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Pathology > Chapter 9 And 10 > Flashcards

Chapter 9 And 10 Flashcards

1
Q

Cyp450 and benzopyrene

A

Generates dna binding metabolite from benzopyrene present in cigarette smoke and grilled meats

Oxidized by hyp2e1 which disrupts differentiation of hematopoietic cells resulting in bone marrow aplasia and AML

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2
Q

How does ground level ozone damage

A

Respiratory epithelium and type 1 alveolar cells ——inflammatory mediators

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3
Q

CO poisoning causes hypoxia then unconsciousness. Describe what happens with hypoxia

A

Decreased oxygen to brain-neuro prob
Lactic acidosis
Breakdown of heart and skeletal muscle creatine kinase

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4
Q

Chronic CO poisoning

A

Basal ganglia and lenticular nuclei first

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5
Q

Morphological changes with CO

A

Brain edema
Punctuate hemorrhage’s
Hypoxia induced neuronal changes

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6
Q

Lead major targets

A 
Bone marrow blood nervous system first
Microcytic hypochromic anemia 
Punctuate wrist drop foot drop 
Renal interstitial fibrosis 
Decreased uric acid secretion saturnine gout
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7
Q

Arsenic poison

A

2-8 weeks
Sensorimotor neuropathy , numbness and pain

Chronic-lung bladder skin cancer

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8
Q

Beryllium

A

Inhaled

Sarcoidosis like granuloma

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9
Q

Chromium and nickel

A

Upper respiratory carcinoma

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10
Q

Organic solvents

A

Leukemia

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11
Q

What is cofactor of Alcohol dehydrogenase . Is this a problem

A

NAD
Can’t beta oxidation and lactate to pyruvate
Acid and fatty liver

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12
Q

How does alcohol cause hepatic injury through tnf and cytokines from macrophages and Kupffer cells

A

Causes release of endotoxin lps from gram negative bacteria in intestinal Fluora

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13
Q

Acute alcohol

A

Subcortical(RAS dependent) -reticular formation -cortical activity

Thennnnnnn lower medulla neurons —respiratory centers respiratory arrest
Acute gastritis and ulceration
Higher levels respiratory arrest

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14
Q

Chronic alcoholism

A

Peripheral neuropathies
Wernicke
Gi bleeds
Dilated heart alcohol cardiomyopathy

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15
Q

____ adductor have been found in alcohol related tumours. What individuals are most susceptible

A

Acetylaldehyde

ALDH22

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16
Q

HRT increases risk of what

A

Ovarian and endometrial cancers

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17
Q

Acetaminophen is made to NAPQI. What metabolizes NAPQI. Clinicaleffects

A

Glutathione conjugates. It. Glutathione low if have a lot. So NAPQI covalently binds to hepatic proteins and damages things and depletes gsh—SUSCEPTIBLE TO ROS, which you get from cyp

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18
Q

How restore glutathione

A

N acetylcysteine

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19
Q

Overdose acetaminophen

A

Centrilobular necoris
Extens to lobules
Liver transplant only hope for survival

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20
Q

Aspirin overdose

A

Bleed prob

Increase breathing -respiratory alkalosis
Compensatory acidosis uncoupling ox phos and stop Krebs cycle

NAUSEA COMA

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21
Q

Chronic asprin

A

Acute erosive gastritis gi bleeds and gastric ulceration

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22
Q

Analgesic nephropathy

A

Asprin and acetaminophen

Tubulointerstitial nephriits, renal papillary necrosis
Analgesic nephropathy

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23
Q

Opiates

A 
Sudden death-depression 
Pulmonary injury-edema sepsis embolism granuloma 
Infection SA right sided tricuspid value
Skin 
Kidney amyloidosis
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24
Q

Meth

A

Releases dopamine in brain inhibits presynaptic neurotransmission at corticostriatal synapses
Slow glutamate release
Euphoria then crash
Violence, confusion psychotic paranoia

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25
Q

MDMA

A 
Euphoria hallucinations 3-6 hours
Increase serotonin in cns
Post use drop in serotonin 
Reduces serotonergic axon terminals 
Increase peripheral effects of dopamine
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26
Q

Marijuana

A

Increase heart rate. And bp
Angina
Laryngitis, pharyngitis, bronchitis, cough and hoarseness
Cognitive impairments
Threefold increase in amount of tar inhaled compared to cigarette

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27
Q

Bath salts

A

Amphetamine

Agitation psychosis mI suicied

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28
Q

PCP

A

Anesthetic

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29
Q

Ketamine

A

Anesthetic

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30
Q

Burn

A

Shock sepsis respiratory insuffiency

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31
Q

Infections of burns

A

PA MRSA candida

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32
Q

Heat stroke progression

A

Thermoregulatory mechanism fail-sweating ceases body temp rises multiorgan dysfunction death

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33
Q

Presentation heat stroke

A

Vasodilation, peripheral pooling of blood decreased effective circulating volume
Sustained muscle contractions
Hyperkalemia tachycardia
Arrhythmia

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34
Q

Malignant hyperthermia

A 
Ryr1 mutation 
Sarcoplasmic reticulum release ca sustained muscle contraction 
After given succinylcholine
Treat with dantrolene 
INCREEASE RIGHT OF HEAT STROKE
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35
Q

What causes sustained muscle contraction

A

Nitrosylation of ryanodine receptor

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36
Q

Hypothermia

A

Below 90 lose consciousness then bradycardia and a fib

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37
Q

Direct cause of injury from hypothermia

A

Increase na from crystallization of water intra and extracellular ya

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38
Q

Indirect causes of hypothermia damage

A

Slow chilling-vasoconstriction increased permeability hypoxia and edema

Fast chilling vasoconstriction and viscocity-ischemic injury and degenerative changes in peripheral nerves (ischemia and infarction)
Vascular injury evident after termpature returns to normal

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39
Q

Electrical injur

A

Burns and ventricular fibrillation

Titanic muscles make hard to let go of a live wire

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40
Q

Morphology of ionizing radiation

A

Dna damage
Nuclear swelling
Soto plasmid swilling and distortions
Vessels dissolute

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41
Q

Marsumus

A 
Somatic protein compartment issue
Albumin normal 
Muscle and fat are energy sources
Leptin low-Hpv axis-cortisol-lipolysis
Head too large for body
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42
Q

Kwashiorkor

A 
Visceral protein problem 
Hypoalbumin low-EDEMA dependents 
Spare subcutaneous muscle mass 
Hyperpigmentation /flakey
Enlarged fatty liversmall bowel decreased villi and crypts (mitosis index)
They mic and lymphoid atrophy
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43
Q

Bone marrow in PEM

A

Aplastic anemia

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44
Q

Anorexia

A

Cardiac arrhythmia, sudden death from hypothalamic

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45
Q

Vitamin a defiency

A

Squamous metaplasia-keratinizing epithelium
Celiac disease
Xeropthalmia
Keratin plaque (bigot)
Desquamation of keratin in urinary tract leaders to renal and urinary bladder infections

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46
Q

Follicular or popular dermatomes vitamin a defiency

A

Hyperkeratinization of the epidermis with plugging of the adnexal gland ducts

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47
Q

Why is vitamin a a treatment for acute promyleocytic leukemia cells

A

Bind pml-rar fusion protein that characterize the cancer

48
Q

Clinical vitamin a defiency

A

Night blind, epithelial metaplasia keratinization (need vitamin a to differentiate epithelial cells)
Bigots spot
Squamous metaplasia -pulmonary infections, bladder stones, immune, follicular or popular dermatomes

49
Q

Vitamin a toxicity

A

Head ache vomit, stupor blurred vision (pseudomotor cerebri)
Weight loss, anorexia, vomiting, bone and joint pain
OSTEOCLASTS-increased bone resorption and increased frequency fractures

50
Q

Low ca, increase of decrease PTH

A

Increase

51
Q

Vitamin d and osteoclast

A

Increase ca increase osteoclast to make more bone

52
Q

PTH effect on vitamin d

A

More

53
Q

Rickets

A

Overgrowth cartilage failure of it to mature

54
Q

Are contours of bone effected in rickets and osteomalatia

A

Just rickets

55
Q

TLR activation of macrophages can induce the increase the conversion of ___ to its active form

A

Vitamin d

56
Q

Too much vitamin d

A

Metastatic calcification

57
Q

Scurvy

A

Bone disease in growing kids and by hemorrhage’s in healing adults

58
Q

Iron defiency

A

Hypochromic microcytic anemia

59
Q

B1

A

Decarboxylation reactions
Wernickes
Korsakoff
Beri beri

60
Q

B6

A

Myelinated spinal cord

61
Q

Obesity

A

T2d, cholelithiasis, cancer

35% Americans obese

62
Q

Thermogenesis

A

Leptin induced

63
Q

What protective hormone is decreased in obese patients that protects against metablic syndrome

A

Adipolectin

64
Q

Pomc cart

A

Energy expenditure msha

65
Q

Npy agrp

A

Food intake via 71/5

66
Q

Pickwickian syndrome

A

Respiratory problems obese

Hypoventilation

67
Q

Obesity causes a pro __ state

A

Inflammatory

68
Q

Why high animal fat give cancer

A

Bile and lower stool bulk and fewer fibers to bind harmful carcinogens

69
Q

Why intrauterine infections the second leading cause of preterm births

A

Tlr inhibit prostaglandin

70
Q

Fetal causes of fgr

A

Torch

Chromosomal congenital

71
Q

Placental causes of fgr( spare brain)

A

3rd trimester burden
Umbilical placental anomalies
Multiple gestational

72
Q

Maternal causes of fgr

A

Thrombophilias: acquired antiphospholipid syndrome
Preeclampsia
Drugs alcohol malnutrition
DECREASED PLACENTAL BLOOD FLOW

73
Q

In rds, hypoxemia causes what

A

Further failure in surfactant synthesis

74
Q

What makes surfactant

A

Glucocorticoids, tgf b thyroxine prolactin

75
Q

How does maternal diabetes effect surfactant

A

Increased glucose levels in mom increases insulin in baby-inhibit surfactant synthesis
Treat with corticosteroid

76
Q

Atelectais

A

Alveoli poorly developed

Eosinophils hyaline membranes

77
Q

Bronchopulmonary dysplasia

A

Striking decrease in alveolar septation (large simplified alveolar structure) and a dysmorphic capillary configuration

Reversible impairment in the development of alveolar septation in saccular stage
From hyperthermia, hyperventilation, prematurity , inflammation tnf il1,6,8 and vascular maldevelopment

78
Q

Infants who recover from rds are at increased risk of what

A

Pda, intracentricular hemorrhage and necrotizing entercolitis

79
Q

Pneumatosis intestinalis

A

Nec

Necrotizing enterocolitis

80
Q

Is nec multifactorial

A

Yup usually start after feeding (bacteria introduction so after that

81
Q

Morphology nec

A

Terminal ileum, cecum, right colon, submucosal gas bubbbles

82
Q

Treat nec

A

Resection, fibrosis

83
Q

Transcervical infections

A

Bacterial except herpes

84
Q

Transplacental infection

A

Viral parasitic except listeria treponema

Through chorionic villi
Parvovirus B19

85
Q

Early onset perinatal sepsis

A

Pneumonia sepsis meningitis
Group b strep
Week

86
Q

Late onset perinatal sepsis

A

Late onset listeria and candida

Week to three months

87
Q

HYDROPS

A

Anemia and jaundice

Anemia liver and hear damage
Less albumin
Edema, hydrops fetalis anasarxa

Jaundice-hemolysis unconjugated

88
Q

Anasarca

A

Generalized edema

89
Q

Non immune hydrops

A

Cv defects, abnormalities, anemia,
Turners, 18, 21, due to cv problem
Turners-lymphatics in neck can lead to postnuchal accumulation (cystic hygroma)
Anemia-a thalassemia deletion of a globin

90
Q

Hydrops associated with anemia

A 
Pale fetus and placenta 
Hepatosplenomegaly due to cv and congestion 
Erythroid precursors 
EXTRAMEDULLARY HEMATOPOIESIS 
ERYTHROBLASTOSIS FETALIS
91
Q

Kernicterus

A

Enlarged brain
Edema
Yellow

92
Q

Pku normal at birth

A

6 months mental retardation

93
Q

Galactosemia

A 
Fail to thrive from birth
Cataracts weeks 
Mental retard 6 months 
AMINOACIDURIA 
Less aa transport due to accumulation in kidney
94
Q

Cf and vit a

A

Vit a defiency leads to night blindness and squamous metaplasia of ducts of pancreas

95
Q

Salivary gland cf

A

Dilation of ducts squamous metaplasia and glandular atrophy and fibrosis

96
Q

Meconium ileus

A

5-10% cf

97
Q

SIDS triple risk

A

Vulnerable infant (serotonin reticular activating system)
Exogenous stressor
Critical development period

98
Q

Laryngeal chemoreceptors

A

Stimulated inhibit cardiorespiratory reflex
Respiratory infection increased secretions
Prone impairs swallowing

99
Q

Male or female SIDS

A

Male

100
Q

Heterotopia(choristoma)

A

Normal cells in abnormal locations

101
Q

Hamartoma

A

Focal growth of tissue that is native to site of origin
Mature and well differentiated but does not follow the architecture of the original tissue
Like a neoplasm

102
Q

Hemangioma

A

Hippel lindau

Subsets familial with cerebral cavernous malformations CCM

103
Q

Lymphangiomas

A

Hamartomatous or neoplasticism
Cystic and cavernous spaces skin but more likely deeper
Benign
Can grow and encroach on vital tissues

104
Q

Lymphangiectasis

A

Dilation of lymph channels
Swelling
Doesn’t extend
Cosmetics

105
Q

Fibrosarcoma

A

Same as adult
Excellent prognosis
Etv6-ntrk3 fusion

106
Q

Teratomas

A

Malignant potential with amount of immature tissue

107
Q

Peaks for teratomas

A

2 and early adult

108
Q

Most common teratomas of kids

A

Sacrococcygeal
Girls
Spina bifida most mature
Older get more likely to be malignant

109
Q

Adult malignant tumor

A

Mesenchyme hematopoietic nervous system bone kidney

110
Q

Neuroblastic Germaine mutation

A

Anaplastic lymphoma kinase alk

111
Q

Somatic gain of function in alk

A

Less than 10% of sporadic

112
Q

Rosetttes

A

Neuroblastoma

Tumor cells concentrically arranged about a central space filled with NEUROPIL

113
Q

Galgioneuroblastoma ganglioneuroma

A

Larger, Schwann

FAVORABLE

114
Q

Neuroblastoma clinical

A 
Large abdominal mass fever weight loss respiratory bone pain 
Pro ptosis each Yoshi’s 
Bladder bowel dysfunction catecholamines
BLUEBERRY MUFFIN BABY 
VMA HVA
115
Q

Poor prognosis neuroblastoma

A 
Myc
Deploidy
1p 11q loss 
1p36 loss
Trkb (a favorable)
Atrx and ptprd genes (neuritogenesis)
116
Q

Wilms

A

Most common primary renal tumor of childhood 1-5

Nephrogenic rests precursors

Pathology (36 decks)

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