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Pathology Flashcards

1
Q

Vimentin stains for…

A

connective tissue intermediate filaments

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2
Q

desmin stains for…

A

muscle intermediate filaments

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3
Q

cytokeratin stains for…

A

epithelial cell intermediate filaments

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4
Q

GFAP stains for…

A

neuroglia intermediate filaments

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5
Q

Neurofilaments stain for…

A

neuron intermediate filaments

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6
Q

Post-strep glomerulonephritis IF and EM findings

A 
IF = C3 granular staining along GBM
EM = subepithelial humps
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7
Q

Anti-GBM disease LM and IF findings

A

LM - glomerular crescents

IF = linear staining (IgG) along GBM

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8
Q

Rapidly progressive glomerulonephritis LM and IF findings

A 
LM = glomerular crescents
IF = fibrinogen in crescent
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9
Q

IgA nephropathy LM and IF findings

A 
LM = mesangial hypercellularity 
IF = IgA in mesangium
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10
Q

Alport syndrome EM findings

A

EM = lamellated appearanced of GBM

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11
Q

Granulomatous Diseases

A 
M. TB
Fungal infections (e.g. histo, coccidioid)
Treponema pallidum (syphilis)
M. leprae (leprosy)
Bartonella Henslae
Sarcoidosis
Crohn's
Granulomatosis with polyangiitis 
Churg-Strauss syndrome
Berylliosis, silicosis

Th1 releases IFN gamma –> macros activated –> release TNF alpha –> induces and maintains granuloma

anti-TNF drugs –> granuloma breakdown –> system disease

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12
Q

Transudate

A

hypocellular
protein poor
specific gravity

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13
Q

Exudate

A

cellular
protein rich
specific gravity >1.020

c/b:
lymphatic obstruction
inflammation

eg cancer, infection, PE

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14
Q

Iron poisoning

A

cell death 2/2 peroxidation of membrane lipid

acute - gastric bleeding
chronic - metabolic acidosis, scarring leading to GI obstruction

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15
Q

Amyloidosis

A

abrnomal aggregation of proteins or their fragments into beta pleated sheet structures –> cell damage and apoptosis

affected tissue = waxy appearance

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16
Q

AL amyloidosis = primary

A

deposition of Ig Light chains

c/b plasma cell d/o or MM

multi organ impact = renal, cardiac, hematologic, hepatomegaly, neuropathy

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17
Q

AA (secondary) amyloidosis

A

fibrils composed of serum Amyloid A –> multisystem

RA, IBD, spondyloarthropathy, chronic infections

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18
Q

Dialysis-related amyloidosis

A

fibrils composed of beta2-microglobulin in pts with ESRD and long-term dialysis

p/w carpal tunnel syndrome and other joint issues

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19
Q

heritable amyloidosis

A

eg ATTR neurologic/cardiac amyloidosis c/b transthyretin (TTR or prealbumin) gene mutation

transthyretin = protein that make amyloid fibrils

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20
Q

senile systemic amyloidosis

A

deposition of wild-type TTR in myocardium and other sites

slower progression of cardiac dysfunction than AL type

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21
Q

organ-specific amyloidosis

A

single organ

Alzheimer’s 2/2 deposition of amyloid-beta protein cleaved from amyloid precursor protein (APP)

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22
Q

what cytokines is cachexia mediated by?

A

TNF-alpha
IFN-gamma
IL-6

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23
Q

what neoplasms are associated with Down Syndrome?

A

ALL (“we ALL fall DOWN”)

AML

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24
Q

what neoplasms are associated with Xeroderma pigmentosum, albinism?

A

squamous cell carcinomas of the skin
melanoma
basal cell carcinoma

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25
Q

what neoplasms are associated with tuberous sclerosis (facial angiofibroma, seizures, mental retardation)?

A

Giant cell astrocytoma
renal angiomyolipoma
cardiac rhabdomyoma

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26
Q

what neoplasm is associated with actinic keratosis?

A

squamous cell carcinoma of the skin

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27
Q

what neoplasm is associated with Plummer-Vinson syndrome (dec Fe)?

A

squamous cell carcinoma of the esophagus

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28
Q

what neoplasms are associated with Paget’s disease of bone?

A

secondary osteosarcoma and fibrosarcoma

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29
Q

what neoplasm is associated with autoimmune disease (eg Hashimoto’s thyroiditis, myasthenia gravis)?

A

Lymphoma

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30
Q

what neoplasms are associated with acanthosis nigricans?

A

visceral malignancy (stomach, lung, uterus)

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31
Q

what neoplasms are associated with radiation exposure?

A

Leukemia
sarcoma
papillary thyroid cancer
breast cancer

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32
Q

abl associated tumor and gene product

A

CML

Tyrosine kinase

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33
Q

c-myc associated tumor and gene product

A

Burkitt’s lymphoma

Transcription factor

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34
Q

bcl-2 associated tumor and gene product

A

follicular and undifferentiated lymphomas (inhibits apoptosis)

anti-apoptotic molecule

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35
Q

ras associated tumor and gene product

A

colon carcinomas

GTPase

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36
Q

L-myc associated tumor and gene product

A

Lung tumor

Transcription factor

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37
Q

N-myc associated tumor and gene product

A

Neuroblastoma

Transcription factor

38
Q

ret associated tumor and gene product

A

MEN2A and 2B

Tyrosine kinase

39
Q

c-kit associated tumor and gene product

A

Gastrointestinal stromal tumor (GIST)

cytokine receptor

40
Q

Rb associated tumor and gene product

A

retinoblastoma, osteosarcoma

inhibits E2F; blocks G1 –> S phase

41
Q

p53 associated tumor and gene product

A

most human cancers, Li-Fraumeni syndrome

Transcription factor for p21, blocks G1 –> S phase

42
Q

p16 and BRAF associated tumor

A

melanoma

43
Q

APC associated tumor

A

colorectal cancer (associated with FAP)

44
Q

WT1 associated tumor

A

Wilm’s Tumor (nephroblastoma)

45
Q

NF1 associated tumor and gene product

A

NeuroFibromatosis 1

RAS GTPase activating protein (RAS-GAP)

46
Q

NF2 associated tumor and gene product

A

NeuroFibromatosis 2

Merlin (schwannomin) protein

47
Q

DPC4 associated tumor and gene product

A

Pancreatic cancer

DPC - Deleted in Pancreatic Cancer

48
Q

DCC associated tumor and gene product

A

Colon cancer

DCC - Deleted in Colon Cancer

49
Q

alpha-fetoprotein tumor marker

A

HCC

Nonseminomatous germ cell tumors (eg testis, ovary)

50
Q

S-100 tumor marker

A

melanoma, neural tumors, schwannomas

51
Q

alkaline phosphatase tumor marker

A

metastases to bone, liver, Paget’s disease of bone

52
Q

bombesin tumor marker

A

neuroblastoma, lung, gastric cancer

53
Q

TRAP tumor marker

A

Tartrate-Resistant Acid Phosphatase (TRAP)

Hairy cell leukemia - BC neoplasm

“TRAP the Hairy animal”

54
Q

asbestos leads to…

A

lung bronchogenic carcinoma > mesothelioma

55
Q

Psammoma bodies

A

laminated concentric calcific spherules:

Papillary adenocarcinoma of thyroid
Serous papillary cystadenocarcinoma of ovary
Meningioma
Malignant mesothelioma

PSaMMoma:
Papillary (thyroid)
Serous (ovary)
Meningioma
Mesothelioma
56
Q

Brain mets from where?

A

Lung > breast > GU > osteosarcoma > melanoma > GI

57
Q

acanthocyte (spur cell)

A

liver disease, abetalipoproteinemia (states of cholesterol dysregulation)

acantho = spiny

58
Q

basophilic stippling

A

“BASte the ox TAiL”

Thalassemia
Anemia of chronic disease
Lead poisoning

59
Q

Bite cell

A

G6PD deficiency

60
Q

Elliptocyte

A

hereditary elliptocytosis

61
Q

macro-ovalocyte

A 
megaloblastic anemia (also hypersegmented PMNs)
BM failure
62
Q

ringed sideroblasts

A

sideroblastic anemia

excess iron in mitochondria = pathologic

63
Q

sideroblastic anemia

A

there are available iron stores in body but can’t incorporate it into Hb due to x-linked defect in DELTA-ALA SYNTHASE

reversible etiologies: EtOH, lead, isoniazid

  • labs: inc iron, normal TIBC, inc ferritin (vs. Fe deficiency anemia where you have dec Fe, inc TIBC, dec ferritin)
  • tx: pryidoxine (cofactor for ALA synthase)
64
Q

schistocyte, helmet cells

A

DIC, TTP/HUS, traumatic hemolysis (i.e. metal heart valve prosthesis)

65
Q

Teardrop cell

A

BM infiltration e.g. myelofibrosis

RBC “sheds a tear” bc it’s been forced out of its home in the BM.

66
Q

Target cell

A

HbC disease, Asplenia, Liver disease, Thalassemia

“HALT” said the hunter to his target.”

67
Q

Heinz bodies

A

oxidation of Fe from ferrous (2+) to ferric (3+) –> denatured Hb precipitation and damage to RBC membrane –> bite cells

seen in G6PD deficiency

Heinz body-like inclusions seen in alpha thalasemia

68
Q

Howell-Jolly bodies

A

basophilic nuclear remnants found in RBCs (remember RBC shouldn’t have nucleus)

normally removed from RBCs by splenic macrophages –> therefore seen in pts with functional hyposplenia, asplenia, or mothball (naphthalene) ingestion

69
Q

Plummer-Vinson syndrome

A

triad of Fe deficiency anemia (microcytosis and hypochromia), esophageal webs, atrophic glossitis

70
Q

alpha thalassemia: 4 gene deletion

A
  • no alpha-globin

- Excess gamma-globin –> incompatible with life, Hydrops fetalis

71
Q

alpha thalassemia: 3 gene deletion

A

HbH disease

  • very little alpha-globin
  • excess beta-globin forms beta4 (HbH)
72
Q

alpha thalassemia: 1-2 gene deletion

A

no clinically significant anemia

73
Q

beta-thalassemia

A

point mx in splice sites and promoter sequences –> dec beta globin synthesis

MEDITERRANEAN POPULATIONS

74
Q

beta-thal minor

A

heterozygote

  • beta chain underproduced
  • asx usually
  • dx = inc HbA2 (>3.5%) on electrophoresis
75
Q

beta-thal major

A

homozygote

  • beta chain is absent causing severe anemia
  • requires blood transfusion (can get secondary hemochromatosis)
  • marrow expansion (“crew cut” on skull x-ray) –> skeletal deformities. “Chipmunk” facies
  • inc HbF (alpha2, gamma2)
76
Q

HbS/beta-thal heterozygote

A

mild to mod sickle cell disease depending on amount of beta globin production

77
Q

lead poisoning causes problems by…

A

inhibits ferrochelatase and ALA dehydratase –> dec heme synthesis

inhibits rRNA degradation –> RBCs retain aggregates of rRNA (see basophilic stippling)

78
Q

Lead poisoning sx and tx

A

LEAD:

  • Lead Lines on gingivae (burton’s lines) and on metaphyses of long bones on x-ray.
  • Encephalopathy and Erythrocyte stippling.
  • Abdominal colic and sideroblastic Anemia.
  • Drops - write and foot drop.

Tx;
Dimercaprol
eDta

Succimer = chelation for kids

79
Q

Giant cell tumor (osteoclastoma)

A

“double bubble” or “soap bubble” appearance on x-ray

benign

epiphysis of long bones (distal femur, proximal tibia)

80
Q

osteochondroma (exostosis)

A

most common benign tumor, males

81
Q

osteosarcoma (osteogenic sarcoma)

A

2nd most common primary malignant bone tumor (after MM)

10-20 years of age

RFs: Paget’s, bone infarcts, radiation, familial retinoblastoma

Codman’s triangle or sunburst pattern. Metaphysis of long bones.

82
Q

Ewing’s

A

boys extremely aggressive with early mets but responsive to chemo

“onion skin”
t(11;22)

83
Q

chondrosarcoma

A

men 30-60 yo

pelvis, spine, scapula, humerus, tibia, femur

medullary cavity

84
Q

sensitive but not specific for SLE

A

ANA

85
Q

Ab very specific for SLE and indicative of poor prognosis

A

anti-dsDNA

86
Q

very specific but not prognostic Ab for SLE

A

anti-Smith

87
Q

sensitive for drug-induced lupus Ab

A

antihistone

88
Q

Polymyositis and Dermatopolymyositis Ab

A

anti-Jo-1 Ab

89
Q

Myasthenia gravis Ab

A

postsynaptic ACh receptor

90
Q

Lambert-Eaton myasthenic syndrome Ab and association

A

presynaptic Ca channel –> dec ACh release

small cell lung cancer

91
Q

Diffuse scleroderma Ab

A

anti-Scl-70 Ab (anti-DNA topoisomerase I Ab)

92
Q

CREST syndrome Ab

A

antiCentromere Ab

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