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Flashcards in Final review Deck (230):
1

What does the word lentigo mean?

small, pigmented spots on skin with clearly defined edge surrounded my normal appearing skin

2

what is ment by the word nevus

nest, melanocytic nevi are nests of multi layered melanocytes found in moles.

3

what is a nevocellular nevi?

benign tumors of melanocyts that have sharp well defined edges stable in shape size and golor.

4

what is a dysplastic nevi?

Larger tumor of melanocytes that have irregular borders and pigment variation., changing in size, elevated and firm.

5

dysplastic nevus syndrome?

autosomal dominant conditions that give one and increased risk of melanoma

6

what can acanthosis nigricans be an indication of?

hyperinsuleniema associated with obesity or sometimes assiciated with a malignancy

7

what is seborrheic keratosis

stuck on keratin filled epidermal speudocysit

8

what is is called when you suddenly get a lot of seborrheic kerotosis lesions?

signs of leser-trelat, may indicate a underlying malignance

9

What is the test for Psorisis?

Auspits sign, scrape away scale and there is pinpoint bleeding

10

What is the test for Pemphigus?

Nikolskis sign, pressing on blister causes the edges to easily expand and its very breakable.

11

What causes pemphigus?

IgG between epidermal keratinocytes that cause blisters

12

bullae?

blisters

13

what can be a hallmark feature of pemphigus?

intraepidermal acanthosysis

14

what happens if you use steroids on tenia, fungal infections.

it will go away for a bit then come back with a vengance.

15

why does steroids not work on fungus?

because it decreases the immune system so the fungus can get a better foothold.

16

erythema multiforme?

Hypersensitivity to drugs or something, targoid lesions, bullae.

17

what is the most serious form of erythema multiforme?

stevens johnson syndrome, extensive involvement of skin and mucus membranes.

18

Erythema nodosom?

shins, 12-20 year olds, raised erythematous (red) painfull nodules of subcutaneous fat.

19

what is erythema nodosom sometimes associate with?

granulomatous diseases and strep, although most of the time there is no known cause, it goes away on its own eventually.

20

What layers are involved in Squamous cell carcinoma?

Keratinocytes invade down into the dermis, rarely metastasize.

21

what is indicative of keratocanthoma?

rapidly growing dome shaped nodules with a keratin filed center

22

what ususally will cure SCC?

complete excision

23

what is the most common tumor in the western world?

Basal cell carcinoma

24

how invasives is basal cell carcinoma?

locally invasive, arising from basal cells of hair follicles

25

what does basal cell carcinoma look like

pearly borders, papules.

26

what is the growth pattern of BSC?

invasive nests of basaloid cells with a palisading growth pattern

27

Pathology

study of the essential nature and charasteristic of disease, signs, symptoms, complications, patogenesis etc.

28

disease

impairment of the noamal states

29

homeostasis

maitenance of a harmonious environmet within body, cell, etc

30

comorbidity

property of disease that gives it a a specific virulence/sequelae

31

iatrogenic

doctor aquired disease

32

symptoms

subjective from patient view

33

signs

objective from doctors view

34

death

no pulse, heart sound or spontaneous respiration, no nucleus in most cells a cell either

35

sub-clinical

no signs or symptoms of infection because the immune system is keeping the infection down

36

illness

unhealthy condition of the body or mind (sickness/disease)

37

etiology

underlying cause of disease

38

pathogenesis

course that a disease takes from start to finish

39

Morphology

presence/conformation of damaged cells and tissues from the infection

40

functional disease

what happens when we know the disease exists but have not discovered any gross or microscopic morphologic changes yet.

41

syndrome

group of signs and symptoms that occur together and characterize a particular abnormality or condition.

42

Eosin

RED and PINK :stains cytoplasm, RBCs and collagen

43

Hematoxylin

BLUE and PURPLE : unclei, bacteria

44

what are the common causes of cell injury?

hypoxia, infections, immunologic reactions, congenital disorders, chemical injury, physical injory

45

what is the most common cause of cellular injury

hypoxia, inability to synthesize sufficient ATP by aerobic oxidation

46

How do infections cause injury?

direct infection, toxins and inflammatory responses of host

47

Vit A

squamous metaplasia, immune deficiency, night blindness

48

Cit C

scurvy

49

vit D

rickets, osteomalacia

50

Vit K

bleeding diathesis

51

Vit B12

megaloblastic anemia, neuropathy, spinal cord degeneration

52

Folate, B9

megaloblastic anemia, neural tube defects

53

Niacin, B3

pellagra, diarrhea, dermatitis dementia and death

54

when does cloudy swelling occur?

intracellular proteins accumulate in cytoplasm, the leaking is from hypoxia and cellular degeneration.

55

why does cloudy swelling occur?

cell is no longer able to maintain homeostasis of ionic and fluid balance. Lack of ATP shuts down necessary pumps,

56

where do free radicals come from?

oxygen derived, uv light, metabolism, inflammation, smoking, ionizing radiation, air polution

57

what does the release of cytocrome C causes?

triggers apoptosis

58

what releases cytocrome C and why?

Mitochondria when its disfunctional and cant make enough atp it becomes permeable.

59

what pumps fail in mitochondria causing and influx of Na/ water and efflux of K

Na/K ATPase pumps start to fail

60

pyknosis is what?

degeneration and condensation of necular chromatin

61

Karyorrhexis is what?

nuclear fragmentation,

62

karyolysis is?

dissolution of nucleus

63

what is the significance of anaplasia

cells divide rapidly but do not bear any resemblance to the normal cells, whether in structure or function.

64

What are the two chief findings of anaplasia?

brick like or random pattern, with dramatic increase of nuclear:cytoplasmic ratio.

65

Primay intentions closure

wound edges are close enough to meet and close, decreases scarring

66

Secondary intention closure

wound edges are far apart, so fills from bottom up with granulous tissue and fibrin

67

tertiary intention closure

keep would open to prevent infection etc so can close later

68

hypoplasia

defective formation or incomplete development of a part

69

agenesis iis what?

absence or failure of formation entirely

70

what is another name for primay stem cells?

labile

71

where are labile, primary stem cells found?

in epidermis, GI tract, etc, and are continuously dividing

72

Stable stem cells are what?

low replication but can be induced to divide

73

what stem cell type is found in hepatocytes, renal tubular epithelia, alveoli and pancreatic acini

stable stem cells

74

Where are permanent stem cells found?

don't ever divide, are found in nerve cells, cardiac and skeletal muscles.

75

what are the three stages of fracture healing?

procallous, fibrocartilaginous callous, osseus callous

76

procallous

hematoma to provide anchorage but w/o structureal integrity

77

fibrocartilaginous callous

fibrous ball around fracture

78

pathologic fractures

caused by disease sequale, like osteoporosis etc

79

traumatic fractures

cause by trauma

80

type of traumatic fractures?

transverse, linear, non-displaced, comminutes, greenstick, spiral, compound

81

communited fracture

bone broken into many pieces

82

Karyotype

number and visual appearance of the chromosomes in the cell nuclei of an organism or species

83

ideogram

schematic representation of chromosomes showing the relative size of the chromosomes and their banding patterns

84

P arm?

short arm

85

Q arm

long arm

86

how many pairs of autosomes

22 pairs of autosomes

87

how many total pairs of chromosomes

23 pairs total.

88

gene once ment what ?

only protein coding sequence of DNA

89

what is a gene now?

any functional unit of a chromosome outside medical circles.

90

what percent of genome is protein coding?

only about 5%

91

what is locus on chromosome?

exact physical location of a gene on a chromosome, it the same in all people

92

alleles?

used to describe the two or more possible variations of a gene within a population

93

genotype

combo of alleles, it?s the actual sequence

94

penotype

the physical reflection of genotype, presence or absence

95

what is a single nucleotide polymorphism, SNP?

DNA sequence variation of single nucleotide between members of a species or paired chromosomes.

96

where does SNPs occur more often

in non coding reions

97

Imprinting of X chromosome

Naturally occuring in females, X inactivation. Only one of the two X chromosomes will be active in cell.

98

Imprinting in general

some genes are only active when transmitted by specific sexed parent, so in the other partent its inactived.

99

when does imprinting of autosomal genes happen?

during gametogenesis and its maintained in somatic cells.

100

what are the 5 points of control for gene expression?

chromatin, transcriptional, translational, post transcript, translate

101

why would dna wrap around histones

DNA is negative and histones are positively charged.

102

where does histone methylation occur

at CpG islands, it ususally down regulates transcription

103

what does histone acetylation do?

up regulating of transcricption cuz it allow unwinding of DNA from histone.

104

what is promoter region?

CpG islands ususally, where the polymerase is told to sit down and get ready to copy

105

transudate

edema fluid with low protein content and low specific gravity, produces non pitting edema

106

exudates

fluid with high protein content and cells and a higher specific gravity

107

what are the three parts of virchows triad?

hypercoagulability, stasis and vascular wall injury

108

What causes hypercoaguability?

clotting disorders, oral contraceptives, malignancy, pregnancy sepsis

109

what causes stasis?

atrial fibrillation, immobility, venous obstruction, venous insufficency,

110

vascular wall injury?

trauma/surgery, venepuncture, heart valve disease, replcement, atherosclerosos, catherters.

111

embolism

moving clot in bloodstream that leaves site of orgin and it occludes vessel

112

what is thrombosis?

non moving clot in arteries, heart chambers, causings infarct, etc.

113

when do fat emboli happen?

bone fractures

114

most common thrombosis?

thromboemboli

115

gas emboli

decompression sickness

116

amniotic fluid emboli

labor complications

117

tumor emboli

bacteria, drug use

118

where do most pulmonary emboli arise from

deep vein thrombosis, diagnosed by spiral CT

119

what is the most common outcome from pulmonary emboli?

nothing, 75% are asymptomatic and go away on their own

120

newspaper test?

transeudate fluid is if you can read news paper through test tube of fluid

121

countries with highes HIV?

African, South africa, nigeria, kenya Mozambique and india

122

why do 10% of hemopheliacs not progress to AIDS

maybe they don't have CCR5 receptors

123

Acute phase of HIV

infection, reduced CD4 with viremia, seroconversion, mono, flulike symptoms

124

lantent phase HIV

lymphadenopathy, viral replication. Low virema, oppurtunistic infection, 10 years

125

what are the two neoplasms that are often seen in AIDS

hairy leukoplakia and kaposi sarcoma, then non hodgkin lymhoma

126

what labs to monitor HIV infection

CD4 count, and HIV1 RNA viral load via PCR

127

what is a mitotic body?

they are the dividing cells in a tissue

128

what do mitotic bodies tell you about cancer?

if there are more mitotic bodies than their should be for specific tissue then you would know tissue was dividing more rapidly and suspect cancer

129

where do sarcomas arise

muscles and connective tissue

130

how do sarcomas spread

blood stream

131

where do carcinomas arise?

epithelium

132

how do carcinomas spread?

lymphatic system

133

what is an adenocarcinoma?

glandular cancer

134

what cells are most sensitive to ionizing radiation?

cells in mitosis or the G2 phase, the are replicating their genome

135

does oma mean the cancer or not?

OMA means swelling or tumor, it doesn't indicate cancer one way or the other.

136

Ames test

detects mutagenic effect on DNA, doesn't show epigenetic changes

137

what cancer kills most males?

hepatocellular carcinoma

138

what cancer kills most females?

cervical cancer

139

when does cancer peak in first world?

80-84 years

140

MEN I

pitutary adenoma, parathyroid hyperplasia and pancreatic tumors.

141

MEN II

parathyroid hyperplasia, phenochromocytoma, medullary thyroid carcinoma.

142

MEN IIB

mucosal neuromas, marfinaoid body habitis, pheochromocytoma, meullary thyroid carcinoma,

143

what does MEN stand for?

multiple endocrine neoplasia, a familiar cancer syndrome

144

paraneoplastic syndrome

may serve as signal for neoplastic diagnosis, when neoplasm is causing a change but its something that isn't directly related to tumor growth, like suddenly you are super tired all the time, it may be hormonal

145

preneoplastic disorders

Acquired (hep B) - increase liklyhood of reaching a cancerous stage and corelate directly with cancer, HepB,

146

direct acting Initiatior is what?

direct acting chemical carcinogens that modify DNA to cause cancer,

147

Indirect initiatior is what?

chemical carcinogen gets altered by our body to become an active carcinogen

148

genotoxic mechanisms

employ DNA damage, chromosomal misentegration

149

non-genotoxic mechanisnm

Employ chronic irrication, cell death ROS , epigenetic to cause problems.

150

what does a person look for to find promoter region?

Promoter region alterations, these alterations have been found in all cancers that have been studies.

151

what type of solar radiation is most carcinogenic?

UVB

152

how does UVB cause cancer

produces dyrimidine dimers in DNA leading to transcritional errors and mutations of proto-oncogenes and tumor supressor genes.

153

what type of radaions used in hospital

ioniing ratiation

154

what is neutron radiation not used?

because governments have outlawed it because they don't want it used against them.

155

what are the three activities are protoonca genes involved in?

growth, cellular differentiation, gene regulation

156

gain of function

oncogenes, one hit process, create more active protein to stimulate cell cycle

157

loss of function

tumor supressors, two hit process, creates no active proteins , inhibits cell cycle

158

how do viruses cause cancer or tumors

by carrying in oncogenes or by incerting into a tumor supressor gene and breaking it.

159

why may two of the same cancers at same stage in two people progress different?

because at each cell divisions, mutations make each cancer different. They may have starteted the same but will continue to be even more different. So one may be hormone sensitive but the other wont

160

7 thing to make tumor be malignant

self sufficent, insufficient inhibitory signals, evade apoptosis, limitless replication, sustained angiogensis, ability to invade, and defects in DNA repair

161

what is the guardian of the genome?

P53

162

where does P53 work?

prevents cell with damaged DNA from entering the S phase.

163

Li-fraumeni syndrome?

germ line rotation of p53, it increases rates of tumors, childhood sarcomas leukemia, breast cancer

164

what two genes regulate apoptosis?

P53 promotes apoptosis and BCL-2 inhibits apoptosis

165

what is the limit of fine needle aspiration?

Does grading (histology) well, it cant determine staging (size, metastisist)it will show that there are cell changes but cant tell if its moved, can't determine stage

166

what is an abnormal vein growth

non fractal growth pattern, it looks evil and twisted.

167

name two nonoclonal antibodies?

CA-125 and CA 19-9

168

CA-125 non clonal antibody for what?

ovarian cancer

169

CA-19-9 non clonal antibody for what

pancreatic cancer

170

BRCA -1

brest cancer

171

tumor grading

more histological and not prognosis indicatior

172

tumor staging

T is size, N is lympnode spread, M is mestatic.

173

TNM is what?

degree of size, lymNode and metastasis, indicator of prognosis

174

grade 4 cancer means?

glands are fuses, no intervening stroma

175

Stage 4 cancer means

metastasis - spreading, poor prognosis

176

Genetic instability in tumor supression

malignant cells are more prone to mutate and accumulate additional defects without dying.

177

what does genetic instability mean for cancer reoccurance

there was a selective growth advantage for the new cancer, so will more resistance to treatment etc.

178

seeding

spread within the same cavity/chamber

179

transplantation

no clean margins, surgical insision could spread by indroducing cell toblood

180

sister mary joseph

discovered periumbical nodes correlated to pancreatic cancer

181

what three cancers like to move to brain

skin, breast and lung

182

what threee cancers like to move to bone

breast lung and prostate then kidney and thyroid

183

what causes osteoblastic lesions

prostate cancer - builds bumps on bone

184

What causes osteolytic lesions

renal and breast cancers - thins out bone

185

how could you test for metastasis to spine?

tuning fork

186

Induction treatment

only treatment, used for advanced disease or when no other treatment exhists

187

Neoadjuvant

chemo first, followed by another treatment

188

adjuvant

combination with other modality, given after other treatments are used.

189

salvage

hail mary, for those that fail to respond to initial chemo

190

what tumors are more sensitive to XRT (radiosensitive)

seminomas and lymphomas - because their cells have high turnover

191

what tumor cells are radio resistane

epithelial and carcomas, because they have a lower cell turnover

192

NCCN?

national comprehensive cancer network, shows staging and therapies for it.

193

bitter almonds

cyanide

194

friity

diabetic

195

garlic

organophosphates, arsenic, DMSO

196

mothballs

naphthalene, camphor

197

how often do patients with CO poisoning turn red

not very often but it does cause blood to be very red even though its not carrying oxygen

198

what poisoning often happens in conjunction with CO poisoning

cyanide poising because of the burning furniture in fires.

199

what is ment by heavy metals

metals or metalloids of environmental concern, denser than iron

200

Do radioisotopes bioconcentrate

yes, they do as they are eaten and move up the food chain.

201

before what date should things not have cesium?

before 1924

202

how can you increase toxicity of HG

methylate it and it becomes more water soluble and can cross the BBB.

203

what are the two main toxicities of mercury poisoning?

neruotoxicity (brain) and nephrotoxicity (kidney

204

is arsinic always poisonous?

no it can be in some species genome

205

what does acure arsenic poisoning cause?

CAN toxicity and hemorragic gastroenteritis

206

what does chronic arsenic cause

malaise, abdominal pain, skin changes, mees lines.

207

mees lines arsenic

horixontal white lines on nails

208

what do lead lines look like

they are not on nails they are at the gingivodental line

209

why is lead worse for children

CNS toxicity,

210

Pica

desire to eat dirt or ice, may be genetic condition

211

basophilic stippling?

seen with microcytic anemia in lead poisoning. Ribosome are spread showing small dots at periphery

212

why do those who start smoking at 30+ not get COPD

because they thart after epithelial transition ends at about 20. this also makes it so that cumulative effects take longer

213

what is the 20 pack year thing.

packs per day times years smoking. 20 = cancer in the othd view.

214

what illness can second hand smoke cause in children

sids, otitis media and asthma/URI

215

what is photochemical smog?

chemical reaction of sun, NO, and VOCs in atmosphere leading to ground level ozones and particles and aldehydes, Nos

216

what was in smog in 1905?

soot, and sulfer from burining coal

217

how is ozone formed?

in atmosphere when NO is broken by sun, and some os for osone.

218

why is silicosis the most common pneumoconiosis?

caused by inhalation of dust or pollutants in smok with silica

219

sillicoderosis

inhale dust and sillica, swelling of lungs

220

caplans syndrome

pneumoconiosis in combination with multiple pulmonary rheumatoid nodes found in rheumatoid arthritis.

221

silicates

adding another atom to silica to make mineral

222

silicon

chemical element, but almost always in combo with O2

223

silicone

polymer of silicone with C and O. solid liquid or gel

224

Pathogonomic

symptom/sign that is character of diesase, that will tell you a specific disease without a doubt

225

what is eggshell calcification

indicates silicosis on an xray, it is pathogonomonic

226

why does inhaling particles cause fibrosis?

magrophage igestion trigger frbrogenic respons via growth factors, promote collagen deposition

227

where do asbestose fibers localize

in septum of alveolus and distal lung.

228

what are asbestosed fibers in lungs cause

rod or dumbell shaped

229

cancer of asbestose

mesothelioma that involves lower lobes and pleura

230

asbestose exposure increases lung cancer by how much

5 times then 55 times if the ysmoke to.