Pathophys Miscellaneous Flashcards
What is hyperkeratosis and give at least one skin condition it occurs in?
Increased thickness of stratum corneum
-> psoriasis
What is parakeratosis and give at least one skin condition it occurs in?
Hyperkeratosis with RETENTION OF NUCLEI in the stratum corneum
-> psoriasis
What is hypergranulosis and give at least one skin condition it occurs in?
Increased thickness of stratum granulosum (Granular layer, 3rd layer)
-> lichen planus
What is spongiosis and give at least one skin condition?
Epidermal accumulation of edema fluid in intercellular spaces (will see spaces between stratum spinosum)
-> occurs due to allergic inflammation, especially eczema (atopic dermatitis) or allergic contact dermatitis
What is acantholysis and give at least one skin condition?
Separation of epidermal cells, especially in the spinosum layer (acantho = spiny, like spur cells in hematology)
-> Pemphigus vulgaris
What is acanthosis and give at least one condition?
Hyperproliferation of epidermis leading to increased spinosum layer
- > acanthosis nigricans -> thickened skin
- > acanthosis also occurs in psorasis
What type of inflammation is most specific for multiple sclerosis?
Perivenular inflammatory infiltrates with autoreactive T cells and macrophages. This occurs due with breakdown of BBB, but not destruction of the blood vessel. #919
How do OCPs work and how do they affect your risk of ovarian cancer?
Work by giving exogenous supply of estrogen -> FSH release by the pituitary is inhibited. Thus, the follicle never develops and cannot be stimulated. LH surge never occurs because estrogen supplied is not high enough to induce this positive feedback mechanism.
Ovarian surface epithelial cancer risk is decreased because less ovulation -> less rupture of ovary surface.
What is the function of the Purkinje cells of the cerebellum?
Only cell involved in the output of the cerebellar cortex
- > they are inhibitory “PurkINje” to the deep nuclei of the cerebellum
- > when the deep nuclei are not inhibited, that send glutamate neurons out of the cerebellum
What are the three structures which communicate with the cerebellum called / where do they hook up? What is the most inferior one also called?
Superior cerebellar peduncle - Attaches to midbrain
Middle cerebellar peduncle - attaches to pons
Inferior cerebellar peduncle - attaches to medulla. Also called the “restiform body”
What is the juxtarestiform body?
Axons which run from the vestibular nuclear complex (at the junction of rostral medulla / caudal pons) to the vestibulocerebellum / spinocerebellum (involved in regulation of vestibular system).
Called juxtarestiform because it runs near the ICP (“restiform body”).
What are archicerebellum, paleocerebellum, and neocerebellum also called? Their function?
Archi = vestibulocerebellum, the oldest one. Includes fastigial nucleus as well as flocculonodular lobe and uvula. Maintains equilibrium with medial most trunk muscles + help from LVST/MVST of vestibular system.
Paleo = Spinocerebellum -> includes globose and emboliform nuclei, coordinates trunk and proximal limb flexor activity thru red nucleus / rubrospinal
Neo = Lateral zone -> includes dentate nucleus, projects to VL thalamus to synergize skilled movements of digital / appendicular muscle
What portion of the hypothalamus primarily control the parasympathetic vs sympathetic nervous system?
parasympathetic -> chills you out and cools you down. Think A/C -> Anterior nucleus of the hypothalamus
Sympathetic is just the opposite -> heats you up when active. Posterior nucleus of hypothalamus.
What will stimulating the anterior vs posterior hypothalamus do?
Anterior -> cools you down. Stimulates vasodilation / sweating (parasympathetic)
Posterior -> heats you up. Stimulates vasoconstriction, shivering (sympathetic)
How does melatonin and the suprachiasmatic nucleus work?
Exact mechanism is unknown, but generally the SCN projects to the pineal gland via norepinephrine. It’s rate of firing dictates melatonin release, which feeds back on the SCN to inhibit its firing. Higher melatonin levels = lower firing rate of SCN to other nuclei = decreased wakefulness. A major afferent to the SCN is also light.
What are the waveforms on EEG in wakefulness, Stage 1 NREM, Stage 2, stage 3, and REM sleep?
Awake, eyes open - Beta (concentrating) Awake, eyes closed - Alpha Stage 1 - Theta / alpha Stage 2 - Spindles and K complexes within Theta background Stage 3 - Delta (slow wave) REM - Beta
BATS Drink Blood
What’s the mnemonic for the layers of the spermatic cord?
ICE tie
Internal spermatic fascia = transversalis fascia derived
Cremasteric muscle and fascia = internal oblique
External spermatic fascia = external oblique
Internal / external mean deep / superficial inguinal ring
How is cranial nerve 3 affected differently if damaged due to ischemia vs compression?
PANS fibers controlling pupillary reflex and accommodation are on outside
Motor fibers controlling LPS / muscles are located centrally.
Ischemia - i.e. diabetic nephropathy -> central motor fibers affected first. Eyes will be down and out with normal pupillary reflex / accommodation
Compression - periphery affected first -> initial loss of pupillary constriction before down and out gaze. I.e. due to Posterior communicating artery aneurysm or uncal herniation.
What type of brain hemorrhage does cerebral amyloid angiopathy typically cause?
Lobar hemorrhages, especially in the elderly. These are intraparenchymal hemorrhages located more superficially in the cortex, especially in the occipital lobes #499
Can an optic tract lesion cause a pupillary light reflex defecet?
Actually yes -> there will be a RAPD showing “dilation” on flashlight test when the light is shone in the eye contralateral to the lesion since photoreceptors on the nasal side contribute disproportionately to the reflex
How does Hep A often present in adults?
Often presents as prodrome of fever and anorexia, followed by jaundice symptoms that make it mimic extrahepatic cholestasis (i.e. dark colored urine, acholic stools, icterus)
What liver disease of middle age women often presents with xanthelasmas / xanthomata? What’s the pathognomonic finding in the liver?
Primary biliary cholangitis
Florid duct lesion (granuloma due to intralobular bile duct destruction) is pathognomonic
What is the cause of obstructive atelectasis and how will it appear on CXR?
Causes include:
- Foreign body obstruction
- Obstruction by bronchial secretions / exudate, i.e. asthma, chronic bronchitis, bronchiectasis
Obstruction needs to be COMPLETE to collapse the lung, the absorption of the air behind the block
CXR -> tracheal deviation towards the affected side since volume is lost.
Progressive loss of air -> loss of radiolucency -> progressive opacification of lung on CXR.
What is the numeric definition of pulmonary hypertension and what gene causes inherited PAH?
mean pulmonary arterial pressure > 25 mmHg at rest.
BMPR2 mutation (bone morphogenic protein receptor 2) -> inactivating mutations will cause vascular smooth muscle proliferation -> normal function is to inhibit proliferation