Brs Path Batch 3

Front 1

cavitation seen only in what kind of TB

Back 1

secondary (Ghon complex only in primary)

Front 2

odontoma

Back 2

most common odontogenic tumor; hamartoma--odontogenic epithelium, odontoblastic tissue

Front 3

Ranula

Back 3

lg mucocele of salivary gl origin, usually on floor of mouth

Front 4

most frequently occurring salivary tumor gland tumor?

Back 4

pleomorphic adenoma (benign but often recurs; "mixed")

Front 5

pulsion esophageal diverticula vs. traction esophageal diverticular

Back 5

pulsion--false, herniation of mucosa through defects in muscular layer; traction--true, result of periesophageall inflammation, scarring, all layers involved

Front 6

Zenker diverticulum

Back 6

esophageal diverticulum immediately above upper esophageal sphincter

Front 7

achalasia due to?

Back 7

(persistent contraction of LES, absence of peristalsis--> dilation); due to loss of ganglion cells in myenteric plexus

Front 8

Cushing ulcer

Back 8

acute gastric ulcer in assoc'n with brain injury

Front 9

Menetrier dz

Back 9

giant hypertrophic gastritis with extreme enlg'ment of gastric rugae

Front 10

is peptic ulcer of stomach a precursor lesion of gastric carcinoma?

Back 10

NO

Front 11

blood group A assoc'd with what neoplasm

Back 11

carcinoma of stomach

Hint 11

None

Front 12

what etiologic factors assoc'd with stomach carcinoma?

Back 12

H. pylori; nitrosamines; excessive salt intake; achlorhydria

Front 13

Krukenberg tumor

Back 13

bilateral involvement of ovaries by metastatic carcinoma of stomach (see signet ring cells)

Front 14

variants of stomach carcinoma

Back 14

intestinal type-polypoid, assoc'd with h.pylori; infiltrating/diffuse--not assoc'd with h.pylori, leather-bottle stomach

Front 15

ulcerated intestinal type stomach carcinoma vs peptic ulcer?

Back 15

peptic ulcer--smooth base w/non elevated, punched out margins; carcinoma--irregular necrotic base and firm, raised margins

Front 16

peptic ulcer assoc'd with what blood group?

Back 16

O

Hint 16

None

Front 17

which peptic ulcer is NOT assoc'd with hypersecretion of gastric acid and pepsin?

Back 17

stomach!

Front 18

peptic ulcer in JEJUNUM suggestive of?

Back 18

Zollinger-Ellison syndrome

Front 19

peptic ulcers assoc'd with?

Back 19

NSAID use; smokers; Z-E syndrome; primary hyperparathyroidism; MEN type 1

Front 20

Meckel diverticulum a remnant of what?

Back 20

embryonic vitelline duct (may contain ectopic gastric, duodenal, colonic, pancreatic tissue)

Front 21

complicatons/assoc'ns of Meckel diverticulum?

Back 21

usually asymptomatic but if ectopic gastric tissue, may ulcerate; intussusception; volvulus

Front 22

cobblestone appearance of GI mucosa assoc'd with?

Back 22

Crohn's

Front 23

celiac dz most commonly assoc'd with what malignancy?

Back 23

enterophaty-type T cell lymphoma

Front 24

Name the dz: distinctive PAS+ macrophages in intestinal mucosa

Back 24

Whipple dz (Tropheryma Whippelii)

Front 25

carcinoid syndrome

Back 25

get cutaneous flushing, watery diarrhea, ab cramps, bronchospasm, R heart valvular lesions; happens if mets to liver

Front 26

carcinoid most frequently where?

Back 26

appendix. if anywhere else, tends to mets to liver-->get carcinoid syndrome

Front 27

ischemic bowel dz most often where?

Back 27

splenic flexure and rectosigmoid junction (watershed areas)

Front 28

angiodysplasia

Back 28

tortuous dilation of small vessels spanning intestinal (sub)mucosa; common cause of otherwise unexplained lower bowel bleeding

Front 29

pseudomembranous colitis due to?

Back 29

EXOTOXIN of C. difficile; get fibrinous necrosis of superficial mucosa

Front 30

flask shaped ulcers in colon--> ?

Back 30

amebic colitis (Entamoeba histolytica)

Front 31

Peutz-Jeghers polyps

Back 31

hamartomatous polyps; part of syndrome; get melanotic accumulations in mouth, hands, genitalia; not malignant but assoc'd with inc'd propensity for malignancy at other sites

Front 32

types of adenomatous polyps

Back 32

(true neoplasms) tubular--most common; tubulovillous; villous--least common, sessile and velvety

Front 33

which kind of adenomatous polyp most likely to turn malignant?

Back 33

villous adenoma

Front 34

tubular adenomas

Back 34

small pedunculated polyps with malignant foci

Front 35

Gardner syndrome

Back 35

AD, numerous adenomatous polyps along with osteomas and soft tissue tumors

Front 36

Turcot syndrome

Back 36

adenomatous polyps and tumors of CNS

Front 37

significance of CAE in colon cancer?

Back 37

nonspecific marker so best for following course of dz

Front 38

most common appendicieal neoplasm?

Back 38

carcinoid

Front 39

Gilbert syndrome

Back 39

common familial D/O; modest elevation of sr UNCONJUGATED bilirubin due to dec'd BR uptake by liver and dec'd activity of glucuronyl trasferase

Front 40

Crigler-Najjar syndrome

Back 40

severe familial D/O; UNCONJUGATED hyperbilirubinemia due to glucuronyl trasnferase deficiency (Amish!);

Front 41

Dubin-Johnson syndrome

Back 41

AR, CONJUGATED hyperbilirubinemia due to defective BR transport; get striking brown to black discoloration of liver due to deposition of very dark granules

Front 42

How is Rotor Syndrome different from Dubin-Johnson syndrome?

Back 42

both are conjugated hyperbilirubinemias due to BR transport problem but no abnl pigmentation of liver in Rotor

Front 43

which hepatitis viruses assoc'd with hepatocellular carcinoma?

Back 43

Hep B, C

Front 44

How is Hep A spread?

Back 44

(ssRNA, picornavirus) fecal-oral

Front 45

infected HBV hepatocytes have what appearance?

Back 45

"ground glass"

Front 46

significance of HBeAg?

Back 46

closely correlated with viral infectivity

Front 47

Which hep virus requires prior or concurret infection with HBV and in what population seen most?

Back 47

Hep D, IV drug users (makes more fulminant course)

Front 48

How distinguish autoimmune hepatitis from other forms (HBV, HCV)

Back 48

both viral and autoimmune-> very high ALTS (1000s!); but autoimmune has hypergammaglobulinemia, anti-smooth muscle Ab

Front 49

DDx for ALT>1000 U/L

Back 49

acute viral hepatitis, drug toxicity (acetaminophen!), shock liver, autoimmune

Front 50

neonatal hepatitis characterized by?

Back 50

giant cell transformation of hepatocytes; bile pigment of prominent w/i canaliculi and hepatocytes

Front 51

hepatic component of yellow fever characterized by?

Back 51

(arbovirus) midzonal hepatic necrosis

Front 52

ingestion of Echinococcus granulosus--> ?

Back 52

hydatid dz of liver; lg parastitic cyts invade liver

Front 53

fatty liver of pregnancy

Back 53

microvesicular fatty liver; acute hepatic liver failure in 3rd trimester; high mortality

Front 54

3 causes of microvesicular fatty liver

Back 54

1. Reye syndrome; 2. fatty liver of preggers; 3. tetracycline toxicity

Front 55

alcoholic hepatitis assoc'd with what sort of fibrosis?

Back 55

irreversible fibrosis that characteristically surrounds CENTRAL vein (perivenular fibrosis)

Front 56

Hobnail liver

Back 56

scarred shrunken liver, in late stages of cirrhosis

Front 57

primary biliary cirrhosis vs primary scleroris cholangitis

Back 57

PBC--women, inc'd AP, AMA+, dx by liver bx, tx: ursodeoxycholic acid; PSC--IBD, inc'd AP, AMA-, dx by cholangiography, tx: none

Front 58

asymptomatic increase in AP in pt with IBD, think?

Back 58

PSC

Front 59

middle aged woman with severe obstructive jaundice, itching, hypercholesterolemia and inc'd AP--?

Back 59

PBC

Front 60

CNS involvement in Wilson dz?

Back 60

Cu deposition in basal ganglia-->extrapyramidal motor signs)

Front 61

hepatorenal syndrome

Back 61

functional renal failure (nl kidneys) characterized by profound Na retention, uremia, oliguria, usually w/ascites

Front 62

Budd-Chiari syndrome

Back 62

thrombotic occlusion of major hepatic veins (post hepatic portal HTN); ab pain ,jaundice, hepatomegaly, ascites, eventual liver failure

Front 63

hepatic adenomas--assoc'd with? big concern?

Back 63

OCP; if subcapsular, may rupture-->severe intraperitoneal hemorrhage

Front 64

what carcinoma assoc'd with aflatoxin B1?

Back 64

hepatocellular carcinoma

Front 65

cholangiosarcoma assoc'd with?

Back 65

clonarchis sinensis (liver fluke), PSC, late complications of throium dioxide, NOT HBV or cirrhosis!

Front 66

strawberry gallbladder

Back 66

(cholestrolosis); yellow cholesterol containing flecks in mucusal surface; NOT assoc'd with inflamm changes or cholelithiasis

Front 67

most common primary tumor of gallbladder?

Back 67

adenocarcinoma

Front 68

Courvoisier law

Back 68

tumors that obstruct common bile duct will cause enlarged distended gallbladder; obstructing stones do not

Front 69

4 big systemic effects of the released cellular components in acute pancreatitis

Back 69

1. resp failure (PLA2 degrades surfactant); 2. subdiaphragmatic inflamm; 3. shallow respirations (b/c of pain); 4. hemorrhage

Front 70

#1 predisposing factor for chronic pancreatitis?

Back 70

alcohol use (also, CF; gld std dx: MRI with MRCP)

Front 71

pancreatic carcinoma usually where?

Back 71

in head-->obstructive jaundice

Front 72

carcinoma in pancreatic tail-->

Back 72

possible pancreatic islet destruction and secondary DM

Hint 72

None

Front 73

hyperhydramnios assoc'd with?

Back 73

duodenal atresia, TEF

Front 74

Name the dz: thickened gomerular capillary walls, subepi immune complex deposition, "spike and dome"

Back 74

memranous glomerulonephritis (a major primary cause of nephrotic syndrome)

Front 75

Kimmelstiel-Wilson nodules assoc'd with what renal dz?

Back 75

diabetic nephropathy (nodular accumulations of mesangial matrix material)

Front 76

renal amyloidosis characterized by

Back 76

subendothelial mesangial amyloid deposits and distinctive fibrillary pattern

Front 77

types of lupus nephropathy (WHO)

Back 77

type 1-no renal involvement; 2--mesangial form; 3--focal proliferative; 4--diffuse proliferative (prototype, most severe); 5--membranous (indistinguishable from membranous GN)

Front 78

4 clinical findings of nephritic syndrome

Back 78

1. oliguria; 2. azotemia; 3. HTN; 4. hematuria

Front 79

what kind of strep usually --> post strep GN?

Back 79

group A beta hemolytic

Front 80

Name the dz: nepritic syndrome, pneumonitis w/hemoptisis, 20-30y/o male

Back 80

Goodpasture syndrome (anti glomerular BM)

Front 81

mutation in alpha5 chain of type IV collagen--> ?

Back 81

Alport syndrome (hereditary nephritis assoc'd with nerve deafness and ocular d/o)

Front 82

Berger dz

Back 82

IgA nephropathy, v common, usually benign recurrent hematuriain kids following infection

Front 83

"tram track" appearance of glomerular BM--> ?

Back 83

membranoproliferative glomerulonephritis (mostly type 1; mesangial matrix expands into glom cap loops)

Front 84

types of membranoproliferative glomerulonephritis

Back 84

1--v. striking tram track; II--dense deposit dx

Front 85

pathognomonic finding for acute pyelonephritis?

Back 85

white cell casts in urine

Front 86

acute drug induce interstitial nephritis most often due to?

Back 86

penicillin derivatives (methicilin!); NSAIDS; diuretics

Front 87

renal papillary necrosis most often assocd with what a) drug, b)disease

Back 87

a) phenacetin + other analgesincs; b) DM

Front 88

is acute tubular necrosis reversible?

Back 88

yes. necrotic tubular cells can be replaced in ~2 wks

Front 89

Fanconi syndrome

Back 89

manifestation of generalized dysfunction of proximal renal tubules; clinically--glycosuria, hyperphosphaturia, aminoaciduria, systemic acidosis

Front 90

Hartnup dz

Back 90

genetic defect--impr'd tubular reabsorp. of tryptophan. can lead to pellagra like symptoms (vit B3 def)

Front 91

coarse, asymmetric corticomedullary scarring indicative of?

Back 91

chronic pyelonephritis

Front 92

thyroidization of kidney

Back 92

seen in chronic pyelonephritis; atrophic tubules contain eosinophilic proteinaceous casts

Front 93

diffuse renal cortical necrosis most often assoc'd with?

Back 93

obstetric catastrophes (placental abruption) or septic shock

Front 94

staghorn calculi

Back 94

ammonium magnesium phosphate stones in renal pevis and calyces, when urine alkalinized by proteus or stpah (urease +)

Front 95

when does adult polycystic kidney dz usually manifest?

Back 95

congenital but usually see clincally 15-30y/o

Front 96

uremic medullay cystic dz

Back 96

(nephronophtisis) v. serious but uncommon ; cysts in MEDULLA of kidney

Front 97

multiple renal cysts, glomerular atrophy, scarring and inc'd risk of renal cell carcinoma--?

Back 97

acquired cystic dz; assoc'd with long term dialysis

Front 98

flank pain, palpable mass, hematuria, polygonal clear cells on histo--?

Back 98

renal cell carcinoma (most common renal malignancy, assoc'd with vHL-csome3)

Front 99

WAGR complex

Back 99

Wilms tumor, Aniridia, Genitourinary malformations, mental-motor Retardation

Front 100

Denys-Drash syndrome

Back 100

WT-1 gene abnl, intersexual D/O, nephorpathy, Wilms tumor

Front 101

Beckwith-Wiedemann syndrome

Back 101

ex of genomic imprinting! (mom); WT-2 del; Wilms tumor, hemihypertrophy, macroglossia, organomegaly, neonatal hypoglyceima

Front 102

transitional cell carcinoma in renal PELVIS assoc'd with?

Back 102

phenacetin abuse