pathoma Flashcards by Jae Yang

Complement classical pathway

C1 binds IgG or IgG bound to antigen

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Hageman factor (FXII)

inactive proinflammatory protein produced in liver; important in DIC (esp GN sepsis); activates coagulation/fibrinolytic system, complement, and kinin system

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Kinin system

Cleaves HMWK into bradykinin, which vasodilates and increases vascular permeability, and mediate pain

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Pain mediated by

PGE2, bradykinin sensitize nerves

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PMN migration factors

LTB4, C5a, IL-8, and bacterial products

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Redness, warmth MOA

Vasodilation of arteriolar smooth muscle, mediated by histamine, prostaglandin (PGI2, D2, E2), and bradykinin

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Swelling mediated by

Histamine, tissue damage

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Fever mediated by

Pyrogens (e.g. LPS) release IL-1 and TNF, which travel to brian and increase COase activity in perivascular cells of the hypothalamus; and increase PGE2, which raises temp set point

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Chemotactic for PMN

C5a

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Opsonin for phagocytosis

IgG, C3b

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Anaphylatoxin

C3a, C5a

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In acute inflammation, fluid and cells enter where?

Post-capillary venule

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What slows PMN in blood vessels?

Selectins (“rolling”): E selectin (TNF, IL-1); P selectin (Weibel Palade bodies, mediated by histamine)

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Weibel Palde bodies has what two factors?

VWF, P-selectin

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Selectins bind what on leukocytes?

Sialyl Lewis X

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E-selectin, CAMs on endothelium induced by

TNF and IL-1

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Integrins on leukocytes induced by

C5a, LTB4 (same ones that brought PMN to the area)

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LAD defect of integrins

CD18 subunit

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Chediak-Higashi syndrome

Microtubule defect leads to impaired phagolysosome formation

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Anti-inflammatory cytokines

IL-10, TGF-beta

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Defining characteristic of granulomatous inflammation

Epithelial histiocytes (surrounded by giant cells, rim of lymphocytes)

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DiGeorge syndrome

Development failure of 3rd, 4th pharyngeal pouch; 22q11 microdeletion

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Sjogren three main criteria

Dry eyes, anti-ribonucleoprotein antibodies, and lymphocyticsialadenitis

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Labile tissue

Bowel, skin, BM

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Stable tissue

Liver

Permanent tissue

Myocardium, skeletal muscle, and neurons

Granulation tissue formation has 3 components

Fibroblasts, capillaries, myofibroblasts

Type III collagen

Granulation tissue, embryonic tissue, uterus, and keloids

Type I collagen

Skin, bon, tendons, organs

Three vitamins needed for wound healing

Vitamin C (hydroxylation of proline/serine), Cu (lysyl oxidase), and Zinc (collagenase)

CD8+ T cells important for

Tumor suppression

Basement membrane two main components

Collagen 4, laminen

Tumor spread through BM

Attach to laminen, express collagenase type 4, and attach to fibronectin in ECM, and enter vascular space

Small-vessel vasculitis: three features that differentiates churg-strauss syndrome and microscopic polyangitis

former has granulomas, peripheral eosinophilia, and asthma

plummer vinson syndreom

Fe deficiency anemia presnts with esophageal web, atrophic glossitis

pathogenesis of ischemic colitis

mucosal hemorrhage and patchy necrosis, with eventual bowel wall thickening, edema, and transmural infarction

osteogenesis imperfecta pw

variable; brittle bones, blue sclerae, hearing loss, increased skin/legament laxity, easy bruisability

prolonged fasting leading to hypoglycemia and low ketone bodies

impaired beta oxidation or ketone body synthesis; normally, beta-oxidation proceeds by sequential removal of 2-C units (acetyl-CoA) from fatty acids, and the first step is catalyzed by acyl-Coa dehydrogenase (short, medium, long chain)

chronic endometritis characteristic cell

plasma cell!

side effect of tamoxifen

endometrial polyp

chocolate cyst increases your risk of

carcinoma

endometrial hyperplasia moa

increased gland/stroma ratio

most impt determining factor of endometrial hyperplasia progression to carcinom

presence of cellular atypia

endometrial carcinoma: 2 pathways

hyperplasia (most, endometroid histology, 60 yo); sporadic (atrophic endometrium, papillary structure with psommoma body formation, p53 mutation, 70 yo)

most common presentation of fibrioids

asymptomatic

PCOS: signature hormone imbalance

LH/FSH ratio >2

PCOS: complication

increased risk of endometrial carcinoma and TIID

BCRA mutation increases risk for what ovarian tumor?

serious carcinoma of ovary and fallopian tube

ovarian tumor: endometrioid carcinoma of ovary is associated with what?

endometrial carcinoma (endometrioid type) - check endometrium!

cystic teratoma can be malignant in the following cases:

1) immature tissue (neuroectoderm); 2) somatic malignancy (SCC)

dysgerminoma serum marker

elevated LDH

endodermal sinus tumor characteristic findings

elevated AFP, schiller-duval bodies (golmerulus-like structures)

choriocarcinoma characteristic findings

cytotrophoblasts, syncytiotrophoblasts, but NO VILLI; small, hemorrhagic tumor with early hematogenous spread; high beta-hCG (may lead to thecal cysts in ovary)

fibroma: tumor of what cell, associated symptoms

fibroblasts; pleural effusions and asites (Meigs syndrome)

sertoli-leydig cell tumor: characteristic finding, present in women?

reinke crystals; yes, both men and women can get this

pseudomyxoma peritonei

massive amounts of mucus in the peritoneum

phenytoin effect on neonate

digit hypoplasia and cleft lip/palate

epispadias moa, a.w.

abnormal position of the genital tubercle; bladder exstrophy

bowen papulosis pw, progression

multiple reddish papules in younger pts (40s); does not progress to invasive carcinoma

cryptorchidism rx; c/b

most resolve spontaneously, but orchiopexy performed before 2 years of age; testicular atrophy with infertility, increased risk for seminoma

most common reason for testicular torsion

congenital failure of testes to attach to the inner lining of the scrotum via processus vaginalis

seminoma pw, prognosis

homogenous mass with no hemorrhage/necrosis, large cells with clear cytoplasm and central nuclei; responds well to radiotherapy

chemotherapy for embryonal carcinoma (immature, primitive cells) may result in?

another type of germ cell tumor =(

teratoma: difference between men and women

may be malignant for men

most common cause of a testicular mass among males >60 yo

lymphoma

prostatic biopsy shows, graded on

small, invasive glands with prominent nucleoli; gleason grading scale based on architecture alone (not nuclear atypia!!!)

prostate cancer spine metastasis pw

increased serum alk phos, PSA, prostatic acid phosphatase (PAP)