Pathology Flashcards
(106 cards)
1
Q
Rapid destruction of valves by Staphylococcus aureus
A
Acute infective endocarditis
2
Q
Gradual damage to valves with long term PUO
A
Subacute infective endocarditis
3
Q
Subacute infective endocarditis signs
A
- PUO
- Clubbing
- Splinter haemorrhages
- Roth spots
- Splenomegaly
- Microscopic haematuria
4
Q
Major causative organism in subacute infective endocarditis
A
Strep viridans
5
Q
Raised serum ALP and ‘beading’ of bile ducts of ERCP (caused by biliary strictures)
A
Primary sclerosing cholangitis
6
Q
Skin rash, thought to be associated with viral infection, characterised by small patches of flakey pink or red skin found predominantly on the torso and back, often preceded by a single oval-shaped ‘herald’ patch 7-14 days prior to the main rash
A
Pityriasis rosea
7
Q
Nutmeg liver
A
Caused by congestive heart failure
8
Q
Oat cells
A
Histological finding associated with small-cell lung cancer
9
Q
CREST syndrome
A
Calcinosis (calcium deposits in soft tissue) Raynaud's phenomenon Esophogeal dysmotility Sclerodactyly Telangiectasia
Anti-centromere
10
Q
CREST syndrome is also known as…
A
Limited cutaneous form of systemic sclerosis/scleroderma
11
Q
Diffuse scleroderma
A
- May also affect internal organs such as the kidneys, lungs and heart (unlike limited cutaneous scleroderma which mainly affects the skin)
12
Q
Stain used in the diagnosis of amyloidosis
A
Congo red (appears apple-green under polarised light)
13
Q
pemphiguS vs pemphigoiD
A
pemphiguS = Superficial pemphigoiD = Deep
14
Q
- Blistering disorder caused by autoantibodies against desmogleins disrupting the desmosomal connections of the epidermis
- Superficial, fragile, intraepidermal bullae
A
Pemphigus vulgaris
15
Q
Nikolsky’s sign
A
Slight rubbing of the skin results in exfoliation of the outermost layer, associated with toxic epidermal necrolysis and pemphigus vulgaris
16
Q
Bullous pemphigoid
A
- Autoantibodies directed against the hemidesmosomes that tether epithelial cells to the basement membrane resulting in less fragile sub-epidermal bullae
- Patients are more likely to have intact, tense bullae (rather than the ruptured and scabbed bullae of pemphigus vulgaris)
17
Q
C1 inhibitor deficiency
A
- C1 inhibitors prevent inappropriate activation of the complement system
- Deficiency may cause hereditary angioedema (episodes of swelling affecting the face, upper airways, extremities and GIT)
18
Q
Skin condition, thought to be immune-mediated, that presents with annular target lesions
A
Erythema multiforme
Can be caused by infections such as HSV or drug reactions e.g. penicillin
19
Q
Slow-growing type of neuroendocrine tumour that may cause flushing, diarrhoea, wheezing and abdominal cramping due to the excessive release of vasoactive hormones
A
Carcinoid (causing carcinoid syndrome, usually due to serotonin release)
20
Q
Test for carcinoid syndrome
A
Urinary 5-HIAA (end product of serotonin/5-HT metabolism)
21
Q
Range of autosomal recessive diseases resulting from mutations in the enzymes that produce cortisol in the adrenal glands
A
Congenital adrenal hyperplasia
22
Q
Most common form of congenital adrenal hyperplasia
A
21-hydroxylase deficiency
23
Q
Key features of 21-hydroxylase deficiency
A
- Elevated ACTH (due to inefficient cortisol synthesis, causing adrenal hyperplasia)
- Androgen excess (synthesis is unaffected by mutation and is driven by an excess of precursors which spill-over from the inefficient cortisol pathway)
- Mineralocorticoid deficiency
24
Q
Parvovirus B19 ‘slapped cheek’ rash
A
Erythema infectiosum
25
Risk to fetus from parvovirus B19
- Less than 20 weeks = 3% risk of hydrops fetalis
| - No risk if greater than 20 weeks
26
RNA virus that may cause flu-like symptoms, a pin-point maculopapular rash and lymphadenopathy in adults and poses a risk to fetal development
Rubella
27
Congenital rubella syndrome (CRS)
Classic triad:
- Sensorineural deafness
- Eye abnormalities
- Congenital heart disease
Rare if infected after 20 weeks
28
Major physiological determinants of plasma osmolarity
Na+, K+, Cl-, HCO3-, urea, glucose
29
Calculating osmolarity
2(Na + K) + urea + glucose
30
Serum osmolality normal range
275 - 295 mmol/kg
31
Osmolar gap
Osmolality (measured) - Osmolarity (calculated)
- Should be less than 10
- An elevated gap may be caused by the presence of an abnormal solute (e.g. ethylene glycol, ethanol, methanol)
32
Anion gap
(Na + K) - (Cl + HCO3)
- Measures the difference between the total concentration of principal cations (positive ions) and anions (negative ions), providing an estimate of the concentration of unmeasured anions in the plasma (since the plasma is electrochemically neutral)
- Under normal physiological conditions the anion gap is mostly contributed to by albumin (a negative protein), thus hypoalbuminaemia can lower the anion gap
33
Normal anion gap
14 - 18 mmol/l
34
Causes of high anion gap metabolic acidosis
K - ketoacidosis (DKA, alcoholic, starvation)
U - uraemia (renal failure)
L - lactic acidosis
T - toxins (ethylene glycol, methanol, salicylates)
35
Virus capable of causing aseptic meningitis and Bornholm disease (fever, headache, attacks of severe pleurodynia)
Coxsackie B virus
36
Rubbing of psoriatic plaques causing pin-point bleeding
Auspitz' sign
36
Parakeratosis
Nucleated cells found in the stratum corneum due to excessive proliferation of keratinocytes (e.g. psoriasis)
37
Guttate psoriasis
Rain-drop plaque distribution, often following a Streptococcal throat infection
38
Wickam's striae
White lines visible in the papules and plaques of lichen planus
39
Clubbing of rete ridges ("test tubes in a rack")
Psoriasis
40
Munro's microabscesses
Psoriasis
41
Saw-toothing of rete ridges
Lichen planus
42
Rapidly growing nodule with a scaly keratin core that arises from sun-damaged hair follicle skin cells
Keratoacanthoma
43
Narrow, elongated cell associated with sarcoma
Spindle cell
44
Causes of microcytic anaemia
IDA
Anaemia of chronic disease
Sideroblastic anaemia
45
Causes of normocytic anaemia
```
Acute blood loss
Anaemia of chronic disease
BM failure
Renal failure
Haemolysis
Pregnancy
```
46
Causes of macrocytic anaemia
```
FATRBC
Fetus (pregnancy)
Antifolates (e.g. phenytoin)
Thyroid (hypothyroidism)
Reticulocytosis
B12 or folate deficiency
Cirrhosis
```
47
Hepcidin
- Produced by the liver
- Inhibits transferrin and reduces iron absorption from the gut
- Causes iron to accumulate in macrophages (key protein: ferritin, intracellular iron storage)
- Invading bacteria deprived of iron
48
Microcytic anaemia with ring sideroblasts in the bone marrow
Sideroblastic anaemia
- Ineffective erythropoiesis with poor incorporation of iron into haemoglobin
- Can lead to haemosiderosis (damage to organs due to haemosiderin deposition)
- Causes: myelodysplastic disorders, chemotherapy, irradiation, alcohol, anti-TB medication
49
Which cells produce intrinsic factor?
Gastric parietal cells
50
Pernicious anaemia
Lack of intrinsic factor for vitamin B12 absorption due to autoimmune attack of parietal cells
51
Inherited haemolytic anaemia
- Membrane (hereditary spherocytosis)
- Enzyme (G6PD deficiency, pyruvate kinase deficiency)
- Haemoglobinopathy (SCD, thalassaemia)
52
Acquired haemolytic anaemia
- Immune (autoimmune and alloimmune)
| - Non-immune (mechanical, PNH, MAHA, infection e.g. malaria, drugs)
53
Chromosome affected in CF due to mutations in the CFTR gene
Chromosome 7
54
Most common CFTR gene mutation in the UK
Delta F508
55
Major copper carrying protein in blood
Caeruloplasmin
56
Intracellular copper transporting protein mutated in Wilson's disease
ATP7B
Leads to reduced levels of serum caeruloplasmin due to poor copper binding to apocaeruloplasmin in the liver
57
Howell-Jolly bodies
Peripheral RBCs containing purple nuclear remnants due to splenic dysfunction (e.g. post-splenectomy, SCD)
58
Nephrotic syndrome
Proteinuria
59
Nephritic syndrome
Proteinuria *and* haematuria
Can occur in post-streptococcal glomerulonephritis
61
Histological features of rheumatic fever
Fibrous vegetations (verrucae)
Aschoff bodies
Anitschkov myocytes
62
Haemophilia A
Factor VIII deficiency
Most common
63
Haemophilia B
Factor IX deficiency
64
Growth medium used for culture of TB
Lowenstein-Jensen medium
65
1st generation cephalosporin
Cephalexin
66
2nd generation cephalosporin
Cefuroxime
67
3rd generation cephalosporins
Cefotaxime
Ceftriaxone
Ceftazidime (covers Pseudomonas)
68
Ophthalmia neonatorum
Neonatal conjunctivitis caused by infection with gonorrhoea or chlamydia via the birth canal
69
Chlamydia serovars responsible for trachoma
A, B and C
70
Chlamydia serovars responsible for genital infection
D-K
71
Chlamydia serovars responsible for lymphogranuloma venereum
L1, L2 and L3
72
Antifungal medication used to treat cryptococcal meningitis and invasive fungal infection
Amphotericin B
73
Virus capable of causing hand, foot and mouth disease and herpangina
Coxsackie A virus
74
Most common cause of HSV encephalitis
HSV-1
| 1 brain!
75
Allopurinol must NOT be prescribed to a patient taking which drug?
Azathioprine
76
Trimethoprim must not be prescribed to a patient taking which drug?
Methotrexate
77
Key ketones
Beta-hydroxybutyrate
Acetoacetate
Acetone
78
Epigastric pain during meals
Gastric ulcer
79
Epigastric pain relieved by meals
Duodenal ulcer (pain worsens 2-3 hours after eating once the pyloric sphincter reopens)
80
Poisoning: nausea, vomiting, abdominal pain, tinnitus, hyperventilation, mixed acid-base disturbance
Salicylates
81
Poisoning: drowsiness, tachycardia, wide QRS on ECG
TCAs
82
Beta blocker overdose with cardiogenic shock
Glucagon
83
Classic histological finding in ulcerative colitis
Crypt abscesses
84
Gene affected in X-linked agammaglobulinaemia
Bruton's tyrosine kinase (Btk) gene
85
Gene affected in Wiskott-Aldrich syndrome
WASP
X-linked
- eczema
- thrombocytopaenia
- immunodeficiency
86
Rheumatoid arthritis, splenomegaly and neutropaenia
Felty's syndrome
87
Condition closely associated with giant-cell arteritis
Polymyalgia rheumatica
88
Leukoerythroblastic anaemia
Anaemia resulting from a space-occupying lesion in the bone marrow, leading to immature white cells and nucleated red blood cells in the peripheral circulation
89
Positive Donath-Landsteiner test
Paroxysmal cold haemoglobinuria
90
Positive sucrose lysis and Ham tests
Paroxysmal nocturnal haemoglobinuria
91
Paroxysmal nocturnal haemoglobinuria
Acquired condition caused by the absence of GPI anchors on the red cell membrane (GPI anchors are protective against complement attack)
92
Kala-azar
Visceral leishmaniasis
93
Visceral leishmaniasis symptoms
Sandfly bite --> infection with protozoan Leishmania
- fever
- hepatosplenomegaly
94
Trypanosomiasis
Tsetse fly bite --> infection with protozoan Trypanosoma
- intermittent fever with lymphadenopathy
- CNS symptoms e.g. sleepiness
95
Reed-Sternberg cells with owl's eye appearance
Hodgkin lymphoma
96
Treatment of toxoplasmosis
Pyrimethamine and sulphadiazine
97
Key bacteria associated with bacterial vaginosis
Gardnerella vaginalis
98
Niacin (vitamin B3) deficiency
Pellagra
- dementia
- diarrhoea
- dermatitis
99
Common causes of athlete's foot
Trichophyton rubrum and Epidermophyton floccosum
100
'Strawberry cervix'
Colpitis macularis - from infection with Trichomonas vaginalis
101
Leventhal-Cole-Lille bodies
Psittacosis
102
Chromosome affected in Prader-Willi/Angelman syndrome
Chromosome 15
103
Prader-Willi syndrome imprinting: paternally or maternally inherited mutation?
Paternal
104
May be caused by anti-leukocyte antibodies in donor blood
TRALI
105
May lead to anaphylaxis to blood transfusions/IVIG
IgA deficiency (reacting to IgA in donor blood)
106
HHV-6 and HHV-7 infection
Childhood
Roseola
Exanthem subitum
