Pathology Flashcards
1
Q
pathology + mechanism
A
keratomalacia
vitamin A deficiency that lead to metaplasia
squamous -> stratified keritanizing squamous epithelium
2
Q
pathology + mechanism
A
myositis ossificans
metaplasia of connective tissue within the muscle into bone
3
Q
early sign of exposure to CO
A
headache!
4
Q
π© cherry red appearance of the skin
A
CO poisoning
5
Q
π© cyanosis with chocolate colored blood
A
methemoglobinemia
6
Q
hallmark of reversible cellular injury
A
cellular swelling
7
Q
hallmark of irreversible cellular injury
A
membrane damage
8
Q
what are the mechanisms through which a cell loses the nucleous?
A
pyknosis: nuclear condensation
karryorhexis: nuclear fragmentation
karyolysis: nuclear dissolution
9
Q
A
fibrinoid necrosis of blood vessel
βbright pink staining of the wallβ
10
Q
in what clinical setting does fibrinoid necrosis occur?
A
malignant hypertention
vasculitis
11
Q
π© congo red staining under microscope
A
amyloidosis
12
Q
π© apple green birefringence under polarized light
A
amyloidosis
13
Q
A
amyloidosis
14
Q
amyloid that accumulates in:
senile cardiac amyloidosis + familial amyloid cardiomyopathy
A
serum transthyretin
mutated serum transthyretin
15
Q
amyloid that accumulates in:
dialysis associated amyloidosis
where does it accumulate?
A
b-microglobulin
joints
16
Q
π© tumor cells in amyloid background
A
medullary carcinoma of the thyroid
17
Q
amyloid that accumulates in: DM
A
amylin deposits in the pancreas
18
Q
mediators that attract neutrophils
A
- LTB4
- C5a
- IL-8
- bacterial pathogens
19
Q
what is defective in leukocyte adhesion deficiency?
A
CD18 subunit of integrins
20
Q
catalase positive organisms to which patients with chronic granulomatous disease are suceptible
A
staph aureus
pseudomonas cepacia
serratia marcescens
nocardia
aspergillus
21
Q
anti-inflammatory cytokines
A
IL-10
TGF-Ξ²
22
Q
common infections with low immunoglobulins
A
bacterial,
enterovirus, giardia lambia
23
Q
wiskott-aldrich triad
A
- thormbocytopenia
- eczema
- recurrent infections
24
Q
A
hereditary angioedema
(C1 inhibitor deficiency)
25
li fraumeni syndrome
propensity to develop multiple types of sarcomas and carcinomas due to a germline mutation in p53 tumor suppressor genes
26
4 carcinomas that spread hematologically?
1. renal cell carcinoma
2. hepatocellular carcinoma
3. choriocarcinoma
4. follicular carcinoma of the thyroid
27
π© omental caking
changes seen on the omentum in ovarian carcinoma due to seeding
28
what tissues/cancers is the chromogranin stain found in?
neuroendocrine
28
what tissues/cancers is the chromogranin stain found in?
neuroendocrine
29
plummer-vinson syndrome
iron deficiency anemia + esophageal web + atrophic glossitis
30
**iron deficiency anemia**
(microcytic, hypocromic, βRDW)
31
finding + ddx
siderroblasts: **siderroblastic anemia**
- ALAS deficiency
- Vit B6 deficiency
- LB poisoning
- Alcoholism
32
what do **nucleated RBC** on smear indicate?
extramedullary hematopoiesis
33
finding + ddx
**target cells**
34
how do you correct reticulocyte count?
RC * Hct/45
35
π© hemosiderinuria
intravascular hemolysis
36
π© βMCHC
hereditary spherocytosis
37
finding + what does it indicate?
**howell-jolly bodies**
fragments of nuclear material in RBC on blod smear, only seen after **splenectomy**
38
dx
spherocytosis
39
organism responsible for osteomyelitis in sickle cell pts?
*salmonella paratyphi*
40
dx
sickle cell disease
41
dx
HbC
42
finding + dx
**heinz bodies**
G6PD deficiency
43
finding + dx
**fatty bone marrow**
aplastic anemia/pancytopenia
44
finding + dx
**fatty bone marrow**
aplastic anemia/pancytopenia
45
finding + dx
cholesterol crystals
**atheroscletoic embolus**
46
dx
fat embolus
47
finding + dx
atypicall lymphocyte
**infectious mononucleosis**
48
π© auer rods
crystals of MPO --> myeloblasts
**AML**
49
finding + dx
**auer rods**
AML
50
finding + dx
**smudge cells**
CLL
51
dx
hairy cell leukemia
52
finding + dx
cerebriform nucleio --> sezary cells
**mycosis fungoides**
53
finding + dx
"starry sky appearance"
**burkitt lymphoma**
54
finding + dx
lacunar cells
**nodular sclerosis - hodgkin lymyphoma**
55
finding + dx
reid steinburg cell
**hodgkin lymphoma**
56
pulseless disease
weak or absent pulse in upper extremities --> **takayasu arteritis**
57
π© string of pearls appearance
polyarteritis nodosa
58
dx
hyaline arteriolosclerosis
59
dx
hyperplastic arteriolosclerosis
60
dressler syndrome
**autoimmune pericarditis**
typically occurs 6-8 weeks after MI
61
finding + dx
**contraction band necrosis**
consequence of reperfusion of MI that results from calcium influx with hypercontractions of myofibrils
62
heart failure cells
**hemosiderin-laden macrophages** that pick up after intraalveolar hemorrhage occurs from congested alveolar capillaries
63
finding + dx
**hemosiderin-laden macrophages** (heart failure cells)
left-sided congestive heart failure
64
finding + dx
**nutmeg liver**
right-sided congestive heart failure
65
finding + dx
bootshaped heart
**tetralogy of fallot**
66
finding + dx
notched ribs
**coartation of the aorta**
67
HACEK organisms
cause of negative blood culture endocarditis
**H**aemophilus
**A**ctinobacillus
**C**ardiobacterium
**E**ikenella
**K**ingella
68
causes of DIC
69
what does crioprecipitate contain?
* factor VIII (8)
* factor XIII (13)
* vWF
* fibrinogen
* fibronectin
70
π© child/young adult with nasal polyp
ddx for cystic fibrosis!!
71
π© pleomorphic keratin positive cells in a background of lymphocytes
nasopharyngeal carcinoma
72
π© currant jelly sputum
lobar pneumonia --> **klebsiella plneumoniae**
(aspiration of enteric flora)
73
organisms seen in aspiration pneumonia
anaerobic bacteria in the oropharynx
* bacteroides
* fusobacterium
* peptococcus
74
dx
lobar pneumonia
75
dx
broncopneumonia
76
dx
intestitial (atypical) pneumonia
77
pott disease
musculoskeletal tuberculosis
78
aspirin-intolerant asthma triad
1. asthma
2. aspirin-induced broncospasms
3. nasal polyps
79
π© honeycomb lung
end stage idiopathic pulmonary fibrosis
79
finding + dx
**charcot-leyden crystals
**
asthma
80
dx
intestitial fibrosis
idiopathic pulmonary fibrosis
81
finding + dx
noncaseating granuloma in the lung
**sarcoidosis**
82
finding + dx
**asteroid body**
sarcoidosis
83
finding + dx
**plexiform lesions** in the lungs
primary pulmunary hypertention
84
finding + dx
hyaline membranes in the lung
**ARDS**
85
dx
"white-out"
**ARDS**
86
caplan syndrome
coal worker's pneumoconiosis (black lung) associated with rhematoid arthritis
87
π© non caseating granulomas in multiple organs
sarcoidosis
88
finding + dx
asbestos bodies
89
finding + dx
"ground glass appearance"
**neonatal resp distress snd.**
90
finding + dx
**keratin pearls**
squamous cell carcinoma of the lung
91
finding + dx
**intercellular bridges**
squamous cell carcinoma of the lung
92
behçhet syndrome triad
1. aphthous ulcers
2. genital ulcers
3. uveitis
93
boerhaave syndrome
rupture of the esophagus that leads to air in the mediastinum + subcutaneous emphysema
93
dx
barret's esophagus
94
dx
| location: stomach
*benign* peptic ulcer
95
dx
| location: stomach
*malignant* peptic ulcer
96
finding + dx
**signet ring cells**
gastric carcinoma **(diffuse type)**
97
dx
**celiac disease**
(flattened villi, hyperplasia of the crypts)
97
sign + dx
double bubble sign
**duodenal atresia**
98
carcinoid syndrome
1. bronchospasm
2. diarrhea
3. flushing of the skin
triggered by stress/alcohol -> stimulate serotonin release by tumor
secondary to carcinoid tumor (ex: small bowel)
99
carcinoid heart
right-sided valvular fibrosis (tricuspid regurg, pulmonary stenosis) secondary to carcinoid tumor of the small bowel
100
sign + dx
lead pipe
**ulcerative colitis**
101
sign + dx
string-sign
**chron disease**
102
findings + dx
cobblestone mucosa + creeping fat
**chron disease**
103
gardner syndrome
FAP with fibromatosis + osteomas
103
turcot syndrome
FAP + CNS tumors
104
finding + dx
| location: gall bladder
**rokitansky-aschoff sinuses**
chronic cholecystitis
105
finding + dx
**porcelain gallbladder**
chronic cholecystitis --> gallbladder carcinoma
106
risk with HEV infx in pregnanct women?
fulminant hepatitis!
107
dx
| location: liver
liver cirrhosis
108
dx
fatty liver
109
findings + dx
hepatocyte swelling + **mallory bodies**
**alcoholic hepatitis**
110
dx
hemochromatosis
111
finding + dx
onion-skin fibrosis
**primary sclerosin cholangitis**
112
how do we ddx extramammary padget disease from melanoma?
***stains!***
padget: PAS+, **keratin +**, S100-
melanoma: PAS-, keratin -, **S100+**
113
dx
condiloma acuminata (HPV)
114
finding + dx
koilocytic change of the nucleous
**HPV**
115
finding + ddx
**malignant epithelial cells in the epidermis**
*ddx:*
* extramammary padget disease (carcinoma in situ)
* melanoma
116
curling ulcer
**acute gastritis** (ulcer) seen in **burn victims** due to hypvolemia which leads to mucosal ischemia
*"burned by the curling iron*
117
cushing ulcer
**acute gastritis** (ulcer) see in patients with **brain injury** due to increased vagal stimulation which leads to β Ach and β H production
*"always cushion the brain*
118
dx
malrotation
119
sign + dx
target sign
**intussuception**
120
sign + dx
coffee bean sign
**volvulus (sigmoid colon)**
121
π© failure to pass meconium in the first 48 hrs
hirschsprung disease!
122
dx
| location: vaginal epithelium
adenosis
(columnar epithelium in the upper vagina)
123
dx
embryonal rhabdomyosarcoma
124
how do we diagnose embryonal rhabdomyosarcoma?
hallmark cell: **rhabdomyoblasts** that exhibit *cytoplasmic cross-striations*
staining: desmin+, **myogenin+**
125
finding + dx
**chocolate cyst**
*endometriosis* with ovarian involvement
126
finding + dx
**gun-powder nodules**
endometriosis with sof tissue implants
127
dx
| location: uterus
endometrial hyperplasia
128
dx
leiomyoma
129
tumors with psammoma bodies
1. papillary carcinoma of the thyroid
2. meningyoma
3. mesothelioma
4. ovarian cancer
5. endometrial carcinoma
130
finding + dx
effacement of the foot processes
ddx:
* minimal change disease
* fsgs
131
dx
focal segmental glomerulosclerosis
132
finding + dx
thick basement membranes
ddx:
* membranous nephropathy
* membrano proliferative glomerulonephritis
133
finding + dx
**granular IF **
*nephropathy:*
* membranous nephropathy
* membrano proliferative glomerulonephritis
*nephritic snd:*
* post-strep glomerulonephritis PSGN
* diffuse proliferative glomerulonephritis
134
finding + dx
**spike and dome appearance**
membranous nephorpathy
135
finding + dx
**tram-track appearance**
MPGN
136
finding + dx
**kimmelstiel-wilson bodies**
DM
137
lupus nephropathy/nephritic syndrome
1. diffuse proliferative glomerulonephritis
2. membranous nephropathy
138
finding + dx
**linear IF**
goodpasteur snd
139
finding + dx
IgA nephropathy
140
π© steril pyuria
uretritis!
chlamydia + neisseria
141
what cells produce erythropoitin?
renal peritubular intestitial cells
141
finding + dx
"thyrodization of the kidney"
**chronic pyelonephritis**
141
dx
renal cell carcinoma
142
dx
| location: kidney
renal cell carcinoma **(clear cell type)**
143
dx
| location: kidney
wilm's tumor
144
WAGR syndrome
Wilms tumor
Aniridia
Genital ambnormalities
mental & motor Retardation
*WT1 tumor supp gene 11p13*
145
denys-drash syndrome
wilms tumor
progressive renal disease
male pseudohermaphroditism
WT1
146
beckwith-wiedemann syndrome
wilms tumor
neonatal hypoglycemia
muscular hemihypertrophy
organomegally
WT2 chrom 11p15
147
testicular/ovarian cancer in children
**yolk sac tumor**
(endodermal sinus tumor)
148
finding + dx
**schiller-duval bodies**
endodermal sinus tumor **(yolk sac tumor)**
149
dx
embryonal carcinoma
150
dx
seminoma
151
finding + dx
**scalloping of the thyroid**
graves disease
152
finding + dx
| location: thyroid
chronic inflammation with germinal centers + **hurthle cells**
**hashimoto thyroiditis**
153
dx
| location: thyroid
**follicular adenoma** of the thyroid
154
findings + dx
| location: thyroid
**orphan annie eye nuclei** + nuclear grooves
**papillary carcinoma** of the thyroid
155
finding + dx
**psammomma body**
papillary carcinoma of the thyroid
156
dx
| location: thyroid
*"malignant cells in an amyloid stroma"*
**medullary carcinoma** of the thyroid
157
π© tender thyroid
granulomatous subacute thryroiditis (de quervain)
158
π© "hard as wood," non tender thyroid
reidel fibrosing thyroiditis
159
***ddx***
reidel fibrosing thyroiditis vs. anaplastic carcinoma of the thyroid
*population!*
adults (40s) --> RFT
elderly --> anaplastic carcinoma
160
waterhouse-friedrichsen snd
**acute adrenal insufficiency** due to hemorrhagic necrosis of the adrenal glands secondary to **neisseria meningitidis sepsis + DIC**
161
π© periareolar mass with *green-brown nipple discharge*
mammary ductal ectasia
162
π© bloody nipple discharge in premenopausal women
intraductal papilloma
163
benign and malignant calcification on mammography
*benign:*
* fat necrosis
* sclerosing adenosis
*malignant*
* ductal carcinoma in situ
164
dx
| location: breast
phylloides tumor
165
dx
| location: breast
ductal carcinoma in situ
(comedo type)
166
dx
| location: breast
invasive ductal carcinoma
(mucinous)
167
dx
| location: breast
inflammatory carcinoma
168
dx
| location: breast
invasive lobular carcinoma
169
dx
**"cannonball"** metastases
**choriocarcinoma**
170
π© male with βPLAP
seminoma!
171
(+) prhen sign
epididimitis!
172
causes of SIADH
*"HEELD-up water*
Head trauma
Ectopic (small cell lung ca)
Exogenous hormones (vasopressin, oxytocin)
Lung disease
Drugs (cyclophosphamide)
173
thyroid storm tx
propranolol (b-block)
propylthiuracil
prednisolone (glucocorticoid)
potassion iodide (lugol)
174
wolff-chaikoff effect
sudden exposure to **iodine excess** temporarily **turns off thyroid peroxidase**
175
jod-basedow phenomenon
iodine induced hyperthyroidism (in a previous iodine depleted patient when given iodine, IV contrast or amiodarone)
176
cardiac pathology associated with freidreich's ataxia?
hypertrophic cardiomyopathy
177
dx
dilated 4th ventricle
**dandy walker malformation**
178
finding + dx
**red neurons**
ischemic stroke (brain infarct)
179
finding + dx
bleeding at the base of the brain
**subarachnoid hemorrhage**
180
finding + dx
**neuritic plaque**
alzheimer
181
finding + dx
**neurofibrillary tangle**
(tau protein - hyperphosphorilated)
*alzheimers*
182
finding + dx
**lewy body**
basal ganglia: *parkinsons*
cortex: *lewy body dementia*
183
finding + dx
"butterfly lesion" (crosses midline)
**glioblastoma multiforme**
184
finding + dx
whorled pattern
**meningioma**
185
finding + dx
"fried egg"
**oligodendrioma**
186
finding + dx
**rosenthal fibers**
pilocytic astrocytoma
187
finding + dx
perivascular pseudorossettes
**ependymoma**
188
π© bone pain that resolves with aspirin
osteoid osteoma
189
finding + dx
| location: bone
mosaic pattern (puzzle piece tumor)
**padget disease of the bone**
190
what is dermatomyositis associated with?
gastric carcinoma!
191
what tumors are miasthenia gravis and lambert-eaton associated with?
MG: thymoma
LE: paraneoplastic (small cell lung ca)
192
what is leser-trΓ©lat associated with?
(multiple seborrheic keratoses)
GI carcinoma
