Patho exam 3

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Patho exam 3
2013-07-02 08:41:33

patho exam 3
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  1. which condyloma is thin, flat, moist, and is associated with secondary syphilis
    condyloma lata
  2. which condyloma is papillary or elevated, is NOT syphilis
    condyloma acuminata
  3. what are the strands of HPV that can cause condyloma acuminata
    • 6
    • 11
  4. what is another name for anogenital warts
  5. what are the frequent offenders of vaginits
    • - candida albicans- most common (fungus)
    • - trich vaginalis (parasite)
  6. an overgrowth of Gardnerella vaginalis due to a decrease in normal flora and increased pH is known as what
    bacterial vaginosis
  7. what are the clinical characteristics of bacterial vaginosis
    thin, malodorous vaginal d/c
  8. which lab is done to check for bacterial vaginosis
    • - saline wet prep- "clue cells"
    • - fishy amine odor released with application of KOH
    • - pH of vaginal secretion >4.5
  9. vulvar tumors affect women usually older than 60 y/o and many are what type of carcinoma
    squamous cell carcinoma
  10. which strand of HPV may be responsible for vulvar tumors
    HPV 16
  11. what do you want to look for when looking for vulvar tumors
    look for areas of leukoplakia in any regions of vulva or adjacent skin
  12. what type of vaginal cancers occur in children younger then 5 y/o
    sarcoma botryoides
  13. an inflammation of the cervix is known as what
  14. what are the pathogens that can cause cervicitis
    • - chlamydia trachomatis
    • - ureaplasma urealyticum
    • - trich vaginalis
    • - candida species
    • - Neisseria gonorrhea
    • - HSV 2
    • - HPV
  15. in cervical carcinoma, what is there an increase in discovery of
    cervical intraepithelial neoplasias (CIN)
  16. what type of tumors of the cervix can be seen on cytology smears
    • - ASCUS= atypical squamous cells of undetermined significance -- repeat PAP 6 mo's
    • - AGUS= atypical glandular cells
    • - LSIL= low grade intra-epithelial lesion
  17. what is CIN I in tumors of the cervix
    mild dysplasia (low grade)
  18. what is CIN II in tumors of the cervix
    moderate dysplasia (high grade)
  19. what is CIN III in tumors of the cervix
    severe dysplasia (high grade)
  20. what is CIS in tumors of the cervix
    carcinoma in situ
  21. what are the risk factors for CIN and invasive CA
    • - early age at first sexual intercourse
    • - multiple sexual partners
    • - partner with multiple sex partners
    • - smokers
    • - persistent infx by high-risk HPV
    • - invasive carcinoma of the cervix
  22. what are the high risk HPV subtypes
  23. what are the low-risk HPV types
  24. the inner lining of the uterus is known as what
  25. the muscular walls of the uterus are known as what
  26. tubes, ovaries and ligaments of the uterus are known as what
  27. excessive or irregular bleeding with no physical lesion is known as what
    Dysfunctional uterine bleeding
  28. This is usually due to an excess estrogen relative to progestin and in time it can give rise to endometrial carcinoma
    Endometrial hyperplasia
  29. These are often called fibroid tumors
  30. These are common benign tumors of uterine smooth muscle, they are found in 30 to 50% of pts during reproductive years, it is more common in blacks and whites usually greater than 30 years old, they do shrink after menopause and are usually multiple and asymptomatic
  31. These are unusual, they are cancers arising from myometrium, do not arise from leiomyoma, they are usually solitary lesions and recurrence after removal is common
  32. This is caused by endometrial tissue outside the uterus
  33. Endometriosis is more common in which patient population
    Nulliparity, early menarche/late menopause, tall/thin Caucasians
  34. Endometriosis is less common in which patient population
    Individuals with multiple births, long lactation, late menarche, black/Asian
  35. This is a growth of basal layer of endometrium down into the myometrium
  36. What can patients present to the clinic with when suspecting adenomyosis
    Menorrhagia, dysmenorrhea
  37. These typically produced bleeding from the uterus as the earliest manifestation
    Tumors of endometrium and myometrium
  38. These can occur at any age, generally at time of menopause, and they result in abnormal uterine bleeding
    Endometrial polyps
  39. Post menopausal vaginal bleeding must be evaluated for what
  40. What is the most common GYN cancer in the United States, the average age at presentation is 61, and most present with abnormal uterine bleeding
    Endometrial carcinoma
  41. Endometrial carcinoma frequently arises from what
    Endometrial hyperplasia
  42. What are the well-defined risk factors for endometrial carcinoma
    • - Obesity/increased synthesis of estrogen in fat deposits
    • - diabetes
    • - hypertension
    • - infertility
  43. This type of infection in endometritis is usually caused by bacterial infections after delivery or miscarriage, and is associated with pain, discomfort, and fever
    Acute infection
  44. This type of infection is associated with endometritis and is associated with either retained gestational tissue, intrauterine contraceptive devices, or chronic gonorrhea pelvic disease
    Chronic infections
  45. Inflammation of the fallopian tubes, nearly always bacterial in origin is known as what
  46. What are the species that cause salpingitis
    Chlamydia, mycoplasma hominis
  47. What are the species that has postpartum salpingitis
    Streptococci and staphylococci
  48. What is an infection of the pelvic organs be on the body of the uterus called
    Pelvic inflammatory disease
  49. What are the principle biochemical abnormalities of polycystic ovaries
    • - Excessive production of androgens
    • - high luteinizing hormone
    • - low follicle stimulating hormone
    • - multiple cystic follicles in the ovaries
  50. What are the clinical presentations of polycystic ovaries
    • Oligomenorrhea
    • hirsutism
    • infertility and obesity
  51. Risk factors for ovarian cancer are what
    • Family history
    • nulliparity
    • high-fat diets
    • anouvulation
  52. Post menopausal vaginal bleeding can because by what
    Endometrial carcinoma
  53. Postpartum uterine infection can because by what
  54. tubal infection is known as what
  55. A painful menses is known as what
  56. A heavy menses is known as what
  57. Ectopic endometrial tissue is known as what
  58. Implantation fertilized egg outside the endometrium is normally called what
    ectopic pregnancy
  59. an interruption of pregnancy before fetal viability is known as what
  60. This type of abortion usually has no identifiable cause, many unknown pregnancies end in this type of abortion
    Spontaneous abortion (miscarriage)
  61. This type of abortion is surgically performed at the women's request
    Induced abortion
  62. Which type of spontaneous abortion is when the fetus and placenta are completely expulsed, and woman resumes normal menses
    Complete spontaneous abortion
  63. Which type of spontaneous abortion is when there is cervical dilation and expulsion of some fetal parts with some parts of placenta being retained
    Incomplete spontaneous abortion
  64. Which type of spontaneous abortion can result in endometritis if it becomes infected
    Incomplete spontaneous abortion
  65. Which type of spontaneous abortion is when there is a death of a fetus, which remains in utero
    Missed spontaneous abortion
  66. Which type of spontaneous abortion is where there is cervical bleeding, but cervix does not dilate and pregnancy may continue uneventfully
    Threatened spontaneous abortion
  67. This is a result of abnormally functioning placenta or abnormal materno-placental interaction
    Toxemia of pregnancy a.k.a. eclampsia
  68. What are some clinical features of pre-eclampsia
    Hyper/reflexia, hypertension, proteinuria, generalized edema
  69. What are some clinical features of eclampsia
    • Hyper/reflexia
    • hypertension
    • proteinuria
    • generalized edema
    • seizures or coma
  70. What is HELLP syndrome
    Hemolytic anemia, Elevated Liver enzymes, Low Platelets
  71. What is the function of the hypothalamus
    Regulates hunger, thirst, sleep and wakefulness plus most of your involuntary mechanisms including body temperature
  72. What is the function of your thyroid glands
    Regulates your energy and your metabolism
  73. What is the function of your pancreas
    Aids in the digestion of proteins, fats and carbohydrates. It produces insulin which controls blood sugar levels
  74. What is the function of ovaries
    Influences how your blood circulates and determines your mental vigor and your sex drive
  75. What is the function of your pituitary gland
    Controls all of the endocrine glands, influences growth, metabolism and regeneration
  76. What is the function of the parathyroid
    Secretes the hormones necessary for calcium absorption
  77. What is the function of the thymus
    Helps build resistance to disease
  78. What is the function of the adrenal glands
    Secretes hundreds of compounds including cortisone and adrenaline which helps to react to emergencies. Regulates your metabolic processes in the cells, water balance, blood pressure
  79. Which hormone stimulates secretion of cortisol and aldosterone by the adrenal cortex
  80. Which hormone stimulates reabsorption of water by kidneys, reducing the concentration of solute in the blood
  81. Which hormone stimulates egg production in females, stimulates sperm production males
    Follicle stimulating hormone
  82. Which hormone regulates development of muscles and bones
    Growth hormone
  83. Which hormone stimulates progesterone and estrogen production, initiates ovulation in females, stimulates testosterone production
    Luteinizing hormone
  84. Which hormone initiates uterine contractions during childbirth, stimulates flow of milk from breast during lactation
  85. Which hormone stimulates milk production and breasts during lactation
  86. Which hormones regulate secretion of the thyroid hormones; thyroxine and triiodothyronine
    Thyroid stimulating hormone
  87. Which type of hormones stimulate functions of other endocrine glands
    trophic hormones
  88. A flat lesion measuring less than 2 cm in diameter, it is not raised or depressed, primarily a change in skin color (ie, freckle) is known as what
  89. This is similar to a macule but larger than 2 cm (skin rash that occurs in measles)
  90. This type of skin lesion is slightly elevated, small induration of skin, with a diameter of less then 1 cm (these are the hallmark of eczema)
  91. This type of skin lesion is similar to a papule but larger (1-5 cm diameter)
  92. A nodule at the diameter exceeding 5 cm is known as what
  93. A fluid filled elevation of the epidermis measuring less than 1 cm in diameter is known as what
  94. a large vesicle measuring more than 1 cm in diameter is known as what
  95. A vesicle filled with pus is known as what
  96. A defect or erosion of the epidermis is known as what
  97. A skin defect covered with coagulated plasma or blood is known as what
  98. keratin layers that cover the skin in flakes or sheets, and that can easily be scrapped away are known as what
  99. A superficial skin defect caused by scratching
  100. A sharp edged defect in the dermis that extends into the deeper layers of the skin is known as what
  101. This is an autosomal dominant trait that has thick scales resembling fish skin
    ichthyosis congenita
  102. This term is used to denote several skin disorders
    Epidermolysis bullosa
  103. This congenital skin disorder is also known as port wine Mark
    Nevus flammeus
  104. An aggregate of small blood vessels usually on the face is known as what
    nevus flammeus
  105. A superficial tearing of epidermal cells is known as what
  106. "bruise"- bleeding into the soft tissues due to disruption of underlying small blood vessels is known as what
  107. A jagged tear, often seen with stretching of the skin and/or underlying tissue is known as what
  108. A clean, sharp cut is known as what
    Incised wound/incision
  109. A deep tubular wound produced by a sharp thin object is known as what
    Puncture wound
  110. What type of puncture wound is when the puncture pierces the tissues
    Penetrating puncture wound
  111. Which type of puncture wound is when the puncture transverses the tissue to make an exit
  112. Which degree burn includes the epidermis only, appears with erythema; blanches with pressure, sensations are intact; mild to moderate pain,and  the healing takes about three – six days without scarring
    First degree
  113. What type of second-degree burn includes the epidermis and superficial dermis; skin appendages intact, appears with erythema, blisters, its moist, elastic, and blanches with pressure, sensations are intact; with severe pain, healing takes about 1-3 weeks; scarring unusual
    Superficial second-degree burn
  114. What type of second-degree burn is when the epidermis and most of the dermis is involved; most skin appendages are destroyed, will have a white color appearing with erythamtous areas dry, waxy looking, less elasticity, reduced blanching to pressure, decreased sensation; maybe less painful, healing takes greater than three weeks; often with scarring and contractures
    Deep second-degree burns
  115. Which degree burn involves the epidermis and all of the dermis; destruction of all skin appendages, appears white, charred, tan, thrombosed vessels; dry and leathery; does not blanch, anesthetic not painful (although surrounding areas of second-degree burns are painful), does not heal; severe scarring and contractures
    Third-degree burns
  116. Which type of cold injury is when the tissue injury results from prolonged exposure to non-freezing cold and moisture presents with skin necrosis, with blisters and ulcers
    Immersion foot – "trench foot"
  117. Which type of cold injury is caused by subfreezing temperatures, involves mostly fingers, toes, ears, nose. Upon rewarming, area may appear blotchy red and swollen
  118. In electrical injuries the most severe damage usually involves what areas near the entry or exit point
    The deeper tissues and possibly internal organs
  119. In electrical injuries when there is damage to the blood vessels what may occur
    • May result in thrombosis secondary to vessel damage
    • Subsequent muscle infarctions may result
    • Fasciotomy to try to prevent this
  120. Which type of radiation injury may result in partial thickness burns, chronic exposure damages the skin and may accelerate the aging of skin and may develop into cancer
    Sunlight injury
  121. Which type of radiation injury is due to prolonged or repeated exposures of large doses which can cause significant lesions
    Ionizing radiation (x-ray, including CT)
  122. What are the four groups within neoplasms of skin
    • Tumors of the epithelial cells
    • Tumors of the pigmentary cells (melanocytes)
    • Tumors of the dermal connective tissue
    • Tumors of the blood-borne cells
  123. What are the A – B – C – D of skin cancer diagnoses
    • A – asymmetry of the lesions
    • B – Borders
    • C – color
    • D – diameter of the lesion – typically greater than 6 mm
  124. This type of tumor of the epithelial cells is the  most common benign skin tumor, is usually friable and easily removed, has a brownish, solitary or multiple flat-topped lesions, and sometimes even a stuck on appearance
    Seborrheic keratosis
  125. What type of tumor of the epithelial cells is the most common malignant one, is seen on sun exposed areas, has a pearly (shiny) surface, often heaped up, with central ulcer, is locally invasive, but does not metastasize
    Basal cell carcinoma
  126. Which type of epithelial cell tumor is seeing on sun exposed areas, considered precancerous, might lead to squamous cell carcinoma, and may progress into a more atypical lesion: carcinoma in situ
    Actinic keratosis
  127. Which type of epithelial cell tumor is most often in sun exposed areas (like basal cells), is a small flat plaque, a persistent ulcer, or slightly elevated. Histologically, indistinguishable from other squamous cell carcinoma, and locally invasive and metastasizes
    Squamous cell carcinoma
  128. Tumors of the pigmentary cells arise from where
  129. This is a macule or patch of the skin in which the melanocytes show hyper-reactivity to UV light
    ephelis (freckle)
  130. This is a sharply demarcated macule occupied by increased number of melanocytes; is unresponsive to UV
  131. This developmental skin abnormality is consisting of an overabundance of melanocytes such as dermal nevus, functional nevus, compound nevus
  132. What is the most common congenital skin anomaly
  133. This is composed of normal skin elements arranged in an abnormal manner, is composed of melanocytes, and are usually innocuous lesions that require no treatment
  134. Which type of nevus is malignant and can require a full thickness excision and skin graft
    Hairy nevus
  135. This is a cancerous tumor originating from the melanocytes, half originate from normal skin, the other half from freckles or pre-existing nevi
  136. What are some common forms of bacterial skin infections
    • Impetigo
    • Folliculitis
    • Furuncle
    • Carbuncle
  137. This type of bacterial skin infection is a superficial infection involving streptococci or Staphylococcus aureus, is characterized by honey colored scabs, it's most found on the face of small children, and highly contagious but responds well to antibiotics
  138. Which type of bacterial skin infection is an infection that is limited to the hair follicles, most often caused by Staphylococcus aureus, and typically involves hairy areas, such as the beard
  139. Which type of bacterial skin infection involves the hair shaft and perifollicular tissue – "boil"
  140. Which type of bacterial skin infection is where the original furuncle now involves multiple hair shafts and become much larger, is often located on the head or neck, and is more common in males than females
  141. What is a chronic recurring infection commonly in the axilla and groin
    Hidradenitis suppurativa
  142. What are dermatophytes caused by
    Fungal pathogens
  143. What tend to live in dead tissue, cause almost no inflammation in underlying skin, and the name often implies the location
  144. Where is tinea pedis located
  145. Where is tinea capitis located
  146. Where is tinea manum located
  147. where is tinea unguium located
  148. where is tinea corporis located
  149. What is the cause of thrush in children
    Candida albicans
  150. Which type of fungi are found primarily in tropical climates
    Blastomycosis, coccidiomycosis
  151. Some invasive deep fungal infections cause large destructive lesions and tumor like lesions called what
  152. This is an abnormality of skin langerhan (dendritic) cells, which modulate inflammation and can be accompanied by localized edema, papules, and vesicles, and usually is accompanied by pruritis
  153. What are the two major forms of eczema and what can cause them
    • Exogenous eczema – environmental cause
    • Endogenous eczema – immune basis?
  154. This is a widespread chronic disease affecting 10 to 20% of the US population, presents with erythema, scaling, and itching of the skin especially nasolabial folds, eyebrows, upper chest, often leads to abundant dandruff, and treatments typically provide little to moderate relief
    Seborrheic dermatitis
  155. This affects 1 to 2% of populations, is T- lymphocyte mediated autoimmunity involving keratinocytes, results in slightly elevated papules and patches that are covered with a silvery scale, mostly on extensor surfaces of extremity such as elbows and knees, and eruptions typically occur symmetrically, then slowly fade away
  156. Which penis malformation has an abnormal location of the urethral orifice on the ventral aspect of the shaft
  157. Which penis malformation has an abnormal location of the urethral orifice on the dorsal aspect of theshaft
  158. And inflammation of the glans penis is known as what
  159. And inflammation of the glans and foreskin is known as what
  160. In balanoposthitis what is an accumulation of desquamated epithelials, sweat, debris that act as a local irritant
  161. This occurs when the prepuce (foreskin) cannot retract back over glans, it is stuck to the glans, and most cases are due to scarring from previous episodes of balanoposthitis
  162. Swollen foreskin that cannot pull back down to the original position that causes swelling and can impair blood supply to the glans is known as what
  163. A penile erection of at least four hours, not associated with sexual stimulation is known as what
  164. Which type of priapism is a complication that is similar to compartment syndrome; later erectile dysfunction result of not quickly corrected
    Ischemic priapism
  165. Which type of priapism is due to trauma to the perineum, spinal cord, and might require only observation
    Non-ischemic priapism
  166. This is the most common STI in the United States
    Genital herpes
  167. Which type of STI produces vesicles with clear fluid, most people are not aware of the infection, patients may have flulike symptoms with the first outbreak, may have several outbreaks the first year and then have decreased frequency, there's no permanent cure
    Genital herpes
  168. This is the most frequent bacterial STI reported in the United States, it is caused by Chlamydia trachomatis, is transmitted via vaginal, anal, or oral sex, and it can be passed to babies during vaginal delivery
  169. in males this STI presents as a purulent urethritis, they will have dysuria, yellow urethral discharge 2 to 5 days after exposure, invades mucosa of urethra and periurethral glands, and if left untreated it can lead to infertility
  170. This STI is caused by Treponema pallidum, it has three clinical stages: primary, secondary, tertiary
  171. Which stage of syphilis is a painless ulcer (chancre) that appears 1 to 12 weeks after exposure
    Primary syphilis
  172. Which stage of syphilis shows within two months to two years after primary infection, the systemic symptoms are a fever, rash (condyloma lata)
    Secondary syphilis
  173. Which stage of syphilis is seen in untreated patients to 2-20 years after primary infection, and is dangerous to CV systems and CNS
    Tertiary Syphilis
  174. Neoplasms of the penis mostly originate from which type of cells
    Squamous epithelium
  175. Which types of HPV can form neoplasms of the penis
    Types 16 and 18
  176. What is the most common form of neoplasm of the penis in which 10% become invasive squamous cell carcinoma's
    Bowen disease
  177. Failure of the testes to descend into the scrotum is known as what
  178. What is the most common type of groin hernia and both sexes, the congenital defect can be patent process vaginalis, the sac might extend into the scrotum
    Indirect inguinal hernia
  179. This type of hernia cannot be reduced and it requires immediate consult to the surgeon to prevent strangulation
    Incarcerated hernia
  180. What is the difference between a strangulated hernia and an incarcerated hernia
    A strangulated hernia is caused by a blood supply that becomes impaired to the incarcerated herniated part
  181. This is a collection of serious fluid in the peritoneal sac around the testes, usually presents as unilateral, can be congenital and infants, and acquired which results in local inflammation in adults
  182. If a patient presents to you with unilateral swelling of the testes what do you want to look for
    Infection, testis tumor, trauma
  183. How can you tell if a patient has a hydrocele
    By using transilluminate
  184. A collection of blood in the scrotal sac is known as a what
  185. This may begin as a UTI or prostatitis, usually caused by gram-negative bacteria in elderly individuals, or chlamydia causes this in young adults, and it may progress to orchitis
  186. Inflammation of the testes is known as what
  187. Which is more serious epididymitis or orchitis
  188. This is more common in young adult white males, and is always considered cancer until proven otherwise
    Testicular neoplasms
  189. What tests are run to determine testicular neoplasms
    • First – scrotal ultrasound
    • Chest radiograph
    • serum tumor markers
  190. Surgery that removes the testes is known as what
  191. 95% of these are germ cell tumors back and differentiate into different cell types
    Testicular neoplasms
  192. If a patient presents with acute scrotal/testicular pain, swelling, and erythema, what do you want to suspect
    Testicular torsion
  193. What is the treatment for a testicular torsion
    Surgery to untwist the testicle and permanently affixed it to the tunica
  194. This feels like a bag of worms in the scrotum superior to the testicle, can cause testis atrophy or sterility, and no treatment is required but can be surgically repaired if painful or causing sterility
  195. Dilated veins of pampiniform plexus is known as a what
  196. If the patient has a varicocele on the right side what must you evaluate for
    Retroperitoneal mass occluding gonadal veins
  197. Which type of prostatitis is usually caused by E. coli, the patient will present to you with dysuria, lower back pain, pelvic pain, fever/chills, may have a painful ejaculation, in blood in the semen
    Acute bacterial prostatitis
  198. Which type of prostatitis presents as a persistent low-grade infection, can be an incidental finding on a urinalysis or rectal exam, and the prostate may be tender and soft
    Chronic prostatitis
  199. This type of prostate disorder peaks in the 70s, most men greater than 80 years old are effected, occurs when the nodules grow gradually squeezing the urethra, it can result in a complete urethral obstruction and that leads to hydronephrosis or renal dysfunction
    Benign prosthetic hyperplasia also known as nodular hyperplasia of the prostate
  200. If the patient presents to you with a progressive decrease in size and strength of a urinary stream, complains of urinary urgency where he has to go all the time and only a little comes out and also urinary frequency, if you feel an easy palpable enlarged prostate on the rectal exam what do you suspect
    Nodular hyperplasia of the prostate also known as benign prosthetic hyperplasia
  201. This usually occurs in older men greater than 60, it is more common than long cancer, but not as deadly, most are adenocarcinomas
    Prostate cancer
  202. A congenital absence of the breast is known as what
  203. Development of more than two breast is known as what
  204. Breast tissue with or without a netball (occasionally found and axilla), is known as what
    Accessory breast
  205. Additional breast along the milk line (as in cats and dogs) is known as what
    Supernumerary breast
  206. Supernumerary nipples without glands is known as what
  207. An operation that lifts ptotic breasts is known as what
  208. Most common inflammatory disease of the breast that usually occurs during lactation, the common pathogens are staph and strep, and a patient has diffuse or localized edema and/or erythema, pain, tenderness to palpation, possible purulent discharge from the nipple is known as what
    Acute mastitis
  209. This type of mastitis is caused by an unknown etiology, and a biopsy to confirm diagnosis and rule out cancer is required
    Chronic mastitis
  210. What are the main symptoms of mastitis
    Breast pain, swelling, redness, fever, enlargement, changed nipple sensation, discharge, itching, tenderness, and/or a breast lump
  211. This is the most common tumor of the female breast, is usually seen in young women, and almost never becomes malignant
  212. These are usually benign, but may become malignant, it is much less common than the fibroadenomas, is a leaf-like tumor that can grow large to massive in size, and in about 50% of malignant ones they tend to metastasize to different sites
    phyllodes tumor
  213. This can mimic breast-cancer both radiographically and on physical exam, patient has a history of trauma in about 50% of the cases, and a needle biopsy is needed for diagnosis
    fat necrosis
  214. This is often called fibrocystic disease in the past, is extremely common in childbearing women, and common findings are breast pain, nipple discharge, and masses
    Fibrocystic breast
  215. This is mostly common in older women, 5th and 6th decades, it can mimic carcinoma clinically and on mammogram, it is a thick, sticky, green to greenish-black discharge that plugs the ducts, and spills into surroundings stroma which leads to plasma cell mastitis
    Mammary duct ectasia
  216. When do you do an excisional biopsy on a breast mass
    When the woman or man is more than 35 years old (Or excise at any age if patient requests)
  217. A neoplastic papillary growth within the lacteriferous duct is as known as a what
    Intraductal papilloma
  218. If a patient presents to you with a serous or bloody nipple discharge and you notice a few millimeter subareolar wart like tumor on the nipple, what are you going to suspect
    Intraductal papilloma
  219. This is second only to lung cancer as the leading cause of cancer death in women, and typically occurs on the left side slightly more than the right
    breast cancer
  220. What are the higher risks for breast cancer
    • Female gender
    • Greater than 30 years of age
    • Caucasians
    • Nulliparity
    • Late age first pregnancy
  221. What are the lower risks for breast cancer
    • Male gender
    • Less than 30 years of age
    • East Asians
    • Multiparity
    • Pregnancy at early age
    • Breast-feeding
  222. When the skin thickens around exaggerated hair follicles due to obstruction of dermal lymphatics by cancer, this is known as what
    peau d'orange
  223. This is a ductal carcinoma involving the nipple, may or may not have a palpable mass, may have nipple itching or burning, or an eczematoid, crusted lesion of the nipple areola
    Paget's disease
  224. If there is a microcalcification (without mass), how is it excised
    Excise with margin of normal tissue
  225. If you have a mass how is it removed
    lumpectomy with margin of normal tissue
  226. This type of cancer most arises from epithelial cells, 80% are infiltrating ductal carcinoma's, most metastasize via lymphatics, most often via the axillary lymph nodes and sometimes the internal mammary nodes
    Breast cancer
  227. Which type of lesions typically spread first to the axillary nodes
    Outer quadrant and centrally located lesions
  228. The external surface of bone, containing osteoblasts, fibroblasts, blood vessels and nerves is known as the what
  229. Spaces where osteocytes (osteoclast and osteoblasts) live within the osteons are called what
  230. these within the osteons extends from the osteocytes
  231. Layers of collagen within osteons are called what
  232. these secrete collagen and ground substance to build bone matrix; called osteocytes after maturing
  233. These cleave or resorb bone
  234. What type of ossification increases the length of the bone
    Endochondral ossification
  235. What type of ossification increases the width of the bone
    Intramembranous ossification
  236. The growth plate part of the long bone is known as the what
  237. Which hormone stimulates the breakdown of bone
  238. Which hormone stimulates bone formation
  239. This is a lateral curvature of the spine
  240. An exaggerated forward curvature of the thoracic spine is known as what
  241. This congenital or hereditary disease is known as brittle bone disease, it occurs with an abnormal development of type 1 collagen (most are autosomal dominant disorders), patient presents with multiple bone fractures and/or blueish tinge to the sclera
    Osteogenesis imperfecta
  242. This congenital or hereditary disease is known as marble bone disease, it is caused by deficient  osteoclastic activity, and occurs as both autosomal recessive and dominant forms
  243. An impaired maturation of cartilage in the developing growth plate that causes a major form of dwarfism and is the most common disorder growth plate, is known as what
  244. This occurs when there is low bone mass micro – architectural deterioration
  245. This is the most common bone disorder seen in the clinic, occurring in elderly, and mainly women
  246. This type of osteoporosis has an unknown etiology but does appear to be caused by decreased estrogen, appears after the age of 30 with bone loss exceeding deposition, common with small frames rather than larger frames, and more common in Caucasians than blacks
    Primary osteoporosis
  247. This type of osteoporosis is caused by prescription drugs such as corticosteroids, can because by malignancies, malabsorption or in adequate intake of calcium phosphate or vitamin D, and can be caused by smoking and alcohol abuse
    Secondary osteoporosis
  248. Osteomalacia of growing bones in children is known as which type of disorder
  249. This is caused by a vitamin D deficiency, aluminum and some antacids that binds to phosphorus, hyperparathyroidism that leads to high serum calcium, low phosphorus, osteoclast breakdown bone and releases calcium into the blood, and promotes the loss of phosphorus blocking reabsorption from urine
  250. Which type of bone tumors can metastasize from other tumors
    Secondary bone tumors
  251. What are the types of benign bone tumors
    • Osteoma
    • Chondroma
    • Nonossifying fibroma
  252. What are the types of malignant bone tumors
    • Osteosarcoma
    • Ewing's sarcoma
    • Giant cell tumor
    • Chondrosarcoma
  253. Which malignant bone tumor is more commonly seen between the ages of 10 to 25 years of age and most often involves the metaphysis of the long bones
  254. Which malignant bone tumor is more commonly seen between the ages of 10 to 20 years of age and is typically found in the metaphysis of the long bone
    Ewings sarcoma
  255. Which malignant bone tumor is more commonly seen between the ages of 20 to 40 years of age
    Giant cell tumor
  256. Which malignant bone tumor is more commonly seen between the ages of 35 to 60 years old
  257. A fracture that heals solidly, without abnormal motion between fragments, but has angulation or displacement is known as a what
  258. When a fracture heals with abnormal motion between fragments it is known as a what
  259. What are the factors that promote fracture healing
    • Immobilization of fracture fragments
    • Good blood supply
    • Vitamin C, D, calcium, phosphorus in diet
    • Good alignment of fragments to avoid mal- union
  260. What are the factors that impair fracture healing
    • Motion between fracture fragments where calluses are replaced by collagenized fibrous tissue instead of bone that leads to a nonunion
    • Soft tissue between fractured fragments
    • Infection (osteomyelitis)
  261. Osteomyelitis in children is often associated with what
  262. This type of infection can spread to bone infection of nearby joints tissue, can occur in IV drug users, infection causes swelling and increased pressure within bone as PMN arrive forming pus, and treatment typically involves IV antibiotics in surgery to drain the pus
  263. a necrotic piece of bone in area of infection within chronic osteomyelitis is known as what
  264. Surrounding an area of new bone formation in chronic osteomyelitis is what
  265. A fracture through a diseased bone is known as what type of fracture
    Pathologic fracture
  266. a fracture with an overlying laceration is known as what type of fracture
    Open fracture
  267. The most common malignant bone tumor in children is what
  268. What is the most common form of joint disease that is common in everyone as we age
  269. This is a chronic systemic autoimmune disorder, onset of symptoms is usually insidious, it is characterized by chronic symmetrical inflammation of joints, laboratory findings often nonspecific, and extra articular manifestations are anemia, pericarditis, episcleritis, and skin lesions
    rheumatoid arthritis
  270. This occurs in rheumatoid arthritis patients where the extensor tendons cannot reach over  enlarged joints, so they go around the joints, what is this known as
    Rheumatoid arthritis
  271. This type of arthritis is caused by lyme disease that is transmitted to human via deer ticks, may occur weeks to months after a bite and is associated with a migrating skin rash, most often affects the knee and can be treated with antibiotic treatment that cures the arthritis
    Infectious arthritis
  272. This is caused by a deposition of uric acid crystals in tissues, can be found in joints, subcutaneous tissue, and kidneys, it causes hyperuricemia which leads to uric acid renal stones
  273. What is the most common cause of metabolic primary gout
    Acid over-production
  274. What is the cause of renal primary gout
    Uric acid under excretion
  275. This type of gout has less inflammation and more bone deformities, is associated with painless subcutaneous deposits of uric acid mostly found on the ears, olecranon, and patella, hypertension is common with this type of gout and can further damage the kidneys, and some have uric acid kidney stone
    Chronic gout
  276. A target like skin lesion and knee pain is associated with what
    Lyme disease
  277. ulnar deviation is classical in this disorder
    Rheumatoid arthritis
  278. Which arthritis is due to chronic wear and tear
  279. Which arthritis has extra articular symptoms
    Rheumatoid arthritis
  280. This is an autoimmune disorder of neuromuscular junction that is characterized by muscle weakness, where anti-bodies are directed against acetylcholine receptors
    Myasthenia gravis
  281. A patient comes into your clinic complaining of being easily fatigued and has muscle weakness, the symptoms usually are worse later in the day, and you notice that their eyelids often show proptosis. What do you suspect
    Myasthenia gravis
  282. This is a muscle disease and which muscle cells degenerate that result in marked weakness, may be inherited as autosomal or sex linked traits, differences between the dystrophies are based on mode of inheritance, age of onset, muscle groups initially expected, and severity of the disease
    Muscular dystrophy's
  283. This is the most common muscular dystrophy
    Duchenne – type muscular dystrophy
  284. This disorder is caused by a defect in the gene for dystrophin, which normally maintains so integrity
    Duchenne – type muscular dystrophy
  285. a mother of a four-year-old pt is brought into your clinic with complaints that she notices her son has a waddling  gait that becomes uncontrollable, the patients mother notes that she has noticed severe muscle wasting and weakness of the respiratory muscles, what is your possible dx
    Duchenne – type muscular dystrophy
  286. What is the most common form of muscle weakness in children, and is an upper motor neuron disease
    Cerebral palsy
  287. This type of myopathy results from chronic hypoperfusion of muscles and peripheral nerves
    Diabetic myopathy
  288. This type of myopathy is when anti-bodies to the tumor antigens cause an immune response that causes damage to the muscles
    Cancer myopathy
  289. This is a necrosis of striated muscle due to either trauma, crush injury, electrical burn, compartment syndrome, ischemia – reperfusion, overuse or hypothermia, may result in over-use or swollen muscles
  290. Tissue damage after establishing blood flow to an area that was previously deprived of blood flow is known as what type of injury
    Ischemia – reperfusion injury
  291. This can be caused by vascular trauma that leads to ischemia – reperfusion that eventually leads to swelling, long bone fractures that lead to swelling, or intraosseous needle for infusing fluids
    Compartment syndrome
  292. How is compartment syndrome prevented and treated
  293. If you have a patient with proptosis with sustained upward gaze what do you think the disorder is
    Myasthenia gravis
  294. This disorder results in myoglobinurea
  295. This disorder can be discovered by amniocentesis
    Muscular dystrophy
  296. This disorder is caused by antibiotic is against the acetylcholine receptors
    Myasthenia gravis
  297. Pseudo – hypertrophy of calf muscles is known in which disorder
    Muscular dystrophy
  298. In soft tissue calcifications, explain dystrophic calcification
    • Normal serum calcium
    • Often associated with healing after inflammation or tissue necrosis
  299. In soft tissue calcification, explain metastatic calcification
    • Elevated serum calcium
    • Not related to cancer
    • Involves derangement of calcium metabolism
  300. This type of ossification is when there is bone formation in soft tissues, and can be caused after trauma or surgery of joints or long bones
    Heterotopic ossification
  301. This causes bone formation in areas of muscle injury or inflammation
    myositis ossificans
  302. Inflammation of a muscle is known as what
  303. This is a malignant mesenchymal neoplasm with skeletal muscle differentiation and is the most common sarcoma in the pediatric population
  304. A common, benign well circumscribed neoplasm of smooth muscle is known as what
  305. What is the most common type of leiomyoma
    Uterine fibroids
  306. A malignant smooth muscle tumor is known as what
  307. What is the most common place for leiomyosarcoma's
    Uterus and G.I. tract
  308. What is the second most common sarcoma of adults
  309. Soft tissue calcification after healing is known as what
    Dystrophic calcification
  310. A common benign fatty tumor is known as what
  311. Temporary dysfunction of the facial nerve or cranial nerve VII is known as what
    Bell's palsy
  312. What are the clinical signs of a basilar skull fracture involving the eye
    Peri orbital ecchymosis
  313. What are the clinical signs of a basilar skull fracture involving the ear
    CSF otorrhea or hemotympanum
  314. What are the clinical signs of a basilar skull fracture involving the nose
    CSF rhinorrhea
  315. What type of skull fracture is a straight line
  316. What type of skull fracture has pieces pushing in toward the brain
  317. What type of skull fracture has an overlying laceration
  318. with increased ICP what is Cushing's triad
    • bradycardia
    • Hypertension
    • irregular respiration
  319. An accumulation of blood between the skull and dura mater is known as what
    Epidural hematoma
  320. A patient comes to see you reporting they had a loss of consciousness and then regained consciousness and now are having severe headaches what could you expect to be happening
    Epidural hematoma
  321. This is an accumulation of blood between the Dura and the arachnoid where the brain itself is injured by blunt trauma
    Subdural hematoma
  322. What are the lateralizing signs of a subdural hematoma
    • Weakness on one side of the body
    • Dilated pupil on one side
    • Abnormal posturing
  323. What is caused by injury to middle meningeal artery from a temporal fracture
  324. Which is caused by injury to the brain itself
  325. What are the two signs of a brain herniation
    • Abnormal pupils
    • Abnormal motor response
  326. What is the term for unequal pupils
  327. Bleeding between the arachnoid membrane and pia mater is known as what
    Subarachnoid hemorrhage
  328. What is a clinical sign of a subarachnoid hemorrhage
    Nuchal rigidity
  329. What are the causes of a subarachnoid hemorrhage
    • Most often caused by brain trauma
    • Vascular abnormalities
  330. These are small aneurysms often found in the circle of Willis
    Berry aneurysms
  331. This type of aneurysm is sometimes associated with polycystic kidney disease and the patient will present with a sudden severe headache, vomiting followed by coma
    Berry aneurysms (cerebral)
  332. These type of aneurysms usually involve larger cerebral arteries, usually the vertebral, basilar, and internal carotid arteries. These fibrose and might not rupture but they do provide a site for a thrombus to form, leading to an ischemic stroke
    Atherosclerotic aneurysms
  333. This is caused by a contusion/hematoma in the brain, with bleeding from ruptured intracerebral vessels
    Intracerebral hemorrhage
  334. Which area of the brain recognizes the meaning of words
    Wernicke's area
  335. Which area of the brain is used for speech and is usually on the left side
    Brocas area
  336. What are the clinical characteristics of a cerebrovascular disease
    • Weakness or paralysis of contra lateral side of the body
    • Difficulty speaking or understanding
    • TIA – transient ischemic attack – resolves within hours
  337. Which type of stroke is more common, is caused by a thrombosis that causes gradual onset of symptoms, and an embolism causes abrupt cerebral dysfunction, a rapid CT is needed to rule out hemorrhagic stroke
  338. This type of stroke is caused from high blood pressure or ruptured aneurysms
    Hemorrhagic stroke
  339. What are the two types of strokes
    Ischemic and hemorrhagic
  340. Which type of stroke is caused by an embolus or a thrombus
  341. Which type of stroke is caused by bleeding into the brain
  342. Which type of stroke is treated with a fibrinolytic
  343. Which type of brain tumors do not metastasize
  344. Which type of brain tumors can still cause much harm and death
  345. Most primary brains cancers are what
  346. And abnormal neuron firing in the brain can cause what
  347. Recurrent seizures due to abnormal biochemical/electrical activity in the brain are known as well
  348. This metabolic abnormality is due to a lack of vitamin B1 (thiamine), is caused by chronic alcoholism, malabsorption, or bariatric surgery
    Wernecke encephalopathy
  349. What are the symptoms of Wernicke's encephalopathy
    Confusion, ataxia, nystagmus
  350. This is due to a high neonatal bilirubin, child might need speech therapy, physical therapy for hypertonia, or cochlear implants
  351. Involuntary repetitive eye movements either horizontal, vertical, rotatory, or mixed is known as what
  352. This is caused by an injury to the brain before, during or after birth. the child will have muscle tightness or spasms, gait disturbance or other motor disturbances, abnormal sensation and perception, site, hearing, or speech impairment, and maybe seizures
    Cerebral palsy
  353. Destruction of oligodendroglial cells which surround the nerve fibers in the brain leads to what
    Multiple sclerosis
  354. This typically affects the white matter of the brain and is presumed to be autoimmune, and destroys of the oligodendroglial cells which surround brain nerve fibers
    Demyelinating disease
  355. what is the most common autoimmune CNS disease
    Multiple sclerosis
  356. What are the sensory and motor abnormalities of multiple sclerosis
    • Loss of touch, with tingling
    • Blurred vision is a frequent early symptom
    • Motor symptoms include: muscle weakness, unsteady gait, uncoordinated movements, and/or sphincter abnormalities such as urinary incontinence
  357. Which diagnostic study is useful in confirming the diagnosis of multiple sclerosis
  358. What is an autoimmune disorder involving demyelination of peripheral nerves
    Guillain-Barre' syndrome
  359. What are some signs or symptoms of Guillain-Barré syndrome
    • Sensory changes in hands/feet
    • Later muscle weakness/paralysis
    • Might require mechanical ventilation
  360. This is a form of dementia with unknown etiology, there are deposits of beta amyloid in plaques and vessels in the cerebral cortex. The microtubule proteins form neurofibril tangles, and it is a progressive neurologic disorder
    Alzheimer's disease
  361. This is due to a loss of pigmented neurons in substantial Niagara, they are neurons that control muscle activity. The patient has a slowness of voluntary muscular movement and a resting tremor of the hands, Cogwell rigility is found on the physical exam, face will gradually lose expressiveness/might drool, and patient often has depression and dementia
    Parkinson disease
  362. This is an autosomal dominant neurodegenerative disorder that primarily affects the caudate nucleus in motor cortex, patient presents with motor disturbances including involuntary gyrating movement of trunk and limb, postural instability, rigidity, progressive dementia, and abnormal behavior
    Huntington's Chorea
  363. This is due to a loss of motor neurons in the anterior horn cells of the spinal cord, midbrain, and eventually the cerebral cortex, it results in muscle wasting and weakness but intellect is not affected
    amyotrophiclateral sclerosis a.k.a. Lou Gehrig's disease
  364. Which neurodegenerative disorders have memory loss, amyloid plaques, and neurofibril tangles
    Alzheimer's disease
  365. Which neurodegenerative disorder involves a movement disorder such as cogwheel rigidity, pill rolling and has decreased dopaminergic neurons in the substantia nigra
  366. Which neurodegenerative disorder includes the triad of motor, cognitive, behavioral problems. It is autosomal dominant and includes the caudate nucleus and cerebral cortex
    Huntington's chorea
  367. Which neurodegenerative disorder includes a movement disorder of weakness and fasciculations, and a loss of motor neurons in the spinal cord, medulla, and cerebral cortex
    Amyotrophic lateral sclerosis
  368. This occurs when there is purulent exudate that forms along the meninges, the most common organisms are group B streptococci and E. coli, Haemophilus influenza, streptococcus pneumonia, neisseira meningitidis
    Bacterial meningitis
  369. A patient presents to the clinic with a headache, vomiting, fever, altered mental status, and possibly having a seizure. You notice that the patient has nuchal rigidity and a positive Kernig's sign, and Brudzinski's sign, what do you think their diagnosis is
  370. This is usually seen in children and young adults, the common pathogens are coxsackievirus B, echovirus, mumpd, Epstein-Barr virus, or herpes, the patient presents with headaches, vomiting and a fever has a positive Brudzinski and Kernig sign and also new nuchal rigidity
    Viral meningitis
  371. This is nearly nearly always a fatal type of encephalitis, the virus is transmitted by saliva of infected animal and travels via peripheral nerves to the CNS
  372. What is the name for nearsighted patients
  373. What is the name for farsighted patients
  374. This is related to irregularity of the cornea or lens
  375. Farsightedness of old age, where the lens is not able to accommodate for near vision is known as what
  376. unequal pull of extra ocular muscles is known as what
  377. If you have clear mucus and suspect conjunctivitis which type of conjunctivitis is it
    Viral conjunctivitis
  378. If you have sticky pus and suspect conjunctivitis which type of conjunctivitis is it
    Bacterial conjunctivitis
  379. This is when conjunctivitis infections extends into the cornea
  380. What is the major cause of blindness in underdeveloped countries
    Chlamydia trachomatis
  381. A blocked tear duct, plus haemphilus, staff, strep causes what
  382. Inflammation of the eyelid, accompanied by redness and swelling that is caused by staff aureus is known as what
  383. A blockage of a meibomian gland that is not infected is known as what
  384. Infection of the hair follicle or sweat gland caused by staff aureus in the eye is known as what
    Hordeolum (stye)
  385. This is a bad inflammation of the iris and ciliary body, is caused by trauma and the patient presents to you with pain and photophobia what is it
    Uveitis (iridocyclitis)
  386. Demyelination of the optic nerve by either an autoimmune disorder or multiple sclerosis is known as what
    Optic neuritis
  387. Blood in the anterior chamber is known as what
  388. Bleeding in the orbit from trauma, anticoagulation, or other disorders that increases the pressure risking the optic nerve is known as what
    Retrobulbar hemorrhage
  389. What is the most common type of cataract
    Senile cataract
  390. A defect in the formation and circulation of aqueous humor that leads to increased intraocular pressure is known as what
  391. Which form of glaucoma is due to a chronic and impaired absorption; intraocular pressure slowly increases
    Primary open angle glaucoma
  392. Which form of glaucoma presents with painful red eye and vision loss; increased intraocular pressure only during the attack
    Acute closed angle glaucoma
  393. Which type of eye disorder is treated by a phakectomy
  394. Which eye problem is treated by a lateral canthotomy
    Retrobulbar hematoma
  395. This is a defect causing loss of central vision and a grid is used to test for this
    Age related macular degeneration
  396. When the retinal pulls away from the back of eye caused by trauma or bleeding, and a patient may see floaters or flashes of light is known as a what
    retinal detachment
  397. Swelling of the optic disc due to increased intracranial pressure is known as what
  398. This is a malignant tumor of the eye, it is inherited genetically and often involves both eyes, and a small child presents with a white pupil is known as a what
  399. What causes dark pigment spots in the retina
    Retinitis pigmentosa
  400. Opacification of the lens causes what
  401. Name a cancer of the skeletal muscles of the eye
  402. Prolonged high concentration of oxygen in a newborn can cause what
    Retinopathy of prematurity
  403. Night blindness is associated with which deficiency
    Vitamin a
  404. This is a pearly white appearance in the ear, it is not cancer but a benign tumor and is caused by a birth defect or a chronic infection, there is negative pressure in the middle year that pulls in the squamous cells, forming a cyst
  405. This disease can be mild to severe with episodic vertigo that last one to several hours, has sensori–neural hearing loss for low-frequency sounds, and tinnitus. There are hydrops and endolymphatic systems of the cochlea and may be caused by an imbalance of pressures between compartments of the inner ear
    Ménière's disease
  406. This type of hearing loss is usually from the external or middle ear due to a foreign body, cerumen, or otitis media
    Conductive hearing loss
  407. This type of hearing loss is due to cochlear abnormalities due to repetitive noise trauma
    Sensory hearing loss
  408. This type of hearing loss is due to old age
  409. This is the least common type of hearing loss and it is due to lesions of the cranial nerve VIII – acoustic neuroma
    neural hearing loss
  410. This type of hearing loss is due to loud sudden impulse sounds or loud repetitive sounds, can also cause tinnitus, and sounds greater than 85 dB can cause hearing loss
    Noise induced hearing loss
  411. A patient comes in complaining of bilateral hearing loss that is worse in one ear, has a family history of hearing loss which often begins between the ages of 30 to 40, it is an autosomal dominant disorder where bone deposits occur on both sides of the oval window
  412. This is a benign slow-growing tumor of the nerve sheath of the acoustic nerve that causes hearing loss, tinnitus, and a balance disorder. If large enough, it can cause cranial nerve VII deficit
    Acoustic Neuroma