Test 42: Pathology Flashcards
Marfan is a defect in what
fibrillin-1
Chromosome 15
2 most common cardiac abnormalities seen in marfan are
- mitral valve prolapse
2. cystic medial degeneration of the aorta– aneurysmal dilation –> untreated - aortic dissection
Marfan syndrome and Homocystinuria have similar characteristics what separates them
Marfan: aortic root dilation
Homocystinuria: intellectual disability and thrombosis
Poor maternal glucose control leads to what
- Transplacental glucose
- baby beta cell hyperplasia
- hyperinsulinism
- Macrosomia
After delivery: baby hypoglycemia
diaphoresis
excessive sweating
Coagulative necrosis develops after what
ischemic injury
morphology of coagulative necrosis
- tissue architecture perserved
- cell anucleated
What causes liquefactive necrosis
- bacterial infections
- central nervous system infarcts
Fat necrosis is seen in what
acute pancreatitis
Caseous necrosis occurs with what
tuberculous infection
Morphology of caseous necrosis
- cheesy tan-white gross appearance
- granuloma
patient with ST-segmen elevation in Leads II, III, aVF.
tight squeezing in chest radiates down left arm
MI due to transmural ischemia of inferior wall of heart
Complete cardiac ischemia for greater than 30 min. shows up how in impacted heart
coagulative necrosis
ischemic cell death in CNV causes what
liquefactive necrosis
Left atrial pressure systolic pressure increase is associated with what heart valve problem
mitral regurgitation
- increase filling of left atrium during systole
pt 8 year old boy: right mandible mass, immigrated from East Africa, temp 98, lymphadenopthy
biopsy: diffuse infiltrate of lymphoid cells and numerous mitotic figures
Burkitt lymphoma
Burkitt lymphoma translocation
- c-Myc oncogene on long arm of chromosome 8
- Ig heavy chain region on chromosome 14
8:14
The product of c-myc is a nuclear phosphoprotien that function as
transcription activitor
histo for Burkitt lymphoma
“starry sky”
- sheets of lymphocytes with interspersed “tangible body” macrophages
translocation for follicular lymphoma
14:18
18: long arm near bcl2 gene
14: Ig heavy chain
translocation for mantle cell lymphoma
11:14
11: cycline D1
14: Ig heavy chain
Translocation for Chronic myelogenous leukemia
Philadelphia chromosome 9:22
BCR-ABL
Regurgitant blood flow from aorta into left ventricle in chronic aortic regurgitation leads to what
increase preload, wall stress
-result with eccentric hypertrophy, increase stroke volume
genetics for hypertrophic cardiomyopathy
autosomal dominant
- mutation in sarcomere gene
- Beta-myosin heavy chain and myosin-binding protein C
How do coagulopathies present
deep-tissue leading in joints, muscles, and subcutaneous tissue
how do platelet defects present
mucocutaneous bleeding
Von Willebrand Disease how does it impact the coagulation cascade
acts to carry/protect factor VIII
Halitosis
foul breath
Periodic, simultaneous, and non-peristaltic contractions of the esophagus due to impaired inhibitory innervation within the esophageal myenteric plexus
diffuse esophageal spasm
pt with memory loss of recent events, loss of executive dysfunction and visuospatial impairment
Alzheimer dementia
histo for Alzheimer
Amyloid plaques (neuritic senile plaques) neurofibrillary tangles
Large intracytoplasmic vacuoles, sometimes described as spongiform is seen in what
Creutzfeldt-Jakob disease
presentation for Lewy body
- attention deficit
- visual hallucinations
- spontaneous parkinsonism
What is seen in multiple lacunar infarcts
vascular dementia
what is the difference between vascular dementia and Alzheimer dementia
vascular dementia: step-wise rather than gradual decline in cognitive function
- also focal neurologic deficits
What is manometry for achalasia
- normal contraction of upper esophageal sphincter
- decreased amplitude of peristalsis mid esophagus
- incomplete relaxation at LES
what happens when Cricopharyngeal dysfunction
failure to relax during swallowing and cause a choking or “food-sticking” sensation on swallowing
Most common congenital heart defect
bicuspid aortic valve
bicuspid aortic valve causes what
atherosclerosis and calcification of aortic valve
- lead to aortic stenosis in greater than 50%
common cause of superior vena cava syndrome
- lung cancer, followed by non-Hodgkin lymphoma
- mediastinal mass
Small cell lung carcinoma is associated with what other disease
Cushing syndrome and syndrome of inappropriate antidiuretic hormone secretion
34 yr old women: dizziness, mild confusion over last week. history of seizures recently started carbamazepine, temp 98, low sodium concentration ? what does she have and why
Inappropriate antidiuretic hormone secretion, SIADH
- carbamazepine
What protein do ADH and oxytocin have? function
neurophysins
- postranslational hormone processing and stabilization during axonal transport
In what nuclei of the hypothalamus does vasopressin and oxytocin come from
ADH: supraoptic nuclei
oxytocin: paraventricular
Most common pediatric malignancy leukemia is
acute lymphoblastic leukemia ALL
8yr old boy: fever, throat pain, severe dyspnea, tachypnea, inspiratory stridor, hematopoietic cells (blasts)
ALL
acute lymphoblastic leukemia
- b/c throat pain = mediastinal mass which compresses the esophagus and trachea and block SVC ( superior vena cava) = T-cell ALL
what is lymphangiosarcoma
rare malignant neoplasm of the endothelial lining of lymphatic channels
when do you see a patient getting lymphangiosarcoma
10 years following radical mastectomy for breast cancer
Persistent lymphedema predisposes to the development of what
lymphangiosarcoma
what is lymphangiosarcoma
rare malignant neoplasm of endothelial lining of lymphatic channels
What can secrete beta-hCG
- placenta
- Choriocarcinoma - testicular germ cell tumor
compare the structure of Beta-hCG
alpha subunit: TSH, LH FSH similar
beta subunit: TSH similar
28 yr old man: panels scrotal mass, increased sweating and heat intolerance , enlarged contender right testicle, increased T4 and T3
increased B-hCG with testicular germ cell tumor
hematemesis
vomiting blood
what does portal vein thrombosis cause
portal hypertension
splenomegaly
varicosities at portocaval anastomoses ( lower esophagus)
What is the gene mutation sequence for colorectal cancer
APC
K-ras
p53 and DCC
role of K-ras
apoptosis
treatment for Gardnerella vaginalis
clindamycin or metronidazole
