Pathology UWorld Flashcards by John Nathanson

Difference between NRTIs and NNRTIs

NNRTIs don’t require phosphorylation to work. include Navirapine, efavirens, delavirdine

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Most common cause of mitral stenosis

Rheumatic fever. Happens years after infection. Atria enlarge, can cause mural thrombi and stroke

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How to distinguish sulfonylurea use from insulinoma

Both have increased insulin, hypoglycemia, increased c peptide. Must test for sulfonylureas in blood

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What kills patients with T2DM?

Heart failure

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Why are lower parts of lungs most sensitive to alpha1antitrypsin deficiency?

Most perfusion. More neutrophils come in and more neutrophil elastase.

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What are potent activators of neutrophil chemotaxis

LTB4, IL8, C5A, bacterial products

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Factor V leiden causes…

Venous thrombosis, cerebral vein thrombosis, pregnancy loss.

Not arterial

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Councilman bodies

Eosinophilic inclusions in the liver caused by viral hepatitis. They correspond to apoptosis occurring

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Markers of lymphoid cells
epithelial cells
myeloid cells
mesenchymal cells
neuroendocrine cells

CD20 for b cells, CD3 for T
Cytokeratin
MPO
Vimentin
Chromogranin A or neuron specific enolase

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Cancers associated with Her2/neu?

Breast, endometrial, cervical, gastric sometimes

Her 2 new is an epithelial growth factor receptor

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What causes amenorrhea in anorexic females?

Decreases in all sex hormones. FSH down, LH down, estradiol down

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Vitiligo

Decreases melanocytes in patches of skin

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Feared complication of UC. How to diagnose

Toxic megacolon (distension, pain). Diagnose with x-ray

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Symptoms of SSPE

Ataxia, myoclonus. Occurs several years after measles infection. Thought to be due to the accumulation of viral nucleocapsids

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Progressive supranuclear palsy

Vertical gaze palzy, gait disfunction. Parkinsonism due to neurodegeneration of frontal subcortical white matter

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What causes fistulas in crohn’s disease?

Transmural inflammation

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Symptoms of hypokalemia

paresthesias, weakness

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Intestinal carcinoid tumor appearance

Nests of uniform cells with round nuclei. Often found in ileum and appendix. Rectum too.

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DeQuervains viral granulomatous thyroiditis

Painful thyroid weeks after viral infection. Transient hyperthyroidism followed by hypothyroidism. Granulomas

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Causes of avascular necrosis?

Steroids, SLE, alcohol, sickle cell

All decrease blood to femur, groin pain

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Uncal herniation (transtentorial herniation)

Will compress CN III causing down and out eyes. Can compress ipsilateral pca causing contralateral hemianopsia with macular sparing.

Worse case scenario? brainstem hemorrhages onto pons -> death

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Ristocetin

Activates GP1B on platelets for binding to vWF. No aggregation during ristocetin test, vW disease

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Rule of 10 for pheo

10% genetic (men2A, 2B, VHL)
10% bilateral
10% extra adrenal
10% malignant

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Which testicular cells are sensitive to temp?

Sertoli cells

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Which cancer don't you do surgery for?

Small cell lung carcinoma

Glucagonoma

Cause necrotic migratory bronze colored erythema (papules on face/perineum), diabetes, and anemia.

Zinc deficiency

Pustular lesions without a central clearing. Impaired wound healing, hair loss, impaired taste

Trosseau's sign

Migratory thrombophlebitis, usually a sign of cancer in pancreas/colon/lung

Medullary thyroid carcinoma

Nests of parafollicular c-cells with amyloid deposits, a feature of MEN2B

Wilson Disease

Mutation in ATP7B on chromosome 13. Decreased secretion of ceruloplasmin, decreased copper excretion

Red neurons

Acute irreversible damage causes cell body shrinkage, pyknosis, decreased nissl substance, eosinophilia

Inferior wall (diaphragmatic surface) leads and artery?

PDA (which comes from the RCA) Check with II, III, aVF

LAD leads

V1 V2

LCX leads

V5 V6

Varicose veins

Dilatation of veins. Predisposes people to skin ulcerations, poor wound healing, painful thromboses

Phlegmasia alba dolens

Ileofemoral venous thrombosis in peripartum women

Pheo vs hyperthyroidism

Pheo can cause transient activation. | hyperthyroidism is constant

Ecchymoses size

>1cm | purpura .5-1 cm

AFP is a marker for

HCC or yolk sac carcinoma

Viral meningitis cell count

Normal glucose, increased protein, 90% lymphocytes Bacterial has low glucose, increased protein, increased neutrophils

APC tumor suppressor does what...

Responsible for intercellular attachment

CSF in MS patientsq

Oligoclonal bands from IgG overload.

Kartagener syndrome

Bronchiectasis, infertility, situs inversus Due to primary ciliary dyskinase

Lupus pancytopenia vs lupus nephritis

Lupus pancytopenia is due to type II HSR against blood cells, Nephritis is type III HSR

Xanthelasmas caused by

either 1 or secondary hyperlipidemia. PBC and other cholestatic syndromes cause increased cholesterol in bloodstream

MEN1

Pituitary (prol/GH) Parathyroid (hypercalcemia) Pancreas (gastrin)

MEN2A

Medullary carc of thyroid Pheo/pheo Parathyroid

MEN2B

Medullary carc Pheo pheo Oral neuromaas/marfanoid habitus

Parvovirus causes...

Slapped cheek rash in kids with fever, knee/wrist symmetric arthritis in adults

What cranial nerve controls lacrimal, mandibular, sublingul glands?

CN VII

Oral glucose tolerance test used to diagnose diabetes in what patent population?

Pregnant women. Check glucose for type 1 and 2

FGF2 purpose

Endothelial cell proliferation/migration and angiogenesis.

Progression of MI 1 day 1 week 1 month

``` coag necrosis 1 day Neutrophils/macrophages 1 week granulation tissue 1 month fibrous scar ```

Gummas

Sign of tertiary syphilis (when VDRL is positive in CSF with pleocytosis), start as a painless indurated granulomatous lesion.

How to diagnose tetanus

With history and physical -- no toxin assay available

What causes clubbing that isn't a respiratory condition? Pathogenesis

Crohn's, malabsorption, hyperthyroidism Thought to be due to increased megakaryocytes and platelest with fibrovasular proliferation

Ureter location

Lies posterior to uterine artery. During hysterectomy, may be cut causing hydronephrosis

Gout birefringence?

Negative. Yellow in parallel light.

Persistant lymphedema can cause..

Lymphangiosarcoma (after radical mastectomy)

Glomangioma

Small blue tumor under nail bed of smooth muscle cell that directs blood away from cold fingers to preserve heat. Found in pads of fingers also.

Can melanomas be subungual?

yes

Gottron Papules

Red, papular lesions over bony prominences in dermatomyositis (also has heliotrope rash over eyelids)