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175 Cards in this Set
- Front
- Back
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What is a collection of blood outside the tissues?
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A blood bank! ha ha ha
seriously, it's a HEMATOMA |
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T or F:
Circulatory dysfunction is often the terminal cause of death in a wide variety of diseases. |
True
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What does DIC stand for?
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Death Is Coming!!!
Really it's DISSEMINATED INTRAVASCULAR COAGULATING disease |
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What does PT stand for? PTT?
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PT = Prothrombin
PTT = Partial Thromboplastin Time |
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T or F:
Measuring the PT tests the extrinsic coagulation pathway. |
True!
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T or F:
Measuring the PTT tests the extrinsic and common coagulation pathway. |
False! Its intrinsic and common.
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T or F:
Measuring the PTT tests the intrinsic coagulation pathway. |
True (along with the common)
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What are the three coagulation pathways?
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Common
Intrinsic Extrinsic |
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What are the intrinsic factors?
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XII
XI IX VIII |
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What do d-dimers measure?
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Measure cross-linked fibrin polymers; indicates the activity of thrombin and plasmin
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Which factors does Vitamin K impact?
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2, 7, 9, and 10
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What are the three major contributors to hemostasis (and thrombosis)?
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Vessel wall endothelium
Platelets Coagulation system |
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What is the end result (goal) of the coagulation system?
Hint: it's to make something... |
To make FIBRIN
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Would a long mucosal bleed time be indicative of a primary or secondary hemostasis disorder?
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Primary
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Pathological hemostasis is known as...
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...thrombosis
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Fill in the blank:
Damaged endothelium releases __________________ which serves as a "glue" for __________. |
Damaged endothelium releases VON WILLEBRANDS FACTOR which serves as a "glue" for PLATELETS.
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T or F:
A disorder of secondary hemostasis would be characterized by spontaneous external bleeding. |
False!
It is INTERNAL bleeding into body cavity |
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The formation of a temporary "plug" from platelets is known as...
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...primary hemostasis
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T or F:
Uninjured endothelial cells express anti-coagulant or anti-thrombotic properties. |
True!
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T or F:
Upon injury, endothelial cells express pro-coagulant (pro-thrombotic) properties including NO and prostacyclin. |
False!
NO and prostacyclin are ANTI-coagulants! |
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Compare and contrast Heparin and Thrombomodulin.
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Both bind endogenous proteins and promote anticoagulant activity.
Heparin binds antithrombin III Thrombomodulin binds thrombin, thus activating Protein C |
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What are some anti-thrombotic molecules?
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NO
Prostacyclin Heparin-like molecules Thrombomodulin t-PA (tissue plasminogen activator) Antithrombin III |
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What are some pro-thrombotic factors?
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VonWillebrand's factor (vWF)
Tissue factor Plasminogen Activator Inhibitor-1 (PAI-1) Thromboxane A2 |
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Which of the anti-thrombotic molecules are also vasodilators?
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NO
Prostacyclin |
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Which of the anti-thrombotic molecules promotes breakdown of fibrin?
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t-PA (tissue plasminogen activator)
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T or F:
t-PA is used in myocardial infarct situations since it directly breaks-down thrombi. |
False!
t-PA doesn't break down clots but it activates plasminogen to PLASMIN and PLASMIN breaks down the clots! |
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T or F:
Heparin has innate anti-coagulant ability. |
False!
It catalyzes antithrombin III (ATIII) which then inactivates several components of the coagulation cascade. |
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Which pro-thrombotic molecule activates the extrinsic clotting system?
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Tissue factor
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Which pro-thrombotic molecule is heavily involved in primary hemostasis?
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Von Willebrand's Factor (vWF)
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Which pro-thrombotic molecule inhibits breakdown of the fibrin clot?
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Plasminogen Activator Inhibitor-1 (PAI-1)
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What substrate of damaged endothelium do platelets adhere to?
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Collagen via vWF
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What factors do platelets release to aid in clotting?
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ADP
Thromboxane A2 (TxA2) Fibrinogen |
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Asprin is an antagonist to clotting. Which molecule does it specifically inhibit?
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Thromboxane A2 (TxA2)
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What are the three steps in the formation of the platelet clot?
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Adhesion and shape change
Secretion Aggregation |
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T or F:
Once Thromboxane A2 is released during aggregation, the hemostatic clot is irreversible. |
False!
Only once THROMBIN is released is the hemostatic clot irreversible. Thromboxane A2 is involved in Secretion not aggregation. |
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Below what level of platelet concentration does spontaneous bleeding occur?
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<20,000/uL (clinically lower than this even)
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Low levels of platelets is known as...
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...thrombocytopenia
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What are the factors involved in the extrinsic system?
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VII and tissue factor (III)
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What are the factors in the common pathway?
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X, V, II, and XIII
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Warfarin is an example of...
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...a vitamin K agonist
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What converts fibrinogen to fibrin?
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Thrombin
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Name some endogenous anticoagulants...
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Protein C
Protein S Anti-thrombin III |
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T or F:
Protein C, S, and anti-thrombin III are catalyzed by heparin-like molecules. |
False!
Proteins C and S are catalyzed by thrombomodulin while ATIII is catalyzed by heparin |
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How does EDTA keep blood from clotting?
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Binds Ca2+ (Ca necessary for clotting)
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T or F:
Hemorrhage and extravasation are synonomous. |
True!
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Blood in a joint space is...
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...bad
Called a HEMARTHROSIS |
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Blood in the poo is called...
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...MELENA
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Blood in urine is called...
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...HEMATURIA
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Coughing up blood (from respiratory tract) is called...
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...HEMOPTYSIS
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What are the small, pin-point foci of hemorrhage called?
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petechiae (petechial hemorrhages)
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Large petechiae are known as...
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...ecchymoses (ecchymotic hemorrhages)
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A collection of petechiae or ecchymoses (or both) is known as...
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...PURPURA
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What are conditions that could cause non-regenerative, iron-deficient anemia?
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GI ulcer
Parasitism |
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The normal breakdown of large clots by the body is known as...
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...organization of the hematoma
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What substance would you find macrophages participating in organization of the hematoma filled with?
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Hemosiderin
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What are three major causes of hemorrhage?
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Trauma
Damage to endothelial cells Coagulation disorders |
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What substance in sweet clover causes a coagulation disorder? What is the mechanism?
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Cumerin is a vitamin K antagonist
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What differentiates a thrombus from a clot (in terms of vessel attachment and consistency)?
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Thrombi are often attached to the endothelium and are more friable than clots
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T or F:
A chicken fat clot is a post mortem event. |
True! It is from RBCs settling out post-mortem
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What are the three most important causes of thrombi?
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Endothelial injury
Alterations of blood flow Hypercoagulability |
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What is the most important cause of thrombi?
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Endothelial injury
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What are two problematic sequelae to thrombi?
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Ischemic injury
Embolism |
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Strongyles in horses can cause what disease involving thrombi?
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Equine verminous arteritis
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T or F:
It is difficult to grossly discriminate between an arterial thrombus and an arterial clot. |
False!
Arterial thrombi have a white/gray head and a red floating tail |
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T or F:
Venous thrombi are difficult to distinguish from venous post mortem clots. |
True!
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Embolization of thrombi is more common in (pick one) veins/arteries.
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Veins due to lack of firm attachment.
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What are the four fates of a thrombus?
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Propagation
Embolization Dissolution (thrombolysis) Organization |
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In which direction does a venous thrombus typically enlarge? An arterial thrombus?
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Venous - away from the heart
Arterial - toward the heart |
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What are the measurable products of fibrinolysis?
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D-dimers (more representative of increased fibrinolysis)
Also Fibrin degradation products (FDPs) |
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Increases in levels of d-dimers is consistent with what condition?
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Disseminated Intravascular Coagulation (DIC)
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The formation of capillaries in an organizing thrombus is known as...
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...recanalization
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T or F:
DIC is a type of bleeding disorder. |
True! It uses up platelets and clotting factors, causing bleeding.
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T or F:
DIC is a clotting disorder. |
True! Numerous microthrombi form throughout the body.
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Predict the following lab findings in a DIC patient:
Platelet number D-dimers/FDPs Buccal mucosal bleeding time |
Thrombocytopenia
Increased d-dimers/FDPs Increased bleed time |
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A focal area of ischemic necrosis is known as...
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...an INFARCT
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Infarcts are caused by occlusion of:
A. arteries B. veins C. both |
BOTH
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T or F:
Venous infarcts are the most common. |
False! ARTERIAL are the most common
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T or F:
Nearly all infarcts are caused by occlusion of vessels by thromboses or emboli. |
True!
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What are some non-thrombotic causes of infarcts?
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torsion (eg: GDV)
pressure (eg: neoplasm) Increased vasoconstriction (eg: ergot toxicity) |
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Why is verminous arteritis a problem when infarcts in tissues with dual blood supply are less susceptible to infarction?
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Because the emboli lodge proximal to the area of anastomosis
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What are the two types of infarcts and what are their associated venous structures?
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White (anemic) infarcts - arterial
Red (hemorrhagic) infarcts - venous |
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What shape do most infarcts have?
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wedge-shaped
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T or F:
All emboli are caused from thrombus mobility. |
False! There can be other emboli (fat, bone marrow, neoplasia, etc)
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Other than thrombi, what are other types of emboli?
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Fat
Bone marrow neoplasia fungi or bacteria parasites amniotic fluid catheters air |
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What is a major cause of cardiomyopathy in cats?
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taurine deficiency
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Where do emboli commonly lodge in cardiomyopathic cats? What is the term for this type of embolism?
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Iliac bifurcation
Saddle emboli |
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T or F:
Hyperemia is always pathologic. |
False. It can be pathologic or physiologic.
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T or F:
Hyperemia is an active process that always involves arteries or arterioles. |
True!
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T or F:
Congestion is always pathologic. |
True (I think)
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Give some examples of physiological hyperemia.
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Exercise
Blushing |
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T or F:
Congestion always involves venous return. |
True
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T or F:
Pathologic active hyperemia is commonly due to inflammation |
True
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What are the three types of congestion?
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Acute local congestion
Chronic local congestion Chronic generalized congestion |
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What kind of congestion is characterized by a thrombosed vein or torsion?
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Acute local congestion
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Which organ is the most impacted by right sided heart failure and how does it present on necropsy?
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Liver
Nutmeg liver |
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Which organ is most affected in left sided heart failure?
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Lungs!
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Macrophages stuffed w/hemosiderin in the lungs are called...
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...heart failure cells
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Excessive fluid in interstitial tissues or body cavities is...
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...EDEMA
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Generalized, severe, subcutaneous edema is called...
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...ANASARCA
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What is another name for ascites?
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Hydroperitoneum
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OK, you've been in vet school for 2.5 terms now...you better get this next one right! What are the 4 causes of edema?
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Increased hydrostatic pressure
Reduced plasma oncotic pressure Decreased lymphatic drainage Increased permeability of vessels |
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In which locations might edema be life threatening?
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brain and lungs
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Inadequate tissue perfusion is known as...
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...SHOCK
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What are the 4 basic types of shock?
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Hypovolemic
Septic Cardiogenic Neurogenic |
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What is the first and most important thing that you can do to reverse hypovolemic shock?
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Give fluids!
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How can you treat septic shock?
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antibiotics and antiinflammatories
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What are the most common organs afflicted with shock-induced lesions?
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Lungs
Liver Adrenals Kidneys Heart Brain GI |
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T or F:
In the chemical theory of carcinogenesis, the effect of an initiator chemical is sufficient for carcinogenesis. |
False, you need an initiator followed by promoters in the correct temporal delivery
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What are the key types of genes involved in carcinogenesis?
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protooncogenes
Tumor suppressor genes apoptosis genes DNA repair genes |
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T or F:
All growth promoting genes are protooncogenes. |
True
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What are some examples of protooncogene classes discussed in class?
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Growth factor production
Growth factor receptors Nuclear transcription factors Cell Cycle regulators Second messengers |
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What are examples of specific protooncogenes discussed in class?
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FOS, JUN, KIT
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T or F:
Protooncogenes permit the unregulated cell self-sufficiency in growth. |
False! This would describe an oncogene
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Cyclins and CDKs are examples of what type of protooncogene?
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Cell cycle regulators
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What are ways to upregulate oncogenes?
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Increase growth factor
Increase growth factor receptors Something "stuck on" in pathway |
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I'm the guardian of the genome! My name is...
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p53
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Malfunction of which type of gene causes insensitivity to inhibitory growth signals?
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Tumor suppressor genes
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What are three interrelated proteins that mediate the cell cycle?
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Cyclin
Cyclin dependent kinase Cyclin dependent kinase inhibitory protein |
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Phosphorylation of which protein allows for progression into S phase?
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Rb protein (tumor suppressor); active form prevents cell progression into G1 and S phases.
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What tumor suppressor protein stalls cells in G1 phase?
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p53
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T or F:
Kinase inhibitors promote cyclin activity and kinases inhibit cyclin activity. |
False! Its the other way around!
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T or F:
Both alleles of a tumor suppressor gene must be knocked-out before they can become oncogenic. |
True!
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What is the most frequently damaged gene in human tumors?
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p53
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What is THE apoptosis-resistance gene (or the one we always talk about at least)?
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Bcl-2
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What are some genetic changes that can result in dysregulation of oncogenic genes?
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Mutation
Chromosomal change (translocation) Gene amplification Epigenetic change (histone changes or methylated DNA) |
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What mechanism of oncogenic dysregulation discussed in class leads to lymphoma (and how)?
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Translocation of myc to C.14 (by IgG) causes overexpression of myc
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T or F:
Leukemia is characterized by increased tyrosine kinase expression |
True!
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What do carcinogenic agents form that bind to DNA?
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Electrophilic intermediates
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The binding of electrophilic intermediates to DNA can have three results. What are these?
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DNA repair and normal function
Apoptosis Permenant DNA lesion |
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T or F:
All chemicals require bioactivation in order to be carcinogenic. |
False! Only indirect carcinogens do.
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T or F:
Direct carcinogens are capable of initiation of DNA damage and promotion of DNA replication. |
False! This describes complete carcinogens!
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What test is used to determine the mutagenic activity of a substance?
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AMES test
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T or F:
The AMES test uses salmonella strains to test possible carcinogens upon. |
True
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What do chimney sweeps and aflatoxins have in common?
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Moldy nuts!
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What protein does aflatoxin inactivate?
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p53
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Choose the correct progression of mutations resulting in colorectal carcinoma.
APC > RAS > APC APC > APC > p53 > RAS p53 > APC > APC > RAS APC > APC > RAS > p53 |
APC > APC > RAS > p53
APC is tumor suppressor RAS is protooncogene p53 knockout results in carcinoma |
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UV radiation results in what type of DNA damage?
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Pyrimidine dimers
Damages p53 and RAS |
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What is the speculated mechanism for chronic irritation causing neoplasia?
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Chronic irritation leads to increased cell division and increased opportunity for DNA issues
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What are examples of transmissible tumors?
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Transmissible venereal tumor (dog)
Tasmanian devil disease |
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T or F:
Transmissible venereal tumors contain canid DNA. |
False!
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What is the difference between productive and non-productive DNA viral oncogenes?
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No viral particles replicated in the non-productive version
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How do HPV E6 and E7 prevent cell apoptosis or growth arrest?
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Block p53, p21, and Rb
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What virus type is implicated in Marek's Disease?
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a herpes virus
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Where does the lymphoma of Marek's disease manifest?
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Liver
Sciatic n. |
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T or F:
All oncotic RNA viruses are retroviruses. |
False!
There is a flavavirus (believe it or not). |
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What is the gene and the gene mechanism involved in Marek's Disease?
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MEQ gene in viral genome upregulates IL-2 which increases lymphocyte division
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What are the three main viral genome genes and what do they encode for?
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GAG - core protein
POL - reverse transcriptase ENV - envelope |
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What are the two types of retroviruses?
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Acute and chronic transforming retroviruses
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T or F:
Acute transforming retroviruses carry their own promoter. |
Tru dat!
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T or F:
Most acute transforming retroviruses are horizontally transmitted. |
False!
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Proviral insertion next to protooncogene results in increased transcription in (choose one - cis or trans) acting chronic transforming retroviruses.
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Cis!
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What is the classical example of an acute transforming retrovirus getting "help" from a closely related virus?
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Feline sarcoma virus w/ FLV
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What can protect against FLV?
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foc-you! No, FOCMA!!
Feline OnCovirus Membrane Antigens |
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What are the oncogenes implicated in FLV?
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Myc
Fes Kit Sis Abl |
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Which genes are affected by Enzootic Bovine Leukosis?
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Upregulates IL2R, GM-CSF (granulocyte macrophage colony stimulating factor)
Inactivates CDK |
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What enzyme do cancer cells express to prevent telomere shortening?
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Telomerase
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Cancer cells must acquire many features to persist and proliferate. What are they (there are 6 or 7)?
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Immortality
Self-sufficient growth (oncogenes) Insensitivity to anti-growth signals (tumor suppressor knockout) Apoptosis evasion DNA repair genes Sustained angiogenesis Ability to invade/metastasize |
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What is the main cell of the immune system involved in surveillance of cellular integrity?
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Cytotoxic T cells (CD8+)
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T or F:
Oncofetal antigens do not induce a host response can be used as a cancer diagnostic tool. |
True
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Which is the major player in antitumor mechanisms? CMI or humoral immunitiy?
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Cell-mediated immunity
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T or F:
There is a positive link between autoimmune disorders and cancer. |
False! No link seen
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How are some ways that tumor cells can evade the immune system?
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No Ag expression
No MHC expression Inhibit/kill Tc cells Hide antigens (slime) Provide abnormal environment for immune function |
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Other than Tc cells, what are two other immune cells important in killing tumors?
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NK cells
Macrophages |
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How can tumor cells provide an abnormal environment for immune function?
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Leaky, unpredictable vasculature
No APCs in tumor tissue Prevent Th cell stimulation |
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T or F:
An ideal chemotherapy should attack cells at multiple stages of the cell cycle. |
True! Not all tumor cells will be synched.
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How can tumor cells be forced into the same proliferative pool?
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Give growth factors (eg: E2 in breast cancer)
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T or F:
Chemotherapy immediately post surgical debulking of a tumor is contraindicated since the patient is recovering from the procedure. |
False! Chemo is necessary since any tumor that wasn't removed will begin proliferating due to reduced competition.
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T or F:
Unchecked neoplasia becomes more aggressive with time. |
True! THis is why early detection is paramount
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What are some unique features of neoplastic cells that can possibly be exploited (other than their mitototic dysregulation)?
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Abnormal antigens
Tendency for glylolitic metabolism and reduced pH High angiogenesis Secretion of abnormal proteins |
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Who stages a tumor? Clinician or pathologist?
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Clinician
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What are the three components to tumor staging?
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T = Tumor size
N = Lymph node involvement M = Metastasis |
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Why are margins important in biopsy specimens?
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Margins allow for determination of malignancy
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What is a common chemotherapy for canine lymphoma?
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CHOP!!
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What are some examples of non-chemotherapeutic agents for cancers?
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Radiation
Hyperthermia Cryosurgery Photodynamic therapy |
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T or F:
Chemotherapy induces more mutations in the animal and can harm the p53 gene. |
True!
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