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99 Cards in this Set

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hemorrhagic necrosis of mamillary bodies
Wernicke-Korsakoff syndrome
abuse of which ilicit drug can cause myocardial irritability (arrythmia!)
cocaine
why is MetOH toxic?
converted to cellular toxins: formaldehyde, formic acid; these damage cells of, e.g., retina, optic nerve--> blindness!
why/how is cyanide toxic?
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)
RBC changes in lead poisoning?
basophilic stippling; hypochromic, microcytic anemia
lead poisoning causes what?
RBC changes, encephalopathy, neuropathy, Fanconi syndrome, lead line in teeth and gums, inc'd radiodensity of long bones
None
mercuric chloride ingestion leads to?
focal GI ulceration and severe renal damage with widespread necrosis and calcification of PCT
vinyl chloride assoc'd with what neoplasm?
hemangiosarcoma of liver
beta-naphthylamine, aniline dyes-->?
transitional cell carcinoma of urinary bladder
ethylene glycol--> ?
acute tubular necrosis; precipitation of calcium oxalate crystals
PCBs (polychrlorinated biphenyls) -->?
chloracne, impotence, visual changes
what is Reye syndrome?
in kids after acute febrile illness; aspirin causes microvesicular fatty change in liver, encephalopathy
why is phenacetin bad?
can cause chronic analgesic nephritis, renal papillary necrosis, urothelial neoplasms (esp TCC of renal pelvis)
what is a Curling ulcer?
acute gastric ulcer assoc'd with severe burns
Kwashiorkor vs marasmus
marasmus--deficiency of all nutrients, in kids <1y/o; Kwashiorkor--portin def with adequate caloric intake, kids >1y/o
in general, vit B complex deficiency--> ?
glossitis, dermatitis, diarrhea
dry beriberi vs wet beriberi
(vit B1 def); dry--peripheral neuropathy; wet--high output cardiac failure (dilated cardiomyopathy)
Wernicke triad
confusion, ataxia, ophthalmoplegia; also: memory loss, confabulatioin
vit B2 def
(riboflavin) cheilosis, glossitis, corneal vascularization, seborrheic dermatitis
diet lacking WHAT causes pellagra?
vit B3 AND tryptophan (niacin can be made from typtophan)
pellagra
vit B3 (and tryptophan) deficiency: dementia, dermatitis, diarrhea
vit B6 deficiecny --> ?
convulsions in infant; similar to B2 def (cheilosis, corneal vascularization, glossitis, seborrheic dermatitis)
in what conditions might you see vit B6 (pyridoxine) def?
chronic alcoholism; INH tx (competes wtih binding site); homocystinuria; pyridoxine responsive anemai (microcytic)
vit A def--> ?
night blindness (insufficient retinal rhodopsin); squamous metaplasia (which can lead to dry eyes?)
hypervitaminosis A --> ?
alopecia, hepatocellular damage, bone changes
hypervitaminosis D --> ?
kids: growth retardation; adults: hypercalciuria, nephrocalcinosis, renal calculi
3 types of arteriosclerosis
1. Monckeberg (medial calcific stenosis); 2. arteriosclerosis; 3. atherosclerosis (plaques)
Monckeberg arteriosclerosis
(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
arteriosclerosis--characterized by? assoc'd with?
characterized by hyaline thickening or proliferative change of small arteries, arterioles; assoc'd with HTN or DM
variants of arteriosclerosis
hyaline--benign nephrosclerosis; hyperplastic--concentric laminated "onionskin" thickening of arteriolar walls, MALIGNANT nephrosclerosis (malignant HTN)
ideal LDL: HDL?
4:1
atherosclerotic aneurysms occur most frequently where?
descending aorta, esp abdominal
what is syphilitic aortitis?
obliterative endarteritis of vaso vasorum which causes necrosis of media, seen in tertiary syphilis; "treebark" appearance
spider telangiectasia
benign vascular tumor; dilated small vessel surrounded by radiating fine channels; assoc'd with hyperestrinism (preggers, chronic liver dz)
Name the dz: localized dilation, convolution of venules, capillaries of skin, mucous membranes?
hereditary hemorrhagic telangiectasia, aka Osler-Weber-Rendu syndrome (AD, often complicated by epistaxis or GI bleeding)
types of hemangioma
capillary--tangle of closely packed capillary like channels; cavernous--lg vascular spaces in internal organs, can occur in von Hippel Lindau
what is a cystic hygroma?
cavernous lymphangioma in neck or axilla, usually
what rare neoplams assoc'd with exposure to As or throrium dioxide (Thorotrast)?
hemangiosarcoma
types of Kaposi sarcoma
classic--older Ashkenazi, mediterranean men; endemic--young African men, children; epidemic--AIDS, HHV8
polyarteritis nodosa assoc'd with what infection?
hep B (30%)
Henoch Schonlein purpura and serum sickness--both examples of what?
hypersensitivty (leukocytoclastic) vasculitis (immune complex dep!)
kinds of angina
stable--most common, precipitated by exertion; unstable--prolonged, recurrent pain @ rest; Prinzmetal--intermittent chest pain at rest (due to vasospasm?)
rheumatic fever due to infection by?
group A beta hemolytic strep (elevated ASO titer--recent strep infection)
Aschoff body
classic lesion of rheumatic fever; area of focal interstitial myocardial inflammation with fragmented collagen and fibrinoid material, Anitschkow myocytes, Aschoff cells (multinucleated giant cells)
McCallum plaque
seen in rheumatic endocarditis
erythema marginatum
distinctive skin rash involving trunk, extremities; characteristic of rheumatic fever
sydenham chorea
involuntary purposeless muscular movements and bizarre grimaces; CNS involvement of rheumatic fever!
marantic endocarditis
nonbacterial thrombotic endocarditis; small STERILE fibrin deposits randomly on valve leaflets; assoc'd with metastatic cancer and other wasting conditions
what endocarditis usually involves right heart?
IV drug use (staph infection); carcinoid
congenital rubella syndrome
cardiovascular defects, microcephaly with mental retardation, deafness, cataracts**, growth retardation; (also see infantile cataracts in galactosemia)
how determine mom's immune status to rubella?
anti-rubella Abs; IgM--recent primary infection; IgG--recent primary, past, or reinfecton
Name the dz and its assoc'ns: biventricular heart failure in young persons, characterized by diffuse myocardial degeneration and necrosis with inflammatory infiltrate
myocarditis. viral (coxsackie) or protozoan (Chagas)
None
most common cause of right ventricular heart failure?
left ventricular heart failure
what is cor pulmonale?
right ventricular hypertrophy and/or dilation secondary to lung dz/primary dz of pulmonary vasculature
drug of choice for diagnosing and abolishing AV nodal arrhythmias?
adenosine--works fast and transiently
clinical use of flecainamide?
class IC antiarrhythmic; only used as last resort treatment of refractory tachyarrhythmias
2 main concerns when using statins?
myopathy, hepatotoxicity
Plummer-Vinson syndrome
Fe deficiency assoc'd with partially obstructing upper esophageal web (and increased risk of oropharynz/upper esophageal cancers)
None
most common form of immune hemolytic anemia?
warm Ab (IgG), often secondary to underlying dzs (HL, NHL, SLE)
acute vs chronic cold agglutinin dz
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
kernicterus
staining of basal ganglia and othe rCNS parts by unconjugated bilirubin (concerned about this in hemolytic dz of newborn, for ex.)
lab tests for PNH paroxysmal nocturnal hematuria)?
Ham (acid serum) test--in vitro complement induced hemolysis in acidified serum; flow cytometry--CD59 neg erythrocytes
None
increased MHCH + erythrocyte osmotic fragility?
Hereditary Spherocytosis (AD, defect in membrane skeletal protein--spectrin!!)
pyruvate kinase deficiency vs glucose 6 phosphate DH def?
PK def--chronic and sustained anemia; G6PD def--self-limited
Hb S mutation
pt mutation in codon 6 of beta globin gene, val->glutamate substituation abolishes site for restriction endonuclease MstII (basis for prenatal dx)
most common malignancy of children?
ALL
ALL type that is most common and amenable to treatment?
has blast cells that are CD10+ (CALLA--common ALL ag)
Name the dz: CD5+ CD10-, smudge cells, >60y/o man
CLL (also CD23+ CD5+)
None
mean survival of CLL?
3-7 years
TRAP + leukemia is? affects who?
hairy cell leukemia; middle aged men
5 common characteristic of myeloproliferative dzs
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
name the dz: bone marrow megakaryocytosis + tear drop cells
chronic idiopathic myelofibrosis
EBV infectious mono vs CMV mono?
EBV--anti-EBV ab, heterophil Abs; CMV--heterophil neg
why get lytic bones lesions ("punched out") in multiple myeloma?
neoplastic plasma cells secrete osteoclast activating factor
M protein =?
sharp spike on electrophoresis seen in MM; usually IgG or IgA, light chain restricted
renal insufficiency in multiple myeloma characterized by?
tubular casts of Bence Jones protein; multinucleated giant cells; metastatic calcification; maybe interstitial infiltrate of malignant plasma cells
How is Waldenstrom's macroglobulinemia different from MM?
not quite mature plasma cell ("plasmacytoid lymphocyte"); monoclonal IgM (not IgA or IgG); NO LYTIC BONE LESIONS
None
Name the dz: monoclonal M protein spike, no Bence Jones proteinuria, <5% plasma cells in bone marrow, no decrease in normal [Ig]?
MGUS
what type of Hodgkin lymphoma affects young women more than men?
nodular sclerosis (the most common kind)
Name the dz: lg numbers of lymphocytes, histocytes and paucity of Reed-Sternberg cells; relatively good prognosis
lymphocyte rich classical HL
Name the dz: polymorphic infiiltrate of eos, plasma cells, histiocytes, Reed-Sternberg cells; areas of necrosis and fibrosis; older persons
mixed cellularity HL
Name the dz: few lymphocytes, many Reed-Sternberg cells, extensive necrosis and fibrosis; poor prognosis
lymphocyte depletion HL (least frequent form)
Name the dz: nodular division of affected lymph nodes by fibrous bands, lacunar cells (Reed-Sternberg cell variant); good prognosis, women>men
nodular sclerosis HL (most common type)
Name the dz: CD10+ CD5- t(14;18)
follicular lymphoma (most common NHL)
None
Name the dz: aggressive, disseminated incurable, in older men; t(11;14)
mantle cell lymphoma
Pautrier abscesses
small pockets of tumor cells within epithelium, in mycosis fungoides
CD4+ T cells with cerebriform nuclei seen in?
mycosis fungoides
functional deficiency of factor VIII and failure of platelet adhesion--> ?
vWF dz (b/c vWF is carrier for factor VIII)
what organism can cause acute epiglottitis (may be life threatening!)
H. influenzae (GNR, encapsulated, grows on heme, NAD; IgA protease)
Curschmann spirals and Charcot-Leyden crystals characterize what kind of COPD?
bronchial asthma
piZZ
alpha 1 AT def, panacinar emphysema, hepatic cirrhosis
what is bronchiectasis?
permanent abnormal dilation caused by chronic infection, with inflammation and necrosis of bronchial wall;
complications of neonatal ARDS
bronchopulmonary dysplasia; intraventricular brain hemorrhage; necrotizing enterocolitis; PDA
asbestosis predisposes one to what neoplasms
bronchogenic carcinoma; malignant mesothelioma
5 common pathologic changes seen in sarcoidosis?
1. interstitial lung dz; 2. enlarged hilar lymph nodes; 3. anterior uveitis; 4. erythema nodosum; 5. polyarthritis
rapid ascent to high altitudes may cause?
pulmonary edema
causes of interstitial (atypical) pneumonia
#1-mycoplasma; also: viral (influenza, adeno, rhino, RSV, etc), Rickettsial (coxiella burnettii--Q fever), psittacosis (chlamydiea, dried bird poo)
Ghon complex
peripheral subpleural parenchymal lesion + involved lymph nodes, only in PRIMARY TB
cavitation seen only in what kind of TB?
secondary