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usmle > General Pathology > Flashcards

General Pathology Flashcards

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USMLE® Step 1 flashcards
1
Q

An increase in stress on an organ leads to

A

Increase in organ size via:

  1. Hypertrophy
  2. Hyperplasia
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2
Q

A decrease in stress on an organ leads to

A

Atrophy

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3
Q

A change in stress leads to

A

Metaplasia (change in cell type)

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4
Q

Mechanism(S) involved in hypertrophy

A
  1. Gene activation
  2. Protein Synthesis
  3. Production of organelles
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5
Q

Mechanisms involved in hyperplasia

A

New cells from stem cells

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6
Q

Mechanism involved in metaplasia

A

Reprogramming of stem cells

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7
Q

Cells that cannot undergo hyperplasia

A
  1. Cardiac cells
  2. Skeletal muscle
  3. Neurons
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8
Q

Decrease in the number of cells occur via

A

Apoptosis

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9
Q

Decrease in cell size occur via

A

Ubiquitin proteosome degradation of cytoskeleton and autophagy of cellular components

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10
Q

Metaplasia involves change in

A

One surface epithelium to another (squamous, columnar, or urothelial)

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11
Q

Is metaplasia reversible or irreversible

A

Reversible

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12
Q

Which vitamin deficiency can result in metaplasia

A

Vit.A deficiency

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13
Q

Example of mesenchymal tissue that can undergo metaplasia

A

Muscle: myositis ossificans (connective tissue within muscle changes to bone during healing or trauma)

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14
Q

Dysplasia

A

Disordered cell growth

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15
Q

Aplasia

A

Failure of cell production during embryogenesis

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16
Q

Hypoplasia

A

Decrease in cell production during embryogenesis, resulting in a relatively small organ (streak ovary in Turner Syndrome)

17
Q

When does cellular injury occur

A

When a stress exceeds a cells ability to adapt

18
Q

Common causes of cellular injury

A 
Inflammation
Nutrition deficiency or excess
Hypoxia 
Trauma 
Genetic mutations
19
Q

What is hypoxia?

A

Low oxygen delivery to tissue

20
Q

What is the function of oxygen in the ETC

A

Act as a electron acceptor

21
Q

Consequence of impaired oxidative phosphorylation

A

Decreased ATP

22
Q

Consequences of low ATP

A

Disruption of:

  1. Na/k pump, resulting in sodium and water buildup in the cell
  2. Ca2+ pump, resulting in high cytosolic ca concn. (Enzyme activation)
  3. Aerobic glycolysis, resulting in switch to anaerobic glycolysis. Lactic acid buildup results in low pH, which denatures proteins and precipitates DNA
23
Q

Causes of hypoxia

A

Ischemia
Hypoxemia
Decrease o2 carrying capacity

24
Q

What is Ischemia

A

Decrease blood flow through an organ

25
Q

Causes of ischemia

A
  1. Decrease arterial perfusion (atherosclerosis)
  2. Decrease venous drainage (Budd-Chiari Syndrome)
  3. Shock (generalized HypoTN resulting in poor tissue perfusion)
26
Q

What is hypoxemia

A

Low partial pressure of oxygen in blood (PaO2 <60mm Hg, SaO2 <90%)

27
Q

Causes of hypoxemia

A
  1. High altitude: decrease ATM pressure, decrease PAO2
  2. Hypoventilation: increased PACO2, decreased PAO2 (COPD)
  3. Diffusion defect: cannot push O2 into blood due to thick barrier
  4. V/Q mismatch : blood bypasses oxygenated lung (right to left shunts); oxygenated air cannot reach blood (atelectasis)
28
Q

Causes of decrease O2 carrying capacity

A

Hb loss or dysfunction:

  1. Anemia (decrease RBC mass) normal PaO2 & SaO2
  2. Carbon monoxide poisoning: binds more avidly to Hb (decr. SaO2)
  3. Methemoglobinemia: Fe3+ cannot bind O2 (decr. SaO2)
29
Q

CO poisoning C/F

A

Cherry- red skin

30
Q

Early sign of CO exposure

A

Headache

31
Q

Methemoglobinemia

A

When Fe2+ is oxidized to Fe3+ which cannot bind O2

32
Q

Causes of metHB

A
  1. Oxidant stress: sulfa and nitrate drugs or newborn
33
Q

C/F of methemoglobinemia

A

Cyanosis with chocolate colored blood

34
Q

Treatment for methemoglobinemia

A

Methylene blue (reduces Fe3+ back to Fe2+)

35
Q

Hallmark of reversible cellular injury

A
  1. Cytosolic swelling: effacement of microvill &membrane blebs
  2. rER swelling: decrease protein synthesis
36
Q

Hallmark of irreversible cellular injury

A

Membrane damage:

  1. Plasma membrane: enzymes leak, calcium enters cell
  2. Mitochondrial membrane: loss of ETC (IMM), cytochrome c leaks
  3. Lysosomes membrane: enzymes leak and become activated by high intracellular calcium

usmle (18 decks)

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