QB - DISEASES2 Flashcards
Deficiency in pyridoxine
Pyridoxine required as cofactor for 1st step in heme synthesis
Decreased heme synthesis –> microcytic, hypochromic pyridoxine-responsive anemia (sideroblastic anemia)
Alveolar cells containing golden cytoplasmic granules –> dark w/ Prussian blue staining; what is pathology?
Prussian blue stains for IRON
Pt. has “heart failure cells” - macrophages that have engulfed a lot of RBCs in pulmonary circulation (due to pulmonary congestion/edema secondary to chronic LEFT heart failure)
Turner’s syndrome: levels of FSH/LH?
Elevated LH and FSH – no negative feedback due to ovarian failure (no breast development, no menarche)
Small chance that some women can have spontaneous puberty –> possibility for pregnancy
Most can only become pregnant w/ donor oocytes - will need supplemental estrogen/progesterone to prepare and maintain uterine lining
Fibroadenoma
most common benign tumor of breast
occur in multiples, in both breasts
increase in size during luteal phase of menstrual cycle/lactation
freely moveable, palpable mass (young)
cellular, myxoid stroma that encircles epithelium-lined glandular and cystic spaces
Ductal carcinoma in situ (DCIS)
precancerous breast lesion
malignant clonal cell proliferation (contained by surrounding ductal BM)
Myopethelial (basal) layer preserved/uninvolved
Paget disease of nipple
Malignant cells spread from superficial DCIS into nipple skin (does not cross BM)
unilateral erythema and scale crust around nipple
Sclerosing adenosis
Central acinar compression/distortion (by surrounding fibrotic tissue) and peripheral ductal dilation
common finding in fibrocystic change
Mammary duct ectasia
Ductal dilation, inspissated breast secretions
Chronic granulomatous inflammation in periductal and interstitial areas
Medullary carcinoma
Solid sheets of vesicular, pleomorphic, mitotically active cells w/ significant lymphoplasmacytic infiltrate around/within tumor – pushing, noninfiltrating border
Temporal arteritis
Inflammation in MEDIUM-sized and LARGE arteries – mononuclear infiltrates & multinucleated giant cells = “giant cell vasculitis”
Granulomas in media of arteries
Narrowing of vessel –> decrease in blood supply to perfused areas:
1) headache
2) craniofacial pain (jaw & tongue claudication) – while chewing
3) polymyalgia rehumatica – neck, torso, shoulder, pelvic girdle pain & morning stiffness; fever, fatigue, weight loss may also occur
4) sudden vision loss (monocular)
Reversal treatment for ingestion of rat poison
Pts. susceptible to GI bleeding (no coagulation factors)
Give fresh frozen plasma and vitamin K1
Hamartoma
Excessive growth of tissue type native to organ of involvement
Most common benign lung tumor
Hamartoma (pulmonary chondroma)
“coin lesion” in pts. 50-60yrs old
Incidental finding on CXR – “popcorn calcifications”
contain islands of mature hyaline cartilage, fat, smooth muscle & clefts lined by respiratory epithelium
Type of lung cancer w/ neuroendocrine markers
Small cell carcinoma of the lung
Keratin pearls characteristic of what type of malignancy?
Squamous cell carcinoma
Membranous GN
Nephrotic
Generalized edema
Heavy proteinuria (>3.5g/day)
Hypoalbuminemia
Hyperlipidemia
IgA nephropathy (Berger disease)
Children/young adults
Painless hematuria
2-3 days after upper respiratory infection
(contrast w/ Post-STREP GN which occurs 2-3 weeks after upper respiratory or skin infection; anti-streptolysin O antibody; low C3 levels)
Squamous cell carcinomas of bladder
RARE
Associated w/ Schistosoma haematobium infection
Urothelial carcinoma
Formerly transitional cell carcinoma
makes up 90% of bladder cancers
Painless gross hematuria
Tumor penetration of bladder wall = major prognostic indicator
(carcinoma in situ - confined to epithelium)
Vitelline duct connects what two structures; when it it obliterated? What condition results if duct persists?
Midgut lumen w/ yolk sac;
Obliterates 7th week
Persistence of vitelline duct = connection between intestinal lumen + umbilicus
Meckel diverticulum most common vitelline duct anomaly: partial closure of vitelline duct –> patent portion attached to ileum (fibrous band may connect tip of Meckel’s diverticulum w/ umbilicus) – can present w/ rectal bleeding/intestinal obstruction
Umbilical hernia
Weakness of abdominal wall at umbilicus - midline protrusions covered by skin
Omphalocele
Midline defect in abdominal wall - incomplete closure – abdominal organs protrude through defect covered w/ peritoneal sac
Facor XIII deficiency
clot instability –> delayed, recurrent bleeding after trauma
Protein C acts w/ Protein S to inactivate what factors?
Factor V and factor VIII
Inability to inhibit Factor V and VIII –> procoagulation state
Factor V Leiden mutation –> procoagulation (bc factor V can’t be inactivated)