Glossary

Question 1

Lactic acidosis

Answer 1

Associated w glycogen storage ds, mainly myopathic forms

An example of a myopathic glycogen storage disease is McArdle’s syndrome (type V)

Basically, if enzymes that fuel the glycolytic pathway are deficient, glycogen stores in the muscle increase. Clinical presentation of m weakness.

M cramping after exercise and a failure of exercise induced lactic acidosis. (Glycolytic storage ds cannot make lactic acid)

Question 2

Acquired

Answer 2

Molecular basis if cancer-> genetic disease
When a person acquires a genetic predisposition to cancer, the damage is said to be non-lethal genetic damage that lies at the heart of carcinogenesis. If it were lethal, the cell would die and mutation would not replicate and would die out.

Question 3

Acute

Answer 3

1. In reference to subdural hematomas. When they are acute there is a CLEAR history of trauma.
2. Morphology of an acute subdural hematoma:
   a. Freshly clotted blood
   b. Underlying brain parenchyma is compressed.

Question 4

Adult Respiratory Distress Syndrome (ADRS):

Answer 4

Pathogenesis:
o Diffuse damage to the alveolar capillaries and epithelium.
o Causative agents may include:
▪ O2 derived free radicals
▪ Aggregation of activated neutrophils
▪ Activation of pulmonary macrophages
▪ Loss of surfactant
o Resultant edema and atelectasis result in poor lung aeration
• Morphology:
o Acute phase:​
▪ Boggy, firm lungs
▪ Hyaline membranes, edema ,acute inflammation
o Proliferative/Organizing Phase:
▪ Proliferation of type II epithelial cells
▪ Interstitial fibrosis
• Clinical Course:
o 85% of pts develop clinical S&S within 72 hours of initiating phenomenon.
o Initially there are no pulmonary symptoms
o Dyspnea and tachypnea, radiographs are NORMAL
o Increasing cyanosis, hypoxemia, respiratory failure, and radiographic appearance of diffuse bilateral infiltrates.
o Hypoxia can be unresponsive to O2à hyaline membrane too thick
o Mortality rate is 40%

Question 5

Alkaline Phosphatase (ALP):

Answer 5

• There are several isoenzymes and they are found in bone, liver, placenta, intestine and Regan (tumor).
• Useful as a tumor marker in:
o Osteoblastic lesions
o Derived from tumor itself
• Benign Conditions (False Positives):
o Pregnancy( baby is making new bone)
o Childhood (growing, bine remodeling)
o Obstructive hepatic disease
o Hepatitis
o Paget’s disease of bone
o Fractures (making new bone to heal)

Question 6

Alpha-1 Antitrypsin:

Answer 6

• Imbalance between proteases and antiproteases result in alveolar wall damage.
• α – antitrypsin is the primary antiproteases

Question 7

Alpha-Fetoprotein:

Answer 7

Alpha-Fetoprotein:
• This is an Oncofetal Antigen
• This is a glycoprotein that is the predominate component of serum proteins in early embryonic life.
• Synthesized by the fetal yolk sac, fetal liver, fetal GI, and in minute amounts by the adult liver.
• Useful as a tumor marker in:
o Hepatocellular carcinoma (AFP is elevated in 60-70% of pts)
o Germ cell tumors of the testis
o Less regularly in carcinomas of the colon, lung and pancreas.
• False Positives:
o *Cirrhosis
o *Massive liver necrosis
o *Chronic hepatitis
o Normal Pregnancy
o Fetal neural tube defects

Question 8

115. Anaplasia: Lack of differentiation.

• Morphology:

Answer 8

o Cellular and nuclear pleomorphism (nuclei having different shapes)
o Nuclear Hyperchromasia (nuclei have too much color)
o Increasednuclear to cytoplasmic ratio
o Increased number of mitosis
o Loss of orientation of cells
o Formation of tumor GIANT cells

Question 9

116. Angiogenesis:

Answer 9

• In reference to neoplasm and tumor angiogenesis
• Tumors cannot enlarge beyond 1-2mm in diameter or thickness unless they are
vascularized! This correlates with MALIGNANCY!
• How do tumors develop a blood supply?
o Factors produced by tumor cells
o Factors produced by inflammatory cells

o The balance between angiogenesis factors and inhibitors pushed to favor angiogenesis.
o Early tumor growth!NO Angiogenesis (months to years)
o Angiogenic switch: change of come cells within tumor to an angiogenic
phenotype.

Question 10

• Angiogenesis Inducers:

Answer 10

o VEGF (vascular endothelial growth factor)
“ Early in tumor growth no angio and remain small.

Question 11

ACP

Acid phosphatase

Answer 11

• numerous isoenzymes found in bone, prostate, erythrocytes and platelets.
• useful as a tumor marker in:
  - prostate carcinoma ( gland itself producing ACP)
  - bone-> osteolytic metastasis
• benign conditions ( false positives):
  - benign prostatic hyperplasia(BPH)
  - mechanical trauma
  - accidental (motorcycle accident)
  - instrumentation (surgery)