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Systemic Disease > 01. Intro > Flashcards

01. Intro Flashcards

1
Q

Damage to what 4 things are typically found in irreversible cellular injury?

A

Plasma membrane damage
Lysosomal membrane damage
Loss of DNA
Loss of mitochondria

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2
Q

What are the 2 most important factors in irreversible cellular injury?

A

Membrane disturbances

Inability to reverse mitochondrial dysfunction

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3
Q

What 3 things will be observed by a light microscope in irreversible cellular injury?

A

Nuclear Karyolysis (loss of basophilia)
Pyknosis (shrinkage of nucleus)
Karyorrhexis (fragmentation of nucleus)

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4
Q

What 4 morphologic changes will be observed by electron microscope in irreversible cellular injury?

A

Ruptured lysosomes
Myelin figures
Lysis of ER
Large Ca rich mitochondrial densities

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5
Q

What do myelin figures indicate in irreversible cellular injury?

A

Phospholipid precipitation

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6
Q

What cellular changes will be observed using a light microscope in reversible cellular injury?

A

Cellular swelling

Fatty change

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7
Q

Under electron microscope, what will be observed in reversible cellular injury?

A

Cellular blebs

Small mitochondrial densities

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8
Q

What are the 2 phases of apoptosis?

A

Initiation

Execution

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9
Q

During initiation of apoptosis, what becomes catalytically active?

A

Caspases

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10
Q

What causes the actual cellular death during the execution phase of apoptosis?

A

Caspases

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11
Q

What is necrosis?

A

Uncontrolled death of cells due to one of the various causes of cellular injury

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12
Q

What are the 4 types of necrosis?

A

Coagulative
Liquefactive
Fat
Caseous

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13
Q

In coagulative necrosis, which is more prominent: protein denaturation or enxymatic breakdown?

A

Protein denaturation

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14
Q

What organs are most affected by coagulative necrosis?

A

Organs with high fat content

-ex. brain

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15
Q

In coagulative necrosis, what changes are seen regarding eosinophils an basophils?

A

Increased eosinophilia of cytoplasm

Decreased basophilia of the nucleus

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16
Q

What organs are most commonly affected by liquefactive necrosis?

A

High fat and low protein content
High enzymatic content
ex - brain, pancreas

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17
Q

Which is more prominent in liquefactive necrosis: protein denaturation or enzymatic breakdown?

A

Enzymatic breakdown

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18
Q

In liquefactive necrosis, what replaces the dead tissue?

A

Lipid-laden macrophages

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19
Q

What is fat necrosis?

A

Change in adipose tissue due to trauma or the release of enzymes from adjacent organs

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20
Q

What combines in fat necrosis to form chalky deposits?

A

Breakdown of lipid

Release of fatty acids

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21
Q

Caseous necrosis is associated with what type of diseases?

A

Granulomatous

-ex. TB

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22
Q

When cellular architecture is lost, what type of necrosis is most common?

A

Liquefactive

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23
Q

What are the 4 stages of WBC movement?

A

Rolling
Pavementing
Transmigration
Chemotaxis

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24
Q

Rolling of WBCs is at least partially due to what?

A

Margination of WBCs from stasis of blood

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25
Q

What is occurring during the pavementing stage of WBC movement?

A

Tight, constant contact of WBCs with endothelium

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26
Q

What occurs during transmigration?

A

WBCs cross through the endothelial layer

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27
Q

What is chemotaxis?

A

Process by which WBCs are drawn to the site of inflammation

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28
Q

Chronic granulomas are a collection of what?

A

Epithelioid histiocytes (activated macrophages)

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29
Q

What 4 things can cause granulomatous inflammation?

A

Bacteria
Fungi
Foreign material
Unknown (sarcoidosis)

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30
Q

What bacteria most commonly causes granulomatous inflammation?

A

Mycobacteria

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31
Q

What 2 fungi commonly cause granulomatous inflammation?

A

Histoplasmosis

Blastomycosis

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32
Q

What general factors impair healing?

A

DM
Infections
Nutrient deficiency
Glucocorticoid therapy

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33
Q

In healing, what does glucocortacoid therapy result in?

A

Decreased fibrosis

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34
Q

What mechanical factor impairs healing?

A

Dehiscence

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35
Q

What are the 3 factors that can impair healing?

A

General factors
Mechanical factors
Poor perfusion

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36
Q

What are the 3 complications of cutaneous wound healing?

A

Inadequate healing
Excessive scar formation
Contractures

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37
Q

What 2 types of excessive scars can result as a complication of cutaneous wound healing?

A

Hypertrophic scars

Keloid scars

38
Q

What are keloid scars?

A

Tissue beyond the boundaries of the wound

39
Q

Inadequate healing can lead to what?

A

Dehiscence or ulceration

40
Q

Which hypersensitivity type is cytotoxic?

A

Type II

41
Q

Which hypersensitivity type is delayed?

A

Type IV

42
Q

Which hypersensitivity type is immediate?

A

Type I

43
Q

Which hypersensitivity type is autoimmune?

A

Type III

44
Q

What mediates type I hypersensitivity reactions?

A

IgE

45
Q

What mediates type II hypersensitivity reactions?

A

IgE

46
Q

What mediates type III hypersensitivity reactions?

A

IgE

47
Q

What mediates type IV hypersensitivity reactions?

A

Cell

48
Q

In type I hypersensitivity, IgE binds to what?

A

Mast cells

Basophils

49
Q

Cytotoxic hypersensitivity leads to what type of lysis of cells?

A

Complement-mediated lysis

50
Q

Name 2 types of cytotoxic reaction.

A

Transfusion

Rh reaction

51
Q

Which type of hypersensitivity reaction involves polymorphonuclear cells?

A

Type III

52
Q

Whicy type of hypersensitivity reaction involves immune complexes being deposited in tissues?

A

Type III

53
Q

What is activated/sensed in type IV reactions?

A

T lymphocytes

54
Q

How long does it take for a type I reaction to occur?

A

Minutes

55
Q

How long does it take for a type II reaction to occur?

A

Hours to days

56
Q

How long does it take for a type III reaction to occur?

A

2-3 weeks

57
Q

How long does it take for a type IV reaction to occur?

A

2-3 days

58
Q

Give 4 examples of an ocular type I reaction.

A

Seasonal allergic conjunctivitis
VKC
Atopic KC
GPC

59
Q

What are 3 examples of systemic type I reactions?

A

Allergic rhinitis
Allergic asthma
Anaphylaxis

60
Q

What are 3 examples of ocular type II reactions?

A

Ocular cicatricial pemphygoid
Pemphigus vulgaris
Dermatitis herpetifromis

61
Q

What are 2 examples of a systemic type II reaction?

A

Goodpasture’s syndrome

MG

62
Q

What are 5 examples of ocular and systemic manifestations of a type III reaction?

A 
RA
SLE
PAN
Bechet's disease
Relapsing polychondritis
63
Q

Transplant rejection is what type of hypersensitivity?

A

Type IV

64
Q

What are some examples of an ocular type IV reaction?

A 
Drug allergy
Herpes disciform keratitis
Phlycenulosis
Corneal transplant rejection
TB
Saroid
Uveitis
HSV
SJS
65
Q

Type I reactions cause the release of what 3 preformed mediators?

A

Histamine
Proteases
Chemotactic factors

66
Q

Type I reactions cause the synthesis of what 4 mediators?

A

Prostaglandins
Leukotrienes
Platelet activating factors
Cytokines

67
Q

What are the typical findings of type I atopy?

A

Rhinitis
Allergic asthma
Food allergies
Conjunctivitis

68
Q

What inhaled substances typically cause a type I reaction in the spring?

A

Tree pollen

69
Q

What inhaled substances typically cause a type I reaction in the summer?

A

Grass pollens

70
Q

What inhaled substances typically cause a type I reaction in the fall?

A

Weed pollens

71
Q

Atopic dermatitis is an example of what type of reaction?

A

Type I

72
Q

What are the 3 major eye associations with type I allergy?

A

Dennie-Morgan sign
Atopic keratoconus
Cataract

73
Q

What is Dennie-Morgan sign?

A

Infra-orbital folds in the eyelid

74
Q

What types of cataract are commonly associated with type I allergy?

A

Anterior sub-capsular cataract
Posterior polar cataract
Anterior cortical

75
Q

Which signs of anaphylaxis require the most aggressive treatment?

A

Respiratory signs

76
Q

Epinephrine should typically be administered ASAP in anaphylaxis. However, it should be avoided in what two cases?

A

Cardiac patiens

Current beta-blocker therapy

77
Q

Tachycardia is more likely indicative of what: Anaphylaxis or vasovagal?

A

Anaphylaxis

78
Q

Bradycardia is more likely indicative of what? Anaphylaxis or vasovagal?

A

Basovagal

79
Q

Vasovagal syncope occurs because of stimulation of what nerve?

A

Vagus

80
Q

What are signs of impending vasovagal syncope?

A

Poor verbal response
Sudden sweating
Feeling dizzy

81
Q

In type II reactions, antibody binds to what?

A

Antigen on the cell surface

82
Q

Type II reactions activate what cells for cell-mediated cytotoxicity?

A

NK cells
Eosinophils
Macrophages

83
Q

Give 5 examples of cytotoxic reactions.

A 
Transfusion reactions
MG
Grave's
Hyperacute graft reactions
Pernicious anemia
84
Q

Type III reactions are an inflammation in response to what?

A

Circulating antigen-antibody complexes

85
Q

Give 3 examples of type III reactions.

A

SLE
RA
Serum sickness

86
Q

Type IV reactions are mediated by what cells?

A

T cells

87
Q

A macrophage + T cell + infiltrate = ???

A

Granuloma

88
Q

Granulomatous type IV reactions may come from what 2 conditions?

A

Crohn’s

Sarcoid

89
Q

SJS is what type of reaction?

A

Type IV

90
Q

Toxic shock syndrome is what type of reaction?

A

Type IV

91
Q

In toxic shock syndrome, what bacteria may cause a super-antigen and bind with T cells?

A

Staph

Strep

92
Q

Toxic shock syndrome is commonly associated with what?

A

Cutaneous lesions

Systemic Disease (12 decks)

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