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Pathology: 4/30- 5/2 > Pathology -FA > Flashcards

Pathology -FA Flashcards

1
Q

What is P-glycoprotein?

A

also known as MDR1 (multi-drug resistance) protein

ATP-dependent transporter, responsible for resistance to chemotherapy. It allows active pumping out of chemotherapy drugs

  • This is UWORLD question
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2
Q

mitochondrial vacuolization: reversible? or irreversible damage?

A

irreversible damage

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3
Q

Displacement of Nissl substance throughout cytoplasm

- what is this? which cells?

A

chromatolysis: AXONAL REACTION in response to axonal injury. Increased protein synthesis

  • Nissl substance: rough ER and ribosomes
  • > indicating increased protein synthesis
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4
Q

Which three organs manifest irreversible ischemia with a red infarction?

A

organs with dual supply

: liver, GI, lung

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5
Q

Three common metaseses to liver in order

A

colon&raquo_space; stomach > pancreas

  • of most common cancers (lung, prostate/breast, colon), colon is the closest to liver
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6
Q

Why is lipofuscin yellow brown?

A

oxidation and polymerization of membrane

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7
Q

In which step of extravasation do decreased CD18 integrin subunits on leukocytes lead to a defect?

A

tight-binding, as a result of inability to attach to ICAM-1 (CD54)

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8
Q

Diapedesis: what process is this? what molecule/ cell marker is involved?

A

WBC travels between endothelial cells and exits blood vessel

PECAM-1 (platelet endothelial cell adhesion molecule), CD31

  • note CD31 is both on leukocytes and endothelium
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9
Q

What is fibrinoid necrosis? example of diseases (2)?

A

immune reactions in VESSEL
: immune complex binds with FIBRIN
-> VESSEL WALL damage

polyarteritis nodosa, giant cell vasculitis

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10
Q

Liquefactive necrosis vs. Fat necrosis

A

Liquefactive necrosis: lysosomal enzyme digesting tissue- ex:

  1. brain (full of lysosome in microglia)
  2. bacterial abscess (neutrophils release lysosome to destroy bacteria)
  3. acute pancreatitis ( necrosis of pancreas tissue vs. fat necrosis involved fat tissues surrounding pancreas)

Fat necrosis: digestion of fat -> saponification: calcification

  • enzymatic : acute pancreatitis (lipase dissolving fat tissues surrounding pancras, which is NOT same as lysosome in liquefactive necrosis)
  • non enzymatic: breast tissue after trauma
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11
Q

TB is example of what type of necrosis? Other examples?gross appearance?

A
  • caseous necrosis
  • systemic fungi infection is also example of caseous necrosis
  • goat-cheese: debris formed by macrophages walling off infecting microorganism
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12
Q

Through what do cytotoxic T cells induce apoptosis?

A

granzymes released into target cells via perforin

-> granzymes activate caspases -> apoptosis

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13
Q

For extrinsic apoptosis pathway, what Fas expresses what CD marker

A

Fas = CD95

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14
Q

Which enzymes are involved in mitochondrial cytochrome release?

A

BAK/BAX: promotes cytochrome c release, pre-apoptotic

Bcl2: inhibition of cytochrome c release, anti-apoptotic

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15
Q

Cachexia is mediated by what four cytokines?

A
  • IL1
  • IL6
  • TNF
  • IFN-gamma
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16
Q

specific gravity cutoff values for

  • exudate
  • transudate
A
  • exudate: >1.02

- transudate: <1.012

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17
Q

tumor grade vs. stage: explain each. which one has more prognostic value?

A

grade: degree of differentiation and mitotic activity

stage: degree of localization/spread/ size
T(size) N(lymph node) M (metastasis)

stage has more prognostic value

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18
Q

By which three main mechanisms do free radicals damage cells?

A
  • membrane peroxidation
  • DNA damage
  • protein modification
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19
Q

A velvety hyperpigmentation suddenly develops on the back of a diabetic patient’s neck. Do you consider performing endoscopy?

A

Yes, though most commonly seen with insulin resistance, acanthosis nigricans can be a sign of visceral malignancy (eg, stomach cancer)

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20
Q

A chemo pt has decreased intracellular doxorubicin and etoposide concentrations. What is the normal function of the protein responsible?

A

Multidrug resistance protein 1 (MDR1), also known as P-glycoprotein, normally pumps out toxins and metabolites

  • keyword: low INTRACELLULAR drug concentration
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21
Q

Dystrophic calcification vs. Metastatic calcification

A
  • Dystrophic calcification
    : normocalcemic, damaged tissue
  • Metastatic calcification
    : hypercalcemic, normal tissue
  • metastatic:
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22
Q

Psammoma bodies: dystrophic or metastatic calcification?

A

dystrophic calcification

  • remember, psammoma bodies happen in all messed up tissues
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23
Q

Regarding cell injury, is nuclear chromatin clumping reversible or irreversible?

A

reversible

  • clumping is not same as shrinkage (pyknosis) or fragmentation (karyorrhexis)
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24
Q

In US, first leading cause of death? second?

A

first: heart disease
second: cancer

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25
Q

Five cancers that can cause polycythemia by secreting EPO?

A
  • RCC
  • pheocytochroma
  • hepatocellular carcinoma
  • hemangioblastoma
  • leiomyoma
26
Q

CDKN2A: What does this gene typically produce?

A

P16

CDKN2A is tumor suppressor gene

27
Q

Metastasis from the lung to the bone results in what type of lesions?

A

mixed: lytic + blastic

28
Q

Metastasis from the prostate to the bone results in what type of lesions?

A

blastic

29
Q

Name the three vitamins with antioxidant properties involved in degrading free radicals.

A

A,C,E

  • top stars ACE for removal of free radicals
30
Q

DNA elecrophoresis finding in apoptosis?

A

DNA laddering due to karyorrhexis

31
Q

Apart from cervical cancer, HPV can also cause cancer at where?

A

head and neck: SCC

32
Q

Free radical damage by carbon tetrachloride causes what pathologic change in the human body?

A

fatty liver

33
Q

Arsenic exposure: what three cancers?

A
  • Squamous cell carcinoma of the skin
  • lung cancer
  • angiosarcoma of the liver
34
Q

What enzyme mediates remodeling of scar (type 3 -> type1 collagen)? what metal is used as a cofactor?

A

collagenase

Zn2+ dependent

35
Q

How does radiation therapy cause apoptosis of tumors and surrounding tissue? Which cell types are particularly susceptible?

A

Free radical formation and dsDNA breakage

: rapidly dividing cells (skin, GI mucosa) are extremely susceptible

36
Q

mutation at the MYCL1 oncogene. Which tumor?

A

Lung cancer

Lung cancer, mycL1 gene

37
Q

bacterial abscess: what type of necrosis?

A

liquefactive necrosis

: bacterial debris degraded by lysosome released from neutrophil

38
Q

Describe the mechanism by which lack of ATP leads to cellular swelling. Is this process reversible or irreversible?

A

Na+/K+ ATPase pumps do not work, thereby causing water influx and reversible swelling/blebbing

cellular swelling is reversible

39
Q

Most common metastasis to brain?

A

lung

  • think like this: of common cancers (lung, breast/prostate, colon), lung is the closest one to brain
40
Q

What infectious microbe is considered as liver fluke? what cancer is it associated with?

A

clonorchis sinensis

associated with cholangiocarcinioma

41
Q

pancreatic cancer is associated with loss of what tumor suppressor gene?

A

DPC4 (Deleted in Pancreatic Cancer)

42
Q

Exposure to Radon has increased her risk for what malignancy?

A

lung cancer

43
Q

ionizing radiation: increased risk for what cancer?

A

papillary carcinoma of thyroid

44
Q

melanoma is associated with what oncogene?

A

BRAF, serine/threonine kinase

45
Q

Cushing syndrome phenotypes with lung mass: what is it?

A

small cell carcinoma (ectopic ACTH)

46
Q

Which two genes are associated with tuberous sclerosis?

A

TSC-1 and TSC-2

TSC (Tuberous SClerorsis)

47
Q

What is choristoma? example?

A

normal tissue in foreign location

Meckel diverticulum

48
Q

Defective in Fas/Fas-L is associated with what disease?

A

autoimmune lymphoproliferative syndrome

49
Q

Function of VHL tumor suppressor gene?

A

Inhibition of hypoxia inducible factor 1a
: transcription factor in a response to hypoxia

with inhibition of hypoxia inducible factor1a, cells can undergo apoptosis under hypoxic condition.

50
Q

Which receptor is deficient? role of this receptor?

  • leukocyte adhesion deficiency type 1
  • leukocyte adhesion deficiency type 2
A
  • leukocyte adhesion deficiency type 1
    : CD18 (LFA-1), binds to ICAM during tight binding
  • leukocyte adhesion deficiency type 2
    : Sialyl-Lewis, binds to P-selectin during rolling
51
Q

name only three irreversible changes

A
  • neoplasia
  • anaplasia
  • differentiation
  • these three are only irreversible changes. All rest others are reversible (even dysplasia and metaplasia)
52
Q

vinyl chloride

  • what occupation?
  • what disease?
A
  • chemical plant

- angiosarcoma of liver (arsenic does same)

53
Q

Why does ESR increased in inflammation?

A

product of inflammation is fibrin.
Fibrin coats RBC, causing RBC to aggregate
Aggregation of RBC leads to more sedimentation

54
Q

What conditions can predispose someone to a lower ESR?

A

microcytosis, sickle cell disease, hypofibrinogenemia, HF, polycythemia

55
Q

How does HF lower ESR?

A

less effective blood in circulation

-> less RBC to sediment

56
Q

How does polycythemia lower ESR?

A

more RBCs dilute aggregation factors

57
Q

Which cell mediates remodeling phase of scar formation

A

fibroblast

-> conversion of type 3 collagen to type 1 by using collagenase

58
Q

N-myc: what cancer?

A

Neurolblastoma

  • N-myc, Neuroblastoma
59
Q

transitional cell carcinoma: what chemical?

A

Aromatic amines (eg, benzidine, 2-naphthylamine)

60
Q

H.pylori: what two cancers?

A 
MALToma
gastric cancer (intestinal type)
61
Q

Excessive alcohol intake will increase risk for which two cancer types?

A
  • hepatocellular carcinoma

- squamous cell carcinoma of esophagus

Pathology: 4/30- 5/2 (4 decks)

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