Gold Path

Mobitz I

Usually due to inferior MI. Rarely goes into 3rd degree block. Txt w/ Atropine or Isoproterenol.

 Mobitz II

BBB association. Often goes to 3rd degree AV block. Usually due to anterior MI.

 a wave

 LA contraction

 Wavy fibers

 Eosinophilic bands of necrotic myocytes. Early sign of MI.

 Serous Pericarditis

Associated w/ nonbacterial; viral (Coxsackie) infection; immunologic reaction.

 Hemorrhagic Pericarditis

 Associated w/ TB or neoplasm

 Restrictive Cardiomyopathy

Aka infiltrative cardiomyopathy that stiffens the heart Due to amyloidosis in the elderly Due to , also see schaumann & asteroid bodies in young (<25 yoa).

 Crescentic GN

Rapidly progressive GN - nephritic syndrome Associated w/ multi system disease or poststrep/post infectious glomerular nephritis

 Membranoproliferative GN

Can be secondary to complement deficiency; chronic infections; CLL See tram tracking

 Type I MembranoProliferative GN deposits

 C3 & IgG deposits

 Type II MembranoProliferative GN deposits

Only C3 deposits Aka Dense deposit disease

 Focal segmental glomerulosclerosis deposits

 IgM & C3 deposits

 Cold agglutinins

Seen in atypical pneumonia It is IgM Ab with specificity for I Ag on adult RBCs

 Scrofula

 TB in the lymph nodes

 Aspirin-Asthma Triad

 Nasal polyps - Rhinitis - bronchoconstriction

 Cloudy swelling

Failure of cellular Na pump Seen in Fatty degeneration of the liver and in Hydropic (Vacuolar) degeneration of the liver

 Hydropic degeneration

Severe form of cloudy swelling Seen with hypokalemia induced by vomitting/diarrhea

 Retinoblastoma

 Chromosome 13

 Wilms tumor of the kidney

 Chromosome 11p

 Agent Orange

Contains dioxin Implicated as a cause of Hodgkin;s disease, non-Hodgkins lymphoma & soft tissue sarcomas

 Ochronosis

Alkaptonuria Error in tyrosine metabolism due to Homogentisic acid (oxidizes tyrosine) Involving intervertebral disks = Ankylosing Spondilitis = Poker spine See dark urine; dark coloration of sclera, tendons, cartilage

 Warthin-Finkeledy cells

Reticuloendothelial giant cells on tonsils, lymph nodes, spleen Seen with Rubeola (measles) due to paramyxovirus

 Subacute Bacterial Endocarditis

 Hemolytic Streptococci (S. viridans) = usually in pt w/ pre-existing heart problem

 Acute Bacterial Endocarditis

Staph aureus, Hemolytic Streptococci, E. coli Common among drug addicts & diabetics

 Mitral Insufficiency

 Ruptured papillary muscle

 Left Anterior Descending branch

Branch of the Left Coronary artery Highest frequency of thrombotic occlusion MI = anterior wall of the LV, especially in apical part of interventricular septum

 Left Circumflex branch

Branch of the Left Coronary artery Occlusion = MI of posterior/lateral wall of the LV

 Bronchopneumonia

Lobular (rather than lobar) Due to Staph aureus; Pseudomonas aeruginosa; Klebsiella; E. coli Abscess formation is common

 Lobar pneumonia

Due to Strep. Pneumoniae infection (5% due to Klebsiella) Red Hepatization: days 1-3 of the pneumonia Gray Hepatization: days 3-8 of untreated pneumonia Complicaitons: pleural effusion; atelectasia; fibrinous pleuritis; empyema; fibrinous pericarditis; otitis media

 Panlobular Emphysema

 1 - antitrypsin deficiency, causing elastase Increased = Increased compliance in the lung

 Farmers Lung

 Due to Micropolyspora faeni (thermophilic actinomycetes)

 Bagassosis

Due to M. vulgaris (actinomycetes) Inhalation of sugar cane dust

 Silo-Fillers Lung

 Due to Nitrogen dioxide from nitrates in corn

 Scirrhous Carcinoma

 Infiltrating Duct Carcinoma w/ fibrosis - most common type of breast carcinoma

 Hofbauer Cells

 Lipid laden macrophages seen in villi of Erythroblastosis Fetalis

 IgA deficiency

Pt has recurrent infections & diarrhea w/ Increased respiratory tract allergy & autoimmune diseases If given blood w/ IgA = develop severe, fatal anaphylaxis reaction

 LDH1 & LDH2

 Myocardium. LDH1 higher than LDH2 = Myocardial Infarction

 LDH3

 Lung tissue

 LDH4 & LDH5

 Liver cells

 Keratomalacia

 Severe Vit A deficiency. See Bitots spots in the eyes = gray plaques = thickened, keratinized ET

 Metabisfite Test

Suspending RBCs in a low O2 content solution Can detect Hemoglobin S, which sickles in low O2

 Microangiopathic Hemolytic Anemia

Can be due to Hemolyitc Uremic Syndrome & Thrombotic Thrombocytopenic Purpura (TTP) See Helmet cells

 Focal Segmental GN exs

 IgA Focal GN = Bergers disease; SLE; PAN; SchonleinHenoch purpura (anaphylactoid purpura)

 Nephrotic Syndrome exs

 Focal (Segmental) GN; Membranous GN; Lipoid (Minimal Change) GN; Membranoproliferative GN; Hep B; Syphilis; Penicillamine

 Hypertensive Hemorrhage

Predilection for lenticulostriate arteries = putamen & internal capsule hemorrhages

 Chronic Cold Agglutinaiton

Associated w/lymphoid neoplasms. See agglutination & hemolysis in tissue exposed to cold. IgM Abs

 Acidophils

Mammotrophs = Prolactin Somatotrophs = GH

 Basophils

Thyrotrophs = TSH Gonadotrophs = LH Corticotrophs = ACTH & FSH

 Vasoconstriction

 TxA2; LTC4; LTD4; LTE4; PAF

 Vasodilation

 PGI2; PGD2; PGE2; PGF2; Bradykinin; PAF

 Increased Vascular Permeability:

 Hist.; 5HT; PGD2; PGE2; PGF2; LTC4; LTD4; LTE4; Bradykinin; PAF

 Platelet Aggregation

ADP; Thrombin; TxA2; collagen; Epinephrine; PAF

 Platelet Antagonist

 Prostacyclin (PGI2)

 Hurlers

 Lysosomal storage disease L Iduronidase Heparan/Dermatan Sulfate accumulation

 Galactosemia

 Deficiency of Galactose 1 Phosphate Uridyl Transferase. Increased Galactose 1 Phosphate

 Autosomal Dominant Diseases

 Adult Poly Cystic Kidney Disease Familial Hypercholestrolemia Disease Hereditary Hemorrhagic Telengectasia (Osler-Weber-Rendu) Hereditary Spherocytosis Huntingtons Disease (chromosome 4p) Marfans Syndrome Neurofibromatosis (von Recklinghausens) Tuberous Sclerosis Von Hippel Lindau Disease

 Autosomal Recessive Diseases

 Tay-Sachs Gauchers Niemann-Pick Hurlers Von Gierkes Pompes Coris McArdles Galactosemia PKU Alcaptonuria

 X Linked Recessive Diseases

 Hunters Syndrome (L-Iduronosulfate Sulfatase deficincy, Increased Heparan/Dermatan Sulfate) Fabrys Disease ( Galactosidase A deficiency, Increased Ceremide Trihexoside) Classic Hemophilia A (Factor VIII deficiency, F8 Gene on X chromosome is bad, Increased Ceremide Trihexoside) Lisch-Nyhan Syndrome (HGPRT deficiency, Increased Uric acid) G6Phosphatase deficiency (G6PDH deficiency, Increased Ceremide trihexoside) Duchennes Muscular Dystrophy (Dystrophin deficinecy, Increased Ceremide Trihexoside)

 Lung Development

Glandular: 5-17 fetal weeks Canalicular 13-25 fetal weeks Terminal Sac 24 weeks to birth Alveolar period birth-8yoa

 Hearts 1st Beat

 21-22 days

 Type I Error

 : Convicting the innocent - accepting experimental hypothesis/rejecting null hypothesis

 Type II Error

 : Setting the guilty free - fail to reject the null hypotesis when it was false

 Power

1 -

 1st Branchial Arch

 Meckels cartillage gives rise to incus/malleus bones of ear

 2nd Branchial Arch

Reicherts cartillage gives rise to stapes bone of ear

 (-) Na+ Pump (ATPase)

Ouabain [(-) K+ pump] Vanadate [(-) phosphorylation] Digoxin [Increased heart contractility]

 (+) Frei Test

Chlamydia trachomatis types L1, L2, L3 = Lymphogranuloma venereum

 3p

 Von Hippel Lindau, Renal Cell CA

 5p

 Familial adenomatous polyposis, Colon CA

 11p

 Wilms tumor

 13q

 Retinoblastoma, Osteosarcoma

 13q

 Breast CA , BRCA-2

 17p

 P53

Most human Cas

 17q

 NF-1 Neurofibromatosis type 1 BRCA-1 -Breast CA, Ovarian CA

 18q

 DCC - Colon & Stomach CA DPC - Pancreatic CA

 22q

 NF-2 Neurofibromatosis type 2 = bilateral acoustic neuroma