Path Flashcards
What is characterized by the development of hypoxemia and bilateral pulmonary infiltrates in the ABSENCE of heart failure??
ARDS-Acute Respiratory Distress Syndrome
What is a Kimmelsteil-Wilson lesion associated with? Nodular (mesangial expansion, glomerular basement membrane thickening, and glomerular sclerosis)
Diabetic Neuropathy
What is the bone tumor most often associated with Paget’s Disease?
OSTEOSARCOMA
What are fragile mucosal folds that cause solid food dysphagia, usually in the mid to lower esophagus? What deficiency (Plummer-Vinson Syndrome) is it commonly seen?
Esophageal Web..iron
Histologically, what are these signs pointing to? acute inflammatory monoarthritis, neutrophilic effusion, and numerous needle-shaped crystals?
GOUT dawg!
What is the most common location for an endometrial cyst?
ovaries
Which vitamin supplementation is NOT advised during pregnancy?
Vitamin A..it can be teratogenic in excess!
MOST follicular __ ____ _______ are associated with a t(14;18) translocation that leads to BCL2 over expression (BCL2 overexp=evasion of apoptosis)
B cell lymphomas
What disease is characterized by AUER bodies and is a t(15;17) chromosomal translocation?
APL-Acute Promyelocytic Leukemia
Which disease is associated with a t(8;14) translocation and classically has round nuclei, basophillic cytoplasm, and prominiant lipid vacuoles?
Burkitt lymphoma
What is characteristic of a t(9;22) translocation and shows leukocytosis with many immature myeloid cells?
CHRONIC myeloGenous leukemia
What is the MOST COMMON translocation in childhood B-cell ACUTE LYMPHOCYTIC LEUKEMIA? (Peripheral blood smear=anemia, thrombocytopenia, and lymphoblasts)
t(12;21)
What form of leukemia am I? malignant cells with notches or clefts and a t(14;18) translocation?
Follicular lymphoma
Which viral infection is associated with ballooning multinucleated giant cells?
Herpes Simplex
Which carcinoma presents with cells at the periphery displaying parallel alignment (palisading)?
basal cell carcinoma
Which infection shows histologically with perinuclear HALOS?
Verruca Vulgaris
Get ready for a new one…What is associated with umbilicated, flesh-colored papules on the skin and mucous membranes? Uh..WHATS ITS CAUSAL AGENT???
Molluscum Contagiosum (wtf?)…poxvirus
What is the most important risk factor for postpartum endometriosis? What organ? What bugs?
Caesarian delivery….uterus…polymicrobial including staph and strept
What is the most common culprit for VIRAL ENCEPHALITIS? Which region of the brain is most commonly affected? WHAT is the TX??
Herpes Simplex Virus (Esp HSV-1!! WHEELHOUSE)..Temporal Lobe…TX=IV acyclovir
What group of viruses cause BUNYAVIRUS encephalitis?
California encephalitis group of viruses (mosquitoes)
What causes the chronic encephalitis known as subacute sclerosing PANenchephalitis?
measles!
What group of viruses does mumps and measles fall into?
PARAmyxOviridae
What is the culprit for RING-enhancing brain lesions in HIV patients??
TOXOPLASMA
What is a common fungal organism that can cause encephalitis in HIV patients?
Cryptococcus
Which PROTOZOA is NOTORIOUS for causing fatal encephalitis in AIDS patients?
A-CANTH-AMOEBA
ACUTE INTERMITTENT PORPHYRIA is caused by a genetic defect in the making of ________ and it characterized by WHAT MAJOR INDICATOR??
PBG (Porpho-Bilinogen) Deaminase
What is the telling factor when diagnosing between PCT (porphyria cutanea tarda) and AIP (acute intermittent porphyia)?
PCT=skin manefestations…AIP no skin manefestations
What is the most common NUTRITIONAL DEFICIENCY in elderly alcoholics?
COBALAMIN (vit B12)
What is an ACUTE postinfectious polyneuropathy characterized by nonspecific prodromal malaise and nausea followed by progressive, ascending paralysis?
GULLIAN-BARRE syndrome
HUH…WHEELHOUSE. Pt complains of difficulty chewing and diplopia…Whats he got? lol
Thymoma (MYASTHENIA GRAVIS) (60-70% have hyperplastic thymic tissue, 10-15% have thymomas)
Retinoblastoma is caused by SEPARATE mutagenic events that inactivate BOTH copies of WHAT GENE? Which chromosome??
RB1 tumor suppressor gene…chromosome 13
What is the most common culprit for joint infection (septic arthritis) ADULTS and children OVER 2yrs??
S. Aureus
What is the most common culprit for joint infection in children UNDER 2yrs?
H. Influenzae
Interesting…what bug most commonly affects joint infection in adolescent peeps?
N gonorrhoeae
Interesting..pt’s with SICKLE CELL DISEASE are more likely susceptible to infection due to WHICH bug? (Regardless of age)
SALMONELLA
WHEELHOUSE: 14mo old boy with RECURRENT WHITE PATCHES on inside of cheeks, wipeable. Presents with dysmorphic face and cleft palate..What are the findings most closely associated with?
FAILED PHARYNGEAL POUCH DEVELOPMENT (DiGeorge Syndrome)…3rd and 4th pharyngeal pouches produce the thymus, so T-cell immunity is compromised…pt has candidiasis
DiGeorge syndrome results in failed development of ________
the 3rd and 4th PHARYNGEAL POUCHES
Which disease is caused by an NADPH oxidase deficinency (causing ineffective intracellular oxidative burst)?
Chronic Granulomatous disease
Rupture of the SUBPERIOSTEAL blood vessels results in _________, usually during traumatic birth and scalp swelling does not cross suture lines
cephaloHEMATOMA
Tearing of the middle meningeal artery results in an _______ hematoma
epidural hematoma
Hereditary Hemochromatosis: excessive GI absorption of _____ stored in the form of ________ with in the _______ and the parenchymal organs
iron…hemosiderin…dermis
portal HTN will first affect the _____ vein and cause _______
splenic vein…splenomegaly
Howell-Jolly bodies are remnants of ______ that are indicative of problems in WHAT organ?
RBC nuclei…spleen
MEGALOBLASTIC anemia is seen in _______ and ______ deficiency.
B12 and B9
A Pulmonary Embolism causes ________ mismatch which leads to ______ that INCREASES ventilation and heart rate via a chemoreceptor reflex..RESULTING IN _______
ventilation-perfusion (V/Q) mismatch…HYPoxyemia…hyperventilation
Hyperventilation can LOWER blood [____], but it cannot compensate fully for blood [____] levels
lower [CO2], but not increase [O2]
Hyperventilation results in RESPIRATORY ________
ALKALOSIS!!!
Hypoventilation results in RESPIRATORY ________
ACIDOSIS!!!
What cardio condition is characterized by increased pulmonary artery pressue, RIGHT ventricular failure, and pulmonary endothelial dysfunction?
IPAH (idiopathic pulmonary arterial hypertension)
What is characterized by AA women, pelvic pressure, pain, infertility, heavy menstrual bleeding (MOST COMMON SYMPTOM)
uterine leiomyomas
INTERESTING: _________ does not present with heavy menstrual bleeding because the pathology is OUTSIDE the uterine cavity
endometriosis
Pts typically present with crampy abdominal pain, tenderness to palpation, and bloody stool with this condition ________.
ischemic colitis (poor blood perfusion to the colon c/o heart failure)
________ presents on a colonoscopy as mucosal hemorrhage
ischemic colitis
COBBLESTONE MUCOSA in the colon is a cardinal sign of ________-
CROHN’s disease
Macrophages w accumulated PAS-positive granules suggest _______ disease…does this disease present with blood in the stool?
WHIPPLE’s…NO blood in stool
Which condition presents as crypt abscesses and multiple pseudopolyps in a colonoscopy?
ulcerative colitis
Impaired intestinal COPPER transport can result in _______ syndrome, an X LINKED recessive disorder characterized by seizures, intellectual disability, skeletal abnormalities and brittle hair
MEN-KES syndrome
Deficiency in DYSTROPHIN, a protein that connects muscle fibers to the ECM causes _________
Duchenne muscular dystrophy
Marfan syndrome is caused by defects in ______, a glycoprotein important in elastic fiber formaiton
FIBRILLIN
Hypoglycemia after prolonged fasting with inappropriately LOW Ketone Bodies (!!) suggest impaired _______
BETA-OXIDATION
WHAT DEFICIENCY is the MOST COMMON GENETIC DEFECT IN BETA-OXIDATION??
Medium-chain ACYL-CoA DEHYDROGENASE (converts acylCoA to Trans-enoyl CoA)
Proto-oncogene or tumor supressor gene? RAS
Proto-oncogene (cholangiocarcinoma, pancreatic adenocarcinoma)
Proto-oncogene or tumor supressor gene? MYC
Proto-oncogene (burkitt lymphoma)
Proto-oncogene or tumor supressor gene? BRCA 1/2
Tumor Suppressor Gene (breast & ovarian Cancer)
Proto-oncogene or tumorsuppressor gene? APC/beta-catenin
Tumor Suppressor Gene (colon, gastric, pancreatic cancer) (famililal adenomatous polyposis)
Proto-oncogene or Tumor Suppressor Gene? ERBB1 (EGFR)
Proto-Oncogene (lung adenocarcinoma)
Proto-oncogene or Tumor Suppressor Gene? TP53
Tumor Suppressor (MOST cancers, La-Fraumeni Syndrome)
Proto-Oncogene or Tumor Suppressor Gene? ERBB2 (HER2)
Proto-Oncogene (Breast cancer)
Proto-oncogene or Tumor Suppressor Gene? RB
Tumor Suppressor gene (retinoblastoma, osteosarcome)
Proto-oncogene or Tumor supressor gene? ABL
Proto-Oncogene (chronic myelogenous leukemia)
Proto-oncogene or Tumor suppressor gene? WT1
Tumor Suppressor (wilms tumor)
Proto-oncogene or Tumor Suppressor gene? BRAF
Proto-oncogene (hairy cell leukemia, melanoma)
Proto-oncogene or Tumor supressor gene? VHL
Renal Cell Carcinoma, Von Hippel-Lindau syndrome
What is the MOST SIGNIFICANT risk factor for osteoarthritis?
age
WHEELHOUSE-What disease?: A chronic, IDIOPATHIC, inflammatory condition that presents with abdominal pain, diarrhea, low-grade fever, AND APTHOUS ULCERS OF THE MOUTH…WHAT IS THE MOST FREQUENTLY INVOLVED SITE???
Crohn Disease…terminal illium
What condition is characterized by neuropsychiatric abnormalities in the setting of severe liver dysfunction (cirrhosis)? What organic substance builds up and crosses the BBB during this condition?
Hepatic ENCEPHALOPATHY…ammonia
What condition involves a decreased mineralization of OSTEOID tissue?
OSTEOMALACIA
What are two common causes of Osteomalacia?
1.Vit D deficiency 2.Malabsorption (celiac’s disease)
Abnormal formation of ______ bone is a feature of PAGETS disease
LAMELLAR
What organism causes VALLEY FEVER?
Cocci-DI-oides IMMITIS (a DI morphic fungus)
What are the two main clinical signs and symptoms of HASHIMOTO’s THYROIDITIS?
1.FATIGUE 2.PAINLESS GOITER
DIG DEEP…what are the names of the cells that are metaplastic, enlarged epithelial cells with prominant nucleoli and abundant eiosinophilic cytoplasm, commonly seen surrounding atrophic thyroid follicles in HASHIMOTO’s THYROIDITIS?
HURTH-LE Cells
What is defined as a diffuse, nontoxic goiter that can occur on an endemic or sporadic basis? FLATTENING of the crowded columnar epithelium occurs in the thyroid follicles..
COLLOID goiter
What is a painless, UNILATERAL neck mass at the thyroid? HISTO findings-intact capsule that separates normal thyroid tissue from numerous well-differentiated, colloid-containing follicles..
Follicular ADENOMA
Thyroid Cancer: follicular carcinoma-capsular invasion occurs and areas of _______ or vascular invasion are common
hemorrhage
What are the 4 clinical signs and symptoms of GRAVES DISEASE?
1.enlarged thyroid 2.hyperthyroidism 3.exopthalmos 4.PRE-TIBIAL MYX-EDEMA
ATRIAL SEPTAL DEFECT: INCREASED [oxygen] in the ________ and _______ of the heart because of shunting of the oxygenated blood.
Right atrium, right ventricle
A consequence of the extra blood volume in the R side of the heart in an Atrial Septal Defect (ASD) results in a widely SPLIT and FIXED ____ sound (sound of the SEMI-LUNAR VALVES ________)
S2….semi-lunar valves CLOSING
Achal-asia (esophageal motility disorder) results from reduced numbers of ________ cells in the esophageal wall. What is the characteristic sign on a barium swallow/x-ray?
inhibitory ganglion cells…“BIRD BEAK” narrowing at the gastroesophageal junction
What is the MOST COMMON autoimmune hemolytic disease?
WARM ANTIBODY AUTOIMMUNE HEMOLYTIC ANEMIA!
What systemic pathologic condition is associated with FIBRIN STRAND-mediated erythrocyte trauma?
DIC. disseminated intravascular coagulation
What is the mechanism for alpha-thalassemia pathology?
impaired hemoglobin synthesis
__________ is a hemolytic anemia due to abnormalities in the RBC structural components SPECTRIN or ANKYRIN
Hereditary Spherocytosis
What are the 2 structural components compromised in HEREDITARY SPHEROCYTOSIS?
Spectrin or Ankyrin
What is the typical culprit for ACUTE BACTERIAL PROSTATITIS?
enteric organisms (like UTI’s!) (E. coli)
Which syndrome is associated with CATCH 22??
DeGeorges Syndrome: Chromosome 22 section deletion…Conotrunctal cardiac defects, Abnormal facies,Thymic aplasia, Cleft Palate, Hypocalcemia
In DeGeorges syndrome, which embryological strucutres fail in development?
3rd and 4th pharyngeal POUCHES
________ _________ _________________ is one of the more COMMON causes of NEPHROTIC syndrome in adults and children, the “collapsing” version of this is particularly common in HIV+ pts
FOCAL SEGMENTAL GLOMERULO-SCLEROSIS
What does the GBM in Anti-GBM disease stand for? What is the main antibody in this pathophys?
Glomerular Basement Membrane…IgG
Which antibody is found in Berger disease (kidney path)?
IgA
What test is used to diagnose a H. Pylori infection?
The urea breath test
Mitral Stenosis is ALMOST ALWAYS caused by _______
rheumatic fever
WHEELHOUSE: ______-_______ syndrome is a rare, autosomal DOMINANT disease in which individuals develop pigmented mucocutaneous MACULES and multiple HAMARTOMOUS POLYPS in the GI TRACT.
Peutz-Jeghers Syndrome
An apical bronchogenic carcinoma that invades the brachial plexus (a “PAN-COAST”) tumor can cause HORNER syndrome through compression of the __________
SUPERIOR CERVICAL GANGLION
CHRONIC EtOHism can cause ATROPHY of the anterior lobes AND _______ vermis
cerebellar (parkinson like tremor)
LITHIUM, used to tx BIPOLAR disorder can interfere with WHICH RENAL HORMONE, thereby ______ water reabsorption
vasopressin (ADH)…REDUCING
Lower GI bleeding in infants is most commonly caused by _______ diverticulum, which results in heterotropic gastric tissue
MECKEL
Huh, this one is rather straight forward…Humoral Immunodeficincy syndromes: Normal B cell count, decreased IgG, IgA, IgM, and IgE values
Common Variable Immunodeficiency (CVI). ALL immunoglobulins are decreased!
What is the behavior of B Cells, IgG, IgA, IgM, and IgE in X-LINKED AGAMMAGLOBULINEMIA?
All decreased
What are the two most susceptible areas to infection in the body during IgA deficiency?
Respiratory and GI
AL-KAP-TON-URIA is an autosomal recessive disorder due to a defect in homogenestic acid DIOXYGENASE. The results are OSTEOARTHROPY and ________
DARK URINE
In maple syrup urine disease, what type of amino acids are not being metabolized correctly?
branched-chain aa’s (leucine, isoleucine, and valine)
In GRAVES DISEASE (hyPERthyroidism), WHAT is the opthalmopathy caused by?
INCREASED GAG production by orbital FIBROBLASTS
What is the MOST COMMON CYANOTIC CONGENTIAL HEART DEFECT?
TET-RALOGY of FALL-OT
What are the 4 cardiac manifestations of Tetralogy of Fallot?
1.Pulmonary Stenosis 2.Right Ventricular Hypertrophy 3.Overriding Aorta 4.Ventricular Septal Defect
What physical action can relieve cyanotic episodes in children with Tetralogy of Fallot?
SQUATTING
What is a COMMON cause of infertility in pts who have had unprotected intercourse with multiple sexual partners?
Pelvic inflammatory disease
Has the previous use of oral contraceptives been linked to infertility?
NO
Lyme disease usually presents with ERYTHEMA MIGRANS (“_______” lesion) at the site of the tick bite
“bull’s eye”
Rocky Mtn Spotted Fever is characterized by a papular or _______ rash that begins on the ______ or ______ and spreads to the trunk, palms, and soles.
petechial rash…ankles or wrists
IMPAIRED SPLENIC FUNCTION significantly increases the risk of SEPSIS caused by ENCAPSULATED BACTERIA LIKE THESE 3:
1.Strept. Pneumoniae 2.H. Influenza 3.N. Meningitidis
Quick, whats the pt got? Smoker, Rt shoulder pain, puffy face and engorged neck veins..
Superior Vena Cava Syndrome (lung or mediastinal tumor compressing the vena cava)
________ is a common cause of NEPHROTIC SYNDROME that is associated with SOLID TUMORS, edema, weight gain, and SEVERE PROTEINURIA
Membranous Glomerulonephritis
McArdle disease (GLYCOGEN storage disease V) is characterized by a ____________ deficiency…symptoms are muscle cramps with exercise, but go away when person gets “second wind”
MYO-PHOS-PHORYLASE
An infection of the orbit, nose, and paranasal sinuses can spread to the CAVERNOUS SINUS..what is one of the FIRST SIGNS of a cavernous sinus thrombus? WHICH CRANIAL NERVE is affected in this sign?
lateral gaze palsy…CN VI
_______ is characterized by CYANOSIS that worsens with feeding, crying, or exercise. Older children with this SQUAT to improve pulmonary blood flow
Tetralogy of Fallot
Mumps-induced ORCHITIS can result in ________ cell atrophy and decreased TESTOSTERONE production
LEYDIG
What enzymatic deficiency causes congentical adrenal hyperplasia leading to excess minralocorticoids (thus HTN) and deficiencies in cortisol and sex steroids?
17alpha-HYDROXYLASE deficency
_______ lymphoma presents as ASYMPTOMATIC lymphadenopaty in the CERVICAL or SUPRACLAVICULAR regions or as a MEDIASTINAL MASS
HODGKIN lymphoma
Hodgkin Lymphoma will have _____-______ cells present in the biopsy
Reed-Sternberg
______ lymphoma is seen in children who present with ascites and abdominal mass arising from the distal ileum, cecum, or mesentary
Burkitt lymphoma
______ lymphoma is an indolent non-Hodgkin lymphoma characterized by waxing and waning lymphadenopathy and over expression of the BCL-2 PROTEIN…LARGE, NON-CLEAVED lymphocytes in biopsy
Follicular lymphoma
Physical manifestations of high _________ levels in a cirrhotic patient include SPIDER ANGIOMATAS, palmer erythemia, testicular atrophy
estrogen
_____ ______ is characterized by loose and bloody stools. Endoscopy reveals erythematous, edematous, FRIABLE, and granular mucosa. Neutrophils accumulate in the CRYPT lumina causing crypt abscesses. CLASSICALLY limited to the MUCOSA
Ulcerative Colitis
Postmenopausal women are at high risk for osteoperosis because of OVARIAN ENDOCRINE HYPOPFUNCTION and ________ deficiency
estrogen
What is the most common sign of Wernike-Korsakoff syndrome in alcoholics?
memory impairment with confabulation (misinterpreted or distorted memories)
AGAIN, pts with 17-alpha-hydroxylase deficiency present with insufficient sex hormones and cortisol and overproduction of minralocorticoids…. WHAT HAPPENS TO THE LEVELS OF: 1. LH 2. ACTH 3.RENIN
- LH increases 2.ACTH increases 3.RENIN decreases
Which organ system is affected in LYNCH syndrome?
Colorectal cancer
Huh, interesting…a HEMANGIOBLASTOMA in the cerebellum makes you at risk for what other carcinoma?
renal cell carcinoma (VHL-von hippel-Lindau disease)
Decreased RBC 2,3-BPG (increases or decreases?) oxygen affinity of normal hemoglobin.
increases
Wilson’s disease has high copper content and rings on WHICH structure of the eye?
cornea
What is the most common estrogen-sensitive benign breast tumor in young women?
Fibroadenoma
Chronic EtOH consumption can cause degeneration of the CEREBELLAR vermis…What is the embryological origin of the cerebellum?
RHOMBencephalon (makes sense…its in the rear!)
Reed-sternberg cells have a LOT of cytoplasm and an “_____ _____” appearance. Uh, what condition are these cells found in again?
“owl eye”…Hodgkin lymphoma
Dilated cardiomyopathy is a finding in chronic, excessive ______ use. The heart is enlarged, the ventricular volumes are increased, BUT there is a normal thickness of the ventricular walls
EtOH
Anti-glomerular basement membrane disease (lol) has which ANTIBODY deposits present?
IgG
A complete _____ pregnancy is an abnormal proliferation of cytotrophoblasts and syncytiotrophoblasts without fetal tissue
MOLAR
In patients with ACNE, retinoids are vitamin ___ analogs that bind nuclear receptors to decrease SEBUM production and INCREASE cellular turnover
Vit A
