Pathology Flashcards
1
Q
1 cause of Cushing Syndrome
A
exogenous use of corticosteroids
2
Q
Bilateral Adrenal Atrophy and decreased ACTH
A
exogenous use of corticosteroids
3
Q
Atrophy of uninvolved Adrenal Gland and decreased ACTH
A
Primary adrenal adenoma, hyperplasia or carcinoma
4
Q
ACTH-secreting pituitary adenoma
A
Cushing Dx
5
Q
Paraneoplastic ACTH secretion
A
small cell lung cancer, bronchial carcinoids
6
Q
HTN, wt gain, moon facies, truncal obesity, buffalo hump, hyperglycemia, striae, osteoporosis, amenorrhea, immune suppression
A
Cushing Syndrome
7
Q
increase free cortisol on 24hr urinalysis
A
Cushing Syndrome
8
Q
Low Dose Dexamethasone suppression test: adequate suppression
A
Cushing Disease
9
Q
Low Dose Dexamethasone suppression test: No Suppression
A
ectopic ACTH secretion
10
Q
CRH Stimulation Test: increase ACTH and Cortisol
A
Cushing Disease
11
Q
CRH Stimulation Test: no increase in ACTH and cortisol
A
ectopic ACTH secretion
12
Q
How Cortisol causes Immunosuppression
A
1) inhibit Phospholipase A2
2) Inhibit IL-2
3) Inhibit Histamine release
13
Q
1 cause of Primary Hyperaldosterone
A
Aldosterone-secreting Adrenal Adenoma (Conn)
14
Q
HTN, hypoK, Met. alkalosis, low plasma renin
A
Conn Syndrome (Primary Hyperaldosterone)
15
Q
Cause of Secondary Hyperaldosterone
A
renal artery stenosis, CHF, cirrhosis or nephrotic syndrome
16
Q
High Plasma Renin (overactive RAS)
A
Secondary Hyperaldosteronism
17
Q
Tx of Secondary Hyperaldosteronism
A
Spironolactone
18
Q
Chronic Primary Adrenal Insufficiency due to adrenal atrophy or destruction
A
Addison Disease
19
Q
Skin Mucosal Hyperpigmentation, hyperK, acidosis, hypotension, increased ACTH
A
Aldosterone and cortisol deficiency (Addision Dx)
20
Q
HyperK, acidosis, hypotension, decreased ACTH
A
secondary adrenal insuffieincy
21
Q
Acute primary adrenal insuffiency due to adrenal hemorrhage associated with Niesseria meningitidis, septicemia, DIC and endotoxic shock
A
Waterhouse-Friedrichsen Syndrome
22
Q
Most common tumor of adrenal medulla in children
A
Neuroblastoma
23
Q
Overexpression of N-myc gene, HTN in children, distended abdomen, Bombesin (+)
A
Neuroblastoma
24
Q
Homovanillic acid (HVA) in urine
A
Breakdown product of dopamine, associated with Neuroblastoma
25
Episodic HTN, palpitations, tachycardia and sweating
Pheochromocytoma
26
Rule of 10's
10% malignant, 10% BL, 10% extra-adrenal (bladder wall), 10% calcify, 10% kids
Pheochromocytoma
27
Urinary VMA
Pheochromocytoma (breakdown product of NE and Epi)
28
Tx of Pheochromocytoma
Irreversible alpha-anatognist (phenoxybenzamine) and beta-blockers followed by tumor resection
29
Salt wasting (hypoNa), kyperK, hypovolemia, HYPOTENSION, clit enlargement or precocious puberty
Congenital Adrenal Hyperplasia, 21-hydroxylase deficiency
30
Cold intolerance, Weight gain, decreased appetite, Constipation
Hypothyroidism
31
Dry, cool skin, coarse, brittle hair, bradycardia, hypercholesterolemia
Hypothyroidism
32
Heat intolerance, weight loss, increased appetite, hyperactive
Hyperthyroidism
33
Diarrhea, icnreases reflexes, chest pain, palpitations, arrhythmia, warm, moist skin
Hyperthyroidism
34
Pretibial myxedema
Graves Dx (hyperthyroidism)
35
Most common cause of hypothyroidism in iodine-sufficient areas
Hashimoto Thyroiditis
36
Anti-thyroid peroxidase, antithyroglobulin antibodies
Hashimoto Thyroiditis
37
HLA-DR5
Hashimoto Thyroiditis
38
Hurthle cells in germinal centers of thyroid tissue
Hashimoto Thyroiditis
39
Hashimoto Thyroiditis increase risk to what cancer?
non-Hodgkin Lymphoma
40
Cretinism
congenital hypothyroidism due to maternal hypothyroidisim, thyroid agenesis or dysgenesis, iodine deficiency
41
Pot-bellied, Pale, Puffy faced child with protruding Umbilicus, protuberant tongue and poor brain development
Cretinism (congenital hypothyroidism)
42
Self-limited hypothyroidsim following a flu-like illness
Subacute thyroiditis (de Quervain)
43
granulomatous inflammation of thyroid, hypothyroidism
Subacute thyroiditis (de Quervain)
44
tender thyroid, hypothyroidism
Subacute thyroiditis (de Quervain)
45
Thyroid replaced by fibrous tissue
Riedel Thyroiditis
46
hard, painless goiter
Riedel Thyroiditis
47
Mimicks anaplastic carcinoma
Riedel Thyroiditis
48
Hyperfunctioning follicular cells working independently of TSH due to mutation in TSH receptor
Toxic multinodular goiter (hyperthyroidism)
49
Jod-Basedow Phenomenon
thyrotoxicosis if a patient with iodine deficiency goiter is made iodine replete (Toxic multinodular goiter)
50
retro-orbital fibroblasts
Proptosis, extraocular muscle swelling - Graves Dx for hyperthyroidism
51
Scalloping of colloid thyroid
Grave's Dx (hyperthyroidism)
52
Tx of Graves
Thioamide (block peroxidase), Radioiodine ablation, Beta-blockers
53
Autoantibodies (IgG) that stimulate TSH-R
Grave's Dx (hyperthyroidism)
54
Stress-induces catecholamine surge seen as serious complicatino of Graves Disease
Thyroid Storm
55
agitation, delirium, fever, diarrhea, coma, increase ALP from increase bones turnover and tachycardia
Thyroid Storm
56
Tx of Thyroid Storm
Propranolol, Propyluracil, Prednisolone
57
Benign proliferation of thyroid follicles surrounded by a fibrous capsule
Follicular adenoma
58
4 Carcinomas that spread through the blood
Renal carcinoma - Renal Vein
Hepatocellular carcinoma - hepatic vein
Follicular carcinoma
Choriocarcinoma
59
Complications of Thyroid resection
Hoarseness - recurrent laryngeal
hypocalcemia - PTH removal
transectino of inferior thyroid artery
60
Orphan Annie Eyes
Papillary carcinoma of Thyroid (most common)
61
RET and BRAF mutations, childhood irradiation
Papillary carcinoma of Thyroid
62
Psammoma bodies, nuclear grooves, spreads to cervical nodes but excellent prognosis
Papillary carcinoma of Thyroid
63
Cancer from parafollicular C cells
medullary carcinoma of thyroid
64
Hypocalcemia, sheets of amyloid stroma associated wtih MEN2A and 2B
medullary carcinoma of thyroid
65
"Stones, bones, groans, and psychiatric overtones"
Primary HyperPTH
66
cystic bone spaces filled with brown fibrous tissue
Osteitis fibrosis cystica
67
Constipation, weakness, kidney stones, acute pancreatitis, depression
Primary HyperPTH
68
Bone lesions due to Secondary or tertiary HyperPTH
Renal Osteodystrophy
69
Causes of secondary hyperPTH
chronic renal disease, hypovitaminosis D, Hypocalcemia, hyperphosphatemia
70
Tetany
Hypocalcemia
71
Chvostek Sign
Tapping facial nerve (cheek) causes contraction of facial mucles, seen in hypoPTH, hypocalcemia
72
Trousseau Sign
Occlude Brachial Artery by BP cuff and get carpal spasm, seen in hypoPTH and hypocalcemia
73
Albright hereditary osteodystrophy
pseudohypoparathyroidism, autosomal dominant unresponsiveness of kidney to PTH
74
Hypocalcemia, shortened 4th/5thh digits, short stature
pseudohypoparathyroidism, Albright hereditary osteodystrophy
75
Mass effect
nonfunctional tumor, bitemporal hemianopsia hypopituitarism and HA
76
microadenoma
<1cm
77
macroadenoma
>1cm
78
Tx of prolactinoma
dopamine agonist Bromocriptine or Cabergoline
79
Large Tongue, deep voice, large hands and feet, coarse facial features, insulin resistance
Acromegaly
80
Most common cause of death in Gigantism
Cardiac Failure
81
increased serum IGF-1, failure to suppress GH following oral glucose tolerance test
Acromegaly
82
Tx of Acromegaly
Octreotide (somatostatin analog) or Pegvisomant (GH-R antagonist) or pituitary resection
83
Intense thirst and polyuria with inability to concentrate urine due to lack of ADH
Diabetes Insipidus
84
Decreased ADH, No change with water restriction, do get change with desmopressin
Central DI
85
normal or increased ADH, no change with water restriction test, no response to DDAVP
Nephrogenic DI
86
Tx of Nephrogenic DI
HCTZ, indomethacin, amiloride, hydration
87
Tx of Central DI
DDAVP, hydration
88
Secondary to hypercalcemia and lithium and demeclocycline
Nephrogenic DI
89
Hyponatremia with continued urinary sodium excretion
SIADH
90
excessive water retention
SIADH
91
Correct SIADH slowly to prevent
Central Pontine Myelinolysis
92
Causes of SIADH
ectopic ADH like small cell lung cancer, CNA disorders/head trauma, pulmonary disease and cyclophosphamide
93
Tx of SIADH
fluid restriction, IV hypertonic saline, conivaptan, tolvaptan and demeclocycline (blocks ADH)
94
Ischemic infarct of pituitary following postpartum bleeding; failure to lactate
Sheehan Syndrome
95
Pituitary Apoplexy
bleeding into pituitary
96
Empty sella syndrome
atrophy or compression of pituitary, often idiopathic or obese women
97
Kimmelstiel-Wilson syndrome
Diabetic nephropathy (kidney disease) from chronic diabetes
98
Diabetic Osmotic Damage of certain cells
Schwann Cells - peripheral neuropathy
Pericytes of Retina BV - blindness
Lens - cataracts
All caused by increased glucose, aldose reductase turns into sorbitol
99
Autoimmune destruction of beta cella
Type IV HS, Type I diabetes mellitus
100
HLA-DR3 and 4
Type I diabetes mellitus
101
Islet leukocytic infiltrate
Type I DM
102
Islet amyloid polypeptide deposits
Type II DM
103
Ketoacidosis
More likely in Type I DM
104
Glucose Intolerance
Type I DM
105
rapid/deep breathing, delirium, dehydration, fruity breath
DKA
106
>300mg/dL sugar, hyperK, acidosis
DKA
107
Mucormycosis (Rhizopus), Cerebral edema, HF
DKA complications
108
tx of DKA
IV fluids, insulin, and potassium
109
Lethargy, Syncope, Diplopia
Whipple Triad of episodic CNS symptoms from insulinoma (Hypoglycemia)
110
Random Glucose >200mg/dL
DM Type II
111
Glucose Tolerance test >200mg/dL 2hr after glucose load
DM Type II
112
Fasting Glucose >126mg/dL
DM Type II
113
Glucose >500mg/dL, hypotension and coma, no ketones
Hyperosmolar Non-Ketotic Coma, associated with Type II DM
114
Achlorhydria, Cholelithiasis and Steatorrhea
Somatostatinoma
115
Watery diarrhea, hypoK, anchlorhydria
VIPoma
116
High levels of 5-HT, recurrent diarrhea, cutaneous flushing, asthmatic wheezing and right sided valvular disease
Carcinoid Syndrome
117
Increased 5-HIAA in urine
Carcinoid Syndrome
118
Tx of Carcinoid Syndrome
resection of Octreotide (somatostatin analog)
119
Most common malignancy in the small intestine
Carcinoid Syndrome
120
Recurrent ulcers in distal duodenum and jejunum
ZE-syndrome
121
Pituitary, parathyroid, and Pancreas Tumors
MEN1 - Wermer Syndrome
122
Commonly present with kidney stones and stomach ulcers
MEN1 - Wermer Syndrome
123
Medullary thyroid carcinoma, Pheochromocytoma, parathyroid hyperplasia
MEN2A (Sipple Syndrome)
124
Medullary thyroid carcinoma, Pheochromocytoma, Oral/intestinal ganglioneuromatosis (mucosal neuromas),
MEN2B
125
Associated with Marfanoid Habitus
MEN2B
126
ret gene mutation
MEN2A and 2B
127
Drunk Drive Thru
Taco Bell
