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166 Cards in this Set

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Goljan Path

Moblitz I
Usually due to inferior MI. Rarely goes into 3rd degree block.

Txt w/Atrophine or Isoproterenol
Goljan Path

Moblitz II
BBB association.

Often goes to 3rd degree AV block

Usually due to anterior MI.
Goljan Path

P wave
Atrial depol
Goljan Path

a wave
LA contraction
Goljan Path

T wave
Vetricular repol
Goljan Path

Wavy fibers
Eosinophilic bands of necrotic myocytes.

Early sign of MI.
Goljan Path

Janeway's lesions
Acute bacterial endocarditis
Nontender, erythematous lesions of palms & soles
Goljan Path

Osler's nodes
Subacute bacterial endocarditis

Tender lesions of fingers & toes
Goljan Path

Thiamine defcy
Wet Beri Beri heart. Dilated (congested) cardiomyopathy due to chronic alcohol consumption.
Dyr Beri Beri = peripheral neuropathy
Wernicki-Korsakoff=ataxia; confusion;
confabulation;
memory loss
Goljan Path

Fibrinous Pericarditis
Associated w/MI: Dressler's
Goljan Path

Serous Pericarditis
Associated w/nonbacterial
viral (Coxsakie) infection
immunologic reaction
Goljan Path

Friction Rub
Pericarditis association
Goljan Path

Hemorrhagic Pericarditis
Associated w/ TB or neoplasm
Goljan Path

Restrictive Cardiomyopathy
Aka infiltrative cardiomyopathy that stiffens the heart
Due to amyloidosis in the elderly
Due to, also see schaumann & asteroid bodies in young(over 25 yoa)
Goljan Path

PML's infectious agent
JC Virus (Papovavirus=dsDNA, naked icosahedral capsid)
Goljan Path

Edema
Increased Pc (more seeps out)

Decreased pie c (less reabsorbed)

Increased permeability

Bloack lymphatic drainage
Goljan Path

Adult Adult Polycrystic Kedney Disease
Commonly see liver cysts & Berry aneurysmns along w/kidney cysts. Hematuria & HTN also present.

3 cysts in ea. Kidney w/+family history confirms diagnosis
Goljan Path

Malignant HTN & Kidneys
Petehial hemorrhages are seen on kidney surfaces = Flea-Bitten surface = young black men
Goljan Path

Nephritic signs
Hematuria

RBC casts

HTN
Goljan Path

Hephrotic signs
Proteinuria

Hypoalbuminemia

Edema
Goljan Path

Podocyte Effacement seen w/
Minumal Change (Lipoid nephrosis) disease
Goljan Path

ASO seen in
Acute post-streptococcal GN (due to betaHGASrtep)

Anti Streptolysin O
Goljan Path

Crescentic GN
Rapidly progressive GN - nephritic syndrome

Associated w/multi system disease or post-strep/post infectious glomerular nephritis
Goljan Path

Hereditary Nephritis
Alport's syndrome. X linked

Renal disease w/deafness & ocualr abnormalities
Goljan Path

Membranoproliferative GN
Can be secondary to complement deficiency; chronic infections; CLL

See tram tracking
Goljan Path

TypeI Membrano Proliferative GN deposits
C3 & IgG deposits
Goljan Path

TypeII Membrano Proliferative GN deposits
Only C3 deposits

Aka Dense deposit disease
Goljan Path

Focal segmental glomerulosclerosis deposits
IgM & C3 deposits
Goljan Path

Cold agglutnins
Seen in atypical pneumonia

It is IgM Ab with specificity for I Ag on adult RBCs
Goljan Path

Scrofula
TB in the lymph nodes
Goljan Path

Aspirin-Asthma Triad
Nasal polyps -

Rhinitis -

bronchoconstriction
Goljan Path

Ferruginous badies
Hemosiderin (pigment w/Fe3) covered magrophages that have been pahgocytised
Goljan Path

Pancoast's tumar causes
Ulnar nerve pain & Horner's syndrome
Goljan Path

Fatty degeneration
Made up primarily of triglycerides

Most commonly due to alcoholism which commonly leads to hepatic cirrhosis

Associated w/ CCl4
Goljan Path

Cloudy swelling
Failure of cellular Na pump

Seen in Fatty degeneration of the liver & in Hydropic(Vacuolar) degeneration of the liver
Goljan Path

Hydropic degeneration
Severe form of cloudy swelling

Seen with hypokalemia induced by vomitting/diarrhea
Goljan Path

Liquefaction necrosis
Rapid enzymatic break down of lipids

Seen commonly in Brain & Spinal cord (CNS) injuries

Seen in suppurative infections=pus formation
Goljan Path

Coagulation necrosis
Result of sudden ischemia

Seen in organs w/end arteries limited collateral circulation) = heart, lung, kidney, spleen
Goljan Path

Caseation necrosis
Combination of both coagulation & liquefaction necrosis

Seen w/M. tuberculosis & Histoplasma capsulatum infection
Goljan Path

Fibrinoid necrosis
Seen in the walls of small arteries

Associated w/malignant hypertension, polyarteritis nodosa, immune mediated vasculitis
Goljan Path

Fat necrosis
Result of lipase actions liberated from pancreatic enzymes

Seen w/Acute pancreatitis = saponification results
Goljan Path

Hemoptysis
Blook in sputum
Goljan Path

Pulmonary embolism
Most commonly thrombus from lower extremity vein
Goljan Path

Phlebothrombosis
From a vein of lower extremities, of a pregant uterus, in Congestive heart failer, bed ridden pt

As a complicaiton in a pt w/Pancreatic CA due to increased d blook coagulability
Goljan Path

Saddle embolus
Embolus lodged in bifurcation of pulmonary trunks

Increased RV strain = RV & RA dilate = Acute cor Pulmonale
Goljan Path

Paradoxical embolism
Right to Left shunt allose a venous embolism to enter arterial circulation

Patent ovale foramen or Atrial septal defect
Goljan Path

Tuberculoid granuloma
Collection of macrophages w/o caseation

Seen w/Sarcoidosis (non-caseating); Syphilis; Brucellosis & Leprotic infections
Goljan Path

Cellulitis
Spreading infection due to streptococcus
Goljan Path

PSA
Prostate Specific Antigen = elevated in prostatic CA
Goljan Path

Increased 5-HT
In cases of metastatic carcinoid, txt w/ Methysergide (5HT antagonist)
Goljan Path

Increased aFeto Protein
Hepatocarcinoma


Neural tub defects
Goljan Path

CEA
Carcinoembryonic Antigen - elevated in Colon CA
Goljan Path

Chromosome 13
Retinoblastoma
Goljan Path

Chromosome 11p
Wilms tumor of the kidney
Goljan Path

Vinyl Chloride
Associated w/ Angiosarcoma of the liver
Goljan Path

Agent Orge
Contains dioxin

Implicated as a cause of Hodgkin's disease, non-Hodgkin's lymphoma & soft tissue sarcomas
Goljan Path

Parasites & CA
Schistosoma haematobium = Urinary bladder CA

S.mansoni- Colon CA

Aspergillus flavus = potent hepatocarcinogen
Goljan Path

Ochronosis
Alkaptonuria
Error in tyrosine metabolism due to Homogentisic acid (oxidizes tyrosine)
Involving intervertebral disks = Ankylosing Spondilitis = Poker spine
See dark urine; dark coloration of sclera, tendons, cartilage
Goljan Path

Lead poisoning
Acid fast inclusion bodies
Increased urinary coproprophyrin
Anemia: microcytic/ hypochromic
Stippling of the basophils
Gingival line & lead line in bones: x-ray
Mental retadation
Goljan Path

Heroin OD, clinically
Massive pulmonary edema w/ frothy fluid from the nostrils
Goljan Path

Fetal alcohol syndrome
Small head,
small eyes,
funnel chest,
ASD,
Mental deficiency,
hirsutism
Goljan Path

Atypical mycobacterium
M. kanasasii & M.avium intracellulare
Goljan Path

Cold abscesses
Liquefied TB lesions similar to pyogenic abscesses but lacking acute inflammation
Goljan Path

Actinomyces isrealli
Farmers infection

Lumpy jaw (from chewing grain) & PID (IUD), but most common is due to saprophyticus
Goljan Path

Congenital Syphilis
Saddle nose,

Saber shin,

Hutchinson's teeth,

nerve deafness,

interstitial keratitis
Goljan Path

Warthin-Finkeledy cells
Reticuloendothelial giant cells on tonsis, lymph nodes, spleen

Seen with Rubeola (measles) due to paramyxovirus
Goljan Path

Diphyllobothrium latum
Tapeworm infection causing megaloblastic anemia by consuming large amoutn of vit B12 in the host
Goljan Path

Subacute Bacterial Endocarditis
alpha Hemolytic Streptococci (S. Viridans) = usually in pt w/pre-existing heart problem
Goljan Path

Acute Bacterial Endocarditis
Staph aureus, beta Hemolytic Streptococci, E. coli

Common among drug addicts & diabetics
Goljan Path

Mitral Insufficiency
Ruptured papillary muscle
Goljan Path

Left Anterior Descending branch
Branch of the Left Coronary artery

Highest frequency of thrombotic occlusion

MI=anterior wall of the LV, especially in apicalpart of interventricular septum
Goljan Path

Left Circumflex branch
Branch of the Left Coronary artery

Occlusion = MI of posterior/lateral wall of the LV
Goljan Path

Dissecting Aneurysm
False aneurysm: it is splitting of the media of the aorta
Usually accompanied w/long history of severe hypertension, also seen w/familial hyperlipidemia, atherosclerotic disease, Marfan's Collagen disease
Zones of medial necrosis +/- slitlike cysts=Medial Cystic Necrosis of Erdheim
Goljan Path

Cor pulmonale
Right ventricular strain, associated w/right ventricular hypertrophy
Goljan Path

Acute Cor Pulmonale
Sudden right ventricular strain due to a massive pulmonary embolism
Goljan Path

Bronchopneumonia
Lobular (rather than lobar)

Due to Staph aureus; Pseudomonas aeruginosa; Klebsiella; E. coli

Abscess formation is common
Goljan Path

Lobar pneumonia
Due to Strep. Pneumoniae infection (5% due to Klebsiella)
Red Hepatization: days 1-3 of the pneumonia
Gray Hepatization: days 3-8 of untreated pneumonia
Complications:pleural effusion: atelectasia; fibrinous pleuritis; empyema; fibrinous pericarditis; otitis media
Goljan Path

Bronchiectasis
Permanent dialation of the bronchi - predisposed by chronic sinusitis & post nasal drip

Supparation associated

Lower lobe > than upper lobe involvement
Goljan Path

Cold Agglutinins
Found w/Mycoplasma pneumoniae
Goljan Path

Panlobular Emphysema
alpha1 - antitrypsin deficiency, causing elastase increased = increased compliance in the lung
Goljan Path

Bulla
Associated w/Emphhysema = "Bleb" = outpouching /
If it ruptures causes Pneumothorax
Goljan Path

Farmer's Lung
Due to Micropolyspora faeni (thermophilic actinomycetes)
Goljan Path

Bagassosis
Due to M. Vulgaris (actinomycetes)

Inhalation of sugar cane dust
Goljan Path

Silo-Filler's Lung
Due to Nitrogen dioxide from nitrates in corn
Goljan Path

G6PDH Deficiency
Sex-linked chronic hemolytic anemia w/o challenge of after eating fava beans

Heinz Bodies appear in RBCs
Goljan Path

HbF greatly increased
Sickle Cell Anemia
Goljan Path

Multiple Myeloma
Lytic lesions of flat bones ("salt & pepper lesions") = vertebrae, ribs, skull;

Hypercalcemia;
Bence-Jones protein casts
Goljan Path

Hodgkin's Disease
Malignant neoplasm of the lymph nodes causing pruritis;
fever = looks like an acute infection

Reed Stern berg cells
Goljan Path

Polyarteritis Nodosa
Immune complex disease of Ag-Ab complexes on blood vessel wall

Half of the immune complexes have Hepatitis B Ag

Can see fever; abd.pain: increased wt; HTN; muscle aches
Goljan Path

Sprue
Celiac disease due to a gluten-induced enteropathy = small intestine villi are blunted

High titers of anti-gliadin Abs & increased IgA levels
Goljan Path

Regional Enteritis
Crohn's Disease

Association w/Arthritus
Uveitis
Erythema Nodosum
Goljan Path

Whipple's Disease
Intestinal Lipodystrophy = malabsorption syndrome
Goljan Path

Kulchitsky cells
Neural cest cells from which carcinoids arise = of the Bronchi:

GIT:

Pancreas
Goljan Path

Ulcerative Colitis
Inflammatory disease of the colon w/increased colon CA incidence
Crypt abscess in the crypts of Lieberkuhn
Pseudopolyps when ulsers are deep
Not transmural involvement
Goljan Path

Vaginal Adenosis
Women exposed to DES (Diethylstilbesterol) in utero before the 18th week of pregnancy

Some develop clear cell adenocarcinoma of the vagina & cervix
Goljan Path

Scirrhous Carcinoma
Infiltration Duct Carcinoma w/ fibrosis - most common type of breast carcinoma
Goljan Path

Hofbauer Cells
Lipid laden macrophages seen in villi of Erythroblastosis Fetalis
Goljan Path

Retinopathy of Prematurity
Retrolintal Fibroplasia = cause of blindness in premies due to high O2 concentrations
Goljan Path

IgA deficiency
Pt has recurrent infections & diarrhea w/increased respiratory tract allergy & autoimmune diseases

If givend blood w/IgA = develop severe, fatal anaphylaxis reation
Goljan Path

Primary Sjorgen's
Dry eyes & dry mouth
arthritis
Increased risk for B cell lymphoma
HLA-DR3 frequent.
Autoimmune disease
Goljan Path

Secondary Sjorgen's
Rheumatoid arthritis, SLE or systemic sclerosis association

RA association shows HLA-DR4
Goljan Path

LDH1 & LDH2
Myocardium
LDH1 higher than LDH2 = Myocardial Infarction
Goljan Path

LDH3
Lung tissue
Goljan Path

LDH4 & LDH5
Liver cells
Goljan Path

Keratomalacia
Severe Vit A deficiency.

See Bitot's spots in the eyes = gray plaques = thickened, keratinized ET
Goljan Path

Metabisfite Test
Suspending RBCs in low O2 content solution

Can detect Hemoglobin S, which sickles in low O2
Goljan Path

Microangiopathic Hemolytic Anemia
Can be due to Hemolyitc Uremic Syndrome & Thrombotic Thrombocytopenic Purpura (TTP)

See Helmet cells
Goljan Path

Wright's stain
Stain for Burkitt's lymphoma
Goljan Path

Mononucleosis
Due to EBV infeciton

If Mono is treated w/Ampicillin, thinking that it is a strep pharyngitis, a rash will occur
Goljan Path

T(8;14)
Burkitt's lymphoma = c-myc oncogene overexpression
Goljan Path

T(9;22)
CML = c-abl/bcr gene formation = Philadelphia translocation
Goljan Path

Langerhan Cell Histiocytosis
Letter Siwe syndrome; Hand Schuller Christian Disease; Eosinophilic Granuloma

Birbeck granules are present = tennis racket shape
Goljan Path

Myeloid Metaplasia
Alkaline phosphatase increased/normal compare to CML = low to absent

Anemia; splenomegaly; platelets increased 1 million = extensive extra-medullary hematopoisis
Goljan Path

Multiple Myeloma
Weakness; wt. loss; recurrent infection; proteinuria; anemia; increased proliferation of plasma cells in BM=plasma cell dx
Serum M protein spike - most often of IgG or IgA

Hypercalcemia (increased bone destruction)
Goljan Path

T(14;18)
NH Lymphoma = bcl2 proto-oncogene overexpression seen w/ Small Cleaved Cell (Follicualr) Lymphoma
Goljan Path

Focal Segmental GN exs
IgA Focal GN = Berger's disease

SLE

PAN

Schonlien-Henoch purpura (anaphylactoid purpura)
Goljan Path

Nephrotic syndrome exs
Focal (Segmental) GN
Membranous GN
Lipoid (Minimal Change) GN
Membranoproliferative GN
Hep B
Syphilis
Penicillamine
Goljan Path

Schistosoma Haematobium
Infection is associated w/Squamous cell CA of the Bladder (most common Bladder CA is transitional cell type)

Associated w/portal HTN due to intrahepatic obstruction
Goljan Path

Penicillin Resistant PID
PID is usually due to N.Gonorrhoeae, but if unresponsive to penicillin think of Bacteroides species
Goljan Path

Duret Hemorrhages
Severe increase in ICP w/ downward diplacement of cerebellar tonsils into Foramen Magnum causing a compression on the brainstem w/hemorrhaging into the pons & midbrain

Nearly always associated w/death due to damage to the vital centers of these areas
Goljan Path

Hypertensive Hemorrhage
Predilection for lenticulostriate arteries = putamen & internal capsule hemorrhages
Goljan Path

Cerebral Emboli are from
MI w/Mural Thrombi
Atrial Fib Thrombi = Marantic thrombi
L-sided Bacterial Endocarditis;
Paradoxical Embolism of septal defect
Goljan Path

Neurosyphilis
Tabes Dorsalis = increase joint position sensation, increase pain sensation, ataxia, Argyl Robertson pupils

Syphilitic meningitis

Paretic neurosyphilis
Goljan Path

5p-
Cri di Chat: mental retardation
small head
wide set eyes
low set ears
cat-like cry
Goljan Path

Trisomy 13
Patau's small head & eyes

cleft lip & palate

many fingers
Goljan Path

Acute Cold Agglutinaiton
Abs to I blood group Ag. Mediated by IgM Abs

Complication of EBV or Mycoplasma pneumoniae infections
Goljan Path

Chronic Cold Agglutinaiton
Associated w/lymphoid neoplasms,

See agglutination & hemolysis in tussue exposed to cold

IgM Abs
Goljan Path

RBC Osmotic Fragility
Hereditary Spherocytosis
Goljan Path

Non-Hodgkin's Lymphomas
Small Lymphocytic: low grade B cell lymphoma of the elderly. Related to CLL
Small Cleaved cell (Follicualr); low grade B cell lymphoma of the elderly. T(14;18) bcl-2 oncogene
Large cell
Lymphoblastic: high grade T cell lymphoma of kids progressing to T-ALL
Small Non Cleaved = Burkitt's: high grade B cell lymphoma. EBV infection. Starry sky histo appearance.
T(8:14) c-myc proto-oncogene. Retlated to B-ALL
Goljan Path

Singer's Nodules
Benign laryngeal polyps associated w/smoking & oversue of the voice
Goljan Path

Paraseptal emphysema
Associated w/blebs (large subpleural bullae) that can rupture & casue pneumothorax
Goljan Path

Superior Vena cava Syndrome
Obstructed due to bronchogenic carcinoma.

Causing swollen face & cyanosis
Goljan Path

Betal nuts
Associated to oral cancer
Goljan Path

Fundal (Type A) Gastritis
Antibodies to parietal cells

pernicious anemia

autoimmune disease
Goljan Path

Antral (Type B) Gastritis
Associated w/Helicobacter (Campylobacter) pylori infection.

90% of duodenal ulcer
Goljan Path

Primary Biliary Cirrhosis
Autoimmune origin; middle aged women; anti-mitochondrial Abs

Jaundice; itching; hypercholesterolemia (can see cutaneous xanthomas)
Goljan Path

Acute Pancreatitis
Increased pancreatic enzymes = fat necrosis; sapponification = sypocalcemia; increased serum amylase

Severe epigastric ab pain; prostration; radiation to the back
Goljan Path

Radiating Back Pain
Chronic pancreatitis
Goljan Path

Complete Hydatidiform Mole
No embryo.

Paternal derivation only.

46XX
Goljan Path

Partial Hydatidiform Mole
Embryo

2 or more sperms fertilized 1 ovum

triploidy/tetraploidy occurs
Goljan Path

Cold Nodules
Hypoplastic Goiter nodules that do not take up radio active iodine. [Opposite; hot & do take up iodine]
Goljan Path

Acidophils
Mummotrophs = Prolactin

Somatotrophs = GH
Goljan Path

Basophils
Thyrotrophs = TSH

Gonadotrophs = LH

Corticotrophs = ACTH & FSH
Goljan Path

Lacunar Strokes
Small/focal aa occlusions. Purely motor or sensory.

Sensory: lesion of thalamus

Motor: lesion of internal capsule
Goljan Path

CSF of Bacterial Meningitis
Decreased Glucose

Increased Protein

Increased Neutrophils

Increased Pressure
Goljan Path

CSF of Viral Meningitis
Normal Glucose;

+/- increased Protein

Increased Lymphocytes
Goljan Path

Marble Bone Disease
Osteoporosis

Albers-Schonberd Disease = inspite of increased bone density,

many fractures = decreased osteoclasts
Goljan Path

C5a
Involved in Chemotaxis (for Neutrophils)
Goljan Path

C3b
Involved in Opsonization (& IgG)
Goljan Path

Anaphylotoxis
C3a & C5a (mediate Histamine release from Basophils & Mast cells)
Goljan Path

vasoactive Mediators
Vasoconstriction: TxA,; LTC4; LTD4; LTE4; PAF

Vasodilation: PGI2; PGD2; PGE2; PGF2alpha; Bradykinin; PAF

Increased Vascular Permeability: Hist.; 5HT; PGD2; PGE2; PGF2alpha; LTC4; LTD4; LTE4; Bradykinin; PAF
Goljan Path

Platelet Aggregation
ADP;

Thrombin;

TxA2;

collagen;

Epinephrine;

PAF
Goljan Path

Platelet Antagonist
Prostacyclin (PGI2)
Goljan Path

Intrinsic Pathway
F XII (Hagman): APTT
Goljan Path

Extrinsic Pathway
F VII: PT
Goljan Path

Lines of Zahn
Aterial thrombi = pale red colored (dark red is venous thrombi)
Goljan Path

Currant Jelly appearance
Post mortem clots
Goljan Path

Emigration: Chemotaxis
1. Margination
2. Pavementing
3. Adhesion
4. Chemotaxis
5. Phagocytosis
6. Intracellular microbial killing
Goljan Path

Transulate
Specific gravity < 1.012 - low protein
Goljan Path

Exudate
Specific gravity > 1.020 - high protein
Goljan Path

Hurler's
Lysosomal storage disease alpha L Iduronidase - Heparan/Dermatan Sulfate accumulation
Goljan Path

Galactosemia
Deficiency of Galactose 1 Phosphate Uridyl Transferace.

Increase Galactose 1 Phosphate
Goljan Path

Phenylketonuria
Deficiency: Phenylalanine Hydroxylase. Increase Phenyalanine & degradation products

Mousy body odor
Goljan Path

Autosomal Dominant Diseases
Adult Poly Cystic Kidney Disease
Familial Hypercholestrolemia Disease
Hereditary Hemorrhagic Telengectasia (Osler-Weber-Rendu)
Hereditary Spherocytosis
Huntington's Disease (chromosome 4p)
Marfam's Syndrome
Neurofibromatosis (von Recklinghausen's)
Tuberous Sclerosis
Von Hippel Lindau Disease
Goljan Path

Autosomal Recessive Diseases
Tay-Sachs
Gaucher's
Niemann-Pick
Hurler's
Von Gierke's
Goljan Path

Autosomal Recessive Diseases
Tay-Sachs
Gaucher's
Niemann=Pick
Hurler's
Von Gierke's
Pompe's
Cori's
McArdle's
Galactosemia
PKU
Alcaptonuria