High Yeild Path Flashcards
Examples of necrosis:
Coagulative necrosis
Liquefactive necrosis
Coagulative- Ischemia (esp heart + kidney)
Liquefactive- Bacterial infection, brain infarction
Complement cascade: Products of C3b
Opsonin
Complement cascade: Products of C5a
Chemotaxis and leukocyte activation
Complement cascade: Products of C3a, C4a, C5a
Anaphylatoxins
Complement cascade: Products of C5-9
Membrane Attack Complexes (MAC)
Deficiency of C3 and C5 leads to
Recurrent pyogenic bacterial infections
Deficiency of C6, C7, and C8
Recurrent infections with Neisseria i
Deficiency of C1 esterase inhibitor
Hereditary Angioedema
Thromboxane
Produced by:
Causes:
Stimulates:
Thromboxane
Produced by: Platelets
Causes: Vasoconstriction
Stimulates: Platelet aggregation
Prostacyclin (PG12)
Produced by:
Causes:
Inhibits:
Prostacyclin (PG12)
Produced by: Endothelial cells
Causes: Vasodilation
Inhibits: Platelet aggregation
Caseating Granulomas
Aggregates of activated macrophages (seen in tuberculosis)
Noncaseating Granulomas
Sarcoidosis, fungal infections, foreign-body reaction
Collagen type I
Skin, bones, tendons, mature cells
Osteogenesis Imperfecta
Collagen type II
Cartilage
Cartilage type III
Embryonic tissue, blood vessels, pliable organs, immature scars
Vascular type EDS
Collagen type IV
Basement membranes
Alport syndrome, Goodpasture’s
Collagen type VI
Connective tissue
Edema: Exudates
Composition:
Cause:
Examples:
Edema: Exudates
Composition: Increased protein, cells, SG higher than 1.020
Cause: Inflammation, increased blood vessel permeability
Examples: Bacterial pneumonia, empyema
Edema: Transudates
Composition:
Causes (2):
Composition: SP less than 1.012
Causes:
1. Increased hydrostatic (venous) pressure - CHF, portal HTN
2. Decreased on optic pressure (decreased albumin) - Liver disease, nephrotic syndrome
Carcinogens: Benzene
Leukemias
Carcinogens: Asbestos
Mesotheliomas, lung tumors
Carcinogens: Arsenic
Skin cancer
DNA Viruses: HPV - Leads to what cancer?
Cervical neoplasia (16 + 18)
Condylomas (6 and 11)
DNA Viruses: EBV - Leads to what conditions?
African Burkitt’s Lymphoma
Carcinoma of the nasopharynx
B cell immunoblastic lymphoma
DNA Viruses: Hep B and Hep C lead to what cancer?
Liver cancer
DNA Viruses: HHV 8 - Leads to what condition?
Kaposi Sarcoma
DNA Viruses: H pylori leads to what conditions?
Stomach cancer and lymphoma
Paraneoplastic Syndromes:
Cushing’s syndrome leads to what cancer?
Lung cancer
Paraneoplastic Syndromes:
SIADH leads to what cancers?
Lung cancer
Intracranial neoplasms
Paraneoplastic Syndromes:
Hypercalcemia leads to what cancers?
Lung cancer
Multiple myeloma
Paraneoplastic Syndromes:
Hypocalcemia leads to what cancers?
Medullary carcinoma of thyroid
Paraneoplastic Syndromes:
Polycythemia leads to what cancers?
Kidney tumors
Liver tumors
Cerebellar vascular tumors
Tumor Markers: a-Fetoprotein (AFP)
Hepatocellular carcinoma
Germ cell tumors (yolk sac, embryonal carcinoma)
Tumor Markers: PSA
Adenocarcinoma of prostate
Tumor Markers: Carcinoembryonic Antigen (CEA)
Adenocarcinomas of colon, pancreas, stomach, breast
Tumor Markers: CA-125
Ovarian cancer
Tumor Markers: S-100
Melanoma
Neural tumors
Nutritional Deficiency: Vitamin A
Night blindness
Dry eyes and skin
Recurrent infections
Nutritional Deficiency: Vitamin D
Decreased calcium
Decreased bone calcification, increased osteoporosis
Rickets (children)
Osteomalacia (adults)
Nutritional Deficiency: Vitamin E
Degeneration of posterior columns of spinal cord
Nutritional Deficiency: Vitamin K
Decreased K dependent factors (2, 7, 9, 10, protein C and S)
Increased bleeding
Increased PT and PTT
Nutritional Deficiency: Vitamin B
Beriberi wet (cardiac) or dry (neurologic)
Wernicke-Korsakoff syndrome (lesions of mammillary bodies)
Nutritional Deficiency: Vitamin B3
Pellegra (4 Ds) Dermatitis, dementia, diarrhea, death
Nutritional Deficiency: Vitamin B12
Megaloblastic anemia
Hypersegmented neutrophils (>5 lobes)
Subacute combined degradation of the spinal cord
Nutritional Deficiency: Vitamin C
Scurvy
Defective collagen formation
Poor wound healing
Decreased bone osteoid
Perifollicular hemorrhages
Bleeding gums, loose teeth
Nutritional Deficiency: Folate
Megaloblastic anemia
Hypersegmented neutrophils
Neural tube defects in utero
Nutritional Deficiency: Iron
Microcytic hypochromic anemia (IDA anemia) with increased TIBC
Inheritance Patterns: Autosomal Dominant (AD)
No skipped gens
M:F 1:1
Recurrence risk 50%
Inheritance Patterns: Autosomal Recessive (AR)
Generations may be skipped
M:F 1:1
Recurrence risk 25%
Inheritance Patterns: X-Linked Dominant (XD)
No skipped generations
NO male to male
F:M 2:1
Inheritance Patterns: X-Linked Recessive (XR)
Skipped generations
No male to male
M > F
Inheritance Patterns: Y Inheritance
Only males
Only male to male
All males effected
Inheritance Patterns: Mitochondrial
M:F 1:1
Only females transmit the disease
XR Diseases: Hematology diseases (3)
G6PD Deficiency
Hemophilia A (def of factor 8)
Hemophilia B (def of factor 9)
XR Diseases: Immunodeficincy Diseases (3)
Bruton Agammaglobulinemia
Chronic Granulomatous disease
Wiskott-Aldrich Syndrome
XR Diseases: Storage Diseases (2)
Fabry’s Disease
Hunter’s Syndrome
XR Diseases: Muscle Disease
Duchenne’s Muscular Dystrophy
Duchenne’s Muscular Dystrophy has a positive ________ maneuver
Gower Maneuver (using hands to rise from floor)
XR Diseases: Metabolic Diseases (2)
Diabetes insipidus (low ADH - central) (normal or high ADH - nephrogenic)
Lesch-Nyah’s syndrome (purine salvage deficiency, excess Uric acid production)
XR Diseases: Other (2)
Red-green colorblindness
Fragile X Syndrome
Autosomal Trisomies: 13
Patau’s Syndrome: Mental retardation, fused central face, cleft lip/palate, heart defects
Autosomal Trisomies: 18
Edward’s Syndrome: Mental retardation, micrognathia, heart defects, rocker bottom feet, clenched fist with overlapping fingers
Autosomal Trisomies: 21
Down Syndrome: Horizontal palmar crease, heart defects, ALL, Alzheimer’s disease (almost 100% after age 35)
Chromosomal Deletions: 11P WTI Gene
WAGR Syndrome > Wilm’s tumor, genital abnormalities, mental retardation
Hypogonadism: Klinefelter’s Syndrome
47 XXY
Testicular dysgenesis
Decreased testosterone
Increased FSH, LH, estradiol
Decreased secondary male characteristics
Tall, gynecomastia, infertility
Hypogonadism: Turner’s Syndrome
45 XO
Ovarian dysgenesis
Decreased estrogen
Increased LH, FSH
Primary amenorrhea
Short
Web neck
Trinucleotide Repeats: Fragile X Syndroe
CGG
Mental retardation
Long face, large ears
Large testes
Trinucleotide Repeats: Huntington’s Syndrome
CAG Repeats
CD8 > Cytotoxic T cells bind with _______
CD4 > Helper T cells bind with __________
CD8 > Cytotoxic T cells bind with (MHC Class II antigens)
CD4 > Helper T cells bind with (MHC Class I antigens)
Secretes IL-2, IL-3, TNFB
Stimulates cell-mediated immune reactions
TH1 cells
Secretes IL-3, IL-4, IL-5, IL-6, IL-10, and GM-CSF
Stimulates antibody production
Th2 cells
MHC I are found on what cells
All nucleated cells
MHC II are found on what cells
All APC, B cells, T cells
Diseases Associated with HLA Types:
HLA-A3
HLA-A3:
Primary hemochromatosis (HA3mochromatosis)
Diseases Associated with HLA Types:
HLA-B27
HLA-B27:
Ankylosis spondylitis
Diseases Associated with HLA Types:
HLA-DR4
HLA-DR4:
Rheumatoid arthritis (4 walls in 1 RHEUM)
Diseases Associated with HLA Types:
HLA-DR2/DR3
HLA-DR2/DR3:
SLE
Hypersensitivity Reactions: Type I
IgE
Allergy, anaphylaxis
Release of histamine and leukotrienes C4 and D4
Urticaria (hives)
Hypersensitivity Reactions: Type II
Antibody (IgG, IgM)
Transfusion reactions, Goodpastures, pemphigus vulgaris
Hypersensitivity Reactions: Type III
Antibody/Antigen complexes
Serum sickness
Hypersensitivity Reactions: Type IV
- Delayed type: CD4, PPD skin test, contact dermatitis
- Cell-mediated: CD8, viral infections, transplant rejection
Who is she??
AR disease
Defective polymerization of micro tubules
Recurrent infections
Albinism
Giant lysosomes in leukocytes
Cheddar-Higashi Syndrome
Who is she???
Defective NADPH oxidase
Recurrent infections with catalase positive organisms
Abnormal nitroblue tetrazolium dye test
Chronic Granulomatous Disease
Who is she??
Mutation of BTK
Defective maturation of B cells
Bacterial infections after 6 months
Tx with immunoglobulin IV
X-Linked Agammaglobulinemia of Bruton (XLA)
Who is she???
Variable clinical presentation
Recurrent infections, esp bacteria and Giardia
Hyperplastic B cell areas
Tx with immunoglobulin injections
Common Variable Immunodeficiency (CVID)
Who is she?
Most common form of immunodeficiency
Most pts asymptomatic
Risk of anaphylaxis with transfusion
IgA Deficiency
Who is she?
Defective development of pharyngeal pouches 3 and 4
Deletion of chromosome 22
Lack of thymus
No T cells
DiGeorge Syndrome
What is CATCH 22
Cardiac abnormalities
Abnormal fancies
Thymic a- or hypoplasia
Cleft palate
Hypocalcemia
Chromosome 22 deletion
DiGeorge Syndrome
Who is SHE???
Mutation in WASP
Recurrent pyogenic infections, eczema, thrombocytopenia
Progressive loss of T cell function
Decreased IgM
Wiskott-Aldrich Syndrome (WAS)
What condition leads to increased incidence of Kaposi’s sarcoma and immunoblastic lymphoma?
AIDS
What condition shows a “double barrel” on X-ray
Dissecting aneurysm of the aorta
What condition is at high risk for a dissecting aneurysm?
Marfan’s Syndrome
Bifurcation of arteries in circle of Willis (anterior communicating artery)
Congenital Heart Defects: Left to right shunt
VSD
ASD
PDA
What type of murmur is associated with PDA
Machine-like continuous murmur
Most common congenital heart defect
VSD
Congenital Heart Defects: Right to Left shunts
TOF: Pulmonary stenosis, VSD, overriding aorta, RVH
Coarctation of the aorta >
Rib notching, increased BP in upper extremities, decreased in lower
Skip lesions (UC or IBD)
IBD
Crypt abscesses (UC or IBD)
UC
Superficial mucosal involvement (UC or IBD)
UC
Risk factors for cholesterol gallstones
Fat, female, fertile, forty,
Who is she?
Hematuria
HTN
Edema
Nephritic syndrome
Epidural or subdural hematoma?
Severe trauma, arterial bleeding, symptoms occur rapidly
Epidural hematoma
Epidural or subdural hematoma?
Minimal trauma in elderly, venous bleeding (bridge veins), symptoms occur slowly
Subdural (below the dura) hematoma
Subarachnoid Hemorrhage sxs and causes
Rupture of berry aneurysm
Worst headache ever
Bloody or xanthochromic spinal tap
Bacterial infections of the meninges - organisms
E. coli
Strep pneumoniae
N meningitidis
Alzheimer’s Disease main characteristics
Diffuse atrophy of cerebral cortex
Dementia (Most common cause in elderly)
Senile plaques (with B-amyloid core)
Neurofibrillary tangles (with abnormal tau protein)
Who is she?
Atrophy of caudate and putamen
Decreased GABA and Ach
Progressive dementia
Choreiform movements
Huntington’s Disease
Who is she?
Substantia nigra depigmentation
Decreased dopamine in corpus striatum
Cogwheel rigidity and akinesia
Tremor
Tx: Dopamine agonists
Parkinson’s Disease
PIP or DIP?
Heberden’s nodes
Bouchard’s nodes
Heberden’s - DIP
Bouchard’s.- PIP