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131 Cards in this Set

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The intrinsic pathway of apoptosis involves Bax which is ___-apoptotic and Bcl-2 which is ____-apoptotic. Changes in proportions of anti- and pro-apoptotic facts lead to increased mitochondria permeability and cytochrome c release
Bax- pro, Bcl-2 = anti
The brain, bacterial abscess, and pleural effusions are considered ____ necrosis
liquefactive
TB and systemic fungi infections cause ____ necrosis
caseous
The pancreas via saponification goes through ____ necrosis
fatty
Blood vessel go through ____ necrosis
fibrinoid
This type of necrosis is common in the limbs and GI tract
gangrenous necrosis
Is cell injury caused by fatty change reversible?
Yes
Is cell injury that results in nuclear pyknosis, karyolysis (nuclear fading) and karyorrhexis (nuclear fragmentation) reversible or irreversible?
irreversible
Is plasma membrane damage to the cell, lysosomal rupture and mitochondrial permeability reversible or irreversible modes of cell injury?
irreversible
What are some organs that are susceptible to hypoxia?
heart (subendocardial tissue), kidney, neurons, liver (area around central vein), watershed areas (splenic flexure, ACA/MCA)
Infarctions of the lung, liver or intestine are red or white infarctions?
red
Reperfusion injury is due to damage by ____
free radicals
The heart, kidney, and spleen undergo red or white infarction?
white
Is Hypovolemic/cardiogenic shock high or low output failure? What happens to the TPR? Is the patient hot or cold and clammy?
low output failure, increase in TPR, cold/clammy pt
Is septic shock high or low output failure? What happens to the TPR? Is the patient hot or cold and clammy?
high output failure, decrease in TPR, hot patient due to dilated arterioles, high venous return
Increased pressure such as nephrolithiasis can lead to reduction in the size or number of cells. This is known as ____
atrophy
Granulation tissue is highly vascularized and ____
fibrotic
Scarring is ____ deposition resulting in altered structure and function
collagen
____ inflammation is mediated by neutrophils, eosinophils, and antibody mediated
Acute
_____ inflammation is mononuclear cell mediated. Associated with blood vessel proliferation, fibrosis. Granuloma: nodular collections of epitheliod macrophages or giant cels
Chronic
Neutrophils exit from blood vessels at sites of tissue injury via what 4 steps?
rolling, tight binding, diapedesis, and migration
E-selectin and P-selectin is expressed on the vasculature/stroma and is responsible for what stage of leukocyte extravasation?
rolling
ICAM-1 expressed on the vasculature/stroma and LFA-1 expressed on the leukocyte is responsible for what stage of leukocyte extravasation?
tight binding
PECAM1 is responsible for what stage of leukocyte extravasation?
diapedesis--> leukocyte travels between endothelial cells and exits blood vessel
What bacterial products mediate neutrophil chemotaxis? Name 4
C5a, IL-8, LTB4, Kallikrein
Free radicals can be eliminated by the enzymes catalase, superoxide dismutase, glutathione peroxidase, spontaneous decay, or antioxidants (vitamins __, ___ and, ___)
A,C,E
CCl4 can cause free radical injury of the _____ leading to necrosis and _____
liver, fatty change
Reperfusion after anoxia, especially after thrombolytic therapy can lead to free radical injury. The free radical injury is mostly mediated by _____
superoxide
What are the three stages of wound healing?
inflammatory, proliferative, remodeling
Fibroblasts, myofibroblasts, endothelial cells, and keratinocytes mediate what phase of wound healing?
Proliferative (2-3 days after wound)
This stage of wound healing is characterized by deposition of granulation tissue and collagen, angiogenesis, epithelial cell proliferation, dissolution of clot, and wound contraction
Proliferative phase
This stage of wound healing is mediated by fibroblasts and is characterized by Type III collagen being replaced by Type I collagen--> leads to increased tensile strength of tissue
Remodeling
This cytokine produced by macrophages induce and maintain granuloma formation.
TNF-alpha, anti-TNF drugs can break down granulomas, leading to disseminated disease
Name some granulomatous disease?
TB, histoplasmosis, syphilis, sarcoidosis, Crohn's disease, leprosy, cat scratch disease (Bartonella Henselae), Berylliosis
Is Transudate or exudate hypocellular and protein poor?
transudate
Transudate is caused by a ____ in hydrostatic pressure and a ____ in oncotic pressure
increase, decrease
Exudate usually occurs due to what two conditions?
lymphatic obstruction or inflammation
Does inflammation and infection cause RBCs to fall at a slower or faster rate within a test tube?
faster
Infections, inflammation, Cancer, Pregnancy, and SLE cause the ESR to go up or down?
up ESR
Sickle cell, polycythemia and CHF cause the ESR to go up or down?
down ESR
What is one of the leading causes of fatality from toxicologic agents in children?
Iron poisoining
____ poisoning leads to cell death due to peroxidation of membrane lipids. Its symptoms can be acute such as gastric bleeding or chronic such as metabolic acidosis, scarring leading to GI obstruction
Iron
____ demonstrated via b-pleated sheets and apple-green birefringence of Congo red stain under polarized light
Amyloidosis
Amylodosis can be caused by A___, an acute phase reactant
AA
Transthyretin is derived from A___ and is seen amyloidosis seen in senile cardiac disease
AF
Amylin is a protein derived from A___ and is an amyloidosis seen in diabetes mellitus type 2
AE
Medullary carcinoma of the thyroid will produce A-CAL, which is derived from _____, and can cause amyloidosis
calcitonin
What is the amyloid protein associated with Alzheimer's disease?
beta-amyloid derived from amyloid precursor protein
What is the amyloid protein that is dialysis associated?
B2-microglobulin
Abnormal proliferation of cells with loss of size, shape and orientation is termed ___
dysplasia
This describes neoplastic cells that have not invaded the basement membrane. There is high nuclear/cytoplasmic ratio and clumped chromatin. Neoplastic cells encompass the entire thickness
Carcinoma in situ
____plasia is irreversible and describes abnormal cells lacking differentiation, resemble primitive cells of same tissue, often equated with undifferentiated malignant neoplasms. Little or no resemblance to tissue of origin
anaplasia
____plasia is fibrous tissue formation in response to neoplasm
desmoplasia
Is grade or stage the degree of cellular differentiation based on histologic appearance of tumor? Usually graded 1-4 based on degree of differentiation and number of mitoses per high power field; character of tumor itself
Grade
Does stage or grade have more prognostic value usually?
stage
Is grade or stage the degree of localization/spread based on site and size of primary lesion, spread to regional lymph nodes, presence of metastases; spread of tumor in a specific patient
stage
A rhabdomyosarcoma is malignant transformation of ____ muscle
skeletal
A _____ is malignant transformation of connective tissue
fibrosarcoma
Is a mature teratoma benign or malignant in a male?
malignant
The term _____ implies epithelial origin, whereas the term ____ denotes mesenchymal origin. Both terms imply malignancy
carcinoma, sarcoma
Cachexia is usually mediated by what cytokine?
TNF-alpha, IFN-Y, and IL-6
Down's syndrome is associated with what neoplasm?
ALL, AML
Xeroderma pigmentosum and albinism are associated with what neoplasms?
melanoma, basal cell carcinoma, and especially squamous cell carcinomas of skin
Chronic atrophic gastritis, pernicious anemia, and postsurgical gastric remnants are associated with what neoplasms?
Gastric adenocarcinoma
Tuberous sclerosis (facial angiofibroma, seizures, and mental retardation) is associated with what neoplasms?
astrocytoma, angiomyolipoma, and cardiac rhabdomyoma
Actinic keratosis is associated with what neoplasm?
squamous cell carcinoma of skin
Barrett's esophagus is associated with what neoplasm?
Esophageal adenocarcinoma
Plummer-Vinson syndrome (atrophic glossitis, esophageal webs, anemia; all due to iron deficiency) is associated with what neoplasm?
squamous cell carcinoma of esophagus
Cirrhosis (alcoholic, hepatitis B or C) is associated with what neoplasm?
hepatocellular carcinoma
The condition ulcerative colitis is associated with what neoplasm?
colonic adenocarcinoma
Paget's disease of the bone is associated with what neoplasm?
secondary osteosarcoma and fibrosarcoma
Immunodeficiency states predisposed the person to develop what neoplasm?
malignant lymphomas
AIDS predisposes a person to develop what neoplasms?
aggressive malignant lymphomas (non-Hodgkin's) and Kaposi's sarcoma
Autoimmune diseases (Hashimoto's thyroiditis and myasthenia gravis) is associated with what neoplasm?
lymphoma
Acanthosis nigricans (hyperpigmentation and epidermal thickening) is associated with what neoplasm?
visceral malignancy (stomach, lung, uterus)
Dysplastic nevus is associated with what neoplasm?
malignant melanoma
Radiation exposure is associated with what neoplasms?
Sarcomas, papillary thyroid cancer, leukemia
The oncogene abl is associated with what tumor and has what gene product?
CML, tyrosine kinase
The oncogene c-myc is associated with what tumor and has what gene product?
Burkitt's lymphoma and the gene product is a transcription factor
The oncogene bcl-2 is associated with what tumor and has what gene product?
follicular lymphoma, it is anti-apoptotic
The oncogene erb-B2 is associated with what tumor and has what gene product?
breast, ovarian, and gastric carcinomas and associated with tyrosine kinase
The oncogene ras is associated with what tumor and has what gene product?
colon carcinoma, GTPase
The oncogene L-myc is associated with what neoplasm and has what gene product?
lung tumor, transcription factor
The oncogene n-myc is associated with what neoplasm and has what gene product?
neuroblastoma, transcription factor
The oncogene ret is associated with what neoplasm and has what gene product?
multiple endocrine neoplasia (MEN) types IIA and IIB, tyrosine kinase
The oncogene "c-kit" is associated with what neoplasm and has what gene product?
gastrointestinal stromal tumor (GIST) and gene product is cytokine receptor
Li-Fraumeni syndrome is characterized by a mutation in what gene?
p53
Breast and ovarian cancer is associated with what gene mutation? Breast cancer alone is associated with what gene mutation?
breast and ovarian - BRCA1, breast cancer alone -BRCA2
A mutation in p16 is associated with what tumor?
melanoma
A mutation in APC is associated with what tumor?
Colorectal cancer (associated with FAP)
A mutation in WT1 is associated with what tumor?
Wilm's tumor
A mutation in NF1 is associated with what tumor?
Neurofibromatosis Type 1
A mutation in DPC is associated with what tumor?
pancreatic cancer
A mutation in DCC is associated with what tumor?
colon cancer
This is a carcinoembryonic antigen that is very nonspecific but is produced by 70% of colorectal and pancreatic cancers; also produced by gastric, breast, and thyroid medullary carcinomas
CEA
With hepatocellular carcinomas and nonseminomatous germ cell tumors (such as yolk sac tumors) this tumor marker is increased
alpha-fetoprotein
Beta-HCG is increased in what tumors?
Hydatidiform moles, choriocarcinomas, and gestational trophoblastic tumors
CA125 is increased in what types of tumors?
ovarian, malignant epithelial tumors
S100 is increased in what types of tumors?
melanoma, neural tumor, schwannomas
Alkaline phosphatase is increased in what type of tumors?
metastases to bone, obstructive biliary disease, Paget's disease of the bone
Bombesin is a tumor marker for what types of neoplasms?
neuroblastoma, lung and gastric cancer
TRAP is a tumor marker for what types of neoplasm?
Hairy cell leukemia
CA-19-9 is a tumor marker for what type of neoplasm?
Pancreatic adenocarcinoma
Calcitonin is a tumor marker for what type of neoplasm?
thyroid medullary carcinoma
EBV is associated with what cancers?
Burkitt's lymphoma, Hodgkin's lymphoma, and nasopharyngeal carcinoma
Cervical carcinoma (16,18) and penile/anal carcinomas are associated with what cancers?
HPV
Kaposi's sarcoma and body cavity fluid B-cell lymphoma is associated with what viral infection?
HHV8
Primary CNS lymphoma is associated with what viral infection?
HIV
H.pylori is associated with what cancer?
gastric adenocarcinoma and lymphoma
Schistosoma haematobium is associated with what cancer?
squamous cell carcinoma of transitional epithelium, e.g. bladder
Aflatoxins produced by ____ can lead to _____ carcinoma
aspergillus, hepatocellular
Vinyl chloride is a carcinogen that can lead to _____
angiosarcoma of the liver
CCL4 is a carcinogen and can impact what organ and cause what?
liver, centrilobular necrosis, fatty change
Nitrosamines (found in smoked foods) can impact what organ and cause what?
stomach, gastric cancer
Cigarette smoke can impact the larynx and cause ______, lung and cause _______, kidney and cause ______, bladder and cause _______
squamous cell carcinoma; squamous cell and small cell carcinoma; renal cell carcinoma; transitional cell carcinoma
Asbestos can impact what organ and cause what?
lung, mesothelioma and bronchogenic carcinoma
Arsenic can affect the skin and cause ______, or it can affect the liver and cause ______
squamous cell carcinoma, angiosarcoma
Naphthalene (aniline dyes) can impact what organ and cause what?
bladder, transitional cell carcinoma
Alkylating agents can impact what organ and cause what?
blood, leukemia
Small cell lung carcinoma can produce ectopic _____ which can lead to Cushings syndrome
ACTH
Small cell lung carcinoma and intracranial neoplasms can produce ectopic _____ which can lead to SIADH
ADH
Squamous cell lung carcinoma, renal cell carcinoma, and breast carcinoma can produce ____ which can lead to hypercalcemia
PTH related peptide
Renal cell carcinoma, hemangioblastoma, hepatocellular carcinoma, and pheochromocytoma can produce ____ which can lead to polycythemia
erythropoietin
A thymoma and small cell lung carcinoma can produce effects such as antibodies against presynaptic calcium channels at neuromuscular junction. This can cause _____ syndrome
Lambert-Eaton syndrome
Leukemias and lymphomas can lead to hyperuricemia to excess nucleic acid turnover. This can lead to what effects?
gout, urate nephropathy
Psammoma bodies are laminated, concentric, ____ spherules seen in what 4 conditions?
they are calcified and seen in papillary adenocarcinoma of thyroid, serous papaillary cystadenocarcinoma of ovary, meningioma, and malignant mesothelioma
What is the leading cause of cancer death in both men and women?/
lung
What primary tumors like to metastasize to the brain?
lung, breast, kidney, skin (melanoma)
What primary tumors like to metastasize to the liver?
colon, stomach, pancreas
What primary tumors like to metastasize to the bone?
prostate, breast, lung, thyroid, testes
Does lung metastases cause osteolytic or osteoblastic lesions? What about prostate mestastases to bone?
lung - lytic; prostate -blastic