Test49: Pathology Flashcards
Phosphate levels of chronic kidney disease? what does this do?
elevated phosphate levels
- bind calcium
Calcitriol
active form of Vitamin D
Elevated phosphate levels and FGF-23 do what do Calcitriol synthesis and PTH
- decreased calcitriol synthesis
- increase PTH synthesis
Elevated PTH can lead to what bone problem
osteitis fibrosa
Most common cardiomyopathy
dilated cardiomyopathy
Most common heritable bleeding disorder
- von Willebrand disease (vWD)
how is von Willebrand disease inherited
autosomal dominant with variable penetrance
what are 2 things prolonged in von Willebrand disease
PTT and leading time
2 functions of von Willebrand disease
- carrier protein for factor VIII
2. mediator of platelet adhesion
What does mitral regurgitation sound like? location
- blowing, holosystolic murmur
- cardiac apex with radiation to axilla
What can cause mitral regurgitation in underdeveloped countries
rheumatic heart disease
66 yr old man: dizziness, bilateral limb ataxia, mass in right lunch, cerebellar Purkinje cell degeneration
paraneopastic cerebellar degeneration
Most common antibodies in paraneoplastic cerebellar deneration
Abs against Hu, Yo, Tr, and P/Q
Small cell lung carcinoma can metastasize where
subacute cerebellar degeneration
Several months to years after brain infarction, the necrotic area looks like
cystic cavity surrounded by wall composed of dense fibers formed by astrocytic processes ( glial scar)
What happens to a patient during the first week after expire to M. tuberculosis
- intracellular bacterial proliferation
What allows M. tuberculosis to proliferate in bacterial cell
sulfatide virulence factor
Autosomal dominant Polycystic kidney disease are associated with other health probelms
- Berry aneurysms
- mitral valve prolapse
- benign hepatic cysts
rupture of Berry aneurysm results in
subarachnoid hemorrhage
Polycystic kidney disease, sudden onset severe headache, nuchal ridigity?
Subarachnoid hemorrhage
Dandy-Walker malformation
- hypoplasia/absence of cerebellar vermis
- cystic dilation of 4th ventricle
complication of Dandy-Walker malformation
- non-communicating hydrocephalus
Arnold-Chiari malformation
- downward displacement of cerebellar vermis and tonsils below foramen magnum
Where does Varicella zoster remain dormant
- dorsal root ganglia
histo for varicella zoster
- intranuclear inclusions in keratinocytes and multinucleate giant cells ( positive Tzank smear)
histo for dermatitis herpetiformis
neutrophils on tips of dermal papillae
Most important poor prognostic factor for post streptococcal glomerulonephritis
increased age
elevated creatine kinase is suggestive of what
myopathy
Patient is fatigued, weight gain myoedema ( focal mounding of muscle following percussion), elevated creatinine kinase ? what causes creatinine kinase increase
serum TSH
what makes up the uterine wall
- simple columnar epithelium
- tubular glands
- stroma
Most common site of endometriosis
ovary, pelvis, peritoneum
Normal epithelium of ovary
simple cuboidal cells
transient procoagulant/anticoagulant imbalance presenting at start of warfarin therapy is caused by
protein C deficiency
Meningococcal septicemia can cause bilateral hemorrhagic infarction of adrenal glands leading to
Waterhouse-Friderchsen syndrome
What is Waterhouse-Friderichsen syndrome
- adrenal insufficiency
- fever
- DIC
- shock
Which hepatitis increases risk for hepatocellular carcinoma
B and C
HBV or HBC integrates DNA in liver cell
HBV has revserve transcriptase
What does the liver do after HBV infection
regeneratie hyperplasia
and liver cell injury
HBV genes disrupts cell control cycle by
inactivating p53
Low-pitched, holosystolic murmur that accentuates during maneuvers that increase after load
ventricular septal defect
Right-sided colon cancers grow how? and present?
- exophytic masses
- occult leading and symptoms of iron deficiency anemai
left-sided colon grow how? causes?
- infiltrate intestinal wall and encircle the lumen
- constipation and symptoms of intestinal obstruction
What is Rectosigmoid involvement of colon cancer cause
hematochezia
constipation that alternates with diarrhea is characteristic of
irritable bowel syndrome
What is increased in serum for hemolytic-uremic syndrome
- lactate dehydrogenase
- unconjugated bilirubin
- BUN
- creatinine
Removal of excess cholesterol from body occurs 2 mechanisms
- excretion of free cholesterol into bile
2. conversion of cholesterol into bile acids
High levels of what increase cholesterol solubility and decrease risk of gallstones
- phosphatidylcholine and bile salts
pigment stones can arise from what condition
unconjugated bilirubin in bile
what can cause black pigment stones
- chronic hemolysis
- ileal disease
epigastric calcifications and history alcohol use ? consequences
chronic alcoholic pancreatitis
- malabsorption
pt has, fever, neurologic symptoms, renal failure, anemia, and thrombocytopenia in setting of GI illness
thrombocytopenia thrombotic purport-hemolytic uremic syndrome
TTP-HUS
Child with generalized edema, mild upper respiratory infection, proteinuria, low albumin
minimal change disease: effacement of podocytes
green discoloration of pus or sputum seen during common bacterial infection is due to
presence of myeloperoxidase
Most common renal malignanty
clear cell carcinoma
- arises from renal proximal tubular cells
cells in renal cell carcinoma
polygonal clear cells filled with accumulated lipids and carbohydrates
Name the mediators that attract neutrophils
- LTB4
- C5a
- IL8
- bacterial products
Familial retinoblastoma is associated with what other disease
osteosarcoma
Familial retinoblastoma occurs as a result of mutation of what
2 RB genes ( “two hits”)
Most common malignant brain tumor of childhood
medulloblastoma
patient with Down Syndrome, ataxia-telangiectasia and neurofibromatosis type1 has an increased risk of developing what
acute lymphoblastic leukemia
first sign of uncal herniation
fixed and dilated pupil on side of lesions
What nerve gets compressed in Transtentorial (uncal herniation)
CN III: oculomotor nerve
Translocationof CML
9:22
bcr-abl tyrosine kinase inhibitor
Most common lung cancer in nonsmoker
non small cell adenocarcinoma
how does shigella invade GI
- microfilm cells in ill peer patches through endocytosis
What kind of stool is passed with shigella
blood and mucus
Old patient becomes aggressive and periodic jerky movements of arms
Huntington’s disease
Huntington’s is loss of what neurotransmitter
GABA
MEN2 syndromes are caused by gremline mutations of what
RET proto-oncogene
enlarging thyroid with elevated calcitonin is what
medullary thyroid cancer
PE for medullary thyroid cancer
- marfanoid habitus
- mucosal neuromas
patient with weight loss despite normal increased food intake, polyuria, polydipsia, and fatigue
type 1 diabetes mellitus
fasting glucose for diabetes
greater than 126
calcium levels in blood and urine for calcium stones
- hypercalciuria ( urine)
- normacalcemic ( blood)
In diastolic heart failure is what is
- left ventricular ejection fraction
- end-diastolic volume
- increased LV filling pressures
- normal
- normal
- increased LV filling pressure
What is the most important determinant for prognosis for tetralogy of fallot
pulmonary stenosis
Symptoms for polymyositits
insidious onset of symmetric proximal muscle weakness affecting the upper and lower extremities
what antibodies are founding polymyositis
- anti-jo-1
- anti-Mi-2-antibodies
against histidyl-tRNA syntheses
Grave’s disease
- autoimmune response against TSH receptor
PE for grave’s disease
- pretibial myxedema
- exopthalmos
- periorbital edema
atherosclerotic plaque can get an endothelial damage and cause what
platelet aggregation/adhesion and release of PDGF
patient with hip pain, decreased range of motion, and underlying sickle cell disease
osteonecrosis
causes of osteonecrosis
CAST Bent LEGS
- Corticosteroids
- Alcoholsim
- Sickle Cell
- Trauma
- ” the bends”
- LEgg-Calve_perthes
- Gaucher disease
- slipped capital fermoral epiphysis
Epithelial ovarian cancer has elevated levels of what in serum
cancer antigen 125 (CA-125)
