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Foundations of Medicine > Pathology > Flashcards

Pathology Flashcards

1
Q

What is Pathology?

A

The study of the essential nature of diseases and especially of the structural and functional changes produced by them

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2
Q

Who is the father of Contemporary Pathology?

A

Giovanni Morgagni

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3
Q

How do you define normal?

A

Normal is defined by cultural, societal, psychological and biological abnormalities.

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4
Q

What does the letters VINDICATE stand for?

A

V- Vascular
I - Infectious/inflammatory
N- Neoplastic
D- Drugs/Toxins
I- Intervention/Iatrogenic
C- Congenital
A- Autoimmune
T- Trauma
E- Endocrine/metabolic

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5
Q

What three things fall in the vascular category?

A
  1. Blood vessels
  2. Inflammation
  3. Clots and blockages
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6
Q

What does neoplasia stand for?

A

New growth

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7
Q

What are three things of the congenital category?

A
  1. Not the same as genetic
  2. Babies can have syndromes that are not genetic
  3. Genetic disease that does not appear until later in life.
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8
Q

What does Endocrine mean?

A

Secrete internally

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9
Q

What three causes might there be in the metabolic category?

A
  1. Endocrine cause
  2. Autoimmune cause
  3. Environmental cause
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10
Q

Define gross pathology

A

Refers to macroscopic manifestations of disease in organs, tissues, and body cavities.

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11
Q

What is aging, and what is involved?

A

The process of growing old
-There is a deterioration of the cells and tissues of the body.
-Signs and symptoms of old age start to come up.
-There is a finite life span and maximum life expectancy.

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12
Q

What is the life expectancy in the UK?

A

80 - 90 years.

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13
Q

What are five common diseases in the elderly?

A

Cardiovascular Disease
Neurodegenerative Diseases
Osteoarticular Disease
Cancer
Susceptibility to infection

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14
Q

What are three cardiovascular diseases common in the elderly?

A

-Hypertension
-Atheroma
-Advanced glycation end products

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15
Q

What three diseases can atheromas cause?

A

Peripheral vascular disease
Cerebrovascular disease
Coronary artery disease

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16
Q

What three things does advanced glycation end products cause?

A

Affect cell matrix & matrix-matrix interactions
Predispose to shear stress
Bind to AGE receptors on endothelial cells

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17
Q

What does binding to AGE receptors cause?

A

Increase permeability
Pro-inflammatory
Pro-coagulant
Increased matrix production

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18
Q

What is the most famous Neurogenerative disease?

A

Alzheimer (A type of dementia)

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19
Q

What three structural things happen to patients with Alzheimer’s?

A

-Frontal and temporal atrophy and compensatory ventricular -dilatation
-Formation of senile plaques and neurofibrillary tangles
-Acceleration of the normal aging process

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20
Q

What are the three Osteoarticular diseases?

A

-Osteoporosis
-Osteoarthritis
-Paget’s disease

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21
Q

What is osteoporosis, and what three things can cause it?

A

Reduced density of bone/bone mass
-Genetic
-Lifestyle (Sedentary, excessive alcohol consumption,
Tobacco use)
-Diet (Salty foods)

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22
Q

What are patients with osteoporosis prone to?

A

Prone to fracture with minimal stress
Limbs (falls) and vertebral bodies

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23
Q

What is osteoarthritis, and what causes it?

A

Degeneration of articular surface
-Wear and tear

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24
Q

What is Paget’s disease?

A

It is an idiopathic disease of bone that disrupts the normal cycle of bone renewal, causing bones to become weakened and possibly deformed.

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25
Q

What is the ratio of people who develop neoplastic diseases?

A

1 in 3

26
Q

What are the three common primary sites for neoplastic sites?

A
  1. Lung
  2. Breasts
  3. Colon
27
Q

What are the three steps for the hypothesis?

A
  1. Clinical
  2. Pathological
  3. Molecular
28
Q

How are these neoplastic diseases formed among families?

A

Accumulation of genetic damage that affects members of key families of genes

29
Q

What happens to the immune system in the elderly?

A

It declines, and they become prone to infection and develop secondary types. Plus there could be a reactivation of latent infection.

30
Q

What are the two pathologies of aging?

A
  1. Protective mechanisms are less effective.
  2. Genetic constitution that exerts deleterious effects later in life is not selected against.
31
Q

What are the three things which affect the process of aging?

A

Genetic factors
Environmental conditions, e.g. diet, social
Manifestation of age-related diseases

32
Q

What two things can cause damage at the molecular level?

A
  1. It results from a progressive decline in the cell’s proliferative capacity and life span.
  2. Exposure to exogenous influences that lead to accumulation of cellular damage at the organelle level.
33
Q

What are the three Structural and Biochemical Changes in Cellular Aging?

A
  1. Morphological abnormalities in mitochondria, reduced ER, distorted Golgi apparatus.
  2. Accumulation of lipofuscin, advanced glycation end products, and abnormally folded proteins.
  3. Attenuation of capacity to undertake critical biochemical processes.
34
Q

What three things happen in attenuating capacity to undertake critical biochemical processes?

A

Decreased oxidative phosphorylation
Synthesis of key nucleic acids and proteins/enzymes is reduced
Reduced capacity for nutrient uptake

35
Q

What organelle is longevity in families?

A

Mitochondria, maternal inheritance.

36
Q

What two genes affect aging processes, and what do they cause?

A

-Insulin/IGF-1 pathway
Decreased signaling prolongs life span
-DNA repair pathways of paramount importance
Werner Syndrome (Progeria)

37
Q

What is senescence?

A

The condition or process of deterioration with age.
–Cells lose the capacity to proliferate in response to mitogenic stimuli

38
Q

What other four things happen in senescence?

A

-Altered morphological feature
-Altered expression of proteins
b-galactosidase
Increased p53, p21, p16 and other CDK inhibitors
-Senescent cells accumulate in somatic tissues over time
Particularly important when stem cell populations are affected
-Reduced capacity for replacing lost or damaged cells compromises normal tissue homeostasis and is associated with aging features.

39
Q

What is replicative Senescence, and what is it controlled by?

A

Replicative senescence entails an irreversible arrest of cell proliferation and altered cell function. It is controlled by multiple dominant-acting genes and depends on the number of cell divisions, not time.

40
Q

What is the Hayflick number?

A

The Hayflick Limit is a concept that helps to explain the mechanisms behind cellular aging. The concept states that a normal human cell can only replicate and divide forty to sixty times before it cannot divide anymore and will break down by programmed cell death or apoptosis.

41
Q

What is the structure of a chromosome? Draw it and label

A

Check-in Notion– Pathology section.

42
Q

What do telomeres ensure? What happens to them after replication?

A

Ensure complete genome replication and protect coding sequences at the chromosome ends from “damage.”
After each round of cell division slight shortening of the telomeres

43
Q

What is telomerase?

A

Telomerase is a large ribonucleoprotein complex responsible for the progressive synthesis of telomeric DNA repeats (TTAGGG) at the 3′ ends of linear chromosomes, thereby reversing the loss of DNA from each round of replication.

44
Q

What is telomerase expressed in?

A

Immortalized cells.

45
Q

What are immortalized cells, and what do they derive from?

A

Cells manipulated to proliferate indefinitely can thus be cultured for long periods.
Immortalized cell lines are derived from various sources with chromosomal abnormalities or mutations that permit them to continually divide, such as tumors.

46
Q

What is the telomere length like after each cell division in Germ cells, Stem cells, cancer cells, and somatic cells? Draw it in the graph.

A

Check-in notion.

47
Q

What are the two key pathways of activation of senescence, e.g., Hyperproliferation stimulated by activated oncogenes?

A
  • p53 – p21
  • p16^INK4A – Rb
48
Q

What is ROS?

A

A type of unstable molecule that contains oxygen and that easily reacts with other molecules in a cell. A build up of reactive oxygen species in cells may cause damage to DNA, RNA, and proteins, and may cause cell death.

49
Q

What is ROS?

A

An unstable molecule that contains oxygen and easily reacts with other molecules in a cell. A build-up of reactive oxygen species in cells may cause damage to DNA, RNA, and proteins and may cause cell death.

50
Q

What is ROS?

A

An unstable molecule that contains oxygen and easily reacts with other molecules in a cell. A build up of reactive oxygen species in cells may cause damage to DNA, RNA, and proteins, and may cause cell death.

51
Q

What three main things does p53 do?

A
  1. p53 can inhibit or promote senescence by either increasing or reducing ROS
  2. p53 regulates the transcription of genes encoding antioxidant enzymes such as SOD
    -Reduce active ROS and repress senescence (and the onset of aging)
  3. Physiological p53
    -Protects against cancer development, senescence, and aging
52
Q

What happens when DNA damage activates p53?

A

It can cause a spike in production of ROS, promoting senescence and cell death.

53
Q

What happens when there is excessive p53 activity?

A

It protects against cancer development but promotes senescence and aging.

54
Q

What is Progeria? What kind of mutation is it? Are there mental development issues? What do they develop in infancy? What usual cause kills them? What is their life expectancy?

A

-Rare genetic condition
-Usually, spontaneous mutation
-Children have normal mental development for the actual age
-In infancy, develop growth retardation with macrocephaly and develop signs of old age
-Usually die as a result of atherosclerosis and its consequences (MI, CVA)
-Life expectancy: late teens to 30 years

55
Q

Draw the model for aging involving Genetic and Environmental factors.

A

Check-in notion– Pathology section

56
Q

Draw the cell cycle.

A

Check-in notion– Pathology section.

57
Q

What are the three inhibitors of apoptosis?

A

Growth factors
Cell matrix components
Viral proteins

58
Q

What are the seven apoptosis inducers?

A

Withdrawal of growth factors
Loss of matrix attachment
Viruses
Free radicals
Ionizing radiation
DNA damage
Fas ligand / CD95 interaction

59
Q

What are the molecular mediators and regulators in the extrinsic and intrinsic pathways?

A

-Extrinsic pathway
Death receptors, eg, CD95/Fas ligand
-Intrinsic pathway
Increased mitochondrial permeability
Bcl-2 family
Cytochrome c / Apaf-1
Can induce OR inhibit
Caspases - cascade
p53

60
Q

Draw the process of apoptosis

A

Check-in notion – Patho section

61
Q

What three things increase and what two things decrease apoptosis?

A

-Increased apoptosis
AIDS
Neurodegenerative disorders
Reperfusion injury
-Decreased apoptosis
Neoplasia
Auto-immune disease

Foundations of Medicine (18 decks)

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