Path- Test 1

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bbeckers88
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93973
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Path- Test 1
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2011-08-04 00:01:37
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Pathology
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Pathology
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  1. Hypertrophy
    increase in size of cells, not in number of cells
  2. Atrophy
    • wasting of tissues
    • lessened function
  3. Hyperplasia
    increase in number of cells
  4. Hypoplasia
    incomplete development of an organ/tissue
  5. Metaplasia
    reversible replacement of one cell type with another
  6. Barrett's esophagus
    type of metaplasia
  7. anaplasia
    change in the structure of cells and orientation to eachother
  8. Aplasia
    defective development or absence of an organ/tissue
  9. Dysplasia
    • Abnormal tissue growth wtih loss of cell orientation, shape, and size
    • BAD!!!- pre-cancerous
  10. cell injury
    • when the limits of adaptive resonse are exceeded
    • reversible- stress/stimuli persist for a short time
    • irreversible- stress/stimuli persist or is severe
  11. features of reversible cell death
    • cell swelling
    • blebs
    • ribosome detachment from ER
    • swelling of mitochondria
    • nuclear chromatin clumping
    • fatty change
  12. features of irreversible cell death
    • plasma membrane damage
    • Ca influx
    • nuclear condensation, fragmentation, and nucleus dissolution
    • lysosome swelling and rupture
    • calcification
  13. Necrosis
    • cell death
    • cells swell and then burst
    • common after ischemia
  14. apoptosis
    • cell death
    • programmed
    • cell shrinkage
  15. Myocardial Infarction
    • type of cell necrosis
    • leakage of cell content
  16. features of cell necrosis
    • enlarged cell
    • nuclear condensation
    • plasma membrane disruption
    • cell contents enzymatically digested
    • inflammation is frequent
    • pathologic
  17. features of apoptosis
    • smaller cell
    • nucleosome fragments
    • cell contents intact
    • no inflammation
    • physiological
  18. Causes of cell injury
    • O2 deprivation (hypoxia, Ischemia)
    • Physical agents
    • Chemical agents/drugs
    • Infectious agents
    • Immunologic agents
    • Genetic derangements
    • Nutritional imbalances
  19. Mechanisms of cell injury
    • ATP depletion
    • Mitochondrial damage (mitochondrial permiability transition)
    • high intracellular Ca+2
    • O2 deprivation and O2 derived free radicals
    • defects in membrane permiability
  20. Mitochondrial permeability transition
    leakage of cytochrome C into cytosol
  21. Free Radical Injury
    • initiated by many things
    • induces cell injury
    • free radical degredation
    • reperfusion after anoxia induces free radicals
  22. types of oxygen radicals
    • hydrogen peroxide
    • superoxide ion
    • hydroxyl radical
    • nitric oxide
  23. direct toxin
    • something that you ingest that is directly bad for you
    • ex: heavy metals
  24. indirect toxin
    • something ingested that the body turns into something bad
    • ex: CCl4
  25. Dose-dependent toxicity
    drugs which are toxic if taken in large amounts
  26. subcelluar responses to injury
    • induction of SER- hypertrophy
    • lysosomal catabolism
    • mitochondrial alterations
    • cytoskeletal abnormalities
    • heat shock proteins
  27. lysosomal catabolism
    • heterophagy- taking things in
    • autophagy- damage from within
  28. mitochondrial alterations
    • hypertrophy
    • atrophy
    • increase size
    • abnormal cristae
  29. cytoskeletal abnormalities impair:
    • tranport
    • cell architecture
    • cell-cell signaling
    • cell strength
    • cell mobility
    • phagocytosis
  30. heat shock proteins
    • protein folding
    • disaggregation
    • chaperones
  31. coagulative necrosis
    • heart, liver, kideny
    • caused by protein denaturation
    • hypoxic death
    • maintains cells architecture
  32. liguifactive necrosis
    • brain
    • caused by enzymatic digestion
    • bacterial infection
    • stroke
    • no cell architecture
  33. gangrenous necrosis
    • limbs, GI tract
    • loss of blood, coagulative necrosis
    • wet gangrene
    • coagulative + liquifactive bacterial action
    • dry gangrene
    • frost bite
  34. caseous necrosis
    • tuberculosis
    • form of coagulative necrosis
    • cheesey-white appearence
    • no tissue architecture
  35. fat necrosis
    • area of fat destrution
    • pancreas
    • fat soaponification- chalky
  36. apoptosis occurs in:
    • embryogenesis
    • hormone induction
    • cell mediated death
    • regulation of cells
    • atrophy
  37. Agros cell electrophoresis apoptosis vs necrosis
    • apoptosis shows laddered
    • necrosis shows smeared
  38. cytochrome C and apoptosis
    cytochrome C come loose becuase of mitochondrial permiability transmission, cytochromes activate caspase and apoptosis
  39. extrinsic pathway of apoptosis
    • FAS ligand causes grouping of death domains
    • activates caspases
  40. intracellular accumulations caused by:
    • abnormal metabolism
    • mutations causing alterations in protein folding and transport
    • deficiency in enzymes
    • inability to degregade phagocytosed particles
  41. naming accumulations
    • exogenous- outside
    • endogenous- inside
  42. lipid accumulations
    • steatosis (fatty change)- abnormal triglyceride accumulation
    • liver heart kidney
  43. alcohol-induced fatty liver
    • alcoholdehydrogenase
    • alcohols -> ketones
  44. cholesterol
    • foamy
    • macrophage eating
  45. protein accumulations
    • reabsorption droplets- kidenys
    • russell bodies- excess protein synthesis
    • amyloidosis- aggregation of abnormal proteins
  46. hyaline change
    • transparent
    • not specific pattern
  47. glycogen accumulations
    clear vaccules in cytoplasm
  48. pigment accumulation
    • exogenous- coal, tattoos
    • endogenous- lipofusion, melanin, hemosiderin
  49. dystrophic calcification
    • occurs in dying tissues
    • normal serum calcium
    • no calcium metabolism pathology
  50. Metastatic calcification
    • in normal tissues
    • elecated serum calcium -> hyperparathyroidism
  51. Metastatic calcification caused by:
    • increased PTH
    • bone destruction
    • vitamin D
    • renal failure
  52. multiple melanoma
    • lucencies in bone
    • especially in long bones
  53. inflammation =
    reaction of blood vessels causing accumulation of fluid and leukocytes in extravascular tissues
  54. inflammation is protective:
    • eliminates microbes
    • eleiminates narcotic cells
    • prepares for tissue repair
  55. Neutrophils and inflammation
    • ~50%
    • first responder
    • acute inflammation
    • forms pus
  56. lymphocytes and inflammation
    • ~30%
    • chronic inflammation
    • cell mediated responders
  57. monocytes and inflammation
    • ~5%
    • long lived
    • macrophage in tissue
  58. Eosinophil and inflammation
    • ~3%
    • parasites and allergies
  59. Basophil and inflammation
    • <1%
    • allergy and antigen
    • histamine released
  60. how to remember the amount of WBCs in inflammation?
    Never Let Monkeys Eat Bananas
  61. Acute inflammation
    • rapid, short lived
    • edema
    • mainly neutrophils
  62. Chornic inflammation
    • slow onset, long lived
    • new blood vessels
    • fibrosis
    • tissue necrosis
    • macrophages and lymphocytes
  63. vascular changes with acute inflammation
    • vasodilation
    • edema
    • leukocyte accumulation
  64. migration of WBCs
    • rouleaux formation of RBCs
    • pushes WBCs to periphery
    • adhesion
    • pavementing
  65. leukocyte extravasation
    • margination to periphery
    • pavementing
    • -rolling
    • -p- selectin and e-selectin
    • -tight binding by integrins (ICAM-1) and adhesion (TNF and IL-1)
    • extravascular migration-cytokines
  66. lysosome activation
    • recognition and attachment of microbe
    • engulfment
    • fuses with lysosome (secondary phagolysosome)
    • killing and degredation
  67. production of O2 intermediates
    • cytoplasmic oxidase
    • active oxidase
    • membrane oxidase
  68. mediators of inflammation
    • plasma derived
    • cell derived
    • biochemically diverse
    • multifunctional
  69. histamine
    • cell derived mediator
    • biogenic amine
    • stimulates retraction of endothelial cells of venules ( increased permeability)
    • short action
    • inactivated by histaminase
    • (vit C stabalizes mast cells)
  70. bradykinin
    • plasma protein
    • increases permiability of venous system
    • produces pain
  71. other mediators of inflammation
    • seratonin
    • prostaglandins
    • leukotrienes
    • nitric oxide
    • cytokines
    • complement
  72. complement
    • plasma proteins from the liver
    • circulate in inactive form
    • activation thru pathway (C3b)
    • forms active fragments, intermediate complexes, terminal membrane attack complex
  73. functions of active complement
    • opsonization
    • anaphylaxis
    • chemotaxis
    • cell lysis
  74. phagocytosis of bacteria
    • attachement to neutrophil (FC and C3b r/cs)
    • engulf bacteria
    • form phagocytic vaccule
    • degranulation of granules
  75. arachadonic acid
    • derived from phospholipids
    • 2 pathways- lipoxygenase and cyclooxygenase
  76. leukotrienes
    • arachadonic acid derivative
    • chemotaxis, vascular permeability
    • bronchospasm
  77. lipoxins
    • arachadonic acid derivative
    • vasodilation, inhibits monocyte chemotaxis
  78. thromboxane
    • arachadonic acid derivative
    • platelet aggregation
    • thrombosis
  79. prostacyclin
    • arachadonic acid derivative
    • oppses thromboxane
  80. prostaglandins
    • arachadonic acid derivative
    • smooth muscle contractions
  81. omega-3 fish oil is anti-inflammatory
    animal fats are pro-inflammatory
  82. S/Sx of infection/injury
    • acute- fever, increased sleep, decreased apettite, increased neutrophils
    • endothelial effects- increased leukocyte adherence and procoagulent and IL-1, decreased anticoagulent
    • fibroblast- increased proliferation, collagen synthesis, PGE
    • Leukocyte effects- increased cytokines
  83. cause of a fever
    • macrophage eat bacteria
    • TNF and IL-1 to hypothalamus
    • increase temperature
  84. endothelial nictic oxide
    • causes platelet adhesion
    • reduced leukocyte adhesion
    • smooth muscle vasculature relaxation- vasodilation
    • activated by Ca influx
  85. inducible nitric oxide
    • activated by cytokines and TNF
    • acts in macrophage
    • to microbe or endothelium of nearby vasculature
  86. specific granules
    • secondary
    • smaller
  87. azurophil granules
    • primary
    • larger
  88. injury causing acute inflammation can lead to:
    • resolution
    • pus formation
    • fibrosis
    • chronif inflammation = FIBROSIS!!!
  89. resolution of inflammation
    • return to normal vascular permiability
    • drain edema thru lymphatics and macrophages (pinocytosis)
    • phagocytosis of apoptotic neutorphils and necrotic debris
    • disposal of macrophages
    • macrophage secrete growth factor
  90. serous inflammation
    • early stage fluid build-up (usually under skin)
    • jt swelliung
    • eczema
    • skin burn
    • infection of skin vesicles
    • effusion- if secreted from peritoneal, pleural, pericardial linings
  91. fibrinous inflammation
    fibrin deposits
  92. purulent inflammation
    pus build-up
  93. Brain abscess
    neutrophil apoptosis not cleaned up by macrophages
  94. abcess
    encapsulated pus
  95. sinus
    connection to surface
  96. fistula
    opening/connection without infectious material
  97. granuloma
    • lymphocytes
    • macrophages
    • multinucleated giant cells
    • scar tissue formation
  98. mononuclear phagocyte maturation
    bone marrow -> blood (monocyte) -> tissue (macrophage)
  99. signs of chronic inflammation
    • fibrosis
    • growth factor
    • tissue injury- nitric oxides
  100. macrophage activation
    • recruited via chemotaxis
    • division
    • immobilization by cytokines and oxidized lipids
    • CAUSES AGGREGATION
  101. macrophages in chronic inflammation
    • activation of INF-gama
    • presents to T cells
    • recruits other cells
    • activated T cell recruitment
  102. tissue regeneration
    • area of organ removed
    • remaining organ hypertrophies to make up for removed portion
  103. tissue regeneration mediated by
    • priming- cytokines, TNF
    • proliferation- growth factors
    • growth inhibition
  104. collagen synthesis
    • translation
    • helix formation
    • propeptide cleavage
    • collagen!
  105. fibronectin
    2 glycoprotein chains held together by disulfide bonds
  106. two forms of angiogenesis
    • endothelial precursor cells from bone marrow
    • angiogenesis from pre-existing vessels
  107. matrix metalloproteinase
    • zinc dependent
    • regulate growth factors
    • inhibit steroids
    • activation of zymogens
  108. primary intention wound healing
    • edges next to each other
    • little tissue loss
    • minimal scaring
    • closure at initial evaluation
  109. secondary intention wound healing
    • wound granulates!
    • wound is packed
    • broad scarslow healing
  110. tertiary intention wound healing
    • delayed primary intention
    • cleaned and observed
    • left open
  111. keloid
    excess collagen deposition causing a raised scar
  112. neoplasia
    • NOT equal to a tumor
    • new growth
  113. tumor
    • equal to neoplasia
    • swelling/mass formation
  114. cancer
    tissue invation/crab-like
  115. oncology
    swelling
  116. reversible plasias
    • hyperplasia
    • metaplasia
    • dysplasia
  117. irreversible plasias
    • anaplasia
    • neoplasia
    • desmoplasia
  118. benign tumors
    • slow
    • expansive/encapsulated
    • no metastases
    • smooth
    • no necrosis or hemorrhage
    • looks like normal tissue
    • normal nuclei
    • few mitosis
  119. malignant tumors
    • fast
    • invasive/metastases
    • no capsule
    • necrosis and hemorrhage
    • does not look like normal tissue
    • pleomorphic nuclei
    • many, irregular mitoses
  120. metastasis
    • invading other tissues
    • thru: lymphatics, blood, body cavities, intraepithelial
  121. blood metastasis
    • hematogenous
    • primary tumor creates a clone
    • clone proliferates and transportates in blood
    • clot= embolization
    • invasion into new tissue
    • makes new tumor
  122. body cavity metastasis
    • transcoelomic spread
    • direct seeding of cavity by cells in that cavity already
  123. intraepithelial metastasis
    tumor cells infiltrate between epithelial cells
  124. how big can a tumor get before it needs blood?
    10mm
  125. angiogenesis via tumor
    • chemotactis
    • fibroblast growth factor
  126. mesenchymal tumor naming
    • benigh= cell origin + oma
    • malignant = cell origin + sarcoma
  127. epithelial tumor naming
    • benign= name + oma
    • malignant= name + carcinoma
  128. eponymic tumors
    named after the person that found them
  129. hodgkin's disease
    lymph node tumor
  130. ewings sarcoma
    bone tumor
  131. kaposi's sarcoma
    skin, AIDS
  132. Tumor staging
    • clinical assessment
    • extent of spread
    • better rating than grading
  133. tumor grading
    histological assessment
  134. biochemistry of cancer cells
    • quantitative
    • cancer cell less differentiated, require less oxygen, fewer mitochondria and sepecialized enzymes
  135. tumor cell regression
    • aquiring embryonic/fetal features
    • fetal protein- liver cells make alpha-fetoprotein
    • embryogenic glycoproteins- carcinoembryonic antigen- large intestines
  136. growth of cancer in vitro
    • lack of contact inhibition
    • anchorage independant growth
    • can be passaged indefinitely
  137. causes of cancer
    • exogenous: chemical, physical, and biological
    • endogenous: oncogenes, tumor suppressor cells
  138. action of chemical carcinogens
    • local action
    • site of digestion/absorption
    • metabolic action- excretion
  139. 3rd hand smoke
    • BAD!
    • residual smoke particles left around after smoking, linger forever!
  140. chemical carcinogenesis
    • 1. initiation/absorption (irreversible changes)
    • 2. promotion (proliferates by promoters)
    • 3. conversion (new cell type, self-proliferates)
    • 4. progression (new genetic feature)
    • 5. colonal expansion
  141. physical carcinogens
    • UV light
    • x rays
    • radioactive isotopes
    • atomoic bomb
  142. action of viral carcinogens
    • integration of viral DNA
    • transduction (acute transforming RNA viruses- FORM ONCOGENES!!)
    • insertion (slow transforming RNA, insert into genome- ACTIVATE ONCOGENES!)
  143. human papilloma virus
    • Human viral carcinogenes
    • invasive
    • cervical carcinoma 16, 18!!!!
    • penile, anal carcinomas
  144. epstein-barr virus
    • Human viral carcinogenes
    • burkitt's lymphoma
    • nasopharyngeal carcinoma (sun)
  145. Hep B and C
    • Human viral carcinogenes
    • liver cancer
  146. Karposi's sarcoma
    • Human viral carcinogenes
    • associated with herpesvirus
    • skin cancer
    • AIDS
  147. Human T cell leukemia
    • Human viral carcinogenes
    • lymphoma virus
    • HIV
    • adult
    • RNA virus
  148. human oncogenes
    • viral oncogenes
    • cellular oncogenes
    • proto-oncogenes (inactive)
    • ongogene is active form, cancer-inducing
    • only needs damage to 1 allele to cause cancer
  149. activating proto-oncogenes
    • point mutation
    • gene amplification
    • chromosomal rearrangement
    • insertion of viral oncogene
  150. tumor suppresor genes
    • protective against oncogenes
    • if BOTH alleles are lost, can not protect = CaNcEr!!!
  151. hereditary cancers
    • neurofibromastosis 1
    • familial adenomatous polyposis coli
    • wilms tumor
    • xeoderma pigmentosum
    • chromosomal fragility
  152. immunotherapy- cancer
    • thumors involute spontaneously to normal
    • BCG for bladder cancer
    • tumor vaccines- for melanoas, renal cells
  153. tumor markers
    NOT primary diagnostic tool
  154. neoplasia manifestations
    • local- diminished funtion, space occupying
    • systemic- cachexia, anorexia, paraneoplastic syndromes
  155. paraneoplastic syndromes
    neoplaias mimicing nearby normal cells
  156. 7 warning signs of cancer- CAUTION!
    • Change in bowel habits
    • A sore that doesnt heal
    • Unusual bleeding/discharge
    • Thickening/lump
    • Indigestion/difficulty swallowing
    • Obvious change in wart or mole
    • Nagging cough/hoarsness of voice
  157. factors determining tumor features
    • type
    • location
    • grade
    • stage
    • host immune status
    • sensitivity to therapy
  158. psammoma bodies found in:
    • papillary adenocarcinoma of the thyroid
    • ovary papillary cystadenocarcinoma
    • menigngioma
    • malignant mesothelioma
  159. psammoma bodies
    • laminated concentric calcific spheres
    • form infarct/calcification of papillae tips
    • calcification of intralymphatic tumor thrombi
  160. incidence
    # of new cases in a population over a time
  161. prevalence
    # of cases in a population over a given time
  162. mortality
    # of deaths in a population over time
  163. morbidity
    # of people having a disease
  164. risk factor: smoking
    • causes lung cancer
    • Sx: cough
  165. risk factor: family history
    • breast cancer
    • sx: lump

    • colon cancer
    • sx: blood in stool
  166. risk factor: promiscuity
    • cervical cancer
    • sx: vaginal bleeding
  167. risk factor: hormonal
    • uterine cancer
    • sx: vaginal bleeding
  168. risk factor: sun
    • skin cancer
    • sx: skin lesion
  169. risk factor: old age
    • prostate cancer
    • sx: dysuria
  170. female cancer incidence
    • breast
    • lung/bronchi
    • colorectal
  171. male cancer incidence
    • prostate
    • long/bronchi
    • colorectal
  172. female cancer mortality
    • lung/bronchi
    • breast
    • colorectal
  173. male cancer mortality
    • lung/bronchi
    • prostate
    • colorectal
  174. cancers often metastasis to:
    liver, lungs, brain, bone
  175. tumors that metastasis to liver
    colon, somtach, pancreas, breast, lung
  176. tumors that metastasis to lung
    breat, GI, kidney, melanoma, lymphoma, leukemia
  177. tumors that metastasis to brain
    lung, breast, kidney, skin, GI
  178. tumors that metastasis to bone
    breast, prostate
  179. exudate
    • righ in cells
    • inflammation
  180. transudate
    • few cells
    • ultra-filtrate
    • specific gravity < 1.012
  181. factors of edema
    • increased hydrostatic pressure and wall permiabilitydecreased oncotic pressure
    • lymphatic obstrution
  182. inflammation and edema
    • increased permeability
    • hyperemia
  183. hydrostatic edema
    • hypertension
    • increased venous back pressure
  184. oncotic-hypoalbuminemia edema
    • proteinuria
    • decreased protein synthesis
  185. obstructive edema
    • b/c tumor/chronic inflammation
    • elephatitis
  186. hyperemia
    • active: dilation of arterioles
    • passive: venous back pressure
  187. chronic passive congestion of lungs causes:
    • edema
    • RBC extravasation into alveoli
    • anoxia
    • pulmonary fibrosis
    • hemosiderin accumolatino b/c of macrophages
  188. consequences of massive hemorrhage
    • blood loss
    • hypovolemic shock
    • exsanguination
    • death!!
  189. consequences of hemorrhage
    • hematoma-compression of tissue from blood
    • intracerebral hemorrhage- stroke/death
    • chronic hemorrhage- slow blood loss, iron defiency anemia
  190. blood amount lost for shock
    • <500 ml- homeostatic compensation
    • 1000-1500ml- circulatory shock
    • >1500- death
  191. thrombosis
    • clotting!!
    • mass of RBCs and fibrin
  192. intravascualr coagulation is a result of:
    • coagulation factors
    • platelets
    • endothelial cells
  193. clotting factors lead to prothrombin-> thrombin
  194. formation of thrombi
    • wall defect covered with fibrin and platelets
    • fibrin anchors RBCs - nascent thrombosis
    • full thromus of RBCs and fibrin
  195. pathology of thrombus
    • intramural heart thrombi
    • valvular heart thrombi
    • arterial thrombi
    • venous thrombi
    • microvascular thrombi
  196. deep venous thrombosis
    • virchows tirad
    • 1. stasis
    • 2. hypercoagulability
    • 3. endothelial damage
    • can lead to pulmonary embolism
  197. fate of thrombi
    • infarct
    • lysis and reperfusion
    • organization (rerouting blood vessles)
    • recanalization- emobolization -> infarct
  198. embolism
    • blockage!!
    • thromboemboli
    • liquid emboli
    • gaseous emboli
    • solid particle emboli
    • amniotic fluid emboli

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