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115 Cards in this Set

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autophagic granules often suggest?
these are intracytoplasmic vacuoles containing debris from degraded organelles; suggest ATROPHY
squamous metaplasia assoc'd with?
chronic irritation, vit A deficiency
myeloid metaplasia =?
extramedullary hematopoiesis
phosphofructokinase activity in cell injury?
increased which leads to increased glycolysis (catalyzes F6P-->F1,6BP?), accumulation of lactate. Acidic pH -->reversible clumping of nuclear chromatin
what are myelin figures?
reversible morphologic signf of late stage hypoxic cell injury; whorl-like structures, probably from damaged membranes
which cells are most susceptible to hypoxic injury?
neurons, esp cerebella Purkinje cells and hippocampal neurons
proliferation and hypertrophy of hepatocyte sER--classic ultrastructural markers of?
barbiturate intoxication
what happens to liver when exposed to CCl4?
chemical cell injury; CCl4 processed by P450s to CCl3 radical which--> lipid peroxidation and damage of cell membrane, disaggregation of ribosomes--> fatty change (b/c can't make proteins necessary for dealing with fat)
what nuclear changes seen in coagulative necrosis?
pyknosis (chromatin clumping); karyorrhexis (chromatin fragmentation); karyolysis (fading of chromatin); disappearance of stainable nuclei
what are Councilman bodies?
apoptotic hepatocytes seen in viral hepatitis
role of p53 in apoptosis?
facilitates apoptosis by decreasing transcription of blc-2 (antiapoptotic) and increasing bax
what is Argyria?
silver poisoning. May lead to permanent gray discoloration of skin and conjunctivae
hemosiderosis vs. hemochromatosis
hemosiderosis--accumulation of ferritin aggregates that stain but NO tissue/organ damage; hemochromatosis--more extensive, WITH organ/tissue DAMAGE
hereditary hemochromatosis genetics?
Hfe gene on chromosome 6 mutation (get triad of micronodular cirrhosis, DM, skin pigmentation)
"brown atrophy" refers to?
lipofuscin accumulation and organ atrophy (common in old age?) (N.B. this is NOT "brown tumor"--osteitis fibrosa cystica??)
milk-alkali syndrome
nephrocalcinosis and renal stones due to milk + antacid self treatment for peptic ulcer
what is dystrophic calcification?
(different from metastatic calcification) occurs in previously damaged tissue, NOT due to hypercalcemia
leukocyte ROLLING mediated by?
leukocyte TRANSMIGRATION mediated by?
C5a, LTB4, HETE, kallikrein, bacterial products are all?
chemotactic factors for PMNs (among other things, probably)
most important opsonins?
IgG, C3b
what stimualte release of His from basophils and platelets?
Ag binding to membrane-bound IgE; anaphylatoxins (C3a, C5a); heat, cold; IL-1
what is endothelial PGI2?
powerful vasoDILATOR and inhibitor of platelet aggregation (epoprostenol is PGI2 analog, vasodilator for pulm HTN)
products of lypoxygenase pathway of arachidonic acid metabolism?
HDETES (5-HDETE-->HETE, a potent PMN chemotacter)
membrane attack complex composed of which complementies?
What happens to catalase+ organisms in Chronica Granulomatous dz?
ingested but not killed b/c of NADPH oxidase deficiency which results in no H202 substrate for MPO. Catalase negatives don't get rid of own H202 so there the host NADPH oxidase can still function
how is chediak-higashi syndrome characterized functionally? Morphologically?
functionally--abnl microtubule formation-->impaired chemotaxis and migration of PMNs; morph--lg cytoplasmic granules, melanosome also affected (albinism!)
Leukocyte Adhesion Deficiency type 1
deficiency of beta 2 integrins
Leukocyte Adhesion Deficiency type 2
fucosyltransferase gene mutation (fucosyltransferase needed for synthesis of Sialyl Lewis X PMNS…i think this is aka CD15s...interacts with selectins on endothelium?)
hemorrhagic infarcts usually occur where?
in lung and GIT, wherever redundant arterial blood supply
how is PTT affected in Antiphospholipid Ab Syndrome?
PROLONGED which is weird for a thrombotic D/O. probably artifact from interaction of Ab with test reagent
what are lines of Zahn?
alternating layers of dark gray platelets and lighter fibrin; in mature arterial thrombi
"mural thrombus"=
thrombus that adheres to one wall of heart chamber or major artery
branch of carotid artery most commonly involved in thromboembolism?
middle cerebral artery
specific gravity of transudate?
7 morphologic manifestations of shock
1. acute tubular necrosis (kidney); 2. centrilobular necrosis (liver). 3. fatty change (heart or liver); 4. areas of necrosis (brain); 5 .patchy mucosal hemorrhages (colon); 6. depletion of lipid (adrenal cortex); 7. pulmonary edema
most common cause of aneuploidy?
meiotic nondisjunction
what is a Roberstonian translocation
long arms (q) or 2 acrocentric chromosomes are joined with common centromere and the short arms (p) are lost
familial form of Down's?
parental meiotic translocation; 3-5% of cases; no relation to maternal age
what are Brushfield spots?
small white spots on periphery of iris in Down syndrome
complications of Down syndrome?
congenital heart dz; acute leukemia (esp lymphoblastic); increased susceptibility to infection; Alzheimers (middle age)
maternal screening for Down syndrome?
alpha fetoprotein is LOW (marker for liver and germ cell cancers, btw); hCG is HIGH; unconjugated estriol is LOW
Cri du chat
5p del; severe mental retardation, microcephaly, catlike cry, hypertelorism
DiGeorge syndrome
microdeletion 22q11--> CATCH 22 (Cardiac abnl, Abnl facies, T cell deficity/Thymic hypoplasia, Cleft palate, Hypocalcemia (b/c dec'd PTH)..all due to microdeletion of 22!)
Edward's syndrome
trisomy 18 (nondisjunction); microcephaly, micrognathia, rocker-bottom feet, congenital heart dz
name the dz: microcephaly, rocker-bottom feet, micognathia, congenital heart dz
Edward's syndrome (trisomy 18)
Name the dz: microcephaly, microphthalmia, cleft lip/palate, polydactyly, congenital heart dz
Patau syndrome (trisomy 13)
Prader Willi syndrome and Angelman syndrome--examples of what?
genomic imprinting. Same del but if from dad-->Prader Willi (uncontrolled appetite!); if from mom-->Angelman ("happy puppet")
what are Lisch nodules?
pigmented iris hamartomas seen in von Recklinghausen dz (NF)
what is the specific mutation in von Recklinghausen dz?
mutation in NF1 gene which codes for GAP--GTPase activating protein
increased incidence of what other tumors seen in von Recklinghausen dz?
pheochromocytoma, Wilms tumor, rhabdomyosarcoma, leukemia
Glial nodules and distorted neurons in cerebral cortex characterize?
tuberous sclerosis
tuberous sclerosis also assoc'd with what tumors?
rhabdomyomas of heart, renal angiolipomyomas
von Hippel Lindau dz assoc'd with what cancer?
renal cell carcinoma; also: hemangioblastomas, adnemoas, and cysts of liver, kidney, pancreas
Tay-Sachs--what's the enzyme deficiency and what accumulates?
hexosaminidase A--> accumulation of GM2 ganglioside
cherry red spot especially assoc'd with what lysosomal storage dz?
Tay-Sachs (hexosaminidase A def); less commonly, in Niemann-Pick dz
glucocerebrosidase def and accumulation of glucocerebroside =?
Gaucher dz (get Gaucher cells--enlarged histocytes with wrinkled tissue paper cytoplasm..where's the food analogy??)
variants of Gaucher dz?
(def of glucocerebrosidase); type 1--80%, normal lifespan possible, no CNS; type 2--infantile, death <1yr, CNS only; type 3--juvie, less severe than type 2, CNS and viscera
Hurley syndrome
AR, mucopolysaccharidosis; alpha-L-iduronidase def-->accumulation of heparin sulfate and dermatan sulafate; death by 10 y/o
deficiency in von Gierke's dz?
glucose 6 phosphatase
deficiency in Pompe's dz?
alpha1,4 glucosidase-->accumulation of glycogen, esp in liver, heart, sk mm; death <3 y/o
deficiency in Cori dz?
amylo1,6glucosidase (debranching enzyme)-->variable accumulation of glycogen leads to stunted growth, hepatomegaly, hypoglycemia
McArdle syndrome
muscle phosphorylase def--> accumulation of glycogen in mm; get painful msucle cramps and weakness post-exercise
infantile cataracts characteristic of what carb metabolism d/o?
name the dz: failure to thrive, infantile cataracts, mental retardation, cirrhosis?
galactosemia (classic)
name the dz: mental deterioration, musty body odor in blond haired blue eyed kids
PKU (phenylalanine hydroxylase mutation)
name the dz: dark urine, ochronosis (dark pigmentation of fibrous tissues and cartilage)
alkaptonuria (homogentisic oxidase def.) AR
defect in Maple Syrup urine dz?
defect in any of the proteins in the branched chain alpha ketoacid dehydrogenase complex
urine in maple syrup dz?
smells like maple syrup (duh); high levels of keto acids of LEUCINE, ISOLEUCINE, VALINE
chromosomal abnormality in cystic fibrosis?
CFTR mutation on csome 7
what organism is common cause of death in CF?
Pseudomonas aeruginosa
what X-linked d/o has characteristic angiokeratomas?
Fabry dz (alpha-galactosidase A def-->ceramide trihexoside accumulation)
normal ratio of T cells?
2:1 CD4+:CD8+
Hot T-Bone stEAk
fever--IL-1; T cell stim--IL-2; bone marrown stim--IL-3; IgE production stim--IL-4; IgA production stim--IL-5
classic vs alternate pathway
classic--initiated by reaction with Ag-Ab complex, leads to MAC; alternate--initiated directly by nonimmunologic stimuli (e.g. invader), leads to MAC
what is MHC?
major histocompatibility complex. Region on csome 6 where genes coding for HLA Ag are
class I vs class II HLA?
I--on almost all human cells, imp in graft rejection; II--mostly on immunocompetent cells
warm Ab AIHA, hemolytic dz of newborn, Goodpasture's--all examples of what kind of hypersensitivity reaction?
type II (cytotoxic)
C1 esterase inhibitor deficiency--> ?
hereditary angioedema; type 1 hypersensitivity
What happens in type III hypersensitivity reaction?
Ab binds Ag (NOT intrinsic part of target cells). Aggregates deposit in vessel walls, etc. complement binds--> PMNs come and cause damage. Hageman factor also activated-->intrinsic pathway coag--> thrombosis and activation of kinins --> vasodilation, edema
serum sickness--what kind of hypersensitivity reaction?
type III
Arthus reaction?
LOCALIZED immune complex dep (type III). Occurs when Ag introduced--via injection or organ transplant-- in presence of preformed Abs
name the type of transplant rejections: T cell mediated, days-months
ACUTE rejection
chronic rejection primarly due to?
Ab-mediated vascular damage
underlying problem in X-linked agammaglobulinemia of Bruton?
mutation in tyrosine kinase gene--> block in maturation of pre B cells to B cells
Name the dz: absence of plasma cells in tissue, absent of poorly defined germinal centers
X-linked agammaglobulinemia
Name the dz: recurrent viral and fungal infections, tetany
DiGeorge syndrome (CATCH-22)
ADA deficiency--> ?
accumulation of deoxyadenosine, deoxy-ATP which are toxic to lymphocytes. Seen in ~50% of AR SCID
Clinical manifestations of SCID
severe infections (of all sorts); high incidence of malignancies; failure to thrive; GVHD after blood 'fusions
Wiskott-Aldrich syndrome
X-linked d/o with eczema, thrombocytopenia, recurrent infections
Significance of gp120?
cell surface protein of HIV virion, has binding sites for CD4 (not just on T cells)
Are AIDS pts hyPER or hyPOgammaglobulinemic?
paradoxically, hyPER b/c even though can't make specific Abs, have polyclonal B cell proliferation
significance of dsDNA in lupus?
ANA react with dsDNA--> very specific for lupus, shows characteristic "rim" pattern on IF; also identifies pt at risk for glomerulonephritis
CREST syndrome
limited scleroderma; Calcinosis, Raynaud phenom, Esophageual dysfxn, Sclerodactyly, Telangiectasias; get anticentromeres, pulm HTN
secondary amyloidosis (reactive systemic amlyoidosis)
AA protein dep (from SSA); chronic tissue destruction--> SSA; usually involves parenchymous organs, esp kidneys)
Familial Mediterranean fever
AR, episodic fever and polyserositisl; AA amyloid depositon
amyloid thought to be derived from glucagon or insulin; seen in type II DM in islet cells
carcinomas are malignant tumors what what origin?
EPITHELIAL (sq cell, tranisitional cell, adeno cell)
what is desmoplasia?
tumor-induced proliferation of non-neoplastic fibrous connective tissue, assoc'd with adenocarcinoma
origin of sarcomas?
what is a choristoma?
small non-neoplastic area of NORMAL tissue misplaced within another organ
What is Trousseau phenomenon?
migratory thrombophlebitis assoc'd with underyling carcinoma--usually of lung or pancreas
CEA is tumor marker for?
carcinomas of COLON, pancrease, stomach, lung, breast
alpha fetoprotein is marker for?
(LOW in Downs); hepatocellular carcinoma, nonseminomatous germ cell tumors of the nuts; also increased in fetal anencephaly and other NTDs
radium watch-dial workers tend to get what kind of cancer?
uranium miners tend to get what kind of cancer?
lung cancer
How is ras an oncogene?
ras codes for p21. mutated--> aberrant p21 that can bind and be activated by GTP but can't be inactivated. (mutated in ~25-30% of malignancies!)
I say "t(8;14)", you say?
Burkitt's lymphoma (inc'd c-myc)
I say, t(14;18), you say?
Follicular lymphoma (inc'd bcl-2)
I say, t(9;22), you say?
CML, Phl csome, bcr-abl, Gleevec\
I say, t(15;17), you say?
APL, tx: retinoic acids (do NOT give regular chemo b/c of tumor lysis syndrome and release of Auer rod material!)
what is a double minute?
small free chromosome-like body resulting from extensive gene amplification
2 examples of gene amplification in cancer?
neuroblastoma (n-myc amp); breast cancer--her2neu
5 cancer suppressor genes
Rb, p53, WT-1,2 (Wilms tumor), APC, BRCA-1
medullary thyroid cancer, bilateral pheochromocytomas, hyperparathyroidism (hyperplasia or tumor); ret mutation