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Human Pathology > Exam II > Flashcards

Exam II Flashcards

1
Q

What percentage of lean body mass is water?

A

~60%

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2
Q

What fraction of TBW is extracellular?

A

1/3

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3
Q

What fraction of TBW is intracellular?

A

2/3

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4
Q

How many liters of water is TBW?

A

42 liters (for 70 kg person)

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5
Q

How is plasma fluid in the interstitial space returned to circulation?

A

Via the lymphatic system

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6
Q

What causes edema, in a mechanical sense?`

A

Anything that increases capillary pressure or reduces colloid pressure

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7
Q

What kind of edema does right-sided heart failure cause?

A

Systemic edema

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8
Q

What kind of edema does left-sided heart failure cause?

A

Pulmonary edema

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9
Q

What can cause reduced plasma osmotic (colloid) pressure?

A

Excessive loss or reduced synthesis of albumin

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10
Q

What protein is responsible for maintaining osmotic (colloid) pressure?

A

Albumin

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11
Q

What can caused reduced synthesis of albumin?

A

Malnutrition or hepatic disease (cirrhosis, hepatic tumors, or hepatitis)

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12
Q

Why does nephrotic syndrome reduce colloid pressure?

A

The kidneys become “leaky”, albumin is lost in the filtrate

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13
Q

What are the two main causes of lymphatic obstruction, and what does it result in?

A

Inflammatory obstruction or resection of lymphatics, leading to lymphedema

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14
Q

What causes peau d’orange?

A

Obstruction of superficial lymphatics by breast cancer tumor (seen in inflammatory breast cancer)

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15
Q

What happens in acute renal failure that results in increased water retention?

A

Increased Na+ retention

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16
Q

What complication of cerebral edema was discussed?

A

Herniation of brain through foramen magnum, leading to death

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17
Q

What percentage of total blood can healthy adults lose acutely?

A

Up to 20%, though more if loss is slow

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18
Q

hemorrhage (n.)

A

extravasation of blood due to rupture of blood vessels

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19
Q

petechiae (n.)

A

1-2mm hemorrhages in skin/mucous membranes

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20
Q

What is usually associated with petechiae?

A

Thrombocytopenia

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21
Q

What do you call blood enclosed within tissue?

A

Hematoma

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22
Q

purpura (n.)

A

3-5mm hemorrhages in skin/mucous membranes

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23
Q

ecchymosis (n.)

A

1-2cm hemorrhages in skin/mucous membranes

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24
Q

What differentiates bruises and ecchymoses?

A

Bruises are ecchymoses specifically caused by trauma

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25
Q

hemostasis (n.)

A

the process of causing bleeding to stop (opposite of hemorrhage)

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26
Q

What is endothelin?

A

An endothelial vasoconstrictor

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27
Q

What is primary hemostasis?

A

Platelet aggregation

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28
Q

What is secondary hemostasis?

A

Thrombin recruiting additional platelets

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29
Q

How is secondary hemostasis caused?

A

Tissue factor activates thrombin, which cleaves fibrinogen into fibrin, creating a fibrin mesh network; thrombin also recruits additional platelets

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30
Q

What is released to limit coagulation?

A

Tissue plasminogen activator (t-PA)

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31
Q

What does the Virchow Triad define?

A

The three predisposing factors of thrombosis

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32
Q

thrombosis (n.)

A

the formation of clot inside a blood vessel

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33
Q

What are the three components of the Virchow triad?

A

Endothelial injury, hypercoagulability, and stasis/turbulence

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34
Q

What is the dominant factor of the Virchow triad?

A

Endothelial injury

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35
Q

What were the three examples of non-disruptive endothelial injury?

A

Radiation, hypercholesterolemia, and cigarette smoke

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36
Q

What are the three things that stasis/turbulence do to cause thrombosis?

A

Disrupt the normal laminar blood flow; prevent dilution of activated clotting factors; prevent inflow of clotting factor inhibitors

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37
Q

What are five causes of high risk hypercoagulability?

A

Prolonged bed rest, myocardial infarction, tissue damage, cancer, and inflamed/prosthetic cardiac valves

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38
Q

What are five causes of low risk hypercoagulability?

A

Atrial fibrillation, cardiomyopathy, oral contraceptives, sickle cell anemia, and smoking

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39
Q

What is thrombus embolization?

A

Dislodging some or all of the thrombus to a distant site

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40
Q

What is phlebothrombosis?

A

Formation of a blood clot in venous circulation sans vein inflammation (phlebitis)

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41
Q

Where do venous thrombi embolize?

A

Towards the lungs

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42
Q

How are thrombi broken up naturally?

A

Dissolution by fibrinolytic activity

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43
Q

What is the main cause of pulmonary embolization?

A

Deep vein thrombosis (DVT) in the legs

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44
Q

cor pulmonale (n.)

A

right ventricular failure, or pulmonary heart disease

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45
Q

What is the main cause of systemic embolization?

A

Intracardiac wall thromboses

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46
Q

What causes most intracardiac wall thromboses?

A

Left ventricular infarcts

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47
Q

How what percent of systemic emboli occur in the brain?

A

10%

48
Q

What are the five kinds of emboli?

A

Thrombus, fat, cholesterol, gas, and amniotic fluid

49
Q

What is a fat embolus usually caused by?

A

Fracture of a long bone, especially the femur

50
Q

What is a cholesterol embolus usually caused by?

A

Atherosclerotic debris

51
Q

What causes an amniotic fluid embolism?

A

A tear in the placenta and rupture of uterine veins

52
Q

What happens to the patient after amniotic fluid embolizes?

A

Immediate hypotensive shock; if survived, followed by DIC

53
Q

What does DIC stand for?

A

Disseminated intravascular coagulation

54
Q

What is the immediate cause of DIC?

A

Widespread fibrin thrombi

55
Q

Is DIC a primary disorder?

A

No, it is a complication.

56
Q

What is “shock”?

A

Cardiovascular collapse

57
Q

Describe the cardiovascular collapse seen in shock.

A

Systemic hypoperfusion as a result of decreased cardiac output or circulating blood volume

58
Q

What are the five main causes of shock?

A

Severe hemorrhage, extensive trauma/burns, large myocardial infarction, massive pulmonary embolism, and microbial sepsis

59
Q

What are the five types of shock?

A

Cardiogenic, hypovolemic, anaphylactic, neurogenic, and septic

60
Q

What causes 70% of septic shock deaths?

A

Gram-negative bacteria

61
Q

What causes gram-negative bacterial sepsis?

A

Degradation in bacterial cell wall, releasing toxic lipopolysaccharides

62
Q

What is the physiological causes of anaphylactic shock?

A

General release of histamine, causing hypotension

63
Q

infectious disease (n.)

A

a disorder in which tissue damage or dysfunction is caused by a microorganism

64
Q

virulent (n.)

A

capable of causing disease

65
Q

What are the four properties that allow an organism to achieve infection?

A

Gain access to body; avoid multiple host defenses; accommodate to growth within human body milieu; parasitize human resources

66
Q

What is the virulence of Q-fever?

A

Inoculum of only one organism needed for infection

67
Q

What are two organisms that can penetrate intact skin?

A

HPV (genital warts) and T. pallidum (syphilis) can penetrate warm, moist skin

68
Q

What is filariasis?

A

Obstruction of lymphatics by inflammation and fibrosis of lymphatics, caused by helminths

69
Q

Why do women have UTIs more than men?

A

Shorter urethra (5-20 cm)

70
Q

What is the organism that causes the plague?

A

Yersinia pestis

71
Q

What class of organisms cause malaria?

A

Protozoans

72
Q

What organism causes malaria?

A

Plasmodium vivax

73
Q

Where does P. vivax attach?

A

Human RBCs by the Duffy blood group receptors

74
Q

What causes chickenpox?

A

Varicella-zoster virus

75
Q

What are the three main modes of disease transmission?

A

Direct contact, indirect contact, and vectors

76
Q

What are the four types of direct contact transmission?

A

Respiratory aerosol, skin, sexual, and transplacental/vertical

77
Q

What are the five types of indirect contact transmission?

A

Fomites, blood, stool, water, and soil

78
Q

What is a fomite?

A

Inanimate object

79
Q

What are the two main transmission vectors?

A

Arthropods and animals

80
Q

What are four example arthropod vectors, and what diseases are associated?

A

Mosquito - malaria, yellow fever, dengue fever; Tick - Lyme disease; Louse - typhus, relapsing fever; Mite - scabies

81
Q

What causes cat scratch fever?

A

Bartonella henselae, a gram-negative organism

82
Q

What are the nine general mechanisms of bacterial pathogenesis?

A

Produce toxins; produce a slimy, phagocytic-resistant polysaccharide coat; free radical resistant cell wall glycolipids; produce substances that bind opsonins; invade epithelial cells; damage to organs/tissues from inflammatory response; grow in areas that are normally sterile; enter into bloodstream and multiply within tissue; consume host resources

83
Q

What are bacteriophages?

A

Viruses that infect bacteria

84
Q

What disease is caused by Mycobacterium leprae?

A

Leprosy

85
Q

What disease is caused by Mycobacterium tuberculosis?

A

Tuberculosis (TB)

86
Q

What organism multiplies in the normally sterile lung and causes pneumococcal pneumonia?

A

Streptococcus pneumoniae

87
Q

What are two diseases caused by bacteriophages?

A

Diphtheria (Corynebacterium diphtheriae) and cholera (Vibrio cholerae)

88
Q

plasmid (n.)

A

an extrachromosomal genetic element not necessary for genetic growth

89
Q

What are three Clostridium species that secrete exotoxins?

A

C. perfringens, C. tetani, and C. botulinum

90
Q

What are the three representative Gram-positive infections we discuss?

A

Staphylococcus aureus, Streptococcal infections, and Corynebacterium diphtheriae

91
Q

What is the shape of C. diphtheriae, and how is it passed?

A

Gram-positive rod, passed by aerosols

92
Q

What is diphtheria?

A

A tough pharyngeal membrane that can block the pharynx, and is toxic to the heart and nerves

93
Q

What organism is one of the leading causes of bacterial pneumonia and meningitis?

A

Streptococcal pneumoniae

94
Q

endocarditis (n.)

A

infection of the inner lining of the heart and heart valves

95
Q

What is the organism and pathogenesis of tetanus?

A

C. tetani - secretes an exotoxin that interferes with inhibitory neurotransmitters (ie. GABA), causing violent muscle spasms

96
Q

What is the organism and pathogenesis of botulism?

A

C. botulinum - secretes an exotoxin that blocks the release of ACh, causing paralysis

97
Q

What is the general treatment for gram-positive infections?

A

Sensitive to penicillins, erythromycins, & cephalosporins

98
Q

What disease does Rickettsia prowazekii cause?

A

Typhus

99
Q

What disease does Rickettsia rickettsii cause?

A

Rocky Mountain spotted fever

100
Q

Why are Rickettsia bacterias considered obligate intracellular parasites?

A

Cannot utilize glucose as an energy source; may need NAD+ and coenzyme A

101
Q

Why are Chlamydiae bacterias considered obligate intracellular parasites?

A

They cannot make ATP

102
Q

When and where was the last case of smallpox?

A

Somalia, 1977.

103
Q

What are the symptoms and signs of smallpox?

A

Sudden onset of high fever, chills, headache, lumbar back pain, and prostration, with common nausea and vomiting; after 2-4 days, rash appears on face, extremities, trunk, and mucous membranes of mouth/eye, progressing over 2-4 weeks

104
Q

What was tuberculosis called in the 18th century?

A

Consumption

105
Q

How much of the world’s population is infected with TB?

A

1/3 of world pop.

106
Q

What are the early symptoms of tuberculosis?

A

Fever, night sweats, weight loss, anorexia, and weakness

107
Q

What is the prognosis of those with untreated TB?

A

1/3 die within one year; 1/2 die within five years

108
Q

What is the cause of death in tuberculosis?

A

Respiratory compromise, cachexia, or other organ involvement

109
Q

cachexia (n.)

A

malnutrition induced by chronic disease

110
Q

What organism causes most human cases of TB?

A

Mycobacterium tuberculosis

111
Q

What is the shape of M. tuberculosis?

A

Slender, rod-shaped bacteria

112
Q

How does someone become infected with tuberculosis?

A

Inhalation of the “tubercle bacilli” (bacteria)

113
Q

What organism causes anthrax?

A

Bacillus anthracis

114
Q

What are the three forms of anthrax, and what is the relative incidence of each in the US?

A

Cutaneous (95%), inhalational (5%), and gastrointestinal (only 11 cases reported)

115
Q

What is the mortality rate of inhalational anthrax?

A

95-100% if untreated; death within 24 hours

Human Pathology (8 decks)

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