Pathology Flashcards
1
Q
3 components of acute inflammation
A
vascular changes
structural changes
immigration of neutrophils (PMNs)
2
Q
chronic inflammation involves infiltration of what cells?
A
mononuclear (macrophages, lymphocytes and plasma cels)
3
Q
3 components of chronic inflammation
A
infiltration of mononuclear cells
tissue destruction
repair involving new vessel prolif.
4
Q
coagulative necrosis happens after a…
A
myocardial infarction
5
Q
liquefactive necrosis is seen in … infections in the….
A
fungal
lung
6
Q
caseous necrosis is most often seen in … and the central necrotic tissue in this appears…
A
TB
white and cheesy
7
Q
what are the 4 hypersensitivity reactions?
A
Anaphylactic type 1
Cytotoxic type 2
Immune complex mediated type 3
Delayed response type 4
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
9
Q
causes of type 1 hypersensitivity?
response time?
A
peanuts, shellfish, penicillin, snake venom, bee stings
5-30 min
10
Q
… is the primary mediator released from mast cells and basophils during a type 1 hypersensitivity rxn
A
histamine
11
Q
erythroblastosis fetalis and rheumatic fever are both examples of what type of hypersensitivity rxn?
A
type 2 cytotoxic
12
Q
which antibodies are involved in a type 2 cytotoxic hypersensitivity rxn?
A
IgG and IgM
13
Q
which hypersensitivity reaction is mediated by Ag/Ab complexes?
A
type 3
14
Q
Lupus is an example of which type of hypersensitivity rxn?
A
type 3
15
Q
Serum sickness is an example of which type of hypersensitivity rxn?
A
type 3
16
Q
hypersensitivity rxn type 4 is mediated by what type of cells?
A
T lymphocytes (memory) takes several days to develop
17
Q
In hypersensitvity type 4 rxns, T lymphocytes encounter an antigen and release …. leading to ….
A
leukokinin
macrophage activation
18
Q
TB skin test, contact dermatitis and corneal transplant rejection are all examples of which hypersensitivity rxn?
A
type 4 (delayed)
19
Q
in gingivitis, bacteria supragingivally tend to be …. and as you go further into the tissue are more…
A
gram positive
gram negative
20
Q
LAP usually has a … onset and periodontal damage involves no more than 2 teeth other than….
A
1st molars and incisors
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
22
Q
NPDs are commonly seen in patients with … , … and …
A
HIV
malnutrition
immunosuppression
23
Q
NUG and NUP have the same etiology and clinical signs except NUP involves
A
clinical attachment loss and alveolar bone loss
24
Q
Lupus happens more often in …. and a distinctive feature is …. and the patients will produce …
A
women
malar butterfly rash
ANA antibodies
25
symptoms of lupus
joint pain
renal disorders
photosensitivity
arthritis
26
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
27
.... 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
28
what causes dry mouth in sjogrens syndrome
lymphocytic infiltrates replacing functional epithelium
29
disease that affects medium and large arteries. patient presents with scalp tenderness, jabbing neck pain, jaw caudication and fever
temporal arteritis (giant cell arteritis)
30
50% of patients with temporal arteritis may also develop .... which is characterizied by fatigue and morning stiffness in the hips and shoulders
polymyalgia rheumatica
31
what are two tests that should be run with temporal arteritis and what is the gold standard for dx?
ESR CRP
biopsy
32
tx for temporal arteritis
steroids
33
erythema multiforme can be caused by .... or ...
herpes simplex virus (HSV)
| drugs
34
erythema multiforme has distinct ... lesions
targetoid (bullseye)
35
... is an autoimmune disease that causes severe blistering of the skin and mucous membranes lining the mouth, nose, throat and genitals
pemphigus vulgaris
36
pemhigus vulgaris results from circulating ... antibodies directed against...
IgG
desmosomes
37
pemphigus vulgaris is associated with the .... sign
nikolsky's
38
.... 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
39
... 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
40
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
41
can you get AIDS through saliva?
no
42
AIDS is cause by a .... virus that uses .... to make viral DNA within infected cells
RNA
| reverse transcriptase
43
in AIDS, there is a severe loss of
CD4+ T cells
44
CD4 count of less than 500 means
CD4 count of less than 200 means
should start medication
HIV has progressed to AIDS
45
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
46
what is the specificity of the ELISA and western blot for AIDS?
99.9%
47
what are the common opportunistic infections that usually cause death in AIDS patients?
pneumocystic pneumonia
mycobacterium tuberculosis
toxoplasmosis
CMV and HSV (kaposi's sarcoma)
48
.... is a malignancy caused by the herpes virus HHV-8
kaposi's sarcoma
49
.... involves the lateral borders of the tongue, it is almost exclusively in HIV patients
hairy leukoplakia
50
... is a gram positive infection with classic honey colored crusted lesions. very common in children
impetigo
51
Herpes type 1 and type 2, which one is above the belt and which one below?
1- above
| 2- below
52
90% of adults with HSV 1 obtain it from
a primary infection as a child
53
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
54
after initial infection of herpes, it hides in ... and can reoccur at any time
trigeminal gasserian ganglion
55
Varicella-zoster virus presents as
chicken pox
56
.... is the reactivation of VZV in the dermatome that was associated with the latent virus
Herpes zoster (shingles)
57
.... disease presents with recurrent oral aphthous ulcers and two of the following features: genital ulcers, eye lesions or skin lesions
behcets
58
behcets disease is most commonly seen in ...
middle eastern and asian young adults
59
.... is the most common cancer of young women and depth of invasion is the number 1 prognostic factor
malignant melanoma
60
characteristics of suspicious skin lesions include ...
```
ABCDE
asymmetry
border
color
diameter
enlarging
```
61
.... is the most common variant of melanoma and it has rapid growth and is clasically found on non-exposed skin
superficial spreading melanoma
62
.... often appears as a shiny, firm, pearly nodule with superficial telangiectasia. progression can lead to central ulceration
basal cell carcinoma
63
.... 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
64
... is the most common cause of primary male hypogonadism
klinefelters syndrome (XXY)
65
... 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
66
... is an AD disease distinguished by hamartomatous polyps in the GI tract and pigmented mucocutaneous lesions
Peutz-Jegher syndrome
67
In ... syndrome, hyperpigmentation is present as mucocutaneous macules on the lips, around the mouth, eyes, nostrils, and on the buccal mucosa
Peutz-Jegher
68
Peutz-Jegher is autosomal ...
dominant
69
this autosomal dominant disease presents with cafe-au-lait spots, neurofibromas and Lisch nodules on the iris
neurofibromatosis type 1 (von recklinghausens disease)
70
... 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
71
Marfans is autosomal ...
dominant
72
Neurofibromatosis type 1 (von reck.) is autosomal ...
dominant
73
.... is an AD disorder that is located on chromosome 4 and involves involuntary movements and dementia
Huntington's chorea
74
Huntington's chorea is autosomal ...
dominant
75
... is an AD disorder that involves deletion on chromosome 5 resulting in 100s of polyps on the colon post puberty
Familial Adenomatous Polypsis (FAP)
76
100% of FAP patients will get
colon cancer
77
... syndrome is a variant of FAP characterized by multi-focal CHRPE's (4 or more) in the fundus
Gardeners
78
FAP is autosomal ...
dominant
79
What can be seen in the mouth with FAP patients?
multiple osteomas of the jaw
80
Sickle cell anemia is autosomal ...
recessive
81
the most common form of sickle cell is caused by a single base mutation where .... is substituting for
valine
| glutamic acid
82
.... is an X-linked recessive disease affecting males and is due to deficiency of coagulation factor 8
Hemophilia A
83
... 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)
84
most common anemia?
iron deficiency
85
... anemia results in .... which is characterized by severe anemia, neutropenia, and thrombocytopenia
aplastic
| pancytopenia
86
what can cause aplastic anemia?
infectious agents
| radiation or drugs (acetazolamide)
87
... 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
88
.... is the most common cancer of plasma cells
multiple myeloma
89
```
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
90
this type of lymphoma, a biopsy is performed to determine T or B cell types
Non-hodgkins lymphoma
91
the predominate cell type in acute leukemia is ...
blast cells
92
..... happens in kids and Auer rods may be in within leukemic cells in the blood
Acute Myeloblastic Leukemia (AML)
93
... is the most common leukemia of kids and has a very good prognosis
Acute Lymphoblastic Leukemia (ALL)
94
.... is a leukemia that affects adults and 90% of cases have the Philadelphia chromosome
Chronic Myelocytic Leukemia (CML)
95
... is a leukemia that is most common in adults and has a good prognosis
Chronic Lymphocytic Leukemia (CLL)
96
what is virchow's triad?
the 3 main components that cause venous thrombosis
1. stasis of blood flow
2. vascular (endothelial) injury
3. hypercoagualbility
97
most common primary malignant brain tumor?
glioblastoma multiforme
98
brain cancer is more commonly ...
secondary (metastasis from lung, breast, prostate)
99
... is the most common benign primary brain tumor
meningioma
100
... 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
101
dx of MS requires 2 separate CNS lesions on .... and they must involve white matter
2 or more occasions
102
.... is demyelination of the peripheral nerves
guillain-barre syndrome
103
... is an autoimmune disease that affects acetylcholine receptors. more common in younger women and older men
myasthenia gravis
104
most common form of dementia?
alzheimers
105
.... disease shows deposits of a protein called beta amyloid and neurofibrillary tangles. Cause is unknown
alzheimers
106
... disease is caused by a deficiency of dopamine in the striatum due to degeneration of neurons in the substantia nigra
parkinsons
107
symptoms of parkinsons
Tremor at rest
Rigidity
Akinesia
Postural instability
also emotional expressions
108
artery most common in epidural hematoma?
middle meningeal artery
109
a subdural hematoma is when venous blood collects between the ... and ... space
dura
| arachnoid
110
TSH and T4 values in hypothyroidism
high TSH
| low T4
111
TSH and T4 in hyperthyroidism
low TSH
| high T4
112
most common type of hypothyroidism?
hashimotos thyroiditis
113
most of hyperthyroidism cases are caused by
graves disease
114
symptoms of hyperparathyroidism
weak bones
constipation
kidney stones
exhausted
115
symptoms of hypoparathyroidism
tetany
changes in mental status
muscle cramps
convulsions
116
.... disease is caused by chronic adrenocortical deficiency that is a result of autoimmune atrophy of the adrenals
addisons
117
symptoms of addisons disease
weakness
weight loss
vomiting
joint pains
118
tx of addisons
replacement therapy with a combo of glucocorticoids and mineralcorticoids
119
.... 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)
120
... is a tumor of the adrenal gland that causes excessive amounts of norepi and epi to be released
pheochromocytoma
121
the main 2 causes of chronic renal failure
diabetes
| HTN
122
.... syndrome is associated with greater than 3.5 grams of protein in the urine
nephrotic syndrome
123
... is a bacterial infection of the kidneys and symptoms include flank pain, fever, and urgency
pyelonephritis
124
most common BACTERIAL STD?
chlamydia
125
chlamydia is caused by
chlamydia trachomatis
126
gonorrhea is caused by
neisseria gonorrhoeae
127
dx of herpes simplex is confirmed by multinucleated giant cells on a
wright-gram stain
128
syphilis is caused by
the spirochete treponema pallidum
129
syphilis has 3 phases, what are they characterized by?
1st- chancre
2nd- lesions in eye, kidney, muc.mem.
3rd- nervous system lesions
130
2nd most common cancer death in males
prostate cancer (most common cancer in term of numbers)
131
prostate cancer with show elevated ... and ...
PSA
| acid phosphatase
132
metastasis from prostate cancer usually travels to
bone
133
2nd most common cancer death in women
breast (most common in terms of frequency)
134
2 main causes for peptic ulcer disease?
helicobacter pylori
| NSAID use
135
in barrets esophagus, squamous cells are changed to
columnar cells
136
barrets esophagus can lead to
esophageal adenocarcinoma
137
which has skip lesions and which has rectal involvement?
crohns disease
ulcerative colitis
crohns- skip
ulcerative colitis- rectal
138
... disease is a copper accumulation and it tends to build up in the liver, brain and cornea
wilsons
139
when will you see mallory bodies?
alcoholic hepatitis
140
what enzymes will be elevated with hepatitis
AST
| ALT
141
Hep A: vaccine avail? route of trans?
yes
fecal oral
142
Hep B: vaccine avail? route of trans?
yes (3 shots)
IV drug use, sex, blood (not saliva)
143
Hep E: vaccine avail? route of trans?
no
fecal oral
144
which type of hepatitis is most likely to lead to chronic?
C
145
Hep C: vaccine avail? route of trans?
no
IV drug use, sex, blood (not saliva)
146
Whats special about Hep D
can only get it if you have Hep B
147
cirrhosis leads to a build up of
urea
148
.... is inflammation of the gall bladder and a clinical dx is murhpys sign
cholecystitis
149
acute pancreatitis occurs secondary to ... or .... and labs show an increase in serum ... and ...
alcohol abuse
gall stones
amylase
lipase
150
Otitis media is pain in the ear and caused by bacterial infections from ... and ...
tx is amoxicillin
Strep pneumoniae
H. Influenza
151
most salivary tumors are in which gland?
parotid
152
most common salivary benign tumor? most common site?
Pleomorphic adenoma (benign mixed tumor)
parotid
153
most common malignant salivary tumor?
mucoepidermoid carcinoma (mucous producing cells)
154
which benign salivary tumor happens bilaterally and is unlikely to become malignant?
Warthins tumor (papillary cystadenoma lymphomatosum)
155
leading cause of COPD?
smoking
156
COPD involves ... and ...
emphysema
| chronic bronchitis
157
patients with emphysema are called
pink puffers
158
... 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
159
... 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
160
patients with chronic bronchitis are called
blue bloaters
161
most common cause of pneumonia in infants
RSV
162
most common kind of lung cancer
adenocarcinoma
163
#1 cancer death of men and women
lung
