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102 Cards in this Set

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cavitation seen only in what kind of TB
secondary (Ghon complex only in primary)
most common odontogenic tumor; hamartoma--odontogenic epithelium, odontoblastic tissue
lg mucocele of salivary gl origin, usually on floor of mouth
most frequently occurring salivary tumor gland tumor?
pleomorphic adenoma (benign but often recurs; "mixed")
pulsion esophageal diverticula vs. traction esophageal diverticular
pulsion--false, herniation of mucosa through defects in muscular layer; traction--true, result of periesophageall inflammation, scarring, all layers involved
Zenker diverticulum
esophageal diverticulum immediately above upper esophageal sphincter
achalasia due to?
(persistent contraction of LES, absence of peristalsis--> dilation); due to loss of ganglion cells in myenteric plexus
Cushing ulcer
acute gastric ulcer in assoc'n with brain injury
Menetrier dz
giant hypertrophic gastritis with extreme enlg'ment of gastric rugae
is peptic ulcer of stomach a precursor lesion of gastric carcinoma?
blood group A assoc'd with what neoplasm
carcinoma of stomach
what etiologic factors assoc'd with stomach carcinoma?
H. pylori; nitrosamines; excessive salt intake; achlorhydria
Krukenberg tumor
bilateral involvement of ovaries by metastatic carcinoma of stomach (see signet ring cells)
variants of stomach carcinoma
intestinal type-polypoid, assoc'd with h.pylori; infiltrating/diffuse--not assoc'd with h.pylori, leather-bottle stomach
ulcerated intestinal type stomach carcinoma vs peptic ulcer?
peptic ulcer--smooth base w/non elevated, punched out margins; carcinoma--irregular necrotic base and firm, raised margins
peptic ulcer assoc'd with what blood group?
which peptic ulcer is NOT assoc'd with hypersecretion of gastric acid and pepsin?
peptic ulcer in JEJUNUM suggestive of?
Zollinger-Ellison syndrome
peptic ulcers assoc'd with?
NSAID use; smokers; Z-E syndrome; primary hyperparathyroidism; MEN type 1
Meckel diverticulum a remnant of what?
embryonic vitelline duct (may contain ectopic gastric, duodenal, colonic, pancreatic tissue)
complicatons/assoc'ns of Meckel diverticulum?
usually asymptomatic but if ectopic gastric tissue, may ulcerate; intussusception; volvulus
cobblestone appearance of GI mucosa assoc'd with?
celiac dz most commonly assoc'd with what malignancy?
enterophaty-type T cell lymphoma
Name the dz: distinctive PAS+ macrophages in intestinal mucosa
Whipple dz (Tropheryma Whippelii)
carcinoid syndrome
get cutaneous flushing, watery diarrhea, ab cramps, bronchospasm, R heart valvular lesions; happens if mets to liver
carcinoid most frequently where?
appendix. if anywhere else, tends to mets to liver-->get carcinoid syndrome
ischemic bowel dz most often where?
splenic flexure and rectosigmoid junction (watershed areas)
tortuous dilation of small vessels spanning intestinal (sub)mucosa; common cause of otherwise unexplained lower bowel bleeding
pseudomembranous colitis due to?
EXOTOXIN of C. difficile; get fibrinous necrosis of superficial mucosa
flask shaped ulcers in colon--> ?
amebic colitis (Entamoeba histolytica)
Peutz-Jeghers polyps
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
types of adenomatous polyps
(true neoplasms) tubular--most common; tubulovillous; villous--least common, sessile and velvety
which kind of adenomatous polyp most likely to turn malignant?
villous adenoma
tubular adenomas
small pedunculated polyps with malignant foci
Gardner syndrome
AD, numerous adenomatous polyps along with osteomas and soft tissue tumors
Turcot syndrome
adenomatous polyps and tumors of CNS
significance of CAE in colon cancer?
nonspecific marker so best for following course of dz
most common appendicieal neoplasm?
Gilbert syndrome
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
Crigler-Najjar syndrome
severe familial D/O; UNCONJUGATED hyperbilirubinemia due to glucuronyl trasnferase deficiency (Amish!);
Dubin-Johnson syndrome
AR, CONJUGATED hyperbilirubinemia due to defective BR transport; get striking brown to black discoloration of liver due to deposition of very dark granules
How is Rotor Syndrome different from Dubin-Johnson syndrome?
both are conjugated hyperbilirubinemias due to BR transport problem but no abnl pigmentation of liver in Rotor
which hepatitis viruses assoc'd with hepatocellular carcinoma?
Hep B, C
How is Hep A spread?
(ssRNA, picornavirus) fecal-oral
infected HBV hepatocytes have what appearance?
"ground glass"
significance of HBeAg?
closely correlated with viral infectivity
Which hep virus requires prior or concurret infection with HBV and in what population seen most?
Hep D, IV drug users (makes more fulminant course)
How distinguish autoimmune hepatitis from other forms (HBV, HCV)
both viral and autoimmune-> very high ALTS (1000s!); but autoimmune has hypergammaglobulinemia, anti-smooth muscle Ab
DDx for ALT>1000 U/L
acute viral hepatitis, drug toxicity (acetaminophen!), shock liver, autoimmune
neonatal hepatitis characterized by?
giant cell transformation of hepatocytes; bile pigment of prominent w/i canaliculi and hepatocytes
hepatic component of yellow fever characterized by?
(arbovirus) midzonal hepatic necrosis
ingestion of Echinococcus granulosus--> ?
hydatid dz of liver; lg parastitic cyts invade liver
fatty liver of pregnancy
microvesicular fatty liver; acute hepatic liver failure in 3rd trimester; high mortality
3 causes of microvesicular fatty liver
1. Reye syndrome; 2. fatty liver of preggers; 3. tetracycline toxicity
alcoholic hepatitis assoc'd with what sort of fibrosis?
irreversible fibrosis that characteristically surrounds CENTRAL vein (perivenular fibrosis)
Hobnail liver
scarred shrunken liver, in late stages of cirrhosis
primary biliary cirrhosis vs primary scleroris cholangitis
PBC--women, inc'd AP, AMA+, dx by liver bx, tx: ursodeoxycholic acid; PSC--IBD, inc'd AP, AMA-, dx by cholangiography, tx: none
asymptomatic increase in AP in pt with IBD, think?
middle aged woman with severe obstructive jaundice, itching, hypercholesterolemia and inc'd AP--?
CNS involvement in Wilson dz?
Cu deposition in basal ganglia-->extrapyramidal motor signs)
hepatorenal syndrome
functional renal failure (nl kidneys) characterized by profound Na retention, uremia, oliguria, usually w/ascites
Budd-Chiari syndrome
thrombotic occlusion of major hepatic veins (post hepatic portal HTN); ab pain ,jaundice, hepatomegaly, ascites, eventual liver failure
hepatic adenomas--assoc'd with? big concern?
OCP; if subcapsular, may rupture-->severe intraperitoneal hemorrhage
what carcinoma assoc'd with aflatoxin B1?
hepatocellular carcinoma
cholangiosarcoma assoc'd with?
clonarchis sinensis (liver fluke), PSC, late complications of throium dioxide, NOT HBV or cirrhosis!
strawberry gallbladder
(cholestrolosis); yellow cholesterol containing flecks in mucusal surface; NOT assoc'd with inflamm changes or cholelithiasis
most common primary tumor of gallbladder?
Courvoisier law
tumors that obstruct common bile duct will cause enlarged distended gallbladder; obstructing stones do not
4 big systemic effects of the released cellular components in acute pancreatitis
1. resp failure (PLA2 degrades surfactant); 2. subdiaphragmatic inflamm; 3. shallow respirations (b/c of pain); 4. hemorrhage
#1 predisposing factor for chronic pancreatitis?
alcohol use (also, CF; gld std dx: MRI with MRCP)
pancreatic carcinoma usually where?
in head-->obstructive jaundice
carcinoma in pancreatic tail-->
possible pancreatic islet destruction and secondary DM
hyperhydramnios assoc'd with?
duodenal atresia, TEF
Name the dz: thickened gomerular capillary walls, subepi immune complex deposition, "spike and dome"
memranous glomerulonephritis (a major primary cause of nephrotic syndrome)
Kimmelstiel-Wilson nodules assoc'd with what renal dz?
diabetic nephropathy (nodular accumulations of mesangial matrix material)
renal amyloidosis characterized by
subendothelial mesangial amyloid deposits and distinctive fibrillary pattern
types of lupus nephropathy (WHO)
type 1-no renal involvement; 2--mesangial form; 3--focal proliferative; 4--diffuse proliferative (prototype, most severe); 5--membranous (indistinguishable from membranous GN)
4 clinical findings of nephritic syndrome
1. oliguria; 2. azotemia; 3. HTN; 4. hematuria
what kind of strep usually --> post strep GN?
group A beta hemolytic
Name the dz: nepritic syndrome, pneumonitis w/hemoptisis, 20-30y/o male
Goodpasture syndrome (anti glomerular BM)
mutation in alpha5 chain of type IV collagen--> ?
Alport syndrome (hereditary nephritis assoc'd with nerve deafness and ocular d/o)
Berger dz
IgA nephropathy, v common, usually benign recurrent hematuriain kids following infection
"tram track" appearance of glomerular BM--> ?
membranoproliferative glomerulonephritis (mostly type 1; mesangial matrix expands into glom cap loops)
types of membranoproliferative glomerulonephritis
1--v. striking tram track; II--dense deposit dx
pathognomonic finding for acute pyelonephritis?
white cell casts in urine
acute drug induce interstitial nephritis most often due to?
penicillin derivatives (methicilin!); NSAIDS; diuretics
renal papillary necrosis most often assocd with what a) drug, b)disease
a) phenacetin + other analgesincs; b) DM
is acute tubular necrosis reversible?
yes. necrotic tubular cells can be replaced in ~2 wks
Fanconi syndrome
manifestation of generalized dysfunction of proximal renal tubules; clinically--glycosuria, hyperphosphaturia, aminoaciduria, systemic acidosis
Hartnup dz
genetic defect--impr'd tubular reabsorp. of tryptophan. can lead to pellagra like symptoms (vit B3 def)
coarse, asymmetric corticomedullary scarring indicative of?
chronic pyelonephritis
thyroidization of kidney
seen in chronic pyelonephritis; atrophic tubules contain eosinophilic proteinaceous casts
diffuse renal cortical necrosis most often assoc'd with?
obstetric catastrophes (placental abruption) or septic shock
staghorn calculi
ammonium magnesium phosphate stones in renal pevis and calyces, when urine alkalinized by proteus or stpah (urease +)
when does adult polycystic kidney dz usually manifest?
congenital but usually see clincally 15-30y/o
uremic medullay cystic dz
(nephronophtisis) v. serious but uncommon ; cysts in MEDULLA of kidney
multiple renal cysts, glomerular atrophy, scarring and inc'd risk of renal cell carcinoma--?
acquired cystic dz; assoc'd with long term dialysis
flank pain, palpable mass, hematuria, polygonal clear cells on histo--?
renal cell carcinoma (most common renal malignancy, assoc'd with vHL-csome3)
WAGR complex
Wilms tumor, Aniridia, Genitourinary malformations, mental-motor Retardation
Denys-Drash syndrome
WT-1 gene abnl, intersexual D/O, nephorpathy, Wilms tumor
Beckwith-Wiedemann syndrome
ex of genomic imprinting! (mom); WT-2 del; Wilms tumor, hemihypertrophy, macroglossia, organomegaly, neonatal hypoglyceima
transitional cell carcinoma in renal PELVIS assoc'd with?
phenacetin abuse