Patho Exam 1 Fenderson Flashcards
A 16-year-old girl complains that she has not started menstruating like other girls her age. The patient is short (4 feet, 11 inches) and has a thick-webbed neck. Physical examination reveals widely spaced nipples and poor breast development.
Turner Syndrome, 45 XO karyotype
genetic disorder caused by maternal nondisjunction of somatic cells in early stages of embryogenesis
A 20-year-old gardener presents to his family physician for treatment of what he describes as “poison ivy.” The patient’s hands and arms appear red and are covered with oozing blisters and crusts.
Type 4 delayed hypersensitivity reaction
A 20-year-old woman has an ovarian tumor removed. The surgical specimen is 10 cm in diameter and cystic. The cystic cavity is found to contain black hair and sebaceous material. Histologic examination of the cyst wall reveals a variety of benign differentiated tissues, including skin, cartilage, and glandular epithelium.
teratoma
A 20-year-old woman with a history of asthma and allergies undergoes skin testing to identify potential allergens in her environment.
A positive skin reaction would be mediated by IgE class immunoglobulins (type iv hypersensitivity reaction)
A 31-year-old woman complains of increased vaginal discharge of 1 month duration. A cervical Pap smear is obtained. Superficial epithelial cells in the smear show condensed (pyknotic) nuclei.
pyknosis – the irreversible condensation of chromatin in the nucleus of the cell undergoing necrosis or apoptosis. The nucleus becomes smaller and stains deeply basophilic as chromatin clumping continues.
Diagnosis: cervical intraepithelial neoplasia
A 35-year-old man asks for advice regarding seasonal eye itching and runny nose (rhinitis).
Hypersensitivity type 1
A 36-year-old woman presents with a suspicious-looking mole on the posterior surface of her neck. Biopsy confirms the diagnosis of malignant melanoma.
The most dangerous form of skin cancer is malignant melanoma, these cancerous growths develop when unrepaired DNA damage to skin cells (most often caused by ultraviolet radiation from sunshine or tanning beds) triggers mutations (genetic defects) that lead the skin cells to multiply rapidly and form malignant tumors.
A 39-year-old man with AIDS is admitted to the hospital with a 3-week history of chest pain and shortness of breath. An x-ray film of the chest shows bilateral nodular masses in the lungs. A CT-guided lung biopsy reveals granulomatous inflammation.
Granulomas = collections of epithelioid cells and multinucleated giant cells that are formed by cytoplasmic fusion of macrophages
Langhans giant cell = nuclei are arranged around the periphery of the cell in a horseshoe pattern. A foreign pathogenic agent can be seen within the cytoplasm of a multinucleated giant cell
Diagnosis: AIDS, granulomatous inflammation
A 40-year-old man is examined by a new family physician who discovers numerous pedunculated skin tumors (neurofibromas) on his face and chest.
- neurofibromatosis
A 42-year-old woman gives birth to a neonate with multiple congenital abnormalities. Physical findings included a flat facial profile, slanted eyes, epicanthal folds, Brushfield spots, short nose, short neck, dysplastic ears, clinodactyly, a large protruding tongue, and a pronounced heart murmur.
Down’s syndrome, Trisomy 21, 3 copies of 21st chromosome
Maternal nondisjunction during the first meiotic division of gametogenesis
A 43-year-old pregnant woman inquires about the possibility of Down syndrome in her unborn child.
maternal non-disjunction, risk increases with age
Amniocentesis and chorionic villus biopsy are safe and reliable prenatal testing
A 45-year-old man presents with increasing abdominal girth and yellow discoloration of his skin and sclera. Physical examination reveals hepatomegaly and jaundice. A Prussian blue stain of a liver biopsy demonstrates iron overload.
Hemosiderin: a partially denatured form of ferritin that aggregates easily and is yellow-brown in the cytoplasm but turns blue with the Prussian blue reaction
Hereditary hemochromatosis: genetic abnormality of iron absorption in the small intestine. Excess iron is stored mostly in the form of hemosiderin, primarily in the liver.
A 45-year-old woman complains of severe headaches and difficulty swallowing. Over the past 6 months, she has noticed small, red lesions around her mouth as well as thickening of her skin. The patient has “stone facies” on physical examination.
Scleroderma– autoimmune disease of connective tissue (collagen vascular disease) - type 4 hypersensitivity
A biopsy would show an accumulation of collagen
A 5-year-old boy punctures his thumb with a rusty nail. Four hours later, the thumb appears red and swollen.
-initial swelling is from increased capillary permeability → localized inflammatory edema
-Diagnosis: inflammatory edema
.A 50-year-old man is found to have blood in his urine during a routine checkup (hematuria). An abdominal CT scan reveals a 2-cm right renal mass. You inform the patient that staging of this tumor is key to selecting treatment and evaluating prognosis.
TNM staging system assesses tumor size and spread locally and systemically (vs grading system, which assesses the degree of differentiation and proliferative capacity)
Tumor
Nodes
Metastases
Diagnosis: Renal cell carcinoma
A 50-year-old man presents with a lesion on the sun-exposed, dorsal surface of his right hand. Biopsy reveals malignant keratinocytes.
Squamous cell carcinoma
. A 50-year-old man with polycystic kidney disease dies of renal failure (uremia). A shaggy exudate on the surface of his heart is observed at autopsy.
-Fibrinous exudate → fibrinous pericarditis (“bread and butter”), friction rub on auscultation
-Diagnosis: ESRD
A 50-year-old woman dies of metastatic ovarian cancer. During the autopsy, a segment of mesentery attached to a loop of small intestine is studded with small white tumor nodules.
Seeding of body cavity
Diagnosis: ovarian cancer, carcinomatosis
A 52-year-old man presents with a pigmented skin lesion that he first noticed 6 months ago.
Melanoma
A 58 year old woman with colon cancer presents with 3 months of increasing shortness of breath. A chest x-ray reveals numerous “coin lesions” in both lungs. Histologic examination of an open lung biopsy demonstrates metastatic colon cancer.
-After invading the interstitial tissue, malignant cells penetrate lymphatic or vascular channels
-Dx: Adenocarcinoma of the Colon
A 64 year old man suffers repeated heart attacks and subsequently dies of cardiac tamponade. histological examination of the heart at autopsy shows abundant scar tissue, which is stained blue with trichrome stain
Collagen scar tissue
A 60 year old man suffered a massive Myocardial Infarction and expired. At autopsy the heart tissue histologically demonstrated loss of nuclei deeply eosiniphilic staining of the cytoplasm and loss of cross striation of cardiac myocytes
Coagulative necrosis
A 65 year old mand from china suffers a massive stroke and expires. The lungs are examined at autopsy. (revealed numerous pigmented nodules scattered throughout the parenchyma
Anthrosis / “Coal Miner Lung”
Often develops pulmonary fibrosis
A 65 year old man with a history of heavy smoking dies of an acute myocardial infarction. The heart is examined at autopsy
Mural Thrombus
A 68 year old man with chronic renal disease complains of headaches and dizziness. Blood pressure is 220/130 mm Hg (Malignant Hypertension). While in the emergency room, the patient suffers a massive stroke and expires. Microscopic examination of the kidney at autopsy shows areas of firbrinoid necrosis.
Fibrinoid necrosis is seen in patients with nectrotizing vasculitis (alteration of injured blood vessels, in which the insulation and accumulation of plasma proteins cause the wall to stain intensely eosin–red material in the wall of the artery.
A 68 year old woman dies of congestive heart failure. A cross seciont of the heart at autopsy is shown.
- Pulmonary hypertension. Cor pulmonale is RB hypertrophy and dilation secondary to pHTN. The most common cause of cor pulmonale is COPD, usually from smoking.
- Diagnosis: Cor Pulmonale, Pulmonary hypertension
A 72 year old man dies of complications of pneumoccocal pneumonia. Histology examination of the lungs at autopsy shows acute inflammatory cells filling in the pulmonary alveoli.
Purulent exudate in the alveoli, alveoli are filled with neutrophils and PMN leukocytes
Dx: Bacterial pneumonia
A 92 year old woman is brought unconscious to the emergency room from a nursing home. Her blood pressure is 70/30 mm Hg. She is febrile (100.5oF) and breathing rapidly (tachypnic). Urinalysis reveals numerous gram-negative organisms.
Septic Shock
A chronic smoker presented to the hospital with relentless coughing. A bronchial biopsy was performed. The biopsy contained fragments of mature squamous epithelium with no evidence of nuclear atypic ( not a neoplasm)
Metaplasia
