First Aid: Pathology Flashcards
What are the two mitochondrial pro-apoptotic regulators? Are they part of the intrinsic or extrinsic pathway?
BAX & BAK, Intrinsic
What is the mitochondrial anti-apoptotic regulator? Is it part of the intrinsic or extrinsic pathway?
Bcl-2, Intrinsic
What protein is released by the mitochondrial that initiates apoptosis? Is it part of the intrinsic or extrinsic pathway?
Cytochrome-c, Intrinsic
Which receptor/ligand pair induce the extrinsic apoptosis pathway?
FasL & FasR(CD95)
Which cytosolic protein family is responsible for carrying out apoptosis? Are they part of the intrinsic or extrinsic pathway?
Caspases, Both
Describe the action of the FasR receptor?
When they bind FasL, the receptors aggregate. This coalescence forms a binding site for Death Domain (FADD). FADD activates Caspases.
What are the six types of necrosis? Give a quick example of where/when they occur. (CLCFFG)
Coagulative - Heart, Liver & Kidney (end arteries, acidophilic)
Liquefactive - CNS (release of lysosomal enzymes)
Caseous - TB, Fungi, Nocardia
Fatty - Pancreatitis
Fibrinoid - Vasculitides (amorphous pink)
Gangrenous - Dry (ischemic) and Wet (infection)
Area of the heart most susceptible to ischemic injury
Subendocardium
Area of the nephron most susceptible to ischemic injury
Straight segment of the PCT & TAL
Area of the liver most susceptible to ischemic injury
Zone III, closest to central vein
Area of the colon most susceptible to ischemic injury
Splenic flexure, Pectinate line
Compare red versus pale infarcts. Where does each occur?
Red (= Reperfusion) occurs in soft tissue with double supply: liver, lungs, intestine. Pale occurs in solid tissue with a single supply: spleen, kidney, heart.
What are the two general classifications of shock? Briefly describe each.
Distributive versus hypovolemic/cardiogenic. Distributive is due to a decrease in TPR (pathologic vasodilation, warm & dry); CO and HR increase. Hypovolemic/Cardiogenic is due to a decrease in CO; TPR increases and there is responsive vasoconstriction (cold & sweaty).
What does atrophy mean?
Decrease in gross size. It does not specify a decrease in cellularity or a decrease in cell size.
What are the FIVE characteristics or inflammation?
Rubor, Tumor, Dolor, Calor & Functio laesa
What three “things” (two of which are cells) are involved in acute inflammation?
Neutrophils, Eosinophils, and antibodies.
Which two cell types are involved in chronic inflammation?
Lymphocytes and fibroblasts.
What are the three possible outcomes of acute inflammation?
Resolution, abscess, or chronic inflammation.
What are the two possible outcomes of chronic inflammation?
Scarring & amyloidosis.
What is chromatolysis?
Round cellular swelling following axonal injury. Nucleus is displaced to periphery.
Describe the difference between dystrophic and metastatic calcification.
Dystrophic is 2o to necrosis(ie. heart valves, abscesses, infarcts, thrombi, Psammoma bodies). Metastatic is 2o to hypercalcemia or to high calcium-phosphate product. The Ca deposits in the renal, pulmonary and gastric mucosa interstitial tissue.
Where does extravasation most likely occur? What are the four steps of leukocyte extravasation?
Postcapillary venules. 1) Margination and rolling 2) Tight binding 3) Diapedesis 4) Migration
Which proteins are important for margination and rolling?
E- or P- selecting or GlyCAM-1 on the endothelium, Sialyl-Lewis or L-selectin on the leokocyte
Which proteins are important for tight binding?
ICAM and VCAM for the endothelium, Integrins for the leokocyte (CD11/18, VLA-4)
Which proteins are important for diapedesis?
PECAM-1 for both the endothelium and the leukocyte
What are the most important chemotactants? Think of five.
C5a, IL-8, LTB4, Kallikrein and Platelet Activating Factor
What are the three ways free radicals can damage cells?
Lipid peroxidation, protein modification and DNA breakage.
What are the three enzymes involved in getting rid of free radical species?
Catalase (both bacterial and human), Superoxide Dismutase (Makes superoxide into peroxide), Gluthation Peroxidase (which uses up gluthatione)
What percentage of tensile strength is regained after scaring? How long does it take?
Three months to achieve 70 to 80% of strength.
What are the two types of pathologic scarring? Describe each.
HYPERTROPHIC SCARS: Slightly increased collagen synthesis arranged in parallel and can be easily resected.
KELOID SCARS: Incredibly increased collagen synthesis with unorganized deposition that extends beyond wound. It happens more in AA in it tends to recur after resection.
What is the role PDGF in wound healing?
Secreted by Macrophages and Platelets to stimulate vascular remodeling, smooth muscle migration and fibroblast growth.
What is the role FGF in wound healing?
Stimulate angiogenesis
What is the role EGF in wound healing?
Stimulate growth via a tyrosine kinase receptor.
What is the role TGF-beta in wound healing?
Angiogenesis, fibrosis and cell cycle arrest
What are the three phases of wound healing? Give a timeline and mention some the cells involved.
Immediately - Inflammatory - Platelets, neutrophils, macrophages
Days - Proliferative - Fibroblasts, Endothelium, Macrophages, Keratinocytes
One week - Remodeling - Fibroblasts (replace Col3 with Col1)
What signal initiates granuloma formation and what signal maintains it?
Th1 secrete gamme-INF and macrophages maintain it with TNF-alpha. (Note: anti-TNF drugs can release TB)