First Aid - Pathology

Front 1

Apoptosis - details?

Back 1

Programmed cell death; ATP required. Intrinsic or extrinsic pathway; both pathways --> activation of cytosolic caspases that mediate cellular breakdown. No significant inflammation.
Characterized by cell shrinkage, nuclear shrinkage and basophilia (pyknosis), membrane blebbing, nuclear fragmentation (karyorrhexis), nuclear fading (karyolysis), and formation of apoptotic bodies, which are then phagocytosed.

Front 2

Intrinsic apoptosis vs. extrinsic apoptosis

Back 2

Intrinsic - occurs during embryogenesis, hormone induction (e.g., menstruation), and atrophy (e.g., endometrial lining during menopause) and as a result of injurious stimuli (e.g., radiation, toxins, hypoxia). Changes in proportions of anti- and pro-apoptotic factors (Bax increased, Bcl-2 decreased) lead to increased mitochondria permeability and release of cytochrome c.

2 extrinsic pathways:
1. ligand receptor interactions (Fas ligand binding to FAS [CD95]).
2. Immune cell (CTLs release perforin and granzyme B)

Front 3

Necrosis - basics?

Back 3

Enzymatic degradation and protein denaturation of a cell resulting from exogenous injury. Intracellular components extravasate. Inflammatory process (unlike apoptosis).

Front 4

Necrosis - 6 types with examples?

Back 4

1. Coagulative - heart, liver, kidney
2. Liquefactive - brain, bacterial abscess, pleural effusion
3. Caseous - TB, systemic fungi
4. Fatty - pancreas (saponification)
5. Fibrinoid - blood vessels
6. Gangrenous - dry (ischemic coagulative) OR wet (with bacteria); common in limbs and in GI tract

Front 5

Cell Injury - Processes reversible with O2?

Back 5

Decreased ATP synthesis.
Cellular swelling (no ATP --> impaired Na+/K+ pump)
Nuclear chromatin clumping
Decreased glycogen
Fatty change
Ribosomal detachment (decreased protein synthesis)

Front 6

Cell Injury - Irreversible processes?

Back 6

Nuclear pyknosis, karyolysis, karyorrhexis
Ca2+ influx --> caspase activation
Plasma membrane damage
Lysosomal rupture
Mitochondrial permeability

Front 7

Areas susceptible to hypoxia - watershed areas?

Back 7

Splenic flexure, ACA/MCA

Front 8

Areas susceptible to hypoxia - Heart

Back 8

Subendocardial tissue

Front 9

Areas susceptible to hypoxia - Kidney

Back 9

Proximal tubule (cortex)
Thick ascending limb (medulla)

Front 10

Areas susceptible to hypoxia - Neurons

Back 10

generally neurons are susceptible

Front 11

Areas susceptible to hypoxia - Liver

Back 11

area around the central vein

Front 12

Infarcts: Red vs. Pale

Back 12

Red - hemorrhagic infarcts occur in loose tissues with collaterals, such as liver, lungs, or intestine, or following reperfusion (REd = REperfusion)
Pale - occur in solid tissues with a single blood supply, such as heart, kidney, and spleen

Front 13

Shock - Hypovolemic/Cardiogenic vs. Septic

Back 13

Hypovolemic/Cardiogenic -
Low-output failure
Increased TPR
Low cardiac output
Cold, clammy patient

Septic Shock -
High-output heart failure
Low TPR
Dilated arterioles, high venous return
Hot patient

Front 14

Atrophy - 6 causes

Back 14

Atrophy is reduction in the size or number of cells. Causes include:
1. decreased hormones (uterus, vagina)
2. decreased innervation (motor neuron damage)
3. decreased blood flow
4. decreased nutrients
5. increased pressure (nephrolithiasis)
6. Occlusion of secretory ducts (Cystic Fibrosis)

Front 15

Inflammation - basics?

Back 15

Characterized by rubor (redness), dolor (pain), calor (heat), tumor (swelling), and functio laesa (loss of function).

Front 16

Inflammation - Fluid Exudation

Back 16

Increased vascular permeability, vasodilation, endothelial injury

Front 17

Inflammation - fibrosis

Back 17

Fibroblast emigration and proliferation; deposition of extracellular matrix

Front 18

inflammation - resolution

Back 18

Restoration of normal structure.
Granulation tissue - highly vascularized, fibrotic
Abscess - fibrosis surrounding pus
Fistula - abnormal communication
Scarring - collagen deposition resulting in altered structure and function

Front 19

Inflammation - Acute process

Back 19

Neutrophil, eosinophil, and antibody mediated. Acute inflammation is rapid onset (seconds to minutes), lasts minutes to days.

Front 20

Inflammation - chronic process

Back 20

Mononuclear cell-mediated: characterized by persistent destruction and repair. Associated with blood vessel proliferation, fibrosis.

Granuloma: nodular collections of epithelioid macrophages and giant cells.

Front 21

Leukocyte extravasation - Four main steps

Back 21

Neutrophils exit from blood vessels at sites of tissue injury and inflammation in 4 steps:
1. Rolling
2. Tight binding
3. Diapedesis
4. Migration

Front 22

Leukocyte extravasation - Rolling - Stroma receptor? Leukocyte molecule?

Back 22

Vasculature/stroma - E-selectin/P-selectin
Leukocyte - Sialyl-Lewis X

Front 23

Leukocyte extravasation - Tight binding - Stroma receptor? Leukocyte molecule?

Back 23

Vasculature/stroma - ICAM-1
Leukocyte - LFA-1 ("integrin")

Front 24

Leukocyte extravasation - Diapedesis - Stroma receptor? leukocyte molecule?

Back 24

Leukocyte travels between endothelial cells and exits blood vessel.
Vasculature/stroma - PECAM-1
Leukocyte- PECAM-1

Front 25

Leukocyte Extravasation - Migration - Stroma receptor? Leukocyte molecule?

Back 25

Leukocyte travels through interstitium to site of injury or infection guided by chemotactic signals.
Vasculature/Stroma - Bacterial products,
CILK:
C5a, IL-8, LTB4 (leukotriene B4), Kallikrein
Leukocyte - various

Front 26

Free radical injury - details?

Back 26

Free radicals damage cells via membrane lipid peroxidation, protein modification, and DNA breakage.
Initiation via radiation exposure, metabolism of drugs (phase I), redox reaction, nitric oxide, transition metals, leukocyte oxidative burst.

Front 27

Free radical injury - Name 3 enzymes and 2 other methods for free radical elimination.

Back 27

Enzymes: Superoxide dysmutase, catalase, glutathione peroxidase
Other: Spontaneous decay, antioxidants (Vitamins A, C, E)

Front 28

Free radical injury - 6 examples of pathology mediated by ROS

Back 28

1. Retinopathy of prematurity
2. Bronchopulmonary dysplasia
3. CCI4 leading to liver necrosis (fatty change)
4. Acetaminophen
5. Iron overload
6. Reperfusion after anoxia (e.g., superoxide), especially after thrombolytic therapy.

Front 29

Wound healing - 3 phases

Back 29

1. Inflammatory (immediate)
2. Proliferative (2-3 days after wound)
3. Remodeling (1 week after wound)

Front 30

Wound healing - Inflammatory phase - Mediators? Characteristics?

Back 30

Platelets, neutrophils, macrophages
Clot formation, inc. vessel permeability and neutrophil migration into tissue; macrophages clear debris 2 days later

Front 31

Wound healing - proliferative phase - Mediators? Characteristics?

Back 31

Fibroblasts, myofibroblasts, endothelial cells, keratinocytes
Deposition of granulation tissue and collagen, angiogenesis, epithelial cell proliferation, dissolution of clot, and wound contraction (mediated by myofibroblasts)

Front 32

Wound healing - remodeling phase - Mediators? Characteristics

Back 32

Fibroblasts
Type III collagen is replaced with Type I collagen, increased tensile strength of tissue

Front 33

Granulomatous diseases - name 8 of them

Back 33

1. Mycobacterium tuberculosis
2. Fungal infections (e.g. histoplasmosis)
3. Treponema pallidum (syphilis)
4. Mycobacterium leprae (leprosy)
5. Bartonella henselae (cat scratch disease)
6. Sarcoidosis
7. Crohn's disease
8. Berylliosis

Front 34

Granulomatous disease - how does this work?

Back 34

Th1 cells secrete IFN-gamma, activating macrophages. TNF-alpha from macrophages induce and mainatin granuloma formation. Anti-TNF drugs can break down granulomas, leading to disseminated disease.

Front 35

Transudate vs. exudate

Back 35

Transudate -
Hypocellular, protein poor, specific gravity <1.012
Due to: inc. hydrostatic pressure, dec. oncotic pressure, Na+ retention

Exudate -
Cellular, protein rich, specific gravity >1.020
Due to: lymphatic obstruction, inflammation

Front 36

Erythrocyte sedimentation rate - details?

Back 36

products of inflammation (e.g., fibrinogen) coat RBCs and cause aggregation. When aggregated, RBCs fall at a faster rate within the test tube.

Front 37

Low ESR - examples?

Back 37

Sickle cell (altered shape), polycythemia (too many), CHF (unknown)

Front 38

High ESR - examples?

Back 38

Infections
Inflammation (e.g., temporal arteritis)
Cancer
Pregnancy
SLE

Front 39

Iron poisoning - details? mechanism? Symptoms (acute and chronic)

Back 39

One of the leading causes of fatality from toxicologic agents in children.
Mechanism - Cell death due to peroxidation of membrane lipids.
Symptoms -
Acute: gastric bleeding
Chronic: metabolic acidosis, scarring leading to GI obstruction

Front 40

Amyloidosis - details?

Back 40

Beta-pleated sheet demonstrable by apple-green birefringence of Congo red stain under polarized light; affected tissue has waxy appearance.

Front 41

Amyloidosis - Bence Jones - Protein? Derived from?

Back 41

AL
Derived from Ig light chains (malignant melanoma)
AL = Light chain

Front 42

Amyloidosis - Secondary - Protein? Derived from?

Back 42

AA
Derived from Serum amyloid-associated protein (chronic inflammatory disease)
AA = Acute-phase reactant

Front 43

Amyloidosis - Senile cardiac- Protein? Derived from?

Back 43

Transthyretin
Derived from AF
AF = old Fogies

Front 44

Amyloidosis - Diabetes Mellitus type 2 - Protein? Derived from?

Back 44

Amylin
Derived from AE
AE = Endocrine

Front 45

Amyloidosis - Medullary carcinoma of the thyroid - Protein? Derived from?

Back 45

A-CAL
Derived from Calcitonin
A-CAL = CALcitonin

Front 46

Amyloidosis - Alzheimer's disease- Protein? Derived from?

Back 46

Beta-amyloid
Derived from Amyloid precursor protein (APP)

Front 47

Amyloidosis - Dialysis-associated - Protein? Derived from?

Back 47

Beta2-microglobulin
Derived from MHC class I proteins

Front 48

Hallmarks of cancer

Back 48

Evading apoptosis, self-sufficiency in growth signals, insensitivity to anti-growth signals, sustained angiogenesis, limitless replicative potential, tissue invasion, and metastasis

Front 49

Neoplastic progression

Back 49

Start with normal cells with basal-->apical differentiation.
Then cells increase in number (hyperplasia). Abnormal proliferation of cells with loss of size, shape, and orientation (dysplasia) occurs.

Carcinoma in situ - Neoplastic cells have not invaded basement membrane. High nuclear:cytoplasmic ratio and clumped chromatin. Neoplastic cells encompass entire thickness.

Cells then invade basement membrane using collagenases and hydrolases (metalloproteinases). Can metastasize if they reacha blood or lymphatic vessel.

Metastasis - spread to distant organ. Cells must survive immune attack. "Seed and soil" theory of metastasis. Seed = tumor embolus. Soil = target organ (liver, lungs, bone, brain, etc)

Front 50

Reversible "-plasias"

Back 50

Hyperplasia - increased number of cells
Metaplasia - one adult cell type is replaced by another. Often secondary to irritation and/or environmental exposure (e.g., squamous metaplasia in trachia and bronchi of smokers).
Dysplasia - abnormal growth with loss of cellular orientation, shape, and size in comparison to normal tissue maturation; commonly preneoplastic

Front 51

Irreversible "-plasias"

Back 51

Anaplasia - abnormal cells lacking differentiation; resemble primitive cells of same tissue, often equated with undifferentiated malignant neoplasms. Little or no resemblance to tissue of origin.
Neoplasia - a clonal proliferation of cells that is uncontrolled and excessive. Neoplasia may be benign or malignant.
Desmoplasia - fibrous tissue formation in response to neoplasm

Front 52

Dysplasia vs. Anaplasia

Back 52

Dysplasia - abnormal growth with loss of cellular orientation, shape, and size in comparison to normal tissue maturation; commonly preneoplastic

Anaplasia - abnormal cells lacking differentiation; resemble primitive cells of same tissue, often equated with undifferentiated malignant neoplasms. Little or no resemblance to tissue of origin.

Front 53

Tumor grade

Back 53

Degree of cellular differentiation based on histologic appearance of tumor. Usually graded I-IV based on degree of differentiation and number of mitoses per high-power field; character of tumor itself.

Front 54

Tumor stage

Back 54

Degree of localization/spread based on site and size of primary lesion, spread to regional lymph nodes, presence of metastases; spread of tumor in a specific patient.

Stage usually has more prognostic value than grade.

Front 55

Tumor nomenclature - Epithelium - Benign? Malignant?

Back 55

Benign - Adenoma, papilloma
Malignant - Adenocarcinoma, papillary carcinoma

Front 56

Tumor nomenclature - Blood cells

Back 56

Leukemia, lymphoma (both are malignant)

Front 57

Tumor nomenclature - Blood vessels - Benign? Malignant?

Back 57

Benign - Hemangioma
Malignant - Angiosarcoma

Front 58

Tumor nomenclature - Smooth muscle - benign? malignant?

Back 58

Benign - Leiomyoma
Malignant - Leiomyosarcoma

Front 59

Tumor nomenclature - Skeletal muscle - benign? malignant?

Back 59

Benign - Rhabdomyoma
Malignant - Rhabdomyosarcoma

Front 60

Tumor nomenclature - Connective tissue - benign? malignant?

Back 60

Benign - Fibroma
Malignant - Fibrosarcoma

Front 61

Tumor nomenclature - Bone - Benign? Malignant?

Back 61

Benign - Osteoma
Malignant - Osteosarcoma

Front 62

Tumor nomenclature - Fat - Benign? Malignant?

Back 62

Benign - Lipoma
Malignant - Liposarcoma

Front 63

Tumor nomenclature - >1 cell type - Benign? Malignant?

Back 63

Benign - Mature teratoma (women)
Malignant - Immature teratoma and mature teratoma (men)

Front 64

Tumor differences - benign vs. malignant

Back 64

benign - usually well differentiated, slow growing, well demarcated, no metastasis

Malignant - May be poorly differentiated, erratic growth, locally invasive/diffuse, may metastasize

Front 65

Cachexia - details?

Back 65

Loss of weight, muscle atrophy, and fatigue that occur in chronic disease (e.g., cancer, AIDS, heart failure, tuberculosis). Mediated by TNF-alpha (nicknamed cachectin), IFN-gamma, and IL-6.

Front 66

Disease conditions associated with neoplasms - Down Syndrome

Back 66

Acute Lymphocytic Leukemia (ALL) - "We ALL fall Down"
Acute Myelogenous Leukemia (AML)

Front 67

Disease conditions associated with neoplasms - Xeroderma pigmentosum, albinism

Back 67

Melanoma, basal cell carcinoma, and especially squamous cell carcinomas of the skin

Front 68

Disease conditions associated with neoplasms - Chronic atrophic gastritis, pernicious anemia, postsurgical gastric remnants

Back 68

Gastric adenocarcinoma

Front 69

Disease conditions associated with neoplasms - Tuberous sclerosis (facial angiofibroma, seizures, mental retardation)

Back 69

Astrocytoma, angiomyolipoma, and cardiac rhabdomyoma

Front 70

Disease conditions associated with neoplasms - Actinic keratosis

Back 70

Squamous cell carcinoma of skin

Front 71

Disease conditions associated with neoplasms - Barret's esophagus (chronic GI reflux)

Back 71

Esophageal adenocarcinoma

Front 72

Disease conditions associated with neoplasms - Plummer-Vinson syndrome (atrophic glossitis, esophageal webs, anemia; all due to iron deficiency)

Back 72

Squamous cell carcinoma of the esophagus

Front 73

Disease conditions associated with neoplasms - Cirrhosis (alcoholic, hepatitis B and C)

Back 73

Hepatocellular carcinoma

Front 74

Disease conditions associated with neoplasms - Ulcerative colitis

Back 74

Colonic adenocarcinoma

Front 75

Disease conditions associated with neoplasms - Paget's disease of bone

Back 75

Secondary osteosarcoma and fibrosarcoma

Front 76

Disease conditions associated with neoplasms - Immunodeficiency states

Back 76

Milignant lymphomas

Front 77

Disease conditions associated with neoplasms - AIDS

Back 77

Aggressive malignant lymphomas (non-Hodgkin's) and Kaposi's sarcoma

Front 78

Disease conditions associated with neoplasms - Autoimmune diseases (e.g., Hashimoto's thyroiditis, myasthenia gravis)

Back 78

Lymphoma

Front 79

Disease conditions associated with neoplasms - Acanthosis nigricans (hyperpigmentation and epidermal thickening)

Back 79

Visceral malignancy (stomach, lung, breast, uterus)

Front 80

Disease conditions associated with neoplasms - Dysplastic nevus

Back 80

Malignant melanoma

Front 81

Disease conditions associated with neoplasms - Radiation exposure

Back 81

Sarcoma, papillary thyroid cancer

Front 82

Oncogenes - details?

Back 82

Gain of function --> cancer. Need damage to only 1 allele.

Front 83

Oncogene - abl gene - Associated tumor? Gene product?

Back 83

CML
Gene product: Tyrosine kinase

Front 84

Oncogene - c-myc - Associated tumor? Gene product?

Back 84

Burkitt's lymphoma
Gene product: transcription factor

Front 85

Oncogene - bcl-2 - Associated tumor? Gene product?

Back 85

Follicular and undifferentiated lymphomas (inhibits apoptosis)
Gene product: anti-apoptotic molecule

Front 86

Oncogene - erb-B2 - Associated tumor? Gene product?

Back 86

Breast, ovarian, gastric carcinomas
Gene product: Tyrosine kinase

Front 87

Oncogene - ras - Associated tumor? Gene product?

Back 87

Colon carcinoma
Gene product: GTPase

Front 88

Oncogene - L-myc - Associated tumor? Gene product?

Back 88

Lung tumor
Gene product: transcription factor

Front 89

Oncogene - N-myc - Associated tumor? Gene product?

Back 89

Neuroblastoma
Gene product: transcription factor

Front 90

Oncogene - ret - Associated tumor? Gene product?

Back 90

Multiple endocrine neoplasia (MEN) types IIA and IIB
Gene product: tyrosine kinase

Front 91

Oncogene - c-kit - Associated tumor? Gene product?

Back 91

Gastrointestinal stromal tumor (GIST)
Gene product: Cytokine receptor

Front 92

Tumor suppressor genes - details?

Back 92

Loss of function --> cancer; both alleles must be lost for expression of disease

Front 93

Tumor suppressor genes - Rb - Associated tumor? Gene products?

Back 93

Retinoblastoma, osteosarcoma
Gene product: Rb gene product blocks G1 -> S phase of cell cycle

Front 94

Tumor suppressor genes - p53 - Associated tumor? Gene product?

Back 94

Most human cancers, Li-Fraumeni syndrome
Gene product: p53 gene product blocks G1 -> S phase of cell cycle

Front 95

Tumor suppressor genes - BRCA1 - Associated tumor? Gene product?

Back 95

Breast and ovarian cancer
Gene product: DNA repair protein

Front 96

Tumor suppressor genes - BRCA2 - Associated tumor? Gene product?

Back 96

Breast cancer
Gene product: DNA repair protein

Front 97

Tumor suppressor genes - p16 - Associated tumor?

Back 97

Melanoma

Front 98

Tumor suppressor genes - APC - Associated tumor?

Back 98

Colorectal cancer (associated with FAP)

Front 99

Tumor suppressor genes - WT1 - Associated tumor?

Back 99

Wilms' tumor

Front 100

Tumor suppressor genes - NF1 - Associated tumor?

Back 100

Neurofibromatosis type 1

Front 101

Tumor suppressor genes - NF2 - Associated tumor?

Back 101

Neurofibromatosis type 2

Front 102

Tumor suppressor genes - DPC - Associated tumor?

Back 102

Pancreatic cancer
DPC - Deleted in Pancreatic Cancer

Front 103

Tumor suppressor genes - DCC - Associated tumor?

Back 103

Colon cancer
DCC - Deleted in Colon Cancer

Front 104

Tumor markers - notes

Back 104

Tumor markers should not be used as the primary tool for cancer diagnosis. They may be used to confirm diagnosis, to monitor for tumor recurrence, and to monitor response to therapy.

Front 105

Tumor markers - Prostatic acid phosphatase

Back 105

Prostate carcinoma.

Front 106

Tumor markers - CEA

Back 106

Carcinoembryonic antigen. Very nonspecific but produced by ~70% of colorectal and pancreatic cancers; also produced by gastric, breast, and thyroid medullary carcinomas.

Front 107

Tumor markers - alpha-fetoprotein

Back 107

Normally made by fetus. Hepatocellular carcinomas. nonseminomatous germ cell tumors of the testis (e.g.,"", yolk tumor).

Front 108

Tumor markers - Beta-hCG

Back 108

"HCG" - Hyditaform moles, Choriocarcinomas and Gestational trophoblastic tumors

Front 109

Tumor markers - CA-125

Back 109

Ovarian, malignant epithelial tumors

Front 110

Tumor markers - S-100

Back 110

Melanoma, neural tumors, Schwannoma

Front 111

Tumor markers - Alkaline phosphatase

Back 111

Metastases to bone, obstructive biliary disease, Paget's disease of bone

Front 112

Tumor markers - Bombesin

Back 112

Neuroblastoma, lung and gastric cancer.

Front 113

Tumor markers - TRAP

Back 113

Tartrate-resistant acid phosphatase.
Hairy cell leukemia (a B-cell neoplasm)
("TRAP the hairy animal.")

Front 114

Tumor markers - CA-19-9

Back 114

Pancreatic adenocarcionma.

Front 115

Tumor markers - Calcitonin

Back 115

Thyroid medullary carcinoma

Front 116

Oncogenic microbes - HTLV-1

Back 116

Adult T-cell leukemia/lymphoma

Front 117

Oncogenic microbes - HBV, HCV

Back 117

Hepatocellular carcinoma

Front 118

Oncogenic microbes - EBV

Back 118

Burkitt's lymphoma, Hodgkin's lymphoma, nasopharyngeal carcinoma

Front 119

Oncogenic microbes - HPV

Back 119

Cervical carcinoma (16, 18), penile/anal carcinoma

Front 120

Oncogenic microbes - HHV-8 (Kaposi's sarcoma-associated herpesvirus)

Back 120

Kaposi's sarcoma, body cavity fluid B-cell lymphoma

Front 121

Oncogenic microbes - HIV

Back 121

Primary CNS lymphoma

Front 122

Oncogenic microbes - H. pylori

Back 122

gastric adenocarcinoma and lymphoma

Front 123

Oncogenic microbes - Schistosoma haematobium

Back 123

Squamous cell carcinoma of transitional epithelium (e.g. bladder)

Front 124

Chemical Carcinogens - Aflatoxins (Aspergillus) - Organ? Impact?

Back 124

Liver - hepatocellular carcinoma

Front 125

Chemical Carcinogens - Vinyl chloride - Organ? Impact?

Back 125

Liver - angiosarcoma

Front 126

Chemical Carcinogens - CCl4 - Organ? Impact?

Back 126

Liver - centrilobular necrosis, fatty change

Front 127

Chemical Carcinogens - Nitrosamines (smoked foods) - Organ? Impact?

Back 127

Stomach - gastric cancer

Front 128

Chemical Carcinogens - Cigarette smoke - Organ? Impact?

Back 128

Larynx - squamous cell carcinoma
Lung - squamous cell and small cell carcinomas
Kidney - renal cell carcinoma
Bladder - transitional cell carcinoma

Front 129

Chemical Carcinogens - Asbestos - Organ? Impact?

Back 129

Lung - Mesiothelioma and bronchogenic carcinoma

Front 130

Chemical Carcinogens - Arsenic - Organ? Impact?

Back 130

Skin - squamous cell carcinoma
Liver - Angiosarcoma

Front 131

Chemical Carcinogens - Naphthalene (aniline) dyes - Organ? Impact?

Back 131

Bladder - transitional cell carcinoma

Front 132

Chemical Carcinogens - Alkylating agents - Organ? Impact?

Back 132

Blood - leukemia

Front 133

Paraneoplastic effects of tumors - ACTH or ACTH-like peptide

Back 133

Cushing's syndrome
Small cell lung carcinoma

Front 134

Paraneoplastic effects of tumors - ADH

Back 134

SIADH
Small cell lung carcinoma and intracranial neoplasms

Front 135

Paraneoplastic effects of tumors - PTH-related peptide, TGF-Beta, TNF, IL-1

Back 135

Hypercalcemia
Squamous cell lung carcinoma, Renal cell carcinoma, and breast carcinoma

Front 136

Paraneoplastic effects of tumors - Erythropoietin

Back 136

Polycythemia
Renal cell carcinoma, hemangioblastoma, hepatocellular carcinoma, pheochromocytoma

Front 137

Paraneoplastic effects of tumors - Antibodies against presynaptic Ca2+ channels at NMJ

Back 137

Lambert-Eaton syndrome (muscle weakness)
Thymoma, small cell lung carcinoma

Front 138

Paraneoplastic effects of tumors - Hyperuricemia due to excess nucleic acid turnover (i.e. cytotoxic therapy)

Back 138

Gout, urate nephropathy
Leukemias and lymphomas

Front 139

Psamomma bodies - details?

Back 139

Laminated, concentric, calcific spherules seen in:
1. Papillary adenocarcinoma of thyroid
2. Serous papillary cystadenocarcinoma of ovary
3. Meningioma
4. Malignant mesothelioma

Front 140

How to remember 4 cancers associated with Psammoma bodies?

Back 140

PSaMMoma:
Papillary (thyroid)
Serous (ovary)
Meningioma
Mesothelioma

Front 141

Cancer epidemiology - Incidence in Men? Women?

Back 141

Men - Prostate (32%) > Lung (16%) > Colon/rectum (12%)
Women - Breast (32%) > Lung (13%) > Colon/rectum (12%)

Lung cancer incidence has dropped in men, but is level for women.

Front 142

Cancer epidemiology - Mortality in Men? Women?

Back 142

Men - Lung (33%) > Prostate (13%)
Women - Lung (23%) > Breast (18%)

Front 143

Common metastases - Brain

Back 143

Lung > breast > kidney > skin (melanoma)

50% of brain tumors are from metastases. Typically multiple well-circumscribed tumors at gray/white matter junction.

Front 144

Common metastases - Liver

Back 144

Colon > stomach > pancreas

Liver and lung are the most common sites of metastasis after the regional lymph nodes.

Front 145

Common metastases - Bone

Back 145

Prostate, breast > lung > thyroid, testes

Metastatic bone tumors are far more common than primary tumors.

Lung = lytic
Prostate = blastic
Breast = lytic and blastic