Sweep 1.1 Flashcards
Duchenne muscular dystrophy is an ——— disorder caused by the absence of a structural protein termed ———- and is seen in about 1/3500 live male births.
X-linked recessive
dystrophin
Dystrophin attaches portions of the muscle fibers to the ———, thus playing an important role in the .
cell membrane
structural and functional integrity of the myocyte
Myasthenia gravis is an ———- which results in destruction of ———— and is manifested by weakness and prominent fatigability of voluntary muscles.
autoimmune disease
acetylcholine receptors in the neuromuscular junction
Myasthenia gravis
The most active muscles generally are
the most severely affected, such as the muscles involved in eye movement, facial expression, chewing, swallowing and respiration.
Myasthenia gravis
The natural course of the condition is improved by ——— ——– and removal of the tumor in those with a ——–. In addition, medications such as ——– have been proven to be beneficial in many cases.
thymectomy in cases of thymus hyperplasia
thymoma
cholinesterase inhibitors and corticosteroids
Myasthenia gravis
Some cases of ———— have been reported. In the past, ———— was a major cause of death; due to improved therapies, the current 5-year survival is 95%.
spontaneous remission
respiratory compromise
Gout: After the joints, the ——– is the most frequently affected organ.
kidney
- Oligodendroglioma.
a. Patients often have several years of
neurologic symptoms including seizures.
- Oligodendroglioma.
b. Mostly
cerebral hemisphere.
- Oligodendroglioma.
c. Well ———-, often ——–. Cells with uniform, round nuclei and perinuclear ———–
circumscribed
calcified
halo (fried egg look)
- Oligodendroglioma.
. Generally better prognosis than .
astrocytoma
- Ependymoma.
a. May manifest with ———- secondary to ——– of the ventricle. May also have ———–.
hydrocephalus
obstruction
CSF dissemination
- Ependymoma.
b. ———- lesions, arising from ———–. Elongated cells with processes radiating around ————- (perivascular pseudorosettes)
Well-circumscribed
ventricular wall
blood vessels
Hypothalamus
- posterior lobe: composed of
modified glial cells and axonal processes extending from hypothalamic neurons
A. Hyperfunction (hyperpituitarism)
o almost always associated with a
pituitary adenoma
B. Hypofunction (hypopituitarism)
• causes:
o nonfunctional pituitary adenoma
o Ischemic necrosis, most commonly from Sheehan’s syndrome (postpartum infarct). Need over 75% of anterior lobe to be destroyed for clinically significant effects.
o Ablation of pituitary by surgery or radiation
o destruction by adjacent tumor
I. Normal Thyroid
• embryology
o develops from an invagination of ——— which arises at the base of the tongue, in the region of the ———
endoderm
foramen cecum
I. Normal Thyroid
• embryology
migrates
caudually to its location anterior and inferior to the thyroid cartilage
Graves’ Disease
• —————, significant genetic component
o Autoantibodies to
autoimmune
TSH receptor; constantly stimulated
Hashimoto Thyroiditis
o Most common cause of ———– where ———– is sufficient
hypothyroidism
dietary iodine
Hashimoto Thyroiditis
o Autoimmune; progressive destruction of ———– with ———-
parenchyma
inflammatory infiltrates
Hashimoto Thyroiditis
o Involves———–cells
CD4+, CD8+, and NK
Hashimoto Thyroiditis
o initially ———-, with progression of disease most patients will become ———–
euthyroid
hypothyroid
Hashimoto Thyroiditis
o Painless thyroid enlargement with
hypothyroidism
Follicular Adenoma
o ————-, 3-5 cm in diameter
solitary nodules
Follicular Adenoma
o grossly separated from the ———— by a ———-
normal thyroid
thin, discrete capsule
Follicular Adenoma
o microscopically composed of ——— with varying amounts of ———-
follicles
colloid
Papillary Thyroid Carcinoma
o accounts for >——-of thyroid cancers
85%
Papillary Thyroid Carcinoma
o 60-70% are ——-
multifocal
Papillary Thyroid Carcinoma
o some cases related to
radiation exposure
Papillary Thyroid Carcinoma
o Many have mutations in the ————–
RET proto-oncogene
Follicular Carcinoma
o accounts for——— of thyroid cancers
5-15%
Follicular Carcinoma
o Older age than ——–; areas with ———–
papillary
dietary iodine deficiency
Follicular Carcinoma
o grossly may resemble an ———- with a ———
adenoma
discrete capsule
Follicular Carcinoma
o Must see invasion through the
capsule or into the blood vessels
Anaplastic Thyroid Carcinoma
o Rare <5%; typically presents as
o ——— prognosis
rapid enlargement in a long standing goiter
extremely poor
Chronic gouty arthritis arises secondary to ——–.
repeated episodes of acute attacks
Chronic gouty arthritis
Crystals become encrusted on the articular surface and even penetrate deeply into ————–
Each deposit is known as a ————- and is diagnostic of gout.
surrounding bone and soft tissue.
tophus
Acute gouty arthritis arises upon precipitation of ——– in the synovial fluid and membranes. These crystals elicit an acute inflammatory response until ———-.
urate crystals
the crystals resolubilize
Fragments of dislodged bone and cartilage often float free in the joint space and form ———-
“joint mice”.
Eventually, the entire surface of the bone becomes exposed, thickened and polished to an ivory-like appearance. At the margins of the joint, small bony outgrowths termed ———- arise and help to further inflame the surrounding synovial membrane.
osteophytes
Osteosarcoma: The radiographic appearance is generally that of a ———–
large, destructive, mixed radiolucent-radiopaque lesion that may present with a “sunburst” appearance.
Osteosarcoma:
A characteristic feature is the formation of an acute angle between the ————
neoplastic bone and the cortex (Codman’s triangle).
Osteosarcoma:
Diagnosis requires
histologic evidence of direct production of osteoid by malignant mesenchymal cells.
Histopathologic examination of early lesions reveals a mixture of ———– intermixed with elongated trabeculae of immature woven bone and this pattern has been termed Chinese characters. When radiographically examined with film capable of high detail (dental films), the affected area will appear as an ill-defined area of —————-
cellular fibrous connective tissue
increased radiopacity described as ground glass.
i. Fibrous Dysplasia is characterized by ————— This may reflect ———- maturation with arrest at an ————– due to a specific mutation.
progressive replacement of normal bone by fibrous tissue intermixed with unorganized, woven bone.
disordered bone
immature stage of woven bone
Fibrous dysplasia
Three clinical patterns are seen:
Monostotic fibrous dysplasia
Polyostotic fibrous dysplasia without endocrine involvement (Jaffe-Lichtenstein Syndrome)
Polyostotic fibrous dysplasia in association with endocrinopathies (McCune-Albright syndrome)
Hematogenous osteomyelitis is caused most frequently by ———–; while mixed infections, often with anaerobes, are seen in those secondary to —————
Staphylococcus aureus
trauma or dental problems.
Osteomyelitis refers to an infection spreading through the ———–.
medullary spaces of a bone
Osteomyelitis
Bacteria can colonize the spaces within bone, normally through one of three pathways.
- Hematogenous spread
- Contiguous infection (i.e. odontogenic infections)
- Direct traumatic introduction (i.e. compound fractures, surgical procedures)
