FIP notes Flashcards
eosinophilia
pink colour
pyknosis
shrinking of nucleus and clumping of chromatin
karyorrhexis
fragmentation and break down of nucleus
karyolysis
pallor and dissolution
gangrenous necrosis is caused by
clostridium perfringens
dystrophic calcification
deposition in necrotic tissue with normal serum calcium
metastatic calcification
deposition in normal tissue with increased serum calcium
primary lysosomal granule
myeloperoxidase
secondary lysosomal granule
lactoferrin and collagen
tertiary lysosomal granule
gelatinase plasminogen activator
what causes the transient adherence of neutrophils?
selectins
what causes the firm adherence of neutrophils? name them
integrins
ICAM 1 and VCAM1
what mediates the movement of neutrophils through the endothelial junction?
PECAM
neutrophils migrate to the site following the chemokine concentration of (2)
IL-6
leukotrienes
what are the vasoactive amines and what are they released by and state their fxn
vasoactive amines cause vasodilation and increased permeability
histamine - released by mast cells, basophils and platelets
serotonin - released by platelets upon aggregation
state the functions of leukotrienes
LTB4 - attracts and activates neutrophils (chemokine)
LTC,D,E4 - vasoconstriction (bronchospasm) and increased permeability
state the functions of prostaglandins
PGD,E2 - increased vasodilation and increased permeability
PGE only - pyrexia
state the functions of prostacyclins
PGI2 - vasodilation and decreased platelet aggregation
state the function of TXA 2
vasoconstriction and increased platelet aggregation
state the function of PAF
platelet aggregation
vasoconstriction
chemotaxi
what is the mechanism of action of aspirin and NSAIDs
cyclooxygenase inhibitors and act by phospholipase A2 inhibition => also inhibits PGE2 production => relief of pyrexia
what type of cells contain heparin and state its function
basophils/ mast cells
anticoagulant
what cytokines do dendritic cells release
IL-2 and IFNgamma
during a granulomatous inflammation, T cells continuously activate macrophages via
IL-2 and TNFgamma
sarcoidosis is a non-caseating granuloma separated by…
what does this cause?
schaumann bodies
asteroid bodies
this causes calcification
sinus formation is a tract of granulation tissue from a cavity to a surface. what is it associated with?
osteomyelitis
a fistula is characteristic of what diseases (2)
crohn’s disease
diverticular disease
what is the function of hepcidin and what does an increase of it indicate?
controls delivery of iron to blood
indicates inflammation
what controls the cell to cell matrix interactions?
integrins
differentiate between type 3 and type 1 collagen.
what is the enzyme and its catalyst?
what phase of wound healing does this occur and what also happens at that stage?
type 1 - elastic type 3 - non-elastic collagenase enzyme Zn catalyst remodelling (last stage) dehydration of excessive ECM by metalloproteinase
during primary intention healing, what day does collagen 3 deposit and what day are sutures removed (enough collagen 1 deposition)?
day 5 and 7
what vitamin is important for collagen formation?
vit C
what element is involved in the crosslinking of collagen/
copper
give 2 neoplasms that warrant the use of sentinel node biopsy
breast and melanoma
what is herceptin used for?
used in IHC to determine tamoxifen’s viability
what is the difference between dysplasia and dyskaryosis and in situ?
degree of change from normal epithelium without involving the full thickness of the epithelium
the same but only cytological (without architecture) => fine needle aspirate
the same but entire epithelium
what kind of anemia is caused by cytotoxic drugs and what do these cytotoxic drugs interfere with?
megaloblastic
DNA synthesis fcked
what kind of anemia is caused by marrow infiltration by tumour cells?
hypoplastic anemia
true or false
tumour activation of clotting factors, platelets, and endothelial cells + inhibition of fibrinolysis leads to abnormal clotting => DVT, PE
True
PS of small cell carcinoma
cushing syndrome (ACTH production) hyponatremia (SIADH production)
cushing syndrome (ACTH production) is a PS of
small cell carcinoma
PS of squamous cell carcinoma
hypercalcemia (PTHRP, TGFalpha, IL-1)
hypercalcemia (PTHRP, TGFalpha, IL-1) is a PS of
squamous cell carcinoma
hyponatremia (SIADH production) is a PS of
small cell carcinoma
PS of adenocarcinoma
Hypertrophic osteoarthropathy (HPOA)
Hypertrophic osteoarthropathy (HPOA) is a PS of
adenocarcinoma
TRUE or FALSE you whore?
neuropathy, myopathy, dermatomyositis, cerebellar degeneration and gynecomastia are all PS’s
TRUE bitch
Li Fraumeni Syndrome is caused by what defect and what type of cancer is formed
p53
sarcomas
what are the histological features of a neuroendocrine tumour?
salt and pepper chromatin
nested appearance
rosette formation
where do carcinoid tumours usually arise?
central large bronchus
appendix
describe the carcinoid tumour in the bronchus
arises in the central large bronchi and grows intraluminally, characterised by BRIGHT RED haemoptysis
what is carcinoid syndrome?
what are the symptoms and diagnosis?
inadequate detoxification of serotonin which regulates intestinal movement
symptoms - facial flushing, bronchospasms, diarrhea and pulmonary stenosis
Dx - increase 5-HIAA in urine (breakdown product)
what is the difference between type 1 and type 2 Multiple Endocrine Neoplasm (MEN)
type 1 - PT, islet of pancreas and pituitary
type 2 - PT, T, adrenal
what cancer has a characteristic lymphocytic response? what is its most common metastases?
seminomas (dysgerminoma)
lung
what tumour is malignant in males but benign in females
teratoma (dermoid cyst in females)
HCG is associated with what carcinoma, what type of carcinoma is it
which germ layer does it arise from
what is the diagnosis
choriocarcinoma
germ cell tumour
trophoblastic
if patient is not pregnant but has consistent vomiting and nausea –> choriocarcinoma
embryonic tumours end in _____
blastoma
give 2 examples of borderline tumours
STUMP (smooth muscles in uterus) and phyllodes in breast
familial breast cancer is due to a mutation of what genes
BRCA 1 and 2
tamoxifen, although treating breast cancer can cause _______ carcinoma and can cause ____
endometrial carcinoma
DVT
EBV causes
what marker is used for this?
Burkitt’s lymphoma (c-ymc)
Hep B and C causes
hepatocellular carcinoma
HPV causes
cervical, anal, oropharyngeal cancer (all 3 openings)
HHV 8 causes
kaposis’s sarcoma
HPV causes alteration in which tumour suppressor genes
p53 and retinoblastoma (Rb)
Alterations on tumour suppressor genes are mainly done through ….
deletions or translocations
a mutation in APC causes what type of cancer
Familial Colon Cancer
state the process of amyloid formation
misfolding of the tertiary protein
Beta-pleated sheet aggregates into cytotoxic oligomers
forms the insoluble amyloid fibril deposits
composition of amyloid
- non branching beta pleated fibrils (this is the misfolded protein)
- non fibrillar pentagonal glycoprotein (Amyloid P)
- proteoglycans
how do amyloids bind together and how do you see it?
H-H bonds
congo red staining under normal light
should appear pink (eosinophilic hyaline)
discuss primary amyloidosis
associated with immunocyte imbalance => AL amyloidosis
overproduced immunoglobulin light chains by proliferating plasma cells in Multiple myeloma (M spike)
discuss secondary amyloidosis
associated with chronic inflammation => AA amyloidosis
overproduction of acute phase proteins during chronic inflammation
derived from SAA (serum amyloid associate precursor misfolded in liver)
what is Abeta amyloid associated with
overproduction of APP => Alzheimer’s disease
what does ATTR amyloidosis affect
overproduction of transthyretin (affects heart)
what is ACal amyloid associated with
overproduction of calcitonin
thyroid medullary carcinoma
where do we see a lardaceous spleen?
amyloidosis
what organ is affected most by amyloidosis and where does the deposition occur?
liver (increased LFTs)
in space of Disse first then parenchymal spaces and sinusoids
what do you expect to find in the intimal layer in atherosclerosis?
smooth muscle cells and lipids
hyperplasia
hypertrophy
atrophy
increase #
increase size
decrease size
why does atheroma not deposit in veins
reduced blood pressure
what causes collagen deposition in atherosclerosis
smooth muscle cells
stable vs unstable plaque
stable - thick fibrous caps and calcification
unstable - thin and inflammation
true vs false aneurysm
intact wall vs not intact
state a congenital and infectious cause of aneurysm
c - Berry Aneurysm (circle of willis)
i - mycotic aneurysm in TB
where does an abdominal aortic aneurysm occur
above aortic bifurcation
below renal artery
what structure in most likely to be affected by an AAA?
ureter
treatment of AAA
statins
what is marfan’s syndrome and what does it cause?
defect in connective tissue affecting aorta
thoracic dissection
in the case of reperfusion injury, what is the treatment and what does it do?
diltiazem
calcium channel blocker - prevent Ca entry into cell
virchow’s triad
- endothelial damage
- abnormal blood flow (bro this is not stasis you idiot)
- hypercoagulability
state the differences of macroscopic appearance of infarction in solidified vs spongy organs
solidified - pale/ white with little hemosiderin pigment
spongy - red/brown with INCREASED hemosiderin pigment
where do we see hypochromic RBC
iron deficiency microcytic anemia
what is this anemia? symptoms: pallor angular cheilitis brittle nails atrophic glossitis
iron deficiency microcytic anemia
what is this?
Dx:
decreased Hb, MCV, serum Fe, Fe sat, ferritin
iron deficiency microcytic anemia
what is this?
Dx:
decreased Hb, MCV, PCV
normal serum Fe, fe sat and ferritin
thalassemia
what do phenytoin and anticonvulsants do
folate malabsorption => megaloblastic macrocytic anemia
what is pernicious anemia and what does it lead to?
autoimmune disease affecting stomach walls, causes gastritis and hence B12 deficiency => megaloblastic macrocytic anemia
what is this anemia?
symptoms:
decreased myelin production leading to neural problems
B12 deficiency megaloblastic macrocytic anemia
what kind of anemia is caused by hyperthyroidism
megaloblastic macrocytic anemia
what kind of anemia is caused by RA, chronic inflammation and renal disease? state the Dx.
normocytic anemia
Dx -
normal Fe, fe sat
normal or increased ferritin (since it is an acute phase reactant)
hypocellularity of the bone marrow is indicative of what anemia?
normocytic
positive coomb’s test indicates (anemia)
haemolytic anemia (autoimmune haemolysis) normocytic anemia (chronic inflammation due to autoimmune disease e.g. RA)
by products of RBC breakdown (haemolytic anemia)
LDH
bilirubin
what is the major side effect of dapsone
autoimmunity
what is the RBC membrane defect that causes haemolytic anemia?
defect in spectrum proteins causing spherocytosis
what is the RBC enzyme defect that causes haemolytic anemia?
G6PD or pyruvate kinase => oxidative haemolysis of RBC
what is the RBC Hb defect that causes haemolytic anemia?
sickle cell - change from glutamic acid into valine
thalassemia - 1 chain overexpressed –> agglutination
what is the only nonimmune and acquired anaemic defect causing hemolytic anemia? what causes it?
microangiopathic hemolytic anemia - this causes schistocytes
eclampsia and DIC
what does TFPI inhibit?
Tissue Factor and factor VII
thrombin + thrombomodulin bind together to activate…
protein C and S which inactivates factors V and VIII
antithrombin, enhanced by heparin inhibits….
complexes with Factors 9,10,11 and thrombin
what is the byproduct of fibrin
D-dimers
what inhibits fibrinolysis?
PAI 1 and alpha-2-antiplasmin
what chromosome is the VWF on?
12 you idiot
what is antiphospholipid Ab syndrome and what is its treatment? what is it a risk factor for
Ab targets phospholipid binding protein
Tx - warfarin
Thromboembolism
by the way, caused by preeclampsia (eclampsia is in microangiopathic hemolytic anemia)
