-
In what disease of the bone do you see atriovenous fistulas leading to high cardiac output failure?
Paget's diseas of bone
-
Pagets is due to high activity of what cells?
osteoblast and osteoclasts
-
Mockenberg arteriosclerosis is due to what?
calcification of the media layer of the BV
-
What are the 3 types of arteriosclerosis?
- MOckenberg calcific sclerosis
- Hypertensive arteriosclerosis
- atherosclerosis
-
Arteriosclerosis of the intima level with fibrofatty plaques is called what?
atherosclerosis
-
In the pathogenesis of atherosclerosis, smooth muscle cells migrate from what level to what level to form foam cells with macrophages?
from media to intima
-
In what kind of hypertension are end organs damaged?
malignant hypertension
-
Under what condition do you see concentric hypertrophy of the LV?
Hypertension
-
Hyaline arteriosclerosis is seen as a result of what?
HTN-where the high BP foces protein thru the endothelium
-
Hyperplastic arteriosclerosis(onion skinning) is seen in what type of HTN?
Malignant hypertension
-
Malignant Hypertension is what systolic and diastolic reading?
- systolic >200
- Diastolic >120
-
Aneurysm?
abnormal dilation of a bv wall due to weakening of the BV wall
-
What are the 3 types of aneurysms?
- saccular
- fusiform
- dissecting
-
What are teh 3 consequences of an aneurysm?
- rupture
- thrombogenesis
- compression of adjecent structures
-
Why do AAA occur below the Renal arteries (L4)?
because the vasa vasorum does not supply blood to that section of the aorta so poor blood supply = pool healing= weakening of the bv wall
-
How much does the bv have to be occluded in order to hear a bruit?
75%
-
Mycotic abdominal aneurysms are caused by what organisms?
- salmonella
- gastroenteritis causng
-
What organism causes obliterative endoarteritis of vasa vasorum?
Treponema Pallidium--Tertiary stage
-
What 2 congenital conditions are associated with a Berry Aneurysm?
-
Berry Aneurysms occur at what site of the Circle of Willis?
Bifurcation of the anterior communicating and anterior cerebral Artery
-
What trace mineral is needed for lysyl oxidase for collagen synthesis?
Cu
-
What happens to the mediastinum in an aortic dissection?
Widening of the mediastinum
-
Poly arteritis nodosa affects every organ except what?
Lungs
-
What 2 antigens could lead to PAN?
-
PAN is what type hypersensitivity?
III
-
Lesions of different age are characteristic of what vasculitis?
PAN
-
Asthma, eosinophilia and granulomas are characteristic of what vasculitis?
Churg-Straus syndrome
-
What 2 vasculitis have p-anca antigens?
- churg-strauss syndrome
- Microscopic polyangitis
-
Kawasaki affects which blood vessels?
coronary arteries
-
Which vasculitis presents with a skin rash and lymphadenopathy
Kawasaki
-
Systemic vasculitis of URT and LRT is seen in what vasculitis?
Churg-Strauss Syndrome
-
Which 2 vasculitis are type III hypersensitivity?
- PAN
- Microscopic Polyangitis
-
What are the drugs and bacteria that could precipitate microscopic polyangitis?
- Drugs: penicillin, Sulfanamides
- beta hemolytic streptococcal ag
-
What vaculitis is associated with HLA-DR4?
Giant cell arteritis
-
Giant cell arteritis is associated with what disease?
Polymyalgia rheumatica
-
Which vasculitis is the pulseless disease?
Takayasu
-
Which vasculitis follows the a URI?
Henoch-Schloein Purpura
-
Thromboangitis Obliterans is also known as what?
Buerger disease
-
What predisposes to Thromboangitis Obliterans?
Smoking
-
What is the difference between Good Pasture Syndrome and Wegener's Granulomatosis?
Good pasture--no sinus involvement
-
What anca is present in Wegener's Granulomatosis?
c-ANCA
-
What are the conditions that predispose to Raynauds Phenomenon
- Thromboangitis Obliterans
- Takayasu
- Thoracic Outlet Syndrome
- Cryoglobulinemia
- CREST
- Cold Glutinin Disease
- Ergot poisoning
-
IgA nephropathy causing vasculitis?
Henoch-Schloeinin Purpura
-
What is affects in Henoch-Schloein Purpura?
-
What 2 vasculitis have c-ANCA?
- church-strauss syndrome
- Microscopic polyangitis
-
What 2 vasculitis are type III hypersensitivity?
- PAN
- MIcroscopic Polyangitis
-
Primary varicose veins occur when?
- valvular incompetence
- weakened BV walls
-
Esophageal Verices are seen under what condition?
liver cirrhosis with portal hypertension
-
Kaposi sarcoma is a frequency of what part of the skin?
endothelium
-
Kaposi sarcoma is caused by what virus?
HHV-8
-
Angiosarcoma of the liver is associated with what 3 compounds?
- Vinyl Chloride
- Arsenic
- Thorostat
-
Strawberry hemangioma is a tumor found in what age group?
children-capillary tumor--regresses spontaneously
-
Cherry Hemangioma is a tumor found in what age group?
- Elderly
- Capillary tumor--does not regresses
-
Where is pyogenic Granulomas usually found?
-
What condition predisposes to Pyogenic Granuloma?
Pregnancy
-
Hemangioblastomas are usually associated with what syndrome?
Von Hippel Syndrome
-
Glomus tumor (Glomangioma) is located where?
underneath the fingernails
-
Kaposi sarcoma presents with what ?
Red purple skin plaques on extremeties but could also be on viscera
-
Chronic or Immunosuppresed Kaposi Sarcoma spreads to viscera?
Immunocompromised and skin lesions may be absent
-
Cystic Hygroma is associated with what Syndrome?
Turne Syndrome
-
Which tumor has a staghorn vascular pattern?
Hemangiopericytoma
-
What is calculus?
mineralized bacterial plaque
-
Difference between gingivitis and Perdiodontitis?
- Gingivitis-inflammation of soft tissue surrounds the gums
- Periodontitis--inflammation of
- periodontal ligament
- alveolar bone
- cementum
-
Pyogenic granuloma is a hemangioma of what?
capillary
-
What can predispose to pyogenic Granuloma?
-
Where does pyogenic granuloma normally occur
-
Inflammation/glossitis occurs in what vitamin deficiency?
Vitamin B ---most of them, cobalamin, niacin, pyridoxine
-
What is the Plummer-Vinson Syndrome?
- Dysphagia
- Iron-deficiency anemia
- Glossitis
-
Peripheral Giant cell Granuloma is caused by what?
Where does it appear?
chronic inflammation
-
What caues Apthous Sores (canker sores)?
stress
-
What test detects herpes?
Tzanck test
-
What does the Tzanck test detect?
multinucleated Giant cells and Intranuclear inclusions
-
Oval yeast like budding cells and pseudohyphae are characteristic of what fungi?
Candida Albicans
-
What are the 3 types of Candidiasis?
- pseudomembrane
- erythomateus
- hyperplastic
-
Who gets white plaque lesions---Hairy Leukoplakia?
Immunocompromised---AIDS
-
What causes Hairy Leukoplakia?
EBV
-
What aspect of the tounge is Hairy Leukoplakia on?
Lateral Aspect
-
Ballooning of squamous cells in upper epithelium is characteristic of what oral condition?
Oral Hairyleukoplakia
-
What predisposes to Leukoplakia?
- Abrasions to the buccal Mucosa i.e
- smoking
- alcohol
- spicy foods
-
Which conditions of the tounge can turn malignant?
-
95% of the time oral cancer is of what origin?
Squamous cell Carcinoma
-
Keratin pearls are characteristic of what type of cancer?
Squamous cell Carcinoma
-
What causes nasopharyngeal carcinoma?
EBV
-
Remnant of the Thyroglossal Duct is called?
Foramen Caecum
-
What is the epithelium of the Thyroglossal duct above the hyoid bone?
Below?
- above-squamous
- below--ciliated columnar
-
Which types of HPV give rise to benign lesions?
6 and 11
-
Reactive vocal cord nodule arises from bc of what stimulation?
- chronic smokers
- singer- or those who strain their vocal cords
- Never give rise to tumors
-
Juvenile Laryngeal Papillomatosis is caused by what?
HPV 6 and 11
-
Abestosis gives rise to what common cancer?
second common?
- bronchogenic carcinoma
- Mesothelioma
-
95% of Larynx carcinoma are of what origin?
squamous cell carcinoma
-
What is the etiology of Larynx carcinoma?
- smoking
- EtOH
- Irradiation
- Asbestosis
- HPV
-
Dry eyes, Dry mouth, Parotitis and Arthritis is what syndrome?
Sjogren Syndrome
-
Dry eyes, dry mouth is what syndrome?
Sica syndrome
-
What antibodies are present in Sjogren syndrome?
-
What are the complication of Mumps?
parotitis, Meningitis, Orchitis, pancreatitis
-
What autoimmune disorder is associated with Sjogren?
Rheumatoid Arthritis
-
Most common benign salivary gland tumor?
Pleiomorphic(mixed) adenoma
-
What is meant by Mixed tumor(Pleiomorphic)
epithelial/mesenchymal components
-
Osler-Weber-Rendu syndrome?
- telangiectasia
- Epistaxis
- AVM
-
cardiac rhabdomyosarcoma and hamartomas of CNS seen in what syndrome?
Tuberous Sclerosis
-
Port wine stain in V1 opthalmic region is part of what syndrome?
Sturge-Weber syndrome
-
What 2 conditions can cause lung hypoplasia?
- oligohydramnios
- renal abnormalities in utero
-
Bronchogenic cystis a detached what primitive structure?
primitive foregut
-
Which is the more common, with large cysts and good prognosis?
congenital pulmonary artery malformation?
CPAM-1
-
What are the the different types of atelectasis?
- obstructive--copd-mediastinum moves toward the affected lung
- Compressive---pleural effusion, pneumothorax--mediastinum moves away from the affected lung
- Patchy--loss of surfactant--NRDS or ARDS
- Contraction--fibrosis due to infection/Tb
-
Which atelectasis is irriversible?
contraction
-
WHat is the difference between typical and atypical pneumonia?
- typical--consolidation in lobe/lung--sputum
- s. pneumonia
- Atypical--interstitial involvement-
- viruses
- chlamydia pneumoniae
- Mycoplasma pneumonia
- Legionella
-
Community acquired pneumonia is by what bacteria?
what is seen on the gram stain?
- s. pneumonia
- lancet diplococci
-
Bacteria causes pneumonia and meningitis in kids?
H. influenza-coccoid rod
-
Bacteria in elderly pt with pneumonia?
Moraxella catarrhalis
-
3 bacteria causes otits media in kids?
- s. pneumonia
- h. influenza
- M.catarrhalis
-
Pneumonia in chronic etoh users?
klebsiella
-
secondary pneumonia in kids and adults after a viral infection?
staph. aureus
-
Cause of nocosomial pneumonia and IV drug user pneumoniae?
staph. aureus
-
Elevated cold agglutinins are found in what type of Pneumonia?
atypical with interstitial infiltrate
-
What is Reye syndrome?
- hepatoencephalopathy with aspirin use after a influenza or VZV infection
- bc aspirin inhibits beta oxidation in liver--liver becomes fatty---no plasma proteins...reduced oncotic pressure..edema in brain..encephalopathy?
-
Aspiration abscess usually occurs where inthe lung?
rt lower lobe
-
Lung abscess occurs when?
- secondary to obstruction
- secondary to septic emboli
- secondary to s. aureus
- aspiration
-
Under what 3 conditions are night sweats present?
- hodgkin lymphoma
- TB
- Takayasu vasculitis
-
Which conditions produce cavitation in the lung?
-
Which pneumoconicosis predisposes to TB?
silicosis
-
What is Pott's disease?
miliary TB in the vertebra
-
What Obstructive lung disease gives a blue bloater?
chronic bronchitis
-
What obstructive lung disease gives a pink puffer?
emphysema
-
Reid index measures the thickness of the mucus glands to the width of the epithelium to the cartilage and indicates what condition?
chronic bronchitis
-
Chronic bronchitis can lead to what 3 consequences?
- infections
- cor pulmonale
- carcinoma because of metaplasia and dysplasia
-
What happens in emphysema?
distruction of elastin= septa resulting in enlarged air spaces
-
What are teh different types of emphysema?
- pancinar--alpha 1 antitrypsin deficiency--uniform in
- centricinar--smoking associated--central part of b
- septal-- enlargerement of distal parts of alveolus--
-
Which emphysema type is associated with smoking and chronic bronchitis?
centricinar
-
WHich type of emphysema can lead to bullae which can spontaneously rupture and lead to pneumothorax?
paraseptal
-
What are the 2 types of asthma?
- extrinsic--allergic-hypersensitivity
- intrinsic---idiopathic--cold,
-
What are curshman spirals?
where is it seen in?
- epithelial cells wrapped in mucus plugs
- asthma
-
What happens to the morphology of the airways in asthma?
- hypertroph of goblet cells
- inflammation
- edema
- hypertrophy of smooth muscle
- thickened basement membrane
-
What is bronchiectasis?
dilation of alveoli due to an obstruction--copd, chronic bronchitis, necrotizing pneumonia, CF, kartageners which leads to inflammation and progressive destruction of the alveolus
-
What is the MCC in COPD?
bronchiectasis
-
Honey comb lung on X ray indicates what?
restrictive interstitial disease
-
Idiopathic pulmonary fibrosis is caused by what?
repeated cycles of injury and healing with increased collagen deposition and ensuing fibrosis
-
Pneumoconicosis are caused by what 3 compounds?
- Asbestos
- Silica
- coal
- berillium
-
What is caplan syndrome?
Rheumatoid nodules + COAL workers pneumoconicosis
-
Coal and silica affect what part of the lung?
upper part
-
what pneumoconicosis caused eggshell dystrophic calcificatio of the hilar lymph nodes?
silicosis
-
What effect does silica have on the function of the phagolysosome?
inhibits it thus predisposing the pt to Tb and carcinoma bc of inefficient macrophage activity
-
What conditions does asbestosis cause in the lung?
- plauqes-calcified
- pleural effusion/interstitial fibrosis
- bronchogenic carcinoma
- mesothelioma
-
Ferriginous body is indicative of what interstitial lung disesae?
asbestosis
-
What are the features of Sarcoidosis
- Gammaglobulinemia
- RA
- ACE high
- Interstitial fibrosis
- Non caseating granulomas
-
What cell population is abundant in the lung in sarcoidosis?
TH4 cells
-
Whats a marker of disease in sarcoidosis?
TNF
-
What HLA associationg with sarcoidosis?
HLA A1 and B8
-
IN sarcoidosis there is anergy to what 2 organisms?
-
WHa is characteristic for sarcoidosis on xray?
bilateral hilar lymphadenopathy
-
Shaumann bodies and asteroid bodies are seen in what restrictive lung diseases?
sarcoidosis
-
What are 3 types of hypersensitivity pneumonitis?
- farmers lung--inhalation of actinomyces spores from hay
- Pigeon breeders lung--inhalation of pigeon excreta
- Humidifier and air conditioned--thermophilic spores of bacteria
-
What happens is ARDS?
alveolar and capillary damage
-
In NRDS and ARDS what is deposited in the alveoli that prevents oxygen diffusion?
hyaline membrane because of diffuese inflammation and fibrosis
-
What shoudl be the sphinogomyelin to lecithin ration?
at least 2
-
Iron laiden macrophages (heart failure cells) are seen in what condition?
pulmonary edema due to left ventricular failure---blood extravasates and is taken up in the alveoli by macrophages
-
V/mismathc is characteristic of what pulmonary condition?
pulmonary emboli
-
What is the difference in the inflammation pattern between good pasture and wegeners granulomatosis?
- good pasturure---linear inflammation
- wegeners----nodal involvement
-
Coin lesion on an xray is most likely?
hamartoma
-
What are teh genetic mutation associated with bronchogenic carcinoma?
-
What is the difference in location between adenocarcinoma and SCC?
- adenocarcinoma--peripheral
- SCC--central
-
Which lung cancer is associated with occupational hazard exposure such as asbestos
bronchogenic
-
What kind of shape does bronchoalveolar(subset of adenocarcinoma) have?
butterfly
-
Where does a bronchoalveolar tumor occur?
wall of bronchiole of alvolar
-
Which lung tumor has keratin pearls?
sCC
-
Which lung cancer has salt and pepper chromatin?
small cell
-
What 2 lung tumors are located centrally?
-
Which 2 lung tumors secrete hormones(paraneoplastic)
- SCC-PTHrp
- Small cells--adh and acth
- Lambert eaton
-
Hypertrophic pulmonary osteroarthropathy
- clubbing
- arthritis
- periosteal new bone formation
-
What are the complications of lung tumors?
- superior vena cava syndrome
- Pancoast tumor
- Horners
- Endocrine
- Recurrent laryngeal
- Effusion pleural
-
benign mesothelioma is acalled?
solitary fibrous tumor
-
What are the two types of malignant mesothelioma?
- sarcomantous--spindle shaped cells
- carcinomatous--ciliated columnar cells
-
What lung tumor resembles pneumonia?
bronchioalvolar tumor
-
Cardiac rhabdoymyoma is associated with what syndrome?
Tuberous Sclerosis
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