Patho Small Group 1 - Justin Flashcards
Metaplasia is always ____________ & _____________
Pathologic and reversible
Metaplasia is commonly caused by process that could lead to _______
Cancer
Define pleomorphism
Variety in size and shape of cancer cells
Metaplasia of the esophagus is also known as
Barrett’s esophagus
Features of squamous cell carcinoma are
Eosinophilia
Large nuclei (much larger than lymphocytes)
Flattening of cells
3 common signs of lung cancer are
Cough
Hemoptysis
Weight loss
Case 3
32 y/o male with jaundice
PE: enlarge tender liver
T: 38.2 HR: 65 BP: 160/80 Bilirubin : 3.9 ( < 1.3 ) AST: 30,483 (< 60) ALT 23,338 ( < 60)
Classic Dx:
Tylenol and EtOH overdose (toxicity)
According to other sources ( ask me if you want them )
Typical transaminases elevation of EtOH + Tylenol # are
AST 19000
ALT 16000
Common causes of hepatic injury are:
Alcohol hepatitis Shock Tylenol toxicity Sepsis Antibiotics Pregnancy Viral hepatitis
Characteristics of alcohol hepatitis are
Age: 40-60 Rapid onset of jaundice Moderately elevated AST < 300 Mild elevation of ALT De Risis ratio AST/ALT > 2
Resources from my other source states that in acute alcohol hepatitis typically shows
AST: 160
ALT: 80
Please do not memorize these numbers but use them as a reference of typical # in most people. Values will be different depending on the person.
Characteristics of Shock
Rapid rise in TA
25-250x ULN
1-3 days steady decline to normal in 7-10 days
Bilirubin increases as TA levels fall
ALP moderately raised (2x at most)
Shock liver which is low cardiac output, leading to hepatic ischemia
Classic Tylenol overdose characteristic are
NAPQI is the toxic metabolite that conjugate with GGT
Normal if adult takes < 10 g / day. (20 pills)
> 12g likely show toxicity
> 16g severe toxicity
1st 24 hr: nausea, vomiting, sweating, pallor, lethargy, malaise
B/t 24-72hr: pt feels fine
B/t 72-96 hr: manifest reappears with jaundice, confusion, bleeding
Tx: N-acetyl cysteine
Sepsis characteristics are
Mildly Elevated bilirubin
Mild elevated TA and ALP
Case 5
65 y/o CC: chest pain
Obese, occluded coronary artery with balloon angioplasty, then dies a few hr later
Micro pathology shows: tiny condense fibrin clot
Red ( hemorrhagic ) infarct
Cause of death:
Coagulative necrosis with reperfusion injury.
Case 7: fever, night sweats, malaise and cough
X ray: lung nodules and enlarge lymph node
Biopsy: langhan multinucleated giant cell
Granuloma present
+ acid fast stain
Classic scenario for
TB mycobacterium tuberculosis
What infection mimics clinical manifestation of TB?
Histoplasma capsulatum - fungal infection
Causes endemic infection in the Mississippi River valley
