Pathology - USMLE Flashcards

Terms Definitions
Ulcerative colitis
Colonic adenocarcinoma
Skin (SCC), liver (angiosarcoma)
Cancer Epidemiology: Female Mortality?
Liver (centrilobular necrosis, fatty change)
Autoimmune diseases (e.g., Hashimoto's thyroiditis, myasthenia gravis)
X-linked or AR:: Cystic fibrosis
Cancer Epidemiology: Female incidence?
Breast (32%)>Lung(13%)>Colorectal(13%)
TUMOR SUPRESSOR GENES: osteosarcoma is associated with what tumor supressor gene mutation
Macro-ovalocytes in the peripheral blood smear are formed from what cell in the bone marrow?
What ovarian carcinoma is characterized by psammoma bodies?
what childhood brain tumor presents with hydrocephalus and rosettes?
what presents with pancreatitis?
hyperchylomicronemia and hypertriglyceridemia?
Common sites that receive metastatic tissue: Most common organ sending metastases?
X-linked or AR:: glycogen storage diseases
What X-linked recessive disease involves mental retardation, self-mutilation, choreoathetosis, spasticity, a decrease in HGPRT, and an increase in uricemia?
Lesch-Nyhan syndrome
What slow-growing primary CNS tumor that affects mostly females is associated with psammoma bodies?
What disorder is associated with spider angiomas, palmar erythema, gynecomastia, testicular atrophy, encephalopathy, abnormalities in clotting factors, and portal HTN?
What disorder causes joint stiffness that worsens with repetitive motion, crepitus, effusions, and swelling and commonly affects the knees, hips, and spine?
What organ must metastasize for carcinoid heart disease to occur?
What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?
Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
What illegal drug can cause rhabdomyolysis, MI, cerebral infarct, and lethal cardiac arrhythmias?
what is marker of yolk sak tumor
What population is Buerger's seen in?
heavy smokers
what is the precursor for amyloidosis confined to pituitary?
what procedure is DIAGNOSTIC of cholecystitis?
HIDA scan
Bleeding Disorders: What disorder type presents with hemarthroses (bleeding into joints), easy brusing, prolonged PT and/or PTT?
Coagulopathies (macrohemorrhages), which can be caused by Hemophilia A/B and von Willebrand's disease (most common)
Autosomal-dominant diseases: What are the clinical findings in Von-Hippel-Lindau disease?
hemiangioblastomas of retina/cerebellum/medulla; about half of affected individuals develop multiple bilateral renal cell carcinomas and other tumors.
What is released from the mitochondria to trigger apoptosis?
Cytochrome c
What renal pathology involves uniform thickening of the glomerular capillary wall, granular appearance under the microscope, and effacement of foot processes?
Membranous glomerulonephritis
What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
Kimmelstiel-Wilson disease
Name the product or products of arachidonic acid:
• Vasodilation and inhibition of platelet aggregation produced by vascular endothelium
Starry sky appearance of macrophages is pathognomonic of what lymphoma?
Burkitt lymphoma
Name the cancer associated with the following oncogenes. (Some may have more than one answer)
• N-myc
Name the type of necrosis.
• Histologically resembles fibrin
Fibrinoid necrosis
What coronary artery vasculitis is seen in Japanese infants and children less than 4 years old with acute febrile illness, conjunctivitis, maculopapular rash, and lymphadenopathy?
Kawasaki disease
What type of neurofibromatosis is associated with bilateral acoustic schwannomas?
Type 2
What is the most common primary malignant tumor in bone?
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples.
• Cardiac muscle
What condition results in the following CSF results?
• Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
Bacterial meningitis
what is characterized by osteoid matrix accumulation around trabeculae?
vitamin D deficiency
what childhood brain tumor is cystic with a tumor nodule?
pilocytic atrocyteoma
what the pathogenesis of syphillis indruced aortic aneurysm?
vasa vasorum obliteration
what are the immunoglobulins produced in multiple myeloma?
IgG and IgA
5a-reductase deficiency: Describe genital development in 5a-reductase deficiency.
Ambiguous genitalia until puberty, when increased testosterone causes masculinization of genitalia.
Aplastic Anemia: Patient presentation of Aplastic Anemia?
Patients with pancytopenia characterized by severe anemia, neutropenia, and thrombocytopenia caused by failure or destruction of multipotent myeloid stem cells.
Most common lethal genetic disease of Caucasians.
Cystic Fibrosis
Congenital Heart Disease: Name 3 common L-to-R shunts.
What autoimmune liver disease is characterized by affecting a middle-aged woman with jaundice, pruritus, fatigue, xanthomas, increased direct bilirubin levels, and antimitochondrial Abs?
Primary biliary cirrhosis
What urinary metabolite is elevated in pheochromocytoma?
Vanillylmandelic acid (VMA)
What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
Duodenal ulcer
What myeloid disorder is characterized by dry bone marrow aspirations, splenomegaly, leukoerythroblastosis, teardrop RBCs, and hyperuricemia due to increased cell turnover?
Myelofibrosis with myeloid metaplasia
What skin condition is a localized proliferation of melanocytes presenting as small, oval, light brown macules?
Benign lentigo
What is the most common infectious agent in HIV?
Pneumocystis carinii
Blue sclera is seen in what hereditary bone disorder?
Osteogenesis imperfecta
What nephrotic syndrome has effacement of the epithelial foot processes without immune complex deposition?
Minimal change disease
What pattern of inheritance is G-6-PD deficiency?
X-linked recessive
A mother takes her 2-week-old infant to the ER because the baby regurgitates and vomits after eating and has peristaltic waves visible on the abdomen and a palpable mass in the right upper quadrant. What is your diagnosis?
Pyloric stenosis
Name the type of necrosis.
• The most common form of necrosis; denatured and coagulated proteins in the cytoplasm
Coagulative necrosis
What chemical can be dangerous if you work in the aerospace industry or in nuclear plants?
What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?
What malabsorption syndrome produces abdominal distention, bloating, flatulence, diarrhea, steatorrhea, and weight loss shortly after eating bread products?
Celiac sprue (gluten-sensitive enteropathy)
What is the term to describe the increase in organ size due to the increase in cell size and function?
Are the following major or minor Jones criteria of rheumatic fever?
• Sydenham chorea
What is the most common infectious agent in HIV?
Pneumocystis carinii
what is suggested by blue sclera and small teeth?
osteogenesis imperfect
what is it called when you have migratory thrombophlebitis?
Trousseau's syndrome
what is suggested by IgA and C3 deposition in skin?
Henoch-Schonlein purpura
Testicular Feminization syndrome (46, XY): What genitalia are present in testicular feminization syndrome?
female genitalia with rudimentary vagina; uterus and uterine tubes generally absent; develop testes (often found in labia majora; surgically removed to prevent malignancy)
Paraneoplastic effects of tumors: Polycythemia
EPO from renal cell CA.
PROSTATIC ADENOCARCINOMA: what are useful tumor markers for prostate CA
psa, and prostatic acid phosphatase
Autosomal-dominant diseases: What chromosome holds the gene involved in Huntington's?
Chromosome 4; triplet repeat disorder ("Hunting 4 food")
What is the term for air in the pleural space?
What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
Porcelain gallbladder
What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex–mediated; and is seen as lumpy-bumpy subepithelial deposits?
Postinfectious GN
What form of coarctation of the aorta is associated with Turner syndrome?
Preductal (infantile)
What are the most common causes of osteomyelitis
• In neonates?
Streptococcus agalactiae
What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?
Gastric ulcer
What thyroiditis presents as a tender, enlarged, firm thyroid gland, usually preceded by an upper respiratory viral illness?
de Quervain thyroiditis
A 20-year-old woman goes to the ER with ptosis, diplopia, weakness in her jaw muscles when chewing, and muscle weakness with repeated use. What is your diagnosis?
Myasthenia gravis
Name the four right-to-left congenital cardiac shunts.
Truncus (1) arteriosus
Transposition of the (2) great vessels
Tri(3)cuspid atresia
Tetra(4)logy of Fallot

They all begin with T
What type of erythema do you see in
• Ulcerative colitis?
Erythema nodosum
Which cerebral herniation results in compression of the anterior cerebral artery?
Cingulate gyrus herniation (subfalcine)
What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
Klinefelter syndrome
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods?
• Prior infection
HBcAb IgG and HBsAb IgG
what is suggested by necrosis surrounded by tumor cells and what brain tumor is it seen in?
pseudopalisading necrosis seen in glioblastoma multiforme
What is suggested by a mutation in the beta-myosin heavy chain?
Hypertrophic cardiomyopathy
what are the serological findings of lethal fulminant hepatitis?
elevated aminotransferase levels, prolonged prothrombin time, eosinophilia
Primary Brain Tumors-Child Peak Incidence: Cerebellar tumor associated with von Hippel-Landau syndrome?
Hemangioblastoma, see foamy cells and high vascularity, can produce excess EPO-->polycythemia.
Congenital Heart Disease: What might you see children with a R-to-L shunt do to relieve discomfort?
Squat to increase venous return
Name four major risk factors for atherosclerosis.
DM, hypercholesterolemia, smoking, and HTN are major risk factors. Being male, obesity, sedentary lifestyle, homocysteine elevation, oral contraceptive pills, and genetics are minor risk factors for atherosclerosis.
If a peripheral blood smear shows schistocytes, reticulocytes, and thrombocytopenia, is it more commonly seen in patients with ITP or TTP?
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
True or false? Pancreatic insufficiency results in vitamin B12 malabsorption.
True. Pancreatic enzymes begin the breakdown of vitamin B12-R complex in the duodenum.
What is the term for RBC remnants of nuclear chromatin in asplenic patients?
Howell-Jolly bodies
What is the name of the tumor when gastric carcinoma spreads to the ovaries?
Krukenberg tumor
What is the main type of cell involved in cellular immunity?
T lymphocyte
What two CD cell surface markers do Reed- Sternberg cells stain positive for?
CD15 and CD30
What are the long term sequelae of abestos exposure?
1. Bronchogenic carcinoma
2. Mesothelioma
Autosomal trisomies: Name 7 findings in trisomy 18
(1) severe mental retardation (2) rocker bottom feet (3) low-set ears (4) microngathia (5) congenital heart dz (6) clenched hands (flexion of fingers) (7) prominent occiput
Genetic gender disorders: Name 5 characteristics of Klinefelter's syndrome
(1) Testicular atrophy (2) Enuchoid body shape (3) Tall, long extremities (4) Gynecomastia (5) Female hair distribution
What triad consists of endothelial injury, changes in laminar flow, and hypercoagulation?
Virchow triad, associated with the formation of a thrombus.
What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
LC4, LD4, and LE 4
Influx of what ion is associated with irreversible cell injury?
Massive influx of calcium
What bilateral AR disorder seen in infancy as progressive renal failure has multiple small cysts at right angles to the cortical surface?
Polycystic kidney disease of childhood
What are the three platelet aggregating factors?
1. ADP
2. PG
3. TXA2
What is the name of the ovarian cyst containing ectodermal, endodermal, and mesodermal elements (i.e., skin, hair, teeth and neural tissue)?
Teratoma (dermoid cyst)
What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
where is the most common site of hematogenously spread osteomyelitis?
long bone metaphysis (rich vascularization)
Fetal Alcohol Syndrome: Who is at greatest risk of FAS?
Newborns of mothers who consumed significant amounts of alcohol (teratogen) during pregnancy (highest risk at 3-8 weeks).
What syndrome results when there is a deletion to paternal chromosome 15? Maternal?
Prader-Willi syndrome and Angelman syndrome, respectively
Autosomal trisomies: What is the life expectancy in Patau's?
Death usually w/in 1 year of birth
What is the term for a reversible change in one cell type to another?
Metaplasia (usually to a more protective cell type)
A chronic alcohol abuser goes to the ER with weakness, a sore, beefy red tongue, loss of vibration and position sense, arm and leg dystaxia, elevated levels of methylmalonic acid in the urine, and anemia with an MCV above 105 fL. What is your diagnosis, a
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working, you will see an increased reticulocyte count on the peripheral smear in about 5 days.
True or false? Obesity, DM, HTN, multiparity, early menarche, and late menopause are all risk factors for endometrial carcinoma.
False. They are all risk factors for endometrial carcinoma except multiparity. Nulliparity, estrogen-producing tumors, and estrogen replacement therapy are also risk factors for endometrial carcinoma.
How much of a vessel must be stenosed to cause sudden cardiac death?
More than 75% of the vessel
What is the term for white retinal spots surrounded by hemorrhage? In what condition are they seen?
Roth spots, and they are seen in bacterial endocarditis.
Is cigarette smoking associated with transitional cell carcinoma of the bladder?
Yes. It is also a cause of cancers of the lung, esophagus, ureter, and kidney, just to name a few.
How many months in how many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
3 months of symptoms in 2 consecutive years
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