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T4- Systemic Patho > T4 patho midterm 2 > Flashcards

T4 patho midterm 2 Flashcards

1
Q

Hemolytic Anemia

A

Premature RBC destruction

Jaundice due to hemoglobin breakdown and increase bilirubin in blood

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2
Q

Autoimmune Hemolytic Anemia-Warm AB AHA

A

Hemolysis due to anti RBC AB (IgG at 37degree C)
Idiopathic
Secondary to cancer and drug use

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3
Q

Autoimmune Hemolytic Anemia-Cold AB AHA

A

IgM AB presence at low temp
Idiopathic
infection, cancer

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4
Q

hereditary Spherocytosis

A

Autosomal dominant
**SPECTRA DEFECT-RBC vulnerability to destruc
Results in splenomegaly
European Descent

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5
Q

G-6-P dehydrogenase deficiency

A

MC in blacks, female children carry disease
Excess peroxide forms **Heinz bodies
**Favism from eating fava beans

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6
Q

Normal Hemoglobin

A

HbA- 2 alpha, 2 beta chains
HbA2- 2 alpha, 2 gamma chains
HbF- 2 alpha, 2 delta chains

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7
Q

Sickle Cell Anemia

A 
Abnormal Hemoglobin (HbS)
Intrincis hemolytic anemia
MC in blacks
Leads to splenic infection
**Blood smear shows Howell Jolly Bodies
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8
Q

Thalassemia

A

Decreased or absent alpha or b chain hemoglobin

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9
Q

Beta Thalassemia

A

A.K.A Cooley Anemia
Most severe type
Decreased beta chain
MC in Mediterranean

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10
Q

Alpha Thalassemia

A

Mild hemolysis and anemia

**Tear drop cells in cell prep

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11
Q

Megaloblastic Anemia

A

B12 or folic acid deficiency
Due to tape worm, diet, pernicious anemia
**Leads to Beefy tongue

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12
Q

Iron Deficiency anemia

A 
Most common type of anemia
Leads to microcytic, hypo chromic anemia
 **Causes Plummer vision Syndrome
Plummer syndrome Triad:
1. microcytic hypochromic anemia
2. esophageal webs
3. glossitis
Causes cheilosis (cracking of lips)
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13
Q

Aplastic anemia

A

Decrease RBC, WBC, platelet

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14
Q

Aplastic anemia causes

A

MC=idiopathic

MC infection from Hep C

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15
Q

Aplastic anemia clinical signs

A

fanconi syndrome

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16
Q

Polycythemia

A

Increase erythrocytes

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17
Q

2 types of polycythemia

A

Relative and absolute

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18
Q

Relative polycythemia

A

Due to dehydration, stress, and decreased plasma

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19
Q

Absolute Polycythemia

A

Primary- Increase viscosity, unknown etiology, causes hepatosplenomegaly
Secondary- Increase erythropoeitin due to COPD, increase altitude, tumor

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20
Q

Leukopenia

A

Decrease WBC due to chronic viral infection

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21
Q

Leukocytosis

A

Increase WBC count
Leukomoid Rxn: WBC count=50,000cells/uL
Dohl Bodies present

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22
Q

Leukemia

A

Malignant neoplasm of bone marrow

in ribs, sternum, vertebrae, pelvis

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23
Q

Leukemia predisposing factors and symptoms

A

irradiation, drugs, down syndrome

hepatosplenomegaly and kidneys, adrenals, CNS issues leading to anemia

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24
Q

Acute Lymphocytic leukemia

A

Children 10 poor prognosis

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25
Q

Chronic Lymphocytic leukemia

A

Elderly >60yoa

50% die of infection

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26
Q

Acute Myelocytic Leukemia

A

MC adult leukemia

very poor prognosis

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27
Q

Chronic myelocytic anemia

A

Middle age

Philedelpha chromosome present

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28
Q

Thrombocytopenia

A

decrease platelet count leading to hemorrhagic disorder

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29
Q

Idiopathic thrombocytopenia

A

MC in children after viral infection

Autoimmune disease

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30
Q

Thrombotic thrombocytopenia purpura

A

Small vessel damage leading to RBC damage
MC in young women
Poor prognosis

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31
Q

Intrinsic clotting time

A

22-35sec

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32
Q

extrinsic clotting time

A

11-13 sec factor VII

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33
Q

Hemophilia A

A

Sex linked recessive, female gives to male

Factor VIII-C deficient

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34
Q

Von willibrands Disease

A

MC hereditary coagulation disease

Absence of VIII-C and VIII-VWF

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35
Q

Vit K deficiency

A

Fat malabsorption leading to decrease in Vit K

Vit K activates clotting factor 2,7,9,10

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36
Q

Disseminated Intravascular Coagulation

A

Intravascular consumption of clotting factors (platelets, fibrinogen, factor 5&8)
Due to sepsis, snake bit, etc

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37
Q

Hodkins Lymphoma (Pel Ebstein Fever)

A

Presence of Reed Sternberg Cells (owl eye appearance)

Malignant lymphoma

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38
Q

lymphocytic predominant hodgkins lymphoma

A 
common in males <40
low prevalence (5%)
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39
Q

Nodular Sclerosing hodgkins lymphoma

A

MC type of hodgkins
MC in females
60% prevalence

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40
Q

Mixed Cellularity Hodgkins Lymphoma

A

2nd most common type

freq in men

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41
Q

Lymphatic Depletion hodgkins lymphoma

A

Men over 50

Fever, weight loss, night sweat

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42
Q

Non Hodgkins Lymphoma

A

No reed stern berg cells

Lymphodenopathy and hepatosplenomegaly

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43
Q

Nodular non hodgkins lymphoma

A

Nodular cells can infiltrate capsule

common in elderly, good prognosis

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44
Q

Diffuse non hodgkins lymphoma

A

lymph node is destroyed

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45
Q

Burkitts Lymphoma

A 
Non Hodgkins lymphoma
MC in african children/young adult
Related to Epstein Barr virus
Africans-effects mandible/maxilla
Americans- effects abdomen
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46
Q

Multiple Myeloma

A

MC malignant plasma cell disorder and malignancy of bone due to increase IgG
Affects bone secreting Osteoclasts

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47
Q

Bence Jones Proteins

A

found in Multiple myeloma

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48
Q

Multiple myeloma effects:

A

middle age to elderly people with bone pain

Neuropathy, myelopathy

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49
Q

GI Epithelium

A

Simple columnar non ciliated (except esophagus and anal canal

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50
Q

Lamina Propria

A

made up of connective tissue

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51
Q

musculosa

A

inner circular and outer longitudinal smooth muscle

52
Q

adventitia

A

CT and blood vessel

53
Q

Mixed parotid tumor

A

MC tumor of salivary gland
W>M
may affect facial nerve

54
Q

Peutz Jeghers syndrome

A

Autosomal dominant

Hard polyps in GIT with pigmentation around lips and oral mucosa

55
Q

Trachea Esophageal Fistula

A

Esophagus connected to trachea
MC congenital esophageal anomaly
leads to pneumonia and electrolyte balance issue

56
Q

Diverticulae

A

sac like protrusion of esophageal wall layers

57
Q

Pulsion Diverticulum

A

False diverticular formed by weak muscle

Signs-Dysphagia, regurgitation of food

58
Q

Zenkers Diverticulum

A

False or fusion diverticulum in upper esophagus
MC type of diverticulum
Leads to dysphagia and bad breath

59
Q

Traction Diverticulum

A

True Diverticula
At lever of tracheal bifurcation due to TB infection
3T’s - Traction, True, TB

60
Q

Achalasia

A

LES doesn’t relax due to neuromotor deficit

61
Q

3 abnormalities of achalasia

A

Aperistalsis, some or no relaxation of LES, Increase tone of LES

62
Q

Esophagitis

A

Inflammation, usually lower half

Can develop into Barretts esophagus

63
Q

Barretts esophagus

A

Precancerous to adenocarcinoma

Columnar metaplasia to squamous epithelium

64
Q

Benign Leiomyoma

A

Rare

65
Q

Malignant squamous cell carcinoma

A

95% of all esophageal cancers
Blacks>whites
Predisposition by smoking, alcohol, achalasia

66
Q

Adenocarcinoma

A

Arises from barrett esophagus

67
Q

Pyloric Stenosis

A

M>F
Congenital abnormality with unknown etiology
Projectile vomiting and palpable knot

68
Q

Hiatal Hernia

A

Stomach herniation thru esophageal hiatus or sal like dilatation

69
Q

Sliding hiatal hernia

A

MC type due to short esophagus sliding thru diaphragm

70
Q

Paraesophageal hiatal hernia

A

Gastric fundus rolls along esophagus thru hiatus into thorax

Can develop into barrette esophagus

71
Q

Acute Gastritis

A

Direct infection (salmonella,H.Pylori,Virus,alcohol,smoking)

72
Q

Chronic Gastritis

A

Achlorohydria destroying G cells due to old age and iron deficiency

73
Q

Chronic Atrophic gastritis

A

affects funds as in pernicious anemia (autoimmune against parietal cells)

74
Q

Peptic Ulcer

A

MC in first part of duodenum and lesser curvature of stomach
MC bacteria- H.Pylori
ANY AGE AFFECTED!

75
Q

Duodenal Ulcer

A

Pain relief by eating

76
Q

Gastric ulcer

A

pain increase by eating

77
Q

Benign Leiomyoma of stomach

A

MC benign tumor of GIT in stomach

78
Q

Hyperplastic Polyp

A

75-90% of all polyps-rarely malignant

79
Q

Adenomatous Polyps

A

20%- slight risk of adenocarcinoma with polyp

80
Q

Malignant Adenocarcinoma of Stomach

A

MC in lesser curvature and pyloric antrum
Increase incidence in Japan and Scandinavia
Predisposition- Genes, A blood type

81
Q

5 forms of adenocarcinoma of stomach

A
  1. Fungating- polypoid ulcerating mass
  2. Ulcerative-Indurated base
  3. Early carcinoma- not in deep tissue
  4. Polypoid- Polyp projecting into lumen
  5. Diffusely Infiltrated- causes Linitus Plastica (thickened fibrotic wall)
82
Q

Linitus plastica

A

caused by diffusely infiltrated form of adenocarcinoma of stomach

83
Q

Kruckenburg Tumor

A

adenocarcinoma of stomach spreading to ovaries via lymph

84
Q

Sentinel or Virchows node

A

Supraclavicular node metastasis via adenocarcinoma of stoamch

85
Q

Meckels Diverticulum

A

Persistance of omphalomesenteric duct
2-2-2
2in long, 2%incidence, 2ft from cecum

86
Q

Giardiasis (small intestine infection)

A

Most prevalent disease in US

Mainly in duodenum causing diarrhea, abdominal pain and anemia

87
Q

SI malabsorption

A

Increase excretion of fat due to vitamin deficiency, mineral deficiency, carbs and protein deficiency

88
Q

Celiac Sprue

A

Gluten Sensitivity leading to malabsorption
Autoimmune disease w/ AB against gluten
HLA-B8 relationship

89
Q

Tropical sprue

A

Malabsorption due to chronic infection w/ E. coli

90
Q

Whipples DIsease

A

Decreased lymphatic uptake of chyomicron in intestine
Less common than celiac sprue
Considered as infectious disease

91
Q

Intussussception

A

One segment of bowel telescoping into another

MC-terminal ileum into cecum

92
Q

Volvulus

A

Twisting of bowel around mesenteric root
MC-Sigmoid colon in elderly
MC- Cecum in young

93
Q

Benign Leiomyoma of SI

A

MC location-Jejunem

Can lead to intersussception or volvulus

94
Q

Cancer and Small intestine…

A

not common location

95
Q

Carcinoid tumor

A

40% of cases occur in appendix

Arise from enterochromaffin cells secreting serotonin

96
Q

Hirsch Sprungs Disease of Large intestine

A

Distended Colon

Increase incidence with down syndrome and chagas disease

97
Q

Hirsch Sprungs disease common location

A

90% in rectum due to lack of meissners plexus ganglion

98
Q

Pseudomembranous Colitis of large intestine

A

AB use causes overgrowth of norma flora creating infection (Ex: C. Diff)

99
Q

Crohns Disease

A

Idiopathic granulomatous inflammation of large intestine involving all layers

100
Q

Crohns disease incidence and location

A

MC in ileum and colon

Equal incidence in both sex, increase in jews

101
Q

Ulcerative colitis

A

Genetic Chronic ulcer inflammatory disease involving rectum and left colon
Causes mucosal ulceration

102
Q

Benign Adenomatous polyp

A

true neoplasm-more villous=more malignant

2 types: tubular adenoma and villous adenoma

103
Q

Tubular adenoma

A

75% of all neoplastic polyps

positive family Hx

104
Q

Villous adenoma

A

precancerous in rectum-large polyps

105
Q

Familial polyposis

A

100% malignancy

Autosomal dominant-develops at 10-20yoa

106
Q

Colorectal adenocarcinoma

A

MC cancer of colon

due to decrease fiber and increase fat

107
Q

Duke staging of colorectal cancer

A 
Stage A: Mucosa only
Stage B1: into muscle
B2: thru muscle, no node involvement
C1: Thru muscle, lymph node  involvement
C2: Thru entire wall, node involvement
D: Distant metastasis

A=Good
B=base invasion
C=carry to lymph
D=distant metastasis

108
Q

Gilberts Syndrome

A

Decreased UDPG transferase leading to hyperbilirubinemia and chronic jaundice
Hereditary

109
Q

Crigler Najjars Syndrome

A

hereditary Absence of glucuronide transferase enzyme->bilirubin encephalopathy->death

110
Q

Dubin-Johnsons Syndrome

A

congenital Hepatocyte defect causing decreased conjugated bilirubin excretion
-Black hepatocytes seen (melanin pigment)

111
Q

Rotors Syndrome

A

Simlar to Dubin Johnsons syndrome without melanin like look

112
Q

Liver Cirrhosis

A

Diffuse nodular fibrosis of liver with irreversible scarring tissue

113
Q

Alcoholic Cirrhosis

A

Liver fibrosis due to hepatocellular injury leading to hyperplasia
W>M

114
Q

Acute Alcoholic Liver

A

Reversible hepatomegaly

115
Q

Chronic Alcoholic liver

A

Irreversible fibrotic process leading to hepatic failure

Increase SGOT

116
Q

Vascular Cirrhosis

A

Hepatic vein thrombosis

painful enlarged liver

117
Q

Metabolic Cirrhosis-hemochromotosis

A

Idiopathic excess of hemosiderin (iron) in liver

118
Q

Metabolic Cirrhosis-Wilsons Syndrome

A

Hereditary excessive copper disease

Kayser Fleisher Ring

119
Q

Chronic Hepatitis Cirrhosis-HBV or HBC)

A

Persistant- Mild transaminases

Aggressive Hepatitis- Necrosis and fibrosis

120
Q

Viral Hepatitis

A

MC cause of liver cell necrosis
Hep A-40% of cases
Enlarged liver, jaundice
Increased AST and ALT

121
Q

Orally transmitted hapatitis

A

A and E

122
Q

Blood transfusion transmitted hepatitis

A

C and G

123
Q

Chronic hepatitis carrier

A

B and C

124
Q

Liver cell adenoma

A

Vascular tumor assoc. with oral contraceptives and anabolic steroids

125
Q

Malignant Hepatocellular Carcinoma

A

MC primary cancer
Males 40-60yrs old
Liver cirrhosis MCC
Increased AFT tumor marker

126
Q

Angiosarcoma of liver

A

Vascular tumors due to vinyl chloride, arsenic, and thorotrast

127
Q

Metastasis of Liver

A

MC type, more so than primary tumors

T4- Systemic Patho (10 decks)

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