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Pathology Flashcards

1
Q

Signs of apoptosis

A 
cell shrinkage
nuclear shinkage (pyknosis)
basophilia
membrane blebbing
nuclear fragmentation (karyorrhexis)
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2
Q

When is intrinsic pathway most active

A

embryogenesis with tissue remodeling

Injury repair

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3
Q

Describe the intrinsic pathway

A

Increased Bax
Decreased Bcl-2
mitochondrial permeability
cytochrome C release

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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

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5
Q

Which organs have liquefactive necrosis

A

Brain, pleural effusion

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6
Q

When do you see fibrinoid necrosis

A

Blood vessels (HTN or vasculitis)

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7
Q

When do you see gangrenous necrosis

A

dry (ischemic)
wet (with bacteria)
Occurs in LIMBS and GI TRACT

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8
Q

Which parts of kidney are most susceptible to damage?

A

medulla

-thick ascending limb and proximal tubule

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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)

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10
Q

Which cells of brain are killed first in global ischemia of brain

A

pyramidal cells of hippocampus

purkinje cells

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11
Q

Red infarct

A

dual supply organs from reperfusion and free radical damage

–lung, liver, intestine

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12
Q

pancreatic cancer risk

A

tobacco

obesity

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13
Q

gastric cancer risk

A

nitrates
tobacco
alcohol

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14
Q

liver cancer risk

A

Hep
cirrhosis
hemachromatosis
aflatoxin

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15
Q

CRC cancer risk

A

IBD
Obesity
charred food

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16
Q

renal cancer

A

smoking
obesity
HTN

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17
Q

bladder cancer

A

tobacco
rubber, aniline dyes
textile

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18
Q

Breast cancer

A

early menarch
late menopause
nulliparity
BRCA

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19
Q

Prostate

A

African american

age

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20
Q

neutrophil rolling

A

vessel: E/P-selectin
WBC: sialyl lewis

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21
Q

neutrophil binding

A

vascular: ICAM-1
WBC: LFA-1 (integrin)

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22
Q

WBC diapedesis

A

Vessel and WBC: PECAM-1

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23
Q

Migration

A

C5a
IL-8
LTB4
Kallikrein

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24
Q

mechanisms by which free radicals damage cells

A

membrane peroxidation
protein modification
DNA breaks

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25
Q

Examples of free radical injury

A

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

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26
Q

Three phases of wound healing

A

inflammatory (neutrophils)
Proliferative (2-3 days, macrophages, keratinocytes, myofibroblasts)
Remodeling (1 week, fibroblasts)

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27
Q

Proliferative wound healing

A

Deposition of granulation tissue(macro) and collagen (fibroblasts)
epithelial cell proliferation (keratinocyte)
contraction of wound (myofibroblast)
angiogenesis (endothelial cells)
Dissolution of clot

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28
Q

Remodeling wound healing

A

Type III collagen replaced by type I

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29
Q

Th1 cells

A

secrete gamma IFN, activating macrophages
Macrophages secrete TNF-alpha
Maintenance of granuloma

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30
Q

Be wary of giving TNF-alpha inhibitors to

A

TB pts

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31
Q

Causes of exudate

A

lymphatic obstruction or inflammation

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32
Q

Decreased ESR:

A

Problems with RBCs usually…
sickle cell
polycythemia
CHF (known)

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33
Q

Increased ESR

A

cancer, pregnancy, SLE

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34
Q

How does iron cause cell death

A

peroxidation of membrane lipids

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35
Q

Acute iron poisoning sx:

A

gastric bleed

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36
Q

Chronic iron poisoning sx:

A

metabolic acidosis and GI obstruction

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37
Q

Amyloid light chain dz

A

plasma cell disorder or multiplemyeloma

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38
Q

Amyloid A dz seen in:

A

RA, IBD, spondyloarthropathy, chronic infection. Multisystem disorder

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39
Q

Dialysis related amyloidosis

A

Fibrils of B2 microglobulin in ESRD pts causing deposition.

–Carpal tunnel and joint problems

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40
Q

Heritable amyloid disease

A

Transthyretin gene mutation

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41
Q

Age related amyloidosis

A

Deposition of normal tranthyretin causes slowly progressive amyloidosis

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42
Q

Organ specific amyloidosis

A

Alzheimer’s disease

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43
Q

How do cancer cells become metastatic?

A

Release of hydrolases and collagenases to break through basement membrane

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44
Q

Anaplasia vs neoplasia

A

anaplasia: no differentiation, primitive looking with no resemblance to original tissue

Neoplasia: clonal proliferation that is excessive

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45
Q

Desmoplasia

A

Fibrous tissue formation in response to neoplasm

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46
Q

Which is more prognostic, grade or stage?

A

Stage usually

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47
Q

Carinoma vs sarcoma

A

sarcoma means mesenchymal origin

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48
Q

which cytokines are responsible for cachexia?

A

TNF-alpha
IFN-y
IL-6

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49
Q

Down’s associated with

A

ALL, AML

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50
Q

xeroderma pigmentosum, albinosum associated w

A

squamous cell carcinoma

also melanoma and basal cell

51
Q

gastric adenocarinoma assoc’d w

A

atrophic gastritis

pernicious anemia

52
Q

tuberous sclerosis associated with

A

giant cell astrocytoma
renal angiomyolipoma
cardiac rhabdomyoma

53
Q

Plummer vinson syndrome assoc’d with

A

squamous cell carcinoma of esophagus

54
Q

barrett’s esophagus

A

esophageal adenocarcinoma

55
Q

ulcerative colitis

A

colonic adenocarc

56
Q

paget’s disease of bone

A

secondary osteosarcoma and fibrosarcoma

57
Q

Immunodeficiency states

A

malignant lymphomas

58
Q

AIDS+other autoimmune disorders

A

lymphomas

59
Q

Acanthosis nigracans

A

visceral malignancy

60
Q

radiation exposure

A

leukemia, sarcoma, papillary thyroid cancer and breast cancer

61
Q

abl gene

A

Tyrosine kinase–>CML

oncogene

62
Q

c-myc

A

burkitt’s–>transcription factor

oncogene

63
Q

bcl-2

A

follicular and other lymphomas

oncogene

64
Q

HER2/neu

A

breast, ovarian, gastric carcinomas–>tyrosine kinase

oncogene

65
Q

Ras

A

colon carcinoma–>GTPase

oncogene

66
Q

L-myc

A

Lung tumor–>transcription factor

oncogene

67
Q

N-myc

A

neuroblastoma–>transcription factor

oncogene

68
Q

ret

A

MEN2A and MEN2B–>tyrosine kinase

oncogene

69
Q

c-kit

A

gastrointestinal stromal tumor–>cytokine receptor

oncogene

70
Q

Rb

A

retinoblastoma osteosarcoma
inhibits E2F; G1-S

tumor suppressor

71
Q

p53

A

Li-Fraumeni etc.
transcribes p21; G1-S

tumor suppressor

72
Q

BRCA1/2

A

Breast and ovarian
DNA repair protein

tumor suppressor

73
Q

p16

A

melanoma

tumor suppressor

74
Q

BRAF

A

melanoma–>B-raf protein

tumor suppressor

75
Q

WT1

A

Wilm’s tumor

tumor suppressor

76
Q

NF1

A

Neurofibromatosis
RAS GTPase activating protein

tumor suppressor

77
Q

NF2

A 
Neurofibromatosis
Merlin protein (schwannomin)

tumor suppressor

78
Q

DPC4

A

Pancreatic cancer

tumor suppressor

79
Q

DCC

A

Colon cancer

tumor suppressor

80
Q

Li Fraumeni

A

Inherited AUTOsomal dominant loss of p53

  • -inherit only one allele, 2nd hit hypothesis
  • -malignancies under age 45
81
Q

PSA elevated in

A

BPH and prostatitis

82
Q

Prostatic acid phosphatase

A

Dx for prostate cancer

83
Q

CEA

A

pancreatic and CRC cancer

Also, gastric, breast, and medullary thyroid

84
Q

alpha fetoprotein

A

HCC

nonseminomatous germ cell tumors

85
Q

beta hCG

A

hydatidiform moles and choriocarcinomas

86
Q

CA-125

A

ovarian cancer

87
Q

S-100

A

melanoma, schwannomas

88
Q

alkaline phosphatases

A

Bone metastases
Liver cancer
Paget’s disease of bone

89
Q

Bombesin

A

Neuroblastoma

lung/gastric

90
Q

TRAP

A

hairy cell leukemia

91
Q

CA-19-9

A

pancreatic adenocarcinoma

92
Q

Chlonorchis sinensis

A

Cholangiocarcinoma (liver fluke)

93
Q

HHV-8

A

kaposi’s sarcoma

94
Q

HPV

A

upper respiratory SCC

95
Q

HTLV-1

A

Adult T cell leukemia

96
Q

EBV

A

burkitt’s
hodgkin’s
nasopharyngeal carcinoma
CNS lymphoma

97
Q

CCl4 causes

A

centrilobular necrosis and fatty liver

98
Q

arsenic

A

squamous cell carcinoma

angiosarcoma

99
Q

naphthalene

A

transitional cell carcinoma of bladdder

100
Q

alkylating agents

A

leukemia

101
Q

Vinyl chloride

A

angiosarcoma of liver

102
Q

Nitrosoamines (smoked food)

A

gastric cancer

103
Q

cigarette smoke

A 
squamous cell (larynx)
squamous/small cell (lung)
renal cell carcinoma
transitional cell carcinoma
pancreatic adenocarcinoma
104
Q

ACTH peptide

A

Small cell lung cancer

105
Q

ADH

A

small cell carcinoma (intracranial)

106
Q

PTHrP

A

squamous cell cancer

RCC

107
Q

Vitamin D

A

Hodgkins lympoma

other lymphomas

108
Q

Erythropoietin

A

Renal cell
Hemangioblastoma
HCC
Pheo

“Ride Hard Pedal Hard (w/ lance)”

109
Q

Lambert Eaton

A

Small cell lung cancer

110
Q

Psamomma bodies

A

Papillary thyroid
Serous (ovary)
Meningioma
mesothelioma

111
Q

Highest incidence cancers in men

A

Prostate
Lung
Colon/rectum

112
Q

Highest incidence cancers in women

A

Breast
Lung
Colon/rectum

113
Q

Highest mortality cancer men

A

lung

prostate

114
Q

Highest mortality cancer women

A

lung

breast

115
Q

Which cancers metastasize to brain?

A

Lung>breast>GU>osteosarcoma>melanoma>GI

–>usually at gray/white matter junction

116
Q

which cancers metastasize to liver?

A

COLON

stomach, pancreas

117
Q

Which cancers metastasize to bone?

A

Prostate, breast>lung>thyroid/testes
Lung=lytic bone lesions
prostate=blastic bone lesions
breast-lytic and blastic bone lesions

118
Q

What is lipofuscin?

A

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
Q

What does hemosiderin look like?

A

yellow brown pigment

120
Q

Superficial venous thromboses (thrombophelbitis) is an indication of

A

Visceral cancer

–Cancers can produce a thromboplastin like substance

121
Q

N-myc

A

oncogene seen in neuroblastoma

122
Q

Cyclin D overexpression

A

breast, lung, esophageal cancers and lymphomas

123
Q

WT-1

A

tumor suppressor=Wilm’s tumor

124
Q

Kras

A

proto oncogene

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