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Flashcards in HY Deck (212):
1

pyknosis?

karyorrhexis?

karyolysis?

pyknosis: ink dot, nuclear condensation

karyorrhexis: fragmentation

karyolysis: disolution

2

Virchow Triad

dirupt in blood flow: stasis activates coag cascade

endothelial cell dmg: endothe protects collagen and tissue factor, prod PGI2 blocks platellet, secrete heparin like molecules > activate antithrombin

 

hypercoag state

3

Positive and negative selection of T cells

 

T cells in bone marrow -> Thymus

->positive->can yopu bond to self antigen -> yes good

Negative -> bind too tight? -> yes -> destroyed to avoid autoimmune apoptosis (FAS ligand binds FAS receptor)

4

Fat necrosis 

 

supponification Ca boinds fatty acids turns chalky

breast due to trauma MVA

contains Giant cells 

 

5

MI-> cardiac enzymes inc-> cath lab -> CE keep increasing why?

 

 

reperfusion injury O2 enter in large amount creating free radicals and causing DMG

6

Protein C and S do what?

 

inactivates factor 5 and 8, deficiency lead to hypercoag state

7

hallamrk of IRReversible injury
 

Membrane DMG

> enzymes leak (like MI troponin leaks) & Ca entering

8

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9

Homocysteine elevated in

B12 and folate def.

cannot convert homocysteine > methionine

10

caspases intrinsic pathway

injury -> DNA dmg/ loss hormonal stimulus -> lowers Bcl2 -> cytochrome c leak00s -> activates caspases

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11

characteristics of thrombus vs postmortum

lines of Zahn

attachment to vessel wall

12

antioxidant vitamins?

Vit A, C, E,Gluthiopne

13

dystropic calcification vs metastatic calcifications

dystrophic calcification: normal Ca/ P, deposits in necrotic tissue

Meta: high Ca/P and deposits in normal tissue

14

every organ type of necrosis?

 

Coag necrosis

except Brain > liquifactive because microglial  > enzymes released

15

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16

39 yo female presets with preclampsia, + protinuria? mst likely

Fibrinoid necrosis of placeta -> necrotic dmg to vessel -> malignatn htn and vasculitis

17

ubiquitin

destroys cytoskeleton

18

Prothrombin 20210A

point mutation that increases prothrombin > thrmbus formation

19

Caseous necrosis

 

cottage cheese

combination of Coag and Liqui

TB or fungals infect

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20

how oral contraceptives affect coagulation

 

estrogen increases prod of COag factors.

21

which metaplasia doesnt progress into CA

Apocrine metaplasia of breast

is a change in fibrolytic

22

Fentox Rx

Fe2+ -> OH- (hydroxyl) antiox (Gluthione)

23

Cytochrome C does what

 

activates apoptosis

inside inner mitochondrial memb

24

how B12 and folate interact

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25

free radical by neutrophil?

 

O2 -1e-> O2- ( superoxide) antioxidant superoxide dismutase

26

gangrenous necrosis

coag necrosis that looks mummified dry

lower limb popletial A. and GI tract

27

free radicals generation

 

during ox phospho by Cytochrome C which transfer electrons

28

barrets esophagus type of

metaplasia squamous epi to clolumnar nonciliated mucinus epi may progress into ADENOCARCINOMA

29

factor 5 Leiden

mutated factor 5 that cannot be deactivated by protein C/S > hypercoag state

most common inherited

30

endothelium prevents clot by

  1. protect collagen and tissue factor
  2. prod PGI2 (opposite of thrmboxane) and NO
  3. secrete heparin like molecule
  4. secrete tPA > converta plasminogen into pasmin > cleaves fibrin and fibrinogen,and destroys coag fact
  5. secrete thrombomodulin > makes thrombin ( normally coverts fibrinogen to fibrin) instead activates protein C > inactivates factor 5 and 8

31

How oxygen transf to blood

 

FiO2 -> PAO2 -> Pa O2 -> SaO2

high alt -- hihg PACO2--intersti fibrosis --

32

Bud Chiarri by

1 Polycythemia Vera: thick blood

2 Lupus coag state

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33

 increased warfarin skin necrosis with 

warfarin block epoxide reductase > cant activate vit K > factors 2, 7, 9, 10, Prot C and S wont work

protein c and S(inactivates factors preventing coag) degrade first so 2, 7, 9 , 10 increase risk for activation 

thats why heaprin also given untill window whe 2, 7, 9, 10 also degrade

 

protein C or S def even more concers cuz cause warfarin skin necrosis

34

homocystinuria

cannot convert homocystine into Cystathionine

incresed lvls of homocystine( causes endothelial dmg)

CF: vessel thrombosis, mental retardation, lens dislocation, long sledner fingers

 

35

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36

night blindness by

 

15, 17 dislocation -> Vit A DEF

37

Liquifactive Necrosis on

 

Brain microglial

abscess by neutrophils

pancreatitits by enzymes

38

radicals with antioxidant

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39

hallamrk of reversible injury

swelling

-> loss of microvilli and membrane blebbing

>RER losses ribosomes, decreases prot synth

40

Carbon monoxide posioning know

 

norm PaO2 but low SaO2 ( bound to Hb)

Cherry face

** early sign headache -> coma -> death

41

role of caspases?

caspases -> proteases/ endonucleases -> break cytoskeleton/ break DNA

42

pt expressed to CHM laundry cleaning agent. what exposed to?

 

CCL4-p450->CCL3-> cells swelling-> ER swelling decreasing prot synth->decreasing apolipoprotein prod decreasing carrying of cholesterol---> Fatty Liver

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43

whats hemochromatosis

increase Fe l- liver dmg by free radical production thats why iron is tightly bound in physiology

44

ATIII def

antithrmbin 3 made by endothelioum aka heparin like molecule

if given heparin ptt wont rise because it cannot activate ATIII, need to give high dose  of heparin and coumadin to maintain anticoag state

45

MEthemoglobimia

Fe2 -> Fe3 which cant bind to o2

Sao2 decreased

oxidant stress ( sulfa and nitrate drugs

newborns

chocolate color blood cyanosis

tx methylene blue -> fe2

46

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47

whats  an  amyloid

misfolded protein that deposits extracellualrlly d causing dmg to tissues

48

stain for amyloidosis

congo and apple green birefringance, beta plated config

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49

PRimary amyloidosis is?

over profd of Ig light chain that deposits

r/t plasma cell dyscresias ie: multiple myeloma

50

secondary amylydoisis

derived form serum amyloid associated proteins, acute rx increased in chronic stated

51

FMF familial medit fever

dysfucntion of neutrophils

autosomal recessive, fever, acute serosal inflamation( ,i,ics append, arthitis, Mi depending where

52

most common organ for amylidoisis

kidney-> mimics nephgrotic syndrome 

followed by heart -> cardiac myopathy decrease wall reflex decrease CO

 

organs need to be transplanted

53

derivative of insulin that causes amylidoisis?

amylin-> deposists in islets of pancreas

54

alzheimer precursor gene which?

 

Chromosome 21 beta amyloid precursos-> alphabeta amyloid deposits in brain

common with Downs syndrome(21) by 40 yo

55

dialisis amyloidosis

beta 2 microgobulin(opart of MHCI structure ) deposists in joints

56

medullaryt carcinoma thyroid how related to amyloids

calcitonin (protein)prod by tumor  deposits within tuymor

57

cells in acute vs chronic inflamation

acute neut edema, due to infection or necrosis

chronic lymphocytes

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58

all gram - outter contain?

 

LPS (lipipolysacharide) like a PAMP ( apthogen associated moleculat patterns

recognized by cd14

59

CD14 

recognizes?

on?

 

recognized LPS on G- bact

on macrophages

60

NF-kb role?

TLR activates NK-> activated immune mediators

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61

Arachnoid acid from?

cascade?

Phospholipiod membrane by phospholipase a2

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62

products of arachnoid acid

Cyclooxyganase and 5 lipoxygenase

63

cyclooxygenase products what they do

prostaglandins

vasoconstricts (artiriole)

increase permeability( post cap venule)

especially PGE2- causes fEver

64

mast cells activated by?

trauma, C3A and C5a, or cross link surface IgE by antigen

65

mast response when activated?

 

release histamine

66

effects of histamine?

vasodialtion artirioles

increase permeability

production of arachnoid acid metabolite particularly LEukotrines

67

complement classical pathway

 

GM Makes Great Cars

bacteria->> IgG/M->>C1 = classic pathway

68

C3A/C5A TRIGGER?

 

C3A/C5A (ANAPHALATOXINS) ->MAST CELL DEGRANULATION -> HISTAMINE RELEASE -> INCREASE PERM -> DELAY RESPONSE ARACHNOID ACID -> * LEUKOTRINES

69

WHAT BRINGS NEUTROPHIL

LTB4

C5A

IL8

BACTERIA PRODUCTS

70

HAGEMAN FACTOR IMPORTANT IN?

PRODUCED BY LIVER

ACTIVATED BY EXPOSURE TO SUBENDOTHELIAL/COLLAGEN

CAUSE ACUTE INFLAMATION

In DIC w/ severe G- sepsis-> also activates Hageman f. -? coag, fibrinolytic, kinin syst activated-> bradykin -> vasodilation. increas eperm, pain

71

G- sepis -> DIC how

In DIC w/ severe G- sepsis-> also activates Hageman f. -? coag, fibrinolytic, kinin syst activated-> bradykin -> vasodilation. increas eperm, pain

72

what mediated pain?

 

PGE2 (pain and fever)

Bradykinin

 

73

C3 to MAC how?

c3- c3 convertase-> C3a, C3b-C5 convertase-> C5a, C5b-C6 C9->MAC

74

fever occurs by?

LPS(pyrogens) cause macrophage-release-> IL1 and TNF-> increase COX in perivascular of hypothalamus -> increase PGE2--> increase temp set point

75

whats margination?

when large molecules like neutrophils enter vasodilated vessels get closer to border at post cap venule -> produce selectin which are speed bumps

76

p selectin vs e selectin

P from Weibel Palade bodies

w: vonWillerbrand

p: P-selectin

E-selectin induced by TNF and IL!

77

what binds to selectins

sialyl Lewis X on leukocyted

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78

adhesions molecules (after rolling) regulated by?

ICAM and VCAM regulated by TNF and IL1

CAMs interactions with integrins causes adhesions of leukocytes

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79

4 molecules that bring neutrphils?

 

C5a

LTB4

IL8

Bacteria prod

80

delay separation of umbilical cord?

Leukocytes adhesion deficiency , defect CD18 (autosomal recesive)

delay separation of umbilical cord

normally necrosis but since neutrophils cant destroy it it wont separate

 

81

Leukocyte adhesion deficiency

Defect of integrins (CD18  subunit)

=delay umbilical cord separation: Neut can destroy the tissue

=increase lvl of neutrophils because normally neutrophils are stroed in lung but impaired adhesion of marginated pools

=recurrent bacterial infections that lack pus

82

where leukocytes transmigrate?

 

psot capillary venules where vasodilation

83

phagocytosis enhanced by?

 

opsonins ( IgG and C3b )

attach to bacteria and easier to recognize

84

Chediak Higashi Syndrome

Autosonal recessive  defective protein traffic

prevents phagosome railroad(microtubules) to lysosome

=increase infections

=neutropenia: neut cant divide so die

=histo:  giant granules next to golgi

=defective 1ry hemostasis (abnorml dense granules in plate)

=Albinism: melanocytes cant move melanin to adjecent kratinocytes

=Peripheral neuropathy: toe nuclues in spine microtubules wont work

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85

best method of destruction

 

o2 dependent best 

HOCL-gen by oxidative burst 

86

oxidative burst how it works

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87

Chronic granulomatous disease is?

NADPH oxidase defect

recurrent infection unable to prod blech ( HOCL-)

x link defect

test nitro blue : if colorless and not blue = +

**infections with S Aureus, P Cepacia S Marcescens Nocardia Aspergillus**

88

Chronic granulomatous disease caused by which microbes

nfections with

S Aureus,

P Cepacia

S Marcescens

Nocardia

Aspergillus*

Nitro blue test if colorless and not blue = +

89

Nitroblue tetrazolium to test for?

chronic granulomatous disease

nfections with S Aureus, P Cepacia S Marcescens Nocardia Aspergillus*

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90

1. NADPH oxidase defect vs 2.myeloperoxidase deficiency

 

1. cannot convert 02 -nadph ox-> o2-

2. cannot convert h2o2 -MPO->HOClp( bleach) last product

1. tested with nitro blue tetrazolium, colorless = + for x link defect

2. increase risk for candida

91

02 independent vs dependent

independent less effective

lysosome in macrophages

major basic protein in eosinophils

 

92

macrophages destroy with

o2 independent

lysosomes in secondaty granules

93

healing induced by 

macrophages:

IL10, TGF beta

both anti inflamatories

94

TGF-Beta and IL10 do what

 

antiinflamatories and induce 

95

with acute inflamation what are the outcomes

 

1. healing by macrophages -> IL10, TGF beta

2 cont acute infla- pus formation, macrophages ->IL8 to bring neut

3. abscess, acute infla surrounded by fibrosis, macrophages -> fibronogenic GF and cytokines

4. chronic inflamation, macropha ->present antigent(ingested virus MHC II) to CD4+ helper ->cytokines that induce chronic inflammation

96

what causes chroninc inflamation

persistent infection

virus

mycobacteria

parasites

fungi

autoimmune

foreign cancers

97

t cells cycle

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98

MHC II present on

AP cells

like macrophages on the outside

99

CD4 activation

 

1st signal binds MHC complex with antigen

2nd signal B7 binds CD28

then secreted cytokines -> inflammation

th1 and th2 subsets

7/28=4= cd4

100

Th1 and Th2 

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101

CD8 activation

MHC I on all nucleated 

and IL2 from CD4 Th1 

causes to secrete perforins and granzymes

granzymes enters proes and activates apoptosis

102

enzyme that activates apoptosis

Caspases

3 ways

1: intrinsic: mitochondrial: cytochrome c leak

2: extrinsic: fas ligans  expresion-> binds fas on target cells activate it

3: CD* -> granzymes 

 

103

naive B cells expess what

IgM and IgD

104

b cell activation

1: antigen bindind by surface IgM or Ig D indices plasma cell that secretes that Igm or IgD

2: b cell present to CD4 helper via MHC II, CD40 on B cell binds CD40L on helpter -> activates CD4 to secrete IL4 and IL5  -> cause B cell isotope swithc and maturation to plasma cells

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105

key characteristic of granuloma

epithelial histiocyte

macrophages with abundant pink cytoplasm

106

non caseating granuloma

lack of central necrosis 

rx to foerign body( implant broken)

sarcoidosis( tiny collections of granulomas)

beryllium

chron's

cat scratch ( neck stallae shape

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107

caseating granulomas

by: TB : AFB stain

fungal

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108

DiGeorge Syndrome fail of what?

what DNA change?

3rd and 4th pharyngeal pouch

22q11

lack structure related to : thymus -> T cell def

lack parathyroid-> hypocalcemia

abnormal great vessels, heart and face

109

SCID etologies

sever immnodeficiency

defective cell and humoral immunity

1. adenosine deaminase def  (ADA needed to deaminate adenosine and other toxic products to lymphocytes

2. cytokine receptor defect((prolif and mature B/T cells)

3. MHC ii def: needed for CD$ activationa and cytokine prod

 

110

SCID 

no T cells ->

no B cells ->

tx?

no T cells -> fungal, viral

no B cells -> bact, protozoa

worst than aids for opport inf ** no live vaccines**

tx? stem transplant

111

x linked Agammaglobulinemia is?

mutation?

decrease immunoglobulins leads to what infection?

when start showing

 

b cells cannot mature into plasma due to Bruton tyrosine kinase

Brutons tyrosine kinase X linked

bacteria ( no IgG - cannot opsonize)

enterovirus and Giardia (decrease IgA GI virus )

shows after 6 months moms ab end, no live vaccines to be given

 

112

CVID is?

risks?

 

Common variable immune def

low immunoglobulins

decrease b cells and cd4 help both needed for immunoglob prod

risk? autoimmune disorder and lymphoma

113

GI disease with IgA Def?

Celiac Disease

increased mucosal infection

114

Why IgM increase in hyper IgM syndrome?

the forst way of the B cell activation not affected but with CD40L on Cd4 or CD4) receptor on B cell, mutation prevent class swithing. cytoknes necessayr for swithing not produced. low IgA, G, E result in recurrent pyogenic infection

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115

Wiskott aldrich syndrome

thrombocytopenia, eczema, recurrent infection

wasp gene mutaion X linked

116

C5-C9 deficiencies risk for 

increased risk for Neisseria gono and menin

117

C1 inhibitor defi

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118

automimmune diaseses affect more?

 

women in child bearing age  30-50

119

SLE type of hypersensitivity?

type 2 - cytotoxic

and type 3 - antigen antivbody complex

120

SLE common in 

ss

AA females 

chronic inflamation: fever and weight loss, butterfly rash when exposed to sunlight, arthritits, pleuriritis, 

121

most common SLE lesion?

 

diffuse proliferative Glomurelonephritits 

122

SLE cardiac problems

 

endocarditits, myocardititis, pericarditits, any layer

 

123

Libman-Saks endocarditis

classical finding with SLE, sterile depositson both sides of mitral valve 

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124

SLE common cause of death?

renal proliferative glomerulonephritits -> infections

125

SLE dx test?

ANA sensitive but not specific

anti dsDNA-> highly specific> DX

126

Drug induced SLE

drugs?

antibody?

drugs: hydrolazine, procainamide, isoniazid

antihistone antibody

removal of rx -> remision

127

antiphospholipid antibody syndrome?

30% of SLE

anticardiolipin antibody interferes with PTT false elevated 

pt actually hypercoagu: DVT, heaptic vein throb (vod chiarri, polycythemiavera) infection, stroje, tx lifelong anticoag

 

128

Sjogren hypersensitivity type?

type 4: lymphocyte mediated dmg

129

cant chew cracker, dirt in eye, frequent caries dx?

Sjogren syndrome

keratoconjunctivits, xerostomia

130

Sjogren synd test

related to what diseases?

test: antiSS-a and antiSS-b both target ribonucleoprotein antibody

Rheumatid arthritis is associated with it

131

Pt with sjogren s/s bilat enlarged parotid. pt says unilateral growth. Dx? 

B cell lymphoma complication of Sjogren unilatera enlarge late . in the course of the disease

132

Diffuse Scleroderma test?

ANA positive antiDNA topoisomerase SCL70 

 

diffuse involved skin and visceral involment ( esophagus: dysphagia)

activation of fibroblast deposit collagen-> fibrosis

133

Scleroderma Localized

local skin and late visceral

CREST

Calcinosis/anti Centromere ab

Raynaud phenomenom

esophageal dysmotility

telangiectasias of the skin

134

Raynaud;s phenomenon 

ud's phenomenon is a condition resulting in discoloration of the fingers and/or the toes after exposure to changes in temperature (cold or hot)

135

Pt with multiple s/s

trouble up stairs, combing hair, SLE like s/s, systemic sclerosis

mixed CT disease

ab against U1 ribonucleoprotein

136

labile tissues

labile have stem cells= constantly regenarating 

bowel(crypts), skin(basal), rbc(bone marrow marker CD34), wbc, pt, lung(type 2 pneumocyte)

137

Stable tissues

Quiescent (G0) but can enter cell cycle

liver, proximal renal tubules( acute tubular necrosis they can regenerate, dialysis till then)

138

Permanent tissues

lack of regenerative potential

myocardium, skeletal muscle, neurons

heal by repair (fibrous scar) MI

139

scar deep enough-

loss of basal layer(stem) -> fibrous scar

140

component granulation tissue

fibroblast ( type 3 collagen)

141

granulation vs granulation tissue

granuloma -> subtype of chronic inflammation

hallmak *** epithelial histiocyte***

IL12(macrophages) CD+ -> CD4 THI -> secrete interference gamma

turns macrophages to Epithelial like

142

granulation turns into

Granulation -> scar

Collagen 3 (pliable) -> collagen 1 ( strong)

uses collagenease (zinc cofactor)

143

types of collagen

 

I: ONE, bONE, high tensile strength

II: carTWOlage

III: reTHREEcular, blood vessel, granulation(pliable)

iV: basement membrane

144

TGF alpha

TGF beta

PDGF

FGF

VEGF

TGF alpha : epithelial and fibroblast growth factor 

TGF beta : by macrophages if no more inf to heal, inhibits inflammation, is a fibroblast GH 

PDGF:  platellet seal -> PDGF -> GH for endothelium, smooth muscle, and fibroblast

FGF(fibroblast growth factor) : angiogenesis, skeletal development

VEGF( vascular endothelial growth factor):  angiogenesis

145

1ry vs 2ry intention

1ry: a pproximated with suture to avoid scar

2ry: not approximaed-> granulation formed fills defect -> myofibrolblast contracts the wounds forming the scar

146

pt with wound heal with secondary and has reduced in size how?

myofibroblast 

granulation has 3 : capillaries, fibroblast, myofibroblast ( contracts)

147

delayed wound healing most common  with?

infections: S aureus 

148

vitamin C role in collagen

Vit C hydroxylation of proline and  lysine -> crosslinking 

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149

Cooper deficiency affects collagen by?

collagen 

cooper is a cofactor of lysyl oxidase which crosslinks Lysine and hydrolysine to form collagen

150

Zinc deficiency affects collagen by?

Zinc is a cofactor for collagen collagenase 3 of granulation tissue-> stronger type 1 

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151

whats is a Keliod?

out of proportion scar tissue

increase type 3 

genetic predispistion AA

affects earlobes, face, upper ext

152

collagen + zinc 

type 3 to 1

153

dicyclomine

anticholinergic used with IBS

154

characteristics of neoplasia

unregulated

irriversible

monoclonal : from single mother cell

155

clonality determined by

G6PD enzyme isoforms

multiple isforms exist only one is inherited from each parent present on X chromosome, on women inactivated in each cell by lyonization random

normal ratio 1:1 maintained in hyperplasia, which is polyclonal (from multiple cells)

in neoplasia only one isoform is present

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156

mononoclonacity produced by?

G6PD *a in all cells instead of different = neoplasm

157

clonality lymphocytes

determined by immunoglobulin Ig light chain either Kappa or lambda normal 3:1, maintained in hyperplasia

in neoplasm only one poliferates either increase like 6:1 or inverst 1:3

158

normal Ig light chain ratio

3kappa : 1 lambda

159

lymp node enlargement possibilities?

a: metastatic CA

b: reactive hyperplasia( infection)

c: lymphoma: biopsy proliferation of lymphocytes w/ 20:1 Ig normal 3:1 K:L

160

benign tumor

do not metastasize

161

malignant tumor

invade local and potential to metastasize

162

tumor of epithelium

benign adenoma (gland), Papilloma (fingerlike) 

malig adenocarcinoma, Papillary carcinoma

163

tumor of mesenchyme

ct: fat bone, vessek, cartilage

benign: lipoma, osteoma, chondroma, angioma

malignant: liposarcoma...

164

tumor of lymphocyte

NEVER BENIGN

malignant: lymphoma, leukemia

165

tumor of melanocyte

 

benign: nevus ( mole)

malignant: melanoma

166

leading cause of death 

adult children

adult: 1st cardio 2nd cancer 3rd cva

children 1st accidents 2nd cancer 3rd congenital

167

most common ca in adults? 123

1 breat/prostate

2 lung

3 colorectal

168

most common causes of ca mortality 123

1 lung

2 breast/prost

3 colorectal

169

how many cancer divisions for symtomps 

30 divisions

170

goal of screening?

catch dysplasia (reversible) or detect carcinoma before clinical s/s

171

mamography goals?

detect cancer in situ( 1cm), usually calcifies before invades or before clinically palpable ( 2cm), larger tumor = more mutationsand chances for metastasis

172

prostate cancer grows  where?

BPH where?

prostate ca grows in posterior peripheral of prostate: silent no symptoms, digital rectal excam close to posterior

BPH:  grows in center of prostate causing s/s

173

benefits of colonoscopy?

catch adenoma before adenocarcinoma or carcinoma before clinical sympt.

174

Aflatoxins

Associated cancer

 

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hepatocellular carcinoma, from Aspergillus from stored grains, 

175

Alkylating agents,  

Associated cancer

Leukemia lymphoma, s/e of chemo

176

alcohol, 

Associated cancer

Squamous cell carcinoma of oropharynx and upper esophagus,

pancreatic carcinoma

hepatocellular carcinoma

177

Arsenic

Associated cancer

women that worked in the field would apply arsenic to whitening back in the days. Present in cigarrette smoke

Squamous cell carcinoma of skin

lung cancer

angiosarcoma

 

178

Asbestos 

Associated cancer

Lung carcinoma and mesothelioma

exposure to asbestos is more likely to lead to lung cancer than mesothelioma

179

exposure to asbestos is more likely to lead to             than         

lung cancer, mesothelioma

180

Cigaretter smoke

Associated cancer

carcinoma of oropharynx, esophagus, lungs, kidneys and bladder

polycyclic hydrocarbons are particulary carcinogenic

181

Nitrosamines

Associated cancer

Stomach carcinoma

on smoked food, responsible for high rate of stomach CA in japan

stomach cancer 2 types : Intestinal carcinoma (nitrosamine), diffuse of carcinoma

182

Naphthylamine

Associated cancer

urothelial carcinoma of bladder

derived from cigarette smoke

183

Vinyl chloride

Associated cancer

angiosarcoma of liver

occupational exp to PVC pipes

184

Nickel, Chromium, Beryllium, or silica

Associated cancer

Lung carcinoma

occupational exp

185

EBV 

Associated cancer

most likely 1 chinese male 2 african infividual present with necj mass

nasopharyngeal carcinoma

burkitt lymphoma

CNS lymphoma in AIDS

186

HHV-8 

Associated cancer

human herpes virus

kaposi sarcoma

tumor of endothelial

187

pt present with purplelish lesion on skin

3 types

1: older eastern european males, skin tx excise

2: AIDS Tx: treat virus w/ antiretroviral and will boost CD4+

3: transplant: tx with reduce immuno suppresion slightly

188

HBV and HCV 

type of cancer

hepatocellular carcinoma

HBV DNA

HCV RNA

189

HBV vs HCN type of virus

HBV DNA

HCV RNA

190

HTLV-1

type of cancer

human T lymphotropic virus

adult t cell lymphoma/leukemia

191

High risk HPV 16, 18, 31, 33

type of cancer

Squamous cell carcinoma of vulva, vagina, anus, and cervic, adenocarcinoma of cervix

192

Ionizing (nuclear reactor accidents and radiotherapy)

type of cancer

generates what free radical

AML, CML, papillary carcinoma of the thyriod

hydroxyl free radical

193

non ionizing ( UVB sunlight most common

results in?

Basal cell carcinoma, squamous cell carcinoma, melanoma of skin

results in formation of pyrimidine dimers in dna excised by restriction endonucleases

seraderma pigments -> high risj skin CA

194

p 53 role?

regulates cell growth, suppresses risk of tumor formation

G1 --> S phase

p53 checks DNA, if dmged,  repair or brings BAX

BAX destroys BCL@ ( stabilizes mito mem) and cytochrome C leaks -> activates caspases -> apoptosis

195

tumor suppresors classic examples

p53

Rb retinoblastoma

196

P53 what is needed for tumors to grow?

both copies need to be knocked out

Knudson two hit hypothesis

197

PDGFB

function

mechanism

tumor associated

its a growth factor problem

platelelet derived GF :

overexpression ( PDGFB) of autocrine loop

Astrocytoma

 

A image thumb
198

ERBB2 ( HER2/neu)

function

mechanism

tumor associated

growth factor receptor problem

epidermal growth factor receptor

amplification 

subset of breast carcinomas

A image thumb
199

pt come w/ hx of breast ca, she read new tx designed against HER2. what new test needed?

HER2 new receptor

progesterone recepto

estrogen receptor

200

RET

function

mechanism

tumor associated

 

neural growth factor receptor

point mutation

MEN 2A, MEN 2B and sporadic medullary carcinoma of thyroid

201

trastuzumab

designed against HER2/neu

breast carcinoma where increase of receptor

202

pt develop multiple tumors in endocrine organs. Tx

if suspect MEN2A, 2B

do RET study 

if + thyrodectomy

203

KIT 

function

mechanism

tumor associated

stem cell growth factor receptor

point mutation

gastrointestinal stromal tumor

204

RAS gene family 

function

mechanism

tumor associated

SIGNAL TRANDUCER

GTP binding prot

point mutation

carcinomas, melanoma, lymphoma

70-80% tumors 

A image thumb
205

ABL

function

mechanism

tumor associated

SIGNAL TRANDUCER

tyrosine kinase

t( 9;22) with BCR

defines CML, also seen in ALL ( adult) ( usually . children. poor prognosis

206

B C- MYC

function

mechanism

tumor associated

Nuclear Regulator: over prod of growth promoting proteins

transcription factor

t(8;14) involving igH

Burkitt Lymphoma: lymphoma of B cells, jey Histology: starry sky appearance blue and white

 

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207

Q image thumb

starry sky appearance = burkitts lymphoma, b calls 

c-MYC , transcriptio factor, t(8;14) involving IgH

A image thumb
208

N-MYC

function

mechanism

tumor associated

nuclear regulatior

transcription factor

amplification

neuroblastoma N-MYC

209

L_MYC

function

mechanism

tumor associated

nuclear regulator

transcription factor

amplification

Lung cell carcinoma (snall cell)

210

CCND1 
( cyclin D1)

function

mechanism

tumor associated

cell cycle regulators

cyclin

t(11;14) involving IgH

Mantle cell Lymphoma

A image thumb
211

CDK4

function

mechanism

tumor associated

 

cell cycle regulators

cyclin-dependent kinase

amplification 

Melanoma

212

where is Ig heavy chain

chromosome 14