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Pathology HM 561
N/A
78
Medical
Graduate
03/30/2013

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Cards

Term
Define "lesion."
Definition
any pathologic abnormality in a cell, tissue, or organ
Term
Distinguish between a functional and structural lesion.
Definition

structural - morphologically detectable

functional - biochemically detectable

Term
Which type of lesion occurs first (structural or functional)? What is the progression of lesions?
Definition
biochemical functional lesion--->detectable structural lesion (ultruastructural--->histologic--->naked eye)
Term
Define "pathogenesis."
Definition
the actual response of cells that leads to lesions and disease
Term
Define "etiology."
Definition
the actual cause of disease
Term
Distinguish between an adapted and injured cell.
Definition

adapted:exists in altered homeostatic state

 

injured: unable to maintain homeostatic state (reversible: cell swelling, steatosis; irreversible: necrosis)

Term

What proliferative capacity (labile, stable, or permanent) do the following set of cells possess?

 

hematopoietic, mucosal, epidermis

Definition
labile
Term

What proliferative capacity (labile, stable, or permanent) do the following set of cells possess?

 

parenchymal, mesechymal, endothelial

Definition
stable (existing in G0 phase)
Term

What proliferative capacity (labile, stable, or permanent) do the following set of cells possess?

 

neurons, cardiac myocytes, skeletal muscle

Definition
permanent (unable to multiply once fully differentiated)
Term
Define hyperplasia
Definition
controlled, increase in cell number of labile or stable cells; reversible
Term

What type of hyperplasia is caused by the following?

 

excessive hormonal stimulation

chronic irritation or injury

increased functional demand

viral infection

 

Definition

pathologic hyperplasia

 

Term
Define hypertrophy.
Definition
increased cell size (more organelles and larger nucleus) due to increase in metabolic activities; reversible
Term

What type of hypertrophy is caused by the following?

 

hormonal stimulation

increased functional demand

Definition
physiologic hypertrophy
Term

What type of hypertrophy is caused by the following?

 

excessive hormonal stimulation

increased functional demand

Definition
pathologic hypertrophy
Term
Can all cell types that undergo hypertrophy also undergo hyperplasia?
Definition
No. Permanent cells can undergo hypertrophy but not hyperplasia.
Term
Define atrophy. How is it different from hypoplasia?
Definition

decreased size and number with increased protein degradation and decreased metabolic activity; reversible


hypoplasia: organ never obtained normal size to begin with.

Term
What type of atrophy is driven by apoptosis during embryogenesis or hormonoal regulation?
Definition
physiologic atrophy
Term

What type of atrophy is caused by the following?

 

decreased functional workload (diffuse atrophy)

decreased nutrient supply (e.g. less blood flow)

decreased neural stimulation (denervation atrophy)

decreased hormonal stimulation

pressure (pressure atrophy - direct pressure on cells)

aging (senile atrophy)

Definition
pathologic atrophy
Term
Define metaplasia.
Definition
substitution of once fully differentiated cell type with another; via reprogramming stem cell; reversible;
Term
What are two main causes of metaplasia?
Definition

chronic irritation

nutrutional deficiency

Term
What is a major tradeoff of metaplasia?
Definition
loss of specialization
Term

What morphological event of cell injury do the following characteristics belong to?

 

increased cell size; loss of basophila (fewer ribosomes); cytoplasmic pallor; nuclear enlargment; blebbing and loss of surface speacializations

 

[image]

[image]

 

Definition
cell swelling; as a result of decreased ATPase action (from a loss of ATP due to hypozia-induced mitochondrial impairment) and many ions rushing in...making cell hypertonic.
Term
What is the main event that characterizes the sublethal--->lethal damage transition?
Definition
cessation of mitochondrial function and subsequent depletion of ATP stores
Term
Distinguish between fatty infiltration and fatty change (steatosis).
Definition

infiltration - lipid accumulation within intervening stroma (can compress parenchyma but will not damage it)

 

steatosis - lipid accumulation within parenchyma

Term

What event of cell injury is characterized by the following?

 

presence of microscopic lesions that appear as clear vacuoles within parenchymal cells; paler yellow; more rounded lobes in case of liver

 

[image]

displaces nucleus to periphery; confirmed by red oil stain

 

[image]

Definition
steatosis; reversible
Term
Describe the abnormal lipid metabolism induced by alcoholism.
Definition

alcoholism--->increased FA mobilization + ethanol--->acetaldehyde (excess byproduct: NADH)

NADH--->triglyceride synthesis--->impaired export of lipoproteins + less FA oxidation in mitochondria

 

[image]

[image]

Term
What is hyaline?
Definition
proteinaceous material with homogenous eodinophilic glassy HE appearance
Term
What are the three types of intracellular hyaline?
Definition

Mallory bodies (alcoholic hyaline)

Russel bodies (Ig accumulations in plasma cells)

Protein reabsorption droplets

Term

What irreversible cell injury process is characterized by the following features?

 

loss of membrane integrity

leakage of cellular contents

unrestricted entry of Ca2+ ions

Definition
necrosis
Term

What type of necrosis is shown here?

 

[image]

Definition
coagulative
Term

What type of necrosis is shown here?

 

[image]

 

[image]

Definition
enzymatic fat necrosis
Term

What type of necrosis is shown here?

 

[image]

Definition
liquefactive
Term

What type of necrosis is shown here?

 

[image]

Definition
caseous
Term

What type of necrosis is shown here?

 

[image]

Definition
fibrinoid
Term

What type of necrosis is shown here?

 

[image]

Definition
gangrenous
Term
What are the major distinctions between necrosis and apoptosis?
Definition

necrosis - accidental, enlarged (swelling); pathologic (many cells at a time), triggers inflammation; disrupted cell membraneleakage of digested cell contents out of cell; 

 

apoptosis - programmed (few cells at a time, with specific enzymes), reduced (shrinkage), may be pathologic or physiologic, does not trigger inflammation (because resultant debris is cleared via MQ's)

Term

Distinguish between the following types of hyaline cell accumulations.

 

[image]

Definition

A - MDB

 

B - Russell Bodies

 

C - Protien Reabsorption Droplets (notice some protein leakage into the lumen)

Term

Identify the following exogenous cellular accumulations.

 

[image]

E.

[image]

F.

[image]

 

G. What two types of endogenous accumulations are shown in the two A's below? How are they distinguished from one another in B?

[image]

Definition

A. Normal Lung

 

B. Anthracosis (mild) - carbon

 

C. Pnumoconiosis - inhaled dust; inflammatory

 

D. Silicosis - silica

 

E. Asbestiosis - with asbestos fiber sticking out of MQ

 

F. Hypercaritenemia

 

G. Hemosiderin and Lipofuscin - distinguished by adding Prussian blue = blue hemosiderin granules.

Term
Distinguish between dystrophic and metastatic calcification.
Definition

dystrophic - in damaged/dying tissue; not associated with high blood Ca2+ levels

 

metastatic - normal tissue; due to high blood Ca2+

Term
[image]
Definition
apoptosis (single cells affected at a time)
Term
[image]
Definition
coagulative (most common type from hypoxia)
Term

Define:

- Karyohexis

- Karyolysis

- Pyknosis

Definition

- nuclear fragmentation

- disappearance of nuclear material

- nuclear condensation and reduced size

Term
Distinguish between the extrinsic pathway and intrinsic pathway of apoptosis.
Definition

extrinsic - death receptors involved

intrinsic - mitochondrial

Term
What are ghost cells (seen only in enzymatic fat necrosis)?
Definition
cells fille with pink necrotic debris but have lost their peripheral nuclei
Term
Which hypoxia-induced type of necrosis involves formation of cysts?
Definition
liquefactive necrosis
Term
List the three purposes of inflammation.
Definition

- containment of injury

- elimination of offending agent

- repair of damaged tissue

Term
List the 5 cardinal signs of inflammation.
Definition

heat

redness

swelling

pain

loss of function

 

Term
What are the two phases of vascular permeability during inflammation? Which chemical mediators stimulate the two phases?
Definition

[image]

immediate: histamine

delayed: cytokines

Term
Distinguish between transudate and exudate.
Definition

transudate: low in protein and low in cells; non-inflammatory

exudate: rich in protein and cells; inflammatory; includes firbin

Term
List the 4 major functions of fibrin in the inflammatory response.
Definition

1. blood clotting

2. confinement of inflammatory agent

3. recruitment of neutrophils

4. scaffold for healing

Term
Which leukocyte predominates in tissues during the first 1-2 days of an inflammatory response, and which predominate after?
Definition
[image]
Term
Serous, fibrinous, and purulent infections are all what major type of inflammation?
Definition
acute inflammation
Term
Nonsuppurative and granulomatous exudate belongs to what major type of inflammation?
Definition
chronic inflammation
Term

Distinguish between acute and chronic inflmmation with regard to:

- color

- consistency

- fibrin vs. fibrous

- hyperemia and edema

- prominent leuocytes

- degeneration and necrosis vs. necrosis + atrophy, hyper(trophy/plasia), (meta/dis)plasia

Definition
[image]
Term
List the 4 plasma-derived protease cascades.
Definition
[image]
Term

To which pathway do the following arachidonic acid metabolites belong to and what are their sources and functions?

- thromboxane A2

- prostacyclin

- prostagalndins

- lipoxins

- leukotrienes

 

Definition
[image]
Term

List the 3 functions of NO.

 

Definition

vasoDILATION

 

inhibition of platelet aggregation and leukocyte recruitment

 

Term
What is the active role of endothelial cells in the inflammatory response?
Definition
leukocyte adhesion; contraction in response to histamne (increased leakage); synthesis of NO and prostacyclin; hemostasis and healing (angiogenesis)
Term
What is the active role of platelets in the inflammatory response?
Definition

pro-inflammatory:

 

granules (seratonin- leakage and vasoDILATION; fibrinogen - hemostasis, leukocyte recriutment, healing)


thromboxane A2 - aggregation and vasoCONSRTICTION

Term
What is the active role of mast cells in the acute inflammatory response?
Definition

granules (histamine - leakage, vasoDILATION); heparin - anticoagulant)

 

cytoplasmic factors (chemokines - eosinophil recruitment)

 

bridges vascular and cellular events

Term
What is the active role of neutrophils in the acute inflammatory response?
Definition

primary granules (myeloperoxidase (MPO) - combine with phagosome to kill bacteria)

 

secondary granules (metalloproteinase - ECM degradation to allow cell-movement through tissue)

 

phagosome - NADPH oxidase at membrane to kill bacteria via formation of bacteriocidal ROS)

[image]

Term
Distinguish between abscess, empyema, and pustule.
Definition

abscess - focal accumulation of pus

 

empyema - pus in body cavity

 

pustule - focal accumulation of pus in epidermis

 

(pus: necrotic debris and neutrophils)

Term

Which leukocyte drives the following repair processes?

- phagocytosis of cellular and tissue debris

- fibroblast migration and collagen synthesis

- angiogenesis and neovascularization

- tissue remodeling (via proteinases)

Definition
macrophages
Term
Distinguish between granulomatous exudate and a granuloma.
Definition

granulomatous exudate: dominated by macrophages

 

granuloma: actual nodular aggegrate of macrophages

Term
Which chemical mediator, produced primarily by MQ's, may lead to systemic shock?
Definition
NO
Term
What are soluble peptides, which are secreted by mature cells, that influence proliferation, differentiation, and migration known as?
Definition
growth factors
Term
What are cyclins and CDKs?
Definition

Cyclins - phase-specific factors that bind to CDKs at the 2 checkpoints of the cell cycle.

 

CDKs - phophorylate and thereby activate proteins critical to phase transition during the cell cycle.

Term
List the 2 fibrous structural proteins that comprise the ECM.
Definition

collagen

elastin

Term
What is proteoglycan?
Definition

core protein + GAG (glycoaminoglycan) side chains

 

e.g.: (heparin/chondroitin/dermatin) sulfate

Term
In which phase of healing do macrophaes play a dominant role? And what is this role?
Definition

inflammatory phase

 

- phagocytosis of necrotic debris

- overall direction of healing (neovascularization, fibroblast attraction and activation, ECM synthesis and remodeling)

Term
In which phase of healing do neovascularization and ECM synthesis occur?
Definition
proliferative phase
Term
What is granulation tissue and what changes occur in the type of collagen as the healing tissue matures?
Definition

granulation tissue - young, vascular, edematous, immature fibrous CT

 

As healing matures, Type III---->Type I occurs

Term
During which phase of the healing process do MMP's (matrix metalloproteinases) act? And what is the role they play in the healing process?
Definition
remodeling phase - degrade ECM components
Term
Distinguish between wound contraction and contracture of the remodeling phase of healing.
Definition

contraction: myofibroblast-mediated wound closing

 

contracture: excessive wound contraction

Term
Distinguish between first and second intention healing.
Definition

first intention: occurs in wounds with minimal tissue loss, with apposable edges, rapid, forms a small scar (minimal granulation)

 

second intention: in wounds with significant tissue loss, non-apposable edges, slow, forms large scar (significant granulation)

 

[image]

Term
What is the role of hyaluronic acid during the early inflammatory phase of healing?
Definition
increases fluidity of tissue to allow cell movement through ECM (so is one ECM component that does not contribute to tensile strength)
Term
Distinguish between the genetic conditions of keloids, exuberant granulation tissue, and desmoids in the process of healing.
Definition

keloids - scar tissue that grows beyond boundaries of original wound

 

exuberant granulation tissue - excessive granulation tissue extends above skin surface and impedes re-epithelialization

 

desmoids - excessive proliferation of fibroblasts; borders on neoplasia

Term
List signs of irreversible cell injury.
Definition
signs of necrosis: nuclear changes (pyknosis, karyorrhexis, karyolysis), loss of cell membrane integrity (leakage of cell contents, unrestricted Ca2+ entry)
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