General Path

Question 1

Apoptosis and Pathways

Answer 1

• Intrinsic, elevated calcium and mitochondrial membrane instability allows cyt c to exit mitochondria and activate caspaces. BCL-2 is anti-apoptotic and BAX is pro-apoptotic
• Extrinsic FAS

Question 2

Gangrene (Dry vs Wet)

Answer 2

• Dry gangrene occurs due to ischemia

- Wet Gangrene due to bacterial infection

Question 3

Leukocyte Extravasation

Answer 3

• Rolling: E-Selectin and P Selectin from WP bodies on endothelial cells bind to sialyl lewis X sugars on leukocytes
• Tight Binding: ICAM on endothelial cells binds to LFA1 on leukocytes (Decreased, can’t extravasate)
• Extravasation: PECAM homotypic interactions

Question 4

Neutrophil Chemoattractants

Answer 4

-C5a, LTB4, IL-8, Kalikrein

Question 5

Wound Healing Stages

Answer 5

• 2 Days: Inflammation, fibrin and macrophages infiltrate are
• 2-3 Days: Granulation tissue (type 3 collagen) neovascularization.
• 1 Week: Replaced by type I collagen myofibroblast contraction

Question 6

Wound Healing Intention

Answer 6

• Primary Intention: Smooth cut, laceration, skin juxtaposed
• Secondary Intention: Wound packed tighlty
• 3 intention: Purposely left open

Question 7

ESR reason

Answer 7

• Inflammatory mediators bind to RBC and make them sediment out faster
• Used for Temporal Ateritis
• Decreased in polycythemia, CHF, Sickle Cell

Question 8

Downs Cancer

Answer 8

ALL

Question 9

Tuberous Sclerosis

Answer 9

Giant Cell Astrocytoma, Renal angiolipoma, cardiac rhabdomyoma

Question 10

Actinic Keratosis

Answer 10

SCC

Question 11

Pagets

Answer 11

Osteosarcoma (adult) child Rb increases risk

Question 12

Immunodeficencies

Answer 12

Lymphomas (kaposi sarcoma for AIDS)

Question 13

Radiation

Answer 13

Leukemia, Papillary Thyroid, Breast

Question 14

Autoimmunity

Answer 14

Lymphomas

Question 15

abl mutation

Answer 15

CML, normally RT, treat with inib

Question 16

C-myc

Answer 16

-Burkitts Lymphoma, transcription factor (same with other myc)

Question 17

BCL-2

Answer 17

Lymphoma

Question 18

Her2Neu

Answer 18

Breast Cancer TK

Question 19

RET

Answer 19

MEN, Hirshprungs TK

Question 20

C-kit

Answer 20

GIST, Cytokine receptor

Question 21

Rb

Answer 21

Retinoblastoma and Osteosarcoma

Normally binds E2F (hypophos) and prevents progression

Question 22

P-53

Answer 22

Li Fraumeni and many cancers. TF for p21 which inhibits transition into S phase

Question 23

BRAF

Answer 23

Melanoma, regulates MAPK

Question 24

NF-1

Answer 24

NF1, regulates RAS pathway

Question 25

CEA

Answer 25

Colorectal, Pancreatic, Breast, medullary thyroid

-Can be used to monitor colorectal cancer response to therapy

Question 26

AFP

Answer 26

HCC

Question 27

CEA

Answer 27

• Colorectal, Breast, Thyroid

- Most indicated to use for response to treatment of colorectal

Question 28

AFP

Answer 28

-HCC, Germ Cell Tumors

Question 29

B HCG

Answer 29

-Ectopics, hyatidaform moles and choriocarcinoma

Question 30

CA-125

Answer 30

Ovarian

Question 31

S-100

Answer 31

Neural Crest: Schwannoma, Melanoma, Neuroendocrine of lung and others

Question 32

ALK-P

Answer 32

Bone Mets, Liver, Pagets

Question 33

Bombesin

Answer 33

-Neuroblastoma, lung, gastric

Question 34

TRAP

Answer 34

-Hairy Cell Leukemia

Question 35

CA 19-9

Answer 35

-Pancreatic

Question 36

Calcitonin

Answer 36

-Medullary Thyroid

Question 37

ACTH

Answer 37

-Small Cell Lung

Question 38

ADH

Answer 38

-Small Cell Lung

Question 39

PTHrP

Answer 39

-SCC lung, breast, renal

Question 40

Vitamin D

Answer 40

-Sarcoidosis, Lymphoma

Question 41

EPO

Answer 41

Renal, HCC, hemangio, pheo

Question 42

Lambert Eaton

Answer 42

Small Cell Lung

Question 43

Brain Mets

Answer 43

-Lung, Breast, Kidney

Question 44

Liver Mets

Answer 44

• Colon

- Also rest of GI tract, but colon most notable (presence of seretonin syndrome means met from carcinoid)

Question 45

Bone

Answer 45

-Prostate, Breast, lung, thyroid, testes