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Path LO final Flashcards

1
Q

What is atrophy and give a physiologic and pathologic example

A

Decrease in size of cells

physio: ovary, uterus, breast after menopause- thymus involution- bone and muscle in elderly
patho: testicular atrophy, ALZHEIMER DEMENTIA

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2
Q

What is hypertrophy

A

increase in size of cells

physio: skeletal muscles in weight lifting
patho: LVH in HTN

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3
Q

What is hyperplasia

A

increase in number of cells
Physio: endometrial hyperplasia due to estrogen
-Hyperplasia and hypertrophy together: uterus in pregnancy, BPH

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4
Q

What is metaplasia

A

adaptive change of one type of cell to another to suit an environment

  • Squamous cell metaplasia due to smoking (bronchial epithelium)
  • Barrets esophagus
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5
Q

What is dysplasia

A

Disordered growth of cells due to chronic irritation

-CIN (detect with PAP) (association with cervical cancer and HPV)

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6
Q

What is anaplasia

A

cancer. undifferentiated, uncontrolled cell growth

- malignant, neoplasm, carcinoma, cancer

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7
Q

What are the 5 hallmarks of anaplasia

A
  • Pleomorphic nucleus
  • Hyperchromatic nucleus
  • High N:C ratio
  • Large nucleoli
  • Mitotic figures
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8
Q

What is necrosis vs autolysis

A

Necrosis is death of cells in a LIVING organism

Autolysis is seen in tissues AFTER death (dissolution)

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9
Q

What is coagulative necrosis

A

Most common type of necrosis
Proteins are denatured and cytoplasm becomes granular. Usually due to anoxia
-Solid organs (heart, kidney, liver)

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10
Q

What is liquefactive necrosis

A

liquefaction of dead cells by enzymes making them gel like

  • Gliosis in brain
  • Bacterial infection causing cavity in lungs
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11
Q

What is caseous necrosis

A

Type of coagulative necrosis characterized by thick cheesy yellow substance

  • Granulomas encasing TB (Ghon complex)
  • Some fungal infections (histoplasmosis)
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12
Q

What is fat necrosis

A

Type of liquefactive necrosis characterized by calcification forming around the cancer
-Pancreas, breast

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13
Q

What is wet gangrene

A

caused by bacterial infection

causes inflammation and liquefaction

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14
Q

What is dry gangrene

A

when necrotic tissue dries out becoming black and mummified

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15
Q

What are dystrophic calcifications

A

macroscopic deposits of calcium in injured or dead tissue

  • atherosclerosis in coronary arteries
  • mitral or aortic stenosis
  • around breast cancer
  • infant periventricular calcifications in congenital toxoplasmosis
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16
Q

What are metastatic calcifications

A

increased serum calcium levels causing calcium deposits in other areas
-calcium stones in gallbladder, kidney, and bladder

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17
Q

What re the five cardinal signs of inflammation

A

heat, redness, swelling, pain, loss of function

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18
Q

GO OVER CELL CHANGES IN INFLAMMATION LEARNING OBJECTIVES

A

do it. do it now

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19
Q

What are Opsonins

A

what PMN use to tag a cell (Fc portion of immunoglobulin and C3 complement)

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20
Q

What is serous inflammation

A

mildest form. clear fluid exudate that is eventually reabsorbed
-Viral (Herpes), AI (SLE), 2nd degree burns

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21
Q

What is fibrinous inflammation

A

exudate rich fibrin

-Bacterial (Strep, PNA) and fibrinous pericarditis (bread and butter)

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22
Q

What is purulent inflammation

A

viscous yellow fluid made of dying PMN and tissue debris causing abscesses

  • Bacteria (staph and strep)
  • Large abscesses form fistulas (crohns)
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23
Q

What is ulcerative inflammation

A

in hollow organs or body surface causing loss of epithelial lining
-PUD

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24
Q

What is pseudomembranous inflammation

A

ulcerative inflammation with FIBRINOPURULENT exudate. When exudate is scared away, bleeding ulcer remains
-C. diff causing pseudomembranous colitis

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25
What is granulomatous inflammation
chronic inflammation caused by antigens that evoke hypersensitivity reaction -TB, certain fungal diseases
26
What are labile/stem cells
continuously dividing at regular rate to give rise to more cells
27
What are stable/quiescent cells
can be stimulated to divide if necessary (partial hepatectomy)
28
What are permanent cells
non-dividing, no proliferation capacity. | -Myocardial cells, brain cells
29
What do myofibroblasts do
hold the edges and pull together through smooth muscle contraction. also lay down collagen to fill space
30
What do angioblasts do
precursors of blood vessels appear 2-3 days after incision. supply new collagen with blood
31
What do fibroblasts do
Lay down fibronectin and type III (immature) collagen, which is later replaced by Type I (mature)
32
What is fibronectin
"glue" for other substances in wound repair, provide tensile strength to connective tissue
33
What is primary intention healing
surgical wound healing (PMN- Macrophages- Myofibroblasts, angioblasts, fibroblasts)
34
What is secondary intention healing
healing of large defects that can't be bridged. | Type III collagen continuously produced and never forms Type I. Causes Keloids
35
What factors promote wound healing
general well being, proteins, vitamin C
36
Define neoplasia, tumor, and oncology
neoplasia: new growth, uncontrolled Tumor: proliferation ("swelling") of neoplastic cells Oncology: study of cancer
37
What are macroscopic features of benign tumors
Expansile, compressing, sharply demarcated, encapsulated
38
What are macroscopic features of malignant tumors
infiltrative, invading, HEMORRHAGE AND NECROSIS
39
What are the three pathways of malignant spread
Lymphatic (breast cancer) Blood stream Direct extension of primary tumor (RCC to adrenals)
40
``` What are the prefixes of the following: Glandular squamous cell cartilage bone smooth muscle fat blood vessel skeletal muscle fibrous tissue germ cells ```
``` adeno- papillo- chondro- osteo- leiomyo- lipo- angio- rhabdomyo- fibro- terato- ```
41
What are the following suffixes for - oma - carcinoma - sarcoma
being malignancy of epithelial origin malignancy of connective tissue
42
What are the exceptions to malignant taxonomy
lymphoma, melanoma, astrocytoma, Seminoma, Mesothelioma, Blastomas (Hodgkins, Ewing's, Kaposi's)
43
What is a Teratoma
tumor derived from 3 germ cells layers (ovaries/testes) | usually at midline of the body
44
What is the tumor grading scale
Done by pathologist | Grade I-III based on degree of anaplasia and # of proliferating cells
45
What is the tumor staging scale
Done by Oncologist Has to do with prognosis Uses TNM scale to stage 1-4
46
What is the TNM scale
Tumor size Lymph node status Metastasis (if metastasis involved, no surgery. palliative care only)
47
Differentiate lepto vs pachymeningitis
leptomeningitis: 95%, involves arachnids and pia, and CSF pachymeningitis: involves dura mater, usually due to infection
48
Associate bacterial infections with their age groups
Neonate: Group B strep, E. Coli, L. monocytogenes Infant: H. influenza Adult: Strep. pneumococcus Military/dorm: Nisseria meningitidis
49
Most definitive diagnosis of meningitis
PMN in CSF
50
Lymphocytes are a hallmark of
TB meningitis viral meningitis chronic fungal meningitis
51
Why is H. influenza resistant to antibiotics
it forms a hard, located leukocyte exudate
52
Clinical signs and symptoms of meningitis
Kids: HA, vomiting, fever Cervcal rigidity, Kernig, Brudzinski Photophobia (exudate over optic chasm)
53
What is a berry aneurysm caused by
absence of muscular layer during fetal formation of a vessel where parent vessel bifurcates into Y shape- only endothelium, lamina, slender adventitia)
54
Where do Berry aneurysms occur
90% in circle of willis - anterior cerebral-anterior communicating - ICA-posterior communicating-anterior cerebral - trifurcation o MCA
55
What can a ruptured berry aneurysm cause
subarachnoid hemorrhage (35-50% mortality) intracerebral/intracranial hemorrhage CN III, IV, VI palsies (ICA aneurysm) seizure (medial lobe compression)
56
What is a preceding symptom of subarachnoid hemorrhage
sudden onset severe headache
57
What causes HTN associated aneurysms
lipid/hyaline deposition deposits due to HTN causing thin walls and CHARIOT BOUCHARD aneurysms
58
What are charcot bouchard aneurysms
microscopic dilations of the TRUNK of a vessel | If they rupture they can cause hypertensive cerebral hemorrhage
59
Where are hypertensive cerebral hemorrhages usually located
Basal ganglia- thalamus (75%) Pons Cerebellum
60
What are symptoms of IC hemorrhage
abrupt one symptoms- Weakness | abrupt ataxia, occipital HA, vomiting (cerebellar hemorrhage)
61
What are red and white cerebral infarcts
Red: hemorrhagic, due to emboli White: bland, due to ischemia
62
How do thrombi and emboli progress
Thrombi: slow, no hemorrhage Emboli: fast, leaky necrotic vessels
63
Locations of tumors by age
Adults: cerebral hemispheres Kids: cerebellum, pons
64
What are the different astrocytomas
Grade I: poorly demarcated, infiltrates cortex. Cerebellum in kids, spinal cord young adults. 5 year life expectancy Grade II: 3 year life expectancy
65
What is an astrocytoma
glial neoplasm, mostly in adults (late middle age and older)
66
GBM characteristics
crosses corpus collosum infiltrating white matter of both hemispheres Mottled red and yellow hemorrhage forming "butterfly" Life expectancy: 18 months
67
Oligodendroma characteristics
White matter of cerebral hemispheres of adults life expectancy 5-10 years seizures No mitotic figures
68
Characteristics of ependymoma
first two decades of life: 4th ventricle (obstruction causes hydrocephalus) adults, spinal cord 4 year survival
69
Characteristics of a Medulloblastoma
in cerebellum ONLY, disseminated through CSF most common intracranial neuroblastic tumor due to loss of short arm of chromosome 17 Radiosensitive 10 year survival rate
70
What are meningiomas
arise form arachnid villi and compress in Parasagittal areas and convexities of cerebral hemispheres erode bone Benign tumor
71
Symptoms of meningiomas
Anosmia (olfactory groove) visual defect/HA Seizures
72
Characteristics of Acoustic neuroma
Schwannoma of CN VIII in Cerebellar pontine angle causes tinnitus and deafness can compress CN V and VII if enlargement
73
Which tumors are likely to metastasize to brain
Melanoma: 50% Breast and lung: Kidney and colon (rare: prostate, liver, sarcoma)

Nayla patho (9 decks)

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