pathoma Flashcards
Complement classical pathway
C1 binds IgG or IgG bound to antigen
Hageman factor (FXII)
inactive proinflammatory protein produced in liver; important in DIC (esp GN sepsis); activates coagulation/fibrinolytic system, complement, and kinin system
Kinin system
Cleaves HMWK into bradykinin, which vasodilates and increases vascular permeability, and mediate pain
Pain mediated by
PGE2, bradykinin sensitize nerves
PMN migration factors
LTB4, C5a, IL-8, and bacterial products
Redness, warmth MOA
Vasodilation of arteriolar smooth muscle, mediated by histamine, prostaglandin (PGI2, D2, E2), and bradykinin
Swelling mediated by
Histamine, tissue damage
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
Chemotactic for PMN
C5a
Opsonin for phagocytosis
IgG, C3b
Anaphylatoxin
C3a, C5a
In acute inflammation, fluid and cells enter where?
Post-capillary venule
What slows PMN in blood vessels?
Selectins (“rolling”): E selectin (TNF, IL-1); P selectin (Weibel Palade bodies, mediated by histamine)
Weibel Palde bodies has what two factors?
VWF, P-selectin
Selectins bind what on leukocytes?
Sialyl Lewis X
E-selectin, CAMs on endothelium induced by
TNF and IL-1
Integrins on leukocytes induced by
C5a, LTB4 (same ones that brought PMN to the area)
LAD defect of integrins
CD18 subunit
Chediak-Higashi syndrome
Microtubule defect leads to impaired phagolysosome formation
Anti-inflammatory cytokines
IL-10, TGF-beta
Defining characteristic of granulomatous inflammation
Epithelial histiocytes (surrounded by giant cells, rim of lymphocytes)
DiGeorge syndrome
Development failure of 3rd, 4th pharyngeal pouch; 22q11 microdeletion
Sjogren three main criteria
Dry eyes, anti-ribonucleoprotein antibodies, and lymphocyticsialadenitis
Labile tissue
Bowel, skin, BM
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)
