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Pathology Flashcards

1
Q

A defect in FAS can lead to what disease?

A

SLE (failure to kill autoreactive t cells)

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2
Q

What type of necrosis is dry gangrene?

A

Liquefactive (check this)

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3
Q

What type of necrosis is wet gangrene?

A

Liquefactive

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4
Q

Are nuclear chromatin clumping and nuclear granule disaggregation reversible or irreversible signs of cell injury?

A

Reversible (with O2)

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5
Q

Are mitochondrial permeability and vacuolization reversible or irreversible signs of cell injury?

A

Irreversible

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6
Q

Areas of red and pale infarcts respectively

A

Red - liver, lungs, intestine or following reperfusion. Pale - heart, kidney, spleen

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7
Q

Mediators of fluid exudation in inflammation

A

Histamine, Serotonin, Bradykinin

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8
Q

When is the resolution phase in inflammation?

A

Days 3-5

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9
Q

Cytokines of acute inflammation

A

IL-1, IL-6, TNF-a

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10
Q

How do acute phase cytokines (IL-1, IL-6, TNF-a) lead to WBC extravasation?

A

By causing increased selectin expression

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11
Q

Neutrophil chemotactic factors

A

C5a, IL-8, LTB4, Kallikrein

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12
Q

Delayed separation of the umbilicus, recurrent bacterial infections

A

Leukocyte adhesion deficiency syndrome, problem with LFA-1

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13
Q

Adhesion of cells to BM and ECM involves what binding to what?

A

Integrins binding to fibronectin, collagen, and laminin

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14
Q

Common cause of dishisence (wound reopening)

A

Increased intraabdominal pressure

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15
Q

Wound ulceration is usually due to what problem during healing?

A

Inadequate vascularization

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16
Q

Two main cytokines in granuloma formation and what types of cells secrete them

A

Th1 secrete g-interferon which activates macrophages to secrete TNF-a (which maintains the granuloma)

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17
Q

What causes cell death in iron poisoning?

A

Peroxidation of membrane lipids

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18
Q

What type of amyloid is associated with dialysis?

A

B2 microglobulin (derived from MHC class 1 proteins)

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19
Q

Define and give an example of anaplasia

A

Abnormal cells lacking differentiation. Eg muscles forming giant cells

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20
Q

Mediators of cachexia (3)

A

TNF-a (main one), IFN-g, IL-6

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21
Q

Neoplasms associated w/ Downs

A

ALL (main one), AML

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22
Q

Tuberous sclerosis features and neoplasms

A

Facial angiofibroma, seizures, MR. Astrocytoma, angiomyolipoma, cardiac rhabdomyoma

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23
Q

Features and neoplasms associated w/ Plummer-Vinson

A

Atrophic glossitis, esophageal webs, anemia (all due to iron def). SCC of esophagus

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24
Q

Neoplasms associated with acanthosis nigricans

A

Visceral cancers (stomach, lung, uterus)

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25
Q

Neoplasms associated w/ radiation exposure

A

Sarcoma, papillary thyroid cancer

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26
Q

Type of gene, associated tumor, and gene product of abl

A

Oncogene, CML, tyrosine kinase

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27
Q

Type of gene, associated tumor, and gene product of c-myc

A

Oncogene, burkitts, TF (controls transcription activation)

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28
Q

Type of gene, associated tumor, and gene product of bcl-2

A

Oncogene, follicular and undifferentiated lymphoma, anti-apototic

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29
Q

Type of gene, associated tumor, and gene product of ret

A

Oncogene, MEN IIA and IIB, tyrosine kinase

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30
Q

Type of gene, associated tumor, and gene product of c-kit

A

Oncogene, GIST, cytokine receptor

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31
Q

Type of gene, associated tumor, and gene product of c-jun (also called jun)

A

Oncogene, Breast and possibly endometrial, DNA binding protein involved in transcription control

32
Q

Which BRCA is involved in just breast cancer and which is involved in another cancer? What is the function of BRCA?

A

DNA repair proteins. BRCA1 also involved in ovarian cancer

33
Q

TS gene in melanoma

A

p16

34
Q

TS gene in FAP

A

APC

35
Q

TS genes in pancreatic cancer and colon cancer

A

DPC (pancreatic), and DCC (colon)

36
Q

Li-Fraumeni can lead to many cancers, particularly of which kind?

A

Sarcomas. Especially targets the breast, brain, and adrenal cortex

37
Q

What cancers produce CEA?

A

Colorectal and pancreatic. Also gastric, breast, and thyroid medullary

38
Q

What cancers is CA-125 a marker for?

A

Ovarian, malignant epithelial tumors

39
Q

What cancers is S-100 a marker for?

A

Melanoma, neural tumors, astrocytomas

40
Q

Toxins associated with liver cancer (and give the cancer for each)

A

Aflatoxin from aspergillus (HCC), Vinyl chloride (angiosarcoma), CCl4 (centrilobular necrosis and fatty change)

41
Q

Cancers associated with cigarette smoke (5)

A

Larynx - SCC, Lung - SCC and small cell, Kidney - RCC, Bladder - Transitional cell carcinoma

42
Q

What cancer do alkylating agents most often cause?

A

Leukemia

43
Q

What cancer produces antibody mediated cerebellar degeneration as a paraneoplastic effect?

A

Small cell ca of lung

44
Q

What are psammoma bodies and what cancers are they found in?

A

Laminated concentric calficic spherules (due to dystrophic calcification). Seen in Papillary adenocarcinoma of thyroid, Serous paillary cystadenocarcinoma of ovary, Meningioma, and Malignant mesothelioma

45
Q

Most common mets to brain

A

Lung, Breast, kidney, skin (in order with lung most common)

46
Q

Most common mets to liver

A

Colon, stomach, pancreas (in order with colon most common)

47
Q

Most common mets to bone

A

Prostate and breast, Lung, Thyroid and testes (with prostate and breast most common)

48
Q

If you give 100 percent O2 and po2 does not go up, do you have a ventilation defect or perfussion defect?

A

Ventilation

49
Q

ABG findings in CO poisoning

A

Hb normal, pO2 normal, O2 sat decreased

50
Q

Methemoglobinemia findings, treatment, and scenario

A

O2 sat will be decreased, other ABG normal. Causes nitrates and nitrites (unclean water) or any sulfa or nitro drug (eg dapsone). Give methylene blue and vitamin c.

51
Q

Drugs that cause G6PD hemolysis

A

Dapsone, primaquine, TMP-SMX, nitroglycerine and prusside. NB - they also cause methemoglobinemia

52
Q

3 main biochemical problems caused by CO

A

1 - Decreased O2 sat, 2 - Left shift of curve, 3 - Inhibition of cytochrome oxidase

53
Q

Why are aspirin and tylenol particularly toxic to the kidney?

A

Tylenol causes free radical damage and aspirin eliminates PGE2 (which dilates afferent arteriole) leading to ischemia (esp in medullary peritubular capillaries).

54
Q

Where can traumatic fat necrosis be seen and what distinguishes it from other entities?

A

The breast. Unlike cancer (which it looks like on mammogram), traumatic fat necrosis will be painful

55
Q

What type of hypersensitivity is at work in any palpable purpura?

A

Type 3

56
Q

How do antibody complexes lead to necrosis?

A

By activating complement which leads to C5a, which is chemotactic to neutrophils. The neutrophils do the damage

57
Q

Which liver zone is most susceptible to fatty change?

A

Zone 3

58
Q

What causes lactic acidosis in alcoholics?

A

High NADH levels (from etoh metabolism) push pyruvate towards lactate

59
Q

Why do alcoholics have fasting hypoglycemia?

A

Their pyruvate has been converted to lactate (due to high NADH levels) and you need pyruvate to start gluconeogenesis

60
Q

Why do you get fatty change in the liver in alcoholism?

A

Excess Glycerol 3 Phosphate accumulates from glycolysis. This is converted to FAs and put in VLDL. Restricting carbs will reduce fatty change

61
Q

Kwashiokor and its mechanism on liver

A

Adequate calories but inadequate protein. Failure to make apolipoproteins for LDL leads to fatty liver and ascites

62
Q

Most common causes of hypercalcemia in hospital and community respectively

A

Hospital - malignancy, Community - primary hyperparathyroidism

63
Q

How does dialysis prevent metastatic calcification?

A

You dialyze out the excess phosphate (which is very high in ESRD). Phosphate drives calcium into tissues (eg heart) which causes damage

64
Q

Examples of ubiquinated proteins (3)

A

Mallory bodies (keratin), Lewy Bodies, Neurofibrillary tangles

65
Q

Between glucagon and insulin, which is a phosphorylator and which is a dephosphorylator?

A

Glucagon is a phosphorylator and insulin is a dephosphorylator

66
Q

What chromosomes are p53 and rb located on?

A

p53 - chromosome 17, rb - 13

67
Q

Two main HPV gene products and what they target

A

E6 (targets p53) and E7 (targets Rb)

68
Q

Two parasites that cause cancer and the cancers they cause

A

Clonesis sinensis (chinese liver fluke) - cholangiocarcinoma, and Shistosoma hematobia - transition to squamous metaplasia and then cancer in the bladder

69
Q

If you have a farmer with a skin lesion that can be scraped off and grow back, what is it most likely?

A

An actinic keratosis (percursor to SCC)

70
Q

What molecules mediate pain in inflammation?

A

PGE2 and Bradykinin

71
Q

Which cells have an oxygen dependent killing system (NADPH oxidase)?

A

Neutrophils and monocytes (but not macrophages)

72
Q

Most common trigger of hemolysis in G6PD deficiency

A

Infection. They have no myeloperoxidase (because HMP shunt not working) and are susceptible to infection

73
Q

How can you tell the difference between chronic granulomatous disease and myeloperoxidase deficiency.

A

Chronic granulomatous disease - Negative (abnormal) NBT test. Myeloperoxidase deficiency - Positive (normal) NBT test.

74
Q

Genetics of chronic granulomatous disease and myeloperoxidase deficiency

A

Chronic granulomatous disease - X recessive, Myeloperoxidase deficiency - AR

75
Q

Where is NO made (primarily)?

A

Endothelial cells

76
Q

Why do corticosteroids lead to an increased neutrophil count on CBC?

A

Because they block synthesis of adhesion molecules, which prevents neutrophils from extravasating. The count is thus artificially elevated

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