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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
Q

why might someone have a heart attack and not feel it?

A

Diabetic neuropathy means they feel pain less

26
Q

what are sx of heart attack in a DM pt?

A

blurred vision, sweating

27
Q

define infarction

A

death of cells due to decreased blood supply

28
Q

what does infarction look like on a heart specimen

A

white area

29
Q

define rheumatic fever

A

group A beta strep pyogenes infection

30
Q

what is puerpal fever

A

rheumatic fever in the 6 weeks post birth

31
Q

what cardiac issue does rheumatic fever cause

A

mitral valve vegetations

32
Q

what ABs are made due to strep sore throat

A

anti streptolysin O ABs

33
Q

complications of RhF

A

autoimmune carditis
arthritis
Sydenham’s chorea
erythema marginatum
mixed mitral valve disease

34
Q

Ix for RhF

A

strep bacteria on blood culture

35
Q

who else gets mitral valve vegatations

A

RhF pts
IVDU
prosthetic heart valve pts

36
Q

what bacteria causes vegetations in IVDU

A

staph aureus

37
Q

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?

A

brain / cord as UMN signs. R sided as L Sx

38
Q

collapse. semi concious when admitted with head deviated to L, L CN palsy, brisk L reflexes, L hypertonia. HTN. Dx?

A

Haemorrhagic stroke (SAH)

39
Q

Causes of haemorrhagic stroke

A

berry aneurysms - secondary to marfans
head injury

40
Q

PMH AF. Develops dysarthria, L hemiplegia. Dx?

A

ischaemic stroke - clot due to AF

41
Q

L homonymous hemianopia, frontal headache, mental deterioration. L hemiparesis. Dx?

A

space occupying lesion

42
Q

L homonymous hemianopia, frontal headache, mental deterioration. L hemiparesis. what causes the eye Sx?

A

R sided tumour thay crosses midline and covers the optic radiation

43
Q

why do CF pts get lung issues

A

produce thick mucous due to ion channel dysfunction –> hard to clear therefore infections / plugging

44
Q

define bronchiectasis

A

dilated pus filled bronchi visible, especially near apex, with patchy consolidation (bronchopnuemonia)

45
Q

what causes bronchiectasis

A

blockage of mucous clearance - tumour, CF etc

46
Q

what is the issue in emphysema

A

damage to alveoli wall

47
Q

what is COPD

A

emphysema + bronchiectasis + chronic pneumonia due to smoking

48
Q

commonest causes of lobar pneumonia

A

strep pneumoniae
staph aureus
haemophilius influenzae

49
Q

commonest causes of bronchopneumonia

A

staph pneumonia
klebsiella

50
Q

what causes pneumonia in kids

A

pseudomonas

51
Q

define lobar pneumonia

A

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
Q

define bronchopneumonia

A

implies a patchy distribution of inflammation often involving more than one lobe

53
Q

name the 4 pathological states of pneumonia

A

congestion
red hepatisation
grey hepatisation
resolution

54
Q

what is congestion pneumonia

A

affected lobe is heavy and red with vascular congestion (hyperaemia) and many bacteria in alveoli

55
Q

what is red hepatisation

A

lobe has a liver like consistency, alveolar spaces are packed with neutrophils, red cells and fibrins

56
Q

what is grey hepatisation in pneumonia

A

the lung is dry, grey and firm as red cells are lysed
fibrino-suppurative exudate persists within the alveoli

57
Q

what is resolution in peumonia

A

in uncomplicated cases, the exudate is enzymatically digested to produce debris, which is reabsorbed by macrophages, coughed up, or organised by fibroblasts

58
Q

what lines airways

A

cilliated epithelium
goblet cells

59
Q

what are alveoli lines with

A

type 1 pneumocytes - flat
type 2 pneumocytes - make surfactant

Path Week 3 (7 decks)

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