MUST KNOW!!!!!!!!!! Flashcards
Grossly: Solid, airless lungs
Microscopically:
Pink necrotic cellular debris
Increased neutrophils
HYALINE MEMBRANE DISEASE
Cataract Deafness Mental retardation PDA Blueberry muffin baby
CONGENITAL RUBELLA SYNDROME
What test determines whether respiration took place on a newborn before death?
FODERE’S TEST/ HYDRO STATIC TEST
What test involves floating of the stomach in water to determine the presence of air?
BRESLAU’S TEST
Cause by Vascular endothelial growth factor(VEGF)
Retinopathy of prematurity
Bronchopulmonary dysplasia
Decrease in alveolar septation
COMPLICATIONS OF OXYGEN THERAPY
Breakdown of mucosal barrier function permits transluminal migration of bacteria?
NECROTIZING ENTEROCOLITIS
Bloody stools
Abdominal distention
Shock develop rapidly due to bleeding
Pneumatosis intestinalis (gas within intestinal walls)
Leading to bowel infarction and strictures
NECROTIZING ENTEROCOLITIS
Accumulation of edema fluid in the fetus during intrauterine growth?
FETAL HYDROPS
Prevention of Immune hydrops?
Administration of RhIg Ig to negative mothers at 28 weeks AOG Within 72 hours of delivery
Hyperplasia of bone marrow
Erythroblastosis fetalis
Large chorionic villi
Kernicterus ( > 20 mg/dl )
HYDROPS FETALIS
AR
Mutations of gene: phenylalanine hydroxylase
Inability to convert phenylalanine to tyrosine
Musty or mousy odor to affected infants
Brain damage and mental retardation
PHENYLKETONURIA
Most common variant of Galactosemia?
Galactose-1-phosphate uridyl transferase
Hepatomegaly Cataract due to sorbitol accumulation Failure to thrive Mental ratardation E. Coli septimecia
GALACTOSEMIA
AR
Loss of CFTR causes decreased Na and Cl reabsorption in sweat glands
Deletion of three nucleotides coding for phenylalanine at AMINO ACID POSITION 508
CYSTIC FIBROSIS
Most common lethal genetic disease that affect caucasian populations?
CYSTIC FIBROSIS
AR Infertility Meconium ileus ATROPHY of exocrine pancreas Respiratory infections due to P. AERUGINOSA
CYSTIC FIBROSIS
Most common cause of death of an infant younger than 1 year old which occur between 2 and 4 months?
SUDDEN INFANT DEATH SYNDROME
Most common tumors of infancy?
HEMANGIOMAS
Most common teratomas of childhood?
SACROCOCCYGEAL TERATOMAS
Most common extracranial solid tumor of childhood?
NEUROBLASTOMA
Neuropil ( faintly eosinophilic fibrillary material)
HOMER-WRIGHT pseudorosettes
Blueberry muffin baby
NEUROBLASTOMA
Homer-wright rosette is associated with?
NEUROBLASTOMA
MEDULLOBLASTOMA
PRIMITIVE NEUROECTODERMAL TUMORS
Flexner- Wintersteiner rosette is associated with?
RETINOBLASTOMA
Consist of tumor cells collected around a blood vessel
PERIVASCULAR PSEUDOROSETTE
Most common primary renal tumor of childhood?
WILMS TUMOR
2-5 years old Mutations in WT1 gene Involve both kidneys Triphasic combination Marked anaplasia
WILMS TUMOR
Interfers with normal remodeling of epiphyses in children (LEAD LINES) Ringed sideroblasts Microcytic hypochromic anemia Basophilic stippling Peripheral demyelinating neuropathy Saturnine gout
LEAD POISONING
What is the drug of choice for acute management of lead poisoning?
EDTA and DIMERCAPROL
What is the drug of choice for outpatient management of lead poisoning?
SUCCIMER
Cerebral palsy Deafness Blindness Mental retardation Dental amalgams
MERCURY POISONING/ MINAMATA DISEASE
Curling ulcers = ___________
Marjolin ulcers = ___________
Cushing ulcers = ___________
GASTRIC ULCER
SQUAMOUS CELL CARCINOMA
INCREASED INTRACRANIAL PRESSURE
What anesthetic drugs are implicated in malignant hyperthermia?
HALOTHANE SUCCINYLCHOLINE
What is the drug of choice for malignant hyperthermia?
DANTROLENE
Weight falls to 60% of normal Deficiency of all nutrients Growth retardation Loss of muscle Extremities are emaciated
MARASMUS
Malnutrition
Edema
Anemia
Liver (fatty)
KWASHIORKOR
Amenorrhea
Severe exercise
Severe diet
Psychiatric disorder
ANOREXIA NERVOSA
Sever dental carries Erosion of tooth enamel (perimolysis) Swollen salivary gland Calluses on back of hands (Russell's sign) Electrolyte imbalance
BULIMIA NERVOSA
Genu varum (bow legs) Rachitic rosary Bleeding gums Poor wound healing Perifollicular hemorrhage
SCURVY/ vitamin c deficiency
Craniotabes
Rachitic rosary
Pectus carinatum
Genu varum
RICKETS
What potentially fatal neurologic complication of measles is prevented by vaccination?
SUBACUTE SCLEROSING PANENCEPHALITIS
Rash on the face down to the proximal extremities
Whitish ulcerated oral mucosa lesions near the opening of stensen duct (kopliks spot)
WARTHIN-FINKELDEY CELLS
MEASLES
Parotitis
Orchitis
Pancreatitis
Encephalitis
MUMPS
WARTHIN-FINKELDEY CELLS
MUMPS
COWDRY TYPE A BODIES ( large, pink to purple intracellular inclusion)
HERPES SIMPLEX INFECTION
Dorsal root ganglion cell necrosis
Dew drop on a rose petal appearance of rash
RAMSAY HUNT SYNDROME
VARICELLA
OWL’S EYE INCLUSION (intracellular basophilic inclusions surrounded by halo)
CYTOMEGALOVIRUS
Blueberry muffin baby
Heterophil negative
Owl’s eye inclusion
CYTOMEGALOVIRUS
Drug of choice for CMV infection?
GANCICLOVIR
Positive heterophil antibodies
Splenic rupture
DOWNEY CELLS (B lymphocytes)
EPSTEIN-BARR VIRUS INFECTION
What malignancies are associated with EBV?
BURKITT’S LYMPHOMA
NASOPHARYNGEAL CANCER
Most common cause of mastitis?
STAPHYLOCCOCUS AUREUS
Erthryogenic toxin Strawberry tongue Centrifugal rash ( sandpaper like ) Pastia's line DICK TEST for susceptibility
SCARLET FEVER
Erysipelas, Pharyngitis and Scarlet fever is associated with etiologic agent?
STREPTOCOCCUS PYOGENES/ GABHS
Pseudomembrane
Myocarditis
Poyneuritis
Airway obstruction
CORYNEBACTERIUM DIPTHERIAE INFECTION
Gram positive intracellular bacilli in the CSF
Focal abscess
TUMBLING MOTILITY
LISTERIA MONOCYTOGENES
Swarming motility
PROTEUS SPP.
Shooting star motility
VIBRIO CHOLERA
Falling leaf motility
GIARDIA LAMBLIA
Mediastinal hemorrhage
Necrosis and exudative inflammation
BOXCAR SHAPED gram positive organism
BACILLUS ANTHRACIS
Beaded gram positive organism in branching filaments
Modified acid fast stain (Fite Faraco)
Suppurative response with central liquefaction
No GRANULOMAS
NOCARDIA ASTEROIDES
Which virulence factor causes whooping in pertussis infection?
TRACHEAL CYTOTOXIN
Necrotizing pneumonia Well demarcated necrotic and hemorrhagic oval skin lesions (Ecthyma gangrenosum) Fleur de lis pattern Hot tub vasiculitis Malignant otitis externa
PSEUDOMONAS AERUGINOSA INFECTION
Painful genital ulcer (CHANCROID)
HAEMOPHILUS DUCREYI
Beefy red ulcer Pseudoepitheliomatous hyperplasia DONOVAN BODIES ( encapsulated cocobacilli in macrophages)
KLEBSIELLA GRANULOMATIS INFECTION
Granuloma formation with caseation necrosis
Potts disease
Lymphadenitis
Used of carbol fucshin for primary stain in the identification of the bacteria
MYCOBACTERIUM TUBERCULOSIS
Most frequent presentation of extrapulmonary TB?
Scrofula in cervical region
LYMPHADENITIS
Most common site of intestinal tuberculosis?
ILEUM
Abundant acid fast bacilli with macrophage associated with AIDS patients with CD4 < 50
MYCOBACTERIUM AVIUM
Hypopigmented plaques
Painless lesion
Bacilli are almost never found
Paucibacillary
TUBERCULOID LEPROSY
LIPID LADEN MACROPHAGES
Globi
Ulnar and peroneal nerves
Sterility
LEPROMATOUS LEPROSY
Palmar rash Chancre Condyloma latum Gummas Neurosyphillis
SYPHILLIS/ TREPONEMA PALLIDUM
Bullos eruption with epidermal sloughing Osteochondritis and periostitis Pale and airless lungs (pneumonia alba) Hutchenson teeth Diffuse hepatic fibrosis
CONGENITAL SYPHILLIS
Macrophage with red cells
Moderate splenomegaly
Acrodermatitis atrophicans
BORRELIA RECURRENTIS
Erythema chronicum migrans
Lyme arthritis
Lyme miningitis
BORRELIA BURGDOFERI
Dusk colored wedge shaped infarcts in the bowel
Enzymatic myonecrosis
Extensive fluid exudate with gas bubbles
CLOSTRIAL GAS GANGRENE
Primary cause of epidymitis?
CHLAMYDIA TRACHOMATIS
Urethritis
Stellate abscess (Lymphogranuloma venereum)
Organism NOT VISIBLE in gram stain
CHLAMYDIA TRACHOMATIS INFECTION
Hemorrhagic rash Thrombosis of the small blood vessels (arterioles) Brain microinfarcts Non cardiogenic pulmonary edema Rickettsia is the causative agent
ROCKY MOUNTAIN SPOTTED FEVER
SOAP BUBBLE LESIONS
Thick gelatinous capsule
CRYPTOCCOCCUS NEOFORMANS
RIGHT ANGLE BRANCHING of irregular wide fungal hypae
MUCORMYCOSIS/ Rizopus and Mucor
Spherules in endospores?
COCCIDIOIDES IMMITES
Intracellular yeast?
HISTOPLASMA CAPSULATUM
Board based bud?
BLASTOMYCES DERMATIDIS
Mariner’s wheel
PARACOCCIDIODES BRASILENSIS
What is the drug of choice for radical cure of benign tertain malaria?
PRIMAQUINE
Maltese cross patern (intraerythrocytic ring shaped trophozoites in tetrads)
BABESIA MICROTI
MOTT cells( plasma cells containing globules filled with immunoglobulins)
Capillary loops
Leptomeningitis
Chancre
AFRICAN SLEEPING SICKNESS
Myocarditis
CHAGAS DISEASE
AFRICAN SLEEPING SICKNESS
What characteristic sign of chagas disease is associated with unilateral periorbital edema?
ROMANA’S SIGN
What are complications associated with chagas disease?
MEGAESOPAHGUS
MEGACOLON
MYOCARDITIS
MEGACOLON
MEGAESPOHAGUS
MYOCARDITIS
CHAGA’s DISEASE
HYPERINFECTION is possible in this parasitic infection?
STRONGYLOIDES STERCOLARIS
Fine sandlike sediment within the hydatid fluid
Rupture may lead to anaphylaxis
PAIR procedure is done
ECHINOCOCCUS GRANULOSUS
Encyst in striated skeletal muscle and cardiac muscle
NURSE CELL
Myocarditis
TRICHINELLA SPIRALIS
White pinhead size granulomas
Heme derived pigments
PIPE STEM fibrosis
Treatment is praziquantel
SCHISTOSOMA JAPONICUM
Increased risk of squamous cell carcinoma of the bladder?
HEMORRHAGIC CYSTITIS
MEYERS KOUVENAAR BODIES
FILARIASIS
River blindness
Onchocercoma
Lizard skin
ONCHOCERCA VOLVULUS
What is the drug of choice for river blindness?
IVERMECTIN
What complication may arise during initiation of treatment due to lysis of onchocercal worms?
MAZZOTTI REACTION
ACUTE ANGLE branching of fungal hypae
TARGET LESIONS
ASPERGILLUS FUMIGATUS
Most common type of esophageal atresia?
TYPE B (Proximal esophageal atresia with Distal tracheoesophgaeal fistula)
Result of failed involution of the VITELLINE DUCT which connects the lumen of the developing gut to the yolk sac
MECKEL’S DIVERTICULUM
2% of the population Abdominal pain and obstruction Within 2 feet (85cm) of the ileocecal valve Approximately 2 inches (5cm) long 2x as common in males as in females Symptomatic by age 2
MECKEL’s DIVERTICULUM
Present in second or third week of life
OLIVE sized abdominal mass on physical exam
Non bilous vomiting
Associate with Turner syndrome and Trisomy 18
HYPERTROPHIC PYLORIC STENOSIS
Result when the ganglion cells undergo premature death (AGANGLIONOSIS)
HIRSCHSPRUNG DISEASE
Failure to pass meconium
Obstructive constipation
Explosive passage of flatus and feces
Enterocolitis
HIRSCHSPRUNG DISEASE
Most common cause of esophagitis associated with HIV?
CANDIDA (MYCOTIC)
Most frequent cause of esophagitis?
REFLUX ESOPHAGITIS
Characterized by intestinal METAPLASIA within the esophageal squamous mucosa
Increased risk of esophageal adenocarcinoma
BARRETT ESOPHAGUS
Definitive diagnosis of barrette esophagus microscopically?
DEMONSTRATION OF INTESTINAL GOBLET CELLS
Arises from long standing GERD and Barrette esophagus
Risk factor of dysplasia, smoking and obesity
Usually occur in the DISTAL THIRD of the esophagus
Intestinal type morphology with mucin production
ESOPHAGEAL ADENOCARCINOMA
Chest pain is the chief complain
Occur in middle third of esophagus
Risk factors of smoking , poverty, PLUMMER VINSON SYNDROME and achalasia
Squamous dysplasia
SQUAMOUS CELL CARCINOMA of esophagus
Transient mucosal inflammatory process which impaired and damage mucosal surface
Well known complication therapy of NSAIDs
Microscopically with intact surface epithelium
ACUTE GASTRITIS
Most common cause of CHRONIC gastritis?
HELICOBACTER PYLORI
MALT lymphoma (lymphoid aggregates with germinal centers and abundant SUBEPITHELIAL plasma cells)
Pit abscess
Antral gastritis
HELICOBACTER PYLORI GASTRITIS
Diffuse mucosal damage Grandular atrophy of oxyntic mucosa Megalobalstic changes Intestinal metaplasia BODY of the stomach common location
AUTOIMMUNE GASTRITIS
Due to imbalances of mucosal defenses and damaging forces
Most often associated with H. Pylori
Duodenum is the common site
PEPTIC ULCER DISEASE
Most common malignancy of the stomach?
GASTRIC ADENOCARCINOMA
Histopathology findings:
Rigid LEATHER BOTTLE appearance wall
SIGNET ring cells (large mucin vacoules pushes the nucleus to the periphery)
Mucin lakes
GASTRIC ADENOCARCINOMA
Sign associated with GI malignancy cahracterized by Diffuse seborrhoic keratosis?
LESERTRELAT SIGN
Best considered to be well differentiated neuroendocrine carcinomas
40 % occur in small intestine
SALT And PEPPER chromatin
CARCINOID TUMOR
Most comon mesenchymak tumor of the abdomen?
GI STROMAL TUMOR
Common site of infarction in ischemic bowel disease?
SPLENIC FLEXURE
Immune mediated enteropathy triggered by the ingestion of GLUTEIN containing food with microspic findings: crypts hyperplasia, villous atrophy and intraepithelia lymphocytosis?
CELIAC DISEASE
Common bacterial enteric pathogen associated with improperly cooked chicken and
GULLAIN BARRE SYNDROME with microscopic findings: cryptitis, crypt abscess and crypt architecture is preserved?
CAMPYLOBACTER ENTEROCOLLITIS
What is the drug of choice eradication of chronic carriage of salmonella in the galbladder?
AMPICILLLIN(6-8 months)
Presence of mucopurulent exudates formERUPTION REMINISCENT OF VOLCANO in histopathology?
PSEUDOMEMBRANOUS COLITIS
TRIAD: diarrhea, weight loss and malabsorption
HISTOPATH:
Distended foamy macrophages
PAS positive
Diastase resistant granules
WHIPPLE’S DISEASE
Transmural inflammation Common in ileum and colon SKIP LESIONS ulcers is deep, knife like No malignant potential COBBLESTONE APPEARANCE
CROHN DISEASE
Limited to mucosa Diffuse distribution of the lesion Common in the colon only Toxic megacolon Ulcers with superficial, broad based
ULCERATIVE COLITIS
Apthous ulcer COBBLESTONE APPEARANCE Paneth cell metaplasia Noncaseating granulomas Crypt abscesses
CHRON’S DISEASE
DIVERTICULITIS is common in?
ELDERLY
Toxic megacolon
Strictures not occur
Serosal surface is normal
Mural thickening is not present
ULCERATIVE COLITIS
Pedunculated smooth surfaced reddish lesions with cystic space
JUVENILE POLYP
Hamartomatous polyps
Arborizing networks
Most common in small intestine
PEUTZ JEGHERS SYNDROME
Low maliganant potential polyp?
HYPERPLASTIC POLYP
Most common malignancy of the GI tract?
COLORECTAL ADENOCARCINOMA
Dietary factors are most closely associated SIGNET RING CELLS Dysplastic epithelium Desmoplastic response Mucin accumulation
COLORECTAL ADENOCARCINOMA
Most common site of metastasis of colorectal adenocarcinoma?
LIVER
Caput medusae
Esophageal varices
Hemorrhoids
PORTAL HYPERTENSION
Bridging fibrous septa
Parenchymal nodules
Disruption of architecture of entire liver
CIRRHOSIS
Dubin Johnson syndrome and Rotor syndrome is associated with?
CONJUGATED HYPERBILIRIBINEMIA
Cholestatic hepatocyte
DILATED canalicular space
APOPTOTIC cells
kupffer cells with BILE pigments
INTRAHEPATIC CHOLESTASIS
Bile ductular PROLIFERATION
Edema, bile pigment retention
Swollen and degenerating hepatocytes
EXTRAHEPATIC CHOLESTASIS
BALLOONING DEGENERATION Councilman bodies Macrophage aggregates Apoptosis Bridging necrosis Prominent inflammation
ACUTE HEPATITIS
Hepatocyte apoptosis
Bridging necrosis
Bridging fibrosis
Deposition of fibrous tissue
CHRONIC HEPATITIS
GROUND GLASS hepatocytes seen in what type of hepatitis?
HEPATITIS B INFECTION
Lymphoid aggregates, bile duct reactive changes and steatosis is seen in what type of hepatitis?
HEPATITIS C INFECTION
T CELL mediated autoimmunity
Anti smooth muscle antibodies POSITIVE
Chronic and progressive hepatitis of unknown etiology
AUTOIMMUNE HEPATITIS
MALLORY BODIES
Hepatocyte swelling and necrosis
Neutrophil reaction
Sinusoidal prevenular fibrosis
ALCOHOLIC HEPATITIS
Excessive accumulation of iron
Mostly deposited in liver, heart, skin and pancreas
TRIAD: Hepatomegaly
Diabetes mellitus
Bronze skin pigmentationHEMOCHROMATOSIS
Deposition of hemosiderin
Cirhhosis
Pancreatic fibrosis
HEMOCHROMATOSIS
Impaired copper excretion into bile and failure to incorporate copper into ceruplasmin
In eye lesion (KAYSER FLEISCHER RINGS)
WILSONS’S DISEASE
AR
PAS positive
DIASTASE resistant
Round to oval cytoplasmic globular inclusions in hepatocytes
Loss inhibition of protease released from neutrophils leads to panacinar emphysema
ALPHA 1 ANTITRYPSIN DEFICIENCY
Obstruction of two or more major hepatic veins
Liver is swollen and rep purple
Tense liver capsule
Severe centrilobular congestion and necrosis
BUDD CHIARI SYNDROME
Benign neoplasm of the liver associated with OCP used?
HEPATIC ADENOMA
Common type of stones in cholelithiasis?
CHOLESTEROL STONES
Most common congenital anomaly of pancreas
ANNULAR PANCREAS
REVERSIBLE pancreatic parenchymal injury associted with inflammation
Most common etiologies are alcoholism and biliary tract disease
ACUTE PANCREATITIS
What is the appropriate treatment for acute pancreatitis?
BOWEL REST
What is the most appropriate analgesic for patients with acute pancreatitis?
MEPERIDINE
IRREVERSIBLE destruction of exocrine parenchyma
Most common cause is long term alcohol abuse
CHRONIC PANCREATITIS
What is the tumor marker for pancreatic cancer?
CA 19-9
What is the surgical treatment for pancreatic cancer?
WHIPPLE PROCEDURE (Pancreaticoduodenectomy)
What is the condition characterized by extrinsic compression of the common hepatic duct, that can be mistaken for pancreatic CA?
MIRRIZI SYNDROME
What is the clinical sign characterized by a painless palpable gallbladder associated with jaundice?
COUVOISIER GALLBLADDER
Oliguria
Hematuria
Hypertension
Azotemia
NEPHRITIC SYNDROME
Edema
Proteinuria
Hypoalbuminemia
Hyperlipidemia
NEPHROTIC SYNDROME
Bilateral
Enlarged kidneys at birth
Sponge-like apperance
Spokes on a WHEEL pattern
ARPKD
Low set ears
Parrot beak nose
Lung hypoplasia
Associated with oligohydramnios
POTTER FACIES
Children 6-10 y o GABHS Sequelae of impetigo Enlarged hypercellular glomeruli SUBEPITHELIAL HUMPS
POST STREPTOCOCCAL GN
What type of RPGN associated with SLE?
TYPE 2 RPGN
Thickened BM
Sup epithelial humps (spike and dome apperance)
Non selective proteinuria
No cells present
Indolent course with poor response to steroids
MEMBRANOUS GLOMERULOPATHY
Diffuse effacement of epithelial foot process by EM No deposits in EM Highly selective proteinuria Excellent response to steroids Good prognosis
MINIMAL CHANGE DISEASE
Most common cause of nephritic syndrome in children?
POST STREPTOCOCCAL GN
Most common cause nephrotic in children?
MINIMAL CHANGE DISEASE
Most common cause nephrotic syndrome in adults?
MEMBRANOUS GLUMERULOPATHY
Most common GN OVERALL?
IgA NEPHROPATHY
Most common cause of ARF?
ACUTE TUBULAR NECROSIS
Most common cause of CRF?
DIABETES MELLITUS
Recurrent gross or microscopic hematuria
Mesangial deposit of IgA
IgA NEPHROPATHY
WIRE LOOP CAPILLARIES seen i what type of SLE?
TYPE IV DIFFUSE PROLIFERATIVE GN
Associated with MULTIPLE MYOMA
CONGOR RED positive
Deposit seen in mesangium, blood vessel wall and interstitium
Present as NEPHROTIC SYNDROME
AMYLOIDOSIS
Associated with PAINLESS HEMATURIA?
TRANSITIONAL CELL CA (urothelial carcinoma)
Maligancy of plama cells BENCE JONES PROTEINS amyloidosis Hypercalcemia Hyperuricemia
MULTIPLE MYELOMA
