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173 Cards in this Set
- Front
- Back
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Transudate v. exudate characteristics
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"1- Hypocellular (vs. exudate cellular)
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Transudate due to (3)
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"1- Increase hydrostatic pressure
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Exudate due to (2)
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"1- Lymphatic obstruction
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4 steps in Leukocyte extravasation
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"1- Rolling- mediated by E and P selectins on vascular endothelium
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NOTE-Amyloid is a fibrillar protein that forms deposits in interstitial tissue, resulting in organ dysfunction"
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"1- Beta pleated sheet that shows apple green birefringence with Congo red stain under polarized light
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Major types of Amylod proteins (3)
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"1-Amyoid Light chain (AL chain)- derived from light chains (e.g. Bence Jones protein)
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Amyloid light chain is associated with
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Multiple Myeloma
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Amyloid Associated Acute Phase reactant associated with
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Chronic inflammation (e.g. RA, TB)
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Hyperplasia definition
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Hyperplasia- increase in number of cells
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Metaplasia definition
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1 adult cell type is replaced by another type
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Dysplasia definition
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Abnormal growth with loss of cellular orientation, shape, and size in comparison to normal tissue maturation, commonly preneoplastic
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Anaplasia definition
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Abnormal cells lacking differentiation, like primitive cells of same tissue, often equal undifferentiated malignant neoplasm
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Neoplasia definition
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A clonal proliferation of cells that is uncontrolled and excessive
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Grade of tumor
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"Degree of cellular differentiation based on histologic appearance of tumor
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Stage of tumor
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"Degree of localization based on site and size of primary lesion, spread to regional lymph nodes, presence of metastases, spread of tumor in a specific patient
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2- Malignant tumors called"
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"
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2- Malignant tumors called"
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"1- Benign tumors= none
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2- Malignant tumors called"
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"1- Benign tumors= Hemangioma
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2- Malignant tumors called"
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"
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2- Malignant tumors called"
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"1- Benign tumors= Rhabdomyoma
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2- Malignant tumors called"
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"1- Benign tumors= osteoma
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2- Malignant tumors called"
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"1- Benign tumors= Lipoma
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2- Malignant tumors called"
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"1- Benign tumors=
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Neoplasm(s) associated w/ Down syndrome
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"1- ALL
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Neoplasm(s) associated w/ Xeroderma pigmentosum, albinism
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"1- Melanoma
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Neoplasm(s) associated w/ Chronic Atrophic gastritis, pernicious anemia, postsurgical gastritic remnants
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Gastric adenocarcinoma
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Neoplasm(s) associated w/ Tuberous sclerosis (facial angiofibroma, seizures, mental retardation
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"1-Astrocytoma
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Neoplasm(s) associated w/ Barrett's esophagus (chronic GI reflux)
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Esophageal adenocarcinoma
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Neoplasm(s) associated w/ Plummer Vinson Syndrome (atrophic glossitis, esophageal webs, anemia, all due to iron deficiency)
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Squamous cell carcinoma of the esophagus
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Neoplasm(s) associated w/ Cirrhosis (alcoholic, hep B and C)
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Hepatocellular carcinoma
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Neoplasm(s) associated w/ Ulcerative colitis
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Colonic Adenocarcinoma
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Neoplasm(s) associated w/ Paget's disease of the bone
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Secondary osteosarcoma and fibrosarcoma
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Neoplasm(s) associated w/ Immunodeficiency states
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Malignant lymphomas
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Neoplasm(s) associated w/ AIDS
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"1-Non-Hodgkin's lymphoma
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Neoplasm(s) associated w/ Autoimmune disease (e.g. Hashimoto's thyroiditis, myasthenia gravis)
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Benign and malignant lymphomas
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Neoplasm(s) associated w/ Acanthosis nigricans (hyper pigmentation and epidermal thickening)
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Visceral malignancy (stomach, lung, breast, uterus)
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Neoplasm(s) associated w/ Dysplastic nevus
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Malignant melanoma
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Neoplasm(s) associated w/ Radiation exposure
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Sarcoma
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Proto- oncogenes are normally involved in (e.g. ABL, HER, MYC, RAS, RET, SIS)
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Involved in normal growth and repair, and as such are growth factors, signal transducers, nuclear transcribers
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Suppressor genes are normally involved in (e.g. APC, BRAC1/2, RB, TP53, VHL, WT1)
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Protect against unregulated cell growth
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Cancer"
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"1- Function- Nonreceptor tyrosine kinase activity/ 2nd messenger
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3- Cancer"
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"1- Function- Nuclear transcription
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3-Cancer"
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"1- function Antiapoptosis genes they stop the leakage of cytochrome C from the mitochondria into the cytosol, which would start apoptosis
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2- related cancers"
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"1- Translocation t(9;22)-BCR-ABL hybrid-> causes Chronic Myelogenous Leukemia (Philly chromosome)
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3- Cancer "
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"1- Function- Receptor synthesis
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3- Cancers (4)"
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"1- Function- Guanosine Triphosphate signal transduction
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3- Cancer"
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"1-function- Nuclear transcription
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3- Cancers"
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"1-Function- Receptor synthesis
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3- Associated tumor?"
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"1-Chromosome- 13q
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3- Associated tumor?"
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"1-Chromosome- 17q
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3- Associated tumor?"
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"1-Chromosome- 13q
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3- Associated tumor?"
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"1-Chromosome- 17p (note both have p)
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2- Associated tumor?"
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"1 Function- Regulates nuclear transcription
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2- Associated tumor?"
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"1-Chromosome- 9p
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2- Associated tumor?"
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"1-Chromosome- 5q
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3- Associated tumor?"
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"1-Chromosome- 11p
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2- Associated tumor?"
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"1-Chromosome- 17q
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2- Associated tumor?"
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"1-Chromosome- 22q
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2- Associated tumor?"
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"1-Chromosome- 18q
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2- Associated tumor?"
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"1-Chromosome- 18q
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PSA tumor markers
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Prostate specific antigen (both prostate carcinoma and prostate hyperplasia)
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Prostatic acid phosphatase
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Prostate carcinoma
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CEA tumor markers for
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Colorectal and pancreatic carcinomas (monitor for recurrences)
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Alpha fetoprotein tumor market for
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"Normally made by fetus.
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Beta- HCG tumor marker for
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"1- Hydatidiform moles
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CA-125 tumor marker for
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"1- Ovarian
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Alkaline phosphatase tumor marker for
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"1- Metastases to bone
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Bombesin tumor marker for
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"1- Neuroblastoma
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TRAP
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Hairy cell leukemia- a B-cell neoplasm
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CA-19-9
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Pancreatic adenocarcinoma
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HTLV-1 associated w/ what cancer
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Adult T cell leukemia
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HBV, HCV associated w/ what cancer
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Hepatocellular carcinoma
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EBV associated w/ what cancer
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"1- Burkitt's Lymphoma
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HPV associated w/ what cancer
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"1- Cervical carcinoma (16, 18)
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HHV-8 (Kaposi's sarcoma associated herpes virus)
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"1- Kaposi's sarcoma
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Psammoma bodies (laminated, concentric, calcific spherules) seen in (4 diseases)
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"1- Papillary adenocarcinoma of thyroid
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Metastasis to brain
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Lung> Breast > skin (melanoma) > kidney (renal cell carcinoma) > GI
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Metastasis to liver
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Colon > Stomach > Pancreas > Breast > Lung
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Metastasis to bone
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"Prostate, Thyroid, testes, Breast, Lung, Kidney
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3- Associated cancer"
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"1- Inactivation genes
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2- Inheritance and pathology"
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"1- 80% of these polpys progress to colorectal cancer. Proximal colon always involved
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Bone metastasis, if osteoblastic, what marker?
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Increase in alk phosphatase
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Bone metastasis, if osteolytic what marker?
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"1- Increase in serum Ca
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Cancer in children (5) in order
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"1- Leukemia
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2- Mortality in order"
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"1- incidence- Endometrial > ovarian > cervical
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H Pylori can be a precursor to 2 cancers they are:
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"1- Lymphoma
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GERD can be precursor to 1 cancer that is
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Adenocarcinoma of the distal esophagus
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A Point mutation means what (note occurs w/ RAS and RET proto oncogenes)
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Means it will keep doing what it was the gene was designed to do without stopping
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Damage to TP53 causes 2 problems
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"1- cell cycle doesn't stop, as TP53 normally inhibits G1 to S phase
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Diethylstilbestrol carcinogen causes
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Clear cell carcinoma of the vagina and cervix
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Oral contraceptives are linked to what cancers
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Breast ovarian carcinomas
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Polycyclic hydrocarbons are linked to
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"1- Squamous cell carcinoma: oral cavity, midesophagus, larynx, lung
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3- Mechanism?"
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"1- Type of virus- A Flavivirus, RNA, enveloped
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3- Mechanism?"
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"1- Type of virus- Retrovirus, RNA, enveloped
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3- Mechanism?"
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"1- Type of virus- Herpes virus, dsDNA, enveloped
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3- Mechanism?"
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"1- Type of virus- Hepadnavirus, ds DNA partial circular, enveloped
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3- Mechanism?"
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"1- Type of virus- Herpes virus, dsDNA, enveloped
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3- Mechanism?"
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"1- Type of virus- Papillomavirus, dsDNA virus, non enveloped
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3- Mechanism?"
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"1- Type of virus- Papillomavirus, dsDNA virus, non enveloped
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Cachexia/ muscle wasting what TNF plays a role
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TNF alpha
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Acanthosis nigricans (velvety, pigmented lesion commonly located in the axilla, groin, under breast) associated with what cancer
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"Stomach carcinoma
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Nephrotic syndrome (diffuse membranous glomerulopathy) can be associated with 3 types of cancer
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"1- Lung carcinoma
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2- Ectopic hormone-"
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"1- Associated cancer- Small cell carcinoma of the lung, medullary carcinoma of the thyroid
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2- Ectopic hormone-"
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"1- Associated cancer- Choriocarcinoma (testis)
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2- Ectopic hormone-"
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"1- Associated cancer- Renal cell carcinoma, primary squamous cell carcinoma of the lung, breast carcinoma, malignant lymphomas (contain 1 alpha hydroxylase)
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2- Ectopic hormone-"
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"1- Associated cancer- Medullary carcinoma of thyroid
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2- Ectopic hormone-"
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"1- Associated cancer- Hepatocellular carcinoma
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2- Ectopic hormone-"
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"1- Associated cancer- Small cell carcinoma of the lung
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2- Ectopic hormone-"
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"1- Associated cancer- Renal cell carcinoma and Hepatocellular carcinoma
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LDH tumor marker for
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Malignant Lymphoma (prognostic factor for response to standard therapy)
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Reed-Sternberg cells
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Distinctive tumor giant cell seen in Hodgkin’s disease; binucleate or bilobed with the 2 halves as mirror images (“owl’s eyes”)
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Reed-sternberg cells are of B cell origin and have what 2 markers
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CD30 and CD15
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Lymphomas have what consitutional signs
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"1-Low grade fever
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Good prognosis of Hodkin's lymphoma
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Increase lymphocytes, decrease Reed sternberg cells
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Non-Hodgkin's Lymphoma associated with
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HIV and immunosuppresion
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2- Nodes involved?"
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"Spread
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50% of Hodgkin's Lymhomas are associated with
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EBV- bimodal distribution- young and old
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Hodgkin's Lymhoma is more common in men except what type
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Nondular sclerosing type
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3- Other"
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"1-Reed Sternberg cells- few
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3- Other"
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"1-Reed Sternberg cells- lot
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3- Other"
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"1-Reed Sternberg cells-
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3- Other"
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"1-Reed Sternberg cells-
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http://i50.tinypic.com/4g15ib.jpg
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Reed Sternberg cell- seen in HL
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Signs of Symptoms of Multiple Myeloma
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"1- Bone destructive lesions, w/ related hypercalcemia
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Multiple Myeloma associated with
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Primary Amyloidosis and punched out lytic bone lesions on X-ray
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Blood smear in Multiple Myeloma shows
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RBCs stacked liker pocker chips (rouleaux formation)
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In Multiple Myeloma monoclonal plasma cells arise in the mrrow and produce which Ig
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"1- IgG (55%) or
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http://i46.tinypic.com/9k029g.jpg
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Plasma cells in patient w/ Multiple Myeloma. Note eccentric nuclei and perinuclear halo of clearer cytoplasm
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Two Autoimune diseases associated with Lymphomas
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"1- Sjogren syndrome- can see salivary and GI lymphomas
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3- Histo signs"
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"1- relationship to what virus- EBV
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Clinical signs of Lymphoma
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"1-Constiutional signs- including alternating bouts of fever w/ remissions, pruritus
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Hand-Schuller Christian disease triad
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"1- lytic lesion in the skull
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Bones jones proteins=
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Excess light chains in the urine seen in MM
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Bone pain in Multiple Myeloma is due to myeloma cells 1) prod? And 2) releasing?
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"1- Prod. An inhibitor of osteoblastic differentiation
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Bones jones renal disease in Multiple myeloma
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Proteinaceous casts with mutlinucleated giant cell reaction
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In Multiple Myeloma you can have nephrocalcinosis describe
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"Metastatic calcification of tubular basement membranes in the collecting ducts
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Hematologic findings in Multple Myeloma (3)
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"1- Normocytic anemia with rouleux (RBCs stacked like coins)
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2- White pulp does what?"
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"1- red pulp- location of macrophages, allowing for antigen trapping and processing
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Hematologic signs of splenectomy (3)
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"1- Nucleated RBCs
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t(14;18) cancer
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"Follicular lymphomas (bcl-2 activation)
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t(15;17)
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M3 type of AML (responsive to all-trans retinoic acid)
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t(11;22)
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"Ewing's Sarcoma
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t(11;14)
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"Mantle cell lymphoma
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4- average age of patient"
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"1- a NHL in diaphysis of long bones, pelvis, scapula, and ribs
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Eosinophilia seen in
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"1- Type I Hypersensitivity reactions
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Eosinopenia seen in 1 thing
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Hypertortolism (e.g. cushings or w/ corticosteroids)
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Basophilia consider
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Myeloproliferative disease
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EBV pathogenesis
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"Infection spreads to B cells in lymph nodes
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Infectious mononucleosis a rash devvelops if the patient takes what drug
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Ampicillin
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In EBV atypical lymphocytes are antigenically stimulated
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T cells
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Initial screening for mono
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Positive heterophil antibody test- detects IgM antibodies against horse (or sheep) RBCs
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If initial positive heterophil antibody test is negative for a patient we think has mono what test can be given
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"Anti-Antiviral capsid antigen (VCA) antibodies test
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Leukemia definition
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Malignant transformation of Bone marrow stem cells
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Acute Lymphoblastic Leukemia most common in?
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Most common leukemia and cancer in children
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Acute Lymphoblastic Leukemia most common in?
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..
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Acute Myeloblastic Leukemia (AML) age group it is seen in
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"15-60 years of age
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Chronic Melogenous Leukemia (CML)what age group
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"40-60 years of age
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Chronic Lymphoblastic Leukemia age group
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"> 60 yrs of age
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Clinical findings of Acute leukemia (including Acute Lymphoblastic Leukemia and Acute Myeloblasstic Leukemia)
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"1- Fever w/ infection
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Key finding in determining if the leukemia is acute or chronic
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"Acute- blasts > 20%
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Polycythemia vera definition
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"Inappropriate absolute polycthemia-
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Polycthemia vera pathogenesis
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"1- Clonoal expansion of myeloid stem cells
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Polycthemia vera Clinical findings
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"1- Hepatosplenomegally
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Only leukemia with thrombocytopenia
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Chronic Myeloblastic Leukemia (CML)
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Most sensitive and specific test for CML
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"BCR- ABL fusion gene
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Acute Myeloblastic Leukemia (AML) clinical findings
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"1- DIC
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What translocation in Acute Lymphoblastic Leukemia offers a good prognosis
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t(12;21)
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Philadelpha Chromosome
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Chromosome 22 with a translocation, seen in CML and ALL
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Adult T cell Leukemia Associated with
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Human T-Cell Leukemia Virus (retrovirus)
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Adult T cell Leukemia pathogenesis
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Activation of TAX gene, which inhibits TP53 suppressor gene, leads to monoclonal proliferation of neoplastic CD4 helper T cells
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Only leukemia without Lymphadenopathy
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"Hairy cell leukemia- a B-cell neoplasm
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Auer rods are
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"Auer rods are peroxidase-positive cytoplasmic inclusions. Seen in acute promyelocytic leukemia (AML)
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http://i47.tinypic.com/zobybr.jpg
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"Auer rods are peroxidase-positive cytoplasmic inclusions. Seen in acute promyelocytic leukemia (AML)
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