Exam 4 [Review Sheet Questions] Flashcards
What infectious disease of the oral cavity is caused by Coxsackie virus?
Hand, Foot & Mouth Disease
What are the alternative names of “Acute Necrotizing Ulcerative Gingivitis”?
“Vincent’s Angina” & “Trench Mouth”
Leukoplakia & Erythroplasia: Which one is most likely to undergo malignant change?
Leukoplakia: 5-15% undergo transformation into squamous cell carcinoma
Erythroplasia: over 50% undergo transformation into squamous cell carcinoma
What is the name of the stone formation in the salivary duct?
Sialolithiasos (but it is more common in the submandibular gland)
What is the technical name for “Mumps”?
Acute Epidemic Parotitis
What are the complications of “Mumps” in adults?
[Infection of]:
- Pancreas
- Testes
- Ovaries
Which tumors of the Parotid Gland can spread along the facial nerve?
1) Mucoepidermoid Carcinoma
2) Adenoid Cystic Carcinoma (more so)
Term that describes “difficulty swallowing”:
Dysphagia
Term that describes “painful swallowing”:
Odynophagia
Which type of Hiatus Hernia produces Reflux Esophagitis (GERD)?
Hiatus Hernia of the sliding type associated with incompetent cardiac sphincter [Figure 15-6]
Definition of “Barrett’s Esophagus”
“Replacement of normal stratified epithelium of the DISTAL esophagus with metaplastic columnar epithelium containing goblet cells”
What type of malignancy can “Barrett’s Esophagus” produce?
Adenocarcinoma
Definition of Achalasia of the Esophagus:
“Failure to relax, referring to the lower esophageal sphincter during swallowing”
(Aperistalsis/increased resting tone of the sphincter)
What is the abnormality that is produced by Achalasia of the Esophagus?
In S. America: Chaya’s Disease (Trypanosoma Cruzi)
(Potentially premalignant): 5% develop esophageal carcinoma
What are the causes of Acute Erosive Gastropathy? (7)
1) Prescriptions
2) Toxicity
3) Stress
4) Chemotherapy Treatment
5) Ischemia
6) Post Burn Injury
7) Hormonal
What type of Chronic Atrophic Gastritis is associated with Pernicious Anemia?
Type A: auto-immune type
(Chronic Atrophic Gastritis)
What type of Chronic Atrophic Gastritis is associated with “Helicobacter Pylori” Infection?
Type B: (Antral Gastritis)
What is the most common site for the development of Peptic Ulcers?
Duodenum & has “Familial Tendency” (MC in Males)
What are the Causative Factors of Peptic Ulcers?
[Duodenal vs. Gastric (4:1)]
Duodenal: greater acid production
Gastric: less mucosal resistance (less prostaglandin PGE2) -> less bicarbonate & mucous production
How would a baby with Congenital Pyloric Stenosis present?
- Symptoms appear 1-3 weeks Postpartum
- Hypertrophic Sphincter
- Projectile Vomitting
- Visible Peristalsis
(Can be associated with a Cleft Palate)
What is the most common site for the formation of an Abdominal Hernia in Males?
1 Indirect Inguinal (Inguinal Canal)
#3 Femoral (into femoral canal)
#4 Periumbilical, Incisional
#5 Diaphragmatic (usually left)
What is the most common site for the formation of an Abdominal Hernia in Females?
Femoral Triangle
Definition of “Volvulus”:
“Twisting around axis of mesentery”
Definition of “Intussusceptions”:
“Telescoping common in terminal ileum (sausage-like mass in the right iliac fossa)”
What are the major causes of Intussusceptions?
- Polyp in the Intestines or from Recent Abdominal Surgery
(Potentially viral infection as well) - In children it is unknown
How would a patient with Intussusceptions present?
- Gangrene
- Vomitting
- Rectal Bleeding (Currant-Jelly Clots)
- Abdominal Pain
- Sausage-like mass on Right Iliac Fossa
What is the cause of Celiac Disease?
Hypersensitivity to gluten (gliadin) in the diet
[BROW = Barley, Rye, Oats, Wheat]
How would a patient with Celiac Disease Present?(Adult & Child)
Adult: Abdominal Pain, Bloating, Nausea/Vomitting
Child: Irritable Anorexia, Diarrhea, Bloating, Weight Loss, Muscle Wasting, FTT
What characteristic histological change is seen with Celiac Disease?
TOTAL VILLOUS ATROPHY PRIMARILY IN THE PROXIMAL SMALL INTESTINE
(Accumulation of lymphocytes in the mucosa)
What is the cause of Whipple’s Disease?
Bacterium called “Tropheryma Whipplei”
What is the major characteristic of Whipple disease?
Villi are distended with “foamy” macrophages in the lamina propria
What are the Diagnostic Clinical Features of Typhoid Fever?
[In Bacteremic Phase]
- Fever
- Leukopenia
- Skin rash “rose spots”
- Bradycardia
- Muscle Pains
[In Intestinal Phase]
- Bloody Diarrhea
- Bacteria in the Stools
What are the characteristic histological changes seen with Amebic Dysentery?
“flask-shaped ulcers caused by undermining of mucosa from below”
Which type of adenomatous polyp (of the colon) is most likely to become malignant?
Villous (Sessile)
What type of Emphysema is typical of “Cigarette Smoking”?
Centriacinar
What type of Emphysema is typical of “alpha-1-antitrypsin” deficiency?
Panacinar
What is the most common cause of “Community Acquired” Primary Pneumonia?
Pneumococcal Pneumonia: (Streptococcus Pneumoniae)
What organism is the most common cause of “Walking Pneumonia”?
Mycoplasma Pneumoniae
What type of Pneumonia is associated by spread from air conditioning cooling towers?
Legionella Pneumonia
What type of Pneumonia is an opportunistic disease seen in AIDS patients?
Pneumocystis Pneumonia (PCP) caused by the fungus “Pneumocystis jirovecii”
(Formerly “carinii”)
Definition of “Bronchiectasis”:
“Abnormal, permanent and irreversible dilation of the bronchial tree PROXIMAL to the Terminal Bronchioles”
What are the characteristics of the typical lesion that is produced in Secondary Tuberculosis?
Located @ the lung Apex & show extensive necrosis with cavitation
What are the causes of “Acute Respiratory Distress Syndrome”?
[See Table 13-1]
Definition of “Pneumoconiosis”:
“Inhaled Inorganic Drugs”
(3 types)
- Anthracosis
- Silicosis
- Asbestosis
What are the possible causes of a Sinus Infection? (6)
1) Extension of Cold
2) Allergic Rhinitis
3) Extraction of Upper Teeth
4) Oroantral Fistula
5) Spread of Infection from Upper Teeth
6) Forcible entry of Infected/Irritant Materials (vomiting against closed nose & mouth, diving, aircraft)
How would a patient with a sinus infection present?
- Pain & Tenderness over Sinus
- Tenderness in Upper Teeth (Maxillary)
- Back and Side of Head (Sphenoid & Ethmoid)
What is meant by the term “Tension Pneumothorax”?
“Blunt force trauma to the chest, MVA/ industrial accidents. Shift of Pulmonary Structures to Opposite Side.”
What are the causes of a Tension Pneumothorax?
MVA or Industrial accidents
How would a patient with Tension Pneumothorax present?
- Shift of pulmonary structures to the opposite side
- Shift of Mediastinum to opposite side
- Chest pain
- Shortness of Breath
- Rapid Breathing
- Racing Heart followed by a Shock
What are the associations with Nasopharyngeal Carcinoma?
In U.S. associated with Cigarette Smoking
(Spreads early to Lymphatics)
What is meant by a “Laryngeal Nodule”?
Reactive lesion that occurs in the vocal cords in people who use their voice regularily. (Preacher/Singer’s Voice)
How is a “Laryngeal Nodule” caused?
Chronic use of the Voice overtime. (Straining, Yelling, & Frequent Singing)
What organism causes “Epiglottitis”?
Haemophilus Influenzae-B
How would a patient with “Epiglotitis” present?
- Young children
- Inspiration Stridor
- Potentially Laryngospasm.
What are the characteristics of “Acute Necrotizing Ulcerative Gingivitis”?
Requires presence of 2 Bacteria:
1) a Fusiform Bacillus
2) a Spirochete (Borrelia Vincentii)
Gingival margins are covered by a grey pseudomembrane
What are the characteristics of “Actinomycosis”?
[Anaerobic Gram (+) Bacillus]
- Rare, produces chronic suppuration inflammation in the mouth and jaw
- Multiple draining sinuses w/ pus containing visible colonies of bacteria “sulfur granules”
What are the characteristics of “Scarlet Fever” (in the oral cavity)?
- Childhood disease
- Toxin causes rash on the skin & Oral Mucosa
- Tongue has a white coat “strawberry tongue”
What are the characteristics of “Leukoplakia”?
[White Patch]
- Hyperkeratosis from chronic irritation
What are the characteristics of “Erythroplasia”?
[Reddish, Velvety Looking Area]
- Dysplasia
What causes “Leukoplakia”?
- Abrasion
- Chipped Tooth
- Chewing Tobacco
- Cigarette’s etc.
(Anything that irritates the mucosa)
What causes “Erythroplasia”?
- Most often: men that aren’t circumcised
- Associated with HPV
What are the characteristics of “Sjogren’s Syndrome”?
[Autoimmune]
- Dry eyes & Mouth
- Rheumatoid Arthritis
What type of tumor is characterized by epithelium in a frond-like arrangement and the presence of lymphoid nodules?
Adenoid Cystic Carcinoma
What are the characteristics of “Tracheoesophageal Fistula”?
- Can cause Neonatal Respiratory Distress Syndrome
- Occurs from malformation of developing trachea & esophagus.
- Ingestion of fluid causes aspiration into lungs with an “Aspiration Pneumonitis”
What are the characteristics of “Zollinger-Ellison Syndrome”?
Associated with the islet cell tumor “Gastrinoma”
What are the characteristics of “Meckel’s Diverticulum”?
- True congenital malformation due to persistence of vitelline duct
- may contain ectopic gastric mucosa & produce peptic ulceration, hemorrhage/perforation of the diverticulum
- May produce a Volvulus
What are the characteristics of “Hirschsprung’s Disease”?
- Congenital issues from lack of parasympathetic supply to rectum.
- produces mechanical obstruction @ birth “Congenital Megacolon”
What are the major characteristics of “Mechanical Obstruction” of the intestine?
Painful distension of the abdomen & increased bowel sounds
- Volvulus & Intussusception
What are the major characteristics of “Paralytic Obstruction” of the intestine?
Painless distension of the abdomen and “silent” bowel sounds
What are the differences between “Mechanical” & “Paralytic” Obstruction of the intestine?
Mechanical: Painful & increased bowel sounds
Paralytic: Painless & silent bowel sounds
What are the characteristics of “Cholera”?
- Production of an enterotoxin causing secretory diarrhea (large watery stools) “rice water stools”
What are the characteristic changes of “Giardiasis”?
- Giardia Lamblia
- Contaminated food & water
- forms a barrier on the inside of the duodenum
What are the characteristics of “Crohn’s Disease”?
1) “skip lesions”
2) Non-caseating Granuloma
3) Fissuring w/ Fistulae formation
4) “cobble stoned” mucosal appearance
5) “garden hose” appearance of wall from Fibrosis
6) “String Sign” from narrowing of bowel segments
What are the characteristics of “Ulcerative Colitis”?
1) Rectum in 80% of cases
2) Migrates Proximally
3) In Active Inflammation -> Hyperemia, Edema & Ulceration of mucosa
4) “Pseudopolyps”
5) No Granuloma
6) Adenocarcinoma Risk
What are the differences between “Crohn’s Disease” and “Ulcerative Colitis”?
What are the characteristics of “Familial Polyposis Coli”?
- Autosomal Dominant
- formation of benign tumors in the colon (age 10)
- malignant transformation in mid-thirties (100+ Polyps, cancer before 30)
- Total Colectomy
What are the characteristics of “Gardner’s Syndrome”?
- Osteomas in the mandible, skull, long bones, & ST neoplasms (fibrosis of the skin)
What are the characteristics of “Peutz-Jeugher’s Syndrome”?
- Hamartomas in Jejunum w/ pigmented lesions in the oral mucosa & around mouth
- Early as 11 years old
- Autosomal Dominant
- Low malignant transformation risk
What are the features of “Carcinoid Syndrome”?
[Only get “Carcinoid Syndrome” if there is secondary metastasis in the liver]
- Increased 5HIAA in urine
What are the characteristics of [Non-Atropic] “INTRINSIC Asthma”?
- In adults w/o evidence of allergen sensitivity
- IgE skin test (-)
- Hyperactive response in bronchioles to stress, activity, viruses, air pollutants, tobacco, ozone etc.
What are the characteristics of [Atrophic] “EXTRINSIC Asthma”?
[Childhood]
- allergy to something in environment
- IgE skin test (+)
- (+) family Hx
- 50% remiss in latent adolescence
- dust, mites, pollens, food, animals etc.
What are the changes in ventilation seen in “Restrictive” Pulmonary diseases?
What are the changes in ventilation seen in “Obstructive” pulmonary diseases?
What is the clinical description for “Emphysema”?
1) Permanent dilation of air spaces distal to terminal bronchiole w/ destruction of lung parenchyma.
2) loss of alveolar surface area for gas exchange
What is the clinical description of “Chronic Bronchitis”?
1) Persistent presence of increased bronchial mucus secretion.
2) WHO definition: cough, productive of sputum for at least 3 months out of the year with 2 years in succession
What is the Pathogenesis of an “Uncomplicated” case of Pneumococcal Pneumonia?
[MC community acquired Pneumonia]
- young to middle-aged adults (MC Males)
- may follow a viral infection
What is the progression of an “Uncomplicated” case of Pneumococcal Pneumonia?
1) Congestion & Consolidation
2) Red Hepatization
3) Gray or White Hepatization
4) Resolution
What are the characteristics of “Sarcoidosis”?
- Non caeseating Epitheloid Granuloma
- depressed cell mediated immunity (anger Gy to tuberculin)
- Hyperactive humoral immunity w/ increased T helper cell activity -> epitheloid Granuloma formation
What are the characteristics of the lesion produced in Primary Tuberculosis?
- Consists of Ghon Focus in periphery of lung consisting of Granuloma w/ Central Caeseation
- Heals w/ fibrous scar forming area of Dystrophic Calcification
The Lesion in Primary Tuberculosis may spread to?
Hilar lymph nodes which is said to be the “Ghon Complex”
What are the characteristics of “Asbestosis”?
- Pleural plaques
- massive pulmonary fibrosis
- bronchogenic carcinoma
- mesothelioma (90% die within 2 years)
Ferruginuos Body “Shish-kebab” or “drum-stick”
What is meant by “Caplan’s Syndrome”?
Combination of:
1) Pneumoconiosis
2) Rheumatoid Arthritis
What are the 4 major types of carcinoma of the Bronchus?
1) Adenocarcinoma (50%)
2) Squamous Carcinoma (20%)
3) Small Cell (Oat Cell) Carcinoma (15%)
4) Large Cell Carcinoma (2%)
What are the different types of Laryngeal Carcinoma? (By site)
1) Squamous Cell Carcinoma (Nasopharynx)
2) Anaplastic Carcinoma
3) Lymphomas of Waldeyer’s Ring
4) Squamous Papiloma
What is “Acute Bronchiolitis”?
Epidemic infection of small airways in children
Progression of what can lead to “Bronchiolitis”?
Hypersensitivity Pneumonitis ->Type IV Hypersensitivity -> Granuloma -> Bronchiolitis Obliterans
Acute Bronchiolitis is seen in what population?
Young Children
Most cases of “Acute Bronchiolitis” are caused by…
Respiratory Syncytial Virus (RSV)
What would a patient with Acute Bronchiolitis present with?
1) Bronchospasm
2) Pneumonia
What can also cause “Acute Bronchiolitis” (other than RSV)?
Adenoviruses (these have higher mortality/complication rate)
What are the symptoms of “Acute Bronchiolitis”?
- Cough
- Chest Tightness
- Cyanosis (in severe cases)
