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Gen Path Final > Sweep 1.4 > Flashcards

Sweep 1.4 Flashcards

1
Q
  1. Secondary biliary cirrhosis-results from ————-
A

obstruction extrahepatic duct

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2
Q

a. Biliary tree obstruction-the primary cause is

A

cholelithiasis (gall stones), then malignancies of biliary tree or head of pancreas.

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3
Q

Secondary biliary cirrhosis

b. Develop secondary inflammation-then

A

fibrosis, hepatic scarring.

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4
Q
  1. Primary biliary cirrhosis (PBS)

a. Inflammatory ——– disease-affects ———–

A

autoimmune

intrahepatic bile ducts.

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5
Q
  1. Primary biliary cirrhosis (PBS)
    b. Primary feature-nonsuppurative inflammatory destruction of ————-also get portal inflammation, scarring and eventually cirrhosis.
A

medium sized intrahepatic ducts

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6
Q
  1. Primary biliary cirrhosis (PBS)

c. Thought to be an ——— etiology.

A

autoimmune

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7
Q
  1. Primary sclerosing cholangitis (PSC)

a. Fibrosing cholangitis of bile ducts-develop ———–

A

luminal obliteration

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8
Q
  1. Primary sclerosing cholangitis (PSC)

b. Liver eventually develops ———-

A

biliary cirrhosis

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9
Q
  1. Primary sclerosing cholangitis (PSC)

d. Note an increase in ———- and ———— in PCS patients

A

chronic pancreatitis

hepatocellular carcinoma (HCC)

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10
Q

G. Metabolic liver disease
3. Nonalcoholic steatohepatitis (NASH). Patients develop ——–, and 10-20% progress to ———- (seen primarily in ——– patients).

A

hepatocyte injury

cirrhosis

obese

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11
Q
  1. Alpha1-antitrypsin deficiency. Develop ——— from protein degrading enzymes. Also develop liver disease, formation ———————- within hepatocytes.
A

pulmonary emphysema

of Mallory bodies and PAS positive granules

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12
Q
  1. Alcoholic liver disease

o 3 overlapping forms:

A

1) hepatic steatosis,
2) EtOH hepatitis,
3) cirrhosis (only develops in a minority of patients).

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13
Q

A. Small Intestine-reactive, non-neoplastic conditions

2. Infectious enterocolitis e.g. Vibrio cholerae, Campylobacter jejuni-

A

acute, self-limited colitis “traveler’s diarrhea”.

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14
Q

Clinical aspects of malabsorption:

1. Osteopenia, tetany:

A

Defective Ca, Mg, Vitamin D and protein absorption

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15
Q

Clinical aspects of malabsorption:

2. Amenorrhea, impotence and infertility:

A

Generalized malnutrition

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16
Q

Clinical aspects of malabsorption:

  1. Deficiencies in Vitamin A and B12:
A

Peripheral neuropathy, nyctalopia (↓ Vitamin A)

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17
Q

A. Colon polyps

a. Hyperplastic:

A

↑ number of cells

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18
Q

A. Colon polyps

b. Hamartomatous:

A

↑ in tissue normally at this site

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19
Q

B. Adenoma

A
  • Neoplastic
  • Dysplastic
  • Shape: Tubular, tubulo-villous, Villous
  • Size: Most important predictor of malignant change
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20
Q

B. Adenoma

• Shape:

A

Tubular, tubulo-villous, Villous

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21
Q

Adenoma

• Size:

A

Most important predictor of malignant change

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22
Q

D. TNM Classification

T: Depth of tumor invasion

A
  1. Submucosa
  2. Muscularis propria
  3. Subserosa or pericolic fat
  4. Contiguous structures
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23
Q

D. TNM Classification

N:

A

Lymph nodes

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24
Q

D. TNM Classification

M:

A

Metastasis

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25
Q

A. Familial Adenomatous Polyposis

Entails mutations of

A

APC gene.

26
Q

A. Familial Adenomatous Polyposis

  1. Gardner’s syndrome: ——————–
A

FAP + Extraintestinal lesions

27
Q

A. Familial Adenomatous Polyposis
Gardner’s syndrome
• Oral manifestions of Gardner syndrome:

A

Unerupted teeth, supernumerary teeth, dentigerous and mandibular cysts, increased risk for odontomas, delayed tooth eruption.

28
Q

Gardner’s syndrome

Also develop ————.

A

benign skin lesions

29
Q

Gardner’s Syndrome

Congenital hypertrophy of ———— (CHRPE).

A

retinal pigment epithelium

30
Q

B. Peutz Jegher Syndrome
• Second most common ——— syndrome
• —————- (Intussusception) and pigmented ———- of mucous membranes and skin.

A

polyposis

Gastrointestinal hamartomatous polyps

macules

31
Q

B. Peutz Jegher Syndrome

• ———– deposits around nose, lips, buccal mucosa, hands and feet, genitalia and perianal region. Develop in early ——–

A

Melanin

childhood

32
Q

B. Peutz Jegher Syndrome

• Non-sun dependant freckling of the skin around the

A

lips and the vermilion zone of the lips – Common feature.

33
Q

A. Crohn Disease
2. Pathology
• ———– inflammation of bowel, particularly ileum (distal small bowel) and colon. Any portion of the GI tract → ————–

A

Segmental transmural

oral involvement frequently seen

34
Q

Crohn disease:

3. Oral manifestations: a. ------------- mucosal thickening with predilection for ----------------- –Can be confused with -----------.  
		b. Mucosal ulcer “cobblestone” ---------- lower than normal tissue
A

Multifocal, linear, nodular, polypoid or diffuse

labial and buccal mucosa and mucosal folds

aphthous ulcers

Diseased tissue

35
Q

A. Crohn Disease

c. —————– identical to those seen in the bowel. Infections (fungal, TB) should be ruled out.

A

Subepithelial, noncaseating granulomatous inflammation

36
Q

B. Ulcerative Colitis

2. Pathology:

A
  • Begins in rectosigmoid area and extends proximally. Not transmural
  • Continuous (diffuse) involvement (pseudo-polyps), not patchy
37
Q

PENILE DISORDERS
Two markers have proven to be helpful in diagnosis, staging and follow-up for these cancers: ————–. These markers are rarely positive in ———- but frequently beneficial in ————- tumors.

A

α-fetoprotein and human chorionic gonadotropin (HCG)

seminomas

nonseminomatous

38
Q

Prostate specific antigen (PSA) represents a useful marker in the management of prostate cancer, but is elevated in both normal prostate and those affected by cancer, prostatitis, or nodular hyperplasia. PSA is of limited value when used as an ———-, but its value is enhanced considerably when combined with ———————-

A

isolated screening test

digital rectal examination, transrectal sonography, and needle biopsy.

39
Q

In addition to being beneficial in the initial diagnosis, PSA also is important in

A

staging of the neoplasm and judging response to treatment.

40
Q

SYPHILIS

A historically famous pattern of congenital syphilis is called Hutchinson triad and consists of:

A
  1. Interstitial keratitis
  2. Hutchinson’s teeth
  3. Eighth nerve deafness
41
Q 
NONGONOCOCCAL URETHRITIS AND CERVICITIS 
Reactive arthritis (Reiter Syndrome) is a significant manifestation of --------------.
A

chlamydial infection

42
Q

NONGONOCOCCAL URETHRITIS AND CERVICITIS

This is an immune-mediated process that develops in response to genitourinary or gastrointestinal infections and predominates in patients who are ———— positive.

A

HLA-B27

43
Q

NONGONOCOCCAL URETHRITIS AND CERVICITIS

It typically presents as a combination of

A

urethritis/cervicitis, arthritis, conjunctivitis, and mucocutaneous lesions.

44
Q

GENITAL HERPES SIMPLEX
The lesions are small vesicles that quickly ulcerate; the diagnosis is made via a smear or biopsy which will reveal the ———– of the virus in epithelial cells (ballooning degeneration of epithelial cells with

A

cytopathologic effects

large, multinucleate “Tzanck cells”).

45
Q 
HUMAN PAPILLOMAVIRUS INFECTION 
Human papillomavirus (HPV) is the cause of a number of epithelial proliferations in the genital tract, including --------------, some precancerous lesions and some carcinomas.
A

condyloma acuminatum

46
Q

HPV infection

Condyloma acuminatum is usually associated with

A

HPV types 6 or 11 and typically arises on moist mucocutaneous surfaces.

47
Q

HPV infection

They present as ————-, and frequently appear in clusters. Other types of HPV (16, 18, 31, 33, 45, 52, and 58) are found more frequently in epithelial neoplasia, including cervical and oropharyngeal cancer. Condylomata sometime occur ———- but more often in ————-.

A

benign papillary nodules

singly

multiple sites

48
Q

DISOSRDERS OF THE CERVIX
Cervical Intraepithelial Neoplasia and Carcinoma of the Cervix
Abnormalities revealed during a ———— examination following application of ———– appear as ———- patches.

A

colposcopy

acetic acid

white

49
Q

menorrhagia

A

(profuse or prolonged bleeding),

50
Q

metrorrhagia

A

(irregular bleeding between periods), and

51
Q

dysmenorrhea

A

(unusually painful menstrual bleeding).

52
Q

Endometriosis is the presence of ————— in locations other than the ———–.

A

endometrial glands and/or stroma

uterine lining

53
Q

Endometriosis

the causation is ———, the most accepted “regurgitation” theory proposes that

A

unknown

menstrual endometrium backflows through the fallopian tubes and also somehow enters the local venous and lymphatic systems.

54
Q

Endometrial Carcinoma

The most common early symptoms are

A

leukorrhea and irregular bleeding, a red flag in postmenopausal women.

55
Q

Polycystic ovarian disease is a common hormonal disorder affecting ————–

A

5-10% of females of reproductive age.

56
Q

Polycystic ovarian disease

The condition was named due to the presence of ————- in ovaries, resulting in increased size of ovaries and excess production of ————.

A

multiple cystic follicles

androgens and estrogens

57
Q

Teratomas of the ovary are tumors which develop from differentiation of ———– into mature tissues which represent all three germ layers: ectoderm, mesoderm, and endoderm.

A

totipotential germ cells

58
Q

Teratomas

These tumors have a tendency to arise in the ———-, and the earlier onset the greater the likelihood of malignancy.

A

first two decades of life

59
Q

Teratomas

Fortunately, at least 90% of these germ cell neoplasms are ————-. Usually, these cysts contain an ———- lining with adnexal skin appendages (hair follicles, sebaceous glands, sweat glands), hence the common designation of ————–.

A

benign mature cystic teratomas

epidermal appearing cyst

dermoid cysts

60
Q

Teratomas

Most are discovered incidentally in young women on abdominal scans or radiography. These tumors often contain

A

hair, bone, cartilage, bronchial or gastrointestinal epithelium, and even teeth!

Gen Path Final (18 decks)

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