CIS things I missed Flashcards by Landon Riggs

What does an apoptotic body look like on H and E?

what is this a part of and what is the major hallmark?

brightly eosinophilic cytoplasm and condensed nucleus

chromatin condenations –> apoptosis

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What are the 4 reasons for apoptosis?

DNA damage

accumulation of misfiled proteins

cell death in infection

pathologic atrophy in parenchymal organs after duct obstruction

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what directly activates ignitor caspases?

FADD

Cytochrome C

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Another name for acid maltase?

what disease?

Lysosomal Glucosidase

Pompe

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what do you see on the CXR for pulmonary edema

white streaking

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why do women with testicular feminization syndrome need testicular surveillance?

they have normal testosterone and the testes have just not descended.. so they’re at a greater risk for cancer.

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What cytokines are found in acute inflammation?

what about chronic inflammation?

TNF, IL1, IL6, chemokines, IL-17

IL-17, IFN-gamma, IL-12

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What can help you figure out endocarditis?

what’s used to confirm DVTs?

stethoscope

Doppler ultrasound

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What increases the production of IFN-gamma and what produces it?

IL-12, dendritic cells and macrophages

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What do both 13 and 18 have that 21 does not? (2 things)

Rocker bottom feet

RENAL MALFORMATIONS

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Trisomy 21, what do they have an increased risk of having before the age of 20?

leukemia

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Increased levels of homocysteine increase the likelihood of what?

thrombus

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what makes it worse if someone has heparin induced thrombocytopenia?

more platelets, more heparin.

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What is the most important cause of primary amenorrhea?

Turner syndrome

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Pyloric Stenosis?

who is it more common in

what kind of disease process is it?

the pyloric sphincter is too thick so the kid has projectile vomiting

it’s 3-5x more common in males

complex multifactorial pattern

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in the question it says “elevated white count, high temp” what kind of inflammation are we looking at?

Acute

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What cytokines do T lymphocytes create and what is their role?

TNF –> stimulates expression of stuff, systemic inflammation

IL-17 –> recruitment of neutrophils and monocytes

IFN-gamma –> activation of macrophages

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What 3 things cause vasodilation?

histamine, prostaglandins (d and e and I), bradykinin

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main function of IL-1?

endothelial activation.

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What does fat emboli look like in the brain?

shower emboli

meaning everywhere

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If bleeding time is on the test, what do you do?

don’t pick it you idiot

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What is the EDS types for each? what are the corresponding gene defects?

Classic

Vascular

Kyphoscoliosis

Classic –> 1+2, COL5A1/2

4 –> COL3A1

6 –> Lysyl hydroxylase

Difference between Niemann Pick type A and B and Niemann Pick type C?

C = NPC1 –> cholesterol transport

A + B –> sphingomyelinase deficiency.

LXA4?

lipoxin A4 –> inhibits neutrophil recruitment and suppresses inflammation

What are the enzymes or protein deficiencies or genes with the following diseases: Marfan Duchenne Osteogenesis imperfecta Pompe Tay Sachs Hunters and Hurlers

Fibrillen 1 Dystrophen Collagen Acid Maltase Hexosaminadase A stuff degrading glycosaminoglycans

What is Cachexia and what is it related to?

state of weight loss and anorexia TNF --> regulates energy balance by promoting lipid and protein mobilization and by suppressing appetite.

What are the 5 things that cause increased vascular permeability?

histamine, serotonin C3A and C5A (by releasing stuff from mast cells) Leuktroienes (C,D,E)

All storage diseases are what genotype?

Autosomal recessive

What are the three possible things that signal for macrophages to eat them?

thrombospondin, C1Q, phosphatidylserine.

Why do we not use Coumadin right away for someone that is prothrombotic?

it inactivates C and S first, leaving someone being prothrombotic --> Coumadin induced skin necrosis --> massive thrombosis with necrosis and gangrene of limbs

What is the theory behind cleft lip? what are these called?

early amnion disruption --> streeter bands

CTL mediated apoptosis?

CTLs secrete perforin, and this releases serine proteases called granzymes

What's the difference between venous and arterial thrombus CLINICALLY for someone with an extremity clot.

Venous --> swollen or painful and warm Arterial --> CYANOTIC, NO PERIPHERAL PULSE. COLD

what disease process can present with cyclops, midline defects, two vessel umbilical cord, intestines outside of the body?

Trisomy 13 (patau)

When do we do a thrombin time?

when you're worried about fibrinogen

What is the outcome for most Turner syndrome babies?

1/4 miscarry in the first 2 months of pregnancy

Explain Female Pseudohermpahroditism? HOW? what can they present with too?

female who looks like a "fake male" --> because her body made too much adrenal androgens in the womb --> CONGENITAL ADRENAL HYPERPLASIA salt wasting due to the congenital adrenal hyperplasia

What do we care about for primary hypercoaguable disorders? what don't we look at?

Protein C, S, antithrombin short PT and PTT means nothing

What's to know about longevity and trisomy 18 and 13?

both usually die within a few weeks and months 18 dies around 18 months

What do you want to look at for a bleeding disorder? thrombotic disorder?

PT, aPTT, CBC, platelet function test genetic testing, APCR, endogenous anticoagulant levels

Congestion causes fluid to enter a space from what mechanism?

hydrostatic pressure only

What do you give an arterial clot RIGHT AWAY? why? what disease is this seen in? what kind of clot?

aspirin --> prevents platelet aggregation (antagonizing platelet function) CAD white

How do we know someone has an inherited disease from the question stem?

fam hx adopted normal person with onset at early age

Lipofuscin is associated with what? what about hemosiderin?

ROS mediated per oxidation of lipid membranes --> wear and tear hemorrhage or bruising.

What artery is most likely embolized by a red thrombus?

pulmonary artery

what are the 4 lysosomal storage diseases to know?

Tay-Sachs Nieman Pick Gaucher Mucopolysaccharidoses

Histologically what tells you it's leukocytosis?

you see band cells which are earlier forms of neutrophils

What are some examples of cardiogenic shock? hypovolemic shock? septic shock?

MI, arrhythmia, pulmonary embolism hemorrhage, vomiting, diarrhea microbial infections, superantigens.

Warburg effect?

increase in rate of glucose uptake and production of lactate

What does Phlebothrombosis mean?

venous thrombosis.

What are the enzymes associated with hunter and hurler?

Hurler --> a-1-iduronidase Hunter -->

What is the fundamental cause of necrotic cell death?

reduction in ATP levels. large groups of cells die

What arachidonic acid metabolites cause vasoconstriction?

Thromboxane A2, LTC4,D,E

What can cause a paradoxical embolism in the brain or other areas than normal?

a patent foramen ovale --> it causes it to go to the other side of the heart and then out systemically to wherever.