PATHOLOGY Flashcards
memorization
The study of the structural, biochemical, and functional changes in cells, tissues, and organs; study of suffering
Pathology
Father of modern Pathology:
Rudolf Ludwig Carl Virchow
Term for diseases of unknown origin:
Idiopathic
Origin of the disease/causative agent
Etiology
Refers to the sequence of events that follow the exposure of cells or tissues to an injurious agent
Pathogenesis
Refers to the structural alterations in cells or tissues that are either characteristic of a disease or diagnostic of an etiologic process
Morphologic changes
The END RESULT of genetic, biochemical and structural changes in cells and are functional abnormalities which leads to the clinical manifestations of disease, as well as its progress
Clinical manifestations
Difference of signs and symptoms:
Signs - OBJECTIVE evidence of the disease; physical observations
Symptoms - SUBJECTIVE evidence of the disease; experienced by the patient
The sum total of changes in the living tissues, in response yo an injurious agent
Inflammation
Five cardinal signs of inflammation:
- Rubor - Redness - increase rate of blood flow
- Tumor - Swelling - increase capillary permeability
- Calor - Heat - transfer of internal heat
- Dolor - Pain - pressure upon sensory nerve
- Function laesa - Loss of function - Pain interference
Classification of Inflammation according to severity or duration:
- Acute inflammation
- Chronic inflammation
- Subchronic inflammation
Inflammation of sudden onset, characterized with 5 cardinal signs
Acute inflammation
Predominant cells in Acute Inflammation:
Neutrophils
Inflammation that involves persistence of injurious agent for weeks or years characterized by proliferation:
Chronic inflammation
predominant cells in Chronic Inflammation:
Mononuclear cells (plasma cells, lymphocytes, macrophages, monocytes)
Inflammation that represents integrade between acute and chronic inflammation
Subchronic inflammation
Classification of inflammation according to type of exudate:
- Serous inflammation
- Hemorrhagic inflammation
- Fibrinous inflammation
- Purulent inflammation
- Catarrhal inflammation
Characterized by extensive outpouring of WATERY, LOW PROTEIN-FLUID derived from either the blood serum or secretions from serosal mesothelial cells (example: blister)
Serous inflammation
Characterized by the admixture of BLOOD and elements of exudates
Hemorrhagic inflammation
Characterized by exudation of large amounts of FIBRINOGEN and precipitation of fibrin masses
Fibrinous inflammation
Characterized by the production of large amount of PUS or purulent exudates:
Purulent inflammation
Characterized by HYPERSECRECTION OF MUCOSA with degenerative changes in the epithelium
Catarrhal inflammation
Defined as a DISRUPTION of the normal anatomical structure and function of the SKIN or other tissues in the body;
WOUND
Injuries where the SKIN IS BROKEN exposing underlying tissues to the environment
OPEN WOUNDS
Types of OPEN WOUNDS:
- Puncture
- Incision
- Laceration
- Abrasion
- Avulsion
- Amputation
mnemonic: “OPEN ang mall” - “PILAAA” bago pumasok
Open wound caused by sharp object that deeply penetrates the skin:
Puncture wound
Open wound caused by sharp-edged object:
Incision
Torn or jagged wounds caused by tearing of the skin via external force:
Laceration
Open wound caused by FRICTION AGAINST A ROUGH SURFACE:
Abrasion
Partial or complete tearing away of the skin causing the separation of the skin from tissue
Avulsion
Complete detachment of limb
Amputation
Injuries where the SKIN REMAINS INTACT, but there is damage to underlying tissues; these wounds may not be immediately visible, making them potentially more dangerous if not diagnosed:
Closed wounds
types of closed wounds:
- Blister
- Hematoma
- Contusions
- Crush-injuries
- Seroma
mnemonic: “CLOSED” ang mall - BaHa, kaya Closed, sayang may Class Suspension pa naman
Fluid-filled sac that forms between the upper layers of the skin, usually as a result of friction, burns, or other types of trauma:
Blister
Blood-filled area that develops under the skin/tissue
Hematoma
Blunt trauma due to damaged small blood vessels
Contusions
Due to squeezing between two surfaces of the body
Crush-injuries
Fluid-filled area that develops under the skin/tissue
Seroma
THREE ABNORMALITIES IN CELL GROWTH:
- Retrogressive changes
- Progressive changes
- Degenerative changes
Abnormal cell growth where organs or tissues are smaller than normal:
Retrogressive changes
Abnormal cell growth where organs or tissues are larger than normal
Progressive changes
Abnormal cell growth where organs or tissues have problems in cellular growth patterns
Degenerative changes
Types of RETROGRESSIVE CHANGES:
- Aplasia
- Agenesia
- Atresia
- Atrophy
- Hypoplasia
Retrogressive change characterized by incomplete or defective development of a tissue or organ
Aplasia
Retrogressive change characterized by complete non-appearance of an organ
Agenesia
Retrogressive change characterized by failure of an organ to form an opening
Atresia
Retrogressive change characterized by acquired decrease in size of a normally developed or mature tissue or organ. It can be PHYSIOLOGIC or PATHOLOGIC
Atrophy
Retrogressive change characterized by failure of an organ to reach or achieve its full mature or adult size due to incomplete development
Hypoplasia
Types of PROGRESSIVE CHANGES:
- Hypertrophy
- Hyperplasia
Increase in size of tissues or organs due to INCREASE IN THE SIZE of individual cells:
Hypertrophy
Usually observed in the skeletal muscles, heart, kidney, endocrine organs and smooth muscles of hollow viscera due to increased work load and endocrine. Examples include
- Uterine hypertrophy during pregnancy
- Bulging muscles of bodybuilders
Physiologic hypertrophy
Due to edema fluid and connective tissue proliferation, Examples include:
- Enlargement of the heart in response to pressure overload
Pathologic hypertrophy
Involves one of the paired organs when the other opposite organ has been removed or suffered from functional insufficiency
Compensatory hypertrophy
Increase in size of an organ or tissue due to INCREASE IN THE NUMBER of cells resulting from growth of new cells:
Hyperplasia
Due to the action of hormones or growth factors occurs when there is a need to increase functional capacity of hormone sensitive organs occurring as natural phenomenon. Example include:
- ENLARGMENT OF FEMALE BREAST AT PUBERTY AND DURING PREGNANCY
Physiologic hyperplasia
Caused by excessive or inappropriate actions of hormones or growth factors acting on target cells. Examples include:
- Endometrial hyperplasia which is a common cause of abnormal uterine bleeding
- Benign prostatic hypeplasia
- Viral infections, such as papillomaviruses
Pathological hyperplasia
Examples of DEGENERATIVE CHANGES:
- Dysplasia
- Anaplasia
- Metaplasia
- Neoplasia
mnemonic: “DAMN”
Regressive alteration in adult cells manifested by variation in size, shape and orientation, associated with chronic inflammation and protracted irritation
Dysplasia
Marked regressive change in adult cells toward more primitive or embryonic cell types, utilized as a criterion toward malignancy/ example: Carcinoma
Anaplasia
Reversible change involving the transformation in one type of adult cell to another
Metaplasia
Continuous abnormal proliferation of cells without control; represents a pathologic overgrowth of the tissue:
Neoplasia
IRREVERSIBLE degenerative changes:
Neoplasia
Anaplasia
REVERSIBLE degenerative changes:
Metaplasia
Dysplasia
Represents a pathologic condition or overgrowth of tissue and is usually autonomous in nature; means “new growth” and a new growth is called neoplasmas
Neoplasia
TWO PARTS OF TUMOR:
- Parenchyma
- Stroma
Part of tumor that refers to the active elements of the tumor
Parenchyma
Part of the tumor that refers to the connective tissue framework with lymphatic and vascular channels
Stroma
Classification of TUMOR according to CAPACITY TO PRODUCE DEATH
Benign
Malignant
Encapsulated’ grow slowly’ non-spreading’ minima; mitotic activity; resemble parent tissue; DO NOT PRODUCE DEATH
BENIGN TUMOR
Benign tumors arising from GLANDS
Adenoma
Mnemonic: PE ‘GA’ = Glands-Adenoma
Benign tumors arising from EPITHELIAL SURFACES:
Papilloma
mnemonic: ‘PE’ GA = Papilloma-Epithelial surfaces
Increase number of cells; invades tissue; lymphatic spread; metastasis; with nuclear structures; WILL PRODUCE DEATH
Malignant tumor
Malignant tumors of EPITHELIAL tissue origin:
CARCINOMA
mnemonic: ‘CE’ SC = Carcinoma-Epithelial tissue
Malignant tumors of CONNECTIVE tissue of origin
SARCOMA
mnemonic: CE ‘SC’ = Sarcoma-Connective tissue
Classification of TUMOR according to HISTOLOGIC CHARACTERISTICS
- Medullary tumors
- Scirrhous tumors
There are more cells than connective tissues; it is SOFT and VERY MALIGNANT
Medullary tumors
There are more connective tissues than cells; it is characterized as STONY and HARD
Scirrhous tumors
Suffix used for Benign Tumors:
-oma
Suffix used for Malignant Tumors of Mesenchymal/Connective tissue:
-sarcoma
Suffix used for Malignant Tumors of Epithelial Tissue:
-carcinoma
examples:
Glands and Ducts - AdenoCARCINOMA
Finger-like (warty) projections - Papillary CARCINOMA
Grading of Tumors:
Differentiated Cells: Resembles NORMAL CELLS
Undifferentiated Cells: Resembles YOUNGER CELLS
BRODERS CLASSIFICATION
Grade I
Differentiated cells:
Undifferentiated cells:
Remarks:
BRODERS CLASSIFICATION
Grade I
Differentiated cells: 76-100%
Undifferentiated cells: 0-25%
Remarks: Well-differentiated
BRODERS CLASSIFICATION
Grade II
Differentiated cells:
Undifferentiated cells:
Remarks:
BRODERS CLASSIFICATION
Grade II
Differentiated cells: 51-75%
Undifferentiated cells: 26-50%
Remarks: Moderately-differentiated
BRODERS CLASSIFICATION
Grade III
Differentiated cells:
Undifferentiated cells:
Remarks:
BRODERS CLASSIFICATION
Grade III
Differentiated cells: 26-50%
Undifferentiated cells: 51-75%
Remarks: Poorly-differentiated
BRODERS CLASSIFICATION
Grade IV
Differentiated cells:
Undifferentiated cells:
Remarks:
BRODERS CLASSIFICATION
Grade IV
Differentiated cells: 0-25%
Undifferentiated cells: 76-100%
Remarks: Anaplastic/Pleomorphic
Value of grading: Guide for treatment
LOWER GRADES:
HIGHER GRADES:
Value of grading: Guide for treatment
LOWER GRADES: SURGERY
HIGHER GRADES: FOR RADIATION/CHEMOTHERAPY
General Rule in BRODER’S CLASSIFICATION:
- Well-differentiated tumors are LESS MALIGNANT
- Higher grades have generally poorer diagnosis
STAGING OF TUMORS
Primary tumors:
STAGING OF TUMORS
Primary tumors:
- T = T1, T2, T3, T4: with INCREASING size of primary lesion
STAGING OF TUMROS
Regional Lymph Nodes Involvement:
STAGING OF TUMROS
Regional Lymph Nodes Involvement:
- N = N0, N1, N2, N3: Indicates PROGRESSIVELY advancing nodal disease
STAGING OF TUMROS
Metastasis:
STAGING OF TUMROS
Metastasis:
- M = M0, M1, M2: Whether there are distant METASTASIS (transfer of abnormal cell from one organ to another)
TWO TYOES OF CELL DEATH:
- Cellular Death
- Somatic Death
Refers to the death of individual cells and can encompass various mechanisms
Cellular Death
Refers to the death of the entire organism, which ultimately results in the death of all the cells in the body
Somatic Death
Types of CELLULAR DEATH:
- Apoptosis
- Necrobiosis
- Necrosis
the PROGRAMMED cell death; often PHYSIOLOGIC, means of elimination of unwanted cells; maybe PATHOLOGIC often some forms of cell injury, especially DNA damage; Morphological identified by NUCLEAR CONDENSATION
APOPTOSIS
The PHYSIOLOGIC cell death
NECROBIOSIS
The PATHOLOGIC cell death
NECROSIS
Basic morphologic changes/Hallmark changes seen in necrosis
Nuclear changes:
- Pyknosis
- Karyorrhexis
- Karyolysis
Reduction in size and condensation of the nucleus:
Pyknosis
Segmentation and fragmentation of the nucleus:
Karyorrhexis
Dissolution of the nucleus:
Karyolysis
Large and granular (cloudy swelling), more acidophilic, dense and opaque, cell boundary is lost, granular coagulation and fragmentation
Cytoplasmic changes
Types of necrosis according to location or extent:
- Focal necrosis
- Massive necrosis
Necrosis that involves a SPECIFIC organ or a particular structure:
Focal necrosis
Necrosis that involves the WHOLE or GREATER part of the organ
Massive necrosis
Types of necrosis according to morphologic changes:
- Coagulative necrosis
- Liquefactive necrosis
- Fat necrosis
- Caseous necrosis
- Gangrenous necrosis
Most common type of necrosis; characterized by TOMBSTONE FORMATION; usually encountered when the ARTERIAL SUPPLY IS CUT OFF anemic or ischemic infarction; also seen in myocardial infarction
COAGULATIVE NECROSIS
Caused by RAPID TOTAL ENZYMATIC DISSOLUTION of the cells with complete destruction of the entire cell; Seen in BACTERIAL INFECTIONS which lead to the formation of pus, probably due to the release of proteolytic enzymes; most commonly encountered in the BRAIN causing HYPOXIC DEATH OF CNS
LIQUEFACTIVE NECROSIS
Involves the peculiar destruction of tissue particularly found in PANCREATIC DEGENERATION resulting to the release of lipase; morphologically, the tissue is characterized by presence of a dull, opaque circumscribed, flat area with CHALKY WHITE PRECIPITATE
FAT NECROSIS
SOFT, FRIABLE CHEESE appearance in its gross state; highly associated with TUBERCULOSIS, also in syphilis, tularemia, and lymphagranuloma inguinale
CASEOUS NECROSIS
Refers to the MASSIVE DEATH OR NECROSIS OF TISSUE caused by combination of ischemia and superimposed bacterial infection
GANGRENOUS NECROSIS
DRY gangrene is caused by:
Arterial occlusion (ex. Hands)
WET gangrene is caused by:
Venous occlusion (ex. Foot -DM)
Primary changes of death (somatic death):
- NERVOUS FAILURE
- loss of coordination of various functions, chiefly loss of reflexes - CIRCULATORY FAILURE
- occur when cardiac function ceases, absence of pulse and heartbeat - RESPIRATORY FAILURE
- absence of oxygen and accumulation of carbon dioxide with loss of oxidative process needed for life
mnemonic: NCR
Secondary changes of death (somatic death):
- Algor mortis
- Rigor mortis
- Livor mortis
- Post-mortem clot
- Desiccation
- Putrefaction
- Autolysis
FIRST DEMONSTRABLE CHANGE observed, characterized by COOLING OF THE BODY, occurRing at definite rate of about 7F/hour and usually important in establishing APPROXIMATE TIME OF DEATH
ALGOR MORTIS
Refers to the RIGIDITY OR STIFFENING of the muscle occurring about 6-12 HOURS after death and persisting for 3-4 DAYS. Change is first seen in the MUSCLES OF THE HEAD AND NECK, later spreading towards the lower extremities, and subsequently disappearing in the same sequence
RIGOR MORTIS
PURPLISH DISCOLORATION of the body due to STASIS and eventual SETTLING DOWN of blood into blood vessels
LIVOR MORTIS
Difference between LIVOR MORTIS and ECCHYMOSIS
Application of pressure:
Oozing blood upon incision:
Location:
Difference between LIVOR MORTIS and ECCHYMOSIS
Application of pressure
LM: discoloration DISAPPEARS UPON PRESSURE and reappears upon release
ECCHYMOSIS: No changes
Oozing blood upon incision:
LM: POSITIVE (+)
ECCHYMOSIS: NEGATIVE (-)
Location:
LM: BLOOD VESSELS
ECCHYMOSIS: TISSUE
Occurs slowly, IMMEDIATELY AFTER DEATH, and may sometimes complicate the determination of the cause of death, particularly regarding the differentiation between post-mortem clots or thrombi
POST-MORTEM CLOT
Immediately after death;
“Chicken Fat” appearance
“Currant Jelly” shaped blood vessels
“Rubbery” consistency
POST-MORTEM CLOT
Before death;
Friable
Tangled, irregular fashion
Detachable, do not have a rubbery consistency
ANTE-MORTEM CLOT
DRYING and WRINKLING OF THE CORNEA and anterior chamber of eye due to absorption of the aqueous humor
DESICCATION
This is characterized by production of FOUL-SMELLING GASES due to the invasion of the tissue by multiplying saprophytic organisms
PUTREFACTION
SELF-DIGESTION of cells
AUTOLYSIS
All are signs of someone who has COVID-19, EXCEPT:
A. Loss of test
B. Productive cough
C. Fever
D. Positive SARC-COV-2 antigen
A. Loss of taste - Symptom, not sign
Rubor: Redness; Calor:
A. Swelling
B. Pain
C. Heat
D. Loss of function
C. Heat
Which of the following wounds is caused by friction against a rough surface?
A. Laceration
B. Contusion
C. Hematoma
D. Abrasion
D. Abrasion
Which among the choices below is a closed wound?
A. Abrasion
B. Laceration
C. Hematoma
D. Amputation
C. Hematoma
What progressive change is characterized by an increase in size of tissues or organs due to increase in the size of individual cells?
A. Hyperplasia
B. Hypoplasia
C. Hypertrophy
D. Neoplasia
C. Hypertrophy
Which of the following is an IRREVERSEIBLE change of tissue?
A. Metaplasia
B. Dysplasia
C. Anaplasia
D. Neoplasia
D. Neoplasia - 1st choice!
C. Anaplasia is also irreversible but the first choice must be Neoplasia
Neoplasia - 1st choice
Anaplasia - 2nd choice
What is the malignant tumor of epithelial tissue origin, which have less tendency to produce supporting tissue/stroma?
A. Sarcoma
B. Carcinoma
C. Adenoma
D. Papilloma
B. Carcinoma
What is the physiologic cell death?
A. Necrosis
B. Apoptosis
C. Necrosis and Apoptosis
D. Somatic death
B. Apoptosis #1 NECROBIOSIS
note: Apoptosis is OFTEN PHYSIOLOGIC, means of elimination of unwanted cells; MAYBE PATHOLOGIC often some forms of cell injury, especially DNA damage’ It is morphological identified by NUCLEAR CONDENSATION.
Somatic death refers to the death or complete cessation of metabolic and functional activities of the organism or the body as a whole. What are the primary changes of death?
A. Nervous and circulatory failure
B. Respiratory failure
C. Nervous, Circulatory and Respiratory failure
D. AOTA
D. AOTA (all of the above)