Patho Flashcards
Rule of 10s of pheochromocytoma
10% malignant 10% bilateral 10% extra-adrenal 10% calcify 10% kids
Hurthle cells
Hashimoto’s thyroiditis
thyroid disease assoc with increased risk of non-Hodgkin lymphoma
Hashimoto thyroiditis
most common cause of death in gigantism
cardiac failure
treatment of nephrogenic DI
Hydrochlorothiazide
Amiloride
Indomethacin
Aggressive correction of hyponatremia leads to
Central pontine myelinolysis
Paraneoplastic syndromes associated with small cell lung CA
ADH and ACTH
Treatment of SIADH
Vasopressin antagonists:
Tolvaptan
Conivaptan
Demeclocycline
most common cause of death among diabetics
myocardial infarction
rule of 1/3 of carcinoid syndrome
1/3 metastasize
1/3 present with second malignancy
1/3 are multiple
gastrin-secreting tumor of pancreas or duodenum
Zollinger-Ellison syndrome
recurrent diarrhea
cutaneous flushing
asthmatic wheezing
R-sided valvular disease
niacin deficiency
high urinary 5-HIAA
Carcinoid syndrome
MEN 1
Wermer syndrome
Pit Pan Para
Pituitary
Pancreas
Parathyroid
MEN 2A
Sipple syndrome
Pheochromocytoma
Parathyroid hyperplasia
Medullary thyroid carcinoma
MEN 2B
Oral / mucosal neuroma
Medullary thyroid carcinoma
Pheochromocytoma
*Marfinoid habitus
clinical syndrome of VIPoma (pancreatic tumor)
WDHA syndrome:
Watery Diarrhea
Hypokalemia
Achlorhydria
benign cystic tumor with germinal centers; second most common salivary gland tumor
Warthin tumor
papillary cystadenoma lymphomatosum
Triad of Plummer-Vinson syndrome
“Plummers DIG”
Dysphagia (esophageal webs)
IDA
Glossitis
CREST Syndrome of limited cutaneous systemic scleroderma
Calcinosis cutis Raynaud phenomenon Esophageal dysmotility Sclerodactyly Telangiectasia
Risk factors for esophageal cancer
AABCDEFFGH Achalasia Alcohol Barrett Cigarette Diverticula Esophageal web Familial Fat GERD Hot liquids
most common site of intestinal gastric adenoca
lesser curvature of stomach
Common symptoms of whipple disease
Foamy Whipped cream in a CAN
Cardiac
Arthralgia
Neurologic
foamy macrophages
PAS +
Tropheryma whipplei (gram +)
Diagnosis of celiac sprue
serum level of tissue transglutaminase antibodies
malabsorption syndrome assoc with dermatitis herpetiformis
celiac sprue
treatment of Crohn’s disease
Corticosteroids Azathioprine Methotrexate Infliximab Adalimumab
treatment of ulcerative colitis
Sulfasalazine
6-mercaptopurine
Infliximab
Colectomy
most common congenital anomaly of the GIT
Meckel diverticulum
Five 2s of Meckel
2% of population 2 inches long 2 feet from ileocecal valve 2 years old 2 types of epithelia (gastric/pancreatic)
Diagnosis of Meckel
Pertechnetate study
uptake by ectopic gastric mucosa
diagnosis of Hirschsprung
rectal suction biopsy
most common cause of small bowel obstruction
adhesions
causes of ileus
post op abdominal surgery
opiates
hypokalemia
sepsis
common location of ischemic colitis
splenic flexure
distal colon
most common non neoplastic polyp in the colon
hyperplastic
Failure of GnRH-secreting neurons to migrate from olfactory lobes to the hypothalamus
Kallmann’s syndrome
FAP
+
osseous and soft tissue tumors
congenital hypertrophy of RPE
Gardner syndrome
FAP
+
malignant CNS tumor
Turcot syndrome
molecular pathogenesis of colorectal carcinoma
loss of APC gene
K-RAS mutation
loss of tumor suppressor gene (p53)
serum marker that decreases in Wilson disease
ceruloplasmin
fatal childhood hepatoencephalopathy
mitochondrial abn fatty liver hypoglycemia vomiting hepatomegaly coma
Reye syndrome
hobnail appearance of the liver
alcoholic cirrhosis
intracytoplasmic eosinophilic inclusions (Mallory bodies) are seen in
alcoholic hepatitis
aflatoxin: HCC
arsenic, vinyl chloride:
angiosarcoma
associated conditions with Budd-Chiari syndrome
hypercoagulable states
polycythemia vera
pregnancy
HCC
conjugated hyperbilirubinemia due to defective liver excretion; presents with grossly black liver
Dubin-Johnson syndrome
absent UDPGT leading to unconjugated hyperbilirubinemia; fatal within a few years
Crigler - Najjar syndrome type I
treatment of Wilson disease
penicillamine
Kayser - Fleischer rings
Wilson disease
hepatolenticular degeneration
symptoms of Wilson disease
Copper is Hella BAD
Ceruloplasmin low, Cirrhosis, Corneal deposits, Carcinoma hepatocellular Hemolytic anemia Basal ganglia degeneration Asterixis Dementia, Dyskinesia, Dysarthria
symptoms of hemochromatosis
“Can Cause Deposits”
Cirrhosis
CHF
Diabetes mellitus
autoimmune conditions associated with primary biliary cirrhosis
CREST
Sjogren
Rheumatoid arthritis
Celiac disease
unknown cause of concentric “onion skin” bile duct fibrosis
presents with alternating strictures and dilatation with beading of intra and extrahepatic bile ducts
Primary sclerosing cholangitis
migratory thrombophlebitis (Trousseau syndrome) seen in
pancreatic adenocarcinoma
obstructive jaundice with palpable, nontender gallbladder
Courvoisier sign in pancreatic adenocarcinoma
cause of isolated basophilia
myeloproliferative disease
CML
conditions decreasing ESR
polycythemia sickle cell disease microcytosis hypofibrinogenemia CHF
Conditions assoc with basophilic stippling
BASically, ACiD Alcohol is LeThal
Anemia of chronic disease
Alcohol
Lead poisoning
Thalassemias
Conditions assoc with target cell
HALT
Hemoglobin C disease
Asplenia
Liver disease
Thalassemia
Conditions assoc with basophilic stippling
BASically, ACiD Alcohol is LeThal
Anemia of chronic disease
Alcohol
Lead poisoning
Thalassemias
Conditions assoc with target cell
HALT
Hemoglobin C disease
Asplenia
Liver disease
Thalassemia
treatment of sideroblastic anemia
pyridoxine
cofactor of ALA synthase
causes of sideroblastic anemia
alcohol lead isoniazid vit B6 def copper def
anemia with elevated homocysteine and methylmalonic acid
Vit B12 deficiency
versus folate deficiency - normal methylmalonic acid
Nonmegaloblastic macrocytic anemias
liver disease
alcoholism
reticulocytosis
drugs (5-FU, zidovudine, hydroxyurea)
Heinz bodies
Bite cells
G6PD deficiency
Triad of PNH
Pancytopenia
veNous thrombosis
Hemolytic anemia
Salmonella osteomyelitis Dactylitis Acute chest syndrome Avascular necrosis Stroke Renal papillary necrosis
are complications of
Sickle cell disease
AIHA seen in Mycoplasma infections and infectious Mononucleosis
Cold agglutinin (IgM)
AIHA seen in Mycoplasma infections and infectious Mononucleosis
Cold agglutinin (IgM)
Schistocytes (helmet cells) are seen in
Macro and microangiopathic hemolytic anemias, thalassemias
Conditions causing eosinopenia
Cushing syndrome
Corticosteroids
Conditions causing lymphopenia
HIV
DiGeorge syndrome
Corticosteroids
SCID
Enzymes inhibited in lead poisoning
Ferrochelatase
ALA dehydratase
most common porphyria
porphyria cutanea tarda
5 Ps of Acute intermittent porphyria
Painful abdomen Port wine-colored urine Polyneuropathy Psychological disturbances Precipitated by drugs, alcohol and starvation
Treatment of acute intermittent porphyria
Glucose
Heme
(to decrease activity of ALA synthase)
platelet disorder characterized by anti GpIIb/IIIa antibodies
may be triggered by viral illness
immune thrombocytopenia
platelet disorder characterized by deficiency of ADAMTS 13 (vWF metalloproteinase)
TTP
pentad of TTP
FAT RN Fever Anemia (microangiopathic hemolytic) Thrombocytopenia Renal (Uremia) Neurologic sx
most common inherited bleeding disorder
von Willebrand disease
Ristocetin cofactor assay is used in the diagnosis of
vWD (decreased agglutination)
Causes of DIC
STOP Making New Thrombi Sepsis (gram neg) Trauma OB complications Pancreatitis Malignancy Nephrotic syndrome Transfusion
decreased ability to inactivate factors V and VIII leading to thrombotic skin necrosis
may present with hemorrhage following administration of warfarin
protein C or S deficiency
Contents of cryoprecipitate
Fibrinogen vWF Fibronectin Factor 8 Factor 13
Blood transfusion risks (electrolyte imbalance)
Hypocalcemia
Hyperkalemia
S/Sx of Parkinson Disease
SMART Shuffling gait Mask-like facies Akinesia/bradykinesia Rigidity Tremors (resting)
disease characterized by bone pain, deformity and hearing loss
increased abnormal osteoclasts - multinucleated cells (100 nuclei)
Paget’s disease of the bone
most common cause of male hypogonadism
Klinefelter syndrome
primary hypogonadism long lower extremities small, firm testes azoospermia intellectual disability gynecomastia sparse body hair
Klinefelter syndrome
47 XXY
Arm span > height
Long fingers
Joint laxity
Marfanoid habitus
gross:
well-defined yellowish tumors of adrenal cortex
adrenocortical adenomas
electrolyte imbalance in Conn’s syndrome
hypokalemia, metab alka
T cell NHL
Adult T cell lymphoma
Mycosis fungoides / Sezary syndrome
lymphoma caused by HTLV-1
Adult T cell lymphoma (NHL)
high serum level of 17-hydroxyprogesterone is diagnostic of
21-hydroxylase deficiency
congenital adrenal hyperplasia
rapid linear growth weight gain excessive sweating oily skin prognathism (protrusion of jaw) thickened calvarium large hands and feet
Gigantism
Acromegaly
type of urethral injury presenting with high-riding prostate
posterior urethral injury
membranous urethra
impaired tail mobility of the sperm (ciliary dyskinesia) leading to infertility
Kartagener syndrome
Streak ovary
Short stature
Shield chest (bicuspid aortic valve, preductal CoA - notched ribs)
Lymphatic defects (webbed neck, cystic hygroma, lymphedema)
Horseshoe kidney
Turner syndrome
45 XO
most common form of male pseudohermaphroditism
androgen insensitivity syndrome (testicular feminization)
condition resulting to female pseudohermaphroditism
CAH
autosomal recessive dso of sexual devt leading to ambiguous genitalia until puberty
5a reductase deficiency
referred pain in the shoulder due to peritoneal irritation, most likely splenic laceration
Kehr’s sign
gallstone ileus (stones >2.5cm) typically lodges in
ileum (narrowest portion of intestine)
most common intra abdominal organ injured during blunt trauma
spleen
conditions causing polyhydramnios
esophageal / duodenal atresia anencephaly maternal DM fetal anemia multiple gestation
most common ovarian tumor in the young (10-30 y/o)
Mature cystic teratoma
(dermoid cyst)
ovarian neoplasm with uniform “fried egg” cells appearance on histology
Dysgerminoma
GCT
large cells in the breast epidermis with clear halo suggesting an underlying DCIS
Paget cells
Peau d’orange is usually seen in this type of breast malignancy
Inflammatory breast CA
most common cause of scrotal enlargement in adult males
varicocele
most common testicular tumor
seminoma
most common testicular tumor in young boys (<3 y/o)
endodermal sinus tumor / yolk sac tumor
most common testicular tumor in older men
testicular lymphoma
tunica vaginalis lesion presenting as a testicular mass due to dilated epididymal duct
spermatocele
premalignant lesion presenting as leukoplakia in penile shaft
Bowen disease
most common extragonadal GCT in infants and young children
sacrococcygeal teratoma
pancreatic tumor presenting with diarrhea, cholelithiasis and DM
somatostatin-producing tumor
in lactase deficiency, stool pH is decreased (<6) because lactose is fermented by bacteria into:
short chain fatty acids:
acetate
butyrate
propionate
constitutive activation of fibroblast growth factor receptor 3
achondroplasia
inhibition of chondrocyte proliferation
most common site of osteonecrosis
femoral head
insufficiency of medial circumflex femoral artery
primary bone tumor:
soap bubble appearance on xray
giant cell tumor
primary bone tumor:
onion skin appearance in bone
Ewing sarcoma
conditions presenting with overproduction of uric acid
Lesch-Nyhan syndrome
Tumor lysis syndrome
von Gierke disease
conditions strongly assoc with HLA-B27
PAIR
Psoriatic arthritis
Ankylosing spondylitis
IBD
Reactive arthritis
Dactylitis
pencil-in-cup deformity on xray
psoriatic arthritis
serum marker sensitive for drug-induced lupus
antihistone antibodies
enlarged lymph node restrictive lung disease bilateral hilar adenopathy increased serum ACE Schaumann and asteroid bodies
Sarcoidosis
most common cause of death in scleroderma
pulmonary sclerosis
acantholysis and nikolsky sign can be seen in
pemphigus vulgaris
acanthosis with parakeratotic scaling
more spinosum, less granulosum
psoriasis
sudden appearance of multiple seborrheic keratoses indicating an underlying malignancy
Leser - Trélat sign
GI, lymphoid malignancy
skin layer affected in:
- SSSS
- TEN
- Stratum Granulosum
- Epidermal-dermal junction
Infections assoc with Erythema Multiforme
Mycoplasma pneumoniae
HSV
Diseases assoc with erythema nodosum
sarcoidosis
crohn’s disease
leprosy
TB
strep infx
histoplasmosis
coccidioidomycosis
wickham striae seen in
lichen planus
most frequent feature of lateral medullary infarct
vertigo
most common location of syringomyelia (vertebral level)
C8-T1
assoc with lewy bodies (a synuclein)
Parkinson disease
atrophy of caudate nuclei on imaging
Huntington disease
choreiform movements
aggression
depression
dementia
CAG repeats
AD
Huntington disease
regions in the brain that are highly vulnerable to ischemia
3 Ps
Pyramidal neurons of HIPPOCAMPUS (temporal lobe)
Pyramidal neurons of cortex (layers 3, 5, 6)
Purkinje layer of cerebellum
Early microscopic finding in liquefactive necrosis of the brain
Red neurons
12 hrs after infarction
most frequent location of a berry aneurysm
Anterior communicating artery
s/sx of Lesch - Nyhan syndrome
HGPRT Hyperuricemia Gout Pissed off (aggression) Retardation dysTonia
assoc with cystic degeneration of the putamen
Wilson’s disease
most common site of ICH
basal ganglia
cavernous sinus thrombosis affects which cranial nerves
3, 4, 5-1, 5-2, 6
clinical triad of urinary incontinence, ataxia and cognitive dysfunction
Normal pressure hydrocephalus
3 Ws (wet, wobbly and wacky) -d/t disrupted corona radiata
s/sx of multiple sclerosis
SIN
Scanning speech
Intention tremors
Nystagmus
(random and asymmetrical tracts)
spinal cord lesion assoc with charcot joints and argyll robertson pupils
tabes dorsalis
peak incidence of sexual abuse
9 - 12 years old
most common form of child maltreatment
child neglect
most common subtype of depression
atypical depression
postpartum blues usually resolve within
10 days
dorsal hand calluses from induced vomiting
Russell sign of bulimia nervosa
caused by decreased orexin production in the lateral hypothalamus
narcolepsy
sensitive indicator of alcohol use
serum gamma glutamyl transferase
intoxication with this hallucinogen leads to perceptual distortions, depersonalization and possible flashbacks
LSD
most common lethal genetic disease in caucasian population
cystic fibrosis
peak of delirium tremens
2 to 5 days after last alcohol drink
tx of acute intermittent porphyria
glucose, heme
to inhibit ALA synthase
conditions characterized by wide splitting of S2
RBBB
Pulmonic stenosis
(delayed RV emptying)
conditions characterized by paradoxical splitting of S2
LBBB
Aortic stenosis
(delayed LV emptying)
most frequent valvular lesion
mitral valve prolapse
most common cause of coronary sinus dilatation
Pulmonary arterial hypertension (due to increased R-sided pressure)
most common cause of death during acute phase of rheumatic fever
myocarditis
complications of aortic stenosis
syncope and angina during exercise
microangiopathic hemolytic anemia
concentric LVH
endocarditis with Strep bovis, check for underlying..?
colorectal carcinoma
endocarditis with negative blood cultures
HACEK
Hemophilus Actinobacillus Cardiobacterium Eikenella Kingella
Rhabdomyoma of the heart is assoc with
tuberous sclerosis
most common primary cardiac tumor in adults
myxoma
causes of dilated cardiomyopathy
ABCCCD
Alcohol abuse Beri beri Cocaine (chronic) Chagas Coxsackie B Doxorubicin
most common childhood systemic vasculitis
HSP
small vessel vasculitis that are p-ANCA +
Microscopic polyangiitis
Churg Strauss
HAMARTOMAS of tuberous sclerosis
Hamartomas (CNS, skin) Angiofibromas Mitral regurg Ash-leaf spots Rhabdomyoma (cardiac) Tuberous sclerosis dOminant autosomal Mental retardation Angiomyolipoma (renal) Shagreen patches, seizures
congenital dse assoc with devt of berry aneurysms
Ehlers Danlos (type IV affecting type 3 collagen)
dses assoc with ADPKD
hepatic cysts
berry aneurysms
MVP
pathognomonic dermatologic feature of lightning strike
Lichtenberg figures
most common cause of mitral stenosis
prior rheumatic carditis
most common genetic cause of homocystinemia
MTHFR deficiency
ESRD on dialysis is at increased risk for which malignancy
renal cell carcinoma
most common cause of ARF (intrarenal azotemia)
acute tubular necrosis
nephrotic syndrome can present with hypercoagulable state due to loss of
antithrombin III
minimal change disease may be assoc with
Hodgkin lymphoma
most common nephrotic syndrome in SLE
membranous nephropathy
difference of Churg Strauss from microscopic polyangiitis
chAGE strauss
Asthma
Granulomatous inflam
Eosinophilia
most common nephropathy worldwide
IgA nephropathy
Berger disease
WBC casts may be seen in
acute pyelonephritis
waxy casts may be seen in
chronic pyelonephritis
thyroidization of kidney occurs in
chronic pyelonephritis
most common type of nephrolithiasis
calcium oxalate stones
most common cause of bilateral fetal hydronephrosis in boys
posterior urethral valves
tuberous sclerosis is assoc with increased frequency of
angiomyolipoma
PAraneoplastic syndromes assoc with REnal cell ca
PA RE
PTHrp
ACTH
Renin
EPO
most common malignant renal tumor in children
Wilm tumor
syndromes assoc with Wilm’s tumor
WAGR
Beckwith - Wiedemann
benign counterpart of renal cell carcinoma
renal oncocytoma
conditions assoc with fibrinoid necrosis
PAN
malignant HTN
hyperacute transplant rejection
Goodpasture syndrome is assoc with what type of nephropathy
RPGN
GBM splitting can be seen in (2)
MPGN (tram-track) Alport syndrome (lamellated GBM)
Type I MPGN is assoc with
Hep B and C
2 associations of nasal polyps
cystic fibrosis
aspirin-intolerant asthma
eosinophil-derived crystals in sputum of asthma patients
Charcot-Leyden crystals
spiral-shaped mucus plugs seen in asthma
Curschmann spirals
interstitial lung disease
increased serum ACE
asteroid bodies
sarcoidosis
only pneumoconioses with increased risk for TB
silicosis
RA + coal workers’ pneumoconiosis
caplan syndrome
psammoma bodies can be seen in this type of lung malignancy
mesothelioma
preductal CoA
bicuspid aortic valve
horse shoe kidney
assoc with?
Turner syndrome
paraneoplastic syndromes assoc with renal cell carcinoma
PTHrP
ACTH
ectopic EPO
most common sources of metastatic tumors to the brain (3)
breast
lung
kidney
most common location of metastatic tumors in the brain
gray-white junction
most common cause of sporadic enceph in the US
tempor lobe encephalitis
s/sx of cholinesterase inhibitor poisoning / organophosphate poisoning
DUMBBELSS
Diarrhea Urination Meiosis Bradycardia Bronchospasm Excitation of CNS and skeletal muscle Lacrimation Sweating Salivation
permanent tissues (3)
skeletal muscle
cardiac muscle
nerve
substances that attract and activate neutrophils (4)
LTB4
C5a
IL-8
bacterial products
bone marrow/liver transplant maculopapular rash diarrhea jaundice hepatomegaly
GVHD
malignancies with propensity for bone mets
“PB KTL” lead kettle
Prostate Breast Kidney Thyroid Lung
most common cause of death in adults with sickle cell disease
acute chest syndrome
perivascular pseudorosettes are characteristic finding on biopsy
ependymoma
rosenthal fibers
GFAP +
cystic lesion with mural nodule
pilocytic astrocytoma
most common vitamin deficiency in the US
folic acid
B9
types of susceptible infection with decreased immunoglobulins (3)
bacteria
enterovirus
giardia
hypersensitivity type in Sjogren
type IV
sjogren syndrome increases the risk of
unilateral enlargement of parotid gland
B cell / marginal zone lymphoma
target protein of antibodies in Sjogren
ribonucleoproteins
target protein of antibodies in scleroderma
DNA topoisomerase I
autoimmune disease with antibodies against U1 ribonucleoprotein
MCTD
complication of nephrotic syndrome char by sudden onset flank pain, hematuria and varicocele
renal vein thrombosis
primary organ of osteoblastic bone mets
small cell lung CA
Hodgkin lymphoma
prostate CA