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Pathoma > High Yield CH 1-3 > Flashcards

High Yield CH 1-3 Flashcards

1
Q

Metaplasia seen in Barrett’s Esophagus

A

Nonkeratinizing squamous epithelium –> nonciliated, mucin-producing columnar cells

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2
Q

How does Barrett’s lead to cancer (and type)

A

Metaplasia –> dysplasia –> cancer - Adenocarcinoma of the esophagus

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3
Q

In Vitamin A deficiency, thin squamous lining of conjunctiva undergoes metaplasia into stratified keratinizing squamous epithelium in this condition.

A

Keratomalacia

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4
Q

Muscle tissue changes to bone after trauma in this condition

A

myositis ossificans (mesenchymal tissue metaplasia)

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5
Q

Low oxygen delivery to tissues

A

Hypoxia

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6
Q

Decreased blood flow through an organ

A

Ischemia

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7
Q

Thrombosis of hepatic vein - most commonly caused by polycythemia vera

A

Budd-Chiari syndrome

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8
Q

Low partial pressure of oxygen in the blood. PaO2 < 60 mmHg, SaO2 <90%

A

Hypoxemia

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9
Q

PA02 vs Pa o2

A

PA = alveolar. Pa = arteriolar

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10
Q

Cherry red appearance of skin. Pa02 normal, Sa02 decreased.

A

Carbon monoxide poisoning

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11
Q

Cyanosis with chocolate - colored blood. Tx?

A

Methemoglobinemia. Tx = intravenous methylene blue to reduce Fe3+ back to Fe2+

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12
Q

Mitochondrial enzyme that activates apoptosis

A

Cytochrome C

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13
Q

Wedge shaped, pale infarct characteristic of ischemic infarction (NOT in brain). Type of necrosis

A

Coagulative necrosis

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14
Q

Necrosis type characteristic of Brain infarction, Abscess, and Pancreatitis.

A

Liquefactive necrosis

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15
Q

Necrosis type characteristic of ischemia of lower limb and GI tract. A type of coagulative necrosis

A

Gangrenous necrosis

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16
Q

Necrosis type characteristic of granulomatous inflammation due to TB or fungal infection.

A

Caseous necrosis

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17
Q

3 disorders psoma bodies (dystrophic calcification) are seen in

A

papillary carcinoma of thyroid
papillary serous carcinoma of ovary
meningioma

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18
Q

calcium deposits on dead tissue when NORMAL serum calcium and phosphate.

A

dystrophic calcification

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19
Q

High serum calcium or phosphate leads to calcium deposition in normal tissue (hyperparathyroid, nephrocalcinonis)

A

metastatic calcification

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20
Q

Necrosis characteristic of malignant hypertension, vasculitis, pre-eclampsia. Necrotic damage to blood vessel wall

A

Fibrinoid necrosis

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21
Q

Bcl2

A

stabilizes mitochondrial membrane. inactivated in intrinsic mitochondrial pathway - leading to caspace activation by cytochrome C and apoptosis

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22
Q

Extrinsic receptor-ligand pathways of caspace activation for apoptosis

A

Fas ligand binds FAS death receptor (CD95) on target cell activating caspaces.
TNF also binds TNF receptor leading to more activation

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23
Q

CD95

A

FAS death receptor - used in apoptosis

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24
Q

CD8 T cell mediated activation of caspaces for apoptosis

A

Perforins from CD8 T cell. Then granzyme enters, activates caspaces

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25
Glutathione, vit a, c, and e are all
antioxidants
26
function of superoxide dismutase (in mitochondira)
superoxide (02-) --> H2O2
27
Function of Glutatione peroxidase in mitochondria
GSH + free radical (OH-) --> GSSG + H20
28
Function of Catalase in peroxisomes
H202 --> 02 + H20
29
Organic solvent used in dry cleaning. leads to fatty change in the liver
Carbon tetrachloride. converts to CCl3 free radical and damages hepatocytes leading to decreased apolipoprotein synthesis
30
B-pleated sheets that stain with Congo red and apple-green birefringence
Amyloid
31
Type of amyloid deposited in systemic, primary amyloidosis
AL amyloid - derived from immunoglobulin light chain. seen in plasma cell dyscrasias (multiple myeloma)
32
Type of amyloid deposited in systemic, secondary amyloidosis
AA, derived from serum amyloid-associated protein (SAA).
33
Nephrotic syndrome, Restrictive cardiomyopathy/arrhythmia, tongue enlargement, malabsorption, hepatosplenomegaly. Seen in
Systemic amyloidosis
34
Non-mutated serum transthyretin deposits in the heart.
Senile cardiac amyloidosis
35
Mutated serum transthyretin depsoits in the heart leading to restrictive cardiomyopathy
Familial amyloid cardiomyopathy
36
Amylin deposits in the islets of the pancreas
Non-insulin dependent diabetes mellitus type II
37
Abeta amyloid in brain
Alzheimer
38
Beta2-microglobulin depsits in joints
Dialysis-associated amyloidosis
39
Calcitonin deposits within tumor. "Tumor cells in an amyloid background"
Medullary carcinoma of the thyroid.
40
CD14
A toll-like receptor on macrophages. Recognises LPS on outer membrane of gram-negative bacteria
41
PGI2,D2, and E2
mediate arteriole vasodilation and increased vascular permeability @ post capillary venule
42
PGE2
mediates pain as well as vascular permeability and vasodilation
43
Cycloxygenase
AA --> Prostaglandins
44
5-lipoxygenase
AA --> Leukotrienes
45
LTB4
attracts and activates neutrophils
46
LTC4, LTD4, LTE4
vasoconstriction, bronchospasm, increased vascular permeability via contraction of pericytes
47
4 key mediators that attract and activate neutrophils
LTB4; C5a; IL-8; Bacterial products
48
Activators of mast cells
1. tissue trauma; 2. C5a, C3a; 3. Cross-linking of cell-surface IgE by antigen
49
Classical pathway of complement activation
C1 binds IgG or IgM that is bound to antigen
50
C3a and C5a
Anaphylatoxins. Trigger mast cell degranulation, resulting in histamine-mediated vasodilation and increased vascular permeability
51
C5a
chemotactic for neutrophils
52
C3b
opsonin for phagocytosis
53
Hageman factor (XII)
activated upon exposure to subendothelial or tissue collagen. 1. activates coagulation and fibrinolytic system. 2. activates complement 3. activates Kinin system
54
Kinin system
Kinin cleaves HMWK to bradykinin
55
Bradykinin
mediates vasodilation, increased vascular permeability and PAIN
56
Cause of Fever
Pyrogens (LPS) cause MACROPHAGES to release IL-1 and TNF which increases CYCLOOXYGENASE activity in PERIVASCULAR cells of the HYPOTHALAMUS. Increased PGE2 raises temperature set point.
57
P-selectin
Released from Weibel-palade bodies. Mediated by histamine. on endothelial cells. bind Sialyl lewis X on leukocytes in rolling step.
58
E-selectin
Induced on endothelial cells by TNF-IL1 in rolling step. binds sialyl lewis X on leukocytes
59
ICAM and VCAM
adhesion step. upregulated on endothelium by TNF and IL-1. bind integrins
60
Integrins
upregulated on leukocytes by C5a and LTB4. adhesion step
61
CD18
Integrins
62
Delayed separation of the umbilical cord, increased circulating neutrophils, recurrent bacterial infections that lack pus formation.
Leukocyte adhesion deficiency. Autosomal recessive defect of integrins (CD18 subunit)
63
Increased risk of pyrogenic infections. Neutropenia. Giant granules in leukocytes. Defective primary hemostasis. ALBINISM. peripheral neuropathy
Chediak-Higashi syndrome - a protein trafficking defect. autosomal recessive. characterized by IMPAIRED PHAGOLYSOSOME FORMATION.
64
NADPH Oxidase
Oxidative burst. O2--> superoxide (02-)
65
Superoxide dismutase (SOD)
superoxide (02-) --> H202
66
Myeloperoxidase (MPO)
H202--> HOCL- [bleach]
67
Poor O2 dependent killing due to NADPH oxidase defect. Recurrent infection of catalase-positive organisms [S. aures, Pseudomonas cepacia; Serratia marcescen; Nocardia; Aspergillus]
Chronic Granulomatous disease (CGD). Nitroblue tetrazolium test is used for screening
68
Defective conversion of H202 to HOCL. Increased risk of Candida infections.
MPO deficiency.
69
Anti-inflammatory cytokines produced by macrophages
IL-10 and TGF-B
70
CD4+ helper T cell activation.
1. extracellular antigen presented on MHCII 2. B7 on APC binds CD28 on CD4+ Cell.
71
TH 1 secretes:
1. IL-2 [T cell growth factor and CD8 T cell activator] and 2. IFN-gamma [macrophage activator]
72
TH 2 secretes:
1. IL-4 [B-cell class switching to IgG and IgE]; 2. IL-5 [eosinophil chemotaxis and activation/ maturation of B cells to plasma cells; class switching to IgA]; and 3. IL-10 [Inhibit TH1 phenotype]
73
CD40
Receptor on B cells - binds CD40L of helper T cell when B cell has an antigen to present. is the second activating signal for T cell, which secretes IL-4 and 5 to turn on B cells.
74
What is a granuloma
collection of epithelioid histicytes (macrophages) surrounded by giant cells and a rim of lymphocytes
75
Stellate shaped granuloma on neck
Cat scratch disease
76
IL-12
From macrophages. induces CD4+ T helper cells to differentiate into Th1 subtype so they can secrete IFN-gamma and convert the macrophages to epithelioid histiocytes and giant cells to make a granuloma.
77
22q11 microdeletion. T-cell deficiency, hypocalcemia, abnormalities of heart, great vessels, face.
Digeorge syndrome
78
Susceptibility to fungal, viral, bacterial and protozoal infection, opportunisitic infections and LIVE VACCINES. Can be due to cytokine receptor defect, Adenosine demaninase deficiency, or MHC class II deficiency.
SCID
79
Mutated Bruton Tyrosine Kinase. X-linked. recrruent bacterial, enterovirus, Giardia. after 6 months old.
X-linked Agammaglobulinemia. MUST AVOID LIVE VACCINES, IIKE POLIO
80
Mutated CD40L on T cell, or CD40 on Bcell. Low IgA, IgG an IgE. recurrent pyogenic infections.
Hyper-IgM Syndrome
81
Nephritic vs Nephrotic syndrome
Nephritic: HTN and hematuria - diffuse proliferative glomerulonephritis; Nephrotic syndrome: increased protein in urine - get membranous glomerulonephritis
82
Small sterile deposits on BOTH sides of the MITRAL valve. common in systemic lupus erythematosus
Libman-Sacks endocarditis
83
3 causes of drug induced lupus
hydralazine; procainamide; isoniazid
84
+ANA and + antihistone
drug-induced SLE
85
Autoimmune dystruction of lacrimal and salivary gland - lymphocyte-mediated damage with fibrosis = TYPE IV. ANA and anti-ribonucleoprotein antibodies (anti-SS-A/Ro and anti-SS-B/La)
Sjogren syndrome
86
ANA and anti-DNA topoisomerase I (Scl-70). activation of fibrobalsts and depostition of collagen
diffuse type of scleroderma
87
CD 34
marker of hematopoietic stem cells
88
Collagen types used in repair
Type III in granulation tissue. removed by collagenase (REQUIRES ZINC) and replaced with type I
89
TGF-alpha
epithelial and fibroblast growth factor
90
TFG-beta
fibroblast growth factor; inhibits inflammation
91
Leading cause of deaths in adults
1. cardiovascular disease 2. cancer; 3. cerebrovascular disease
92
Leading cause of death in children
1. accidents; 2. CANCER; 3. Congenital defects
93
Most common cancers
1. Skin 2; breast/prostate; 3. Lung; 4. Colorectal
94
Most common causes of cancer mortality in adults
1. Lung (5 yr = 15%); 2. Breast/prostate; 3. Colorectal.
95
Location of prostate cancer
posterior/peripheral. BPH is located in the center.
96
CyclinD/CDK4 complex
phosphorylates the retinoblastoma protein which promotes progression through G1/S checkpoint
97
p53
Regulates progression from G1-->S. binds E2F until phosphorlyated by Cyclin D/CDK4. induce apoptosis if DNA damage is unrepairable by upgregulating BAX which disrupts Bcl2
98
Inherited loss of one p53. characterized by the propensity to develop multiple types of carcinoma and sarcoma
Li-Fraumeni syndrome
99
t(14: 18)
Follicular lymphoma. Moves Bcl2 (18) to Ig Heavy chain locus (14).
100
Cancer that spreads hematogenously (4)
1. Renal cell carcinoma (renal vein) 2. Hepatocellular Carcinoma (hepatic vein) 3. Follicular carcinoma of the thyroid; 4. Choriocarcinoma

Pathoma (15 decks)

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