Week 7 + Pathology Flashcards
When you see a tumor that is necrotic, what does that tell you?
The tumor is growing too fast for its blood supply to keep up.
Is an in-situ neoplasm malignant? Is it considered cancer?
It is malignant, but it is not “cancer” because the basement membrane is keeping it confined. Given time, it will break through the BM.
What is the difference between grading and staging?
Grade is dependent on microscopic evaluation: How closely do the cells resemble the cell of origin?
Stage refers to the degree of cancer spread to lymph nodes and to distant sites.
What are the seven hallmarks of cancer?
- Self-sufficient in growth signals.
- Evades the immune system.
- Evades apoptosis.
- Immortal.
- Insensitive to growth inhibition.
- Angiogenesis.
- Metastasis.
State whether each of the following is a good prognosticator, or a bad prognosticator for breast cancer:
Her2/Neu positive
Estrogen receptor positive
Progesterone receptor positive
Her2/Neu is bad.
Estrogen and progesterone receptors are good; can be used as targets for cancer treatment.
Do most metaplastic and hyperplastic tissues eventually progress to neoplasia?
Nope
Name three organ systems that are affected by hereditary hemochromatosis (aka bronze diabetes) and clinical findings associated with each organ.
Liver: cirrhosis appears as irregular borders on CT, biopsy would show collagen and fibrosis between hepatocyte nodules.
Skin: hyperpigmentation.
Pancreas: iron accumulation in pancreas would show staining for iron. Grossly, the pancreas would be dark brown. There is also no insulin secretion due to beta cell damage, so the patient may be hyperglycemic.
How does a mutated HFE gene ultimately cause cell damage?
Too much iron uptake in the GI tract –> free iron generates a lot of reactive oxygen species –> cell damage
What is the genetic mutation involved in hereditary hemochromatosis?
Mutation in the HFE gene
What tends to accumulate in hepatocytes when metabolic processes are altered?
fat
What does oil red O stain do?
Stains fat red
Plaques are made of accumulations of ________, whereas tangles are made of ________ protein.
plaques are made of beta-amyloid, tangles are made of Tau protein
________ is “cellular trash” that can accumulate in cells that don’t divide much, such as ______ and ______ cells.
Lipofuscin can be seen in neurons and cardiac cells.
What is amyloid and how does it form?
Amyloid can form when any protein misfolds, forming beta-pleated sheets that render the protein insoluble, leading to the tendency to aggregate.
_____ protein is an insoluble amyloid protein that forms in the setting of multiple myeloma, where plasma cells make _____ that misfold and accumulate.
AL protein is the insoluble protein that is a result Ig/antibody misfolding and accumulation
In the setting of _______ _______, macrophages remain activated, releasing IL-1 and IL-6, which stimulates ______ cells to secrete ______ protein that can misfold and form insoluble aggregates of _____ protein.
in the setting of chronic inflammation, macrophages secrete cytokines and stimulates liver cells to secrete serum amyloid A (SAA protein) –> AA protein aggregations (amyloidosis)
What type of amyloidosis is characterized by mutant transthyretin that aggregates and forms ATTR proteins?
Familial amyloidosis
Which stain is used specifically for amyloid? How does it do it?
congo red stain intercalates between beta-pleated sheets and gets stuck in there
If you see positive staining with congo red polarized light apple-green birefringence on a histo slide from the brain of a patient with Alzheimer’s, what does that indicate?
There are amyloid plaques in the brain.
In the development of amyloidogenesis, there is an enzymatic switch from _________ to ________, resulting in the release of __________ peptides that form aggregates –> amyloid fibrils.
enzyme switch from alpha-secretase to beta-secretase –> A-beta peptide release –> A-beta aggregates –> amyloid fibrils
Are prions normally found in neurons?
Yeah
