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USMLE Step 1-2015 > Path > Flashcards

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1
Q

Karyorrhexis

A

Nuclear fragmentation

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2
Q

Pyknosis

A

Nuclear shrinkage

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3
Q

Role of Apaf-1

A

Apaf-1 induces caspases, but Bcl-2 prevents cytochrome c release by binding and inhibiting Apaf-1

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4
Q

Role of FADD

A

After Fas-FasL crosslink, multiple Fas molecules coalesce, forming a binding site for a death domain containing adaptor protein, FADD. FADD binds inactive caspaces, activating them

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5
Q

Karyolysis

A

Dissolution

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6
Q

30 year old female presents with fibrinoid necrosis reasoning?

A

Commonly seen in preeclampsia where very high BP can cause fibrinoid necrosis of the placenta

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7
Q 
Areas suceptible to hypoxia/ischemia and infarction
Brain
Heart
Kidney
Liver
Colon
A

ACA/MCA/PCA boundary areas
Subendocardium of LV
Straight segment of proximal tubule (medulla) and thick ascending limb (medulla)
Around the central vein (zone III)
Splenic flexure, rectum (watershed areas that receive dual blood supply from most distal branches of 2 arteries, which protects these areas from single-focal blockage). However, these areas are suceptible to ischemia from systemic hypoperfusion.

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8
Q

Likelihood of cell injury based on what 3 factors?

A

1) Type of stress
2) Severity
3) Type of cell affected

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9
Q

Final electron acceptor in ETC

A

O2

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10
Q

Areas suceptible to ischemia from systemic hypoperfusion (eg. cardiac arrest, shock)

A

ACA/MCA/PCA boundary areas, splenic flexure, rectum

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11
Q

Hypoic ischemic encephalopathy affects what two cells

A

Pyramidal cells of hippocampus and purkinje cells of cerebellum

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12
Q

Organ suceptibility to infarction after occlusion of feeding artery is ranked greatest to least as follows:

A

CNS>Myocardium>Kidney>Spleen>Liver

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13
Q

3 organs suceptible to hemorrhagic infarction

A

Lung, liver, intestine

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14
Q

3 organs suceptible to pale infarction

A

Spleen, heart, kidney

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15
Q

Chromatolysis in 3 steps

A

Axonal injury causes

1) cellular body swelling
2) movement of nuclei to periphery
3) dispersion of nissl substance to increase protein synthesis to help with regeneration of axon

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16
Q

Dystrophic calcification

A

Normocalcemic deposition of calcium into abnormal tissues secondary to necrosis/injury

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17
Q

Metastatic calcification

A

Hypercalcemic (secondary to disorder that increases calcium) deposition of tissues into normal tissue

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18
Q

3 common tissues of metastatic calcification?

A

Kidney, lung, gastric mucosa b/c these tissues lose acid quickly. Increase in pH favors deposition

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19
Q

Mechanism of cytoskeleton degradation?

A

Ubiquitin proteosome degradation by intermediate filaments of cytoskeleton are “tagged” with ubiquitin and destroyed by proteosomes

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20
Q

Two mechanisms by decrease in cell size

A

Ubiquitin proteosome degradation of cytokskeleton and autophagy of cellular components

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21
Q

Most dangerous free radical

A

*OH (hydroxyl free radical)

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22
Q

3 scenarios where you would see exudate

A

Lymphatic obstruction, malignancy, inflammation/infection

23
Q

3 scenarios where you would see transudate

A

Increase Na+ absorption, Increased hydrostatic pressure (HF), decreased oncotic pressure (nephrotic syndrome, cirrhosis)

24
Q

Granuloma formation

A

1) MHC Class II presenting macrophages present antigen to CD4+ t cells
2) Secrete IL-12 to differentiate CD4+t cells into Th1 cells
3) TH1 cells secrete interferon gamma to activate macrophages
4) Macrophages secrete TNF alpha to maintain/induce granuloma formation

25
Q

5 categories with increased ESR

A

inflammation (temporal arteritis), anemia (except sickle cell), infection, cancer (multiple myeloma), pregnancy, autoimmune

26
Q

5 categories with decreased ESR

A

Sickle cell anemia (altered shape), polycythemia (increase RBC dilute aggregation factors), HF, microcytosis, hypofibrinogenemia

27
Q

Primary amyloidosis has deposition of what

A

Deposition of proteins from Ig Light chains

28
Q

Secondary amyloidosis has deposition of what

A

Fibrils composes of serum amyloid a (acute phase reactant seen in inflammation)

29
Q

Dialysis-related has deposition of what

A

Fibrils composed of B2 microglobulin

30
Q

Heritable amyloidosis due to?

A

Transthyretin gene mutation

31
Q

Age-related (senile) systemic amyloidosis

A

Deposition of normal (wild-type) transthyretin

32
Q 
Organ-specific:
Precursor protein/peptide responsible for localized amyloidosis
1) Cardiac atria: 
2) Thyroid gland
3) Pituitary gland
4) Pancreatic islets in DM2
5) Alzheimer disease
A

Amyloid deposition into single organ

1) ANP
2) Calcitonin
3) Prolactin
5) B-amyloid protein
4) IAPP (islet amyloid polypeptide)

33
Q

Lipofucin caused by

A

Lipid peroxidation

34
Q

Method cells use to invade basement membrane

A

Collagenases and hydrolases (metalloproteinases)

35
Q

How is cell-cell contact lost in invasive carcinoma?

A

Inactivation of E-cadherin which promotes metastisis

36
Q

Metalloproteinases degrade?

A

Component of ECM and basement membrane, composed primarily of laminin+collagens (work through tissue remodeling)

37
Q

P-glycoprotein and role in cancer therapy

A

ATP dependent efflux pump protein that has a broad specificity for hydrophobic compoudnds and pumps out toxins, including chemotherapeutic agents (one mechanism of decreased repsonsiveness or resistance to chemotherapy over time)

38
Q

Which has a more prognostic value? Stage or grade?

39
Q

Anaplasia

A

Equated with undifferentiated malignant neoplasms with complete lack of differentiation and no resempblance to tissue of origin

40
Q

Single most important prognostic factor for cancer prognosis?

A

Metastases

41
Q

Desmoplasia

A

Fibrous tissue formation in response to neoplasm

42
Q

Sarcoma origin

A

Mesenchymal

43
Q

Carcinoma origin

A

Epithelial

44
Q

Most Carcinomas spread via _____ while most sarcomas spread ______

A

lymphatics, hematogenously

45
Q

Epithelium derived benign/malignant cancer

A

adenoma, papillary adenoma

Adenocarcinoma, papillary carcinoma

46
Q

Mesenchyme (blood cells) beningn and malignant cancer

A

Beningn does not exist

Malignant Lukemia, lymphoma

47
Q

Blood vessels benign and malignant cancer

A

Benign Hemangioma

Malignant: Hemangiosarcoma

48
Q

Smooth muscle benign and malignant cancer

A

Benign: Leiomyoma
Malignant: Leiomyosarcoma

49
Q

Striated muscle benign and malignant cancer

A

Benign: Rhabdomyoma
Malignant: Rhabdomyosarcoma

50
Q

Connective tissue benign and malignant cancer

A

Benign: Fibroma
Malignant: Fibrosarcoma

51
Q

Bone benign and malignant cancer

A

Benign: Osteoma
Malignant: osteosarcoma

52
Q

Fat benign and malignant cancer

A

Benign: Lipoma
Malignant: Liposarcoma

53
Q

What is cachexia mediated by

A

TNFalpha (cachectin)–>main mediator, IFN gamma, IL1, IL6

USMLE Step 1-2015 (18 decks)

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