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Chiro Essentials Pathology > Neoplasia, MSK and Cardiovascular Path > Flashcards

Neoplasia, MSK and Cardiovascular Path Flashcards

1
Q

Burkitt’s vs Hodgkin’s lymphoma

A

Burkitt: starry-sky appearance, EBV (mosquito), MC in kids

Hodgkin’s: Reed-Sternberg cells (binucleated cells, owl eye appearance), MC in adults

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2
Q

Adrenal medulla tumor secretes excess nor-epinephrine and symptoms?

A

Pheochromocytoma: paroxysms of palpitations, perspiration, pressure headaches, VMA in urine

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3
Q

Mesenchymal, stromal, epithelial cell tumor of the kidney

A

Wilm’s - MC in kids

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4
Q

MC 1o bone cancer in adults

A

Multiple myeloma: malignant plasma cells in marrow, M spike (inc IgG), Bence Jones protein (urine), nocturnal bone pain, recurrent infections

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5
Q

MC 1o bone cancer in children and teens

A

Osteosarcoma: bones aroundknee joint - lower femur and upper tibia

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6
Q

What malignant bone tumor mimics osteomyelitis?

A

Ewing’s Sarcoma

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7
Q

MC benign smooth muscle tumor in uterus?

A

Uterine leiomyome (fibroid)

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8
Q 
4 Main Types of Leukemia - differentiate
Acute lymphoblastic
Acute myelogenous
Chronic myelogenous
Chronic lymphocytic
A

Acute lymphoblastic - <5 yrs
Acute myelogenous - 80% in adults, Auer rods+
Chronic myelogenous - 30-60 yrs, philadelphia chromosome (tranlocation Chromosome 9 to 22), anemia, bleeding, infxn
Chronic lymphocytic - >60, men, lymphadenopathy

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9
Q

BCR-abl

A

on philadelphia chromosome (CML)

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10
Q

N-MYC

A

neuroblastoma

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11
Q

L-MYC

A

Lung cancer

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12
Q

P16

A

Melanoma

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13
Q 
These chemical carcinogens cause what?
Nitrosamine
Asbestos
Benzene
Aflatoxin
A

Nitrosamine - esophageal cancer
Asbestos - mesothelioma
Benzene - leukemia
Aflatoxin - hepatocellular carcinoma

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14
Q

Thee radiation carcinogens cause what?
UV light
X-rays
Uranium

A

UV light - melanoma
X-rays - thyroid cancer
Uranium - lung cancer

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15
Q 
These microbial carcinogens cause what?
HPV 16/18
HHV 8
EBV
Hep B/C
A

HPV 16/18 - cervical cancer
HHV 8 - Kaposi sarcoma
EBV - Burkitt’s lymphoma
Hep B/C - hepatocellular carcinoma

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16
Q 
These tumor markers indicate what?
B-HCG
CEA
AFP
PSA
CA-125
S-100
Acanthosis nigricans
A 
B-HCG: choriocarcinoma
CEA: colon cancer
AFP: hepatocellular carcinoma
PSA: Prostate cancer
CA-125: ovarian cancer
S-100: melanoma
Acanthosis nigricans: adenocarcinoma, lung, breast, stomach cancer (obesity, diabetes)
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17
Q

MC Cancer prevalence vs death

A

Prevalence M - prostate, F breast, then lung then colorectal

Deaths: lung then prostate/breast then bowel

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18
Q

Cyanotic vs Acyanotic heart disease

A

Cyanotic: R-L shunt (Fallot’s tetralogy, Transposition of great vessels, persistent Truncus Arteriosus)
Acyanotic: L-R shund (VSD, ASD, PDA)

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19
Q

Fallot’s tetraology

A

Pulmonary STENOSIS, rt ventricular hypertrophy, overriding aorta, VD

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20
Q

Failure of ostium secundum to close?

A

ASD

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21
Q

MC congenital heart disease?

A

VSD

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22
Q

Rheumatic fever:

A

Post strep infxn, TIIHS
Aschoff bodies (granulomas w/Anitschkow giantcells), MacCallum patches (L atrium)
Jones major criteria: sydenham’s chorea, polyarthritis, erythema marginatum, carditis, subcutaneous nodules
MC damaged valve is mitral, then aortic rarely pulmonary or tricuspid

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23
Q

Endocarditis
Subacute bacterial:
Acute bacterial:
Libman-Sacks:

A

Endocarditis - Strep pyogenes/viridans, staph aureus
Subacute bacterial: infxn previous damaged valves (rheumatic fever) fever, new murmur, splinter hemorrhages, Olser’s nodes, Janeway nodules
Acute bacterial: infxn of previously healthy valved - IV drug users
Libman-Sacks: sterile endocarditis of mitral and tricuspid valves in SLE

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24
Q

Thrombus vs Embolism

A

Thrombus: clot in atheroscleroticvessel w/line of Zahn
Embolism: dislodged mass of undissolved material in vessel travelling in blood (arterial - painful, pale, pulseless, perishingly cold limb)

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25
Q

Arterio vs Atherosclerosis

A

Arterio: thickening of A w/loss of elasticity and contractility due to infiltration of tunica intima by collagen and smooth muscle fibers
Athero: lipid/calcium deposits in tunica intima, RF’s arterial HTN, tobacco, hereditary, endocrine, sedentary, obese, male, age and S/S subendothelial fatty streaks, fibrosis, atheroma, rupture w/eventual occlusion or embolus formation

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26
Q

Ischemic Heart DIsease vs MI

A

IHD: coronary atherosclerosis –> Angina, MI, CHF
MI: ischemic necrosi of myocardium due to blocked coronary A (L nt descending) pain not relieved by rest, release of cardiac enzymes (Troponin, CKMB, Lactic Dehydrogenase)

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27
Q

Angina Pectoris vs Prinzmetal

A

Pectoris: reversible inadequately perfused myocardium and pain aggravated by stress/exertion, relief w/rest
Prinzmetal: occur at rest due to coronary A spasm

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28
Q 
Aneuyrsm:
Atherosclerotic
Dissecting
Syphilitic
Berry
A

Aneuyrsm: localized dilation of A
Atherosclerotic - MC AAA
Dissecting - longitudinal intraluminal tearing of ascending T aorta (Marfan’s, Ehlers-Danlos, long HTN)
Syphilitic - 3o syphilis affects arch of aorta
Berry - congenital weaknesses >30 yrs (Adult polycystic disease of the kidney, anterior circle of Willis, subarachnoid hemorrhage in YA, severe thunder clap HA, neck stiff, LoC)

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29
Q

HTN
Essential
2o
Malignant

A

HTN: elevation BP >140/90 3+ visits
Essential: unknown, RF fam hx, lots of salt, stress, obesity
2o: unilateral renal A stenosis, hyperthyroidism, Cushing, pheochromocytoma
Malignant: rapidly progressing, severe vascular damage, early death from stroke/HF

30
Q

CHF causes and symptoms

A

Cause: CAD, HTN, valvular heart disease, congenital heart disease, cardiomyopathy
Symptoms: dyspnea on exertion, basal crackles in lungs, paroxysmal nocturnaldyspnea, raised JVP, tender hepatomegaly, bilateral pitting ankle edema

31
Q

Cardiomyopathy:

A

diseased myocardium, caused by alcohol, pregnancy, viral infxn (dilated, hypertrophic, restrictive)

32
Q

Cor pulomale

A

Rt side heart failure due to COPD, pulmonary embolism

33
Q

Cardiac tamponade:

A

Heart compressed due to excess fluid in pericardial sack

Beck’s triad: hypotension, heart sounds distant, high jugular venous pressure

34
Q

Peripheral Vascular disease:

A 
Atherosclerotic narrowing of large A
Intermittent claudication (leg pain worse on walking, relieved by rest
35
Q

DVT vs PE

A

DVT: Virchow’s triad (viscosity increased clotting, stasis in V from prolonged immobilization, damage to endothelium from vessel wall due to trauma) may be related to contraceptive pill, Factor V Leiden defect, may have painful swollen leg
PE: DVT from leg/pelvis, embolus to IVC to heart to pulm trunk and occludes a pulmonary A/br causing ventilation/perfusion mismatch, SoB, pleuritic chest pain, hemoptysis

36
Q

Varicose V vs Thrombophlebitis

A

Varicose: tortuous dilated superficial V may lead to
Thrombophlebitis: inflammation of V wall, swollen tender superficial cord, may lead to thrombosis

37
Q

Raynaud’s disease vs phenomenon

A

Disease: dec BF triggered by cold/emotion (white, blue, red) in young females w/o cause
Phenomenon: 2o to SLE, scleroderma, atherosclerosis, CREST syndrome

38
Q

CREST syndrome

A 
Calcinosis cutis
Raynaud's phenomenon
Esophageal dysfunction
Sclerodactyly
Telangiectasia
39
Q

TIIIHS in medium sized A, 30% + for HepB

Symptoms

A

Polyarteritis Nodosa

fever, joint, ab pain, palpable purpura

40
Q

Thromboangitis Obliterans/Buerger’s

A

Idiopathic segmental inflammation of medium A/V in male smokers btw 20-40 with intermittend claudication and weakdisal pulses

41
Q

Giant cell inflammation in small A

Symptoms

A

Temporal arteritis - raised ESR< elderly, ass w/polymyalgia rheumatica, can affect small A (br of ICA/vertebral A), can cause blindness

42
Q

Takayasu’s arteritis/Pulseless disease

A

Inflammation of aorta; possible autoimmune

MC Asian females <40 - absent pulses in upper limbs

43
Q

Hemangioma:

A

benign BV tumor in skin/spine

44
Q

Caused by HHV Type 8 in HIV/AIDS

A

Kaposi Sarcoma

45
Q

Benign myxomatous tumor in fossa ovalis

A

Atrial myxoma

46
Q

Osteomalacia vs Rickets

A

Osteomalacia: loss of bone quality + softening of bone, dec Vit D in adults, Looser’s zones
Rickets: loss of bone quality, dec Vit D in kids, bowlegs, rachitic rosary (swollen costochondral joints)

47
Q

Osteitis fibros cystica cause and S/S

A

hyperparathyroidism

Brown bone cyst and hypercalcemia

48
Q

Paget’s disease/Osteitis Deformans cause in who?

A

Paramyxovirus infxn

Older ppl w/thickening of bones and deformities

49
Q

Neuropathic joint disease: joint destruction b/c of loss of pain
Cause and S/S

A

Charcot’s joint
Tabes dorsalis, DM, syringomyelia, leprosy
Destruction, debris, deformity, disorganization of joint

50
Q

Most common benign tumor of the hand

A

Enchondroma - expansile, benign, cartilage

51
Q

Multiple enchondromas (MC hands)

A

Ollier’s disease

52
Q

Osteoma

A

Dense, mature bone island in skull/spine

53
Q

Benign metaphyseal bone tumor extending into epiphysis

A

Giant cell tumor

54
Q

Anuerysmal bone cyst

A

eccentric soap bubble x-ray appearance from diaphysis to metaphysis and blood-filled

55
Q

Sunray appearance + Codman’s triangle with periosteal elevation

A

Osteosarcoma/osteogenic sarcoma

56
Q

3rd MC malignant bone tumor in men 30-60

A

Chondrosarcoma

57
Q

RA everything you know! Show me what you got!

A

autoimmune bilateral small joint disease in HLA-DR3/4+ RF IgG ab in 70-80% of pt, joint inflamm characterized by pannus (inflamed granulation tissue in joint space destroying articular surface) and swan neck, ulnar deviation, boutonniere, Haygarth’s node and Bouchard’s nodes, Felty’s syndrome (splenomegaly, neutropenia)
Still’s in kids at small/med joints (wrist, knee)with lymphadenopathy and splenomegaly

58
Q

SLE what do you know??

A

ANA +, anti ds-DNA ab, HLA-DR3/4, MC in younger females, more severe in young black females, polyarthritis, butterfly rash, photosensitivity, nephrotic syndrome, Libman-Sack’s endocarditis

59
Q

Sjogren’s syndrome symptoms seen in waht conditions? In who? antibodies to?

A

Xerophthalmia, xerostomia, arthritis
RA, slceroderma
Women btw 40-60
Ribonucleoproteins (SS-A/B)

60
Q

Scleroderma: in who? types? S/S?

A

unknown multisystem autoimmune disorder F3:1, 50-60, limited or diffuse
CREST: calcinosis, raynaud’s phenomenon, esophageal hypomotility, sclerodactyly, telangiectasia, anti-centromere Ab

61
Q

HLA-B27+ arthridities

A

Psoriatic: polyarhtritis w/silver-scales over extensors, pitted nails, dactylitis
Enteropathic: UC/Crohn’s related
AS/Marie Strumpell’s: SI and LBP, bamboo spine
Reiter’s: conjunctivities, urethritis, arthritis (joint/heel), caused by Chlamydia or Shigella infxn

62
Q

OA you can do it if you really try!

A

DJD in weight-bearing joints (hips, knees, spine) in older females leading to joint space narrowing, subchondral sclerosis, osteophytes, Heberdens, bouchard’s nodes

63
Q

Gout or podagra or gonagra

A

hyperuricemia, males, alcohol, purine-rich foods,
Acute gout severe 1st met-phalangeal joint pain
Chronic: tophi (uric acid crystals in ear/skin over joins - need-shaped, negatively birefringent)

64
Q

Borrelia Burgdorferi causes?

S/S?

A

Lyme disease - deer tick: ixodes scapularis

Polyarthritis, bulls-eye lesion (erythema migrans, Bell’s palsy

65
Q

Ach Receptor Ab in?
Who gets it?
S/S?

A

Myasthenia gravis
30+ females, >60 yr males, those with thymic hyperplasia or maybe a thymoma
diplopia, ptosis problem chewing, fatigue, repetitive muscle use, +tensilon test

66
Q

Antibodies to pre-synaptic voltage-gated calcium channels @neuromuscular junction
Causes + epidemiology
S/S?

A

Lambert-Eaton syndrome prevents ACH from being released by vesicles
Small (oat) cell lung cancers, >60 yr males
Weakness improve w/repetitive use, Tensilon test usually negative

67
Q

Dermatomyositis what ya got?

A

unknown cause - autoimmune disorder, MC in F
Heliotrope rash, Gottron’s papules, ANA and anti-Jo-1 Ab
10% associated w/malignancy of lung, breast, guy, ovary

68
Q

Peroneal muscular wasting, inability to evert foot, progressive hereditary N damage

A

Charcot-Marie-Tooth

69
Q

AVN of head of femur in 4-10 yr olds

A

Legg-Calve-Perthes Disease

70
Q

Possible traumatic Salter-Harris Type 1 epiphyseal fx in overweight children and teens

A

SCFE

71
Q

Contracture of palmar fasica where ring and little finger bend to palm
Associated with what conditions?

A

Dupuytren’s contracture

DM, cirrhosis, long term use of phenytoin (anti-epilipetic)

72
Q

Polymyalgia rheumatica - who gets it? S/S?

A

Females >50
pain and stiffnes in shoulder and hips, malaise, fever, associated w/temporal arteritis, can lead to blindness, highly elevated ESR w/normal CK

Chiro Essentials Pathology (4 decks)

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