Pathology: inflammation Flashcards Preview

FA Review > Pathology: inflammation > Flashcards

Flashcards in Pathology: inflammation Deck (161):
1

True or false: apoptosis requires ATP

True

2

Apoptosis via the intrinsic pathway and extrinsic pathway both lead to activation of what proteins?

Caspases

3

What is nuclear shrinkage seen in apoptosis?

Pyknosis

4

What is the nuclear fragmentation seen in apoptosis?

Karyorrhexis

5

What happens to the cytoplasm of cells undergoing apoptosis?

Deep eosinophilia

6

DNA laddering, seen in apoptosis, is caused by what (name the process used, and the enzyme)?

Radiation, causing endonucleases to cleave DNA

7

BAX is pro or anti apoptotic?

Pro

8

Bcl-2 is pro or anti apoptotic?

Anti

9

What is the chemical released from mitochondria that cause apoptosis?

Cytochrome C

10

How does Bcl-2 prevent cytochrome 2 release?

Binds and inhibits Apaf-1

11

What is the MOA of the intrinsic pathway of apoptosis?

Changes in regulating fators

12

What are the two routes of the extrinsic pathway of apoptosis?

-Ligand receptor (FasL binds to Fas)
-CTL release of perforin/granzyme

13

What is the the route of apoptosis that the thymus undergoes?

Fas +FasL

14

What happens in the apoptotic pathway when Fas binds FasL?

Forms a death domain (FADD)

15

Defective Fas-Fasl interaction is the basis for what types of disorders?

Autoimmune disorders

16

What types of tissues undergo coagulative necrosis?

Tissues supplied by end arteries (heart, liver, kidneys) with cell walls

17

What types of tissues undergo liquefactive necrosis?

Brain, abscesses--areas with high fat content

18

What types of infections cause caseous necrosis? (3)

TB
Systemic fungal infections
Nocardia

19

What causes the dark blue stain of fatty necrosis?

Ca deposits

20

What are the histological characteristics of fibrinoid necrosis?

Amorphous and pink on H&E

21

What are the two types of gangrenous necrosis?

Wet (Infection)
Dry (ischemic coagulative)

22

Reversible with O2, or irreversible: ATP depletion

Reversible

23

Reversible with O2, or irreversible: nuclear pyknosis, karyorrhexis, or karyolysis

Irreversible

24

Reversible with O2, or irreversible: cellular/mito swelling

Reversible

25

Reversible with O2, or irreversible: nuclear chromatin clumping

Reversible

26

Reversible with O2, or irreversible: Lysosomal rupture

Irreversible

27

Reversible with O2, or irreversible: Mitochondrial permeability

Irreversible

28

Reversible with O2, or irreversible: cellular fatty changes

Reversible

29

Reversible with O2, or irreversible: ribosomal/polysomal detachment

Reversible

30

Reversible with O2, or irreversible:membrane blebbing

Reversible

31

What is the most susceptible part of the brain to necrosis?

ACA/MCA/PCA boundary areas

32

What is the most susceptible area of the heart to necrosis?

Subendocardium

33

What is the most susceptible area of the kidney to necrosis?

Straight segment of the proximal tubule

34

What is the most susceptible area of the liver to necrosis?

Central vein

35

What is the most susceptible area of the colon to necrosis?

Splenic flexure

36

Reperfusion injury is caused by what? What type of infarcts (red or white)

Free radicals
Red

37

Pale infarcts occur in what types of tissue?

Solid tissues with single blood supply

38

What is the first sign of shock?

Tachycardia

39

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

40

What happens to total pulmonary resistance, cardiac output, and venous return in distributive shock?

Lower TPR
Increased CO
Increased venous return

41

What happens to the pulmonary capillary wedge pressure in distributive shock? cardiogenic shock? Hypovolemic shock?

Distributive = decreased
Cardiogenic = increased
Hypovolemic = decreased

42

Vasodilation or vasoconstriction: Distributive shock and hypovolemic/cardiogenic (match correctly)

Vasodilation in distributive
Vasoconstriction for cardiogenic/hypovolemic

43

Which type of shock in which BP can be restored using IVF: cardiogenic or distributive

Cardiogenic/hypovolemic

44

An increased or decreased in endogenous hormones will cause atrophy?

Decrease

45

An increased or decreased in exogenous hormones will cause atrophy?

Increase

46

An increase or decrease in metabolic demand will cause atrophy?

Decrease

47

An increase or decrease in pressure (generally) will cause atrophy?

Increased (e.g. nephrolithiasis)

48

What are the cardinal signs of inflammation?

Rubor (redness)
Dolor (pain)
Calor (heat)
Tumor (edema)
Functio laesa (function loss)

49

What are the first WBCs that are seen in acute inflammation?

PMNs

50

What are the WBCs that are seen in chronic inflammation?

Mononuclear cells and fibroblasts

51

What is in a granuloma?

Nodular collections of epithelioid macrophages and giant cells

52

What is the hallmark cell that can be found in chronic inflammation?

Giant cells

53

What are the possible outcomes of chronic inflammation?

Scarring, amyloidosis

54

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

55

What is dystrophic calcification? Is it associated with hypercalcemia?

Ca deposition in tissues secondary to necrosis
NOT directly associated with hypercalcemia

56

What is metastatic calcification? Is it associated with hypercalcemia?

Widespread Ca deposition secondary to hypercalcemia

57

Which tissues are most affected by metastatic calcification?

Kidneys
Lungs
Gastric mucosa

58

Extravasation predominantly occurs where?

At postcapillary venules

59

What are the four steps of extravasation?

1. margination/rolling
2. Tight binding
3. Diapedesis
4. Migration

60

What are the two signaling proteins that allow for margination and rolling of PMNs?

E-selectin
P-selectin

61

What are the two signalling proteins that allow for tight binding to occur?

ICAM1 (CD54)
VCAM1 (CD106)

62

What is the one signalling molecule that allows for leukocyte diapedesis?

PECAM-1 (CD31)

63

What are the family of molecules that guide leukocytes to their destination after they have crossed the blood vessel border?

Chemotactic products

64

What are the three ways in which free radicals damage cells? (hint: three different classes of polymers)

Lipid peroxidation
Protein modification
DNA breakage

65

Which vitamins are antioxidants?

A
C
E

66

What is inhalation injury?

Damage to lungs/bronchi d/t inhalation of combustion byproducts

67

What are the two pathological types of scars?

Hypertrophic
Keloids

68

Which has a higher amount of collagen synthesis: keloid scars, or hypertrophic scars?

Keloid

69

Which type of scarring: hypertrophic or keloid) has parallel arrangement of collagen? Which has disorganized?

Hypertrophic = parallel
Keloid = disorganized

70

How frequently do hypertrophic scars recur after resection? Keloids?

Hypertrophic = infrequently
Keloid = Frequently

71

What is the effect of PDGF? What cells secrete it?

Induces vascular remodeling
Secreted by macrophages and platelets

72

What is the role of FGF in wound healing?

Stimulates all aspects of angiogenesis

73

What is the role of EGF in healing?

Stimulates cell growth via Y kinases

74

What is the role of TGF-beta in wound healing?

Angiogenesis + fibrosis

75

What is the role of metalloproteinases in wound healing?

Tissue remodeling

76

Which cells are primarily involved in the remodeling phase of wound repair?

Fibroblasts

77

What are the cells that are involved in proliferative phase of wound healing?

Fibroblasts
Macrophages
Endothelial cells
Lots o' cells

78

What role do fibroblasts play in tissue remodeling?

Increases Type I collagen deposition (instead of Type III)

79

What cytokine do Th1 cells secrete to maintain a granuloma?

IFN-gamma

80

What cytokine do macrophages secrete to maintain a granuloma?

TNF-alpha

81

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

82

Exudate or transudate: cellular

Exudate

83

Exudate or transudate: protein rich

Exudate

84

Exudate or transudate:specific gravity

Transudate

85

Exudate or transudate: cause by lymphatic obstruction

Exudate

86

Exudate or transudate: caused by inflammation/malignancy

Exudate

87

Exudate or transudate: caused by an increase in hydrostatic pressure

Transudate

88

Exudate or transudate: cause by a decrease in oncotic pressure/ Na retention

Transudate

89

Increase or decrease in ESR: Anemia

Increased

90

Increase or decrease in ESR: infections

increased

91

Increase or decrease in ESR: sickle cell disease

Decrease

92

Increase or decrease in ESR: polycythemia

Decreased (d/t RBCs diluting aggregation factors)

93

Increase or decrease in ESR: CHF

Decreased (unknown cause)

94

Increase or decrease in ESR: pregnancy

Increased

95

Increase or decrease in ESR: SLE

Increased

96

What does ESR measure?

Products of inflammation causing aggregation of RBCs

97

How does Fe lead to disease?

Peroxidation of lipids

98

What are the symptoms of acute Fe poisoning?

n/v dysentery

99

What are the symptoms of chronic Fe poisoning (as in hemochromatosis)?

Metabolic acidosis
scarring

100

What is the treatment for acute/chronic Fe poisoning?

Chelating agents + dialysis

101

What is amyloidosis?

Abnormal aggregation of proteins into beta=pleated sheets

102

What is the cause of AL amyloidosis (which protein deposition)?

Light chain Ig deposition (e.g. in multiple myeloma)

103

What is the cause of AA amyloidosis (which protein deposition)?

FIbrils of serum Amyloid (e.g. RA, IBD)

104

What is the protein that causes dialysis related amyloidosis?

Fibrils of beta2 microglobulin in pts with ESRD

105

Dialysis pt presenting with carpal tunnel = ?

Amyloidosis

106

How is ATTR, amyloidosis acquired?

Heritable

107

Senile amyloidosis is caused by deposition of what protein?

Deposition of TTR in myocardium and other sites

108

Beta amyloid deposition in the brain = which disease?

Alzheimers

109

What is lipofuscin cause by?

Oxidation and polymerization of autophagocytosis organellar membranes

110

What does carcinoma in situ mean?

Neoplastic cells have not invaded BM

111

What are the enzymes that allow tumors to pierce the BM?

Collagenases and hydrolases

112

What is the P-glycoprotein (aka MDR1)?

Glycoprotein used to pump out toxins, including chemotherapeutic agents

113

What is metaplasia?

One adult cell is replaced by another of a different type (e.g. Barrett's esophagus)

114

True or false: metaplasia and dysplasia are reversible

True

115

What is anaplasia?

Loss of structural differentiation and function of cells, resembling primitive cells of same tissue

116

What is neoplasia?

A clonal proliferation of cells that is uncontrolled and excessive

117

What is desmoplasia?

Fibrous tissue formation in response to neoplasia

118

True or false: neoplasia, neoplasia, and desmoplasia are all irreversible

True

119

What does it mean to grade a tumor?

Degree of cellular differentiation (1= high, 4= low[bad])

120

Which has more prognostic value: stage or grade of a tumor?

Grade

121

What does it mean to stage a tumor?

Degree of localization/spread based on site and size of secondary lesion
(stage = spread)

122

What is the TNM staging system?

Tumor size
Node involvement
Metastases

123

The term carcinoma implies what?

Epithelial origin of tumor

124

The term sarcoma implies what?

Denotes mesenchymal origin of tumor

125

Most carcinoma spread (BLANK) whereas most sarcomas spread (BLANK)

Carcinomas spread lymphatically
Sarcomas spread hematogenously

126

Adenomas come from what tissue type?

Glands

127

Malignant or benign: adenocarcinomas

Malignant

128

Malignant or benign: Hemangioma

Benign

129

Malignant or benign: leiomyoma

Bening

130

Malignant or benign: angiosarcoma

Malignant

131

Malignant or benign, and what tissue type is it from: Rhabdomyoma

Benign-- striated muscle

132

Malignant or benign, and what tissue type is it from: fibroma

Benign-- CT

133

Malignant or benign, and what tissue type is it from: fibrosarcoma

Malignant--CT

134

Malignant or benign, and what tissue type is it from: osteoma

benign--Bone

135

Malignant or benign, and what tissue type is it from: osteosarcoma

malignant--bone

136

Malignant or benign, and what tissue type is it from: liposarcoma

Malignant--fat

137

Upregulation of what enzyme in tumors prevents chromosome shortening and cell death?

Telomerase

138

What are the three major cytokines that are involved with cachexia in CA pts?

TNF-alpha
IFN-gamma
IL-6

139

Acanthosis nigricans is associated with what neoplasm?

Visceral malignancy

140

AIDS is associated with what neoplasm?

Kaposi
Non-hodgkins lymphoma

141

Actinic keratosis is associated with what neoplasm?

Squamous cell carcinoma of the skin

142

Autoimmune diseases (e.g. SLE, hashimoto thyroiditis) is associated with what neoplasm?

Lymphoma

143

Barrett's esophagus is associated with what neoplasm?

Esophageal adenocarcinoma

144

Chronic atrophic gastritis is associated with what neoplasm?

Gastric adenocarcinoma

145

Cirrhosis is associated with what neoplasm?

Hepatocellular carcinoma

146

Cushings is associated with what neoplasm?

Small cell lung CA

147

Dermatomyositis is associated with what neoplasm?

Lung CA

148

Down syndrome is associated with what neoplasm?

ALL ("we ALL fall DOWN")

149

Dysplastic nevus is associated with what neoplasm?

Malignant melanoma

150

Hypercalcemia is associated with what neoplasm?

Squamous cell lung CA

151

Immunodeficiency states are associated with what neoplasm?

Malignant lymphomas

152

What is Eaton-lambert syndrome? What malignancy is associated with it?

Autoimmune attack of Ca channels at the neuromuscular junction

Small cell lung cancer

153

Myasthenia gravis is associated with what malignancy?

Thymoma

154

Paget's disease of the bone is associated with what malignancy?

Secondary osteosarcoma

155

Plummer-Vinson syndrome (Fe-deficiency anemia + esophageal webs + dysphagia) is associated with what malignancy?

Squamous cell carcinoma of the esophagus

156

Polycythemia is associated with what neoplasm?

Renal cell carcinoma

157

Radiation exposure is associated with what neoplasm?

Leukemia
sarcoma

158

SIADH (syndrome of inappropriate antidiuretic hormone secretion) is associated with what neoplasm?

Small cell lung CA

159

Tuberous sclerosis is associated with what neoplasm?

Giant cell astrocytoma

160

Ulcerative colitis is associated with what neoplasm?

Colonic adenocarcinoma

161

Xeroderma pigmentosum is associated with what neoplasm?

melanoma
Basal cell carcinoma