Information Needed to answer Bikmans test questions Flashcards
(112 cards)
1
Q
What disorder is associated with dry, crusty, black sores on toes and feet
A
Dry gangrenous necrosis
2
Q
what causes gangrenous necrosis
A
hypoxia
3
Q
why does hypoxia lead to a damaged cell
A
- a lack of Oxygen means that ATP can’t be produced from the ETC chain.
- Low ATP means that the sodium-potassium pump and calcium pumps can’t work.
- cell will swell, and if not corrected the cell will lyse
4
Q
what happens to the mitochondria in a hypoxia condition
A
the mitochondria swell as well
5
Q
What are the three main changes that take place in necrosis
A
- nuclear changes
- cytoplasmic changes
- calcification
6
Q
What are the nuclear changes that take place in necrosis
A
Pyknosis
Karyorrhexis
Karyolysis
7
Q
what is pyknosis
A
the clumping of chromatin in the nucleus
8
Q
what is karyorrhexis
A
fragmentation of the nucleus
9
Q
what is karyolysis
A
nuclear dissolution and chromatin lysis
10
Q
What is the main cytoplasmic change associated with necrosis
A
increased eosinophilia (seen as red stains)
11
Q
What causes the calcification associated with necrosis
A
dead cells that are converted into fatty acids (instead of being phagocytosed) those fatty acids attract a lot of calcium and calcification results
12
Q
What are the two types of calcification
A
dystrophic calcification
metabolic calcification
13
Q
what is the difference between dystrophic and metabolic calcification
A
metabolic can occur in any tissue and is a result of hypercalcemia
dystrophic occurs with necrosis, often in atheroma. not related to hypercalcemia
14
Q
What are the different types of necrosis
A
coagulative necrosis liquefactive necrosis caseous necrosis fat necrosis fibrinoid necrosis gangrenous necrosis
15
Q
what is coagulative necrosis and what tissues does it affect
A
it is protein denaturation (albumin becomes opaque)
it affects the kidneys, spleen, heart, and adrenal glands
16
Q
what is liquefactive necrosis and what tissues does it affect
A
it affects the hydrolytic enzymes
it affects the neurons and glial cells of the brain
17
Q
What is caseous necrosis and what tissues does it affect
A
it is a combination of coagulative and liquefactive necrosis, it often forms a granuloma
18
Q
What is fat necrosis, and what tissues does it affect
A
it affects the action of lipases
it affects the pancreas, breast, and abdominal organs
19
Q
What is fibrinoid necrosis, and what tissues does it affect
A
it is complexes of antigens and antibodies that are deposited in the walls of arteries
20
Q
What are the two types of gangrenous necrosis
A
wet and dry
21
Q
what tissues does gangrenous necrosis affect
A
the limbs, not organs
22
Q
what is typical of dry gangrenous necrosis
A
insufficient blood
coagulative
dry, crusty, and black skin
23
Q
What is typical of wet gangrenous necrosis
A
infection
liquefactive
cold, swollen, black
Foul odor (pus)
24
Q
what are the two types of inflammation
A
chronic and acute
25
what kind of cells will you see in the tissues in acute inflammation
mostly neutrophils
26
what kind of cells will you see in the tissues in chronic inflammation
monocytes/macrophages and lymphocytes
27
What do monocytes look like
1. Large
2. oddly shaped
3. nucleus doesn't fill the entire space and isn't segmented
28
what do lymphocytes look like
1. the nucleus almost fills the entire space and isn't segmented
29
what do neutrophils look like
1. has a polymorphuous (PMN or segmented) nucleus
| 2. few neutral granulocytes
30
What do eosinophils look like
1. a PMN cell
| 2. many red granulocytes
31
what do basophils look like
1. a PMN cell
| 2. many blue granulocytes
32
what is the first leukocyte to arrive at the site of infection
neutrophils
33
What role does arachadonic acid play in inflammation
it is broken down into 4 different molecules that affect inflammation
34
what 4 metabolites is arachadonic acid broken down into that affect inflammation
Via cyclooxygenase:
prostaglandins
prostacyclins
thromboxanes
Via lipoxygenase:
leukotrienes
35
From where does a cell get the arachadonic acid that is broken down into prostaglandins, prostacyclins, thromboxanes, and leukotrienes
the phospholipids of the cell membrane
36
what enzyme converts the phospholipids of the cell membrane into arachadonic acid
phospholipase A2
37
What are the products when COX (cyclooxygenase) reacts with arachadonic acid
prostaglandins
prostacyclins
thromboxanes
38
how do prostaglandins affect inflammation
they increase inflammation
they increase clotting
and thermoregulation
39
how do prostacyclins affect inflammation?
cause vasodilation
inhibit platelet activation
reduce clotting
40
how do thromboxanes affect inflammation
activate platelets and make them sticky
41
what are the products of lipoxygenase reacting with arachadonic acid
leukotrienes
42
how do leukotrienes affect inflammation
cause smooth muscle contraction in the trachea (they cause most of the inflammation in asthma and allergic rhinitis)
43
which of the metabolites of arachadonic acid causes the inflammation in asthma and allergic rhinitis
leukotrienes
44
on what enzymes to anti-inflammatory steroids act, what does that cause
they act on phospholipase A2 and cyclooxygenase
this stops arachadonic acid from being made from phospholipases, and stop arachadonic acid from being metabolized into prostaglandins, prostacyclins, and thromboxanes
45
Where does aspirin act
On COX (cyclooxygenase) stopping arachadonic acid from being metabolized into prostacyclines, prostaglandins, and thromboxanes
46
What is the affect of Omega 3 fatty acids (n-3 PUFA) on inflammation
it inhibits COX and produces resolvins (anti-inflammatory things)
So it reduces inflammation
47
How can one get n-3 PUFAs
eating fish, eggs, milk, many meats (grass fed animals)
48
What is the relationship between omega 3 fatty acids and periodontitis
intake of omega 3 fatty acids (DHA and EPA) are inversely associated with periodontitis. dietary therapy with more omega 3 fatty acids could help prevent and treat periodontitis
49
what is periodontitis
inflammation of the periodontium
50
how is periodontitis associated with insulin
periodontitis is associated with insulin resistance
51
how is inflammation associated with insulin resistance
inflammation leads to insulin resistance
52
What is a nevus
a benign proliferation of melanocytes (a mole)
53
What are the three types of moles (locations in which they are)
Junctional (dermal epidermal junction)
Compound (partially into the dermis)
Intradermal (completely in the dermis)
54
which of the three types of nevi (moles) is most likely to become malignant
compound nevus
55
What is a melanoma
a malignant tumor of melanocytes
56
What are the ABCDE's you look for in a nevus to determine if it may be malignant
```
A - Asymmetry
B - Border
C - Color
D - Diameter
E - Elevation
```
57
can melanoma arise from a benign nevus
yes
58
what affect can sun exposure have on our risk of developing melanoma
more sun exposure = more risk of melanoma
59
What determines the prognosis of someone diagnosed with melanoma
how deep the melanoma has invaded the skin
60
What are the four types of melanoma
1. superficial spreading
2. nodular
3. lentigo maligna
4. acral lentiginous
61
What is a superficial spreading melanoma
a melanoma that spreads but stays in the epidermis
62
what is a nodular melanoma
the most agressive form of melanoma, it tends to grow deep as opposed to broad
63
what is a lentigo maligna melanoma
a melanoma that evolves from a lentigo maligna on the skin
64
what is acral lentiginous melanoma
a melanoma that is found on a non-hair bearing surface
65
which type of melanoma is most likely found on the roof of her mouth
acral lentiginous
66
what is the % chance of 5 years survival for melanomas that are
1. less than 1mm deep
2. between 1 and 2 mm deep
3 between 2 and 4 mm deep
1. 80-95% 5 year survival
2. 30-60% 5 year survival
3. 35% 5 year survival
67
What is the most common type of anemia
iron-deficient anemia
68
What kind of anemia is iron-deficient anemia
microcytic, hypochromic anemia
| small RBCs with Low hemoglobin
69
What are two telling symptoms of iron-deficient anemia
```
Atrophic glossitis (smooth tongue)
Koilonychia (indented finger nails)
```
70
What are potential causes of iron-deficient anemia
1. Decreased Iron intake
a. poor diet
b. poor absorption
2. Increased iron loss
a. GI bleeding
b. menses
c. hemorrhage
3. Increased Iron requirement
a. pregnancy
71
What is anemia
a reduction below the normal in hemoglobin or red blood cell number
72
What are the symptoms of anemia
```
Pale skin
jaundice (if hemolytic)
breathless ness
tachycardia
dizziness
fatigue
```
73
what kind of anemia is related to low G6PDH levels
G6PDH deficient anemia
74
how does low G6PDH levels cause anemia
G6PDH assists glutathione in getting rid of reactive oxygen species. if you have low G6PDH levels, then glutathione wont be able to get rid of them, and you will have high reactive oxygen species. Those kill RBCs
75
is G6PDH deficient anemia intra or extracorpuscular
it is intracorpuscular
76
What kind of cells are associated with G6PDH deficiency
RBCs with heinz bodies
| AKA bite cells
77
is G6PDH a hemolytic anemia
yes, it causes the destruction of RBCs
78
the heinz bodies are piles of _____
globin
79
Fava beans (and some drugs) can set off what kind of anemia
G6PDH deficient anemia
80
can G6PDH deficient anemia cause jaundice
yes, because it is a hemolytic anemia
81
in diagnosing jaundice a doctor will look at stool and urin color to figure out where the jaundice is coming from. When the urine and stool are both Dark, what is that indicative of
hemolytic anemia
82
what are the signs of hemolytic anemia
```
increased bilirubin
increased LDH
reduced haptoglobin
increased reticulocytes
nucleated RBCs in blood
```
83
What are the different types of hemolytic anemias
```
Microangiopathic hemolytic anemia
autoimmune hemolytic anemia
sickle cell anemia
thalassemia
hereditary spherocytosis
G6PDH deficiency
```
84
What type of anemia is associated with prominent cheek bones
thalassemia
85
is thalassemia intra or extracorpuscular
intracorpuscular
86
What are the RBCs like in thalassemia
hypochromic and microcytic
87
What is actually the problem in thalassemia
inability to make sufficient alpha or Beta chain of hemoglobin
88
What happens to EPO levels in thalassemia
they are increased to increase RBC production
89
What can determine whether thalassemia is a problem with the alpha or beta chain of hemoglobin
ethnicity
South east Asians = alpha chain problems
Mediterranians = beta chain problems
90
What causes the prominent cheek bones in thalassemia
high levels of erythropoesis
91
can thalassemia lead to jaundice
yes
92
What is marfan syndrome
a disorder of connective tissues, manifested by changes in the skeleton, eyes, and cardiovascular system
93
what is the actual problem in marfan syndrome
an abnormality of fibrillin 1 (elastic fibers)
94
What are the features of someone with marfan syndrome
1. unusually tall with long extermities
2. bilateral subluxination of the eye lens (ectopica lentis)
3. cardiovascular legions: mitral valve prolapse
4. increased risk of cleft palate and caries
95
is marfan syndrome a heritable disorder
yes
96
is marfan syndrome a sex linked disorder
no. it is an autosomal dominant disorder
97
What disorder is most associated with
- shortness
- webbing of the neck
- edema
- wide chest
- reduced carrying angle
- low hairline
Turner syndrome
98
what is the actual problem in turner syndrome
a female with only one X
99
is turner sydrome autosomal or sex chromosome aneuploidy
sex chromosome aneuploidy
100
how could someone get turner syndrome
one parent did nondisjunction of the sex chromosomes. so from one parent you get X (normal) from the other you do not get a sex chromosome
101
What are the three ways a tumor will metastasize
seeding
lymphatic spread
hematogenous spread
102
What is seeding (metastasize)
tumor invades the body cavity
a bit breaks off of something in the body cavity and attaches to something else
ovarian cancer spreads this way
103
What way do carninomas generally metastisize
lymphatic spread (tumor spreads through the lymph)
104
what ways do sarcomas generally metastasize
hematogenous spread (through the blood)
105
can carcinomas spread through hematogenous spread
yes
106
where to sarcomas end up most commonly
the liver and lungs
107
What is dysplasia
disorderly changes in non-neoplastic epithelial cells
108
what is anaplasia
a complete lack of differentiation
109
is a benign tumor highly or poorly differentiated tissue
highly
110
is a malignant tumor highly or poorly differentiated tissue
poorly
111
What is a benign fat tumor
lipoma
112
what is a malignant fat tumor
liposarcoma
