PATHOLOGY Flashcards by Janus Palermo

The study of the structural, biochemical, and functional changes in cells, tissues, and organs; study of suffering

Pathology

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Father of modern Pathology:

Rudolf Ludwig Carl Virchow

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Term for diseases of unknown origin:

Idiopathic

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Origin of the disease/causative agent

Etiology

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Refers to the sequence of events that follow the exposure of cells or tissues to an injurious agent

Pathogenesis

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Refers to the structural alterations in cells or tissues that are either characteristic of a disease or diagnostic of an etiologic process

Morphologic changes

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The END RESULT of genetic, biochemical and structural changes in cells and are functional abnormalities which leads to the clinical manifestations of disease, as well as its progress

Clinical manifestations

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Difference of signs and symptoms:

Signs - OBJECTIVE evidence of the disease; physical observations

Symptoms - SUBJECTIVE evidence of the disease; experienced by the patient

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The sum total of changes in the living tissues, in response yo an injurious agent

Inflammation

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Five cardinal signs of inflammation:

Rubor - Redness - increase rate of blood flow
Tumor - Swelling - increase capillary permeability
Calor - Heat - transfer of internal heat
Dolor - Pain - pressure upon sensory nerve
Function laesa - Loss of function - Pain interference

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Classification of Inflammation according to severity or duration:

Acute inflammation
Chronic inflammation
Subchronic inflammation

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Inflammation of sudden onset, characterized with 5 cardinal signs

Acute inflammation

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Predominant cells in Acute Inflammation:

Neutrophils

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Inflammation that involves persistence of injurious agent for weeks or years characterized by proliferation:

Chronic inflammation

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predominant cells in Chronic Inflammation:

Mononuclear cells (plasma cells, lymphocytes, macrophages, monocytes)

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Inflammation that represents integrade between acute and chronic inflammation

Subchronic inflammation

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Classification of inflammation according to type of exudate:

Serous inflammation
Hemorrhagic inflammation
Fibrinous inflammation
Purulent inflammation
Catarrhal inflammation

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Characterized by extensive outpouring of WATERY, LOW PROTEIN-FLUID derived from either the blood serum or secretions from serosal mesothelial cells (example: blister)

Serous inflammation

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Characterized by the admixture of BLOOD and elements of exudates

Hemorrhagic inflammation

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Characterized by exudation of large amounts of FIBRINOGEN and precipitation of fibrin masses

Fibrinous inflammation

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Characterized by the production of large amount of PUS or purulent exudates:

Purulent inflammation

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Characterized by HYPERSECRECTION OF MUCOSA with degenerative changes in the epithelium

Catarrhal inflammation

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Defined as a DISRUPTION of the normal anatomical structure and function of the SKIN or other tissues in the body;

WOUND

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Injuries where the SKIN IS BROKEN exposing underlying tissues to the environment

OPEN WOUNDS

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Types of OPEN WOUNDS:

1. Puncture 2. Incision 3. Laceration 4. Abrasion 5. Avulsion 6. Amputation mnemonic: "OPEN ang mall" - "PILAAA" bago pumasok

Open wound caused by sharp object that deeply penetrates the skin:

Puncture wound

Open wound caused by sharp-edged object:

Incision

Torn or jagged wounds caused by tearing of the skin via external force:

Laceration

Open wound caused by FRICTION AGAINST A ROUGH SURFACE:

Abrasion

Partial or complete tearing away of the skin causing the separation of the skin from tissue

Avulsion

Complete detachment of limb

Amputation

Injuries where the SKIN REMAINS INTACT, but there is damage to underlying tissues; these wounds may not be immediately visible, making them potentially more dangerous if not diagnosed:

Closed wounds

types of closed wounds:

1. Blister 2. Hematoma 3. Contusions 4. Crush-injuries 5. Seroma mnemonic: "CLOSED" ang mall - BaHa, kaya Closed, sayang may Class Suspension pa naman

Fluid-filled sac that forms between the upper layers of the skin, usually as a result of friction, burns, or other types of trauma:

Blister

Blood-filled area that develops under the skin/tissue

Hematoma

Blunt trauma due to damaged small blood vessels

Contusions

Due to squeezing between two surfaces of the body

Crush-injuries

Fluid-filled area that develops under the skin/tissue

Seroma

THREE ABNORMALITIES IN CELL GROWTH:

1. Retrogressive changes 2. Progressive changes 3. Degenerative changes

Abnormal cell growth where organs or tissues are smaller than normal:

Retrogressive changes

Abnormal cell growth where organs or tissues are larger than normal

Progressive changes

Abnormal cell growth where organs or tissues have problems in cellular growth patterns

Degenerative changes

Types of RETROGRESSIVE CHANGES:

1. Aplasia 2. Agenesia 3. Atresia 4. Atrophy 5. Hypoplasia

Retrogressive change characterized by incomplete or defective development of a tissue or organ

Aplasia

Retrogressive change characterized by complete non-appearance of an organ

Agenesia

Retrogressive change characterized by failure of an organ to form an opening

Atresia

Retrogressive change characterized by acquired decrease in size of a normally developed or mature tissue or organ. It can be PHYSIOLOGIC or PATHOLOGIC

Atrophy

Retrogressive change characterized by failure of an organ to reach or achieve its full mature or adult size due to incomplete development

Hypoplasia

Types of PROGRESSIVE CHANGES:

1. Hypertrophy 2. Hyperplasia

Increase in size of tissues or organs due to INCREASE IN THE SIZE of individual cells:

Hypertrophy

Usually observed in the skeletal muscles, heart, kidney, endocrine organs and smooth muscles of hollow viscera due to increased work load and endocrine. Examples include - Uterine hypertrophy during pregnancy - Bulging muscles of bodybuilders

Physiologic hypertrophy

Due to edema fluid and connective tissue proliferation, Examples include: - Enlargement of the heart in response to pressure overload

Pathologic hypertrophy

Involves one of the paired organs when the other opposite organ has been removed or suffered from functional insufficiency

Compensatory hypertrophy

Increase in size of an organ or tissue due to INCREASE IN THE NUMBER of cells resulting from growth of new cells:

Hyperplasia

Due to the action of hormones or growth factors occurs when there is a need to increase functional capacity of hormone sensitive organs occurring as natural phenomenon. Example include: - ENLARGMENT OF FEMALE BREAST AT PUBERTY AND DURING PREGNANCY

Physiologic hyperplasia

Caused by excessive or inappropriate actions of hormones or growth factors acting on target cells. Examples include: - Endometrial hyperplasia which is a common cause of abnormal uterine bleeding - Benign prostatic hypeplasia - Viral infections, such as papillomaviruses

Pathological hyperplasia

Examples of DEGENERATIVE CHANGES:

1. Dysplasia 2. Anaplasia 3. Metaplasia 4. Neoplasia mnemonic: "DAMN"

Regressive alteration in adult cells manifested by variation in size, shape and orientation, associated with chronic inflammation and protracted irritation

Dysplasia

Marked regressive change in adult cells toward more primitive or embryonic cell types, utilized as a criterion toward malignancy/ example: Carcinoma

Anaplasia

Reversible change involving the transformation in one type of adult cell to another

Metaplasia

Continuous abnormal proliferation of cells without control; represents a pathologic overgrowth of the tissue:

Neoplasia

IRREVERSIBLE degenerative changes:

Neoplasia Anaplasia

REVERSIBLE degenerative changes:

Metaplasia Dysplasia

Represents a pathologic condition or overgrowth of tissue and is usually autonomous in nature; means "new growth" and a new growth is called neoplasmas

Neoplasia

TWO PARTS OF TUMOR:

1. Parenchyma 2. Stroma

Part of tumor that refers to the active elements of the tumor

Parenchyma

Part of the tumor that refers to the connective tissue framework with lymphatic and vascular channels

Stroma

Classification of TUMOR according to CAPACITY TO PRODUCE DEATH

Benign Malignant

Encapsulated' grow slowly' non-spreading' minima; mitotic activity; resemble parent tissue; DO NOT PRODUCE DEATH

BENIGN TUMOR

Benign tumors arising from GLANDS

Adenoma Mnemonic: PE 'GA' = Glands-Adenoma

Benign tumors arising from EPITHELIAL SURFACES:

Papilloma mnemonic: 'PE' GA = Papilloma-Epithelial surfaces

Increase number of cells; invades tissue; lymphatic spread; metastasis; with nuclear structures; WILL PRODUCE DEATH

Malignant tumor

Malignant tumors of EPITHELIAL tissue origin:

CARCINOMA mnemonic: 'CE' SC = Carcinoma-Epithelial tissue

Malignant tumors of CONNECTIVE tissue of origin

SARCOMA mnemonic: CE 'SC' = Sarcoma-Connective tissue

Classification of TUMOR according to HISTOLOGIC CHARACTERISTICS

1. Medullary tumors 2. Scirrhous tumors

There are more cells than connective tissues; it is SOFT and VERY MALIGNANT

Medullary tumors

There are more connective tissues than cells; it is characterized as STONY and HARD

Scirrhous tumors

Suffix used for Benign Tumors:

-oma

Suffix used for Malignant Tumors of Mesenchymal/Connective tissue:

-sarcoma

Suffix used for Malignant Tumors of Epithelial Tissue:

-carcinoma examples: Glands and Ducts - AdenoCARCINOMA Finger-like (warty) projections - Papillary CARCINOMA

Grading of Tumors:

Differentiated Cells: Resembles NORMAL CELLS Undifferentiated Cells: Resembles YOUNGER CELLS

BRODERS CLASSIFICATION Grade I Differentiated cells: Undifferentiated cells: Remarks:

BRODERS CLASSIFICATION Grade I Differentiated cells: 76-100% Undifferentiated cells: 0-25% Remarks: Well-differentiated

BRODERS CLASSIFICATION Grade II Differentiated cells: Undifferentiated cells: Remarks:

BRODERS CLASSIFICATION Grade II Differentiated cells: 51-75% Undifferentiated cells: 26-50% Remarks: Moderately-differentiated

BRODERS CLASSIFICATION Grade III Differentiated cells: Undifferentiated cells: Remarks:

BRODERS CLASSIFICATION Grade III Differentiated cells: 26-50% Undifferentiated cells: 51-75% Remarks: Poorly-differentiated

BRODERS CLASSIFICATION Grade IV Differentiated cells: Undifferentiated cells: Remarks:

BRODERS CLASSIFICATION Grade IV Differentiated cells: 0-25% Undifferentiated cells: 76-100% Remarks: Anaplastic/Pleomorphic

Value of grading: Guide for treatment LOWER GRADES: HIGHER GRADES:

Value of grading: Guide for treatment LOWER GRADES: SURGERY HIGHER GRADES: FOR RADIATION/CHEMOTHERAPY

General Rule in BRODER'S CLASSIFICATION:

- Well-differentiated tumors are LESS MALIGNANT - Higher grades have generally poorer diagnosis

STAGING OF TUMORS Primary tumors:

STAGING OF TUMORS Primary tumors: - T = T1, T2, T3, T4: with INCREASING size of primary lesion

STAGING OF TUMROS Regional Lymph Nodes Involvement:

STAGING OF TUMROS Regional Lymph Nodes Involvement: - N = N0, N1, N2, N3: Indicates PROGRESSIVELY advancing nodal disease

STAGING OF TUMROS Metastasis:

STAGING OF TUMROS Metastasis: - M = M0, M1, M2: Whether there are distant METASTASIS (transfer of abnormal cell from one organ to another)

TWO TYOES OF CELL DEATH:

1. Cellular Death 2. Somatic Death

Refers to the death of individual cells and can encompass various mechanisms

Cellular Death

Refers to the death of the entire organism, which ultimately results in the death of all the cells in the body

Somatic Death

Types of CELLULAR DEATH:

1. Apoptosis 2. Necrobiosis 3. Necrosis

the PROGRAMMED cell death; often PHYSIOLOGIC, means of elimination of unwanted cells; maybe PATHOLOGIC often some forms of cell injury, especially DNA damage; Morphological identified by NUCLEAR CONDENSATION

APOPTOSIS

The PHYSIOLOGIC cell death

NECROBIOSIS

The PATHOLOGIC cell death

NECROSIS

Basic morphologic changes/Hallmark changes seen in necrosis Nuclear changes:

1. Pyknosis 2. Karyorrhexis 3. Karyolysis

Reduction in size and condensation of the nucleus:

Pyknosis

Segmentation and fragmentation of the nucleus:

Karyorrhexis

Dissolution of the nucleus:

Karyolysis

Large and granular (cloudy swelling), more acidophilic, dense and opaque, cell boundary is lost, granular coagulation and fragmentation

Cytoplasmic changes

Types of necrosis according to location or extent:

1. Focal necrosis 2. Massive necrosis

Necrosis that involves a SPECIFIC organ or a particular structure:

Focal necrosis

Necrosis that involves the WHOLE or GREATER part of the organ

Massive necrosis

Types of necrosis according to morphologic changes:

1. Coagulative necrosis 2. Liquefactive necrosis 3. Fat necrosis 4. Caseous necrosis 5. Gangrenous necrosis

Most common type of necrosis; characterized by TOMBSTONE FORMATION; usually encountered when the ARTERIAL SUPPLY IS CUT OFF anemic or ischemic infarction; also seen in myocardial infarction

COAGULATIVE NECROSIS

Caused by RAPID TOTAL ENZYMATIC DISSOLUTION of the cells with complete destruction of the entire cell; Seen in BACTERIAL INFECTIONS which lead to the formation of pus, probably due to the release of proteolytic enzymes; most commonly encountered in the BRAIN causing HYPOXIC DEATH OF CNS

LIQUEFACTIVE NECROSIS

Involves the peculiar destruction of tissue particularly found in PANCREATIC DEGENERATION resulting to the release of lipase; morphologically, the tissue is characterized by presence of a dull, opaque circumscribed, flat area with CHALKY WHITE PRECIPITATE

FAT NECROSIS

SOFT, FRIABLE CHEESE appearance in its gross state; highly associated with TUBERCULOSIS, also in syphilis, tularemia, and lymphagranuloma inguinale

CASEOUS NECROSIS

Refers to the MASSIVE DEATH OR NECROSIS OF TISSUE caused by combination of ischemia and superimposed bacterial infection

GANGRENOUS NECROSIS

DRY gangrene is caused by:

Arterial occlusion (ex. Hands)

WET gangrene is caused by:

Venous occlusion (ex. Foot -DM)

Primary changes of death (somatic death):

1. NERVOUS FAILURE - loss of coordination of various functions, chiefly loss of reflexes 2. CIRCULATORY FAILURE - occur when cardiac function ceases, absence of pulse and heartbeat 3. RESPIRATORY FAILURE - absence of oxygen and accumulation of carbon dioxide with loss of oxidative process needed for life mnemonic: NCR

Secondary changes of death (somatic death):

1. Algor mortis 2. Rigor mortis 3. Livor mortis 4. Post-mortem clot 5. Desiccation 6. Putrefaction 7. Autolysis

FIRST DEMONSTRABLE CHANGE observed, characterized by COOLING OF THE BODY, occurRing at definite rate of about 7F/hour and usually important in establishing APPROXIMATE TIME OF DEATH

ALGOR MORTIS

Refers to the RIGIDITY OR STIFFENING of the muscle occurring about 6-12 HOURS after death and persisting for 3-4 DAYS. Change is first seen in the MUSCLES OF THE HEAD AND NECK, later spreading towards the lower extremities, and subsequently disappearing in the same sequence

RIGOR MORTIS

PURPLISH DISCOLORATION of the body due to STASIS and eventual SETTLING DOWN of blood into blood vessels

LIVOR MORTIS

Difference between LIVOR MORTIS and ECCHYMOSIS Application of pressure: Oozing blood upon incision: Location:

Difference between LIVOR MORTIS and ECCHYMOSIS Application of pressure LM: discoloration DISAPPEARS UPON PRESSURE and reappears upon release ECCHYMOSIS: No changes Oozing blood upon incision: LM: POSITIVE (+) ECCHYMOSIS: NEGATIVE (-) Location: LM: BLOOD VESSELS ECCHYMOSIS: TISSUE

Occurs slowly, IMMEDIATELY AFTER DEATH, and may sometimes complicate the determination of the cause of death, particularly regarding the differentiation between post-mortem clots or thrombi

POST-MORTEM CLOT

Immediately after death; "Chicken Fat" appearance "Currant Jelly" shaped blood vessels "Rubbery" consistency

POST-MORTEM CLOT

Before death; Friable Tangled, irregular fashion Detachable, do not have a rubbery consistency

ANTE-MORTEM CLOT

DRYING and WRINKLING OF THE CORNEA and anterior chamber of eye due to absorption of the aqueous humor

DESICCATION

This is characterized by production of FOUL-SMELLING GASES due to the invasion of the tissue by multiplying saprophytic organisms

PUTREFACTION

SELF-DIGESTION of cells

AUTOLYSIS

All are signs of someone who has COVID-19, EXCEPT: A. Loss of test B. Productive cough C. Fever D. Positive SARC-COV-2 antigen

A. Loss of taste - Symptom, not sign

Rubor: Redness; Calor: A. Swelling B. Pain C. Heat D. Loss of function

C. Heat

Which of the following wounds is caused by friction against a rough surface? A. Laceration B. Contusion C. Hematoma D. Abrasion

D. Abrasion

Which among the choices below is a closed wound? A. Abrasion B. Laceration C. Hematoma D. Amputation

C. Hematoma

What progressive change is characterized by an increase in size of tissues or organs due to increase in the size of individual cells? A. Hyperplasia B. Hypoplasia C. Hypertrophy D. Neoplasia

C. Hypertrophy

Which of the following is an IRREVERSEIBLE change of tissue? A. Metaplasia B. Dysplasia C. Anaplasia D. Neoplasia

D. Neoplasia - 1st choice! C. Anaplasia is also irreversible but the first choice must be Neoplasia Neoplasia - 1st choice Anaplasia - 2nd choice

What is the malignant tumor of epithelial tissue origin, which have less tendency to produce supporting tissue/stroma? A. Sarcoma B. Carcinoma C. Adenoma D. Papilloma

B. Carcinoma

What is the physiologic cell death? A. Necrosis B. Apoptosis C. Necrosis and Apoptosis D. Somatic death

B. Apoptosis #1 NECROBIOSIS note: Apoptosis is OFTEN PHYSIOLOGIC, means of elimination of unwanted cells; MAYBE PATHOLOGIC often some forms of cell injury, especially DNA damage' It is morphological identified by NUCLEAR CONDENSATION.

Somatic death refers to the death or complete cessation of metabolic and functional activities of the organism or the body as a whole. What are the primary changes of death? A. Nervous and circulatory failure B. Respiratory failure C. Nervous, Circulatory and Respiratory failure D. AOTA

D. AOTA (all of the above)

PATHOLOGY Flashcards

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