Pathalogical Diseases Flashcards

Question

a patient with RA, develops **subcutaneous lumps** on the extensor aspect of her forearms. What are these lumps and how do they appear microscopically?

Answer 1

**Rheumatoid nodules** is a local swelling or tissue lump, usually rather firm to touch, like an unripe fruit. Fibrin necrosis in the middle, surrounded by granuloma formation.

Answer 2

**Xiehl-neelsen stain** to stain micro bacterium for suspecting TB. (Mycobacteria dont stain cause they don't have cell wall. ) ACE\>\> higher in sarcoidosis

Answer 3

Foreign body giant cell\>\> nulcei scattered

Answer 4

TB in vertebrae.

Answer 5

is a **vaccine** against TB that is prepared

Answer 6

TB nodes in cervical region.

Answer 7

\* Acid fast- retains stains even on treatment with mixture of acid and alcohol. \* Mantoux test– a screening test for TB. It is a delayed hypersensitivity

Answer 8

Ghon focus can be reactivated and spread to the lung. immune sytem memory T cells releases cytokines to try to control the new outbreak, which forms more areas of caseous necrosis which **cavitates**\> this allows the bacteria to dissaminate\> or spread throughout the lungs\> bronchopneumonia it can also spread via the vascular tissue and effect other tissues in the body!

Answer 9

- inherited disorder - procollagen doesn't convert to **_tropocollagen_** - Type 3\> Three ED 1) Skin- **hyperextensible**, thin, fragile & susceptible to injury 2) Joints – **hypermobile,** predisposition to joint dislocation \*\*Because the collagen in internal organs is also affected patients can suffer from rupture of the colon and, in some forms, large arteries. Corneal rupture and retinal detachment can also be seen.

Answer 10

vitamen C deficiency \> procollagen can't do hydroxylation in ER \> reduced cross- linking and defective helix formation \> ppl unable to heal wounds 3adl\>tendacy to BLEED - bleeding gums - loss of tooth ppl had black bones when they died\> bc there was a lot of bleeding in ur bones!

Answer 11

**"brittle bone disease"** It results in bones that break easily. TYPE 1 COLLAGEN Patients have ***too little bone tissue (osteopenia)*** and hence extreme skeletal fragility. - **Blue sclera**\>due to decreased collagen in the sclera, making it translucent that permits visualisation of the underlying choroid - **Hearing loss**\> due to abnormality in bone formation in ears - **Dental imperfections** **-multiple fractures** *(may be confused with child abuse)*

Answer 12

-X-linked disease \> patients usually male ## Footnote Type 4 collagen abnormal \> **BASEMENT MEMBRANE ! (type 4\> floor)** *Dysfunction of the:* glomerular basement membrane Cochlea of the ear lens of the eye (Also neural deafness and eye disorders \_

Answer 13

parenchymal nodules\> containing hepatocytes with fibrotic bands in btw *Nodularity*\> result from **hepatocytes** regeneration and scarring

Answer 14

**Oxygenation Zones** within a liver acinus ## Footnote Zone 1\> closest to vascular zone Zone 2\> intermediate Zone 3\> furthest **Zone 3** is most susceptible to ischaemic damage as it is the furthest from the oxygenated arterial supply

Answer 15

blue area\> sclerosis around central vein

Answer 16

Cirrhosis is **Irreversible scarring** of the liver caused by continuous long-term liver damage. Scar tissue replaces healthy tissue in the liver + prevents the liver working properly. _Causes:_ *ABCDEF* Alcohol B hepatits C Hepatits Drugs Ethanol Fe overload (hemochromatosis)

Answer 17

\*\*\*Cirho**ssis**\> balwa in the space of d**isss**e\*\*\* ## Footnote (normally type 1 & 3 collagen r in\> portal tract and around central vein, while collagen 4\> is in space of disse) ***_in Cirhossis\>\> Collagen 1 & 3 r in space of disse!!_*** Hepatocytes r injured\>kupffer cells activation\> releases cytokines that allow **stellate cells** to change and r constantly active\>secrete **_TGF-B\>_** becomes highly fibrogenic & myofibroblast-like\> besides laying down collagen and scar tissue in the **space of disse**, due to their myofibroblast talent, these cells r contracting and increased vascular resistence! alllll of this will contribute to **compressing the sinusoids**!

Answer 18

Arise due to **portal hypertensio**n or promblems with **liver function** itself

Answer 19

after trauma or liposuction. when a bone is fractures, bone marrow fat cells that r injured break up and realease oil droplets. these oil droplets stick together & r sucked into the ruptured veins. * (Respiratory & neurological symptoms)* * breathless, madness* can reach to the **brain**! ***mostly seen in those with pelvic or long bone fracture!*** ***or sometimes it doesn't have to be due to long bone, it can be bc of a biochemcial abnormality, theres a depostition of fat in the blood.***

Answer 20

A blood clot that develops within a deep vein in the body, usually in the leg. _predisposing factors_ – immobility/bed rest – post-operative – pregnancy and post- partum – ***oral*** contraceptives – severe burns – cardiac failure – disseminated cancer _Treatment_: 1) give IV heparin (doesn't really dissolve thrombus, but prevents it from getting bigger) (helping it) 2) oral Warfarin \*\*starts with heparin (bc it starts quickly) _Prevention_ _1)_ give stockings\> they compress veins to prevent stagnation 2) flowtron boots\> they inflate, activating muscle calf pump!

Answer 21

An air or gas embolism is a bubble that becomes trapped in a blood vessel and blocks it. Decompression sickness (a form of gas embolism) = occurs when ppl experience a sudden decrease in atmospheric P. When air is breathed out at high p. (during deep see dive) increased amounts of gas (mostly nitrogen) is **dissolved** in the blood & tissues. when divers ascends (depressurizes) too rapidly!\> the nitrogen comes OUT of the solution and into the blood!

Answer 22

During delivery, c- section, a tear in the amniotic membrane can occur and amniotic fluid can get into the maternal circulation. ARDS, hypotension, seizures, loss of conciousness, DIC *(bc amnionic fluid has prothrombotic substances)*

Answer 23

a cancer type of cancer that starts in the bones **a malignant mesenchymal tumor where the cencerous cells produce bone matrix** *sarcoma=mesenchymal origin* --\>mostly in metaphyisis of long bones, around the KNEE **Macroscopic**: codmann's triangle or sunburst pattern on xray (from elevation of periosteium) coarse, gritty, gray and white lacelike pattern od neoplastic bone treat w/ chenotherapy

Answer 24

**onycholysis** ## Footnote separation of the nail plate from the underlying nail bed psorasis!!

Answer 25

B cells live too long beyond their life span\>\> **many abnormal B lymphocyte wbc**\>\> lymphocytes look normal under a microscope, but are abnormal as they do not function properly.

Answer 26

Sarcoidosis is a rare condition that causes small patches of red and swollen tissue, called granulomas, to develop in the organs of the body. It usually affects the lungs and skin. ***The symptoms of sarcoidosis depend on which organs are affected, but typically include:*** tender, red bumps on the skin shortness of breath a persistent cough

Answer 27

During delivery, ceserian section, a tear in the placental membrane or rupture of uterine veins & amniotic fluid can get into the maternal circulation. ARDS, hypotension, seizures, loss of conciousness, DIC (bc amnionic fluid has prothrombotic substances)

Answer 28

Chaissans disease: persistance of gas emboli in the skeleteal system leads to multiple foci of ischemic necrosis\>\> more common istes r at the tibia, femoral heads, humerus

Answer 29

**Metaplasia** of oesophageal *stratified squamous epithelium* to *gastric glandular or intestinal type epithelium w/ Goblet cells* _Cause_: due to chronic **acid reflux** esophagitis (GERD) , that occurs w/ a hiatus hernia _Complication_: asssociated with ^ risk of **adenocarcinoma** *_ur esophageous doesnt like that reflux and decides to change its identity) :P_*

Answer 30

Osteosarcoma the periosteum here has been lifted, has laid down a proximal traingular shell of bone known as **_Codmans triangle_** 🔺

Answer 31

anthracosis: aysymptomatic condition dound in many urbna dwellers exposed to sooty air

Answer 32

if use had a traumatic injury, and u start to exersize and go back to what u were doing tooo soon........ **fibroblasts** can undergo metaplasia into **osteoblasts**! SHIITT and can produce bone IN THE FREAKING MUSCLE! this is reversible with rest

Answer 33

**Skeletal muscle atroph**y (atrophy of disuse) due to a decrease in cell and tissue size. This is the result of decreased functional demand/workload. **Osteoporosis** of disuse as a result of increased bone resorption. This is as a result of lack of mechanical stress on the bone.

Answer 34

## Footnote - Decreased pulmonary ventilation, atelectasis and pneumonia. - Thromboembolism. - Pressure sores. - Skeletal muscle atrophy - Osteoporosis of disuse

Answer 35

increase in **size of the prostate gland** occurs during *aging*. ## Footnote occurs in periutheral zone and presses on the *urethra* and partially _obstruct the flow of urine_, **_Macroscopic_**: smooth, elastic, firm nodular enlargment **_Complications:_** - bladder outflow obstruction. - urinary tract infection (UTI) - acute urinary retention - Bladder muscle hypertrophy - Bladder distension **_Symptoms_**: - nocturia or dysuria - difficulty starting & stopping urine - urge to urinate **_Treatment_** A1-antagonist\> relaxes smooth muscle (terazosin, tamsulosin) \*\*does not cause cancer!

Answer 36

enlargement and thickening (hypertrophy) of the walls of ventricle LVH can occur when some factor makes your heart **work harder** than normal to pump blood to your body: - aortic stenosis - hypertension - Hypertrophic cardiomyopathy - athletic training ***_complications:_*** * can compress on its own blood supply * HF * arrythmeia * atrial fibrillation * IHDaortic root dilation * cardiac arrest * stroke

Answer 37

**Thickened Stratum Coreum** with a highly proliferative epidermis and thickining (acanthosis) Commonly seen in\> The skin of the **elbows, knees,** scalp, ears, lumbosacral area, intergluteal cleft and the glans penis. **_Macroscopically_** – papules, pink to salmon-coloured plaques covered by loosely adherent **scales** which are silver/white in colour. **_Microscopically_** – acanthosis & parakeratosis w/ a low or **absent granular layer.** * **microabscesses** of neutrophils . * The epidermal rete are elongated and clubbed. * thinning of the epidermis over the dermal papillae w/ **dilated blood vessels** within the papillae * – **Pinpoint bleeding points** when the psoriatic scale is scarped off. **_Pathophysiology:_** Psoriasis is a **T cell-mediated disease** (CD4+ and CD8+) with **increased keratinocyte proliferation.** unknown antigen \> triggers T cells \> produce GF for keratinocytes & induce them to proliferate at approximately 10x the normal rate!! *Psoriasisssss\> ssscaly, microabsseeesss*

Answer 38

- Nails - Psoriatic arthritis (They can show yellow-brown discolouration (‘oil-slick nails’), pitting, dimpling, separation of the nail bed (onycholysis), thickening and crumbling.)

Answer 39

- picks disease.

Answer 40

Atrophy cuz the best way to shute doen and atrophy an endorcrone gland is to give it doses of its own hormones! the administration of **glucocorticoids** ex: Prednisone, can s**uppress the hypothalamic-pituitary-adrenal-pathway!** the resulting **drop in ACTH levels** will cause the adrenal glands to atrophy!

Answer 41

Any time an internal body part pushes into an area where it doesn't belong, it's called a hernia. is when part of the stomach squeezes up into the chest through an opening ("hiatus") in the diaphragm.

Answer 42

affecting blood supply to legs due to atheroscleotic plaque! * intermittent claudication\> pain in calf when walking * leriche syndrome\>Pain that radiates to back of hips and buttocks. * ischemic rest pain * Gangrene

Answer 43

theres a gap in the left iliac artery, meaning there is a blockage! but u can see collateral circulation developed!

Answer 44

a 'mini' stroke u get neurological symptoms similar to that of a stroke! BUTTTT **they resolve w/ in 24 hrs!** ***Usually secondary to microemboli originating from the heart or carotid or vertebral arteries.*** Cerebral infarction= symtoms dont resolve w/ in 24 hrs!

Answer 45

A rapid onset of cerebral deficit (usually focal) **lasting more than 24 hours** or leading to death, with no cause apparent other than a vascular one.

Answer 46

_Ischemic=_ A stroke due to reduction or **cessation of blood flow** to a localised area of brain due to arterial occlusion or hypoperfusion. _Haemmorrhagic_= A stroke due to to **bursting of a bv** **Hypertension!**

Answer 47

**defects in the LDL receptor** \> decreased hepatic uptake of LDL and therefore increased circulating LDL - tend to have MI before age of 20!!! * "my family did not receive the RECEPIT to the butter"*

Answer 48

Transient ischaemic attack (TIA).

Answer 49

A common form of **intracranial aneurysm.** ## Footnote No, they are congenital or secondary to blood vessel injury. **circle of Willis** and the **adjacent arteries.** After rupture the blood accumulates in the ***_subarachnoid_*** space.

Answer 50

inner layer of tunica media tear! open and blood enter the tear, ## Footnote ***this seperates the media into 2 layers!***

Answer 51

**_Erythema nodosum_** is a type of panniculitis. Panniculitis occurs when there is inflammation of the layer of fat lying underneath the skin. The inflammation causes red rounded lumps (nodules) to form just below the skin surface, which are tender. Erythema nodosum most commonly affects both shins.

Answer 52

 Obesity  Diabetes mellitus  Treatment with steroids

Answer 53

Bands of fibrous tissue that form between abdominal tissues and organs

Answer 54

Kaposi's sarcoma is a rare type of vascular tumor cancer caused by a **virus**.

Answer 55

Xeroderma pigmentosum (XP) is a rare, autosomal ***recessive*** disorder. There is an **impairment of the skin's ability to repair damage from ultraviolet (UV) light**, 🌞🌞🌞🌞🌞🌞🌞🌞🌞🌞🌞🌞🌞🌞 The main presenting features of XP are **photosensitivity, skin changes and a high incidence of skin cancer and 👁 damage** at a very young age. Skin changes occur first over the areas most exposed to light, initially on the face. XP is an autosomal recessive genetic condition caused by alterations (mutations) in **_9_** different genes. \>\> Eight of the genes make up the nucleotide excision repair pathway (NER) that identities and repairs UV induced DNA damage. The ninth gene acts to bypass unrepaired damage.

Answer 56

causes fatty liver, mallory's hyaline accumalated in hepatocytes

Answer 57

A disordered proliferation of axons resulting in a tangled mass

Answer 58

Hepatitis can be classified as acute or chronic. Chronic hepatitis is defined as over 6 months history with histology of i**nflammation and necrosis.** Laboratory diagnosis: **Raised serum ALT, AST and LDH.** These are cytosolic hepatocellular enzymes and their presence in the blood indicates poor hepatocyte integrity. **Raised bilirubin** (often conjugated) – indicates poor biliary excretory function. **Decreased albumin,** raised PT (reliant on factors 2,7,9,10 produced by the liver), r**aised ammonia** – these findings indicate poor hepatocyte function.

Answer 59

Raised serum amylase in first 24 hours. Raised serum lipase from 72-96 hours. In 10% see glycosuria. Hypocalcaemia possible – due to precipitation of calcium salts in fat necrosis

Answer 60

**What it is** – Genetically disorder resulting in increased intestinal absorption of dietary iron Presentation – may be asymptomatic, or present with multiple-organ-related symptoms **Complications** - liver damage, heart dysfunction and multiple endocrine failures, especially of the pancreas, arthropathy, hypogonadism **Treatment** – Therapeutic phlebotomy (bleed the buggers)

Answer 61

lymphoid follicles r collection of lympohcytes that get to their maxium size in the appendix during adolecense. if infection occurs\> the immun esystem ramps up and the follicles can grow!

Answer 62

the appendix can keep on swelling and eventually compress on the surrounded blood vessels causing **Ischmeia**! increased pressure causes the appendix to burst and rupture and the Pus leaks out c=and goes into the perotineal cavity Sepsis, abscess, peritonitis

Answer 63

the appendix is always secreting mucos like the instestines. when it gets obstructed, the mucos accumalates and compresses on agencent visceral nerves leading to\>\> abdominol pain

Answer 64

Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, collectively known as the meninges. * **Raised intracranial p\>\> death** * **Septecemia**

Answer 65

Sulci cant be seen due to the filling of the lines by **Purulent exudate pus,** due to acute inflammation. Compression of the brain because the skull is rigid. Raised intra cranial pressure

Answer 66

**Neonates:** Group B strep, organism acquired from the mother. Usually during a UTI. E Coli, Streptococcus pneumonia **Children:** Strep pneumonia, Group B streptoccus **Young Adults:** Menogococal meningitis, Strep. pneumonia **Older age groups:** Streptococcus pneumonia

Pathalogical Diseases Flashcards

(106 cards)