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Path Week 3 > Hi - Path Museum > Flashcards

Hi - Path Museum Flashcards

1
Q

SoB , raised JVP, ankle oedema. Prev MI. Dx?

A

heart failure

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2
Q

blood supply and drainage to liver

A

hepatic artery and vein (central)
portal artery and vein

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3
Q

where does the portal vein come from

A

gut and spleen

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4
Q

which vein dilates due to fluid overload

A

central vein

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5
Q

what does a PM liver look like with HF

A

nutmeg liver

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6
Q

why does the liver change colour in HF

A

backflow of fluid from heart due to fluid overload, down hepatic vein into liver. causes congestion in liver, leading to extracellular pooling of blood which is white. “nutmeg”

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7
Q

can you see liver BVs in a normal liver

A

no

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8
Q

vomitting large amounts of blood with chronic hep B. Dx?

A

oesophageal varices

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9
Q

pathophysiology of oesophageal varices due to hep B

A

hep B –> fibrosis –> cirrhosis –> backflow pressure on portal vein –> portal HTN –> varices –> rupture –> +++ bleeding due to high pressure

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10
Q

2 biggest causes of varices

A

viral hep
alcoholic hep

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11
Q

where else do varices occur

A

oesophageal
rectal

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12
Q

features of liver failure

A

caput medusae
palmar erythema
ascites
bruising
encephalopathy
dupetrens
gynaecomastia
jaundice

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13
Q

bright red blood in pan after stool passed, change in bowel habit and weight loss over 2 months. DDx?

A

bowel cancer
IBD
IBS - unlikely due to bleed
gastroenteritis

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14
Q

if suspecting colorectal cancer, what do you do?

A

2 week wait referral
Colonoscopy, imaging and physical exam

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15
Q

bowel cancer that has not invaded through bowel wall. Dx?

A

adenoma

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16
Q

bowel cancer that has invaded through bowel wall. Dx?

A

adenocarcinoma

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17
Q

contrast shared Sx of bowel cancer vs malignant bowel cancer sx only

A

shared = tenesmus, bleeding, change in bowel habit
malignant = weight loss, fever, night sweats, reduced appetite, bowel obstruction

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18
Q

staging method for bowel cancer

A

TNM
t = depth of invasion
n = nodes
m = mets

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19
Q

tx options for colorectal ca

A

colectomy
chemo
radio - only if tumour left after surgery

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20
Q

which colorectcal cancer is primarily treated by radio

A

rectal ca

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21
Q

left lower abdo pain, fever. Prev PC cramping, constipation. Dx?

A

diverticulosis –> diverticulitis

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22
Q

cause of diverticulosis

A

low fibre diet –> constipation –> straining –> stretching of weak points in bowel wall

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23
Q

complications of diverticulosis

A

diverticulitis
perforation

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24
Q

Tx of diverticulitis

A

increase fibre in diet
Sx Tx - analgesia, laxatives
ABx

25
why might someone have a heart attack and not feel it?
Diabetic neuropathy means they feel pain less
26
what are sx of heart attack in a DM pt?
blurred vision, sweating
27
define infarction
death of cells due to decreased blood supply
28
what does infarction look like on a heart specimen
white area
29
define rheumatic fever
group A beta strep pyogenes infection
30
what is puerpal fever
rheumatic fever in the 6 weeks post birth
31
what cardiac issue does rheumatic fever cause
mitral valve vegetations
32
what ABs are made due to strep sore throat
anti streptolysin O ABs
33
complications of RhF
autoimmune carditis arthritis Sydenham's chorea erythema marginatum mixed mitral valve disease
34
Ix for RhF
strep bacteria on blood culture
35
who else gets mitral valve vegatations
RhF pts IVDU prosthetic heart valve pts
36
what bacteria causes vegetations in IVDU
staph aureus
37
collapse. semi concious when admitted with head deviated to L, L CN palsy, brisk L reflexes, L hypertonia. HTN. where in the CNS is the lesion, and how do you know?
brain / cord as UMN signs. R sided as L Sx
38
collapse. semi concious when admitted with head deviated to L, L CN palsy, brisk L reflexes, L hypertonia. HTN. Dx?
Haemorrhagic stroke (SAH)
39
Causes of haemorrhagic stroke
berry aneurysms - secondary to marfans head injury
40
PMH AF. Develops dysarthria, L hemiplegia. Dx?
ischaemic stroke - clot due to AF
41
L homonymous hemianopia, frontal headache, mental deterioration. L hemiparesis. Dx?
space occupying lesion
42
L homonymous hemianopia, frontal headache, mental deterioration. L hemiparesis. what causes the eye Sx?
R sided tumour thay crosses midline and covers the optic radiation
43
why do CF pts get lung issues
produce thick mucous due to ion channel dysfunction --> hard to clear therefore infections / plugging
44
define bronchiectasis
dilated pus filled bronchi visible, especially near apex, with patchy consolidation (bronchopnuemonia)
45
what causes bronchiectasis
blockage of mucous clearance - tumour, CF etc
46
what is the issue in emphysema
damage to alveoli wall
47
what is COPD
emphysema + bronchiectasis + chronic pneumonia due to smoking
48
commonest causes of lobar pneumonia
strep pneumoniae staph aureus haemophilius influenzae
49
commonest causes of bronchopneumonia
staph pneumonia klebsiella
50
what causes pneumonia in kids
pseudomonas
51
define lobar pneumonia
contiguous air spaces of part or all of a lobe are homogenously filled with exudate that can be visualised on radiographs as a lobar / segmental consolidation
52
define bronchopneumonia
implies a patchy distribution of inflammation often involving more than one lobe
53
name the 4 pathological states of pneumonia
congestion red hepatisation grey hepatisation resolution
54
what is congestion pneumonia
affected lobe is heavy and red with vascular congestion (hyperaemia) and many bacteria in alveoli
55
what is red hepatisation
lobe has a liver like consistency, alveolar spaces are packed with neutrophils, red cells and fibrins
56
what is grey hepatisation in pneumonia
the lung is dry, grey and firm as red cells are lysed fibrino-suppurative exudate persists within the alveoli
57
what is resolution in peumonia
in uncomplicated cases, the exudate is enzymatically digested to produce debris, which is reabsorbed by macrophages, coughed up, or organised by fibroblasts
58
what lines airways
cilliated epithelium goblet cells
59
what are alveoli lines with
type 1 pneumocytes - flat type 2 pneumocytes - make surfactant

Path Week 3 (7 decks)

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