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80 Cards in this Set
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What is polycythemia, mech/example please
ON TEST |
Mech: Erythropoietin-like substance
Example: Renal cell carcinoma condition in which there is an increase in the proportion of blood volume that is occupied by red blood cells, which is measured as hematocrit level. >It can be due to an increase in the mass of red blood cells or to a decrease in the volume of plasma Paraneoplastic Syndrome |
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what is a choristoma*** ON TEST
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A mass of irregularly formed,
essentially mature tissue present at a site where such tissue normally is NOT found E.g., pancreatic exocrine tissue in the wall of the stomach – ***NOT a neoplasm |
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What is hypercalcemia (mech and example)
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Mech: Parathormone-like substance
Example: Lung (squamous cell) carcinoma Paraneoplastic Syndrome |
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What is a hamartoma ***ON TEST
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A mass of irregularly formed,
essentially mature tissue present at a site where such tissue normally IS found E.g., cartilage and smooth muscle in the lung ***– NOT a neoplasm |
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Please list the Mechanism and an example of Trousseau's Syndrome
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produces MUCIN (coagualtive substance, prothrombosis)
Mechanism: hypercoaguable state Example: Various carcinomas (the example he used in practice questions was pancreatic adenocarcinoma..which was not anywhere in his lecture but there it is) Paraneoplastic Syndrome |
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When would you want to maximize sensitivity at the cost of specificity?
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You would want to do this for diseases that are easily treated (so you want to catch 100% of the cases), or very serious diseases (such as HIV)
note that you will see false positives normally there is another secondary tests |
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When do you want to maximize specificity at the cost of some sensitivity?
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for diseases that are very serious but not curable (such as pancreatic cancer)
this is because the intervention for a person with the disease is quite severe |
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If you know that the test sensitivity is 80% for a 50% disease prevalence for 1,000 ppl in a population, what do A and C =?
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A: 400 (true positive)
C: 100 (false negatives) |
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what organ is most prone to finding cancer incidentally?
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kidney
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What is a tumor with >1 cell type called?
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teratoma is example
pleomorphic adenoma |
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Rhabdomyoma is what?
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benign tumor of skeletal muscle
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What is a benign tumor of smooth muscle called? malignant?
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benign: lelomyoma
malignant: lelomyosarcoma |
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please discuss the neoplastic cells ("tumor parenchyma")
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Usually, tumors consist of one cell type (though the cells may differ in appearance due to tumor heterogeneity)
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what is a teratomas
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germ cell tumor (usually found in female)
> 1 cell type in tumor can see all sorts of tissue types because it is from the germ cells (endo, ecto, meso, etc. so can see hair, teeth, brain, its F'in nasty!) |
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what is in situ? ON TEST
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tumor still in normal place
neoplasm that has not yet breached or broken through basement membrane |
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what is the most frequent dominant mutation in cancer?
***probably on test |
Ras
Intracellular signal transduction pathways (note: P53 is the next most common) |
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what are c-ret (MEN); c-kit (GIST)
? c-kit WILL BE ON TEST!!! |
Cell surface receptors (for growth factors)
GIST-gastro intestinal stromal tumor these are 2 things that onco-genes code for, will lead to cancer yo |
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In HPV, what viral product promotes the degradation of p53? what is the importance of this
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E6
leads to loss of tumor suppression |
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Follicular lymphoma is caused by?
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~85% have chromosomal translocation that places Bcl2 under transcriptional control of Ig heavy chain promoter: t(14;18)
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Problems with MLH1, MSH2 lead to what?
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hereditary nonpolyposis colon cancer (HNPCC)
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c-kit is associated with what? what is c-kit?
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GIST
gastrointestinal stromal tumor c-kit is a cell surface receptor for growth factors |
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What is the Rb gene?
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Loss of function gene
(retinoblastoma gene product) Guards a critical point in the cell cycle Loss of function leads to unregulated cell proliferation |
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What is Li Fraumeni syndrome?
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germline mutation in p53 with predisposition of cancers of multiple organs
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WHITE TEXT
Nodal Status, what are the grades? |
N1-3
Presence and extent of lymph node metastasis note you can have N0 where there is no metastasis |
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Colorectal carcinoma is due to a loss or a mutation of what?
What does this lead to? |
APC locus on chromosome 5q
loss of p53 gene (loss of tumor suppression) |
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HBV, HCV
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hepatcellular carcinoma
VIRAL |
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HPV
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mucosal Squamous cell carcinoma
VIRAL |
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EBV (epstein barr)
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lymphoma (prominent in people who are immune suppressed); nasopharyngeal carcinoma
VIRAL |
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HHV 8
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Kaposi sarcoma (setting of HIV)
VIRAL |
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Type III HS Rxn
ab? |
immune complex disease
IgG, IgM, IgA Ab’s complex with either circulating Ag or with Ag that is deposited in tissues Immune complexes elicit inflammation via complement activation Directed against exogenous or endogenous Ag Autoimmune diseases; serum sickness Collage-vascular diseases SLE; RA (rheumatoid arthritis); types of glomerulonephritis; types of vasculitis |
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If blood was cross matched, typed, and everything seemed okay,and you saw a transfusion reaction, what might you start thinking?
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~40% pts have IgA autoantibodies
Important consideration for blood transfusions Recipient circulating anti-IgA antibodies can react with IgA in donor serum transfusion reaction |
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say a person has none of the standard signs of blood clotting but they are still experiencing it (under 50)
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genetic mutation in factor V leidien gene mutation
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people with Antiphospholipid Syndrome (APS) have what lab finding? Why is this kind of unexpected?
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elevated PT and PTT
even though they have blood clots |
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exudate
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high protein content
acute inflammatory Neutraphils present |
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virchow's triad
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stasis: interrupted blood-flow, change to turbulent blood flow
endothelial injury hypercoagulability |
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pt. presents with hypocalcemia, cardiac anomalies, and recurrent infections
what does this patient have? |
DiGeorge Syndrome
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If you have an immune disorder that is CELLULAR what is your problem?
**white text |
T cells
problems with infections |
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transudate
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noninflammatory
increased hydrostatic pressure or decreased plasma oncotic pressure Predominantly plasma fluid Low protein content |
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Patient comes in complaining of dry mouth and dry eyes
you see keratin in the conjuctiva what does this person have? |
Sjogren Syndrome
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if you see antibodies targeted against double-stranded DNA what would you be thinking?
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SLE
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you see a patient with fibrosis in the skin and cyanosis of the tips of fingers associated with Raynaud phenomena. What might you investigate further as a possible disease?
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Scerloderma
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what is hyperacute rejection?
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tissue rejection that occurs within minutes or hours
Rapid cyanosis, congestion, mottling – immediate graft failure Ag-Ab rxn at endothelial cell (type II HS rxn) Deposition of Ig, complement: fibrin-rich thrombi Action of preformed host Ab’s against donor Ag (ABO Red cell or HLA antigens) |
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you see a lack of B cells with no determinable reason, at least not clear. what is this due to?
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CVID
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if you have more localized scleroderma, what would you have?
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CREST syndrome
Calcinosis; Raynaud phenomenon; esophageal dysmotility; sclerodactyly; telangiectasia |
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a patient is in surgery getting a new kidney. The doctor removes the clamps to allow blood from the host to mix with the new kidney. The surgeon then sees rapid cyanosis, congestion, and mottling.
The surgeon says damn he is having... |
hyperacute rejection
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what is Libman-Sacks Endocarditis ?
what is it seen in? |
endocarditis of the mitral valve in lupus erythematosus
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Scerloderma
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Systemic sclerosis
Excessive systemic fibrosis: skin, GI tract, kidneys, heart, muscles, lung |
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what is Graft vs. Host Disease (GVHD)
what kind of transplant is this seen in ? |
Donor immune cells target host cells
seen in bone marrow transplant |
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what is acute rejection of tissue?
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most common type of rejection to occur
happens in 7-10 days or months/yrs depending on use of immunosuppression Humoral (type II HS rxn) or cellular (type IV HS rxn), or both |
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Multiple sclerosis is what type of HS rxn?
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IV
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a patient has recently had a bone marrow transplant and is now experiencing Rash, diarrhea, cramping/abd pain, liver dysfunction
what is going on? |
Graft vs. Host Disease (GVHD)
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if you see someone with renal problems and a slew of others such as Skin, joint,respiratory, cardiac, CNS, serous membranes
what are you thinking? this could be on the test |
SLE
key is renal + other things (thus systemic) |
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what type of HS rxn are seen in transplant rejection
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both Type II (humoral rejection)
and type IV (cell-mediated delayed) |
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What is Anergy *** ON THE TEST!!!
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occurs when an individual lacks the appropriate T-cell component for delayed cell hypersensitivity rxn
Pt will get negative PPD test, so it will look like they don't have TB This is what happens in AIDS |
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if you have cellular acute rejection, what is the immune system targeting?
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endothelial cells
will see Endotheliitis Generally responds well to immunosuppressant tx (e.g., cyclosporine) Precursor to chronic rejection |
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what is CREST syndrome?
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Calcinosis;
Raynaud phenomenon; esophageal dysmotility; sclerodactyly; telangiectasia (small dilated blood vessels near the surface of the skin or mucous membranes) localized sclerosis |
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if you see someone with sausage fingers (mmmm sausage) and raynaud phenomenon what are you thinking
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CREST syndrome
localized sclerosis |
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a patient who seems to have the symptoms of TB is given a test. The PPD comes back negative but you are darned if it doesn't look like TB. What are you guessing the person is an example of?
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anergy
occurs when an individual lacks the appropriate T-cell component for delayed cell hypersensitivity rxn Pt will get negative PPD test, so it will look like they don't have TB This is what happens in AIDS |
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what is primary Protein-energy malnutrition (PEM)?
secondary? |
Primary: insufficient quantity in diet
Secondary: adequate supply, but inability to absorb, process, store or utilize |
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you have a man that comes in. his occupation is a sandblaster. he has nodular fibrosis in the upper lobes of the lungs.
what does he have? |
Silicosis
due to Exposure to silicon dioxide |
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what is Pneumoconioses
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progressive fibrosing pulmonary disease caused by inhalation of aerosolized particles
gets into alveoli |
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if you see Mees lines (transverse bands in the finger nails) and the pt has garlic breath, what does this person have?
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arsenic poisoning
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what is the highest form of cancer associated with tobacco?
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strongest relationship for squamous cell carcinoma, small cell carcinoma
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you have an autorepair worker presenting with a cough what should you start thinking
TEST |
Asbestosis
that shit is in the breaks |
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you have a shipyard worker, doing insulation work what should you start thinking
TEST |
Asbestosis
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man comes in who works around nuclear reactors. he has acute pneumonitis (lots of coughing, and fever)
what does he have? |
Berylliosis
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what does Vitamin C deficiency lead to?
ON TEST |
scurvy
needed for producing collagen see bleeding gums |
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man comes in with noncaseating granulomas of the lung. he reports having worked in the aerospace industry, what does he have? is it chronic or actute?
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Berylliosis
chronic |
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Megaloblastic anemia is associated wtih what?
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alcoholism
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if you see Metabolic acidosis due to oxalic acid what is the cause
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Ethylene glycol
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you see a dead patient on autopsy, you see a bright cherry red discoloration of the mucous membrane, what is this?
**on test!!! |
Carbon monoxide (CO) poisoning
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you have a patient with bitter almond scented breath, they have systemic asphyxia, what do they have?
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cyanide poisoning
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what is Kwashiorkor?
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Severity of PROTEIN malnutrition disproportionately greater that total caloric deprivation
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ON TEST
if you see oxalate crystals collecting in renal tubules leading to renal failure, what should you be thinking is the cause? |
Ethylene glycol
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Protein-energy malnutrition (PEM) is what ?
ON THE TEST!!! |
insufficient:
Energy Essential AA and FA for structural integrity |
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what type of protein is lost in Kwashiorkor? what does this lead to?
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Loss of visceral protein is profound
(liver) Severe hypoalbuminemia with resultant edema (this is those kids with the big bellies in africa) |
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What is the most common cancer to form with exposure to asbestos?
ON TEST***** |
Bronchogenic carcinoma
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what is marasmus? (please list 4 things to describe it)
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Severe reduction in caloric intake
>60% reduction in normal body weight (for gender and height) Serum albumin is normal or mildly reduced Growth retardation and loss of muscle mass (somatic compartment primarily affected |
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if you have a patient with TB and multiple lung nodules what should you be thinking?
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Silicosis
due to Exposure to silicon dioxide |
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Cigarette smoking + asbestos exposure will have a synergistic effect leading to what disease?
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Bronchogenic carcinoma
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