First Aid: Pathology + Pharm Flashcards
What are two absolute requirements for apoptosis to occur?
ATP and Caspases
Bcl 2 and BAX are key factors involved in the intrinsic apoptosis pathway. What would occur if either were overexpressed? What is the key step leading to apoptosis in this pathway?
Changes in pro/anti-apoptotic factors can lead to INCR MT permeability and cytochrome c release –> activates caspases
INCR Bcl2--> Apaf 1 over inhibitition, DECR. caspase activation --> tumorigenesis (e.g. follicular lymphoma) INCR BAX (BAK) --> Pro-apoptotic
What are the two pathways of the extrinsic apoptosis pathway? What happens if there is a defect in one of these?
- Ligand receptor interactions (FasL binding to Fas [CD95] –> crosslinking –> coalesce –> death domain binding site –> FADD –> activates caspases)
- Immune cell (cytotoxic T-cell release of perforin and granzyme B)
A defect especially in Fas-FasL binding –> autoimmune disorders (this process responsible for thymic negative selection)
Match the type of necrosis with main associated characteristics and/or pathologies/locations:
- Coagulative
- Liquefactive
- Caseous
- Fatty
- Fibrinoid
- Gangrenous
- Heart, liver, kidney (protein denaturation then enzymatic degradation)
- Brain (CNS), bacterial abscess (lysosomal enzyme release)
- TB, systemic fungi, Nocardia
- Enzymatic (pancreatitis-saponification) or nonenzymatic (breast trauma)
- Vasculitides, malignant HTN
- Dry (ischemic coagulative) and wet (infection); limbs and GI tract
A cell is swollen and also exhibits MT swelling. You also notice nuclear chromatin clumping and fatty change on gross specimen. Are these changes reversible? When would they not be reversible?
Yes, with proper oxygenation
Irreversible - PLasma membrane damage, lysosomal rupture, MT peremeability
Match the Organ with areas of ischemic susceptibility:
- Brain
- Heart
- Kidney
- Liver
- Colon
- ACA/MCA/PCA boundary areas
- Subendocardium (LV)
- Medulla: Straight segment of proximal tubule and thick ascending limb
- Area around central vein (zone III)
- Splenic flexure, rectum
Where would you see red infarcts? Pale infarcts?
Red - areas w/ lots of blood supplies and loose tissue –> Lungs, liver, intestine
Pale - solid tissue –> Heart, kidney, spleen
A patient presents with tachycardia, low BP, and warm dry skin. you determine they are in a state of shock and have high cardiac output. What type of shock could this be and would IV fluids help increase the BP?
Septic, neurogenic or anaphylactic shock
-IV fluids would not increase BP
Could give Epi
What mediates acute inflammation and how long does this last? What about chronic inflammation? What are the outcomes of each?
Acute - PMNs, eosinophils and antibodies (rapid onset in seconds/minutes, can last minutes/days)
outcome - complete resolution or abscess formation
Chronic - Mononuclear cell (lymphocyte, monocyte, macrophages) and fibroblast mediated (onset in 2-3 days, can last long time)
outcome - granuloma, scarring and amyloidosis
What characteristics define a granuloma?
Epithelioid Histiocytes
Giant cells and rim of lymphocytes can also be present, but may not be
What is chromatolysis?
Process involving cell body after axonal injury –> Round cell swelling, displace nuclease to periphery, dispersion of Nissl substance in cytoplasm
What is chromatolysis?
Process involving cell body after axonal injury –> Round cell swelling, displace nuclease to periphery, dispersion of Nissl substance in cytoplasm
What is dystrophic calcification and where is it seen? What would serum calcium levels reveal?
Calcium deposition secondary to necrosis
Localized (e.g. heart valves) - TB (lungs/pericardium), liquefactive necrosis of chronic abscesses, fat necrosis, infarcts, thrombi, schistosomiasis, Monckeberg arteriolosclerosis, congenital CMV + toxoplasmosis, psammoma bodies
Normocalcemic in serum test
What is metastatic calcification and where is it seen? What would you see on serum exam?
Widespread deposition secondary to hypercalcemia (primary hyperparathyroidism, sarcoidosis, hypervitaminosis D) or high calcium-phosphate product (e.g. chronic renal failure + 2nd hyperPTH, long term dialysis, calciphylaxis, warfarin)
Calcium mainly in interstitial tissues of kidney, lungs and gastric mucosa (high pH favors deposits)
High serum calcium
What is metastatic calcification and where is it seen? What would you see on serum exam?
Widespread deposition secondary to hypercalcemia (primary hyperparathyroidism, sarcoidosis, hypervitaminosis D) or high calcium-phosphate product (e.g. chronic renal failure + 2nd hyperPTH, long term dialysis, calciphylaxis, warfarin)
Calcium mainly in interstitial tissues of kidney, lungs and gastric mucosa (high pH favors deposits)
High serum calcium
