1. Introduction to FS II Flashcards
Tools of Pathology
• Eyes and Hands: much can be learned from visual scrutiny and skillful palpation
- Light microscope (biopsy):
- Wide variety of stains to visualize various ____ [e.g. Hematoxylin and eosin (H&E); PAS]
- Histochemical stains (react with specific ____)
- Dark-field, phase-contrast and fluorescence microscopy
- Electron microscopy
- Cellular and molecular technologies
Recognizing a lesion is not ____ (via E+H); in order to diagnose lesion you must explore further steps > light microscopy (histomorphologic changes, or stains can be used to view presence of antigen)
Some diseases require ultrastructure > ____
tissue
chemical
diagnostic
electron microscopy
Hematoxylin and eosin stain
(H and E)
• Hematoxylin, a ____ dye, has an affinity for ____ charged structures: nucleic acids such as DNA in chromosomes and RNA in ribosomes (blue)
• Eosin is an ____ dye with an affinity for ____ charged structures: few positively large structure, staining varies between cells; cytoplasmic components of the cell (pink to red)
basic
negatively
acidic
positively
4 Critical Events Involved in Pathology and Disease
Etiology
____
Morpholoigcal changes
____
pathogenesis
functional changes
Etiology
• Factor(s) responsible for causing disease
–____ (or genetic, congenital)
–____ (acquired)
• e.g. infectious, nutritional, chemical, physical
• Important to identify: –understand disease –diagnosis of disease –Treatment of specific disorder vs treating clinical manifestations – Prevention
• A disease may have more than one etiology
(i.e., ____)
• Sometimes difficult to identify: ____
Intrinsic > present early on (almost at birth); can be ____ (mutation in enzyme that messes w/ metabolism), or can be more ____ (DS), or can be ____ (result of a uterine trauma, but not genetically encoded)
Extrinsic > everything else
intrinsic
extrinsic
multifactorial
idiopathic
genetic
complex
congenital
Pathogenesis
• Sequence of events in the ____ of cells or tissues to etiologic agent, from stimulus to expression of disease.
• Results in:
–structural and/or functional abnormalities
–signs and symptoms of disease
• 6 Pathogenic mechanisms:
–Inflammation, ____, immune- mediated (immunopath), ____, infectious disease, neoplasia)
• Often complicated; the expression of disease may be ____ removed from the initial cause (i.e, etiology)
The etiologic trigger and pathogenic mechanism (and morphological change) are separated in ____ (the etiologic even can occur well before you see the presence of a lesion)
If the etiology/pathogenesis is ____; you cannot prevent the disease from occurring in the future; but if you do know it, you can prevent by preventing exposure to ____ or vaccinating; if you don’t know E, but know the P you can modify the ____ to prevent damage to the organ
response
vascular disturbances
genetics
several steps
time
unknown
E agent
process
Morphologic Changes
• Structural alterations in cells or tissues that are either characteristic or diagnostic of the disease –Lesions: • abnormality in a tissue • usually \_\_\_\_ but may be \_\_\_\_ or \_\_\_\_. • Lesions are not \_\_\_\_
–____: refers to an abnormality found only in one condition
Morphologic changes is observed at 2 levels > ____ level (lesion) (can be molecular or metabolic); lesions are not static > they change with time (can be early, late, or mixed; ____ PROCESS)
anatomic
molecular
metabolic
static
pathognomonic
clinical gross
dyanmic
Macule > ____ area, usually on the skin (NOT ____)
Papule > small, solid ____
Plaque > related to papule but ____
Nodule > larger, elevations that are ____ OR ____ > can be solitary, or there can be multiple ____
They relate to ____ (a solid, fluid-filled tissue)
Pustule > contains ____
Cyst > always ____ lined, usually fluid-filled, can be in ____ or ____ tissue
discolored elevated elevation larger solid fluid-filled nodules masses pus epithelial soft hard
Vescile/bulla > fluid-filled ____; typically associated with ____ or ____ injury
Ulcers > break in ____ of tissue
Atrophy > break down of tissue and decrease in size (broken leg and the kidney)
Extravasion of blood lesions > when they’re small: ____ (usually the size of the head of pin); larger: ____; a larger area is ____
Accumulation of extravascular blood > ____
All these lesions can occur in ____ as well
blisters viral infection immuno-mediated epithelial lining petechiae purpura ecchymosis hematoma
internal organs
Morphologic Changes
• Recognition of ____ forms the basis of clinical diagnosis
–Traditional focus on morphologic changes:
• ____: tissue removed from a person during life and sent to a pathologist for diagnosis
• ____: examination of part or all of a dead body by a pathologist
–Now includes ____ and ____ approaches
Can be observed by the ____ level > gives you an idea of the pathogenic mechanism
disease patterns biospy autospy molecular immunologic histopathologic
Functional Changes
• Functional abnormalities are the result of genetic, biochemical and structural changes in cells and tissues giving rise to clinical manifestations:
–Symptoms: ____ observations
—• Syndrome: a set or cluster of symptoms which occur together in ____ patients; not necessarily due to the same ____
–Signs: evidence of disease discovered by a ____ on physical exam
–Findings: ____, lab or ____ results
Once morphologic changes occur (changes in structure of tissue, function, etc.) > functional changes (clinical manifestations)
patients subjective
different
cause
clinician
surgical
x-ray
Relationship between knowledge of disease process (Type I diabetes) and treatment
Type I > ____
Early diagnosis was combined with ____ where you can prevent further damage to the ____ (red)
Knowing the ____ and ____ allows prevention of the disease and intervention (minimizing damage), as opposed to simply treating it on a ____ sense
juvenile diabetes
immunosuppressive medications
pancreas
etiological
pathogenesis
chronic
Differential Diagnosis
- Exercise of listing in ____ all possible diagnoses of a given condition (based upon clinical presentation, etc)
- Usually from the ____ to the ____
• Initiate precisely formulated diagnostic sequence when confronted with patient who presents with signs and/or symptoms of possible disease
• Establish approach
– All pertinent clinical findings are identified
– Accomplish entire procedure ____, effectively, and reproducibly
• Accuracy of ____ is most important
– Dictates ____ and extent of ____
orderly fashion
most likely
least likely
rapidly
diagnosis
type
treatment
