test47: pathology Flashcards
child with serologic tests showing autoantibodies that react with tissue transglutaminase has?
Celiac disease
Celiac disease patients react to what? where does it come from
gliadin, product of gluten
What part the digestive tract does celiac disease hit
duodenum and jejunum
hydrogen breath tests for
lactose intolerance
Rectal suction biopsy is gold standard in diagnosing what
Hirschsprung disease or congenital aganglionic megacolon
Terminal ileum biospy is performed for what disease
Crohn disease
periodic acid-Schiff stain (PAS) stains for what
glycogen
PAS can be used to diagnose what
Whipple disease ( tropheryma whipple)
alkaline phosphatase is an enzyme marker of what
osteoblasts
pathophysiology for pemphigus vulgaris
- autoantibodies against desmosomes ( desmoglzins 1 and 3)
- disrupt intraepithelial cleavage
Nikolsky sign
new blisters may form with gentle traction or rubbing
Asboe-Hansen sign
bullae spread laterally when pressure is applied on top
Lowest pH of nephron is found where
distal tubules and collecting ducts
what precipitates uric acid crystals
low pH
what is tumor lysis syndrome
lysis of tumor cells cause intracellular ions, K, phosphorous and uric acid to join serum
prevention of tumor lysis
hydration and urine alkalinization
54 man: history of Hep C. vomiting red blood, abdominal distention, gynecomastia, repetitive flickering motion of hands, what causes altered mental status
increase load of nitrogenous substances absorbed by the gut
liver disease and Bun value and why
Decreased BUN b/c ammonia is not efficiently converted to urea.
Grave disease
hyperthyroidism
treatment for graves
radioactive iodine
how is iodine taken up into thyroid
- against concentration gradient via sodium-iodide symporter
- also transports perchlorate and pertechnetate
What exercises strengthen pelvic floor muscles and can improve symptoms of stress urinary incontinence
Kegel exercise
Levator ani and coccygeus
pelvic floor muscles
what can cause stress incontinence
increase intra-abdominal pressure
sciatica ( siatic nerve compression) presents hoq
low back pain radiating down on one side of the hip to the leg, without urinary incontinence
how do uremic toxins in blood impact platelets? causes? txt?
- qualitative platelet disorder
- prolonged bleeding time
- dialysis
patient with excessive bleeding around catheter exit site to start dialysis what what PT, PTT, platelet count, and bleeding time
everything normal except bleeding time is increased
abnormal myelocyte precursors contain what in cell
aurer rod: coarse rod shaped intracytoplasmic granules
myelocyte precursor cells are founding what
acute myelogenous leukemia
What is the M3 variant for AML
acute promyelocytic leukemia
translocation for acute promyelocytic leukemia
t (15;17)
17: retinoid acid receptor alpha
15: promyelocytic leukemia
t(8:14)
Burkitt lymphoma
8: c-myc
14: Ig heavy chain
t(11;14)
mantle cell lymphoma
older women with intermittent abdominal pain and cholesterol-containing mass lodged at ileocecal valve has what
gallstone ileus
how does gallstone ileum erode insetting lumen
cholecystoenteric fistula
what are signs of small bowel obstruction
abdominal distension
tenderness
high-pitched bowel sounds
pneumobilia? causes
air in biliary tree,
caused by fistula between gallbladder and GI tract
What is the main cause of acute cholecystitis
gallstone obstruction of cystic duct
what is the preferred initial imaging test for diagnosis of acute cholecystitis
ultrasound: wall thickening, pericholecystic fluid
- when not conclusive: nuclear medicine hepatobiliary scanning
explain hepatobiliary scan
radio tracer give IV
- taken up by hepatocytes
- excreted in bile
- gallbladder not visualized
pt with cardiogenic shock and evidence of watershed necrosis likely suffered from
hypoxic-ischemic encephalopathy
what part of the brain are most vulnerable to ischemic injury
pyramidal cells of hippocampus and purkinje cells of cerebellum
where is watershed zones of brain
- located at borders between areas perfused by anterior, middle, and posterior cerebral arteries
how do cortical watershed infarcts typically appear
bilateral wedge-shaped strips of necrosis over cerebral convexity, parallel and adjacent to longitudinal cerebral fissure
daytime somnloence, non restorative sleep and elevated blood pressure in the setting of underlying obesity, morning headaches suggest?
obstructive sleep apnea
complications of obstructive sleep apnea
- pulmonary hypertension, right heart failure, arrhythmias
abdominal pain and pancreatic calcifications suggest
chronic pancreatitis
low hemoglobin and elevated mean corpuscular volume is what type of anemia
macrocytic anemia
most common cause of chronic pancreatitis
ethanol
Folic acid synthesis what in RBC
thymidine
purine and pyrimidine bases
pancreatic insufficiency is associated with what vitrine
B12 deficiency
- pancreatic enzymes cleave R factor of B12, allowing binding to intrinsic factor
Libman-Sacks endocarditis occurs in who
Systemic lupus erythematosus
what is libeman-sacks endocarditis
small cardiac valvular vegetations on either side of value
- fibrotic valve thickening and deformity
68 caucsasion male: chewing difficulty, persistent headaches, tenderness over patient’s temples
giant cell arteritis