Pathology Flashcards
(155 cards)
1
Q
Mobitz I
A
–Progressive PR int lengthening–>drop QRS
aka weinkebach
Usually due to inferior MI. Rarely progresses to 3rd degree heart block
Tx: Atropine or isoproterenol
2
Q
Mobitz II
A
-intermittent P nonconduction
BBB association
Often progresses to 3rd deg AV block
Usually due to anterior MI
3
Q
P wave
A
atrial depol
4
Q
a wave
A
LA contraction
5
Q
T wave
A
ventricular repolarization
6
Q
Wavy fibers
A
Eiosinophilic bands of necrotic myocytes. Early sign of MI
7
Q
Janeway’s Lesions
A
Acute bacterial endocarditis
Nontender, erythematous lesions on palms & soles
8
Q
Osler’s Nodes
A
Subacute endocarditis sign?
Tender lesions of fingers & toes
“ouch ouch Osler”
9
Q
Thiamine deficiency
A
Wet Beri Beri -> heart. Dilated cardiomyopathy due to chronic ETOH consump
Dry Beri Beri = peripheral neuropahty
Wernicke-Korsakoff= ataxia, confusion, confabulation, memory loss, vision changes
10
Q
Fibrinous Pericarditis
A
Associated w MI–3-7 days ppost transmural MI
Dresslers (6-8 wk)– autoimmune Igs to pericardium
11
Q
Serous pericarditis
A
Associate w/ nonbacterial causes: viral (Coxsackie) infection, immunologic rxns
12
Q
Friction Rub
A
Pericarditis associated finding
13
Q
Hemorrhagic pericarditis
A
Associated w TB or neoplasm
14
Q
Restrictive Cardiomyopathy
A
stiffens heart, diastolic dysfct
Due to amyloidosis in elderly
Die to Schaumann & asteroid bodies in youn (<25)?
15
Q
PML’s infectious agent
A
JC virus
papovirus= dsDNA, naked icosohedral capsid
16
Q
Edema
A
- ↑Pc (more seeps out)
- ↓πc (less reabsorbed into vessel)
- ↑ permeability endothelium
- Block lymphatic drainage
17
Q
Adult Polycystic Kidney Disease
A
AKA autosomal-dominant polycystic kidney disease
Commonly see: liver cysts, Berry aneurysms along w/ kidney cysts. Hematurea & HTN often present
3 cysts in each kidney w + fam hx confirms dx
18
Q
Malignant HTN & Kidneys
A
Petechial hemorrhages are seen on kidney surfaces= Flea-bitten kidneys
Young AA men
19
Q
Nephritic Signs
A
Hematuria; RBC casts; HTN
20
Q
Nephrotic Signs
A
Proteinuria; hypoalbuminemia; edema
21
Q
Podocyte Effacement
A
Seen w Minimal Changes Disease (lipoid nephrosis)
22
Q
ASO
A
Seen in Acute post-streptococcal GN (due to βHGASrtep)
Anti streptinolysin O
23
Q
Crescentic GN
A
Rapidly progressive GN- nephritic syndrome
Associated w/ multisystem disease or post-strep/post-infectious glomerular nephritis
24
Q
Hereditary Nephritis
A
Alport’s syndrome…X linked
Renal disease w/ deafness & occular abnormalities
25
Membranoproliferative GN
Can be secondary to to complement deficiency, chronic infections, CLL
See "tram tracking" on histo
26
Type I Membranoproliferative GN Deposits
C3 and IgG deposits-- immune complex deposits
27
Type II Membranoproliferative GN Deposits
Only C3 deposits
| AKA dense deposit disease
28
Focal Segmental Glomerulosclerosis Deposits
IgM & C3 deposits
29
Cold Agglutinins
Seen in atypical pneumonia (mono, mycoplasma)
| It is IgM Ab w/ specificity for I Ag on adult RBCs
30
Scrofula
TB in the lymph nodes
31
Aspirin-Asthma Triad
Nasal polyps, allergic rhinitis, bronchoconstriction
32
Ferruginous Bodies
Hemosiderin (pigment w/ Fe3+) covered fibers that have been phagocytized by macrophages
33
Pancoast Tumor
Sx: Ulnar nerve pain & Horner's syndrome, hoarse voice
34
Fatty Degeneration
Made up primarily of triglycerides
MCC: alcoholism, leads to cirrhosis
Associated w CCl4-
35
Cloudy swelling
Failure of cellular Na pump
| Seen in fatty change of liver and in hydropic (vacuolar) degneration of the liver
36
Hydropic degeneration
Severe form of cloudy swelling
| seen w/ hypokalemia incuded by vomiting/diarrhea
37
Liquefactive Necrosis
Rapid enzymatic breakdown of lipids
Seen commonly w CNS lesions
Seen in suppurative infection= pus formation
38
Coagulation Necrosis
Result of sudden ischemia
| Seen in organs w end arteries (limited collateral circ)= heart, lung, kidney, spleen
39
Caseating Necrosis
Combination of both coag & liquefaction nec
| Seen w/ M. Tb and Histoplasma capsulatum infection
40
Fibrinoid Necrosis
Seen in the walls of small arteries
| Assoc. w/ malignant HTN, polyarteritis nodosa, immune-mediated vasculitis
41
Fat Necrosis
Result of lipase actions liberated from pancreatic enzymes
| Seen w/ acute pancreatitis--> saponification results
42
Hemoptysis
Blood in sputum
43
Pulmonary Embolism
Most commonly thrombus from deep vein of lower extremity
| -Virchow's triad
44
Phlebothrombosis
-venous blood clot forms independently of inflamm. of vessel
From: a vein of lower extremities, a pregnant uterus, in CHF, bed ridden pt.
As a complication in a pt w pancreatic Ca due to inc. blood coagulability
45
Saddle Embolus
Embolus lodged in a bifurcation of pulmonary trunks
| Inc. in RV strain= RV & RA dilate= acute cor pulmonale
46
Paradoxical Embolism
R to L shunt allows a venous embolism to enter arterial circulation
Patent foramen ovale or Atrial Septal Defect
47
Tuberculoid Granuloma
Collection of macrophages w/o caseation
| Seen w/ sarcoidosis (non-caseating); syphilis; Brucellosis; Leprotic infections
48
Cellulitis
Spreading infection due to strep.
| -inflammation of connective tissue, dermsi, subcut
49
PSA
Prostate specific antigen=elevated in prostate Ca
| Controversial training measure
50
Elevated 5HT
In cases of metastatic carcinoid
| Tx: w methysergide (5-HT antagonist)
51
Elevated alpha-Feto Protein (AFP)
Seen in:Hepatocarcinoma
| Neural tube defects
52
CEA
Carcinoembryonic Antigen= elevated in colon CA
53
Chromosome 13
Retinoblastoma
54
Chromosome 11p
Wilms' tumor of the kidney
55
Vinyl Chloride
Associated w/ Angiosarcoma of the liver
56
Agent Orange
Contains dioxin
| Implicated as a cause of Hodgkin's disease, non-Hodgkin's lymphoma & soft tissue sarcomas
57
Parasites & CA
Schistosoma haematobium= Urinary bladder CA risk
Schistosoma mansoni= colon cancer risk
Aspergillus flavus= potent hepatocarincogen
58
Ochronosis
Inherited form: Alkaptonuria= black urine
Error in tyrosine metabolism due to homogentisic acid (oxidize tyrosine)
Involving intervertebral discs= ankylosing spondylitis= poker spine
See dark urine, sclera, tendons, cartilage
59
Lead poisoning
```
Acid fast inclusion bodies
Inc urinary caproporphyrin
Anemia: microcytic/hypochromic
Stippling of the basophils
Gingival line & lead line in bones on X-ray
Mental retardation
```
60
Heroin OD, clinically
Massive pulmonary edema w/ frothy fluid from the nostrils
61
Fetal Alcohol Syndrome
Small head, small eyes, funnel chest, ASD, mental deficiency, hirsutism
62
Atypical mycobacterium
M. kansasii & M. avium intercellulare
63
Cold Abcesses
Liquified TB lesions similar to pyogenic abcesses but lacking acute inflammation
64
Actinomyces Isrealli
```
Farmers Infection
Lumpy jaw (from chewing grain) & PID (IUD) but most common is due to saprophyticus
```
65
Congenital Syphilis
Saddle nose, Saber shin, Hutchinson's teeth, nerve deafness, interstitial keratitis
66
Warthin-Finkeledy Cells
Reticuloendotheial giant cells on tonsils, lymph nodes, spleen
Seen w Rubeola (measles) due to paramyxovirus
67
Diphylbothrium latum
Tapeworm infection causing megaloblastic anemia by consuming large amt of B12 in host
68
Acutea Bacterial Endocarditis
Staph aureus, Beta hemolytic strep, E. coli
| Common among IVDA and diabetics
69
Subacute Bacterial Endocarditis
alpha hemolytic Strep (S. viridans)..usually in pt w preexistig heart/valve problem
70
Mitral Insufficiency
Rupture papillary muscle
71
Left Anterior Descending Branch
Branch of the left coronary artery
Highest freq. of thrombotic occlusion
MI= anterior wall of LV, esp. in apical part of interventricular septum
72
Left Circumflex Branch
Branch of LCA
| Occlusion= MI of posterior/lateral wall of LV
73
Dissecting Aneurysm
False aneurysm: splitting of the media of the aorta
Usually w long hx of severe HTN, also seen w/ familial hyperlipidemia, athersclerotic disease, Marfan's
Zones of medical necrosis +/- slit-like cysts=medical cystic nec. of Erdheim--> autosomal dom, aka familal thoracic aortic aneurysm
74
Cor Pulmonale
RV strain due to pulmonary HTN, associated, associated w/ RV hypertrophy
75
Acute Cor Pulmonale
Sudden RV strain due to massive PE
76
Bronchopneumonia
Lobular rather than lobar
Common causes: S. aureus, P. aeruginosa, Klebsiella, E. coli,
Abcess formation is common
77
Lobar pneumonia
Community acquired= Strep pneumo infection (5% due to Klebsiella)
Red hepatization= day 1-3 of pneumonia
Gray hepatization= 3-8 of untxed pneumonia
Complications: pleural effusion, atelectasia, fribrinous pleuritis, empyema, fibrinous peridcarditis, otitis media
78
Bronchiectasis
Permanent dilatation of the bronchi-- predisposed by chronic sinusitis & post-nasal drip
supparation associated
Lower lobe> upper lobe
79
Cold Agglutinins
- Usually IgM, autoimmune hemolytic anemia
| Found in mycoplasma pneomonea, mono, CLL
80
Panlobular Emphysema
A1AT deficiency associated
| Inc. Elastase= Inc compliance in the lung
81
Bulla
Associated w/ emphysema= "Bleb" = outpouching ...may rupture and cause spontaneous pneumothorax
82
Farmer's Lung
Due to micropolyspora faeni (thermophilic actinomyces)
| Type III hypersensitivity pneumonitis
83
Bagassosis
Hypersensitivity pneumonitis
| Due to M. vulgaris (actinomycetes) from moldy sugar cane
84
Silo-Filler's Disease
Due to NO2 inhalation from nitrates in corn
85
G6PD deficiency
Enzyme in pentose phosphate shunt...regens NADPH
Sex-linked chronic hemolytic anemia w/o challenge or after eating fava beans/oxidative stress
Heinz bodies appear on RBCS, bite cells seen
86
Elevated HbF
Seen in Sickle Cell Anemia
87
Multiple Myeloma
Lytic lesions of flat bones ("salft & pepper" lesions") ...vertebrea, ribs, skull
Hypercalcemia, Bence-Jones Protein Casts
"CRAB"
88
Hodgkin's Disease
Malignant neoplasm of the lymph nodes causing: pruritis, fever= can mimic EBV/acute infections
Reed-Sternberg cells
89
Polyarteritis Nodosa
Immune complex depostion on vessel walls
Medium/small vessel vasculitis
Hep B Ag association (30% of pt.s)
Can see fever, abd. pain, dec. weight, HTN, muscle aches
90
Sprue
Celiac disease due to gluten-induced enteropathy= small intestine villi blunted
High titers of anti-gliadin Abs & IgA levels
91
Regional Enteritis
AKA Crohn's disease
| Association w/ arthritis; uveitis; erythema nodosum
92
Whipple's Disease
Caused by bacterium Tropheryma whipplei (actinomycetes).
| Intestinal lipodystrophy= malabsorption syndrome
93
Kulchitsky Cells
Neural crest cells from which carcinoids arise in the bronchi, GIT, Pancreas
94
Ulcerative Colitis
Inflammatory disease of the colon w/ inc. colon CA incidence
Crypt abcess in the crypts of Lieberkuhn
Pseudopolyps when ulcers are deep
No transmural involvement
95
Vaginal adenosis
Women exposed to DES (diethylstilbesterol) in utero before 18th week of pregnancy
Some develop clear cell adenocarcinoma of vagina & cervix (usually < 30 yo)
96
Scirrhous Carcinoma
Infiltrating ductal carcinoma w/ fibrosis-- most common type of breast carcinoma
97
Hofbauer Cells
Lipid laden macrophages seen in villi of Erythroblastosis Fetalis (hemolytic disease of the newborn)-- seen w maternal IgG crossing placenta
98
Retinopathy of Prematurity
aka Retrolental fibroplasia
| blindness in premies due to high supplemental O2 concentration...leads to free radical injury
99
IgA deficiency
Genetic cause
Pt has recurrent infection & diarrhea w/ inc repiratory tract allergy & autoimmune disease
If given blood w IgA--> develop severe anaphylaxis
100
Primary Sjogrens
Autoimmune-- HLADR3 associated
| Sx:Dry eyes & dry mouth, arthritis. Inc risk of B cell lymphoma.
101
Secondary Sjogrens
RA, SLE< or systemic sclerosis associated
| HLA-DR4 associated
102
LDH1& LDH2
Myocardium
| LDHI > LDH2--> MI
103
LDH3
Lung Tissue
104
LDH4 & LDH5
Liver cells
105
Keratomalacia
Severe Vit A deficiency. See Bitot's spot in the eyes= gray plaques= thickened, keratinized conjunctiva
106
Metabisulfite Test
Suspending RBCS in a low O2 content sol'n
| Can detect Hemoglobin S, which sickles in low O2
107
Microangiopathic Hemolytic Anemia
Can be due to HUS and TTP
| See helmet cells
108
Wright's Stain
Stain for Burkitt's lymphoma
109
Mononucleosis
Due to EBV infection (CMV possible)
| If mono is txed w ampicillin, thinking that it is a strep pharyngitis, a rash will occur
110
T(8:14)
Burkitt's lymphoma translocation
| c-myc oncogene overexpression
111
T(9:22)
Philadelphia chromosome, translocation of CML= abl/bcr gene formation
112
Langerhan Cell Histiocytes
Dendritic cells of skin & mucosa
Birbeck granules present tennis racket shape
Langerhans cell histiocytosis subtypes:Letterer-Siwe disease, Hand Schuller Christian Disease, Eiosinophilic Granuloma
113
Myeloid Metaplasia
Alkaline Phosphatase elevated/normal (compared to low in CML)
Anemia; splenomegaly; platelets> 1 mill= extensive extra-medullary hematopoiesis
114
Multiple Myeloma
Weakness, weight loss, recurrent infections, proteinuria, anemia, proliferation of plasma cells in BM= plasma cell dz
Serum M protein spike...most often IgG or IGA light chain
Hypercalcemia...lytic bone lesions
115
T(14:18)
NHL Lymphoma= bcl2 proto-oncogene overexpression seen w/ follicular lymphoma
116
Focal Segmental Glomerulonephrosis Exs
IgA focal GN= Berger's disease, SLE, PAN, Henoch-Schonlein purpura
117
Nephrotic Syndrome Exs
Focal (segmental); membranous GN, lipoid (minimal change) GN, membranoproliferative GH, Hep B, Syphilis, pencillamine
118
Schistosoma Haematobium
Infection is associated w/ squamous cell CA of the bladder (most common bladder Ca in transitional cell type)
associated w portal HTN due to intrahepatic obstruction
119
Penicillin Resistant PID
PID usually due to N. gonnorhea, but if unresponsive to penicillin think of bacteroides cause
120
Duret Hemmorrhages
Severe ↑ in ICP w/ downward diplacement of cerebellar tonsils into Foramen Magnum causing acompression on the brainstem w/ hemorrhaging into the pons & midbrain Nearly always associated w/ death due to damage to the vital centers in these areas
121
Hypertensive Hemorrhage
Predilection for lenticulostriate arteries= putamen& internal capsule hemorrhages
122
Cerebral Embolism
from MI w/ mural thrombis, or atrial fib thrombi= marantic thrombi; L-sided bacterial endocarditis; paradoxical embolism w a septal defect
123
Neurosyphilis
Tabes Dorsalis= Dec joint position sensation, dec pain sensation, Argyl Roberston pupils
Syphilitic Meningitis
Paretic neurosyphilis
124
5p deletion
Cri du Chat: mental retardation, small head, wide set eyes, low set ears, cat like cry
125
Trisomy 13
Patou's: small head & eyes, cleft lip & palate; many fingers
126
Acute cold agglutination
Abs to I blood group Ag. Mediated by IgM ABs
| Complication of EBV or mycoplasma pneumonial infections
127
Chronic Cold Agglutination
Assoicated w/ lymphoid neoplasms. See agglutination & hemolysis in tissue exposed to cold IgM Abs
128
RBC Osmotic Fragility
Hereditary spherocytosis
129
Non-Hodgkin's Lymphomas
Small lymphocytics: low grade B cell lymphoma of the elderly. Related to CLL
Follicular lymphoma: low grade B cell lymphoma of the elderly. T(4:18) bcl2 oncogene
Large Cell
Lymphoblastic: high grade T cell lymphoma of kids progressing to T-ALL
Small Non cleave= Burkitt's= high grade B cell lymphoma. EBV infection assoc. "starry sky" histo appearance. T(8:14) c-myc proto-oncogene. Related to B-ALL
130
Singer's Nodules
Benign laryngeal polyps associated w/ smoking & overuse of the voice
131
Paraseptal Emphysema
Associated w/ blebs (large subpleural bullae) that can rupture and cause pneumothorax
132
Superior Vena Cava Syndrome
Obstructed due to bronchogenic carcinom. Causing swollen face & cyanosis
133
Betel Nuts
AKA Areca nut, chewed in South Asia
| Associated w oral cancer
134
Fundal (Type A) Gastritis
Antibodies to Parietal cells; pernicious anmia; autoimmune disorders
135
Antral (type B) Gastritis
Associated w H. pylori infection. 90% of duodenal ulcers have this bacteria present
136
Primary Biliary Cirrhosis
Autoimmune origin: see in middle aged women, anti-mitochondrial Abs
Sx: jaundice, itching, hypercholesterolemia (can see cutaneous xanthomas)
137
Acute Pancreatitis
Elevated pancreatic enzymes= fat necrosis saponification.-> hypocalcemia, inc serum amylase
Severe epigastric pain, prostration, radiation to the back
138
Pain radiating to back
Chronic pancreatitis
139
Complete hydatidiform mole
No embryo. Paternal DNA only...46XX
140
Partial hydatidiform mole
Embryo. 2 or more sperm fertilized 1 ovum. Triploidy/tetraploidy occurs
141
Cold Nodules
Hypoplastic goiter nodles that do not take up radioactive iodine. (vs. hot nodules do)
142
Acidophils
From anterior pituitary (adenohypophysis)
Mammatrophins= prolactin
Somatotrophins= GH producing
"GPA"
143
Basophils
From anterior pituitary (adenohypophysis)
Thyrotrophins= TSH
Gonadotrophins= LH& FSH
Corticotrophins= ACTH
144
Lacunar Strokes
Small/focal aa occlusions. Purely motor or sensory
Sensory= thalamic lesion
Motor= internal capsule
145
CSF of Bacterial Meningitis
↓ Glucose; ↑ Protein; ↑ Neutrophils; ↑ Pressure
146
CSF of Virla Meningitis
Normal Glucose; +/-↑ Protein; ↑ Lymphocytes
147
Marble Bone Disease
Osteopetrosis: Albers-Schonberg Disease= inherited disorder. inspite of inc bone density many fractures due to dec osteoclast activity
148
C5a
complement factor chemoattractant-- Involved in chemotaxis (for neutrophils)
149
C3b
complement factor involved in opsonization
150
Anaphylotoxins
C3a and C5a (mediate Histamine releasefrom basophils & mast cells)
151
Vasoactive mediators
Vasoconstriction: TxA2; LTC4; LTD4; LTE4; PAF
Vasodilation: PGI2; PGD2; PGE2; PGF2α; Bradykinin; PAF
↑d Vascular Permeability: Hist.; 5HT; PGD2; PGE2; PGF2α; LTC4; LTD4; LTE4; Bradykinin; PAF
152
Platelet Aggregation
ADP; Thrombin; TxA2; collagen; Epinephrine; PAF
153
Platelet Antagonist
Prostacyclin (PGI2)
154
Intrinsic Pathway-- coag
F XII(Hagman): follow w PTT
155
Extrinsic Pathway-- Coag
F VII: follow w PT
