Pathology Flashcards Preview

USMLE Step 1 > Pathology > Flashcards

Flashcards in Pathology Deck (155):
1

Mobitz I

--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

Mobitz II

-intermittent P nonconduction
BBB association
Often progresses to 3rd deg AV block
Usually due to anterior MI

3

P wave

atrial depol

4

a wave

LA contraction

5

T wave

ventricular repolarization

6

Wavy fibers

Eiosinophilic bands of necrotic myocytes. Early sign of MI

7

Janeway's Lesions

Acute bacterial endocarditis
Nontender, erythematous lesions on palms & soles

8

Osler's Nodes

Subacute endocarditis sign?
Tender lesions of fingers & toes
"ouch ouch Osler"

9

Thiamine deficiency

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

Fibrinous Pericarditis

Associated w MI--3-7 days ppost transmural MI
Dresslers (6-8 wk)-- autoimmune Igs to pericardium

11

Serous pericarditis

Associate w/ nonbacterial causes: viral (Coxsackie) infection, immunologic rxns

12

Friction Rub

Pericarditis associated finding

13

Hemorrhagic pericarditis

Associated w TB or neoplasm

14

Restrictive Cardiomyopathy

stiffens heart, diastolic dysfct
Due to amyloidosis in elderly
Die to Schaumann & asteroid bodies in youn (<25)?

15

PML's infectious agent

JC virus
papovirus= dsDNA, naked icosohedral capsid

16

Edema

- ↑Pc (more seeps out)
-↓πc (less reabsorbed into vessel)
-↑ permeability endothelium
- Block lymphatic drainage

17

Adult Polycystic Kidney Disease

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

Malignant HTN & Kidneys

Petechial hemorrhages are seen on kidney surfaces= Flea-bitten kidneys
Young AA men

19

Nephritic Signs

Hematuria; RBC casts; HTN

20

Nephrotic Signs

Proteinuria; hypoalbuminemia; edema

21

Podocyte Effacement

Seen w Minimal Changes Disease (lipoid nephrosis)

22

ASO

Seen in Acute post-streptococcal GN (due to βHGASrtep)
Anti streptinolysin O

23

Crescentic GN

Rapidly progressive GN- nephritic syndrome
Associated w/ multisystem disease or post-strep/post-infectious glomerular nephritis

24

Hereditary Nephritis

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