Pathology Flashcards
1
Q
Signs of apoptosis
A
cell shrinkage nuclear shinkage (pyknosis) basophilia membrane blebbing nuclear fragmentation (karyorrhexis)
2
Q
When is intrinsic pathway most active
A
embryogenesis with tissue remodeling
Injury repair
3
Q
Describe the intrinsic pathway
A
Increased Bax
Decreased Bcl-2
mitochondrial permeability
cytochrome C release
4
Q
Describe the extrinsic pathway
A
Fas ligand binds Fas-R (CD95)
- Cytosolic caspases activated
- Cellular breakdown
OR
Killer T cell releases granzyme and perforin
5
Q
Which organs have liquefactive necrosis
A
Brain, pleural effusion
6
Q
When do you see fibrinoid necrosis
A
Blood vessels (HTN or vasculitis)
7
Q
When do you see gangrenous necrosis
A
dry (ischemic)
wet (with bacteria)
Occurs in LIMBS and GI TRACT
8
Q
Which parts of kidney are most susceptible to damage?
A
medulla
-thick ascending limb and proximal tubule
9
Q
Which parts of colon are susceptible to hypoxia?
A
splenic flexure and rectum
–dual blood supply to distal areas protects from single vessel blockage, but not systemic ischemia (aka watershed)
10
Q
Which cells of brain are killed first in global ischemia of brain
A
pyramidal cells of hippocampus
purkinje cells
11
Q
Red infarct
A
dual supply organs from reperfusion and free radical damage
–lung, liver, intestine
12
Q
pancreatic cancer risk
A
tobacco
obesity
13
Q
gastric cancer risk
A
nitrates
tobacco
alcohol
14
Q
liver cancer risk
A
Hep
cirrhosis
hemachromatosis
aflatoxin
15
Q
CRC cancer risk
A
IBD
Obesity
charred food
16
Q
renal cancer
A
smoking
obesity
HTN
17
Q
bladder cancer
A
tobacco
rubber, aniline dyes
textile
18
Q
Breast cancer
A
early menarch
late menopause
nulliparity
BRCA
19
Q
Prostate
A
African american
age
20
Q
neutrophil rolling
A
vessel: E/P-selectin
WBC: sialyl lewis
21
Q
neutrophil binding
A
vascular: ICAM-1
WBC: LFA-1 (integrin)
22
Q
WBC diapedesis
A
Vessel and WBC: PECAM-1
23
Q
Migration
A
C5a
IL-8
LTB4
Kallikrein
24
Q
mechanisms by which free radicals damage cells
A
membrane peroxidation
protein modification
DNA breaks
25
Examples of free radical injury
retinopathy of prematurity
bronchopulmonary dysplasia (neonates given PPV and O2)
carbon tetrachloride=liver necrosis
Acetaminophen overdose (fulminant hepatitis)
Iron overload
Reperfusion after anoxia and thrombolytic therapy
26
Three phases of wound healing
inflammatory (neutrophils)
Proliferative (2-3 days, macrophages, keratinocytes, myofibroblasts)
Remodeling (1 week, fibroblasts)
27
Proliferative wound healing
Deposition of granulation tissue(macro) and collagen (fibroblasts)
epithelial cell proliferation (keratinocyte)
contraction of wound (myofibroblast)
angiogenesis (endothelial cells)
Dissolution of clot
28
Remodeling wound healing
Type III collagen replaced by type I
29
Th1 cells
secrete gamma IFN, activating macrophages
Macrophages secrete TNF-alpha
Maintenance of granuloma
30
Be wary of giving TNF-alpha inhibitors to
TB pts
31
Causes of exudate
lymphatic obstruction or inflammation
32
Decreased ESR:
Problems with RBCs usually...
sickle cell
polycythemia
CHF (known)
33
Increased ESR
cancer, pregnancy, SLE
34
How does iron cause cell death
peroxidation of membrane lipids
35
Acute iron poisoning sx:
gastric bleed
36
Chronic iron poisoning sx:
metabolic acidosis and GI obstruction
37
Amyloid light chain dz
plasma cell disorder or multiplemyeloma
38
Amyloid A dz seen in:
RA, IBD, spondyloarthropathy, chronic infection. Multisystem disorder
39
Dialysis related amyloidosis
Fibrils of B2 microglobulin in ESRD pts causing deposition.
| --Carpal tunnel and joint problems
40
Heritable amyloid disease
Transthyretin gene mutation
41
Age related amyloidosis
Deposition of normal tranthyretin causes slowly progressive amyloidosis
42
Organ specific amyloidosis
Alzheimer's disease
43
How do cancer cells become metastatic?
Release of hydrolases and collagenases to break through basement membrane
44
Anaplasia vs neoplasia
anaplasia: no differentiation, primitive looking with no resemblance to original tissue
Neoplasia: clonal proliferation that is excessive
45
Desmoplasia
Fibrous tissue formation in response to neoplasm
46
Which is more prognostic, grade or stage?
Stage usually
47
Carinoma vs sarcoma
sarcoma means mesenchymal origin
48
which cytokines are responsible for cachexia?
TNF-alpha
IFN-y
IL-6
49
Down's associated with
ALL, AML
50
xeroderma pigmentosum, albinosum associated w
squamous cell carcinoma
| also melanoma and basal cell
51
gastric adenocarinoma assoc'd w
atrophic gastritis
| pernicious anemia
52
tuberous sclerosis associated with
giant cell astrocytoma
renal angiomyolipoma
cardiac rhabdomyoma
53
Plummer vinson syndrome assoc'd with
squamous cell carcinoma of esophagus
54
barrett's esophagus
esophageal adenocarcinoma
55
ulcerative colitis
colonic adenocarc
56
paget's disease of bone
secondary osteosarcoma and fibrosarcoma
57
Immunodeficiency states
malignant lymphomas
58
AIDS+other autoimmune disorders
lymphomas
59
Acanthosis nigracans
visceral malignancy
60
radiation exposure
leukemia, sarcoma, papillary thyroid cancer and breast cancer
61
abl gene
Tyrosine kinase-->CML
| oncogene
62
c-myc
burkitt's-->transcription factor
| oncogene
63
bcl-2
follicular and other lymphomas
| oncogene
64
HER2/neu
breast, ovarian, gastric carcinomas-->tyrosine kinase
| oncogene
65
Ras
colon carcinoma-->GTPase
| oncogene
66
L-myc
Lung tumor-->transcription factor
| oncogene
67
N-myc
neuroblastoma-->transcription factor
| oncogene
68
ret
MEN2A and MEN2B-->tyrosine kinase
| oncogene
69
c-kit
gastrointestinal stromal tumor-->cytokine receptor
| oncogene
70
Rb
retinoblastoma osteosarcoma
inhibits E2F; G1-S
tumor suppressor
71
p53
Li-Fraumeni etc.
transcribes p21; G1-S
tumor suppressor
72
BRCA1/2
Breast and ovarian
DNA repair protein
tumor suppressor
73
p16
melanoma
tumor suppressor
74
BRAF
melanoma-->B-raf protein
tumor suppressor
75
WT1
Wilm's tumor
tumor suppressor
76
NF1
Neurofibromatosis
RAS GTPase activating protein
tumor suppressor
77
NF2
```
Neurofibromatosis
Merlin protein (schwannomin)
```
tumor suppressor
78
DPC4
Pancreatic cancer
tumor suppressor
79
DCC
Colon cancer
tumor suppressor
80
Li Fraumeni
Inherited AUTOsomal dominant loss of p53
- -inherit only one allele, 2nd hit hypothesis
- -malignancies under age 45
81
PSA elevated in
BPH and prostatitis
82
Prostatic acid phosphatase
Dx for prostate cancer
83
CEA
pancreatic and CRC cancer
Also, gastric, breast, and medullary thyroid
84
alpha fetoprotein
HCC
| nonseminomatous germ cell tumors
85
beta hCG
hydatidiform moles and choriocarcinomas
86
CA-125
ovarian cancer
87
S-100
melanoma, schwannomas
88
alkaline phosphatases
Bone metastases
Liver cancer
Paget's disease of bone
89
Bombesin
Neuroblastoma
| lung/gastric
90
TRAP
hairy cell leukemia
91
CA-19-9
pancreatic adenocarcinoma
92
Chlonorchis sinensis
Cholangiocarcinoma (liver fluke)
93
HHV-8
kaposi's sarcoma
94
HPV
upper respiratory SCC
95
HTLV-1
Adult T cell leukemia
96
EBV
burkitt's
hodgkin's
nasopharyngeal carcinoma
CNS lymphoma
97
CCl4 causes
centrilobular necrosis and fatty liver
98
arsenic
squamous cell carcinoma
| angiosarcoma
99
naphthalene
transitional cell carcinoma of bladdder
100
alkylating agents
leukemia
101
Vinyl chloride
angiosarcoma of liver
102
Nitrosoamines (smoked food)
gastric cancer
103
cigarette smoke
```
squamous cell (larynx)
squamous/small cell (lung)
renal cell carcinoma
transitional cell carcinoma
pancreatic adenocarcinoma
```
104
ACTH peptide
Small cell lung cancer
105
ADH
small cell carcinoma (intracranial)
106
PTHrP
squamous cell cancer
| RCC
107
Vitamin D
Hodgkins lympoma
| other lymphomas
108
Erythropoietin
Renal cell
Hemangioblastoma
HCC
Pheo
"Ride Hard Pedal Hard (w/ lance)"
109
Lambert Eaton
Small cell lung cancer
110
Psamomma bodies
Papillary thyroid
Serous (ovary)
Meningioma
mesothelioma
111
Highest incidence cancers in men
Prostate
Lung
Colon/rectum
112
Highest incidence cancers in women
Breast
Lung
Colon/rectum
113
Highest mortality cancer men
lung
| prostate
114
Highest mortality cancer women
lung
| breast
115
Which cancers metastasize to brain?
Lung>breast>GU>osteosarcoma>melanoma>GI
| -->usually at gray/white matter junction
116
which cancers metastasize to liver?
COLON
| stomach, pancreas
117
Which cancers metastasize to bone?
Prostate, breast>lung>thyroid/testes
Lung=lytic bone lesions
prostate=blastic bone lesions
breast-lytic and blastic bone lesions
118
What is lipofuscin?
intracellular, yellow brown pigment resulting from free radical injury and lipid peroxidation.
Seen in the heart/liver of aging/cachectic patients. Caused by "wear and tear"
119
What does hemosiderin look like?
yellow brown pigment
120
Superficial venous thromboses (thrombophelbitis) is an indication of
Visceral cancer
| --Cancers can produce a thromboplastin like substance
121
N-myc
oncogene seen in neuroblastoma
122
Cyclin D overexpression
breast, lung, esophageal cancers and lymphomas
123
WT-1
tumor suppressor=Wilm's tumor
124
Kras
proto oncogene
