Term
|
Definition
increase in cell size
no new cells, just bigger cells
seen in heart and spleen, SM in asthma, tubules in pyelonephritis, thyroid in Graves |
|
|
Term
|
Definition
increase in cell number
seen in organs with hormonal control
prostate, adrenal, thyroid, breast, uterus, etc. |
|
|
Term
|
Definition
once normal, now smaller
seen in kidney, liver, adrenals, muscles, brain |
|
|
Term
|
Definition
never normal in size
developmental disorder
seen in brain, heart, bone marrow |
|
|
Term
|
Definition
proteinaceous deposit exhibiting beta sheet structure
identified by apple-green birefringence when stained with congo red and seen under polarized light |
|
|
Term
| infarction characteristic shape |
|
Definition
wedge
arterial blood vessels distribute in an inverted "tree-like" fashion |
|
|
Term
|
Definition
nuclei are lost
structures appear ghost-like or out of focus |
|
|
Term
|
Definition
i.e. lung abscess
PMNs that release hydrolytic enzymes
parenchyma is destroyed
pocket of pus (PMNs, debris, fibrin) |
|
|
Term
|
Definition
tuberculosis assoc.
cottage-cheese grossly due to partial hydrolysis of lipids in mycobacterial cell wall
granuloma with necrotic center
macrophages and lymphocytes
giant cells and multinucleated macrophages (histiocytes) |
|
|
Term
|
Definition
i.e. pancreatitis
usually destruction of fatty tissue
damaged traumatically or by toxin
dying cells release enzymes (i.e. lipases)
surrounding fat is hydrolyzed and forms long-chain fatty acid-calcium complexes
grossly, looks like soap
tissue destroyed, but inflammatory cells absent |
|
|
Term
|
Definition
seen in lower extremities and bowel
primary cause of gangrene is reduced blood supply to the affected tissues
dry gangrene, wet gangrene |
|
|
Term
|
Definition
protein, w/ or w/o fibrin, w/o cells
reversible process that can be removed by PMNs |
|
|
Term
|
Definition
connective tissue, capillaries, healing, scarring, organization
cellular reaction
not reversible |
|
|
Term
|
Definition
cellular swelling
cell membrane blebs
detached ribosomes
chromatin clumping |
|
|
Term
| irreversible cell injuries |
|
Definition
lysosomes rupture
dense bodies in mitochondria
cell membrane rupture
karyolysis, karyorrhexis, pyknosis |
|
|
Term
|
Definition
continuously dividing
ex: epithelium, bone marrow |
|
|
Term
|
Definition
quiescent (in G0 stage)
ex: hepatocytes, SM, lymphocytes |
|
|
Term
|
Definition
nondividing
ex: neurons, skeletal and cardiac muscle |
|
|
Term
| highly ischemia susceptible cells |
|
Definition
|
|
Term
| intermediate ischemia susceptible cells |
|
Definition
| myocardium, hepatocytes, renal epithelium (30min-2hr) |
|
|
Term
| low ischemia susceptible cells |
|
Definition
| fibroblasts, epidermis, skeletal muscle (many hours) |
|
|
Term
| common mechanisms of cell injury |
|
Definition
mitochondrial damage
entry of Ca++
protein misfolding
DNA damage |
|
|
Term
| consequences of mitochondrial damage injury |
|
Definition
| leakage of pro-apoptotic factors |
|
|
Term
| consequences of entry of Ca++ injury |
|
Definition
increase in mitochondrial permeability
activation of multiple cellular enzymes |
|
|
Term
| consequences of protein misfolding injury |
|
Definition
| activation of pro-apoptotic proteins |
|
|
Term
| consequences of DNA damage injury |
|
Definition
| activation of pro-apoptotic proteins |
|
|
Term
|
Definition
messy vs. clean
unplanned vs. planned
injury vs. injury |
|
|
Term
| diseases of too little apoptosis |
|
Definition
| cancer, autoimmune disorders |
|
|
Term
| diseases of too much apoptosis |
|
Definition
| neurodegenerative diseases, ischemic injury, virus-induced lymphocyte depletion |
|
|
Term
|
Definition
| binds and inactivates p53 |
|
|
Term
|
Definition
| mimic or increase production of Bbcl-2 |
|
|
Term
| types of intracellular accumulations |
|
Definition
normal substance that cannot be metabolized (fatty liver, TG)
genetic defect in metabolism (a1-trypsin deficiency or storage diseases like Guacher's)
no normal enzyme to degrade an abnormal substance (silica-silicosis) |
|
|
Term
|
Definition
@ necrotic tissue
serum Ca++ is normal
ex: atheromas, heart valves, psammoma body, asbestos body |
|
|
Term
|
Definition
hypercalcemia induced
@ healthy tissues
etiologies: parathyroid, skeletal metastases, vitamin D, renal failure
found: lungs, arteries |
|
|
Term
| acute inflammation characteristics |
|
Definition
immediate
transient
edema
neutrophils
fibrin
necrosis |
|
|
Term
| chronic inflammation characteristics |
|
Definition
gradual
prolonged
fibrosis and vessels
mononuclear cells
collagen
resolution of necrosis |
|
|
Term
|
Definition
fluid leakage
etiologies: increased hydrostatic pressure (venous outflow obstruction, congestive HF); decreased colloid osmotic pressure (decreased protein synthesis, liver disease, increased protein loss, kidney disease) |
|
|
Term
|
Definition
fluid and protein leakage
etiology: increased interendothelial spaces, vasodilation, stasis |
|
|
Term
| mediators of vasodilation |
|
Definition
| prostaglandins and nitric oxide |
|
|
Term
|
Definition
migration - approach endothelium
rolling - selectins
adhesion (pavementing) - integrin
transmigration (diapedisis) - integrin
chemotaxis |
|
|
Term
|
Definition
recognition and attachment - opsonins, receptors
engulfment
killing and degradation - oxidative burst, enzyme digestion |
|
|
Term
|
Definition
IgG-Fc, C3b, iC3b
[collectins] |
|
|
Term
| leukocyte opsonin receptors |
|
Definition
|
|
Term
|
Definition
rapid release of reactive oxygen species (superoxide radical and hydrogen peroxide) from different types of cells
NAPDH oxidase makes superoxide
Myeloperoxidase uses the reactive oxygen species hydrogen peroxide to produce hypochlorous acid |
|
|
Term
|
Definition
| enzyme that produces superoxide for the oxidative burst used in phagocytosis |
|
|
Term
|
Definition
uses the reactive oxygen species hydrogen peroxide to produce hypochlorous acid
involved in the oxidative burst of phagocytosis |
|
|
Term
|
Definition
vasodilates
produced by endothelium and macrophages
synthesis req. L-arginine, O2, NAPDH, other cofactors, NO synthase
inhibits rolling and adhesion of leukocytes
microbicidal |
|
|
Term
vasoactive amines
(histamine) |
|
Definition
stored in granules of mast cells and basophils
released into surrounding inflammatory tissue by allergen binding multiple IgE molecules on mast cells |
|
|
Term
|
Definition
| precursor to prostacyclins, prostaglandins, thromboxanes, lipoxins, leukotrienes and 5-HETE |
|
|
Term
|
Definition
vasodilate, increase vascular permeability
derivative of arachidonic acid, cyclooxygenase pathway |
|
|
Term
|
Definition
vasodilate, inhibit platelet aggregation
derivative of arachidonic acid, cyclooxygenase pathway |
|
|
Term
|
Definition
vasoconstrict, promote platelet aggregation
derivative of arachidonic acid, cyclooxygenase pathway |
|
|
Term
|
Definition
inhibit neutrophil adhesion and chemotaxis
derivative of arachidonic acid, lipoxygenase pathway |
|
|
Term
|
Definition
chemotaxis of leukocytes
derivative of arachidonic acid, lipoxygenase pathway |
|
|
Term
|
Definition
vasoconstrict, bronchospasm, increase vascular permeability
derivative of arachidonic acid, lipoxygenase pathway |
|
|
Term
|
Definition
|
|
Term
|
Definition
| major chemotactic factor for neutrophils |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
angiogenesis and edema [no pericytes on vessels]
fibroblasts
evolving inflammation |
|
|
Term
| scar tissue (after granulation) |
|
Definition
|
|
Term
|
Definition
Source: plts, macs, saliva, urine, milk, plasma
Function: mitogenic for keratinocytes and fibroblasts |
|
|
Term
TGF-beta
(as growth factor) |
|
Definition
Source: plts, T cells, endoth, macs, sm muscle, FB
Fucntion:
chemotactic - inflammatory cells/fb/sm muscle
increase - scar, angiogenesis
decrease - MMP, epith proliferation |
|
|
Term
|
Definition
Source: many
Function: increase vascular permeability, mitogenic for endothelial cells, angiogenesis |
|
|
Term
|
Definition
Source: plts, macs, endo, keratinocytes, sm muscle
Function:
chemotactic - phago, fb, sm muscle
activate - phago, fb
mitogenic - fb, endo, sm muscle
increase - keratinocyte migration, angiogenesis, wound contraction |
|
|
Term
|
Definition
Source: macs, masts, T cell, endo, fb
Function:
chemotactic - fb
mitogenic - fib, epithe
increase - keratinocyte migration, angiogenesis, wound contraction, matrix deposition |
|
|
Term
1* intention
(wound healing) |
|
Definition
clean, closely approximated margins
minimal clot/granulation tissue, motion or bacteria |
|
|
Term
2* intention
(wound healing) |
|
Definition
large tissue defect or reopened surgical wound
greater inflammation and granulation tissue
healing time depends on size of defect
wound contraction up to 95% at 6wks (myofibroblasts and elastin remodeling) |
|
|
Term
|
Definition
type of pathological wound healing
wound rupture resulting from tension or infection
ex: nonhealing ulcer in DM or PVD |
|
|
Term
|
Definition
pathological wound healing
granulation tissue excess (pyogenic granuloma, "proud flesh")
keloid
fibromatosis - desmoid, aggressive fibromatois, ??neoplastic |
|
|
Term
|
Definition
| Etiology: myocardial dysfx, atherosclerosis, infarcts, hypertension, aortic/mitral valve diseases, myocarditis, constrictive pericarditis |
|
|
Term
|
Definition
decreased cardiac output - decreased tissue perfusion
reactive vasoconstriction - increased vascular tone
PERIPHERAL AND PULMONARY EDEMA
organ congestion - liver, spleen, kidneys, GI, etc.
Effusions - pleural, peritoneal (ascites) |
|
|
Term
| left CHF symptoms and signs |
|
Definition
Dyspnea
Decreased activity level
Paroxysmal nocturnal dyspnea
Orthopnea
Jugular vein distention
Increased BNP
Peripheral edema
Pulmonary rales |
|
|
Term
|
Definition
| Left sided failure, pulmonary HTN, pulmonary/tricuspid valve disease, myocarditis |
|
|
Term
|
Definition
decreased cardiac output - decreased tissue perfusion
reactive vasoconstriction - increased vascular tone
PERIPHERAL EDEMA (no pulmonary edema)
organ congestion - liver, spleen, kidneys, GI, etc.
Effusions - pleural, peritoneal (ascites) |
|
|
Term
|
Definition
diuretics - help excrete sodium and water
ACE inhibitors - decrease the activation of Angiotensin system |
|
|
Term
|
Definition
| increased amount of blood in capillaries and venules |
|
|
Term
|
Definition
increased blood flow to area due to inflammation or vascular control
inflammation - vasodilation, increased permeability
exercise - increase muscle tissue blood flow
heat - increased skin blood flow |
|
|
Term
|
Definition
reduced venous return/obstruction of venous return
edema, common with CHF |
|
|
Term
|
Definition
centrilobular congestion - cardiac cirrhosis
centrilobular necrosis/fibrosis
chronic
nutmeg liver |
|
|
Term
| constrictive pericarditis*** |
|
Definition
fibrous bands constrict pericardium to heart surface
assoc. with CHF sometimes (etiology) |
|
|
Term
|
Definition
| hemosiderin laden macrophages in lung tissue that shows pulmonary edema |
|
|
Term
| humoral mediators of blood pressure |
|
Definition
vasopressin (ADH) - increase BP
angiotensin II - increase BP
aldosterone - increase BP
epinephrine - increase BP
norepinephrine - increase BP
ACE inhibitors - decrease BP
beta-blockers - decrease BP
diuretics - decrease BP |
|
|
Term
|
Definition
humoral mediators
vascular reactivity - receptors
vascular caliber - vasodilator Rx
blood viscosity - proteins, RBCs
cardiac output - SVxHR, blood volume
vessel elasticity - atherosclerosis
neural stimulation - SNS activation, beta-blockers |
|
|
Term
|
Definition
coronary artery disease/atherosclerosis
left ventricular hypertrophy
stroke
nephrosclerosis/end stange renal disease
peripheral vascular disease
retinopathy |
|
|
Term
| consequences of CAD/atherosclerosis |
|
Definition
|
|
Term
| consequences of left ventricular hypertrophy |
|
Definition
|
|
Term
|
Definition
cerebral vascular accident
intracerebral hemorrhage |
|
|
Term
| consequences of nephrosclerosis |
|
Definition
|
|
Term
| consequences/signs of peripheral vascular disease |
|
Definition
| caludication, ischeamia, thrombosis, infarcts, gangrene |
|
|
Term
| consequences/signs of retinopathy |
|
Definition
| hemorrhages, atherosclerosis, ischemis, edema, visual loss |
|
|
Term
| 1* hemostasis (general idea) |
|
Definition
vascular seal, platelets
vasoconstriction, platelet adhesion, platelet aggregation |
|
|
Term
| 2* hemostasis (general idea) |
|
Definition
coagulation pathway
endothelial/platelet activation, coagulation cascade |
|
|
Term
|
Definition
activated by vWF or collagen
discoid
release aggregation factors - ADP, thromboxane A2
recruited and aggregate to form hemostatic plug |
|
|
Term
|
Definition
prostaglandin I2
nitric oxide
ADPase
(all from endothelium) |
|
|
Term
|
Definition
platelet inhibitor
acetylates COX1 enzyme
inhibits aggregation
used to prevent thrombosis in atherosclerosis (pre and post MI) |
|
|
Term
|
Definition
platelet inhibitors
inhibits ADP receptors on platelet surface |
|
|
Term
| abciximab, eptifibatide, tirofiban |
|
Definition
platelet inhibitors
glycoprotein IIb/IIIa inhibitors
used in coronary artery catheterization/angioplasty/stent placement |
|
|
Term
|
Definition
less than 2mm
pinpoint loss of blood into tissues (ex: skin)
inadequate primary hemostasis |
|
|
Term
|
Definition
>3mm, but <1cm
larger loss of blood into tissues (ex: skin) than petechiae
inadequate primary hemostiss |
|
|
Term
|
Definition
severe bleed (brain, GI, etc.)
can be due to inadequate primary hemostasis |
|
|
Term
|
Definition
>1-2cm
subcutatneous hemorrhage
assoc. with inadequate primary or secondary hemostasis |
|
|
Term
|
Definition
mutation in Factor V
results in hyper-coagulable state
reduced degradation of Factor V by Protein C |
|
|
Term
| antithrombin III deficiency |
|
Definition
autosomal dominant or acquired
assoc. w/ nephrotic syndrome or DIC
results in hypercoagulable state |
|
|
Term
| protein C or S deficiency |
|
Definition
| results in hypercoagulable state |
|
|
Term
|
Definition
| pancreatic cancer and thrombi |
|
|
Term
| anti-phospholipid syndrome |
|
Definition
Lupus anticoagulant
assoc. with SLE, pregnancy, viral infections
causes miscarriages stillbirths in pregnancy
ANTIBODIES TO CARDIOLIPIN, beta-2 glycoprotein I, phosphatidylserine
results in hypercoagulable state |
|
|
Term
myoglobin
(biochem marker) |
|
Definition
increased at 2-4hr
non-specific, any striated muscle injury increases |
|
|
Term
cardiac troponin I or troponin T
(biochemical marker) |
|
Definition
increased at 4-6hr
primary criteria for MI
remain elevated 5-10d |
|
|
Term
creatine kinase (MB)
(biochemical marker) |
|
Definition
increased at 6hr
not as sensitive as troponins for MI
remains elevated 1-2d |
|
|
Term
lactate dehydrogenases (LDH)
(biochemical marker) |
|
Definition
esp. isoenzyme 1
increased at 6hr+
not commonly used
elevated for >3d |
|
|
Term
|
Definition
elevation assoc. with CHF
run test in MI to see if assoc. with CHF complication |
|
|
Term
| time after MI at greatest risk for rupture |
|
Definition
5-7d
macrophages eating away debris, but not much fibroblastic activity yet |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| MI findings, >3d but <4wks |
|
Definition
chronic inflammation
early part of this is rupture risk period
granulation tissue formation
granulation maturation
fibrosis begins |
|
|
Term
|
Definition
|
|
Term
|
Definition
high mortality
MI, ventricular rupture, arrhythmia, tamponade, pulmonary embolism
prolonged hypotension, impaired tissue perfusion |
|
|
Term
|
Definition
hemorrhage, fluid loss
burns, vomiting/GI, trauma |
|
|
Term
|
Definition
high mortality
overwhelming infections (septicemia)
endotoxic shock - release of bacterial cell wall components (LPS) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| IgE mediated hypersensitivity |
|
|
Term
|
Definition
lysosomal storage disease
HEXOSAMINODASE A ENZYME DEFECT
brain rich in gangliosides (sphingosine)
deposition of GM2 gangliosides in heart, liver, spleen, brain
progressive neurologic damage with death at 2-3yrs
measure enzyme activity in serum and white cells |
|
|
Term
|
Definition
lysosomal storage disease, juvenile
GLUCOCEREBROSIDES
hepatosplenomegaly
significant neural deposition
early death |
|
|
Term
|
Definition
lysosomal storage disease, adult
CLUCOCEREBROSIDES
WBCs and RBCs with glucocerebrosides; esp. accumulate in macrophages
massive hepatosplenomegaly
adult presentation, normal life span |
|
|
Term
|
Definition
glycogen storage disease
GLUCOSE-6-PHOPSPHATASE
hepatomegaly, hypoglycemia, hyperlipidemia
failure to thrive, stunted growth, most survive
can't break down glucose, sub in cornstarch |
|
|
Term
|
Definition
glycogen storage disease
myopathic
muscular weakness, cramps, normal life span
MUSCLE PHOSPHORYLASE |
|
|
Term
|
Definition
glycogen storage disease, generalized
ALPHA-1,4-GLUCOSIDASE
diffuse organ involvement, early death
MOST SEVERE OF GLYCOGEN STORAGE DISEASE |
|
|
Term
| alpha-1-antitripsin defieicny |
|
Definition
autosomal recessive
DEFICIENCY/DEFECT ENZYME
hepatic cirrhosis, pulmonary emphysema
variable in severity and time of presentation
Dx by A-1-AT level and phenotype
MM-100% enzyme, MZ-58%, ZZ-15%, SS-60%, MS-80% |
|
|
Term
|
Definition
autosomal recessive
AMINO ACID SUBSITUTE, ABNORMAL HEMOGLOBIN STRUCTURE
Dx - Hgb phenotyping (electrophoresis)
SS-homozygoous sickle cell disease; SC-hemoglobin C trait, sickle process disorder;
Tx - supportive, hydroxyurea to stimulate HgbF production, bone marrow transplant |
|
|
Term
|
Definition
autosomal recessive
SODIUM/CHLORIDE ION TRANSPORT SYSTEM DEFECT
DELTA F508, multiple alleles possible
pulmonary bronchiectasis, pneumonias, pulmonary failure
hepatic cirrhosis
malabsorption
infertility
Dx - tyrpsinogen level (screen, increased), sweat chloride test (increase), gene defects |
|
|
Term
| a-1-at deficiency indcidence |
|
Definition
1% with abnormal phenotype
1:1800 ZZ |
|
|
Term
|
Definition
1:4000
8% carrier rate in blacks |
|
|
Term
| cystic fibrosis incidence |
|
Definition
|
|
Term
|
Definition
autosomal recessive
1* etiology - hereditary - excessive iron absorption
2* etiology - excessive iron overload states (beta-thalassemia w/ mult. transfusions)
micronodular cirrhosis, diabetes, skin hyperpigmentation
Dx - iron levels of serum and liver, genetic analysis |
|
|
Term
| hemochromatosis incidence |
|
Definition
|
|
Term
|
Definition
autosomal recessive
PHENYLALANINE HYDROXYLASE DECREASED ACTIVITY
accumulation of phenylalanine and metabolites
mental retardation by 6mo
motor dysfx, seizures, HYPOpigmentation of skin/hair
Dx - phenylalanine in blood, tyrosine in blood
Tx - restrict phenylalanine in diet |
|
|
Term
| phenylketonuria incidence |
|
Definition
|
|
Term
|
Definition
autosomal recessive
GALACTOSE-1-PHOSPHATE URIDYLTRANSFERSASE DEFECT (GAL-1-PUT)
Normal, G or Duarte phenoyptes
GG-0% activity, DG-25%, GN-50%, DN-75%
accumulation of galactose in liver, spleen, lens, kidney, heart, brain and RBCs
jaudice with hepatomegaly (later cirrhosis)
sepsis (E. coli), acidosis
corneal opacity
Dx - galactose, G1P levels; Gal-1-PUT activity and phenotype |
|
|
Term
|
Definition
|
|
Term
| congenital adrenal hyperplasia |
|
Definition
autosomal recessive
21-HYDROXYLASE DEFECT (95%), also 17 and 3 hydroxylases
adrenal hyperplasia w. virilization (androgen excess), ambiguous genitaliea
salt wasting >> hypotension, death
Dx - 17-OH progesterone level, other hormone levels, gene typing
Tx - glucocorticoids |
|
|
Term
|
Definition
|
|
Term
|
Definition
MEDIUM CHAIN ACYL-COA DEHYDROGENASE DEFICIENCY
acidosis, liver dysfunction, coma, death
sequelae - developmental delay, retardation |
|
|
Term
|
Definition
|
|
Term
| DM Type 1 etiology/pathophysiology |
|
Definition
destruction of beta-cells and absence of insulin
genetics - HLA, multiple factors
autoimmunity - T-cell mediated, environmental insult as trigger
Auto-antibodies - islet cell, GAD65, IA-2, IA-2beta, insulin [1+ in 85-90% pts]
children, youth but technically at any age
lymphocytic infiltrate in pancreas/islets w/ fiboriss and hyalinization |
|
|
Term
| DM Type 2 etiology/pathophysiology |
|
Definition
peripheral resistence to insulin w/ increase secretion early changing to decrease secertion by beta-cell failure later
Genetics - complex, multiple, obesity, gestation DM, metabolic sydnrome
adults typically, but inc. freq. in children recently
amyloid deposition in pancreas/islets |
|
|
Term
|
Definition
polydipsia/polyuria - osmotic diuresis from excess glucose in urine, dehydration
diabetic ketoacidosis - T1DM
non-ketotic hyperglycemia - T2DM
complications |
|
|
Term
|
Definition
hypoglycemia --> shift to fatty acid metabolism for energy --> production of ketone bodies --> metabolic acidosis
coma, shock, death possible |
|
|
Term
|
Definition
microangiopathy, cerebral vascular infarcts, hemorrhage
retinopathy, cataracts, glaucoma
myocardial infarct
atherosclerosis
islet cell low (insulitis T1, amyloid T2)
nephrosclerosis (glomerulosclerosis, arteriosclerosis, pyelonephritis)
peripheral vascular atherosclerosis, gangrene, infections
peripheral neuropathy |
|
|
Term
| Kimmelstiel-Wilson lesion |
|
Definition
nodular glomerulonecrosis
DM complication |
|
|
Term
|
Definition
% of pts who test positive for disease out of total pts with disease
= True positive/(true positive + false negative)*100 |
|
|
Term
|
Definition
% of patients who test negative for disease out of total patients w/o disease
=True negatives/(true negatives + false positives) |
|
|
Term
|
Definition
what % of (+) tests are actually positive for disease
what % of (-) tests are actually negative for disease |
|
|
Term
|
Definition
= TP/(TP+FP)*100
higher prevalance increases PV+ |
|
|
Term
|
Definition
|
|
Term
|
Definition
# of people with disease currently
cumulative, total
ex: DM has high prevalence and low incidence |
|
|
Term
|
Definition
annual # of people who get disease
new cases only
Ex: common cold has high incidence and low prevalence |
|
|
Term
electrolyte panel
(components) |
|
Definition
| sodium, potassium, chloride, bicarbonate [anion gap - can calculate from] |
|
|
Term
limited metabolic panel
(components) |
|
Definition
| sodium, potassium, chloride, bicarb, glucose, urea, creatinine, calcium |
|
|
Term
comprehensive metabolic panel
(components) |
|
Definition
| sodium, potassium, chloride, bicarb, glucose, urea, creatinine, calcium, albumin, total protein, total bilirubin, alkaline phosphatase, aspartate aminotransferase (AST), alanine aminotransferase (ALT) |
|
|
Term
|
Definition
Na-[Cl + HCO3-]
normal is greater than 15 |
|
|
Term
|
Definition
= Total - HDL - TG/5
normal is <110mg/dL |
|
|
Term
lipid profile
(components) |
|
Definition
| total, HDL, TG, [calculate LDL] |
|
|
Term
complete blood count (CBC) w/ differential
(components) |
|
Definition
| WBC - types (neu, lymp, mono, eosin, baso), Hgb conc., hematocrit, platelet count, RBC morphology, RBC indices (MCV, MCH, MCHC) |
|
|
Term
| deconjugated/total bilirubin |
|
Definition
>4 - obstruction, hepatitis
<0.2 - hemolysis |
|
|
Term
type I hypersensitivity
(anaphylactic) |
|
Definition
Antibody - IgE
Antigen - exogenous
Response time - 15-30min
Appearance - weal & flare
Histology - basophils and eosinophils
Transfer w/ - Ab
Ex: asthma, hay fever |
|
|
Term
type II hypersensitivity
(cytotoxic) |
|
Definition
Antibody - IgM, IgG
Antigen - cell surface
Response time - minutes to hours
Appearance - lysis and necrosis
Histology - Ab and complement
Transfer w/ - Ab
Ex: erythroblastosis, fetalis, Goodpasture's nephritis |
|
|
Term
type III hypersensitivity
(immune complex) |
|
Definition
Antibody - IgM, IgG
Antigen - soluble
Response time - 3-8hrs
Appearance - erythema, edema, necrosis
Histology - complement and neutrophils
Transfer w/ - Ab
Ex: SLE, farmer's lung disease |
|
|
Term
type IV hypersensitivity
(delayed type) |
|
Definition
Antibody - none
Antigen - tissues and organs
Response time - 48-72hr
Appearance - erythema and induration
Histology - monocytes and lymphocytes
Transfer w/ - T cells
Ex: tuberculin test, poison ivy, granuloma |
|
|
Term
|
Definition
type I hypersensitivity
tissue remodeling
mucus plug, basement membrane thickening, inflammation with eosinophils (CD4+, Th2, NK cells) |
|
|
Term
| Rheumatic fever pathology |
|
Definition
Achoff bodies/Antischkow cell, Achoff Giant cell
granulomatous lesions that follow necrosis/degenerative phase and precedes fibrosis |
|
|
Term
| hyperacute transplant rejection |
|
Definition
preformed antidonor antibody (ABO incompatibility)
complement in endothelium
grossly - paily, cyanotic non-functioning organ
Histology - rapid thrombotic vasculitis with PMN perivascular infiltrates and ischemic necrosis |
|
|
Term
| acute transplant rejection |
|
Definition
type II ab-mediated
necrotizing vasculitis - acute-Ab mediated activation of phagocytes
or
intimal thickening + inflammatory cells + foamy macrophages + smooth muscle proliferation
MONONUCLEAR CELL infiltrate, type IV hypersensitivity reaction
Tx - b-cell depleting therapy (rituximab), monoclonal anti-CD20 |
|
|
Term
| chronic transplant rejection |
|
Definition
graft arteriosclerosis
vascular lumen replacement by accumulation of smooth muscle cells and connective tissue (fibrosis) in vessel intima
obliterative intimal fibrosis
FIBROBLASTS?
interstitial fibrosis and atrophy |
|
|
Term
|
Definition
bone marrow transplants
transplanted T cells recognize recipient as foreign and mount rejection response
icterus, scaling rash, apoptosis, and LYPHOCYTIC INFILTRATE
Tx - high dose steroids, anti-thymocyte globulins, T-cell depletion transplants |
|
|
Term
systemic lupus erythematosus
(pathophys) |
|
Definition
immune compolex deposition
Antibodies - antinuclear (ANA), anti-dsDNA, anti-Sm
other non-nuclear autoantibodies (false positive HIV and syphilis)
chronic, remitting and relapsing, febrile illness |
|
|
Term
systemic lupus erythematosus
(symptoms) |
|
Definition
Skin - butterfly malar rash, discoid rash, photosensitivity
Joints - arthritis (nonerosive, non-deforming synovitis)
CNS - cerebral vasculitis, seizures, psychosis
CVS - pericarditis, Libman-Sacks non-bacterial verrucous endocarditis
Spleen - splenomegaly
Lungs - pleuritis, pulmonary interstitial fibrosis
Hematologic - hemolytic anemia, leukopenia, lymphopenia, thrombocytopenia, thrombosis
Renal - glomerulonephritis (wire loops) |
|
|
Term
| scleroderma/systemic sclerosis |
|
Definition
excessive fibrosis and collagen deposition
CREST syndrome
anti-Scl-70 antibody |
|
|
Term
|
Definition
Calcinosis cutis - subepidermal calcium deposition
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly - cannot extend finbers, get shiny skin b/c of collagen
Telangiectasia
ANTI-CENTROMERE Ab, also see in 1* biliary cirrhosis |
|
|
Term
|
Definition
Symptoms: keratoconjunctiva and siccaxerostomia (dry eyes, dry mouth)
anti-SS-A/anti-SS-B
salivary gland changes - mononuclear infiltrate, interstitial fibrosis, glandular atrophy
increased risk of lymphoma |
|
|
Term
|
Definition
agammaglobulinemia
tyrosine kinase deficiency |
|
|
Term
|
Definition
mucosal infections, anaphylactic rxn during transfusion
related to CVI |
|
|
Term
|
Definition
chromosome 22 delection
thymic hypoplasia |
|
|
Term
|
Definition
| defect of both humoral and cell mediated immunity |
|
|
Term
|
Definition
Ig light chain fragments from plasma cells
1* amyloidsosis
seen in simply dysfunctional conditions to malignant multiple myeloma |
|
|
Term
|
Definition
| amyloid beta plaques from amyloid precursor protein |
|
|
Term
|
Definition
| abnormal growth that continues |
|
|
Term
|
Definition
reversible change in which one adult cell type is replaced by another adult cell type
Ex: Barrett's esophagus, squamous-to-columnar |
|
|
Term
|
Definition
atypical proliferative changes due to chronic irritation or inflammation, premalignant change
Ex: cervix, squamous nuclear changes |
|
|
Term
|
Definition
maligntnat, lack of differentiation, undifferentiated, hallmark of malignant transformation
cellular/nuclear pleomorphism, increased nuclear-cytoplasmic (N/C) ratio, nuclear hyperchromasia, large nulcleoli |
|
|
Term
|
Definition
| already malignant but hasn't punched through the BM yet |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
for malignant tumors only
based on degree of differentiation and mitotic rate
Grades I-IV (higher = more anaplastic)
Important in brest, prostate, endometrium and astrocytomas
done by pathologists |
|
|
Term
|
Definition
for malignant tumors only
how far cancer has spread
based on tumor size (T), lymph node involvement (N), and distant metastases (M)
involves pathologist, radioly, other imagining, lab tests, etc.
CIS = stage 0 often
usually stage 0-stage 4 |
|
|
Term
|
Definition
1. self-sufficiency in growth signals
2. insensitivity to growth-inhibitory signals
3. altered cellular metabolism
4. evations of apoptosis
5. limitless replicative potential (immortality)
6. sustained angiogenesis
7. ability to invade and metastasize
8. ability to evade host immune resonse |
|
|
Term
|
Definition
point mutation
chromosomal translocation
gene amplification |
|
|
Term
|
Definition
mutated in half of all cancer types
Controls: cell cycle pathway, DNA repair and synthesis, cell differentiation, apoptosis
inactivated by viral oncoproteins |
|
|
Term
| top 3 cancer incidence in men |
|
Definition
| prostate, lung, colorectal |
|
|
Term
| top 3 cancer incidence in women |
|
Definition
|
|
Term
| top 3 cancer death in men |
|
Definition
| lung, prostate, colorectal |
|
|
Term
| top 3 cancer death in women |
|
Definition
|
|
Term
| dominant hereditary cancer predispositions |
|
Definition
100-10,000x relative risk
marker phenotype in affected
multiple generations, many family members |
|
|
Term
| DNA repair defect cancer predisposition |
|
Definition
10-100 relative risk
sensitive to environmental carcinogens
fail to detect or repair mutations
high spontaneous mutation rate
chromosomal instability
Ex: Xeroderma pigmentosum, ataxia-telangiectasia, Bloom's syndrome, Faconi's anemia |
|
|
Term
|
Definition
2-10 relative risk
no marker phenotype
2 or more close relatives, early onset
multiple or bilateral tumors
Ex: BRCA1/2, Lynch Syndrome (HNPCC) |
|
|
Term
|
Definition
40% familial, 60% sporadic
mutated Rb gene, 10,000fold risk
bilateral tumors in infancy
increased risk of osteosarcoma in childhood |
|
|
Term
neurofibromatosis
(cancer assoc.) |
|
Definition
plexiform neurofibromas
sarcomas, esp. neurogenic
NF1 - glioma and MPNST
NF2 - early mortality of spinal astrocytomas and ependymomas |
|
|
Term
Cushing syndrome
(paraneoplastic) |
|
Definition
small cell lung cancer
pancreatic carcinoma
neural tumors
(ACTH or similar) |
|
|
Term
|
Definition
small cell lung carcinoma
intracranial tumors
(ADH or atrial natriuretic hormones) |
|
|
Term
hypercalcemia
(paraneoplastic) |
|
Definition
squamous cell lung carcinoma
breast carcinoma
renal carcinoma
adult T-cell leukemia/lymphoma
(PTHrp, TGF-alpha, TNF, IL-1) |
|
|
Term
hypoglycemia
(paraneoplastic) |
|
Definition
ovarian carcinoma
fibrosarcoma
other mesenchymal sarcomas
(insulin or insulin-like) |
|
|
Term
polycythemia
(paraneoplastic) |
|
Definition
renal carcinoma
cerebellar hemangioma
hepatocellular carcinoma
(erythropoietin) |
|
|
Term
myasthenia
(paraneoplastic) |
|
Definition
bronchogenic carcinoma
thymic neoplasm
(immunologic substance) |
|
|
Term
acanthosis nigricans
(paraneoplastic) |
|
Definition
gastric carcinoma
lung carcinoma
uterine carcinoma
DM
(EGF or immunological) |
|
|
Term
venous thrombosis
(paraneoplastic) |
|
Definition
Trouseau's - pancreatic carcinoma
bronchogenic carcinoma
other cancers... |
|
|
Term
|
Definition
APL
prostatic carcinoma
(tumor products activate clotting) |
|
|
Term
|
Definition
lung, esophageal, gastric and colon carcinoma
mesothelioma |
|
|
Term
| breast fibrocystic changes |
|
Definition
| cystic formation and fiboris OR epithelial hyperplasia OR sclerosing adenosis |
|
|
Term
|
Definition
unopened cysts
brown to blue |
|
|
Term
| cysts and fibrosis of breast |
|
Definition
increase fibrous stroma, dilated ducts and formation of cysts of various size
lined by large polygonal cells with abundant eosinophilic cytoplasm
(apocrine metaplasia) |
|
|
Term
| epithelial hyperplasia of breast |
|
Definition
commonly coexists with fibrosis, cysts, and adenosis
proliferation causes increase in layers of duct-lining epithelium beyond the usual double layer
mild, moderate or florid
architectural or cellular atypia -> atypical hyperplasia |
|
|
Term
|
Definition
presence of architectural or cellular atypia in prsence of breast epithelial hyperplasia
bad sign |
|
|
Term
| sclerosing adenosis of breast |
|
Definition
destruction of normal lobular architectur
increased number of glands
hard, cartilaginous consistency begins to approx that found in breast ca
microcalcifications frequent
proliferation of epithelial and myoepithelial cells
minimal or no inc. risk of breast ca. |
|
|
Term
|
Definition
bilaterally
multiple nodules
pain prior to menstruation
type of microcalcifications |
|
|
Term
| breast changes, slight inc. risk |
|
Definition
1.5-2x
hyperplasia moderate to florid
ductal papilloomatosis |
|
|
Term
| breast changes, significant inc. risk |
|
Definition
5x
atypical hyperplasia
ductal or lobular with ductal involvement |
|
|
Term
types of ductal carcinoma in situ
(breast) |
|
Definition
architecture - solid, comedo, cribiform, papillary, micropapillary, apocrine, clinging, clear cell
nuclear grade - low, intermediate, high |
|
|
Term
lobular carcinoma in situ
(breast) |
|
Definition
| proliferation in temrminal ducts and/or ductules of loosely cohesive cells |
|
|
Term
invasive ductal carcionoma
(histopath) |
|
Definition
most common
dnese fibrous stroma
cells form tubules
stellate shape grossly |
|
|
Term
invasive lobular carcinoma
(histopath) |
|
Definition
orderly row of cells
often multiple
bilateral |
|
|
Term
| Scharff-Bloom-Reichardson grading |
|
Definition
for breast cancer
tubular formation - more is better
nuclear grade - less polymorphism is better
mitotic activity - less is better |
|
|
Term
| inflammatory breast carcinoma |
|
Definition
dermal lymphatic obstruction --> lymphatic drainage blocked
pea d'orange
worse prognosis |
|
|
Term
|
Definition
grossly exzematous patches on nipple
paget cell are large cells in epidermis with clear halo
suggests underlying carcinoma |
|
|
Term
|
Definition
fresh water ponds, plumbing systems and aerosols
prevent outbreaks through hyper-chlorination of water in hospitals |
|
|
Term
|
Definition
staph aureous with TSST-1 toxin
also sporadically by other staph and strep |
|
|
Term
|
Definition
Borrelia burgdorferi (spirochete)
rash, arthritis, (meningitis, myocarditis)
deer tick and white-tail deer reservoirs
rat tick and woodrat in CA |
|
|
Term
|
Definition
condyloma, dysplasia and cervical carcinoma assoc.
head/neck squamous carcinoma assoc.
Types 16 & 18 - E6 and E7 proteins block p53, Rb and p21 action |
|
|
Term
|
Definition
homeless, elderly in nursing homes, prisonors, AIDS patients
poor, malnourished, crowded living conditions |
|
|
Term
|
Definition
SW USA
carried by deer mice esp. when lots of pinon nuts
Navajos harvest the pinon nuts and get virus |
|
|
Term
|
Definition
diseases that are capable of spreading person to person
contagious |
|
|
Term
|
Definition
| diseases acquired in the hospital |
|
|
Term
|
Definition
CD21 (CR2) on B cells and macs
mostly CD8+ atypical lymphocytes as well |
|
|
Term
|
Definition
| acetylcholine receptor on neurons |
|
|
Term
| rhinovirus surface receptor |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
G+ streptococci
binds tightly to blood and oral epithelial cells |
|
|
Term
|
Definition
found on GN rods and cocci
proteins at tips bind surgars |
|
|
Term
| macrophage receptors for bacteria |
|
Definition
|
|
Term
| epithelial receptors for bacteria |
|
Definition
|
|
Term
| immune evasion by microbes |
|
Definition
inaccessibility - C. difficile in lumen
block phagocytosis - S. pneu capsule
antigenic variation - influenza and rhinovirus
immunosuppression - EBV, HIV |
|
|
Term
|
Definition
bacteria and candida
any body fluid
30 minutes |
|
|
Term
|
Definition
bacteria, fungi (all), viral inclusions, parasites; EVERYTHING
best on smears
1min prep |
|
|
Term
|
Definition
fungi and a few bacteria
most sensitive for fungi |
|
|
Term
| (modified) acid-fast stain |
|
Definition
mycobacteria and nocardia
sputum, must be concentrated and decontaminated for high specificity |
|
|
Term
|
Definition
target cell
extracellular
no buds |
|
|
Term
| histoplasma capsulatum morphology |
|
Definition
| macrophage with yeast inside |
|
|
Term
|
Definition
circular
big w/ little circles inside |
|
|
Term
| cyrptococus neoformans morphology |
|
Definition
|
|
Term
|
Definition
|
|
Term
| DFA stain (direct fluorescent antibody) |
|
Definition
sputum or respitarory washings
legionella, bordetlla pertussis, herpes virus, others
influenza A currently (high spec, low sens) |
|
|
Term
| diertle/warthin-starry stain |
|
Definition
| treponema pallidum (syphilis) |
|
|
Term
| inflammatory response to different microbes |
|
Definition
bacteria - PMNs, liquefactive necrosis, abscess
fungi - macs/lymphocytes, granulomas
virus - lymphocytes, cytopathic effect |
|
|
Term
| most important mediator in TB |
|
Definition
IFN-gamma
activates macrophages and causes positive skin test |
|
|
Term
|
Definition
peripheral lesion and lymph node in mid lung fields
Ghon complex - involved in reactivation later
miliary TB - pulmonary artery to lung or pulmonary vein to systemic involvement
cavitary
chronic pulmonary |
|
|
Term
|
Definition
mainly infection in upper lung field
mostly due to reactivation
more necrosis
miliary and cavitary |
|
|
Term
|
Definition
squamous epithelial cell infected by HPV
changes: nucleus enlarged, irregular nuclear membrane, hyperchromatic nucleus, perinuclear halo |
|
|
Term
|
Definition
staph, GNRs, anaerobes
aspiration with spread through airways |
|
|
Term
|
Definition
strep pneu, kleb pneu, h. flu
(encapsulated bacteria)
aspiration then spread through alveolar walls (pores of Kohn) |
|
|
Term
|
Definition
human lung fluke - one of few parasites that migrates through lung
GRANULOMATOUS RXN TO EGGS
multi-nuc histiocytes, rim of lymphocytes/fibrosis |
|
|
Term
|
Definition
opportunistic infection
NARROW SEPTATE HYPHAE BRANCH AT ACUTE ANGLES
found in blood vessel walls |
|
|
Term
| mucormycosis (rhizipomycosis) |
|
Definition
assoc. w/ DKA, transplant, heme-onc
rhinocerebral mucormycosis - disastrous complication
BROAD IRREGULAR RIBBON-LIKE HYPHAE, ASEPTATE, RIGHT ANGLE BRANCHING
northern USA = mucor
southern USA = rhizopus |
|
|
Term
|
Definition
SULFUR GRANULES (YELLOW GROSSLY, PINK/BLUE MICRO)
FILAMENTOUS anaerobic bacteria
G+, acid-fast negative
DRAINING FISTULAS, poor oral hygeine |
|
|
Term
|
Definition
inflammation/infection of fallopian tube
C. trachomatis or N. gonorrhoeae
consequences: sterility, ectopic pregnancy |
|
|
Term
|
Definition
most ascend from bladder infection
E. coli most common etiology
high fever, chills, pain,
THYROIDIZATION OF KIDNEY |
|
|
Term
|
Definition
corynebacterium diptheriae
PSEDUOMEMBRANE IN TRACHEA/BRONCHI
exotoxin destroys myocytes --> myocarditis --> fatal arrhythmias or heart failure
ABSCESSES IN MYOCARDIUM - die from myocarditis or heart failure |
|
|
Term
| obliterative endarteritis |
|
Definition
1*, 2* or 3* syphilis
arteries attacked
plasma cells surround vasovasorum
tertiary - ascending or thoracic aorta (80%)
treponema pallidum |
|
|
Term
|
Definition
obliterative endarteritis, chancre
treponema pallidum |
|
|
Term
|
Definition
mycobacterium tuberculosis
communicable
Micro - necrotizing granulomas
Gross - caseous granulomas, Ghon complex, apical disease
ACID-FAST BACILLI AEROBE, slow growing |
|
|
Term
|
Definition
non communicable
Micro - necrotizing granuloma
Morph - 2-3micron, budding yeast, intracellular, dimorphic funti
inhale conidia from soil |
|
|
Term
|
Definition
California and arizona
Micro - necrotizing granulomas
Morph - spherules contain endospores, dimorphic fungus
inhalation of arthroconidia
resembles tuberculosis |
|
|
Term
|
Definition
large yeast with broad-based buds
Micro - epithelium proliferation
pseudoepitheliomatous hyperplasia
(mimics squamous carcinoma of skin)
Inflammation - histiocytes, giant cells, abscess w/ PMNs |
|
|
Term
|
Definition
pneumocystis jiroveci
Cysts and trophozoites forms
GMS --> cysts; Giemsa --> trophozoites
each cyst contains 8 trophozoites; cysts like cups/targets/grooves
BUNCH OF PINK FOAMY STUFF IN ALVEOLI |
|
|
Term
|
Definition
variably sized budding yeast with THICK CAPSULE OF MUCOPOLYSACCHARIDES
LATEX AGGLUTINATION on CSF/sputum - high sens and spec
100% fatal if untreated |
|
|
Term
|
Definition
anterior/motor horns destroyed
paralytic form in non-vaccinated adults |
|
|
Term
|
Definition
FLASK-SHAPED ULCERS IN COLON
ERYTHROPHAGOCYTOSIS - ingestion of RBCs by microbe
Dx - collect stool for ova and parasite exam
Rx- metronidazole |
|
|
Term
|
Definition
AUTOINFECTION - entire life cycle possible in immunocompromised human
ASSOC. W/ HTLV-1 INFECTIONS
Micro - CALCIFIED WORMS
present with pneumonia |
|
|
Term
|
Definition
NUCLEUS ONLY INCLUSIONS
COWDRY B TYPE
febrile, systemic
upper resp., conjuctivitis, tonsilitis, ear infection, croup, gastroenteritis, meningitis |
|
|
Term
|
Definition
enlarged cells
intranuclear (COWDRY B) and cytoplasmic inclusions |
|
|
Term
|
Definition
nuclear inclusions (Cowdry B)
ganglia and adrenal medulla |
|
|
Term
|
Definition
brain abscess
RING-ENHANCING LESION = cysts |
|
|
Term
|
Definition
lymphocytes in portal zones
loss of hepatocytes, cirrhosis |
|
|
Term
|
Definition
60% of common colds
binds ICAM1 on respiratory epithelial cells
INDUCES MUCUS SECRETION VIA BRADYKININ RELEASE
dx - clinical
Histo (nasal mucosa) - abundant mucin/mucosal edema, lymphocytes, plasma cells |
|
|
Term
|
Definition
types A, B or C; ssRNA
subtypes based on hemagglutinin and neuraminidase in lipid envelope
CLEARED BY CYTOTOXIC T CELLS KILLING INFECTED CELLS
Dx- viral Ag by DFA, multiplex RT-PCR
Rx- oestelamivir, zanamavir effective in first 24-48hrs |
|
|
Term
|
Definition
| minor antigenic change due to point mutations |
|
|
Term
|
Definition
| major antigenic change (both H and N replaced) due to genetic reassortment between animal and human influenza A viruses |
|
|
Term
|
Definition
|
|
Term
|
Definition
Staph aureus MRSA>MSSA
GNR- Kleb, E. coli; pseudomonas
Legionella
Anaerobes |
|
|
Term
| complications of lobar pneumonia |
|
Definition
abscess
pleuritis and empyema
organizing pneumonia (residual fibrosis)
bacteremia and sepsis
infarction |
|
|
Term
| streptococcus pneumoniae pneumonia |
|
Definition
G+ LANCET SHAPED DIPLOCOCCI
blood culture more specific but less sensitive |
|
|
Term
haemophilus influenzae
(resp infection |
|
Definition
life threatening EPIGLOTITTIS - submucosal inflammatory edema may obstruct airway <24hr after onset
children 2-4yr
Micro - dense fibrin-rich exudates of PMNs
Dx- TINY G- COCCOBACILLI, CULTURE ON CHOCOLATE AGAR, rapid ID w/ latex agglutination or DNA probe |
|
|
Term
|
Definition
necrotizing pneumonia with necrotizing vasculitis
acute inflammation in lungs
SMALL G- ROD, COMPLETE HEMOLYSIS ON BLOOD AGAR, SMELLS FRUITY
purple haze of bacteria on H&E around vessels |
|
|
Term
|
Definition
| PLUMP G- RODS, white spaces around rods = ENCAPSULATED, MUCOID ON MACCONKEY AGAR |
|
|
Term
|
Definition
glycolipid causes serpentine growth pattern
virulence increased |
|
|
Term
|
Definition
polysaccharide similar to endotoxin
inhibits macs activation by IFN-gamma
induces macs to secrete TNF-alpha (fever, wt loss, tissue damage) & IL-10 (suppress T cell proliferation) |
|
|
Term
|
Definition
high immunogenic
could play role in autoimmune rxns induced by TB |
|
|
Term
|
Definition
CD4 - secrete IFN-gamma to activate macs, epithelioid granuloma formation and removal of TB
CD8 - kill infected macs, caseating granulomas |
|
|
Term
|
Definition
hematogenous spread to many organs
tiny yellow-white granulomas
pulm artery --> lungs
pulm vein --> body |
|
|
Term
|
Definition
G+ COCCI, GRAPE-LIKE CLUSTER, facultative anaerobes
CATALASE+, COAGULASE+
acute pygenic inflammation w/ ABSCESSES
skin, wound, deep tissue, blood stream, pneumonia, septic arthritis, food poisoning, acute enterocolitis, scalded skin syndrome |
|
|
Term
|
Definition
tender, subcutaneous inflammatory nodule - extends to dermis
Risk: neutrophil defect, obesity, steroids, occlusive dressings, diabetes |
|
|
Term
|
Definition
series of coalescent furuncles that express pus from multiple tracks
Rx- incision and drainage, abx |
|
|
Term
|
Definition
primary pyodermia sen in children, 2-5y/o
staph or strep
confined to superficial epidermis
skin ulcerates |
|
|
Term
|
Definition
healthcare associated = highly reistant - all b-lactams and others
community associated = just resist b-lactams and erithromycin
MecA gene in RT-PCR |
|
|
Term
Group A strep
(streptococcus pyogenes) |
|
Definition
G+ COCCI IN PAIRS OR LONG CHAINS
B-HEMOLYTIC
pharyngitis, tonsillitis, erysipelas, impetigo, cellulitis, wound inf, scarlet fever, necrotizing fasciitis, septicemia, pneumonia |
|
|
Term
|
Definition
butterfly rash, bright red, confluent rash
neutrophil infiltration
trunk, arms = small punctate rash |
|
|
Term
| streptococccal pneumoniae |
|
Definition
| most important cause of Ca bacterial pneumonia |
|
|
Term
| bacterial meningitis, agents, neonates |
|
Definition
|
|
Term
| bacterial meningitis, agents, children/young adults |
|
Definition
|
|
Term
| bacterial meningitis, agents, adults |
|
Definition
| s. pneu, n. meningitidis, H. flu, L. monocytogenese |
|
|
Term
|
Definition
Px - fever, HA, photophobia, irritability, altered mental status, neck stiffness
Tests - CT scan, lumbar puncture (increased WBC nuetrophils, decreased glucose, increased protein)
Tx - stat empiric abx |
|
|
Term
|
Definition
13 serogroups based on capsule
meningitis, septicemia, DIC, Waterhouse-Frederichson syndrome
young adults, army barracks, college dorms, campus
Dx - Gram stain and culture
G- DIPPLOCOCCI, CHOCOLATE AGAR |
|
|
Term
listeriosis
(L. monocytognes) |
|
Definition
SMALL G+ RODS, resemble cocci
foodborne, disseminates hematogneously, affinity for CNS and placenta
CNS infection for septicemia in immunocompromised
grow in macrophages or epithelial cells
Histo - focal necrosis, microabscesses in various organs; monocytes and macrophages and T cells at periphery of lesions |
|
|
Term
|
Definition
anaerobe vs. aerobe
not acid fast vs. weak acid fast
filamentous vs. filamentous
branching vs. branching |
|
|
Term
|
Definition
muscle necrosis in wounds (gas gangrene)
cellulitis, food poisoning, bowel necrosis
ALPHA-TOXIN (PHOSPHOLIPASE C)
ANAEROBIC G+ SPORE FORMING |
|
|
Term
|
Definition
muscle necrosis in wounds (gas gangrene)
cellulitis, food poisoning, bowel necrosis
ANAEROBIC G+ SPORE FORMING |
|
|
Term
|
Definition
wound or umbilical stump
release tetanospamin
spastic paralysis by blocking GABA
ANAEROBIC G+ SPORE FORMING |
|
|
Term
|
Definition
grow in contaminated foo
release neurotoxin that causes descending flaccid paralysis of respiratory and skeletal muscle
binds irreversbile to peripheral nerve endings (NMJ) blocking release of ACh
ANAEROBIC G+ SPORE FORMING |
|
|
Term
|
Definition
hospital assoc. or abx assoc. diarrhea
(quinolones, or proton pump inhibitors)
PSEUDOMEMBRANOUS ULCERATIVE COLITIS
MUSHROOM CLOUD ON MICRO
tx - VANCO OR FLAGYL |
|
|
Term
|
Definition
- hospital >72 - molecular assay for C. diff
- outpatient - bacterial culture
- neg bacterial cultures or travel history or AIds --> ELISA for Giardia and Crypto
- then viral screen
- then molecular screen for all of above (super $$$$) |
|
|
Term
| bacterial infections in stool samples |
|
Definition
salmonella
shigella
E. coli O157
campylobacter
shiga toxin |
|
|
Term
|
Definition
staph - 2-4hr
botulism - 2h-8d (12-48hr avg)
b. cereus - 1-6hr vomit, 6-24hr diarrhea [fried rice]
c. perfringens - 9-15hr |
|
|
Term
|
Definition
V. cholerae and toxigenic E. coli
multiply in mucous layer over epithelium |
|
|
Term
| invasive enteroritis, bacterial agents |
|
Definition
Shigella, salmonella, campylobacter
invade mucosa and lamina propria
inflammation, ulceration, bloody stools |
|
|
Term
|
Definition
damages mucosa --> peyer's patches --> mesenteric LN --> blood stream --> systemic infection
ROSE SPOTS ON ABDOMEN, confusion, weakness, bronchitis, pneumonia |
|
|
Term
|
Definition
candida - oral thrush, esophagitis
disseminates to stomach, lower GI and systemic organs (immunocompromised) |
|
|
Term
|
Definition
attach to epithelial brush border
cysts not killed by chlorine
freq. day care
anorexia, N, D, ramping, flatulence, abdominal distension, wt. loss, malabsorption, MUSHY FOUL-SMELLING STOOLS
Dx - wet mount -> PEAR SHAPED TROPHOZOITES WITH FALLING LEAF MOTILITY |
|
|
Term
|
Definition
| form gametes sna pores inside enterocytes |
|
|
Term
|
Definition
intestinal helminth
large number -> obstruct gut or invade bile ducts |
|
|
Term
|
Definition
| suck blood from villi --> Fe deficiency anemia |
|
|
Term
|
Definition
| major cause of childhood diarrhea |
|
|
Term
|
Definition
epidemic GE with D, N, V
children and adults |
|
|
Term
| shigellosis (bacillery dysentery) |
|
Definition
colon invaded by NONMOTILE LACTOSE(-) G- RODS
most pt <5y/o, day care assoc. outbreaks
Sx- fever, abdominal cramps, watery to bloody D, low volume |
|
|
Term
campylobacter enteritis
(campylobacter jejuni) |
|
Definition
MOTILE COMMA-SHAPED G- ROD, MICROAEROPHILIC, 42*C GROWTH
Sx-diarrhea, abdominal pain, fever after 2-10d
inflammation of entire gut, colonic crypt abscesses, hyperemia, infiltrates of PMNs, lymphocytes and plasma cells |
|
|
Term
yersinia enteritis
(yersinia enterocolitica) |
|
Definition
infrequent in US, more in northern europe, s. america, africa, asia
foodborne outbreaks
GROW AT REFRIGERATOR TEMPS
terminal ileum to olon, lesions like typhoid, ENLARGE MESENTERIC LN w/ STELLATE ABSCESSES |
|
|
Term
|
Definition
diarrhea w/ fever and abdominal cramps
Food: eggs, ice cream, turkey, chicken, beef, ham, pork, misc.
Infections: food poisoning, enteric fevers, bacteremia, osteomyelitis if sickle cell disease |
|
|
Term
|
Definition
illness caused by enterotoxin
toxin activates adenylate cyclase in small bowel mucosa -> secretion of Cl- and H2O --> massive secretory diarrhea
"RICE WATER STOOLS" |
|
|
Term
|
Definition
cholera-like toxin (heat labile)
source = food or water
TRAVELER'S DIARRHEA |
|
|
Term
|
Definition
dysentery, involves colon and resembles shigellosis
source = food or water, communicable |
|
|
Term
| enteroadherent (enteropathogenic) e. coli |
|
Definition
pili adhere to receptors --> diarrhea
common O groups
source = food, water
diarrhea of toddlers and infants |
|
|
Term
|
Definition
O157:H7
Shiga-like toxin, no invasion
Source = undercooked beef
hemorrhagic diarrhea and colitis, Hemolytic uremic syndrome |
|
|
Term
cellular immune dysfunction
agents of opportunity, bacteria |
|
Definition
TB, legionella, listeria, salmonella
(intracellular) |
|
|
Term
cellular immune dysfunction
agents of opportunity, fungi |
|
Definition
| aspergillus, candida, hisotplasma, cryptococcus |
|
|
Term
cellular immune dysfunction
agents of opportunity, protazoa |
|
Definition
| cyrptosporidium, toxoplasma |
|
|
Term
cellular immune dysfunction
agents of opportunity, virus |
|
Definition
|
|
Term
cellular immune dysfunction
(allow for agents of opportunity) |
|
Definition
DiGeorge, X-linked agammaglobulinemia of Bruton
aging, malnutrition, malignancy, viral disease, AIDS |
|
|
Term
|
Definition
Target cells: CD4+ T cells, macrophages, dendritic cells
R5 strains are M-tropic use CCr5 as corecptors for penetration
X4 strains are T-tropic use CXCR4 as coreceptors for penetration |
|
|
Term
| opportunistic infections in AIDS |
|
Definition
| pseudomonas, legionella, m. avium-intracellulare, m. tuberculosis, candida, cryptococcus, pneumocystis |
|
|
Term
|
Definition
Early - viremia, fever, fatigue
Latent - 7-10yrs w/ minor lymphadenopathy and minor infections such as candida and herpes zoster
Final (crisis) - persistent lymphadenopathy, fever, rash, opportunistic infections, neoplasms, CNS disorders |
|
|
Term
| release of HIV from latency |
|
Definition
1. latently infected CD4+ cell encounters environmental angitgen
2. NF-KB released activates replication of proviral HIV DNA; TNF can also activate replication
3. macrophages and T cells are activated, HIV replication occurs |
|
|
Term
| definition of HIV crisis phase |
|
Definition
HIV-1 mRNA >30,000uL
CD4+ T cell <200uL
opportunistic infections
fever and rash are constant
oral candidiasis is predictor of rapid progression |
|
|
Term
|
Definition
| Kaposi's sarcoma (HSV8), Hodgkins and esp. Non-Hodgkins B cell lymphomas, cervical squamous carciobnoma, HPV-associated oral cancers |
|
|
Term
cellular immune dysfunction
agents of opportunity, bacteria |
|
Definition
TB, legionella, listeria, salmonella
(intracellular) |
|
|
Term
cellular immune dysfunction
agents of opportunity, fungi |
|
Definition
| aspergillus, candida, hisotplasma, cryptococcus |
|
|
Term
cellular immune dysfunction
agents of opportunity, protazoa |
|
Definition
| cyrptosporidium, toxoplasma |
|
|
Term
cellular immune dysfunction
agents of opportunity, virus |
|
Definition
|
|
Term
cellular immune dysfunction
(allow for agents of opportunity) |
|
Definition
DiGeorge, X-linked agammaglobulinemia of Bruton
aging, malnutrition, malignancy, viral disease, AIDS |
|
|
Term
|
Definition
Target cells: CD4+ T cells, macrophages, dendritic cells
R5 strains are M-tropic use CCr5 as corecptors for penetration
X4 strains are T-tropic use CXCR4 as coreceptors for penetration |
|
|
Term
| opportunistic infections in AIDS |
|
Definition
| pseudomonas, legionella, m. avium-intracellulare, m. tuberculosis, candida, cryptococcus, pneumocystis |
|
|
Term
|
Definition
Early - viremia, fever, fatigue
Latent - 7-10yrs w/ minor lymphadenopathy and minor infections such as candida and herpes zoster
Final (crisis) - persistent lymphadenopathy, fever, rash, opportunistic infections, neoplasms, CNS disorders |
|
|
Term
| release of HIV from latency |
|
Definition
1. latently infected CD4+ cell encounters environmental angitgen
2. NF-KB released activates replication of proviral HIV DNA; TNF can also activate replication
3. macrophages and T cells are activated, HIV replication occurs |
|
|
Term
| definition of HIV crisis phase |
|
Definition
HIV-1 mRNA >30,000uL
CD4+ T cell <200uL
opportunistic infections
fever and rash are constant
oral candidiasis is predictor of rapid progression |
|
|
Term
|
Definition
| Kaposi's sarcoma (HSV8), Hodgkins and esp. Non-Hodgkins B cell lymphomas, cervical squamous carciobnoma, HPV-associated oral cancers |
|
|
Term
|
Definition
most common reportable STD
obligate intracellular G- ROD
elementary bodies (infect) and reticulate bodies (multiply)
urethritis, cervicitis, salpingitis, PID, LGV, trachoma |
|
|
Term
gonorrhea
(neisseria gonorrhoeae) |
|
Definition
G- COCCUS
urethritis, phryngitis, proctitis, salpingitis, bacteremia w/ arthritis and dermatitis
ARTHRITIS IN ONE JOINT
MORE VIRULENT THAN CHLAMYDIA |
|
|
Term
syphilis
(treponema pallidum) |
|
Definition
spirochete with flaggelum, VISUALIZE ON DARKFIELD, SILVER STAINS OR DFA
1* - chancre in 3-4wks at invasion site
2* - rash, fever, lymphadenopathy in 10wks (esp. plasma and soles)
3* - aorta, heart, CNS, etc., years later |
|
|
Term
|
Definition
obliterative endarteritis
plasma cell infiltrate
bind endothelial cells via fibronectin
abs prevent more chancres but can't clear spirochetes |
|
|
Term
|
Definition
syphilis assoc. 2*
2cm elevated plaques on penis or vulva
plasma cells and endarteritis |
|
|
Term
|
Definition
VDRL - non-treponemoal tests, positive early and disappear, nonspecific
FTA - treponemal tests, positive lifelong, negative early, more specific |
|
|
Term
trichomoniasis
(trichomonas vaginalis) |
|
Definition
anaerobic, FLAGELLATED PROTAZOA, TROPHOZOITES ONLY
urethritis, vaginitis, superficial infection with ithcing and watery discharge |
|
|
Term
|
Definition
| clue cell - covered with bacteria, seen on Giemsa, Gram- |
|
|
Term
|
Definition
HPV assoc., types 6 & 11
benign |
|
|
Term
|
Definition
soft chancre, painful, tropical ulcer
SCHOOL OF FISH ON GRAM STAIN
culture on chocolate |
|
|
Term
|
Definition
osler's nodes
janeway lesions
splinter hemorrhages
roth spots
(staph or strep) |
|
|
Term
|
Definition
prostate specific antigen
prostate cancer marker |
|
|
Term
|
Definition
| colorectal/pancreatic tumor marker |
|
|
Term
|
Definition
| hepatic and yolk-sac tumor marker |
|
|
Term
|
Definition
| choriocarcinoma/molar pregnancy tumor marker |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Burkitt's lymphoma (c-myc) |
|
|
Term
|
Definition
| Follicular lymphoma (bcl-2) |
|
|
Term
|
Definition
| AML M3 (promyelocytic leukemia) |
|
|
Term
|
Definition
|
|
Term
|
Definition
night blindness
xerophthalmia (dry eye) - keratinized squamous replaces mucus-secreting epithelium
squamous metaplasia in lung and bladder |
|
|
Term
|
Definition
increase intracranial pressure
papilledema, HA, vomit
bone pain and hypercalcemia |
|
|
Term
|
Definition
HYPOCALCEMIA, BONE LOSS, RICKETS, OSTEOMALACIA
UNMINERALIZED MATRIX IN RICKETS AND OSTEOMALACIA |
|
|
Term
|
Definition
bleeding
esp. intracranial in infants, bleeding umbilical stump
Factors II, VII, IX, X, Protein S and C
Rx- fresh frozen plasma + vitamin |
|
|
Term
|
Definition
wound healing dysfunction
improper collagen development and wound healing (esp. in oral cavity) |
|
|
Term
|
Definition
cofactor in oxidative decarboxylation
results in DECREASED ATP
cardiovascular and nervous system problems
1/4 of all alcoholics
Dry and wet beriberi, Wernicke-Korsacoff syndrome |
|
|
Term
|
Definition
thiamine deficiency
polyneuropathy
myelin degeneration |
|
|
Term
|
Definition
thiamine deficiency
cardiovascular
vasodilation produces HF and edema |
|
|
Term
| Wernicke-Korsakoff syndrome |
|
Definition
W - ataxia, confusion
K - amnesia, confabulation |
|
|
Term
|
Definition
niacin deficiency
used as coenzyme for dehydrogenases
found in grains legumes and seed oils
DERMATITIS-DIARRHEA-DEMENTIA |
|
|
Term
|
Definition
Scurvy
capillary and venule wall are weak with hemorrhages (purpura and ecchymoses)
child - tooo much cartilage, not enough osteoid protein, bowed legs and deformed chest
bacterial infections assoc. with gingival hemorrhage |
|
|
Term
|
Definition
neural tube defects in fetus
macrocytic anemia |
|
|
Term
|
Definition
acrodermatitis, growth retardation, impaired wound healing, hypogonaism
(anorexia) |
|
|
Term
| spinal epidural abscess ddx |
|
Definition
vertebral osteomyelitis
tuberculosis |
|
|
Term
|
Definition
| 2* infection of epidural hematoma |
|
|
Term
|
Definition
empyema
usually from direct extension (i.e. from sinus or injury) |
|
|
Term
| bacterial meningitis histopath |
|
Definition
subarachnoid space - gelatinous purulent or fibrinous exudate
exudate more abundant in sulci and at base of brain
ventriculitis may coexist
phlebitis with venous occlusion and hemorrhagic infaction
leptomeningeal fibrosis |
|
|
Term
| complications of bacterial meningitis |
|
Definition
inflammation of vessel wall - mycotic aneurysm
non-communicating hydrocephalus - blocking of foramina |
|
|
Term
|
Definition
local extension - mastoiditis, sinusitis
hematogenous - bacterial endocarditis, cyanotic congenital heart disease, chronic pulmonary septic foci |
|
|
Term
| brain abscess (signs and symptoms) |
|
Definition
increased intracranial pressure
edema
herniation ventriculitis
meningitis
sinus thrombosis |
|
|
Term
| brain abscess (morphology) |
|
Definition
central liquefactive necrosis
wall of granulation tissue and mixed inflammatory cell infiltrate
delicate fibrous capsule
edema of adjacent parenchyma and gliosis |
|
|
Term
| brain abscess (treatment) |
|
Definition
| surgical drainage and antimicrobials |
|
|
Term
|
Definition
basal meningitis, fibrosis, endarteritis, thombosis
tuberculoma - near surface, rupturing can cause violent meningitis
Histopath - caseating granulomata, extensive meningeal fibrosis, obliteration of foramina of Luschka and Magendie, hydrocephalus |
|
|
Term
|
Definition
newborns
multiple microabscesses |
|
|
Term
| aspergillus brain infection |
|
Definition
angiophilic, aerophilic --> vascular thrombosis --> infarction
often assoc. w/ pulmonary or paranasal sinus infections
rarely gives rise to abscesses |
|
|
Term
|
Definition
only immunocompromised and diabetics
angiophilic
produces thrombosis --> destroy paranasal sinus tissues, orbital tissues, and intracranial tissues
reaches cavernus sinus --> INTERNAL CAROTID ARTERY THOMBOSIS --> MASSIVE BRAIN INFARCTION
tx - none |
|
|
Term
|
Definition
usually spreads from lungs
immunocompromised pts but also healthy
PARENCHYMAL MULTI-CYSTIC LOOKING LESIONS - SWISS CHEESE
meningitis - acute or chronic |
|
|
Term
|
Definition
2* to focus in lung
accumulate in cells
granulomatous inflammation
prevalent in mid-west |
|
|
Term
| meningiovascular syphilis |
|
Definition
lymphoplasmacytic meningitis
thickening of intima of small and medium size arteries
endaritis obliterans |
|
|
Term
|
Definition
rotting of spinal cord
inflammation and degeneration of dorsal roots and posterior columns of spinal cord
SYPHILIS |
|
|
Term
|
Definition
SUPER RARE
encephalitis due to treponema pallidum |
|
|
Term
|
Definition
inflammatory mass of rubbery consistency containing spirochetes, acts as tumor mass
SYPHILIS |
|
|
Term
|
Definition
2nd and 3rd stages of borrelia burgdorferi infection
meningitis, radiculitis, neuropathy, encephalitis
Sx - ataxia, paralysis, dementia, other
CSF- inc. monocytic cells, slight inc. protein
Histopath- lymphoplasmacytic infiltrate, vaculitis in meninges |
|
|
Term
| viral brain infections (general histopath) |
|
Definition
diffuse infiltration of microglia
perivascular lymphocytic infiltrate
multinucleated giant cells (AIDS encephalitis)
neuronophagia - phagocytosis of neuronal remnants |
|
|
Term
|
Definition
rabies
cytoplasmic inclusion |
|
|
Term
|
Definition
involves both gray and white matter
necrotizing or non-necrotizing types |
|
|
Term
| necrotizing panencephalitis agents |
|
Definition
|
|
Term
| non-necrotizing panencephalitis agents |
|
Definition
|
|
Term
|
Definition
predominantly involves gray matter
PMNs in 24hrs, followed by lymphocytes, neuronophagia, and microglial nodules
agents - enterovirus, rabies, arboviruses |
|
|
Term
|
Definition
predominantly involves white matter
agents - HIV, PML, post-infection |
|
|
Term
| enterovirus brain infection |
|
Definition
30-50% viral meningitis
most cases of poliomyelitis
fecal-oral transmision
highly infective, 75% of household contacts (+) for coxsackie |
|
|
Term
|
Definition
rhabdovirus family
wild carnivores and bats as reservoir [SKUNKS]
incuation 15d-1yr, dormant in muscles
Micro - perivascular inflammation, w/o tissue necrosis, NEGRI body (hippocampus or purkinje cells of cerebellum) |
|
|
Term
| herpes simplex encephalitis |
|
Definition
basal frontal and temporal lobes, usually towards midline
neonates - highly destrutive lesion in whole brain and other organs
NECROTIZING AND HEMORRHAGIC ENCEPHALITIS
aggressive
tx - rapidly, |
|
|
Term
| cytomegalovirus encephalitis |
|
Definition
| fetal infections - predilection for periventricular region, tissue destruction and calcifications; microcephaly and cortical dysplasias |
|
|
Term
| progressive multifocal leukoencephalopathy (PML) |
|
Definition
etiology - papovavirus (JC polyomarvirus)
immunocompromised pts
DESTROYS OLIGODENDROGLIAL CELLS - EXTENSIVE DEMYELINATION
no significant inflammatory infiltrate |
|
|
Term
|
Definition
can occur during fetal development after transplacental transmission
periventricular regions with calcifications and necrosis (ddx CMV)
abscess like lesions
SMALL PSEUDOCYSTS CONTAINING LARGE NUMBER OF ORGANISMS |
|
|
Term
| entamoeba histolytica in brain |
|
Definition
CNS abscess is rare and late complication of intestinal disease
hematogenous dissemination of trophozoites
ID trophs in abscess wall |
|
|
Term
|
Definition
seeds nasal passage following swimming in FRESH WATER
enters CNS through cribiform plate
acute fulminant presentation with death in 72hr
1* AMOEBIC MENINGOENCEPHALITIS
extensive necrosis and hemorrhage of brain |
|
|
Term
|
Definition
hematogenous dissemination into CNS from lower respiratory tract or skin
contact wearer
subacute or chronic disease
Sx - focal neurologic deficits, focal seizures, usually fatal
Histo - granulomatous lesions |
|
|
Term
|
Definition
1-10% of falciparum infections
usually children
incubate 1-3wk
s/s - increased intracranial pressure
pathogenesis - occlusion of CNS capillaries by infected RBCs
mortality - 20-50% |
|
|
Term
| hypoxic ischemic encephalopathy |
|
Definition
global brain ischemia
temporary interruption or severe reductionn of blood flow to brain
transient, permanent |
|
|
Term
| specific vulnerable neuron types in brain |
|
Definition
CA1 region of hippocampus
basal ganglia
cerebral cortex - 3rd, 5th, and 6th layers
cerebellar cortex - Purkinje cells***** |
|
|
Term
| specific vulnerable regions in brain |
|
Definition
WATERSHED ZONES
border zones between arterial supplies |
|
|
Term
| irreverisble neuronal injury |
|
Definition
w/ reperfusion = eosinophilic neuronal necrosis - ischemic cell change, selective neuronal necoris
W/o reperfusion = neuronal ghost cells (completely necrotic, fuzzy appearance) |
|
|
Term
|
Definition
loss of CA1 region of hippocampus
anterograde amnesia |
|
|
Term
|
Definition
|
|
Term
|
Definition
one hemisphere's uncus hernaties
displaces brainstem to other side
posterior cerebral artery compressed --> ischemia dna petechial hemorrhage |
|
|
Term
|
Definition
hemorrhage 2* to herniation in midbrain and upper pons
paramedian artery rupture |
|
|
Term
| clinical signs of uncal herniation |
|
Definition
ipsilateral dilate pupil, ptosis - CNIII stretching
contralateral homonymous hemianopia -ipsilateral compression of posterior communicating artery
ipsilateral paresis - compression of contralateral crus cerebri
duret hemorrhages - caudal displacement of BS
hydrocephalus - compression of cerebral aqueduct |
|
|
Term
| risk factors of cerebrovascular disease |
|
Definition
| cardiac disease, TIA, obesity, oral contraceptives |
|
|
Term
| transient ischemic attack |
|
Definition
small territory
may or may not be assoc. w/ an infarction
focal neurologic symptom of sudden onset lasting less than 24hrs
caused by cerebrovascular disease
emboli, arterial stenosis, extrinsic arterial compression, small cerebral infarct or hemorrhage |
|
|
Term
|
Definition
| ischemic penumbra - area around structural damage of stroke; functionally impaired but can be rescued from structural damagesur |
|
|
Term
|
Definition
|
|
Term
|
Definition
small, no larger than 1.5cm
associated with basal ganglia, thalamus and base of pons
HTN assoc. |
|
|
Term
| brain ischemic infarct, acute findings |
|
Definition
6-8rs
pale, soft, swollen, blurred G-W matter junction
Micro:
1hr-neuronal and perineuronal vacuolation, DARK NEURONS
4-12hr-pallor of tissue (leaky BBB), RED NEURONs
15-24hr-5d- infiltration w/ PMNs |
|
|
Term
| brain ischemic infarct, subacute findings |
|
Definition
2d-3wk
gelatinous, friable, distinct boundaries
gradual removal of tissue
Micro:
infiltration with macrophages
phagocytosis of cell debris and myelin |
|
|
Term
| brain ischemic infarct, old (remote) findings |
|
Definition
mo-yrs
cystic, hemosiderin staining, axonal loss
Micro:
cyst formation
residual macrophages
gliotic wall |
|
|
Term
|
Definition
| symptoms in lower distal extremeties |
|
|
Term
| most freq. cause of ischemic infarction |
|
Definition
|
|
Term
| large or small embolism etiology |
|
Definition
| atrial fibrillation, MI, bacterial endocarditis, rheumatic endocarditis, nonbacterial endocarditis, cardiac surgery, arterial thrombosis |
|
|
Term
|
Definition
ulcerated atheroma
trauma (fat emboli) - crushing injuries w/ extensive damage to bone marrow |
|
|
Term
|
Definition
bridging veins
early - acute and subacute -> trauma, assoc. w/ brain contusion, mixture of blood and CSF, may not clot
chronic - mainly elderly, may not recall trauma, slow development, my distort brain, fibrous organization (membrane formation, rebleeding common, granulation tissue org, grows and rebleeds) |
|
|
Term
|
Definition
often preceded by blow to head that tears MMA
commonly lucid interval
LOC at contusion and later due to accumulation of blood |
|
|
Term
| intraparenchymal hemorrhage |
|
Definition
90% related to HTN
40-75y/o, greater in AA
basal ganglia 60%, thalamus 10%, pons 10%, cerebellum 10%
90% mortality |
|
|
Term
|
Definition
| aneurysms 51%, miscellaneous etiology 43%, vascular anomalies 6% |
|
|
Term
| berry (saccular) aneurysm |
|
Definition
develop in area where there is weakness in vessel wall
usually at point of bifurcation of vessels
contains only endothelium and adventitia as wall
50% assoc. with HTN |
|
|
Term
| arteriovenous malformations (histopath) |
|
Definition
high pressure system; shunts between arterial vessels and venous system
parenchyma between the abnormal blood vessels
ischemia in surrounding tissue and gliosis, see some macs |
|
|
Term
| cavernous hemangioma (histopath) |
|
Definition
high pressure arteriovenous system
gliosis, presence of macs, no intervening parenchyma between abnormal vessels |
|
|
Term
| arteriovenous malformation (clinical) |
|
Definition
onset 10-40
M:F is 2:1
location - usually supratentorial
S/S - HA, seizures, focal neurologic deficit, hemorrhage
Mortality - 20% after hemorrhage |
|
|
Term
| Alzheimer disease (protein and pathology) |
|
Definition
Protein: B-amyloid (AB)
Pathology: amyloid plaques
Notes: mutation in rare familial forms |
|
|
Term
| Alzheimer/tauopathies (protein and pathology) |
|
Definition
Protein: tau
Pathology: neurofibrillary tangles |
|
|
Term
| Parkinsonism (protein and pathology) |
|
Definition
Protein: alpha-synuclein
Pathology: Lewy bodies
Notes: mutations in some types of familial PD |
|
|
Term
| Creutzfeldt-Jakob (protein and pathology) |
|
Definition
Protein: prion protein
Pathology: insoluble aggregates
Notes: transmitted as protein in misfolded state |
|
|
Term
| Huntington (protein and pathology) |
|
Definition
Protein: huntingtin
Pathology: neuronal inclusions
Notes: one of several genetic polyglutamate repeat disorders |
|
|
Term
| amyotrophic lateral sclerosis (ALS) (protein and pathology) |
|
Definition
Protein: superoxide dismutase, TDP-43
Pathology: loss of motor neurons
Notes: mutated SOD tends to form aggregates, loss of enzyme fx increases susceptibility to oxidative stress |
|
|
Term
|
Definition
most common progressive dementia
global cognitive decline
dissuf synaptic and neuronal loss
intracellular neurofibrillary tangles, extracellular amyloid plaques, amyloid angiopathy
Gross - atrophy of frontal, temporal and parietal lobes
ApoE - increased risk of development of late onset, E4 variant, increases deposition of beta-amyloid, 40% cases
amyloid precursor protein mutation on chromosome 22 --> familial early onset |
|
|
Term
|
Definition
severity of Alz disease
based on location of tangles |
|
|
Term
|
Definition
severity of Alz disease
based on # of plaques and correlated to age |
|
|
Term
|
Definition
progressive neurodegenerative disease
Gross - depigmentation of substantia nigra and locus ceruleus
Micro - loss if pigmented catecholaminergic neurons, gliosis of SN and LC, accumulation of Lewy bodies (round eosinophilic cytoplasmic inclusions)
BRADYKINESIA, RESTING TREMOR, COGWHEEL RIGIDITY, SHUFFLING GAIT |
|
|
Term
|
Definition
single or multiple
cytoplasmic, eosinophilic
round to elongated inclusions
often have dense core surrounded by pale halo
fine filaments densely packed in the core but loose at rim
alpha-synuclein compose the filaments |
|
|
Term
|
Definition
S/S: chorea, ballism, myoclonus, dystonia, tics, dementia
Inheritance: auto dom, huntingtin protein, trinucleotide repeat (N=<35)
more repeats = earlier onset
anticipation
Pathology: degeneration of cortical areas, esp. head of caudate; basal ganglia atrophy
Histo: atrophy, gliosis, large and small neurons |
|
|
Term
|
Definition
2nd to AD in prevalence
S/S: dementia, HALLUCINATIONS, marked fluctuation in cognition, Parkinsonism (+/-)
Protein: alpha-synuclein
Pathophys: alpha-synuclein deposits in BS or cortical areas first, amgydala/cingulate/neocoritical; some to litte atrophy
Hisotology: neurons w/ LB in cortex, more diffuse distribution |
|
|
Term
| Frontotemporal Lobar Dementia |
|
Definition
PERSONALITY CHANGES, aphasias (temporal lobe, semantic, progressive nonfluent)
Inheritance: sporadic or hereditary
Heterogenous group: accumulations in neurons variable -> tau, TDP, FUS, UDS, ni |
|
|
Term
|
Definition
type of frontal temporal dementia/degen
Protein: tau
Etiology: mostly sporadic
PAth: extreme atrophy of frontotemporal lobe, ventricles dilated, massive loss of neurons, spongey tissue, tau inclusions, DENTATE GYRUS OF HIPPOCAMPUS |
|
|
Term
|
Definition
grade I
children, infratentorial>supratentorial
cystic, contrast enhancing
ROSENTHAL FIBERS and EGBs
most favorable outcome of astrocytomas |
|
|
Term
|
Definition
grade II
cerebral white matter in adults, brain stem in children
non-enhancing
IDH1/2 mutations - 70%, better prognosis
ATRX loss
mild increase in cellularity, nuclear pleomorphism |
|
|
Term
|
Definition
grade III
trapped neurons
mitoses, infiltrative, increased cellularity, increase anaplasia |
|
|
Term
|
Definition
grade IV
Gross - butterfly lesion, crosses midline thru corpus callosum; hemorrhagic, necrotic center
Micro - PALISADING NECROSIS, glomeruloid vascular proliferation (thickened blood vessels), mitoses
25% of adult 1* brain tumors
anaplasia, necrosis, vascular proliferation
RING-ENHANCING
avg. survival <1yr
RTK path 80%, TP53 path 80%, pRB path 70%, MGMT methylation status |
|
|
Term
|
Definition
tend to be more superficial
Micro - fried egg, round-oval nuclei, chicken wire vessels
adults 4th-5th decade, WHO grades II-II
ARISE IN WHITE MATTER, CALCIFICATIONS
better prognosis than astrocytoma
1p18q codeletions - 80%, diagnostic, better prognosis due to better treatment for |
|
|
Term
|
Definition
most are intraventricular
childhood-adolescence
intracranial in children, spinal cord in adults
EPENDYMAL AND PERIVASCULAR ROSETTES
prognosis significantly better than astrocytomas or oligodendrogliomas
more solid, easier to excise
tumor cells are oval to round, pale to eosinophilic |
|
|
Term
|
Definition
by definition found in cerebellum
childhoood
ataxia
SMALL BLUE ROUND CELLS, HIGHLY MALIGNANT, SPINAL METS, RADIOSENSITIVE |
|
|
Term
|
Definition
20% of primary adult brain tumors
30-60y/o, 3:2 for m:f in brain, 5:1 for spinal cord
WHO grades I-III, 13 histologic types
Micro- WHORLS, PSAMMOMA BODIES |
|
|
Term
|
Definition
NF2 assoc. esp if 2 in CPA
biphasic - Antoni A (compact cells), Antoni B (less compact); Verocay bodies (type of rosette)
Benign, Grade I |
|
|
