USMLE supreme 2
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- What is the major function of the D1 receptor?
- relax renal vascular smooth muscle
- What is the major function of the D2 receptor?
- modulate transmitter release, esp. in brain
- What is the major function of the H1 receptor (4)?
- -pain -pruritis -produce mucous -contract bronchioles
- What is the major function of the H2 receptor (4)?
- increase gastric acid secretion
- What is the major function of the a1 receptor?
- increase vascular smooth muscle contraction
- What is the major function of the a2 receptor (2)?
- -decrease sympathetic outflow -decrease insulin release
- What is the major function of the M1 receptor?
- CNS
- What is the major function of the B1 receptor (5)?
- increase HR, -inc. contractility, -inc. renin release, -inc. lipolysis, -inc. aq. Humor formation
- What is the major function of the M2 receptor?
- decrease heart rate
- Draw the brachial plexus
- Nerve(s) associated with longus colli and scalene muscles
- Nerve roots C5,6,7,8
- What is the major function of the B2 receptor (3)?
- vasodilation, bronchodilation, inc. glucagon release
- What is the major function of the M3 receptor?
- increase exocrine gland secretions
- Nerve roots associated with median nerve
- C6,7,8,T1
- What is the major function of the V1 receptor?
- increase vascular smooth muscle contraction
- Nerve roots associated with ulnar nerve
- C8,T1
- Nerve roots associated with axillary nerve
- C5,6
- Nerve roots associated with radial nerve
- C5,6,7,8
- What is the major function of the V2 receptor?
- increase water permeability and reabsorption in the renal collecting tubules
- Nerve roots associated with medial antebrachial cutaneous nerve
- C8,T1
- Nerve roots associated with subclavius
- C5,6
- What second messenger system does Gi work through?
- adenylcyclase reduces cAMP levels and protein kinase A is reduced
- Nerve roots associated with medial brachial cutaneous nerve
- T1
- What second messenger system does Gq work through?
- Lipids phospholipase C--> I PIP2 to IP3 + DAG DAG inc. protein kinase C IP3 inc. Intracellular Ca2+
- Nerve roots associated with lateral pectoral nerve
- C5,6,7
- Nerve roots associated with 1st intercostal nerve
- T1
- What second messenger system does Gs work through?
- adenylcyclase converts ATP to cAMP to phosphorylate protein kinase A
- Nerve roots associated with medial pectoral nerve
- C8,T1
- Nerve roots associated with musculocutaneous nerve
- C5,6,7
- Nerve roots associated with suprascapular nerve
- C5,6
- Nerve roots associated with upper and lower subscapular nerve
- C5,6
- Nerve roots associated with dorsal scapular nerve
- C5
- Nerve roots and muscle associated with long thoracic nerve
- C5,6,7 innervates serratus anterior muscle
- Nerve roots associated with thoracodorsal nerve
- C7,8
- Autosomal recessive diseases (12)
- -Alpha 1 antitrypsin deficiency -infant polycystic kidney disease -CF -Albinism -Phenylketonuria -Thalassemias -Sickle cell anemia -hemochromatosis -Glycogen storage diseases: Von Gierke's, Pompe's, Cori's, McArdle's -Mucopolysaccharidoses (except Hunter's): Hurler's -lysosomal storage dz / Sphingolipidoses (except Fabry's): Niemann Pick, Tay Sachs /Sandhoff's, Gaucher's, metachromatic leukodystrophy, Krabbe's.
- _____are associated with low folic acid intake during pregnancy.
- Neural tube defects
- 90% of adult polycystic kidney disease cases are due to mutation in _____(gene and chromosome).
- APKD1 (on chromosome 16)
- 95% of Down's syndrome cases are due to what?
- meiotic nondisjunction of homologous chromosomes (4% due to Robertsonian translocation and 1% due to Down mosaicism)
- A patent ductus arteriosus is maintained by what 2 things?
- PGE synthesis + low oxygen tension
- Abnormalities associated with Marfan's syndrome:
-
Skeletal: -tall -long extremities, -hyperextendible joints, -long tapering fingers/toes
Cardiovascular: -cystic medial necrosis of aorta, -aortic incompetence, -aortic dissection, -aortic aneurysm, -floppy mitral valve
Ocular: subluxation of lenses - Adult polycystic kidney disease is associated with what other diseases or disorders?
-
polycystic liver disease; BERRY ANEURYSMS;
mitral valve prolapse - developmental retardation microcephaly thin upper lip indistinct philtrum flat midface short palpabral fissures This child at risk for what other problems?
- Baby with Fetal Alcohol Syndrome. At risk for -limb dislocation -heart fistulas and -lung fistulas
- Becker's muscular dystrophy is due to____.
- dystrophin gene mutations (not deletions) Becker's is less severe.
-
Besides pulmonary infections, what are some other consequences of CF?
(2) -
infertility in males;
malabsorption leading to fat-soluable vitamin deficiencies (A,D,E,K) - Causes of female pseudohermaphroditism:
- congenital adrenal hyperplasia or exogenous administration of androgens during pregnancy i.e. excessive and inappropriate exposure to androgenic steroids during early gestation
- Characteristic murmur with a patent ductus arteriosus.
- continuous, 'machine-like'
- Characteristics of Duchenne's MD:
- onset before age 5 weakness begins in pelvic girdle progresses superiorly pseudohypertrophied calf (fibrofatty replacement of muscle) cardiac myopathy Gower's maneuver (arms to get up)
- Characteristics of female pseudohermaphroditism:
- ovaries present but external genitalia are virilized or ambiguous
- Characteristics of Fragile X syndrome:
-
macro-orchidism (enlarged testes),
long face with a large jaw,
large everted ears,
autism - Characteristics of Hereditary Spherocytosis:
- -spheroid erythrocytes -hemolytic anemia -increased MCHC -splenectomy is curative
- Characteristics of male pseudohermaphroditism:
- testes present, but external genitalia are female or ambiguous.
- Children may do this to increase venous return with R-to-L shunt.
- squat
- Compare the cholesterol levels of heterozygores and homozygotes with familial hyperchlosterolemia:
- Heterozygotes (1 : 500) cholest. levels around 300mg/dL Homozygotes (very rare) cholest. levels over 700 mg/dL.
- Complications associated with homozygous familial hypercholesterolemia:
- severe atherosclerotic disease early in life tendon xanthomas (classically in the Achilles tendon) Myocardial Infarction before age 20
- Congenital heart defects are often due to which infection?
- rubella
- Cri-du-chat syndrome results from a congenital deletion on which chromosome?
- short arm of chromosome 5 46 XX or XY, 5p- 5 yr- Cry when you start preschool
- Define Meningocele:
- meninges herniate through spinal canal defect picture on p. 229
- Define Meningomyelocele:
- meninges and spinal cord herniate through spinal canal defect picture on p.229
- Define pseudohermaphroditism:
- disagreement between the phenotypic (external genitalia) and gonadal (testes vs. ovaries) sex.
- Define Spina bifida occulta:
- failure of bony spinal canal to close, but no structural herniation. (usually seen at lower vertebral levels)
- Describe a true hermaphrodite:
- 46 XX or 47 XXY both ovary and testicular tissue present; ambiguous genitalia
- Describe Eisenmenger's syndrome:
- Uncorrected VSD, ASD, or PDA leads to progressive pulm. HTN. As pulm. resistance increases, the shunt changes from L to R to R to L, which causes late cyanosis (clubbing and polycythemia).
- Does coarctation of the aorta affect males or females most commonly?
- 3:1 males to females
- Down's syndrome is associated with increased or decreased levels of AFP?
- decreased AFP goes DOWN, with Down's Syndrome
- what change in amniotic fluid AFP is evidence of a neural tube defect.
- Elevated AFP
- Explain the adult type of coarctation of the aorta and give some associated symptoms.
- aortic stenosis distal to ductus arteriosus (postductal) aDult is Distal to Ductus notching of the ribs, hypertension in upper extremities, weak pulses in lower extermities (check femoral pulse)
- Explain the infantile type of coarctation of the aorta. What is it commonly associated with?
- aortic stenosis proximal to insertion of ductus arteriosus (preductal) 'INantile, IN close to the heart.' associated with Turner's syndrome
- Explain the pathogenesis of eisenmeinger's syndrome
- In fetal period, shunt is R to L (normal). In neonatal period, lung resistance decreases and shunt becomes L to R with subsequent RV hypertrophy and failure (abnormal).
- Explain the transposition of the great vessels.
- Aorta leaves RV (anterior) and pulmonaryt trunk leaves LV (posterior) this leads to separation of systemic and pulmonary circulations.
- Familial Adenomatous Polyposis features:
- Colon becomes covered with adenomatous polyps after puberty 'FAP' F= five (deletion on chromosome 5) A= autosomal dominant inheritance P= positively will get colon cancer (100% without resection)
- Findings in Von Recklinghausen's disease:
- -cafe-au-lait spots, -neural tumors, -Lisch nodules (pigmented iris hamartomas), -skeletal disorders (scoliosis), and -increased tumor susceptibility
- Findings of Cri-du-chat syndrome:
- -microcephaly, -severe Mental Retardation, -high pitched crying/mewing -cardiac abnormalities
- Findings with Huntington's disease:
- depression progressive dementia choreiform movements caudate atrophy dec. GABA and Ach
- list type of L-to-R shunt Frequency:
- VSD>ASD>PDA
- Gender identity is based on what two things?
- 1. external genitalia 2. sex of upbringing
- Genetic anticipation of Fragile X syndrome may be shown by what?
- Triplet repeat (CGG)n
- Highest risk of development of fetal alcohol syndrome at __ to ___ weeks.
- 3 to 8
- How does CF present in infancy?
- Failure to thrive
- How is CF diagnosed?
- increased concentration of Cl- ions in sweat test
- How is Muscular dystrophy diagnosed?
- muscle biopsy increased serum CPK
- Huntington's disease manifests between the ages of :
- 20 and 50
- Incidence and characteristics and Turner's syndrome:
- 1 in 3000 births -short stature, -ovarian dysgenesis, -webbed neck, -coarction of the aorta -shield chest -streak ovaries
- Incidence and characteristics of double Y males:
- 1 in 1000 births -phenotypically normal, -very tall, severe acne, -antisocial behavior(1-2%)
- Incidence and characteristics of Edward's syndrome:
- 1 in 8000 births Trisomy 18 clenched hands (flexion of fingers) low-set ears, micrognathia, prominent occiput congenital heart disease, rocker bottom feet, severe MR, Death within 1 year of birth.
- Incidence and characteristics of Klinefelter's syndrome:
- 1 in 850 births testicular atrophy, eunuchoid body shape, tall, long extremities, gynecomastia, female hair distribution
- Incidence and characteristics of Patau's syndrome:
- 1 in 6000 births trisomy 13 cleft lip/palate, microphthalmia, microcephaly, polydactly, abnormal forebrain structures, congenital heart disease severe MR Death within 1 year of birth.
- What is the genetic problem in Marfan's?
- fibrillin gene mutation
- Mechanism of Fetal Alcohol Syndrome may be :
- inhibition of cell migration
- Most common form of male pseudohermaphroditism is ____.
- testicular feminization (androgen insensitivity) results from a mutation in the androgen receptor gene (X linked recessive); blind-end vagina
- Name 3 examples of L-to-R shunts. (late cyanosis) 'blue kids'
- 1. VSD (ventricular septal defect) 2. ASD (atrial septal defect 3. PDA (patent ductus arteriosus)
- Name 3 examples of R-to-L shunts. (early cyanosis) 'blue babies'
- The 3 T's' 1. Tetralogy of Fallot 2. Transposition of great vessels 3. Truncus arteriosus
- Name 7 common congenital malformations
- 1. heart defects 2. Hypospadias (when the urethral canal is open on the undersurface of the penis or on the perineum) 3. Cleft lip w/ or w/out cleft palate 4. congenital hip dislocation 5. Spina Bifida 6. Anencephaly 7. Pyloric stenosis
- Name 11 autosomal-dominant diseases:
- 1. Adult polycystic kidney disease 2. Familial hyperchloresterolemia (type IIA) 3. Marfan's syndrome 4. Von Hippel-Lindau disease 5. Huntington's disease 6. Familial Adenomatous Polyposis 7. Hereditary Spherocytosis 8. Achondroplasia 9. Von Recklinghausen's disease (NF1) 10. NF2 11. Tuberous Sclerosis FAMiNe is DOMINANT on Hunger TV
- Name an X-linked recessive muscular disease that leads to accelerated muscle breakdown.
- Duchenne's Muscular Dystrophy
- Name the 4 components of Tetralogy of Fallot.
- PROVe 1. Pulmonary Stenosis 2. RVH (right ventricular hypertrophy) 3. Overriding aorta (overrides the VSD) 4. VSD (ventricular septal defect)
- Neural tube defects (spina bifida and anencephaly) are associated with increased levels of ___ in the amniotic fluid and maternal serum.
- AFP (alpha fetal protein)
- Newborns of mothers who consumed significant amounts of alcohol (teratogen) during pregnancy are at risk for _______.
- fetal alcohol syndrome (the number one cause of congenital malformations in the U.S.)
- Patau's syndrome = trisomy ___
- 13 (hint: Puberty - 13)
- Pathogenesis of Cystic Fibrosis:
- defective Cl- channel --> secretion of abnormally thick mucus--> plugs lungs, pancreas, and liver --> recurrent pulmonary infections (Pseudomonas & Staph aureus), chronic bronchitis, bronchiectasis, pancreatic insufficiency (malabsorption and steatorrhea), meconium ileus in newborns.
- cyanotic spells occur with what?
- Tetralogy of Fallot
- Pyloric stenosis is associated with______.
- polyhydramnios; projectile vomiting
- T/F: Trisomy 21 is associated with advanced maternal age.
- True (from 1 in 1500 births in women<20 to 1 in 25 births in women>45)
- Tetralogy of Fallot leads to early cyanosis from a R-to-L shunt across the ____.
- VSD
- The defect in Von Recklinghausen's disease is found on which chromosome?
- 17 (hint: 17 letters in Recklinghausen's)
- The gene responsible for Huntington's disease is located on chromosome__.
- 4 ; triplet repeat disorder
- The incidence of neural tube defects is decreased by maternal ingestion of what?
- folate
- Transposition of great vessels is a common congenital heart disease in offspring of _____ mothers.
- diabetic
- Transposition of great vessels is not compatible with life unless what is present?
- a shunt that allows adequate mixing of blood (VSD, PDA, or patent foramen ovale)
- Trisomy 18 is also known as______.
- Edward's syndrome (hint: Election age = 18)
- Turner's syndrome is the most common cause of what?
- primary amenorrhea
- Von Hippel-Lindau disease characteristics:
- hemangioblastomas of: -retina -medulla -cerebellum 1/2 develop multiple bilateral renal cell carcinomas and other tumors
- Von Hippel-Lindau disease is associated with the deletion of what gene?
- VHL gene (tumor suppressor) on chromosome 3 (3p)
- What are some findings of Down's syndrome?
- mental retardation flat facial profile prominent epicanthal folds simian crease duodenal atresia congenital heart disease (MC endocardial cushion defect->ASD) Alzheimer's disease in individuals over 35 increased risk of ALL
- What does a heart with Tetralogy of Fallot look like on x-ray?
- boot-shaped due to RVH
- What gender genetic disorder has been observed with increases frequency among inmates of penal institutions?
- Double Y males (XYY)
- What is different about the juvenile form of polycystic kidney disease?
- it is recessive
- What is Gower's maneuver?
- requiring assistance of the upper extermities to stand up (indicates proximal lower limb weakness)
- What is the cause of Duchenne's MD?
- a deleted dystrophin gene (hint: 'D' for deletion)
- What is the cause of Tetralogy of Fallot?
- anterosuperior displacement of the infundibular septum
- What is the incidence of Down's syndrome?
- 1 in 700 births
- What is the most common cause of early cyanosis?
- Tetralogy of Fallot
- What is the most common chromosomal disorder and cause od congenital mental retardation?
- Down's syndrome (trisomy 21)
- What is the most common congenital cardiac anomaly?
- VSD
- What is the most common lethal genetic disease of Caucasians?
- Cystic Fibrosis
- What is the second most common cause of mental retardation?
- Fragile X syndrome
- What is the underlying cause of Cystic Fibrosis incl. chromosome?
- Autosomal - recessive defect in CFTR gene on chromosome 7
- What is the underlying cause of Familial hypercholesterolemia?
- defective or absent LDL receptor leading to elevated LDL
- 1. What is used to close a patent ductus arteriosus? 2. What is used to keep it open?
- 1. Indomethacin 2. PGE (may be necessary to sustain life in conditions such as transposition of the great vessels)
- Which gene is affected in Fragile X?
- methylation and expression of the Fragile X Mental Retardation 1 gene (FMR 1 gene)
- Which genetic gender disorder has an inactivated X chromosome (Barr body)?
- Klinefelter's syndrome
- Why are female carriers of X-linked recessive disorders rarely affected?
- because of random inactivation of X chromosomes in each cell
- X-linked recessive disorders (10)
- Bruton's agammaglobulinemia Ocular albinism Wiscott-Aldrich syndrome Fragile X Fabry's G6PD deficiency Hemophilia A and B Hunter's syndrome Lesch-Nyhan syndrome Duchenne's MD BOW to the Fair queen w/ Good X genes and dont' lose HOLD of your head.
- XO =
- Turner's syndrome (think: 'hugs and kisses' -XO- from Tina Turner)
- XXY =
- Klinefelter's syndrome one of the most common causes of hypogonadism in males
- Approximately what percentage of brain tumors arise from metastasis?
- 0.5
- Are basal cell carcinomas invasive?
- Locally invasive but rarely metastasize
- Are Ewing's sarcomas likely to metastasize?
- Yes. They are extremely aggressive with early metastasis. However, they are responsive to chemotherapy.
- Are meningiomas resectable?
- Yes
- Are squamous cell carcinomas of the skin invasive?
- Locally invasive but rarely metastasize
- Are the majority of adult tumors supratentorial or infratentorial?
- Supratentorial
- Are the majority of childhood tumors supratentorial or infratentorial?
- Infratentorial
- Common histopathology often seen in squamous cell carcinomas of the skin?
- Keratin pearls
- Define anaplasia
- Abnormal cells lacking differentiation; like primitive cells of the same tissue. Often equated with undifferentiated malignant neoplasms. Tumor giant cells may be formed.
- Define dysplasia
- Abnormal growth with loss of cellular orientation, shape, and size in comparison to normal tissue maturation. It is reversible but is often a preneoplastic sign.
- Define hyperplasia
- Increase in the number of cells (reversible)
- Define metaplasia
- One adult cell type is replaced by another (reversible). It is often secondary to irritation and/or environmental exposure (e.g. squamous metaplasia in the trachea and bronchi of smokers)
- Define neoplasia
- Clonal proliferation of cells that is uncontrolled and excessive
- Do oncogenes cause a gain or loss of function?
- Gain of function
- Do tumor suppressor genes cause a gain or loss of function?
- Loss of function. Both alleles must be lost for expression of disease
- Does a melanoma have a significant risk of metastasis?
- Very significant risk! The depth of the tumor often correlates with the risk of metastasis.
- From what cells do meningiomas most commonly arise?
- Arachnoid cells external to the brain
- benign tumors of epithelial origin are called?
- 1. Adenoma 2. Papilloma
- 2 Names for a malignant tumor of mucosal epithelial origin.
- 1. Adenocarcinoma 2. Papillary carcinoma
- Give 2 examples of malignant tumors of blood cell (mesenchymal) origin.
- 1. Leukemia 2. Lymphoma
- Give Name for a benign tumor of blood vessel origin.
- Hemangioma
- Name for a benign tumor of bone origin.
- Osteoma
- Give name for benign tumor of more than one cell type.
- Mature teratoma
- Give name for a benign tumor of skeletal muscle (mesenchymal) origin.
- Rhabdomyoma
- Give an name for a benign tumor of smooth muscle origin.
- Leiomyoma
- Name for malignant tumor of blood vessel origin.
- Angiosarcoma (mesenchymal)
- Give an example of a malignant tumor of bone origin.
- Osteosarcoma (mesenchymal)
- Give an example of a malignant tumor of more than one cell type.
- Immature teratoma
- Give an example of a malignant tumor of skeletal muscle origin.
- Rhabdomyosarcoma (mesenchymal)
- Give an example of a malignant tumor of smooth muscle (mesenchymal) origin.
- Leiomyosarcoma
- Give an example of a neoplasm associated with Down's Syndrome.
- Acute Lymphoblastic Leukemia (ALL) we ALL fall DOWN
- How are tumor markers used?
- Tumor markers are used to confirm diagnosis, to monitor for tumor recurrence, and to monitor the response to therapy. They should not be used as a primary tool for diagnosis.
- How is prostatic adenocarcinoma most commonly diagnosed?
- Digital rectal exam (detect hard nodule) or by prostate biopsy
- How often do primary brain tumors undergo metastasis?
- Very rarely
- In what population is osteochondroma most often found?
- Usually men under the age of 25
- In which age group is prostatic adenocarcinoma most common?
- Men over the age of 50
- Is malignant transformation in osteochondroma common?
- Malignant transformation to chondrosarcoma is rare
- Name 1 common tumor staging system.
- TNM system T= size of tumor, N=node involvement, and M=metastases
- Name 3 herniation syndromes that can cause either coma or death when the herniations compress the brainstem
- 1. Downward transtentorial (central) herniation 2. Uncal herniation 3. Cerebellar tonsillar herniation into the foramen magnum
- Name 4 factors that predispose a person to osteosarcoma.
- 1. Paget's disease of bone 2. Bone infarcts 3. Radiation 4. Familial retinoblastoma
- Name 4 possible routes of herniation in the brain
- 1. Cingulate herniation under the falx cerebri 2. Downward transtentorial (central) herniation 3. Uncal herniation 4. Cerebellar tonsillar herniation into the foramen magnum
- Name 5 primary brain tumors with peak incidence in adulthood.
- 1. Meningioma 2. Glioblastoma multiforme 3. Oligodendroglioma 4. Schwannoma 5. Pituitary adenoma
- Name 5 primary brain tumors with peak incidence in childhood.
- 1. Medulloblastoma 2. Hemangioblastoma 3. Ependymomas 4. Low-grade astrocytoma 5. Craniopharyngioma Brain tumors get Children at the HELM
- Name 5 sites from which tumor cells metastasize to the brain.
- 1. Lung 2. Breast 3. Skin (melanoma) 4. Kidney (renal cell carcinoma) 5. GI
- Name a common histopathological sign of basal cell carcinoma nuclei
- The nuclei of basal cell tumors have 'palisading' nuclei
- Name a population at a greater risk for melanoma.
- Fair-skinned people (blue eyes and red hair have also been considered as factors)
- Name the 5 primary tumors that metastasize to the liver
- 1. Colon 2. Stomach 3. Pancreas 4. Breast 5. Lung
- Name two of the most common sites of metastasis after the regional lymph nodes
- The liver and the lung
- Name two presenting sequelae of a pituitary adenoma.
- 1. Bitemporal hemianopsia (due to pressure on the optic chiasm) 2. Hypopituitarism
- On which chromosome is the p53 gene located?
- 17p
- On which chromosome is the Rb gene located?
- 13q
- On which chromosomes are the BRCA genes located?
- BRCA 1 is on 17q and BRCA 2 is on 13q
- Out of the 6 primary tumors that metastasize to bone, which two are the most common?
- Metastasis from the breast and prostate are the most common
- What 2 cancers are associated with EBV?
- 1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma
- What 2 neoplasms are associated with AIDS?
- 1. Aggressive malignant lymphomas (non-Hodgkins) 2. Kaposi's sarcoma
- What 2 tumors are associated with Autoimmune disease (e.g. Hashimoto's thyroiditis, myasthenia gravis, etc.)?
- Benign and malignant thymomas
- What 2 neoplasms are associated with Paget's disease of bone?
- 1. Secondary osteosarcoma 2. Fibrosarcoma
- What 2 neoplasms are associated with facial angiofibroma, seizures, and mental retardation?
- Tuberous sclerosis 1. Astrocytoma 2. Cardiac rhabdomyoma
- What are 2 characteristic findings in carcinoma in situ?
- 1. Neoplastic cells have not invaded the basement membrane 2. High nuclear:cytoplasmic ratio and clumped chromatin
- What are 2 characteristic findings of an invasive carcinoma?
- 1. Cells have invaded the basement membrane using collagenases and hydrolases 2. Able to metastasize if they reach blood or lymphatic vessels.
- What are 2 neoplasms associated with Xeroderma pigmentosum?
- 1. Squamous cell carcinoma of the skin 2. Basal cell carcinoma of the skin
- What are 3 disease findings associated with Alkaline Phosphatase?
- 1. Metastases to bone 2. Obstructive biliary disease 3. Paget's disease of bone
- What are 6 primary tumors that metastasize to bone?
- 1. Breast 2. Prostate 3. Kidney 4. Lung 5. Testes 6. Thyroid
- What are a common histopathological finding of meningiomas?
- Psammoma bodies. These are spindle cells concentrically arranged in a whorled pattern.
- What are ependymomas?
- Ependymal cell tumors most commonly found in the 4th ventricle. May cause hydrocephalus
- What are the steps in the progression of neoplasia?
- 1. Normal 2. Hyperplasia 3. Carcinoma In Situ/Preinvasive 4. Invasion
- What are two signs of bone metastases in prostatic adenocarcinoma?
- Alkaline phosphatase & PSA (prostate-specific antigen) Elevations in serum
- What are two useful tumor markers in prostatic adenocarcinoma?
- Prostatic acid phosphatase and prostate-specific antigen (PSA)
- What can be associated with the risk of melanoma?
- Sun exposure
- What cancer is associated with HBV and HCV (Hep B and C viruses)?
- Hepatocellular carcinoma
- What cancer is associated with HHV-8?
- Kaposi's carcinoma Kaposi's sarcoma-associated herpes virus KSHV
- What cancer is associated with the HTLV-1 virus?
- Adult T-cell leukemia
- What cancers are commonly associated with HPV (human papilloma virus)?
- Cervical carcinoma, penile, and anal carcinoma
- What causes the local effect of a mass?
- Tissue lump or tumor
- What causes the local effect of a nonhealing ulcer?
- Destruction of epithelial surfaces (e.g. stomach, colon, mouth, bronchus)
- What causes the local effect of a space-occupying lesion?
- -Raised ICP w/ brain neoplasms. -Anemia w/ bone marrow replacement. -CN deficits w/ compression
- What causes the local effect of bone destruction?
- Pathologic fracture or collapse of bone
- What causes the local effect of edema?
- Venous or lymphatic obstruction
- What causes the local effect of hemorrhage?
- Caused by ulcerated area or eroded vessel
- What causes the local effect of inflammation of a serosal surface?
- Pleural effusion, pericardial effusion, or ascites
- What causes the local effect of obstruction in the biliary tree?
- Jaundice
- What causes the local effect of obstruction in the bronchus?
- Pneumonia
- What causes the local effect of obstruction in the left colon?
- Constipation
- What causes the local effect of pain?
- Any site with sensory nerve endings. Remember that tumors in the brain are usually painless.
- What causes the local effect of perforation of an ulcer in the viscera?
- Peritonitis or free air
- What causes the local effect of seizures?
- Tumor mass in the brain.
- What causes the localized loss of sensory or motor function?
- Compression or destruction of nerve (e.g. recurrent laryngeal nerve by lung or thyroid cancer causes hoarseness)
- What causes the paraneoplastic effect gout?
- Hyperuricemia due excess nucleic acid turnover (secondary to cytotoxic therapy of various neoplasms)
- What causes the paraneoplastic effect of Cushing's disease?
- ACTH or ACTH-like peptide (secondary to small cell lung carcinoma)
- What causes the paraneoplastic effect of hypercalcemia?
- PTH-related peptide, TGF-a, TNF-a, IL-2 (secondary to squamous cell lung carcinoma, renal cell carcinoma, breast carcinoma, multiple myeloma, and bone metastasis)
- What causes the paraneoplastic effect of Lambert-Eaton syndrome?
- Antibodies against presynaptic Ca2+ channels at NMJ (Thymoma, bronchogenic carcinoma)
- What causes the paraneoplastic effect of Polycythemia?
- Erythropoietin (secondary to renal cell carcinoma)
- What causes the paraneoplastic effect of SIADH?
- ADH or ANP (secondary to small cell lung carcinoma and intracranial neoplasms)
- What chemical carcinogen is commonly associated with the centrilobar necrosis and fatty acid change?
- CCL4
- What chemical carcinogen is commonly associated with the esophagus and stomach?
- Nitrosamines
- What chemical carcinogen is commonly associated with the lungs?
- Asbestos (Causes mesothelioma and bronchogenic carcinoma)
- What chemical carcinogen is commonly associated with the skin (squamous cell)?
- Arsenic
- What chemical carcinogen(s) are commonly associated with the liver?
- Aflatoxins and vinyl chloride
- What is a chondrosarcoma?
- Malignant cartilaginous tumor.
- What is a common genetic finding in Ewing's sarcoma?
- 11;22 translocation
- What is a common gross pathological sign seen in Ewing's sarcoma?
- Characteristic 'onion-skin' appearance of bone
- What is a common origin of a chondrosarcoma?
- May be of primary origin or from osteochondroma
- What is a common sign found on the x-ray of a person with osteosarcoma?
- Codman's triangle (from elevation of periosteum)
- What is a craniopharyngioma?
- Benign childhood tumor. Often confused with pituitary adenoma because both can cause bitemporal hemianopsia. Calcification of the tumor is common.
- What is a Ewing's sarcoma?
- Anaplastic small cell malignant tumor.
- What is a giant cell tumor?
- Locally aggressive benign tumor around the distal femur, proximal tibial region.
- What is a gross pathological sign of basal cell carcinoma?
- Pearly papules
- What is a helpful mnemonic to remember the neoplasm associated with Down's Syndrome?
- We ALL go DOWN together.
- What is a helpful mnemonic to remember the site of metastasis to the brain?
- Lots of Bad Stuff Kills Glia
- What is a helpful mnemonic to remember the types of cancer that metastasize to the liver?
- Cancer Sometimes Penetrates Benign Liver
- What is a helpful mnemonic to remember what tumors metastasize to bone?
- BLT with a Kosher Pickle
- What is a Hemangioblastoma?
- Most often a cerebellar tumor. Associated with von Hippel Lindau syndrome when found with retinoblastoma.
- What is a low-grade astrocytoma?
- Diffusely infiltrating glioma. In children, it is most commonly found in the posterior fossa.
- What is a medulloblastoma?
- Highly malignant cerebellar tumor. A form of primitive neuroectodermal tumor (PNET). Can compress 4th ventricle causing hydrocephalus