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ASDOH Clinical Pathology > Test 1 > Flashcards

Test 1 Flashcards

1
Q

]Cells adapt to change in 6 distinct ways, what are they?

A 
○	Atrophy
○	Hypertrophy
○	Hyperplasia 
○	Metaplasia
○	Dysplasia
○	Anaplasia
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2
Q

Whats the best example of Atrophy

A

■ Thymus undergoing involution

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3
Q

The best example of pathological Atrophy

A

■ Ischemic organs are typically small (kidneys involved in atherosclerosis)

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4
Q

The best physiologic example of Hypertrophy

A

■ Skeletal muscles in body builders due to weight training

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5
Q

The best pathologic example of Hypertrophy

A

■ Hypertrophy of the heart that occurs as an adaptation to increased workload

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6
Q

The best pathologic hyperplasia example

A

○ Endometrial hyperplasia due to estrogens

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7
Q

Best physiologic hyperplasia example

A

■ Physiologic hypertrophy of the uterine smooth muscle cells during pregnancy accompanied by hyperplasia

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8
Q

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

A

Metaplasia

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9
Q

Examples of adaptive change of one cell type for another to suit the environment

A

○ Squamous metaplasia of the bronchial epithelium due to smoking
○ Gastric or glandular metaplasia of the GE junction in Barrett’s esophagus

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10
Q

Disordered growth of tissues resulting from chronic irritation or infection

A

Dysplasia

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11
Q

The best example of Dysplasia

A

■ Cervical intraepithelial neoplasia or CIN based on PAP smears

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12
Q

Undifferentiated and uncontrolled growth of cells. The hallmark of malignant transformation!

A

Anaplasia or cancer

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13
Q

Other names for Anaplasia

A

○ Malignancy
○ Carcinoma
○ Cancer
○ Neoplasm

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14
Q

What are Microscopic hallmarks of anaplasia?

A

○ Cell and nuclei display marked cellular pleomorphism
■ Variation in size and shape
○ Nuclei are irregular and hyperchromatic
○ Extremely high nuclear/cytoplasmic ratio (N/C ratio)
■ About 1:1 instead of 1:4 or 1:6
○ Large nucleoli present within the nucleus
○ Large numbers of abnormal mitotic figures

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15
Q

Reversible Cell Injury characteristics

A

○ Swelling of the cytoplasm and it’s organelles due to malfunctioning ATP Na/K pump
○ Glycolysis takes over, PH decreases
○ If energy is restored the cell will survive and balance out.

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16
Q

condensation of the chromatin

A

■ Pyknosis

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17
Q

Fragmentation of the nucleus into small particles (nuclear dust)

A

■ Karyorrhexis

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18
Q

Involves dissolution of the nucleus and lysis of chromatin by enzymes

A

■ Karyolysis

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19
Q

Characteristics of irreversible cell injury

A

DNA in the Nucleus is damaged, cytoplasm is destroyed. Cells will release/leak enzymes into the ECF e.g… Hepatocytes release AST or LDH

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20
Q

What is coagulative cell necrosis?

A

■ The most common form of necrosis
■ Occurs when cell proteins are altered or denatured
■ Cell outlines are preserved and the cytoplasm appears finely granular
■ Occurs in solid internal organs
● Ex: heart, kidney, spleen, and liver
infarction
■ Appears white: dead myocytes and neutrophils that have infiltrated before the cells died

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21
Q

■ Most often caused by anoxia
● Ex: heart tissue undergoing a myocardial
■ Occurs in solid internal organs
● Ex: heart, kidney, spleen, and liver
infarction

A

coagulative cell necrosis

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22
Q

What is Liquefactive necrosis?

A

■ Refers to a process by which dead cells liquefy under the influence of certain cell enzymes

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23
Q

■ Occurs most often in the brain
● Brain cells lose their contours and liquify
● Typical of brain infarcts which are usually soft and are ultimately transformed into a fluid filled cavity

A

Liquefactive necrosis

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24
Q

What is caseous necrosis?

A

■ A form of coagulative necrosis in which a thick, yellowish, cheesy substance forms

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25
Q

■ Typically found in tuberculosis, characterized by the development of lung granulomas, inside of which can be found caseous necrosis
■ Can also be seen in some fungal infections

A

caseous necrosis

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26
Q

Fungi responsible for caseous necrosis in some infections

A

● Histoplasmosis

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27
Q

What is Fat necrosis?

A

■ A specialized form of liquefaction necrosis caused by the action of lipolytic enzymes
■ Limited to fat tissue, usually around the pancreas

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28
Q

What is one of the best example of fat necrosis?

A

● Enzymes are released into adjacent fat tissue after rupture of the pancreas (due to trauma, acute pancreatitis, etc) causing degradation of fat into glycerol and free fatty acids

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29
Q

What are Dystrophic calcifications?

A

○ Represents an extracellular deposition of calcium from the circulation into dead or dying necrotic tissue, often visible to the naked eye

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30
Q

The best example of Dystrophic calcification

A

■ Calcifications in atherosclerotic coronary arteries contributing to narrowing of vessels

Others
■ Calcifications of the mitral or aortic valves leading to impeded blood flow (stenosis)
■ Calcifications seen around breast cancers that can be visualized by mammography
■ Infact periventricular calcifications seen in congenital toxoplasmosis

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31
Q

What are Metastatic calcifications?

A

○ Reflects derange calcium metabolism, NOT cell injury, usually associated with increased serum calcium levels, leading to deposition of calcium in other locations

32
Q

When do we see Metastatic calcification?

A

■ Hyperparathyroidism
■ Vitamin D toxicity
■ Chronic renal failure
calcium stones in gall bladder, kidney, and bladder are due to precipitation of salts from solution into tissues.

33
Q

Have expansile growth and compress the normal surrounding tissue WITHOUT infiltration or invasion

A

Benign tumors

34
Q

Characteristics of Benign Tumors

A

○ Histologically, composed of cells that resemble the tissue from which they have arisen
○ Cells are composed of a uniform population in which all the cells have the same features
■ Regularly shaped round or oval nuclei
■ All the same size with evenly distributed chromatin and normal nuclei
■ Well-developed cytoplasm

35
Q

Histologically show prominent anaplasia

A

Malignant tumors

36
Q

Spread of malignant cells occurs through three main pathways:

A

○ Lymphatics
○ Bloodstream
○ Direct extension of the primary tumor

37
Q

A cancer that loves to spread through Lymphatics

A

Breast

38
Q

A cancer that loves to spread through the Bloodstream

A

Many, Not sure which one’s best.

39
Q

A cancer that loves to spread through Direct extension of the primary tumor

A

■ Usually by seeding of the surface of the body cavities

■ Renal cell carcinoma seeding to the adrenal

40
Q

Tumors derived from the 3 germ cell layers are called:

A

○ Teratomas (benign)

○ Teratocarcinomas (malignant)

41
Q

Not all tumors that end in “-oma” are benign, and the most important examples are?

A

○ Lymphomas
○ Melanomas
○ Astrocytomas
○ Seminomas

42
Q

Malignant tumors of epithelial origin are called

A

carcinomas

eg..
○ Squamous cell carcinoma
○ Adenocarcinoma
○ Transitional cell carcinoma

43
Q

The names for malignant tumors of connective tissue origin are coined from the root of the cell type and suffix

A

sarcoma

44
Q

Malignant tumors composed of embryonic tissue are called.

A

Blastomas

e.g…
○ Retinoblastoma
○ Neuroblastoma
○ Medulloblastoma

45
Q

What are the three grades of malignancy

A

○ Grade I: well-differentiated
○ Grade II: moderately differentiated
○ Grade III: poorly or undifferentiated

46
Q

TMN Criteria takes into account…

A

○ Tumor size
○ Lymph node status
○ Distant Metastasis

47
Q

What cancer(s) do Nitrosamine cause?

A

■ GI Tract cancers (especially esophageal and stomach cancers)
■ Nitrates (preservatives) may react with other dietary components to form nitrosamines

48
Q

What cancer(s) do Polycyclic Aromatic Hydrocarbons cause?

A

○ lung cancer
○ skin, soft tissue, and breast cancers
○ angiosarcoma of the liver

49
Q

dibenzanthracene cause cancer in…

A

implicated in skin, soft tissue, and breast cancers

50
Q

Vinyl Chloride (plastics) implicated in cancer of?

A

angiosarcoma of the liver

51
Q

Nature of Aflatoxin B1

A

■ Natural product of aspergillus flavus, among the most potent liver carcinogen
■ Contaminates produce in Africa and Asia

52
Q

Effect of Aromatic Amines (Naphthylamina/ Azo Dyes)

A

■ Indirect action on urinary bladder and liver tumors
● Liver: due to metabolism
● Bladder: hydrolysis to hydroxylamine causing cancer

53
Q

Effects of UV Light

A 
●	Enzyme activation
●	Inhibition of cell division
●	Mutagenesis
●	Cell death
●	Cancer (skin)
54
Q

Most important effect of UV light is

A

Formation of pyrimidine dimers of DNA, not seen in any other carcinogen

55
Q

Asbestos causes?

A

■ Mesothelioma

56
Q

HPV virus causes?

A 
■	DNA virus that induces lesions that progress to squamous cell carcinoma in the:
     ●	Cervix
     ●	Oropharynx
     ●	Penis
     ●	Anus
     ●	Vagina
57
Q

Hepatitis B causes?

A

development of hepatocellular carcinoma

58
Q

Epstein-Barr Virus causes?

A

Causes Burkitt’s Lymphoma and Nasopharyngeal Carcinoma
● Burkitt’s in African children
● Nasopharyngeal in Africa and Asia

59
Q

Human Herpesvirus 8 causes?

A

Kaposi Sarcoma which is a vascular neoplasm associated with AIDS patients

60
Q

Mutated normal cellular genes (proto-oncogenes) that normally encode for proteins important to basic cell function regulating growth and differentiation

A

Oncogens

61
Q

Proto-oncogenes are transformed into oncogenes by four basic mechanisms:

A

● Point mutations:
● Gene amplification:
● Chromosomal rearrangements:
● Insertion of the viral genome:

62
Q

Two best known Tumor Suppressor Genes

A

retinoblastoma gene 1 (Rb-1) and p53

63
Q

What is Barrett’s esophagus?

A

■ Glandular cell metaplasia in esophagus

64
Q

■ Benign tumor of epithelial origin:

A

papilloma

65
Q

■ Benign tumor of connective tissue

A

name of tissue “-oma”

66
Q

■ Benign tumor of glandular:

A

adenoma

67
Q

■ Malignant tumor of epithelial origin

A

Carcinoma

68
Q

■ Malignant tumor of glandular origin

A

adenocarcinoma

69
Q

■ Malignant tumor of connective tissue:

A

Sarcoma

70
Q

■ Malignant tumor of placental origin:

A

Blastoma

71
Q

The five exception to the benign “-oma” rule

A

■ Seminomas, lymphomas, mesothelioma, astrocytoma, melanoma

72
Q

Differentiate necrosis from autolysis

A

○ Necrosis is in living cells, autolysis occurs after death

73
Q

Who does the grading vs. who does the staging?

A

○ Pathologist→ grading

○ Oncologist→ staging

74
Q

● Japan and Latin America (Chile), also Ireland

● 10x higher in these countries than in US

A

■ Stomach Cancer:

75
Q

● Highest incidence in US (3-4x more common)

● High fiber diet in India, Japan, Africa, and Latin America decreases risk (US has high fat diet)

A

■ Colorectal Cancer:

ASDOH Clinical Pathology (3 decks)

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