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68 Cards in this Set

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List 4 reasons for atrophy?
Denervation
Ischemia
DMD
Immobilization
What is Goldblatt Kidney
Small kidney resulting from renal artery stenosis
Aplastic Anemia
Myositis Ossificans
Barrett's Lymphoma
Congenital Adrenal
Gravid Uterus
Myelofibrosis
Verruca Vulgaris
Goldblatt kidney
Atrophic Gastritis
Klinefelter's Syndrome
Aplastic Anemia - Atrophy
Myositis Ossificans - Metaplasia (muscle to bone)
Barrett's Lymphoma- Metaplasia (due to GERD)
Congenital Adrenal - Hyperplasia
Gravid Uterus - Hypertrophy and Hyperplasia
Myelofibrosis - Metaplasia (myeloid line to fibrous CT)
Verruca Vulgaris - Hyerplasia (too many keratinocytes)
Goldblatt kidney - Ischemis Atrophy
Atrophic Gastritis - Metaplasia
Klinefelter's Syndrome - Hypogonadism, Hypoplasia
Explain what following terms mean...

Dysplasia
Dystrophy
Desmoplasia
Neoplasia
Dysplasia-Disorganized or abnormal growth (atypia)
Dystrophy-Defective nutrition or degenerative disorder
Desmoplasia-Fibrou tissue formation in stroma of tumor
Neoplasia-Uncontrolled clonal proliferation of cells
What is Calcinosis?

Two types? Their definition?
Formation of calcium deposits in any tissue.

Types
(1) Dystrophic Calcficiation - Due to tissue damage. Ca and Phosphate levels are normal.

(2) Metastatic Calcification - Due to imbalance of Ca-PO4 in blood.
What are lipofuscin?
Residual lysosomal vesicles with undigestible material. Usually created as part of Heterophage, not Autophage.

NOTE: Autophagy would create Lipofuscins only when the cell has experienced Oxidative Damage.
What is hemosiderin?
Iron Oxide deposits. One of the last stages of a bruise.

Caused by bleeding into an organ. Macrophages phagocytose Hb and release Hemosiderin and Porphyrin.
What is Alcoholic Hyaline?

Stain...
Aka Mallory body; mainly found in liver cells.

Composed of keratin-like intermediate filament protein.

Eosinophilic, hence pink color.
Diptheria

How does Diptheria Exotoxin work?
Diptheria bacteria release exotoxin that damages heart and causes fatty acid accumulation.

It blocks protein synthesis by irreversible inactivation of elongation factor 2 (EF-2). This inhibits translation and so protein synthesis stops.
Signs of diptheria?
Pseudomembrane of larynx

Fatty change of heart - alternating layers of fatty and normal tissue produces tiger stripes.
Describe fatty changes in following tissues.

Heart
Liver
Macrophages
Heart-usually due to diptehria exotoxin. Can be seen as tiger stripes. Cases heart failure.

Liver - Hepatic Steatosis. Multiple causes. Increase alcohol consumption, Increased free FA delivery to liver, decrease apoprotein synthesis

Macrophages - Cholesterol accumulation. Foamy macrophages and foam cells in atherosclerosis.
Differential of clear spaces in cytoplasm as seen with microscopy...and their special stains.
(1) Glycogen (PAS positive material that is diastase sensitive)
(2) Water (no special stain-hydropic change)
(3) Lipid (oil Red O)
List different mechanisms that cause fatty change in liver?
(1) Increase free FA delivery to liver (secondary to lipolysis)

(2) Increased formation of Trig as seen with alcohol use

(3) Decreased production of Apoproteins

(4) Carbon tetrachloride (which is metabolized to free radical which damages RER and apoprotein production is disturbed)
What is Kwashiorkor?

Descrine carbon tetrachloride damage?
Protein Malnutrition

Carbon tetrachloride is metabolized to toxic free radical (trichloromethyl) that damages RER and decreases production of apoprotein and VLDL
Special stain for hemosiderin is...
Prussian blue
Best way to see lipofucin..
Electron Microscopy (does not stain)
Special stain for lipid
oil red O
Special stain for glycogen
PAS positive material that is diastase sensitive
How does injurious stimulus effect a cell?
(1) Membrane damage (damage to mito, lysosomes)

(2) Increase in intracellular Ca (protein damage)

(3) Increase in reactive oxygen species inside the cell

(4) Decrease ATP (due to damage to mito)
List some tipping points for necrosis?
Rupture of lysosomes.
Swelling of ER and dissociation of ribosomes from RER.
Dense bodies in the Mito
Protein synthesis has stopped.
Injurious stimuli for necrosis are...
Ischemia, Toxins, Increase Intracellular Ca, Reactive Oxygen species

Effects many cells in the region (unlike apoptosis)
List seven differences between Necrosis and Apoptosis?
Necrosis - (1) Cluster of cells, (2) content is spilled in extracellular space, (3) results in inflammation, (4) DNA degradation results in smear of DNA (Apoptosis has ladder configuration), (5) cells swell, (6) cells are not phagocytosed by macrophages, membranes are destroyed, (7)takes a while to complete (apoptosis only takes a few mins).
Which enzymes are involved in protecting cells from ROS damage?
SOD - Superoxide dismutase (superoxide into oxygen and Hydrogen peroxide)
Catalase - Hydorgen peroxide to water and oxygen
Glutathoine Peroxidase
What is unique about apoptotic cell membrane?
Cell membrane has phosphotidyl serine on the outside, normally its inside (negatively charged)
What are the two receptors for extrinsic pathway of apoptosis?
TNF and FAS
List some ways to activate Caspases?
P53 (due to DNA damage) and Granzyme (from Tcyt cells)
How do macrophages recognize apoptotic blebs for phagocytosis?
Via Phosphotidyl Serine on its membrane. Because this is usually on the inside of membrane.
What is phospholipid Flipase?
Flips plasma mebrane and so Phosphotidyl serine ends up on the outside.
List ways to detect apoptosis?
DNA ladder configuration, TUNEL essay
Caspase cleavage/activation
Phoshoptidyl Serine on the outside; Annexin V binding.
Steps for TNF stimulating apoptosis?
(1) TNFR1 binds to TNF
(2) TNFR1-TNF complex activates TRADD
(3) TRADD activates FADD
(4) FADD activates capsase 8
Steps for TNF inhibiting apoptosis?
TRADD binds to NF-KB/IK transcription regulation system via Adaptor protein.

IK is degraded.
NF-KB gets into nucleus and upregulates transcription. Inhibiting Apoptosis.
What is NAIP? Mutations in NAIP cause...
NAIP - Neuronal Apoptosis Inhibitory Protein. Mutations of NAIP cause spinal muscle dystrophy.
What defines intrinsic pathway of apoptosis?
No involvment from a receptor/ligand.

Increase permeability of Mito causes apoptosis.
What is the function of BCL-2?
it stops apoptosis. By 1.Blocking cytoC and 2. Apaf-1.
How does p53 impact cytoC levels in cytoplasm?
it increases it.

p53 causes formation of BAX pores in mito. CytoC and other pro-apoptotic factors can leak out and cause the cell to go apoptosis.
Initiator caspases...
Executioner caspase....

Named caspase because...
Caspase 8 and 9
Caspase 3 and 6

C is for Cysteine protease and aspase is for cleavage after aspartic acid residue.
What is a councilman body?
Councilman body results from the apoptotic death of a single liver cell.
What is Toxic Epidermal Necrosis?
Drug induced TEN is related to presence of Fas on keratinocytes. Can be treated with Ig to prevent Fas from binding to FasL.
Which peptides are responsible for vasodilation as part of inflammatin?
PG, Histamine, NO, Bradykinin
Which peptides are responsible for increased vascular permeability during inflammation?
Histamine, Bradykinin, C3a, C5a, LT C4, D4, E4
Effects of bradykinin?
Vasodilation, Increased Vascular permeability and pain
Six possible reasons for increased endothelial permeability?
(1) EC contraction (HIstamine)(2) Increased Transcytosis (VEGF) (3) Direct injury (4) Leukocyte induced injury (5) Leakage due to angiogenesis (VEGF) (6) Delayed prolonged - Secondary kinins, complement cascade
Three types of integrins are...
CD18 plus

CD11a - Form LFA1
CD11b - Form CR3 (Mac-1)Binds iC3bBb
CD11c - Form CR4 (aka gp150, 95) binds iC3bBb
How are following complement cascades activated?

Classical
Alternative
Classical - IgM and IgG and C-reactive protein.

Alternative - IgA, LPS, C3 Nephritic factor
Cause and Findings of Leukocyte Adhesion Disorder?
Cause: Defective CD18 Integrin

Findings - (1) Recurrent infections (2) Insufficient wound healing (3) Delayed separation of umbilical cord

Labs: Neutrophil count will be HIGH but neutrophils at inflammation site will be low.
Cause and Findings of Leukocyte Adhesion Disorder?
Cause: Defective CD18 Integrin

Findings - (1) Recurrent infections (2) Insufficient wound healing (3) Delayed separation of umbilical cord

Labs: Neutrophil count will be HIGH but neutrophils at inflammation site will be low.
Cause and findings of Chronic Granulomatous Disease?
XR - Defective NADPH Oxidase. (Oxygen burst can't happen).

(1) Recurrent infections with catalase positive organisms

Lab finding: Nitroblue Tetrazolium dye test will be abnormal (clear; in normal person the result is purple)
Which factor blocks the Alternative complement cascade? Which molecule stimulates this factor?
Factor H.

Sialic acid
Function of DAF?

Effects of DAF Deficiency...
Decay Accelerating Factor - Accerate decay of C3 convertase. Stop complement cascade.

Deficiency causes pancytopenia. Just like, Paroxysmal Nocturnal Hemoglobinuria.
Important defense against Neisseria includes...
MAC attack
Which products of Arachidonic pathway are chemotactic?

Which inhibit chemotaxis?
HETE and LTB4.

Lipoxins
Which PG is causes fever?

Female related?
PGE2.

PGF2
How are leukotrienes degraded?
By Aryl Sulfatase from eosinophils.
What is a carcinoid tumor?
A tumor that can secrete large amount of Serotonin.
What protein is used to differentiate between becterial versus viral infections?
C-reactive protein.

Elevated CRP for bacterial and Decrease CRP for viral infections.
List 4 functions of IL4
(1) Stimulate Th2 and Inhibit Th1. B cell growth factor. (2) IMP - Isotype switching to IgE (3) Inhibit Macrophage activation (4) Inhibit switch IgG2a to IgG3.
Mnemonic for remembering IL functions?
Acute T Bone 2 A Chronic 1
IL1 IL2 IL3 IL4 IL5 IL6 IL12
Which molecules are important for differentiation of Th1 versus Th2.
Th1 - IL12, IL27, IFNy

Th2 - IL4
2 major types of IFN? And their source?
Anti-viral - Alpha, beta, omega (most cells)

Immune - Gamma (T killer cells, NK cells, Th1 cells)
Potent stimulator of macrophages is...
IFNy
Nitric Oxide

Source..
Synthesized from..
Function..
Synthesis upregulated by...
EC, brain (constitutive NOS expression) and Macrophages (inducible NOS - induced by inflammatory chemokines)

Arginine, Molecular oxygen and NADPH

Vasodilation, Decreased platlet aggregation and adhesion

Intracellular Calcium (ca-calmodulin complex help with influx of calcium)
Where are following stem cells found?

Hepatic stem cell
Satelite cells
Limbus cell
canals of Hering

basal lamina of myotubules

canals of schlemm
What is desmoid?
Deep-seated type of fibromatosis. Can be extra-abdominal, abdominal and intra-abdominal.

Abdominal - Occurs in females after pregnancy (c-section)
What is congenital tortocollis?
Unilateral fibrosis of sternocleidomastoid muscle.
What is peyronie's disease?
Penile fibromatosis
How does cyanide and mercuric chloride cause cell injury?
Cyanide: Inhibits mito enzyme cytochrome oxidase stopping the ATP production.

Mercuric chloride: Binds to sulfydryl groups of proteins of cellular membranes. (cells of GI tract and kidney are more likely to be damaged)
Which two are considered to be important markers for severe mitochondrial dysfunction?
(1) Dense bodies (calcifications) are formed in mito.

(2) Cytochrome C release from mito causing apoptosis.
Four possible complications associated with scar formation?
Pyogenic granuloma, Keloid, Fibromatosis, Contractures