Test 42: Pathology

Question 1

Marfan is a defect in what

Answer 1

fibrillin-1

Chromosome 15

Question 2

2 most common cardiac abnormalities seen in marfan are

Answer 2

1. mitral valve prolapse

2. cystic medial degeneration of the aorta– aneurysmal dilation –> untreated - aortic dissection

Question 3

Marfan syndrome and Homocystinuria have similar characteristics what separates them

Answer 3

Marfan: aortic root dilation
Homocystinuria: intellectual disability and thrombosis

Question 4

Poor maternal glucose control leads to what

Answer 4

• Transplacental glucose
• baby beta cell hyperplasia
• hyperinsulinism
• Macrosomia

After delivery: baby hypoglycemia

Question 5

diaphoresis

Answer 5

excessive sweating

Question 6

Coagulative necrosis develops after what

Answer 6

ischemic injury

Question 7

morphology of coagulative necrosis

Answer 7

• tissue architecture perserved

- cell anucleated

Question 8

What causes liquefactive necrosis

Answer 8

• bacterial infections

- central nervous system infarcts

Question 9

Fat necrosis is seen in what

Answer 9

acute pancreatitis

Question 10

Caseous necrosis occurs with what

Answer 10

tuberculous infection

Question 11

Morphology of caseous necrosis

Answer 11

• cheesy tan-white gross appearance

- granuloma

Question 12

patient with ST-segmen elevation in Leads II, III, aVF.

tight squeezing in chest radiates down left arm

Answer 12

MI due to transmural ischemia of inferior wall of heart

Question 13

Complete cardiac ischemia for greater than 30 min. shows up how in impacted heart

Answer 13

coagulative necrosis

Question 14

ischemic cell death in CNV causes what

Answer 14

liquefactive necrosis

Question 15

Left atrial pressure systolic pressure increase is associated with what heart valve problem

Answer 15

mitral regurgitation

- increase filling of left atrium during systole

Question 16

pt 8 year old boy: right mandible mass, immigrated from East Africa, temp 98, lymphadenopthy
biopsy: diffuse infiltrate of lymphoid cells and numerous mitotic figures

Answer 16

Burkitt lymphoma

Question 17

Burkitt lymphoma translocation

Answer 17

1. c-Myc oncogene on long arm of chromosome 8
2. Ig heavy chain region on chromosome 14

8:14

Question 18

The product of c-myc is a nuclear phosphoprotien that function as

Answer 18

transcription activitor

Question 19

histo for Burkitt lymphoma

Answer 19

“starry sky”

- sheets of lymphocytes with interspersed “tangible body” macrophages

Question 20

translocation for follicular lymphoma

Answer 20

14:18

18: long arm near bcl2 gene
14: Ig heavy chain

Question 21

translocation for mantle cell lymphoma

Answer 21

11:14

11: cycline D1
14: Ig heavy chain

Question 22

Translocation for Chronic myelogenous leukemia

Answer 22

Philadelphia chromosome 9:22

BCR-ABL

Question 23

Regurgitant blood flow from aorta into left ventricle in chronic aortic regurgitation leads to what

Answer 23

increase preload, wall stress

-result with eccentric hypertrophy, increase stroke volume

Question 24

genetics for hypertrophic cardiomyopathy

Answer 24

autosomal dominant

• mutation in sarcomere gene
• Beta-myosin heavy chain and myosin-binding protein C

Question 25

How do coagulopathies present

Answer 25

deep-tissue leading in joints, muscles, and subcutaneous tissue

Question 26

how do platelet defects present

Answer 26

mucocutaneous bleeding

Question 27

Von Willebrand Disease how does it impact the coagulation cascade

Answer 27

acts to carry/protect factor VIII

Question 28

Halitosis

Answer 28

foul breath

Question 29

Periodic, simultaneous, and non-peristaltic contractions of the esophagus due to impaired inhibitory innervation within the esophageal myenteric plexus

Answer 29

diffuse esophageal spasm

Question 30

pt with memory loss of recent events, loss of executive dysfunction and visuospatial impairment

Answer 30

Alzheimer dementia

Question 31

histo for Alzheimer

Answer 31

``` Amyloid plaques (neuritic senile plaques) neurofibrillary tangles ```

Question 32

Large intracytoplasmic vacuoles, sometimes described as spongiform is seen in what

Answer 32

Creutzfeldt-Jakob disease

Question 33

presentation for Lewy body

Answer 33

1. attention deficit 2. visual hallucinations 3. spontaneous parkinsonism

Question 34

What is seen in multiple lacunar infarcts

Answer 34

vascular dementia

Question 35

what is the difference between vascular dementia and Alzheimer dementia

Answer 35

vascular dementia: step-wise rather than gradual decline in cognitive function - also focal neurologic deficits

Question 36

What is manometry for achalasia

Answer 36

1. normal contraction of upper esophageal sphincter 2. decreased amplitude of peristalsis mid esophagus 3. incomplete relaxation at LES

Question 37

what happens when Cricopharyngeal dysfunction

Answer 37

failure to relax during swallowing and cause a choking or "food-sticking" sensation on swallowing

Question 38

Most common congenital heart defect

Answer 38

bicuspid aortic valve

Question 39

bicuspid aortic valve causes what

Answer 39

atherosclerosis and calcification of aortic valve | - lead to aortic stenosis in greater than 50%

Question 40

common cause of superior vena cava syndrome

Answer 40

- lung cancer, followed by non-Hodgkin lymphoma | - mediastinal mass

Question 41

Small cell lung carcinoma is associated with what other disease

Answer 41

Cushing syndrome and syndrome of inappropriate antidiuretic hormone secretion

Question 42

34 yr old women: dizziness, mild confusion over last week. history of seizures recently started carbamazepine, temp 98, low sodium concentration ? what does she have and why

Answer 42

Inappropriate antidiuretic hormone secretion, SIADH | - carbamazepine

Question 43

What protein do ADH and oxytocin have? function

Answer 43

neurophysins | - postranslational hormone processing and stabilization during axonal transport

Question 44

In what nuclei of the hypothalamus does vasopressin and oxytocin come from

Answer 44

ADH: supraoptic nuclei oxytocin: paraventricular

Question 45

Most common pediatric malignancy leukemia is

Answer 45

acute lymphoblastic leukemia ALL

Question 46

8yr old boy: fever, throat pain, severe dyspnea, tachypnea, inspiratory stridor, hematopoietic cells (blasts)

Answer 46

ALL acute lymphoblastic leukemia - b/c throat pain = mediastinal mass which compresses the esophagus and trachea and block SVC ( superior vena cava) = T-cell ALL

Question 47

what is lymphangiosarcoma

Answer 47

rare malignant neoplasm of the endothelial lining of lymphatic channels

Question 48

when do you see a patient getting lymphangiosarcoma

Answer 48

10 years following radical mastectomy for breast cancer

Question 49

Persistent lymphedema predisposes to the development of what

Answer 49

lymphangiosarcoma

Question 50

what is lymphangiosarcoma

Answer 50

rare malignant neoplasm of endothelial lining of lymphatic channels

Question 51

What can secrete beta-hCG

Answer 51

- placenta | - Choriocarcinoma - testicular germ cell tumor

Question 52

compare the structure of Beta-hCG

Answer 52

alpha subunit: TSH, LH FSH similar | beta subunit: TSH similar

Question 53

28 yr old man: panels scrotal mass, increased sweating and heat intolerance , enlarged contender right testicle, increased T4 and T3

Answer 53

increased B-hCG with testicular germ cell tumor

Question 54

hematemesis

Answer 54

vomiting blood

Question 55

what does portal vein thrombosis cause

Answer 55

portal hypertension splenomegaly varicosities at portocaval anastomoses ( lower esophagus)

Question 56

What is the gene mutation sequence for colorectal cancer

Answer 56

APC K-ras p53 and DCC

Question 57

role of K-ras

Answer 57

apoptosis

Question 58

treatment for Gardnerella vaginalis

Answer 58

clindamycin or metronidazole