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USMLE STEP1 📚👩🏻‍⚕️ > Pathology☠️ > Flashcards

Pathology☠️ Flashcards

1
Q

ABL genes mutation
T(9:22) BCR

A

CML
Signal transducer mutation

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2
Q

Tumor suppressor genes

A

TP53
Retinoblastoma genes

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3
Q

TS gene function

A

Regulate cell cycle growth
From G1 to S phase
P53- induce apoptosis if detect abnormalities
Rb- E2F transcription factor (G-S phase)
Rb must ne knocked out for tumor formation

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4
Q

Tissue invsion mechanism of tumor cells

A

Loss of E-cadherin
Cell detached -loose Intracellular junction
Metalloproteinase- destroy BM and ECM
Tumor cells migrate through ECM - vascular dissemination

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5
Q

Tumor spread and Mets types

A
  1. Lymphatic ( draining sites )
  2. Hematogenous ( RCC/HCC)
  3. Seeding ( ovarian Ca - omentum )
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6
Q

Astrocytoma results from which oncogenes mutation ?

A

Growth factor (PDGF)

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7
Q

Growth factor receptor mutation leads to which cancer ?

A

Breast /ovarian (HER2) ERBB2 (epithelial GFR)

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8
Q

PVC exposure cause what cancer ?

A

Angiosarcoma of liver

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9
Q

Cause of T cell exhaustion in tumor microenvironment

A

PD-L1on tumor cell or APC cells interact with PD1 on T cells which lead to T cell exhaustion
CTLA-4 on T cell outcompete B7 on APC - loss of T cell signal
Results in immune exhaustion/evasion

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10
Q

Anti-PD1

A

Nivolumab
Cemiplimab

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11
Q

Anti -PDL1

A

Atezolizumab

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12
Q

Anti CTLA-4

A

Ipilimumab

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13
Q

Cancer cause by Ionizing radiation

A

AML
CML
Thyroid ca ( papillary-epithelium)

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14
Q

UVB (non ionizing )

A

Basal cell ca
SCC
Melanoma

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15
Q

Aromatic amines
Textile (dyes)

A

Transitional cell carcinoma

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16
Q

Aflatoxin

A

HCC

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17
Q

Nickel
Chromium
Beryllium

A

Occupational exposure - lung cancer

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18
Q

Atrophy

A

Decrease cell mass/size due to ubiquitin protease degradation of cells
Causes: trauma / reduced blood suppy/ disuse / poor nutrition/ hormonal

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19
Q

Barret esophagus Metaplasia changes

A

Squamous to gastric columnar
May progress to adenoca of esophagus

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20
Q

Myositis ossifican pathology

A

Formation of bone within muscle after trauma

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21
Q

Reversible cell injury

A

Ribosomal detachment from golgi
Membrane blebbing
Nuclear chromatin clumping

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22
Q

Irreversible cell injury

A

Ca in
Troponin out ( seen in cardiac ischemia)
Nuclear degradation
Rupture of lysosome ( autolysis)
Cell swell and burst

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23
Q

Bcl-2 overexpression

A

Follicular lymphoma (14:18)
DLBCL
decrease Caspase activity —> tumorigenesis

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24
Q

Apoptosis 3 pathways

A
  1. intrinsic (mitochondrial) - radiation /ROS/ hypoxia/ misfolded protein /etc
    2.Extrinsic( death receptor) Fas of TNF-a
    3.granzyme /perforin B
    All activates executional caspases in the cell that lead to blebbing/shrinkage and apoptotic body formation
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25
Types of necrosis
1. Coagulative -ischemia /infarct 2.liquefactive- brain infarct 3. Caseous- TB/ Fungi /Nocardia 4.Fat- pancreatitis / breast tissue injury - release lipase (breaks down TG into FA bind with Ca - saponification) 5.gangrenous - dry/wet 5.fibrinoid -immune vascular / hypertensive ER
26
Acetaminophen overdose can cause what toxicity ?
Hepatotoxicity Activates cytochrome P450 in liver ,convert CCL4 to CCL3 (ROS) - hepatic steatosis Decrease apolipoprotein synthesis - centrilobular necrosis
27
Red infarct patho
RBC + fibrin strand Hemorrhagic infarct ( venous occlusion /insufficiency
28
Reperfusion injury
ROS Free radical damage after angioplasty
29
Pale infarct
Arterial infarct / insufficiency Solid organs with single blood supply (heart / kidney)
30
Which type of neuron and part of neuron are most susceptible to ischemic insult ?
Purkinje cells of cerebellum Pyramidal cells of hippocampus and neocortex
31
Neoplasia is common in which type of tissues?
Rapidly regenerating cells such as hair/ skin / bone marrow / GI / Gonads
32
Types of abnormal calcification
1. Dystropic 2. Metastasis
33
Calcium in abnormal disease cells Localized ( Eg: aortic stenosis )
Dyamorphic calcification 2 to injury or necrosis
34
Calcium deposit in healthy tissue Widespread deposit ( eg nephrocalcinosis )
Metastasis calcification 1 hyperphosphotamia 1 hyperparathyroidism CKD Sarcoidosis Vit Dnosis
35
Abnormal protein ( beta pleated sheets) misfolding
Amyloidosis
36
What is observed with Congo red stain Apple green birefringence ?
Amyloid deposit
37
ANP high in
Atrial amyloidosis Increase risk for AF
38
B amyloid protein is seen in what neurological ds ?
Alzheimer’s
39
Islet amyloid peptide
T2DM
40
High Calcitonin in what carcinoma
Medullary thyroid Ca
41
Pain is regulated by
Bradykinin PGE2 Histamine
42
Fever is regulated by
IL1 / TNF - increase COX activity /increase PGE2
43
Acute phase reactant
(Unregulated) Amyloid A Fibrinogen CRP Ferritin Hepatoglobulin Hepcidin Procalcitonin (Downregulated ) Albumin Transferrin Transtgyretin
44
Hepcidin function
Decrease iron absorption Decrease iron release Anemia of chronic disease
45
Hageman factor
CF XII
46
Increase ESR
Most anemia Malignancy Infection Renal disease
47
Decrease ESR
Polycythemia Sickle cell disease ( shape altered) HF Microcytosis
48
Phases of wound healing
1. Inflammatory ( ( plt /Mph/ neut) 2.proliferation ( granulation tissue formation ) 3. Remodeling fibroblast /col III -Col I
49
Roles of T cell Th1 Th2
Th1 - pro inflammatory Th2- anti-inflammatory /repair
50
Protooncogenes include
GF ( PDGF) GF-R ( HER2/ERBB2) Signal transducer (KRAS) TF (C-myc) Cytokine receptor (c-KIT) Antiapoptotic molecule Tyrosine kinase -non-R (BCR-ABL/ JAK2)
51
JAK2 mutation
Myeloproluferative disorder
52
BCR/ABL
CML /ALL
53
C -myc N-myc
Burkitt Neuroblastoma
54
APC Gene mutation.
CR ca (associate with FAP)
55
BRCA1/2 mutation
Familiar ( ask Hx) Breast /prostrate /ovaries /pancreas ca
56
Werner’s Syndrome
3Ps Pituitary Pancreas Parathyroid Seen in MEN1
57
RB1 mutation
Retinoblastoma G1-Sphase block /inhibit E2F
58
Wilm tumor
Nephroblastoma Most common pediatric renal ca
59
Schistosomiasis haematobium ( fluke) causes which Ca?
Squamous cell bladder Ca
60
Uterus 5 times bigger Uterine bleeding High b-HCG
Choriocarcinoma
61
High b-HCG in
GTD Choriocarcinoma Hydatidform mole mixed germ cell tumor
62
High AFP in
HCC Yolk sac tumor Ataxia -talangectasia Neural tube defect
63
NF 1
Nerve tumor Small nerve of skin Large nerve of visceral Cafe au lait spot Cut macules Iris
64
NF2
Affect auditory nerves Tinnitus Hearing loss Acoustic neuromas CN VIII
65
Ca -19-9
Pancreatic Adenocarcinoma
66
Ca 125
Epithelial ovarian ca
67
CEA
CRC Pancreatic Ca
68
Ca 15-3/ Ca27-29
Breast Cancer
69
Cytokines that cause cachexia
IFN-r TNF-a IL-1 IL-6
70
Endocrine disorders in NE cancers ( SCLC/ SCC/ renal/bladder/ovarian )
Cushion (high ACTH) SIADH (high ADH) Hypercalcemia ( 1,25 OH D3)

USMLE STEP1 📚👩🏻‍⚕️ (13 decks)

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