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National Boards Part I > Pathology > Flashcards

Pathology Flashcards

1
Q

Degeneration:

Calcification

A

Metastatic = Ca++ into normal tissue
Hypervitaminosis D

Dystrophic = Ca++ into abnormal/damaged tissue
Atherosclerosis, atheroma

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2
Q

Degeneration:

Caseous

A

cheesy

tuberculosis

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3
Q

Types of Degeneration

Albuminous

A

cloudy swelling

membrane injury, ion transfer fucked

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4
Q

Degeneration:

Coagulation

A

Infarction (MI)

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5
Q

Degeneration:

Enzymatic

A

Pancreas

(digests itself inside-out)

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6
Q

Degeneration:

Fatty

A
  • *Liver = “nutmeg liver”** (reversible if caught early)
  • *Heart = “tabby cat heart”** (stripes)

fatty dot → fatty streak → fatty plaque (atheroma) → fibroatheroma (fibrous tissue, calcium)

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7
Q

Degeneration:

Liquefactive

A
  • *CNS**
  • brain melts, tertiary syphilis, leprosy*
  • *or skin**
  • infection*
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8
Q

Degeneration:

Wallerian

A

peripheral nerves

degenerates to next Node of Ranvier
“dying back phenomenon”

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9
Q

Degeneration:

Zenker’s (Waxy)

A

hyaline cartilage

most common in skeletal muscle
(at epiphyseal plates)

muscle replaced with hyaline cartilage

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10
Q

Cellular Degeneration

A

Karyolysis: nuclear rupturing/fading/destruction

Karyorrhexis: nuclear swelling

Pyknosis: nuclear condensation

All the above = “nuclear dissolution”
leads to an anuclear necrotic cell

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11
Q

Developmental Changes

A

Agenesis: absence of organ (usually paired organs; renal, testicular.. odontoid)

Aplasia: small remnants of the organ, lack of development

Hypoplasia: smaller than normal, usually defective

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12
Q

Primary Pathology
vs
Secondary Pathology

A

Primary

  • arrives spontaneously
  • organ in question is fucked up

Secondary

  • usually insidious
  • resultant from other trauma/pathology
  • organ in question is malfunctioning, due to some other organ not working properly
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13
Q

Growth Disturbances

Cancer

A

Metaplasia: functional change from one cell type to another

Dysplasia: change in size/shape/fx, precancerous, but last stage that can be returned to normal

  • *Anaplasia:** complete disorganization of a cell (cancer)
  • squamous cell carcinoma*
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14
Q

Collagen Types

A

Type 1
bone, muscle, tendons, ligaments

Type 2
disc (specifically nucleus pulposis)

  • *Type 3**“reticular collagen”, spleen and lymph nodes
  • *early wound healing**

Type 4
basement membrane of all tissues

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15
Q

Pneumoconiosis

Silicosis

A

silica from sand, rock, glass

Rocky QUarry disease

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16
Q

Pneumoconiosis

Asbestosis

A

asbestos

leads to mesothelioma

malignant tumor

Naval shipyard

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17
Q

Pneumoconiosis:

Siderosis

A

Iron dust particles

Iron Ore Mill/Steel Mill occupants

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18
Q

Pneumoconiosis:

Byssinosis

A

cotton dust

Brown Lung

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19
Q

Pneumoconiosis:

Anthracosis

A

Black Lung Disease from miners

Caplan’s Syndrome
(anthracosis + RA)

W.Virginia coal mines

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20
Q

Pneumoconiosis:

Histomycosis/Histoplasmosis

A

Endemic fungus

Mississippi/Ohio Valleys

“Mississippi Valley Fever”
“Ohio Valley Fever”

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21
Q

Pneumoconiosis:

Coccidiomycosis

A

Endemic fungus in deserts of SW USA

“San Joaquin Valley Fever”
(just Valley Fever in other states)

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22
Q

Pneumoconiosis:

Blastomycosis

A

Endemic fungus on Eastern seaboard

Florida to Nova Scotia

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23
Q

Asthma

A

Sputum analysis:
Curschmann’s Spirals
& Charcot-Leyden Crystals

↑IgE, ↑Eosinophils
(↑<em>IgE: wheezes, sneezes and weird ass diseases)</em>

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24
Q

Cystic Fibrosis

A
  • Chloride channels affected
  • “sweat test”
    • mother notices, tastes salt = Salty Baby Syndrome
  • Affects:
    • GI mucous linings
    • respiratory mucous linings
    • exocrine secretions
  • Susceptible to pseudomonas aeruginosa
  • frequently requires lung transplants
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25
Q

Hemosiderosis

A

iron in lungs due to bleeding

rib fracture
pulmonary embolism (?)
stab/gunshot wound

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26
Q

Pulmonary Fibrosis

A

honeycomb lung

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27
Q

Tuberculosis

A

caseous necrosis in lung

Gohn complex, granulomas, epithelioid histiocytes

If spread to spine = “Pott’s Disease”
(with fracture or collapse of VB = Gibbus deformity)

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28
Q

Wegner’s Granulomatosis

A

Vasculitis of lung and kidney arteries

any system can be affected (polyangitis)

Ben Wegman has vasculitis of lung and kidney

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29
Q

Emphysema

A

Alpha-1-antitrypsin (A1AT) deficiency = loss of elasticity

can’t breathe out

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30
Q

Azotemia

A

decreased tubular excretion of nitrogen

↑nitrogen in the blood

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31
Q

Hydronephrosis

A

most commonly caused by prostate problems/ureter stones

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32
Q

Kidney Stones

A

“Nephrolithiasis”

acute nephritic shock:

mc stone: calcium oxalate/ Ca++ urate

pain pattern: constant LBP, radiates to flank
localized groin pain = stone in ureters

painful voiding, pink urine

Dx: Murphy’s Punch

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33
Q

Nephritic Syndrome

A

RBCs and minor amount of protein in urine

(hematuria, mild proteinuria)

acute glomerulonephritis

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34
Q

Nephrotic Syndrome

A
  • *“Pre-eclampsia”**
  • *“HEP”: H_ypertension / _E**dema / massive Proteinuria

Eclampsia
HEP + seizure/convulsions+ coma
(potentially fatal)

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35
Q

Polycystic Kidney

A

multiple cysts on kidneys

moth-eaten appearance

idiopathic

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36
Q

Renal Shock

A

acute tubular necrosis

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37
Q

Wilm’s Disease

A

“nephroblastoma”

mixed (palpable) tumor of kidney in children
(if kids experience LBP = no bueno)

*mc malignant tumor found in kids

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38
Q

Addison’s Disease

A

↓cortisol, ↓BP
hypoadrenia/adrenal fatigue

inadequate cortisol levels = ↑↑ACTH to stimulate cortisol release
↑↑ACTH leads to ↑MSH
↑Melanocyte Stimulating Hormone = hyperpigmentation

fatigue

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39
Q

Cushing’s Disease

A

↑cortisol (z. fasciculata)

hyperadrenia

moon faces, buffalo hump, purple striae, central obesity

hypertension, water retention

<i>(opposite of Addison’s Disease)</i>

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40
Q

Conn’s Disease

A

↑↑Aldosterone (z. glomerulosa)

↑↑ADH = water retention

hypertension

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41
Q

Goiter

A

hyperplasia of thyroid cells due to lack of iodine

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42
Q

Grave’s Disease

A

Hyperthyroidism

exopthalmoses

heat intolerance

weight loss

rapid HR

weight loss

T3/T4 fiddles with thermostat, turns ↑ = <strong>↑HR, ↑BP, hot</strong>

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43
Q

Hashimoto’s

A

Autoimmune cause of hypothyroidism

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44
Q

Myxedema

A

Hypothyroidism

Cretinism in child

cold intolerance
weight gain
slow HR/bradycardia
loss of lateral 1/3 eyebrows
slow mental faculties (memory, common sense)

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45
Q

Cryptorchism

A

undescended testes

can cause testicular cancer

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46
Q

Endometriosis

A

mc site: ovary

<em>(endometrial cells should only be in uterus or outside body)</em>

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47
Q

Epispadias/Hypospadias

A

Epispadias: urethra exits dorsal surface of penis

Hypospadias: urethra exits ventral surface of penis

extreme cases lead to chordee
= sharp angulation of penis

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48
Q

↑HCG

A
  • pregnancy
  • hydatidiform mole
    • non-viable embryo that has implanted
    • “cancer-like”
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49
Q

Leiomyoma

A

tumor of smooth muscle

fibroids in the uterus
(may disappear at menopause)

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50
Q

Polycystic Ovarian Disease
PCOS

A

anovulation

obesity

hirsutism
(excess hair on body and face)

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51
Q

Seminoma

A

cancer of testes (mc form)

mesenchymal/stem cells

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52
Q

Congenital Syphilis

A

born to mother with syphilis

  • Hutchinson’s teeth = notched upper incisors
  • Rhagades = cracks at edge of mouth
  • Saddle nose deformity = bridge flattened
  • Sabre Blade Tibia
  • Interstitial keratitis = produces visual changes, sometimes at tympanic membrane
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53
Q

Acquired Syphilis

A

Treponema Pallidum

Primary
Hard, painless chancre on perineum

Secondary
maculopapular rash and condylomata lata

Latency
may or may not have symptoms

Tertiary
tabes dorsalis, aortic aneurysm, gummas in CNS,
Argyll Robertson Pupil/ “prostitute’s pupil”
<em>accomodates, but doesnt respond)</em>

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54
Q

Pupils

A

Argyll Robertson Pupil
does not react to light, but constricts upon accomodation

Adie’s Pupil
tonic pupil dilation (mydriasis) due to CNIII Edinger-Westphal nucleus

Miosis
tonic pupil constriction due to injury to sympathetic cervical ganglia

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55
Q

Changroid

A

soft, painful chancre

Haemophilus ducreyi infection
(G- coccobacillus)

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56
Q

Gardnerella vaginalis

A

bacterial vaginosis

similar to Trichimonas, except bacterial

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57
Q

Gonorrhea

A

Gram (-) diplococcus

mcc PID/Pelvic Inflammatory Disease
mcc salpingitis (fallopian tube infection)

  • *burning urination**
  • *yellow/green pus** in urine

may produce arthritis (mc DJD in knee)

coffee bean shaped

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58
Q

Lymphogranuloma venereum

A

Chlamydia

rectal strictures (elasticity loss)

Dx: Frei Test

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59
Q

Trichimonas Clamydia

A

Purulent vaginal discharge

Protozoan

vaginosis

(green/yellow, frothy, foul, fish-like)

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60
Q

Achalasia

A

spasm of lower esophageal sphincter

causes megaesophagus (expansion) of upper esophagus

lack of motility
(due to absence of myenteric plexus)

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61
Q

Barrett’s esophagus

A

metaplasia of esophageal cells into stomach cells

caused by GERD

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62
Q

Budd-Chiari

A

occlusion of hepatic veins

Triad
abdominal pain / ascites / hepatomegaly

Acute
rapid severe upper abdominal pain, jaundice, hepatomegaly, ↑liver enzymes, eventual encephalopathy/shock

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63
Q

Celiac Disease
aka “non-tropical sprue”

A

gluten intolerance/enteropathy

loss of villi = loss of absorption

intestinal lining flattened & hole-punched

GF diet

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64
Q

Cholecystitis

A

1 cause of gallstones

gallbladder inflammation

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65
Q

Cholelithiasis

A

gallstones

mcc by cholecystitis

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66
Q

Chron’s Disease
“regional ileitis”, “distal ileitis”, “regional enteritis”

A

seen in young people

distal small intestine (ileum), cecum, ascending colon
(R-sided problem)

skip-lesions = “cobblestone” appearance

NO bloody diarrhea

autoimmune

leads to dehydration bc most water absorbed in small intestine

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67
Q

Diverticula

A

outpouching in the intestine

usually lower L quadrant
(sigmoid and descending)

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68
Q

Dysphagia

A

difficulty swallowing

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69
Q

Enteritis

A

bowel inflammation due to improper sanitation

mcc of death of children worldwide
due to dehydration from diarrhea

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70
Q

Hemorrhoids

A

Swollen and inflamed veins in the rectum and anus that cause discomfort and bleeding

mcc of frank red blood in stool

frank blood = bright red
melena = upper GI bleed- - dark, digested blood

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71
Q

Hirschprung’s Disease

A

Congenital megacolon

absence of myenteric plexus
= parasympathetic motor plexus

*Meissner’s plexus is chemosensitive

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72
Q
A
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73
Q

Intussusception

A

telescoping (collapsing) of intestine onto itself

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74
Q

Irritable Bowel Syndrome

IBS

A

stress related

spastic colon

distention

pain

diarrhea

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75
Q

Mallory-Weiss Syndrome

A

Hematemesis (vomitting blood)
due to alcoholism

distention of esophageal veins → bleed into stomach

“Mallory Weiss tears”
= distal esophageal/proximal stomach lacerations

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76
Q

Meckel’s Diverticulum

A

outpouching of distal ileum

(R side: iliocecal/distal ileum)

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77
Q

Peutz Jegher’s Syndrome

A

Polyposis, characterized by polypz in the entire GI tract

beningn

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78
Q

Plummer Vinson Syndrome

A

iron deficiency anemia

cheilosis

esophageal webbing
(partial esophageal occlusion)

glossitis

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79
Q

Pyloric stenosis

A

Infant projectile vomitting

newborns

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80
Q

Sliding hiatal hernia

A

anatomically shortened esophagus

too short

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81
Q

Steatosis

A

fat in stool

problem with gallbladder

Guacamole rampage = steatosis

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82
Q

Ulcerative Colitis*
“Toxic Megacolon”

A

pathological intestingal changes

ulcers

bloody diarrhea

affects L abdomen
(descending colon, sigmoid colon)

“lead pipe rigidity”

starts at colon, moves distally

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83
Q

Volvulus

A

twisting of an organ around its long axis

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84
Q

Zenker’s Diverticulum

A

outpouching of esophagus/pharynx

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85
Q

Diabetes Insipidus

A

↓ADH

due to PP problem

dehydration

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86
Q

Diabetes Mellitus

A

↓insulin production by β-cells of pancreas

1st seen in eyes

mc die from heart disease or renal failure

polydipsia, polyuria, polyphagia

(Islets of Langerhaans)

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87
Q

Hemochromatosis

A

iron in organs and skin

“bronze diabetes”

*iron absorption requires vitamin C

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88
Q

Kwashiorkor

A

protein malnutrition

severe edema

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89
Q

Marasmus

A

calorie malnutrition, includes protein

wasting away

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90
Q

Wilson’s Disease

A

inborn error of copper metabolism

Kayser-Fleisher Rings = copper deposits in eye

Hepatolenticular degeneration

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91
Q

ALS
Amyotrophic Lateral Sclerosis

“Lou Gherig’s Disease”

A

anterior horn and corticospinal tracts affected

complete motor loss
no sensory loss

LMN in upper extremities
UMN in lower extremities

progressive disease

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92
Q

Alzheimer’s

A

severe atrophy of cerebral cortex
progressive

↓ACh

#1 cause of dementia

50-60+ years old

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93
Q

Arnold Chiari

A

Type 1
cerebellar tonsils herniate (specifically vermis)

Type 2
[Type1] + meningiomyelocele in lumbar spine

*can get syrinx because of hydrocephalus - Rexed Lamina 10

brain matter outside brain

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94
Q

Brain Tumors

Astrocytoma

A

Types I and II

mc CNS tumor

best prognosis

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95
Q

Brain Tumors:

Glioma

A

mc CNS tumor

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96
Q

Brain Tumors:

Glioblastoma multiform

A

worst prognosis

affects cerebrum

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97
Q

Brain Tumors:

Medulloblastoma

A

mc seen in cerebellar vermis in children

mc cerebellar tumor

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98
Q

Brain Tumors:

Oligodendroglioma

A

slowest growing

affects cerebrum

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99
Q

Brain Tumors:

Schwannoma

A

CN VIII

Acoustic neuroma

onion bulb tumor
mcc of unilateral sensorineural hearing loss

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100
Q

Brain Tumors

A

mc brain tumor = Astrocytoma

mc cns tumor = Glioma

worst prognosis = Glioblastoma Multiform

mc cerebellum tumor = Medulloblastoma

slowest/cerebrum = Oligodendroglioma

CN VIII/acoustic neuroma = Schwannoma

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101
Q

Friedreich’s Ataxia

A

lesions of sclerosis of spinocerebellar* tract

chromosome 9

*spinocerebellar: unconscious proprioception

(neurofibrillary tangles)

102
Q

Guillan-Barre Syndrome*
“post-infectious polyradiculopathy”

A

mc seen after recent flu or vaccination

PNS demyelination

areflexia and ascending paralysis

reaches diaphragm = fatal

103
Q

Horner’s Syndrome

A

interruption of cervical sympathetics
(trauma, pancoast tumor*)

S/Sx: ptosis, miosis, anhydrosis, enophthalmosis

*pancoast tumor @ lung apices, disrupts cervical sympathetic ganglia

104
Q

Leprosy
“Hansen’s Disease”

A

liquefactive necrosis

skin damage

sensory nerve destruction
(early sign = feels no pain)

105
Q

Multiple Sclerosis

A

CNS demyelinization
and plaquing of spinal cord or brain

  • *Charcot’s Triad (SIN)**
  • *s**canning speech, intention tremor, nystagmus

distal mms affected
visual disturbances

Corticospinal tracts* affected

106
Q

Myasthenia Gravis

A

formation of antibodies against ACh receptors
@ myoneural junction

Thymoma: thymus enlargment

progressive weakness and fatigue

Starts in ocular muscles, worse at end of day
diplopia: dbl vision

tight, sore mms in jaw and hands

autoimmune

Corticospinal tracts affected

107
Q

Neurofibromatosis
“Von Recklinghausen’s Disease”

A

Café au Lait spots

“coast of California” appearance

108
Q

Onion Bulb Tumor

A

Schwann cell tumor

109
Q

Parkinson’s Disease
“Paralysis Agitans”

A

↓dopamine in basal ganglia

difficulty starting/stopping motion
inability to move + tremor = “cogwheel rigidity”

Inclusions: Lewy Bodies

masked faces, stooped posture, resting tremor,
shuffling/propulsive gait

Substantia nigra of mesencephalon
affected

110
Q

PLS
Posterolateral Sclerosis

“Combined Systems Disease”

A

Longstanding B12 deficiency* (Pernicious Anemia) → PLS

Dorsal columns and corticospinal tract affected

*lack of intrinsic factor

111
Q

Poliomyelitis

A

Affects brainstem, then CNs, possibly breathing apparatus

If affects anterior horn = produces LMNL

<em>(Polio transmission = oral/fecal)</em>

112
Q

Syringomyelia

A

cystlike formation from central canal of sc

leads to loss of pain/temperature, bilaterally
+ signs of UMNL in upper ext

“cape-like” distribution of pins and needles sensation
(shoulders, arms, back)

Caused by syrinx (central dilation of sc)

113
Q

Wernicke-Korsakoff

A

Alcoholic psychosis with dementia

Thiamine (B1) depletion
due to severe alcoholism over time

Destroys: Wernicke’s area @ angular gyrus, temporal lobe

114
Q

Tumors, Cancers, Cysts

Benign vs Malignant

A

Benign

  • slow-growing
  • encapsulated
  • non-destructive
  • asymptomatic, usually
  • short zone of transition
  • easily removed
  • “-oma” (usually)

Malignant

  • non-encapsulated
  • long zone of transition
  • periosteal reactions if in bone
  • deep, boring night pain
  • weight loss
  • fevers, night sweats
  • metastases
    • automatically worst grade
    • mcc bone cancer
  • “-carcinoma”
  • “-sarcoma”
115
Q
A
116
Q

Aneurysmal Bone Cyst
“ABC”

A

benign

metaphyseal/diaphyseal
(without crossing growth plate)

eccentric: not at center of bone

“Blister of Bone”
blisters, bubbles

<20 yo

117
Q

Brown’s Tumor*

A

“tumor-like” radiolucency

loss of bone density
from hyperparathyroidism (↑PTH)
118
Q

Chordoma

A

cancer mc seen in sacrum

crosses jts

(notochord remnants)

119
Q

Ewing Sarcoma

A

multi-laminated periosteal reaction

cortical saucerization

Children 10-25 (?)

moth-eaten appearance in medulla
mimics osteomyelitis

(onion-skin appearance)

120
Q

Multiple Myeloma
“Plasma cell leukemia/sarcoma”

A

mc primary bone malignancy in adults

amyloid buildup

inclusion bodies: Russell bodies

xray: “punched-out” lesions, raindrop skull

121
Q

Osteosarcoma

A

most common primary bone cancer in children (10-30)

122
Q

Simple/Unicameral bone cyst

A

“SBC” or “UBC”

benign

metaphyseal/diaphyseal

concentric

“fallen fragment sign”

Age < 20

found in long bones

123
Q

Adenoma

A

tumor of glandular tissue

124
Q

Cachexia

A

wasting away

125
Q

Carcinoma in situ

A

cancer that has not invaded basement membrane

“in stasis”, no metastases

126
Q

Chondroblastoma

A

benign bone tumor
age < 20

epiphyseal/metaphyseal
(mostly cartilagenous tissue)

127
Q

Chondroma

A

benign tumor of cartilage

most commonly within feet/hands

128
Q

Cryptorchidism

A

absence of one or both testes in scrotum

can cause testicular cancer

(failure to descend)

129
Q

Enchondroma

A

benign hand tumor

stippled calcification

2+ = “multiple enchondromatosis”

enchondromatosis + soft tissue swelling + bone deformity
= Maffuci’s Syndrome

130
Q

Fibroma

A

myxomatous tissue

spindled, polyhedral cells

multiple nuclei

131
Q

Fibrous dysplasia

A

benign tumor

ground glass appearance

café au lait patches

“Coast of Maine” appearance

in early puberty = Albright’s Disease

rind sign

132
Q

Giant Cell Tumor

A

tumor of osteoclasts
osteoclastoma

mc in knee

quasi-malignant

epiphyseal/metaphyseal

ages 20-40

133
Q

Histiocytosis X

A

“Hans-Schüller-Christian disease”
“histocytic granuloma”
“eosinophilic granuloma”

lipid accumulation → vertebral plana (“pancake vertebrae”)

discs preserved

134
Q

Krukenberg’s

A

cancer of stomach
metastasizes to ovaries

signet ring cell tumor

form of adenocarcinoma

135
Q

Leukoplakia

A

white patch on oral mucosa from tobacco

cannot be wiped off

precancerous

136
Q

Lung Cancers

A

Adenocarcinoma
Oat cell/Small cell
Squamous cell

can get lung cancer from arsenic poisoning
(arsenic in treated wood)

metastasis from lung most commonly goes to the brain

137
Q

Lung Cancers

Adenocarcinoma

A

mc with non-smokers

best prognosis

138
Q

Lung Cancers

Oat Cell/Small Cell

A

worst prognosis

139
Q

Lung Cancers

Squamous Cell

A

most common in smokers

140
Q
A
141
Q

Neurofibromatosis

A

“Von Recklinghausen’s Dz”

Café au Lait patches

“Coast of California” appearacnce

142
Q

Osteoid Osteoma

A

pain worse at night
relived by aspirin

ages 15-25

radiolucent nidus
w/reactive sclerosis

143
Q

Osteoma

A

mc benign tumor of the skull

mc in frontal sinus (frontal bone)

144
Q

Osteomyelitis

A

Chronic = Brodie’s Abcess

sequestrum involucrum cloaca
dead bone newly-formed bone drainage

mcc staph aureus

145
Q

Pheochromocytoma

A

neuroblastoma

benign tumor of adrenal medulla

episodic hypertension

146
Q

Stomach Cancer

A

mc in lesser curvature

“leather bottle” stomach
= adenocarcinoma

147
Q

Virchow’s Nodes

A

enlarged supraclavicular lymph nodes (L)
due to metastasis

usually GI tract

usually L side
supraclavicular lymph nodes

148
Q

Chemotaxis

A

movement of WBCs along concentration gradient
of tissue-damage byproducts

149
Q

Pavementing/Margination

A

WBCs lining damaged vessels

adhesion of leukocytes to endothelium

150
Q

Diapedesis
AKA Leukocyte extravasation

A

neutrophils and monocytes squeeze through walls of blood vessels towards site of damaged tissue or infection

151
Q

Clot Formation

A

fibrinogen → via THROMBOPLASTIN → fibrin

requires Vit K and Calcium in cascade

152
Q

Exudate

A

fluid and [high protein}

= damaged capillary wall

153
Q

Transudate

A

fluid and [low protein}

= normal capillary wall

154
Q

5 Stages of Inflammation

A
  1. injury​
  2. vasoconstriction
  3. vasodilation (via histamine and bradykinin)
  4. swelling/edema (chemotaxis → diapedesis)
  5. healing
    mast cells make heparin and serotonin, triggers myofibroblasts to constrick and make type 3 collagen for early wound healing. scar = fibrin
155
Q

Bradykinin/Histamine

A

vasodilation

↑ inflammation

156
Q

Leukotrienes

Prostaglandins

Substance P

A

inflammation pathway

↑ inflammation

157
Q

Enkephalins

Endorphins

A

pain control
“personal morphine”

↓ inflammation

158
Q

NSAIDs

A

Non-Steroidal Anti-Inflammatory Drugs

Cycloxygenase (COX) inhibitor

↓ inflammation

159
Q

Steroids

A

phospholipase A2 inhibitor

prednisone

↓inflammation

160
Q

Basophils

A

become mast cells

make histamine, bradykinin, srotonin, heparin

161
Q

B-lymphocytes

A

transform into plasma cells

make antibodies

162
Q

Granulocytes

A

“BEN”

Basophils
Eosinophils
Neutrophils

163
Q

Agranulocytes

A

Lymphocytes and Monocytes

164
Q

Macrophage

A

Monocyte at tissue level

Kupffer cells = liver
Dust cells = lung
Microglia = brain
Langerhaan = skin

165
Q

Natural Killer Cells

A

“MEN”

Monocytes
Eosinophils
Neutrophils

166
Q

T-Lymphocytes

A
  • T-Helper Cells (CD4)
    activate B-cells
    mature in thymus
  • T-Killer Cells (CD8)
    cytotoxic
    destroys cancer, kills foreign agents
    transplant rejections
    mature in thymus
  • T-Suppresor Cells
    T-Regulatory cells
    ↓ immune system
    slows antibody production
    mature in thymus
167
Q

Neutrophils

A

60%

increase in acute bacterial infections
and acute inflammation

168
Q

Lymphocytes

A

30%

increase in viral conditions
and chronic inflammation

169
Q

Monocytes

A

5-8%

chronic conditions

change into phagocytes at tissue level

170
Q

Eosinophils

A

2-4%

increase in parasites and allergies

171
Q

Basophils

A

0-0.5%

like mast cells

produce heparin and histamine

↑ in conditions that cause histamine release

172
Q

Immune Complex

(Acquired Immunity)

A

Antigen
↓
Macrophage
↓
CD4
↓
productes lymphokines
↓
stimulates b-lymphocytes
↓
converts plasma cells
↓
produce antibodies

173
Q

Natural Immunity

A

Involves:

Natural Killer Cells
Mast Cells
Basophils
Macrophages

174
Q

Bruton’s Agammaglobulinemia

A

blood cell disorder

↓Bcells and ↓IgG

mc primary immunodeficiency at birth

X-linked

175
Q

DiGeorge’s Syndrome

A

hypoplasia of thymus
↓
primary T-cell deficiency at birth
(all T-cells)

176
Q

Hodgkin’s

A

Pel Epstein fever

Biopsy: Reed Sternberg Cells

enlarged lymph nodes

hepatosplenomegaly

177
Q

Multiple Myeloma

A

Leukemia of bone marrow

affects plasma cells

Age 50+

example of non-Hodgkin’s Lymphoma

178
Q

Severe combined immune deficiency

A

Newborn w/o proper B or T cells

bone marrow problem

in adult, mc due to aplastic anemia

benzene poisoning

179
Q

Coagulation

A
  • Injury → thromboplastin release (needs vitamin K)
  • thromboplastin triggers production of prothrombin in liver
  • prothrombin (w VitK & Ca) converts to thrombin (II)
  • fibrinogen (using thrombin) converts to fibrin (clot)
  • positive feedback/”feed forward” more thrombin produced = more fibrin produced
  • clot breakdown: fibrolysin & plasmin dissolve clot
180
Q

Hemophilia A

A

CF VIII deficiency

“a” / “eight”

Von Willebrand Disease

decrease in platelet adhesion

181
Q

Hemophilia B

A

CF IX deficiency

Christmas Factor Disease

X-chromosome
females = carrier, males = disease

182
Q

Hemophlia C

A

CF XI deficiency

mild hemophilia

183
Q

Clotting Factors

A
  • X = Stuart Prower Factor
  • XII = Hageman Factor
184
Q

Aplastic Anemia

A

↓RBCs, ↓WBCs in blood

caused by benzene poisoning

associated with bone marrow degeneration

185
Q

Iron Deficiency Anemia

A

↓RBC production

nutritional

mcc by chronic blood loss

menses

microcytic, hypochromic

186
Q

Pernicious Anemia

A

↓RBC production

nutritional

lack of intrinsic factor

gastritis can be a cause

187
Q

Folic Acid Anemia

A

↓RBC production

nutritional

during pregnancy

B9 deficient

megaloblastic anemia
leads to spina bifida occulta

188
Q

B12 Anemia

A

↓RBC production

nutritional

seen in vegetarians

macrocytic, hypochromic

189
Q

Anemias caused by
bone marrow suppression

A

toxins (benzene → aplastic anemia)

chemotherapy

190
Q

Anemia from

chronic blood loss

A

↓iron

microcytic, hypochromic

Fe+ is the only “red” thing in the body

191
Q

Anemia from

Hemorrhage

A

normochromic, normocytic

192
Q

Anemia from

Hemolytic breakdown

A

due to sickle cell or malaria

193
Q

Thalassemia Major
“Cooley’s Anemia”
“Homozygous Beta Thalassemai”
“Mediterranean anemia”

A

body makes an abnormal form of hemoglobin
child inherits 2 mutated genes, one from each parent

“hair on end” appearance on skull xray

genetic

194
Q

Anemia from

Erythroblastosis Fetalis

A
  • *Rh ( - ) mother**
  • mother is “negative” with worry*
  • ( Rh ( + ) father )*

Rh ( + ) baby

Type II Hypersensitivity
cytotoxic

Only relevant in <strong>2nd pregnancy</strong>
Developed in first pregnancy - attack in second

195
Q

Pancytopenia

A

↓RBC
↓WBC
↓platelets

196
Q

Polycythemia

A

↑RBCs

1° polycythemia = Polycythemia Rubra Vera
(pathological)

2° polycythemia = relative polycythemia
(normal response to high altitudes)

197
Q

Thrombocytopenia

A

↓platelets in the blood

198
Q

Berry Aneurysm

A

localized dilation of an artery

Berry in the Circle of Willis
=subarachnoid hemorrhage

199
Q

Dissecting Aneurysm

A

localized dilation of an artery

longitudinal tearing away of the aorta

“tearing pain”

200
Q

Abdominal Aortic Aneurism
“AAA”

A

localized dilation of aorta

sudden LBP
hypovolemic shock
thready pulse

“curvilinear calcification”
“fusiform shape”

201
Q

Atherosclerosis

A

fatty plaque deposition
(atheroma)

form of arteriosclerosis

lipid deposits in intima of
large and medium sized arteries

narrowing of lumen

202
Q

Buerger’s Disease
“Thromboangitis Obliterans”

A

lower extermity

males w history of smoking

intermittent claudication
= cramping upon exertion

203
Q

Cardiac Tamponade

A

fluid to pericardial space

prevents proper ventricular filling

emergency room!

204
Q

Monkeberg’s Sclerosis

A

tunica media of medium sized arteries
calcified

smokers and diabetics

205
Q

Prinzmetal’s Angina

A

coronary artery vasospasm

206
Q

Raynaud’s Syndrome

A

arterial vasospasm

may be 1° or 2° to other collagen diseases like lupus

hands and feet

triphasic color change:
WHITE → BLUE → RED

triggered by cold or emotion

can lead to dry gangrene

typically upper extremity in female smokers

207
Q

Rhabdomyoma

A

tumor of striated muscle or heart muscle

208
Q

Sickle Cell Anemia

A

half-moon shaped RBCs

“H-shaped vertebra”

homozygous sickle cell allele

209
Q

Temporal Arteritis
“giant cell arteritis”

A

temporal arteries

assoc. w long-standing hypertension

affects opthalmic artery

can lead to blindness

210
Q

Tetralogy of Fallot“DRIP”

A

D extrorotation of aorta
“dextroposition”

R ight ventricular hypertrophy

I nterventricular septal defect

P ulmonic Stenosis

211
Q

Valvular lesions

A

tooth extractions
(<em>Strep</em> infection causing Aschoff bodies from rheumatic fever)

mitral valve affected
(Syphilis affects aortic valve
Strep affects mitral valve)

212
Q

Acute Lymphoblastic Leukemia

ALL

A

mc in children

“ALL the little children”

213
Q

Acute Myeloblastic Anemia

AML

A

any age

mc acute leukemia in adults
(85% of cases)

worst prognosis

214
Q

Chronic Lymphoblastic Leukemia

CLL

A

mc chronic leukemia in adults

  • chronic leukemia*
  • “Cranky Late Lifers”*
215
Q

Chronic Myelocytic Leukemia

CML

A

young adulthood (30-40)

↑granulocytes

“Philadelphia chromosome”
(#22)

216
Q

Alkaptonuria

A

homogentistic acid accumulation

black/blue deposits in cartilage, ears, nose, cheeks

causes onchronosis
(IVD calcification)

black urine

can have ↑tyrosine
(Homogentistic acid is intermediate in
phenylalanine & tyrosine metabolism)

217
Q

Charcot Marie Tooth

A

hereditary

progressive peroneal muscle atrophy

tibialis anterior
seen in swing of gait

218
Q

Huntington’s Chorea

A

hereditary onset age 30-50

basal ganglion affected
(atrophy of caudate)

↓GABA

dementia, death

219
Q

Marfan’s Syndrome

A

arachnodactyly
spider-like fingers

lens dislocation

dissecting aortic aneurysms

tall, thin stature

220
Q

Phenylketonuria

A

phenylalanine → X → tyrosine

due to phenylalanine hydroxylase

retardation

possibly managed if caught early:
phenylalanine-free diet for life

221
Q

Cri du Chat Syndrome

A

piece of chromosome 5 missing
“CHS #5 aberration”

Cat’s cry
characteristic cry of newborn

usually disappears by age 1-2

222
Q

Neimann Pick’s

A

lipodystrophy

​sphingomyelinase deficiency
= ↑sphingomyelin

223
Q

Tay Sach’s

A

lipodystrophy

↑gangliosides in brain

cherry red spots on macula

infant death

mc in Ashkenasi Jews

224
Q

Duchene’s Muscular dystrophy

A

boys age 3-7

pseudohypertrophy of calves

muscle replaced with fat

recessive, x-linked

waddling gait

proximal muscles affected

225
Q

Myotonic dystrophy

A

can’t relax muscles

cataracts, insulin resistance

226
Q

Kleinfelter’s

A

47XXY karyotype

tall male
low IQ

testicular atrophy

gynecomastia

sterile

227
Q

Turner’s

A

45X0 karyotype

female

short

webbed neck

amenorrhea

lacks female 2° characteristics

228
Q

Myositis Ossificans

A

calcium or bone within muscle
d/t trauma

mc in quads or biceps

if adductors = “Prussian’s Disease”

example of metaplasia

229
Q

Paget’s
“Osteitis Deformans”

A

Case Hx: men over 50, increased hat size, bone deformity or enlargement, cortical thickening

4 Radiology phases:
lytic → mixed → blastic → malignant degeneration
osteoclastic combined osteoblastic <strong>osteosarcoma</strong>

Lab:
↑alkaline phosphatase, ↑urinary hydroxyproline
normal calcium and phosphorus

pathological cell = osteoclastic cell

230
Q

Scleroderma

“Progressive Systemic Sclerosis”

A

CREST Signs:

  • Calcinosis Cutis
  • Raynaud’s phenomenon
  • Esophageal problems
  • Sclerodactyly
  • Telangectasis
  • = dilation of superficial blood vessels*

sero(+) for RA

resorption of distal tufts (acrosteolysis)

231
Q

Acid Phosphatase

A

elevated in prostate cancer
w ruptured the prostate capsule

232
Q

Alkaline phosphatase

A

elevated in liver and bone conditions

233
Q

Brown’s Atrophy

A

lipofuscin buildup in organs

“lipofuscin granules are old age pigments”

234
Q

Mineral Deficiencies

A

#1 in United States
Calcium deficiency

#1 Worldwide
Iron deficiency

235
Q

Caplan’s Syndrome

A

arthritis

coal miners lung w RA nodules

236
Q

Felty’s Syndrome

A

chronic rheumatoid arthritis with splenomegaly

237
Q

Gonococcal Arthritis

A

usually affects the knee

Gonorhhea - mcc PID in females

238
Q

Gouty Arthritis

(metabolic arthritis)

A

Uric acid in blood
<strong>tophi</strong> = crystal deposits in tissue

if in big toe = “podagra”

monoarticular

MCC: high purine diet
red wine, red meat, aged cheeses

destroys from outside-in
“juxtarticular erosions”
“overhanging edge sign”

239
Q

Osteoarthritis

OA or DJD

A

unilateral distribution
in weight-bearing joints

subchondral sclerosis, osteophytes

Heberden’s Nodes (DIP)
Bouchard’s Nodes (PIP)

mc location = hip, then knee

mc arthritis

240
Q

Psoriatic Arthritis
PA

A

seronegative arthritide

HLAB27+

periarticular erosions
mouse ear erosions

silver scales, pitted nails

241
Q

Rheumatoid Arthritis

RA

A

inflammatory

bilateral, symmetrical distribution

ulnar deviation of wrist
ankylosing of spine

pannus formation
hypertrophy of synovium of joint

Haygarth’s Nodes (MCP)
Bouchard’s Nodes (PIP)
<strong>(never hits DIP joints) *</strong>

( + ) RA factor

Boutonniere or Swan Neck deformities

transverse ligament instability

242
Q

Seronegative Arthritis

A

“PEAR”

Psoriatic

Enteropathic arthropathy

Ankylosing Spondylitis

Reiter’s Syndrome

243
Q

Seropositive Arthritis

A

“RSSS”

Rheumatoid Arthritis

Sjogren’s

Scleroderma

Systemic Lupus Erythematosus

244
Q

Sjogren’s

A

xeropthalmia
dry eyes

xerostomia
dry mouth

seropositive
for RA latex

“Sjogren’s in the desert”

245
Q

Systemic Lupus Erythematosus

A 
photosensitivity
butterfly rash ("malar rash")

autoimmune

antibodies against DNA

most damaged organ: kidney

ANA/FANA Test

246
Q

Legg Calve Perthes Disease

“Perthes Disease”

A

AVN of head of femur
in child

247
Q

Avascular Necroses

A

“osteonecrosis” = death of bone due to lack of blood

AVN of lunate = Keinbock’s
“kind hands, cold feet”
AVN of tarsal navicular = Kohler’s

AVN of head of femur in child = Legg Calve Perthes

AVN of scaphoid/navicular = Preisser’s

AVN of multiple vertebral endplates = Scheuermann’s
<strong> disc space spared </strong>- leads to <strong>hyperkyphosis</strong>

248
Q

Colles Fracture

A

most common fracture of the wrist

Fx of distal radius with posterior displacement
(of distal fragment)

“dinner fork deformity”

FOOSH

249
Q

Smith’s Fracture

A

“Reverse Colles”

Fx of distal radius with anterior displacement
of distal fragment

“garden spade deformity”

250
Q

Osgood Schlatter’s

A

“Tibial Apophysitis”

avulsion of tib tub of knee
in young, athletic children

251
Q
A

National Boards Part I (9 decks)

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