Pathology Flashcards

1
Q

What protein is overexpressed in follicular lymphoma? [14;18]?

A

Bcl2 overexpressed -> APAF1 overly inhibited -> APAF1 can’t bind and activate cyt. c -> decreased caspase activation

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2
Q

Full out the rest: DNA dmg -> p53 -> …?

A

p53 -> BAX/BAK -> Cyt C -> caspases -> execution

mito pw = intrinsic pw; Fas:FasL is extrinsic pw

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3
Q

What does Bcl-2 inhibit?

A

Cyt C & APAF-1

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4
Q

What is the pathophysiology of fibrinoid necrosis a product of?

A

Immune complexes combine w/fibrin -> vessel wall dmg

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5
Q

Which part of the heart is most susceptible to ischemia?

A

Subendocardium (LV)

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6
Q

Which parts of the kidney are most susceptible to ischemia? (2)

A

PCT (straight part in medulla)

TAL (medulla)

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7
Q

Which liver zone is most susceptible to ischemia?

A

Zone 3 around central vein

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8
Q

Which parts of the colon are most susceptible to ischemia? (2)

A

Splenic flexure
Rectum

(watershed)

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9
Q

What is Wallerian degeneration?

A

Degeneration of axon distal to site of injury (macrophages)

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10
Q

Which pts are usually normocalcemic: those w/dystrophic or metastatic calcification?

A

Dystrophic calcification

besides calcification [dark], see also small bony tissue and thick fibrotic wall on histo

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11
Q

What part of leukocyte extravasation is defective in leukocyte adhesion def. type 2?

A

Margination & rolling (decreased Sialyl-Lewis^x on WBCs, binds selectins)

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12
Q

What part of leukocyte extravasation is defective in leukocyte adhesion def. type 1?

A

Binding (decreased CD18 integrin on WBCs, binds CAM’s)

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13
Q

What structure on both WBC’s and stroma is needed for diapedesis?

A

PECAM-1 on both

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14
Q

What binds during rolling phase (after margination), and where does each come from?

A

Vasculature/stroma:
E-selectin from TNFa and IL-1
P-selectin from weibel-Palade bodies

WBCs: Sialyl-Lewis^x

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15
Q

What binds during the adhesion/tight binding phase?

A

Vasculature/stroma:
ICAM-1
VCAM-1

WBCs:
Integrins (LFA-1, Mac-1, VLA-4)

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16
Q

What binds during the diapedesis phase?

A

PECAM-1 (CD31) in both WBCs and stroma

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17
Q

Actions of PDGF?

A

(secreted via activated platelets, macrophages)

  • Vascular remodeling
  • Smooth muscle cell migration
  • FIbroblast growth -> collagen synthesis
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18
Q

Actions of TGF-beta?

A
  • Angiogenesis (like VEGF, FGF)
  • Fibrosis
  • Cell cycle arrest
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19
Q

What collagen type is first laid down in wound healing (proliferative phase, day 3 - 1 week)? What does it change to during the remodeling phase (1 week to 6+ months)?

A

Type III to type I

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20
Q

Why should you always test for latent TB before starting anti-TNF therapy?

A

TNF-a from macrophages maintain granulomas.

If lost, bacteria may disseminate to the blood.

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21
Q

Describe the basis behind sed rate testing.

A

Erythrocyte sedimentation rate

  • Inflammatory products coat RBCs, cause aggregation
  • Denser RBC’s fall at faster rate
  • Eg’s of high ESR = anemias, infection, cancer, inflammation, renal dz, pregnancy
22
Q

What type of amyloidosis is more often seen after dialysis?

A

Beta2-microglobulin deposits (may p/w carpal tunnel)

23
Q

What type of amyloidosis is more often seen in older pts (senile)?

A

Transthyretin (TTR) deposits in cardiac ventricles

24
Q

What is the beta-amyloid of AD cleaved from?

A

Amyloid precursor protein

25
Q

In what disease does the islet amyloid polypeptide (IAPP) commonly deposit? (*What is this made out of?)

A

T2DM (*amylin in pancreatic islets)

26
Q

What pigment tends to deposit in the heart, colon, liver, eye, and other organs during normal aging?

A

Lipofuscin

27
Q

What does anaplastic mean?

A

Complete lack of differentiation

28
Q

How does dysplasia differ from hyperplasia?

A

Loss of size, shape, and orientation of cells (abnormal proliferation)

Hyperplasia = increased # of cells

29
Q

What do neoplastic cells use to get through BM?

What do they down-relgulate to stop adhering to neighboring cells?

A

MMP’s

E-cadherin

30
Q

What is a tumor “grade”?

A

Degree of cellular differentiation and mitotic activity on histo.
Range: low grade (well-differentiated) to high grade (poorly/un-differentiated or anaplastic)

  • Not that useful vs. stage
31
Q

Which part of TMN staging is most important?

A

M

32
Q

What is a hamartoma?

A

Disorganized overgrowth of tissues in their native lands.

33
Q

What is a choristoma?

A

Nl tissue in foreign land.

34
Q

Fibromas/fibrosarcomas refer to what type of mesenchyme?

A

CT

35
Q

What is the benign version of a melanoma?

A

Nevus/mole

36
Q

Cancer a/w acanthosis nigricans?

A

Gastric adenocarcinoma (& other visceral malig)

37
Q

What is Leser-Trelat sign?

A

Sudden-onset multiple seborrheic keratoses

38
Q

What cancer is Leser-Trelat sign a/w?

A

Gastric adenocarcinoma (& other visceral malig)

39
Q

What cancer is ^ calcitriol a/w?

A

Lymphoma

40
Q

What cancers are PTHrP a/w?

A

SQC of the lung, head, neck.

Renal, bladder, breast, and ovarian carcinomas.

41
Q

What cancers is ^ EPO a/w?

A

RCC, HCC, hemangioblastoma, pheochromocytoma, leiomyoma

42
Q

What 2 paraneoplastic syndromes are a/w thymoma?

A
Pure red cell aplasia (anemia w/ low reticulocytes)
Good syndrome (hypogammaglobulinemia)
43
Q

What is Trousseau syndrome?

A

Migratory superficial thrombophlebitis

44
Q

What cancer is Trousseau syndrome a/w?

A

Adenocarcinomas, esp. pancreatic

45
Q

What is nonbacterial thrombotic (marantic) endocarditis?

A

Deposition of sterile platelet thrombi on heart valves.

46
Q

What cancer is nonbacterial thrombotic (marantic) endocarditis a/w?

A

Adenocarcinomas, esp. pancreatic

47
Q

What cancer is a/w anti-NMDA receptor encephalitis?

A

Ovarian teratoma

48
Q

What cancer is a/w opsoclonus-myoclonus ataxia? (“dancing eyes, dancing feet”)

A

Neuroblastoma (kids)

Small cell lung (adults)

49
Q

What cancer is a/w myasthenia gravis?

A

Thymoma

50
Q

Where are PSaMMoma bodies found? (cancers)

A

Papillary carcinoma of the thyroid
Serous papillary cystadenocarcinoma of the ovary
Meningioma
Malignant mesothelioma

51
Q

What are 4 carcinomas that can spread hematogenously?

A

HCC
RCC
Follicular thyroid carcinoma
Choriocarcinoma

52
Q

Most common cancer to met to the liver?

A

Colon

By far most common. Also stomach, then pancreas