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Sys Path Exam 1
Exam 1
186
Other
Graduate
03/09/2011

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Term
LAD supplies
Definition
apex
ant LV wall
2/3 spetum
(supplies most of anterior part of the heart)
Term
LCX supplies
Definition
Lateral LV
Term
RCA supplies
Definition
RV
Post 2/3 of septum (post descending artery)
Posterior basal LV
Term
Normal White blood cell counts (absolute value) for:
- WBC
Definition
4000 - 11000 per microliter
Term
Normal White blood cell counts (absolute value) for:
- Neutrophils
Definition
1800- 8500 per microliter
Term
Normal White blood cell counts (absolute value) for:
- lymphocytes?
Definition
1000- 4800 per microliter
Term
Normal White blood cell counts (absolute value) for:
- monocytes?
Definition
0- 800 per microliter
Term
Normal White blood cell counts (relative value- % of total WBC) for:
- Neutrophils
Definition
40-74%
Term
Normal White blood cell counts (relative value- % of total WBC) for:
- Lymphocytes
Definition
14-46%
Term
Normal White blood cell counts (relative value- % of total WBC) for:
- Monocytes
Definition
4-13%
Term
Normal White blood cell counts (relative value- % of total WBC) for:
- Eosinophils?
Definition
0-7 %
Term
Normal White blood cell counts (relative value- % of total WBC) for:
- Basophils
Definition
0-3%
Term
Chronic myelogenous leukemia involves which cell type?
Definition
granulocytes
Term
Chronic myelomonocytic leukemia includes:
Definition
monocytes and neutrophils
Term
Definition of Lymphoma
Definition
Malignant neoplasm of lymphoid linease cells or histiocytes (monocyte lineage) forming a local mass in soft tissue or bone
Term
Definition of Leukemia
Definition
Neoplasia of any blood cell lineage involving bone marrow and peripheral blood
Term
Chronic myelogenous leukemia involves which fusion of genes?
Definition
BCR-ABL fusion gene
(Nearly always bc of t(9;22) = PHILADELPHIA CHROMOSOME (Ph*)
Term
Multiple Myeloma affects primarily in bone (order):
Definition

Vertebrae

ribs

skull

pelvis

femur

Term
Langerhans Cell Disease involves:
Definition
proliferation of LANGERHANS CELLS accompanied by =
EOSINO
LYMPHO
PLASMA CELLS
Term
Which disease is described as "teeth floating in air"?
Definition
Langerhans Cell disease
Term
Two diseases with Punched out / ill-defined radiolucencies?
Definition
Multiple myeloma
Langerhans Cell disease
Term
Most common initial presentation of Hodgkin lymphoma =
Definition
Enlargement of cervical or supraclavicular lymph notes
Term
What is the diagnostic cell for Hodgkin lymphoma?
Definition
Reed-sternberg cells
Term
In the oral cavity, what is the most common lymphoma?
Definition
B cell lymphomas (non-hodgkin)
Term
Characteristic of Non-hodgkin - nodal
Definition
Nontender
slowly enlarging
initially freely movable mass involving lymph node

Progresses to a single or multiple fixed masses which may feel connected (matted together)
Term
Bone lesions of Extra nodal non-hodgkin
Definition

 

  • Pain/ discomfort 
  • Paresthesia 
  • RL on Radiograph (PA inflammatory lesions - may look like) 
  • perforate bone cortex
  • soft tissue swelling

 

Term
Soft tissue lesions of Extra nodal non-hodgkin
Definition
Non tender, ill defined, firm swelling
Erythema and ulceration
Term
Advanced disease of Extra nodal non-hodgkin
Definition
Malaise
Fever,
sweating
weight loss
Term
Low grade peripheral lymphoid neoplasm:
Definition
SLL/ CLL
Term
Int grade of common periph lymphoid neoplasm
Definition
Diffuse large B cell lymphoma/ T cell lymphoma
Term
High grade B cell neoplasm
Definition
Burkitt lymphoma
Term
Burkitt lymphoma - distinguish the two types
Definition
African - always involves EBV
American/non-African - may be caused by EBV but doesn't involve it
Term
SLL
Definition
Small lymphocytic lymphoma
- usually nodal, indolent, difficult to cure
(appear as normal B lymphocytes)
often evolves into CLL
Term
Burkitt lymphoma associated w/ what chromosome change?
Definition
chromosomal translocation t(8;14) (c-MYC)
Term
Histology of Burkitt lymphoma
Definition
Starry sky
Term
Leukemia classification
- Acute and Chronic
Definition
Acute - very immature
Chronic - relatively mature
Term
Leukemia classification
- General division: Lymphoid and Myelogenous
Definition
L = ALL, CLL
M = AML, CML
Term
Elements involved in polycythemia vera?
Definition
Erythroid
Granulocytic
Megakaryocytic
Term
Clinical features:
- CHronic myelogenous leukemia
Definition
if ANEMIC
weight loss
Splenomegaly
SEVERAL SIGNS HEAD AND NECK
Term
Clinical features:
- Polycythemia vera
Definition
Headache, dizziness, GI symptoms, hematemesis, Mela mild splenomegali
Signs of Platelet problems in oropharynx
Term
Systemic manifestations of ALL/AML?
Definition
Abrupt onset
Anemia, bleeding disorder, infections, bone pain, lymphadenopathy, hepato-splenomegaly
Term
Clinical feature of multiple myeloma
Definition
Bone pain
Fractures
Anemia
Low platelets (bleeding) low neutro
Inc serum calcium (hypercalcemia) confusion, weakness, lethargy constipation
Term
What disease involves bence-jones proteins?
Definition
multiple myeloma.
Also involves immunoglobin, amyloid deposition
Term
Which WBC disorders is NOT associated with EBV infection?
Definition
LEUKEMIA

(lymphomas are; infectious mono is)
Term
Important Lab tests - RBC lecture
- RBC
Definition
3.5 to 6.0 x 10^6/ mL
Term
Important Lab tests - RBC lecture
- Reticulocyte count
Definition
0.5 - 1.5%
Term
Important Lab tests - RBC lecture
- Hb
Definition
12-18 g/dl
Term
Important Lab tests - RBC lecture
- Hematocrit
Definition
or Packed RBCs/volume = 37-54%
Term
Important Lab tests - RBC lecture
- Mean corpuscular cell volume
Definition
82-96 mm^3

to determine anisocytosis
Term
Important Lab tests - RBC lecture
- Red blood cell distribution width
Definition
11.5-14.5

To determine poikiloctosis
Term
WHO classification of Anemia
- children 6mos to 5 yrs
Definition
Hb < 11g/dl
Term
WHO classification of Anemia
- children 5-11
Definition
Hb < 11.5g/dl
Term
WHO classification of Anemia
- adult males
Definition
Hb < 13g/dl
Term
WHO classification of Anemia
- non-preggerz
Definition
Hb < 12g/dl
Term
WHO classification of Anemia
- preggerz
Definition
Hb < 11g/dl
Term
WHO classification of Anemia
- severe anemia
Definition
Hb < 7 g/dl
Term
Severe long standing anemia leads to:
Definition
fatty change (reversible) in response to hypoxia
involves liver, heart, kidneys
Term
Concave finger nails is called? found in?
Definition
koilonychia (found in anemia)
Term
Summary of Anemias
- Iron def anemia
- cells look?
Definition
LACK OF IRON = INSUFF. HEMOGLOBIN SYNTHESIS
HYPOCHROMIC, MICROCYTIC
Term
Summary of Anemias
- Anemia of chronic dz
- cells look
Definition
caused by PROD. of INFLAMM. CELLS
- normocytic, normochromic
Term
Summary of Anemias
- megalobastic anemia
- cells look like
Definition
DEFICIENCY IN FOLATE/B12
enlarged abnorm hematopoietic PRECURSORS (megaloblasts) in bone marrow
Term
Summary of Anemias
- aplastic anemia
Definition
BONE MARROW FAILURE
Term
Summary of Anemias
- myelophthisic anemia
Definition
replacement of bone marrow w/ METASTATIC CARCINOMA and GRANULOMATOUS DZ
Term
Which anemia causes "tear-drop red blood cells"?
Definition
MYELOPHTHISIC ANEMIA
Term
2 dz that causes microcytic hypochromic RBC
Definition

iron def anemia

beta thal. minor

Term
Clinical symptoms of anemia- IRON DEF
Definition
"burning tongue"
patchy / diffuse erythema
atrophy of FILIFORM papillae
taste alteration
fissuring
also - these may be due to candidiasis
Term
Plummer vinson syndrome is seen in which anemia?
Definition
iron def
Term
Plummer vinson syndrome in iron def involves what that is particularly imp to us?
Definition
anemia
glossitis
dysphagia
sq cell carcinoma or eso/oral/pharyngal
Term
What happens in PERNICIOUS ANEMIA?
Definition
Autoimmune destruction of parietal cells (probably due to atrophic gastritis)
Parietal cells contain intrinsic factor
Intrinsic factor is necessary for absorption of vit B12
Term
Common sign of pernicious anemia?
Definition
symmetric paresthesia - TINGLING OR NUMBNESS OF EXTREMETIES
burning of tongue
patchy erythema, pallor
surface atrophy, lobulation
SKIN MAY BE YELLOW
Term
Intracorpuscular hemolytic anemia def
Definition
marked by defects, most often genetically determined in the red cell itself
Term
extracorpuscular hemolytic anemia def
Definition
marked by defects, most often acquired, of the extraerythrocytic env, such as circulating antibodies or an enlarged spleen
Term
Thalassemia - clinical manifestations?
Definition
frontal bossing
hair on end appearance of calvaria
enlarged jaws
honeycomb bone pattern
Term
Alpha-thalassemias
- hydrops fetalis
Definition
fatal before birth --/--
Term
Alpha-thalassemias
- hemoglobin H
Definition
moderately severe anemia --/-a
Term
Alpha-thalassemias
- alpha thalassemia trait
Definition
similar to beta thal trait severeties are about the same
--/aa or -a/-a
Term
Alpha-thalassemias
- silent carrier
Definition
-a/aa
Term
Feature of anemia, bleeding disorders, or susceptibility to infections
- granulocytes? Problem and norm
Definition
problem < 500 granulocytes / mL

norm 3000 - 8000
Term
Feature of anemia, bleeding disorders, or susceptibility to infections
- platelets? abnorm and norm
Definition
abnorm is < 20,000 platelets / mL

norm is 150,000 to 450,000
Term
Feature of anemia, bleeding disorders, or susceptibility to infections
- reticulocytes/mL (abnorm and norm)
Definition
abnorm is <10,000 reticulocytes/ mL

norm is 50,000
Term
Clinical of aplastic anemia?
Definition
pallor
ging bleeding, mucosal petechiae
ging enlargement
mucosal ulcers
Term
Hemolytic anemia (3 things)
Definition
shortened RBC life (120 days usually)
inc in accumulation of hemoglobin catabolism (hemosiderin - brown; bilirubin- yellow)
inc in erthropoiesis (compensation)
Term
Clinical presentation of hemolytic anemia?
Definition
fatigure, weakness, headache, rapid pulse
jaundice!
splenomegaly - early on
Term
Clinical presentation of Sickle cell anemia
Definition
Reduced trabeculation
hair on end appearance of calvaria
delayed dental eruption
dental hypoplasia
ishemic necrosis
neuropathy
Term
Sickle cell anemia- consequences of crises
- Acute chest syndrom may lead to?
Definition
COR PULMONALE = right sided failure due to problem of the lung
Term
Other hemolytic anemias
Definition
Hereditary spherocytosis
G6DH deficiency
Traumatic
Immunolytic
Term
Hereditary spherocytosis
Definition
intracorpuscal disease ,extravas hemolysis
splenectomy corrects the anemia
Term
Gluc 6 dehydrogenase deficiency
Definition
x linked
older RBC are susceptible to oxidative stress
hemolysis precipitated by infections and osme drugs

INTRAVAS hemolytic INTRACORPUSCAL
Term
traumatic - what kind of hemolysis?
Definition
INTRAVASCULAR
Term
immunohemolytic- classified as
Definition
intravas
extracap
Term
Inc in red blood cell numbers is called?
Definition
polycythemia
Term
reactive polycythemia?
Definition
excess erythropoietin
dehydration
Term
neoplastic polycythemia
Definition
polycythemia vera
- red cell precursors can be exposed to neoplastic processes and in turn effect the RBCs
Term
Absolute polycythemia- primary
Definition
polycythemia vera
Term
absolute polycythemia- secondary?
Definition
inc erythropoietin levels
Term
Why do bones necrose in multiple myeloma?
Definition
An osteoclast-activating factor secreted by the neoplastic plasma cells
Term
Best test for pernicious anemia?
Definition
CBC, vit b12, test for candida infection
Term
Which anemia causes jaundice?
Definition
hemolytic anemia
sickle cell anemia

BOTH= DESTRUCTION OF RBC THUS JAUNDICE
Term
4 things that can cause splenomegaly
Definition
extramedullary hematopoiesis
infiltration by malignant cells
systemic infections
presence of many structurally abnormal periph blood cells
Term
Antibiotics for prophylaxis
Definition
Amoxicillin 2 grams po 30-60 min prior to dental proc

clindamycin 600 mg po 30-60 min prior to dental proc
Term
Pneumothorax
Definition
collapsed lung

air in pleural cavity
Term
hydrothorax
Definition
heart failure w/ pulmonary edema
Term
Hemothorax
Definition
Blood in the pleural cavity
Term
Empyema
Definition
response on the VISCERAL surface, fibrous CT on the surface of the lung is trying to isolate pus that would otherwise try to get into the thorax
Term
Def of atelectasis
Definition
lack of gas exchange within the alveoli, due to alveolar collapse or fluid consolidation
Term
Def of consolidation
Definition
clinical term for solidification into a firm, dense mass. = CLINICAL SIGN FOR LOBAR PNEUMONIA
Term
Def of bronchiectasis
Definition
IRREVERSIBLE dilatation of bronchi as a consequence of the destruction of the muscular and elastic elements of their walls
Term
Lobar refers to
Definition
consolidation of an entire lobe
Term
bronchopneumonia
Definition
scattered, solid foci in the same or several lobes
Term
pneumonia (pulmonary lecture) is a generic term that refers to
Definition
inflammation and consolidation of the parenchyma
Term
Pneumonia represents what kind of inflammation?
Definition
intra-alveolar
Term
bacterial pneumonia: which bacteria?
Definition
streptococcus pneumoniae
staph aureus
Term
streptococcus pneumoniae usually causes what kind of pneumonia? what other organism does as well?
Definition
lobar pneumonia along w/ klebsiella pneumoniae
Term
distinction between lobar and broncho pneumonia?
Definition
NOT DUE TO DIFF BACTERia but to HOW WELL THE BODY CAN FIGHT IT OFF!!
Term
Pathogenesis of bacteria in the lung?
Definition
ACUTE INFLAM RESPONSE (pmns) IN ALVEOLUS
CONGESTION OF CAPILLARIES
EDEMA with RELATIVE HIGH CONTENT OF SERUM PROTEINS (EXUDATE)
INTRA-ALVEOLAR HEMORRHAGE

RED HEPATIZATION STAGE
Term
WHITE HEPATIZATION STAGE
Definition
2 days or more
MQ phagosytose PMNS!!
Fibrin in alveolus
congestion gone, but lung is still firm
Term
RESOLUTION (pulmonary lec)
Definition
removal of the intra-alvolar exudate and the lung returns to normal
Term
Complications of pneumococcal pneumonia
Definition
pleuritis
pleural effision
pyothorax
empyema
Term
pleuritis
Definition
inflammation extends to pleura
PAINFUL
Term
Klebsiella pneumoniae produces what in the lung? Leads to what?
Definition
mucoid appearance w/ production of gelatinous sputum. can lead to BRONCHOPLEURAL FISTULA
Term
Only organism that causes lobar pneumonia no matter what?
Definition
klebsiella pneumonia
Term
W/ tuberculosis, macrophages degrade some TB and present antigen to T cells. Where do the MQ carry Tb (to which lymph nodes)?
Definition
Hilar and mediastinal lymph nodes
Term
Epitheloid cells
Definition
MQ aggregate and form granulomas (as in TB)
Term
Langerhan giant cells
Definition
Epitheloid cells fuse to form multinucleated giant cells w/ nuclei in the periphery
Term
Caseous nerosis
Definition
langerhans giant cells and other forein body giant cells release lytic enzymes and damage host lung tissue
Term
What are T cells trying to do when they secrete MIF?
Definition
Macrophage inhibitory factor - inhibit the migration of MQ (that contain TB). Protective response to contain the spread of TB infection to other parts of the body.
Term
Ghon focus
Definition
lung lesion of primary TB infection - seen as COIN LESION in X RAY
Located in the subpleural area.
Term
Ghon complex
Definition
hallmark lesion of primary TB

combination of the ghon focus and the enlarged hillar/mediastinal nodes
Term
if immuno compromised, what happens to ghon complex?
Definition
calcifies. A SMALL AMT OF ORGANISMS WITHIN THE COMPLEX MAY REMAIN VIABLE FOR YEARS
Term
Proliferation of M. tuberculosis in ppl that have been previously infected is called
Definition
SECONDARY/ REACTIVATION/ CAVITARY TB
Term
Characteristic of secondary TB
Definition
formation of many, new granulomas and tissue necrosis and production of TB CAVITIES
Term
hemoptysis
Definition
coughing up of blood
Term
primary progressive TB
Definition
when primary TB does NOT get walled off and you go straight to miliary TB
Term
VIRAL PNEUMONIA== NEED TO KNOW!
Definition
INTERSTITIAL RATHER THAN ALEVEOLAR PNEUMONIA (diffuse alveolar damage)
Term
What's indicative of viral pneumonia?
Definition
nonproductive cough
interstitial edema
predominantly a mononuclear infiltrate with INTERSTITIAL FIBROSIS
Term
lung abscess is usually due to:
Definition
ASPIRATION OF ANAEROBIC BACTERIA FROM OROPHARYNX
Term
Other causes of lung abscess:
Definition
SEPTIC EMBOLIC
TRAUMA
BRONCHIAL OBSTRUCTION W/ or W?O bronchiectasis
Term
Pink puffer?
Definition
When you have exertional dypsnea = NEED TO WORK TO BREATHE OUT.. as in COPD (asthma, chronic bronchitis, emphysema)
Term
Hereditary alpha 1 antitrypsin deficiency
Definition
how we learned about emphysema
varients in the proteinase inhibitor gene (piZZ associated w/ dec activity in alpha 1 antitrypsin, emphysema, often hepatic cirrhosis)
Term
Increased hydrostatic pressure is seen w/ failure of:
Definition
the LEFT SIDE OF THE HEART (BACKWARD FAILURE)
- nonINFLAMMATORY PROCESS
Term
What is seen w/ inc hydrostatic pressure in the lung?
Definition
PINK PRECIPITATE, intralveolar, granular TRANSUDATE
Term
"heart failure cells"
Definition
W/ inc hydrostatic press in the lung, transudate intra-alveolar. MQ come in to phagocytose the RBC. Release hemosiderin. "Brown"- brown induration of the lungs.
Term
In long standing cases of pulmonary congestion as seen with these 2 diseases, the heart failure cells are abundant and the fibrosis and thicking of alveolar walls cause the lungs to be firm and brown.
Definition
Mitral stenosis
prolongs hypertension (CPC of lung)
Term
Browning of the lung due to aging?
Definition
brown atrophy of the heart

NOT DUE TO HEMOSIDERIN BUT TO LIPOFUSCIN
Term
diaphoresis
Definition
profuse sweating
Term
orthopnea
Definition
difficulty breathing when lying on back
Term
cyanotic
Definition
lack of oxygen
Term
Pulmonary emboli arise from
Definition
DEEP VEINS OF THE LOWER EXTREMETIES
Term
Pulmonary infarcts are typically
Definition
hemorrhagic bc the bronchial artery pumps blood into the necrotic area
Term
saddle embolism
Definition
occlusion of the main trunk of the pulmonary a. at its bifurcation FATAL
Term
Acute cor pulmonale
Definition
hemmorphagic lung. NO RIGHT VENTRICLE HYPERTROPHY
Term
Chronic cor pulmonale
Definition
get w/ emphysema
Term
Squamous cell carcinoma (lung)
Definition
most arise in the central portion of the lung from the major or segmental bronchi
Term
adenocarcinoma (lung)
Definition
tend to arise in the periphery of the lung and are often associated w/ pleural fibrosis and subpleural scars.
Term
carcinomas of the lung of all histological types metastasize most freq to
Definition
regional lymph nodes, particular the hilar and mediastinal nodes
Term
most frequent site of extranodal metastasis of pulmonary carcinoma is
Definition
adrenal gland
Term
Pneumoconiosis
Definition
pulmonary diseases caused by the inhalation of inorganic dusts (asbestosis, silicosis)
Term
what kind of disease is asbestosis?
Definition

dec in the compliance of the lung. thus RESTRICTIVE LUNG DISEASE

but also considered OBSTRUCTIVE

Term
asbestosis advanced causes?
Definition
fibrosis honey comb lung
Term
3 reasons for lung abscesses
Definition
Bronchial obstruction (often by cancer(
aspiration of gastric contends
Complication of bacterial pneumonia
Term
bread and butter
Definition
pericarditis
Term
What do the heart myocytes release in response to cardiomegaly?
Definition
atrial natriuretic peptide (casodilator that will lead to the body getting rid of water bc of high pressure --> dec bp)
Term
fibroelastosis
Definition
disease of the endocardial lining
Term
What supplies the posterior descending artery?
Definition
most of us are right dominant (means the right coronary artery is supplying the posterior descending a)
30% of ppl are left dominant (means the right coronary a would be a very small blood vessel and posterior descending branches of the circumflex will be a much larger blood vessel to supply the back)
Term
Hypertrophy of the left ventricle
Definition
commonly caused by HYPERTENSION and AORTIC/ MITRAL VALVULAR DZ
Term
Hypertrophy of the right ventricle
Definition
LEFT VENT. FAILURE
CHRONIC LUNG DISEASE
MITRAL VALVE DISEASE
CONGENITAL HEART DISEASE (w/ left to right shunt)
cor pulmonale
Term
Def of cor pulmonale
Definition
right ventricular hypertrophy and / or dilation secondary to lung disease or primary disease of the pulmonary vasculature, such as primary pulmonary hypertension. emphysema is a freq cause.
Term
characteristic of cor pulmonale
Definition
pulmonary arterial hypertension
Term
Clinical manifestations of LEFT SIDE HEART FAILURE
Definition
dyspnea and orthopnea
pleural effusion w/ hydrothorax
reduction in renal perfusion
cerebral anoxia
Term
claudication def
Definition
condition of the blood vessels that leads to narrowing and hardening of the arteries that supply the legs and feet
Term
Arteriosclerosis (umbrella term)
- what is atherosclerosis include
Definition
aorta
coronary
cerebral
Term
Arteriosclerosis (umbrella term)
- medial calcinosis
Definition
muscular arteries
Term
Arteriosclerosis (umbrella term)
- arteriolar sclerosis
Definition
arterioles
Term
Enzyme pathonomonic for MI?
Definition
CK-MB
Other enzyme is troponin contractile proteins (troponin I and T)
Term
CPK is?
Definition
not heart specific - found in brain, skeletal m and heart
Term
What do macrophages secrete that are mitogenic for myointinmal cellls (smooth muscle cells in the intima) as in the case of atherosclerosis?
Definition
PDGF
TNF
IL-1
INF alpha
Term
Fatty streaks consist of
Definition
LIPID LADEN MACROPHAGES (foam cells)
T cells
SMOOTH MUSCLE CELLS
Term
What has "onion-skin lesions"?
Definition
Hyperplastic arteriolosclerosis
Term
aortic stenosis
Definition
calcification of anatomically normal and most commonly by congenitally abnormal bicuspid aortic valves
Term
aortic insufficiency
Definition
dilation of the ascending aorta, related to hypertension and aging
Term
mitral stenosis
Definition
rheumatic heart disease (99%)
Term
mitral insufficiency
Definition
myxomatous degeneration (commonly seen in mitral valve prolapse)
Term
rheumatic fever follows:
Definition
beta hemolytic strep group A pyogenes pharyngitis

-antistreptolysin O antibodies in serum
Term
bread and butter can be seen in which auto dz?
Definition
rheumatic fever
Term
Only disease in which blood vessels develop on the valve itself?
Definition
rheumatic mitral stenosis
Term
floppy valve?
Definition
mitral valve prolapse
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