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114 Cards in this Set

  • Front
  • Back
What is Pathology?
The study of disease

medical specialty used to understand how disease works, diagnose by signs, prevention by studying structural biochemical and functional change in the cell tissue or organ
What are the aspects of pathology?
General
Diagnostic
Anatomic/systemic
Clinical
Forensic
Toxicological/experimental
Who was the father of pathology?
Rudolph Virchow

"regardless of etiology disease begins at the molecular level
What is disease?
an abnormal body process with characteristic signs that may affect the whole body or parts

**begins at the molecular and cellular level**
What are the 4 aspects of disease?
Etiology - cause of disease
Pathogenesis - mechanism
Molecular/morphologic - change
Clinical manifestation - functional consequence of change
Who was the father of pathology?
Rudolph Virchow

"regardless of etiology disease begins at the molecular level
What are the 2 classes of etiology?
Genetic (intrinsic)
Acquired (extrinsic)

Etiology is multifactual
What is Pathogenesis?
Sequence of events from inital stimulus to the ultimate expression of the disease in the response of cells or tissues to the etiology
What are molecular and morphologic changes when referring to disease?
refers to structure alterations in cells or tissues that are either characteristic of a disease or diagnostic of an etiologic process
What is clinical manifestation of disease?
results of genetic, biochemical and structural changes in cells and tissues are functional abnormalities leading to clinical manifestations
What is a sign vs a symptom?
Sign - what we see as a clinician
Symptom - what the patient feels
What are the types of diagnosis?
Clinical
Differential
Morphologic
Etiologic
Clinical Pathologic
What is a diagnosis?
concise statements or conclusion concerning the nature, cause or name of a disease
What is a differential diagnosis?
list of disease that account for the evidence or lesions of the case
What is a clinical diagnosis?
based on history, signs, physical exam

*may provide differential diagnosis
What is a morphologic diagnosis?
based on predominant lesions in the tissue
What is an etiologic diagnosis?
a definitive name for a specific disease
What is a clinical pathologic diagnosis?
based on the changes observed in the chemistry of fluids and the hematology, structure and function of cells collected from a living patient
What is Prognosis?
foretelling of the coarse of a disease
an outcome
can be good, intermediate or poor
What is Pathognomonic?
Characteristic or indicative of a specific disease
*sometimes other diseases look similar so its not pathognomonic
What is Necrosis vs apoptosis?
Necrosis tissue death that cases inflammation

apoptosis- programmed cell death where cells are killed and eaten by macrophages, no inflammation
What is cell adaptation?
occurs when the cell homeostasis is distorted by stresses or pathologic stimuli
What is atrophy?
decrease in size and or number of cells and their metabolic activity after normal growth
What is hypertrophy?
increase in size of cells and their functions
synthesis of more organelles and structural proteins, bigger cells
What is Hyperplasia?
increase in the number of cells of an organ, may occur with hypertrophy
What is metaplasia?
change in the phenotype of differentiated cells due to chronic irritation

ex transitional to squamous epithelial
What is dysplasia?
abnormal development of epithelial cells
used in neoplastic processes
carcinoma in situ
What is cell injury?
damage or pathologic alterations in molecules and structures that can occur in cells and extracellular compartments
What are types of O2 deprivation?
hypoxia
ischemia
anoxia
anemia
CO2 Toxicity
Cyanide toxicosis
What is hypoxia?
inadequate oxygenation of tissue
What is ischemia?
reduction of O2 in tissue
What is anoxia?
complete reduction of O2 in tissue
What is anemia?
reduces number of RBC in blood or volume or are deficient in hemoglobin
What us cyanide toxicosis pathogenesis?
Plants containing glycosides
free cyanide reacts with ferric iron which forms cytochrome oxudase which stops cellular respiration = deprivation of O2

ex arrow grass (Triglochin maritima) Early shoots of Sorghum grass (seeds ok to eat)
What are physical effects that causes cell injury/death?
Trama - damage blood supply
extreme heat - denatures
extreme cold - crystals/blood
excessive heat - metabolic rxn
electricity - generates heat
ionization radiation - radicals
radiation - neoplasia, damage
What are chemical effects that causes cell injury/death?
Chemical agents that include toxins and drugs
ex lead
can directly or indirectly induce cell injury or cell apoptosis
carbon tetrachloride, chloroform behaves like it

Bacterial - exotoxins, gram (-) bacteria release LPS


Viruses shut down host protein synthesis by inducing increased membrane permeability and Ca entry

Nutritional deficiency - vit E, no protection against free radicals
What are some other types of tissue injury?
denetic derangement - purkinje cell necrosis in cerebellar abiotrophy of calves

immunologic rxn and dysfunction - complement

T-lymphocyte indused cell apoptosis in viral infection

aging
What are important targets of injurious stimuli?
mitochondria -site of ATP generation
cell membranes
Protein synthesis
Cytoskeleton
Genetic apparatus of the cell
What are general mechanisms of cell injury?
ATP depletion
Mitochondrial change
influx of Ca
Free radials
What can cause ATP depletion?
associated with hypoxic and chemical injury

depletion < 5% - 10% have critial effects on cellular systems such as:
1 reduction of Na pump
2 change in metabolism due to decreased O2
3 failure of Ca pump
4 disruption of protein synthetic apparatus - detachment of ribosomes
5 misfolded proteins
What can cause mitochondrial damage?
important in most types of cell injury (toxins, hypoxia)

oxidative stress - increase in cytosolic Ca 2
leakage of cytochrome C - trigger apoptotic pathway
membrane damage and loss of calcium homeostasis (free cytosolic Ca 2 is normally maintained by ATP dependant CA transporters)
Ca influx = ischemia, denature proteins poison mitochondria, activate cellular enzymes
What are free radicals?
Single unpaired e- in outer orbit, extremely unstable and react with organic and inorganic chemicals

initiates autocatalytic rxns
molecules reacting with free radicals convert to free radicals too
reacts with lipids, proteins and nucleic acids causing peroxidation of membranes, cross-linking and DNA damage respectively
What are sources of free radicals?
Absorption of UV light
redox reaction
exposure to toxins
What can terminate free radicals?
superoxide dismutase
glutathione peroxidase
catalase
antioxidants (vit E,A,C, beta- carotein, ceruplasmin, ferritin
What is a reversible cell injury?
change in homeostatic norms that return to original state when stressor or injurous stimuli is removed

ex cellular swelling and fatty changes (featherlike-circular like microscopically)
What is irreversible cell injury?
Change in homeostatic norms that go beyond the point of no return and undergo cell death

ex necrosis and apoptosis
What is Necrosis?
cells inability to maintain integrity

cell contents leak and cause inflammation
enzymes for digestion come from lysozymes of dying cells or lysosomes of WBCs recruited
What are some examples of nucleic changes due to necrosis
Karyolysis - nuclear fading
pyknosis - nuclear shrinkage
Karyorrhexis - nuclear fragmentation
What are gross characteristics of necrosis?
pale, soft, friable and sharply demarcated from viable tissue by a zone of inflammation
What do patterns of necrosis provide?
Clues about the underlying cause but not the mechanism of disease
What are the 6 types of pattens of necrosis?
Coagulation
Liquification
Gangrenous
Caseous
Fat
Fibrnoid
What is coagulation necrosis?
where architecture of dead tissue is preserved
caused by ischemia
removed by lysozymes and phagocytosis
What is an infarct?
a localized area of coagulative necrosis
What is Liquefactive necrosis?
usually found in the CNS

dead cells are digested and give a liquid form because of focal bacterial and sometimes fungal infections
What is caseous necrosis?
cheese-like appearance and seen in chronic infection
poorly degradable lipids from bacterial origin
causes granuloma
What is an abscess?
a localized collection of pus in a cavity formed by disintegration of tissues surrounded by fibrous connective tissue

the bodies defense against foreign materials
What is gangrenous necrosis?
begins as coagulative necrosis due to ischemia and seen in the distal limbs

can be wet or dry
What is fat necrosis?
focal areas of fat destruction

can be enzymatic, traumatic and necrotic
What is Fibrinoid necrosis?
type of necrosis due to immune reactions involving blood vessels

not seen grossly

Ag-Ab complexes are deposited in the wall of the vasculature
What is apoptosis?
programmed cell death triggered by specific receptor mediated stimuli loss of signals on well differentiated cells
can be physiological or pathological
What are examples of Physiological Apoptosis?
Embryogenesis, involution of organs, epithelial turn over
What are examples of pathological apoptosis?
TNF-alpha, DNA damage,misfolded proteins, viral infections, atrophy of organs
What is the intrinsic pathway for apoptosis?
the major mechanism of apoptosis. Results in increase mitochondrial permeability and release pro-apoptotic molecules
withdrawal of hormones or injury - release cytocome C into cytoplasm initiates suicide controlled by pro and anti apoptotic membranes of Bcl family
What are the Anti-apoptotic proteins?
What are the Pro-apoptotic proteins?
Anti
Bcl-2, Bcl-x, Mcl-1

Pro
BAX, BAD, BAK, BIM, BID
What is the intrinsic pathway for apoptosis?
initiated by death receptors or Fas-L
death receptors = TNF receptor
Fas-L = cytotoxic T lymphocytes
caspase 8 activated
What are some disorders associated with apoptosis?
mutations in p53 = give rise to cancer
autoimmune disorders
neurodegenerative
death of virus in infected cells
What is Autophagy?
cell eats its own contents
occurs in times of nutritional deprivation, formation of the phagolysosome
What is Heterophagy?
When a phagocytic WBC injests dead/dying cells
What are intracellular accumulations?
abnormal amounts of various substances due to
1) normal cellular constituents in access (h20, lipid, protein)
2)abnormal substances both exogenous (minerals/ infections agents) or endogenous (abnormal synthesis or metabolism)
3) pigment
What is lipolysis?
the accumulation of TG and other lipid metabolites with in the cytosol or a parachymal cell
What stains glycogen?
PAS (periodic acid schiff)

also stains type 4 collagen
What are examples of excess glycogen?
Equine polysaccharide storage myopathy

A-GM1- gangliosidosis in beagles, spaniels, water dogs, siamese and DSH cats. Problems with B galactosidase

b-GM-2 gangliosidosis, seen in GSP and japanese spanial, problems with hexosaminodase
What is a characteristic of excess production of protein?
grape-like hyaline bodies called russell bodies which is seen in the cytoplasm of some plasma cells (mott cells)

excess protein can be caused by misfolder proteins of viral inclusion bodies
What is Amyloidosis?
a condition associated with a # of inherited and inflammatory disorders in which extracellular deposits of fibrillar proteins are responsible for tissue damage and functional compromise
2 Types
primary - seen in humans, light chain derived amyloidosis (plasma cell proliferation)
secondary - seen in vet med, reactive systemic amyloidosis common in beagles, sharpeis, siameses cats
What is the distribution of water in the body?
60% water
40% intracellular
20% extracellular
What two factors control the movement of water in the vasculature?
hydrostatic pressure
plasma colloid osmotic pressure
What are the main types of collagen?
Type 1 found in extracellular matrix and type 4 found in basement membranes
What influences hydrostatic pressure?
the beating of the heart
What influences colloid osmotic pressure?
plasma proteins
How is excess fluid removed from the interstitium?
by the lymphatics via the thoracic duct
What is edema?
the accumulation of fluid in the interstitium due to inadequate drainage of the lymphatics
What is transudate fluid?
a non inflammatory, protein poor low specific gravity fluid resulting from increased hydrostatic pressure or decreased plasma protein associate with heart failure, renal failure and malnutrition
What is exudate fluid?
an inflammatory, protein rich fluid of high specific gravity resulting from vascular permeability
What are the four mechanisms of edema?
increased hydrostatic pressure
decreased osmotic pressure
sodium and water retention
increased microvascular permeability
What condition do we see a nutmeg liver appearance?
right sided heart failure
What are some pathways activated when hydrostatic pressure occurs?
activation of RAAS

ADH
What factors are associated with increased microvascular permeability.
histamine
complement products C5a and C3a
leukotrienes
all widen interendothelial gaps
What is lymphadema?
swelling of a part of the body by an increased quantity of lymph due to a lymphatic system disorder
What is hydrothorax?
water in the thoracic cavity
What is hydropericardium?
water in the pericardium, surrounding the heart.
What is hydroperitoneum?
water in the abdomen
ascites
What is is hydroureter?
distension of ureter with water due to an obstruction
What is hydronephrosis?
water accumulated in the kidney
What is hydrocephalus
Water accumulated with in the ventricles of the brain
What is anasarca?
a term used for generalized edema
What is hyperemia?
increase blood volume to a particular tissue
a local active process due to dilation leading to increased blood flow and engorgement of vessels with oxygenated blood (erythematous)
What is congestion?
increased blood volume of blood in tissue
can be systemic or local, passive process due to vascular engorgement due to outflow of blood accumulation of deoxygenated hemaglobin (cyanosis)
What is chemosis?
edema of the conjunctiva
What is hemorrhage?
the extravasation of blood into the extravascular space
What is atherosclerosis?
condition of fatty material along the walls of arteries
What is shock?
condition in which the body isn't getting enough blood flow
What are causes of hemorrhage?
trauma
vascular erosion by neoplasia or inflammatory process
endothelial damage
What can cause direct endothelial damage?
endotoxemia
infectious agents (adenovirus)
uremic toxins
immune complexes that activate comeplement (type III hypersensitivity)
What is hemothorax?
blood in the thoracic cavity
What is hemopericardium?
blood around the heart?
What is hemoperitoneum?
blood in the abdominal cavity
What is hemarthrosis?
blood in the joints
What is an aneurysm?
balloon like dilation of blood vessels
can be saccular, fusiform or rupture
What is hematemesis
Vomiting blood
What is hematochezia?
defecating blood from the lower GI tract
What is melena?
defecated blood from the upper GI tract
What is hematuria?
Urinating blood
What is epistaxis?
bleeding from the nose
What is hemoptysis?
coughing up blood