Patho Small Group 1 - Justin Flashcards Preview

Pathology block 1 > Patho Small Group 1 - Justin > Flashcards

Flashcards in Patho Small Group 1 - Justin Deck (24)
1

Metaplasia is always ____________ & _____________

Pathologic and reversible

2

Metaplasia is commonly caused by process that could lead to _______

Cancer

3

Define pleomorphism

Variety in size and shape of cancer cells

4

Metaplasia of the esophagus is also known as

Barrett's esophagus

5

Features of squamous cell carcinoma are

Eosinophilia
Large nuclei (much larger than lymphocytes)
Flattening of cells

6

3 common signs of lung cancer are

Cough
Hemoptysis
Weight loss

7

Case 3

32 y/o male with jaundice
PE: enlarge tender liver

T: 38.2
HR: 65
BP: 160/80
Bilirubin : 3.9 ( < 1.3 )
AST: 30,483 (< 60)
ALT 23,338 ( < 60)

Classic Dx:

Tylenol and EtOH overdose (toxicity)

According to other sources ( ask me if you want them )

Typical transaminases elevation of EtOH + Tylenol # are
AST 19000
ALT 16000

8

Common causes of hepatic injury are:

Alcohol hepatitis
Shock
Tylenol toxicity
Sepsis
Antibiotics
Pregnancy
Viral hepatitis

9

Characteristics of alcohol hepatitis are

Age: 40-60
Rapid onset of jaundice
Moderately elevated AST < 300
Mild elevation of ALT
De Risis ratio AST/ALT > 2

Resources from my other source states that in acute alcohol hepatitis typically shows
AST: 160
ALT: 80

Please do not memorize these numbers but use them as a reference of typical # in most people. Values will be different depending on the person.

10

Characteristics of Shock

Rapid rise in TA
25-250x ULN

1-3 days steady decline to normal in 7-10 days

Bilirubin increases as TA levels fall
ALP moderately raised (2x at most)

Shock liver which is low cardiac output, leading to hepatic ischemia

11

Classic Tylenol overdose characteristic are

NAPQI is the toxic metabolite that conjugate with GGT

Normal if adult takes < 10 g / day. (20 pills)
> 12g likely show toxicity
> 16g severe toxicity

1st 24 hr: nausea, vomiting, sweating, pallor, lethargy, malaise

B/t 24-72hr: pt feels fine
B/t 72-96 hr: manifest reappears with jaundice, confusion, bleeding

Tx: N-acetyl cysteine

12

Sepsis characteristics are

Mildly Elevated bilirubin
Mild elevated TA and ALP

13

Case 5
65 y/o CC: chest pain
Obese, occluded coronary artery with balloon angioplasty, then dies a few hr later

Micro pathology shows: tiny condense fibrin clot
Red ( hemorrhagic ) infarct

Cause of death:

Coagulative necrosis with reperfusion injury.

14

Case 7: fever, night sweats, malaise and cough

X ray: lung nodules and enlarge lymph node

Biopsy: langhan multinucleated giant cell
Granuloma present
+ acid fast stain

Classic scenario for

TB mycobacterium tuberculosis

15

What infection mimics clinical manifestation of TB?

Histoplasma capsulatum - fungal infection
Causes endemic infection in the Mississippi River valley

16

How do you test for histoplama capsulatum ?

Grocott stain = black dots

17

Low bicarbonate could be a result of

Kidney failure

18

These are based on the resource i found

Typical TA elevation of hepatocellular diseases

AST: 160
ALT: 80

Alcoholic hepatitis

19

These are based on the resource i found

Typical TA elevation of hepatocellular diseases

AST 120
ALT 180

Autoimmune hepatitis

20

These are based on the resource i found

Typical TA elevation of hepatocellular diseases

AST: 46
ALT: 78

Chronic hepatitis C

21

These are based on the resource i found

Typical TA elevation of hepatocellular diseases

AST: 400
ALT: 800

Acute viral hepatitis

22

These are based on the resource i found

Typical TA elevation of hepatocellular diseases

AST: 19,000
ALT: 16,000

EtOH and Tylenol toxicity

23

Aminotransferases > 5 ULN

Acute or chronic liver problem?

Acute problem

24

Aminotransferases < 5 ULN

Acute or chronic liver problem?

Chronic