Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FMS 3 > Pathology > Flashcards

Pathology Flashcards

1
Q

What are the causes of localized edema?

A
  • inflammation
  • allergic rxn
  • venous obstruction
  • lymphatic obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the causes of systemic edema?

A

(increased retention of total Na+ and H20)

  • congestive heart failure
  • renal disease
  • hypoproteinemia (protein loss/kidney disease, decreased synthesis/liver disease, malnutrition/decreased intake)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is hyperemia?

A

-increased blood flow due to vasodilation. Active process.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the characteristics of acute pulmonary edema?

A
  • due to left ventricular failure–>increase hydrostatic pressure
  • engorgement of capillary beds–>capillary rupture–>edna in air spaces
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the characteristics of chronic pulmonary edema?

A
  • persistent, less hydrostatic pressure that acute
  • thickened interstitium
  • “heart failure cells”-macrophages w/ hemosiderin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the characteristics of acute liver congestion?

A
  • secondary to shock or hepatic vein thrombosis
  • centrilobular hepatocytes more vulnerable
  • central vein and sinusoids distended w/ blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the characteristics of chronic liver congestion?

A
  • due to right ventricular failture
  • mottled red and yellow appearance “nutmeg” liver
  • possible fatty change in mid lobular and necrosis in centrilobular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the three components of hemostasis?

A

1) endothelial cells (vessel wall injured)
2) platelets
3) coagulation cascade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the sequence of events that results in hemostasis?

A

1)exposure to subendothelium→Platelet binding and activation
2)platelet adherence/aggregation→ primary platelet plug
3) Activation of coagulation cascade at the same time as 1) and 2)
4) Last 2 steps of coagulation cascade →definitive platelet plug
•prothrombin→thrombin
•fibrinogen→fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can cause small vessel hemorrhage?

A
  • can be secondary to congestion and ↑ hydrostatic pressure
  • bleedling disorders, involving platelet deficiency
  • abnormalities of coagulation
  • ↑ vessel fragility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can cause large vessel hemorrhage?

A
  • Trauma
  • Atherosclerosis
  • Congenital aneurysms
  • Inflammatory conditions
  • Erosion caused by tumor infiltration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the differences between a blood clot and a thrombus?

A

A thrombus is:
•Result of coagulation cascade and platelet activation (blood clot is cascade only)
•Develops in vascular system or heart in living person (blood clot in extravascular)
•Often attached to underlying endothelium (blood clot not attached)
•Displays orderly layering of platelets and fibrin (blood clot randomly oriented)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Virchow triad?

A

1) endothelial injury
2) disruption of laminar blood flow: stasis or turbulence
3) blood hypercoagulability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the main cause of arterial thrombosis?

A

atherosclerotic vessel disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the sequence of events that lead to artherogenesis?

A

1) endothelial injury to large/med arteries
2) retention of LDL and endothelial activation
3) LDL oxidation
4) formation of foam cells and propagation of chronic inflammation
5) endothelial dysfunction
6) healing by smooth muscle cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the causes of cardiac thrombi?

A
  • MI
  • left atrial dilation
  • atrial fib
  • valvular disease (vegetation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the causes of aortic thrombi?

A

-atherosclerosis and aneurysm, which is secondary to atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the causes of venous thrombosis?

A

-pockets of stagnant blood in valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Whats the major distinction between superficial and deep vein thrombosis?

A

DVT are prone to embolization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the potential outcomes of thrombi?

A

1) dissolution
2) propagation
3) organization/recanalization
4) embolization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does disseminated intravascular coagulation (DIC) lead to death?

A

o Systemic activation of coagulation→ intravascular fibrin deposition →thrombosis in small/mid vessels→organ failure→ death , At the same time…
o Systemic activation of coagulation→depletion of platelets + coagulation factors→bleeding→death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What activates DIC through thromboplastic substances?

A
  • Endotoxin in gram negative sepsis
  • Obstetric complications, e.g. amniotic fluid embolism, premature placental detachment
  • Malignant tumors
  • Traumatized/necrotic tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What activates DIC through endothelial injury?

A
  • Endotoxin in gram negative sepsis
  • Antigen antibody complexes
  • Temperature extremes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the clinical symptoms of DIC?

A
  • Pulmonary edema w/ respiratory distress
  • Skin/mucous membrane bleeding
  • Hemorrhage from surgical incisions
  • Neurological signs
  • Acute renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the laboratory findings of DIC?

A
  • Thrombocytopenia from platelet consumption
  • Prolonged bleeding time
  • Elevated fibrin split products
  • Microangiopathic hemolytic anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are sources of systemic thromboemboli?

A

1) left ventricular wall thrombi
2) left atrial wall thrombi
3) valvular vegetations
4) atherosclerotic plaques or aortic aneurysms (<20%)
5) paradoxical emboli (rare) – travel from right to left heart, e.g. through patent foramen ovale, originate from venous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are sources of pulmonary thromboembolism?

A

Mostly DVT

-saddle embolus-lodges in pulmonary artery bifurcation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What causes fat embolism?

A

complication of long bone fractures, physical trauma, burns →fatty marrow released into bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the source of atheroma embolism?

A
  • Release of necrotic lipid debris in atherosclerotic plaque
  • Affects: kidney, spleen, brain, intestine (small arteries)
  • Histology: cleft like spaces from cholesterol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What causes amniotic fluid embolism?

A
  • Amniotic membrane rupture →respiratory distress, cyanosis, collapse
  • Emboli includes: epithelial cells, lanugo hair, fat, mucous droplets, intestinal discharge of fetus
  • DIC initiating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the causes of gas embolism?

A
  • side effect of medical care
  • penetrating chest wall injury
  • Decompression sickness -Caisson syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does the clinical impact of ischemia depend on?

A
  • availability and integrity of collateral blood supply
  • rate of development of obstruction
  • tissue susceptibility to ischemia
  • metabolic rate of tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What tissues do white infarcts occur in?

A

solid organs w/ poor collateral circulation- heart, kidney, brain, spleen
-caused by arterial occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What causes red infarcts? Where does it usually occur?

A
  • venous infarcts- hemorrhage is from capillary rupture
  • in lung/liver, organs with dual blood supply or marginal collateral circulation
  • necrotic tissues w/ reperfusion of necrotic area
35
Q

What organs tend to have wedge shaped infarcts?

A

Kidney, lung, spleen

36
Q

What causes Hypovolemic shock?

A

caused by large drop in intravascular blood volume due to:
•External/internal hemorrhage
•Fluid loss – vomiting, diarrhea, dehydration
•Plasma loss –burns

37
Q

What is cardiogenic shock caused by?

A
  • Heart pump failure
  • Associated with MI, or complications associated with MI – arrhythmias, interventricular septal reupture, ventricular free wall rupture
  • Pulmonary embolism
38
Q

What causes generalized vasodilation shock?

A
  • anaphylactic shock
  • neurogenic shock
  • septic shock
39
Q

What are the stages of shock?

A

1) compensation (nonprogressive)-tachycardia and peripheral vasocontriction
2) impaired tissue perfusion (progressive) - prolonged vasocontriction
3) decompensation (irreversible) - loss of vasoconstriction reflex - death likely

40
Q

Do you need high sensitive or specificity for a discovery test? (Might the patient have the disease?)

A

High sensitivity. Most patients with the disease should have a positive result.

41
Q

For a confirmation test, what is the requirement for the test?

A

100% specificity. False positives not tolerated.

42
Q

For an exclusion test, the test must be..what?

A

100% sensitive. False negatives not tolerated.

43
Q

What are the important veins that thrombosis occurs in that results in infarct?

A
  1. renal vein
  2. superior sagittal sinus
  3. mesenteric veins
44
Q

What are Grey Turner’s sign or Cullen’s sign?

A

Produced by hemorrhagic pancreatitis, blood in retroperitoneal space that dissects into the flanks or to the umbilicus

45
Q

What are the common predisposing factors for acute pancreatitis?

A

Alcohol abuse and cholelithiasis

46
Q

What are some less common predisposing factors for acute pancreatitis?

A 
abdominal trauma
infections
hypercalcemia
penetrating duodenal ulcer
use of certain drugs
hyperlipoproteinemia
hereditary pancreatitis
47
Q

What are some non specific laboratory findings in acute panreatitis?

A

low Cl-, high bicarb due to vomiting
low Ca++, very low w/ normal albumin means poor prognosis
high Hgb and Hct
high glucose increased glucagon, decreased insulin
elevated TGs, common in alcoholics

48
Q

What are specific measurements of pancreatitis?

A

serum amylase and serum lipase

49
Q

chronic elevations of serum amylase with little or no abdominal pain are seldom due to pancreatitis, but may be due to_____?

A

renal failure, decreased clearance of amylase released into serum

50
Q

What is needed to diagnose MI?

A 
1) rise in cardiac biomarkers, ie troponin-serial determinations over 12 hours
In addition, need one of following
a) symptoms of ischemia
b)ECG changes indicative of new ischemia
c) new Q waves by ECG
d)imaging evidence
51
Q

When can acute MI be excluded from diagnosis?

A

negative troponin at presentation and every 4-6 hours until 12 hours pass

52
Q

What is included in a hepatitis panel for acute hepatitis?

A

Anti HAV IgM, HBsAg, anti-HBc IgM, anti-HCV

53
Q

What do the following test results indicate?

HBsAg+ for 6 months, HBV DNA+, HBeAg+, anti-HBe-

A

chronic active HBV infection

HBeAg is the excreted form of the antigen

54
Q

What do the following test results indicate?

HBsAg+ for 6 months, HBV DNA+, HBeAg-, anti-HBe+

A

chronic carrier

55
Q

What mutation and gene is involved relating to Wilm’s tumor?

A

WT1 gene loss - deletion -nephroblastoma

56
Q

What gene and cancer is related to amplification mutation?

A

myc is unregulated and associated with neuroblastoma

57
Q

What genes are related to apoptosis and what cancers are associated?

A

p53 - apoptosis inducer - bladder, lung, ovary cancer

bcl-2 - apoptosis block - B cell lymphomas

58
Q

What tumor suppressor genes are related to colon cancer?

A

APC

59
Q

What gene is related to retinoblastoma and what is its functional category?

A

RB, is a tumor suppressor gene

60
Q

What genes if loss or inactivated, associated with mismatch repair, cause colon, endometrium cancer?

A

MSH2, LH1, PMS1, PMS2

61
Q

What are the most common types of cancer in men? What causes the most mortality? (from most to least common)

A 
Most common cancers:
1. prostate
2. Lung
3. Colon
4. Urinary
Most deaths
1. Lung
2. Prostate
3. colon
4. pancreas
62
Q

What are the most common types of cancer in women? What causes the most mortality? (from most to least common)

A 
Most common cancers:
1. Breast
2. Lung
3. colon
4. uterus
Most deaths
1. Lung
2. breast
3. colorectal
4. pancreas
63
Q

What are the neoplasms with single gene Mendelian inheritance?

A
  • retinoblastoma - deletion of Rb gene
  • Wilm’s tumor - nephroblastoma - deletion of WT1 gene
  • neurofibromatosis - NF-1 gene
  • Familial polyposis Coli - APC gene
64
Q

What is CEA a tumor marker for?

A

colorectal carcinoma

65
Q

What is AFP a tumor marker for?

A

hepatocellular carcinoma and neural tube defects

66
Q

What is hCG a tumor marker for?

A

trophoblastic disease

67
Q

What is hCG and AFP tumor markers for, used together?

A

testicular carcinomas

68
Q

What are immunoglobulins tumor markers for?

A

multiple myeloma

69
Q

What are CA15-3 and CA27-29 tumor markers for?

A

breast carcinoma

70
Q

What is CA19-9 a tumor marker for?

A

pancreatic carcinoma

71
Q

What is CA125 a tumor marker for?

A

ovarian carcinoma

72
Q

Hypercalcemia associated with cancer occurs in what three settings?

A
  1. solid tumors that produce hypercalcemia
  2. hematologic malignancies, esp multiple myeloma and T cell lymphoma
  3. widespread metastatic disease involving bone
73
Q

What are the laboratory findings of solid tumors that give rise to hypercalcemia in the absence of metastasis?

A
  • hypercalcemia

- hypophosphatemia

74
Q

What are the laboratory findings of patients with hypercalcemia due to metastatic cancer and osteolysis?

A
  • hypercalcemia

- hyperphosphatemia

75
Q

What cancer is the major cause of ectopic Cushing syndrome?

A

carcinomas of the lung, esp small cell carcinoma

76
Q

Why do some carcinomas lead to ectopic Cushing disease?

A

produce large amounts of POMC which is converted to ACTH –>cortisol release–>cushing syndrome

77
Q

What are the most common types of cancer in pediatrics versus adults?

A 
pediatrics:
1. lymphomas 50%
2. blastomas
3. CNS tumors
adults
1. carcinomas 85%
78
Q

List some carcinogenic chemicals and their associated cancers.

A
  1. soot -scrotal cancer -polycyclic HCs
  2. aromatic amine - benzidine and naphtylamine- bladder cancer
  3. azo dyes - liver tumors
  4. nitrosamines -stomach cancer
79
Q

What gene is associated with the ‘Philadelphia chromosome’ of chronic myelogenous leukemia (CML)?

A

ABL

80
Q

What are examples of oncogenic RNA viruses?

A

HTLV -human t leukemia virus type I
HIV
Hep C maybe with HBV

81
Q

What are examples of oncogenic DNA viruses?

A
  • HPV
  • EBV - epstein barr virus
  • Hep B virus
  • HHV and CMV
82
Q

What are BRCA1 and 2 genes involved in?

A

DNA repair

83
Q

Generally, what activates DIC?

A
  • release of thromboplastic substances into the circulation

- widespread injury to endothelial cells

FMS 3 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions