Gen Path Recalled Questions

General Pathology Review Notes: Lungs: 1. 2. 3. 4. 5. 6. 7. 8. 9.

Mucous gland hyperplasia -------Chronic bronchitis Airway dilation and scarring-----Bronchiectasis Air space enlargement------------Emphysema Smooth muscle hyperplasia, excess mucus section------Asthma Pneumoconioses--------------------Nota Atopy---------------------------------Asthma Blue Bloaters------------------------Chronic Bronchitis Expiratory Airflow Limitation----Asthma Anti-trypsin deficiency-------------Emphysema 1. 2. 3. 4. 5.

Masson bodies-------------------------Cryptogenic Organizing Pneumonia Ferrougenous bodies------------------Asbestos Schaumman bodies--------------------Sacoidosis Asteroid bodies------------------------Sarcoidosis Keratinization--------------------------Small cell CA

Small cell vs. non-small cell CA Adenocarcinoma, small and large cell CA. Carcinoid. 1. Inhibits Caveolin 1 of pulmonary fibrosis----------- TGF- B1 2. Complication of Amiodarone in pulmonary disease----------- Pneumonitis and Fibrosis 3. Homogeneous granular precipitate within the alveoli--------- PAP (Pulmonary Alveolar Proteinosis) 4. Atheromas of pulmonary artery------------------------------------ Pulmonary Hypertension 5. SARS- Severe Acute Respiratory Syndrome etiology-------- Coronavinus 6. Most common manifestation of Asbestos exposure-----------Pleural plaques 7. Organism that causes both acute lower respiratory tract inf. and meningitis in children--------------------------------------------------------------Haemophilus influenzae 8. Org. causing community acquired pneumonia in pts. with cystic fibrosis--------------------------------------------------------------------------Pseudomonas aeruginosa 9. Tumor with lung < 3cm.------------------------------------------T1 10. Metastasis to ipsilateral mediastinal or subcarinal LN -------N2 11. Most common type of Lung cancer in women---------------- Adenocarcinoma 12. Sympathetic Ganglia invasion effect of lung CA spread----- Horner Syndrome 13. Lambert- Eaton Myasthenic syndrome- caused by auto-Abs to presynaptic membrane----------------------------------------------------------Calcium Channels 14. Collar-button lession tumor--------------------------------------Carcinoid tumor 15. Tumor composed of organoid trabecular----------------------Carcinoid tumor 16. Coin lesion on routine chest film-------------------------------Lung Hamartoma 17. Type of mesothelioma resembling fibrosarcoma-------------Mesenchymal type 18. Distant Metastasis-------------------------------------------------M1 19. Kulchitsky cells found in----------------------------------------Small cell

PRELIM EXAM ON: 1. 2. 3. 4. 5.

White Bloob Cell Disorder, B-Cell, T-Cell, Both or None

CLL----------------------------------------B Cell Anaplastic Lymphoma-------------------T Cell Burkitt's Lymphoma ---------------------B Cell Hairy Cell Leukemia---------------------B Cell Marginal/ Mantle Zone Lymphoma--- B Cell

T-Cell, B-Cell , RS (Reed-Sternberg) Cell, NK Cell 1. 2. 3. 4. 5.

CD3----------- T-Cell CD 56--------- NK Cell CD 15---------RS Cell CD 21 -------- B-Cell CD 30-------- RS Cell

CML, Polycythemia Vera (PCV), Essential Thrombocytosis, Primary Myelofibrosis 1. Increased Red Cell Mass ----------------------PCV 2. Erythromelalgia-------------------------------- Essential Thrombocytosis 3. Dry tap------------------------------------------ NOTA- Hairy Cell Leukemia 1. CD marker of Histiocytes--------------------CD 1+ 2. LCA Leukocyte common Ag----------------- CD 45 3. Most common CA of children---------------ALL 4. Most common Monoclonal Gammopathy—MGUS 5. Best test to diagnose leukemia---------------6. TRAP + (tartrate resistant acid phosphatase)--- Hairy Cell Leukemia 7. EBV receptor--------------------------------------- CD 21 8. Express high levels of cyclin D1------------------Mantle (zone) cell lymphoma 9. Clover leaf/ flower cells---------------------------- Adult T cell Leukemia 10. Reed – Sternberg cell variant in mixed cellularity type Hodgkin’s Lymphoma----------------------------------------Mononuclear variant 11. FAB classification of M6 of AML ------------Erythroid myeloid subtype 12. Most common myeloproliferative disorder13. Combination of calvarial bone defects, diabetes insipidus and exophthalmos-------------------------------- Hand Schuller Christian Triad 14. Birbeck granules best seen in-----------Electron microscopy as tennis racket like appearance. 15. Most aggressive Hodgkins lymphoma---------16. T cell location in the lymph node--------------Paracortex 17. Common manifestation of CML----------------18. FAB classification with gum infiltration--------M5 monocytic leukemia 19. LAP score of pts. With CML --------------------Decreased LAP score 20. Leukemia that metastasize into the testis--------------ALL

Tumor, Diseases of Immune System, Heart diseases: 1. Choristoma------------excessive growth in an abnormal location or heterotopia. 2. Causes of cell injury a. O2 deprivation b. Physical agents c. Chemical agents and drugs d. Infectious agents e. Immunologic reactions f. Genetics derangements g. Nutritional imbalance 3. Fibrinoid Necrosis---------assoc. with type III Hypersensitivity NOTE: types of Hypersensitivity (ACID) I - Anaphylaxis or Immediate II - Cytotoxic III - Immune Complex IV - Delayed/Cell Mediated (T-Cell) 4. Mechanism of cell Injury a. Decrease ATP b. Mitochondrial damage c. Calcium Influx d. Increase ROS (reactive O2 Specie) e. Membrane damage f. Protein Misfolding, DNA damage 5. Generation of Free Radicals a. Normal metabolic processes b. Absorption of Radiant energy ex. Ionizing radiation c. Inflammation d. Enzymatic metabolism exogenous chemicals or drugs e. Transition metals f. NO (Nitric Oxide) 6. Apoptosis in Pathologic State a. DNA Damage b. Accumulation of misfolded proteins c. Cell death on certain viral infection d. In Parenchymal organs 7. Accumulation of lipid on parenchymal organs 8. Metastatic Calcification a. Sarcoidosis b. RF c. Paget disease d. Necrosis

Dystrophic Calcification------- Ca++ deposits in dying tissues/Necrosis with NORMAL calcium level Metastatic Calcification-------- Ca++ in normal tissues; Hypercalcemia 9. Outcomes of chronic Inflammation 10. Roles of Macrophage a. Phagocytosis b. Key effector cells c. Participate in effector phase of Humoral immunity 11. Main cell in chronic Inflammation---------------Macrophage 12. Eosinophils------------------------------with MBP (Major Basic Protein) 13. Granulomatous Inflammation a. TB b. Leprosy c. Syphilis d. Cat scratch e. Sarcoidosis f. Crohn dse 14. VEGF----------------------------Angiogenesis 15. Postmortem Clot----------------Lines of Zahn 16. Right to Left Shunt --------------------------Early Cyanosis a. Tetralogy of Fallot (VSD, Pulmonary stenosis, Overriding of Aorta, Right ventricular hypertrophy) b. Transposition of Great Arteries c. Persistent Truncus Arteriosus d. Tricuspid Atresia Left to Right Shunt---------------------------Late cyonosis a. VSD b. ASD c. PDA 17. White infarct except a. Spleen b. Heart c. Kidney d. lungs-----------Red Infant (hallow organ kasi!) 18. Edwards Syndrome (Trisomy 18) a. Micrognathia b. Rocker bottom feet c. Congenital heart disease 19. NK cells--------------------CD 16 and CD 56 20. Class I MHC --------------CD 8 Tc/Ts lymphocytes 21. Class II MHC -------------CD 4 Th/Ti lymphocytes 22. HLA B27------------------- Ankylosing Spondylitis 23. Myasthenia Gravis---------Type II hypersensitivity 24. T- Cell mediated----------- Type IV hypersensitivity 25. Epitheloid Cells ---------- Activated Macrophages 26. ANA ----------------------- Anti-Nuclear Antibodies in Autoimmune disorders:

4 Patterns of Nuclear Fluorescence suggests type of Ab (+) in patient’s serum 1. Homogenous/Diffuse nuclear staining 2. Rim/Peripheral ------------ Ab of DNA 3. Speckled pattern ---------- Ab of non-DNA 4. Nucleolar pattern --------- Most often in SYSTEMIC SCLEROSIS 27. DiGeorge Syndrome ----------Absence of T lymphocytes; del 22 q 11 ---------- Fail to dev. 3rd and 4th Pharyngeal pouch-----No THYMUS 28. Systemic Sclerosis-----------------Progressive interstitial and perivascular fibrosis in the skin and multiple organs 2 MAJOR TYPES 1. Diffuse Scleroderma------------Wide spread skin and visceral involvement 2. Limited Scleoderma----------- with CREST syndrome C Calcinosis---------------------Ca++ depo. On soft tissue R Raynauds Phenomenon -------PAIN E Esophageal dysmotility S Sclerodactyly------------------ Hands (sloughing) T Telangiectasia--------------- Dilated small BV Surface of skin ( Spider Angioma) SJOGREN SYNDROME-----Chronic disease characteristics: 1. dry eyes ------- (Keratoconjunctivitis) 2. dry mouth ----- (xerostomia) resulting from immunologically mediated destruction of LACRIMAL and SALIVARY GLANDS or SICCA Mixed Connective Tissue Disease: 1. SLE 2. Systemic sclerosis 3. Polymyositis X – linked Agammaglobulinemia ------BRUTON’S Agammaglobulinemia--------- Failure of B cell precursors to develop into mature B Cell IMMUNOLOGY NOTES: 1. Hyper - IgM Syndrome ---------Patients make IgM abs. but are deficient in their ability to produce IgG, IgA and IgE ---------Affects ability of helper T cells to deliver activating signals to B cells and macrophages. 2. Di George Syndrome (Thymic Hypoplasia ) ----- Deletion of Ch. 22 q 11 ----- T - Cell deficiency results from failure of development of 3 rd and 4th pharyngeal pouches (No thymus) 3. Severed Combined Immunodeficiency (SCID)

-----Defects in both humoral (B- Cell) and cell mediated (T Cell) immune responses 4 Wiskott - Aldrich Syndrome . ------Immunodeficiency with Thrombocytopenia and ECZEMA and marked recurrent Infection; X-linked recessive 5. Genetic Deficiency of Complement System -------Def. of C2 most common 6. AIDS---------- retrovirus human immunodeficiency deficiency virus (HIV) characterized by profound immunosuppression that leads to opportunistic infections, secondary neoplasm and neurologic manifestations Western blot bands: p24, gp41 and gp126/160 Decrease CD 4:CD 8 ratio 7. Altered Monocyte/Macrophage Function in AIDS 1. Decrease Chemotaxis and phagocytosis 2. Decrease Class II HLA expression 3. Diminished capacity to present Ag to T-cells 8. Opportunistic Infection accounts for the majority of Deaths in untreated patients with AIDS CANDIDIASIS-------------most common fungal infection in AIDS 9. Tumors associated with AIDS 1. Kaposi Sarcoma 2. Lymphoma 3. Uterine Cervix 4. Anal Cancer 10. Amyloidosis Amyloid------------- pathologic proteinaceous subs. deposited in extracellular space in tissues and organs of the body. PRECURSOR 1. Hemodialysis associated Amyloidosis in Chronic Renal Failure----------A - beta 2 - microglobulin 2. Senile Systemic Amyloidosis -------TTR (transthyretin) GEN PATH MIDTERMS INFECTIOUS DISEASES: 1. Vector: Sandfly------------- Leishmaniasis 2. Clinical presentation of pt. with leprosy ------ Decreased cell mediated immune response 3. Stained black in Ag Methenamine stain; MOT: pigeon droppings---Histoplasma capsulatum 4. Fungal normal Flora of skin, vagina and GIT: ----------- Candida albicans 5. Encapsulated fungi that cause meningoencephalitis ------- Cyptococcus neoformans

6. False about Prions--------------------Contain DNA and RNA in its coat 7. Type of Hypersensitivity of TB granuloma ------------ Type IV or Delayed type 8. Cause of gas gangrene ------------------- Clostridium perfringens 9. Common site of manifestation of mumps ----------- Parotid Gland 10. Bacterial Adhesins as a virulent factor ----------- Pili 11. Ulcerated whitish Mucosal Lesions in the buccal cavity --- cheeks near the gumline --- Koplik Spots----------Measles Rubeola 12. Pseudomembrane in tonsillar/pharyngitis ----------- Corynebacterium diphtheria 13. Hepatic Schistosomiasis except: a. Portal hypertension b. Splenomegaly c. Esophageal varices d. Ascites e. Liver Abscess 14. Organ/Tissue first affected in polio virus -------- Oropharynx 15. Condyloma lata TRUE -------------- Secondary Syphilis 16. Acquired from ingesting undercooked pork and penetrate skeletal muscle----Trichinella spiralis 17. Influenza virus adhesion ------- Hemagglutinin 18. Post-streptococcal Syndrome----------- Streptococcus pyogenes/Group A 19. How can the baby acquire congenital Rubella syndrome-----------pregnant contract the virus during first trimester 21. Cytopathic effect of HERPES VIRUS --------- Cowdry type A 22. GRO --- pap’s smear squamous dysplasia ---------- due to HPV 16 22. Ancylostoma duodenale (Hookworm) type of anemia ---------- Microcytic, Hypochromic 23.Gonococcal infection ---------------- Infection of what organ may lead to ectopic pregnancy ------Fallopian Tube 24. Most common Infectious agent causing acute respiratory disease -------- Virus

REVIEW NOTES on GENERAL PATHOLOGY TOPIC: IMMUNOPATHOLOGY; IMMUNODEFICIENCY DISORDERS 1. TYPE III Hypersensitivity -------------- SLE 2. Ig that can cross the placenta ----------- IgG 3. Mechanism of disease by Pathogens: 1. Utilize host nutritional resources 2. Physical damage to host tissue 3. Production of toxic substances 4. Primary Immunodeficiency disorders ------- Digeorge, Hyper IgM syndrome & others 5. Hassal’s Corpuscle of Thymus----------------Type IV reticular epithelial cells ----------- potent source cytokines ----------- aids in maturation of dendritic cells 6. Stroma ------------- Facilitate cell to cell and Ag - receptor interaction 7. Major function of B cells ----------- Secretion of Abs. 8. Checkpoint Cell ------- Regulatory Cells 9. Antigen Binding Region ------------ Variable Region; VDJ Segment 10. Methods of Diagnosing ATOPY 1. History taking 2. Skin test 3. RIST 4. RAST 11. Mngt. Of Allergen 1. Avoidance of allergen 2. Hyposensitization 3. Dry therapy 12. Mechanism of cytolysis 1. Complement fixation to Ag-Ab complex on cell surface 2. Phagocytosis enhanced by Ab (opsonin) 3. ADCC-----------Ab-Dependent Cellular Cytotoxicity 13. Immunodeficiency with thrombocytopenia and eczema-------Wiskott - Aldrich Syndrome 14. Don’t belong in the group a. Nocardioses (the only bacteria) b. Pneumocystoses

c. Candidiasis d. Histoplasmosis e. Cryptococcosis 15. HIV pt. --- high incidence of what CA ------- Kaposi Sarcoma 16. Abnormality of HIV ----------- Decrease phagocytosis and chemotaxis 17. Precursor of senile systemic amyloidosis------ TTR/Transthyretin 18. CA of thyroid associated in amyloidosis --- Medullary CA 19. Stain from gross examination of amyloidosis ----------- Lugol's stain 20. Clinical manifestation of amyloidosis except ---- Atroply of myocardial fibers ---------- should be Cardiomegaly 21. Diagnosis of multiple myeloma asso. Amyloid: 1. Presence of M-band in electrophoresis 2. Bence-Jones protein in urine 3. Increase Light chains and monoclonal Ig 23. Transplantation in same species --------------- Allogeneic; Syngeneic 23. Allogeneic Transplantation ------------ Alloantigens elicit both cell – mediated and humoral immune response ------------ Transplanted cells det. by polymorphic genes inherited from both parents 24. Cytokines in Cancer a. Leukotrienes b. Y - IFN c. Growth factors d. 2 of the above e. All of the above DISEASE of INFANCY and CHILDHOOD 1. Polydactyly and Syndactyly ---- MALFORMATION 2. Cleft lip with or without Cleft palate ---- MALFORMATION 3. Amniotic band ----- Disruption 4. Infant of Oligohydramnios sequence 5. Hyaline membrane dse. ----- RDS Note: Eosinophilic thick hyaline, membranes lining the dilated Alveoli

6. Necrotiting Enterocolitis (NEC) --- Submucosal gas bubbles --- Pneumatosis intestinalis 7. Bone marrow infant with PARVOVIRUS B19 --- 5th dse. of childhood erythema infectiosum (erythroid precursors) 8. Brain --- Yellow discoloration -------- Kernicterus --- Increase B1 9. Hydrops Fetalis; Cystic Hygromas ---- edema, generalized, neck 10. Hydrops Fetalis --- Compensatory hyperplasia of erythroid precursors ----- Extramedullary hematopotesis; Non-immune hydrops fetalis 11. Galactosemia --- LIVER Extensive FATTY CHANGE and delicate fibrosis 12. Cystic fibrosis ------------- Changes in pancreas Note: Dilated and Plug ducts with eosinophilic mucin 13. CF involving the lungs ------------ Pseudomonas Infections 14. Congenital capillary hemangioma ------ Benign (Von Hippel Lindau Dse.) 15. Sacrococcygeal ------- Teratoma 16. Adrenal Neuroblastoma ------- ALK gene, Anaplastic, Lymphoma, Kinase gene 17. Homer -Wright pseudorosettes ----- tumor cells concentrically arranged at central space filled with NEUROPIL (faintly eosinophilic fibrillary material); (+) NSE 18. Ganglioneuromas ------------ Neoplastic Ganglion Cells --- Spindle shaped Schwann cells --- background of stroma 19. Wilm’s tumor --- lower pole of KIDNEY ------- with tightly packed BLUE Cells consistent with BLASTEMAL COMPONENT --------- “Focal Anaplasia”