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Hemophilia A = X-linked recessive, deficiency of Factor VIII (anti-hemophilic factor). Hemophilia B (Christmas disease) = Factor IX deficiency. Both present similar. vWF carries Factor VIII, vWF deficiency → low VIII but also platelet dysfunction.
Hemophilia A is due to deficiency of:
1) Factor VIII
2) Factor IX
3) Factor XI
4) von Willebrand factor
Correct answer: 1) The recognized fates of a thrombus are: propagation (growth), embolization, dissolution (fibrinolysis), and organization with possible recanalization (ingrowth of endothelial cells/fibroblasts, sometimes restoring partial luminal flow). Neoplastic transformation is not a recognized fate.
The fate of a thrombus does NOT include:
1) Spontaneous conversion into neoplastic tissue
2) Propagation
3) Organization and recanalization
4) Embolization
Correct answer: 3) The G6PD gene is X-linked, making G6PD deficiency an X-linked disorder predominantly affecting males, analogous to hemophilia A, which is also X-linked recessive and is in fact the most common hereditary disease associated with serious bleeding.
The gene for glucose-6-phosphate dehydrogenase (G6PD) is located on which chromosome?
1) Chromosome 6
2) Chromosome 11
3) The X chromosome
4) Chromosome 17
Correct answer: B) Langhans' giant cells, seen in tuberculosis and sarcoidosis, have nuclei arranged peripherally in a horseshoe or ring pattern (or clustered at the poles). Foreign body giant cells have randomly scattered nuclei; Touton giant cells have a vacuolated lipid-laden rim (as in xanthoma); Aschoff giant cells derive from cardiac histiocytes in rheumatic nodules.
Giant cells with nuclei arranged in a horseshoe or peripheral ring pattern, classically seen in tuberculosis, are called:
1) Foreign body giant cells
2) Langhans' giant cells
3) Touton giant cells
4) Aschoff giant cells
EBV tumor list: Burkitt lymphoma, B-cell lymphomas in immunodeficient (HIV, post-transplant), subset of Hodgkin lymphoma (mixed cellularity), nasopharyngeal carcinoma (100% non-keratinizing), subset of T-cell lymphomas, NK cell lymphomas, gastric carcinomas (∼10%), and rarely sarcomas in immunosuppressed. Hepatocellular carcinoma associated with HBV, HCV, not EBV.
EBV is associated with all EXCEPT:
1) Nasopharyngeal carcinoma
2) Subset of Hodgkin lymphoma
3) Gastric carcinoma subset
4) Hepatocellular carcinoma
Phase 1 inflammation: within 24 hrs, blood clot, exudation of plasma, neutrophils, some monocytes. Phase 2 clearance: proteolytic enzymes from neutrophils, autolytic enzymes from dead cells, macrophages clear necrotic debris and RBCs. Phase 3 ingrowth: angiogenesis + fibrogenesis.
Phases of granulation tissue formation in order:
1) Phase of inflammation → Phase of clearance → Phase of ingrowth
2) Clearance → Inflammation → Ingrowth
3) Ingrowth → Inflammation → Clearance
4) Inflammation → Ingrowth → Clearance
The migration of leukocytes from intravascular to extra vascular compartment
occurs through:
1). Desmosomic destruction
2). Enlargement of interendothelial Junctions
3). Endothelial pores
4). Transmembrane proteins
Correct answer: B) Libman-Sacks endocarditis produces small (1–4 mm), sterile, granular pink vegetations, often on valve undersurfaces, valvular endocardium, chordae, or mural endocardium, associated with fibrinoid necrosis of the valve. This differs from the large, bulky, non-sterile vegetations of infective endocarditis and the small, warty vegetations along lines of closure in rheumatic fever.
Libman-Sacks endocarditis, seen in SLE, characteristically produces vegetations located:
1) Only on the upper (outflow) surface of valve cusps, large and bulky
2) On the undersurface of atrioventricular valves and mural endocardium, small and sterile
3) Along lines of valve closure only, large and friable
4) Exclusively on the aortic valve with destructive changes
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