Boards Review: Pathology (Hematopoietic, Vascular)

DIC, or disseminated intravascular coagulation, occurs after uncontrolled activation of clotting factors and fibrinolytic enzymes. This condition is often seen in cases of major tissue damage from burns, sepsis, or complications of pregnancy. In DIC, there is widespread clot formation throughout the blood vessels, leading to the consumption of clotting factors and platelets. This can result in excessive bleeding and organ damage. Therefore, DIC is the correct answer for this question.

Aortic dissection occurs when there is a tear in the innermost layer of the aorta, called the intima. This tear allows blood to flow into the other layers of the aortic wall, causing separation and potentially leading to aortic rupture. Aortic dissection is a serious medical condition that requires immediate medical attention.

The most common forms of thalassemia in Southeast Asia are alpha-thalassemia, alpha-thalassemias, and alpha thalassemia. Thalassemia is a genetic blood disorder that affects the production of hemoglobin, leading to anemia. In Southeast Asia, alpha-thalassemia is particularly prevalent due to the high frequency of carriers in the population. These three answers all refer to the same condition, just with slightly different wording, and therefore they are all correct.

Acute leukemias have a higher proportion of undifferentiated blast cells circulating in the bloodstream compared to chronic leukemias. These blast cells are immature and have not fully developed into mature blood cells. Therefore, the correct answer is "less" because chronic leukemias have a higher proportion of differentiated cells compared to acute leukemias.

When oxidized lipids are ingested by MPs, they form foam cells. Foam cells are a type of immune cell that contains an accumulation of oxidized lipids, specifically cholesterol. These cells are typically found in atherosclerotic plaques, which are fatty deposits that build up on the walls of arteries. The formation of foam cells is a key step in the development of atherosclerosis, as they contribute to the progression of plaque formation and narrowing of the arteries.

The tunica intima is the only layer found in capillaries. Capillaries are the smallest blood vessels in the body and have a very thin wall composed of a single layer of endothelial cells, which make up the tunica intima. This layer allows for the exchange of gases, nutrients, and waste products between the blood and surrounding tissues. The absence of other layers, such as the tunica media and tunica adventitia, in capillaries allows for their high permeability and efficient exchange of substances.

Thrombocytopenia is a condition characterized by a decrease in the number of platelets in the blood. A normal platelet count ranges from 150,000 to 450,000 platelets per microliter (uL) of blood. Therefore, a fall in platelets to below 70,000/uL is considered thrombocytopenia. The answer options provided all represent the same value, which is the threshold for thrombocytopenia.

Atheromas are lesions that develop on artery walls and are comprised of macrophages, low-density lipoproteins, fibrin, and smooth muscle. They are usually asymptomatic and are considered complicated plaques. Atheromas are commonly associated with atherosclerosis, a condition characterized by the buildup of plaque on the artery walls, which can lead to various cardiovascular diseases.

Aplastic anemia can be caused by various factors including toxic exposure to radiation, chemicals, and therapeutic drugs. It can also be caused by viral infections and idiopathic (unknown) factors. These factors can damage the bone marrow, leading to a decrease in the production of red blood cells, white blood cells, and platelets, resulting in aplastic anemia.

Port wine stains, strawberry marks, and vascular spiders are all examples of hemangiomas. Hemangiomas are benign tumors that are made up of blood vessels. They can appear as red patches or marks on the skin, and are often present at birth or develop shortly after. These vascular abnormalities can vary in size and shape, and may fade over time or persist throughout a person's life.

Kaposi's sarcoma is a fast-growing opportunistic disease commonly found in AIDS patients. It is caused by a type of herpes virus known as Human Herpesvirus 8 (HHV-8). This cancerous condition affects the skin and mucous membranes, causing the development of abnormal blood vessels and lesions. The weakened immune system in AIDS patients allows the HHV-8 virus to thrive and lead to the rapid progression of Kaposi's sarcoma. Therefore, Kaposi's sarcoma is considered a significant opportunistic disease in individuals with AIDS.

The symptoms of macrocytic anemia include glossitis, weight loss, peripheral neuropathy, depression, and paranoia. Glossitis refers to the inflammation of the tongue, which can cause pain and difficulty in swallowing. Weight loss is a common symptom of anemia, as it can affect the body's ability to absorb nutrients properly. Peripheral neuropathy is a condition that affects the nerves in the extremities, causing tingling, numbness, and weakness. Depression and paranoia can also be symptoms of macrocytic anemia, as the condition can affect mood and overall mental well-being.

Pernicious anemia is caused by a lack of intrinsic factor, a protein produced by the stomach that is necessary for the absorption of vitamin B12. Without intrinsic factor, the body is unable to properly absorb vitamin B12 from the diet, leading to a deficiency of this essential nutrient. This deficiency can result in various symptoms such as fatigue, weakness, and neurological problems.

Polycythemia vera is a myeloproliferative disorder characterized by an abnormal increase in red blood cells (RBCs) due to neoplastic clonal proliferation in the bone marrow. This condition leads to an elevated hematocrit level and increased blood viscosity, which can cause symptoms such as headaches, dizziness, and fatigue. Polycythemia vera is typically caused by a mutation in the JAK2 gene, leading to uncontrolled production of RBCs. Treatment options include phlebotomy to reduce blood volume, medication to suppress bone marrow activity, and aspirin to prevent blood clot formation.

Multiple myeloma is a type of cancer that arises from B-lymphocytes, which are a type of white blood cells. It is more commonly seen in individuals aged 50-60 years. One of the characteristic features of multiple myeloma is the presence of punched out, lytic lesions in the bone, which can lead to bone pain and fractures. These lesions result in the resorption of bone, which can cause hypercalcemia. Multiple myeloma is also associated with the presence of Bence Jones proteins, which can be detected in the urine, and renal failure.

Thrombocytopenia is the most common cause of abnormal bleeding. Thrombocytopenia is a condition characterized by a low platelet count, which are essential for blood clotting. When there is a deficiency in platelets, the blood is unable to clot properly, leading to abnormal bleeding. This can manifest as prolonged or excessive bleeding from minor cuts or bruises, nosebleeds, or heavy menstrual periods. Thrombocytopenia can be caused by various factors such as medication side effects, autoimmune disorders, viral infections, or certain cancers. Proper diagnosis and treatment are necessary to manage the underlying cause and prevent further complications.

Long-term anemia can result in multiple symptoms and complications. Pallor, increased heart rate, and orthostatic hypotension are all common manifestations of anemia. Anemia leads to a decrease in red blood cells, which are responsible for carrying oxygen to the tissues. As a compensatory mechanism, the heart pumps faster to try to deliver more oxygen to the body, resulting in an increased heart rate. Orthostatic hypotension, or low blood pressure upon standing, can occur because of the decreased blood volume caused by anemia. Additionally, anemia can cause abnormal heart sounds, such as late diastolic murmur and systolic ejection murmur, due to changes in blood flow and turbulence in the heart.

Non-Hodgkin's lymphoma is a type of lymphoma that affects B-cells and has different forms, including an African and an American form. Burkitt's lymphoma is a specific subtype of Non-Hodgkin's lymphoma that is commonly found in Africa and is associated with the Epstein-Barr virus. Therefore, both Non-Hodgkin's lymphoma and Burkitt's lymphoma can be considered as the correct answer to the question.

Vitamin K is necessary for the synthesis of clotting factors II, VII, IX, and X. These factors play a crucial role in the coagulation cascade, which is the process by which blood clots are formed to prevent excessive bleeding. Without sufficient vitamin K, these clotting factors cannot be produced adequately, leading to impaired blood clotting and an increased risk of bleeding disorders. The answer options provided all list the correct clotting factors that require vitamin K for their synthesis.

The most common forms of thalassemia in the Mediterranean and the US are beta-thalassemia, beta-thalassemias, and beta thalassemia.

Jaundice and hemosiderosis are both specific symptoms of hemolysis. Jaundice refers to the yellowing of the skin and eyes due to an excess of bilirubin in the blood, which occurs when red blood cells are broken down. Hemosiderosis, on the other hand, is the accumulation of iron in tissues, particularly in the liver, as a result of excessive breakdown of red blood cells. Both symptoms are directly related to the destruction of red blood cells, which is characteristic of hemolysis.

von Willebrand's disease is the most common hereditary clotting problem. This disease is caused by a deficiency or dysfunction of von Willebrand factor, a protein involved in blood clotting. It can lead to prolonged bleeding, easy bruising, and excessive bleeding after injury or surgery. The inheritance of von Willebrand's disease can vary, with both autosomal dominant and recessive patterns possible. Treatment options include medications to increase von Willebrand factor levels or promote clotting, as well as avoiding certain medications and procedures that can worsen bleeding.

Temporal arteritis, also known as giant cell arteritis, is the most common form of vasculitis. It is an inflammatory condition that affects the blood vessels, particularly the large and medium-sized arteries. Temporal arteritis primarily affects the arteries in the head, especially the temporal arteries, which supply blood to the scalp and face. It typically occurs in individuals over the age of 50 and is characterized by symptoms such as headache, jaw pain, vision problems, and fatigue. If left untreated, temporal arteritis can lead to serious complications, including blindness, stroke, and aortic aneurysm.

The correct answer is thrombophlebitis, phlebothrombosis. Thrombophlebitis refers to the inflammation of a vein with the formation of a blood clot, while phlebothrombosis refers to the formation of a blood clot within a vein without inflammation.

Arteriosclerosis most probably begins with damage to the vascular endothelium. The endothelium is the inner lining of blood vessels, and when it becomes damaged, it can lead to inflammation and the accumulation of fatty deposits, known as plaques, in the arterial walls. Over time, these plaques can harden and narrow the arteries, restricting blood flow and potentially leading to various cardiovascular diseases, including heart attacks and strokes. Therefore, damage to the vascular endothelium is a critical initial step in the development of arteriosclerosis.

Buerger's disease, also known as thromboangitis obliterans, is a disease characterized by ischemia, pain, gangrene, and necrosis of the digits. This condition is caused by inflammation and clotting of the blood vessels, leading to blockages and reduced blood flow. As a result, the affected digits may experience pain, become pale or cyanotic, and eventually develop gangrene and necrosis. Buerger's disease is commonly associated with smoking and primarily affects young male smokers. Treatment involves quitting smoking and managing symptoms to prevent further complications.

Red blood cell hemolysis can be caused by various factors. Mechanical trauma to cells refers to physical damage to the cells, which can rupture them and lead to hemolysis. Complement induced damage refers to the activation of the complement system, a part of the immune system, which can cause the destruction of red blood cells. Extravascular hemolysis occurs when red blood cells are broken down outside of the blood vessels, usually in the spleen or liver. All of these factors can contribute to red blood cell hemolysis.

Atherosclerosis is a condition characterized by the buildup of plaque in the arteries, leading to their narrowing and reduced blood flow. Large elastic arteries, such as the aorta, are commonly affected by atherosclerosis. These arteries are responsible for carrying oxygen-rich blood from the heart to the rest of the body. The elasticity of these arteries allows them to expand and contract with each heartbeat. However, with atherosclerosis, the plaque buildup causes them to become stiff and less flexible, compromising their ability to deliver blood efficiently.

Atherosclerotic and berry are two common types of aneurysms. Atherosclerotic aneurysms occur due to the buildup of plaque in the arteries, causing them to weaken and bulge. Berry aneurysms, on the other hand, are small, rounded, and usually occur in the brain's blood vessels. They are called "berry" aneurysms because they resemble a small berry or sac. Both types of aneurysms can be serious and require medical attention.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked disorder that leads to hemolytic anemia with oxidative stress. This condition is caused by a lack of the G6PD enzyme, which plays a crucial role in protecting red blood cells from damage caused by reactive oxygen species. Without adequate G6PD activity, red blood cells become more susceptible to oxidative stress, leading to their destruction and the development of anemia. This disorder is inherited in an X-linked recessive manner, meaning it primarily affects males, while females are usually carriers of the condition.

The Philadelphia chromosome is a common lab finding in the diagnosis of chronic myelogenous leukemias. This chromosome is a genetic abnormality resulting from a translocation between chromosomes 9 and 22. It creates a fusion gene called BCR-ABL1, which leads to the overproduction of an abnormal protein. The presence of the Philadelphia chromosome is a hallmark of chronic myelogenous leukemia and is detected through cytogenetic analysis or molecular testing.

Reed-Sternberg cells are multi-nucleated giant cells that are characteristic of Hodgkin's lymphoma. They are large, abnormal cells that can be identified under a microscope. These cells play a role in the pathogenesis of Hodgkin's lymphoma and are used in the diagnosis of the disease.