Pathology Test 4

Front 1

what are the physical symptoms of gigantism

Back 1

1. increased body size
2. disproportionally long arms and legs

Front 2

what are the physical symptoms of acromegaly

Back 2

1. growth of soft tissue, skin and viscera
2. bone enlargement of face, hands, feet and jaw
3. separation of teeth

Front 3

definition of hyperpituitarism

Back 3

excess production of anterior pituitary hormones caused by a functional adenoma

Front 4

what is the most common hyperfunctioning pituitary adenoma

Back 4

PROLACTINOMA
1. manifestation of hyperprolactinemia are more obvious in PREMENOPAUSAL women

Front 5

clinical manifestations of PROLACTINOMA

Back 5

1. amenorrhea
2. galactorrhea
3. loss of libido
4. infertility

Front 6

most cases of anterior pituitary hypofunction are caused by...(3)

Back 6

1. nonsecretory pituitary adenomas
2. ischemic necrosis of the pituitary
3. ablation of the pituitary by surgery or radiation

Front 7

what is the most common form of clinically significant ischemic necrosis of the anterior pituitary

Back 7

Sheehan's Syndrome

Front 8

what are the two morphological stages of Diffuse Non-Toxic Goiter

Back 8

1. hyperplastic phase where follicles are lined by crowded columnar cells
2. colloid involution when follicular epithelium is flattened and cuboidal, and colloid is abundant

Front 9

what are THREE important points about Multinodular Goiter

Back 9

1. can be NONTOXIC
2. may induce THYROTOXICOSIS
3. frequently mistaken for neoplasia

Front 10

morphologically multinodular goiter presents as...

Back 10

multilobulated asymmetrically enlarged glands

Front 11

multinodular goiter can clinically cause...

Back 11

1. airway obstruction
2. dysphagia
3. compression of large vessels
4. hyperthyroidism (toxic multinodular goiter)

Front 12

Graves Disease is characterized by...

Back 12

1. thyrotoxicosis
2. infiltrative ophthalmopathy
3. infiltrative dermopathy

Front 13

pathogenesis of Graves diseases...

Back 13

1. autoimmune disease
2. thyroid stimulating immunoglobulins binds to TSHr
3. thyroid growth stimulating immunoglobulins have been implicated in the proliferation of thyroid follicular epithelium

Front 14

what is the morphology of Graves disease

Back 14

diffuse hypertrophy and hyperplasia of thyroid follicular epithelium

Front 15

how would Graves Disease be diagnosed

Back 15

1. elevated circulating levels of free T3 and T4
2. THYROTOXICOSIS

Front 16

what are some symptoms of thyrotoxicosis

Back 16

OVER ACTIVE SYMPATHETICS
1. heat intolerance
2. hypermotility
3. malabsorption
4. palpitations
5. tachycardia
6. proximal muscle weakness
7. wide starring gaze

Front 17

what are TWO primary cause sof hypothyroidism

Back 17

1. hashimoto thyroiditis
2. iodine deficiency

Front 18

clinical manifestations of vitamin D deficiency is children

Back 18

1. frequent fractures
2. short deformed limbs
3. bowing legs
4. weakened growth zones in long bones

Front 19

cretinism

Back 19

1. occurs in offspring of iodine deficient mothers
2. impaired development of the skeletal system and CNS
3. MENTAL RETARDATION

Front 20

symptoms of myxedema

Back 20

1. cold intolerance
2. apathy
3. mucopolysaccharide-rich edema accumulates in skin and subcutaneous tissue
4. accounts for broadening and coarsening of facial features and enlargement of tongue

Front 21

what are two major clinical manifestations of hypothyroidism?
lab diagnosis?

Back 21

1. cretinism
2. myxedema

TSH level is increased
T4 levels are decreased

Front 22

morphologically what is diagnostic for thyroid tumor

Back 22

1. orphan annie nuclei
2. psamomma bodies represent calcified structures within papillae

clinical:
1. non-functional
2. painless
3. good prognosis

Front 23

what is the most common form of thyroid cancer

Back 23

papillary tumors
-associated with previous exposure to ionizing radiation

Front 24

definition of Cushing Disease

Back 24

primary hypothalamic-pituitary disease associated with hypersecretion of ACTH

Front 25

what causes Cushing Syndrome

Back 25

1. adrenal adenoma
2. adrenal carcinoma
3. bilateral hyperplasia

Front 26

what are some clinical signs of Cushing Syndrome

Back 26

1. hypertension
2. weight gain
3. moon face and buffalo hump
4. osteoporosis
5. cutaneous striae
6. INCREASE serum cortisol

Front 27

what is primary hyperparathyroidism caused by?
secondary?

Back 27

PRIMARY:
autonomous hyperplasia or a tumor
*usually an adenoma

SECONDARY:
prolonged states of hypocalcemia

Front 28

what is morphologically significant in regards to hyperparathyroidism

Back 28

1. dissecting osteitis (cancellous bone osteoclast, railroad tracks)
2. osteopenia (decreased bone density)

Front 29

what are the hallmark signs of hyperparathyroidism

Back 29

1. increased bone cell
2. peritrabecular fibrosis
3. cystic brown tumors

Front 30

what are beta cells

Back 30

beta cells synthesize and secrete insulin and make up 70% of the islet

Front 31

what are characteristics of chronic renal failure

Back 31

1. results in hyperphosphatemia
2. hypocalcemia develops (damaged kidneys)
3. PTH secretions INCREASES at all levels of serum calcium
4. INCREASE osteoclast activity
5. metabolic acidosis

Front 32

what are the clinical and genetics prevalence of type 1 DM

Back 32

1. CHILDREN
2. NORMAL weight
3. DECREASED blood insulin
4. KETOACIDOSIS
5. anti-inslet antibodies
6. 40% twin concordance

Front 33

what are the clinical and genetics prevalence of type 2 DM

Back 33

1. ADULTS
2. OBESITY
3. normal or increased blood insulin
4. KETOACIDOSIS
5. no anti-islet antibodies
6. 60-80% twin concordance

Front 34

what is the pathogenesis and islet activity of type 1 DM

Back 34

1. autoimmune-immunopathic mechanism
2. severe insulin deficiency
3. insulinitis followed by atrophy and fibrosis
4. severe beta-cell depletion

Front 35

what is the pathogenesis and islet activity of type 2 DM

Back 35

1. insulin resistance
2. no inflammation of islet cells
3. focal atrophy/amyloid deposition
4. mild beta-cell depletion

Front 36

what are the THREE important points for type 1 DM

Back 36

1. inflammatory cell infiltrates (CD4+, CD8+ T cells and macrophages)
2. islet beta cells are selectively destroyed by CD8+ T Cells
3. autoantibodies to islet cell antigen indicates a risk for type 1 DM

Front 37

what are the two metabolic defects that characterize type 2 diabetes

Back 37

1. derangement in beta cell secretion of insulin
2. decreased response of peripheral tissues to respond to insulin

Front 38

derangement of beta cell secretion of insulin in type 2 DM may cause

Back 38

decrease in beta cell mass and islet degeneration, may be associated with deposition of islet amyloid (AMYLOIDOSIS)

Front 39

what are the quantitative and qualitative abnormalities of the insulin signaling pathway that leads to decreased response of peripheral tissues to respond to insulin

Back 39

1. down regulation of the insulin receptors
2. decreased insulin receptor phosphorylation and tyrosine kinase activity
3. reduced levels of active intermediates in the insulin signaling pathway

Front 40

lab diagnosis for DM 2

Back 40

1. a random glucose > 200mg/dL, with classical signs and symptoms
2. a fasting glucose > 126mg/dL on more than one occasion
3. abnormal oral glucose tolerance test, in which glucose is >200mg/dL 2 hours after a standard carbohydrate load

Front 41

what are FOUR morphological complications of diabetes...

Back 41

1. atherosclerosis
2. microangiopathy
3. diabetic nephropathy
4. neuropathy

Front 42

what is a tonsillar herniation (cerebellar coning)

Back 42

impaction of cerebellar tonsils in foramen magnum results in...
1. compression of medulla
2. RESPIRATORY ARREST
3. death

Front 43

what are the important consequences of IIP

Back 43

1. hemorrhage into midbrain and pons
2. papilledema due to compression of retinal vein

Front 44

what are the FOUR routes of infection in the CNS

Back 44

1. through blood (MOST COMMON)
2. direct implantation (traumatic)
3. local extension
4. peripheral nerves

Front 45

what are the common organisms associated with acute pyogenic meningitis

Back 45

1. H. influenzae
2. meningococci
3. pneumococci
4. E. coli

Front 46

what is a clinical picture of acute pyogenic meningitis

Back 46

1. subarachnoid space is filled with infecting organisms and neutrophils
2. CSF cloudy and purulent
3. PHOTOPHOBIA
4. increased intracranial pressure
5. increased protein
6. decreased sugars

Front 47

what is an example of VIRAL Meningitis

Back 47

ARBOVIRUS ENCEPHALITIS
1. most common cause of epidemic encephalitis
2. EASTERN EQUINE ENCEPHALITIS

transmission:
horse->mosquito->man

Front 48

what is the most common etiology of intracranial hemorrhage

Back 48

HYPERTENSION
-results from rupture of microaneurysms (Charcot-Bouchard) at bifurcation of intraparenchymal arteries

Front 49

where is the most common sit for Charcot-Bouchard aneurysm to occur

Back 49

lenticulostriate arteries (branches of Middle Cerebral Arteries)

VERY SMALL BLOOD VESSELS

Front 50

what is the most common cause of subarachnoid hemorrhage

Back 50

1. blood in subarachnoid space between arachoid and pia mater
2. rupture of berry aneurysm at bifurcations of major cerebral arteries (circle of willis)
3. associated with heavy exercise

Front 51

multiple sclerosis

Back 51

1. demyelinating disease of CNS
2. common in middle aged white women

Front 52

what is the clinical presentation of MS

Back 52

1. paresthesias, sensory or motor symptoms in a limb
2. abnormal gait
3. urinary urgency
4. optic neuritis (blurring vision)
5. mental dysfunction
6. paraplegia

Front 53

what are the TWO main degenerative disease of the cerebral cortex

Back 53

1. Alzheimer Disease (ACh deficiency)
2. Pick Disease

-causes dementia

Front 54

Parkinson Disease is defined as

Back 54

aka Paralysis Agitans
1. degeneration of dopaminergic neurons and fibers of substantia nigra and striatum
2. causes tremors and rigidity
3. slowness of movements with gait
4. pill rolling tremors

Front 55

Lou Gehrigs Disease

Back 55

1. Amyotrophic Lateral Sclerosis
2. most common form of motor neuron disease

Front 56

UPPER Motor Lesion in Lou Gehrigs causes...

Back 56

1. spastic paralysis
2. hyperactive stretch reflexes (Babinski reflex)
3. NO MUSCULAR ATROPHY

Front 57

LOWER Motor Lesion in Lou Gehrigs causes...

Back 57

1. MUSCULAR ATROPHY
2. flaccid paralysis
3. absence of reflex responses
3. most common form of Lou Gehrigs