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Step Numero Uno > Pathoma > Flashcards

Pathoma Flashcards

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1
Q

Hypertrophy definition on a cellular level

A

An increase in the size of cells

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2
Q

An increase in the size of cells

A

Hypertrophy

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3
Q

Hyperplasia definition

A

An increase in the number of cells

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4
Q

An increase in the number of cell

A

Hyperplasia

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5
Q

For a cell to increase in size it needs:

A
  • Cytoskeleton must increase in size (require inc gene activation –> inc protein synthesis - since cytoskeleton largely comprised of proteins)
  • Inc production of organelles (b/c need to be able to sustain inc work)
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6
Q

Cytoskeleton is largely comprised of what?

A

Proteins

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7
Q

Hyperplasia involves production of new cells from what?

A

Stem cells

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8
Q

Name 3 permanent tissues

A

Cardiac muscle, skeletal muscle, nerves

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9
Q

What are permanent tissues?

A

Don’t have stem cells –> cannot make new cells (ie hyperplasia) –> can only undergo hypertrophy

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10
Q

Pathologic hyperplasia can progess to what?

A

Dysplasia and eventually cancer

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11
Q

What is a notable exception of pathologic hyperplasia that does not inc risk for cancer?

A

Benign prostatic hyperplasia

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12
Q

Benign prostatic hyperplasia will or will not progress to cancer?

A

It will NOT progress to cancer. This hyperplasia is an exception and does not inc the risk of cancer.

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13
Q

Atrophy definition

A

Decreased size of an organ

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14
Q

Atrophy results in the decreased size of an organ, how is this accomplished?

A
  • Dec cell number via apoptosis
  • Dec cell size via ubiquitin-proteosome degradation of the cytoskeleton and autophagy of cellular components
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15
Q

Decreased size of an organ

A

Atrophy

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16
Q

Epithelium lines what?

A

Surfaces of the body (gut, urogenital tract, etc.)

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17
Q

Metaplasia definition

A

A change in stress on an organ leads to a change in CELL TYPE

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18
Q

A change in stress on an organ leads to a change in cell type

A

Metaplasia

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19
Q

Most common form of metaplasia

A

switch from one surface epithelium type to another think Barrett’s esophagus

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20
Q

What is the normal esophagus lined w/?

A

Nonkeratinizing squamous epithelium

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21
Q

In Barrett’s Esophagus what happens?

A

Intestinal Metaplasia of esophageal lining due to acid reflux from the stomach nonkeratinizing squamous epithelium –> nonciliated, mucin producing columnar cells

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22
Q

What cell type change is seen in Barrett’s Esophagus?

A

Nonkeratinizing squamous epithelium (normal) –> nonciliated, mucin producing columnar cells

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23
Q

How does metaplasia occur?

A

Metaplasia occurs via reprogramming of stem cells to produce a new cell type

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24
Q

Is metaplasia reversible or irreversible

A

It is REVERSIBLE, just need to remove the stressor (ie acid reflux in barrett’s esophagus)

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25
Does metaplasia have an increased risk for cancer?
YES Under persistent stress, metaplasia can progress to dysplasia and eventually result in cancer
26
What can metaplasia progress to?
Dysplasia --\> cancer
27
What metaplastic state is known to NOT increase the risk of cancer?
Apocrine metaplasia of the breast does NOT increase the risk for cancer
28
Apocrine metaplasia of the breast is special bc?
Apocrine metaplasia of the breast does NOT increase the risk for cancer
29
Benign Prostatic Hyperplasia is special because?
BPH does NOT increase the risk for cancer
30
What vitamin deficiency can result in metaplasia?
Vitamin A b/c necessary for differentiation of specialized epithelial surfaces and immune system
31
Vitamin A is necessary for differentiation of what type of cells and if deficient can lead to what?
Vitamin A b/c necessary for differentiation of specialized epithelial surfaces (ie conjunctiva covering the eye) and maturation of immune system Vit A deficiency can --\> metaplasia
32
What vitamin is necessary to maintain the conjunctiva of the eye?
Vitamin A Vit A deficiency --\> metaplasia where the normal goblet cell, columnar epithelium of conjunctiva becomes keratinizing squamous epithelium which can --\> destruction of the cornea (keratomalacia) and blindness
33
Keratomalacia
Destruction of the cornea and thickening of the conjunctiva Seen in Vit A deficiency (due to metaplasia)
34
Xerophthalmia
Dry eyes
35
Vit A deficiency can cause:
Dry eyes (xerophthalmia), destruction of the cornea and thickening of the conjunctiva (keratomalacia), and blindness - Largely due to metaplasia of conjunctiva
36
Retinoic acid receptor found on what chromosome?
Chromosome 17
37
a t(15:17) disrupts what?
Disrupts retinoic acid receptor (vit A receptor) --\> myeloid cells do not mature and remain in blast state --\> acute promyelocytic leukemia
38
a t(15:17) is seen in what disease?
Acute promyelocytic leukemia
39
What is given as a treatment to acute promyelocytic leukemia?
ATRA - all trans retinoic acid (a derivative of vit A)
40
What is all trans retinoic acid a derivative of?
Vitamin A
41
What is mesenchymal tissue?
It is connective tissue (ie bone, blood vessels, fat, cartilage)
42
Can mesenchymal tissue undergo metaplasia?
YES; think myositis ossificans
43
What is myositis ossificans?
When connective tissue w/in muscle changes to bone during healing after trauma It's an example of mesenchymal metaplasia
44
What's an example of mesenchymal metaplasia?
Myositis ossificans - connective tissue w/in muscle changes to bone during healing after trauma
45
How can you tell the difference b/t myositis ossificans from metastatic bone cancer on scan?
- Ossification is w/in muscle and not attached/connected to the bone (therefore not growing off of it) - Bone in image is also healthy looking
46
Definition of dysplasia
Disordered cellular growth (most often referring to proliferation of PREcancerous cells) dys = bad plasia = growth Dysplasia = "bad growth"
47
What term means bad growth and is usually used to refer to proliferation of PREcancerous cells?
Dysplasia
48
What is the dysplasia before cervical cancer called?
Cervical intraepithelial neoplasia (CIN)
49
Dysplasia often arises from what?
Pathological Hyperplasia (ie endometrial hyperplasia) or Metaplasia (ie Barrett esophagus)
50
Is dysplasia reversible or irreversible?
REVERSIBLE - alleviation of inciting stress
51
Does dysplasia have an increased risk for cancer?
YES - if stress is not alleviated, dysplasia will progress to carcinoma (irreversible)
52
Once a tissue has progressed to cancer is the cancer stage reversible or irreversible?
IRREVERSIBLE
53
Definition of aplasia
Aplasia is failure of cell production during embryogenesis (ie unilateral renal agenesis)
54
Failure of cell production during embryogenesis
Aplasia
55
Unilateral renal agenesis
1 of the kdneys fails to develop during embryogenesis - it's a form of aplasia
56
Hypoplasia definition
A decrease in cell production during embryogenesis resulting in a SMALL organ (ie streak ovary in Turner Syndrome)
57
A decrease in cell production during embryogenesis resulting in a relatively small organ
Hypoplasia ex: streak ovary in Turner Syndrome
58
Streak ovary in turner syndrome is an example of what type of cell production?
Hypoplasia - decrease in cell production during embryogenesis resulting in relatively small organ
59
Which is more susceptible ot ischemic injury neurons or skeletal muscles?
Neurons are highly susceptible to ischemic injury
60
Slowly developing ischemia results in what?
Atrophy (ex renal artery atherosclerosis --\> atrophy of kidney)
61
Acute ischemia results in what?
Injury (ex: renal artery embolus --\> renal injury)
62
Slow or acute ischemia results in atrophy?
Slow
63
Slow or acute ischemia results in injury?
Acute
64
Hypoxia definition
Low oxygen delivery to tissues
65
Deficiency in the amount of oxygen reaching tissues
Hypoxia
66
what is the final electron acceptor in the electron transport chain?
Oxygen | (oxidative phosphorylation)
67
Decreased oxygen impairs what resulting in decreased ATP production?
Impairs oxidative phosphorylation
68
Impaired oxidative phophorylation results in what?
Decreased ATP production
69
Lack of ATP can lead to what?
Cellular injury
70
Name 3 causes of hypoxia
Ischemia, hypoxemia, and decreased O2 carrying capacity of blood
71
Ischemia definition
Decreased blood flow through an organ
72
Decreased blood flow through an organ
Ischemia
73
Name 3 causes of ischemia
1. Decreased arterial perfusion (atherosclerosis) 2. Decreased venous drainiage (Budd-Chiari syndrome) 3. Shock - generalized hypOtension resulting in poor tissue perfusion Think: something disrupting blood flow (either to or from)
74
What is budd-chiari syndrome?
Budd-Chiari syndrome = occlusion of hepatic vein(s) --\> dec fresh blood flow --\> infarction of liver
75
Budd chiari syndrom most commonly caused by?
Polychythemia vera B/c RBC count inc --\> thick & viscous blood --\> inc risk for thrombi
76
Budd Chiari syndrome associated with (7 things):
1. Polycythemia Vera 2. Pregnancy 3. Lupus anticoagulant (lupus --\> hypercoaguable state) 4. Use of oral contraceptives 5. Postpartum state 6. Paroxysmal nocturnal hemoglobinuria 7. Hepatocellular carcinoma
77
Hypoxemia definition
Low concentration/partial pressure of oxygen in blood (PaO2 \< 60mmHg, SaO2 \< 90%)
78
Low concentration/partial pressure of oxygen in blood (PaO2 \< 60mmHg, SaO2 \< 90%)
Hypoxemia
79
If PaO2 \< 60mmHg & SaO2 \< 90% patient has
Hypoxemia
80
Hypoxemia can result from (4 things):
1. High altitude 2. Hypoventilation 3. Diffusion defect 4. V/Q mismatch Think: Why is oxygen not getting in or CO2 not getting out?
81
How does high altitude cause hypoxemia
Decreased barometric pressure (FiO2) --\> decrease in alveolar oxygen partial pressure (PAO2) b/c less pressure outside to push O2 into alveolar sacs
82
FiO2 =?
Atmospheric O2 pressure
83
Atmospheric O2 pressure =?
FiO2
84
PAO2 = ?
Partial pressure in Alveolar sacs
85

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