19. General pathology Flashcards by Ch Mora

Indicates that an antigen(antibody generating) is present

Inflammation

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Redness

Rubor

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Heat

Calor

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Pain

Dolor

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Swelling

Tumor

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Loss of function

Function laesa

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They cause vasodilation and increase in vascular permeability

Mediators of inflammation

prostaglandin, bradykinin, kallidin
histamine
lymphocytes
wbc enzymes

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Mediators of inflammation that produces PAIN

Prostaglandins
Bradykinin
Kallidin

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Most important mediator of inflammation

Histamine

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Cells that produces histamine

Mast cells
Eosinophils
Basophils
Platelets

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Opp fxn of histamine

Histamine = vasodilation

Serotonin = vasoconstriction

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H1 receptors

Bronchi - bronchoconstriction

Bv - vasodilation

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H2 receptors

Stomach - increase HCl acid

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H3 receptors

Cns

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BQ: Dse assoc with ⬇️ T cell count in Thymus and ⬇️ PTH in Parathyroid gland

DiGeorge Syndrome

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BQ: DiGeorge Syndrome = ⬇️ PTH
- Hypoparathyroidism
-Hypocalcemia
==

Tetany

- chvostek and trosseous sign

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What is the disease associated with ⬇️ B cell count?

Bruton’s agammaglobulinemia

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Matured in thymus

T lymphocytes

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T helper cell

CD4

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Cytotoxic T cell

CD8

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Specialized CD8

NK cells

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Matures in bone marrow

B lymphocytes

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Activated B cells ; produces immunoglobulins

Plasma cells

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Effects of vascular permeability

Escape of plasma contents towards interstitial tissues

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``` Numerous proteins (albumin) Seen in ABSCESS ```

Exudate

``` Few protein (albumin) Seen in EDEMA(pitting or non pitting) and gingival crevicular fluid/sulcular fluid ```

Transudate

Specific gravity of exudate

> 1.018

Specific gravity of Transudate

< 1.012

Peripherally lining up of WBCs | Preparation for diapedesis

Pavementing or Migration

BQ: What is the passive movement of blood cells across endothelial wall?

Diapedesis - (after mag line up ng wbc sa periphery or pavementing, magmmove yung wbc across endothelial wall or endothelium which is the wall of the blood vessel because antigen is outside the blood vessel or at the surface)

What is the specialize movement of lymphocytes across endothelium?

Emperipolesis

What organelle is used by WBCs to move across endothelium? For motility

Pseudopods

BQ: It is the phenomenon through which blood borne antigens are attracted and fixed to areas of inflammation? (bacteria from secondary inflammatory site are attracted to primary inflammatory site)

Anachoresis

Movement from Point A to Point B:with CHEMOTACTIC AGENTS | motile cells are attracted to chemotactic agents

Chemotaxis

Chemotactic agents for neutrophils

Antigens

Chemotactic agents for Wbcs like monocyte

Neutrophils

“cell eating”

Phagocytosis

Process of cell digestion

Phagosome Lysosome Phagolysosome Residual bodies

2 types of immunity

Nonspecific/Passive/Innate (NPI) | Specific/Active/Adaptive (SAA)

1st line of defense (skin, Hcl acid in stomach)

NPI - Barriers

2nd line of defense

NPI: Phagocytes

2 types of SAA immunity

Humoral | Cell mediated

Mediated primarily by B cells

Humoral immunity

1. Bcells bind to antigen’s epitope 2. B cells will engulf antigen (endocytosis) 3. Antigen will be digested and production of MHC 2 4. CD4 will read MHC 2 and will result to - CD4 activation - B lymphocyte activation (memory b cell/ plasma cell)

Presented antigen to alarm immune system

Major histocompatibility Complex 2

Produces antibodies or immunoglobulins that binds to the specific antigen

Plasma cells

Binding of antibodies to antigen results to

Complement activation

Accumulation of C3B/opsonin on the antigen

Opsonization

Membrane attack complex

C5b

Mediated primarily by T cells

Cell mediated

1. Cell becomes infected by pathogen or becomes a cancer cell 2. Cell produces abnormal proteins 3. Cell will produce MHC1 4. CD8 will read MHC1 and will result to CD8 activation 5. CD8 cells bond to the cell with MHC1 and kills it

Sudden onset | Injury > resistance

Acute infection

Long standing | Injury = resistance

Chronic infection

Bilateral involvement of submn, subli, submental spaces

Ludwigs angina

Tx for ludwigs angina

Antibiotics

Management of fluctuant swelling in ludwigs angina

Incision and drainage

Blade used for I and D of swelling in ludwigs angina

Blade 11

Aka phlegmon

Cellulitis

Inflammation of the cells

Cellulitis

Tx for cellulitis

Antibiotics | NO ASPIRATION!!!!!

2 examples of acute infection

Ludwigs angina | Cellulitis

Seen in chronic apical periodontitis

Abscess Granuloma Cyst

How to differentiate abscess, granuloma and cyst

Biopsy

Most common stage of granuloma

Granulomatous stage

BQ: Lining of cyst

Stratified squamous

Leukocytosis is a characteristic of what infection?

Acute bacterial

Lymphocytosis is a characteristic of what infection?

Acute viral and chronic bacterial

What cells are found in chronic infections??

Macrophages Lymphocytes Plasma cells

Other names for type 1 hypersensitivity

Immediate hypersensitivity Allergic Anaphylactic

Mediator in Hypersensitivity type 1

IgE

Other name for Hypersensitivity type 2

Cytotoxic hypersensitivity | CyTWOtoxic

Mediator for hypersensitivity type 2

IgG and IgM

Other name for hypersensitivity type 3

Immune complex hypersensitivity

Mediator in hypersensitivity type 3

Antigen and antibody complex

Other names for hypersensitivity type 4

Delayed hypersensitivity | T cell mediated

Type of hypersensitivity which takes days before reactions appear

Type 4 = Delayed

Mediator in hypersensitivity type 4

Immune cells

Type of hypersensitivity reaction when serum of horse is injected to the rabbit?

Type 3 - Immune complex

Type of hypersensitivity reaction seen in urticaria

Type 1

Type of hypersensitivity reaction seen in Serum sickness

Type 3

Type of hypersensitivity reaction seen in erythroblastosis fetalis

Type 2

Type of hypersensitivity reaction seen in asthma

Type 1

Type of hypersensitivity reaction seen in arthus reaction

Type 3

Type of hypersensitivity reaction seen in hemolytic anemia

Type 2

Type of hypersensitivity reaction seen in SLE

Type 3

Pathognomonic sign of SLE

Butterfly rash

3 types of cells according to regenerative properties

Labile Stable Permanent

Cells that multiplies throughout life; short life

Labile cells

Cell that multiplies when damaged

Stable cells

Cells that cannot multiply

Permanent cells

Example of labile cells

Epithelial cells in the skin

Examples of Stable cells

Stable KPL | - kidney, pancreas, liver

Examples of permanent cells

Neuron Mature rbc Skeletal and cardiac muscles

Retrogressive changes in cells and tissues characterized by abnormal structural changes WITHIN THE CELL and decreased function. It may be reversible or irreversible depending on the injury

Cellular degeneration

Mildest and most common type of cellular degeneration

Cloudy swelling (reversible)

Swelling of cells results to pale or cloudy appearance of tissue

Cloudy swelling

Excessive swelling of cells de to excessive water accumulation

Hydropic or Vacuolar (reversible)

Accumulation of lipids or fats within the cells

``` Fatty degeneration (reversible) Example fatty liver ```

Accumulation of PCT cells

Hyaline droplets

Alcoholic cirrhosis (Laennec's cirrhosis)

Mallory bodies

Yellow fever

Councilman bodies

Sign of yellow fever

Jaundice

Typer of intracellular hyaline accumulation - plasma cells

Russell-Fuchs bodies

Typhoid fever

Zenker's degeneration

Causative agent of typhoid fever

Salmonella typhi

What is the most common type of staining?

Haemotoxylin and eosin staining

Immature rbcs with nucleus

Reticulocytes

Nucleus of mature rbc

None/ no nucleus

BQ: What is the hyaline accumulation in glomerulus resulting to sclerosis and associated with diabetes?

``` "Kimmelstiel-Wilson Syndrome" Diabetic glomerulosclerosis (reversible) ```

Extracellular hyaline accumulation of Amyloid(abnormal protein fragments)

Amyloidosis

Amyloidosis is seen in what type of staining?

Congo red staining

Tissue death; irreversible

Necrosis

Type of necrosis where proteins are denatured or coagulated

Coagulation necrosis

Most common organ involved in coagulation necrosis

Heart

Least common organ involved in coagulation necrosis

Brain

"Liquefaction" of injured tissue

Liquefaction necrosis

Most common organ involved in liquefaction necrosis

Brain

Cheeselike material

Caseous necrosis

soft granulomatous growth

Gumma - gummatous necrosis

Type of necrosis Seen in lower extremities of diabetic patients

Gangrenous necrosis

Tx for gangrenous necrosis in diabetic pxs

Amputation

fat calcium complexes accumulation

Fat necrosis

Most common organ involved in fat necrosis

Pancreas

Bacterial infection that produces gas in tissues in gangrene

Gas gangrene

Causative agent of gas gangrene

Clostridium perfringens | Gram+anaerobic

Type of necrosis assoc with hypoxia and ischemia in all tissues

Coagulation necrosis

Type of necrosis assoc with tuberculosis of lungs

Caseous necrosis

Causative agent of tb of lungs which is also good in creating drug resistance

Mycobacterium tb

Treatment for TB

``` RIPES rifampicin Isoniazid Pyrazinamide Ethambutol Streptomycin ```

Type of necrosis assoc with tertiary syphilis

Gummatous necrosis

Type of syphilis where there is chancre sores

Primary syphilis

Type of syphilis where there are white mucous patches

Secondary syphilis

Type of syphilis where there is gummatous necrosis

Tertiary syphilis

Causative agent for syphilis

Treponema pallidum

Dark pigmentation of skin | From melanocytes

Melanin

Brown to black

Eumelanin

Red to yellow

Pheomelanin

Red pigment, carries oxygen in rbc

Hemoglobin

Red portion of hemoglobin

Heme | Porphyrin

Green pigment

Biliverdin

Yellow pigment

Bilirubin | Urobilin - urine

Golden brown or rust | Seen in heart failure cells of liver

Hemosiderin

Brown, feces pigment

Stercobilin

Wear and tear pigment, common in neurons

Lipofuscin or lipochrome

Blue-Gray-Black gingiva

Plumbism Argyria Mercury poisoning

Lead poisoning

Plumbism

Bluish line in marginal gingiva Seen in plumbism

Burton line - Plumbism

Silver poisoning

Argyria

BQ: Black pigmentation??

Silver nitrate

Cherry red tissues

Carbon monoxide poisoning

Greenish black teeth

Tetracycline stain

Tetracyline staining can affect children until what age

Until 8 years old only | Because crowns are fully developed

Yellowish teeth

Iron def anemia (cause of yellowing of teeth: ferrous sulfate)

BQ: Copper accumulation with keyser fleischer ring(brown green bordered eyes)??

Wilson's disease

Violet stain

Potassium permanganate

BQ: Mediator of humoral immunity?

B cells

BQ: Plasma cells are from what cells?

B cells

BQ: Other term for C3b?

Opsonin

BQ: Ano pnpresent ng B cell?

MHC 2

BQ: mediator of cell mediated immunity?

T cells

Protects stomach from acid

Prostaglandins

What causes EDEMA?

Vasodilation = ⬆️blood flow to the area Increase vascular permeability - (normally, closed ung vessels. But bumubuka ung vessels pag may inflammation, nakakalabas yung mga fluids = edema)

Lifespan of platelets

10 days

Normal count of platelets

150,000-450,000

Growth peak of thymus | - 200% size then shrinks

10-12 years old

BQ: What are deficient in pxs with DiGeorge syndrome?

Thymus and Parathyroid gland

Hypersensitive facial nerve seen in tetany

Chvostek sign

Hand of obstetrician seen in tetany

Trosseous sign

Granulocytes

BEN

Agranulocytes

Monocytes and macrophages

Wbc that has azurophilic granules

Neutrophils

Other names for neutrophils

PMN cells / Stab cells

BQ: How to differentiate Exudate from Transudate

Number of proteins More - exudate Few - transudate

2 site where transudate can be seen

Edema | Gingival crevicular fluid (sulcus)

Location where WBC normally floats

Central portion of blood stream

When there is presence of an antigen, WBC are peripherally lining up: which is called?

Lining up in the periphery - Pavementing or Migration

Butterfly shape gland

Thyroid gland

Butterfly shape bone

Sphenoid bone

It is a severe allergic reaction

Anaohylaxis

⬇️ BP = "Loss of blow flow" which is called

Shock (In anaphylactic shock: Mast cells produces histamine which targets h1 receptors: smooth muscles of bronchi and blood vessels=vasodilation:⬇️BP:loss of blood flow~ Anaphylactic shock)

BQ: Doc for anaphylactic shock

1:1,000 Epinephrine IM(90degrees)

Most common muscle for IM injection

Vastus lateralis (part of quadriceps muscles)

3 muscles used for IM

Vastus lateralis Gluteus maximus Deltoid

Safest part of gluteus maximus for IM injection to avoid SCIATIC NERVE

Superolateral or upper outer corner

BQ: Binding site of Bcells in antigen

Epitope

BQ: mediator of Humoral immunity

B cells

BQ: Antigen presented by B cells to alarm the immune system

MHC 2

Meeting of Bcell and CD4 results to

Activation of both CD4 and B cell

BQ: Plasma cells are derived from

B cells

Once nagbind yung Antibodies sa epitope ng antigen start na ng

Start of complement system

BQ: binding site of COMPLEMENT PROTEINS on the Antibody

Fc receptors

BQ: How many are the complement proteins? From what organ?

>30 CP from the LIVER

BQ: accumulation of C3b or opsonin

Opsonization

Immunity present at birth

Nonspecific Passive Innate

Acquired immunity

Specific Adaptive Active

An infected T cell creates what proteins

Abnormal proteins

BQ: What is presented by the T cells to alarm the immune system

MHC 1

BQ: Presentation of MHC1 by the T cells activates what cells in order to prevent viral replication

CD8 cells

Other name for alcohol cirrhosis (long neck)

Laennec’s cirrhosis

Loss of blood supply

Infarction

Most common organ assoc w infarction

Heart

Least common organ assoc with infarction

Liver

2 old terms for syphilis

Lues disease | Great pox

Diff dx of white mucous patches

Secondary syphilis Candidiasis White hairy leukoplakia

BQ: common side effect of rifampicin

Hepatotoxic

BQ: side effect of streptomycin

Ototoxic (ears)

Macrophages of TB

Epitheloid cells | Langhans cells

2 cells derived from neural crest cells

Melanocytes | Neuroglia/glial cells

Wear and tear arthritis

Osteoarthritis