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Aaron-Exit: Championship Rounds > Pathoma Chapter 2D > Flashcards

Pathoma Chapter 2D Flashcards

1
Q

Sjogren syndrome is characterized by what lab tests?

A

ANA and anti-ribonucleoprotein antibodies (anti-SS-A/Ro and anti-SS-B/La)

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2
Q

Sjogren syndrome is often associated with?

A

other autoimmune diseases, especially rheumatoid arthritis

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3
Q

Sjogren syndrome results in increased risk for?

A

B-cell (marginal zone) lymphoma, which presents as unilateral enlargement of the parotid gland late in disease course

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4
Q

Scleroderma is

A

Autoimmune tissue damage with activation of fibroblasts and deposition of collagen (fibrosis)

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5
Q

Scleroderma is divided into?

A

diffuse and localized types

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6
Q

Diffuse type of scleroderma exhibits?

A

skin and early visceral involvement.

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7
Q

Scleroderma involves

A

Almost any organ can be involved; esophagus is commonly affected, resulting in disordered motility (dysphagia for solids and liquids).

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8
Q

Scleroderma is characterized by what lab tests?

A

ANA and anti-DNA topoisomerase I (Scl-70) antibody

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9
Q

Scleroderma localized type exhibits?

A

local skin and late visceral involvement.

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10
Q

What is CREST syndrome?

A

For localized type scleroderma: Calcinosis/anti-Centroniere antibodies, Raynaud phenomenon. Esophageal dysmotility, Sclerodactyly, and Telangiectasias of the skin.

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11
Q

What is mixed connective tissue disease?

A

autoimmune-mediated tissue damage with mixed features of SLE, systemic sclerosis, and polymyositis

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12
Q

What is mixed connective tissue disease characterized by?

A

serum antibodies against U1 ribonucleoprotein

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13
Q

When is healing initiated?

A

when inflammation begins.

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14
Q

Wound healing occurs via?

A

a combination of regeneration and repair

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15
Q

In wound healing regeneration occurs via?

A

Replacement of damaged tissue with native tissue; dependent on regenerative capacity of tissue

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16
Q

Tissues are divided into three types based on?

A

regenerative capacity: labile, stable, and permanent.

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17
Q

Labile tissues

A

possess stem cells that continuously cycle to regenerate the tissue.

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18
Q

Examples of Labile tisues

A
  1. Small and large bowel (stem cells in mucosal crypts) 2. Skin (stem cells in basal layer) 3. Bone marrow (hematopoietic stem cells)
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19
Q

Stable tissues are

A

comprised of cells that are quiescent G0, but can reenter the cell cycle to regenerate tissue when necessary.

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20
Q

What is a classic example of regeneration?

A

In the liver by compensatory hyperplasia after partial resection. Each hepatocyte produces additional cells and then reenters quiescence.

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21
Q

Permanent tissues

A

lack significant regenerative potential (myocardium, skeletal muscle, and neurons).

22
Q

Repair

A

Replacement of damaged tissue with fibrous scar, Occurs when regenerative stem cells are lost (e.g., deep skin cut) or when a tissue lacks regenerative capacity (e.g., healing after a myocardial infarction

23
Q

Granulation tissue

A

Its formation is the initial phase of repair

24
Q

In the initial phase of repair what does the fibroblasts do?

A

deposit type III collagen

25
Q

In the initial phase of repair what does the capillaries do?

A

provide nutrients

26
Q

Granulation tissue consists of?

A

fibroblasts (deposit type III collagen), capillaries (provide nutrients), and myofibroblasts (contract wound)

27
Q

Granulation tissue eventually results in?

A

scar formation, in which type 111 collagen is replaced with type 1 collagen

28
Q

Type III collagen is

A

pliable and present in granulation tissue, embryonic tissue, uterus, and keloids.

29
Q

Type I collagen

A

has high tensile strength and is present in skin, bone, tendons, and most organs,

30
Q

Collagenase

A

removes type 111 collagen and requires zinc as a cofactor.

31
Q

Tissue regeneration and repair is mediated by?

A

paracrine signaling via growth factors (e.g macrophages secrete growth factors that target fibroblasts)

32
Q

What results in gene expression and cellular growth?

A

Interaction of growth factors with receptors (e.g.. epidermal growth factor with growth factor receptor)

33
Q

Examples of mediators of tissue repair and regeneration

A

TGF-alpha, TGF-beta, platelet, fibroblast growth factor, VEGF

34
Q

TGF-alpha

A

epithelial and fibroblast growth factor

35
Q

TGF-beta

A

important fibroblast growth factor; also inhibits inflammation

36
Q

Platelet-derived growth factor

A

growth factor for endothelium, smooth muscle, and fibroblasts

37
Q

Fibroblast growth factor

A

important for angiogenesis; also mediates skeletal development

38
Q

Vascular endothelial growth factor (VEGF)

A

important for angiogenesis

39
Q

Cutaneous healing occurs via

A

primary or secondary intention.

40
Q

Primary intention

A

Wound edges are brought together (e.g., suturing of a surgical incision); leads to minimal scar formation

41
Q

Secondary intention

A

Edges are not approximated. Granulation tissue fills the defect; myofibroblasts then contract the wound, forming a scar.

42
Q

Delayed wound healing occurs in

A
  1. Infection (most common cause; S aureus is the most common offender)
43
Q

Vitamin C is

A

an important cofactor in the hydroxylation of proline and lysine procollagen residues; hydroxylation is necessary for eventual collagen cross-linking.

44
Q

What is necessary for the formation of stable collagen?

A

Copper is a cofactor forlysyl oxidase, which cross-links lysine and hydroxy lysine to form stable collagen.

45
Q

What is a cofactor for collagenase?

A

Zinc which replaces the type III collagen of granulation tissue with stronger type I collagen

46
Q

What are some causes for delayed wound healing?

A

foreign body, ischemia, diabetes, and malnutrition,

47
Q

Dehiscence is

A

rupture of a wound; most commonly seen after abdominal surgery

48
Q

Hypertrophic scar is

A

excess production of scar tissue that is localized to the wound

49
Q

Keloid is

A

excess production of scar tissue that is out of proportion to the wound

50
Q

Keloid is characterized by

A

excess type III collagen

51
Q

Keloid genetic predisposition

A

more common in African Americans

52
Q

Keloid classically affects what areas of the body?

A

earlobes, face, and upper extremities

Aaron-Exit: Championship Rounds (27 decks)

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