Flashcards in Pathology: inflammation Deck (161):
True or false: apoptosis requires ATP
Apoptosis via the intrinsic pathway and extrinsic pathway both lead to activation of what proteins?
What is nuclear shrinkage seen in apoptosis?
What is the nuclear fragmentation seen in apoptosis?
What happens to the cytoplasm of cells undergoing apoptosis?
DNA laddering, seen in apoptosis, is caused by what (name the process used, and the enzyme)?
Radiation, causing endonucleases to cleave DNA
BAX is pro or anti apoptotic?
Bcl-2 is pro or anti apoptotic?
What is the chemical released from mitochondria that cause apoptosis?
How does Bcl-2 prevent cytochrome 2 release?
Binds and inhibits Apaf-1
What is the MOA of the intrinsic pathway of apoptosis?
Changes in regulating fators
What are the two routes of the extrinsic pathway of apoptosis?
-Ligand receptor (FasL binds to Fas)
-CTL release of perforin/granzyme
What is the the route of apoptosis that the thymus undergoes?
What happens in the apoptotic pathway when Fas binds FasL?
Forms a death domain (FADD)
Defective Fas-Fasl interaction is the basis for what types of disorders?
What types of tissues undergo coagulative necrosis?
Tissues supplied by end arteries (heart, liver, kidneys) with cell walls
What types of tissues undergo liquefactive necrosis?
Brain, abscesses--areas with high fat content
What types of infections cause caseous necrosis? (3)
Systemic fungal infections
What causes the dark blue stain of fatty necrosis?
What are the histological characteristics of fibrinoid necrosis?
Amorphous and pink on H&E
What are the two types of gangrenous necrosis?
Dry (ischemic coagulative)
Reversible with O2, or irreversible: ATP depletion
Reversible with O2, or irreversible: nuclear pyknosis, karyorrhexis, or karyolysis
Reversible with O2, or irreversible: cellular/mito swelling
Reversible with O2, or irreversible: nuclear chromatin clumping
Reversible with O2, or irreversible: Lysosomal rupture
Reversible with O2, or irreversible: Mitochondrial permeability
Reversible with O2, or irreversible: cellular fatty changes
Reversible with O2, or irreversible: ribosomal/polysomal detachment
Reversible with O2, or irreversible:membrane blebbing
What is the most susceptible part of the brain to necrosis?
ACA/MCA/PCA boundary areas
What is the most susceptible area of the heart to necrosis?
What is the most susceptible area of the kidney to necrosis?
Straight segment of the proximal tubule
What is the most susceptible area of the liver to necrosis?
What is the most susceptible area of the colon to necrosis?
Reperfusion injury is caused by what? What type of infarcts (red or white)
Pale infarcts occur in what types of tissue?
Solid tissues with single blood supply
What is the first sign of shock?
What is distributive shock?
a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in inadequate supply of blood to the body's tissues and organs
What happens to total pulmonary resistance, cardiac output, and venous return in distributive shock?
Increased venous return
What happens to the pulmonary capillary wedge pressure in distributive shock? cardiogenic shock? Hypovolemic shock?
Distributive = decreased
Cardiogenic = increased
Hypovolemic = decreased
Vasodilation or vasoconstriction: Distributive shock and hypovolemic/cardiogenic (match correctly)
Vasodilation in distributive
Vasoconstriction for cardiogenic/hypovolemic
Which type of shock in which BP can be restored using IVF: cardiogenic or distributive
An increased or decreased in endogenous hormones will cause atrophy?
An increased or decreased in exogenous hormones will cause atrophy?
An increase or decrease in metabolic demand will cause atrophy?
An increase or decrease in pressure (generally) will cause atrophy?
Increased (e.g. nephrolithiasis)
What are the cardinal signs of inflammation?
Functio laesa (function loss)
What are the first WBCs that are seen in acute inflammation?
What are the WBCs that are seen in chronic inflammation?
Mononuclear cells and fibroblasts
What is in a granuloma?
Nodular collections of epithelioid macrophages and giant cells
What is the hallmark cell that can be found in chronic inflammation?
What are the possible outcomes of chronic inflammation?
What is chromatolysis? What are the three hallmarks of it?
Neuron body cell changes after injury.
1. Round cellular swelling
2. Displacement of nucleus to the periphery
3. Dispersion of Nissl substance
What is dystrophic calcification? Is it associated with hypercalcemia?
Ca deposition in tissues secondary to necrosis
NOT directly associated with hypercalcemia
What is metastatic calcification? Is it associated with hypercalcemia?
Widespread Ca deposition secondary to hypercalcemia
Which tissues are most affected by metastatic calcification?
Extravasation predominantly occurs where?
At postcapillary venules
What are the four steps of extravasation?
2. Tight binding
What are the two signaling proteins that allow for margination and rolling of PMNs?
What are the two signalling proteins that allow for tight binding to occur?
What is the one signalling molecule that allows for leukocyte diapedesis?
What are the family of molecules that guide leukocytes to their destination after they have crossed the blood vessel border?
What are the three ways in which free radicals damage cells? (hint: three different classes of polymers)
Which vitamins are antioxidants?
What is inhalation injury?
Damage to lungs/bronchi d/t inhalation of combustion byproducts
What are the two pathological types of scars?
Which has a higher amount of collagen synthesis: keloid scars, or hypertrophic scars?
Which type of scarring: hypertrophic or keloid) has parallel arrangement of collagen? Which has disorganized?
Hypertrophic = parallel
Keloid = disorganized
How frequently do hypertrophic scars recur after resection? Keloids?
Hypertrophic = infrequently
Keloid = Frequently
What is the effect of PDGF? What cells secrete it?
Induces vascular remodeling
Secreted by macrophages and platelets
What is the role of FGF in wound healing?
Stimulates all aspects of angiogenesis
What is the role of EGF in healing?
Stimulates cell growth via Y kinases
What is the role of TGF-beta in wound healing?
Angiogenesis + fibrosis
What is the role of metalloproteinases in wound healing?
Which cells are primarily involved in the remodeling phase of wound repair?
What are the cells that are involved in proliferative phase of wound healing?
Lots o' cells
What role do fibroblasts play in tissue remodeling?
Increases Type I collagen deposition (instead of Type III)
What cytokine do Th1 cells secrete to maintain a granuloma?
What cytokine do macrophages secrete to maintain a granuloma?
Why should you always test for TB prior to starting anti-TNF therapy?
TNF needed to maintain granuloma. Thus anti-TNF will cause breakdown and disseminated disease
Exudate or transudate: cellular
Exudate or transudate: protein rich
Exudate or transudate:specific gravity
Exudate or transudate: cause by lymphatic obstruction
Exudate or transudate: caused by inflammation/malignancy
Exudate or transudate: caused by an increase in hydrostatic pressure
Exudate or transudate: cause by a decrease in oncotic pressure/ Na retention
Increase or decrease in ESR: Anemia
Increase or decrease in ESR: infections
Increase or decrease in ESR: sickle cell disease
Increase or decrease in ESR: polycythemia
Decreased (d/t RBCs diluting aggregation factors)
Increase or decrease in ESR: CHF
Decreased (unknown cause)
Increase or decrease in ESR: pregnancy
Increase or decrease in ESR: SLE
What does ESR measure?
Products of inflammation causing aggregation of RBCs
How does Fe lead to disease?
Peroxidation of lipids
What are the symptoms of acute Fe poisoning?
What are the symptoms of chronic Fe poisoning (as in hemochromatosis)?
What is the treatment for acute/chronic Fe poisoning?
Chelating agents + dialysis
What is amyloidosis?
Abnormal aggregation of proteins into beta=pleated sheets
What is the cause of AL amyloidosis (which protein deposition)?
Light chain Ig deposition (e.g. in multiple myeloma)
What is the cause of AA amyloidosis (which protein deposition)?
FIbrils of serum Amyloid (e.g. RA, IBD)
What is the protein that causes dialysis related amyloidosis?
Fibrils of beta2 microglobulin in pts with ESRD
Dialysis pt presenting with carpal tunnel = ?
How is ATTR, amyloidosis acquired?
Senile amyloidosis is caused by deposition of what protein?
Deposition of TTR in myocardium and other sites
Beta amyloid deposition in the brain = which disease?
What is lipofuscin cause by?
Oxidation and polymerization of autophagocytosis organellar membranes
What does carcinoma in situ mean?
Neoplastic cells have not invaded BM
What are the enzymes that allow tumors to pierce the BM?
Collagenases and hydrolases
What is the P-glycoprotein (aka MDR1)?
Glycoprotein used to pump out toxins, including chemotherapeutic agents
What is metaplasia?
One adult cell is replaced by another of a different type (e.g. Barrett's esophagus)
True or false: metaplasia and dysplasia are reversible
What is anaplasia?
Loss of structural differentiation and function of cells, resembling primitive cells of same tissue
What is neoplasia?
A clonal proliferation of cells that is uncontrolled and excessive
What is desmoplasia?
Fibrous tissue formation in response to neoplasia
True or false: neoplasia, neoplasia, and desmoplasia are all irreversible
What does it mean to grade a tumor?
Degree of cellular differentiation (1= high, 4= low[bad])
Which has more prognostic value: stage or grade of a tumor?
What does it mean to stage a tumor?
Degree of localization/spread based on site and size of secondary lesion
(stage = spread)
What is the TNM staging system?
The term carcinoma implies what?
Epithelial origin of tumor
The term sarcoma implies what?
Denotes mesenchymal origin of tumor
Most carcinoma spread (BLANK) whereas most sarcomas spread (BLANK)
Carcinomas spread lymphatically
Sarcomas spread hematogenously
Adenomas come from what tissue type?
Malignant or benign: adenocarcinomas
Malignant or benign: Hemangioma
Malignant or benign: leiomyoma
Malignant or benign: angiosarcoma
Malignant or benign, and what tissue type is it from: Rhabdomyoma
Benign-- striated muscle
Malignant or benign, and what tissue type is it from: fibroma
Malignant or benign, and what tissue type is it from: fibrosarcoma
Malignant or benign, and what tissue type is it from: osteoma
Malignant or benign, and what tissue type is it from: osteosarcoma
Malignant or benign, and what tissue type is it from: liposarcoma
Upregulation of what enzyme in tumors prevents chromosome shortening and cell death?
What are the three major cytokines that are involved with cachexia in CA pts?
Acanthosis nigricans is associated with what neoplasm?
AIDS is associated with what neoplasm?
Actinic keratosis is associated with what neoplasm?
Squamous cell carcinoma of the skin
Autoimmune diseases (e.g. SLE, hashimoto thyroiditis) is associated with what neoplasm?
Barrett's esophagus is associated with what neoplasm?
Chronic atrophic gastritis is associated with what neoplasm?
Cirrhosis is associated with what neoplasm?
Cushings is associated with what neoplasm?
Small cell lung CA
Dermatomyositis is associated with what neoplasm?
Down syndrome is associated with what neoplasm?
ALL ("we ALL fall DOWN")
Dysplastic nevus is associated with what neoplasm?
Hypercalcemia is associated with what neoplasm?
Squamous cell lung CA
Immunodeficiency states are associated with what neoplasm?
What is Eaton-lambert syndrome? What malignancy is associated with it?
Autoimmune attack of Ca channels at the neuromuscular junction
Small cell lung cancer
Myasthenia gravis is associated with what malignancy?
Paget's disease of the bone is associated with what malignancy?
Plummer-Vinson syndrome (Fe-deficiency anemia + esophageal webs + dysphagia) is associated with what malignancy?
Squamous cell carcinoma of the esophagus
Polycythemia is associated with what neoplasm?
Renal cell carcinoma
Radiation exposure is associated with what neoplasm?
SIADH (syndrome of inappropriate antidiuretic hormone secretion) is associated with what neoplasm?
Small cell lung CA
Tuberous sclerosis is associated with what neoplasm?
Giant cell astrocytoma
Ulcerative colitis is associated with what neoplasm?