Systemic Pathology Lecture 1

Front 1

Define general pathology.

Back 1

The study of the etiology (cause) and patholgenesis (evolution) of disease and response of the organism to disease.

Front 2

How are the cause and the response of a disease characterized in general pathology?

Back 2

Stereotyped and limited

Front 3

Is it fair to say that most organ systems in the body suffer from the same agent and give a similar response? If so, how do outcomes differ?

Back 3

Most organ systems DO suffer from the same etiologic agents and respond similarly. However, the final outcome/resolution - repair or organismic death will differ depending on agent/pathogenesis/organ system.

Front 4

What are some responses of common responses of organ systems to etiologic agents?

Back 4

(1) Ischemia in brain is rapidly fatal
(2) Ischemia in heart has potential for scar/repair
(3) Ischemia in kidney tubules - potential for resolution/regeneration

Front 5

What may the outcomes of a disease depend on?

Back 5

(1) nature of etiology agent
(2) Pathogenisis/host response
(3) Propeties of Organ System

Front 6

What is systemic pathology?

Back 6

Systemic pathology is the study of the etiologies, the pathogenesis, and the host response specific to a particular organ system.

Front 7

Define general pathology again - relating this time to clinic.

Back 7

General pathology is the "basic science" or ("pre-clinical") aspects of disease and response to disease (cell biology, genetics, immunology, microbiology).

Front 8

What should a general pathologists be able to do?

Back 8

He/she has the ability to recognize some agents and cellular responses - cell injury and death, inflammation, repair, neoplasia.

Front 9

Define systemic pathology again - relating this time to clinic.

Back 9

Systemic pathology is the clinical aspects of disease as expressed in each organ system. It is a tissue based clinical science that is becoming more dependent on cellular and molecular analysis.

Front 10

What is surgical pathology definition?

Back 10

Surgical pathology is the study of tissues removed from living patients.

Front 11

Describe the chronology of breast cancer findings.

Back 11

(1) Patient feels breast mass.
(2) Visits family physician
(3) Physician obtains mammogram, read by radiologist.
(4) Mammogram is suspicious, referred to surgeon.
(5) Patient researches on internet.
(6) Surgeon removes mammogram with radiologist, obtains a core biopsy, sends to pathology.
(7) Therapeutic options are discussed with the patient.
(8) Surgical material is reviewed by pathology and discussed with patient's oncologists.
(7) Additional therapy is undertaken.

Front 12

Explain the cancer grade system.

Back 12

The "grade" is how similar that issue is to the original tissue - Grade 1 is very similar and Grade 3 is not very similar.

Front 13

In dxing cancer txt, why are estrogen receptor positive 3+, progesterone receptor positive 3+, c-erbB-2 negative important?

Back 13

These are all important is important in determning treatment.

Front 14

What are BRCA 1 and 2?

Back 14

BRCA 1 and 2 are genes that are common in breast cancer. Women in the family get breast cancer before 50. Males are also susceptible to other types of cancer. If BRCA 1 is on one breast - it is highly likely you will get cancer on the other breast.

Front 15

What are sentinal nodes?

Back 15

Sentinal nodes are where the surgeon inserts a marker into the site where the tumor was - the dye will by taken up by the lymph node - that node is most likely to be taken up by the tumor - if negative - no more surgery; if positive - more surgery

Front 16

What is stage?

Back 16

Stage is how far something has spread from origin.

Front 17

What is the TNM system?

Back 17

T- stands for the size of the tumor and whether it has invaded nearby tissues
N - describes regional lymph node involvment
M - describes distant metastasis

Front 18

What do intraoperative consultations invovle?

Back 18

(1) Confirmation of tumor diagnosis by frozen section, gross examination, and/or touch imprints
(2) Evaulation of adequacy of margins
(3) Adequacy of tissue for subsequent diagnosis or complete tumor workup
(4) Selection of tissues for special studies
(5) Selection of tissue for tumor banking
(6) Demonstration of gross pathology for teaching.

Front 19

Describe the order in which malignant tissues are taken care of.

Back 19

(1) Screening
(2) Abnormality found
(3) Excision
(4) Gross Trimn
(5) Margins Inked
(6) Frozen (liquid nitrogen) for sectioning
(7) Sliced
(8) Microscopy

Front 20

Describe the order of light microscopy.

Back 20

(1) Fixatin of tissue using fomalin to harden tissue.
(2) Dehydration of tissue using increasing concentrations of alcohol.
(3) Infiltration of paraffin to make a tumor block.
(4) Using a microtome, slice block in sections that are 3-5 microns thick.
(5) Section placed on glass slide.
(6) Slide rehydrated to allow water based stains to penetrate the section
(7) Staining with hematoxyline and eosin.

Front 21

Define cytopathology.

Back 21

Cytopathology is derived from the Greek word "kytos" meaning hollow vessel. It is the study of cells, their structure and function. Cytopathology is a diagnostic technique used to examine cells from various body sites to determine the cause and nature of disease.

Front 22

What is abrasive cytology? What is an example?

Back 22

In abrasive cytology, cells are dislodged by brushing or washing. Examples include PAP smars and samples obtained by endoscopy. Cells are then smeared on slide and fixed.

Front 23

What is FNA?

Back 23

FNA stands for Fine Needle Aspiration. This is useful for tumors and infections. Target present and either palpated or found by imaging technology (ultrasound, x-ray, ect.)

Front 24

What does the cytopathologist evaluate?

Back 24

- cellularity of specimen
- cell size and shape
- cellular arrangment
- cell cytoplasm
- nucleus/nucleolus
- extracellular material and cellular background

Front 25

What does exopthalamous signify?

Back 25

Grave's disease - an immune mediated disorder

Front 26

What does VINDICATE stand for?

Back 26

V- vascular
I-Infammatory/Immune
N-Neoplasms
D-drug/toxic/chemical
I-Infectious
C-Congenital
A-Allergic
T-Trauma
E-Endocrine

Front 27

Describe xanthoma hypercholeserolemia.

Back 27

Hypercholesterolemia is the presence of high cholesterol in the blood. Xanthoma is the deposition of cholesterol in patches on the skin or in the tendons.

Front 28

What are the pathologic processes once an etiologic agent is encountered?

Back 28

(1) Inflammation - acute vs. chronic
(2) Cytoplasmic changes - reversible
(3) Cell death - irreversible - apoptosis or necrosis
(4) Repair
(5) Adaptive Growth

Front 29

What are some cellular responses to reversible injury?

Back 29

(1) Abnormal storage
(2) Hypertrophy
(3) Hyperplasia
(4) Dysplasia
(5) Neoplasia

Front 30

What are some tissue responses to nonlethal cellular injury and necrotic lethal cellular injury?

Back 30

(1) Acute Inflammation
(2) Thrombosis
(3) Chronic Inflammation
(4) Fibrosis

Front 31

What is dysplasia? Is it reversible?

Back 31

Dysplasia is irregular cell growth that is potentially reversible.

Front 32

What is neoplasia?

Back 32

Abnormal proliferation in cell growth. (cancer) disorganized, often NOT consistent in appearance with adjacent cells. Look out of place. This is irreversible.

Front 33

What is metaplasia? Is it reversible?

Back 33

Metaplasia Reversible is change, that is from one adult cell type replaced byanother type. This is not considered “normal.”

Front 34

Differentiate between acute inflammation and chronic inflammation.

Back 34

Acute inflammation is characterized by vascular changes followed by the presence of PMN (mainly neutrophils). There is usually a bacterial etiology.
Chronic inflammation is characterized by mononuclear leukocytes - macrophages, lymphocytes, plasma cells. This usually has a viral, fungal, and immune etiology.

Front 35

What are examples of repair granulation tissue?

Back 35

Neovascularization, fibrosis, scar

Front 36

Desribe Acute and Chronic Pnemonia as described in pneuomia.

Back 36

Inflammation of the lung is termed pneumonia and may be associated with many etiologies (infectious and chemical are common). Acute pneumonia shows many cells with segmented nuclei (PMNS). A chronic pneumonia shows few PMNS but many mononuclear cells including macrophages, lymphocytes, and plasma cells. Pink fibrin strands in the alveoli suggests leakage of plasma from blood vessels.

Front 37

Describe chronic inflammation and repair as described by peptic ulcers.

Back 37

An ulcer bed demonstrates necrosis of the mucosa and glands - which results in necrosis and a coagulated exudate. Early granulation tissue can be seen at the bottom of the ulcer bed.