Final review Flashcards
(230 cards)
1
Q
What does the word lentigo mean?
A
small, pigmented spots on skin with clearly defined edge surrounded my normal appearing skin
2
Q
what is ment by the word nevus
A
nest, melanocytic nevi are nests of multi layered melanocytes found in moles.
3
Q
what is a nevocellular nevi?
A
benign tumors of melanocyts that have sharp well defined edges stable in shape size and golor.
4
Q
what is a dysplastic nevi?
A
Larger tumor of melanocytes that have irregular borders and pigment variation., changing in size, elevated and firm.
5
Q
dysplastic nevus syndrome?
A
autosomal dominant conditions that give one and increased risk of melanoma
6
Q
what can acanthosis nigricans be an indication of?
A
hyperinsuleniema associated with obesity or sometimes assiciated with a malignancy
7
Q
what is seborrheic keratosis
A
stuck on keratin filled epidermal speudocysit
8
Q
what is is called when you suddenly get a lot of seborrheic kerotosis lesions?
A
signs of leser-trelat, may indicate a underlying malignance
9
Q
What is the test for Psorisis?
A
Auspits sign, scrape away scale and there is pinpoint bleeding
10
Q
What is the test for Pemphigus?
A
Nikolskis sign, pressing on blister causes the edges to easily expand and its very breakable.
11
Q
What causes pemphigus?
A
IgG between epidermal keratinocytes that cause blisters
12
Q
bullae?
A
blisters
13
Q
what can be a hallmark feature of pemphigus?
A
intraepidermal acanthosysis
14
Q
what happens if you use steroids on tenia, fungal infections.
A
it will go away for a bit then come back with a vengance.
15
Q
why does steroids not work on fungus?
A
because it decreases the immune system so the fungus can get a better foothold.
16
Q
erythema multiforme?
A
Hypersensitivity to drugs or something, targoid lesions, bullae.
17
Q
what is the most serious form of erythema multiforme?
A
stevens johnson syndrome, extensive involvement of skin and mucus membranes.
18
Q
Erythema nodosom?
A
shins, 12-20 year olds, raised erythematous (red) painfull nodules of subcutaneous fat.
19
Q
what is erythema nodosom sometimes associate with?
A
granulomatous diseases and strep, although most of the time there is no known cause, it goes away on its own eventually.
20
Q
What layers are involved in Squamous cell carcinoma?
A
Keratinocytes invade down into the dermis, rarely metastasize.
21
Q
what is indicative of keratocanthoma?
A
rapidly growing dome shaped nodules with a keratin filed center
22
Q
what ususally will cure SCC?
A
complete excision
23
Q
what is the most common tumor in the western world?
A
Basal cell carcinoma
24
Q
how invasives is basal cell carcinoma?
A
locally invasive, arising from basal cells of hair follicles
25
what does basal cell carcinoma look like
pearly borders, papules.
26
what is the growth pattern of BSC?
invasive nests of basaloid cells with a palisading growth pattern
27
Pathology
study of the essential nature and charasteristic of disease, signs, symptoms, complications, patogenesis etc.
28
disease
impairment of the noamal states
29
homeostasis
maitenance of a harmonious environmet within body, cell, etc
30
comorbidity
property of disease that gives it a a specific virulence/sequelae
31
iatrogenic
doctor aquired disease
32
symptoms
subjective from patient view
33
signs
objective from doctors view
34
death
no pulse, heart sound or spontaneous respiration, no nucleus in most cells a cell either
35
sub-clinical
no signs or symptoms of infection because the immune system is keeping the infection down
36
illness
unhealthy condition of the body or mind (sickness/disease)
37
etiology
underlying cause of disease
38
pathogenesis
course that a disease takes from start to finish
39
Morphology
presence/conformation of damaged cells and tissues from the infection
40
functional disease
what happens when we know the disease exists but have not discovered any gross or microscopic morphologic changes yet.
41
syndrome
group of signs and symptoms that occur together and characterize a particular abnormality or condition.
42
Eosin
RED and PINK :stains cytoplasm, RBCs and collagen
43
Hematoxylin
BLUE and PURPLE : unclei, bacteria
44
what are the common causes of cell injury?
hypoxia, infections, immunologic reactions, congenital disorders, chemical injury, physical injory
45
what is the most common cause of cellular injury
hypoxia, inability to synthesize sufficient ATP by aerobic oxidation
46
How do infections cause injury?
direct infection, toxins and inflammatory responses of host
47
Vit A
squamous metaplasia, immune deficiency, night blindness
48
Cit C
scurvy
49
vit D
rickets, osteomalacia
50
Vit K
bleeding diathesis
51
Vit B12
megaloblastic anemia, neuropathy, spinal cord degeneration
52
Folate, B9
megaloblastic anemia, neural tube defects
53
Niacin, B3
pellagra, diarrhea, dermatitis dementia and death
54
when does cloudy swelling occur?
intracellular proteins accumulate in cytoplasm, the leaking is from hypoxia and cellular degeneration.
55
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,
56
where do free radicals come from?
oxygen derived, uv light, metabolism, inflammation, smoking, ionizing radiation, air polution
57
what does the release of cytocrome C causes?
triggers apoptosis
58
what releases cytocrome C and why?
Mitochondria when its disfunctional and cant make enough atp it becomes permeable.
59
what pumps fail in mitochondria causing and influx of Na/ water and efflux of K
Na/K ATPase pumps start to fail
60
pyknosis is what?
degeneration and condensation of necular chromatin
61
Karyorrhexis is what?
nuclear fragmentation,
62
karyolysis is?
dissolution of nucleus
63
what is the significance of anaplasia
cells divide rapidly but do not bear any resemblance to the normal cells, whether in structure or function.
64
What are the two chief findings of anaplasia?
brick like or random pattern, with dramatic increase of nuclear:cytoplasmic ratio.
65
Primay intentions closure
wound edges are close enough to meet and close, decreases scarring
66
Secondary intention closure
wound edges are far apart, so fills from bottom up with granulous tissue and fibrin
67
tertiary intention closure
keep would open to prevent infection etc so can close later
68
hypoplasia
defective formation or incomplete development of a part
69
agenesis iis what?
absence or failure of formation entirely
70
what is another name for primay stem cells?
labile
71
where are labile, primary stem cells found?
in epidermis, GI tract, etc, and are continuously dividing
72
Stable stem cells are what?
low replication but can be induced to divide
73
what stem cell type is found in hepatocytes, renal tubular epithelia, alveoli and pancreatic acini
stable stem cells
74
Where are permanent stem cells found?
don't ever divide, are found in nerve cells, cardiac and skeletal muscles.
75
what are the three stages of fracture healing?
procallous, fibrocartilaginous callous, osseus callous
76
procallous
hematoma to provide anchorage but w/o structureal integrity
77
fibrocartilaginous callous
fibrous ball around fracture
78
pathologic fractures
caused by disease sequale, like osteoporosis etc
79
traumatic fractures
cause by trauma
80
type of traumatic fractures?
transverse, linear, non-displaced, comminutes, greenstick, spiral, compound
81
communited fracture
bone broken into many pieces
82
Karyotype
number and visual appearance of the chromosomes in the cell nuclei of an organism or species
83
ideogram
schematic representation of chromosomes showing the relative size of the chromosomes and their banding patterns
84
P arm?
short arm
85
Q arm
long arm
86
how many pairs of autosomes
22 pairs of autosomes
87
how many total pairs of chromosomes
23 pairs total.
88
gene once ment what ?
only protein coding sequence of DNA
89
what is a gene now?
any functional unit of a chromosome outside medical circles.
90
what percent of genome is protein coding?
only about 5%
91
what is locus on chromosome?
exact physical location of a gene on a chromosome, it the same in all people
92
alleles?
used to describe the two or more possible variations of a gene within a population
93
genotype
combo of alleles, it?s the actual sequence
94
penotype
the physical reflection of genotype, presence or absence
95
what is a single nucleotide polymorphism, SNP?
DNA sequence variation of single nucleotide between members of a species or paired chromosomes.
96
where does SNPs occur more often
in non coding reions
97
Imprinting of X chromosome
Naturally occuring in females, X inactivation. Only one of the two X chromosomes will be active in cell.
98
Imprinting in general
some genes are only active when transmitted by specific sexed parent, so in the other partent its inactived.
99
when does imprinting of autosomal genes happen?
during gametogenesis and its maintained in somatic cells.
100
what are the 5 points of control for gene expression?
chromatin, transcriptional, translational, post transcript, translate
101
why would dna wrap around histones
DNA is negative and histones are positively charged.
102
where does histone methylation occur
at CpG islands, it ususally down regulates transcription
103
what does histone acetylation do?
up regulating of transcricption cuz it allow unwinding of DNA from histone.
104
what is promoter region?
CpG islands ususally, where the polymerase is told to sit down and get ready to copy
105
transudate
edema fluid with low protein content and low specific gravity, produces non pitting edema
106
exudates
fluid with high protein content and cells and a higher specific gravity
107
what are the three parts of virchows triad?
hypercoagulability, stasis and vascular wall injury
108
What causes hypercoaguability?
clotting disorders, oral contraceptives, malignancy, pregnancy sepsis
109
what causes stasis?
atrial fibrillation, immobility, venous obstruction, venous insufficency,
110
vascular wall injury?
trauma/surgery, venepuncture, heart valve disease, replcement, atherosclerosos, catherters.
111
embolism
moving clot in bloodstream that leaves site of orgin and it occludes vessel
112
what is thrombosis?
non moving clot in arteries, heart chambers, causings infarct, etc.
113
when do fat emboli happen?
bone fractures
114
most common thrombosis?
thromboemboli
115
gas emboli
decompression sickness
116
amniotic fluid emboli
labor complications
117
tumor emboli
bacteria, drug use
118
where do most pulmonary emboli arise from
deep vein thrombosis, diagnosed by spiral CT
119
what is the most common outcome from pulmonary emboli?
nothing, 75% are asymptomatic and go away on their own
120
newspaper test?
transeudate fluid is if you can read news paper through test tube of fluid
121
countries with highes HIV?
African, South africa, nigeria, kenya Mozambique and india
122
why do 10% of hemopheliacs not progress to AIDS
maybe they don't have CCR5 receptors
123
Acute phase of HIV
infection, reduced CD4 with viremia, seroconversion, mono, flulike symptoms
124
lantent phase HIV
lymphadenopathy, viral replication. Low virema, oppurtunistic infection, 10 years
125
what are the two neoplasms that are often seen in AIDS
hairy leukoplakia and kaposi sarcoma, then non hodgkin lymhoma
126
what labs to monitor HIV infection
CD4 count, and HIV1 RNA viral load via PCR
127
what is a mitotic body?
they are the dividing cells in a tissue
128
what do mitotic bodies tell you about cancer?
if there are more mitotic bodies than their should be for specific tissue then you would know tissue was dividing more rapidly and suspect cancer
129
where do sarcomas arise
muscles and connective tissue
130
how do sarcomas spread
blood stream
131
where do carcinomas arise?
epithelium
132
how do carcinomas spread?
lymphatic system
133
what is an adenocarcinoma?
glandular cancer
134
what cells are most sensitive to ionizing radiation?
cells in mitosis or the G2 phase, the are replicating their genome
135
does oma mean the cancer or not?
OMA means swelling or tumor, it doesn't indicate cancer one way or the other.
136
Ames test
detects mutagenic effect on DNA, doesn't show epigenetic changes
137
what cancer kills most males?
hepatocellular carcinoma
138
what cancer kills most females?
cervical cancer
139
when does cancer peak in first world?
80-84 years
140
MEN I
pitutary adenoma, parathyroid hyperplasia and pancreatic tumors.
141
MEN II
parathyroid hyperplasia, phenochromocytoma, medullary thyroid carcinoma.
142
MEN IIB
mucosal neuromas, marfinaoid body habitis, pheochromocytoma, meullary thyroid carcinoma,
143
what does MEN stand for?
multiple endocrine neoplasia, a familiar cancer syndrome
144
paraneoplastic syndrome
may serve as signal for neoplastic diagnosis, when neoplasm is causing a change but its something that isn't directly related to tumor growth, like suddenly you are super tired all the time, it may be hormonal
145
preneoplastic disorders
Acquired (hep B) - increase liklyhood of reaching a cancerous stage and corelate directly with cancer, HepB,
146
direct acting Initiatior is what?
direct acting chemical carcinogens that modify DNA to cause cancer,
147
Indirect initiatior is what?
chemical carcinogen gets altered by our body to become an active carcinogen
148
genotoxic mechanisms
employ DNA damage, chromosomal misentegration
149
non-genotoxic mechanisnm
Employ chronic irrication, cell death ROS , epigenetic to cause problems.
150
what does a person look for to find promoter region?
Promoter region alterations, these alterations have been found in all cancers that have been studies.
151
what type of solar radiation is most carcinogenic?
UVB
152
how does UVB cause cancer
produces dyrimidine dimers in DNA leading to transcritional errors and mutations of proto-oncogenes and tumor supressor genes.
153
what type of radaions used in hospital
ioniing ratiation
154
what is neutron radiation not used?
because governments have outlawed it because they don't want it used against them.
155
what are the three activities are protoonca genes involved in?
growth, cellular differentiation, gene regulation
156
gain of function
oncogenes, one hit process, create more active protein to stimulate cell cycle
157
loss of function
tumor supressors, two hit process, creates no active proteins , inhibits cell cycle
158
how do viruses cause cancer or tumors
by carrying in oncogenes or by incerting into a tumor supressor gene and breaking it.
159
why may two of the same cancers at same stage in two people progress different?
because at each cell divisions, mutations make each cancer different. They may have starteted the same but will continue to be even more different. So one may be hormone sensitive but the other wont
160
7 thing to make tumor be malignant
self sufficent, insufficient inhibitory signals, evade apoptosis, limitless replication, sustained angiogensis, ability to invade, and defects in DNA repair
161
what is the guardian of the genome?
P53
162
where does P53 work?
prevents cell with damaged DNA from entering the S phase.
163
Li-fraumeni syndrome?
germ line rotation of p53, it increases rates of tumors, childhood sarcomas leukemia, breast cancer
164
what two genes regulate apoptosis?
P53 promotes apoptosis and BCL-2 inhibits apoptosis
165
what is the limit of fine needle aspiration?
Does grading (histology) well, it cant determine staging (size, metastisist)it will show that there are cell changes but cant tell if its moved, can't determine stage
166
what is an abnormal vein growth
non fractal growth pattern, it looks evil and twisted.
167
name two nonoclonal antibodies?
CA-125 and CA 19-9
168
CA-125 non clonal antibody for what?
ovarian cancer
169
CA-19-9 non clonal antibody for what
pancreatic cancer
170
BRCA -1
brest cancer
171
tumor grading
more histological and not prognosis indicatior
172
tumor staging
T is size, N is lympnode spread, M is mestatic.
173
TNM is what?
degree of size, lymNode and metastasis, indicator of prognosis
174
grade 4 cancer means?
glands are fuses, no intervening stroma
175
Stage 4 cancer means
metastasis - spreading, poor prognosis
176
Genetic instability in tumor supression
malignant cells are more prone to mutate and accumulate additional defects without dying.
177
what does genetic instability mean for cancer reoccurance
there was a selective growth advantage for the new cancer, so will more resistance to treatment etc.
178
seeding
spread within the same cavity/chamber
179
transplantation
no clean margins, surgical insision could spread by indroducing cell toblood
180
sister mary joseph
discovered periumbical nodes correlated to pancreatic cancer
181
what three cancers like to move to brain
skin, breast and lung
182
what threee cancers like to move to bone
breast lung and prostate then kidney and thyroid
183
what causes osteoblastic lesions
prostate cancer - builds bumps on bone
184
What causes osteolytic lesions
renal and breast cancers - thins out bone
185
how could you test for metastasis to spine?
tuning fork
186
Induction treatment
only treatment, used for advanced disease or when no other treatment exhists
187
Neoadjuvant
chemo first, followed by another treatment
188
adjuvant
combination with other modality, given after other treatments are used.
189
salvage
hail mary, for those that fail to respond to initial chemo
190
what tumors are more sensitive to XRT (radiosensitive)
seminomas and lymphomas - because their cells have high turnover
191
what tumor cells are radio resistane
epithelial and carcomas, because they have a lower cell turnover
192
NCCN?
national comprehensive cancer network, shows staging and therapies for it.
193
bitter almonds
cyanide
194
friity
diabetic
195
garlic
organophosphates, arsenic, DMSO
196
mothballs
naphthalene, camphor
197
how often do patients with CO poisoning turn red
not very often but it does cause blood to be very red even though its not carrying oxygen
198
what poisoning often happens in conjunction with CO poisoning
cyanide poising because of the burning furniture in fires.
199
what is ment by heavy metals
metals or metalloids of environmental concern, denser than iron
200
Do radioisotopes bioconcentrate
yes, they do as they are eaten and move up the food chain.
201
before what date should things not have cesium?
before 1924
202
how can you increase toxicity of HG
methylate it and it becomes more water soluble and can cross the BBB.
203
what are the two main toxicities of mercury poisoning?
neruotoxicity (brain) and nephrotoxicity (kidney
204
is arsinic always poisonous?
no it can be in some species genome
205
what does acure arsenic poisoning cause?
CAN toxicity and hemorragic gastroenteritis
206
what does chronic arsenic cause
malaise, abdominal pain, skin changes, mees lines.
207
mees lines arsenic
horixontal white lines on nails
208
what do lead lines look like
they are not on nails they are at the gingivodental line
209
why is lead worse for children
CNS toxicity,
210
Pica
desire to eat dirt or ice, may be genetic condition
211
basophilic stippling?
seen with microcytic anemia in lead poisoning. Ribosome are spread showing small dots at periphery
212
why do those who start smoking at 30+ not get COPD
because they thart after epithelial transition ends at about 20. this also makes it so that cumulative effects take longer
213
what is the 20 pack year thing.
packs per day times years smoking. 20 = cancer in the othd view.
214
what illness can second hand smoke cause in children
sids, otitis media and asthma/URI
215
what is photochemical smog?
chemical reaction of sun, NO, and VOCs in atmosphere leading to ground level ozones and particles and aldehydes, Nos
216
what was in smog in 1905?
soot, and sulfer from burining coal
217
how is ozone formed?
in atmosphere when NO is broken by sun, and some os for osone.
218
why is silicosis the most common pneumoconiosis?
caused by inhalation of dust or pollutants in smok with silica
219
sillicoderosis
inhale dust and sillica, swelling of lungs
220
caplans syndrome
pneumoconiosis in combination with multiple pulmonary rheumatoid nodes found in rheumatoid arthritis.
221
silicates
adding another atom to silica to make mineral
222
silicon
chemical element, but almost always in combo with O2
223
silicone
polymer of silicone with C and O. solid liquid or gel
224
Pathogonomic
symptom/sign that is character of diesase, that will tell you a specific disease without a doubt
225
what is eggshell calcification
indicates silicosis on an xray, it is pathogonomonic
226
why does inhaling particles cause fibrosis?
magrophage igestion trigger frbrogenic respons via growth factors, promote collagen deposition
227
where do asbestose fibers localize
in septum of alveolus and distal lung.
228
what are asbestosed fibers in lungs cause
rod or dumbell shaped
229
cancer of asbestose
mesothelioma that involves lower lobes and pleura
230
asbestose exposure increases lung cancer by how much
5 times then 55 times if the ysmoke to.
