Pathology c Flashcards
DIRTY MEDICINE
Autosomal Dominant Dx (song)
“Von, Von, ALS, Rb, MEN
Tubes & Spheres & Huntingdon
Marfan, Ehler’s Dan
NF1 and 2, don’t FAP too much
Autosomal Dominant, yes this song is clutch”
* Von Hippel Lindau
* Von Willebrand Disease
* Amyotrophic Lateral Sclerosis (ALS)
* Retinoblastoma
* Multiple Endocrine Neoplasia (MEN)
* Tuberous Sclerosis
* Hereditary Spherocytosis
* Huntingdon’s Disease
* Marfan’s Syndrome
* Ehler’s Danlos Syndrome
* Neurofibromatosis
* Familial Adenomatous Polyposis
List of reportable Diseases (song)
“A, B, C and HIV
Syphilis & Gonorr’ee
MMR, Chicken Pox
TB test your patient’s socks
Salmonella, Shigella too
Report this shit is what you should do!”
- Hepatitis A Hepatitis B
- Hepatitis C
- HIV
- Syphilis
- Gonorrhea
- Measles Mumps
- Rubella
- Chicken Pox
- Tuberculosis
- Salmonella
- Shigella
Autosomal recessive disease (song)
“Alpha, beta, pee-ew
Iron, Copper, Bern-sou
Hartnup, Glanzman, Fanconi
AR yes it’s true!”
- Alpha-1-Antitrypsin Deficiency (ALPHA)
- Beta-Thalassemia (BETA)
- Phenylketonuria (PEE-EW)
- Hemochromatosis (IRON)
- Wilson’s Disease (COOPER)
- Bernard-Soulier (BERN-SOU)
- Hartnup Syndrome (HARTNUP)
- Glanzman Thrombasthenia (GLANZMAN)
- Fanconi FANCONI
Osteochondroma
(benign/malignant, epi, location, findings)
- Benigno
- Epidemio: Hombres, <25 años
- Localización: Metáfisis
- Tumor BENIGNO MÁS COMÚN
- Proyección de crecimiento lateral
- Cubierto por una capa de cartílago
“ OSTEO- COMMON- DROMA”
Osteoma
(benign/malignant, epi, location, findings)
- Benigno
- Epidemio: Edad media
- Localización: Cara
- Asociado con GARDNER SYNDROME (FAP)
- Obstrucción del Ostium = signos de presión de los senos
“OSTEOOOOOOOOMA in the GARDen”
Osteoid Osteoma
(benign/malignant, epi, location, findings)
- Benigno
- Epidemio: Hombres <25
- Locación: corteza de huesos largos
- Dolor de huesos en la noche que CEDE con NSAIDs (vs. Osteoblastoma)
- RX: masa con nucleo radiolúcido (negro) (como osteoblastoma)
“OO that feels better”
Osteoblastoma
(benign/malignant, epi, location, findings)
- Benigno
- Epidemio: Hombres <25
- Localización: Vértebras
- Dolor de huesos en la noche que NO CEDE con NSAIDs (vs. Osteoid osteoma)
- RX: masa con nucleo radiolúcido (negro) (como Osteoid osteoma)
“BLASTed with pain”
Chondroma
(benign/malignant, location)
- Benign
- Location: medulla of small bones ( hands/ feet)
Giant Cell Tumor
(benign/malignant, epi, location, findings)
- Benigno
- Epidemio: 20-40 años
- Localización: epifisis de huesos largos y prominencia de la rodilla
- Células gigantes que surgen de la médula osea
- Causa de fracturas patológicas
- RX: Soap Bubble appearance
- Mononuclear RANK-L expressing cells
“Don’t drop the SOAP or else you’ ll get a GIANT suprise”
Osteosarcoma
(benign/malignant, epi, location, findings)
- Malignant
- Epidemio: Hombres adolecentes
- Localización: Metáfisis de huesos largos
- Factores de riesgo: RETINOBLASTOMA, Paget Disease, radiation
-RX: SUNBURST Appearance and lifting of the periosteum
Chondrosarcoma
(benign/malignant, location)
- Malignant
- Localización: Medulla of pelvis “ central skeleton”
Ewing Sarcoma (benign/malignant, epi, location, findings)
- Malignant
- Epidemio: Niños blancos < 15 años
- Localización: diafisis de los huesos largos
- RX: ONION SKIN appearance
- Neuroectodermal originating small blue cells that resenble lymphocytes
- t (11,22) tranlocation
- Overexpression of EWS-FLI1
” EW, an ONION!”
Lysosomal Storage Diseases
- ## Fabry Disease
Fabry Disease (type of disease, enzyme, accumulation, findings)
- Lysosomal storage disease
- Enzyme: Alpha-Galactosidase-A
- Accumulation: Ceramide Trihexoside
- Hypohidrosis
- Angiokeratomas
- Renal failure
- Pheripheral neuropathy
” My FABRite activity is making a CERAMIc GALAxy, sorry to keep HARPing on it.”
Gaucher Disease (type of disease, enzyme, accumulation, findings)
- Lysosomal storage disease
- Enzyme: Glucocerebrosidase
- Accumulation: Glucocerebroside
Osteoporosis - Most common
- Gross femoral head (avascular necrosis)
- Gaucher cells or lipid-laden tissue paper cytoplasm
” (in a crying voice because of Tears) OMGauch he’s such a BRO”
Tay-sachs Disease (type of disease, enzyme, accumulation, findings)
- Lysosomal storage disease
- Enzyme: Hexosaminidase A
- Accumulation: GM2- Ganglioside
- Cherry- Red macula
-Onion skin lysosomes
-NO hepatosplenomegaly (vs. Niemann-pick)
” a GANG OF siX SMALL Jews”
Niemann- Pick Disease (type of disease, enzyme, accumulation, findings)
- Lysosomal storage disease
- Enzyme: Sphingomyelinase
- Accumulation: Sphingomyelin
- Cherry-red macula
- Foam cells or lipid laden macrophages
- YES hepasplenomegaly (vs. Tay-sachs)
“PICK your nose with a BIG FOAMy SPHINGer”
Krabbe Disease (type of disease, enzyme, accumulation, findings)
- Lysosomal storage disease
- Enzyme: Galactocerebrosidase
- Accumulation: Galactocerebrosidase
- Globoid cells
-Oligodendrocyte destruction - Optic atrophy
” Mr. KRABBE give me a GALAxy GLOBoo”
Metachromatic Leukodystophy (type of disease, enzyme, accumulation, findings)
Lysosomal storage disease
- Enzyme: Arysulfatase A
- Accumulation: Cerebroside sulfate
- Central and peripheral demyelination
-Ataxia
-Dementia
How much proteinuria you found in Nephrotic syndrome?
> 3.5 g/day
How much proteinuria you found in Nephritic syndrome?
<3.5 g/day
Nephrotic syndrome symptoms
Hypoalbuminemia
Hyperlipidemia
Hypogammaglobulineamia
Hypercoagulability
Nephytic syndrome symptoms
HTN
Edema
Hematuria and aconthocytes “thorn like cytoplasmic projections”
Oliguria and azotemia
Nephrotic syndromes
- Focal Segmental Glomerulosclerosis
- Minimal Change Disease
- Membranous Nephropathy
- Diabetic Glomerulonephropaty
- Amiloidosis
Nephritic Syndromes
- Poststreptococcal GN
- Rapidly Progressive GN
- IgA Nephropaty
- Alport Syndrome
- Membranoproliferative GN
Focal Segmental Glomerulosclerosis (5)
Nephrotic syndromes
-Sickle Cell Disease and HIV
- Hyalinosis and segmental sclerosis
- Effacement of foot podocytes
- Non specific IgM, C1, or C3 deposition in mensagial matrix
Membranous Nephropathy primary vs. secondary
Nephrotic syndromes
Primary: Antibodies to Phospholipase A1 (anti- PLA2R)
Secondary: infection (HCV, HBV), Auntoinmune disease (SLE), Medication ( NSAIDs, peniciline , Gold)
Minimal Change Disease (7)
Nephrotic syndromes
- Children
- Recent infection and inmunization
- Hodgkin lymphoma
- Effacement or efusion of foot podocytes
- negative inmunofluorescence
- Normal appearing glomeruli
” CHINDREN are of MINIMAL age and tend to have small FEET”
Membranous Nephropathy (3)
- Anti- PLA2R + infection, medication and autoinmmune
- Spike and dome appearance of subepithelial deposits
- thickened basement membrane and capillaries
“ IMA Proud MEMBER of the SPIKE AND DOME club”
Diabetic Glomerulonephropaty (3)
- Nephrotic syndrome
Mensagial sclerosis - Kimmelstiel Wilson Nodule: sclerotic, eosiniophilic nodules with central acellular region
- Nonenzymatic glycosulation of base membrane cause microalbuminuria
Amyloidosis
- AA protein = inlAAmation
- AL protein= multipAL myeloma
- Apple green birefringence under polarized light
Poststreptococcal GN (7)
Nephritic syndrome
- Chindren 2-4 weeks after group A Beta Hemolytic infection
- Type III hypersensitivity
- Antistreptococcal atibodies (ASO)
- Serum C3 levels low
- Enlarges, hypercellular, glomeruli
- Lumpy bumpy/ granular /satarry sky appearance
- Subepithelial humps
PSG= PS3
- Type 3 hypersensitivity
- Occurs 3 weeks after infx
- ASO (3 letters)
- Decrease C3
Rapidly Progressive GN individual diseases with immunofluorescence staining
Nephritic syndrome
- Crescent formation in bowman space
Goodpasture Syndrome - line
Granulomatosis with polyangiitis- negative or pauci immune
Microscopic Polyangiits - negative or pauci immune
Diffuse Proliferative Glomerulonephritis - granular
IgA Nephropaty
Nephritic syndrome
- Normal c3 evels
- IgA elevated leves
- Type II hypersinsitivity
- Symtoms: lung and GI infections+ kyney (asyntomatic microhematuria).
- Mensagial IgA deposition or proliferation
Alport Syndrome
Nephritic syndrome
Type II hypersinsitivity
- Type IV collagen defect
- Symtoms: sensorineural deafness, glomerulonephritis, lens dislocation/ retinopathy
- basket weave
“ Can’t see, can’t pee, can’t hear thee”
Membranoproliferative GN
Nephritic syndrome
- HCV AND HBV
Co- exist with nephrotic syndrome
- Type I- Immunoglobulin mediated (SLE)
- Type II- Complemete mediated (IgG antibodies C3 convertase, AKA, Dense deposit diasease)
- C3 complemente low (both)
- intravenus drug abuse (both)
- Tram track appearance= mensagial ingrowth with glomerular double contour
Goodpasture Syndrome
- Rapidly Progressive GN
- Type II hypersinsitivity
- Anti- GBM and anti- alveolar antibodies
- Affect type IV collagen
- Symtoms: kyney (hematuria) + lung (hemoptysis )
- linear immunofluorescence
Granulomatosis with polyangiitis
Rapidly Progressive GN
- pr3-ANCA / c- ANCA
- Small and medium sized vasculitis
- Affect type IV collagen
- Symtoms: kyney (hematuria) + lung (hemoptysis ) + nasal (rhinosinusitis)
- weak/absent immunofluorescence
Microscopic Polyangiits
Rapidly Progressive GN
- p-ANCA / MPO- ANCA
- Small vessel necrotizing vasculitis
- weak/absent immunofluorescence
Diffuse Proliferative Glomerulonephritis
Rapidly Progressive GN
- SLE
- WIRE LOOPS
- Granular immunofluorescence
Epididimitis
Unilateral, painful teticle
- Prehn sign (+)
- cremaster ( +)
- Fever, dysuria, more urinary freq
- Urethral discharge
- E. coli
- Chalmydia /Gonorrhoeae
Testicular Torsion
Unilateral, painful teticle
- Prehn sign ( - )
- cremaster ( - )
- Nausea/ vomiting
- High rinding teste
- Pailess scrotal mass in neonates
Hydrocele
Painless, enlarged testicle
- Translumination (+)
- Fluid acumulation in TUNICA VAGINALIS
- Comunicating : YES affected by Valsalva
- NON- Comunicating : NOT affected by Valsalva
Varicocele
Painless, enlarged testicle
- Translumination (-)
- Panpiniform plexus, obstruction of spermatic vein
- LEFT testicle most common
- BAG of WORMS
Most ommon agent that cause mastitis and treatment:
- S. Aureus
- Dicloxacillin + continue to breast feed
Most common sing of mammary Duct Ectasia
Green- Brown nipple discharge + periareolar mass
Histology of Fat necrosis of the Breast
Giant cells with calcifications assocaited with mechanical trauma or breast surgery
Fibrocystic Changes’s time and type (3)
- Premenopausal woman
- Apocrine Metaplasia - NO risk
- Sclerosis adenosis- some risk
Atypical hyperplasia - Significant risk
Intraductal Papilloma
Bloody Nipple Discharge + Fibrovascular projections lines by ephitelial cells
+
Underlying myopithelium (physical and chemical tumor supressor) ( no in papillary carcinoma)
Intraductal= myoepithelium INCLUDED
Papillary = Myoepithelium POPPED
Fibroadenoma caracteristics
Estrogen sensitive
15-35 year old women
Phyllodes Tumor
- 40- 50 year old women
- Bening (mostly) to malignant (rarely)
- leaf - like projections int epithelium- line stroma and dilated lumen
Ductal Carcinoma in Situ caracteristics
- Not yet invaded the basement membrane
calcifications
Invasive Ductal Carcinoma subtypes
Breaks through basement membrane
- Medullary Breast Carcinoma: Syncytial, sheet- like growth with lymphocytic infiltrate
- Inflammatory Breast Carcinoma: Dermal Lymphatic invasion, worst prognosis, Peau D’Orange.
Lobular carcinoma in Situ
-Not yet invaded the basement membrane
- Lacks E-Cadherin
Lobular Carcinoma = Lacks Caherin
Invasive Lobular Carcinoma
- Breaks through basement membrane
- Lacks E-Cadherin
- Non- cohesive cells organized in a single file pattern
ILC= Individual Line Carcinoma
Small Cell Carcinoma (location, histopathology, association)
- Location: Central
- Histopathology: Kulchitsky cells
Association: - Smoking
- Chromogranin A
- L-myc oncogene
- Paraneoplastic syndromes: ADH (SIADH), ACTH (Cushing Syndrome), Lambert-Eaton.
Small Cell Lung
- S (Somoking), C (Chomogranin A), L (L- myc)
- S (SIADH), C ( Cushing Syndrome), L (Lambert-Eaton)
Bronchial Carcinoid Tumor (location, histopathology, association)
- Location: Central of Peripheral
- Histopathology: Prominent rosettes
Association: - Children
- Chromogranin
- Carcinoid Syndrome (serotonin 5 HT secretion: flushing, diarrhea, bronchoespasm, diaphoresis, GI upset)
- Mass effect
Squamous Cell Carcinoma (location, histopathology, association)
Location: Central
- Histopathology: Keratin Pearls and Desmosomes
Association:
- Smoking
- PTHrP (Paraneoplastic Syndrome) (hypercalcemia)
” sQuamous= hyperQalcemia, Qeratin Pearls, and cell Qonnections”
Adenocarcinoma (location, histopathology, association)
Location: Peripheral
- Histopathology: Mucin
Association:
- NON- Smokers
- Woman
- EGFR, ALK and KRAS gene mutation
- Hypertrophic Osteoarthropathy
- Relative better prognosis
Large Cell Carcinoma (location, histopathology, association)
Location: Peripheral
- Histopathology: Anaplastic, undifferentiated, pleiomorphic giant cells
Association:
- Smoking
- Poor prognosis
