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Pathology II Chamberlin Fall 2014 > Pathology II MT 2 Study Guide Material > Flashcards

Pathology II MT 2 Study Guide Material Flashcards

1
Q

Lung Cancer: T or F?
A. The 5 year survival rate is 35%
B. NSCLC & SCLC together = 80% L CA cases
C. Occurs most often between 40 and 70 yo
D. Usu pt in their 60’s w/ acute Sx

A

A. False. 15%
B. False. SCLC + NSCLC = 90% of cases
C. True
D. False. Usu pt in their 50’s w/ Sx they have had for several months.

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2
Q

Lung CA symptoms
A. Cough is 1st and most common (75%) Sx
B. Chest pain occurs in about 10% of pts
C. Weight loss occurs in about 40% of pts
D. Dyspnea occurs in about 20% of pts

A

A. True
B. False
C. True
D. True

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3
Q

Lung CA Risks
A. Bronchogenic carcinoma is any malignant neoplasm that arises in the lung tissue
B. The total # of yrs of smoking, independent of age, determines lung CA risk
C. Quitting for 10 yrs reduces risk to level of non-smoker.

A

A. True
B. False. The younger a person is when they start smoking, the greater risk they have of getting lung cancer.
C. False. Quitting for 10 yrs reduces risk but NOT to level of non-smoker.

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4
Q

NSCLC or SCLC?
A. Three major types are adenocarcinoma, squamous cell carcinoma, and large cell undifferentiated carcinoma
B. Grows faster & greater risk of metastasis
C. All subtypes behave and are Txd similarly

A

A. NSCLC
B. SCLC
C. NSCLC

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5
Q 
NSCLC or SCLC?
A. More common, is ~80% of lung CA cases
B. "Oat cell" carcinoma
C. Responds better to chemotherapy
D. Paraneoplastic syndromes are common
A

A. NSCLC
B. SCLC
C. SCLC
D. SCLC

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6
Q

SCLC, SCC, Adeno, or Large cell?
A. Keritinization (pearls or individual cells w/ eosinophilic dense cytoplasm)
B. 3 P’s: Peripheral, Pigmented, Puckered
C. May 1st find on routine CXR, but often not before cancer has spread

A

A. SCC
B. Adenocarcinoma
C. Adenocarcinoma

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7
Q

SCLC, SCC, Adeno, or Large cell?
A. Usu occur in the periphery of the lung
B. Usu central in the lung
C. May occur anywhere but most commonly central near the hilum
D. Can occur anywhere in the lung

A

A. Adenocarcinoma
B. SCC
C. SCLC
D. Large cell

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8
Q

SCLC, SCC, Adeno, or Large cell?
A. Really a glandular epithelial tumor that produces mucin
B. Histology shows small dark staining epithelial cells w/ scant cytoplasm
C. Epithelial tumor with large nuclei and moderate amounts of cytoplasm

A

A. Adenocarcinoma
B. SCLC
C. Large cell

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9
Q

SCLC, SCC, Adeno, or Large cell?
A. Well circumscribed and may contain central necrotic cores
B. Found in sheets
C. Most freq Dxd lung CA ~ 1/3rd of cases
D. 1st sign may be a paraneoplastic syndrome

A

A. Adenocarcinoma
B. SCC (Large cell not found in sheets as often as SCC is)
C. Adenocarcinoma
D. SCLC

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10
Q

SCC: T or F?
A. Related to chronic inflammation and injury of bronchial ciliated columnar epithelium
B. Arise from main bronchi
C. Presents later with symptoms when central than when it occurs at the periphery
D. Has a better prognosis than most lung CA

A

A. True
B. False. Arise from main, lobar, or segmental bronchi
C. False.
D. False

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11
Q

Bronchial carcinoid tumors: T or F?
A. Most common primary lung neoplasm in children
B. Separate type of lung neoplasm
C. Syndrome mb diarrhea, facial flushing and wheezing, (if liver metastasis)
D. Strongly associated with smoking
E. 5 year survival rate of approximately 85%

A 
A. True
B. True
C. True
D. False
E. True
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12
Q

Pancoast Tumor: T or F?
A. Tumor in apex of the lung infiltrates the brachial plexus
B. Cough with viscous sputum, dyspnea
C. No involvement of adjacent vertebra and ribs

A

A. True
B. False. Pain, numbness and weakness of the affected arm
C. False. May be involved

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13
Q

Horner’s syndrome: T or F?
A. Involvement of cervical & thoracic sympathetic nerves
B. Contralateral miosis, ptosis, facial anhidrosis,
C. Enohpthalmos

A

A. True
B. False. Ipsilateral
C. True

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14
Q

What are the signs and symptoms of Superior Vena Cava syndrome?

A

Obstruction of venous drainage

•Sx: dilation of neck veins, neck and facial edema, redness

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15
Q

Potential complications of OM

A

Perforation, Cholesteatoma, Mastoiditis, Labyrinthitis, Meningitis, Encephalitis, Bullous Myringitis

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16
Q

Meniere’s or Accoustic Neuroma?
A. Over production of endolymph causes tinnitus, SNHL, vertigo
B. Benign tumor from Schwann cells of CN VIII
C. progressive unilateral hearing loss
D. Tinnitus, dizziness, otalgia, trigeminal neuralgia, hemiparesis or paralysis of CN VII may all be present

A

A. Meniere’s
B. Accoustic Neuroma
C. Accoustic Neuroma
D. Accoustic Neuroma

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17
Q

Meniere’s or Accoustic Neuroma?
A. Benign
B. Occurs ages 20-50
C. Invasion and compression of the internal auditory meatus, cerebellum and brain stem.
D. Risk factors include FHx, AI conditions, allergies, trauma, syphilis

A

A. Both
B. Meniere’s
C. Accoustic Neuroma
D. Meniere’s

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18
Q

Cholesteatomas: T or F?
A. Often the result of a chronic OM
B. May grow into surrounding tissue and cause deafness
C. Lined w keratinizing squamous/columnar epithelium
D. Filled with pus

A

A. True
B. True
C. True
D. False. Amorphous debris and sometimes cholesterol

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19
Q

Cholesteatomas: T or F?
A. May cause facial paralysis, infx & intracranial abscess
B. Arises in inner ear or middle ear
C. Enlargement => erosion into ossicles, labyrinth, adjacent bone, and surrounding soft tissue

A

A. True
B. False. ME, TM or adjacent structures, or the mastoid
C. True

20
Q

Otitis externa: T or F?
A. May present as local furuncle or diffuse general infx
B. Typically viral
C. Allergies eczema psoriasis, seb derm predispose
D. Other risks are increased canal acidity, injury, and irritiants

A

A. True
B. False. bacterial, occasionally fungal
C. True
D. False. True except increased canal acidity, should be decreased

21
Q

Scleritis or conjunctivitis?
A. Vessels displace with cotton swab
B. BVs do not vasoconstrict w phenylephrine
C. More serious; may point to inflammation of uvea
D. May result from systemic dz like RA, 5% are from infx

A

A. Conjunctivitis
B. Scleritis
C. Scleritis
D. Scleritis

22
Q

Glaucoma T or F?
A. Decreased intraocular pressure
B. Lack of drainage of the aqueous humor fr ant chamber
C. Optic nerve has diffuse loss of ganglion cells and thinning of the retinal nerve fiber layer
D. Optic nerve cupping and atrophy

A

A. False. Increased pressure
B. True
C. True
D. True

23
Q

Glaucoma: Open or Closed Angle?
A. Pressure builds in posterior chamber
B. Canals of Schlemm & trabecular networks are blocked
C. Canals of Schlemm and trabecular networks are open
D. Degeneration and obstruction of the trabecular meshwork ==> Resistance to aq humor drainage

A

A. Closed
B. Closed
C. Open
D. Open

24
Q

T or F: Pre-proliferative diabetic retinopathy
A. DM => thickening of basemnt membrn of retinal BVs
B. Microaneurysms and micro-occlusions are rare
C. Hyper permeable vasculature ==> transudates
D. Changes lead to macular edema (can cause vision loss) and also a risk for retinal detachment

A

A. True
B. False. Microaneurysms occur frequently. Micro-occlusions of the small vessels also occur
C. False. Exudates
D. True

25
Q

What is the body’s normal response to acute blood loss?

A
  1. Vol restored by shift of water from intra/intercellular to intravasculature space
  2. Dilution lowers Hct
  3. Decease in O2 in renal JGA cells –> EPO release
  4. EPO –> BM increases erythropoiesis. Increased reticulocytes, Hct, polychromasia and RDW.
26
Q

Acute blood loss: T or F?
A. External blood loss allows for “recycling” of Fe.
B. Internal blood loss - body depends on iron stores - no recycling.
C. Immediately after acute blood loss peripheral smear appears normocytic and normochromic.
D. Normal central pallor is about 1/2 of RBC.

A

A. False. No recycling
B. False. Allows for recycling
C. True
D. False. 1/3

27
Q

Why are hemolytic anemias dangerous?

A

Can lead to gallstones, pulmonary HTN, and jaundice, in addition to general anemia symptoms like SOB and fatigue. (Lindsay)

28
Q

Describe the direct Coombs (antiglobulin) test.

A
  1. Blood taken fr pt w immune mediated hemo. anemia
  2. Washed RBCs incubated w antihuman Ab
  3. RBCs agglutinate; antihuman Ab link
29
Q

Describe the INdirect Coombs (antiglobulin) test.

A
  1. Donor’s blood added to tube w recipient’s serum + Ab
  2. Donor RBCs + recipient Ig form antigen-AB complexes
  3. Antihuman Ig added
  4. RBCs agglutinate b/c human IG attached to RBC
30
Q 
Coombs test: Direct or Indirect?
A. Warm AIHA
B. IgM
C. Idiopathic, SLE, neoplastic dz
D. Acute, self-limiting (myco. pneum. & mono, HIV, CMV)
A

A. Direct
B. Indirect. (Direct is mostly IgG w some IgA)
C. Direct
D. Indirect

31
Q

Antibody classes: A,D,E,G, or M?
A. Found in GI, Resp, UG tracts, saliva, tears, breast milk
B. Provides majority of Ab immunity against pathogens
C. Kills infx in early stages of B cell-mediated immunity
D. Triggers histamine release from mast cells, basophils

A

A. IgA
B. IgG
C. IgM
D. IgE

32
Q 
Epiglottitis, Laryngotracheobronchitis, or Pharyngitis?
A. Produces steeple sign on neck X-ray 
B. Commonly caused by H. Influenzae
C. Often caused by parainfluenza virus
D. Can be "high-riding"
A

A. Laryngotracheobronchitis
B. Epiglottitis
C. Laryngotracheobronchitis
D. Epiglottitis

33
Q

Epiglottitis, Laryngitis/Laryngeal Polyps, or Pharyngitis?
A. SSx are the 4 Ds:
B. Can be caused by GERD
C. Children 2-5 used to be most susceptible
D. Can involve anterior or posterior cervical adenopathy

A

A. Epiglottitis
B. Laryngitis/Laryngeal Polyps
C. Epiglottitis
D. Pharyngitis

34
Q

T or F: Pharyngitis
A. N gonorrhea ~ post. cervical chain adenopathy
B. Mononucleosis ~ anterior cervical chain adenopathy
C. C. Diptheriae often causes gray exudate
D. GABHS ~ anterior cervical cervical lymphadenopathy

A

A. False. Produces greenish exudate
B. False. Posterior cervical chain adenopathy
C. True
D. True

35
Q

T or F: Random
A. Laryngeal polyps often transform into malignancies
B. Singer’s nodules are bilateral; polyps are unilateral
C. Viral pharyngitis can produce exudate
D. Ag X-reactivity occurs between M proteins on GABHS and epitopes of cardiac myosin and laminin ==> ARF

A

A. False. Essentially never do
B. True
C. True. Thought to be absent but it is possible
D. True

36
Q

T or F: Bacterial Pharyngitis/ARF
A. ARF is leading cause of cardiovasc. death in 0-50yo
B. From GAS pharyngitis, strep skin infx, scarlet fever
C. Peritonisillar abscesses have greater potential for airway obstruction than retro/parapharygeal abscesses
D. Peritonsillar abscesses can => “hot potato” voice

A

A. True
B. False. Results from GAS pharyngitis only
C. False
D. True

37
Q

T or F: Vertigo
A. BPPV is a rare cause of recurrent vertigo in middle ear
B. Ramsay Hunt syndrome can cause vertigo
C. Displaced otoliths stim. CN VIII hair cells
D. BPPV and Meniere’s both can cause hearing loss
E. Viral infx precedes labyrinthitis but not BPPV

A 
A. False. Most common
B. True
C. True
D. False. BPPV does not
E. True
38
Q

T or F: Oral Pathologies
A. Leukoplakia is a clinical diagnosis
B. PAS stains polysaccharides of hyphae & budding yeast
C. Tzank smears may show leukocytes w herpes viral infx
D. Irritation fibromas blanche, pyogenic granulomas don’t blanche.

A

A. False. It is a clinical description not a clinical entity
B. True
C. False. Shows large squamous cells with inclusions
D. True

39
Q

Glaucoma: Open or Closed? Primary or Secondary?
A. Clogged trabecular netwrk in presence of open angle
B. Aq drainage physically blocked by a narrow canal
C. Pathological membranes which form over the iris can contract and narrow or close off the aqueous outflow.
D. Most common form; assoc. w MYOC gene

A

A. Secondary Open
B. Primary Closed
C. Secondary Closed
D. Primary Open

40
Q

SCC: Well, Moderately, or Poorly Differentiated?
A. See intercellular bridges but not pearls
B. Difficult to tell whether cells are of squamous origin
C. See keratin pearls

A

A. Moderately
B. Poorly
C. Well

41
Q

Mikulicz or Mucocele?
A. Produce fluctuant swellings of lower lip; w blue hue
B. Often due to trauma causing blockage/rupture of salivary gland duct
C. Painless gland enlargement w xerostomia
D. Involves salivary and lacrimal gland enlargement

A

A. Mucocele
B. Mucocele
C. Mikulicz
D. Mikulicz

42
Q

The most common form of viral sialadentitis is secondary to _____ infection.

A

Mumps

43
Q

T or F: Pleomorphic adenoma
A. When removed by enucleation recurrence rate is 4%
B. Presents as painless slow growing mobile mass w/in parotid or submandibular areas or buccal cavity
C. Can progress to adenocarcinomas; risk incr. w time
D. Make up the majority of parotid gland tumors

A

A. False. 25% with enucleation. 4% for parotidectomyis
B. True
C. True
D. True

44
Q

Which one of these is just plain wrong?
A. Thyroglossal duct cysts present as midline masses
B. Infectious rhinitis is usually viral
C. Malignant odontogenic cysts are rare & ameloblastic
D. Branchial cleft cysts present as lateral neck masses
E. Posterior cervical lymphadenopathy is common

A

E. Posterior cervical lymphadenopathy is common

45
Q

T or F: Malignant otitis externa
A. Osteomyelitis of the mastoid bone
B. Often caused by S Aureus
C. Most often in the elderly, diabetic and immunocomp
D. Granulation tissue is apparent in the external canal
E. Mild pain and scant thin discharge

A

A. False. Temporal
B. False. Pseudomonas. Often begins w pseudomonas OE
C. True
D. True
E. False. Foul smelling, purulent otorrhea,severe otalgia

Pathology II Chamberlin Fall 2014 (5 decks)

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