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Clin Path > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Decrease in the size of a tissue, organ, or the entire body

A

Atrophy

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2
Q

_________ physiologic examples include:

thymus undergoing involution, ovaries, uterus and breast after menopause, and elderly bone

A

atrophy

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3
Q

3 Pathologic examples of atrophy from slides

A
  1. Ischemic organs are typically small
  2. testicular atrophy
  3. alzheimer dementia
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4
Q

An increase in the size of tissue or organs due to enlargement of individual cells?

A

hypertrophy

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5
Q

Enlargement of skeletal muscles in body builders due to weights is physiologic example of what?

A

Hypertrophy

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6
Q

Name 2 pathologic examples mentioned in the slides of hypertrophy

A
  1. the heart as an adaptation to increase workload

2. The left ventricle of the heart due to hypertension (concentric hypertrophy)

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7
Q

An adaptive increase in the number of cells that can cause enlargement of tissue or organs?

A

Hyperplasia

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8
Q

2 examples from the slides of hyperplasia

A
  1. Endometrial hyperplasia due to estrogen

2. hyperplastic polyps of the colon or stomach

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9
Q

T/F hyperplasia and hypertrophy can be seen together?

A

True - BPH increase both the size, number of glands, and stroma of the prostate. Also during pregnancy, hypertrophy of the uterine smooth muscle cells is accompanied by hyperplasia

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10
Q

An adaptive change of one cell type from another to suit the environment.

A

Metaplasia (reversible)(can progress to dysplasia)

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11
Q

Two examples of metaplasia mentioned in slides.

A
  1. Squamous metaplasia of the bronchial epithelium due to smoking
  2. Gastric or glandular metaplasia of GE junction in Barrett’s Esophagus
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12
Q

Disordered growth of tissues resulting from chronic irritation or infection

A

Dysplasia - considered a precancerous condition

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13
Q

Best example of dysplasia?

A

Cervical dysplasia (cervical intraepithelial neoplasia or CIN) based on PAP smears ** Remember there is an association of dysplasias and cervical cancers with HIV

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14
Q

Undifferentiated and uncontrolled growth of cells - the hallmark of malignant transformation

A

Anaplasia (AKA malignancy, carcinoma, cancer, neoplasm)

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15
Q

5 cellular Hallmarks of Anaplasia

A
  1. Cellular Pleomorphism
  2. Hyperchromatic nuclei
  3. High nuclear/cytoplasma ratio
  4. Large nucleoli
  5. Abnormal mitotic figures
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16
Q

______ tumors have a limited growth potential and a good outcome. Often _________ which is composed of CT. They have _______ growth and usually _______ the normal surrounding tissue. Histologically they are composed of cells that resemble the ________ from which they have arisen. The cells are composed of a ______ population and a ____ developed cytoplasm.

A 
Benign
Encapsulated
Expansile
Compress
Tissue
Uniform
Well
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17
Q

The cells of benign tumors usually retain the microscopic features of their _____ of ______. The tumors are thus ______ according to the cell type which they resemble the most, with the addition of the suffix _____. If the tumor is of epithelial and glandular origin the tumor is an ________, if squamous, the benign tumor is a _______.

A 
Tissue 
Origin
Named
-oma
Adenoma
Papilloma
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18
Q

6 Key features of Malignant tumors

A
  1. Lack capsule
  2. Invade surrounding tissue by infiltration
  3. Hemorrhage
  4. Necrosis
  5. Lack sharp borders
  6. Undifferentiated cells
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19
Q

Malignant tumors of epithelial origin are called ________.

A

Carcinomas (i.e. squamous cell carcinoma, adenocarcinoma, transitional cell carcinoma)

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20
Q

______ increases the risk of mesothelioma and squamous cell cancers. Most common site is the pleura of the lungs

A

Asbestos

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21
Q

Name the 4 oncogenic viruses and what cancer they are linked to.

A
  1. HPV - Squamous cell carcinoma of the cervix
  2. HBV - Primary hepatocellular carcinoma (also HCV)
  3. Epstein-Barr Virus - Burkitts Lymphoma and Nasopharyngeal Carcinoma
  4. HHV 8 - Kaposi’s Sarcoma
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22
Q

Name the 4 ways of activing oncogenes.

A
  1. Point Mutations -> squamous carcinomas, mutated ras/ erb-b gene
  2. Gene Amplification - cell acquires an increased number of copies of the proto-oncogene, more copies more malignant the tumor -> Neuroblastoma (N-myc gene)
  3. Chromosomal Rearrangements - translocation of 1 chromosomal fragment onto another, or deletion. leads to juxtapositioning of genes that are normally distant from one another. -> Burkitts lymphoma (C-myc)
  4. Insertion of the viral genome - typically of slow transforming viruses, results in disruption of normal chromosomal architecture and genetic dysregulation (Hep B)
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23
Q

In regards to cell adaptation, which type is typically mild or short-lived? Characterized by cellualr swelling, AKA hydropic degeneration, and reflects the increased influx of water into the CYTOPLASM and mitochondria from altered permeability of the plasma membrane.

A

Reversible Cell Adaptation

24
Q

In regards to cell adaptation, If acute stress to which a cell must react exceeds its ability to adapt, the resulting changes in structure and function lead to the death of the cell. Morphologically recognized by changes in the NUCLEUS or by rupture of the cell membrane and loss of cell integrity.

A

Irreversible Cell Adaptation - DX by high levels of cytoplasmic enzymes such as AST of LDH, typically found in patients with MI’s or viral hepatitis

25
Q

_________ - seen in tissues after death

A

Autolysis

26
Q

________ - seen in living tissues ( with inflammation)

- death of cells or tissue within a living organism.

A

Necorsis

27
Q

Name the 4 types of Necorsis and examples of where they are found.

A
  1. Coagulative -most common- cell proteins are altered or denatured usually due to anoxia-> MI
  2. Liquefactive - dead cells liquify -> in the brain from infarcts
  3. Caseous - thick, yellowish, cheesy substance -> TB lung granulomas and fungal Histoplasmosis
  4. Fat - specialized form of liquefaction necrosis due to lipolytic enzyme -> fat around pancreas
28
Q

Calcification that deals with deranged calcium metabolism not cell injury and associated with increased serum calcium levels leading to deposition of Ca in other locations -> seen in hyperparathyroidism, vit D toxicity and chronic renal failure. Forms Ca stones

A

Metastatic Calcifications

29
Q

Which Calcification deals with extracellular deposition of calcium from the circulation into dead or dying necrotic tissue often visible to the naked eye and range from gritty, sand-like grains to firm, rock-hard material
Examples:
1. Calcification in Athersclerotic coronary arteries contributes to narrowing of vessels
2. Calcification of the Mitral or Aortic valves leading to impeded blood flow (Stenosis)
3. Calcification seen around breast cancers that can be visualized by mammography
4. Infant periventricular calcifications seen in congenital Toxoplasmosis

A

Dystrophic Calcification

30
Q

How do nitrosamines cause cancer?

A

Nitrites are added to preserve processed food and they react with dietary components to form nitorsamines -> especially esophageal and stomach cancers.

31
Q

What cancer does 3,4, Benzpyrene cause?

A
  • causes lung cancer
  • comes from cigarette smoke
  • type of polycyclic aromatic hydrocarbon
32
Q

Refers to the extent of spread. Done by Oncologist
-It is done by clinically assessing the extent of tumor spread, based on examination, radiographic studies, and biopsy results and takes into account the size of the primary tumor and the presence or absence of lymph node and distant metastasis. Helps decide medical vs surgical tx

A

Staging

33
Q

What is based on the degree of anaplasia and on the number of proliferating cells done by Pathologist
- Anaplasia is determined by the shape and irregularity of the cells, large number of atypical mitoses, nuclear pleomorphism and tumor giant cells.

A

Grading

34
Q

Define the 3 grades of a tumor

A

Grade I - tumor are Well-Differentiated tumor
Grade II - tumors are Moderately Differentiated.
Grade III - tumors Poorly or Undifferentiated

35
Q

What are the 3 routes of metastases?

A
  1. The lymphatics (i.e. Breast cancer)
  2. The blood stream (i.e. Many cancers)
  3. Direct extension of the primary tumor, usually by seeding of the surface of body cavities (i.e. Renal cell carcinoma seeding to the adrenal gland)
36
Q

Where are the more common squamous cell carcinomas located?

A

Lung, esophagus, base of mouth, tongue, cervix, penis, areas of the bladder

37
Q

Where are the more common adenocarcinomas located?

A

Colon, breast, prostate, renal cell, adrenals, liver, gastric, periaortic lymph nodes

38
Q

Highest amounts of stomach and colon cancers by country

A

Stomach -> #1 Japan, Chile, Ireland

Colon -> #1 USA due to high fat low fiber diets

39
Q

Liver cancer is in association with Hep B/C and ?

A

Aflatoxin B1 and azo dyes - endemic to orient and philippines

40
Q

_________ - Normal cells that have regulatory genetic mechanisms that protect them against activated or newly acquired oncogenes

A

Tumor Suppressor Genes

41
Q

Name the 2 best know tumor suppressor genes

A
  1. Retinoblastoma (Rb-1)
  2. p53 (colon or breast carcinoma)
    others include NF-1, BRCA-1, WT-1
42
Q

_________- Mutated Normal Cellular genes that normally encode for proteins important for basic cell function that regulates growth and differentiation. May encode for growth factors, cell surface receptors…

A

Proto-oncogenes

43
Q

_____ is formed from decay chain of _______-_______ series of elements. Emits ____ particles that bind to ____ in the home which equals potential for ______ into lungs. Cancer associated with this -______.

A 
Radon
Uranium-Radium
Alpha
Dust
Inhalation
Lung Cancer
44
Q

____ light causes: enzyme inactivation, inhibition of cell ______, _________, cell death, and _______. Classified as a physical _______. Mechanism: ___ radiation forms ______ dimers of ___. Damage that is not seen with any ________, that is mutagenic and ________.

A 
UV
Division
Mutagenesis
Cancer
Carcinogen
UV
pyrimidine 
DNA
Carcinogen
Carcinogenic
45
Q

Name 3 cancers attributed to UV exposure

A
  1. Basal Cell
  2. Melanoma
  3. Squamous cell
46
Q

What does the most common hematological complication of neoplastic disease result in?

A

marrow inflitration

47
Q

_________ ________ can provide a mean of monitoring recurrence of the cancer in patients who had surgical resection of the tumor or are undergoing chemo/radiation

A

Paraneoplastic Syndrome - systematic effect of cancer not attributed to tumor invasion or metastasis but caused by hormones released by tumor cell.

48
Q

TNM staging refers to?

A

T- Tumor size
N- Lymph Node Status
M - Metastasis
A number is given to each and it helps determine the stage of cancer and to the extent of the spread. Helps decide what tx should be done. ONCOLOGIST DETERMINES

49
Q

Vinyl chloride (makes plastics) exposure can cause?

A

Angiosarcoma of the liver

50
Q

What paraneoplastic syndrome release ACTH?

A

Cushings Syndrome - small cell cancer of the lung.

SS - hypokalemia, HTN, muscle weakness, obesity, buffalo hump, moon face

51
Q

What paraneoplastic syndrome release PTH/TGF?

A 
Squamous cell carcinoma of the lung
Breast adenocarcinoma
Metastatic bone disease
Multiple myeloma and lymphomas
SS- Hypercalcemia due to osteoclast activating factor.
52
Q

What paraneoplastic syndrome release Erythropoietin

A

Renal Carcinoma - most common hematologic complication of neoplastic disease. SS -> polycytemia

53
Q

What paraneoplastic syndrome release Thromboplastin?

A

Pancreatic carcinoma
Mucin producing adenocarcinomas of GI tract and lung
Tumors of breast, ovary, and prostate
SS - Venous thromnbosis - commonly in deep leg veins

54
Q

What 2 paraneoplastic syndrome release Antibodies of NMJ?

A
  1. Small cell carcinoma of the lung. SS -Lambert Eaton Syndrome, resembles Myastenia Gravis, muscular weakness
  2. Thymoma - SS-> Myasthenia Gravis, muscular wekaness, fatigue, wasting.
55
Q

What paraneoplastic syndrome release ADH?

A

small cell carcinoma
prostate, GI or pancreatic cancer. SS -> inappropriate antidiuresis, Na and H2O retention and intoxication, altered mental status, seizures, coma, death

56
Q

What cancer can cause anemia?

A

Gi and colon cancer - usually normocytic and normochromic which are the most common findings in patients with cancer

Clin Path (3 decks)

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