GP 6,7,8

Question 1

how much of the 60% of fluid body weight is made of intracellular fluid?

Answer 1

40% intracellular fluid

Question 2

how much of the 60% of fluid body weight is made up of extracellular fluid?

Answer 2

20% total
plasma 4%
interstitium 16%

Question 3

what is the extracellular matrix also called

Answer 3

intersitium

Question 4

what is the extracellular matrix made up of?

Answer 4

-structural (collagen type I, elastin)
-adhesive (fibronectin, laminin)
-absorptive components (glycosaminoglycans, proteoglycans)

Question 5

what is the difference between lymphatic and venule interendothelial junctions

Answer 5

venules or arterioles allow movement of fluid between blood and interstitum where as lymphatic vessel junctions allow things to pass but can also expand and shut/seal it off

Question 6

what controls fluid movement in the body?

Answer 6

-hormones
-receptors
-osmotic and hydrostatic forces
-integrity of the vascular system

Question 7

what hormones in the body control fluid movement

Answer 7

-RAAS (vasoconstriction and water retention)
-artial natriuretic peptide (ANP) by cardiomyocytes (promoting renal sodium and water excretion and stimulating vasodilation)

Question 8

what receptors in the body help regulate/control fluid movement and where are they located?

Answer 8

-osmoreceptors in hypothalamus
-baroreceptors in blood vessels

Question 9

what is shock

Answer 9

cardio vascular collapse
circulatory failure
-systemic hypoperfusion due to macro- and/or micro-circulatory failures

Question 10

what are the steps toward the outcome of shock

Answer 10

hypotension > impaired tissue perfusion > cellular hypoxia > anaerobic metabolism > cellular degeneration > cell death

Question 11

what are the two types of macrocirculatory failure shock

Answer 11

cardiogenic
hypovolemic

Question 12

what is cariogenic shock and what are some examples

Answer 12

-failure of the heart to adequately pump blood
- myocardial infarction, ventricular tachycardia, fibrillation, arrhythmias, hic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), cardiac output obstruction (pulmonary embolism, aortic stenosis), pericardial tamponade

Question 13

what is hypovolemic shock

Answer 13

reduced circulation of blood volume by massive blood loss or fluid (vomiting, diarrhea or burns) leading to decreased vascular pressure and tissue hypoperfusion

Question 14

main difference between macro and micro circulatory failure

Answer 14

macro is decrease volume of the heart but micro total blood volume is the same it is just being maldistributed

Question 15

what type of shock is microcirculatory failure and explain what it is

Answer 15

blood maldistribution
-decrease peripheral vascular resistance and polling of blood in vascular peripheral tissue

Question 16

what are three types of blood maldistribution shock

Answer 16

1. anaphylactic shock: generalized type I (Ig E) hypersensitivity
2. septic shock: most common type- endotoxemia
3. neurogenic shock: trauma, particular trauma to nervous system, electrocution, fear , emotional stress

Question 17

what does DIC result in pathologically

Answer 17

1. small blood clot formation inside blood vessels throughout body
2. consumption of coagulation proteins and platelets > disruption of normal coagulation causing abnormal bleeding
3. clots plug normal blood flow to organs (kidneys, distal extremities) > ischemic injury

Question 18

what is acute respiratory distress syndrome ARDS

Answer 18

multifactorial source of injury to respiratory capillary endothelium (generally primary) and epithelium (diffuse alveolar damage, necrosis, often secondary)

Question 19

what does TLR-4 do to the endothelium and monocytes/macrophages in septic shock

Answer 19

-when LPS (of gram negative bacteria) bind to endothelium it down-regulates the anticoagulants (tissue factor pathway inhibitor and theombomodulin)
-when LPS binds to monocytes/macropahges it increases production of IL-1,IL-6, TNF

Question 20

what are some inciting causes of ARDS

Answer 20

endotoxemia, sepsis, disseminated pulmonary infections, extensive trauma, burns, transfusions, DIC, pancreatitis, aspiration of gastric contents

Question 21

what is happening during neurogenic shock

Answer 21

if there is trauma, spinal cord injury, fear, electricity > the body triggers generalized autonomic nervous system > sympathetic tone gets lost and the parasympathetic tone dominates, vasodilation > massive peripheral vasodilation w bradycardia > pooling of blood > hypoperfusion

Question 22

stages in development of shock

Answer 22

-compensation: heart rate increases, peripheral vasoconstriction, ADH and angiotensin II released > increased blood pressure and blood is diverted to vital tissue
-progression: anaerobic metabolism > acidosis , vasodilation
-irreversible: cell and tissue necrosis, leading to multi-organ failure and death

Question 23

what is metaplasia

Answer 23

-reversible exchange within a tissue of one mature cell type (differentiated adult cells) for another mature (adult) cell type (changing cell types)
-requires “reprogramming” of reserved cells (stem cells)

Question 24

what is dysplasia

Answer 24

-atypical differentiation, disorderly arrangement
-may be partially reversible
-it often develops at sites of chronic inflammation
*disorganized

Question 25

steps in neoplastic transformation

Answer 25

1. initation: irreversible genetic change in replicating cell population 2. promotion: reversible; do not affect DNA directly, create an environment that gives initiated cells a growth advantage over the rest of the population 3. progression: irreversible/reversible, conversion of benign tumor to an increasingly malignant tumor and ultimaelty to metastatic tumor (promoting own blood supply, proliferating, detaching and moving to distant sites)

Question 26

what are the heritable alterations contributing yo carcinogenesis

Answer 26

DNA mutation epigenetic changes chromosomal alt

Question 27

what origin are -carinoma from

Answer 27

epithelial origin

Question 28

what origin are -sarcoma from

Answer 28

mesenchymal origin

Question 29

Answer 29

know this list

Question 30

what is the bengin and malignant neoplasms for glandular epithelium

Answer 30

-benign: adenoma -malignant: carcinoma

Question 31

what is the benign and malignant neoplamsmic terms for squamous epithelium

Answer 31

-bengin: papilloma -malignant: squamous cell carcinoma

Question 32

what is the benign and malignant neoplasmic terms for liver

Answer 32

-benign: hepatoma -malignant: heptatocellular carcinoma

Question 33

what is the benign and malignant neoplamic term for skeletal muscle

Answer 33

-bengin: rhabdomyoma -malignant: rhadomyosarcoma

Question 34

what its benign and malignant neoplamic term for smooth muscle

Answer 34

-benign: leiomyoma -malignant: leiomyosarcoma

Question 35

what is the bengin and malignant neoplasmic term for bone

Answer 35

-benign: osteoma -malignant: osteosarcoma

Question 36

what tumor-like lesion is hamartoma

Answer 36

disorganized, mature tissue in normal location

Question 37

what tumor-like lesion is choristoma

Answer 37

disorganized, ,nature tissue in abnormal location (ectopic)

Question 38

Answer 38

know this

Question 39

what is the descriptor word for this tumor

Answer 39

pedunculate polypoid

Question 40

descriptor word for this tumor

Answer 40

papillary

Question 41

decriptor word for this tumor

Answer 41

ulcerated

Question 42

descriptor word for this tumor

Answer 42

sessile attached to base without stalk

Question 43

descriptor word for this tumor

Answer 43

annular ring shaped

Question 44

descriptor word for this tumor

Answer 44

fungating marked ulceration and necrosis, bad smell

Question 45

describe the pattern of this histological image of this tumor

Answer 45

sheets (common for round cell tumor)

Question 46

describe the pattern of this histological image of this tumor

Answer 46

packets common in neuroendocrine tumors

Question 47

describe the pattern of this histological image of this tumor

Answer 47

nests common in invasive carcinoma

Question 48

describe the pattern of this histological image of this tumor

Answer 48

cords often seen in epithelial tumors

Question 49

describe the pattern of this histological image of this tumor

Answer 49

lobules common in some epi tumors

Question 50

describe the pattern of this histological image of this tumor

Answer 50

acini indicative of glandular epithelial origin

Question 51

describe the pattern of this histological image of this tumor

Answer 51

lobules indicative of glandular epithelia origin

Question 52

describe the pattern of this histological image of this tumor

Answer 52

cystic seen in some glandular tumors

Question 53

describe the pattern of this histological image of this tumor

Answer 53

whorls seen in mesenchymal (connective tissue) tumors

Question 54

describe the pattern of this histological image of this tumor

Answer 54

papillary glandular tumors

Question 55

describe the pattern of this histological image of this tumor

Answer 55

bundles typically mesenchymal tumors

Question 56

Answer 56

take a look

Question 57

what is the mechanism for invasion, stepping from benign to malignant

Answer 57

-impairment of cell adhesion -basement membrane (basal lamina) degradation via proteases -extension into permissive tissue, cleavage of basement membrane protein generates novel sites that bind to receptors on tumor cells and stimulate migration

Question 58

stages of invasion and metastasis

Answer 58

1. transformed cells must detach from main mass, adhere to and penetrate the basement membrane and enter the cellular matrix 2. intravastion- extension through endothelium, interaction with lymphoid cells and coating with platelets (formation of tumor emboli) 3. extravasation- extension back through endothelium, formation of metastatic deposit, and angiogenesis

Question 59

what are the common metastatic routes to go other places in the body

Answer 59

1. hematogenous (preferred routes for sarcomas) 2. lymphatic (preferred by carcinomas) 3. transcoelomic exfoliation and implantation (mesotheliomas)

Question 60

what is the paraneoplastic syndrome associated with apocrine adenocarcinoma of the anal sac

Answer 60

hypercalcemia

Question 61

what is your diagnosis?

Answer 61

-neoplastic round cells -solid sheets -basophilic cytoplasmic granules -eosinophils present

Question 62

routes for hematogenous to get to places in the body

Answer 62

Question 63

diagnosis and route of metastasis

Answer 63

cholangiocellular carcinoma with transcolemic exfoliation and implantation

Question 64

diagnosis and route of metastasis

Answer 64

humeral osteosarcoma with metastasis to lung

Question 65

paraneoplastic syndrome

Answer 65

symptom complexes that cannot be directly attruvited to local or distant tumors ex hypercalcemia

Question 66

what are the primary effects of tumors

Answer 66

-loss of function: metastatic or primary tumors in lungs leading to impaired respiration -pain and discomfort: specific sites such as bone

Question 67

explain mechanism of septic shock

Answer 67

most common cause is endotoxins that produce gram - bacteria, the LPS from the gram - bacterial cell wall forms a complex with blood proteins and LPS binds to TLR-4

Question 68

what is morphological diagnosis and tissue change

Answer 68

endocardiosis myxomatous metaplasia

Question 69

what is the diagnosis

Answer 69

oligodendrolioma

Question 70

what is your diagnosis

Answer 70

lymphoma (round cell tumor)

Question 71

classify this hemorrhage

Answer 71

petechial hemorrhage

Question 72

capillaries vs lymphatics

Answer 72

-capillaries: atertial-venous transition, tissue to blood nutrient and waste transition -lymphatics: bind end capillaries that dump into venous system, low pressure valved that depend on forces like muscle contraction to maintain flow, large gaps that allow fluid and proteins to move in and out of interstitium

Question 73

when LPS induces a high production of TNF, IL1, IL6/IL8, NO, PAF what occurs

Answer 73

they promote high systemic vasodilation and increased vascular permeability > intravascular plasma protein loss decreased oncotic forces > additional intravascular fluid loss > toxins and cytokines induce loss of peripheral vascular tone > hypotension > hypoperfusion > septic shock

Question 74

what are some heritable alterations that contribute to carcinogenesis

Answer 74

DNA mutations epigenetic changes chromosomal alterations

Question 75

spindle cells are usually associated with what type of neoplastic cell

Answer 75

sarcoma

Question 76

brain tumors are usually named for the cell type in the brain, what are the names for astrocytes and oligodendorcytes

Answer 76

astrocytoma oligodendroglioma