Histology - Exam 3 Cc's With Hints

Front 1

Signs
· Amyloid deposits and calcified spherites (or psammoma bodies) accompany excessive synthesis and secretion of prolactin

Back 1

Prolactinomas

Treatment:· Bromocriptine
o Dopamine agonist
o Reduces tumor size and inhibits prolactin secretion
· Tumors larger than 10 mm in diameter (macroadenomas) require surgery or radiation.

Hint 1

Accounts for 30% of all neoplastic pituitary tumors, is the most common type.
·
A tumor of mammotrophs

In women, leads to:
- Amenorrhea
- Infertility
- Osteopenia
- Galactorrhea

In men, leads to:
- Erectile dysfunction

Loss of libido

Front 2

Signs
- Labored breathing
- Cyanosis
- Caused by inability of pulmonary alveoli to expand or remain open after inspiration.

Etiology

Inadequate supply of surfactant at birth

Related to deficient surfactant production, or,

Failure of development and maturation of type II pneumocytes

Back 2

Infant Respiratory distress syndrome.

Corticoid steroid therapy emphasized in class

Hint 2

Treatment depends on disease severity and prematurity of the infant.

Include:
- Supply O2 to assist respiration
- Mechanical ventilation
- Corticosteroid therapy
- Delivery of artificial surfactant to the lungs.

Front 3

Symptoms
1. Situs inversus
2. Reversal of body organ positioning during prenatal development
3. Sinusitis
4. Bronchiectasis
a. Chronic enlargement of bronchial airways.
5. Manifests in neonatal life
6. Chronic upper and lower respiratory tract disease

Results in defective mucociliary clearance

Males demonstrate infertility secondary to immotile spermatozoa.

Back 3

Kartagener syndrome (also known as primary ciliary dyskinesia. An immotile cilia syndrome)

Hint 3

Etiology
- Autosomal recessive pattern
- Unknown origin
Signs
- EM reveals a deficiency of dynein arms in the cilia

Leads to their motility defect

Front 4

Symptoms
Thick and sticky mucous, which predisposes the patient to chronic lung infections.

Etiology
- Autosomal recessive disorder caused by defective CF transmembrane conductance regulator.
- An active transporter
- Defective transport of chloride ions in mucous cells of seromucous glands in the respiratory tract.

Also affects cells producing sweat, saliva and pancreatic secretions.

Back 4

Cystic fibrosis

Hint 4

Danger
- Respiratory failure is the most dangerous consequence.
- Can be life-threatening
Treatment
Good candidates for gene-therapy.

Front 5

Symptoms
Clinical manifestations range from mild to life-threatening
- An inflammatory disorder of the exocrine pancreas

Etiology (causation)
- Associated with alcoholism or excessive alcohol intake.
- Acinar cell injury or pancreatic duct obstruction may lead to inappropriate extracellular leakage of activated digestive enzymes
- Leads to autodigestion of pancreatic acini.

Back 5

Acute pancreatitis

Hint 5

Diagnosis
- Elevated serum amylase and lipase levels.

Complications
- Edema and progressive fibrosis of the stroma
- Causes hemorrhage and ultimately pancreatic insufficiency.

Front 6

Symptoms
Most have no symptoms
Blockage can cause
a. Jaundice
b. Biliary colic (severe abdominal pain)

Etiology
The presence of stones in the gallbladder or extrahepatic biliary ducts.
Often solid deposits of cholesterol or calcium salts.

Back 6

Cholelithiasis

Hint 6

Cholecysistis
Gallbladder inflammation or infection
Marked by:
- Mucosal inflammation
- Abnormal thickening of muscularis layer (layer 2)

Treatment
Most common is laparoscopic surgery.

Front 7

Symptoms: polyuria, with great amounts (15-20 L) of hypotonic urine and polydipsia (extreme thirst)

Back 7

Diabetes insipidus

Hint 7

Causes: Damage to supraoptic nuclei of hypothalmous or damage to hypothalamohyophyseal tract interferes with ADH production (therefore, kidneys do not concentrate urine, etc)

Front 8

Symptoms: eye bulging, heat intolerance, nervousness, irritiable, weight loss in presence of appetite

Back 8

Hyperthyroidism- exophthalmic goiter (Graves disease)

Goiter is a non-specific term for chronic enlargement of the thryroid

Hint 8

Cause:
autoimmune disorder- antibodies to the TSH receptor on follicular cells
-thyroid hormone production up, colloid volume down and TSH is suppressed
-lymphocyte infiltration

Front 9

Symptoms: goiter

Back 9

Hypothyroidism- Hashimoto thyroidism

Hint 9

Cause: autoimmune disorder- thyroid peroxidase antibodies

Front 10

Symptoms:

excessive production of PTH leads to hypercalcemia, nephrolithiasis -renal stones with calcium oxalate and calcium phosphate

Or

Carninoma of parathyroid- poor prognosis

Back 10

Primary hyperparathyroidism

Hint 10

Cause: adenoma of parathyroid gland- chief cells interspersed with giant cells

Front 11

Symptoms: insufficient corticosteroid-

raised pituitary ACTH levels- abnormal pigmentation of skin and oral mucous membranes

Insufficient cortisol- related to muscle weakness and fatigability

Insufficient aldosterone- interfere with renal fluid and electrolyte balance lowers blood pressure, circulatory shock

Back 11

Addison disease or

Primary adrenocorical insufficiency

Inadequate production of glucocorticoid and mineralcorticoid hormones

Hint 11

Cause: incomplete development of cortex, autoimmune, severe infection (TB), idiopathic atrophy

Inadequate production of glucocorticoid and mineralcorticoid hormones

Front 12

Neoplasm that arises from catecholamine-producing cells.

elevated epineprhine and norepinephrine.
- sustained or intermittent hypertension

Back 12

Pheochrocytoma

Hint 12

ADULT tumors of the adrenal medulla

Front 13

Malignant tumor derived from embryonic neural crest cells (chromaffin cells or postganglionics)

Usually metastatic and worse

Back 13

Neuroblastoma

Hint 13

CHILD tumors of the adrenal medulla

Front 14

Type 1-autoimmune destruction of beta cells,

Back 14

Diabetes mellitus

Hint 14

Type 2- islets accumulate amyloid

Front 15

Abnormally dilated submucosal veins -occur in distal 1/3
When portal blood flow is obstructed- become collateral vessels between portal and systemic circulations

Back 15

Esophageal varices

Bad things: prone to rupture, life threatening

Treatment: Endoscopy

Hint 15

Causes: Cirrhosis and portal hypertension from alcoholic liver disease and viral hepatities
(increased enodthelin-1, vasoconstrictor and decreased nitric oxide, dilator= portal hypertension)

Front 16

Symptom: heartburn, rarely leads to more serious adenocarcinoma

Back 16

Barrett esophagus

Hint 16

Cause: GERD patients at risk

Metaplasia of the esophageal epithelium, columnar (like stomach) replaces usual stratified squamous

Can occur anywhere above the GE junction

Front 17

Inflammation of the esophagus with damage to the epithelium

Back 17

Esophagitis

Hint 17

Cause: reflex of gastric contents into lower esophagus- impairs repair of mucosa

Front 18

Chronic condition common in adults over 40

Ballooned squamous epithelial cells with irregular thickened regions (leukoplakia)

Lamina propria with elongated papillae and infiltrated eosinophils, neutrophils and plasma cells

Back 18

Gastroesophageal reflux disease (GERD)

Hint 18

Cause: accompanies hiatal hernia or incompetent lower sphincter

Front 19

Symptoms: inflammation of the stomach, gastric ulcers via urease, chronic: gastric adenocarcinoma

Back 19

Heliobacter pylori

Treatment: antibiotics

Hint 19

Gram-negative bacterium, inhabits gastric mucosa
-unclear mode of transmission but infection rates high in developed, underdeveloped

Diagnosis: look at mucosa and stool, blood

Front 20

Symptoms: severe abdominal pain and distention, nausea, vomiting, diarrhea- life threatening if untreated

Back 20

Peritonitis Localized or diffuse inflammation of the peritoneum

Hint 20

Cause: entry of bacteria into the peritoneal cavity via an internal perforation of the digestive tract or external penetrating wound (E. coli or Enterococus faecalis)- gastric ulcer, appendicitus, diverticulitis, cholescystitis, gangrenous obstruction of the small intestine, complication of surgery

Front 21

Symptoms: bleeding diarrhea and abdominal pain, life-threatening complications

Back 21

Chrohn's disease

Types of Inflammatory bowel disease, small intestine and colon

Hint 21

Cause: polygenetic
Abnormalities penetrate all four layers of affected wall, deep ulcerations, granulomas, prominent lymphoid aggregates and dilated submucosal lymphatics

Front 22

Entire colon and terminal ileum can be evaluated in one examination, used to screen for colon cancer- biopsy samples can be obtained
Used to remove polyps (abnormal elevations of colonic mucosa)-may progress from adenomas to carcinomas

Back 22

Colonoscopy

Hint 22

Hereditary and dietary factors play a role in formation of polyps and colorectal neoplasms

Front 23

Hyperplasia associated

Back 23

Adenocarcinoma of the small intestine

Front 24

Presence of diverticula, or herniations of mucosa and submucosa through the muscularis externa of the colon

Back 24

Diverticulosis

Hint 24

Cause: unknown, but low-fiber diets in developed countries

Prevention: high-fiber diet (25-30mg/day)

Front 25

Symptoms: cramps, bloating, constipation, blood in stool, perforations, tears, bleeding and infection

Back 25

Diverticulitis-

Hint 25

Inflammation of the diverticula


Treatment: antibiotics, may need surgery

Front 26

Cause: obstruction of the narrow lumen, greater susceptibiliy to bacterial infection

Symptoms: pain in lower right quadrant, nausea, vomiting

Diagnosis: CT scan, WBC count

Back 26

Appendicitis

Inflammation of the appendix

Hint 26

First affects the mucosa, penetration of other layers may lead to abcess, necrosis, perforation into the peritoneal cavity, and peritonitis (inflammation of the peritoneum)

Treatment: appendectomy

Front 27

Varicose submucosal veins of the hemorrhoidal plexus that protrude into the rectum or anal canal- common

Internal hemorrhoids- above pectinate line, superior hemorrhoidal veins

External hemorrhoids-below pectinate line, infereior hemorroidal plexus

Back 27

Hemorrhoids

Hint 27

Cause: genetic predisposition and increased pressure in the veins resulting from straining or pregnancy

Chronic congestion of veins, lack valves, lead to thrombosis and bleeding

Front 28

Hepatitis A: acute hepatocellular injury, elevated serum aminotransferase?, and bilirubin levels, and serum IgM and anti HAV antibodies

Hepatitis B: ground glass hepatocytes, caused by accumulation of hepatitis B surface antigen in endoplasmic reticulum

Hepatitis C: (blood), may be chronic, cirrhosis and hepatocellular carcinoma

Back 28

Viral hepatitis

Hint 28

Broad array of acute or chronic inflammatory liver disorders

Cause: hepatotropic viruses; Epstein-Barr virus, herpes simplex virus, and cytomegalovirus

Front 29

Symptoms: liver cell damage, extensive fibrosis and inflammation, hepatocytes accumulate fate and distend-mitochondria grossly enlarged,

mallory bodies (inclusion)-aggregates of intermediate (cytokeratin) filaments of the cytoskeleton

Parallel functional alterations in cell oxidation and metabolism

Back 29

Excessive ethanol consumption

Hint 29

Toxic to the liver

Front 30

End stage of chronic liver disease, excessive deposition of CT produces abnormal fibrous septa made of collagen bundles;

Persistent liver cell necrosis leads to nodules of regenerating hepatocytes encircled by fibrosis- marked disruption in micro-architecture of liver

Back 30

Cirrhosis

Hint 30

Progression: distortion of the vascular supply, portal hypertension, reduced hepatocyte function and liver failure

Cause: alcohol abuse, biliary obstruction, viral hepatitis

Front 31

Symptoms: jaundice because of excess circulating bilirubin
Deposits of bile pigment in dilated canaliculi, hepatocytes and ducts

Back 31

Intrahepatic cholestasis

Pathologic state of reduced bile formation or flow

Hint 31

Cause: ion pump or permeability defect in the canalicular membrane or in contractile properties of canaliculi or bile ducts
Diagnostic: elevated levels of serum alkaline phospatase, enzyme in canaliculi and ductal epithelium

Front 32

-abnormally low levels of this serum protease inhibitor, a glycoprotein usually produced by hepatocytes- defect in migration from RER to golgi results in dilated RER cisternae *distinctive feature

Back 32

Autosomal recessive a1-antitryppsin deficiency

Common genetic liver disease in infancy and childhood

Hint 32

Severe damage to hepatocytes-causes hepatitis in newborns and cirrhosis- liver transplant needed

Front 33

Leading cause of cancer deaths worldwide (85% due to cigarettes)

Most- carcinomas arising from repiratory epithelium of the trachiobronchial treee or pneumocytes of pulmonary alveoli

Back 33

Lung cancer

Hint 33

Non-small cell carcinomas-most common, grow rapidly, metastasize and respond poorly
Small-cell carcinomas- arise form bronchial epithelium and are highly malignant (20%)

Carcinoid tumors-slow-growing neuroendocrine neoplasms from pleuripotential basal cells of respiratory epithelium (5%)

Front 34

Symptoms: dyspnea, couching, respiratory distress, and wheezing result from bronchiospasm, bronchial wall edema and hypersecretion of mucous glands

Back 34

Asthma

Disorder with heightened response of the tracheobronchial tree to numerous stimuli, millions affected annually

Hint 34

Mucosal and submucosal edema, thickening of the basement membrane, hypertrophy of smooth muscle, and profuse infiltration of leukocytes, usually eosinophils; intraluminal mucous plugs- narrow airway; hypercontraction of smooth muscle- greater resistance to airflow.

Front 35

Symptoms: labored breathing and cyanosis

Cause: inability of alveoli to expand or remain open after inspiration; due to inadequate supply of surfactant, related to deficient production or failure of development/maturation of type II pneumocytes

Back 35

Infant respiratory distress syndrome
(hyaline membrane disease)

Affects 10% of premature infants

Hint 35

Treatment: depend on severity, supply of O2, mechanical ventilation, corticosteroid therapy , artificial surfactant

Front 36

Somatotroph - Growth Hormone (GH)-
Mammotroph- Prolactin (PRL)- milk secretion

Back 36

Acidophils:

40% of total anterior pituitary cell population

Hint 36

Anterior pituitary

Front 37

Corticotroph-Adrenocorticotropic hormone(ACTH)- hormone release from adrenal cortex

Gonadotroph- Follicle-stimulating hormone (FSH),

LH-ovarian follicle and sperm

Thyrotroph- Thyrotropin (TSH)- thyroid hormone synthesis and secretion

Back 37

Basophils

10% of total anterior pituitary cell population

Hint 37

Anterior pituitary

Front 38

Paraventricular Nucleus: Oxytocin (OXY)- uterine contraction, milk ejection

Supraoptic: ADH- water excretion, arteriolar constriction

Back 38

Posterior lobe of pituitary

Hint 38

*Herring bodies

Front 39

Melanocyte-stimulating hormone

B-endorphin

Back 39

Intermediate lobe

Hint 39

Small, lobular zone closer to posterior pituitary

Front 40

lowers blood calcium levels and counterbalances parathyroid

Back 40

C cells of thyroid

Hint 40

Calcitonin

What cells does it come from?

Front 41

BMR,

gluconeogenesis,

lipolysis,

eating,

role in CNS development

Back 41

Follicular cells of thyroid

Hint 41

T3, T4, colloid

Formed by which cells

Front 42

increase blood calcium level- (osteoclast, kidney-reabsorption of Ca and activate vitamin D to increase absorption of Ca)

Back 42

Chief cells of parathyroid

(oxyphils have unknown function)

Hint 42

PTH- parathyroid hormones-

Secreted by which cells?

Front 43

Zona Glomerulosa: salt
Mineralcorticoids- aldosterone

Zona Fasciculata: sugar
Steroid hormones- cortisol

Zona Reticuloaris: sex
Sex hormones- androgens

Back 43

Cortex of adrenal gland

Hint 43

These hormones are produced where?

Front 44

Chromaffin cells:
catecholamines- epinephrine, norepinephrine

Back 44

Medulla of adrenal gland

Hint 44

These hormones are produced where?

Front 45

A-cells: glucagon

B-cells- Insulin. *halo

Delta cell - *dark granule, somatostatin- inhibitory function for whichever is not going

F-cells
Pancreatic polypeptide

Back 45

Islets of Langerhans

Front 46

Stratified squamous

Back 46

Esophagus

Hint 46

Distal: Cardiac glands
Submucosal glands

Front 47

Simple columnar
Surface mucous cell
Mucous neck cell
Parietal cell
Chief cell
Enteroendocrine

Back 47

Stomach

Hint 47

Proximal: Cardiac glands
Gastric glands
Distal: pyloric glands

Front 48

Villous columnar epithelium
Enterocytes
Goblet cells
Paneth cells
Crypt base columnar cell (stem cell)
enteroendocrine

Back 48

Small intestine

Hint 48

Submucosal (Brunner's) glands

Front 49

Goblet cells
Enterocytes
Enteroendocrine cells

Back 49

Large intestine

Front 50

Stratified Squamous Epithelium
Goblet cells

Back 50

Anal canal

Front 51

These swollen macrophages with ingested hemosiderin may be seen in sputum and are known as heart failure cells.

Back 51

Congestive heart failure - Heart failure cells.

Hint 51

○ Erythrocytes from the bloodstream may escape into pulmonary alveolar spaces.
○ Alveolar macrophages phagocytose them.

Front 52

On the luminal surface increase surface area.

Back 52

Microvilli of Endothelial cells.

Hint 52

- React to antibodies to ACE (angiotensin-converting enzyme)

Inhibitors are used to treat congestive heart failure.

Front 53

a. Pathologic function
i. Fibrosis (Dudek heavily emphasized this disease)

Back 53

1. Collagen

Hint 53

Ii. Typified by difficulty breathing, toughened collagen fibers

Front 54

a. Physiologic function
i. Recoils the lung after inhalation

Back 54

2. Elastic fibers