Exam 4 Review Exam 4 Review Outline This

Exam 4 Review

Exam 4 Review Outline This review covers the following: • Nervous System • Female and Male Reproductive Systems • Endocrine System I’ll mention a few things about Developmental Pathology (also: check out the summary I posted on 12/7). I’ll leave skin for you to review at your leisure.

Nervous System Pathology

What does each of these cells do? • • • Neurons Astrocytes Oligodendrocytes Microglia Ependymal cells

1 2 If a patient had a blockage at 1, what would you call the resulting disorder? How about 2?

Middle cerebral artery area Anterior cerebral artery area Infarct at ACA/MCA watershed Posterior cerebral artery area Infarct at PCA/MCA watershed What is a watershed infarct?

Focal Cerebral Ischemia • What causes hemorrhagic (red) infarcts? • What causes ischemic (pale) infarcts? • What are transient ischemic attacks (TIAs)?

Thrombus Hemorrhagic (L) vs. ischemic (R) infarction

Traumatic Vascular Injury Name three kinds of intracranial hemorrhages. • Where does each occur? • What’s the typical clinical setting in each? • How fast does each one progress?

Tumors in the Brain Briefly describe features of tumors arising from: • glial cells • neurons • meningeal cells • nerve sheath cells

Multiple Sclerosis • • What is the basic problem in MS? What is the cause? How do patients present? What do you see in the brain?

Multiple sclerosis

Alzheimer Disease • What are the symptoms of Alzheimer disease? • What is the pathology in the brain?

Alzheimer disease: brain atrophy

Alzheimer disease: plaques (L) and tangles (R)

Parkinson Disease • What are the symptoms of Parkinson disease? • What is the underlying pathology in the brain?

Parkinson disease (R) : atrophy of substantia nigra

Parkinson disease: Lewy body

Michael J. Fox and Muhammad Ali

Huntington Disease • What are the symptoms of Huntingon disease? • What’s going on in the brain?

Read this story about Katharine and her family: http: //www. nytimes. com/2007/03/18/health/18 huntington. html

Amyotrophic Lateral Sclerosis • What are the symptoms of ALS? • What is the underlying pathology?

Steven Hawking

Female Reproductive System

Cervical Carcinoma • How common is it (now)? • What causes it? • What are the precursor lesions called?

Spectrum of cervical intraepithelial neoplasia (CIN)

Uterus • • What is endometriosis? What causes endometrial hyperplasia? What causes endometrial carcinoma? How dangerous is endometrial carcinoma?

Ovaries • What is the most common ovarian tumor? • What are the risk factors for ovarian carcinoma? • What are the symptoms of ovarian carcinoma?

Origin of Ovarian Tumors Surface epithelial tumors Germ cell tumors Sex cord-stromal tumors Cystadenoma • Cystadenocarcinoma • • Teratoma • Dysgerminoma • Yolk sac tumor • Choriocarcinoma • Granulosa-theca cell tumor • Sertoli-Leydig cell tumor

Breast • What is the most common cause of a breast lump? • What are the risk factors for breast carcinoma?

Most breast lumps are benign

Male Reproductive Pathology

Testis • What is the most common type of testicular carcinoma? • What is the prognosis?

Prostate • How does nodular hyperplasia typically present? • How does prostatic carcinoma typically present? • Why?

Endocrine Pathology

Pituitary Hyperpituitarism • Too much anterior pituitary hormone(s) (can you name them? ) • What is the most common cause? • How might the patient present? Hypopituitarism • Too little anterior pituitary hormone(s) • What are some causes?

Thyroid Hyperthyroidism • What are some symptoms? • What is the most common cause in the US? Hypothyroidism • What are some symptoms? • What is the most common cause in the US? • What is the most common cause in underdeveloped countries?

Name the type of thyroiditis associated with each Toy Story character, and describe why the name fits.

Non-Neoplastic Thyroid Diseases Graves disease • What is the clinical triad of symptoms? • What is the cause? Goiter • What does “goiter” mean? • What are some causes? • What is the mechanism?

Neoplastic Thyroid Diseases • If someone has a thyroid nodule, what is the most likely cause? • Name the four types of thyroid cancer. • Which one has the best prognosis? • Which one is the most common? • Which one is seen in MEN? Which kind, MEN I or II?

What thyroid tumor does this make you think of? Why?

Adrenal Glands Cushing syndrome • Too much of what hormone? • What are the four causes? • What are some symptoms?

Adrenal Glands Addison disease • Too little what? • What is the cause? • What are some symptoms? • Why is the skin bronze? Waterhouse-Friderichsen Syndrome • Too little what? • What is the usual cause? • What are some symptoms? • Is it dangerous?

Adrenal Medulla Tumors Pheochromocytoma • Cell of origin? • What’s the major symptom? • Why is it the 10% tumor? Neuroblastoma • Cell of origin? • Who gets it?

What endocrine disorder does this patient most likely have?

What endocrine disorder does this patient most likely have?

What endocrine disorder does this patient most likely have?

What endocrine disorder does this patient most likely have?

What endocrine disorder does this patient most likely have?

What endocrine disorder do these patients most likely have?

MEN • What are the MEN syndromes? • Why are they so bad for the patient?

Which MEN syndrome is associated with this man? • What tumors are these patients likely to get? • What is the genetic abnormality, and why is it like this man?

Which MEN syndrome is associated with this man? • What tumors are these patients likely to get? • What is the genetic abnormality, and why is it like this man?

Developmental Pathology

Types of genetic abnormalities Trisomies XY Microdeletion Microduplication AD Repeats 21 Klinefelter Prader-Wili Marfan Fragile X 18 Turner Angelman 13 Di. George

? What trisomy do these three boys have? How do you get a trisomy? Name some typical findings and risks in this syndrome (what is the name for the palmar finding? ). Name and describe two other trisomies.

What sex chromosome abnormality does this patient most likely have? What is his karyotype? What symptoms could he have?

What sex chromosome abnormality does this patient most likely have? What might her karyotype be? What symptoms could she have?

This little boy has Di. George syndrome. What is the chromosomal abnormality in this syndrome? What are some typical characteristics of this syndrome?

This little girl has Prader-Willi syndrome. What is the chromosomal abnormality in this syndrome? What are some typical characteristics of this syndrome?

These patients have Fragile X syndrome. What is the genetic abnormality? What are some of the symptoms?