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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
Q

Glutathione, vit a, c, and e are all

A

antioxidants

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26
Q

function of superoxide dismutase (in mitochondira)

A

superoxide (02-) –> H2O2

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27
Q

Function of Glutatione peroxidase in mitochondria

A

GSH + free radical (OH-) –> GSSG + H20

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28
Q

Function of Catalase in peroxisomes

A

H202 –> 02 + H20

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29
Q

Organic solvent used in dry cleaning. leads to fatty change in the liver

A

Carbon tetrachloride. converts to CCl3 free radical and damages hepatocytes leading to decreased apolipoprotein synthesis

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30
Q

B-pleated sheets that stain with Congo red and apple-green birefringence

A

Amyloid

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31
Q

Type of amyloid deposited in systemic, primary amyloidosis

A

AL amyloid - derived from immunoglobulin light chain. seen in plasma cell dyscrasias (multiple myeloma)

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32
Q

Type of amyloid deposited in systemic, secondary amyloidosis

A

AA, derived from serum amyloid-associated protein (SAA).

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33
Q

Nephrotic syndrome, Restrictive cardiomyopathy/arrhythmia, tongue enlargement, malabsorption, hepatosplenomegaly. Seen in

A

Systemic amyloidosis

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34
Q

Non-mutated serum transthyretin deposits in the heart.

A

Senile cardiac amyloidosis

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35
Q

Mutated serum transthyretin depsoits in the heart leading to restrictive cardiomyopathy

A

Familial amyloid cardiomyopathy

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36
Q

Amylin deposits in the islets of the pancreas

A

Non-insulin dependent diabetes mellitus type II

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37
Q

Abeta amyloid in brain

A

Alzheimer

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38
Q

Beta2-microglobulin depsits in joints

A

Dialysis-associated amyloidosis

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39
Q

Calcitonin deposits within tumor. “Tumor cells in an amyloid background”

A

Medullary carcinoma of the thyroid.

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40
Q

CD14

A

A toll-like receptor on macrophages. Recognises LPS on outer membrane of gram-negative bacteria

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41
Q

PGI2,D2, and E2

A

mediate arteriole vasodilation and increased vascular permeability @ post capillary venule

42
Q

PGE2

A

mediates pain as well as vascular permeability and vasodilation

43
Q

Cycloxygenase

A

AA –> Prostaglandins

44
Q

5-lipoxygenase

A

AA –> Leukotrienes

45
Q

LTB4

A

attracts and activates neutrophils

46
Q

LTC4, LTD4, LTE4

A

vasoconstriction, bronchospasm, increased vascular permeability via contraction of pericytes

47
Q

4 key mediators that attract and activate neutrophils

A

LTB4; C5a; IL-8; Bacterial products

48
Q

Activators of mast cells

A
  1. tissue trauma; 2. C5a, C3a; 3. Cross-linking of cell-surface IgE by antigen
49
Q

Classical pathway of complement activation

A

C1 binds IgG or IgM that is bound to antigen

50
Q

C3a and C5a

A

Anaphylatoxins. Trigger mast cell degranulation, resulting in histamine-mediated vasodilation and increased vascular permeability

51
Q

C5a

A

chemotactic for neutrophils

52
Q

C3b

A

opsonin for phagocytosis

53
Q

Hageman factor (XII)

A

activated upon exposure to subendothelial or tissue collagen.

  1. activates coagulation and fibrinolytic system.
  2. activates complement
  3. activates Kinin system
54
Q

Kinin system

A

Kinin cleaves HMWK to bradykinin

55
Q

Bradykinin

A

mediates vasodilation, increased vascular permeability and PAIN

56
Q

Cause of Fever

A

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
Q

P-selectin

A

Released from Weibel-palade bodies. Mediated by histamine. on endothelial cells. bind Sialyl lewis X on leukocytes in rolling step.

58
Q

E-selectin

A

Induced on endothelial cells by TNF-IL1 in rolling step. binds sialyl lewis X on leukocytes

59
Q

ICAM and VCAM

A

adhesion step. upregulated on endothelium by TNF and IL-1. bind integrins

60
Q

Integrins

A

upregulated on leukocytes by C5a and LTB4. adhesion step

61
Q

CD18

A

Integrins

62
Q

Delayed separation of the umbilical cord, increased circulating neutrophils, recurrent bacterial infections that lack pus formation.

A

Leukocyte adhesion deficiency. Autosomal recessive defect of integrins (CD18 subunit)

63
Q

Increased risk of pyrogenic infections. Neutropenia. Giant granules in leukocytes. Defective primary hemostasis. ALBINISM. peripheral neuropathy

A

Chediak-Higashi syndrome - a protein trafficking defect. autosomal recessive. characterized by IMPAIRED PHAGOLYSOSOME FORMATION.

64
Q

NADPH Oxidase

A

Oxidative burst. O2–> superoxide (02-)

65
Q

Superoxide dismutase (SOD)

A

superoxide (02-) –> H202

66
Q

Myeloperoxidase (MPO)

A

H202–> HOCL- [bleach]

67
Q

Poor O2 dependent killing due to NADPH oxidase defect. Recurrent infection of catalase-positive organisms [S. aures, Pseudomonas cepacia; Serratia marcescen; Nocardia; Aspergillus]

A

Chronic Granulomatous disease (CGD). Nitroblue tetrazolium test is used for screening

68
Q

Defective conversion of H202 to HOCL. Increased risk of Candida infections.

A

MPO deficiency.

69
Q

Anti-inflammatory cytokines produced by macrophages

A

IL-10 and TGF-B

70
Q

CD4+ helper T cell activation.

A
  1. extracellular antigen presented on MHCII 2. B7 on APC binds CD28 on CD4+ Cell.
71
Q

TH 1 secretes:

A
  1. IL-2 [T cell growth factor and CD8 T cell activator] and 2. IFN-gamma [macrophage activator]
72
Q

TH 2 secretes:

A
  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
Q

CD40

A

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
Q

What is a granuloma

A

collection of epithelioid histicytes (macrophages) surrounded by giant cells and a rim of lymphocytes

75
Q

Stellate shaped granuloma on neck

A

Cat scratch disease

76
Q

IL-12

A

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
Q

22q11 microdeletion. T-cell deficiency, hypocalcemia, abnormalities of heart, great vessels, face.

A

Digeorge syndrome

78
Q

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.

A

SCID

79
Q

Mutated Bruton Tyrosine Kinase. X-linked. recrruent bacterial, enterovirus, Giardia. after 6 months old.

A

X-linked Agammaglobulinemia. MUST AVOID LIVE VACCINES, IIKE POLIO

80
Q

Mutated CD40L on T cell, or CD40 on Bcell. Low IgA, IgG an IgE. recurrent pyogenic infections.

A

Hyper-IgM Syndrome

81
Q

Nephritic vs Nephrotic syndrome

A

Nephritic: HTN and hematuria - diffuse proliferative glomerulonephritis;
Nephrotic syndrome: increased protein in urine - get membranous glomerulonephritis

82
Q

Small sterile deposits on BOTH sides of the MITRAL valve. common in systemic lupus erythematosus

A

Libman-Sacks endocarditis

83
Q

3 causes of drug induced lupus

A

hydralazine; procainamide; isoniazid

84
Q

+ANA and + antihistone

A

drug-induced SLE

85
Q

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)

A

Sjogren syndrome

86
Q

ANA and anti-DNA topoisomerase I (Scl-70). activation of fibrobalsts and depostition of collagen

A

diffuse type of scleroderma

87
Q

CD 34

A

marker of hematopoietic stem cells

88
Q

Collagen types used in repair

A

Type III in granulation tissue. removed by collagenase (REQUIRES ZINC) and replaced with type I

89
Q

TGF-alpha

A

epithelial and fibroblast growth factor

90
Q

TFG-beta

A

fibroblast growth factor; inhibits inflammation

91
Q

Leading cause of deaths in adults

A
  1. cardiovascular disease 2. cancer; 3. cerebrovascular disease
92
Q

Leading cause of death in children

A
  1. accidents; 2. CANCER; 3. Congenital defects
93
Q

Most common cancers

A
  1. Skin 2; breast/prostate; 3. Lung; 4. Colorectal
94
Q

Most common causes of cancer mortality in adults

A
  1. Lung (5 yr = 15%); 2. Breast/prostate; 3. Colorectal.
95
Q

Location of prostate cancer

A

posterior/peripheral. BPH is located in the center.

96
Q

CyclinD/CDK4 complex

A

phosphorylates the retinoblastoma protein which promotes progression through G1/S checkpoint

97
Q

p53

A

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
Q

Inherited loss of one p53. characterized by the propensity to develop multiple types of carcinoma and sarcoma

A

Li-Fraumeni syndrome

99
Q

t(14: 18)

A

Follicular lymphoma. Moves Bcl2 (18) to Ig Heavy chain locus (14).

100
Q

Cancer that spreads hematogenously (4)

A
  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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