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Systemic Disease > 01. Intro > Flashcards

01. Intro Flashcards

1
Q

Damage to what 4 things are typically found in irreversible cellular injury?

A

Plasma membrane damage
Lysosomal membrane damage
Loss of DNA
Loss of mitochondria

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2
Q

What are the 2 most important factors in irreversible cellular injury?

A

Membrane disturbances

Inability to reverse mitochondrial dysfunction

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3
Q

What 3 things will be observed by a light microscope in irreversible cellular injury?

A

Nuclear Karyolysis (loss of basophilia)
Pyknosis (shrinkage of nucleus)
Karyorrhexis (fragmentation of nucleus)

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4
Q

What 4 morphologic changes will be observed by electron microscope in irreversible cellular injury?

A

Ruptured lysosomes
Myelin figures
Lysis of ER
Large Ca rich mitochondrial densities

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5
Q

What do myelin figures indicate in irreversible cellular injury?

A

Phospholipid precipitation

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6
Q

What cellular changes will be observed using a light microscope in reversible cellular injury?

A

Cellular swelling

Fatty change

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7
Q

Under electron microscope, what will be observed in reversible cellular injury?

A

Cellular blebs

Small mitochondrial densities

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8
Q

What are the 2 phases of apoptosis?

A

Initiation

Execution

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9
Q

During initiation of apoptosis, what becomes catalytically active?

A

Caspases

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10
Q

What causes the actual cellular death during the execution phase of apoptosis?

A

Caspases

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11
Q

What is necrosis?

A

Uncontrolled death of cells due to one of the various causes of cellular injury

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12
Q

What are the 4 types of necrosis?

A

Coagulative
Liquefactive
Fat
Caseous

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13
Q

In coagulative necrosis, which is more prominent: protein denaturation or enxymatic breakdown?

A

Protein denaturation

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14
Q

What organs are most affected by coagulative necrosis?

A

Organs with high fat content

-ex. brain

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15
Q

In coagulative necrosis, what changes are seen regarding eosinophils an basophils?

A

Increased eosinophilia of cytoplasm

Decreased basophilia of the nucleus

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16
Q

What organs are most commonly affected by liquefactive necrosis?

A

High fat and low protein content
High enzymatic content
ex - brain, pancreas

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17
Q

Which is more prominent in liquefactive necrosis: protein denaturation or enzymatic breakdown?

A

Enzymatic breakdown

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18
Q

In liquefactive necrosis, what replaces the dead tissue?

A

Lipid-laden macrophages

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19
Q

What is fat necrosis?

A

Change in adipose tissue due to trauma or the release of enzymes from adjacent organs

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20
Q

What combines in fat necrosis to form chalky deposits?

A

Breakdown of lipid

Release of fatty acids

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21
Q

Caseous necrosis is associated with what type of diseases?

A

Granulomatous

-ex. TB

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22
Q

When cellular architecture is lost, what type of necrosis is most common?

A

Liquefactive

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23
Q

What are the 4 stages of WBC movement?

A

Rolling
Pavementing
Transmigration
Chemotaxis

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24
Q

Rolling of WBCs is at least partially due to what?

A

Margination of WBCs from stasis of blood

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25
What is occurring during the pavementing stage of WBC movement?
Tight, constant contact of WBCs with endothelium
26
What occurs during transmigration?
WBCs cross through the endothelial layer
27
What is chemotaxis?
Process by which WBCs are drawn to the site of inflammation
28
Chronic granulomas are a collection of what?
Epithelioid histiocytes (activated macrophages)
29
What 4 things can cause granulomatous inflammation?
Bacteria Fungi Foreign material Unknown (sarcoidosis)
30
What bacteria most commonly causes granulomatous inflammation?
Mycobacteria
31
What 2 fungi commonly cause granulomatous inflammation?
Histoplasmosis | Blastomycosis
32
What general factors impair healing?
DM Infections Nutrient deficiency Glucocorticoid therapy
33
In healing, what does glucocortacoid therapy result in?
Decreased fibrosis
34
What mechanical factor impairs healing?
Dehiscence
35
What are the 3 factors that can impair healing?
General factors Mechanical factors Poor perfusion
36
What are the 3 complications of cutaneous wound healing?
Inadequate healing Excessive scar formation Contractures
37
What 2 types of excessive scars can result as a complication of cutaneous wound healing?
Hypertrophic scars | Keloid scars
38
What are keloid scars?
Tissue beyond the boundaries of the wound
39
Inadequate healing can lead to what?
Dehiscence or ulceration
40
Which hypersensitivity type is cytotoxic?
Type II
41
Which hypersensitivity type is delayed?
Type IV
42
Which hypersensitivity type is immediate?
Type I
43
Which hypersensitivity type is autoimmune?
Type III
44
What mediates type I hypersensitivity reactions?
IgE
45
What mediates type II hypersensitivity reactions?
IgE
46
What mediates type III hypersensitivity reactions?
IgE
47
What mediates type IV hypersensitivity reactions?
Cell
48
In type I hypersensitivity, IgE binds to what?
Mast cells | Basophils
49
Cytotoxic hypersensitivity leads to what type of lysis of cells?
Complement-mediated lysis
50
Name 2 types of cytotoxic reaction.
Transfusion | Rh reaction
51
Which type of hypersensitivity reaction involves polymorphonuclear cells?
Type III
52
Whicy type of hypersensitivity reaction involves immune complexes being deposited in tissues?
Type III
53
What is activated/sensed in type IV reactions?
T lymphocytes
54
How long does it take for a type I reaction to occur?
Minutes
55
How long does it take for a type II reaction to occur?
Hours to days
56
How long does it take for a type III reaction to occur?
2-3 weeks
57
How long does it take for a type IV reaction to occur?
2-3 days
58
Give 4 examples of an ocular type I reaction.
Seasonal allergic conjunctivitis VKC Atopic KC GPC
59
What are 3 examples of systemic type I reactions?
Allergic rhinitis Allergic asthma Anaphylaxis
60
What are 3 examples of ocular type II reactions?
Ocular cicatricial pemphygoid Pemphigus vulgaris Dermatitis herpetifromis
61
What are 2 examples of a systemic type II reaction?
Goodpasture's syndrome | MG
62
What are 5 examples of ocular and systemic manifestations of a type III reaction?
``` RA SLE PAN Bechet's disease Relapsing polychondritis ```
63
Transplant rejection is what type of hypersensitivity?
Type IV
64
What are some examples of an ocular type IV reaction?
``` Drug allergy Herpes disciform keratitis Phlycenulosis Corneal transplant rejection TB Saroid Uveitis HSV SJS ```
65
Type I reactions cause the release of what 3 preformed mediators?
Histamine Proteases Chemotactic factors
66
Type I reactions cause the synthesis of what 4 mediators?
Prostaglandins Leukotrienes Platelet activating factors Cytokines
67
What are the typical findings of type I atopy?
Rhinitis Allergic asthma Food allergies Conjunctivitis
68
What inhaled substances typically cause a type I reaction in the spring?
Tree pollen
69
What inhaled substances typically cause a type I reaction in the summer?
Grass pollens
70
What inhaled substances typically cause a type I reaction in the fall?
Weed pollens
71
Atopic dermatitis is an example of what type of reaction?
Type I
72
What are the 3 major eye associations with type I allergy?
Dennie-Morgan sign Atopic keratoconus Cataract
73
What is Dennie-Morgan sign?
Infra-orbital folds in the eyelid
74
What types of cataract are commonly associated with type I allergy?
Anterior sub-capsular cataract Posterior polar cataract Anterior cortical
75
Which signs of anaphylaxis require the most aggressive treatment?
Respiratory signs
76
Epinephrine should typically be administered ASAP in anaphylaxis. However, it should be avoided in what two cases?
Cardiac patiens | Current beta-blocker therapy
77
Tachycardia is more likely indicative of what: Anaphylaxis or vasovagal?
Anaphylaxis
78
Bradycardia is more likely indicative of what? Anaphylaxis or vasovagal?
Basovagal
79
Vasovagal syncope occurs because of stimulation of what nerve?
Vagus
80
What are signs of impending vasovagal syncope?
Poor verbal response Sudden sweating Feeling dizzy
81
In type II reactions, antibody binds to what?
Antigen on the cell surface
82
Type II reactions activate what cells for cell-mediated cytotoxicity?
NK cells Eosinophils Macrophages
83
Give 5 examples of cytotoxic reactions.
``` Transfusion reactions MG Grave's Hyperacute graft reactions Pernicious anemia ```
84
Type III reactions are an inflammation in response to what?
Circulating antigen-antibody complexes
85
Give 3 examples of type III reactions.
SLE RA Serum sickness
86
Type IV reactions are mediated by what cells?
T cells
87
A macrophage + T cell + infiltrate = ???
Granuloma
88
Granulomatous type IV reactions may come from what 2 conditions?
Crohn's | Sarcoid
89
SJS is what type of reaction?
Type IV
90
Toxic shock syndrome is what type of reaction?
Type IV
91
In toxic shock syndrome, what bacteria may cause a super-antigen and bind with T cells?
Staph | Strep
92
Toxic shock syndrome is commonly associated with what?
Cutaneous lesions

Systemic Disease (12 decks)

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