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Pathology 245Pathology 245--248248
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Asbestosis Asbestosis
Increased risk of Mesothelioma & BrochogenicIncreased risk of Mesothelioma & Brochogenic
CancerCancer
Asbestosis & Smoking = Increased risk of Asbestosis & Smoking = Increased risk of Bronchogenic CancerBronchogenic Cancer
Ferruginous bodiesFerruginous bodies
Ivory white pleural plaquesIvory white pleural plaques
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Neonatal R espirator y Distress Neonatal R espirator y Distress
SyndromeSyndrome
Surfactant deficiency Surfactant deficiency
Alveolar collapse Alveolar collapse Dx: lecithinDx: lecithin--toto--sphingomyelin ratio insphingomyelin ratio in
amniotic fluid (usually <1.5 in NRDS)amniotic fluid (usually <1.5 in NRDS)
Tx: steroids Tx: steroids ² ² before birth; artificial surfactantbefore birth; artificial surfactantfor infantfor infant
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K artagener·s SyndromeK artagener·s Syndrome
Immotile CiliaImmotile Cilia
Dynein arm defectDynein arm defect Infertility Infertility
Recurrent Sinusitis,Recurrent Sinusitis,
BronchiectasisBronchiectasis Associated with Situs Associated with Situs
InversusInversus
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Lung CancerLung Cancer
Leading Cause of Cancer deathLeading Cause of Cancer death
Dx: cough, hemoptysis, brochial obstruction,Dx: cough, hemoptysis, brochial obstruction,
wheezing, ´coinµ lesion on x wheezing, ´coinµ lesion on x--ray ray Bronchogenic CarcinomaBronchogenic Carcinoma
Carcinoid TumorCarcinoid Tumor
Metastases (Very common: Brain, Bone, Liver)Metastases (Very common: Brain, Bone, Liver)
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Lung CancerLung Cancer
SPHERESPHERE of Complicationsof Complications
SSuperior vena cava syndromeuperior vena cava syndrome
PPancoast·s tumorancoast·s tumor HHorner·s syndromeorner·s syndrome
EEndocrine (paraneoplastic)ndocrine (paraneoplastic)
R R ecurrent laryngeal symptom·securrent laryngeal symptom·s
EEffusions (pleural or pericardial)ffusions (pleural or pericardial)
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Brochogenic CarcinomaBrochogenic Carcinoma
Peripherally Peripherally
Adenocarcinoma (most common) Adenocarcinoma (most common)
Brochioalveolar Carcinoma (not related to smoking)Brochioalveolar Carcinoma (not related to smoking) Large Cell Carcinoma (undifferentiated)Large Cell Carcinoma (undifferentiated)
SSentrally entrally
SSquamous Cell Carcinomaquamous Cell Carcinoma
SSmall Cell Carcinoma ( mall Cell Carcinoma ( associated with ectopic hormone productionassociated with ectopic hormone production ) )
Both linked toBoth linked to SSmoking moking
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Adenocarcinoma = most Adenocarcinoma = most
common for women andcommon for women and
nonnon--smokers.smokers.
Small cell carcinoma =Small cell carcinoma =
neuroendocrine, cells lookneuroendocrine, cells look
like lymphocytes w/ biglike lymphocytes w/ bignucleinuclei
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Carcinoid TumorCarcinoid Tumor
Can cause carcinoid syndromeCan cause carcinoid syndrome
Flushing, diarrhea, wheezing, salivationFlushing, diarrhea, wheezing, salivation
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Pancoast TumorPancoast Tumor
Apex of Lung Apex of Lung
May cause Horner·s Syndrome (ptosis, myosis,May cause Horner·s Syndrome (ptosis, myosis,
anhidrosis)anhidrosis)
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PneumoniaPneumonia
Interstitial (Atypical)Interstitial (Atypical)
Viruses, Mycoplasma, Legionella, Chlamydia Viruses, Mycoplasma, Legionella, Chlamydia
Patchy, inflammation in interstial areas at alveolar wallsPatchy, inflammation in interstial areas at alveolar walls
BronchopneumoniaBronchopneumonia
S. aureus, H. flu., Klebsiella, S. pyogenesS. aureus, H. flu., Klebsiella, S. pyogenes
Patchy, inflammation into alveoliPatchy, inflammation into alveoli
L
obarL
obar Pnuemococcus most oftenPnuemococcus most often
ConsolidationConsolidation
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A lzheimer·s Disease A lzheimer·s Disease Most common cause of dementia in elderly Most common cause of dementia in elderly Plaques (BetaPlaques (Beta--amyloid core) & Neurofibrillary amyloid core) & Neurofibrillary
Tangles Tangles
May cause amyloid angiopathy (intracranialMay cause amyloid angiopathy (intracranialhemorrhage)hemorrhage)
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Pick ·s DiseasePick ·s Disease
Progressively degenerative neurological diseaseProgressively degenerative neurological disease with no known prevention, or cure with no known prevention, or cure
Pick Bodies (Intracytoplasmic inclusion bodies)Pick Bodies (Intracytoplasmic inclusion bodies)
Specific to Frontal and Temporal Lobes inSpecific to Frontal and Temporal Lobes inCerebral CortexCerebral Cortex
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Huntington·s DiseaseHuntington·s Disease
Atrophy of caudate nucleus Atrophy of caudate nucleus
Chorea & dementiaChorea & dementia
Autosomal Dominant Autosomal Dominant ² ²Chromosome 4Chromosome 4 Loss of GABAergic neuronsLoss of GABAergic neurons
Expansion of Expansion of C AGC AG repeatsrepeats
´́CCaudate losesaudate loses A A Ch andCh and GG ABAµ ABAµ
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Park inson·s DiseasePark inson·s Disease
TR A P TR A P (You are TRAPped in your Body)(You are TRAPped in your Body)
T Tremor at Restremor at Rest
R R igidity (Cogwheel)igidity (Cogwheel)
A A kinesiakinesia
PPostural instability ostural instability
Depigmentation of substantia nigraDepigmentation of substantia nigra Loss of dopaminergic neuronsLoss of dopaminergic neurons
Lewy BodiesLewy Bodies
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S pinocerebellar Motor NeuronS pinocerebellar Motor Neuron
Degenerative DiseasesDegenerative Diseases
Amyotrophic lateral sclerosis ( Lou Gehrig·s Amyotrophic lateral sclerosis ( Lou Gehrig·s
Disease)Disease)
Both Upper andL
ower motor neuron signsBoth Upper andL
ower motor neuron signs PolioPolio
Lower motor neuron signsLower motor neuron signs
Werdnig Werdnig--Hoffman DiseaseHoffman Disease Floppy baby at BirthFloppy baby at Birth
Tongue fasciculations Tongue fasciculations
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Intracranial HemorrhageIntracranial Hemorrhage
Epidural hematomaEpidural hematoma Middle meningeal artery rupture, lucid interval, ´biconvex diskµMiddle meningeal artery rupture, lucid interval, ´biconvex diskµ
Subdural hematomaSubdural hematoma
Rupture of bridging veins, delayed Sx, crescentRupture of bridging veins, delayed Sx, crescent--shapedshapedhemorrhagehemorrhage
Subarachnoid hemorrhageSubarachnoid hemorrhage Usually ruptured anuerysm or Arteriovenous Malformation,Usually ruptured anuerysm or Arteriovenous Malformation,
´worst headache of my lifeµ´worst headache of my lifeµ
Parenchymal hematomaParenchymal hematoma HTN, amyloid angiopathy, diabetes, tumorHTN, amyloid angiopathy, diabetes, tumor
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Berr y A neur ysmBerr y A neur ysm
Occur at the bifurcations in theOccur at the bifurcations in theCircle of WillisCircle of Willis
Most Common Complication =Most Common Complication =Rupture = subarachnoidRupture = subarachnoidhemorrhage/strokehemorrhage/stroke
Associated with polycystic Associated with polycystic
kidney disease, Ehler·skidney disease, Ehler·s--Danlos,Danlos,MarfansMarfans
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Multiple SclerosisMultiple Sclerosis
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Multiple SclerosisMultiple Sclerosis
MMyelinyelin SSheath destructionheath destruction
Periventricular plaques, preservation of axons,Periventricular plaques, preservation of axons,
loss of oligodendrocytes, increased IgG in CSFloss of oligodendrocytes, increased IgG in CSF Most often affects women in 20·s & 30·sMost often affects women in 20·s & 30·s
Classic Triad of MS is aClassic Triad of MS is a SINSIN
SScanning Speechcanning Speech IIntention Tremorntention Tremor
NNystagmusystagmus
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Demyelinating/dysmyelinatingDemyelinating/dysmyelinating
diseases diseases
Progressive multifocal leukoencephalopathy Progressive multifocal leukoencephalopathy
Associated with JC Virus, 2 Associated with JC Virus, 2--4% of AIDS patients4% of AIDS patients
Postinfectious encephalomyelitisPostinfectious encephalomyelitis
Metachromatic leukodystrophy Metachromatic leukodystrophy
A sphingolipidosis A sphingolipidosis
GuillainGuillain--Barre SyndromeBarre Syndrome
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GuillainGuillain--Barre SyndromeBarre Syndrome
GBS destroys the protective covering of theGBS destroys the protective covering of the
peripheral nerves (myelin sheath), disabling theperipheral nerves (myelin sheath), disabling the
nerves from transmitting signals to the muscles.nerves from transmitting signals to the muscles.
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GuillainGuillain--Barre SyndromeBarre Syndrome
MMotor effect isotor effect is MMore severe than Sensory ore severe than Sensory
Symmetric ascending muscle weaknessSymmetric ascending muscle weakness
Possible facial facial diplegia & autonomicPossible facial facial diplegia & autonomicdysfunctiondysfunction
Associated with infections, inoculations & stress Associated with infections, inoculations & stress
Dx: increased CSF protein with normal cell count,Dx: increased CSF protein with normal cell count,papilledemapapilledema
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PoliomyelitisPoliomyelitis
Poliovirus (fecalPoliovirus (fecal--oral)oral)
Destroys anterior horn cellsDestroys anterior horn cells Sx: H/A, fever, Ab pain, sore throat, LMNSx: H/A, fever, Ab pain, sore throat, LMN
lesions (muscle weakness & atrophy,lesions (muscle weakness & atrophy,
fasciculations, fibrillation, hyporeflexiafasciculations, fibrillation, hyporeflexia ) )
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SeizuresSeizures
Epilepsy = disorder of recurrent seizuresEpilepsy = disorder of recurrent seizures
Causes: genetic, infection, metabolic, tumors,Causes: genetic, infection, metabolic, tumors,trauma, stoketrauma, stoke
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SeizuresSeizures
Partial Siezures = 1 area of BrainPartial Siezures = 1 area of Brain
Simple PartialSimple Partial -- awareaware
ComplexP
artialComplexP
artial ² ² impaired awarenessimpaired awareness Generalized Siezures = diffuseGeneralized Siezures = diffuse
Absence Absence ² ² blank stareblank stare
MyoclonicMyoclonic ² ² quick, repetitive jerksquick, repetitive jerks
Tonic Tonic--clonicclonic ² ² altering of stiffness & mov·taltering of stiffness & mov·t
Atonic Atonic ² ² ´drop seizuresµ´drop seizuresµ
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Aphasia Aphasia
Broca·sBroca·s Expressive = nonfluent, intact comprehensionExpressive = nonfluent, intact comprehension
Broca·s area = inferior frontal gyrusBroca·s area = inferior frontal gyrus
Wernicke·s Wernicke·s Receptive = fluent, impaired comprehensionReceptive = fluent, impaired comprehension
Wernicke·s area = superior temporal gyrus Wernicke·s area = superior temporal gyrus
BroBroca·s isca·s is BroBroken speech;ken speech; W Wernicke·s isernicke·s is W Wordy butordy butmakes no sensemakes no sense
W Wernicke·s = ´ernicke·s = ́W What?µhat?µ
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