Path

Question 1

coag cascade factors that are inhibited by WARFARIN (not F)

Answer 1

factors 2, 7, 9, 10 / anticoagulants Protein C & S

Question 2

things that prolong the PT (4) not F

Answer 2

Warfarin
DIC
Liver failure
Factor 5 or 10 deficiency

Question 3

Light chain (multiple myeloma) becomes what in
1. blood 2. urine 3. kidney
not F

Answer 3

1. amyloid (deposits in tissue)
2. Bence-Jones protein
3. renal failure

Question 4

Multiple myeloma: over-production of which Ig?

not F

Answer 4

IgG or IgA

Question 5

Waldenstrom Macroglobulinemia: over-production of which Ig?

not F

Answer 5

IgM (pentamer = BIG = macro)

Question 6

CD maker on the NEOPLASTIC plasma cells? (multiple myeloma)

not F

Answer 6

CD56+

Question 7

factors that increase OSTEOLYTIC bone mets, cancer (2)

Answer 7

IL-6

PTH-related peptides

Question 8

factors that increase OSTEOBLASTIC bone mets, cancer (2)

Answer 8

endothelin-1

insulin-like growth factor

Question 9

ATROPHY, dec in cellular SIZE involves what pathway

what cellular changes are seen (2)

Answer 9

ubiquitin-proteosome pathway

autophagic vacuoles
lipofuscin granules (peroxidized lipid turnover byproduct)

Question 10

METAPLSIA

Answer 10

replace one adult cell type by another cell type
epithelial tissue (commonly in)
reprogram at the stem cell level
cause: irritation, persistent stress

Question 11

what kind of epithelial cells are very resilient (metaplasia)

Answer 11

squamous

Question 12

cellular injury mechanisms

Answer 12

entry of ca2+ -> abnormal [Ca2+] homeostatis -> inc mito permeability, mitochondrial damage -> ATP depletion, accumulation of oxygen radicals (ROS) -> loss of cellular membrane integrity

Question 13

cytoplasmic changes of necrosis (3)

Answer 13

increased eosinophilia
nuclear shrinkage & dissolution
calcification (late)

Question 14

Nuclear changes in necrosis (3)

Answer 14

pyknosis (nuclear shrinkage, inc basophilia)

• > karyorrhexis (nuclear fragmentation)
• > karyolysis (blue color of nucleus fades, lose normal chromatin, less basophilis)

nucleus eventually disappears

Question 15

what’s the mediating enzymes in apoptosis that turns on proteases (cytoskeleton) and endonucleases (DNA)?

Answer 15

caspase

Question 16

blood clot made up of what 3 things

Answer 16

RBC, plt, fibrin

Question 17

Tissue factor (Thromboplastin)

Answer 17

activates Factor 7 to start extrinsic pathway (coag cascade)

Question 18

plasminogen

Answer 18

cleaves thrombin and fibrin clots

Question 19

Thrombin

Answer 19

(Acts on numerous stages of the coag cascade)
1. fibrinogen -(thrombin)-> fibrin
2. activates Factor 8 (stabilizes clot)
activates endothelial cells (Adhesion, fibrinolysis)
induces plt aggregation
activates leukocytes (WBC)

Question 20

which Vitamin is important in coag cascade?

Answer 20

Vit K

Question 21

3 factors that contribute to Thrombosis

VIRCHOW’S TRIAD

Answer 21

1. endothelial injury
2. abnormal blood flow (turbulence)
3. hypercoagulability

Question 22

Mural thrombus

Answer 22

thrombus that forms in the heart wall

hypocontractility + endocardial damage (due to MI)

Question 23

embolus can be made up of which material

Answer 23

solid, liquid, or gaseous mass

fat, nitrogen, amniotic fluid

Question 24

Fat embolism syndrome

Answer 24

bone fracture (fat from BM) trauma or otrho surgery, or soft tissue trauma
s/s: respiratory failure (fat goes to pulm bv), mental confusion, fat induces mechanical damage and coag cascade -> DIC

Question 25

amniotic fluid embolus

Answer 25

amniotic fluid w/ fetal skin cell (squamous cells, keratin debris) is highly thrombogenic/irritant -> obstructive complication of labor or delivery s/s: sob, neurologic symptoms (mental confusion, agitation), DIC sudden onset fatal

Question 26

red infarct

Answer 26

due to + hemorrhage previously congested tissue dual circulation venous occlusion reperfusion

Question 27

congestion (vs. hyperemia) often presents with what

Answer 27

edema -> necrosis/atrophy/fibrosis

Question 28

what determines the tumor type in malignant neoplasms

Answer 28

intermediate filaments

Question 29

adenocarcinoma in what organs

Answer 29

GI tract, liver, lung

Question 30

small cell (neuroendocrine) carcinoma in what organs

Answer 30

lung | prostate

Question 31

most sarcomas arise as sarcomas and not from benign neoplasm

Answer 31

no benign. | only malignant

Question 32

melanoma 1. derived from what tissue? 2. what kind of growth is worse? horizontal or vertical

Answer 32

1. neural crest | 2. vertical

Question 33

blastomas 1. aka 2. how differentiated?

Answer 33

1. small round blue cell tumors of childhood | 2. UNdifferentiated: can use immuno and molecular studies to confirm diagnosis

Question 34

dysplasia

Answer 34

disorderly growth and lack of maturation loss of polarity overlapping cells nuclear enlargement/nuclear membrane irregularity (loss of smooth borders) haven't broken BM

Question 35

desmoplasia

Answer 35

Fibrous tissue formation (fibroblasts make collagen) in response to neoplasm firm, non-mobile common in adenomas

Question 36

Grading is based on 4 histological features

Answer 36

differentiation nuclear pleomorphism tumor necrosis (more aggressive) mitotic activity (hyperchromatic: lots of cell division)

Question 37

tumor staging

Answer 37

facilitate prognosis & tx | TNM system

Question 38

TNM system of tumor staging

Answer 38

T: Tumor size/location N: involvement of lymph Node M: Mestastasis

Question 39

inflammatory cytokine that's responsible for CACHEXIA

Answer 39

PIF (proteolysis inducing factor)

Question 40

Her2Neu

Answer 40

TYROSINE KINASE receptor (for growth factors) gene amplification in ~20% of breast/ovarian cancer