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Pathology
Study questions for second pathology test
50
Biology
Undergraduate 4
10/26/2009

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Term
Three triggers for thrombus formation.
Definition
Direct injury to vessel walls, stagnation of blood flow, hypercoagulative state (autoimmune or genetic)
Term
What are the two factors that can initiate the clotting cascade?
Definition
Hageman factor (inflammatory response), tissue factor 8 (released by platelets)
Term
Role of platelets in thrombus formation.
Definition
Activating thrombin and fibrinogen, recruitment of other platelets
Term
Which serine protease cleaves fibrinogen to fibrin?
Definition
Thrombin
Term
Two chemical mediators of cyclooxygenase pathway are involved in regulating thrombus formation?
Definition
Thromboxane and prostacyclin
Term
How does an endothelial cell negatively regulate thrombus formation?
Definition
Nitric oxide and prostacyclin secretion, physical barrier between plateletes and collagen/vWF.
Term
What is the major source of venous emboli?
Definition
Stasis (reduction in turbulent flow)
Term
Aterial emboli are primarily associated with what disease process?
Definition
Atherosclerosis
Term
What does infarction mean?
Definition
Necrosis as a result of ischemic event
Term
How does congestive heart failure lead to generalized edema?
Definition
Reduction in blood pressure (shock) - seeping of fluid out of capillaries because of loss of blood flow/pressure
Term
Five types of shock and what do they have in common?
Definition
Cardiogenic, hypovolemic (hemorrhage), septic, anaphylactic, neurogenic (brain damage) - all have a reduction in blood pressure/volume, increase in vasodilation and vascular permeability
Term
How can you bleed to death from disseminated intravascular coagulation?
Definition
Pseudo-hemophiliac state - all clotting proteins and platelets are consumed
Term
What is atherosclerosis?
Definition
Thinning of blood vessel lumen by deposition of fats and cholesterol
Term
What is the unifying hypothesis for atherosclerosis pathogenesis?
Definition
Cholesterol leaked into blood vessels, oxidized cholesterol activates macrophages, cytokines released, fibroinflammatory response, "foam cell" necrosis (oxidized cholesterol not easily digested), "positive feedback" of macrophages and necrotic core formation
Term
What type of inflammation occurs in atherosclerosis?
Definition
Fibroinflammation
Term
Structure of an atheroma.
Definition
Necrotic core, foam cells and inflammatory factors, neovascularization, fibrous cap
Term
How can an atheroma lead to an infarct?
Definition
Platelets form thrombi when cap ruptures, thrombi becomes embolytic, thrombus gets stuck in heart
Term
What can we learn about atherosclerosis and ischemic heart disease resulting in myocardial infarction from the genetic condition known as familial hypercholesterolemia?
Definition
Cholesterol unable to be uptaken, causing increase in LDL, decrease in HDLs/VHDLs, direct atherosclerosis as a result of lack of cell uptake of cholesterol - DRAMATIC effect (5-6x serum LDL)
Term
What are the four principle effects of ischemic heart disease?
Definition
Myocardial infarct, angina, chronic congestive heart failure, and sudden death
Term
What is the primary cause of myocardial infarction?
Definition
Ischemic event
Term
What are the four major risk factors for IHD?
Definition
Hypertension, cigarette smoking, diabetes, blood cholesterol level
Term
Describe the events occurring in the damaged myocardium from 12 hours to 3 months following a myocardial infarction.
Definition
Necrosis of myocardial cells, leukocyte chemotaxis, inflammatory response, fibrosis formation (3 months for myocardial fibrosis)
Term
What are the top three cancers in terms of incidence?
Definition
1) Breast/prostate, 2) Lung, 3) Colon/rectum
Term
What are the top three cancers in terms of mortality?
Definition
1) Lung, 2) Breast/prostate, 3) Colon/rectum
Term
What are the three general features that distinguish benign from malignant neoplasms?
Definition
Invasion, metastasis, and appearance
Term
Define anaplasia
Definition
A reversion of differentiation in cells - characteristic of malignant neoplasms
Term
Define pleomorphic
Definition
Variable in size, shape, and appearance of cells and/or nuclei - characteristic of malignant neoplasms
Term
Define hyperchromatic
Definition
Abundance of DNA in cancer cells, indicating malignancy
Term
Define dysplasia
Definition
Cellular abnormality is restricted to the originating tissue (early neoplasms)
Term
Explain the clonal origin of neoplasms
Definition
Neoplastic growth comes from the cancerous transformation of a single cell
Term
What type of cancer protein is Ras?
Definition
Ras is a family of genes encoding small GTPases involved in cell growth, differentiation, and survival.
Term
What is the significance of Ras?
Definition
Single most common oncogenic mutation location - can be transformed by a point mutation, causing the growth signal to never stop.
Term
What are the three mechanisms for altering protooncogenes to oncogenes?
Definition
1) Change in protein structure (increase in activity or loss of regulation), 2) Increase in protein concentration (gene amplification, increased mRNA stability, gene duplication), 3) chromosomal translocation (incrased gene expression)
Term
How does Rb work normally and in carcinogenesis?
Definition
Rb normally prevents excessive cell growth by inhibiting cell cycle progression. In carcinogenesis, it is inactivated, allowing the cell to escape G0 and enter the cell cycle
Term
How does p53 work normally and in carcinogenesis?
Definition
Normally, p53 activates DNA repair proteins, induces growth arrest (usually for the purpose of repair), and initiates apoptosis. In carcinogenesis, p53's activity is either severely reduced or lacking altogether
Term
How does APC work normally and in carcinogenesis?
Definition
Normally, APC helps control how often a cell divides, how it attaches to other cells, or whether a cell moves within or away from a tissue. In carcinogenesis, APC causes misregulation of cadherins, altered cell migration, and chromosome instability
Term
What is meant by the "Two-hit hypothesis" and "Loss of heterozygosity"(LOH)?
Definition
Only one working allele of a tumor suppressor gene is necessary for its function, so both must be mutated for the cancer phenotype to appear.
Term
What are the five types of DNA repair mechanisms?
Definition
Homologous recomination, mismatch repair, nucleotide excision repair, DNA crosslink repair, non-homologous end joining
Term
A genetic defect in which DNA repair mechanism is the most common cancer predisposition?
Definition
Mismatch repair
Term
How is the reactivation of telomerase thought to be related to cancer?
Definition
The lengthening of the DNA strands brought about by telomerase helps maintain the immortality of cancer cells (telomerase activation in >90% of all tumors)
Term
What are the three categories of carcinogens?
Definition
Viral, chemical, and physical
Term
How can HPV infection lead to cervical cancer?
Definition
Viral replication and gene integration leads to p53 binding and degradation by E6 protein and Rb (blocks cell cycle progression) inhibition by E7
Term
What is the difference between a tumor initiator and a tumor promoter?
Definition
Initiators contribute to the transformation of normal cells, promoters amplify carcinogenic effects of initiators
Term
Define toxic effect
Definition
Reproducible, dose-dependent reaction reflecting direct action of the compound or its metabolites on a tissue
Term
What are the four characteristics that influence toxicity?
Definition
Absorption, distribution, metabolism, excretion
Term
The majority of complications associated with use of oral contraceptives are related to what vascular process?
Definition
Deep vein thrombosis (and thromboembolism)
Term
How is the vascular endothelium damaged during hyperthermia?
Definition
Altered vascular permeability, edema, blisters, general vasodilation, inefficient cardiac function, altered respiration, and ultimately death
Term
How is the vascular endothelium damaged during local hypothermia?
Definition
Endothelium lining of venules and capillaries damages small vessel permeability - activating an inflammatory response and the formation of localized edema and blisters
Term
Which types of burns allow for regeneration and why?
Definition
First and second - the basal cells (the source of regenerating epithelial surface cells) remain intact
Term
What is a common sign of reversible alcohol induced injury in the liver?
Definition
Fatty liver. As a side note, cirrhosis is irreversible
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