Step 1 General Review Flashcards by Nathan Hansen

Squamous metaplasia from smoking injury

___ in mediastinal LN
__ in lung parenchyma

metastatic disease in brain req

noncaseating granulomas
caseating granulomas

invasive disease

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Reversible injury is indicated by ___

may see __ in cytoplasm, representing __ segments of __

sometimes called __ or __

may have inc ___, becoming more pronounced w __

cellular swelling

clear vacuoles, distended, ER

hydropic change, vacuolar degen

eosinophilic staining, necrosis

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Reversible cell injury

__ alterations, such as B and loss of __
__ changes, such as ___

Dilation of ___, __ may be present w detached __

__ alterations, w disaggregation of __/__ elements

plasma membrane, blebbing, microvilli
mitochondrial, amorphous densities

ER, myelin figures, polysomes

nuclear, granular/fibrillar

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Progressive injury and cellular destruction is ___

cell fragmentation and phagocytosis is ___

necrosis

apoptosis

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__ involves sequestration of cellular organelles into cytoplasmic autophagic vacuoles

eventually fuse w __ and __ material

enhanced during ___, allowing cell ___

acts in __/__ manner

dysreg can occur in __, ___ and ___

can defend against

Autophagy

lysosomes, digest

nutrient deprivation, survival

coordinated/sequential

cancer, IBD, neurodeg dz

microbes

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Recurrent bacterial infections, impaired/delayed wound healing, marked leukocytosis dz

PMN lack ___
lueks cannot adhere to __

leukocyte adhesion disorder

CD18
endothelium

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best strategy to prevent PMN infilitration blocks __

integrins

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__ is induced by chem mediators such as __, causing __ and __ of blood

inc vasc permeability by __, __, other __ produces __ bw endothelial cells

inc passage of __ to endothelium

allows __/__ to enter site of __/__
fluid leak results in __

__ and __ also involved, showing __/___

vasodilation, histamine, erythema, stasis

histamine, kinins, mediators, gaps

fluids

plasma proteins/leuks, injury/host damage
edema

Lymph vessel/nodes
erythema, swelling

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__ activates macrophages

__/__/__ stimulates macrophage to promote leuk recruitment and inflamm

T lymph that is activated to __/__ can also induce __/__ by releasing ))/__

IFN Y

TNF, IL1, chemokines

TH1, TH17, leuk recruitment/inflamm
IL17, TNF

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Cough, fever, fatigue, wl, hilar adenopathy w granuloma formation dz is

distince, wll formed __ w concentric ___

__ distribution
exclusively ___
coalescent ___

sarcoidosis

granulomas, fibrosis

lymphangitic
interstitial
nodules

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Broad based budding yeast

narrow bud yeast, smaller

halo yeast

blasto

histo

cryptococcus

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Acute inflammation leads to __ recruitment

chronic leads to __ formation

PMN

fibrosis/scar

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Apoptosis due to lack of __
results in ___
antagonizes ___
activates ___ channel

leakage of ___
activates __
eventually ___

survival signal
dna damage
BCL2
BAX/BAK

Cytochrome C
caspases
apoptosis

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Fragile X syndrome mechanism ___ leads to loss of ___

Fragile X ataxia mechaism __ leads to accumultion of ___

repeat is ___

location is ___

trxn silencing, protein fxn

trxn dysreg, toxic mRNA

CGG

untranslated region

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Freidrich ataxia mechanism ___ leads to loss of ___

triplet is __

location is ___

trxn silencing, protein fxn

GAA

intron

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Huntington dz mechanism is __ w ___

toxic __ mutation

triplet is __

location

polyglutamine expansion, misfolding

gain of fxn

CAG

exon

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atherosclerosis caused by excessive __ w loss of __

LDL, laminar blood flow

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Virchow-s thrombosis triad

Abnormal blood flow such as __ and __

Hypercoag inherited __ or acquired ___

endothelial injury such as __ and ___

stasis, turbulence

factor 5 leiden, disseminated cancer

hypercholesterolemia, inflam

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__ contributes to arterial/cardiac thrombosis by causing __ or __

fomrs __ contributing to local pockets of __

normal blood flow is __, so __ flow centrally away from endothelium

stasis/turbulence promote ___ enhancing procoag/leuk adhesion
disrupt __ and cause __/__ interaction
prevent washout/dilution of __ by __ and inflow of ___

turbulence, endothelial injury/dysfxn

countercurrents
stasis

laminar, platelets

endothelial activation
laminar flow, platelet/endothelium

clotting factors, new blood, clotting factor inhibs

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atherosclerotic plaques expose __ and __ and cause __

aneurysms result in __

AMI assc w __ and __

dilated atrium is site of __

hyperviscosity inc __ to flow, resulting in ___

SCA impedes blood flow through ___

vWF/tissue factor, turbulence

stasis

stasis, flow abnorm

stasis

resistance, stasis

small vessels

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substance derived from ___ complexes w coagulant protein to activate protein C to cleave factors 5/8

__ interacts w __ on endothelial membrane to activate ___ to inactive factor __/__

endothelial cells

thrombin, thrombomodulin, Protein C, 5a/8a

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DIC

intravascular access of procoagulant
\_\_ comps, such as \_\_
\_\_ such as \_\_/\_\_ adenocarcinomas/mucins
\_\_ such as \_\_ or \_\_, tissue factor
S\_\_, \_\_

Diffuse endothelial injury
\_\_ infection, \_\_ tropic
\_\_ infect
\_\_/\_\_ toxin, \_\_\_
\_\_ disorders

obstetric, amniotic fluid
cancer, panc/other
trauma, crush injury/CNS
sepsis/endotoxin

ricketsial, endothelial
meningococcal
endothelial/shiga, E coli
immune complex

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Healing process of uninfected skin does not include __ at infection site

cells that can heal in sunburn

dermal appendages

hair follicle epithelial

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Apoptosis is __ of cell death to eliminate __/__ cells

characterized by __ of protein/DNA
initiated by __
removal via __

Mito (intrinsic) path- loss of __ + __ or __
assc w leakage of __ into mito membrane

process inhibited by __ indued by __ from GF

programmed, unwanted/damaged

enzymatic
caspases
phagocytes

survival signals, DNA damage/misfolded proteins
pro-apoptotc proteins

BCL2, survival signals

Apoptosis death receptor eliminates __ and damage by __ initiated by engagement of __ such as __/__ by __ on adjacent cells

self reactive lymphs/cytotoxic T lymphs death receptors, TNF/FAS ligand

early genetic lesions of cancer is unlikely to involve ___ unless assc w ___

loss of p53 Li Fraumeni syndrome

endometrial biopsy shows endometrial hyperplasia wout atypia is

granulosa/theca cell tumor

EGFR inhibitors do not work on tumors assc w ____

KRAS activation

histologic appearance alone can only be assc w may be _ or _ or __ prognosis is best determined by ___

grade anaplastic, moderate, well dff tumor stage

which cell removes red cells from circulation mechanism is ___, via __ response

NK cells complement dependent, type 2

overlapping involvement of inflammatory disorders due to structural ___ major influencers are characteristics of ___ and local ___ complexes are __ size, formed w __ excess, most __ concentrated sites include organs where blood is __ at high pressure to form other fluids (__/__) often affects __ and __

vulnerability to immune complex deposition complex, vasc alterations medium, antigen, pathogenic filtered, urine/synovial fluid glomeruli/joints

drug to inhibit Type 1 reaction without inhibiting immediate mediator targets __

phospholipase a2

swelling/cyanosis in minutes of transplant is a result of rejection mediated by ___ recognizing foreign __ on graft can be directly via __ or indirectly after __ and presentation by ___ tx of graft rejection relies on ___ to inhibit __ to graft trasnplanting __ requires matching of __/__ and is complicated by __

preformed antibody Host t cells, HLA antigens APC in graft uptake, host APC immunosuppressives, immune response HSC, donor/host, GVHD

Hyperacute rejection- preformed __ bind to graft endothelium _ after transplant leads to __/__ and __ failure Acute cell reject- t cells destroy ___ by __/__ rxns acute humoral reject- __ damage graft vasculature ``` chronic reject- dominated by __ caused by __ and __ T cells secrete __ to proliferate vasc SM cells ab cause __ eventually leads to ___ ```

antidonor antibodies, immeditely thrombosis, ischemic damage, rapid graft failure graft parenchyma, cytotoxicitiy/inflam rxn ab ``` arteriosclerosis t cell activation/ab cytokines endothelial injury parenychmal fibrosis ```

Anemia SLE- D, I, __ on red cells HS- D, N, __ defect Mycoplasma- D, I, __ on red cells PA- __ deficit, __ due to impaired DNA synth, Parvo- __ deficit, pure __ aplasia

destructive, immune mediated, IgG destructive, nonimmune, red cell prodxn, megaloblastic prodxn, RBC

Microcytic/hypochromic due to ___ Iron def due to __, __, __ Globin def due to __/__ porphyrin def due to __

failed Hb synth diet, rapid growth, chonic loss hemoblobinopathies, thal porphyrias

Failed DNA synth anemia appears __ __/__ def could be __/__

macrocytic/megaloblastic B1/folate MDS/chemo

Stem cell failure/destrxn anemia appears __/__ due to __/___

normochromic/normocytic aplastic anemia, infiltrative disorders

Pancytopenia, nuclear/cytoplasmic dyssynchrony, some myeloblasts __ syndrome

myelodysplastic syndrome

T12, 21 __ prog, __ dz T15, 17 __ prog, __ dz T 8,21 __ prog, dz Del 5/7 or trisomy 8 dz T8,14 dz Inversion of 16 __ prog, __ T9,22 dz, prog 11q23 translocation dz, prog __

good, ALL good, APL good, AML myelodysplastic syndrome Burkitt lymphoma, leukemia good, AML bad MLL, bad

Epidural bleed is __, impact to __ area affects ___ clinical pic is __ w __ progression Sudbural is __, onset is __ affects ___ seen in __/__/___

arterial, temporal MMA biphasic, rapid venous, insidious bridging veins infant/elderly/alcoholics

Subarachnoid hemorrhage such as ___, or __ bleed is __, __ progression ___ and __ signs Intracerebral- ___ __ aneurysm ___ location, __ prog affects __/__/____

congenital Berry anuerysm, PC kidney arterial, rapid pounding HA, global hyperTN charcot houchard arterial, rapid thalamus/cerebellum/cerebral white matter

movement of PMN through tissue mediated by __

chemokines

acidosis promotes ___

hyperK

trisomy, hCG slightly elevated mom w vaginal bleeding multicystic mass small, grape like masses minimal troph proliferation dx is

partial hydatidiform mole

recurrent N meningitidis infections seen w

terminal complement defic

__ is intact, indicates __ and not ___ __ have eosinopgilic cytoplasm surrounded by __

BM, metaplasia, dysplasia epithial macros fibrotic ring

lots of energy req to miantain correct ___ w nutrient dep, cell struggles to ___ difficulties seen in __ and __ cells round up w injury to keep low ___ ratio

cellular structure maintain shape neurons, renal podocytes SA to V

Cellular swelling induces uptake of __ to maintain __ cells drop microvilli becomes important in __ w __

water, electron pumps GI dz, celiac dz

Irreversible processes Nuclear ___/___ Lysosome __ and release of __/___

frag, pyknosis | rupture, lytic proteins/endonucleases

CGD def in ___ __ allow for PMN adherence __ damages endothelium, released from ___

NADPH oxidase integrins TNF, macros

Acute inflam response predominant cell type stops __ as macros release __/__ to upregulate receptors on __/___

PMNs laminar flow, chemokines/cytokines endothelium/leuks

chronic infam cell type | takes __

monocytes/T lymphs | long time

Apoptosis w __/__ Intrinsic occurs following __ __ is anti-apoptotic __ regulates caspases, which eventually destroy material Extrinsic pathway- __ mediated includes ___

nuclear fragmentation/condensation injury BCL2 p53 receptor PD1

most common cause of mental retard in males

Fragile x syndrome

regulation of coag factors occurs from ___ Thrombin cleaves __ to __ w intact endothelium Thrombin binds to thrombomodulin, generates ___ interacts w __/__ to inhibit __

endothelial cells F5/8, F5a/8a thrombomodulin receptor anti-thrombin 3 PGI2/TXA2, F5a/8a

__ mutation inc risk of clots always __ thrombosis __ mutation is venous thrombosis

Factor V leiden venous Prothrombin

DIC- widespread, multiple __ w immediate __ inc __, __/__, __ __ in smear, low __/__

microthrombi, lysis D dimer, PT/PTT, thrombi schistocytes, platelets/fibrinogen

cells tht __ are apoptotically programmed __ most cancerous mutation early lesions active __, inactive __ or alter genes for ___ Pathway- GF to __ to ___ to __ __ most common signal transduction cancer

constantly replicating p53 signal transducre, tumor suppressor, apoptosis receptor, signal transduction, cell cycle RAS