fa pathology q's

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y Stack - pathology q's Table Review

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pathology q's

Question Answer

What is apoptosis and what are the

wo pathways

programmed cell death, intrinsic or extrinsic

What is the energy requirement forpoptosis

ATP

n which scenarios does apoptosisccur via the intrinsic pathway

embryogenesis, hormone induction (menstruation), atrophy(endometrial lining during menopause), result of injurious stimuli likradiation, toxins, hypoxia)

What changes occur, and what dohey lead to

levels of anti and pro apoptotic factors leading to inc mito permeabiand release of cytochrome c

What are the signals for the extrinsicathway

ligand receptor interactions -Fas ligand binding Fas (CD95) or killercells

What substances mediate the effectsf the extrinsic pathway

perforin and granzyme

oth pathways activate whichytosolic enzymes that mediateellular breakdown

caspases

What are the characteristics ofpoptosis

cell shrinkage, nuclear shrinkage and basophilia (pyknosis), membblebbing, pyknotic nuclear fragmentation (karyorrhexis), nuclear fad(karyolysis), and formation of apoptotic bodies, which arephagocytosed - no inflammation

What is the term for enzymaticegradation and protein denaturationf a cell resulting from exogenous

njury

necrosis

What happens to intracellularomponents in necrosis

extravasate

What kind of process is necrosis inflammatory

Where does coagulative necrosisccur

heart, liver, kidney

Where does liquefactive necrosis

ccur brain, bacterial abscess, pleural effusion

When does caseous necrosis occur TB, systemic fungi

Where does fatty necrosis occur pancreas (saponification)

Where does fibrinoid necrosis occur blood vessels

When does gangrenous necrosisccur

dry in ischemic coagulative, wet with bacteria: common in limbs andtract

What are the pro/anti apoptoticroteins and which is which

Bax is pro and Bcl-2 is anti


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What cell injuries are reversible withO2

dec ATP synth, cellular swelling from a lack of ATP (no Na/K pumpnuclear chromatin clumping, dec glycogen, fatty change, ribosomaldetachment (dec protein synthesis)

What cell injuries are irreversiblenuclear pyknosis, karyolysis, karyorrhexis; Ca2+ influx leading tocaspase activation; plasma membrane damage; lysosomal rupturemitochondrial permeability

What kind of infarcts are red andwhere do they occur

hemorrhagic, occur in loose tissues or with collaterals, such as liverlungs intestine or following reperfusion

Where do pale infarcts occur solid tissues with single blood supply such as heart, kidney, and sp

What is reperfusion injury due to damage by free radicals

What is atrophy and what are theauses

reduction in the size or number of cells - dec in hormones, decinnervation, dec blood flow, dec nutients, inc pressure, occlusion ofsecretory ducts

n which organs does atrophy occurecause of a lack of hormones

uterus and vagina

n what scenario does atrophy occura dec innervation

motor neuron damage

n which scenario does atrophyccur via inc pressure

nephrolithaisis

n which scenario does atrophyccur via occlusion of secretoryucts

CF

What are the characteristic findingsn inflammation

rubor, dolor, calor, tumor and functio laesa

What aspects of the inflammatoryrocess cause fluid exudation

inc vasc perm, vasodltn, endothelial injury

What aspects of the inflammatoryrocess cause fibrosis

fibroblast emigration and proliferation; deposition of extracellular ma

What occurs in the resolution of annflammatory process

restoration of nl structure

What is granulation tissue highly vascularized, fibrotic

What is an abscess fibrosis surrounding pus

What is a fistula abnl communication

What is scarring collagen deposition resulting in altered structure or fxn

What cells/substances mediate

cute inflammation and what is theme of onset and how long does it

ast

PMNs, eosinophils, antibody - rapid onset, lasts minutes to days

What cells mediate chronicnflammation and how isharacterized

mononuclear cells, persistent destruction and repair, assocaited witblood vessel proliferation, fibrosis and granuloma

What is a granuloma nodular collections of epitheliod MACS and giant cells

What is the first step of leukocytextravasation what molecules

rolling, E/P selectin, sialyl lewisX


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mediate on the vasc/stroma and theeukocyte

What is the second step of leukocytextravasion and what molecules

mediate on the vasc/stroma and theeukocyte

tight binding, ICAM-1, LFA-1 (integrin)

What is the 3rd step of leukocytextravasation and what molecules

mediate on vasc/stroma and theeukocyte

diapedesis, PECAM-1, PECAM-1

What is diapedesis leukocyte travels between endothelial cells and exits blood vessels

What is the 4th step of leukocytextravasation and what molecules

mediate on the vasc/stroma andeukocyte

migration, bacterial products and CILK (C5a, IL-8, LTB4, Kallikrein)and various leukocyte binders

What happens in leukocyte migrationleukocyte travels through interstitium to site of injury or infection guby chemotactic signals

ow do free radical damage cells membrane lipid peroxidation, protein modification, DNA breakage

ow are free radicals initiatedradiation exposure, metabolism of drugs in phase 1, redox reactionnitric oxide, transition metals, leukocyte oxidative burst

ow are free radical eliminated enzymes

n what pathology of the eye is freeadical injury the cause

Retinopathy of prematurity - O2 toxicity

n what pathology of the lungs is freeadical injury the cause

bronchopulmonary dyslpasia

What free radical damage leads to

ver necrosis

CCi4 leading to fatty change

What drug can cause free radicalnjury

Acetominphen

Overload of what metal can causeee radical injury

Iron

Reperfusion free radical injury canccur after what scenario

anoxia, especially aftery thrombolytic therapy

What are the 8 granulomatousiseases

TB, fungal infnx, syphillis, leprosy, cat scratch fever, sarcoidosis,crohns, berylliosis

What substance do Th1 cells secreteo activate MACS and what do

MACS secrete to maintainranuloma formation

IFN-gamma, and TNF alpha

What drugs can lead toisseminated disease in patients

with granulomasanti-TNF

Which is hyocelluar - transudate orxudate

transudate

Which is protein rich - transudate or


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xudateexudate

Which has a specific gravity > 1.020 exudate

What are the causes of a transudate inc hydrostatic pressure, dec oncotic pressure, Na retention

What are the causes of an exudate lymphatic obstruction, inflammation

What causes an elevated ESRproducts of inflammation coat RBCs and cause aggregation - whenaggregated fall at a faster rate within the test tube

What are the causes of elevatedSR infections, inflammation (temporal arteritis), cancer, pregs, SLE

What are the causes of e decreasedSR

sickle cell, polycythemia (too many), CHF (unknown)

What is a leading cause of fatalityom toxilogic agents in children and

what is the MOIiron poisoning, cell death due to peroxidation of membrane lipids

What are the symptoms of ironoisoning in acute and chronic

acute - gastric bleeding, chronic - metabolic acidosis, scarring leadito GI obstruction

eta pleated sheets demonstratable

y apple green birefringence ofCongo red stain under polarized light

amyloidosis

ow does the affected tissue appearn amyloidosis

waxy

What is the protein in primarymyloidosis and where is it derivedom

ligh chain, Ig light chains (multiple myeloma)

What is the protein in secondarymyloidosis and where is it derivedom

acute phase reactant, serum amyloid-associated protein (chronicinflammatory disease)

What is the protein in senile cardiacmyloidosis

transthyretin

What is the protein in amyloidosiswith DM type 2

amylin

What is the protein in amyloidosiswith medullary carcimona of thehyroid and what is it derived from

A-CAL, calcitonin

What is the protein in amyloidosiswith alzheimers and what is it

erived from

beta amyloid, amyloid precursor protein

What is the protein in dialysisssociated amyloidosis and what is iterived from

beta2 microglobulin, MHC class 1 proteins

What are the findings inypovolemic/cadiogeneic shock inerms of ouput, TPR, CO, skin temp

low-output TPR, inc TPR, low CO, cold clammy

What are the findings in septic shockn terms of output, TPR, venous

high output failure, dec TPR, dilated arterioles, high venous return, pt


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eturn skin temp

What are the hallmarks of cancerevading apoptosis, self-sufficiency in growth signals, insensitivity toantigrowth signals, sustained angiogenesis, limitless replicativepotential, tissue invasion and metastasis

What is it called when cells havencreased in number

hyperplasia

bnl proliferation of cells with lozz of

ze, shape and orientation

dysplasia

ave neoplastic cells invaded theM in carcinoma in situ

no - preinvasive

What is the N/C ration in neoplastichanges

high

n carcinoma in situ, what amount ofhickness do neoplastic cellsepresent and are the cells polyconalr monoclonal

entire thickness, monoclonal

What do cells use to invade the BM

n invasive carcinoma collagenases and hydrolases

t what point are invasivearcinomas able to metastasize

once they reach a lymph or blood vessel

What is the seed and soil theory ofmetastasis

seed

What changes in cadherin, integrin,nd integrin receptors occur in

metastatic diseasedec cadherin, inc laminin, inc integrin receptors

s hyperplasia reversible or

reversible

reversible

What happens in metaplasia and is iteversible

one adult cell type is replaced by another, often 2ndary to irritationand/or environmental exposure like sqamous metaplasia in tracheaand bronchi of smokers; reversible

What happens in dysplasia and is iteversible

abnl growth with loss of cellular orientation, shape, and size incomparison to nl tissue; commonly perneoplastic; reversible

What happens in anaplasia and is iteversible

abnl cells lacking differentiation; primitive cells of same tissue, oftenequated with undiff malignant neoplasms - little or no resemblence tissue of origin; irreversible

What happens in neoplasia and is it

eversible

clonal differentiation of cells that is uncontrolled and excessive;

irreversible

What happens in desmoplasia and isreversible

fibrous tissue formation in response to neoplasm; irreversible

What is the tumor gradedegree of cellular differentiation based on histologic appearance of tumor

ow are tumors gradedI-IV; degree of differntiation and number of mitoses per high powerfield, character of tumor itself

What is tumor stagedegree of localization/spread based on site and size of primary lesiospread to regional lymph nodes, presence of metastases; spread of


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tumor in a specific patient

Which usually has more prognosticalue, grade or stage

stage - usually

What neoplasm is associated withDown syndrome

ALL, AML

What neoplasm is associated withP, albinism

melanoma, basal cell carcinoma - esp sqaumous cells carcinoma othe skin

What neoplasm is associated withhronic atrophic gastritis, perniciousnemia, postsurgical gastricemnants

gastric adenocarcinoma

What neoplasm is associated withuberous sclerosis (facialngiofibromas, seizures, mentaletardation)

astrocytoma, angiomyolipoma, cardiac rhabdomyoma

What neoplasm is associated withctinic keratosis

squamous cell carcinoma of the skin

What neoplasm is associated witharrets esophagus

Esophageal carcinoma

What neoplasm is associated withlummer-vinson syndrome (atrophiclossitis, esophageal webs, anemiaue to iron def)

squamous cell carcinama of esophagus

What neoplasm is associated withrrhosis (EtOH, HBV, HCV)

HCC

What neoplasm is associated withlcerative colitis

colonic adenocarcinoma

What neoplasm is associated withagets diease of bone

2ndary osteosarcoma and fibrosarcoma

What neoplasm is associated witheing immunoCised

malignant lymphoma

What neoplasm is associated withIDS

aggressive malignant lymphomas (non Hodgkins) and KS

What neoplasm is associated withutoimmune disease

lymphoma

What neoplasm is associated with

canthosis nigricans visceral neoplasm - stomach, lung, breast, uterus

What neoplasm is associated withysplastic nevus

malignant melanoma

What neoplasm is associated withadiation exposure

sarcoma, papillary thyroid cancer

With oncogenes and gain of function,ow many alleles need to beamaged to cause cancer

one

What tumor is associated with abl,


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nd what gene product does it codeor

CML, tyrosine kinase

What tumor is associated with c-mycene and what does it code for

burkitts lymphoma, transcription factor

What tumor is associated with bcl-2nd what does it code for

follicular and undifferentiated lymphomas, anti apoptotic molecule

What tumor is erb-2 associated with

nd what does it code for

breast, ovarian, gastric carcinomas, tyrosine kinase

What tumor is assocaited with rasnd what does it code for

colon carcinoma, GTPase

What tumor is associated with L-mycnd what does it code for

lung, transcription factor

What tumor is associated with N-myc and what does it code for

neuroblastoma, transcription factor

What tumor is associated with retnd what does it code for

MEN types II and III, tyrosine kinase

What tumor is c-kit associated withnd what does it code for gastrointestinal stromal tumor (GIST), cytokine receptor

With tumor suppressor genes andoss of function how many allelesmust be lost to cause cancer

two

What tumor is Rb (13q) associatedwith and what does it do

retinoblastoma, osteosarcoma, blocks G1 to S phase of cell cycle

What tumor is p53 (17p) associatedwith and does it do

most human cancers, Li-Fraumeni, blocks G1 to S

What tumor is BRCA1 (17q)

ssociated with and what does it dobreast, ovarian, DNA repair protein

What tumor is BRCA2 (13q)ssociated with and what does it do

breast, DNA repair protein

What tumor is associated with p169p)

melanoma

What tumor is associated with APC5q)

colorectal cancer, esp in FAP

What tumor is associated with WT111p)

wilms tumor

What tumor is associated with NF117q)

neurofibromatosis type 1

What tumor is associated with NF222q)

neurofibromatosis type 2

Wht tumor is associated with DPC18q)

pancreatic cancer

What tumor is associated with DCC18q)

colon cancer

What is PSA used forProstate specific antigen, used to screen for prostate carcinoma, ca


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be elevated in BPH and prostatitis

What is prostatic acid phosphatasesed for

prostate cancer

What is CEA used forcarcinoembryonic antigen - non specific, produced by around 70% colorectal and pancreatic cancers, also produced by gastric, breastand thyroid medullary carcinomas

What cancer is alpha fetoprotein

sed to screen for

HCC, nonseminomatous germ cell tumors of the testis (yolk sac tum

What cancer does hCG used tocreen for

hydatidiform moles, choriocarcinomas and gestational trophoblastictumors

What cancer is CA-125 used tocreen for

ovarian, malignant epithelial tumors

What cancer is S100 used to screenor

melanoma, neural tumors, astrocytomas

What cancer is alk phos used tocreen for

metastases to bone, obstructive biliary disease, pagets disease ofbone

What cancer is bombesin used tocreen for neuroblastoma, lung and gastric cancer

What cancer is TRAP used to screenor

tartrate-resistant acid phosphatase, Hairy cell leukemia - a B cellneoplasm

What cancer is A-19-9 used tocreen for

pancreatic adenocarcinoma

What cancer is calcitonin used tocreen for

thyroid medullary carcinoma

What are tumor markes used forconfirm diagonsis, monitor tumor recurrence, monitor response totherapy

What cancer does HTLV-1 cause adult T cell leukemia/lymphoma

What cancer does HBC/HCV cause HCC

What cancer does EBV cause butkitts, nasopharyngeal carcinoma

What cancer does HPV cause cervical carcinoma (16, 18), penile/anal carcinoma

What cancer doe HHV-8 cause kaposi's sarcoma body cavity fluid B-cell lymphoma

What cancer does HIV cause primary CNS lymphoma

What cancer does H. pylori cause gastric adenocarcinoma and lymphoma

What cancer does schistosoma

ause

squamous cell carcinoma of transitional epitheliam in the bladder

What cancer is caused by alftoxinsnd what fungus produces them

HCC, aspergillus - in peanuts

What cancer does vinyle chlorideause

liver (angiosarcoma)

What cancer does CCl4 cause liver (centrolobular necrosis, fatty change)

What cancer does nitrosaminesause and where do you find it

esophagus, stomach, smoked foods

What cancer does cigarrette smoke larynx (squamous cell carcinoma, lung (squamous and small cell


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ause carcinoma), kidney (RCC), and bladder (TCC)

What cancer does asbestos cause lung mesothelioma and bronchogenic carcinoma

What cancer does arsenic cause skin (SCC) and liver (angiocarcinoma)

What cancer does napthalene dyesause

bladder cancer (TCC)

What cancer do alkylating agentsause

blood (leukemia)

What paraneoplastic affects of smallell carcinoma

ACTH or ACTH like peptide creating cushings

What is the paraneoplastic effect ofmall cell lung carcinoam AND

ntracranial neoplasmsADH creating SIADH

What is the paraneoplasitc effect ofquamous cell carcinoma, RCC andreast carcinoma

PTH related peptide, TGF-beta, TNF, IL-1 causing hypercalcemia

What is the paraneoplastic effect ofRCC and hemangioblastoma

EPO causing polycythemia

What is the paraneoplastic effect ofhymoma and small cell lungarcinoma

antibodies against Ca channels at NMG - Lambert Eaton

What is the pareneoplastic effect ofeukemias and lymphomas

hyperuricemia due excess nucleic acid production, gout urateneuropathy

nder what cirumstances do you seesammoma bodies

papillary adencarcinoma, serous papillary cystadenocarcinoma,meningioma, malignant mesothelioma

What is a psammoma body laminated, concentric, calcific spherules

What are the top 3 cancers in men -

ncidence prostate, lung, CRC

What are the top 3 cancers inwomen - incidence

breast, lung, CRC

What are the top 2 cancers in men -mortality

lung, prostate

What are the top 2 cancers inwomen - mortality

lung, breast

What is the trend in lung cancereaths among men and women

plateaued in men, rising in women

ow high is cancer in the causes ofeath in the US

2nd

What are the primary tumors thatmestasize to the brain

lung, breast, kidney, skin, GI

What percentage of brain tumors areom metastases and how do theyppear on imaging

50, multiple well-circumscribed tumors at grey-white jxn

Which primary tumors met to theung

colon > stomach > pancrease > breast > lung


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What are the primary tumors thatmet to bone

prostate, thyroid, testes, breast, lung, kidney - breast and prostatemost common

Which bone mets are lytic and whichre blastic

lung

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