Basic Pathology Flashcards
Physiologic vs pathologic hypertrophy: Athlete’s heart
Physiologic
Physiologic vs pathologic hypertrophy: Pregnant uterus
Physiologic hypertrophy after an initial physiologic hyperplasia
2 mechanisms of atrophy resulting in a decrease in size of cells
1) Ubiquitin-proteasome degradation
2) Autophagy
Mechanism of atrophy resulting in a decrease in number of cells
Apoptosis
Normal left ventricular thickness
1.5 cm
Normal right ventricular thickness
0.5 cm
Mechanism of metaplasia
Reprogramming of stem cells
Epithelial vs mesenchymal: Type of tissue most commonly affected by metaplasia
Epithelial
Most common type of metaplasia
Squamous metaplasia
Type of metaplasia seen in the cervix
Glandular/columnar metaplasia
Mesenchymal metaplasia characterised by heterotropic ossification usually within large muscles
Myositis ossificans
Cellular adaptation that takes place in the specialized conjunctival epithelium in vitamin A deficiency
Keratomalacia (metaplasia)
Symptom experienced by patients with keratomalacia
Night blindness
Vitamin A is essential in the maturation of the immune system hence it (ATRA) is used in the treatment of
Acute promyelocytic leukemia
T/F Metaplasia is premalignant
F
T/F Dysplasia is premalignant
T
Ischemia can cause permanent damage to the brain if not reversed within
3-5 minutes
T/F Hyperplasia can progress to dyplasia and CA
T
Example of hyperplastic condition that may progress to CA
Endometrial hyperplasia
Pathologic hypertrophy vs hyperplasia: BPH
Hyperplasia
T/F BPH is premalignant
F
Type of hyperplasia in the endometrium that may progress to carcinoma
Complex hyperplasia
Most common cause of cellular injury
Hypoxia
Final electron acceptor in the ETC
O2
Substance that has 100x more affinity to hgb than O2
CO
Appearance of skin with CO poisoning
Cherry red
First symptom of CO poisoning
Headache
Most common cause of hypoxia
Ischemia
Most common cause of Budd-Chiari syndrome (renal vein thrombosis)
Polycythemia
Spectrum of morphologic changes that follow cell death in living tissue
Necrosis
Type of necrosis seen in arteries and autoimmune diseases
Fibrinoid necrosis
Cellular change responsible for shedding of endometrium in menstrual cycle
Apoptosis
Literal meaning of apoptosis
Falling of leaves
Type of cell death responsible for spaces between fingers in embryologic development
Apoptosis
T/F Necrosis is always pathologic
T
Substance that initiates cell death
Caspases
CD of fas receptor
CD95
Where in the mitochondria is cytochrome c located
IMM
Pro-apoptotic factors
1) Bax
2) Caspase 3
3) p53
Antiapoptotic factors
Bcl-2
Most common form of lipid deposited in fatty change
TAG
Most common cause of fatty change in adults
Alcohol
Abnormal protein deposited in multiple myeloma
Russel bodies
Pink, eosinophilic inclusions in plasma cells in patients with multiple myeloma
Russel bodies
Glycogen storage diseases
Very Poor CArbohydrate Metabolism I - von Gierke's II - Pompe's III - Cori's IV - Andersen V - McArdle
Morphologic hallmark of cell death
Loss of nucleus
Coagulative necrosis is usually due to
Ischemia
Type of infarction seen with arterial occlusion
Pale/white infarction
Type of infarction seen with venous occlusion
Red infarction
White vs red infarction: Renal
White
White vs red infarction: Testicular
Red
Type of necrosis seen in the pancreas
Liquefactive
Type of necrosis seen in uterus of pregnant women with preeclampsia
Fibrinoid necrosis
Type of necrosis seen in malignant hypertension
Fibrinoid necrosis
Enzyme deficient in Gaucher’s disease
Glucocerebrosidase
Enzyme deficient in Tay-Sach’s disease
Hexosaminidase A
Enzyme deficient in Nieman-Pick’s disease
Sphingomyelinase
Disease in which microscopically, the nucleus is pushed to the periphery and the cytoplasm looks like crumpled tissue paper
Gaucher’s disease
Most common endogenous pigment
Lipofuscin
Substance accumulation in which DM may arise and called bronze DM
Hemochromatosis
Malarial pigment
Hematin/hemozoin
Malarial pigment: (+) vs (-) Prussian blue
Negative
Pigment: P. falciparum
Maurer’s dots
Pigment: P. malariae
Zieman’s dots
Pigment: P. ovale
James dots
Pigment: P. vivax
Schuffner’s dots
Copper storage is seen in what disease
Wilson’s disease or hepatolenticular degeneration
Enzyme increased in alcohol poisoning resulting in fatty liver due to esterification of FA to TAG
Alpha glycerophosphate
Formed when tyrosine oxidase catalyses the oxidation of tyrosine to dihydroxyphenylalanine
Melanin storage
Disease in which there is a lack of homogentisic dioxygenase leading to accumulation of homogentisic acid causing urine to turn black upon exposure to air
Alkaptonuria
Close differential for melanin storage being similar in having brown-black pigment (seen in alkaptonuria)
Onchronosis
Calcium deposits seen in non-viable or dying tissue
Psamomma bodies or asbestos bodies
Diseases in which psamomma bodies are seen
PSMM
1) Papillary thyroid CA
2) Serous ovarian CA
3) Meningioma
4) Mesothelioma
Dystrophic vs metastatic calcification: Causes organ dysfunction
Dystrophic
Any change within or outside cell which gives a homogenous, glassy, pink appearance on routine H and E
Hyaline change
Hyaline change that gives (+) Congo Red stain
Amyloid
Appearance of (+) Congo Red stain
(+) birefringence (green) on polarised microscope
Hallmark of early hemodynamic change
Increased blood flow
Hallmark of acute inflammation
Increased vascular permeability and edema
P-selectin is derived from
Weibel-Palade bodies
Normal fluid exchange and microvascular permeability are dependent on
An intact endothelium
Refers to transport of fluid through endothelial cells by channels of interconnected, uncoated vesicles and vacuoles (vesiculovacuolar organelles)
Transcytosis
Why is there LEAKAGE from regenerating capillaries?
Proliferating endothelial cells are leaky
Hydrothorax is defined as
Any amount >15mL in the thoracic space
Blood vessels involved in active congestion
Arterioles
Blood vessels involved in passive congestion
Veins
Zone of the liver most susceptible to toxin
Zone 1
Autosomal recessive defect of integrins
Leukocyte adhesion defect 1
CD mutated in leukocyte adhesion defect 1
b chain of CD11/CD18 integrins
Substances that up regulate integrins
1) LTC4
2) C5a
Preformed mediators of inflammation found in secretory granules of leukocytes
1) Histamine
2) Serotonin
3) Lysosomal enzymes
Cellular source of histamine in inflammation
Mast cells
Cellular source of serotonin in inflammation
Platelets
Cellular source of lysosomal enzymes in inflammation
Neutrophils
Defective leukocyte adhesion due to mutations in fucosyl transferase
Leukocyte adhesion defect 2
Genetic defect wherein there is decreased oxidative burst
CGD
Most common infections encountered in CGD
Catalase (+) organisms
Catalase (+) organisms
1) S. aureus
2) Pseudomonas cepacia
Enzyme defect in CGD
NADPH oxidase
Test for CGD
Nitroblue tetrazolium test
Nitroblue tetrazolium test result in CGD
Normal
DDx for CGD
Myeloperoxidase deficiency
Decreased leukocyte functions because of mutations affecting protein involved in lysosomal membrane trafficking
Chediak-Hegashi syndrome
Most common infections encountered in Chediak-Higashi syndrome
Pyogenic infections
Components of Chediak-Higashi syndrome
1) Giant platelets
2) Albinism
3) Microtubule system defect
Source of secretions in inflammation
Endothelial cells
3 major opsonins
1) Fc fragment of IgG
2) C3b
3) Plasma lectins (MBL in 3rd pathway of c’ activation)
Auer rods are seen in WBCs of patients with
AML
Stage of WBC development where azurophilic granules are seen
Promyelocyte
Stage of WBC development where specific granules are seen
Myelocyte
Last stage of WBC development that is capable of cell division
Myelocyte
WBC granules: AKA primary granules
Azurophilic granules
WBC granules: AKA secondary granules
Specific granules
WBC granules: AKA tertiary granules
Gelatinase granules
Primary vs secondary granules: MPO
Primary
Primary vs secondary granules: Collagenase
Secondary
Primary vs secondary granules: Lysozyme
Primary, secondary, and tertiary
Primary vs secondary granules: Elastase
Primary
Primary vs secondary granules: Lactoferin
Secondary
Half-life of neutrophils in circulation
4-6h
Half-life of neutrophils in tissue
1-2 days
Characteristic substance present in eosinophilic granules that are very toxic to parasites
MBP
Tissue basophils
Mast cells
Characteristic substance present in basophilic granules
Histamine
CD marker for macrophages/monocytes
CD68
2 mechanisms of destruction of phagocytosed material
1) O2-dependent
2) O2-independent
Most effective mechanism of destruction of phagocytosed material
O2-dependent
O2-dependent destruction of phagocytosed material is aka
Oxidative burst
WBCs that exhibit O2-independent killing of phagocytosed material
Macrophages/monocytes
Macrophage in skin and mucosa
Langerhans cells
Macrophage in placenta
Hoffbauer cell
Another name for tissue macrophages
Histiocytes
Half-life of monocytes in circulation
24-72 hrs
WBC: Source of multinucleate giant cells
Monocyte
WBC: Source of epitheloid cells
Monocyte
Population: T lymphocytes vs B lymphocytes
T
Secretions in serous inflammation is derived from
Mesothelial cells
Patterns of acute inflammation: Skin blister
Serous
Patterns of acute inflammation: Abscess
Suppurative
Patterns of acute inflammation: Bread and butter pericarditis
Fibrinous
Patterns of acute inflammation: Diphtheria infection
Membranous
Patterns of acute inflammation: Clostridium difficult infection
Membranous
Lipoxins: Stimulate vs inhibit chemotaxis
Inhibit
Proteins produced by inflammatory cells that play a role in inflammation
Cytokines
Small proteins that attract PMNs
Chemokines
Macrophages: Lymph nodes
Sinus histiocytes
Macrophages: Lungs
Dust cells
Macrophages: Connective tissue
Histiocytes
Macrophages: CNS
Microglial cells
Macrophages: Kidney
Intraglomerular mesangial cell
Macrophages: Bone
Osteoclast
Macrophages: Granuloma
Epitheloid histiocytes
Cellular sources of serotonin (2)
1) Platelets
2) Enterochromaffin cells
Vasoconstrictor and platelet activator in COX pathway
TXA2
PG mediator of pain and fever
PGE2
PG that decreases platelet aggregation
PGI2
Key component of kinin system
Bradykinin
Brought about by intensive deposition of collagen
Fibrosis
Vitamin required for hydroxylation of procollagen
Vitamin C
T/F Granuloma always has central necrosis
F
Proliferation of cells and tissues to replace lost structures
Regeneration
Process of tissue necrosis resulting from interference of blood supply
Infarction
Type of infarction that is sterile
Bland infarction
Caused by air embolism in chronic decompression sickness
Caisson disease
Embolus from venous to arterial circulation
Paradoxical embolus
Steps in primary hemostasis
1) Adhesion
2) Activation
3) Aggregation
Steps in secondary hemostasis
1) Thrombin formation
2) Stable fibrin clot formation
Virchow’s triad
1) Stasis
2) Hypercoagulability
3) Blood vessel injury
Endotoxic shock: G+ vs G-
G-
AKA endotoxin
Bacterial wall LPS
A genetic locus on chromosome 6 that encodes for cell surface compatibility
MHC
MHC I vs MHC II: HLA A, B, C
MHC I
MHC I vs MHC II: Present in all nucleated cells and platelets
MHC I
Ig Class: Surface of B cells
IgD
Ig Class: Surface of mast cells
IgE
Ig Class: Immediate hypersenstivity
IgE
Ig Class: Crosses placental barrier
IgG
Ig Class: Pentamer
IgM
Ig Class: Dimer
IgA
Ig Class: Mucosal surface
IgA
Ig Class: Primary immune response
IgG
B cells are found in (2)
1) Superficial cortex of LN
2) White pulp of spleen
CD: Pre B cell
CD 10
CD: NK cells
CD18
MHC II/HLA disease associations: Lupus
DR2
MHC II/HLA disease associations: Multiple sclerosis
DR2
MHC II/HLA disease associations: Sjogren
DR3
MHC II/HLA disease associations: RA
DR4
MHC II/HLA disease associations: IDDM
DR3
MHC II/HLA disease associations: Graves
DR3
MHC II/HLA disease associations: Hashimoto
DR5
MHC II/HLA disease associations: Primary biliary cirrhosis
DR8
Complement factors that are anaphylatoxins
C3a, C5a
Type of hypersensitivity: Arthus reaction
Type III
Type of hypersensitivity: Fibrinoid necrosis of vessels
Type III
Type of hypersensitivity: Polyarteritis nodosa
Type III
Type of hypersensitivity: RA
Type IV
Type of hypersensitivity: Crohn
Type IV
Organ transplantation: Monozygotic twins
Syngeneic
Organ transplantation: Same species
Allogeneic
Organ transplantation: Different species
Xenogeneic
Hyperacute, acute. subacute, chronic: Rejection that produces arthus reaction with ag-ab mediated fibrinoid vasculitis
Hyperacute
Hyperacute, acute. subacute, chronic: Rejection characterised by cell-mediated or humorally mediated vasculitis
Acute
Hyperacute, acute. subacute, chronic: Rejection characterised by vasculitis with marked thickening of intima of blood vessels, fibroblast and myocyte proliferation and luminal narrowing
Subacute
GVHD most commonly occurs following what transplant
Non-autologous bone marrow
Organs most damaged in GVHD (4)
1) Liver
2) Spleen
3) Intestine
4) Skin
Hallmark of chronic inflammation
Tissue fibrosis
