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116 Cards in this Set
- Front
- Back
E(Epidermal) GF
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Made in platelets, macrophages
Acts on keratinocytes to migrate, divide Acts on fibroblasts to produce “granulation” tissue |
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T(Transforming) GF-alpha
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Made in macrophages, T-cells, keratinocytes
Similar to EGF, also effect on hepatocytes |
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H(Hepatocyte) GF
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Made in “mesenchymal” cells
Proliferation of epithelium, endothelium, hepatocytes Effect on cell “motility” |
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VE(Vascular Endothelial) GF
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Made in mesenchymal cells
Triggered by HYPOXIA Increases vascular permeability Mitogenic for endothelial cells KEY substance in promoting “granulation” tissue |
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PD(Platelet Derived) GF
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Made in platelets, but also MANY other cell types
Chemotactic for MANY cells Mitogen for fibroblasts Angiogenesis Another KEY player in granulation tissue |
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F(Fibroblast) GF
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Made in MANY cells
Chemotactic and mitogenic, for fibroblasts and keratinocytes Re-epithelialization Angiogenesis, wound contraction Hematopoesis Cardiac/Skeletal (striated) muscle |
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T(Transforming) GF-beta
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Made in MANY CELLS
Chemotactic for PMNs and MANY other types of cells Inhibits epithelial cells Fibrogenic Anti-Inflammatory |
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K(Keratinocyte) GF
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Made in fibroblasts
Stimulates keratinocytes: Migration Proliferation Differentiation |
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I(Insulin-like) GF-1
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Made in macrophages, fibroblasts
Stimulates: Sulfated proteoglycans Collagen Keratinocyte migration Fibroblast proliferation Action similar to GH (Pituitary Growth Hormone) |
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TNF (Tumor Necrosis Factor)
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Made in macrophages, mast cells, T-cells
Activates macrophages KEY influence on other cytokines |
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Interleukins
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Made in macrophages, mast cells, T-cells, but also MANY other cells
MANY functions: Chemotaxis Angiogenesis REGULATION of other cytokines |
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INTERFERONS
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Made by lymphocytes, fibroblasts
Activates MACROPHAGES Inhibits FIBROBLASTS REGULATES other cytokines |
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EDEMA
ONLY 4 POSSIBILITIES!!! |
ONLY 4 POSSIBILITIES!!!
Increased Hydrostatic Pressure Reduced Oncotic Pressure Lymphatic Obstruction Sodium/Water Retention |
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Transudate vs Exudate
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Transudate
results from disturbance of Starling forces specific gravity < 1.012 Exudate results from damage to the capillary wall specific gravity > 1.012 |
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HYPEREMIA
Active or passive process? |
Active process
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CONGESTION
Passive or active process? |
Passive process
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When does pulmonary edema occur?
Pressure? |
Pulmonary edema occurs only when the pulmonary capillary pressure rises to values exceeding the plasma colloid osmotic pressure, which is approximately 28 mm Hg in the human. Because the normal pulmonary capillary pressure is 8 to 12 mm Hg, there is a substantial margin of safety in the development of pulmonary edema.
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What is the difference between Pre and post-motrem clot?
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Premortem clots have texture and usually ADHERE to a vessel wall. Post mortem clots have a jelly or chicken fat consistency.
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PLATELET ADHESION
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Primarily to the subendothelial ECM
Regulated by vWF, which bridges platelet surface receptors to ECM collagen |
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PLATELET AGGREGATION MOLECULES
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ADP
TxA2 (Thromboxane A2) THROMBIN from coagulation cascade also FIBRIN further strengthens and hardens and contracts the platelet plug |
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Vit-K dep. factors:
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II, VII, IX, X, Prot. S, C, Z
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Virchow’s TRIANGLE
(thrombosis) |
ENDOTHELIAL INJURY
ABNORMAL FLOW (NON-LAMINAR) HYPER- COAGULATION |
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Lines of Zahn
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Lines of Zahn, gross and microscopic, top, is evidence to prove a clot is PRE-mortem.
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Red vs. White infarction?
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RED vs. WHITE
END ARTERIES vs. NO END ARTERIES |
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MHC MOLECULES (Gene Products)
I |
I (All nucleated cells and platelets), cell surface glycoproteins, ANTIGENS
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MHC MOLECULES (Gene Products)
II |
II (APC’s, i.e., macs and dendritics, lymphs), cell surface glycoproteins, ANTIGENS
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MHC MOLECULES (Gene Products)
III |
III Complement System Proteins
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HYPERSENSITIVITYREACTIONS (4)
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I (Immediate Hypersensitivity)
II (Antibody Mediated Hypersensitivity) III (Immune-Complex Mediated Hypersensitivity) IV (Cell-Mediated Hypersensitivity) |
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HYPERSENSITIVITYREACTIONS
I |
I (Immediate Hypersensitivity)
“Immediate Allergic Reactions”, which may lead to anaphylaxis, shock, edema, dyspnea death |
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HYPERSENSITIVITYREACTIONS
II (4) |
II (Antibody Mediated Hypersensitivity)
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HYPERSENSITIVITYREACTIONS
III (4) |
III (Immune-Complex Mediated Hypersensitivity)
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HYPERSENSITIVITYREACTIONS
IV (4) |
IV (Cell-Mediated Hypersensitivity)
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TYPE II DISEASES
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Autoimmune Hemolytic Anemia, AHA
Idiopathic Thrombocytopenic Purpura, ITP Goodpasture Syndrome (Nephritis and Lung hemorrhage) Rheumatic Fever Myasthenia Gravis Graves Disease Pernicious Anemia, PA |
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TYPE III HYPERSENSITIVITY
IMMUNE COMPLEX MEDIATED DESIESE |
Common Type III Diseases- SLE (Lupus), Poly(Peri)arteritis Nodosa, Poststreptococcal Glomerulonephritis, Arthus reaction (hrs), Serum sickness (days)
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TYPE IV HYPERSENSITIVITY
Example |
Tuberculin Skin Reaction
DIRECT ANTIGEN to CELL CONTACT GRANULOMA FORMATION CONTACT DERMATITIS |
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LUPUS (SLE)
Etiology Morphology Biochem test? |
Etiology: Antibodies (ABs) directed against the patient’s own DNA, HISTONES, NON-histone RNA, and NUCLEOLUS
Morphology: “Butterfly” rash, skin deposits, glomerolunephritis (NOT discoid) Postive A.N.A |
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CANCERS of AIDS
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KAPOSI SARCOMA
B-CELL LYMPHOMAS CNS LYMPHOMAS CERVIX CANCER, SQUAMOUS CELL |
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Misnomers
hepatoma: |
hepatoma: malignant liver tumor
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Kuru
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Kuru is an incurable degenerative neurological disorder (brain disease) that is a type of transmissible spongiform encephalopathy, caused by a prion found in humans. Taken from the Fore word "kuria/guria", 'to shake'. It is also known as the laughing sickness due to the pathologic bursts of laughter people would display when afflicted with the disease. Kuru was probably transmitted among members of the Fore tribe of Papua New Guinea via cannibalism.
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ARTERIO-SCLEROSIS
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GENERIC term for ANYTHING which HARDENS arteries
Atherosclerosis (99%) Mönckeberg medial calcific sclerosis (1%) |
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“Framingham” data
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Major riskfactor for atherosclerosis
Hyperlipidemia Hypertension Cigarette Smoking Diabetes Milletus |
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hypertension is described as two different types of changes in arterioles, usually renal.
HOW? |
Benign: Hyalization of arteriole wall
Malignant: Fibrinoid necrosis and “onion skinning” of arteriole wall |
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THROMBOANGIITIS OBLITERANSBUERGER(‘s) Disease
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100% caused by cigarette smoking
MEN>>>F, 30’s, 40’s Often arteries are 100% obliterated, hence the name “obliterans” EXTREMITIES most often involved |
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Raynaud “Phenomenon”
Primary |
PRIMARY: (formerly Raynaud “DISEASE”)
Digital PALLORCYANOSISHYPEREMIA (WHITE) (BLUE) (RED) Vasoconstriction usually triggered by COLD, emotion Can be tip of nose, not only digits Self Limited, Gangrene UN-common Arteries often do NOT show diagnostic pathology |
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Raynaud “Phenomenon”
Secondary |
SECONDARY: (formerly Raynaud “Phenomen.”)
Atherosclerosos SLE Buerger Disease |
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“BOXCAR” effect.
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squaring off of the nuclei, so called “BOXCAR” effect.
(in heart i think) |
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CONGENITAL HEARTDEFECTS
(critical period?) |
Faulty embryogenesis (week 3-8)
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CHF: Autopsy Findings
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Cardiomegaly
Chamber Dilatation Hypertrophy of myocardial fibers, BOXCAR nuclei |
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CHD L to R shunt
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LR SHUNTS: all “D’s” in their names
NO cyanosis Pulmonary hypertension SIGNIFICANT pulmonary hypertension is IRREVERSIBLE |
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CHD R to L shunt
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RL SHUNTS: all “T’s” in their names
CYANOSIS (i,.e., “blue” babies) VENOUS EMBOLI become SYSTEMIC |
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Libman-Sacks
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Libman-Sacks endocarditis is a form of nonbacterial endocarditis that is seen in systemic lupus erythematosus
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Carcinoid Syndrome
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Episodic skin flushing
Cramps Nausea & Vomiting Diarrhea ↑serotonin, ↑ 5HIAA in urine FIBROUS INTIMAL THICKENING RV, Tricuspid valve, Pulmonic valve (all RIGHT side) Similar to what Fen-Phen does on the LEFT side |
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“restrictive” cardiomyopathy
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A “restrictive” cardiomyopathy is a wall which is NOT thickened or dilated necessarily, but RIGID in diastolic relaxation.
↓ ventricular compliance Chiefly affects DIASTOLE NORMAL chamber size and wall thickness THREE similar diseases affecting predominantly the SUBENDOCARDIAL area: Endomyocardial Fibrosis (African children) Loeffler Endomyocarditis (eosinophilic leukemia) Endocardial Fibroelastosis (infants) |
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Dilated cardiomyopathy
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Impairment of contractility (systolic dysfunction)
Interstitial Fibrosis 50% die in 2 years |
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Hypertrophic cardiomyopathy
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Impairment of compliance (diastolic dysfunction)
INTERSTITIAL fibrosis CLINICAL: ↓chamber volume, ↓SV, ↓ diastolic filling |
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MYOCARDITIS
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INFLAMMATION of MYOCARDIUM
Chiefly microbial COXACKIE A & B, CMV, HIV Trypanosoma cruzi (Chagas dis.), 80% Trichinosis Toxoplasmosis Lyme disease (5%) Diphtheria IMMUNE: Post-viral, rheumatic, SLE, drug hypersensitivityalpha-methyl dopa, sulfas BOTH HYPER-, HYPO- -thyroidism |
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PERICARDITIS
Serous |
Rheum. Fever (RF), SLE, scleroderma, tumors, uremia
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PERICARDITIS
Fibrinous |
FIBRINOUS: MI (Dressler), uremia, radiation, RF, SLE, s/p open heart surgery
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PERICARDITIS
Hemorrhagic assoc. w/ |
HEMORRHAGIC: Malignancy, TB
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PERICARDITIS
Casoeus |
CASEOUS: TB
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PERICARDITIS
Chronic |
CHRONIC: (ADHESIVE, CONSTRICTIVE)
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Most common place for metastis in general?
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LUNG is the MOST COMMON site for all metastatic tumors, regardless of site of origin
It is the site of FIRST CHOICE for metastatic sarcomas for purely anatomic reasons! |
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NECROTIZING” Upper Airway Lesions
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“WEGENER” Granulomatosis
“Lethal” Midline Granuloma “Lethal” midline granuloma is thought to be a malignant tumor of NK (Natural Killer) cells. |
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OLFACTORY`-ESTHESIONEUROBLASTOMA
Has what in micro? |
Like any other neuroblastoma, it may have “rosettes”.
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“zell-ballen''
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Tumors of the carotid body are composed of “balls of cells”, or “zell-ballen” in German
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Warthin Tumor
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PAPILLARY CYSTADENOMA LYMPHOMATOSUM of salivary gland (beign)
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Schiatzki
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Schiatzki “Ring” in lower esophagus
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“ZENKER” diverticulum
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High diverticulum of esophagus
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MALLORY-WEISS
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LACERATION in lower esophagus
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tumor cells are derived from the interstitial cells of Cajal..?
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G.I.S.T.
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ACUTE APPENDICITIS diagnosis
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NEED NEUTROPHILS in the MUSCULARIS to confirm the DIAGNOSIS
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JAUNDICE
Hemolytic Type of bilirubin? |
Hemolytic (UN-conjugated)
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JAUNDICE
Obstructive Type of bilirubin? |
Obstructive (Conjugated)
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BERGER DISEASE
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IgA NEPHROPATHY
Mild hematuria Mild proteinuria IgA deposits in mesangium |
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ALPORT SYNDROME
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Progressive Renal Failure
Nerve Deafness VARIOUS eye disorder DEFECTIVE COLLAGEN TYPE IV |
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Henoch-Schonlein Purpura
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(IgA-NEPH)
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Malacoplakia
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soft yellow plaques filled with macrophages and calcium
found in the urinary tract is associated with: Prolonged therapy with systemic corticosteroids Organ transplantation Diabetes mellitus Lymphoma Rheumatoid arthritis |
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Michaelis-Gutmann
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Michaelis-Gutmann bodies contain Fe and Ca in macrophages
found in the urinary tract Is assoc. w/ Malacoplakia |
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Brunn nests
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Brunn nests are clusters of urothelium which usually lie UNDER the surface mucosa. They can undergo glandular (i.e., columnar) metaplasia.
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Schiller-Duvall Body
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YOLK SAC TUMOR
Most common testicular tumor in male CHILDREN |
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Compare testicular and ovarian teratomas
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Most testicular teratomas are malignant.
Most ovarian teratomas are benign (e.g., dermoid cyst) |
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Lichen Sclerosus et Atrophicus
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Inflammation of vulvular skin
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VIN, SCC
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Like condylomas, HIGHLY linked to HPV
VIN=changes leading to SCC-in-situ, look like “plaques” |
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Stein-Leventhal syndrome
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POLY-Cystic Ovarian Disease
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“Immature” teratomas are regarded as
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“Immature” teratomas are regarded as malignant
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Call-Exner bodies
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Call-Exner bodies are virtually diagnostic of granulosa cell tumors.
Q: Do they remind you of “rosettes”? Ans: YES |
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Number 1 commandment in pathology:
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Number 1 commandment in pathology: NEVER diagnosis a malignant papilloma on a frozen section!!!!! NEVER. :P
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“INDIAN” FILE PATTERN assoc w/
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INFILTRATING LOBULAR CA.
(breast) |
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ANTERIOR PITUITARY
ACIDOPHILS |
ACIDOPHILS
GROWTH HORMONE PROLACTIN |
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ANTERIOR PITUITARY
BASOPHILS |
BASOPHILS
TSH ACTH LH, FSH |
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Sheehan’s syndrome
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HYPO-pituitarism
Sheehan’s syndrome (Post-partum ischemic necrosis) |
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Goiter
Exophthalmos ??? |
HYPER-THYROIDISM
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Cretinism
Myxedema (coma) |
HYPO-THYROIDISM
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GRAVES DISEASE
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aka, diffuse toxic goiter
HYPERTHYROIDISM EXOPHTHALMOS PRE-TIBIAL MYXEDEMA Autoimmune, auto-antibodies to TSH |
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PLUMMER DISEASE
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aka, nodular toxic goiter
Hyperthyroidism |
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HÜRTHLE
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oxyphilic adenoma
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BIOLOGIC BEHAVIOR of thyroid malignacy:
Papillary CA Follicular CA |
Papillary CA lymph nodes
Follicular CA blood vessels, bone |
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PHEOCHROMOCYTOMAS, rule of 10 applies to what?
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PHEOCHROMOCYTOMAS, aka, primary tumors of the adrenal medulla
10% arise in an MEN setting 10% are EXTRA-adrenal 10% are bilateral 10% are malignant 10% are in childhood |
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Wermer Syndrome
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Wermer Syndrome = MEN I
Parathyroid, pancreatic, pituitary |
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cotton wool spots
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RETINOPATHY in Dm
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PREMALIGNANT/MALIGNANT
Of skin and there character |
ACTINIC (Solar) KERATOSIS, i.e. precursor to SCC
SQUAMOUS CELL CARCINOMA, squamous “pearls”, intercellular bridges. BASAL CELL CARCINOMA, by far, MOST COMMON, BLUE palisading nests. BOTH SCC and BCC related to SUN (i.e., radiation) exposure. (as is MM also) MERKEL CELL CARCINOMA (TUMOR), VERY MALIGNANT AND LETHAL, LOOK LIKE SMALL CELL CA. OF LUNG |
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Name the FOUR histopathologic findings in most of the forms of psoriasis: 1,2,3,4
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1) Parakeratosis,
2) hyperplasia, 3) rete peg elongation, 4) MUNRO abscesses. |
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Acanthylosis
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Acantholysis: Loss of intercellular connections resulting in loss of cohesion between keratinocytes.
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Paget Disease (bone)
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OSTEOCLAST DYSFUNCTION
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POTTS disease
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TB of spine is known as POTTS disease
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Guillain-Barré
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Guillain-Barré (inflmmatory nephropathy)
Preceded by “influenza”-like illness NO actual specific etiologic agent isolated, autoimmune disease to myelin gangliosides most likely Inflammation of a peripheral nerve DEMYELINATION “ASCENDING” paralysis |
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Why are Schwannomas the ONLY tumors of peripheral nerve?
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Because SCHWANN cells are the ONLY nucleated cells found IN a nerve
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Hassal’s corpuscles
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Hassal’s corpuscles are fused epithelial reticular cells in Thymus
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Syringomyelia
(Syrinx) |
Syringomyelia is damage to the spinal cord due to the formation of a fluid-filled area within the cord
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PRION DISEASES:common features
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“SPONGIFORM” changes in neurons and glia
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TAUOPATHIES
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Most cortical dementias are known as TAUOPATHIES
eg. Pick's disease (frontal lobe) |
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LEUKO”-DYSTROPHIES
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abnormal “myelin” synthesis
Eg. Krabbe Metachromatic- Adreno- Pelizaeus-Merzbacher Canavan |
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What is a typical histo-finding in Glioblastoma?
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Pallisading and necrosis
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What is a typical histo-finding in Neuroblastoma?
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rosettes
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FAMILIAL TUMOR SYNDROMES
NF-1 |
Neurofibromas
Gliomas |
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FAMILIAL TUMOR SYNDROMES
NF-2 |
Schwannomas
Meningiomas |