Information Needed to answer Bikmans test questions Flashcards
What disorder is associated with dry, crusty, black sores on toes and feet
Dry gangrenous necrosis
what causes gangrenous necrosis
hypoxia
why does hypoxia lead to a damaged cell
- a lack of Oxygen means that ATP can’t be produced from the ETC chain.
- Low ATP means that the sodium-potassium pump and calcium pumps can’t work.
- cell will swell, and if not corrected the cell will lyse
what happens to the mitochondria in a hypoxia condition
the mitochondria swell as well
What are the three main changes that take place in necrosis
- nuclear changes
- cytoplasmic changes
- calcification
What are the nuclear changes that take place in necrosis
Pyknosis
Karyorrhexis
Karyolysis
what is pyknosis
the clumping of chromatin in the nucleus
what is karyorrhexis
fragmentation of the nucleus
what is karyolysis
nuclear dissolution and chromatin lysis
What is the main cytoplasmic change associated with necrosis
increased eosinophilia (seen as red stains)
What causes the calcification associated with necrosis
dead cells that are converted into fatty acids (instead of being phagocytosed) those fatty acids attract a lot of calcium and calcification results
What are the two types of calcification
dystrophic calcification
metabolic calcification
what is the difference between dystrophic and metabolic calcification
metabolic can occur in any tissue and is a result of hypercalcemia
dystrophic occurs with necrosis, often in atheroma. not related to hypercalcemia
What are the different types of necrosis
coagulative necrosis liquefactive necrosis caseous necrosis fat necrosis fibrinoid necrosis gangrenous necrosis
what is coagulative necrosis and what tissues does it affect
it is protein denaturation (albumin becomes opaque)
it affects the kidneys, spleen, heart, and adrenal glands
what is liquefactive necrosis and what tissues does it affect
it affects the hydrolytic enzymes
it affects the neurons and glial cells of the brain
What is caseous necrosis and what tissues does it affect
it is a combination of coagulative and liquefactive necrosis, it often forms a granuloma
What is fat necrosis, and what tissues does it affect
it affects the action of lipases
it affects the pancreas, breast, and abdominal organs
What is fibrinoid necrosis, and what tissues does it affect
it is complexes of antigens and antibodies that are deposited in the walls of arteries
What are the two types of gangrenous necrosis
wet and dry
what tissues does gangrenous necrosis affect
the limbs, not organs
what is typical of dry gangrenous necrosis
insufficient blood
coagulative
dry, crusty, and black skin
What is typical of wet gangrenous necrosis
infection
liquefactive
cold, swollen, black
Foul odor (pus)
what are the two types of inflammation
chronic and acute
what kind of cells will you see in the tissues in acute inflammation
mostly neutrophils
what kind of cells will you see in the tissues in chronic inflammation
monocytes/macrophages and lymphocytes
What do monocytes look like
- Large
- oddly shaped
- nucleus doesn’t fill the entire space and isn’t segmented
what do lymphocytes look like
- the nucleus almost fills the entire space and isn’t segmented
what do neutrophils look like
- has a polymorphuous (PMN or segmented) nucleus
2. few neutral granulocytes
What do eosinophils look like
- a PMN cell
2. many red granulocytes
what do basophils look like
- a PMN cell
2. many blue granulocytes
what is the first leukocyte to arrive at the site of infection
neutrophils
What role does arachadonic acid play in inflammation
it is broken down into 4 different molecules that affect inflammation
what 4 metabolites is arachadonic acid broken down into that affect inflammation
Via cyclooxygenase:
prostaglandins
prostacyclins
thromboxanes
Via lipoxygenase:
leukotrienes
From where does a cell get the arachadonic acid that is broken down into prostaglandins, prostacyclins, thromboxanes, and leukotrienes
the phospholipids of the cell membrane
what enzyme converts the phospholipids of the cell membrane into arachadonic acid
phospholipase A2
What are the products when COX (cyclooxygenase) reacts with arachadonic acid
prostaglandins
prostacyclins
thromboxanes
how do prostaglandins affect inflammation
they increase inflammation
they increase clotting
and thermoregulation
how do prostacyclins affect inflammation?
cause vasodilation
inhibit platelet activation
reduce clotting
how do thromboxanes affect inflammation
activate platelets and make them sticky
what are the products of lipoxygenase reacting with arachadonic acid
leukotrienes
how do leukotrienes affect inflammation
cause smooth muscle contraction in the trachea (they cause most of the inflammation in asthma and allergic rhinitis)
which of the metabolites of arachadonic acid causes the inflammation in asthma and allergic rhinitis
leukotrienes
on what enzymes to anti-inflammatory steroids act, what does that cause
they act on phospholipase A2 and cyclooxygenase
this stops arachadonic acid from being made from phospholipases, and stop arachadonic acid from being metabolized into prostaglandins, prostacyclins, and thromboxanes
Where does aspirin act
On COX (cyclooxygenase) stopping arachadonic acid from being metabolized into prostacyclines, prostaglandins, and thromboxanes
What is the affect of Omega 3 fatty acids (n-3 PUFA) on inflammation
it inhibits COX and produces resolvins (anti-inflammatory things)
So it reduces inflammation
How can one get n-3 PUFAs
eating fish, eggs, milk, many meats (grass fed animals)
What is the relationship between omega 3 fatty acids and periodontitis
intake of omega 3 fatty acids (DHA and EPA) are inversely associated with periodontitis. dietary therapy with more omega 3 fatty acids could help prevent and treat periodontitis
what is periodontitis
inflammation of the periodontium
how is periodontitis associated with insulin
periodontitis is associated with insulin resistance
how is inflammation associated with insulin resistance
inflammation leads to insulin resistance
What is a nevus
a benign proliferation of melanocytes (a mole)
What are the three types of moles (locations in which they are)
Junctional (dermal epidermal junction)
Compound (partially into the dermis)
Intradermal (completely in the dermis)
which of the three types of nevi (moles) is most likely to become malignant
compound nevus
What is a melanoma
a malignant tumor of melanocytes
What are the ABCDE’s you look for in a nevus to determine if it may be malignant
A - Asymmetry B - Border C - Color D - Diameter E - Elevation
can melanoma arise from a benign nevus
yes
what affect can sun exposure have on our risk of developing melanoma
more sun exposure = more risk of melanoma
What determines the prognosis of someone diagnosed with melanoma
how deep the melanoma has invaded the skin
What are the four types of melanoma
- superficial spreading
- nodular
- lentigo maligna
- acral lentiginous
What is a superficial spreading melanoma
a melanoma that spreads but stays in the epidermis
what is a nodular melanoma
the most agressive form of melanoma, it tends to grow deep as opposed to broad
what is a lentigo maligna melanoma
a melanoma that evolves from a lentigo maligna on the skin
what is acral lentiginous melanoma
a melanoma that is found on a non-hair bearing surface
which type of melanoma is most likely found on the roof of her mouth
acral lentiginous
what is the % chance of 5 years survival for melanomas that are
1. less than 1mm deep
2. between 1 and 2 mm deep
3 between 2 and 4 mm deep
- 80-95% 5 year survival
- 30-60% 5 year survival
- 35% 5 year survival
What is the most common type of anemia
iron-deficient anemia
What kind of anemia is iron-deficient anemia
microcytic, hypochromic anemia
small RBCs with Low hemoglobin
What are two telling symptoms of iron-deficient anemia
Atrophic glossitis (smooth tongue) Koilonychia (indented finger nails)
What are potential causes of iron-deficient anemia
- Decreased Iron intake
a. poor diet
b. poor absorption - Increased iron loss
a. GI bleeding
b. menses
c. hemorrhage - Increased Iron requirement
a. pregnancy
What is anemia
a reduction below the normal in hemoglobin or red blood cell number
What are the symptoms of anemia
Pale skin jaundice (if hemolytic) breathless ness tachycardia dizziness fatigue
what kind of anemia is related to low G6PDH levels
G6PDH deficient anemia
how does low G6PDH levels cause anemia
G6PDH assists glutathione in getting rid of reactive oxygen species. if you have low G6PDH levels, then glutathione wont be able to get rid of them, and you will have high reactive oxygen species. Those kill RBCs
is G6PDH deficient anemia intra or extracorpuscular
it is intracorpuscular
What kind of cells are associated with G6PDH deficiency
RBCs with heinz bodies
AKA bite cells
is G6PDH a hemolytic anemia
yes, it causes the destruction of RBCs
the heinz bodies are piles of _____
globin
Fava beans (and some drugs) can set off what kind of anemia
G6PDH deficient anemia
can G6PDH deficient anemia cause jaundice
yes, because it is a hemolytic anemia
in diagnosing jaundice a doctor will look at stool and urin color to figure out where the jaundice is coming from. When the urine and stool are both Dark, what is that indicative of
hemolytic anemia
what are the signs of hemolytic anemia
increased bilirubin increased LDH reduced haptoglobin increased reticulocytes nucleated RBCs in blood
What are the different types of hemolytic anemias
Microangiopathic hemolytic anemia autoimmune hemolytic anemia sickle cell anemia thalassemia hereditary spherocytosis G6PDH deficiency
What type of anemia is associated with prominent cheek bones
thalassemia
is thalassemia intra or extracorpuscular
intracorpuscular
What are the RBCs like in thalassemia
hypochromic and microcytic
What is actually the problem in thalassemia
inability to make sufficient alpha or Beta chain of hemoglobin
What happens to EPO levels in thalassemia
they are increased to increase RBC production
What can determine whether thalassemia is a problem with the alpha or beta chain of hemoglobin
ethnicity
South east Asians = alpha chain problems
Mediterranians = beta chain problems
What causes the prominent cheek bones in thalassemia
high levels of erythropoesis
can thalassemia lead to jaundice
yes
What is marfan syndrome
a disorder of connective tissues, manifested by changes in the skeleton, eyes, and cardiovascular system
what is the actual problem in marfan syndrome
an abnormality of fibrillin 1 (elastic fibers)
What are the features of someone with marfan syndrome
- unusually tall with long extermities
- bilateral subluxination of the eye lens (ectopica lentis)
- cardiovascular legions: mitral valve prolapse
- increased risk of cleft palate and caries
is marfan syndrome a heritable disorder
yes
is marfan syndrome a sex linked disorder
no. it is an autosomal dominant disorder
What disorder is most associated with
- shortness
- webbing of the neck
- edema
- wide chest
- reduced carrying angle
- low hairline
Turner syndrome
what is the actual problem in turner syndrome
a female with only one X
is turner sydrome autosomal or sex chromosome aneuploidy
sex chromosome aneuploidy
how could someone get turner syndrome
one parent did nondisjunction of the sex chromosomes. so from one parent you get X (normal) from the other you do not get a sex chromosome
What are the three ways a tumor will metastasize
seeding
lymphatic spread
hematogenous spread
What is seeding (metastasize)
tumor invades the body cavity
a bit breaks off of something in the body cavity and attaches to something else
ovarian cancer spreads this way
What way do carninomas generally metastisize
lymphatic spread (tumor spreads through the lymph)
what ways do sarcomas generally metastasize
hematogenous spread (through the blood)
can carcinomas spread through hematogenous spread
yes
where to sarcomas end up most commonly
the liver and lungs
What is dysplasia
disorderly changes in non-neoplastic epithelial cells
what is anaplasia
a complete lack of differentiation
is a benign tumor highly or poorly differentiated tissue
highly
is a malignant tumor highly or poorly differentiated tissue
poorly
What is a benign fat tumor
lipoma
what is a malignant fat tumor
liposarcoma
