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New lab 3 Flashcards

1
Q

Describe the condition and it’s features

A

cavernous hemangioma:

  • affects brain & liver
  • stroma in between blood vessels
  • Persist (need surgery)
  • Neurodeficits, seizures, & memory loss
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2
Q

Overproduction of arginine vasopressin (antidiuretic hormone [ADH]) by a tumor causes syndrome of inappropriate ADH secretion (SIADH)

A

SIADH

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3
Q

Describe the condition and it’s features

A

Capillary hemangioma:

  • Affects eyelids, face, neck, chest, & butt
  • decreases vision (amblyopia) & droops eye
  • DISAPPEARS over time
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4
Q
  • Affects eyelids, face, neck, chest, & butt
  • decreases vision (amblyopia) & droops eye
  • DISAPPEARS over time
A

Capillary hemangioma

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5
Q

Describe the features of Von Hippel Lindau syndrome

A

Hemangioblastomas or retinal angiomas
- Pheochromocytomas
- Pancreatic cystadenomas or neuroendocrine tumors
- renal cell carcinoma

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6
Q

Hemangioblastomas or retinal angiomas
- Pheochromocytomas
- Pancreatic cystadenomas or neuroendocrine tumors
- renal cell carcinoma

A

Von Hipple Lindau syndrome

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7
Q

Describe the features of the condition

A

Lymphangioma:

  • Benign congenital malformation of the lymph vessels that are usually cystic or cavernously dilated
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8
Q

Describe the features of this condition

A

Pulmonary Hamartoma

  • Condensed tissue with a mix of pale myxomatous tissue
  • benign lung (most common)
  • Popcorn calcifications
  • Coin lesions
  • SOB, coughing, but minimal respiratory problems
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9
Q
  • Condensed tissue with a mix of pale myxomatous tissue
  • benign lung (most common)
  • Popcorn calcifications
  • Coin lesions
  • SOB, coughing, but minimal respiratory problems
A

Pulmonary Hamartoma

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10
Q

Elderly patient comes in for routine checkup, has coughing, SOB and minimal respiratory problems. There is no Past Medical History or anything extraordinary. Pulmonary nodule is seen on CT and X-ray scans.

A

Pulmonary Hamartoma

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11
Q

Describe the features of the condition

A

Gastric/pancreatic choristoma

  • Pancreatic lobules are seen within the submucosa of the GI lining & gall bladder
  • Different organ cells in the tissue
  • most common spots stomach, gall bladder, then eye
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12
Q
  • Pancreatic lobules are seen within the submucosa of the GI lining & gall bladder
  • Different organ cells in the tissue
  • most common spots stomach, gall bladder, then eye
A

Gastric/pancreatic choristoma

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13
Q

Female) patient shows up with recurrent pain in the right hypochondriac region. Barium x-ray is done, or endoscopy is done, which shows mass in gallbladder or stomach. Patient says they have a burning sensation during digestion.

A

This is because there are pancreatic enzymes in the stomach. There is no further action that needs to take place.

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14
Q

Describe the tissue

A

normal bowel

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15
Q

Describe the features of the condition

A

Necrotizing enterocolitis

  • Hemorrhagic necrosis in the mucosa and muscular wall
  • gas bubbles inbetween the submucosa
  • disintegrated vili
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16
Q
  • Hemorrhagic necrosis in the mucosa and muscular wall
  • gas bubbles inbetween the submucosa
  • disintegrated vili
A

Necrotizing enterocolitis

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17
Q

After being born, 2 weeks later the baby is brought back with symptoms of bloody stool and abdominal distention. Gas tracks are seen along the bowel wall, cystic “bubbly” collections. Air is collected in intestinal wall

A

Necrotizing enterocolitis

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18
Q

After being born, 2 weeks later the baby is brought back with symptoms of bloody stool and abdominal distention. Gas tracks are seen along the bowel wall, cystic “bubbly” collections. Air is collected in intestinal wall, but if it is intraluminal air

A

Hirshsprung’s

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19
Q

Describe the features of Hirschsprung disease

A

hyperreactivity to bacteria which produces Toll-Like Receptors.
Mass is seen in duodenal area

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20
Q

Describe the features of the condition

A

Neonatal Respiratory Distress Syndrome / Hyaline Membrane Disease

  • Eosinophilic hyaline membranes (made of fibrin & necrotic type 2 pneumocytes) line alveolar ducts & alveoli
  • Increased vascular permeability
  • lack of surfactant

signs:
- Respiratory distress/nasal flaring

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21
Q
  • Eosinophilic hyaline membranes (made of fibrin & necrotic type 2 pneumocytes) line alveolar ducts & alveoli
  • Increased vascular permeability
  • lack of surfactant

signs:
- Respiratory distress/nasal flaring

A

Neonatal Respiratory Distress Syndrome / Hyaline Membrane Disease

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22
Q

Describe the features of the condition

A

Fibroadenoma of the Breast

-shows well circumscribed
- uniformly hypercellular stroma,
- uniform distribution of glands and stroma
- fibrous capsule covering breast mass
- mobile

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23
Q

-shows well circumscribed
- uniformly hypercellular stroma,
- uniform distribution of glands and stroma
- fibrous capsule covering breast mass
- mobile

A

Fibroadenoma of the Breast

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24
Q

Describe the features of the condition

A

Mature Cystic Teratoma of the Ovary/aka Dermoid Cyst

-shows all different types of layers: Ectoderm, Mesoderm, Endoderm,
-see blood vessels, sebaceous glands, smooth muscles (everything). Hair, teeth, sebaceous everything

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25
Q

-shows all different types of layers: Ectoderm, Mesoderm, Endoderm,
-see blood vessels, sebaceous glands, smooth muscles (everything). Hair, teeth, sebaceous everything

A

Mature Cystic Teratoma of the Ovary/aka Dermoid Cyst

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26
Q

: Mostly asymptomatic, may have increased abdominal girth, urine frequency increased due to increased pressure, lower abdominal pain sometimes.
30 y/o female pt with hyperthyroidism, weight loss, palpitations, tachycardia. Lab findings: Increased T3/T4, decreased TSH

Whats the differential diagnosis?

A

Differential Diagnoses:
- Graves Disease ~ Increased T3/T4, decreased TSH

  • Confusion, Irritability, hallucinations 🡪 Lumbar puncture shows anti-NMDAR antibodies [autoimmune encephalitis]
  • Ovarion Torsion

Radio iodine test uptake 🡪 normally increased but comes back normal.
Next step: Ultrasound of the abdominal area

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27
Q

Aflatoxin B1-associated hepatocellular carcinomas have a particular mutation in _______,
a G : C→T : A trans version in codon 249.

A

TP53

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28
Q

Describe the features of initiators

A

exposure to a carcinogen, DNA damage is fast and irreversible

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29
Q

Describe the features of Promoters

A

These induce tumors to arise from proliferating cells, they don’t directly damage DNA & are reversible

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30
Q

Describe the features of direct acting carcinogens

A

Weak carcinogens that don’t need to metabolically converted to damage DNA

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31
Q

Describe the features of indirect acting carcinogens

A

Chemicals that need to be metabolically converted to become carcinogenic

ex. polycyclic hydrocarbons or benzo (a) pyrene)

The main metabolic agent in cytochrome P450-dependent monooxygenase

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32
Q

Chemicals that need to be metabolically converted to become carcinogenic

ex. polycyclic hydrocarbons or benzo (a) pyrene)

The main metabolic agent in cytochrome P450-dependent monooxygenase

A

indirect acting carcinogens

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33
Q

Weak carcinogens that don’t need to metabolically converted to damage DNA

A

direct acting carcinogens

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34
Q

These induce tumors to arise from proliferating cells, they don’t directly damage DNA & are reversible

A

promoters

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35
Q

exposure to a carcinogen, DNA damage is fast and irreversible

A

initiators

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36
Q

Describe the features of HTLV-1

A

causes adult T-cell leukemia/lymphoma (ATLL), Japan, the Caribbean basin, South America, and Africa, USA

HTLV-1 targets CD4+ T cells and its transforming effect is caused by the Tax gene protein, which is crucial for viral replication.

Tax protein disrupts the cell cycle inhibitor p16/INK4a, promotes cyclin D activation, and hinders DNA repair functions by inhibiting ATM-mediated cell cycle.

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37
Q

HTLV-1 targets CD4+ T cells and its transforming effect is caused by the Tax gene protein, which is crucial for viral replication.

Tax protein disrupts the cell cycle inhibitor p16/INK4a, promotes cyclin D activation, and hinders DNA repair functions by inhibiting ATM-mediated cell cycle.

A

HTLV-1

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38
Q
A
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39
Q

Describe the features of HPV & cancer

A

HPVs (types 16 and 18) cause cervical, anogenital, and oropharyngeal cancers

E6 & E7 protein contributes to cancer development

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40
Q

How does E6 protein in long term HPV (16 & 18) infections cause cancers?

A

by binding and breaking proteins (p53 and BAX) & increasing the expression of TERT an enzyme involved in telomerase function. The p53 protein, with a specific variation at amino acid 72, is more vulnerable to degradation by E6, increasing the risk of cervical carcinomas.

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41
Q

How does E7 protein in long term HPV (16 & 18) infections cause cancers?

A

E7 protein binds RB protein, releasing E2F factors and promoting cell cycle progression. E7 also inactivates p21, p27 inhibitors and activates cyclins E and A.

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42
Q

What cancer does EBV cause

A

African form of Burkitt’s lymphoma.

B-cell lymphomas in immunosuppressed individuals

Hodgkin lymphoma.

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43
Q

Describe how EBV leads to cancer

A

It infects B lymphocytes and oropharynx cells, using CD21 receptors on B cells. The oncogene LMP-1 activates NF-κB and JAK/STAT pathways, preventing apoptosis with BCL2 activation. EBNA-2 triggers the expression of host genes like cyclin D.

44
Q

In areas with EBV-related Burkitt lymphoma, some cells survive by reducing expression of these antigens.

A

EBNA2 & LMP-1

45
Q

Lymphoma only develops with the acquisition of the t(__,___) translocation, activating the ________

A

8, 14

&

c-MYC oncogene.

46
Q

How does H.pylori lead to cancer?

A

H. pylori causes gastric adenocarcinoma by producing CagA protein, which enters gastric cells and triggers a signaling cascade resembling uncontrolled growth factor stimulation

47
Q

Location and impingement on adjacent structures

Functional activity (synthesis of hormones, cytokines)

Bleeding and infections

Rupture and infarction

Cachexia (wasting)

A

effects of tumor on the host

48
Q

effects of tumor on the host

A

Location and impingement on adjacent structures

Functional activity (synthesis of hormones, cytokines)

Bleeding and infections

Rupture and infarction

Cachexia (wasting)

49
Q

In young adults, malignant ________is a leading cause of SVCS.

A

lymphoma

50
Q

Chest X-ray: Increased upper right-sided mediastinal mass

Compression of phrenic & right recurrent laryngeal nerve

Symptoms:
Neck and facial swelling
Shortness of breath
Cough
Hoarseness worsens with bending forward or when supine
Dilated neck veins
Increased number of collateral veins on anterior chest wall.

A

Superior vena cava syndrome due to a malignant lymphoma (young adults)

51
Q

Describe the features of SVCS

A

Chest X-ray: Increased upper right-sided mediastinal mass

Compression of phrenic & right recurrent laryngeal nerve

Symptoms:
Neck and facial swelling
Shortness of breath
Cough
Hoarseness worsens with bending forward or when supine
Dilated neck veins
Increased number of collateral veins on anterior chest wall.

52
Q

Paraneoplastic syndromes are important for 3 reasons

A

1) early indicator of hidden tumors
2) can cause severe clinical issues,
3) can mimic metastatic disease.

53
Q

Describe the features of Cushing’s syndrome

A
  • 50% develop Small cell carcinoma of the lung.
  • Excessive production of corticotrophin or corticotrophin-like peptides causes it.

Excess ectopic ACTH = Excess cortisol

54
Q

What is the precursor for corticotrophin?

A

pro-opiomelanocortin.

55
Q

Describe the features of Lung cancer + Cushings

A

have high levels of pro-opiomelanocortin and corticotrophin in their blood.

56
Q

Describe the features of Pituitary induced cushings

A
  • Patients with pituitary disease-induced Cushing syndrome only have elevated serum corticotrophin levels.
57
Q
  • overproduction of cortisol, hirsutism, hyperglycemia
  • muscle wasting
  • hypokalaemia with metabolic alkalosis
  • Hypertension
  • Moon” face,
  • abdominal striae and “Buffalo” hump
A

Symtoms of cushings

58
Q

Describe the symptoms of Cushings

A
  • overproduction of cortisol, hirsutism, hyperglycemia
  • muscle wasting
  • hypokalaemia with metabolic alkalosis
  • Hypertension
  • Moon” face,
  • abdominal striae and “Buffalo” hump
59
Q

Describe the features of SIADH

A

Over production of arginine vassopressin leads to Excessive ADH production by a tumor leads to SIADH

60
Q

Syndrome of inappropriate ADH secretion (SIADH)
is associated with which cancer?

A

small cell lung carcinoma

61
Q

Describe the symptoms of SIADH

A

Increased ADH–decreased urine output–decreased thirst–increased retention of water– hyponatremia.

-altered mental status
-seizures
-coma and sometimes death

62
Q

Increased ADH–decreased urine output–decreased thirst–increased retention of water– hyponatremia.

-altered mental status
-seizures
-coma and sometimes death

A

Describe the symptoms of SIADH

63
Q

Describe the features of hypercalcemia leading to cancer

A

1) Osteolysis induced by cancer, whether primary in bone, such as multiple myeloma, or metastatic to bone from any primary lesion

2) Production of calcemic humoral substances by extra osseous neoplasms.

64
Q

What cancer is most commonly associated with hypercalcemia

A

small cell carcinoma of the lung

65
Q

Tumors most associated with paraneoplastic hypercalcemia are carcinomas of the _____, ______, _______ & ________

A

breast, lung, kidney, and ovary.

66
Q

Describe the features of condition

A

Acanthosis nigricans is a skin disorder with gray-black patches, typically seen in people over 40. These patches are associated with gastrointestinal cancer and can manifest before the cancer is diagnosed

67
Q

Antibodies, presumably induced against tumor cell antigens that cross-react with neuronal cell antigens, have been detected.

A

Neuromyopathic paraneoplastic syndromes

68
Q

Describe the features of Neuromyopathic paraneoplastic syndromes

A

the body produces antibodies (defensive proteins) against antigens found on tumor cells. These antibodies may also interact with antigens on neuronal cells (cells in the nervous system).

akaimmune response against tumors might accidentally affect the healthy neurons as well.

69
Q

Describe the features of the condition

A

Myasthenia Gravis usually associated with a thymoma

70
Q

-Ptosis,
Diplopia
-Skeletal muscle weakness which increases with exercise

A

Myasthenia gravis (ass with thymoma)

71
Q

Describe the symptoms of Myasthenia gravis (ass with thymoma)

A

-Ptosis,
Diplopia
-Skeletal muscle weakness which increases with exercise

72
Q

Describe the features of Lambert Eaton Myasthenia syndrome

A

Disease of the neuromuscular junction Autoantibodies to the calcium channel (PQ-type voltage-gated calcium channels)

Associated with SCLC

73
Q

Describe the symptoms of LEMS

A

Clinical Symptoms:
1. Affected individuals develop proximal muscle weakness and autonomic dysfunction.
2. No clinical improvement is produced by anticholinesterase agents

74
Q

Clinical Symptoms:
1. Affected individuals develop proximal muscle weakness and autonomic dysfunction.
2. No clinical improvement is produced by anticholinesterase agents

A

symptoms of LEMS

75
Q

Disease of the neuromuscular junction Autoantibodies to the calcium channel (PQ-type voltage-gated calcium channels)

Associated with SCLC

A

Describe the features of Lambert Eaton Myasthenia syndrome

76
Q

Describe the features & symptoms of Hypertrophic osteoarthropathy

A

Associated with bronchogenic carcinomas

(1) periosteal new bone formation, primarily at the distal ends of long bones, metatarsals, metacarpals, and proximal phalanges;

(2) arthritis of the adjacent joints;

(3) clubbing of the digits

77
Q

Describe the features of Migratory Thrombophlebitis (Trousseau syndrome)

A

associated carcinomas of the pancreas.

Acute disseminated intravascular coagulation is most associated with acute promyelocytic leukemia and prostatic adenocarcinoma

78
Q

associated carcinomas of the pancreas.

Acute disseminated intravascular coagulation is most associated with acute

A

Describe the features of Migratory Thrombophlebitis (Trousseau syndrome)

79
Q

Describe the features of Nonbacterial thrombotic endocarditis

A

Bland, small, nonbacterial fibrinous vegetation’s form on the left sided cardiac valve leaflets in individuals with advanced mucin-secreting adenocarcinomas

can lead to emboli

80
Q

Bland, small, nonbacterial fibrinous vegetation’s form on the left sided cardiac valve leaflets in individuals with advanced mucin-secreting adenocarcinomas

can lead to emboli

A

Describe the features of Nonbacterial thrombotic endocarditis

81
Q

Cushings ass

A

SCLC
Pancreatic cancer
Neural tumors

caused by Excess ACTH

82
Q

SIADH ass

A

SCLC
Intracranial neoplasms

caused by Excess ADH or ANP

83
Q

Hypercalcemia ass

A

Squamous cell carcinoma of the lung
Breast cancer
Renal cancer
Adult T-cell lymphoma

Caused by excess Parathyroid related protein (PTRP), TGFa, TNF, & IL1

84
Q

Hypoglycemia ass

A

Ovarian cancer
Fibrosarcoma
Mesenchymal sarcomas

Caused by excess Insulin or insulin-like subs

85
Q

Polycythemia ass

A

renal cancer
cerebellar hemangioma
liver cancer

Excess erythropoietin

86
Q

Myasthenia ass

A

Bronchogenic cancer
Thymoma

Imunno issue

87
Q

CNS/PNS disorders ass

A

breast cancer

88
Q

Hypertrophic osteoarthropathy ass

A

bronchogenic tumor
thymic tumor

89
Q

Trousseaus ass

A

pancreatic cancer
bronchogenic cancer

mucins activate clotting

90
Q

DIC ass

A

acute promyelocytic leukemia
prostatic cancer

tumor products activate clotting

91
Q

Nonbacterial thrombotic endocarditis ass

A

Advance cancers

hypercoagulability

92
Q
A

well differentiated

93
Q
A

moderately differentiated

94
Q
A

poorly differentiated

95
Q

N(0–3): degree of spread to regionallymph nodes
N0:
N1:
N2:
N3:

A

0 = No tumor cells spread to regionallymphnodes

1= : regional lymph node metastasis present; (tumor spread to closest regional lymph nodes)

2= Tumor spread to an extent between N1 and N3 (N2 is not used at all sites)

3 = Tumor spread to more distant lymph nodes

96
Q

T1 N0 M0

A

Small, low-grade cancer, no metastasis, no spread to regional lymph nodes

consideredStageI.

97
Q

Small, low-grade cancer, no metastasis, no spread to regional lymph nodes

A

T1 N0 M0

consideredStageI.

98
Q

Large, high-grade cancer, with spread to regional lymph nodes and other organs

A

T4 N3 M1

considered Stage IV.

99
Q

T4 N3 M1

A

Large, high-grade cancer, with spread to regional lymph nodes and other organs

considered Stage IV.

100
Q

assessment of readily palpable lesions in sites such as the breast, thyroid, and lymph nodes.

A

Fine-needle aspiration cytology:

101
Q

suspected malignancy in which tumor cells are easily accessible or shed and widely used to screen for carcinoma of the cervix

A

Cytologic smears:

102
Q

generally removes the entire area of the tumor with surrounding the part of normal tissue

A

excisional biopsy

103
Q

procedure in which a small area of tissue is taken to identify the composition

A

Incisional biopsy

104
Q

specific antibodies facilitate the identification of cell products
or surface markers.

A

Immunohistochemistry:

105
Q

prostate-specific antigen (PSA) and thyroglobulin are markers of carcinomas of the ______,_____

A

prostate and thyroid.

106
Q

ERBB2 or HER2

A

breast cancers

Path SJSM (26 decks)

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