Step1 questions general pathology Flashcards
Caudal Regression Syndrome
sacral aegenesis, lower extremity paralysis, urinary incontenence; poorly controlled maternal diabetes
staph protein A
Bind fc portion of IgG preventing activation of compliment.
osteoporosis risk factors
smoking, menopause, corticosteroid, no exercise, caucasian, low BMI, alcohol
Type III hypersensitivity
Deposition of circulating complement-fixing immune complexes
Serum sickness
Type III hypersensitivity: fever, urticaria, arthralgias, glomerulonephritis and lymphadenopathy 5-10 days after exposure
Pathophysiology of acne
Follicular epidermal hyperproliferation, excessive sebum production, inflammation, propionibacterium acne
Ehlers-Danlos Syndrome
Abnormal collagen formation (I or IV) which manifest with hypermobile joints, hyperelastic skin, fragile tissue causing easy bruises and wounding.
Chronic mesenteric ischemia
Postprandial abdominal pain, weight loss, pain out of proportion to physical findings.
Pathophysiology of Chronic mesenteric ischemia
Similar to stable angina which is caused by atherosclerosis. In this case pain due to intestinal hypoperfusion during meals when more blood is needed for digestion.
wilson disease
Autosomal recessive, ATP7B mutation on chromosome 13, accumulation of Cu causing free radial damage in liver. Cu deposits in cornea(Kayser-Fleicher rings) and basal ganglia(parkinsonian symptoms).
Adenoma to carcinoma sequencein colon adenocarcinomas
1.from normal mucosa to small polyp (APC), 2.increase in size of the polyps(K-ras), 3.malignant transformation (p53 n DCC)
Coagulative infarct in kidney (wedge-shaped lesion)
Due to emboli from left heart
Lesion are result of chronic sun exposure and precursor to squamous cell carcinoma. Basal cell atypia, hyperkeratosis(hyperplasia of the stratum corneum) and parakeratosis(abnormal retention of cell nucei in stratun corneum).
Actinic Keratoses
Late onset Differential Cyanosis
Patent Ductus Arteriosus (Left-to-right shunt reversal to Right-to-left) due to resultant pulmonery hypertension
Coarctation of the Aorta
presents as blood pressure discrepancy between upper and lower extremities. If presewnt with Ductus arterious, it causes differential cyanosis in infancy.
Syringomyelia
Formation of cerebrospinal fluid-filled cavities in the cervical region of the spinal cord especially the ventral white commissure anf the ventral horn.
Destruction of Ventral white commissure
Loss of pain and temperature sensation in the arms and hands bilateral
Destruction of motor neurons in ventral horns
Flacid paralysis and atrophy of intrinsic muscles of hand and LMN signs
Holoprosencephaly (fused cerebral hemispheres), single ventricle, fused basal ganglia ae examples of:
Malformation: primary defect in cell that form an organ.
What is Holopronsencephaly associated with?
Trisomy 13(patau), trisomy 18(Edward’s, fetal alcohol syndrome.
Amniotic band syndrome
disruption or secondary destruction of well-formed organ
Potter syndrome
Sequence: low volume amniotic fluid causes fetal compression by the uterus resulting in flattened facies, abnormal limbs and hypoplastic lungs.
Acute and painless monocular vision loss. Pale retina and cherry-red macula.
Central retinal artery occlusion. Central retinal artery is a branch of the ophtalmicartery which arises from the internal carotid artery. Macula has a separate blood supply from the choroid artery.
Bilateral wedge-shaped bands of necrosis over the cerebral convenxity, lateral to the interhemispheric fissure. Located on watershed ares.
Ischemic-hypoxic encephalopathy due to profound cerebral hypoperfusion.
Gallstone ileus pathology
Large gallstone erodes into the intestinal lumen through a cholecystoenteric fistula
Gallstone ileus findings
Intestinal gas pattern consistent with intestinal obstruction AND air in the biliary tree (pneumobilia).
Painless waxing and waning lymphadenopathy, T(14;18), overexpression of bcl-2 oncogene.
Non-hodgkin follicular lymphoma of B cell origin.
Alpha-1 antitrypsin deficiency
Panacinar emphysema secondary to destruction of alveolar walls by tissue-damaging enzymes. (interalveolar septa destruction) ALSO, liver disease (PAS stained unsecreted granules in periportal hepatocytes)
Stain dark blue for hemosiderin
Prussian blue
Turner syndrome
Bicuspid aortic valve, short stature, short and thick neck, broad chest and short fourth metacarpal
Hemolytic-uremic Syndrome
Common cause of acute renal failure in children. Characterized by triad of acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia. Associated with shiga toxin-producing organisms like E-coli and shigella dysenteriae.
Hemolytic-uremic Syndrome Pathogens
Shiga toxin-producing organism like E.coli and Shigella dysenteriae.
Patient with obstructive sleep apnea, which organ is responsible for increased hematocrit?
kidney, peritubular cells in renal cortex snese hypoxia and respond by releasing erythropoietin which stimulates erythrocyte production in bone marrow.
Pathophys of vitiligo
loss of melanocytes
Vitamin K dependent factors
II, VII, IX, X
Autoimmune destruction of pancreatic beta cells
Type 1 diabetes. Islet destruction by T lymphocytes, yet antibodies against islet antigens can be detected in the serum.
early detection of diabetic neprhopathy
Albumin
Hypovolemic shock
Low-output failure, increased TPR, cold, clammy pt due to vasoconstriction
Septic shock
High output failure, decreased TPR, hot pt and vasodilation
treatment of iron poisoning
Deferoxamine
what is cachexia mediated by?
INF gamma, TNF alpha and IL6
Tumor grade
Cellular differentiation
Tumor Stage
Most important prognostic factor. Localizationa nspread. TNM.
oncogene abl
CML
oncogene c-myc
Burkitt’s
oncogene bcl-2
follicular lymphoma
Her2/neu oncogene
breast, ovarian and gastric carcinomas
ras oncogene
Colon cancer
L-myc and N-myc oncogene
Lung tumor and Neuroblastoma
ret oncogene
Multiple endocrine neoplasia 2A n2B
c-kit oncogene
gastrointestinal stromal tumor
APC tumor supressor gene
colorectal cancer
HBV and HCV associated cancer
Hepatocellular carcinoma
EBV ass. Cancer
burkitt’s lymphoma, hodgkin’s lymphoma, naso[haryngeal carcinoma and CNS lymphoma
HPV asso. Cancer
cervical carcinoma, upper respiratory SCC
HHV-8 asso. Cancer
kaposi’s sarcoma
H.pylori asso. Cancer
gastric adenocarcinoma and lymphoma
schistosoma haematobium asso. Cancer
bladder cancer
Paraneoplastic of small cell lung carcinoma
ACTH, ADH, antibodies against presynaptic Calcium at NMJ causing a lambert eaton syndrome
paraneoplastic of squamous cell lung carcinoma
PTH
paraneoplastic of hodgkin’s lymphoma
vitD3
paraneoplastic of renal cell carcinoma
EPO
Pt with upper abdominal discomfort, Gastric biopsy in urea containing solution caused the pH to increase
Helicobacter pylori infection. Urease converts the urea to carbon dioxide and ammonia and cause and increase in pH.
Most common type of kidney stones
CALCIUM: Calcium oxolate and calcium phosphate
Lab. Abnormalities with calcium kidney stone
Normocalcemia and hypercalciuria
Pt with severe chest pain not relieved by rest or nitroglycerin, diaphoresis, dyspnea and nausea. ST segment elevation and deep Q development. Cause?
Fully obstructive thrombus superimposed on a ruptured atherosclerotic cononary artery plaque
Pt with severe chest pain not relieved by rest or nitroglycerin, diaphoresis, dyspnea and nausea.
Acute transmural myocardial infarction
stable angina
stable atheromatous lesion without overlying thrombus but obstructing greater than 75% of coronary lumen.
Pt with progressive exertional dyspnea, decreased forved vital capacity, attenuated alpha-1 antitrypsin fraction
Panacinar emphysema: form of COPD
lobes affected by panacinar emphysema
lower lobes because they get greater perfusion allowing more neutrophils
lobes affected by centriacina emphysema
upper lung lobes and strong association with chornic smoking
Pt with episode of gross hematuria and family history of sickle cell disease?
Papillary necrosis
Causes of papillary necrosis
Sickle cell disease or trait, alagesic nephropathy (phenacetin), diabetes mellitus, acute pyelonephritis and urinary tract obstruction.
blue sclerae and history of several fractures
Osteogenesis imperfecta, autosomal dominant inheritance
Osteogenesis imperfecta primary impairment?
Bone matrix formation due to defective collagen type I.
Pt with right lower quadrant pain, vaginal bleeding, last menstrual period 7 weeks ago, history of pelvic inflammatory disease, signs of hemorrhagic shock, endometrium would most likely reveal?
Decidualized endometrium aka gestational due to rupture of ectopic pregnancy
Main risk factor for ectopic pregnancy
History of pelvic inflammatory disease
Where is H. pylori located In the stomach
gastric antrum
