basic pathology Flashcards
what is pyknosis?
nuclear shrinkage in apoptosis
what is karyorrhexis
nuclear fragmentation
what are two pathways of extrinsic apoptosi?
- ligand recpetor ineractions (Fas ligand binds to Fas = CD95)
- immune cell (cytotoxic release of performin and granzyme B)
name 6 types of necrosis
coagulative
liquefactive
caseous
fatty
fibrinoid
gangrenous
3 organs coag necrosis
heart
liver
kidney
3 examples of liquefactive necrosis
brain
bacterial abscess
pleural effusion
2 examples of caseous necrosis
TB
systemic fungi
fatty necrosis
perinpancreatic fat (saponification via lipase)
fibrinoid necrosis
blood vessels
gangrenous necrosis example
dry (ischemic coagulative) or wet (with bacteria); common in limbs and GI tract
what types of cell injury are reverisble with O2 (6)
decreased ATP synthesis
cellular swelling (no ATP –> impaired Na+/K+ ATPase)
nuclear chromatin clumping
decreased glycogen
fatty change
ribosomal detachment
what 5 changes are seen in irreversible cell injury?
think: membran damage
- nuclear pyknosis, karyolysis, karyorrhexis
- ca2+ influx–>caspase activation
- plasma membrane damage
- lysosomal rupture
- mitochondrial permeability
what areas are susceptible to hypoxia in:
brain -
heart -
kidney (2)
liver -1
colon -
brain - watershed areas of ACA/MCA/PCA/boundary - pyramidal cells of hippocampus and purkinje cells
heart - subendocardium (LV)
kidney: straight segment of proximal tubule(medulla) + thick ascending limb (medulla)
liver = area around central vein
colon - splenic flexure and rectum
where do red infarcts occur(3)?
damage of reperfusion
hemorhagic infarcts occur in **loose tissue ** with collaterals : liver, lung, intestine following **reperfusion **
reperfusion –>damage by free radicals
pale infarcts - 3 organs w/one blood supply
heart
kidney
spleen
hypovolemic/cardiogenic shock
type of output
tpr?
cardiac output
skin
Low-output failure
increased TPR
low cardiac output
cold, clammy pt (vasoconstriction)
septic shock
type of output
tpr?
cardiac output
skin
high-output failure
decreased TPR
dilated arterioles, high venous return
hot patient (vasodilation)
what are 6 causes of atrophy?
decreased hormones
decreased: innervation (motor neuron damage), blood flow, nutrients
increased pressure: nephrolithiasis
occlusion of secretory ducts: ie cystic fibrosis.
5 cardinal signs of inflammation
rubor -redness
dolor -pain
calor -heat
tumor -swelling
function laesa-loss of function
3 vascular components of acute inflammation
increased vascular permeability
vasodilation
endothelial injury
what are vascular components of inflammation
- increased vascular permeability (post cap venules)
- vasodilation of arterolies
- endothelial injury
3 things that mediate acute inflammation
neutrophil
eosinophil
antibody
what type of inflammation if a granuloma
chronic = nodular collections of epitheliod macrophages and giant cells
what are two outcomes of chronic inflammation?
scarring and amyloidosis
mononuclear cell mediated: charaterized by destruction and repair
associated with blood vessel proliferation, fibrosis
chronic inflammation
what are the four steps of leukocyte extravasation
note location: post capillary venules
- rolling (leukocyte: siall-lewis X; endothelial cell: e-selectin(induced by TNF-1 and IL-2), P-selectin(from weibel paladie bodies and mediated by histamine)
- tight binding: leukocyte: ICAM-1 (upregulated by TNF and IL-1) neutrophil - has LFA-1 = integrin upregulated by C5a, LTB4
3. diapedesis - PECAM-1
**4. migration - guided by chemotactic singals: C5a IL-8, LTB4, Kallikrein (CILK) **
what type of drug metabolism –> free radical injury?
phase I
which 3 enzymes can neutralize free radicals
which vitamins?
enzymes: H2O2: catalase +glutathione, peroxidase superoxide: superoxide dismutase,
vitamins: ACE
- retinopathy of prematurity
- bronchopulmonary dysplasia
- CCL4 —> liver necrosis(fatty change)
- acetaminophen OD
- iron overload (hemochromatosis)
- reperfusion after anoxia(superoxide)
are all examples of:
free radical injury
how do free radicals damage cells: 3 ways here
membrane lipid peroxidation
protein modification
DNA breakage
what from macrophages induces and maintains granuloma formation?
TNF alpha
transudate
cellularity
protein
specific graviy
3 causes
hypocellular
protein poor
specific gravity <1.012
due to: increased hydrostatic pressure, decreased oncotic pressure, Na+ retention
exudate
cellularity
protein
specific graviy
3 causes
cellular
protein rich
specific gravity >1.020
due to: lymphatic obstruction and inflammation
2 caseating granulomas
TB and fungal infections
when fibrinogen coats RBCs, what does it cause?
fibrinogen = product of inflammation that coats RBCs and causes aggregation. when aggregated, RBCs fall at a faster rate within test tube (ESR)
4 causes of increased ESR
PIICS
infections
inflammations
cancer
pregnancy
SLE
3 causes of decreased ESR?
CPS
sickle cell (altered shape)
polycythemia (too many)
CHF
what is deposited in dialiysis realted beta-amyloid?
how does it present?
b2-microglobulin in pts w/ESRD + long-term dialysis
presents as carpal tunnel and other joint tissue
8 hall marks of cancer
evasion of apoptosis
self-sufficiency in growth signals
insensitvity to anti-growth signals
sustained angiogenesis
limitless replicative potential
tissue invation
metastasis.
which two enzymes used to invade basement membrane?
collagenases and hydrolaes
what is a fibrous tissue formation in resonse to neoplasm
desmoplasia
stage vs grade
grade - degree of cellular proliferation based on histologic appearance of individual tumor
stage - degree of localiztion/spread based on site and primary lesion, spread to regional lymph node, presence of mets,
TNM
what is TNM staging system?
T- tumor size
N - node involvement
M - metastases
which 3 cytokines mediate cachexia?
TNF-alpha
IFN-gamma
IL-6
down syndroma associated cancers
AML
ALL
xerodermal pigmentosa and albinism associated cancers?
melanoma
basal cell carcinooma
squamous cell of skin
tuberous sclerosis (facial angiofibroma + seizures + metnal retardation)
giant cell astrocytoma
renal angiomyolipoma
cardiac rhabdomyoma
actinic keratosis
squamous cell carcinoma
plummer vinsion syndrome
squamous cell of esophagus
acanthosis nigricans (hyperpigmenation and epidermal thickening)
visceral malignancy (stomach, lung, uterus)
dysplastic nevus
malingant melanoma
radiation exposure
leukemia
sarcoma
papillary thyroid cancer
breast cancer
name 9 oncogenes
note: all gain of function —> increased cancer risk, need only to damage 1 allele
- abl- CML - tyrosine kinase
- c-myc - burkitt lymphoma -transcirption factor
- bcl-2 - follicular lymphoma - antiapoptotic gene
- HER2/neu breast-ovariang gastric - tyrosine kinase
- ras - colonic carcinoma - GTPase
- L-myc - lung tumor - transcription
- N-myc - adrenal medulla neuroblatoma - transcription factor
- ret - MEN2A, 2B, tyrosine kinase
- c-kit - Gastrointestial stromal tumor - cytokine receptor
what are the symptoms of acute iron poisoning?
chronic?
acute - gastric bleeding
chronic = metabolic acidosis, scarring –> GI obstruction
heritable type of amyloid?
age-related?
heritable = mutated transthyretin
age related - normal transthyretin TRR
at risk for which cancer:
AIDs patientw
Kaposi sacrocma and aggressive malignant lymphoma
autoimmune diseases associated with which cancer (hashimoot’s thyroiditis, myasthenia gravis?
lymphoma
myasthenia gravis = thymoma
abl oncogene
abl oncogene CML - tyrosine kinase
c-myc oncogene
c-myc oncogene Burkitt lymphoma - transcription factor
ras oncogene
ras oncogene colonic carcinoma - GTPase
c-kit oncogene for which cancer?
c-kit gastrointestinal tumor - cytokine receptor - oncogene
what are the tumor suppressor genes?
10
tumor suppressor genes Rb, p53, BRCA1+BRCA2, p16, BRAF, APC, WT1, NF1 + NF2, DPC4, DCC
Rb tumor suppressor gene - which cancer?
Rb retinoblastoma, osteosarcoma, inhibits E2F; blocks G1-S phase
p53 which cancer?
p53 most human cancers; Li-Fraumeni syndrome; transcription factor for p21, blocks G1—>S phase
p16 tumor suppressor gene - which cancer?
p16 melanoma
which cancer for BRAF?
BRAF melanoma
NF-1 and NF-2 which cancers?
NF1 neurofibromatosis type 1 on chromosome 17 - RAS GTPase activating proten (RAS-GAP)
NF2 Neurofibromatosis type 2 ch. 22 = merlin (schwannomin protein)
marker for which tumors?
bombesin
bombesin neuroblastoma + lugn and gastric cacioma
S-100 marks which tumors?
S-100 melanoma, schwannoma, neural tumor
aflatoxins - whch cancer?
aflatoxins liver -hepatocellular carcinoma
vinyl chloride which cancer?
vinyl chloride angiosarcoma
carbon tetrachloride which cancer?
Carbon tetrachlordie liver - centrilobular necrosis + fatty change
nitrosamines - which cancer?
nitrosamines (smoked food) stomach - gastric caner
cigarette smoke, which cancers?
cigarrete smoke larynx (squamous), lung (squamous and small cell), kidney (renal cell carcinoma), bladder (transitional cell), pancrease(adenocarcinoma), cervical carcnoma
arsenic which cancers?
arsenic skin - squamous cell; liver- angiosarcoma
which four cancers produce EPO?
EPO polycythemia - renal cell carcinoma, hemagioblastoma, hepatocellular carnioma, pheochromocytoma
which four cancers associated with psammoma bodies?
psammoma bodies PSaMMoma: papillary(thyroid), serous(ovary), meningioma, mesothelioma
