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Flashcards in Path General Principals High Yield Deck (110):
1

T/F: Apoptosis does not require ATP

FALSE...it is ATP dependent

2

What is pyknosis?

Nuclear shrinkage

3

What is karyorrhexis?

Nuclear fragmentation

4

Which pathway of apoptosis is involved in tissue remodeling during embryogenesis?

Intrinsic pathway

5

What triggers the intrinsic pathway of apoptosis?

Regulating factor is wthdrawn from a proliferating cell population

6

Is an increase or decrease in the BAX/ BAK pro-apoptotic?

Increase

7

Is an increase or decrease in Bcl-2 pro- apoptotic?

Decrease

(Bcl-2 is antiapoptotic)

8

How does Bcl-2 inhibit the activation of caspases?

It inhibits cyt c release by binding to and inhibiting Apaf-1 (which normally induces teh activation of caspases)

9

How is the extrinsic pathway activated?

Ligand receptor interations (FasL binding to Fas)

Immune cell (cytotoxic T cell release of perforing and granzyme B)

10

What is an example of FasL- Fas mediated apoptosis?

Negative selection the the thymus

11

Name the type of necrosis:

ischemia / infarcts in most tissues

Coagulative

12

Name the type of necrosis:

bacterial abscesses, brain infarcts

Liquifactive

13

Name the type of necrosis:

TB, systemic fungi with macrophages walling off the infectie organism

Caseous

14

Name the type of necrosis:

saponification seen in acute pancreatitis due to enzymes, also seen in breast trauma

Fat

15

Name the type of necrosis:

immune reactions in vessels, immune complexes combine with fibrin

Fibrinoid

16

Name the type of necrosis:

Vessel walls are thick and pink

Fibrinoid

17

Which of the following are reversible signs of cell injury?

1- ATP depletion
2- Membrane blebbing
3- Nuclear pykosis (shrinkage)
4- Fatty change
5- Lysosomal rupture
6- Cell/ mitochondrial swelling
7- Mitochondrial permeability/ vacuolization
8- Ribosomal/ poysomal detachment

ATP depletion

Membrane bledding

Fatty change

Cell/ mitochondrial swelling

Ribosomal/ polysomal detachment

18

When does red infarct occur?

Venous occlusion in tissues with multiple blood supplies

Reperfusion

19

When does pale infarct occur?

Occur in solid organs with a single blood supply (heart, kidney, and spleen)

20

What is the cellular component of inflammation?

Acute--> Neutrophils antibody, eosinophils

Chronic--> Mononuclear cells, and fibroblasts

21

What is chromatolysis?

process involving the neuronal cell body following axonal injury that is characterized by:

1- round cellular swelling
2- displacement of teh nucleus to the periphery
3- dispersion of Nissel substance throughout cytoplasm

22

"calcium depositoin in abnormal tissue usually secondary to necrosis"

dystrophic calcificatoin

23

"widespread deposition of calcium in normal tissue or high calcium phosphate product levels"

metastatic calcification

24

What can cause metastatic calcification?

Hyperparathyroidism, sarcoidosis, hypervitaminosis D

25

In metastatic calcification...where does calcification usually occur?

Kidney, lung, gastric mucosa

26

Is the patient normocalcemic in dystrophic calcification or metastatic calcification?

Dystrophic

27

What molecules are important in margination and rolling during leukocyte extravasation?

E- selectin and P- selectin (found in vasculature)

28

What do E- selectin and P- selectin bind?

Sialyl- Lewis (on the leukocyte)

29

What mediates TIGHT binding of leukocytes during leukocyte extravasation?

ICAM-1 (CD 54)

VCAM-1 (CD106)

30

What does ICAM-1 bind?

CD11/18 integrins (LFA-1, Mac-1)

31

What does VCAM bind?

VLA-4 integrin

32

What mediates DIAPEDESIS during leukocyte extravasation?

PECAM-1 (CD 31)

33

What mediates MIGRATION of leukocytes in leukocyte extravasation?

Chemotactic products--> C5a, IL-8, LTB4, kallikrein, platelet activating factor

34

What induces E selectin?

TNF and IL-1

35

What induces P selectin?

Histamine (from weibel- palade bodies)

36

What is diapedesis?

WBC travels between endothelial cells and exits blood vessel

37

What are the 3 ways that free radical damage cells?

1- Membrane lipid peroxidation
2- Protein modification
3- DNA breakage

38

Name 3 enzymes that can eliminate free radicals?

Catalase
Superoxide dismutase
Glutathione peroxidase

39

What vitamins act as antioxidants?

Vit A, B, C

40

What are the 2 types of scars?

1- hypertrophic

2- keloid

41

What is the collagen arrangement in hypertrophic scars? In keloid scars?

Hypertrophic scars--> parallel

Keloid scars--> disorganized

42

What race has a higher incidence of keloid scars?

African americans

43

What is the function of FGF?

stimulates angiogenesis

44

What is the function of PDGF?

Induces vascular remodeling and smooth muscle migration

Stimulates fibroblast growth for collagen synthesis

45

What does EGF do?

stimulates cell growth via tyrosine kinase

46

What is the function of TGF-beta?

Angiogenesis, fibroblasts, cell cycle arrest

47

What is the function of metalloproteinases?

Tissue remodeling

48

What is the function of VEGF?

Stimulates angiogenesis

49

What are the 3 phases of wound healing?

1- Inflammatory (

50

What cells begin to predominate during the proliferative and remodeling phase of wound healing?

fibroblsts

51

In wound healing what type of collagen is initially deposited?

Type III

52

What is type III collagen replaced with??

Type I

53

What cytokine initiates granulomas?

IFN- gamma

54

What cytokine maintains granulomas?

TNF alpha

55

What type of cell secretes IFN alpha to activate macrophages?

Th1 cells

56

What are 3 causes of exudate?

Lymphatic obstruction
Inflammation/ infection
Malignancy

57

What are 3 causes of transudate?

Increase hydrostatic pressure
Decreased oncotic pressure
Na+ retention

58

Elevated or decreased ESR:

Anemia

elevated

59

Elevated or decreased ESR:

sickle cell anemia

decreased

60

Elevated or decreased ESR:

Pregnancy

Elevated

61

Elevated or decreased ESR:

Autoinnnume dsorders

Elevated

62

Elevated or decreased ESR:

Polycythemia

Decreased

63

What condition is AL amyloidosis seen in?

Multiple myeloma/ plasma disorders

It is light chain deposition (hence AL)

64

What condition can AA amyloidosis be seen in?

Chronic inflammation (RA, IBD, protracted infection ect)

65

What can cause Beta2 microglobulin amyloidosis?

Dialysis

66

How can Beta2 microglobulin amyloidosis present?

Carpel tunnel syndrome

67

What mutation is responsible for heritable amyloidosis?

Transthyretin gene mutation

68

What causes age related/ senile amyloidosis?

deposition of normal transthyretin in myocardium and other sites

69

What is IAPP amyloidosis associated with? What deposits in this type of amyloidosis?

T2DM

(Deposition of amylin in pancreatic islets)

70

What is the yellow brown pigment that appears with normal aging?

Lipofuscin

71

What forms lipofuscin?

formed by oxidation and polymerization of autophagocytosed organellar membranes

72

"abnormal proliferation of cells with loss of size, shape, and orientation"

dysplasia

73

Describe the nuclear/ cytoplasmic ratio in neoplastic cels

increased!

74

Describe the nuclear/ cytoplasmic ratio in neoplastic cels

increased!

75

What is p- glycoprotein? What is it seen in?

multidrug resistance protein 1

Seen in adrenal cell carcinoma (but also in other cancer cells)

76

What is the function of p- glycoprotein?

used to pump out toxins--> including chemo agents

77

"increased number of cells"

hyperplasia

78

"one adult cell type is replaced by another usually secondary to irritation or environmental exposure"

Metaplasia

79

"abnormal growth with loss of cellular orientation, shape size, in comparison to normal tissue"

Dysplasia

80

Which types of inappropriate cell growth patterns are reversible?

Hyperplasia
Metaplasa
Dysplasia

81

Which types of inappropriate cell growth patters are irreversible?

Anaplasia
Neoplasia
Desmoplasia

82

"loss of structural differentiation and function of cells, resembling primative cells of same tissue"

Anaplasia

83

"uncontrolled and excessive CLONAL proliferation of cells that can be benign or malignant"

Neoplasia

84

"fibrous tissue formation in response to neoplasm"

desmoplasia

85

What is more important...grade or stage?

Stage

86

Is a low grade cancer well differentiated or poorly differentiated?

Well!!

87

What are the components of the staging system?

T= Tumor size
N= node involvement
M= Metastases

88

Do benign, malignant or both have an upregulation of telomerase preventing chroomosome shortening and cell death?

Malignant

89

What is cachexia?

Weight loss, muscle atrophy and fatigue that occurs in chronic disease

90

What mediates cachexia?

TNF- alpha, IFN- gamma, and IL-6

91

Acanthosis nigricans is an indicator of...

visceral malignancy (and insulin resistance

92

What type of cancer can cirrhosis lead to?

Hepatocellular

93

What type of cancer can ulcerative coloitis lead to?

colon adenocarcinoma

94

What is a precursor to SCC of the skin?

actinic keratosis

95

What types of cancer can dermatomyositis and poolyomyositis be associated with?

Predispose to visceral malignancies (particularly GU)

96

Multiple seborrheic keratosis is associated with which 4 underlying malignancies?

1- GI
2- Breast
3- Lung
4- Lymphoid

97

Plummer- Vinson syndrome predisposes to which type of cancer?

SC of the esophagus

98

Veroderma pigmentosa predisoses to what types of cancer?

SCC
BCC
Melanoma

99

What cancers does AIDS predispose a patient to?

Lymphoma

Kaposi sarcoma

100

What 3 cancers does immunodificiency predispose to?

Lyphoma
Melanoma
RCC

101

What is the mutation seen in Li- Fraumeni Syndrome?

p53

102

Radiation exposure put an individual at increased risk for which 4 cancers?

1- Papillary thyroid cancer
2- Sarcoma
3- Breast cancer
4- Leukemia

103

What are the 3 most common cancers in men?

1- Prostate
2- Lung
3- Colon/ rectum

104

What are the 3 most deadly cancers in men

1- Lung
2- Prostate
3- colon/ rectum

105

What are the 3 more deadly cancers in women?

1- Lung
2- breast
3- colon/ rectum

106

What are the 3 most common cancers in men?

1- breast
2- lung
3- colon/ rectum

107

What 5 tumors are known to met to the brain?

1- Lung
2- breast
3- prostate
4- melanoma
5- GI

108

What 3 tumors are known to me to the liver?

1- colon
2- stomach
3- pancreas

109

What tumors are know to met to the bone?

1- Prostate/ breast
2- lung/ thyroid/ kidney

110

Which bone mets are blastic?

prostate

breast and lung are mixed

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