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114 Cards in this Set

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Causes of eosinophilia =
1) neoplasm
2) asthma
3) allergy
4) collagen vascular dz
5) parasites
Which leukocyte has a bilobate nucleus, makes histaminase & arylsulfatase, and is highly phagocytic for Ag:Ab complexes?
eosinophils
Which type of cell resembles basophils structurally and functionally, but is found in tissue instead of blood, and binds IgE to its membrane?
mast cells - mediate allergic reaction
Which leukocyte mediates the acute inflammatory response, is multi-lobate, and phagocytic?
neutrophil
What can be found inside a neutrophil granule/lysosome?
1) myeloperoxidase
2) hydrolytic enzymes
3) lactoferrin
4) lysozyme
Which type of blood cell has an eccentric nucleus, "clock face" chromatin, lots of RER, and a well-developed Golgi?
plasma cell - makes lots of Ab specific to a particular Ag
What type of cell phagocytizes bacteria, cellular debris, old RBCs, and can present Ag on MHC II?
macrophages - differentiated from monocytes, activated by gamma IFN
I am an antigen presenting cell. I have MHC II and Fc receptor on my surface. I induce the primary Ab response. What am I?
dendritic cell - called Langerhans cells on skin
What do Protein C & S do?
inactivate Va & VIIIa
In the extrinsic pathway, Factor VIIa + ___ activate Factor X.
tissue factor
In the intrinsic pathway, Factors ___a + ___a activate Factor X.
IXa + VIIIa
Factor Xa + ___ cleave prothrombin to thrombin.
Va
Thrombin cleaves ___ to ___, then Factor ___a will help form a cross linked clot.
fibrinogen, fibrin, XIIIa
What does antithrombin III do?
inactivates: thrombin, IXa, Xa, XIa
What does tPA do?
generates plasmin to cleave fibrin (thrombolytic agent)
What effects does bradykinin have?
1) inc. pain
2) inc. vasodilation
3) inc. vascular permeability
Metaplasia =
replacement of 1 cell type by another, often 2ndary to irritation or environmental exposure (smoker's trachea)
Dysplasia =
abnormal cell growth and maturation w/loss of orientation, shape, and size, often neoplastic but still reversible
Anaplasia =
abnormal cells lacking differentiation, look like primitive cells of same tissue but can be undifferentiated malignant neoplasm
Neoplasia =
CLONAL proliferation that is uncontrolled and excessive
Tumor grade refers to:
histology, degree of differentiation, # mitoses per hpf
Tumor stage refers to:
metastases, degree of spread based on site and size of lesion, more PROGNOSTIC value than grade
A papilloma is:
benign epithelial tumor
A hemangioma is:
benign blood vessel tumor
An angiosarcoma is:
malignant blood vessel tumor
"Carcinoma" implies ___ origin.
epithelial
"Sarcoma" implies ___ origin.
mesenchymal (bone, muscle, fat, blood vessels)
What neoplasms are associated w/Down syndrome?
ALL, AML
What neoplasms are associated w/xeroderma pigmentosum and albinism?
melanoma, basal cell CA, squamous cell CA of skin
What neoplasm is associated w/chronic atrophic gastritis and pernicious anemia?
gastric ACA
What neoplasms are associated w/tuberous sclerosis? (recall: cortical hamartomas, facial angiofibromas, seizures, mental retard)
astrocytoma, cardiac rhabdomyoma
What neoplasm is associated w/actinic keratosis?
squamous cell CA of skin
What neoplasm is associated with Barrett's esophagus?
esophageal ACA
What is Plummer-Vinson syndrome and what neoplasm is it associated with?
P-V syndrome is iron deficiency --> anemia, atrophic glossitis, esophageal webs; associated w/squamous cell CA of esophagus!
What neoplasm is associated w/ulcerative colitis?
colon ACA
What neoplasms are associated w/Paget's bone disease?
osteosarcoma, fibrosarcoma
An immunocompromised state predisposes one to which kind of neoplasm?
malignant lymphomas
Having AIDS predisposes one to which neoplasms?
NHL, Kaposi's sarcoma
Having an autoimmune disease, such as Hashimoto's or myasthenia gravis, predisposes one to which neoplasm?
benign and malignant thymomas
Acanthosis nigricans (hyperpigmented, thick skin) predisposes a person to which neoplasms?
visceral malignancies, like stomach, lung, breast, uterus
abl
CML
c-myc
Burkitt's lymphoma
bcl-2
follicular and undifferentiated lymphomas
erb-B2
breast, ovarian, gastric CA
ras
colon CA
L-myc
lung tumor
N-myc
neuroblastoma (Homer-Wright rosettes)
ret
- MEN II (parathyroid, medullary CA of thyroid, pheochromocytoma)
- MEN III (medullary CA of thyroid, pheochromocytoma, mucosal neuromas)
Rb
13q - retinoblastoma, osteosarcoma
BRCA-1, 2
17q, 13q - breast and ovarian CA
p53
17p - most human cancers, Li-Fraumeni syndrome
p16
9p - melanoma
APC
5q - colorectal CA
WT1
11q - Wilm's tumor
NF1
17q - neurofibromatosis type 1 (cafe au lait spots, Lisch iris hamartomas, scoliosis, pheochromocytoma)
NF2
22q - neurofibromatosis type 2 (bilateral acoustic schwannomas, optic gliomas, juvenile cataracts)
DPC
18q - pancreatic CA
DCC
18q - colon CA
PSA (prostatic acid phosphatase)
prostate-specific antigen; screen for prostate CA (but first use the digital technology because it's the most cost-effective screening method!)
CEA (carcinoembryonic antigen)
very nonspecific, made by 70% of pancreatic and colorectal CA, also gastric and breast CA
a-fetoprotein
hepatocellular CA, yolk sac tumor
b-hCG
hydatidiform moles, choriocarcinoma, gestational trophoblastic tumors (also some germinomas make b-hCG)
CA-125
ovarian, malignant epithelial tumors
S-100
melanoma, astrocytoma, neural tumors
alkaline phosphatase
mets to bone, obstructive biliary disease, Paget's bone disease
bombesin!!
neuroBLASToma, lung, gastric CA
TRAP (tartrate resistant acid phosphatase)
hairy B-cell leukemia
Psammoma bodies can be seen in which malignancies?
1) papillary serous cystadenocarcinoma of thyroid
2) serous cystadenocarcinoma of ovary
3) meningioma
4) malignant mesothelioma
HTLV-1
adult T-cell leukemia
HBV, HCV
hepatocellular carcinoma
EBV
Burkitt's lymphoma, nasopharyngeal carcinoma
HPV
cervical carcinoma, penile/anal carcinoma
HHV-8
Kaposi's sarcoma, body cavity fluid B-cell lymphoma
aflatoxins
hepatocellular carcinoma
vinyl chloride
liver angiosarcoma (recall: ugly bloody picture from QBank)
CCl4
liver centrilobular necrosis and fatty change
nitrosamines
esophageal and gastric CA
cigarette smoke
laryngeal and lung CA
asbestos
malignant mesothelioma and bronchogenic CA
arsenic
squamous cell CA of skin
naphtalene (aniline) dyes
bladder transitional cell CA (can also be caused by phenacetin, smoking, cyclophosphamide)
alkylating agents
blood (leukemia)
ACTH or ACTH-like peptide
small cell CA of lung; Cushing's syndrome
ADH
small cell CA of lung, intracranial neoplasms; SIADH (tx with demeclocycline)
PTH-related peptide, TGF-b, TNF-a, IL-1
squamous cell CA of lung, renal cell CA, breast CA, multiple myeloma, lytic bone metastasis; hypercalcemia
erythropoietin
renal cell CA, hemangioblastoma
antibodies against presynaptic Ca channels at nmj
thymoma, small cell CA of lung; Lambert-Eaton syndrome of muscle weakness
hyperuricemia
leukemia, lymphoma (tumor lysis syndrome); gout, urate nephropathy (radiolucent)
Tumor mets to brain:
lung, bone, melanoma, renal cell CA, GI
Tumor mets to liver:
colon > stomach > pancreas > breast > lung
Tumor mets to bone:
BREAST, lung, thyroid, PROSTATE, kidney, testes
Blastic bone mets =
prostate OR breast
Cancer is the ___ leading cause of death in the US.
2nd - heart disease is 1st
___ cancer is the leading cause of cancer death in the US.
Lung
Spherocytes could mean:
hereditary spherocytosis, autoimmune hemolysis
Macro-ovalocytes:
megaloblastic anemia, marrow failure
Helmet cells, schistocytes:
traumatic hemolysis, DIC
Teardrop cell:
myelometaplasia with myelofibrosis (marrow fibrosis)
Acanthocyte "spur cell":
liver disease (abetlipoproteinemia)
Target cell:
HbC disease (mild hemolytic anemia), aspenia, liver disease, thalassemia
Poikilocytes:
TTP, HUS, microvascular damage, DIC
Burr cell:
Kidney disease (TTP, HUS)
High serum bilirubin, pigment gallstones, and high reticulocyte count indicate (generally speaking) ___ anemia.
hemolytic
How do you determine if a patient's hemolysis is due to an autoimmune cause?
Direct Coomb's test: take patient's RBCs and add anti-Ig Ab --> if RBC agglutinate, means RBCs covered with Ig and it is autoimmune hemolysis
After you've determined the RBC hemolysis is autoimmune, what do you do to narrow down the differential?
Agglutinin test: warm agglutinin positive (IgG) means chronic anemia seen in diseases like lupus and CLL or on meds like methyldopa; cold agglutinin positive (IgM) means an acute anemia seen during recovery from Mycoplasma pneumoniae or infectious mononucleosis
Erythroblastosis fetalis =
Rh(-) mother's anti-Rh antibodies attack Rh(+) baby's RBCs
What is the indirect Coomb's test?
take patient's serum and add normal RBCs --> if these agglutinate, means patient serum had anti-RBC immunoglobulins
Hereditary spherocytosis =
intrinsic defect in RBC membrane (problem with spectrin, ankyrin) --> less membrane --> extravascular hemolysis; don't see central pallor, have high MCHC and RDW
How do you confirm a suspected diagnosis of hereditary spherocytosis?
osmotic fragility test - this is not autoimmune hemolysis so it's Coomb's negative
Paroxysmal nocturnal hemoglobinuria =
intrinsic RBC membrane defect (missing CD55, CD59) --> susceptible to complement lysis --> urine hemosiderin
Microangiopathic anemia =
intravascular hemolysis seen in DIC, TTP, HUS, lupus, malignant HTN; see schistocytes
Causes of DIC:
1) OBSTETRIC complications
2) sepsis
3) transfusion
4) trauma
5) malignancy
6) acute pancreatitis
7) nephrotic syndrome
Prolonged PT, prolonged PTT, low platelets, high fibrin split products (D-dimers) =
DIC
Microthrombi, global consumption of platelets and clotting factors =
DIC