Case Study Exam 1

Question 1

malignant epithelial neoplasm

Answer 1

carcinoma

Question 2

malignant mesenchymal neoplasm

Answer 2

sarcoma

Question 3

malignant neoplasms of hematopoietic cells

Answer 3

lymphoma/leukemia

• oma = swelling/tumor
• emia = of the blood

Question 4

derived from a single cell

Answer 4

clonal

Question 5

differences bw benign & malignant

Answer 5

• differentiation & anaplasia
• rate of growth
• local invasion
• metastasis

Question 6

genes that are altered in cancer

Answer 6

• oncogenes: growth promoting
• tumor suppressor genes: growth inhibiting
• genes that regulate apoptosis
• genes involved in DNA repair

Question 7

role of p53

Answer 7

• tumor suppressor protein

- senses damage, promotes cell cycle arrest, repair, exit from cell cycle or apoptosis

Question 8

____ & _____ oncoproteins inactivate p53 and RB, respectively.

Answer 8

E6 inactivates p53

E7 inactivates RB

Question 9

High-risk HPV oncoproteins

Answer 9

E6 and E7

Question 10

High-risk HPV strains

Answer 10

16 & 18

Question 11

Low-risk HPV strains

Answer 11

6 & 11

Question 12

What is the TNM classification?

Answer 12

T(umor)
N(ode)
M(etastasis)
Describes cancer stage, most powerful predictor of outcome

Question 13

local signs of cancer

Answer 13

swelling, hemorrhage, ulceration, pain

Question 14

metastatic signs of cancer

Answer 14

enlarged lymph nodes, hepatomegaly, splenomegaly, pain or fracture of affected bones, neurological symptoms

Question 15

systemic signs of cancers

Answer 15

weight loss (poor appetite & cachexia), fatigue, anemia, paraneoplastic phenomena

Question 16

cachexia

Answer 16

weakness or wasting of the body due to chronic illness

Question 17

symptoms of acute appendicitis

Answer 17

• periumbilical pain (right lower quadrant)
• nausea
• vomiting
• low-grade fever
• elevated WBC count

Question 18

Cells associated with acute inflammation?

Answer 18

• Neutrophils!

- neutrophilic infiltration of the lumen, muscular wall, & periappendiceal soft tissues

Question 19

Diagnosis of acute appendicitis requires what?

Answer 19

neutrophilic infiltration of the muscularis propria

Question 20

Coagulative necrosis

Answer 20

due to ischemia
-can still see cell outline but protein is denatured inside
-happens everywhere except brain
Ex: myocardial infarction

Question 21

liquefactive necrosis

Answer 21

digestion of dead cells & tissue
-lots of leukocytes, many neutrophils release catalytic enzymes
-typically occurs in CNS
Ex: brain abscess

Question 22

caseous necrosis

Answer 22

looks cheese-like
-due to body trying to wall-off & kill w/ macrophages
Ex: tuberculosis

Question 23

fat necrosis

Answer 23

destruction of fat
-chalky calcification
saponification
Ex: breast fat necrosis, pancreatitis

Question 24

gangrenous necrosis

Answer 24

coagulative necrosis in limb, lack of blood flow.

Ex: gangrene toe

Question 25

fibrinoid necrosis

Answer 25

antigen deposits in vessel and fibrils form around it

Question 26

Risk factors & causes for MI

Answer 26

-major underlying cause: artherosclerosis Risk factors: -smoking, diabetes, HBP

Question 27

Purpose of a cervical PAP test?

Answer 27

to detect squamous intraepithelial lesions (SIL) from HPV infection

Question 28

What are the 4 possible interpretations of a pap test that a pathologist may report?

Answer 28

1) Normal 2) LSIL (low-grade squamous intraepithelial lesion) 3) HSIL (high-grade squamous intraepithelial lesion) 4) In-situ carcinoma

Question 29

Common risk factors for cervical neoplasia

Answer 29

-early age at first intercourse -HIV -multiple sex partners -male partner w/ multiple sex partners -smoking -persistent infection by high-risk strains of HPV** (**most important for progression to carcinoma)

Question 30

What are the causes of appendicitis?

Answer 30

- fecalith (fecal stone) - gallstone - tumor - mass of worms - lymphoid hyperplasia (lymph nodes enlarged in appendix)

Question 31

How to diagnose appendicitis?

Answer 31

adults - CT | kids - abdominal ultrasound

Question 32

treatment of appendicitis

Answer 32

laparoscopic appendectomy

Question 33

what would happen if appendicitis is not treated?

Answer 33

- ulceration > perforation - peritonitis - sepsis > shock > organ failure > death

Question 34

what are the risk factors for MI?

Answer 34

- increasing age - atherosclerosis - male - family/personal history of CAD - tobacco use - diabetes

Question 35

causes of MI

Answer 35

- atherosclerotic plaque changes (rupture, ulceration, hemorrhage) > thrombus (clot) superimposed - embolus (clot dislodges, travels to coronaries) - drugs (ex cocaine) - hypertrophy (large heart needs more O2)

Question 36

Risk factors of cervical neoplasia

Answer 36

- HPV - early stage of first intercourse - multiple sexual partners - smoking - immunosuppression