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Step Numero Uno > Pathoma > Flashcards

Pathoma Flashcards

1
Q

Hypertrophy definition on a cellular level

A

An increase in the size of cells

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2
Q

An increase in the size of cells

A

Hypertrophy

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3
Q

Hyperplasia definition

A

An increase in the number of cells

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4
Q

An increase in the number of cell

A

Hyperplasia

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5
Q

For a cell to increase in size it needs:

A
  • Cytoskeleton must increase in size (require inc gene activation –> inc protein synthesis - since cytoskeleton largely comprised of proteins)
  • Inc production of organelles (b/c need to be able to sustain inc work)
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6
Q

Cytoskeleton is largely comprised of what?

A

Proteins

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7
Q

Hyperplasia involves production of new cells from what?

A

Stem cells

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8
Q

Name 3 permanent tissues

A

Cardiac muscle, skeletal muscle, nerves

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9
Q

What are permanent tissues?

A

Don’t have stem cells –> cannot make new cells (ie hyperplasia) –> can only undergo hypertrophy

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10
Q

Pathologic hyperplasia can progess to what?

A

Dysplasia and eventually cancer

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11
Q

What is a notable exception of pathologic hyperplasia that does not inc risk for cancer?

A

Benign prostatic hyperplasia

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12
Q

Benign prostatic hyperplasia will or will not progress to cancer?

A

It will NOT progress to cancer. This hyperplasia is an exception and does not inc the risk of cancer.

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13
Q

Atrophy definition

A

Decreased size of an organ

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14
Q

Atrophy results in the decreased size of an organ, how is this accomplished?

A
  • Dec cell number via apoptosis
  • Dec cell size via ubiquitin-proteosome degradation of the cytoskeleton and autophagy of cellular components
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15
Q

Decreased size of an organ

A

Atrophy

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16
Q

Epithelium lines what?

A

Surfaces of the body (gut, urogenital tract, etc.)

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17
Q

Metaplasia definition

A

A change in stress on an organ leads to a change in CELL TYPE

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18
Q

A change in stress on an organ leads to a change in cell type

A

Metaplasia

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19
Q

Most common form of metaplasia

A

switch from one surface epithelium type to another think Barrett’s esophagus

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20
Q

What is the normal esophagus lined w/?

A

Nonkeratinizing squamous epithelium

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21
Q

In Barrett’s Esophagus what happens?

A

Intestinal Metaplasia of esophageal lining due to acid reflux from the stomach nonkeratinizing squamous epithelium –> nonciliated, mucin producing columnar cells

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22
Q

What cell type change is seen in Barrett’s Esophagus?

A

Nonkeratinizing squamous epithelium (normal) –> nonciliated, mucin producing columnar cells

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23
Q

How does metaplasia occur?

A

Metaplasia occurs via reprogramming of stem cells to produce a new cell type

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24
Q

Is metaplasia reversible or irreversible

A

It is REVERSIBLE, just need to remove the stressor (ie acid reflux in barrett’s esophagus)

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25
Q

Does metaplasia have an increased risk for cancer?

A

YES Under persistent stress, metaplasia can progress to dysplasia and eventually result in cancer

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26
Q

What can metaplasia progress to?

A

Dysplasia –> cancer

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27
Q

What metaplastic state is known to NOT increase the risk of cancer?

A

Apocrine metaplasia of the breast does NOT increase the risk for cancer

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28
Q

Apocrine metaplasia of the breast is special bc?

A

Apocrine metaplasia of the breast does NOT increase the risk for cancer

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29
Q

Benign Prostatic Hyperplasia is special because?

A

BPH does NOT increase the risk for cancer

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30
Q

What vitamin deficiency can result in metaplasia?

A

Vitamin A b/c necessary for differentiation of specialized epithelial surfaces and immune system

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31
Q

Vitamin A is necessary for differentiation of what type of cells and if deficient can lead to what?

A

Vitamin A b/c necessary for differentiation of specialized epithelial surfaces (ie conjunctiva covering the eye) and maturation of immune system

Vit A deficiency can –> metaplasia

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32
Q

What vitamin is necessary to maintain the conjunctiva of the eye?

A

Vitamin A Vit A deficiency –> metaplasia where the normal goblet cell, columnar epithelium of conjunctiva becomes keratinizing squamous epithelium which can –> destruction of the cornea (keratomalacia) and blindness

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33
Q

Keratomalacia

A

Destruction of the cornea and thickening of the conjunctiva Seen in Vit A deficiency (due to metaplasia)

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34
Q

Xerophthalmia

A

Dry eyes

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35
Q

Vit A deficiency can cause:

A

Dry eyes (xerophthalmia), destruction of the cornea and thickening of the conjunctiva (keratomalacia), and blindness - Largely due to metaplasia of conjunctiva

36
Q

Retinoic acid receptor found on what chromosome?

A

Chromosome 17

37
Q

a t(15:17) disrupts what?

A

Disrupts retinoic acid receptor (vit A receptor) –> myeloid cells do not mature and remain in blast state –> acute promyelocytic leukemia

38
Q

a t(15:17) is seen in what disease?

A

Acute promyelocytic leukemia

39
Q

What is given as a treatment to acute promyelocytic leukemia?

A

ATRA - all trans retinoic acid (a derivative of vit A)

40
Q

What is all trans retinoic acid a derivative of?

A

Vitamin A

41
Q

What is mesenchymal tissue?

A

It is connective tissue (ie bone, blood vessels, fat, cartilage)

42
Q

Can mesenchymal tissue undergo metaplasia?

A

YES; think myositis ossificans

43
Q

What is myositis ossificans?

A

When connective tissue w/in muscle changes to bone during healing after trauma It’s an example of mesenchymal metaplasia

44
Q

What’s an example of mesenchymal metaplasia?

A

Myositis ossificans - connective tissue w/in muscle changes to bone during healing after trauma

45
Q

How can you tell the difference b/t myositis ossificans from metastatic bone cancer on scan?

A
  • Ossification is w/in muscle and not attached/connected to the bone (therefore not growing off of it)
  • Bone in image is also healthy looking
46
Q

Definition of dysplasia

A

Disordered cellular growth (most often referring to proliferation of PREcancerous cells)

dys = bad

plasia = growth

Dysplasia = “bad growth”

47
Q

What term means bad growth and is usually used to refer to proliferation of PREcancerous cells?

A

Dysplasia

48
Q

What is the dysplasia before cervical cancer called?

A

Cervical intraepithelial neoplasia (CIN)

49
Q

Dysplasia often arises from what?

A

Pathological Hyperplasia (ie endometrial hyperplasia) or Metaplasia (ie Barrett esophagus)

50
Q

Is dysplasia reversible or irreversible?

A

REVERSIBLE - alleviation of inciting stress

51
Q

Does dysplasia have an increased risk for cancer?

A

YES - if stress is not alleviated, dysplasia will progress to carcinoma (irreversible)

52
Q

Once a tissue has progressed to cancer is the cancer stage reversible or irreversible?

A

IRREVERSIBLE

53
Q

Definition of aplasia

A

Aplasia is failure of cell production during embryogenesis (ie unilateral renal agenesis)

54
Q

Failure of cell production during embryogenesis

A

Aplasia

55
Q

Unilateral renal agenesis

A

1 of the kdneys fails to develop during embryogenesis - it’s a form of aplasia

56
Q

Hypoplasia definition

A

A decrease in cell production during embryogenesis resulting in a SMALL organ (ie streak ovary in Turner Syndrome)

57
Q

A decrease in cell production during embryogenesis resulting in a relatively small organ

A

Hypoplasia

ex: streak ovary in Turner Syndrome

58
Q

Streak ovary in turner syndrome is an example of what type of cell production?

A

Hypoplasia - decrease in cell production during embryogenesis resulting in relatively small organ

59
Q

Which is more susceptible ot ischemic injury neurons or skeletal muscles?

A

Neurons are highly susceptible to ischemic injury

60
Q

Slowly developing ischemia results in what?

A

Atrophy

(ex renal artery atherosclerosis –> atrophy of kidney)

61
Q

Acute ischemia results in what?

A

Injury

(ex: renal artery embolus –> renal injury)

62
Q

Slow or acute ischemia results in atrophy?

A

Slow

63
Q

Slow or acute ischemia results in injury?

A

Acute

64
Q

Hypoxia definition

A

Low oxygen delivery to tissues

65
Q

Deficiency in the amount of oxygen reaching tissues

A

Hypoxia

66
Q

what is the final electron acceptor in the electron transport chain?

A

Oxygen

(oxidative phosphorylation)

67
Q

Decreased oxygen impairs what resulting in decreased ATP production?

A

Impairs oxidative phosphorylation

68
Q

Impaired oxidative phophorylation results in what?

A

Decreased ATP production

69
Q

Lack of ATP can lead to what?

A

Cellular injury

70
Q

Name 3 causes of hypoxia

A

Ischemia, hypoxemia, and decreased O2 carrying capacity of blood

71
Q

Ischemia definition

A

Decreased blood flow through an organ

72
Q

Decreased blood flow through an organ

A

Ischemia

73
Q

Name 3 causes of ischemia

A
  1. Decreased arterial perfusion (atherosclerosis)
  2. Decreased venous drainiage (Budd-Chiari syndrome)
  3. Shock - generalized hypOtension resulting in poor tissue perfusion

Think: something disrupting blood flow (either to or from)

74
Q

What is budd-chiari syndrome?

A

Budd-Chiari syndrome = occlusion of hepatic vein(s) –> dec fresh blood flow –> infarction of liver

75
Q

Budd chiari syndrom most commonly caused by?

A

Polychythemia vera

B/c RBC count inc –> thick & viscous blood –> inc risk for thrombi

76
Q

Budd Chiari syndrome associated with (7 things):

A
  1. Polycythemia Vera
  2. Pregnancy
  3. Lupus anticoagulant (lupus –> hypercoaguable state)
  4. Use of oral contraceptives
  5. Postpartum state
  6. Paroxysmal nocturnal hemoglobinuria
  7. Hepatocellular carcinoma
77
Q

Hypoxemia definition

A

Low concentration/partial pressure of oxygen in blood (PaO2 < 60mmHg, SaO2 < 90%)

78
Q

Low concentration/partial pressure of oxygen in blood (PaO2 < 60mmHg, SaO2 < 90%)

A

Hypoxemia

79
Q

If PaO2 < 60mmHg & SaO2 < 90% patient has

A

Hypoxemia

80
Q

Hypoxemia can result from (4 things):

A
  1. High altitude
  2. Hypoventilation
  3. Diffusion defect
  4. V/Q mismatch

Think: Why is oxygen not getting in or CO2 not getting out?

81
Q

How does high altitude cause hypoxemia

A

Decreased barometric pressure (FiO2) –> decrease in alveolar oxygen partial pressure (PAO2) b/c less pressure outside to push O2 into alveolar sacs

82
Q

FiO2 =?

A

Atmospheric O2 pressure

83
Q

Atmospheric O2 pressure =?

A

FiO2

84
Q

PAO2 = ?

A

Partial pressure in Alveolar sacs

85
Q
A

Step Numero Uno (4 decks)

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