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pathoma Flashcards

1
Q

Complement classical pathway

A

C1 binds IgG or IgG bound to antigen

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2
Q

Hageman factor (FXII)

A

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

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3
Q

Kinin system

A

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

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4
Q

Pain mediated by

A

PGE2, bradykinin sensitize nerves

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5
Q

PMN migration factors

A

LTB4, C5a, IL-8, and bacterial products

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6
Q

Redness, warmth MOA

A

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

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7
Q

Swelling mediated by

A

Histamine, tissue damage

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8
Q

Fever mediated by

A

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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9
Q

Chemotactic for PMN

A

C5a

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10
Q

Opsonin for phagocytosis

A

IgG, C3b

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11
Q

Anaphylatoxin

A

C3a, C5a

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12
Q

In acute inflammation, fluid and cells enter where?

A

Post-capillary venule

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13
Q

What slows PMN in blood vessels?

A

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

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14
Q

Weibel Palde bodies has what two factors?

A

VWF, P-selectin

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15
Q

Selectins bind what on leukocytes?

A

Sialyl Lewis X

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16
Q

E-selectin, CAMs on endothelium induced by

A

TNF and IL-1

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17
Q

Integrins on leukocytes induced by

A

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

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18
Q

LAD defect of integrins

A

CD18 subunit

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19
Q

Chediak-Higashi syndrome

A

Microtubule defect leads to impaired phagolysosome formation

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20
Q

Anti-inflammatory cytokines

A

IL-10, TGF-beta

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21
Q

Defining characteristic of granulomatous inflammation

A

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

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22
Q

DiGeorge syndrome

A

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

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23
Q

Sjogren three main criteria

A

Dry eyes, anti-ribonucleoprotein antibodies, and lymphocyticsialadenitis

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24
Q

Labile tissue

A

Bowel, skin, BM

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25
Q

Stable tissue

A

Liver

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26
Q

Permanent tissue

A

Myocardium, skeletal muscle, and neurons

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27
Q

Granulation tissue formation has 3 components

A

Fibroblasts, capillaries, myofibroblasts

28
Q

Type III collagen

A

Granulation tissue, embryonic tissue, uterus, and keloids

29
Q

Type I collagen

A

Skin, bon, tendons, organs

30
Q

Three vitamins needed for wound healing

A

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

31
Q

CD8+ T cells important for

A

Tumor suppression

32
Q

Basement membrane two main components

A

Collagen 4, laminen

33
Q

Tumor spread through BM

A

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

34
Q

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

A

former has granulomas, peripheral eosinophilia, and asthma

35
Q

plummer vinson syndreom

A

Fe deficiency anemia presnts with esophageal web, atrophic glossitis

36
Q

pathogenesis of ischemic colitis

A

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

37
Q

osteogenesis imperfecta pw

A

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

38
Q

prolonged fasting leading to hypoglycemia and low ketone bodies

A

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)

39
Q

chronic endometritis characteristic cell

A

plasma cell!

40
Q

side effect of tamoxifen

A

endometrial polyp

41
Q

chocolate cyst increases your risk of

A

carcinoma

42
Q

endometrial hyperplasia moa

A

increased gland/stroma ratio

43
Q

most impt determining factor of endometrial hyperplasia progression to carcinom

A

presence of cellular atypia

44
Q

endometrial carcinoma: 2 pathways

A

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

45
Q

most common presentation of fibrioids

A

asymptomatic

46
Q

PCOS: signature hormone imbalance

A

LH/FSH ratio >2

47
Q

PCOS: complication

A

increased risk of endometrial carcinoma and TIID

48
Q

BCRA mutation increases risk for what ovarian tumor?

A

serious carcinoma of ovary and fallopian tube

49
Q

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

A

endometrial carcinoma (endometrioid type) - check endometrium!

50
Q

cystic teratoma can be malignant in the following cases:

A

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

51
Q

dysgerminoma serum marker

A

elevated LDH

52
Q

endodermal sinus tumor characteristic findings

A

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

53
Q

choriocarcinoma characteristic findings

A

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

54
Q

fibroma: tumor of what cell, associated symptoms

A

fibroblasts; pleural effusions and asites (Meigs syndrome)

55
Q

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

A

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

56
Q

pseudomyxoma peritonei

A

massive amounts of mucus in the peritoneum

57
Q

phenytoin effect on neonate

A

digit hypoplasia and cleft lip/palate

58
Q

epispadias moa, a.w.

A

abnormal position of the genital tubercle; bladder exstrophy

59
Q

bowen papulosis pw, progression

A

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

60
Q

cryptorchidism rx; c/b

A

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

61
Q

most common reason for testicular torsion

A

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

62
Q

seminoma pw, prognosis

A

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

63
Q

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

A

another type of germ cell tumor =(

64
Q

teratoma: difference between men and women

A

may be malignant for men

65
Q

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

A

lymphoma

66
Q

prostatic biopsy shows, graded on

A

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

67
Q

prostate cancer spine metastasis pw

A

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

step 1 (17 decks)

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