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Pathology
Pathology I
135
Pathology
Professional
01/31/2011

Additional Pathology Flashcards

 


 

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Term
Increased intracellular calcium and ROS cause..........
Definition
Protein breakdown and DNA damage.
Term
Loss of ATP eventually causes......
Definition
Hydropic swelling due to osmotic imbalance.
Term
ROS scavenging systems are:
Definition
1) antioxidants (Vitamin E)
2) glutathione peroxidase
3) superoxide dismutase
4) catalase
Term
Enzymes activated by intracellular calcium include:
Definition
1) phospholipases
2) proteases
3) ATPases
4) endonucleases
Term
Irreversible mitochondrial damage is marked by......
Definition
Formation of a high-conductance channel in the inner mitochondrial membrane (disrupts oxidative phosphorylation).
Term
The main feature of reversible cell injury is _____________.
Definition
Hydropic swelling; fluid seems to accumulate in the cisternae of the ER; mitochonria may also swell, and ribosomes may become detached from them; blebs may form too.
Term
In order to control cell size, sodium must be regulated by:
Definition
1) semi-permeable nature of the plasma membrane
2) plasma membrane sodium pump
3) supply of ATP
Term
Anaerobic glycolysis can be stimulated by increased _____________.
Definition
AMP
Term
Fatty change normally occurs in what cell types?
Definition
Hepatocytes and myocardial cells
Term
In coagulative necrosis, ___________ is the primary pattern.
Definition
Protein denaturation; no heterolysis, and compelte autolysis is blocked by lack of lysosomes; in the brain, hypoxia results in liquefactive necrosis!
Term
Pyknosis
Definition
Chromatin clumping as the nucleus shrinks.
Term
Karyorrhexis
Definition
Fragments of the nucleus are scattered throughout the cytoplasm.
Term
Karyolysis
Definition
No nucleus or loss of chromatin staining.
Term
Liquefactive necrosis is characteristic of ___________ infections.
Definition
Focal bacterial..... occasionally fungal.
Term
Caseous necrosis is characteristic of ____________.
Definition
Foci of tuberculous infection; like coagulative necrosis but NO ORIGINAL ARCHITECTURE CAN BE SEEN.
Term
Gangrenous necrosis is............
Definition
Ischemic coagulative necrosis with a superimposed liquefactive componenet (commonly from anaerobic saprophytes).
Term
Fibrinoid necrosis
Definition
Alterations of injured blood vessels in which accumulations of plasma proteins cause the wall to stain intensely.
Term
Apoptosis is characterized by _____________ and _____________.
Definition
Chromatin condensation and DNA fragmentation.
Term
Bcl-2 proteins(+) and Bad/Bax(-)
Definition
One of the regulators of apoptosis in the control stage.
Term
The execution stage of apoptosis involves activation of ___________.
Definition
Cysteine-specific proteases (caspases).
Term
Mitochondria during apoptosis............
Definition
Develop permeability pores and release cytochrome C into the cytoplasm.
Term
Fatty change occurs most often in the _________ and can be caused by............
Definition
Liver (parenchymal cells); caused by toxins, protein malnutrition, diabetes mellitus, obesity, anoxia, and hepatotoxins.
Term
Excess proteins within cells usually appear as..........
Definition
Rounded, eosinophilic droplets, vacuoles, or aggregates in the cytoplasm.
Term
In diabetics, epithelial cells of the renal proximal tubules are enlarged by ____________.
Definition
Excess glycogen (from hyperglycemia).
Term
Incomplete digestion of cerebrosides, gangliosides, and the products of the breakdown of mucopolysaccharides are known as what, respectively?
Definition
Gaucher disease, Tay-Sachs disease, and Hunter syndrome.
Term
Hemosiderin
Definition
An iron storage protein (along with ferritin) that is hemoglobin derived and stains golden yellow to brown; excessive iron in the body results in hemosiderosis.
Term
Lipofuscin
Definition
Golden-brown granules that is formed by the turnover of membrane constituents of a cell (lipid peroxidation); only seen in terminally differentiated cells or cells that cycle infrequently (liver).
Term
Melanin
Definition
Brown-black pigment formed when the enzyme tyrosinase catalyzes the oxidation of tyrosine to dihydroxyphenylalanine in melanocytes.
Term
The most common exogenous pigment is ___________.
Definition
Carbon (anthracosis).
Term
Ubiquitin
Definition
A heat-shock protein that facilitates degradation of proteins that are denatured beyond repair; chaperones are intimately involved in protein folding; heat-shock proteins help to limit tissue necrosis.
Term
Hepatocytes respond to barbiturates by..........
Definition
Hypertrophy of the smooth ER (leads to increased volume of the ER).
Term
Megomitochondria have been seen in ____________ and increased number of mitochondria have been seen in ___________.
Definition
Liver of alcoholics..........inherited metabolic diseases.
Term
Cytchalasin B and toxins affect ___________ by preventing polymerization.
Definition
Thin filaments (composed of actin and myosin) in the cytoskeleton; cytoskeletal abnormalities may be marked by intracellular accumulations of fibrillar material.
Term
Mallory body
Definition
Accumulations of keratin filaments and neurofilaments that are associated with cell injury in the liver of alcoholics; intermediate filaments provide a flexible intracellular scaffold.
Term
Dystrophic calcification
Definition
Occurs locally in non-viable or dying tissues (necrosis); calcium salts have a basophilic, amorphous granular and sometimes clumped appearance; involves the formation of an apatite crystal with both an initiation and propogation phase.
Term
Metastatic calcification
Definition
Occurs in normal tissues whenever there is hypercalcemia (as in hyperparathyroidism).
Term
Cellular senescence
Definition
A state that all non-tumor cells eventually reach; it is a non-dividing state.
Term
The most common and most important cause of inflammation is ___________.
Definition
Infection
Term
AIDS patients can have a fatal infection from _______________.
Definition
Pneumocystis carinii
Term
Hyperemia
Definition
More blood is brought to an affected area under increased pressure (causes hotness of the area).
Term
Two reasons why edema forms during inflammation:
Definition
2) loss of barrier function of capillaries and venules
3) increased hydrostatic pressure from arterioles
Term
The most common mechanism for increased vascular permeability during inflammation is __________.
Definition
Formation of gaps/pores in venules and capillaries (fast and short-lived.....unlike junctional retraction); caused by histamine, leukotrienes, etc.; also, there is increased activity of the vesicular transport system across the endothelium.
Term
What are the 3 inflammatory mediators that are preformed in granules?
Definition
Histamine, serotonin (from platelets), and lysosomal enzymes.
Term
Proteolytic enzymes from from neutrophils do what?
Definition
Digest vascular basement membranes and activate kinin, complement, and plasmin systems; elastase is an example.
Term
Neutrophils (and to a lesser degree macrophages) release oxygen radicals which then do what?
Definition
Injure endothelial cells, attack the basement membrane of small vessels, and depolymerize proteoglycans.
Term
Arachidonic acid is formed when.............
Definition
Membrane phospholipids are hydrolyzed by phospholipase A2 or phospholipase C (abundant in neutrophils, macrophages, and PLATELETS); corticosteroids inhibit phospholipases.
Term
LTC4, LTD4, and LTE4
Definition
Cysteinyl leukotrienes that are produced by mast cells and cause vasoconstriction, bronchospasm, and increased vascular permeability.
Term
TNF-alpha and IL-1
Definition
Produced by mast cells and macrophages during ENDOTHELIAL ACTIVATION; cause junctional retraction and upregulation of cell surface adhesion molecules on endothelial cells.
Term
Inflammasome
Definition
A molecular complex involved in the activation of inflammatory caspases which causes the maturation of immature IL-1.
Term
Necrotic cells induce inflammation and vascular permeability partly via hypoxia-induced production of ______.
Definition
VEGF
Term
The complement system is activated by _____.
Definition
Ag/Ab, LPS; the plasmin system also activates the complement system; both the kinin and plasmin systems are activated by Factor XII.
Term
Immediate transient responses occur after mild injury and are mediated by ________, _________, and __________.
Definition
Histamine, bradykinin, and leukotrienes.
Term
Immediate prolonged responses are biphasic and are mediated by ___________, ____________, ___________, and later ____________.
Definition
Bradykinin, complement products, ROS, and later IL-1/TNF.
Term
An example of fibrinous exudate is.......
Definition
Pericarditis wherein the fibrin exudate becomes organized and causes scarring instead of resolution via macrophages.
Term
Hemorrhagic exudate is associated with more severe injury and hemorrhagic pericarditis is most likely to occur with _________ or __________.
Definition
Metastatic tumor or TB.
Term
Endotoxic shock
Definition
Caused by endotoxin-producing gram(-) bacilli; endotoxins are bacterial wall lipopolysaccharides consisting of a toxic fatty acid (lipid A) core and a complex polysaccharide coat (including O antigen).
Term
TLR4 recognizes ________, TLR5 recognizes _________, and TLR9 recognizes ___________.
Definition
LPS, a protein in flagella, and unmethylated C- and G-rich DNA sequences.
Term
Macrophages can secrete ______ and ________ to inhibit inflammation from apoptotic cells.
Definition
IL-10 and Transforming Growth Factor-beta.
Term
High mobility group box 1 protein (HMGB1)
Definition
A nuclear protein present in all cells that is thought to be proinflammatory along with DNA-chromatin complexes, heat shock proteins, and monosodium urate microcrystals.
Term
What two cells are associated with allergic reactions?
Definition
Mast cells and basophils; eosinophils are linked to hypersensitivity reactions (asthma).
Term
Stasis
Definition
The presence of numerous dilated small blood vessels packed with RBCs and slow-flowing blood.
Term
ICAM-1 and VCAM-1
Definition
Are ligands on endothelial cells for integrins located on the lymphocytes.
Term
Selectins bind to sialylated forms of oligosaccharides, which themselves are covalently bound to _________________.
Definition
various Mucin-like glycoproteins.
Term
Beta-2 integrins
Definition
LFA-1 and Mac-1 bind to ICAM-1
Term
Beta-1 integrin
Definition
VLA-4 binds to VCAM-1
Term
P-selectin is normally stored in _______________.
Definition
Weibel-Palade bodies
Term
Chemokines that also activate integrins on the leukocytes bind to _______________ on endothelial cells.
Definition
Heparin sulfate glycosaminoglycans
Term
Diapedisis
Definition
Transmigration of the leukocyte via the homophilic adhesion molecule PECAM-1.
Term
Which LAD accounts for delayed cord separation?
Definition
LAD-I; mutation in the gene coding for beta-2 integrin subunit (CD18).
Term
LAD-II
Definition
Neutrophils are completely deficient in sialyl-Lewis(x) which causes there to be no reaction with E and P selectins; periodontitis is the major persistent manifestation.
Term
LAD-III
Definition
Integrins are expressed normally, but there is a genetic loss in the activation of beta-2 integrin by chemokines; marked by bleeding tendency and leukocytosis.
Term
_____________ is an exogenous source that can cause chemotaxis.
Definition
N-formyl-methionine terminal amino acid in bacteria.
Term
Endogenous sources that stimulate chemotaxis.......
Definition
C3a/C5a, Leukotriene B4 (LTB4), and cytokines (particularly those of the chemokine family.
Term
At which stage can the developing neutrophil no longer proliferate?
Definition
Myelocyte
Term
What types of cells release granulocyte-colony stimulating factor?
Definition
Fibroblasts, endothelial cells, and lymphocytes.
Term
Neutropenia
Definition
<1500 neutrophils per mL (normal is 6000); Benign Ethnic Neutropenia is 1200/mL; severe gingivitis or periodontitis are the most common clinical signs of infection in these cases!
Term
Cyclic neutropenia
Definition
Less than 200 neutrophils/mL for 3-6 days every three weeks; treated with G-CSF to get cells past the myelocyte stage.
Term
Decisive Period
Definition
The first 4 hours after infection for neutrophils to get in and stop it! The status of the local blood supply is a critical factor (i.e. shock is bad).
Term
Receptors on leukocytes for chemotaxis, activation, etc. include......
Definition
Seven transmembrane domain G-protein coupled receptors for lipids, formyl-methionyl peptides, and chemokines.
Term
Two opsonins are ______ and _______.
Definition
IgG and C3b; compromised in patients with hypogammaglobulinemia.
Term
Dead microorganisms are degraded by _____________ and __________.
Definition
Lysosomal acid hydrolases and elastase; myeloperoxidase (MPO) from granules reacts with hydrogen peroxide to form perchlorate.
Term
Lactic acid in phagolysosomes is actually what kills this bacterium......
Definition
Pneumococci.
Term
Chediak-Higashi Syndrome
Definition
Defect in phagolysosome formation; characterized by photophobia, gingivitis, and periodontitis.
Term
Protain A in Staph aureus has this mechanism of avoiding neutrophils.......
Definition
Binds to fixed-chain region of IgG.
Term
Resolution of inflammation is accredited to......
Definition
Lipoxins (derived from the neutrophils LXA4 and LXB4); they inhibit chemotaxis and superoxide generation and promote neutrophil apoptosis and monocyte chemotaxis (no cytokine production though).
Term
Fenton reaction
Definition
Occurs in neutrophils; hydrogen peroxide is converted to a radical alcohol which oxidizes fatty acids, proteins, and DNA.
Term
Examples of labile cells include.........
Definition
Skin, mucous membrane of mouth, GI, urinary, and respiratory tracts; more than 1.5% of these cells are undergoing mitosis.
Term
Examples of stable cells include.........
Definition
Parenchymal cells of the liver, pancreas, thyroid, salivary glands, adrenal cortex, renal tubular epithelium, and connective tissue cells (osteoblasts, fibroblasts, endothelial cells).
Term
Scarring will occur in the absence of necrosis if the exudate becomes organized as in the case of.......
Definition
Fibrinopurulent pericarditis or peritonitis.
Term
After a cut, hemostasis is initiated by ___________, ___________, and ___________.
Definition
Serotonin, thromboxane A2, and fibrin clot.
Term
Macrophages secrete __________ and __________ along with ___________.
Definition
Collagenase and elastase along with cytokines that stimulate fibroblast chemotaxis.
Term
During angiogenesis, endothelial cells secrete __________.
Definition
Collagenases to degrade the basement membrane surrounding the capillary; capillary and lymphatic channels do not anastamose with each other.
Term
Myofibroblasts have a ___________ nucleus.
Definition
Folded, accordion-like nucleus; myofibroblasts are normally seen at the periphery of granulation tissue.
Term
Mast cells in the late stage of wound healing:
Definition
Secrete cytokines for the formation of basement membranes; low-dose histamine may stimulate fibroblasts to make collagen; mast cells are the second most abundant cell in connective tissue behind fibroblasts.
Term
Gaping wounds are made smaller by two mechanisms:
Definition
1) Contraction of the scab (within the first few days)
2) Contraction of myofibroblasts (more significant)
Term
Regenerated epithelium is _______ than the normal epidermis, but without _________.
Definition
Thicker.......rete ridges; less firmly attached to dermis too.
Term
Which two cytokines have systemic effects?
Definition
IL-6 and TNF
Term
PDGF
Definition
Chemoattractant for neutrophils, monocytes, and fibroblasts; stimulates proliferation of endothelial cells and macrophages; Regranex is used to treat diabetic ulcers.
Term
EGF (Epidermal Growth Factor)
Definition
Stimulates proliferation and migration of keratinocytes, proliferation of fibroblasts, and granulation tissue formation; also secreted by salivary glands.
Term
VEGF
Definition
Produced by platelets, macrophages, and endothelial cells in response to PDGF, TGF-beta, and HYPOXIA; in the saliva, it provides oral homeostasis?
Term
TGF-beta
Definition
Promotes collagen/ECM synthesis and inhibits collagen degradation; also induces TIMPs (tissue inhibitor of metalloproteinases); unfortunately, TGF-beta is involved in fibrosis in lung, liver, and kidneys after chronic inflammation.
Term
Irradiated skin is dry because......
Definition
Sebaceous glands and sweat glands are damaged; radiation also causes increased fibrosis and thinning of epidermis due to cytotoxic effects on fibroblasts and keratinocytes.
Term
Vitamin C is needed for........
Definition
The hydroxylation of proline and lysine (Scurvy).
Term
Vitamin A is needed for........
Definition
Normal epithelialization and proteoglycan synthesis.
Term
Zinc is needed for......
Definition
Granulation tissue formation; it is a cofactor of numerous enzymes including DNA and RNA polymerase.
Term
Steroids lead to poor wound healing due to.............
Definition
Diminished fibrosis (good for an eye infection though).
Term
During cancer, three systemic factors include:
Definition
1) Increased glucose turnover
2) Accelerated protein catabolism
3) Uptake of Vitamin C by tumors
Term
Proud flesh may need to be cauterized with ____________.
Definition
Silver nitrate
Term
Keloids may be triggered by......
Definition
Implantation of foreign materials or complications from burns and scalds (recurrence is high in keloids).
Term
Cicastriation
Definition
Contracture (excessive wound contraction); seen in liver cirrhosis and burns of the skin.
Term
Traumatic neuroma
Definition
Not a neoplasm; reactive proliferation of neuronal tissue after damage; tumor-like mass develops; common site is mental foramen, tongue, and lower lip.
Term
The only part of the kidney that can regenerate is the..........
Definition
Cortical tubules
Term
In the nervous system the _____ can repair and the _______ can regenerate.
Definition
CNS.......PNS
Term
Chronic inflammation results in _______ and _________ hypertension.
Definition
Portal and renal
Term
Macrophages are unable to degrade bacteria for certain strains of __________.
Definition
Streptococci
Term
Most chronic inflammatory lesions are..........
Definition
Quiescent with outbursts (as in periodontitis).
Term
Specefic (primary) chronic inflammation can be caused by these three things.
Definition
1) Virus
2) Tumors
3) Transplant rejection

Primary chronic inflammation does not see much acute inflammation!
Term
Infective endocarditis, bronchiectasis, and periodontitis are examples of........
Definition
Non-specific chronic inflammation; in these diseases, the primary causative agent may have disappeared a while ago.
Term
Abscess
Definition
A collection of pus usually from S. aureus; acute abscesses can enlarge while a chronic abscess is encapsulated by granulation tissue.
Term
During periodontitis, the sulcular epithelium........
Definition
Becomes hyperplastic and migrates apically.
Term
Definition of a granuloma
Definition
A tissue aggregate of epithelioid macrophages as a part of a cell-mediated immune response.
Term
Characterisitcs of epithelioid cells
Definition
Lots of pink cytoplasm (like a squamous epithelial cell), but nuclei are long and stringy.
Term
Schaumann bodies ("conchoid bodies")
Definition
Laminated calcified nuggets in the cytoplasm of giant cells; common in foreign bodies, TB, and rheumatic fever.
Term
Beside TB, what other infections cause caseating necrosis?
Definition
Dimorphic fungi such as Histoplasmosis capsulatum or Cryptococcus neoformans; also starch as a foreign body.
Term
What are two endogenous sources from which foreign body granulomas can occur?
Definition
Keratin or bony sequestra
Term
Sarcoidosis
Definition
A granulomatous disease of unknown etiology; lung is involved 90% of the time, but it is a mutli-system disorder with cutaneous manifestations 25% of the time (LUPUS PERIO); oral manifestations are uncommon; lung present asteroid bodies and Schaumann bodies with no caseous necrosis!
Term
Diagnosis of sarcodiosis
Definition
Bilateral hilar lymphadenopathy or pulmonary fibrosis; positive KVEIM test; ACE levels rise and fall with the disease's activity.
Term
Crohn's Disease
Definition
Granulomas are looser than TB or sarcoidosis; Glossitis may appear secondary to the iron, folate, or Vitamin B12 deficiency that develops.
Term
Melkersson-Rosenthal Syndrome
Definition
An orofacial granulomatous disease with unilateral facial paralysis, facial swelling, and a fissured tongue; when only the lips swell together, it's called Cheilitis granulomatosa.
Term
What is the one granulomatous disease that involves the salivary glands?
Definition
Sarcoidosis
Term
Pupura
Definition
Slightly larger than petechiae; caused by thrombocytopenia, mononucleosis, etc.
Term
Differential diagnosis pecking order for non-healing ulcers......
Definition
Trauma --> malignancy --> infection
Term
Riga-Fede disease
Definition
An eosinophilic ulcer in infants due to early eruption of teeth
Term
Epulis fissuratum is more common in males/females.
Definition
Females
Term
3 Ps for the differential diagnosis of an epulis.
Definition
1) Pyogenic granuloma
2) Peripheral ossifying fibroma- occurs ONLY in the gingiva
3) Peripheral giant cell granuloma- ONLY on gingiva as well

Both of the latter two are determined histologically by the presence of multi-nucleated giant cells, extravasated hemorrhage, and hemosiderin.
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