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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
what neoplasms are associated with tuberous sclerosis (facial angiofibroma, seizures, mental retardation)?
Giant cell astrocytoma renal angiomyolipoma cardiac rhabdomyoma
26
what neoplasm is associated with actinic keratosis?
squamous cell carcinoma of the skin
27
what neoplasm is associated with Plummer-Vinson syndrome (dec Fe)?
squamous cell carcinoma of the esophagus
28
what neoplasms are associated with Paget's disease of bone?
secondary osteosarcoma and fibrosarcoma
29
what neoplasm is associated with autoimmune disease (eg Hashimoto's thyroiditis, myasthenia gravis)?
Lymphoma
30
what neoplasms are associated with acanthosis nigricans?
visceral malignancy (stomach, lung, uterus)
31
what neoplasms are associated with radiation exposure?
Leukemia sarcoma papillary thyroid cancer breast cancer
32
abl associated tumor and gene product
CML Tyrosine kinase
33
c-myc associated tumor and gene product
Burkitt's lymphoma Transcription factor
34
bcl-2 associated tumor and gene product
follicular and undifferentiated lymphomas (inhibits apoptosis) anti-apoptotic molecule
35
ras associated tumor and gene product
colon carcinomas GTPase
36
L-myc associated tumor and gene product
Lung tumor Transcription factor
37
N-myc associated tumor and gene product
Neuroblastoma Transcription factor
38
ret associated tumor and gene product
MEN2A and 2B Tyrosine kinase
39
c-kit associated tumor and gene product
Gastrointestinal stromal tumor (GIST) cytokine receptor
40
Rb associated tumor and gene product
retinoblastoma, osteosarcoma inhibits E2F; blocks G1 --> S phase
41
p53 associated tumor and gene product
most human cancers, Li-Fraumeni syndrome Transcription factor for p21, blocks G1 --> S phase
42
p16 and BRAF associated tumor
melanoma
43
APC associated tumor
colorectal cancer (associated with FAP)
44
WT1 associated tumor
Wilm's Tumor (nephroblastoma)
45
NF1 associated tumor and gene product
NeuroFibromatosis 1 RAS GTPase activating protein (RAS-GAP)
46
NF2 associated tumor and gene product
NeuroFibromatosis 2 Merlin (schwannomin) protein
47
DPC4 associated tumor and gene product
Pancreatic cancer DPC - Deleted in Pancreatic Cancer
48
DCC associated tumor and gene product
Colon cancer DCC - Deleted in Colon Cancer
49
alpha-fetoprotein tumor marker
HCC | Nonseminomatous germ cell tumors (eg testis, ovary)
50
S-100 tumor marker
melanoma, neural tumors, schwannomas
51
alkaline phosphatase tumor marker
metastases to bone, liver, Paget's disease of bone
52
bombesin tumor marker
neuroblastoma, lung, gastric cancer
53
TRAP tumor marker
Tartrate-Resistant Acid Phosphatase (TRAP) Hairy cell leukemia - BC neoplasm "TRAP the Hairy animal"
54
asbestos leads to...
lung bronchogenic carcinoma > mesothelioma
55
Psammoma bodies
laminated concentric calcific spherules: Papillary adenocarcinoma of thyroid Serous papillary cystadenocarcinoma of ovary Meningioma Malignant mesothelioma ``` PSaMMoma: Papillary (thyroid) Serous (ovary) Meningioma Mesothelioma ```
56
Brain mets from where?
Lung > breast > GU > osteosarcoma > melanoma > GI
57
acanthocyte (spur cell)
liver disease, abetalipoproteinemia (states of cholesterol dysregulation) acantho = spiny
58
basophilic stippling
"BASte the ox TAiL" Thalassemia Anemia of chronic disease Lead poisoning
59
Bite cell
G6PD deficiency
60
Elliptocyte
hereditary elliptocytosis
61
macro-ovalocyte
``` megaloblastic anemia (also hypersegmented PMNs) BM failure ```
62
ringed sideroblasts
sideroblastic anemia excess iron in mitochondria = pathologic
63
sideroblastic anemia
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
schistocyte, helmet cells
DIC, TTP/HUS, traumatic hemolysis (i.e. metal heart valve prosthesis)
65
Teardrop cell
BM infiltration e.g. myelofibrosis RBC "sheds a tear" bc it's been forced out of its home in the BM.
66
Target cell
HbC disease, Asplenia, Liver disease, Thalassemia "HALT" said the hunter to his target."
67
Heinz bodies
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
Howell-Jolly bodies
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
Plummer-Vinson syndrome
triad of Fe deficiency anemia (microcytosis and hypochromia), esophageal webs, atrophic glossitis
70
alpha thalassemia: 4 gene deletion
- no alpha-globin | - Excess gamma-globin --> incompatible with life, Hydrops fetalis
71
alpha thalassemia: 3 gene deletion
HbH disease - very little alpha-globin - excess beta-globin forms beta4 (HbH)
72
alpha thalassemia: 1-2 gene deletion
no clinically significant anemia
73
beta-thalassemia
point mx in splice sites and promoter sequences --> dec beta globin synthesis MEDITERRANEAN POPULATIONS
74
beta-thal minor
heterozygote - beta chain underproduced - asx usually - dx = inc HbA2 (>3.5%) on electrophoresis
75
beta-thal major
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
HbS/beta-thal heterozygote
mild to mod sickle cell disease depending on amount of beta globin production
77
lead poisoning causes problems by...
inhibits ferrochelatase and ALA dehydratase --> dec heme synthesis inhibits rRNA degradation --> RBCs retain aggregates of rRNA (see basophilic stippling)
78
Lead poisoning sx and tx
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
Giant cell tumor (osteoclastoma)
"double bubble" or "soap bubble" appearance on x-ray benign epiphysis of long bones (distal femur, proximal tibia)
80
osteochondroma (exostosis)
most common benign tumor, males
81
osteosarcoma (osteogenic sarcoma)
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
Ewing's
boys extremely aggressive with early mets but responsive to chemo "onion skin" t(11;22)
83
chondrosarcoma
men 30-60 yo pelvis, spine, scapula, humerus, tibia, femur medullary cavity
84
sensitive but not specific for SLE
ANA
85
Ab very specific for SLE and indicative of poor prognosis
anti-dsDNA
86
very specific but not prognostic Ab for SLE
anti-Smith
87
sensitive for drug-induced lupus Ab
antihistone
88
Polymyositis and Dermatopolymyositis Ab
anti-Jo-1 Ab
89
Myasthenia gravis Ab
postsynaptic ACh receptor
90
Lambert-Eaton myasthenic syndrome Ab and association
presynaptic Ca channel --> dec ACh release small cell lung cancer
91
Diffuse scleroderma Ab
anti-Scl-70 Ab (anti-DNA topoisomerase I Ab)
92
CREST syndrome Ab
antiCentromere Ab

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