lizamariereagan's version from 2015-05-05 20:50


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What are the characteristcis of the proliferative stagedeposition of granulation tissue and collagen, angiogenesis, epithelial cell proliferation, dissolution of clot, and wound contraction (mediated by myofibroblasts)
What are the mediators for remodelingfibroblasts
What are the characteristics of remodeling stagetype III collagen replaced by type I collagen , increased tensile strength of tissues


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Mneumonic for exudate vs transudatethick and thin
Cellularity of exudatecellular
Cellularity of transudatehypocellular
Protein content of exudateprotein –rich
Protein content of transudateprotein –poor


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Specific gravity of exudate> 1.02
Specific gravity of transudate<1.02
What is exudate due tolymphatic obstruction, inflammation/ infection, malignancy
What is transudate due topressure issues →increased hydrostatic pressure (CHF), decreased oncotic pressure (cirrhosis), sodium retention


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Regarding ESR – what causes them to aggregate?they are coated with products of inflammation (eg fibrinogen) and when aggregated, RBC fall at a faster rate within the test tube
What increases ESR?anemias, infections, inflammation, cancer, pregnancy, autoimmune diorders and increased circulating levels if fibrinogen
What decreases ESRsickle cell (altered shaped), polycythemia (increased RBCs “dilute” aggregation factors), CHF, microcytosis and hypofibrinogenemia
What activates the hepatic secretion of acute phase proteins like fibrinogen?IL-1, IL-6 and TNF alpha


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Why do cells die in iron poisoningperoxidation of membrane lipids
Symptoms of actue iron poisoningnausea, vomiting, gastric bleeding, lethargy
Symptoms of chronic iron poisoningmetabolic acidosis, scarring leading to GI obstruction
Treatment of iron poisoningchelation (IV deferoxamine, oral deferasirox) and dialysis


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What happens in amyloidosisabnormal aggregation of proteins (or their fragments) into beta pleated sheet structures
What is AL primary amyloidosis due todue to deposition of proteins from Ig Light chains
What is AL primary amyloidosis associated withplasma cell disorders or multiple myeloma
What is AA secondary amyloidosis fibrils composed ofamyloid A
When do you see AA secondary amyloidosiswith chronic conditions like rheumatoid arthritis, IBD, spondyloarthropathy, protracted infection


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What are the fibrils composed of in dialysis related amyloidosisbeta 2 microglobulin
How may dialysis related amyloidosis present?as carpal tunnel syndrome
heritable amyloidosis due to mutation of whatdue to transthyretin gene mutation
what is age-related (senile) systemic amyloidosis due todeposition of normal (wild type) transthyretin in myocardium and other sites – slower progression
what is an example of organ-specific amyloidosisAlzheimer disease


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what is deposited in Alzheimer diseaseamyloid beta protein cleaved from amyloid precursor protein (APP)
what is an organ-specific amyloidosis related to diabetes mellitus type 2islet amyloid polypeptide (IAPP) caused by deposition of amylin in pancreatic islets
what is lipofuscina yellow brown (on h and e stain) wear and tear pigment associated with normal aging
how is lipofuscin formedby oxidation and polymerization of autophagocytosed organellar membranes


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what is the neoplastic progression?normal, hyperplasia (low grade dysplasia), carcinoma in situ/preinvasive (high grade dysplasia, no invasion of basement membrane), invasive carcinoma (invasion of basement membrane – no longer reversible, used collagenases and hydrolases (metalooproteinases), can mets),
what is p-glycoprotein also known asmultidrug resistance protein 1 (MDR1)
what does p-glycoprotein doexpressed by some cancer cells and pumps out toxins including chemotherapeutic agents
is p-glycoprotein dependent on ATP?yes!


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What is hyperplasiaincreased number of cells
What is metaplasiaone adult cell type replaced by another
What is metaplasia secondary to?irritation (like barretts or environmental exposure )
What is dysplasiaabnormal growth with loss of cellular orientation, shape, and size in comparison to normal tissue
Which –plasia is preneoplasticdysplasia


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What –plasias are reversiblehyper, meta and dys
What –plasias are irreversibleana, neo and desmo
What is anaplasialoss of structural differentiation of function of cells
What does anaplasia resemblethe primitive cells of the same tissue
What is anaplasia equated withundifferentiated malignant neoplasms


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What is neoplasiaclonal proliferation of cells that is uncontrolled and excessive
Is neoplasia benign or malignantcan be both
What is desmoplasiafibrous tissue formation in response to neoplasm
What is an example of desmoplasialinitis plastic in diffuse stomach cancer


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What is tumor grade determined bydegree of cellular differentiation and mitotic activity
What is the scale for tumor grade1-4, 1 = low grade (well differentiated); 4=high grade (poorly differentiated, anaplastic)
What has more prognostic value, grade or stagestage
What is tumor stagedegree of localization/spread based on site and size of primary lesion, spread to regional lymph nodes, presence of mets (stage = spread)
What is the staging systemTNM (tumor size, node involvement, mets)


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What origin does carcinoma imply?epithelial
What origin does sarcoma imply?mesenchymal
How do carcinomas spread?lymphatically
How do sarcomas spreadhematogenously
What are exceptions to carcinomas spreading lymphaticallyrenal cell carcinoma (invades renal vein), hepatocellular carcinoma (invades hepatic vein), follicular carcinoma of the thryroid and chriocarcinoma


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Benign epithelial tumoradenoma or papilloma
Malignant epithelial tumoradenocarcinoma, papillary carcinoma
What cell types are considered mesenchymeblood cells/vessels, smooth/striated muscle, connective tissue, bone and fat
Benign blood vessel hemangioma
Malignant blood vesselangiosarcoma


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Benign smooth muscleleiomyoma
Malignant smooth muscleleiomyosarcoma
Benign striated musclerhabdomyoma
Malignant striated musclerhabdomyosarcoma
Benign connective tissuefibroma


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Malignant connective tissuefibrosarcoma
Benign boneosteoma
Malignant boneosteosarcoma
Benign fatlipoma
Malignant fatliposarcoma


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What is cachexiaweight loss, muscle atrophy and fatigue that occur in chronic disease
What is cachexia mediated byTNF-alpha (nicknamed cachetin), IFN-gamma and IL-6


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Neoplasm associated with acanthosis nigricans (hyperpigmentation and epidermal thickening)visceral malignancy (esp stomach)
Neoplasm associated with actinic keratosissquamous cell carcinoma of skin
Neoplasm associated with AIDSaggressive malignant lymphomas (non-Hodgkin) and Kaposi sarcoma
Neoplasm associated with autoimmune diseases (eg hashimoto thyroiditis, sle)lymphoma
Neoplasm associated with barret esophagus (chronic GI reflux)esophageal adenocarcinoma


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Neoplasm associated with chronic atrophic gastritis, pernicious anemia, postsurgical gastric remnantsgastric adenocarcinoma
Neoplasm associated with cirrhosishepatocellular carcinoma
Neoplasm associated with cushing syndromeSmall cell lung carcinoma
Neoplasm associated with dermatomyositislung cancer
Neoplasm associated with down syndromeALL, AML


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Neoplasm associated with dysplastic nevusmalignant melanoma
Neoplasm associated with hypercalcemiasquamous cell lung cancer
Neoplasm associated with immunodeficiency statesmalignant lymphomas
Neoplasm associated with lambert-eaton mysathenic syndromesmall cell lung cancer
Neoplasm associated with myasthenia gravis, pure RBC aplasia, hypogammaglobulinemiathymoma


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Neoplasm associated with paget disease of bonesecondary osteosarcoma and fibrosarcoma
Neoplasm associated with plummer-vinson syndrome (decreased iron)squamous cell carcinoma of esophagous
Neoplasm associated with polycythemiarenal cell carcinoma, hepatocellular carcinoma
Neoplasm associated with radiation exposureleukemia, sarcoma, papillary thyroid cancer, and breast cancer
Neoplasm associated with SIADHsmall cell lung cancer


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Neoplasm associated with Tuberous sclerosis (facial angiofibroma, seizures, intellectual disability)giant cell astrocytoma, renal angiomyolipoma, and cardiac rhabdomyoma
Neoplasm associated with UCcolonic adenocarcinoma
Neoplasm associated with xeroderma pigmentosum, albinismmelanoma, basal cell carcinoma, and especially squamous cell carcinomas of skin
Neoplasm associated with Multiple seborrheic keratosisGI, breast, lung and lymphoid malignancies
Neoplasm associated with li-fraumeni syndromep53 mutation predisposes to various cancer types at a young age (eg sarcoma, breast, leukemia, adrenal gland)


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What happens with oncogenesgain of function → increased cancer risk
How many alleles do you need to damage in an oncogeneone
Gene product of BCR-ABLtyrosine kinase
Gene product of bcl-2anti-apoptotic molecule ( inhibits apoptosis)
Gene product of BRAFserine/threonine kinase


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Gene product of c-kitcytokine receptor )for stem cell factor)
Gene product of c-myctranscription factor
Gene product of HER2/neu (c-erbB2)tyrosine kinase
Gene product of l-myctranscription factor
Gene product of n-myctranscription factor
Gene product of rasGTPase


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Gene product of rettyrosine kinase
Associated tumor of BCR_ABLCML, ALL
Associated tumor of bcl-2follicular and undifferentiated lymphomas
Associated tumor of BRAFmelanoma
Associated tumor of c-kitgastrointestinal stromal tumor (GIST)
Associated tumor of c-mycburkitt lymphoma


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Associated tumor of HER2/neu (c-erb2)breast, ovarian, and gastric carcinomas
Associated tumor of l-myclung tumor
Associated tumor of n-mycneuroblastoma
Associated tumor of rascolon cancer, lung cancer, pancreatic cancer
Associated tumor of retMEN 2A and 2B


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What are tumor suppressor genesget loss of function leading to increased cancer risk
How many allelles must be lost for expression of disease?both
Gene product of BRCA1 and BRCA2DNA repair protein
Gene product of CPD4/SMAD4DPC (deleted in pancreatic cancer)
Gene product of DCCDCC (deleted in colon cancer)


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Gene product of NF1RAS GTPase activating protein (neurofibromin)
Gene product of NF2merlin (schwannomin) protein
Gene product of p16cyclin-dependent kinase inhibitor 2A
Gene product of p53transcription factor for p21 , blocks G1 to S phase
Gene product of Rbinhibits E2F ; blocks G1 to S phase


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Gene product of TSC1hamartin protein
Gene product of TSC2tuberin protein
Gene product of VHLinhibits hypoxia inducible factor 1a
Associated tumor of APCcolorectal cancer (associated with FAP)
Associated tumor of BRCA1 and BRCA2breast and ovarian cancer


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Associated tumor of CPD4/SMAD4pancreatic cancer
Associated tumor of DCCcolon cancer
Associated tumor of MEN1MEN type 1
Associated tumor of NF1neurofibromatosis type 1
Associated tumor of NF2neurofibromatosis type 2
Associated tumor of p16melanoma


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Associated tumor of p53most human cancers, li-frumeni syndrome
Associated tumor of PTENbreast cancer, prostate cancer, endometrial cancer
Associated tumor of Rbretinoblastoma, osteosarcoma
Associated tumor of TSC1 and TSC2tuberous sclerosis
Associated tumor of VHLvon Hippel-Lindau disease
Associated tumor of WT1 and WT2Wilms tumor (nephroblastoma)


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What is the most common ocular tumor of childhoodretinoblastoma
How does retinoblastoma presentwhite pupillary reflex (leukocoria) in kids < 5 years
Is sporadic retinoblastoma unilateral or bilateral ?unilateral
Are sporadic cases of retinoblastoma at risk for other malignanciesno
Is the majority of cases of retinoblastoma sporadic or familial ?sporadic (60%)


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Is familial retinoblastoma bilateral or unilateralbilateral most of the time
Are familial retinoblastoma cases related with developing other tumorsyes –osteosarcoma occurs most often
What do OCP’s decrease the risk ofnon-hereditary ovarian and endometrial cancer
What decresases the risk of ovarian cancermultiparity and breast feeding


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What are tumor markers used forused to monitor tumor recurrence and response to therapy
How is definitive diagnosis made in cancervia biopsy
which alkaline phosphatase is easily denatured by heatbone (bone = boil)
what are the sources of alkaline phosphataseplacenta, liver, intestine and osteoblastic activity
alkaline phosphatasemets to bone, liver, paget disease of bone, seminoma (placental ALP)


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beta- hCGhydatidiform moles, choriocarcinomas (gestational trophoblastic diseas), testicular cancer, pregnancy
what is beta-hCG produced bysyncytiotrophoblasts of placenta
CA-15-3/CA-27-29breast cancer
Ca-19-9pancreatic adenocarcinoma
CA-125ovarian cancer


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Calcitoninmedullary thyroid carcinoma
CEAcarcinoembryonic antigen; very nonspecific but produced by about 70% of colorectal and pancreatic cancers – also produced by gastric, breast and medullary thyroid carcinoma
PSAfollow prostate adenocarcinoma ; elevated in BPH and prostatitis
S-100neural crest origin (eg melanomas, neural tumors, schwannomas), langerhans cell histiocytosis
TRAPtartrate- resistant acid phosphatase; hairy cell leukemia (a b cell neoplasm) (TRAP the HAIRY animal!)


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What does TRAP represent?osteoclastic activity
What represents osteoclastic activityTRAP, urinary hydroxyproline and urinary deoxypyridinoline (most reliable)
What does the triple test look atalpha-fetoprotein, beta hCG and estriol
When is the triple test performedbetween weeks 16 and 18 of gestation
If there’s an abnormal result in the triple test, what is the next step?fetal ultrasonography