Pathology Flashcards
A 90 year old female resident of a nursing home is evaluated for weakness and bone pain. She has a history of vertebral fracture. Her history is significant for type 2 diabetes and chronic renal insufficiency. She eats processed food and spends most of the day indoors. She doesn’t exercise. Which of the following bony abnormalities is most likely etiology of the patient’s complaint?
Osteoid formation
Nutritional deficiencies, including vitamin D deficiency, result from poor diet and lack of sunlight. This can result in osteomalacia, a disorder characterized by periosteal bone pain, that occurs when low levels of circulating 25-hydroxy vitamin D cause secondary hyperthyroidism, which mobilizes calcium from the bone. This results in decreases mineralization and deposition of unmineralized osteoid matrix in bone. Osteoid bone is easily fractured.
A 49 year-old male patient has had a cough for the past 3 months. He has also noticed fullness in his face for the past 2 months. His history is significant for a 60 pack-year history of tobacco abuse. On examination, his respiratory rate is 20 and BP is 150/90. Examination is significant for a rounded face, excess fatty tissues over the posterior neck and back and truncal obesity with abdominal striae. Urine glucose is 3+. Chest X-ray is significant for a 2cm mass in the right upper lobe, with hilar adenopathy. Which is most likely to be increased in concentration?
ACTH
Presentation typical of Cushing syndrome. The presentation and pathology are typical of small cell carcinoma of the lung which produces a neuroendocrine tumor associated with paraneoplastic syndromes, including ectopic production of ACTH. Other neuroendocrine syndromes that are related to lung cancer include Eaton-Lambert, SIADH and subacute sensory neuropathy.
Which of the following are not included in the steps for leukocyte extravasation?
A. Tight binding
B. Transmigration
C. Presenting
D. Rolling
C. Presenting
Leukocyte extravasation is the steps involved in getting the leukocyte to the site of inflammation: tight binding, transmigration, rolling
Describe Wernicke aphasia
Impaired speech comprehension
Describe Broca aphasia
Impaired speech production
(Bro - pro)
Which conditions are associated with inflammatory synovitis?
Psoriatic arthritis
Rheumatoid arthritis
IBD associated arthritis
Infectious arthritis
Acute rhematic fever
Gout. pseudogout
scleroderma
SLE
Acute crystal synovitis
An 8 year old male presents with a painless limp with gradual onset over the past 2 weeks. He has had, according to his mother, intermittent complaints of pain in the knee on the affected side. His PMH is unremarkable and immunizations are up to date.
His exam reveals hip stiffness and loss of abduction and internal rotation to the right. His gait is antalgic. Radiographic studies of the pelvis including frog-leg laterals and AP pelvis films, reveal medial joint space widening. What is true of the most probable diagnosis?
The etiology is a disruption of the blood supply.
The presentation is associated with avascular necrosis of the femoral head
What outcome is most likely a long-term sequela in a patient with COPD who presents with a new onset of:
dyspnea of exertion
a holosystolic murmur at the apex of the heart
prominent S3 gallop
pulmonary rales
lower extremity edema
Left-sided heart failure
Left-sided CHF results in an increase in left ventricular pressure, pulmonary edema, swelling/congestion of the lower legs, and shortness of breath
Rupture of which vessel would result in an epidural hemorrhage?
Middle meningeal artery
Middle meningeal artery is found between the dura matter and the skull, so blood would accumulate in the epidural space
A 5 year old female patient is seen for routine immunizations and her physician notices foot drop on exam. Further questioning of her mother reveals that the patient has frequent complaints of abdominal pain and has not been keeping up with her friends in kindergarten. Lab studies are significant for increased serum iron and ferritin and decreased total iron binding capacity. They are living with the patient’s grandmother in an older home. Which is most likely finding on peripheral blood smear?
Basophilic stippling
Lead toxicity is characterized by encephalopathy, abdominal pain, wrist and foot drop and gingival or epiphyseal lead lines. Bone marrow will often show ringed sideroblasts and basophilic stippling of RBCs
What are the following associated with:
Auer bodies
Burr cells
Howell-Jolly bodies
Basophilic stippling
Heinz bodies
Auer bodies - acute myelogenous leukemia
Burr cells - macroangiopathic anemia
Howell-Jolly bodies - asplenic patients
Heinz bodies - hemolytic anemia
Which of the following locations is most likely to contain a true glomus body?
A. Femoral artery emerging from under the inguinal ligament
B. Medial tarsal tunnel
C. Nail bed/distal location in toe
D. Lymph accumulation at the vertical lymph node
C. Nail bed/distal location in toe
