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Exit Notecards > Pathoma Chapter 1B > Flashcards

Pathoma Chapter 1B Flashcards

1
Q

What happens to Bcl2 in the intrinsic mitochondrial pathway?

A

Cellular injury, DNA damage, or loss of hormonal stimulation leads to inactivation of Bcl2

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2
Q

In the intrinsic mitochondrial pathway lack of Bcl 2 results in what?

A

allows cytochrome c to leak from the inner mitochondrial matrix into the cytoplasm and activate caspases.

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3
Q

What is the extrinsic receptor-ligand pathway?

A

FAS ligand binds to (CD95) FAS death receptor and TNF binds TNF receptor (both activate caspases)

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4
Q

What is an example of FAS ligand binding to FAS death receptor (CD95) on the target cell activating caspases

A

negative selection of thymocytes in thymus

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5
Q

Cytotoxic CD8+ T cell-mediated pathway releases what?

A

perforins and granzyme ex CD8+ T-cell killing of virally infected cells is an example.

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6
Q

Perforins

A

secreted by CD8+ T cell create pores in membrane of target cell

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7
Q

Granzyme

A

secreted from CD8+ T cell enters pores and activates caspases

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8
Q

Free radicals are what?

A

chemical species with an unpaired electron in their outer orbit.

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9
Q

When does physiologic generation of free radicals occur?

A

it occurs during oxidative phosphorylation

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10
Q

How are free radicals generated physiologically?

A

Cytochrome c oxidase (complex IV) transfers electrons to oxygen. Partial reduction of O2 yields superoxide (O2.) hydrogen peroxide (H202), and hydroxyl radicals (OH.)

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11
Q

Pathologic generation of free radicals arises with?

A

Ionizing radiation, inflammation, metals, drugs and chemicals

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12
Q

Ionizing radiation and Pathologic generation of free radicals

A

water hydrolyzed to hydroxyl free radical

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13
Q

Inflammation and Pathologic generation of free radicals

A

NADPH oxidase generates superoxide ions during oxygen dependent killing by neutrophils.

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14
Q

Metals and Pathologic generation of free radicals

A

(e.g., copper and iron) Fe generates hydroxyl free radicals (Fenton reaction).

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15
Q

Drugs and chemicals and Pathologic generation of free radicals

A

P450 system of liver metabolizes drugs (e.g acetaminophen), generating free radicals.

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16
Q

Free radicals cause

A

cellular injury via peroxidation of lipids and oxidation of DNA and proteins; DNA damage is implicated in aging and oncogenesis.

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17
Q

Elimination of free radicals occurs via what?

A

Antioxidants, Enzymes, Metal carrier proteins

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18
Q

Elimination of free radicals via Antioxidants

A

glutathione and vitamins A , C, and E

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19
Q

Elimination of free radicals via Enzymes

A

SOD, glutathione peroxidase, catalase

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20
Q

Superoxide dismutase

A

(in mitochondria) superoxide (O2.?>H202)

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21
Q

Glutathione peroxidase

A

(in mitochondria) GSH + free radical GSSH and H202

22
Q

Catalase

A

(in peroxisomes) H2O2 ?> O2 and H202

23
Q

Elimination of free radicals via Metal carrier proteins

A

transferrin and ceruloplasmin

24
Q

Free Radical Injury

A

Carbon tetrachloride (CCl4) and Reperfusion Injury

25
Q

Carbon tetrachloride - What is it used for?

A

Organic solvent used in the dry cleaning industry

26
Q

How is CCl4 metabolized?

A

Converted to CC14 free radicals by P450 system of hepatocytes

27
Q

CCl4 results in what?

A

cell injury with swelling of RER, ribosomes detach, impairing protein synthesis. Decreased apolipoproteins lead to fatty change in the liver

28
Q

Reperfusion injury

A

Return of blood to ischemic tissue results in production of O2-derived free radicals, which further damage tissue. Leads to a continued rise in cardiac enzymes (troponin) after reperfusion of infarcted myocardial tissue

29
Q

What is an amyloid?

A

It is a misfolded protein that deposits in the extracellular space, thereby damaging tissues.

30
Q

What are the shared features of amyloid proteins?

A

beta-pleated sheet configuration, Congo red staining and apple-green birefringence when viewed microscopically under polarized light Deposition can be systemic or localized,

31
Q

What is primary amyloidosis?

A

It is systemic deposition of AL amyloid, which is derived from immunoglobulin light chain

32
Q

What is primary amyloidosis associated with?

A

plasma cell dyscrasias (e.g multiple myeloma)

33
Q

Secondary amyloidosis is?

A

systemic deposition of AA amyloid, which is derived from serum amyloid-associated protein (SAA).

34
Q

What is SAA?

A

It is an acute phase reactant that is increased in chronic inflammatory states, malignancy, and Familial Mediterranean Fever (FMF).

35
Q

What is FMF due to?

A

a dysfunction of neutrophils (autosomal recessive) and occurs in persons of Mediterranean origin.

36
Q

What does FMF present with?

A

episodes of fever and acute serosal inflammation

37
Q

FMF can mimic what?

A

appendicitis, arthritis, or myocardial infarction

38
Q

How does FMF result in AA amyloid deposition in tissues?

A

High SAA during attacks deposits as AA amyloid in tissues

39
Q

What is the most common organ involved in systemic amyloidosis?

A

kidney

40
Q

What are the clinical findings of systemic amyloidosis?

A

Nephrotic syndrome, Restrictive cardiomyopathy or arrhythmia, Tongue enlargement, malabsorption, and hepatosplenomegaly

41
Q

Diagnosis of systemic amyloidosis requires what?

A

tissue biopsy, Abdominal fat pad and rectum are easily accessible biopsy targets.

42
Q

Damaged organs of systemic amyloidosis must be…

A

transplanted. Amyloid cannot be removed.

43
Q

What is localized amyloidosis?

A

Amyloid deposition that is usually localized to a single organ

44
Q

What is senile cardiac amyloidosis?

A

Non-mutated serum transthyretin deposits in the heart. Usually asymptomatic; present in 25% of individuals > 80 years of age

45
Q

Familial amyloid cardiomyopathy

A

Mutated serum transthyretin deposits in the heart leading to restrictive cardiomyopathy, 5% of African Americans carry the mutated gene.

46
Q

Non-insulin-dependent diabetes mellitus (type II)

A

Anylin (derived from insulin) deposits in the islets of the pancreas,

47
Q

Alzheimer disease

A

amyloid beta (derived from J-amyloid precursor protein) deposits in the brain forming amyloid plaques

48
Q

Gene for J-APP is present on…

A

chromosome 21.

49
Q

Downs syndrome and Alzheimers?

A

Most individuals with Down syndrome (trisomy 21) develop Alzheimer disease by the age of 40 (early-onset).

50
Q

Dialysis-associated amyloidosis

A

B-microglobulin deposits in joints,

51
Q

Medullary carcinoma of the thyroid

A

Calcitonin (produced by tumor cells) deposits within the tumor (‘tumor cells in an amyloid background’).

Exit Notecards (29 decks)

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