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265 Cards in this Set
- Front
- Back
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Pathology
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structural alterations in cells, tissues, and organs that can aid in identifying causes of disease
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Pathogenesis
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tissue changes associated with development of disease
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etiology
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study of the cause of disease
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idipathic
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diseases that have no identifiable cause
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iatrogenic
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disease occurring after medical treatment
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what is an example of an iatrogenic disease?
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leukemia after chemo
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prognosis
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expected outcome
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acute disease
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sudden appearance of signs and symptoms that last only a short time
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chronic disease
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develops slowly and the signs and symptoms last a long tie
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remissions
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disappearance of or diminished symptoms
ex. cancer and MS |
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exacerbations
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symptoms become worse or more severe
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complication
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onset of disease in person already experiencing another existing disease
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example of complication
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rheumatoid arthritis patients take high doses of steroids which could cause Chushi's disease
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sequela
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unwanted outcomes of disease
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example of sequela
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stroke could cause paralysis
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signs
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objective or measurable alterations
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example of Local/systemic signs
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Local: redness, swelling
systemic: fever, leukocytosis (increased leukocytes) |
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symptoms
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subjective alterations that the patient reveals to you
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examples of symptoms
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pain, nausea, shortness of breath
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prodromal period:
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vague symptoms such as fatigue/loss of appetitte before onset of specific s/s
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insidious symptoms
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vague or nonspecific feelings and the awareness that the body is changing
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latent period
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disease present but no symptoms are readily apparent
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example of a disease that has a latent period?
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syphillis
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disorder
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abnormality of function
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an example of disorder?
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bleeding disorder
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clinical manifestations
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signs and symptoms that comrpise the evidence of disease
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syndrome
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group of symptoms that occur together
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epidemiology
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study of tracking patterns in disease occurence and transmission among population by geographic region
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incidence
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number of new cases in a specific time period
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prevalence
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number of existing cases in a specific time period
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risk factor/predisposing factor
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increases the probability of disease but does not cause it
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precipitating factor
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condition or event that does cause disease
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atrophy
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cell shrinkage
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phsiologic atrophy
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occurs with early development
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example of physiologic atrophy
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shrinkage of the thymus gland with early development
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pathologic atrophy
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occurs with decreased work load, pressure, uses, blood supply, nutrition, hormonal or nerve stimulation
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Disuse atrophy
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skeletal muscle atrophy caused by prolonged bedrest
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Hypertrophy
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increase in cell size
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physiologic hypertrophy
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increase in work load
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2 examples of physiologic hypertrophy
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1) when one kidney is removed the other adapts tto increased work load
2) Uterine/mammary gland enlargement with pregnancy |
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Hyperplasia
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increase in cell number
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what are the 2 kinds of physiologic hyperplasia?
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compensatory and hormonal
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compensatory physiologic hyperplasia (and example)
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regeneration of certain organs
ie when a portion of a liver is removed, the liver cells regenerate |
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hormonal physiologic hyperplasia(2 examples)
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estrogen dependent organs (breast and uterus)
endometrial thickening in preparation to receive a fertilized egg |
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pathologic hyperplasia (and example)
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usually caused by excessive hormones
ex. inappropriate endometrial thickening with aging --> excessive menstrual flow these thickening cells can become malignant |
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Dysplasia
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abnormal changes in a cell (deranged)
i.e. size, shape, organization |
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what is an example of dysplasia?
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epithelial tissue of the cervis
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how can dysplasia be classified?
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as mild, moderate, or severe, low grade or high grade
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can dysplasia be reversed? how?
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can be reversed if the stimulus is removed
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Metaplasia
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reversible replacement of one mature cell type by another
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what is an example of metaplasia?
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bronchial lining of airway:
normal columnar ciliated epithelial cells are replaced by stratified squamous cells secondary to cigarette smoking |
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The extent of cellular injury is dependent upon what 4 things?
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1)type of cell
2)state of cell degree of differentiation degree of succeptibility 3) adaptive process of the cell 4) type, severity, and duration of the injury stimulus |
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What are the 4 general mechanisms of cellular injury?
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1) ATP depletion
2) oxygen and oxygen-derived free radicals 3) intracellular calcium and loss of calcium steady state 4) defects in membrane permeability |
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What causes ATP depletion
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a decrease in mitochondrial phosphorylation.
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What is the leading cause of cellular injury?
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hypoxia (lack of sufficent oxygen
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hypoxia
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lack of sufficient energy
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what are the 6 stages of a hypoxic event?
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1) ischemia (usually)
2) decrease in mitochondrial phsphorylation 3) loss of ATP ( the above damage cell membrane) 4) failure of sodium-potassium pump 5) vacuolation 6) accumulation of calcium |
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what happens as the sdium-potassium pump fails
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when the cell membrane is damaged, the sodium potassium pump fails which causes sodium to rush into the cell and potassium is pushed out. This causes a fluid shift where all the fluid is not going INTO the cell.
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Vacuolation
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swelling of the cell
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what causes vacuolation in cellular injury?
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caused y failure of the sodium-potassium pump which causes the rush of sodium followed by fluid INTO the cell
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What causes the accumulation of calcium in cellular injury?
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the rapid influx of sodium into the cell with the failure of the Na K pump pushes the calcium out of the cell and into the surrounding tissue which damages the tissue
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what are possible causes for hypoxic injury? (7)
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decreased oxygen in air
loss of hemoglobin decreased production of RBC diseases of respiratory/cardiovascular poison ichemia anoxia |
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what is the most common cause of hypoxic injury?
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ischemia
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ischemia
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reduced blood supply
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what can cause ischemia?
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gradual narrowin gof the arteries or a clot that partially blocks blood flow, etc.
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anoxia
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total lack of oxygen
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what can cause anoxia?
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a large blood clot that completely blocks blood flow
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what is the danger in restoring oxygen after Anoxia?
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it can cause a reprofusion injury
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definition of a reprofusion injury:
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injuyr resulting from the restoration of oxygen to a cell in anoxia
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what causes a reprofusion injury?
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formation of reactive oxygen radicals (free radicals) -> further membrane damage and mitochondrial calcium overload --> cell necrosis
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what cells are the main component of a reprofusion injury and why?
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neutrophils because they automatically appear with cellular injury and can block the flow of oxygenated RBC's to the area
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free radical
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unstable electrically uncharged atoms or groups of atoms with unpaired electrons
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what do free radicals do for stability?
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the give up or steal an electron for stability
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what is the danger of free radicals?
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they initiate a chain reacion with proteins, carbs, and lipids
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what are the 4 damages free radicals can do?
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1) lipid peroxidation
2) attack of critical proteins 3) DNA framented 4) mitochondrial damage |
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lipid peroxidation
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destruction of polyunsaturated lipids
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what is the primary choice of mood altering drugs?
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ethanol
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what can ethanol result in? (2)
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liver and nurtitional disorders
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what nutritional disorders can ethanol result in? (4)
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Magnesium, vitamin B6, thimaine, phosphorus definiciencies
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What are the acute alterations of ethanol?
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CNS
reversible hepatic (liver) and gastric changes |
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Hepatic
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liver
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what are the chronic alterations caused by ethanol?
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structural alterations in ALL organs and tissues
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what are the physical abnormalities of FAS? (6)
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Congenital anomalies
microcephaly low birth weight cardiovascular defects developmental disabilities (physical and mental) death |
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what are the 4 kinds of unintentional injuries?
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blunt
contusion abrasion laceration |
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what are 3 different names for a contusion?
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bruise, ecomosis, hematoma
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abrasion
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loss of the superficial layer
ex. road rash, carpet burn |
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Laceration
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tear in the tissue
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what clinical setting are lacerations most common in?
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nursing homes because the skin of the patients loses tinsel strength as they age
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what are the four sharp force injuries?
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incised wound
stab wound puncture wounds chopping wounds |
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incised wound
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made by a surgeon or doctor, longer than it is deep
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what causes a fever?
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the release of endogenous pyrogens from bacteria or macrophages
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what kind of response is a fever?
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acute inflamatory response
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what causes a in creased HR?
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incrase in oxidative metabolic processes resultin from the fever
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leukocytosis
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increase in leukocytes
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what causes the presence of cellular enzymes after injury?
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release of enzymes from the cells of tissue in extracellular fluid
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what are 5 systemic manifestations?
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1) fever
2) increased HR 3) increase in leukocytes 4) pain 5) presence of cellular enzymes |
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necrosis
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cell death
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where does coagulative necrosis occur?
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kidneys, heart, and adrenal glands
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what causes coagulative necrosis?
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protein denaturation
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what are the physical characteristics of coagulative necrosis?
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albumin changes from a gelatinous, transparent state to a firm opaque state
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Where does liquefactive necrosis occur?
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brain
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what are 2 possible causes of liquefactive necrosis?
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1) ischemic injury to neurons and glial cells in the brain
2) bacterial infection |
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what are the physical characteristics of liquefactive necrosis?
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dead tissue becomes soft, liquifies, and is walled off from healthy tissue
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caseous necrosis
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a combination of coagulative and liquefactive necrosis
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where does caseous necrosis occur
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lungs
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what are the physical characteristics of caseous necrosis?
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tissues resemble clumped chees in that they are soft and granular. a granulomatous inflammatory wall encloses areas of caseous necrosis
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where does fat necrosis occur?
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breast, pancreas and other abdominal structures
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what are the physical characteristics of fat necrosis?
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tissue appears opaque and chalk white
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gangrene
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death of tissue, not just a cell; it is a complication of necrosis
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what causes gangrene?
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severe hypoxic injury
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what causes dry gangrene
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coagulative necrosis
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what are the physical characteristics of dry gangrene?
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skin is very dry, shrinks, and wrinkles develop. color changes dark brown or black
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what causes wet gangrene?
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neutrophils invade the infected area and cause liquefactive necrosis
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where does wet gangrene occur?
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internal organs
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what physical characteristics does wet gangrene display?
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site becomes cold, swollen, and black and there is a foul odor
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what is the danger of severe wet gangrene?
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death
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what causes gas gangrene?
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infection of injured tissue by one of many species of clostridium
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how does clostridium cause gas gangrene?
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it produces hydrolytic enzymes and toxins that destroy connective tissue and cellular membranes and cause bubbles of gas to form in muscle cells
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how can gas gangrene become fatal?
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enzymes lyse the membranes of red blood cells, destroying their oxygen-carrying capacity
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what causes death in an individual with gas gangrene?
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shock
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what physiological changes occur with aging? (4)
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atrophy
decreased function loss of cells compensatory cellular changes (hypertrophy and hyperplasia -> metaplasia, dysplasia and neoplasia) |
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what occurs with aging of the aterial, pulmonary, and musculoskeletal systems?
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progressive stiffness and rigidity
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in aging what changes in regards to cell loss?
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the renewal no longer matches cell loss so we lose more cells than we make
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immunologic tolerance _______ as we age
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decreases
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what affect does aging have on the GI tract?
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descreased emptying; hydrochloric acid
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sarcopenia
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muscular atrophy
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what happens to muscles as we age?
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sarcopenia
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what happens to skin with age?
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atrphy and wrinkling
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what are the total body changes caused by aging?
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1) decreased height
2) reduction in circumference of neck, thighs, arms, 3) widening pelvis 4) lengthening nose and ears |
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frailty (definition and results)
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wasting syndrom of aging
results in falls, functional decline, disease, and death |
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what are 7 manifestations of somatic death?
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1) cessation of respiration and circulation
2) algor mortis 3) pupil dilation 4) loss elasticity 5) rigor mortis 6) livor mortis 7 putrefecation/skin discoloration |
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aglor mortis
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gradual decrease in body temp
occurs in the first 24 hours after death |
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Rigor mortis
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muscle stiffening
6 hours after death, lasts 36-62 hours |
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livor mortis
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purple discoloration
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what is the leading cause of MR/ miscarriage?
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chromosomal abberations
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triploidy
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zygote that has three copies instead of two; incompatible with life
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tetraploidy
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euploid cells ahve 92 chromosomes
(incompatible with life) |
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aneuploid
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does not contain 23 chromosomes
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what causes aneuploid?
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nondisjunction
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what is the affect of autosomal aneuploid?
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down syndrome
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where is the highest occurence of aneuploidy?
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sex chromosome
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what is the occurence in males and females of aneuploid on the sex chromosome?
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1 in 500 males; 1 in 900 females
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what are two examples of aneuploid on the sex chromosome?
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turner syndrome
klinefelters syndrome |
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turner syndrome
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45, x
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klinefelters syndrome
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47, xxy
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trisomy
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three copies of one chromosome
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monosomy
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one copy of chromosome
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nondisjunction
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failure of chromatid separation
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what is the most common cause of downs syndrome?
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trisomy 21 (95%)
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what is the IQ range for a downs syndrome individual
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20-70 (mental retardation
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what is the reproduction prognosis for downs syndrom
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all males are sterile, some females can reproduce
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turners syndrom is only found in....
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females
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what is specific to turners syndrome in regards to elbows and nipples, neck and stature?
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reduced carrying angle at elbow
widely spaced nipples short stature webbing of neck |
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what are the impacts on testes, breast, and body hair of kleinfelter syndrome?
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small testes
some breast development sparse body hair |
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deletion:
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broken chromosomes and lost DNA
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what is a disease that can be caused by deletions?
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Cri Du Chat syndrome
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duplications
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duplication of chromosomes
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what does a duplication of chromosome 5 cause
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mental retardation
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inversion
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two breaks take place on a chromosome followed by the reinseration of the missing fragment at its original site, but in inverted order
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inversion has the most serious affect on:
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the offspring of an individual with an inverted chromosome
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translocation
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interchange between nonhomologous chromosomes
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fragile sites
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areas on chromosomes that develop distinctive breaks and gaps. most don't appear to cause disease
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Fragile X (pathology)
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chromatin fails to condense during mitosis
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fragile X syndrome affects more...
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affects males more than females
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what is the second most common cause of MR?
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fragile X syndrom
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what are the physical characteristics of fragile X?
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long face, large mandible, large everted ears, hyperextensible joints, hich arched palate, mitral valve prolapse, macroorchidism
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genotype
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gene composition
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phenotype
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outward appearance
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dominant
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observable effects
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recessive
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hidden effects
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carrier
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has diseased gene, but phenotypically normal
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what is the M vs F occurance of autosomal dominant disorders?
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male=female in transmission
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are there skipped generations in autosomal dominant disorders?
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no skipped generations
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what % of offspring are affected with an autosomal dominant mutation?
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1/2
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delayed age of onset possible in autosomal dominant?
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yes
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what is an example of autosomal dominant?
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neurofibromatosis
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what is the M vs F transmission rate of autosomal recessive?
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male = female
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consanguinity makes ______ more likely
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autosomal recessive traits
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an autosomal recessive trait may be seen in _______ of affected individuals but usualy not in ______
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siblings, parents
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what is the recurrence risks for autosomal recessive traits?
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1/4 normal homozygote
1/2 carriers phenotypically normal 1/4 homozygote with disesase |
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if a parent is homozygote with a autosomal recessive gene they will affect...
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all offspring
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what are the possibilities for females with an x-linked gene?
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homozygous for disease, homozygous with normal allele, or heterozygous
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what are the possibilities for males with and x-linked gene?
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hemizygous (only 1 x)
if inherets the diseased x, he will be affected |
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x linked genes affect more _______ than ________
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males than females
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an x linked trait is never transmitted from _______ to ________
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father to son
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an x linked trait is passed from an affected father to _______ daughters
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all
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daughters of an affected father will be _______ but _____ of their ____ will be affected
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phenotypically normal, 1/2, sons
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what is an example of an x linked trait?
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Duchanne muscular Dystrophy
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what is the recurrence risk of an x linked trait with a carrier mother and normal father
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transmitted to 1/2 their sons
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what is the recurrence risk of an x linked trait with an affected father and moral mother?
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all sons mormal, all daughters carriers
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what is the recurrence risk of an x linked trait with an affected father and carrier mother?
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1/4 will be carriers
1/2 will be affected 1/4 will be normal homozygote |
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sex limited trait
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occurs in only one sex because of anatomical differences
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what are 2 examples of a sex limited trait?
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uterine and testicular defects
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influenced trait example
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male pattern baldness
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what are 2 examples of multifactorial inheritance?
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1) environmentally influenced traits
2) polygenic traits |
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polygenic traits
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several genes acting together
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what are 2 examples of multifactorial traits?
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hieght and IQ
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benign tumors grow ______ while malignant tumors grow ________
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slowly; rapidly
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benign tumors have a _______ mitotic index while malignant tumors have a ______ mitotic index
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low; high
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which kind of tumor is well differentiated and looks like the tissue it came from?
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benign, malignant tumors are not well differentiated.
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which kind of tumor has a well defined capsule?
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benign; malignant tumors are not encapsulated
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benign tumors are _____ invasive while malignant tumors invade ______ and _______
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not; local structures and tissues
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which tumors do not metastisize?
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benign
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how do malignant tumors spread distally?
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through the bloodstream and lymphatics
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tumors are named....
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accrding to the tissue from which they arise and include the suffix "oma"
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lipoma
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fatty tumor
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glioma
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tumor of the glial cells (brain)
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leiomyoma
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tumor of the smooth muscle
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chondroma
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tumor of the cartilage
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carcinoma
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malignant epithelial tumor
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sarcoma
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malignant connective tissue tumors
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what is the hallmark of malignancy?
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anaplasia
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anaplasia
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change in the structure and orientation of cells, characterized by a loss of differentiation
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lympoma
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cancer of the lymphatic tissue
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leukemia
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cancer of blood forming cells
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carcinoma in situ
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preinvasive epithelial malignant tumors of glandular or epithelial origin that have not broken through the basement membrane or invaded the surrounding stroma
Best kind of cancer to have |
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stage 1 or A cancer
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cancer confined to the organ or origin
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stage 2 or B cancer
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cancer that is locally invasive
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stage 3 or C cancer
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cancer that has spread to the regional structures such as lymph nodes
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stage 4 or D cacner
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cancer that has spread to distant sights such as liver cancer spreading to lung or prostate cancer spreading to bone
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where does liver cancer like to spread to?
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lungs
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where does prostate cancer like to spread to?
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bone
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in the TNM system T =
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primary tumor, the number equals the size of the tumor
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in the TNM system the N =
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lymph node involvement; a higher number means more nodes are involved
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in the TNM system the M =
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extent of distant metastases
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what is the first stage of the metastatic process?
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local spread (invasion of local tissue)
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anaplasia
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loss of differentiation
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angiogensis
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growth of new vessels
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advanced cancers can secrete....
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angiogenic factors (VEGF)
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what tumors produce tumor markers
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both malignant and benign
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what are the 3 uses of tumor markers?
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1) screen and identify individuals at high risk
2) help diagnose the specific type of tumor 3) follow the clinical course of cancer |
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what marker is present for hepatic or germ cell cancer?
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AFP (alpha-fetoprotein)
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what marker is present with colon, liver, pancreas, lung, breast, and other cancers?
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carcinoembryonic antigen (CEA)
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what marker can be seen with germ cell, islet cell cancers and teratomas?
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B-human chorionic gonadotropin (B-HCG)
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what marker will a prostate cancer leave?
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prostate-specific antigen (PSA)
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what marker will a cancer of the pheochromocyoma (adrenal medulla) show?
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catecholamines
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a neroblastoma will leave what marker?
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Homovanillic acid/vanillylmandilic acid (HVA/VMA0
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Muptiple myeloma will leave what marker?
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urinary Bence-Jones protein
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pituitary adenomas leave wat marker?
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adrenocorticotropic hormone (ACTH)
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what are the 6 hallmarks of cancer?
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1) self-sufficiency in growth signals
2) insensitivity to antigrowth signals 3) evading apoptosis 4) limitless replicative potential 5) sustained angiogenesis 6) tissue ivasion and metastasis |
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What 5 virus' can cause cancer?
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1) hep B and C
2) Epstein-Barr virus (EBV) 3) Kaposi's sarcoma herpesvirus (KSHV) 4) Human papillomavirus (HPV) 5) Human T cell Leukemia-lymphoma virus (HTLV) |
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What bacteria can cause cancer?
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Helicobacter pylori
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what is the danger H. pylori?
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peptic ulcer disease
stomach carcinoma mucosa associated lymphoid tissue lymphomas |
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Direct metastatis
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known as local spread; it is the direct invasion of contiguous organs
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distant metastasis:
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metastasis to distant organs through the blood and lymphatic systems
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what are the 4 phases of metastasis?
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1) gransformation
2) growth 3) local invasion 4) Distant metastasis |
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the spread of cancer is dependent on what 4 things?
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1) rate of growth
2) degree of differentiation 3) presence or absense of anatomic barriers 4) various biologic factors |
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what are 6 mechanisms of local spread?
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1) cellular multiplication
2) mitotic rate vs. cell death rate 3) mechanical pressure 4) release of lytic enzymes 5) decreased cell to cell adhesion 6) increased motility of individual tumor cells |
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what are the steps of spread of cancer from a primary site to a distant site? (5)
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1) direct or continuous extension
2) penetration into lymphatics, blood vessels, or body cavities 3) transport to lymph or blood 4) transport to secondary sites 5) entry and growth in secondary sites |
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where does metasis often occur first?
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in the first capillary bed encountered by circulating cells
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organ tropism
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preferential growth of cancerous cells in certain organs
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what are 5 clinical manifestations of cancer?
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pain, fatigue, anemia, leukopenia and thrombocytopenia, infection
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what is the most significant cause of death in cancer patients?
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infection
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what factors influence pain in cancer patients?
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fear, anxiety, sleep loss, fatique, physical deterioration
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what is the most frequently reported symptom of cancer?
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fatigue
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what are 4 causes of anemia in cancer patients?
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1) chronic bleeding (iron deficiency)
2) severe malnutrition 3) medical therapies 4) malignancy of blood-forming organs |
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what 3 things can cause leukopenia and thrombocytopenia?
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direct tumor invasion of bone marrow
chemotherapeutic agents radiation therapy |
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paraneoplastic syndromes
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complexes that connot be explained by local or distant spread of tumor
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what percentage of patients are affected with paraneoplastic syndrome?
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10% of patients
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what are 3 significant findings or paraneoplastic syndromes?
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1) earliset symptom of unknown cancer
2) represent life-threatening problems 3) may mimic progression, interfering with treatment |
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what is the underlying cancer ofcushings syndrome
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small cell carcinoma of lung
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what is the underlying cacner of inappropriate ADH?
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smal cell carcinoma of lung, intracranial neoplasms
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what are the 5 cancers that could cause hypercalcermia?
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1) squamous cell carcinoma of lung
2) breast carcinoma 3) renal carcinoma 4) adult T cell leukemia/lymphoma 5) ovarian carcinoma |
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cachexia
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most severe form of malnutrition
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what are the causes of cachexia? (7)
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anorexia
weight loss anemia asthenia poor performance taste alterations altered protein, lipid, carb metabolism |
