Pathology Quiz 6 Ssl

Front 1

what is sicca syndrome

Back 1

primary Sjogren's - dry mouth and eyes

Front 2

secondary Sjogren

Back 2

associated with RA, SLE, scleroderma, thyroiditis, or MCTD

Front 3

symptoms of Sjogren's

Back 3

keratoconjunctivitis sicca; xerostomia; arthritis & kidney dz

Front 4

Epidemiology of Sjogren

Back 4

middle aged women - 2 million in US
autoimmune exocrinopathy
T cells infiltrate and destroy glands
specific ANA - anti-SSA, anti SSB

Front 5

with which ANA are systemic probs more likely in Sjogren

Back 5

anti SSA

Front 6

clinical picture - sjogren

Back 6

dry mouth & eyes
shortness of breath poss (resp dryness)
40X risk of lymphoma
20% MS like CNS syndrome
40% - nephritis (anti-SSA marker)

Front 7

What is scleroderma?

Back 7

aka Progressive Systemic Sclerosis - family of slowly progressing dz with EXCESSIVE FIBROSIS throughout the body

Front 8

Etiology of scleroderma

Back 8

unclear - fibroblasts making excessive collagen - triggered by IL-1?
ANA - esp anti-endothelial Ab

Front 9

morphology of scleroderma

Back 9

"onion-skinning" small vessel intima proliferation/concentric fibrosis
Raynaud phenomenon
sclerodactyly
"rubber hose" esophagus

Front 10

sclerodactyly

Back 10

tight, thick skin, esp on hands and fingers (webs btwn fingers)

Front 11

sceleroderma - clinical

Back 11

generalized fibrotic bound skin with sclerodactyly and hypopigmentation; chronic progressive dermatosis characterized by boardlike hardening and immobility of the affected skin and visceral involvement, particulary the lungs, esophagus, kidneys & heart.

Front 12

CREST syndrome

Back 12

Calcinosis, Raynauds, esophageal dysmotility, sclerodactyly, Telangiectasis
aka "limited scleroderma"

Front 13

Telangiectasia

Back 13

are widely open (dilated) blood vessels in the outer layer of the skin (in legs = spider veins)

Front 14

morphea

Back 14

variant of scleroderma - segmental atrophic and slightly fibrobtic mottled hyperpigmentated and hypopigmented plaques (raised) (skin only, not systemic, rarely progresses)

Front 15

Polymyositis-dermatomyositis

Back 15

polymyositis - inflamm dz that damages skeletal mm
dermatomyositis - similar, with skin involvement

Front 16

Etiology of polymyositis

Back 16

prob. autoimmune
can occur w other collagen/vascular dz
also cancer, D-penicillamine rxn, SLE

Front 17

morphology of polymyositis

Back 17

affects PROXIMAL mm of extremities; SPARES EXTRA-OCULAR

Front 18

morphology of dermatomyositis

Back 18

butterfly raxh, heliotrope eyelids, periorbital edema and GROTTON LESIONS. Poss soft tissue calcification

Front 19

Grotton lesions

Back 19

scaling purple bumps or patches on fingers, elbows & knees. (look like eczema)
char of dermatomyositis

Front 20

clinical presentation of PM-DM

Back 20

weakness getting up from a chair or climbing steps
fine motor skills affected (later dz)
risk for lung, ovary, stomach CA

Front 21

diagnosis of polymyositis/dermatomyositis

Back 21

elevated CK
muscle biopsy

Front 22

MCTD

Back 22

mixed connective tissue dz

Front 23

other name for MCTD

Back 23

"undifferentiated connective tissue dz"

Front 24

morphology

Back 24

features of SLE, polymyositis and scleroderma.
severe RAYNAUD & joint pain
mild myositis
swollen fingers

Front 25

Fibromyalgia - description

Back 25

syndrome of tender points, generalized muscle pain, fatigue, sleep d/o, head pain, depression and digestive sx. No abnormal labwork or morphology

Front 26

Fibromyalgia - etiology (theories)

Back 26

localized metabolic shutdown due to phosphate or uric acid buildup
mitochondrial dysfx - ATP deficient
Aluminum excess - inh glycolysis/ox-phosphorylation
Low serotonin levels
Increased Substance P

Front 27

Fibromyalgia - risk factors

Back 27

Neck injury; low Vit A & E; restless leg (64% v 2.15% gen pop); autonomic dysfx (HR up 30bpm p standing); lack of restorative sleep; chronic widespread pain

Front 28

Fibromyalgia - dx

Back 28

History of widespread pain present for at least 3 mos, both above & below waist (low back counts), bilat; axial skeleton. Pain in 11/18 tender points on digital palpation

Front 29

Fibromyalgia - tx - allopathic

Back 29

amytryptiline, trazadone (sleeping pills)
opiates for pain
cognitive behavioral therapy

Front 30

Fibromyalgia - tx - naturopathic

Back 30

KREB CYCLE nutrient supp; homeopathy, acupunc; bodywork; neurofeedback; ALPHA STIM; food allergy elim; detox; tx of dysbiosis & heavy metals

Front 31

neoplasia - def

Back 31

new growth - cb benign or malignant

Front 32

metaplasia - def

Back 32

reversible replacement of one differentiated cell type with another mature differentiated cell type (cb precancerous, not always)

Front 33

types of metaplasia

Back 33

smoker's larynx; lower esophagus fm chronic reflux

Front 34

dysplasia - def

Back 34

abnormal development (of organs or cells) or an abnormal structure resulting from such growth
(disorder, pleiomorphic)

Front 35

anaplasia - def

Back 35

cancerous - not common - always malignant - Reversion of cells to an immature or a less differentiated form,

Front 36

fibroids

Back 36

benign neoplasms in uterus - can compress local strux - pressure against bladder/erratic heavy bleeding /pregnancy probs

Front 37

metastatic cancer

Back 37

has travelled through blood or lymph - see small satellites throughout organ, rather than one or two cancerous areas

Front 38

B9 v malignant

Back 38

B9 - smaller, slower growing, don't spread, normal cells in abnormal pattern - ROUND
malignant - CAULIFLOWER larger, less well demarcated, angiogenesis, pleiomorphic, can have necrotic center, metastatic

Front 39

pace of malignant growth

Back 39

single cell - 30 divisions B4 detectable; 10 more divisions b4 incompatible with life

Front 40

mutations

Back 40

initial mutation gathers others - tumor made up of several different mutation types