Patho Block 1 Flashcards
1
Q
Group O blood has what Ag and Ab
A
No Ag
Both A and B Ab
2
Q
What are the S/ s of Multiple Myeloma
A
Renal failure
anemia
leukopenia
Diagnosis based on x-rays, bone marrow biopsy, and serum protein electrophoresis
• Large gamma globulin spike (Bence-Jones proteins)
3
Q
Why do the outer tissues retain their appearance in coagulative necrosis
A
rapid inactivation of hydrolytic enzymes prevents tissue lysis
thus tissues retain original form and consistency
4
Q
What is the pathological path of an arterial emboli
A
Heart, to carotid artery, to brain, to stroke
5
Q
UV light radiation causes what kind of cancer
A
Skin cancer
Squamous cell carcinoma (SCC),
Basal cell carcinoma (BCC),
Melanoma
6
Q
What does amniotic fluid analysis
(Amniocentesis) in prenatal testing look for?
A
Fluid sampled from amniotic sac at 12 - 18 weeks
Chemical and chromosomal analysis
7
Q
Which Ig does the Alternate pathway use
A
IgA
8
Q
Carcinoembryonic Antigen (CEA)
Is a tumor marker for cancer where?
A
Colon, stomach
9
Q
What is the most common method of staging
A
The TNM system
T: size of primary tumor
N: Lymph node involvement
M: metástasis or not
10
Q
What are the two pathways of the arachodonic acid derivates
A
Lipoxygenase (LOX) pathway
Cyclooxygenase (COX) pathway
11
Q
What is Shock
A
Simply hypo-perfusion resulting in tissue anoxia and organ failure
12
Q
Loss or gain of a chromosome(s) alters genetic expression is called
A
A numerical abnormality
13
Q
What does etiology mean
A
Origin of the disease
Underlying causes and modifying fxs
14
Q
What is the difference between wet and dry gangrene
A
- “wet gangrene” = bacteria are active, necrosis is more liquefactive
- “dry gangrene” = as tissue dries, becomes black “mummified”
15
Q
What are the three classifications of anemia
A
• Decreased hematopoiesis (inadequate production)
• Abnormal hematopoiesis
(incorrect production)
• Increased loss or destruction of RBCs (taken out of circulation)
16
Q
Which WBC type is often seen in chronic infections
A
Eosinophils
- slower mobility
- survive longer
Macrophages
-long living
17
Q
What patient population is Lupus most common in
A
Women
18
Q
Describe the first step of wound healing
Hemostasis
A
Vasoconstriction, platelet activation, coagulation
Fibrin, platelets, and RBCs join to form clot
Vasoconstriction initially (briefly), then vasodilation as healing begins
19
Q
What does RDW measure
A
Red Blood Cell Distribution Width
= variation of RBC volume
20
Q
What are the characteristics of benign tumors
A
Remain localized
Do not spread to other tissues
Grow slowly (Atypical mitosis)
Well-differentiated cells resembling their normal counterparts
21
Q
What is a common medication that can Lys the plasma membrane
A
Tylenol
Liver, kidney
22
Q
What 4 things can tumor markers be used for
A
Diagnosis
Predict response to cancer tx
Asses response to tx
Monitor the patient for cancer return
23
Q
What are three causes plasma membrane morphology
A
Lysis
Complement system
Free radicals
24
Q
What are the 4 functions of neutrophils
A
Mobility Phagocytosis Bactericidal activity (Kill O2, radicals) Cytokines production (Prolongs Inflamation and promotes FEVER)
25
How can endonucleases causes pathology
DNA and chromatin fragmentation
26
Biopsy of what lymph node is oftenusedtodetect metastatic cells as part of cancer staging
The sentinel lymph node
27
What are some examples of Type IV hypersensitivity granulomas
TB (Mycobacterium tuberculosis), (M. leprae), and fungi, sarcoidosis
28
Due to their slow growth, benign tumors are…
Encapsulated- tumor contained within smooth walled, fibrous capsule
And
Expansive- Exerts a mass effect by compressing on other tissues
29
Adding fluids to the body will ______ Hct value
Decrease
30
Where do most PE arise from
DVTs in the legs or pelvis
31
What is the culminating purpose of the complement system
Membrane Attach Complex
32
Genotype vs Phenotype
Geno: genetic form
Pheno: physical expression
33
What are 5 types of cellular adaptation
```
Atrophy
Hypertrophy
Hyperplasia
Metaplasia
Dysplasia
```
34
What are the initial symptoms of Hypovolemic shock
```
Elevated HR
Increased RR
vasoconstriction “Cold and Clammy”
Increased Thirst
Light headedness
```
(COMPENSATION)
35
Hepatitis B virus causes what kind of cancer
Hepato-cellular carcinoma (HCC)
36
What is the normal adult heme composition
2 Alpha and 2 Beta chains
37
What are the 4 types of emboli
Thromboembolism
Solid Particle Embolism
Liquid emboli
Gaseous Emboli
38
What is the tx for Acute Myelogenous Leukemia (AML)
chemotherapy induces remission in 60%
* High recurrence rate - under 30% remain disease free at 5 years
* Radiation / chemotherapy, then bone marrow transplant (BMT)
39
What Ag and Ab do group AB have
Both A and B Ag
| No Ab
40
Name that disease:
Onset ~65 y/o
Immature myoblasts
Spleen/ nodes enlarged
HIGH RECURRENCE RATE
Acute Myelogenous Leukemia
41
What are the S/s of Chronic Myelogenous Leukemia (CML)
Slow onset of symptoms: fatigue, ↓endurance, infxs, splenomegaly, thrombus
42
What are 4 S/s of a tumor
Impinge upon vital tissues
Impair function of surrounding tissues
Cause death of involved tissues
Provided a nidus for infection
43
What is pernicious anemia
autoimmune d/o of stomach parietal cells decreases B12 absorption
44
Name that disease:
Onset <5 y/o
Immature lymphoid cells
Rapid Course
Good Prognosis and remission
Acute Lymphoblastic Leukemia
45
Define structural chromosomal abnormalities
Similar to genetic changes with neoplasms
* Deletion -portion is lost during replication
* Inversion (or Breakage) -portion breaks off & reinserted upside down or in wrong location
* Translocation-portion of chromosome inserted into another location
46
What are the 5 cardinal signs of acute inflammation
Calor (warmth)
Rubor (erythema)
Tumor (edema)
Dolor ( pain )
Loss of function **
47
What is thrmbocytosis
Excess circulating platelets, such as after a splenectomy
48
All three pathways of the complement system end with
BIG MAC ATTACK
49
What is a Sarcoma
A cancer of mesenchymal origin
| Bone, cartilage, fat, blood cells, connective tissue
50
Malignant cells retain only functions essential to _________
Live and proliferate
51
What part of the Ab attached to the Antigen it was designed for
The light chain
52
Nitrosamines cause
Colon Cancer
53
Bradykinin is formed throughout he activation of Hageman factor with is aka
COAG Fx XII
54
Tissues that are easily damaged by radiation are also
readily treated by radiation therapy
55
Describe the 3rd stage in wound healing
Proliferation
New tissue is made from collagen and fibronectin
Epithelialization occurs
Wound contracts and new blood vessels are constructed
56
What is the best method for preventing genetic disorders
Prevention is best method
– update immunizations
-good nutrition
-avoiding smoking/alcohol
57
What explains why a disease arises
The etiology
58
What does neutrophillia suggest
Bacterial infection
59
What is the major difference between dystrophic and metastatic calcification
Dystrophic is in damaged, dying, or dead tissues
Metastatic is in normal healthy tissues
60
In hereditary spherocytosis
How will the mcv, mch and mchc present
MCV decreased – smaller cells so smaller volume
• MCH/MCHC increased – hemoglobin compressed into smaller RBC
61
What are the two types of thrombotic thrombocytopenia purpura
Primary – antibodies against enzyme that BREAKS DOWN Von Willebrand (clotting) factor
Secondary – from cancer, pregnancy, HIV, anti-platelet drugs, immuno-suppression
62
Serum is…
| Plasma is…
When there is a blood clot in a blood sample, the left over fluid is serum
When the blood sample is pereserved with anticoagulants and run through a centrifuge, the fluid that is not RBCs is plasma
63
What are three examples of abnormal hematopoiesis
```
Sickle cell (Defect in B chain Hgb)
Thalassemia
(Defect in Hgb A, Beta or Alpha chain)
Hereditary spherocytosis
(RBC protein error)
```
64
An increased retic count with anemia signifies what..
* Bone marrow responds to anemic state by increasing production
* ↑ retic count shows anemia is NOT caused by marrow failure
65
What are the S/s of Acute Myelogenous leukemia
Spleen and lymph nodes usually enlarged
• Neutropenia, thrombocytopenia, and anemia are common
66
EBV
(Epstein-Barr virus , a Herpes Virus )
Causes what kind of cancer
Burkitt’s Lymphoma and Hodgkin’s
67
Losing body fluids will _______ Hct value
Increase
68
What does Retic measure
Number of immature RBCs in blood sample
• Reflection bone marrow’s production of new RBCs
69
What is megaloblastic anemia from
usually inadequate intake or malabsorption of B12 or Folate
70
What causes mesothelioma
Asbestos (tumor of lung pleura)
71
How many days post injury does the maturation phase of tissue remodeling occur
21 days post injury
72
Define Morphogenesis
Morphogenesis = evolution and development of organ or other body part
73
How do free radicals damage the plasma membrane
By reacting with the membrane phospholipids
74
What does eosinophilia suggest
Allergies or parasitic infections
75
What actions do you take for a minor transfusion reaction
Give diphenhydramine, methyl prednisone, and epi
76
Where are cells sampled from in a chorionic villus sampling
Fetal cells obtained from the chorion- a part of the placenta
Uses a sampling tool that enters through the vagina.
77
What tissues does coagulative necrosis mostly effect
Solid organs
78
What is the most important cause of delayed healing
Infections
79
What is cachexia
Unexplained weight loss, common in cancer pts
80
Name that disease
Onset Adults >45 years old
Punched out appearance
Hypercalcemia
Protienuria
Death within 3-4 years
Myeloma
81
In lymphatic spread what is the first node that receives drainage from primary tumor site…
Sentinel Lymph node
82
What are two types of pathological calcification
Dystrophic and Metastatic
83
Marrow suppression by cytotoxic drugs, chemo/rad therapy, or viral infx, can lead to what type of anemia
Aplastic Anemia
84
Vaso and Angio are generic terms for
Vessels
Can be blood or lymph
85
Define Agenesis
absence of organ or part of organ contains primordial tissue
86
What is the principle mechanism of first/ primary intention wound healing
Epithelial regeneration
- staples
- sutures
- seri strips
- adhesives
87
Pyrogens are released by…
Cause what..
Released by neutrophils
Caused Hypothalmus to being prostaglandin synthesis
88
What is grading of a tumor
Based on histology of the tumor
Used for treatement and planning of certain cancers
Reflectes the degree of differentiation
89
With regard to cytoplasm..
Highly differentiated cells have______
Undifferentiated cells have_____
Very abundant amounts in highly differentiated cells (liver, kidney)
Scant amounts in undifferentiated cells (often have larger nuclei)
90
What plasma derived mediator starts the coag cascade
Bradykinin
91
What is the largest group of genetic disorders
Recessives are largest group of genetic disorders ;however over all incidence in population is low
92
Describe caseous necrosis
“Cheesy” area created as affected cells fall apart
Typically seen in TB and some fungal infections (histoplasmosis)
93
Why are red blood cells Biconcave
* Biconcave shape; increases surface area for O2 and CO2 diffusion
* Highly flexible; able to bend shape when passing through narrow capillary beds
94
Define mar fans syndrome
Connective tissue disorder impacting formation of fibrillin
tall and slender habitus with elongated head/forehead
Elongated fingers
Aortic aneurysms, aortic dissection & rupture
Cardiac valves poorly structured – “floppy valves”
95
HPV causes what kind of cancer
Carcinoma of the cervix and penis
96
What are the S/s of a Vaso-Vagal event
Prodrome
(light-headed, nausea, cold sweats, pale skin/face, tunnel vision)
```
Brief LOC (quickly regained)
Without amnesia
```
97
What is the function of CD8 cells
(T-suppressor/cytotoxic cells)
Suppress unwanted antibody production
Cytotoxic killing of cells recognized as “foreign”
– viral infected cells, cancer (CA) cells
98
What is another name for hydrothorax
Pleural effusion,
-fluid in the chest, outside the lung tissue
99
Type I hypersensitivity is what Ig mediated response
IgE
Antigens (allergen) sensitize
B-lymphocytes→Plasma Cells→IgE
100
What are the three phases of shock
Compensated
Decompensated
Irreversible
101
What is melena
Dark sticky feces containing DIGESTED blood
102
Define gangrene
Secondary change in ALREADY necrotic tissue
103
What are the most frequent new cancer cases in men and women
Men: prostate
Women: breast
104
What are the three types of abnormal hematopoiesis anemia
* SickleCellanemia
* Thalassemia
* Spherocytosis
105
What is the highest rick factor for cancer
Environmental causes ~65% of cancer risk
106
What is inate vs acquired immunity
Inherited ves learned
107
How is type and screen blood held
places blood on “soft reserve” for low probability transfusion
108
How does aplastic anemia cause pathology
bone marrow becomes hypocellular as stem cells are replaced by fat
109
An platelet count less that 50,000 is a high risk for what..
Increased bleeding from surgery
110
What are the S/s of a major transfusion RXN
Fever, chills, back pain, dyspnea, RENAL FAILURE
111
Less differentiation in grading equals…
More aggressive tumor
112
What are the four imbalances that cause edema
```
Imbalances in:
Vascular pressure
Permeability
Oncotic pressure
Lymphatic Drainage
```
113
What disorder is an error in protein metabolism, specifically errors in. Phenylalanine to tyrosine conversion
Phenylketonuria
114
What kind of edema can you drain with a needle
Localized edema in a BODY CAVITY
115
What is the most important and common cause of cell injury
O2 Deprivation
| Hypoxia, anoxia
116
What is an intravascular thrombosis
Thrombus clot in an intact blood vessel
117
Which type of cell is least effected by chemotherapy and radiation
- Labile
- stable
- permanent
Permanent
118
What is the most important and frequently encountered autosomal disorder in the US
Familial Hypercholesterolemia
Low-DensityLipoprotein(LDL)receptor deficiency on liver cells
119
Where does HIV replicate
Retrovirus – replicates via reverse transcriptase especially in T-lymphocytes
120
What are the 3 pathways of the complement system
Classical
Alternate
Lectin
121
What does chorionic villus biopsy in pre natal testing look for
Direct tissue sampling of placenta for chromosomal and enzyme analysis
122
What are the two types of Hemophilia
```
Hemophilia A (factor VIII)
Generally mild bleeding problems, may be symptomatic
```
and
```
Hemophilia B (factor IX).
Severe form w/ excessive bleeding even from minor injury
```
123
Chronic inflammation is most often associated with which WBC
Lymphocytes and macrophages
124
What is the definitive finding to diagnose Lupus
ANA
| (Anti-nuclear antibodies) found by immunofluorescene microscopy
125
How can ATPases cause pathology
Speed up the depletion of ATP
126
What is a hypertrophic scar
Scar forms thicker than expected
127
Where do Arterial emboli originate from
Heart or large arteries
128
In an amniocentesis, where are the cells sampled from
Fetal cells obtained from fluid in the amniotic sac where the fetus is held during the pregnancy
Ultrasound is used to guide a large needle thought the abdomen into the amniotic sac
129
What are the three types of necrosis and which is the most common
Coagulative (Most common)
Liquefactive
Caseous
130
Does the alternate pathway involve antigen-antibody complexes
NO
131
What are the actions to take in a major transfusion RXNs
STOP THE TRANSFUSION
IV fluids to maintain UOP
IV Bicarbonate to alkaline the urine to reduce Hgb precipitation in the kidneys
Send donor and pt blood to LAB ASAP
132
What is the most significant complication of a venous emboli
Pulmonary Embolism
133
What are the specifics for
T1
T2
T3
T1- solitary tumor
T2- tumor <5cm
T3- At least one tumor >5cm
134
What are 4 examples of Type I hypersensitivity
Anaphylaxis
Allergic Rhinitis
Asthma (allergy induced)
Atopic dermatitis
135
What is the X linked recessive disorder that is amplification of a fragile portion on the X chromosome
Fragile X syndrome
- mental deficiency
Characteristic head and facial appearance
Broad forehead, elongated face, large prominent ears, strabismus (cross eyed), high arched palette
136
Define teratogens
Agents known to cause fetal malformations
137
S/s of sickle cell
Persons <40% total HbS are often asymptomatic
Sickle Cell Crisis – triggered by fever, resp dz, phys exertion, dehydration
• Hemolysis of abnormal cells leads to anemia, jaundice and biliary stones
138
Most cancers occur in what stage of life
Mid to later years >55yrs
139
What are the 3 things needed to diagnose an auto immune disorder
1. Auto-antibodies can be documented
2. Immune mechanisms are causing pathologic lesions
3. Evidence the disorder has an immune origin
140
Name that disease:
Onset >30yrs
Philadelphia chromosome
Three phases
(Blast Crisis Phase)
HIGH MORTALITY RATE
Chronic Myelogenous Leukemia
141
What are the clinical features of Acute Lymphoblastic Leukemia (ALL)
* Lymph nodes enlarged & mild splenomegaly
| * Rapid course - recurrent infections, malaise, bleeding into skin and major organs
142
What is the more common form of immunodeficiency
Acquired (secondary) Immunodeficiency
Immuno-suppression by chemotherapy or steroids
Diabetes
Bone marrow dysfunction
AIDs
143
What is the precursor to mast cells
Basophils
144
What is the presentation of classic hemophilia
Hemophilia A “classic hemophilia”
- Factor VIII
more common form, usually milder symptoms
Easy nose & oral bleeding
Bleeding into joints even from minor trauma Cerebral hemorrhage
145
What does the term “staging” mean with cancer
Determines the extent of tumor spread
| Is more prognostic value that grading
Better at predicting 5yr survival
146
Basophils granules are rich in what chemical
Histamine
147
Define Hypoplasia
underdevelopment of tissue, organ, or entire body
148
What are three causes of JVD
HF
Cardiac Tamponade
Tension Pneumothorax
149
Define hyperplasia
Increased tissue or organ size due to an increase in the number of cells
150
Iron deficiency anemia is most common in ..
Women
151
Define hypertrophy
Increased size of tissues or organs due to enlargement of individual cells
152
What can lead to a folate (B9) deficiency
Pregnancy and Lactation
Or ETOH abuse
(Damage to the GI system)
153
Explain oncotic pressure imbalance in edema
Albumin in bloodstream helps hold fluid (H2O) inside blood vessels, if this becomes disrupted, fluid does not stay within blood vessel leading to edema
154
What are the 6 kinds of inflammation
```
Serous
Fibrous
Purulent
Ulcerative
Pseudomembranous
Granulomatous
```
155
What demographic does thalassemia effect most
Mediterranean and southeast Asian ancestry
156
Morphological changes help determine what.. .
The nature fo the disease and its progression
157
What are two examples of permanent cells
Non-dividing; lack capacity to replicate, New cells can not be formed; healing by fibrous scarring
QNeurons,myocardium
158
What are the 4 types of Normocytic anemia
* Aplastic Anemia
* Myelophthisic Anemia
* SickleCellanemia
* RBC loss or destruction
(MCV NORMAL)
159
In what stage of wound healing does epitheliazation occur
3rd stage
| Proliferation
160
What is secondary polycythemia
Over-production of RBCs stimulated by increased erythropoietin release
• Usually from prolonged hypoxia – lung & heart dz; renal cell CA; adaptive for high
altitudes
161
What is the function of NK cells
Natural Killer Cells
Subset of T-cells without antigen receptors
– part of innate immunity present at birth
Do not require antigen-sensitization to recognize and kill virally infected cells and some cancer cells
162
What is the term for disorders only expressed by homozygous recessive pairs
Autosomal recessive disorders
163
What is 47XX +21 or 47XY +21
Trisomy 21
| Down’s syndrome
164
What is 47XXY
Kleinfelters
Is a male phenotype disorder
Little to no sperm production
2* sex characteristics do not develop fully
* Small penis with atrophic testes (infertility)
* Scant pubic and body (axillary, facial hair) hair
* Mild gynecomastia (partial breast development)
* Facial features are eunuchoid
* unclear gender characteristics ; little to no facial hair
* Body habitus – tall height w/ unusually long arms/legs
* Abnormal body. proportions (long legs & short trunk)
* Potential learning disabilities
165
Which cells are most effected by chemotherapy and radiation therapy
- labile
- stable
- permanent
Labile
166
Describe metastatic calcification
Occurs in normal (healthy) tissues
Other disease process creates a secondary hypercalcemia
Example: Hyperparathyroidism, Multiple Myeloma
167
Prostate-Specific antigen (PSA)
Is a tumor marker for cancer where?
Prostate
168
The classical complement pathway starts with….
And antigen antibody complex
169
What is the most reliable feature separating malignant from benign tumors
Is the tumor invasive or not
170
What are the two types of thalassemia
Alpha Thalassemia – alpha chain defect; less severe (often termed Thalassemia minor or trait)
• Beta Thalassemia – beta chain defect; severe lethal form
171
How does PKU effect children/ infants
* By 6 months old, phenylalanine excess affects developing CNS-mental retardation, seizures, etc
* Excess phenylalanine inhibits melanin synthesis – children have fair skin & hair, blue eyes
172
Which part of the Anitbody is Specific & Unique to each immunoglobulin class
The heavy Chain
173
What is the pilocarpine test
Diagnosis for cystic fibrosis
Sweat chloride test
Pilocarpine solution and electrical current applied to skin surface triggers excessive NaCl excretion into sweat
174
What are three types of Ionizing radiation
Alpha, Beta, Gamma
175
What are the risk factors for a DVT
```
Inactivity (blood stasis)
Smokers
Pregnancy
Contraceptives
Cancer
Previous Hx of Thrombosis
Advanced Age
```
176
What is signifigant about Rh and pregnancy
A Rh neg mother birthing a Rh pos baby
She creates Ab, and if she has a second Rh pos baby, then there will be complications
177
What are the clinical characteristics of cystic fibrosis
* Pulmonaryinfections–pneumonias
| * Pancreatic insufficiency -malnutrition/ malabsorption
178
What is the Temporary & orderly change of one cell type to another (along same cell line)
Metaplasia
179
How does the body maintain normal BP during compensated shock
Tachycardia
Vasoconstriction
And reduced UOP
180
Describe the 2nd step of wound healing
Inflammation
Begins shortly after injury; blood vessels leak into wound
Localized swelling
Controls bleeding and prevents infection
181
Describe dystrophic calcification
Occurs in damaged, dying or dead tissues
•May occur even with normal calcium blood levels
• Encountered with any type of necrosis
• Example: atheroma of advanced atherosclerosis
182
What is needed to cure chronic idiopathic thrombocytopenia purpura
Splenectomy
183
What is the most common cause of inflammation
Infections (duh)
- bacterial
- viral
- fungal
- parasitic
184
What are oncgenes
Genetic cause of cancer that Arise from damaged or mutated normal genes
Allows uncontrolled cell growth and poor differentiation
185
What percentage of pediatric inpatients with have a genetic disorder
20%
186
Name and define the Lymphoid Cells
Non Granulated WBC w/ Large dense nucleus
* Lymphocytes (T & B cells)
* Natural Killer cells
187
What demographic is most effected by Chronic Lymphocytic Leukemia
Older patients older than 50
188
What are the 4 stages of wound healing
- hemostasis
- inflammatory
- proliferative
- remodeling
189
Name that disease:
```
Onset > 50 y/o
Slowly progressive
Increased Infxs
Survive 7-9 years
No response to Chemotx
```
Chronic Lymphocytic Leukemia
190
90 percent of pts with Chronic Myelogenous Luekemia have what chromosomal defect
Philadelphia chromosome 22 abnormality
191
How do most patients w/ aplastic anemia die
Uncontrollable infections and bleeding and
| From overwhelming sepsis
192
What is the most preventable teratogen
Alcohol!
193
What is becks triad
Hypotension
Muffled Heart Sounds
JVD
194
What is a notorious post-op killer of otherwise healthy Pts?
PE
Pulmonary embolism
195
How does Ionizing radiation cause cancer, and what tissues are most susceptible
Creates free radicals
Most susceptible:
stem cells
hematopoietic (blood-forming)
reproductive organs
epidermis of skin & intestine
fetal tissue
(esp 1st trimester rapid organogenesis)
196
What are the later S/s of Hypovolemic shock
Low BP
| Confusion/ AMS
197
What are the clinical features of Hodgkin’s Lymphoma
large nodes, especially in neck and mediastinum
• Reed-Sternberg cells - multi-lobed nucleus surrounded by clear halo (“owls eye”)
Bimodal peaks at ages 25 and 55
198
What is the most common paraneoplastic syndrome.
| Indirect indicator of possible cancer
Hypercalcemia
199
Sweating from the skin contain…
| Water loss from respiration contains..
Water and electrolytes
Pure water vapor only
200
What is the difference between petechia, púrpura, and ecchymosis
* Petechiae – pinpoint red spots
* Purpura – larger reddish or purple spots
* Ecchymosis – bruise, contusion
(ALL THREE DO NOT BLANCH)
201
What does lymphocytosis suggest
Viral infection or chronic infection (TB)
202
What is myelophthisic anemia
replacement of bone marrow by cancers, fibrosis, or granulomas
• Examples: leukemia; multiple myeloma
203
Define aplasia
entire organ mass composed of primordial/rudimentary tissue
204
What are the three subtypes of non Hodgkin’s lymphoma
Folicular
Dioffuse Large B cell Lymphoma
Burketts lymphoma
205
What is the order of events from Metaplasia to cancer
Metaplasia → Dysplasia → Neoplasia (irreversible)→ Cancer (irreversible)
206
Clinical characteristics: Familial hypercholesterolemia
Atherosclerosis and HD
| Xanthomas- lipid rich, yellow-brown nodules or plaques
Deposits on eyelids are highly characteristic
207
What is anasarca
Fluid accumulation throughout the body
Edema is evident in many body location s
-typically due to heart, liver, or kidney failure, or extremely poor diets
208
Describe the LOX pathway
LOX produces Leukotrienes - promote chemotaxis (call in WBCs) & increase vascular permeability •
Lipoxins – act at end of inflammatory phase; signal phagocytosis (clean up) of dead cells
209
What are the S/s of a tension Pneumo
Increased RR and Air Hunger
(Progressive respiratory distress)
JVD
Tracheal Deviation
(Seen on X-ray, late late sign when seen anatomically)
210
What is leukopenia
WBCs below normal levels
* Rare; often induced by cytotoxins especially during chemo/rad therapy for cancers
* High risk for overwhelming infections
211
What is a pericardial effusion
Fluid in the pericardium
212
Define congenital disorders
present at birth, but NOT always genetic
213
Inflammation can occur in organisms capable of…
neurovascular & cellular response to injury
214
What is the most common type of emboli
Thromboemboli (blood clots, free floating fragments from thrombi)
215
What are examples of Labile cells
(Easily regenerate for wound healing)
| -skin, GI tract, hematopoietic
blood-cell-forming
216
What are the three types of microcytic anemia
* Iron deficiency
* Thalassemia
* Spherocytosis
(MCV IS DECREASED)
217
What X linked recessive disorder has a defect with dystrophin protein in muscle cells
Duchenne’s muscular dystrophy
| -leads to progressive muscular wasting and weakness
218
Describe Hemophilia
defect in coagulation factor which results in bleeding disorder.
219
What are the characteristics of malignant tumors
Easily spread to other tissues
Invade and destroy structures
Grow very fast with little to no differentiation (Anaplasia)
220
What does MHC measure
Mean Corpuscular Hemoglobin
| = avg hemoglobin amount per RBC
221
What causes wound dehiscence
Too much tension of wound edges
222
When do Macrophages appear in acute infections
3-4 days after onset of infection or tissue destruction
223
What is hereditary spherocytosis
RBC disorder in caucasians
Structure protein defect! Not an iron issue
produces smaller & less flexible RBCs captured and lysed by the spleen
224
What is the most aggressive form of non Hodgkin’s lymphoma
Diffuse Large B-cell Lymphoma - most aggressive form but most responsive to tx
• Complete remission in 75% w/ 50% may remain disease free for several yrs
225
How is the alternate complement system activated
Bacterial/ fungal endotoxins, snake venoms
226
What is the most common acute leukemia in adults (average age 65)
Acute Myelogenous Leukemia (AML)
(radiation and benzene)
* Proliferation of myeloblasts = immature bone marrow cells
* Blast cells take over marrow and “choke out” normal stem cells
227
Neoplastic cells can be killed but not _______
Repaired
Neoplasia is irreversible
228
What is an example of metaplasia
Barrett’s esophagus
229
What does MCV measure
Mean Corpuscular Volume
| = avg volume (size) per RBC
230
Transudative fluid is the result of what four factors
Increase vascular pressure ( pushes fluid out of vessels)
Increased permeability
(Allows for fluid to leak out of cells easily)
Decreased oncotic pressure
(Fluid is not held in vessels, loss of gravity)
Decrease Lymphatic drainage
(Interstitial fluid is not removed properly)
231
Risk of metastasis in increases with what four factors
Aggressive local invasion
Lack of differentiation
Rapid Growth
Large Size
232
What is the single most importation environmental factor for cancer risk
Smoking #1
| Alcohol #2
233
What is the opposite of anemia
Polycythemia
234
What effect do steroids have on wound healing
Anti-inflammatory effects may weaken scar formation
235
What medication is contraindicated in vWF disease
Asprin
236
What is ascites
Abnormal amount of fluid in abdominal cavity
237
What are the 4 types of prenatal diagnosis
Ultrasound
Maternal blood analysis
Chorionic Villus Biopsy
Amniotic Fluid Analysis
238
What is 45XO
Turners syndrome
Female phenotype disorder
* 2° sex characteristics do not fully develop at puberty
* Amenorrhea with atrophic ovaries (infertility)
* Genitalia, vagina & uterus does develop normally
* Wide out set nipples with rudimentary breast buds only
* Body habitus – short stature
* Webbed (broadened) neck
* Cubitus Valgus arms angle out ward at elbows
* Heart defects common – Coarctation (stricture) of Aorta
239
What disorder Produce abnormally thick mucus secretions blocking airways and pancreatic ducts
Cystic Fibrosis
240
What are two examples of stable cells
Rarely self-divides; can be stimulated to replicate as needed
– Kidney (proximal renal tubules)
-Liver – can regenerate to some extent
241
Describe contracture Vs stricture
Contracture, linear scars become shorter
Stricture, circular scars become smaller
242
What are the clinical S/s of systemic inflammation
```
Fever
Leukocytosis
Increased HR and BP
Decreased sweating
Anorexia
Somnolence
Malaise
```
243
Prostacyclin acts to counteract
The COX pathway
(Prostaglandins and Thromboxane)
From getting out of control
244
What are two examples of COX pathway inhibitors
ASA (Asprin), NSAIDS
| Inhibit prostaglandins and thrmboxane
245
Define atresia
absence or closure of body opening or tubular structure
| lacks hollow portion / lumen
246
When is Rhogam given to a suspecting mother
Typically twitching 12 hours of delivery
Prevents mother from developing Anti Rh antibodies
247
Pts with Chronic myelogeneous luekemia usually die within,….
3-5 years
248
What are the three morphologies of anemia
* Microcytic
* Normocytic
* Macrocytic
249
What are the first WBC to appear in an acute inflammation
Neutrophils
250
Fibrinous inflammation is most indicative of
Bacterial infections
251
What are the two types of wound healing repair techniques
First or primary intention
And secondary intention
252
What is the pathogenesis of chronic lymphocytic leukemia
Slowly progressive; most survive 7-9 yrs
• Increased infections because neoplastic lymphocytes do not fight infx as well as neutrophils
253
What is the role of CD4 Cells
• Part of antigen response
→Help B-lymphocytes produce antibodies
Secrete cytokines (interleukin)
Stimulate macrophages to become phagocytic
Trigger IgE and other immunoglobulins to activate eosinophils & basophils
254
How much urine output is required to clear the byproducts of metabolism
500-800 ml/day
255
Describe Lymphangitis
infection spreading along the lymphatic vessels; seen as red streaks (blood poisoning)
256
Human chorionic Gonadotropin (HCG)
Is a tumor marker for cancer located where?
Testicle
257
Define involution failure
persistence of embryonic structures; normally lost during development
258
What does megaloblastic anemia do to RBCs and WBCs
Macrocytic RBCs & hypersegmented WBCs
259
What would a tumor thats <2.3 cm, with Positve lymph nodes, and no metastisis be in the TNM staging
<2.3= T1
Positive lymph node= N1
No meta= M0
260
What is the ratio of Na/K in the extracellular vs the intracelluar fluid
Extracellular: high NA low K
Intracellular: low NA high K
261
What causes cells start rapid proliferation in epithelization
Contact inhibition
262
Granulomatous inflammation is most associated with
Chronic inflammation not acute
TB, fungal, parasites
263
What is the normal CD4/CD8 ration and what is the ratio in AIDs pts
normally, CD4 outnumber CD8 by 2-4:1
with AIDS, ratio often drops to 0.5:1 or less
264
Group B blood has what Ag and what Ab
B Ag
| Anti A Ab
265
Which organ is particularly vulnerable to fibrotic scarring
The spleen
| autospleenectomy
266
How can you treat polycythemia
Cytotoxic drugs
• Therapeutic phlebotomy (blood letting)
267
What are the two primary lymphoid tissues
```
Thymus (T cells)
Bone Marrow ( B cells)
```
268
What does the term aneuploid mean
cells possessing an abnormal number of chromosomes
269
H. Pylori causes
Peptic ulcers which can lead to adenocarcinomas
270
What is Lymphadenopathy
enlarged lymph nodes
reacting to an inflammatory or infection trigger
If slowly enlarging, persistent, and non-tender – possible early cancer
271
What does thrombotic thrombocytopenia purpura cause
Abnormal clotting in small vessels
microangiopathy
RBCs subjected to stress in narrowed vessels—
272
What is the prominent clinical presentation for polycythemia
Splenomegaly
273
What are two types of radiation causes of cancer
UV light Radiation
And
Ionizing Radiation
274
Alpha-fetoprotein (AFP)
Is a tumor marker for cancer where?
Liver and Testicle
275
Eosinophils are associated with what kind of reaction
Allergic reactions and parasitic infections
276
What is the clinical sign of Muliptle Myeloma
Surrounding bone destruction creates ‘punched-out’ appearance
• Calcium released from bones
277
What does CAUTION stand for
| Possible signs of cancer
C• Change in bowel or bladder habits
A• A sore that does not heal
U• Unusual bleeding or discharge
T• Thickening or a lump in breast or elsewhere
I• Indigestion or difficulty swallowing
O• Obvious change in wart or mole
N• Nagging cough or hoarseness
278
What do mature RBCs and platelets lack..
A nucleus
279
What are the two distinctions of gangrene
Wet and Dry gangrene
280
Name that disease:
One set Bimodal age peaks
Neck and mediastinal nodes
Reed Sternberg cells
80% survival rate
Hodgkin’s
281
What are disorders called that skip generations
Familial Disorders
Frequently are NOT inherited according to Mendelian genetic rules
282
How can you tell the difference between thalassemia and Iron deficiency
With electrophoresis that identifies HbA2
283
What is liquefactive necrosis
Tissues dissolve; most often in brain
Lytic enzymes transform tissue into pus within an abscess
284
What are two examples of Type II hypersensitivity
```
Graves Disease (Thyroid)
Hemolytic Anemia (RBCs)
```
Autoimmune disorders
285
What is a carcinoma
A cancer of epithelial origin
| Skin, GI, GU, Lung
286
TORCH syndrome impacts which organ systems
Multiple
* Brain -mental retardation ,neurologic symptoms
* Eyes - small size, cataracts
287
The Ab are found in what component of blood
Mostly in the plasma
288
Platelet counts below 20,000 can result in…
Spontaneous bleeding
289
Expectant mothers older than 35 should receive prenatal counseling for what disorder
Trisomy 21
290
What are the two types of inflammation
Acute vs Chronic
291
What is the difference between transudative and exudative edema
Transudative: clear serous fluid w/ low protein content & little to no cellular material
(Low specific gravity, clear)
Exudative: cloudy, pus-like fluid w/ high protein content, WBCs and cellular debris
(Has thick proteins, and is not clear, purulent)
292
What gives rise to the presenting signs and symptoms of the patient
The pathology of the disease
293
What are the three phases of progression in Chronic Myelogenous Leukemia (CML)
Chronic phase – lasts 2-3 yrs w/ marked leukocytosis and thrombocytosis
Accelerated phase – increased blast production from marrow
Blast Crisis phase – usually heralds death
294
What is hematochezia
Bloody stools
295
How can phospholilapses cause pathology
cause membrane damage
296
How does the lectin complement system get activated
starts with carbohydrate binding on bacterial surface
297
What is leukocytosis
WBCs above normal levels
* Normal response to inflammation or infection
* Persistent leukocytosis may represent early malignancy
298
Acute inflammation is associated most with what WBC
Neutrophils
299
Describe Type III hypersensitivity
Antibodies are formed as part of an ‘appropriate’ immune response
However, antigen-antibody complexes incorrectly deposit in/on other structures
Immune complexes become trapped in semi-permeable membranes
• Accidently activates complement system→recruits WBCs→resulting in cell damage
300
What is aplastic anemia
Loss of stem cells from bone marrow.
| Results in pancytopenia
decreased production of all blood cell lines
301
75% of congenital defects are…
Idiopathic
302
Explain Ischemia-reperfusion injury
Tissue damage occurring after re-establishing blood flow to an ischemic area
Lack of blood flow causes decrease O2 @ cellular level,
Na-K pump fails,
Permeability increases and cells swells
Free radical precursors are released
```
Blood flow is restored
Damage cell leaks out toxic contents
Neutrophils attack and destroy cells
O2 activates free radical precursors
More damage is caused
```
303
What describes how a disease develops
The pathogenesis
304
What are the three mechanisms of shock
```
Pump failure (cardiogenic shock)
(The hypoperfusion is directly related to the heart failing to pump)
```
```
Volume problem ( Hypovolemic shock)
(The hypoperfusion is directly related to an insufficient volume in the vessels)
```
```
Pipe problem ( hypotonic shock/ distributive shock)
(The hypoperfusion is a result of a loss of vascular tone)
```
305
What are the 5 types of decreased hematopoiesis anemia
* AplasticAnemia
* Myelophthisic Anemia
* Iron deficiency
* B12 & Folate deficiency
* Protein deficiency
306
Exudative fluid arrises from what factor
```
Increase permeability
(Allows larger proteins and molecules to get out of the vessel into the interstitium)
```
307
What are 5 known carcinogenic agents
```
Chemical
Microbial
Viral
Radiation
Genetic
```
308
Define: genome
The complete set of chromosomes
309
spontaneous abortions (miscarriage) often during 1st trimester without woman’s knowledge are often the result from
Morphogenesis
310
What percent is fluid of Total Body weight
60%
311
What is the pathogenesis of cystic fibrosis
Dysfunction in chloride transport
Mucus w/ less NaCL will also have less H20
Thicker mucus clogs the lumen of many organs
312
What is the WBC prominent associated with IgE
Basophils
313
Cellular hypoxia leads to…. Which in then leads too..
Decreased production of ATP, which leads to failure of the Na-K pump
314
Clinical Characteristics of Trisomy 21
Mental Retardation – most significant feature
intellectual disability ranges widely
Facial Features – wide face, low nose, slanted eyes w/ epicanthal folds
macroglossia (enlarged tongue) often protruding
Abnormal Extremities – hands w/ ‘simian’ crease; shortened limbs; 5th finger shorter
Internal Organ Defects – heart defects; GI tract atresia/stenosis; infertility (Males > Females)
Hematologic Abnormalities – anemia; predisposition for leukemia
315
What causes con wilderbrands disease
Deficiency of Von Willebrand’s factor (vWF)
• vWF helps platelet adhesion and stabilizes clotting Factor VIII - making it last longer
316
Explain permeability imbalance in edema
Higher permeability allows more fluid to leak out of blood vessels leading to more edema
317
What are the indirect indicators of possible cancer
Hypercalcemia
| Hyper coagulation
318
Cancer Antigen 125 (CA125)
Is a tumor marker for cancer where ?
Lung Breast, ovary, and pancreas
319
What is the marked S/s of irreversible shock
Circulatory collapse
MARKED hypoprofusion
Hypotension, RR failure, acidosis, anuria, DIC
320
Napthylanmine dyes cause
Bladder cancer
321
How can proteases cause pathology
Break down membrane and cytopskeltal proteins
322
What can ultrasound be used for in prenatal testing
non-invasive, widely available, & inexpensive
• Look for fetal malformations & placenta development/placemen
323
What are the three major steps to inflammation
Dilation
Increased permeability
Emigration of Leukocytes
324
What are the three pathways of metastatic spread
Hematogenous spread
Lymphatic Spread
Direct seeding of body cavity surfaces
325
Aflatoxin (from aspergillus fungus) causes
Liver cancer
326
What are the three general etiologies of Hypotonic/ Distributive Shock
1. Sepsis
2. Anaphylaxis
3. Neurogenic trauma
327
Purulent inflammation arises form
Pus forming bacteria
328
In what gender are X linked recessive disorders expressed in
Expressed in males only.
Females only carry the X-linked trait.
329
Describe Type IV hypersensitivity
Mediated by Previously Sensitized Cells
(T-lymphocytes and macrophages)
Antibodies are NOT involved
Macrophages take up antigen and present antigen to T-lymphocytes
330
What are paraneoplastic syndromes
May be an early sign of occult (hidden) neoplasm
- hypercalcimia
- hyper coagulation
331
What is the most common form of anemia
Iron Deficiency Anemia
332
What is the process of phenylketonuria
Phenylalanine is not metabolized causing phenylalanine to accumulate, which then breaks down into phenylketones, which is then secreted in the urine.
333
What are 3 clinical examples of type III hypersensitivity
Lupis (SLE)
Post streptococcal Glomerulonephritis
Polyarteritis nodosa
(Autoimmune disorders)
334
What kind of non hogskins lymphoma is endemic in children with EBV
Burkitts Lymphoma
Involves mandible & face; responds well to chemotx
335
What is the difference of Hypoxia/ Anoxia and Ischemia
Hypoxia/ Anoxia is a reduced or lack of O2 specifically
Where ischemia is insufficient blood flow to an area and causes more damage as tissue lacks both O2, nutrients, and results in an excess of waste build up
336
```
Grade X:
Grade I:
Grade II:
Grade III:
Grade IV:
```
```
X: unknown
I: well differentiated, low grade
II: moderately differentiated
III: poorly differentiated
IV: undifferentiated, High grade
```
337
What Ig mediates Type II hypersensitivity
IgM and IgG
Antibodies bind to antigens in/on cells or tissue component
Gets confused,
Activates complement system→Membrane Attack Complex (MAC)→Cell Lysis (Cytotoxicity)
338
What is the gene defect in Hemophilia
Gene defect of coagulation factors;
50% are X-linked & 50% are spontaneous mutations
339
What are the secondary lymphoid tissues
Lymph nodes (tonsils and adenoids)
Spleen
GI and Bronchial Mucosa (MALT)
340
What are the clinical features of Idiopathic Thrombocytopenia Púrpura
Petechiae or
* Easy bleeding from nose or gums
* Splenomegaly common - sequestration of platelet-antibody complexes
341
What is the defection sickle cell anemia
Defect w/ hemoglobin synthesis produces Hemoglobin S (HbS)
342
What are the clinical features of non Hodgkin’s lymphoma
* Painless lymph node enlargement, may be solitary or diffuse
* Extra-nodal tumor spread – tumor cells infiltrate major organs
* Systemic symptoms – fatigue, malaise, fever, sweating
343
Explain Vascular pressure imbalance in edema
– mostly impacts the venous return system
Increased hydrostatic pressure pushes fluid outside blood vessels leading to more edema
344
S/s for Thrombotic thrombocytopenia purpura
* Purpura and ecchymosis; bleeding from nose or gums
* Hemolytic anemia – leads to anemia, jaundice
* Small vessel disease affects brain, kidneys, eyes
345
```
What happens if an embolus gets lodged in the
Brain-
Intestine-
Kidney-
Lower Extremity-
```
* Brain – ischemic stroke or infarction
* Intestine – bowel (mesentery) ischemia or infarction
* Kidney – infarcts w/ hematuria
• Lower Extremity
-Tiny emboli - “blue toe” necrosis
-Large emboli - ischemia of tissues
cold, pulseless leg
346
What is the most common lethal autosomal disorder
Cystitis fibrosis
347
What is the tx for Acute Lymphoblastic Leukemia (ALL)
With modern chemotherapy, remission achieved in ~66%
* without chemotherapy – usually fatal in 3-6 months
* Prognosis is better for children than adults
348
Where is a common spot for DVT
Deep vein thrombosis typically occurs in the legs or pelvis
349
What are the three types of chromosomal structural abnormalities
Deletion
Inversion
Translocation
350
What area is most often effected by direct seeding metastatic spread?
Most often seen in the peritoneal cavity
351
What are 4 causes of cardiogenic shock
MI
Vfib
Pericardial Tamponade
Tension Pneumo
352
Oncogenes created by 4 main mechanisms:
1. Point Mutation
2. Gene Amplification
3. Chromosomal Rearrangement (Translocation)
4. Insertion of Viral Genome
353
Chrons disease, celiacs, GI ulcers, gastric bypass pts, can all lead to what type of anemia
```
Megaloblastic anemia
(B12 deficiency)
```
354
Generally, Tumor Markers are NOT recommended for routine screening
With what Exception:
Prostate-specific antigen is used for prostate cancer screening
355
Define Atrophy
Decreased size or growth of tissue or organ often w/ diminished fxn
356
Histamine is released form what cells
Mast cells, basophils, and platelets
| Preformed
357
Nuclear pathology results in failure of:
protein & enzyme synthesis; growth regulation, mitosis
358
Describe Lymphadenitis
lymph node itself is infected usually forming an abscess
359
Due to their rapid growth malignant tumors are..
Poorly demarcated, lacking a defined wall or capsule
And
Invasive, penetrating the surrounding tissue.
360
What is the presentation for Christmas Disease
Hemophilia B “Christmas Dz”
– Factor IX (Christmas factor)
Less common but often more severe form
Easy nose & oral bleeding
Bleeding into joints even from minor trauma Cerebral hemorrhage
361
What type of blood would be used in an emergency situation
O RBCs
362
A male with Iron deficiency anemia should be suspected for what
GI ulcer or Cancer
363
How are X-linked recessive disorders transmitted
Mother’s transmit disorder only to sons
Fathers w/ disease transmit trait to daughter.
FATHERS DO NOT TRANSMIT DISORDER TO SONS
364
What is the body’s first response to injury
Vascular changes (dilation)
365
What is the approx liters of water a day for intake
2.5 liters per day
75% from oral
25% from solid foods
366
What is the most signifiant feature of trisomy 21
Mental retardation
367
Ulcerative inflammation is from
Surface tissue breakdown from underlying inflammation
| Body surfaces/ mucosa
368
What are the two classes of pathogenesis
Genetic and acquired
369
Group O is known as the …
| Group AB
O is the universal donor because it has no antigens
AB is the universal recipient because they have no Ab
370
Iron deficiency anemia, canses RBCs to be…
Microcytic and Hypochromic
| Smaller and less color
371
What does MCHC measure
Mean Corpuscular Hemoglobin Concentration
| = avg conc of hemoglobin/RBC
372
How is Rh Ab formed
Only formed when Rh neg pt is exposed to Rh pos
373
Describe the 4th step in wound healing
Tissue remodeling
Maturation phase
(begins 21 days after injury)
Collagen is remodeled
Wound closes however subsurface remodeling continues
Full strength achieved after several months
374
What are 2 types of Macorcytic Anemia
b12 or folate deficiency
| MCV ELEVATED
375
Slowly enlarging and persistent non tender lymph nodes is a warning sign for…
Cancer
376
What is the action of bradykinin
It’s a plasma derived acute inflammation mediator
Simular to histamine, but slower
Amplifies and prolongs inflammatory response
Capable of inciting pain
377
What are the 3 main functions of the complement system
Prolongs Inflammation
Phagocytosis through opsinaization
Cell Lysis through MAC attack
378
What are the clinical features/ S/s of DVT
Pain
Warmth
And Color changes
(Changes are seen unilaterally)
379
What is virchows triad of thrombosis
1. Injury to endothelium
2. Hemodynamics changes in vein
3. Hypercoagulable state
380
What is the highest risk of blood compatibly reaxns
Whole blood transfusions
Minor are from preservatives not front he blood
381
What is the normal ration of CD4 to CD8 cells
Normally,
| CD4 outnumber CD8 by 2-4 to 1
382
What are the three causes of iron deficiency anemia
```
Increased Iron Loss ( blood loss)
Decreased Iron uptake
(poor diet, absorption)
Increased Iron requirement
(Pregnancy, menses, surgery)
```
383
What determines a persons observed phenotype
Expressed genotype + Environmental influences
384
What are the two most frequently involved organs with hematogenous metastatic spread
Liver and the Lungs
385
What is thrombocytopenia
Abnormal low platelet count
386
How is cross-matched blood kept
held specifically for that patient only
387
What does the acronym TORCH stand for
Used for Microbial teratogens
T-Toxoplasmosis (parasite from cat feces)
O – Other less common microbes Epstein-Barr, Varicella, Listeria
R-Rubella (German measles)
C-Cytomegalovirus (CMV) (common human virus)
H-Herpes Virus
388
What is Chronic Myelogenous Leukemia (CML)
Bone marrow becomes overgrown w/malignant cells
90% w/ Philadelphia chromosome 22 abnormality
Most patients are older than 30yrs
389
What are the the S/s of polycythemia
Splenomegaly is prominent feature
* Skin appears dark red or flushed
* Blood is hyper-viscous & tends to clot easily
* Headaches, hypertension, visual and neurologic problems
390
What is the S/s of minor transfusion RXNs
Urticaria, fever, bronchospams
391
What are the 5 causes of “loss or destruction” of RBCs anemia
* Bleeding (acute/chronic)
* Malaria
* Hemolytic anemia
* Medications
* Spleen Sequestration
392
What is considered the hallmark of malignancy
Anaplasia
Lack of differentiation
393
Parasites such as Schistosoma haematobium are associated with what type of cancer
Bladder cancer
394
Hypertrophy can only occur in what type of muscle
Heart and striated
395
What does the term Neoplasia mean
“New Growth”
Neoplasms or tumors
NOT necessarily cancer
Can be Benign or Malignant
(example:wart vs. melanoma)
396
What happens if enzymes
| (from lysosomes) accidentally leak within a cell
Injured cell cytoplasm becomes acidic; inappropriately activating enzymes
Once activated, the enzymes cause significant cell damage
397
Malignant cells regress to…
Fetal/ embryonic functions of that cells line
398
Hyperplasia is usually the result of what
Hormonal stimulation , mediations, or chronic injury
399
What is the Disorderly transition, arrangement and layering of cells types and is often considered precancerous
Dysplasia
400
Arsinic causes
Skin cancer
401
What are the 5 types of Morphogenesis
```
Agenesis
Aplasia
Atresia
Hypoplasia
Involution failures
```
402
What is the most common form of leukemia in children esp under age 5
Acute Lymphoblastic Leukemia (ALL)
* bone marrow w/ immature lymphoid cells (blasts)
* malignant lymphoid cells in peripheral blood
403
Define: Karyotype
the full chromosome set contained within a nucleus.
Often referred to as chromosomal count/code - 46XX (human female), 46XY (human male)
404
What is the difference between a pulmonary infiltrate and a pleural effusion
In an infiltrate the fluid has infiltrated the tissues (it is IN the tissue)
In an effusion, is it AROUND the tissue.
405
Name and define the Myeloid Cells
Granulated WBCs / Complex Nucleus
* Neutrophils, Eosinophils, Basophils
* RBCs and Platelets
406
What is a major physical teratogen
Radiatio
| Medical X-rays
407
What is the normal urine output per day
1-1.5 liters per day
408
How do cyanide disrupt oxidative phosphorylation
Disrupts the Cytochrome C oxidase step
Decreases atp production, leads to cellular hypoxia
409
What is the result of Na-K pump failure
Na osmotically “tries” to get into the cell, but pump prevents this
If pump fails, then too much Na and water enter cell
Resulting in cellular edema, dysfunction, and possible lysis
410
Which is worse Hemophilia A or B
B is worse w. Excessive bleeding
411
Oxidative phosphorylation leads to…
ATP production, and energy for the cell
412
Group A blood has what Ag and what Ab
A-Ag
| Anti-B Ab
413
Is Rh and dominant or recessive gene
Dominant
414
What leads to a Vaso-Vagal episode
1. Deep brainstem activated by triggering stimuli
(sight of blood; extreme emotional distress)
- Enhanced parasympathetic (vagal) tone→sudden bradycardia (nausea, diaphoresis)
- Decreased sympathetic tone→sudden vasodilation (blood pressure drops, pallor)
2. Combination of sudden bradycardia and hypotension decreases the cardiac output
3. Brain becomes under perfused→syncope (faint)
415
What is the largest percentage of cancer deaths in men and women
Lung and bronchus cancers
416
What is the most common clinical form of Type IV hypersensitivity
Contact dermatitis
417
Serous inflammation is most indicative of
Physical agents
| Burns, poison ivy
418
What are the lab value levels for anemia in men and women
Anemia Levels:
M < 13 g/dL
F < 11.5 g/dL
419
What are the criteria for SLE (Lupus)
SLE Criteria:
(4 or more required for diagnosis)
• Dermatitis - Malar rash and discoid rash
• Arthritis - Non-erosive arthritis in 2 or more peripheral joints
• Nephritis-Renal disorders foundin >50% of SLE patients
• Serositis - Pleuritis, pericarditis
• Neuritis–varietyofneurologicdisorders
• Vasculitis
• Hematologicdisorder-hemolyticanemia,leukopenia,lymphopenia
420
Pseudomembranous inflammation is most associated with
C. Diff
421
Interstitial space is often called …
“Third space”
Space between cells, not within vessels, cells, or body cavities
422
Is chemo effective for pts with multiple myeloma
No, death within 3-4 years
423
Name that disease:
Onset Any age
Painless lymph node
Extra nodal tumor spread
Variable survivability
Non-hodgkins
424
What is the most common outcome of inflammation
Complete resolution
425
What effect does histamine have on the endothelium
Increase permeability
426
Spleen enlargement causes what
Cytopenia from sequestration
427
Rapid hypoxia/ anoxia most often leads to what type of necrosis
Coagulative
428
What are the classic symptoms of a PE
Sudden chest pain, very rapid onset of seconds to mins
Sudden SOB and Tachypnea
Hemopytsis ( coughing up blood)
429
How does fetal alcohol syndrome progress
Causes intrauterine growth delay
Small baby w/ facial changes
430
What is the marked sign of decompensated shock
Hypotension and Acidosis
431
Deficiency in these 4 nutrients can lead to anemia
* Iron deficiency
* B12 & Folate deficiency
* Protein deficiency
432
What are 4 causes of chronic inflammation
Resistant microbes
Autoimmune diseases
Repeated toxic exposure
Foreign bodies
433
What are the two types of wound reactions
Regenerative (repair)
Scar formation
(often occur together)
434
Which cells are least sensitive to Ionization radiation
Nerve cells
Bone (not marrow)
Muscle
435
How can apoptosis cause pathology
Usually does not, nor does it trigger inflammation however lack of physiologic apoptosis can lead to leukemia or syndactyl (webbed toes)
436
To for hemophilia
Infusions of MAN MADE recombinant clotting factors
437
What are the two classes of inflammatory mediators
Plasma derived and cell-derived
438
Define an embolism
Freely mobile, intravascular mass carried from one site to another
439
What does maternal blood analysis in prenatal testing look for
Screen for fetal substances in maternal circulation
• Alpha-fetoprotein (AFP) ↓ levels associated with Down’s
440
Describe COX pathway
Produces Prostaglandins - vasodilation, vascular permeability, pain, and fever
Thromboxane - platelet aggregation, thrombosis, vasoconstriction
441
What does hemoarethrosis mean
Blood in a joint or synovial cavity
442
What are three common lab markers for irreversible cell injury
AST- Aspartate aminotransferase
ALT - Alanine aminotransferase
LDH - lactate dehydrogenase
443
Explain lymphatic drainage imbalance in edema
Interstitial fluid unable to drain away causing fluid accumulation which leads to edema
444
What are the 4 major groups of abnormal immune responses
* Type I – Anaphylactic or Atopic Reaction
* Type II – Cytotoxic Antibody-Mediated Reaction
* Type III – Immune Complex-Mediated Reaction
* Type IV – Cell-Mediated or Delayed-Type Reaction
445
What is primary polycythemia
(polycythemia vera)
• Myeloproliferative disorder considered neoplastic
• Hematopoietic stem cell proliferation WITHOUT external stimuli causes over-production of RBCs
