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Pathology (FA) Flashcards

1
Q

Name 3 causes of ↓ ESR

A
  • Sickle cell (altered shape)
  • Polycythemia (too many)
  • CHF (unknown)
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2
Q

Granulomatous disease cellular signaling process?

A

Th1 cells secrete γ-interferon, activating macrophages.
TNF-α from macrophages induce & maintain granuloma formation.

(anti-TNF drugs can, as a side effect, cause sequestering granulomas to breakdown, leading to disseminated disease)

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3
Q

Mechanism of cell death in Iron Poisoning?

A

Cell death due to per oxidation of membrane lipids

acute Sx = gastric bleeding
chronic Sx = metabolic acidosis, scarring leading to GI obstruction

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4
Q

Amyloidosis due to deposition of proteins from Ig Light Chains can be ass’d w/ what disease(s)?

A

Can occur as a plasma cell disorder or ass’d w/ multiple myeloma

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5
Q

Fibrils composed of serum Amyloid A - ass’d w/ what diseases?

A

Chronic diseases like RA, IBD, spondyloarthropathy, chronic infections

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6
Q

Name 4 tumors where Psammoma bodies are seen?

A

PSaMMoma

  • Papillary adenocarcinoma of thyroid
  • Serous papillary cystadenocarcinoma of ovary
  • Meningioma
  • Malignant mesothelioma
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7
Q 
Neutrophil extravasation:
Structures on (a) vasculature & (b) leukocyte that cause "rolling"?
A 
Vasculature/stroma = E-selectin & P-selectin
Leukocyte = Sialyl-Lewis(x)
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8
Q 
Neutrophil extravasation:
Structures on (a) vasculature & (b) leukocyte that cause "tight binding"?
A 
Vasculature/stroma = ICAM-1
Leukocyte = LFA-1 (integrin)
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9
Q 
Neutrophil extravasation:
Structures on (a) vasculature & (b) leukocyte that cause "Diapedesis"?
(leukocyte travels between endothelial cells & exits blood vessels)
A 
Vasculature/stroma = PECAM-1
Leukocyte = PECAM-1
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10
Q 
Neutrophil extravasation:
Structures on (a) vasculature & (b) leukocyte that cause "migration"?
(leukocyte travels through interstitial to site of injury or infection guided by chemotactic signals)
A 
Vasculature/stroma = Bacterial products: C5a, IL-8, LTB4, & Kallikrein (CILK)
Leukocyte = Various
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11
Q

What are the criteria to diagnose Rheumatic Fever?

Typical cause?

A 
"JONES" criteria:
Joints (polyarthritis)
O (heart shape -- carditis)
Nodules (subcutaneous)
Erythema marginatum
Sydenham's chorea

Cause = Streptococcus pyogenes – this occurs when host develops antibodies to M-protein in the cell wall, which facilitates attachment to host cells & inhibits opsonization by the alternative pathway.

(“PHaryngitis can result in rheumatic PHever & glomerulonePHritis)

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12
Q

Wilson’s Disease results in inadequate hepatic copper excretion & failure of copper to enter circulation as ceruloplasmin. What are some symptoms of copper accumulation from this disease?

A
  • Cirrhosis & Hepatocellular Carcinoma
  • Corneal deposits (K-F rings)
  • Hemolytic anemia
  • Basal Ganglia degeneration (Parkinsonian Sx)
  • Dementia, Dyskinesia, Dysarthria, Asterexis
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13
Q

Hemochromatosis classic triad?

A

Micronodular cirrhosis, Diabetes Mellitus, & skin pigmentation

(also results in CHF, testicular atrophy in males, & ↑ risk of hepatocellular carcinoma)

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14
Q

Associated risk factors for Transitional Cell Carcinoma?

A
  • Phenacetin
  • Smoking
  • Aniline Dyes
  • Cyclophosphamide (DNA alkylating agent, cross-links DNA, reqs activation by liver)

ass’d w/ problems in your “Pee SAC”

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15
Q

What’s seen on histology in drug-induced interstitial nephritis?

A

Eosinophilia (pyuria)

(Inflammation & azotemia, i.e. nephritis, typically occur 1-2 weeks after drug, but may occur months after starting NSAIDS)

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16
Q

Acute tubular necrosis of the kidneys — key finding?

What are the risks during the maintenance phase & during the recovery phase?

A

Key finding = Granular “muddy brown” casts

Maintenance (oliguric) phase risk = Hyperkalemia

Recovery phase risk = Hypokalemia

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17
Q

Describe the changes seen in bone during renal osteodystrophy

A

Subperiosteal thinning of bone

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18
Q

Embryologic cause of D-transposition of the Great Vessels?

A

Due to failure of the aorticopulmonary septum to spiral

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19
Q

Turner Syndrome — is the aortic coarctation proximal or distal to the ductus arteriosus?

A

Proximal

infantile type; adult type is Distal & most commonly ass’d w/ bicuspid aortic valve

20
Q

Common false lab finding in Selective IgA deficiency?

A

False-positive β-hCG due to presence of heterophile antibody

21
Q

What does IL-12 receptor deficiency cause/result in?

A
  • ↓Th1 response
  • ↓ IFN-γ
  • Disseminated mycobacterial infections
22
Q

Thymic Aplasia (DeGeorge Syndrome) is due to a failure to develop what embryologically?

What else is it ass’d w/?

A

Failure to develop 3rd & 4th branchial pouches (22q11 deletion). Thymus & Parathyroids fail to develop.

  • Tetany (↓Ca2+ & ↓PTH)
  • Recurrent viral/fungal infections (↓T-cells)
  • Truncus Arteriosus
  • Tetralogy of Fallot
23
Q

What is the defect in Hyper-IgE Syndrome (Job’s Syndrome)?

A

Th1 cells fail to produce IFN-γ → inability of neutrophils to respond to chemotactic stimuli

24
Q

New test for Chronic Granulomatous Disease (instead of Nitroblue tetrazolium dye reduction)?

A

CGD = Abnormal Dihydrorhodamine (DHR) Flow Cytometry Test

25
Defective IL-2 receptor results in..?
SCID
26
Triad: Cerebellar defects, Spider angiomas, & IgA deficiency
Ataxia-Telangiectasia (defects in ATM gene, which codes for DNA repair enzymes) Cerebellar defects = Ataxia Spider angiomas = Telangiectasias
27
What's defective in a Leukocyte Adhesion Deficiency?
Defect in LFA-1 integrin (CD18) protein on phagocytes - Neutrophilia - Recurrent bacterial infections w/ delayed separation of umbilical cord
28
What are the Urease positive bugs?
Cryptococcus, H. pylori, Proteus, Ureaplasma, Nocardia, Klebsiella, S. epidermidis, S. saprophyticus "CHuck norris hates PUNKSS"
29
What is the significance of a bug being "urease-positive"?
These bugs can hydrolyze urea → ammonia, causing urine alkalinization. This can cause formation of stag horn calculi, which can be a nidus for infection
30
Which bacteria express IgA Protease?
S. pneumoniae, H. influenzae, & Neisseria "SHiN"
31
Encapsulated bacteria?
S. pneumoniae, H. influenzae (type B), N. meningitidis, E. coli, Salmonella, Klebsiella pneumoniae, & group B Strep "SHiNE SKiS" - they are opsonized & then cleared by spleen. Asplenics have decreased opsonizing ability & are at risk for severe infection. Give S. pneumonia, H. influenza, & N. meningitides vaccines
32
Rickettsia rickettsii vs. Rickettsia typhi: Rash?
Rickettsia rickettsii: Starts @ wrists & ankles, then spreads to trunk, palms, & soles Rickettsia typhi: Starts centrally & then spreads out, sparing palms & soles
33
2 forms of Chlamydiae that each cause mucosal infections?
1. Elementary body (small, dense) is "ENfectious" & ENters cells through ENdocytosis 2. Reticulate body Replicates in cell by fission; form seen on tissue culture
34
Lab diagnosis of Chlamydia?
Cytoplasmic inclusions seen on Giemsa or fluorescent antibody-stained smear
35
What does Chlamydia trachoma tis cause?
- Reactive arthritis - Conjuctivitis - Nongonococcal urethritis - PID
36
Mycoplasma pneumoniae Tx?
Macrolides or Fluoroquinolone | Penicillin ineffective since they have no cell wall
37
What are Roth's spots?
Round white spots on retina surrounded by hemorrhage | seen in bacterial endocarditis
38
Osler's Nodes?
Tender, raised lesions on finger or toe pads
39
4 complications of bacterial endocarditis?
- Chorae rupture - Glomerulonephritis - Suppurative pericarditis - Emboli
40
Early lesion heart murmur in Rhematic heart disease? Later lesion heart murmur?
Early = Mitral regurgitation Late = Mitral stenosis
41
Rheumatic heart disease -- histology?
Aschoff bodies - Granuloma w/ giant cells Anitschkow's cells - activated histiocytes Elevated ASO titer
42
Rheumatic fever is what type of hypersensitivity?
Type II (not direct effect of bacteria) Antibodies to M protein
43
When do you expect to see Pulsus Paradoxus?
Cardiac Tamponade | ↓ in amplitude of systolic BP by >10mmHg during inspiration
44
What are Kussmaul's Respirations?
increases in JVP on inspiration instead of a normal decrease
45
Embryologic cause of Tetralogy of Fallot?
Anterosuperior displacement of the infundibular septum
46
How to Mullerian Duct abnormalities present in females?
Primary amenorrhea w/ fully developed secondary sexual characteristics (indicator of functional ovaries)
47
Embryologic cause of Bicornuate Uterus?
Incomplete fusion of Paramesonephric ducts

AA_Rapid Review (15 decks)

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