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Step 1 Review > Path General Principals High Yield > Flashcards

Path General Principals High Yield Flashcards

1
Q

T/F: Apoptosis does not require ATP

A

FALSE…it is ATP dependent

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2
Q

What is pyknosis?

A

Nuclear shrinkage

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3
Q

What is karyorrhexis?

A

Nuclear fragmentation

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4
Q

Which pathway of apoptosis is involved in tissue remodeling during embryogenesis?

A

Intrinsic pathway

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5
Q

What triggers the intrinsic pathway of apoptosis?

A

Regulating factor is wthdrawn from a proliferating cell population

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6
Q

Is an increase or decrease in the BAX/ BAK pro-apoptotic?

A

Increase

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7
Q

Is an increase or decrease in Bcl-2 pro- apoptotic?

A

Decrease

Bcl-2 is antiapoptotic

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8
Q

How does Bcl-2 inhibit the activation of caspases?

A

It inhibits cyt c release by binding to and inhibiting Apaf-1 (which normally induces teh activation of caspases)

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9
Q

How is the extrinsic pathway activated?

A

Ligand receptor interations (FasL binding to Fas)

Immune cell (cytotoxic T cell release of perforing and granzyme B)

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10
Q

What is an example of FasL- Fas mediated apoptosis?

A

Negative selection the the thymus

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11
Q

Name the type of necrosis:

ischemia / infarcts in most tissues

A

Coagulative

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12
Q

Name the type of necrosis:

bacterial abscesses, brain infarcts

A

Liquifactive

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13
Q

Name the type of necrosis:

TB, systemic fungi with macrophages walling off the infectie organism

A

Caseous

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14
Q

Name the type of necrosis:

saponification seen in acute pancreatitis due to enzymes, also seen in breast trauma

A

Fat

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15
Q

Name the type of necrosis:

immune reactions in vessels, immune complexes combine with fibrin

A

Fibrinoid

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16
Q

Name the type of necrosis:

Vessel walls are thick and pink

A

Fibrinoid

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17
Q

Which of the following are reversible signs of cell injury?

1- ATP depletion
2- Membrane blebbing
3- Nuclear pykosis (shrinkage)
4- Fatty change
5- Lysosomal rupture
6- Cell/ mitochondrial swelling
7- Mitochondrial permeability/ vacuolization
8- Ribosomal/ poysomal detachment
A

ATP depletion

Membrane bledding

Fatty change

Cell/ mitochondrial swelling

Ribosomal/ polysomal detachment

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18
Q

When does red infarct occur?

A

Venous occlusion in tissues with multiple blood supplies

Reperfusion

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19
Q

When does pale infarct occur?

A

Occur in solid organs with a single blood supply (heart, kidney, and spleen)

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20
Q

What is the cellular component of inflammation?

A

Acute–> Neutrophils antibody, eosinophils

Chronic–> Mononuclear cells, and fibroblasts

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21
Q

What is chromatolysis?

A

process involving the neuronal cell body following axonal injury that is characterized by:

1- round cellular swelling
2- displacement of teh nucleus to the periphery
3- dispersion of Nissel substance throughout cytoplasm

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22
Q

“calcium depositoin in abnormal tissue usually secondary to necrosis”

A

dystrophic calcificatoin

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23
Q

“widespread deposition of calcium in normal tissue or high calcium phosphate product levels”

A

metastatic calcification

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24
Q

What can cause metastatic calcification?

A

Hyperparathyroidism, sarcoidosis, hypervitaminosis D

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25
Q

In metastatic calcification…where does calcification usually occur?

A

Kidney, lung, gastric mucosa

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26
Q

Is the patient normocalcemic in dystrophic calcification or metastatic calcification?

A

Dystrophic

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27
Q

What molecules are important in margination and rolling during leukocyte extravasation?

A

E- selectin and P- selectin (found in vasculature)

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28
Q

What do E- selectin and P- selectin bind?

A

Sialyl- Lewis (on the leukocyte)

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29
Q

What mediates TIGHT binding of leukocytes during leukocyte extravasation?

A

ICAM-1 (CD 54)

VCAM-1 (CD106)

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30
Q

What does ICAM-1 bind?

A

CD11/18 integrins (LFA-1, Mac-1)

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31
Q

What does VCAM bind?

A

VLA-4 integrin

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32
Q

What mediates DIAPEDESIS during leukocyte extravasation?

A

PECAM-1 (CD 31)

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33
Q

What mediates MIGRATION of leukocytes in leukocyte extravasation?

A

Chemotactic products–> C5a, IL-8, LTB4, kallikrein, platelet activating factor

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34
Q

What induces E selectin?

A

TNF and IL-1

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35
Q

What induces P selectin?

A

Histamine (from weibel- palade bodies)

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36
Q

What is diapedesis?

A

WBC travels between endothelial cells and exits blood vessel

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37
Q

What are the 3 ways that free radical damage cells?

A

1- Membrane lipid peroxidation
2- Protein modification
3- DNA breakage

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38
Q

Name 3 enzymes that can eliminate free radicals?

A

Catalase
Superoxide dismutase
Glutathione peroxidase

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39
Q

What vitamins act as antioxidants?

A

Vit A, B, C

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40
Q

What are the 2 types of scars?

A

1- hypertrophic

2- keloid

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41
Q

What is the collagen arrangement in hypertrophic scars? In keloid scars?

A

Hypertrophic scars–> parallel

Keloid scars–> disorganized

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42
Q

What race has a higher incidence of keloid scars?

A

African americans

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43
Q

What is the function of FGF?

A

stimulates angiogenesis

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44
Q

What is the function of PDGF?

A

Induces vascular remodeling and smooth muscle migration

Stimulates fibroblast growth for collagen synthesis

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45
Q

What does EGF do?

A

stimulates cell growth via tyrosine kinase

46
Q

What is the function of TGF-beta?

A

Angiogenesis, fibroblasts, cell cycle arrest

47
Q

What is the function of metalloproteinases?

A

Tissue remodeling

48
Q

What is the function of VEGF?

A

Stimulates angiogenesis

49
Q

What are the 3 phases of wound healing?

A

1- Inflammatory (

50
Q

What cells begin to predominate during the proliferative and remodeling phase of wound healing?

A

fibroblsts

51
Q

In wound healing what type of collagen is initially deposited?

A

Type III

52
Q

What is type III collagen replaced with??

A

Type I

53
Q

What cytokine initiates granulomas?

A

IFN- gamma

54
Q

What cytokine maintains granulomas?

A

TNF alpha

55
Q

What type of cell secretes IFN alpha to activate macrophages?

A

Th1 cells

56
Q

What are 3 causes of exudate?

A

Lymphatic obstruction
Inflammation/ infection
Malignancy

57
Q

What are 3 causes of transudate?

A

Increase hydrostatic pressure
Decreased oncotic pressure
Na+ retention

58
Q

Elevated or decreased ESR:

Anemia

A

elevated

59
Q

Elevated or decreased ESR:

sickle cell anemia

A

decreased

60
Q

Elevated or decreased ESR:

Pregnancy

A

Elevated

61
Q

Elevated or decreased ESR:

Autoinnnume dsorders

A

Elevated

62
Q

Elevated or decreased ESR:

Polycythemia

A

Decreased

63
Q

What condition is AL amyloidosis seen in?

A

Multiple myeloma/ plasma disorders

It is light chain deposition (hence AL)

64
Q

What condition can AA amyloidosis be seen in?

A

Chronic inflammation (RA, IBD, protracted infection ect)

65
Q

What can cause Beta2 microglobulin amyloidosis?

A

Dialysis

66
Q

How can Beta2 microglobulin amyloidosis present?

A

Carpel tunnel syndrome

67
Q

What mutation is responsible for heritable amyloidosis?

A

Transthyretin gene mutation

68
Q

What causes age related/ senile amyloidosis?

A

deposition of normal transthyretin in myocardium and other sites

69
Q

What is IAPP amyloidosis associated with? What deposits in this type of amyloidosis?

A

T2DM

Deposition of amylin in pancreatic islets

70
Q

What is the yellow brown pigment that appears with normal aging?

A

Lipofuscin

71
Q

What forms lipofuscin?

A

formed by oxidation and polymerization of autophagocytosed organellar membranes

72
Q

“abnormal proliferation of cells with loss of size, shape, and orientation”

A

dysplasia

73
Q

Describe the nuclear/ cytoplasmic ratio in neoplastic cels

A

increased!

74
Q

Describe the nuclear/ cytoplasmic ratio in neoplastic cels

A

increased!

75
Q

What is p- glycoprotein? What is it seen in?

A

multidrug resistance protein 1

Seen in adrenal cell carcinoma (but also in other cancer cells)

76
Q

What is the function of p- glycoprotein?

A

used to pump out toxins–> including chemo agents

77
Q

“increased number of cells”

A

hyperplasia

78
Q

“one adult cell type is replaced by another usually secondary to irritation or environmental exposure”

A

Metaplasia

79
Q

“abnormal growth with loss of cellular orientation, shape size, in comparison to normal tissue”

A

Dysplasia

80
Q

Which types of inappropriate cell growth patterns are reversible?

A

Hyperplasia
Metaplasa
Dysplasia

81
Q

Which types of inappropriate cell growth patters are irreversible?

A

Anaplasia
Neoplasia
Desmoplasia

82
Q

“loss of structural differentiation and function of cells, resembling primative cells of same tissue”

A

Anaplasia

83
Q

“uncontrolled and excessive CLONAL proliferation of cells that can be benign or malignant”

A

Neoplasia

84
Q

“fibrous tissue formation in response to neoplasm”

A

desmoplasia

85
Q

What is more important…grade or stage?

A

Stage

86
Q

Is a low grade cancer well differentiated or poorly differentiated?

A

Well!!

87
Q

What are the components of the staging system?

A 
T= Tumor size
N= node involvement
M= Metastases
88
Q

Do benign, malignant or both have an upregulation of telomerase preventing chroomosome shortening and cell death?

A

Malignant

89
Q

What is cachexia?

A

Weight loss, muscle atrophy and fatigue that occurs in chronic disease

90
Q

What mediates cachexia?

A

TNF- alpha, IFN- gamma, and IL-6

91
Q

Acanthosis nigricans is an indicator of…

A

visceral malignancy (and insulin resistance

92
Q

What type of cancer can cirrhosis lead to?

A

Hepatocellular

93
Q

What type of cancer can ulcerative coloitis lead to?

A

colon adenocarcinoma

94
Q

What is a precursor to SCC of the skin?

A

actinic keratosis

95
Q

What types of cancer can dermatomyositis and poolyomyositis be associated with?

A

Predispose to visceral malignancies (particularly GU)

96
Q

Multiple seborrheic keratosis is associated with which 4 underlying malignancies?

A

1- GI
2- Breast
3- Lung
4- Lymphoid

97
Q

Plummer- Vinson syndrome predisposes to which type of cancer?

A

SC of the esophagus

98
Q

Veroderma pigmentosa predisoses to what types of cancer?

A

SCC
BCC
Melanoma

99
Q

What cancers does AIDS predispose a patient to?

A

Lymphoma

Kaposi sarcoma

100
Q

What 3 cancers does immunodificiency predispose to?

A

Lyphoma
Melanoma
RCC

101
Q

What is the mutation seen in Li- Fraumeni Syndrome?

A

p53

102
Q

Radiation exposure put an individual at increased risk for which 4 cancers?

A

1- Papillary thyroid cancer
2- Sarcoma
3- Breast cancer
4- Leukemia

103
Q

What are the 3 most common cancers in men?

A

1- Prostate
2- Lung
3- Colon/ rectum

104
Q

What are the 3 most deadly cancers in men

A

1- Lung
2- Prostate
3- colon/ rectum

105
Q

What are the 3 more deadly cancers in women?

A

1- Lung
2- breast
3- colon/ rectum

106
Q

What are the 3 most common cancers in men?

A

1- breast
2- lung
3- colon/ rectum

107
Q

What 5 tumors are known to met to the brain?

A 
1- Lung
2- breast
3- prostate
4- melanoma
5- GI
108
Q

What 3 tumors are known to me to the liver?

A

1- colon
2- stomach
3- pancreas

109
Q

What tumors are know to met to the bone?

A

1- Prostate/ breast

2- lung/ thyroid/ kidney

110
Q

Which bone mets are blastic?

A

prostate

breast and lung are mixed

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