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225 Cards in this Set

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Define neoplasia.
A neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of normal tissues and persists in the same excessive manner after cessation of the stimuli which evoke the change.
In contrast to normal cells, the growth of neoplastic cells is?
Autonomous, excessive and disorganized
Autonomous means?
The growth of neoplastic cells is independent of growth factors and regulatory mechanisms operating inside the normal tissues.
Excessive means?
This excess may be evident in the size of the outgrowths and the duration of the proliferation.
Disorganized means?
The structures formed by tumor cells differ from normal tissues and do not fit into the general organization scheme of the normal body.
Define other key words used in the study of neoplasia: Tumor?
Tumor-literally a swelling ("tumefaction"). It is used as a synonym for neoplasm.
Clinically, tumors are classified as? (2)
•benign (good natured, innocuous)
•malignant (bad, ominous, potentially lethal).
Cancer?
a synonym for malignant tumors.
Oncology?
the science dealing with the study of tumors (Greek term oncos is equivalent to the Latin term tumor, meaning a swelling).
What are hamartomas?
Hamartoma is a mass composed of cells and tissues native to the organ in which structures arose, usually during fetal development. (Disorganized)
Examples include: Mole
melanocytic nevus - This skin hamartoma represents an aggregate of pigment cells that are normally dispersed in the skin.
Pulmonary hamartoma
It presents as a nodule composed of cartilage, bronchial epithelium, and smooth muscle cells
What are choristomas?
is a mass composed of normal cells or tissues found in a wrong location.
It is also called?
Ectopia.
Examples include: (2)
•Pancreatic choristoma in the stomach or in the liver
•Ectopic brain tissue in the nasal cavity
Define dysplasia.
Dysplasia means abnormal growth and differentiation. The term may have a developmental pathology or oncologic meaning.
In developmental pathology, dysplasia is used to?
describe morphogenetic abnormalities (e.g., dysplastic kidneys).
In oncology, dysplasia is used to?
describe disorderly growth and maturation of cells that are not normal but are not obviously malignant either. This kind of dysplasia is a premalignant condition, a precursor of invasive neoplasia.
Dysplasia can also be considered?
as a transitional stage linking neoplasia to hyperplasia or metaplasia.
Examples include:
•Squamous dysplasia of the cervix.
Dysplasia may be graded as mild, moderate, or severe (grade I, II, or III). Severe dysplasia cannot be reliably distinguished from carcinoma in situ. To avoid misunderstanding, dysplasia and carcinoma of the cervix are grouped together under the name cervical intraepithelial neoplasia (CIN), which is then graded as mild, moderate, or severe.
•Liver cell dysplasia.
It is well-known that liver cell carcinomas arise at an increased rate in cirrhosis caused by viral hepatitis B and C. Such pathologically altered liver may contain preneoplastic cells that can be recognized in histologic sections. Such cells have irregularly enlarged nuclei with prominent nucleoli.
What is anaplasia?
Adult somatic cells are differentiated-that is, they express genes in a tissue-specific manner. Anaplasia of tumor cells is defined as lack of differentiation. Anaplastic tumor cells differ from normal cells and pathologists can recognize them as "atypical."
•Pleomorphism is?
variation in size and shape of nuclei.
•Hyperchromatic nuclei is where?
the chromatin in the nuclei is increased in amount and irregularly distributed ("clumped").
•Atypical mitoses is?
mitoses may be tripolar ("Mercedes logo-like") or multipolar, in contrast to bipolar normal mitoses.
•High nuclear:
cytoplasmic ratio, thus resembling embryonic cells.
•Or Bizarre cells like?
giant cells.
KEY POINTS: NEOPLASIA (3)
1.Tumors are classified and named on the basis of their clinical and pathologic features, which must be correlated to determine the prognosis and the mode of therapy for each tumor.
2.Most tumors can be classified as either benign or malignant.
3.Metastasis, a unique feature of malignant tumors, is a complex process resulting in the transfer of tumor cells from the site of origin to distant organs.
How are neoplasms classified clinically?
Neoplasms can be classified on the basis of their clinical behavior as benign or malignant.
Benign tumors have what kind of prognosis?
A good prognosis.
malignant tumors have what kind of prognosis?
An unfavorable prognosis and are potentially lethal.
A third category can be recognized for some tumor types, such as ovarian tumors. These tumors are called?
borderline malignant or low-grade malignant tumors.
If recognized early and surgically resected, such borderline tumors have?
an excellent prognosis (>95% 5-year survival), but if untreated they metastasize and kill the patient.
What is the basis of histologic or histogenetic classification of tumors?
Tumors often retain many of the histologic features of their tissue of origin.
For example:
•a squamous cell carcinoma resembles
normal squamous epithelium.
•transitional cell papilloma of the urinary bladder is lined by transitional epithelium resembling
normal transitional epithelium.
On the basis of such microscopic data (histologically), one can determine?
the composition of the tumors and in many instances theoretically reconstruct the histogenesis of most tumors (from Greco-Latin words histo, meaning tissue, and genesis, meaning development).
The histologic-histogenetic classification of tumors is widely used to?
amplify the clinical classification.
The histologic-histogenetic classification serves as a basis for?
selecting treatment and for formulating the prognosis of the neoplastic disease in each particular case.
What is the difference between carcinoma and sarcoma?
Most human organs (except for the nervous system) are composed of epithelial or connective tissue cells or both.
Carcinoma:
Malignant tumors of epithelial origin are called carcinomas.
Sarcomas:
Sarcomas are malignant tumors of connective tissue origin.
Epithelial cells of carcinomas form?
nests surrounded by nonneoplastic connective tissue stroma.
In sarcomas, which are of connective tissue origin, the tumor cells are?
intermixed with the nonneoplastic stromal cells.
Carcinoma (CA) is composed of?
epithelial malignant cells surrounded by stroma that contains fibroblasts, collagen, and blood vessels.
Since the epithelial cells form glands, this tumor is classified as?
an adenocarcinoma.
Sarcoma (SA) is composed of?
malignant connective tissue (mesenchymal) cells that merge imperceptibly with other nonneoplastic mesenchymal cells that form the stroma of the tumor. The blood vessels are included in the stroma of this sarcoma but are not as visible as in the loose stroma of the carcinoma.
Are there any benign equivalents of carcinomas and sarcomas?
Yes. The names for benign tumors are formed by adding the suffix -oma to the cell of their origin.
A benign tumor originating from fibroblasts is called?
fibroma
a tumor of fat cells is called?
Lipoma
a tumor of smooth muscle cells is called?
Leiomyoma
a tumor of striated muscles is called?
Rhabdomyoma
a tumor of bone is called?
Osteoma
Benign epithelial tumors could be called?
Epitheliomas
Epitheliomas
is not specific enough and is not used at all.
Instead, benign epithelial tumors are known under a number of other names, such as:
•Adenoma.
This tumor is composed of cells forming glands or tubules.
Benign endocrine gland tumors are also called?
adenomas.
•Papilloma.
This descriptive term is derived from the Latin word for the nipple.
Papillomas appear as?
nipple-like protrusions on the surface of the skin or a hollow organ (e.g., urinary bladder).
The surface of some papillomas may branch into smaller fronds which give such tumors a?
cauliflower appearance
•Polyp.
This term is derived from the Greek term meaning "numerous feet" as seen in the octopus.
These tumors may be attached to?
the surface of the skin or mucosa of hollow organs by a stalk.
Other tumors form finger-like epithelial protrusions broadly attached to the surface of their origin. Such tumors are called?
sessile polyps.
On the basis of their histologic features and presumed cell or tissue of origin, neoplasms can be classified as: (4)
-Epithelial tumors.
-Tumors of blood cells and lymphocytes.
-Tumors of neural and glial cells and neural support structures.
-Germ cell tumors.
Epithelial tumors - More than 80% of all human tumors are of epithelial origin. They can be benign or malignant. Depending on the type of epithelium, these tumors are classified as:(4)
1.Squamous cell tumors.
2.Glandular tumors.
3.Transitional cell tumors.
4.Connective tissue tumors
Squamous cell tumors:
Benign & Maglignant
Benign: squamous cell papilloma.
Malignant: squamous cell carcinoma.
Glandular tumors:
Benign & Maglignant
Benign: adenoma
Malignant: adenocarcinoma.
Transitional cell tumors:
Benign & Maglignant
Benign: transitional cell papilloma.
Malignant: transitional cell carcinoma.
Connective tissue tumors:
Benign (3) & Maglignant (3)
Benign tumors include: fibromas, lipomas, and osteomas, etc.
Malignant tumor equivilants: fibrosarcomas, liposarcomas, osteosarcomas, etc.
Tumors of blood cells and lymphocytes. (5 minimum)
All tumors in this category are malignant. They include entities such as lymphomas, leukemias, multiple myeloma, polycythemia rubra vera, Hodgkin's disease, and others.
Tumors of neural and glial cells and neural support structures. (3)
This category includes tumors such as neuroblastoma, gliomas, and meningiomas.
Germ cell tumors. (4)
This category includes tumors such as seminoma, teratoma, teratocarcinoma, and choriocarcinoma.
What are mixed tumors?
Mixed tumors are composed of both epithelial and connective tissue tumor cells.
Benign mixed tumors composed of epithelial and myoepithelial cells and cells resembling cartilage cells are commonly found in the?
salivary glands.
Malignant mixed tumors are called?
carcinosarcomas.
Carcinosarcomas composed of adenocarcinoma and various sarcoma cells are most often found in the?
uterus.
uterine tumors are also called?
malignant mixed Müllerian tumors.
What are teratomas?
Teratomas are tumors of germ cell origin.
Teratomas are composed of tissues derived from three germinal layers:
ectoderm, endoderm, and mesoderm.
in a teratoma one may find ectodermal derivatives such as?
skin and neural tissue
in a teratoma one may find endodermal derivatives such as?
intestine-like and bronchial-like structures
in a teratoma one may find mesodermal tissues such as?
bone or cartilage all intermixed in a haphazard manner.
Malignant teratomas are called?
teratocarcinomas.
Teratocarcinomas tumors consist of?
differentiated somatic tissues and malignant stem cells.
These stem cells are developmentally equivalent to?
early embryonic cells and are called embryonal carcinoma cells.
What is the difference between leiomyoma and rhabdomyoma?
Leiomyomas are tumors composed of smooth muscle cells. Rhabdomyomas are tumors of striated muscle cells (i.e., cells forming the skeletal or heart muscle).
Malignant tumors composed of the smooth muscle and skeletal muscle cells are called?
leiomyosarcomas and rhabdomyosarcomas, respectively.
What are blastomas?
Blastomas are tumors composed of immature cells resembling those that form the fetal anlage or primordia of adult organs.
Retinoblastoma is a tumor of the?
Eye.
neuroblastoma is a tumor composed of?
nerve precursors cells (neuroblasts).
hepatoblastoma is a tumor composed of?
fetal hepatocytes.
•Hodgkin disease-
a special form of malignant lymphoma.
•Ewing sarcoma-
a malignant bone tumor.
•Wilms tumor-
a malignant kidney tumor of childhood, also known as nephroblastoma
•Kaposi sarcoma-
a blood vessel tumor of the skin and internal organs
•Burkitt lymphoma-
a form of malignant lymphoma
Is seminoma a benign tumor?
The suffix -oma attached to the cell or tissue of origin of a specific tumor is commonly used to name benign tumors (e.g., osteoma and fibroma). There are, however, some important exceptions to this rule, and seminoma is one of them.
Seminoma is a malignant tumor of the?
seminal epithelium in the testis.
The equivalent tumor originating from the female germ cells in the ovary is called?
dysgerminoma.
Give some other examples of malignant tumors ending in -oma.
•Glioma. (3 types)
Almost all tumors derived from glia cells are malignant. This group includes tumors such as astrocytoma, oligodendroglioma, and ependymoma, all of which are actually malignant.
•Lymphoma.
All lymphoid neoplasms are malignant. To emphasize this fact, it is customary to add an adjective and call these tumors malignant lymphomas.
•Insulinoma, gastrinoma, somatostatinoma, and glucagonoma.
These endocrine pancreatic tumors originating from the islets of Langerhans may be either malignant or benign. Histologically, it is not possible to distinguish benign from malignant endocrine tumors.
Is meningioma a benign tumor?
Most meningiomas (96%) are biologically benign intracranial tumors of limited growth potential. Due to their intracranial location and the proximity to vital centers, meningiomas must be removed surgically because they can increase the intracranial pressure and compress the vital centers. Even though biologically benign, such meningiomas may kill the host (i.e., act in a clinically "malignant" manner).
What is the difference between tumor invasion and metastasis?
Malignant tumors invade locally and extend into the surrounding normal tissues. On the other hand, metastasis is a spread of tumors to sites that are anatomically separate from their site of origin.
How do tumors metastasize? (3)
Tumors may metastasize three ways:
•Lymphatic spread:
•Hematogenous spread:
•Seeding of body cavities:
What is Lymphatic spread?
Tumor cells invade the lymphatics and spread to local lymph nodes.
What is Hematogenous spread?
Tumor cells invade the blood vessels and are carried by blood to distant sites.
What is seeding of body cavities?
Tumor cells enter the cavities and float in the serous fluid to attach on the surface of the peritoneal or pleural cavity.
Which tumors metastasize through the lymphatics, and which ones metastasize hematogenously? (2)
Previously, it was thought that carcinomas metastasize through the lymphatics and sarcomas through blood vessels. This rule is only partially correct, and there are many exceptions.
•Tumors of organs that are rich in lymphatics, such as the breast and the large intestine, metastasize preferentially through the lymphatics. Such tumors may metastasize hematogenously as well, but blood-borne metastases usually occur in later stages of the disease.
•Tumors originating in organs that are well vascularized but contain few lymphatics, such as bones, tend to metastasize hematogenously. This fact accounts for the high rate of hematogenous metastases of bone sarcomas.
Which carcinomas metastasize more often hematogeneously than through the lymphatics? (2)
Carcinomas of the liver and the kidney, two organs that have more blood vessels than lymphatics, metastasize more often hematogeneously than lymphogenously.
Do all malignant tumors metastasize?
No. Malignant tumors of the brain usually kill the patient before the tumor has the chance to metastasize. The fact that brain tumors do not have metastases does not automatically mean that the cells of these tumors cannot metastasize.
Evidence that brain tumors can metastasize includes the following:
•“Drop-metastases" in the spinal cord.
These metastases develop occasionally from cerebellar medulloblastoma cells carried to distant sites by the cerebrospinal fluid.
•Lymph node metastases in patients who have had brain surgery.
It is assumed that the surgery has breached the blood-brain barrier and thus allowed the tumors to metastasize.
•Metastases through shunts.
Some brain cancer patients whose cerebrospinal fluid is drained into the abdominal cavity by a tube have developed distant metastases. Such metastases arise from tumor cells carried by the cerebrospinal fluid through the man-made shunt.
Which tumors spread primarily by seeding of body cavities?
Peritoneal seeding is common in patients with ovarian cancer. Malignant tumors originating from the surface epithelium of the ovary tend to detach and float away in the peritoneal fluid. Such floating cells may attach to the serosal surfaces covering the abdominal wall or abdominal organs.
Staging is used to determine
the extent of spread of a tumor, overall, staging is much more predictive of the tumor behavior and is thus more valuable for prognosis.
Staging is based on?
correlating all the available clinical data with the pathologic findings.
•For example, the size of the tumor is assessed radiologically and on gross examination during surgery and in the pathology laboratory. The lymph nodes are examined to establish whether the tumor has spread to local and distant lymph nodes. Radiologic and radioisotope studies can be used to establish whether there are distant metastases.
Grading of tumors is based on?
microscopic examination of tumor tissues obtained at the time of operation or by biopsy.
Tumors are graded on a scale from?
I to III

Descriptively:
I. well differentiated
II. moderately well differentiated
III. poorly differentiated.
What is the TNM system?
The TNM system is used for staging of tumors.
In the TNM System, T stands for?
T stands for the size of the tumor, which is expressed according to defined criteria for each anatomic site on a scale from 1 to 4.
In the TNM System, N stands for?
N (from 0 to 3) stands for lymph node involvement.
In the TNM System, M stands for?
M (0 negative, 1 positive) stands for distant metastases.
A small tumor that has not metastasized yet is designated as?
T1, N0, M0.
A small tumor that has metastasized to lymph nodes and distant sites is designated as?
T1, N1, M1.
Are there other staging systems besides the TNM system?
Yes. TNM is not a perfect system, and many other systems have been developed by cancer societies and even major medical centers. Some tumor staging systems were devised even before the TNM system was proposed and are still used in clinical practice. Probably the best known staging system is the Dukes system for staging colon cancer.
Acute inflammation is?
immediate and early response to injury designed to deliver leukocytes to sites of injury.
AI lasts?
hours, days to months
AI: sudden or persistant?
usually of sudden onset
classical signs of AI?
vascular and exudative (discharge) processes predominate
Chronic inflammation is?
prolonged inflammation
CI lasts?
weeks, months to years
In CI does scarring occur?
Yes, by fibrosus
CI characterized by?
Exudation
CI arises with?
persistent infections and/or prolonged exposure to toxic agents
Prolonged and persistent inflammation marked chiefly by?
new connective tissue formation
CI may be a continuation of?
an acute form or a prolonged low-grade form of inflammation.
What are the two most common morphological changes?
Cellular swelling and fatty change
What is the first change to be recognized in almost all types of cell injury?
Cellular swelling
Cellular swelling is also referred to as:
Hydropic change
What is cellular swelling?
Membrane damage causes the cell to lose ionic and fluid homeostasis
What is fatty change?
A result of metabolic derangement of injured cells that have high quantities of lipids. It is usually seen in the liver
What are the four mechanisms of the accumulation of fat in cells?
1) Increased peripheral mobilization of free fatty acids and uptake to cells
2) Increased conversion of fatty acids to triglycerides
3) Reduced oxidation of triglycerides to acetyl-CoA
4) Deficiency of apoproteins which prevent export of triglycerides
Example of Increased peripheral mobilization of free fatty acids and uptake to cells:
- diabetes mellitus (no glucose, so we need fat)
Example of Increased conversion of fatty acids to triglycerides:
- alcohol
Example of Reduced oxidation of triglycerides to acetyl-CoA:
- hypoxia, alcohol
Examples of Deficiency of apoproteins which prevent export of triglycerides:
- genetic disease, protein malnutrition
The most common cause of fatty change in the liver is:
Alcohol
FUNCTIO LAESA
term coined by Virchow
- the result of swelling and pain=loss of function
CALOR
=heat=result of vessel dilation and increased blood flow to the inflamed/injured tissue
DOLOR
=pain=due to pressure on nerve endings from swelling and from chemical mediators which are released to facilitate the inflammatory process
TUMOR
=swelling=caused by accumulation of exudates in the inflamed part
Rubor
Redness, especially as a sign of inflammation.
What are macrophages called when they become filled with lipids?
Foam Cells
Foam Cells
=cholesterol intracellular accumulation-scavenger macrophages in contact with lipid debris of necrotic cells or abnormal forms of plasma lipid may become stuffed with lipid because of their phagocytic activities.
What is a xanthoma?
Clusters of foamy cells found in subepithelial connective tissue of skin and tendons
What is hyperplasia?
Increase in number of cells caused by cell division
What are the two types of hyperplasia?
Physiological or pathological.
Physiological hyperplasia is either:
Hormonal or compensatory
Physiological-hormonal example of hyperplasia:
Estrogen stimulation of endometrium during pregnancy
Physiological-compensatory example of hyperplasia:
Removal of a kidney results in hyperplasia of other kidney
Pathological example of hyperplasia:
Thyroid hyperplasia – Graves Disease
What is involution?
The opposite of hyperplasia = reduction in the number of cells through apoptosis
What are some examples of apoptosis (hormonal)? (3)
- Endometrium during menstrual cycle
- Lactating breast after weaning
- Prostrate after castration
What are the Adaptations?
(6)
Atrophy
Hypertrophy
Hyperplasioa
Metaplasia
Dysplasia
Storage
What is atrophy?
A decrease in the size and function of a cell, tissue, or organ.
It shrinks in volume and shuts down its function. It can return to normal.
What are the causes of atrophy? (6)
- Decreased workload
- Loss of innervation
- Diminished blood supply
- Inadequate nutrition
- Loss of trophic stimulation
- Aging
What is hypertrophy?
- Increase in the size of existing cells.
- Increase in their functional capacity, usually in skeletal/cardia muscle – can’t divide
- Increase is due to increased synthesis or cell proteins and organells (more mito.)
Physiological Stimuli of hypertrophy: (2)
Exercise w/skeletal muscle, estrogen stimulation of uterus in pregnancy
Pathological stimuli of hypertrophy:
Hypertension – hypertrophic left ventricle
What is metaplasia?
Reversible adaptation in which one adult cell type changes or differentiates into different mature cell type
Usually a result of longstanding exposure to stress, causing a change for a better suited type of cell
Examples of metaplasia: (2)
Chronic irritation by cigarette smoke to bronchi = squamous metaplasia
Urinary bladder due to infection – transitional becomes squamous (squamous metaplasia)
Phlebothrombosis
Occlusive venous thrombi
What are the most important clinical conditions complicated by deep vein thrombosis?
Deep vein thrombosis of the calf (DVT or phlebothrombosis) is the most common form of thrombosis that is clinically diagnosed. DVT may be related to varicose dilatation of calf veins, but often its causes are not apparent.
Chemoattractants can be?
exogenous or endogenous.
Exogenous chemoattractants are derived from?
bacterial polypeptides, which carry a terminal formylated-methionine sequence
Similarly, endogenous chemoattractants are generated from?
mitochondrial polypeptides released from damaged cells.
Other important endogenous chemotactic substances include? (3)
- Products of complement system activation (e.g., C5a)
- Arachidonic acid derivatives formed through the lipoxygenase pathway (e.g., leukotriene B4)
- Cytokines (e.g., IL-8)
What are the main arachidonic acid-derived mediators of inflammation? (2)
Arachidonic acid is formed from cell membrane phospholipids. Once formed inside the cell, arachidonic acid is metabolized through two major pathways:
- Cyclooxygenase pathway.
- Lipoxygenase pathway.
Cyclooxygenase pathway: This pathway leads to? (3 major)
the formation of prostaglandins of the PGD, PGE, and PGF series; prostacyclin (also known as PGI2); and thromboxane.
Endothelial cells produce preferentially?
prostacyclin, which prevents the aggregation of platelets and acts as a potent vasodilator.
Platelets, on the other hand, produce preferentially?
thromboxane, which favors aggregation of platelets and vasoconstriction. PGE2 stimulates smooth muscle cell contraction.
How could the arachidonic acid metabolism be inhibited?
Aspirin and nonsteroidal anti-inflammatory drugs inhibit cyclooxygenase and block the synthesis of prostaglandins, thromboxane A, and prostacyclin; corticosteroids promote the synthesis of lipocortin, an inhibitor of phospholipase, thus reducing the production of arachidonic acid.
dystrophic calcification
necrotic tissue is impregnated with calcium salts
MAJORLY SEEN in athromas and athrosclerosis
An example of dystrophic calcification causing organ dysfunction?
if dystrophic calcification happens in aortic valve it can cause aortic stenosis
Metastatic Calcification
can be seen in normal tissue when there is hypercalcemia
4 causes of Metastatic Calcification include:
- inc parathyroid secretion
- bone destruction
- Vit-D disorder
- renal failure (you would retain phosphates leading to inc hyperthyroidism……
What are emboli?
Emboli are particulate, fluid, or gaseous material carried by the bloodstream from the site of their origin or entry into the circulation to other parts of the body.
What are the most common and clinically most important emboli?
- Venous.
- Arterial.
- Paradoxical.
What is a venous emboli?
These originate in the veins and are carried by venous blood into the lungs.
What is a arterial emboli?
These emboli originate in the heart or aorta and large arteries and are carried by arterial blood into various organs, such as the brain, kidney, and spleen.
What is a paradoxical emboli?
These emboli originate as venous emboli, but instead of reaching the lungs they cross through a foramen ovale or some right-to-left shunt in the heart and thus reach the arterial circulation.
What are pulmonary emboli?
Pulmonary embolism (PE) is most often caused by venous thromboemboli originating in the veins of the lower extremities. Depending on the size of the thromboemboli and the extent of embolization, PE may present in several forms.
Where do arterial emboli lodge most often?
Arterial emboli may occlude any artery. Which artery will be occluded depends on the size of the thrombus. Large thrombi occlude large arteries, such as those of the legs and arms, and celiac, mesenteric, renal, splenic, or cerebral arteries. Smaller emboli reach the branches of these arteries in various organs.
What are septic thromboemboli?
Septic emboli result from infected thrombi, such as valvular vegetations in bacterial endocarditis. Infarct caused by such emboli becomes infected by bacteria and transforms into an abscess.
What is air embolism?
Air embolism is caused by entry of atmospheric air into the circulation or by the appearance of intravascular nitrogen bubbles due to decompression. Air bubbles may occlude blood vessels or cause disseminated intravascular coagulation (DIC). DIC is triggered by platelets that tend to adhere to nitrogen bubbles and become activated to initiate the coagulation cascade.
What is fat embolism?
Fat embolism results from the entry of fat globules into the circulation. In most instances, the cause of fat embolism is fracture of long bones. Fat cells in the bone marrow rupture due to trauma, releasing their contents into the venous blood. Trauma of subcutaneous or breast fat cells usually does not cause fat embolism.
What is bone marrow embolism?
Entry of bone marrow particles into the circulation may occur upon fracture of bones that contain hematopoietic bone marrow. Typically, it occurs during cardiopulmonary resuscitation of people who have had a cardiac arrest.
What is tumor embolism?
Tumor cells may enter the circulation by migrating through the wall of capillaries but also through the wall of larger vessels during surgery. Circulating tumor cells may be found in many tumor patients, but only a minority of these cells ultimately form emboli.
What are cholesterol emboli?
Cholesterol emboli result from the entry of cholesterol crystals from atherosclerotic lesions into the arterial bloodstream. Typically, this occurs during catheterization of the aorta or a surgical procedure, but it may also be caused by spontaneous rupture of an atheroma. These crystals occlude capillaries causing microscopic infarcts.
What is foreign body embolism?
Foreign bodies entering the circulation may be carried to distant parts of the body by the circulation. Examples of such emboli are cotton, wool, or cloth fibers entering the blood flow during surgery, crystals of talc or starch injected by intravenous drug abusers, and bullets.
What is amniotic fluid embolism?
Amniotic fluid may enter into the uterine veins during childbirth. Fortunately, it is very rare (1:80,000 deliveries), but if it occurs it is lethal in 80% cases.
What is thrombosis?
Thrombosis is a pathologic process characterized by intravascular clotting in a living person. Clots formed in circulating blood inside the blood vessels or cardiac chambers are called thrombi. Postmortem clots or coagula formed in a test tube are not called thrombi.
What is Virchow's triad?
Rudolf Virchow, the famous German pathologist, suggested in 1845 that three factors promote thrombosis:
-Changes in the vessel wall
-Changes of blood flow
-Changes in the composition of blood
Which changes in the blood flow predispose to thrombosis?
-Stasis, typically found in dilated veins
-Turbulent flow, typically encountered in abnormally dilated heart chambers that are not contracting regularly (e.g., atrial fibrillation) or arterial aneurysms
A mnemonic to remember common causes of thrombosis is THROMBI:
-Tissue damage (trauma, fractures, burns, and surgery)
-Hereditary conditions (factor V Leyden, deficiency of antithrombin, and protein C or S)
-Rest (prolonged bed rest after surgery or in old age)
-Obstetrics (normal pregnancy, eclampsia, and abruptio placentae)
-Malignancy
-Blood flow disturbances (varicose veins, myocardial infarct, aneurysms, and apoplexy)
-Immune mechanisms (SLE-anti-phospholipid antibody and polyarteritis nodosa)
What is the color of a hematoma?
Hematoma is a grossly visible accumulation of extravasated blood in the tissue. First it is red, and then as the blood is deoxygenated it becomes dusky and bluish red. As the red blood cells fall apart, biliverdin will form and the hematoma will appear greenish. Bilirubin formed from biliverdin will give it a yellow hue.
Polycyclic aromatic hydrocarbons:
found in tobacco smoke and tar. May cause lung cancer and skin cancer.
Aromatic azo dyes:
urinary bladder cancer in workers in aniline dye industry.
Aflatoxin B-1-toxin produced by?
Aspergillus flavus that grows on moldy grains and peanuts. Suspected as cause of liver cancer in underdeveloped countries.
Nickel:
cancer of nasal cavity and lungs in mine workers.
Arsenic:
skin cancer in vineyard workers.
Asbestos
mesothelioma in shipyard and insulation workers.
Phospholipase
A phospholipase is an enzyme that hydrolyzes phospholipids[1] into fatty acids and other lipophilic substances. There are four major classes, termed A, B, C and D distinguished by what type of reaction they catalyze.
Nitrosamines
Any of a class of organic compounds with the general formula R2NNO or RNHNO, present in various foods and other products and found to be carcinogenic in laboratory animals.
Type I - Immediate Hypersensitivity
IgE - Anaphylactic RXN
Histamine
Prostaglandin
TNF
Leukotrenes
Eosinophils
Impure
Adults
Receive
Pink
Houses
to
Love
Elves
Type II - Antibody Mediated DZ's
Igm & IgG - Cytotoxic
Antibody to fixed tissue antigen
PCN RXN
Erythroblastosis Fetalis
Graves DZ
Transfusion RXN
Good Pasture
Sjogerns DZ
Myasthenia Gravis
Pertitious Anemia
Burtons DZ
I'm interrogating cytotoxic
antibody's fixed against
planetary realignment
every fucking
given day
they react
gleefully pinching
simple dwarves
muttering goofy
plans all
before daybreak
Type III - Immune Complex DZ's
Immunocomplex DZ
Lupus (SLE)
Serum Sickness
Post Strep. Glomerulonephritis
Polyartertis Nodosa
Reacive Artheritis
Arthus RXN
Irritating Dogs
Lick Simple
Shouting Schoolchildren
Pushing Silver Guns
Pigs Nimbly
Race After
Attacking Racoons
Type IV - T Cell Mediated Hypersensitivity
T-Cell Mediated delayed Hypersensitivity
2 Types:
CD4 Delayed Type Hypersensitivity
CD8 Direct Cell Cytotoxicity
Contact Dermititis
T.B.
Rheumatioid Arthritis
M.S.
Crohn's DZ
Type I DM
They may discuss having
2 types:
Four-D Terrorizing Hounds
Eight-D Cautious Cows
Can Dogs
Take Back
Radical Attacking
Mad Steaks
Can Dogs
Tempt 1 Death?
Suppresor genes
Tumor suppressor genes regulate mitosis and cell division. When their function is impaired, the result is a high rate of uncontrolled cell growth or cancer. Damage to tumor suppressor genes contributes to a large number of different types of tumors.
Melanoma
A dark-pigmented, usually malignant tumor arising from a melanocyte and occurring most commonly in the skin.
Cystadenoma
A benign tumor derived from glandular tissue, in which secretions are retained and accumulate in cysts. Also called cystoadenoma.
UV LIGHT
causes mutation of the TP53 gene
IONIZING RADIATION (4)
provides a way to diagnose tumors and its a potent mutagen and destroyer of cells
-occurs as x-rays and gamma rays and high energy particles—alpha and beta particles
-exerts effects on cells by displacing electrons from molecules and atoms altering the cell
-DNA is the target, damaging it by forming free radicals
EPSTEIN-BARR VIRUS
-involved in pathogenesis of human tumors
-tropism/infection of B-cells—causing them to proliferate
—leads to B-cell immortilization—causes lymphoblastoid cells lines
—they express EBV encoded antigens