Flashcards in test #39 4.29 Deck (159)
what does "end-organ" blood supply mean?
interruptions in blood flow lead to formation of infarct
renal: small number of collaterals between segmental renal arteries
recall nephrotic syndrome presents w/ 5 things
1. edema (loss of albumin / oncotic pressure
4. hypercoagulation (loss of antithrombin III & increased coag factors
5. infection (loss of immunoglobulins)
histology of crohn's vs. ulcerative colitis
crohns: noncaseating granulomas & lymphoid aggregates (Th1 mediated)
ulcerative colitis: crypt abscesses (Th2 mediated)
blood in crohn's vs. ulcerative colitis
crohn's: + occult blood
ulcerative colitis: gross bleeding
string sign on barium swallow
crohn's disease: narrowing of the intestinal segment due to inflammation of intestinal wall
ulcers in crohn's? gross morphology?
1. linear or serpiginous ulcerations
2. cobblestone mucosa
3. transmural inflammatory infiltrate.
gross morphology of ulcerative colitis
1. mucosal & submucosal inflammation
2. friable mucosal pseudopolyps w/ freely hanging mesentary
loss of haustra = lead pipe
cells in moles vs. choriocarcinoma
mole: only trophoblasts; swelling villi
choriocarcinoma: trophoblasts & syncitiotrophoblasts; NO VILLI
clinical presentation of:
complete vs. partial hydatidiform mole
both: vaginal bleeding & cramps/pressure
-SIZE greater than dates &
-extremely HIGH b-hCG
[hCG can lead to:
- hyperemesis gravidarum
- theca-lutein cysts
macroscopic: complete vs. partial hydatidiform mole?
complete: friable mass of cystic, thin-walled, grapelike structures. exclusively TROPHOBLASTIC TISSUE. "bunch of grapes"
partial: mix of normal & gross enlarged chorionic villi; FETAL PARTS (fetus, cord, amniotic membrane)
micropscopic appearance: complete vs. partial hydatidiform mole?
complete: enlarged, EDEMATOUS villi w/ extensive & diffuse trophoblastic HYPERPLASIA
(no fetal tissue)
partial: some enlarged vili w/ more moderate & FOCAL trophoblastic hyperplasia.
- normal villi & fetal tissue also present
karyotype of complete & partial hydatidiform mole?
complete: completely PAPA 46 XX or 46 XY (sperm fertilizes empty egg; sperm chromosomes duplicate usu: 46 XX more common)
partial: 69 XXX or XXY
usu 1 egg w/ 2 sperms
risk of malignancy in complete & partial hydatidiform mole?
complete: 15-20% risk of malignant trophoblastic disease
partial: low risk of malignancy <5%
where is TRH made?
paraventricular nucleus of hypothalamus
main regulator of TSH section?
- T3 acts on paraventricular nucleus to decrease synthesis/release of TRH.
- down regulate TSH gene transcription & TRH receptor expression
T4 in peripheral tissues
converted to T3 or rT3 by specific deiodinases
(t3 cannot become T4 or rT3)
potency, half-life, metabolism of T4, T3, rT3
T4: 7 days
T3: 1 day
rT3: <1 day
cleared via glucuronidation in liver
[t3 not prescribed bc short half-life & rapid GI absorption = wide fluctuations]
acute acalculous cholecystitis
acute inflammation of gallbladder in absence of stones.
stasis & ischemia
PE: jaundice & palpable right upper quadrant mass = NOT SEEN IN calculous cholecystitis
complications: gangrene, perforation, emphysematous cholecystitis -- infxn w/ gas-producing agent: clostridium, e. coli
usu in hospitalized patients & severely ill
diagnosed on abdominal radiograph: rim of calcium deposits outline gallbladder
associated w/ gallbladder carcinoma
congenital dilations of common bile duct
chronic cholecystitis results in..
thickening of gallbladder wall.
US: shruken, fibrosed gallbladder
clornarchis infxn of gallbladder is associated w..
brown pigment stones
black vs. brown gallstones
black: intravascular hemolysis
brown: biliary infxn
how does valsalva affect heart?
exhale against closed glottis
abnormal proliferation of mast cells & increased histamine secretion
--> increase histamine --> gastric hypersecretion
can see nests of mast cells in bowel mucosa
chemical irritation from long-standing cholethiasis
herniation of gallbladder mucosa into muscular wall --> Rokitansky-Aschoff sinus: ducts in muscle
late complication: porcelain gallbladder
mast cells in GI tract?
mast cell proliferation in bone marrow & other organs
1. GI: increased gastric acid
- inactivation of pancreatic & intestinal enzymes --> diarrhea
- also N/V, cramps, ulcer
2. syncope, flushing, hypotension, tachycardia, bronchospasm
3. pruitus, uticaria, dermatographism
H2 receptors increase intracellular
(gastrin/Ach = Ca2+)