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FA Review > Pathology: inflammation > Flashcards

Pathology: inflammation Flashcards

1
Q

True or false: apoptosis requires ATP

A

True

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2
Q

Apoptosis via the intrinsic pathway and extrinsic pathway both lead to activation of what proteins?

A

Caspases

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3
Q

What is nuclear shrinkage seen in apoptosis?

A

Pyknosis

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4
Q

What is the nuclear fragmentation seen in apoptosis?

A

Karyorrhexis

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5
Q

What happens to the cytoplasm of cells undergoing apoptosis?

A

Deep eosinophilia

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6
Q

DNA laddering, seen in apoptosis, is caused by what (name the process used, and the enzyme)?

A

Radiation, causing endonucleases to cleave DNA

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7
Q

BAX is pro or anti apoptotic?

A

Pro

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8
Q

Bcl-2 is pro or anti apoptotic?

A

Anti

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9
Q

What is the chemical released from mitochondria that cause apoptosis?

A

Cytochrome C

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10
Q

How does Bcl-2 prevent cytochrome 2 release?

A

Binds and inhibits Apaf-1

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11
Q

What is the MOA of the intrinsic pathway of apoptosis?

A

Changes in regulating fators

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12
Q

What are the two routes of the extrinsic pathway of apoptosis?

A
  • Ligand receptor (FasL binds to Fas)

- CTL release of perforin/granzyme

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13
Q

What is the the route of apoptosis that the thymus undergoes?

A

Fas +FasL

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14
Q

What happens in the apoptotic pathway when Fas binds FasL?

A

Forms a death domain (FADD)

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15
Q

Defective Fas-Fasl interaction is the basis for what types of disorders?

A

Autoimmune disorders

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16
Q

What types of tissues undergo coagulative necrosis?

A

Tissues supplied by end arteries (heart, liver, kidneys) with cell walls

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17
Q

What types of tissues undergo liquefactive necrosis?

A

Brain, abscesses–areas with high fat content

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18
Q

What types of infections cause caseous necrosis? (3)

A

TB
Systemic fungal infections
Nocardia

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19
Q

What causes the dark blue stain of fatty necrosis?

A

Ca deposits

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20
Q

What are the histological characteristics of fibrinoid necrosis?

A

Amorphous and pink on H&E

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21
Q

What are the two types of gangrenous necrosis?

A

Wet (Infection)

Dry (ischemic coagulative)

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22
Q

Reversible with O2, or irreversible: ATP depletion

A

Reversible

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23
Q

Reversible with O2, or irreversible: nuclear pyknosis, karyorrhexis, or karyolysis

A

Irreversible

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24
Q

Reversible with O2, or irreversible: cellular/mito swelling

A

Reversible

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25
Q

Reversible with O2, or irreversible: nuclear chromatin clumping

A

Reversible

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26
Q

Reversible with O2, or irreversible: Lysosomal rupture

A

Irreversible

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27
Q

Reversible with O2, or irreversible: Mitochondrial permeability

A

Irreversible

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28
Q

Reversible with O2, or irreversible: cellular fatty changes

A

Reversible

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29
Q

Reversible with O2, or irreversible: ribosomal/polysomal detachment

A

Reversible

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30
Q

Reversible with O2, or irreversible:membrane blebbing

A

Reversible

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31
Q

What is the most susceptible part of the brain to necrosis?

A

ACA/MCA/PCA boundary areas

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32
Q

What is the most susceptible area of the heart to necrosis?

A

Subendocardium

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33
Q

What is the most susceptible area of the kidney to necrosis?

A

Straight segment of the proximal tubule

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34
Q

What is the most susceptible area of the liver to necrosis?

A

Central vein

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35
Q

What is the most susceptible area of the colon to necrosis?

A

Splenic flexure

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36
Q

Reperfusion injury is caused by what? What type of infarcts (red or white)

A

Free radicals

Red

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37
Q

Pale infarcts occur in what types of tissue?

A

Solid tissues with single blood supply

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38
Q

What is the first sign of shock?

A

Tachycardia

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39
Q

What is distributive shock?

A

a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in inadequate supply of blood to the body’s tissues and organs

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40
Q

What happens to total pulmonary resistance, cardiac output, and venous return in distributive shock?

A

Lower TPR
Increased CO
Increased venous return

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41
Q

What happens to the pulmonary capillary wedge pressure in distributive shock? cardiogenic shock? Hypovolemic shock?

A 
Distributive = decreased
Cardiogenic = increased
Hypovolemic = decreased
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42
Q

Vasodilation or vasoconstriction: Distributive shock and hypovolemic/cardiogenic (match correctly)

A

Vasodilation in distributive

Vasoconstriction for cardiogenic/hypovolemic

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43
Q

Which type of shock in which BP can be restored using IVF: cardiogenic or distributive

A

Cardiogenic/hypovolemic

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44
Q

An increased or decreased in endogenous hormones will cause atrophy?

A

Decrease

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45
Q

An increased or decreased in exogenous hormones will cause atrophy?

A

Increase

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46
Q

An increase or decrease in metabolic demand will cause atrophy?

A

Decrease

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47
Q

An increase or decrease in pressure (generally) will cause atrophy?

A

Increased (e.g. nephrolithiasis)

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48
Q

What are the cardinal signs of inflammation?

A 
Rubor (redness)
Dolor (pain)
Calor (heat)
Tumor (edema)
Functio laesa (function loss)
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49
Q

What are the first WBCs that are seen in acute inflammation?

A

PMNs

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50
Q

What are the WBCs that are seen in chronic inflammation?

A

Mononuclear cells and fibroblasts

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51
Q

What is in a granuloma?

A

Nodular collections of epithelioid macrophages and giant cells

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52
Q

What is the hallmark cell that can be found in chronic inflammation?

A

Giant cells

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53
Q

What are the possible outcomes of chronic inflammation?

A

Scarring, amyloidosis

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54
Q

What is chromatolysis? What are the three hallmarks of it?

A

Neuron body cell changes after injury.

  1. Round cellular swelling
  2. Displacement of nucleus to the periphery
  3. Dispersion of Nissl substance
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55
Q

What is dystrophic calcification? Is it associated with hypercalcemia?

A

Ca deposition in tissues secondary to necrosis

NOT directly associated with hypercalcemia

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56
Q

What is metastatic calcification? Is it associated with hypercalcemia?

A

Widespread Ca deposition secondary to hypercalcemia

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57
Q

Which tissues are most affected by metastatic calcification?

A

Kidneys
Lungs
Gastric mucosa

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58
Q

Extravasation predominantly occurs where?

A

At postcapillary venules

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59
Q

What are the four steps of extravasation?

A
  1. margination/rolling
  2. Tight binding
  3. Diapedesis
  4. Migration
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60
Q

What are the two signaling proteins that allow for margination and rolling of PMNs?

A

E-selectin

P-selectin

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61
Q

What are the two signalling proteins that allow for tight binding to occur?

A

ICAM1 (CD54)

VCAM1 (CD106)

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62
Q

What is the one signalling molecule that allows for leukocyte diapedesis?

A

PECAM-1 (CD31)

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63
Q

What are the family of molecules that guide leukocytes to their destination after they have crossed the blood vessel border?

A

Chemotactic products

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64
Q

What are the three ways in which free radicals damage cells? (hint: three different classes of polymers)

A

Lipid peroxidation
Protein modification
DNA breakage

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65
Q

Which vitamins are antioxidants?

66
Q

What is inhalation injury?

A

Damage to lungs/bronchi d/t inhalation of combustion byproducts

67
Q

What are the two pathological types of scars?

A

Hypertrophic

Keloids

68
Q

Which has a higher amount of collagen synthesis: keloid scars, or hypertrophic scars?

69
Q

Which type of scarring: hypertrophic or keloid) has parallel arrangement of collagen? Which has disorganized?

A 
Hypertrophic = parallel
Keloid = disorganized
70
Q

How frequently do hypertrophic scars recur after resection? Keloids?

A 
Hypertrophic = infrequently
Keloid = Frequently
71
Q

What is the effect of PDGF? What cells secrete it?

A

Induces vascular remodeling

Secreted by macrophages and platelets

72
Q

What is the role of FGF in wound healing?

A

Stimulates all aspects of angiogenesis

73
Q

What is the role of EGF in healing?

A

Stimulates cell growth via Y kinases

74
Q

What is the role of TGF-beta in wound healing?

A

Angiogenesis + fibrosis

75
Q

What is the role of metalloproteinases in wound healing?

A

Tissue remodeling

76
Q

Which cells are primarily involved in the remodeling phase of wound repair?

A

Fibroblasts

77
Q

What are the cells that are involved in proliferative phase of wound healing?

A

Fibroblasts
Macrophages
Endothelial cells
Lots o’ cells

78
Q

What role do fibroblasts play in tissue remodeling?

A

Increases Type I collagen deposition (instead of Type III)

79
Q

What cytokine do Th1 cells secrete to maintain a granuloma?

80
Q

What cytokine do macrophages secrete to maintain a granuloma?

81
Q

Why should you always test for TB prior to starting anti-TNF therapy?

A

TNF needed to maintain granuloma. Thus anti-TNF will cause breakdown and disseminated disease

82
Q

Exudate or transudate: cellular

83
Q

Exudate or transudate: protein rich

84
Q

Exudate or transudate:specific gravity

A

Transudate

85
Q

Exudate or transudate: cause by lymphatic obstruction

86
Q

Exudate or transudate: caused by inflammation/malignancy

87
Q

Exudate or transudate: caused by an increase in hydrostatic pressure

A

Transudate

88
Q

Exudate or transudate: cause by a decrease in oncotic pressure/ Na retention

A

Transudate

89
Q

Increase or decrease in ESR: Anemia

90
Q

Increase or decrease in ESR: infections

91
Q

Increase or decrease in ESR: sickle cell disease

92
Q

Increase or decrease in ESR: polycythemia

A

Decreased (d/t RBCs diluting aggregation factors)

93
Q

Increase or decrease in ESR: CHF

A

Decreased (unknown cause)

94
Q

Increase or decrease in ESR: pregnancy

95
Q

Increase or decrease in ESR: SLE

96
Q

What does ESR measure?

A

Products of inflammation causing aggregation of RBCs

97
Q

How does Fe lead to disease?

A

Peroxidation of lipids

98
Q

What are the symptoms of acute Fe poisoning?

A

n/v dysentery

99
Q

What are the symptoms of chronic Fe poisoning (as in hemochromatosis)?

A

Metabolic acidosis

scarring

100
Q

What is the treatment for acute/chronic Fe poisoning?

A

Chelating agents + dialysis

101
Q

What is amyloidosis?

A

Abnormal aggregation of proteins into beta=pleated sheets

102
Q

What is the cause of AL amyloidosis (which protein deposition)?

A

Light chain Ig deposition (e.g. in multiple myeloma)

103
Q

What is the cause of AA amyloidosis (which protein deposition)?

A

FIbrils of serum Amyloid (e.g. RA, IBD)

104
Q

What is the protein that causes dialysis related amyloidosis?

A

Fibrils of beta2 microglobulin in pts with ESRD

105
Q

Dialysis pt presenting with carpal tunnel = ?

A

Amyloidosis

106
Q

How is ATTR, amyloidosis acquired?

107
Q

Senile amyloidosis is caused by deposition of what protein?

A

Deposition of TTR in myocardium and other sites

108
Q

Beta amyloid deposition in the brain = which disease?

A

Alzheimers

109
Q

What is lipofuscin cause by?

A

Oxidation and polymerization of autophagocytosis organellar membranes

110
Q

What does carcinoma in situ mean?

A

Neoplastic cells have not invaded BM

111
Q

What are the enzymes that allow tumors to pierce the BM?

A

Collagenases and hydrolases

112
Q

What is the P-glycoprotein (aka MDR1)?

A

Glycoprotein used to pump out toxins, including chemotherapeutic agents

113
Q

What is metaplasia?

A

One adult cell is replaced by another of a different type (e.g. Barrett’s esophagus)

114
Q

True or false: metaplasia and dysplasia are reversible

115
Q

What is anaplasia?

A

Loss of structural differentiation and function of cells, resembling primitive cells of same tissue

116
Q

What is neoplasia?

A

A clonal proliferation of cells that is uncontrolled and excessive

117
Q

What is desmoplasia?

A

Fibrous tissue formation in response to neoplasia

118
Q

True or false: neoplasia, neoplasia, and desmoplasia are all irreversible

119
Q

What does it mean to grade a tumor?

A

Degree of cellular differentiation (1= high, 4= low[bad])

120
Q

Which has more prognostic value: stage or grade of a tumor?

121
Q

What does it mean to stage a tumor?

A

Degree of localization/spread based on site and size of secondary lesion
(stage = spread)

122
Q

What is the TNM staging system?

A

Tumor size
Node involvement
Metastases

123
Q

The term carcinoma implies what?

A

Epithelial origin of tumor

124
Q

The term sarcoma implies what?

A

Denotes mesenchymal origin of tumor

125
Q

Most carcinoma spread (BLANK) whereas most sarcomas spread (BLANK)

A

Carcinomas spread lymphatically

Sarcomas spread hematogenously

126
Q

Adenomas come from what tissue type?

127
Q

Malignant or benign: adenocarcinomas

128
Q

Malignant or benign: Hemangioma

129
Q

Malignant or benign: leiomyoma

130
Q

Malignant or benign: angiosarcoma

131
Q

Malignant or benign, and what tissue type is it from: Rhabdomyoma

A

Benign– striated muscle

132
Q

Malignant or benign, and what tissue type is it from: fibroma

A

Benign– CT

133
Q

Malignant or benign, and what tissue type is it from: fibrosarcoma

A

Malignant–CT

134
Q

Malignant or benign, and what tissue type is it from: osteoma

A

benign–Bone

135
Q

Malignant or benign, and what tissue type is it from: osteosarcoma

A

malignant–bone

136
Q

Malignant or benign, and what tissue type is it from: liposarcoma

A

Malignant–fat

137
Q

Upregulation of what enzyme in tumors prevents chromosome shortening and cell death?

A

Telomerase

138
Q

What are the three major cytokines that are involved with cachexia in CA pts?

A

TNF-alpha
IFN-gamma
IL-6

139
Q

Acanthosis nigricans is associated with what neoplasm?

A

Visceral malignancy

140
Q

AIDS is associated with what neoplasm?

A

Kaposi

Non-hodgkins lymphoma

141
Q

Actinic keratosis is associated with what neoplasm?

A

Squamous cell carcinoma of the skin

142
Q

Autoimmune diseases (e.g. SLE, hashimoto thyroiditis) is associated with what neoplasm?

143
Q

Barrett’s esophagus is associated with what neoplasm?

A

Esophageal adenocarcinoma

144
Q

Chronic atrophic gastritis is associated with what neoplasm?

A

Gastric adenocarcinoma

145
Q

Cirrhosis is associated with what neoplasm?

A

Hepatocellular carcinoma

146
Q

Cushings is associated with what neoplasm?

A

Small cell lung CA

147
Q

Dermatomyositis is associated with what neoplasm?

148
Q

Down syndrome is associated with what neoplasm?

A

ALL (“we ALL fall DOWN”)

149
Q

Dysplastic nevus is associated with what neoplasm?

A

Malignant melanoma

150
Q

Hypercalcemia is associated with what neoplasm?

A

Squamous cell lung CA

151
Q

Immunodeficiency states are associated with what neoplasm?

A

Malignant lymphomas

152
Q

What is Eaton-lambert syndrome? What malignancy is associated with it?

A

Autoimmune attack of Ca channels at the neuromuscular junction

Small cell lung cancer

153
Q

Myasthenia gravis is associated with what malignancy?

154
Q

Paget’s disease of the bone is associated with what malignancy?

A

Secondary osteosarcoma

155
Q

Plummer-Vinson syndrome (Fe-deficiency anemia + esophageal webs + dysphagia) is associated with what malignancy?

A

Squamous cell carcinoma of the esophagus

156
Q

Polycythemia is associated with what neoplasm?

A

Renal cell carcinoma

157
Q

Radiation exposure is associated with what neoplasm?

A

Leukemia

sarcoma

158
Q

SIADH (syndrome of inappropriate antidiuretic hormone secretion) is associated with what neoplasm?

A

Small cell lung CA

159
Q

Tuberous sclerosis is associated with what neoplasm?

A

Giant cell astrocytoma

160
Q

Ulcerative colitis is associated with what neoplasm?

A

Colonic adenocarcinoma

161
Q

Xeroderma pigmentosum is associated with what neoplasm?

A

melanoma

Basal cell carcinoma

FA Review (22 decks)

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