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Pathology > Chapter 9 And 10 > Flashcards

Chapter 9 And 10 Flashcards

1
Q

Cyp450 and benzopyrene

A

Generates dna binding metabolite from benzopyrene present in cigarette smoke and grilled meats

Oxidized by hyp2e1 which disrupts differentiation of hematopoietic cells resulting in bone marrow aplasia and AML

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2
Q

How does ground level ozone damage

A

Respiratory epithelium and type 1 alveolar cells ——inflammatory mediators

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3
Q

CO poisoning causes hypoxia then unconsciousness. Describe what happens with hypoxia

A

Decreased oxygen to brain-neuro prob
Lactic acidosis
Breakdown of heart and skeletal muscle creatine kinase

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4
Q

Chronic CO poisoning

A

Basal ganglia and lenticular nuclei first

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5
Q

Morphological changes with CO

A

Brain edema
Punctuate hemorrhage’s
Hypoxia induced neuronal changes

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6
Q

Lead major targets

A 
Bone marrow blood nervous system first
Microcytic hypochromic anemia 
Punctuate wrist drop foot drop 
Renal interstitial fibrosis 
Decreased uric acid secretion saturnine gout
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7
Q

Arsenic poison

A

2-8 weeks
Sensorimotor neuropathy , numbness and pain

Chronic-lung bladder skin cancer

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8
Q

Beryllium

A

Inhaled

Sarcoidosis like granuloma

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9
Q

Chromium and nickel

A

Upper respiratory carcinoma

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10
Q

Organic solvents

A

Leukemia

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11
Q

What is cofactor of Alcohol dehydrogenase . Is this a problem

A

NAD
Can’t beta oxidation and lactate to pyruvate
Acid and fatty liver

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12
Q

How does alcohol cause hepatic injury through tnf and cytokines from macrophages and Kupffer cells

A

Causes release of endotoxin lps from gram negative bacteria in intestinal Fluora

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13
Q

Acute alcohol

A

Subcortical(RAS dependent) -reticular formation -cortical activity

Thennnnnnn lower medulla neurons —respiratory centers respiratory arrest
Acute gastritis and ulceration
Higher levels respiratory arrest

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14
Q

Chronic alcoholism

A

Peripheral neuropathies
Wernicke
Gi bleeds
Dilated heart alcohol cardiomyopathy

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15
Q

____ adductor have been found in alcohol related tumours. What individuals are most susceptible

A

Acetylaldehyde

ALDH22

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16
Q

HRT increases risk of what

A

Ovarian and endometrial cancers

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17
Q

Acetaminophen is made to NAPQI. What metabolizes NAPQI. Clinicaleffects

A

Glutathione conjugates. It. Glutathione low if have a lot. So NAPQI covalently binds to hepatic proteins and damages things and depletes gsh—SUSCEPTIBLE TO ROS, which you get from cyp

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18
Q

How restore glutathione

A

N acetylcysteine

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19
Q

Overdose acetaminophen

A

Centrilobular necoris
Extens to lobules
Liver transplant only hope for survival

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20
Q

Aspirin overdose

A

Bleed prob

Increase breathing -respiratory alkalosis
Compensatory acidosis uncoupling ox phos and stop Krebs cycle

NAUSEA COMA

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21
Q

Chronic asprin

A

Acute erosive gastritis gi bleeds and gastric ulceration

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22
Q

Analgesic nephropathy

A

Asprin and acetaminophen

Tubulointerstitial nephriits, renal papillary necrosis
Analgesic nephropathy

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23
Q

Opiates

A 
Sudden death-depression 
Pulmonary injury-edema sepsis embolism granuloma 
Infection SA right sided tricuspid value
Skin 
Kidney amyloidosis
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24
Q

Meth

A

Releases dopamine in brain inhibits presynaptic neurotransmission at corticostriatal synapses
Slow glutamate release
Euphoria then crash
Violence, confusion psychotic paranoia

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25
MDMA
``` Euphoria hallucinations 3-6 hours Increase serotonin in cns Post use drop in serotonin Reduces serotonergic axon terminals Increase peripheral effects of dopamine ```
26
Marijuana
Increase heart rate. And bp Angina Laryngitis, pharyngitis, bronchitis, cough and hoarseness Cognitive impairments Threefold increase in amount of tar inhaled compared to cigarette
27
Bath salts
Amphetamine | Agitation psychosis mI suicied
28
PCP
Anesthetic
29
Ketamine
Anesthetic
30
Burn
Shock sepsis respiratory insuffiency
31
Infections of burns
PA MRSA candida
32
Heat stroke progression
Thermoregulatory mechanism fail-sweating ceases body temp rises multiorgan dysfunction death
33
Presentation heat stroke
Vasodilation, peripheral pooling of blood decreased effective circulating volume Sustained muscle contractions Hyperkalemia tachycardia Arrhythmia
34
Malignant hyperthermia
``` Ryr1 mutation Sarcoplasmic reticulum release ca sustained muscle contraction After given succinylcholine Treat with dantrolene INCREEASE RIGHT OF HEAT STROKE ```
35
What causes sustained muscle contraction
Nitrosylation of ryanodine receptor
36
Hypothermia
Below 90 lose consciousness then bradycardia and a fib
37
Direct cause of injury from hypothermia
Increase na from crystallization of water intra and extracellular ya
38
Indirect causes of hypothermia damage
Slow chilling-vasoconstriction increased permeability hypoxia and edema Fast chilling vasoconstriction and viscocity-ischemic injury and degenerative changes in peripheral nerves (ischemia and infarction) Vascular injury evident after termpature returns to normal
39
Electrical injur
Burns and ventricular fibrillation | Titanic muscles make hard to let go of a live wire
40
Morphology of ionizing radiation
Dna damage Nuclear swelling Soto plasmid swilling and distortions Vessels dissolute
41
Marsumus
``` Somatic protein compartment issue Albumin normal Muscle and fat are energy sources Leptin low-Hpv axis-cortisol-lipolysis Head too large for body ```
42
Kwashiorkor
``` Visceral protein problem Hypoalbumin low-EDEMA dependents Spare subcutaneous muscle mass Hyperpigmentation /flakey Enlarged fatty liversmall bowel decreased villi and crypts (mitosis index) They mic and lymphoid atrophy ```
43
Bone marrow in PEM
Aplastic anemia
44
Anorexia
Cardiac arrhythmia, sudden death from hypothalamic
45
Vitamin a defiency
Squamous metaplasia-keratinizing epithelium Celiac disease Xeropthalmia Keratin plaque (bigot) Desquamation of keratin in urinary tract leaders to renal and urinary bladder infections
46
Follicular or popular dermatomes vitamin a defiency
Hyperkeratinization of the epidermis with plugging of the adnexal gland ducts
47
Why is vitamin a a treatment for acute promyleocytic leukemia cells
Bind pml-rar fusion protein that characterize the cancer
48
Clinical vitamin a defiency
Night blind, epithelial metaplasia keratinization (need vitamin a to differentiate epithelial cells) Bigots spot Squamous metaplasia -pulmonary infections, bladder stones, immune, follicular or popular dermatomes
49
Vitamin a toxicity
Head ache vomit, stupor blurred vision (pseudomotor cerebri) Weight loss, anorexia, vomiting, bone and joint pain OSTEOCLASTS-increased bone resorption and increased frequency fractures
50
Low ca, increase of decrease PTH
Increase
51
Vitamin d and osteoclast
Increase ca increase osteoclast to make more bone
52
PTH effect on vitamin d
More
53
Rickets
Overgrowth cartilage failure of it to mature
54
Are contours of bone effected in rickets and osteomalatia
Just rickets
55
TLR activation of macrophages can induce the increase the conversion of ___ to its active form
Vitamin d
56
Too much vitamin d
Metastatic calcification
57
Scurvy
Bone disease in growing kids and by hemorrhage’s in healing adults
58
Iron defiency
Hypochromic microcytic anemia
59
B1
Decarboxylation reactions Wernickes Korsakoff Beri beri
60
B6
Myelinated spinal cord
61
Obesity
T2d, cholelithiasis, cancer | 35% Americans obese
62
Thermogenesis
Leptin induced
63
What protective hormone is decreased in obese patients that protects against metablic syndrome
Adipolectin
64
Pomc cart
Energy expenditure msha
65
Npy agrp
Food intake via 71/5
66
Pickwickian syndrome
Respiratory problems obese | Hypoventilation
67
Obesity causes a pro __ state
Inflammatory
68
Why high animal fat give cancer
Bile and lower stool bulk and fewer fibers to bind harmful carcinogens
69
Why intrauterine infections the second leading cause of preterm births
Tlr inhibit prostaglandin
70
Fetal causes of fgr
Torch | Chromosomal congenital
71
Placental causes of fgr( spare brain)
3rd trimester burden Umbilical placental anomalies Multiple gestational
72
Maternal causes of fgr
Thrombophilias: acquired antiphospholipid syndrome Preeclampsia Drugs alcohol malnutrition DECREASED PLACENTAL BLOOD FLOW
73
In rds, hypoxemia causes what
Further failure in surfactant synthesis
74
What makes surfactant
Glucocorticoids, tgf b thyroxine prolactin
75
How does maternal diabetes effect surfactant
Increased glucose levels in mom increases insulin in baby-inhibit surfactant synthesis Treat with corticosteroid
76
Atelectais
Alveoli poorly developed | Eosinophils hyaline membranes
77
Bronchopulmonary dysplasia
Striking decrease in alveolar septation (large simplified alveolar structure) and a dysmorphic capillary configuration Reversible impairment in the development of alveolar septation in saccular stage From hyperthermia, hyperventilation, prematurity , inflammation tnf il1,6,8 and vascular maldevelopment
78
Infants who recover from rds are at increased risk of what
Pda, intracentricular hemorrhage and necrotizing entercolitis
79
Pneumatosis intestinalis
Nec | Necrotizing enterocolitis
80
Is nec multifactorial
Yup usually start after feeding (bacteria introduction so after that
81
Morphology nec
Terminal ileum, cecum, right colon, submucosal gas bubbbles
82
Treat nec
Resection, fibrosis
83
Transcervical infections
Bacterial except herpes
84
Transplacental infection
Viral parasitic except listeria treponema Through chorionic villi Parvovirus B19
85
Early onset perinatal sepsis
Pneumonia sepsis meningitis Group b strep Week
86
Late onset perinatal sepsis
Late onset listeria and candida | Week to three months
87
HYDROPS
Anemia and jaundice Anemia liver and hear damage Less albumin Edema, hydrops fetalis anasarxa Jaundice-hemolysis unconjugated
88
Anasarca
Generalized edema
89
Non immune hydrops
Cv defects, abnormalities, anemia, Turners, 18, 21, due to cv problem Turners-lymphatics in neck can lead to postnuchal accumulation (cystic hygroma) Anemia-a thalassemia deletion of a globin
90
Hydrops associated with anemia
``` Pale fetus and placenta Hepatosplenomegaly due to cv and congestion Erythroid precursors EXTRAMEDULLARY HEMATOPOIESIS ERYTHROBLASTOSIS FETALIS ```
91
Kernicterus
Enlarged brain Edema Yellow
92
Pku normal at birth
6 months mental retardation
93
Galactosemia
``` Fail to thrive from birth Cataracts weeks Mental retard 6 months AMINOACIDURIA Less aa transport due to accumulation in kidney ```
94
Cf and vit a
Vit a defiency leads to night blindness and squamous metaplasia of ducts of pancreas
95
Salivary gland cf
Dilation of ducts squamous metaplasia and glandular atrophy and fibrosis
96
Meconium ileus
5-10% cf
97
SIDS triple risk
Vulnerable infant (serotonin reticular activating system) Exogenous stressor Critical development period
98
Laryngeal chemoreceptors
Stimulated inhibit cardiorespiratory reflex Respiratory infection increased secretions Prone impairs swallowing
99
Male or female SIDS
Male
100
Heterotopia(choristoma)
Normal cells in abnormal locations
101
Hamartoma
Focal growth of tissue that is native to site of origin Mature and well differentiated but does not follow the architecture of the original tissue Like a neoplasm
102
Hemangioma
Hippel lindau Subsets familial with cerebral cavernous malformations CCM
103
Lymphangiomas
Hamartomatous or neoplasticism Cystic and cavernous spaces skin but more likely deeper Benign Can grow and encroach on vital tissues
104
Lymphangiectasis
Dilation of lymph channels Swelling Doesn’t extend Cosmetics
105
Fibrosarcoma
Same as adult Excellent prognosis Etv6-ntrk3 fusion
106
Teratomas
Malignant potential with amount of immature tissue
107
Peaks for teratomas
2 and early adult
108
Most common teratomas of kids
Sacrococcygeal Girls Spina bifida most mature Older get more likely to be malignant
109
Adult malignant tumor
Mesenchyme hematopoietic nervous system bone kidney
110
Neuroblastic Germaine mutation
Anaplastic lymphoma kinase alk
111
Somatic gain of function in alk
Less than 10% of sporadic
112
Rosetttes
Neuroblastoma | Tumor cells concentrically arranged about a central space filled with NEUROPIL
113
Galgioneuroblastoma ganglioneuroma
Larger, Schwann | FAVORABLE
114
Neuroblastoma clinical
``` Large abdominal mass fever weight loss respiratory bone pain Pro ptosis each Yoshi’s Bladder bowel dysfunction catecholamines BLUEBERRY MUFFIN BABY VMA HVA ```
115
Poor prognosis neuroblastoma
``` Myc Deploidy 1p 11q loss 1p36 loss Trkb (a favorable) Atrx and ptprd genes (neuritogenesis) ```
116
Wilms
Most common primary renal tumor of childhood 1-5 | Nephrogenic rests precursors

Pathology (36 decks)

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