Extra Q Flashcards

1
Q

Example for Dysplasia

A

Cervical Intraepithelial Neoplasia

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2
Q

Edema=

A

Increased in interstitial fluid

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3
Q

Virchow’s triad

A

Hypercuagulability
Endothelail injury
Stasis

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4
Q

Inflammation that causes blood clot to block a vein=

A

Thrombophlebitis

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5
Q

Systemic HTN= ______ mmHg

A

> 140/90mmHg

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6
Q

Etiology of primary HTN

A

95% unknown

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7
Q

Common cause of secondary HTN

A

Renal artery stenosis

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8
Q

How does Renal artery stenosis leads to HTN

A

Stenosis decreases blood flow to glomeruli
Renin secretion
AT-2 raises BP
Release of Aldos.

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9
Q

Commonly afected by atherosclerosis

A

Abdominal aorta
Coronary a
Internal carotid
Popliteal

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10
Q

Complication of atherosclerosis 4

A

Stenosis
Thrombosis
Enbolism
Weakening and aneurysm

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11
Q

Arteriolosclerosis is devided into 2

A

Hyaline

Htperplastic

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12
Q

Htperplastic Arteriolosclerosis=

A

Thickening of vessel wall by hyperplasia of SMC

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13
Q

Calcification of the media of muscular vessels is called

A

Monckeberg medial sclerosis

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14
Q

Aortic dissection=

A

Intimal tear with dissection of blood through media of the aortic wall

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15
Q

In Polyarteritis Nodosa what types of lesions are present?

A

Lesions of varying stages are present.

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16
Q

What is the treatment for Kawasaki disease?

A

Aspirin

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17
Q

Polyarteritis Nodosa classic presentation

A

HTN in young adults

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18
Q

How does the early lesion of Polyarteritis Nodosa appear on imaging?

A

String on pearls

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19
Q

Buerger disease treatment

A

Stop smoking

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20
Q

What is Churg-Strauss Syndrome?

A

Necrotizing granulomatous inflammation with eosinophils involving multiple organs, especially lungs and heart
Asthma!!

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21
Q

In which vasculitis can we find eosinophilia?

A

Churg-Strauss Syndrome

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22
Q

In Kawasaki disease involvement of what is common and what does this usually lead to?

A

MI

ילד שנוסע על אופנוע זה באח יגרום לאמא שלו לחטוף התקף לבב

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23
Q

What is Henoch-Schönlein Purpura?

A

Vasculitis due to IgA immune complex deposition

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24
Q

What are fatty streaks?

A

flat yellow lesions of the intima consisting of lipid-laden macrophages

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25
Q

How can HTN lead to aortic dissection?

A

Hypertension results in hyaline arteriosclerosis of the vasa vasorum; decreased flow causes atrophy of the media.

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26
Q

What is hyperplasia driven by?

Breast during pregnancy

A

estrogen and progesterone produced by the corpus luteum

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27
Q

Inflammation of the breat (4)

A

Acute mastitis, periductal mastitis, mammary duct ectasia, fat necrosis

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28
Q

Breast fibrocystic change will present as what in physical exam?

A

Lumpy breast

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29
Q

For what type of fibrocystic change is there no increased risk for carcinoma?

A

Fibrosis, cysts, and apocrine metaplasia

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30
Q

For what type of fibrocystic change is there 2x increased risk for carcinoma?

A

Ductal hyperplasia and sclerosing adenosis

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31
Q

For what type of fibrocystic change is there 5x increased risk for carcinoma?

A

Atypical hyperplasia

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32
Q

What is phyllodes tumor?

A

Fibroadenoma-like tumor with overgrowth of the fibrous component

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33
Q

biopsy of phyllodes tumor histo features?

A

Leaf like structure

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34
Q

What are the histologic subtypes of DCIS based on?

A

architecture; comedo type is characterized by high-grade cells with necrosis and dystrophic calcification in the center of ducts

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35
Q

Breast cancer

A
DCIS
Invasive ductal carcinoma
Lobular Carcinoma In Situ
Invasive lobular carcinoma
Hereditary breast cancer
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36
Q

Subtypes of Invasive ductal carcinoma

A

Tubular
Mucinus
Medullary
Inflammatory

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37
Q

Which cancer is the most common invasive cancer of the breast?

A

Invasive ductal carcinoma

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38
Q

What is the most important predictive factor for breast cancer?

A

estrogen receptor (ER), progesterone receptor (PR), and HER2/neu gene amplification (overexpression) status

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39
Q

Antiestrogenic agent=

A

Temoxifen

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40
Q

What is HER2/neu?

A

Growth factor-R present on the cell surface

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41
Q

Common screening methods include

A
  1. Pap smear 2. Mammography 3. PSA and DRE 4. Hemoccult test and colonoscopy
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42
Q

Categories of oncogenes include

A

growth factors, growth factor receptors, signal transducers, nuclear regulators, and cell cycle regulators

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43
Q

Nitrosamines

Where are they found and what cancer they produce?

A

Stomach carcinoma, Found in smoked foods, responsible for high rate of stomach carcinoma in japan

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44
Q

Naplithylamine

Where are they found and what cancer they produce?

A

Urothelial carcinoma of bladder. Derived from cigarette smoke

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45
Q

The cyclin D / CDK4 complex does what?

A

phosphorylates the retinoblastoma protein, which promotes progression through the G-S checkpoint

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46
Q

RET

A

Neural growth factor receptor, Point mutation MEN 2A, MEN 2B and sporadic medullary carcinoma of thyroid

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47
Q

RET

A

Neural growth factor receptor, Point mutation MEN 2A, MEN 2B and sporadic medullary carcinoma of thyroid

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48
Q

How does p53 induce apoptosis?

A

upregulates BAX, which disrupts Bcl2 leading to cytochrome c leaks from the mitochondria activating apoptosis

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49
Q

p53 Germline mutation results in

A

Li-Fraumani syndrome

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50
Q

Hematogenous spread is characteristic of what?

A

sarcomas and some carcinomas

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51
Q

What are some examples of hematogenous spread?

A

renal cell carcinoma, hepatocellular carcinoma, follicular carcimoma of the thyroid, choriocarcinoma

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52
Q

What is the target cell type for the immunohistochemical stain of chromogranin?

A

neuroendocrine cells (small cell carcinoma of lung and carcinoid tumors)

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53
Q

What is the target cell type for the immunohistochemical stain of S-100?

A

Melanoma
Schwannomas
Neurofibromas

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54
Q

What is aspirin-intolerant asthma characterized by?

A

the triad of asthma, aspirin induced bronchospasms, and nasal polyps

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55
Q

What is usually the difference between papillomas in adults children?

A

Single in adults

Multiple in children

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56
Q

What are the risk factors for laryngeal carcinoma?

A

Alcohol
Smoking
Rarely laryngeal papilloma

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57
Q

laryngeal carcinoma cancer type

A

Squamous cell carcinoma

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58
Q

What are the most common causes for lobar pneumonia?

A

Strep. Pneumo

Klebsiella

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59
Q

What are the classic gross phases of lobar pneumonia? (4)

A

Congestion
Red hepatization
Grey hepatization
Rezolution

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60
Q

What are the causes of bronchopneumonia?

A

Staphylococcus aureus, haemophilus influenzae, Pseudomonas aeruginosa, Moraxella calarrhalis, Legionella pnemnophila

61
Q

What does aspiration pneumonia classically result in?

A

Right lower lobe abscess

62
Q

What does primary TB result in?

A

focal, caseating necrosis in the lower lobe of the lung and hilar lymph nodes that undergoes fibrosis and calcification, forming a Ghon complex

63
Q

What does biopsy in secondary TB reveal?

A

caseating granulomas, AFB stain reveals acid-fast bacilli

64
Q

What does chronic bronchitis lead to?

A

increased thickness of mucus glands relative to overall bronchial wall thickness (Reid index increases to > 50%; normal is < 40%)

65
Q

What does inflammation in the lung normally lead to?

A

release of proteases by neutrophils and macrophages.

66
Q

What are the clinical features of emphysema?

A
  1. Dyspnea and cough with minimal sputum 2. Prolonged expiration with pursed lips (pink-pu lier) 3. Weight loss 4. Increased anterior-posterior diameter of chest (barrel-chest) 5. Hypoxemia and cor pulmonale (late complications)
67
Q

HSN I

A
**Soluble Ag
Ag cross linked IgE on mast cell
Degranulation
Histamine release
Chemokines
Inflammation
68
Q

HSN I examples

A

Allergic asthma

Anaphylaxis

69
Q

HSN II

A

Bound Ag
IgG or IgM binds cell surface Ag
Cell is opsonized and phagocytosed
NK killing or complement

70
Q

HSN II examples

A

Rheumatic fever
MG
Graves disease
Transfusion reaction

71
Q

HSN III

A

Ab-Ag complex activates complement

Attracts Neut.

72
Q

HSN III examples

A

SLE
Polyarthritis nodosa
PSGN

73
Q

HSN IV

A

CD8 T cell kill target cells

74
Q

HSN IV examples 4T’s

A

T cells
Transplant rejection
TB skin test
Touching (contact dermatitis)

75
Q

SLE is type __ HSN

A

III

and also II

76
Q

SLE is associated with what deficiency?

A

Early complement proteins

77
Q

Early complement proteins deficiency in SLE will cause

A

Decreased clearance of Ab-Ag complex

78
Q

SLE symp mnemonic

A

RASH ON PAIN

Rash
Arthritis
Serositis
Hematologic
Oral ulcers
Renal disease
Photosensativity
ANA Ab
Immunologic disorders
Neurologic
79
Q

SLE causes what heart problem

A

Libman Sacks endocarditis

Nonbacterial

80
Q

Whic Ab can we find in Sjorgen syndrome

A

Anti-Ro

Anti-La

81
Q

Sjorgen syndrome=

A

Autoimmune disorder charact. by destruction of exocrine glands by lymphocytic infiltrates
Lacrimal and salivary

סג’ורגן וואלה מייבש את הפה רק לומר את השם הזה

82
Q

Rejection to allografts is a response mainly to ___ molecules

A

MHC

83
Q

What are the types of rejection (4)

A

Hyperacute
Acute cellular rejection
Acute humoral rejection
Chronic rejection

84
Q

Hyperacute rejection=

A

Host Ab binds graft endotheliun
Thrombosis
Ischemic damage

85
Q

Acute cellular rejection=

A

T cell destroy graft parenchyma by cytotoxicity

86
Q

Acute humoral rejection=

A

Ab damage the graft vasculature

87
Q

Chronic rejection=

A

Arteriosclerosis by proliferation of SMC

88
Q

What leads to loss of contact inhibition in neoplasia?

A

Loss of E-cadherin

89
Q

Children cancer incidence

A

Leukemia
CNS
Neuroblastoma

90
Q

Four Carcinomas Rout Hematogenously

A

Follicular thyroid carcinoma
Choriocarcinoma
Renal cell carcinoma
Hepatocellular carcinoma

91
Q

Cancer that metastesize to Bone

A
Prostate
Breast
Kidney
Thyroid
Lung
92
Q

Oncogenes require how many alleles to be damages?

A

One is enough

93
Q

Oncogenes example

A

HER2/neu
JAK2
BCR-ABL
BCL-2

94
Q

BCL-2 is an

A

Antiapoptotic molecule

95
Q

BCL-2 in what cancers?

A

Follicular and diffused large B Cell Lymphoma (BCL)

96
Q

EGFR mutation can appear in which cancers?

A

Lung adenocarcinoma

Epit. tumr of head and neck

97
Q

Tumor suppressor genes example

A

APC
BRCA1/BRCA2
Rb
P53

98
Q

Mutation in APC leads to

A

Colorectal cancer

99
Q

Job of Rb

A

Inhibits E2F

Blocks G1->S phase

100
Q

Mutation in Rb leads to

A

Retinoblastoma

Osteosarcoma

101
Q

Mutation in P53 appears in most cncer but give examples

A

Li Fraumeni synd.: Sarcoma Breast Leukemia Adrenal gland

102
Q

Hereditary cancer syndromes (4)

A
Familial Adenomatous Polyposis
Lynch
Li-Fraumeni
Von-Hipple Lindau
MEN
103
Q

Familial Adenomatous Polyposis is due to

A

AD APC mutation

104
Q

Lynch synd. is also known as

A

Hereditary Nonpolyposis Colorecta Carcinoma

105
Q

Lynch syndrome is due to

A

Inherited mutation in DNA mismatch repair enzymes

עשו לינץ’ לאנזים שמתקן

106
Q

Li-Fraumeni synd is due to

A

P53 mutation

107
Q

VHL is due to

A

Abnormal growth of blood vessels due to VHL mutation

108
Q

VHL symp

A

Most commonly renal cell carcinoma

109
Q

MEN1-

A

Pituitary tumors
Pancreatic endocrine tumors
Parathyroid adenomas

110
Q

MEN2A-

A

Parathyroid hyperplasia
Medullary thyroid carcinoma
Pheochromocytoma

111
Q

MEN2B-

A

Medullary thyroid carcinoma

Pheochromocytoma

112
Q

Zollinger Ellison syndrome

A

Gastrin secreting tumor

113
Q

Define what happens in nephritic syndrome

A

Glomerular inflammation->GBM damage->Loss off RBC into urine->hematuria

114
Q

Define what happens in nephrotic syndrome

A

Podocytes damage->Impaired charge barrier->proteinuria

115
Q

What is pneumoconioses?

A

Interstitial fibrosis due to occupational exposure

116
Q

What is sarcoidosis?

A

Systemic disease characterized by noncaseating granulomas in multiple organs

117
Q

What happens in acute respiratory distress syndrome?

A

Leakage of protein-rich fluid leads to edema and formation of hyaline membranes in alveoli

118
Q

Why is acute respiratory distress syndrome secondary to so many diseases?

A

Activation of neutrophils induces protease-mediated and free radical damage of type 1 and II pneumocytes.

119
Q

What does surfactant do?

A

decreases surface tension in the lung, preventing collapse of alveolar air sacs after expiration

120
Q

Why is neonatal respiratory distress syndrome associated with maternal diabetes?

A

Insulin decreases surfactant production

121
Q

For lung cancer what are are particularly mutagenic? (from cigarrete)

A

Polycyclic aromatic hydrocarbons and arsenic

122
Q

Precents of small cell carcinoma of lung

Surgery or chemo?

A

15% of lung cancer

Chemo

123
Q

What are the subtypes of non-small cell carcinoma?

A

Adenocarcinoma 40%
Squamous cell carcinoma 30%
Large cell carcinoma
Carcinoid

124
Q

unique site of distant metastasis is the ____ in lung cancer

A

Adrenal gland.

125
Q

What is the characteristic histology for small cell carcinoma?

A

Poorly differentiated small cells; arises from neuroendocrine (Kulchitsky) cells

126
Q

What is the characteristic histology for Carcinoid tumor?

They are positive to

A

Well differentiated neuroendocrine cells; chromogranins positive

127
Q

What are psammoma bodies

A

Round collection of calcium

128
Q

What are the inflammatory dermatoses? (5)

A
Contact dermatitis
Atopyc dermatitis
Psoriasis
Acne vulgaris
Lichen planus
129
Q

Atopyc dermatitis

A

Pruritic, erythematous, oozing rash with vesicles and edema; often involves the face and flexor surfaces

130
Q

What is psoriasis due to

A

Excesss keratin

131
Q

Epidermal hyperplasia is also called

A

Acanthosis

132
Q

Blistering dermatoses (4)

A

Pemphigus vulgaris
Bollous pemphigoid
Dermatitis herpatiformis
Erythema multiforme

133
Q

Dermatitis herpatiformis=

A

IgA deposition on the tip of papillae

134
Q

Skin epithelial tumors

A

Seborrheic keratosis
Basal cell carcinoma
Squamous cell carcinoma

135
Q

Everything about seborrheic keratosis

A

Benign
Elderly
Raised discolored plaques
Keratin pseudocyst

136
Q

Most common cutaneous malignancy

A

Basal cell carcinoma

137
Q

Basal cell carcinoma skin histo

A

Nodules of basal cells with peripheral palisading

138
Q

Most common type of melanoma

A

Superficial spreading

139
Q

Phases of wound healing

A

Inflammatory- PLT,MPH,Neut.
Proliferative- Fibro,myo,endoth,kerati,MPH
Remodeling- Fibroblasts

140
Q

Repair=

A

Replacement of damaged tissue with fibrous scar

When regenerative cells are lost

141
Q

Inflammation types

A

Serous- watery, skin blister
Fibrinous- fibrin, pericarditis
Purulent- pus, abscesses

142
Q

Granulomatous inflamation

A

Type of chronic infl.
Activated MPH
Lymphocytes

143
Q

DiGeorge syndrome

A

Thymic hypopasia
Deficient T cell maturtion
Volunarble

144
Q

Polycythema Vera

A

Neoplastic proliferation of mature myeloid cells
Especially RBC
JAK2 mutation
Hyperviscosity

145
Q

Essential thrombocythemia

A

Neoplastic proliferation of mature myeloid cells
Especially PLT
JAK2 mutation
High risk for thrombosis

146
Q

Decrease number of Neut.

A

Neutropenia

147
Q

Multiple myeloma=

A
Overproduction of IgG
CRAB clinical features
HyperCalcemia
Renal involvenet
Anemia
Bone lesions
148
Q

Special feature of megaloblastic anemia

A

Hypersegmented neutrophils

149
Q

GIST

A

GastroIntestinal Stromal Tumor
Mesenchymal neoplasm
Arise from smooth muscle pacemaker cells of Cajal
KIT gene