General Path Flashcards
Disolution of Chromatin
Karyolysis
in apoptosis
nuclear fragmentation
karyohexis
Nuclear shrinkage
pyknosis
Initiation of Intrinsic apoptosis pathway
Growth factor withdrawl
exposure to injurious stimuli
Initiation of Extrinsic apoptosis path
Fas (CD95)
Cytotoxic T cell release perforin and granzyme B
Reperfusion type of necrosis
Red coagulative
Rolling receptors for Neutrophils and vascular tissue
Vascular–E and P selectin
leukocyte–Sialyl-Lewis
Tight bonding receptors for leukocyte
Vascular–ICAM-1
leukocyte–LFA-1 (integrin)
Diapedisis receptors for leukocytes
PECAM-1 for leukocytes and vascular tissue
Migration chemotactic signals for leukocytes
C5a
IL-8
LTB4
Kallikrein
“CILK”
Inflammatory phase of wound healing cells
plts., neutrophils, macrophages
Proliferative Phase of wound healing cells
fibroblasts, myofibroblasts, endothelial cells, keratinocytes, macrophages
Remodeling phase of wound healing cells
fibroblasts
Inflammatory phase of wound healing
clot formation
vessel permeability and neutrophil migration
Macs clear debris in 2 days
Proliferative Phase (2-3 days post injury)
Deposition of granulation tissue and collagen (type III) angiogenesis epithelial cell proliferation dissolution of clot wound retraction due to myofibroblasts
Remodeling phase (1 week post injury)
Type III collagen replaced by Type I
increased tensile strength of tissue
Granuloma formation mechanism
INF-gamma from TH1 cells activate macrophages
macrophages secrete TNF-alpha –> induce and maintain granuloma
Fluid with:
Hypocellular
Protein poor
Specific gravity < 1.012
Transudate
Due to increased hydrostatic pressure
decreased π
Na retention
Fluid with:
Hypercellular
Protein Rich
Specific Gravity > 1.020
Exudate
Due to :
Lymphatic obst.
Inflammation
increased permeability
Mechanism of cell death with Fe poisoning
Sx
Peroxidation of lipid membrane
Sx: GI bleed (acute)
Metabolic acidosis, scarring –> GI obstruction (Chronic)
ß pleated sheet structures deposition leading to cell death and apoptosis
Amyloidosis
Congo Red
Apple Green Birefringence
AL Amyloidosis (1º)
Ig Light Chains
plasma cell disorder associated with multiple myeloma
AA Amyloidosis (2º)
Fibrils composed of Amyloid A
RA
IBD
TB
Dialysis related Amyloidosis
ß2-microglobin
Carpal tunnel Syndrome, joint pain
Heritable Amyloidosis
Transthyretin (TTR or prealbumin) gene mutation
ATTR–neurologic/cardiac amyloidosis
Age Related Amyloidosis
Depostion of normal TTR in myocardium (other sites too)
Slower progression than AL
Organ Specific Amyloidosis
Deposition in specific organ
Most important–Alzheimer’s Disease
ß-amyloid protein
Neoplastic progression
Normal –> Hyperplasia –> CA in situ –> Invasion –> Metastasis
how do tumors invade basement membrane
collegenases and hydrolases
Loss of size, shape, orientation of cell
dysplasia
Increase in # of cells
hyperplasia
Increase in size of cells
hypertrophy
One adult cell type replaced by another
metaplasia
abnormal cells lacking differentiation
anaplasia
clonal proliferation fo cells taht is uncontrolled and excessive
neoplasia
Fibrous tissue formation in response to neoplasm
desmoplasia
Prognostic predictor of tumor
stage
degree of localization/spread
Degreee of cellular differentiation
Tumor Grade
Benign tumor of epithelium
Adenoma
Papilloma
Malignant tumor of Epithelium
adenocarcinoma
papillary carcinoma
Malignant tumor of blood cells
Leukemia
Lymphoma
Benign tumor of blood vessels
hemangioma
malignant blood vessel tumor
angiosarcoma
Smooth muscle cell tumor–benign and malignant
Benign–leiomyoma
Malignant–leiomyosarcoma
Striated muscle tumors
Benign–rhabdomyoma
Malignant–rhabdomyosarcoma
Connective tissue tumors
Benign–fibroma
Malignant–fibrosarcoma
Bone tumor
Benign–osteoma
Malignant–osteosarcoma
Fat tumors
benign–lipoma
malignant–liposarcoma
Origin of Sarcoma
mesenchymal
Origin of carcinoma
epithelial
Neoplasm associated with Down Syndrome
ALL
Neoplasm associated with Xeroderma pigmentosum and albinism
Melanoma
Basal cell CA
especially Squamous cell CA of skin
Neoplasm associated with Chronic atrophic gastritis, pernicious anemia, postsurgical gastric remnants
Gastric Adenocarcinoma
Neoplasm associated with tuberous sclerosis
Giant cell astrocytoma
renal angiomyolipoma
cardiac rhabdomyoma
Tuberous Sclerosis Sx
Facial Angiofibroma
seizures
mental retardation
Neoplasm associated with Actinic Keratosis
Squamous cell CA of skin
Neoplasm associated with Barrett’s Esophagus (chronic GI reflux)
Esophageal adenocarcinoma
Neoplasm associated with Plummer Vinson Syndrome (low Fe)
Squamous cell CA of esophagus
Neoplasm associated with cirrhosis
HCC
Neoplasm associated with UC
Colonic adenocarcinoma
Neoplasm associated with Paget’s disease of bone
2º ostiosarcoma and firbrosarcoma
Neoplasm associated with immunodefficiency states
malignant lymphomas
Neoplasm associated with AIDS
agressive malignant lymphoma
kaposi’s Sarcoma (HHV-8)
Neoplasm associated with Autoimmune diseases
Lymphoma
Neoplasm associated with Acanthosis nigracans
visceral malignancy (stomach, lung, uterus)
Neoplasm associated with dysplastic nevus
malignant melanoma
Neoplasm associated with radiation exposure
leukemia
sarcoma
papillary thyroid cancer
breast cancer
Prostate CA tumor markers
PSA
PAP–prostatic acid phosphatase
CEA tumor marker
70% colorectal and pancreatic cancers
gatric, brease, medullary thyroid CA
alpha fetal protein tumor marker
HCC
Nonseminomatous germ cell tumors
ß-hCG tumor marker
Hydatidiform moles
Choriocarcinoma
gestational trophoblastic disease
Ovarian Cancer marker
CA-125
S-100 tumor marker
melanoma
neural tumors
schwannomas
Alkaline Phosphatase tumor marker
Mets to bone and liver
paget’s disease of bone
Bombesin
neuroblastoma
lung cancer
gastric cancer
TRAP+ Cancer
Hairy cell leukemia
CA-19-9 tumor marker
pancreatic adenocarcinoma
Marker for medullary thyroid CA
Calcitonin
CEA
HTLV-1 associated cancers
Adult T-Cell Leukemia/lymphoma
HBV/HCV associated cancers
Hepatocellular CA
EBV associated cancers
Burkitt’s Lymphoma
Hodgkin’s Lymphoma
nasopharyngeal CA
CNS lymphoma
HPV associated cancers
Cervical CA (16, 18)
Penile/anal CA
upper respiratory squamous cell CA
HHV-8 associated cancers
Kaposi’s Sarcoma
body cavity fluid B-cell lymphoma
H. pylori associated cancers
Gastric adenocarcinoma and lymphoma
Schistosoma haematobium associated cancers
squamous cell bladder cancer
Liver fluke (Clonorchis sinensis) associated cancers
cholangiocarcinoma
Tumor causing cushing’s syndrome Sx
increased ACTH or ACTH-like peptide
Small cell CA of lung
Tumor causing SIADH
Small Cell CA of lung
intracranial neoplasm
PTHrP secreting tumor
squamous cell lung CA
renal cell CA
breast cancer
causes hypercalcemia
1,25 OH2 D3 (calcitrol) secreting tumor
Hodgkin’s lymphoma
some non-hodgkin
causes hypercalcemia
EPO secreting tumor
RCC
hemangioblastoma
HCC
pheochromocytoma
causes polycythemia
Tumor that causes Lambert Eaton Syndrome
Small Cell CA of lung
tumors that cause hypercalcemia
Squamous cell CA of lung
RCC
breast cancer
Hodgkin’s and some non-Hodgkin’s lymphoma
Cancer incidence Men and women
- Prostate/breast
- lung
- Colon/rectum
Cancer mortality men and women
- Lung
2. prostate/breast
Most common Mets to brain
- lung
- breast
- GU
- osteosarcoma
- melanoma
- GI
Most common mets to liver
- Colon
- stomach
- pancreas
Most common mets to bone
- prostate/breast
- lung
- thyroid
- Testes
Most common site for mets after regional lymph nodes
Liver
lung
Location/description of mets to brain most commonly
well-circumscribed tumors at gray/white matter jxn