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156 Cards in this Set
- Front
- Back
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What is apoptosis?
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programmed cell death
ATP is required |
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What mediates apoptosis?
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capsases
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What is pyknosis?
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basophilia
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What is karyorrhexis?
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nuclear fragmentation
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What is karyolysis?
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nuclear fading
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What characterizes apoptosis?
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cell shrinkage
membrane blebbing pyknosis karyorrhexis karyolysis |
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When does apoptosis occur?
(5) |
embryogenesis
hormone induction(menstruation) immune cell-med death injurious stimuli (radiation, hypoxia) atrophy (endometrial lining- menopause) |
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What is necrosis?
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enzymatic degradation of a cell resulting from exogenous injury
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What characterizes necrosis?
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enzymatic digestion
protein denaturation release of intracell components -inflammatory process |
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Coagulative necrosis
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heart
liver kidneys |
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liquefactive necrosis
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brain
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caseous necrosis
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TB
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fat necrosis
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pancreas
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fibrinoid necrosis
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blood vessels
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gangrenous necrosis
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limbs, GI
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Features of reversible cell injury
6 |
cell swelling
nuclear chromatin clumping dec ATP synth ribosomal detachment glycogen depletion fatty change |
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Features of irreversible cell injury
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plasma membrane damage
lysosomal rupture Calcium influx- oxidative phosphoryl. nuclear pyknosis, karyorrhexis, karyolysis mitochondrial permeability |
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inflammation is characterized by:
5 |
rubor -red
dolor- pain calor- heat tumor- swelling functio laesa - loss of function |
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Fluid exudation
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increased vascular permeability
vasodilation endothelial injury |
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leukocyte activation
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1.emigration- rolling, tight binding, diap.
2. chemotaxis- bacterial products, complement, chemokines 3. phagocytosis and killing |
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Substances that are chemotactic for neutrophils
4 |
IL-8
C5a LTB4 kallikrein |
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fibrosis
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fibroblast emigration, proliferation
deposition of ECM |
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acute inflammation
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neutrophils, eosinophils, antibodies
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chronic inflammation
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mononuclear cell mediated:
persistant destruction and repair blood vessel proliferation fibrosis granulomas |
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What is a granuloma?
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nodular collections of epithelioid macrophages and giant cells
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Granulomatous diseases
11ish |
TB
Wegeners Histo, Blasto, Coccidoides, Crypto Syphillis Listeria leprosy Bartonella Sarcoidosis Crohns |
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What mediates granuloma formation?
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IL-2
interferon-gamma |
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Transudate
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hypocellular
protein poor specific gravity less than 1.012 |
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What causes a transudate?
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inc hydrostatic pressure
decreased oncotic pressure Sodium retention |
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Exudate
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cellular
protein rich spec gravity greater than 1.020 |
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What causes an exudate?
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lymphatic obstruction
inflammation |
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leukocyte extravasation:
what is it and what are the steps? |
neutrophils exit from blood vessels at sites of tissue injury and inflammation
1. rolling 2. tight binding 3. diapedesis 4. migration |
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Rolling
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E-selectin and P-selectin on vascular endothelium
sialyl LewisX on leukocyte |
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Tight binding
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ICAM-1 on vasc endothelium
LAF-1 (Integrin) on leukocyte |
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Diapedesis
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PECAM-1
leukocyte travels between endothelial cells and exits blood vessel |
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Migration
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leukocyte travels through interstitium to site of injury or infection
guided by cytokines |
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Free radical injury is initiated by
6 |
radiation exposure
metabolism of drugs (phase 1) nitric oxide transition metals leuk oxidative burst *reperfusion injury (often from thrombolytics)- causes superoxide production |
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How do free radicals induce cell injury?
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membrane lipid peroxidation
protein modification dna breakage |
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What enzymes are involved in free radical degredation?
3 |
catalase
superoxide dismutase gluthathione peroxidase |
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Antioxidants
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vitamines A, C, E
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Amyloid structure
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beta pleated sheet
affected tissue looks waxy |
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Stain for amyloid
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Congo red stain
apple-green birefringence under polarized light |
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Primary amyloid:
protein |
AL (light chain)
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Primary amyloid:
derived from |
Ig light chains (multiple myeloma)
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Secondary amyloid:
protein |
AA (acute phase reactant)
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Secondary amyloid:
derived from |
Serum amyloid-associated (SAA) protein (chronic inflammatory disease)
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Senile cardiac amyloid:
protein |
Transthyretin
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Senile cardiac amyloid:
derived from |
AF (old fogies)
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Diabetes mellitus type 2 amyloid:
protein |
Amylin
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Diabetes mellitus type 2 amyloid:
derived from |
AE (E endocrine)
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Medullary carcinoma of the thyroid
amyloid protein |
A-CAL (Calcitonin)
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Medullary carcinoma of the thyroid
amyloid- derived from |
Calcitonin
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Alzheimers amyloid:
protein |
Beta-amyloid
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Alzheimers amyloid:
derived from |
amyloid precursor protein (APP)
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Dialysis-associated amyloid:
protein |
beta 2 microglobulin
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Dialysis-associated amyloid:
derived from |
MHC class I proteins
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hypovolemic/cardiogenic shock:
caused by? findings? |
low-output failure
cold, clammy patient low-cardiact output increased total peripheral resistance |
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septic shock:
caused by? findings? |
high-output failure, high mixed venous pressure
hot patient dilated arterioles dec total peripheral resistance |
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hyperplasia
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increased in number
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dysplasia
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loss of size, shape, orientation
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In situ carcinoma
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no invasion of BM
high nuclear/cytoplasmic ratio clumped chromatin monoclonal tumor cells |
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Invasive carcinoma
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invasion of BM
invasion due to collagenases and hydrolases |
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seed and soil theory of metastasis
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seed = tumor embolus
soil = target organ angiogenesis allows for tumor survival |
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Features of metastasis
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decreased cadherin
increased laminin increased integrin receptors |
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metaplasia
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1 adult cell type replaced by another
irritant or environmental exposure |
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reversible "-plasias"
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hyperplasia
metaplasia dysplasia |
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irreversible "-plasias"
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anaplasia
neoplasia desmoplasia |
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anaplasia
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abnormal cells lacking differentation- primative cells of same tissue
(undifferentiated malignant neoplasms) |
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neoplasia
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clonal proliferation of cells
uncontrolled, excessive |
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desmoplasia
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fibrous tissue formation in response to neoplasm
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Tumor grade
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degree of cellular differentiation
number of mitoses per high power field 1-4 |
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Tumor stage
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degree of spread
site and size |
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TNM tumor staging system
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t tumor
n node m mets |
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benign epithelial tumors
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adenoma
papilloma |
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malignant epithelial tumors
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adenocarcinoma
papillary carcinoma |
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benign mesenchymal tumors:
vessels smooth muscle skeletal muscle bone fat |
hemangioma
leiomyoma rhabdomyoma osteoma lipoma |
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malignant mesenchymal tumors:
vessels smooth muscle skeletal muscle bone fat |
angiosarcoma
leiomyosarcoma rhabdomyosarcoma osteosarcoma liposarcoma |
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Down Syndrome neoplasms
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ALL
AML |
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Xeroderma pigmentosum, albinism neoplasms
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Melanoma
BCC SCCs!!! |
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Chronic atrophic gastritis,
pernicious anemia neoplasms |
gastric adenocarcinoma
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Tuberous sclerosis neoplasms
(facial angiofibroma, seizures, mental retardation) |
astrocytoma
angiomyolipoma cardiac rhabdomyoma |
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actinic keratosis neoplasm
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SCC
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Barrett's esophagus neoplasm
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esophageal adenocarcinoma
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Plummer-Vinson syndrome neoplasm (esophageal web, anemia, atrophic glossitis)
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SCC of esophagus
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Cirrhosis neoplasm
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HCC
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Paget's disease of bone neoplasm
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secondary osteosarcoma
fibrosarcoma |
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Immunodeficiency associated neoplasm
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malignant lymphoma
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AIDS associated neoplasms
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aggressive malignant lymphomas (non-H)
Kaposi's |
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Autoimmune associated neoplasms
(Hashimotos, MG) |
Benign and malignant lymphomas
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Acanthosis nigricans neoplasms
(hyperpigmentation and epidermal thickening) |
visceral malignancy
(stomach, lung, breast, uterus-- bikini) |
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Dysplastic nevus neoplasm
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Malignant melanoma
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Radiation exposure neoplasm
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sarcoma
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What is an oncogene?
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gain of function leads to cancer
only need damage to 1 allele |
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abl:
associated tumor oncogene or tumor suppressor |
CML
oncogene |
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c-myc:
associated tumor oncogene or tumor suppressor |
Burkitt's lymphoma
oncogene |
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Rb:
associated tumor oncogene or tumor suppressor |
Retinoblastoma
osteosarcoma tumor suppressor 13q |
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bcl-2:
associated tumor oncogene or tumor suppressor |
lymphomas
oncogene |
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BRCA1
associated tumor oncogene or tumor suppressor |
breast
ovarian tumor suppressor 17q |
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BRCA2
associated tumor oncogene or tumor suppressor |
breast
tumor sup 13q |
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p53
associated tumor oncogene or tumor suppressor |
lots
Li Fraumeni tumor sup 17p |
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erb-B2
associated tumor oncogene or tumor suppressor |
breast
ovarian GI oncogene |
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ras
associated tumor oncogene or tumor suppressor |
colon
oncogene |
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L-myc
associated tumor oncogene or tumor suppressor |
lung
oncogene |
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p16
associated tumor oncogene or tumor suppressor |
Melanoma
tumor suppressor 9p |
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APC
associated tumor oncogene or tumor suppressor |
colon
tumor suppressor 5q |
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WT1
associated tumor oncogene or tumor suppressor |
Wilms
tumor suppressor 11p |
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NF1
associated tumor oncogene or tumor suppressor |
neurofibromatosis 1
17q |
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N-myc
associated tumor oncogene or tumor suppressor |
neuroblastoma
oncogene |
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ret
associated tumor oncogene or tumor suppressor |
multiple endocrine neoplasia (MEN) types 2 and 3
oncogene |
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c-kit
associated tumor oncogene or tumor suppressor |
Gastrointestinal stromal tumor (GIST)
oncogene |
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NF2
associated tumor oncogene or tumor suppressor |
neurofibromastis type 2
tumor suppressor 22q |
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DPC
associated tumor oncogene or tumor suppressor |
pancreatic
tumor suppressor 18q |
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DCC
associated tumor oncogene or tumor suppressor |
colon
tumor suppressor 18q |
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prostate ca tumor markers
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PSA
prostatic acid phosphatase |
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Colorectal ca tumor marker
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CEA
nonspecific |
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Pancreatic ca tumor marker
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CEA- nonspecific
CA 19-9 |
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HCC tumor marker
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AFP
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Yolk sac tumor marker
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AFP
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hydatidiform moles tumor marker
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beta- hCG
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choriocarcinoma tumor marker
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beta-hCG
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Gestational trophoblastic tumors
tumor marker |
beta-hCG
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Malignant epithelial tumors marker
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CA-125
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Melanoma tumor marker
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S-100
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neural tumors tumor marker
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S-100
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Astrocytoma tumor marker
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S-100
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Bone mets tumor marker
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Alkaline phosphatase
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Obstructive biliary disease marker
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alkaline phosphatase
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Paget's disease of bone marker
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alkaline phosphatase
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Neuroblastoma tumor marker
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Bombesin
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lung tumor markers
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Bombesin
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Gastric cancers tumor marker
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Bombesin
CEA |
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Hairy cell leukemia- B cell- tumor marker
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TRAP
tartrate-resistant acid phosphatase |
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HTLV-1 associated cancer
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T cell leuk
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HBV and HCV associated cancer
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HCC
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EBV associated cancer
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Burkitt's lymphoma
nasopharyngeal ca |
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HPV associated cancer
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Cervical 16,18
anal/penile |
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HHV-8
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Kaposi's
B-cell lymphoma |
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Aflatoxins affect which organ and cause what?
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Liver (HCC)
produced by aspergillus |
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Vinyl chloride affects which organ and causes what?
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Liver (angiosarcoma)
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CCl4 affects which organ and cause what?
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liver (centrilobular necrosis, fatty change)
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nitrosamines affect which organ and cause what?
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esophagus, stomach cancer
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cigarette smoke: affect which organ and cause what?
4 organs |
larynx SCC
lung SCC and small cell kidney RCC bladder TCC |
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asbestos affects which organ and cause what?
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lung mesothelioma, pleural plaques etc
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arsenic affects which organ and cause what?
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Skin SCC
liver angiosarcoma |
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naphthalene dyes (analine) affect which organ and cause what?
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bladder TCC
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Alkylating agents affect which organ and cause what?
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blood- leukemia
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Paraneoplastic:
ACTH or ACTH-like peptide Cushing's |
small cell lung ca
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Paraneoplastic:
ADH causes SIADH |
small cell lung ca
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Paraneoplastic:
PTH-related peptide (also TGF beta, TNF, and IL-1) causing hypercalcemia |
squamous cell lung
renal cell ca breast ca |
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Paraneoplastic:
erythropoietin causing polycythemia |
renal cell ca
hemangioblastoma |
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Paraneoplastic:
Antibodies against calcium channels causing lambert eaton |
small cell lung ca
thymoma |
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Paraneoplastic:
hyperuricemia due to excess nucleic acid turnover causing gout and urate nephropathy |
leukemias
lymphomas |
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Psammoma bodies
what are they and what neoplasms are they associated with? (PSMM) |
laminated, concentric, calcific spherules seen in:
1. papillary adenocarc of thyroid 2. serous pap cystadenoma ovary 3. meningioma 4. malignant mesothelioma |
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Brain mets
Lots of Bad Stuff Kills Glia |
lung
breast Skin (melanoma) Kidney GI |
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Liver mets
Cancer Sometimes Penetrates Benign Liver |
Colon
Stomach Pancreas Breast Lung |
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Bone mets
P.T. Barnum Loves Kids |
Prostate
Thyroid Testes Breast Lung Kidney |
