Untitled Quiz

Infectious Leukocytosis

• This condition is caused by neutrophils
• Neutrophil count exceeds 65%
• Bands (bi-lobed neutrophils) are always present
• Bacterial infection is the cause for the increase in WBC count

Acute Lymphoblastic Leukemia

• Exclusively affects children and never occurs above 50 years old
• Symptoms include fever, cough, shortness of breath, and lung infection, followed by anemia with a hemoglobin level less than 10, and a platelet count less than 50,000
• High WBC count with blasts
• Cells display large nuclei and scanty cytoplasm
• TdT and CD10 are diagnostic features
• It metastasizes in the brain and testes
• Patients with Down syndrome and hyperdiploidy, translocation between 1(12;21) generally have a good prognosis
• A poor prognosis is associated with t(9,22)

Chronic Lymphoblastic Leukemia

• It leads to weakness, tiredness, and anemia
• There is a history of infection, autoantibodies, and jaundice, it typically affects those above 60 years old
• Signs include bleeding symptoms, lack of hemoglobin, thrombocytopenia, and low blast count
• Smudge cells, which have an irregular border without a nucleus, are present
• This condition never occurs below the age of 60

Follicular Lymphoma

• Most commonly affects middle-aged women with a mass growing around the neck, cervical, or clavicular area of the body
• It features waxing and waning painless lumps with no interfollicular zone
• BCL-2's inhabitation of apoptosis is the cause, specifically due to t(14,18)

Waldenstrom Macroglobulinemia

• Mainly diagnosed in elderly individuals or those with a history of stroke
• Recurrent thrombotic events, increased immunoglobulins, and increased gamma globulins (IgM) are present
• Lytic lesions and back pain are absent, with normal calcium and creatine levels with no renal symptoms

Multiple Myeloma

• Presents with renal pain/symptoms, bone lesions, hypercalcemia, headaches, and back pain
• Lytic lesions are visible, creatinine is increased, and there are 3+ urine proteins
• Nephrotic syndrome (protein loss) with a negative dipstick, is present alongside edema
• It is caused by immunoglobulins and the monoclonal spike is IgG
• Patients typically have a history of fractures
• It is a plasma cell neoplasm
• Heart problems can arise due to amyloidosis and an increase in lambda chains, leading to congestive cardiac failure

Burkitt's Lymphoma

• Typically diagnosed in patients who have migrated from Africa with high fever and jaw swelling
• B cells and macrophages, exhibiting a "starry sky appearance" are visible
• C-MYC t(8,14) increases MYC proteins, with tyrosine kinase upregulation
• Virus = EBV is the cause

Acute Myeloid Leukemia

• Auer rods are present in the smear
• Signs of infection, fever, thrombocytopenia, and low hemoglobin are also present
• This leads to acute promyelocytic leukemia t(15,17) with bleeding
• PT and PTT times are prolonged, and WBC levels are elevated, indicating DIC
• Benzene is typically the main cause and is treated with vitamin A

Chronic Myelogenous Leukemia

• WBC count stays above normal but blasts are 1-2%
• Large cytoplasm myelocytes and metamyelocytes, elderly patients are present
• A BCR-ABL gene mutation (Philadelphia chromosome), and intracytoplasmic tyrosine kinase lead to t(9,22), and thrombocytopenia

Myelofibrosis

• Causes weakness, tiredness, petechial hemorrhages, low platelet count, low hemoglobin, and a decrease in WBC count
• Teardrop cells are present and the JAK mutation is the cause
• This is differentiated from aplastic anemia by the presence of fat instead of teardrop cells

Langerhans Cell Histiocytosis

• Causes recurrent headaches, scalp rash, excessive thirst, and urination
• High calcium levels, lytic lesions, skin rash history, and recurrent ear infections are observed
• Diagnosis involves identifying Birbeck granules, S-100, and CD1a markers

Tumor Lysis Syndrome

• It affects patients diagnosed with Burkitt's lymphoma and undergoing chemotherapy, typically after 2 days
• Unable to pass urine, creatinine levels are generally low
• It causes hyperuricemia (excess uric acid), hypocalcemia, and hyperkalemia that causes arrhythmia

Transplant Rejection

• History of renal transplant and low urine output is less than 200mL
• Renal failure presents with high creatinine levels
• Preformed IgE antibodies attack endothelial cells, causing type II HSR, fibrinoid necrosis, and thrombus in all BVs- leading to organ malfunction
• Primarily occurs after 1-2 months
• Option 1 is cell-mediated by CD4 cells, mainly Th2, and Option 2 is antibody-mediated

CREST Syndrome

• Includes limited and systemic forms
• Patients are unable to grip with their hands
• Signs include pale discoloration, calcifications and difficulty swallowing solid foods
• CD4 T cells, mainly Th1, produce fibrous tissue in the ECM
• Primarily diagnosed in women over 50 years

Scleroderma

• A systemic generalized condition
• Exhibits similar symptoms in addition to shortness of breath and creatinine

SLE

• Mainly diagnosed in women
• Includes photosensitive rash on the face, fever, and joint pains, along with blood in the urine
• Characterized by Anti-ds DNA antibodies and Anti-smith antibodies
• If the patient has history of hypertension, and is pregnant and presents with a malar rash and joint paints (drug induced - hydralazine) this will give give Anti-Histone antibodies
• Renal symptoms are absent with drug induced lupus

SCID

• It is X-linked and autosomal recessive
• Children typically develop recurrent lung infections with rashes and oral or skin candida
• Pneumocystis is observed in upper part of the mediastinum without a thymus shadow
• If the child is male, it is X-linked (IL-7 or IL-2)
• If the child is female, it is autosomal recessive (adenosine deaminase deficiency)
• Manifests immediately after birth where anything after 6 months = not SCID
• No heart problems are observed

X-linked Agammaglobulinemia

• Emerges after 8 months
• Symptoms include coughing and shortness of breath
• Lymph nodes are impalpable due to lacking germinal centers and B cells
• Recurrent bacterial infections in male children with normal calcium levels occur
• It is caused by a lack of intracytoplasmic tyrosine kinase (Bruton kinase) Btk

DiGeorge Syndrome

• Features include lack of a parathyroid gland, leading to low calcium levels and occurs before 6 months
• Presents with recurrent infections, absent thymus, heart problems,
• It correlates with chromosome 22q11 deletion and TXB1 gene deletion

Wiskott-Aldrich Syndrome

• Consists of eczema, low platelet count (without petechial hemorrhages), and recurrent infections.
• Serum IgM levels are low with IgG usually normal
• It involves a WASP protein mutation located on 11.23 and a loss of T lymphocytes in peripheral blood

Colon Cancer

• The primary cause of metastasis, often reaching the liver
• Involves Type IV collagenase or Matrix Metalloproteinases that degrades the BM

Liver Cancer

• It forms only in the liver, either from hepatocytes or epithelial cells
• Alpha fetoprotein is normal, implying growth from epithelial cells (Polyvinyl Chloride)
• Alpha feto-protein is elevated, implying growth from hepatocytes - Aflatoxin

Cervical Cancer

• Characterized by irregular spotting or post-coital bleeding
• Commonly associated with HPV 16 and 18

Gastric Cancer

• It presents with a history of smoking, abdominal pain, weight loss, and decreased appetite
• Nitrosamines are the primary cause of developing the disease
• Supraclavicular lymphadenopathy (Virchow’s node)

Poisoning Hydrocarbons Aniline Dyes

• Exposure through the dye or printing industry
• Symptoms include blood in the urine and a mass in the bladder
• It leads to transitional cell carcinoma, caused by aniline dyes (naphthylamine)

Colon Cancer

• APC gene mutation needs to acquire a KRAS mutation in order to become malignant.
• TP53 mutation is triggered if there is metastasis
• Left-Sided colon cancer includes:
  • Occurs in patients above 60 years of age
  • Villous adenomas - Polyp without a stalk
  • Multipe polyps

Lynch Syndrome (HNPCC)

• Diagnosed in young patients with right-sided colon cancer with Microsatellite instability
• Characterized by MSH2 or MLH1 mutations
• Endometrial cancer can develop in females, and the condition runs in families

The Immediate Consequence of FAP1 Gene Inactivity

• Impacts cells that develop into cancer

Xeroderma Pigmentosum

• Related to sun exposed areas
• Presents a rash with fungating mass, squamous cell carcinoma
• Mainly prominent in young patients
• Mismatch repair mutation is a factor

Acanthosis Nigricans

• Includes dark discoloration around the neck that does not itch with no improvement from antifungal creams
• Gastric cancer is the primary cause

TP53

• Multiple cancers occur in one family or individual

Carcinoma of the Breast

• There is a lump in the breast, with a maternal diagnosis of ovarian cancer (BRCA 1)
• If cancer is with 2 siblings, it is BRCA2
• HER2 causes faster patient deterioration

Neurofibromatosis Type 2

• Involves headaches, difficulty seeing, hearing loss, and a mass in the head, blurring vision
• Can also involve Meningioma or schwannoma diagnosis (psammoma bodies - concentric calcifications) along with Merlin mutation
• Usually only occurs in the brain

Lambert Eaton

• Presents with difficulty rising or walking that improves with movement
• Associated with small cell carcinoma of the lung
• Calcium imbalance, only related with hypercalcemia

Osteoarthropathy

• Includes both elevation of periosteum and adenocarcinoma of lung
• Pain is in joint of person with this ailment

Retinoblastoma

• Autosomal dominant, and 50% will develop it
• Tumor grows in eye. Family history of osteosarcoma are present

Polycythemia Vera

• Elderly patient suffering burning in feet and itching, mainly while showering
• includes increased production of RBCs (JAK2 mutation)
• Hematocrit above 20
• Elevated WBC count, risk of venous thrombus in hepatic/mesenteric artery/vein
• Possible hepatomegaly and ascites

Iron Deficiency Anemia

• Patients include weakness and tiredness
• Presents with hypochromic (pale) microcytic RBCs with central pallor
• Young children may have parasites
• Women aged 40-50 may have menstruation periods while those 60+ have colon cancer
• Ferritin levels are low

Sequestration Crisis

• Occurs below age 3 and features hepatomegaly, hypovolemic, anemia, jaundice, and splenomegaly in the body
• OR possibly may be painful for those older (painful crisis) and Hb around or below 8
• Globin chain defect

Autoimmune Hemolytic Anemia

• Observed via history of jaundice and fatigue. Patient displays no pain, yet displays antibodies
• Autoimmune disorder brought upon from medication- (lupus IgG-induced)

Upper Respiratory Tract Infection

• It’s due to mycoplasma or Epstein-Barr virus (EBV)
• Cause may be through IgM antibodies

Immune Thrombocytopenic Purpura

• Characterized with bleeding and very low platelet count
• Irregular menstruation periods
• GP2B/3A

Thrombotic Thrombocytopenic Purpura

• Confusion, irritability, and high creatinine levels
• History includes confusion, irritability, high creatinine levels, hemoglobin levels around 8, and schistocytes
• ADAMTS13 is the source of this

Secondary Polycythemia

• Comes from high altitutde, and is more prevalent for those in the middle age range.
• Hemoglobin/Hematocrit levels are high

Pernicious Anemia

• Weakness and neurological defects related to anemia are present
• Antibodies react to B12 levels leading to weakness and potential issues such as not being able to walk

Check Later

• Occurs around 3-6
• All sickle cell patients don't have periods of sleep after 6 years

Aplastic Anemia

• Weakness, Platelet Low, Hemoglobin low
• May see fat cells in bone marrow assay

Hereditary Spherocytosis

• Is hereditary (no Coombs effect)
• Osmolality fragility test is required

Parvovirus B19

• Causes Jaundice from Low reticulocyte count

Hemolytic Uremic Syndrome

• Patients show history of diarrhoea and abdominal swelling
• Symptoms include neurological function problems, and E. coli infection

Von Willebrand

• Characterized by family history and swelling/bleeding
• PTT usually protrudes longer

Factor VII Deficiency

• High Bleeding time
• Joint Swelling and Pain
• Can be identified with Proconvertin

General Pathology of Burns

• Cytokines are formed and a loss of fluid and permeability is noted

Lead Poisoning

• Caused by metal (usually at manufacturing site)
• Patients may show basophilic, or weakness from neuropathy

Cystic Fibrosis

• Respiratory distress with issues passing stool- (Hirschsprung's)
• Chloride channels can be attributed to obstruction

Vitamin A (Hypervitaminosis)

• Display headache with vomiting and lumbar problems
• CT scan is normal

High Glucose Levels

• Caused from the hormones Leptin and PYY- increasing weight in patients
• GLP and PYY help feel full

Malnutrition

• Causes B100 protein and albumin levels to drop

Mucopolysaccharidosis

• Causes mental impairment. Patients will test positive with the detection of sulphate

Vitamin D deficiency

• Patients usually have bowing or bones and kidney problems
• Treated with Vitamin D

Neural Tube Defect

• Anencephaly often occurs with deficiency in folic acid

Carbon Monoxide/Hypoxia

• Respiratory or lung-related. Accumulates in bone marrow tissue

Fragile X

• Characterized by problems, often with mental impairments

Vitamin K Deficiency

• Baby problems- like bleeding and internal failure; Often within 2 weeks from child birth

Marfan Syndrome

• Vision Impairments (Myopia)
• Shortness of breath, usually tall

Erhler-Danlos Syndrome

• Easy-tear (stretched often or elastic)
• Bruising or poor function

Down Syndrome

• Causes defects of all kinds (both heart and lung)

Id target protein of anti apoptotic drug

• Hormone Withdtawal and Radiation
• There is a large tumor because of the tumor suppression
• BCL-2 levels drop and increases cell death

General Information to Necrosis

• Inability for blood to reach organs
• Cellular structure remains unchanged

Neurogenic Atrophy

• Nerve or fracture related
• Muscle weakness due to atrophy