Patho - General Flashcards
Plummer-Vinson Syndrome
details and tx
dysphagia and IDA
IDA > weakness, fatigue and dyspnea
dysphagia via esophageal webbing
shiny red tongue via papillary atrophy
tx with iron supplementation
Tumors with Psammoma bodies
meningioma
papillary thyroid carcinoma
mesothelioma
papillary serous carcinoma of breast + ovary
MMPtPbo
Lambert-Eaton Myasthenic Syndrome
s/s, pathophys, associations, differential
S/S: GAIT issues, difficulty standing from chair/climbing stairs, AUTONOMIC issues (dry mouth, impotence), OCULOBULBAR issues (diplopia, ptosis, dysarthria/-phagia) and HYPORELFEXIA
pathophys: anti-VDCC autoantibodies affect ACh release
association: malignancy, especially SCLC
differential: myasthenia gravis does not have hyporeflexia, autonomic sx; LEMS has incremental response to repetitive stimulation (MG gets worse with repetitive stim)
Adenoma-Carcinoma sequence in colon cancer
Normal colon
APC inactivation with beta-catenin accumulation > hyperproliferative epithelium
KRAS activation > adenoma formation
p53 inactivation > carcinoma formation
Thymoma-associated paraneoplasia
myasthenia gravis
Cancer assoc. with hypercalcemia via hormone production (which cancer + which hormone)
SQUAMOUS cell lung cancer
PTHrP (not PTH)
Cancers assoc. with Cushing syndrome
other than pituitary or adrenal adenoma
SCLC or pancreatic cancer
ectopic ACTH or CRH
Paroxysmal Nocturnal Hemoglobinuria
pathophys, s/s, main organ involved + how?
mutation of PIGA gene > impaired GPI anchor protein > impaired anchoring of CD55 (DAF) and CD56 (MAC inhibitory protein) > complement-mediated hemolysis
hemolytic anemia
pancytopenia
thrombosis - at atypical sites; hepatic, portal + cerebral vv.
kidney - HEMOSIDEROSIS + thrombosis > CKD
MEN type 1
pituitary adenoma, primary hyperparathyroidism and pancreatic endocrine tumor
MEN type 2A
RET mutation
medullary thyroid cancer - more aggressive and earlier than sporadic MTC
pheochromocytoma
primary hyperparathyroidism (parathyroid hyperplasia)
MEN type 2B
RET mutation
medullary thyroid cancer - more aggressive and earlier than sporadic MTC
pheochromocytoma
mucosal neuromas
marfanoid habitus
Specific risk factors for PANCREATIC and PROSTATE cancer
pancreatic - smoking, obesity
prostate - age and african-american
Specific risk factors for BLADDER and RENAL cancers
renal - smoking, obesity, hypertension; toxin exposure (HEAVY METALS, PETROLEUM)
bladder - smoking, OCCUPATIONAL EXPOSURES (rubber, plastics, aromatic amine dyes, textiles, leather) SCHISTOSOMA haematobium and CYCLOPHOSPHAMIDE
Specific risk factors for GASTRIC and COLORECTAL cancers
gastric - dietary nitrate, alcohol/tobacco, H. pylori
colon - hereditary (HNPCC, FAP), IBD, obesity, charred/fried food
Specific risk factors for LIVER and BREAST cancers
liver - hepatitis B and C, cirrhosis, hemochromatosis, AFLATOXIN
breast - early menarche, late menopause, nulliparity, BRCA
Wilson’s Disease
epidem; organs affected; tx
rare AR; usually present at 5-40 y/o
mutations reduce ceruloplasmin and hepatobiliary copper secretion
liver damage - Cu is pro-oxidant
corneal deposits - Kayser-Fleischer ring (slit lamp)
basal ganglia deposits - cause atrophy
d-penicillamine or trietine for Cu chelation
Kartagener Syndrome
inheritance + other name? triad + other s/s?
AR “primary ciliary dyskinesia”
triad = chronic sinusitis, bronchiectasis, situs inversus
Impaired ciliary clearance > chronic cough, sinusitis and bronchiectasia
Situs inversus - in 50% pts
Infertility - sperm flagella / fallopian cilia issues
Tumor Grade vs. Stage
Grade - degree of differentiation of cells
Stage - degree of expansion + invasion (TNM); more important for prognosis!
Turner syndrome
internal abnormalities (not musculoskeletal) + their consequences
CV - bicuspid aorta or COARCTATION
renal - HORSESHOE kidney
repro - STREAK OVARY, infertility, amenorrhea
What is the gating mechanism for CFTR chloride channel?
ATP-gated
must bind 2 ATP before the chloride channel open
Hemochromatosis
inheritance? main organs affected? TRIAD? labs?
AR disorder > high GI iron absorption
iron overload in parenchymal organs like heart, liver, pancreas
liver - HEPATOMEGALY, pain, HYPERPIGMENTATION
pancreas - islet destruction > DM (“bronze diabetes”)
impotence
arthropathy
cardiac dysfunction + enlargement
mildly high LFTS
elevated plasma iron, >50% transferrin saturation, high ferritin
What is “oncosis”?
ischemic cell death
ATP depletion > ionic pump malfunction, swelling, cytosol clearing, ER/Golgi dilation, mitochondrial condensation, chromatin clumping, and cytoplasmic blebbing
Bone mets
mnemonic for which are most common
which are lytic/blastic/mixed?
(aka lucent vs. sclerotic lesions on imaging)
Prostate, Breast > Kidney, Thyroid, Lung
(lead kettle = PB KTL)
SCLC, Prostate - blastic
NSCLC, Kidney, Thyroid - all lytic
Breast - mixed
Peutz-Jegher syndrome
inheritance
s/s
complications
AD
Multiple hamartomas in GI tract
Hyperpigmentation of mouth, lips, hands + genitals
incr. risk of BREAST and GI cancers
What is CHORISTOMA vs. HAMARTOMA?
choristoma - normal tissue in abnormal location (gastric epith in Meckel diverticulum)
hamartoma - disorganized overgrowth of tissue in native location (P-J syndrome)
Aside from the “PB KTL” common primary tumors giving mets to bone…
what are some other cancers that give bone mets?
blastic - Hodgkin
mixed - GI tumors
lytic - MM, NHL and melanoma
4 mechanisms of reperfusion injury
2 intracellular/biochem-related; 2 inflammation related
- ROS formation - by parenchyma, endoth. + WBCs
- Mitochondrial permeability increase - irreversible
- Neutrophil infiltration
- Complement activation
Cellular mechanism responsible for rapid release of CREATINE KINASE into circulation in reperfusion injury
(it’s very simple…)
cell membrane damage
A neoplasm is described as “not invading the stroma or vessels” but otherwise sounds malignant (rapid growth, causing significant symptoms, atypical cells etc.)…
is it considered benign or malignant?
still MALIGNANT just is “IN SITU” because it doesn’t invade past BM
(ex: pulmonary adenocarcinoma in situ - columnar mucinous cells in alveoli)
