Flashcards in Pathology Deck (94):
irreversible condensation of chromatin in the nucleus of a cell undergoing apoptosis
destructive fragmentation of a dying cell (cell undergoing apoptosis); irreversible
Dissolution of the chromatin/Fading of the nucleus of a dying cell; part of apoptosis; irreversible
Apoptosis vs Necrosis
Apoptosis-->no inflammation; form apoptotic bodies, which are phagocytosed
Necrosis --> swelling and inflammation; intracellular components extravasate
Cell injury that's reversible with oxygen:
-decreased ATP synthesis
-Cellular swelling (ie no ATP --> impaired Na/K pump)
-Nuclear chromatin clumping
-ribosomal detachment (decreased protein synthesis)
Cell injury that's irreversible
-Nuclear pyknosis, karyolysis, karyhorrhexis (all processes involved in apoptosis)
-Calcium influx--> caspase activation
-plasma membrane damage
-mitochondiral permeability (ie with intrinsic pathway of apoptosis)
Areas that are susceptible to hypoxia:
*Watershed areas --> Splenic flexure and ACA/MCA
*Subendocardial tissue of heart
*Proximal Tubule in cortex of Kidney
*Thick Ascending limb in medulla of kidney
*Area around central vein of liver
Red vs Pale Infarcts
Red = hemorrhagic; happens in tissues with loose collaterals, like liver, lungs, intestine; or, after reperfusion of an area
Pale happen in solid tissues with old one blood supply (like heart, kidney, spleen)
What causes reperfusion injury?
Damage by free radicals
Hypovolemic/Cardiogenic Shock vs Septic Shock findings:
-Low cardiac output
-Cold, Clammy pt
-dilated arterioles, high venous return
Mediators of fluid exudation in inflammation:
Acute phase cytokines associated with inflammation?
Enzymes involved in remodeling of ECM following injury
--> require ZINC! this is why Zinc deficiencies result in delayed wound healing!
Why is vitamin C important for wound healing?
-->fibrosis, need collagen for deposition of ECM; need vitamin C for collagen!
Two supplements given to pts who are healing:
-Vitamin C (for collagen)
-Zinc (for metalloproteinases)
5 steps of Leukocyte Extravasion:
1) Rolling (E- and P-Selectins and Sialyl Lewis leukocyte)
2) Tight binding (ICAM and Integrin)
3) Diapedesis (PECAM)
4) Migration (Bacterial products and chemotactic signals = C5a, IL-8, LTB4, Kallikrein)
signals for neutrophil chemotaxis?
Delayed separation of umbilicus, and abnormal integrin:
Leukocyte Adhesion Deficiency
Which vitamins are anti-oxidants (can eliminate free radicals)?
A, C, E
3 phases of wound healing: When does each phase occur? which cells are the mediators? characteristics?
-->Mediators: platelets, neutrophils, macrophages
-->form clot, neutrophils go into tissue, macrophages clean up
-->2-3 days after wound
-->Mediators: fibroblasts, myofibroblasts, endothelial cells, keratinocytes
-->granulation tissue, collagen, angiogenesis, epithelial cell proliferation, dissolve clot, wound contraction
-->1 week after wound
--> Mediators: Fibroblasts
--> Type I collagen replaces type III collagen (type I is for late wound repair; type III is for granulation/early wound repair)
Type of collagen involved in early wound healing? late wound healing?
-Early wound healing --> granulation tissue --> Collagen Type III
Late wound repair --> Scar tissue --> Type I collagen (stronger)
Pathogenesis of granuloma formation:
Th1 cells secrete IFN-gamma --> activate macrophages --> macrophages secrete TNF-alpha --> induces and maintains granuloma formation
***If give pt with a granuloma an anti-TNF drug --> drug can break down granulomas, leading to disseminated disease
Transudate vs Exudate:
What is the ESR?
--> Erythrocyte sedimentation rate
--> inflammatory products, like fibrinogen, coat RBCs, causing them to aggregate. So, when put in test tube, aggregated RBCs fall at a faster rate....
3 conditions with DECREASED ESR?
-Sickle Cell (weird RBC shape!)
-Polycythemia (too many RBCs!)
-CHF (not sure why...)
5 states in which have increased ESR?
=amyloid seen in multiple myeloma; derived from Ig light chains
amyloid protein in Alzheimer's deases
protein seen in dialysis-associated amyloidosis
*note: have B2-microglobulin on MHC I; this amyloid is derived from MHC-I proteins
protein seen in senile cardiac amyloidosis
protein seen in Medullary Carcinoma of the thyroid
-->derived from Calcitonin
Carcinoma in situ =
-->cells have not yet invaded basement membrane, but neoplastic cells encompass entire thickness
-->have high nuclear/cytoplasmic ratio and clumped chromatin
What enzymes do neoplastic cells use to invade the basement membrane?
Collagenases and Hydrolases (metalloproteinases)
mass of MATURE tissue ENDOGENOUS to site from where it originates (similar to hyperplasia...)
Which of these processes are reversible? irreversible?
Hyperplasia--> increased # of cells
Metaplasia--> one adult type replaced by another
Dysplasia--> abnormal growth, loss of cellular orientation, shape, size; commonly pre-neoplastic
Anaplasia-->abnormal cells, lack differentiation; very primitive; little/no resemblance to tissue of origin
Neoplasia--> uncontrolled, excessive, clonal proliferation of cells
Desmoplasia--> fibrous tissue formation in response to neoplasm
Features of Anaplastic cells:
-high nucleus:cytoplasm ratio
-nuclear chromatin clumpin
-lots of mitotic figures
Are mature teratomas benign or malignant?
in women--> benign
in men--> malignant
benign tumor of blood vessels; usually affect infants, then disappear spontaneously in the months following birth
malignant tumor of blood vessels; chronic lymphedema is a predisposing factor (ie following a radical mastectomy with axillary lymph node dissection to treat breast cancer)
Rhabdomyoma and Rhabdoymyosarcoma
benign and malignant tumors of skeletal muscle
benign tumor of connective tissue
loss of weight, muscle atrophy, fatigue --> occurs in chronic disease
-mediated by: TNF-alpha, IFN-gamma, IL-6
Neoplasms associated with Down Syndrome?
Neoplasms associated with Tuberus Sclerosis (facial angiofibroma, seziures, MR, ash leaf spots)?
-Cardiac rhabdomyoma (about 2/3rds of TS pts)
Neoplasm associated with Barrett's esophagus?
Neoplasm associated with Plummer-Vinson syndrome (atrophic glossitis, esophageal webs, anemia; all d/t iron deficiency)?
-Squamous cell carcinoma of esophagus
Neoplasm associated with Ulcerative Colitis?
Neoplasm associated with autoimmune diseases (ie Hashimoto's, Myasthenia gravis)?
Neoplasmas associated with radiation exposure?
-Papillary thyroid cancer
Neoplasm associated with Sjogren's?
Neoplasm associated with Cirrhosis (alcoholic, hepatitis B/C)
Neoplasms associated with Paget's disease of bone?
follicular and undifferentiated lymphomas
Breast, ovarian, gastric carcinomas
Neuroblastoma (childhood adrenal medulla tumor)
MEN 2a and 2B
Gastrointestinal Stromal Tumor
BRCA1 and 2
-->DNA repair protein
-->Breast and ovarian (1), just breast (2)
colorectal cancer (associated with FAP and Gardner's syndrome)
-->used to screen for prostate carcinoma
nonspecific tumor marker for colorectal and pancreatic cancers; also gastric, breast, medullary thyroid carcinomas
alpha-fetoprotien = tumor marker for:
-also for yolk sac tumors
Beta-hCG = tumor marker for:
-Gestational trophoblastic tumors
CA-125 = tumor marker for:
S-100 = tumor marker for:
(both are derived from neural crest)
Alkaline Phosphatase = tumor marker for?
-metastases to bone
-Paget's disease of bone
-obstructive biliary disease
TRAP = tumor marker for?
= Tartrate-resistant acid phosphatase
-->marker for Hairy cell leukemia (B-cell neoplasm)
"TRAP the Hairy animal!"
CA-19 = tumor marker for?
Calcitonin = tumor marker for?
Medullary thryoid carcinoma
Cancer associated with HIV (not with HIV-associated conditions; just with HIV)?
Primary CNS lymphoma
Cancer associated with H. pylori?
Gastric adenocarcinoma and lymphoma
Cancer associated with Aflatoxins (aspergillus)?
cancer associated with vinyl chloride?
Cancer associated with Nitrosamines (smoked food)?
4 cancers associated with smoking?
-Squamous cell carcinoma
-Squamous cell and small cell carcinoma
-Renal cell carcinoma
-Transitional cell carcinoma
2 cancers associated with asbestos
2 cancers associated with Arsenic?
-Squamous cell carcinoma
Cancer associated with Naphthalene/Aniline dyes?
Transitional Cell Carcinoma of bladder
Cancer associated with alkylating agents?
Cancer associated with radon (coal mines, basements)?