Term
| Hypothyroidism vs. Hyperthyroidism |
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Definition
Hypothyroidism
Cold Intolerance
Non-pittingedema
Hyperthyroidism
HEat intolerance |
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Term
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Definition
Cold Intolerance
Non-pittingedema of extremities (known as myxedema) that results from accumulation of proteoglycans
•Puffy eyelids, characteristic apathetic facies, enlarged tongue (due to proteoglycans)
•Coarse, frowsy hair
•Pale, cool skin, and scaly dermatitis |
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Term
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Definition
Ectopic ADH Production: Inappropriately high secretion of ADH can result from lung tumors
•This result in retention of excess water without retention of sodium, which leads to hyponatremia
Increased Unrination |
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Term
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Definition
Low Na+ due to water excretion without Na+ retention
Related to
hypomagnacimea
hypoglucocemia |
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Term
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Definition
Over secretion of Parathiroid gland
Located posterior medial to Thiroid gland
Patients with this form of primary hyperparathyroidism are usually picked up with routine chemistry panels in which a high serum calcium is noted. A parathormone (PTH) assay reveals a high normal to elevated level of PTH
•A pseudo-capsule, or rim of normal parathyroid tissue, is around the outside of the adenoma
•No Fat Cellsin the adenoma |
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Term
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Definition
(hypopituitarism)
•Ischemic necrosis or infarct of pituitary gland, secondary tohypotension occurring in the late stage of pregnancy or post-partum in women
Common cause of Sheehan Syndrome is post-partum hemorrhage
Amenorrhea, hypothyroidism, possible adrenal atrophy are manifestations of this condition |
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Term
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Definition
Pathologic Changes: Composed of elongated ducts and hyperplastic stroma resembling intralobular connective tissue
Lesions are Sharply circumscribed spherical nodule
-Freely mobile: The lump will move on palpation
-This distinguishes it from a cancer, which is anchored to the stroma so it stays put |
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Term
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Definition
Sac formation
Palpable mass
oral contraceptives
cystic tumor containing milk or a milky substance that is usually located in the mammary glands. It is caused by a protein plug that blocks off the outlet. Galactoceles are benign and are not a cause for concern. Once lactation has ended the cyst will resolve on its own without intervention
Galactocele may be associated with oral contraceptive use |
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Term
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Definition
•A giant fibroadenoma
•May be benign or malignant
•Generally aggressive locally, but it does not metastasize
•Histology looks similar to a benign fibroadenoma, but the stroma is more hypercellular
No pain
no skin ulceration
Heavy
No nipple discharge
No Aux lymph nodes |
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Term
| Paget Disease of the Nipple |
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Definition
Uncommon form of Ductal Carcinoma, which extends outward to involve the epidermis, nipple, and areola
•Inflammation around nipple is seen; poor prognosis
•Therapy: Lumpectomy, mastectomy, radical mastectomy (including lymph nodes) if necessary
-Tamoxifen:Estrogen antagonist
-If the tumor is estrogen-receptor positive, then Tamoxifen works in 70% of cases
Estrogen-receptor positivity correlates with a good prognosis
This means that the tumor-cells are better developed, and they responsible to Tamoxifen |
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Term
| Metastatic Patterns of Paget Disease of the Nipple |
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Definition
Metastatic Patterns: Axillary nodes ->supraclavicular and infraclavicular nodes ->internal mammary nodes ->distant sites
–Distant Sites: Lung and pleura, liver, bone, adrenals, skin |
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Term
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Definition
Second most common cancer
•Invasive carcinoma arising in lobular epithelium
•Indian Files: Characteristic cords of monotonous cells infiltrating between stromal fibers, found in Lobular Carcinoma |
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Term
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Definition
Endocrine Changes
Acne; Virilization, amenorrhea in females, impotence in males
Changes in lab values
•Increased levels of 17-hydroxysteroidsfound in the urine
•Dexamethasone Suppression Test:It is used to distinguish ACTH-dependent Cushing Disease from ACTH-Independent Cushing Syndrome
•Cushing Disease: High dose dexamethasone will suppress pituitary secretion of ACTH, but it will not suppress primary hypersecretion of Cortisol (as in an adrenal tumor) |
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Term
| Cushing Syndrome vs. Cushing Disease |
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Definition
| ACTH-dependent Cushing Disease from ACTH-Independent Cushing Syndrome |
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Term
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Definition
•Diffuse, non-nodular enlargementof thyroid
-Follicles become smaller and lose colloid
-Follicular cells become hypertrophied (taller)
-Thyroid has a scalloped or "moth-eaten" appearance
•All of the symptoms of hyperthyroidism above, plus exophthalmos
•Diagnosis is established by a 131I-Uptake Test
-Rapid, diffuse uptake of 131I into the Thyroid gland, plus elevated levels of T3and T4, is diagnostic of Graves Disease |
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Term
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Definition
-Celomic Metaplasia: Metaplasia of peritoneal lining to endometrial glandular cells
-Most common sites: ovaries, tubes, and broad ligaments
-Glands with Stroma: Endometriosis has normal-appearing tissue, glands with stroma
»This distinguishes it from adenocarcinoma, which shows back to back glands, and little or no stroma
Symptoms: Dysmenorrhea, dysfunctional uterine bleeding (DUB), dyspareunia and infertility
Dyspareunia:Pain during intercourse
•Dysmenorrhea:Painful menstruation, or pain during menstruation
•Menorrhagia:Excessive or profuse menses |
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Term
|
Definition
| Grossly, in areas of endometriosis the blood is darker and gives the small foci of endometriosis the gross appearance of "powder burns". Small foci are seen here just under the serosa of the posterior uterus in the pouch of Douglas.Such areas of endometriosis can be seen and obliterated by cauterization via laparoscopy |
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Term
| Polycystic Ovary Syndrome (PCO) |
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Definition
Affects obese women
Adipose tissue ->excess estrone ->stimulates GnRH and suppression of FSH ->high LH/FSH ratio, which is characteristic of PCO
•Symptoms include: Classic triad of Hirsutism, Amenorrhea, Obesity, Hirsutism: related to excess androgens |
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Term
|
Definition
| pelvic pain due to distension of the vagina with accumulated menses |
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Term
|
Definition
| Endometrial hyperplasia usually results with conditions of prolonged estrogen excess and can lead to metrorrhagia (uterine bleeding at irregular intervals, spotting), menorrhagia (excessive bleeding with menstrual periods), or menometrorrhagia (excessive bleeding both at menses and irregular intervals)) |
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Term
|
Definition
itching/irritation of female genitalia
Dermatofibrosis |
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Term
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Definition
Male counterpart to seminoma
•Primordial germ cells: Clear glycogen-filled cytoplasm arranged in large nests
Symptoms: Occurs in younger women and has a very good prognosis |
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Term
| Endodermal Sinus(Yolk Sac) Tumor |
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Definition
Rare and highly malignant
•Usually happen in young patients 10-12
•Tumor resembles the mesenchyme of the primitive yolk-sac |
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Term
| Endodermal Sinus(Yolk Sac) Tumor Testing |
|
Definition
Alpha-Fetoprotein (AFP):Means used to both diagnosing and monitoring the tumor
•Schiller-Duval Bodies: Characteristic structure resembling fetal glomeruli |
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Term
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Definition
| a benign nodular thickening of the vas deferens, that of vasectomy and is implicated in late vasectomy failure |
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Term
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Definition
•Found along with cysts of varying size
Most common cause of an abdominal mass in the neonate
•Bad prognosis
•Baby will die early, and presentation is similar to Potter's Syndrome (oligohydramnios) |
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Term
| distinguishing between Cystic Renal Dysplasia and Wilms tumor |
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Definition
•Inject a contrast-dye into large kidney to distinguish them
•If the dye distributes into cysts, then it is renal dysplasia
•If it doesn't, then it is probably a solid Wilms tumor |
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Term
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Definition
| can develop as a complication of Persistent Urachus |
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Term
| Polycystic Kidney Disease(PKD) |
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Definition
•Renal failure occurs late-onset (adult) when it occurs, but it only occurs in about 50% of cases
•Nocturia is a common early symptom, from Non-Oliguric failure
•Pain, due to bleeding infection, or rapid cyst growth
10% association with Barry Anurism |
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Term
|
Definition
•Non-inflammatory nephropathies
•Nephrosis: Clinically characterized by proteinuria, loss of protein in the urine, usually due to loss of negative charge, or holes, in the glomerular basement membrane
No hypertension
Loss of negative charge on glomerular basement membrane leads to loss of epithelial foot-processes, which is only visible at the EM microscopic level
Treatment with corticosteroidsis always quite successful
Complications:
•Hypoalbuminemia
•Edema, resulting from hypoalbuminemia
•Don't treat it with diuretics! It is not an inflammatory edema
•Hyperlipidemia, resulting from compensatory synthesis of lipoproteins in liver |
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Term
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Definition
| Inflammation is usually focal and segmental and is restricted to mesangium, hence it would be classified as a Mesangioproliferative Glomerulonephritis |
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Term
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Definition
Pathogenesis is identical to IgA nephropathy in the kidney, but systemic manifestations differ
•Systemic Manifestations
-Purpura of lower extremities
-Polyarthralgia
-Colicky abdominal pain, and bloody stool
•Bacterial Endocarditis: Glomerulonephritis is a complication of subacutebacterial endocarditis, of Staph Aureus or Strep Pyogenes origin |
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Term
|
Definition
ATN is not an inflammatory process, but is rather due to ischemia
-Prerenal:Fall in renal blood flow, from hypotension or shock
-Intrarenal:Toxic injury to any part of the kidney nephrons, from glomerulus to collecting ducts
-Postrenal:Due to urinary obstruction
Serum lactate, Nitrogen, and Creatnine increase
Serum Lactate, nitrogen, creatinine increase
-"Distalization" of proximal tubules; loss of brush-border
-Single-cell necrosis of disparate cells
-Granular casts |
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Term
|
Definition
•Most common complication
•Renal tumors do not occur in the other forms of PKD
•If you were seeing anemia (due to renal failure) and you all of a sudden find a rising hematocrit, then suspect a renal cell carcinoma, secreting excess erythropoietin
GI bleeds |
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Term
| Eagle-Barrett (Prune Belly) Syndrome |
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Definition
-Bilateral cryptorchidism (failure of balls to drop)
-Talipesequinovarus(club feet) and hip dislocation
-Ureteralreflux ->advanced hydroureteronephrosisis present |
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Term
|
Definition
Southeast, Tennessee valley
Forms uncalcified granulomas in the lungs in immunocompetent people
•Granulomas are similar to the cutaneous ones formed by Sporothrix |
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Term
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Definition
•Hypersensitivity pneumonitis caused by exposure to moldy hay, typically occurring in farmers
•Lung biopsy exhibits caseating and non-caseating epitheloid cell granuloma, lymphocytic infiltration and alveolitis
Treated with coticosteroids |
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Term
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Definition
•Swelling and edema of the mucosa of the epiglottis lead to obstruction of the respiratory tract
Tracheostomy is needed when cyanosis develops |
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Term
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Definition
Factors that predispose to pneumonia
•Loss of cough reflex (coma, anesthesia)
•Viral Pneumonia (loss of ciliary carpet)
•Interference with phagocytic function by the effect of smoke and alcohol
•Pulmonary edema or congestion
•Accumulated secretion, cystic fibrosis |
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Term
| Panacinar (Panlobular) Emphysema |
|
Definition
Entire acinus is uniformly involved, primarily in the lower zones of the lung, with destruction of alveolar septa from the center to the periphery
Typically occurs in lower lung zones
Alpha1-Antitrypsin Deficiency is an autosomal recessive disorder seen in 1% of all patients with COPD
•Alpha1-Antitrypsin inhibits neutrophil elastases, enzymes that digest elastin and other structural components of the alveolar septa |
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Term
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Definition
•Presence of a chronic productive cough without a discernible cause for at least 3 months out of the year, for 2 successive years
•Cigarette smoking is most important cause
•Hypersecretion of mucus in response to chronic injury
•Hypertrophy and Hyperplasia of submucosal glands also occur
•Mucous and goblet cell show metaplasia and hyperplasia
•Goblet cells are normally 1:20 cells of bronchial epithelium, but they can become as prevalent as 1:1
•Can also serous mucous metaplasia, indicative of chronic inflammation |
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Term
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Definition
•Typically seen in young adults during vigorous exercise
•Patients exhibit acute chest pain and shortness of breath (most
Common presenting symptoms
•Chest X-ray reveals a collapsed lung on one side and collection of air in the pleural cavity
•Occurs due to formation of sub-pleural emphysematous blebs |
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Term
|
Definition
•Unilateral pneumothorax sufficiently extensive to shift the mediastinum to the opposite side, with compression of the opposite lung
•Air continues to leak into the space like a check valve
•Can be life-threatening and the air must be immediately drained |
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Term
| Spontaneous Pneumothorax vs. Tension Pneumothorax |
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Definition
Spontaneous - during excessive
Tension - unilateral shift of lung |
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Term
| Ulcerative Colitis Complications |
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Definition
•Toxic Megacolon:Extensive dilatation of colon, where wall is thin, friable, and subject to perforation
•Colonic Carcinoma
-Increased risk for cancer with prolonged disease
-Occurs because of continual regeneration of epithelia intestinal dysplasia
-Usually occurs after 10 years with Ulcerative Colitis
-This type of cancer is different than colonic adenocarcinoma arising from polyps: they are often multiple and are flat lesions rather than polypoid |
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Term
|
Definition
Autosomal-recessive deficiency of ceruloplasmin, causes inability to transport copper in the blood copper accumulates in liver
Copper builds up in other organs, such as, the brain, cornea, renal tubules
•Copper Stain:Copper will appear as brown-granules in the hepatocytes
•Disease affects brain as well as liver, hence "Hepatolenticular Degeneration“
•Kayser-Fleischer Ring: Deposition of copper in Descemet's Membrane of the cornea |
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Term
| Congenital Pyloric Stensois |
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Definition
Projectile Vomiting: The vomit does not contain bile (it never reaches duodenum)
Symptoms
•Voracious Appetite
•Hypochloremic Alkalosis
•Low HCl with metabolic alkalosis, due to loss of gastric juices because of vomiting
•Visible peristaltic movements can be seen, and a palpable lump is felt near the pylorusPyloromyotomy
•Surgical incision made along the length of the pylorus |
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Term
| Chronic (Non-Erosive) Gastritis |
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Definition
•Superficial Gastritis: Just superficial mucosa
•Atrophic Gastritis:Inflammation becomes transluminal, and mucosa becomes flattened
•The inflammatory cells can leave, leaving behind a thin mucosa Gastric "atrophy“
•Intestinal Metaplasia:Similar to Barrett Esophagus, this metaplasia is pre-cancerous
•Dyspepsia (impaired digestion accompanied by bloating and heartburn) is the common symptom of chronic gastritis
•A non-specific finding
•Helicobacter pylori infection is frequently seen with chronic gastritis |
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Term
|
Definition
pt. presents with diarreah (foul smell)
No abdominal pain
Fat in stool
•Autoimmune attack against Gliadin loss of intestinal villi and flattening of mucosa malabsorption at the brush borderFlattened
•Hyperplastic crypts, with chronic inflammatory cells found between the crypts
Antibodies to gliadin, the breakdown byproduct of glutenwhich is found in wheat and rye |
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Term
| Zenker (pulsion) Diverticulum |
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Definition
| Outpocketing creates a blind pouch, which stores food that leads to halitosis |
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Term
| Tracheoesoophageal Fistula |
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Definition
Aspiration pneumonia in the infant is a serious complication of swallowing of milk by the affected child and its regurgitation and then aspiration
Epiphrenic diverticulum: an outpouching of the lower part of esophagus due to lower esophageal sphincter dysfunction |
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Term
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Definition
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Term
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Definition
Presents initially with vague anterior abdominal pain around the umbilicus as acute abdomen (referred pain)
Pain later converts to sharp RLQ (right lower quadrant) pain |
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Term
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Definition
•Clostridium Difficileinfection resulting from antibiotic therapy
•Inflammation is caused by a toxinelaborated by C. Difficile --not by the bug itself |
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Term
| Bud-Chiari Syndrome Complications |
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Definition
•Esophageal Varices:Engorged veins around lower esophagus, which can rupture, causing surgical emergency
•Internal Hemorrhoids:Portal-caval anastomoses around the rectum
•Caput Medusae:Engorged umbilical veins, around the umbilicus
•Splenomegaly:Occurs due to increased blood pressureHypersplenismis a decrease in the life-span of all blood-cells enhanced removal of blood cells because of a hyperplastic spleen |
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Term
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Definition
Hypocalcemia: Fat Necrosis and autodigestion release fats into the blood saponification of fats with calcium hypocalcemia as all calcium is sequestered by fats
-Amylaseblood-levels go up in first 24 hrs (> 400 units)-Lipaselevels will go up within 72-96 hours-Enlarged pancreas by CT scan |
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Term
| Endocrine Cancers of Pancreas |
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Definition
| Whipple triad-Hypoglycemic attack with serum glucose at 50 mg/dl-Symptoms of hypoglycemia --CNS symptoms-Hypoglycemic attacks relieved by glucose intake |
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Term
| Multiple Endocrine Neoplasia |
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Definition
•MEN TYPE I (Wermer Syndrome): Cluster of findings-Gastrinoma Peptic Ulcer-Prolactinoma Hyperprolactinemia-Adrenal Cortical Adenoma
•MEN TYPE II (Sipple Syndrome): Cluster of findings-Bilateral Pheochromocytoma-No gastrinoma-Bilateral medullary carcinoma of the thyroid |
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Term
|
Definition
| Insulin Resistance, caused by gross obesity |
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Term
| TYPE-II Diabetes Diagnosis |
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Definition
•Two step process to establish diagnosis
•Fasting plasma glucose (FPG) > 140 mg/dl on two occasions
•Glucose Tolerance Test: Give oral glucose 75gm
•Wait 2 hours and measure plasma glucose
•Failed Test:2 hr plasma glucose > 200 mg/dl at least twice (1/2 hr intervals) during the two hour period
•Impaired Test:2 hr plasma glucose > 140 mg/dl, with one intervening value >200 mg/dl after oral glucose tolerance test
•About 25% of patients of this condition eventually become diabetic |
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Term
| Gastro-Esophageal Reflux Disease(GERD) |
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Definition
•Barrett Esophagus: Squamous ->Columnar Metaplasia of squamous esophageal epithelium
•Esophageal epithelium can change to gastric or intestinal epithelium
•Intestinalepithelium carries a higher chance of becoming cancerous |
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Term
| Serous Cystadenocarcinoma |
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Definition
•Most common malignant ovarian tumor
•30% of ovarian cancers
•Papillary Projections are common, with hemorrhage and necrosis
•Multilocular, when it is malignant, as opposed to unilocular when it is benign
•Psammoma Bodies are laminated, calcified concretions characteristically found in this tumor |
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Term
|
Definition
•Tumor has a peak incidence in the 25-35 year age group
•Undifferentiated cells resembling early embryonic cells
•Gross appearance: Yellow with brown discoloration
•No lymphocytes, unlike seminoma; More nuclear crowding |
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Term
|
Definition
•Lymphocytic Infiltration: the tumor cells are arranged into solid nests surrounded by fibrous septa that are infiltrated with lymphocytes
•Cancer cells are clear and contain glycogen, which stains PAS positive
•Granulomascan be formed in response to seminomas, as a response to tumor antigens |
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Term
| Embryonal Carcinoma vs. Seminoma |
|
Definition
Embryonal Carcinoma
No lymphocytes
Nuclear crowding
Yellow w/ brown discoloring
Seminoma
Lymphocyte infiltration
Stain PAS positive |
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Term
|
Definition
•Fibrotic tubes from PID, usually
•Rupture usually occurs by 12 weeks
•Blood in the Cul de sac (Rectouterine Pouch)
Lower abdominal pain |
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Term
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Definition
•Results from the fertilization of an ovum that lacks functional DNA, hence all chromosomes are paternal
•Very young (younger than 15) and very old (older than 50) mothers are at increased risk
•Placenta has grossly swollen chorionic villi, resembling a bunch of grapes. Trophoblastic proliferation
•No embryo is present |
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Term
|
Definition
•
C-Cell Hyperplasiais the precursor lesion to medullary carcinoma
•
MEN Type-II:
-Familial Medullary Carcinoma is associated with MEN Type-II, while sporadic carcinoma is not
•
Occurs in equal frequency in hyperthyroidism (Graves disease) and euthyroid |
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Term
|
Definition
| Though pituitary adenomas are benign, they can produce disorders either from a mass effect (usually visual problems from pressing on the optic chiasm and/or headaches) or from production of excess of hormones such as prolactin or ACTH. |
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Term
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Definition
| It is much more cellular and the cells have much more pleomorphism and hyperchromatism than the benign leiomyoma |
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Term
|
Definition
| Characteristic structure resembling fetal glomeruli |
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Term
|
Definition
Painful swelling of one or both epididymides with fever and a variable incidence of dysuria and pyuria
Vasitis Nodos |
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Term
|
Definition
Occurs when the umbilical artery fails to close
•Urachus may be closed at one or both ends, forming a urine-filled urachal cyst
•Urachal Adenocarcinomacan develop as a complication |
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Term
|
Definition
| Coagulation necrosis of renal tubules due to impaired blood flow or impaired filtration |
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Term
|
Definition
Happens to Divers
a.k.a. the Benz |
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Term
|
Definition
•Chronic infection with Mycobacterium tuberculosis, an acid-fast bacilli, which can only grow on Lowenstein-Jensen agar
•Spread via inhalation of respiratory droplets, most commonly infecting right lung
•Rising incidence in the US due to HIV & multidrug resistance |
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Term
|
Definition
•Associated with the initial infection
•Classically disease of lower lung lobes (bacilli deposited in dependent portion of lung during inspiration)
•Usually asymptomatic After inhalation of mycobacteria, macrophages engulf the bacilli that survive intracellularly
•Classic histopathologic finding is the "caseating granuloma" |
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Term
| Secondary (Reactivation) Tuberculosis |
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Definition
•Reactivation of bacilli in apical lung segments due to the I oxygen tension in upper lobes
•Insidious onset, fevers, chills, night sweats, weight loss, cough, hemoptysis
•Risk factors include HIV, imprisonment, homeless, malnourished |
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Term
|
Definition
| Tuberculosis Classic radiologic finding is "Ghon complex“ combination of granulomasin the form of calcified nodule at the primary focus in the calcified hilar lymph nodes |
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Term
|
Definition
•Tuberculosis that has disseminated hematogenously either through the lung, or disseminated to other any other organ in the body, often the liver, spleen, bone, kidneys, pericardium, spine, meninges
•Presents in any patient with immune deficiencyClassic syndromes
•Potts disease = TB of spine, presents with multiple compression fractures
•Scrofula = TB causing massive cervical lymphadenopathy
•Gastroenteritis with profuse diarrhea & colitis |
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Term
|
Definition
•
Occurs as a result of penetrating wounds of the thoracic wall as a result of rib fractures or stab wounds
•
May also be seen as a result of thoracocentesis, pleural or lung biopsies or pressure-assisted ventilation |
|
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Term
|
Definition
•Ulcerative colitis always starts in the rectum and works its way proximally, often extending through sigmoid and left colon
•Crypt Abscessesare common |
|
|
Term
| Ulcerative Colitis vs. Chrons |
|
Definition
|
|
Term
| Acute Edematous Pancreatitis |
|
Definition
| Interstitial pancreatitis, most common and mildest form |
|
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Term
| Acute Hemorrhagic Pancreatitis |
|
Definition
| 5% of cases, very severeMassive hemorrhage leads to quick death |
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