final, old exams Flashcards
What does the word lentigo mean?
small, pigmented spots on skin with clearly defined edge surrounded my normal appearing skin
what is ment by the word nevus
nest, melanocytic nevi are nests of multi layered melanocytes found in moles.
what is a nevocellular nevi?
benign tumors of melanocyts that have sharp well defined edges stable in shape size and golor.
what is a dysplastic nevi?
Larger tumor of melanocytes that have irregular borders and pigment variation., changing in size, elevated and firm.
dysplastic nevus syndrome?
autosomal dominant conditions that give one and increased risk of melanoma
what can acanthosis nigricans be an indication of?
hyperinsuleniema associated with obesity or sometimes assiciated with a malignancy
what is seborrheic keratosis
stuck on keratin filled epidermal speudocysit
what is is called when you suddenly get a lot of seborrheic kerotosis lesions?
signs of leser-trelat, may indicate a underlying malignance
What is the test for Psorisis?
Auspits sign, scrape away scale and there is pinpoint bleeding
What is the test for Pemphigus?
Nikolskis sign, pressing on blister causes the edges to easily expand and its very breakable.
What causes pemphigus?
IgG between epidermal keratinocytes that cause blisters
bullae?
blisters
what can be a hallmark feature of pemphigus?
intraepidermal acanthosysis
what happens if you use steroids on tenia, fungal infections.
it will go away for a bit then come back with a vengance.
why does steroids not work on fungus?
because it decreases the immune system so the fungus can get a better foothold.
erythema multiforme?
Hypersensitivity to drugs or something, targoid lesions, bullae.
what is the most serious form of erythema multiforme?
stevens johnson syndrome, extensive involvement of skin and mucus membranes.
Erythema nodosom?
shins, 12-20 year olds, raised erythematous (red) painfull nodules of subcutaneous fat.
what is erythema nodosom sometimes associate with?
granulomatous diseases and strep, although most of the time there is no known cause, it goes away on its own eventually.
What layers are involved in Squamous cell carcinoma?
Keratinocytes invade down into the dermis, rarely metastasize.
what is indicative of keratocanthoma?
rapidly growing dome shaped nodules with a keratin filed center
what ususally will cure SCC?
complete excision
what is the most common tumor in the western world?
Basal cell carcinoma
how invasives is basal cell carcinoma?
locally invasive, arising from basal cells of hair follicles
what does basal cell carcinoma look like
pearly borders, papules.
what is the growth pattern of BSC?
invasive nests of basaloid cells with a palisading growth pattern
Pathology
study of the essential nature and charasteristic of disease, signs, symptoms, complications, patogenesis etc.
disease
impairment of the noamal states
homeostasis
maitenance of a harmonious environmet within body, cell, etc
comorbidity
simultaneous presence of one or more additional disorders that co-occur with primary disease. property of disease that gives it a a specific virulence/sequelae
iatrogenic
doctor aquired disease
symptoms
subjective from patient view
signs
objective from doctors view
death
no pulse, heart sound or spontaneous respiration, no nucleus in most cells a cell either
sub-clinical
no signs or symptoms of infection because the immune system is keeping the infection down
illness
unhealthy condition of the body or mind (sickness/disease)
etiology
underlying cause of disease
pathogenesis
course that a disease takes from start to finish
Morphology
presence/conformation of damaged cells and tissues from the infection
functional disease
when a disease is present that impairs bodily process but upon inspection, there are no changes or signs, even microscopically, IBS and migraines, maybe depression
syndrome
group of signs and symptoms that occur together and characterize a particular abnormality or condition.
Eosin
RED and PINK :stains cytoplasm, RBCs and collagen
Hematoxylin
BLUE and PURPLE : unclei, bacteria
what are the common causes of cell injury?
hypoxia, infections, immunologic reactions, congenital disorders, chemical injury, physical injory
what is the most common cause of cellular injury
hypoxia, inability to synthesize sufficient ATP by aerobic oxidation
How do infections cause injury?
direct infection, toxins and inflammatory responses of host
Vit A
squamous metaplasia, immune deficiency, night blindness
Cit C
scurvy
vit D
rickets, osteomalacia
Vit K
bleeding diathesis
Vit B12
megaloblastic anemia, neuropathy, spinal cord degeneration
Folate, B9
megaloblastic anemia, neural tube defects
Niacin, B3
pellagra, diarrhea, dermatitis dementia and death
when does cloudy swelling occur?
intracellular proteins accumulate in cytoplasm, the leaking is from hypoxia and cellular degeneration.
why does cloudy swelling occur?
cell is no longer able to maintain homeostasis of ionic and fluid balance. Lack of ATP shuts down necessary pumps,
where do free radicals come from?
oxygen derived, uv light, metabolism, inflammation, smoking, ionizing radiation, air polution
what does the release of cytocrome C causes?
triggers apoptosis
what releases cytocrome C and why?
Mitochondria when its disfunctional and cant make enough atp it becomes permeable.
what pumps fail in mitochondria causing and influx of Na/ water and efflux of K
Na/K ATPase pumps start to fail
pyknosis is what?
degeneration and condensation of necular chromatin
Karyorrhexis is what?
nuclear fragmentation,
karyolysis is?
dissolution of nucleus
what is the significance of anaplasia
cells divide rapidly but do not bear any resemblance to the normal cells, whether in structure or function.
What are the two chief findings of anaplasia?
brick like or random pattern, with dramatic increase of nuclear:cytoplasmic ratio.
Primay intentions closure
wound edges are close enough to meet and close, decreases scarring
Secondary intention closure
wound edges are far apart, so fills from bottom up with granulous tissue and fibrin
tertiary intention closure
keep would open to prevent infection etc so can close later
hypoplasia
defective formation or incomplete development of a part
agenesis iis what?
absence or failure of formation entirely
what is another name for primay stem cells?
labile
where are labile, primary stem cells found?
in epidermis, GI tract, etc, and are continuously dividing
Stable stem cells are what?
low replication but can be induced to divide
what stem cell type is found in hepatocytes, renal tubular epithelia, alveoli and pancreatic acini
stable stem cells
Where are permanent stem cells found?
don’t ever divide, are found in nerve cells, cardiac and skeletal muscles.
what are the three stages of fracture healing?
procallous, fibrocartilaginous callous, osseus callous
procallous
hematoma to provide anchorage but w/o structureal integrity
fibrocartilaginous callous
fibrous ball around fracture
pathologic fractures
caused by disease sequale, like osteoporosis etc
traumatic fractures
cause by trauma
type of traumatic fractures?
transverse, linear, non-displaced, comminutes, greenstick, spiral, compound
communited fracture
bone broken into many pieces
Karyotype
number and visual appearance of the chromosomes in the cell nuclei of an organism or species
ideogram
schematic representation of chromosomes showing the relative size of the chromosomes and their banding patterns
P arm?
short arm
Q arm
long arm
how many pairs of autosomes
22 pairs of autosomes
how many total pairs of chromosomes
23 pairs total.
gene once ment what ?
only protein coding sequence of DNA
what is a gene now?
any functional unit of a chromosome outside medical circles.
what percent of genome is protein coding?
only about 5%
what is locus on chromosome?
exact physical location of a gene on a chromosome, it the same in all people
alleles?
used to describe the two or more possible variations of a gene within a population
genotype
combo of alleles, it?s the actual sequence
penotype
the physical reflection of genotype, presence or absence
what is a single nucleotide polymorphism, SNP?
DNA sequence variation of single nucleotide between members of a species or paired chromosomes.
where does SNPs occur more often
in non coding reions
Imprinting of X chromosome
Naturally occuring in females, X inactivation. Only one of the two X chromosomes will be active in cell.
Imprinting in general
some genes are only active when transmitted by specific sexed parent, so in the other partent its inactived.
when does imprinting of autosomal genes happen?
during gametogenesis and its maintained in somatic cells.
what are the 5 points of control for gene expression?
chromatin, transcriptional, translational, post transcript, translate
why would dna wrap around histones
DNA is negative and histones are positively charged.
where does histone methylation occur
at CpG islands, it ususally down regulates transcription
what does histone acetylation do?
up regulating of transcricption cuz it allow unwinding of DNA from histone.
what is promoter region?
CpG islands ususally, where the polymerase is told to sit down and get ready to copy
transudate
edema fluid with low protein content and low specific gravity, produces non pitting edema
exudates
fluid with high protein content and cells and a higher specific gravity
what are the three parts of virchows triad?
hypercoagulability, stasis and vascular wall injury
What causes hypercoaguability?
clotting disorders, oral contraceptives, malignancy, pregnancy sepsis
what causes stasis?
atrial fibrillation, immobility, venous obstruction, venous insufficency,
vascular wall injury?
trauma/surgery, venepuncture, heart valve disease, replcement, atherosclerosos, catherters.
embolism
moving clot in bloodstream that leaves site of orgin and it occludes vessel
what is thrombosis?
non moving clot in arteries, heart chambers, causings infarct, etc.
when do fat emboli happen?
bone fractures
most common thrombosis?
thromboemboli
gas emboli
decompression sickness
amniotic fluid emboli
labor complications
tumor emboli
bacteria, drug use
where do most pulmonary emboli arise from
deep vein thrombosis, diagnosed by spiral CT
what is the most common outcome from pulmonary emboli?
nothing, 75% are asymptomatic and go away on their own
newspaper test?
transeudate fluid is if you can read news paper through test tube of fluid
countries with highes HIV?
African, South africa, nigeria, kenya Mozambique and india
why do 10% of hemopheliacs not progress to AIDS
maybe they don’t have CCR5 receptors
Acute phase of HIV
infection, reduced CD4 with viremia, seroconversion, mono, flulike symptoms
lantent phase HIV
lymphadenopathy, viral replication. Low virema, oppurtunistic infection, 10 years
what are the two neoplasms that are often seen in AIDS
hairy leukoplakia and kaposi sarcoma, then non hodgkin lymhoma
what labs to monitor HIV infection
CD4 count, and HIV1 RNA viral load via PCR
