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NBME > Pathology c > Flashcards

Pathology c Flashcards

DIRTY MEDICINE

1
Q

Autosomal Dominant Dx (song)

A

“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

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2
Q

List of reportable Diseases (song)

A

“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

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3
Q

Autosomal recessive disease (song)

A

“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

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4
Q

Osteochondroma
(benign/malignant, epi, location, findings)

A
  • Benigno
  • Epidemio: Hombres, <25 años
  • Localización: Metáfisis
  • Tumor BENIGNO MÁS COMÚN
  • Proyección de crecimiento lateral
  • Cubierto por una capa de cartílago

“ OSTEO- COMMON- DROMA”

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5
Q

Osteoma
(benign/malignant, epi, location, findings)

A
  • Benigno
  • Epidemio: Edad media
  • Localización: Cara
  • Asociado con GARDNER SYNDROME (FAP)
  • Obstrucción del Ostium = signos de presión de los senos

“OSTEOOOOOOOOMA in the GARDen”

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6
Q

Osteoid Osteoma
(benign/malignant, epi, location, findings)

A
  • 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”

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7
Q

Osteoblastoma
(benign/malignant, epi, location, findings)

A
  • 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”

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8
Q

Chondroma
(benign/malignant, location)

A
  • Benign
  • Location: medulla of small bones ( hands/ feet)
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9
Q

Giant Cell Tumor
(benign/malignant, epi, location, findings)

A
  • 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”

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10
Q

Osteosarcoma
(benign/malignant, epi, location, findings)

A
  • Malignant
  • Epidemio: Hombres adolecentes
  • Localización: Metáfisis de huesos largos
  • Factores de riesgo: RETINOBLASTOMA, Paget Disease, radiation
    -RX: SUNBURST Appearance and lifting of the periosteum
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11
Q

Chondrosarcoma
(benign/malignant, location)

A
  • Malignant
  • Localización: Medulla of pelvis “ central skeleton”
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12
Q

Ewing Sarcoma (benign/malignant, epi, location, findings)

A
  • 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!”

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13
Q

Lysosomal Storage Diseases

A
  • ## Fabry Disease
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14
Q

Fabry Disease (type of disease, enzyme, accumulation, findings)

A
  • 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.”

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15
Q

Gaucher Disease (type of disease, enzyme, accumulation, findings)

A
  • 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”

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16
Q

Tay-sachs Disease (type of disease, enzyme, accumulation, findings)

A
  • 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”

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17
Q

Niemann- Pick Disease (type of disease, enzyme, accumulation, findings)

A
  • 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”

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18
Q

Krabbe Disease (type of disease, enzyme, accumulation, findings)

A
  • Lysosomal storage disease
  • Enzyme: Galactocerebrosidase
  • Accumulation: Galactocerebrosidase
  • Globoid cells
    -Oligodendrocyte destruction
  • Optic atrophy

” Mr. KRABBE give me a GALAxy GLOBoo”

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19
Q

Metachromatic Leukodystophy (type of disease, enzyme, accumulation, findings)

A

Lysosomal storage disease
- Enzyme: Arysulfatase A
- Accumulation: Cerebroside sulfate
- Central and peripheral demyelination
-Ataxia
-Dementia

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20
Q

How much proteinuria you found in Nephrotic syndrome?

A

> 3.5 g/day

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21
Q

How much proteinuria you found in Nephritic syndrome?

A

<3.5 g/day

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22
Q

Nephrotic syndrome symptoms

A

Hypoalbuminemia
Hyperlipidemia
Hypogammaglobulineamia
Hypercoagulability

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23
Q

Nephytic syndrome symptoms

A

HTN
Edema
Hematuria and aconthocytes “thorn like cytoplasmic projections”
Oliguria and azotemia

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24
Q

Nephrotic syndromes

A
  • Focal Segmental Glomerulosclerosis
  • Minimal Change Disease
  • Membranous Nephropathy
  • Diabetic Glomerulonephropaty
  • Amiloidosis
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25
Q

Nephritic Syndromes

A
  • Poststreptococcal GN
  • Rapidly Progressive GN
  • IgA Nephropaty
  • Alport Syndrome
  • Membranoproliferative GN
26
Q

Focal Segmental Glomerulosclerosis (5)

A

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

27
Q

Membranous Nephropathy primary vs. secondary

A

Nephrotic syndromes
Primary: Antibodies to Phospholipase A1 (anti- PLA2R)
Secondary: infection (HCV, HBV), Auntoinmune disease (SLE), Medication ( NSAIDs, peniciline , Gold)

27
Q

Minimal Change Disease (7)

A

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”

28
Q

Membranous Nephropathy (3)

A
  • 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”
29
Q

Diabetic Glomerulonephropaty (3)

A
  • Nephrotic syndrome
    Mensagial sclerosis
  • Kimmelstiel Wilson Nodule: sclerotic, eosiniophilic nodules with central acellular region
  • Nonenzymatic glycosulation of base membrane cause microalbuminuria
30
Q

Amyloidosis

A
  • AA protein = inlAAmation
  • AL protein= multipAL myeloma
  • Apple green birefringence under polarized light
31
Q

Poststreptococcal GN (7)

A

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

32
Q

Rapidly Progressive GN individual diseases with immunofluorescence staining

A

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

33
Q

IgA Nephropaty

A

Nephritic syndrome
- Normal c3 evels
- IgA elevated leves
- Type II hypersinsitivity
- Symtoms: lung and GI infections+ kyney (asyntomatic microhematuria).
- Mensagial IgA deposition or proliferation

34
Q

Alport Syndrome

A

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”

35
Q

Membranoproliferative GN

A

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

36
Q

Goodpasture Syndrome

A
  • Rapidly Progressive GN
  • Type II hypersinsitivity
  • Anti- GBM and anti- alveolar antibodies
  • Affect type IV collagen
  • Symtoms: kyney (hematuria) + lung (hemoptysis )
  • linear immunofluorescence
37
Q

Granulomatosis with polyangiitis

A

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

38
Q

Microscopic Polyangiits

A

Rapidly Progressive GN
- p-ANCA / MPO- ANCA
- Small vessel necrotizing vasculitis
- weak/absent immunofluorescence

39
Q

Diffuse Proliferative Glomerulonephritis

A

Rapidly Progressive GN
- SLE
- WIRE LOOPS
- Granular immunofluorescence

40
Q

Epididimitis

A

Unilateral, painful teticle
- Prehn sign (+)
- cremaster ( +)

  • Fever, dysuria, more urinary freq
  • Urethral discharge
  • E. coli
  • Chalmydia /Gonorrhoeae
41
Q

Testicular Torsion

A

Unilateral, painful teticle
- Prehn sign ( - )
- cremaster ( - )

  • Nausea/ vomiting
  • High rinding teste
  • Pailess scrotal mass in neonates
42
Q

Hydrocele

A

Painless, enlarged testicle
- Translumination (+)

  • Fluid acumulation in TUNICA VAGINALIS
  • Comunicating : YES affected by Valsalva
  • NON- Comunicating : NOT affected by Valsalva
43
Q

Varicocele

A

Painless, enlarged testicle
- Translumination (-)

  • Panpiniform plexus, obstruction of spermatic vein
  • LEFT testicle most common
  • BAG of WORMS
44
Q

Most ommon agent that cause mastitis and treatment:

A
  • S. Aureus
  • Dicloxacillin + continue to breast feed
45
Q

Most common sing of mammary Duct Ectasia

A

Green- Brown nipple discharge + periareolar mass

46
Q

Histology of Fat necrosis of the Breast

A

Giant cells with calcifications assocaited with mechanical trauma or breast surgery

47
Q

Fibrocystic Changes’s time and type (3)

A
  • Premenopausal woman
  • Apocrine Metaplasia - NO risk
  • Sclerosis adenosis- some risk
    Atypical hyperplasia - Significant risk
48
Q

Intraductal Papilloma

A

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

49
Q

Fibroadenoma caracteristics

A

Estrogen sensitive
15-35 year old women

50
Q

Phyllodes Tumor

A
  • 40- 50 year old women
  • Bening (mostly) to malignant (rarely)
  • leaf - like projections int epithelium- line stroma and dilated lumen
51
Q

Ductal Carcinoma in Situ caracteristics

A
  • Not yet invaded the basement membrane
    calcifications
52
Q

Invasive Ductal Carcinoma subtypes

A

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.

53
Q

Lobular carcinoma in Situ

A

-Not yet invaded the basement membrane
- Lacks E-Cadherin

Lobular Carcinoma = Lacks Caherin

54
Q

Invasive Lobular Carcinoma

A
  • Breaks through basement membrane
  • Lacks E-Cadherin
  • Non- cohesive cells organized in a single file pattern

ILC= Individual Line Carcinoma

55
Q

Small Cell Carcinoma (location, histopathology, association)

A
  • 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)

56
Q

Bronchial Carcinoid Tumor (location, histopathology, association)

A
  • Location: Central of Peripheral
  • Histopathology: Prominent rosettes
    Association:
  • Children
  • Chromogranin
  • Carcinoid Syndrome (serotonin 5 HT secretion: flushing, diarrhea, bronchoespasm, diaphoresis, GI upset)
  • Mass effect
57
Q

Squamous Cell Carcinoma (location, histopathology, association)

A

Location: Central
- Histopathology: Keratin Pearls and Desmosomes
Association:
- Smoking
- PTHrP (Paraneoplastic Syndrome) (hypercalcemia)

” sQuamous= hyperQalcemia, Qeratin Pearls, and cell Qonnections”

58
Q

Adenocarcinoma (location, histopathology, association)

A

Location: Peripheral
- Histopathology: Mucin
Association:
- NON- Smokers
- Woman
- EGFR, ALK and KRAS gene mutation
- Hypertrophic Osteoarthropathy
- Relative better prognosis

59
Q

Large Cell Carcinoma (location, histopathology, association)

A

Location: Peripheral
- Histopathology: Anaplastic, undifferentiated, pleiomorphic giant cells
Association:
- Smoking
- Poor prognosis

NBME (2 decks)

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