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Pathology 1 > Exam 1 > Flashcards

Exam 1 Flashcards

0
Q

How do melasma and vitiligo differ!

A

Melasma is a hyperpigmentation, whereas vitiligo is depigmentation. Melasma is hormonally regulated and so is easier to treat, often regresses after pregnancy. Vitiligo is often autoimmune/genetic and is difficult to treat (skin bleaching)

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1
Q

What is the significance of desmosomes in skin pathology?

A

Desmosomes help attach layers of the skin to each other. Damage to these structures can cause pemphigus (blisters) and acantholysis. Nikolskis sign helps diagnose this. Can occur in superficial or basal layers.

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2
Q

What is the fundamental difference between freckles and lentigo?

A

Lentigo involves melanocyte hyperplasia whereas freckles (ephelides) involves a normal amount of melanocytes but increased melanin production.

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3
Q

What does the word lentigo mean?

A

A flat spreading out with clear borders. Like sun spots or Lentigious melanoma or acral- Lentigious melanoma (peripheral, seen in dark-skinned individuals mostly)

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4
Q

What are the characteristics of congenital birthmarks?

A

Called nevi (nest of melanocytes) . Present at birth. Large nevi can develop into melanoma in rare cases.

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5
Q

What is meant by the word nevus?

A

Nest- a nest of melanocytes. Can be a congenital birthmark or a mole

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6
Q

What characteristics indicate that a nevus may be dysplastic?

A

Large, irregular pigmentation and borders. ABCD (asymmetry, irregular borders, varied color, large diameter). AD CMM1 gene. Biggest factor: growth rate- observe over time with pictures

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7
Q

Which type of melanoma has the best prognosis? Which has the worst?

A

Lentigo maligna melanoma has the best prognosis (flat, only on the surface). Nodular melanoma has the worst prognosis (due to vertical growth pattern)

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8
Q

What is the most common type of melanoma?

A

Acral lentiginous melanoma is most common in dark-skinned individuals. Superficial spreading melanoma is the most common type otherwise.

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9
Q

In general, how is the malignant potential of melanoma assessed?

A

ABCDs for moles ( asymmetrical, irregular borders, varied color, diameter >5mm)
EFGs for nodular melanoma (elevated, firm, growing)
In general, growth indicates malignant potential.
Vertical growth also indicates increased malignancy versus horizontal growth.

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10
Q

What can acanthosis nigricans be an indication of?

A

Thickened, hyperpigmented skin in axillae and groin. Often associated with obesity, hyperinsulinemia or an internal malignancy

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11
Q

What is the sign of leser-trelat?

A

The sudden appearance of multiple seborrheic keratoses (keratin build-up nodule with “stuck on appearance”) that may indicate an underlying malignancy

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12
Q

What is the basic pathophysiology of psoriasis?

A

Autoimmune disorder characterized by an increased proliferation and turnover of keratinocytes. Elongation and thickening of rete ridges, hyperkeratosis, epidermal hyperplasia

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13
Q

What test is used in the clinic to evaluate for psoriasis?

A

Auspitz sign: removing the silvery plaque results in pinpoint bleeding due to the dilated capillaries in the dermis and the increased rete ridge size.

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14
Q

What is the basic pathophysiology of pemphigus?

A

Autoimmune disorder characterized by intraepidermal blister formation. Autoantibodies to desmoglien 3 of the desmosomes results in loss of adhesion between dermal layers (acantholysis) and blisters. Easily ruptured, flaccid blisters

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15
Q

What test is used in the clinic to evaluate for pemphigus?

A

Nikolskis sign- put pressure on the blister, see if in ruptures easily.

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16
Q

What immunoglobulin is involved in the pathogens is of dermatitis herpetiformis? And what disease is the condition thought to be linked to?

A

Deposition of IgA gliadin antibodies at the dermal papillae causing blister formation. Often associated with celiac sprue

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17
Q

What is the difference between xerosis and eczema?

A

Eczema is an inflammatory condition characterized by IgE mediated hypersensitivity. Xerosis is decreased skin lipids often in aging and diabetes.

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18
Q

What is the basis of the butterfly rash of cutaneous lupus erythematous?

A

Deposition of DNA-anti DNA complexes in the basement membrane if the epidermis

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19
Q

Is pityriasis rosea a dangerous condition?

A

No, it’s benign but may cause temporary substantial discomfort

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20
Q

What is the difference between erythema nodosum and erythema multiforme?

A

E.multiforme is a hypersensitivity reaction characterized by target lesions. E.nodosum is a generalized rash usually on the skin that is uncomfortable but goes away in 2-3 weeks, with a number of causes (TB, sarcoid, strep)

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21
Q

What skin layers are involved in BCC, SCC and melanoma?

A

Melanoma: melanocytes in dermal layers
BCC: basal (deeper)
SCC: squamous (dermal and epidermal)

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22
Q

What is the definition of pathology?

A

The characteristics of a disease, including signs, symptoms, pathogenesis, complications, structural and functional alterations in cells, organs and tissues

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23
Q

What is the definition of disease?

A

An impairment of the normal state of a living animal or plant body or part

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24
Q

What is iatrogenic?

A

Disease caused by a health care profession or health care

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25
Q

What is idiopathic?

A

An unknown cause

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26
Q

“Signs” of disease represent what part of the SOAP note?

A

Objective

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27
Q

“Symptoms” represents what part of a SOAP note?

A

Subjective

28
Q

What is disease “etiology”?

A

An underlying cause

29
Q

What is disease pathogenesis?

A

The progression of disease

31
Q

What is a functional derangement?

A

A known disease with no know dysfunction (eg. Chronic fatigue syndrome)

32
Q

On an H and E stain, what structures turn blue, which turn red?

A

Eosin turns cytoplasm and proteins red. Hematoxylin stain nuclei, DNA and bacterial structures blue/purple

33
Q

If proteins in the cytoplasm turn red, how can those normal proteins be differentiated from the protein amyloid, which is found in many diseases?

A

The stain “congo red” stains amyloid only. also polarized light can turn amyloid proteins green.

34
Q

What types of diseases or conditions might amyloidosis be found in? (6)

A

B cell proliferations, chronic inflammation, chronic renal failure, alzheimers disease, Type 2 diabetes, prion disease

35
Q

What are southern, northern, western and dot blot used for?

A

Southern blot (DNA). Northern blot (RNA), Western blot (protein), Dot blot (S,W,N blot for a specific condition)

36
Q

What is the difference between necrosis and apoptosis?

A

apoptosis is programmed cell death, whereas necrosis occurs after irreversible cell damage and is accompanied by inflammation

37
Q

What are common causes of cellular injury?

A

hypoxia (most common), ischemia, infections by viruses, bacteria, parasites, fungi, prions, chemical injury, immunologic hypersensitivity, autoimmune diseases, congenital disorders

38
Q

What is the difference between Marasmus and Kwashiorkor?

A

Marasmus is a decrease in total caloric intake, which can result in nutritional imbalance. Kwashiorkor is a decrease in total protein intake, with itchy rash and a protuberant belly as distinctive characteristics of the condition

39
Q

A deficiency in vitamin A can lead to what?

A

squamous metaplasia, immune deficiency, night blindness

40
Q

A deficiency in vitamin C can lead to____

A

scurvy

41
Q

A deficiency in vitamin D can lead to ______

A

rickets and osteomalacia

42
Q

A deficiency in vitamin K can lead to _______

A

bleeding diathesis

43
Q

A deficiency in vitamin B12 can lead to_____

A

megaloblastic anemia, neuropathy, spinal cord degeneration

44
Q

A deficiency in Folate can lead to _______

A

megaloblastic anemia, neural tube defects

45
Q

A deficiency in niacin can lead to______

A

pellagra (diarrhea, dermatitis and dementia)

46
Q

When does cloudy swelling occur?

A

cloudy sweling occurs when cells are in capable of maintaining ionic and fluid homeostasis. decreased ATP, and NA pump activity leads to Na and water retention and isoosmotic gain of water.

47
Q

Where do free radicals come from?

A

oxygen

48
Q

What are the steps of cellular injury starting with mitochondrial dysfunction?

A

mitochondrial dysfunction–>decreased ox. phosph. –>decreased ATP –> highly permeable mitochondria –> apoptosis trigger cytochrome C released –>Na/K ATpase pumps fail –>Influx of Na and H2O –>efflux of K –>cellular swelling

49
Q

What is the most common form of necrosis? what are other types of necrosis? (5)

A

coagulative necrosis is the most common form of necrosis (denaturing and coagulation of cytoplasmic proteins). liquefaction necrosis (autolysis with proteolytic enzymes). caseous necrosis (combination of coagulation and liquefaction, “cottage-cheese”-like). Fat necrosis (lipases act on adipocytes- chalky white). Gangrenous necrosis (dead tissue, can be liquefactive or coagulative)

50
Q

How do the treatments of wet and dry gangrene differ?

A

wet gangrene is generally treated with amputation to avoid pathogen infection.

51
Q

What types of diseases is Caseous necrosis characteristic of?

A

granulomatous diseases like TB (combination of liquefaction and coagulation, with a cottage cheese-like appearance)

52
Q

How does gene regulation of apoptosis work?

A

bcl-2 gene prevents mitochondrial release of cytochrome C and binds up pro-apoptotic protease activating factor. p-53 arrests the cell cycle and is elevated by DNA injury, stimulate apoptosis is genetic repair is impossible.

53
Q

What do caspases do and why are the important?

A

apoptosis is mediated by a cascade of caspases. these digest nuclear and cytoskeletal proteins and activate endonucleases.

54
Q

What is steatosis and what are its two main causes in the western world?

A

an abnormal accumulation of triglycerides usually due to increased lipids and cellular metabolic damage. too much free fat or to much fatty acid synthesis, excess esterification of FAs to TCGs

55
Q

What is the pathological significance and appearance of Lipofuscin?

A

Lipofuscin is not a pathological substance, it is a ‘wear and tear’ pigment that is the result of indigestible material in lysosomes. can be a cause of age spots

56
Q

What is hemosiderosis, and why is it seen in venous stasis ulcers of the lower extremity?

A

hemosiderin is a major storage form of iron and is formed during iron overload. In venous stasis ulcers, blood pools in the lower extremity and mcrophages recover iron from the hemoglobin into hemosiderin. This causes local hemosiderosis (ecchymosis/bruising).

57
Q

What is the difference between dystrophic calcification and metastatic calcification?

A

metastatic calcification occurs when serum levels of Ca or phosphate are elevated. dystrophic calcification occurs when local tissues become non-viable.

58
Q

What type of changes occur from adaptive responses to injury?

A

atrophy, hypertrophy, hyperplasia, metaplasia, dysplasia, neoplasia, anaplasia

59
Q

What is an example of physiologic hypertrophy?

A

weight lifting

60
Q

What is an example of pathologic hypertrophy?

A

cardiac muscle hypertension

61
Q

What are the two chief findings of anaplasia and what is the significance of anaplasia?

A

Increased nucleus/cytoplasm ratio with total loss of differentiation. seen in malignant neoplasms

62
Q

What is the difference between primary, secondary and tertiary intentions?

A

primary intention is sutures, secondary is no union, tertiary is delayed union (sutures placed later)

63
Q

What is the difference between hypoplasia and agenesis?

A

hypoplasia is defective or incomplete formation of a part. agenesis is the absense/failure of formation

64
Q

What are the three stages of tissue repair?

A

inflammatory phase, proliferative phase, remodeling phase

65
Q

What are labile cells? What tissues are they in?

A

continuously dividing stem cells. found in the epidermis, mucosal epithelium, GI tract epithelium

66
Q

What are Stable cells? What tissues are they in?

A

a stem cell with a low level of replication. found in hepatocytes, renal tubular epithelium and pancreatic acini

67
Q

What are permanent cells? What tissues are they in?

A

stem cells which never (rarely) divide. found in nerve cells, cardiac myocytes, skeletal muscle

68
Q

What are the three stages of fracture healing?

A

procallus (anchorage wo rigidity) –>fibrocartilagenous callous –>osseous callous

69
Q

What is the difference between a pathological fracture and a traumatic fracture?

A

A traumatic fracture is generally due to an accident whereas a pathological fracture is due to a preexisting disease or condition that predisposes the patient to fractures of bone

Pathology 1 (2 decks)

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