Pathology I Block 1
Card Set Information
Pathology I Block 1
Pathology Block 1
What type of necrosis is seen in the brain?
What type of necrosis is seen in tuberculosis patients?
What type of necrosis occurs everywhere in the body except in the brain?
A type of necrosis where antigen:antibody complexes bind to fibrin in a Blood Vessel is called what?
In a patient with acute pancreatitis what type of necrosis is seen?
Necrosis due to bacterial or fungal infection is caused what?
What type of necrosis is described as cheeselike?
Coagulative necrosis superimposed with infection is said to be what?
What is the difference between apoptosis and necrosis in terms of the cell size?
What are the nuclear changes seen in necrosis?
Pyknosis---> karyorrhexis---> karyolysis
decreased size of nucleus and increased basophilia---> fragmentation of nucleus--> diminished basophilia
Bone formation in muscle
Gastric acid reflux is known to cause what type of metaplasia?
Squamous to columnar metaplasia
Deficiency of what vitamin results in squamous metaplasia?
What kind of metaplasia occurs in a chronic cigarette smoker?
Columnar to squamous metaplasia
What happens to the gyri and sulci in a patient with Alzeimer's?
The gyri are narrowed and sulci are widened
What is used to identify Glycogen?
In what age group are you going to encounter lipofuscin?
What is ochronosis?
tissues turning a dark color
What stain is used for Iron?
Pallor, icterus, cyanosis, Clubbing, Lymphodenopathy, edema
What causes coagulative necrosis?
History of stroke would produce what necrosis?
Necrosis and infection produces what type of necrosis?
In what ppl would you find fat necrosis?
Depostition of immune complexes produces what type of necrosis?
Hypesensitivity reactions Type III produces what type of necrosis?
Cyanine inhibits what enzyme?
What is worse, hypoxia or ischemia, why?
ischemia because aerobic and anaerobic oxidation is halted
How does protein malnutrition cause fatty change in the liver?
no protein= no apolipoprotein= can't export FA out of the liver
How does hypoxia cause fatty change in the liver/heart?
Hypoxia= low oxygen= inhibits fatty acid oxidation
How does starvation cause fatty acid liver change?
starvation increases mobilization of fatty acids
Two stains for fat?
What is used to stain for Glycogen?
PAS- periodic acid shift
How does anemia produce a tigered affect of affected myocardium with unaffected myocardium with fatty change?
anemia=low oxygen=inhibition of FA oxidation= deposition of lipids in alternating myocardium
What is cholesterolosis?
cholesterol rich macrophages in the lamina propria of the gall bladder
What is Atherosclerosis?
smooth muscle cells and macrophages filled with oxidized cholesterol in the intima layer of the arterial wall
What is a Xanthoma?
cholesterol filled macrophages in the CT
Where are Xanthomas found?
Nieman Pick C results in what?
cholesterol accumulation in multiple organs
What are Russell bodies?
rER inclusions filled with proteins due to increased protein synthesis
What is found in pink hyaline reabsorption droplets?
Where are pink hyaline reabsorption droplets found in the kidney due to proteinuria?
proximal renal tubules
In alpha-1- antitrypsin deficiency where do misfolded proteins accumulate?
ER of the liver
In what cells are Russell bodies found?
active plasma cells
Vimentin is an intermediate filament characteristic of what ?
Glial intermediate filaments are characteristic of what cells?
Intracellular accumulations of proteins usually appear as what?
rounded eosinophilic droplets
Eosinophilic inclusion droplets of what intermediate protein are found in alcoholic liver disease?
Pink= hyaline droplets=protein
Alcoholic hyaline is composed of what intermediate protein?
Walls of kidney arteries are often hyalinzed due to what two chronic conditions?
Accumulation of coal in macrophages in the lymph nodes in the tracheobronchial regions is called?
Tattoo pigment and coal dust resides in what cell of the dermis?
A product of lipid peroxidation of lipid membrane is what?
What substrate acts as a telltale sign of free radical injury and lipid peroxidation?
What is cachexia?
Physical wasting with loss of weight and muscle
Where does lipofuscin accumulates?
perinuclear region of
What is ochronosis?
deposition of homogentisic acid in CT and skin
Aggregates of ferritin micelles is called what?
Stain for heme and hemosiderin?
Deposition of calcium in dying tissue, locally is called what?
Hypercalcemia may lead to what type of calcification?
In _____________ macrophages activate a vitamin D precursor.
Calorie restriction activates a class of what proteins that are thought to promote expression of protein that mediate longevity
Causes for acute inflammation?
5 cardinal signs of inflammation?
Fluid that is rich in proteins, leukocytes in the interstitial space is called?
Fluid that is low in protein and leukocytes in the interstitial space is called?
In terms of specific gravity what is the difference between exudate and transudate?
exudate has high specific gravity
What are the 3 events of blood vessels that occur around the area of inflammation?
increased blood flow
increased vascular permeability
extravasation of leukocytes into the interstitial space
Inflammation induced vasodilation is induced by what two chemical mediators?
Increased permeability of BV is mediated by the contraction of endothelial cells mediated by which molecules?
histamine, bradykinin, substance P, leukotrienes
Inflammation of lymph vessels is called?
Inflammation of lymph nodes is called?
What drains the increased extracellular fluid in the interstitial space during inflammatory edema?
Angiogenesis as well as formation of new lymphatic vessels occurs during inflammation for what reason?
to accomodate increased blood flow
to accomodate increased extracellular fluid in the interstitium
Sialyl-lewis glycoprotein on the leukocyte binds to what on the endothelium?
P and E selectins
Integrin binds to what on the endothelium?
Which selectin is used for homing of T lymphocytes to HEV of lymph nodes?
Firm adhesion of leukocytes to endothelium is mediated by what two molecules?
Which two molecules upregulate selectins on the endothelium in response to inflammation?
What increases the avidity of integrins?
What molecule between enodothelial cells allows for transmigration?
Leukocyte adhesion deficiency type I is caused by what?
Leukocyte Adhesion Deficiency type II is caused by what?
defective fucosyl transferase which synthesizes Sialyl-Lewis glycoproteins
What are the chemotactic agents that allow for migration of leukocytes in the Interstitium?
Neutrophils predominate in infections caused by what?
Mammalian glycoproteins and glycolipids contain _____ as the terminal group while bacterial glyco proteins and lipids contain-------
sialic acid and N-actylglucosamine
fucose and mannose
The glycopeptide coat of all bacteria contains _______
which is hydrolyzed by lysozy
Mediators of inflammation come from what two different sources?
plasma proteins via liver
Histamine acts on which receptors located on the arterioles and post capillary venules?
What essential aa gives rise to arachidonic acid?
Which prostoglandin induces uterine contraction and broncho and vasoconstriction?
Which prostoglandin inhibits platelet aggregation and is a potent vasodilator?
Lipoxins A and B have what function?
inhibit neutrophil adhesion and chemotaxis
What is the function of PGD and E?
Which leukotriene is involved in neutrophil chemotaxis?
Which leukotriens mediate vaso and bronchoconstriction?
LTC4, LTD4, LTE4
What agent blocks conversion of AA to Leukotrienes?
What agent blocks leukotriene receptor?
Which chemical mediator has both inflammatory functions such as vasodilation and increasing permeability as well as inhibiting leukocyte adhesion?
The familial Mediterranea fever is caused by a deficient what?
Chronic inflammation as in Familial Mediterrean fever results in protein deposition in tissues called what?
Sustained production of what contributes to cachexia?
Chemokines signal thru what type of receptor?
G protein coupled receptors
Which chemokine is used as a coreceptor for HIV1?
What cytokine is produced by Th17 cells that recruit neutrophils?
What are the 3 functions of Complement system?
inflammation ---via C3a, C5a
Factor XII has an effect on what 4 different cascades?
What type of signalling is upregulated in Marfans?
Congenital contractural arachnodactyly
Diagnostic tool for Marfans?
Ehler's Danlos syndrome
What chronic inflammatory conditions lead to cancer?
H. Pylori gastritis
Chronic inflammation can lead to what 4 conditions?
neurodegenerative disorder (Alzeimer's)
Diabete Mellitus I
What are the possible mechanisms of chronic inflammation leading to neoplasms?
stem cell recruitment
production of ROS
What are the 3 events to which acute inflammation can ultimately lead to?
1. Resolution of inflammation
3. Chronic inflammation
What are the 3 products that cause tissue damage in chronic/acute inflammation?
What are the 3 molecules which mediate fever?
How does LPS induce fever?
LPS induces Il-1 and TNF release from Leukocytes
IL-1 and TNF upregulate COX enzyme
COX enzyme synthesizes PGE2
PGE2 resets temperature point in posterior hypothalamus
What two molecules mediate pain?
Which chemokine receptors are used by HIV-1 for entry into the cell?
What are the molecules involved in acute inflammation?
What are the molecules involved in chronic inflammation?
What are the vasoconstriction molecules?
LT C, D,E
Molecules which promote vasodilation?
Molecules which promote vascular permeability
Molecules which promote vascular permeability?
What are the 2 components of blood that participate in inflammation reaction?
What is Serum Amylod Protein A (SAA protein)?
What function does it serve during acute phase protein?
redirects high-density lipoproteins to macrophages at a site of injury
Which acute phase protein is used as a marker for increased risk of myocardial infarction in patients with coronary artery disease?
C reactive protein
Prolonged presence of acute phase proteins because of chronic inflammation tends to cause deposition of proteins called what?
Fibrinogen has what effect during acute phase protein production?
binds RBC and causes them to sediment
What acute phase protein causes increased Erythrocyte Sedimentation Rate?
Fibrinogen binds to RBC and stacks them
What are the four acute phase proteins?
1- C reactive protein
2- Serum Amyloid A protein (SSA protein)
What acute phase protein is responsible for reducing the availability of iron during chronic inflammation?
Elevated levels of what acute phase protein causes Microcytic, Hypochromic Anemia?
What are the 3 functions of complement?
1-Inflammation- C3a, C5a
3- Membrane attack complex (MAC)- C5b-C9
What is one chemical mediator that elicits most of the vascular and cellular reactions of inflammation such as vasodilation, increased permeability, chemotaxis, degranulation, leukocyte adhesion
Platelet Activating Factor
Bone Marrow suppression as caused by tumor, radiation, chemotherapy causes what immuno-suppression?
Decreased Leukocyte Production
Diabetes, Malignancy and sepsis cause what kind of immuno-deficiency?
Chronic Granulomatous Disease is of 2 types:
Which component of the cell is defective in each i.e Cytoplasmic or membrane
In what form are plasma proteins involved in inflammation present in the plasma?
Rupture of arteries and colon are commonly seen in what type of Ehler's Danlos Syndrome?
Arthrochalasia and Dermatosparaxsis are forms of Ehler's Danlos syndrome caused by deficiency of collagen?
In what type of Ehler's Danlos Syndrome are ocular fragility seen?
Classical type of Ehler's Danlos syndrome is caused by what mutation?
Vascular type of Ehler's Danlos Syndrome is caused by what mutation
What are the 6 types of Ehler's Danlos syndrome?
1. Classical- COL5A1, COL5A2
2. Hypermobility-uknown mutation
4. Kyphoscoliosis- Lysyl Hydroxylase
5. Arthrochalasia- COL1A1, COL1A2
6. Dermatosparaxsis- Procollagen N-peptidase
What are the 3 symptoms of Marfans?
Tricuspid/Mitral prolapse----> mitral regurgitation
Defective extracellular matrix seen in Marfans is most likely due to upregulation or what growth factor?
A mutation in FBN-2 causes what?
Congenital Contractual Arachnodactyly
Chemical Mediators involved in Vasodialtion?
What factor do hypoxic cells produce which induce the production of inflammatory mediators?
What molecules do necrotic cells release that stimulate the release of inflammatory mediators?
In what cells does Parvovirus replicates?
What is the difference between Transudate and Exudate in terms of the protein content and specific gravity?
Exudate--high protein content, high specific gravity
Transudate- low protein content, low specific gravity
Purulent inflammation is made up of what?
neutrophilic pus and cellular debris
What is the difference between lobar and bronchopneumonia?
Lobar--whole lobe is involved
Bronchopneumonia---diffuse parts of the lung are involved
What is responsible for erythema?
When is stasis produced?
upon vasodilation and increased vascular permeability
What is instrumental in accumulation of neutrophils along the endothelium?
Stasis--slowing down of blood flow
Transport of fluids and protein thru the endothelium
Which chemical mediator promotes transcytosis?
Vascular leakage of plasma fluid and proteins in patients with _______ can cause life threatening loss of fluid?
What 4 factors increase vascular permeability?
1-histamine, serotonin, bradykinin, thromboxanes, PAF, substance P
2- endothelial injury due to burns, toxins
3- leukocyte mediated injury in chronic inflammation
inflamed lymph nodes
inflamed lymph vessels
What is margination?
redistribution of leukocytes adjacent to the endothelium
P-selectin molecules are stored in what cells?
In what structure?
- Endothelial cells
- Weibel-Palade bodies
Which molecules stimulate the redistribution of P-selectins from Weibell-Palade Bodies to the surface of the endothelial cells?
Sialyl-Lewis glycoproteins or Integrins involved in rolling of leukocytes along the endothelium?
Which molecule on the Leukocytes is involved in adhesion to the endothelium?
What Leukocyte molecule is involved in Diapedes?
PECAM-1 or CD31
Integrin molecules binds to what receptors on the endothelium?
What is transmigration or diapedes?
movements of a phagocyte thru the endothelial cells
Transcytosis vs. Transmigration
Transcytosis--movement of fluid and plasma proteins thru the endothelial cells
Transmigration-movement of Leukocytes the the endothelial cells
Thru what molecules are leukocytes able to bind to the extracellular matrix proteins?
In what bacterial infection do neutrophils predominate instead of macrophages?
What are the 3 opsonins?
1- IgG antibodies
Bacterial glycoproteins and glycolipids have what sugar in contrast with mammalian GlycoProteins and Glycolipids
fucose and mannose
sialic acid and n-acetylglucosamine
In what condition are increased susceptibility to infections and albinism present?
What effect does intake of fish oil have on inflammation?
Fish oil gives rise to resolvins and protectins which are anti-inflammatory
What are the mediators that act as anti-inflammatory agents?
What is the initial stimuli for initiation of inflammation?
necrotic cells contents-uric acid, ATP,
Hypoxic cells contens--HIF-1alpha
Histamine exerts its vasoactive effects on blood vessels by binding to what receptors?
ADH acting on the blood vessels acts on what receptors?
Arachidonic acid could be converted from what essential fatty acid?
Which cells makes Thromboxane?
Which cell makes prostacyclin?
Balance between what two mediators ensures a right balance of clot making and breaking?
What is the proposed mechanism of how Cox-2 inhibitors increase the risk of arterial thrombosis?
Celebrex(Cox-2 inhibitor) blocks the synthesis of prostacyclin in endothelial cells which stop platelet aggregation
While platelets are making Thromboxane which promotes platelet aggregation
Resulting in an im-balance and promotion of arterial thrombi
What are the 2 drugs that are used in asthma that
-block leukotriene production?
-block leukotriene receptors?
How do corticosteroids inhibit the synthesis of mediators of inflammation?
by reducing the transcription of gene coding for
What combines with NO to form Reactive Nitrogen Species?
What are the enzymes that degrade free radicals?
What is the mechanism of injury caused by reperfusion?
Reperfusion generates free radicals
How many different types of No synthase are there?
Which chemical mediator has both pro-inflammatory and anti-inflammatory properties?
Which inflammatory mediator is considered to an endogenous mechanism for controlling inflammatory responses?
Which cytokines are produced in acute inflammation?
Which cytokines are produced in chronic inflammation
Mutations in what interleukin gene cause inherited autoinflammatory syndromes such as Familial Mediterranean fever?
In gout, the inflammasome complex (IL-1) is activated to produce a condition called Gout by what substrate?
In patients with Familiar Mediterranean Fever, the chronic inflammation may lead to deposition of protein called what?
TNF regulates energy balance by promoting protein and lipid mobilization for production of acute phase proteins resulting in wasting called?
Eotaxin cytokine recruits what cells?
Chemokines bind to what type of enzyme linked receptors?
What is the action of IL-17 ?
neutrophil activation and chemotaxis
What are the 2 anti-protease commonly found in serum and other secretions?
Acid proteases work where in the neutrophil?
Phagolysosome where the pH is acidic
What kind of proteases degreade ECM like collagen, elastin, fibrin?
What are the functions of Neuropeptipe P (substance P)?
stimulation of secretion by endocrine glands
C3 and C5 can be cleaved by what?
enzymes in the exudate
Fibrinous exudate is commonly seen in the inflammation of what?
body cavities such as pericardium, pleura, peritoneum, meninges
Purulent inflammation is primarily made up of what leukocytes?
pus forming bacteria
What is silicosis?
lung inflammation due to prolonged inhalation of silica
Macrophages in spleen and lymph nodes are called what?
What is immune inflammation?
when T and B cells are involved in the inflammation
Eosinophils contain what type of protein that elimincates parasites?
major basic protein
What is osteomyelitis?
inflammation of bone
What leukocytes are found in osteomyelitis?
Giant cells with nuclei arranged peripherally are called what?
Giant cells with nuclei arranged in the middle of the cell are called what?
What cytokine transforms macrophages into epitheliod cells?
What bacteria causes Tuberculosis?
What type of granuloma is seen in Tuberculosis?
What type of granuloma is seen in cat-scratch fever?
Rounded or stellate
Which granuloma has a "gumma" granuloma appearance?
What is one probably mechanism thru which fever might help fight infection?
Fever might induce heat-shock proteins
Why do you see anemia in chronic inflammation?
because an acute-phase protein called hepcidin reduces the bioavailability of iron during infection
What are leukemoid rxns?
elevated WBC count
What types of infections cause neutrophilia?
What type of infections cause lymphocytosis?
Typhoid fever has what effect on leukocytes?
What 2 cytokines mediate septic schock?
What is the reason for hypertrophy of the uterus during pregnancy?
What are the 2 mechanisms involved in cardiac hypertrophy?
G protein coupled receptors
Hypertrophy of the heart is associated with a switch from adult contractile proteins to what form?
What vasoactive mediator is upregulated in a hypertrophied heart?
Which epithelium in a woman undergoes hypertrophy and hyperplasia?
Transcription factors involved in hypertrophy have what 3 effects?
1-induction of fetal gene
2- increases synthesis of contractile proteins
3- induces expression of growth factors
Hyperplasia of the endometrium and prostate is due to what?
excess hormone stimulation
How does a papilloma virus induces hyperplasia of epithelium?
viral genes code for growth factors
Hyperplasia can be cause by two factors?
What are common causes of atrophy?
reduced nerve supply
reduced blood supply
lack of endocrine stimulation
Deficiency of what vitamin is known to induce squamous metaplasia in the respiratory epithelium?
formation of bone in muscle
Vitamin A regulates gene expression thru what receptor?
What is the first manifestation of cell injury?
Coagulative necrosis may be seen in what tissues?
What is seen in coagulative necrosis ?
all tissues except brain
no degradation of cells for some time
Liquefactive necrosis occurs where?
What is it characterized by?
In the brain
formation of liquid and pus
How is Fibrinoid necrosis produced?
when immune complexes precipitate with fibrin in the wall of arteries
Influx of what ion activates proteases and other degradating enzymes?
What are the intracellular enzymes that Ca activates?
phospholipase, protease, endonuclease, ATPase
What is oxidative stress?
unchecked accumulation of free radicals
What damage do free radicals perform?
At which point are injuries to cells considered irreversible?
-loss of mitochondrial ability to create ATP
- serious loss of membrane integrity
What are Myelin figures?
remnants of plasma membrane in vacuoles
What is the most useful strategy in ischemic injuries?
reducing core body temperature to 92 F
What are the causes of Ischemic-reperfusion injury?
What is used to stain for apoptotic bodies?
What are the two pathways of initiating apoptosis?
intrinsic--mitochondria via cyt c
What is hemosiderin?
aggregates of ferritin molecules which hold iron
What are psammoma bodies?
collections of calcium salts
What is the deficient enzyme in Tay-Sachs?
Hexaminidase A deficiency arises from a mutation in what chromosome?
Nieman-Pick is caused by a mutation in what chromosome?