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Nayla patho > Path LO final > Flashcards

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
Q

What is granulomatous inflammation

A

chronic inflammation caused by antigens that evoke hypersensitivity reaction
-TB, certain fungal diseases

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26
Q

What are labile/stem cells

A

continuously dividing at regular rate to give rise to more cells

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27
Q

What are stable/quiescent cells

A

can be stimulated to divide if necessary (partial hepatectomy)

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28
Q

What are permanent cells

A

non-dividing, no proliferation capacity.

-Myocardial cells, brain cells

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29
Q

What do myofibroblasts do

A

hold the edges and pull together through smooth muscle contraction. also lay down collagen to fill space

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30
Q

What do angioblasts do

A

precursors of blood vessels appear 2-3 days after incision. supply new collagen with blood

31
Q

What do fibroblasts do

A

Lay down fibronectin and type III (immature) collagen, which is later replaced by Type I (mature)

32
Q

What is fibronectin

A

“glue” for other substances in wound repair, provide tensile strength to connective tissue

33
Q

What is primary intention healing

A

surgical wound healing (PMN- Macrophages- Myofibroblasts, angioblasts, fibroblasts)

34
Q

What is secondary intention healing

A

healing of large defects that can’t be bridged.

Type III collagen continuously produced and never forms Type I. Causes Keloids

35
Q

What factors promote wound healing

A

general well being, proteins, vitamin C

36
Q

Define neoplasia, tumor, and oncology

A

neoplasia: new growth, uncontrolled
Tumor: proliferation (“swelling”) of neoplastic cells
Oncology: study of cancer

37
Q

What are macroscopic features of benign tumors

A

Expansile, compressing, sharply demarcated, encapsulated

38
Q

What are macroscopic features of malignant tumors

A

infiltrative, invading, HEMORRHAGE AND NECROSIS

39
Q

What are the three pathways of malignant spread

A

Lymphatic (breast cancer)
Blood stream
Direct extension of primary tumor (RCC to adrenals)

40
Q 
What are the prefixes of the following: 
Glandular
squamous cell
cartilage
bone
smooth muscle
fat
blood vessel
skeletal muscle
fibrous tissue
germ cells
A 
adeno-
papillo- 
chondro- 
osteo- 
leiomyo-
lipo-
angio-
rhabdomyo-
fibro-
terato-
41
Q

What are the following suffixes for

  • oma
  • carcinoma
  • sarcoma
A

being
malignancy of epithelial origin
malignancy of connective tissue

42
Q

What are the exceptions to malignant taxonomy

A

lymphoma, melanoma, astrocytoma, Seminoma, Mesothelioma, Blastomas
(Hodgkins, Ewing’s, Kaposi’s)

43
Q

What is a Teratoma

A

tumor derived from 3 germ cells layers (ovaries/testes)

usually at midline of the body

44
Q

What is the tumor grading scale

A

Done by pathologist

Grade I-III based on degree of anaplasia and # of proliferating cells

45
Q

What is the tumor staging scale

A

Done by Oncologist
Has to do with prognosis
Uses TNM scale to stage 1-4

46
Q

What is the TNM scale

A

Tumor size
Lymph node status
Metastasis
(if metastasis involved, no surgery. palliative care only)

47
Q

Differentiate lepto vs pachymeningitis

A

leptomeningitis: 95%, involves arachnids and pia, and CSF
pachymeningitis: involves dura mater, usually due to infection

48
Q

Associate bacterial infections with their age groups

A

Neonate: Group B strep, E. Coli, L. monocytogenes
Infant: H. influenza
Adult: Strep. pneumococcus
Military/dorm: Nisseria meningitidis

49
Q

Most definitive diagnosis of meningitis

A

PMN in CSF

50
Q

Lymphocytes are a hallmark of

A

TB meningitis
viral meningitis
chronic fungal meningitis

51
Q

Why is H. influenza resistant to antibiotics

A

it forms a hard, located leukocyte exudate

52
Q

Clinical signs and symptoms of meningitis

A

Kids: HA, vomiting, fever
Cervcal rigidity, Kernig, Brudzinski
Photophobia (exudate over optic chasm)

53
Q

What is a berry aneurysm caused by

A

absence of muscular layer during fetal formation of a vessel where parent vessel bifurcates into Y shape- only endothelium, lamina, slender adventitia)

54
Q

Where do Berry aneurysms occur

A

90% in circle of willis

  • anterior cerebral-anterior communicating
  • ICA-posterior communicating-anterior cerebral
  • trifurcation o MCA
55
Q

What can a ruptured berry aneurysm cause

A

subarachnoid hemorrhage (35-50% mortality)
intracerebral/intracranial hemorrhage
CN III, IV, VI palsies (ICA aneurysm)
seizure (medial lobe compression)

56
Q

What is a preceding symptom of subarachnoid hemorrhage

A

sudden onset severe headache

57
Q

What causes HTN associated aneurysms

A

lipid/hyaline deposition deposits due to HTN causing thin walls and CHARIOT BOUCHARD aneurysms

58
Q

What are charcot bouchard aneurysms

A

microscopic dilations of the TRUNK of a vessel

If they rupture they can cause hypertensive cerebral hemorrhage

59
Q

Where are hypertensive cerebral hemorrhages usually located

A

Basal ganglia- thalamus (75%)
Pons
Cerebellum

60
Q

What are symptoms of IC hemorrhage

A

abrupt one symptoms- Weakness

abrupt ataxia, occipital HA, vomiting (cerebellar hemorrhage)

61
Q

What are red and white cerebral infarcts

A

Red: hemorrhagic, due to emboli
White: bland, due to ischemia

62
Q

How do thrombi and emboli progress

A

Thrombi: slow, no hemorrhage
Emboli: fast, leaky necrotic vessels

63
Q

Locations of tumors by age

A

Adults: cerebral hemispheres
Kids: cerebellum, pons

64
Q

What are the different astrocytomas

A

Grade I: poorly demarcated, infiltrates cortex. Cerebellum in kids, spinal cord young adults. 5 year life expectancy
Grade II: 3 year life expectancy

65
Q

What is an astrocytoma

A

glial neoplasm, mostly in adults (late middle age and older)

66
Q

GBM characteristics

A

crosses corpus collosum infiltrating white matter of both hemispheres
Mottled red and yellow hemorrhage forming “butterfly”
Life expectancy: 18 months

67
Q

Oligodendroma characteristics

A

White matter of cerebral hemispheres of adults
life expectancy 5-10 years
seizures
No mitotic figures

68
Q

Characteristics of ependymoma

A

first two decades of life: 4th ventricle (obstruction causes hydrocephalus)
adults, spinal cord
4 year survival

69
Q

Characteristics of a Medulloblastoma

A

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
Q

What are meningiomas

A

arise form arachnid villi and compress in
Parasagittal areas and convexities of cerebral hemispheres
erode bone
Benign tumor

71
Q

Symptoms of meningiomas

A

Anosmia (olfactory groove)
visual defect/HA
Seizures

72
Q

Characteristics of Acoustic neuroma

A

Schwannoma of CN VIII in Cerebellar pontine angle
causes tinnitus and deafness
can compress CN V and VII if enlargement

73
Q

Which tumors are likely to metastasize to brain

A

Melanoma: 50%
Breast and lung:
Kidney and colon
(rare: prostate, liver, sarcoma)

Nayla patho (9 decks)

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