jonjonnavarro's version from 2016-05-16 16:22


Question Answer
InfectionIdentifiable source of microbial insult
SepsisIdentifiable source of infection + SIRS
Severe sepsisSepsis + organ dysfunction
Septic shockSepsis + cardiovascular collapse

Macrophage activities during wound healing

Question Answer
PhagocytosisReactive oxygen species, Nitric oxide
DébridementCollagenase, elastase
Cell recruitment and activation Growth factorsPDGF, TGF-β, EGF, IGF
Cell recruitment and activation CytokinesTNF-α, IL-1, IL-6
Cell recruitment and activationFibronectin
Matrix synthesis Growth factorsTGF-β, EGF, PDGF
Matrix synthesis CytokinesTNF-α, IL-1, IFN-γ
Matrix synthesis Enzymesarginase, collagenase
Matrix synthesisProstaglandins, Nitric oxide
Angiogenesis Growth factorsFGF, VEGF
Angiogenesis CytokinesTNF-α
AngiogenesisNitric oxide

Osteogenesis imperfecta: clinical and genetic features

Question Answer
IMild bone fragility, blue sclera
II“Prenatal lethal”; crumpled long bones, thin ribs, dark blue sclera
IIIProgressively deforming; multiple fractures; early loss of ambulation
IVMild to moderate bone fragility; normal or gray sclera; mild short stature

Different clinical approaches to the closure and healing of acute wounds.

Question Answer
Primary IntentionEpithelialization, Connective Tissue Repair
Secondary IntentionContraction, Epithelialization
Tertiary IntentionContraction, Connective Tissue Repair

Inherited Predisposition to Pancreatitis

CFTR (7q31) :Cystic fibrosis transmembrane conductance regulator
Question Answer
PRSS1 (7q34)Serine protease 1 (trypsinogen 1)
SPINK1 (5q32)Serine peptidase inhibitor, Kazal type 1
CASR (3q13)Calcium-sensing receptor
CTRC (1p36)Chymotrypsin C (caldecrin)
CPA1 (7q32)Carboxypeptidase A1


Question Answer
CFTR (7q31)Epithelial anion channel.
PRSS1 (7q34)Cationic trypsin.
SPINK1 (5q32)Inhibitor of trypsin.
CASR (3q13)Membrane-bound receptor that senses extracellular calcium levels and controls luminal calcium levels.
CTRC (1p36)Degrades trypsin, protects the pancreas from trypsin-related injury
CPA1 (7q32)Exopeptidase involved in regulating zymogen activation


Question Answer
CFTR (7q31) Loss-of-function mutations alter fluid pressure and limit bicarbonate secretion, leading to inspissation of secreted fluids and duct obstruction
PRSS1 (7q34) Gain-of-function mutations prevent self-inactivation of trypsin
SPINK1 (5q32)Mutations cause loss-of-function, increasing trypsin activity
CASR (3q13)Mutations may alter calcium concentrations and activate trypsin.
CTRC (1p36)Degrades trypsin, protects the pancreas from trypsin-related injury
CPA1 (7q32)Exopeptidase involved in regulating zymogen activation

Inherited Predisposition to Pancreatic Cancer

Question Answer
STK11 130Peutz-Jeghers syndrome
PRSS1, SPINK1Hereditary pancreatitis
CDKN2AFamilial atypical multiple-mole melanoma syndrome
UnknownStrong family history (3 or more relatives with pancreatic cancer)
Multiple, including BRCA1, BRCA2, PALP2, BRCA2Hereditary breast and ovarian cancer
Multiple, including MLH1, MSH2 (2p21)Hereditary non-polyposis colorectal cancer (HNPCC)

Major Causes of Ureteral Obstruction

Question Answer
Intrinsic CalculiOf renal origin, rarely more than 5 mm in diameter Larger renal stones cannot enter ureters
Intrinsic StricturesCongenital or acquired (inflammations)
Intrinsic TumorsTransitional cell carcinomas arising in ureters Rarely, benign tumors or fibroepithelial polyps
Intrinsic Blood clotsMassive hematuria from renal calculi, tumors, or papillary necrosis
Intrinsic NeurogenicInterruption of the neural pathways to the bladder
Extrinsic PregnancyPhysiologic relaxation of smooth muscle or pressure on ureters at pelvic brim from enlarging fundus
Extrinsic Periureteral inflammationSalpingitis, diverticulitis, peritonitis, sclerosing retroperitoneal fibrosis
Extrinsic EndometriosisWith pelvic lesions, followed by scarring
Extrinsic TumorsCancers of the rectum, bladder, prostate, ovaries, uterus, cervix; lymphomas, sarcomas

Pathologic T (Primary Tumor) Staging of Bladder Carcinoma

Question Answer
TaNoninvasive, papillary
TisCarcinoma in situ (noninvasive, flat)
T1Lamina propria invasion
T2Muscularis propria invasion
T3a Microscopic extravesicle invasion
T3bGrossly apparent extravesicle invasion
T4Invades adjacent structures

Pathologic Classification of Common Testicular Tumors

Question Answer
Germ Cell Tumors Seminomatous tumorsSeminoma, Spermatocytic seminoma
Germ Cell Tumors Nonseminomatous tumorsEmbryonal carcinoma, Yolk sac (endodermal sinus) tumor, Choriocarcinoma
Germ Cell TumorsTeratoma
Germ Cell Tumors Sex Cord-Stromal Tumors Leydig cell tumor, Sertoli cell tumor

Proteins of Bone Matrix

Question Answer
Osteoblast-Derived ProteinsType I collagen
Calcium-binding proteinsOsteonectin, bone sialoprotein
Cell adhesion proteinsOsteopontin, fibronectin, thrombospondin
CytokinesIL-1, IL-6, RANKL
EnzymesCollagenase, alkaline phosphatase
Growth factorsIGF-1, TGF-β, PDGF
Proteins involved in mineralizationOsteocalcin

Diseases of the Skeleton with Identified Genetic Defects

Question Answer
Brachydactyly types D and E HOXD13Short, broad terminal phalanges of first digits
Camptomelic dysplasia SOX9Sex reversal, abnormal skeletal development
Cleidocranial dysplasia RUNX2Abnormal clavicles, Wormian bones, supernumerary teeth
Holt-Oram syndrome TBX5Congenital abnormalities, forelimb anomalies
Nail-patella syndrome LMX1BHypoplastic nails, hypoplastic or aplastic patellas, dislocated radial head, progressive nephropathy
Waardenburg syndrome types 1 and 3 PAX3Hearing loss, abnormal pigmentation, craniofacial abnormalities


Question Answer
Achondroplasia FGFR3Short stature, rhizomelic shortening of limbs, frontal bossing, midface deficiency
Hypochondroplasia FGFR3Disproportionately short stature, micromelia, relative macrocephaly
Osteopetrosis, autosomal dominant LRP5Increased bone density, hearing loss, skeletal fragility
Osteopetrosis, infantile form RANKLIncreased bone density
Osteoporosis-pseudoglioma syndrome LRP5Congenital or infant-onset loss of vision, skeletal fragility
Thanatophoric dysplasia FGFR3Severe limb shortening and bowing, frontal bossing, depressed nasal bridge


Question Answer
Achondrogenesis type 2 COL2A1 Type II collagenShort trunk
Metaphyseal dysplasia, Schmid type COL10A1 Type X collagenMildly short stature
Osteogenesis imperfecta types 1-4 COL1A1, COL1A2 Type I collagenBone fragility
Osteopetrosis with renal tubular acidosis CA2 Carbonic anhydraseIncreased bone density, fragility, renal tubular acidosis
Osteopetrosis, late onset type 2 CLCN7 Chloride channelIncreased bone density, fragility

Classification of Major Primary Tumors Involving Bones

Question Answer
Hematopoietic (20) Myeloma, LymphomaVertebrae, pelvis
Cartilage forming (30) OsteochondromaMetaphysis of long bones
Cartilage forming (30) ChondromaSmall bones of hands and feet
Cartilage forming (30) ChondroblastomaEpiphysis of long bones
Cartilage forming (30) Chondromyxoid fibromaTibia, pelvis
Cartilage forming (30) Chondrosarcoma (conventional)Pelvis, shoulder


Question Answer
Bone forming (26) Osteoid osteomaMetaphysis of long bones
Bone forming (26) OsteoblastomaVertebral column
Bone forming (26) OsteosarcomaMetaphysis of distal femur, proximal tibia
Unknown origin (15) Giant cell tumorEpiphysis of long bones
Unknown origin (15) Aneurysmal bone cystProximal tibia, distal femur, vertebra
Unknown origin (15) Ewing sarcomaDiaphysis of long bones
Unknown origin (15) AdamantinomaTibia
Notochordal (4) ChordomaClivus, sacrum


Question Answer
Hematopoietic (20) Myeloma, LymphomaMalignant plasma cells or lymphocytes replacing marrow space
Cartilage forming (30) OsteochondromaBony excrescence with cartilage cap
Cartilage forming (30) ChondromaCircumscribed hyaline cartilage nodule in medulla
Cartilage forming (30) ChondroblastomaCircumscribed, pericellular calcification
Cartilage forming (30) Chondromyxoid fibromaCollagenous to myxoid matrix, stellate cells
Cartilage forming (30) Chondrosarcoma (conventional)Extends from medulla through cortex into soft tissue, chondrocytes with increased cellularity and atypia


Question Answer
Bone forming (26) Osteoid osteomaCortical, interlacing microtrabeculae of woven bone
Bone forming (26) OsteoblastomaPosterior elements of vertebra, histology similar to osteoid osteoma
Bone forming (26) OsteosarcomaExtends from medulla to lift periosteum, malignant cells producing woven bone
Unknown origin (15) Giant cell tumorDestroys medulla and cortex, sheets of osteoclasts
Unknown origin (15) Aneurysmal bone cystVertebral body, hemorrhagic spaces separated by cellular, fibrous septae
Unknown origin (15) Ewing sarcomaSheets of primitive small round cells
Unknown origin (15) AdamantinomaCortical, fibrous , bone matrix with epithelial islands
Notochordal (4) ChordomaDestroys medulla and cortex, foamy cells in myxoid matrix

Chromosomal Abnormalities in Soft tissue Tumors

Question Answer
Ewing sarcoma family tumorsDisordered protein with multiple functions, including aberrant transcription, cell cycle regulation, RNA splicing and telomerase
Liposarcoma—myxoid and round-cell typeArrests adipocytic differentiation
Synovial sarcomaChimeric transcription factors, interrupts cell cycle control
Rhabdomyosarcoma—alveolar typeChimeric transcription factors, disrupt skeletal muscle differentiation
Dermatofibrosarcoma protuberansPromoter driven overexpression of PDGF-ß, autocrine stimulation
Infantile fibrosarcomaChimeric tyrosine kinase leads to constitutively active Ras/MAPK pathway

Soft Tissue Tumors

Question Answer
Adipose LipomaMature adipose tissue
Adipose Well-differentiated LiposarcomaAdipose tissue with scattered atypical spindle cells
Adipose Myxoid liposarcomaMyxoid matrix, “chicken wire” vessels, round cells, lipoblasts
Fibrous Nodular fasciitisTissue culture growth, extravasated erythrocytes
Fibrous Deep fibromatosisDense collagen, long, unidirectional fascicles
Skeletal muscle RhabdomyomaPolygonal rhabdomyoblasts, “spider” cells
Skeletal muscle Alveolar rhabdomyosarcomaUniform round discohesive cells between septae
Skeletal muscle Embryonal rhabdomyosarcomaPrimitive spindle cells, “strap” cells


Question Answer
Smooth muscle LeiomyomaUniform, plump eosinophilic cells in fascicles
Smooth muscle LeiomyosarcomaPleomorphic eosinophilic cells
Vascular HemangiomaCircumscribed mass of capillary or venous channels
Vascular AngiosarcomaInfiltrating capillary channels
Nerve sheath SchwannomaEncapsulated, fibrillar stroma, nuclear palisading
Nerve sheath NeurofibromaMyxoid, ropy collagen, loose fascicles, mast cells
Nerve sheath Malignant peripheral nerve sheath tumorTight fascicles, atypia, mitotic activity, necrosis


Question Answer
Uncertain histotype Solitary fibrous tumorBranching ectatic vessels,
Uncertain histotype Synovial sarcomaTight fascicles of uniform basophilic spindle cells, Pseudoglandular structures
Uncertain histotype Undifferentiated pleomorphic sarcomaHigh grade anaplastic polygonal, round or spindle cells, Bizarre nuclei, atypical mitoses, necrosis
Uncertain histotype Alveolar soft part sarcomaMultiple nodules of eosinophilic round cells, septae
Uncertain histotype Clear cell sarcomaSheets of pale or clear spindle cells, wreath-like giant cells


Question Answer
Simplethe overlying skin is intact.
Compoundthe bone communicates with the skin surface.
Comminutedthe bone is fragmented.
Displacedthe ends of the bone at the fracture site are not aligned.
Stressa slowly developing fracture that follows a period of increased physical activity in which the bone is subjected to repetitive loads
“Greenstick”extending only partially through the bone, common in infants when bones are soft
Pathologicinvolving bone weakened by an underlying disease process, such as a tumor

Vascular sites

Question Answer
Large Granulomatous diseaseGiant cell arteritis, Takayasu arteritis
Medium Immune complex mediatedpolyarteritis nodosa
Medium Anti-endothelial cell antibodiesKawasaki disease
Small Vasculitis without asthma or granulomas ANCAmicroscopic polyangiitis
Small Granulomas, no asthma ANCAWegener granulomatosis
Small Eosinophilia, asthma, and granulomas ANCAChrug-Strauss syndrome
Small Immune complex mediated SLESLE Vasculitis
Small Immune complex mediated IgAHenoch Scholein Purpura
Small Immune complex mediated CryoglobulinCryoglobulin vasculitis
Small Immune complex mediated OtherGood pasture disease

Blood vessels Most common

Question Answer
Primary hyperaldosteronismmost common causes of secondary hypertension
Chronic hypertensionmost common cause of left ventricular hypertrophy
hypertensionmost common etiology associated with ascending aortic aneurysms.
Thoracic aortic aneurysmsmost commonly associated with hypertension
Giant cell (temporal) arteritismost common form of vasculitis among older individuals
Pulmonary embolismmost common serious clinical complication of DVT
group A β-hemolytic streptococcimost common agent of Lymphangitis
Capillary hemangiomasmost common type of hemangioma
Juvenile hemangiomas“strawberry type” hemangiomas of the newborn are extremely common
Nevus flammeus “birthmark”, the most common form of vascular ectasia
Hemangiomasvery common tumors characterized by increased numbers of normal or abnormal vessels filled with blood
cavernous lymphangiomascommon in the neck of Turner syndrome patient


Question Answer
Pancreas divisummost common congenital anomaly of the pancreas
Gallstones and biliary sludgemost common cause pancreatic duct obstruction
Alcohol abusemost common cause of chronic pancreatitis
VHL tumor suppressor genemost common genetic abnormality in serous cystic neoplasms
Infiltrating ductal adenocarcinoma of the pancreasmore commonly known as pancreatic cancer
head of pancreas carcinomamost common cause of distal common bile duct obstruction

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