Extra Q Flashcards
1
Q
Example for Dysplasia
A
Cervical Intraepithelial Neoplasia
2
Q
Edema=
A
Increased in interstitial fluid
3
Q
Virchow’s triad
A
Hypercuagulability
Endothelail injury
Stasis
4
Q
Inflammation that causes blood clot to block a vein=
A
Thrombophlebitis
5
Q
Systemic HTN= ______ mmHg
A
> 140/90mmHg
6
Q
Etiology of primary HTN
A
95% unknown
7
Q
Common cause of secondary HTN
A
Renal artery stenosis
8
Q
How does Renal artery stenosis leads to HTN
A
Stenosis decreases blood flow to glomeruli
Renin secretion
AT-2 raises BP
Release of Aldos.
9
Q
Commonly afected by atherosclerosis
A
Abdominal aorta
Coronary a
Internal carotid
Popliteal
10
Q
Complication of atherosclerosis 4
A
Stenosis
Thrombosis
Enbolism
Weakening and aneurysm
11
Q
Arteriolosclerosis is devided into 2
A
Hyaline
Htperplastic
12
Q
Htperplastic Arteriolosclerosis=
A
Thickening of vessel wall by hyperplasia of SMC
13
Q
Calcification of the media of muscular vessels is called
A
Monckeberg medial sclerosis
14
Q
Aortic dissection=
A
Intimal tear with dissection of blood through media of the aortic wall
15
Q
In Polyarteritis Nodosa what types of lesions are present?
A
Lesions of varying stages are present.
16
Q
What is the treatment for Kawasaki disease?
A
Aspirin
17
Q
Polyarteritis Nodosa classic presentation
A
HTN in young adults
18
Q
How does the early lesion of Polyarteritis Nodosa appear on imaging?
A
String on pearls
19
Q
Buerger disease treatment
A
Stop smoking
20
Q
What is Churg-Strauss Syndrome?
A
Necrotizing granulomatous inflammation with eosinophils involving multiple organs, especially lungs and heart
Asthma!!
21
Q
In which vasculitis can we find eosinophilia?
A
Churg-Strauss Syndrome
22
Q
In Kawasaki disease involvement of what is common and what does this usually lead to?
A
MI
ילד שנוסע על אופנוע זה באח יגרום לאמא שלו לחטוף התקף לבב
23
Q
What is Henoch-Schönlein Purpura?
A
Vasculitis due to IgA immune complex deposition
24
Q
What are fatty streaks?
A
flat yellow lesions of the intima consisting of lipid-laden macrophages
25
How can HTN lead to aortic dissection?
Hypertension results in hyaline arteriosclerosis of the vasa vasorum; decreased flow causes atrophy of the media.
26
What is hyperplasia driven by?
| Breast during pregnancy
estrogen and progesterone produced by the corpus luteum
27
Inflammation of the breat (4)
Acute mastitis, periductal mastitis, mammary duct ectasia, fat necrosis
28
Breast fibrocystic change will present as what in physical exam?
Lumpy breast
29
For what type of fibrocystic change is there no increased risk for carcinoma?
Fibrosis, cysts, and apocrine metaplasia
30
For what type of fibrocystic change is there 2x increased risk for carcinoma?
Ductal hyperplasia and sclerosing adenosis
31
For what type of fibrocystic change is there 5x increased risk for carcinoma?
Atypical hyperplasia
32
What is phyllodes tumor?
Fibroadenoma-like tumor with overgrowth of the fibrous component
33
biopsy of phyllodes tumor histo features?
Leaf like structure
34
What are the histologic subtypes of DCIS based on?
architecture; comedo type is characterized by high-grade cells with necrosis and dystrophic calcification in the center of ducts
35
Breast cancer
```
DCIS
Invasive ductal carcinoma
Lobular Carcinoma In Situ
Invasive lobular carcinoma
Hereditary breast cancer
```
36
Subtypes of Invasive ductal carcinoma
Tubular
Mucinus
Medullary
Inflammatory
37
Which cancer is the most common invasive cancer of the breast?
Invasive ductal carcinoma
38
What is the most important predictive factor for breast cancer?
estrogen receptor (ER), progesterone receptor (PR), and HER2/neu gene amplification (overexpression) status
39
Antiestrogenic agent=
Temoxifen
40
What is HER2/neu?
Growth factor-R present on the cell surface
41
Common screening methods include
1. Pap smear 2. Mammography 3. PSA and DRE 4. Hemoccult test and colonoscopy
42
Categories of oncogenes include
growth factors, growth factor receptors, signal transducers, nuclear regulators, and cell cycle regulators
43
Nitrosamines
Where are they found and what cancer they produce?
Stomach carcinoma, Found in smoked foods, responsible for high rate of stomach carcinoma in japan
44
Naplithylamine
Where are they found and what cancer they produce?
Urothelial carcinoma of bladder. Derived from cigarette smoke
45
The cyclin D / CDK4 complex does what?
phosphorylates the retinoblastoma protein, which promotes progression through the G-S checkpoint
46
RET
Neural growth factor receptor, Point mutation MEN 2A, MEN 2B and sporadic medullary carcinoma of thyroid
47
RET
Neural growth factor receptor, Point mutation MEN 2A, MEN 2B and sporadic medullary carcinoma of thyroid
48
How does p53 induce apoptosis?
upregulates BAX, which disrupts Bcl2 leading to cytochrome c leaks from the mitochondria activating apoptosis
49
p53 Germline mutation results in
Li-Fraumani syndrome
50
Hematogenous spread is characteristic of what?
sarcomas and some carcinomas
51
What are some examples of hematogenous spread?
renal cell carcinoma, hepatocellular carcinoma, follicular carcimoma of the thyroid, choriocarcinoma
52
What is the target cell type for the immunohistochemical stain of chromogranin?
neuroendocrine cells (small cell carcinoma of lung and carcinoid tumors)
53
What is the target cell type for the immunohistochemical stain of S-100?
Melanoma
Schwannomas
Neurofibromas
54
What is aspirin-intolerant asthma characterized by?
the triad of asthma, aspirin induced bronchospasms, and nasal polyps
55
What is usually the difference between papillomas in adults children?
Single in adults
| Multiple in children
56
What are the risk factors for laryngeal carcinoma?
Alcohol
Smoking
Rarely laryngeal papilloma
57
laryngeal carcinoma cancer type
Squamous cell carcinoma
58
What are the most common causes for lobar pneumonia?
Strep. Pneumo
| Klebsiella
59
What are the classic gross phases of lobar pneumonia? (4)
Congestion
Red hepatization
Grey hepatization
Rezolution
60
What are the causes of bronchopneumonia?
Staphylococcus aureus, haemophilus influenzae, Pseudomonas aeruginosa, Moraxella calarrhalis, Legionella pnemnophila
61
What does aspiration pneumonia classically result in?
Right lower lobe abscess
62
What does primary TB result in?
focal, caseating necrosis in the lower lobe of the lung and hilar lymph nodes that undergoes fibrosis and calcification, forming a Ghon complex
63
What does biopsy in secondary TB reveal?
caseating granulomas, AFB stain reveals acid-fast bacilli
64
What does chronic bronchitis lead to?
increased thickness of mucus glands relative to overall bronchial wall thickness (Reid index increases to > 50%; normal is < 40%)
65
What does inflammation in the lung normally lead to?
release of proteases by neutrophils and macrophages.
66
What are the clinical features of emphysema?
1. Dyspnea and cough with minimal sputum 2. Prolonged expiration with pursed lips (pink-pu lier) 3. Weight loss 4. Increased anterior-posterior diameter of chest (barrel-chest) 5. Hypoxemia and cor pulmonale (late complications)
67
HSN I
```
**Soluble Ag
Ag cross linked IgE on mast cell
Degranulation
Histamine release
Chemokines
Inflammation
```
68
HSN I examples
Allergic asthma
| Anaphylaxis
69
HSN II
Bound Ag
IgG or IgM binds cell surface Ag
Cell is opsonized and phagocytosed
NK killing or complement
70
HSN II examples
Rheumatic fever
MG
Graves disease
Transfusion reaction
71
HSN III
Ab-Ag complex activates complement
| Attracts Neut.
72
HSN III examples
SLE
Polyarthritis nodosa
PSGN
73
HSN IV
CD8 T cell kill target cells
74
HSN IV examples 4T's
T cells
Transplant rejection
TB skin test
Touching (contact dermatitis)
75
SLE is type __ HSN
III
| and also II
76
SLE is associated with what deficiency?
Early complement proteins
77
Early complement proteins deficiency in SLE will cause
Decreased clearance of Ab-Ag complex
78
SLE symp mnemonic
RASH ON PAIN
```
Rash
Arthritis
Serositis
Hematologic
Oral ulcers
Renal disease
Photosensativity
ANA Ab
Immunologic disorders
Neurologic
```
79
SLE causes what heart problem
Libman Sacks endocarditis
| Nonbacterial
80
Whic Ab can we find in Sjorgen syndrome
Anti-Ro
| Anti-La
81
Sjorgen syndrome=
Autoimmune disorder charact. by destruction of exocrine glands by lymphocytic infiltrates
Lacrimal and salivary
סג'ורגן וואלה מייבש את הפה רק לומר את השם הזה
82
Rejection to allografts is a response mainly to ___ molecules
MHC
83
What are the types of rejection (4)
Hyperacute
Acute cellular rejection
Acute humoral rejection
Chronic rejection
84
Hyperacute rejection=
Host Ab binds graft endotheliun
Thrombosis
Ischemic damage
85
Acute cellular rejection=
T cell destroy graft parenchyma by cytotoxicity
86
Acute humoral rejection=
Ab damage the graft vasculature
87
Chronic rejection=
Arteriosclerosis by proliferation of SMC
88
What leads to loss of contact inhibition in neoplasia?
Loss of E-cadherin
89
Children cancer incidence
Leukemia
CNS
Neuroblastoma
90
Four Carcinomas Rout Hematogenously
Follicular thyroid carcinoma
Choriocarcinoma
Renal cell carcinoma
Hepatocellular carcinoma
91
Cancer that metastesize to Bone
```
Prostate
Breast
Kidney
Thyroid
Lung
```
92
Oncogenes require how many alleles to be damages?
One is enough
93
Oncogenes example
HER2/neu
JAK2
BCR-ABL
BCL-2
94
BCL-2 is an
Antiapoptotic molecule
95
BCL-2 in what cancers?
Follicular and diffused large B Cell Lymphoma (BCL)
96
EGFR mutation can appear in which cancers?
Lung adenocarcinoma
| Epit. tumr of head and neck
97
Tumor suppressor genes example
APC
BRCA1/BRCA2
Rb
P53
98
Mutation in APC leads to
Colorectal cancer
99
Job of Rb
Inhibits E2F
| Blocks G1->S phase
100
Mutation in Rb leads to
Retinoblastoma
| Osteosarcoma
101
Mutation in P53 appears in most cncer but give examples
Li Fraumeni synd.: Sarcoma Breast Leukemia Adrenal gland
102
Hereditary cancer syndromes (4)
```
Familial Adenomatous Polyposis
Lynch
Li-Fraumeni
Von-Hipple Lindau
MEN
```
103
Familial Adenomatous Polyposis is due to
AD APC mutation
104
Lynch synd. is also known as
Hereditary Nonpolyposis Colorecta Carcinoma
105
Lynch syndrome is due to
Inherited mutation in DNA mismatch repair enzymes
עשו לינץ' לאנזים שמתקן
106
Li-Fraumeni synd is due to
P53 mutation
107
VHL is due to
Abnormal growth of blood vessels due to VHL mutation
108
VHL symp
Most commonly renal cell carcinoma
109
MEN1-
Pituitary tumors
Pancreatic endocrine tumors
Parathyroid adenomas
110
MEN2A-
Parathyroid hyperplasia
Medullary thyroid carcinoma
Pheochromocytoma
111
MEN2B-
Medullary thyroid carcinoma
| Pheochromocytoma
112
Zollinger Ellison syndrome
Gastrin secreting tumor
113
Define what happens in nephritic syndrome
Glomerular inflammation->GBM damage->Loss off RBC into urine->hematuria
114
Define what happens in nephrotic syndrome
Podocytes damage->Impaired charge barrier->proteinuria
115
What is pneumoconioses?
Interstitial fibrosis due to occupational exposure
116
What is sarcoidosis?
Systemic disease characterized by noncaseating granulomas in multiple organs
117
What happens in acute respiratory distress syndrome?
Leakage of protein-rich fluid leads to edema and formation of hyaline membranes in alveoli
118
Why is acute respiratory distress syndrome secondary to so many diseases?
Activation of neutrophils induces protease-mediated and free radical damage of type 1 and II pneumocytes.
119
What does surfactant do?
decreases surface tension in the lung, preventing collapse of alveolar air sacs after expiration
120
Why is neonatal respiratory distress syndrome associated with maternal diabetes?
Insulin decreases surfactant production
121
For lung cancer what are are particularly mutagenic? (from cigarrete)
Polycyclic aromatic hydrocarbons and arsenic
122
Precents of small cell carcinoma of lung
| Surgery or chemo?
15% of lung cancer
| Chemo
123
What are the subtypes of non-small cell carcinoma?
Adenocarcinoma 40%
Squamous cell carcinoma 30%
Large cell carcinoma
Carcinoid
124
unique site of distant metastasis is the ____ in lung cancer
Adrenal gland.
125
What is the characteristic histology for small cell carcinoma?
Poorly differentiated small cells; arises from neuroendocrine (Kulchitsky) cells
126
What is the characteristic histology for Carcinoid tumor?
| They are positive to
Well differentiated neuroendocrine cells; chromogranins positive
127
What are psammoma bodies
Round collection of calcium
128
What are the inflammatory dermatoses? (5)
```
Contact dermatitis
Atopyc dermatitis
Psoriasis
Acne vulgaris
Lichen planus
```
129
Atopyc dermatitis
Pruritic, erythematous, oozing rash with vesicles and edema; often involves the face and flexor surfaces
130
What is psoriasis due to
Excesss keratin
131
Epidermal hyperplasia is also called
Acanthosis
132
Blistering dermatoses (4)
Pemphigus vulgaris
Bollous pemphigoid
Dermatitis herpatiformis
Erythema multiforme
133
Dermatitis herpatiformis=
IgA deposition on the tip of papillae
134
Skin epithelial tumors
Seborrheic keratosis
Basal cell carcinoma
Squamous cell carcinoma
135
Everything about seborrheic keratosis
Benign
Elderly
Raised discolored plaques
Keratin pseudocyst
136
Most common cutaneous malignancy
Basal cell carcinoma
137
Basal cell carcinoma skin histo
Nodules of basal cells with peripheral palisading
138
Most common type of melanoma
Superficial spreading
139
Phases of wound healing
Inflammatory- PLT,MPH,Neut.
Proliferative- Fibro,myo,endoth,kerati,MPH
Remodeling- Fibroblasts
140
Repair=
Replacement of damaged tissue with fibrous scar
| When regenerative cells are lost
141
Inflammation types
Serous- watery, skin blister
Fibrinous- fibrin, pericarditis
Purulent- pus, abscesses
142
Granulomatous inflamation
Type of chronic infl.
Activated MPH
Lymphocytes
143
DiGeorge syndrome
Thymic hypopasia
Deficient T cell maturtion
Volunarble
144
Polycythema Vera
Neoplastic proliferation of mature myeloid cells
Especially RBC
JAK2 mutation
Hyperviscosity
145
Essential thrombocythemia
Neoplastic proliferation of mature myeloid cells
Especially PLT
JAK2 mutation
High risk for thrombosis
146
Decrease number of Neut.
Neutropenia
147
Multiple myeloma=
```
Overproduction of IgG
CRAB clinical features
HyperCalcemia
Renal involvenet
Anemia
Bone lesions
```
148
Special feature of megaloblastic anemia
Hypersegmented neutrophils
149
GIST
GastroIntestinal Stromal Tumor
Mesenchymal neoplasm
Arise from smooth muscle pacemaker cells of Cajal
KIT gene
