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IPAP 21-2 Soph Semester > Patho Block 1 > Flashcards

Patho Block 1 Flashcards

1
Q

Group O blood has what Ag and Ab

A

No Ag

Both A and B Ab

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2
Q

What are the S/ s of Multiple Myeloma

A

Renal failure

anemia

leukopenia

Diagnosis based on x-rays, bone marrow biopsy, and serum protein electrophoresis

• Large gamma globulin spike (Bence-Jones proteins)

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3
Q

Why do the outer tissues retain their appearance in coagulative necrosis

A

rapid inactivation of hydrolytic enzymes prevents tissue lysis
thus tissues retain original form and consistency

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4
Q

What is the pathological path of an arterial emboli

A

Heart, to carotid artery, to brain, to stroke

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5
Q

UV light radiation causes what kind of cancer

A

Skin cancer

Squamous cell carcinoma (SCC),
Basal cell carcinoma (BCC),
Melanoma

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6
Q

What does amniotic fluid analysis

(Amniocentesis) in prenatal testing look for?

A

Fluid sampled from amniotic sac at 12 - 18 weeks

Chemical and chromosomal analysis

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7
Q

Which Ig does the Alternate pathway use

A

IgA

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8
Q

Carcinoembryonic Antigen (CEA)

Is a tumor marker for cancer where?

A

Colon, stomach

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9
Q

What is the most common method of staging

A

The TNM system
T: size of primary tumor
N: Lymph node involvement
M: metástasis or not

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10
Q

What are the two pathways of the arachodonic acid derivates

A

Lipoxygenase (LOX) pathway

Cyclooxygenase (COX) pathway

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11
Q

What is Shock

A

Simply hypo-perfusion resulting in tissue anoxia and organ failure

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12
Q

Loss or gain of a chromosome(s) alters genetic expression is called

A

A numerical abnormality

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13
Q

What does etiology mean

A

Origin of the disease

Underlying causes and modifying fxs

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14
Q

What is the difference between wet and dry gangrene

A
  • “wet gangrene” = bacteria are active, necrosis is more liquefactive
  • “dry gangrene” = as tissue dries, becomes black “mummified”
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15
Q

What are the three classifications of anemia

A

• Decreased hematopoiesis (inadequate production)

• Abnormal hematopoiesis
(incorrect production)

• Increased loss or destruction of RBCs (taken out of circulation)

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16
Q

Which WBC type is often seen in chronic infections

A

Eosinophils

  • slower mobility
  • survive longer

Macrophages
-long living

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17
Q

What patient population is Lupus most common in

A

Women

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18
Q

Describe the first step of wound healing

Hemostasis

A

Vasoconstriction, platelet activation, coagulation

Fibrin, platelets, and RBCs join to form clot

Vasoconstriction initially (briefly), then vasodilation as healing begins

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19
Q

What does RDW measure

A

Red Blood Cell Distribution Width

= variation of RBC volume

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20
Q

What are the characteristics of benign tumors

A

Remain localized
Do not spread to other tissues
Grow slowly (Atypical mitosis)

Well-differentiated cells resembling their normal counterparts

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21
Q

What is a common medication that can Lys the plasma membrane

A

Tylenol

Liver, kidney

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22
Q

What 4 things can tumor markers be used for

A

Diagnosis
Predict response to cancer tx
Asses response to tx
Monitor the patient for cancer return

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23
Q

What are three causes plasma membrane morphology

A

Lysis
Complement system
Free radicals

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24
Q

What are the 4 functions of neutrophils

A 
Mobility 
Phagocytosis 
Bactericidal activity 
(Kill O2, radicals) 
Cytokines production 
(Prolongs Inflamation and promotes FEVER)
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25
Q

How can endonucleases causes pathology

A

DNA and chromatin fragmentation

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26
Q

Biopsy of what lymph node is oftenusedtodetect metastatic cells as part of cancer staging

A

The sentinel lymph node

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27
Q

What are some examples of Type IV hypersensitivity granulomas

A

TB (Mycobacterium tuberculosis), (M. leprae), and fungi, sarcoidosis

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28
Q

Due to their slow growth, benign tumors are…

A

Encapsulated- tumor contained within smooth walled, fibrous capsule

And

Expansive- Exerts a mass effect by compressing on other tissues

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29
Q

Adding fluids to the body will ______ Hct value

A

Decrease

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30
Q

Where do most PE arise from

A

DVTs in the legs or pelvis

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31
Q

What is the culminating purpose of the complement system

A

Membrane Attach Complex

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32
Q

Genotype vs Phenotype

A

Geno: genetic form

Pheno: physical expression

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33
Q

What are 5 types of cellular adaptation

A 
Atrophy 
Hypertrophy 
Hyperplasia 
Metaplasia 
Dysplasia
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34
Q

What are the initial symptoms of Hypovolemic shock

A 
Elevated HR 
Increased RR 
vasoconstriction “Cold and Clammy” 
Increased Thirst 
Light headedness

(COMPENSATION)

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35
Q

Hepatitis B virus causes what kind of cancer

A

Hepato-cellular carcinoma (HCC)

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36
Q

What is the normal adult heme composition

A

2 Alpha and 2 Beta chains

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37
Q

What are the 4 types of emboli

A

Thromboembolism
Solid Particle Embolism
Liquid emboli
Gaseous Emboli

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38
Q

What is the tx for Acute Myelogenous Leukemia (AML)

A

chemotherapy induces remission in 60%

  • High recurrence rate - under 30% remain disease free at 5 years
  • Radiation / chemotherapy, then bone marrow transplant (BMT)
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39
Q

What Ag and Ab do group AB have

A

Both A and B Ag

No Ab

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40
Q

Name that disease:

Onset ~65 y/o
Immature myoblasts
Spleen/ nodes enlarged

HIGH RECURRENCE RATE

A

Acute Myelogenous Leukemia

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41
Q

What are the S/s of Chronic Myelogenous Leukemia (CML)

A

Slow onset of symptoms: fatigue, ↓endurance, infxs, splenomegaly, thrombus

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42
Q

What are 4 S/s of a tumor

A

Impinge upon vital tissues

Impair function of surrounding tissues

Cause death of involved tissues

Provided a nidus for infection

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43
Q

What is pernicious anemia

A

autoimmune d/o of stomach parietal cells decreases B12 absorption

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44
Q

Name that disease:

Onset <5 y/o
Immature lymphoid cells
Rapid Course

Good Prognosis and remission

A

Acute Lymphoblastic Leukemia

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45
Q

Define structural chromosomal abnormalities

A

Similar to genetic changes with neoplasms

  • Deletion -portion is lost during replication
  • Inversion (or Breakage) -portion breaks off & reinserted upside down or in wrong location
  • Translocation-portion of chromosome inserted into another location
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46
Q

What are the 5 cardinal signs of acute inflammation

A

Calor (warmth)
Rubor (erythema)
Tumor (edema)
Dolor ( pain )

Loss of function **

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47
Q

What is thrmbocytosis

A

Excess circulating platelets, such as after a splenectomy

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48
Q

All three pathways of the complement system end with

A

BIG MAC ATTACK

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49
Q

What is a Sarcoma

A

A cancer of mesenchymal origin

Bone, cartilage, fat, blood cells, connective tissue

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50
Q

Malignant cells retain only functions essential to _________

A

Live and proliferate

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51
Q

What part of the Ab attached to the Antigen it was designed for

A

The light chain

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52
Q

Nitrosamines cause

A

Colon Cancer

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53
Q

Bradykinin is formed throughout he activation of Hageman factor with is aka

A

COAG Fx XII

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54
Q

Tissues that are easily damaged by radiation are also

A

readily treated by radiation therapy

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55
Q

Describe the 3rd stage in wound healing

Proliferation

A

New tissue is made from collagen and fibronectin

Epithelialization occurs

Wound contracts and new blood vessels are constructed

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56
Q

What is the best method for preventing genetic disorders

A

Prevention is best method
– update immunizations
-good nutrition
-avoiding smoking/alcohol

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57
Q

What explains why a disease arises

A

The etiology

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58
Q

What does neutrophillia suggest

A

Bacterial infection

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59
Q

What is the major difference between dystrophic and metastatic calcification

A

Dystrophic is in damaged, dying, or dead tissues

Metastatic is in normal healthy tissues

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60
Q

In hereditary spherocytosis

How will the mcv, mch and mchc present

A

MCV decreased – smaller cells so smaller volume

• MCH/MCHC increased – hemoglobin compressed into smaller RBC

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61
Q

What are the two types of thrombotic thrombocytopenia purpura

A

Primary – antibodies against enzyme that BREAKS DOWN Von Willebrand (clotting) factor

Secondary – from cancer, pregnancy, HIV, anti-platelet drugs, immuno-suppression

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62
Q

Serum is…

Plasma is…

A

When there is a blood clot in a blood sample, the left over fluid is serum

When the blood sample is pereserved with anticoagulants and run through a centrifuge, the fluid that is not RBCs is plasma

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63
Q

What are three examples of abnormal hematopoiesis

A 
Sickle cell (Defect in B chain Hgb) 
Thalassemia 
(Defect in Hgb A, Beta or Alpha chain) 
Hereditary spherocytosis 
(RBC protein error)
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64
Q

An increased retic count with anemia signifies what..

A
  • Bone marrow responds to anemic state by increasing production
  • ↑ retic count shows anemia is NOT caused by marrow failure
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65
Q

What are the S/s of Acute Myelogenous leukemia

A

Spleen and lymph nodes usually enlarged

• Neutropenia, thrombocytopenia, and anemia are common

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66
Q

EBV
(Epstein-Barr virus , a Herpes Virus )

Causes what kind of cancer

A

Burkitt’s Lymphoma and Hodgkin’s

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67
Q

Losing body fluids will _______ Hct value

A

Increase

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68
Q

What does Retic measure

A

Number of immature RBCs in blood sample

• Reflection bone marrow’s production of new RBCs

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69
Q

What is megaloblastic anemia from

A

usually inadequate intake or malabsorption of B12 or Folate

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70
Q

What causes mesothelioma

A

Asbestos (tumor of lung pleura)

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71
Q

How many days post injury does the maturation phase of tissue remodeling occur

A

21 days post injury

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72
Q

Define Morphogenesis

A

Morphogenesis = evolution and development of organ or other body part

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73
Q

How do free radicals damage the plasma membrane

A

By reacting with the membrane phospholipids

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74
Q

What does eosinophilia suggest

A

Allergies or parasitic infections

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75
Q

What actions do you take for a minor transfusion reaction

A

Give diphenhydramine, methyl prednisone, and epi

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76
Q

Where are cells sampled from in a chorionic villus sampling

A

Fetal cells obtained from the chorion- a part of the placenta

Uses a sampling tool that enters through the vagina.

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77
Q

What tissues does coagulative necrosis mostly effect

A

Solid organs

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78
Q

What is the most important cause of delayed healing

A

Infections

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79
Q

What is cachexia

A

Unexplained weight loss, common in cancer pts

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80
Q

Name that disease

Onset Adults >45 years old

Punched out appearance
Hypercalcemia
Protienuria

Death within 3-4 years

A

Myeloma

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81
Q

In lymphatic spread what is the first node that receives drainage from primary tumor site…

A

Sentinel Lymph node

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82
Q

What are two types of pathological calcification

A

Dystrophic and Metastatic

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83
Q

Marrow suppression by cytotoxic drugs, chemo/rad therapy, or viral infx, can lead to what type of anemia

A

Aplastic Anemia

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84
Q

Vaso and Angio are generic terms for

A

Vessels

Can be blood or lymph

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85
Q

Define Agenesis

A

absence of organ or part of organ contains primordial tissue

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86
Q

What is the principle mechanism of first/ primary intention wound healing

A

Epithelial regeneration

  • staples
  • sutures
  • seri strips
  • adhesives
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87
Q

Pyrogens are released by…

Cause what..

A

Released by neutrophils

Caused Hypothalmus to being prostaglandin synthesis

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88
Q

What is grading of a tumor

A

Based on histology of the tumor

Used for treatement and planning of certain cancers

Reflectes the degree of differentiation

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89
Q

With regard to cytoplasm..

Highly differentiated cells have______

Undifferentiated cells have_____

A

Very abundant amounts in highly differentiated cells (liver, kidney)

Scant amounts in undifferentiated cells (often have larger nuclei)

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90
Q

What plasma derived mediator starts the coag cascade

A

Bradykinin

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91
Q

What is the largest group of genetic disorders

A

Recessives are largest group of genetic disorders ;however over all incidence in population is low

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92
Q

Describe caseous necrosis

A

“Cheesy” area created as affected cells fall apart

Typically seen in TB and some fungal infections (histoplasmosis)

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93
Q

Why are red blood cells Biconcave

A
  • Biconcave shape; increases surface area for O2 and CO2 diffusion
  • Highly flexible; able to bend shape when passing through narrow capillary beds
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94
Q

Define mar fans syndrome

A

Connective tissue disorder impacting formation of fibrillin

tall and slender habitus with elongated head/forehead

Elongated fingers

Aortic aneurysms, aortic dissection & rupture

Cardiac valves poorly structured – “floppy valves”

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95
Q

HPV causes what kind of cancer

A

Carcinoma of the cervix and penis

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96
Q

What are the S/s of a Vaso-Vagal event

A

Prodrome
(light-headed, nausea, cold sweats, pale skin/face, tunnel vision)

Brief LOC (quickly regained) 
Without amnesia
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97
Q

What is the function of CD8 cells

A

(T-suppressor/cytotoxic cells)

Suppress unwanted antibody production

Cytotoxic killing of cells recognized as “foreign”
– viral infected cells, cancer (CA) cells

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98
Q

What is another name for hydrothorax

A

Pleural effusion,

-fluid in the chest, outside the lung tissue

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99
Q

Type I hypersensitivity is what Ig mediated response

A

IgE

Antigens (allergen) sensitize
B-lymphocytes→Plasma Cells→IgE

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100
Q

What are the three phases of shock

A

Compensated
Decompensated
Irreversible

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101
Q

What is melena

A

Dark sticky feces containing DIGESTED blood

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102
Q

Define gangrene

A

Secondary change in ALREADY necrotic tissue

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103
Q

What are the most frequent new cancer cases in men and women

A

Men: prostate
Women: breast

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104
Q

What are the three types of abnormal hematopoiesis anemia

A
  • SickleCellanemia
  • Thalassemia
  • Spherocytosis
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105
Q

What is the highest rick factor for cancer

A

Environmental causes ~65% of cancer risk

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106
Q

What is inate vs acquired immunity

A

Inherited ves learned

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107
Q

How is type and screen blood held

A

places blood on “soft reserve” for low probability transfusion

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108
Q

How does aplastic anemia cause pathology

A

bone marrow becomes hypocellular as stem cells are replaced by fat

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109
Q

An platelet count less that 50,000 is a high risk for what..

A

Increased bleeding from surgery

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110
Q

What are the S/s of a major transfusion RXN

A

Fever, chills, back pain, dyspnea, RENAL FAILURE

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111
Q

Less differentiation in grading equals…

A

More aggressive tumor

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112
Q

What are the four imbalances that cause edema

A 
Imbalances in: 
Vascular pressure 
Permeability 
Oncotic pressure 
Lymphatic Drainage
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113
Q

What disorder is an error in protein metabolism, specifically errors in. Phenylalanine to tyrosine conversion

A

Phenylketonuria

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114
Q

What kind of edema can you drain with a needle

A

Localized edema in a BODY CAVITY

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115
Q

What is the most important and common cause of cell injury

A

O2 Deprivation

Hypoxia, anoxia

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116
Q

What is an intravascular thrombosis

A

Thrombus clot in an intact blood vessel

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117
Q

Which type of cell is least effected by chemotherapy and radiation

  • Labile
  • stable
  • permanent
A

Permanent

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118
Q

What is the most important and frequently encountered autosomal disorder in the US

A

Familial Hypercholesterolemia

Low-DensityLipoprotein(LDL)receptor deficiency on liver cells

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119
Q

Where does HIV replicate

A

Retrovirus – replicates via reverse transcriptase especially in T-lymphocytes

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120
Q

What are the 3 pathways of the complement system

A

Classical
Alternate
Lectin

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121
Q

What does chorionic villus biopsy in pre natal testing look for

A

Direct tissue sampling of placenta for chromosomal and enzyme analysis

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122
Q

What are the two types of Hemophilia

A 
Hemophilia A (factor VIII)
Generally mild bleeding problems, may be symptomatic

and

Hemophilia B (factor IX). 
Severe form w/ excessive bleeding even from minor injury
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123
Q

Chronic inflammation is most often associated with which WBC

A

Lymphocytes and macrophages

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124
Q

What is the definitive finding to diagnose Lupus

A

ANA

(Anti-nuclear antibodies) found by immunofluorescene microscopy

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125
Q

How can ATPases cause pathology

A

Speed up the depletion of ATP

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126
Q

What is a hypertrophic scar

A

Scar forms thicker than expected

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127
Q

Where do Arterial emboli originate from

A

Heart or large arteries

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128
Q

In an amniocentesis, where are the cells sampled from

A

Fetal cells obtained from fluid in the amniotic sac where the fetus is held during the pregnancy

Ultrasound is used to guide a large needle thought the abdomen into the amniotic sac

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129
Q

What are the three types of necrosis and which is the most common

A

Coagulative (Most common)

Liquefactive

Caseous

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130
Q

Does the alternate pathway involve antigen-antibody complexes

A

NO

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131
Q

What are the actions to take in a major transfusion RXNs

A

STOP THE TRANSFUSION

IV fluids to maintain UOP
IV Bicarbonate to alkaline the urine to reduce Hgb precipitation in the kidneys

Send donor and pt blood to LAB ASAP

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132
Q

What is the most significant complication of a venous emboli

A

Pulmonary Embolism

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133
Q

What are the specifics for
T1
T2
T3

A

T1- solitary tumor
T2- tumor <5cm
T3- At least one tumor >5cm

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134
Q

What are 4 examples of Type I hypersensitivity

A

Anaphylaxis
Allergic Rhinitis
Asthma (allergy induced)
Atopic dermatitis

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135
Q

What is the X linked recessive disorder that is amplification of a fragile portion on the X chromosome

A

Fragile X syndrome

  • mental deficiency
    Characteristic head and facial appearance
    Broad forehead, elongated face, large prominent ears, strabismus (cross eyed), high arched palette
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136
Q

Define teratogens

A

Agents known to cause fetal malformations

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137
Q

S/s of sickle cell

A

Persons <40% total HbS are often asymptomatic

Sickle Cell Crisis – triggered by fever, resp dz, phys exertion, dehydration

• Hemolysis of abnormal cells leads to anemia, jaundice and biliary stones

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138
Q

Most cancers occur in what stage of life

A

Mid to later years >55yrs

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139
Q

What are the 3 things needed to diagnose an auto immune disorder

A
  1. Auto-antibodies can be documented
  2. Immune mechanisms are causing pathologic lesions
  3. Evidence the disorder has an immune origin
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140
Q

Name that disease:

Onset >30yrs
Philadelphia chromosome
Three phases
(Blast Crisis Phase)

HIGH MORTALITY RATE

A

Chronic Myelogenous Leukemia

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141
Q

What are the clinical features of Acute Lymphoblastic Leukemia (ALL)

A
  • Lymph nodes enlarged & mild splenomegaly

* Rapid course - recurrent infections, malaise, bleeding into skin and major organs

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142
Q

What is the more common form of immunodeficiency

A

Acquired (secondary) Immunodeficiency

Immuno-suppression by chemotherapy or steroids

Diabetes

Bone marrow dysfunction

AIDs

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143
Q

What is the precursor to mast cells

A

Basophils

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144
Q

What is the presentation of classic hemophilia

A

Hemophilia A “classic hemophilia”
- Factor VIII

more common form, usually milder symptoms

Easy nose & oral bleeding

Bleeding into joints even from minor trauma Cerebral hemorrhage

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145
Q

What does the term “staging” mean with cancer

A

Determines the extent of tumor spread

Is more prognostic value that grading
Better at predicting 5yr survival

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146
Q

Basophils granules are rich in what chemical

A

Histamine

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147
Q

Define Hypoplasia

A

underdevelopment of tissue, organ, or entire body

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148
Q

What are three causes of JVD

A

HF

Cardiac Tamponade

Tension Pneumothorax

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149
Q

Define hyperplasia

A

Increased tissue or organ size due to an increase in the number of cells

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150
Q

Iron deficiency anemia is most common in ..

A

Women

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151
Q

Define hypertrophy

A

Increased size of tissues or organs due to enlargement of individual cells

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152
Q

What can lead to a folate (B9) deficiency

A

Pregnancy and Lactation
Or ETOH abuse
(Damage to the GI system)

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153
Q

Explain oncotic pressure imbalance in edema

A

Albumin in bloodstream helps hold fluid (H2O) inside blood vessels, if this becomes disrupted, fluid does not stay within blood vessel leading to edema

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154
Q

What are the 6 kinds of inflammation

A 
Serous 
Fibrous 
Purulent 
Ulcerative 
Pseudomembranous 
Granulomatous
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155
Q

What demographic does thalassemia effect most

A

Mediterranean and southeast Asian ancestry

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156
Q

Morphological changes help determine what.. .

A

The nature fo the disease and its progression

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157
Q

What are two examples of permanent cells

A

Non-dividing; lack capacity to replicate, New cells can not be formed; healing by fibrous scarring

QNeurons,myocardium

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158
Q

What are the 4 types of Normocytic anemia

A
  • Aplastic Anemia
  • Myelophthisic Anemia
  • SickleCellanemia
  • RBC loss or destruction

(MCV NORMAL)

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159
Q

In what stage of wound healing does epitheliazation occur

A

3rd stage

Proliferation

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160
Q

What is secondary polycythemia

A

Over-production of RBCs stimulated by increased erythropoietin release

• Usually from prolonged hypoxia – lung & heart dz; renal cell CA; adaptive for high
altitudes

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161
Q

What is the function of NK cells

A

Natural Killer Cells

Subset of T-cells without antigen receptors

– part of innate immunity present at birth

Do not require antigen-sensitization to recognize and kill virally infected cells and some cancer cells

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162
Q

What is the term for disorders only expressed by homozygous recessive pairs

A

Autosomal recessive disorders

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163
Q

What is 47XX +21 or 47XY +21

A

Trisomy 21

Down’s syndrome

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164
Q

What is 47XXY

A

Kleinfelters
Is a male phenotype disorder

Little to no sperm production
2* sex characteristics do not develop fully

  • Small penis with atrophic testes (infertility)
  • Scant pubic and body (axillary, facial hair) hair
  • Mild gynecomastia (partial breast development)
  • Facial features are eunuchoid
  • unclear gender characteristics ; little to no facial hair
  • Body habitus – tall height w/ unusually long arms/legs
  • Abnormal body. proportions (long legs & short trunk)
  • Potential learning disabilities
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165
Q

Which cells are most effected by chemotherapy and radiation therapy

  • labile
  • stable
  • permanent
A

Labile

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166
Q

Describe metastatic calcification

A

Occurs in normal (healthy) tissues

Other disease process creates a secondary hypercalcemia

Example: Hyperparathyroidism, Multiple Myeloma

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167
Q

Prostate-Specific antigen (PSA)

Is a tumor marker for cancer where?

A

Prostate

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168
Q

The classical complement pathway starts with….

A

And antigen antibody complex

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169
Q

What is the most reliable feature separating malignant from benign tumors

A

Is the tumor invasive or not

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170
Q

What are the two types of thalassemia

A

Alpha Thalassemia – alpha chain defect; less severe (often termed Thalassemia minor or trait)

• Beta Thalassemia – beta chain defect; severe lethal form

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171
Q

How does PKU effect children/ infants

A
  • By 6 months old, phenylalanine excess affects developing CNS-mental retardation, seizures, etc
  • Excess phenylalanine inhibits melanin synthesis – children have fair skin & hair, blue eyes
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172
Q

Which part of the Anitbody is Specific & Unique to each immunoglobulin class

A

The heavy Chain

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173
Q

What is the pilocarpine test

A

Diagnosis for cystic fibrosis

Sweat chloride test

Pilocarpine solution and electrical current applied to skin surface triggers excessive NaCl excretion into sweat

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174
Q

What are three types of Ionizing radiation

A

Alpha, Beta, Gamma

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175
Q

What are the risk factors for a DVT

A 
Inactivity (blood stasis) 
Smokers 
Pregnancy 
Contraceptives 
Cancer 
Previous Hx of Thrombosis 
Advanced Age
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176
Q

What is signifigant about Rh and pregnancy

A

A Rh neg mother birthing a Rh pos baby

She creates Ab, and if she has a second Rh pos baby, then there will be complications

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177
Q

What are the clinical characteristics of cystic fibrosis

A
  • Pulmonaryinfections–pneumonias

* Pancreatic insufficiency -malnutrition/ malabsorption

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178
Q

What is the Temporary & orderly change of one cell type to another (along same cell line)

A

Metaplasia

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179
Q

How does the body maintain normal BP during compensated shock

A

Tachycardia
Vasoconstriction
And reduced UOP

180
Q

Describe the 2nd step of wound healing

Inflammation

A

Begins shortly after injury; blood vessels leak into wound

Localized swelling

Controls bleeding and prevents infection

181
Q

Describe dystrophic calcification

A

Occurs in damaged, dying or dead tissues
•May occur even with normal calcium blood levels
• Encountered with any type of necrosis
• Example: atheroma of advanced atherosclerosis

182
Q

What is needed to cure chronic idiopathic thrombocytopenia purpura

A

Splenectomy

183
Q

What is the most common cause of inflammation

A

Infections (duh)

  • bacterial
  • viral
  • fungal
  • parasitic
184
Q

What are oncgenes

A

Genetic cause of cancer that Arise from damaged or mutated normal genes

Allows uncontrolled cell growth and poor differentiation

185
Q

What percentage of pediatric inpatients with have a genetic disorder

A

20%

186
Q

Name and define the Lymphoid Cells

A

Non Granulated WBC w/ Large dense nucleus

  • Lymphocytes (T & B cells)
  • Natural Killer cells
187
Q

What demographic is most effected by Chronic Lymphocytic Leukemia

A

Older patients older than 50

188
Q

What are the 4 stages of wound healing

A
  • hemostasis
  • inflammatory
  • proliferative
  • remodeling
189
Q

Name that disease:

Onset > 50 y/o 
Slowly progressive 
Increased Infxs 
Survive 7-9 years 
No response to Chemotx
A

Chronic Lymphocytic Leukemia

190
Q

90 percent of pts with Chronic Myelogenous Luekemia have what chromosomal defect

A

Philadelphia chromosome 22 abnormality

191
Q

How do most patients w/ aplastic anemia die

A

Uncontrollable infections and bleeding and

From overwhelming sepsis

192
Q

What is the most preventable teratogen

A

Alcohol!

193
Q

What is becks triad

A

Hypotension

Muffled Heart Sounds

JVD

194
Q

What is a notorious post-op killer of otherwise healthy Pts?

A

PE

Pulmonary embolism

195
Q

How does Ionizing radiation cause cancer, and what tissues are most susceptible

A

Creates free radicals

Most susceptible:
stem cells

hematopoietic (blood-forming)

reproductive organs

epidermis of skin & intestine

fetal tissue
(esp 1st trimester rapid organogenesis)

196
Q

What are the later S/s of Hypovolemic shock

A

Low BP

Confusion/ AMS

197
Q

What are the clinical features of Hodgkin’s Lymphoma

A

large nodes, especially in neck and mediastinum

• Reed-Sternberg cells - multi-lobed nucleus surrounded by clear halo (“owls eye”)

Bimodal peaks at ages 25 and 55

198
Q

What is the most common paraneoplastic syndrome.

Indirect indicator of possible cancer

A

Hypercalcemia

199
Q

Sweating from the skin contain…

Water loss from respiration contains..

A

Water and electrolytes

Pure water vapor only

200
Q

What is the difference between petechia, púrpura, and ecchymosis

A
  • Petechiae – pinpoint red spots
  • Purpura – larger reddish or purple spots
  • Ecchymosis – bruise, contusion

(ALL THREE DO NOT BLANCH)

201
Q

What does lymphocytosis suggest

A

Viral infection or chronic infection (TB)

202
Q

What is myelophthisic anemia

A

replacement of bone marrow by cancers, fibrosis, or granulomas

• Examples: leukemia; multiple myeloma

203
Q

Define aplasia

A

entire organ mass composed of primordial/rudimentary tissue

204
Q

What are the three subtypes of non Hodgkin’s lymphoma

A

Folicular

Dioffuse Large B cell Lymphoma

Burketts lymphoma

205
Q

What is the order of events from Metaplasia to cancer

A

Metaplasia → Dysplasia → Neoplasia (irreversible)→ Cancer (irreversible)

206
Q

Clinical characteristics: Familial hypercholesterolemia

A

Atherosclerosis and HD

Xanthomas- lipid rich, yellow-brown nodules or plaques
Deposits on eyelids are highly characteristic

207
Q

What is anasarca

A

Fluid accumulation throughout the body

Edema is evident in many body location s

-typically due to heart, liver, or kidney failure, or extremely poor diets

208
Q

Describe the LOX pathway

A

LOX produces Leukotrienes - promote chemotaxis (call in WBCs) & increase vascular permeability •

Lipoxins – act at end of inflammatory phase; signal phagocytosis (clean up) of dead cells

209
Q

What are the S/s of a tension Pneumo

A

Increased RR and Air Hunger
(Progressive respiratory distress)

JVD

Tracheal Deviation
(Seen on X-ray, late late sign when seen anatomically)

210
Q

What is leukopenia

A

WBCs below normal levels

  • Rare; often induced by cytotoxins especially during chemo/rad therapy for cancers
  • High risk for overwhelming infections
211
Q

What is a pericardial effusion

A

Fluid in the pericardium

212
Q

Define congenital disorders

A

present at birth, but NOT always genetic

213
Q

Inflammation can occur in organisms capable of…

A

neurovascular & cellular response to injury

214
Q

What is the most common type of emboli

A

Thromboemboli (blood clots, free floating fragments from thrombi)

215
Q

What are examples of Labile cells

A

(Easily regenerate for wound healing)

-skin, GI tract, hematopoietic
blood-cell-forming

216
Q

What are the three types of microcytic anemia

A
  • Iron deficiency
  • Thalassemia
  • Spherocytosis

(MCV IS DECREASED)

217
Q

What X linked recessive disorder has a defect with dystrophin protein in muscle cells

A

Duchenne’s muscular dystrophy

-leads to progressive muscular wasting and weakness

218
Q

Describe Hemophilia

A

defect in coagulation factor which results in bleeding disorder.

219
Q

What are the characteristics of malignant tumors

A

Easily spread to other tissues

Invade and destroy structures

Grow very fast with little to no differentiation (Anaplasia)

220
Q

What does MHC measure

A

Mean Corpuscular Hemoglobin

= avg hemoglobin amount per RBC

221
Q

What causes wound dehiscence

A

Too much tension of wound edges

222
Q

When do Macrophages appear in acute infections

A

3-4 days after onset of infection or tissue destruction

223
Q

What is hereditary spherocytosis

A

RBC disorder in caucasians

Structure protein defect! Not an iron issue

produces smaller & less flexible RBCs captured and lysed by the spleen

224
Q

What is the most aggressive form of non Hodgkin’s lymphoma

A

Diffuse Large B-cell Lymphoma - most aggressive form but most responsive to tx

• Complete remission in 75% w/ 50% may remain disease free for several yrs

225
Q

How is the alternate complement system activated

A

Bacterial/ fungal endotoxins, snake venoms

226
Q

What is the most common acute leukemia in adults (average age 65)

A

Acute Myelogenous Leukemia (AML)

(radiation and benzene)

  • Proliferation of myeloblasts = immature bone marrow cells
  • Blast cells take over marrow and “choke out” normal stem cells
227
Q

Neoplastic cells can be killed but not _______

A

Repaired

Neoplasia is irreversible

228
Q

What is an example of metaplasia

A

Barrett’s esophagus

229
Q

What does MCV measure

A

Mean Corpuscular Volume

= avg volume (size) per RBC

230
Q

Transudative fluid is the result of what four factors

A

Increase vascular pressure ( pushes fluid out of vessels)

Increased permeability
(Allows for fluid to leak out of cells easily)

Decreased oncotic pressure
(Fluid is not held in vessels, loss of gravity)

Decrease Lymphatic drainage
(Interstitial fluid is not removed properly)

231
Q

Risk of metastasis in increases with what four factors

A

Aggressive local invasion

Lack of differentiation

Rapid Growth

Large Size

232
Q

What is the single most importation environmental factor for cancer risk

A

Smoking #1

Alcohol #2

233
Q

What is the opposite of anemia

A

Polycythemia

234
Q

What effect do steroids have on wound healing

A

Anti-inflammatory effects may weaken scar formation

235
Q

What medication is contraindicated in vWF disease

A

Asprin

236
Q

What is ascites

A

Abnormal amount of fluid in abdominal cavity

237
Q

What are the 4 types of prenatal diagnosis

A

Ultrasound

Maternal blood analysis

Chorionic Villus Biopsy

Amniotic Fluid Analysis

238
Q

What is 45XO

A

Turners syndrome

Female phenotype disorder

  • 2° sex characteristics do not fully develop at puberty
  • Amenorrhea with atrophic ovaries (infertility)
  • Genitalia, vagina & uterus does develop normally
  • Wide out set nipples with rudimentary breast buds only
  • Body habitus – short stature
  • Webbed (broadened) neck
  • Cubitus Valgus arms angle out ward at elbows
  • Heart defects common – Coarctation (stricture) of Aorta
239
Q

What disorder Produce abnormally thick mucus secretions blocking airways and pancreatic ducts

A

Cystic Fibrosis

240
Q

What are two examples of stable cells

A

Rarely self-divides; can be stimulated to replicate as needed
– Kidney (proximal renal tubules)
-Liver – can regenerate to some extent

241
Q

Describe contracture Vs stricture

A

Contracture, linear scars become shorter

Stricture, circular scars become smaller

242
Q

What are the clinical S/s of systemic inflammation

A 
Fever 
Leukocytosis 
Increased HR and BP 
Decreased sweating 
Anorexia 
Somnolence
Malaise
243
Q

Prostacyclin acts to counteract

A

The COX pathway
(Prostaglandins and Thromboxane)
From getting out of control

244
Q

What are two examples of COX pathway inhibitors

A

ASA (Asprin), NSAIDS

Inhibit prostaglandins and thrmboxane

245
Q

Define atresia

A

absence or closure of body opening or tubular structure

lacks hollow portion / lumen

246
Q

When is Rhogam given to a suspecting mother

A

Typically twitching 12 hours of delivery

Prevents mother from developing Anti Rh antibodies

247
Q

Pts with Chronic myelogeneous luekemia usually die within,….

A

3-5 years

248
Q

What are the three morphologies of anemia

A
  • Microcytic
  • Normocytic
  • Macrocytic
249
Q

What are the first WBC to appear in an acute inflammation

A

Neutrophils

250
Q

Fibrinous inflammation is most indicative of

A

Bacterial infections

251
Q

What are the two types of wound healing repair techniques

A

First or primary intention

And secondary intention

252
Q

What is the pathogenesis of chronic lymphocytic leukemia

A

Slowly progressive; most survive 7-9 yrs

• Increased infections because neoplastic lymphocytes do not fight infx as well as neutrophils

253
Q

What is the role of CD4 Cells

A

• Part of antigen response
→Help B-lymphocytes produce antibodies

Secrete cytokines (interleukin)

Stimulate macrophages to become phagocytic

Trigger IgE and other immunoglobulins to activate eosinophils & basophils

254
Q

How much urine output is required to clear the byproducts of metabolism

A

500-800 ml/day

255
Q

Describe Lymphangitis

A

infection spreading along the lymphatic vessels; seen as red streaks (blood poisoning)

256
Q

Human chorionic Gonadotropin (HCG)

Is a tumor marker for cancer located where?

A

Testicle

257
Q

Define involution failure

A

persistence of embryonic structures; normally lost during development

258
Q

What does megaloblastic anemia do to RBCs and WBCs

A

Macrocytic RBCs & hypersegmented WBCs

259
Q

What would a tumor thats <2.3 cm, with Positve lymph nodes, and no metastisis be in the TNM staging

A

<2.3= T1
Positive lymph node= N1
No meta= M0

260
Q

What is the ratio of Na/K in the extracellular vs the intracelluar fluid

A

Extracellular: high NA low K

Intracellular: low NA high K

261
Q

What causes cells start rapid proliferation in epithelization

A

Contact inhibition

262
Q

Granulomatous inflammation is most associated with

A

Chronic inflammation not acute

TB, fungal, parasites

263
Q

What is the normal CD4/CD8 ration and what is the ratio in AIDs pts

A

normally, CD4 outnumber CD8 by 2-4:1

with AIDS, ratio often drops to 0.5:1 or less

264
Q

Group B blood has what Ag and what Ab

A

B Ag

Anti A Ab

265
Q

Which organ is particularly vulnerable to fibrotic scarring

A

The spleen

autospleenectomy

266
Q

How can you treat polycythemia

A

Cytotoxic drugs

• Therapeutic phlebotomy (blood letting)

267
Q

What are the two primary lymphoid tissues

A 
Thymus (T cells) 
Bone Marrow ( B cells)
268
Q

What does the term aneuploid mean

A

cells possessing an abnormal number of chromosomes

269
Q

H. Pylori causes

A

Peptic ulcers which can lead to adenocarcinomas

270
Q

What is Lymphadenopathy

A

enlarged lymph nodes
reacting to an inflammatory or infection trigger

If slowly enlarging, persistent, and non-tender – possible early cancer

271
Q

What does thrombotic thrombocytopenia purpura cause

A

Abnormal clotting in small vessels

microangiopathy

RBCs subjected to stress in narrowed vessels—

272
Q

What is the prominent clinical presentation for polycythemia

A

Splenomegaly

273
Q

What are two types of radiation causes of cancer

A

UV light Radiation

And

Ionizing Radiation

274
Q

Alpha-fetoprotein (AFP)

Is a tumor marker for cancer where?

A

Liver and Testicle

275
Q

Eosinophils are associated with what kind of reaction

A

Allergic reactions and parasitic infections

276
Q

What is the clinical sign of Muliptle Myeloma

A

Surrounding bone destruction creates ‘punched-out’ appearance

• Calcium released from bones

277
Q

What does CAUTION stand for

Possible signs of cancer

A

C• Change in bowel or bladder habits

A• A sore that does not heal

U• Unusual bleeding or discharge

T• Thickening or a lump in breast or elsewhere

I• Indigestion or difficulty swallowing

O• Obvious change in wart or mole

N• Nagging cough or hoarseness

278
Q

What do mature RBCs and platelets lack..

A

A nucleus

279
Q

What are the two distinctions of gangrene

A

Wet and Dry gangrene

280
Q

Name that disease:

One set Bimodal age peaks

Neck and mediastinal nodes
Reed Sternberg cells

80% survival rate

A

Hodgkin’s

281
Q

What are disorders called that skip generations

A

Familial Disorders

Frequently are NOT inherited according to Mendelian genetic rules

282
Q

How can you tell the difference between thalassemia and Iron deficiency

A

With electrophoresis that identifies HbA2

283
Q

What is liquefactive necrosis

A

Tissues dissolve; most often in brain

Lytic enzymes transform tissue into pus within an abscess

284
Q

What are two examples of Type II hypersensitivity

A 
Graves Disease (Thyroid) 
Hemolytic Anemia (RBCs)

Autoimmune disorders

285
Q

What is a carcinoma

A

A cancer of epithelial origin

Skin, GI, GU, Lung

286
Q

TORCH syndrome impacts which organ systems

A

Multiple

  • Brain -mental retardation ,neurologic symptoms
  • Eyes - small size, cataracts
287
Q

The Ab are found in what component of blood

A

Mostly in the plasma

288
Q

Platelet counts below 20,000 can result in…

A

Spontaneous bleeding

289
Q

Expectant mothers older than 35 should receive prenatal counseling for what disorder

A

Trisomy 21

290
Q

What are the two types of inflammation

A

Acute vs Chronic

291
Q

What is the difference between transudative and exudative edema

A

Transudative: clear serous fluid w/ low protein content & little to no cellular material
(Low specific gravity, clear)

Exudative: cloudy, pus-like fluid w/ high protein content, WBCs and cellular debris
(Has thick proteins, and is not clear, purulent)

292
Q

What gives rise to the presenting signs and symptoms of the patient

A

The pathology of the disease

293
Q

What are the three phases of progression in Chronic Myelogenous Leukemia (CML)

A

Chronic phase – lasts 2-3 yrs w/ marked leukocytosis and thrombocytosis

Accelerated phase – increased blast production from marrow

Blast Crisis phase – usually heralds death

294
Q

What is hematochezia

A

Bloody stools

295
Q

How can phospholilapses cause pathology

A

cause membrane damage

296
Q

How does the lectin complement system get activated

A

starts with carbohydrate binding on bacterial surface

297
Q

What is leukocytosis

A

WBCs above normal levels

  • Normal response to inflammation or infection
  • Persistent leukocytosis may represent early malignancy
298
Q

Acute inflammation is associated most with what WBC

A

Neutrophils

299
Q

Describe Type III hypersensitivity

A

Antibodies are formed as part of an ‘appropriate’ immune response

However, antigen-antibody complexes incorrectly deposit in/on other structures

Immune complexes become trapped in semi-permeable membranes

• Accidently activates complement system→recruits WBCs→resulting in cell damage

300
Q

What is aplastic anemia

A

Loss of stem cells from bone marrow.

Results in pancytopenia
decreased production of all blood cell lines

301
Q

75% of congenital defects are…

A

Idiopathic

302
Q

Explain Ischemia-reperfusion injury

A

Tissue damage occurring after re-establishing blood flow to an ischemic area

Lack of blood flow causes decrease O2 @ cellular level,
Na-K pump fails,
Permeability increases and cells swells
Free radical precursors are released

Blood flow is restored 
Damage cell leaks out toxic contents 
Neutrophils attack and destroy cells 
O2 activates free radical precursors
More damage is caused
303
Q

What describes how a disease develops

A

The pathogenesis

304
Q

What are the three mechanisms of shock

A 
Pump failure  (cardiogenic shock) 
(The hypoperfusion is directly related to the heart failing to pump) 
Volume problem ( Hypovolemic shock) 
(The hypoperfusion is directly related to an insufficient volume in the vessels) 
Pipe problem ( hypotonic shock/ distributive shock) 
(The hypoperfusion is a result of a loss of vascular tone)
305
Q

What are the 5 types of decreased hematopoiesis anemia

A
  • AplasticAnemia
  • Myelophthisic Anemia
  • Iron deficiency
  • B12 & Folate deficiency
  • Protein deficiency
306
Q

Exudative fluid arrises from what factor

A 
Increase permeability 
(Allows larger proteins and molecules to get out of the vessel into the interstitium)
307
Q

What are 5 known carcinogenic agents

A 
Chemical 
Microbial 
Viral 
Radiation 
Genetic
308
Q

Define: genome

A

The complete set of chromosomes

309
Q

spontaneous abortions (miscarriage) often during 1st trimester without woman’s knowledge are often the result from

A

Morphogenesis

310
Q

What percent is fluid of Total Body weight

A

60%

311
Q

What is the pathogenesis of cystic fibrosis

A

Dysfunction in chloride transport

Mucus w/ less NaCL will also have less H20

Thicker mucus clogs the lumen of many organs

312
Q

What is the WBC prominent associated with IgE

A

Basophils

313
Q

Cellular hypoxia leads to…. Which in then leads too..

A

Decreased production of ATP, which leads to failure of the Na-K pump

314
Q

Clinical Characteristics of Trisomy 21

A

Mental Retardation – most significant feature
intellectual disability ranges widely

Facial Features – wide face, low nose, slanted eyes w/ epicanthal folds

macroglossia (enlarged tongue) often protruding

Abnormal Extremities – hands w/ ‘simian’ crease; shortened limbs; 5th finger shorter

Internal Organ Defects – heart defects; GI tract atresia/stenosis; infertility (Males > Females)

Hematologic Abnormalities – anemia; predisposition for leukemia

315
Q

What causes con wilderbrands disease

A

Deficiency of Von Willebrand’s factor (vWF)

• vWF helps platelet adhesion and stabilizes clotting Factor VIII - making it last longer

316
Q

Explain permeability imbalance in edema

A

Higher permeability allows more fluid to leak out of blood vessels leading to more edema

317
Q

What are the indirect indicators of possible cancer

A

Hypercalcemia

Hyper coagulation

318
Q

Cancer Antigen 125 (CA125)

Is a tumor marker for cancer where ?

A

Lung Breast, ovary, and pancreas

319
Q

What is the marked S/s of irreversible shock

A

Circulatory collapse
MARKED hypoprofusion

Hypotension, RR failure, acidosis, anuria, DIC

320
Q

Napthylanmine dyes cause

A

Bladder cancer

321
Q

How can proteases cause pathology

A

Break down membrane and cytopskeltal proteins

322
Q

What can ultrasound be used for in prenatal testing

A

non-invasive, widely available, & inexpensive

• Look for fetal malformations & placenta development/placemen

323
Q

What are the three major steps to inflammation

A

Dilation
Increased permeability
Emigration of Leukocytes

324
Q

What are the three pathways of metastatic spread

A

Hematogenous spread

Lymphatic Spread

Direct seeding of body cavity surfaces

325
Q

Aflatoxin (from aspergillus fungus) causes

A

Liver cancer

326
Q

What are the three general etiologies of Hypotonic/ Distributive Shock

A
  1. Sepsis
  2. Anaphylaxis
  3. Neurogenic trauma
327
Q

Purulent inflammation arises form

A

Pus forming bacteria

328
Q

In what gender are X linked recessive disorders expressed in

A

Expressed in males only.

Females only carry the X-linked trait.

329
Q

Describe Type IV hypersensitivity

A

Mediated by Previously Sensitized Cells
(T-lymphocytes and macrophages)

Antibodies are NOT involved

Macrophages take up antigen and present antigen to T-lymphocytes

330
Q

What are paraneoplastic syndromes

A

May be an early sign of occult (hidden) neoplasm

  • hypercalcimia
  • hyper coagulation
331
Q

What is the most common form of anemia

A

Iron Deficiency Anemia

332
Q

What is the process of phenylketonuria

A

Phenylalanine is not metabolized causing phenylalanine to accumulate, which then breaks down into phenylketones, which is then secreted in the urine.

333
Q

What are 3 clinical examples of type III hypersensitivity

A

Lupis (SLE)
Post streptococcal Glomerulonephritis
Polyarteritis nodosa

(Autoimmune disorders)

334
Q

What kind of non hogskins lymphoma is endemic in children with EBV

A

Burkitts Lymphoma

Involves mandible & face; responds well to chemotx

335
Q

What is the difference of Hypoxia/ Anoxia and Ischemia

A

Hypoxia/ Anoxia is a reduced or lack of O2 specifically

Where ischemia is insufficient blood flow to an area and causes more damage as tissue lacks both O2, nutrients, and results in an excess of waste build up

336
Q 
Grade X: 
Grade I: 
Grade II: 
Grade III: 
Grade IV:
A 
X: unknown 
I: well differentiated, low grade 
II: moderately differentiated 
III: poorly differentiated 
IV: undifferentiated, High grade
337
Q

What Ig mediates Type II hypersensitivity

A

IgM and IgG

Antibodies bind to antigens in/on cells or tissue component
Gets confused,

Activates complement system→Membrane Attack Complex (MAC)→Cell Lysis (Cytotoxicity)

338
Q

What is the gene defect in Hemophilia

A

Gene defect of coagulation factors;

50% are X-linked & 50% are spontaneous mutations

339
Q

What are the secondary lymphoid tissues

A

Lymph nodes (tonsils and adenoids)
Spleen
GI and Bronchial Mucosa (MALT)

340
Q

What are the clinical features of Idiopathic Thrombocytopenia Púrpura

A

Petechiae or

  • Easy bleeding from nose or gums
  • Splenomegaly common - sequestration of platelet-antibody complexes
341
Q

What is the defection sickle cell anemia

A

Defect w/ hemoglobin synthesis produces Hemoglobin S (HbS)

342
Q

What are the clinical features of non Hodgkin’s lymphoma

A
  • Painless lymph node enlargement, may be solitary or diffuse
    • Extra-nodal tumor spread – tumor cells infiltrate major organs
  • Systemic symptoms – fatigue, malaise, fever, sweating
343
Q

Explain Vascular pressure imbalance in edema

A

– mostly impacts the venous return system

Increased hydrostatic pressure pushes fluid outside blood vessels leading to more edema

344
Q

S/s for Thrombotic thrombocytopenia purpura

A
  • Purpura and ecchymosis; bleeding from nose or gums
  • Hemolytic anemia – leads to anemia, jaundice
  • Small vessel disease affects brain, kidneys, eyes
345
Q 
What happens if an embolus gets lodged in the 
Brain- 
Intestine- 
Kidney- 
Lower Extremity-
A
  • Brain – ischemic stroke or infarction
  • Intestine – bowel (mesentery) ischemia or infarction
  • Kidney – infarcts w/ hematuria

• Lower Extremity
-Tiny emboli - “blue toe” necrosis
-Large emboli - ischemia of tissues
cold, pulseless leg

346
Q

What is the most common lethal autosomal disorder

A

Cystitis fibrosis

347
Q

What is the tx for Acute Lymphoblastic Leukemia (ALL)

A

With modern chemotherapy, remission achieved in ~66%

  • without chemotherapy – usually fatal in 3-6 months
  • Prognosis is better for children than adults
348
Q

Where is a common spot for DVT

A

Deep vein thrombosis typically occurs in the legs or pelvis

349
Q

What are the three types of chromosomal structural abnormalities

A

Deletion
Inversion
Translocation

350
Q

What area is most often effected by direct seeding metastatic spread?

A

Most often seen in the peritoneal cavity

351
Q

What are 4 causes of cardiogenic shock

A

MI
Vfib
Pericardial Tamponade
Tension Pneumo

352
Q

Oncogenes created by 4 main mechanisms:

A
  1. Point Mutation
  2. Gene Amplification
  3. Chromosomal Rearrangement (Translocation)
  4. Insertion of Viral Genome
353
Q

Chrons disease, celiacs, GI ulcers, gastric bypass pts, can all lead to what type of anemia

A 
Megaloblastic anemia 
(B12 deficiency)
354
Q

Generally, Tumor Markers are NOT recommended for routine screening
With what Exception:

A

Prostate-specific antigen is used for prostate cancer screening

355
Q

Define Atrophy

A

Decreased size or growth of tissue or organ often w/ diminished fxn

356
Q

Histamine is released form what cells

A

Mast cells, basophils, and platelets

Preformed

357
Q

Nuclear pathology results in failure of:

A

protein & enzyme synthesis; growth regulation, mitosis

358
Q

Describe Lymphadenitis

A

lymph node itself is infected usually forming an abscess

359
Q

Due to their rapid growth malignant tumors are..

A

Poorly demarcated, lacking a defined wall or capsule

And

Invasive, penetrating the surrounding tissue.

360
Q

What is the presentation for Christmas Disease

A

Hemophilia B “Christmas Dz”
– Factor IX (Christmas factor)
Less common but often more severe form

Easy nose & oral bleeding

Bleeding into joints even from minor trauma Cerebral hemorrhage

361
Q

What type of blood would be used in an emergency situation

A

O RBCs

362
Q

A male with Iron deficiency anemia should be suspected for what

A

GI ulcer or Cancer

363
Q

How are X-linked recessive disorders transmitted

A

Mother’s transmit disorder only to sons

Fathers w/ disease transmit trait to daughter.

FATHERS DO NOT TRANSMIT DISORDER TO SONS

364
Q

What is the body’s first response to injury

A

Vascular changes (dilation)

365
Q

What is the approx liters of water a day for intake

A

2.5 liters per day

75% from oral
25% from solid foods

366
Q

What is the most signifiant feature of trisomy 21

A

Mental retardation

367
Q

Ulcerative inflammation is from

A

Surface tissue breakdown from underlying inflammation

Body surfaces/ mucosa

368
Q

What are the two classes of pathogenesis

A

Genetic and acquired

369
Q

Group O is known as the …

Group AB

A

O is the universal donor because it has no antigens

AB is the universal recipient because they have no Ab

370
Q

Iron deficiency anemia, canses RBCs to be…

A

Microcytic and Hypochromic

Smaller and less color

371
Q

What does MCHC measure

A

Mean Corpuscular Hemoglobin Concentration

= avg conc of hemoglobin/RBC

372
Q

How is Rh Ab formed

A

Only formed when Rh neg pt is exposed to Rh pos

373
Q

Describe the 4th step in wound healing

Tissue remodeling

A

Maturation phase
(begins 21 days after injury)

Collagen is remodeled

Wound closes however subsurface remodeling continues

Full strength achieved after several months

374
Q

What are 2 types of Macorcytic Anemia

A

b12 or folate deficiency

MCV ELEVATED

375
Q

Slowly enlarging and persistent non tender lymph nodes is a warning sign for…

A

Cancer

376
Q

What is the action of bradykinin

A

It’s a plasma derived acute inflammation mediator

Simular to histamine, but slower

Amplifies and prolongs inflammatory response

Capable of inciting pain

377
Q

What are the 3 main functions of the complement system

A

Prolongs Inflammation
Phagocytosis through opsinaization
Cell Lysis through MAC attack

378
Q

What are the clinical features/ S/s of DVT

A

Pain
Warmth
And Color changes

(Changes are seen unilaterally)

379
Q

What is virchows triad of thrombosis

A
  1. Injury to endothelium
  2. Hemodynamics changes in vein
  3. Hypercoagulable state
380
Q

What is the highest risk of blood compatibly reaxns

A

Whole blood transfusions

Minor are from preservatives not front he blood

381
Q

What is the normal ration of CD4 to CD8 cells

A

Normally,

CD4 outnumber CD8 by 2-4 to 1

382
Q

What are the three causes of iron deficiency anemia

A 
Increased Iron Loss ( blood loss) 
Decreased Iron uptake 
(poor diet, absorption) 
Increased Iron requirement
(Pregnancy, menses, surgery)
383
Q

What determines a persons observed phenotype

A

Expressed genotype + Environmental influences

384
Q

What are the two most frequently involved organs with hematogenous metastatic spread

A

Liver and the Lungs

385
Q

What is thrombocytopenia

A

Abnormal low platelet count

386
Q

How is cross-matched blood kept

A

held specifically for that patient only

387
Q

What does the acronym TORCH stand for

A

Used for Microbial teratogens

T-Toxoplasmosis (parasite from cat feces)
O – Other less common microbes Epstein-Barr, Varicella, Listeria
R-Rubella (German measles)
C-Cytomegalovirus (CMV) (common human virus)
H-Herpes Virus

388
Q

What is Chronic Myelogenous Leukemia (CML)

A

Bone marrow becomes overgrown w/malignant cells

90% w/ Philadelphia chromosome 22 abnormality

Most patients are older than 30yrs

389
Q

What are the the S/s of polycythemia

A

Splenomegaly is prominent feature

  • Skin appears dark red or flushed
  • Blood is hyper-viscous & tends to clot easily
  • Headaches, hypertension, visual and neurologic problems
390
Q

What is the S/s of minor transfusion RXNs

A

Urticaria, fever, bronchospams

391
Q

What are the 5 causes of “loss or destruction” of RBCs anemia

A
  • Bleeding (acute/chronic)
  • Malaria
  • Hemolytic anemia
  • Medications
  • Spleen Sequestration
392
Q

What is considered the hallmark of malignancy

A

Anaplasia

Lack of differentiation

393
Q

Parasites such as Schistosoma haematobium are associated with what type of cancer

A

Bladder cancer

394
Q

Hypertrophy can only occur in what type of muscle

A

Heart and striated

395
Q

What does the term Neoplasia mean

A

“New Growth”

Neoplasms or tumors

NOT necessarily cancer

Can be Benign or Malignant
(example:wart vs. melanoma)

396
Q

What happens if enzymes

(from lysosomes) accidentally leak within a cell

A

Injured cell cytoplasm becomes acidic; inappropriately activating enzymes

Once activated, the enzymes cause significant cell damage

397
Q

Malignant cells regress to…

A

Fetal/ embryonic functions of that cells line

398
Q

Hyperplasia is usually the result of what

A

Hormonal stimulation , mediations, or chronic injury

399
Q

What is the Disorderly transition, arrangement and layering of cells types and is often considered precancerous

A

Dysplasia

400
Q

Arsinic causes

A

Skin cancer

401
Q

What are the 5 types of Morphogenesis

A 
Agenesis 
Aplasia 
Atresia 
Hypoplasia 
Involution failures
402
Q

What is the most common form of leukemia in children esp under age 5

A

Acute Lymphoblastic Leukemia (ALL)

  • bone marrow w/ immature lymphoid cells (blasts)
  • malignant lymphoid cells in peripheral blood
403
Q

Define: Karyotype

A

the full chromosome set contained within a nucleus.

Often referred to as chromosomal count/code - 46XX (human female), 46XY (human male)

404
Q

What is the difference between a pulmonary infiltrate and a pleural effusion

A

In an infiltrate the fluid has infiltrated the tissues (it is IN the tissue)

In an effusion, is it AROUND the tissue.

405
Q

Name and define the Myeloid Cells

A

Granulated WBCs / Complex Nucleus

  • Neutrophils, Eosinophils, Basophils
  • RBCs and Platelets
406
Q

What is a major physical teratogen

A

Radiatio

Medical X-rays

407
Q

What is the normal urine output per day

A

1-1.5 liters per day

408
Q

How do cyanide disrupt oxidative phosphorylation

A

Disrupts the Cytochrome C oxidase step

Decreases atp production, leads to cellular hypoxia

409
Q

What is the result of Na-K pump failure

A

Na osmotically “tries” to get into the cell, but pump prevents this

If pump fails, then too much Na and water enter cell

Resulting in cellular edema, dysfunction, and possible lysis

410
Q

Which is worse Hemophilia A or B

A

B is worse w. Excessive bleeding

411
Q

Oxidative phosphorylation leads to…

A

ATP production, and energy for the cell

412
Q

Group A blood has what Ag and what Ab

A

A-Ag

Anti-B Ab

413
Q

Is Rh and dominant or recessive gene

A

Dominant

414
Q

What leads to a Vaso-Vagal episode

A
  1. Deep brainstem activated by triggering stimuli
    (sight of blood; extreme emotional distress)
  • Enhanced parasympathetic (vagal) tone→sudden bradycardia (nausea, diaphoresis)
  • Decreased sympathetic tone→sudden vasodilation (blood pressure drops, pallor)
    2. Combination of sudden bradycardia and hypotension decreases the cardiac output
    3. Brain becomes under perfused→syncope (faint)
415
Q

What is the largest percentage of cancer deaths in men and women

A

Lung and bronchus cancers

416
Q

What is the most common clinical form of Type IV hypersensitivity

A

Contact dermatitis

417
Q

Serous inflammation is most indicative of

A

Physical agents

Burns, poison ivy

418
Q

What are the lab value levels for anemia in men and women

A

Anemia Levels:
M < 13 g/dL
F < 11.5 g/dL

419
Q

What are the criteria for SLE (Lupus)

A

SLE Criteria:
(4 or more required for diagnosis)
• Dermatitis - Malar rash and discoid rash
• Arthritis - Non-erosive arthritis in 2 or more peripheral joints
• Nephritis-Renal disorders foundin >50% of SLE patients
• Serositis - Pleuritis, pericarditis
• Neuritis–varietyofneurologicdisorders
• Vasculitis
• Hematologicdisorder-hemolyticanemia,leukopenia,lymphopenia

420
Q

Pseudomembranous inflammation is most associated with

A

C. Diff

421
Q

Interstitial space is often called …

A

“Third space”

Space between cells, not within vessels, cells, or body cavities

422
Q

Is chemo effective for pts with multiple myeloma

A

No, death within 3-4 years

423
Q

Name that disease:

Onset Any age
Painless lymph node
Extra nodal tumor spread

Variable survivability

A

Non-hodgkins

424
Q

What is the most common outcome of inflammation

A

Complete resolution

425
Q

What effect does histamine have on the endothelium

A

Increase permeability

426
Q

Spleen enlargement causes what

A

Cytopenia from sequestration

427
Q

Rapid hypoxia/ anoxia most often leads to what type of necrosis

A

Coagulative

428
Q

What are the classic symptoms of a PE

A

Sudden chest pain, very rapid onset of seconds to mins

Sudden SOB and Tachypnea

Hemopytsis ( coughing up blood)

429
Q

How does fetal alcohol syndrome progress

A

Causes intrauterine growth delay

Small baby w/ facial changes

430
Q

What is the marked sign of decompensated shock

A

Hypotension and Acidosis

431
Q

Deficiency in these 4 nutrients can lead to anemia

A
  • Iron deficiency
  • B12 & Folate deficiency
  • Protein deficiency
432
Q

What are 4 causes of chronic inflammation

A

Resistant microbes
Autoimmune diseases
Repeated toxic exposure
Foreign bodies

433
Q

What are the two types of wound reactions

A

Regenerative (repair)

Scar formation

(often occur together)

434
Q

Which cells are least sensitive to Ionization radiation

A

Nerve cells
Bone (not marrow)
Muscle

435
Q

How can apoptosis cause pathology

A

Usually does not, nor does it trigger inflammation however lack of physiologic apoptosis can lead to leukemia or syndactyl (webbed toes)

436
Q

To for hemophilia

A

Infusions of MAN MADE recombinant clotting factors

437
Q

What are the two classes of inflammatory mediators

A

Plasma derived and cell-derived

438
Q

Define an embolism

A

Freely mobile, intravascular mass carried from one site to another

439
Q

What does maternal blood analysis in prenatal testing look for

A

Screen for fetal substances in maternal circulation

• Alpha-fetoprotein (AFP) ↓ levels associated with Down’s

440
Q

Describe COX pathway

A

Produces Prostaglandins - vasodilation, vascular permeability, pain, and fever

Thromboxane - platelet aggregation, thrombosis, vasoconstriction

441
Q

What does hemoarethrosis mean

A

Blood in a joint or synovial cavity

442
Q

What are three common lab markers for irreversible cell injury

A

AST- Aspartate aminotransferase
ALT - Alanine aminotransferase
LDH - lactate dehydrogenase

443
Q

Explain lymphatic drainage imbalance in edema

A

Interstitial fluid unable to drain away causing fluid accumulation which leads to edema

444
Q

What are the 4 major groups of abnormal immune responses

A
  • Type I – Anaphylactic or Atopic Reaction
  • Type II – Cytotoxic Antibody-Mediated Reaction
  • Type III – Immune Complex-Mediated Reaction
  • Type IV – Cell-Mediated or Delayed-Type Reaction
445
Q

What is primary polycythemia

A

(polycythemia vera)
• Myeloproliferative disorder considered neoplastic

• Hematopoietic stem cell proliferation WITHOUT external stimuli causes over-production of RBCs

IPAP 21-2 Soph Semester (20 decks)

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