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Micropathology > Packet 2 (page 8-25, Exam 1) > Flashcards

Packet 2 (page 8-25, Exam 1) Flashcards

1
Q

What are the 8 causes of atrophy?

Note: prior deck had 5 of these, but we stopped mid info for the quiz

A

1) decreased work load
2) disuse
3) ischemia
4) malnutrition/starvation
5) pressure/compression
6) denervation
7) lack of endocrine stimulation/hormonal
8) normal aging

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2
Q

What is AAA?

A

abdominal aortic aneurysm (usually around L1/L2)

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3
Q

What is amyloidosis?

A

deposition of amyloid (an abnormal protein produced in the bone marrow) in the liver, kidney, spleen, or other tissues in certain diseases and interferes with normal function
-amyloid gets deposited in between cells, tissues, and organs
-several forms of this exists
-can occur with general aging or in various pathological processes, may be hereditary
-symptoms depend on which organs are affected
-may include swelling, fatigue, and weakness, SOB, and numbness, tingling, or pain in the hands and feet

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4
Q

What is the most common form of amyloidosis?

A

primary amyloidosis

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5
Q

What is primary amyloidosis?

A

-deposition of amyloid (an abnormal protein produced in the bone marrow)
-occurs w/o another associated disease and most often affects the heart, lungs, skin, tongue, nerves, an/or intestines

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6
Q

What is secondary amyloidosis?

A

associated with chronic diseases such as TB, RA, or osteomyelitis
-most often affects the kidneys, spleen, liver, and intestines
-if the underlying disease is treated, this form of amyloidosis often will go away

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7
Q

Which chronic disease is known to have an ulnar deviation (wrist starts to deviate towards ulna overtime)?

A

RA

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8
Q

What diseases are associated with amyloid deposition (causes secondary amyloidosis)?

A

-RA
-hodgkin’s leukemia
-repetitive UTIs
-multiple myeloma
-alzheimers disease

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9
Q

Hereditary amyloidosis runs in families, this type often affects the….

A

nervous and digestive systems

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10
Q

What route of transmission is polio transmitted through?

A

fecal oral route

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11
Q

Denervation is the loss of nerve supply to the muscle. This can cause atrophy due to….

A

poliomyelitis (polio that causes inflammation of muscles, rare form of polio)
-atrophy of skeletal muscle after destruction of LMNs

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12
Q

Is polio an anterograde or retrograde virus?

A

retrograde virus, so it affects the corresponding muscle directly and will atrophy

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13
Q

What is flaccid paralysis?

A

-LMN lesion
-weakness or paralysis due to decreased muscle tone

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14
Q

What is spastic paralysis?

A

-opposite of flaccid paralysis
-increased muscle tone
-tonic spams, with increased reflexes

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15
Q

What are some examples that may disrupt endocrine stimulation/hormones and cause atrophy?

A

-sheehans syndrome
-simmonds disease
-addisons disease

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16
Q

What is this?
-condition that affects women who lose a life threatening amount of blood in childbirth, or who have severe low blood pressure during or after childbirth, which can deprive the body of oxygen
-the lack of oxygen causes damage to the pituitary gland

A

Sheehans syndrome

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17
Q

What is the most common cause of avascular (ischemic) necrosis of the pituitary gland?

A

Sheehans syndrome

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18
Q

What is another name for the anterior pituitary gland?

A

adenohypophysis

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19
Q

What is another name for the posterior pituitary gland?

A

neurohypophysis

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20
Q

Which disease is this?
-also known as pituitary cachexia
-a chronic deficiency of function of the pituitary gland which leads to atrophy of many of the viscera including the heart, liver, spleen, kidneys, thyroid, adrenals, and gonads
-the destruction of the pituitary gland (hypophysis) may be caused by tumors, embolism (blood clot), infections and trauma
-results in emaciation (extreme wasting) and death if left untreated

A

simmonds disease

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21
Q

Which disease is this?
-a disorder in which the adrenal glands do not produce enough hormones, specifically cortisol and sometimes aldosterone too
-when the body is under stress, like fighting an infection, a deficency in cortisol can result in life threatening crisis characterized by low blood pressure
-symptoms include fatigue, nausea, darkening of skin (darkening of palmer creases and bronze coloration of skin), dizziness upon standing (orthostatic hypotension)
-tx: hormone replacement

A

addisons disease

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22
Q

With normal aging, some patients are diagnosed with what disease and can cause atrophy?

A

diabetes mellitus (would need to check their dorsal pedis pulse)

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23
Q

Is hypertrophy reversible or irreversible?

A

reversible

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24
Q

Hypertrophy is an increase in size of tissue or organ due to enlargement of existing cells. What are the characteristics?

A

-increase in organelles
-usually found in tissues that do not have readily reproducible cells
-increase in size due to increase protein in cellular components like plasma membrane, mitochondria, ER, etc.

note: hypertrophy per se does not involve proliferation but does often coexist with hyperplasia

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25
Q

What is the best example of a tissue that will show hypertrophy? What are some other examples?

A

best example= heart

other examples:
-kidney
-skeletal m.
-smooth m.

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26
Q

What are the 2 main triggers for hypertrophy?

A

1) mechanical stretch/ trophic (physiologically, this would be an increase in functional demand)
2) growth factors (hormonal)

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27
Q

What 2 cell changes/adaptations would you see in a pregnant woman?

A

hypertrophy and hyperplasia

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28
Q

What is an example of a pathological response of hypertrophy?

A

hypertension (HTN)
-puts functional demand on the heart to supply blood to the body
-the higher the BP, the larger the myocardial cells grow
-ANP (atrial natriuretic factor)- any of several peptide hormones released by the atria of the heart in response to an abnormal increase in blood flow
-the main function of ANP is to lower BP and control electrolyte homeostasis through excretion of sodium, potassium, and water

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29
Q

T/F: the mechanism for both hyperplasia and hypertrophy is, in general, increased workload and endocrine stimulation

A

true

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30
Q

Is hyperplasia reversible or irreversible?

A

reversible

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31
Q

Hyperplasia is an increase in number of cells resulting from an increased rate of cellular division. What are the characteristics?

A

-increase cell production in a normal tissue or organ
-only occurs in cells capable of mitosis (liable and stable cells)
-can be due to the growth of completely normal cells (physiologic hyperplasia) or a result of abnormal or pre-cancerous change (pathologic hyperplasia)

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32
Q

What are the 2 reasons for physiological hyperplasia?

A

1) hormonal
-mainly in estrogen dependent organs
-pregnancy
-lactation
-uterus
-menstrual cycle

2) compensatory
-liver (new growth in as early as 12 hours, damage can repair itself)
-kidney (glycoprotein erythropoietin (EPO))

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33
Q

EPO is a hormone produced in which organ?

A

kidneys

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34
Q

What is EPO essential for?

A

the formation of RBCs

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35
Q

The kidney cells that make EPO are sensitive to low oxygen levels in the blood that travels through the kidney. When oxygen levels are too low (__________), like in severe anemia, the cells make and release EPO. EPO stimulates the bone marrow to produce more RBCs. This increases the oxygen carrying capacity of the blood

A

hypoxia

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36
Q

EPO was one of the first drugs produced through ___________________ technology and is widely used in conditions where RBC production is deficient (stimulates bone marrow to produce more RBCs)

A

recombinant DNA

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37
Q

Pathologic hyperplasia is the abnormal proliferation of normal cells and can occur as a response to….

A

excess hormonal stimulation or growth factors on target cells

38
Q

What is endometrial hyperplasia?

A

-a condition of the female reproductive system
-the lining of the uterus (endometrium) becomes unusually thick due to too many cells (hyperplasia)
-in some women this can increase risk of developing endometrial cancer
-usually due to hormone imbalance with estrogen and progesterone
-in females, hormonal changes in estrogen dependent organs can lead to ovarian dysfunction

39
Q

Thyroid hyperplasia is commonly known as what disease?

A

Grave’s disease or hyperthyroidism

40
Q

What is thyroid hyperplasia (also known as Grave’s disease or hyperthyroidism)?

A

-diffuse hyperplasia of the thyroid gland
-autoimmune condition in which excess thyroid hormone is unchecked by the normal feedback loop between the thyroid and the pituitary gland
-LATS (long acting thyroid stimulation)
-TSI (thyroid stimulating immunoglobulin)

41
Q

What are the signs and symptoms of thyroid hyperplasia (also known as Grave’s disease or hyperthyroidism)?

test q- im assuming just know a couple, will probably be a short response q

A

-fine brittle hair
-increased perspiration
-enlarged liver
-nausea
-vomiting
-diarrhea
-hand tremors
-bulging eyes (exophthalmos)
-enlarged thyroid
-abnormal heart rhythms
-increased appetite
-unexplained weight loss
-loss of libido
-amenorrhea (loss of mensuration)
-irritability
-hyperactivity
-high blood sugar
-intolerance to heat
-low serum cholesterol
-increased production of thyroid hormones

memory cue- this is grave’s disease, you’re approaching the grave faster because your metabolism is sped up and in overdrive

42
Q

What is the difference between hypothyroidism and hashimoto’s?

A

hypothyroidism is a problem with just thyroid gland, whereas hashimoto’s is a problem with the immune system

43
Q

What are the signs and symptoms of hypothyroidism?

test q- im assuming just know a couple, will probably be a short response q

A

-thinning hair or hair loss
-puffy face
-dry and coarse skin
-constipation
-cool extremities and swelling of the limbs
-loss of eyebrow hair
-enlarged thyroid
-slow heart beat
-poor appetite
-infertility
-heavy mensuration
-carpal tunnel syndrome
-not enough thyroid hormones
-weight gain
-poor memory
-intolerance to cold
-feeling of tiredness

note: metabolism is slowed down here

44
Q

What is epidermal hyperplasia?

A

similar to a callus but doesn’t return to normal when mechanical stimulation ceases

45
Q

PSA is prostate specific antigen test that can determine what?

A

enlarged prostate, aka prostate nodular hyperplasia (glandular and strommal)

46
Q

Is metaplasia reversible or irreversible?

A

usually reversible

47
Q

That is the theory behind metaplasia?

A

-develops from a reprogramming of stem cells existing in mostly epithelium or of undifferentiated mesenchymal tissue (from embryonic mesoderm)
-these precursor cells mature along a new path because of signals from cytokines and growth factors
-usually caused by some sort of irritation or inflammation
-usually reduces cell function

48
Q

What are the 4 examples we went over in class that cause squamous metaplasia?

A

1) smoking
2) GERD (gastroesophageal reflux disease)
3) squamous metaplasia of the endocervix
4) vitamin A deficiency

49
Q

Squamous metaplasia in the bronchi is caused by long term tobacco use. What does this involve and what cell changes?

A

ciliated pseudo-stratified columnar epithelium changes so that no cilia or mucous secretion occurs (this means the airway can no longer clear airways from toxins, cancer, bacteria, etc.)

this can involve true vocal cods and bronchi

50
Q

What is GERD (gastroesophageal reflux disease)?

A

-relaxed lower esophageal sphincter leads to acid reflux injury of squamous epithelial and subsequent glandular metaplasia
-can lead to barrett’s esophagus (dysplasia)

51
Q

What are the symptoms of GERD (gastroesophageal reflux disease)?

A

-chest pain
-difficulty swallowing
-bloody, tarry, or black stools
-vomiting (coffee ground appearance, blood is in it)

52
Q

Squamous metaplasia of the endocervix is defined by a presence of islands of squamous cells above the….

A

squalocolumnar junction

53
Q

What is the endocervix? What cells are there?

A

-upper 2/3 of the cervix
-the opening of the cervix that leads into the uterus
-contains columnar glandular cells

54
Q

What is the exocervix (also known as ectocervix)? What cells are here?

A

-lower 1/3 of cervix
-seen by doctor during a speculum exam
-composed of squamous cells

55
Q

The midpoint between the exocervix and the endocervix is the…..

A

squalocolumnar junction

56
Q

Where is the most common site in the body to develop cancer?

A

squalocolumnar junction (cervix)

57
Q

What can trigger cancer cells to develop in the squalocolumnar junction of the cervix?

A

-microbes like herpes, chlamydia, gonorrhea, or trichomonas
-HPV
-chronic irritation like an IUD
-chemical irritants
-endocrine changes

58
Q

T/F: squamous metaplasia always leads to the development of cancer

A

false

59
Q

T/F: squamous metaplasia can occur for girls undergoing puberty with quick hormonal changes

A

true

60
Q

Metaplasia in general is most commonly caused by what?

A

some form of irritation or abrasion (but can also be caused by bacteria or viruses)

61
Q

Which vitamin is an element of the protein that absorbs light in the receptors of the retina?

A

vitamin A

62
Q

T/F: since humans don’t make vit A, it must be consumed

A

true, like carrots

63
Q

What are the benefits of vit A?

A

helps to combat free radicals and prevent epithelia from undergoing squamous metaplasia (keratinized epithelium)

64
Q

Vit A deficiency manifests with ocular keratinization. How does this work?

A

-xerophthalmia = dry eyes which specifically begins with drying of the cornea from keratinization of the lacrimal and mucus secreting epithelium
-keratin blocks sweat glands and tear glands (tears decrease)
-keratin debris builds up as bitot spots which roughen and destroy the cornea
-squamous metaplasia (keratinization, cells become hard) occurs in the mucus secreting epithelium, of the lungs and kidneys

65
Q

What are the symptoms of vit A deficiency?

A

-dry skin
-dry eyes
-dry lips
-night blindness
-infertility
-delayed growth
-throat and chest infections
-poor wound healing
-acne
-bitot’s spots
-impaired immunity
-thick or scaly skin

66
Q

What is osseous metaplasia?

part 2 boards q

A

new bone at sites of tissue injury

67
Q

Myositis ossificans is an example of osseous metaplasia. What is myositis ossificans?

part 2 boards q

A

-a condition where bone tissue forms inside muscle or other soft tissue after an injury
-usually 2-4 weeks later
-tends to develop on young adults and athletes who are more likely to have traumatic injuries
-mostly occurs in large muscles of the arms or legs

68
Q

Cancerous cells are known as ____________. This is irreversible and the cells will need to be removed

A

anaplasia

69
Q

What does cell invasion mean?

A

cancer metastasizes and invades other tissues

70
Q

Is dysplasia reversible or irreversible?

A

usually reversible BUT sometimes precedes malignancy

71
Q

Dysplasia is a loss in the uniformity of the individual cells, as well as a loss in their architectural orientation. What are the characteristics/ morphological manifestations?

A

-a disruption in size, shape, and organization of mature cells
-not a true adaptation but more like atypical hyperplasia
-if its an irreversible form: advance into carcinoma in situ and then invasive cancer
-disorderly maturation (maturing at different rates) and spatial arrangement (looks disorganized/ chaotic arrangement of cells)
-marked variability in nuclear size and shape (pleomorphism)
-increased mitotic rate
-abnormal mitotic patterns

72
Q

What cells most commonly have dysplasia and where?

test q

A

epithelial cells especially in the cervix, respiratory tract, and oral cavity

73
Q

What are the causes of dysplasia?

A

protracted chronic inflammation or irritation (same as metaplasia)

74
Q

What are the 2 classification options for dysplasia?

A

1) mild, moderate, or severe dysplasia
2) low grade dysplasia OR high grade dysplasia

75
Q

What are the 3 examples discussed in class for dysplasia?

A

1) HPV type 16
2) barrett’s esophagus
3) leukoplakia (white patches on your tongue, gums or the inside of your cheek)

76
Q

Exophthalmos means….

A

bulging eyes

77
Q

Xerophthalmia means….

A

dry eyes

78
Q

Is anaplasia reversible or irreversible?

A

irreversible (this is the cell type for malignant tumors)

79
Q

What is the hallmark of cancer cells (anaplasia)?

A

-the more anaplastic a lesion, the more aggressive
-the more differentiated the cells, the less aggressive

80
Q

What is cell differentiation?

A

the process during which young, immature (unspecified) cells take on individual characteristics and reach their mature (specialized) form and function

81
Q

What does pleomorphism mean?

A

marked variability in nuclear size and shape

82
Q

What are the 4 main characteristics of anaplasia?

A

1) pleomorphic (marked variation in size and shape, exceeds dysplastic cells)
2) poor differentiation
3) cell changes in size, shape, hyperchromasia, mitotic figures, prominent large nucleoli, more frequent and bizarre mitosis
4) large nucleus cytoplasm ratio of 6:1 when in normal cells its 1:6

83
Q

What does hyperchromasia mean?

A

a nucleus that looks darker than normal when examined under microscope

84
Q

What does mitotic figures mean?

A

a cell that is in the process of dividing to create 2 new cells

85
Q

What is exfoliative cytology?

A

microscopic exam of cells shed (desquamated) from body surfaces or obtained from the body to determine the presence or absence of a cancerous condition

the cells may be obtained by aspiration, washing, smear, scraping

ex: scraping of a tissue or lesion for mouth, skin lesion, cervix

86
Q

What are the 2 major factors for exfoliative cytology?

A

1) anaplasia
2) malignant cells shed more easily and are less cohesive

87
Q

Papanicolaou developed a method for diagnosing cancer for the uterine, vaginal, and cervical cells using __________________________. The pap test is an easily performed noninvasive and inexpensive procedure to screen for pre-invasive and invasive cervical cancer

A

exfoliative cytology

88
Q

What are the 5 rankings under the papanicolauo classification system?

test q

A

1) class 1 = normal
2) class 2 = probably normal
-inflammatory, regenerative metaplastic or degenerative cells
3) class 3 = doubtful dysplasia
-very inflammatory or degenerative cells
-dysplasia
4) class 4 = probably malignant
-very dysplastic cells or carcinoma in situ
5) class 5 = malignant- anaplasia, invasive, metastasis

89
Q

Pap tests can also be classified under the CIN classification. This is only used when new growth but not necessarily cancer is found. The degree of change represents the degree of dysplasia. What are the 3 CIN classifications?

A

CIN 1= mild dysplasia
-thickening with moderate loss of polarity and differentiation

CIN 2 = moderate dysplasia

CIN 3 = severe carcinoma in situ
-no clear stratification
-altered cell types and no cell differentiation

progressed more than CIN 3= cancer

90
Q

What is carcinoma in situ (CIS) or SITU cancer?

A

-a group of abnormal cells that are found only in the place where they are first formed in the body
-has defined boundaries
-no spreading
-it is still attached to the basement membrane
-these abnormal cells may become cancer and spread to nearby tissue
-CIS is different from invasive carcinoma which has spread to surrounding tissue and from metastatic carcinoma which has spread throughout the the body to other tissues and organs
-CIS is considered to be precancerous and is referred to as stage 0
-can appear anywhere in the body including the cervix, bladder, breast, skin, mouth, eyes

Micropathology (9 decks)

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