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UWORLD Pathology
Round 4 UWORLD
| Question | Answer |
|---|---|
| What is the most common type of pericarditis? | Fibrinous pericarditis |
| How is Fibrinous pericarditis characterized? | Pericardial inflammation with a serous, fibrin-containing exudate in the pericardial space. |
| What are common and featured findings of acute pericarditis? | Pleuritic chest pain and a triphasic friction rub |
| What condition is associated with a Triphasic friction rub? | Pericarditis |
| What are the most common rheumatic diseases that can develop Pericarditis? | SLE and RA |
| What type of hypertrophy is associated with Aortic regurgitation? | Eccentric ventricular hypertrophy |
| What is the anatomical result of the eccentric ventricular hypertrophy seen with AR? | Dilated cavity with thin ventricular walls |
| Are fibers in AR ventricular hypertrophy added in series or in parallel? | Series |
| Eccentric hypertrophy adds fiber in parallel or series? | Series |
| Concentric hypertrophy adds fibers in parallel or series? | Parallel |
| What is a common cause of Eccentric ventricular hypertrophy? | Chronic AR from artic root dilation |
| Is DCM associated with systolic or diastolic heart failure? | Systolic heart failure |
| Is eccentric hypertrophy associated with volume overload or increased pressure? | Volume overload |
| What are valvular conditions that may result in DCM? | Aortic Regurgitation (AR) and Mitral Regurgitation (MR) |
| What is the result of chronic volume overload in Dilated Cardiomyopathy? | Progressive eccentric ventricular hypertrophy that eventually leads to reduced ventricular contractility and decompensated heart failure |
| What are the next steps in pathogenesis of chronic ventricular overload, as seen with DCM? | Eccentric ventricular hypertrophy --> reduced ventricular contraction ----> Decompensated heart failure |
| What is Epidermolysis bullosa? | Group of inherited disorders characterized by epithelial fragility |
| What condition can be suspected if the patient's skin is extremely fragile even with minor trauma? | Epidermolysis bullosa |
| What protein mutation is most often associated with the development of Epidermolysis bullosa? | Keratin |
| What is the most common cause of Epidermolysis bullosa (EB) simplex? | Keratin mutations |
| What cutaneous condition is due to mutations to protein in intraepidermal and dermo epidermal adhesion complex? | Epidermolysis bullosa |
| What are the key characteristics describing Psoriasis? | Hyperkeratosis and confluent parakeratosis of the Stratum Corneum, and epithermal hyperplasia (acanthosis) with elongated rete ridges |
| What dermatological conditions are associated with hyperkeratosis and parakeratosis of the S corneum? | Psoriasis |
| Which layer of the skin affected in Psoriasis? | Stratum Corneum |
| What is the name of the micro-abscesses in Psoriasis? | Munro micro abscesses |
| What condition is associated with Munro micro abscesses? | Psoriasis |
| Which hormones are secreted in excess in Acromegaly? | GH and Insulin-like growth factor-1 |
| What does the excess GH and IGF-1 in Acromegaly cause? | Hyperplasia of articular chondrocytes and synovial hypertrophy |
| What WBC infiltration cell is associated with DM type 1? | Islet Leukocytic infiltration in Pancreatic B-cell |
| What is the MCC of DM type 2? | Insulin resistance accompanied by relative insulin deficiency |
| What condition is associated with Dohle bodies in blood smear? | Leukemoid reaction |
| What are the most significant findings in blood smear of a Leukamoid reaction sample? | Neutrophilia with reactive features (Dohle bodies), and neutrophil precursors |
| What are neutrophil precursors? | Band, metamyelocytes, and myelocytes |
| How is the LAP (Leukocyte Alkaline Phosphatase) level, increased, decreased, or normal, in Leukemoid reaction? | Normal or increased |
| What is the most common inherited cause of hypercoagulability in young patients? | Factor V Leiden mutation |
| What does Factor V Leiden mutation cause? | Va resistance to inactivation by activated protein C |
| What condition is due to inability to inactivate a Factor V by activated protein C? | Factor V Leiden deficiency |
| What grading scale is used in Prostate cancer? | Gleason grade |
| What does the Gleason grade scale use in Prostate cancer measures? | Glandular architecture disruption and risk of extra-organ spread |
| Does a poorly diffentiated glandular structure get a high or low Gleason grade? | High Gleason grade |
| What zone of the prostate is most likely to give rise to prostate cancer? | Peripheral zone of the gland |
| What organ or structure is often affected by Prostate cancer growth? | Rectum |
| What is the best way to obtain a biopsy of Prostate cancer? | Transrectal approach and grabbing multiple random samples from the periphery of the gland |
| Which parts of the deep brain are often affected by Lacunar strokes? | Basal ganglia and Pons |
| What subcortical white matter areas of the brain are often damaged by Lacunar infracts? | Internal capsule and Corona radiata |
| What is the greatest risk factor for Lacuna Strokes? | Hypertension |
| Why does HTN is a risk factor for Lacunar strokes or infarcts? | Causes hardening/thickening of the vessel wall (hypertensive arteriolar sclerosis) |
| _____________ is a syndrome of prolonged, repetitive muscle contractions. | Dystonia |
| Which part of the brain is often damaged that leads to Dystonia? | Basal ganglia |
| What is another term used for Cervical dystonia? | Spasmodic torticollis |
| What are common examples of focal dystonia? | Spasmodic torticollis, Blepharospasm, and Writer's cramp |
| What is Myelopathy associated with vitamin B12 deficiency called? | Subacute Combined Degeneration |
| What transcription factor is associated with the immune response to infection? | Nuclear factors-kappa B (NF-kB) |
| What is the inactive form of NF-kB? | IkB |
| Where in the cell is NF-kB located? | Cytoplasm |
| What is contracture? | Excessive matrix metalloproteinase activity and myofibroblast accumulation in the wound margins |
| Which areas of the body are more prone to develop contractures? | Palms, soles, anterior thorax, or at serious burn sites |
| What are common synovial fluid findings of Septic arthritis? | High leukocyte count (> 100,000/mm3) and absent crystals |
| What is another term used for Pott disease? | Mycobacterium tuberculosis spondylitis |
| What condition is known to be mycobacterium infecting the vertebrae? | Pott disease |
| What are the most common autopsy findings of Anaphylaxis? | Upper airway edema, hyperinflammation of the lungs form airway obstruction, and cerebral edema from hypoxia |
| What type of edema is often seen in anaphylaxis? | Oropharyngeal edema |
| What kind of shock is associated with anaphylaxis? | Distributive shock |
| What is the name or term given to interatrial myocardial granules in carditis? | Aschoff bodies |
| Which condition is associated with Aschoff bodies? | Rheumatic fever |
| What are Aschoff bodies? | Interatrial myocardial granulomas |
| What contains Aschoff bodies? | Plump macrophages with abundant cytoplasm and central, slender ribbons of chromatic |
| What cells are strongly associated with Aschoff bodies? | Anitschkow, or caterpillar cells |
| What is the name of the macrophages forming Aschoff bodies? | Anitschkow, or caterpillar cells |
| What causes LVOT obstruction in hypertrophic cardiomyopathy? | Hypertrophied interventricular septum and abnormal systolic anterior motion of the anterior leaflet of the mitral valve |
| Which valve leaflet is associated with creating the LVOT obstruction seen HCM? | Mitral valve leaflet |
| What changes, proportionally, the degree of LVOT obstruction in HCM? | Change in left ventricular blood volume |
| What cells give rise the Medullary thyroid cancer? | Parafollicular Calcitonin-secreting C cells |
| Which tumor arises from Parafollicular calcitonin-secreting C cells? | Medullary Thyroid cancer |
| What is the histological description of Parafollicular Calcitonin-secreting C cells? | Nests or sheets of polygonal or spindle-shaped cells with extracellular amyloid deposits |
| Which thyroid cancer type is characterized by sheets of polygonal or spindle-shaped cells? | Medullary Thyroid cancer |
| What are common effects due to Sheehan syndrome in the mother? | Failure of lactation due to deficiency in prolactin |
| What condition or syndrome is associated with Peripartum hypotension? | Sheehan syndrome |
| What is the effect caused by Sheehan syndrome in the Pituitary gland? | Panhypopituitarism |
| What are disturbances or effects due to Atrophic gastritis? | Hypochlorhydria, low intrinsic factor production, low vitamin B12 deficiency, and elevated methylmalonic acid levels |
| What does the effect of reticulocyte count due to Vitamin B12 deficiency? | Reticulocyte count increase |
| Which artery is associated with Saddle pulmonary embolism? | Main pulmonary artery |
| What is a thrombolytic complication malignancy? | Hypercoagulable state and in a strong risk factor for DVT |
| How is Extramedullary hematopoiesis characterized? | EPO-stimulated, hyperplastic marrow cell invasion of extramedullary organs (liver and spleen) |
| What is the MCC of extramedullary hematopoiesis? | Severe chronic hemolytic anemias, such as Beta-thalassemia |
| What are the classic histopathologic findings of Syphilis? | Proliferative endarteritis with a surrounding plasma cell infiltrate |
| What are cavernous hemangiomas? | Vascular malformations that occur most commonly within the brain parenchyma |
| What are some complications of cavernous hemangiomas? | Intracerebral hemorrhage and seizure |
| What areas of the brain are most affected by small artery cerebral arteriosclerosis leading to Vascular dementia? | Subcortical areas |
| What are the main signs/symptoms of Vascular dementia? | Focal motor deficits, abnormal gait, urinary symptoms, and psychiatric symptoms |
| Which CNS cells are preferential by HIV to replicate? | Macrophages |
| What is the normal time range for SAH to occur after initial insult? | 3-12 days |
| What are the CT scan findings of SAH? | It remains unchanged |
| What is the effect on DNA by Ionizing radiation? | Cellular and DNA damage by generation of ROS |
| What are the GI tract mucosa effects due to ionizing radiation? | Abdominal pain and diarrhea due to mucosal denudation, inflammation, and edema |
| What type of GI cancer is associated with KRAS gene mutation? | Colorectal cancer |
| What does KRAS gene mutation generate? | Constitutive activation of the EGFR pathway, promoting increased cell proliferation and growth. |
| What are some examples of anti-EGFR drugs? | Cetuximab and Panitumumab |
| What is encoded by HER2 oncogene? | Transmembrane glycoprotein with intrinsic tyrosine kinase activity |
| What are the contents of material in Lobar pneumonia? | Cytokine-mediated accumulation of neutrophils and proteinaceous material in the alveoli |
| Which WBC type is associated with lobar pneumonia? | Neutrophils |
| What replaces the neutrophils in lobar pneumonia in the later stages of the disease? | Macrophages that digest fibrinous exudes |
| Is the infiltrate of Hypersensitive pneumonitis, lymphocytes or neutrophilic? | Lymphocytic infiltrate |
| What are histological findings of hypersensitive pneumonitis? | Lymphocytic infiltrate, poorly formed non-caseating granulomas, and septal fibrosis |
| What cells mediate Sarcoidosis disease, CD4+ or CD8+ T cells? | CD4+ T cells |
| What is an important ratio to be considered in Sarcoidosis? | High CD4+/CD8+ ratio |
| What are the nodes (bony enlargements) associated with OA? | Heberden nodes and Bouchard nodes |
| Which joint enlargement gives rise to the Heberden nodes? | Distal interphalangeal |
| What joint enlargement gives rise to the Borchard nodes? | Proximal interphalangeal |
| RA or OA. Bony enlargement of the DIP and PIP. | Osteoarthritis |
| RA or OA. Hand bones from osteophytes | Osteoarthritis |
| RA or OA. synovial hyperplasia, inflammatory infiltrates, and synovia angiogenesis. | Rheumatic arthritis |
| What replaces the joint space in RA? | Pannus |
| What is Pannus? | Invasive mass is composed of fibroblast-like synovial cells, granulation tissue and inflammatory cells |
| What kind of hypertrophy is seen with DCM? | Eccentric hypertrophy |
| Which cardiomyopathy is associated with eccentric remodeling of the left ventricle? | Dilated Cardiomyopathy |
| What type of arrhythmias are often fatal and due to DCM? | Ventricular arrhythmia |
| What is the mode of inheritance of Familiar DCM? | Autosomal dominant |
| What gene is truncated in Familiar Dilated Cardiomyopathy" | TTN gene |
| What does the TTN gene code for? | Sarcomere protein titin |
| Mutated TTN gene. Dx? | Familiar DCM |
| What is the single most important frisk factor foe Aortic dissection? | Hypertension |
| Along with HTN, what other risk factors for aortic dissection? | Smoking, DM, and hypercholesterolemia, as all these accelerate atherosclerosis, leading to aortic aneurysm and then aortic dissection |
| What can be the result of untreated or unfixed PDA? | Eisenmenger syndrome |
| What are some signs and symptoms of PDA? | Lower extremity with clubbing, and cyanosis without pulse discrepancy |
| How is cyanosis of PDA distinguished from cyanosis due to large septal defects and ToF? | Large septal defects and ToF cause whole-body cyanosis, while PDA cyanosis is seen in the lower extremities only |
| What is the histopathological description of atrial myxoma? | Amorphous extracellular matrix with scattered stellate or globular myxoma cells with abundant mucopolysaccharide ground substance |
| What specific cells indicate alveolar hemorrhage in cardiac patients? | Alveolar hemosiderin-Landen macrophages |
| What is the most common setting in which Hemosiderin-laden macrophages appear? | Chronic elevation of Pulmonary Capillary hydrostatic pressure in the setting of Left-sided HF. |
Created by:
rakomi
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