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B2. PATH 1
Cushing's Syndrome Characteristics
More Common in Women
Exogenous Etiologies
Glucocorticoids
Endogenous Etiologies
Decreased ACTH
Primary Adrenal Disease
Increased ACTH
Pituitary Adenoma (Cushing's Disease)
Paraneoplastic: Small Cell Carcinoma
CRF-releasing Tumors
2 mins
Cushing's Syndrome Symptoms And Diagnosis
Symptoms/Findings
Osteoporosis
Amenorrhea
Truncal Obesity
Skin Changes
Buffalo Hump
Immune Suppression
Moon Facies
Hypertension
Decreased Insulin Sensitivity
Diagnosis
24-hour urine free Cortisol
Dexamethasone Suppression Test
2 mins
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Pathophysiology
Hypersecretion of ADH
Increased Sensitivity to ADH
Signs & Symptoms
Serum Hypoosmolality
Coma and Seizure
Dilutional Hyponatremia
Cramps and Tremors
Euvolemia
Change in LOC
2 mins
Acanthosis Nigricans
Associations
Endocrine Disorders
Diabetes Mellitus
Obesity
Malignancy
Presentation
Velvety Plaques
Dark, Thickened Flexural Areas
Diagnosis
Hyperkeratosis with Melanocytes
Treatment
Treat Underlying Disorder
2 mins
Adult T Cell Lymphoma
Caused by HTLV 1
Japan, West Africa, Caribbean
Present with cutaneous lesions
Aggressive
1 min
Human Papillomavirus (HPV)
Characteristics
Non-enveloped
Circular
Double Stranded DNA
Disease
Warts 1, 2, 6, 11
Condyloma acuminata
Type 16, 18
Cervical Carcinoma
Penile Carcinoma
AIDS/Immunocompromised
Worsened by Smoking
Diagnosis
Koilocytic change in squamous epithelium
Pyknotic Nuclei Surrounded by Clear Halo
Treatment
Vaccine Available
4 mins
Infectious Mononucleosis
Mechanism
Herpes-like Viral Infection
Signs and Symptoms
Fatigue
Fever
Sore Throat
Head and Body Aches
Hepatomegaly and Splenomegaly
Swollen Lymph Nodes in Neck and Armpits
Rash
Considerations
Suppressed Immune Response
Positive Monospot
2 mins
Epstein Barr Virus
Characteristics
Herpesvirus 4
Double Stranded DNA
Linear
Enveloped
Signs and Symptoms
Infectious Mononucleosis
Virus Attaches to CD21 in B Cells
Nasopharyngeal Carcinoma
Burkitt's Lymphoma
Hodgkin's Lymphoma
1 min
Epstein Barr Virus Mononucleosis
Mononucleosis
Fever
Hepatomegaly
Splenomegaly
Pharyngitis
Posterior Cervical Lymphadenopathy
Atypical Lymphocytes
Heterophile Antibodies
Rash Develops if treated with Ampicillin
Hodgkin's Lymphoma
2 mins
Burkitt's Lymphoma
Adolescents or young adults
C-myc gene moves next to heavy chain Ig gene
T 8;14
Starry sky appearance
Sheets of lymphocytes with interspersed macrophages
Jaw lesion in endemic (African) form
Pelvis or abdomen in non endemic form (American form)
Associated with EBV
2 mins
Hepatitis B Virus Disease
Can turn chronic
< 10% of adults become chronic carriers
90% of newborns become chronic carriers
Cirrhosis
Hepatocellular carcinoma
Membranous Glomerulonephritis
Polyarteritis nodosa
Serum sickness like syndrome
2 mins
Hepatitis C (HCV) Assessment
Transmission
Blood Transmission
High Risk Sex (rare)
IV Drug Users
Incubation
7 Weeks
Chronic Disease
Cirrhosis
Considerations
Barrier Protection
2 mins
Hepatitis B (HBV) Assessment
Transmission
Bodily Fluids
Blood Transmission
People Who Use IV Drugs
Incubation
Variable 1-6 Months
Assessment
Fever
Nausea and Vomiting
Hepatomegaly
Chronic Disease
Cirrhosis
Hepatocellular Carcinoma
Considerations
Vaccination
2 mins
Basal Cell Carcinoma of the Skin
Pathophysiology
Most Common Skin Cancer
2/3 of Cases Due to UV Light Exposure
Pink, Pearl-like Lesions
Rolled Borders
Telangiectasias
Commonly Upper Lip
Diagnosis
Shave Biopsy
Pallisading Nuclei
Treatment
Mohs Micrographic Surgery
2 mins
Squamous Cell Carcinoma of the Skin
Epidemiology
2nd Most Common Skin Cancer
UV Light Exposure
Long-term Immunosuppression
Arsenic Exposure
Signs/Symptoms
Ulcerative Red Lesion
Precursor Actinic Keratosis
Commonly Lower Lip
Diagnosis
Biopsy shows Keratin Pearls
Treatment
Mohs Micrographic Surgery
2 mins
Acute Myelogenous Leukemia (AML)
Myeloblasts Increase on Peripheral Smear
Median Onset 60 Years
T 15;17 M3 Subtype
Auer Rods
Disseminated Intravascular Coagulation (DIC) is a Common Presentation
M5 Gum Infiltration
Responds to Vitamin A
3 mins
Hodgkin Lymphoma Signs & Symptoms
Signs and Symptoms
Localized Single Group of Lymph Nodes
Contiguous Spread
Constitutional B Symptoms
Low-Grade Fever
Night Sweats
Weight Loss
2 mins
Hodgkin Lymphoma Pathophysiology
Pathophysiology
Reed-Sternberg Cells
Binucleate
Owl's Eyes Appearance
CD 15 and CD 30
B Cell Origin
Bimodal Age Distribution
2 mins
Melanoma Mechanism and Characteristics
Mechanism
Associated with Sunlight Exposure
Mutation in B-RAF kinase
Large Number of Moles
Fair-Skinned People at Higher Risk
Growth Phases
Radial Growth Phase
No Metastasis
Vertical Growth Phase
Depth of Tumor Correlates with Risk of Metastasis
1 min
Chronic Myelogenous Leukemia (CML)
Pathophysiology
BCR-ABL
9;22 Translocation
Philadelphia Chromosome
Signs & Symptoms
Tyrosine Kinase
Low Alkaline Phosphatase
Splenomegaly
Considerations
Blast Crisis
Age 30 to 90 Years
Responds to Imatinib
3 mins
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