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Pathology (J) > Pathology > Flashcards

Pathology Flashcards

1
Q

Rapid destruction of valves by Staphylococcus aureus

A

Acute infective endocarditis

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2
Q

Gradual damage to valves with long term PUO

A

Subacute infective endocarditis

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3
Q

Subacute infective endocarditis signs

A
  • PUO
  • Clubbing
  • Splinter haemorrhages
  • Roth spots
  • Splenomegaly
  • Microscopic haematuria
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4
Q

Major causative organism in subacute infective endocarditis

A

Strep viridans

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5
Q

Raised serum ALP and ‘beading’ of bile ducts of ERCP (caused by biliary strictures)

A

Primary sclerosing cholangitis

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6
Q

Skin rash, thought to be associated with viral infection, characterised by small patches of flakey pink or red skin found predominantly on the torso and back, often preceded by a single oval-shaped ‘herald’ patch 7-14 days prior to the main rash

A

Pityriasis rosea

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7
Q

Nutmeg liver

A

Caused by congestive heart failure

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8
Q

Oat cells

A

Histological finding associated with small-cell lung cancer

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9
Q

CREST syndrome

A 
Calcinosis (calcium deposits in soft tissue)
Raynaud's phenomenon
Esophogeal dysmotility
Sclerodactyly
Telangiectasia

Anti-centromere

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10
Q

CREST syndrome is also known as…

A

Limited cutaneous form of systemic sclerosis/scleroderma

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11
Q

Diffuse scleroderma

A
  • May also affect internal organs such as the kidneys, lungs and heart (unlike limited cutaneous scleroderma which mainly affects the skin)
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12
Q

Stain used in the diagnosis of amyloidosis

A

Congo red (appears apple-green under polarised light)

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13
Q

pemphiguS vs pemphigoiD

A 
pemphiguS = Superficial
pemphigoiD = Deep
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14
Q
  • Blistering disorder caused by autoantibodies against desmogleins disrupting the desmosomal connections of the epidermis
  • Superficial, fragile, intraepidermal bullae
A

Pemphigus vulgaris

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15
Q

Nikolsky’s sign

A

Slight rubbing of the skin results in exfoliation of the outermost layer, associated with toxic epidermal necrolysis and pemphigus vulgaris

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16
Q

Bullous pemphigoid

A
  • Autoantibodies directed against the hemidesmosomes that tether epithelial cells to the basement membrane resulting in less fragile sub-epidermal bullae
  • Patients are more likely to have intact, tense bullae (rather than the ruptured and scabbed bullae of pemphigus vulgaris)
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17
Q

C1 inhibitor deficiency

A
  • C1 inhibitors prevent inappropriate activation of the complement system
  • Deficiency may cause hereditary angioedema (episodes of swelling affecting the face, upper airways, extremities and GIT)
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18
Q

Skin condition, thought to be immune-mediated, that presents with annular target lesions

A

Erythema multiforme

Can be caused by infections such as HSV or drug reactions e.g. penicillin

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19
Q

Slow-growing type of neuroendocrine tumour that may cause flushing, diarrhoea, wheezing and abdominal cramping due to the excessive release of vasoactive hormones

A

Carcinoid (causing carcinoid syndrome, usually due to serotonin release)

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20
Q

Test for carcinoid syndrome

A

Urinary 5-HIAA (end product of serotonin/5-HT metabolism)

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21
Q

Range of autosomal recessive diseases resulting from mutations in the enzymes that produce cortisol in the adrenal glands

A

Congenital adrenal hyperplasia

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22
Q

Most common form of congenital adrenal hyperplasia

A

21-hydroxylase deficiency

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23
Q

Key features of 21-hydroxylase deficiency

A
  • Elevated ACTH (due to inefficient cortisol synthesis, causing adrenal hyperplasia)
  • Androgen excess (synthesis is unaffected by mutation and is driven by an excess of precursors which spill-over from the inefficient cortisol pathway)
  • Mineralocorticoid deficiency
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24
Q

Parvovirus B19 ‘slapped cheek’ rash

A

Erythema infectiosum

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25
Q

Risk to fetus from parvovirus B19

A
  • Less than 20 weeks = 3% risk of hydrops fetalis

- No risk if greater than 20 weeks

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26
Q

RNA virus that may cause flu-like symptoms, a pin-point maculopapular rash and lymphadenopathy in adults and poses a risk to fetal development

A

Rubella

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27
Q

Congenital rubella syndrome (CRS)

A

Classic triad:

  • Sensorineural deafness
  • Eye abnormalities
  • Congenital heart disease

Rare if infected after 20 weeks

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28
Q

Major physiological determinants of plasma osmolarity

A

Na+, K+, Cl-, HCO3-, urea, glucose

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29
Q

Calculating osmolarity

A

2(Na + K) + urea + glucose

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30
Q

Serum osmolality normal range

A

275 - 295 mmol/kg

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31
Q

Osmolar gap

A

Osmolality (measured) - Osmolarity (calculated)

  • Should be less than 10
  • An elevated gap may be caused by the presence of an abnormal solute (e.g. ethylene glycol, ethanol, methanol)
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32
Q

Anion gap

A

(Na + K) - (Cl + HCO3)

  • Measures the difference between the total concentration of principal cations (positive ions) and anions (negative ions), providing an estimate of the concentration of unmeasured anions in the plasma (since the plasma is electrochemically neutral)
  • Under normal physiological conditions the anion gap is mostly contributed to by albumin (a negative protein), thus hypoalbuminaemia can lower the anion gap
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33
Q

Normal anion gap

A

14 - 18 mmol/l

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34
Q

Causes of high anion gap metabolic acidosis

A

K - ketoacidosis (DKA, alcoholic, starvation)
U - uraemia (renal failure)
L - lactic acidosis
T - toxins (ethylene glycol, methanol, salicylates)

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35
Q

Virus capable of causing aseptic meningitis and Bornholm disease (fever, headache, attacks of severe pleurodynia)

A

Coxsackie B virus

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36
Q

Rubbing of psoriatic plaques causing pin-point bleeding

A

Auspitz’ sign

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36
Q

Parakeratosis

A

Nucleated cells found in the stratum corneum due to excessive proliferation of keratinocytes (e.g. psoriasis)

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37
Q

Guttate psoriasis

A

Rain-drop plaque distribution, often following a Streptococcal throat infection

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38
Q

Wickam’s striae

A

White lines visible in the papules and plaques of lichen planus

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39
Q

Clubbing of rete ridges (“test tubes in a rack”)

A

Psoriasis

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40
Q

Munro’s microabscesses

A

Psoriasis

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41
Q

Saw-toothing of rete ridges

A

Lichen planus

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42
Q

Rapidly growing nodule with a scaly keratin core that arises from sun-damaged hair follicle skin cells

A

Keratoacanthoma

43
Q

Narrow, elongated cell associated with sarcoma

A

Spindle cell

44
Q

Causes of microcytic anaemia

A

IDA
Anaemia of chronic disease
Sideroblastic anaemia

45
Q

Causes of normocytic anaemia

A 
Acute blood loss
Anaemia of chronic disease
BM failure
Renal failure
Haemolysis
Pregnancy
46
Q

Causes of macrocytic anaemia

A 
FATRBC
Fetus (pregnancy)
Antifolates (e.g. phenytoin)
Thyroid (hypothyroidism)
Reticulocytosis
B12 or folate deficiency
Cirrhosis
47
Q

Hepcidin

A
  • Produced by the liver
  • Inhibits transferrin and reduces iron absorption from the gut
  • Causes iron to accumulate in macrophages (key protein: ferritin, intracellular iron storage)
  • Invading bacteria deprived of iron
48
Q

Microcytic anaemia with ring sideroblasts in the bone marrow

A

Sideroblastic anaemia

  • Ineffective erythropoiesis with poor incorporation of iron into haemoglobin
  • Can lead to haemosiderosis (damage to organs due to haemosiderin deposition)
  • Causes: myelodysplastic disorders, chemotherapy, irradiation, alcohol, anti-TB medication
49
Q

Which cells produce intrinsic factor?

A

Gastric parietal cells

50
Q

Pernicious anaemia

A

Lack of intrinsic factor for vitamin B12 absorption due to autoimmune attack of parietal cells

51
Q

Inherited haemolytic anaemia

A
  • Membrane (hereditary spherocytosis)
  • Enzyme (G6PD deficiency, pyruvate kinase deficiency)
  • Haemoglobinopathy (SCD, thalassaemia)
52
Q

Acquired haemolytic anaemia

A
  • Immune (autoimmune and alloimmune)

- Non-immune (mechanical, PNH, MAHA, infection e.g. malaria, drugs)

53
Q

Chromosome affected in CF due to mutations in the CFTR gene

A

Chromosome 7

54
Q

Most common CFTR gene mutation in the UK

A

Delta F508

55
Q

Major copper carrying protein in blood

A

Caeruloplasmin

56
Q

Intracellular copper transporting protein mutated in Wilson’s disease

A

ATP7B

Leads to reduced levels of serum caeruloplasmin due to poor copper binding to apocaeruloplasmin in the liver

57
Q

Howell-Jolly bodies

A

Peripheral RBCs containing purple nuclear remnants due to splenic dysfunction (e.g. post-splenectomy, SCD)

58
Q

Nephrotic syndrome

A

Proteinuria

59
Q

Nephritic syndrome

A

Proteinuria and haematuria

Can occur in post-streptococcal glomerulonephritis

61
Q

Histological features of rheumatic fever

A

Fibrous vegetations (verrucae)
Aschoff bodies
Anitschkov myocytes

62
Q

Haemophilia A

A

Factor VIII deficiency

Most common

63
Q

Haemophilia B

A

Factor IX deficiency

64
Q

Growth medium used for culture of TB

A

Lowenstein-Jensen medium

65
Q

1st generation cephalosporin

A

Cephalexin

66
Q

2nd generation cephalosporin

A

Cefuroxime

67
Q

3rd generation cephalosporins

A

Cefotaxime
Ceftriaxone

Ceftazidime (covers Pseudomonas)

68
Q

Ophthalmia neonatorum

A

Neonatal conjunctivitis caused by infection with gonorrhoea or chlamydia via the birth canal

69
Q

Chlamydia serovars responsible for trachoma

A

A, B and C

70
Q

Chlamydia serovars responsible for genital infection

A

D-K

71
Q

Chlamydia serovars responsible for lymphogranuloma venereum

A

L1, L2 and L3

72
Q

Antifungal medication used to treat cryptococcal meningitis and invasive fungal infection

A

Amphotericin B

73
Q

Virus capable of causing hand, foot and mouth disease and herpangina

A

Coxsackie A virus

74
Q

Most common cause of HSV encephalitis

A

HSV-1

1 brain!

75
Q

Allopurinol must NOT be prescribed to a patient taking which drug?

A

Azathioprine

76
Q

Trimethoprim must not be prescribed to a patient taking which drug?

A

Methotrexate

77
Q

Key ketones

A

Beta-hydroxybutyrate
Acetoacetate
Acetone

78
Q

Epigastric pain during meals

A

Gastric ulcer

79
Q

Epigastric pain relieved by meals

A

Duodenal ulcer (pain worsens 2-3 hours after eating once the pyloric sphincter reopens)

80
Q

Poisoning: nausea, vomiting, abdominal pain, tinnitus, hyperventilation, mixed acid-base disturbance

A

Salicylates

81
Q

Poisoning: drowsiness, tachycardia, wide QRS on ECG

A

TCAs

82
Q

Beta blocker overdose with cardiogenic shock

A

Glucagon

83
Q

Classic histological finding in ulcerative colitis

A

Crypt abscesses

84
Q

Gene affected in X-linked agammaglobulinaemia

A

Bruton’s tyrosine kinase (Btk) gene

85
Q

Gene affected in Wiskott-Aldrich syndrome

A

WASP

X-linked

  • eczema
  • thrombocytopaenia
  • immunodeficiency
86
Q

Rheumatoid arthritis, splenomegaly and neutropaenia

A

Felty’s syndrome

87
Q

Condition closely associated with giant-cell arteritis

A

Polymyalgia rheumatica

88
Q

Leukoerythroblastic anaemia

A

Anaemia resulting from a space-occupying lesion in the bone marrow, leading to immature white cells and nucleated red blood cells in the peripheral circulation

89
Q

Positive Donath-Landsteiner test

A

Paroxysmal cold haemoglobinuria

90
Q

Positive sucrose lysis and Ham tests

A

Paroxysmal nocturnal haemoglobinuria

91
Q

Paroxysmal nocturnal haemoglobinuria

A

Acquired condition caused by the absence of GPI anchors on the red cell membrane (GPI anchors are protective against complement attack)

92
Q

Kala-azar

A

Visceral leishmaniasis

93
Q

Visceral leishmaniasis symptoms

A

Sandfly bite –> infection with protozoan Leishmania

  • fever
  • hepatosplenomegaly
94
Q

Trypanosomiasis

A

Tsetse fly bite –> infection with protozoan Trypanosoma

  • intermittent fever with lymphadenopathy
  • CNS symptoms e.g. sleepiness
95
Q

Reed-Sternberg cells with owl’s eye appearance

A

Hodgkin lymphoma

96
Q

Treatment of toxoplasmosis

A

Pyrimethamine and sulphadiazine

97
Q

Key bacteria associated with bacterial vaginosis

A

Gardnerella vaginalis

98
Q

Niacin (vitamin B3) deficiency

A

Pellagra

  • dementia
  • diarrhoea
  • dermatitis
99
Q

Common causes of athlete’s foot

A

Trichophyton rubrum and Epidermophyton floccosum

100
Q

‘Strawberry cervix’

A

Colpitis macularis - from infection with Trichomonas vaginalis

101
Q

Leventhal-Cole-Lille bodies

A

Psittacosis

102
Q

Chromosome affected in Prader-Willi/Angelman syndrome

A

Chromosome 15

103
Q

Prader-Willi syndrome imprinting: paternally or maternally inherited mutation?

A

Paternal

104
Q

May be caused by anti-leukocyte antibodies in donor blood

A

TRALI

105
Q

May lead to anaphylaxis to blood transfusions/IVIG

A

IgA deficiency (reacting to IgA in donor blood)

106
Q

HHV-6 and HHV-7 infection

A

Childhood
Roseola
Exanthem subitum

Pathology (J) (2 decks)

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