Brs Path Batch 2

Front 1

hemorrhagic necrosis of mamillary bodies

Back 1

Wernicke-Korsakoff syndrome

Front 2

abuse of which ilicit drug can cause myocardial irritability (arrythmia!)

Back 2

cocaine

Front 3

why is MetOH toxic?

Back 3

converted to cellular toxins: formaldehyde, formic acid; these damage cells of, e.g., retina, optic nerve--> blindness!

Front 4

why/how is cyanide toxic?

Back 4

inhibits intracellular cytochrome oxidase by binding ferric iron and preventing cellular oxidation. this can cause death w/i minutes! (on autopsy: petechiae, scent of bitter almonds)

Front 5

RBC changes in lead poisoning?

Back 5

basophilic stippling; hypochromic, microcytic anemia

Front 6

lead poisoning causes what?

Back 6

RBC changes, encephalopathy, neuropathy, Fanconi syndrome, lead line in teeth and gums, inc'd radiodensity of long bones

Hint 6

None

Front 7

mercuric chloride ingestion leads to?

Back 7

focal GI ulceration and severe renal damage with widespread necrosis and calcification of PCT

Front 8

vinyl chloride assoc'd with what neoplasm?

Back 8

hemangiosarcoma of liver

Front 9

beta-naphthylamine, aniline dyes-->?

Back 9

transitional cell carcinoma of urinary bladder

Front 10

ethylene glycol--> ?

Back 10

acute tubular necrosis; precipitation of calcium oxalate crystals

Front 11

PCBs (polychrlorinated biphenyls) -->?

Back 11

chloracne, impotence, visual changes

Front 12

what is Reye syndrome?

Back 12

in kids after acute febrile illness; aspirin causes microvesicular fatty change in liver, encephalopathy

Front 13

why is phenacetin bad?

Back 13

can cause chronic analgesic nephritis, renal papillary necrosis, urothelial neoplasms (esp TCC of renal pelvis)

Front 14

what is a Curling ulcer?

Back 14

acute gastric ulcer assoc'd with severe burns

Front 15

Kwashiorkor vs marasmus

Back 15

marasmus--deficiency of all nutrients, in kids <1y/o; Kwashiorkor--portin def with adequate caloric intake, kids >1y/o

Front 16

in general, vit B complex deficiency--> ?

Back 16

glossitis, dermatitis, diarrhea

Front 17

dry beriberi vs wet beriberi

Back 17

(vit B1 def); dry--peripheral neuropathy; wet--high output cardiac failure (dilated cardiomyopathy)

Front 18

Wernicke triad

Back 18

confusion, ataxia, ophthalmoplegia; also: memory loss, confabulatioin

Front 19

vit B2 def

Back 19

(riboflavin) cheilosis, glossitis, corneal vascularization, seborrheic dermatitis

Front 20

diet lacking WHAT causes pellagra?

Back 20

vit B3 AND tryptophan (niacin can be made from typtophan)

Front 21

pellagra

Back 21

vit B3 (and tryptophan) deficiency: dementia, dermatitis, diarrhea

Front 22

vit B6 deficiecny --> ?

Back 22

convulsions in infant; similar to B2 def (cheilosis, corneal vascularization, glossitis, seborrheic dermatitis)

Front 23

in what conditions might you see vit B6 (pyridoxine) def?

Back 23

chronic alcoholism; INH tx (competes wtih binding site); homocystinuria; pyridoxine responsive anemai (microcytic)

Front 24

vit A def--> ?

Back 24

night blindness (insufficient retinal rhodopsin); squamous metaplasia (which can lead to dry eyes?)

Front 25

hypervitaminosis A --> ?

Back 25

alopecia, hepatocellular damage, bone changes

Front 26

hypervitaminosis D --> ?

Back 26

kids: growth retardation; adults: hypercalciuria, nephrocalcinosis, renal calculi

Front 27

3 types of arteriosclerosis

Back 27

1. Monckeberg (medial calcific stenosis); 2. arteriosclerosis; 3. atherosclerosis (plaques)

Front 28

Monckeberg arteriosclerosis

Back 28

(medial calcific sclerosis); radial and ulnar arteries in >50y/o get ring-like calcifications that do NOT obstruct (b/c intima not involved); "pipestem" arteries

Front 29

arteriosclerosis--characterized by? assoc'd with?

Back 29

characterized by hyaline thickening or proliferative change of small arteries, arterioles; assoc'd with HTN or DM

Front 30

variants of arteriosclerosis

Back 30

hyaline--benign nephrosclerosis; hyperplastic--concentric laminated "onionskin" thickening of arteriolar walls, MALIGNANT nephrosclerosis (malignant HTN)

Front 31

ideal LDL: HDL?

Back 31

4:1

Front 32

atherosclerotic aneurysms occur most frequently where?

Back 32

descending aorta, esp abdominal

Front 33

what is syphilitic aortitis?

Back 33

obliterative endarteritis of vaso vasorum which causes necrosis of media, seen in tertiary syphilis; "treebark" appearance

Front 34

spider telangiectasia

Back 34

benign vascular tumor; dilated small vessel surrounded by radiating fine channels; assoc'd with hyperestrinism (preggers, chronic liver dz)

Front 35

Name the dz: localized dilation, convolution of venules, capillaries of skin, mucous membranes?

Back 35

hereditary hemorrhagic telangiectasia, aka Osler-Weber-Rendu syndrome (AD, often complicated by epistaxis or GI bleeding)

Front 36

types of hemangioma

Back 36

capillary--tangle of closely packed capillary like channels; cavernous--lg vascular spaces in internal organs, can occur in von Hippel Lindau

Front 37

what is a cystic hygroma?

Back 37

cavernous lymphangioma in neck or axilla, usually

Front 38

what rare neoplams assoc'd with exposure to As or throrium dioxide (Thorotrast)?

Back 38

hemangiosarcoma

Front 39

types of Kaposi sarcoma

Back 39

classic--older Ashkenazi, mediterranean men; endemic--young African men, children; epidemic--AIDS, HHV8

Front 40

polyarteritis nodosa assoc'd with what infection?

Back 40

hep B (30%)

Front 41

Henoch Schonlein purpura and serum sickness--both examples of what?

Back 41

hypersensitivty (leukocytoclastic) vasculitis (immune complex dep!)

Front 42

kinds of angina

Back 42

stable--most common, precipitated by exertion; unstable--prolonged, recurrent pain @ rest; Prinzmetal--intermittent chest pain at rest (due to vasospasm?)

Front 43

rheumatic fever due to infection by?

Back 43

group A beta hemolytic strep (elevated ASO titer--recent strep infection)

Front 44

Aschoff body

Back 44

classic lesion of rheumatic fever; area of focal interstitial myocardial inflammation with fragmented collagen and fibrinoid material, Anitschkow myocytes, Aschoff cells (multinucleated giant cells)

Front 45

McCallum plaque

Back 45

seen in rheumatic endocarditis

Front 46

erythema marginatum

Back 46

distinctive skin rash involving trunk, extremities; characteristic of rheumatic fever

Front 47

sydenham chorea

Back 47

involuntary purposeless muscular movements and bizarre grimaces; CNS involvement of rheumatic fever!

Front 48

marantic endocarditis

Back 48

nonbacterial thrombotic endocarditis; small STERILE fibrin deposits randomly on valve leaflets; assoc'd with metastatic cancer and other wasting conditions

Front 49

what endocarditis usually involves right heart?

Back 49

IV drug use (staph infection); carcinoid

Front 50

congenital rubella syndrome

Back 50

cardiovascular defects, microcephaly with mental retardation, deafness, cataracts**, growth retardation; (also see infantile cataracts in galactosemia)

Front 51

how determine mom's immune status to rubella?

Back 51

anti-rubella Abs; IgM--recent primary infection; IgG--recent primary, past, or reinfecton

Front 52

Name the dz and its assoc'ns: biventricular heart failure in young persons, characterized by diffuse myocardial degeneration and necrosis with inflammatory infiltrate

Back 52

myocarditis. viral (coxsackie) or protozoan (Chagas)

Hint 52

None

Front 53

most common cause of right ventricular heart failure?

Back 53

left ventricular heart failure

Front 54

what is cor pulmonale?

Back 54

right ventricular hypertrophy and/or dilation secondary to lung dz/primary dz of pulmonary vasculature

Front 55

drug of choice for diagnosing and abolishing AV nodal arrhythmias?

Back 55

adenosine--works fast and transiently

Front 56

clinical use of flecainamide?

Back 56

class IC antiarrhythmic; only used as last resort treatment of refractory tachyarrhythmias

Front 57

2 main concerns when using statins?

Back 57

myopathy, hepatotoxicity

Front 58

Plummer-Vinson syndrome

Back 58

Fe deficiency assoc'd with partially obstructing upper esophageal web (and increased risk of oropharynz/upper esophageal cancers)

Hint 58

None

Front 59

most common form of immune hemolytic anemia?

Back 59

warm Ab (IgG), often secondary to underlying dzs (HL, NHL, SLE)

Front 60

acute vs chronic cold agglutinin dz

Back 60

both mediated by IgM abs; acute--anti I blood group, infectious mono, mycoplasma pneumoniae; chronic--anti-i Abs, assoc'd with lymphoid neoplasms, Raynaud phenom

Front 61

kernicterus

Back 61

staining of basal ganglia and othe rCNS parts by unconjugated bilirubin (concerned about this in hemolytic dz of newborn, for ex.)

Front 62

lab tests for PNH paroxysmal nocturnal hematuria)?

Back 62

Ham (acid serum) test--in vitro complement induced hemolysis in acidified serum; flow cytometry--CD59 neg erythrocytes

Hint 62

None

Front 63

increased MHCH + erythrocyte osmotic fragility?

Back 63

Hereditary Spherocytosis (AD, defect in membrane skeletal protein--spectrin!!)

Front 64

pyruvate kinase deficiency vs glucose 6 phosphate DH def?

Back 64

PK def--chronic and sustained anemia; G6PD def--self-limited

Front 65

Hb S mutation

Back 65

pt mutation in codon 6 of beta globin gene, val->glutamate substituation abolishes site for restriction endonuclease MstII (basis for prenatal dx)

Front 66

most common malignancy of children?

Back 66

ALL

Front 67

ALL type that is most common and amenable to treatment?

Back 67

has blast cells that are CD10+ (CALLA--common ALL ag)

Front 68

Name the dz: CD5+ CD10-, smudge cells, >60y/o man

Back 68

CLL (also CD23+ CD5+)

Hint 68

None

Front 69

mean survival of CLL?

Back 69

3-7 years

Front 70

TRAP + leukemia is? affects who?

Back 70

hairy cell leukemia; middle aged men

Front 71

5 common characteristic of myeloproliferative dzs

Back 71

1. middle aged-eldery; 2. proliferation of 1+ in myeloid series; 3. basophilia and increased nucleated RBC; 4. increased sr uric acid; 5. prominent splenomegaly

Front 72

name the dz: bone marrow megakaryocytosis + tear drop cells

Back 72

chronic idiopathic myelofibrosis

Front 73

EBV infectious mono vs CMV mono?

Back 73

EBV--anti-EBV ab, heterophil Abs; CMV--heterophil neg

Front 74

why get lytic bones lesions ("punched out") in multiple myeloma?

Back 74

neoplastic plasma cells secrete osteoclast activating factor

Front 75

M protein =?

Back 75

sharp spike on electrophoresis seen in MM; usually IgG or IgA, light chain restricted

Front 76

renal insufficiency in multiple myeloma characterized by?

Back 76

tubular casts of Bence Jones protein; multinucleated giant cells; metastatic calcification; maybe interstitial infiltrate of malignant plasma cells

Front 77

How is Waldenstrom's macroglobulinemia different from MM?

Back 77

not quite mature plasma cell ("plasmacytoid lymphocyte"); monoclonal IgM (not IgA or IgG); NO LYTIC BONE LESIONS

Hint 77

None

Front 78

Name the dz: monoclonal M protein spike, no Bence Jones proteinuria, <5% plasma cells in bone marrow, no decrease in normal [Ig]?

Back 78

MGUS

Front 79

what type of Hodgkin lymphoma affects young women more than men?

Back 79

nodular sclerosis (the most common kind)

Front 80

Name the dz: lg numbers of lymphocytes, histocytes and paucity of Reed-Sternberg cells; relatively good prognosis

Back 80

lymphocyte rich classical HL

Front 81

Name the dz: polymorphic infiiltrate of eos, plasma cells, histiocytes, Reed-Sternberg cells; areas of necrosis and fibrosis; older persons

Back 81

mixed cellularity HL

Front 82

Name the dz: few lymphocytes, many Reed-Sternberg cells, extensive necrosis and fibrosis; poor prognosis

Back 82

lymphocyte depletion HL (least frequent form)

Front 83

Name the dz: nodular division of affected lymph nodes by fibrous bands, lacunar cells (Reed-Sternberg cell variant); good prognosis, women>men

Back 83

nodular sclerosis HL (most common type)

Front 84

Name the dz: CD10+ CD5- t(14;18)

Back 84

follicular lymphoma (most common NHL)

Hint 84

None

Front 85

Name the dz: aggressive, disseminated incurable, in older men; t(11;14)

Back 85

mantle cell lymphoma

Front 86

Pautrier abscesses

Back 86

small pockets of tumor cells within epithelium, in mycosis fungoides

Front 87

CD4+ T cells with cerebriform nuclei seen in?

Back 87

mycosis fungoides

Front 88

functional deficiency of factor VIII and failure of platelet adhesion--> ?

Back 88

vWF dz (b/c vWF is carrier for factor VIII)

Front 89

what organism can cause acute epiglottitis (may be life threatening!)

Back 89

H. influenzae (GNR, encapsulated, grows on heme, NAD; IgA protease)

Front 90

Curschmann spirals and Charcot-Leyden crystals characterize what kind of COPD?

Back 90

bronchial asthma

Front 91

piZZ

Back 91

alpha 1 AT def, panacinar emphysema, hepatic cirrhosis

Front 92

what is bronchiectasis?

Back 92

permanent abnormal dilation caused by chronic infection, with inflammation and necrosis of bronchial wall;

Front 93

complications of neonatal ARDS

Back 93

bronchopulmonary dysplasia; intraventricular brain hemorrhage; necrotizing enterocolitis; PDA

Front 94

asbestosis predisposes one to what neoplasms

Back 94

bronchogenic carcinoma; malignant mesothelioma

Front 95

5 common pathologic changes seen in sarcoidosis?

Back 95

1. interstitial lung dz; 2. enlarged hilar lymph nodes; 3. anterior uveitis; 4. erythema nodosum; 5. polyarthritis

Front 96

rapid ascent to high altitudes may cause?

Back 96

pulmonary edema

Front 97

causes of interstitial (atypical) pneumonia

Back 97

#1-mycoplasma; also: viral (influenza, adeno, rhino, RSV, etc), Rickettsial (coxiella burnettii--Q fever), psittacosis (chlamydiea, dried bird poo)

Front 98

Ghon complex

Back 98

peripheral subpleural parenchymal lesion + involved lymph nodes, only in PRIMARY TB

Front 99

cavitation seen only in what kind of TB?

Back 99

secondary