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Pathology

FA review Round 2 2020

QuestionAnswer
What is the cause of Bell's palsy? Facial nerve (CN VII) lesion
What are clinical features of Bell's palsy? 1. Ipsilateral dry eye 2. Ipsilateral dry mouth, and decrease sense of taste 3. Ipsilateral retroauricular pain 4. Increased sensitivity to noise and facial paralysis
Malignant neoplasm of plasma cells Multiple myeloma
What are some characteristics of Multiple Myeloma (MM)? 1. Lytic bone lesions 2. Hypercalcemia, Proteinuria 3. Monoclonal immunoglobulin spike
What is the name for the proteins seen in Multiple myeloma due to nephrotoxic effects? Bence-Jones proteins
How are the lytic bone lesions in MM described in the skull? Punch-out lesions in the skull
Where in the anatomy of the brain do Medulloblastomas in children are most commonly located? Cerebellar midline
What is the histological description of childhood Medulloblastomas? Small blue cells arranged in Homer-Wright rosettes
Common cerebellar midline tumor in children. Medulloblastoma
What are the common focal deficit symptoms seen with Medulloblastomas? Gait disturbances and ataxia
A kid has a "funny" gait and ataxia. What is the most probable brain tumor causing such symptoms? Medulloblastoma
What brain tumor in children is often found in the Cerebellar midline? Medulloblastoma
Which is the main hepatitis virus associated with Hepatocellular carcinoma? Chronic Hepatitis C infection
What are the main labs to Hepatocellular carcinoma? 1. Elevated AFP levels 2. Increased INR
Which GI tumor is seen with elevated levels of AFP? Hepatocellular carcinoma
In HCC, is serum AFP elevated or decreased? Elevated
What is a common complication in a person in chemotherapy due to a leukemia or lymphoma? Tumor Lysis syndrome
What is a very likely cause of death in people with Tumor Lysis syndrome (TLS)? Cardiac arrhythmias
What causes the arrhythmias in Tumor Lysis syndrome? Excess serum K+ and Low Ca2+ in blood, which lead to weakness and cardiac arrhythmias
Is TLS seen with hyper- or Hypokalemia? Hyperkalemia
What are the main electrolyte abnormalities produced by Tumor Lysis syndrome? 1. Hyperkalemia 2. Hypocalcemia 3. Hyperuricemia
What arthritis condition is often seen with Tumor Lysis syndrome? Gout due to excess uric acid, which then causes renal failure
What are the treatment options for Tumor Lysis syndrome? Allopurinol and Rasburicase
Which ocular condition is treated with Bevacizumab? Wet Macular degeneration
What is the MOA of Bevacizumab? Monoclonal antibody that inhibits VEGF
What Growth Factor (GF) is targeted by Bevacizumab? VEGF
Which anticancer drug is known to be a monoclonal antibody to VEGF? Bevacizumab
What is the function of VEGF? Promotion of blood vessel proliferation, expansion, and overexpression.
What is commonly used to treat Wet Macular degeneration? Bevacizumab
What is a possible and suspected nephrogenic condition that involves fever, rash and deteriorating renal function after antibiotic use? Acute Interstitial nephritis
What is Acute Interstitial Nephritis? Pattern of renal injury usually associated with an abrupt deterioration in renal function characterized histopathologically by inflammation and edema of the renal interstitium
What are the most common antibiotics that cause AIN? Penicillins, Cephalosporins, and Sulfonamides
What is expected to be found in the urine sample of AIN? WBC casts and Eosinophilia
A urine sample with WBC casts and eosinophils should raise suspicion of what renal condition? Acute Interstitial nephritis
What important characteristic is seen in histological examination of Squamous cell cancer of the skin? Keratinization
Squamous cell cancer of the skin is: Locally invasive skin cancer; rarely metastasizes
Squamous cancer of skin is more common in the upper or lower lip? Lower lip
Which type of skin cancer is often seen in the Upper lip are? Basal cell carcinoma
Which type of skin cancer is seen in the lower lip most commonly, Basal cell or Squamous cell cancer of the skin? Squamous cell carcinoma
What is the gross description of Squamous cell carcinoma of the skin? Scaly, ulcerated lesion with irregular borders
Basal cell or Squamous cell carcinoma of the skins is associated with telangiectasias? Basal cell carcinoma
What are common associated conditions of Squamous cell cancer of the skin? 1. Immunosuppression 2. Chronic non-healing wounds 3. Occasionally arsenic exposure
A patient has been exposed to arsenic, which type of skin cancer is more commonly to develop? Squamous cell carcinoma
What is the key lesion or feature fo Squamous cell skin cancer? Ulcerative red lesions
What is a common dermatologic condition to Squamous cell skin caner? Actinic keratosis
What is Actinic Keratosis? A scaly plaque, which is a precursor of Squamous cell carcinoma of the skin
What are the risk factors for breast cancer? 1. Increased estrogen exposure 2. Family Hx in first-degree relatives 3. Obesity 4. African descent
What are examples of conditions that lead to an increased Estrogen exposure in females? 1. Early menarche 2. Late menopause
What is the most common of all breast cancers? Invasive ductal cancer
Of all the breast cancer types, which has the worst prognosis? Inflammatory breast cancer
What is the clinical presentation of Gastric adenocarcinoma? Decreased weight, abdominal pain, and early satiety
What are some common metastasis sites of Gastric cancer? 1. Periumbilical node ==> Sister Mary Joseph node 2. Left Supraclavicular adenopathy ====> Virchow node
Where is the "Sister Mary Joseph node" located? Periumbilical
What cancer is associated with "Sister Mary Joseph node"? Gastric adenocarcinoma
What is the name of the tumor that travels (primary tumor) from the stomach to the Ovary? Krukenberg tumor
Krukenberg tumor goes from the _______________ to the ___________. Stomach --------> Ovaries
What is a common and severe renal complication usually happening 2-3 weeks after an episode of self-resolving strep throat infection? Postinfectious (strep) glomerulonephritis
PSGN is what type of hypersensitivity reaction? Immune-mediated type III
PSGN is a type I, II, III, or IV hypersensitivity reaction? Type III
What is the MCC of Intraparenchymal hemorrhage? Systemic hypertension
Signs and symptoms seen in Intraparenchymal hemorrhage? Headache, vomiting, decreased level of concionciness,and increased ICP
What type of cerebral hemorrhage is due to rupture of a berry aneurysm? Subarachnoid hemorrhage
PCOS is associated with development of what type of cerebral hemorrhage? Subarachnoid hemorrhage
Hypertensive vasculopathy often leads to what type of cerebral hemorrhage? Intraparenchymal hemorrhage
Where is the blood seen the CT of a intraparenchymal hemorrhage? Parenchyma and ventricles
Where is the blood collected or seen in a CT of a Subarachnoid hemorrhage? Near circle of willis, cisternae, and fissures
What is the pathogenesis of Primary dysmenorrhea? Involves myometrial stimulation via Prostaglandin release at menses
How is Primary dysmenorrhea commonly presented? Painful menses, caused by uterine contraction to decrease blood loss resulting in ischemic pain
What is the usual treatment for pain caused by Primary dysmenorrhea? NSAIDs
What is the definition of Executive function? Ability to organize and perform tasks
What test is usually performed to test Executive function? Clock drawing test
How is a deficit to Executive functioning commonly presented? 1. Decreased working memory 2. Decreased inhibition (impulsivity) 3. Decreased emotional control
Craniopharyngiomas: Account for 80-90% of neoplasm arising in the pituitary region
What is the MC supratentorial tumor of childhood? Craniopharyngiomas
How are Craniopharyngiomas commonly presented? 1. Elevated ICP --> early morning headaches, Nausea, and Vomit 2. Endocrine dysfunction --> Increased thirst an urination due to diabetes insipidus and stunted growth 3. Visual disturbances
Description of a cluster headache: Severe, recurrent, and unilateral headache with conjunctival injection, lacrimation, rhinorrhea, and transient Horner syndrome
Which type of headache is seen with transient Horner syndrome? Cluster headache
Cluster headaches are commonly bilateral or unilateral? Unilateral
Unilateral, severe headache, that causes rhinorrhea, lacrimation, and red eyes. Cluster headache
What is the prophylaxis medication for Cluster headaches? Verapamil
What is used as treating acute episodes of cluster headaches? Sumatriptan and 100% oxygen
When is Verapamil used in headache? Prophylaxis of Cluster headaches
What is another name for Kartagener syndrome? Primary Ciliary dyskinesia
What is the deficit leading to Kartagener syndrome? Dynein arm defect that results in subfertility and infertility, in women and men, respectively.
What cardiac condition is characteristic of Kartagener syndrome? Dextrocardia
Dynein arm defect. Dx? Kartagener syndrome
What are Dynein arms? Heavy changs in colis and stems that attach from a microtubule pari iwithni the axoneme of cilia or flagella toward and adjacent pair
Multiple Myeloma is characterized by: Clonal proliferation of plasma cells that produce monoclonal immunoglobulin
What lung condition is often seen with Multiple Myeloma? Lobar pneumonia with consolidation of the lower lobes
What is a common and dangerous complication of Aortic dissection? Cardiac tamponade
What are common symptoms of Aortic dissection? 1. Tearing chest pain, radiating to the back 2. Asymmetric pulses
What causes the asymmetric pulses seen in Aortic dissection? Involvement of the aortic arch or possibly the descending aorta
Which vessels are involved in cases that produce asymmetric pulses? Aortic arch and/or descending aorta
Stone obstruction of the Common Bile duct Choledochlithliasis
What are the 3 clinical features of Choledocholithliasis? 1. RUQ pain 2. Jaundice 3. Cholestatic Pattern of Liver test results
What are the main measurement or levels measured in Liver testing? ALP, AST/ALT, and bilirubin
What liver test result is grossly elevated in cholestatic patterns? ALP
Lab results: - Grossly elevated ALP - Elevated bilirubin - Mild elevation/Normal ALT/AST Represents what liver test pattern? Cholestatic
What liver test is the most elevated in a Hepatitis? Grossly elevated AST/ALT, compared to ALP
What is the sign that indicates Cholecystitis? (+) Murphy sign
What condition is dx with a (+) Murphy sign? Cholecystitis
What is the Murphy sign? Pain upon inspiration, when the inflamed gallbladder comes into contact with the examiner's hand
Placenta attaches to myometrium without penetrating it. Dx? Placenta accreta
What is a common cause of Post-partum bleeding? Placenta accreta, in case that a vaginal delivery was attempted
MM is caused by: Neoplastic proliferation of monoclonal plasma cells that produce large amounts of IgG, resulting in elevated levels of serum proteins
What causes the appearance of Bence-Jones proteins in urine in a patient with MM? Large amounts of IgG produced by neoplastic plasma cells
Where do UMN have their cell bodies? Cortex and brainstem
Where do UMN synapse? Ganglia of LMNs at the Anterior Horn
What is mainly modulated by UMNs? Voluntary control and reflexes of skeletal muscle
UMN lesion is seen in damage to the: Neurons PROXIMAL to the Anterior Horn of the Spinal cord
Are UMN proximal or distal to the Anterior Horn of the Spinal cord? Proximal
Are LMN proximal or distal to the Anterior Horn of the Spinal cord? Distal
Which, LMN or UMN, are proximal to the Anterior Horn of the Spinal cord? UMN
What is the MC presentation, in respect to clinical symptoms, of Sickle cell trait? Generally benign
What is the abbreviation used in Sickle cell trait? HbSA
Autoimmune demyelinating disease that most often occurs in women in their 20s and 30s. Multiple Sclerosis
What are common symptoms of Multiple Sclerosis? Optic neuritis, INO, and nonspecific neurologic deficits (numbness, tingling, and weakness)
What are the two main causes of Duodenal ulcers? H. pylori infection and chronic use of NSAIDs
Besides H. pylori and NSAIDs, what is a common environmental factor that causes Duodenal ulcers? Tobacco smoking
What is the Chvostek sign? Facial muscle twitch that occurs on tapping over CN VII on the cheek, and is an specific finding of Hypocalcemia.
What electrolyte level produces a (+) Chvostek sign? Hypocalcemia
Which GI condition is often associated with a (+) Chvostek sign? Acute pancreatitis
What causes hypocalcemia in acute pancreatitis? Sequestration of Calcium secondary to intraperitoneal saponification
A person with an acute event of pancreatitis, is expected to also have a positive _______________ sign. Chvostek sign
Which virus is associated with CNS lymphomas? EBV
What population is often seen with solitary CNS lymphomas? Immunocompromised (AIDS)
EBV is: - Herpes virus (HHV-4) - Infects B cells through the CD21 receptor
What cells are infected by EBV? B cells
How can EBV infect B cells? Through CD21 receptor attachment
How do EBV cause development of lymphomas in AIDS patient? Viral protein within B-cells inhibitor apoptosis, promote proliferation, and have protective mechanism to go unrecognized by cytotoxic T-cells
What is produced by Type II pneumocytes? Surfactant
What is the function of surfactant? Decrease alveolar surface tension
Histological description of Type II pneumocytes: Cuboidal non-ciliated epithelial cells
Which respiratory cells are cuboidal, nonciliated epithelial cells? Type II pneumocytes
What are the immunohistochemical stains for SLL? (+) CD5 and (+) CD23
Which malignancy is seen with (+) CD5 and (+) CD23? SLL
Preeclampsia is characterized by: Hypertension, proteinuria, and edema after 20 weeks of gestation
What are the complications of Preeclampsia? 1. HELLP syndrome 2. Eclampsia/ seizure 3. Acute kidney injury
What is the treatment of Pre-eclampsia? 1. Antihypertensives 2. IV Magnesium sulfate (to prevent seizures) 3. Delivery of fetus
What is an important cause of Dilated Cardiomyopathy (DCM)? Autoimmune cardiac myocytes
What is the Trousseau syndrome? Migratory thrombophlebitis seen in advanced Pancreatic tumors
What is an important factor leading to development of the Trousseau syndrome? Tissue factor
What is caused by the liberation of tissue factor and seen in Pancreatic cancer? Trousseau syndrome
What is the Hepatorenal syndrome? Progressive form of renal failure caused by a reduction in GFR due to declining liver function
How is the kidney anatomy affecte in Hepatorenal syndrome? Unaffected
Which liver-renal condition is seen with normal size and shape of kidneys? Hepatorenal syndrome
What is Cachexia? Chronic condition in which the muscles weaken and waste
What are some cytokines involved in Cachexia? TNF-alpha, IL-1, IL-6, and C5a
What are some actions in which TNF-a, IL-1, IL-6, and C5a cytokines are involved? Fever, weight loss, and recruitment of the late phase cytokines
What is a possible consequence of chronic alcoholism? Alcoholic Cerebellar degeneration
What are some characteristics of Alcoholic cerebellar degeneration? Gait impairment, and later cause dysarthria, intermittent diplopia and blurred vision
What is the association in fetus with mothers with a n elevated AFP? Open NTDs
Which CSF maternal level leads to development of Open NTDs? Elevated AFP
What are some common Open NTDs? Meningocele, Mielomeningocele, encephalocele, and anencephaly.
Spina bifida oculate is seen with ________________ levels of AFP. Normal
Which is the only Open NTD seen with a normal level of AFP in the mother? Spina bifida oculta
How are NTDs prevented? Adequate intake of Folic acid by the mother during pregnancy
What are common causes of intestinal obstruction in neonates? Intestinal atresias
What is a common proximal intestinal atresia associated with Down syndrome? Duodenal atresia
What is the cause of Duodenal atresias? Failure of recanalization of the GI tract during embryogenesis
Failure of recanalization of the GI tract during embryogenesis is the main cause of: Duodenal atresia
What intestinal atresia is associated with Down syndrome? Duodenal atresia
How is a duodenal atresia commonly presented? Quickly after birth with intractable emesis
How is renal perfusion maintained in patients with bilateral renal artery stenosis? Kidneys are highly dependent of AT II levels in order to maintain renal perfusion
Which enzyme is particularly vital in renal perfusion in patients with bilateral RAS? AT II
Which medications are not contraindicated but must be used with extreme caution in patients with bilateral RAS? ACE-inhibitors
How is Basal cell carcinoma of the skin presented? Pink or Flesh-colored pearly papules, on sun-exposed skin that can be locally invasive, but virtually never metastatic
What is the histological description of Basal cell carcinoma of the skin? Purely basaloid population with minimal stromal response, areas of palisading nuclei, and small fusiform with litter cytoplasm
Palisading nuclei is seen in which type of skin cancer? Basal cell carcinoma
What thromboembolic condition is often associated with Pancreatic cancer? DVTs (pulmonary embolism)
What are the classic signs of Pancreatic cancer? 1. Weight loss 2. Painless jaundice 3. Migratory thrombophlebitis
The presence of Trosseum syndrome and other Pancreatic cancer symptoms raise the risk for: Hypercoagulopathy leading to development of DVTs
What thyroid condition is a self-limiting disease that follows a Flu-like illness? Subacute thyroiditis
How is Subacute thyroiditis thyroid gland presented? Tender and largedc
Is the goiter in Subacute thyroiditis painful or non-painful? Painful
What are the findings of the bx of a Subacute thyroiditis thyroid gland sample? Inflammatory infiltrate with multinucleated giant cells
Which is the mature defense mechanism, Repression or Suppression? Suppression
Immature or Mature self defence mechanism. Repression? Immature
Ego defense mechanism defined by consciously withholding negative thoughts or feelings. Suppression
If a person deliberately avoids and/or withholds negative feelings or thoughts, by changing topics or avoiding such discussions, such action is known as _________________. Suppression
Subconsciously withholding negative thoughts or feelings. Repression
What conditions is known to develop UMNs and LMNs deficits? Amyotrophic Lateral Sclerosis (ALS)
What parts of the Spinal cord are affected by ALS? Anterior horn and Corticospinal tracts
Which condition is known to affect anterior horn and corticospinal tracts? Amyotrophic Lateral Sclerosis (ALS)
What lab measures are characteristically elevated by Vitamin B12 deficiency? Methylmalonic acid and Homocysteine
What type of anemia is developed by Vitamin B12 deficiency? Megaloblastic anemia
ACTH is elevated or decreased by Primary Adrenal insufficiency? Elevated
Which autoimmune condition is characterized by low levels of 11-deoxycortisol and cortisol, and elevated ACTH? Primary Adrenal insufficiency
What causes in Addison disease the elevated levels of ACTH? Atrophic adrenal glands cannot respond to ACTH
How does ARDS affect End-Diastolic filling pressure and PCWP? Unaffected
List of ARDS clinical associations: 1. Diffuse, pulmonary infiltration CXR 2. Hypoxemia, increased A-a gradient, and decreased lung compliance 3. Increased pulmonary arterial pressure
What is the MCC of Prerenal azotemia? Hypoperfusion of the kidneys, which can be secondary to hypovolemia as a result of bleeding.
What is the urine osmolarity of Prerenal azotemia? > 500 mOsm/kg
Urine sodium in prerenal azotemia is: < 20 mEq/L
If the Fractional excretion of Na+ in prerenal azotemia < 1% or >2%? < 1%
A BUN;Cr ratio > 20 indicates what type of renal injury? Prerenal azotemia
Granulomatosis with polyangiitis is (+) for: c-ANCA
(+) c-ANCA vasculitis. Dx? Granulomatosis with polyangiitis
What are some features or Granulomatosis with polyangiitis vasculitis? 1. (+) c-ANCA 2. Necrotizing granulomas i the lungs and upper airways 3. Necrotizing glomerulonephritis
Which vasculitis is known to develop necrotizing granulomas in lungs and Upper airways, and necrotizing glomerulonephritis? Granulomatosis with polyangiitis
Which malignancies are associated with the appearance of Ferruginous bodies? Bronchogenic carcinoma and Mesothelioma
Which is more common to occur Mesothelioma or Bronchogenic carcinoma? Bronchogenic carcinoma
What is an important and key histological finding in Bronchogenic carcinoma and Mesothelioma? Ferruginous bodies
What are histological features or Whipple disease? Presence of numerous Foamy macrophages in the lamina propria of the small intestine
What type of stain is used in identifying the foamy (vacuolated) macrophages of Whipple disease? Hematoxylin and Eosin stain
TIBC in Hemochromatosis is: Decreased
What causes the decrease of TIBC in Hemochromatosis? Downregulation and saturation of Transferrin
In Primary Adrenal insufficiency, ACTH is: Elevated , due to absence of negative feedback by Cortisol
Another name for IgA nephropathy? Buerger disease
What disease is seen with IgA immune-complex deposits in the mesangium as seen with IF? Buerger disease
Which nephropathy occurs concurrently with an URI tract infection? Buerger disease
What is the typical ratio of ALT and AST in alcoholic patients? AST 2:1 ALT
If the level of AST is nearly twice the level of ALT is safe to suspect cirrhosis due to: Alcoholism
Created by: rakomi
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