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piggy > Musculo - Pathology Part 2 > Flashcards

Musculo - Pathology Part 2 Flashcards

1
Q

Hypercalcemia associated with sarcoidosis occurs because of the increased conversion of what substance into its active form in epithelioid macrophages?

A

Vitamin D

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2
Q

What type of arthritis is associated with sarcoidosis?

A

Rheumatoid arthritis (remember: GRAIN (Gammaglobulinemia, Rheumatoid arthritis, ACE increase, Interstitial fibrosis, Noncaseating granulomas)

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3
Q

What is the treatment for sarcoidosis?

A

Steroids

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4
Q

Polymyositis involves progressive _____ (proximal/distal) muscle weakness.

A

Proximal

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5
Q

Which part of the immune system causes damage in polymyositis?

A

CD8+ T-cell-induced injury to myofibers

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6
Q

Polymyositis most often involves what body part?

A

Shoulders

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7
Q

Dermatomyositis is similar to polymyositis but also involves what skin symptom?

A

Rash (heliotrope, malar and shawl and face)

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8
Q

Which lab results are abnormal in polymyositis/dermatomyositis?

A

Elevated creatine kinase, elevated aldolase, positive antinuclear antibody, and anti-Jo-1

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9
Q

What is the diagnostic procedure for dermatomyositis and polymyositis?

A

Muscle biopsy

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10
Q

What is the treatment for polymyositis and dermatomyositis?

A

Steroids are used to treat both disorders

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11
Q

Gottrons papules are symptoms of what disease?

A

Dermatomyositis

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12
Q

While the symptoms of myasthenia gravis _____ (improve/worsen) with muscle use, symptoms of Lambert-Eaton syndrome _____ (improve/worsen) with muscle use.

A

Worsen; improve

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13
Q

Myasthenia gravis is caused by autoantibodies to which receptor?

A

Acetylcholine receptors

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14
Q

Name two ophthalmic manifestations of myasthenia gravis.

A

Ptosis and diplopia

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15
Q

Myasthenia gravis is associated with which type of tumor?

A

Thymoma

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16
Q

Individuals with myasthenia gravis complain of generalized weakness that is worse in the _____ (morning/evening).

A

In myasthenia gravis, weakness tends to be worse toward the end of the day

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17
Q

Lambert-Eaton syndrome is caused by autoantibodies to which types of ionic channels, leading to a decrease in acetylcholine release?

A

Calcium channels

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18
Q

Lambert-Eaton syndrome leads to _____ (proximal/distal) muscle weakness.

A

Proximal

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19
Q

Which malignancy is most closely associated with Lambert-Eaton syndrome?

A

Small-cell lung cancer

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20
Q

True or False? Both myasthenia gravis and Lambert-Eaton syndrome improve with acetylcholinesterase inhibitor use.

A

False; although myasthenia gravis symptoms reverse with the use of acetylcholinesterase inhibitors, there is no reversal in Lambert-Eaton syndrome with acetylcholinesterase inhibitors alone such as edrophonium

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21
Q

While myasthenia gravis involves autoantibodies against the _____ (presynaptic/postsynaptic) acetylcholine receptors, Lambert-Eaton syndrome involves autoantibodies against the _____ (presynaptic/postsynaptic) calcium channels.

A

Postsynaptic; presynaptic

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22
Q

In contrast to myasthenia gravis, Lambert-Eaton syndrome spares what muscle group?

A

Extraocular muscles

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23
Q

What five characteristics are associated with mixed connective tissues diseases?

A

Raynauds phenomenon, Fatigue, Arthralgias, Myalgias, and Esophageal hypomotility (remember: Raynauds FAME)

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24
Q

Patients with mixed connective tissue disease are positive for _____ autoantibodies.

A

U1 ribonucleoprotein

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25
Q

What is the treatment for mixed connective tissue disease?

A

Steroids

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26
Q

What condition involves excessive fibrosis and collagen deposition throughout the body but most commonly under the skin?

A

Scleroderma

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27
Q

Does scleroderma affect more men or women?

A

Women

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28
Q

Although scleroderma most commonly affects the skin, what four other organ systems can it affect?

A

Cardiovascular, pulmonary, gastrointestinal, and renal

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29
Q

Describe the progression of diffuse scleroderma.

A

Widespread skin involvement, rapid progression, and early visceral involvement

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30
Q

What are the two types of scleroderma?

A

Diffuse scleroderma and CREST syndrome

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31
Q

Diffuse scleroderma is associated with which antibody?

A

Anti-Scl-70 antibody (anti-DNA topoisomerase I antibody)

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32
Q

What does CREST stand for?

A

Calcinosis, Raynauds phenomenon, Esophageal dysmotility, Sclerodactyly, and Telangiectasia

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33
Q

A patient presents for examination. Although middle-aged, she has no wrinkles (denies plastic surgery) and her skin is puffy and taut. She also complains of difficulty swallowing. From what disease is she suffering?

A

Scleroderma

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34
Q

Skin involvement in CREST syndrome is often confined to which two areas of the body?

A

Fingers and face

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35
Q

Which has a more benign course: diffuse scleroderma or CREST syndrome?

A

CREST syndrome

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36
Q

Which antibody is associated with CREST syndrome?

A

Anticentromere antibody (remember: C for CREST)

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37
Q

What is a lipoma?

A

A soft, well-encapsulated tumor derived from fat

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38
Q

True or False? Lipoma recurrences are common even after excision.

A

False; simple excision of lipomas is usually curative

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39
Q

While lipomas are _____ (benign/malignant) in nature, liposarcomas are _____ (benign/malignant).

A

Benign; malignant

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40
Q

Rhabdomyoma is a benign tumor derived from what kind of muscle?

A

Striated (skeletal or cardiac) muscle

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41
Q

Rhabdomyoma of the heart is associated with which genetic disease?

A

Tuberous sclerosis

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42
Q

What is the most common malignant soft tissue tumor of childhood?

A

Rhabdomyosarcoma

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43
Q

Rhabdomyosarcomas often arise from skeletal muscle from what two locations in the body?

A

Head and neck

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44
Q

_____ (Macules/Patches) are flat discolorations of the skin <1 cm in size, while _____ (macules/patches) represent a similar lesion except they are > 1 cm in size.

A

Macules; patches

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45
Q

_____ (Papules/Plaques) are elevated skin lesions < 1 cm in size, while _____ (papules/plaques) represent a similar lesion but are > 1 cm in size.

A

Papules; plaques

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46
Q

_____ (Bullae/Vesicles) are small fluid-containing blisters, while _____ (bullae/vesicles) are large fluid-containing blisters.

A

Vesicles; bullae

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47
Q

Which dermatologic term describes a transient vesicle?

A

Wheal

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48
Q

What irregular, raised lesion results from scar tissue hypertrophy following trauma to skin, especially in African-Americans?

A

Keloid

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49
Q

What is the medical term for a blister containing pus?

A

Pustule

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50
Q

Dried exudate from a vesicle, bulla, or pustule is called a _____.

A

Crust

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51
Q

An increased thickness of the stratum corneum is known as _____.

A

Hyperkeratosis

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52
Q

Which phenomenon describes hyperkeratosis with retention of nuclei in stratum corneum, as seen in psoriasis?

A

Parakeratosis

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53
Q

While acantholysis is the _____ (hyperplasia/separation) of epidermal cells, acanthosis represents epidermal _____ (hyperplasia/separation).

A

Separation; hyperplasia

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54
Q

Tinea versicolor is an example of what type of dermatologic lesion?

A

Macule

55
Q

Acne vulgaris is an example of what type of dermatologic lesion?

A

Papule

56
Q

Psoriasis causes what gross and microscopic dermatologic lesions?

A

Plaques, parakeratosis and hyperkeratosis

57
Q

Chickenpox is an example of what type of dermatologic lesion?

A

Vesicle

58
Q

Hives are an example of what type of dermatologic lesion?

A

Wheal

59
Q

Pemphigus vulgaris causes which pathologic change of the epidermis?

A

Acantholysis

60
Q

Another name for warts, _____ are soft, tan-colored, cauliflower-like lesions of the skin.

A

Verrucae

61
Q

Name three histopathologic findings in verrucae.

A

Epidermal hyperplasia, hyperkeratosis, and koilocytosis

62
Q

Warts found on the hands are referred to as _____ _____, while warts found on the genitals are called _____ _____.

A

Verruca vulgaris; condyloma acuminatum

63
Q

Condyloma acuminatum, or genital warts, are caused by what virus?

A

Human papillomavirus

64
Q

What is the lay term for a nevocellular nevus, a benign lesion?

A

Mole

65
Q

Hives, also known as _____, are pruritic wheals that form secondary to degranulation of what type of cell?

A

Urticaria; mast cells

66
Q

A freckle, a lesion that results from increased melanin pigment, is also known as _____.

A

Ephelis

67
Q

In the case of atopic dermatitis (eczema), pruritic eruption takes place on which surfaces of the body?

A

Flexor surfaces

68
Q

Atopic dermatitis is often associated with which two other atopic diseases?

A

Asthma and allergic rhinitis

69
Q

Allergic contact dermatitis is a type _____ hypersensitivity reaction that follows exposure to an allergen.

A

IV

70
Q

Acanthosis with parakeratotic scaling that is particularly found on knees and elbows is called what?

A

Psoriasis

71
Q

An increased stratum spinosum and a decreased stratum granulosum is seen with which skin disorder?

A

Psoriasis

72
Q

A woman develops plaques and papules with silvery scaling on her elbows and knees. Pinpoint bleeding occurs when a scale is removed. What is the name of the sign describing the latter phenomenon? What is the most likely diagnosis?

A

Auspitz sign; psoriasis

73
Q

Which skin disorder is described as flat, pigmented, squamous epithelial proliferation with keratin-filled cysts?

A

Seborrheic keratosis

74
Q

What is the Sign of Leser-Trélat?

A

The sudden appearance of multiple seborrheic keratoses indicating underlying malignancy

75
Q

In albinism, melanocyte number is _____ (increased/decreased/unchanged), while in vitiligo melanocyte number is _____ (increased/decreased/unchanged).

A

Unchanged (ie normal); decreased

76
Q

In albinism, decreased melanin production is due to what?

A

Decreased activity of tyrosinase

77
Q

What developmental failure can result in albinism?

A

Failure of neural crest cell migration during development

78
Q

How does vitiligo appear clinically?

A

As irregular areas of complete skin depigmentation

79
Q

Melasma, or skin hyperpigmentation, is associated with what two situations?

A

Pregnancy and oral contraceptive use

80
Q

Name two organisms that commonly cause impetigo.

A

Staphylococcus aureus and Streptococcus pyogenes

81
Q

Which infectious superficial skin infection is commonly characterized by honey-colored crusting?

A

Impetigo

82
Q

Cellulitis, an acute painful spreading infection of the dermis and subcutaneous tissues, is most commonly caused by which two organisms?

A

Staphylococcus aureus and Streptococcus pyogenes

83
Q

Name the deep tissue infection caused by flesh-eating bacteria that results in crepitus due to bacterial production of carbon dioxide and methane.

A

Necrotizing fasciitis

84
Q

Which bacteria cause necrotizing fasciitis?

A

Anaerobic bacteria and Streptococcus pyogenes

85
Q

Staphylococcal scalded skin syndrome is caused by a bacterial product called an _____ that destroys the keratinocyte attachments in the stratum _____ only.

A

Exotoxin; granulosum

86
Q

A parents calls the pediatrician because her newborn has a fever and rash. Every time she picks the baby up, it seems like her skin peels off. From what is the baby suffering?

A

Staphylococcal scalded skin syndrome

87
Q

Which virus causes hairy leukoplakia?

A

Epstein-Barr virus

88
Q

Hairy leukoplakia is associated with which underlying medical condition?

A

HIV infection

89
Q

True or False? Hairy leukoplakia is described as white painless plaques on the tongue that can be easily scraped off.

A

False; hairy leukoplakia is characterized by white plaques on the tongue that cannot be scraped off

90
Q

Which autoimmune blistering skin disorder affects the skin but not the oral mucosa?

A

Bullous pemphigoid

91
Q

Which blistering autoimmune skin disorder is most severe?

A

Pemphigus vulgaris

92
Q

A patient presents with bullae sparing the oral mucosa. From what disease is she suffering?

A

Bullous pemphigoid

93
Q

While in bullous pemphigoid immunoglobulin G antibody is directed against the _____, in pemphigus vulgaris immunoglobulin G antibody is directed against the _____.

A

Hemidesmosomes (epidermal basement membrane); desmosomes

94
Q

What is the difference in the appearance of bullous pemphigoid and pemphigus vulgaris on immunofluorescence?

A

Bullous pemphigoid demonstrates linear immunofluorescence whereas pemphigus vulgaris reveals antibodies around cells of the epidermis in a reticular or netlike pattern

95
Q

A patient presents with large bullae. On exam, there is epidermal separation on stroking of the lesion. What is this sign called and from what disorder is this patient suffering?

A

Positive Nikolskys sign; the patient has pemphigus vulgaris

96
Q

True or False? A positive Nikolskys sign is common in both pemphigus vulgaris and bullous pemphigoid.

A

False; patients with bullous pemphigoid have a negative Nikolskys sign

97
Q

Patients with bullous pemphigoid have what cell type within blisters?

A

Eosinophils

98
Q

What skin condition is associated with celiac disease?

A

Dermatitis herpetiformis

99
Q

Dermatitis herpetiformis is associated with pruritic papules and vesicles and deposits of what at the tips of dermal papillae?

A

Immunoglobulin A

100
Q

Which skin disorder presents with multiple types of lesions, including macules, papules, vesicles, and target lesions?

A

Erythema multiforme

101
Q

List four causes of erythema multiforme.

A

Infection (Mycoplasma pneumoniae, HSV), drugs, cancers, and autoimmune disease

102
Q

Which syndrome is characterized by high fever, bulla formation, necrosis, ulceration of the skin, and a high mortality rate?

A

Stevens-Johnson syndrome

103
Q

Stevens-Johnson syndrome usually has what etiology?

A

Drug reaction

104
Q

A more severe form of Steven-Johnson syndrome is known as what?

A

Toxic epidermal necrolysis

105
Q

Which skin disorder involves pruritic, purple, and polygonal papules?

A

Lichen planus

106
Q

What infectious disease is associated with lichen planus?

A

Hepatitis C

107
Q

Which skin disorder is described as small, rough, erythematous, or brownish papules?

A

Actinic keratosis

108
Q

What kind of lesion is actinic keratosis: malignant, benign, or premalignant?

A

Premalignant

109
Q

Name two clinical conditions that are associated with acanthosis nigricans.

A

Hyperlipidemia (ie., from Cushings disease, diabetes) and hyperinsulinemia

110
Q

Erythema nodosum is characterized by inflammatory lesions of subcutaneous fat located on which part of the body?

A

Anterior shins

111
Q

With what disease processes is erythema nodosum associated?

A

Coccidioidomycosis, histoplasmosis, tuberculosis, leprosy, streptococcal infections, sarcoidosis

112
Q

What skin disorder is characterized by a herald patch followed by a Christmas tree distribution of lesions?

A

Pityriasis rosea

113
Q

Describe the appearance and course of pityriasis rosea.

A

Multiple papular eruptions with spontaneous remissions

114
Q

In what stage of life is strawberry hemangioma seen?

A

During the first few weeks of life

115
Q

At what age does strawberry hemangioma typically regress?

A

5 to 8 years of age

116
Q

At what age do cherry hemangiomas appear?

A

30 to 49 years of age

117
Q

Cherry hemangiomas _____ (do/do not) regress spontaneously.

A

Do not

118
Q

Squamous cell carcinoma is associated with what environmental exposures?

A

Sunlight and arsenic

119
Q

Where does squamous cell carcinoma most commonly occur?

A

Hands and face

120
Q

Does squamous cell carcinoma metastasize rarely or commonly?

A

Rarely

121
Q

What is the histopathologic finding in squamous cell carcinoma?

A

Keratin pearls

122
Q

What is a common precursor lesion to squamous cell carcinoma?

A

Actinic keratosis

123
Q

What is the gross appearance of squamous cell carcinoma?

A

Ulcerative red lesion

124
Q

Squamous cell carcinoma is associated with what chronic condition?

A

Associated with chronic draining sinuses in the skin

125
Q

Keratoacanthoma is a variant of squamous cell carcinoma with what growth pattern?

A

Rapid growth (4-6 weeks) and spontaneous regression (4-8 weeks)

126
Q

Where are basal cell carcinomas most commonly found?

A

On sun-exposed areas of the body

127
Q

Basal cell tumors have _____ nuclei seen on histology.

A

Palisading

128
Q

Basal cell carcinomas are locally invasive but almost never _____.

A

Metastasize

129
Q

What is the gross appearance of basal cell carcinomas?

A

Pearly papules

130
Q

A bald male patient presents with a lesion on the crown of his head. It has rolled edges with central ulceration. What type of cancer does he have?

A

Basal cell tumor

131
Q

What aspect of a melanoma correlates best with the risk of metastases?

A

Depth of invasion

132
Q

What lesion is a precursor of melanoma?

A

Dysplastic nevus (atypical mole)

133
Q

What tumor marker is associated with melanoma?

A

S-100

134
Q

Describe the physical appearance of melanoma on exam.

A

Dark with irregular borders

piggy (83 decks)

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