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NBDE part 1 > Pathology > Flashcards

Pathology Flashcards

1
Q

3 components of acute inflammation

A

vascular changes
structural changes
immigration of neutrophils (PMNs)

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2
Q

chronic inflammation involves infiltration of what cells?

A

mononuclear (macrophages, lymphocytes and plasma cels)

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3
Q

3 components of chronic inflammation

A

infiltration of mononuclear cells
tissue destruction
repair involving new vessel prolif.

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4
Q

coagulative necrosis happens after a…

A

myocardial infarction

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5
Q

liquefactive necrosis is seen in … infections in the….

A

fungal

lung

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6
Q

caseous necrosis is most often seen in … and the central necrotic tissue in this appears…

A

TB

white and cheesy

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7
Q

what are the 4 hypersensitivity reactions?

A

Anaphylactic type 1
Cytotoxic type 2
Immune complex mediated type 3
Delayed response type 4

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8
Q

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

A

B lymphocyte
IgE

IgE

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9
Q

causes of type 1 hypersensitivity?

response time?

A

peanuts, shellfish, penicillin, snake venom, bee stings

5-30 min

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10
Q

… is the primary mediator released from mast cells and basophils during a type 1 hypersensitivity rxn

A

histamine

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11
Q

erythroblastosis fetalis and rheumatic fever are both examples of what type of hypersensitivity rxn?

A

type 2 cytotoxic

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12
Q

which antibodies are involved in a type 2 cytotoxic hypersensitivity rxn?

A

IgG and IgM

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13
Q

which hypersensitivity reaction is mediated by Ag/Ab complexes?

A

type 3

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14
Q

Lupus is an example of which type of hypersensitivity rxn?

A

type 3

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15
Q

Serum sickness is an example of which type of hypersensitivity rxn?

A

type 3

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16
Q

hypersensitivity rxn type 4 is mediated by what type of cells?

A

T lymphocytes (memory) takes several days to develop

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17
Q

In hypersensitvity type 4 rxns, T lymphocytes encounter an antigen and release …. leading to ….

A

leukokinin

macrophage activation

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18
Q

TB skin test, contact dermatitis and corneal transplant rejection are all examples of which hypersensitivity rxn?

A

type 4 (delayed)

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19
Q

in gingivitis, bacteria supragingivally tend to be …. and as you go further into the tissue are more…

A

gram positive

gram negative

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20
Q

LAP usually has a … onset and periodontal damage involves no more than 2 teeth other than….

A

1st molars and incisors

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21
Q

GAP usually affects people …., attachment loss affects at least …. other than …

A

under 30 but can be older too
3 teeth
1st molars and incisors

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22
Q

NPDs are commonly seen in patients with … , … and …

A

HIV
malnutrition
immunosuppression

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23
Q

NUG and NUP have the same etiology and clinical signs except NUP involves

A

clinical attachment loss and alveolar bone loss

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24
Q

Lupus happens more often in …. and a distinctive feature is …. and the patients will produce …

A

women
malar butterfly rash
ANA antibodies

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25
Q

symptoms of lupus

A

joint pain
renal disorders
photosensitivity
arthritis

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26
Q

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 …

A

women

5th

small

morning

RF

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27
Q

…. 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

A

sjogrens

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28
Q

what causes dry mouth in sjogrens syndrome

A

lymphocytic infiltrates replacing functional epithelium

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29
Q

disease that affects medium and large arteries. patient presents with scalp tenderness, jabbing neck pain, jaw caudication and fever

A

temporal arteritis (giant cell arteritis)

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30
Q

50% of patients with temporal arteritis may also develop …. which is characterizied by fatigue and morning stiffness in the hips and shoulders

A

polymyalgia rheumatica

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31
Q

what are two tests that should be run with temporal arteritis and what is the gold standard for dx?

A

ESR CRP

biopsy

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32
Q

tx for temporal arteritis

A

steroids

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33
Q

erythema multiforme can be caused by …. or …

A

herpes simplex virus (HSV)

drugs

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34
Q

erythema multiforme has distinct … lesions

A

targetoid (bullseye)

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35
Q

… is an autoimmune disease that causes severe blistering of the skin and mucous membranes lining the mouth, nose, throat and genitals

A

pemphigus vulgaris

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36
Q

pemhigus vulgaris results from circulating … antibodies directed against…

A

IgG

desmosomes

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37
Q

pemphigus vulgaris is associated with the …. sign

A

nikolsky’s

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38
Q

…. is an autoimmune disease that causes blistering skin due to a response to 2 hemidesmosomal proteins within the dermal epidermal jxn that separate

A

bullous pemphigus

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39
Q

… 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

A

oral lichen planus

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40
Q

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

A

oral lichen planus

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41
Q

can you get AIDS through saliva?

A

no

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42
Q

AIDS is cause by a …. virus that uses …. to make viral DNA within infected cells

A

RNA

reverse transcriptase

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43
Q

in AIDS, there is a severe loss of

A

CD4+ T cells

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44
Q

CD4 count of less than 500 means

CD4 count of less than 200 means

A

should start medication

HIV has progressed to AIDS

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45
Q

how is a patient tested for HIV/AIDS

A

ELISA test is a screening test for HIV

Western blot is used to confrim the ELISA test

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46
Q

what is the specificity of the ELISA and western blot for AIDS?

A

99.9%

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47
Q

what are the common opportunistic infections that usually cause death in AIDS patients?

A

pneumocystic pneumonia
mycobacterium tuberculosis
toxoplasmosis
CMV and HSV (kaposi’s sarcoma)

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48
Q

…. is a malignancy caused by the herpes virus HHV-8

A

kaposi’s sarcoma

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49
Q

…. involves the lateral borders of the tongue, it is almost exclusively in HIV patients

A

hairy leukoplakia

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50
Q

… is a gram positive infection with classic honey colored crusted lesions. very common in children

A

impetigo

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51
Q

Herpes type 1 and type 2, which one is above the belt and which one below?

A

1- above

2- below

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52
Q

90% of adults with HSV 1 obtain it from

A

a primary infection as a child

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53
Q

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

A

primary herpetic gingivostomatitis

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54
Q

after initial infection of herpes, it hides in … and can reoccur at any time

A

trigeminal gasserian ganglion

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55
Q

Varicella-zoster virus presents as

A

chicken pox

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56
Q

…. is the reactivation of VZV in the dermatome that was associated with the latent virus

A

Herpes zoster (shingles)

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57
Q

…. disease presents with recurrent oral aphthous ulcers and two of the following features: genital ulcers, eye lesions or skin lesions

A

behcets

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58
Q

behcets disease is most commonly seen in …

A

middle eastern and asian young adults

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59
Q

…. is the most common cancer of young women and depth of invasion is the number 1 prognostic factor

A

malignant melanoma

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60
Q

characteristics of suspicious skin lesions include …

A 
ABCDE
asymmetry
border
color
diameter
enlarging
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61
Q

…. is the most common variant of melanoma and it has rapid growth and is clasically found on non-exposed skin

A

superficial spreading melanoma

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62
Q

…. often appears as a shiny, firm, pearly nodule with superficial telangiectasia. progression can lead to central ulceration

A

basal cell carcinoma

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63
Q

…. 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

A

squamous cell carcinoma

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64
Q

… is the most common cause of primary male hypogonadism

A

klinefelters syndrome (XXY)

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65
Q

… 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

A

turners syndrome

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66
Q

… is an AD disease distinguished by hamartomatous polyps in the GI tract and pigmented mucocutaneous lesions

A

Peutz-Jegher syndrome

67
Q

In … syndrome, hyperpigmentation is present as mucocutaneous macules on the lips, around the mouth, eyes, nostrils, and on the buccal mucosa

A

Peutz-Jegher

68
Q

Peutz-Jegher is autosomal …

69
Q

this autosomal dominant disease presents with cafe-au-lait spots, neurofibromas and Lisch nodules on the iris

A

neurofibromatosis type 1 (von recklinghausens disease)

70
Q

… 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

71
Q

Marfans is autosomal …

72
Q

Neurofibromatosis type 1 (von reck.) is autosomal …

73
Q

…. is an AD disorder that is located on chromosome 4 and involves involuntary movements and dementia

A

Huntington’s chorea

74
Q

Huntington’s chorea is autosomal …

75
Q

… is an AD disorder that involves deletion on chromosome 5 resulting in 100s of polyps on the colon post puberty

A

Familial Adenomatous Polypsis (FAP)

76
Q

100% of FAP patients will get

A

colon cancer

77
Q

… syndrome is a variant of FAP characterized by multi-focal CHRPE’s (4 or more) in the fundus

78
Q

FAP is autosomal …

79
Q

What can be seen in the mouth with FAP patients?

A

multiple osteomas of the jaw

80
Q

Sickle cell anemia is autosomal …

81
Q

the most common form of sickle cell is caused by a single base mutation where …. is substituting for

A

valine

glutamic acid

82
Q

…. is an X-linked recessive disease affecting males and is due to deficiency of coagulation factor 8

A

Hemophilia A

83
Q

… 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

A

osteogenesis imperfecta (brittle bone disease)

84
Q

most common anemia?

A

iron deficiency

85
Q

… anemia results in …. which is characterized by severe anemia, neutropenia, and thrombocytopenia

A

aplastic

pancytopenia

86
Q

what can cause aplastic anemia?

A

infectious agents

radiation or drugs (acetazolamide)

87
Q

… deficiency causes pernicious anemia which involves autoantibodies against parietal cells of the stomach resulting in decreased production of intrinsic factor (which absorbs vit b12)

A

vitamin b12

88
Q

…. is the most common cancer of plasma cells

A

multiple myeloma

89
Q 
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)
A

Hodgkin’s Lymphoma

90
Q

this type of lymphoma, a biopsy is performed to determine T or B cell types

A

Non-hodgkins lymphoma

91
Q

the predominate cell type in acute leukemia is …

A

blast cells

92
Q

….. happens in kids and Auer rods may be in within leukemic cells in the blood

A

Acute Myeloblastic Leukemia (AML)

93
Q

… is the most common leukemia of kids and has a very good prognosis

A

Acute Lymphoblastic Leukemia (ALL)

94
Q

…. is a leukemia that affects adults and 90% of cases have the Philadelphia chromosome

A

Chronic Myelocytic Leukemia (CML)

95
Q

… is a leukemia that is most common in adults and has a good prognosis

A

Chronic Lymphocytic Leukemia (CLL)

96
Q

what is virchow’s triad?

A

the 3 main components that cause venous thrombosis

  1. stasis of blood flow
  2. vascular (endothelial) injury
  3. hypercoagualbility
97
Q

most common primary malignant brain tumor?

A

glioblastoma multiforme

98
Q

brain cancer is more commonly …

A

secondary (metastasis from lung, breast, prostate)

99
Q

… is the most common benign primary brain tumor

A

meningioma

100
Q

… is an autoimmune disease marked by recurrent inflammation of the CNS resulting in demyelination. females affected more and is more common in northern latitudes

A

multiple sclerosis

101
Q

dx of MS requires 2 separate CNS lesions on …. and they must involve white matter

A

2 or more occasions

102
Q

…. is demyelination of the peripheral nerves

A

guillain-barre syndrome

103
Q

… is an autoimmune disease that affects acetylcholine receptors. more common in younger women and older men

A

myasthenia gravis

104
Q

most common form of dementia?

A

alzheimers

105
Q

…. disease shows deposits of a protein called beta amyloid and neurofibrillary tangles. Cause is unknown

A

alzheimers

106
Q

… disease is caused by a deficiency of dopamine in the striatum due to degeneration of neurons in the substantia nigra

A

parkinsons

107
Q

symptoms of parkinsons

A

Tremor at rest
Rigidity
Akinesia
Postural instability

also emotional expressions

108
Q

artery most common in epidural hematoma?

A

middle meningeal artery

109
Q

a subdural hematoma is when venous blood collects between the … and … space

A

dura

arachnoid

110
Q

TSH and T4 values in hypothyroidism

A

high TSH

low T4

111
Q

TSH and T4 in hyperthyroidism

A

low TSH

high T4

112
Q

most common type of hypothyroidism?

A

hashimotos thyroiditis

113
Q

most of hyperthyroidism cases are caused by

A

graves disease

114
Q

symptoms of hyperparathyroidism

A

weak bones
constipation
kidney stones
exhausted

115
Q

symptoms of hypoparathyroidism

A

tetany
changes in mental status
muscle cramps
convulsions

116
Q

…. disease is caused by chronic adrenocortical deficiency that is a result of autoimmune atrophy of the adrenals

117
Q

symptoms of addisons disease

A

weakness
weight loss
vomiting
joint pains

118
Q

tx of addisons

A

replacement therapy with a combo of glucocorticoids and mineralcorticoids

119
Q

…. 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

A

cushing’s (hypercortisolism)

120
Q

… is a tumor of the adrenal gland that causes excessive amounts of norepi and epi to be released

A

pheochromocytoma

121
Q

the main 2 causes of chronic renal failure

A

diabetes

HTN

122
Q

…. syndrome is associated with greater than 3.5 grams of protein in the urine

A

nephrotic syndrome

123
Q

… is a bacterial infection of the kidneys and symptoms include flank pain, fever, and urgency

A

pyelonephritis

124
Q

most common BACTERIAL STD?

125
Q

chlamydia is caused by

A

chlamydia trachomatis

126
Q

gonorrhea is caused by

A

neisseria gonorrhoeae

127
Q

dx of herpes simplex is confirmed by multinucleated giant cells on a

A

wright-gram stain

128
Q

syphilis is caused by

A

the spirochete treponema pallidum

129
Q

syphilis has 3 phases, what are they characterized by?

A

1st- chancre
2nd- lesions in eye, kidney, muc.mem.
3rd- nervous system lesions

130
Q

2nd most common cancer death in males

A

prostate cancer (most common cancer in term of numbers)

131
Q

prostate cancer with show elevated … and …

A

PSA

acid phosphatase

132
Q

metastasis from prostate cancer usually travels to

133
Q

2nd most common cancer death in women

A

breast (most common in terms of frequency)

134
Q

2 main causes for peptic ulcer disease?

A

helicobacter pylori

NSAID use

135
Q

in barrets esophagus, squamous cells are changed to

A

columnar cells

136
Q

barrets esophagus can lead to

A

esophageal adenocarcinoma

137
Q

which has skip lesions and which has rectal involvement?

crohns disease
ulcerative colitis

A

crohns- skip

ulcerative colitis- rectal

138
Q

… disease is a copper accumulation and it tends to build up in the liver, brain and cornea

139
Q

when will you see mallory bodies?

A

alcoholic hepatitis

140
Q

what enzymes will be elevated with hepatitis

141
Q

Hep A: vaccine avail? route of trans?

A

yes

fecal oral

142
Q

Hep B: vaccine avail? route of trans?

A

yes (3 shots)

IV drug use, sex, blood (not saliva)

143
Q

Hep E: vaccine avail? route of trans?

A

no

fecal oral

144
Q

which type of hepatitis is most likely to lead to chronic?

145
Q

Hep C: vaccine avail? route of trans?

A

no

IV drug use, sex, blood (not saliva)

146
Q

Whats special about Hep D

A

can only get it if you have Hep B

147
Q

cirrhosis leads to a build up of

148
Q

…. is inflammation of the gall bladder and a clinical dx is murhpys sign

A

cholecystitis

149
Q

acute pancreatitis occurs secondary to … or …. and labs show an increase in serum … and …

A

alcohol abuse
gall stones

amylase
lipase

150
Q

Otitis media is pain in the ear and caused by bacterial infections from … and …

tx is amoxicillin

A

Strep pneumoniae

H. Influenza

151
Q

most salivary tumors are in which gland?

152
Q

most common salivary benign tumor? most common site?

A

Pleomorphic adenoma (benign mixed tumor)

parotid

153
Q

most common malignant salivary tumor?

A

mucoepidermoid carcinoma (mucous producing cells)

154
Q

which benign salivary tumor happens bilaterally and is unlikely to become malignant?

A

Warthins tumor (papillary cystadenoma lymphomatosum)

155
Q

leading cause of COPD?

156
Q

COPD involves … and …

A

emphysema

chronic bronchitis

157
Q

patients with emphysema are called

A

pink puffers

158
Q

… is a disease that is marked by an enlargement of air spaces and a decrease in recoiling because of destruction of the alveolar walls

159
Q

… 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

A

chronic bronchitis

160
Q

patients with chronic bronchitis are called

A

blue bloaters

161
Q

most common cause of pneumonia in infants

162
Q

most common kind of lung cancer

A

adenocarcinoma

163
Q

1 cancer death of men and women

NBDE part 1 (9 decks)

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