Genpath Flashcards
What does the term pathogenesis mean?
Deals with how a disease develops
Where is smooth endoplasmic reticulum most prominent and what is its main function?
Most prominently found in the liver, adrenal cells, Leydig cells. Metabolic functions
What are the two types of secondary lysosomes?
Heterophagosomes and AUTOphagosomes
What is a heterphagasome
Formed by fusion of phagosomes and lysosomes. The phagosomes contain outside material like food particles
What are AUTOphagosomes
Very similar to hetero phagosomes in that they are formed by the fusion of phagosomes and lysosomes. However the phagosomes contain worn out and damaged cell organelles.
What are the three possible outcomes to cell injury?
Reversible injury; the cell recovers and returns to normal function
Apoptosis; Programmed cell removal and death
Cell death/necrosis
What causes reversible cell injury?
Brief hypoxia, Or brief anoxia. Or low concentrations of toxins.
What causes irreversible cell injury?
Heavy doses of toxins, sustained anoxia, and prolonged hypoxia
What happens to the nucleus of a cell when it is going through an irreversible cell injury
Pyknosis- Condensation of chromatin
Karyorrhexis- Fragmentation of the nucleus into nuclear dust
Karyolysis- Dissolution of nuclear structure as a result of enzymatic digestion
Describe the four different ways that a cell can suffer irreversible injury defined as necrosis
Coagulative, liquefactive, Caseous, enzymatic fat necrosis
What is the most common type of necrosis for a cell?
Coagulative necrosis
What causes coagulative necrosis and what is the outcome?
Anoxia. Cell membrane is preserved, organelles and nucleus coagulate
This happens to internal organs such as the heart, liver, and kidneys
What is liquefactive necrosis?
When the cell is completely digested by hydrolytic enzymes resulting in dissolution of tissues. They become soft and liquefy. This happens to brain, skin, and joints
What is caseous necrosis?
A special form of coagulative necrosis
The cost is tuberculosis; centre part of the tuberculosis granuloma becomes necrotic and the Cell falls apart. This happens in the lungs
What is enzymatic fat necrosis?
A special form of liquefactive necrosis caused by Lipo lytic enzymes and is limited to fat tissues usually around the pancreas. It happens in acute pancreatitis. Enzymes release into adjacent fat tissue degrading fat into glacier all and free fatty acids forming calcium soaps.
Fight club anyone?
What is gangrene and what is it caused by?
Dried out necrotic tissue, dark black and mummified- Dry gangrene
Bacterial infection, inflammation and secondary liquefaction- Wet gangrene
What’s the difference between physiological and pathological apoptosis?
Physiological occurs in foetal development; natural progression. For example the dissolution of webbing between the toes
Pathological occurs as a result of disease. For example, liver cells infected with hepatitis
What is fibrosis?
The extensive deposition of collagen that occurs in chronic inflammation; may cause tissue dysfunction. Example: arthrosclerosis
What’s the term used to describe the formation of new blood vessels?
Angiogenesis
Name the five groups of disease agents
Bacteria, viruses, fungi, protozoans, Helminths (Invertebrate worms)
What is Rickettsia?
Non-motile, Gram negative bacteria
What is monosomy
Loss of one chromosome leading to a chromosomal abnormality a.k.a. birth defect
What is a trisomy?
A birth defect marked by the gain of an additional chromosome
What is turner syndrome
Genetic disorder caused by the partial or complete absence of one X chromosome. Would result in a short stature, learning disabilities, heart defects, delayed puberty, and infertility.
What is klinefelters syndrome
A genetic condition that results when a boy is born with an extra copy of the X chromosome. Adversely affects testicular growth resulting in smaller than normal testicles and leading to lower production of testosterone, reduce muscle mass, reduce body and facial hair, and enlarged breast tissue.
What is the difference between an autosomal dominant disorder and an autosomal recessive disorder?
Autosomal dominant disorder’s result in a trait being fully expressed even if only one copy of the gene is present; Marfan syndrome, familial hypercholesterolaemia
Autosomal recessive disorder’s are only expressed if the gene is inherited from both parents and parents are usually asymptomatic carriers. For example, cystic fibrosis, lysosomal storage disease, phenylketonuria
What is a super bug and how did it come about? Give some examples
Super bugs are antibiotic resistant organisms resulting from antibiotic overuse. For example: MRSA, Multi drug resistant Mycobacterium tuberculosis, vancomycin resistant enterococci, Multi drug resistant pseduomonas aeruginosa, Clostridium difficile
What’s the difference between infection and intoxication?
some bacteria, all viruses, and all parasites caused an illness via infection
And intoxication results when a person eats food containing toxins that cause illness.
Does a fever indicate that a person is infectious?
No. It can be a symptom of infection as well as a symptom of non-infectious pathologies.
What is normal temperature and what constitutes as a low grade fever or a high-grade fever?
Normal: 98.6 Fahrenheit/37 Celsius
Low grade fever: up to 102 Fahrenheit/39 Celsius
High-grade fever: over 102 Fahrenheit/39°C
What are the effects of a prolonged high fever?
Can cause seizures, delirium, disorientation, and Hallucinations
What is the definition of an infection?
When an organism establishes a parasitic relationship with host
What is the process of infection?
Transmission, incubation, infection
What is required for a transmission of an infection?
A portal of entry, a mode of transportation, and a portal of exit
What’s the difference between principal and opportunistic pathogen’s?
Principal pathogens cause disease in people with intact immune systems and opportunistic pathogen’s don’t cause disease in healthy people but can cause devastating effects to people who are immuno compromised
What is another name for a hospital acquired infection?
Nosocomial infection
What is a vector?
Involving insects or animals that act as intermediaries between two or more hosts
What are the three lines of defense?
First line of defense: external barriers/secretions and microbial antagonisms
Second line of defense: inflammation
Third line of defense: immune response
What is a mycoplasma?
A very small self replicating bacteria with no cell wall that depends on the host for nutrition
How is fungi reproduce?
By budding off
What is the most common bacterial pathogen on the skin?
Staphylococcus
What is one of the most common bacterial pathogen’s of humans in general?
Streptococcus
What is Scarlett fever?
Usually follows untreated strep throat. Pyogenic exotoxin. Affects kids aged 2 to 10
What’s another name for streptococcal gangrene
Necrotizing fasciitis
What Graham negative anaerobic bacteria caused the bubonic plague?
Yersinia pestis
What does aids infect in the body?
CD m4 and T cells
What triggers a herpes outbreak?
Mucosal contact is required for the initial transmission and after the first outbreak it becomes latent in the sensory ganglia. Periodic lifetime outbreaks are triggered by a bad cold, high stress, and decreased immune function
Name the different types of herpes
Type one: cold sores
Type two: Genital
Herpetic Whitlow: herpes of the terminal phalanx (Can be type one or two)
Type three: varicella zoster ( Chickenpox/shingles)
Type for: EBV/Epstein-Barr virus/infectious mononucleosis/the kissing disease
Type five: cytomegalovirus
Type six and seven: B and T cells virus is associated with Roseola
Type eight: associated with Kaposi’s sarcoma in AIDS
What is another term for ringworm?
Tinea corporis
What is tinea versicolour
Superficial fungal infection which leads to hypo pigmented or hyper pigmented patches on the skin
What is lymphangitis
Inflammation of the lymph vessels
What is lymphadenitis
Inflammation of one or more lymph nodes
What is lymphoedema
Increase lymph fluid in the tissues
What is Lymphadenopathy
Enlargement of the lymph nodes
What are the four stages of lymphoedema
Stage zero: latent, heaviness aching and fatigue in Limb
Stage one: soft, pitting, reverses with elevation, fibrosis begins
Stage two: no pitting. No reversal with elevation. Skin changes. Chronic inflammation. Recurrent bacterial and fungal infections
Stage III: lymphostatic elephantitis
What is Stemmer sign
A thick skin fold over the second toe denoting lymphoedema
Name the four key components in the inflammation process
Changes in circulation of blood, changes in vessel wall permeability, white blood cell response, release of soluble mediators
What is the first response to injury?
Circulatory changes
What is the term pavementing mean?
Term used to describe vessel wall changes in the process of inflammation; it is when leucocytes adhere to the endothelial cells
What is transudate
Protein rich edema
What is histamine
A chemical mediator for inflammation ; Released by mast and platelets; causes increased blood vessel permeability. It is a vasodilator and a bronchoconstrictor. Last less than 30 minutes
What is Bradykinin
Plasma proteins formed by the hagemen factor. Same effects as histamine but at a slower pace. Increased blood vessel permeability. Vasodilator and bronchoconstrictor. An important difference between this and histamine is that bradykinin causes pain
What is the chemically mediated complement system?
The complement system is when several proteins are activated in cascade acting on one another. There are three pathways that activate the cascade;
classical pathway-Activated by antigen antibody complexes
Alternative pathway- Activated by bacterial endotoxins, fungi, snake venom
Lectin pathway- Activated by binding of lectin to bacteria
What are AAD’s? arachidonic acid derivatives
arachidonic acid derivatives Derived from phospholipids of the cell membrane that form Leukotrienes and Prostaglandins.
What is another name for leukocytes?
Polymorphonuclear neutrophils
What is the precursor to a mast cell?
Basophils
What are the two main phagocytic cells?
Monocytes/macrophages and neutrophils
What are possible causes of inflammation ?
Infectious, chemical, physical, immune
What type of cell holds the edges of damaged tissue together?
Myofibroblasts
What is an Angioblast?
Precursor of blood vessels; proliferate from small blood vessels at the edges of damaged tissue. Appear 2 to 3 days after injury. By DAY6 new blood vessels are formed. They allow for oxygen and nutrients to flow to the injured site and provide a route for scavenger cells to remove tissue debris and scabs
What is the role of a fibroblast?
They produce extracellular matrix. Made up of fibronectin and collagen
What are the components of granulation tissue?
Fibroblasts, angioblasts, macrophages, and myofibroblasts
What is a natural killer cell?
Large granular lymphocytes that are not T nor B lymphocytes.The function is to kill viruses, infected cells, and tumour cells. They bind to potential target cells and release cytotoxic granules and cytokinesis.
Natural killer cells burst forth from the tonsils, lymph nodes and spleen and destroy infected and cancerous cells while the immune systems T and B cells are still mobilizing.
Without natural killer cells, threatening conditions can get a strong foothold before the adaptive immune system response kicks in.
What is major histocompatibility complex?
These are Cell markers on the surface of our body’s cells that are unique to each of us and tell our immune system that the cells are self. Ie fingerprint
What is the term used to describe the part of the antigen that binds to the antibody?
Epitopes
The greater amount of epitopes that a bacterium has the more places that an antibody can bind and therefore the greater the immune response produced
What were major histocompatibility complex previously called?
Human leucocyte antigen a.k.a. HLA’s
They are inherited. They can predispose or increase an individual susceptibility to certain diseases
Are vaccinations considered active or passive immunity?
Active immunity.
What secondary lymphoid organs do T and B’s lymphocytes enter the blood circulation to colonize?
The spleen and lymph nodes
Are there more t or B lymphocytes in the body?
2/3 of all lymphocytes are T cells
What are T-helper cells?
Master regulators. 75% of all T cells. CD4 cells. Assist B cells to mature and produce antibodies recruiting protein mediators called Lymphokines.
Activates macrophages, helps other T cells recognize and destroy virally infected cells, helps natural killer cells kill infected cells. HIV destroys helper T cells
What are T suppressor cells?
They suppress the activation of the immune system and prevent pathologic self reactivity.
What are cytotoxic T cells?
They express CD8 antigen on their surface and mediate the killing of virus infected or tumour cells
What are the type of B lymphocytes?
Plasma cells or memory B
What are memory B cells?
Circulate among the blood, tissues and lymphoid system for a year or longer; responsible for rapid and sustained immune response that occurs with repeated exposure to the same antigen. They remember what happened.
What are plasma cells?
Fully differentiated B lymphocytes that produce immuno globin’s. The surface of plasma cell is coded with immuno globin’s a.k.a. antibodies
What antibody is responsible for eliminating parasitic infections and functions during allergic reactions?
IgE
Activates mast cells to release histamine and is associated with anaphylaxis, hives, allergy induced asthma
What is another name for acquired immunity?
Humoral
What type of immune responses do be lymphocytes produce in comparison to that of T lymphocytes?
B produces a humoral immune response and t produces a cellular immune response
Your patient comes to you complaining that their child has a sore throat, fever, really red tongue that looks almost like a strawberry and a rash everywhere but their palms and soul. What condition does the child most likely have?
Scarlett fever; group a strep/strep pyogenes
What is the term that is used to define an increase in the size of the tissues that is caused by an increase in the number of cells?
Hyperplasia
Define Neoplasia
Uncontrolled growth of cells whose proliferation Cannot be adequately controlled by normal regulatory mechanisms operating in normal tissue. They do not achieve the same level of differentiation
Where would you see a normal type of hyperplasia occur?
Increased breast size in pregnancy, bone callus formation, wound healing a.k.a. scars
What is metaplasia
A reversible and benign but abnormal change in which one normally differentiated cell type is replaced by another for example in smokers lungs columnar epithelial cells change to squamous epithelium
Or in Barrett’s oesophagus the screen this epithelial of the oesophagus changes to granular epithelial of stomach
What is dysplasia
Possibly reversible change that often proceeds malignancy characterized by altered morphology. Disorganization of cells and marked variability in nuclear size and shape. Increased often abnormal mitosis
What is anaplasia
The most advanced form of displeasure with complete loss of differentiation and is characterized by malignant cells only
What is carcinoma in situ
Cancer that has stayed in place where it began and has not spread to neighbouring tissues
What is the definition of meta-stasis
Implantation of cancer cells into non-contagious sites
What are the three main pathways of metastasis
Via the blood, via the lymph, via seeding of the surface of the body cavities
What is tumour angiogenesis
And blood vessels from the surrounding tissue grow into the solid tumour eating in its survival and growth.
What are common sites for meta-stasis
Lymph nodes, liver, lungs, bone and brain
What are some exceptions to the oma rule meaning that they are not benign even with that suffix?
lymphoma, glioma, Seminoma
What is a teratoma
Derived from germ cells and contain tissues that are formed from all three germ layers: ectoderm, mesoderm, and endoderm
Describe the grading system for malignancy
Grades 1 to 3; lower grades are more closely resembling normal cells and higher grades have poor differentiation. Microscopic evaluation is based on the degree of cellular differentiation
What are some clinical signs of cancer?
Anorexia/cachexia, Blood disorders (Anemia/thrombosis), Immunosuppression, fever, nausea/vomiting, Cancer pain a.k.a. night pain
What is atopy
Genetically predisposed condition where IGE antibodies produced to common environmental allergens a K a topic dermatitis
What is a macule
A small flat skin lesion less than 2 cm. Example: freckle
What is a patch
A flat larger skin lesion. Example: childhood rash caused by measles
What is a papule
A slightly elevated smaller than 1 cm skin lesion. Example: eczema
What is a nodule
Slightly elevated skin lesion greater than 1 cm. Example: mole
What is a tumour
A nodule greater than 5 cm
What is a vesicle
Fluid filled elevation of the epidermis smaller than 1 cm. Example: herpesvirus lesion/cold sore on the lip
What is a Bulla
A fluid filled elevation of the epidermis greater than 1 cm. Example: burns
What is a pustule
A vesicle filled with pus. Example: impetigo
What is an ulcer
A defect of the epidermis. Example: syphilitic Chancer
What is a crust
A skin defect covered by coagulated plasma. Example: scab
What are scales
Cureton layers covering the skin as flakes or sheets that can be scraped away. Example: seborrheic keratosis, psoriasis
What are squames
Large scale’s. Example: ichthyosis
What is excoriation
Superficial skin defects caused by scratching
What is a fissure
Sharp edged defect extending deeper into the dermis. Example: athletes foot
What is impetigo
A superficial skin infection characterized by superficial pustules caused by streptococcal or staphylococcus aureus
What is folliculitis
Common skin infection limited to hair follicles and caused by staphylococcus aureus
What is a furuncle
Another term for a boil; skin infection and beating hair shaft and spreading two parafollicule tissue
What is a carbuncle
A larger boil as a result of spread of injection to adjacent hair follicles
What are dermatophytoses
Fungal infection of the skin; most common sites are feet, head, nails, axilla, and groin
What is tinea pedis
Athletes foot; fungal infection between the toes
What is tinea unguium
Fungal infection that is chronic in the nail
What is tinea corporis
Ringworm; fungal infection on the skin appearing a circular or irregular shaped patches
What is tinea cruris
Jock itch; fungal infection of the groin area
What is tinea capitis
Scalp ringworm; fungal infection typically affecting children and causing local hair loss
What is candida albicans
Fungal infection in the common cause of thrush in children
What is another term for lice
Pediculosis
What are scabies
I contagious skin disease caused by Sarcoptes scabiei. They burrow into the epidermis
What is another term for contact dermatitis
Exogenous eczema
What is another term for dandruff
Seborrhoeic dermatitis. Affects 10 to 20% of the population. Often occurs at the nasolabial folds, eyebrows, upper chest and scalp
What is another name for a senile wart
Seborrhetic keratosis. Common and benign
What is the most common type of malignant skin tumour?
Basal cell carcinoma. Good prognosis.
What is the type of skin tumour that has the worst prognosis?
Squamous cell carcinoma
What is squamous cell carcinoma often preceded by?
Actinic keratosis and carcinoma in situ
What is Lentigo
Immaculate or popular that is pigmented but does not respond to the skin.
What are the ABCDs of diagnosing a malignant melanoma?
A: asymmetry of the pigmented lesion
B: irregular borders
C: color; varies from dark black to dark brown to red
D: diameter of the lesion; one should worry at the lesionexceed 6 mm in diameter
What is Kaposi’s sarcoma
Dermal tumour composed of blood vessels and perivascular connective tissue. Scene and people diagnosed with aids. Herpes virus type eight cells have been isolated from Kaposi’s sarcoma cells and it has been proposed that the virus causes tumours and immuno suppressed hosts
Name and describe the four types of diseases of the nail
Onychogryphosis: Nail deformity with no known cause
Koilonychia: Spoon shaped mail; due to iron deficiency anaemia
Onychomosis: Chronic fungal infection of the nails
Paronychia: Bacterial infections of the cuticle
What is hirustism
A hormonal or idiopathic Excess of hair
What is alopecia
Loss of hair from the scalp. Alopecia areata is focal where as diffuse Alopecia is broad and affects males more than females
What is trichotillomania
A psychological urge to pull out your hair
What is the body’s response to specific invaders?
The adaptive or acquired response
What is the substance that triggers the immune response?
Antigen
What is the main role of antibodies?
To take antigen/microbes for destruction by immune system cells
What are the two types of Maine working cells and immune system? And what do they do?
T lymphocytes can recognize hidden organisms and destroy cells well be lymphocytes differentiate into memory or plasma cells to create antibodies
What type of basil is produced that acts immediately against antigens once contact with T-helper cells has occurred and how did he sell stop antigens from infecting other cells?
Plasma cells; create antibodies that mark them for destruction
Considering adaptive immunity, why is the secondary response to a previously identified pathogen so much faster than the primary response?
Because memory cells exist that remember the pathogen from the last infection
What is MHC?
Major Histocompatibility complexes ; The cells fingerprints that identifies the self from non-self
What is a cutaneous papilloma
A skin tag. Benign.
What is urticaria
Hives; skin rash with red, raised, and itchy bumps
What are corns?
Hard dick and areas of the skin that form as a consequence of rubbing, friction, or pressure on the skin
What types of embolisms can occur?
Pulmonary, arterial, gas, fat, tumour
Name acquired heart defects
Endocarditis: rheumatic, non-bacterial thrombotic, acute infective, subacute infective
Myocarditis
Pericarditis
What is GERD
Affects the lower oesophageal sphincter with heartburn and may lead to barrettes oesophagus which is a pre-cancerous condition
What is pyloric stenosis
Infantile condition in which Pyloric sphincter is enlarged;leads to narrowing of opening leading into duodenum; infant throws up often
What is peptic ulcer disease
Formation of ulcers in the stomach, duodenum and to some extent in the esophagus; leads to pain in the epigastric area
What is gastric Adenocarcinoma
Stomach cancer; a malignant cancer that develops in the gastric glands
What is gastroenteritis
Information of the G.I. tract that involves the stomach and small intestine; symptoms may include diarrhea, vomiting, and abdominal pain. Fever, lack of energy and dehydration may also occur
What is constipation?
Bell movements that are in frequent or hard to pass. Complications from constipation may include hemorrhoids, anal fissures, or faecal impaction
What is coeliac disease
Gluten sensitive enteropathy or sprue. It is a hyper sensitivity to gluten/gliadin
What is the difference between ulcerative colitis and Crohn’s disease
Ulcerative colitis is the information of the mucosa of the colon and rectum with ulcerations whereas Crohn’s disease is a chronic transmural information of the G.I. tract most often involving the ileum and the colon
What is irritable bowel syndrome
GI disorder that causes a domino pain, bloating, constipation, and diarrhoea it is not an inflammatory disease
Name how to contract the different types of hepatitis.
Hepatitis A: contaminated food and drink
Hepatitis B: blood transfusion, exposure to contaminated blood and blood products/sexual contact. Can lead to a hepatocellular carcinoma
Hepatitis C: blood transfusion, exposure to contaminated blood and blood products or sexual contact. Less severe than hepatitis B
Hepatitis D: coinfection or following a pre-existing HBV infection
Hepatitis C: transmitted by faecal oral route
Hepatitis G: transmitted by infected blood or blood products
What is cirrhosis
And end-stage liver disease. Chronic liver disease. Formation of fibrous scars
What is haemochromatosis
Excessive accumulation of iron in the body. I can be genetic or secondary due to excessive iron uptake or blood transfusions
What is cholelithiasis
Gallstones. Cholesterol stones and pigmentary stones.
What is Cholecytisis
Gallbladder information as a result of gallstones which enters to be closer which allows entry of bacteria; may cause biliary obstruction producing obstructive jaundice due to hyperbilirubinemia
What is another term for jaundice?
Icterus
What is Wilson’s disease?
A rare autosomal recessive inherited disorder of copper metabolism, characterized by excessive deposition of copper in the liver, brain, and other tissues
What are urinary tract infection
Graham negative bacteria and circulating blood and those entering urinary tract from outside. More common in women
What is acquired cystic kidney disease?
Kidney disease that develops in later stages of end-stage kidney disease. Most common occurrence is in patients that have started to undergo dialysis
What is cystic renal dysplasia?
Congenital anomaly that occurs in babies during early kidney devel in utero. Usually affects one kidney
What is polycystic kidney disease?
Developmental disorder that causes kidneys to enlarge and contain numerous Fluid filled cyst’s
What is pyelonephritis
Can be a cute or chronic; bacterial infections of the kidney. Acute is due to suppurative infection and can evolve into chronic. Chronic is when the kidney parenchyma Is destroyed and the kidney itself becomes smaller
What is Glomerulonephritis
I need a logic disorder causing kidney information and damage of the glumeruli
What is diabetic nephropathy
What about disease affecting the kidneys as a result of diabetes. Patients present with polyuria, glycosuria, proteinuria. May lead to chronic renal failure
What is urolithiasis
Bladder stones. Formation of urinary stones which are composed of calcium, struvite, uric acid or cystine. In renal pelvis or urinary bladder. The symptoms hematuria and urinary colics. Larger stones mechanically extracted using lithotripsy or ultrasound targeting.
What is cystitis
Bacterial infection of the urinary bladder. It can be a
cute which is mucosal haemorrhage visible during cystoscopy or it can be chronic which includes hemorrhage, ulceration, and or thickening
What are the phases of scar tissue formation?
Inflammation, proliferation, and remodelling
