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113 Cards in this Set
- Front
- Back
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two or more non-inguinal sites of non tender lymphadenopathy
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Persistent Generalized Lymphadenopathy (PGL)
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how to diagnosis Persistent Generalized Lymphadenopathy (PGL)
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biopsy
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mechanism of AIDS Lymphoma
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EBV activates B cell activation and expansion which
increases in IL6R and growth factors |
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malignant neoplasm of lymphocytes in lymph nodes or GI tract or brain
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lymphoma
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MOA of B cell activation in AIDS Lymphoma
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protein 1 of EBV inhibits Bax (apoptotic) and increases Bcl2 (antiapoptotic) so B cells are around longer
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MOA of IL6R activation in AIDS Lymphoma
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C-terminal activation region of LMP-1 binds to TNFR and activates NFkB signaling pathway that increases IL2, IL2R, IL6
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what stage of HIV infection would you see neoplasms
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Stage 4
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what stage of HIV infection would you be asymptomatic and have PGL
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Stage 1
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what stage of HIV infection would you see >10% weight loss, chronic diarrhea, oral hairy leukoplakia, thrush
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Stage 3
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what stage of HIV infection would you see <10% weight loss, herpes zoster, and minor mucocutaneous lesions
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Stage 2
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HIV virus that proliferates in skin cells
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Molluscum contagiousum
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AIDS defining illness that is normally quiescent in dorsal root ganglion and spreads along dermatomes when reactivated
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Herpes Zoster
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baseline HIV tests important for specifying viral strain
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CD4 cell count
Plasma HIV-1 RNA HIV genotype |
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increased nitrogen due to increased urea & creatinine
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azotemia
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CD4 count associated with:
Kaposi's sarcoma Lymphoma, Tuberculosis |
500 cells/mm^3
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CD4 count associated with:
Pneumocystosis jirovecii pneumonia Toxoplasmosis Candidal esophagitis |
250 cells/mm^3
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CD4 count associatd with:
retina or conjunctival microvasuclopathy CMV retinitis Keratoconjunctivitis sicca VZV retinitis Mycobacterium avium Cryptococcus Microsporidosis HIV encephalopathy PML |
100 cells/mm^3
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percentage of AIDS pts with CNS involvement at autopsy
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90%
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central necrotic mass surrounded by edema and inflammation, favors neuron rich areas like cerebral cortex, basal ganglia and brainstem
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Toxoplasmosis
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protozoal from of Toxoplasmosis that causes tissue injury
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Tachyzoite
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protozoal form of Toxoplasmosis that fill cysts and pseudocysts collect around neurons and perivascular macrophages
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Bradyzoite
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clinical presentation of Toxoplasmosis
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seizures, hemiparesis, cranial nerve deficits, H/A, fever, lethargy
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image of Toxoplasmosis seen on CT scan
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ring enhancing lesions
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single most common CNS mycosis
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Cryptococcus neofromans
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Cryptoccomas
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choroid plexus based masses consisting of gelatinous material (due to capsular mucopolysaccharides)
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opportunistic demyelinating disease of the CNS caused by some DNA viruses such as JC and HIV-1; associated with defective cell mediated immunity
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Progressive Multifocal Leukoencephalopahty
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area of cerebral hemisphere affected by PML
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white matter
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appearance of PML affected oligodendrolions
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ground glass
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memory loss, impaired comprehension, apathy, tremor, gait disturbance in 15% HIV + adults and 30% of HIV + kids
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AIDS dementia
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AIDS related carcinomas with increased incidence
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uterine ca
anal ca |
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AIDS defining illness that is aggressive form of TB, acid fast stain
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Mycobacterium avium intracellulare
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Pneumocystic carnii pneumonia presentation in lungs
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cup-like cysts in alveoli
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kidney manifestation of HIV & heroine use
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focal segment glomerulonephritis (glomerulosclerosis)
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cardiac manifestations of HIV
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infectious endocarditis (right sided in IVDA)
myocarditis thrombotic endocarditis pericardial effusions premature atherosclerosis |
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biliary manifestation of HIV
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acalculous cholecystitis
sclerosis cholangitis pancreatitis NHL |
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AIDS defining neoplastic diseases
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Kaposi's Sarcoma
NHL (systemic, CNS) HL Cervical Carcinoma |
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how to name benign tumor
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cell type + -oma (i.e. adenoma)
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how to name malignant tumor
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carcinoma (epithelial cell origin)
sarcoma (mesenchymal cell origin) |
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exceptions to the rules of nomenclature of tumors
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melanoma *malignant
lymphoma *malignant |
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lack of differentiation
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anaplasia
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variation in size and shape
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pleomorphism
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disorderly proliferation
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dysplasia
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extent to which a tumor resembles a tissue of origin
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differentiation
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secondary tumor implants from malignant tumor
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metastasis
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type of tumor that may be encapsulated, well demarcated, locally invasive
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benign tumor
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type of metastasis typical of carcinomas
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lymphatic spread
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type of metastasis typical of sarcomas
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hematogenous spread to liver or lung
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lymphomas associated with EBV
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NHL, HL, Burkitt's Lymphoma
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bug that causes chronic gastritis which leads to stomach adenocarcinoma
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H. pylori
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hepatitis viruses associated with hepatocellular carcinoma
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Hep B, Hep C
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oncogene that overexpresses PDGR
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sis
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oncogenes that over expresses FGF
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hst-1, int-2
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associated with overexpression of EGF receptor
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erbB-1
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associated with amplification of EGF receptor
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erbB-2
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associated with point mutation
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ret
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point mutations, GTP binding, many carcinomas
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ras
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translocation, tyrosine kinase, CML, ALL
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abl
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translocation transcriptional activators, burkitt's lymphoma
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myc
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amplification, transcriptional activators, neuroblastoma, small cell cancer of lung, neuroblastoma
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N-myc
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amplification seen in breast ca, esophageal ca, and some lymphomas
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Cyclin D
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cancer suppressor gene associated with retinoblastoma
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rb
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cancer suppressor gene associated with colon, breast, lung ca, some sarcomas
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p53
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cancer suppressor gene associated with wilm's tumor
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wt
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cancer suppressor gene associated with ewing's sarcoma
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ews
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cancer suppressor gene associated with breast cancer
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brca-1
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cancer suppressor gene associated with colon and gastric ca
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DCC
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cancer suppressor gene associated with schwannoma, neurogenic sarcoma
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NF1
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cancer suppressor gene associated with schwannoma, meningioma
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NF-2
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cancer suppressor gene associated with colon, gastric, and pancreatic cancer
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APC
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kind of mutation that leads to HNPCC and xeroderma pigmentosum
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mutations in DNA repair genes
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genes that regulate apoptosis
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p53
bcl-2 |
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translocation associated with CML
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myc (t9:22)
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chromosomal deletion in non hemotopoietic tumors
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chr 13
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translocation associated with Burkitt's Lymphoma
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(t8:14)
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gene amplified in breast cancer
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c-erb B-2
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tumor cells are triggered into cell cycle more readily
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doubling time
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proportion of cells in the replicative pool
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growth fraction
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most tumor cells can enlarge without being vascularized
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1-2 mm
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mechanism of metastasis
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invasion of ECM---detachment of tumor cells---attachment of tumor cells to matrix---degradation of ECM---migration of tumor cells
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RNA oncogenic virus that results in leukemia
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HTLV-1
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paracrine stimulation of stellate stromal myofibroblasts with type I collage and c-fibronectin matrix production
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desmoplasia
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vary in size, shape, and number of follicles, often in children & adolescents, tingible body macrophages
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Follicular Hyperplasia
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common in kids and pple w/ significant infxn, may have inflamm. infiltrate
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Necrotizing Lymphadenitis
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unilateral posterior lymph nodes, reactive follicular hyperplasia, small aggregates of epithelial histiocytes, monocytoid B cells in subcapsular and trabecular sinuses
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Toxoplasmosis Lymphadenitis
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differentiates Follicular Hyperplasia of syphilis
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solitary inguinal lymphadenopathy
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type of granulomatous lymphadenitis in young women, fever, changes like SLE, macrophages with "C" shaped nuclei
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Kikuchi Disease
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type of granulomatous lymphadenitis with asteroid bodies, Schaumen bodies, calcium oxalate crystals
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Sarcoidosis
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type of granulomatous lymphadenitis with stellate abscesses surrounded by pallisading macrophages and histiocytes in germinal centers
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Cat Scratch Disease (Bartonella Henselae)
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immunocompromised patient with dermal lesions, increased capillaries, plump endothelial cells, granular eosinophilic material
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Bacillary Angiomatosis
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similar to cat scratch disease, negative silver stain, presence of chlamydia
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Lymphogranuloma Venereum
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cells with multiple nuclei and eospinophilic intranuclear inclusions in HIV related hyperplasia
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Warthin-Finkeldey
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core protein located in germinal centers of HIV related hyperplasia
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p24
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type of diffuse pattern lymphadenopathy that may resemble lymphoma, mottled appearance caused by immunoblasts & lymphocytes, cells may resemble RS cells
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infectious mononucleosis
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type of diffuse lymphadenopathy that used to be seen with smallpox vaccine, resembles infectious mono
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post vaccinial lymphadenitis
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type of diffuse lymphadenopathy associated with hypersentivity
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Dilantin hypersensitvity
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key feature of follicular hyperplasia in rheumatoid arthritis
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Russel bodies
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Type of Castleman's Disease with onion skin pattern mantle zone hyperplasia and lolipop hyalinized vessels
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Hyaline Vascular
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type of Castleman's Disease linked to HHV8
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multicentric
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type of Castleman's Disease with sheets of plasma, often asymptomatic
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Plasma Cell
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sinus histiocytes with massive lymphadenopathy, bilateral nontender cervical nodes, presents first two decades of life
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Rosai-Dorman Syndrome
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disease caused by Tropheryma Whippelii, foamy macrophages, sickle shaped bacillary organisms, malabsorption, hyperpigmentation, more in men
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Whipple Disease
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Lymphadenopathy, splenomegaly, hypergammaglobulinemia, autoimmune features, mutation of FAS (CD95)
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Autoimmunve Lymphoproliferative Syndrome
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mucocutaneous lymph node syndrome Kids, Conjunctivitis, Coronary artery Involvement, nodal architecture obliterated
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Kawasaki Disease
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first order organ where colon cancer metastasizes
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liver
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where prostate cancer metastasizes
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lumbar spine & pelvis
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expression of what by squamous cell carcinoma of the cervix allow it to avoid attack by CD8 cells or apoptosis
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FasL
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hematogenous metastasis of sarcoma goes to...?
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lungs
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hematogenous metastasis of lung ca goes to...?
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brain, liver, bone, adrenal
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hematogenous metastasis of colon ca goes to...?
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liver, lung
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hematogenous metastasis of rectal ca goes to...?
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lung, liver
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hematogenous metastasis of prostate ca goes to...?
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bone
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hematogenous metastasis of head and neck ca goes to...?
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lung
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hematogenous metastasis of breast ca goes to...?
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lung, liver, bone, brain
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