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Chiro Essentials Pathology > Neoplasia, MSK and Cardiovascular Path > Flashcards

Neoplasia, MSK and Cardiovascular Path Flashcards

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1
Q

Burkitt’s vs Hodgkin’s lymphoma

A

Burkitt: starry-sky appearance, EBV (mosquito), MC in kids

Hodgkin’s: Reed-Sternberg cells (binucleated cells, owl eye appearance), MC in adults

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2
Q

Adrenal medulla tumor secretes excess nor-epinephrine and symptoms?

A

Pheochromocytoma: paroxysms of palpitations, perspiration, pressure headaches, VMA in urine

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3
Q

Mesenchymal, stromal, epithelial cell tumor of the kidney

A

Wilm’s - MC in kids

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4
Q

MC 1o bone cancer in adults

A

Multiple myeloma: malignant plasma cells in marrow, M spike (inc IgG), Bence Jones protein (urine), nocturnal bone pain, recurrent infections

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5
Q

MC 1o bone cancer in children and teens

A

Osteosarcoma: bones aroundknee joint - lower femur and upper tibia

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6
Q

What malignant bone tumor mimics osteomyelitis?

A

Ewing’s Sarcoma

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7
Q

MC benign smooth muscle tumor in uterus?

A

Uterine leiomyome (fibroid)

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8
Q 
4 Main Types of Leukemia - differentiate
Acute lymphoblastic
Acute myelogenous
Chronic myelogenous
Chronic lymphocytic
A

Acute lymphoblastic - <5 yrs
Acute myelogenous - 80% in adults, Auer rods+
Chronic myelogenous - 30-60 yrs, philadelphia chromosome (tranlocation Chromosome 9 to 22), anemia, bleeding, infxn
Chronic lymphocytic - >60, men, lymphadenopathy

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9
Q

BCR-abl

A

on philadelphia chromosome (CML)

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10
Q

N-MYC

A

neuroblastoma

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11
Q

L-MYC

A

Lung cancer

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12
Q

P16

A

Melanoma

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13
Q 
These chemical carcinogens cause what?
Nitrosamine
Asbestos
Benzene
Aflatoxin
A

Nitrosamine - esophageal cancer
Asbestos - mesothelioma
Benzene - leukemia
Aflatoxin - hepatocellular carcinoma

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14
Q

Thee radiation carcinogens cause what?
UV light
X-rays
Uranium

A

UV light - melanoma
X-rays - thyroid cancer
Uranium - lung cancer

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15
Q 
These microbial carcinogens cause what?
HPV 16/18
HHV 8
EBV
Hep B/C
A

HPV 16/18 - cervical cancer
HHV 8 - Kaposi sarcoma
EBV - Burkitt’s lymphoma
Hep B/C - hepatocellular carcinoma

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16
Q 
These tumor markers indicate what?
B-HCG
CEA
AFP
PSA
CA-125
S-100
Acanthosis nigricans
A 
B-HCG: choriocarcinoma
CEA: colon cancer
AFP: hepatocellular carcinoma
PSA: Prostate cancer
CA-125: ovarian cancer
S-100: melanoma
Acanthosis nigricans: adenocarcinoma, lung, breast, stomach cancer (obesity, diabetes)
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17
Q

MC Cancer prevalence vs death

A

Prevalence M - prostate, F breast, then lung then colorectal

Deaths: lung then prostate/breast then bowel

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18
Q

Cyanotic vs Acyanotic heart disease

A

Cyanotic: R-L shunt (Fallot’s tetralogy, Transposition of great vessels, persistent Truncus Arteriosus)
Acyanotic: L-R shund (VSD, ASD, PDA)

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19
Q

Fallot’s tetraology

A

Pulmonary STENOSIS, rt ventricular hypertrophy, overriding aorta, VD

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20
Q

Failure of ostium secundum to close?

A

ASD

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21
Q

MC congenital heart disease?

A

VSD

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22
Q

Rheumatic fever:

A

Post strep infxn, TIIHS
Aschoff bodies (granulomas w/Anitschkow giantcells), MacCallum patches (L atrium)
Jones major criteria: sydenham’s chorea, polyarthritis, erythema marginatum, carditis, subcutaneous nodules
MC damaged valve is mitral, then aortic rarely pulmonary or tricuspid

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23
Q

Endocarditis
Subacute bacterial:
Acute bacterial:
Libman-Sacks:

A

Endocarditis - Strep pyogenes/viridans, staph aureus
Subacute bacterial: infxn previous damaged valves (rheumatic fever) fever, new murmur, splinter hemorrhages, Olser’s nodes, Janeway nodules
Acute bacterial: infxn of previously healthy valved - IV drug users
Libman-Sacks: sterile endocarditis of mitral and tricuspid valves in SLE

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24
Q

Thrombus vs Embolism

A

Thrombus: clot in atheroscleroticvessel w/line of Zahn
Embolism: dislodged mass of undissolved material in vessel travelling in blood (arterial - painful, pale, pulseless, perishingly cold limb)

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25
Arterio vs Atherosclerosis
Arterio: thickening of A w/loss of elasticity and contractility due to infiltration of tunica intima by collagen and smooth muscle fibers Athero: lipid/calcium deposits in tunica intima, RF's arterial HTN, tobacco, hereditary, endocrine, sedentary, obese, male, age and S/S subendothelial fatty streaks, fibrosis, atheroma, rupture w/eventual occlusion or embolus formation
26
Ischemic Heart DIsease vs MI
IHD: coronary atherosclerosis --> Angina, MI, CHF MI: ischemic necrosi of myocardium due to blocked coronary A (L nt descending) pain not relieved by rest, release of cardiac enzymes (Troponin, CKMB, Lactic Dehydrogenase)
27
Angina Pectoris vs Prinzmetal
Pectoris: reversible inadequately perfused myocardium and pain aggravated by stress/exertion, relief w/rest Prinzmetal: occur at rest due to coronary A spasm
28
``` Aneuyrsm: Atherosclerotic Dissecting Syphilitic Berry ```
Aneuyrsm: localized dilation of A Atherosclerotic - MC AAA Dissecting - longitudinal intraluminal tearing of ascending T aorta (Marfan's, Ehlers-Danlos, long HTN) Syphilitic - 3o syphilis affects arch of aorta Berry - congenital weaknesses >30 yrs (Adult polycystic disease of the kidney, anterior circle of Willis, subarachnoid hemorrhage in YA, severe thunder clap HA, neck stiff, LoC)
29
HTN Essential 2o Malignant
HTN: elevation BP >140/90 3+ visits Essential: unknown, RF fam hx, lots of salt, stress, obesity 2o: unilateral renal A stenosis, hyperthyroidism, Cushing, pheochromocytoma Malignant: rapidly progressing, severe vascular damage, early death from stroke/HF
30
CHF causes and symptoms
Cause: CAD, HTN, valvular heart disease, congenital heart disease, cardiomyopathy Symptoms: dyspnea on exertion, basal crackles in lungs, paroxysmal nocturnaldyspnea, raised JVP, tender hepatomegaly, bilateral pitting ankle edema
31
Cardiomyopathy:
diseased myocardium, caused by alcohol, pregnancy, viral infxn (dilated, hypertrophic, restrictive)
32
Cor pulomale
Rt side heart failure due to COPD, pulmonary embolism
33
Cardiac tamponade:
Heart compressed due to excess fluid in pericardial sack | Beck's triad: hypotension, heart sounds distant, high jugular venous pressure
34
Peripheral Vascular disease:
``` Atherosclerotic narrowing of large A Intermittent claudication (leg pain worse on walking, relieved by rest ```
35
DVT vs PE
DVT: Virchow's triad (viscosity increased clotting, stasis in V from prolonged immobilization, damage to endothelium from vessel wall due to trauma) may be related to contraceptive pill, Factor V Leiden defect, may have painful swollen leg PE: DVT from leg/pelvis, embolus to IVC to heart to pulm trunk and occludes a pulmonary A/br causing ventilation/perfusion mismatch, SoB, pleuritic chest pain, hemoptysis
36
Varicose V vs Thrombophlebitis
Varicose: tortuous dilated superficial V may lead to Thrombophlebitis: inflammation of V wall, swollen tender superficial cord, may lead to thrombosis
37
Raynaud's disease vs phenomenon
Disease: dec BF triggered by cold/emotion (white, blue, red) in young females w/o cause Phenomenon: 2o to SLE, scleroderma, atherosclerosis, CREST syndrome
38
CREST syndrome
``` Calcinosis cutis Raynaud's phenomenon Esophageal dysfunction Sclerodactyly Telangiectasia ```
39
TIIIHS in medium sized A, 30% + for HepB | Symptoms
Polyarteritis Nodosa | fever, joint, ab pain, palpable purpura
40
Thromboangitis Obliterans/Buerger's
Idiopathic segmental inflammation of medium A/V in male smokers btw 20-40 with intermittend claudication and weakdisal pulses
41
Giant cell inflammation in small A | Symptoms
Temporal arteritis - raised ESR< elderly, ass w/polymyalgia rheumatica, can affect small A (br of ICA/vertebral A), can cause blindness
42
Takayasu's arteritis/Pulseless disease
Inflammation of aorta; possible autoimmune | MC Asian females <40 - absent pulses in upper limbs
43
Hemangioma:
benign BV tumor in skin/spine
44
Caused by HHV Type 8 in HIV/AIDS
Kaposi Sarcoma
45
Benign myxomatous tumor in fossa ovalis
Atrial myxoma
46
Osteomalacia vs Rickets
Osteomalacia: loss of bone quality + softening of bone, dec Vit D in adults, Looser's zones Rickets: loss of bone quality, dec Vit D in kids, bowlegs, rachitic rosary (swollen costochondral joints)
47
Osteitis fibros cystica cause and S/S
hyperparathyroidism | Brown bone cyst and hypercalcemia
48
Paget's disease/Osteitis Deformans cause in who?
Paramyxovirus infxn | Older ppl w/thickening of bones and deformities
49
Neuropathic joint disease: joint destruction b/c of loss of pain Cause and S/S
Charcot's joint Tabes dorsalis, DM, syringomyelia, leprosy Destruction, debris, deformity, disorganization of joint
50
Most common benign tumor of the hand
Enchondroma - expansile, benign, cartilage
51
Multiple enchondromas (MC hands)
Ollier's disease
52
Osteoma
Dense, mature bone island in skull/spine
53
Benign metaphyseal bone tumor extending into epiphysis
Giant cell tumor
54
Anuerysmal bone cyst
eccentric soap bubble x-ray appearance from diaphysis to metaphysis and blood-filled
55
Sunray appearance + Codman's triangle with periosteal elevation
Osteosarcoma/osteogenic sarcoma
56
3rd MC malignant bone tumor in men 30-60
Chondrosarcoma
57
RA everything you know! Show me what you got!
autoimmune bilateral small joint disease in HLA-DR3/4+ RF IgG ab in 70-80% of pt, joint inflamm characterized by pannus (inflamed granulation tissue in joint space destroying articular surface) and swan neck, ulnar deviation, boutonniere, Haygarth's node and Bouchard's nodes, Felty's syndrome (splenomegaly, neutropenia) Still's in kids at small/med joints (wrist, knee)with lymphadenopathy and splenomegaly
58
SLE what do you know??
ANA +, anti ds-DNA ab, HLA-DR3/4, MC in younger females, more severe in young black females, polyarthritis, butterfly rash, photosensitivity, nephrotic syndrome, Libman-Sack's endocarditis
59
Sjogren's syndrome symptoms seen in waht conditions? In who? antibodies to?
Xerophthalmia, xerostomia, arthritis RA, slceroderma Women btw 40-60 Ribonucleoproteins (SS-A/B)
60
Scleroderma: in who? types? S/S?
unknown multisystem autoimmune disorder F3:1, 50-60, limited or diffuse CREST: calcinosis, raynaud's phenomenon, esophageal hypomotility, sclerodactyly, telangiectasia, anti-centromere Ab
61
HLA-B27+ arthridities
Psoriatic: polyarhtritis w/silver-scales over extensors, pitted nails, dactylitis Enteropathic: UC/Crohn's related AS/Marie Strumpell's: SI and LBP, bamboo spine Reiter's: conjunctivities, urethritis, arthritis (joint/heel), caused by Chlamydia or Shigella infxn
62
OA you can do it if you really try!
DJD in weight-bearing joints (hips, knees, spine) in older females leading to joint space narrowing, subchondral sclerosis, osteophytes, Heberdens, bouchard's nodes
63
Gout or podagra or gonagra
hyperuricemia, males, alcohol, purine-rich foods, Acute gout severe 1st met-phalangeal joint pain Chronic: tophi (uric acid crystals in ear/skin over joins - need-shaped, negatively birefringent)
64
Borrelia Burgdorferi causes? | S/S?
Lyme disease - deer tick: ixodes scapularis | Polyarthritis, bulls-eye lesion (erythema migrans, Bell's palsy
65
Ach Receptor Ab in? Who gets it? S/S?
Myasthenia gravis 30+ females, >60 yr males, those with thymic hyperplasia or maybe a thymoma diplopia, ptosis problem chewing, fatigue, repetitive muscle use, +tensilon test
66
Antibodies to pre-synaptic voltage-gated calcium channels @neuromuscular junction Causes + epidemiology S/S?
Lambert-Eaton syndrome prevents ACH from being released by vesicles Small (oat) cell lung cancers, >60 yr males Weakness improve w/repetitive use, Tensilon test usually negative
67
Dermatomyositis what ya got?
unknown cause - autoimmune disorder, MC in F Heliotrope rash, Gottron's papules, ANA and anti-Jo-1 Ab 10% associated w/malignancy of lung, breast, guy, ovary
68
Peroneal muscular wasting, inability to evert foot, progressive hereditary N damage
Charcot-Marie-Tooth
69
AVN of head of femur in 4-10 yr olds
Legg-Calve-Perthes Disease
70
Possible traumatic Salter-Harris Type 1 epiphyseal fx in overweight children and teens
SCFE
71
Contracture of palmar fasica where ring and little finger bend to palm Associated with what conditions?
Dupuytren's contracture | DM, cirrhosis, long term use of phenytoin (anti-epilipetic)
72
Polymyalgia rheumatica - who gets it? S/S?
Females >50 pain and stiffnes in shoulder and hips, malaise, fever, associated w/temporal arteritis, can lead to blindness, highly elevated ESR w/normal CK

Chiro Essentials Pathology (4 decks)

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