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ASDOH Clinical Pathology > Test 1 > Flashcards

Test 1 Flashcards

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1
Q

]Cells adapt to change in 6 distinct ways, what are they?

A 
○	Atrophy
○	Hypertrophy
○	Hyperplasia 
○	Metaplasia
○	Dysplasia
○	Anaplasia
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2
Q

Whats the best example of Atrophy

A

■ Thymus undergoing involution

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3
Q

The best example of pathological Atrophy

A

■ Ischemic organs are typically small (kidneys involved in atherosclerosis)

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4
Q

The best physiologic example of Hypertrophy

A

■ Skeletal muscles in body builders due to weight training

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5
Q

The best pathologic example of Hypertrophy

A

■ Hypertrophy of the heart that occurs as an adaptation to increased workload

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6
Q

The best pathologic hyperplasia example

A

○ Endometrial hyperplasia due to estrogens

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7
Q

Best physiologic hyperplasia example

A

■ Physiologic hypertrophy of the uterine smooth muscle cells during pregnancy accompanied by hyperplasia

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8
Q

An adaptive change of one cell type for another to suit the environment

A

Metaplasia

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9
Q

Examples of adaptive change of one cell type for another to suit the environment

A

○ Squamous metaplasia of the bronchial epithelium due to smoking
○ Gastric or glandular metaplasia of the GE junction in Barrett’s esophagus

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10
Q

Disordered growth of tissues resulting from chronic irritation or infection

A

Dysplasia

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11
Q

The best example of Dysplasia

A

■ Cervical intraepithelial neoplasia or CIN based on PAP smears

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12
Q

Undifferentiated and uncontrolled growth of cells. The hallmark of malignant transformation!

A

Anaplasia or cancer

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13
Q

Other names for Anaplasia

A

○ Malignancy
○ Carcinoma
○ Cancer
○ Neoplasm

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14
Q

What are Microscopic hallmarks of anaplasia?

A

○ Cell and nuclei display marked cellular pleomorphism
■ Variation in size and shape
○ Nuclei are irregular and hyperchromatic
○ Extremely high nuclear/cytoplasmic ratio (N/C ratio)
■ About 1:1 instead of 1:4 or 1:6
○ Large nucleoli present within the nucleus
○ Large numbers of abnormal mitotic figures

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15
Q

Reversible Cell Injury characteristics

A

○ Swelling of the cytoplasm and it’s organelles due to malfunctioning ATP Na/K pump
○ Glycolysis takes over, PH decreases
○ If energy is restored the cell will survive and balance out.

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16
Q

condensation of the chromatin

A

■ Pyknosis

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17
Q

Fragmentation of the nucleus into small particles (nuclear dust)

A

■ Karyorrhexis

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18
Q

Involves dissolution of the nucleus and lysis of chromatin by enzymes

A

■ Karyolysis

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19
Q

Characteristics of irreversible cell injury

A

DNA in the Nucleus is damaged, cytoplasm is destroyed. Cells will release/leak enzymes into the ECF e.g… Hepatocytes release AST or LDH

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20
Q

What is coagulative cell necrosis?

A

■ The most common form of necrosis
■ Occurs when cell proteins are altered or denatured
■ Cell outlines are preserved and the cytoplasm appears finely granular
■ Occurs in solid internal organs
● Ex: heart, kidney, spleen, and liver
infarction
■ Appears white: dead myocytes and neutrophils that have infiltrated before the cells died

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21
Q

■ Most often caused by anoxia
● Ex: heart tissue undergoing a myocardial
■ Occurs in solid internal organs
● Ex: heart, kidney, spleen, and liver
infarction

A

coagulative cell necrosis

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22
Q

What is Liquefactive necrosis?

A

■ Refers to a process by which dead cells liquefy under the influence of certain cell enzymes

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23
Q

■ Occurs most often in the brain
● Brain cells lose their contours and liquify
● Typical of brain infarcts which are usually soft and are ultimately transformed into a fluid filled cavity

A

Liquefactive necrosis

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24
Q

What is caseous necrosis?

A

■ A form of coagulative necrosis in which a thick, yellowish, cheesy substance forms

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25
■ Typically found in tuberculosis, characterized by the development of lung granulomas, inside of which can be found caseous necrosis ■ Can also be seen in some fungal infections
caseous necrosis
26
Fungi responsible for caseous necrosis in some infections
● Histoplasmosis
27
What is Fat necrosis?
■ A specialized form of liquefaction necrosis caused by the action of lipolytic enzymes ■ Limited to fat tissue, usually around the pancreas
28
What is one of the best example of fat necrosis?
● Enzymes are released into adjacent fat tissue after rupture of the pancreas (due to trauma, acute pancreatitis, etc) causing degradation of fat into glycerol and free fatty acids
29
What are Dystrophic calcifications?
○ Represents an extracellular deposition of calcium from the circulation into dead or dying necrotic tissue, often visible to the naked eye
30
The best example of Dystrophic calcification
■ Calcifications in atherosclerotic coronary arteries contributing to narrowing of vessels Others ■ Calcifications of the mitral or aortic valves leading to impeded blood flow (stenosis) ■ Calcifications seen around breast cancers that can be visualized by mammography ■ Infact periventricular calcifications seen in congenital toxoplasmosis
31
What are Metastatic calcifications?
○ Reflects derange calcium metabolism, NOT cell injury, usually associated with increased serum calcium levels, leading to deposition of calcium in other locations
32
When do we see Metastatic calcification?
■ Hyperparathyroidism ■ Vitamin D toxicity ■ Chronic renal failure calcium stones in gall bladder, kidney, and bladder are due to precipitation of salts from solution into tissues.
33
Have expansile growth and compress the normal surrounding tissue WITHOUT infiltration or invasion
Benign tumors
34
Characteristics of Benign Tumors
○ Histologically, composed of cells that resemble the tissue from which they have arisen ○ Cells are composed of a uniform population in which all the cells have the same features ■ Regularly shaped round or oval nuclei ■ All the same size with evenly distributed chromatin and normal nuclei ■ Well-developed cytoplasm
35
Histologically show prominent anaplasia
Malignant tumors
36
Spread of malignant cells occurs through three main pathways:
○ Lymphatics ○ Bloodstream ○ Direct extension of the primary tumor
37
A cancer that loves to spread through Lymphatics
Breast
38
A cancer that loves to spread through the Bloodstream
Many, Not sure which one's best.
39
A cancer that loves to spread through Direct extension of the primary tumor
■ Usually by seeding of the surface of the body cavities | ■ Renal cell carcinoma seeding to the adrenal
40
Tumors derived from the 3 germ cell layers are called:
○ Teratomas (benign) | ○ Teratocarcinomas (malignant)
41
Not all tumors that end in “-oma” are benign, and the most important examples are?
○ Lymphomas ○ Melanomas ○ Astrocytomas ○ Seminomas
42
Malignant tumors of epithelial origin are called
carcinomas eg.. ○ Squamous cell carcinoma ○ Adenocarcinoma ○ Transitional cell carcinoma
43
The names for malignant tumors of connective tissue origin are coined from the root of the cell type and suffix
sarcoma
44
Malignant tumors composed of embryonic tissue are called.
Blastomas e.g... ○ Retinoblastoma ○ Neuroblastoma ○ Medulloblastoma
45
What are the three grades of malignancy
○ Grade I: well-differentiated ○ Grade II: moderately differentiated ○ Grade III: poorly or undifferentiated
46
TMN Criteria takes into account...
○ Tumor size ○ Lymph node status ○ Distant Metastasis
47
What cancer(s) do Nitrosamine cause?
■ GI Tract cancers (especially esophageal and stomach cancers) ■ Nitrates (preservatives) may react with other dietary components to form nitrosamines
48
What cancer(s) do Polycyclic Aromatic Hydrocarbons cause?
○ lung cancer ○ skin, soft tissue, and breast cancers ○ angiosarcoma of the liver
49
dibenzanthracene cause cancer in...
implicated in skin, soft tissue, and breast cancers
50
Vinyl Chloride (plastics) implicated in cancer of?
angiosarcoma of the liver
51
Nature of Aflatoxin B1
■ Natural product of aspergillus flavus, among the most potent liver carcinogen ■ Contaminates produce in Africa and Asia
52
Effect of Aromatic Amines (Naphthylamina/ Azo Dyes)
■ Indirect action on urinary bladder and liver tumors ● Liver: due to metabolism ● Bladder: hydrolysis to hydroxylamine causing cancer
53
Effects of UV Light
``` ● Enzyme activation ● Inhibition of cell division ● Mutagenesis ● Cell death ● Cancer (skin) ```
54
Most important effect of UV light is
Formation of pyrimidine dimers of DNA, not seen in any other carcinogen
55
Asbestos causes?
■ Mesothelioma
56
HPV virus causes?
``` ■ DNA virus that induces lesions that progress to squamous cell carcinoma in the: ● Cervix ● Oropharynx ● Penis ● Anus ● Vagina ```
57
Hepatitis B causes?
development of hepatocellular carcinoma
58
Epstein-Barr Virus causes?
Causes Burkitt’s Lymphoma and Nasopharyngeal Carcinoma ● Burkitt’s in African children ● Nasopharyngeal in Africa and Asia
59
Human Herpesvirus 8 causes?
Kaposi Sarcoma which is a vascular neoplasm associated with AIDS patients
60
Mutated normal cellular genes (proto-oncogenes) that normally encode for proteins important to basic cell function regulating growth and differentiation
Oncogens
61
Proto-oncogenes are transformed into oncogenes by four basic mechanisms:
● Point mutations: ● Gene amplification: ● Chromosomal rearrangements: ● Insertion of the viral genome:
62
Two best known Tumor Suppressor Genes
retinoblastoma gene 1 (Rb-1) and p53
63
What is Barrett’s esophagus?
■ Glandular cell metaplasia in esophagus
64
■ Benign tumor of epithelial origin:
papilloma
65
■ Benign tumor of connective tissue
name of tissue “-oma”
66
■ Benign tumor of glandular:
adenoma
67
■ Malignant tumor of epithelial origin
Carcinoma
68
■ Malignant tumor of glandular origin
adenocarcinoma
69
■ Malignant tumor of connective tissue:
Sarcoma
70
■ Malignant tumor of placental origin:
Blastoma
71
The five exception to the benign "-oma" rule
■ Seminomas, lymphomas, mesothelioma, astrocytoma, melanoma
72
Differentiate necrosis from autolysis
○ Necrosis is in living cells, autolysis occurs after death
73
Who does the grading vs. who does the staging?
○ Pathologist→ grading | ○ Oncologist→ staging
74
● Japan and Latin America (Chile), also Ireland | ● 10x higher in these countries than in US
■ Stomach Cancer:
75
● Highest incidence in US (3-4x more common) | ● High fiber diet in India, Japan, Africa, and Latin America decreases risk (US has high fat diet)
■ Colorectal Cancer:

ASDOH Clinical Pathology (3 decks)

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