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Pathology > General patho 0422Q > Flashcards

General patho 0422Q Flashcards

1
Q

what is a common complication of aspiration PNA?

A

LUNG ABSCESS

caused by anaerobic bacteria of gingivodental sulcus (fusobacterium, peptostreptococcus, bacteroides)

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2
Q

who gets aspiration PNA?

A

pts with impaired consciousness OR decreased ability to swallow (alcoholics, chronically ill, demented)

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3
Q

what sx are seen with lung abscess?

A

cough with copious foul-smelling sputum.

fever, malaise, weight loss, clubbing, leukocytosis.

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4
Q

where do lung abscesses most often develop?

A

RIGHT lung bc right bronchus is straighter

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5
Q

where does gastric cancer commonly met to?

A
  1. left supraclavicular sentinel node (Virchows node)
  2. periumbilical region (SQ mass - Sister Mary Joseph nodule)
  3. ovary (Krukenberg tumor)
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6
Q

Krukenberg tumor

A

mucin-producing signet ring cells in ovarian stroma.

common type of metastatic ovarian cancer.

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7
Q

where do systemic emboli arise from?

A

left atrium or left ventricle

ex: LA clot, LV clot, valvular vegetation, aortic atherosclerotic plaque

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8
Q

what simultaneous clinical features point to emboli?

A

stroke, intestinal/foot ischemia, renal infarction

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9
Q

what gene mutation is involved in hemochromatosis?

A

HFE protein (chromo 6) - unregulated iron uptake by transferrin/iron complex endocytosis (high Fe GI absorption)

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10
Q

what are the more serious complications of hemochromatosis?

A

liver cirrhosis, HCC

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11
Q

what does positive babinski sign indicate?

A

[extension/dorsiflexion of toes with plantar stroking]

UMN lesion (other signs include hyperreflexia, muscle weakness/paralysis, and spasticity)

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12
Q

what is the straight leg raise test?

A

leg held straight while raised off exam table - pain indicates sciatic nerve root (L4-S3) irritation. intervertebral disc herniation causing sciatica.

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13
Q

kaposi sarcoma affects?

A

skin but can have extracutaneous spread to LUNGS and GI TRACT

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14
Q

what is the most important RF for development of intimal tears leading to aortic dissection?

A

hypertension

less commonly, cystic medial degeneration of marfan

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15
Q

what are major RFs for atherosclerosis predisposing to aortic aneurysm?

A

smoking, diabetes, hypercholesterolemia

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16
Q

what is the schilling test?

A

give pt oral radiolabeled vit B12 followed by IM injection of unlabeled B12 – measure urinary excretion of radioactive B12 – normal excretion indicates dietary deficiency while decreased excretion indicates intestinal problem (pernicious anemia or malabsorption)

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17
Q

sx of carcinoid syndrome (metastatic to liver)

A
  1. vasomotor instability: cutaneous flushing, dizziness
  2. GI: secretory diarrhea, crampy pain
  3. bronchoconstriction: dyspnea with wheezing
  4. right sided valvular heart disease (tricuspid, pulmo)
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18
Q

how does phosphatidylcholine affect cholesterol?

A

phospholipid that makes chol soluble - high levels (along with high levels of bile acid) help decrease risk for gallstones

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19
Q

complications of adult-type coarctation of aorta

A

HTN-associated: LV failure, ruptured dissecting aortic aneurysm, intracranial hemorrhage (increased incidence of congenital berry aneurysm)

20
Q

causes of spontaneous intracranial hemorrhage in young adults

A
  1. AV malformations
  2. ruptured cerebral aneuryms
  3. sympathomimetic drugs (cocaine)
21
Q

what change is seen with congenital pyloric stenosis?

A

hypertrophy of pyloric muscularis mucosa (palpable olive-sized mass)

22
Q

how does desmopressin acetate (DDAVP) treat mild-moderate hemophilia A and vW disease?

A

synthetic vasopressin analog that release factor VIII and vWf from endothelial cells

23
Q

what is Virchows triad?

A
  1. endothelial injury
  2. venous stasis
  3. hypercoag state

predispose to DVT

24
Q

morphology of NSAID-assoc. chronic renal injury

A

papillary necrosis and chronic interstitial nephritis

25
Q

vWf functions

A
  1. protective carrier for circulating factor VIII

2. promoter of plt adhesion to injured epith surfaces - bind plt glycoprots to collagen on injured bld vessel wall

26
Q

what is the major cause of mitral regurg?

A

mitral insuff due to myxomatous degeneration (mitral valve prolapse predisposes to infected vegetations) - native valve bacterial endocarditis (plt and fibrin deposit on valves spontaneously, then microorgs colonize valves during bacteremia)

27
Q

what is the COD in rare but lethal acute rheumatic fever?

A

heart failure due to severe myocarditis (with MR)

28
Q

when does acute rheumatic fever occur?

A

10d-6wks after group A strep pharyngitis.

most often age 5-15.

29
Q

how common is the occurrence of acute rheumatic fever and PSGN together?

A

RARE!

30
Q

what is lacunar infarct most commonly due to?

A

hypertensive arteriolosclerosis of small penetrating arterioles.
involves basal ganglia, pons, internal capsule, or deep white matter of brain.
small size < 15 mm

31
Q

what is most affected by ischemic ATN?

A

tubular epith cells - proximal tubule and thick ascending limb of Henle

32
Q

what is syringomyelia?

A

formation of cavity (syrinx) in cervical SC - damage to ventral white commissure leads to bilateral loss of P&T. extension of syrinx destroys motor neurons (ventral horns) causing flaccid paralysis, atrophy of intrinsic hand mm, other LMN signs

33
Q

red neuron

A

neuron responding to irreversible injury.
changes evident 12-24hrs after event.
cell body shrinks, eosinophilic cytoplasm, pyknosis of nucleus, loss of Nissl substance.

34
Q

how does sickle cell disease affect spleen?

A

repeated splenic infarctions resulting in splenic atrophy with scarring/fibrosis or asplenia (by young adulthood) - after autosplenectomy, pts are predisposed to infx with encapsulated bact.

35
Q

why are pts with sickle cell or other hemolytic anemias predisposed to folic acid deficiency (and thus, macrocytic change)?

A

increased RBC turnover

36
Q

what do ECG findings in leads II, III, aVF along with MI sx indicate?

A

transmural ischemic injury to INFERIOR wall of heart (supplied by posterior descending branch of RCA)

37
Q

how do pts with vWf disease often present?

A

lifelong hx of gingival bleeding, epistaxis, mucosal bleeding, menorrhagia.
occult bleeding may be sufficient to cause iron deficiency anemia.

38
Q

histology of acute viral hepatitis

A

panlobular lymphocytic infiltrates.
ballooning hepatocytes.
hepatocyte necrosis.
hepatocyte apoptosis (acidophliic councilman bodies).

39
Q

what is the most common hepatic malignancy?

A

mets from another primary site (breast, lung, colon). more common than HCC.

40
Q

what does a matched V/Q defect mean?

A

ventilation defect matched by perfusion defect = lung collapse or consolidation

41
Q

why is there an increased incidence of subdural hematoma in elderly indivs after minor trauma?

A

age-related brain atrophy: distance from skull to brain surf increases, and cortical bridging veins are under more tension/rupture more easily.

gradual onset of sx. subtle and variable presentation (“great imitator”)

42
Q

what factors predispose to infective endocarditis?

A

prosthetic heart valves.

prior valvular inflamm, damage, and scarring.

43
Q

what do the vegetations assoc. with bacterial endocarditis represent?

A

fibrin and plt deposition at site of bact colonization (most common: S.aureus)

44
Q

what is a common cause of acute renal failure in children?

A

HEMOLYTIC-UREMIC SYNDROME (HUS) - shiga toxin producing E.coli or Shigella dysenteriae.

TRIAD: ARF, microangiopathic hemolytic anemia, thrombocytopenia

45
Q

what are signs of hemolysis?

A

pallor.
red urine.
etc…

Pathology (10 decks)

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