Pathology (Sections 21-) Flashcards Preview

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Flashcards in Pathology (Sections 21-) Deck (205):
1

Clinically significant infectious etiology of endometritis

Chlamydia trachomatis

2

Infection that begins in the vulva/vagina that ascends to involve the upper reproductive tract

Presents as pelvic pain, adnexal tenderness, fever, and vaginal discharge

Pelvic Inflammatory Disease

3

Type of PID
Initial infection from endocervical mucosa
Ascends via direct mucosal spread

Gonococcal PID

4

Type of PID
Associated with uterine manipulation
Spreads lympohematogenously

Non-gonococcal PID

5

Non-neoplastic epithelial lesion of the vulva
Leukoplakia
Thinning of the epidermis
Not pre-malignant

Lichen sclerosus

6

Non-neoplastic epithelial lesion of the vulva
Acanthosis
Not pre-malignant

Squamous Hyperplasia of the Vulva

7

Most common type of Vulvar SCCA

Non-HPV related (70%)

8

Failure of Mullerian Duct fusion
Usually accompanied by uterine didhelphys
Associated wih DES exposure in utero

Septate Vagina

9

Remnant of the Wolffian/Mesonephric Duct

Gartner Duct Cyst

10

Most common vaginal malignancy

Direct spread from cervical carcinoma

11

Most common primary vaginal malgnancy

SCCA

12

Disease of the young (<5 years)
Grape-like clusters
Malignant embryonal rhabdomyoblasts
May cause urinary tract obstruction

Sarcoma Botryoides

13

Most important factor in developing cervical CA

HPV 16 (60%) and HPV 18 (10%) infection

14

MoA: E7 in Cervical CA

Inactivates Rb, p21, and p27;
Promotes cell proliferation

15

MoA: E6 in Cervical CA

Inactivates p53
Promotes cellular immortality

16

Grading of CIN

LSIL:
Confined to lower third of the epithelium

HSIL:
Expansion to upper 2/3 of the epithelium

17

Most common cause of death in cervical cancer

Uremia from renal spread of malignancy

18

Pap Smear Monitoring

Start at 21 or within 3 years of first coitus; repeat every 3 years until 30 years of age

Beyond 30, repeat every 5 years

If (+) HR HPV, repeat every 6-12 months

19

Quadrivalent (6, 11, 16, 18) vaccine for HPV

Gardasil

20

AUB Etiologies

PALM COEINS

Polyp
Adenomyosis
Leiomyoma
Malignancy

Coagulopathy
Ovulatory dysfunction
Edometrial Pathology
Iatrogenic
Not classified

21

Abnormal uterine bleeding without an organic/structural cause

Most common cause:
Anovuatory Cycle (unopposed estrogen)

Dysfunctional Uterine Bleeding

22

Ectopic endometrial tissue
Infertility, dysmenorrhea, pelvic pain
Most common site: Chocolate Cysts (Ovary)
Mediated by elevated PGE2 (increases estrigen synthesis)

Endometriosis

23

Endometrial glands in the myometrium
AUB, colicky dysmenorrhea, dyspareunia
Symmetrically enlarged corpus with blood lakes

Adenomyosis

24

Regurgitation Theory (Endometriosis)

Implantation of ectopic endometrial tissue via retrogade menstruation

25

Benign endometrial mass associated with Tamoxifen use

Endometrial Polyp

26

Tumor suppressor gene found to be inactivated in cases of endometrial hyperplasia

PTEN

27

Most common malignancy of the female genital tract

Endometrial CA

28

Type of EM CA
50's-60's
Unopposed Estrogen
Endometroid Morphology
PTEN Mutation
Indolent, lymphatic spread

Type I
(Endometroid)

29

Type of EM CA
60's-70's
Atrophic uterus, thin physique
Serous/Clear Cell/Mixed Mullerian Morphology
TP53 Mutation
Aggressive; intraperitoneal lymphatic spread

Type II
(Serous)

30

Most common tumor in women

Leiomyoma

31

Gene mutation involved in leiomyomas

MED 12

32

Most common type of Leiomyoma

Intramural

33

Most common pathogen seen in Salphingitis

Gonococcus

34

Lined by flattened granulosa cells in the ovary
Exhibit Luteinization
Hyperplasia of ovarian theca lutein (Hyperthecosis)

Cystic Follicles (if < 2cm)
Follicular Cysts (if > 2cm)

35

Lined by luteinized granulosa cells in the ovary
May rupture and cause peritoneal reaction

Corpus Luteum Cysts

36

Stein-Leventhal Syndrome

Complex endocrine disorder characterized by:
1. Hyperandrogenism
2. Menstrual abnormalities
3. Infertility
4. Chronic Anovulation
5. Polycystic ovaries

Associated with: T2DM, MS
Also known as Polycystic Ovarian Syndrome

37

Most common ovarian tumor

Mullerian Epithelium Type

38

Most common type of Surface Epithelial ovarian tumors

Serous

39

Tumor marker for Surface Epithelial ovarian tumors

CA 125

40

Type of serous tumor
Well-differentiated
Precursor lesion: Borderline Tumors
Mutations in KRAS. BRAF, ERBB22

Low-grade Serous Tumor

41

Type of serous tumor
Moderately- to poorly-differentiated
Precursor: Serous tubal intraepithelial carcinoma (STIC)
TP53, BRCA mutation

High-grade Serous Tumor

42

Surface epithelial ovarian tumor
Mostly benign
Primary type is rare; consider extraovarian primary
KRAS Mutation
Usually unilateral
Associated with Pseudomyxoma Peritonei (mucinous ascites)

Mucinous Tumor

43

Most common extraovarian source of mucinous ovarian tumors

Appendix

44

Surface epithelial ovarian tumor
Coexists with endometriosis (15-20%)
PTEN Mutation
Hallmark: Tubular glands resembling endometrium
Bilateral (40%)

Endometroid Tumor

45

Most common Germ Cell Tumor in females

Benign Cystic Teratoma

46

Type of GCT
Dermoid Cyst-like architecture
Reproductive age women
Contain structures derived from > 1 germ cell layer
Benign

Mature Teratoma

47

Type of GCT
Solid architecture
Young women, children
Contains neuroepthelium
Malignant

Immature Teratoma

48

Teratoma containing ectopic thyroid tissue
May cause hyperthyroidism

Struma ovarii

49

Teratoma that secretes serotonin

Carcinoid
(rule-out primary intestinal carcinoid)

50

Germ Cell Tumor
Predominant tissue: Oogonia
Nests of large, vesicular cells with central nuclei and clear cytoplasm
KIT Mutation
Favorable prognosis

Most common malignant GCT

Dysgerminoma
(Seminoma in males)

51

Germ Cell Tumor
Predominant tissue: Extraembryonic yolk sac
Central blood vessels enveloped by tumor cells within a space lined by tumor cells (Schiller-Duval Bodies)
AFP Mutation
Favorable prognosis

Second most common malignant GCT

Yolk Sac Tumor
(Endodermal Sinus Tumor)

52

Germ Cell Tumor
Predominant tissue: Placenta
HCG Mutation
Unfavorable prognosis

Ovarian Chriocarcinoma

53

Most common primary tumors in ovarian metastasis

Tumors of Mullerian Origin
(Uterus, FT, contralateral ovary, pelvic peritoneum)

54

Most common extra-mullerian primary in ovarian metastasis

Bone, GIT

55

Signet ring GIT carcinoma that frequently metastasizes to the ovaries

Krukenberg Tumor

56

Cystic swelling of the chorionic villi with trophoblastic proliferation
Differential for bleeding during the first trimester

Hydatidiform Mole

57

Triploid Karyotype
Beta-HCG < 100,000
(+) Fetal components, amnion
p57 positive

Partial Mole

58

Diploid Karyotype
Beta-HCG > 100,000
(-) Fetal components, amnion
p57 negative
"Snowstorm" on TV UTZ

Complete Mole

59

Proliferation of cytotrophoblasts and syncitiotrophoblasts WITHOUT villi formation
Rapidly invasive, widely metastasizing

Gestational Choriocarcinoma

60

Character of nipple discharge consistent with malignancy

Unilateral, spontaneous

61

Most common pathogens associated with mastitis

Staphylococcus aureus
Streptococcus pyogenes

62

Benign breast lesion
> 2 cell layers in a duct
Distorted lumina at periphery
Mimics Ductal Carcinoma-in-situ

Epithelial Hyperplasia

63

Solid cords or double strand of cells in a densely fibrotic stroma, compressing ducts
Closely mimics Breast CA

Sclerosing Adenitis

64

Papillary fronds with fibrovascular cores
Bloody nipple discharge present in stalk infarcts

Papilloma

65

Central nidus of entrapped glands in a hyalinized stroma
Combination of epithelial hyperplasia, sclerosing adenosis, and papilloma of the breast

Complex Sclerosing Lesion

66

Breast neoplasia
Cribiriform pattern
"Cookie Cutter" Appearance
Loss of 16p function, gain of 17q function

Atypical ductal hyperplasia

Ductal Carcinoma-in-situ
(complete ductal involvement)

67

Breast neoplasia
Monomorphic, loosely cohesive cells
Loss of E-cadherin

Atypical lobular hyperplasia

Lobular Carcinomain-situ
(>50% acini involved in a lobule)

68

Most common non-skin malignancy in women

Breast CA

69

Female
BRCA1 (Ch17) and BRCA2 (Ch13) Mutation
Estrogen excess

Risk factors for Breast CA

70

Breast CIS
Disrupted lobules
Papillary, cribiriform patterns
(+) Necrosis, calcifications
Paget disease of the nipple
Less likely to be bilateral (10-20%)
Variable hormonal status

Ductal CIS

71

Breast CIS
No disruption of lobules
No papillary, cribiriform patterns
No necrosis, calcifications
No nipple involvement
More likely to be bilateral (20-40%)
ER (+), PR (+), HER2 (-)

Lobular CIS

72

Pagetoid Spread

Presence of malignant cells between basement membrane and overlying luminal cells

73

In situ breast disease + absence of intact myoepithelial layer
Haphazardly arranged cells with desmoplasia

Invasive Ductal Carcinoma, No Special Type

74

Components of Nottingham Histologic Score

1. Tubule Formation
2. Nuclear Pleiomorphism
3. Mitotic Figures (per 10 hpf)

Used in grading Invasive ductal carcinoma

75

CDH1 (E-Cadherin) Loss
Tumor cells in single file ("Indian File")
Scant desmoplasia
Mucin (+) signet rings

Most common breast cancer to present as occult primary (proven malignant but primary malignancy unknown)

Invasive Lobular Carcinoma

76

ER, HER (-)
Syncytium-like solid sheets of large cells with pleiomorphic nuclei in the breast
Lymphoplasmacytic infiltrates
Pushing Borders

Medullary CA

77

High-grade breast tumor
No particular molecular type
Peau d'orange

Inflammatory CA

78

Most common benign tumor of the female breast

Fibroadenoma

79

Characteristics of COMPLEX Fibroadenomas

Cysts larger then 0.3cm
Papillary apocrine change
sclerosing Adeosis
ePithelial Calcifications

(Mnemonic: CPAP)

80

Proliferation of intralobular stroma with epithelium
Ch1q gain Mutation
HOXB13 mutation suggests aggressive behavior
Leaf-like projections

Phyllodes Tumor

81

Characteristics of Male Breast CA

1. Rare
2. ER (+)
3. Distant metastases are common on initial diagnosis

82

Most common cause of hyperpituitarism

Functional anterior pituitary adenoma

83

Most common type of pituitary adenoma

Prolactinoma

84

Second most common type of pituitary adenoma

Somatotroph Adenoma

85

Acidophilic cell lines in the pituitary gland

Lactotrphs
Somatotrophs

86

Basophilic cell lines in the pituitary gland

Corticotroph
Gonadotroph
Thyrotrophs

87

PAS (+) cell line in the pituitary

Corticotrophs
(due to carbohydrate moiety present in pro-opiomelanocortin)

88

Protein used to differentiate neoplastic from normal pituitary parenchyma

Reticuln (Collagen Type III):
More sparse in neoplastic tissues

89

Most common cell types in pituitary carcinomas

Corticotrophs (42%)
Lactotrophs (33%)

90

Pathophysiology: Sheehan Syndrome

Hypopituitarism brought about by ischemic necrosis of the anterior pituitary secondary to pregnancy.

MoA: Physiologic lactotroph hyperplasia in pregnancy without a corresponding increase in blood supply

Posterior pituitary spared due to its independent arterial supply

91

Epithelium-lined cysts found at the posterior portion of the Anterior Pituitary;

Arises from the remnant of an embryonic structure associated with pituitary development

Rathke Cleft Cyst

92

Bimodal age incidence
Origin: Vestigial remnants of Rathke's Pouch
Presents with hypopituitarism or pituitary mass effects
Favorable prognosis

Craniopharyngioma

93

Type of Craniopharyngioma
Squamous Epithelium: Cords, Nests
(+) Spongy reticulum
(+) Peripheral palisading
(+) Wet Keratin
(+) Cyst Formation

Adamantinomatous

94

Type of Craniopharyngioma
Squamous Epithelium: Sheets, Pappillae
(-) Spongy reticulum
(-) Peripheral palisading
(-) Wet Keratin
(-) Cyst Formation

Papillary

95

Hypothyroidism in infancy/early childhood

Features:
Mental Retardation
Short stature
Coarse facial features
Protruding Tongue
Umbilical hernia

Cretinism

96

Hypothyroidism in late childhood/adulthood

Features:
Slowing of physical and mental activity
Overweight
Hypercholesterolemia
Non-pitting edema
Coarse facial features
Macroglossia
Accumulation of matrix substances in tissue

Myxedema

97

Hormonal picture of thyroiditides in general

Initially hyperthyroid (release of preformed hormones), progressing to hypothyroidism (destruction of tissue)

98

Autoantibodies against thyroglobulin and thyroid peroxidase
Painless goiter
(+) Germinal centers, Fibrosis
(-) Granulomas
Hurthle Cells
Type 4 with Type 2 HSR

Hashimoto Thyroidtis

99

Autoantibodies against Thyroid Peroxidase
Painless goiter
Usually with comorbid autoimmune condition
(+) Germinal centers
(-) Fibrosis, granulomas

Subacute Lymphocytic / Postpartum Thyroiditis

100

Cell-mediated damage to follicular cells
Painful goiter
Preceding history of URTI
(+) Granulomas

Granulomatous Thyroiditis

101

Fibrosis of neck structures, including the Thyroid Gland
Associated with Ormond's Disease

Reidel Thyroiditis

102

Triad of Graves Disease

1. Hyperthyroidism
2. Ophthalmopathy (exophthalmos)
3. Dermopathy (pretibial myxedema)

103

Most common cause of endogenous hyperthyroidism

Graves Diseases

104

Autoimmune process in Graves Disease

Type 2 HSR
(Thyroid Stimulating Autoantibodies)

105

Pathophysiology: Graves opthalmopathy and dermopathy

Activation of TSH receptor-(+) fibroblasts in the retroorbital area and the skin, leading to MATRIX DEPOSITION

106

Most common cause of Goiter

Iodine Deficiency
(Increased TSH-mediated growth as compensation for decreased iodine)

107

Morphologic phases of Goiter

1. Hyperplastic
(Mediated by TSH; diffuse symmetrical enlargement)

2. Colloid Involution
(post-replenishment of iodine; increase in colloid synthesis)

108

Pathogenesis of Multinodular Goiter

Scarring from recurrent, alternating hyperplastic-colloid involution states of the thyroid

109

Plummer Syndrome

Autonomous, toxic nodule arising from long-standing MNNTG
(-) Ophthalmopathy, Dermopathy

110

Features that suggest thyroid malignancy

1. Solitary nodule
2. Male
3. Young
4. Hx of Radiation
5. Cold/Non-functional nodules

111

Commonly seen mutations in TOXIC goiters/adenomas

Gain of function mutations:
1. TSH Receptor
2. Alpha-subunit of the Gs signalling system

112

Feature seen in Thyroid adenomas that are absent in multinodular goiters

Intact, well-formed capsules

113

Most common type of thyroid carcinoma

Papillary (>85%)

114

Second most common type of thyroid carcinoma

Follicular (5-15%)

115

Thyroid carcinoma associated with parafollicular cells

Medullary

116

All thyroid carcinomas involve "cold nodules" except

Follicular

117

Paraneoplastic syndromes associated with Medullary thyroid carcinoma

1. VIP
2. ACTH
3. Calcitonin

118

Thyroid carcinoma
Papillary fronds
Orphan Annie Nuclei (optically clear)
Psammoma Bodies

Papillary thyroid CA

119

Thyroid carcinoma
Cytologically normal follicular cells
Hurthle Cells in some cases

Follicular thyroid CA

120

Thyroid carcinoma
Pleiomorphic giant cells (osteoclast-like)
Spindle-shpaed cells (sarcomatous appearance)

Anaplastic thyroid CA

121

Thyroid carcinoma
Small spindle-shaped cells with amyloid deposits
Sporadic type (70%): No parafollicular cell hyperplasia as compared to Familial type (30%)

Medullary thyroid CA

122

Most common cause of primary hyperparathyroidism

Adenoma

123

Mutations associated with parathyroid neoplasias

Cyclin D1, MEN1

124

Von Recklinghausen Disease

Increase osteoclastic activity
Peritrabecular fibrosis
Cystic brown tumors

125

Most common cause of secondary hyperparathyroidism

Renal Failure
(compensatory increase in PTH due to calcium wasting)

126

Calciphylaxis

Metastatic calcification of the blood vessels leading to ischemic injury

127

Pseudohypoparathyroidism

End organ resistance to PTH

128

Most common cause of hypothyroidism

Iatrogenic (surgical)

129

Most common susceptibility gene of T1DM

Chromosome 6 (6p21)

130

Triad of T2DM Pathogenesis

1. Genetic
2. Environmental
3. Proinflammatory State

131

Most important environmental factor in T2DM

Central/visceral obesity
(increased lipolysis leads to insulin resistance)

132

Hallmark of macrovascular T2DM changes

Accelerated atherosclerosis secondary to endothelial dysfunction

133

Hallmark of microvascular T2DM changes

Diffuse thickening of BM

134

Proteinaceous accumulation in the Bowman Space secondary to protein leak from the glomerulus in DM nephropathy

PAS (+)

Kimmelstel-Wilson Bodies

135

Whipple Triad in Insulinomas

1. Hypoglycemia
2. Neuroglycopenic symptoms
3. Relief upon parenteral glucose administration

136

Pancreatic islet cell tumor
Hypergastrinemia
Severe peptic ulceration (jejunum)
Usually malignant

Gastrinoma

137

Pancreatic neuroendocrine tumor
Secretes VIP
Presents as WDHA Syndrome
(Watery diarrhea, Hypokalemia, Achlorhydia)

Verner-Morrison Syndrome

138

Most common cause of Cushing Syndrome

Exogenous Steroids
(iatrogenic)

139

Most common endogenous cause of Cushing Syndrome

Corticotrophic pituitary adenoma (70%)

Also known as Cushing Disease

140

Homogenous, pale, basophilic cytoplasm characteristic of ACTH-secreting cells

Crooke-hyaline change

141

Bilateral diffuse or nodular hyperplasia of the zona fasciculata and reticularis
Dexamethasone suppression observed at high doses in PITUITARY pathologies

ACTH-dependent Cushing Syndrome

142

Most common cause of primary hyperaldosteronism

Bilateral idiopathic hyperplasia

143

MoA of secondary hyperaldosteronism in pregnancy

Estrogen induces an increase in plasma renin substrates

144

Expected finding of Fludricortisone suppression test in primary hyperaldosteronism

Suppression

145

Most common enzyme deficiency in congenital adrenal hyperplasia

21-hydroxylase deficiency

146

Types of CAH

Salt-wasting
(Total 21-hydroxylase deficiency; (-) Gluco, Mineralo)

Simple Virilizing
(Sufficient mineralocorticoids, (-) Gluco)

Late-Onset
(Partial 21-hydroxylase deficiency; asymptomatic)

147

Bilateral adrenal hemorrhage secondary to disseminated bacterial infection (N. meningitides)

Waterhouse-Friedrichsen Syndrome

148

Most common cause of Addison Disease

Autoimmune adrenalitis

149

Primary chronic adrenal insufficiency
Decreased: Mineralo, Gluco
Collateral MSH increase (hyperpigmentation)
Irregularly shrunken adrenals with lymphoid infiltrates
(-) ACTH stimulation test

Addison Disease

150

Hormone deficiencies usually seen in secondary adrenal insufficiency

Glucocorticoid
Androgen

151

Hyperadrenalism usually seen in adrenal adenomas

Hyperaldosteronism, Hypercortisolism

152

Hyperadrenalism usually seen in adrenal carcinomas

Virilization

153

Cytogenetic origin: Chromaffin Cells
Surgically-correctible hypertension

Pheochromocytoma

154

Rule of 10's (Pheochromocytoma)

10% Extra-adrenal
10% Bilateral
10% Malignant
10% without hypertension

155

Syndrome:

Prolactinoma
Primary Hyperparathyroidism
Pancreatic neuroendocrine tumors (PP, Insulinomas)

MEN 1
(Wermer Syndrome)

156

Syndrome:

Pheochromocytoma
Medullary Thyroid Carcinoma
Parathyroid Hyperplasia

MEN 2A
(Sipple Syndrome)

157

Syndrome:

Pheochromocytoma
Medullary Thyroid Carcinoma
Neuromas
Ganglioneuromas
Marfanoid Habitus

MEN 2B

158

Separation of nail from nail bed

Onycholysis

159

Diffuse epidermal hyperplasia

Acanthosis

160

Discontinuity of the skin showing incomplete epidermal loss

Erosion

161

Keratinization with retained nuclei in the stratum corneum

Parakeratosis

162

Intercellular edema of the epidermis

Spongiosis

163

Thickening of the stratum corneum

Hyperkeratosis

164

Hyperplasia of the stratum granulosum

Hypergranulosis

165

Intracellular edema of the epidermis

Hydropic Swelling

166

Mutations associated with Dysplastic Nevi

CDKN2A
(disruption in cell cycle control)

TERT
(telomerase)

167

MoA: Benign nature of Melanocytic Nevi

Intact p16 suppression despite RAS* mutation

*pro-growth signalling

168

Stages of progression
(Melanoma)

Lentigo (Basal layer of Epidermis)

Dysplastic Nevus (Epidermal atypia; some dermal involvement)

Early Melanoma (Epidermis and superficial dermis)

Advanced Melanoma (Structures beyond dermis)

169

Most important risk factor for melanoma

Sun Exposure

170

Skin condition arising from a defect in endonuclease activity in epithelial cells, reducing the capacity of the skin to repair cellular damage associated with UV exposure

Xeroderma Pigmentosum

171

Growth phase pattern in melanoma that provides the greatest risk of metastasis

Vertical Growth
(versus radial growth)

172

Special stain used for melanoma

Melanin stain
(silver-based)

173

On hand lens inspection:
Small pore-like ostia impacted with keratin

Seborrheic Keratosis

174

Rapid increase in number of seborrheic keratoses;
often seen in paraneoplastic syndromes of GIT tumors

Leser-Trelat Sign

175

Horn Cysts

Small keratin-filled cysts

176

Thickened, hyperpigmented skin
Velvet-like texture
Flexural areas
Hyperkeratosis
Basal cell hyperpigmentation WITHOUT melanocytic hyperplasia

Acanthosis Nigricans

177

Sun-damaged skin
Premalignant lesion to SCCA
Cutaneous horn
Atypical dyskeratotic cells in basal epidermis with intercellular bridges (no bridges in SCCA)

Actinic Keratosis

178

Second most common tumor arising in sun-exposed sites
Associated with Epidermodysplasia verruciformis
Plaques to nodules with ulceration
More metastatic than locally aggressive

SCCA

179

Most common invasive cancer in humans
Associated with Gorlin Syndrome (Nevoid BCCA)
Pearly papules with telangiectasia, rodent ulcer
More locally aggressive than metastatic

BCCA

180

Wart-like lesions caused by HPV 5 and HPV 8

Epidermodysplasia Verruciformis

181

Increase in dermal microvascular permeability, clinically presenting as wheals

Urticaria

182

Type 4 HSR of the skin
Hallmark: Hyperkeratosis, acanthosis, and spongiosis

Acute Eczematous Dermatitis

183

Type 4 HSR of the skin (CD8+ T-cell)
Separation of skin layers at the dermal-epidermal junction (DEJ)
Target Lesion:
1. Red macule or papule with a pale, vesicular, or eroded center
2. Superficial perivascular lymphocytic infiltrate
3. Dermal edema

Erythema Multiforme

184

Spectrum of Erythema Multiforme

Steven-Johnson Syndrome
(<10% BSA, with mucosal and systemic involvement)

SJS-TEN Overlap
(10-30% BSA)

Toxic Epidermal Necrolysis
(>30% BSA)

185

Site of separation between skin layers in Reiter Disease (Staphylococcal Scalded Skin Syndrome)

Stratum granulosum

186

Type 4 HSR of the skin
Salmon-colored plaques with loosely adherent silver scales
Acanthosis with elongation of rete ridges (test tubes on a rack appearance)
Thinned/absent stratum granulosum

Auspitz Sign
Koebner Phenomenon
Spongiform pustules of Kogoj
Munro microabscesses

Psoriasis

187

Auspitz Sign

Pinpoint bleeding when lifting a scale

188

Koebner Phenomenon

Emergence of the lesion at new sites post-trauma

189

Abscesses formed in the stratum corneum;
associated with psoriasis

Munro microabscesses

190

Macules and papules on an erythematous-yellow, greasy base with extensive scaling and crusting
Associated with Malassezia infections

Seborrheic Dermatitis

191

Type 4 HSR of the skin
Pruritic, purple, polygonal, planar papules and plaques (6 P's)
Wickham Striae
Civatte/colloid bodies
Epidermal hyperplasia Keratosis
Sawtoothing of DEJ

Lichen Planus

192

Whitish lines visible on papules and plaques in Lichen Planus and other dermatophytoses

Wickham Striae

193

Eosinophilic hyaline bodies associated with Lichen Planus

Civatte Bodies

194

Pathophysiology: Epidermolysis bullosa

Defects in keratin, laminin, and Type VII collagen

195

Chronic inflammation of pilosebaceous unit
Hallmark: Comedogenesis
Pathogen: Propinibacterium sp.

Acne vulgaris

196

Pruritic pink to skin-colored papules with central umbilication
Pox Virus

Molluscum Contagiousum

197

Large ellipsoid, homogenous cytoplasmic inclusions in the stratum granulosum and stratum corneum
Associated with Pox Virus

Molluscum Bodies

198

Localized problems in migration and condensation of mesenchyme

Dysostoses

199

Most common skeletal dysplasia

Achondroplasia

200

Most common lethal form of dwarfism

Thanatophoric Dysplasia

201

Brittle bone disease
Defect in collagen type 1 synthesis
Brittle Bone Disease
Most lethal subtype: Type II

Most common inherited disorder of connective disorder

Osteogenesis Imperfecta

202

Impaired osteoclast function
Marble Bone Disease
Diffuse symmetric skeletal sclerosis
First disorder to be treated with hematopoietic stem cell transplantation
Absence of medullary canal
Erlenmeyer Flask Deformity

Albers-Schonberg Disease
(Osteopetrosis)

203

Hallmark of Osteoporosis

Histologically normal bone, but decreased in quantity

204

Increased but disordered and structurally unsound bone mass
Primarily a disease of the elderly
Commonly affects the axial skeleton and proximal femur
Bone pain from microfractures

Paget Disease
(Osteitis Deformans)

205

Phases of Paget Disease

Osteoclastic Phase
Mixed
Osteoblastic Phase