Pathology

Question 1

What are characteristics of apoptosis?

Answer 1

1) eosinophilic cytoplasm
2) cell / nuclear shrinkage
3) membrane blebbing
4) nuclear fragmentation (karyorrhexis)
5) apoptotic bodies which undergo phagocytosis

Question 2

what are indicators of apoptosis?

Answer 2

1) DNA laddering. during karyorrhexis (nuclear fragmentation), endonucleases cleave at internucleosomal regions –> 180 bp fragments.

Question 3

intrinsic pathway specific molecules

Answer 3

1) imbalance of anti- / pro apoptotic factors –> incr. mitochondrial permeability + CYTOCHROME C release.
2) BAX / BAK = pro APOPTOSIS
3) Bcl-2 –> prevents cytochrome C release / Apaf-1 mediated activation of caspases

Question 4

2 pathways of extrinsic pathway

Answer 4

1) ligand receptor: FasL binding to CD95 [Fas]

2) immune cell mediated: cytotoxic T-cell release of perforin / granzyme B

Question 5

example of Fas-FasL interaction

Answer 5

thymic medullary negative selection. defective Fas-FasL binding –> autoimmune disorders

Question 6

differences b/w coagulative + liquefactive necrosis

Answer 6

1) coagulative = proteins denature first, followed by enzymatic degradation
2) liquefactive: lysosomal enzymes released followed by enzymatic degradation

Question 7

difference b/w red vs. pale infarct

Answer 7

red = hemorrhagic –> loose tissues w/ multiple blood supplies, with injury due to reperfusion injury.
pale infarts = single blood supply –> solid tissues.

Question 8

pathogenesis of granulomas

Answer 8

Th1 cells secrete y-interferon –> macrophage activation –> TNF-a secretion –> granuloma formation. TEST for LATENT TB before starting anti-TNF therapy as granulomas make breakdown and cause disseminated disease

Question 9

primary amyloidosis

Answer 9

deposition of proteins from Ig Light chains (plasma cell disorder / multiple myeloma) (affects multiple organ systems)

Question 10

AA amyloidosis

Answer 10

2ndary due to chronic conditions. fibrils of amyloid A –> multisystem

Question 11

dialysis related amyloidosis

Answer 11

fibrils of B2-microglobulin w/ ESRD / long-term dialysis –> presents as carpal tunnel syndrome

Question 12

age-related systemic amyloidosis

Answer 12

normal TTR deposition in myocardium / elsewhere. slow progression to cardiac dysfunction than AL amyloidosis

Question 13

Alzheimer deposition

Answer 13

amyloid-beta protein from amyloid precursor protein cleaving

Question 14

diabetes mellitus 2 deposition

Answer 14

islet amyloid polypeptide cdeposition in pancreatic islets

Question 15

hyperplasia

Answer 15

increase in cell number

Question 16

dysplasia

Answer 16

abnormal proliferation of cells w/ loss of size, shape, and orientation

Question 17

carcinoma insitu

Answer 17

1) high N:C ratio
2) clumped chromatin
3) neoplastic cells have not invaded basement membrane

Question 18

p-glycoprotein

Answer 18

multidrug resistance protein 1 (MDR1): expressed by colon / liver cancer to pump out chemotherapeutic agents

Question 19

metaplasia

Answer 19

one adult cell type replaced by another, secondary to irritation

Question 20

desmoplasia

Answer 20

fibrous tissue formation in response to neoplasm

Question 21

association between tuberous sclerosis and neoplasm

Answer 21

giant cell astroctoma, renal angiomyolipoma, cardiac rhabdomyoma

Question 22

BRAF

Answer 22

oncogene –. gain of function –> one damaged allele –> incr. cancer risk.

1) serine/threonine kinase
2) associated w/ melanoma

Question 23

c-kit

Answer 23

Gastrointestinal Stromal Tumor (GIST)

Question 24

BRCA1/BRCA2

Answer 24

tumor suppressor gene –> both alleles must be lost –> incr. cancer risk –> DNA repair protein

Question 25

p53

Answer 25

tumor suppressor gene. transcription factor for p21; blocks G1 –> S phase

Question 26

calcitonin as a tumor marker

Answer 26

medullary thyroid carcinoma

Question 27

Ca-125 as a tumor marker

Answer 27

ovarian cancer

Question 28

S100 asa tumor marker

Answer 28

neural crest cells origin (melanoma, neural tumors, schwannomas, langerhans cell histiocytosis

Question 29

PSAMMOMA Bodies

Answer 29

laminated, concentric calcific spherules.

1) papillary carcinoma of thyroid
2) serous papillar cystadenocarcinoma of ovary
3) meningioma
4) malignant mesotheioma