First Aid

Question 1

hypoxic ischemic encephalopathy

Answer 1

affects pyramidal cells of hippocampus and Purkinje cells

Question 2

areas of colon susceptible to ischemia

Answer 2

splenic flexure, rectum

Question 3

leukocyte extravasation- protein mediators

Answer 3

Rolling– E and P selectin (vasculature), Sialyl-Lewis (leukocyte). Also GlyCAM-1, CD34 (vasculature) and L-selectin (leukocyte)

Tight binding - ICAM-1 /CD54(vasculature), CD11/18 integrins (LFA-1, Mac-1) (leukocyte). Also VCAM-1 (CD106) (vasculature) and VLA-4 integrin (leukocyte)

Diapedesis - PECAM-1 (CD31)

Migration- C5a, IL-8, LTB4, kallikrein, platelet activating factor

Question 4

Apaf-1

Answer 4

Bcl-2 normally prevents cytochrome c release by binding to and inhibiting Apaf-1, which normally induces caspase activation

Question 5

chromatolysis

Answer 5

involving cell body following axonal injury. increased protein synthesis–> swelling, nuclear displacement, Nissl substance dispersion

Question 6

PDGF

Answer 6

secreted by activated PLTs and macrophages, induces vascular remodeling and smooth muscle cell migration. Stimulates fibroblast growth.
(wound healing)

Question 7

FGF

Answer 7

angiogenesis stimulator

wound healing

Question 8

TGF-beta

Answer 8

stimulates angiogenesis, fibrosis, cell cycle arrest.

wound healing

Question 9

granuloma formation - mechanism

Answer 9

Th1 cells secrete gamma interferon, activates macrophages. TNF-alpha from macrophages induce and maintain granuloma formation. (anti-TNF drugs can cause granulomas to break down)

Question 10

decreased ESR

Answer 10

RBCs fall at decreased rate in tube. see in sickle cell, polycythemia, CHF.

Question 11

sx of iron poisoning

Answer 11

acute- gastric bleeding, N/V, lethargy

chronic- metabolic acidosis, scarring leading to GI obstruction

Question 12

primary amyloidosis (AL)

Answer 12

deposition of proteins from Ig light chains. can be associated with MM. often affects renal, cardiac, hematologic, GI (hepatomegaly) and neurologic

Question 13

secondary amyloidosis (AA)

Answer 13

seen with chronic conditions. Serum Amyloid A. multisystem.

Question 14

Dialysis related amyloidosis

Answer 14

fibrils composed of beta-2 microglobulin. may present as carpal tunnel.

Question 15

Heritable amyloidosis

Answer 15

eg ATTR neurologic/cardiac amyloidosis due to transthyretin (TTR or prealbumin) gene mutation

Question 16

age-related amyloidosis

Answer 16

deposition of normal TTR in myocardium and other sites. slower progression of cardiac dysfunction.

Question 17

organ specific amyloidosis

Answer 17

localized to single organ- eg in Alzheimer’s. also islet amyloid polypeptide (IAPP) commonly seen in DM type 2 and caused by deposition of amylin in pancreatic islets.

Question 18

lipofuscin

Answer 18

yellow brown “wear and tear pigment” associated with aging. formed by oxidation and polymerization of autophagocytosed organellar membranes.

Question 19

p-glycoprotein

Answer 19

(MDR1). expressed by some cancer cells to pump out toxins, including chemotherapeutic agents (one mechanism of resistance)

Question 20

anaplasia

Answer 20

loss of structural differentiation and function of cells, resembling primitive cells of same tissue; often equated with undifferentiated malignant neoplasms. may see giant cells.

Question 21

mediators of cachexia

Answer 21

TNF-alpha, IFN-gamma, IL-6

Question 22

dermatomyositis- neoplasm?

Answer 22

lung cancer

Question 23

squamous cell carcinoma of lung- paraneoplastic?

Answer 23

hypercalcemia

Question 24

polycythemia associated malignancies

Answer 24

RCC, HCC

Question 25

tuberous sclerosis associated malignancies

Answer 25

giant cell astrocytoma, renal angiomyolipoma, cardiac rhabdomyoma

Question 26

BRAF

Answer 26

serine/threonine kinase oncogene indicated in melanoma

Question 27

c-kit

Answer 27

oncogene indicated in GIST: cytokine receptor

Question 28

L-myc

Answer 28

transcription factor indicated in lung tumors

Question 29

Ras

Answer 29

indicated in colon, lung, pancreatic cancers (GTPase)

Question 30

CPD4 / SMAD4

Answer 30

tumor suppressor deleted in pancreatic cancer (gene product = DPC)

Question 31

DCC

Answer 31

tumor suppressor deleted in colon cancer

Question 32

p16

Answer 32

tumor suppressor deleted in melanoma (cyclin dependent kinase inhibitor 2A)

Question 33

PTEN

Answer 33

tumor suppressor in breast, prostate, endometrial ca

Question 34

TSC1, TSC2

Answer 34

tumor suppressors in tuberous sclerosis. TSC1 –> hamartin protein; TSC2–> tuberin protein.

Question 35

VHL

Answer 35

tumor suppressor in von Hippel-Lindau disease- inhibits hypoxia inducible factor 1a

Question 36

AFP tumor marker- cancers?

Answer 36

HCC, hepatoblastoma, yolk sac (endodermal sinus) tumor, testicular cancer, mixed germ cell tumor

Question 37

CA-15-3 / CA-27-29

Answer 37

breast cancer tumor marker

Question 38

CA- 19-9

Answer 38

pancreatic adenocarcinoma tumor marker

Question 39

TRAP (tumor marker)

Answer 39

tartrate-resistant acid phosphatase (TRAP). hairy cell leukemia (B cell)

Question 40

Clonorchis sinesis- associated cancer?

Answer 40

liver fluke– cholangiocarcinoma

Question 41

arsenic- cancers?

Answer 41

liver- angiosarcoma; lung cancer; skin squamous cell cancer

Question 42

carbon tetrachloride- cancers?

Answer 42

liver- centrilobular necrosis, fatty change

Question 43

ionizing radiation

Answer 43

affects thyroid – papillary thyroid carcinoma

Question 44

radon

Answer 44

causes lung cancer

Question 45

vinyl chloride

Answer 45

causes angiosarcoma (liver)

Question 46

calcitriol (D3) paraneoplastic syndrome

Answer 46

Hodgkin’s and some non Hodgkin’s lymphomas

Question 47

PTHrP

Answer 47

squamous cell lung, RCC, breast

Question 48

EPO paraneoplastic

Answer 48

RCC, thymoma, hemangioblastoma, HCC, leiomyoma, pheo

Question 49

Psammoma bodies- mnemonic

Answer 49

PSaMMoma
Papillary thyroid
Serous papillary cystadenocarcinoma of ovary
Meningioma
Malignant mesothelioma