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