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Pathology/Pharm > Pathology - Sheet1 > Flashcards

Pathology - Sheet1 Flashcards

1
Q

Cardiogenic/Hypovolemic Shock

A
  • Low output failure
  • incr TPR
  • Low cardiac output
  • Cold, clammy pt (vasoconstriction)
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2
Q

Septic Shock

A
  • High output failure
  • low TPR, vasodilation
  • High cardiac output
  • Hot pt (vasodilation)
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3
Q

Rolling

A
  • neutrophil: Siayl-Lewis

- endothelial: E/P Selectin

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4
Q

Tight binding

A
  • neutrophil: Integrin/LFA-1

- endothelial: ICAM-1

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5
Q

Diapedesis

A
  • neutrophil: PECAM-1

- endothelial: PECAM-1 (platelet enodthelial cell adhesion molecule-1)

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6
Q

Migration of the leukocyte, bacterial products (that attract):

A 
C5a
IL-8
LTB4
Kallikrein
(CILK)
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7
Q

Free radicals eliminated by

A

Antioxidants: Vit A, C, E
Catalase, Superoxide dismutase, Glutathion peroxidase
Spnotaneous decay

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8
Q

Granulomatous diseases

A 
TB, systemic fungal (histo, cocci) - caseating
Syphilis (treponema pallidum/Gummas)
Leprosy (M. leprae)
Bartonella henselae (cat scratch)
Sarcoidosis
Crohns
Wegners/granulomatis w polyangiitis
Churg-Strauss
Berylliosis, Silicosis
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9
Q

granuloma formation

A
  • infected macrophage secretes IL-12 –> T cells and NK cells then secrete IFN-gamma –> activate macrophages (Janus Kinase –> STAT –> increased killing abilities), which secrete TNF-alpha –> Granuloma formation.
  • anti TNFalpha meds –> granuloma breakdown and disseminated ds
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10
Q

Incr ESR

A

Infxns, cancer, SLE, inflammation, pregnancy

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11
Q

Decr ESR

A

Sickle cell (altered shape), polycythemia (too many, make it hard to fall efficiently), CHF

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12
Q

Iron poisoning

A
  • -> peroxidation of membrane lipids (from formation of free radicals)
  • Acute: gastric bleeding
  • Chronic: metabolic acidosis (loss of bicarb in diarrhea?) scarring –> GI obstruction
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13
Q

Amyloidosis

A
  • abnl aggregatino of proteins or their fragments into Beta-pleated sheet structures
  • -> cell damage, apoptosis
  • affected tissue has waxy appearance
  • apple-green birefringence (congo red stain)
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14
Q

Amyloidosis: AL (primary)

A

Deposition of Ig Light chains (MM, plasma cell disorder)

–> Nephrotic syndrome, heart failure, arrhythmia, easy brusing, hepaomegaly, neuropathy (goes everywhere!!)

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15
Q

Amyloidosis: AA (secondary)

A

Composed of Amyloid A

  • seen in chronic ds: RA, IBD, spondylarthropathy, infxns
  • -> multisystem (like AL/primary)
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16
Q

Amyloidosis: dialysis related

A
  • Beta2-microglobulin in pts w ESRD and long-term dialysis

- -> Carpal tunnel syndrome, other joint shit

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17
Q

Amyloidosis: inherited

A

many types

-one is: ATTR neurologic/cardiac amyloidosis from transthyretin (TTR/prealbumin) mutation

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18
Q

Amyloidosis: Age-related (senile) systemic

A
  • Deposition of normal (wild-type) TTR in myocardium and other sites
  • -> slower progression of heart failures vs. AL
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19
Q

Amylodosis to 1 organ

A

Alzheimers! Deposition of amyloid-B protein cleaved from APP (amyloid precursor protein)

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20
Q

How cancer invades –> Metastases

A
  • invades BM using Collagenases and Hydrolases (metalloproteinases)
  • “Seed and soil” theory: Seed=tumor embolus (floats around until it finds someplace to settle), Soil=target organ (specifically wants to go to X organ)
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21
Q

Reversible (cell changes)

A
  • Hyperplasia - incr in number of cells
  • Metaplasia - change from type A cells to type B (barrett’s!)
  • Dysplasia: loss of cell orientation, shape, size; preneoplastic
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22
Q

Irreversible (cell changes)

A
  • Anaplasia: abnl cells lacking differentiation)
  • Neoplasia: clonal prolif of cells (uncontrolled); benign or malignant
  • Desmoplasia: fibrous tissue formation in response to neoplasm
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23
Q

Grade and Stage

A
  • Grade: degree of cellular differentiation
  • Stage** (prognostic): degree of localization.spread baded on site of primary lesion (based on clinical or pathologic findigns: Tumor size, Node involvement, Metastases)
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24
Q

Carcinoma/Sarcoma

A
  • Carcinoma: eptihelial origin. Sarcoma: mesenchymal origin
  • e.g. (benign/Malignant)
  • Blood vessels = Hemangioma/Angiosarcoma
  • smooth m= Leiomyoma/Leiomyosarcoma
  • Bone = Osteoma/Ostesarcoma
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25
Q

Cachexia

A

weight loss, muscel atrophy, fatigue

-Mediated by TNF-alpha (“Cachectin”), IFN-gamma, IL-6

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26
Q

Down syndrome –>

A

ALL, AML, Alzheimers

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27
Q

Xeroderma pigmentosum, Albinism –>

A

Melanoma, basal cell, squamous cell**

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28
Q

Chronic atrophic gastritis, perncious anemia, post-surgical gastric remnants –>

A

Gastric adenocarcinoma

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29
Q

Tuberous sclerosis (facial angiofibroma, seizures, MR) –>

A

Giant cell astrocytoma, renal angiomyolipoma, cardiac rhabdomyoma

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30
Q

Actinic keratosis –>

A

Squamous cell carcinoma of skin

31
Q

Barrett’s esophagus –>

A

Esophageal adenocarcinoma

32
Q

Plummer-Vinson syndrome (low iron) –>

A

Squamous cell ca. of esophagus

33
Q

Cirrhosis (alcoholic, hep B, C) –>

A

HCC

34
Q

Ulcerative colitis –>

A

Colonic adenocarcinoma

35
Q

Paget’s ds of bone –>

A

2ndary Osteosarcoma and fibrosarcoma

36
Q

AIDS –>

A

NHL and Kaposis

37
Q

AI diseases (Hashimoto’s, Myasthenia gravis) –>

A

Lymphoma

38
Q

Acanthosis nigricians (hyperpigmentation and epidermal thickening) –>

A

Visceral malignancy (stomach, lung, uterus)

39
Q

Dysplastic nevus –>

A

Malignant melanoma

40
Q

Radiation exposure –>

A

Leukemia, Sarcoma, Papillary thyroid cancer, breast ca

41
Q

HER2/neu (c-erbB2) gene product

A

Tyrosine kinase (mutation in breast, ovarian, and gastric cancers) –> mutation accelerates cell proliferation

42
Q

L-myc

A

Transcription factor (Lung tumor GOF mutation)

43
Q

N-myc

A

Transcription factor (Neuroblastoma,GOF)

44
Q

ret

A

Tyrosine kinase (MEN 2a/2b GOF mutation)

45
Q

c-kit

A

Cytokine receptor (GIST GOF mutation)

46
Q

Rb (LOF mutation)

A

nl: inhibits E2F, blocks G1–>S

- retinoblastoma, osteosarcoma

47
Q

p53 (LOF mutation)

A

nl: Transcription factor for p21, blocks G1–>S)

- Lifraumeni, most cancers

48
Q

BRAF (LOF mutation)

A

nl: B-raf

Melanoma (also p16 LOF)

49
Q

NF1 (LOF mutation)

A

nl: RAS GTPase activating protein (RAS-GAP)

- NF-1 chr 17

50
Q

NF2 (LOF mutation)

A

nl: Merlin (schwannomin) protein

- NF-2 chr 22 (bilateral acoustic schwannomas, juvenile cataracts)

51
Q

DPC4 (LOF mutation)

A

Deleted in Pancreatic Cancer

52
Q

DCC (LOF mutation)

A

Deleted in Colon Cancer

53
Q

Tumor marker: Prostatic acid phosphatase

A

Prostate carcinoma (also PSA but can also be elevated in BPH and prostatitis)

54
Q

tumor marker: CEA

A

“CarcinoEmbryonic Antigen” – seen in 70% of Colorectal and Pancreatic cancers (also CA19-9)

55
Q

tumor marker: Alkaline Phosphatase

A

Metastases to bone, liver, Paget’s ds of bone

56
Q

tumor marker: Bombesin

A

Neuroblastoma, lung and gastric cancer

57
Q

tumor marker: Calcitonin

A

Medullary thryoid cancer

58
Q

HPV assoc w

A

Cervical cancer (16,18), Penile/anal carcinoma, Upper respiratory SCC**

59
Q

HHV-8/Kaposis assoc w

A

Kaposi’s sarcoma, body cavity fluid B-cell lymphoma

60
Q

toxin: vinyl chloride –>

A

Liver: angiosarcoma

61
Q

Cigarette smoke –>

A 
Larynx: squamous cell ca.
Lung: Squamous cell and small cell
Kidney: Renal cell carcinoma
Bladder: Transitional cell carcinoma
Pancreas: Pancreatic adenocarcinoma
62
Q

toxin: asbestos –>

A

Lung: Bronchogenic carcinoma > mesothelioma

63
Q

toxin: arsenic –>

A

Skin: Squamous cell
Liver: Angiosarcoma

64
Q

toxin: Naphthalene (aniline) dyes –>

A

Bladder: transitional cell carcinoma

65
Q

toxin: alkylating agents –>

A

Blood: leukemia (AML)

66
Q

Small cell lung ca (Paraneoplastic) –>

A
  • ACTH 0r ACTH-like peptide –> Cushings

- AB’s against presynaptic Ca2+ channels at NMJ –> Lambert-Eatong syndrome (muscle weakness0

67
Q

small cell lung cancer and Intracranial neoplasms (paraneoplastic) –>

A

ADH –> SIADH

68
Q

Squamous cell carcinoma, Renal cell carcinoam, Breast cancer (paraneoplastic) –>

A

PTHrP –> Hypercalcemia

69
Q

Hodgkin’s lymhoma, some NHL’s (paraneoplastic)

A

1,25 (OH)2-D3 / Calcitriol –> Hypercalcemia

70
Q

Renal cell carcinoma, Hemangioblastoma, HCC, Pheochromocytoma (paraneoplastic)

A

EPO –> Polycythemia

71
Q

Psammoma bodies

A 
Laminated concentric calcific spherules
-PSaMMoma:
Papillary (thryoid)
Serous (ovary)
Meningioma
Mesothelioma
72
Q

Metastasize to brain (gray/white matter jxn)

A

Lung > breast > GU > Osteosarcoma > Melanoma > GI

73
Q

Metastasize to liver

A

Colon&raquo_space; stomach > pancreas

74
Q

Metastasize to bone (axial skeleton)

A

Prostate (blastic), breast (lytic and blastic ) > Lung (lytic) > Thyroid, testes

Pathology/Pharm (1 decks)

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