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Pathology Flashcards

1
Q

ATP dependent program cell death

A

Apoptosis

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2
Q

What enzyme is involved in both Intrinsic and Extrinsic pathways of apoptosis

A

Caspases

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3
Q

What happens to the cell membrane during apoptosis

A

Intact without significant inflammation

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4
Q

What is sensitive indicator of apoptosis

A

DNA laddering

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5
Q

What is DNA laddering

A

Fragments in multiples of 180bp

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6
Q

What regulates the Intrinsic pathway

A

Bcl-2 family proteins

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7
Q

Which proteins are the PRO-apoptotic proteins

A

BAX and BAK

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8
Q

What are the ANTI-apoptotic proteins

A

Bcl-2 and Bcl-x

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9
Q

Which anti-apoptotic protein keeps the mitochondrial outer membranes impermeable preventing CYTOCHROME C release from the inner mitochondrial matrix

A

Bcl-2

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10
Q

Over expression of Bcl-2 can lead to

A

Follicular lymphoma ( t[14;18] )

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11
Q

What is involved in the Extrinsic pathway

A
  1. Ligand receptor interactions

2. Cytotoxic CD8+ T-cell mediated (Immune cell)

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12
Q

What happens in Ligand receptor interactions

A

FasL bind to Fas [CD95 death receptor] on target cell activating caspases or TNF-alpha binding to its receptor

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13
Q

What happens in Cytotoxic CD8+ T cell mediated (Immune cell) pathway

A

Cytotoxic T-cell release of perforin creates pores and Granzyme B–> activate caspases

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14
Q

Autoimmune Lymphoproliferative syndrome is caused by

A

Defective Fas-FasL interactions

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15
Q

The histology of this necrosis has cell outline preserved but NO nuclei and increased cytoplasmic binding to Eosin dye

A

Coagulative necrosis

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16
Q

Where can’t coagulative necrosis occur

A

Brain

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17
Q

What necrosis is seen in bacteria abscesses and BRAIN infarct

A

Liquefactive necrosis

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18
Q

Fragmented cells and debris surrounded by lymphocytes and macrophages

A

Caseous Necrosis

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19
Q

What causes Fat necrosis

A

Damaged cells release LIPASE to break down triglyceride liberating Fatty acids to bind calcium—-> SAPONIFICATION

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20
Q

How does saponification appear on H&E

A

Dark blue

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21
Q

Necrosis which causes vessels walls to be THICK and PINK (type 3 HSR)

A

Fibrinoid

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22
Q

Liquefactive superimposed on coagulative

A

Wet Gangrenous

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23
Q

What infarct occurs in venous occlusion and tissues with multiple blood supply

A

Red infarct

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24
Q

Examples of tissue with red infarct

A

Liver, Intestine, Testes, reperfusion

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25
What is the cause of Reperfusion injury
Free Radicals
26
Where does Pale (anemic) infarcts occur
Solid Organs with single blood supply (heart, kidney ad spleen)
27
What is cells are first released during Acute inflammation
1. Neutrophile 2. Eosinophil 3. mast cells * * Basophil mediated
28
What are some outcome of acute inflmmation
1. Complete resolution 2. Abscess formation 3. or Progression to chronic inflammation
29
What cells are first released during chronic inflammation
Mononuclear cells 1. monocytes and macrophages 2. lymphocytes 3. plasma cells * * Fibroblast mediated
30
Persistent destruction and repair associated with blood vessel proliferation and fibrosis
Chronic inflammation
31
Nodular collection of epithelioid macrophages and giant cells
Granuloma
32
Calcium deposition in abnormal tissues which tend to be localized
Dystrophic calcification
33
Where does Leukocyte extravasation usually occur
Post capillary venules
34
Which tissues CANNOT undergo hyperplasia but can only undergo hypertrophy
Permanent tissue (cardiac muscle, skeletal muscle and nerve)
35
In what condition can a cell undergo hyperplasia but does not increase risk of cancer
Benign Prostatic Hyperplasia (BPH)
36
A decrease in cell number occurs via
Apoptosis
37
A decrease in CELL SIZE occur via
Ubiquitin-proteosome and Autophagy
38
In ubiquitin proteosome degradation what is tagged to be destroyed
Intermediate Filament
39
What happens in autophagy cellular components
involves generation of autophagic vacuoles that fuse with lysosomes
40
When a change in stress on an organ cause a change in cell type.
Metaplasia
41
Thin squamous lining of the conjunctiva undergoes metaplasia into stratified keratinizing squamous epithelium. The change is called
Keratomalacia
42
Failure of cell production during embryogenesis
Aplasia
43
Example of Aplasia
Unilateral renal agenesis
44
A decrease in cell production during embryogenesis (small organ)
Hypoplasia
45
Example of Hypoplasia is
Streak ovary in Turner Syndrome
46
Soft and friable necrotic tissue with cottage cheese-like appearance
Caseous Necrosis
47
Which enzyme breaks down cytoskeleton in apoptosis
Proteases
48
Which enzyme breaks down DNA in apoptosis
Endonucleases
49
Pathological hyperplasia leads to ....
Dysplasia ---> Cancer
50
Which hyperplasia does not increase the pt's risk for cancer?
BPH (does not increase risk for prostate cancer)
51
Which vitamin deficiency can result in metaplasia
Vitamin A
52
List 5 common causes of cellular injury
1. Hypoxia 2. Inflammation 3. Nutritional deficiency/excess 4. Trauma 5. Genetic mutations
53
What is hypoxia?
Low O2 delivery to tissues (MC/impt cause of cell injury)
54
What is the end result of hypoxia?
Lack of ATP ===> Cell injury
55
List causes of hypoxia
1. Ischemia 2. Hypoxemia 3. Decreased O2 carrying capacity
56
What decreases O2 carrying capacity?
1. Anemia 2. Carbon monoxide poisoning 3. Methemoglobinemia
57
What causes hypoxemia?
1. High altitude 2. Hypoventilation 3. Diffusion defect 4. V/Q mismatch
58
What is diffusion defect?
Partial alveolar pressure of O2 unable to push O2 into blood d/t thick diffusion barrier (eg interstitial pulm. fibr)
59
What is V/Q mismatch?
1. Blood bypass oxygenated lung (circulatory issue: R --> L shunt) 2. Oxygenated air unable to reach lung (ventilation issue: atelectiasis)
60
What causes ischemia?
1. Decrease arterial perfusion 2. Decreased venous drainage 3. Shock
61
Pt with CO poisoning would present with ......
1. Cherry red appearance of skin (flushed) - classic | 2. Headache (early sign of exposure)
62
What is the classical finding in methemoglobinemia?
1. Cyanosis | 2. Chocolate colored blood
63
Pt presents with cyanosis and chocolate colored blood. What is the diagnosis?
Methemoglobinemia
64
What is the mechanism associated with methemoglobinemia?
Inability of iron in heme to bind to O2 d/t the fact that it is Fe3+. Fe2+ only can bind O2.
65
What is the Tx for methemoglobinemia
IV methylene blue. (reduce Fe3+ to Fe2+)
66
What are the morphological signs of cell death?
LOSS OF NUCLEUS via 1. pyknosis - nuclear condensation 2. kayorrhexis - fragmentation 3. karyolysis - dissolution
67
What is amyloid?
Misfolded proteins that deposit in xtracelluar space --> damage of tissues
68
What are the types of systemic amyloidosis?
Primary & Secondary
69
Systemic deposition of AL amyloid......
Primary systemic amyloidosis
70
Systemic deposition of AA amyloid.....
Secondary amyloidosis
71
What is AA amyloid derived from?
Serum amyloid associated protein (SAA)
72
What is SAA (serum amyloid assoc protein)?
It is an acute phase reactant.
73
When is SAA increased?
1. Chronic inflammatory states 2. Malignancy 3. Familial Mediterranean Fever (FMF)
74
What is Familial Mediterranean Fever (FMF)?
1. Dysfunction of neutrophils (Autosomal Recessive) in a person of Mediterranean origin
75
What is the clinical presentation of FMF?
1. Episodes of fever (recurring fever) | 2. acute serosal inflammation
76
Who is normally affected by FMF?
Persons of Mediterranean descent
77
What illnesses does FMF mimic?
1. Appendicitis 2. Arthritis 3. MI
78
What are the clinical findings of systemic amyloidosis?
1. Nephrotic syndrome (MC organ = Kidney) 2. Restr. cardiomyopathy/arrhythmia 3. Tongue enlargement 4. Malabsorption 5. Hepatosplenomegaly
79
Amyloidosis localized to one organ...
Localized amyloidosis
80
Cause of senile cardiac amyloidosis?
Deposition of non-mutated serum transthyretin in the heart
81
Cause of familial amyloid cardiomyopathy?
Deposition of mutated serum transthyretin in the heart --> restrictive cardiomyopathy
82
List examples of localized amyloidosis..
1. Senile cardiac amyloidosis 2. Familial amyloid cardiomyopathy 3. Non-insulin dependent DM2 4. Alzheimer dz 5. Medullary carcinoma of the thyroid 6. Dialysis assoc. amyloidosis
83
What area in the Brain is susceptible to ischemia?
``` Boundary areas of ACA/MCA - anterior MCA/PCA - posterior Purkinje cells of the cerbellum Pyramidial cells of the HIPPOCAMPUS & Neocortex ```
84
What area in the Heart in susceptible to ischemia?
Sub-endocardium (LV)
85
What areas of the kidney are susceptible to ischemia?
Straight segment of the proximal tubule (medulla) | Thick ascending limb of loop of Henle (medulla)
86
What area of the liver is susceptible to ischemia?
Zone III = Area around central vein
87
What area of the Colon is susceptible to ischemia?
Splenic flexure | Rectum
88
What area of Stomach is susceptible to ischemia?
Fundus

SMART 2 (7 decks)

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