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step 1 quick hits > basic pathology > Flashcards

basic pathology Flashcards

1
Q

what is pyknosis?

A

nuclear shrinkage in apoptosis

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2
Q

what is karyorrhexis

A

nuclear fragmentation

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3
Q

what are two pathways of extrinsic apoptosi?

A
  1. ligand recpetor ineractions (Fas ligand binds to Fas = CD95)
  2. immune cell (cytotoxic release of performin and granzyme B)
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4
Q

name 6 types of necrosis

A

coagulative

liquefactive

caseous

fatty

fibrinoid

gangrenous

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5
Q

3 organs coag necrosis

A

heart

liver

kidney

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6
Q

3 examples of liquefactive necrosis

A

brain

bacterial abscess

pleural effusion

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7
Q

2 examples of caseous necrosis

A

TB

systemic fungi

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8
Q

fatty necrosis

A

perinpancreatic fat (saponification via lipase)

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9
Q

fibrinoid necrosis

A

blood vessels

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10
Q

gangrenous necrosis example

A

dry (ischemic coagulative) or wet (with bacteria); common in limbs and GI tract

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11
Q

what types of cell injury are reverisble with O2 (6)

A

decreased ATP synthesis

cellular swelling (no ATP –> impaired Na+/K+ ATPase)

nuclear chromatin clumping

decreased glycogen

fatty change

ribosomal detachment

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12
Q

what 5 changes are seen in irreversible cell injury?

think: membran damage

A
  1. nuclear pyknosis, karyolysis, karyorrhexis
  2. ca2+ influx–>caspase activation
  3. plasma membrane damage
  4. lysosomal rupture
  5. mitochondrial permeability
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13
Q

what areas are susceptible to hypoxia in:

brain -

heart -

kidney (2)

liver -1

colon -

A

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

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14
Q

where do red infarcts occur(3)?

damage of reperfusion

A

hemorhagic infarcts occur in **loose tissue ** with collaterals : liver, lung, intestine following **reperfusion **

reperfusion –>damage by free radicals

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15
Q

pale infarcts - 3 organs w/one blood supply

A

heart

kidney

spleen

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16
Q

hypovolemic/cardiogenic shock

type of output

tpr?

cardiac output

skin

A

Low-output failure

increased TPR

low cardiac output

cold, clammy pt (vasoconstriction)

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17
Q

septic shock

type of output

tpr?

cardiac output

skin

A

high-output failure

decreased TPR

dilated arterioles, high venous return

hot patient (vasodilation)

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18
Q

what are 6 causes of atrophy?

A

decreased hormones

decreased: innervation (motor neuron damage), blood flow, nutrients

increased pressure: nephrolithiasis

occlusion of secretory ducts: ie cystic fibrosis.

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19
Q

5 cardinal signs of inflammation

A

rubor -redness

dolor -pain

calor -heat

tumor -swelling

function laesa-loss of function

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20
Q

3 vascular components of acute inflammation

A

increased vascular permeability

vasodilation

endothelial injury

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21
Q

what are vascular components of inflammation

A
  1. increased vascular permeability (post cap venules)
  2. vasodilation of arterolies
  3. endothelial injury
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22
Q

3 things that mediate acute inflammation

A

neutrophil

eosinophil

antibody

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23
Q

what type of inflammation if a granuloma

A

chronic = nodular collections of epitheliod macrophages and giant cells

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24
Q

what are two outcomes of chronic inflammation?

A

scarring and amyloidosis

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25
Q

mononuclear cell mediated: charaterized by destruction and repair

associated with blood vessel proliferation, fibrosis

A

chronic inflammation

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26
Q

what are the four steps of leukocyte extravasation

note location: post capillary venules

A
  1. 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)
  2. 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) **

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27
Q

what type of drug metabolism –> free radical injury?

A

phase I

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28
Q

which 3 enzymes can neutralize free radicals

which vitamins?

A

enzymes: H2O2: catalase +glutathione, peroxidase superoxide: superoxide dismutase,
vitamins: ACE

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29
Q
  1. retinopathy of prematurity
  2. bronchopulmonary dysplasia
  3. CCL4 —> liver necrosis(fatty change)
  4. acetaminophen OD
  5. iron overload (hemochromatosis)
  6. reperfusion after anoxia(superoxide)

are all examples of:

A

free radical injury

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30
Q

how do free radicals damage cells: 3 ways here

A

membrane lipid peroxidation

protein modification

DNA breakage

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31
Q

what from macrophages induces and maintains granuloma formation?

A

TNF alpha

32
Q

transudate

cellularity

protein

specific graviy

3 causes

A

hypocellular

protein poor

specific gravity <1.012

due to: increased hydrostatic pressure, decreased oncotic pressure, Na+ retention

33
Q

exudate

cellularity

protein

specific graviy

3 causes

A

cellular

protein rich

specific gravity >1.020

due to: lymphatic obstruction and inflammation

34
Q

2 caseating granulomas

A

TB and fungal infections

35
Q

when fibrinogen coats RBCs, what does it cause?

A

fibrinogen = product of inflammation that coats RBCs and causes aggregation. when aggregated, RBCs fall at a faster rate within test tube (ESR)

36
Q

4 causes of increased ESR

PIICS

A

infections

inflammations

cancer

pregnancy

SLE

37
Q

3 causes of decreased ESR?

CPS

A

sickle cell (altered shape)

polycythemia (too many)

CHF

38
Q

what is deposited in dialiysis realted beta-amyloid?

how does it present?

A

b2-microglobulin in pts w/ESRD + long-term dialysis

presents as carpal tunnel and other joint tissue

39
Q

8 hall marks of cancer

A

evasion of apoptosis

self-sufficiency in growth signals

insensitvity to anti-growth signals

sustained angiogenesis

limitless replicative potential

tissue invation

metastasis.

40
Q

which two enzymes used to invade basement membrane?

A

collagenases and hydrolaes

41
Q

what is a fibrous tissue formation in resonse to neoplasm

A

desmoplasia

42
Q

stage vs grade

A

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

43
Q

what is TNM staging system?

A

T- tumor size

N - node involvement

M - metastases

44
Q

which 3 cytokines mediate cachexia?

A

TNF-alpha

IFN-gamma

IL-6

45
Q

down syndroma associated cancers

A

AML

ALL

46
Q

xerodermal pigmentosa and albinism associated cancers?

A

melanoma

basal cell carcinooma

squamous cell of skin

47
Q

tuberous sclerosis (facial angiofibroma + seizures + metnal retardation)

A

giant cell astrocytoma

renal angiomyolipoma

cardiac rhabdomyoma

48
Q

actinic keratosis

A

squamous cell carcinoma

49
Q

plummer vinsion syndrome

A

squamous cell of esophagus

50
Q

acanthosis nigricans (hyperpigmenation and epidermal thickening)

A

visceral malignancy (stomach, lung, uterus)

51
Q

dysplastic nevus

A

malingant melanoma

52
Q

radiation exposure

A

leukemia

sarcoma

papillary thyroid cancer

breast cancer

53
Q

name 9 oncogenes

note: all gain of function —> increased cancer risk, need only to damage 1 allele

A
  1. abl- CML - tyrosine kinase
  2. c-myc - burkitt lymphoma -transcirption factor
  3. bcl-2 - follicular lymphoma - antiapoptotic gene
  4. HER2/neu breast-ovariang gastric - tyrosine kinase
  5. ras - colonic carcinoma - GTPase
  6. L-myc - lung tumor - transcription
  7. N-myc - adrenal medulla neuroblatoma - transcription factor
  8. ret - MEN2A, 2B, tyrosine kinase
  9. c-kit - Gastrointestial stromal tumor - cytokine receptor
54
Q

what are the symptoms of acute iron poisoning?

chronic?

A

acute - gastric bleeding

chronic = metabolic acidosis, scarring –> GI obstruction

55
Q

heritable type of amyloid?

age-related?

A

heritable = mutated transthyretin

age related - normal transthyretin TRR

56
Q

at risk for which cancer:

AIDs patientw

A

Kaposi sacrocma and aggressive malignant lymphoma

57
Q

autoimmune diseases associated with which cancer (hashimoot’s thyroiditis, myasthenia gravis?

A

lymphoma

myasthenia gravis = thymoma

58
Q

abl oncogene

A

abl oncogene CML - tyrosine kinase

59
Q

c-myc oncogene

A

c-myc oncogene Burkitt lymphoma - transcription factor

60
Q

ras oncogene

A

ras oncogene colonic carcinoma - GTPase

61
Q

c-kit oncogene for which cancer?

A

c-kit gastrointestinal tumor - cytokine receptor - oncogene

62
Q

what are the tumor suppressor genes?

10

A

tumor suppressor genes Rb, p53, BRCA1+BRCA2, p16, BRAF, APC, WT1, NF1 + NF2, DPC4, DCC

63
Q

Rb tumor suppressor gene - which cancer?

A

Rb retinoblastoma, osteosarcoma, inhibits E2F; blocks G1-S phase

64
Q

p53 which cancer?

A

p53 most human cancers; Li-Fraumeni syndrome; transcription factor for p21, blocks G1—>S phase

65
Q

p16 tumor suppressor gene - which cancer?

A

p16 melanoma

66
Q

which cancer for BRAF?

A

BRAF melanoma

67
Q

NF-1 and NF-2 which cancers?

A

NF1 neurofibromatosis type 1 on chromosome 17 - RAS GTPase activating proten (RAS-GAP)

NF2 Neurofibromatosis type 2 ch. 22 = merlin (schwannomin protein)

68
Q

marker for which tumors?

bombesin

A

bombesin neuroblastoma + lugn and gastric cacioma

69
Q

S-100 marks which tumors?

A

S-100 melanoma, schwannoma, neural tumor

70
Q

aflatoxins - whch cancer?

A

aflatoxins liver -hepatocellular carcinoma

71
Q

vinyl chloride which cancer?

A

vinyl chloride angiosarcoma

72
Q

carbon tetrachloride which cancer?

A

Carbon tetrachlordie liver - centrilobular necrosis + fatty change

73
Q

nitrosamines - which cancer?

A

nitrosamines (smoked food) stomach - gastric caner

74
Q

cigarette smoke, which cancers?

A

cigarrete smoke larynx (squamous), lung (squamous and small cell), kidney (renal cell carcinoma), bladder (transitional cell), pancrease(adenocarcinoma), cervical carcnoma

75
Q

arsenic which cancers?

A

arsenic skin - squamous cell; liver- angiosarcoma

76
Q

which four cancers produce EPO?

A

EPO polycythemia - renal cell carcinoma, hemagioblastoma, hepatocellular carnioma, pheochromocytoma

77
Q

which four cancers associated with psammoma bodies?

A

psammoma bodies PSaMMoma: papillary(thyroid), serous(ovary), meningioma, mesothelioma

step 1 quick hits (15 decks)

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