Section 1
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Antigliadin antibodies
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Cards (725)
Section 1
(50 cards)
Antigliadin antibodies
Celiac disease
Blue sclera
Osteogenesis imperfecta
Albuminocytologic dissociation
Guillain-Barre (↑ protein in CSF with only modest ↑in cell count)
Bilateral hilar adenopathy, uveitis
Sarcoidosis
Atrophy of the mammillary bodies
Wernicke's encephalopathy
Small/medium-artery Vasculitis strongly associated w/smoking (much weaker association w/smokeless)
Buerger's disease AKA thromboangitis obliterans
Babinski's sign indicates
UMN lesion
Burton's lines
Lead poisoning
"Brown tumor" of bone
Hyperparathyroidism causing Osteitis fibrosa cystica(von Recklinghausen's disease of bone) Hemorrhage causes brown color of osteolytic cysts; Also seen in renal osteodystrophy, a co-morbidity of CRF (MC cause of secondary hyper-PTH)
Aschoff bodies
Rheumatic fever
Vasculitis MC associated withP-ANCA (aka MPO-ANCA); this dz is a form of polyarteritis nodosa (usually medium) affecting smaller arteries than classic PAN
Microscopic polyangiitis; (P-ANCA/MPO-ANCA also associated with Churg-Strauss dz and primary pauci-immune cresenteric GN)
Often precedes squamous cell carcinoma
Actinic keratosis
Cerebellar tonsillar herniation
Arnold-Chiari malformation
Posthepatic venous thrombosis
Budd-Chiari syndrome
Brushfield's spots (Grayish-brown spots in the peripheral iris)
Down syndrome
Autosplenectomy
Sickle cell anemia
Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
Polyostotic fibrous dysplasia (in and of itself = Albright's DISEASE), precocious puberty, cafe-au-lait spots, short stature, young girls
Albright's syndrome (aka McCune-Albright syndrome)
Boutonniere deformity
Rheumatoid arthritis
Defective dystrophin; less severe than Duchenne's
Becker's muscular dystrophy
Boot-shaped heart on x-ray
Tetralogy of Fallot; RVH
Bouchard's nodes
Osteoarthritis (PIP swelling 2° to osteophytes)
8:14 translocation; associated with EBV
Burkitt's lymphoma
Hereditary nephritis with nerve deafness
Alport's syndrome
"Bamboo spine" on x-ray
Ankylosing spondylitis
Arachnodactyly
Marfan's syndrome
Auer rods are not always seen in this disorder but are pathognomonic when they are seen (Elongated, needle-shaped, cytoplasmic clumps of azurophilic granules composed of fused lysosomes in leukemic blast cells; azurophilic granules normally contain lysosomal enzymes such as myeloperoxidase, phospholipase A2, Acid Hydrolases, Elastase, defensins, neutral serine proteases, lysozyme, and bactericidal/permeability increasing protein)
Acute myelogenous leukemia (especially the promyelocytic type)
Anticentromere antibodies
CREST sz (occasionally seen in scleroderma, of which CREST is cutaneous variant)
Basophilic stippling of RBCs
Lead poisoning
Anti-double-stranded DNA antibodies (ANA antibodies)
SLE (type III hypersensitivity)
Anti-basement membrane antibodies; specifically against alpha-3 chain of collagen type IV
Goodpasture's syndrome
Anti-IgG antibodies
Rheumatoid arthritis
Bence Jones proteins
Multiple myeloma (kappa or lambda Ig light chains in urine), Waldenstrom's macroglobulinemia (IgM)
Branching rods in oral infection
Actinomyces israelii
Blue-domed cysts
Fibrocystic change of the breast
Bloody tap on LP
Subarachnoid hemorrhage
X-linked agammaglobulinemia
Bruton's disease
Birbeck granules on EM
Histiocytosis X (eosinophilic granuloma)
1° adrenocortical deficiency
Addison's disease
Antineutrophil antibodies
Vasculitis
"Blue bloater"
Chronic bronchitis
Bernard-Soulier disease
Defect in platelet adhesion (gp1b; adheres to vWF)
Antihistone antibodies
Drug-induced SLE
Baker's cyst in popliteal fossa
Most commonly seen in rheumatoid arthritis; may be caused by any form of knee arthritis as well as Lyme Disease.
Antimitochondrial antibodies
1° biliary cirrhosis
Anti-epithelial cell antibodies
Pemphigus vulgaris
Bartter's syndrome
Hyperreninemia
Berger's disease
IgA nephropathy
LMN CN VII palsy
Bell's palsy
Argyll Robertson pupil (+ pupillary constriction on accomodation with absent pupillary light reflex)
Neurosyphilis (in tertiary stage)
Section 2
(50 cards)
Elastic skin
Ehlers-Danlos syndrome
Superior trunk brachial plexus injury ("waiter's tip")
Erb-Duchenne palsy
Chancroid (painful)
Haemophilus ducreyi
Post-MI fibrinous pericarditis
Dressler's syndrome
Predisposition to gastric carcinoma
Chronic atrophic gastritis
Charcot-Leyden crystals
Bronchial asthma (Think A-B-C; Asthma-Bronchi-Charcot [C= Charcot-Leyden crystals, and Curshmann's spirals which are also characteristic of bronchial asthma])
Trypanosome cruzei infection
Chagas' disease
Currant-jelly sputum
Klebsiella
Acute gastric ulcer associated with CNS injury
Cushing's ulcer
Congenital conjugated hyperbilirubinemia (black liver)
Dubin-Johnson syndrome
Donovan bodies (intracellular inclusions of the rod-shaped organism within phagocytes/histiocytes)
Granuloma inguinale; caused by klebsiella granulomatis, formerly known as calymmatobacterium granulomatis
Chvostek's sign
Hypocalcemia (facial muscle spasm upon tapping)
Dermatitis, dementia, diarrhea
Pellagra (niacin, vitamin B3 deficiency)
Continuous machinery murmur
Patent ductus arteriosus
Charcot's triads (triad 1 & triad 2)
Multiple sclerosis (nystagmus, intention tremor,scanning speech), cholangitis (jaundice, RUQ pain, fever)
Trisomy 18 associated with rocker-bottom feet, low-set ears, heart disease
Edwards' syndrome
Clue cells
Bacterial vaginosis (Gardnerella vaginalis)
Cardiomegaly with apical atrophy
Chagas' disease
Deleted dystrophin gene (X-linked recessive)
Duchenne's muscular dystrophy
Chancre (not painful)
1° syphilis
Cold agglutinins
Mycoplasma pneumoniae, infectious mononucleosis
Dog or cat bite
Pasteurella multocida
Cotton-wool spots
Chronic hypertension
Acute gastric ulcer associated with severe burns
Curling's ulcer (when doing bicep CURLs, you feel the burn)
Vasculitis MC associated with C-ANCA (now called PR3-ANCA); often leads to RPGN (75%), lung damage, and arthritis (60%)
Wegener's granulomatosis; (formerly classifies as small vessel vasculitis though it affects small and medium-sized aa)
Cowdry type A bodies
Herpesvirus
Cerebriform nuclei
Mycosis fungoides (cutaneous T-cell lymphoma)
Condylomata lata
2° syphilis
Councilman bodies
Toxic or viral hepatitis
Caisson disease
Gas emboli
Eburnation (polished, ivory-like appearance of bone)
Osteoarthritis
Eisenmenger's complex
Late cyanosis shunt (uncorrected L → R shunt becomes R → L shunt)
Cold intolerance
Hypothyroidism
Cherry-red spot on macula
Tay-Sachs, Niemann-Pick disease, central retinal artery occlusion (as well as in many other lipid-storage disorders)
Crescents in Bowman's capsule
Rapidly progressive/crescentic glomerulonephritis (RPGN)
Depigmentation of neurons in substantia nigra
Parkinson's disease (basal ganglia disorder--rigidity, resting tremor, bradykinesia)
Cough, conjunctivitis, coryza
Measles
Cafe-au-lait spots on skin
Neurofibromatosis
Cheyne-Stokes respirations (oscillation of ventilation between apnea and tachypnea with a crescendo-decrescendo pattern in the depth of respirations, to compensate for changing serum partial pressures of oxygen and carbon dioxide)
Central apnea in CHF and ↑ intracranial pressure
DES exposure in utero
Clear cell adenocarcinoma of the vagina
Congenital unconjugated hyperbilirubinemia
Crigler-Najjar syndrome (also Gilbert's dz which is more common and usually benign/asymptomatic)
Phagocyte deficiency
Chediak-Higashi disease
elevated D-dimers
DIC
Debranching enzyme deficiency
Cori's disease
"Chocolate cysts"
Endometriosis
Diabetes insipidus + exophthalmos
Hand-Schuller-Christian disease (associated with multifocal Langerhan's cell histiocytosis; often seen is a triad of exophthalmos, lytic bone lesions (often in the skull), and diabetes insipidus (from pituitary stalk infiltration)
Bronchial asthma (whorled mucous plugs)
Curschmann's spirals (Think A-B-C; Asthma of the Bronchi = Curschmann)
Call-Exner bodies
Granulosa-theca cell tumor of the ovary
Calf pseudohypertrophy
Duchenne's muscular dystrophy
Codman's triangle on x-ray
Osteosarcoma
Section 3
(50 cards)
Hyperphagia + hypersexuality + hyperorality + hyperdocility
Kluver-Bucy syndrome (amygdala)
Koplik spots
Measles
Idiopathic polyneuritis
Guillain-Barre syndrome
Jarisch-Herxheimer reaction
Syphilis—overaggressive treatment of an asymptomatic patient that causes symptoms due to rapid lysis
High-output cardiac failure (dilated cardiomyopathy)
Wet beriberi (thiamine, vitamin B1 deficiency)
Erythema chronicum migrans
Lyme disease
Honeycomb lung on x-ray
Interstitial fibrosis
Autoantibodies against alveolar and glomerular basement membrane proteins
Goodpasture's syndrome
"Hair-on-end" appearance on x-ray
β-thalassemia, sickle cell anemia (extramedullary hematopoiesis)
Gowers' maneuver
Duchenne's (use of patient's arms to help legs pick self off the floor)
Glucocerebrosidase deficiency
Gaucher's disease
Increased uric acid levels
Gout, Lesch-Nyhan syndrome (HGPRT deficiency), myeloproliferative disorders, loop and thiazide diuretics
Homer Wright rosettes
Neuroblastoma
Koilocytes
HPV
Heberden's nodes
Osteoarthritis (DIP swelling 2° to osteophytes)
HbF
Thalassemia major
"Fat, female, forty, and fertile"
Cholelithiasis (4 F's = highest risk)
Keratin pearls
Squamous cell carcinoma
HLA-DR3 or -DR4
Diabetes mellitus type 1 (caused by autoimmune destruction of β cells)
Colon polyps with osteomas and soft tissue tumors
Gardner's syndrome
Heinz bodies (RBC inclusions of denatured hemoglobin)
G6PD deficiency
Hypersegmented neutrophils
Macrocytic anemia
Fatty liver
Alcoholism
Bilateral amygdala lesions
Kluver-Bucy syndrome
Krukenberg tumor
Gastric adenocarcinoma with ovarian metastases
Heterophil antibodies
Infectious mononucleosis (EBV)
HbS
Sickle cell anemia
Neutrophil chemotaxis abnormality
Job's syndrome
Kayser-Fleischer rings
Wilson's disease
Dynein defect
Kartagener's syndrome
Howell-Jolly bodies
Splenectomy (or nonfunctional spleen)
Hyperpigmentation of skin
1° adrenal insufficiency (Addison's disease)
Ferruginous bodies
Asbestosis
Caudate degeneration (autosomal dominant)
Huntington's Dz
Horner's syndrome
Ptosis, miosis, and anhidrosis
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo), Down syndrome
Increased α-fetoprotein in amniotic fluid/maternal serum
Anencephaly, spina bifida (neural tube defects)
Chronic progressive histiocytosis
Hand-Schuller-Christian disease
Kimmelstiel-Wilson nodules
Diabetic nephropathy
Benign congenital unconjugated hyperbilirubinemia
Gilbert's syndrome
Defect in platelet aggregation (gpIIb/IIIa; fibrin cross-links)
Glanzmann's thrombasthenia
HLA-B27
Reiter's syndrome, ankylosing spondylitis
Common tumor in AIDS in MSM (men who have sex with men); Caused by HHV-8
Kaposi's sarcoma
Proximal tubular reabsorption defect
Fanconi's syndrome
Hypochromic microcytosis
Iron deficiency anemia, lead poisoning
Hypertension (often hypernatremic) + hypokalemia
Conn's syndrome (hyperaldosteronism)
Janeway lesions
Endocarditis
Hypersensitivity vasculitis associated with hemorrhagic urticaria and URIs
Henoch-Schonlein purpura
Intussusception
Adenovirus (causes hyperplasia of Peyer's patches)
Ghon focus
1° TB
Section 4
(50 cards)
Pannus
Rheumatoid arthritis
Palpable purpura on legs and buttocks post-infxn; MC vasculitis of children; Associated with IgA nephropathy (berger's dz)
Henoch-Schonlein purpura
Painless jaundice
Pancreatic cancer (head)
Lysosomal glucosidase deficiency associated with cardiomegaly
Pompe's disease
Lens dislocation + aortic dissection + joint hyperflexibility
Marfan's syndrome (fibrillin deficit)
"Pink puffer"
Emphysema (centroacinar [smoking], panacinar [α1-antitrypsin deficiency])
Vertebral tuberculosis
Pott's disease
Mallory bodies
Alcoholic liver disease
Nutmeg liver
CHF; more specifically, right-heart failure leading to hepatic congestion --> nutmeg appearance
Sphingomyelinase deficiency
Niemann-Pick disease
Nigrostriatal dopamine depletion
Parkinson's disease
Owl's eye
CMV
Bronchogenic apical tumor associated with Horner's syndrome
Pancoast's tumor
"Lumpy-bumpy" appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis
No lactation postpartum
Sheehan's syndrome (pituitary infarction)
Podocyte fusion
Minimal change disease
Progressive frontotemporal degeneration leading to dementia similar to Alzheimer's; also displays progressive non-fluent aphasia
Pick's disease
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Wegener's and Goodpasture's (hemoptysis and glomerular disease)
Negri bodies
Rabies
Ascending polyneuropathy preceded by GI or respiratory infection
Guillain-Barre syndrome
Port-wine stain
Hemangioma; Port-wine stain on the face is a manifestation of Sturge-Weber dz also showing leptomeningeal angiomatosis due to intracerebral AVM
McBurney's sign
Appendicitis
Osler's nodes
Endocarditis
Pick bodies (silver-staining, spherical aggregations of tau proteins in neurons)
Pick's disease (aka frontotemporal degeneration/dementia)
Lytic bone lesions on x-ray
Multiple myeloma
Libman-Sacks disease
Endocarditis associated with SLE
HGPRT deficiency
Lesch-Nyhan syndrome
Lucid interval (transient improvement in symptoms following traumatic head injury; followed by deterioration of pt's status)
Epidural hematoma
Muscle phosphorylase deficiency
McArdle's disease
Benign intestinal polyposis and Black macules on lips/oral mucosa
Peutz-Jeghers syndrome (AD)
Esophageal webs with iron deficiency anemia
Plummer-Vinson syndrome
Needle-shaped, negatively birefringent crystals
Gout
Lisch nodules
Neurofibromatosis (von Recklinghausen's disease)
MLF/Medial longitudinal fasciculus syndrome (aka Intranuclear opthalmoplegia; disorder of lateral conjugate gaze in which affected eye shows impaired adduction)
Multiple sclerosis
Polyneuropathy, cardiac pathology, and edema
Dry beriberi (thiamine, vitamin B1 deficiency)
Lines of Zahn
Arterial thrombus
Monoclonal antibody spike
Multiple myeloma (called the M protein; usually IgG or IgA), MGUS (monoclonal gammopathy of undetermined significance), Waldenstrom's (M protein = IgM) macroglobulinemia
Periosteal elevation on x-ray
Pyogenic osteomyelitis
Nephritis + cataracts + hearing loss
Alport's syndrome
Lewy bodies (alpha-synuclein inclusions in neurons of diseased brain)
Parkinson's disease
Podagra
Gout (MP joint of hallux)
Philadelphia chromosome (bcr-abl; t9:22 )
CML (may sometimes be associated with AML)
"Orphan Annie" nuclei
Papillary thyroid carcinoma
Kussmaul hyperpnea (breathing is first rapid and shallow but as acidosis worsens, breathing gradually becomes deep, slow, labored and gasping)
Diabetic ketoacidosis
Esophagogastric lacerations (usually seen after heavy drinking/heavy vomiting)
Mallory-Weiss syndrome
Neurofibrillary tangles
Alzheimer's disease
Occupational exposure to asbestos
Malignant mesothelioma
Low serum ceruloplasmin
Wilson's disease
Penile fibrosis
Peyronie's disease
Myxedema
Hypothyroidism
Section 5
(50 cards)
Postpartum pituitary necrosis
Sheehan's syndrome
Reinke crystals (Inclusions normally found in Leydig Cells)
Leydig cell tumor
Swollen gums/tooth loss, bruising, poor wound healing, anemia
Scurvy (ascorbic acid, vitamin C deficiency)—vitamin C is necessary for hydroxylation of proline and lysine in collagen synthesis
Slapped cheeks
Erythema infectiosum (fifth disease)
Pseudopalisade tumor cell arrangement
Glioblastoma multiforme
Congenital conjugated hyperbilirubinemia
Rotor's syndrome
Smith antigen
SLE
Rash on palms and soles
2° syphilis (T. pallidum), Rocky Mountain spotted fever (R. rickettsii) , hand-foot-and-mouth disease (coxsackie A & enterovirus 71 of picornavirdeae)
Recurrent vasospasm in extremities
Raynaud's syndrome
Rhomboid crystals, positively birefringent
Pseudogout
Senile plaques
Alzheimer's disease
Sipple's syndrome
MEN type IIa
Shwartzman reaction (endotoxin induced thrombosis in affected tissue often causing reticuloendothelial blockade; often seen during delivery or abortion)
Neisseria meningitidis
Rouleaux formation (Stacked RBCs)
Multiple myeloma (or any condition [infxn, inflammation, CT disorders, and DM) where plasma protein conc. is increased, particulary that of acute phase proteins such as fibrinogen)
Sezary syndrome
Cutaneous T-cell lymphoma
Urethritis, conjunctivitis, arthritis
Reiter's syndrome
S4 may be caused by (2 main conditions)
Aortic stenosis, or hypertrophic subaortic stenosis
Spike and dome on EM
Membranous glomerulonephritis
Ptosis, miosis, anhidrosis
Horner's syndrome (Pancoast's tumor)
Renal epithelial casts in urine
Acute toxic/viral nephrosis
Schiller-Duval bodies
Yolk sac tumor (think SHELLer-Duvall bodies; crack open an egg SHELL to get to the yolk)
What abnormal heart sound would be heard in Left-to-right shunt (VSD, PDA, ASD), mitral regurgitation, or LV failure (CHF)
S3
Recurrent pulmonary Pseudomonas and S. aureus infections
Cystic fibrosis
Sulfur granules
Actinomyces israelii
Pseudorosettes
Ewing's sarcoma
Reed-Sternberg cells
Hodgkin's lymphoma
"Strawberry tongue"
Scarlet fever (also seen in Kawasaki's dz)
RBC casts in urine
Acute glomerulonephritis
Spitz nevus
Benign juvenile melanoma
S3 may be caused by (3 general conditions)
Left-to-right shunt (VSD, PDA, ASD), mitral regurgitation, or LV failure (CHF)
Rib notching
Coarctation of aorta
Splinter hemorrhages in fingernails
Endocarditis
Skip lesions
Crohn's disease
String sign on x-ray
Crohn's disease
Dry eyes, dry mouth, arthritis
Sjogren's syndrome
Streaky ovaries
Turner's syndrome
Subepithelial humps on EM
Poststreptococcal glomerulonephritis (Different from IgA nephropathy where symptoms usually begin within 1-2 days of a URI; Poststreptococcal GN usually occurs a few weeks after initial infxn)
"Smudge cell" (smaller than normal, fragile B-lymphocytes that break or "smudge" when smeared on a glass slide)
CLL (express CD19 & CD20 as do all B-cells and characteristically express CD5 & CD23)
Roth's spots in retina
Endocarditis
Soap bubble on x-ray
Giant cell tumor of bone
Increased Reid index (normally <0.4; Index >0.4 indicates mucous gland hyperplasia)
Chronic bronchitis (Reid index = thickness of mucous gland layer / wall thickness [distance from epith. BM to perichondrium of cartilage])
Red urine in the morning
Paroxysmal nocturnal hemoglobinuria
Positive anterior "drawer sign"
Anterior cruciate ligament injury
Suboccipital lymphadenopathy
Rubella
Simian crease
Down syndrome
Renal cell carcinoma + cavernous hemangiomas + adenomas
von Hippel-Lindau disease
Russell bodies
Multiple myeloma
Starry-sky pattern
Burkitt's lymphoma
Signet-ring cells
Gastric carcinoma
What abnormal heart sound would be heard in Aortic stenosis, or hypertrophic subaortic stenosis
S4
Section 6
(50 cards)
Tophi
Gout
Basket weave lamination of BM
Alport's dz
Hepatolenticular degeneration
Wilson's disease
C3NeF
Type II MPGN
WBC casts in urine
Acute pyelonephritis
Rupture or break in the glomerular BM on EM
RPGN
Wermer's syndrome
MEN type I
triad of risk factors for thrombosis - blood stasis, endothelial damage, hypercoagulation
Virchow's triad
Triple phosphate/struvite stones with Staghorn calculi
Proteus bacteria induced kidney stones
von Recklinghausen's disease of bone
Osteitis fibrosa cystica ("brown tumor")
Coarse, irregular, and granular IF (visualized as "lumpy-bumpy")
Poststreptococcal GN (also in MN, and lupus nephropathy)
Adrenal hemorrhage associated with meningococcemia
Waterhouse-Friderichsen syndrome
t(8;14); associated with EBV
Burkitt's lymphoma (c-myc activation)
Corticomedullary scarring over blunted calyces with "thyroidization" of tubules
Chronic pyelonephritis
Xanthochromia (CSF)
Subarachnoid hemorrhage
BM thickening due to nonenzymatic glycosylation
Diabetic nephropathy
Tram-track appearance
MPGN
Hemorrhagic pneumonitis w/ glomerulonephritis
Goodpasture sz
Spike and dome appearance
Membranous GN
Costovertebral angle tenderness, fever, and burning on urination
Acute pyelonephritis
Hematuria, oliguria, azotemia, and HTN
Nephritic Sz
Upper GI diverticulum
Zenker's diverticulum
Collapsing FSGS and tubuloreticular inclusions (appear as black meshy network) on EM
HIV-nephropathy (More common in blacks whether HIV infxn or not)
Tendon xanthomas (classically Achilles)
Familial hypercholesterolemia
Kimmelstiel-Wilson nodules
Diabetic nephropathy
Xerostomia + arthritis +keratoconjunctivitis
Sjogren's syndrome (sicca syndrome)
ARF presenting as severe oliguria
Acute tubular necrosis
Malabsorption syndrome caused by Tropheryma whippelii
Whipple's disease
Gastrin-secreting tumor associated with ulcers
Zollinger-Ellison syndrome
Thumb sign on lateral x-ray
Epiglottitis (Haemophilus influenzae)
von Recklinghausen's disease (not of bone)
Neurofibromatosis with cafe-au-lait spots
Sclerosis of some glomeruli with only parts of capillary tufts affected
FSGS
Tabes dorsalis
3° syphilis
"Worst headache of my life"
Berry aneurysm—associated with adult polycystic kidney disease
t(14;18) (bcl-2 activation)
Follicular lymphomas (18-14 = FOURllicular)
"Wire loop" appearance on LM
Lupus nephropathy (think LOOPus nephropathy)
Prolonged use of phenacetin, aspirin, acetaminophen, caffeine, or codeine
Analgesic abuse nephropathy
Proteinuria, generalized edema, hyperlipidemia, and lipiduria
Nephrotic Sz
t(9;22) Philadelphia chromosome, (bcr-abl hybrid)
CML
"Tram-track" appearance on LM
Membranoproliferative glomerulonephritis
Systolic ejection murmur(crescendo-decrescendo)
Aortic valve stenosis
Virchow's node
Left supraclavicular node enlargement from metastatic carcinoma of the stomach
Waxy casts in urine
Chronic end-stage renal disease
WBCs in urine
Acute cystitis
Thyroidization of kidney
Chronic bacterial pyelonephritis
Trousseau's signs migratory thrombophlebitis and carpal spasm)
Trousseau's sign of malignancy (pancreatic cancer) and trousseau's sign of latent tetany (hypocalcemia)
Normal glomeruli on LM, but fusion of foot processes on EM
Minimal Change Dz (lipoid nephrosis)
Berry aneurysms w/wo subarachnoid hemorrhage
Polycystic kidney dz
PICA thrombosis
Wallenberg's syndrome
Immune complex deposits in mesangium associated with Henoch-Schonlein purpura (1/3 of HSP pt's get this dz)
IgA nephropathy (Berger Dz)
Section 7
(50 cards)
Benign tumor composed of thick-walled bvv, smooth muscle, and fat
Angiomyolipoma (-angio = bvv, -myo = muscle, -lipo
Tumor-like formations in bone (polyostotic fibrous dysplasia; Albright's dz), café au lait spots, precocious puberty
McCune-Albright Sz
Retinal/cerebellar hemangioblastomas, renal cysts, and RCC
Von Hippel-Lindau sz
Dramatic improvement of muscle weakness with anticholinesterases
Myasthenia gravis
"Mosaic" or "Jigsaw" pattern of lamellar bone on LM
Paget Dz (AKA Osteitis deformans)
Blue sclera, multiple childhood fractures
Osteogenesis imperfect
Sickle cell anemia and bone pain - Name most likely dx and causative agent
Osteomyelitis due to salmonella infxn (**remember, "sickle 'sal' anemia" or "sickle sal-monemia"
Interstitial foam cells, and Psammoma bodies on renal biopsy LM
Papillary RCC
Triad of arthritis, nongonococcal urethritis/cervicitis, and conjunctivitis
Reiter sz
Dragging sensation in the flank
PKD
Osteoblastic mets to bone
Prostate ca
Endosteal scalloping with flocculant densities on X-ray
Chondrosarcoma
Poorly staining cells with some normal staining cells, and perinuclear halo on Renal biopsy
Chromophobe RCC
Red-brown/orange-yellow colored synovial surface with finger-like villi
Pigmented villonodular synovitis
Penile fibromatosis
Peyronie Dz
Arthritis of metatarsophalangeal joints monosodium urate crystals
Gout
Bread & butter (fibrinous) pericarditis
Uremia
Small, round, blue, cell tumor of bone in children
EWS/PNET
Kyphosis and lordosis in a postmenopausal woman
osteoporosis
Costovertebral pain, palpable mass, hematuria
Classic Triad of RCC
Malignant cartilage
Chondrosarcoma
Pseudo-horn cyst
Seborrheic keratosis
RA, splenomegaly, and neutropenia
Felty Sz (I FELT a large spleen in a pt w/ RA)
Herring bone pattern on LM
Fibrosarcoma
TB infection with involvement of vertebral bodies
Pott's Dz
Congenital renal fusion at the lower poles of kidneys
Horseshoe kidney
Bladder mass in pt w/hx of exposure to Beta-napthylamine or cyclophosphamide
TCC of the bladder
Morning stiffness, symmetric involvement of PIP joints
RA
Carcinoma mets to bone and leukoerythroblastosis
Meyelopthistic anemia
Oligohydramnios, hypoplastic lungs, extremity defects (Potter's sequence)
Bilateral renal agenesis
Proliferative synovitis with CD4+ T-cells in synovium
RA
Absent rheumatoid factor and nodules, ANCA positive
Juvenile onset RA
Hx of cyclophosphamide chemoTx or adenovirus infxn
Hemorrhagic Cystitis
Dupuytren contracture
Palmar fibromatosis
Heberden nodes (women; DIP joint swelling secondary to osteophytes)
Osteoarthritis
Homer-Wright rosette
PNET
Headache, head enlargement, visual disturbances, deafness
Paget's Dz of bone (osteitis deformans)
Ulnar deviation of the fingers, radial deviation of wrists
RA
Child presenting with palpable flank mass and hematuria
Wilm's tumor (MC childhood renal malignancy)
Young boy with clumsiness and difficulty walking with pseudohypertophy of calf muscles
Duchenne muscular dystrophy
Herniated synovial cyst of the knee
Baker's cyst
Prolonged dialysis for ESRD
Acquired cystic Dz of the kidney (also increased risk of RCC (7% of dialyzed pts after 10 yrs))
Michaelis-Gutmann bodies on LM
Malacoplakia
Acanthosis nigricans
GI malignancy
Eburnation, "polished ivory" appearance of articular bone surfaces
Osteoarthritis
Pt < 20yo showing Codman's triangle on X-ray
Osteosarcoma (Mets always assumed)
Crescent-like formation in majority of glomeruli
RPGN (AKA crescenteric GN)
Bone tumor in the knee>hip>shoulder>mandible
Osteosarcoma (Mets always assumed)
Soft tissue tumor near joint in extremity w/ biphasic appearance on LM of Spindle cells and epitheliod foci
Synovial sarcoma
Bladder Ca associated with Schistosoma hematobium
SqCC
Section 8
(50 cards)
Name the 4 most important primary glomerular dzz associated with nephrotic sz
1. Minimal change dz (lipoid nephrosis) 2. FSGS 3. Membranous nephropathy 4. MPGN ( Often mixed nephrotic/-itic presentation
Malar rash
SLE
Malignant fibrohistiocytic neoplasms are referred to as?
Fibrosarcomas (formerly: malignant fibrous histiocytoma)
Focal sclerosis on LM, Segmental foot process effacement, microvillous/cystic changes on EM
FSGS
Pentad of Findings: Fever, neurological sx. Hemolytic anemia, thrombocytopenic purpura, thrombi in glomerular capillaries/arterioles
Idiopathic thrombotic thrombocytopenic purpura (1 cause of thrombotic microangiopathy).
Most common cause of nephrotic sz in US adults
FSGS
GFR 50% of normal
Diminished reserve
Nikolsky's sign (rubbing of the skin results in exfoliation of the skin's outermost layer)
Pemphigus vulgaris
Breslow depth & Clark level
Melanoma (These are prognostic indicators used for melanomas. Breslow depth is the more important one as it relates to degree/potential of invasion)
Sezary-Lutzner cell and/or pautrier's microabscesses
Mycosis fungoides type of cutaneous T-cell lymphoma (CTCL is a class of Non-Hodgkin's lymphomas w/ many subgroups)
Polyuria, nocturia, electrolyte disturbances
Renal tubular defects
GFR < 20% of normal
Renal failure
Hematuria, azotemia, variable proteinuria, oliguria, mild edema, and HTN
Acute nephritic Sz
Intraepidermal blister cavity "tombstoning"
Pemphigus vulgaris
Infarction of bone and marrow due to a vascular abnormality
Osteonecrosis (aka avascular necrosis)
Malignant SM neoplasm
Leiomyosarcoma
Common settings in which FSGS occurs (from MC to LC)
Idiopathic > glomerular scarring from other primary glom. Dz, eg IgA nephropathy > loss of renal mass > heroin abuse/HIV/infxn/obesity) > mutations in podocyte or slit diaphragm proteins
Darier's sign
Mastocytocsis (urticaria pigmentosa)
Uncertain fibrohistiocytic neoplasm
DFSP (dermatofibrosarcoma protuberans)
Benign SM neoplasm
Leiomyoma
Collapsing FSGS
HIV-nephropathy
Acute onset azotemia, with oliguria or anuria
ARF
Elevated BUN and creatinine in pt with postrenal obstruction
Postrenal azotemia
GFR 20-50% of normal
Renal insufficiency
Azotemia with constellation signs and sx in many other organs
Uremia
Benign fibrous tumors
Reactive pseudosarcomas: Nodular fasciitis and myositis ossificans
Malignant fibrous tumor
Fibrosarcoma
Retraction artifact
BCC
Renal colic, hematuria, recurrence
Nephrolithiasis
Glomerular hematuria, subnephrotic proteinuria or combination both
Asx hematuria and/or proteinuria
Elevated BUN and creatinine in pt with renal hypoperfusion
Prerenal azotemia
Anti-GBM antibodies
Goodpasture's sz
Most common cause of nephrotic sz in children
MCD (proteinuria highly selective for ALBUMIN)
Name the systemic dzz/conditions giving rise to secondary GN
1. DM 2. Amyloidosis 3. SLE 4. Drugs 5. Infxns 6. Malignancies 7. Others
Lipid in proximal tubules on LM and/or Diffuse foot process effacement with microvillous and microcystic changes on EM
MCD
Uncertain SM neoplasm
Atypical leiomyoma
Most common cause of osteo/avascular necrosis
Steroid tx
Marked proteinuria (>3.5gm/day), hypoalbuminemia, severe edema, hyperlipidemia, lipiduria
Nephrotic Sz
Targetoid lesion
Erythema multiforme
4 M's: Megaly (large cell), Margination (of chromatin), Molding (crowding of cells), Multi (multiple nuclei in cell)
Herpesvirus infxn
Name 3 minor (but not necessarily uncommon)primary glomerular dzz associated with nephrotic sz
1. IgA nephropathy 2. Fibrillary GN 3. Immunotactoid GN
Benign fibrohistiocytic neoplasms
Fibrous histiocytoma and dermatofibroma (skin)
Black or Hispanic pt (MC) with nonselective proteinuria, more hematuria, reduced GFR, HTN (sometimes), and poor steroid response/px
FSGS
Uncertain fibrous tumors
Superficial and deep fibromatoses
Marker of visceral malignancy
Acanthosis nigricans
Acute nephritis, proteinuria, and ARF
RPGN
Wickham striae and/or Koebner phenomenon
Lichen Planus
Prolonged uremia
CRF
Subepidermal blistering without tombstoning
Bullous pemphigoid
GFR < 5% of normal
End-stage dz
Section 9
(50 cards)
Clinical term for thickening of the granular cell layer of the epidermis
Hypergranulosis
Linear, subendothelial IgG deposition on IF
Goodpasture sz
PKD2 or Polycystin 2
AD PKD (10%)
What skin lesion is a blister that is <5mm in diameter?
Vesicle
Renal cancer associated with MET protooncogene
Hereditary papillary RCC
What skin lesion is a blister that is >5mm in diameter?
Bulla
Name the non-neoplastic renal pathologies commonly recurring after transplantation
MPGN, FSGS, fibrillary GN, IgA nephropathy
Most common cause of dwarfism; Autosomal Dominant
Achondroplasia
What skin lesion is similar to a macule but larger (>5mm)?
Patch
Wear-and-tear arthritis
Osteoarthritis
Joint disorder associated with HLA-DRB1 and PTPN22
RA
Antibodies against noncollagenous portion of the alpha-3 chain of type IV coll.
Goodpasture sz
Benign localized hyperplasia of melanocytes
lentigo
Matrix producing tumor in the central skeleton
Chondrosarcoma
Matrix producing primary bone tumor with peak incidence of <20 yo and 2nd peak in elderly with additional risk factors
Osteosarcoma (Additional elderly risk factors include: Paget Dz, infarcts and radiation tx)
Clinical term thickening of the stratum spinosum
Acanthosis
Irregular granular or linear C3 foci in BM and mesangium
MPGN Type II
Immobilization of a previously moveable (synovial) joint due to inflammation
Ankylosis
Ach receptor antibodies
Myasthenia gravis
Three variants of RA mentioned in class/notes can occur associated with these inflammatory dzz
RA associated with ulcerative colitis, Sjogren sz and SLE (non-erosive RA)
Granular, subepithelial IgG and C3 deposition on IF
MGN (human model of Heymann nephritis)
ADAMTS-13 (a protease that normally cleaves vWF multimers)
ITTP
IgG and C3 along capillary loops on IF; Sometimes C1q and C4 on IF
MPGN Type I
Dystrophin
DMD
RF negative, HLA-B27 positive arthritides (4 major include ankylosing spondylitis, Reiter's sz, enteritis associated, and psoriatic)
Seronegative spondyloarthropathies
Collagen most abundant in bone
Type I collagen
Rheumatoid factor (auto-IgM against Fc of IgG)
RA
Name the most common causes of bacterial arthritis (5)
Gonococcus, strep, staph, H. influenza (children), and gram negative coliforms
What skin lesion is a flat, non-elevated discoloration less than 5mm in diameter?
Macule
Common malignancies in adults that mets to bone
Prostate/breast, kidney, lung
Clinical term for thickening of the stratum corneum
Hyperkeratosis
What type of anemia is assoaciated with carcinoma mets to bone?
Myelopthistic anemia (Will see leukoerythroblastosis)
Most common skin malignancy
BCC
PKD1 or Polycystin 1
AD PKD (85%)
IgM and C3 positive on IF
FSGS
What skin lesion is essentially a large papule that may or may not express surface changes and may lie relatively superficial or deep in the subcutis?
Nodule
What skin lesion is similar to a patch but shows elevation?
Plaque
C3NeF (C3 nephritic factor stabilizes C3 convertase causing increased breakdown of C3 and in turn, hypo-C3-emia)
MPGN Type II
Bone tumor associated with RB gene and p53 mutation
Osteosarcoma
EWSFL11, (11;22)(q24;q12) translocation
Ewing sarcoma/PNET
Mutation in podocin, alpha-actinin, or nephrin
FSGS
t(x:18) and fused gene SYT-SSX
Synovial sarcoma
Name the 4 seronegative spondyloarthropathies mentioned in class/notes
Ankylosing, Reiter sz, enteritis associated, psoriatic
Most common cause of pyogenic osteomyelitis except in pts with sickle cell anemia
s. aureus (salmonella in sickle cell anemia pts)
Short arm of chromosome 3 (3p1)
VHL & Hereditary/familial clear cell carcinoma of the kidney
Common malignancies in children that mets to bone
Neuroblastoma, Wilm's tumor, osteosarcoma, Ewing's sarcoma, rhabdomyosarcoma
Increased RANK (receptor found on surface of osteoclasts) and RANKL (found on surface of osteoblasts) expression
Postmenopausal osteoporosis (RANKL activates RANK to stimulate osteoclastic bone resorption; estrogen > testosterone likely suppress expression)
HLA-B27 in pt with back pain
Ankylosing spondylitis
Most common malignant primary bone tumor
Osteosarcoma (Produces primitive (non-calcified) bone, aka osteoid)
Collagen most abundant in articular cartilage
Type II collagen
Section 10
(50 cards)
Occipito-encephalocele (rare condition)
Arnold-Chiari malformation (Chiari III malformation)
Granular IgA deposits in dermal papillae and along BM
Dermatitis herpetiformis
Virus remains latent in trigeminal ganglion. Periodically reactivated by colds/fevers, sun, stress, trauma and menstrual periods. Afebrile illness with no adenopathy.
Herpes labialis
Most common salivary gland tumor in children
Parotid hemangioma
Salivary tumor (the only one with male preponderance; also associated w/smoking) exhibiting papillary fronds lined by a double row of oncocytic cells resting on a non-neoplastic resident lymphoid stroma with germinal centers
Warthin's tumor
hyperkeratosis, band-like lymphocytes infiltrate that hugs the basal layer, liquefaction of basal cells, saw-toothing of rete ridges, exocytosis.
Lichen planus
CD1a and S100 positive on IF
Langerhan's cell histiocytosis
Lesions resembling secondary herpes but with small, recurrent ulcers that resolve in 7-10d but are differentiated from 2nd herpes infxn due to completely different location and lack of vesicle formation
Recurrent apthous ulcers (do not occur in smokers)
Constitutional viral sx with cervical LA and lesions on hands, feet, and buttox.
Hand, foot, and mouth dz (coxsackie virus)
PAS stain demonstrating hyphae
Tinea (ringworm) or other dermatophyte infxn
Hypoplastic cerebellum (rare condition)
Arnold-Chiari malformation (Chiari IV malformation; contrast to Dandy-Walker malformation in which there is underdevelopment [hypoplasticity] or complete absence of the cerebellar VERMIS)
BRAF mutations regarding skin lesion
Melanomas and nevi
Maternal infxn and child with microcephaly or cerebral calcifications
TORCHES (maternal TOxoplasma, Rubella, CMV, or HErpes, Syphilis)
Erythema multiforme affecting mouth, eyes, skin, and genital mucosa. Type IV hypersens. With target lesions of palms and soles
Stevens-Johnson Sz
Slow growing, pseudoencapsulated, lobulated tumor occurring mostly in the parotid gland
Acinic cell carcinoma
IgG against hemidesmosomes (linear IgG and complement deposition along BM)
Bullous pemphigoid
Lesions may resemble primary herpes but; Spare gingiva, have confluent slough, and have skin/other mucosal lesions
Stevens-Johnson sz
Salivary tumor that appears very benign, but is actually very malignant. "Wolf in sheep's clothing"
Adenoid cystic carcinoma (High degree of mets, highly invasive, bone provides no barrier)
Most common malignancy of the submandibular gland, but commonly occurs on the palate
Adenoid cystic carcinoma
Oral lesion that does not affect smokers
Recurrent apthous ulcers (stomach ulcers, canker sores)
Elevated maternal serum AFP (alpha fetoprotein)
Neural tube defects (spina bifida occulta, meningocele, meningomyelocele, anencephaly); (Folic acid - markedly decreases incidence of NTD's by lowering homocysteine levels; homocysteine = CNS and heart teratogen)
Most common malignant salivary neoplasm found on palate and retromolar pad
Mucoepidermoid tumor
Cystic dilation of the fourth ventricle with aplasia or hypoplasia of the cerebellar vermis and an enlarged posterior fossa
Dandy-Walker cyst (think about it, someone with aplasia/hypoplasia of the cerebellar vermis wouldn't be a very "Dandy Walker")
Oral candida with no apparent underlying dz
HIV infxn
Lesions resembling primary herpes but; necrotic papillae, absent oral vesicles or ulcers, not expected in children
ANUG
Failure of hemispheric cleavage; associated with cyclopia, agnathia, and cleft/palate
Holoprosencephaly (70% of trisomy 13 [aka Patau sz or trisomy D] patients have this; also increased in children of diabetic mothers)
Granular deposition of IgG, IgM, and complement at the DE junction
SLE
Resembles primary herpes infxn but lacks gingivitis and has digital lesions
Hand, foot, and mouth dz (coxsackie virus)
Elongated cerebellar tonsils extending through the foramen magnum, late onset hydrocephalus
Arnold-Chiari malformation (Type I)(50% have syringomyelocele)
Hydrocephalus in childhood with beaking of the midbrain, small posterior fossa with elongated cerebellar tonsils and herniated cerebellar vermis, s-shaped kink at the cervico-medullary junction.
Arnold-Chiari malformation (Chiari II malformation)
Acute febrile dz with small vesicles/ulcers limited to soft palate and pharynx
Herpangina (herpanginA virus = Coxsackie A; may also be caused by Coxsackie B or echoviruses)
Most common cause of infectious blindness in the US
Ocular herpes (Often results from auto-innoculation)
Periodic crops of vesicles/ulcers on gingiva/hard palate induced by fever, colds, trauma, stress..
Secondary intraoral herpes
Skin malignancy associated with p53 mutation
SqCC > BCC
Maternal alcohol abuse during pregnancy, facial abnormalities, microcephaly, cardiac defects, others
FAS
Due to rupture of thin walled veins occurring in prematurity with perinatal anoxia
Germinal matrix hemorrhage
Auto-IgG antibodies to desmoglein 3 in desmosomes (IgG and complement deposits between keratinocytes)
Pemphigus vulgaris
Salivary malignancy with high degree of perineural invasion, showing cribiform or "swiss cheese" pattern on histology
Adenoid cystic carcinoma
White plaques which scrape off leaving raw, red mucosa. Usually in immunocompromised or pt using antibiotics, and diabetics
Candida
Punched out necrotic ulcers of gingival papillae
ANUG (acute necrotizing ulcerative gingivitis; aka "trench mouth"
Only salivary gland tumor with high preponderance for males; also associated with smoking (Is smoking really "Warth" it?)
Warthin's tumor
Unilateral dermatomal skin lesions
Herpes zoster infxn (shingles)
Benign salivary neoplasm originating from ductal cells, usually located in the upper lip, resembling an adenoid cystic carcinoma histologically
Canalicular adenoma
PTCH and multiple BCC's
Gorlin sz, aka basal cell nevus sz
PTCH (30%)
Sporadic BCC
Acute febrile illness with malaise and cervical adenopathy. With associated acute hemorrhagic gingivitis
Primary herpetic gingivostomatitis
Most common salivary neoplasm (70% of salivary neoplasms)
Benign mixed tumor (BMT)
This condition is described as the non-development of a particular brain structure that may be asymptomatic, but may be associated with other abnormalities
Agenesis of the corpus callosum
If a patient has herpes zoster infxn with lesions on the tip of the nose, what does this predict?
Ocular spread (refer to ophthalmologist)
Oral hairy leukoplakia (caused by EBV) with no apparent underlying dz
HIV infxn
Section 11
(50 cards)
Schiller-Duvall bodies + Hyaline droplets rich in α-fetoprotein
Yolk sac tumor
Most common cause of bacterial meningitis overall
N. meningiditis
Liquefactive necrosis leading to cyst formation and gliosis healing
Cerebral infarction
Most often caused by ruptured berry aneurysms>atherosclerotic aneurysms and arteriovenous malformations (the latter 2 sometimes occur in intra- or extraparenchymal vessels)
Subarachnoid hemorrhage
Non-erosive arthritis
SLE
Contusion at site of impact; Usually from blow to a stationary head
Coup contusion
2 most common general causes of cerebral infarction
Thrombosis (atherosclerosis w/wo plaque hemorrhage); Embolism (from cardiac mural thrombi or valvular vegitations)
Hydrocephalus in infants and young children will cause what observable physical sign? Why?
Head enlargement, because the fontanelles have yet to fuse
Compensatory expansion of entire CSF compartment in response to extensive brain tissue loss
Hydrocephalus ex vacuo
Absent postpartum lactation
Sheehan's Sz
4 most common (general) causes of hydrocephalus
Congenital malformations, neoplasms, infxns, hemorrhage
Crypt abscess
Ulcerative colitis
Chocolate cysts
Endometriosis
MC Fungi causing infection of the CNS
Cryptococcus, aspergillus, mucor, histoplasmosis, or candida
McBurney's Sign
Apendicitis
Necrotic foci next to lateral ventricles appearing grossly as chalky-yellow plaques; hypoxic/ischemic lesion of premature infants
Periventricular leukomalacia (PVL)
Skip lesions
Crohn's dz
Defined as the morphologic pattern of intracranial ischemia due to cardiorespiratory failure or shock
Anoxic encephalopathy
Ventricular dilation resulting from an obstruction along the subarachnoid path of CSF flow
Communicating hydrocephalus (communicating because ventricular system is still potentially patent)
Spinal anterior horn degeneration in pt with suspected viral infxn
Poliovirus infxn
Cowdry A inclusions (intranuclear) in frontal/anterior temporal lobes
Herpesvirus infxn
Microscopic infarctions (<1cm) associated with hypertensive cerebral microvascular dz; Occur anywhere but prefer basal ganglia and pons
Lacunar infarcts
Upper esoph. diverticulum
Zenker's diverticulum
Esophago-gastric lacerations
Mallory-Weiss Sz
Most common cause of intracerebral hemorrhage? Complicated by minute arterial dilations referred to as?
HTN (HTN induced intracerebral hemorrhages most often affect basal ganglia/thalamus); Charcot-Bouchard aneurysms
Contusion opposite the point of impact, from a moving head striking a surface; Usually inferior frontal/anterior temporal regions
Contre-coup contusion
Morphologic pattern of intracranial ischemia due to HTN, ruptured aneurysm, or vascular malformation
Intracranial hemorrhage
Episode of impaired neurologic fx due to temporary (transient) disrturbance in cerebral circulation; no permanent damage but precursor for future stroke
TIA
Kayser Fleischer rings, low serum ceruloplasmin
Wilson's dz (hepatolenticular degeneration)
Other causes of bacterial meningitis in adults? Neonates?
S. pneumonia, listeria; Group B strep, E. coli, Listeria
Morphologic pattern of intracranial ischemia due to atherothrombosis or thrombotic embolism
Cerebral Infarction
Councilman bodies
Acute viral hepatitis or viral hemorrhagic fevers
Most common arterial sites of thrombotic (2) and embolic (1) occlusion leading to stroke
Carotid bifurcation and MCA (thrombotic), MCA (embolic)
Axonal spheroids on microscopy; damage involves corpus callosum, periventricular structures, and rostral pons
Diffuse axonal injury
Most sensitive areas of the brain to hypoxic/anoxic injury
CA1 region of hippocampus (Sommer sector), layers 3,5, & 6 of the cerebral cortex, cerebellar purkinje cells, caudate and putamen
Negri bodies in hippocampus and cerebellar purkinje cells
Rabies infxn
Blood filled space between the skull and dura, associated with skull fracture and lacerated MMA; If not corrected, increasing intracranial pressure leads to herniation and death
Epidural hematoma
Enhanced ring pattern on X-ray, central necrosis w/acute infl., granulation tissue, fibrous capsule, reactive gliosis
Brain abscess (strep, staph, gram neg. bacilli, and anaerobes)
Signet ring cells
Gastric adenocarcinoma
Granuloma with caseous necrosis at base of brain (if meningitis present); DDX includes sarcoidosis on histology and gross appearance
Tuberculosis abscess (may occur in parenchyma or leptomeninges)
Angioinvasive fungi
Aspergillus or Mucor
Trousseau's sign (carpal spasm on brachial artery occlusion [BP cuff])
Hypocalcemia
Intracranial hemotoma in alcoholic or elderly pt.; Due to sheering of parasagittal bridging veins w/wo skull fracture
Subdural hematoma
Mild ↑ indirect (unconj.) bilirubin + no other abnormal findings
Gilbert's sz
"Brown tumor"
Osteitis fibrosa cystica (aka Von Recklinghausen's disease of bone) in hyperparathyroidism
Ventricular dilation above an occlusion in the ventricular system (often cerebral aqueduct or foramen of Monro)
Non-communicating hydrocephalus (interrupted or "non-communicating" flow of CSF through ventricular system)
CNS infxn usually due to extension of sinus infxn; Strep and staph
Subdural abscess
Chvostek's sign (facial mm spasm on CN VII palpation)
Hypocalcemia
Blue-domed cysts
Fibrocystic change of the breast
CNS infxn, usually strep and staph; Caused by trauma, osteomyelitis, extension from sinus infxn, surgery
Epidural abscess
Section 12
(50 cards)
Purulent perierethral discharge
N. gonnorheae infxn
Pheochromocytoma, medullary thyroid ca, parathyroid hyperplasia
MEN IIA (Sipple's sz)
(-) HBsAg, (-) HBcAb, (+) HBsAb
Immunized by vaccination
Maternal use of Desplex (diethylstilbestrol; DES) during pregnancy
Daughter with clear cell adenocarcinoma of the vagina
Mass in hilar region of liver + jaundice + empty gall bladder
Klatskin tumor
Call-exner bodies
Granulose-theca cell tumor of ovary (think granulosa-theCALL cell tumor of the ovary)
Gastric adenocarcinoma with ovarian mets.
Krukenburg tumor
Outpoutching in the distal ileum
Meckel's diverticulum
Pleomorphic tumor with Spindle cells (Thyroid)
Anaplastic carcinoma of thyroid
Anti-mitochondrial antibodies
Primary biliary cirrhosis
Periportal bile "lakes" & bile infarcts + bile duct hyperplasia and clinical feature of cholestasis
Secondary biliary cirrhosis
Thyroid Follicular Adenoma w/ cells containing Abundant Mitochondria
Hurthle Cell Adenoma
Molluscum bodies
MCV (a poxvirus) infected cells
Severe ↑ indirect bilirubin at birth with no suspicion of hemolysis
Crigler-Najjar sz
Clinically similar to G. inguinale with inguinal LN enlargement
Lymphogranuloma venereum
Neck mass in pt w/Hx of previous exposure to ionizing radiation
Papillary Thyroid Carcinoma
Courvoisier's sign
Pancreatic carcinoma; or carcinoma of extrahep. Bile duct itself
Associate the following criteria with their clinical significance/diagnostic guidance regarding patients presenting with a thyroid mass: 1. Solitary nodule, 2. Pt is male, 3. Pt is <40yo, 4. Pt has hx of head/neck radiation, 5. Nodule is "hot" on radioactive iodine uptake scan
criteria 1-3 = More likely to be neoplastic, criterion 4 = Increased risk of neoplasm, criterion 5 = More likely to be benign
Congenital aganglionic megacolon
Hirschprung's dz
Myxedema, cold intolerance, weight gain, lethargy
Hypothyroidism
Esophageal webs with iron deficiency anemia
Plummer-Vinson sz
Neoplastic lymphoid cells in thyroid w/ Hx of Hashimoto's
Lymphoma of the thyroid
(+) mucin stain, (-) bile stain, (+) CEA + findings consistent with intrahepatic bile duct obst.
Cholangiocarcinoma
Warty projections on vulvar surface or genito-anal region
Condyloma accuminata (genital warts caused by HPV 6 & 11 most commonly)
Hyperthyroidism resulting from hyperactive nodule in multinodular goiter
Plummer's Sz
White area of thinned, "cigarette paper" appearance on skin of labia
Lichen sclerosis (May be precursos lesion for SqCC, usually benign though)
MARFAN HABITUS,Pheochromocytoma, medullary thyroid ca, multiple neuromas/gangliomas of skin & mucosa
MEN IIB (Multiple mucosal neuromas)
Medullary Thyroid carcinoma + RET mutation without other MEN IIA features
Familial medullary thyroid carcinoma
Heat intolerance, weight loss/diarrhea, irritability/anxiety, wide-set stare
Hyperthyroidism
Foamy green discharge and vaginal itching; Large, pear-shaped flagellated protozoa on wet mount
Trichomoniasis
Cowdry A bodies/inclusions
HSV or VZV infected cells
Periportal Onion skin fibrosis cholestasis/cholangiohepatitis/cirrh.
1° sclerosing cholangitis
Koilocyte/koilocytic change
HPV infected cell
Non-tender ulcer along vulvar surface
Syphilitic chancre (Condyloma lata)
Squamous cell hyperplasia of vulva in response to scratching or rubbing of the vulvar mucosa
Lichen simplex chronicus
Anti-smooth muscle and ANA antibodies in the setting of chronic hepatitis
Autoimmune (lupoid) hepatitis
Large liver mass with multiple blood filled spaces + (+) CD31 stain
Hepatic angiosarcoma
Triad:1Hyperthyroidism - hyperfunctional diffusely enlarged thyroid2Exopthalmopathy - infiltrative opthalmopathy 3Pretibial myxedema - infiltrative localized dermopathy
Grave's dz
Clue cell
Bacterial vaginosis (Gardnerella vaginalis)
(+) HBsAg, (+) HBcAb, (-) HBsAb
Acute HepB or Chronic carrier
Fat, female, forty, fertile
The 4 F's indicating the highest risk population for development of cholelithiasis or "gallstones" often leading to acute cholecystitis
Firm, smooth, skin colored, pearly-whitish, papule w/ Central umbilication
Molluscum contagiosum (MCV - poxvirus)
Small white, red, or brown areas of vulva +/- itching
Vular intraepithelial neoplasia (VIN)
Colon polyps with osteomas and soft tissue tumors
Gardner's sz
Parathyroid, pancreas, pituitary tumors
MEN I (Wermer's sz)
Bullous lesions forming open ulcers in genital region lasting 7-10 days
Genital herpes - HSV-2 infxn
Mallory bodies
Alcoholic liver dz
Donovan bodies containing calymmatobacterium (Donovani) granulomatis
Granuloma inguinale
(-) HBsAg, (+) HBcAb, (+) HBsAb
Full recovery from previous infxn + immunity
(-) mucin stain, (+) α-fetoprotein, (+) bile stain + findings consistent with intrahepatic bile duct obst
Hepatocellular carcinoma
Section 13
(50 cards)
HLA-B35 (associated with a dz that usually occurs in females following a viral URI)
Subacute granulomatous thyroiditis (aka De Quervain's thyroiditis or painful subacute thyroiditis to be distinguished from the other form of subacute thyroiditis, subacute lymphocytic, silent, or painless thyroiditis)
Arias-Stella phenomenon (originally thought to occur in cancer but is now known to be normal)
Hypersecretory state of the endocervical glands mimicking the pregnant endometrium
Schiller stain (+) (iodine stain test)
Mature, non-keratinized, benign squamous cells; used in dx of cervial cancer; benign squamous cells will take up iodine and stain brown due to glycogen content whereas immature, keratinized, early neoplastic cells will not take up the iodine (Schiller stain negative)
Stromal invasion of an ovarian tumor
True adenocarcinoma
APC (Adenomatous polyposis coli gene)
Familial adenomatous polyposis ca
Ovarian tumor of transitional epithelium origin containing Walthard rests
Brenner's tumor
Gonadal tumor containing primordial germ cells, fibrous septae, and lymphocytes
Dysgerminoma in females; Seminoma in males
RET/PTC & BRAF mutations
Papillary Thyroid Ca.
CD31 + tumor
Angiosarcoma; CD31 is found on endothelial cells (as well as other cells) and so is a useful immunohistochemical marker for vascular neoplasms
BRCA 1/2
Ovarian serous carcinomas
p53
Type II Endometrial carcinoma (>90% of cases)
Grey-turner sign
Acute hemorrhagic pancreatitis
Bilateral breast masses
Infiltrating lobular carcinoma
Molar villi within myometrium, vascular space, or other extrauterine sites found
6months after molar evacuation~Invasive mole
CD117 (c-kit)
Gastrointestinal Stromal Tumor (GIST)
Cullen sign (periumbilical ecchymotic skin discoloration) and/or Grey-Turner sign (ecchymotic discoloration of the flank)
Acute hemorrhagic pancreatitis
Snowstorm pattern of filled uterus on ultrasound + hydropic grape-like clusters of villi
Complete hydatidiform mole
Mole with enlarged, edematous villi and normal, maybe fibrotic villi.
Partial hydatidiform mole
Cottage cheese
Candida albicans infxn of the vulva/vagina/cervix
Sex cord-stromal tumor producing:1. Estrogen, 2. Testosterone + Reinke crystals seen under LM
1. Granulosa-theca cell tumor; 2. Sertoli-leydig cell tumor
Synaptophysin (+)
Well differentiated carcinoid tumor; Neuroendocrine carcinoma; poorly differentiated SCC and LCC
Micronodular hyperplasia
Increase in the number of the endocervical glands
RAS or t(2:3) with PAX-8/PPARγ1 fusion
Follicular Thyroid Ca.
69XXY > 69XXX > 69XYY
Partial mole
Anti-GAD, Anti-ICA 512, Anti-insulin
Type I DM autoantibodies
Thyroid tissue tumor in ovary
Struma ovarii
HNF1α
MODY3
Transcription factor 7-like-2 (TCF7L2) polymorphism
Type II DM (think; TCF7L2 ends in 2, as in DM type 2)
DNA mismatch repair loss of fx mutation
Hereditary non-polyposus ca.
Nipple epidermal involvement by malignant cells; Ulceration, fissuring, and oozing of the nipple skin.
Paget's Dz of the Nipple
Plasma cells present in the endometrial stroma
Chronic endometritis
Neoplasm expressing gain of fx mutation in TSH receptor causing constitutive phosphorylation of cAMP(+)
Follicular adenoma of the thyroid
Meig's syndrome is a triad seen only in women and presents as ascites, right sided hydrothorax, and a particular tumor. What is the tumor found in Mieg's triad?
Ovarian fibrothecoma (aka fibroma or thecoma; These tumors are usually over 10cm when associated with Meig's sz)
↑↑ HCG levels compared to normal pregnancy
Complete hydatidiform mole
Ovarian tumor without stromal invasion
Borderline "........"oma
Pseudomyxoma peritonei
1° Adenocarcinoma of the appendix(99%)
Eversion (cervix)
Extrusion of the epithelial surface of the endocervical canal into the vaginal canal replacing a portion of the squamous cervix
PTEN
Type I Endometrial carcinoma (30-80% of cases)
Inguinal LNsà Pelvic LNsà Iliac LNsà Periaortic LNs
LN spread pattern of Vulvar ca
Presence of endometrial glands and stroma in the myometrium
Adenomyosis
HNF4α
MODY1
Lymphocytes and plasma cells in the cervical stroma +/- germinal follicles in the peripubertal and postpartum females
Cervicitis; If germinal follicles present, follicular cervicitis
Strawberry cervix
Cervical involvement of a Trichomonas vaginalis parasitic infxn
Distant mets, inflammatory carcinoma, locally advanced, LN involvement & large size
All are major poor prognostic indicators in invasive carcinoma
Bilateral Germ Cell Tumor
Mature Teratoma (20%), Dysgerminoma (~15%)
Hydatidiform mole with 46XX genotype
Complete mole
HLA-DR3/DR4 haplotypes; CD25 mutation (α chain IL-2 receptor); °CTLA4 and PTPN mutation
Type I DM
CIN, VIN, VAIN
HPV16/18 induced dysplasia MC precursor lesion for SqCC
Layer of rhabdomyoblasts beneath the squamous mucosa of the vagina
Sarcoma botryoides (embryonal rhabdomyosarcoma)
Hobnail cell pattern
Clear cell adenocarcinoma of the ovary
Section 14
(50 cards)
Point mutation on codon 12 of K-ras
Carcinoma of the pancreas (90%of cases) (think, a K-ras mutation causes carcinoma of the pan-K-ras)
2 neoplasms commonly causing acromegaly as a paraneoplastic sz and mediators responsible
Carcinoid tumors & SCC of the lung/GNrH & GH
DNA damage by UV rays commonly lead to what 3 malignancies?
SqCC, BCC, and melanoma of the skin
(+) Placental alk phosph (PLAP), OCT-3/4, NANOG, c-kit
Immunohistochemical markers for Seminoma
p53 > c-myc > Her-2/neu
Epithelial ovarian cas
α-fetoprotein in male with no liver pathology
Yolk sac tumor
For each tumor-suppressor gene/chromosome/action combination listed, name the associated cancer: 1. p16/9p/cell cycle control & DNA repair, 2. WT1/11q/nuclear transcription, 3. NF1/17q/inhibits ras signal transduction, 4. NF2/22q/signaling and cytoskeleton reg
1. Melanoma, 2. Wilm's tumor, 3. NF type I, 4. NF type II
Paraneoplastic sz produced by thymoma's and bronchogenic carcinoma's and mediator responsible
Lambert-Eaton myasthenic sz/autoab's agains presynaptic Ca++ channels
Neoplasms associated with HPVs 16 and 18 and the mechanism
Cervical, vulvar, penile, and anal carcinomas; E7 inactivated RB, E6 disables p53
AIRE1
Autoimmune polyendocrinopathy Sz
Neoplasms associated with HHV-8 and population in which they are seen
Kaposi's sarcoma and B-cell lymphoma; seen in immunocompromised
Hypercalcemia is the MC endocrine paraneoplastic sz: Name the MC neoplasms/mediators causing hypercalcemia
SqCC of lung/PTHrP, RCC/TGF-a, Breast ca/TNF-a, Multiple Myeloma/IL-2, Bone mets/lysis
CFTR gene
Cystic fibrosis
Abnormal proliferation of cells with loss of size, shape, and orientation
Dysplasia
Primary neoplasm MC causing cushing's sz and the mediator responsible
SCC of the lung/ACTH or ACTH-like peptide
For each chemical carcinogen, name the associated cancer: 1. Aniline dyes (beta-napthylamine), 2. Alkylating agents, 3. Benzene
1. TCC, 2. Leukemia, 3. Acute leukemia
Neoplasms associated with HTLV-1 and mechanism
Adult T-cell leukemia; the tax gene leads to high rate of proliferation of T-cells, leaving them vulnerable to mutations and translocations
For each chemical carcinogen, name the associated cancer/pathology: 1. Aflatoxin, 2. Vinyl chloride, 3. CCl4, 4. Nitrosamines, 5. Arsenic
1. HCC, 2. Angiosarcoma of the liver, 3. Centrilobular necrosis/fatty change, 4. Esophageal and gastric cancer, 5. SqCC of the skin
gain of fx mutation in α-subunit of Gs
Somatotroph pituitary adenoma
Live & Kicking Tumors Penetrate The Bone
Primary cancers metastasizing to bone: Lung, Kidney, Thyroid, Prostate, Testes, Breast
Neoplasm associated with HBV and HCV and mechanism
HCC; Chronic liver injury and regenerative hyperplasia --> increased vulnerability
GNAS1 mutation (codes for stimulatory G-protein alpha subunit; Gs-alpha)
Pseudohypoparathyroidism (Due to peripheral receptor insensitivity to PTH)
a-Inhibin
Sex cord-stromal tumors
For each proto-oncogene/action combination listed, name the associated tumor: 1. ras/signal transduction, 2. L-myc/transcription activator, 3. N-myc/transcription activator, 4. ret/GF receptor
1. colon carcinoma, 2. lung tumor, 3. neuroblastoma, 4. MEN types I & II
(+) CD30, cytokeratins, OCT-3/4, PLAP
Immunohistochemical markers for Embryonal carcinoma
Thyroid growth stimulating antibodies & TSH-binding inhibitor antibodies
Grave's dz
The following classes of genes must be turned on/off (which one?) in order to lead to cancer; Proto-oncogenes, tumor-suppressor/anti-oncogenes
Proto-oncogenes - ON, Tumor-suppressor genes - OFF
Cancers Sometimes Penetrate Benign Liver
Primary cancers metastasizing to liver: Colon > Stomach > Pancreas > Breast > Lung (Mets are by far most common liver cancers)
Common paraneoplastic sz of RCC and mediator responsible
Polycythemia/erythropoietin
The following classes of genes must be turned on/off (which one?) in order to lead to cancer; Proto-oncogenes, tumor-suppressor/anti-oncogenes
Proto-oncogenes - ON, Tumor-suppressor genes - OFF
K-ras mutation (on ovarian biopsy)
Tumors of limited malignant potential (Borderline tumors) of the ovary
CYP21B
Congenital adrenocortical hyperplasia
Cancer in males showing ↑ lactate dehydrogenase
Testicular cancers
Carcinogenic chemical that leads to irreversible DNA damage in the cell
Initiator
Neoplasms associated with EBV and mechanism
Burkitt's lymphoma and nasopharyngeal carcinoma; Causes B-cell proliferation --> increased mutation rate
For each tumor-suppressor gene/chromosome/action combination listed, name the associated cancer: 1. DPC/18q/cell surface receptor, 2. DCC/18q/cell surface receptor
1. Pancreatic cancer (also highly associated w/ K-ras), 2. Colon cancer
Metastatic dz of bone is much more common than primary bone cancers; Name the 2 MC primary sites of bone mets
Breast & Prostate
HCG in male
Choriocarcinoma
Pyrimidine (or thymidine) dimers usually result from what specific type of radiation? How are they normally repaired?
UVB light; nucleotide excision repair (People with xeroderma pigmentosum [AR] are defective in this pathway)
For each tumor-suppressor gene/chromosome/action combination listed, name the associated cancer: 1. RB/13q/cell cycle reg., 2. BRCA 1 & 2/17q & 13q/DNA repair, 3. p53/17p/regulation of cell cycle and apoptosis after DNA damage
1. retinoblastoma & osteosarcoma, 2. Breast and ovarian ca, 3. Most human cancers & Li-Fraumeni sz
Estrogen/progesterone receptors and Her-2/neu
Immunohistochemical prognostic markers used in breast cancer
For each proto-oncogene/action combination listed, name the associated tumor: 1.abl/signal transduction, 2. c-myc/transcription activator, 3. bcl-2/inhibits apoptosis, 4. erb-B2 or HER-2/GF receptor
1. CML, 2. Burkitt's Lymphoma, 3. Follicular and undifferentiated lymphomas, 4. Breast, ovarian, and gastric carcinomas
Carcinogenic chemical that does not affect DNA, but promote cell growth and differentiation, usually reversible
Promoter
Lots of Bad Stuff Kills Glia
Primary cancers metastasizing to brain: Lung > Breast > Skin > Kidney > GI (Brain mets is more common than primary brain ca)
BRCA-2 mutation and axillary LAD in a male patient with family hx of breast ca
Male breast carcinoma
Neoplasm associated with H. pylori and mechanism
Gastric cancer; chronic inflammation
Name the AR disease showing a very high incidence of skin cancer. What is the defect?
Xeroderma pigmentosum; nucleotide excision repair
MC neoplasms causing SIADH and the mediators responsible
SCC of the lung/ADH, Intracranial neoplasms/ANP & BNP
Neoplasms associated with Down syndrome
ALL and AML
Nucleus:cytoplasm ratio in benign vs. malignant cells
Benign - Normal, malignant - Increased
Section 15
(25 cards)