General patho 0422FA

Question 1

what is the hallmark of reversible injury?

Answer 1

cellular swelling (no ATP leads to impaired Na-K pump)

Question 2

what is the hallmark of irreversible injury?

Answer 2

membrane damage (plasma, mito, lysosome)

Question 3

hypovolemic/cardiogenic shock

Answer 3

low output failure
increased TPR
low CO
cold, clammy pt

Question 4

septic shock

Answer 4

high output failure
decreased TPR
dilated arterioles, high venous return
hot pt

Question 5

granuloma

Answer 5

nodular collection of epithelioid macrophages and giant cells.

characteristic of chronic inflammation.

Question 6

which cytokine is assoc. with granuloma formation?

Answer 6

TNF alpha from macrophages

Question 7

apoptosis

Answer 7

cell shrinkage, nuclear shrinkage and basophilia (pyknosis), membrane blebbing, nuclear fragmentation (karyorrhexis), nuclear fading (karyolysis), apoptotic bodies.

NO INFLAMMATION.

Question 8

what enz mediates apoptosis?

Answer 8

caspases (protease, endonuclease)

Question 9

what activates caspases?

Answer 9

1. cyto c from inner mito matrix
2. FAS ligand binding FAS receptor (CD95)
3. CD8+ release of perforins and granzyme B

Question 10

what molecules are involved with fever?

Answer 10

IL-1 and TNF from macrophages increase COX activity, then PGE2 raises temp set point (hypothalamus)

Question 11

steps of leukocyte (neutrophil) extravasation

Answer 11

1. margination
2. rolling: selectin speed bumps
3. tight binding/adhesion: ICAM, VCAM bind to integrins on leukocytes
4. transmigration/chemotaxis
5. phagocytosis

Question 12

which molecules are opsonins?

Answer 12

IgG, C3b - enhance phagocytosis

Question 13

what is the O2-dependent reaction that kills microbes in phagolysosomes?

Answer 13

O2 (NADPH oxidase) O2- (superoxide dismutase) H2O2 (myeloperoxidase) HOCl-

Question 14

what are the anti-inflamm cytokines?

Answer 14

IL-10, TGF-beta secreted by macrophages

Question 15

granulomatous diseases

Answer 15

1. mycobacterium tuberculosis
2. fungal infections (histoplasmosis)
3. treponema pallidum (syphilis)
4. M. leprae (leprosy)
5. bartonella henselae (cat scratch dz)
6. sarcoidosis
7. Crohn’s disease
8. berylliosis

Question 16

transudate

Answer 16

protein poor. spec grav < 1.012. hypocellular.

due to increased hydrostatic pressure, decreased oncotic pressure, Na retention.

Question 17

exudate

Answer 17

protein rich. spec grav > 1.020. cellular.

due to lymphatic obstruction, inflamm.

Question 18

increased ESR

Answer 18

infections. 
inflamm (temporal arteritis). 
cancer.
pregnancy.
SLE.

Question 19

decreased ESR

Answer 19

sickle cell - altered shape.
polycythemia - too many.
CHF.

Question 20

systemic amyloidosis

Answer 20

1. primary: Bence jones (AL derived from Ig light chains)

2. secondary: AA derived from SAA protein in chronic inflamm dz

Question 21

localized amyloidosis

Answer 21

1. senile cardiac: transthyretin derived from AF
2. DM2: amylin derived from AE (insulin)
3. medullary carcinoma of thyroid: A-CAL derived from calcitonin
4. Alzheimer: beta amyloid derived from APP
5. dialysis: beta2-microglobulin derived from MCH I prots

Question 22

what enzs are used when tumors invade BM?

Answer 22

metalloproteinases: collagenase, hydrolase

Question 23

psammoma bodies

Answer 23

1. papillary adenocarcinoma of thyroid
2. serous papillary cystadenocarcinoma of ovary
3. meningioma
4. malignant mesothelioma

PSaMMoma