Pathology 1 Block 3

Front 1

What protein is required for HIV to bind to T cell

Back 1

Gp 120

Front 2

What are the high risk groups for contracting HIV?

Back 2

1) MSM
2) Prostitues
3) IV drug abusers + partners
4) Health Care workers
5) babies of HIV + moms ( decrease since HAART)
6) Blood transfusions

Front 3

Where is the HIV located in
a) males
b) females

Back 3

a) spermatozoa and Seminal Fluid
b) Glandular epithelium and the langerhans interdigitating cells.

Front 4

What method of transmission has the highest risk /exposure

Back 4

blood transfusions by far ( 9,000 / 10000)
Next highest is needle sharing (67 / 10,000)

Front 5

What is the first protein that becomes apparent for HIV infection? and when?

Back 5

p24 at about 15 days after infection

Front 6

What are the top five clinical findings in an HIV patient

Back 6

1) Fatigue
2) Fever
3) Weight Loss
4) Pharyngitis
5) myalgia

Front 7

What direction does the shift occur in T cells of HIV patients?

Back 7

From Th1 to Th2

Front 8

Stages of AIDs

Back 8

1) no symptoms
2) weight loss of less than 10%, possible herpes zoster
3) weight loss of more than 10%, 1 month fever, hairy leukoplakia, candidas
4) opportunistic infections.

Front 9

What are the AIDS defining malignant neoplasias?

Back 9

1) kaposi sarcoma (HHV 8)
2) castleman's dx (HHV 8)
3) non - hodgkins (EBV)
4) Primary effusion lymphoma (HHV 8)
5) Cervical and Anal Squamous cell carcinoma (HHV 8)

Front 10

What is the D/D for Kaposi Sarcoma

Back 10

Bacillary angiomatosis (scratch fever)

Front 11

What dx is correlated with inability for B cells to differentiate

Back 11

Agammaglobulinemia

Front 12

What happens if you can't have T cell differentiation?

Back 12

SCID

Front 13

Describe the 2 types of Coomb's Test

Back 13

Test the mothers blood it's indirect coombs.
Test the babies blood it's Direct coombs.

Front 14

What are the 4 types of Hypersensitivity RXN's

Back 14

Type 1: IgE mediated (immediate RXN). Mast / basophil degranulation leading to anaphylaxis
Type 2: Antibody mediated. Eg. Blood typing (ABO)
Type 3: Immune Complex. Eg. SLE
Type 4: Cell mediated ( CD8) Eg. Hashimotos

Front 15

What are examples of Type 2 hypersensitivity rxn's?
hint : there are 6

Back 15

1) Good pastures: presents with hematuria and hemoptysis
2) Rh in preganacy
3) Graves: antibodies against the TSH receptors.
4) Myestenia Gravis: blocks the ACoA receptors at the NMJ
5) Incompatible blood transfusions
6) Anti neutrophil cytoplasmic antibody (ANCA); leads to spilling of O radicals and poly arteritis.

Front 16

What are Type 3 hypersensitivy rxn's?

Back 16

1) SLE
2) serum sickness
3) post streptococcal glomerular nephritis
4) poly arteritis nordosum

Front 17

What are ex. of type 4 hypersensitivity?

Back 17

1) Hashimoto's hypothyroidism
2) sjogran's destruction of lacrimal and salivary glands.
3) poison Ivy rash

Front 18

What is it called when a mother develops antibodies to Rh and attacks fetal blood?

Back 18

Erythroblastosis Fetalis

Front 19

What is the MXN of Dx for Goodpastures?

Back 19

Develop antibodies to the basement membrane of the lung and the kidneys.

Front 20

Ring or Rim appearance is associated with what antibody?

Back 20

Anti ds - DNA

Front 21

"Lumpy bumpy"

Back 21

post streptococcal glomerular nephritis

Front 22

Hurthle Cells

Back 22

associated with hashimoto's (type 2 hypersensitivity)

Front 23

Pannis

Back 23

Inflamed mass of synovial fluid seen in rheumatoid arthritis

Front 24

Which autoimmune dx's aren't female dominant

Back 24

Goodpastures

Front 25

Henoch - Schonlein purpura

Back 25

Involves IgA complexes in the glomeruli, BV's, joints and intestines.

Front 26

Anti DNA antibody

Back 26

Classic of SLE

Front 27

B cell hyperactivity (chronic lymphocytic leukemia) leads to

Back 27

antibodies against RBCs and platlets.
Paradox: because seen in AIDs patients.

Front 28

What is the Mxn that causes rheumatic fever

Back 28

Strep pyogenese M protein shows molecular mimicry with connective tissue in heart valves.

Front 29

What microbe mimics TSH receptors thereby causing graves dx?

Back 29

Yersinia entercolitica.

Front 30

Why are Autoimmune dx's more common in women?

Back 30

Estrogen might cause the calcineurin activation of T cells.

Front 31

What are three drugs that can induce SLE?

Back 31

1) Procainamide: arrythmia
2) hydralazine: hypertension
3) isoniazide: tuberculosis

Front 32

If patient is positive for ANA's what would you want to test to confirm SLE

Back 32

1) anti - dsDNA is better but not definity
2) anti - smith is definitive but only seen in 20% of patients.

Front 33

Clincal presentations of SLE

Back 33

1) Malar rash
2) alopecia
3) anti protien c& s therefore increased clotting
4) hemolytic enemia and thrombocytopenia.

Front 34

What is stained in Rx induced SLE

Back 34

Anti - histone antibodies

Front 35

anti La or Ro indicate what?
hint: nucleolar staining.

Back 35

Sjogren's syndrome.

Front 36

Scleroderma (limited) shows what symptoms? antibodies?

Back 36

Anti - centromere antibodies
Symptoms are Crest
Calcification
raynaud's (decreased blood flow to fingers)
Esophageal dysmotility
Sclerodactyly
Telangiectasias

Front 37

Shirmer Test

Back 37

Place paper under eyes to test tear production when suspecting sjogren's syndrome.

Front 38

Rheumatoid Factor

Back 38

IgM anti - bodies to the Fc component of IgG's.

Front 39

What are the symptoms of Polymyositis? What is the cormorbidity?

Back 39

Anti -synthetase (Jo) antibodies
Increase serum CPK
Proximal extremity pain.
dx is associated with lung and other types of cancer.

Front 40

Mixed connective tissue disease

Back 40

Anti - RNP antibody
1) esophageal
2) Raynaud's
3) arthritis
d/d GERD

Front 41

What are 3 ANCA associated Dx's?

Back 41

1) Wegener's
2) Churg - Strauss
3) microscopic poly angitis

Front 42

Describe Wegener's

Back 42

Extensive upper and lower respiratory tract inflammatory dx seen in middle age men.

Front 43

Churg - Strauss

Back 43

associated with long term asthma patients.

Front 44

Microscopic polyangiitis

Back 44

Most common cause of rapidly progressing glomerulonephritis

Front 45

What are growth factors for;
a) RBCs
b) PMNs

Back 45

a) erythropoietin
b) G - CSF

Front 46

What signals cell to go from G0 to G1

Back 46

cyclins and CDK's

Front 47

What two effects does p53 have on restricting the cell cycle.

Back 47

1) activates p21 which activates GTPase
2) activates Bax which is an apoptotic gene.

Front 48

How does HPV 16 cause cancer

Back 48

Phosphorylates RB and inactivates p53.

Front 49

What is the Fxn of APC

Back 49

Binds to beta catenin and maintains cell adhesion. If deleted than patients will have 1000s of polyps and 100% chance of getting colon cancer by age 50.

Front 50

What gene deletion is responsible for Neurofibromatosis

Back 50

NF - 1

Front 51

What is Lynch Syndrome

Back 51

Familial non - polyposis. mismatch genes are deleted. Assoc. with colon and endometrial cancer.

Front 52

How many doublings are required to feel or see cancer on an xray

Back 52

30.
this leads to the formation of 10 ^9 cells which is 1 cm in diameter.

Front 53

Hodkins lymphoma

Back 53

B cells are malignant and rest of cells are normal. B cells are called Reed - Sternberg Cells.
Extranodal involvement is NOT common

Front 54

Non - Hodgkins

Back 54

Both B and T cells are malignant.
Extranodal / systemic involvement is inevitable.

Front 55

Sarcoma Byotriodes

Back 55

Skeletal muscle tumor in the vagina of a baby girl. this is a developmental rabdomyosarcoma.

Front 56

Most common tumor in the abdomen of babies?

Back 56

Neuroblastoma. tumor of the adrenal medulla.

Front 57

choristoma

Back 57

Tumor involving cells being in the wrong spot.