Pathology Flashcards
3 components of acute inflammation
vascular changes
structural changes
immigration of neutrophils (PMNs)
chronic inflammation involves infiltration of what cells?
mononuclear (macrophages, lymphocytes and plasma cels)
3 components of chronic inflammation
infiltration of mononuclear cells
tissue destruction
repair involving new vessel prolif.
coagulative necrosis happens after a…
myocardial infarction
liquefactive necrosis is seen in … infections in the….
fungal
lung
caseous necrosis is most often seen in … and the central necrotic tissue in this appears…
TB
white and cheesy
what are the 4 hypersensitivity reactions?
Anaphylactic type 1
Cytotoxic type 2
Immune complex mediated type 3
Delayed response type 4
in a type 1 hypersensitivity reaction, an allergen activates a …. and …. antibodies are produced and bind to the surface of mast cells and basophils.
A second exposure to the allergen causes cross-linking of …. which allows calcium to enter the cell and cause degranulation
B lymphocyte
IgE
IgE
causes of type 1 hypersensitivity?
response time?
peanuts, shellfish, penicillin, snake venom, bee stings
5-30 min
… is the primary mediator released from mast cells and basophils during a type 1 hypersensitivity rxn
histamine
erythroblastosis fetalis and rheumatic fever are both examples of what type of hypersensitivity rxn?
type 2 cytotoxic
which antibodies are involved in a type 2 cytotoxic hypersensitivity rxn?
IgG and IgM
which hypersensitivity reaction is mediated by Ag/Ab complexes?
type 3
Lupus is an example of which type of hypersensitivity rxn?
type 3
Serum sickness is an example of which type of hypersensitivity rxn?
type 3
hypersensitivity rxn type 4 is mediated by what type of cells?
T lymphocytes (memory) takes several days to develop
In hypersensitvity type 4 rxns, T lymphocytes encounter an antigen and release …. leading to ….
leukokinin
macrophage activation
TB skin test, contact dermatitis and corneal transplant rejection are all examples of which hypersensitivity rxn?
type 4 (delayed)
in gingivitis, bacteria supragingivally tend to be …. and as you go further into the tissue are more…
gram positive
gram negative
LAP usually has a … onset and periodontal damage involves no more than 2 teeth other than….
1st molars and incisors
GAP usually affects people …., attachment loss affects at least …. other than …
under 30 but can be older too
3 teeth
1st molars and incisors
NPDs are commonly seen in patients with … , … and …
HIV
malnutrition
immunosuppression
NUG and NUP have the same etiology and clinical signs except NUP involves
clinical attachment loss and alveolar bone loss
Lupus happens more often in …. and a distinctive feature is …. and the patients will produce …
women
malar butterfly rash
ANA antibodies
symptoms of lupus
joint pain
renal disorders
photosensitivity
arthritis
rheumatoid arthritis is more common in …. and happens in the … decade of life causes pain in …. joints and the pain is worse in the … and they will test positive for …
women
5th
small
morning
RF
…. syndrome is a slowly progressive inflammatory autoimmune disease affecting primarily exocrine glands, it is marked by the triad of dry mouth, dry eyes, and arthritis
sjogrens
what causes dry mouth in sjogrens syndrome
lymphocytic infiltrates replacing functional epithelium
disease that affects medium and large arteries. patient presents with scalp tenderness, jabbing neck pain, jaw caudication and fever
temporal arteritis (giant cell arteritis)
50% of patients with temporal arteritis may also develop …. which is characterizied by fatigue and morning stiffness in the hips and shoulders
polymyalgia rheumatica
what are two tests that should be run with temporal arteritis and what is the gold standard for dx?
ESR CRP
biopsy
tx for temporal arteritis
steroids
erythema multiforme can be caused by …. or …
herpes simplex virus (HSV)
drugs
erythema multiforme has distinct … lesions
targetoid (bullseye)
… is an autoimmune disease that causes severe blistering of the skin and mucous membranes lining the mouth, nose, throat and genitals
pemphigus vulgaris
pemhigus vulgaris results from circulating … antibodies directed against…
IgG
desmosomes
pemphigus vulgaris is associated with the …. sign
nikolsky’s
…. is an autoimmune disease that causes blistering skin due to a response to 2 hemidesmosomal proteins within the dermal epidermal jxn that separate
bullous pemphigus
… is an autoimmune disorder that is chronic, inflammatory and of unknown etiology. it appears to be T cell mediated. It presents with a white reticular pattern with multiple lesions in a bilateral and symmetric distribution
oral lichen planus
what disease presents with reticular lesions that consist of white papules and striations that form a lacy network called wickhams striae on the buccal mucosa, gingiva, alveolar sulcus and lower vermillion lip
oral lichen planus
can you get AIDS through saliva?
no
AIDS is cause by a …. virus that uses …. to make viral DNA within infected cells
RNA
reverse transcriptase
in AIDS, there is a severe loss of
CD4+ T cells
CD4 count of less than 500 means
CD4 count of less than 200 means
should start medication
HIV has progressed to AIDS
how is a patient tested for HIV/AIDS
ELISA test is a screening test for HIV
Western blot is used to confrim the ELISA test
what is the specificity of the ELISA and western blot for AIDS?
99.9%
what are the common opportunistic infections that usually cause death in AIDS patients?
pneumocystic pneumonia
mycobacterium tuberculosis
toxoplasmosis
CMV and HSV (kaposi’s sarcoma)
…. is a malignancy caused by the herpes virus HHV-8
kaposi’s sarcoma
…. involves the lateral borders of the tongue, it is almost exclusively in HIV patients
hairy leukoplakia
… is a gram positive infection with classic honey colored crusted lesions. very common in children
impetigo
Herpes type 1 and type 2, which one is above the belt and which one below?
1- above
2- below
90% of adults with HSV 1 obtain it from
a primary infection as a child
manifestation of primary infections of HSV type 1 is rare but it is termed…. It is extremely painful and patient will have rew swollen oral mucosa with herpetic lesions present covering mucosa
primary herpetic gingivostomatitis
after initial infection of herpes, it hides in … and can reoccur at any time
trigeminal gasserian ganglion
Varicella-zoster virus presents as
chicken pox
…. is the reactivation of VZV in the dermatome that was associated with the latent virus
Herpes zoster (shingles)
…. disease presents with recurrent oral aphthous ulcers and two of the following features: genital ulcers, eye lesions or skin lesions
behcets
behcets disease is most commonly seen in …
middle eastern and asian young adults
…. is the most common cancer of young women and depth of invasion is the number 1 prognostic factor
malignant melanoma
characteristics of suspicious skin lesions include …
ABCDE asymmetry border color diameter enlarging
…. is the most common variant of melanoma and it has rapid growth and is clasically found on non-exposed skin
superficial spreading melanoma
…. often appears as a shiny, firm, pearly nodule with superficial telangiectasia. progression can lead to central ulceration
basal cell carcinoma
…. is the malignancy of the stratum spinosum layer of the epidermis. non-healing ulcer that often appears as an erythematous plaque. It can arise from a pre-cancerous lesion called actinic keratosis
squamous cell carcinoma
… is the most common cause of primary male hypogonadism
klinefelters syndrome (XXY)
… is due to an absent X chromosome in females. Most common cause of primary amenorrhea and is characterized by short stature, webbing of neck. Only sex aneuploidy
turners syndrome
… is an AD disease distinguished by hamartomatous polyps in the GI tract and pigmented mucocutaneous lesions
Peutz-Jegher syndrome
In … syndrome, hyperpigmentation is present as mucocutaneous macules on the lips, around the mouth, eyes, nostrils, and on the buccal mucosa
Peutz-Jegher
Peutz-Jegher is autosomal …
dominant
this autosomal dominant disease presents with cafe-au-lait spots, neurofibromas and Lisch nodules on the iris
neurofibromatosis type 1 (von recklinghausens disease)
… syndrome is an AD connective tissue disorder that presents with long extremities, subluxating joints, longs fingers/toes, aortic incom, dissecting aortic aneurysm and floppy mitral valves
Marfans
Marfans is autosomal …
dominant
Neurofibromatosis type 1 (von reck.) is autosomal …
dominant
…. is an AD disorder that is located on chromosome 4 and involves involuntary movements and dementia
Huntington’s chorea
Huntington’s chorea is autosomal …
dominant
… is an AD disorder that involves deletion on chromosome 5 resulting in 100s of polyps on the colon post puberty
Familial Adenomatous Polypsis (FAP)
100% of FAP patients will get
colon cancer
… syndrome is a variant of FAP characterized by multi-focal CHRPE’s (4 or more) in the fundus
Gardeners
FAP is autosomal …
dominant
What can be seen in the mouth with FAP patients?
multiple osteomas of the jaw
Sickle cell anemia is autosomal …
recessive
the most common form of sickle cell is caused by a single base mutation where …. is substituting for
valine
glutamic acid
…. is an X-linked recessive disease affecting males and is due to deficiency of coagulation factor 8
Hemophilia A
… is caused by a host of genetic defects giving rise to abnormal collagen synthesis and is characterized by blue sclera, malocclusion, and malformations of the teeth due to dentinogensis imperfecta
osteogenesis imperfecta (brittle bone disease)
most common anemia?
iron deficiency
… anemia results in …. which is characterized by severe anemia, neutropenia, and thrombocytopenia
aplastic
pancytopenia
what can cause aplastic anemia?
infectious agents
radiation or drugs (acetazolamide)
… deficiency causes pernicious anemia which involves autoantibodies against parietal cells of the stomach resulting in decreased production of intrinsic factor (which absorbs vit b12)
vitamin b12
…. is the most common cancer of plasma cells
multiple myeloma
This disease shows the following: 2 peak age groups (15-30 and >50) Reed-Sternberg cells (owl eyes) Prognosis is good 50% are assoc. with EBV (mono)
Hodgkin’s Lymphoma
this type of lymphoma, a biopsy is performed to determine T or B cell types
Non-hodgkins lymphoma
the predominate cell type in acute leukemia is …
blast cells
….. happens in kids and Auer rods may be in within leukemic cells in the blood
Acute Myeloblastic Leukemia (AML)
… is the most common leukemia of kids and has a very good prognosis
Acute Lymphoblastic Leukemia (ALL)
…. is a leukemia that affects adults and 90% of cases have the Philadelphia chromosome
Chronic Myelocytic Leukemia (CML)
… is a leukemia that is most common in adults and has a good prognosis
Chronic Lymphocytic Leukemia (CLL)
what is virchow’s triad?
the 3 main components that cause venous thrombosis
- stasis of blood flow
- vascular (endothelial) injury
- hypercoagualbility
most common primary malignant brain tumor?
glioblastoma multiforme
brain cancer is more commonly …
secondary (metastasis from lung, breast, prostate)
… is the most common benign primary brain tumor
meningioma
… is an autoimmune disease marked by recurrent inflammation of the CNS resulting in demyelination. females affected more and is more common in northern latitudes
multiple sclerosis
dx of MS requires 2 separate CNS lesions on …. and they must involve white matter
2 or more occasions
…. is demyelination of the peripheral nerves
guillain-barre syndrome
… is an autoimmune disease that affects acetylcholine receptors. more common in younger women and older men
myasthenia gravis
most common form of dementia?
alzheimers
…. disease shows deposits of a protein called beta amyloid and neurofibrillary tangles. Cause is unknown
alzheimers
… disease is caused by a deficiency of dopamine in the striatum due to degeneration of neurons in the substantia nigra
parkinsons
symptoms of parkinsons
Tremor at rest
Rigidity
Akinesia
Postural instability
also emotional expressions
artery most common in epidural hematoma?
middle meningeal artery
a subdural hematoma is when venous blood collects between the … and … space
dura
arachnoid
TSH and T4 values in hypothyroidism
high TSH
low T4
TSH and T4 in hyperthyroidism
low TSH
high T4
most common type of hypothyroidism?
hashimotos thyroiditis
most of hyperthyroidism cases are caused by
graves disease
symptoms of hyperparathyroidism
weak bones
constipation
kidney stones
exhausted
symptoms of hypoparathyroidism
tetany
changes in mental status
muscle cramps
convulsions
…. disease is caused by chronic adrenocortical deficiency that is a result of autoimmune atrophy of the adrenals
addisons
symptoms of addisons disease
weakness
weight loss
vomiting
joint pains
tx of addisons
replacement therapy with a combo of glucocorticoids and mineralcorticoids
…. is a result of excessive corticosteroids and patients present with obesity, moon face and buffalo hump. they also have osteoporosis, HTN, poor wound healing, hyperglycemia and elevated cortisol
cushing’s (hypercortisolism)
… is a tumor of the adrenal gland that causes excessive amounts of norepi and epi to be released
pheochromocytoma
the main 2 causes of chronic renal failure
diabetes
HTN
…. syndrome is associated with greater than 3.5 grams of protein in the urine
nephrotic syndrome
… is a bacterial infection of the kidneys and symptoms include flank pain, fever, and urgency
pyelonephritis
most common BACTERIAL STD?
chlamydia
chlamydia is caused by
chlamydia trachomatis
gonorrhea is caused by
neisseria gonorrhoeae
dx of herpes simplex is confirmed by multinucleated giant cells on a
wright-gram stain
syphilis is caused by
the spirochete treponema pallidum
syphilis has 3 phases, what are they characterized by?
1st- chancre
2nd- lesions in eye, kidney, muc.mem.
3rd- nervous system lesions
2nd most common cancer death in males
prostate cancer (most common cancer in term of numbers)
prostate cancer with show elevated … and …
PSA
acid phosphatase
metastasis from prostate cancer usually travels to
bone
2nd most common cancer death in women
breast (most common in terms of frequency)
2 main causes for peptic ulcer disease?
helicobacter pylori
NSAID use
in barrets esophagus, squamous cells are changed to
columnar cells
barrets esophagus can lead to
esophageal adenocarcinoma
which has skip lesions and which has rectal involvement?
crohns disease
ulcerative colitis
crohns- skip
ulcerative colitis- rectal
… disease is a copper accumulation and it tends to build up in the liver, brain and cornea
wilsons
when will you see mallory bodies?
alcoholic hepatitis
what enzymes will be elevated with hepatitis
AST
ALT
Hep A: vaccine avail? route of trans?
yes
fecal oral
Hep B: vaccine avail? route of trans?
yes (3 shots)
IV drug use, sex, blood (not saliva)
Hep E: vaccine avail? route of trans?
no
fecal oral
which type of hepatitis is most likely to lead to chronic?
C
Hep C: vaccine avail? route of trans?
no
IV drug use, sex, blood (not saliva)
Whats special about Hep D
can only get it if you have Hep B
cirrhosis leads to a build up of
urea
…. is inflammation of the gall bladder and a clinical dx is murhpys sign
cholecystitis
acute pancreatitis occurs secondary to … or …. and labs show an increase in serum … and …
alcohol abuse
gall stones
amylase
lipase
Otitis media is pain in the ear and caused by bacterial infections from … and …
tx is amoxicillin
Strep pneumoniae
H. Influenza
most salivary tumors are in which gland?
parotid
most common salivary benign tumor? most common site?
Pleomorphic adenoma (benign mixed tumor)
parotid
most common malignant salivary tumor?
mucoepidermoid carcinoma (mucous producing cells)
which benign salivary tumor happens bilaterally and is unlikely to become malignant?
Warthins tumor (papillary cystadenoma lymphomatosum)
leading cause of COPD?
smoking
COPD involves … and …
emphysema
chronic bronchitis
patients with emphysema are called
pink puffers
… is a disease that is marked by an enlargement of air spaces and a decrease in recoiling because of destruction of the alveolar walls
emphysema
… is a disease marked by a productive cough for 3 consecutive months in 2 or more years due to hypertrophy of mucous-secreting glands in the bronchioles
chronic bronchitis
patients with chronic bronchitis are called
blue bloaters
most common cause of pneumonia in infants
RSV
most common kind of lung cancer
adenocarcinoma
1 cancer death of men and women
lung
