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2010-05-06 19:11:00

Part One National Boards
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  1. Types of Degeneration
    • Coagulation
    • Liquefaction
    • Caseous
    • Enzymatic
    • Fatty
    • Zenker's
    • Wallerian
    • Cloudy Swelling
  2. Coagulation
    • Infarction
    • Myocardial Infarction
  3. Liquefaction
    • CNS
    • Stroke
  4. Caseous
  5. Enzymatic
  6. Fatty
  7. Zenker's (Waxy)
    Hyaline- seen in skeletal muscle
  8. Wallerian
    peripheral nerves
  9. Cloudy swelling
  10. Developmental Changes
    • Agenesis
    • Hypoplasia
    • Aplasia
  11. Agenesis
    absence of an organ (usually paired organ)
  12. Hypoplasia
    organ smaller than normal and defective
  13. Aplasia
    small remnants of the organ present (lack of development)
  14. Disturbances of Growth
    • Atrophy
    • Hypertrophy
    • Hyperplasia
    • Metaplasia
    • Dysplasia
    • Anaplasia
  15. Atrophy
    decreased in size (disuse)
  16. Hypertrophy
    increase in size (muscle exercise)
  17. Hyperplasia
    increase in number of cells (pregnant uterus)
  18. Metaplasia
    changes from one cell type to another (PCCE changes to stratified squamous in the lung, a smoker)
  19. Dysplasia
    changes in size, shape or function of a cell (precedes cancer, but is reversible)
  20. Anaplasia
    complete disorganization of a cell (cancer)
  21. Types of Cancer
    • Carcinoma
    • Sarcoma
  22. Carcinoma
    cancer of epithelial tissue that usually spreads by way of the lymphatic system.
  23. Sarcoma
    Cancer of the connective tissue that usually spreads by blood.
  24. General Terminology
    • Bacteremia
    • Septicemia
    • Anoxia
    • Hypoxia
    • Thrombus
    • Clot
    • Embolus
    • Diapedesis
    • Chemotaxis
    • Phagocytosis
  25. Bacteremia
    bacteria in the blood
  26. Septicemia
    pathogens or toxins in the blood
  27. Anoxia
    absence of oxygen
  28. Hypoxia
    deficiency of oxygen
  29. Thrombus
    platelet deposition
  30. Clot
    fibrinogen into fibrin via thromboplastin
  31. Embolus
    foreign body in the blood that travels
  32. Diapedesis
    neutrophils and monocytes squeeze through the walls of blood vessels.
  33. Chemotaxis
    Movement of WBC's in response to a concentration gradient of a variety of tissue damage products.
  34. Phagocytosis
    accomplished by neutrophils and macrophages
  35. Pneumoconiosis
    • Silicosis
    • Asbestosis
    • Siderosis
    • Byssinosis
    • Berylliosis
    • Anthracosis
  36. Silicosis
    silicon related to TB
  37. Asbestosis
    asbestos leads to mesothelioma
  38. Siderosis
    iron dust
  39. Byssinosis
    cotton dust called Brown lung
  40. Berylliosis
    Fibers- aircraft manufacturing
  41. Anthracosis
    Black lung dz. from Miners
  42. Syphilis
    • Congenital- 5 signs
    • Acquired
  43. Syphilis Congenital- 5 signs
    • Hutchinson's teeth
    • Rhagades
    • Saddle nose deformity
    • Sabre blade tibia
    • Interstitial keratitis
  44. Hutchinson's teeth
    notched permanent incisors
  45. Rhagades
    fissures or cracks at the edge of the mouth
  46. Saddle nose deformity
    bridge of nose flattened
  47. Interstitial keratitis
    Produces visual changes. This condition sometimes associated with deafness as well.
  48. Syphilis Acquired
    • Primary stage
    • Secondary stage
    • Latency
    • Tertiary
  49. Primary stage syphilis
    hard, singular painless nodule on perineum
  50. Secondary stage syphilis
    maculopapular rash and condylomata lata (flat warts on the vulva)
  51. Latency syphilis
    May or may not have symptoms
  52. Tertiary syphilis
    Tabes dorsalis, aortic aneurysm, argyll Robertson pupil, Gummas (necrosis in body tissues)
  53. Other venereal diseases
    • Chancroid
    • Gonorrhea
    • Lymphogranuloma venereum
    • Chlamydia trachomatis
    • Granuloma inguinale
    • Trichimonas
    • Gardenella vaginalis
  54. Chancroid
    Soft chancre, painful caused by Hemophilus ducery
  55. Gonorrhea
    Gram negative diplococcus causes burning on urination with pus in the urine. Can produce arthritis in the knee.
  56. Lymphogranuloma venereum
    Chlamydia is the organism. Produces rectal strictures. DX: Frei test
  57. Chlamydia trachomatis
    white discharge. Pelvic Inflammatory Disease aka- PID
  58. Granuloma inguinale
    red nodules in inguinal reagion
  59. Trichimonas
    Purulent vaginal discharge, green and frothy protozoan
  60. Gardenella vaginalis
    Foul smelling vaginal discharge. Clue cells.
  61. Gastrointestinal Disorders
    • Dysphasia
    • Siding hiatal hernia
    • Diverticula
    • Volvulus
    • Intussusception
    • Celiac disease
    • Crohns
    • Hirschbrung's
    • Ulcerative colitis
    • Irritable bowel
    • Peutz Jegher's
  62. Dysphagia
    difficulty swallowing
  63. Sliding hiatal hernia
    due to anatomically shortened esophagus
  64. Diverticula
    Outpouching in the intestine. Usually lower left quadrant of the abdomen.
  65. Volvulus
    twisting of an organ
  66. Intussusception
    telescoping of intestine onto itself
  67. Celiac disease
    intolerance to gluten. low of villi. must stay on gluten free diet.
  68. Crohn's disease
    Regional ileitis. Seen in young people. Affects the proximal small intestine and colon. Produces skip lesions, autoimmune. Right abdomen.
  69. Hirschbrung's
    Congenital megacolon. Absence of the myenteric plexus. Aeurbach plexus.
  70. Ulcerative colitis
    Pathological intestinal changes, ulcers, bloody diarrhea, complications produce toxic megacolon. Left side.
  71. Irritable bowel
    Spastic colon, distension, pain, diarrhea. Stress related.
  72. Peutz Jegher's
    Polyposis characterized by polyps in the entire GI tract.
  73. Miscellaneous Diseases
    • Still's
    • Paget's
    • Parkinson's
    • Multiple Sclerosis
    • Myasthenia gravis
    • ALS
    • PLS
    • Syringomyelia
    • Arnold Chiari
    • Huntington's
    • Alzheimer's
    • Friedreich's ataxia
    • Guillian Barre
    • Poliomyelitis
    • Korsakoff
    • Charcot Marie Tooth
    • Duchenne's muscular dystrophy
  74. Still's Disease
    A form of juvenile rheumatoid arthritis
  75. Paget's Disease
    Osteitis deformans. Produces thickening and deformity of bone
  76. Parkinson's Disease
    AKA- paralysis agitans. Problem with dopamine in the basal ganglia. Inclusion bodies called Lewy bodies. Patient has masked face, stooped posture, resting tremor and festinating gait.
  77. Multiple Sclerosis
    Demyelinization and plaguing of the spinal cord or brain. Charcot's triad: scanning speech, intention tremor and nystagmus. Characterized by exacerbations and remissions.
  78. Myasthenia gravis
    Formation of antibodies that block the ACH receptors at the myoneural junction producing excess cholinesterase. Thymic enlargement. Causes progressive weakness and fatigue. First starts in the extra ocular muscles. Diplopia.
  79. ALS
    AKA- Lou Gherig's disease. Anterior horn and corticospinal tracts afected with no sensory loss. MOTOR.
  80. PLS
    AKA- combined systems disease. Dorsal columns and corticospinal tract affected. Results from long term pernicious anemia.
  81. Syringomyelia
    Cyst like formation from the central canal of the spinal cord that leads to loss of pain and temperature and signs of an upper motor neuron lesion. Describes as a "cape like" distribution of pins and needles sensation.
  82. Arnold Chiari
    Congenital- brain stem drops through foramen magnum
  83. Huntington's
    Hereditary onset 30-50 yoa. Basal ganglia affected, deficiency of GABA. Produces dementia and death.
  84. Alzheimer's
    Progressive severe atrophy of the cerebral cortex. Aluminum deposits found in the brain.
  85. Friedreich's ataxia
    Lesions of sclerosis of the spinocerebrellar tract
  86. Guillian Barre
    Polyneuritis of the PNS. Seen following immunizations and produces an ascending paralysis. Can be fatal.
  87. Poliomyelitis
    If it affects the anterior horn it produces LMNL. If it affects the brain stem, then cranial nerves are affected and the breathing apparatus may be damaged.
  88. Korsakoff
    Alcoholic psychosis. Depletion of thiamine (B1) due to severe alcoholism.
  89. Charcot Marie Tooth
    Hereditary progressive peroneal muscle atrophy
  90. Duchenne's Muscular Dystrophy
    Pseudohypertrophy of the calves usually boys 3-7 yoa. Recessive sex linked gene. X chromosome linked. Fatal.
  91. Metabolic Disorders
    • Kwashiorkor
    • Marasmus
    • Wilson's
    • Diabetes insipidus
    • Diabetes mellitus
  92. Kwashiorkor
    Protein malnutrition
  93. Marasmus
    calorie malnutrition, includes protein
  94. Wilson's
    Inborn error of copper metabolism. Kayser Fleisher rings in the iris.
  95. Diabetes insipidus
    Decreased ADH due to posterior pituitary problem
  96. Diabetes mellitus
    Decreased production of insulin by the beta cells of the pancrease (Islets of Langerhans) Produces polydypsia, polyuria and polyphagia
  97. Genetic Disorders
    • Turner's
    • Kleinfelter's
    • Down's
    • Fragile X
    • Phenylketonuria
    • Von Gierke's
    • Tay Sach's
    • Gaucher's
    • Krabbe's
    • Niemann Pick's
    • Alkaptonuria
    • Duchenne's MD
  98. Turner's
    XO, female, short stature, webbed neck, lacks female secondary sex characteristics 45X karyotype
  99. Kleinfelter's
    XXY, tall male, low IQ, testicular atrophy, gynecomastia, sterile
  100. Down's
    Trisomy 21, male or female, retarded
  101. Fragile X
    The most common form of mental retardation involving a minimum of 2 X chromosomes and one or more Y chromosomes
  102. Phenylketonuria
    Con not convert phenylalanine to tryosine due to lack of phenylalanine hydolases, retardation can be controlled by diet if caught early.
  103. Von Gierke's
    Lacks enzyme to breakdown glycogen. Excessive amounts of glycogen deposited in the liver.
  104. Tay Sach's
    Inscreased ganglioside content in the brain (glycocerebroside), hexosaminidase A deficency, cherry red spots in the macula, infant death.
  105. Gaucher's
    Excess glucocerebroside in the brain, liver and spleen
  106. Krabbe's
    Excess galactocerebroside in white matter
  107. Niemann Pick's
    abnormal increase in sphingomyelin
  108. Alkaptonuria
    Accumulation of homogentisic acid, blue black deposits in the ears, nose and cheeks. Produces ochronosis causing calcification of the discsof the spine. Urine turns black on standing.
  109. Duchenne's MD
    Seen mostly in boys 3-7 yoa. Produces hypertrophy of the calf muscles. Recessive sex linked gene. Increased CPK.
  110. Tumors
    • Cardiac Sarcoma
    • Myxoma
    • Teratoma
    • Adenoma
    • Krukenberg's
    • Wilm's
    • Leiomyoma
    • Rhabdomyoma
    • Osteosarcoma
    • Multiple myeloma
    • Metastasis
    • Lipoma
    • Hemangioma
    • Xanthoma
    • Chondroma
    • Papilloma
    • Seminoma
    • Virchow's nodes
  111. Cardiac Sarcoma
    Most commom cardiac malignant tumor of the heart
  112. Myxoma
    Most common benign tumor
  113. Teratoma
    tumor of all three germinal layers
  114. Adenoma
    tumor of glandular tissue
  115. Krukenberg's
    cancer of the stomach that metastasizes to the ovary
  116. Wilm's
    Mixed tumor of the kidney in children
  117. Leiomyoma
    tumor of smooth muscle (fibroids in the uterus)
  118. Rhabdomyoma
    tumor of striated muscle or heart muscle
  119. Osteosarcoma
    Most common bone caner in children
  120. Multiple myeloma
    Most common primary malignancy in adults
  121. Metastasis
    Most common form of cancer in the spine
  122. Lipoma
    fatty tumor
  123. Hemangioma
    Benign tumor of blood vessels
  124. Xanthoma
    Yellow tumor of connective tissue
  125. Chondroma
    Benign tumor of cartilage
  126. Papilloma
    associated with warts
  127. Seminoma
    Most common cancer of testes
  128. Virchow's nodes
    Enlarged supraclavicular lymph nodes due to metastasis, usually GI tract
  129. White Blood Cells
    • Neutrophils
    • Lymphocytes
    • Monocytes
    • Eosinophils
    • Basophils
  130. Neutrophils
    60% increased in acute bacterial infections
  131. Lymphocytes
    30% increased in viral conditions
  132. Monocytes
    5-8% chronic conditions, changes to phagocytes
  133. Eosinphiles
    2-4% parasites and allergies
  134. Basophils
    0-.5% similar to mast cells, produces heparin and histamine. Increased in blood disorders
  135. Lymphocytes
    • B
    • T
  136. B Lymphocytes
    Transforms to a plasma cell
  137. T Lymphocytes
    • Matures in the thymus
    • 1. Helper: activates B
    • 2. Supressor: decreases antibody production
    • 3. Killer: kills foreign agents ( transplant rejection)
  138. Immune Complex

    Step 1 of 5
    1. antigen enters
  139. Immune Complex
    2 of 5
    2. phagocytosed by macrophages
  140. Immune Complex
    3 of 5
    3. Exposes antigen to B cells and T helper cells
  141. Immune Complex
    4 of 5
    4. T cells make sure that B cells react
  142. Immune Complex
    5 of 5
    5. Plasma cells make antibodies forming the immune complex
  143. Heart and Blood Vessel Disease
    • arteriosclerosis
    • atherosclerosis
    • Monkeberg's sclerosis
    • Aneurysm
    • Buerger's
    • Raynaud's
    • Temporal arteritis
    • Takayasu arteritis
  144. Arteriosclerosis
    thickening, calcification and loss of elasticity of the arterial walls
  145. Atherosclerosis
    deposition of fatty plaques (atheroma) This is a form of arteriosclerosis.
  146. Monkeberg's sclerosis
    tunica media of medium sized arteries calcified
  147. Aneurysm
    • Berry
    • Dissecting
    • Abdominal aorta
  148. Berry Aneurysm
    Berry in the circle of Willis, subarachnoid hemorrhage
  149. Dissecting Aneurysm
    longitudinal tearing away from the aorta
  150. Abdominal aorta aneurysm
    can cause low back pain due to erosion of the anterior vertebral body (m/c area to see an aneurysm)
  151. Buerger's
    AKA- thromboangitis obliterans. Young male who smokes heavily. Intermittent claudication. (lower exteremities, femoral art.)
  152. Raynaud's
    Vasospasm of the arteries. May be primary or secondary to other collagen diseases such as Lupus. Found in the hands and feet producing a triphasic color change, from pallor to cyanosis to rubor. Brought on by cold or emotion. Can lead to gas gangrene.
  153. Temporal arteritis
    AKA- Giant cell arteritis. Affects the temporal arteries. Associated with long standing hypertension. Blindness. (Medical emergency)
  154. Takayasu arteritis
    AKA- pulseless disease. granulomatous inflammation of the aortic arch.
  155. Congenital heart and blood vessel disease
    • Tetralogy of Fallot
    • Coarctation of the aorta
  156. Tetralogy of Fallot
    likely to cause cyanosis
  157. Tetralogy of Fallot

    D. Dextro rotation of the aorta
  158. Tetralogy of Fallot

    R. Right ventricular hypertrophy
  159. Tetralogy of Fallot

    I. Interventricular septal defect
  160. Tetralogy of Fallot

    P. Pulmonic stenosis
  161. Coarctation of the aorta
    narrowing of the lumen produces increased blood pressure in the upper extremities and decreased blood pressure in the lower extremities.
  162. Blood Cell Disorders
    • Hodgkin's lymphoma
    • Non Hodgkin's lymphoma
    • Burkett's lymphoma
    • Multiple Myeloma
    • Bruton's agammaglobulinemia
  163. Hodgkin's lymphoma
    Causes seriously enlarged lymph nodes. Produces a Pel Epstein fever which comes and goes. Diagnosed based upon tissue biopsy and presence of the Reed Sternberg cell
  164. Non Hodgkin's lymphoma
    Mostly seen in older people. No Reed Sternberg cells. Symptoms same as Hodgkin's, but more severe. Includes Burkett's lymphoma which is described by its "starry sky" appearance and if found in Africa. Produced Jaw swelling.
  165. Burkett's lymphoma
    described by its "starry sky" appearance and if found in Africa. Produced Jaw swelling.
  166. Multiple Myeloma
    A leukemia of the bone marrow. Affects plasma cells. Seen over the age of 50.
  167. Bruton's agammaglobulinemia
    X linked hereditary disease, decreased IgG, decreased B cells, B cell deficiency.
  168. Leukemia
    • Acute lymphoblastic (ALL)
    • Chronic lymphocytic (CLL)
    • Acute myeloblastic (AML)
    • Chronic myelocytic (CML)
  169. Acute lymphoblastic (ALL)
    seen in children
  170. Chronic lymphocytic (CLL)
    older 75% over 60 increased mature lymphocytes
  171. Acute myeloblastic (AML)
    Any age (worse prognosis)
  172. Chronic myelocytic (CML)
    young adulthood, increased granulocytes "Philadelphia chromosome"
  173. Anemia
    Lack or loss of RBC's
  174. Anemia

    Hemorrhage. Hemolytic breakdown of cells by some disease in the body such as sickle cell anemia or malaria.
  175. Anemia (loss)

    Thalassemia Major
    AKA- Cooley's anemia. Homozygous Beta thalassemia. AKA- Mediterranean anemia
  176. Anemia (loss)

    Erythroblastosis fetalis
    Rh (-) Mother, Rh (+) Father, Rh (+) baby (2nd baby is affected)
  177. Anemia (decreased production of RBC's)
    • Nutritional
    • Bone Marrow suppression
  178. Anemia (decreased)

    iron deficiency most common.

    • Pernicious
    • Folic Acid
    • B-12
  179. Anemia (decreased)

    due to lack of intrinsic factor
  180. Anemia (decreased)

    Folic acid
    seen in pregnancy
  181. Anemia (decreased)

    seen in vegetarians
  182. Anemia (decreased)

    Bone Marrow suppression
    Decreased RBC's due to toxins or chemotherapy
  183. Polycythemia
    • increase in RBC's
    • Can be in response to high altitudes or lung problems
  184. Process of Coagulation
    • Injury leads to release of thromboplastin (need vitamin K) ---> production of prothrombin ---> thrombin.
    • fibrinogen ---> fibrin (clot)
  185. Process of Coagulation
    • Thromboplastin (released by damaged cells)
    • Prothrombin (formed in liver)
    • Fibrinogen (formed in liver)
  186. Process of Coagulation

    Positive feedback
    the more thrombin produced, the more fibrin is produced.
  187. Immunoglobulins
    • IgA
    • IgD
    • IgE
    • IgG
    • IgM
  188. IgA
    Exocrine secretions, milk, tears and saliva
  189. IgD
  190. IgE
    Lines respiratory and intestinal tracts. Associated with allergies (increased eosinophils), asthma, Hay fever, parasitic infection
  191. IgG
    Major antibody against virus, bacteria, toxins. Passes placenta
  192. IgM
    Early part of every immune response. Largest. 10 binding sites. primary immune response.
  193. Hypersensitivity Reactions
    • Type I: Anaphylactic
    • Type II: Cytotoxic or autoimmune
    • Type III: Immune complex
    • Type IV: Delayed
  194. Type I: Anaphylactic
    Seen in bronchial asthma, hay fever, food allergies, drug reactions, bee stings. Mast cells and basophils make histamine. Reaction occurs in minutes.
  195. Type II: Cytotoxic or autoimmune
    erythroblastosis fetalis, Goodpasture's, IgG and IgM produced. Reaction takes hours to days.
  196. Type III: Immune complex
    Seen in serum sickness, acute glomerulonephritis, SLE, Arthus reaction. IgG/ antigen antibody complex produced. Takes days.
  197. Type IV: Delayed
    Seen in TB testing, transplant rejection, contact dermatitis (poison ivy). antigen sensitivity T cells. Takes a few days.
  198. Arthritis
    • Rheumatoid
    • Osteoarthritis
    • Gouty arthritis
    • Reiter's
    • SLE
    • Gonococcal
    • Hemophilia
  199. Rheumatoid
    Inflammatory condition usually begins in the hands. Symmetrical distribution. Leads to deformity (ulnar deviation of the wrist) and ankylosis in the spine. Produces pannus fomation over the joints an exudate on synovial cells. Haygarth's and Bouchard's nodes.
  200. Osteoarthritis
    • A degenerative change that occurs in everyone. Usually unilateral distribution in weight bearing joints such as the hips and knees. Produces decreased joint space, subchondral sclerosis and osteophytes.
    • Dip joint- Heberden's node
  201. Gouty arthritis
    From inability to properly digest purines. Produces synovial thickening and secondary inflammatory edema (no pannus). Excess uric acid in the blood leads to tophi formation. Big toe- podagra.
  202. Reiter's
    Associated with chlamydia infection. Includes conjunctivitis, urethritis and arthritis
  203. SLE
    A collagen disease ( autoimmune) that can produce arthritis. Produces skin changes, Libman endocarditis. butterfly rash, produces antibodies against double stranded DNA. (ANA test- Anti Nuclear Antibody test)
  204. Gonococcal
    usually affects the knee
  205. Hemophilia
    usually affects the knee
  206. Bone Tumors: Benign
    • Epiphysis
    • Metaphysis
    • Diaphysis
  207. Bone Tumors: Benign

    • chondroblastoma
    • Giant Cell tumor
  208. Bone Tumors: Benign

    • osteoblastoma
    • osteochondroma
    • non-ossifying fibroma
    • osteoid osteoma
    • chondromyxoid fibroma
  209. Bone Tumors: Benign

    • enchondroma (hands most common)
    • fibrous dysplasia
  210. Bone Tumors: Malignant
    • Diaphysis
    • Metaphysis
    • Epiphaseal plate
  211. Bone Tumors: Malignant

    • Ewing's sarcoma 5-20 yoa
    • chondrosarcoma
  212. Bone Tumors: Malignant

    • osteosarcoma (knee) 10-20 yoa (femur) 50%
    • osteomyelitis
  213. Bone Tumors: Malignant

    Epiphseal plate
    Hematogenous osteomyelitis
  214. Clotting
    • (liver makes it and puts it into the blood)
    • BLOOD
    • (add calcium and potassium)
    • FIBRIN
    • CLOTS
  215. Hypersensitivity Reactions
    • Type I: Anaphylactic
    • Type II: Cytotoxic
    • Type III: Immune Complex
    • Type IV: Cell Mediated Hypersensitivity (Delayed)
  216. Type I: anaphylactic
    • Disorder: Bronchial asthma
    • Immune Machanism: IgE, Basophils, Mast cells
  217. Type II: Cytotoxic
    • Disorder: Goodpasteur's, Erythroblastosis fetalis, blood tranfusions
    • immune Mechanism: Traget cells, Phagocytosis, IgG
  218. Type III: Immune Complex
    • Disorder: Arthus reaction, serum sickness, RA, Lupus
    • immune Mechanism: antigen/ antibody, compliment
  219. Type IV: Cell Mediated Hypersensitivity (Delayed)
    • Disorder: TB, contact dermatitis (poison ivy), transplant rejection
    • Immune Mechanism: T cells