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AA_Rapid Review > Pathology (FA) > Flashcards

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
Q

Defective IL-2 receptor results in..?

26
Q

Triad: Cerebellar defects, Spider angiomas, & IgA deficiency

A

Ataxia-Telangiectasia
(defects in ATM gene, which codes for DNA repair enzymes)

Cerebellar defects = Ataxia
Spider angiomas = Telangiectasias

27
Q

What’s defective in a Leukocyte Adhesion Deficiency?

A

Defect in LFA-1 integrin (CD18) protein on phagocytes

  • Neutrophilia
  • Recurrent bacterial infections w/ delayed separation of umbilical cord
28
Q

What are the Urease positive bugs?

A

Cryptococcus, H. pylori, Proteus, Ureaplasma, Nocardia, Klebsiella, S. epidermidis, S. saprophyticus

“CHuck norris hates PUNKSS”

29
Q

What is the significance of a bug being “urease-positive”?

A

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
Q

Which bacteria express IgA Protease?

A

S. pneumoniae, H. influenzae, & Neisseria

“SHiN”

31
Q

Encapsulated bacteria?

A

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
Q

Rickettsia rickettsii vs. Rickettsia typhi: Rash?

A

Rickettsia rickettsii: Starts @ wrists & ankles, then spreads to trunk, palms, & soles

Rickettsia typhi: Starts centrally & then spreads out, sparing palms & soles

33
Q

2 forms of Chlamydiae that each cause mucosal infections?

A
  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
Q

Lab diagnosis of Chlamydia?

A

Cytoplasmic inclusions seen on Giemsa or fluorescent antibody-stained smear

35
Q

What does Chlamydia trachoma tis cause?

A
  • Reactive arthritis
  • Conjuctivitis
  • Nongonococcal urethritis
  • PID
36
Q

Mycoplasma pneumoniae Tx?

A

Macrolides or Fluoroquinolone

Penicillin ineffective since they have no cell wall

37
Q

What are Roth’s spots?

A

Round white spots on retina surrounded by hemorrhage

seen in bacterial endocarditis

38
Q

Osler’s Nodes?

A

Tender, raised lesions on finger or toe pads

39
Q

4 complications of bacterial endocarditis?

A
  • Chorae rupture
  • Glomerulonephritis
  • Suppurative pericarditis
  • Emboli
40
Q

Early lesion heart murmur in Rhematic heart disease? Later lesion heart murmur?

A

Early = Mitral regurgitation

Late = Mitral stenosis

41
Q

Rheumatic heart disease – histology?

A

Aschoff bodies - Granuloma w/ giant cells

Anitschkow’s cells - activated histiocytes

Elevated ASO titer

42
Q

Rheumatic fever is what type of hypersensitivity?

A

Type II (not direct effect of bacteria)

Antibodies to M protein

43
Q

When do you expect to see Pulsus Paradoxus?

A

Cardiac Tamponade

↓ in amplitude of systolic BP by >10mmHg during inspiration

44
Q

What are Kussmaul’s Respirations?

A

increases in JVP on inspiration instead of a normal decrease

45
Q

Embryologic cause of Tetralogy of Fallot?

A

Anterosuperior displacement of the infundibular septum

46
Q

How to Mullerian Duct abnormalities present in females?

A

Primary amenorrhea w/ fully developed secondary sexual characteristics (indicator of functional ovaries)

47
Q

Embryologic cause of Bicornuate Uterus?

A

Incomplete fusion of Paramesonephric ducts

AA_Rapid Review (15 decks)

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