patho Flashcards
1
Q
Specialized tye of “grinder” that selectively chews up denatured proteins, releasing peptides
A
Proteasomes(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.6
2
Q
It synthesizes new proteins for the plasma membrane
A
Rough endoplasmic reticulum(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.6
3
Q
Abundant in liver and gonads where it is used for steroid hormone and lipoprotein synthesis, and modification of hydrophobic compounds into water-soluble molecules
A
Smooth endoplasmic reticulum(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.6
4
Q
Intracellular organelles that contain degradative enzymes that permit digestion of macromolecules
A
Lysosomes(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.6
5
Q
Cell organelle that break down fatty acids, generating hydrogen peroxide in the process
A
Peroxisomes(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.6
6
Q
The ability of cells to adopt a particular shape, maintain polarity, organize relationship of intracellular organelles, and move about depends on this intracellular scaffolding of proteins
A
Cytoskeleton(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.10
7
Q
It shuttles internalized material to the appropriate intracellular siters or direct newly synthesized materials to the cell surface or targeted organelle.
A
Endosomal vesicles(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.6
8
Q
Source of ATP and metabolic intermediates needed for anabolic metabolism, site of heme synthesis, and contain important sensors of cell damaga that can initiate and regulate the process of programmed cell death.
A
Mitochondria(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.6
9
Q
Water and carbon dioxide diffuse across the cell lipid bilayers through what process (type of diffusion)
A
Passive membrane diffusion(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.9
10
Q
The process by which large molecules are exported from cells.
A
Exocytosis(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.9
11
Q
The movement of endocytosed vesicles between the apical and basolateral compartments of cells for transferring large amount of protein across epithelial barrier and rapid movement of large volumes of solute.
A
Transcytosis(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.9
12
Q
Non-coated plasma membrane invagination (“little caves”) associated with cAMP, GPI-linked molecules, SRC-family kinases, and folate receptor.
A
Caveolae(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.9
13
Q
A fluid-phase process during which the plasma membrane invaginates and is pinched off to form a cytoplasmic vesicle.
A
Pinocytosis(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.9
14
Q
Major uptake mechanism for macromolecules such as transferrin and LDL, which bind to receptors localized in clathrin coated pits.
A
Receptor-mediated endocytosis(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.20
15
Q
Most abundant cytosolic protein in cells.
A
Actin(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 11
16
Q
They serve as connecting cables for “molecular motor” proteins that use ATP to move vesicles, organelles, or other molecules.
A
Microtubules(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 11
17
Q
Cell junction that seal adjacent cells together to create a continuous barrier that restrics paracellular movement of ions and other molecules.
A
Occluding junctions (tight junctions)(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 11
18
Q
Cell junctions that mechanically attach cells and their intracellular cytoskeletons to other cells or to extracellular matrix.
A
Anchoring junctions (desmosomes) (tight junctions)(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 11
19
Q
Junctions that mediate the passage of chemical or electrical signals from one cell to another.
A
Communicating junctions (gap junctions) (TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 12
20
Q
Cell organelle that consists of stacked cisternae that progressively modify protein
A
Golgi apparatus(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 12
21
Q
Cell-cell signaling pathway: cells in immediate vicinity are affected.
A
Paracrine signaling(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 16
22
Q
Cell-cell signaling pathway: molecules secreted by a cell affect tat same cell.
A
Autocrine signaling(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 16
23
Q
Cell-cell signaling pathway: activated neurons secrete neurotransmitters at specialized cell junctions onto target cells.
A
Synaptic signaling(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 16
24
Q
Cell-cell signaling pathway: A mediator is released into the bloodstream and acts on target cells at a distance.
A
Endocrine signaling(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 16
25
Vitamin D and steroid hormones are cell-permeable ligands for this type of receptor.
Intracellular receptors(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 16
26
Its major role is to stimulate the activity of genes required for cell growth and cell division.
Growth factors(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 18
27
Growth factor: Stimulate keratinocyte migration and formation of granulation tissue
Epidermal growth factor(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 19
28
Growth factor: stimulate proliferation of hepatocytes and other epithelial cells.
Transforming growth factor-alpha(TGF-a)(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 19
29
Growth factor: enhances proliferation of hepatocytes and increases cell motility
Hepatocyte growth factor(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 19
30
Growth factor: stimulates proliferation of endothelial cells and increases vascular permeability
Vascular endothelial growth factor (VEGF)(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 19
31
Growth factor: chemotactic for neutrophils, fibroblasts, and smooth muscles, and activates proliferation of fibroblasts and endothelial cells.
Platelet-derived growth factor (PDGF) (VEGF)(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 19
32
Growth factor: chemotactic and mitogenic for fibroblasts and stimulates angiogenesis and ECM protein synthesis
Fibroblast growth factors (FGFs) (VEGF)(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 19
33
Component of ECM responsible for the ability of tissues to recoil and recover their shape after physical deformation.
Elastin(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 23
34
Component of ECM that confer resistance to compressive forces, also provide lubrication between bony surfaces.
Proteoglycan(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 23
35
The most abundant glycoprotein in basement membrane.
Laminin(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 24
36
A major component of the interstitial ECM.
Fibronectin(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 24
37
A large family of transmembrane glycoproteins that allow cells to attach to ECM constituents, linking the intracellular cytoskeleton with the outside world.
Integrins(TOPNOTCH)Robbins Basic Pathology 9th ed. p. 24
38
Sequence of events in cell cycle
G1/Presynthetic growth-S/DNA synthesis-G2/Premitotic growth- M/mitotic phase (TOPNOTCH) Robbins Basic Pathology, 9th ed., p.25
39
Two important properties of stem cells
Self-renewal and assymetric division. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 26
40
Most undifferentiated stem cells which are totipotent, and can be induced to form specialized cells of all three germ cell layers.
Embryonic stem cells(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 27
41
Variety of stem cell with limited repertoire of differentiated cells that they can generate.
Tissue stem cells(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 27
42
Increase in size of cells resulting in increased size of organ.
Hypertrophy(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 34
43
Increase in number of cells.
Hyperplasia(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.35
44
Hypertrophy of hyperplasia?Uterus during pregnancy
Both Estrogen stimulated SM hyperthrophy and hyperplasia (TOPNOTCH)Robbins Basic Pathology, 9th ed. p.34
45
Hypertrophy or hyperplasia?Wound healing
Hyperplasia(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.4
46
Hypertrophy or hyperplasia?
Female breast at puberty
Both. (TOPNOTCH) Robbins Basic Pathology 9th ed., p 36
47
Cellular adaptation of non-dividing cells such as myocardial fibers.
Hypertrophy (TOPNOTCH)
48
A 50 y/o male has untreated hypertension for several years. What cellular alteration will be most likely seen in the myocardium?
Hypertrophy (TOPNOTCH)
49
A 40 y/o male underwent partial hepatectomy. What cellular adaptation will the liver most likely undergo?
Hyperplasia(TOPNOTCH)
50
The most common stimulus for hypertrophy of muscle
Increased workload (TOPNOTCH) Robbins Basic Pathology, 9th ed., p.34
51
A 65 y/o male presents with 3-month history of weak stream, straining, and hesitancy. There is no history of prostate cancer. Prostate was severely enlarged without nodules. PSA level is 3 mcg. What cellular adaptation does the prostate most likely undergo?
Hyperplasia(Case of BPH) (TOPNOTCH)
52
Stimulus for hyperplasia in BPH
Hormonal stimulation by androgens. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 36
53
Cellular adaptation in papilloma virus infection
Hyperplasia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 36
54
Reduction in the size of an organ or tissue due to decrease in cell size and number
Atrophy(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 35
55
A 60 y/o female has been experiencing hot flushes and irritability. Her uterine epithelium will most likely reveal what type of cellular adaptation?
Atrophy(in menopause)(TOPNOTCH)
56
Chronic production of this cytokine is thought to be responsible for appetite suppression and lipid depletion, culminating in muscle atrophy and marked muscle wasting (cachexia)
Tumor necrosis factor (TNF)(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 35
57
A reversible change in which one differentiated cell type is replaced by another cell type.
Metaplasia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 37
58
A 49 y/o female had a chronic history of heartburn. Biopsy done showed glandular changes in the distal epithelium of the esophagus. What cellular adaptation is present?
Metaplasia. This is a case of Barret's esophagus (squamous to glandular epithelium) (TOPNOTCH)
59
The basal cell changes seen in reflux esophagitis is an example of this adaptive change
Metaplasia (TOPNOTCH)
60
Most common epithelial metaplasia
Columnar to squamous(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 37
61
Type of metaplasia in trachea and bronchi in habitual cigarette smoking
Columnar to squamous(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 37
62
Its hallmarks are reduced oxidative phosphorylation with resultant depletion of energy stores in the form of ATP and cellular swelling
Reversible injury(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 38
63
Type of cell death characterized by nuclear dissolution, without complete loss of membrane integrity.
Apoptosis(TOPNOTCHRobbins Basic Pathology, 8th ed. p.7
64
Type of cell death which is energy-dependent, tightly regulated, and associated with normal cellular functions.
Apoptosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.7
65
Type of cell death which results from a pathologic cell injury.
Necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.9
66
Type of cell death associated with inflammation.
Necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.10
67
It is the irreversible condensation of chromatin in the nucleus of a cell undergoing necrosis or apoptosis. It is characterized by nuclear shrinkage and increased basophilia.
Pyknosis(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.42
68
It is the destructive fragmentation of the nucleus of a dying cell.
Karyorrhexis (TOPNOTCH)Robbins Basic Pathology, 8th ed. p.10
69
It is the complete dissolution of the chromatin of a dying cell.
Karyolysis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.10
70
This is the first manifestation of almost all forms of injury to cells.
Cellular swelling(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.8
71
Small clear vacuoles within the cytoplasm, representing pinched-off segments of the endoplasmic reticulum.
Hydropic change or Vacuolar degeneration (TOPNOTCH)Robbins Basic Pathology, 8th ed. p.23
72
Appearance of lipid vacuoles in the cytoplasm.
Fatty Change(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.23
73
Surface blebs, increased eosinophilia of the cytoplasm, cellular swelling.
Reversible/ Early Ischemic Injury(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.18
74
Cell injury with loss of nuclei, cellular fragmentation and leakage of cellular contents.
Irreversible/ Necrotic cellular injury(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.18
75
Cell injury with loss of microvilli, blunting, appearance of smal amorphous densities, ER dilation and disaggregation of granular and fibrillar elements.
Reversible/ Early Ischemic Injury(TOPNOTCH)Robbins Basic Pathology, 9th ed., p.41
76
A form of tissue necrosis in which the component cells are dead but the basic tissue architecture is preserved. The affected tissues take on a firm texture.
Coagulative necrosis(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.43
77
Characterized by digestion of dead cells, resulting in transformation of the tissue into a liquid viscous mass.
Liquefactive necrosis(TOPNOTCH)Robbins Basic Pathology , 9th ed. p.43
78
Refers to focal areas of fat destruction, typically resulting from release of activated pancreatic lipases into the substance of the pancreas and the peritoneal cavity. The foci of necrosis contain shadowy outlines of necrotic fat cells with basophilic calcium deposits, surrounded by an inflammatory reaction.
Fat necrosis (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 44
79
A special form of necrosis usually seen in immune reactions involving blood vessels. Deposits of immune complexes, together with fibrin that has leaked out of vessels, result in a bright pink and amorphous appearance in H&E stains, called "fibrinoid" (fibrin-like) by pathologists.
Fibrinoid necrosis (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 44
80
Seen in focal bacterial or, occasionally, fungal infections, because microbes stimulate the accumulation of inflammatory cells and the enzymes of leukocytes digest the tissue.
Liquefactive necrosis (TOPNOTCH)Robbins Basic Pathology, 8th ed. p.10
81
This term is usually applied to a limb, generally the lower leg, that has lost its blood supply and has undergone coagulative necrosis involving multiple tissue layers.
Gangrenous necrosis(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.43
82
Friable, white appearance of necoris. It appears as a structureless collection of fragmented or lysed cells and amorphous granular debris enclosed within a distinctive inflammatory border.
Caseous necrosis(TOPNOTCH)Robbins Basic Pathology, 9th ed. p.43
83
Obstruction of the blood supply would lead to which type of pathologic process in the brain parenchyma?
Liquefactive necrosis (TOPNOTCH)
84
The type of necrosis seen in tissue injury associated with acute pancreatitis
Enzymatic fat necrosis. (TOPNOTCH)
85
A 32 y/o male complains of chronic cough and weight loss. CXR showed an ill-defined mass along the apex of the right lobe. Sputum AFB was positive. Biopsy of the lung will most likely reveal what kind of necrosis?
Caseation necrosis (TOPNOTCH)
86
These are chemical species with a single unpaired electron in the outer orbital.
Free radicals(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.18
87
They block free radical formation or inactivate free radicals. Examples of these are the lipid-soluble vitamins E, A, and C, and glutathione in the cytosol.
Antioxidants(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 48
88
Most common cause of cell injury in clinical medicine.
Ischemia(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.18
89
Patient presented with heaviness in the chest, nausea, and diaphoresis. Troponin I and CKMB were noted to be elevated. What is the mechanism of the elevation of cardiac enzyme?
Leakage of intracellular proteins through the damaged cell membrane reflecting irreversible injury and cell death in the tissues. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 50
90
Composed of membrane-bound vesicles of cytosol and organelles seen in programmed-cell death.
Apoptotic Bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.19
91
Characterized by cell shrinkage, chromatic condensation, formation of cytoplasmic blebs and apoptotic bodies, and phagocytosis by macrophages.
ApoptosisTOPNOTCH) Robbins Basic Pathology, 9th ed., p. 53
92
Type of cell death in embryogenesis
ApoptosisTOPNOTCH) Robbins Basic Pathology, 9th ed., p. 52
93
Type of cell death in menopause
ApoptosisTOPNOTCH) Robbins Basic Pathology, 9th ed., p. 52
94
Restoration of blood flow to ischemic but otherwise viable tissue paradoxically results in exacerbated and accelerated injury.
Ischemia-Reperfusion Injury(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.18
95
Pathway of apoptosis trigerred by loss of survival signals, DNA damage and accumulation of misfolded proteins. Inhibited by Anti-apoptotic members of the Bcl family.
Mitochondrial / Intrinsic Pathway(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.22
96
Pathway of apoptosis responsible for elimination of self-reactive lymphocytes and damage by cytotoxic T lymphocytes. Initiated by TNF receptors.
Death Receptor / Extrinsic Pathway(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.22
97
It involves sequestration of cellular organelles into cytoplasmic autophagic vacuoles that fuse with lysosomes and digest enclosed material.
Autophagy(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 61
98
Refers to any abnormal accumulation of triglycerides within parenchymal cells. Most often seen in the liver but can also occur in the heart, sk m., and kidneys.
Fatty change/Steatosis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 62
99
Other name for macrophages in contact with lipid debris of necrotic cells or abnormal forms of lipoproteins. Filled with minute, membrane-bound vacuoles of lipid, imparting a foamy appearance to their cytoplasm.
Foam cells(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.24
100
Presence of cholesterol-filled macrophages in subepithelial connective tissue of skin or tendons.
Xanthomas(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.24
101
Hypertrophy or hyperplasia?Cardiomegaly due to hypertension
Hypertrophy due to increased workload(TOPNOTCH)
102
Most common exogenous pigment?
Carbon(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.26
103
"Wear and Tear pigment"?
Lipofuschin(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.26
104
Pigment produced by tyrosinase-catalyzed oxidation of tyrosine to dihydroxyphenylalanine.
Melanin(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.26
105
Hemoglobin-derived granular pigment that is golden-yellow to brown in color. Accumulates in excess of iron.
Hemosiderin(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.26
106
Histochemical reaction used to identify hemosiderin.
Prussian blue test(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.26
107
Abnormal calcium deposition occuring in the absence of calcium metabolic derangements.
Dystrophic calcification.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.26
108
Calcium deposition in normal tissues occuring in the presence of hypercalcemia.
Metastatic calcification (TOPNOTCH)Robbins Basic Pathology, 8th ed. p.26
109
Grossly seen as fine white granules or clumps, often felt as gritty deposits. Histologically, intra/extracellular basophilic deposits.
Calcium salts(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.27
110
A result of a progressive decline in the proliferative capacity and lifespan of cells.
Cellular aging(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.29
111
Appears as round or oval masses with intensely eosinophilic cytoplasm, nuclei with various stages of chromatin condensation and aggregation, karyorrhexis.
Apoptotic cell(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.20
112
Membrane bound vesicles of cytosol and organelles quickly extruded and phagocytosed without eliciting inflammatory response.
Apoptotic bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.20
113
Clear vacuoles within parenchymal cells, displacing the nucleus to the cell periphery.
Fatty change (TOPNOTCHRobbins Basic Pathology, 8th ed. p.24
114
Focal, intracellular fat deposits creating alternating bands of yellowed myocardium with alternating bands of darker red-brown uninvolved heart or "tigered effect".
Fatty change of the heart(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.24
115
Rounded, eosinophilic accumulation of newly synthesized immunoglobulins in the rough ER of plasma cells.
Russel bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.25
116
Eosinophilic cytoplasmic inclusion in liver cells composed of aggregated intermediate filaments which resist degradation. Seen in patients woth alcoholic liver disease.
Mallory body / "alcoholic hyalin"(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.25
117
Aggregated protein inclusions that contain microtubule-associated proteins and neurofilaments, reflecting disrupted neuronal cytoskeleton.
Neurofibrillary tangles in Alzheimer's disease(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.26
118
An insoluble brownish-yellow granular intracellular material that accumulates as a function of age and atrophy. Appears as perinuclear electron-dense granules on electron microscopy.
Lipofuschin(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.26
119
What substance accumulates in the cytoplasm of liver cells in steatosis?
Triglyceride (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 62
120
Mechanism of triglyceride accumulation in malnutrition
Defective transport (TOPNOTCH)
121
A 70 y/o woman was brought to the clinic because of a 3 year history of progressive memory impairment, difficulty finding words, and irritability. What is the pathogenesis of this condition?
Abnormal folding of AB peptides causing aggregation within neurons and apoptosis (Case of Alzheimer Disease) (TOPNOTCH)
122
Pathogenesis: abnormal folding of PrPSC causing neuronal death (affected prion protein)
Creutzfeldt-Jacob disease (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 58
123
Pathogenesis: absence of enzymatic activity in lungs causing destruction of elastic tissue
Alpha-1-antitrypsin deficiency (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 58
124
Fundamental cause of necrotic cell death
Reduction in ATP levels(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 45
125
Other term for fatty change
Steatosis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 62
126
Most common causes of significant fatty change in the liver
Alcohol abuse and non-alcoholic fatty liver disease(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 62
127
Alteration within the cells or in the extracellular space that gives a homogeneous, glassy, pink appearnce in H&E histologic section
Hyaline change(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 61
128
In this disease, glycogen can be seen in renal tubular epithelial cells, liver cells, B cells of islets of Langerhans, and heart muscle cells.
Diabetes mellitus(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 64
129
A condition when there is systemic overload of iron, hemosiderin may be deposited in many organs and tissues.
Hemosiderosis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 65
130
An inherited disease characterized by extreme accumulation of iron, associated with liver, heart, and pancreatic damage, and resulting in liver fibrosis, heart failure, and diabetes mellitus.
Hemochromatosis. (TOPNOTCH)
131
A rare metabolic disease causing black pigment deposition in the skin, connective tissue, and cartilage.
Alkaptonuria(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 64
132
Foci of dystrophic calcification which appears as lamellated configurations because of their resemblance to grains of sand. Seen in some types of papillary cancer.
Psammoma bodies (TOPNOTCH)
133
Jaundice is due to accumulation of what pigment?
Bilirubin. (TOPNOTCH)
134
What type of necrosis is most characteristic of ischemia involving the heart or kidney?
Coagulative necrosis (TOPNOTCH)
135
What type of necrosis is most often caused by sudden ischemia from vascular occlusion?
Coagulative necrosis (TOPNOTCH)
136
A 56 y/o man died after 24-hour hospitalization for severe crushing chest pain. The type of necrosis of myocardium will most likely reveal:
Coagulative necrosis (TOPNOTCH)
137
The kidney in nephrocalcinosis is an example of what type of calcification? Dystrophic or metastatic?
Metastatic calcification (TOPNOTCH)
138
Dystrophic or metastatic calcification? Calcific aortic stenosis
Dystrophic calcification(TOPNOTCH)
139
Dystrophic or metastatic calcification?Left anterior descending coronary artery with atheromatous plaques
Dystrophic calcification(TOPNOTCH)
140
Dystrophic or metastatic calcification? Sarcoidosis
Metastatic calcification (TOPNOTCH)
141
Dystrophic or metastatic calcification? Paget disease
Metastatic calcification (TOPNOTCH)
142
After a tibial fracture in a 19 year old football player, the leg is immobilized to permit healing. The leg muscles decrease in size due to: (A) decrease in cell size, (B) decrease in cell number, (C) inadequate nutrition, (D) loss of hormonal stimulation
decrease in cell size (atrophy) (TOPNOTCH) Robbins Basic Pathology, 8th ed. P. 4
143
A 30 year old thalassemic male has been receiving multiple blood transfusions throughout his life. What is the expected intracellular accumulation in the parenchymal cells of his liver, heart, and endocrine organs?
Hemosiderin(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.26
144
An 80 year old female is found to have calcified aortic valves. Which of the following is the likely cause? (A) renal failure with secondary hyperparathyrodism, (B) accumulation of calcium in damaged valves despite absence of calcium derangements, (C) parathyroid-related protein production from an underlying malignancy, (D) hypercalcemia from multiple myeloma
Accumulation of calcium despite absence of calcium derangements (dystrophic calcification) (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp26-27.
145
In industrialized nations, what are the most common causes of fatty change in the liver?
Alcohol abuse and diabetes (TOPNOTCH) Robbins Basic Pathology, 8th ed. P 23.
146
A 22 year old female is on the first day of her menses. Which of the following characterizes the events in her endometrial cells: (A) endometrial cells show shrinkage and nuclear condensation, (B) neutrophils accumulate around the cells, (C) severe mitochondrial swelling and plasma membrane destruction, (D) accumulation of amorphous pink material
Endometrial cells show shrinkage and nuclear accumulation (Apoptosis) (TOPNOTCH) Robbins Basic Pathology 8th ed., pp 19-20
147
It is a response of vascularized tissues to infection and damaged tissues that brings cells and molecules of host defense from the circulation to the sites where they are needed, in order to eliminate the offending agents.
Inflammation (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 69
148
The first step in a typical inflammatory reaction
Recognition of offending agent (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 70
149
The main components of inflammation
Vascular reaction and cellular response. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 72
150
The sequential steps in a typical inflammatory reaction
Recognition of offending agent, recruitment of leukocytes and plasma proteins, removal of agent, regulation of response, repair.(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 70
151
Inflammation which is characterized by exudation of fluid and plasma protein and a predominantly neutrophilic leukocyte accumulation.
Acute inflammation(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 71
152
Inflammation typified by influx of lymphocytes and macrophages associated with vascular proliferation and deposition of connective tissue.
Chronic inflammation(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 71
153
Five cardinal signs of inflammation
Heat (calor)redness (rubor)swelling (tumor)pain (dolor)loss of function (functio laesa)(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 71
154
Initial vascular response to injury
Vasoconstriction.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.33
155
Three major components of acute inflammation
Vasodilation, increased permeability, leukocyte emigration. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 73
156
An ultrafiltrate of blood which contains little protein, little or no cellular material and low specific gravity as a result of osmotic or hydrostatic imbalance across the vessel wall without increase in vascular permeability.
Transudate. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 73
157
An extravascular fluid with high protein content. Its presence implies an increased vascular permeability, triggered by tissue injury and ongoing inflammatory reaction.
Exudate(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 73
158
Denotes an excess fluid in the interstitial tissue or serous cavities
Edema (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 73
159
Effect of histamine on vascular smooth muscle
Vasodilation. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 73
160
The most common mechanism of increased vascular permeability.
Contraction of endothelial cells resulting in increased interendothelial spaces. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 74
161
Proliferation of lymphatic vessels and painful enlarged lymph nodes secondary to inflammation.
Reactive or inflammatory lymphadenitis. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 74
162
State the molecule in the endothelium responsible for this stage of vascular inflammatory response:Rolling
Selectins (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 76
163
State the molecule in the lymphocyte responsible for this stage of vascular inflammatory response:Firm adhesion
Integrins(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 76
164
State the molecule in the endothelium responsible for this stage of vascular inflammatory response:Transmigration
PECAM-1/CD 31(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 77
165
State the endothelial adhesion molecule responsible for this stage of vascular inflammatory response:Intercellular adhesion
ICAM -1(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 76
166
State the lymphocytic adhesion molecule counterpart of the following endothelial receptors:E-Selectin
Sialyl-Lewis X modified glycoprotein (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 76
167
State the lymphocytic adhesion molecule counterpart of the following endothelial receptors:P-Selectin
Sialyl-Lewis X modified glycoprotein (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 76
168
State the lymphocytic adhesion molecule counterpart of the following endothelial receptors:ICAM-1
Integrins (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 76
169
State the lymphocytic adhesion molecule counterpart of the following endothelial receptors:CD-31
CD-31(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 76
170
The process of leukocyte accumulation at the periphery of blood vessels
Margination(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 75
171
Arrange the following steps in the inflammatory response:A. Recruitment of leukocytesB. Regulation of responseC. Recognition of injurious agentD. Removal of agentE. Resolution
C, A, D, B, E (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 72
172
Arrange the steps in leukocyte recruitment:A. TransmigrationB. Rolling C. MarginationD. Firm adhesion
C, B, D, A (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 75
173
Process of coating microorganisms with proteins that facilitate phagocytosis.
Opsonization (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 75
174
A lymphocyte with ingested microorganism fused with lysosome is called _______.
Phagolysosome(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 78
175
The process of migration of the leukocytes through the endothelium.
Transmigration or diapedesis. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 76
176
Process of leukocyte migration toward sites of infection or injury along a chemical gradient.
Chemotaxis (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 77
177
The most important lysosomal enzyme involved in bacterial killing.
Elastase(TOPNOTCH)
178
A peptide leukocyte granule constituent which kills microbes by creating holes in their membranes.
Defensins(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.40
179
Predominant form of leukocyte during the first 6 - 24 hours of inflammation?
Neutrophils(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 77
180
Predominant form of leukocyte during 24-48 hrs after the onset of inflammation?
Monocytes(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 77
181
Predominant cellular infiltrate in Pseudomonas infection.
Neutrophils(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 77
182
Predominant cellular infiltrate in viral infections
Lymphocytes (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 77
183
Predominant cellular infiltrate in allergic reactions
Eosinophils (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 77
184
Sequential steps in phagocytosis
Recognition and attachment of particle to be ingested, engulfment and formation of phagocytic vacuole, killing or degradation of ingested material. (TOPNOTCH) Robbins Basic Pathology, 9th ed. P.78
185
First step in phagocytosis
Recognition and attachment of particle to be ingested(TOPNOTCH) Robbins Basic Pathology, 9th ed. P.78
186
Substances responsible for leukocyte-induced tissue injury
Lysosomal enzymes, reactive oxygen and nitrogen species.(TOPNOTCH)
187
Defective synthesis of CD 18 B-subunit of leukocyte integrins LFA-1 and Mac-1 leading to impaired leukocyte adhesion and migration through endothelium.
Leukocyte adhesion deficiency type 1(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.41
188
Caused by a defect in fucose metabolism resulting in absence of sialyl-lewis X, the oligosaccharide on leukocytes that binds to selectins on activated endothelium.
Leukocyte adhesion deficiency type 2(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.41
189
Results from a defect in the protein involved in membrane docking and fusion.
Chediak-Higashi syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.41
190
NADPH deficiency or defect resulting in decreased oxidative burst.
Chronic Granulomatous Disease(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.42
191
Type of inflammatory mediators that are normally sequestered in intracellular granules and can be rapidly secreted by granule exocytosis or are synthesized de novo in response to a stimulus.
Cell-derived mediators.(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 82
192
Type of mediators that are produced mainly in the liver and are present in the circulation as inactive precursors that must be activated by proteolytic cleavages to acquire their biologic properties.
Plasma-derived mediators. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 83
193
The richest sources of histamine
Mast cells (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 83
194
Effects of histamine of arterioles and venules
Dilation of arterioles and increases permeability of venules. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 83
195
Arachidonic acid metabolites/derivatives
Prostaglandin, prostacyclin, thromboxane, leukotrienes, lipoxin. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 84
196
Arachidonic acid derivative that causes vasoconstriction and promotes platelet aggregration.
Thromboxane A2 (TXA2) (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 84
197
Arachidonic acid metabolite implicated in increased vascular permeability and bronchospasm
LTC4, LTD4, and LTE4 (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 84
198
Arachidonic acid metabolite that causes chemotaxis and leukocyte adhesion.
Leukotriene B4 (LTB4) and hydroxyeicosatetraenoic acid (HETE). (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 84
199
Cytokines that induce systemic acute-phase response associated with infection or injury, and are implicated in sepsis.
TNF, IL-1 (and IL-6) (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 86
200
The cytokines that are important mediators of acute-phase reaction causing fever.
TNF, IL-1 (and IL-6) (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 99
201
3 Functions of complement proteins
Inflammation, opsonization and phagocytosis, and cell lysis. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 89
202
Morphologic hallmarks of acute inflammation
Vasodilation and accumulation of leukocytes and fluid in the extravascular tissue. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 90
203
Type of acute inflammation characterized by the outpouring of watery, relatively protein-poor fluid derived from the serum or endothelial lining of peritoneal, pleural, and pericardial cavities.
Serous inflammation (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 90
204
Fluid in a serous cavity is called ______.
Effusion (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 90
205
This type of inflmmation results from greater vascular permeability that allows larger molecules to pass the endothelial barrier.
Fibrinous inflammation (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 90
206
Histologically, appears as an eosinophilic meshwork of threads or sometimes an amorphous coagulum.
Fibrinous inflammation (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 90
207
This type of inflammation is manifested by the presence of large amounts of purulent exudate consisting of neutrophils, necrotic cells, and edema fluid.
Suppurative (purulent) inflammation (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 90
208
Focal collections of pus that may be caused by seeding pyogenic organisms into a tissue or by secondary infections of necrotic foci.
Abscess (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 90
209
It is an excavation of the surface of an organ or tissue that is produced by necrosis of cells and sloughing of inflammatory necrotic tissue.
Ulcer (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 91
210
Vasoactive amines that are preformed molecules in secretory granules of mast cells, basophils and platelets.
Serotonin, Histamine (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 83
211
Complement fragments which are anaphylotoxins.
C3a, C5a (A for anaphylotoxin) (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 89
212
Complement fragment which aids in opsonization.
C3b (b for binding)(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 89
213
Membrane attack complex
C5b, C6-9 (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 89
214
Deficiency of the terminal components of complement predisposes to what infection.
Neisseria infections. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 89
215
It is the cytolytic endproduct of the complement cascade, which forms a transmembrane channel causing osmotic lysis of target cells.
Membrane attack complex (C5b,C6-9) (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 89
216
Platelet-activating factor (PAF) is a phospholipid-derived mediator that is now known to have multiple inflammatory effects. What are these?
Platelet aggregration, vasoconstriction (vasodilation in low concentration), bronchoconstriction, and increased venular permeability. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 89
217
Enzyme blocked by NSAIDS.
Cyclooxygenase 1 and 2 (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 85
218
Enzyme inhibited by glucocorticoids
Phospholipase A2 (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 85
219
Polypeptide products of many cell types that function as mediators of inflammation and immune response.
Cytokines (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 86
220
They are a family of small structurally related proteins that act primarily as chemoattractants for different subsets of leukocytes.
Chemokines (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 87
221
Major cytokines in acute inflmmation.
TNF and IL-1 (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 86
222
A short-lived, soluble, free-radical gas produced by endothelial cells causing smooth muscle relaxation and vasodilation.
Nitric oxide (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 80
223
This component of the coagulation cascade initiates four systems involved in the inflammatory response, namely the kinin, clotting, fibrinolytic and complement systems.
Activated Hageman Factor / Factor XIIa(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.52
224
Inflammation characterized by infiltration with mononuclear cells, tissue destruction and repair involving angiogenesis and fibrosis.
Chronic Inflammation(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 93-94
225
Macrophages in the liver
Kupffer cells (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 94
226
Macrophages in the spleen and lymph nodes
Sinus histiocytes(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 94
227
Macrophages in the CNS
Microglial cells (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 94
228
Pathway of macrophage activation induced by microbial products such as endotoxin, cytokines, or foreign substance to produce substance for host defense and inflammatory reactions
Classical pathway. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 94
229
Pathway of macrophage activation induced by cytokines produced by T lymphocytes and other cells with the principal function of tissue repair.
Alternative pathway. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 95
230
Macrophages in the lungs
Alveolar Macrophages (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 94
231
A focus of epitheloid cells, rimmed by fibroblasts, lymphocytes, histiocytes, occasional giant cells.
Noncaseating tubercle, Tuberculosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.56
232
Central amorphous granular debris, loss of all cellular detail, acid-fast bacilli
Caseating tuberculosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.56
233
Acid-fast bacilli in macrophages, noncaseating granulomas
Leprosy(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.56
234
Microscopic to visible lesion, enclosing wall of histiocytes, plasma cell infiltrates, necrotic central cells without loss of cellular outline
Gumma (Syphilis)(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.56
235
Rounded or stellate granuloma containing central granular debris and recognizable neutrophils, giant cells uncommon.
Cat-scratch Disease(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.56
236
Noncaseating granulomas with abundant activated macrophages
Sarcoidosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.56
237
Occasional noncaseating granulomas in intestinal walls, with dense chronic inflammatory infiltrate
Crohn's disease(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.56
238
Cells with pink, granular cytoplasm with indistinct boundaries.
Epitheloid cells (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 98
239
40-50 um in size, consisting of a large mass of cytoplasm and many nuclei.
Giant cells (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 98
240
Necrotic material which appears amorphous, structureless, granular debris, with complete loss of cellular details.
Caseous necrosis (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 98
241
Cytokines which stimulate prostaglandins in the hypothalamus, producing fever.
TNF, IL-1(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.57
242
A form of chronic inflammation characterized by collections of activated macrophages, often with T lymphocytes.
Granulomatous inflammation. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 98
243
Diseases with granulomatous inflammation
TB, Leprosy, syphilis, cat-scratch disease, sarcoidosis, Crohn's disease, systemic mycoses (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 98
244
True or false. Schistosomiasis may cause granulomatous inflammation
True. (TOPNOTCH)
245
True or false. Histoplasmosis may cause granulomatous inflammation
True. (TOPNOTCH)
246
A 5 y/o child touches a lit candle and develops a small blister on his right hand. The blister is an example of what type of inflammation?
Serous inflammation. (TOPNOTCH)
247
The hallmark of chronic inflammation
Tissue destruction (TOPNOTCH)
248
A 20 y/o male was admitted due to RLQ pain of 18 hours duration. Appendectomy and revealed an edematous and erythematous appendix. An infiltrate of what cells would be most likely seen?
Neutrophils (TOPNOTCH)
249
Heat and redness in acute inflammation is due to what pathogenetic mechanism?
Increased blood flow (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 74
250
An 18 year old college student accidentally scalds his hand while ironing, where a large unruptured blister forms. What is seen in the blister? (A) protein poor fluid (B) eosinophilic meshwork of amorphous coagulum (C) large necrotic center surrounded by neutrophils (D) epithelioid macrophages and giant cells
protein poor fluid (Morphologic patterns of acute inflammation) (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp 43-44
251
A 64 year old stroke patient at the ICU with a chest radiograph showing a cavitary lesion in the right lower lung lobe with fluid levels. What is seen in that lobe? (A) protein poor fluid (B) eosinophilic meshwork of amorphous coagulum (C) extensive necrosis and neutrophilic infiltrates (D) epithelioid macrophages and giant cells
large necrotic center surrounded by neutrophils (Morphologic patterns of acute inflammation) (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp 43-44
252
A rheumatologist auscultates a friction rub in a 33 year old admitted lupus patient. What is seen in her pericardial cavity? (A) protein poor fluid (B) eosinophilic meshwork of amorphous coagulum (C) large necrotic center surrounded by neutrophils (D) epithelioid macrophages and giant cells
eosinophilic meshwork of amorphous coagulum (Morphologic patterns of acute inflammation) (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp 43-44
253
A 33 year old female who underwent partial thyroidectomy for a colloid nodule 5 years ago underwent a completion thyroidectomy for persistent enlargement. On her present thyroid specimen, the original excision site shows a sutured area. Microscopic examination of that area will show (A) epithelioid cells with occasional giant cellssurrounding a necrotic center (B) neutrophils surrounding a necrotic center (C) protein poor fluid (D) giant cells surrounding refractile bodies
giant cells surrounding refractile bodies (Granulomatous Inflammation) (TOPNOTCH) Robbins Basic Pathology, 8th ed. P 56
254
What is expected in the involved intestine of a patient with Chron disease? (A) eosinophilic network of amorphous coagulum (B) foci of neutrophils with necrotic debris (C) occasional noncaseating granulomas with dense chronic inflammatory infiltrate (D) pockets of protein poor fluid
occasional noncaseating granulomas with dense chronic inflammatory infiltrate (Granulomatous Inflammation) (TOPNOTCH)Robbins Basic Pathology, 8th ed. p.56
255
Cells of these tissues are continuously being lost and replaced by maturation from stem cells and by proliferation of mature cells. Can readily regenerate after injury as long as the pool of stem cells is preserved.
Labile tissues(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
256
Cells of theses tissues are quiescent and have only minimal replicative activity in their normal state. Capable of proliferating in response to injury or loss of tissue mass.
Stable tissues(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
257
Cells of these tissues are considered to be terminally differentiated and nonproliferative in postnatal life.
Permanent tissues(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.62
258
Labile, stable or permanent tissues:Bone marrow
Labile(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
259
Labile, stable or permanent tissues:Vaginal epithelium
Labile(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
260
Labile, stable or permanent tissues:Salivary glands
Labile(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
261
Labile, stable or permanent tissues:Liver parenchyma
Stable(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
262
Labile, stable or permanent tissues:Endothelium
Stable(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
263
Labile, stable or permanent tissues:Smooth muscle cells
Stable(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
264
Labile, stable or permanent tissues:Neurons
Permanent(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.62
265
Labile, stable or permanent tissues:Cardiac muscle
Permanent(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.62
266
Type of collagen found in basement membrane
Type IV collagen(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.67
267
This is the most abundant glycoprotein in basement membrane.
Laminin(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.68
268
The pink, soft, granular tissue seen beneath the scab of a skin wound.
Granulation tissue(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.70
269
Maturation and reorganization of fibrous tissue
Remodeling(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.70
270
Healing of a clean, uninfected surgical incision approximated by surgical sutures
Healing by first intention / Primary Union(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.74
271
Type of healing wherein tissue is allowed to heal by itself before suturing. Used in large wounds, in the presence of abscess, or ulceration.
Healing by secondary intention / secondary union(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.76
272
Wound strength reaches 70 - 80 % of normal in ______ months.
3 months(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.77
273
Single most important cause of delay in wound healing.
Infection(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.77
274
True or false: Complete restoration can occur only in tissues composed of stable and labile cells.
True(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.77
275
Refers to the restoration of tissue architecture and function after an injury.
Repair (TOPNOTCH)Robbins Basic Pathology, 8th ed. p.77
276
True or false:Injury to tissues composed of permanent cells does not result to scarring.
False. Injury to tissues composed of permanent cells, inevitably results to scarring.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.77
277
Process of replacing damaged components of a tissue, returning to a normal state.
Regeneration (TOPNOTCH)Robbins Basic Pathology, 8th ed. p.77
278
Migration and proliferation of fibroblasts with deposition of ECM.
Scar formation(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.72
279
Maturation and reorganization of fibrous tissue
Remodeling(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.73
280
Arrange the steps in cutaneous wound healing:A. Formation of granulation tissueB. ECM remodelingC. Inflammation
C, A, B(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.72
281
It consists of a series of steps at which the cell checks for the accuracy of replication and mitosis and instructs itself to proceed to the next step.
Cell cycle(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
282
In the cell cycle, this is called the presynthetic growth phase.
G1(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
283
In the cell cycle, this is also called the premitotic growth phase.
G2(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
284
These steps in the cell cycle prevents DNA replication or mitosis of damaged cells and either transiently stop the cell cycle to allow repair, or eliminate irreversibly damaged cells by apoptosis.
Checkpoint control(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
285
These enzymes promote DNA replication and various aspects of mitosis. They are required for cell cycle progression. Forms complexes with cyclin.
Cyclin-dependent kinases (CDK)(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.61
286
This cytokine is released from activated macrophages, and is mitogenic for keratinocytes and fibroblasts. It also stimulates keratinocyte migration and granulation tissue formation.
Epidermal Growth Factor (EGF)(TOPNOTCH)
287
This cytokine increases vascular permeability and is mitogenic for endothelial cells.
Vascular Endothelial Growth Factor (VEGF)(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.71
288
Pattern of extracellular signaling wherein the target cell is itself.
Autocrine(TOPNOTCH)
289
Pattern of extracellular signaling wherein the target cell is adjacent to the secretory cell.
Paracrine(TOPNOTCH)
290
Pattern of extracellular signaling wherein the target cell is distant to the secretory cell.
Endocrine(TOPNOTCH)
291
Synthesized by mesenchymal cells, present in the spaces between cells in connective tissue, between epithelium and supportive vascular and smooth muscle structures.
Interstitial Matrix(TOPNOTCH)
292
Component of ECM which confers tensile strength and recoil.
Fibrous proteins s.a. Collagen and elastin(TOPNOTCH)
293
Component of ECM that permits resilience and lubrication.
Proteoglycans, hyaluronan(TOPNOTCH)
294
Component of ECM that connect the elements to one another and to the cells.
Adhesive glycoproteins(TOPNOTCH)
295
What is the hallmark of tissue repair?
Tissue granulation. (TOPNOTCH)
296
A 28 y/o male suffered from traumatic injury of the muscles of his left lower extremity. In this type of tissue, repair is typically dominated by? Scar formation or regeneration?
Scar formation. In permanent tissues like skeletal and cardiac muscle, repair is dominated by scar formation. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 101
297
Liver, kidney and pancreas. Labile, stable or permanent tissues?
Stable. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 101
298
A patient has a large wound on his right arm as a result of a vehicular crash. Initially his wound is filled with granulation tissue composed of fibroblast and new blood vessels. What is responsible for inducing formation of new blood vessels?
Vascular Endothelial Growth Factor (VEGF)(TOPNOTCH)
299
Following hepatectomy, liver undergo repair by __________.
Regeneration. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 102
300
Steps in scar formation
Angiogenesis, Formation of granulation tissue, Remodelling. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 102
301
It is characterized by proliferation of fibroblast and new thin walled, delicate capillaries in a loose ECM often admixed with inflammatory cells.
Granulation tissue. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 103
302
Roles of macrophage in tissue repair.
Clear offending agent and dead tissue, provide growth factor, secrete cytokines for fibroblast proliferation and connective tissue synthesis.(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 104
303
Granulation tissue appear after how many days after injury?
3-5 days. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 104
304
A 50 y/o coal worker experienced gradual onset of dyspnea and non-productive cough. He was then diagnosed with pulmonary fibrosis. What is the most important cytokine that causes the development of fibrosis following chronic inflammation?
Transforming growth factor-? (TGF-?) is the most important cytokine for synthesis and deposition of connective tissue protein. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 105
305
A 52 y/o diabetic female patient developed a non-healing wound on his right foot. She is currently on an anti-hyperglycemic and an antihypertensive.What factor is the most likely implicated in the abnormal wound healing?
Presence of uncontrolled blood glucose level/Diabetes. (TOPNOTCH)
306
Cells present within 24 hours of tissue injury.
Neutrophils (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 106
307
Predominant cells on Day 3 after tissue injury
Macrophages.(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 106
308
An important feature in healing by secondary intention/secondary union.
Wound contraction involving formation of myofibroblasts at the edge of the wound. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 108
309
True or False. Wound strength returns to normal 3 months after a carefully sutured wound.
False. Only up to 70-80% of normal and usually does not improve beyond that. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 108
310
Patient X had a laceration on his right arm and underwent suture and repair. Wound healing continues, however, the site was disfiguring and developed a raised nodule after 2 months. The abnormality presented is ___.
Keloid formation (TOPNOTCH)
311
Patient receiving glucocorticoid therapy for the autoimmune disease developed an abscess. Poor wound healing may result from glucocorticoid therapy due to:
Inhibition of TGF-B and diminished fibrosis secondary to glucocorticoid therapy. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 106
312
One week after an exploratory laparatomy, a 30-year old obese female patient had "rupture of the wound". This complication in tissue repair is due to inadequate formation of granulation tissue or scar formation.
Dehiscence. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 109
313
A 5 y/o patient had second degree burn of the palms. She is more prone to what type of abnormality in tissue repair?
Contracture. (TOPNOTCH)
314
Collagen deposition in cellular repair is largely a function of what cells?
Fibroblasts (TOPNOTCH)
315
The hallmark of tissue healing is:
Granulation tissue (TOPNOTCH)
316
Vitamin C retards wound healing because
Collagen synthesis is inhibited (TOPNOTCH)
317
Phase of cutaneous wound healing: formation of granulation tissue, proliferation and migration of connective tissue cells and re-epithelialization of wound surface
Proliferation (2nd phase) (TOPNOTCH)
318
Phase of cutaneous wound healing: ECM deposition, tissue remodeling and wound contraction
Maturation (3nd phase) (TOPNOTCH)
319
Its characteristic feature is the presence of new small blood vessels and proliferation of fibroblasts
Granulation tissue (TOPNOTCH)
320
True or False. Granulation tissue is more prominent in healing by secondary union.
True (TOPNOTCH)
321
Hypertrophic scar is due to accumulation of excessive amount of___.
Collagen (TOPNOTCH)
322
In wound healing, collagen is produced by:
Myofibroblasts(TOPNOTCH)
323
A 33 year old man sustains a stab injury on his right forearm. Two days after the incident, what can be seen in his stab wound? (A) dense collagen deposition (B) pink amorphous material devoid of cellular elements (C) accumulation of fibroblasts and macrophages (D) fibroblasts and capillaries in a loose extracellular matrix
fibroblasts and capillaries in a loose extracellular matrix (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp 70-71
324
What is expected in the surgical scar of a 21 year old who underwent appendectomy one month ago? (A) Absence of dermal appendages (B) fibroblasts and capillaries in a loose extracellular matrix (C) intense intlammation and large amounts of granulation tissue (D) peak neovascularization
Absence of dermal appendages (Healing by First Intention) (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp74-76
325
A 19 year old black male who got his right earlobe pierced 3 months ago developed a raised scar on that area. If examined microscopically, what should be seen? (A) dense collagen deposited in bundles (B) thickened stratum corneum of the epidermis (C) large amounts of granulation tissue (D) neutrophil aggregates with necrotic centers
dense collagen deposited in bundles (TOPNOTCH) Robbins Basic Pathology 8th ed, p 77
326
What is the cell responsible for wound contraction, especially in wounds that heal by second intention?
myofibroblast (TOPNOTCH) Robbins Basic Pathology 8th ed, p 76
327
Extravasation of fluid into interstitial spaces due to increases in vascular volume or pressure, decreases in plasma protein content or alterations in endothelial function.
Edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.81
328
It is a severe and generalized edema with profound subcutaneous tissue swelling.
Anasarca(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.81
329
The edema fluid occuring with volume or pressure overload or under conditions of reduced plasma protein.
Transudate(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.82
330
Edema secondary to increased vascular permeability and inflammation.
Exudate(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.82
331
The serum protein most responsible for maintaining intravascular colloid osmotic pressure.
Albumin(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.83
332
In breast cancer, infiltration and obstruction of superficial lymphatics can cause edema of the overlying skin, called _______ appearance.
Peau d' orange(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.83
333
Microscopically, it is reflected primarily as a clearing and separation of the extracellular matrix elements with subtle cell swelling.
Edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
334
Diffuse edema usually more prominent in certain body areas as a result of the effects of gravity.
Dependent edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
335
True or false:Dependent edema is a prominent feature of left-sided heart failure.
False.Dependent edema is a feature of right-sided HF, while pulmonary congestion is a feature of left-sided HF.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
336
Edema due to renal dysfunction which manifests disproportionately in tissues with loose connective tissue matrix, e.g. Eyelids.
Periorbital edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
337
Finger pressure over significantly edematous subcutaneous tissue displacing the interstitial fluid, leaving a finger-shaped depression on the skin.
Pitting edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
338
Condition wherein the lungs weigh 2-3x the normal, and on sectioning reveals frothy, sometimes blood-tinged mixture of air, fluid and extravasated red cells.
Pulmonary edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
339
Condition wherein the brain is grossly swollen, with narrowed sulci and distended gyri showing signs of flattening against the underlying skull.
Brain edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
340
It is an active process resulting from augmented blood flow due to arteriolar dilation. Affected tissue is redder than normal, because of engorgement with oxygenated blood.
Hyperemia(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
341
It is a passive process resulting from impaired venous rturn out of a tissue.Tissue has a blue-red color due to accumulation of hemoglobin in the affected tissue.
Congestion(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
342
Characterized by alveolar capillaries engorged with blood, with associated alveolar septal edema or focal minute intra-alveolar hemorrhage.
Acute pulmonary congestion(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
343
Pulmonary septa are thickened and fibrotic, with hemosiderin-laden macrophages in alveolar spaces.
Chronic pulmonary congestion(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
344
Hemosiderin- laden macrophages
Heart-failure cells(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
345
The central vein and sinusoids of the liver are distended with blood, with central hepatocyte degeneration. The periportal hepatocytes are better oxygenated.
Acute hepatic congestion(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
346
The central regions of the hepatic lobules are grossly red-brown and slightly depressed and are accentuated against the surrounding zones of uncongested tan, sometimes fatty liver (nutmeg liver).
Chronic passive congestion of the liver(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
347
Presence of centrilobular necrosis with hepatocyte drop-out, hemorrhage and hemosirin-laden macrophages
CPC of the liver(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
348
Extravasation of blood from vessels into the extravascular space.
Hemorrhage(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
349
Accumulation of blood within a tissue.
Hematoma(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
350
1-2mm hemorrhages into skin, mucous membranes, or serosal surfaces.
Petechiae(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
351
3-5mm hemorrhages which can occur with trauma, vascular inflammation, or increased vascular fragility.
Purpura(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
352
1-2cm subcutaneous hematomas/bruises.
Ecchymoses (TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
353
It is a consequence of tightly regulated processes that maintain blood in a fluid, clot-free state in normal vessels while inducing the rapid formation of a localized hemostatic plug at the site of vascular injury.
Normal hemostasis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
354
Pathologic form of hemostasis.
Thrombosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
355
It occurs after an initial injury, as a result of reflex neurogenic mechanisms.
Arteriolar vasoconstriction(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
356
A potent endothelium-derived vasocontrictor.
Endothelin(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
357
Receptors responsible for platelet adhesion.
GpIb receptors- platelet Von Willebrand factor - endothelium(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.88
358
Deficiency of GpIb receptors.
Bernard-Soulier syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.88
359
Deficiency of GpIIb-IIIa receptors.
Glanzmann thrombasthenia(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.88
360
It is a membrane-bound procoagulant glycoprotein synthesized by endothelium, which becomes exposed at the site of injury.
Thromboplastin/Factor III(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.88
361
Formation of a hemostatic plug due to platelet aggregation
Primary hemostasis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
362
Hemostasis characterized by activation of thrombin through the coagulation cascade.
Secondary hemostasis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
363
True or false:The primary aggregation of platelets is irreversible.
False.(TOPNOTCH)
364
Two substances essential for the formation of a primary hemostatic plug.
ADP and TXA2(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.87
365
True or false:Activation of the coagulation cascade and subsequent thrombin formation is reversible.
False. Irreversible(TOPNOTCH)
366
Substance that activates the coagulation proteins.
Calcium(TOPNOTCH)
367
Substance that mediates further platelet aggregation and degranulation.
ADP(TOPNOTCH)
368
Substance that increases platelet activation and causes vasoconstriction. Synthesized by activated platelets.
TXA2(TOPNOTCH)
369
Most important initiator of the coagulation cascade.
Tissue factor(TOPNOTCH)
370
A protein found on endothelial cells involved in the breakdown of blood clots which catalyzes conversion of plasminogen to plasmin.
Tissue plasminogen activator (t-PA) and Urokinase(TOPNOTCH)
371
Components of Virchow's triad?
Endothelial injuryStasisHypercoagulability(TOPNOTCH)
372
It is a major contributor to the development of VENOUS thrombi.
Stasis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.94
373
Type of blood flow found in normal blood vessels, wherein platelets flow centrally in the vessel lumen, separated from the endothelium by a slow moving clear zone of plasma.
Laminar flow(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.94
374
Alteration in blood flow that contributes to arterial and cardiac thrombosis by causing endothelial injury or dysfunction as well as formation of countercurrents and local pockets of stasis.
Turbulence(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.94
375
Any alteration of the coagulation pathway that predisposes to thrombosis.
Hypercoagulability(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.95
376
A detached, intravascular solid, liquid or gaseous mass that is carried by the blood distal to its point of origin.
Embolus(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.95
377
Apparent laminations seen in a thrombus, representing pale platelet and fibrin layers alternating with darker erythrocyte-rich layers.
Lines of Zahn(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
378
Significance of Lines of Zahn?
Represents thrombosis in the setting of blood flow, seen in antemortem clots.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
379
Thrombi occuring in heart chambers or aortic lumen
Mural thrombi(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
380
Gelatinous thrombi with a dark red dependent portion where red cells have settled by gravity with a yellow "chicken fat" supernatant. Usually unattached to underlying wall.
Postmortem thrombi(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
381
Thrombi on heart valves.
Vegetations(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
382
Sterile, verrucous endocartidis occuring in patients with SLE.
Libman-Sacks endocartidis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
383
Vegetations occuring in the presence of non-infected valves in hypercoagulable states.
Nonbacterial thrombotic endocarditis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
384
Fate of a thrombus wherein the thrombus accumulates additional platelets and fibrin, eventually causing vessel obstruction.
Propagation(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
385
Fate of a thrombus wherein it may dislodge or fragment and transported elsewhere in the vasculature.
Embolization(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
386
Fate of a thrombus as a result of of fibrinolytic activity leading to rapid shrinkage and even total lysis of recent thrombi.
Dissolution(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
387
Fate of a thrombus wherein it may induce inflammation and fibrosis and establish some degree of blood flow.
Organization and recanalization(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
388
True or false:Therapeutic administration of fibrinolytic agents is generally effective only within a few hours of thrombus formation.
True(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
389
Most common site of venous thrombosis.
Superficial or deep veins of the leg(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
390
Most common sequelae of deep venous thrombosis.
Pulmonary embolism(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
391
Tumor-associated procoagulant release largely responsible for the increased risk of thromboembolic phenomena seen in disseminated cancers.
Migrating thrombophlebitis or Trousseau's syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.98
392
Hardening or thickening of the arteries as a result of the accumulation of fatty materials, macrophages, platelets and other inflammatory mediators.
Atherosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.98
393
Fates of a thrombus (4)
PropagationResolution/DissolutionOrganization and recanalizationEmbolization(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.98
394
Embolus occluding a bifurcation in the pulmonary tree.
Saddle embolus(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
395
True or false:A patient who has had one pulmonary embolus has a decreased risk of developing another embolus.
False.The patient is at risk of developing more pulmonary emboli.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
396
A venous embolus which entered the systemic circulation through an interarterial or interventricular defect.
Paradoxical embolus(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
397
Most common symptom of pulmonary embolism.
None/ Asymptomatic (60-80%)(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
398
Right Ventricular failure secondary to pulmonary hypertension.
Cor pulmonale(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
399
Emboli in the arterial circulation.
Systemic thromboembolism(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
400
Most common origin of systemic thrombi.
Intracardiac mural thrombi (80%)(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
401
Major site of arteriolar embolization.
Lower extremities (75%)Brain (10%)(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
402
Microscopic fat globules found in the circulation after fractures of long bones or after soft-tissue trauma.
Fat embolism(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
403
Symptoms of pulmonary insufficiency, neurologic symptoms, anemia, and thrombocytopenia characterize what syndrome?
Fat embolism syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
404
Gas bubbles within the circulation obstructing vascular flow and causes distal ischemic injury.
Air embolism(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
405
Amount of air in the circulation which produces clinical effects of air embolism.
>100 mL(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
406
This occurs when individuals are exposed to sudden changes in atmospheric pressure (e.g. Deep sea divers, scuba divers).
Decompression sickness(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
407
The rapid formation of gas bubbles within skeletal muscles and supporting tissues in and around joints causing pain.
Bends(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
408
Gas bubbles in the lung vasculture causing edema, hemorrhages, focal atelectasis and emphysema.
Chokes(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
409
More chronic form of decompression sickness where persistence of gas emboli in the bones leads to multiple foci of ischemic necrosis.
Caisson disease(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
410
Treatment of choice for decompression sickness.
Hyperbaric compression chamber(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
411
Underlying cause of amniotic fluid embolism.
Entry of amniotic fluid into the maternal circulation through a tear in the placetal membranes and rupture of uterine veins.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
412
Presence of marked pulmonary edema, diffuse alveolar damage, and presence of squamous cells in the pulmonary circulation shed from fetal skin, lanugo hair, fat and mucin.
Amniotic fluid embolism(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
413
White or red infarct?Venous occlusion
Red infarct(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
414
White or red infarct?Lung infarction
Red infarct(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
415
White or red infarct?Intestinal infarct
Red infarct(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
416
White or red infarct?Myocardial infarction
White infarct(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
417
White or red infarction?Splenic infact
White infarct(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
418
White or red infarction?Wedge infarct
White infarct(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
419
The dominant histologic characteristic of infarction.
Ischemic coagulative necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.101
420
Histologic characteristic of brain infarcts.
Liquefactive necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.101
421
This occurs when bacterial vegetations from a heart valve embolize or when microbes seed an area of necrotic tissue.
Septic infarct(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.101
422
Most common sequalae of septic infarcts.
Abscess(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.101
423
Major determinants of the eventual outcome of an infarct. (4)
Nature of vascular supplyRate of development of occlusionVulnerability to hypoxiaOxygen content of blood(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.101
424
Neurons undergo irreversible damage when deprived of their blood supply for _______.
3-4 minutes(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.102
425
Myocardial cells undergo irreversible damage after ______ minutes of ischemia.
20-30 minutes(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.102
426
It is the final common pathway for severe hemorrhage, extensive trauma, burns, large MI, pulmonary embolism and sepsis.
Shock(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.102
427
End results of shock (3)
HypotensionImpaired tissue perfusionHypoxia(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.102
428
This type of shock results from failure of the cardic pump which maybe caused by MI, ventricular arrythmias, cardiac tamponade or outflow obstruction.
Cardiogenic shock(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.102
429
This type of shock results from loss blood or plasma volume.
Hypovolemic shock(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.102
430
This type of shock is caused by microbial infection, caused by gram negative and gram positive bacteria and fungi
Septic shock(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.102
431
True or false:Systemic bacteremia must be present to induce septic shock.
FalseHost inflammatory response to local extravascular infections may be sufficient to induce septic shock.(TOPNOTCHRobbins Basic Pathology, 8th ed. p.102
432
Type of shock which occurs in the setting of an anesthetic accident or spinal cord injury as a result of loss of vascular tone and peripheral pooling of blood.
Neurogenic shock(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.102
433
This type of shock represents systemic vasodilation and increased vascular permeability caused by IgE hypersensitivity reaction.
Anaphylactic shock(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.102
434
Septic shock caused by gram negative bacilli.
Endotoxic shock(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.103
435
Criteria for SIRS.
Temp 38 CelciusHR >90 bpmRR >20 or PaCO2 12,000 cells/mm3 or 10% bands(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.103
436
Adrenal changes in shock.
Cortical cell lipid depletion(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.106
437
Kidney changes in shock.
Acute tubular necrosis resulting in oliguria, anuria, and electrolyte disturbances.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.106
438
Gastrointestinal changes in shock.
Focal mucosal hemorrhage and necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.106
439
Lung changes in shock.
Diffuse alveolar damage if due to bacterial sepsis and trauma.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.106
440
The main mechanism of edema in inflammatory disease is:
increase vascular permeability (TOPNOTCH)
441
Sudden death in pulmonary embolism is due to:
Acute right heart failure (TOPNOTCH)
442
Accumulation of fluid within tissues
Edema (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 113
443
Accumulation of fluid within body cavities
Effusion (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 113
444
Patient presented with pain, swelling, and tenderness of left leg. What is the mechanism of edema in this condition?
Increased hydrostatic pressure. It is caused by impaired venous return as a result of DVT.(TOPNOTCH)
445
Patient presented with dyspnea, orthopnea, easy fatigability, and bipedal edema. The mechanism of edema in this condition is.
Increased hydrostatic pressure (TOPNOTCH)
446
Patient presented with periorbital edema and ankle edema. Lab result shows high lipid levels, and low serum albumin. What is the mechanism of edema in this condition?
Reduced plasma oncotic pressure secondary to protein/albumin loss (case of Nephrotic syndrome) (TOPNOTCH)
447
Mechanism of edema in severe liver disease
Reduced plasma osmotic pressure due to reduced protein synthesis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 114
448
Mechanism of edema caused by Wuchereria bancrofti
Lymphatic obstruction(in Filariasis)(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 114
449
A chronic alcoholic male presented with easy fatigability and orthopnea. Chest radiograph showed bilateral pleural effusion, while abdominal ultrasound showed ascites and small liver. What is the mechanism of effusion in this condition?
Reduced plasma oncotic pressure (TOPNOTCH)
450
Patient X presented with pitting edema of the legs, jugular vein distention, and elevated transaminases. If the liver showed a nutmeg appearance, the patient most likely have:
Chronic passive congestion of the liver secondary to congestive heart failure (TOPNOTCH)
451
Patient with left-sided heart failure may develop pulmonary edema because of what mechanism?
Increased hydrostatic pressure (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th ed., p. 114
452
Assay that assesses the function of proteins in the extrinsic pathway (factors VII, X, V, II, fibrinogen)
Prothrombin time (PT) (TOPNOTCH) RobbIns Basic Pathology, 9th ed., p. 119
453
Assay that screens the function of proteins in the intrinsic pathway (factors XII, XI, IX, VIII, X, V, II, and fibrinogen)
Partial thromboplastin time (PTT) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 119
454
Most important coagulation factor, its various enzymatic activities control diverse aspects of hemostasis
Thrombin (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 119
455
Prostacyclin, nitric oxide and adenosine diphosphatase action: platelet activation or platelet inhibition?
Platelet inhibition(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 121
456
Patient presents with epistaxis and GI bleeding. Lab result showed low platelet count. The patient may have defect in _____. Primary or secondary hemostasis?
Primary hemostasis (TOPNOTCH)
457
Patient presented with knee joint and swelling after a soccer game. However, no physical evidence of injury was noted. He is most likely suffering from what defect in hemostasis?
Secondary hemostasis. Bleeding into joints following minor trauma is particularly characteristic of hemophilia. (TOPNOTCH) Robbins Basic Pathology, 9th ed, p. 122
458
Fatal and most feared complication of severe thrombocytopenia
Intracerebral hemorrhage (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 122
459
Patient was on anticoagulation therapy for the treatment of arterial thromboembolism. However, few days later she was noted to have blood in the urine and reddish spots on her legs. Platelet count was 20. What is the pathophysiologic mechanism for this condition?
Formation of antibodies against complexes of heparin and platelet factor 4 on platelet surface resulting to platelet activation, aggregration, and consumption. (HIT)(TOPNOTCH)
460
Syndrome presenting with recurrent thromboses, repeated miscarriages, cardiac valve vegetation, and thrombocytopenia.
Antiphospholipid antibody syndrome (TOPNOTCH) Robbins Basic Pathology, 9th ed., p.124
461
Most common site of arterial thrombi
Coronary arteries (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 125
462
True or False. Saphenous vein thrombosis often cause embolization.
False. Superficial vein thrombosis rarely embolize. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 126
463
Lower extremity DVT are often associated with____. Turbulent blood flow, endothial injury or hypercoagulable state?
Hypercoagulable state (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 126
464
Major cause of arterial thromboses
Atherosclerosis (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 126
465
Systemic activation of thrombin leading to widespread formation of thombi in microcirculation, and consumption of platelets and coagulation factors.(TOPNOTCH)
Disseminated Intravascular Coagulation/Consumptive coagulopathy(TOPNOTCH)
466
Patient X fractures his right femur after falling from a height of 10 meters. After 2 days of hospitalization, he developed sudden onset of dyspnea, tachycardia, and restlessness. Diffuse petechial rashes was noted on his trunk. What is the most likely diagnosis?
Fat emboli (TOPNOTCH)
467
A 60 y/o female, bed-ridden, was admitted to the hospital with shortness of breath and hemoptysis. Physical examination finds the patient to be afebrile, tachycardic, calf tenderness and widely split S2. What is the most likely diagnosis?
Pulmonary embolism (TOPNOTCH)
468
A 30 year old female experienced dyspnea and edema after being injected with antibiotic. She later lost consciousness and BP rapidly declined, and later went into shock. The is due to:
Anaphylactic shock (TOPNOTCH))
469
A bedridden elderly patient experienced sudden onset of dyspnea and hemoptysis. The underlying lesion that led to this complication was most likely located in which site?
Veins lof lower extremity. It is the most common site of DVT leading to pulmonary embolism. (TOPNOTCH)
470
Exudate or transudate? Inflammation
Exudate(TOPNOTCH)
471
Exudate or transudate? Nephrotic syndrome
Transudate(TOPNOTCH)
472
Exudate or transudate? Chronic liver disease
Transudate(TOPNOTCH)
473
A stillborn baby with Turner syndrome is found to have generalized edema and a large lymphangioma around her neck at autopsy. Heart and aorta findings were unremarkable. What is the mechanism for her edema? (A) Reduced oncotic pressure (B) lymphatic obstruction (C) sodium retention (D) inflammation
Lymphatic obstruction (TOPNOTCH) Robbins Basic Pathology 8th ed. pp82-83
474
Which of the following will most likely produce pulmonary edema? (A) mitral valve stenosis (B) pulmonary hypertension (C) tricuspid stenosis (D) subpulmonic valve stenosis
mitral stenosis (TOPNOTCH) Robbins Basic Pathology 8th ed. P 84
475
In which of the following cases would cerebral edema be more generalized? (A) a meningioma on the parietal cortex (B) viral encephalitis (C) occlusion of the right cerebral artery (D) frontal abscess
viral encephalitis (TOPNOTCH) Robbins Basic Pathology 8th ed. P84
476
A patient with congestive heart failure dies. At autopsy, his liver appears grossly similar to nutmeg. Which describes an expected microscopic finding? (A) lymphocytic infiltrates in the portal tracts (B) hepatocyte necrosis around central veins (C) hepatocyte necrosis around hepatic arterioles (D) vacuolated hepatocytes and giant cell formation
hepatocyte necrosis around central veins (TOPNOTCH) Robbins Basic Pathology 8th ed., p. 85.
477
A Stage IV breast cancer patient on prolonged bed rest suddenly develops difficulty of breathing and dies. At autopsy, a blood clot in the main pulmonary artery is found. Which of the following supports a thromboembolic origin, rather than a postmortem clot? (A) pale platelet and fibrin layers alternating with darker erythrocyte-rich layers (B) gelatinous consistency, with a dark dependent portion and a yellow supernatant (C) chicken fat appearance (D) lines of Kahn
pale platelet and fibrin layers alternating with darker erythrocyte-rich layers (lines of Zahn) (TOPNOTCH) Robbins Basic Pathology 8th ed, p96
478
A pregnant patient in her third trimester is hit by a car and sustains a femoral fracture. She subsequently goes into labor and delivers a preterm baby via vaginal delivery. A few minutes later, she has sudden dyspnea, cyanosis, and dies. At autopsy, there was pulmonary edema, a ventricular septal defect, and squamous cells in the microcirculation. What is the immediate cause of death? (A) amniotic fluid embolism (B) fat embolism (C) paradoxical embolism (D) air embolism
Amniotic fluid embolism(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.100
479
In pure hypovolemic shock, which of the following organs will manifest the least cellular changes? (A) brain (B) adrenals (C) kidneys (D) lungs
Lungs (TOPNOTCH) Robbins Basic Pathology 8th ed. P 105.
480
These agents cause transmissible spongiform encephalopathies.
Prions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 321
481
Infected cells show distinct nuclear and ill-defined cytoplasmic inclusions.
CMV infection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 322
482
Infected cells show glassy nuclear inclusions, frequently with a surrounding halo.
Herpesvirus infection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 322
483
Infected hepatocytes show diffuse granular (ground-glass) cytoplasm.
Hepatitis B viral infection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 322
484
Sexually transmitted protozoan that can colonize the vagina and male urethra.
Trichomonas vaginalis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 325
485
Protozoan acquired either by contact with oocyte-shedding kittens or by consumption of cyst-ridden undercooked meat.
Toxoplasma gondii(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 325
486
Size of microorganisms for them to be inhaled directly into the alveoli.
5 um(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 327
487
These microorganisms grow in contaminated food and releases powerful enterotoxins that cause food poisoning symptoms without any bacterial multiplication in the gut.
Staphylococcal strains(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 327
488
Intestinal helminth that cause disease when present in large numbers or cause obstruction of the gut.
Ascaris lumbricoides(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 326
489
Helminth that causes iron deficiency anemia by chronic loss of blood.
Hookworms(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 327
490
Helminth that depletes vitamin B12 giving rise to an illness resembling pernicious anemia.
Diphyllobotrium latum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 327
491
Placentofetal route as a mode of transmission is also referred to as ________.
Vertical transmission(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 329
492
The ability of bacteria to cause disease.
Virulence(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 331
493
Bacterial surface molecules that bind to host cells.
Adhesins(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 332
494
Filamentous proteins on gram negative bacteria which allow exchange of genes between bacteria, and also involved in adherence.
Fimbriae/pili(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 332
495
Clostridium perfringens produces this toxin that disrupts plasma membranes resulting in digestion of host tissues and collagen.
Alpha toxin (lecithinase)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 334
496
Bacterial toxins with the capacity to stimulate large populations of T lymphocytes, functionally resulting in a "cytokine storm".
Superantigens(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 334
497
Examples of antigen presenting cells.
Dendritic cellsMacrophagesB-cells(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 334
498
A superantigen secreted by S. aureus which causes inflammation, fever and shock. Found in the vagina of menstruating women.
Toxic shock syndrome toxin (TSST-1)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 334
499
Collection of neutrophils which gives rise to localized liquefactive necrosis.
Abscess(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 334
500
High risk agents of bioterrorism which are easily disseminated and has high potential for mortality. An example is smallpox.
Category A(TOPNOTCH)
501
A distinctive form of mononuclear inflammation usually evoked by infectious agents that resist eradication, but are capable of stimulating strong T cell mediated immunity. Characterized by epitheloid cells which may fuse to form giant cells.
Granulomatous inflammation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 335
502
Agents that are relatively easy to disseminate and produces moderate morbidity and low mortality. An example is E.coli O157:H7 which can cause HUS.
Category B(TOPNOTCH)
503
Includes emerging pathogens that have the potential for mass dissemination with high morbidity and mortality. Examples are Nipah virus and Hanta virus.
Category C(TOPNOTCH)
504
An 8 y/o female presented with fever, sore throat, conjunctivitis, and blotchy, reddish brown rashes on the face, trunk, and extremities. In this condition, lymphoid organs have marked follicular hyperplasia, large germinal center, and randomly distributed Warthin-Finkeldey cells. The most likely cause of this disease is:
Rubeola virus. Warthin-Finkeldey cells are multinucleate giant cells with eosinophilic nuclear and cytoplasmic inclusion bodies. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 355
505
Ulcerated mucosal lesion near the opening of Stensen duct marked by necrosis, neutrophilic exudate, and neovascularization.
Koplik spots - pathognomonic of measles (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 355
506
What protects against reinfection with measles?
Antibody-mediated immunity (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 355
507
Most common extrasalivary gland complication of mumps infection
Aseptic meningitis (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 356
508
A 10 y/o male presented with fever and bilateral swelling and pain of parotid glands aggravated by intake of sour food. What is the most likely finding in the gland interstitium in this disease?
Edematous, diffusely infiltrated by macrophages, lymphocytes, and plasma cells(Mumps) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 356
509
True of false. Poliovirus infects only humans.
True(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 356
510
Mode of transmission of West Nile virus
Vector-borne (mosquito) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 356
511
Viruses that most frequently establish latent infections in humans
Herpesviruses (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 357
512
A 10 y/o child presented with vesicular around the lips and cervical lymphadenopathy. Histopathologic finding showed cells containing large, pink to purple intranuclear inclusion that consist of viral replication proteins. The etiologic agent for this condition is:
HSV-1 (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 357
513
A 28 y/o female complained of itchiness and vesicular lesions on her genitalia which later progress to ulcerations. The cause of this condition is:
HSV-2 causing genital herpes (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 357
514
Latent infection with this virus is seen in neuron and/or satellite cells around neurons in the dorsal root ganglia.
Varicella-Zoster Virus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 357
515
A 62 y/o male presented with painful vesicular rash in a stripe-like pattern over the left side of his trunk. On microscopy, the sensory ganglia contain a dense, predominantly mononuclear infiltrate, with herpetic intranuclear inclusions within neurons. This is a case of:
Shingles/Herpes zoster (TOPNOTCH)
516
Syndrome caused by varicella zoster virus with involvement of geniculate nucleus causing facial paralysis
Ramsay Hunt Syndrome (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 359
517
A neonate was noted to have jaundice, anemia, and hepatosplenomegaly. Patient also had microcephaly, and brain showed foci of calcification. The most likely diagnosis is:
Cytomegalic inclusion disease (caused by CMV) (TOPNOTCH)
518
Morphology of cells in CMV
Prominent intranuclear basophilic inclusion set off from nuclear membrane by a clear halo (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 359
519
A 6 y/o male presented with fever, lymphadenopathy, and hepatomegaly. Lab showed abnormal liver function test and lymphocytosis. These are the most common clinical manifestion in
CMV infection in immunocompetent host. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 360
520
Virus implicated in nasopharyngeal carcinoma and some lymphomas.
Epstein-Barr Virus. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 360
521
A 16 y/o male presented with high fever for a week, sore throat, enlarged lymph node in the posterior cervical and axillary region, and splenomegaly. Peripheral smear showed large lymphocytes with abundant cytoplasm containing clear vacuolization, an oval, indented nucleus and scattered cytoplasmic azurophilic granules (10% atypical lymphocytes). The main target cells of this condition is/are:
B cells and epithelial ells of the oropharynx. (EBV infection) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 360
522
Patient with EBV infecction will have a positive or negative heterophile antibody reaction (Monospot test)
Positive heterophile antibody reaction. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 362
523
A disorder caused by mutations in the SH2D1A gene, which encodes a signaling protein that participates in T-cell and NK-cell activation and antibody production. It is characterized by an ineffective immune response to EBV.
X-linked lymphoproliferation syndrome (Duncan Disease) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 362
524
Toxin responsibe for Ritter's disease
Exfoliative A and B toxin(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 363
525
Other term for staphylococcal scalded-skin syndrome.
Ritter's disease (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 363
526
A 5 y/o male was admitted due to sunburn-like rash over the entire body and evolving into fragile bullae. Presence of desquamation of the epidermis occurs at the level of the granulosa layer. What is the cause of this condition?
Staphylococcus aureus (causing Staphylococcal scalded skin syndrome) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p.364
527
Coagulase-negative organism causing opportunistic infections in catheterized patients,patients with prosthetic valves and drug addicts.
Staphylococcus epidermidis (TOPNOTCH) Robbins Basic Pathology, 9th ed., p.364
528
A 30 y/o female was noted to have dyspnea and generalized erythematous rash. She developed hypotension, renal failure, coagulopathy and liver dysfunction. History revealed the use of tampons. The most likely diagnosis is:
Toxic shock syndrome caused by S. aureus (TOPNOTCH) Robbins Basic Pathogy, 9th Ed p. 363
529
A 50 y/o female presented with a 1-week history of progressive, productive cough, and 2 days of spiking fever. Chest examination was notable for decreased breath sounds on the right lower lung field. Chest radiograph demonstrated a right lower lobe infiltrate. A blood culture was subsequently positive for gram positive cocci in pairs. what is the likely organism causing this illness?
Streptococcus pneumoniae. (TOPNOTCH)
530
An 18 y/o female presented with painful swelling in her feet, knees, and wrist. The patient had been well until 10 days prior to admission when she developed a severe sore throat accompanied by fever. What is the most likely cause of his illness?
Streptococcus pyogenes/GABHS(TOPNOTCH)
531
Surface protein present in S. pyogenes responsible for antibodies and T cells cross-reacting with cardiac proteins.
M protein. (TOPNOTCH)
532
A 6 y/o male presented with tonsillopharyngitis, circumoral pallor and erythematous, sandpaper like rashes covering the trunk and extremities. What is the most likely cause of this illness?
This is a case of Scarlet fever caused by Streptococcus pyogenes (TOPNOTCH)
533
A 35 y/o female presented with rapidly spreading erythematous cutaneous swelling on the face with rashes that are sharp, welll-demarcated , serpiginous border forming a butterfly distribution on the face. On histologic exam, there is a diffuse, edematous, neutrophilic inflammation of the dermis and dermis extending to the subcutaneous tissue. This is caused by what microorganism?
S. pyogenes (case of erysipelas) (TOPNOTCH)
534
A 43 y/o male had a two-week history of fever, chills, weakness, and anorexia following a dental extraction. On physical examination, patient had high pitched murmur best heard at the apex. Echocardiogaphy done showed an irregular vegetation attached to mitral valve. The most likely cause of endocarditis in this case is:
Streptococcus viridans. (TOPNOTCH)
535
A 26 y/o previously healthy woman develops fever within 24 hours of delivery of an infant born at 32 weeks. Vaginal swab of the mother revealed Gram positive coci. Blood culture showed organism that are catalase negative, beta-hemolytic on blood agar. The most likely cause of bacteremia is:
Streptococcus agalactiae (Group B Streptococcus) (TOPNOTCH)
536
A 5 y/o old unimmunized child presented with persistent sore throat , cough and fever for 1 week. On examination, the neck was diffusely swollen with tender, bilateral cervical adenopathy. There were hemorrhagic areas on the hard palate and necrotic grayish membrane on the soft palate and tonsils. Morphologic finding of Intense neutrophilic infiltration in the tissues with marked vascular congestion, interstitial edema, and fibrin exudation were noted. This is caused by
Corynebacterium diphtheriae (TOPNOTCH)
537
True or false. Toxin produced by Corynebacterium diphtheriae are the ones responsible for the clinical manifestations of diphtheria.
True. (TOPNOTCH)
538
A 2 mo old male was admitted to the hospital with a history of fever, vomiting, and convulsions. Birth history was unremarkable. CNS finding were suggestive of meningitis. Gram staining of CSF showed mononuclear cells with moderate Gram positive bacilli with tumbling motility. The most likely etiologic agent for this condition is:
Listeria monocytogenes. (TOPNOTCH)
539
This organism causes a painless, pruritic papule developing into a vesicle, which ruptures with remaining ulcer becoming covered with a characteristic eschar.
Bacillus anthracis. (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 366
540
Lesion caused by this organism are typified by necrosis and exudative inflammation rich in neutrophils and macrophages and presence of large, boxcar-shaped gram-positive extracellular bacteria in chains.
Bacillus anthracis. (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 367
541
A 48 y/o male was admitted with a 4 month history of cough with purulent sputum, hremoptysis, and fever. He wa diagnosed with AIDS 2 years earlier and was on antiretivirals irregularly. On examination, HR=98bpm, RR= 26 /min. Chest auscultation revealed decreased breath sounds on the upper third of right hemithorax. CXR demonstrated consolidation in the upper lobe of the right lung. Bronchoscopy with lavage revealed presence of branching filamentous gram positive organism. The organism described is
Nocardia asteroides. (TOPNOTCH)
542
A 17 y/o college student presented with fever, chills, headache, joint pains and myalgia. On physical examination, she is tachycardic, febrile, with mild hypotension. There was noted petechial rashes on her trunk and legs. Gram stain revealed gram-negative coffee-bean shaped diplococci. The most likely cause of this condition is
Neisseria meningitidis. (TOPNOTCH)
543
A 25 y/o female complained of severe pelvic pain and fever. A greenish yellow cervical discharge was detected on physical examination. Gram negative diplococci were isolated from the endocervical swab. What is the most likely cause?
Neisseria gonorrhea (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 368
544
A 2-month old infant was admitted with fever, lymphocytosis, and bouts of violent coughing that often end in vomiting. Blood culture showed small gram-negative rods. The most likely diagnosis is:
Pertussis (TOPNOTCH)
545
Mechanism on how B. pertussis toxin impair host defenses.
Inhibits phagocytosis, inhibits neutrophils and macrophages and paralyzing cilia. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 369
546
Bacteria causing laryngotracheobronchitis with features of bronchial mucosal erosion, hyperemia, and copious, mucopurulent exudate. It may present with hypercellularity and enlargement of mucosal lymph follicles and peribronchial lymph nodes along side a marked peripheral lymphocytosis (up to 90%)
Bordetella pertussis. (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 369
547
A 67 y/o female was admitted with a 1 week history of cough and pleuritic chest pain. Physical examination revealed tachypnea, rhonchi in both upper lobes. The next day, patient's condition deteriorated and had severe respiratory distress. Autopsy revealed extensive bilateral bronchopneumonia and necrosis in the terminal airways in a fleur-de-lis pattern, with striking pale necrotic centers and red, hemorrhagic peripheral areas. The most likely cause of this disease is:
Pseudomonas aeruginosa (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 369
548
An opportunistic aerobic gram-negative bacillus that is frequent, deadly pathogen of people with cystic fibrosis, severe burns, or neutropenia.
Pseudomonas aeruginosa (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 369
549
A 32 y/o female on chronic immunosuppressive therapy was admitted for the management of her abdominal wound infection. On hospital day 18, patient developed erythematous papulovesicules on the left upper chest and right medial leg progressing rapidly to necrotic and hemorrhagic oval ulcers. What organism most likely cause this condition?
Pseudomonas aeruginosa (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 370
550
Organism that causes lymph node enlargement (buboes) with distinct histologic features of massive proliferation of organism, early appearance of effusions with few inflammatory cells, necrosis of tissues and blood vessels with hemorrhage and thrombosis, and neutrophilic infiltrates in necrotic areas.
Yersinia pestis (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th Ed p. 370
551
A 25 y/o male initially presented with a tender erythematous papule on the penis which produce an irregular, painful, non-indurated ulcer over several days. The base of the ulcer is covered by shaggy, yellow-gray exudate. Microscopically, the ulcer contains a superficial zone of neutrophilic debris and fibrin, and an underlying zone of granulation tissue containing areas of necrosis and thrombosis. This infection is caused by:
Haemophilus ducreyi (causing Chancroid) (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 370
552
A 45 y/o sexually active male presented with a 3-month history of few painless ulcerated lesions on the penis and scrotum. The painless nodules slowly evolved to red ulcerated lesions over 1 month. Physical examination revealed multiple, raised, beefy-red nontender round ulcers on the shaft of penis and scrotum. The ulcers had clean friable granulating bases. Microscopic examination with Giemsa stain revealed numerous encapsulated coccobacilli in macrophages. The most likely diagnosis is:
Granuloma inguinale/donovanosis (Klebsiella granulomatis) (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 370
553
A 25 y/o male initially presented with a tender erythematous papule on the penis which produce an irregular, painful, non-indurated ulcer over several days. The base of the ulcer is covered by shaggy, yellow-gray exudate. Microscopically, the ulcer contains a superficial zone of neutrophilic debris and fibrin, and an underlying zone of granulation tissue containing areas of necrosis and thrombosis. This infection is caused by:
Klebsiella granulomatis (TOPNOTCH)
554
True or false. A positive tuberculin test differentiates active disease from infection.
False. A positive tuberculin test signifies T-cell mediated immunity to mycobacterial antigen. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 371
555
How many days or weeks after mycobacterium infection will it develop delayed hypersensitivity to M. tuberculosis as detected by Mantoux skin test?
2-4 weeks (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 371
556
The critical mediator that enables macrophages to contain M. tuberculosis infection by stimulating maturation of phagolysosome, stimulation of expression of inducible nitric oxide synthase and mobilization of defensins against bacteria.
IFN gamma(TOPNOTCH) Robbins Pathologic Basis of Disease, 9th Ed p. 372
557
True or False. Immunity to M. tuberculosis is primarily mediated by TH1 cells.
True. TH1 cells stimulate macrophages to kill the bacteria (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 373
558
Secondary pulmonary tuberculosis classically involves what part of the lungs?
Apex of the upper lobes of one or both lungs. (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 373
559
True or false. The absence of characteristic granulomas in tissues in HIV-positive patients precludes (rule out) the diagnosis of tuberculosis.
False. Atypical features of TB in HIV-positive patients include increase frequency of false-negative sputum smears, tuberculin tests, and absence of granuloma, particularly in the late stages of HIV.(TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 374
560
A 1 to 1.5 cm area of gray-white inflammation with consolidation in primary tuberculosis.
Ghon focus (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 374
561
Most frequent presentation of extrapulmonary tuberculosis.
Lymphadenitis (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 376
562
A 42 y/o male nonsmoker with AIDS began to experience cough, mild hemoptysis, and progressive dyspnea. CD4 cell count was 45 cell/ul. A chest radiograph revealed hilar adenopathy and perihiral infiltrates. AFB smear was negative. Bronchoscopy was done and microscopic finding showed an abundnat acid-fast bacilli within macrophages. The organism causing the illness is:
Mycobacterium avium complex (TOPNOTCH)
563
Pattern of leprosy presenting with dry, scaly skin lesions that lack sensation and often have assymetric involvement of large peripheral nerves.
Tuberculoid leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 377
564
Pattern of leprosy causing symmetric skin thickening and nodules with widespread invasion of mycobacteria into Schwann cells and into endoneural and perineural macrophages damaging the peripheral nervous system.
Lepromatous leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 377
565
Pattern of leprosy characterized by TH1 response associated with production of IL-2 and IFN gamma
Tuberculoid leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 377
566
Pattern of leprosy associated with weak TH1 response and in some cases increase in TH2 response resulting to weak cell-mediated immunity.
Lepromatous leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 377
567
A 30 y/o male presented with a flat, red, anesthetic skin lesions on his left thigh extending to his knee which had been present for 2 years. These lesions enlarged and develop irregular shapes with indurated, elevated, hyperpigmented margins and depressed pale centers. On microscopic examination, all sites of involvement have granulomatous lesions. Bacilli are almost never found. This is a case of__.
Tuberculoid leprosy/Paucibillary leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 377
568
This disease presents with macular, papular, or nodular lesion on the face, ears, wrists, elbows and knees, progressing to coalescence of nodular, anesthetic lesions. (+) leonine facies. Morphologic findings of this disease reveals skin and peripheral nerve lesions containing large aggregates of lipid laden macrophages (lepra cells) often filled with asses (globi) of acid fast bacilli.
Lepromatous/multibacillary leprosy (TOPNOTCH) Robbins Basic Pathology, 9th Ed p. 378
569
A 19 y/o male presents to the clinic because of a lesion on his penis. Genital exam showed a red, solitary, raised , indurated, non-tender lesion on the ventral side of his penis. Neurologic exam was within normal limits. What is the most likely diagnosis?
Primary syphilis(chancre)(TOPNOTCH)
570
A 34 y/o male presented with circular violaceous, papulosquamous lesions on his palms, soles, and entire body. He admitted having unprotected sex with his new partner 6 weeks before the onset of his lesions. Broad-based plaques were noted in the inner thighs and anogenital region. Silver-gray erosions were noted on the pharyngeal and genital area. What is the most likely diagnosis(and stage)?
Secondary syphilis. (TOPNOTCH)
571
Characteristic of all stages of syphilis
Proliferative endarteritis. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 379
572
Serologic test/s that are sensitive for secondary syphilis
Both non-treponemal antibody tests and antitreponemal antibody tests. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 379
573
Serologic tests that are very sensitive for tertiary and latent syphilis.
Treponemal tests (Fluorescent Treponemal antibody absorption test, T pallidum enzyme immunoassay test) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 379
574
Most frequent involvement of tertiary syphilis
Aorta (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 380
575
A 39 y/o male presented with a white-gray and rubbery mass on the forehead that had been slowly progressive over the previous 6 years. Biopsy showed that lesion have centers of coagulated, necrotic material and margins composed of plump, palisading macrophages and fibroblasts surrounded by large number of mononuclear leukocytes. What is the lesion described?
Syphilitic gumma (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 381
576
A neonate presented with snuffles, bullous eruption of the palms and soles, saddle nose deformity, and anterior bowing of the tibia. What is the most likely cause?
T. pallidum (causing congenital syphilis) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 381
577
Late manifestations of congenital syphilis (triad)
Interstitial keratitis, Hutchinson teeth, and eighth-nerve deafness (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 381
578
Disseminated infection from this microorganism cause secondary skin lesions, lymphadenopathy, migratory joint and muscle pain, cardiac arrythmias, and meningitis.
Borrelia burgdorferi (causing congenital syphilis) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 381
579
A 60 y/o male presented with severe pain and edema of left foot and leg, bullous vesicles, and foul-smelling wound discharge 3 days after sustaining a crushing injury. Crepitations were noted over the inflamed muscles. What is the most likely cause of this condition?
Clostridium perfringens (causing gas gangrene/clostridium myonecrosis) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 383
580
Most common sexually transmitted bacterial disease
Chalmydia trachomatis infection(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 383
581
A 28 y/o male presented with painful, swollen lymph node at the inguinal area, associated with fever, and myalgia. Two weeks prior, patient recalled had a small, painless pustule on the scrotum. The most likely diagnosis is:
Lymphogranuloma venereum (TOPNOTCH)
582
Lymph node involvement in this condition is characterized by a granulomatous inflammatory reaction associated with irregularly shaped foci of necrosis containing neutrophils (stellate abscess).
Lymphogranuloma venereum (caused by Chlamydia trachomatis)(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 384
583
Presents with dysphagia and retrosternal pain; endoscopic findings of white plaques and pseudomembranes resembling oral thrush on the esophageal mucosa.
Candida esophagitis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 386
584
Associated with intense itching and thick, curd-like discharge common in women who are diabetic, pregnant, or on OCP.
Candida vaginitis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 386
585
A 70 y/o male, with prior history of TB, presents with occassional cough, hemoptysis, fever, and respiratory distress. CXR showed a mass surrounded by a crescentic rim on the right upper lobe within a cavitary lesion. Biopsy done revealed no malignant cell. This is most likely a case of:
Pulmonary aspergilloma (TOPNOTCH)
586
A 60 y/o diabetic female presented with fever and left periorbital pain and sweling. A nasal eschar involving the enitre nose with discharge from the nasal cavity. Biopsy from the eschar showed foci of nonseptate fungal hyphae and hyphal branches at right angles. The most likely cause of her condition is:
Mycormycetes (TOPNOTCH)
587
The etiology of cerebral malaria, wherein brain vessels are plugged with parasitized red vessels. Around the vessels are ring hemorrhages related to local hypoxia. (TOPNOTCH)
Plasmodium falciparum (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 392
588
What is the major cause of sudden death in Chagas disease?
Cardiac arrythmia. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 395
589
The causative agent of Chagas disease
Trypanosoma cruzi (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 394
590
Nematode that causes patchy interstitial myocarditis characterized by many eosinophils and scattered giant cells.
Trichinella spiralis (TOPNOTCH) Robbins Basic Pathology, 9th ed., 397
591
Pathogenesis of hepatic fibrosis in schistomiasis
Eggs carried into the parenchyma cause severe chronic inflammation; TH2 response and activated macrophages. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 398
592
Pipe-stem fibrosis of the liver, portal enlargement without intervening regenerative nodules, and granuloma are associated with infection caused by:
Schistosoma mansoni and S. japonicum. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 398
593
A chronic carrier state of typhoid fever is most likely due to persistence of the organism in the:
Gall bladder (TOPNOTCH)
594
A 38 y/o man with AIDS present with deteriorating mental status. Lumbar tap was done. CSF was stained with india ink and mucicarmine revealed capsulated yeasts that stain bright red. What is the most likely diagnosis?
Cryptococcosis (TOPNOTCH)
595
A 53 year old woman presents with 5 days of productive cough and high grade fevers. Crackles were auscultated at the left lung. Sputum cultures grew Streptococcus pneumoniae. Her lungs will show which histologic picture? (A) suppurative inflammation with sparing of alveolar septa (B) thickened alveolar septa with mononuclear infiltrates (C) lysis of alveolar walls and coalescing abscesses (D) epithelioid macrophages and giant cells
suppurative inflammation with sparing of alveolar septa (TOPNOTCH)Robbins Basic Pathology, 8th Ed p334-335
596
A 44 year old HIV-positive man is admitted for diarrhea of one month duration. Fecalysis did not show parasitic ova or cysts. Colonoscopy showed a diffusely erythematous mucosa. Biopsy was performed which showed sheets of macrophages filled with filamentous structures that were bright pink on acid fast staining. The likely organism is (A) Cryptosporidium parvum (B) Isospora belli (C) Mycobacterium bovis (D) Mycobacterium avim-intracellulare
Mycobacterium avium-intracellulare dx Infectious mononucleosis case (TOPNOTCH) pp326-327
597
This term refers to protection against infections.
Immunity(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.108
598
It is the collection of cells and molecules that are responsible for defending against pathogenic microbes.
Immune system(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.108
599
Type of immunity mediated by neutrophils, macrophages and natural killer cells and includes epithelial barriers of the skin, GIT and respiratory tract.
Innate immunity (natural/native)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.108
600
Type of immunity mediated by lymphocytes and their products, and is normally silent and responds to the presence of microbes by becoming active, expanding and generating potent mechanisms for neutralizing and eliminating microbes.
Adaptive immunity (acquired/specific)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.108
601
Type of adaptive immunity mediated by soluble antibody proteins that are produced by B lymphocytes.
Humoral immunity(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.109
602
Type of adaptive immunity mediated by T lymphocytes.
Cell-mediated or cellular immunity(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.109
603
Mediated by antibodies and is effective against extracellular microbes.
Humoral immunity(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.109
604
Reaction of T-lymphocytes, designed to combat cell-associated microbes (e.g. Phagocytosed microbes and microbes in the cytoplasm of infected cells).
Cell-mediated immunity(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.109
605
Reaction of immune system against one's own cells.
Autoimmunity(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.119
606
Results from activation of TH2 CD4+ helper T cells by environmental antigens, leading to the production of IgE antibodies, which become attached to mast cells.
Type I Hypersensitivity (immediate)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
607
Caused by antibodies that bind to fixed tissue or cell surface antigens and promote phagocytosis and destruction of the coated cells or trigger pathologic inflammation in tissues.
Type II Hypersensitivity (Antibody-mediated)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
608
Caused by antibodies binding to antigens to form complexes that circulate and may deposit in vascular beds and stimulate inflammation, secondary to complement activation.
Type III Hypersensitivity (immune complex mediated)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
609
Cell-mediated immune responses in which T lymphocytes cause tissue injury, either by producing cytokines that induce inflammation and activate macrophages, or by directly killing cells.
Type IV Hypersensitivity (T-cell mediated/Delayed)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
610
Indicate type of hypersensitivity reaction:SLE
Type III(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
611
Indicate type of hypersensitivity reaction:Multiple sclerosis
Type IV(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
612
Indicate type of hypersensitivity reaction:Transplant rejection
Type IV(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
613
Indicate type of hypersensitivity reaction:Anaphylaxis
Type I(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
614
Indicate type of hypersensitivity reaction:Goodpasture syndrome
Type II(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
615
Indicate type of hypersensitivity reaction:Serum sickness
Type III(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
616
Indicate type of hypersensitivity reaction:Arthus reaction
Type III(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
617
Indicate type of hypersensitivity reaction:Autoimmune hemolytic anemia
Type II(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
618
Indicate type of hypersensitivity reaction:Allergies
Type I(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
619
Indicate type of hypersensitivity reaction:Type I DM
Type IV(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
620
Indicate type of hypersensitivity reaction:Tuberculosis
Type IV(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
621
Indicate type of hypersensitivity reaction:Bronchial asthma
Type I(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
622
Indicate type of hypersensitivity reaction:Acute rheumatic fever
Type II(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
623
Indicate type of hypersensitivity reaction:Poststreptococcal glumerulonephritis
Type III(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
624
Indicate type of hypersensitivity reaction:Polyarteritis nodosa
Type III(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
625
Indicate type of hypersensitivity reaction:Rheumatoid arthritis
Type IV(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
626
Indicate type of hypersensitivity reaction:Inflammatory bowel disease
Type IV(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
627
Indicate type of hypersensitivity reaction:Tuberculin reaction
Type IV(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
628
Indicate type of hypersensitivity reaction:Reactive arthritis
Type III(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
629
Indicate type of hypersensitivity reaction:Graves disease
Type II(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
630
Indicate type of hypersensitivity reaction:Acute rheumatic fever
Type II(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
631
Indicate type of hypersensitivity reaction:Myasthenia gravis
Type II(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
632
Indicate type of hypersensitivity reaction:Insulin resistant DM
Type II (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
633
Indicate type of hypersensitivity reaction:Pernicious anemia
Type II(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
634
A special form of graft rejection occuring in the setting where preformed antidonor antibodies are present in the circulation of the host before transplant. Occurs within minutes to a few hours after transplantation.
Hyperacute rejection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.133
635
Rejection which occurs within days to weeks of transplantation in a nonimmunosuppressed host. Caused by both cellular and humoral immune mechanisms.
Acute rejection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.133
636
Acute rejection most commonly seen within the first months after transplantation, typically accompanied by signs of renal failure. Extensive CD4+ and CD8+ T-cell infiltration with edema and mild interstitial hemorrhage.
Acute cellular rejection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.133
637
Acute rejection caused by antidonor antibodies. May take the form of necrotizing vasculitis with endothelial cell necrosis, neutrophilic infiltration, deposition of antibody, complement, and fibrin, and thrombosis.
Acute humoral rejection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.133
638
Rejection which present clinically months to years after transplantation with a progressive rise in serum creatinine levels. Dominated by arteriosclerosis, interstitial fibrosis and loss of renal parenchyma.
Chronic rejection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.133
639
A multisystem autoimmune disease which principally affects the skin, kidneys, serosal membranes, joints and heart. Associated with autoantibodies including ANAs.
Systemic Lupus Erythematosus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.139
640
SOAP BRAIN MD mnemonic for SLE stands for?
SerositisOral ulcersArthritisPhotosensitivityBloodRenal disorderANA positiveImmunologic disorderNeurologic disorderMalar rashDiscoid rash(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.140
641
How many symptoms must be present in a patient for her/him to be diagnosed as having SLE?
4 out of 11 symptoms(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.140
642
Most serious and most common form of renal lesion in SLE. "Wire-loop" appearance of glomerular capillary walls.
Diffuse proliferative glomerulonephritis (Class IV)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.142
643
Cardiac manifestation of SLE, which occurs as nonspecific mononuclear infiltrates and the presence of irregular 1-3mm warty deposits on either surface of the leaflets.
Libman-Sacks Endocarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.144
644
A systemic, chronic inflammatory disease affecting many tissues but principally attacking the joints to produce a nonsuppurative proliferative synovitis that frequently progress to destroy articular cartilage and underlying bone with resulting disabling arthritis.
Rheumatoid arthritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.145
645
Characteristic lesion in RA, formed by proliferating synovial-lining cells admixed with inflammatory cells, granulation tissue and fibrous connective tissue.
Pannus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.146
646
Cytokine which plays a central role in the pathogenesis of RA.
TNF(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.146
647
A clinicopathologic entity with a triad of dry eyes, dry mouth and arthritis.
Sjogren syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.148
648
Characterized by progressive fibrosis involving the skin, GIT and other tissues. May be a result of activation of fibroblasts by cytokines produced by T cells.
Systemic sclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.149
649
A vascular disorder characterized by reversible vasospasm of the arteries. Typically the hands turn white due to vasospasm, then blue due to cyanosis, then red due to reactive hyperemia.
Raynaud phenomenon(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.151
650
One of the more common forms of primary immune deficiency characterized by absent or markedly decreased numbers of B-cells in the circulation, with depressed serum levels of all classes if immunoglobulin.
X-linked agammaglobulinemia (Bruton disease)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.152
651
Most common of all the primary immune deficiencies characterized by recurrent sinopulmonary infections and diarrhea.
Isolated IgA deficiency(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.154
652
A constellation of genetically distinct syndromes with common feature of defects in both humoral and cell-mediated immune responses, making affected infants susceptible to severe recurrent infections by bacteria, viruses, fungi, protozoans, and opportunistic infections.
Severe Combined Immunodeficiency(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.154
653
Autosomal recessive form of SCID is due to deficiency of what enzyme?
Adenosine deaminase (ADA)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.154
654
An X-linked recessive disease characterized by thrombocytopenia, eczema, and marked vulnerability to recurrent infection ending in early death.
Wiskott-Aldrich Syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.155
655
HIV viral surface proteins essential for viral entry into cells.
gp41 and gp120(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.157
656
A form of pneumonia in HIV patients caused by a yeast-like fungus.
Pneumocystis carinii pneumonia (PCP)(TOPNOTCH)
657
Main cellular target of HIV.
CD4+ helper T cells(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.158
658
P.carinii pneumonia occurs in AIDS patients with CD4+ T cell count of ______.
Less than 200 cells/uL(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.163
659
Most common secondary infection of the CNS in patients with AIDS.
Toxoplasmosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.163
660
Most common neoplasm in AIDS patients, caused by HHV8. Characterized by cutaneous lesions with or without internal involvement.
Kaposi sarcoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.164
661
A disorder of protein misfolding, causing extracellular deposition of pink or red colored deposits stained with Congo red, with apple-green birefringence in polarized light.
Amyloidosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.166
662
Cells of immune system
T- and B-lymphocytes, dendritic cells, macrophages, natural killer cells, innate lymphoid cells. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 190
663
Tissues of the immune system
Bone marrow, thymus, lymph nodes, spleen, mucosal and cutaneous lymphoid tissue. (TOPNOTCH) Robbin Basic Pathology, 9th ed., p. 193
664
The most important antigen-presenting cells for initiating T-cell responses against protein antigens
Dendritic cells(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 191
665
A 48 y/o male patient underwent kidney transplant suddenly developed bloody urine few hours after the procedure. Nephrectomy was done and revealed a cyanotic, mottled, and flaccid kidney and necrotic kidney cortex. There is neutrophilic accumulation in the arterioles, glomeruli, and peritubular capillaries. Glomeruli undergo thrombotic occlusion of capillaries and fibrinoid necrosis in arterial walls. The most likely diagnosis is:
Hyperacute rejection (TOPNOTCH) Robbin Basic Pathology, 9th ed., p. 233
666
A 45 y/o female presented with signs of kidney failure 2 months after her renal transplant. Immunohistochemical staining reveals both CD4+ and CD8+ lymphocytes. Morphologic findings showed an extensive interstitial inflammation with infiltration of tubules and focal tubular injury. This is a case of:
Acute cellular (T-cell mediated) rejection (TOPNOTCH) Robbin Basic Pathology, 9th ed., p. 234
667
Preformed antidonor antibodies present in the circulation of the recipient is implicated in what type of rejection pattern?
Hyperacute rejection (TOPNOTCH) Robbin Basic Pathology, 9th ed., p. 233
668
A 30 y/o male developed oliguria and subsequent renal failure 3 weeks after an uneventful kidney transplant. Renal findings showed inflammation of glomeruli and peritubular capillaries, deposition of complement breakdown and focal small vessel thrombosis. This is a case of:
Acute antibody-mediated rejection (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 234
669
A 24 y/o female diagnosed with renal failure underwent renal transplant. Four years later, increasing levels of creatinine was noted, and biopsy showed an interstitial fibrosis and tubular atrophy, glomerulopathy with duplication of basement membrane, and multilayering of peritubular capillary basement membranes. Interstitial mononuclear cell infiltrates, NK cells and plasma cells were also noted. This is a case of:
Chronic rejection(TOPNOTCH)Robbins Basic Pathology, 9th ed., p.234
670
The result of hypoplasia or lack of thymus in DiGeorge Syndrome
Variable loss of T-cell mediated immunity (TOPNOTCH) Robbins Basic Pathology, 9th ed., p.241
671
The hallmark of AIDS
Profound immune deficiency, primarily cell-mediated immunity (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 245
672
A 32-year old female, presents to the clinic with symptoms of fatigue, joint pains, and malar rash. CBC revealed anemia and low platelet count. The most likely diagnosis is:
Systemic Lupus Erythematosus (TOPNOTCH)
673
The hallmark of SLE
Production of autoantibodies (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 218
674
The fundamental defect in SLE
Failure of mechanisms that maintain self-tolerance (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 219
675
Most common manifestation of SLE
Hematologic manifestation (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 218
676
Most common hematologic finding in SLE
Anemia(TOPNOTCH)
677
Most common and most severe form of lupus nephritis
Diffuse lupus nephritis/Class IV(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 224
678
The most common causes of death in SLE
Renal failure and intercurrent infections (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 225
679
Cytokine most firmly implicated in the pathogenesis of Rheumatoid arthritis
TNF (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1210
680
Major cytokine produced by TH1, stimulates macrophage activation and IgG antibody production. Plays a role in autoimmune and other chronic inflammatory diseases.
IFN-gamma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 198
681
The dominant immune reactions of these subset of helper cells are the stimulation of IgE production and activation of mast cells and eosinophils.
TH2(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 198
682
These are the mediators of adaptive immunity and the only cells that produce specific and diverse receptors for antigens
Lymphocytes(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 199
683
Immunity mediated by antibodies and is effective against extracellular microbes in the circulation and mucosal lumens.
Humoral immunity(TOPNOTCH)Robbins Basic Pathology, 9th ed p. 200
684
Type of immunity design to combat phagocytosed microbes and microbes in the cytoplasm of infected cells.
Cell-mediated immunity(TOPNOTCH)Robbins Basic Pathology, 9th ed p. 200
685
These are cells the help B cells to make antibodies, activate macrophages to destroy ingested microbes, stimulate recruitment of leukocytesand regulate all immune responses to protein antigens.
CD4+ helper T cells(TOPNOTCH)Robbins Basic Pathology, 9th Ed p.200
686
These are cells that express antigens in the cytoplasm that are seen as foreign, such as virus-infected and tumor cells.
CD8+ cytotoxic T lymphocytes(TOPNOTCH)Robbins Basic Pathology, 9th Ed p.200
687
The most potent vasoactive and spasmodic agents causing increasing vascular permeability and causing bronchial smooth muscle contraction.
Leukotrienes C4 and D4(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 203
688
A lipid mediator produced by some mast cell populations, not derived from arachidonic acid, causing platelet aggregation, increased vascular permeability, and vasodilation.
Platelet-activating factor(PAF)(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 203
689
True or False. Atopic individuals tend to have higher serum IgE levels and more IL-4 producing Th2 cells.
True. (TOPNOTCH)
690
This disease presents with nephritis and lung hemorrhage due to complement and Fc receptor-mediated inflammation due to antibody against noncollagenous protein in basement membranes of kidney glomeruli and lung alveoli.
Goodpasture syndrome(TOPNOTCH)Robbbins Basic Pathology, 9th ed., p. 206
691
This disease causes demyelination in CNS is perivascular inflammation due to inflammation mediated by TH1 and TH17 cytokines, myelin destruction by activated macrophages.
Multiple sclerosis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 209
692
Type of immunity primarily affected by AIDS
Cell-mediated immunity(TOPNOTCH)
693
Mucocutatnous ulcerations involving the mouth, esophagus, external genitalia, and perianal region in AIDS patient may be caused by
Herpes simplex virus infection(TOPNOTCH)
694
An 18 year old female presents with a day-old circular erythematous plaque with vesicles on her neck. She relates a history of wearing a new metallic pendant three days ago, and has had a similar history with other metallic jewelry. If the plaque is biopsied, which inflammatory cell is expected to predominate? (A) neutrophil (B) eosinophil (C) mast cell (D) lymphocyte
Lymphocyte (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp128-130
695
An 8 year old male with a strep throat four weeks ago develops tea-colored urine. A kidney biopsy showed hypercellular glomeruli with neutrophils. Electron microscopy showed subepithelial "humps." These findings are caused by (A) antibodies against glomerular basement membrane (B) antibodies against endothelium (C) immune complex deposition (D) T-cell mediated recruitment of neutrophils
immune complex deposition (TOPNOTCH) Robbins Basic Pathology, 8th ed. P126
696
A 5 year old female with a strep throat two weeks ago develops joint pains and fever. Auscultation revealed a friction rub. What type of hypersensitivity is responsible?
Type II (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.120
697
A 33 year old female presents with morning stiffness of the PIP and MCP joints of the hands. On workup, she is positive for rheumatoid factor. Which of the following is expected in the involved joints? (A) synovial hypertrophy with dense lymphoid aggregates (B) synovial atrophy with epithelioid macrophages (C) synovial hypertrophy devoid of leukocytes (D) synovial atrophy with dense lymphoid aggregates
synovial atrophy with dense lymphoid aggregates (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp145-146
698
A 50 year old female with chronic red eye is diagnosed with keratoconjunctivitis sicca and is referred to by her ophthalmologist for bilateral infraauricular masses. Her oral mucosa has multiple fissures. Biopsy of the infraauricular masses will likely show (A) epithelial and myoepithelial cells admixed with chondroid stroma (B) lymphoplasmacytic infiltration with ductal hyperplasia (C) basaloid cells in cribriform structures (D) highly pleomorphic epithelial cells and numerous atypical mitoses
lymphoplasmacytic infiltration with ductal hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp148-149
699
Patients with diffuse scleroderma have sclerotic atrophy of the skin. Which other organ is most commonly involved? (A) kidneys (B) heart (C) lungs (D) gastrointestinal tract
gastrointestinal tract (90% of patients) (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp 149-150
700
A 22 year old male has unprotected sex and develops generalized lymphadenopathy five days later. The following month, he tests positive on HIV screening. Excision biopsy of one of his lymph nodes would likely show (A) marked follicular hyperplasia (B) epithelioid macrophages and giant cells (C) diffuse infiltration by atypical mononuclear cells (D) subcapsular necrosis
marked follicular hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed. P 165
701
A 68 year old female with multiple myeloma dies of acute renal failure. At autopsy, her kidneys and liver were pale gray, with waxy cut sections, while her spleen showed tapioca-like granules. On histology, these organs show deposits that (A) have empty vacuoles that uptake Sudan black (B) are infiltrated by neutrophils and histiocytes (C) will fluoresce an apple green color when stained with Congo red (D) are bluish, with concentric lamellations
will fluoresce an apple green color when stained with Congo red (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp 169-170
702
This term literally means "new growth".
Neoplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
703
An abnormal mass of tissue the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after the cessation of stimuli which evoked the change.
Neoplasm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
704
Study of tumors.
Oncology(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
705
Benign or malignant?Localized
Benign(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
706
Benign or malignant?Amenable to surgical removal
Benign(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
707
Benign or malignant?Invades and destroys adjacent tissues.
Malignant(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
708
What are the two basic components of tumors?
Parenchyma and Stroma(TOPNOTCH)
709
Benign or malignant?Metastasis
Malignant(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
710
This component of tumors largely determines its biologic behavior.
Parenchyma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
711
This component of tumors determines the name of the growth.
Parenchyma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
712
This component of tumors is crucial to the growth of neoplasms since it carries the blood supply and provides support to the growth of cells.
Stroma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
713
Benign or malignant?Fibroma
Benign(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.176
714
Benign or malignant?Chondroma
Benign(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.176
715
Benign or malignant?Adenoma
Benign(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.176
716
Benign or malignant?Hepatoma
Malignant(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.176
717
Benign or malignant?Papilloma
Benign(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.176
718
Malignant neoplasms arising in mesenchymal tissue or its derivatives.
Sarcomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.175
719
Benign tumor arising in fibrous tissue is called?
Fibroma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.175
720
A benign cartilagenous tumor is called?
Chondroma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.175
721
This is a benign epithelial neoplasm which produces glandular patterns or neoplasms derived from glands but not necessarily exhibit glandular patterns
Adenoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.175
722
These are benign epithelial neoplasms, growing on any surface that produce microscopic or macroscopic finger-like fronds.
Papillomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.174
723
A mass that projects above a mucosal surface to form a macroscopically visible structure.
Polyps(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.175
724
A cancer of fibrous tissue origin.
Fibrosarcoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.175
725
Malignant neoplasms of epithelial cell origin.
Carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.175
726
Carcinoma of squamous cell origin.
Squamous cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.176
727
Benign or malignant?Lymphoma
Malignant(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.176
728
Benign or malignant?Seminoma
Malignant(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.176
729
The extent to which neoplastic cells resemble their normal forebears morphologically and functionally.
Differentiation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.176
730
This is considered a hallmark of malignancy, which literally means "to form backward".
Anaplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.177
731
These cells display marked pleomorphism, nuclei are variable and bizzare in size and shape. Chromatin is course and clumped. Mitoses are often numerous and distinctly atypical.
Anaplastic cells(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.177
732
This term is defined by disorderly but non-neoplastic proliferation of cells, described as a loss in uniformity of individual cells and in their architectural orientation.
Dysplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.178
733
Defined as dysplastic changes which involve the entire thickness of the epithelium.
Carcinoma -in- situ(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.178
734
True or false?Dysplasia always progress to cancer.
False(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.178
735
True or false?Lack of capsule in a neoplastic growth indicates malignancy.
FalseSome benign tumors are not encapsulated.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.179
736
This term describes the development of secondary implants discontinuous with the primary tumor, in remote tissues.
Metastasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.179
737
Next to metastasis, this is the most reliable feature that distinguishes malignant from benign tumors.
Local invasiveness(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.179
738
Methods of dissemination of malignant neoplasms? (3)
SeedingLymphatic spreadHematogenous spread(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.180
739
This is the mode of dissemination of cancers of the ovary and CNS.
Spread by seeding(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.180
740
This is the mode of dissemination more typical of carcinomas.
Lymphatic spread(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.180
741
This is the mode of dissemination more typical of sarcomas.
Hematogenous spread(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.180
742
It is defined as the first lymph node in a regional lymphatic basin that receives lymph flow from a primary tumor.
Sentinel lymph node(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.180
743
What are the most common sites of metastasis involved in hematogenous dissemination of cancer?
Liver and lungs(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.181
744
This substance is a byproduct of metal smelting, a component of alloys, electrical and semiconductor devices which could cause cancer of the lungs and skin and hemangiosarcomas.
Arsenic and its compounds(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.183
745
This substance was formerly used for fire-resistant textiles and construction materials which could cause lung cancer and more prominently malignant mesothelioma
Asbestos(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.183
746
This substance is commonly used as a solvent in paint, rubber, dry cleaning, adhesives and detergents which could cause leukemias and Hodgkin lymphoma.
Benzene(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.183
747
This substance is used as hardener for metal alloys used in aerospace applications and nuclear reactors which is commonly associated with cancer of the lung.
Beryllium and its compounds(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.183
748
This substance is used in solders, batteries and metal alloys commonly associated with cancers of the prostate.
Cadmium and its compounds(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.183
749
This substance is a refrigerant and used as adhesive for plastics, which causes hepatic angiosarcoma.
Vinyl chloride(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.183
750
Inherited gene : Cancer syndromeRB gene :__________
Retinoblastoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.184
751
Inherited gene : Cancer syndromep53 : ______________
Li Fraumeni Syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.184
752
Inherited gene : Cancer syndrome__________ : Familial Adenomatous Polyposis / Colon CA
APC Gene(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.184
753
Inherited gene : Cancer syndrome_________ : Breast on Ovarian Tumors
BRCA 1 gene(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.184
754
Inherited gene : Cancer syndrome_________ : Breast Cancer only
BRCA 2 gene(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.184
755
Inherited gene : Cancer syndromeRET gene : _________
Multiple Endocrine Neoplasia 1 and 2(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.184
756
Inherited gene : Cancer syndrome__________ : Colon cancer
kras gene(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.184
757
Normal cellular genes whose products promote cell proliferation.
Proto-oncogenes(TOPNOTCH)
758
Normal cellular genes whose products promote cell proliferation.
Proto-oncogenes(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.188
759
It is a naturally occurring carcinogenic agent produced by some strains of Aspergillus, a mold that grows on improperly stored grains and nuts.
Aflatoxin B(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.209
760
There is a strong correlation between the dietary level of Aflatoxin and what type of cancer?
Hepatocellular Carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.209
761
These substances require metabolic conversion to be carcinogenic.
Indirect - acting carcinogens(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.209
762
These substances stimulate proliferation of the mutated cells.
Promoters(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.210
763
How does ionizing radiation cause cancer?
Through chromosome breakage, translocations and point mutations leading to genetic damage and carcinogenesis.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.210
764
What is the mechanism of action of UV rays in the formation of neoplastic cells?
UV rays induce formation of pyrimidine dimers within DNA leading to mutations.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.210
765
This is the only retrovirus that has been demonstrated to cause cancer in humans.
Human T-cell Leukemia Virus -1 (HTLV-1)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.211
766
HPV strains which has been implicated in the genesis of cervical and anorectal cancer.
HPV 16, 18(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.212
767
EBV has been implicated in the pathogenesis of the following cancers except:A. Burkitt lymphomaB. Lymphoma in HIV patientsC. Nasopharyngeal carcinomaD. Hodgkin lymphomaE. None of the above
E. none of the above(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.212
768
Which hepatitis virus leads to hepatocellular carcinoma?
HBV, HCV(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.213
769
This is the first bacterium to be classified as a carcinogen.
Helicobacter pylori(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.213
770
What type of cancer can be caused by H.pylori?
Gastric adenocarcinoma Gastric MALT lymphomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.214
771
These are benign epithelial neoplasms, growing on any surface that produce microscopic or macroscopic finger-like fronds.
Papillomas(TOPNOTCH)
772
Tumor antigens are presented on the cell surface by MHC Class I molecules to which type of T lymphocytes?
CD8+ T lymphocytes(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.215
773
Single most important defining characteristic of malignancy
Metastasis (TOPNOTCH)
774
A biopsy of the stomach reveals an area of normal appearing pancreatic tissue. This is an example of what type of lesion?
Choristoma (TOPNOTCH)
775
Bronchogenic carcinoma tends to metastasize where?
Adrenals and brain (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 274
776
The most frequent form of cancer in males
Prostate cancer (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 276
777
The most frequent form of cancer in females
Breast cancer (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 276
778
Most common cause of cancer death in both male and female
Lung cancer (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 276
779
Most important infectious agent associated with cervical carcinoma and head and neck cancers.
Human papilloma virus (TOPNOTCH)
780
Leukoplakia may give rise to what type of carcinoma?
Squamous carcinoma (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 279
781
Most common type of abnormality involving proto-oncogenes in human tumors
Point mutations of RAS family genes(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 286
782
Activation of ABL nonreceptor tyrosine kinase by chromosomal translocation and creation of BCR-ABL fusion gene is associated with what type of leukemia
CML, ALL(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 290
783
"Guardian of the genome", a tumor suppressor gene that regulates cell cycle progression, DNA repair, cellular senescence, and apoptosis, and the most frequently mutated gene in human cancers
TP53 (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 293
784
"Gatekeeper of colonic neoplasia"; tumor suppressor that function by downregulating growth-promoting signaling pathways.
APC (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 296
785
Steps in invasion of cancer cells
Dissociation of cancer cells-Degradation of ECM-Attachment to novel ECM components-Migration and invasion of tumor cells. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 306
786
Autosomal dominant disorder characterized by familial carcinomas of the colon predominantly cecum and proximal colon.
Hereditary nonpolyposis colon cancer (HNPCC) syndrome (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 314
787
Syndrome causing colon cancer resulting from defects in a family of genes encoding a group of proteins that work together to carry out DNA mismatch repair.
Hereditary nonpolyposis colon cancer (HNPCC) syndrome (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 314
788
The increased incidence of skin cancer following UV light exposure associated with xeroderma pigmentosus is caused by:
Disorder of DNA repair/inability to repair pyrimidine dimers(HNPCC) syndrome (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 314
789
Pathogenesis of this tumor involves the translocation resulting to overactivity of MYC gene
Burkitt lymphoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 317
790
Philadelphia chromosome is characteristic of what type of leukemia
CML(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 317
791
An important cause of benign warts, cervical cancer, and oropharyngeal cancer
HPV (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 329
792
Implicated in gastric adenocarcinoma and MALT lymphoma
H. pylori(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 329
793
Cytokine implicated in cancer cachexia
TNF-alpha(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 330
794
The most common endocrinopathy ; usually seen in small-cell lung carcinoma
Cushing syndrome(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 330
795
The most common paraneoplastic syndrome related to cancer; seen in patients with squamous cell carcinoma
Hypercalcemia(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 330
796
The most important humoral factor associated with paraneoplastic hypercalcemia of malignancy.
PTHRP(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 330
797
Tumor marker:Medullary carcinoma of thyroid
Calcitonin(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 337
798
Tumor marker:Trophoblastic tumors
Human chorionic gonadotropin(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 337
799
Tumor marker: liver cell cancer and nonseminomatous germ cell tumor
Alpha fetoprotein(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 337
800
Tumor markers: prostate cancer
PSA and prostatic acid phosphatase (TOPNOTCH) Robbins Basic Pathology, 9th ed., p.337
801
Tumor marker: pheochromocytoma
Catecholamine(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 337
802
Tumor marker: ovarian cancer
CA-125(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 337
803
Cervical biopsy of a 35 y/o female with cervical erosion shows squamous epithelium that exhibit atypia, pleomorphism, disorderly spatial arrangement. This adaptive response is:
Dysplasia (TOPNOTCH)
804
RAS oncogene qualitatively changes function of proto-oncogene through which form of mutation?
Point mutations (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 286
805
Chemical carcinogen implicated in the causation of mesothelioma
Asbestos(TOPNOTCH)
806
A 56 year old woman with a breast mass has a preoperative diagnosis of invasive ductal carcinoma by core needle biopsy, with no palpable axillary lymph nodes. She undergoes surgery where her breast mass is injected with a blue dye, and the first axillary node that takes up the dye is submitted to pathology. Which method is next done on the node if the surgeon wants to know within minutes if there is metastasis? (A) fine needle aspiration (B) frozen section (C) immunohistochemistry (D) flow cytometry
frozen section (TOPNOTCH)Robbins Basic Pathology, 8th Ed, p 220
807
A 25 year old male with an intranasal mass undergoes a tissue biopsy that shows malignant round cells. The pathologist needs to know if it is an undifferentiated carcinoma or a lymphoma. What can be done to differentiate? (A) Frozen section (B) Immunohistochemistry (C) Flow cytometry (D) serologic tumor markers
Immunohistochemistry (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp220-221
808
A 12 year old female presents with pallor and gum bleeding. A complete blood count with peripheral smear shows numerous blasts. What is needed to be done on her bone marrow for a more precise diagnosis? (A) frozen section (B) papanicolau smear (C) aspiration and flow cytometry (D) serologic tumor markers
aspiration and flow cytometry (TOPNOTCH)Robbins Basic Pathology, 8th Ed p 221
809
These disorders are derived from one's parents, transmitted through gametes through the generations, and are therefore familial.
Hereditary disorders(TOPNOTCH)
810
This term literally means "present at birth".
Congenital(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.227
811
This term refers to permanent changes in the DNA.
Mutations(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.227
812
This type of mutation results from the substitution of a single nucleotide base by a different base, resulting in the replacement of one amino acid by another.
Missense mutation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.227
813
This type of mutation results in the replacement of one amino acid by a stop codon, resulting in chain termination.
Nonsense mutation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.227
814
Missense, nonsense and silent mutations are examples of ________ mutations, wherein only one base pair is replaced.
Point mutations(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.227
815
This type of mutation occur when the insertion or deletion of one or two bse pairs alters the reading frame of the DNA strand.
Frameshift mutations(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.227
816
These mutations are characterized by amplification of a sequence of three nucleotides.
Trinucleotide repeat mutations(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.227
817
Disease characterized by CGG trinucleotide repeats.
Fragile X Syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.227
818
This is a neurodegenerative genetic disorder that affects muscle coordination and leads to cognitive decline and psychiatric problems.
Huntington's disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.229
819
Genetic mutation in Huntington's disease?
CAG trinucleotide repeats(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.229
820
This disorder is a chronic, slowly progressing inherited genetic disorder characterized by muscle wasting, cataracts, heart conduction defects, endocrine changes and myotonia.
Myotonic Dystrophy(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.229
821
Genetic mutation found in myotonic dystrophy?
CTG Trinucleotide repeats(TOPNOTCH)
822
A point mutation wherein a single base pair is replaced but codes for the same amino acid, therefore has no effect on the functioning of the protein.
Silent mutation(TOPNOTCH)
823
An example of point mutation wherein a purine base is replaced by another purine base or a pyrimidine base is replaced by another pyrimidine base.
Transition(TOPNOTCH)
824
A point mutation wherein a purine is replaced by a pyrimidine or vice versa.
Transversion(TOPNOTCH)
825
Diseases caused by single gene defects are called?
Mendelian Disorders(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.228
826
A condition wherein both dominant and recessive alleles of a gene pair may be fully expressed in the heterozygote.
Codominance(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.228
827
The presence of many allelic forms of a single gene is called _______.
Polymorphism(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.228
828
This occurs when one gene influences or leads to multiple phenotypic traits.
Pleiotropy(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.228
829
A phenomenon wherein a single phenotype or genetic disorder may be caused by mutations of several genetic loci or allele.
Genetic heterogeneity Note: compare with pleiotropy(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.228
830
A transmission pattern of inheritance which is manifested in the heterozygous state, wherein at least one parent of an index case is usually affected, both males and females are affected and both can transmit the condition.
Autosomal dominant (AD)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.229
831
This pattern of inheritance occur when BOTH of the alleles at a given gene locus are mutants, wherein the parents are not affected, but offspring have 1 in 4 chance (25%) of being affected.
Autosomal recessive(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.229
832
Pattern of inheritance wherein the disorder is transmitted by heterozygous female carriers only to 50% of the sons. An affected male does not transmit the disorder to sons but all daughters are carriers.
X-linked disorders(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.229
833
An autosomal dominant disorder of connective tissues characterized by abnormally long legs, arms and fingers, joint hyperextensibility, pectus excavatum, lens subluxation and increased risk of aortic dissection.
Marfan Syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.230
834
Integral component of elastic fibers defective in Marfan Syndrome.
Fibrillin 1(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.230
835
Fibrillin 1 is encoded by what gene?
FBN1 gene (chromosome 15q21)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.230
836
A collection of disorders caused by defects in collagen synthesis or structure, characterized by hyperextensible skin and joint hypermobility, rupture of internal organs and poor wound healing.
Ehlers-Danlos SyndromesThere are 6 variants to Ehlers-Danlos (nice to know)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.231
837
This autosomal recessive inborn error of metabolism is characterized by inability to convert phenylalanine to tyrosine, strong mousy or musty odor of urine and sweat, decreased pigmentation of hair and skin, eczema, seizures and mental retardation.
Phenylketonuria (PKU)(TOPNOTCH)
838
This autosomal dominant disorder is caused by a mutation in the gene that specifies the receptor for LDL, impairing the intracellular transport and catabolism of LDL.
Familial hypercholesterolemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.232
839
Enzyme deficient in classic PKU.
Phenylalanine hydroxylase (PAH)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.234
840
An autosomal recessive disorder of galactose metabolism characterized by jaundice, liver damage, cataracts, neural damage, vomiting and diarrhea.
Galactosemia(TOPNOTCH)
841
Deficiency of this enzyme can also cause symptoms of phenylketonuria due to decreased synthesis of a cofactor in the conversion of phenylalanine to tyrosine.
Dihydrobiopteridine reductase (DHPR)Enzyme responsible for the reduction of Dihydrobiopterin (BH2) to Tetrahydrobiopterin (BH4).(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.234
842
Enzyme deficient in galactosemia.
Galactose-1-phosphate uridyltransferase(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.235
843
Lysosomal storage disease due to deficiency of glucosylceramidase.
Gaucher disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.236
844
Lysosomal storage disease due to deficiency of B-Hexosaminidase A.
Tay-Sachs disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.236
845
Lysosomal storage disease due to deficiency of a-Galactosidase A.
Fabry disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.236
846
Lysosomal storage disease due to deficiency of Sphingomyelinase.
Niemann-Pick disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.236
847
Lysosomal storage disease common among Ashkenazi Jews characterized by motor weakness, mental retardation, blindness, neurologic dysfunction and death.
Tay-Sachs disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.236
848
Lysosomal storage disease characterized by accumulation of glucosylceramide in mononuclear phagocytic cells, which enlarge, forming "wrinkled tissue paper" cytoplasmic appearance.
Gaucher disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.238
849
What do you call the pathognomonic cell characterized by "wrinkled tissue paper" cytoplasmic appearance.
Gaucher cell(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.238
850
These disorders result from the accumulation of mucopolysaccharides in many tissues including the liver, spleen, heart, blood vessels, brain, cornea and joints. Affected patients have coarse facial features.
Mucopolysaccharidoses(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.238
851
Mucopolysaccharidosis characterized by corneal clouding, coronary arterial and valvular depositions, which occurs due to deficiency of a-L-iduronidase, leading to accumulation of dermatan and heparan sulfate.
Hurler syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.239
852
An X-linked mucopolysaccharidosis which is due to a deficiency of L-iduronate sulfatase. Symptoms are similar to Hurler syndrome, but without corneal clouding.
Hunter syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.239
853
Glycogen storage disease characterized by hepatomegaly, renomegaly, hypoglycemia, hyperlipidemia and hyperuricemia, leading to gout and skin xanthomas.
von Gierke's disease (Type I)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.240
854
von Gierke's disease is due to a deficiency of what enzyme?
Glucose-6-phosphatase(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.240
855
Glycogen storage disease characterized by accumulation of glycogen in skeletal muscles leading to painful cramps during strenuous exercise and myoglobinuria.
McArdle syndrome (type V)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.240
856
Glycogen storage disease characterized by mild hepatomegaly, cardiomegaly, muscle hypotonia, and may lead to cardiorespiratory failure.
Pompe disease (type II)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.240
857
Enzyme deficient in McArdle syndrome.
Muscle phosphorylase(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.240
858
These disorders may result from alterations in the number or structure of chromosomes and may affect autosomes or sex chromosomes.
Cytogenetic disorders(TOPNOTCH)
859
These disorders may result from alterations in the number or structure of chromosomes and may affect autosomes or sex chromosomes.
Cytogenetic disorders(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.241
860
It is a term used to describe the presence of two or more populations of cells in the same individual.
Mosaicism(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.242
861
This refers to a lack of one chromosome of the normal complement (e.g. XO).
Monosomy(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.244
862
This refers to the presence of three copies of a particular chromosome, instead of two.
Trisomy(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.244
863
This mechanism occurs due to the failure of chromosome pairs to separate properly during meiosis stage 1 or 2.
Nondisjunction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.243
864
This mechanism implies transfer of a part of one chromosome to another chromosome.
Translocation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.243
865
This mechanism involves loss of a portion of a chromosome.
Deletion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.243
866
Patients with this syndrome have severe mental retardation, flat facial profile, epicanthic folds, cardiac malformations, increased risk of leukemia, and premature development of Alzheimer's disease.
Down syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.244
867
Down syndrome is also called _________
Trisomy 21(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.245
868
Trisomy 18 is also called ________ syndrome.
Edwards syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.245
869
Trisomy 13 is also called _________ syndrome.
Patau syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.244
870
Syndrome characterized by a prominent occiput, low set ears, micrognathia, rocker-bottom feet, renal malformation, mental retardation and heart defects.
Edwards syndrome / trisomy 18(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.245
871
Syndrome characterized by mental retardation, microcephaly, micropthalmia, polydactyly, cleft lip and palate, cardiac and renal defects, umbillical hernia and rocker-bottom feet.
Patau syndrome/Trisomy 13(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.245
872
Syndrome characterized by thymic hypoplasia with diminished T-cell immunity and parathyroid hypoplasia with hypocalcemia.
DiGeorge syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.245
873
Syndrome characterized by congenital heart disease affecting outflow tracts, facial dysmorphism and developmental delay.
Velocardiofacial syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.245
874
Deletion of genes from this chromosome gives rise to DiGeorge and velocardiofacial syndromes.
22q11.2Remember mnemonic CATCH22(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.245
875
The q from 22q11.2 refers to ________.
"Long arm" of chromosome 22.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.246
876
Syndrome defined as male hypogonadism that develops when there are at least two X chromosomes and one or more Y chromosomes.
Klinefelter syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.246
877
Syndrome manifested by a eunochoid body habitus, reduced facial, body and pubic hair, gynecomastia, testicular atrophy, decreased serum testorerone and increased urinary gonadotropin levels. It is the most common cause of hypogonadism in males.
Klinefelter syndrome (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.246
878
Most common chromosomal derangement in Klinefelter syndrome.
47XXY(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.246
879
Syndrome which results from the partial or complete monosomy of the short arm of the X chromosome.
Turner syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.247
880
Inheritance associated with mitochondrial DNA.
Maternal inheritance(TOPNOTCH)
881
Neurodegenerative disease which manifests as progressive bilateral loss of central vision that leads to blindness. This is the prototypical disorder of mutations in mitochondrial genes.
Leber hereditary optic neuropathy(TOPNOTCH)
882
Inheritance associated with mitochondrial DNA.
Maternal inheritance(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.247
883
An epigenetic process wherein certain genes are differentially "inactivated" during paternal and maternal gametogenesis.
Genomic imprinting(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.252
884
This refers to transcriptional silencing of the maternal allele.
Maternal imprinting(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.251
885
Refers to the transcriptional silencing of the paternal allele.
Paternal imprinting(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.251
886
Syndrome characterized by mental retardation, short stature, hypotonia, obesity, small hands and feet, and hypogonadism. Paternal imprinting.
Prader-Willi syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.251
887
Syndrome manifested as mental retardation, ataxic gait, seizures and inappropriate laughter. Also called the "happy puppet syndrome". Maternal imprinting.
Angelman syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.251
888
These represent primary errors of morphogenesis due to an intrinsically abnormal developmental process.
Malformations(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.254
889
These result from secondary destruction of an organ or body region that was previously normal in development, due to an extrinsic disturbance in morphogenesis.
Disruptions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.254
890
These are due to generalized compression of the growing fetus by abnormal biomechanical forces, for example uterine constraint.
Deformations(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.254
891
This refers to multiple congenital anomalies that result from secondary effects of a single localized aberration in organogenesis. The initiating event may be a malformation, deformation or disruption.
Sequence(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.254
892
This refers to the presence of several defects that cannot be explained on the basis of a single localizing initiating error in morphogenesis.
Malformation syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.253
893
Elements of the TORCH complex.
TOxoplasmaTreponema pallidumRubellaCytomeglovirusHerpesvirus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.256
894
Most common cause of neonatal mortality.
Congenital anomalies(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.253
895
Second most common cause of neonatal mortality.
Prematurity(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.257
896
Lungs of infants with this disease are normal size but are heavy and relatively airless. They have a mottled purple color, with poorly developed atelectatic alveoli.
Neonatal Respiratory Distress Syndrome / Hyaline Membrane Disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.257
897
Characteristic eosinophilic membranes line the respiratory bronchioles, alveolar ducts and random alveoli, which contain necrotic epithelial cells admixed with extravasated plasma proteins.
Hyaline Membrane Disease / Neonatal RDS(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.257
898
Two well known complications of high concentration ventilator administered oxygen in infants suffering from RDS.
Retrolental fibroplasia / retinopathy of prematurityBronchopulmonary dysplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.258
899
Characteristic lesion in the retina of infants suffering from retrolental fibroplasia?
Neovascularization or retinal vessel proliferation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.258
900
Main component of pulmonary surfactant.
Dipalmitoylphosphatidylcholine (DPPC) ~40%(TOPNOTCH)
901
Characteristic abnormality in bronchopulmonary dysplasia?
Alveolar hypoplasia or a decrease in the number of mature alveoli.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.258
902
What is the fundamental abnormality in neonatal RDS?
Insufficient pulmonary surfactant(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.258
903
This condition occurs more commonly in very-low-birth-weight infants, as a result of intestinal ischemia, bacterial colonization of gut and formula milk feeding.
Necrotizing enterocolitis (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.258
904
Microscopic features of NEC.
Presence of submucosal gas bubbles, transmural coagulative necrosis, ulceration and bacterial colonization.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.259
905
Defined as the sudden death of an infant under 1 year of age which remains unexplained after a thorough investigation.
Sudden Infant Death Syndrome / SIDS(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.260
906
Multiple petechiae of the thymus, visceral and parietal pleura and epicardium, congested lungs with vascular engorgement with or without pulmonary edema.
Sudden Infant Death Syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.260
907
Results from antibody-induced hemolytic disease in the newborn that is caused by blood group incompatibility between mother and fetus, leading to edema fluid accumulation.
Immune Hydrops(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.261
908
Erythroid precursors with large homogenous, intranuclear inclusions and a surrounding peripheral rim of residual chromatin can be seen in the bone marrow aspirate of an infant infected with this virus. This leads to development of non-immune hydrops.
Parvovirus B19(TOPNOTCH)
909
Isolated postnuchal fluid accumulation in fetuses with hydrops.
Cystic hygroma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.261
910
A lethal condition characterized by generalized edema of the fetus.
Hydrops fetalis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.261
911
Increased hematopoietic activity leading to the presence of large number of immature red cells, including reticulocytes, normoblasts and erythroblasts. Characteristic finding in fetal anemia-associated hydrops.
Erythroblastosis fetalis(TOPNOTCH)
912
Primary gene defect in cystic fibrosis.
Abnormal CFTR (CF transmembrane conductance regulator) Chromosome 7q31.2(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.262
913
Lungs with extensive mucous plugging and dilated tracheobronchial tree. Pancreatic ducts dilated and plugged with eosinophilic mucin, atrophic parenchymal glands replaced by fibrous tissue. Hepatic steatosis, Azoospermia and infertility are some of the features of this disease.
Cystic fibrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.262
914
Patients with cystic fibrosis are prone to developing infections caused by these three organisms.
S. aureusH. InfluenzaeP. aeruginosa(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.266
915
How is cystic fibrosis diagnosed?
Persistently elevated sweat chloride concentration(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.267
916
Most common tumors of infancy.
Hemangioma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.267
917
Microscopically normal cells or tissues that are present in abnormal locations.
Heterotopia or choristoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.267
918
Port wine stains are associted with these syndromes. (2)
von Hippel-Lindau Sturge-Weber syndromes(TOPNOTCH)
919
This refers to an excessive but focal overgrowth of cells and tissues native to the organ in which it occurs.
Hamartoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.267
920
Large, flat to elevated, irregular, red-blue masses in the skin.
Port wine stains(Large hemangiomas)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.267
921
These represent the lymphatic counterpart of hemangiomas characterized as cystic and cavernous spaces lined by endothelial cells and surrounded by lymphoid aggregates,usually containing pale fluid.
Lymphangiomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.268
922
What do you call the rosettes found in neuroblastomas?
Homer-Wright pseudorosettes(TOPNOTCH)
923
Most common germ cell tumors of childhood,associated with meningocoele and spina bifida.
Sacrococcygeal teratomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.268
924
Tumor of the adrenal medulla composed of small, primitive-appearing cells with dark nuclei, scant cytoplasm, and poorly defined cell borders growing in solid sheets within a finely fibrillar matrix. Rosettes can be found in which tumor cells are concentrically arranged about a CENTRAL SPACE FILLED with neuropil.
Neuroblastomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.269
925
This is used in the screening of patients with neuroblastoma.
Urinary vanillylmandelic acid and homovanillic acid (VMA/HVA)(TOPNOTCH)
926
Differentiated lesions containing more large cells with vesicular nuclei and abundant eoinophilic cytoplasm, in the absence of neuroblasts, usually accompanied by mature spindle shaped Schwann cells.
Ganglioneuroma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.270
927
Disseminated neuroblastoma with multiple cuteaneous metastases with deep blue discoloration to the skin.
"Blueberry muffin baby"(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.270
928
This tumor is composed of small, round cells with large hyperchromatic nuclei and scant cytoplasm, with characteristic structures consisting of clusters of cuboidal or short columnar cells arranged around a CENTRAL LUMEN. The nuclei are displaced away from the lumen, which appears to have a limiting membrane.
Retinoblastoma(Differentiate with neuroblastoma)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.271
929
Rosettes in retinoblastoma are called _______.
Flexner-Wintersteiner rosettes(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.271
930
Clinicial findings include poor vision, strabismus, whitish hue to the pupils ("cat's eye reflex"), pain and tenderness to the eye.
Retinoblastoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.271
931
Most common primary tumor of the kidney in children.
Wilm's tumor / Nephroblastoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.271
932
Components of the WAGR syndrome.
Wilm's tumorAniridiaGenital abnormalitiesMental retardation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.272
933
Presents grossly as a large, solitary, well-circumscribed mass. On cut-section, tumor is soft, homogenous, and tan to gray, with occasional foci of hemorrhage, cystic degeneration and necrosis.
Wilm's tumor(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.272
934
Microscopically, a combination of blastemal, stromal and epithelial cell types is observed. (Triphasic combination) Blastemal components described as sheets of small blue cells with few distinctive features. Stromal cells are fibrocytic or myxoid in nature. Epithelial cells take the form of abortive tubules or glomeruli.
Wilm's tumor(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.272
935
Associated with inactivation of the WT1 gene of chromosome 11p13.
WAGR syndrome and Denys-Drash syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p.272
936
Patient presents with mental retardation, motor incoordination, and blindness. Ophthalmologic exam showeed cherry-red spots on the macula. Brain showed neurons ballooned with cytoplasmic vacuoles. What is the enzyme deficiency?
Hexosaminidase A. (Case of Tay-Sachs Disease) (TOPNOTCH)
937
An 18 y/o male was recently diagnosed with a genetic disorder. His parents do not manifest the disease, but one of his parent carries the gene with phenotypic expression. Some of his relatives manifest the same disease but with different presentation. What type of Mendelian disorder does the patient most likely have?
Autosomal dominant disorder. With this type, some patient do not have affected parents, has variations in penetrance and expressivity, age at onset is delayed. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 140
938
True or False. Male patient with hemophilia does not transmit the disorder to his sons, but all daughters are carriers.
True. Hemophilia is an X-linked disorder. (TOPNOTCH)
939
True or False. Female hemophilia carrier will transmit the disease to half her sons and half her daughter.
False. X-linked disorders are transmitted by heterozygous females to their sons, who manifest the disease. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 142
940
True or False. Female hemophilia carrier will manifest with decrease Factor VIII.
False (TOPNOTCH)
941
True or False. In female hemophilia carrier, only one of the X chromosome shows abnormality.
True (TOPNOTCH)
942
True or False. In X-linked disorders, female carriers are usually protected because of random inactivation of one X chromosome.
True (TOPNOTCH)
943
True or False. In X-linked disorders, heterozygous female carrier will never manifest the disease.
False (TOPNOTCH)
944
A 26 y/o male was referred to a cardiologist due to presence of murmur at the aortic area. On history, patient suffered from severe myopia at the age of 6. His development was normal except that he was taller than the rest of his family members and friends. Examination of abdomen showed visible pulsation above the umbilicus. The most striking feature in this syndrome is:
Skeletal abnormalities. (case of Marfan Syndrome) (TOPNOTCH)
945
The most life-threatening feature of Marfan syndrome
Cardiovascular lesions (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 145
946
The 2 most common lesions of Marfan Syndrome
Mitral valve prolapse and dilation of ascending aorta (TOPNOTCH) Robbins Basic Pathology, 9th ed, p. 145
947
A 4 y/o male presented with cutaneous xanthomas on the extensor surfaces of his arms, knees, and elbow since he was 1 year old. He was found to have serum cholesterol greater than 1000 mg/dl and triglyceride level of 170 mg/dl. Both parents had high cholesterol levels. What is the cause of hypercholesterolemia in this condition?
Impared transport of LDL into the cells (Case of Familial Hypercholesterolemia) (TOPNOTCH)
948
A 6 mo old infant presented with failure to thrive, vomiting, fever, and hepatosplenomegaly. Progressive deterioration of the infant led to death. Autopsy finding showed lipid laden phagocytic foam cells widely distributed in the spleen, liver, lymph nodes, GIT and lungs. Tissue cells are enlarged, with innumerable vacuoles staining for fat, and lysosome contain concentric lamellated myelin figures. The patient is deficient of what enzyme?
Sphingomyelinase (case of Niemann-Pick Disease Type A) (TOPNOTCH)
949
A 1 y/o infant succumbed to death. Autopsy finding showed shrunken gyri and widened sulci. There is vacuolation and ballooning of neurons noted. Cells are enlarged with innumerable small vacuoles of uniform size, imparting foaminess to the cytoplasm. This is a case of:
Niemann-Pick Disease (TOPNOTCH)
950
Presents with fractures, bone pain and thrombocytopenia. Morphologic findings of distended phagocytic cells and have fibrillary type of cytoplasm, intensely positive for PAS staining.
Gaucher disease (TOPNOTCH)
951
A 21 y/o female of short stature presented with primary amenorrhea, shield-shaped chest, "thick neck", and absence of secondary female characteristics. Estrogen level were decreased, while FSH and LH are increased. What is the most likely diagnosis?
Turner syndrome (TOPNOTCH)
952
The most common chromosomal disorder
Down Syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 161
953
The most common genetic cause of mental retardation.
Down Syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 161
954
Most common pathogenesis of Trisomy 21
Meiotic nondisjunction (TOPNOTCH)
955
Most common congenital heart defects in Trisomy 21
Endocardial cushion defects(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 163
956
Why are patients with DiGeorge syndrome has T-cell immunodeficiency?
Because of thymic hypoplasia (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 163
957
A 14 y/o male presented with gynecomastia and small testes. He was noted to have difficulties in school when he was 8. He was tall for his age. You would suspect:
Klinefelter syndrome (TOPNOTCH)
958
Classic karyotype patttern of Klinefelter syndrome
47,XXY(TOPNOTCH)
959
Single most important cause of primary amenorrhea
Turner syndrome (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 166
960
Most important cause of increased mortality in children with Turner syndrome.
Cardiovascular abnormalities (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 166
961
Patient presents with mental retardation, long face with large mandible, large everted ears, and large testicles. The most likely diagnosis is:
Fragile X Syndrome (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 169
962
Most distinctive feature of Fragile X syndrome
Macro-orchidism(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 169
963
The neonate was noted to have microcephaly, short palpebral fissure, maxillary hypoplasia, growth retardation, and psychomotor disturbances. The mother denies intake of drugs during pregnancy. The most likely cause
Alcohol (TOPNOTCH)
964
Deficiency in homogentisic oxidase results in this condition which manifests black discoloration of the urine
Alkaptonuria (TOPNOTCH)
965
Most common cause of respiratory distress in the newborn
Hyaline Membrane Disease (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 457
966
This teratogenic drug disrupts expression of homeobox proteins implicated in the patterning of lims, vertebrae, and craniofacial structures.
Valproic acid (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 456
967
Most commonly responsible for fetal growth restriction.
TORCH infections (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 457
968
Most common maternal condition associated with SGA infants
Vascular diseases (chronic hypertension, preclampsia) (TOPNOTCH) Robbins Basic Pathology, 9th ed, p. 457
969
A 28 week old male delivered via CS by a diabetiic mother presented with dyspnea and cyanosis. Fine rales are heard over both lung fields. CXR revealed uniform minute reticulogranular densities, producing a ground glass appearance. The fundamental defect in this condition is:
Pulmonary surfactant (Case of RDS) (TOPNOTCH)
970
The most common cause of mortality in children ages 1-4 years old.
Accidents (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 452
971
A 28 week old male dies 20 hours after birth. Autopsy findings showed a solid, airless, and reddish purple lungs with poorly developed alveoli. Necrotic cellular debris incorporated within eosinophilic hyaline membranes lines the respiratory bronchioles, alveolar ducts and alveoli. The most likely cause of death of the neonae is:
Respiratory distress syndrome/Hyaline membrane disease (TOPNOTCH)
972
Premature infant, bottle-fed, developed bloody stool, abdominal distention. Abdominal radiograph showed pneumotis intestinalis. Diagnosis:
Necrotizing enterocolitis(TOPNOTCH)
973
Morphology: intestinal segment is distended, friable and congested, with transmural coagulative necrosis, ulceration, bacterial colonization, and submucosal bubbles.
Necrotizing enterocolitis(TOPNOTCH)
974
Most common cause of early-onset neonatal sepsis and early-onset bacterial meningitis
Group B streptococcus(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 460
975
The most serious threat of fetal hydrops
CNS damage -kernicterus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 463
976
Most common site of neuroblastoma
Adrenal medulla (TOPNOTCH)
977
Presents with a large abdominal mass crossing the midline, hematuria, intestinal obstruction, and hypertension.
Wilm's tumor (TOPNOTCH)
978
A 22 year old male consults an ophthalmologist for sudden blindness on the right. He is found to have lens subluxation. He is unusually tall and lean, with long limbs and fingers. These findings are due to abnormalities in fibrillin 1, which is secreted by (A) megakaryocytes (B) fibroblasts (C) histiocytes (D) fibroclasts
fibroblasts (TOPNOTCH)Robbins Basic Pathology, 8th Ed, p 230
979
A lysosomal storage disease with a mutation in the gene that encodes glucosylceramidase presents with an accumulation of glucosylceramide in mononuclear phagocytic cells in the liver, spleen, and marrow. These pathognomonic cells are (A) enlarged, with a "wrinkled tissue paper" cytoplasm (B) epithelioid, with "slipper-shaped" nuclei (C) multinucleated, with 8 to 20 nuclei (D) studded with reddish brown cytoplasmic granules
enlarged, with a "wrinkled tissue paper" cytoplasm (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp237-238
980
A baby is born with epicanthic folds, flat facial profile, simian crease, and a gap between the first and second toe. Auscultation reveals a holosystolic murmur. The clinical findings are due to an extra chromosome that is most commonly caused by (A) meiotic duplication (B) meiotic nondisjunction (C) fertilization by two spermatozoa (D) translocation
meiotic nondisjunction (TOPNOTCH)Robbins Basic Pathology, 8th Ed p 244
981
A premature female neonate admitted at the PICU develops sepsis, with blood cultures showing growth of Candida sp. She is also found to be persistently hypocalcemic. She dies on her 7th day. On autopsy, she was found to have fungal endocarditis and thymic hypoplasia. She most likely has (A) an extra chromosome 22 (B) a deletion in chromosome 22 (C) a 9:22 chromosomal translocation (D) a duplication in chromosome 22
a deletion in chromosome 22 (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp 245-246
982
A stillborn fetus is found to have polydactyly, an umbilical hernia, and cleft lip and palate. Autopsy showed a ventral septal defect, renal dysplasia, and holoprosencephaly. Karyotyping will likely show (A) Monosomy X (B) Deletion in chromosome 5 (C) Trisomy 13 (D) Trisomy 18
Trisomy 13 (TOPNOTCH)Robbins Basic Pathology, 8th Ed p 245.
983
A 19 year old female consults a gynecologist for primary amenorrhea. Apart from her short stature, there are no other unusual clinical findings. Why must Turner Syndrome be ruled out? (A) mosaicism or partial monosomy may produce a mild form of the syndrome (B) 45,X abnormalities manifest in only half of females by the age of 18 (C) when combined with Fragile X, the typical features such as neck webbing and cubitus valgus are masked (D) supplementation with folate during gestation masks the typical features of neck webbing and cubitus valgus
mosaicism or partial monosomy produces a milder form (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp247-248
984
A stillborn male fetus delivered to a 41 year old G7P7 is found to have flattened facies and clubbed feet. Autopsy showed renal agenesis and pulmonary hypoplasia. What is the main culprit of the findings in the fetus? (A) maternal age (B) multiparity (C) renal agenesis (D) pulmonary hypoplasia
renal agenesis (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp 253-254
985
A G3P3 mother has premature rupture of membranes at 35 weeks age of gestation, and delivers a live baby boy with poor APGAR scores. The obstetrician delivered a placenta with dull-looking membranes, which showed chorioamnionitis on histopathology. Culture of which organism from the placental tissue suggests an transcervical origin of infection? (A) Group B Streptococcus (B) Toxoplasma (C) Plasmodium (D) Rubella
Group B Streptococcus (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 256
986
A G1P1 preeclamptic mother delivers a live baby boy at 27 weeks age of gestation. The baby develops respiratory distress a few minutes later and is admitted at the PICU. He dies the next day, and is sent for autopsy. Which of the following supports respiratory distress syndrome of the newborn? (A) thickened alveolar septa with lymphocytic infiltrates (B) alveolar spaces filled with neutrophils (C) eosinophilic material lining the alveolar walls (D) hemosiderin laden macrophages in the alveolar spaces
eosinophilic material lining the alveolar walls (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp 257-258
987
A premature male neonate who was delivered at 33 weeks AOG and admitted at the PICU develops abdominal distention, bloody stools, and hypotension. An abdominal radiograph shows gas within the intestinal wall. What is the expected histologic findings of the involved intestine? (A) coagulative necrosis of the mucosa and muscularis (B) arteriovenous fistulas in the submucosa (C) melanosis of the mucosa (D) crypt abscesses and noncaseating granulomas
coagulative necrosis of the mucosa and muscularis (TOPNOTCH)Robbins Basic Pathology, 8th Ed p 259
988
What is the most common autopsy finding in sudden infant death syndrome? (A) patent ductus arteriosus (B) multiple petechiae in the thymus and pleural surfaces (C) bilateral adrenal hemorrhage (D) flattening of gyri in the cerebral cortex
multiple petechiae on the thymus and visceral surfaces (TOPNOTCH)Robbins Basic Pathology, 8th Ed p 260
989
How does parvovirus B19 infection cause fetal hydrops? (A) it causes a chronic myocarditis leading to heart failure (B) it infects the lymphatic ducts causing peripheral fluid accumulation (C) it causes placental villi atrophy, exposing the fetal circulation to maternal antibodies (D) it infects erythroid precursors, causing anemia
it infects erythroid precursors, causing anemia (TOPNOTCH)Robbins Basic Pathology, 8th Ed p 262
990
A 4 month old infant with abdominal enlargement presents with multiple bluish-gray subcutaneous nodules. Workup showed a 10 cm mass in the paravertebral region. Biopsy of the nodules showed small round cells with dark nuclei scanty cytoplasm, some forming rosettes arranged in a finely fibrillar matrix. Immunohistochemical studies showed the cells to be positive for neuron specific enolase and negative for leucocyte common antigen. These tumor cells are derived from (A) antigen presenting cells in the dermis (B) neural crest (C) nephrogenic rests (D) lymphoid precursors
neural crest (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp 269-270
991
A 2 year old male is noticed to have a whitish pupil on photographs. Workup showed a tumor in the posterior chamber. The eye is enucleated, and the tumor shows sheets of small round cells with hyperchromatic nuclei and scant cytoplasm. Occasional clustering around central lumens are seen. On further history, a cousin also had a similar tumor and died. The patient has an increased risk of developing which tumour later in life: (A) hepatoblastoma (B) pheochromocytoma (C) osteosarcoma (D) Wilms tumour
osteosarcoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p 271
992
A 4 year old female undergoes left nephrectomy for Wilms tumor. Which of the following findings in the nephrectomy specimen is associated with an increased risk of developing the same tumor in the right kidney? (A) nephrogenic rests (B) abortive tubules or glomeruli (C) extensive fibrosis (D) adipose tissue, cartilage, and osteoid
nephrogenic rests (TOPNOTCH)Robbins Basic Pathology, 8th Ed p 272
993
A gas formed by sunlight-driven reactions involving nitrogen oxides. Together with oxides and fine particulate matter, it forms "smog".
Ozone(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 282
994
A nonirritating , colorless, tasteless, odorless gas produced bu the imperfect oxidation of carbonaceous materials. Binds to hemoglobin with high affinity causing systemic asphyxiation and CNS depression.
Carbon monoxide(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 282
995
Carbon monoxide in the blood is called _______.
Carboxyhemoglobin(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 282
996
Acute poisoning of carbon monoxide produces this characteristic color of the skin and mucous membranes.
Cherry red color(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 283
997
Microcytic, hypochromic anemia, with basophilic stippling of erythrocytes, peripheral demyelinating neuropathy which manifests as footdrop and wristdrop, colic characterized by extremely severe, poorly localized abdominal pain, and chronic renal damage are the features of poisoning with this heavy metal.
Lead(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 283
998
Main source of exposure to this heavy metal are contamintaed fish and dental amalgams, causing tremor, gingivitis and bizarre behavior.
Mercury(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
999
Consumption of fish contaminated with methyl mercury causing cerebral palsy, deafness, blindness, and major CNS defects in children exposed in utero.
Minamata disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
1000
Antidote for mercury poisoning.
Thimerosal(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
1001
Chronic exposure with this heavy metal results in hyperpigmentation and hyperkeratosis which may develop into basal or squamous cell carcinomas.
Arsenic(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
1002
This heavy metal is used mainly in batteries and fertilizers, which can contaminate soil. Can cause obstructive lung disease and kidney damage.
Cadmium(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
1003
Disease caused by cadmium in Japan, presenting as a combination of osteoporosis and osteomalacia, associated with renal disease.
Itai-itai disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
1004
May be released from combustion of fossil fuels, burning of coal and gas, and also present in tar and soot. Among the most potent carcinogens, implicated in lung and bladder cancer.
Polycyclic hydrocarbons(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287
1005
Synthetic products that resist degradation and are lipophilic, typically used as pesticides, with anti-estrogenic and anti-androgenic activity, and causes neurologic toxicity.
Organochlorines (e.g. DDT)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287
1006
These can cause skin disorders such as folliculitis and chloracne, consisting of acne, cyst formation, hyperpigmentation, and hyperkeratosis, around the face and behind the ears.
Dioxins and Polychlorinatedbiphenyls (PCB)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287
1007
It is the most preventable cause of human death.
Smoking(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287
1008
Components of cigarette smoke that are potent carcinogens in animals and are most likely involved in the causation of lung carcinomas in humans.
Polycyclic hydrocarbons and nitrosamines(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 288
1009
Chronic alcoholics are at an increased risk of developing this type of cancer as a result of liver injury.
Hepatocellular carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 290
1010
These refer to untoward effects of drugs that are given in conventional therapeutic settings.
Adverse drug reactions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 291
1011
A long acting tetracycline which can cause a diffuse blue-gray pigmentation of the skin.
Minocycline(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 293
1012
Oral contraceptives have a protective effect against these cancers.
Endometrial and ovarian CA(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
1013
Oral contraceptives may increase the risk of developing this type of cancer in women.
Cervical CA(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
1014
Prolonged use of oral contraceptives is associated with the development of this rare benign tumor especially in older women.
Hepatic adenoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
1015
Toxic metabolite of paracetamol or acetaminophen causing centrilobular necrosis that may progress to liver failure.
NAPQI (N-acetyl-p-benzoquinoneimine)(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 422
1016
Toxic dose for acetaminophen.
15-25 grams/day(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
1017
Antidote for acetaminophen poisoning.
N-acetylcysteine(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 294
1018
Manifested by headache, dizziness, tinnitus, difficulty of hearing, mental confusion, drowsiness, nausea, vomiting, and diarrhea, with CNS changes that can progress to convulsions and coma.
Salicylism(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
1019
Adult toxic dose of aspirin.
10-30 grams(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
1020
Mixtures of aspirin and phenacetin, or its active metabolite acetaminophen, when taken over several years can cause tubulointerstitial nephritis and renal papillary necrosis called _______.
Analgesic nephropathy(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
1021
This drug of abuse can precipitate lethal arrythmias, hyperpyrexia, seizures, amd respiratory arrest during acute overdose. Causes nasal septal perforation, decrease in lung diffusing capacity in those who inhale smoke and dilated cardiomyopathy during chronic use.
Cocaine or "crack" (cocaine derivative)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 295
1022
Addictive opiod derived from the poppy plant which can cause euphoria, hallucinations, somnolence, sedation, and increased risk of sudden death.
Heroin(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 296
1023
Drug made from the leaves of Cannabis sativa plant which can cause distortion of sensory perception and impairs motor coordination.
Marijuana(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 297
1024
Psychoactive substance found in marijuana.
Delta 9- Tetrahydrocannabinol (THC)(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 297
1025
Mechanism of action of aspirin.
Irreversibly blocks the enzyme cyclooxygenase.(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 297
1026
A wound produced by scraping or rubbing resulting in removal of superficial layer of the skin.
Abrasion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1027
A wound usually produced by a blunt object, characterized by damage to blood vessels and extravasation of blood into tissues.
Contusion (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1028
A tear or disruptive stretching of tissue caused by the application of force by a blunt object, causing jagged and irregular edges to the skin.
Laceration(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1029
A wound inflicted by a sharp instrument, wherein bridging blood vessels are severed.
Incision(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1030
A wound caused by a long, narrow instrument.
Puncture wound(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1031
Burn classification which involves total destruction of the epidermis and dermis, with loss of thermal appendages.
Full thickness burn (3rd and 4th degree)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1032
Burn classification wherein the thermal appendages are spared but involves at least the deeper portions of the skin.
Partial thickness burn(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1033
Partial thickness burn that involves both the epidermis and superficial dermis.
Second degree burn(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1034
Partial thickness burn that involves the epidermis only.
First degree burn(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1035
Grossly, these burns are white or charred and anesthetic due to nerve ending destruction.
Full thickness burns(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1036
These burns are pink or mottled with blisters and are painful.
Second degree burn (partial thickness)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1037
Histologic change in the skin during burns.
Coagulative necrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
1038
Leading cause of death in burn patients.
Organ system failure secondary to burn sepsis.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299
1039
Cramping of voluntary muscles in association with vigorous exercise as a result of electrolyte loss via sweating.
Heat cramps(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299
1040
Most common hyperthermic syndrome. A sudden onset of prostration and collapse, resulting from failure of the cardiovascular system to compensate for hypovolemia, secondary to water depletion.
Heat exhaustion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299
1041
Associated with high ambient temperatures and high humidity. Thermoregulatory mechanisms fail, sweating ceases and core body temperature rises. Due to marked generalized peripheral vasodilation with peripheral pooling of blood and decreased effective circulating volume.
Heat stroke(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299
1042
Two types of injuries caused by electricity.
BurnsVFib or cardiac and respiratory center failure(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299
1043
This may injure cells directly or indirectly by generating free radicals from water or molecular oxygen, damages DNA and rapidly dividing cells. Exposure may predispose to neoplastic transformation, vascular damage, sclerosis and tissue fibrosis.
Ionizing radiation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 300
1044
Malnutrition caused by lack of nutrients from the diet.
Primary malnutrition(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 304
1045
Malnutrition caused by malabsorption, impaired nutrient utilization or storage, excess losses or increased nutrient needs.
Secondary or conditioned malnutrition(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 304
1046
Protein energy malnutrition which occurs when protein deprivation is relatively greater than reduction in total calories. Associated with generalized edema, flaky paint appearance of the skin, alternating bands of pale and dark hair, enlarged fatty liver, apathy, listlessness and loss of appetite.
Kwashiorkor(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 305
1047
Protein energy malnutrition caused by a decrease in both protein and calorie intake, and weight falls below 60% of normal for sex, height and age. Serum albumin is normal or slightly reduced.
Marasmus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 305
1048
Self-induced starvation, resulting in marked weight loss.
Anorexia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 306
1049
A condition wherein a patient binges on food and then induces vomiting.
Bulimia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 306
1050
Deficiency of this vitamin causes night blindness, xerophthalmia, keratomalacia, Bitot spots and eventually corneal ulceration.
Vitamin A(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 307
1051
Condition in children as result of vitamin D deficiency causing the following signs and symptoms: frontal bossing of the head, rachitic rosary, pigeon breast deformity, lumbar lordosis and bow legs.
Rickets (children)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 309
1052
Deficieny of this vitamin causes impaired collagen formation, leading to gum bleeding, easy bruisability, and impaired wound healing.
Vitamin C (Scurvy)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 312
1053
Symptoms of cheilosis, stomatitis, glossitis, dermatitis and corneal vascularization results from deficiency of this vitamin.
Vitamin B2 (Riboflavin)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 314
1054
Symptoms of cheilosis, glossitis, dermatitis, and peripheral neuropathy.
Vitamin B6 (Pyridoxine)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 314
1055
Leading causes of death in developed countries
Ischemic heart disease and cerebrovascular disease (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 405
1056
The most important catalyst of phase I reactions; detoxify xenobiotics
Cytochrome P-450 enxyme system (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 407
1057
A 55 y/o male presented to the ER following a house fire. He was lethargic, tachycardic, tachypneic and displayed memory disturbance. Skin was noted to be cherry red. What is the most likely cause?
Carbon monoxide poisoning (TOPNOTCH)
1058
A 5 y/o boy presented to the clinic due to hyperactivity and impulsiveness. Hearing acuity was below normal, and speech and language were slightly delayed. History reveals that the boy lives in an old house in the community. PBS showed hypochromia and microcytosis. What is the most likely diagnosis?
Lead poisoning (TOPNOTCH)
1059
Toxic effects of this heavy metal include cerebral palsy, deafness, blindness, and kidney damage. Cause of Minamata disease.
Mercury (TOPNOTCH)
1060
"King of poisons"
Arsenic (TOPNOTCH)
1061
Most toxic form of arsenic
Trivalent compounds of arsenic(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 412
1062
The most serious consequence of chronic exposure to this heavy metal is the increased risk for the development of cancers, particularly of the lungs, bladder, and skin.
Arsenic (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 412
1063
The principal toxic effects of toxicity to this heavy metal are obstructive lung disease and renal tubular damage that may progress to ESRD.
Cadmium (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 413
1064
Exposure to benzene increases risk of what hematologic condition
Leukemia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 413
1065
Exposure to vinyl chloride used in the synthesis of polyvinyl resins leads to the development of what tumor?
Angiosarcoma of the liver (TOPNOTCH) Robbins Basic Pathology, 9th ed.,p.414
1066
Main enzyme system involved in alcohol metabolism
Alcohol dehydrogenase(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 417
1067
Enlarged and fatty liver is seen in kwashiorkor or marasmus?
Kwashiorkor(TOPNOTCH)
1068
A major complication of anorexia nervosa and bulimia
Cardiac arrythmia and sudden death due to hypokalemia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 435
1069
Symptos of acute toxicity to these vitamin include headache, diziness, vomiting, stupor, and blurred vission, which may be confused with those of a brain tumor (pseudotumor cerebri)
Vitamin A(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 438
1070
Craniotabes, frontal bossing, squared appearance of the head, rachitic rosary, pigeon chest deformity, lumbr lordosis, and bowing of the legs are associated with what vitamin deficiency?
Vitamin D deficiency (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 441
1071
Toxicity of this vitamin may cause calcification of soft tissue and bone pain.
Vitamin D(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 441
1072
Rash around the eyes, mouth,and nose, anorexia, diarrhea, growth retardaation, depressed wound healing and impaired nigh vision are associated with ____ deficiency
Zinc(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 443
1073
Muscle weakness, neurologic defects and abnormal collagen cross-linking are associated with ___ deficiency.
Copper(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 443
1074
Disease characterized by bone disease in growing children and by hemorrhages and healing defects in both children and adults.
Scurvy(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 443
1075
Syndrome composed of respiratory abnromalities in very obese persons.
Hypoventilation syndrome/pickwickian syndrome (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 448
1076
Hormone synthesized by fat cells which regulates food intake an energy expenditure. Its binding to its receptors in the hypothalamus increases energy consumption by stimulating POMC/CART neurons.
Leptin(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 448
1077
Aflatoxin is implicated in what type of cancer?
Hepatocellular carcinoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 449
1078
True or False. High animal intake and low fiber has been imlicated in colon cancer.
True (TOPNOTCH)
1079
Lead has a more damaging effect on the brains of children than in adults because of (A) a more permeable blood-brain barrier (B) immature lenticular nuclei (C) less microglia and astrocytes(D) greater proportion of fetal hemoglobin in the blood
a more permeable blood-brain barrier (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 283
1080
Chronic exposure to arsenic is associated with the development of the following malignancies EXCEPT (A) squamous cell carcinoma of the skin (B) mucoepidermoid carcinoma of the salivary glands (C) lung carcinoma (D) basal cell carcinoma
mucoepidermoid carcinoma of the salivary glands (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
1081
Exposure to vinyl chloride has been found to cause (A) multiple uterine leiomyomas (B) hepatic angiosarcoma (C) squamous cell carcinoma of the skin (D) transitional carcinoma of the bladder
hepatic angiosarcoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287
1082
Tobacco smoke, when combined with this, is known to have a multiplicative effect on the risk of developing laryngeal cancer (A) alcohol (B) diet rich in animal fat (C) dietary nitrates (D) oral sex
alcohol (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 289
1083
Progestin is added to estrogen in hormone replacement therapy for menopausal women to reduce the risk of (A) breast cancer (B) endometrial cancer (C) thromboembolism (D) all of the above
endometrial cancer (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 293
1084
During a routine ultrasound, a 38 year old G1P0 was found to have a solitary, 4 cm diameter, hepatic mass in the right lobe, beneath the capsule. She has a history of regular oral contraceptive use since 18 years old, and stopped 1 year ago. She has never been infected by HBV or HCV. She does not drink alcohol. If the mass is excised, it would most likely show (A) benign-looking hepatocytes in cords and sheets, absent portal tracts, and prominent blood vessels (B) proliferation of endothelial cells some containing lumens with RBCs (C) portal tracts with chronic inflammation and bile duct proliferation (D) pleomorphic cells, bizarre giant cells, atypical mitoses, and necrosis
benign-looking hepatocytes in cords and sheets, absent portal tracts, and prominent vessels (hepatic adenoma) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294, p664)
1085
Liver damage in acetaminophen overdose is characterized histologically by (A) brisk neutrophilic infiltration of portal tracts (B) hepatocytes with extensively vacuolated cytoplasm (C) centrilobular necrosis (D) bile duct proliferation
centrilobular necrosis (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
1086
A 65 year old man has been regularly taking aspirin and acetaminophen for 20 years. This predisposes him to developing (A) chronic interstitial nephritis (B) renal papillary necrosis (C) transitional cell carcinoma of the renal pelvis (D) all of the above
all of the above (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294, 564
1087
An 4 year old orphan boy with a scar on his forehead was found locked in a small room under the stairs by his abusive uncle and aunt. He has been kept there and fed crackers and milk since he was 1 year old. He has a squared appearance of the head, a pigeon breast deformity, lumbar lordosis, and bowing of the legs. These physical findings are due to deficiency of (A) calcium (B) vitamin A (C) vitamin C (D) vitamin D
vitamin D (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 309-312
1088
In these arteries, elastic fibers alternate in layers with smooth muscle cells. Examples are the common carotid artery, iliac arteries and pulmonary arteries.
Large or elastic arteries(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 340
1089
In these arteries, tunica media is composed primarily of smooth muscle cells, with elastin limited to the internal and external elastic lamina. Examples are the coronaries and renal arteries.
Medium-sized or muscular arteries(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 340
1090
These are the principal control points for regulation of physiologic resistance to blood flow.
Arterioles(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 340
1091
These vessels are approximately the diameter of an RBC, have an endothelial cell lining but no media.
Capillaries(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
1092
Diameter of an RBC.
7-8 um(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
1093
These are thin-walled, endothelium lined channels that drain excess interstitial tissue fluid, returning it to blood via the thoracic duct.
Lymphatics(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
1094
These are small spherical dilatations, typically in the circle of Willis.
Developmental/berry aneurysms(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
1095
These are abnormal, typically small, direct connections between arteries and veins that bypass the intervening capillaries.
Arteriovenous fistulas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
1096
Focal, irregular thickening of the walls of medium and large muscular arteries. Segments of the vessel wall are focally thickened by combination of irregular medial and intimal hyperplasia and fibrosis, causing luminal stenosis.
Fibromuscular dysplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
1097
Literally means hardening of the arteries, term reflecting arterial wall thickening and loss of elasticity, affecting small arteries and arterioles.
Arteriolosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 343
1098
Characterized by calcific deposits in muscular arteries, typical in persons older than 50 yrs old. The radiographically visible, palpable calcifications do not encroach on the vessel lumen, and are not clinically significant.
Mockenberg medial calcific sclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 343
1099
Characterized by intimal lesions called atheromas that protrude into vascular lumina.
Atherosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 343
1100
Three principal components of an atheromatous plaque.
1. Cells (SM cells, macrophages, T cells)2. Extracellular matrix (collagen, elastic fibers, proteoglycans)3. Intracellular and extracellular lipidFibrous cap, central lipid core, neovascularization(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 344
1101
Non-modifiable risk factors for atherosclerosis. (4)
Increasing ageMale genderFamily historyGenetic abnormalities(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 344
1102
Composed of lipid-filled foam cells but are not significantly raised and thus do not cause any disturbance in blood flow. Can appear as early as 1 year, and present in virtually all children older than 10 years old.
Fatty streaks(TOPNOTCH)
1103
Composed of lipid-filled foam cells but are not significantly raised and thus do not cause any disturbance in blood flow. Can appear as early as 1 year, and present in virtually all children older than 10 years old.
Fatty streaks(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 349
1104
Arrange in descending order, based on which blood vessel is most extensively involved in development of atherosclerosis.Popliteal arteries, internal carotid arteries, circle of Willis, coronaries, abdominal aorta
Abdominal aorta > coronaries > popliteal arteries > internal carotid arteries > circle of Willis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 350
1105
Fate of an atheromatous plaque wherein the luminal surface exposes the bloodstream to highly thrombogenic substances and induces thrombus formation.
Rupture, ulceration or erosion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 351
1106
Fate of an atheromatous plaque due to rupture of the overlying fibrous cap or the thin-walled vessels in the areas of neovascularization.
Hemorrhage(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 351
1107
Fate of an atheromatous plaque causing discharge of debris into the bloodstream, producing microemboli composed of plaque contents.
Atheroembolism(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 351
1108
Fate of an atherosclerotic plaque due to increased pressure or ischemic atrophy of the underlying media, with loss of elastic tissue, leading to weakness of the vessel wall.
Aneurysm formation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 351
1109
Most common cause of hypertension.
Idiopathic (essential hypertension)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 355
1110
This vascular lesion consists of a homogenous pink hyaline thickening of the walls of arterioles with loss of underlying structural detail and with narrowing of the lumen. A major morphologic characteristic in benign nephrosclerosis.
Hyaline arteriolosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 356
1111
Characteristic of malignant hypertension, associated with "onion-skin" concentric, laminated, thickening of the walls of arterioles with luminal narrowing. These laminations consist of smooth muscle cells and thickened duplicated basement membrane.
Hyperplastic arteriolosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 356
1112
It is a localized abnormal dilation of a blood vessel or heart.
Aneurysm(TOPNOTCH)
1113
It is a localized abnormal dilation of a blood vessel or heart.
Aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
1114
Aneurysm which involves all three layers of the arterial wall, or the attenuated wall of the heart.
True aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
1115
A breach in the vascular wall leading to an extravascular hematoma that freely communicates with the intravascular space.
False aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
1116
Arises when blood enters the wall of an artery, as a hematoma dissecting between its layers. Often, but not always aneurysmal in origin.
Arterial dissection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
1117
Aneurysms which are spherical outpouchings, involving only a portion of the vessel wall, varying in size from 5-20cm in diameter and often contain thrombi.
Saccular aneurysms(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
1118
Aneurysms which involve diffuse, circumferential dilation of a long vascular segment, varies in diameter and length, and can involve extensive portions of the aortic arch, abdominal aorta,and iliacs.
Fusiform aneurysms(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
1119
Two most important causes of aortic aneurysms.
AtherosclerosisCystic medial degeneration of the arterial media(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
1120
Infection of a major artery that causes weakness to its wall.
Mycotic aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
1121
This disease can more commonly affects men >50 years old. Lesion usually positioned below the renal arteries and above the aortic bifurcation. Can be saccular or fusiform.
Abdominal aortic aneurysm (AAA)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 358
1122
Abdominal aortic aneurysm characterized by dense periaortic fibrosis containing abundant lymphoplasmacytic infiltrate with manybmacrophages and often giant cells.
Inflammatory AAA(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 358
1123
Atherosclerotic lesions infected by lodging of circulating microorganisms in the wall, particularly in the setting of bacteremia from a Salmonella gastroenteritis. Suppuration further destroys the media, potentiating rapid dilation and rupture.
Mycotic abdominal aortic aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 358
1124
Small blood vessels and vasa vasorum show luminal narrowing and obliteration (obliterative endarteritis), scarring of the vessel wall and a dense surrounding rim of lymphocytes and plasma cells that may extend into the media. Characteristic of the tertiary stage of syphilis.
Syphilitic aortitis(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 359
1125
Most common point of origin of an aortic dissection.
Ascending aorta, 10 cms from the aortic valve(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 360
1126
Most frequent pre-existing histologically detectable lesion in aortic dissection, characterized by elastic tissue fragmentation and separation of the elastic and smooth muscle cell elements of the media by cystic spaces filled with amorphous proteoglycan-rich extracellular matrix.
Cystic medial degeneration(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 361
1127
Classification of aortic dissection involving either them ascending aorta only or both the ascending and descending aorta.
Type A dissections (proximal) Type I DeBakey - ascending aorta only Type II DeBakey - ascending and descending aorta(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 361
1128
Classification of aortic dissections involving the descending aorta only, usually distal to the subclavian artery.
Type B dissection / type III DeBakey(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 361
1129
Granulomatous inflammation frequently involving the temporal artery, occuring in patients >50 years old, associated with polymyalgia rheumatica.
Giant cell (Temporal) arteritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 363
1130
Granulomatous inflammation usually occuring in patients younger than 50 years old. Classically involves the aortic arch, with intimal hyperplasia and irregular thickening of the vessel wall. Origin of great vessels are obliterated causing weakness of peripheral pulses.
Takayasu arteritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 364
1131
Used to distinguish between giant cell arteritis and takayasu arteritis of the aorta.
Age of patient40 Giant cell arteritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 364
1132
In this disease, affected blood vessels develop nodular intimal thickening, granulomatous inflammation within the inner media centered on the internal elastic membrane, and fragmentation of the internal elastic lamina. Typically involves temporal and ophthalmic arteries.
Giant - cell/Temporal arteritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 364
1133
A systemic vasculitis causing transmural necrotizing inflammation of small to medium sized vessels, with mixed infiltvrate of neutrophils, eosinophils, and mononuclear cells, frequently accompanied by fibrinoid necrosis.Typically involves renal arteries but spares pulmonary vessels.
Polyarteritis Nodosa (PAN)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 365
1134
Arteritis associated with mucocutaneous lymph node syndrome, which usually occurs in children. Coronary arteries can be involved with aneurysm formation or thrombosis. Fibrinoid necrosis usually less prominent.
Kawasaki disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 366
1135
Granulomatous inflammation involving the respiratory tract and necrotizing vasculitis affecting small vessels, including cresencteric glomerulonephritis. Associated with c-ANCA.
Wegener granulomatosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 367
1136
A necrotizing vasculitis that generally affects capillaries, arterioles and venules, with few or no immune deposits. Necrotizing glomerulonephritis and pulmonary capillaritis are common. Associated with p-ANCA.
Microscopic polyangiitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 368
1137
Eosinophil-rich and granulomatous inflammation involving the respiratory tract and necrotizing vasculitis affecting small vessels. Associated with asthma and blood eosinophilia. Associated with p-ANCA.
Churg-Strauss syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 368
1138
Characterized by sharply segmental avute and chronic vasculitis of medium sized and small arteries, predominantly of the extremities. There is acute and chronic inflammation accompanied by luminal thrombosis, containing microabscess composed of neutrophils surrounded by granulomatous inflammation. Stromg relationship with cigarette smoking.
Thromboangiitis obliterans (Buerger disease)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 368
1139
Results from an exaggerated vasoconstriction of digital arteries and arterioles, inducing paroxysmal pallor or cyanosis of the digits of the hands and feet.
Raynaud phenomenon(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 369
1140
Reflects an exaggeration of central and local vasomotor responses to cold or emotion. Structural changes in the arterial walls are absent except late in course when intimal thickening can appear.
Primary Raynaud phenomenon (Raynaud disease)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 369
1141
Reflects vascular insufficiency of the extremities in the context of arterial disease caused by other entities including SLE, Buerger disease, or atherosclerosis.
Secondary Raynaud phenomenon(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 370
1142
Abnormally dilated, tortous veins produced by prolonged increase in intraluminal pressure and loss of vessel wall support. Veins show wall thinning at the points of maximal dilation with smooth muscle hypertrophy and intimal fibrosis. Focal thrombosis and venous valve deformities are common.
Varicose veins(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 370
1143
Most common blood vessels involved in development of varicose veins.
Superficial veins of the upper and lower leg(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 370
1144
Three sites of varices produced in the presence of portal hypertension.
GEJ (Esophageal varices)Rectum (Hemorrhoids)Periumbillical veins (Caput medusae)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 370
1145
Common and serious complication of of deep vein thrombosis (DVT).
Pulmonary embolism(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 371
1146
The acute inflammation elicited when bacterial infections spread into and through the lymphatics.
Lymphangitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 371
1147
These are bright red to blue lesions, that vary from a few millimeters tomseveral centimeters in diameter. Unencapsulated aggregates of closely packed, thin-walled capillaries, usually blood-filled and lined by flattened endothelium. Vessels are separated by scant connective tissue stroma.
Capillary hemangiomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 372
1148
Appears as red-blue, soft, spongy masses 1-2 cm in diameter, which can affect large subcutaneous areas of the face, extremities, and othe body regions. Mass is sharply defined but not encapsulated, composed of large, cavernous, blood-filled spaces.
Cavernous hemangioma(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 372
1149
This form of capillar hemangioma is a rapidly growing peduncular red nodule on the skin, gingival, or oral mucosa, bleeds easily and is often ulcerated.
Pyogenic granuloma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 373
1150
These are round, slightly elevated, red-blue firm nodules, less than 1 cm diameter that can resemble a minute focus of hemorrhage UNDER THE NAIL. Histologically, these are aggregates, nests, and masses of tumor cells intimately associated with branching vascular channels.
Glomus tumor (Glomangioma)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 373
1151
A specialized arteriovenous structure involved in thermoregulation.
Glomus body(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 373
1152
This lesion is the ordinary "birthmark" and is the most common form of ectasia. Characteristically a flat lesion on the head or neck, ranging in color from light pink to deep purple.
Nevus flammeus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 374
1153
This non-neoplastic vascular lesion grossly resembles a spider. There is radial, often pulsatile array of dilated subcutaneous arteries or arterioles about a central core, that blanches when pressure is applied to its center.
Spider telangiectasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 374
1154
An opportunistic infection in immunocompromised persons that manifest as vascular proliferations involving skin, bone, brain and other organs. Characterized grossly by red papules and nodules, or rounded subcutaneous masses. Histologically, there is capillary proliferation with prominent epitheloid EC's showing nuclear atypia and mitoses. Lesions contain stromal neutrophils, nuclear dust nd purplish granular material.
Bacillary angiomatosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 374
1155
Common in patients with AIDS, caused by HHV 8, causing skin lesions ranging from patches, plaques to nodules.
Kaposi sarcoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 375
1156
These are malignant endothelial neoplasms, with varying histology from plump, anaplastic but recognizable endothelial cells producing vascular channels to widely undifferentiated tumors having solid, spindle cell appearance and producing nondefinite blood vessels.
Angiosarcoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 376
1157
Form of hypertension characterized by systolic pressure more than 200 mmHg or diastolic pressure more than 120 mmHg, renal failure, and retinal hemorrhages and exudates.
Malignant Hypertension (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 488
1158
The most important independent risk factor for atherosclerosis.
Family history(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 492.
1159
The initial event in the pathogenesis of atherosclerosis
Endothelial injury and dysfunction. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 494
1160
The major lipoprotein involved in the pathogenesis of atherosclerosis.
LDL(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 494
1161
2 most important causes of endothelial dysfunction
Hemodynamic disturbances and hypercholesterolemia. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 494
1162
The key processes in atherosclerosis
Intimal thickening and lipid accumulation (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 496
1163
The major structural component of fibrous cap in an atheromatous plaque
Collagen(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 500
1164
Medial ischemia leading to degenerative changes of aorta, leading to scarring, loss of elastic fibers, inadequate extracellular matrix synthesis, and production of amorphous ground substance. This can be seen in Marfan syndrome and scurvy.
Cystic medial degeneration(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 502
1165
Most common etiology associated with ascending aortic aneurysm
Hypertension (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 502
1166
A 70 y/o male, hypertensive, present with sudden severe abdominal pain. On physical examination, there is a presence of pulsatile abdominal mass. The most likely diagnosis is:
Abdominal aortic aneurysm(TOPNOTCH)
1167
The most frequent preexisting histologically detectable lesion in aortic dissection
Cystic medial degeneration(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 504
1168
Presents with sudden onset of excruciating pain, usually beginning in the anterior chest, radiating to the back between the scapulae, and moving downward.
Aortic dissection(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 505
1169
Most common cause of death in aortic dissection.
Rupture of the dissection into the pericardial, pleural or peririthoneal cavities.(TOPNOTCH) Robbins Basica Pathology, 9th ed., p. 505
1170
A 38 y/o male presents with severe headache and diplopia associated with fever and fatigue. Area along the course of the superficial temporal artery was painful to palpation. Biopsy done revealed intimal thickening of the artery, granulomatous inflmmation of the internal elastic lamina with infiltrate of T cells and macrophages. What is the most likely diagnosis?
Giant cell arteritis (TOPNOTCH)
1171
Patient initially present with fatigue, weight loss and fever and then reduced blood pressure and weak pulses in the carotids and upper extremities, ocular disturbances and neurologic deficits. The most likely diagnosis is:
Takayasu arteritis(TOPNOTCH)
1172
Most common involved blood vessel in Takayasu arteritis.
Aortic arch (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 509
1173
This disease presents with rapidly accelerating hypertension, abdominal pain, bloody stool, myalgia and peripheral neuritis. The most likely diagnosi:
Polyarteritis nodosa(TOPNOTCH)
1174
A 4 y/o female presented with fever and maculopapular rash on her trunk and extremities. This is associated with conjunctival erythema, edema of the hands and feet, and cervical lymph node enlargement. The patient is at risk for what type of blood vessel involvement?
Coronary artery aneurysm which may lead to acute MI. (Case of Kawasaki Disease) (TOPNOTCH)
1175
Patient presents with asthma, allergic rhinitis, palpable purpura, GI bleeding, renal disease, and cardiomyopathy. Histologic findings showed vascular granulomata and hypereosinophilia. The most likely diagnosis is:
Churg-Strauss syndrome(TOPNOTCH)
1176
It presents as a clinical triad of recurrent oral apthous ulcers, genital ulcers, and uveitis.
Behcet Disease(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 511
1177
This disease presents with persistent pneumonitis with bilateral nodular infiltrates, chronic sinusitis, mucosal ulceration of the nasopharynx, and renal disease. Histologic findings of upper respiratory tract lesion showed mucosal granuloma with geographic patterns of central necrosis and vasculitis. The most likely diagnosis:
Granulomatosis with polyangitis/Wegener granulomatosis(TOPNOTCH)
1178
A 30 y/o male, smoker, presents with severe leg pain aggravated by exercise and relieved on rest. It further progressed to extremity ulcerations. What is the most likely diagnosis?
Thromboangiitis obliterans (Buerger disease)(TOPNOTCH)
1179
Most imprortant risk factor for DVT
Prolonged immobiliztion resulting in venous stasis. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 514
1180
A 50 y/o male, diagnosed with lung cancer, presented with edema and cyanosis of the head , neck, and arms with cyanosis. This is a case of:
Superior vena cava syndrome (TOPNOTCH)
1181
The most common etiologic agent in lymphangitis.
Group A beta hemolyitc streptococcus. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 515
1182
An autosomal dominant disorder caused by mutations in genes that encode components of TGF-B signaling pathway. Presents with telengiectasia that are widely distributed over the skin and mucus membranes.
Hereditary hemorrhagic telengiectasia/Osler-Weber-Rendu disease (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 516
1183
Most common type of hemangioma
Capillary hemangioma(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 516
1184
Painful tumors arising from modified smooth muscle cells of arteriovenous structure, most commonly found in the distal portion of the digits.
Glomus tumor (Glomangioma)(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 517
1185
A 13 year old male dies of a stray bullet to the head on New Year's Eve. At autopsy, there is a flat yellowish streak seen on the intimal surface of his abdominal aorta, near the bifurcation of the renal arteries. This streak (A) causes minor disturbance in blood flow (B)is expected in his age group (C) is composed of hemosiderin-filled foam cells (D) would have certainly evolved into an atheromatous plaque if he lived to old age
expected in his age group ("fatty streak" (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp 348-349)
1186
Early atherosclerotic lesions are usually focal, patchy, and eccentric because (A) there are differences in the vascular hemodynamics at various points (B) the expression of LDL receptors along the blood vessels is varied (C) concentrations of macrophage-activating cytokines are different along blood vessels (D) certain endothelial cells are more sensitive to toxins and hyperglycemia than others
there are differences in vascular hemodynamics at various points (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 349
1187
A 65 year old diabetic female with poor glycemic control and a 5 year history of intermittent chest pain develops pallor, shortness of breath and diaphoresis. She dies 16 hours later. At autopsy, the left ventricular wall is thickened, with dark mottling of the anterior portion, along with the septum and apex. Which of the following describes the likely histology of her left anterior descending artery? (A) an eccentric atheromatous plaque with a fibrous cap (B) a ruptured fibrous cap with calcifications in the lumen of the vessel (C) a ruptured fibrous cap with thrombus formation (D) complete occlusion of the original lumen by fibrous tissue, with neovascularization in the periphery
a ruptured fibrous cap with thrombus formation (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.351
1188
What is the most common cause of aneurysms?
atherosclerosis (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 358
1189
What is the most common site of atherosclerotic aneurysms?
abdominal aorta(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 358
1190
A 75 year old male with heart failure symptoms of 10 years dies. At autopsy, his aortic trunk is dilated, with fibrous scars and wrinkling of the intima. The aortic valve is also dilated, and the left ventricle is markedly enlarged. Microscopic examination of the aorta shows narrowed or obliterated vasa vasorum to be narrowed, with a dense rim of lymphocytes and plasma cells, some extending into the media. Which of the following can suggest the etiology of the patient's findings? (A) family history of diabetes (B) chronic alcohol intake (C) history of sexually transmitted infection (D) occupational exposure to benzene
history of sexually transmitted infection (tertiary/cardiovascular syphilis) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.359, 703
1191
A 30 year old female with 3 year history of fever, weight loss and fatigue presents with right eye blindness. PE showed weak pulses in the upper extremities. Which of the following suggests that she has Takayasu arteritis, rather than temporal arteritis? (A) age (B) constitutional symptoms (C) giant cells in the large blood vessels (D) giant cells in the medium blood vessels
age (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 364-365
1192
Classic polyarteritis nodosa affects small to medium sized vessels most commonly in which organ? (A) kidneys (B) heart (C) liver (D) GI tract
kidneys (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 365
1193
A 2 year old boy presents with erythema of the conjunctiva, oral mucosa, palms and soles, with focal erosions. Palpation shows enlarged cervical lymph nodes. He suddenly dies a few hours after ER admission. Autopsy showed marked mononuclear infiltration of his left anterior descending artery, with fibrinoid necrosis and lumen occlusion. What could have prevented this fatal sequela? (A) low dose corticosteroids (B) Hepatitis B vaccine (C) Beta-lactam and aminoglycoside combination (D) intravenous immunoglobulin
intravenous immunoglobulin (Kawasaki disease) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.366
1194
A 42 year old man with 2 weeks of epistaxis undergoes an intranasal biopsy, which showed chronic granulomatous inflammation with giant cells. Xray showed cavitary lung lesions. He is treated with anti-Koch's for 6 months, but the epistaxis recurred. He also developed hematuria. Which of the following can help support a diagnosis of Wegener's granulomatosis, rather than TB? (A) positive P-ANCA (B) positive C-ANCA (C) urinalysis with RBC morphology (D) biopsy of the lung lesion
positive C-ANCA (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 367-368
1195
A 27 year old Israeli expat presents with intermittent pain and pallor of the right index and middle fingers, precipitated by smoking and cold temperature. He reports symptomatic relief whenever he stops smoking. What is expected in the arteries of the involved fingers? (A) thrombus with neutrophil aggregates and necrosis (B) histiocytes and giant cells (C) ruptured fibrous cap and underlying foamy cells (D) eosinophils and lymphocytes in the media and intima
thrombus with neutrophil aggregates and necrosis (Buerger disease) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.368
1196
A 21 year old G1P0, 24 weeks AOG, has a reddish 1.0 cm diameter nodule on her left lower gum. She reports that the nodule appeared at 1 month of pregnancy. A biopsy showed shows capillaries with an acute and chronic inflammatory infiltrate and stromal edema. There is no pleomorphism, necrosis, or atypical mitosis. This nodule (A) can be found in 20% of pregnant women (B) is malignant (C) may spontaneously regress or fibrose after pregnancy (D) is metastatic from an ovarian primary
may spontaneously regress or fibrose after pregnancy (granuloma gravidarum/pregnancy tumor/pyogenic granuloma) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.373
1197
A 3 year old female with a large "port wine stain" on the right side of her face has occasional seizures. Further examination showed mental developmental delay. She may also have (A) more extensive vascular malformations (B) multiple colonic polyps (C) color blindness (D) alpha thalassemia
more extensive vascular malformations (Sturge-Weber syndrome) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.374
1198
A 38 year old HIV-positive man has multiple reddish-purple plaques and nodules on his arms and legs. He has never been on antiretroviral therapy. Biopsy of one of the nodules showed sheets of plump spindle cells encompassing small vessels and slit-like spaces, with focal hemorrhage, hemosiderin deposits, lymphocytes, and macrophages. Mitotic figures are common. This neoplasm has been shown to be infected with (A) HPV 16 (B) HHV 8 (C) Hepatitic C (D) HPV 18
HHV8 (Kaposi Sarcoma) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 375
1199
The morphologic and clinical effects of this condition primarily result from progressive damming of blood within the pulmonary circulation. The left ventricle is hypertrophied and dilated, with secondary left atrial dilation. The lungs are heavy and boggy, with perivascular and interstitial transudate, alveolar septal edema, and intra-aleolar edema. Hemosiderin-laden macrophages are present.
Left sided heart failure(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381
1200
Hemosiderin laden macrophages are also called _______
Heart failure cells(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381
1201
This is usually the earliest and most significant compaint of patients in Left sided HF.
Dyspnea(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381
1202
Most common cause of right sided HF.
Left sided HF(TOPNOTCH)
1203
This is a particularly dramatic form of breathlessness, awakening patients from sleeo with attacks of extreme dyspnea bordering on suffocation.
Paroxysmal nocturnal dyspnea(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381
1204
Isolated right sided HF occuring in patients with intrinsic lung disease that result in chronic pulmonary hypertension.
Cor Pulmonale(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381
1205
Long standing severe right-sided HF leads to fibrosis of centrilobular areas, creating this condition.
Cardiac cirrhosis(TOPNOTCH)
1206
The liver is increased in size and weight, a cut section reveals congested red centers of liver lobules surrounded bybpaler, sometimes fatty peripheral regions.
Nutmeg liver (CPC of the liver)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381
1207
Right-sided HF produces a tense, enlarged spleen, achieving weights of 300-500 grams. Sinusoidal dilation present.
Congestive splenomegaly(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381
1208
This is a hallmark of right sided HF.
Pedal and pretibial edema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 382
1209
Most congenital heart disease arise from faulty embryogenesis during what AOG?
3 - 8 weeks AOG(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 382
1210
An abnormal communication between chambers of the heart or blood vessels.
Shunt(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 383
1211
These a typically smooth-walled defects near the foramen ovale, usually without associated cardiac abnormalities. Accompanied by right atrial and ventricular dilation, right ventricular hypertrophy and dilation of the pulmonary artery.
Ostium secundum ASD(TOPNOTCH)
1212
Reversal of blood flow through a prolonged (left-to-right shunt) due to pulmonary hypertension, yielding right-sided pressures that exceed those on the left side. This causes unoxygenated blood to go into circulation, causing cyanosis.
Eisenmenger syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 383
1213
These occur at the lowest part of the atrial septum and can extend to the mitral and tricuspid valves. Abnormalities of the AV Valves are usually present, forming a cleft in the anterior leaflet of the mitral valve or septal leaflet of the tricuspid valve.
Ostium primum ASD(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 384
1214
Incomplete closure of the ventricular septum leading to left-to-right shunting. The right ventricle is hypertrophied and often dilated. Diameter of pulmonary artery is increased because of the increased volume by the right ventricle.
Ventricular Septal Defect(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 385
1215
This arises from the left pulmonary artery and joins the aorta just distal to the origin of the left subclavian artery.
Ductus arteriosus(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 385
1216
In this condition, some of the oxygenated blood flowing from the left ventricle is shunted back to the lungs. Proximal pumonary arteries, left atrium and ventricle may become dilated.
Patent ductus arteriosus(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 385
1217
The most common cause of cyanotic congenital heart disease. Heart is large and "boot shaped" as a result of right ventricular hypertrophy.
Tetralogy of Fallot(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 385
1218
Components of Tetralogy of Fallot.
Pulmonary valve stenosisOverriding of aortaRight ventricular hypertrophyVentricular septal defect(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 386
1219
It is a discordant connection of the ventricles to their vascular outflow. The defect is an abnormal formation of the truncal and aortopulmonary septa. Right ventricular hypertrophy becomes prominent, while the left ventricle becomes somewhat atrophic.
Transposition of the Great Arteries(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 386
1220
Predominant manifestation of TGA?
Early cyanosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 387
1221
Characterized by tubular narrowing of the aortic segment between the left subclavian artery and the ductus arteriosus. DA is usually patent and is the main source of blood to the distal aorta. RV is hypertrophied and dilated, pulmonary trunk is also dilated.
Preductal "infantile" coarctation of the aorta(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 387
1222
Aorta is sharply constricted by a ridge of tissue at or just distal to the ligamentum arteriosum. Constricted segment is made of smooth muscle and elastic fibers that are continuous with the aortic media, and lined by thickened intima. Ductus arteriosus is closed. Proximally, the aortic arch and its vessels are dilated, LV is hypertrophic.
Postductal "adult" coarctation of the aorta(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 387
1223
There is upper extremity hypertension, due to poor perfusion of the kidneys, but weak pulses and low blood pressure in the lower extremities. Claudication and coldness of the lower extremities also present. Enlarged intercostal and internal mammary arteries due to collateral circulation, seen as rib "notching" on xray.
Postductal coarctation of the aorta (without a PDA)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388
1224
Left-to-right or Right-to-Left shunt?Atrial septal defect
Left-to-right(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388
1225
Left-to-right or Right-to-Left shunt?TOF
Right-to-Left(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388
1226
Left-to-right or Right-to-Left shunt?VSD
Left-to-right(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388
1227
Left-to-right or Right-to-Left shunt?Eisenmenger syndrome
Right-to-Left (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388
1228
Left-to-right or Right-to-Left shunt?Transposition of great arteries
Right-to-Left(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388
1229
A condition wherein ischemia causes pain but is insufficient to lead to death of myocardium.
Angina pectoris(TOPNOTCH)
1230
A condition wherein ischemia causes pain but is insufficient to lead to death of myocardium.
Angina pectoris(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388
1231
A condition wherein the severity or duration of ischemia is enough to cause cardiac muscle death.
Acute Myocardial Infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388
1232
This refers to progressive cardiac decompensation (heart failure) following myocardial infarction.
Chronic Ischemic Heart Disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388
1233
This can result from a lethal arrythmia following myocardial ischemia.
Sudden Cardiac Death(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388
1234
How many percent should the lumen of a blood vessel be obstructed for it to be symptomatic, in the setting of increased demand?
70-75% (critical stenosis)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 389
1235
How many percent should the lumen of a blood vessel be obstructed for it to be symptomatic at rest?
90%(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 389
1236
Episodic chest pain associated with exertion or some other form of increased myocardial oxygen demand. Pain described as crushing or squeezing substernal sensation which can radiate to left arm. Relieved by rest or vasodilators.
Stable angina(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 390
1237
Increasing frequency of pain, precipitated by progressively less exertion, episodes tend to be more intense and longer lasting.
Unstable angina(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 390
1238
Angina occuring at rest due to coronary artery spasm.
Variant or Prinzmetal angina(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 390
1239
Infarct involving >= 50% of the myocardial wall thickness.
Transmural infarcts(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 391
1240
Most common blood vessel involved in myocardial infarction?
Left anterior descending artery (40-50%)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 392
1241
Electron microscope findings 30 minutes after an ischemic event.
Microfibril relaxation, glycogen loss and mitochondrial swelling(TOPNOTCH)
1242
An infarct can be readily identified by a reddish blue discoloration after how many hours after MI?
12-24 hours(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 393
1243
Coagulation necrosis ensues how many hours after MI?
4-12 hrs after an irreversible injury(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 394
1244
Injury to infarcts mediated in part by oxygen free radicals generated by increased number of infiltrating leukocytes facilitated by reperfusion.
Reperfusion injury(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 394
1245
Cardiac enzymes that become detectable 2-4 hours post-infarct peaks at 48 hours and remains elevated for 7-10 days.
Troponin I and Troponin T(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 395
1246
This cardiac enzyme is detectable in the blood within 2-4 hrs of MI, peaks at 24-48 hrs and returns to normal within approximately 72 hrs.
CKMB(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 395
1247
Myocardial rupture may occur how many days after MI?
3-7 days after infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 397
1248
This occurs within 2-3 days of a transmural infarct and typically resolves within time. It is the epicardial manifestation of the underlying myocardial inflammation.
Pericarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 397
1249
A late complication of MI, most commonly results from a large transmural anteroseptal infarct that heals with formation of a thin scar tissue.
Ventricular aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 397
1250
This type of hypertrophy develops in pressure-overloaded ventricles, with an increase in wall thickness, and reduced cavity diameter.
Concentric hypertrophy(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 399
1251
Type of hypertrophybthat develops in patients with volume overload such as aortic valve insufficiency. Characterized by hypertrophy associated with ventricular dilation.
Eccentric hypertrophy(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 399
1252
In this disease the left ventricle may exceed 2.0cm in thickness and the heart may weigh >500 grams. Microscopically, myocyte diameter increases, associated with irregular nuclear enlargement and hyperchromasia ("box-car nuclei"), and increased interstitial fibrosis.
Sytemic Hypertensive heart disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 399
1253
It is the failure of a valve to open completely, obstructing forward flow.
Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 401
1254
This results from failure of a valve to close completely, thereby allowing reversed flow.
Insufficiency(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 401
1255
The hallmark of this disease is heaped-up calcified masses on the outflow side of the cusps, which protrude intonthe sinuses of Valsalva and mechanically impede valve opening. Cusps may become secondarily fibrosed and thickened.
Calcific aortic stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 401
1256
This is characterized by ballooning or hooding of the mitral leaflets. Affected leaflets are enlarged, redundant, thick and rubbery. The tendinous cords are elongated, thinned and occasionally ruptured. Histologically, there is thinning of the fibrosa layer of the valve, accompanied by expansion of the middle spongiosa layer with increased deposition of mucoid material.
Myxomatous degeneration of the mitral valve(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 402
1257
Patients with this disease may complain of palpitations, dyspnea or atypical chest pain. Auscultation shows a midsystolic click associated with a regurgitant murmur.
Mitral valve prolapse(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 402
1258
Pathognomonic sign for rheumatic fever,consisting of of a cental zone of degenerating, hypereosinophilic ECM infiltrated by lymphocytes, ocassional plasma cells and plump, activated macrophages.
Aschoff bodies(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 402
1259
These cells have abundant cytoplasm and central nuclei with chromatin arrayed in a slender, wavy ribbon (caterpillar cells) which can be found in all three layers of the heart in rheumatic fever. A component of Aschoff bodies.
Anitschkow cells(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 403
1260
Characterized by organization and subsequent scarring, as a sequelae of rheumatic fever. The mitral (or tricuspid) valve is involved, with leaflet thickening, commisural fission and shortening, thickening and fusiong of the chordae tendinae. Fibrous bridging across valvular commisures create "fishmouth" or " buttonhole" deformity.
Chronic Rheumatic Heart Disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 403
1261
Most common valve involved in RHD.
Mitral valve (upto 70% of cases with RHD)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 405
1262
Major components Jones Criteria for RF.
CarditisMigratory polyarthritisSubcutaneous nodulesErythema marginatumSyndenham chorea(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 406
1263
Minor components Jones criteria for RF
FeverArthralgiaElevated acute phase reactants (e.g. CRP)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 406
1264
How many major and/or minor manifestations are needed to diagnose RF?
Remember: 20122 major 0 minor or1 major 2 minor(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 406
1265
Endocarditis of previously normal valves, the most common causative agent is S. aureus.
Acute bacterial endocarditis(TOPNOTCH)
1266
Serious infection characterized by microbial invasion of heart valves or mural endocardium, often with destruction of the underlying cardiac tissues. The heart valves are friable, bulky and potentially destructive.
Infective endocarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 406
1267
Endocarditis affecting previously damaged or abnormal valves, commonly caused by viridans Streptococci.
Subacute bacterial endocarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 406
1268
Most consistent sign of infective endocarditis.
Fever(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 407
1269
Characterized by deposition of sterile, non-inflammatory, nondestructive and small (1mm) masses of fibrin, platelets and other blood components on cardiac valves, along the line of closure of leaflets or cusps.
Nonbacterial thrombotic endocarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 407
1270
Sterile vegetations thatvcan develop on the valves of patients with SLE. These are small, granular, pinkish vegetations 1-4mm in diameter and can be located on the undersurface of AV valves, on the cords or endocardium.
Libman-Sacks endocarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 408
1271
The lesions of this disease are distinctive, glistening white intimal plaquelike thickenings on the endocardial surfaces of the cardiac chambers and valve leaflets seen in patients with carcinoid tumors. The lesions are composed of muscle cells and sparse collagen fibers embedded in an acid mucopolysaccharide-rich matrix.
Carcinoid heart disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 408
1272
Cardiomyopathy which is characterized by progressive cardiac dilation and contractile dysfunction. The heart is characteristically enlarged and flabby, with dilation of all chambers,the ventricular thickness may be less than, equal to or greater than normal.
Dilated cardiomyopathy(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 411
1273
Alcohol intake and infection with coxsackie B virus are some of the causes of this cardiomyopathy.
Dilated cardiomyopathy(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 411
1274
Characterized by myocardial hypertrophy, abnormal diastolic filling and ventricular outflow obstruction. The heart is thick-walled, heavy and hypercontracting. There is an assymetrical septal hypertrophy described as "banana-like". Histologically, there is severe myocyte hypertrophy and disarray with interstitial fibrosis.
Hypertrophic cardiomyopathy(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 412
1275
Mechanism of heart failure in hypertrophic cardiomyopathy.
Diastolic dysfunction (impaired compliance)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 412
1276
A common cause of sudden death in young athlethes.
Hypertrophic cardiomyopathy(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 412
1277
The ventricles are of approximately normal size or slightly enlarged, the cavities not dilated, and the myocardium is firm. Biatrial dilation is common. Microscopically, there is interstitial fibrosis, varying from minimal to patchy to extensive and diffuse.
Restrictive cardiomyopathy(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 413
1278
Mechanism of heart failure in restrictive cardiomyopathy.
Diastolic dysfunction or impaired compliance(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 413
1279
Inflammation of the myocardium.
Myocarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 414
1280
Most common type of myocarditis wherein lymphocytes infiltrate the interstitium. This may resolve or heal by progressive fibrosis.
Lymphocytic myocarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 414
1281
Myocarditis that has interstitial and perivascular infiltrates composed of lymphocytes, macrophages and a high proportion of eosinophils.
Hypersensitivity myocarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 414
1282
Myocarditis characterized by widespread inflammatory infiltrates containing multinucleated giant cells interspresed with lymphocytes, eosinophils and plasma cells. Poor prognosis.
Giant-cell myocarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 414
1283
Myocarditis distinctive by virtue of parasitization of scattered myofibers by trypanosomes accompanied by an inflammatory infiltrate of neutrophils, lymphocytes, macrophages and occasional eosinophils.
Chagas myocarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 414
1284
Viruses which account for most cases of myocarditis.
Coxsackie A and B(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 414
1285
Type of pericarditis found in patients with uremia or viral infection. The exudate imparts an irregular apperance to the pericardial surface (bread and butter pericarditis).
Fibrinous pericarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 416
1286
Bacterial pericarditis manifests with this type of exudate.
Fibrinopurulent (suppurative)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 416
1287
Heart is completely encased by dense fibrosis that it cannot expand normally during diastole.
Constrictive pericarditis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 416
1288
Normal amount of pericardial fluid in pericardial sac.
30 - 50 mL of thin, straw-colored fluid(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 417
1289
Serous pericardial effusion can be caused by _________
CHF, hypoalbuminemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 417
1290
Chylous pericardial fluid can be caused by _______
Mediastinal lymphatic obstruction(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 417
1291
Rapidly developing collections of fluid within the pericardial sac can restrict diastolic cardiac filling producing this fatal sequelae.
Cardiac tamponade(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 417
1292
The most common tumor of the heart.
Metastatic tumor(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 417
1293
Most common primary tumor of the adult heart.
Myxoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 417
1294
Major clinical manifestations of this cardiac tumor are due to valvular "ball-valve" obstruction, embolization or a syndrome of constitutional symptoms.
Myxoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 418
1295
The most frequent primary tumor of the heart in infants and children. These are generally small gray-white myocardial masses composed of a mixed population of cells, the most characteristic of which are large, rounded or polygonal cells containing numerous glycogen-laden vacuoles separated by strands of cytoplasm, so-called spider cells.
Rhabdomyomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 418
1296
Serosanguinous pericardial effusion can be caused by ________
Blunt chest trauma, malignancy, ruptured MI, aortic dissection(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 418
1297
The most severe pulmonary changes in congestive heart failure
Accumulation of edema fluid in the alveolar spaces (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 529
1298
Morphologic finding/telltale signs of previous episodes of pulmonary edema
Hemosiderin-laden macrophages (Heart failure cells) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 529
1299
Most common underlying etiology of diastolic failure
Hypertension (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 529
1300
Group of congenital heart disease characterized by increase pulmonary blood flow but are not initially associated with cyanosis
Left-to-right shunts (ASD, VSD, PDA) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 533
1301
Most common genetic cause of congenital heart disease
Trisomy 21 (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 533
1302
A 24 y/o female complained of shortness of breath and orthopnea lasting several days. The patient reported having diagnosed since childhood as having "hole in the heart." Physical exam revealed holosystolic murmur most audible in the left parasternal area accompanied by thrill. Rales were heared in the bilateral lower lung field. The most likely cause of her condition:
VSD (TOPNOTCH)
1303
Most common cause of myocardial ischemia
Obstructive atherosclerotic lesions in the epicardial coronary arteries (TOPNOTCH) Robbins Basic Patholgoy, 9th ed., p. 538
1304
The cause of sudden cardiac death in myocardial infarction
Ventricular arrythmia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 539
1305
Irreversible cell injury in MI occur in how many minutes?
20-40 minutes (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 541
1306
Irreversible injury of ischemic myocytes in MI occurs first in what zone in the heart?
Subendocardial zone (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 541
1307
What blood vessel supply the posterior third of the ventricular septum in majority of the individuals?
Right coronary artery (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 541
1308
Pattern of infarction caused by occlusion of an epicardial vessel
Transmural infarction (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 543
1309
Pattern of infarction caused by plaque disruption or hypotension, causing circumferential myocardial damage
Subendocardial infarction (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 543
1310
Pattern of infarct also referred to as an "ST elevation myocardial infarct"
Transmural infarction (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 543
1311
Pattern of infarct also referred to as a "non-ST elevation infarct"
Subendocardial infarction (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 543
1312
The typical changes of coagulative necrosis becomes detectable in how many hours of injury?
First 6-12 hours(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 545
1313
Microscopic findings in irreversibly injured myocytes characterized by intensely eosinophilic intracellular stripes composed of closely packed sarcomeres.
Contraction bands(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 546
1314
A 62 y/o obese male had sudden onset of heaviness in the chest, associated with diaphoresis and dyspnea which started 3 hours prior to consult at the ER. The biomarkers that are most sensitive and specific of myocardial damage that you will request:
Troponins I and T (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 547
1315
A 72 y/o female experienced chest pain and hypotension. A posterior transmural infarct was suspected. Most common complications in this type of infarct
Conduction blocks, right ventricular involvement, or both (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 549
1316
Free wall rupture, expansion, mural thrombi, and aneurysm are common in what type/location of infarct?
Anterior transmural infarct(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 549
1317
Most common cause of rhythm disorder
Ischemic injury(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 550
1318
A 24 y/o female presents with history of recurrent fever and joint pains accompanied by ECG changes and increased ASO titer in the past 2 years. Physical examination reveals cardiac murmur. What is the clinical impression?
Rheumatic heart disease (TOPNOTCH)
1319
Characteristic anatomic change in MVP
Interchordal ballooning of mitral leaflets (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 556
1320
Most frequent mechanism of SCD
Lethal arrythmia (asystole, ventricular fibrillation) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 552
1321
Earliest microscopic change in systemic hypertensive heart disease
increase in transverse diameter of myocytes (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 552
1322
Most common type of VSD
Membranous (Interventricular septum) VSD(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 535
1323
The common feature of pulmonary thromboembolism, obstructive sleep apnea, altitude disease, and parenchymal lung disease
Pulmonary hypertension. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 530
1324
A 5 wk old infant presents with tachypnea, diaphoresis, and difficulty feeding. A harsh, continuous, machinery-like murmur was noted upon auscultation. What is the most likely diagnosis?
Patent ductus arteriosus(TOPNOTCH)
1325
Presents with hypertension in the upper extremities, and manifestations of arterial insufficiency such as claudication and coldness. Produce a radiographical visible erosion (notching) of the undersurfaces of the ribs.
Coarctation of the aorta (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 537
1326
Major cause of infective endocarditis among intravenous drug abusers
Staphylococcus aureus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 559
1327
Most common cause of endocarditis of native but previously damaged or otherwise abnormal valves
Streptococcus viridans (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 559
1328
Predominant manifestations of RF
Carditis and arthritis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 559
1329
Classic hallmark of Infective endocarditis
Vegetations on heart valves(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 559
1330
A 72 year old hypertensive female last seen apparently well 3 days ago, is found dead in her bathroom with rigor mortis and no signs of foul play. At autopsy, her heart showed left ventricular hypertrophy and a pale tan area at the anteroseptal wall. There are no thrombi in the heart chambers. The valves are unremarkable. Microscopic examination of the pale area showed well-established granulation tissue with new blood vessels and collagen deposition. Neutrophils are rare. She died of (A) an MI that occured 1 hour prior to demise (B) an MI 12 hours prior to demise (C) an MI 2 days prior to demise (D) something else entirely
something else entirely (evolution of morphologic changes in myocardial infarction) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P 393
1331
In hypertensive heart disease, there is concentric thickening of the left ventricular wall. A concomitant left atrial dilatation may also be seen due to (A) volume overload from a ventricle with narrowed lumen (B) pressure overload from a ventricle with narrowed lumen (C) cytokines secreted by hypertrophic ventricular myocytes cause atrophy of atrial myocytes (D) cytokines secreted by hypertrophic ventricular myocytes cause metaplasia of atrial myocytes
volume overload from a ventricle with narrowed lumen (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P 399
1332
What feature in a stenotic aortic valve suggests rheumatic valvular disease, rather than calcific aortic stenosis? (A) bicuspid valve (B) masses of calcium on the outflow side of cusps (C) fibrotic cusps (D) fusion of the commmissures
fusion of the commisures (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P402
1333
A 20 year old asymptomatic female is found to have a midsystolic click on her preemployment physical examination. A 2D echo showed mitral valve prolapse. The involved leaflet would show (A) numerous fibroblasts with and dense collagen deposition (B) thinning of the fibrosa layer and myxoid expansion of the spongiosa layer (C) deposition of amorphous material that shows apple-green birefringence when stained with Congo red (D) fibrous stroma with gland-like structures secreting mucin
thinning of fibrosa layer and myxoid espansion of the spongiosa layer (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P402
1334
A 5 year old male who had a sore throat 3 weeks ago develops fever and joint pains. Auscultation revealed a friction rub, and ASO titers are increased. Which of the following is expected in the patient? (A) friable vegetations on the mitral valve containing fibrin, neutrophils and gram-positive cocci (B) small vegetations on the mitral valve with abundant eosinophils (C) myocardium with circumscribed aggregates of mononuclear cells and macrophages with prominent nucleoli (D) myocardium with poorly-circumsccribed aggregates of multinucleated giant cells
myocardium with circumscribed aggregates of mononuclear cells and macrophages with prominent nucleoli (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P 403-404
1335
A 19 year old football player dies suddenly during one training session. At autopsy, his heart showed myocardial hypertrophy with disproportionate thickening of the septum, and a narrowed left ventricular lumen. Microscopic examination showed myocyte hypertrophy, myofiber disarray, and interestitial fibrosis. These findings are due to (A) a mutation in one of his genes encoding sarcomeric proteins (B) a silent Coxsackie virus B infection (C) an undisclosed 3 year history of alcohol intake (D) anabolic steroids he has been taking for 6 months
a mutation in one of his genes encoding sarcomeric proteins (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P. 412-413
1336
A 34 year old female on routine checkup is found to have a diastolic murmur. 2D echo showed a pedunculated 3 cm mass in her left atrium attached to the atrial septum. She has no other known masses on workup. She undergoes heart surgery where the atrial mass is resected. Which of the following is its most likely histology? (A) stellate cells admixed with endothelial and fibroblastic cells embedded in an abundant extracellular matrix (B) sheets of large polygonal cells containing glycogen-containing vacuoles arranged around a central nucleus (C) fascicles of fibroblasts and interspersed collagen bundles (D) sheets of pleomorphic cells lining vascular spaces, some with intracytoplasmic lumens, with atypical mitoses and areas of necrosis
stellate cells admixed with endothelial and fibroblastic cells embedded in an abundant extracellular matrix (TOPNOTCH) Robbins Basic Pathology, 8th ed. Pp 417-418
1337
Average volume per cell, expressed in femtoliters.
Mean cell volume (MCV)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 423
1338
A reduction in the oxygen-transporting capacity of blood.
Anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 422
1339
The average content of hemoglobin per red cell, expressed in picograms.
Mean cell hemoglobin (MCH)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 423
1340
The average concentration of hemoglobin in a given volume of packed red cells, expressed in g/dL.
Mean cell hemoglobin concentration (MCHC)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 423
1341
The coefficient of variation of red cell volume.
Red cell distribution width (RDW)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 423
1342
Anemia of acute blood loss is described as ______.
Normocytic, normochromic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 423
1343
Life span of a normal red cell.
120 days(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 424
1344
Anemia characterized by an increased rate of cell destruction, a compensatory increase in erythropoeisis that results in reticulocytosis, and retention of products of cell destruction, including iron.
Hemolytic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 424
1345
A circulating protein that binds and clears free hemoglobin.
Haptoglobin(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 424
1346
Hemolysis that can result from mechanical trauma, or biochemical or physical agents that damage the red cell membrane.
Intravascular hemolysis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 424
1347
Hemolysis which takes place largely within phagocytic cells of the spleen and liver.
Extravascular hemolysis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 424
1348
This disorder is characterized by an intrinsic defect in the red cell membrane, that renders the cells spheroidal, less defomable and vulnerable to splenic sequestration and destruction.
Hereditary spherocytosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 424
1349
Small, dark nuclear remnants seen within red cells in PBS of hereditary spherocytosis.
Howell-Jolly bodies(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 425
1350
On PBS, red cells are spherical which lack central pallor, and they show increased osmotic fragility when placed in hypotonic salt solutions.
Hereditary spherocytosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 425
1351
Structural proteins that are defective in hereditary spherocytosis.
Spectrin and ankyrin(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 425
1352
This results from substitution of valine for glutamic acid at the 6th position of the B-chain, producing HbS.
Sickle cell anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 426
1353
Bizarre, elongated, spindled or boat-shaped cells on PBS.
Sickle cell anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 427
1354
Prominent cheekbones and changes in skull resembling a "crew-cut" skull x-ray.
Sickle cell anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 427
1355
Patients with sickle cell disease are predisposed to infections caused by these type of bacteria.
Encapsulated bacteria(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 428
1356
Treatment for sickle cell disease by increasing levels of HbF.
Hydroxyurea(TOPNOTCH)
1357
Treatment for sickle cell disease by increasing levels of HbF.
Hydroxyurea(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 428
1358
Feared complication of sickle cell disease which can be trigerred by pulmonary infections or fat emboli from necrotic marrow that secondarily involve the lung.
Acute chest syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 428
1359
Major complication of sickle cell disease which occurs in the setting of acute chest syndrome, causing ischemic injury to the CNS.
CNS stroke(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 428
1360
Represents a sudden but usually temporary cessation of erythropoeisis, usually trigerred by parvovirus B19 infections in patients with sickle cell disease.
Aplastic crises(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 428
1361
In beta thalassemia, an individual who inherits one abnormal allele (out of 2) has this asymptomatic to mildly symptomatic condition.
B- Thalassemia minor/trait(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 429
1362
Individuals with B-thalassemia who inherit two abnormal alleles, with severe anemia requiring regular blood tranfusions.
B- Thalassemia major(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 429
1363
Red cells with a central, dark-red puddle due to collection of hemoglobin.
Target cells(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 430
1364
Target cells are often seen in this condition.
B-thalassemia minor(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 430
1365
In the PBS of this condition, nucleated red cells (normoblasts) are seen, which reflect underlying erythropoeisis.
B-thalassemia major(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 430
1366
Anemia of beta thalassemia.
Microcytic, hypochromic(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 430
1367
Disease caused by deletion of 3 alpha globin genes.
Hemoglobin H disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 431
1368
Condition caused by deletion of 1 alpha globin gene.
Silent carrier(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 431
1369
Condition caused by deletion of 2 alpha globin genes.
Alpha thalassemia trait(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 431
1370
Condition caused by deletion of all four alpha globin genes.
Hydrops fetalis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 429
1371
Precipitates of denatured globin seen in RBC's.
Heinz bodies(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 432
1372
Heinz bodies are seen in the blood smear of this condition.
G6PD Deficiency(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 432
1373
Bite cells are seen in ________.
G6PD Deficiency(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 432
1374
A rare disorder of unknown etiology, causes hemolytic anemia which results from an acquired membrane defect secondary to a mutation that affects myeloid stem cells. Hemolysis occurs during sleep.
Paroxysmal nocturnal hemoglobinuria(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 432
1375
Hemolysis caused by IgG or IgA antiodies that are active at 37 degC, which results in opsonization of red cells by the autoantibodies.
Warm antibody immunohemolytic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 433
1376
Anemia caused by low-affinity IgM which bind to red cell membranes only at temp
Cold antibody immunohemolytic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 433
1377
Anemia observed in a variety of pathologic states, in which small vessels become particularly obstructed.(e.g. DIC, malignant HTN, SLE, etc.)
Microangiopathic hemolytic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 433
1378
Schistiocytes, burr cells, helmet cells, triangle cells are seen in this condition.
Microangiopathic hemolytic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 433
1379
X-linked disorder in which red cells are unusually susceptible to damage cause by oxidants.
G6PD Deficiency(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 432
1380
Red blood cells in iron deficiency anemia.
Microcytic, hypochromic(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 436
1381
Diagnostic criteria for iron deficiency anemia:____ Ferritin____Serum iron level____Transferrin saturation____Total Iron Binding Capacity (TIBC)
Low ferritinLow serum iron levelsLow transferrin saturationIncreased TIBC(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 435
1382
Diagnostic criteria for anemia of chronic disease:____ Ferritin____Serum iron level____Transferrin saturation____Total Iron Binding Capacity (TIBC)
Increased ferritinLow serum iron levelsLow transferrin saturationDecreased TIBCNormocytic, normochromic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 435
1383
Principal causes of megaloblastic anemia.
Folate deficiencyVitamin B12 deficiency(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 437
1384
Bone marrow is markedly hypercellular as a result of increased number of megaloblasts, which are large cells that have delicate, finely reticulated nuclear chromatin and abundant basophilic cytoplasm.
Megaloblastic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 437
1385
PBS finding in neutrophils and red cells of patients with megaloblastic anemia.
Hypersegmented neutrophils, large, egg-shaped macro-ovalocytes(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 437
1386
Difference between megaloblastic and pernicious anemia.
Presence of neurologic abnormalities in pernicious anemia.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 438
1387
Deficiency in folate causes this type of anemia.
Megaloblastic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 438
1388
Deficiency in Vitamin B12 causes this type of anemia.
Pernicious anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 438
1389
Etiology of pernicious anemia.
1.Vitamin B12 malabsorption secondary to autoantibodies against parietal cells and intrinsic factor which is needed in its absorption.2. Gastrectomy or ileal resection(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 438
1390
Principal neurologic lesion in pernicious anemia.
Demyelination of posterior and lateral columns of the spinal cord.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 439
1391
Bone marrow is markedly hypocellular, with >90% of the intertrabecular space being occupied by fat.
Aplastic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 439
1392
Tear drop cells are also called __________.
Dacrocytes(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 440
1393
Dacrocytes are found in peripheral blood of patients with this type of anemia.
Myelophthisic anemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 440
1394
Increase in blood concentration of red cells, with an increase in Hgb concentration.
Polycythemia or erythrocytosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 441
1395
Polycythemia secondary to reduced plasma volume.
Relative polycythemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 441
1396
Polycythemia secondary to abnormal proliferation of myeloid stem cells and low erythropoeitin levels.
Primary polycythemia (Absolute)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 441
1397
Polycythemia secondary to increased erythropoeitin levels due to lung disease, high-altitude living, cyanotic heart disease and EPO secreting tumors.
Secondary polycythemia (Absolute)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 441
1398
Total white cell count is reduced to 1000 cells/uL. Affected persons are extremely susceptible to bacterial and fungal infections.
Neutropenia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 441
1399
A self-limited disease of adolescents and young adults that is causd by B lymphocytotropic EBV characterized by fever, sore throat and generalized lymphadenitis, an increase of atypical lymphocytes in blood and an antibody and T cell response to EBV.
Infectious mononucleosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 442
1400
Cells with abundant cytoplasm 12-16um in diameter that contains azurophilic granules, and an oval, indented or folded nucleus.
Atypical lymphocytes (Infectious mononucleosis)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 442
1401
Inflamed nodes are swollen, gray-red and engorged. There are large germinal centers containing numerous mitotic figures. Affected nodes are tender and fluctuant if with extensive abscess formation.
Acute nonspecific lymphadenitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 444
1402
This pattern is associated with infections or inflammatory processes that activate B cells which create a follicular or germinal center reaction. Lymph node architecture is preserved, lymphoid nodules vary in shape and size, mixed lymphocytic infiltrates with prominent phagocytic and mitotic activity within germinal centers.
Follicular hyperplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 444
1403
Reactive pattern characterized by distention and prominence of the lymphatic sinusoids, due to marked hypertrophy of lining endothelial cells and an infiltrate of histiocytes. Encountered in lymph nodes draining cancers.
Sinus histiocytosis(TOPNOTCH)
1404
Characterized by reactive changes within T-cell regions of the lymph node, usually encountered during viral infections, following certain vaccinations, and immune reactions induced by certain drugs.
Paracortical hyperplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 444
1405
Formation of sarcoid-like ganulomas that undergo central necrosis associated with neutrophil accumulation. This irregular stellate necrotizing granuloma is seen in patients presenting with a raised inflammatory node, vesicle or eschar at site of injury. History of exposure to cats.
Cat scratch disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 444
1406
Causative agent for cat scratch disease(TOPNOTCH)
Bartonella henselae(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 444
1407
Lymphoblasts with irregular nuclear contours, condensed chromatin , small nucleoli and scant agranular cytoplasm. Blasts compose >25% of marrow cellularity. Most common childhood leukemia.
Acute lymphocytic leukemia (ALL)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 447
1408
Frequent small "cleaved" cells mixed with large cells, growth pattern nodular, centroblasts present. Occurs in older adults, usually involves nodes, marrow, spleen. Associated with t(14;18).
Follicular lymphoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 451
1409
Small to intermediate-sized irregular lymphocytes growing in a diffuse pattern, no centroblasts and proliferation centers. Occurs mainly in older males, GI tract commonly affected. Associated with t(11;14).
Mantle cell lymphoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 452
1410
Plasma cells in sheets, with prominent nucleoli or inclusion containing Ig. Presents as disseminated bone disease, with destructive lytic lesions.
Plasmacytoma / plasma cell myeloma(TOPNOTCH)
1411
Intermediate-sized round lymphoid cells with 2-5 prominent nucleoli. Nuclear remnants phagocytosed by interspersed macrophages with abundant clear cytoplasm, "starry sky pattern"
Burkitt lymphoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 453
1412
Sheets of small, round lymphocytes and scattered ill-defined foci of larger, actively dividing cells diffusely efface involved LN. A foci of mitotically active cells called proliferation centers are pathognomonic.
Small lymphocytic leukemia (SLL) / Chronic lymphocytic leukemia (CLL)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 450
1413
Fragile neoplastic lymphocytes that are frequently disrupted during smear preparation.
Smudge cells(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 450
1414
Smudge cells are seen in this type of leukemia.
CLL(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 450
1415
Tumor cells have large nuclei with open chromatin and prominent nucleoli. Most important type of lymphoma in adults, accounting to ~50% of adult NHL.
Diffuse large B-cell lymphoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 452
1416
Multifocal destructive bone lesions seen as punched-out defects in bone radiographs.
Multiple myeloma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 455
1417
Excess light or heavy chains along with complete Igs synthesized by neoplastic plasma cells.
Bence-Jones proteins(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 454
1418
Cells with two mirror-image nuclei or nuclear lobes, each containing a large acidophilic nucleolus surrounded by a distinctive clear zone, imparting an owl-like appearance.
Reed-Sternberg cell(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 456
1419
A distinctive groups of neoplasms that arise almost invariably in a single lymph node or chain of lymph nodes and spread characteristically in a stepwise fashion to anatomically contiguous nodes.
Hodgkin Lymphoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 456
1420
Most common form of Hodgkin lymphoma, characterized by a large cell which has a single multilobate nucleus with small nucleoli and an abundant pale-staining cytoplasm called lacunar cells.
Nodular sclerosis HL(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 457
1421
Most common form of HL in patients greater than 50 years old, with male predominance, plentiful RS cells and heterogenous cellular infiltrates.
Mixed cellularity HL(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 458
1422
Cells found in adult T-cell lymphoma which appear to have multilobulated nuclei.
Cloverleaf or flower cell(TOPNOTCH)
1423
Subgroup of HL characterized by a large number of small resting lymphocytes admixed with a variable number of benign histiocytes. Variant RS cells described as multilobed, puffy nucleus Which appears like a "popcorn". Excellent prognosis.
Lymphocyte-predominance HL(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 458
1424
Cells with fiery red cytoplasm, seen in Multiple myeloma
Flame cells(TOPNOTCH)
1425
Cells with pink globular cytoplasmic inclusions, seen in Multiple myeloma
Russell bodies(TOPNOTCH)
1426
Cells with blue globular nuclear inclusions, seen in Multiple myeloma
Dutcher bodies(TOPNOTCH)
1427
Multiple nuclei, prominent nucleoli, and cytoplasmic droplets containing Ig.
Bizarre, multinucleated cells(TOPNOTCH)
1428
Bizarre multinucleated cells, flame cells, Russel bodies and Dutcher bodies are all seen in what disease?
Multiple myeloma(TOPNOTCH)
1429
Bone marrow aspirate shows hypercellular martow packed with myeloblasts and azurophilic needle-like material called Auer rods.
Acute Myelogenous Leukemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 462
1430
Leukemia of children most responsive to chemotherapy.
Acute Lymphoblastic Leukemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 461
1431
Hodgkin lymphoma subgroup most commonly associated with EBV infection.
Lymphocyte depleted(TOPNOTCH)
1432
Mature B-cell tumor in the elderly, where cells have fine hair-like projections (hairy cells).
Hairy cell leukemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 459
1433
t(9;22) is also called ______.
Philadelphia chromosome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 465
1434
Hodgkin lymphoma subgroup with highest count of RS cells.
Mixed cellularity type(TOPNOTCH)
1435
This correlates with good prognosis in Hodgkin lymphoma.
High Lymphocyte : Reed-Sternberg cell ratio(TOPNOTCH)
1436
Hodgin lymphoma subgroup not associated with EBV.
Nodular sclerosis and lymphocyte predominant(TOPNOTCH)
1437
Hodgkin lymphoma subgroup with poorest prognosis.
Lymphocyte depleted HL(TOPNOTCH)
1438
Tumor of the thymus associated with myastheni gravis and pure red cell aplasia.
Thymoma(TOPNOTCH)
1439
Pentalaminar tubules, often with a dilated terminal end (tennis racket-like appearance).
Birbeck granules(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 467
1440
Proliferative disorder of the dendritic cells which has birbeck granules.
Langerhans Cell Histiocytosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 467
1441
Pathology behind polycythemia vera.
Mutation in tyrosine kinase JAK2, which acts in signalling pathways of the erythropoeitin receptors, rendering them hypersensitive to erythropoeitin.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 466
1442
Treatment for polycythemia vera.
Phlebotomy(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 466
1443
Collection of aggressive tumors that are comprised of immature myeloblasts which replace the marrow and suppress normal hematopoiesis.
Acute Myelogenous Leukemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 467
1444
Myeloid tumor arising from a pluripotent stem cell associated with mutatios of the BCR-ABL gene. If untreated, may progress to a blast crisis.
Chronic Myelogenous Leukemia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 467
1445
Most common myelodysplastic syndrome. A myeloid tumor in which abnormal megakaryocytes stimulate marrow fibroblasts to release collagen, replacing the marrow space, leading to pancytopenia and extramedullary hematopoeisis.
Myeloid metaplasia with Myelofibrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 467
1446
Other name for acute disseminated Langerhans cell histiocytosis.
Letterer-Siwe disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 468
1447
Caused by a systemic activation of coagulation pathways, leading to formation of thrombi throughout the microcirculation.
Disseminated intravascular coagulation(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 469
1448
Characterized by spontaneous bleeding, prolonged bleeding time, and normal PT and PTT.
Thrombocytopenia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 471
1449
Drug-induced disorder caused by IgG antibodies that bind to platelet factor IV on platelet surfaces, which activates platelets and induce their aggregation.
Heparin-Induced Thrombocytopenia (HIT)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 472
1450
Associated with pentad of fever, thrombocytopenia, microangipathic hemolytic anemia, transient neurologic deficits and renal failure.
Thrombotic thrombocytic purpura(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 472
1451
Associated with childhood onset microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. No neurologic symptoms.
Hemolytic uremic syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 472
1452
Caused by antiplatelet antibodies directed against glycoproteins IIb-IIIa, Ib-IX.
Immune thrombocytopenic purpura(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 472
1453
Decreased gp Ib leads to defective platelet adhesion, associated with decreased platelet count.
Bernard-Soulier Syndrome(TOPNOTCH)
1454
Caused by deficiency of ADAMTS13, a vWF metalloprotease.
Thrombotic thrombocytopenic purpura(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 472
1455
Caused by shiga-like toxin in EHEC (E. coli O157:H7) from improperly cooked burgers.
Hemolytic uremic syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 472
1456
Decreased gp IIb-IIIa leads to defective platelet aggregation, associated with normal platelet count.
Glanzmann thrombasthenia(TOPNOTCH)
1457
Most common bleeding disorder.
vWF disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 474
1458
Most common hereditary disease associated with life threatening bleeding,
Hemophilia A(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 474
1459
An X-linked recessive disorder caused by reduction in factor VII activity.
Classic Hemophilia/ Hemophilia A(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 474
1460
An X-linked disorder caused by deficiency of Factor IX, or Christmas factor. Bleeding time is normal, PTT is prolonged.
Hemophilia B/ Christmas Disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 474
1461
A state associated with excessive removal of formed elements of blood, resulting in anemia, leukopenia or thrombocytopenia.
Hypersplenism(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 476
1462
A 17 y/o male presented with a short history of fever, tonsillitis and monolateral enlarged cervical lymph nodes. PE revealed enlargement of righ cervical lymph node, 3 cm in diameter hard , and pharyngeal hyperemia. Biopsy was done and showed a malignant population of round monomorphic B cells interspersed with macrophages forming the start in the "starry sky" pattern. This is a case of:
Burkitt lymphoma (TOPNOTCH)
1463
An 18 y/o male presents with easy fatigability, fever, and cutaneous bleeding. Bone marrow biopsy showed 40% myeloblasts. What is the most likely diagnosis?
AML (TOPNOTCH)
1464
The most common cause of agranulocytosis
Drug toxicity (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th ed., p. 582
1465
What laboratory finding differentiate leukemoid reaction from CML?
Elevated leukocyte alkaline phosphatase. (TOPNOTCH)
1466
An 8 month old presented with anemia. Red cells were noted to be oval and macrocytic. Nutritional history revealed that the infant was exclusively fed raw goat's milk. The most likely cause of his anemia is:
Folate deficiency (TOPNOTCH)
1467
A 2 y/o child arrived at well-child clinic. Mother reported that her child is exclusively breastfed for 6 months and then supplemented mainly by carrots. The patient is most likely prone to developing anemia caused by:
Vitamin B12 deficiency (TOPNOTCH)
1468
Most common type of cancer in children; highly aggressive tumors manifest with signs and symptoms of bone marrow failure, or as rapidly growing masses
Acute lymphoblastic leukemia/Lymphoblastic lymphoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 598
1469
Most common leukemia of adults which usually presents with bone marrow and lymph node involvement.
Small lymphocytic lymphoma/CLL(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 598
1470
Most common leukemia of adults which usually presents with bone marrow and lymph node involvement.
Follicular lymphoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 598
1471
Most common lymphoma of adults
Diffuse Large B-Cell Lymphoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 598
1472
Very aggressive tumor of mature B cells that usually arise at extranodal sites; strongly associated with translocations involving MYC proto-oncogene
Burkitt Lymphoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 598
1473
Plasma cell neoplasm commonly associated with lytic bone lesions, pathologic fractures, chronic pain, hypercalcemia, renal failure, and acquired immune abnormalities.
Multiple Myeloma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 599
1474
Major pathologic feature of multiple myeloma
Bone destruction mediated by neoplastic plasma cells(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 599
1475
True or False. Cellular immunity is relatively unaffected in Multiple myeloma
True(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 600
1476
Single most important factor in the pathogenesis of renal failure in Multiple myeloma
Bence-Jones proteinuria(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 600
1477
True or False. Age younger 2 years is associated with a worse prognosis in ALL.
True(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 592
1478
Abrupt stormy onset, symptoms of depressed marrow function, and mass effects by neoplastic infiltration , including bone pain are more common in ALL or AML?
ALL (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 592
1479
The leading cause of cancer deaths in children
ALL (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 592
1480
This lymphoma often presents a mass involving the mandible and shows an unusual predilection for involvement of abdominal viscera, particularly the kidneys, ovaries, and adrenal glands.
Endemic Burkitt lymphoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 597
1481
A 40 y/o male presented with unexplained weight loss, fever, and night sweats. Chest radiograph showed a mediastinal mass. Histologic findings showed large cells with multiple nuclei with large inclusion-like nucleolus. What is the most likely diagnosis?
Hodgkin Lymphoma (Presence of Reed-Sternberg cells) (TOPNOTCH)
1482
A 52 y/o female presents with dragging sensation in the abdomen associated with anemia, weakness, and weight loss. Chromosomal analysis showed presence of BCR-ABL fusion gene. What is the most likely diagnosis?
CML (TOPNOTCH)
1483
Presence of anemia, hemoglobinemia, hemoglobinuria, hemosiderinuria, and jaundice are manifestations of intravascular or extravascular hemolysis?
Intravascular hemolysis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 631
1484
Patient presents with anemia, splenomegaly, and jaundice. Peripheral blood smear shows small, dark-staining red cells lacking the central zone of pallor. Father had prolonged jaundice since childhood. What is the most likely diagnosis?
Hereditary spherocytosis(TOPNOTCH)
1485
A 5 y/o male presented with malaise and low grade fever for 10 days. He was diagnosed with toxoplasmosis and was given pyrimethamine and sulfadiazine. Three days after, patient presented with jaundice and dark urine. PBS showed Heinz bodies and bite cells. What is the most likely diagnosis?
G6PD Deficiency(TOPNOTCH)
1486
Hemolysis and vaso-occlusive crisis are common in this form of anemia caused by mutaion of glutamic acid to valine.
Sickle-cell anemia(TOPNOTCH)
1487
The most common trigger for episodic hemolysis in G6PD Deficiency
Infection(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 634
1488
A 19 y/o African-American male presented with severe pain in the chest and extremities, splenomegaly, and anemia. PBS showed reticulocytosis, presence of target cells, and sickled cells. Three days prior , patient developed cough and fever. For the past 3 years, patient had suffered from recurrent pains and jaundice. What is the pathophysiologic mechanism responsible for the most serious clinical features of this disease?
Microvascular occlusion (in Sickle cell disease) (TOPNOTCH)
1489
Leading cause of disease-related death in individuals with PNH
Thrombosis(TOPNOTCH) Robbins Basic Pathology, 9th ed. P. 642
1490
The immediate cause of megaloblastosis, and a common denominator of folic acid and vitamin B12 deficiency
Suppressed synthesis of DNA (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 648
1491
Most common nutritional disorder in the world
Iron Deficiency Anemia(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 649
1492
An 18 y/o female complained of generalized weakness, lethargy, and light headedness. She revealed she was having excessive bleeding during menstruation from the previous 6 months. Upon examining, she was noted to have pallor, tachycardia, and swollen tongue. Most likely morphology of RBC:
Microcytic, hypochromic anemia (Case of IDA) (TOPNOTCH)
1493
Presents signs and symptoms of anemia, thrombocytopenia, and neutropenia. Splenomegaly is characteristically absent. And the red cell are usually macrocytic and normochromic. (+) Reticulocytopenia. Bone marrow is hypocellular. What is the condition described?
Aplastic anemia(TOPNOTCH)Robbins Basic Pathology, 9th ed. p. 654
1494
Virus implicated in acute red cell aplasia
Parvovirus B19 (TOPNOTCH)) Robbins Basic Pathology, 9th ed., p. 655
1495
Most feared complication of thrombocytopenia
Intracranial bleeding (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 657
1496
Most common presenting symptoms of this condition are spontaneous bleeding from mucous membranes, excessive bleeding from wounds, or menorrhagia. Bleeding tendency often goes unnoticed until some hemostatic stress, such as surgery, reveals its presence. Patients may have defects in platelet function despite a normal platelet count, prolonged PTT.
von Willebrand disease (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 662
1497
Patient with this disease has a tendency toward easy bruising and massive hemorrhage after trauma or operative procedures, and recurrent bleeding into the joints. Petechiae are absent. Patients have a prolonged PTT and normal PT.
Hemophilia A and B (Factor VIII and IX Ddeficiency) (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 663
1498
Two major mechanisms that trigger DIC
Release of tissue factor and widespread endothelial injury(TOPNOTCH) Robbins Basic Pathology, 9th ed. P. 663
1499
A 5 year old male is observed by his mother to have tea-colored urine whenever he has infections. One particular episode of pneumonia required hospital admission, where the child developed jaundice also. A peripheral blood smear showed red cells with Heinz bodies, while other red cells had parts of their cytoplasm "plucked out". The child likely has a deficient enzyme required in the production of reduced glutathione, the gene for which is found on (A) X chromosome (B) Y chromosome (C) chromosome 21 (D) chromosome 22
X chromosome (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P 431-432
1500
An 8 year old child from the slums has easy fatigability and pallor. A peripheral blood smear shows large, egg-shaped red cell precursors, and hypersegmented neutrophils. Short of measuring serum folate and vitamin B12 levels, what finding will suggest a vitamin B12 deficiency, rather than a folate deficiency? (A) gastrointestinal symptoms (B) neurologic symptoms (C) development of congestive heart failure (D) megaloblasts on bone marrow aspirate smears
neurologic symptoms (TOPNOTCH)Robbins Basic Pathology, 8th Ed. Pp 437-439
1501
A 33 year old female presents with pallor, easy fatigability, and echymoses. Her spleen is not enlarged. A CBC showed profound anemia and markedly decreased WBC and platelet counts. A bone marrow core biopsy showed marrow that is predominantly replaced by fat, with few lymphocytic and plasma cells. The most common cause of her condition is (A) myelotoxic drugs (B) viral infection (C) bacterial infection (D) idiopathic
idiopathic (aplastic anemia) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P439
1502
A 14 year old male develops fever, sore throat, lymphadenitis, and fatigue. His CBC shows leukocytosis, with a lymphocytic predominance. Peripheral blood smear shows some large leukocytes with abundant cytoplasm occasional azurophilic granules, and indented nuclei with fine chromatin. Monospot test and anti-EBV titers are positive. The large leukocytes seen are (A) monocytes (B) megakaryocytes (C) B cells (D) T cells
T cells (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P 443
1503
Lymph nodes that drain cancers but do not yet harbor metastatic deposits often show (A) follicular hyperplasia (B) paracortical hyperplasia (C) sinus histiocytosis (D) fibrous obliteration
sinus histiocytosis (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P 444
1504
A 55 year old male presents with pallor and easy fatigability. Physical exam showed massive splenomegaly. CBC showed marked leukocytosis, and a peripheral smear showed numerous neutrophils, metamyelocytes, and myelocytes. Basophils are also seen. A bone marrow aspirate shows a similar picture. This man likely has (A) a BCR-ABL fusion gene (B) a JAK2 mutation (C) an 8:22 translocation (D) an 11:22 translocation
a BCR-ABL fusion gene (Chronic myelogenous leukemia) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P 464
1505
In primary myelofibrosis, marrow fibroblasts are stimulated to proliferate by PDGF and TGF-beta released from (A) granulocyte precursors (B) erythroid precursors (C) lymphoid cells (D) neoplastic megakaryocytes
neoplastic megakaryocytes (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P 466
1506
A 28 year old female is found to have a mediastinal mass on chest xray during a preemployment medical exam. On history, she is found to have muscle fatigue that worsens as the day progresses. She undergoes surgery where her mediastinal mass is resected. Microscopic examination showed sheets of bland spindle cells with sparse inflammatory infiltrates. Her tumor is (A) a metastasis from an undiagnosed endometrial mass (B) a metastasis from an occult breast malignancy (C) a lymphoma(D) a thymoma
a thymoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P 476
1507
Loss of lung volume cause by inadequate expansion of airspaces, resulting in shunting of inadequately oxygenated blood from pulmonary arteries into veins.
Atelectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 480
1508
Atelectasis which occurs when an obstruction prevents air from reaching distal airways.
Resorption atelectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 480
1509
Atelectasis usually associated with accumulation of fluid, blood, or air within the pleural cavity, which mechanically collapse the adjacent lung.
Compression atelectasis (aka passive or relaxation atelectasis)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 481
1510
Atelectasis which occurs when either local or generalized fibrotic changes in the lung or pleura hamper expansion and increase elastic recoil during expiration.
Contraction or cicatricial atelectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 481
1511
Lungs are dark red, firm, airless and heavy. There is capillary congestion, necrosis of alveolar epithelial cells, interstitial and intra-alveolar edema and hemorrhage and neutrophils in capillaries. Hyaline membrane is also characteristic, lining the alveolar ducts.
Acute Respiratory Distress Syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 482
1512
Diffuse pulmonary disease characterized by limitation of airflow, usually resulting from an increase in resistance caused by partial or complete obstruction atvany level.
Obstructive pulmonary disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483
1513
Diffuse pulmonary disease characterized by reduced expansion of lung parenchyma accompanied by decreased total lung capacity.
Restrictive lung disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483
1514
Lung volumes in obstructive lung disease:FEV1FVCFEV1:FVC ratio
FEV1 - decreasedFVC - normal / increasedFEV1:FVC ratio - decreased(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483
1515
Lung volumes in restrictive lung diseaseFEV1FVCFEV1:FVC ratio
FEV1 - normal/decreasedFVC - decreasedFEV1:FVC ratio - near normal(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483
1516
Characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchioles accompanied by destruction of their walls without obvious fibrosis. There is thinning oof the alveolar walls and loss of elastic tissue.
Emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 485
1517
Type of emphysema involving the central or proximal parts of the acini, formed by respiratory bronchioles, while distal parts are spared. Lungs deep pink and less voluminous, affecting the upper 2/3 of the lungs. Occurs in smokers.
Centriacinar (centrilobular) Emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 485
1518
Type of emphysema wherein the acini are uniformly enlarged from the level of the respiratory bronchiole to the terminal alveoli. Occurs more commonly in the lower lung zones. Occurs in a-antitrypsin deficiency.
Panacinar (panlobular) emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 485
1519
Type of emphysema wherein only the distal part is primarily involved. Lesion is adjacent to the pleura along the lobular connective tissue septa and at the lobe margins. More severe at the upper half of the lungs, forming bullae.
Distal acinar (paraseptal) emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 486
1520
Barrel-chested, dyspneic, prolonged expiration, sits forward in a hunched-over position, adequate oxygenation of oxygen. "Pink puffers".
COPD predominantly emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
1521
History of recurrent infections with purulent sputum, less prominent dyspnea and respiratory drive, becomes hypoxic and are pften cyanotic and obese. "Blue bloaters".
COPD predominantly chronic bronchitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
1522
Defined as persistent productive cough for at least 3 consecutive months in at least 2 consecutive years.
Chronic bronchitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
1523
Mucosal lining of the larger airways is usually hyperemic and swollen with edema fluid, often covered by a layer of mucinous or mucopurulent secretions. Trachea and bronchi have enlarged mucus-secreting glands.
Chronic bronchitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
1524
Characterized by goblet cell metaplasia, mucus plugging, inflammation and fibrosis, and sometimes complete obliteration of the lumen due to fibrosis.
Chronic bronchiolitis (small airway disease)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
1525
Most important underlying risk factor for chronic bronchitis.
Cigarette smoking(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
1526
Triad of 1.intermittent and reversible airway obstruction2.chronic bronchial inflammation with eosinophils3.bronchial smooth muscle cell hypertrophy and hyperreactivity
Asthma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
1527
Collections of crystalloids made up of eosinophil proteins.
Charcot-Leyden crystals(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 492
1528
Whorls of shed epithelium found in mucus plugs.
Curschmann spirals(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 492
1529
Curshmann spirals and Charcot-Leyden crystals are found histologically in this disease.
Asthma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 492
1530
Permanent dilation of bronchi and bronchioles caused by destruction of theuscle and elastic supporting tissue, resulting from chronic necrotizing infections.
Bronchiectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 493
1531
An autosomal recessive disorder frequently associated with bronchiectasis and sterility in males.
Kartagener syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 493
1532
Refers to a pulmonary disorder of unknown etiology characterized patchy interstitial fibrosis. Grossly, pleural surfaces of the lung have the appearance of cobblestones because of retraction scars along the interlobular septa.
Idiopathic Pulmonary Fibrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 495
1533
A thrombus that lodges astride a pulmonary artery bifurcation, which causes pulmonary hypertension, which can lead to hypoxia and cor pulmonale.
Saddle embolus(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 505
1534
Most common symptom of pulmonary embolism.
None, asymptomatic 60-80% of the time.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 506
1535
Mean pulmonary pressures reach one-fourth or more of systemic pressures.
Pulmonary hypertension(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 506
1536
Encountered in young persons, more commonly in women, marked by fatigue, syncope, dyspnea on exertion, and sometimes chest pain. Cause of increased pulmonary pressures is unknown.
Primary pulmonary hypertension(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 506
1537
Clinical features of this disease reflect the underlying disease, with accentuation of respiratory insufficiency and right-sided heart strain.
Secondary pulmonary hypertension(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 507
1538
Pneumonia with a patchy distribution of inflammation involving more than one lobe.
Bronchopneumonia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 509
1539
Four stages of pneumococcal pneumonia.
Congestion, red hepatization, gray hepatization, resolution(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 510
1540
Affected areas are red-blue, congested and subcrepitant. Inflammatory reaction is largely confined within the walls of the alveoli. Septa widened and edematous, with mononuclear infiltrates of lymphocytes, histiocytes and plasma cells. Alveolar spaces are free of cellular exudate.
Atypical pneumonia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 513
1541
A localized area of suppurative necrosis within the pulmonary parenchyma, resulting in the formation of one or more large cavities.
Lung abscess(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 515
1542
Pulmonary abscess resulting from aspiration of infective material are much more common on the left or right side?
Right side since it's shorter and more vertical.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 515
1543
Form of tuberculosis that develops in a previously unexposed, unsensitized person.
Primary tuberculosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518
1544
Implantation of the inhaled M. tuberculosis bacilli in the distal airspaces of the lungs, causes the formation of this 1 - 1.5 cm area of gray-white inflammatory consolidation.
Ghon focus(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518
1545
Ghon focus + nodal involvement = ________
Ghon complex(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518
1546
Radiographically detectable calcified Ghon complex.
Ranke complex(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518
1547
Pattern of disease that arises in previously sensitized host to M. tuberculosis.
Secondary or reactivation TB(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 520
1548
Occurs when TB bacilli drain through the lymphtics into lymphatic ducts, which eventually empty into the rightside of the heart and into pulmonary circulation. Individual lesions are small, visible foci of yellow-white consolidation scattered through the parenchyma.
Miliary TB(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 520
1549
The most frequent form of extrapulmonary TB.
TB Lymphadenitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 521
1550
TB lymphadenitis of the cervical LN.
Scrofula(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 521
1551
Round to oval small yeast forms measuring 2-5 um in diameter.
Histoplasma capsulatum(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 523
1552
Thick walled non-budding spherules 20-60 um diameter, often filled with small endospores.
Coccidiodomycosis immitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 523
1553
Round to oval and larger fungi, which reproduce by broad-based budding.
Blastomycosis dermatitidis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 523
1554
Cells infected by this virus exhibit gigantism of the cell and nucleus. An enlarged inclusion surrounded by a clear halo "owl's eye" is seen. It is the most common opportunistic viral pathogen in AIDS.
Cytomegalovirus (CMV)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 524
1555
Opportunistic infection of the lungs having a characteristic intra-alveolar foamy, pink-staining exudate "cotton candy exudate", with thickened septa and mononuclear infiltrate.
Pneumocystis carinii pneumonia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 526
1556
Most frequent disease-causing fungus.
Candida albicans(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 526
1557
The fungus is a 5-10 um yeast, has a thick, gelatinous capsule and reproduces by budding. Most likely acquired through bird droppings. Visualized by India ink or Giemsa stain.
Cryptococcus neoformans(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 527
1558
Which type of lung cancer is treated by chemotherapy only? Why?
Small cell lung carcinomaIt is an aggressive tumor which usually have metastasized at the time of diagnosis.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 529
1559
Lung carcinoma best treated with surgery since they respond poorly to chemotherapy.
Non-small cell lung carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 529
1560
Types of lung cancer with strongest association with tobacco exposure.
Squamous cell carcinomaSmall-cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 530
1561
Lung cancer which are peripherally located, most common type of lung cancer in women and nonsmokers. Grows slowly and metastasize early. Assumes a variety of forms, incliding acinar, papillary and solid types.
Adenocarcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 531
1562
Lung carcinoma which typically have large, prominent nucleoli, and a moderate amount of cytoplasm, with minimal glandular or squamous differentiation.
Large-cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 531
1563
Lung carcinoma which appear as pale gray, centrally located masses. Nests and cords of polygonal cells with scant cytoplasm, granular chromatin and inconspicuous nuclei. FNAB shows nuclear molding of adjacent cells. Associated with several paraneoplastic syndromes.
Small cell lung carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 532
1564
Other name for small cell lung carcinoma.
Oat cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 532
1565
Paraneoplastic syndromes associated with oat cell carcinoma.
Cushing syndromeSIADH Lambert-Eaton myasthenic syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 532
1566
Hypercalcemia due to excessive production of PTH related protein is usually seen in patients with this type of lung carcinoma.
Squamous cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 532
1567
Form of lung cancer that is thought to arise from neuroendocrine cells, called Kulchitsky cells, that line the bronchial mucosa and resemble intestinal carcinoids. Nests of small, rounded, uniform cells with "salt and pepper" chromatin.
Bronchial carcinoids(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 534
1568
Presence of fluid in the pleural space.
Pleural effusion(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 535
1569
Air or other gas in the pleural sac.
Pneumothorax(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 535
1570
A collection of whole blood in the pleural cavity.
Hemothorax(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 535
1571
A pleural collection of a milky lymphatic fluid containing microglobules of lipid.
Chylothorax(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 535
1572
A rare cancer seen in patients who work in shipyards, miners and insulators. Lesion is preceeded by extensive pleural fibrosis and plaque formation. May be epithelial, sarcomatoid or biphasic in morphology.
Malignant mesothelioma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 536
1573
Rare neoplasm with strong links to EBV and high frequency among the Chinese population. Characterized by large epithelial cells having indistinct borders (syncitial growth) and prominent eosinophilic nucleoli.
Nasopharyngeal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 537
1574
Smoothe, hemispherical protrusions located on the true vocal cords, composed of fibrous tissue and covered by stratified squamous mucosa.
Vocal cord nodules(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 537
1575
A benign neoplasm usually on the true vocal cords that forms a soft, raspberry-like excresence rarely more then 1 cm in diameter. Consists of multiple, slender, finger-like projections.
Laryngeal papilloma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 537
1576
Histologic manifestation of acute respiratory distress syndrome and acute lung injury.
Diffuse alveolar damage(TOPNOTCH)Robbins Pathologic Basis of Disease, 9th Ed. p. 672
1577
A 70 y/o male presented to the ER with a 10 day history of fever followed by rapidly progressive dyspnea for 3 days prior to admission. Physical examination revealed tachypnea, central cyanosis, and extensive fine inspiratory crackles of the chest. Severe hypoxemia was noted on ABG. Chest radiograph revealed bilateral diffuse alveolar infiltrates with normal cardiac size. An extensive ground glassing was also. Diagnosis? Characteristic histologic picture expected for this condition?
ARDS. Hyaline membranes lining the alveolar walls. (TOPNOTCH)
1578
The key initiating events and the basis of lung damage in ARDS
Damage to endothelial and alveolar epithelial cells. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 674
1579
Disease characterized by abnormally large alveoli separated by thin septa with only focal centriacinar fibrosis.
Emphysema (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 677
1580
Mild chronic inflammation of the airways (predominantly lymphocytes) and enlargement of mucus-secreting glands of the trachea and bronchi are seen in:
Chronic bronchitis(TOPNOTCH)Robbins Basic Pathology, 9th Ed. p. 679
1581
A 55 y/o female presented with chronic cough, productive of thick, tenacious sputum, recurrent episodes of fever associated with pleuritic chest pain. Crackles were noted on auscultation. Chest radiograph showed presence of "tram tracks". The most likely diagnosis:
Bronchiectasis(TOPNOTCH)
1582
Dilation of bronchi and bronchioles, with acute and chronic inflammatory exudation, desquamation of the lining epithelium and extensive areas of ulceration, are characteristics of what disease?
Bronchiectasis (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 683
1583
Earliest feature of chronic bronchitis
Hypersecretion of mucus in the large airways. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 678
1584
Subbasement membrane fibrosis, hyperplasia of bronchial wall muscle, hypertrophy of bronchial glands, and inflammatory infiltrate in the bronchial wall. These are morphologic findings in:
Asthma(TOPNOTCH) Robbins Pathologic Basis of Disease, 9th ed., p. 682
1585
Fundamental abnormality in atopic asthma
Exagerrated TH2 response (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 680
1586
Key inflammatory cells found in asthma
Eosinophils (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 683
1587
Most common bacterial cause of acute exacerbation of COPD
Haemophilus influenzae. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 703
1588
A 3 y/o child was brought to ER due to sudden onset of high fever, labored breathing, and drooling. The most likely cause of this condition is:
Haemophilus influenzae (TOPNOTCH)
1589
3 most common causes of otitis media in children
Streptococcus penumoniae, Haemophilus influenzae, Moraxella catarrhalis (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 703
1590
Most freqent cause of gram negative bacterial pneumonia.
Klebsiella pneumoniae (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 703
1591
A 45 y/o alcoholic male presented with fever, tachypnea, and cough with thick, mucoid, blood-tinged sputum. Chest radiograph showed right middle lobe opacification and bulging fissure sign. The most likely cause of pneumonia in this case is:
Klebsiella pneumoniae (TOPNOTCH)
1592
An important cause of secondary bacterial pneumonia in children and adults following a viral respiratory illness (measles, influenza)
Staphylococcus aureus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 703
1593
Cause of pneumonia associated with high incidence of lung abscess and empyema
Staphylococcus aureus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 703
1594
Most common cause of community acquired pneumonia
Streptococcus pneumoniae. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 707
1595
Distribution of pneumonia caused by Streptococcus pneumoniae, lobar or patchy consolidation?
Lobar (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 707
1596
Predominant histologic pattern in viral pneumonia
Interstitial inflammatory reaction of the walls of alveoli (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 707
1597
Cause of pneumonia seen particularly in organ transplant recipients.
Pneumonia caused by Legionella pneumophila. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 708
1598
Common cause of pneumonia in persons with cystic fibrosis, burn victims and in patients with neutropenia
Pneumonia caused by Pseudomonas aeruginosa (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 708
1599
Most frequent cause/mechanism of lung abscess
Aspiration of infective material (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 708
1600
Cardinal histologic change in lung abscess
Suppurative destruction of lung parenchyma within the central area of cavitation (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 709
1601
Major morphologic correlate of chronic rejection
Bronchiolitis obliterans (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 712
1602
Type of emphysema in smoking
Centriacinar (centrilobular) Emphysema(TOPNOTCH)
1603
Most common histologic pattern of bronchogenic carcinoma
Adenocarcinoma (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 715
1604
Most common site of lung squamous cell carcinoma
Central/hilar region (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 715
1605
Most common type of lung cancer in men
Squamous cell carcinoma (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 716
1606
Histologic characteristics of this type of lung carcinoma is keratinization and/or intercellular bridges.
Squamous cell carcinoma (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 716
1607
Pulmonary embolism could lead to this type of shock
Cardiogenic shock (TOPNOTCH)
1608
Mechanism of pulmonary edema in left sided CHF.
Increased hydrostatic pressure(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 671
1609
Associated with medial hypertrophy of the pulmonary muscular and elastic arteries, pulmonary arterial atherosclerosis, and right ventricular hypertrophy.
Pulmonary hypertension(TOPNOTCH)Robbins Basic Pathology, 9th Ed. p. 700
1610
An autoimmune disease characterized by rapidly progressive glomerulonephritis and necrotizing hemorrhagic interstitial pneumonitis.
Goodpasture syndrome(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 701
1611
Presents with cough, fever, and copious foul-smelling sputum, usually with antecedent primary lung infection. Cardinal histologic change in this condition is suppurative destruction of lung parenchyma within the central area of cavitaion.
Lung abscess(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 709
1612
Pneumonia acquired by inhalation of dust particles from soil contaminated with bird or bat droopings that contain micronidia. Symptoms resemble those of tuberculosis.
Histoplasmosis(TOPNOTCH)Robbins Basic Pathology, 9h Ed. p. 709
1613
The most common site of metastatic neoplasm
Lung(TOPNOTCH)Robbins Basic Pathology, 9h Ed. p. 721
1614
Sudden death in pulmonary embolism is caused by:
Blockage of blood flow through the lungs.(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 698
1615
Inflammatory cell implicated in the pathogenesis of ARDS (A) type II pneumocyte (B) neutrophil (C) fibroblast (D) eosinophil
neutrophil (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 482
1616
Of the types of emphysema that cause clinically significant airway obstruction, which one is the commonest? (A) centriacinar (B) panacinar (C) distal acinar (D) irregular
Centriacinar (centrilobular) Emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 485
1617
In chronic bronchitis, a Reid index of more than 0.4 is diagnostic. The Reid index is the ratio of the thickness of the (A) metaplastic mucosa to the submucosal gland layer (B) submucosal gland layer to the bronchial wall (C) metaplastic mucos to the bronchial wall (D) cartilage to the submucosal gland layer
submucosal gland layer to the mucosal wall (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
1618
Gross examination of lungs that show airways that can be followed almost to the pleural surfaces is characteristic of (A) emphysema (B) bronchiectasis (C) pulmonary sequestration (D) chronic bronchitis
Bronchiectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 493
1619
Usual interstitial pneumonia, or idiopathic pulmonary fibrosis, is differentiated from other fibrosing interstitial diseases by (A) the temporal heterogeneity of the fibrosing lesions (B) presence of a lymphocytic infiltrate (C) exuberant fibroblastic proliferation (D) association with a connective tissue disease such as SLE
the temporal heterogeneity of the fibrosing lesions (B is nonspecific and may occur in any; C may be seen in cryptogenic organizing pneumonia; D is wrong because by definition, "idiopathic" must not be associated with other conditions) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. Pp. 495-496
1620
Which cell is the key element in the initiation and perpetuation of lung injury and fibrosis in pneumoconioses? (A) alveolar macrophage (B) neutrophil (C) respiratory epithelium basal cell (D) type II pneumocyte
alveolar macrophage (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 497
1621
Which pneomoconiosis is associated with an increased susceptibility to tuberculosis? (A) anthracosis (B) silicosis (C) asbestosis (D) sarcoidosis
silicosis (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 499
1622
Concomitant cigarette smoking in patients who have been exposed to asbestos greatly increases the risk of (A) bronchogenic carcinoma (B) mesothelioma (C) carcinoid tumor (D) hamartoma
bronchogenic carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 500, 530
1623
Which of the following is more prevalent in nonsmokers than smokers? (A) sarcoidosis (B) centriacinar emphysema (C) desquamative interstitial pneumonia (D) respiratory bronchiolitis
sarcoidosis (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P. 501
1624
What is the histopathologic sine qua non of sarcoidosis? (A) noncaseating epithelioid granuloma (B) Schaumann bodies (C) asteroid bodies (D) caseation necrosis
noncaseating epithelioid granuloma (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P501
1625
A 33 year old woman with mitral stenosis from rheumatic heart disease develops hepatomegaly and bipedal edema. She eventually dies of heart failure. An autopsy is done. Which of the following lung findings supports pulmonary hypertension? (A) coagulative necrosis of alveoli with intraparenchymal hemorrhage (B) medial hypertrophy and reduplication of elastic membranes in small arteries (C) medium arteries with chronic inflammatory infiltrate and fibrinoid necrosis (D) vessels of varying caliber with endothelial proliferation
medial hypertrophy and reduplication of elastic membranes in small arteries (TOPNOTCH)Robbins Basic Pathology, 8th Ed. P 507
1626
A 40 year old lady develops progressive dyspnea and hemoptysis of 1 week. On further history, she reports tea-colored urine. Her condition worsens, and she dies. At autopsy, her lung alveoli have thickened fibrous septa, and the lumens diffusely filled with hemosiderin-laden macrophages. Immunofluorescence showed a linear pattern of immunoglobulin deposition along the alveolar septa. Kidney samples also showed the same pattern. Her dismal clinical picture is a consequence of antibodies against (A) fibrillin (B) elastin (C) collagen III (D) collagen IV
collagen IV (Goodpasture syndrome) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. Pp 507-508
1627
Patients with sickle cell disease have an increased risk of streptococcal pneumonia because (A) macrophages that remove the encapsulated organims are significantly reduced due to a nonfunctioning spleen (B) there is immunologic anergy to the streptococcal capsule which has structural similarity to hemoglobin S (C) the inherent resistance to malaria in sickle cell patients primes the cytotoxic T cells for protozoan, but not bacterial, infections (D) chronic hemolysis in sickle cell disease releases growth factors for the fastidious streptococcal bacteria
macrophages that remove the encapsulated organims are significantly reduced due to a nonfunctioning spleen (TOPNOTCH)Robbins Basic Pathology, 8th Ed. Pp 428, 509
1628
Which of the following patients with secondary tuberculosis have an increased likelihood of NEGATIVE sputum AFB smears? (A) 55 year old HIV-positive man with CD4+ counts 300 cells/mm3 (C) 43 year old HIV-negative man
55 year old HIV-positive man with CD4+ counts
1629
A 55 year old man with a 50 pack year smoking history presents with a 5 cm right lung mass in the middle lobe. A CT-guided aspiration biopsy is performed, which shows round to polygonal cells twice the size of lymphocytes, with unappreciable cytoplasm, finely granular chromatin. Some of the cells demonstrate nuclear molding. What is the first line of treatment? (A) lobectomy (B) radiation therapy (C) chemotherapy (D) anti-Koch's
chemotherapy (small cell carcinoma) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. Pp 531-534)
1630
A 41 year old asymptomatic woman presents with a nodule on a routine xray. CT scan showed a 3-cm bronchial mucosal plaque penetrating the bronchial wall and fanning out into the peribrochial tissue, resembling a collar button. A bronchoscopy with core biopsy is done, which showed nests of uniform cells bearing regular round nuclei with salt-and-pepper chromatin, with little pleomorphism and mitosis. Which of the following is TRUE? (A) 70-80%% of patients with this tumor have hilar node metastasis at presentation (B) the tumor is thought to arise from the Kupffer cells that line the bronchial mucosa (C) Patients commonly present with the syndrome of diarrhea, flushing, and cyanosis (D) it can be considered as a less aggressive cousin to small cell carcinoma, both belonging in a spectrum of pulmonary neuroendocrine neoplasms
it can be considered as a less aggressive cousin to small cell carcinoma, both belonging in a spectrum of pulmonary neuroendocrine neoplasms (A- 5-15% nodal metastasis; B - arises from Kulchitsky cells; C - rarely presents with the syndrome) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. Pp 534
1631
A 28 year old man complains of epistaxis of one month duration. His otorhinolaryngologist finds an ill-defined erythematous mass in his nasopharynx, and performs a biopsy, which showed sheets and clusters of large epithelial cells having indistinct cell borders with eosinophilic nucleoli, with a background of lymphocytes. Which of the following is TRUE? (A) the mass is associated with EBV infection (B) the lymphocytes are neoplastic (C) the mass is usually resistant to radiotherapy (D) 5-year survival rates are less than 5%
the mass is associated with EBV infection (nasopharyngeal carcinoma) (B - the lymphocytes are not neoplastic; C - it is radiosensitive; D - 5-year survival rates 50% even for advanced cancers) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. Pp 537
1632
In laryngeal carcinoma, which tumor location has the best prognosis? (A) supraglottis (B) glottis (C) sublottis (D) epiglottis
glottis (TOPNOTCH)Robbins Basic Pathology, 8th Ed. Pp 538
1633
A glomerular syndrome dominated by the acute onset of usually grossly visible hematuria, mildly moderate proteinuria, azotemia, edema and hypertension.
Acute nephritic syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 542
1634
A glomerular syndrome characterized by heavy proteinuria, hypoalbunemia, severe edema, hyperlipidemia and lipiduria.
Nephrotic syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 542
1635
Characterized by bacteriuria and pyuria, which may be asymptomatic.
Urinary tract infection(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 542
1636
Most common type of collagen found in glomerular basement membrane.
Type IV(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 543
1637
Most frequent cause nephrotic syndrome in children. Under light microscope, the glomerular basement membrane appears normal, but on electron microscopy, GBM shows uniform and diffuse effacement of foot processes of the podocytes. Good response to corticosteroid therapy.
Minimal change disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 550
1638
A lesion characterized histologically by sclerosis affecting some but not all glomeruli and involving only segments of each affected glomerulus.
Focal segmental glomerulosclerosis (FSGS)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 550
1639
Slowly progressive disease characterized by the presence of subepithelial immunoglobulin-containing deposits along the glomerular basement membrane. Histologically, there is diffuse thickening of the BM. (+) spike and dome pattern on electron microscopy. Often resistant to steroid therapy.
Membranous glomerulonephritis (Membranous Nephropathy)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 551
1640
Characterized by discrete SUBENDOTHELIAL electron-dense deposits in irregular granular pattern.
Type I MPGN(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 553
1641
GBM is thickened, showing a "tram-track" appearance on PAS stains. There is proliferation of mesangial and endothelial cells as well as infiltrating leukocytes.
MPGN(Membranoproliferative Glomerulonephritis)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 553
1642
MPGN wherein the lamina densa and the SUBENDOTHELIAL space of the GBM are transformed into an irregular, ribbon-like extremely electron dense structure.
Type II MPGN(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 554
1643
Caused by glomerular deposition of immune complexes resulting in diffuse proliferation and swelling of resident glomerular cells. There is uniformly increased cellularity of glomerular tufts. Electron microscopy show subepithelial "humps" against the GBM, with granular deposits of IgG and complement.
Acute postinfectious (poststreptococcal) Glomerulonephritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 555
1644
Most common cause of recurrent microscopic or gross hematuria and is the most common glomerular disease revealed by renal biopsies.
IgA Nephropathy (Berger disease)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 555
1645
Pathologic hallmark of this disease is the deposition of IgA in the mesangium.
IgA nephropathy (Berger Disease)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 556
1646
Nephritis accompanied by nerve deafness, lens dislocation, posterior cataracts and corneal dystrophy.
Alport syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 556
1647
Caused by mutations in genes encoding GBM collagen, manifest as hematuria and slowly progressing proteinuria and declining renal function. GBM has "basket-weave" appearance due to splitting and lamination of the lamina densa.
Hereditay nephritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 557
1648
A clinical syndrome characterized by rapid and progressive lossof renal function with features of nephritic syndrome,often with severe oliguria. Histologic feature is the presence of crescents.
Rapidly Progressive Glomerulonephritis (Crescentic GN)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 557
1649
CrGN characterized by linear deposits of IgG and C3 on the GBM. anti-GBM Ab also bind to pulmonary alveolar capillary basement membranes to produce pulmonary hemorrhages associated with renal failure.
Anti-Glomerular Basement Membrance Antibody (Type I) CrGN(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 557
1650
CrGN which are immune complex-mediated disorders, as a complication of any of the IC nephritides including PSGN, IgA Nephropathy and HSP. There is segmental necrosis and characteristic granular pattern of the underlying immune complex disease.
Immune Complex-Mediated (Type II) CrGN(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 558
1651
CrGN defined by the lack of anti-GBM Ab and immune complex deposition. Glomeruli show segmental necrosis, negative immunofluorescence.
Pauci-immune (Type III) CrGN(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 558
1652
An important cause of end-stage renal disease presenting as chronic renal failure. Kidneys are symmetrically contracted, surfaces are red-brown and diffusely granular. Glomeruli are obliterated with marked interstitial fibrosis.
Chronic glomerulonephritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 559
1653
A common suppurative inflammation of the kidney and renal pelvis caused by bacterial infection, either by hematogenous spread or through ascending infection.
Pyelonephritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 560
1654
Hallmark of this disease is scarring involving the pelvis or calyces, or both, leading to papillary blunting and marked calyceal deformities.
Chronic pyelonephritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 562
1655
Nephritis with prominent eosinophilic and mononuclear inflitrate, with pronounced edema.
Acute Drug-Induced Interstitial Nephritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 563
1656
A clinicopatholigic entity characterized by damaged tubular epithelial cells and clinically by acute suppression of renal function.Most common cause of acute renal failure.
Acute tubular necrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 564
1657
Characterized by necrosis of short segments of the tubules, seen in the straight portions of the PCT and TALOH. There is a variety of tubular injuries, associated with proteinaceous casts in the distal tubules and collecting ducts.
Ischemic ATN(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 566
1658
ATN characterized by necrosis and injury of the PCT with sparing of the tubular membranes.
Toxic ATN(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 566
1659
Phase of ATN lasting about 36 hrs, dominated by the inciting medical, surgical or obstetric event. Slight decline in renal output and a rise in serum creatinine.
Initiation phase(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 566
1660
Phase of ATN where urine output falls markedly, between 50-400mL/day. Dominated by signs and symptoms of uremia and fluid overload.
Maintenance phase(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 566
1661
Phase of ATN characterized by a steady increase in urine volume, electrolyte imbalance and increased vulnerability to infection.
Recovery(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 566
1662
Chronic interstitial nephritis associated with renal papillary necrosis. The necrotic papillae appear yellowish-brown, showing coagulative necrosis associated with loss of cellular detail with preservation of tubular outlines.
Analgesic nephropathy(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 564
1663
T-cell mediated immune reaction of the kidneys to an offending agent, characterized by interstitial inflammation, with abundant eosinophils and edema.
Drug-induced interstitial nephritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 564
1664
Renal changes in benign hypertension, associated with hyaline arteriolosclerosis, appearing as homogenous, pink hyaline thickening of arterial walls. Larger blood vessels show fibroelastc hyperplasia.
Benign nephrosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 566
1665
Acute renal injury assiciated with malignant hypertension. The kidneys show small, pinpoint petechial hemorrhages, "flea-bitten" appearance. Concentric arrangement of cells, described as "onion-skin" lesions cause marked narrowing of arterioles and small arteries.
Malignant nephrosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 567
1666
Characterized by widespread thrombosis and presence of fibrin thrombi in glomeruli and small vessels resulting in acute renal failure. Consequence of childhood HUS and TTP.
Thrombotic microangiopathies(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 568
1667
One of the main causes of acute renal failure in children.
Hemolytic Uremic Syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 568
1668
Innocuous lesions of the kidney, 1-5cm in diameter, translucent, lined by a gray, glistening, smooth membrane, filled with clear fluid. Composed of a single layer of cuboidal or flattened cuboidal epithelium, usually confined to the cortex.
Simple renal cyst(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 569
1669
Autosomal dominant. Kidneys are enlarged, composed solely of cysts without intervening parenchyma. Cysts are filled with clear or turbid fluid. Cysts may arise at any level of the nephron, with variable, often atrophic lining.
Adult polycystic kidney disease (APKD)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 569
1670
What is the pathology behind APKD?
Defective gene PKD1,which codes for polycystin-1.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 569
1671
Function of policystin-1?
Protein that is involved in cell-cell or cell-matrix adhesion.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 569
1672
Autosomal recessive. There are numerous small cysts in the cortex and medulla, giving the kidney a "sponge-like" appearance. Cysts have uniform cuboidal epithelium. Associated with multiple cysts in the liver.
Childhood Polycystic Kidney Disease (CPKD)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 570
1673
An under-recognized cause of chronic kidney disease in children and young adults, associated with mutations in several genes that encode neohrocystins that may be involved in ciliary function. Kidneys are contracted and contain multiple cysts.
Medullary cystic disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 571
1674
Calculus formation at any level of the urinary collecting system.
Urolithiasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 571
1675
Most common composition of kidney stones. Precipitates in the presence of alkaline urine.
Calcium oxalate and/or calcium phosphate(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 571
1676
Most important cause of kidney stone formation.
Supersaturation(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
1677
Kidney stones occuring in patients with alkaline urine due to UTI, particularly Proteus vulgaris and Staphylococci.
Struvite stones(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
1678
Component of struvite stones.
Magnesium ammonium phosphate(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
1679
Kidney stones seen in patients with gout and leukemias. Urine pH is decreased.
Uric acid stones(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
1680
Kidney stones associated with a defect in the renal transportation of certain amino acids. Forms in acidic urine.
Cystine stones(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
1681
Branching structures which create a cast of the renal pelvis and calyceal system.
Stagnorn calculi(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
1682
Most common composition of staghorn calculi.
Magnesium ammonium phosphate (Struvite)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
1683
Dilation of the renal pelvis and calyces, accompanied by atrophy of the renal parenchyma, caused by obstruction to urine outflow.
Hydronephrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 572
1684
Dilation of the ureters secondary to obstruction.
Hydroureter(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 573
1685
Most common malignant tumor of the kidney.
Renal cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 573
1686
Tumors derived from renal tubular epithelium, located primarily at the cortex. With three common forms, clear cell, papillary renal cell and chromophobe renal carcinomas.
Renal cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 573
1687
Most common form of renal cell carcinoma.
Clear cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 574
1688
Renal carcinoma, usually solitary and large, spherical masses reaching up to 15cms in diameter. Cut surface show yellow orange to gray-white, with prominent areas of cystic softening and hemorrhage. Cells appear vacuolated or may be solid.
Clear cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 574
1689
Renal carcinoma exhibiting varying degrees of papilla formation with fibrovascular cores. Cells have clear to pink cytoplasm.
Papillary renal cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 574
1690
Renal cell carcinoma which tends to be tan-brown, cells have clear, flocculent cytoplasm with very prominent, distinct cell membranes. Nuclei surrounded by halos of cleared cytoplasm.
Chromophobe-type renal cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 574
1691
Tumor of the urinary bladder, characterized as small, frond-like structures having delicate fibrovascular core covered by multilayered, well-differentiated transitional epithelium.
Benign papilloma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 575
1692
Dominant clinical presentation of bladder carcinoma.
Painless hematuria(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 575
1693
Protozoa associated with increased risk of bladder carcinoma.
Schistosoma haematobium(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 576
1694
Chemotherapeutic agent associated with development of hemorrhagic cystitis and increased risk of bladder carcinoma.
Cyclophosphamide(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 576
1695
Electron Microscopy: Subepithelial humps
PSGN (TOPNOTCH)
1696
Light Microscopy: Hyalinized glomeruli
Chronic Glomerulonephritis (TOPNOTCH)
1697
Electron Microscopy: Subepithelial deposits
Membranous glomerulopathy (TOPNOTCH)
1698
Electron Microscopy: Loss of foot processes
Minimal Change Disease (TOPNOTCH)
1699
Electron Microscopy: Subendothelial deposits
MPGN Type 1 (TOPNOTCH)
1700
Flourescence Microscopy: Linear IgG and C3
Goodpasture's disease (TOPNOTCH)
1701
Light Microscopy: Normal, with lipid in tubules
Minimal Change Disease (TOPNOTCH)
1702
What are the 3 classic diagnostic features of RCC?
1. Costovertebral Pain (TOPNOTCH)2. Palpable Mass3. Hematuria
1703
Among the 3 classic diagnostic features of RCC, which feature is the most reliable?
Hematuria (TOPNOTCH)
1704
RCC morphology: pale eosinophilic cells, often with a perinuclear halo, arranged in solid sheets with a concentration of the largest cells around the blood vessels
Chromophobe RCC (TOPNOTCH)
1705
RCC morphology: rounder or polygonal shape and have abundant clear or granular cytoplasm with stains with glycogen and lipid
Clear Cell RCC (TOPNOTCH)
1706
RCC morphology: arise from DCT and are typically hemorrhagic and cystic
Papillary RCC (TOPNOTCH)
1707
RCC morphology: irregular channels lined by highly atypical epithelium with a hobnail pattern.
Collecting Duct Carcinoma (TOPNOTCH)
1708
RCC morphology: Interstitial foam cells and psamomma bodies
Papillary Carcinoma (TOPNOTCH)
1709
Urolithiasis: most common type
Calcium Oxalate stones (TOPNOTCH)
1710
Urolithiasis: staghorn calculi
Triple stones/ struvite stones/ Magnesium Ammonium Phosphate stones (TOPNOTCH)
1711
Urolithiasis: caused by genetic defects in the renal absorption of amino acids
Cystine stones (TOPNOTCH)
1712
Urolithiasis: associated with urea-splitting bacteria
Triple stones/ struvite stones/ Magnesium Ammonium Phosphate stones (TOPNOTCH)
1713
Urolithiasis: radiolucent
Uric Acid Stones (TOPNOTCH)
1714
Urolithiasis: common in patients with leukemia
Uric Acid Stones (TOPNOTCH)
1715
What is the most common cause of renal artery stenosis?
Occlusion by an atheromatous plaque at the origin of the renal artery (TOPNOTCH)
1716
What is the most common type of Fibromuscular Dysplasia; intimal, medial, or adventitial?
Medial (TOPNOTCH)
1717
Gross morphology: flea bitten appearance of the kidneys
Malignant Hypertension (TOPNOTCH)
1718
What are the two histological alterations in the blood vessels of patients with malignant hypertension?
1. Fibrinoid Necrosis of arterioles2. Onion-skinning (TOPNOTCH)
1719
What are the 3 complications of acute pyelonephritis?
1. Papillary Necrosis2. Pyonephrosis3. Perinephric Abscess (TOPNOTCH)
1720
Among the 3 complications of acute pyelonephritis, which one is mainly seen in diabetics and in those with urinary tract obstruction?
Papillary necrosis (TOPNOTCH)
1721
Morphology: acute neutrophilic exudate within tubules and the renal substance
Acute pyelonephritis (TOPNOTCH)
1722
ATN morphology: focal tubular epithelial necrosis at multiple points along the nephron, with large skip areas in between
Ischemic ATN (TOPNOTCH)
1723
ATN morphology: manifested by acute tubular injury with non specific tubular necrosis
Toxic ATN (TOPNOTCH)
1724
ATN morphology: Eosinophilic hyaline casts containing Tamm Horsfall protein
Ischemic ATN (TOPNOTCH)
1725
ATN morphology: severely injured cells that are not yet dead might contain large acidophilic inclusions
Mercuric Chloride ATN (TOPNOTCH)
1726
ATN morphology: accumulation of neutral lipids in injured cells
Carbon Tetrachloride poisoning (TOPNOTCH)
1727
ATN morphology: marked ballooning and hydrophic or vacuolar degeneration of proximal convulated tubules and often times calcium oxalate crystals are seen in the lumen
Ethylene Glycol ATN (TOPNOTCH)
1728
Morphology: patchy interstitial suppurative inflammation, intratubular aggregates of neutrophils, and tubular necrosis
Acute pyelonephritis (TOPNOTCH)
1729
Gross morphology: irregularly scarred; if bilateral, the involvement is asymmetric
Chronic pyelonephritis (TOPNOTCH)
1730
Gross morphology: kidneys are diffusely and symmetrically scarred
Chronic glomerulonephritis (TOPNOTCH)
1731
Morphology: hallmark is the coarse, discrete, corticomedullary scar overlying a dilated, blunted, or deformed calyx
Chronic pyelonephritis (TOPNOTCH)
1732
What is the main cause of renal dysfunction in Multiple Myeloma?
Bence Jones protein (TOPNOTCH)
1733
Morphology: bence jones tubular casts appear as pink to blue amorphous masses, sometimes concentrically laminated, often with fractured and angulated appearance, filling and distending the lumens
Multiple Myeloma (TOPNOTCH)
1734
Morphology: narrowing of the lumens of arterioles and small arteries, caused by thickening and hyalinization of the walls (hyaline arteriolosclerosis)
Benign nephrosclerosis (TOPNOTCH)
1735
Morphology: classic diagnostic finding is enlarged hypercellular glomeruli
PSGN (TOPNOTCH)
1736
Gross morphology: wedge-shaped lesions, with base against the cortical surface and the apex pointing toward the medulla
Renal infarcts (TOPNOTCH)
1737
What is the first step in the pathogenesis of ascending infection that leads to pyelonephritis?
Colonization of the distal urethra and introits by coliform bacteria (TOPNOTCH)
1738
Morphology: "fibrin caps" and "capsular drops"
Diabetic kidney (TOPNOTCH)
1739
Morphology: diffuse increase in mesangial matrix and characteristic PAS positive nodules
Diabetic glomerulosclerosis (TOPNOTCH)
1740
Flourescence microscopy: deposition of IgA, sometimes with IgG and C3, in the mesangial region
Henoch Schonlein Purpura (TOPNOTCH)
1741
Gross morphology: wedge-shaped lesions, with base against the cortical surface and the apex pointing toward the medulla
Renal infarcts (TOPNOTCH)
1742
What is the most common cause of clinical pyelonephritis?
Ascending infection (TOPNOTCH)
1743
Morphology: "tram track" "double contour" glomerular capillary walls
Membranoproliferative Glomerulonephritis (TOPNOTCH)
1744
Morphology: collapsed glomerular tufts and the crescent shaped mass of proliferating cells and leukocytes internal to Bowman capsule
Rapidly Progressive Glomerulonephritis (TOPNOTCH)
1745
Morphology: glomeruli show thickening and sometimes splitting of capillary walls, due largely to endothelial and subendothelial swelling, and deposits of fibrin-related materials in the capillary lumens, subendothelially, and in the mesangium.
Childhood Hemolytic Uremic Syndrome(TOPNOTCH)
1746
Gross morphology: fine, leathery granularity of the surface of the kidney
nephrosclerosis(TOPNOTCH)
1747
What is the emerging viral pathogen that causes pyelonephritis in kidney allografts?
Polyoma virus(TOPNOTCH)
1748
Morphology: enlarged tubular epithelial cells with nuclear inclusions
Polyoma kidney (TOPNOTCH)
1749
Electron microscopy: irregular thickening of the BM of the glomerulus, lamination of the lamina densa, and foci of rarefaction
Alport Syndrome (TOPNOTCH)
1750
Morphology: lamina densa of the GBM is transformed into an irregular, ribbon like, extremely electron dense structure
Dense Deposit Disease or Type II MPGN (TOPNOTCH)
1751
ESRD is defined as GFR less than how many percent of normal?
5%(TOPNOTCH)
1752
Renal failure is defined as GFR less than how many percent of normal?
20%-25%(TOPNOTCH)
1753
In renal insufficiency is defined as GFR less than how many percent of normal?
20%-50%(TOPNOTCH)
1754
Diminished renal reserve is define as GFR less than how many percent of normal?
50%(TOPNOTCH)
1755
An 18 y/o female presented with decreased in urine volume and edema. BP = 150/100. RBC cast was present in the urine. What is the most likely light microscopy pattern of this condition?
Acute glomerulonephritis (TOPNOTCH)
1756
An 18 y/o female presented with decreased in urine volume and edema. BP = 150/100. RBC cast was present in the urine. Two weeks prior, patient had sore throat and tonsillar swelling. What is the clinical impression?
PSGN (TOPNOTCH)
1757
Patient presented with fever, nausea, and flank pain. Urinalysis showed gross hematuria, increased pus cells, and presence of WBC cast. The most likely diagnosis is:
Acute pyelonephritis (TOPNOTCH)
1758
A 10 y/o male presents with generalized edema. BP is 90/60. Urinalysis showed Protein 3+, and presence of fatty cast. The most likely diagnosis is:
Nephrotic syndrome (TOPNOTCH)
1759
A 50 y/o patient with long standing hypertension and diabetes presented with complaints of pruritus, lower extremity edema, nausea and vomiting. Urinalysis showed presence of protein and waxy casts. Presence of waxy casts may indicate:
Chronic kidney disease (TOPNOTCH)
1760
A 5 y/o child presents with short history of facial edema that has now progressed to swelling of the feet and abdomen. Other symptoms include nausea, vomiting and abdominal pain. High levels of protein was noted in the urine. The parents reported that the child had fever few days before the development of the swelling. Biopsy was done. On light microscopy, no significant structural changes were noted except for the few lipids in the tubules. What can be expected on electron microscopy?
Loss of foot processes (TOPNOTCH)
1761
Characterized by rapid decline in GFR, with concurrent dysreglation of fluid and electrolyte balance, and retention of metabolic waste products.
Acute kidney injury(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 898
1762
Most frequent clinical presentation of this disease is rapidly progressive glomerulonephritis. The anti-GBM antibodies cross react with pulmonary alveolar basement membranes to produce pulmonary hemorrhage, associated also with renal failure.
Goodpasture syndrome(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 912
1763
The most common cause/mechanism of acut nephritic syndrome
immune-mediated glomerular injury(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 914
1764
Its presence in the urine represents lipoprotein resorbed by tubular epithelial cells and then shed along with injured tubular cells.Present in Nephrotic syndrome
Oval fat bodies(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 914
1765
Most frequent systemic causes of nephrotic syndrome
Diabetes, amyloidosis, SLE(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 914
1766
Most common cause of nephrotic syndrome in older adults
Membranous glomerulopathy(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 914
1767
A 6 y/o male presented with massive proteinuria and edema. There is no hypertension or hematuria noted. Patient responded well to corticosteroid. The principal lesion in this condition:
Uniform and diffuse effacement of foot processes(Minimal change disease) (TOPNOTCH)
1768
Most common type of glomerulonephritis worldwide
IgA Nephropathy/Berger Disease(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 923
1769
Presents with gross hematuria after an infection of the respiratory, GIT or urinary tract, microscopic hematuria, with or without proteinuria. Hematuria last for several days, only to return every few months. These are the clinical features of what renal pathology?
IgA Nephropathy/Berger Disease(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 923
1770
This childhood syndrome consists of purpuric skin lesions, abdominal pain, intestinal bleeding, and arthralgia along with renal abnormalities.
Henoch Schonlein Purpura (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 926
1771
Most common renal manifestation of multiple myeloma
Chronic kidney disease (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 938
1772
True or False. Patients with malignant hypertension have markedly elevated levels of plasma renin.
True (TOPNOTCH)
1773
Most common cause of renal artery stenosis
Narrowing by an atheromatous plaque (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 940
1774
Following a prodrome of influenza-like or diarrheal symptoms, this syndrome presents with sudden onset of bleeding manifestation, severe oliguria, hematuria, associated with microangiopathic hemolytic anemia, thrombocytopenia and prominent neurologic changes.
Hemolytic Uremic Syndrome(TOPNOTCH)Robbins Basic Pathology, 9th Ed. p. 942
1775
Earliest manifestation in bilateral partial obstruction of the ureter
Polyuria and nocturia(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 951
1776
Patient presents with flank pain, hematuria, and flank mass. Abdominal CT revealed a mass on the upper pole of the left kidney. CT guided biopsy showed a tumor that are made up of cell with basophilic cytoplasm and are non-papillary. The most likely histologic type of renal carcinoma described is:
Clear cell carcinoma(TOPNOTCH)
1777
Most common site of metastasis of renal cell carcinoma
Lungs(TOPNOTCH) Robbins Basic Pathology, 9th ed. P. 955
1778
A 32 year old woman develops tea-colored urine, periorbital edema, and decreasing urine output. A renal biopsy shows glomeruli with collapsed glomerular tufts and crescent-shaped masses of proliferating cells and leukocytes internal to the Bowman's capsule. Which immunofluorescence pattern indicates that she is amenable to plasmapheresis? (A) linear staining of IgG and C3 along the GBM (B) granular "lumpy bumpy" deposits of Ig and/or complement in the GBM and/or mesangium (C) no distinct Ig or complement deposition (D) none of the above
linear staining of IgG and C3 (Anti-GBM antibody CrGN/Type I) (B - Type II - immune complex mediated; C - Type III - pauci immune; neither are helped by plasmapharesis) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 557-558.
1779
An 18 year old female has sore throat and fever. The next day, she develops tea-colored urine for a week, which spontaneously resolves. Six months later, her hematuria recurs. She is also found to have increased serum IgA. Which of the following renal biopsy findings is consistent with her disease? (A) presence of C1q and C4 deposits in the glomeruli (B) IgA deposits in the mesangium (C) granular deposits of IgG and complement (D) subepthelial "humps" on electron microscopy
IgA deposits in the mesangium (Berger disease) (all other choices are seen in PSGN, which develops 1 to 4 weeks after infection)
1780
A 10 year old male presents with periorbital edema. Urinalysis shows persistent albuminuria. Which renal biopsy finding will indicate that he will respond to short coursse corticosteroid therapy? (A) normal-looking glomerulus by light miscroscopy, with podocyte foot process effacement on electron microscopy (B) some glomeruli with segmental increased mesangial matrix and hyaline deposits (C) diffusely thickened GBM on light microscopy, with subepithelial deposits in a "spike and dome" pattern on electron microscopy (D) a "tram track" appearance of the thickened GBM on PAS stain
normal-looking glomerulus on light microscopy, with podocyte foot process effacement on electron microscopy (minimal change disease) (B - FSGS; C - membranous GN; D - membranoproliferative GN) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 550-554
1781
A 38 year old male presents with gross hematuria. Imaging workup shows three renal masses. He undergoes radical nephrectomy, where gross examination of the kidney specimen showed yellowish masses with foci of hemorrhage. The mass nearest the hilum appears to infiltrate into the renal vein. On histopathology, the masses are composed of sheets of clear, vacuolated cells with round to oval nuclei, and occasional mitoses. The patient also had a history of brain surgery at 14 years old for a cerebellar hemangioblastoma. This association raises the possibility which syndrome? (A) Li Fraumeni (B) Von Hippel-Lindau (C) Tuberous sclerosis (D) Gardner
von Hippel-Lindau (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 573-74
1782
Which of the following is the most important prognostic factor in bladder tumors? (A) histologic grade (B) painless hematuria (C) histologic type (D) depth of invasion
depth of invasion (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 576
1783
Lesion of the female vulva characterized by thinning of the epidermis and disappearance of rete pegs, hydropic degeneration of basal cells, superficial hyperkeratosis, dermal fibrosis with scant perivascular, mononuclear inflammatory cell infiltrate. Occurs most commonly in postmenopausal women.
Lichen sclerosus(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713
1784
This disorder of the vulva is marked by epithelial thickening, expansion of the stratum granulosum, significant surface hyperkeratosis and pronounced leukocytic infiltrate. Appears clinically as an area of leukoplakia.
Lichen simplex chronicus(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713
1785
These are flat, moist, minimally elevated lesions that occur in secondary syphilis.
Condyloma lata(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713
1786
Lesions of the anogenital area which may be papillary and distinctly elevated or may be somewhat flat and rugose. Characteristic cellular morphology is the presence of cytoplasmic vacuolization with nuclear angular polymorphism and koilocytosis. Hallmark of HPV infection.
Condyloma acuminata(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713
1787
Red, scaly plaque, microscopically characterized by the spread of malignant cells within the epithelium, occasionally with invasion of underlying dermis. May have underlying carcinoma of a vulvar or perineal gland.
Paget disease of the Vulva(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 715
1788
A soft polypoid mass, which is a rare form of primary vaginal cancer. Usually encountered in infants and children less than 5 y/o.
Sarcoma botryoides (embryonal rhabdomyosarcoma)(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 716
1789
Most commonly develops in the transformation zone of the cervix. Produces a "barrel cervix" if the tumor encircles the cervix and invades the underlying stroma.
Invasive carcinoma of the cervix(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 719
1790
Protruding polypoid masses which are inflammatory in origin, soft, yields to palpation, and have a smooth, glistening surface with underlying cystically dilated spaces filled with mucinous secretion.
Endocervical polyp(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721
1791
Refers to the growth of the basal layer of the endometrium down to the myometrium. Nests of endometrial stroma, glands or both are found in the myometrium, in between muscle bundles.
Adenomyosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721
1792
Characterized by the presence of endometrial glands and stroma in a location outside the endomyometrium. Undergoes cyclic bleeding. Also called "chocolate cysts".
Endometriosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 722
1793
These are sharply circumscribed, firm, gray-white masses of the uterus, with "whorled" cut surface.
Leiomyoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721
1794
Solitary tumors of the uterus which arise de novo from the mesenchymal cells of the myometrium. Characterized byvtche presence of tumor necrosis, cytologic atypia and mitotic activity.
Leiomyosarcomas(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 725
1795
Type of endometrial carcinoma associated with estrogen excess and endometrial hyperplasia.
Endometroid carcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 727
1796
Type of endometrial carcinoma which occurs in older women and is usually associated with endometrial atrophy.
Serous carcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 727
1797
Small, fluid-filled cysts which originate from the unruptured graafian follicles or in follicles that have ruptured and immediately sealed.
Follicle and luteal cysts(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728
1798
Triad of oligomenorrhea, infertility and obesity in young women secondary to excessive production of estrogens and androgens.
Polycystic ovaries(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728
1799
Other name for polycystic ovary syndrome?
Stein-Leventhal syndrome(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728
1800
Two most important risk factors for development of ovarian cancer.
Nulliparity and family history(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729
1801
Mutation of this gene is associated in the development of both ovarian and breast cancers.
BRCA 1(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729
1802
Mutation of this gene is associated with the development of breast cancer only,
BRCA 2(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729
1803
Benign lesion of the ovary most commonly seen in women 30-40 years old. Most frequent of the ovarian tumors. Serosal covering is smooth and glistening. Characterized histologically by tall, columnar epithelium and the presence of Psammoma bodies.
Serous tumor of the ovary(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 730
1804
Large, multilocular tumors of the ovaries, without psammoma bodies. Composed of mucin-producing epithelial cells.
Mucinous Tumors (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731
1805
Metastasis of mucinous tumor of the gastrointestinal tract to the ovaries is called?
Krukenberg tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731
1806
A rare, solid, unilateral ovarian tumor consisting of an abundant stroma containing nests of transitional-like epithelium resembling that of the urinary tract.
Brenner Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
1807
Unilateral ovarian tumor composed of sheets or cords of large cleared cells separated by scant fibrous strands. Stroma may contain lymphocytes and occasional granuloma. Usually occur on the 2nd-3rd decade of life.
Dysgerminoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
1808
Unilateral ovarian tumor which occur during the 1st 3 decades of life. Characterized by small, hemorrhagic focus with syncitiothrophoblast and cytotrophoblast. Metastasize early.
Choriocarcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
1809
Sex cord tumor seen as small, gray to yellow-brown, and solid lesions. May resemble development of testis with tubules, or cords and plump pink Sertoli cells. May be masculinizing or defeminizing.
Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
1810
Microscopically, the distinguishing feature is a variety of immature or barely recognizable areas of differentiation toward cartilage, bone, muscle, nerve, and other structures. Found early in life.
Immature Malignant Teratomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733
1811
Tumor of the ovary composed entirely of mature thyroid tissue. May hyperfunction and produce hyperthyroidism. Appear as small, solid, unilateral brown ovarian masses
Struma ovarii (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733
1812
A voluminous mass of swollen, sometimes cystically dilated, chorionic villi, appearing grossly as grapelike structures.
Hydatidiform Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 735
1813
This type of H. mole shows hydropic swelling of chorionic villi and virtual absence of vascularization of villi. No fetal parts seen.
Complete mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736
1814
This type of H. mole shows villous edema that involves only some of the villi and the trophoblastic proliferation is focal and slight, with characteristic irregular scalloped margin. Fetal parts/embryo may be seen.
Partial mole(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736
1815
These are complete moles that are more invasive locally but do not metastasize. Microscopically, the epithelium of the villi is marked by hyperplastic and atypical changes, with proliferation of both cuboidal and syncytial components.
Invasive Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736
1816
Appear as very hemorrhagic, necrotic masses within the uterus. The tumor is purely epithelial, composed of anaplastic cuboidal cytotrophoblast and syncytiotrophoblast, chorionic villi are not formed. High propensity for metastasis.
Choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737
1817
Term used to describe hyperplasia that cytologically resemble lobular carcinoma in situ, but the cells do not fill or distend more than 50% of the acini within a lobule.
Atypical lobular hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
1818
The lumen of the ducts, ductules, or lobules of the breast is filled with a heterogeneous population of cells of different morphologies. Irregular slit-like fenestrations are prominent at the periphery.
Epithelial Hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
1819
These lesions are characterized by proliferation of lining epithelial cells and myoepithelial cells in small ducts and ductules, yielding masses of small gland patterns within a fibrous stroma. The acini are arranged in a swirling pattern, and the outer border is usually well circumscribed.
Sclerosing Adenosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 741
1820
A nonbacterial chronic inflammation of the breast associated with inspissation of breast secretions in the main excretory ducts.
Mammary duct ectasia (periductal or plasma cell mastitis) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742
1821
The lesion is small, often tender, rarely more than 2 cm in diameter, and sharply localized, with a central focus of necrotic fat cells surrounded by neutrophils and lipid-filled macrophages. Caused by some antecedent trauma to the breast.
Traumatic fat necrosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742
1822
Small lobulated and cystic lesion of the breast that may grow rapidly. Exhibit "leaflike" clefts and slits on gross section.
Phyllodes Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 743
1823
A neoplastic papillary growth within a duct, usually solitary and less than 1 cm in diameter, consisting of delicate, branching growths within a dilated duct or cyst.
Intraductal Papilloma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 743
1824
A type of noninvasive carcinoma of the breast that tends to fill, distort, and unfold involved lobules and thus appears to involve ductlike spaces.
Ductal Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 745
1825
A type of noninvasive carcinoma of the breast expands but does not alter the underlying lobular architecture. Cells are monomorphic with bland, round nuclei and occur in loosely cohesive clusters in ducts and lobules. Tend to be bilateral, and increases risk for development of breast CA.
Lobar Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746
1826
Caused by the extension of DCIS up to the lactiferous ducts and into the contiguous skin of the nipple.
Paget disease of the nipple (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746
1827
This type of cancer produces a desmoplastic response, replacing normal breast fat and forms a hard, palpable mass. Advanced cancers may cause dimpling of the skin, retraction of the nipple, or fixation to the chest wall.
Invasive ductal carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
1828
Breast cancer defined by the clinical presentation of an enlarged, swollen, erythematous breast, usually without a palpable mass. The blockage of numerous dermal lymphatic spaces by carcinoma results in the clinical appearance (e.g peau d' orange)
Inflammatory carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
1829
Breast cancer which consists of cells morphologically identical to the cells of LCIS. Occasionally they surround cancerous or normal-appearing acini or ducts, creating a so-called "bull's-eye pattern."
Invasive lobular carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
1830
A rare subtype of carcinoma consisting of sheets of large anaplastic cells with pushing, well-circumscribed borders, with a pronounced lymphoplasmacytic infiltrate.
Medullary carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
1831
A rare subtype of carcinoma which appear grossly as a soft and gelatinous mass which abundant quantities of extracellular mucin that dissects into the surrounding stroma.
Colloid (mucinous) carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
1832
Usually present as irregular mammographic densities. Microscopically, the carcinomas consist of well-formed tubules with low-grade nuclei. Lymph node metastases are rare, and prognosis is excellent.
Tubular carcinomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
1833
Grossly, appears as a button-like, subareolar swelling. in bilateral breasts of males.
Gynecomastia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 750
1834
Large, multilocular tumors of the ovaries, without psammoma bodies. Composed of mucin-producing epithelial cells.
Mucinous Tumors (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731
1835
Metastasis of mucinous tumor of the gastrointestinal tract to the ovaries is called?
Krukenberg tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731
1836
Unilateral ovarian tumor composed of sheets or cords of large cleared cells separated by scant fibrous strands. Stroma may contain lymphocytes and occasional granuloma. Usually occur on the 2nd-3rd decade of life.
Dysgerminoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
1837
Unilateral ovarian tumor which occur during the 1st 3 decades of life. Characterized by small, hemorrhagic focus with syncitiothrophoblast and cytotrophoblast. Metastasize early.
Choriocarcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
1838
Sex cord tumor characterized by solid gray fibrous cells to yellow (lipid-laden) plump thecal cells. Most hormonally inactive.
Thecoma-fibroma tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
1839
Sex cord tumor seen as small, gray to yellow-brown, and solid lesions. May resemble development of testis with tubules, or cords and plump pink Sertoli cells. May be masculinizing or defeminizing.
Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
1840
On transection, filled with sebaceous secretion and matted hair, bonw and cartilage, nests of bronchial or gastrointestinal epithelium, and other recognizable lines of development are also present.
Benign (Mature) Cystic Teratomas / Dermoid Cyst(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733
1841
Microscopically, the distinguishing feature is a variety of immature or barely recognizable areas of differentiation toward cartilage, bone, muscle, nerve, and other structures. Found early in life.
Immature Malignant Teratomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733
1842
Appear as very hemorrhagic, necrotic masses within the uterus. The tumor is purely epithelial, composed of anaplastic cuboidal cytotrophoblast and syncytiotrophoblast, chorionic villi are not formed. High propensity for metastasis.
Choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737
1843
A cystic dilation of an obstructed duct that arises during lactation.
Galactocele (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
1844
Multifocal, bilateral blue-brown cysts ("blue dome cysts") of the breast, measuring 1-5 cm diameter, filled with serous turbid fluid. Occurs normally in the menstrual cycle.
Simple fibrocystic change of the breast(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
1845
Term used to describe hyperplasia that cytologically resemble lobular carcinoma in situ, but the cells do not fill or distend more than 50% of the acini within a lobule.
Atypical lobular hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
1846
The lumen of the ducts, ductules, or lobules of the breast is filled with a heterogeneous population of cells of different morphologies. Irregular slit-like fenestrations are prominent at the periphery.
Epithelial Hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
1847
These lesions are characterized by proliferation of lining epithelial cells and myoepithelial cells in small ducts and ductules, yielding masses of small gland patterns within a fibrous stroma. The acini are arranged in a swirling pattern, and the outer border is usually well circumscribed.
Sclerosing Adenosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 741
1848
A nonbacterial chronic inflammation of the breast associated with inspissation of breast secretions in the main excretory ducts.
Mammary duct ectasia (periductal or plasma cell mastitis) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742
1849
The most common benign neoplasm of the female breast.
Fibroadenoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742
1850
A discrete, usually solitary, freely movable nodule, 1 to 10 cm in diameter, easily "shelled out" lesion of the breast. Histologically there is a loose fibroblastic stroma containing ductlike, spaces lined by a layer of epithelium that are regular and have a well-defined, intact basement membrane.
Fibroadenoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742
1851
A type of noninvasive carcinoma of the breast that tends to fill, distort, and unfold involved lobules and thus appears to involve ductlike spaces.
Ductal Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 745
1852
A type of noninvasive carcinoma of the breast expands but does not alter the underlying lobular architecture. cells are monomorphic with bland, round nuclei and occur in loosely cohesive clusters in ducts and lobules. Tend to be bilateral, and increases risk for development of breast CA.
Lobar Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746
1853
Morphology: large macrophages with granular PAS positive cytoplasm and several dense, round Michaelis Gutmann bodies.
Malacoplakia (TOPNOTCH)
1854
In gonococcal infection of the female reproductive system, inflammatory changes will appear about how many days after the inoculation of the organism?
2-7 days (TOPNOTCH)
1855
These cells are distinguised by a clear separation "halo" from the surrounding epithelial cells and a finely granular cytoplasm containing mucopolysaccharide that stains with PAS, Alcian Blue, and Mucicarmine
Paget cells (TOPNOTCH)
1856
What is the probable precursor of vaginal adenocarcinoma?
Vaginal adenosis (TOPNOTCH)
1857
What do you call the glandlike structures filled with an acidophilic material similar to immature follicles that are seen in Granulosa Theca Cell tumors?
Call Exner bodies (TOPNOTCH)
1858
Presence of these structures characterize serous tumors of the ovaries
Psammoma bodies (TOPNOTCH)
1859
These tumors are distinguished from serous and mucinous tumors of the ovaries by the presence of tubular glands that resemble the endometrium
Endometriod tumor (TOPNOTCH)
1860
A key factor in the development of endometrial hyperplasia and related cancers is the inactivation of what tumor suppressor gene?
PTEN (TOPNOTCH)
1861
What is the most common location of vaginal adenocarcinoma?
Anterior wall of the upper third of Vagina (TOPNOTCH)
1862
This is a condition in which glandular columnar epithelium of mullerian type either appears beneath the squamous epithelium or replaces it
Vaginal Adenosis (TOPNOTCH)
1863
What are the 4 cardinal histologic features of Lichen Sclerosus of the Vulva or Chronic atrophic vulvitis?
Atrophy of the epidermis with disappearance, of the rete pegs, hydrophic degeneration of the basal cells, replacement of the underlying dermis by dense collagenous fibrous tissue, and monoclonal band like lymphocytic infiltrate (TOPNOTCH)
1864
Morphology: acanthosis of the vulvar squamous epithelium frequently with hyperkeratosis
Lichen SImplex Chronicles (TOPNOTCH)
1865
Morphology: presence of large tumor cells lying singly or in small lusters within the epidermis and its appendages
Extra mammary Paget Disease (TOPNOTCH)
1866
Morphology: tumor cells resemble tennis racket with small protrusions of cytoplasms from one end
Embryonal Rhabdomyosarcoma (TOPNOTCH)
1867
Clustering of tumor cells in a so called "Cambium Layer" is seen in what type of rhabdomyosarcoma?
Embryonal Rhabdomyosarcoma (TOPNOTCH)
1868
On histological examination of the cervix, epithelial spongiosis is associated with what type of infection?
T. vaginal infection (TOPNOTCH)
1869
On histological examination of the cervix, epithelial ulcers with intranuclear inclusions within the epithelial cells and lymphocytic infiltration is associated with what type of infection?
HSV (TOPNOTCH)
1870
Morphology: these are composed of dense fibrous stroma covered with endocervical columnar epithelium
Endocervical polyp (TOPNOTCH)
1871
What is considered the most important agent in cervical oncogenesis?
HPV (TOPNOTCH)
1872
Koilocytic atypia is considered what type of CIN lesion?
CIN I (TOPNOTCH)
1873
What is the most common pattern seen in invasive cervical carcinoma?
Fungating (TOPNOTCH)
1874
On histological examination of the endometrium, what is the earliest morphological evidence of ovulation?
Basal vacuolation (TOPNOTCH)
1875
Morphology: ectopic endometrial glands and stroma with numerous macrophages containing hemosiderin
Endometriosis (TOPNOTCH)
1876
The combination of ovarian tumor, hydrothorax, and ascites is designated as
Meigs Syndrome (TOPNOTCH)
1877
What type of ovarian cancer is best considered as the counterpart of the seminoma of the testes?
Dysgerminoma (TOPNOTCH)
1878
About 1% of the dermoids undergo malignant transformation of any one of the component elements present, but most commonly, they differentiate into what type of carcinoma?
Squamous Cell Carcinoma (TOPNOTCH)
1879
Morphology: characterized by a lining of tall columnar epithelial cells with apical mucin and the absence of cilia, resembling cervical or intestinal epithelium
Mucinous tumors (TOPNOTCH)
1880
Morphology: lined by a rim of bright yellow luteal tissue containing luteinized granulosa cells
Luteal cyst (TOPNOTCH)
1881
Morphology: characterized chiefly by dilations of ducts, inspissation of breast secretions, and marked periductal and interstitial chronic granulomatous reaction
Mammary Duct Ectasia (TOPNOTCH)
1882
What are the 3 principal patterns of morphologic changes seen in Fibrocystic Changes of the breast?
1. Cyst formation with apocrine metaplasia2. Fibrosis3. Adenosis (TOPNOTCH)
1883
Morphology: proliferation of intralobular stroma surrounding and often pushing and distorting the associated epithelium. The border is sharply delimited from the surrounding tissue
Fibroadenoma (TOPNOTCH)
1884
What is the most important prognostic factor useful as a predictive factor for the response of therapy in patients with breast cancer?
Presence of estrogen and progesterone receptors (TOPNOTCH)
1885
Morphology: characterized by solid syncytium like sheets occupying 75% of the tumor , prominent lymphoplasmacytic infiltrate and a non inflitrative border
Medullary carcinoma of the breast (TOPNOTCH)
1886
The histologic hallmark of this tumor is the pattern of single infiltrating tumor cells, often only one cell in width, or in loose clusters or sheets
Invasive lobular carcinoma (TOPNOTCH)
1887
This is a rare manifestation of breast cancer and presents as a unilateral erythematous eruption with a scale crust
Paget disease (TOPNOTCH)
1888
These are stellate lesions characterized by a central nidus of entrapped glands in a hyalinized stroma
Complex Sclerosing Lesion or Radial Scar (TOPNOTCH)
1889
Morphology: composed of multiple branching fibrovascular cores, each having a connective tissue axis lined by luminal and myoepithelial cells
Papillomas (TOPNOTCH)
1890
What is the most common clinical presentation of breast disease
Pain (TOPNOTCH)
1891
The principal mammographic signs of breast carcinoma
Densities and calfications (TOPNOTCH)
1892
Morphology: the main histologic feature is keratinizing squamous epithelium extending to an abnormal depth into the orifices of the nipple ducts
Periductal mastitis (TOPNOTCH)
1893
Mammographic appearance: Large lobulated "popcorn" calcifications
Fibroadenoma (TOPNOTCH)
1894
Morphology: characterized by solid sheets of pleomorphic cells with high-grade nuclei and central necrosis detected mamographically as clusters or linear and branching microcalcifications
Comedocarcinoma (TOPNOTCH)
1895
Morphology: Terminal ducts (without lobule formation) are lined by a multilayered epithelium with small papillary tufts and surrounding periductal hyalinization and fibrosis.
Gynecomastia (TOPNOTCH)
1896
Morphology: terminal duct lobular unit is enlarged, and the acini are compressed and distorted within the lumens. Calcifications are often present within the lumens.
Sclerosing adenosis(TOPNOTCH)
1897
Morphology: central fibrovascular core extends from the wall of a duct. The papillae arborize within the lumen and are lined by myoepithelial and luminal cells
Intraductal papilloma(TOPNOTCH)
1898
Cellular proliferation resembling ductal carcinoma in situ or lobular carcinoma in situ but lacking sufficient qualitative or quantitative features for a diagnosis of carcinoma in situ
Atypical hyperplasia(TOPNOTCH)
1899
Refers to a proliferation of cells identical to those of LCIS but the cells do not fill or distend more than 50% of the acini within a lobule.
Atypical Lobular hyperplasia(TOPNOTCH)
1900
Recognized by its histologic resemblance to ductal carcinoma in situ, including a monomorphic cell population, regular cell placement, and round lumina. However, the lesions are characteristically limited in extend, and the cells are not completely monomorphic in type or they fail to completely fill ductal spaces
Atypical hyperplasia(TOPNOTCH)
1901
What are the two major risk factors for breast carcinoma?
Hormonal and Genetics/family history(TOPNOTCH)
1902
This is a subtype of DCIS which is recognized by bulbous protrusions without a fibrovascular core, often forming complex intraductal patents.
Micropapillary DCIS(TOPNOTCH)
1903
Earliest lesions consist of red papules progressing to vesicles then to painful coalescent ulcers on the vulvar or vaginal area. Smears shows multinucleated squamous cellswith basophilic viral inclusion with a ground-glass appearance. This is caused by:
HSV (TOPNOTCH) Robbins Basic Pathologym 9th ed, p. 993
1904
Presents with pearly, dome-shaped papules with a dimpled center. Central waxy core contains cells with cytoplasmic viral inclusion. The lesion described is:
Molluscum contagiosum(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 993
1905
Manifests with vulvovaginal pruritus, erythema, swelling, and curdlike vaginal discharge. Wet KOH mount of discharge shows pseudospore or filamentous fungal hyphae.
Candidiasis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 994
1906
Presents with yellow, frothy vaginal discharge, vulvovaginal discomfort, dysuria, and dyspareunia. The vaginal and cervical mucosa typically has a fiery red appearance, with marked dilatation of cervical mucosal vessels ("strawberry cervix"). The cause is:
Trichomonas vaginalis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 994
1907
Presents with thin, green-gray, fishy vaginal discharge. Pap smear reveal squamous cells covered with a shaggy coating coccobacilli.
Bacteria vaginosis(caused by Gardnerella vaginalis)(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 994
1908
This infection is characterized by marked acute inflammation of mucosa; smears of inflammatory exudate shows phagocytosed gram-negative diplococci within neutrophils.
Gonococcal infection(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 995
1909
Most common site of vaginal carcinoma
Upper vagina, posterior wall at the junction with ectocervix(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1000
1910
True or False: All HSILS are considered to be at high risk for progression to carcinoma.
True(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1003
1911
Viral proteins implicated in the ability of HPV to act as carcinogen by interfering with the activity of tumor suppressor proteins.
E6 and E7(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1002
1912
Most common histologic subtype of cervical carcinoma
Squamous Cell Carcinoma (TOPNOTCH)
1913
Most common high-risk HPV type causing cervical precursor lesions and cervical carcinomas.
HPV-16.(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1007
1914
Most frequent cause of dysfunctional bleeding
Anovulation(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1009
1915
Disease of women in active reproductive life; causes infertility, dysmenorrhea, pelvic pain. Endometrial glands and stroma outside of the uterus.
Endometriosis (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1012
1916
An important cause of abnormal uterine bleeding; frequent precursor to endometrial carcinoma; most commonly caused by by unopposed estrogen stimulation.
Endometrial hyperplasia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1013
1917
Most common invasive cancer of the female genital tract
Endometrial carcinoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1013
1918
True or False. Malignant transformation of leiomyoma to leiomyosarcoma is rare.
True(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1020
1919
The majority of ovarian neoplasm arise from?
Mullerian epithelium(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1023
1920
The most common primary malignant ovarian tumor
Serous adenocarcinoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1023
1921
Most common germ cell tumor of the ovary in women of reproductive age
Mature cystic teratoma/dermoid cyst(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1031
1922
Glomerulus-like structure composed of a central blood vessel enveloped by tumor cells within a space lined by tumor cells
Schiller-Duval body(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1031
1923
Characteristic histologic feature of Yolk Sac Tumor
Schiller-Duval body(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1031
1924
Ovarian tumor that may elaborate large amounts of estrogen; Two thirds occur in post-menopausal women; potentially malignant
Granulosa cell tumor(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1032
1925
Biomarker useful for identifying granulosa an other sex cord-stromal tumors, and monitoring treatment.
Serum inhibin(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1032
1926
Serum marker for ovarian carcinoma
CA-125(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1029
1927
Ovarian tumor that often functional and commonly produce masculinization or defeminization; peak incidence 20-30 y/o; cut surface is usually solid, gray to golden brown in appearance.
Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. `033
1928
Most common extra-mullerian tumors metastatic to the ovary
Carcinoma of the breast and GIT(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1034
1929
Systemic syndrome characterized by widespread maternal endothelial dysfunction that presents during pregnancy with hypertension, edema, and proteinuria.
Preeclampsia(TOPNOTCH) Robbins Basic Pathology, p. 1034
1930
Morphology: placental infarcts, retroplacental hematoma, abnormal decidual vessels, fibrin thrombi in the portal capillaries and hemorrhagic necrosis of the liver, kidney glomeruli show marked swelling of endothelial cells, mesangial cell hyperplasia, amorphous dense deposits on the endothelial side of basement membrane.
Preeclampsia(TOPNOTCH) Robbins Basic Pathology, p. 1039
1931
Choriocarcinoma is most often preceded by:
Complete H. mole(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1041
1932
Most common cause of acute bacterial mastitis
Staphylococcus aureus(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1046
1933
Most important risk factors of breast cancer
Estrogenic stimulation and age(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1057
1934
Most common molecular subtype of invasive breast cancer
ER-positive, HER2-negative, low proliferation(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1060
1935
Histologic hallmark: presence of discohesive infiltrating tumor cells, often including signet-ring cell containing mucin droplets.
Lobular carcinoma of the breast(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1065
1936
Most important prognostic factor for invasive carcinoma of the breast in the absence of lymph node status.
Axillary lymph node status(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1066
1937
A 44 year old G3P3 has a routine Pap smear, which reported "LSIL." A colposcopy showed a reddish area in the posterior cervix. Biopsy showed an intact squamous epithelium with some cells showing dark, angulated nuclei surrounded by a clear cytoplasm. The biopsy will be read as (A) normal (B) CIN I (C) CIN II (D) CIN III
CIN I (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 718-719
1938
A 38 year old G2P2 presents with dysmenorrhea and menorrhagia. Ultrasound shows a symmetrically enlarged uterus, with a 4 cm thick myometrium, and endometrium with normal thickness. She opts to have a hysterectomy. The histopathology showed nests of endometrial glands and stroma in the myometrium between the muscle bundles. The endometrium is described as "proliferative." She has (A) a leiomyoma (B) adenomyosis (C) endometrial stromal sarcoma (D) endometrial carcinoma
Adenomyosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721
1939
A 42 year old G4P4 has had a 20 year history of dysmenorrhea. An ultrasound shows a right adnexal cyst. She undergoes a right salpingoophorectomy. The right ovary has been converted to a 10 cm diameter brown cystic mass, filled with dark brown fluid. The internal surface is shaggy. Microscopic examination shows hemorrhage and hemosiderin deposits, and occasional endometrial glands and stroma. This lesion (A) contains nonfunctioning endometrium (B) probably originated from retrograde implantation of menstrual endometrium (C) is malignant (D) all of the above
probably originated from retrograde implantation of menstrual endometrium (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 722
1940
Which of the following is associated with endometrial hyperplasia? (A) Stein-Leventhal syndrome (B) granulosa-theca cell tumors (C) obesity (D) all of the above
all of the above (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 723
1941
Which of the following has the highest risk of developing endometrial carcinoma? (A) cystically dilated endometrial glands, with single layer of endometrial cells (B) crowded branched endometrial glands, with tall, columnar epithelium exhibiting stratification and nuclear atypia (C) nests of closely packed glands with single layer of endometrial cells (D) regularly spaced endometrial glands, with epithelium exhibiting supranuclear vacuoles, and stromal edema
crowded branched endometrial glands, with tall, columnar epithelium exhibiting stratification and nuclear atypia (complex hyperplasia with atypia) (A- disordered endometrium; C - hyperplasia without atypia; D - secretory endometrium) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 723-724
1942
A 48 year old G0P0 woman has menorrhagia. Ultrasound shows multiple sharply circumscribed myometrial and submucosal masses. She undergoes hysterectomy. Histopathology showed whorled bundles of smooth muscle cells, with rare mitoses, and no necrosis. These masses (A) commonly transform into sarcomas (B) may shrink postmenopausally (C) are polyclonal (D) all of the above are true
may shrink postmenopausally (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 724
1943
Which of the following is a risk factor for endometrial carcinoma? (A) obesity (B) diabetes mellitus (C) hypertension (D) all of the above
all of the above (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 725
1944
In endometrial carcinomas, which histologic pattern is associated with p53 mutations, arises in a background of endometrial atrophy, and has a poor prognosis? (A) serous (B) mucinous (C) endometrioid (D) adenosquamous
serous (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 726
1945
A 22 year old presents with signs of acute abdomen. On history, she has been amenorrheic for 8 weeks. Pelvic examination showed a tender right adnexal mass. She undergoes emergency laparotomy with right salpingectomy. At histopathology, the fallopian tube is dilated with a point of rupture. The lumen is filled with blood clots. Which of the following histopathologic findings proves tubal pregnancy? (A) decidualized tubal epithelium (B) infiltrates of neutrophilic agreggates and necrosis (C) diffuse hemorrhage and fibrin deposition (D) chorionic villi
chorionic villi (TOPNOTCH) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 734
1946
Which of the following statements on ovarian cancer is true? (A) the risk is higher in BRCA 2 mutations than in BRCA1 (B) multiparity is a risk factor (C) oral contraceptives somewhat reduces the risk (D) all of the above
oral contraceptives somewhat reduces the risk (A - higher in BRCA1, B - nulliparity is a risk) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729
1947
Epithelial tumors of the ovary can be benign, borderline, or malignant. Which histologic type is more likely to be malignant than benign? (A) serous (B) mucinous (C) endometrioid
endometrioid (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731
1948
A 17 year old female presents with a 10 cm left ovarian cyst and undergoes oophorectomy. On histopathology, the cyst is filled with sebum and hair. There is a solid area with a gritty cut surface. Which of the following histologic findings characterizes the tumor as immature? (A) islands of cartilage and bone (B) nests of pseudostratified epithelium (C) sheets of round cells with scant cytoplasm, some forming rosettes (D) foci of glial cells admixed with neuropil
sheets of round cells with scant cytoplasm, some forming rosettes (neuroepithelial differentiation) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733
1949
Which of the following ovarian tumors can produce virilizing signs and symptoms? (A) granulosa cell tumor (B) thecoma (C) sertoli-leydig tumor (D) dysgerminoma
Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
1950
Which of the following trophoblastic lesions has a triploid karyotype? (A) complete mole (B) partial mole (C) invasive mole (D) placental site trophoblastic tumor
Partial mole(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 735-736
1951
Which of the following tumors is most responsive to chemotherapy? (A) gonadal choriocarcinoma (B) gestational choriocarcinoma (C) placental site trophoblastic tumor
gestational choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737
1952
A 32 year old female presents with a 5 year history of a right breast lump. A core needle biopsy is performed. Which of the following findings represents a lesion that can progress to ductal carcinoma? (A) small and large cysts with cuboidal to columnar epithelium and surrounding fibrous stroma (B) lymphocytes and plasma cells infiltrating the periductal stroma (C) loose fibroblastic stroma with compressed, slit-like epithelium lined spaces (D) expanded ducts with proliferating monomorphic epithelial cells, with rigid, round fenestrations
expanded ducts with proliferating monomorphic epithelial cells, with rigid, round fenestrations (atypical ductal hyperplasia) (A - fibrocystic changes; B - chronic mastitis; (C) - fibroadenoma) (TOPNOTCH) Robbins Basic Pathology, 8th ed., pp 739-743
1953
A 39 year old female presents with bloody discharge from the right nipple. A subareolar lump is palpated. It is excised and submitted to histopathology, which showed multiple papillae with connective tissue cores and lined by an outer cuboidal epithelial layer, and an inner myoepithelial layer. This lesion (A) is also known as cystosarcoma phyllodes (B) is malignant (C) usually arises in a lactiferous duct (D) all of the above
usually arises in a lactiferous duct (intraductal papilloma) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p743
1954
A 45 year old female presents with a right breast lump. An excision is performed, showing an ill-defined firm mass. Histopathology shows cells invading individually into the stroma, some forming aligned strands or chains. Other cells encircle normal-appearing ducts, forming a bull's eye pattern. This carcinoma (A) is almost always associated with HER2/NEU overexpression (B) frequently metastasizes into CSF, serosal surfaces and gastrointestinal tract (C) consists more than 80% of breast carcinomas (D) all of the above are true
frequently metastasizes into CSF, serosal surfaces and gastrointestinal tract (invasive lobular carcinoma) (A - Her2/Neu overexpression very rare; C - uncommon type,
1955
Which of the following breast carcinomas has the worst prognosis? (A) pure medullary carcinoma (B) mucinous carcinoma (C) tubular carcinoma (D) ductal carcinomas of no special type
ductal carcinoma of no special type (TOPNOTCH) Robbins Basic Pathology, 8th ed., pp 748-749
1956
Small, painful, rounded superficial erosions of the mouth, covered with a gray-white exudate and having an erythematous rim.
Aphthous ulcers (canker sores)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
1957
Extremely common infection caused by herpes simplex virus type 1.
Herpetic stomatitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
1958
Test used to identify HSV infection.
Tzanck test(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
1959
Glassy, intranuclear acidophilic inclusion bodies.
Herpes simplex virus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
1960
Adherent white, curd-like, circumscribed plaque within the oral cavity. The pseudomembrane can be scraped off revealing an underlying granular erythematous inflammatory base.
Oral candidiasis /"thrush"(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
1961
An oral lesion seen in patients with HIV. White confluent patches with "hairy" or corrugated surface with marked epithelial thickening.
Hairy leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
1962
Hairy leukoplakia is caused by what infectious agent?
Epstein-Barr virus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
1963
A whitish, well-defined mucosal patch or plaque caused by epidermal thickening or hyperkeratosis, commonly seen in the vermillion border of the lower lip, buccal mucosa, hard and soft palates.
Leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
1964
Oral lesion showing a corrugated surface caused by excessive hyperkeratosis. Recurring and spreads insiduously, resulting in a warty-type lesion.
Verrucous leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
1965
Red, velvety, granular, circumscribed lesions of the mouth with poorly defined, irregular boundaries. High malignant transformation rate.
Erythroplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
1966
Most frequent site of oral cavity carcinomas.
Vermillion border of the lateral margins of the lower lip(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
1967
Pearly white to gray, circumscribed thickenings of the oral mucosa, which grows in exophytic pattern to produce a visible and palpable nodular, eventually fungating lesions.
Oral cavity carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
1968
Most common lesion of the salivary glands resulting from blockage or rupture of a salivary gland duct.
Mucocele(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
1969
Inflammation of the salivary glands.
Sialadenitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
1970
Salivary and lacrimal gland inflammatory enlargement presenting as painless lesions, and dry mouth. Can be caused by sarcoidosis, leukemia, and lymphoma.
Mikulicz syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
1971
Incomplete relaxation of lower esophageal sphincter in response to swallowing.
Achalasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
1972
Destruction of the myenteric plexus of the esophagus, duodenum, colon and ureter caused by a flagellate protozoa.
Chagas disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
1973
Causative agent for Chagas disease.
Trypanosoma cruzi(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
1974
Adult with progressive dysphagia to solids and eventually to all foods, caused by a narrowing of the lower esophagus, usually as a result of chronic inflammatory disease.
Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
1975
A congenital defect which causes the esophagus to end in a blind-ended pouch.
Esophageal atresia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
1976
Most common type of esophageal atresia.
Esophageal atresia with distal tracheoesophageal fistula(Type C)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
1977
Thin membranes of normal esophageal tissue consisting of mucosa and submucosa that can partially obstruct the esophagus.
Esophageal web(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
1978
Congenital esophageal webs commonly appear in which segment of the esophagus?
Middle and inferior third of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
1979
A diverticulum of the mucosa of the pharynx just above the cricopharyngeal muscle.
Zenker's diverticulum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
1980
A triangular area in the pharyngeal wall where a Zenker's diverticulum may develop.
Killian's triangle(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
1981
Protrusion of the stomach above the diaphragm, creating a bell-shaped dilation, bounded below by the diaphragmatic narrowing.
Sliding hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
1982
Hernia wherein a portion of the stomach, usually along the greater curvature, enters the thorax through the widened space between the muscular crura.
Paraesophgeal (rolling) hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
1983
Longitudinal tears along the gastroesophageal junction seen in chronic alcoholics after a bout of retching or vomiting.
Mallory-Weiss tears(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
1984
Tortuous dilated veins lying within the submucosa of the distal esophagus and proximal stomach due to increased portal pressure, usually due to cirrhosis. May cause massive hemorrhage if ruptured.
Esophageal varices(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 587
1985
Presence of eosinophils in the epithelial layer, basal zone hyperplasia and elongation of lamina propria papillae are histologic findings in this condition.
Reflux esophagitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 588
1986
Defined as the replacement of the normal distal stratified squamous mucosa by metaplastic columnar epithelium containing goblet cells. A complication of long-standing GERD.
Barrett esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
1987
Esophageal lesion at risk of developing adenocarcinoma:Reflux esophagitis or Barrett esophagus?
Barrett esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 589
1988
Squamous cell carcinoma of the esophagus commonly occur at which segment of the esophagus?
Proximal 2/3 of the esophagusAdenocarcinoma- distal 1/3(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
1989
Most common symptoms of esophageal cancer.
Dysphagia and odynophagia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
1990
Mucin-producing glandular tumors of the distal esophagus showing intestinal-type features.
Adenocarcinoma of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
1991
Presence of chronic inflammatory changes in the mucosa of the stomach eventually leading to mucosal atrophy and epithelial metaplasia.
Chronic gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
1992
Most important etiologic association with chronic gastritis. A non-invasive, non-spore forming S-shaped gram negative rod.
Helicobacter pylori(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
1993
Gastritis resulting from production of autoantibodies to the gastric gland parietal cells, leading to gland destruction and mucosal atrophy with loss of acid and intrinsic factor.
Autoimmmune gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
1994
Refers to the replacement of gastric epithelium with columnar and goblet cells of intestinal variety.
Intestinal metaplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
1995
A acute mucosal inflammatory process of the stomach, marked by mucosal edema and inflammatory infiltrate of neutrophils and chronic inflammatory cells. Regenerative replication of cells in the gastric pit is prominent.
Acute gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
1996
One of the major causes of hematemesis, especially in alcoholics.
Acute gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
1997
A breach in the mucosa that extends through the muscularis mucosae into the submucosa or deeper.
Ulcers(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
1998
Breach in the epithelium of the gastrointestinal mucosa only.
Erosions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
1999
Chronic, solitary lesions that occur in any portion of the GIT exposed to the aggressive action of acidic peptic juices.
Peptic ulcers(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 594
2000
Major cause of peptic ulcer disease in patients without H. pylori disease.
NSAID use(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 595
2001
Histologic layers in a chronic, nonperforated, open ulcer.
From luminal surface:NecrosisInflammationGranulation tissueScar(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
2002
Chief complication of peptic ulcer.
Bleeding(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
2003
Increases risk of developing gastric adenocarcinoma:Acute gastritis vs. peptic ulcer disease?
Acute gastritisPUD is NOT a premalignant lesion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
2004
Acute gastric ulceration which occurs in the presence of extensive burns.
Curling ulcer(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
2005
Acute gastric ulceration which occurs in the presence of injury to the CNS.
Cushing ulcer(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
2006
Composed of hyperplastic gastric mucosal epithelium and an inflamed edematous stroma. A mass lesion arising from the mucosa.
Gastric polyp(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 597
2007
Most common site of gastric carcinoma within the stomach.
Pylorus and antrum (50-60%), along the lesser curvatureCardia (25%)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 598
2008
What are the two most important factors in the genesis of colonic diverticula?
Focal weakness in the colonic wall and increased intraluminal pressure(TOPNOTCH)
2009
Morphologic feature of gastric carcinomas with greatest impact on prognosis.
Depth of invasion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
2010
Gastric carcinoma confined to the mucosa and submucosa, regardless of the presence or absence of perigastric LN metastasis.
Early gastric carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
2011
Gastric carcinoma which has extended below the submucosa into the muscular wall.
Advanced gastric carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
2012
Three macroscopic growth patterns of gastric carcinoma.
Exophytic - protrusion of mass into lumenFlat or depressed - no obvious tumor mass within the mucosaExcavated - a shallow or deeply eroded crater(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
2013
Rigid and thickened stomach, secondary to extensive malignant infiltration.
Linitis plastica(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
2014
Histologic classification of gastric carcinoma composed of malignant cells forming neoplastic intestinal glands resembling colonic adenocarcinoma. Associated with H. pylori induced chronic gastritis.
Intestinal variant(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
2015
Histologic classification of gastric carcinoma composed of gastric-type mucous cells that do not form glands but permeate the mucosa and wall as "signet-ring" cells in an infiltrative growth pattern.
Diffuse variant(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
2016
A malignancy in the ovary that metastasized from a gastric adenocarcinoma.
Krukenberg tumor(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
2017
Complete failure of development of the intestinal lumen.
Atresia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
2018
Narrowing of the intestinal lumen with incomplete obstruction.
Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
2019
Most common intestinal anomaly which results from the failure of involution of the omphalomesenteric duct, leaving a persistent blind-ended tubular protrusion as long as 5-6cm.
Meckel diverticulum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
2020
A congenital defect of the periumbillical abdominal musculature that creates a membranous sac, into which intestines herniate.
Omphalocoele(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
2021
Extrusion of the intestines caused by lack of formation of a portion of the abdominal wall.
Gastroschisis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
2022
Condition that prevents the intestines from assuming their normal intra-abdominal positions.
Malrotation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
2023
Critical lesion in the development of Hirschprung disease.
Lack of ganglion cells in the muscle wall and submucosa of the affected segment.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
2024
Ischemic lesion of the intestines which extends only up to the muscularis mucosae.
Mucosal infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
2025
Ischemic lesion of the intestines involving the mucosa and submucosa, sparing the muscular wall.
Mural infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
2026
Ischemic lesion of the intestines involving all of the visceral layers.
Transmural infarct(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
2027
Most common cause of transmural infarction of the intestines.
Acute occlusion of a major mesenteric artery(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
2028
Development of sudden abdominal pain out of proportion to the physical signs. Sometimes accomplanied by bloody diarrhea. May progress to shock and vascular collapse within hours.
Ischemic bowel injury(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
2029
A weakness or defect in the wall of the peritoneal cavity, which permits protrusion of a pouch-like serosa lined sac of peritoneum.
Hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 603
2030
A blind pouch that communicates with the lumen of the gut. Histologically describes as small, flask-like or spherical outpouchings, usually 0.5 to 1 cm diameter.
Diverticula(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
2031
Telescoping of a proximal segment of a bowel into the immediately distal segment
Intussusception(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 604
2032
Refers to twisting of a loop of bowel or other structure about its base of attachment, constricting venous outflow and sometimes the arterial supply.
Volvulus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 604
2033
Characterized by transmural inflammation of the bowel, associated with noncaseating granulomas and fistula formation. Intestinal walls are rubbery and thick. (+) skip lesions, creeping fat mesentery
Crohn's disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 613
2034
An ulceroinflammatory disease of the colon which is limited to the mucosa and submucosa. No granulomas, no skip lesions. High risk of carcinoma development.
Ulcerative colitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 614
2035
Small, nipple-like, hemispherical, smooth protrusions of the intestinal mucosa. May occur singly or multiple.contains abundant crypts luned by well-differentiated goblet or epithelial cells separated by scant lamina propria.
Hyperplastic polyps(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 617
2036
Hamartomatous proliferations mainly of lamina propria, enclosing widely spaced, dilated cystic glands. Occur most frequently in children younger than 5 years old.
Juvenile polyps(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
2037
Most common type of intestinal adenoma, which are tubular glands with slender stalks and raspberry-like heads composed pf neoplastic epithelium forming branching glands lined by tall, hyperchromatic cells.
Tubular adenomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
2038
Larger, more ominous intestinal epithelial polyp. Tends to occur in older persons at the rectum or rectosigmoid. Sessile, velvety and cauliflower-like mass projecting 1-3cm above the surrounding mucosa. Frondlike villiform extensions covered by dysplastic columnar epithelium.
Villous adenomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
2039
Composed of broad mix of tubular and villous areas, an intermediate between tubular and villous lesions.
Tubulovillous adenomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
2040
Uncommon autosomal dominant disorder with propensity for malignant transformation. Patients with this disease typically develop 500 to 2500 colonic adenomas that carpet the mucosal surface.
Familial adenomatous polyposis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619
2041
Uncommon hamartomatous polyps associated with melanotic mucosal and cutaneous pigmentation. Caused by germ-line mutations in LKB1 gene.
Peutz-Jeghers syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619
2042
Polypoid, exophytic masses that extend along the wall of capacious cecum and ascending colon. Symptoms of fatigue, weakness and iron deficiency anemia.
Right sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623
2043
Annular, encircling lesions, "napkin-ring" constrictions of the bowel and narrowing of the lumen. Symptoms pf occult bleeding, changes in bowel habit or crampy left lower quadrant discomfort.
Left-sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623
2044
Tumor of the small intestines, showing spindle cells with elongated nuclei with fine chromatin and eosinophilic fibrillar cytoplasm. (+) c-KIT gene mutation
Gastrointestinal stromal tumors (GIST)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 628
2045
Most common site of carcinoid tumors.
Small intestine(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 774
2046
Tumors arising from endocrine cells along the GIT. Solid, yellow-tan appearance on transection. Neoplastic cells have a scant, pink granular cytoplasm and a round-to-oval stippled nucleus.
Carcinoid tumors(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 627
2047
What is the most common ectopic tissue rests seen in the esophagus?
Ectopic Gastric Mucosa seen in the upper third of the esophagus (TOPNOTCH)
2048
What is the most common location of Mallory Weiss Tears?
Esophagogastric junction or in the proximal gastric (TOPNOTCH)
2049
Definitive diagnosis of Barret Esophagus is made when what type of cells is seen in the columnar mucosa?
Intestinal Goblet Cells(TOPNOTCH)
2050
What type of esophagitis presents with punched out linear ulcers with nuclear inclusions seen in degenerating epithelial cells?
Herpesvirus esophagitis(TOPNOTCH)
2051
What type of esophagitis presents with linear ulcerations of the esophageal mucosa with histologic findings of intranuclear and cytoplasmic inclusions?
CMV esophagitis(TOPNOTCH)
2052
98% of Peptic Ulcers are located in what part of the GIT?
First portion of the anterior part of the duodenum(TOPNOTCH)
2053
What is the most common location of gastric ulcer?
Lesser curvature (TOPNOTCH)
2054
What is the most common location of gastric carcinoma is?
Pylorus and antrum > Cardia > body and fundus(TOPNOTCH)
2055
What is the morphologic feature of gastric carcinoma that has the greatest impact on the clinical outcome?
Depth of invasion(TOPNOTCH)
2056
What is the most common primary source of gastric metastasis?
Systemic lymphoma(TOPNOTCH)
2057
What is the usual organism that cause spontaneous bacterial peritonitis in patients with nephrotic syndrome?
E. coli(TOPNOTCH)
2058
In bacterial peritonitis, approximately how many hours from the time of initiation before there is loss of the gray, glistening quality of the peritoneal surface and it becomes dull and lusterless?
2-4 hours(TOPNOTCH)
2059
What is the histologic criterion for the diagnosis of acute appendicitis?
Presence of neutrophilic infiltration of the muscularis propria.(TOPNOTCH)
2060
What is the most important prognostic indicator of colorectal carcinoma?
The extent of the tumor at the time of diagnosis or the stage(TOPNOTCH)
2061
Morphology: a type of adenoma that has frondlike villiform extensions of the mucosa, covered by dysplastic, sometimes very disorderly columnar epithelium
Villous adenomas(TOPNOTCH)
2062
These structures represent islands of inflamed regenerating mucosa surrounded by ulceration
Inflammatory or pseudopolyps(TOPNOTCH)
2063
Most adenomas are seen in what part of the GIT?
Ampulla of Vater(TOPNOTCH)
2064
Most tubular adenomas are found in what part of the GIT?
Colon(TOPNOTCH)
2065
Gross morphology: small, flask like or spherical outpouchings, usually 0.5 to 1 cm and located in the sigmoid colon
Colonic diverticula(TOPNOTCH)
2066
Morphology: thin wall composed of flattened or atrophic mucosa, compressed submucosa, and attenuated or totally absent muscularis propria.
Colonic diverticula(TOPNOTCH)
2067
What are the two most important factors in the genesis of colonic diverticula?
Focal weakness in the colonic wall and increased intraluminal pressure(TOPNOTCH)
2068
What is the most common site of angiodysplasia?
Cecum(TOPNOTCH)
2069
Morphology: these are tortuous dilations of submucosal and mucosal blood vessels
Angiodysplasia(TOPNOTCH)
2070
What area of the GIT is at greatest risk of ischemic injury?
Splenic flexure(TOPNOTCH)
2071
Morphology: diffuse active inflammation with crypt abscess and glandular architectural distortion
Ulcerative Colitis(TOPNOTCH)
2072
What is the earliest lesion seen in Crohn Disease?
Focal neutrophilic infiltration into the epithelial layer, particularly overlying mucosal lymphoid aggregates(TOPNOTCH)
2073
What is the hallmark of inflammatory bowel disease, both CD and UC?
Chronic mucosal damage(TOPNOTCH)
2074
Gross morphology: narrowing of lumen, bowel wall thickening, serosal extension of mesenteric fat, and linear ulceration of the mucosal surface
Crohn disease(TOPNOTCH)
2075
What are the two key pathogenic abnormalities seen in Idiopathic Inflammatory Bowel disease?
Strong immune response against normal flora and defects in epithelial barrier function(TOPNOTCH)
2076
Gross morphology: intestinal wall is rubbery and thick, as a consequence of edema, inflammation, fibrosis and hypertrophy of the muscularis propria
Crohn disease(TOPNOTCH)
2077
Morphology: small intestinal mucosa laden with distended macrophages in the lamina propria which are PAS positive and contains numerous bacilli and diastase resistant granules
Whipple disease(TOPNOTCH)
2078
Intestinal lipodystrophy is associated with what disease entity?
Whipple disase(TOPNOTCH)
2079
Morphology: diffuse severe atrophy and blunting of villi, with a chronic inflammatory infiltrate in the lamina propria
Celiac disease(TOPNOTCH)
2080
Morphology: focal crypt cell necrosis or apoptosis with minimal to absent inflammatory cell response in the lamina propria
Acute GVHD(TOPNOTCH)
2081
Morphology: marked blunting of the small intestinal villi with a mixed inflammatory infiltrate resembling the atrophic stage of celiac disease
Giardiasis(TOPNOTCH)
2082
Morphology: superficial erosion of the mucosa and an adherent pseudomembrane of fibrin, mucus, and inflammatory debris
Pseudomembranous colitis(TOPNOTCH)
2083
Morphology: small intestinal mucosa usually exhibits modestly shortened villi and infiltration of the lamina propria by lymphocytes
Viral gastroenteritis(TOPNOTCH)
2084
What virus affecting the GIT can produce a flat mucosa resembling celiac sprue?
Rotavirus(TOPNOTCH)
2085
Morphology: characterized by the absence of ganglion cells and ganglia in the muscle wall and submucosa of the affected segment
Hirchsprung Disease/Congenital Aganglionic Megacolon(TOPNOTCH)
2086
Stercoral ulcers are seen in what disease entity?
Hirchsprung Disease/Congenital Aganglionic Megacolon(TOPNOTCH)
2087
The majority of these tumors are positive for c-KIT (CD 117)
Gastrointestinal Stromal Tumor(TOPNOTCH)
2088
What is the most common site of gastric carcinoma?
Pylorus and antrum 50%-60%(TOPNOTCH)
2089
What is the most favored site of gastric carcinoma?
lesser curvature of the anthropyloric region(TOPNOTCH)
2090
What is the most common type of gastric polyp?
Hyperplastic polyp(TOPNOTCH)
2091
In gastritis, histologically, what signifies an active inflammation?
Presence of neutrophils above the basement membrane.(TOPNOTCH)
2092
H. pylori infection in duodenal ulcers is present in about how many percent of patients?
Virtually ALL (70% in patients with gastric ulcer(TOPNOTCH)
2093
Most common site of diverticulitis
Sigmoid colon (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th ed., p. 803
2094
A 10 y/o male presented with recurrent painless rectal bleeding with no other associated symptoms. PE findings were unremarkable. The abdomen was soft, non tender, with no palpable mass. What is the clinical impression?
Meckel Diverticulum (TOPNOTCH)
2095
Most common site of Meckel Diverticulum
Antimesenteric border of ileum (TOPNOTCH)
2096
True or False. Meckel diverticulum is a true diverticulum
True (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751
2097
Most common site of acquired diverticula.
Sigmoid colon (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751
2098
The most common true diverticulum
Meckel Diverticulum (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751
2099
A 3 week old male infant presented to the ER due to vomiting. Mother denies bilious or bloody emesis. Mother states he is always hungry and vomits after nearly every bottle. PE reveals firm, ovoid, 2 cm abdominal mass. What is the most likely diagnosis?
Pyloric stenosis (TOPNTOCH)
2100
Pathology of Pyloric stenosis
Hyperplasia of pyloric muscularis propria (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751
2101
Pyloric is more common in male or female?
3-5x more common in male (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751
2102
A 3-day-old infant presented with emesis and failure to pass meconium for the first 36 hours. PE revealed a moderately distended abdomen. Bowel sound are active. No organs or abdominal masses were palpated. Anus was patent. What is the clinical impression?
Hirchsprung's Disease (TOPNOTCH)
2103
Most important diagnostic test in Hirchsprung Disease
Rectal biopsy (TOPNOTCH)
2104
Histologic findings in Hirchsprung Disease
Absence of ganglion cells in the submucosal and myenteric plexuses.(and hypertrophic extrinsic nerve fibers) (TOPNOTCH)
2105
Typically presentes with failure to pass mecondium in the immediate postnatal period, followed by obstruction or constipation, often with visible ineffective peristalsis, progressing to abdominal distention and bilious vomiting.
Hirchsprung's Disease(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 752
2106
Most frequent site of ectopic gastric mucosa
Upper third of esophagus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 750
2107
Aganglionic segment of the colon presents with distention or contracted appearance?
Grossly normal or contracted appearance. Normal proximal colon-dilated. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 752
2108
Dysphagia, regurgitation of undigested food, aspiration, and halitosis strongly suggest diagnosis of ______.
Zenker diverticulum (TOPNOTCH)
2109
It is characterized by the triad of incomplete LES relaxation, increased LES tone, and aperistalsis of the esophagus
Achalasia(TOPNOTCH) Robbins Basic Pathology, 9th ed., p.753
2110
Patient presented with dysphagia for both solid and liquid, difficulty in belching, and chest pain. The esophageal obstruction is most likely caused by?
Impaired smooth muscle relaxation of LES (Case of Achalasia) (TOPNOTCH)
2111
It is the result of distal esophageal inhibitory neuronal/ganglion cell degeneration.
Primary achalasia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 753
2112
Characterized by transmural tearing and rupture of the distal esophagus. Patients present with severe chest pain, tachypnea and shock.
Boerhaave syndrome. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 754
2113
Most frequent cause of esophagitis
Reflux of gastric contents in the lower esophagus. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 755
2114
Most common cause of gastroesophageal reflux
Transient lower esophageal sphincter relaxation. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 755
2115
Severe form of this condition may have histologic finding of eosinophils recruited into the squamous mucosa followed by neutrophils. Basal zone hyperplasia and elongation of lamina propria papillae of the esophagus may be present.
GERD (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 755
2116
Barrett esophagus confers an increased risk of what cancer?
Esophageal adenocarcinoma (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 757
2117
A 55 y/o patient with a chronic history of heartburn and acid regurgitation underwent EGD, and revealed patches of red, velvety mucosa with interface of light-brown columnar epithelium with goblet cells. He is at risk for developing___.
Esophageal adenocarcinoma. This is a case of Barret esophagus. (TOPNOTCH)
2118
Patient presented with odynophagia, dysphagia, progressive weight loss, chest pain and vomiting. A 5 cm mass was noted at the distal 3rd of the esophagus, which ulcerate and invade deeply. The most likely diagnosis is
Esophageal adenocarcinoma. It usually occurs in the distal 3rd of esophagus. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 758
2119
Most common site of volvulus
Sigmoid colon(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 778
2120
Most common cause of intestinal obstruction in children younger than 2 years of age
Intussusception(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 778
2121
Presents with sudden onset of cramping, left lower abdominal pain, a desire to defecate, and passage of blood or bloody diarrhea.
Acute colonic ischemia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 780
2122
Most common acquired GI emergency of neonates, particularly those who are premature or of low birth weight.
Necrotizing enterocolitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 780
2123
Immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed individual
Celiac disease/Celiac sprue/Gluten-sensitive enteropathy(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 782
2124
Most sensitive test for Celiac sprue
IgA antibodies against tissue transglutaminase(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 783
2125
Most common bacterial enteric pathogen; an important cause of traveler's diarrhea
Campylobacter jejuni(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 786
2126
Watery diarrhea associated with ingestion of improperly cooked chicken, unpasteurized milk or contaminated water. It is an important bacterial cause of food poisoning.
Campylobacter enterocolitis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 786
2127
Diagnosis of Campylobacter enterocolitis, stool culture or biopsy?
Stool culture(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 787
2128
Presents with 1 week of diarrhea, fever, and abdominal pain, constitutional symptoms for about 1 month. May also present with waxing and waning diarrhea. Caused by gram-negative, facultative anaerobe.
Shigellosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 787
2129
Complications of Shigella infection(Triad)
Sterile reactive arthritis, urethritis, and conjunctivitis.(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 788
2130
Infection by a gram-negative bacilli causing diarrhea, common in young children and older adults by ingestion of contaminated food, particularly raw or undercooked meat, poultry, eggs, and milk.
Salmonella(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 789
2131
Patients with sickle cell disease are particularly susceptible to osteomyelitis caused by:
Salmonella(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 789
2132
The principal cause of traveler's diarrhea
Enterotoxigenic E. Coli(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 790
2133
Mechanism of diarrhea in this infection : adenylate cyclase activation, increase intracellular cAMP, opens CFTR to drive chloride secretion and diarrhea.
Cholera(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 785
2134
Most common etiologic agent causing pseudomembranous colitis/antibiotic-associated colitis.
Clostridium difficile(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 791
2135
Most frequent complication of Peptic ulcer disease
Bleeding(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 768
2136
Most frequent etiology of noninfectious chronic gastritis
Autoimmmune gastritis(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 768
2137
Characterized by irregular enlargement of gastric rugae associated with excessive secretion of TFG-alpha.
Menetrier disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 768
2138
Syndrome most commonly found in the small intestine or pancreas, caused by gastrin-secreting tumors; most remarkable feature is doubling of oxyntic mucosal thickness
Zollinger-Ellison Syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 769
2139
Most common site of gastric adenoma in the stomach
Antrum(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 770
2140
Most common malignancy of the stomach
Adenocarcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 771
2141
Most common type of cancer the predominates in high-risk areas and develops from flat dysplasia and adenomas
Intestinal-type gastric cancer(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 772
2142
Most common site of extranodal lymphoma
Stomach(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 773
2143
Most common inducer of MALToma in the stomach
H. pylori(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 773
2144
GI Tumor characterized by cutaneous flushing, sweating, bronchospasm, colicky abdominal pain, diarrhea, and right-sided cardiac valvular fibrosis.
Carcinoid tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 774
2145
The most common mesenchymal tumor of the abdomen
GI stromal tumor(GIST) tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 775
2146
The most important prognostic factor for GI Carcinoid tumor
Location(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 775
2147
Most common site of GIST
Stomach(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 777
2148
Most frequent cause of intestinal obstruction
Hernias(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 777
2149
Most common sites of ischemic bowel disease
Splenic flexure, sigmoid colon, rectum(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 784
2150
Autosomal recessive disorder presenting with explosive diarrhea with watery, frothy stools, and abdominal distention.
Congenital lactase (disaccharidase) deficiency(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 784
2151
IBD presenting with thick wall appearance, transmural inflammation, skip lesions, knife-like ulcer, marked fibrosis and serositis
Crohn disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., . 797
2152
IBD which may presents with thin wall appearance, inflammation limited only to mucosa, marked pseudopolyps, broad-based ulcer, moderate lymphoid reaction, and toxic megacolon (complication)
Ulcerative colitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 797
2153
Most important characteristic of colorectal adenomas that correlates with risk of malignancy.
Size of the tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 808
2154
An autosomal dominant disorder in which patients develop numerous colorectal adenomas as teenager caused by mutation of APC
Familial adenomatous polyposis(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 809
2155
Most common syndromic form of colon cancer; colon cancers tend to occur at younger ages
HNPCC or Lynch syndrome(TOPNOTCH)Robbins Basic Pathoogy, 9th ed., p. 809
2156
Most common location of HNPCC
Right colon(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 809
2157
Autosomal dominant disorder characterized by familial clustering of cancers at several sites caused by DNA mismatch repair
HNPCC or Lynch syndrome(TOPNOTCH)Robbins Basic Pathoogy, 9th ed., p. 809
2158
Location of colorectal cancer presenting with fatigue and weakness due to iron deficiency anemia
Right-sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623
2159
Most common site of metastasis of colorectal adenocarcinoma
Liver(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 813
2160
Which of the following statements regarding oral plaques is TRUE? (A) leukoplakia has a strong association with tobacco use (B) among the oral leukoplakias, those on the floor of the mouth have the highest rate of transformation to squamous cell carcinoma (C) hairy leukoplakia in AIDS patients have a high risk of malignant transformation (D) erythroplakia is less likely to undergo malignant transformation than leukoplakia
leukoplakia has a strong association with tobacco use (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp 581-82
2161
Which of the following is the most common site of oral cavity carcinoma? (A) lateral orders of the mobile tongue (B) floor of mouth (C) vermilion border of the lateral margins of the lower lip (D) hard palate
Vermillion border of the lateral margins of the lower lip(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
2162
A 28 year old man presents with a 5 year history of a slow growing, painless, preauricular mass. FNAB showed clusters of bland cells admixed with myxoid material. He undergoes parotidectomy, and histopathologic examination of the mass shows bland epithelial cells forming clusters, ducts, and sheets, with surrounding myxoid stroma. There are also islands of cartilage. His tumor (A) can metastasize (B) is a chondrosarcoma (C) is the commonest tumor of the parotid gland (D) does not undergo malignant transformation
is the commonest tumor of the parotid gland (pleomorphic adenoma) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 584
2163
A 55 year old male smoker undergoes parotidectomy for a cystic mass. Histopathology shows cystic spaces lined by abranching, two-tiered layer of epithelial cells, with well developed lymphoid tissue right beneath the lining. This tumor is thought to arise from (A) respiratory epithelium (B) heterotopic salivary tissue trapped within a lymph node (C) myoepithelial cells (D) macrophages
heterotopic salivary tissue in a lymph node (Warthin tumor) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585.
2164
A 60 year old chronic alcoholic man suddenly has massive hematemesis and dies. At autopsy, his lower esophagus shows bluish, dilated veins in the submucosa with surrounding erythema. One of the veins is ruptured. Which of the following is expected of his liver? (A) smaller than normal, firm, with nodular external surface (B) markedly enlarged, with multiple hemorrhages on cut section (C) smaller than normal, with a nutmeg appearance on cut section (D) markedly enlarged, with a greasy yellowish cut surface
smaller than normal, firm, with a nodular external surface (cirrhosis) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 587
2165
A 24 year old female complains of heartburn, usually following spicy or sour meals. She takes antacids, with partial relief. She undergoes endoscopy where her lower esophagus appears diffusely erythematous with some epithelial erosions. A biopsy showed eosinophils in the epithelial layer, with basal zone hyperplasia. This is (A) reflux esophagitis (B) Barrett esophagus (C) esophageal candidiasis (D) squamous cell carcinoma
Reflux esophagitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 588
2166
A 33 year old man with a 10 year history of intermittent heartburn undergoes endoscopy, where his lower esophagus appears salmon-pink and velvety. Biopsy of the velvety area shows an epithelium composed of columnar cells with dark basal nuclei, and interspersed goblet cells. Compared to the normal population, this man has a 30- to 100-fold greater risk of developing (A) lymphoma (B) squamous cell carcinoma (C) adenocarcinoma (D) carcinoid
adenocarcinoma of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
2167
Which is the most common site of esophageal squamous cell carcinoma? (A) cervical (B) upper thoracic (C) middle third (D) distal third
middle third (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 590
2168
What is the most important etiologic association of chronic gastritis? (A) Helicobacter pylori (B) Smoking (C) Alcohol abuse (D) NSAIDS
Helicobacter pylori(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
2169
The histologic changes in chronic gastritis may predispose to the development of (A) squamous cell carcinoma and adenocarcinoma (B) adenocarcinoma and lymphoma (C) lymphoma and gastrointestinal stromal tumour (D) gastroinstestinal stromal tumor and squamous cell carcinoma
adenocarcinoma and lymphoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.592
2170
A 34 year old triathlete on chronic NSAIDs consults for chronic epigastric pain. An endoscopy showed a punched out, 2cm diameter ulcer in the duodenum, with perpendicular margins, extending into the submucosa. If a biopsy is performed, arrange the following layers from internal to external: (A) inflammation (B) necrosis (C) scar (D) granulation tissue
necrosis, inflammation, granulation tissue, scar (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
2171
A 25 year old man who suffered from a scalding burn, 80% of his body surface area, is admitted. In the burn unit, coffee ground material is observed in his NGT. Which of the following describes the type of gastric ulcer expected? (A) multiple,
multiple,
2172
Which of the following gastric polyps is a true neoplasm? (A) hyperplastic polyp (B) hypoplastic polyp (C) fundic gland polyp (D) adenoma
adenoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 597-598
2173
Which of the following is a known risk factor for the diffuse type of gastric adenocarcinoma? (A) intestinal metaplasia (B) dietary nitrites (C) E-cadherin mutation (D) Her2-neu amplification
E cadherin mutation (all other choices are risk factors for intestinal type) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 598
2174
Why do infants and children with Meckel diverticulum often present with melena? (A) the mucosa of the diverticulum is highly vascular (B) the diverticulum may have functioning gastric mucosa (C) patients with Meckel diverticulum have an increased likelihood of developing adenomas that can bleed (D) Meckel diverticulum is susceptible to Entamoeba histolytica infection
the diverticulum may have functioning gastric mucosa (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
2175
A 3 month old female with a perinatal history of delayed passage of meconium presents with alternating diarrhea and constipation. Imaging studies show a dilated cecum, ascending and transverse colon. The remaining distal colon is not dilated. Which of the following biopsy findings confirms Hirschprung disease? (A) absence of ganglion cells in the sigmoid (B) presence of ganglion cells in the transverse colon (C) presence of ganglion cells in the cecum (D) presence of ganglion cells in the descending colon
absence of ganglion cells in the sigmoid (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
2176
A 65 year old diabetic suffers an acute MI and is admitted at the ICU. The next day, he develops severe abdominal pain and melena, and dies a few hours later. Autopsy showed a dark red jejunum and ileum. Examination of one of the mesenteric artery branches shows 95% narrowing by atherosclerosis. Which of the following is the expected histologic finding of the affected bowel? (A) increased mitotic rate in mucosal crypts, decreased maturation of surface epithelial cells, variable neutrophilic infiltration (B) hemorrhagic and necrotic mucosa and submucosa with sloughing off of epithelium (C) tortuous mucosal and submucosal vessels (D) flask like submucosal ulcers filled with necrotic debris
hemorrhagic and necrotic mucosa and submucosa with sloughing off of epithelium (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
2177
Which of the following features of intestinal adenomas is the main determinant of risk of harboring an adenocarcinoma? (A) size (B) histologic architecture (C) severity of dysplasia (D) degreee of inflammation
size (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
2178
Which of the following is most likely affected by Familial Adenomatous Polyposis? (A) 44 year old female with 150-160 tubular adenomas in the colon (B) 65 year old male with 20-30 tubulovillous adenomas in the colon (C) 54 year old female with 120-130 hyperplastic polyps in the colon (D) 13 year old male with 30-40 hamartomatous polyps in the colon
44 year old female with 150-160 tubular adenomas in the colon (minimum of 100 colonic adenomas) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619
2179
Carcinoids in which of the following location is least likely to have metastasized at the time of diagnosis? (A) appendix (B) ileum (C) stomach (D) colon
appendix (also, rectum) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.626
2180
Marked cell enlargement with irregularly clumped cytoplasm showing large, clear space
Ballooning degeneration (TOPNOTCH) Robbins Basic Pathology, 8th ed,. 633
2181
Multiple tiny fat droplets that do not displace the nucleus which appear in such conditions as alcoholic liver disease, Reye syndrome, and acute fatty liver of pregnancy.
Microvesicular steatosis Robbins Basic Pathology, 8th ed, p. 633
2182
A single large fat droplet that displaces the nucleus seen in alcoholic liver disease or in the livers of obese or diabetic individuals.
Macrovesicular steatosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633
2183
Diffuse, foamy, swollen appearance to the hepatocyte caused by retained biliary material.
Feathery degeneration(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633
2184
Poorly stained mummified hepatocytes
Coagulative necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633
2185
Isolated hepatocytes become shrunken, pyknotic, and intensely eosinophilic.
Apoptosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633
2186
Hepatocyte necrosis is distributed immediately around the central vein, extending into the midzonal area in the setting of ischemia and several drug and toxic reactions.
Centrilobular necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633
2187
A pattern of nonrhythmic, rapid extension-flexion movements of the head and extremities, best seen when the arms are held in extension with dorsiflexed wrists, seen in patients with hepatic encephalopathy.
Asterixis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 635
2188
A diffuse process characterized by bridging fibrous septa, in the form of delicate bands or broad scars around multiple adjacent lobes, and the conversion of normal liver architecture into structurally abnormal nodules, encircled by fibrotic bands. Liver architecture is disrupted.
Liver Cirrhosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 635
2189
Presence of ground-glass hepatocytes, a finely granular, eosinophilic cytoplasm and sanded nuclei, shown by electron microscopy
Hepatitis B infection(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 645
2190
Necrotic cells appear to have dropped out with collapse of the sinusoidal collagen reticulin framework where the cells have disappeared; scavenger macrophage aggregates mark sites of dropout.
Hepatocyte cytolysis (in viral hepatitis)(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 647
2191
Hepatocytes shrink, become intensely eosinophilic, and have fragmented nuclei; effector T cells may be present in the immediate vicinity.
Hepatocyte apoptosis (in viral hepatitis)(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 647
2192
The hallmark of serious liver damage
Fibrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 647
2193
May occur as solitary or multiple lesions, ranging from millimeters to massive lesions, many centimeters in diameter. They are generally produced by gram-negative bacteria such as Escherichia coli and Klebsiella sp.
Pyogenic (bacterial) hepatic abscesses (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 648
2194
Liver is enlarged, soft, yellow and greasy. Lipid accumulates to the point of creating large clear macrovesicular globules, compressing and displacing the nucleus to the periphery of the hepatocyte.
Hepatic Steatosis (Fatty Liver)(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 649
2195
Eosinophilic, cytoplasmic inclusions characteristic of alcoholic hepatitis.
Mallory bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650
2196
Almost always accompanied by a brisk sinusoidal and perivenular fibrosis; occasionally periportal fibrosis may predominate.
Alcoholic hepatitis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650
2197
Liver is yellow-tan, fatty, and enlarged, usually weighing over 2 kg. Over the span of years it is transformed into a brown, shrunken, nonfatty organ, sometimes weighing less than 1 kg.
Alcoholic Cirrhosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650
2198
Pattern of cirrhosis in viral hepatitis.
Macronodular(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650
2199
Pattern of cirrhosis in alcoholic hepatitis.
Micronodular(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650
2200
The liver may shrink to 500 to 700 gm and become transformed into a limp, red organ covered by a wrinkled, overly large capsule. Necrotic areas have a muddy red, mushy appearance with blotchy bile staining. Complete destruction of hepatocytes in contiguous lobules leaves only a collapsed reticulin framework and preserved portal tracts.
Massive hepatic necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 653
2201
Golden-yellow granules in the cytoplasm of periportal hepatocytes, which stain blue with the Prussian blue stain.
Hemosiderin(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 655
2202
Green to brown deposits of copper in Descemet membrane in the limbus of the cornea.
Kayser-Fleischer rings (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 656
2203
Excessive copper deposition in the liver causing hepatic changes ranging from mild fatty change to massive liver necrosis. In the brain, injury affects the basal ganglia, demonstrating atrophy and cavitation. Kayser-Fleischer rings are characteristic.
Wilson disease(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 655
2204
Hepatocytes with round to oval cytoplasmic globular inclusions which are strongly positive in a periodic acid-Schiff stain. By electron microscopy they lie within smooth, and sometimes rough, endoplasmic reticulum.
Alpha-1 antitrypsin Deficiency(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 657
2205
A rare disease characterized by microvesicular fatty change in the liver and encephalopathy. Microscopy of hepatocellular mitochondria reveals pleomorphic enlargement and electron lucency of the matrices, with disruption of cristae and loss of dense bodies.
Reye syndrome / "mitochondrial hepatopathies" (TOPNOTCH)Robbins Basic Pathology, 8th ed, p658
2206
A chronic, progressive, and often fatal cholestatic liver disease, characterized by a nonsuppurative destruction of small and medium-sized intrahepatic bile ducts florid duct leesion. On cut surface, the liver is hard, with a finely granular appearance, with extraordinary yellow-green pigmentation.
Primary biliary cirrhosis (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 659
2207
A chronic cholestatic disorder, characterized by progressive fibrosis and destruction of extrahepatic and large intrahepatic bile ducts. Affected portal tracts show concentric periductal onion-skin fibrosis and a modest lymphocytic infiltrate. Progressive atrophy of the bile duct epithelium leads to obliteration of the lumen, leaving behind a solid, cordlike fibrous scar.
Primary sclerosing cholangitis (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 660
2208
Liver is slightly enlarged, tense, and cyanotic, with rounded edges. Microscopically, there is congestion of centrilobular sinusoids. With time, centrilobular hepatocytes become atrophic, resulting in markedly attenuated liver cell cords. Liver fibrosis mostly "centrilobular".
Passive congestion of the liver secondary to right-sided heart failure.(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 660
2209
Hepatocytes in the central region of the lobule undergo ischemic necrosis. The liver takes on a variegated mottled appearance, reflecting hemorrhage and necrosis in the centrilobular regions, alternating with pale midzonal areas, known traditionally as the "nutmeg" liver.
Passive congestion of the liver secondary to left-sided heart failure.(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 661
2210
A rare condition wherein there is primary dilation of sinusoids, impeding hepatic blood efflux. Associated with exposure to anabolic steroids, OCP's and danazol.
Peliosis hepatis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 661
2211
Results from the thrombosis of two or more major hepatic veins and is characterized by hepatomegaly, weight gain, ascites, and abdominal pain. The liver is swollen, is red-purple, and has a tense capsule. The affected hepatic parenchyma reveals severe centrilobular congestion and necrosis.
Budd-Chiari syndrome (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 662
2212
Caused by toxic injury to sinusoidal endothelium. Damaged endothelial cells slough off and create emboli that block blood flow. Accompanied by passage of red blood cell into the space of Disse, proliferation of stellate cells, and fibrosis of terminal branches of the hepatic vein.
Sinusoidal Obstruction Syndrome (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 662
2213
Well-demarcated but poorly encapsulated lesion, consisting of hyperplastic hepatocyte nodules with a central fibrous scar. Appears in noncirrhotic livers and may reach up to many centimeters in diameter. It occurs in response to local vascular injury.
Focal nodular hyperplasia (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 664
2214
These appear in cirrhotic livers, are larger than surrounding cirrhotic nodules but do not display atypical features. Contains more than one portal tract, have an intact reticulin framework, and do not seem to be precursors of malignant lesions.
Macroregenerative nodules (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 664
2215
These are lesions larger than 1 mm in diameter that appear in cirrhotic livers. Considered to be precursors of hepatocelluar cancers, are often monoclonal, and may contain chromosome aberrations similar to those present in liver cancers.
Dysplastic nodules (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 664
2216
May appear grossly as (1) a unifocal, usually massive tumor, (2) a multifocal tumor made of nodules of variable size or (3) a diffusely infiltrative cancer, permeating widely and sometimes involving the entire liver, blending imperceptibly into the cirrhotic liver background.
Primary Hepatocellular Carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 665
2217
A distinctive variant of HCC, which occurs in adults (
Fibrolamellar carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed, p. 873
2218
Gallbladder stones that are mostly radiolucent, ovoid and firm; can occur singly but most often there are several, with faceted surfaces resulting from apposition to one another. They are pale yellow but w/ increasing proportions of CaCO3, phosphates and bilirubin, they turn gray-white to black and radiopaque.
Cholesterol stones (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 668
2219
May arise anywhere in the biliary tree and are trivially classified as black and as brown. Contain calcium salts of unconjugated bilirubin and lesser amounts of other calcium salts, mucin glycoproteins, and cholesterol.
Pigment stones(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 668
2220
A type of pigment stone found in sterile gallbladder bile, usually small and present in large quantities and crumble easily. 50% to 75% are radiopaque.
Black pigment stones (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 668
2221
A type of pigment stone found in infected intrahepatic or extrahepatic ducts. Tends to be single or few in number and are soft with a greasy, soaplike consistency that results from the presence of retained fatty acid salts released by the action of bacterial phospholipases on biliary lecithins. Contains calcium soaps, and are radiolucent.
Brown pigment stones(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 668
2222
Gallbladder is usually enlarged (twofold to threefold) and tense, and it assumes a bright red or blotchy, violaceous to green-black discoloration, imparted by subserosal hemorrhages. The gallbladder lumen is filled with a cloudy or turbid bile that may contain fibrin, blood, and frank pus.
Acute cholecystitis (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 669
2223
Condition wherein the exudate contained in the gallbladder is composed virtually of pure pus.
Empyema of the gallbladder(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 669
2224
Severe cholecystitis wherein the GB is transformed into a green-black necrotic organ.
Gangrenous cholecystitis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 669
2225
The gallbladder may be contracted, of normal size, or enlarged. Presence of stones in the absence of inflammation is diagnostic.
Chronic cholecystitis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 669
2226
Defined as a complete obstruction of bile flow caused by destruction or absence of all or part of the extrahepatic bile ducts.
Biliary atresia (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 670
2227
Appears as a poorly defined area of diffuse thickening and induration of the gallbladder wall that may cover several square centimeters or involve the entire gallbladder, scirrhous and very firm in consistency.
Infiltrating pattern of gallbladder carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 671
2228
This pattern of GB carcinoma grows into the lumen as an irregular, cauliflower mass, but at the same time it invades the underlying wall.
Exophytic pattern of gallbladder carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 671
2229
Appear typically with an abundant fibrous stroma (desmoplasia) explaining their firm, gritty consistency. Most exhibit clearly defined glandular and tubular structures lined by somewhat anaplastic cuboidal to low columnar epithelial cells. Bile pigment and hyaline inclusions are not found within the cells.
Cholangiocarcinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 672
2230
Morphology: Characterized by fibrosing cholangitis of bile ducts, with a lymphocytic infiltrate, and progressive atrophy of the bile duct epithelium, and obliteration of the lumen
Primary Sclerosing Cholangitis(TOPNOTCH)
2231
Morphology: Concentric periductal fibrosis or Onion-Skin fibrosis with solid, cordlike fibrous scar.
Primary Sclerosing Cholangitis(TOPNOTCH)
2232
Morphology: Panlobular giant cell transformation of hepatocytes and formation of hepatocyte "rosettes"
Neonatal Cholestasis(TOPNOTCH)
2233
What is the histological hallmark of irreversible liver damage?
Deposition of fibrous tissue(TOPNOTCH)
2234
"Ground Glass Hepatocytes" are seen in what type of Viral Hepatitis?
Hepatitis B(TOPNOTCH)
2235
What type of viral hepatitis frequently show lymphoid aggregates within portal tracts?
Hepatitis C(TOPNOTCH)
2236
What is the most common liver tumor of young childhood?
Hepatoblastoma(TOPNOTCH)
2237
What are the most common benign neoplasm in the liver?
Hemangiomas(TOPNOTCH)
2238
These benign neoplasms tend to occur in young women who have used oral contraceptives and regress on discontinuance of their use.
Liver cell Adenoma(TOPNOTCH)
2239
Rokitansky- Aschoff sinuses are structures seen in what organ?
Gallbladder(TOPNOTCH)
2240
What is the most common congenital anomaly of the gallbladder?
Presence of Phrygian Cap (folded fundus)(TOPNOTCH)
2241
What is the tetralogy of cholesterol stone formation?
1. Supersaturation of bile with cholesterol2. Gallbladder hypomotility3. Cholesterol nucleation4. Hypersecretion of GB mucus(TOPNOTCH)
2242
AKA Strawberry Gallbladder
Cholesterolosis(TOPNOTCH)
2243
Acute calculous cholecystitis is most commonly precipitated by what condition?
Obstruction of the neck or cystic duct by a Gallbladder stone(TOPNOTCH)
2244
Morphology: Prominence of Rokitansky-Aschoff sinuses
Chronic Cholecystitis(TOPNOTCH)
2245
What is the most common cause of cholangitis?
Choledocholithiasis(TOPNOTCH)
2246
True or False. Gallstones are seen in 60%-90% of Carcinoma of the Gallbladder.
True(TOPNOTCH)
2247
What is the most common growth pattern of Gallbladder carcinoma? Infiltrating or Exophytic?
Infiltrating(TOPNOTCH)
2248
These are tumors arising from the part of the common bile duct between the cystic duct junction and the confluence of the right and left hepatic ducts at the liver hilus
Klatskin tumors(TOPNOTCH)
2249
Morphology: feathery degeneration and focal detergent dissolution of hepatocytes, giving rise to bile lakes filled with cellular debris and pigment
Cholestasis(TOPNOTCH)
2250
What does unrelieved cholestasis lead to?
Portal tract fibrosis(TOPNOTCH)
2251
What is the outcome of 85% of Acute Hepatitis infection?
Chronic Hepatitis(TOPNOTCH)
2252
These inclusions are a characteristic but not specific feature of alcoholic liver disease.
Mallory bodies(TOPNOTCH)
2253
Morphology: macrovesicular steatosis, involving most regions of the hepatic lobule. The intracytoplasmic fat is seen as clear vacuoles.
Alcoholic liver disease(TOPNOTCH)
2254
What zone of the liver if particularly vulnerable of ischemic injury and number of drug and toxic reactions?
Centrilobular zone(TOPNOTCH)
2255
What zone of the liver is particularly affected in eclampsia?
Periportal zone(TOPNOTCH)
2256
At least how many percent of the liver must be damaged before hepatic failure ensues?
at least 80%(TOPNOTCH)
2257
What are the 4 major consequences of portal hypertension?
Ascites, formation of portosystemic venous shunts, congestive splenomegaly, and hepatic encephalopathy(TOPNOTCH)
2258
Ascites becomes clinically detectable at what amount?
500 ml(TOPNOTCH)
2259
Morphology: portal tract expansion with inflammatory cells and fibrous tissue and interface hepatitis with spillover of inflammation into the adjacent parenchyma. Lymphoid aggregates can also be seen.
Chronic Viral Hepatitis C(TOPNOTCH)
2260
Morphology: liver biopsy shows steatosis, multifocal parenchymal inflammation, Mallory hyaline, hepatocyte death, and sinusoidal fibrosi
Steatohepatitis or Nonalcoholic Steatohepatitis(TOPNOTCH)
2261
In Hemochromatosis, what is the most common site of hemosiderin deposition?
Liver(TOPNOTCH)
2262
What are the 3 clinical features of Hemochromatosis?
Deposition of hemosiderin, cirrhosis, and pancreatic fibrosis(TOPNOTCH)
2263
Morphology: characterized by the presence of round to oval cytoplasmic globular inclusions in hepatocytes, which in routine H and E stains are acidophilic and indistinctly demarcated from the surrounding cytoplasm
A1 antitrypsin deficiency(TOPNOTCH)
2264
Morphology: characterized by coarse fibrous septae that subdivide the liver in a jigsaw like pattern
Secondary biliary cirrhosis(TOPNOTCH)
2265
Morphology: florid duct lesion
Primary Biliary Cirrhosis(TOPNOTCH)
2266
The combination of hypoperfusion and retrograde congestion acts synergistically to generate what type of necrosis in the liver?
Centrolobular hemorrhagic necrosis(TOPNOTCH)
2267
Morphology: periportal sinusoids contain fibrin deposits with hemorrhage into the space of Disse, leading to periportal hepatocellular coagulative necrosis
Pre-Eclampsia/Eclampsia(TOPNOTCH)
2268
Type of liver transplant rejection : severe obliterative arteritis of small and larger arterial vessels results in ischemic changes in the liver parenchyma
Chronic Rejection(TOPNOTCH)
2269
Type of liver transplant rejection: infiltration of a mixed population of inflammatory cells into portal tracts, bile ducts, and hepatocyte injury and endothelitis
Acute cellular rejections(TOPNOTCH)
2270
What do you call the small tubular channels that are sometimes burried within the gallbladder wall adjacent to the liver?
Ducts of Luschka(TOPNOTCH)
2271
What is the most common congenital anomaly seen in the Gallbladder?
A folded fundus or so called phrygian cap(TOPNOTCH)
2272
Gross morphology: the mucosal surface of the gallbladder is studded with minute yellow flecks
Strawberry Gallbladder(TOPNOTCH)
2273
What type of pigment stones are generally seen in infected intrahepatic or extra hepatic ducts?
Brown pigment stones(TOPNOTCH)
2274
Gross morphology: GB is shrunken, nodular, and chronically inflamed with foci of necrosis and hemorrhage
Xanthogranulomatous cholecystitis(TOPNOTCH)
2275
Hallmarks of HCV infection
Persistent infection and chronic hepatitis (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th ed., p. 834
2276
Defining histologic feature of chronic viral hepatitis
Mononuclear portal infiltration (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 837
2277
Diagnostic hallmark of Hepatitis B; these are cells with ER swollen by HBsAg
Ground-glass hepatocytes(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 837
2278
Characteristic feature of alcoholic hepatitis which present as clumped, amorphous, eosinophilic material in ballooned hepatocytes. May also be present in Wilson disease and in chronic biliary tract disease.
Mallory-Denk bodies (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 843
2279
Deeply eosinophilic staining apoptotic hepatocytes seen in acute and chronic hepatitis.
Acidophilic bodies (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 823
2280
The principal cell type involve in scar deposition in the liver
Hepatic stellate cell(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 823
2281
Associated with encephalopathy and coagulopathy that occurs within 26 weeks of initial liver injury in the absence of pre-existing liver disease, caused by massive hepatic necrosis
Acute liver failure(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 825
2282
Most common intrahepatic cause of portal hypertension
Cirrhosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 828
2283
Most frequent mode of transmission of HBV in high prevalence regions
Transmission during childbirth(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 832
2284
Most frequent mode of transmission of HBV in low prevalence regions
Unprotected sex and IV drug abuse(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 832
2285
Serologic marker detected during window period of HBV infection
IgM anti-HBc antibody(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 833
2286
Best predictor of chronicity of HBV infection
Age at the time of infection(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 833
2287
Most common risk factor for HCV infection
IV drug abuse(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 834
2288
Type of viral hepatitis associated with metabolic syndrome
Hepatitis C virus infection (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 835
2289
Type of viral hepatitis implicated in the high mortality rate among pregnant women
Hepatitis E Virus infection(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 835
2290
Main inflammatory cells in both acute and chronic viral hepatitis
T cells(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 839
2291
Type of autoimmune hepatitis most often seen in middle-aged women and is most characteristically associated with antinuclear and anti-smooth muscle antibodies
Type 1 autoimmune hepatitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 840
2292
Type of autoimmune hepatitis most often seen in children or teenager and is associated with anti-liver kidney microsomal autoantibodies
Type 2 autoimmune hepatitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 840
2293
Predominant cells and characteristic component of inflammatory infiltrate in biopsy specimens showing autoimmune hepatitis
Plasma cells(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 840
2294
Most common hepatotoxin causing acute liver failure
Acetaminophen(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 841
2295
Most common hepatotoxin causing chronic liver disease
Alcohol(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 841
2296
Characterized by hepatocyte swelling and necrosis, Mallory-Denk bodies, neutrophilic reaction, fibrosis, perisinosoidal scar in the space of Disse of the centrilobilar region
Alcohol Hepatitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 843
2297
Micronodular cirrhosis described for end-stage alcoholic liver disease due o long-term alochol use
Laennec cirrhosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 843
2298
Volume threshold for the developmet of alcoholic liver disease
80gm/day of alcohol(TOPNOTCH)Robbins Basic Pathology, 9th ed. P. 845
2299
Most common site of hemosiderin deposition
Liver(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 848
2300
An autosomal disorder caused by mutation of ATP7B gene resulting in impaired copper excretion into bile and failure to incorporate copper into ceruloplasmin
Wilson Disease(TOPNOTCH)Robbins Basic Pathology, 9th ed, p. 849
2301
Presents with movement disorders (tremor, chorea, tremor),rigid dystonia, psychiatric symptoms, hemolytic anemia, green to brown deposits in Descemet membrane in the limbus
Wilson Disease(TOPNOTCH)Robbins Basic Pathology, 9th ed, p. 849
2302
Most sensitive and accurate test for Wilson disease
Increase in hepatic copper content(TOPNOTCH)Robbins Basic Pathology, 9th ed, p. 850
2303
Most specific screening test for Wilson Disease
Increased urinary excretion of copper copper content(TOPNOTCH)Robbins Basic Pathology, 9th ed, p. 850
2304
Most characteristic laboratory finding in primary biliary cirrhosis
Antimitochondrial antibodies(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 858
2305
Mechanism of physiologic jaundice of the newborn
Impaired bilirubin conjugation(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 853
2306
Hereditary unconjugated hyperbilirubinemia caused by severe UGT1A1 deficiency and is fatal around the time of birth
Crigler-Najjar syndrome type 1(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 853
2307
An autosomal recessive disorder caused by impaired biliary excretion of bilirubin glucoronides due to mutation in canalicular multidrug resistance protein 2(MRP2)
Dubin-Johnson syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 854
2308
Most common cause of bile duct obstruction in adults
Extrahepatic cholelithiasis(gallstones)(TOPNOTCH)Robbins Basic Pathology,9th ed., p. 854
2309
Histologic hallmark: influx of periductular neutrophils directly into the bile duct epithelium and lumen
Ascending cholangitis(TOPNOTCH)Robbins Basic Pathology,9th ed., p. 854
2310
Most common form of cholestasis of sepsis wherein bile plugs within predominantly centrilobular canaliculi
Canalicular cholestasis(TOPNOTCH)Robbins Basic Pathology,9th ed., p. 855
2311
Disorder of intrahepatic gallstone formation leading to repeated bouts of ascending cholangitis; has pigmented calcium bilirubinate stones in distended intrahepatic bile ducts
Hepatolithiasis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 856
2312
Presents with neonatal cholestasis, normal birthweight and postnatal weight gain, initially normal stools change to acholic stools.
Biliary atresia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 857
2313
Morphology: Inflammation and fibrosing stricture of the hepatic or common bile ducts; cirrhosis develops within 3-6 mos of birth if uncorrected
Biliary atresia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 857
2314
Florid duct lesion by liver biopsy, elevated alkaline phosphatase and gamma-glutamyltransferase, hypercholesterolemia,
Primary biliary cirrhosis(TOPNOTCH)Robbins Basic Pathology, 9th ed. P. 858
2315
Presents with characteristic beading on radiographs of intrahepatic and extrahepatic biliary tree; strong association with IBD particularly ulcerative colitis
Primary biliary cirrhosis(TOPNOTCH)Robbins Basic Pathology, 9th ed. P. 861
2316
Presents most often in children before age 10 as jaundice, recurrent abdominal pain, symptoms that are typical of biliary colic; caused by congenital dilations of CBD
Choledochal cyst(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 861
2317
Presents with liver enlargement, pain, and ascites due to obstruction of two or more hepatic veins.
Budd-Chiari syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 863
2318
Most important premalignant lesions for cholangiocarcinoma
Biliary intraepithelial neoplasias(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 874
2319
Most common malignancy of the extrahepatic biliary tract
Carcinoma of the gallbladder(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 879
2320
Most important risk factor for gallbladder cancer
Gallstones(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 879
2321
Atrophic, chronically obstructed, often dilated gallbladder, containing clear secretions
Hydrops of the gallbladder(TOPNOTCH)
2322
Patients with chronic hemolytic anemias, severe ileal dysfunction or bypass, and bacterial contamination of the biliary tree are at risk for developing what kind of gallbladder stones?
Pigment stones(TOPNOTCH)
2323
In severe form of this condition, patient presents with micronodular cirrhosis, diabetes mellitus, and abnormal skin pigmentation.
Hemochromatosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 847
2324
A 28 year old man with a history of IV drug abuse develops jaundice and malaise. Which of the following liver biopsy findings particularly suggests a hepatitis C infection? (A) ballooning degeneration of hepatocytes (B) ground glass appearance of hepatocyte cytoplasm, with "sanded" nuclei (C) bile duct proliferation and lymphoid aggregate formation (D) tangled skeins of pink cytoplasmic inclusions in degenerating hepatocytes, with neutrophilic infiltrates
bile duct proliferation and lymphoid aggregate formation (TOPNOTCH)Robbins Basic Pathology, 8th ed, p646-647
2325
A 25 year old medical intern draws blood from a chronic hepatitis B patient sustains a needlestick injury. He forgets to consult the infection control unit, and develops jaundice 2 months later. A biopsy of his liver will show (A) hemosiderin-laden periportal hepatocytes ((B) ground glass appearance of hepatocyte cytoplasm, with "sanded" nuclei (C) bile duct proliferation and lymphoid aggregate formation (D) tangled skeins of pink cytoplasmic inclusions in degenerating hepatocytes, with neutrophilic infiltrates
ground glass appearance of hepatocyte cytoplasm, and "sanded" nuclei (TOPNOTCH)Robbins Basic Pathology, 8th ed, p646-647
2326
A 45 year old male during a drinking spree gets into a fight, and is stabbed. A medicolegal autopsy is performed. Given his chronic alcoholism, his liver will likely show (A) hemosiderin-laden periportal hepatocytes (B) ground glass appearance of hepatocyte cytoplasm, with "sanded" nuclei (C) bile duct proliferation and lymphoid aggregate formation (D) tangled skeins of pink cytoplasmic inclusions in degenerating hepatocytes, with neutrophilic infiltrates
tangled skeins of pink cytoplasmic inclusions in degenerating hepatocytes (Mallory bodies), with neutrophilic infiltrates (TOPNOTCH)Robbins Basic Pathology, 8th ed, p 649-650
2327
Which of the following is most likely to have nonalcoholic fatty liver disease? (A) 28 year old overweight man with dyslipidemia and family history of Type 2 DM (B) 14 year old student with alpha thalassemia with history of multiple blood transfusions since childhood (C) 33 year old teacher on his 1st month of taking anti-Koch's medication (D) 44 year old architect with a 30 pack year smoking history
28 year old overweight man with dyslipidemia and family history of Type 2 DM (insulin resistance) (TOPNOTCH)Robbins Basic Pathology, 8th ed, p 654
2328
A 40 year old man with beta thalassemia and long history of blood transfusions dies of congestive heart failure. At autopsy, his liver, heart, and pancreas appear dark brown. Histologic examination of his liver shows hepatocytes with golden brown cytoplasmic granules. These granules will stain with (A) prussian blue (B) rhodanine (C) periodic acid schiff (D) hematoxylin
Prussian blue (iron stain)(TOPNOTCH)Robbins Basic Pathology, 8th ed, p 654-655
2329
Patients with hemochromatosis have a 200-fold higher risk of developing which malignancy compared to the normal population?
hepatocellular carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed, p 656
2330
A 30 year old male with inflammatory bowel disease develops jaundice. On hepatic ultrasound, there are strictures and beading of the large bile ducts, and pruning of the small bile ducts. A liver biopsy showed portal tracts with concentric periductal onion-skin fibrosis, and a modest lymphocytic infiltrate. In five years, he has a 10 to 15% chance of developing (A) colorectal carcinoma (B) hepatocellular carcinoma (C) cholangiocarcinoma (D) hepatic lymphoma
cholangiocarcinoma (primary sclerosisng cholangitis) (TOPNOTCH)Robbins Basic Pathology, 8th ed, p 659
2331
In which of the following conditions is Budd-Chiari syndrome most likely? (A) Christmas disease (B) von Willebrand disease (C) Factor VIII deficiency (D) pregnancy
pregnancy (TOPNOTCH)Robbins Basic Pathology, 8th ed, p 662
2332
Which of the following is a risk factor for the development of cholangiocarcinoma? (A) primary sclerosing cholangitis (B) exposure to the radiologic agent Thorotrast (C) infection with Clonorchis (D) all of the above
all of the above (TOPNOTCH)Robbins Basic Pathology, 8th ed, p 671
2333
This disease is characterized by the following morphological changes:(1) microvascular leakage causing edema, (2) necrosis of fat by lipases, (3) an acute inflammatory reaction, (4) proteolytic destruction of parenchyma,(5) destruction of blood
Acute pancreatitis (TOPNOTCH) Robbins Basic Pathology, 8th ed., pg. 677
2334
Cardinal manifestation of acute pancreatitis
Abdominal pain(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 679
2335
Necrosis of pancreatic tissue affecting acinar and ductal tissues as well as the islets of Langerhans; vascular damage causes hemorrhage into the parenchyma.
Acute necrotizing pancreatitis(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 678
2336
Characterized by parenchymal fibrosis, reduced number and size of acini, and variable dilation of the pancreatic ducts. With relative sparing of Islets of Langerhans. Ductal concretions are present
Chronic pancreatitis(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 680
2337
Presents as painless, slow-growing cystic masses filled with thick, tenacious mucin, lined with columnar mucinous epithelium, associated with densely cellular stroma. Almost always arise in women
Mucinous cystic neoplasm of the pancreas(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 681
2338
Similar to mucinous cystic neoplasms but appear more frequently in men
Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 682
2339
Most common location of pancreatic cancer.
Head of pancreas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 684
2340
Most common symptom of pancreatic carcinoma located at the tail and body of the gland?
None/AsymptomaticSince it does not impinge on the biliary tract, it may be quite large and widely disseminated by the time they are discovered.(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 684
2341
Moderately to poorly differentiated adenocarcinoma forming abortive tubular structures or cell clusters and exhibiting an aggressive, deeply infiltrative growth pattern.
Pancreatic carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 684
2342
Type of pancreatic carcinoma showing prominent acinar cell differentiation with zymogen granules and exocrine enzyme production
Acinar cell carcinomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 684
2343
Type of pancreatic carcinoma with focal squamous differentiation in addition to glandular differentiation.
Adenosquamous carcinomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 684
2344
What is the most common clinically significant congenital anomaly of the pancreas?
Pancreas Divisum(TOPNOTCH)
2345
This congenital abnormality develops embryologically when one portion of the ventral pancreatic primordium becomes fixed, while the other portion of this primordium is drawn around the duodenum
Annular Pancreas(TOPNOTCH)
2346
The most common cause of acute pancreatitis is?
Excessive alcohol intake(TOPNOTCH)
2347
5 morphological alterations in Acute pancreatitis
1. Edema caused by microvascular leakage2. Necrosis of fat caused by lipolytic enzymes3. Acute inflammatory reaction4. Destruction of pancreatic parenchyma by proteolytiz enzymes5. Destruction of blood vessels with subsequent interstitial hemorrage(TOPNOTCH)
2348
The most common cause of chronic pancreatitis is?
Long term alcohol abuse(TOPNOTCH)
2349
This condition is characterized by parenchymal fibrosis, reduced number and size of acini with relative sparing of the islets of Langerhans, and variable dilation of the pancreatic ducts.
Chronic Pancreatitis(TOPNOTCH)
2350
What is the most constant morphological feature of Chronic Pancreatitis?
Acinar Loss(TOPNOTCH)
2351
60% of cancers of the pancreas arise in what area?
Head > Body > Tail(TOPNOTCH)
2352
What is the most frequently altered oncogene in pancreatic cancer?
K-RAS (TOPNOTCH)
2353
What is the most frequently inactivated tumor suppressor gene in pancreatic cancer?
p16(TOPNOTCH)
2354
What is the strongest environmental risk factor for developing Pancreatic Cancer?
Smoking(TOPNOTCH)
2355
What are the two characteristic features of Pancreatic Cancer?
Highly invasive and it elicits an intense non neoplastic host reaction called a desmoplastic response(TOPNOTCH)
2356
Where do Pancreatic cancers usually metastasize?
Lungs and bones(TOPNOTCH)
2357
This variant of Pancreatic cancer is characterized by formation of zymogen granules and the production of exocrine enzymes including trypsin and lipase`
Acinar cell carcinoma(TOPNOTCH)
2358
What is the first symptom of pancreatic cancer?
Pain(TOPNOTCH)
2359
These structures are formed by the walling off of areas of peripancreatic hemorrhagic fat necrosis with fibrous tissue and are usually composed of central necrotic hemorrhagic material rich in pancreatic enzymes surrounded by non epithelial lined fbrous w
Pseudocyts(TOPNOTCH)
2360
These kinds of cyst account for 75% of cysts seen in the pancreas
Pseudocyts(TOPNOTCH)
2361
Morphology: Pancreas shows region of fat necrosis and focal pancreatic parenchymal necrosis
Acute pancreatitis(TOPNOTCH)
2362
What is the most important triggering event in acute pancreatitis?
Activation of trypsinogen and subsequent autodigestion of the pancreatic substances(TOPNOTCH)
2363
2 most common causes of acute pancreatitis
Biliary tract disease and alcoholism. (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th ed., p. 884
2364
A 32 y/o male presented with abdominal pain, nausea, and vomiting. Pain was described as constant and intense with radiation to the upper back. Lab result showed elevated plasma amylase. The clinical impression is:
Acute pancreatitis (TOPNOTCH)
2365
Morphology: mild inflammation, interstitial edema, and focal fat necrosis in the pancreas and peripancreatic fat.
Acute interstitial pancreatitis (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 887
2366
Morphology: pancreatic substance is red-black form hemorrhage and contains interspersed foci of yellow-white, chalky fat necrosis. Peritoneal cavity contains serous, turbid, brown-tinged fluid containing globules of fat.
Acute necrotizing pancreatitis (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 887
2367
Morphology: Extensive parenchymal necrosis accompanied by dramatic hemorrhage within the substance of the gland.
Hemorrhagic pancreatitis (TOPNOTCH)
2368
Clinical features include intermittent or persistent abdominal pain, intestinal malabsorption, and diabetes. It is characterized by irreversible injury of the pancreas.
Chronic pancreatitis. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 889
2369
A 53 y/o male, smoker, presented with abdominal pain, weight loss, and jaundice since 1 month. The abdominal CT revealed a mass on the pancreas. What part of the pancreas is most likely affected?
Head of the pancreas. Obstructive jaundice is associated with most cases of carcinoma of the head of the pancreas. (TOPNOTCH) Robbins Basic Pathology, 9th ed. P. 894
2370
Migratory thrombophlebitis occuring in pancreatic cancer due to elaboration of PAF and procoagulants from the carcinoma or its necrotic products.
Trosseau sign(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 894
2371
Most patients with this disease present with abdominal pain and weight loss, sometimes accompanied by jaundice and DVT, and succumb to the disease within 1 to 2 years.
Pancreatic cancer(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 895
2372
Poorly defined cyst with a necrotic brown-black wall, lacks epithelial lining. It is usually solity and may be situated within the pancreas or in the lesser omental sac or in the retroperitoneum. Formed when areas of intrapancreatic or peripancreatic hemorrhagic fat necrosis are walled off by fibrous tissue and granulation tissue.
Pancreatic pseudocysts(TOPNOTCH)Robbins Basic Pathology, 9th ed., pg. 890
2373
A 44 year old alcoholic woman has been having intermittent postprandial epigastric pain of 5 years. An imaging study done showed a solitary 3 cm cyst at the anterior portion of his pancreatic head. Fearing the worst, she opts to undergo a Whipple procedure, and the definitive specimen showed a cyst with a smooth internal surface and surrounding fibrosis. Microscopic examination showed a cyst wall lined by fibrin, granulation tissue, and chronic inflammation. There is no epithelial lining observed. The cyst (A) is a common sequela of acute pancreatitis (B) is hormonally responsive to estrogen (C) is a precursor to pancreatic adenocarcinoma (D) is known to harbor K-RAS mutations
is a common sequela of acute pancreatitis (pancreatic pseudocyst) is (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 680.
2374
Which of the following is associated with an increased risk of pancreatic carcinoma? (A) smoking (B) chronic pancreatitis (C) diabetes mellitus (D) all of the above
all of the above is (TOPNOTCH) Robbins Basic Pathology, 8th ed., 683
2375
An abnormal opening of the urethra along the ventral aspect of the penis.
Hypospadias(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 687
2376
An abnormal opening of the urethra along the dorsal aspect of the penis.
Epispadias(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 687
2377
A congenital malformation of the bladder associated with epispadias.
Bladder extrophy(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688
2378
A condition in which the prepuce cannot be retracted easily over the glans penis
Phimosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688
2379
Appears grossly as a solitary, plaquelike lesion on the shaft of the penis. Histologic examination reveals morphologically malignant cells throughout the epidermis with no invasion of the underlying stroma. Has potential for malignant transformation.
Bowen disease(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688
2380
Bowen disease which presents as an erythematous patch on the glans penis.
Erythroplasia of Queyrat(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688
2381
Occurs in young, sexually active males, histologically identical to Bowen disease. Presents with multiple reddish brown papules on the glans and is most often transient, with rare progression to carcinoma in immunocompetent patients.
Bowenoid papulosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688
2382
Appears as a gray, crusted, papular lesion, most commonly on the glans penis or prepuce, which infiltrates the underlying connective tissue to produce an indurated, ulcerated lesion with irregular margins.
Squamous cell carcinoma of the penis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689
2383
A variant of squamous cell carcinoma characterized by a papillary architecture, less striking cytologic atypia, and rounded, pushing deep margins.
Verrucous carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689
2384
Most common cause of scrotal enlargement, which is an accumulation of serous fluid within the tunica vaginalis usually secondary to infection or malignancy.
Hydrocele(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689
2385
Represents failure of testicular descent into the scrotum which involves the right testis more commonly than the left. Causes increased risk of sterility and development of testicular cancer.
Cryptorchidism(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 690
2386
Most important cause of firm, painless enlargement of the testis.
Testicular neoplasms(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 690
2387
Composed of sheets of large, uniform cells with distinct cell borders, clear, glycogen-rich cytoplasm, and round nuclei with conspicuous nucleoli. The cells are often arrayed in small lobules with intervening fibrous septa.
Seminomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 691
2388
These tumors contain a mixture of medium-sized cells, large uninucleate or multinucleate tumor cells, and small cells with round nuclei that are reminiscent of secondary spermatocytes.
Spermatocytic seminoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 691
2389
Ill-defined, invasive masses containing foci of hemorrhage and necrosis. Poorly differentiated, pleomorphic cells in cords, sheets, or papillary formation; most contain some yolk sac and choriocarcinoma cells
Embryonal carcinoma of the testis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692
2390
Most common primary testicular neoplasm in children younger than 3 years of age.
Yolk sac tumors/endodermal sinus tumors(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692
2391
Low cuboidal to columnar epithelial cells forming microcysts, sheets, glands, and papillae, often associated with eosinophilic hyaline globules. (+) Schiller-Duval bodies
Yolk sac tumors/endodermal sinus tumors(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692
2392
Structures resembling primitive glomeruli, seen in yolk sac tumors.
Schiller-Duval bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692
2393
Cytotrophoblast and syncytiotrophoblast without villus formation
Choriocarcinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692
2394
Tissues from all three germ-cell layers with varying degrees of differentiation
Teratomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692
2395
Teratoma which contain fully differentiated tissues from one or more germ cell layers (e.g., neural tissue, cartilage, adipose tissue, bone, epithelium) in a haphazard array.
Mature teratomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692
2396
Teratoma which contain immature somatic elements reminiscent of those in developing fetal tissue.
Immature teratomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692
2397
Characterized by the presence of an acute, neutrophilic inflammatory infiltrate, congestion, and stromal edema of the prostate.
Acute prostatitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 695
2398
Characterized by variable amount of lymphoid infiltrate, evidence of glandular injury, and, frequently, concomitant acute inflammatory changes of the prostate.
Chronic prostatitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 695
2399
Nodular hyperplasia is usually more pronounced in what part/s of the prostate?
Inner (central and transitional) region of the prostate(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 696
2400
Composed of proliferating prostatic glandular elements and fibromuscular stroma. The glandular lumina often contain inspissated, proteinaceous secretory material, termed corpora amylacea.
Nodular Hyperplasia of the Prostate (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 697
2401
Major hormonal stimulus for proliferation in nodular hyperplasia of the prostate.
DHT (Dihydrotestosterone)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 698
2402
Most common area of the prostate affected by prostatic carcinoma.
Outer (peripheral) glands (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 698
2403
Concentration of this biochemical marker is of great value in monitoring patients after treatment for prostate cancer.
Prostate specific antigen (PSA)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 700
2404
A commonly used method for grading prostatic carcinoma, which is based on features such as the degree of glandular differentiation, the architecture of the neoplastic glands, nuclear anaplasia, and mitotic activity.
Gleason system(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 700
2405
A chronic venereal infection caused by the spirochete Treponema pallidum, whose fundamental microscopic lesion is a proliferative endarteritis and an accompanying inflammatory infiltrate rich in plasma cells.
Syphilis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702
2406
An irregular, firm mass of necrotic tissue surrounded by resilient connective tissue. Contains a central zone of coagulation necrosis surrounded by a mixed inflammatory infiltrate composed of lymphocytes, plasma cells, epithelioid cells, giant cells, and a peripheral zone of dense fibrous tissue. Seen in tertiary syphilis.
Gumma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702
2407
This stage of syphilis is characterized by the presence of an indurated chancre at the site of initial inoculation, associated with painless regional lymphadenopathy.
Primary Syphilis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702
2408
Both nontreponemal and antitreponemal antibody tests are strongly positive in virtually all cases of this stage of syphilis.
Secondary syphilis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702
2409
In males this is manifested most often as a purulent urethral discharge, associated with an edematous, congested urethral meatus. Gram stain of urethral discharge, demonstrates the characteristic gram-negative, intracellular diplococci.
Gonorrhea (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 705
2410
A gram-negative intracellular bacterium that causes a disease that is clinically indistinguishable from gonorrhea in both men and in women.
Chlamydia trachomatis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707
2411
C. trachomatis infection causing a triad of reactive arthritis, conjunctivitis and generalized mucocutaneous lesions.
Reiter syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707
2412
This STD is a chronic, ulcerative disease caused by certain strains of C. trachomatis, which presents with nonspecific urethritis, papular or ulcerative lesions involving the lower genitalia, regional adenopathy, or an anorectal syndrome.
Lymphogranuloma venereum (LGV) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707
2413
This STD is an acute, ulcerative infection caused by Haemophilus ducreyi, a small, gram-negative coccobacillus. The lesion is an irregular ulcer, whose base is covered by a shaggy, yellow-gray exudate. Regional lymph nodes are enlarged and tender.
Chancroid (Soft Chancre) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707
2414
A chronic inflammatory disease caused by Calymmatobacterium granulomatis. The organisms are demonstrable in Giemsa-stained smears of the exudate as minute coccobacilli within vacuoles in macrophages (Donovan bodies). Regional lymph nodes are typically spared.
Granuloma Inguinale (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 708
2415
The initial lesions of this infection are painful, erythematous vesicles on the mucosa or skin of the lower genitalia and adjacent extra-genital sites. Cowdry type A inclusions appear as light purple, homogeneous intranuclear structures surrounded by a clear halo.
HSV 2(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 708
2416
Caused by HPV types 6 and 11. Lesions vary from small, sessile lesions to large, papillary proliferations measuring several centimeters in diameter.
Condylomata acuminata (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 709
2417
What is the most common cause of hydronephrosis in infants and children?
Ureteropelvic junction obstruction (TOPNOTCH)
2418
Fiery red appearance of the cervix is associated with what type of infection?
Strawberry cervix is associated with T. vaginalis infection (TOPNOTCH)
2419
Approximately 70% of prostate carcinoma will arise in what zone of the gland?
Peripheral zone ( posterior location) (TOPNOTCH)
2420
Morphology: hallmark is nodularity due to glandular proliferation or dilation and to fibrous or muscular proliferation of the stroma
BPH (TOPNOTCH)
2421
Morphology: appear as minute, disseminated abscesses or diffuse edema, congestion, and boggy suppuration of the entire prostate
Acute prostatitis (TOPNOTCH)
2422
Morphology: aggregation of numerous lymphocytes, plasma cells, and macrophages as well as neutrophils within the prostatic substance
Chronic prostatitis (TOPNOTCH)
2423
Morphology: tumor cells are arranged in distinctive trabeculae with a tendency to form cordlike structures resembling immature seminiferous tubules
Sertoli Cell Tumors or Androblastoma (TOPNOTCH)
2424
Morphology: rod shaped crystalloids of Reinke
Leydig/Interstitial Cell Tumors (TOPNOTCH)
2425
What is the most common form of testicular neoplasm in men over the age of 60?
Testicular Lymphoma (TOPNOTCH)
2426
Morphology: disorganized collection of lands, cartilage, smooth muscle, and immature stroma
Teratoma of the testes (TOPNOTCH)
2427
What do you call the structures resembling endodermal sinuses that may be seen in Yolk Sac Tumor?
Schiller Duval Bodies (TOPNOTCH)
2428
Morphology: reveals large cells with distinct cell borders, pale nuclei, clear or watery appearing cytoplasm, prominent nucleoli, and a sparse lymphocytic infiltrate
Seminona (TOPNOTCH)
2429
Within how many hours should the testes be explored surgically and untwisted manually so the testes will be viable after a testicular torsion?
Within 6 hours(TOPNOTCH)
2430
Morphology: clear vacuolization of the prickle cells
Condylomata acuminatum (koilocytosis) (TOPNOTCH)
2431
What HPV DNA type is found in approximately 80% of Bowen Disease and bowenoid papulosis?
HPV Type 16 (TOPNOTCH)
2432
What type of bladder cancer is associated with long standing schistosomiasis?
Squamous cell carcinoma (TOPNOTCH)
2433
In bladder carcinoma, the major decrease in survival is associated with tumor invading what layer of the bladder?
Muscularis propria (detrussor muscle) (TOPNOTCH)
2434
Umbrella cells with abundant cytoplasm, cells with oval nuclei often with nuclear grooves can be seen in what type of epithelium?
Urothelium(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 959
2435
Most common primary malignant tumor of the ureter
Urothelial carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 960
2436
Ureteral narrowing or obstruction characterized by fibrotic proliferative inflammatory process encasing retroperitoneal structures and causing hydronephrosis
Sclerosing Retroperitotneal Fibrosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p 961
2437
Primary or idiopathic retroperitoneal fibrosis is also called___.
Ormond Disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., p 961
2438
Most common and serious congenital anomaly of the urinary bladder
Vesicoureteral reflux(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 961
2439
Most common cause of acute cystitis
E. coli (TOPNOTCH)Robbins Basic Pathology, 9th ed, p. 962
2440
Laminated mineralized concretions resulting from deposition of calcium in enlarged lysosomes, present within the macrophages; seen in Malakoplakia.
Michaelis-Gutmann bodies(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 963
2441
Most common precursor lesions to invasive urothelial carcinoma
Non-invasive papillary tumors(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 964
2442
Most important risk factor for bladder carcinoma
Cigarette smoking(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 964
2443
True or False. Patients with exstrophy of the bladder have an increased risk of adenocarcinoma.
True(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 962
2444
A newborn baby was noted to pass out out urine through a small opening at the area of the umbilicus. This is due to :
A patent urachus(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 962
2445
True or False. Patients with urachal cyst are are risk for carcinoma.
True(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 962
2446
Most common bladder tumors
Urothelial tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 964
2447
Dominant and sometimes only clinical manifestation of bladder cancer
Painless hematuria(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 967
2448
Urothelial carcinoma associated with loss of the TP53 and RB tumor suppressor genes and frequently progresses to muscle-invasive disease.
Non-invasive high grade urothelial carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 968
2449
Urothelial carcinoma associated with gain of function FGFR3 and HRAS mutation.
Non-invasive low-grade urothelial carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 968
2450
Most common cause of bladder obstruction in males
BPH (TOPNOTCH)
2451
Inflammatory lesion that presents as a small, red, painful mass about the external urethral meatus, consisting of inflamed granulation tissue covered by friable mucosa which may ulcerate and bleed with the slightest trauma, typically in older females.
Urethral caruncle(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 969
2452
Characterized by arrested germ cell development associated with marked hyalinization and thickening of the basement membrane of the spermatic tubules.
Cryptorchidism(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 972
2453
Most frequent causes of epididymitis in sexually active men younger than age 35 years.
C. trachomatis and N. gonorrhoea(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 974
2454
Most frequent causes of epididymitis in men older than age 35 years.
E. Coli and Pseudomonas(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 974
2455
Most common benign paratesticular tumor
Adenomatoid tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 975
2456
Most common malignant paratesticular tumors in children
Rhabdomyosarcroma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 975
2457
Most common malignant paratesticular tumors in adults
Liposarcoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 975
2458
The most common testicular tumor in men agest 15-34 years old
Germ Cell tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 975
2459
Syndrome composed of cryptorchidims, hypospadias, and poor sperm quality; also associated with germ cell tumors
Testicular dysgenesis syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 975
2460
Most common type of germ cell tumor
Seminoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 976
2461
Most common testicular tumor in infants and children up to 3 years of age
Yolk sac tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 976
2462
Lymphatic spread is common to all forms of testicular tumors. Which group of nodes are initially involved?
Retroperitoneal para-aortic nodes(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 979
2463
Most aggressive nonseminomatous germ cell tumors
Pure choriocarcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 979
2464
Biomarker elevated in yolk sac tumor
Serum AFP(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 979
2465
Biomarker elevated in choriocarcinoma
Serum HCG(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 979
2466
Its most common presenting feature is testicular swelling; may manifest with gynecomastia and sexual precocity due to elaboration of androgens, and even corticosteroids.
Leydig Cell Tumors (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 980
2467
It has a distinctive golden brown homogeneous cut surface. Histologically, cells are large and have round, polygonal cell outlines, abundant granular eosinophilic cytoplasm, and round central nucleus. Cytoplasm contains lipid droplets, vacuoles, lipofuscon, or crystalloid of Reinke.
Leydig Cell Tumors (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 980
2468
Presents as a testicular mass. These neoplasm appear as firm, small nodules with a homogeneous gray-white to yellow cut surface. Tumor cell are arranged in distinctive trabeculae and form cordlike structures and tubules.
Sertoli cell tumors(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 980
2469
It is characterized by formation of large, fairly discrete nodules in the periurethral region of the prostate. The most common benign prostatic disease in men older than age 50 years.
Benign Prostatic Hyperplasia or Nodular Hyperplasia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 982
2470
Major clinical problem in BPH
Urinary obstruction(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 983
2471
The most common form of cancer in men.
Adenocarcinoma of the prostate(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 983
2472
DRE was performed in a patient and demonstrated a gritty and firm prostate. PSA was 6 ng/ml. Biopsy of prostate was done and showed crowded glands lined by a single uniform layer of cuboidal epithelium, lack branching and papillary infolding, and absent outer basal cell layer. What is the diagnosis?
Prostate adenocarcinoma(TOPNOTCH)
2473
Most common location of prostate cancer
Posterior location, peripheral zone of the gland(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 985
2474
The most common tumor to secondarily involve the prostate
Urothelial cancer(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 990
2475
Which of the following has been implicated in the development of squamous cell carcinoma of the penis? (A) smegma (B) smoking (C) HPV infection (D) all of the above
all of the above (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688
2476
A 3 year old male presents with only one palpable testicle. Imaging showed an undescended right testis. Which of the following is true? (A) his left testis has an increased risk for developing cancer (B) surgical placement of his right testis into his scrotum before puberty eliminates the risk of cancer (C) surgical placement of his right testis into his scrotum after puberty eliminates the risk of cancer (D) all of the above are true
his right testis has an increased risk for developing cancer (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689
2477
A 25 year old develops bilateral parotitis and fever. He was never vaccinated with MMR. A few days later, he develops bilateral testicular pain and swelling. This complication (A) is more common in children (B) occurs in 80% of adult males (C) consists of a predominantly lymphoplasmacytic inflammatory infiltrate (D) all of the above are true
consists of a predominantly lymphoplasmacytic infiltrate (A- rare in children, B - 20% in adults) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 690
2478
Which of the following confers an increased risk of testicular cancer? (A) intersex syndromes (B) a brother who has testicular cancer (C) cancer in the contralateral testis (D) all of the above
all of the above (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 690
2479
A 44 year old cyclist presents with a unilateral painless testicular mass. Serum HCG is slightly elevated, while serum AFP is normal. Orchiectomy is performed, and the mass is fairly circumscribed, pale, and fleshy. Microscopic examination showed large, uniform cells with distinct borders, clear glycogen-rich cytoplasm, and conspicuous nucleoli. The stroma has a lymphocytic infiltrate. His tumor (A) is exquisitely radiosensitive (B)may be associated with foci of intratubular germ cell neoplasia elsewhere in the testis (C) is histologically identical to ovarian dysrgerminoma (D) all of the above
all of the above (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 691
2480
A 2 year old boy presents with marked right testicular enlargment. Serum HCG is slightly elevated, while serum AFP is markedly elevated. Orchiectomy is performed, and on microscopic examination, the tumor is composed of low cuboidal to columnar epithelial ccells forming microcysts, sheets, glands, and papillae, with eosinophilic hyaline globules. This tumor (A) is rare in this age group (B) may harbor structures resembling primitive glomeruli (C) has a more benign behavior than seminomas (D) all of the above are true
may harbor structures resembling primitive glomeruli (Schiller Duvall bodies) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692
2481
A 55 year old man complains of urinary frequency, intermittency, and weak stream. A digital rectal exam showed a diffusely enlarged, doughy prostate. Serum PSA is 2 ng/L. He undergoes TURP. Histopathology will likely show (A) glands with inner columnar cells and outer flattened cells, some areas thrown into folds, admixed with fibrous stroma (B) small crowded round glands, some coalescing, with cells containing prominent nucleoli (C) nests and sheets of cells with amphophilic cytoplasm and prominent nucleoli (D) glands forming glomeruloid structures
glands with inner columnar cells and outer flattened cells, some areas thrown into folds, admixed with fibrous stroma (nodular prostatic hyperplasia) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 696-697
2482
In nodular prostatic hyperplasia, (A) epithelial cells have prominent nucleoli (B) the pathology usually arises in the peripheral zone (C) circulating systemic androgens are consistently elevated (D) clinical symptoms are seen in 10% of patients
clinical symptoms are seen in 10% of patients (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 697-698
2483
A 28 year old male sex worker presents with multiple maculopapular lesions of the palms and soles and generalized lymphadenopathy. His oral cavity also shows similar lesions. He reports that two months ago, he noticed a painless ulcer with indurated margins on the shaft of his penis, which has now disappeared. Which of the following is accurate? (A) if a biopsy of his penile ulcer and his present lesions were done, they would both show proliferative endarteritis with lymphoplasmacytic infiltrate (B) his present lesions are not infectious (C) if he is left untreated, the commonest tertiary form of his disease are gummas in the bone and skin (D) he is likely negative for antitreponemal antibody at his present stage
if a biopsy of his penile ulcer and his present lesions were done, they would both show proliferative endarteritis with lymphoplasmacytic infiltrate (B - present lesions are infectious; (C) commonest tertiary is cardiovascular (D) positive in virtually all 2ndary syphilis) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 701-703
2484
A 19 year old college student consults for penile discharge. He discloses a history of unprotected sex. A gram stain of the smear of the discharge shows numerous neutrophils, some of which harbor gram negative cocci in pairs in the cytoplasm. The likely etiologic agent is (A) Trichomonas (B) Chlamydia (C) Treponema (D) Neisseria
Neisseria (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 705
2485
A 31 year old male with multiple sexual partners presents with several painless verrucous papules around the coronal sulcus of his penis. Excision is done, and microscopic examination showed stratified squamous epithelium in a papillary architecture. Some of the squamous cells have irregular, hyperchromatic nuclei surrounded by a perinuclear halo. His lesions are caused by (A) HSV-2 (B) HPV (C) Calymmatobacterium granulomatis (D) Haemophilus ducreyi
HPV (TOPNOTCH)Robbins Basic Pathology, 8th ed., p709
2486
A benign, well-circumscribed, soft lesion of the pituitary gland that may compress the optic chiasm and adjacent structures. Composed of relatively uniform, polygonal cells arrayed in sheets, cords, or papillae.
Pituitary adenoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 754
2487
Most common type of hyperfunctioning pituitary adenoma.
Prolactinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 754
2488
Microscopically, these are composed of densely or sparsely granulated cells, and immunohistochemical stains demonstrate growth hormone within the cytoplasm of the neoplastic cells.
Growth Hormone-Producing Adenomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 754
2489
A condition characterized by excessive urination (polyuria) caused by an inability of the kidney to properly resorb water from the urine.
Diabetes insipidus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 757
2490
Enzyme deficient in central Diabetes insipidus.
Anti-diuretic hormone(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 757
2491
Disease caused by excessive levels of ADH, leading to resorption of excess water, with resultant hyponatremia.
syndrome of inappropriate ADH secretion (SIADH)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 757
2492
The most common cause of hypothyroidism in areas of the world where iodine levels are sufficient. Presents as painless enlargement of the gland, associated with hypothyroidism.
Hashimoto thyroiditis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 757
2493
The thyroid is diffusely and symmetrically enlarged, with intact capsule. Microscopically, reveals a mononuclear inflammatory infiltrate and the presence of Hurthle or oxyphil cells, which are cells with eosinophilic, granular cytoplasm.
Chronic Lymphocytic (Hashimoto) Thyroiditis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 761
2494
A rare disorder characterized by extensive fibrosis involving the thyroid and contiguous neck structures. Idiopathic in nature.
Riedel thyroiditis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 762
2495
Believed to be caused by a viral infection or a postviral inflammatory process, this lesion of the thyroid gland is characterized by unilateral or bilateral enlargement of the thyroid, with disruption of thyroid follicles. Extravasation of colloid leads to a granulomatous reaction. Healing occurs by resolution of inflammation and fibrosis.
Subacute Granulomatous (de Quervain) Thyroiditis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 762
2496
Also known as "silent" or "painless" thyroiditis n a subset of patients the onset of disease follows pregnancy. Unlike Hashimoto thyroiditis, follicular atrophy or Hurthle cell metaplasia are not commonly seen.
Postpartum thyroiditis/ Subacute Lymphocytic Thyroiditis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 762
2497
Thyroid gland is diffusely enlarged due to hyperplasia and hypertrophy of the thyroid follicular cells. The follicular epithelial cells are tall, columnar, and more crowded than usual. These cells actively resorb the colloid in the centers of the follicles, resulting in the "scalloped" appearance of the edges of the colloid.
Graves Disease(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 764
2498
Goiter which occurs in areas where the soil, water and food supply contain little iodine.
Endemic goiter(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 765
2499
Diffuse, symmetric enlargement of the gland due to TSH-induced hypertrophy and hyperplasia of thyroid follicular cells.
Diffuse goiter(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 765
2500
Goiter characterized by enlarged, colloid-rich gland. On cut surface, the thyroid is usually brown, glassy and translucent.
Colloid goiter(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 765
2501
Irregular enlargement of the thyroid as a result of recurrent episodes of hyperplasia and involution.
Multinodular goiter(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 765
2502
Probability of being benign or malignant.A solitary nodule seen in a 20-yr old male.
Malignant(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 766
2503
Probability of being benign or malignant.Multiple, hot nodules.
Benign(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 766
2504
Probability of being benign or malignant.A solitary, cold nodule.
Malignant(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 766
2505
A solitary, spherical lesion that compresses the adjacent non-neoplastic thyroid. Neoplastic cells are demarcated from the adjacent parenchyma by a well-defined, intact capsule, which is a hallmark of this tumor.
Thyroid adenoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 766
2506
Most common carcinoma of the thyroid.
Papillary carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 767
2507
Thyroid carcinoma which may occur at any age and is associated with previous exposure to ionizing radiation. The nuclei of cells contain very finely dispersed chromatin, which imparts an optically clear appearance, giving rise to the designation "ground-glass" or "Orphan Annie eye" nuclei.
Papillary carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 767
2508
The second most common form of thyroid cancer. Usually present at an older age a peak incidence in the middle adult years. Microscopically, these are composed of fairly uniform cells forming small follicles, reminiscent of normal thyroid.
Follicular Carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 769
2509
Neuroendocrine neoplasms derived from the parafollicular cells, or C cells, of the thyroid, which secrete calcitonin. Associated with MEN 2A and 2B. May be solitary or multicentric, composed of polygonal to spindle-shaped cells, which may form nests, trabeculae, and follicles, contains amyloid.
Medullary carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 770
2510
Carcinoma of the thyroid usually seen in the elderly. Associated with high mortality rate. These present as bulky masses that typically grow rapidly beyond the thyroid capsule into adjacent neck structures.
Anaplastic carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 771
2511
A solitary lesion of the parathyroid gland which are composed predominantly of chief cells almost invariably confined to a single gland. A rim of compressed, non-neoplastic parathyroid tissue, generally separated by a fibrous capsule, is often visible at the edge of the adenoma.
Parathyroid adenoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 773
2512
These tumors of the parathyroid glands are usually firm or hard tumors, adhering to the surrounding tissue as a result of fibrosis or infiltrative growth. May weigh >5 grams. The cytologic features and mitotic activity are variable.
Parathyroid carcinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 773
2513
Inadvertent removal of parathyroids during thyroidectomy.
Surgical ablation(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 775
2514
An autoimmune disease characterized by progressive destruction of islet beta cells, leading to absolute insulin deficiency.
Type 1 diabetes mellitus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 781
2515
Caused by a combination of peripheral resistance to insulin action and an inadequate compensatory response of insulin secretion by the pancreatic beta cells.
Type 2 diabetes mellitus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 781
2516
Vascular lesion associated with hypertension, which is more prevalent in diabetics.
Hyaline arteriolosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 781
2517
A diffuse increase in mesangial matrix along with mesangial cell proliferation and is always associated with basement membrane thickening of the glomerulus. Seen in patients with diabetes mellitus.
Diffuse mesangial sclerosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783
2518
A glomerular lesion made distinctive by ball-like deposits of a laminated matrix situated in the periphery of the glomerulus .
Nodular glomerulosclerosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783
2519
The ball-like deposit seen in nodular glomerulosclerosis.
Kimmelstiel-Wilson lesion(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783
2520
A special pattern of acute pyelonephritis seen more often in diabetics.
Necrotizing papillitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 784
2521
Most common pancreatic endocrine neoplasms.
beta-cell tumors (insulinomas) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788
2522
These benign tumors look remarkably like giant islets, with preservation of the regular cords of monotonous cells and their orientation to the vasculature.
Insulinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788
2523
What syndrome is described by the association of pancreatic islet cell lesions with hypersecretion of gastric acid and severe peptic ulceration?
Zollinger-Ellison syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788
2524
Tumors associated with increased serum glucagon and a syndrome consisting of mild diabetes mellitus, a characteristic skin rash (necrolytic migratory erythema), and anemia.
alpha-Cell tumors (glucagonomas) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789
2525
Most common cause of Cushing syndrome.
Administration of exogenous glucocorticoids(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789
2526
Primary hypothalamic-pituitary disease associated with oversecretion of ACTH. The adrenal glands characterized by variable degrees of bilateral nodular cortical hyperplasia.
Cushing disease(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789
2527
In this condition, the normal granular, basophilic cytoplasm of the ACTH-producing cells in the anterior pituitary is replaced by homogeneous, lightly basophilic material. This results from high levels of endogenous or exogenous glucocorticoids.
Crooke hyaline change(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 790
2528
Lung cancer associated with a paraneoplastic syndrome leading to excessive production of ACTH.
Small-cell lung cancer(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 792
2529
Caused either by an aldosterone-producing adrenocortical neoplasm, usually an adenoma, or by primary adrenocortical hyperplasia, resulting in suppression of the renin-angiotensin system and decreased plasma renin activity.
Primary hyperaldosteronism/ Conn syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 792
2530
A characteristic feature of aldesterone-producing adenomas which is the presence of eosinophilic, laminated cytoplasmic inclusions. These are typically found after treatment with the anti-hypertensive drug which is the DOC for primary hyperaldosteronism.
Spironolactone bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 792
2531
The adrenals are hyperplastic bilaterally, sometimes expanding to 10 to 15 times their normal weights,due to sustained elevation in ACTH. The adrenal cortex is thickened and nodular, and on cut section, the widened cortex appears brown as a result of depletion of all lipid
Congenital adrenal hyperplasia(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 793
2532
Acute adrenal insufficiency caused by severe bilateral adrenal hemorrhage in an infant with overwhelming sepsis. The adrenals are grossly hemorrhagic and shrunken; microscopically, little residual cortical architecture is discernible
Waterhouse-Friderichsen syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 794
2533
An uncommon disorder resulting from progressive destruction of the adrenal cortex. May be due to autoimmune adrenalitis, tuberculosis, AIDS, or metastatic cancers.
Addison disease/ chronic adrenocortical insufficiency(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 794
2534
The adrenals are reduced to small, flattened structures that usually retain their yellow color because of a small amount of residual lipid. Histologically, there is atrophy of cortical cells with loss of cytoplasmic lipid, particularly in the zonae fasciculata and reticularis, due to decreased ACTH stimulation.
Secondary hypoadrenalism (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 795
2535
Characterized by irregularly shrunken glands, which may be exceedingly difficult to identify within the suprarenal adipose tissue. Histologically, the cortex contains only scattered residual cortical cells in a collapsed network of connective tissue.
Primary autoimmune adrenalitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 795
2536
Neoplasms composed of chromaffin cells which synthesize and release catecholamines and other peptide hormones. Composed of polygonal to spindle-shaped chromaffin cells compartmentalized intonests, or "Zellballen," by a rich vascular network.
Pheochromocytomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 797
2537
Most common extra-cranial solid tumor of childhood. Occur most commonly during the first 5 years of life and may arise during infancy.
Neuroblastoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 798
2538
Components of MEN1?
Parathyroid: Primary hyperparathyroidismPancreas: ZES, insulinoma, etc.Pituitary: prolactin-secreting macroadenoma, somatotrophin-secreting tumors(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 798
2539
Components of MEN2A?
Thyroid: Medullary carcinomaAdrenal medulla: pheochromocytomasParathyroid: parathyroid gland hyperplasia (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 799
2540
Components of MEN2B?
Thyroid: Medullary carcinomaAdrenal medulla: pheochromocytomaExtraendocrine manifestations: ganglioneuromas of mucosal sites (gastrointestinal tract, lips, tongue) and marfanoid habitus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 799
2541
All individuals carrying germ-line RET mutations are advised to undergo prophylactic thyroidectomy to prevent the development of what type of carcinoma?
Medullary Carcinoma (TOPNOTCH)
2542
What is the most common site of gastrinomas in individuals with MEN-1?
Duodenum (TOPNOTCH)
2543
What is the most frequent anterior pituitary tumor encountered in individuals with MEN-1?
Prolactinoma (TOPNOTCH)
2544
Morphology: demonstrates characteristic nests of cells (zellballen) with abundant cytoplasm
Pheochromocytomas (TOPNOTCH)
2545
Morphology: the adrenals are grossly hemorrhagic and shrunken with little residual cortical architecture discernable
Waterhouse Friederichsen Syndrome (TOPNOTCH)
2546
What is the most common cause of primary adrenal insufficiency in developed countries?
Autoimmune adrenalitis (TOPNOTCH)
2547
Spirinolactone bodies are seen in what tumor?
Aldosterone producing adenomas (TOPNOTCH)
2548
Crook hyaline change is seen in?
Cushing syndrome (TOPNOTCH)
2549
Watery Diarrhea, hypokalemia, achlorhydria or WDHA syndrome is seen in?
VIPoma (TOPNOTCH)
2550
Syndrome of mild DM, characteristic rash (necrolytic migratory erythema), and anemia is seen in what tumor?
Glucagonomas or alpha cell tumors (TOPNOTCH)
2551
Syndrome of DM, cholelithiasis, steatorrhea, and hypochlorhydria is seen in what tumor?
Somatostatinoma or delta cell tumor (TOPNOTCH)
2552
Approximately 60%-80% of patients with DM will develop some form of diabetic retinopathy after how many years from the time of diagnosis?
15-20 years (TOPNOTCH)
2553
The fundamental lesion of DM retinopathy
neovascularization (TOPNOTCH)
2554
What special pattern of acute pyelonephritis is common in diabetics compared to non diabetics?
Necrotizing papillitis or papillary necrosis (TOPNOTCH)
2555
These are PAS positive glomerular lesions made distinctive by ball like deposits of laminated matrix situated in the periphery of the glomerulus
Nodular glomerulosclerosis or Kimmelstiel Wilson lesion (TOPNOTCH)
2556
What are the three most important glomerular lesions seen in DM?
Basement membrane thickening, diffuse mesangial sclerosis, and nodular glomerulosclerosis (TOPNOTCH)
2557
What is the hallmark of diabetic macrovascular disease?
Accelerated atherosclerosis (TOPNOTCH)
2558
What is the most common cause of death in diabetics?
Myocardial Infarction (TOPNOTCH)
2559
What morphological change seen in pancreas is more commonly associated with DM Type 2 than DM Type 1?
Amyloid replacement of islets (TOPNOTCH)
2560
What is the hallmark of hypocalcemia?
Tetany (TOPNOTCH)
2561
The most common cause of clinically apparent hypercalcemia
Malignancy (TOPNOTCH)
2562
The most common cause of asymptomatic elevated blood calcium
Primary hyperparathyroidism (TOPNOTCH)
2563
A peculiar feature of this type of thyroid carcinoma is the presence of multicentric C cell hyperplasia
Familial Medullary Cancers of the thyroid (TOPNOTCH)
2564
Acellular amyloid deposits are seen in what type of thyroid cancer?
Medullary Carcinoma (TOPNOTCH)
2565
Morphology: fairly uniform cells forming small follicles containing colloid, quite reminiscent of normal thyroid
Follicular Carcinoma of the thyroid (TOPNOTCH)
2566
These are concentrically calfcified structures that are often present in papillary carcinoma of the thyroid
Psamomma bodies (TOPNOTCH)
2567
Morphology: the nuclei of these tumor cells contain finely dispersed chromatic which imparts an optically clear or empty appearance, giving rise to the designation ground glass or Orphan Annie eye
Papillary Carcinoma of the thyroid (TOPNOTCH)
2568
The major risk factor predisposing to thyroid cancer
Ionizing radiation, particularly in the first two decades of life (TOPNOTCH)
2569
Morphology: diffuse hypertrophy and hyperplasia of thyroid follicular epithelial cells with scalloping of the margins
Graves disease (TOPNOTCH)
2570
Morphology: lymphocytic infiltration with hyperplastic germinal centers within the thyroid parenchyma and patch disruption and collapse of thyroid follicles
Subacute lymphocytic or Painless thyroiditis (TOPNOTCH)
2571
Morphology: thyroid parenchyma contains a chronic inflammatory infiltrate with multinucleate giant cells enclosing naked pools and fragments of colloid
Subacute or granulomatous thyroiditis (TOPNOTCH)
2572
Morphology: the thyroid parenchyma contains a dense lymphocytic infiltrate with germinal centers and deeply eosinophilic Hurthle cells line the residual thyroid follicles
Hashimoto Thyroiditis (TOPNOTCH)
2573
What variant of craniopharyngoma frequently contains radiologicaly demonstrable calcifications?
Adamantinomatous craniopharyngoma (TOPNOTCH)
2574
What is the most common cause of hyperpituitarism?
Adenoma (TOPNOTCH)
2575
Hypofunction of the anterior pituitary occurs when approximately how much of the parenchyma is lost?
75% (TOPNOTCH)
2576
These cysts are lined by ciliated cuboidal epithelium with occasional goblet cells and anterior pituitary cells, can accumulate proteinaceous fluid and expand, compromising the normal gland
Rathke Cleft Cyst (TOPNOTCH)
2577
The craniopharyngomas are thought to arise from what structure?
Vestigial remnants of Rathke pouch (TOPNOTCH)
2578
What is the earliest and most consistent feature of hyperthyroidism?
Cardiac manifestations (TOPNOTCH)
2579
This condition presents with impaired developments of the skeletal system and central nervous system, manifested by severe mental retardation, short stature, coarse facial features, a protruding tongue, and umbilical hernia
Cretinism (TOPNOTCH)
2580
These are epithelial cells with abudant eosinophilic, granular ctyoplasm seen in Hashimoto thyroiditis
Hurthle cells (TOPNOTCH)
2581
What is the most important feature in making the distinction between a thyroid adenoma and a multinodular goiter?
In adenoma, the neoplastic cells are demarcated from the adjacent parenchyma by a well defined intact capsule. In multinodular goiters, they lack a well formed capsule (TOPNOTCH)
2582
What is the hallmark of all follicular adenomas?
Well formed capsule encircling the tumor. So, careful evaluation of the integrity of the capsule is therefore critical in distinguishing follicular adenomas from follicular carcinomas which demostrate capsular and or vascular invasion (TOPNOTCH)
2583
What is the most common clinically significant congenital anomaly of the thyroid?
Thyroglossal duct or cyst (TOPNOTCH)
2584
Lamellar keratin formation or "wet keratin" is a diagnostic feature of what tumor?
Adamantinomatous craniopharyngoma (TOPNOTCH)
2585
Morphology: extensive infiltration of the parenchyma by a mononuclear inflammatory infiltrate containing small lymphocytes, plasma cells, and well developed germinal centers
Hashimoto thyroiditis (TOPNOTCH)
2586
Morphology: in its hyperplastic phase, they thyroid gland is diffusely and symmetrically enlarged and the follicles are lined by crowded columnar cells, which may pile up and form projections similar to those seen in Grave's disease
Diffuse nontoxic (simple) goiter (TOPNOTCH)
2587
Morphology: Variant of papillary carcinos ma that is marked with tall columnar cells with intensely eosinophilic cytoplasm lining the papillary structures. The cells are at least twice as tall as they are wide.
Tall cell variant (TOPNOTCH)
2588
Morphology: nuclei are usually round to ovoid, with stippled "salt and pepper" chromatin
Pheochromocytoma (TOPNOTCH)
2589
Pathogenesis: Dysfunction in T cell selection and regulation leading to breakdown in self-tolerance to islet autoantigens
Type 1 diabetes mellitus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1108
2590
Pathogenesis: Insulin resistance in peripheral tissues and failure of compensation by beta cells
Type 2 diabetes mellitus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1108
2591
Characterized by inflammatory infiltrate of T cells and macrophages, beta cell depletion and islet atrophy
Type 1 diabetes mellitus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1108
2592
Characterized by amyloid deposition in islets and mild beta cell depletion. No insulitis.
Type 2 diabetes mellitus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1108
2593
Most potent anabolic hormone with multiple synthetic and growth-promoting effects.
Insulin (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1109
2594
The most important environmenta risk factor for type 2 diabetes
Obesity(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1111
2595
The most common precipitating factor in DKA
Failure to take insulin(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1114
2596
What explains the wide, staring gaze and lid lag in hyperthyroidism?
Sympathetic overstimulation of superior tarsal muscle(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1084
2597
Most common cause of endogenous hyperthyroidism
Graves Disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1089
2598
Triad of clinical findings in Graves Diseae
Hyperthyroidism, infiltrative ophthalmopathy, and pretibial myxedema(infiltrative dermopathy)(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1089
2599
The most common antibody subtype seen in 90% of patients with Graves disease.
Thyroid stimulating immunoglobulin(TSI) Robbins Basic Pathology, 9th ed., p. 1089
2600
Patient presents with heat intolerance, palpitations, tibial edema, and exophthalmos. Thyroid gland was noted to be symmetrically enlarged. The most likely diagnosis is:
Graves disease(TOPNOTCH)
2601
Effect of iodine in the morphology of thyroid in Graves disease
Involution of epithelium and accumulation of colloid(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1089
2602
Laboratory features of Graves disease
Elevations in serum free T3 and T4 and decreased serum TSH(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1090
2603
Most important single screening test for hyperthyroidism
TSH(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1084
2604
Most often cause of congenital hypothyroidism
Iodine deficiency in the diet(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1085
2605
Presents with slowing of physical and mental activity, fatigue, apathy, constipation, decreased sweating, shortness of breathing, cold intolerance, overweight.
Myxedema/Hypothyroidism(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1086
2606
Most sensitive sceening test for hypothyroidism
Serum TSH level(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1085
2607
A middle aged-woman presents with painless enlargement of the thyroid that is symmetric and diffuse, with some symptoms of hypothyroidism. What is the most likely diagnosis?
Hashimoto's thyroiditis(TOPNOTCH)
2608
It causes symmetric enlargement of the entire thyroid gland without producing nodularity. Patients are usually clinically euthyroid.
Diffuse nontoxic (simple) goiter (TOPNOTCH)
2609
Patient presents with mass on the anterior neck and dysphagia. Thyroid is assymetrically enlarged. Thyroid functions tests are normal. Cut section showed irregular nodules containing brown, gelatinous colloid. The microscopic appearance showed colloid-rich follicles lined by flattened, inactive epithelium and areas of follicular hyperplasia. What is the most likely diagnosis?
Multinodular goiter(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1091
2610
True or False. Nodules in males are more likely to be neoplastic than are those in females.
True(TOPNOTCH)
2611
True or False. Solitary nodule are more likely to be neoplast than are multiple nodules.
True(TOPNOTCH)
2612
True or False. Nodules in younger patients are more likely to be neoplastic than are those in older patients.
True(TOPNOTCH)
2613
True or False. Functional nodules that take up radioactive iodine in imaging studies(hotnodules0 are much more likely to be benign than malignant.
True(TOPNOTCH)
2614
What is the most common benign neoplasm of the thyroid?
Follicular adenoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1100
2615
Patient presents with enlarged feet and hands, thickened and sausage-like fingers, jaw protrusion and broadening of the lower face, generalized muscle weakenss. The diagnosis of this condition relies on what elevated serum ___ and ___ levels.
GF and IGF-1(TOPNOTCH)
2616
Development of large destructive pituitary adenoma after surgical removal of the adrenal gland. This condition occurs most often because of the inhibitory effect of adrenal corticosteroids.
Nelson syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1080
2617
Presents with amenorrhea, galactorrhea, loss of libido and infertility.
Lactotroph adenoma(TOPNOTCH)
2618
Most common form of clinically significant ischemic necrosis of the anterior pituitary. May present with amenorrhea ang infertility.
Sheehan syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1081
2619
Presents with hyponatremia, cerebral edema, absence of peripheral edema due to ectopic ADH secretion by malignant neoplasm, drugs, and a variety of CNS disorders.
SIADH(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1082
2620
May present with growth retardation in children, headache and visual disturbances. In adult, these neoplasm is thought to rise from vestigial remnant of Rathke pouch.
Craniopharyngoma(TOPNOTCH)Robbins Basic Pathology, 9th ed,. P. 1082
2621
Histologic variant of craniopharyngioma most often observed in children
Adamantinomatous craniopharyngoma (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1082
2622
Histologic variant of craniopharyngioma most often observed in adults
Papillary craniopharyngoma (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1082
2623
Presents with rapidly enlarging bulky neck mass, dyspnea, dysphagia, hoarsenes, and cough. Histologic finding of pleomorphic giant cells, spindle cells or mixed. Highly fatal.
Anaplastic carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1098
2624
Amyloid deposits are characteristic of this histologic type of thyroid cancer.
Medullary cancer(TOPNOTCH)
2625
Most common clinically significant congenital anomaly of the thyroid.
Thyroglossal duct or cyst (TOPNOTCH)
2626
Most common cause primary hyperparathyroidism
Solitary parathyroid adenoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p.1101
2627
The combination of increased osteoclast activity, peritrabecular fibrosis, and cystic brown tumors
von Recklinghausen disease of bone/osteitis fibrosa cystica(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1102
2628
The most common mechanism through which osteolytic tumors induce hypercalcemia
Secretion of PTHrP(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1103
2629
Classic findings of hypocalcemia on physical examination
Chvostek sign and Trosseau sign(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1105
2630
The most frequent pattern in diabetic neuropathy
Distal symmetric polyneuropathy of the lower extremities(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1120
2631
The most common cause of hypercotisolism
Exogenous administration of steroids(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1125
2632
Most common adrenal finding in endogenous Cushing syndrome
Nodular hyperplasia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1125
2633
Presents with hypertension, weight gain, moon facies, truncal obesity, elevated urinary steroid secetion, low ACTH
Cushing syndrome caused by an adrenal tumor(TOPNOTCH)
2634
Presents with signs and symptoms of elevated cortisol levels, with failure of low-dose and high-dose dexamethasone to suppress cortisol secretion
Ectopic ACTH secretion(e.g ACTH production by tumors)(TOPNOTCH)
2635
Most common form of Cushing syndrome, ACTH levels are elevated and cannot be suppressed by administration of low dose of dexamethasone.
Pituitary Cushing syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1125
2636
Most common manifestation of primary hyperaldosteronism
BP elevation(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1126
2637
Overproduction of aldosterone and decreased plasma renin activity, hypertension and hypokalemia
Primary aldosteronism(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1127
2638
Newborn presents with hyponatremia, hyperkalemia, hypotension, cardiovascular collapse, and virilization. What is the most likely diagnosis?
Salt-wasting syndrome, CAH(TOPNOTCH)
2639
Presents with hyperkalemia, hyponatremia, volume depletion, hypotension, hyperpigmentation of sun-exposed areas, weakness, nausea vomiting, weight loss, abdominal pain.
Primary adrenal insufficiency(TOPNOTCH)
2640
The dominant clinical manifestation of pheochromocytoma
Hypertension(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1135
2641
Presents with paroxysmal episodes of hypertension, tachycardia, palpitations, headache, sweating, tremor, apprehension, elevated urinary vanillylmandelic acid and metanephrines.
Pheochromocytoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1146
2642
The principal secretory product of pineal gland
Melatonin(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1137
2643
A 33 year old female presents with blurring of vision, galactorrhea and amenorrhea. A cranial CT shows a pituitary mass. She undergoes surgery to excise the mass. Her tumor (A) is associated with MEN-1 in >50% of cases (B) is composed of lobules of distinct cell populations of cells , some acidophilic, others basophilic (C) is composed of a uniform cell population and absent a reticulin network (D) is most probably of acidophilic morphology due to her prolactinemic signs and symptoms
is composed of a uniform cell population and absent a reticulin network (A - MEN-1 association in 3%; B - normal pituitary; D - functional status cannot be predicted from its histologic appearance) (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp 754-755
2644
A 40 year old female presents with an anterior left neck mass. She undergoes a left thyroid lobectomy. The specimen has a solitary well-circumscribed nodule on the inferior pole. Which microscopic finding points to an adenoma, rather than a dominant nodule in a multinodular goiter? (A) well defined, intact capsule and compressed adjacent thyroid parenchyma (B) follicles of different sizes, resembling the surrounding thyroid parenchyma (C) presence of nuclear enlargement, nuclear grooves, and some with clearing (D) small follicles invading the capsule
well defined, intact capsule and compressed adjacent thyroid parenchyma (B - multinodular goiter; C - papillary carcinoma; D - follicular carcinoma) (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp766-769)
2645
A 36 year old female presents with an anterior neck mass, and palpable cervical lymph nodes. She undergoes total thyroidectomy and neck dissection. On her right thyroid lobe is a 6 cm solid tan mass. Some of the lymph nodes also have a solid tan cut surface. Which of the following histologic findings is definite evidence of papillary thyroid carcinoma? (A) cells with enlarged nuclei, fine chromatin, some with nuclear grooves and clearing (B) follicles containing papillary infoldings, lined by thyrocytes with dark round nuclei (C) follicles with thick, pink colloid (D) follicles lined by tall columnar cells, and colloid with a scalloped appearance
cells with enlarged nuclei, fine chromatin, some with nuclear grooves and clearing (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 768
2646
A 15 year old male presents with an anterior neck mass. A deceased uncle also had an anterior neck mass in his teen years. The thyroid is excised, and histopathology showed polygonal to spindle shaped tumor cells in nests and trabeculae, admixed with amyloid deposits. Which of the following is most accurate? (A) the amyloid deposits are composed of altered calcitonin molecules (B) the patient is likely hypocalcemic (C) the patient's surrounding thyroid parenchyma has no C cell hyperplasia (D) most cases of this tumor are familial
the amyloid deposits are altered calcitonin molecules (medullary thyroid carcinoma) (B - hypocalcemia is not a feature; C - multicentric C cell hyperplasia is a feature in familial forms; D - most cases are sporadic) (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp 770-771
2647
Which of the following renal histologic findings is most characteristic of diabetes? (A) focal mild pyelonephritis (B) diffuse mesangial sclerosis (C) arteriosclerosis of efferent arterioles of the glomerulus (D) crescentic glomerulonephritis
arteriosclerosis of the efferent arterioles of the glomerulus (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp783-784
2648
Of the pancreatic endocrine neoplasms or islet cell tumors, which is most commonly benign? (A) insulinomas (B) gastrinomas (C) VIPomas (D) nonfunctioning islet cell tumors
Insulinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788
2649
A 44 year old male presents with intermittent, intense epigastric pain unrelieved by antacids or H2 blockers. He also has occasional diarrhea. An endoscopy revealed multiple gastric, duodenal, and jejunal ulcers. Zollinger-Ellison syndrome is considered. Where can the tumor be located? (A) pancreas (B) duodenum (C) peripancreatic soft tissues (D) all of the above
all of the above ("gastrinoma triangle") (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp788-789
2650
Which of the following is the commonest cause of Cushing syndrome? (A) anterior pituitary tumor (B) adrenocortical neoplasm (C) small cell lung carcinoma (D) medication
medication (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp 789-790
2651
Which of the following findings is most compatible with adrenal Cushing syndrome? (A) elevated ACTH, elevated cortisol (B) decreased ACTH, decreased cortisol (C) decreased ACTH, elevated cortisol (D) elevated ACTH, decreased cortisol
decreased ACTH, elevated cortisol (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 789
2652
Known as "brittle bone disease".
Osteogenesis Imperfecta (TOPNOTCH)Robbins Basic Pathology,8th ed., p802
2653
This is a group of hereditary disorders caused by defective synthesis of type I collagen. Classic finding of a "blue sclerae" is seen in one type of this disorder.
Osteogenesis Imperfecta (TOPNOTCH)Robbins Basic Pathology,8th ed., p802
2654
Characterized by , disproportionate shortening of the proximal extremities, bowing of the legs, and a lordotic (sway-backed) posture.
Achrondroplasia (TOPNOTCH)Robbins Basic Pathology,8th ed., p802
2655
A group of rare genetic disorders characterized by reduced osteoclast-mediated bone resorption and therefore defective bone remodelling. Literally means "stone bone".
Osteopetrosis(TOPNOTCH)Robbins Basic Pathology,8th ed., p802
2656
The hallmark of this disease is loss of bone which tends to be most conspicuous in trabecular bone. The bony trabeculae are thinner and more widely separated than usual, resulting in an increased susceptibility to fractures.
Osteoporosis (TOPNOTCH)Robbins Basic Pathology,8th ed., p804
2657
Characterized by repetitive episodes of frenzied, regional osteoclastic activity and bone resorption, followed by exuberant bone formation, and finally by an apparent exhaustion of cellular activity. Pathognomonic feature is a "mosaic pattern" of lamellar bone.
Paget Disease (Osteitis Deformans) (TOPNOTCH)Robbins Basic Pathology,8th ed., p806
2658
The hallmark of this disease is increased osteoclastic activity, with bone resorption. This leads to characteristic radiographic changes best seen along the radial aspect of the middle phalanges of the second and third fingers.
Hyperparathyroidism (TOPNOTCH)Robbins Basic Pathology,8th ed., p808
2659
Characterized by dead bone with empty lacunae is interspersed with areas of fat necrosis and insoluble calcium soaps. The cortex is usually not affected because of collateral blood supply.
Osteonecrosis (avascular necrosis)(TOPNOTCH)Robbins Basic Pathology,8th ed., p809
2660
Inflammation of the bone and marrow cavity.
Osteomyelitis(TOPNOTCH)Robbins Basic Pathology,8th ed., p809
2661
What do you call the dead entrapped bone seen in infected sites of bones affected with osteomyelitis?
Sequestrum(TOPNOTCH)Robbins Basic Pathology,8th ed., p809
2662
What do you call the shell of living tissue around a segment of devitalized bone?
Involucrum (TOPNOTCH)Robbins Basic Pathology,8th ed., p809
2663
Benign bone tumor characterized as exophytic growths attached to bone surface of the face and skull, which may histologically resemble normal bone.
Osteoma(TOPNOTCH)Robbins Basic Pathology,8th ed., p811
2664
Benign bone tumor that are cortical tumors, histologically described as interlacing trabeculae of woven bone. Characteristic symptom is pain. Common locations include the metaphyses of the femur and tibia.
Osteoid osteoma(TOPNOTCH)Robbins Basic Pathology,8th ed., p811
2665
These bone-forming lesions arise in vertebral transverse and spinous processes of the vertebral column, which may be histologically similar to osteoid osteoma.
Osteoblastoma(TOPNOTCH)Robbins Basic Pathology,8th ed., p811
2666
A bone-producing malignant mesenchymal tumor, characterized as gritty, gray-white tumors, often exhibiting hemorrhage and cystic degeneration. The production of mineralized or unmineralized bone (osteoid) by malignant cells is essential for diagnosis.
Osteosarcomas(TOPNOTCH)Robbins Basic Pathology,8th ed., p811
2667
These are relatively common benign hyaline cartilage-capped outgrowths attached by a bony stalk to the underlying skeleton.
Osteochondromas (TOPNOTCH)Robbins Basic Pathology,8th ed., p814
2668
These are benign tumors of hyaline cartilage, described as gray-blue, translucent well-circumscribed nodules. May be seen in metaphyseal regions of tubular bones of the hands and feet. On x-ray, the unmineralized nodules of cartilage produce well-circumscribed oval lucencies surrounded by thin rims of radiodense bone (O-ring sign).
Enchondromas (TOPNOTCH)Robbins Basic Pathology,8th ed., p814
2669
Chondromas seen on the bone surface.
Juxtacortical chondromas(TOPNOTCH)Robbins Basic Pathology,8th ed., p814
2670
These lesions arise within the medullary cavity of the bone to form an expansile glistening mass that often erodes the cortex. They exhibit malignant hyaline and myxoid cartilage.
Conventional chondrosarcomas (TOPNOTCH)Robbins Basic Pathology,8th ed., p814
2671
These tumors are characterized as viscous and gelatinous, with the matrix oozing from the cut surface. Spotty calcifications are typically present, with central necrosis creating cystic spaces.
Myxoid chondrosarcomas(TOPNOTCH)Robbins Basic Pathology,8th ed., p815
2672
Presents as sharply demarcated radiolucencies surrounded by a thin zone of sclerosis. They are gray to yellow-brown, and microscopically are cellular lesions composed of cytologically benign fibroblasts and macrophages. The fibroblasts classically exhibit a "storiform (pinwheel) pattern".
Fibrous Cortical Defect and Nonossifying Fibroma (TOPNOTCH)Robbins Basic Pathology,8th ed., p815
2673
A benign tumor of the bone wherein all components of normal bone are present, but they fail to differentiate into mature structures. Curved trabeculae of woven bone mimick "Chinese characters" histologically.
Fibrous Dysplasia (TOPNOTCH)Robbins Basic Pathology,8th ed., p816
2674
Primary malignant small round-cell tumor of bone and soft tissue, characterized by Sheets of small round cells with scant, cleared cytoplasm, circled about a central fibrillary space or "Homer-Wright rosettes".
Ewing sarcoma (TOPNOTCH)Robbins Basic Pathology,8th ed., p817
2675
A relatively uncommon benign tumor usually arising in individuals in their 20s to 40s. These are large and red-brown lesions with frequent cystic degeneration, composed of uniform oval mononuclear cells with frequent mitoses, with scattered osteoclast-type giant cells containing 100 or more nuclei.
Giant-cell tumors (GCTs)/Osteoclastoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p.1204
2676
These are the most common malignant tumor of bone.
Metastatic tumors (TOPNOTCH)Robbins Basic Pathology,8th ed., p818
2677
Pathways of metastasis to the bone.
1) direct extension, (2) lymphatic or hematogenous dissemination, (3) intraspinal seeding(TOPNOTCH)Robbins Basic Pathology,8th ed., p818
2678
Characterized by fibrillation and cracking of the articular cartilage matrix, bone eburnation, and bony outgrowths/spurs (osteophytes). Full-thickness portions of the cartilage are lost, and the subchondral bone plate is exposed.
Osteoarthritis (TOPNOTCH)Robbins Basic Pathology,8th ed., p819
2679
Characterized by a dense neutrophilic infiltrate permeating the synovium and synovial fluid. Long, slender, needle-shaped monosodium urate crystals are frequently found in the cytoplasm of the neutrophils as well as in small clusters in the synovium.
Acute gouty arthritis(TOPNOTCH)Robbins Basic Pathology,8th ed., p821
2680
Results from repetitive precipitation of urate crystals during acute attacks. The synovium becomes hyperplastic, fibrotic, and thickened by inflammatory cells, forming a pannus that destroys the underlying cartilage.
Chronic tophaceous arthritis (TOPNOTCH)Robbins Basic Pathology,8th ed., p821
2681
Formed by large aggregations of urate crystals surrounded by an intense inflammatory reaction of lymphocytes, macrophages, and foreign-body giant cells, attempting to engulf the masses of crystals. Pathognomonic feature of gout.
Tophi (TOPNOTCH)Robbins Basic Pathology,8th ed., p821
2682
Refers to multiple different renal complications associated with urate deposition, variously forming medullary tophi, intratubular precipitations, or free uric acid crystals and renal calculi.
Gouty nephropathy(TOPNOTCH)Robbins Basic Pathology,8th ed., p821
2683
Also known as chondrocalcinosis or-more formally-calcium pyrophosphate crystal deposition disease. The crystals are weakly birefringent, rhomboid in shape with blunted ends.
Pseudogout (TOPNOTCH)Robbins Basic Pathology,8th ed., p823
2684
Main causative agent of suppurative arthritis in late adolescence and young adulthood.
Neisseria gonorrhea(TOPNOTCH)Robbins Basic Pathology,8th ed., p824
2685
Individuals with sickle cell disease are prone to developing osteomyelitis and suppurative arthritis caused by this agent.
Salmonella(TOPNOTCH)Robbins Basic Pathology,8th ed., p824
2686
Arthritis caused by infection with the spirochete Borrelia burgdorferi, transmitted by deer ticks of the Ixodes ricinus complex.
Lyme arthritis (TOPNOTCH)Robbins Basic Pathology,8th ed., p824
2687
A small (
Ganglion cyst(TOPNOTCH)Robbins Basic Pathology,8th ed., p825
2688
The most severe and the most common form of muscular dystrophy. Characterized by marked variation in muscle fiber size, caused by concomitant myofiber hypertrophy and atrophy. The definitive diagnosis is based on the demonstration of abnormal staining for "dystrophin" in immunohistochemical preparations.
Duchenne muscular dystrophy (DMD) (TOPNOTCH)Robbins Basic Pathology,8th ed., p825
2689
This can present as either acute or chronic proximal muscle weakness, and can precede the onset of other signs of thyroid dysfunction. Findings include myofiber necrosis, regeneration, and interstitial lymphocytes.
Thyrotoxic myopathy (TOPNOTCH)Robbins Basic Pathology,8th ed., p830
2690
This can occur with binge drinking, where there is an acute toxic rhabdomyolysis with accompanying myoglobinuria that can cause renal failure. On histology, there is myocyte swelling and necrosis, myophagocytosis, and regeneration.
Ethanol myopathy (TOPNOTCH)Robbins Basic Pathology,8th ed., p830
2691
An autoimmune disorder of the neuromuscular junction characterized by muscle weakness which first manifests in the extraocular muscles. Caused by circulating antibodies to the skeletal muscle acetylcholine receptors (AChRs).
Myasthenia gravis (TOPNOTCH)Robbins Basic Pathology,8th ed., p830
2692
This syndrome characteristically develops as a paraneoplastic process most commonly in the setting of small-cell lung carcinoma. Presents with muscle weakness secondary to decreased vesicle release in response to presynaptic action potential.
Lambert-Eaton Myasthenic Syndrome (TOPNOTCH)Robbins Basic Pathology,8th ed., p830
2693
Soft tissue tumor which presents as soft, gelatinous, grapelike masses on the surfaces of the bladder or vagina.
Sarcoma botryoides(TOPNOTCH)Robbins Basic Pathology,8th ed., p830
2694
It is the most common soft tissue sarcoma of childhood and adolescence, usually appearing before age 20.
Rhabdomyosarcoma (TOPNOTCH)Robbins Basic Pathology,8th ed., p831
2695
Diagnostic cell in rhabdomyosarcoma, characterized as round or elongated cells that may contain cross-striations visible by light microscopy.
Tadpole or strap cells(TOPNOTCH)Robbins Basic Pathology,8th ed., p831
2696
Soft, yellow, well-encapsulated masses of mature adipocytes; they can vary considerably in size. Histologically, they consist of mature white fat cells with no pleomorphism
Lipoma (TOPNOTCH)Robbins Basic Pathology,8th ed., p832
2697
Malignant neoplasms of adipocytes, which usually present as relatively well-circumscribed lesions. Diagnostic feature are lipoblasta, similar to fetal fat cells, with cytoplasmic lipid vacuoles that scallop the nucleus.
Liposarcomas (TOPNOTCH)Robbins Basic Pathology,8th ed., p833
2698
A self-limited, reactive fibroblastic proliferation that typically occurs in adults on the volar aspect of the forearm. Consists of plump, randomly arranged, immature-appearing fibroblasts in an abundant myxoid stroma. Not a true tumor.
Nodular Fasciitis(TOPNOTCH)Robbins Basic Pathology,8th ed., p833
2699
This develops in the proximal muscles of the extremities in athletic adolescents and young adults after trauma. Distinguished from other fibroblastic proliferations by the presence of metaplastic bone. Excision is curative.
Myositis Ossificans (TOPNOTCH)Robbins Basic Pathology,8th ed., p833
2700
Malignant neoplasms composed of fibroblasts. These are soft unencapsulated, infiltrative masses frequently with areas of hemorrhage and necrosis. Malignant spindle cells are arranged in a "herringbone pattern".
Fibrosarcoma (TOPNOTCH)Robbins Basic Pathology,8th ed., p834
2701
These are relatively common benign lesions in adults presenting as circumscribed, small (
Benign Fibrous Histiocytoma (Dermatofibroma) (TOPNOTCH)Robbins Basic Pathology,8th ed., p834
2702
A variety of soft tissue sarcomas Characterized by considerable cytologic pleomorphism, the presence of bizarre multinucleate cells, and "storiform" architecture .
Malignant fibrous histiocytoma (MFH) (TOPNOTCH)Robbins Basic Pathology,8th ed., p834
2703
Benign smooth muscle tumors described as well-circumscribed neoplasms that can arise from smooth muscle cells anywhere in the body, but are encountered most commonly in the uterus.
Leiomyoma (TOPNOTCH)Robbins Basic Pathology,8th ed., p835
2704
These commonly present as firm, painless masses of the skin, deep soft tissues of the extermities and retroperitoneum. Histologically, they show spindle cells with cigar-shaped nuclei arranged in interweaving fascicles.
Leiomyosarcoma (TOPNOTCH)Robbins Basic Pathology,8th ed., p835
2705
What is the mineral that gives bone strength and hardness and is the storehouse for 99% of the body's calcium, 85% of the body's phosphorous, and 65% of the body's sodium and magnesium?
Calcium Hydroxyapatite (TOPNOTCH)
2706
Of all the proteins in the bone matrix, which one is unique to the bone?
Osteocalcin (TOPNOTCH)
2707
Identify the bone cell: responsible for bone resorption
Osteoclast (TOPNOTCH)
2708
Identify the bone cell: most numerous than any other bone forming cell
Osteocytes (TOPNOTCH)
2709
Identify the bone cell: initiate the process of mineralization and express cell surface receptors that bind many hormones
Osteoblasts (TOPNOTCH)
2710
What is the functional unit of bone?
Osteoblast and Osteoclast act in coordination and are considered the functional unit of bone known as the Basic Multicellular Unit (TOPNOTCH)
2711
In what part of the bone can you see the histological abnormalities seen in achondroplasia?
Growth plate (TOPNOTCH)
2712
Gross appearance: lack a medullary canal and the end of long bones are bulbous (Erlenmeyer Flask Deformity) and misshapen. The neural foramina are small and compress exiting nerves
Osteopetrosis (TOPNOTCH)
2713
What is the main defect in Osteopetrosis?
Deficient Osteoblastic Activity (TOPNOTCH)
2714
Osteoporosis cannot be reliably detected in plain radiographs until how much of the bone mass is lost?
30-40% (TOPNOTCH)
2715
What is the histologic hallmark of Paget Disease of the bone?
Mosaic pattern of lamellar bone (Jigsaw pattern) (TOPNOTCH)
2716
A variety of tumor and tumor like conditions develop in pagetic bone. However, what is the most dreaded complication of this condition?
Sarcoma (Osteosarcoma > Malignant Fibrous Histiocytoma, or chondrosarcoma) (TOPNOTCH)
2717
80% of cases, what bone is involved in Paget DIsease?
Axial skeleton and proximal femur (TOPNOTCH)
2718
What is the most common site of tuberculous osteomyelitis?
Spine (thoracic and lumbar) > knees and hips (TOPNOTCH)
2719
Most cases of osteomyelitis reach the bone via what route?
Hematogenous (TOPNOTCH)
2720
What do you call a small intraosseous abscess that frequently involves the cortex and is walled off by reactive bone?
Brodie abscess (TOPNOTCH)
2721
What do you call the morphologic variant of osteomyelitis that typically develops in the jaw and is associated with extensive new bone formation that obscures much of the underlying osseous structures?
Sclerosing osteomyelitis of Garre (TOPNOTCH)
2722
What do you call a dead piece of bone?
Sequestrum (TOPNOTCH)
2723
Reactive woven or lamellar bone may be deposited and when it forms a sleeve of living tissue around a segment of devitalized bone, it is known as?
Involucrum (TOPNOTCH)
2724
Morphology: Edematous granulation tissue containing numerous plasma cells and necrotic bone
Congenital Syphilitic Bone infection and Acquired syphillis (TOPNOTCH)
2725
What is the most common primary malignant tumor of bone, exclusive of myeloma and lymphoma, and accounts for approximately 20% of primary bone cancers.
Osteosarcoma (TOPNOTCH)
2726
What are the 3 conditions associated with the development of osteosarcoma?
1. Paget disease2. Bone infarcts3. Prior irradiation (TOPNOTCH)
2727
What part of the bone do osteosarcomas usually arise?
Metaphyseal region of the long bone of the extremities, 60% occur about the knee. (TOPNOTCH)
2728
Morphology: Coarse, lacelike pattern of neoplastic bone produced by anaplastic malignant tumor cells
Osteosarcoma (TOPNOTCH)
2729
Morphology: sheets of uniform small, round cells that are slightly larger than lymphocytes with small amounts of clear cytoplasm.
Ewing Sarcoma (TOPNOTCH)
2730
Morphology: Presence of Homer Write rosettes ( tumor cells are arranged in a circle about a central fibrillary space)
Ewing Sarcoma (TOPNOTCH)
2731
The diagnostic cell of embryonal, alveolar, and pleomorphic variants of Rhabdomyosarcoma which contains eccentric eosinophilic granular cytoplasm rich in thick and thin filaments
Rhabdomyoblast (TOPNOTCH)
2732
Tadpole or strap cells are seen in what soft tissue tumor?
Rhabdomyosarcoma (TOPNOTCH)
2733
Morphology: characterized by malignant spindle cells that have cigar shaped nuclei arranged in interweaving fascicles.
Leiomyosarcoma (TOPNOTCH)
2734
Morphology: histological hallmark is the dual line of differentiation of tumor cells, epithelial like cells and spindle cells
Synovial Sarcoma (TOPNOTCH)
2735
Gross morphology: unencapsulated, infiltrative, soft, fish flesh masses, often having areas of hemorrhage and necrosis
Fibrosarcoma (TOPNOTCH)
2736
These cells mimic fetal fat cells and contain round clear cytoplasmic vacuoles of lipid that scallop the nucleus. Seen in liposarcoma.
Lipoblasts (TOPNOTCH)
2737
Most common soft tissue tumor of adulthood.
Lipoma (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1220
2738
Pathognomonic hallmark of gout
Tophi (TOPNOTCH)
2739
What are the most common cutaneous lesions seen in RA?
Rheumatoid Nodules (TOPNOTCH)
2740
The most important factors in the development of Osteoarthritis
Aging and mechanical effects (TOPNOTCH)
2741
Bone eburnation and joint mice are seen in what disease entity?
Osteoarthritis (TOPNOTCH)
2742
The most common cancers that metastasize to the bone are?
Prostate, breast, kidney, and lung (TOPNOTCH)
2743
What bones are most commonly involved in skeletal metastasis?
In descending order: Axial skeleton ( vertebral column, pelvis, ribs, skull, and sternum), proximal femur, and humerus (TOPNOTCH)
2744
Skeletal metastases are typically multifocal, however, what carcinomas that metastasize to the bone are notorious for producing solitary lesions?
Ca of Kidney and Thyroid (TOPNOTCH)
2745
Morphology: uniform oval mononuclear cells that have indistinct cell membranes and appear to grow in syncitium with scattered numerous osteoclast type giants cells having 100 or more nuclei that have identical features to those of the mononuclear cells
Giant cell Tumor (TOPNOTCH)
2746
Morphology: trabeculae mimic chinese characters
Fibrous Dysplasia (TOPNOTCH)
2747
Morphology: Storiform pattern or pinwheel pattern created by benign spindle cells with scattered osteoclast
Fibrous cortical defect and nonossifying fibroma (TOPNOTCH)
2748
What is the primary characteristic of osteosarcoma?
The formation of bone by the tumor cells (TOPNOTCH)
2749
Seen in Xray as subperiosteal resorption producing thinned cortices in the middle phalanges of the index and middle finger and loss of the lamina dura around the teeth (TOPNOTCH)
Hyperparathyroidism (Generalized osteitis fibrosa cystica or von Recklinghausen disease of the bone) (TOPNOTCH)
2750
The combined picture of increased bone cell activity, peritrabecular fibrosis, and cystic brown tumors is the hallmark of what disease of abnormal mineral homeostasis?
Hyperparathyroidism (Generalized osteitis fibrosa cystica or von Recklinghausen disease of the bone) (TOPNOTCH)
2751
What is the most important prognostic feature of a bone sarcoma?
Histological grade (TOPNOTCH)
2752
O ring sign is seen in what cartilage forming tumor?
Chondroma (TOPNOTCH)
2753
Morphology: chicken wire pattern of mineralizaton
Chondroblastoma (TOPNOTCH)
2754
Myositis ossificans is distinguised from the other fibroblastic proliferations by the presence of what structure?
Metaplastic bone (TOPNOTCH)
2755
Most common cause of skeletal dysplasia and a major cause of dwarfism
Achondroplasia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1184
2756
Most common inherited disorder of connective tissue
Osteogenesis Imperfecta(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1185
2757
Hyaline cartilage is composed of what type of collagen?
Type II collagen(TOPNOTCH)
2758
Most common type of joint disease
Osteoarthritis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1208
2759
Presents with deep, achy joint pain that worsens with use, morning stiffness, crepitus, and limitation of ROM, osteophytes(bony outgrowths), sparing of wrists, elbow, and shoulder.
Osteoarthritis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1209
2760
Radiographic hallmark of this joint disease are joint effusions and juxta-articular osteopenia with erosion and narrowing of joint space and loss of articular cartilage.
Rheumatoid arthritis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1212
2761
Presents with malaise, fatigue, and generalized musculoskeletal pain. After several weeks, may present with symmetric joint pain affecting metacarpophalangeal, PIP, wrists, ankles and knees. The lumbosacral region and hips are spared. Involved joints are swollen, warm, painful, stiif when rising in the morning or following inactivity. What is the most likely diagnosis?
Rheumatoid arthritis(TOPNOTCH)
2762
It causes destruction of articular cartilage and bony ankylosis, especially of the sacroiliac and apophyseal joints. May present with lower back pain and spine immobility.
It causes destruction of articular cartilage and bony ankylosis, especially of the sacroiliac and apophyseal joints. May present with lower back pain and spine immobility.
2763
Also known as rheumatoid spondylitis and Marie-Strumpell disease
Ankylosis spondylitis(TOPNOTCH)Robbins Basic Pathology, 9th ed. P. 1213
2764
Triad of arthritis, non-gonococcal urethritis or cerviciis, and conjunctivitis
Reactive arthritis(TOPNOTCH)Robbins Basic Pathology, 9th ed. P. 1213
2765
Presents with asymmetric pain and stiffness of the ankle and knee joints several weeks of the inciting bout of urethritis or diarrhea. May present with sausage-finger or toe, calcaneal spurs and bony outgrowths.
Reactive arthritis(TOPNOTCH)Robbins Basic Pathology, 9th ed. P. 1213
2766
Chronic inflammatory arthropathy concurrently or following the onset of skin disease. Produc the characteristic "pencil in cup" deformity , due to involvement of DIP of the hands and feet in an assymetric distribution.
Psoriatic arthritis(TOPNOTCH)Robbins Basic Pathology, 9th ed. P. 1213
2767
Main causative agent of infectious arthritis in children younger than 2 years old.
H. influenza(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1213
2768
Main causative agent of infectious arthritis in older children and adults.
S. aureus(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1213
2769
Main causative agent of infectious arthritis in patients with sickle cell disease.
Salmonella(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1213
2770
Most common joint affected in nongonoccocal suppurative arthritis.
Knee(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1213
2771
Presents with sudden development of acutely painful and swollen joint with decreased ROM, associated with fever, leukocytosis, and elevated ESR. Usually involves only a single joint.
Suppurative arthritis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1213
2772
Most common joints affected in mycobacterial arthritis
In descending order: Hips, knees, and ankles.(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1215
2773
Genetic disorder resulting from complete absence of HGPRT, produced by mutation in the HPRT gene causing hyeruricemia.
Lesch-Nyhan syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1215
2774
Presents with joint pain associated with localized hyperemia, warmth, usually in the first metatasophalangeal joint. Associated with excessive alcohol intake. Radiographs of chronic condition show characteristic juxta-articular erosion and loss of joint space.
Gouty arthritis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1216
2775
Cytokine that is mainly implicated in the pathogenesis of RA.
TNF(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1217
2776
The fundamental abnormality in this disorder is too little bone resulting in extreme skeletal fragility. Other findings include blue sclerae, hearing loss, and dental imperfections.
Ostegenesis Impefecta(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1185
2777
Also known as marble bone disease and Albers-Schonberg disease
Osteopetrosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1186
2778
Morphology: Erlenmeyer flask deformity (end of long bones are bulbous), bones lack a medullary canal, neural foramina are small, primary spongiosa persists, deposited bone is not remodeled and tends to be woven.
Osteopetrosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1186
2779
First genetic disease treated with hematopoietic stem cell transplantation.
Osteopetrosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1187
2780
Effect of decreased estrogen level after menopause
Increase bone resorption (and formation)(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1189
2781
Hallmark of osteoporosis
Histologically normal bone that is decreased in quantity(TOPNOTCH)Robbins Basic Pathology, 9th ed, p 1189
2782
Presents with pain due to microfracture or bone overgrowth, and enlargement of craniofacial skeleton pproducing leontiasis ossea, inability to hold the head erect. May also cause chalk-stick type fractures and arteriovenous shunt. Xray: enlarged, coarsened cortices and cancelous bone.
Paget Disease (Osteitis Deformans) (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1191
2783
Most dreaded complication of Paget disease
Sarcoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 11911
2784
The fundamental defect in these disorders is an impairment of mineralization and a resultant accumulation of unmineralized matrix due to vitamin D deficiency or its abnormal metabolism.
Rickets(children) and Osteomalacia(adult)(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1191
2785
Most common cause of osteomyelitis.
S. aureus(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1195
2786
Most common cause of osteomyelitis in individuals with sickle cell disease.
Salmonella(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1195
2787
Characteristic radiographic findings of a lytic focus of bone destrucrion surrounded by a zone of sclerosis
Osteomyelitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1196
2788
Presents with painful, progressively enlarging masses usually in the metaphyseal region of the extremities; sudden fracture; Xray: large destructive, mixed lytic and blastic mass with infiltrative margins, Codman triangle
Osteosarcoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1198
2789
The most common benign bone tumor
Osteochondroma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1200
2790
A 17 year old presents with a painfull swelling of the right knee. Radiographs show a lytic and blastic mass in the distal femur, with lifting of the surrounding periosteum. Which of the following is consistent with the diagnosis of osteosarcoma? (A) malignant mesenchymal cells in a chondromyxoid stroma (B) round, blue cells in sheets, with scant clear cytoplasm (C) multinucleated giant cells and a background of mononuclear cells (D) malignant mesenchymal cells with osteoid formation
malignant mesenchymal cells with osteoid formation (TOPNOTCH)Robbins Basic Pathology,8th ed., p 813
2791
A 42 year old male has repeated bouts of inflammation of his big toe, associated with drinking alcohol and cold weather. There is a knobby, nodular swelling around the involved joint. There are similar nodules in some of his fingertips and on his earlobe. If one of these nodules is biopsied, it would likely show (A) curved trabeculae of woven bone and surrounding fibrous tissue (B) marked proliferation of the synovium with underlying dense lymphoplasmacytic infiltrate (C) aggregate of amorphous material surrounded by reactive fibroblasts, lymphocytes, macrophages, and foreign-body giant cells (D) granulomas with epithelioid macrophages, giant cells with nuclei in a horeshoe configuration, and central necrosis
aggregate of amorphous material surrounded by reactive fibroblasts, lymphocytes, macrophages, and foreign-body giant cells (TOPNOTCH)Robbins Basic Pathology,8th ed., p 820-821
2792
A 7 year old female is observed to have a fleshy, grape-like mass protruding from her vagina. A biopsy showed large round cells with abundant granular eosinophilic cytoplasm. Some of the cells are elongated. The tumor (A) is commonly associated with chromosomal translocations (B) common in childhood and adolescence (C) may be positive for desmin and muscle-specific actin (D) all of the above
all of the above (TOPNOTCH)Robbins Basic Pathology,8th ed., p831
2793
This term is the accumulation of edema fluid within the epidermis. Characterizes all forms of eczamatous dermatitis.
Spongiosis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 839
2794
An uncommon, usually self-limited disorder that seems to be a hypersensitivity response to certain infections and drugs. Patients present with an array of "multiform" lesions, including macules, papules, vesicles, and bullae, as well as the characteristic targetoid lesion consisting of a red macule or papule with a pale vesicular or eroded center.
Erythema Multiforme (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 840
2795
In this skin disorder, there is marked epidermal thickening (acanthosis), and loss of the stratum granulosum with extensive overlying parakeratotic scale. The most typical lesion is a well-demarcated, pink to salmon-colored plaque covered by loosely adherent silver-white scale.
Psoriasis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 841
2796
This sign is described as bleeding upon removal of scales from the lesions of psoriasis.
Auspitz sign(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 841
2797
Small aggregates of neutrophils within the parakeratotic stratum corneum in psoriasis.
Munro microabscesses(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 841
2798
Small aggregates of neutrophils within the spongiotic superficial epidermis in psoriasis.
Pustules of Kogoj(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 841
2799
Layer of the skin which is affected in psoriasis.
S. granulosum(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 841
2800
"Pruritic, purple, polygonal, planar papules, and plaques" describes this disorder of the skin and mucosa. The pattern of inflammation of this disorder is characterized by angulated, zigzag contour ("sawtoothing") of the dermoepidermal junction.
Lichen Planus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 841
2801
Anucleate, necrotic basal cells seen in the inflamed papillary dermis of patients with lichen planus are called?
Colloid bodies or Civatte bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 841
2802
Presents as roughening of the skin that takes on an appearance reminiscent of "lichen on a tree". It is a response to local repetitive trauma such as continual rubbing or scratching.
Lichen Simplex Chronicus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 842
2803
Common lesions of children and adolescents, caused by human papillomavirus (HPV). Histologic features include epidermal hyperplasia that is often undulant in character, and cytoplasmic vacuolization (koilocytosis).
Verrucae (warts)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 843
2804
The most common type of wart. Occurs anywhere but are found most frequently on the hands, particularly on the dorsal surfaces and periungual areas, where they appear as gray-white to tan, flat to convex, 0.1- to 1-cm papules with a rough, pebble-like surface.
Verruca vulgaris(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 844
2805
These warts are common on the face or dorsal surfaces of the hands. These warts are flat, smooth, tan macules.
Verruca plana/flat wart(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 844
2806
These warts occur on the soles and palms. Described as rough, scaly lesions that may reach 1 to 2 cm in diameter, coalesce, and be confused with ordinary calluses.
Verruca plantaris and verruca palmaris(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 844
2807
These warts occurs on the penis, female genitalia, urethra, and perianal areas.
Condyloma acuminatum (venereal wart) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 844
2808
A rare autoimmune blistering disorder resulting from loss of integrity of normal intercellular attachments within the epidermis and mucosal epithelium. Caused by a type II hypersensitivity reaction
Pemphigus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 845
2809
Common histologic denominator in all forms of pemphigus, described as the lysis of the intercellular adhesion sites.
Acantholysis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 845
2810
In this variant of pemphigus, acantholysis selectively involves the layer of cells immediately above the basal cell layer, giving rise to a suprabasal acantholytic blister. There is uniform deposition of immunoglobulin and complement along the cell membranes of keratinocytes, producing a characteristic "fishnet" appearance.
Pemphigus vulgaris(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 845
2811
In this variant of pemphigus, acantholysis selectively involves the superficial epidermis at the level of the stratum granulosum.
Pemphigus foliaceus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 845
2812
An autoimmune disease in which the characteristic finding is linear deposition of IgG antibodies and complement in the basement membrane zone. Characterized by a subepidermal, nonacantholytic full-thickness epidermal fluid-filled blister.
Bullous pemphigoid (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 846
2813
A rare disorder characterized by urticaria and grouped vesicles. Fibrin and neutrophils accumulate selectively at the tips of dermal papillae, forming small microabscesses, which coalesce to form a subepidermal blister. On immunofluorescence, granular deposits of IgA are localized at the tips of dermal papillae.
Dermatitis herpetiformis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 846
2814
These common epidermal tumors occur most frequently in middle-aged or older individuals. The lesions consist of an orderly proliferation of uniform, benign basaloid keratinocytes with a tendency to form keratin microcysts (horn cysts), which has a "stuck-on" appearance on the skin.
Seborrheic keratosis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 849
2815
These are rare tumors that primarily occur in the head and neck region of older individuals. They usually present as flesh-colored papules and can be a marker for an internal malignancy.
Sebaceous Adenoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 849
2816
These lesion is usually the result of chronic exposure to sunlight and is associated with hyperkeratosis. The dermis contains thickened, blue-gray elastic fibers or "solar elastosis" which is the result of chronic sun damage.
Actinic keratoses(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 850
2817
Acronym for remembering the histologic features of actinic keratoses.
"Sunny" SPAINS S - solar elastoses (dermal sun damage)P - parakeratosisA - atypia (keratinocytic)I - inflammationN - not full thickness atypia(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 850
2818
A common tumor arising on sun-exposed sites in older people, with higher incidence in women. Arise from prior actinic keratoses. Characterized by highly anaplastic, rounded cells with foci of necrosis and only abortive, single-cell keratinization (dyskeratosis).
Squamous cell carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 851
2819
This is the most common human cancer, which is a slow-growing tumor that rarely metastasizes. Tends to occur at sites subject to chronic sun exposure and in lightly pigmented people. h
Basal cell carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 852
2820
These tumors present as pearly, smooth-surfaced papules, often containing prominent, dilated subepidermal blood vessels (telangiectasia). The cells have scant cytoplasm, small hyperchromatic nuclei, and a peripheral palisade with clefting from the stroma.
Basal cell carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 852
2821
This refers to any benign congenital or acquired neoplasm of melanocytes.
Melanocytic nevus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 853
2822
These are large nevi and may occur as hundreds of lesions on the body surface. They are flat macules to slightly raised plaques, with a "pebbly" surface. Considered as a marker of melanoma risk.
Dysplastic nevi(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 854
2823
This cancer of the skin may develop from a dysplastic nevus, and results from excessive sun exposure. Malignant cells have large nuclei with irregular contours having chromatin characteristically clumped at the periphery of the nuclear membrane and prominent eosinophilic nucleoli often described as "cherry red". Has both radial and vertical growth phases.
Melanoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 855
2824
This determines the biologic behavior of melanomas.
Nature and extent of the vertical growth phase (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 857
2825
What is the most common type of all autoimmune blistering disordering of the skin (pemphigus)?
Pemphigus Vulgaris(TOPNOTCH)
2826
Histologically, what is the most common denominator in all forms of pemphigus?
Acantholysis (TOPNOTCH)
2827
Morphology: Subepidermal nonacantholytic blisters
Bullous Pemphigoid (TOPNOTCH)
2828
Morphology: Suprabasal acantholytic blister
Pemphigus Vulgaris (TOPNOTCH)
2829
Morphology: Characteristically, fibrin and neutrophils accumulate selectively at the tips of the dermal papillae forming small microabscesses
Dermatitis Herpetiformis (Seen in Celiac Disease) (TOPNOTCH)
2830
Morphology: accumulation of neutrophils beneath the stratum corneum
Impetigo (TOPNOTCH)
2831
Munro microabscesses is classically seen in?
Psoriasis (TOPNOTCH)
2832
Auspitz sign is associated with what condition?
Psoriasis (TOPNOTCH)
2833
Pearly papules often containing prominent, dilated subepidermal blood vessels (telangiectasias)
Basal Cell Carcinoma (TOPNOTCH)
2834
What is the most commonly accepted exogenous cause of squamous cel carcinoma of the skin?
Exposure to UV light (TOPNOTCH)
2835
Cutaneous horns are seen in what condition?
Actinic Keratosis (TOPNOTCH)
2836
Morphology: characterized by loss of melanocytes
Albinism (TOPNOTCH)
2837
In albinism, melanocytes are present but melanin pigment is not produced due to what enzyme deficiency or defect?
Tyrosinase (TOPNOTCH)
2838
Q: + for melanocyte-associated proteins such as tyrosinase or Melan-A or S
Vitiligo (TOPNOTCH)
2839
The early developmental stage in melanocytic nevi is called?
Junctional nevi (TOPNOTCH)
2840
Most junctional nevi grow into the underlying dermis as nests or cords of cells and are calle
Compound nevi (TOPNOTCH)
2841
When all the epidermal nests of compound nevi are lost entirely they form what
intradermal nevi (TOPNOTCH)
2842
Appears to play an important role in the development of skin malignant melanoma
Sunlight (TOPNOTCH)
2843
What are the 5 clinical warning signs of melanoma?
1. enlargement of a pre-existing mle2. itching or pain in pre-existing mole3. development of a new pigment lesion during adult life4. irregularity of the borders of a pigment lesion5. variegation of color within a pigmented lesion (TOPNOTCH)
2844
Appears clinically as flesh-colored, dome shaped nodules with central, keratin filled plug, imparting a crater like topography
Keratoacanthoma (TOPNOTCH)
2845
Morphology: Central, keratin filled crater surrounded by proliferating epitheal cells that extend upward in a lip-like fashion over the sides of the crater and downward into the dermis as irregular tongues
keratoacanthoma (TOPNOTCH)
2846
The most important clinical sign of malignant melanoma
change in color, size, or shape in a pigmented lesion (TOPNOTCH)
2847
In Malignant Melanoma, what type of growth indicated the tendency of a melanoma to grow horizontally within the epidermal and superficial dermal layers, often for a prolonged period of time?
Radial growth (TOPNOTCH)
2848
In Malignant Melanoma, what are the determinants of a more favorable prognosis?
1. Tumor depth of less than 1.7 mm2. Absence or low numbers of mitoses3. Presence of a brisk TIL response (Tumor Infiltrating Leukocytes)4. Absence of regression 5. Female gender6. Location on extremity skin (TOPNOTCH)
2849
A 20 y/o male, previously known case of peanut allergy inadvertently took biscuits containing peanuts. Within a short time, he developed pink wheals on his extremities and trunk that are pruritic. Histologic findings in his lesion will include:
Sparse superficial perivenular infiltrate of mononuclear cells and eosinophils. (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th ed., p. 1162
2850
Most important cause of cutaneous squamous cell carcoma
DNA damage induced by UV light exposure(TOPNOTCH)Robbins Basic Pathology 9th ed., 122
2851
Usually present as pearly papules contaning prominent dilated subepidermal blood vessles(telangiectasia), which may ulcerate and locally invade bone or facial sinuses; cells at the periphery of tumor cell islands tend to be arranged radially with long axes in parallel alignment(palisading)
Basal cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1157
2852
Actinic keratosis may lead to what type of skin cancer?
Cutaneous squamous cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1157
2853
Histologic hallmark of Cutaneous T-cell Lymphoma
Presence of Sezary-Lutzner cells(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1160
2854
Presents with small, pruritic papules to large edematous plaques, which may coalesce to form annular, linear, or arcform configurations. There is usually superficial perivenular infiltrate consisting of mononuclear cells, rare neutrophils, and eosinophils
Urticaria(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1162
2855
Febrile form of erythema multiforme associated with extensive involvement of skin, lips and oral mucosa, conjunctiva, urethra, and genital and perianal areas, often seen in children.
Steven-Johnson syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1164
2856
It is characterized by kertinocyte injury mediated by skin-homing CD8+ band cytotoxic T lymphocytes; presenting with diverse array of lesions.
Erythema Multiforme (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1164
2857
Process by which local trauma induce psoriatic lesions in susceptible individuals
Koebner phenomenon(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1165
2858
Presents with macules and papules on an erythematous-yellow, often greasy base, in association with extensive scaling and crusting. Histologically, mounds of parakeratosis containing neutrophils and serum are present at the ostia of hair follicles(Follicular lipping)
Seborrheic dermatitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1166
2859
Group of disorders caused by inherited defects in structural proteins that lend mechanical stability to the skin; common feature is a proclivity to form blisters at sites of pressure, rubbing, or trauma, at or soon after birth
Epidermolysis bullosa(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1171
2860
Presents with urticaria and vesicles associated with scarring that are exacerbated by exposure to sunlight. The vesicles are subepidermal in location and dermis contains vessels with walls that are thickened by glassy deposits of serum proteins.
Porphyria(TOPNOTCH)Robbins Basic Pathology, 9th ed., p 1172
2861
Presents with stages of flushing, then persistent erythema and telangiectasia, followed by pustules and papules, and lastly by permanent thickening of the nasal skin by confluent erythematous papules and prominent follicles(rhinophyma)
Rosacea(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1174
2862
Presents with multiple lesions on the skin and mucus membranes, with predilection for the trunk and anogenital areas. Lesions are firm, often pruritic, pink to skin-colored umbilicated papules, with curd-like material which can be expressed from the central umbilication
Molluscum contagiosum(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1176
2863
The pathogenesis of blister formation in this condition is related to bacterial production of a toxin that cleaves desmoglein 1, the protein responsible for cell-to-cell adhesion within the uppermost epidermal layers.
Impetigo(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1177
2864
Presents as an erythematous macule and multiple pustules. As pustules break, shallow erosions from, covered with drying serum, giving the characteristic honey-colored crust
Impetigo(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1177
2865
It has the characteristic microscopic feature of accumulation of neutrophils beneath the stratum corneum often producing a subcorneal pustule containing serum proteins and inflammatory cells.
Impetigo(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1177
2866
A 25 year old male presents with well-demarcated pink plaques on his elbows, scalp, and knees that have a silvery scale. A biopsy showed acanthosis, elongated rete ridges, loss of stratum granulosum with an overlying parakeratotic scale, thinning of the epidermis overlying the dermal papillae, and neutrophil aggregates in the parakeratotic stratum corneum. The dermatologist removes one of the scales, and a pinpoint bleeding is observed. This phenomenon is due to (A) the acanthosis (B) thinning of the epidermis overlying the dermal papillae (C) neutrophil aggregates (D) elongated rete ridges
thinning of the epidermis overlying the dermal papillae (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 841
2867
A 62 year old woman has a coin-like, dark brown plaque on her chest that appears stuck-on. She has it excised, and histopathology showed an orderly proliferation of basaloid cells, with keratin microcysts. Some of the basaloid cells have melanin. Her lesion (A) is a tumor of malignant melanocytes (B) is common in her age group (C) will exhibit a fishnet appearance if subjected to immunofluorescence (D) is a melanocytic nevus
is common in her age group (seborrheic keratosis) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 845848-849
2868
A 33 year old female has multiple flesh-colored papules on her face, neck, trunk, and limbs. One of the papules is excised, which showed a lobular proliferation of sebocytes, some with vacuolated cytoplasm, others more basaloid in appearance. Her lesions may be a sign of underlying (A) colorectal carcinoma (B) nonHodgkin lymphoma (C) aplastic anemia (D) thalassemia
colorectal carcinoma (sebaceous adenoma and Muir-Torre syndrome) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 849
2869
A 45 year old male has a pearly papule with prominent vessels on his eyelid. He has it excised, and the lesion showed multiple nodules of basaloid cells with scant cytoplasm and peripheral palisading. The nodules appear separated from the stroma. His lesion (A) frequently metastasizes to distant sites (B) is correlated to sun exposure (C) is associated with HPV infection (D) may arise on mucosal surfaces
is correlated with sun exposure (basal cell carcinoma) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 852
2870
This pattern of neuronal cell injury leads to shrunken individual cell bodies and nuclei. They are prominently stained by eosin, leading to the term "red neurons."
Acute hypoxic/ischemic injury(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 860
2871
These are round, faintly basophilic, PAS-positive, concentrically lamellated aggregates of polyglucosans that range between 5 and 50 micrometers, and are located wherever there are astrocytic end processes, especially in the subpial and perivascular zones, seen more frequently with advancing age.
Corpora amylacea (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 861
2872
Cells which produce myelin in the CNS.
Oligodendrocytes (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 861
2873
Cells which line the ventricles, and are located in the region of the obliterated central canal of the spinal cord.
Ependymal cells (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 861
2874
These are responsible for the secretion of CSF. It has a specialized epithelial covering with a fibrovascular stroma that may contain meningothelial cells.
Choroid plexus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 861
2875
These are bone marrow-derived cells that function as the phagocytes of the CNS.
Microglia (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 861
2876
It is the accumulation of excess fluid within the brain parenchyma. The brain is softer than normal and often appears to "overfill" the cranial vault. In generalized edema the gyri are flattened, the intervening sulci are narrowed, and the ventricular cavities are compressed.
Cerebral Edema (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 861
2877
This occurs when the integrity of the normal blood-brain barrier is disrupted. With increased vascular permeability, fluid shifts from the vascular compartment into the intercellular spaces of the brain.
Vasogenic edema (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 861
2878
This is due to an increase in intracellular fluid secondary to neuronal, glial, or endothelial cell membrane injury, as might be encountered in an individual with a generalized hypoxic/ischemic insult or with exposure to some toxins.
Cytotoxic edema(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 861
2879
Refers to the accumulation of CSF leading to dilation of the ventricular system which resulted from an obstacle or disruption of flow seen most commonly at the foramen of Monroe or aqueduct of Sylvius.
Noncommunicating hydrocephalus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 862
2880
Refers to the accumulation of CSF leading to dilation of the ventricular system due to reduced resorption of CSF. All of the ventricular system is enlarged.
Communicating hydrocephalus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 862
2881
This refers to dilation of the ventricular system with a compensatory increase in CSF volume secondary to a loss of brain parenchyma, as may occur after infarcts or with a degenerative disease.
Hydrocephalus ex vacuo (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 862
2882
This ccurs when unilateral or asymmetric expansion of a cerebral hemisphere displaces the cingulate gyrus under the edge of falx. This may be associated with compression of branches of the anterior cerebral artery.
Subfalcine (cingulate) herniation(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 862
2883
This occurs when the medial aspect of the temporal lobe is compressed against the free margin of the tentorium. As the temporal lobe is displaced, the third cranial nerve is compromised, resulting in pupillary dilation and impairment of ocular movements on the side of the lesion ("blown pupil").
Transtentorial (uncinate) herniation (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 862
2884
This refers to displacement of the cerebellar tonsils through the foramen magnum. This pattern of herniation is life-threatening, because it causes brain stem compression and compromises vital respiratory and cardiac centers in the medulla.
Tonsillar herniation (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 862
2885
These linear or flame-shaped lesions usually occur in the midline and paramedian regions, which are hemorrhagic lesions that accompany transtentorial herniation. Presence of these lesion implies poor prognosis.
Duret hemorrhages(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 862
2886
In the setting of this condition, the brain is swollen, with wide gyri and narrowed sulci. The cut surface shows poor demarcation between gray and white matter. Results from generalized reduction of cerebral perfusion, usually below systolic pressures of less than 50mmHg.
Global Cerebral Ischemia (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 863
2887
These are wedge-shaped areas of infarction that occur in those regions of the brain and spinal cord that lie at the most distal fields of arterial perfusion. Usually seen after hypotensive episodes.
Border zone ("watershed") infarcts(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1264
2888
Pattern of necrosis seen in nonhemorrhagic infarcts of the brain.
Liquefaction necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 863
2889
The most frequent cause of subarachnoid hemorrhage. It is a thin-walled outpouching of an artery. At the neck of the aneurysm, the muscular wall and intimal elastic lamina stop short and are absent from the aneurysm sac itself; the sac is made up of thickened hyalinized intima. The adventitia covering the sac is continuous with that of the parent artery
Saccular (berry) aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 866
2890
Patients with this type of intracranial hemorrhage complains of having "the worst headache I've ever had"/ thunderclap headache.
Subarachnoid Hemorrhage (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 866
2891
Most common location for berry/saccular aneurysms.
Anterior communicating artery in the Circle of WIllis (40%)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 867
2892
This is a disease in which amyloidogenic peptides are deposit in the walls of medium- and small-caliber meningeal and cortical vessels, which results in the weakening of the vessel wall and increases the risk of hemorrhage.
Cerebral amyloid angiopathy (CAA) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 863
2893
Hemorrhages associated with cerebral amyloid angiopathy (CAA) due to involvement of the cerebral hemispheres?
Lobar hemorrhages(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 863
2894
A type of vascular malformation which are characterized by of ectatic venous channels.
Venous angiomas (varices) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 868
2895
Most common location for berry aneurysms.
Anterior communicating artery in the Circle of WIllis (40%)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 867
2896
The involved vessels in this condition resemble a tangled network of wormlike vascular channels. Microscopically, they are enlarged blood vessels separated by gliotic tissue, often with evidence of prior hemorrhage.
Arteriovenous malformations (AVM)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 868
2897
A type of vascular malformation which are characterized by microscopic foci of dilated, thin-walled vascular channels separated by relatively normal brain parenchyma and occurring most frequently in the pons.
Capillary telangiectasias(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 868
2898
Minute aneurysms in vessels that are less than 300 micrometers in diameter, associated with chronic hypertension.
Charcot-Bouchard microaneurysms (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 868
2899
This leads to accumulation of arterial blood between the dura and the skull. The expanding hematoma has a smooth inner contour that compresses the brain surface. Clinically, patients may experience a lucid interval between the moment of trauma and development of neurologic symptoms.
Epidural Hematoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 870
2900
This is an inflammatory disorder that involves multiple small to medium-sized parenchymal and subarachnoid vessels and is characterized by chronic inflammation, multinucleated giant cells and destruction of the vessel wall. Affected individuals manifest a diffuse encephalopathic clinical picture, often with cognitive dysfunction; improvement occurs with steroid and immunosuppressive treatment.
Primary angiitis of the CNS (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 868
2901
This describes reversible altered consciousness from head injury in the absence of contusion. The characteristic transient neurologic dysfunction includes loss of consciousness, temporary respiratory arrest, and loss of reflexes.
Concussion(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 869
2902
Injury which may occur from collision of the brain with the skull opposite the site of impact.
Contrecoup injury(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 868
2903
These are wedge shaped lesions of the brain parenchyma which occur secondary to trauma. The broad base of the wedge spans the surface and centered on the point of impact.
Contusions(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 868
2904
Blood vessel involved in epidural hematoma.
Middle meningeal artery(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 870
2905
Blood vessels involved in subdural hemorrhage.
Bridging veins(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 870
2906
This is an extension of CNS tissue through a defect in the vertebral column, most commonly in the lumbosacral region. both The meninges and spinal cord parenchyma are included in the cystlike structure visible just above the buttocks.
Myelomeningocele(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 872
2907
Herniation of the meninges through a defect in the vertebral column.
Meningocoele(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 872
2908
This is a malformation of the anterior end of the neural tube, with absence of the brain and top of skull.
Anencephaly(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 872
2909
This is a diverticulum of malformed CNS tissue extending through a defect in the cranium. It most often involves the occipital region or the posterior fossa.
Encephalocele(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 872
2910
Characterized by an increased number of irregularly formed gyri that result in an irregular bumpy or cobblestone-like surface.
Polymicrogyria(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 872
2911
Characterized by a disruption of the normal midline patterning. In severe forms the brain is not divided into hemispheres or lobes and may be associated with facial midline defects like cyclopia.
Holoprosencephaly (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 872
2912
Consists of a small posterior fossa and a misshapen midline cerebellum with downward extension of vermis through the foramen magnum; hydrocephalus and a lumbar myelomeningocele are typically also present.
Arnold-Chiari malformation Type II(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 872
2913
Consists of low-lying cerebellar tonsils which extend through the foramen magnum at the base of the skull. This can lead to obstruction of CSF flow and compression of the medulla, resulting in symptoms of headache or cranial nerve deficits.
Arnold-Chiari malformation type I(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 872
2914
Cerebral malformation characterized by an enlarged posterior fossa. The cerebellar vermis is absent, and replaced by a large, midline cyst that is lined by ependyma and is contiguous with leptomeninges on its outer surface.
Dandy-Walker malformation (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 872
2915
Spinal cord abnormality characterized by a discontinuous or confluent expansion of the ependyma-lined central canal of the cord.
Hydromyelia(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 873
2916
CSF findings in bacterial meningitis.
Increased pressureabundant neurophilsprotein - elevatedglucose - reduced(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 874
2917
This is an inflammatory process of the leptomeninges and CSF within the subarachnoid space.
Meningitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 874
2918
In acute cases of this condition, an exudate is evident within the leptomeninges over the surface of the brain. On microscopic examination, neutrophils fill the entire subarachnoid space in severely affected areas or may be found predominantly around the leptomeningeal blood vessels.
Acute meningitis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 874
2919
A form of neurosyphilis, resulting from damage to the sensory nerves in the dorsal roots producing impaired joint position sense and resultant ataxia, loss of pain sensation, leading to skin and "Charcot joints". There is loss of both axons and myelin in the dorsal roots, with pallor and atrophy in the dorsal columns of the spinal cord.
Tabes dorsalis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 875
2920
Presents with generalized symptoms of headache, malaise, mental confusion, and vomiting. The subarachnoid space contains a gelatinous or fibrinous exudate, most often at the base of the brain, obliterating the cisterns and encasing cranial nerves. There may be discrete white granules scattered over the leptomeninges. Obliterative endarteritis may be seen.
Tuberculous meningitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 874
2921
CSF findings in tuberculous meningitis.
Moderate pleiocytosis - predominantly monocytesprotein - elevatedglucose - moderately reduced/normal(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 874
2922
Caused by invasion of the brain by Treponema pallidum and manifests as insidious but progressive loss of mental and physical functions with mood alterations (including delusions of grandeur), terminating in severe dementia.
Paretic neurosyphilis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 874
2923
This virus tends to localize in the paraventricular subependymal regions of the brain, which results in a severe hemorrhagic necrotizing ventriculoencephalitis and choroid plexitis.
Cytomegalovirus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 877
2924
These are discrete lesions with central liquefactive necrosis and a surrounding fibrous capsule. On microscopic examination, there is exuberant neovascularization around the necrosis that is responsible for the marked edema and formation of granulation tissue. Outside the fibrous capsule is a zone of reactive gliosis.
Brain Abscesses (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 876
2925
The pathognomonic finding of this disease is a spongiform transformation of the cerebral cortex and deep gray matter structures (caudate, putamen); consists of a multifocal process that results in the uneven formation of small, empty, microscopic vacuoles of varying sizes within the neuropil and sometimes in the perikaryon of neurons.
Creutzfeldt-Jakob Disease (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 880
2926
Viral encephalitis which involves inferior and medial regions of the temporal lobes and the orbital gyri of the frontal lobes. Perivascular inflammatory infiltrates are usually present, and Cowdry type A intranuclear viral inclusion bodies can be found in both neurons and glia.
Herpes Encephalitis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 876
2927
Reactivation of varicella in adults manifests as a painful, vesicular skin eruption in the distribution of one or a few dermatomes.
Shingles / Herpes Zoster(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 876
2928
This lesion caused by JC virus, consist of patches of irregular, ill-defined destruction of the white matter that enlarge. Each lesion is an area of demyelination, in the center of which are scattered lipid-laden macrophages and a reduced number of axons.
Progressive Multifocal Leukoencephalopathy (PML) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 877
2929
These are predominantly benign tumors of adults, usually attached to the dura, and arising from the meningothelial cell of the arachnoid. Histologic patterns include syncitial, fibroblastic, psammomatous, secretory and microcystic.
Meningiomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 885
2930
Five most common primary sites of carcinoma which may metastasize to the brain.
LungBreastSkin (melanoma)KidneyGIT(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 885
2931
These are infiltrative tumors that form gelatinous, gray masses, and may show cysts, focal hemorrhage, and calcification. On microscopic examination, the tumor is composed of sheets of regular cells with spherical nuclei containing finely granular chromatin (similar to normal oligodendrocytes) surrounded by a clear halo of cytoplasm.
Oligodendrogliomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 883
2932
A nonimmune process characterized by loss of myelin involving the center of the pons, most often after rapid correction of hyponatremia.
Central pontine myelinolysis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 889
2933
These are inherited dysmyelinating diseases in which the clinical symptoms derive from either abnormal myelin synthesis or turnover.
Leukodystrophies (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 889
2934
Profound memory disturbances as a result of thiamine deficiency.
Korsakoff syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 890
2935
An autoimmune demyelinating disorder characterized by distinct episodes of neurologic deficits, separated in time, attributable to white matter lesions that are separated in space. Affected areas show multiple, well-circumscribed, slightly depressed, glassy, gray-tan, irregularly shaped lesions, termed "plaques".
Multiple Sclerosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 887
2936
This condition occurs in the setting of thiamine deficiency and chronic alcoholism. Characterized by foci of hemorrhage and necrosis, particularly in the mammillary bodies but also adjacent to the ventricle, especially the third and fourth ventricles.
Wernicke encephalopathy(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 890
2937
Characterized by "flapping" tremor, depressed levels of consciousness, which may lead to coma. Result of decreased hepatic function.
Hepatic encephalopathy (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 891
2938
It is the most common cause of dementia in the elderly, characterized by presence of plaques and neurofibrillary tangles, composed of tau proteins.
Alzheimer's disease(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 893
2939
Mutation in Friedreich ataxia.
GAA trinucleotide repeat (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 895
2940
This is a clinical syndrome characterized by masked facies, stooped posture, slowness of voluntary movement, festinating gait rigidity, and a "pill-rolling" tremor. There are single or multiple, intracytoplasmic, eosinophilic, round to elongated inclusions that often have a dense core surrounded by a pale halo or "Lewy bodies".
Parkinson disease (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 894
2941
It is an inherited autosomal dominant disease characterized clinically by progressive movement disorders and dementia, with degeneration of the striatum (caudate and putamen).
Huntington Disease (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 894
2942
Mutation in Huntington disease.
CAG trinucleotide repeats(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 895
2943
It is an autosomal recessive progressive illness, generally beginning in the first decade of life with gait ataxia, followed by hand clumsiness and dysarthria.
Friedreich ataxia (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 895
2944
This is the most common form of neurodegeneration affecting the motor system. It is characterized by muscle atrophy and hypereflexia due to loss of both upper and lower motor neurons.
Amyotrophic Lateral Sclerosis (Motor Neuron Disease; Lou Gehrig's Disease) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 895
2945
This is one of the most common life-threatening diseases of the peripheral nervous system. It may develop spontaneously or after a systemic infection (usually viral) or other stress. Usually presents with rapidly progressive, ascending motor weakness that may lead to death from failure of respiratory muscles.
Guillain-Barre Syndrome (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 899
2946
These are benign tumors arising from Schwann cells, which are well-circumscribed encapsulated, firm, gray masses but may also have areas of cystic and xanthomatous change.
Schwannomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 899
2947
Present in the dermis and subcutaneous fat, these well-delineated but unencapsulated masses are composed of spindle cells. The stroma of these tumors is highly collagenized and contains little myxoid material.
Cutaneous neurofibroma.(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 899
2948
These tumors may arise anywhere along a nerve, may be multiple, and is not easily separated from the nerve.
Plexiform neurofibroma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 899
2949
This autosomal dominant disorder is characterized by neurofibromas (plexiform and solitary), gliomas of the optic nerve, pigmented nodules of the iris (Lisch nodules), and cutaneous hyperpigmented macules (cafe au lait spots).
Type 1 Neurofibromatosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 901
2950
This is an autosomal dominant disorder in which patients develop a range of tumors, most commonly bilateral vestibular (acoustic) schwannomas and multiple meningiomas.
Type 2 Neurofibromatosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 901
2951
An autosomal dominant syndrome characterized by the development of hamartomas and benign neoplasms involving the brain and other tissues. The lesions are firm areas of the cortex that, in contrast to the softer adjacent cortex, have been likened to potatoes, hence the appellation "tubers."
Tuberous Sclerosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 901
2952
An autosomal dominant inherited disease in characterized by development of hemangioblastomas within the cerebellar hemispheres, retina, and less commonly the brain stem and spinal cord. A cerebellar capillary hemangioblastoma, is the principal neurologic manifestation of the disease.
von Hippel-Lindau Disease (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 901
2953
What is the dominant histopathologic finding in Immune mediated neuropathies like Guillain- Barre Syndrome?
Inflammation of peripheral nerve, manifested as perivenular and endoneurial infiltration by lymphocytes, macrophages, and a few plasma cells(TOPNOTCH)
2954
What is the most common type of peripheral neuropathy seen in adult-onset DM?
Symmetric neuropathy that involves distal sensory and motor nerves (TOPNOTCH)
2955
In patients with peripheral neuropathy, what is the predominant histologic findings?
Axonal neuropathy (TOPNOTCH)
2956
Morphology: Perifascicular Atrophy
Dermatomyositis (TOPNOTCH)
2957
Morphology: presence of rimmed vacuoles within myocytes and are highlighted by basophilic granules at their periphery. In addition, the vacuolated fibers may also contain amyloid deposits that stain with Congo Red.
Inclusion body myositis (TOPNOTCH)
2958
Morphology: Panfascicular atrophy
Spinal Muscular Atrophy (Infantile Motor Neuron Disease (TOPNOTCH)
2959
What are the 5 histopathologic abnormalities common to Duchenne Muscular Dystrophy and Becker Muscular Dystrophy?
1. Variation in fiber diameter 2. Increased numbers of internalized nuclei 3. Degeneration, necrosis, and phagocytosis of muscle fibers 4. Regeneration of muscle fibers 5. Proliferation of endomysial connective tissue (TOPNOTCH)
2960
Morphology: In later stages of this disease, all muscles eventually become almost totally replaced by fat and connective tissue
Duchenne Muscle Dystrophy (TOPNOTCH)
2961
What is the histologic pathology that is usually seen in Duchene muscle dystrophy and is rare in Becker Muscle Dystrophy?
Enlarged, rounded, hyaline fibers that have lost their normal cross striation, believed to be hypercontracted fibers (TOPNOTCH)
2962
Morphology: Ring fiber ( subsarcolemmal band of cytoplasm that appears distinct from the center of the fiber) and Sarcoplasmic mass
Myotonic Dystrophy (TOPNOTCH)
2963
Morphology: Disuse changes with Type 2 fiber atrophy, post synaptic membrane is simplified, with loss of AChRs from the region of the synapse. Immune complexes as well as the MAC of the complement cascade can be found along the post synaptic membrane as well
Myasthenia Gravis (TOPNOTCH)
2964
Electron Microscopy: tubular and filamentous inclusions are seen in the cytoplasm and the nucleus, and they are composed of B-amyloid or hyperphosphorylated tau.
Inclusion body myositis (TOPNOTCH)
2965
Grotton lesions (scaling erythematous eruption or dusky red patches over the knuckles, elbows, and knees) are seen in what disease entity?
Dermatomyositis (TOPNOTCH)
2966
Morphology: the most consistent pathologic findings in skeletal muscle are aggregates of abnormal mitochondria that stain with modified Gomori Trichrome and fiber appears irregular on cross section "ragged red fibers" and on electron microscope, they contain "parking lot inclusions"
Mitochondrial Myopathies (Oxidative phosphorylation Disease) (TOPNOTCH)
2967
This is general reaction of the motor unit which is a result of primary destruction of the axon, with secondary disintegration of its myelin sheath.
Axonal degeneration (TOPNOTCH)
2968
This general reaction of the motor unit occurs when there is dysfunction of the Schwann cell or damage to the myelin sheath; there is no primary abnormality of the axon
Segmental demyelination (TOPNOTCH)
2969
Morphology: endoneurial arterioles show thickening, hyalinization, and intense PAS positivity in their walls and extensive reduplicaton of the basement membrane.
Peripheral Neuropathy in DM Type 2 (TOPNOTCH)
2970
Of all the dystrophies, this type is the only one that shows pathologic changes in the intrafusal fibers of muscle spindles, with fiber splitting, necrosis and regeneration
Myotonic Dystrophy (TOPNOTCH)
2971
Morphology: the principal morphologic characteristic is accumulation of lipid within myocytes. The myofibrils are separated by vacuoles that stain with oil red O or Sudan black
Lipid Myopathies (TOPNOTCH)
2972
Lambert Eaton Myasthenic Syndrome is a paraneoplastic process which commonly develops in what type of carcinoma?
Small cell carcinoma of the lungs (TOPNOTCH)
2973
The most important histopathological indicator of CNS injury, regardless of etiology
Gliosis(TOPNOTCH)
2974
Lafora bodies
Myoclonic Epilepsy(TOPNOTCH)
2975
Gross morphology: gyri are flattened, intervening sulci are narrowed, and the ventricular cavities are compressed
Generalized cerebral edema(TOPNOTCH)
2976
A syndrome of sudden, deep intracerebral hemorrhage that follows even minor head trauma by an interval of 1-2 weeks
Spat-apoplexie (Delayed post traumatic hemorrhage) (TOPNOTCH)
2977
Subdural hematomas most often become manifest approximately how many hours after the injury?
48 hours(TOPNOTCH)
2978
The most widely accepted explanation for diffuse axonal injury
mechanical forces damage the integrity of the axon at the node of Ranvier, with subsequent alterations in axoplasmic flow(TOPNOTCH)
2979
Morphology: wide asymmetric distribution of axonal swellings that appear within hours of the injury and are best demonstrated with silver impregnation techniques or with immunoperoxidase stains for AB protein
Diffuse axonal injury(TOPNOTCH)
2980
How long does it take for the clot to lyse in subdural hematomas?
1 week(TOPNOTCH)
2981
How long does it take for fibroblasts to grow from the dural surfaces into the hematoma after subdural hematoma/
2 weeks(TOPNOTCH)
2982
How long does it take for the development hyalinized connectice tissue in SDH
1-3 months(TOPNOTCH)
2983
Gross morphology: brain is swollen, gyri are widened, and the sulci are narrowed
Global cerebral ischemia(TOPNOTCH)
2984
In the setting of global ischemia, early histological changes are seen after how many hours after the insult?
12-24 hours(TOPNOTCH)
2985
In the setting of global ischemia, subacute changes are seen after how many hours after the insult?
24 hours to 2 weeks(TOPNOTCH)
2986
In the setting of global cerebral ischemia, repair is seen after approximately how many weeks?
2 weeks(TOPNOTCH)
2987
In the setting of global ischemia, this is characterized by eventual removal of all necrotic tissue, loss of normally organized CNS structure, and gliosis
Repair(TOPNOTCH)
2988
In the setting of global ischemia, this is characterized by necrosis of tissue, influx of macrophages, vascular proliferation and reactive gliosis
Subacute changes(TOPNOTCH)
2989
In the setting of global ischemiaThis is characterized by acute neuronal cell damage
Early change(TOPNOTCH)
2990
Morphology: pathognomonic finding is a spongiform transformation of the cerebral cortex
Creutzfeldt-Jakob Disease(CJD)(TOPNOTCH)
2991
Morphology: mononuclear cell perivacular cuffs and neuronophagia of the anterior horn motor neurons of the spinal cord
Poliomyelitis(TOPNOTCH)
2992
In the immunosuprressed individual, the most common pattern of involvement in viral meningitis is:
Subacute encephalitis(TOPNOTCH)
2993
Although any type of cell within the CNS can be infected with CMV, the virus tends to localize at what particular area in the brain?
Paraventricular subependymal regions(TOPNOTCH)
2994
What is the principal neurologic manifestation of Von Hippel Lindau Disease?
Cerebellar capillary hemangioblastoma(TOPNOTCH)
2995
Antoni A and Antoni B patterns of growth are seen in what tumors of the CNS?
Schwannoma(TOPNOTCH)
2996
Morphology: histologic appearance similar to anaplastic astrocytoma with the additional feature of necrosis and vascular or endothelial cell proliferation
Glioblastoma multiforme(TOPNOTCH)
2997
Pseudopalisading
Glioblastoma multiforme(TOPNOTCH)
2998
Glomeruloid body
Glioblastoma multiforme(TOPNOTCH)
2999
Lesion of what area of the brain appear to be the best correlate of the memory disturbance and confabulation seen in Korsakoff syndrome?
Medial dorsal nucleus of the thalamus(TOPNOTCH)
3000
Morphology: foci of hemorrhage and necrosis, particularly in the mammillary bodies but also adjacent to the ventricle, especially the third and fourth ventricles
Wernicke encephalopathy(TOPNOTCH)
3001
The spinal cord shows loss of axons and gliosis in the posterior columns, the distal portions of the corticospinal tracts, and the spinocerebellar tracts.
Friedreich Ataxia(TOPNOTCH)
3002
The abnormalities are predominantly in the cerebellum,with loss of Purkinje and granule cells; there is also degeneration of the dorsal columns, spinocerebellar tracts and anterior horn cells and a peripheral neuropathy
Ataxia Telangiectasia(TOPNOTCH)
3003
Gross morphology: pallor of the substantia nigra
Parkinson Disease(TOPNOTCH)
3004
Gross morphology: the brain shows pronounced, frequently asymmetric, atrophy of the frontal and temporal lobes with conspicuous sparing of the posterior two thirds of the superior temporal gyrus
Pick Disease(TOPNOTCH)
3005
What are the 3 major microscopic abnormalities of Alzheimer disease?
Neuritic/Senile PlaquesNeurofibrillary tanglesAmyloid angiopathy(TOPNOTCH)
3006
What is the principal clinical manifestation of Alzheimer disease?
Dementia(TOPNOTCH)
3007
What is the most common cause of dementia in the elderly?
Alzheimer Disease(TOPNOTCH)
3008
Gross morphology: variable degree of cortical atrophy with widening of the cerebral sulci that is most pronounced in the frontal, temporal, and parietal lobes with compensatory ventricular enlargement (hydrocephalus ex vacuo)
Alzheimer Disease(TOPNOTCH)
3009
Neurotic plaques are focal, spherical collection of dilated, tortuous, silver staining neuritic processes often around a central amyloid core, which may be surrounded by clear halo, and can be stained with Congo red. What is the most predominant component of this plaque core?
AB peptide(TOPNOTCH)
3010
Neurofibrillary tangles are bundles of filaments in the cytoplasm of the neurons that displace or encircle the nucleus. What is the major component of this structure?
Tau proteins(TOPNOTCH)
3011
Hirano bodies
Alzheimer's disease (TOPNOTCH)
3012
What is the principal neurologic manifestation of Von Hippel Lindau Disease?
Cerebellar capillary hemangioblastoma(TOPNOTCH)
3013
Patients with Von Hippel Lindau Disease has the propensity to develop what type of carcinom?
Renal Cell Carcinoma(TOPNOTCH)
3014
These are firm areas of the cortex that, in contrast to the softer adjacent cortex, have been likened to potatoes and are composed of haphazardly arranged neurons that lack the normal laminar organization of neocortex.
Cortical hamartomas or "tubers' of Tuberous Sclerosis (TOPNOTCH)
3015
Malignant Peripheral Nerve Sheath Tumor (MPNST, Malignant Schwannoma) is strongly associated with what type of Familial Tumor Syndrome?
Neurofibromatosis Type 1(TOPNOTCH)
3016
What are the 5 most common carcinoma that metastasize to the brain?
Lung, breast, Melanoma, Kidney, and GIT. (TOPNOTCH)
3017
What is the most common CNS neoplasm in immunosuppressed patients, including those with AIDS and immunosuppression after transplantaion?
Primary CNS Lymphoma(TOPNOTCH)
3018
Morphology: composed of sheets of regular cells with spherical nuclei containing finely granular chromatin surrounded by a clear halo of cytoplasm and calcification if present in as many as 90% of these tumors.
Oligodendroglioma(TOPNOTCH)
3019
Morphology: characterized by amild to moderate increase in the number of glial cell nuclei, somewhat variable nuclear pleomorphism, and an interveing feltwork of fine, GFAP positive astrocytic cell processes that give the background a fibrillary appearance.
Well differentiated fibrillary astrocytomas(TOPNOTCH)
3020
Morphology: perivascular pseudorosettes
Ependymoma(TOPNOTCH)
3021
Morphology: the anterior roots of the spinal cord are thin; the precentral gyrus may be atrophic and demonstrates a reduction the number of anterior horn neurons throughout the length of the spinal cord with associated reactive gliosis. Remaining neurons often contain Bunina bdoies and PAS positive cytoplasmic inclusions.
Amyotorphic Lateral Sclerosis(TOPNOTCH)
3022
Morphology: composed of bipolar cells with long, thin "hairlike" processes that are GFAP- Positive; Rosenthal fibers, eosinophilic granular bodies, and microcysts are often present.
Pilocytic Astrocytoma (TOPNOTCH)
3023
Morphology: similar to anaplastic astrocytoma with the additional features of necrosis and vascular or endothelial cell proliferation, each of which often has a stereotypic appearance.
Glioblastoma Multiforme(TOPNOTCH)
3024
Morphology: characterized by areas of stromal response with collagen and reticulin deposition and nodules of cells forming "pale islands" that have more neuropil and lack the reticulin deposition
Desmoplastic variant of Medulloblastoma(TOPNOTCH)
3025
Gross morphology: the brain is small and shows striking atrophy of the caudate nucleus and the putamen. The globus pallidus may be atrophied secondarily, and the lateral and third ventricles are dilated.
Huntington Disease(TOPNOTCH)
3026
What are the two most common primary tumors of the optic nerve?
Glioma and Meningioma (TOPNOTCH)
3027
Morphology: characterized histologically by chronic inflammation and replacement of orbital fat by fibrosis
Idiopathic orbital inflammation (TOPNOTCH)
3028
What is the most common malignancy of the eyelid?
Basal cell carcinoma (TOPNOTCH)
3029
Morphology: histological hallmark is the thinning of the cornea with breaks in the Bowman's layer
Keratoconus (TOPNOTCH)
3030
Morphology: deposition of calcium in Bowmans layer
Calcific Band keratopathy (TOPNOTCH)
3031
This type of keratopathy develops in patients who are exposed chronically to high levels of ultraviolet light
Actinic band keratopathy (TOPNOTCH)
3032
Morphology: numerous drop like excrescences - guttata- protrude downward from Descemet's membrane
Fuchs dystrophy (TOPNOTCH)
3033
Also known as the End-Stage Eye
Phthisis Bulbi (TOPNOTCH)
3034
Morphology: diffuse loss of ganglion cells and thinning of the retinal nerve fiber layer, in advanced cases, the optic nerve is both cupped and atrophic
Glaucomatous optic nerve damage (TOPNOTCH)
3035
Flexner Wintersteine Rosettes
Retinoblastoma (TOPNOTCH)
3036
Morphology: a neovascular membrane is positioned between the retinal pigment epithelium and Bruchs membrane
Age related macular degeneration (TOPNOTCH)
3037
"waxy pallor" of the optic disk
Retinitis Pigmentosa (TOPNOTCH)
3038
In this condition, both rods and cones are lost to apoptosis
Retinitis Pigmentosa (TOPNOTCH)
3039
Elschnig' spots
Malignant hypertension (TOPNOTCH)
3040
What is known to be a reliable histological marker of diabetes mellitus in the eye?
Thickening of the BM of the epithelium of the pars plicata of the ciliary body (TOPNOTCH)
3041
Cytoid bodies
Hypertension (TOPNOTCH)
3042
Macular star
Malignant hypertension (TOPNOTCH)
3043
Morphology: characterized by diffuse granulomatous inflammation of the urea. Plasma cells are typically absent, but eosiophils may be identified in the infiltrate
Sympathetic ophthalmia (TOPNOTCH)
3044
What is the most common intraocular malignancy in adults?
Metastasis to the uvea, typically to the choroid (TOPNOTCH)
3045
What is the most common primary intraocular malignancy in adults?
Uveal melanoma (TOPNOTCH)
3046
These are the resident monocyte-lineage population of CNS that proliferate and accumulate in response to injury.
Microglia (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1254
3047
Subfalcine(cingulate) herniation leads to compression of what blood vessel?
Anterior cerebral artery(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1255
3048
Transtentoria(uncinate) herniation compress what structures?
CN III and Posterior Cerebral artery(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1255
3049
Patient X who had a moderate traumatic injury presented with lethargy. 12 hours later it he progressed rapidly to having dilated pupils and impairment of ocular movements. This is most likely due to:
Transtentorial (uncinate) herniation/CN III compression (TOPNOTCH)
3050
A malformation characterized by reduction in the number of gyri, agyria in extreme cases
Lissencephaly(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1257
3051
Infarcts in the supratentorial periventricular white matter in premature infants presenting with chalky yellow plaques consisting of discrete regions of white matter necrosis and calcification
Perventricular leukomalacia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1259
3052
Most common site of contusions in the brain
Frontal and temporal lobes(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1260
3053
Vascular injury presenting with slowly evolving neurologic symptoms, often with a delay from the time of injury(most often within 48 hours of injury) Grossly, it appears as a collection of freshly clotted blood along the brain surface, without extension into the depths of sulci.
Subdural hematoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1262
3054
After a vehicular crash, patient presented with quadriplegia and respiratory distress. Spinal cord injury was suspected. This can be due to damage to what level of vertebra?
Above C4(TOPNOTCH)
3055
CNS cells most sensitive to ischemia
Neurons(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1264
3056
Clinicopathologic syndrome arising in the setting of malignant hypertension, characterized by diffuse cerebral dysfunction, including headaches, confusion, voming, and convulsion, and sometimes leading to coma
Acute hypertensive encephalopathy(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1268
3057
Risk factor most commonly associated with deep brain parenchymal hemorrhages.
Hypertension(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1268
3058
Most common cause of bacterial meningitis in adolescents and young adults.
Neisseria meningitidis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1272
3059
Typical CSF findings in brain abscess
Increased WBC, increased protein, normal glucose(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1273
3060
Most serious complications of chronic TB meningitis
Arachnoid fibrosis(producing hydrocephalus) and Obliterative endarteritis(causing arterial occlusion and infarction)(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1274
3061
Morphology: perivascular accumulation or lymphocytes and/or neutrophils, multiple foci of necrosis of gray and white matter, single-cell neuronal necrosis with phagocytosis of debris, microglial nodules
Viral Encephalitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1275
3062
It produces brain abscess, most ofen in the cerebral cortex and deep gray nuclei, central necrosis, petechial hemorrhages surrounded by acute and chronic inflammation, macrophage infiltration, and vascular proliferation; CT and MRI studies may show multiple ring enhancing lesions.
Toxoplasmosis of the CNS(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1280
3063
A rapidly progressive encephalitis, cerebral malaria, is the complication with the highest mortality caused by what etiologic agent?
Plasmodium falciparum(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1280
3064
HSV-1 infection has predilection to what part of the brain?
Temporal lobe(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1281
3065
This group of degenerative disorders is caused by "spreading" of misfolded proteins, allowing a pathogenic protein to acquire many of the characteristics of an infectious agent. Accumulation of PrPSC in neural tissue seems to the cause of pathologic changes in these diseases.
Prion diseases(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1281
3066
The most common prion disease that manifest clinically as a rapidly progressive dementia.
Creutzfeldt-Jakob Disease (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1283
3067
Pathologic hallmarks of Alzheimer disease
Plaques and tangles(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1288
3068
The fundamental abnormality in this disease is the accumulation of A-beta and tau in specific brain regions.
Alzheimers Disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1288
3069
Syndrome caused by deletions in mitochondrial DNA, characterized by ophthalmoplegia, pigmentary degeneratation of the retina, and complete heart block
Kearns-Sayre syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1245
3070
Mitochondrial disoder caused by mutations in either mtDNA or the nuclear genome causing subacute necrotizing encephalopathy
Leigh syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1245
3071
A 12 year old student presents with lethargy, fever, and headaches. These progress to irritability, anxiety, and confusion, with difficulty in swallowing. He refuses any drink being offered. A few days later, he slips into a coma, and dies. On history, he was bitten by a stray dog 4 months ago. At autopsy, where would the characteristic infected neurons with cytoplasmic inclusions most likely be found? (A) frontal and parietal cerebral cortex (B) hippocampus and cerebellum (C) globus pallidus and medulla (D) pineal gland and pituitary
hippocampus and cerebellum (TOPNOTCH) Robbins Pathologic Basis of Disease 8th ed
3072
A 19 year old male presents with fever and changes in mood and behavior. His neck is supple, and shows no lateralizing signs, or cranial nerve defects. Memory is impaired. A lumbar tap is performed with a slight lymphocytosis and protein elevation. Bacterial cultures were negative. On PCR, herpes simplex virus I was detected. THe histologic changes of necrotizing inflammation and Cowdry Type A bodies would most likely be found in (A) temporal lobes (B) occipital lobes (C) cerebellar vermis (D) parietal lobes
temporal lobes (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 876
3073
A 78 year old woman in a nursing home is found dead in her bed. She has had a 5 year history of progressive disorientation, memory loss, and alteration of mood and behavior. In her final year, she was mute and could not perform activities of daily living without assistance. Her relatives requested an autopsy, and her brain showed cortical atrophy with widening of the sulci. Histology showed multiple plaques and neurofibrillary tangles. The plaques are collections of neuritic processes with a central core of extracellular (A) amyloid (B) tau protein (C) glycogen (D) sphingomyelin
amyloid (Alzheimer disease) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 893
3074
A 45 year old actor begins to experience hand tremors, and eventually develops a shuffling gait, a stooped posture, and diminished facial expressions. His mental faculties are intact. What is the expected histologic change in his brain? (A) loss of pigmented catecholaminergic neurons in his midbrain (B) loss of neurons in the striatum (C) foci of hemorrhage and necrosis in the mamillary bodies (D) multiple Lewy bodies in his cerebral cortex
loss of pigmented catecholaminergic neurons in his midbrain (pallor of substantia nigra in Parkinsonism) (B - Huntington disease; C - Wernicke encephalopathy; D - Lewy body dementia/disease) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 893-894
3075
A 30 year old saleslady has untreated hypertension. While at work, her colleagues heard her complain of an excruciating headache then lose consciousness a few seconds later. She was pronounced dead at the ER. An autopsy is performed, which showed massive subarachnoid hemorrhage, and a ruptured aneurysm at the right anterior cerebral artery. Her kidneys were markedly enlarged, with multiple 3-4 cm diameter cysts. Which of the following is accurate? (A) the aneurysm is neoplastic (B) the aneurysm was likely present at birth (C) her kidney disease is heritable, in an autosomal dominant fashion (D) her kidney disease more commonly manifests in early childhood
her kidney disease is heritable, in an autosomal dominant fashion (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 569-570, 866-867
3076
A 26 year old backpacker presents with seizures. On imaging, there are four 1-2 cm cysts in his cerebral cortex. He undergoes surgery, where two were removed. Histopathology showed an ovoid structure with a tegument, underlying smooth muscle, three oval suckers, all surrounded by an intense inflammmatory infiltrate of plasma cells, lymphocytes, and eosinophils. The surrounding brain tissue is gliotic. The patient acquired this infection by ingesting (A) raw pork (B) raw beef (C) ova from cat litter (D) raw freshwater crabs
raw pork (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 880
3077
A 33 year old woman has been having intermittent headache for 3 years. She develops a seizure. Imaging studies show a 4 cm well circumscribed intracranial mass at the convexity of the right cerebral cortex, compressing the adjacent brain. The tumor is surgically excised, and histopathology showed cells in syncytial whorls, some in fascicles. There are occasional concentric calcifications interspersed. There is no significant mitosis, necrosis, pleomorphism, or brain invasion. Her tumor is (A) a metastasis from a thyroid primary (B) a primary lymphoma (C) a glioma (D) a meningioma
a meningioma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 886
3078
A 40 year old lawyer presents with seizures and loss of consciousness. On imaging, there is a contrast-enhancing, intracranial mass straddling the corpus callosum, with a "butterfly" appearance. An open biopsy is performed, which showed a densely cellular tumor of with astrocytic cell processes, foci of necrosis with surrounding pseudo-palisading of tumor cell nuclei, vascular proliferation, and numerous mitoses. His tumor (A) is a glioma (B) is poorly circumscribed (C) confers a dire prognosis (D) all of the above
all of the above (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 882
