blue-purple. | Eosin stains the cytoplasm, RBCs, and collagen pink-red.

Question 28

Cellular injury can cause necrosis or apoptosis, what's the difference?

Answer 28

apoptosis: cell programmed death which DOES NOT involve inflammation necrosis: non-programmed cell death, involves inflammation and is usually due to tissue damage (hypoxia, chemical, drugs, etc.)

Question 29

What are common causes of cellular injury?

Answer 29

Hypoxia: most common cause of cellular injury, resulting in the inability to synthesize sufficient ATP by aerobic oxidation (ie ischemia). Infections: cause injury by direct infection, toxins, and inflammatory responses of the host. Immunologic reactions, congenital disorders, and chemical injury are other possibilities; also see physical injury, anorexia, obesity/excessive caloric intake.

Question 30

Vitamin A deficiency could lead to which diseases?

Answer 30

squamous metaplasia, immune deficiency, night blindness

Question 31

Vitamin C deficiency may lead to what disease?

Answer 31

Vitamin C: scurvy

Question 32

Vitamin D deficiency may lead to which diseases?

Answer 32

Vitamin D: rickets and osteomalacia

Question 33

Vitamin K deficiency may lead to which disease?

Answer 33

Vitamin K: bleeding diathesis (used in clotting cascade)

Question 34

Vitamin B12 deficiency may lead to which diseases?

Answer 34

Vitamin B12: megaloblastic anemia, neuropathy, spinal cord degeneration

Question 35

Vitamin B9 (Folate) deficiency may lead to which diseases?

Answer 35

Vitamin B9 (Folate): megaloblastic anemia and neural tube defects

Question 36

Vitamin B3 (Niacin) deficiency may lead to what disease?

Answer 36

Vitamin B3 (Niacin): pellagra (diarrhea, dermatitis, dementia, and death)

Question 37

When does cloudy swelling occur?

Answer 37

Cloudy swelling occurs when intracellular proteins accumulate in the serum. *Cellular swelling occurs when cells are incapable of maintaining ionic and fluid homeostasis. There is a decreased ATP concentration and Na-pump activity, causing Na, Ca, and water to accumulate intracellularly.

Question 38

Where do free radicals come from?

Answer 38

Many free radicals are oxygen-derived; processes such as UV light, metabolism, inflammation, smoking, ionizing radiation, and air pollution also create free radicals.

Question 39

Describe the basic pathway in an injured cell that begins with mitochondrial dysfunction and leads to cellular swelling.

Answer 39

Mitochondrial dysfunction leads to a decrease in oxidative phosphorylation and ATP, making the mitochondria highly permeable, releasing cytochrome c, triggering apoptosis. The Na/K ATPase pumps start to fail, causing influxes of Na and water, efflux of K, cellular and ER swelling. Other nuclear changes: pyknosis is the degeneration and condensation of nuclear chromatin; karyorrhexis is nuclear fragmentation; karyolysis is the dissolution of the nucleus

Question 40

What is the significance of anaplasia, what are the two chief findings of anaplasia?

Answer 40

De-differentiation of cells is anaplasia and will show a “brick-like” pattern and a dramatic increase of the nuclear:cytoplasmic ratio.

Question 41

What is the difference between primary, secondary, and tertiary (delayed closure) intentions?

Answer 41

Primary - approximate wound edges and close; decreases scarring and heals well. Secondary - wound edges do not become approximated and become filled with granulous tissue and fibrin. Tertiary (delayed) - keep open for a period of time in order to prevent infection or edema.

Question 42

What is the difference between hypoplasia and agenesis?

Answer 42

Hypoplasia is a defective formation or incomplete development of a part whereas agenesis is the absence or failure of formation.

Question 43

What are the different types of stem cells and where are they found?

Answer 43

``` Labile cells (primary stem cells): continuously dividing and found in the epidermis, GI tract, etc. Stable cells: have a low level of replication and can be induced to divide; found in hepatocytes, renal tubular epithelia, alveoli, and pancreatic acini. Permanent cells: do not ever divide and are found in nerve cells, cardiac myocytes, and skeletal muscles. ```

Question 44

What are the three stages of fracture healing?

Answer 44

Procallous: a hematoma that provides anchorage but no structural integrity. Fibrocartilaginous callous: characterized by a fibrous ball around the fracture. Osseus callous

Question 45

What is the difference between a traumatic fracture and a pathologic fracture?

Answer 45

Pathologic fractures are caused by disease sequelae, etc. Traumatic fractures are what we consider normal fractures of bone, including transverse, linear, non-displaced, comminutes, greenstick, spiral, compound, etc.