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USMLE Step 1 > Pathology > Flashcards

Pathology Flashcards

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1
Q

Mobitz I

A

–Progressive PR int lengthening–>drop QRS
aka weinkebach
Usually due to inferior MI. Rarely progresses to 3rd degree heart block
Tx: Atropine or isoproterenol

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2
Q

Mobitz II

A

-intermittent P nonconduction
BBB association
Often progresses to 3rd deg AV block
Usually due to anterior MI

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3
Q

P wave

A

atrial depol

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4
Q

a wave

A

LA contraction

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5
Q

T wave

A

ventricular repolarization

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6
Q

Wavy fibers

A

Eiosinophilic bands of necrotic myocytes. Early sign of MI

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7
Q

Janeway’s Lesions

A

Acute bacterial endocarditis

Nontender, erythematous lesions on palms & soles

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8
Q

Osler’s Nodes

A

Subacute endocarditis sign?
Tender lesions of fingers & toes
“ouch ouch Osler”

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9
Q

Thiamine deficiency

A

Wet Beri Beri -> heart. Dilated cardiomyopathy due to chronic ETOH consump
Dry Beri Beri = peripheral neuropahty
Wernicke-Korsakoff= ataxia, confusion, confabulation, memory loss, vision changes

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10
Q

Fibrinous Pericarditis

A

Associated w MI–3-7 days ppost transmural MI

Dresslers (6-8 wk)– autoimmune Igs to pericardium

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11
Q

Serous pericarditis

A

Associate w/ nonbacterial causes: viral (Coxsackie) infection, immunologic rxns

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12
Q

Friction Rub

A

Pericarditis associated finding

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13
Q

Hemorrhagic pericarditis

A

Associated w TB or neoplasm

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14
Q

Restrictive Cardiomyopathy

A

stiffens heart, diastolic dysfct
Due to amyloidosis in elderly
Die to Schaumann & asteroid bodies in youn (<25)?

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15
Q

PML’s infectious agent

A

JC virus

papovirus= dsDNA, naked icosohedral capsid

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16
Q

Edema

A
  • ↑Pc (more seeps out)
  • ↓πc (less reabsorbed into vessel)
  • ↑ permeability endothelium
  • Block lymphatic drainage
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17
Q

Adult Polycystic Kidney Disease

A

AKA autosomal-dominant polycystic kidney disease
Commonly see: liver cysts, Berry aneurysms along w/ kidney cysts. Hematurea & HTN often present
3 cysts in each kidney w + fam hx confirms dx

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18
Q

Malignant HTN & Kidneys

A

Petechial hemorrhages are seen on kidney surfaces= Flea-bitten kidneys
Young AA men

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19
Q

Nephritic Signs

A

Hematuria; RBC casts; HTN

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20
Q

Nephrotic Signs

A

Proteinuria; hypoalbuminemia; edema

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21
Q

Podocyte Effacement

A

Seen w Minimal Changes Disease (lipoid nephrosis)

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22
Q

ASO

A

Seen in Acute post-streptococcal GN (due to βHGASrtep)

Anti streptinolysin O

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23
Q

Crescentic GN

A

Rapidly progressive GN- nephritic syndrome

Associated w/ multisystem disease or post-strep/post-infectious glomerular nephritis

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24
Q

Hereditary Nephritis

A

Alport’s syndrome…X linked

Renal disease w/ deafness & occular abnormalities

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25
Q

Membranoproliferative GN

A

Can be secondary to to complement deficiency, chronic infections, CLL
See “tram tracking” on histo

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26
Q

Type I Membranoproliferative GN Deposits

A

C3 and IgG deposits– immune complex deposits

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27
Q

Type II Membranoproliferative GN Deposits

A

Only C3 deposits

AKA dense deposit disease

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28
Q

Focal Segmental Glomerulosclerosis Deposits

A

IgM & C3 deposits

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29
Q

Cold Agglutinins

A

Seen in atypical pneumonia (mono, mycoplasma)

It is IgM Ab w/ specificity for I Ag on adult RBCs

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30
Q

Scrofula

A

TB in the lymph nodes

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31
Q

Aspirin-Asthma Triad

A

Nasal polyps, allergic rhinitis, bronchoconstriction

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32
Q

Ferruginous Bodies

A

Hemosiderin (pigment w/ Fe3+) covered fibers that have been phagocytized by macrophages

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33
Q

Pancoast Tumor

A

Sx: Ulnar nerve pain & Horner’s syndrome, hoarse voice

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34
Q

Fatty Degeneration

A

Made up primarily of triglycerides
MCC: alcoholism, leads to cirrhosis
Associated w CCl4-

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35
Q

Cloudy swelling

A

Failure of cellular Na pump

Seen in fatty change of liver and in hydropic (vacuolar) degneration of the liver

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36
Q

Hydropic degeneration

A

Severe form of cloudy swelling

seen w/ hypokalemia incuded by vomiting/diarrhea

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37
Q

Liquefactive Necrosis

A

Rapid enzymatic breakdown of lipids
Seen commonly w CNS lesions
Seen in suppurative infection= pus formation

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38
Q

Coagulation Necrosis

A

Result of sudden ischemia

Seen in organs w end arteries (limited collateral circ)= heart, lung, kidney, spleen

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39
Q

Caseating Necrosis

A

Combination of both coag & liquefaction nec

Seen w/ M. Tb and Histoplasma capsulatum infection

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40
Q

Fibrinoid Necrosis

A

Seen in the walls of small arteries

Assoc. w/ malignant HTN, polyarteritis nodosa, immune-mediated vasculitis

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41
Q

Fat Necrosis

A

Result of lipase actions liberated from pancreatic enzymes

Seen w/ acute pancreatitis–> saponification results

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42
Q

Hemoptysis

A

Blood in sputum

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43
Q

Pulmonary Embolism

A

Most commonly thrombus from deep vein of lower extremity

-Virchow’s triad

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44
Q

Phlebothrombosis

A

-venous blood clot forms independently of inflamm. of vessel
From: a vein of lower extremities, a pregnant uterus, in CHF, bed ridden pt.
As a complication in a pt w pancreatic Ca due to inc. blood coagulability

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45
Q

Saddle Embolus

A

Embolus lodged in a bifurcation of pulmonary trunks

Inc. in RV strain= RV & RA dilate= acute cor pulmonale

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46
Q

Paradoxical Embolism

A

R to L shunt allows a venous embolism to enter arterial circulation
Patent foramen ovale or Atrial Septal Defect

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47
Q

Tuberculoid Granuloma

A

Collection of macrophages w/o caseation

Seen w/ sarcoidosis (non-caseating); syphilis; Brucellosis; Leprotic infections

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48
Q

Cellulitis

A

Spreading infection due to strep.

-inflammation of connective tissue, dermsi, subcut

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49
Q

PSA

A

Prostate specific antigen=elevated in prostate Ca

Controversial training measure

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50
Q

Elevated 5HT

A

In cases of metastatic carcinoid

Tx: w methysergide (5-HT antagonist)

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51
Q

Elevated alpha-Feto Protein (AFP)

A

Seen in:Hepatocarcinoma

Neural tube defects

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52
Q

CEA

A

Carcinoembryonic Antigen= elevated in colon CA

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53
Q

Chromosome 13

A

Retinoblastoma

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54
Q

Chromosome 11p

A

Wilms’ tumor of the kidney

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55
Q

Vinyl Chloride

A

Associated w/ Angiosarcoma of the liver

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56
Q

Agent Orange

A

Contains dioxin

Implicated as a cause of Hodgkin’s disease, non-Hodgkin’s lymphoma & soft tissue sarcomas

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57
Q

Parasites & CA

A

Schistosoma haematobium= Urinary bladder CA risk
Schistosoma mansoni= colon cancer risk
Aspergillus flavus= potent hepatocarincogen

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58
Q

Ochronosis

A

Inherited form: Alkaptonuria= black urine
Error in tyrosine metabolism due to homogentisic acid (oxidize tyrosine)
Involving intervertebral discs= ankylosing spondylitis= poker spine
See dark urine, sclera, tendons, cartilage

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59
Q

Lead poisoning

A 
Acid fast inclusion bodies
Inc urinary caproporphyrin
Anemia: microcytic/hypochromic
Stippling of the basophils
Gingival line & lead line in bones on X-ray
Mental retardation
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60
Q

Heroin OD, clinically

A

Massive pulmonary edema w/ frothy fluid from the nostrils

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61
Q

Fetal Alcohol Syndrome

A

Small head, small eyes, funnel chest, ASD, mental deficiency, hirsutism

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62
Q

Atypical mycobacterium

A

M. kansasii & M. avium intercellulare

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63
Q

Cold Abcesses

A

Liquified TB lesions similar to pyogenic abcesses but lacking acute inflammation

64
Q

Actinomyces Isrealli

A 
Farmers Infection
Lumpy jaw (from chewing grain) & PID (IUD) but most common is due to saprophyticus
65
Q

Congenital Syphilis

A

Saddle nose, Saber shin, Hutchinson’s teeth, nerve deafness, interstitial keratitis

66
Q

Warthin-Finkeledy Cells

A

Reticuloendotheial giant cells on tonsils, lymph nodes, spleen
Seen w Rubeola (measles) due to paramyxovirus

67
Q

Diphylbothrium latum

A

Tapeworm infection causing megaloblastic anemia by consuming large amt of B12 in host

68
Q

Acutea Bacterial Endocarditis

A

Staph aureus, Beta hemolytic strep, E. coli

Common among IVDA and diabetics

69
Q

Subacute Bacterial Endocarditis

A

alpha hemolytic Strep (S. viridans)..usually in pt w preexistig heart/valve problem

70
Q

Mitral Insufficiency

A

Rupture papillary muscle

71
Q

Left Anterior Descending Branch

A

Branch of the left coronary artery
Highest freq. of thrombotic occlusion
MI= anterior wall of LV, esp. in apical part of interventricular septum

72
Q

Left Circumflex Branch

A

Branch of LCA

Occlusion= MI of posterior/lateral wall of LV

73
Q

Dissecting Aneurysm

A

False aneurysm: splitting of the media of the aorta
Usually w long hx of severe HTN, also seen w/ familial hyperlipidemia, athersclerotic disease, Marfan’s
Zones of medical necrosis +/- slit-like cysts=medical cystic nec. of Erdheim–> autosomal dom, aka familal thoracic aortic aneurysm

74
Q

Cor Pulmonale

A

RV strain due to pulmonary HTN, associated, associated w/ RV hypertrophy

75
Q

Acute Cor Pulmonale

A

Sudden RV strain due to massive PE

76
Q

Bronchopneumonia

A

Lobular rather than lobar
Common causes: S. aureus, P. aeruginosa, Klebsiella, E. coli,
Abcess formation is common

77
Q

Lobar pneumonia

A

Community acquired= Strep pneumo infection (5% due to Klebsiella)
Red hepatization= day 1-3 of pneumonia
Gray hepatization= 3-8 of untxed pneumonia
Complications: pleural effusion, atelectasia, fribrinous pleuritis, empyema, fibrinous peridcarditis, otitis media

78
Q

Bronchiectasis

A

Permanent dilatation of the bronchi– predisposed by chronic sinusitis & post-nasal drip
supparation associated
Lower lobe> upper lobe

79
Q

Cold Agglutinins

A
  • Usually IgM, autoimmune hemolytic anemia

Found in mycoplasma pneomonea, mono, CLL

80
Q

Panlobular Emphysema

A

A1AT deficiency associated

Inc. Elastase= Inc compliance in the lung

81
Q

Bulla

A

Associated w/ emphysema= “Bleb” = outpouching …may rupture and cause spontaneous pneumothorax

82
Q

Farmer’s Lung

A

Due to micropolyspora faeni (thermophilic actinomyces)

Type III hypersensitivity pneumonitis

83
Q

Bagassosis

A

Hypersensitivity pneumonitis

Due to M. vulgaris (actinomycetes) from moldy sugar cane

84
Q

Silo-Filler’s Disease

A

Due to NO2 inhalation from nitrates in corn

85
Q

G6PD deficiency

A

Enzyme in pentose phosphate shunt…regens NADPH
Sex-linked chronic hemolytic anemia w/o challenge or after eating fava beans/oxidative stress
Heinz bodies appear on RBCS, bite cells seen

86
Q

Elevated HbF

A

Seen in Sickle Cell Anemia

87
Q

Multiple Myeloma

A

Lytic lesions of flat bones (“salft & pepper” lesions”) …vertebrea, ribs, skull
Hypercalcemia, Bence-Jones Protein Casts
“CRAB”

88
Q

Hodgkin’s Disease

A

Malignant neoplasm of the lymph nodes causing: pruritis, fever= can mimic EBV/acute infections
Reed-Sternberg cells

89
Q

Polyarteritis Nodosa

A

Immune complex depostion on vessel walls
Medium/small vessel vasculitis
Hep B Ag association (30% of pt.s)
Can see fever, abd. pain, dec. weight, HTN, muscle aches

90
Q

Sprue

A

Celiac disease due to gluten-induced enteropathy= small intestine villi blunted
High titers of anti-gliadin Abs & IgA levels

91
Q

Regional Enteritis

A

AKA Crohn’s disease

Association w/ arthritis; uveitis; erythema nodosum

92
Q

Whipple’s Disease

A

Caused by bacterium Tropheryma whipplei (actinomycetes).

Intestinal lipodystrophy= malabsorption syndrome

93
Q

Kulchitsky Cells

A

Neural crest cells from which carcinoids arise in the bronchi, GIT, Pancreas

94
Q

Ulcerative Colitis

A

Inflammatory disease of the colon w/ inc. colon CA incidence
Crypt abcess in the crypts of Lieberkuhn
Pseudopolyps when ulcers are deep
No transmural involvement

95
Q

Vaginal adenosis

A

Women exposed to DES (diethylstilbesterol) in utero before 18th week of pregnancy
Some develop clear cell adenocarcinoma of vagina & cervix (usually < 30 yo)

96
Q

Scirrhous Carcinoma

A

Infiltrating ductal carcinoma w/ fibrosis– most common type of breast carcinoma

97
Q

Hofbauer Cells

A

Lipid laden macrophages seen in villi of Erythroblastosis Fetalis (hemolytic disease of the newborn)– seen w maternal IgG crossing placenta

98
Q

Retinopathy of Prematurity

A

aka Retrolental fibroplasia

blindness in premies due to high supplemental O2 concentration…leads to free radical injury

99
Q

IgA deficiency

A

Genetic cause
Pt has recurrent infection & diarrhea w/ inc repiratory tract allergy & autoimmune disease
If given blood w IgA–> develop severe anaphylaxis

100
Q

Primary Sjogrens

A

Autoimmune– HLADR3 associated

Sx:Dry eyes & dry mouth, arthritis. Inc risk of B cell lymphoma.

101
Q

Secondary Sjogrens

A

RA, SLE< or systemic sclerosis associated

HLA-DR4 associated

102
Q

LDH1& LDH2

A

Myocardium

LDHI > LDH2–> MI

103
Q

LDH3

A

Lung Tissue

104
Q

LDH4 & LDH5

A

Liver cells

105
Q

Keratomalacia

A

Severe Vit A deficiency. See Bitot’s spot in the eyes= gray plaques= thickened, keratinized conjunctiva

106
Q

Metabisulfite Test

A

Suspending RBCS in a low O2 content sol’n

Can detect Hemoglobin S, which sickles in low O2

107
Q

Microangiopathic Hemolytic Anemia

A

Can be due to HUS and TTP

See helmet cells

108
Q

Wright’s Stain

A

Stain for Burkitt’s lymphoma

109
Q

Mononucleosis

A

Due to EBV infection (CMV possible)

If mono is txed w ampicillin, thinking that it is a strep pharyngitis, a rash will occur

110
Q

T(8:14)

A

Burkitt’s lymphoma translocation

c-myc oncogene overexpression

111
Q

T(9:22)

A

Philadelphia chromosome, translocation of CML= abl/bcr gene formation

112
Q

Langerhan Cell Histiocytes

A

Dendritic cells of skin & mucosa
Birbeck granules present tennis racket shape
Langerhans cell histiocytosis subtypes:Letterer-Siwe disease, Hand Schuller Christian Disease, Eiosinophilic Granuloma

113
Q

Myeloid Metaplasia

A

Alkaline Phosphatase elevated/normal (compared to low in CML)
Anemia; splenomegaly; platelets> 1 mill= extensive extra-medullary hematopoiesis

114
Q

Multiple Myeloma

A

Weakness, weight loss, recurrent infections, proteinuria, anemia, proliferation of plasma cells in BM= plasma cell dz
Serum M protein spike…most often IgG or IGA light chain
Hypercalcemia…lytic bone lesions

115
Q

T(14:18)

A

NHL Lymphoma= bcl2 proto-oncogene overexpression seen w/ follicular lymphoma

116
Q

Focal Segmental Glomerulonephrosis Exs

A

IgA focal GN= Berger’s disease, SLE, PAN, Henoch-Schonlein purpura

117
Q

Nephrotic Syndrome Exs

A

Focal (segmental); membranous GN, lipoid (minimal change) GN, membranoproliferative GH, Hep B, Syphilis, pencillamine

118
Q

Schistosoma Haematobium

A

Infection is associated w/ squamous cell CA of the bladder (most common bladder Ca in transitional cell type)
associated w portal HTN due to intrahepatic obstruction

119
Q

Penicillin Resistant PID

A

PID usually due to N. gonnorhea, but if unresponsive to penicillin think of bacteroides cause

120
Q

Duret Hemmorrhages

A

Severe ↑ in ICP w/ downward diplacement of cerebellar tonsils into Foramen Magnum causing acompression on the brainstem w/ hemorrhaging into the pons & midbrain Nearly always associated w/ death due to damage to the vital centers in these areas

121
Q

Hypertensive Hemorrhage

A

Predilection for lenticulostriate arteries= putamen& internal capsule hemorrhages

122
Q

Cerebral Embolism

A

from MI w/ mural thrombis, or atrial fib thrombi= marantic thrombi; L-sided bacterial endocarditis; paradoxical embolism w a septal defect

123
Q

Neurosyphilis

A

Tabes Dorsalis= Dec joint position sensation, dec pain sensation, Argyl Roberston pupils
Syphilitic Meningitis
Paretic neurosyphilis

124
Q

5p deletion

A

Cri du Chat: mental retardation, small head, wide set eyes, low set ears, cat like cry

125
Q

Trisomy 13

A

Patou’s: small head & eyes, cleft lip & palate; many fingers

126
Q

Acute cold agglutination

A

Abs to I blood group Ag. Mediated by IgM ABs

Complication of EBV or mycoplasma pneumonial infections

127
Q

Chronic Cold Agglutination

A

Assoicated w/ lymphoid neoplasms. See agglutination & hemolysis in tissue exposed to cold IgM Abs

128
Q

RBC Osmotic Fragility

A

Hereditary spherocytosis

129
Q

Non-Hodgkin’s Lymphomas

A

Small lymphocytics: low grade B cell lymphoma of the elderly. Related to CLL
Follicular lymphoma: low grade B cell lymphoma of the elderly. T(4:18) bcl2 oncogene
Large Cell
Lymphoblastic: high grade T cell lymphoma of kids progressing to T-ALL
Small Non cleave= Burkitt’s= high grade B cell lymphoma. EBV infection assoc. “starry sky” histo appearance. T(8:14) c-myc proto-oncogene. Related to B-ALL

130
Q

Singer’s Nodules

A

Benign laryngeal polyps associated w/ smoking & overuse of the voice

131
Q

Paraseptal Emphysema

A

Associated w/ blebs (large subpleural bullae) that can rupture and cause pneumothorax

132
Q

Superior Vena Cava Syndrome

A

Obstructed due to bronchogenic carcinom. Causing swollen face & cyanosis

133
Q

Betel Nuts

A

AKA Areca nut, chewed in South Asia

Associated w oral cancer

134
Q

Fundal (Type A) Gastritis

A

Antibodies to Parietal cells; pernicious anmia; autoimmune disorders

135
Q

Antral (type B) Gastritis

A

Associated w H. pylori infection. 90% of duodenal ulcers have this bacteria present

136
Q

Primary Biliary Cirrhosis

A

Autoimmune origin: see in middle aged women, anti-mitochondrial Abs
Sx: jaundice, itching, hypercholesterolemia (can see cutaneous xanthomas)

137
Q

Acute Pancreatitis

A

Elevated pancreatic enzymes= fat necrosis saponification.-> hypocalcemia, inc serum amylase
Severe epigastric pain, prostration, radiation to the back

138
Q

Pain radiating to back

A

Chronic pancreatitis

139
Q

Complete hydatidiform mole

A

No embryo. Paternal DNA only…46XX

140
Q

Partial hydatidiform mole

A

Embryo. 2 or more sperm fertilized 1 ovum. Triploidy/tetraploidy occurs

141
Q

Cold Nodules

A

Hypoplastic goiter nodles that do not take up radioactive iodine. (vs. hot nodules do)

142
Q

Acidophils

A

From anterior pituitary (adenohypophysis)
Mammatrophins= prolactin
Somatotrophins= GH producing
“GPA”

143
Q

Basophils

A

From anterior pituitary (adenohypophysis)
Thyrotrophins= TSH
Gonadotrophins= LH& FSH
Corticotrophins= ACTH

144
Q

Lacunar Strokes

A

Small/focal aa occlusions. Purely motor or sensory
Sensory= thalamic lesion
Motor= internal capsule

145
Q

CSF of Bacterial Meningitis

A

↓ Glucose; ↑ Protein; ↑ Neutrophils; ↑ Pressure

146
Q

CSF of Virla Meningitis

A

Normal Glucose; +/-↑ Protein; ↑ Lymphocytes

147
Q

Marble Bone Disease

A

Osteopetrosis: Albers-Schonberg Disease= inherited disorder. inspite of inc bone density many fractures due to dec osteoclast activity

148
Q

C5a

A

complement factor chemoattractant– Involved in chemotaxis (for neutrophils)

149
Q

C3b

A

complement factor involved in opsonization

150
Q

Anaphylotoxins

A

C3a and C5a (mediate Histamine releasefrom basophils & mast cells)

151
Q

Vasoactive mediators

A

Vasoconstriction: TxA2; LTC4; LTD4; LTE4; PAF
Vasodilation: PGI2; PGD2; PGE2; PGF2α; Bradykinin; PAF
↑d Vascular Permeability: Hist.; 5HT; PGD2; PGE2; PGF2α; LTC4; LTD4; LTE4; Bradykinin; PAF

152
Q

Platelet Aggregation

A

ADP; Thrombin; TxA2; collagen; Epinephrine; PAF

153
Q

Platelet Antagonist

A

Prostacyclin (PGI2)

154
Q

Intrinsic Pathway– coag

A

F XII(Hagman): follow w PTT

155
Q

Extrinsic Pathway– Coag

A

F VII: follow w PT

USMLE Step 1 (9 decks)

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