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Systems Pathology Exam One > Extra Conditions > Flashcards

Extra Conditions Flashcards

0
Q

Red meat and alcohol can be risk factors for what condition due to purine emphasis?

A

Gout

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1
Q

What condition is an abnormal purine metabolism leading to uric acid accumulation?

A

Gout

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2
Q

When uric acid accumulates in gout, what do they become?

A

Monosodium urate crystals (tophus/tophi)

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3
Q

What occurs with gout?

A

Recurrent acute joint inflammation leading to destruction and fibrosis

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4
Q

Over 90% of the cases of gout is what kind?

A

Primary - hyperuricemia

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5
Q

What is the hypothesized cause of primary gout?

A

Enzyme defects

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6
Q

With primary gout, what accumulates in the blood?

A

Uric acid

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7
Q

What is secondary gout?

A

Gout that is secondary to another disease or from drug exposure

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8
Q

What are examples of some causes of secondary gout?

A

Renal disease leukemia, multiple myeloma, diuretics

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9
Q

What is the cause of the inflammation of gout?

A

Failed crystal phagocytosis

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10
Q

What is the usual age of those with gout?

A

Over 30

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11
Q

Gout usually occurs among which gender?

A

Males

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12
Q

What is the most common location for gout inflammation?

A

Hallux (MTP) aka podagra

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13
Q

About what percent of the population is affected by gout?

A

1%

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14
Q

The historical name, “Kings Disease”, is associated with what condition?

A

Gout

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15
Q

Monoarticular inflammation is characteristic of what condition?

A

Gout

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16
Q

What is the first stage of gout?

A

Asymptomatic hyperuricemia

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17
Q

What is the second stage of gout?

A

Acute gouty arthritis causing erythema

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18
Q

What is the third stage of gout?

A

Repeated chronic tophaceous arthritis that fails to resolve itself between cycles

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19
Q

20% of those with gout die from what issue?

A

Renal failure (gouty nephropathy)

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20
Q

What are other names for pseudogout?

A

Chondrocalcinosis or Calcium Pyrophosphate Deposition Disease (CPDD)

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21
Q

What causes pseudogout?

A

Altered pyrophosphate metabolism

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22
Q

Are most cases of pseudogout inherited?

A

No, most commonly sporadic

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23
Q

What is the usual location for pyrophosphate crystal deposition of pseudogout?

A

Knee, wrist, shoulder, hip, elbow, ankle

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24
Q

Only about how many cases of pseudogout lead to destruction of joints from inflammation?

A

50%

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25
Q

After what age is pseudogout seen among half of the population?

A

Over the age of 85

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26
Q

What is the usual onset age for pseudogout?

A

Over 50

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27
Q

What is the treatment for pseudogout?

A

Palliative medicine (NSAIDs or corticosteroids)

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28
Q

What specific location in the wrist is common for pseudogout to occur?

A

Triangular fibrocartilage complex

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29
Q

What is hydroxyapatite deposition disease usually called?

A

Calcific tendinitis

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30
Q

What is the sign of calcific tendinitis on X-ray?

A

Soft tissue opacities from ossification

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31
Q

What is the most common location for calcific tendinitis?

A

Rotator cuff muscles

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32
Q

What is the age of onset for calcific tendinitis?

A

40-70

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33
Q

What is the most common muscle affected by calcific tendinitis?

A

Supraspinatus

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34
Q

Adhesive capsulitis (frozen shoulder) and increased age are risk factors for what condition?

A

Calcific tendinitis

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35
Q

What is the other name for diffuse idiopathic skeletal hyperostosis?

A

Forestier disease

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36
Q

What ligament is affected in the cervical and thoracic spine in DISH?

A

Anterior longitudinal ligament (ALL)

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37
Q

What is the usual spinal location for DISH?

A

T7-T11

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38
Q

What is the most common age for DISH?

A

50-70

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39
Q

What are risks for DISH?

A

Diabetes and HLA-B27

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40
Q

Can we adjust patients with DISH?

A

Yes

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41
Q

What is the most common cause of infectious arthritis?

A

Bacteria

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42
Q

What occurs with infectious arthritis?

A

Rapid joint destructions within days

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43
Q

What is the treatment for infectious arthritis?

A

Based on microbial agent: IV antibiotics and analgesics

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44
Q

What is the name of the pus forming infectious arthritis?

A

Suppurative arthritis

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45
Q

What is the most common location for suppurative arthritis?

A

Knee

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46
Q

90% of suppurative arthritis involve how many joints?

A

Just one (monoarticular)

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47
Q

Which microbe is the most common agent involved with suppurative arthritis among children under 2 years of age?

A

Haemophilus influenzae

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48
Q

Which microbe is the most common agent involved in suppurative arthritis among children older than 2 years of age and adults?

A

Staphylococcus aureus

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49
Q

Which microbe is the most common agent involved in adolescents and young adults?

A

Neisseria gonorrhoeae

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50
Q

Who is at a higher risk for neisseria gonorrhoeae causing infectious arthritis?

A

Sexually active females

51
Q

What is the most common microbe at fault for infectious arthritis among those with sickle cell anemia?

A

Salmonella spp

52
Q

What is the frequency of Lyme arthritis in the US?

A

20,000 cases per year

53
Q

What microbe is at fault for Lyme arthritis?

A

Borrelia burgdorferi

54
Q

How is Lyme arthritis diagnosed?

A

Presence of IgM and IgG in serum

55
Q

What occurs in the first stage of Lyme arthritis?

A

Red lesion with pale center, fever, lymphadenopathy, and is self resolving in weeks

56
Q

What occurs in stage two of Lyme arthritis?

A

Secondary skin lesions, migratory joint pain, myalgia, meningitis, arrhythmias

57
Q

What occurs in the third stage of Lyme arthritis?

A

2-3 years after infection, chronic polyarthritis of large joints and possible encephalitis

58
Q

What are space occupying lesions?

A

SOL: pus, blood, tumor, or edema (things that are in an area where they shouldn’t be potentially causing problems)

59
Q

Are primary joint neoplasms rare or common?

A

Very rare and most commonly benign

60
Q

Which is more common: tumor like lesions or neoplasia in joints?

A

Tumor like lesions

61
Q

What are the two examples of tumor like lesions?

A

Ganglion or synovial cyst

62
Q

What is the common location for a ganglion?

A

Wrist

63
Q

What makes up a ganglion?

A

Degenerative connective tissue

64
Q

What is the name of a synovial cyst in the popliteal region?

A

Baker’s cyst

65
Q

What is the difference between a ganglion and a synovial cyst?

A

Communication with the synovium is present in synovial cysts only

66
Q

What is the typical age for tenosynovial giant cell tumors?

A

20-50 years

67
Q

What joint condition involves an aggressive benign tumor?

A

Tenosynovial giant cell tumor (TGCT)

68
Q

What is the type of TGCT that is larger?

A

Diffuse TGCT (pigmented villonodular synovitis)

69
Q

Which type of TGCT is smaller and involved with the tendon sheaths?

A

Localized TGCT

70
Q

What is the common location for diffuse TGCT?

A

Knee

71
Q

What is the common location for localized TGCT?

A

Hand

72
Q

What is the most common soft tissue tumor of the hand?

A

Localized TGCT

73
Q

Tumors of adipose, fibrous, muscle, vessels, or the PNS are what kind of tumors?

A

Soft tissue tumors

74
Q

Are soft tissue tumors usually benign or malignant?

A

Benign (100X)

75
Q

If a soft tissue tumor is malignant, what is it called?

A

Soft tissue sarcoma

76
Q

What is the most common area for a soft tissue tumor or sarcoma?

A

Thigh (but can occur anywhere)

77
Q

What is the exception for a location where soft tissue tumors are more likely to be malignant than benign?

A

Skeletal muscle

78
Q

What is a benign tumor of adipocytes?

A

Lipoma

79
Q

What is a malignant tumor of adipocytes?

A

Liposarcoma

80
Q

What is the most common type of soft tissue tumor of adults?

A

Lipoma

81
Q

What type of soft tissue tumor is likely to be encapsulated?

A

Lipoma

82
Q

What is the usual age range for liposarcomas?

A

40-50

83
Q

What is the location for possible metastasis for a liposarcoma?

A

Lungs

84
Q

What is the usual location for liposarcomas?

A

Retroperitoneum, thigh

85
Q

What is the genetic factor of liposarcomas?

A

Degraded p53 resulting from a translocation of chromosomes 12 and 16

86
Q

What is the term for a reactive fibroblastic mass?

A

Nodular fasciitis

87
Q

What is the usual location for a nodular fasciitis?

A

Volar (Palm-side) of arm, chest, back

88
Q

Nodular fasciitis tends to result from what kind of event?

A

Trauma (10-15%)

89
Q

What is the term for reactive metaplastic bone?

A

Myositis ossificans

90
Q

What is the most common location for myositis ossificans?

A

Proximal extremity muscles

91
Q

A hard, painless mass is characteristic of what kind of fibrous tumor like mass?

A

Myositis ossificans

92
Q

What condition should you attempt to rule out when suspicious of myositis ossificans due to their similarities in appearance?

A

Osteosarcoma

93
Q

Myositis ossificans is common among what group of people?

A

Adolescent athletes

94
Q

What type of fibrous like tumor mass is benign but locally invasive that tends to commonly recur?

A

Finromatosis

95
Q

Dupuytren contracture and Peyronie disease are examples of what kind of fibromatosis?

A

Superficial

96
Q

What is the most common age for superficial fibromatosis?

A

40-70

97
Q

What another term for deep fibromatosis?

A

Desmoid tumor

98
Q

Where are desmoid tumors or deep fibromatoses most commonly found?

A

Abdominal area

99
Q

Which type of fibromatosis is associated with Gardner Syndrome?

A

Deep

100
Q

What is the term for a slow growing, malignant fibrous like tumor mass?

A

Fibrosarcoma

101
Q

What are the usual locations for fibrosarcomas?

A

Thigh, retroperitoneum, knee

102
Q

What is the most common age for fibrosarcomas?

A

35-55

103
Q

Neoplastic fibroblasts and anaplastic spindle cells are associated with what kind of fibrous like tumor mass?

A

Fibrosarcomas

104
Q

25% of fibrosarcomas metastasize hematogenously to what location, most commonly,

A

Lungs

105
Q

Herringbone pattern is associated with what fibrous like mass tumor?

A

Fibrosarcomas

106
Q

What are skeletal muscle precursors?

A

Rhabdomyoblasts

107
Q

What is the term for a malignant and aggressive skeletal muscle tumor?

A

Rhabdomyosarcoma

108
Q

What is the most common location generally and specifically for rhabdomyosarcomas?

A

Generally in areas with little skeletal muscle. Specifically in the areas of the head and neck

109
Q

What are other locations for rhabdomyosarcomas?

A

Genitourinary, extremities, trunk

110
Q

What is the most common pediatric soft tissue sarcoma?

A

Rhabdomyosarcoma

111
Q

What changes with the prognosis for adults with rhabdomyosarcomas?

A

Poor prognosis (2/3 of pediatrics will be 100% cured)

112
Q

What is the term for a benign smooth muscle tumor?

A

Leiomyoma

113
Q

What is the term for a malignant smooth muscle tumor?

A

Leiomyosarcoma

114
Q

What is the most common location for a leiomyoma?

A

Uterus (often called fibroids)

115
Q

What population is more at risk for leiomyosarcomas?

A

Adult females

116
Q

What is a unique common area for leiomyosarcomas?

A

Inferior vena cava (retroperitoneum or extremities)

117
Q

Spindle cells and cigar shaped nuclei are associated with what kind of smooth muscle tumor?

A

Leiomyosarcomas

118
Q

What makes up 10% of all soft tissue sarcomas?

A

Synovial sarcomas

119
Q

What is the most common age range for synovial sarcomas?

A

20-40 years

120
Q

What is the unique pattern of growth associated with synovial sarcomas?

A

Cells grow in solid cords or aggregates

121
Q

Why is synovial sarcoma an inappropriate name?

A

Only <10% of cases actually are intra-articular

122
Q

What is the most common location for a synovial sarcoma?

A

Knee (60-70%)

123
Q

What is the treatment for synovial sarcomas?

A

Limb-sparing surgery and chemotherapy

124
Q

What is the usual survivability for those with synovial sarcomas?

A

10 year survivability of 10-30%

Systems Pathology Exam One (7 decks)

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