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General Pathology Flashcards

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1
Q

Hypertrophy Definition?

A

• ↑in size of cell

• No. of cells : Remain same

• Seen in : Permanent or non-dividing cells

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2
Q

Hypertrophy Mechanism?

A

↑synthesis of proteins

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3
Q

Hypertrophy Examples?

A
  1. Physiological : - Uterus during pregnancy
  • Breast during lactation
  • Skeletal muscle in exercise
  1. Pathological :

LVH in hypertension

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4
Q

Hyperplasia Definition?

A

• ↑in number of cell

• Seen in : Dividing cells & non-dividing cells

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5
Q

Hyperplasia Mechanism?

A

Growth factor induced proliferation

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6
Q

Hyperplasia Example?

A
  1. Physiological :
  • Hormonal: Breast in pregnancy/puberty
  • Compensatory: Liver (Post hepatectomy)
  1. Pathological :
  • BPH
  • Endometrial hyperplasia
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7
Q

Atrophy Definition?

A

• ↓cell size

• ↓cell number

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8
Q

Atrophy Mechanism?

A

↓protein synthesis/ ↑degradation

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9
Q

Atrophy Example?

A

• Senile : Alzheimer’s

• Pressure

• Ischemic : ↓blood supply

• Nutritional : Kwashiorkor/Marasmus

• Disuse : Fracture

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10
Q

Metaplasia?

A

• Reversible change of one differentiated cell type to another

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11
Q

Metaplasia Mechanism?

A

Reprogramming of stem cells

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12
Q
A

• Chronic smoker :

Pseudo stratified epithelium to Stratified squamous epithelium

• Barrett’s esophagus

• Myositis ossificans (Connective tissue metaplasia)

• Vit A deficiency metaplasia

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13
Q

What is Barrett’s esophagus?

A

• Seen in GERD.
• Stratified squamous epithelium replaced by pseudostratified columnar epithelium.
• ↑ Risk of esophageal adenocarcinoma.

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14
Q

What is the histopathological finding in Barrett’s esophagus?

A

• Intestinal metaplasia (glandular epithelium).
• Goblet cells (mucin-containing).

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15
Q

What special stain is used for identifying goblet cells?

A

• Alcian blue (mucin).

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16
Q

What are the characteristic features of reversible cell injury?

A

• Cellular swelling/hydropic change (most common feature).
• Myelin figures.
• Mitochondria are the most affected organelle.

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17
Q

What are the characteristic features of irreversible cell injury?

A

• Amorphous densities in mitochondria (visible on electron microscopy).
• Nuclear changes (seen on light microscopy):
• Pyknosis: Chromatin clumping.
• Karyolysis: Chromatin dissolution.
• Karyorrhexis: Fragmentation of the nucleus.
• Myelin figures (more prominent in irreversible injury).
• Defects in cell membrane.

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18
Q

Features of most common type of necrosis?

A

Coagulative

• Denaturation of proteins

• Type of dry gangrene

• Architecture preserved

• Cell outline preserved

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19
Q

What are examples of coagulative necrosis?

A

• All solid organs except brain

  • Heart (M/c) : myocardial infarction

• Zenker’s degeneration

• Burns

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20
Q

What are the features of liquefactive necrosis?

A

• Enzymatic digestion of cells.
• Cell outline not preserved.
• Wet gangrene.

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21
Q

What are examples of liquefactive necrosis?

A

• Brain.
• Fungal infections.
• Abscesses.

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22
Q

What are the features of caseous necrosis?

A

• Cheese-like appearance.
• Combination of coagulative + liquefactive necrosis.

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23
Q

What are examples of caseous necrosis?

A

• Tuberculosis (TB).
• Fungal infections: Histoplasmosis, coccidioidomycosis.

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24
Q

What are the features of fat necrosis?

A

• Traumatic: Injury-induced (e.g., breast).
• Enzymatic: Pancreatic enzyme release (e.g., omentum, pancreas, mesentery).

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25
What are the features of fibrinoid necrosis?
• Pink color deposition (fibrin-like material). • Seen in type 2/type 3 hypersensitivity reactions.
26
What are examples of fibrinoid necrosis?
• Polyarteritis nodosa (PAN) (type 3 hypersensitivity). • Malignant hypertension. • Aschoff nodule (rheumatic fever).
27
What is gangrenous necrosis?
• Can be dry or wet gangrene. • Dry gangrene: Often in limbs (coagulative necrosis). • Wet gangrene: Often due to infection (liquefactive necrosis).
28
What organism is commonly used for apoptotic studies?
• C. elegans (Nematode).
29
What is the most important organelle affected in apoptosis?
• Mitochondria.
30
What are the markers of apoptosis?
• Annexin V: Early marker of apoptosis. • CD-95: Fas receptor involved in apoptotic signaling.
31
What is the significance of Annexin A1?
• It is a marker for hairy cell leukemia
32
What are the pro-apoptotic and anti-apoptotic factors in apoptosis?
• Pro-apoptotic factors: Bax, Bak, Bim, Bid, Bad, PUMA, NOXA. • Anti-apoptotic factors: Bcl-2, Bcl-x1, Mcl-1.
33
What are the different types of caspases in apoptosis?
• Initiator caspases: Casp 8, 9, 10. • Execution caspases: Casp 3, 6, 7.
34
What is the definition of necrosis?
• Enzymatic/ischemic process. • Passive process. • Death of groups of cells. • Always pathological.
35
What is the definition of apoptosis?
• Genetically programmed cell death. • Active process. • Single cell death. • Can be physiological or pathological.
36
How does the cell size change in necrosis and apoptosis?
• Necrosis: Cell size increases (swelling). • Apoptosis: Cell size decreases (shrinkage).
37
How is the cell membrane affected in necrosis and apoptosis?
• Necrosis: Cell membrane is affected (damaged). • Apoptosis: Cell membrane remains intact.
38
Is inflammation present in necrosis and apoptosis?
• Necrosis: Inflammation is present. • Apoptosis: Inflammation is absent.
39
What markers are associated with necrosis and apoptosis?
• Necrosis: No specific markers. • Apoptosis: Annexin V, CD-95.
40
What is the PAGE pattern in necrosis and apoptosis?
• Necrosis: Smear pattern. • Apoptosis: Step ladder pattern.
41
What is necroptosis?
• Aka programmed necrosis. • Mechanism: Apoptosis-like, mediated by RIP1 & RIP3. • Morphology: Necrosis. • Seen in: • Mammalian growth plate. • Acute pancreatitis. • Neurodegenerative diseases.
42
What is pyroptosis?
• Pyrogen-induced apoptosis. • Caused by fever and infections.
43
What is entosis?
• Non-macrophage cells kill other cells. • Seen in autoimmune hepatitis.
44
What is efferocytosis?
• Phagocytosis of apoptotic cells. • Reduces pro-inflammatory cytokines.
45
• Increased Fe²⁺ levels lead to activation of glutathione dependent defences which in turn leads to lipid peroxidation which causes loss of membrane permeability and cell death. • Role: Cancer, stroke, neurodegenerative diseases.
46
What is dystrophic calcification?
• Occurs in dead tissues. • Serum Ca²⁺: Normal. • Examples: RAT • Rheumatic vegetation. • Atheromatous plaque. • TB lymph node. • Psammoma bodies.
47
What is metastatic calcification?
• Occurs in living tissues. • Serum Ca²⁺: Elevated. • Examples: • Bone disease (e.g., multiple myeloma). - Vit D related disease. - Sarcoidosis. - Milk alkali syndrome. - Parathyroid disease.
48
Special stain for psammoma bodies
Von kossa
49
What is anthracosis?
• Microscopy: Black carbon pigment. • Characteristics: Seen in lung (common), associated with air pollution.
50
What is lipofuscin?
• Microscopy: Perinuclear brown pigment. • Cause: Free radical injury, aging/wear & tear. • Seen in: Brown atrophy of liver/heart. • Special stain: Oil Red O.
51
What is melanin?
• Microscopy: Black-colored pigment derived from tyrosine. • Special stain: Masson-Fontana. • Note: Associated with malignant melanoma. • IHC markers: Melan-A, HMB-45, S-100. • DOPA reaction: Positive.
52
What is hemosiderin?
• H&E : Golden yellow, brown colour • Iron overload • Special stain : Prussian blue/Perl’s stain
53
What stain is used to detect glycogen accumulation?
• H&E: Clear vacuoles. • Special stain: PAS (Periodic acid-Schiff).
54
What stain is used to detect lipid accumulation?
• H&E: Clear vacuoles. • Special stains: Sudan black, Oil red O.
55
What is the appearance of protein accumulation on H&E staining?
• H&E: Eosinophilic, granular appearance.
56
What is the appearance of hyaline accumulation on H&E staining?
• H&E: Eosinophilic, smooth appearance.
57
What is the appearance of calcium accumulation on H&E staining?
• H&E: Basophilic, gritty appearance. • Special stains: Von Kossa, Alizarin red S.
58
What is Werner syndrome?
• Cause: Premature aging due to DNA helicase defect.
59
What is the Hayflick limit?
• The number of times a cell divides throughout its lifespan. Normal: 60-70
60
What is the role of telomerase in cellular aging?
• Function: Inhibits cellular aging (Immortality gene). • Produces: More telomeres. • High telomerase activity: Found in cancer cells, stem cells, and germ cells. • Poor/zero activity: Found in somatic cells.
61
What are sirtuins?
• Function: NAD-dependent protein deacetylases. • Effect: Increase longevity. • Role: Involved in diabetes mellitus, cancer, and cellular aging.
62
How does calorie restriction affect lifespan?
• Effect: Increases lifespan due to reduced cellular aging.
63
What is the most common stain in histopathology?
• Stain: Hematoxylin & eosin.
64
What is the most common stain in hematology?
• Stain: Romanowsky (Leishman & Giemsa)
65
What stain is used for reticulocytes?
• Stain: Supravital stain.
66
What stain is used for lymphoblasts?
• Stain: PAS (Periodic acid-Schiff).
67
What stains are used for myeloblasts?
• Stains: NSE, SBB, Oil red O, MPO.
68
What stain is used for monoblasts?
• Stain: NSE (Non-specific esterase).
69
What stain is used for hairy cells?
• Stain: TRAP (Tartrate-resistant ACID phosphatase).
70
What stains are used for lipids?
• Stains: Oil red O, Sudan black.
71
What stain is used for iron?
• Stain: Prussian blue.
72
What stains are used for calcium?
• Stains: Von Kossa, Alizarin red S
73
What stain is used for glycogen?
• Stain: PAS (Periodic acid-Schiff).
74
What stains are used for copper?
• Stains: Rhodamine, Rubeanic acid.
75
What stain is used for mast cells?
Stain: Toluidine blue.
76
What stains are used for mucin?
• Stains: Mucicarmine, Alcian blue
77
What stain is used for reticulin fibres?
• Stain: Silver stain.
78
What stain is used for elastin fibres?
• Stain: Van Gieson (VG/VVG).
79
What stain is used for collagen?
• Stain: Masson trichrome.
80
What stain is used for melanin?
• Stain: Masson-Fontana.
81
What stain is used to detect H. pylori?
• Stain: Warthin-Starry silver stain.
82
What stain is used for Cryptococcus?
• Stain: India ink
83
What stains are used for fungi?
• Stains: Silver methenamine (GMS), PAS (Periodic acid-Schiff).
84
What stain is used for amyloid?
• Stain: Congo red.
85
What are the two main types of inflammation?
1. Acute inflammation: • Short duration. • Sudden onset. • Prominently involves neutrophils. 2. Chronic inflammation: • Longer duration. • Insidious onset. • Prominently involves macrophages and monocytes.
86
What are the cardinal signs of inflammation?
1. Rubor: Redness. 2. Calor: Increased temperature. 3. Dolor: Pain. 4. Tumor: Swelling. 5. Functio laesa: Loss of function.
87
What is the earliest vascular event in inflammation?
• Early transient vasoconstriction (Earliest event).
88
List the key vascular events in inflammation in order.
1. Early transient vasoconstriction. 2. Vasodilation. 3. Increased vascular permeability (Most critical event). 4. Stasis (slowing of blood flow). 5. Margination, redistribution, and pavementing of cells. 6. Rolling. 7. Adhesion. 8. Transmigration (diapedesis). 9. Chemotaxis. 10. Opsonization (coating of microbes). 11. Phagocytosis.
89
What is the most critical vascular event in inflammation?
• Increased vascular permeability.
90
What mediates rolling in inflammation?
• Selectins mediate the rolling process
91
What are the types of selectins, their distribution, and their ligands?
1. E-Selectin: • Distribution: Endothelium. • Ligands: Sialyl Lewis X-modified glycoprotein and related glycans on leukocytes. 2. P-Selectin: • Distribution: Platelets (found in Weibel-Palade bodies) and endothelium. • Ligands: Sialyl Lewis X on leukocytes. 3. L-Selectin: • Distribution: Leukocytes. • Ligands on endothelium: • GlyCAM-1. • MadCAM-1. • CD34.
92
What mediates adhesion during inflammation?
Integrins
93
What are the sources of chemoattractants?
1. Exogenous: • Bacterial cell wall products like N-formyl methionine. 2. Endogenous (secreted by cells): • Leukotrienes: LTB4. • Interleukin: IL-8. • Complement factors: C5a, C3b.

Pathology RR (3 decks)

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