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Pathology: 4/30- 5/2 > Pathology -FA > Flashcards

Pathology -FA Flashcards

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1
Q

What is P-glycoprotein?

A

also known as MDR1 (multi-drug resistance) protein

ATP-dependent transporter, responsible for resistance to chemotherapy. It allows active pumping out of chemotherapy drugs

  • This is UWORLD question
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2
Q

mitochondrial vacuolization: reversible? or irreversible damage?

A

irreversible damage

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3
Q

Displacement of Nissl substance throughout cytoplasm

- what is this? which cells?

A

chromatolysis: AXONAL REACTION in response to axonal injury. Increased protein synthesis

  • Nissl substance: rough ER and ribosomes
  • > indicating increased protein synthesis
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4
Q

Which three organs manifest irreversible ischemia with a red infarction?

A

organs with dual supply

: liver, GI, lung

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5
Q

Three common metaseses to liver in order

A

colon&raquo_space; stomach > pancreas

  • of most common cancers (lung, prostate/breast, colon), colon is the closest to liver
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6
Q

Why is lipofuscin yellow brown?

A

oxidation and polymerization of membrane

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7
Q

In which step of extravasation do decreased CD18 integrin subunits on leukocytes lead to a defect?

A

tight-binding, as a result of inability to attach to ICAM-1 (CD54)

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8
Q

Diapedesis: what process is this? what molecule/ cell marker is involved?

A

WBC travels between endothelial cells and exits blood vessel

PECAM-1 (platelet endothelial cell adhesion molecule), CD31

  • note CD31 is both on leukocytes and endothelium
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9
Q

What is fibrinoid necrosis? example of diseases (2)?

A

immune reactions in VESSEL
: immune complex binds with FIBRIN
-> VESSEL WALL damage

polyarteritis nodosa, giant cell vasculitis

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10
Q

Liquefactive necrosis vs. Fat necrosis

A

Liquefactive necrosis: lysosomal enzyme digesting tissue- ex:

  1. brain (full of lysosome in microglia)
  2. bacterial abscess (neutrophils release lysosome to destroy bacteria)
  3. acute pancreatitis ( necrosis of pancreas tissue vs. fat necrosis involved fat tissues surrounding pancreas)

Fat necrosis: digestion of fat -> saponification: calcification

  • enzymatic : acute pancreatitis (lipase dissolving fat tissues surrounding pancras, which is NOT same as lysosome in liquefactive necrosis)
  • non enzymatic: breast tissue after trauma
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11
Q

TB is example of what type of necrosis? Other examples?gross appearance?

A
  • caseous necrosis
  • systemic fungi infection is also example of caseous necrosis
  • goat-cheese: debris formed by macrophages walling off infecting microorganism
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12
Q

Through what do cytotoxic T cells induce apoptosis?

A

granzymes released into target cells via perforin

-> granzymes activate caspases -> apoptosis

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13
Q

For extrinsic apoptosis pathway, what Fas expresses what CD marker

A

Fas = CD95

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14
Q

Which enzymes are involved in mitochondrial cytochrome release?

A

BAK/BAX: promotes cytochrome c release, pre-apoptotic

Bcl2: inhibition of cytochrome c release, anti-apoptotic

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15
Q

Cachexia is mediated by what four cytokines?

A
  • IL1
  • IL6
  • TNF
  • IFN-gamma
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16
Q

specific gravity cutoff values for

  • exudate
  • transudate
A
  • exudate: >1.02

- transudate: <1.012

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17
Q

tumor grade vs. stage: explain each. which one has more prognostic value?

A

grade: degree of differentiation and mitotic activity

stage: degree of localization/spread/ size
T(size) N(lymph node) M (metastasis)

stage has more prognostic value

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18
Q

By which three main mechanisms do free radicals damage cells?

A
  • membrane peroxidation
  • DNA damage
  • protein modification
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19
Q

A velvety hyperpigmentation suddenly develops on the back of a diabetic patient’s neck. Do you consider performing endoscopy?

A

Yes, though most commonly seen with insulin resistance, acanthosis nigricans can be a sign of visceral malignancy (eg, stomach cancer)

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20
Q

A chemo pt has decreased intracellular doxorubicin and etoposide concentrations. What is the normal function of the protein responsible?

A

Multidrug resistance protein 1 (MDR1), also known as P-glycoprotein, normally pumps out toxins and metabolites

  • keyword: low INTRACELLULAR drug concentration
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21
Q

Dystrophic calcification vs. Metastatic calcification

A
  • Dystrophic calcification
    : normocalcemic, damaged tissue
  • Metastatic calcification
    : hypercalcemic, normal tissue
  • metastatic:
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22
Q

Psammoma bodies: dystrophic or metastatic calcification?

A

dystrophic calcification

  • remember, psammoma bodies happen in all messed up tissues
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23
Q

Regarding cell injury, is nuclear chromatin clumping reversible or irreversible?

A

reversible

  • clumping is not same as shrinkage (pyknosis) or fragmentation (karyorrhexis)
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24
Q

In US, first leading cause of death? second?

A

first: heart disease
second: cancer

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25
Five cancers that can cause polycythemia by secreting EPO?
- RCC - pheocytochroma - hepatocellular carcinoma - hemangioblastoma - leiomyoma
26
CDKN2A: What does this gene typically produce?
P16 CDKN2A is tumor suppressor gene
27
Metastasis from the lung to the bone results in what type of lesions?
mixed: lytic + blastic
28
Metastasis from the prostate to the bone results in what type of lesions?
blastic
29
Name the three vitamins with antioxidant properties involved in degrading free radicals.
A,C,E * top stars ACE for removal of free radicals
30
DNA elecrophoresis finding in apoptosis?
DNA laddering due to karyorrhexis
31
Apart from cervical cancer, HPV can also cause cancer at where?
head and neck: SCC
32
Free radical damage by carbon tetrachloride causes what pathologic change in the human body?
fatty liver
33
Arsenic exposure: what three cancers?
- Squamous cell carcinoma of the skin - lung cancer - angiosarcoma of the liver
34
What enzyme mediates remodeling of scar (type 3 -> type1 collagen)? what metal is used as a cofactor?
collagenase | Zn2+ dependent
35
How does radiation therapy cause apoptosis of tumors and surrounding tissue? Which cell types are particularly susceptible?
Free radical formation and dsDNA breakage | : rapidly dividing cells (skin, GI mucosa) are extremely susceptible
36
mutation at the MYCL1 oncogene. Which tumor?
Lung cancer Lung cancer, mycL1 gene
37
bacterial abscess: what type of necrosis?
liquefactive necrosis | : bacterial debris degraded by lysosome released from neutrophil
38
Describe the mechanism by which lack of ATP leads to cellular swelling. Is this process reversible or irreversible?
Na+/K+ ATPase pumps do not work, thereby causing water influx and reversible swelling/blebbing cellular swelling is reversible
39
Most common metastasis to brain?
lung * think like this: of common cancers (lung, breast/prostate, colon), lung is the closest one to brain
40
What infectious microbe is considered as liver fluke? what cancer is it associated with?
clonorchis sinensis associated with cholangiocarcinioma
41
pancreatic cancer is associated with loss of what tumor suppressor gene?
DPC4 (Deleted in Pancreatic Cancer)
42
Exposure to Radon has increased her risk for what malignancy?
lung cancer
43
ionizing radiation: increased risk for what cancer?
papillary carcinoma of thyroid
44
melanoma is associated with what oncogene?
BRAF, serine/threonine kinase
45
Cushing syndrome phenotypes with lung mass: what is it?
small cell carcinoma (ectopic ACTH)
46
Which two genes are associated with tuberous sclerosis?
TSC-1 and TSC-2 TSC (Tuberous SClerorsis)
47
What is choristoma? example?
normal tissue in foreign location | Meckel diverticulum
48
Defective in Fas/Fas-L is associated with what disease?
autoimmune lymphoproliferative syndrome
49
Function of VHL tumor suppressor gene?
Inhibition of hypoxia inducible factor 1a : transcription factor in a response to hypoxia with inhibition of hypoxia inducible factor1a, cells can undergo apoptosis under hypoxic condition.
50
Which receptor is deficient? role of this receptor? - leukocyte adhesion deficiency type 1 - leukocyte adhesion deficiency type 2
- leukocyte adhesion deficiency type 1 : CD18 (LFA-1), binds to ICAM during tight binding - leukocyte adhesion deficiency type 2 : Sialyl-Lewis, binds to P-selectin during rolling
51
name only three irreversible changes
- neoplasia - anaplasia - differentiation * these three are only irreversible changes. All rest others are reversible (even dysplasia and metaplasia)
52
vinyl chloride - what occupation? - what disease?
- chemical plant | - angiosarcoma of liver (arsenic does same)
53
Why does ESR increased in inflammation?
product of inflammation is fibrin. Fibrin coats RBC, causing RBC to aggregate Aggregation of RBC leads to more sedimentation
54
What conditions can predispose someone to a lower ESR?
microcytosis, sickle cell disease, hypofibrinogenemia, HF, polycythemia
55
How does HF lower ESR?
less effective blood in circulation | -> less RBC to sediment
56
How does polycythemia lower ESR?
more RBCs dilute aggregation factors
57
Which cell mediates remodeling phase of scar formation
fibroblast -> conversion of type 3 collagen to type 1 by using collagenase
58
N-myc: what cancer?
Neurolblastoma * N-myc, Neuroblastoma
59
transitional cell carcinoma: what chemical?
Aromatic amines (eg, benzidine, 2-naphthylamine)
60
H.pylori: what two cancers?
``` MALToma gastric cancer (intestinal type) ```
61
Excessive alcohol intake will increase risk for which two cancer types?
- hepatocellular carcinoma | - squamous cell carcinoma of esophagus

Pathology: 4/30- 5/2 (4 decks)

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