Pathology Flashcards
1
Q
What is pathology?
A
The study of the structural, molecular, and functional manifestation of disease, and the mechanisms that cause a disease
2
Q
Vacutainer Tubes
A
Tool used by pathologists to test skin, cell, or body fluid for disease
3
Q
In a clinical setting, pathologists are responsible for:
A
- Evaluation of surgical, cytologic, hematologic, and autopsy specimens 2. Genetic testing and tissue typing 3. Blood transfusions, apheresis, stem cell and donor services 4. Microbiology, immunology, coagulation, and biochemical testing
4
Q
Mechanism of Disease
A
pathogenesis
5
Q
Etiology mnemonic and what it stands for
A
VINDICATEP Vascular Inflammation Neoplasm Drug/Toxin Infection Congenital/Genetic Auto-immune/immune Trauma/Physical Endocrine/Nutrition/Metabolic Psychological
6
Q
Disease
A
Molecular, cellular, tissue, organ, and organismic damage caused by etiology (VINDICATEP) and mediated by pathogenic mechanisms
7
Q
Diagnosis
A
the name for the disease
8
Q
Pathogenesis
A
the sequence of events that leads from etiology to manifestation of disease
9
Q
Symptom
A
Disease manifestation of disease as perceived and reported by the patient
10
Q
Sign
A
Manifestation of the disease that can be identified by the physical examination, laboratory tests, imaging studies, and other methods
11
Q
Differential Diagnosis
A
A ranked list of most likely diagnoses based on the signs and symptoms of disease in a given patient
12
Q
Sub-cellular responses to an injury
A
Occur in a reversibly injured cell 1. Increased intracellular volume 2. Mitochondria swelling and calcification 3. Disaggregated ribosomes 4. Cell membrane bleb 5. Aggregated cytoskeletal elements 6. Dilated, vesicular endoplasmic reticulum
13
Q
Hypertrophy
A
Increased size of cells, which also results in increased organ or tissue size; Cellular response to injury
14
Q
Hyperplasia
A
Cellular response to injury; Non-neoplastic increase in the number of cells in an organ or tissue
15
Q
Atrophy
A
Cellular response to injury; Reduced size of cells or organs
16
Q
Metaplasia
A
Cellular response to injury; Conversion of one differentiated cell type to another
17
Q
Neoplasm
A
Cellular response to injury; Autonomous growth of cell proliferation
18
Q
Bengin Neoplasm
A
Neoplasm that remains localized
19
Q
Malignant Neoplasm
A
Neoplasm that spreads or is capable of spreading to distant sites (metastasize)
20
Q
Hydropic Degeneration
A
Abnormal swelling because of increased water within organelles usually caused by toxin or injury
21
Q
What cellular response to injury is this image portraying?
A
hypertrophy
22
Q
What cellular response to injury is this image portraying?
A
hypertrophy
23
Q
Dysplasia
A
Cellular response to injury; Disorded growth and maturation of the cellular components of a tissue. May be a precursor to malignant neoplasia.
24
Q
What cellular response to injury is the cellular tissue portraying?
A
hyperplasia
25
What cellular response to injury is this tissue showcasing?
Metaplasia
26
What cellular response to injury is this tissue showcasing?
atrophy
27
What cellular phenomena is showcased as a response to cell injury?
hydropic degeneration
28
What cellular repsonse to injury is portrayed?
dysplasia
29
What is portrayed in this organ?
bengin neoplasm
30
What is portrayed in this organ?
malignant neoplasm
31
Etiologies of atrophy
1. Reduced functional demand
2. Inadequate oxygen supply
3. Insufficient nutrients
4. Interrupted trophic signals
5. Persistent cell injury
6. Increased pressure
7. Chronic Disease (ex.
32
In general, malignant neoplasma have **less/more** well differentiated cells that have **larger/smaller** nuclei that are pleomorphic, atypical, hyperchromatic and more often undergoing mitosis. Example seen in attached photo.
less; larger
33
A. Adrenal hyperlasia
B. Benign adrenal adenoma
C. Malignant adrenal carinoma
D. Adrneal hypertrophy
B. Benign adrenal adenoma
34
What are the two main major pathways to cells death?
apoptosis and necrosis
35
Apoptosis
Cell death caused by activation of internal molecular pathways leading to cell death
36
TNF
"tumor necrosis factor" initiates apoptosis by binding to TNF receptor and triggers caspases leading to cell death
37
Necrosis
cell death caused by pathological lethal injury that often orginates outside of the cell
ex. injury by hupoxia, inflammation, molecular toxin, burn
38
Match the arrows "1, 2, 3, and 4" with the corresponding letter...
A. Pyknosis
B. Normal nucleus
C. Karyorrhexis
D. Karyolysis
1. B.
2. A.
3. C.
4. D.
39
T/F Cell death is demonstrated histologically by nuclear changes
T
40
Pyknosis
the nucleus becomes smaller and stains deeplu basohpilic because of chromitin clumping
41
Karyorrhexis
the pyknotic nucleus breaks up into many smaller fragments
42
Karyolysis
the nucleus may be extruded from the cell of have progressive loss of chromatin staining resulting in the disappearance of the nucleus
43
Coagulative necrosis
Nuclei disappear (karyolysis) and cytoplasm becomes more homogeneous resulting in ghost cells with no nuclei
44
What type of necrosis is shown?
ischemic necrosis
45
What type of necrosis is shown?
Coagulative necrosis
46
liquifactive necrosis
rapid dissolution of cells that liquefies the necrotic tissue. Most often caused by intense localized infiltratino of neutrophilic polymorphonuclear leukocytes at sites of severe acute inflammation. **Localized acute inflammation with liquifactive necrosis is called an abscess.**
47
What type of necrosis is depicted in the blue circle?
abcess with liquifactice necrosis and cavitation
48
What type of necrosis is depicted in the blue circle?
liquified necrosis
49
caseous necrosis
necrosis caused by tuberculosis with marginal zones of aggregated macrophages and necrotic central zone of necrosis containing amorphous debris dervied from necrotic host cells and necrotic mycobacterial cells
50
granulomas
nodular gross lesions formed during caseous necrosis
51
What type of necrosis is shown in the photo?
caseous necrosis
52
dense infiltrates of macrophages
grsnulomatous inflammation
53
Inflammation is a double edged sword that can cause ______ and \_\_\_\_\_\_\_
morbidity and mortality
ex. pneumonia
54
fat necrosis
specifically affects adipose tissue and most commonly results from pancreatitis or trauma resulting in the release of lipases that free up fatty acids that bind calcium to form calcium soaps (sponification)
seen in alcoholics
55
What type of necrosis is featured in this photo?
fat necrosis
56
Four cardnial signs of acute inflammation and the 5th added
1. Rubor (redness)
2. Tumor (swelling)
3. Dulor (pain)
4. Calor (heat)
5. Functio Laesa (loss of function)
57
Label "A" and "B" either acute inflammation or chronic inflammation and provide reason
A. acute inflammation- densely packed polymorphonuclear neutrophils with multiobed nuclei
B. Chronic inflammation- mononuclear leukocytes including lymphocytes, monocytes, macrophages and plasma cells
58
acute inflammation
1. numerous neutorphils
2. Vasodilation - increased blood flow to affected area (transduction- fluid casuing edema)
3. Exudate- plasma proteins
59
Chronic Inflammation
1. Influx of numerous mononuclear leukocytes
2. INcreased extracellular matrix (collagen)
60
Inflammation Response to incision with hemorrhage
1. Coagulation stops hemorrhage: early events - humoarl (coagulation) and cellular (platelet, mast cells, neutrophils, and endothelial) activation
2. Neutophils follow chemotactic gradient to sites of injury
3. Monocytes enter sites of acute inflammation and initially realease factors similar to neurtrophils
5. Monocytes transform into macrophages that are phagocytic and secrete cytokines that attract lymphocytes
61
endothelial proliferation after injury to the skin leads to
new capillaries grow into devitalized tissue to supply oxygen and nutrients for repair
62
granulation tissue
stage of repair characterized ny new capillaries in young fibrous tissue
63
residual collagen at site of injury
scab
64
Fibrosis caused by cell/tissue injury **can/cannot** contriubute to long term morbidity
can
65
What does A and B point to?
a. nodules of regerneating hepatocytes
b. fibrosis
example of how bibrosis caused by cell/tissue injury can lead to long term morbidity ex shown is liver cirrhosis (common in alcholoics and hep C patients)
66
thrombosis
activation of circulating platelets and coagulation factors ; occurs when endothelial contimutiu is lost or blood flow is reduced
67
inadequate thrombosis
can cause hemorrhagic diseases
68
thrombosis that obstructs normal flow
ischemic disease
69
embolization causes
thromboembolic disease
70
lower extremity deep vein thrombosis causes
1. stasis
2. vascular
3. hypercoagulability
4. advanced age
5. sickle cell disease
71
lower extremity deep vein thrombosis outcomes
1. lysis- break down
2. propagation - move through
3. organization- may become a permanent part of the body
4. recanalization- new passage way forms through the thrombus
5. embolization- pieces can berak off
72
partial thromboplastin time (PTT) test
blood test that measures the time it take for blood to clot (developed by UNC in 1952)
- find a cause of abnormal bleeding or bruising
- check for low levels of blood clotting factors that may cause bleeding disorders such as hemophilia
- check for conditions that cause excess clotting problems thrombophilia
- check if it is safe to do a procedure or surgery that might cause bleeding
- check how well the liver is working
73
teratogen and example
a factor that casues malformation of an embryo
ex. microcephaly induced by maternal zika virus infection
74
morphogenesis
the origin of formation and development
75
autosomal dominant polycystic kidney diseas (ADPKD)
genetic abnormal morphogenesis, 1:500, 10% of end stage kidney diseas in the USA, caused by mutations in genes for porteins involved in primary cilium function, cell cycle regualtion and intracellular calcium transport in epithelial cells
76
agenesis
complete absence of an organ or component of an organ
77
aplasia
persistence of an underdeveloped organ wihtout the mature organ; does not funcation normally
78
hypoplasia
reduced size caused by incomplete development ex. microcephaly
79
atresia
incomplete formation of a lumen
80
dysplasia
abnormal tissue differentiation during development
81
ectopia
normally formed organ that is outside its normal anatomic location
82
cystic fibrosis
the most common lethel autosomal recessie disorder in whites
defective chloride fibrosis transmembrane conductance regulator (CFTR)
83
cystic fibrosis is characterized by
- chronic pulmonary disease
- deficient exocrine pancreatic function
- other complications of inspissated (thick) mucus in multiple organs
84
Both photos are histological slides from the pancreas... which one (A or B) has cystic fibrosis?
B
85
What pathology is shown in this gross and micro photo of the lung?
cystic fibrosis
86
Question 1. The increased number of glandular cells in the breast of this pregnant woman can be described by which of the following terms?
a. Hypertrophic
b. Hyperplastic
c. Dysplastic
d. Neoplastic
b. Hyperplastic
87
Question 2. This patient’s uterus has dramatically increased in size during pregnancy. Which of the following terms describes the physiologic process(es) involved with this increased size?
a. Hypertrophy
b. Hyperplasia
c. Hypertrophy and hyperplasia
d. Neoplasia
a.Hypertrophy
88
Question 5. Metaplasia of the bronchial epithelium in this patient is:
a) An adaptive response of tissue with little risk of dysplasia or malignant transformation occurring in the area
b) An irreversible cellular change caused by harmful components in smoke
c) A reversible adaptation to harmful components in smoke
d) A site of inevitable eventual development of carcinoma
b)An irreversible cellular change caused by harmful components in smoke
89
Question 6. Microscopically, this squamous cell carcinoma has irregular islands of neoplastic epithelial cells surrounded by non-neoplastic fibrous stroma, which is what makes carcinomas firm. The fibrous tissue results from:
a) Hyperplasia
b) Desmoplasia
c) Dysplasia
d) Metaplasia
b)Desmoplasia
90
Question 2 The formation of capillaries in the healing tissue is most directly associated with proliferation of which cell type?
a. neutrophils
b. endothelial cells
c. macrophages
d. fibroblasts
b.endothelial cells
91
Question 2 The repair of necrosis in the heart is very different from that in the liver because of:
a. different growth factors at the two sites
b. different nutritional status of the organs
c. different oxygen requirements of the organs
d. different proliferative capacity of cells
d.different proliferative capacity of cells
92
Question 1. The function of the CFTR gene product is which of the following
a. a cAMP regulated chloride channel
b. a cell permeability regulator
c. an iron transport protein
d. a sodium/potassium exchange channel
a.a cAMP regulated chloride channel
93
Question 2. Essentially all the pathophysiology associated with CFTR defects can be most directly explained by which of the following
a. decreased hydration of mucus secretions
b. decreased secretion of chloride and hence increased water reabsorption by epithelial cells.
c. excessive transport of CFTR protein to the cell membrane
d. increased secretion of chloride and hence increased water reabsorption by epithelial cells.
a.decreased hydration of mucus secretions
94
Question 4. CF is the most common lethal autosomal recessive gene in which racial/ethnic group ?
a. Asian
b. African-American
c. Found at equal frequency in all racial/ethnic groups
d. Caucasian
d.Caucasian
95
Question 3. The most common cause of death in CF patients is which of the following ?
a. biliary cirrhosis
b. distal intestinal obstruction syndrome (scarring, adhesions impaction and intussusception)
c. end stage lung disease
d. pancreatic insufficiency & nutritional failure
c.end stage lung disease
96
what type of necrosis ?
fat necrosis
97
what type of necrosis ?
liquifactive
98
what type of necrosis ?
caseous
