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Flashcards in Pathology Deck (124):
1

Signs of apoptosis

cell shrinkage
nuclear shinkage (pyknosis)
basophilia
membrane blebbing
nuclear fragmentation (karyorrhexis)

2

When is intrinsic pathway most active

embryogenesis with tissue remodeling
Injury repair

3

Describe the intrinsic pathway

Increased Bax
Decreased Bcl-2
mitochondrial permeability
cytochrome C release

4

Describe the extrinsic pathway

Fas ligand binds Fas-R (CD95)
-Cytosolic caspases activated
-Cellular breakdown

OR

Killer T cell releases granzyme and perforin

5

Which organs have liquefactive necrosis

Brain, pleural effusion

6

When do you see fibrinoid necrosis

Blood vessels (HTN or vasculitis)

7

When do you see gangrenous necrosis

dry (ischemic)
wet (with bacteria)
Occurs in LIMBS and GI TRACT

8

Which parts of kidney are most susceptible to damage?

medulla
-thick ascending limb and proximal tubule

9

Which parts of colon are susceptible to hypoxia?

splenic flexure and rectum
--dual blood supply to distal areas protects from single vessel blockage, but not systemic ischemia (aka watershed)

10

Which cells of brain are killed first in global ischemia of brain

pyramidal cells of hippocampus
purkinje cells

11

Red infarct

dual supply organs from reperfusion and free radical damage
--lung, liver, intestine

12

pancreatic cancer risk

tobacco
obesity

13

gastric cancer risk

nitrates
tobacco
alcohol

14

liver cancer risk

Hep
cirrhosis
hemachromatosis
aflatoxin

15

CRC cancer risk

IBD
Obesity
charred food

16

renal cancer

smoking
obesity
HTN

17

bladder cancer

tobacco
rubber, aniline dyes
textile

18

Breast cancer

early menarch
late menopause
nulliparity
BRCA

19

Prostate

African american
age

20

neutrophil rolling

vessel: E/P-selectin
WBC: sialyl lewis

21

neutrophil binding

vascular: ICAM-1
WBC: LFA-1 (integrin)

22

WBC diapedesis

Vessel and WBC: PECAM-1

23

Migration

C5a
IL-8
LTB4
Kallikrein

24

mechanisms by which free radicals damage cells

membrane peroxidation
protein modification
DNA breaks

25

Examples of free radical injury

retinopathy of prematurity
bronchopulmonary dysplasia (neonates given PPV and O2)
carbon tetrachloride=liver necrosis
Acetaminophen overdose (fulminant hepatitis)
Iron overload
Reperfusion after anoxia and thrombolytic therapy

26

Three phases of wound healing

inflammatory (neutrophils)
Proliferative (2-3 days, macrophages, keratinocytes, myofibroblasts)
Remodeling (1 week, fibroblasts)

27

Proliferative wound healing

Deposition of granulation tissue(macro) and collagen (fibroblasts)
epithelial cell proliferation (keratinocyte)
contraction of wound (myofibroblast)
angiogenesis (endothelial cells)
Dissolution of clot

28

Remodeling wound healing

Type III collagen replaced by type I

29

Th1 cells

secrete gamma IFN, activating macrophages
Macrophages secrete TNF-alpha
Maintenance of granuloma

30

Be wary of giving TNF-alpha inhibitors to

TB pts

31

Causes of exudate

lymphatic obstruction or inflammation

32

Decreased ESR:

Problems with RBCs usually...
sickle cell
polycythemia
CHF (known)

33

Increased ESR

cancer, pregnancy, SLE

34

How does iron cause cell death

peroxidation of membrane lipids

35

Acute iron poisoning sx:

gastric bleed

36

Chronic iron poisoning sx:

metabolic acidosis and GI obstruction

37

Amyloid light chain dz

plasma cell disorder or multiplemyeloma

38

Amyloid A dz seen in:

RA, IBD, spondyloarthropathy, chronic infection. Multisystem disorder

39

Dialysis related amyloidosis

Fibrils of B2 microglobulin in ESRD pts causing deposition.
--Carpal tunnel and joint problems

40

Heritable amyloid disease

Transthyretin gene mutation

41

Age related amyloidosis

Deposition of normal tranthyretin causes slowly progressive amyloidosis

42

Organ specific amyloidosis

Alzheimer's disease

43

How do cancer cells become metastatic?

Release of hydrolases and collagenases to break through basement membrane

44

Anaplasia vs neoplasia

anaplasia: no differentiation, primitive looking with no resemblance to original tissue

Neoplasia: clonal proliferation that is excessive

45

Desmoplasia

Fibrous tissue formation in response to neoplasm

46

Which is more prognostic, grade or stage?

Stage usually

47

Carinoma vs sarcoma

sarcoma means mesenchymal origin

48

which cytokines are responsible for cachexia?

TNF-alpha
IFN-y
IL-6

49

Down's associated with

ALL, AML

50

xeroderma pigmentosum, albinosum associated w

squamous cell carcinoma
also melanoma and basal cell

51

gastric adenocarinoma assoc'd w

atrophic gastritis
pernicious anemia

52

tuberous sclerosis associated with

giant cell astrocytoma
renal angiomyolipoma
cardiac rhabdomyoma

53

Plummer vinson syndrome assoc'd with

squamous cell carcinoma of esophagus

54

barrett's esophagus

esophageal adenocarcinoma

55

ulcerative colitis

colonic adenocarc

56

paget's disease of bone

secondary osteosarcoma and fibrosarcoma

57

Immunodeficiency states

malignant lymphomas

58

AIDS+other autoimmune disorders

lymphomas

59

Acanthosis nigracans

visceral malignancy

60

radiation exposure

leukemia, sarcoma, papillary thyroid cancer and breast cancer

61

abl gene

Tyrosine kinase-->CML
oncogene

62

c-myc

burkitt's-->transcription factor
oncogene

63

bcl-2

follicular and other lymphomas
oncogene

64

HER2/neu

breast, ovarian, gastric carcinomas-->tyrosine kinase
oncogene

65

Ras

colon carcinoma-->GTPase
oncogene

66

L-myc

Lung tumor-->transcription factor
oncogene

67

N-myc

neuroblastoma-->transcription factor
oncogene

68

ret

MEN2A and MEN2B-->tyrosine kinase
oncogene

69

c-kit

gastrointestinal stromal tumor-->cytokine receptor
oncogene

70

Rb

retinoblastoma osteosarcoma
inhibits E2F; G1-S

tumor suppressor

71

p53

Li-Fraumeni etc.
transcribes p21; G1-S

tumor suppressor

72

BRCA1/2

Breast and ovarian
DNA repair protein

tumor suppressor

73

p16

melanoma

tumor suppressor

74

BRAF

melanoma-->B-raf protein

tumor suppressor

75

WT1

Wilm's tumor

tumor suppressor

76

NF1

Neurofibromatosis
RAS GTPase activating protein

tumor suppressor

77

NF2

Neurofibromatosis
Merlin protein (schwannomin)

tumor suppressor

78

DPC4

Pancreatic cancer

tumor suppressor

79

DCC

Colon cancer

tumor suppressor

80

Li Fraumeni

Inherited AUTOsomal dominant loss of p53
--inherit only one allele, 2nd hit hypothesis
--malignancies under age 45

81

PSA elevated in

BPH and prostatitis

82

Prostatic acid phosphatase

Dx for prostate cancer

83

CEA

pancreatic and CRC cancer

Also, gastric, breast, and medullary thyroid

84

alpha fetoprotein

HCC
nonseminomatous germ cell tumors

85

beta hCG

hydatidiform moles and choriocarcinomas

86

CA-125

ovarian cancer

87

S-100

melanoma, schwannomas

88

alkaline phosphatases

Bone metastases
Liver cancer
Paget's disease of bone

89

Bombesin

Neuroblastoma
lung/gastric

90

TRAP

hairy cell leukemia

91

CA-19-9

pancreatic adenocarcinoma

92

Chlonorchis sinensis

Cholangiocarcinoma (liver fluke)

93

HHV-8

kaposi's sarcoma

94

HPV

upper respiratory SCC

95

HTLV-1

Adult T cell leukemia

96

EBV

burkitt's
hodgkin's
nasopharyngeal carcinoma
CNS lymphoma

97

CCl4 causes

centrilobular necrosis and fatty liver

98

arsenic

squamous cell carcinoma
angiosarcoma

99

naphthalene

transitional cell carcinoma of bladdder

100

alkylating agents

leukemia

101

Vinyl chloride

angiosarcoma of liver

102

Nitrosoamines (smoked food)

gastric cancer

103

cigarette smoke

squamous cell (larynx)
squamous/small cell (lung)
renal cell carcinoma
transitional cell carcinoma
pancreatic adenocarcinoma

104

ACTH peptide

Small cell lung cancer

105

ADH

small cell carcinoma (intracranial)

106

PTHrP

squamous cell cancer
RCC

107

Vitamin D

Hodgkins lympoma
other lymphomas

108

Erythropoietin

Renal cell
Hemangioblastoma
HCC
Pheo

"Ride Hard Pedal Hard (w/ lance)"

109

Lambert Eaton

Small cell lung cancer

110

Psamomma bodies

Papillary thyroid
Serous (ovary)
Meningioma
mesothelioma

111

Highest incidence cancers in men

Prostate
Lung
Colon/rectum

112

Highest incidence cancers in women

Breast
Lung
Colon/rectum

113

Highest mortality cancer men

lung
prostate

114

Highest mortality cancer women

lung
breast

115

Which cancers metastasize to brain?

Lung>breast>GU>osteosarcoma>melanoma>GI
-->usually at gray/white matter junction

116

which cancers metastasize to liver?

COLON
stomach, pancreas

117

Which cancers metastasize to bone?

Prostate, breast>lung>thyroid/testes
Lung=lytic bone lesions
prostate=blastic bone lesions
breast-lytic and blastic bone lesions

118

What is lipofuscin?

intracellular, yellow brown pigment resulting from free radical injury and lipid peroxidation.

Seen in the heart/liver of aging/cachectic patients. Caused by "wear and tear"

119

What does hemosiderin look like?

yellow brown pigment

120

Superficial venous thromboses (thrombophelbitis) is an indication of

Visceral cancer
--Cancers can produce a thromboplastin like substance

121

N-myc

oncogene seen in neuroblastoma

122

Cyclin D overexpression

breast, lung, esophageal cancers and lymphomas

123

WT-1

tumor suppressor=Wilm's tumor

124

Kras

proto oncogene