Ayads Gen Path MT2

Description:	Ayad's Gen Path MT2
Category:	Chiropractic
Created by:	thenathan on 2009-07-13

Question	Answer
What cells normally divide throughout life to replace the continually lost cells?	Labile cells
Surface epithelial cells, crypt cells of gut mucosa, hematopoietic stem cells?	Labile cells
Following injury, surviving cells proliferate rapidly to replace lost ones?	Labile cells
Long-life span, very slow rate of division?	Stable cells
They remain in intermitotic phase for long periods, retain capacity to enter the mitotic cycle when needed (replacement of damaged cells)?	Stable cells
What are the two types of stable cells?	Parenchymal cells of solid organs, Mesenchymal cells
No capacity for mitotic division in post-natal life?	Permanent cells
Neurons, Myocardial cells, skeletal muscle cells are what type of cells?	Permanent cells
Injury to tissue w/ permanent cells is always followed by a scar formation (no regeneration is possible, irreversible)?	Permanent cells
What type of necrosis happens following myocardial infarction?	Coagulative necrosis
Fibroblasts are stimulated by?	Chemical mediators
Fibroblasts are stimulated to do what?	Proliferate, and secrete: collagen, elastic/reticular fibers, extracellular matrix, actin/myosin filaments (myofibroblasts)
What is fibronectin?	Glycoprotein
What does fibronectin do?	Promotes angiogenesis, and is chemotactic to fibroblasts and promotes organization
What is a glycoprotein derived from plasma?	Fibronectin
Initial scar formation is laid down by what type of cells?	Myofibroblasts
Essential for angiogenesis and chemo tactic (direction)?	Capillaries, fibroblasts
Early contraction is due to?	Myofibroblast
Late contraction is due to?	Collagen
What are the 3 types of skin wounds?	Abrasion, Incision/laceration (1st intention), wounds w/ epidermal defect (2nd intention)
How long does a scar take to increase tensile strength of a scar to 40%?	4 weeks
How long does a scar take to increase tensile strength of a scar to 80%?	4 months
Secondary wounds are characterized by?	Extensive necrosis, large wounds, secondary infection, inflammation, foreign body
Causes of defective wound healing?	Fail of synthesis of collagen fibers, excessive collagen production, local factors, diabetes mellitus, and excessive levels of corticosteroids
What causes failure of synthesis of collagen fibers?	Deficiency of vitamin C, Ehlers-Danlos syndrome
What is Ehlers-Danlos syndrome?	Deficiency of enzymes involved in collagen synthesis (rubber man)
List 2 local factors of defective wound healing?	Foreign body, necrotic tissue, infection, abscess formation, abnormal blood supply
What is the problem with high levels of corticosteroids?	Interfere w/ phagocytosis, decrease arachidonic acid metabolites, decrease collage formation
Growth factors involved in wound healing?	Platelet-derived Growth factor, Epithelial growth factor, IL-1 and TNF, Thrombin
PDGF does what?	Proliferation of fibroblasts, enhances wound healing
EGF does what?	Proliferation of epithelial cells and fibroblasts
IL-1 and TNF do what?	Chemotactic for fibroblasts, increased collagen synthesis (fibrogenic cytokines)
Thrombin does what?	Fibroblast mitosis
Edema in the pleural cavity is known as what?	Hydrothorax
Edema in the peritoneal cavity is known as what?	Ascites
Edema in the pericardial cavity is known as what?	Hydropericardium
What force takes fluid out?	Hydrostatic pressure
What force brings it back?	Osmotic pressure
Increase of blood due to active arterial dilation is known as?	Hyperemia
What are two types of Hyperemia?	Physiologic (muscles during exercise), Pathologic (inflammation)
Passive increase of blood due to impaired venous drainage?	Congestion
Localized congestion is due to?	Venous obstruction
Generalized congestion is seen in?	Right heart failure
Alveolar macrophages engulf hemosiderin in lung congestion?	Heart failure cells
Heart failure cells are seen in which organ?	Lungs
Liver congestion is a result of?	Right side heart failure
Nutmeg liver is seen in what problem?	Liver congestion, fatty change
Splenic congestion is due to what?	Liver cirrhosis, portal hypertension
Secretion of ADP leads to platelet aggregation is known as what reaction?	Platelet release reaction
ADP is what?	Platelet aggregator
2 steps in platelet plug?	Adhesion, aggregation
3 important factors in hemostasis?	Endothelial cell, blood platelet, coagulation factors
What causes platelet adhesion?	Von Willebrand’s factor
What causes platelet aggregation?	ADP, Thromboxane
Injured endothelial cells initiate thrombosis by?	Von willebrand’s factor, Tissue factor (thromboplastin)
Virchow’s Triad?	Endothelial injury (most important), Alteration of normal blood flow, hyper-coagulability of blood
What is the most important factor of Virchow’s triad?	Endotherlial injury
Arterial thrombi, grey Red mass w/ apparent laminations?	Lines of Zahn
Types of arterial thrombi?	Non-occlusive (mural), Occlusive (most common), Vegetative (occur on cardiac valves)
What is the most common type of arterial thrombi?	Occlusive
What are the lines of Zahn?	Red layer of RBC’s
Lines of Zahn are seen where?	Arterial thrombi
Venous thrombi commonly occur where?	Lower limbs
Venous thrombi can result in what type of emboli?	Pulmonary
Almost always occlusive?	Venous thrombi
Fragmented or detached thrombi?	Thromboembolism
Pulmonary embolism is due to?	Venous embolism
Systemic embolism is due to?	Arteriol embolism
What causes pulmonary embolism?	Thrombi of systemic veins (usually deep veins of leg)
Systemic embolisms are derived from what type of thrombi?	Mural thrombi
What is the most common embolism?	Thromboembolism
What is the 2nd most common embolism?	Fat embolism
Fat embolisms are due to?	Fracture, burn, or surgery
Gas embolism is seen in?	Caisson disease, Decompression sickness
What gas is involved in gas embolism?	Nitrogen
What type of necrosis is infarction?	Coagulative necrosis
What are types of infarcts?	Pale, white anemic and Red, hemorrhagic
Pale, white anemic infarct is due to what type of obstruction?	Arterial obstruction
Red, hemorrhagic infarct is due to what type of obstruction?	Venous obstruction
Hemorrhagic infarcts occur in which organs?	Lung, liver, small intestine, ovary, testis
White, anemic infarcts occur in which organs?	Spleen, heart, kidney, brain
Types of shock?	Cardiogenic, hypovolemic, peripheral sequestration of blood volume
Decreased cardiac output due to heart failure?	Cardiogenic shock
Decreased cardiac output due to decrease blood volume?	Hypovolemic shock
3 types of shock due to peripheral sequestration of blood volume?	Septic shock, anaphylactic shock, neurogenic shock
What type of shock involves endotoxin of gram negative bacteria?	Septic shock
What type of shock involves chemical mediators of allergy?	Anaphylactic shock
What type of shock involves anesthesia, spinal cord injury?	Neurogenic shock
What are 5 causes of shock?	Cardiogenic, neurogenic, hypovolemic, anaphylactic, septic
Stages of shock?	Compensation, impaired tissue perfusion (decompensation), irreversible stage
Stage of compensation is associated with?	Mild hypotension
Stage of impaired tissue perfusion (decompenstion) is associated with?	Lactic acidosis
Irreversible stage is associated with?	Failure of peripheral vasoconstriction
Polypoid tumors are usually what?	Benign
Ulcerated tumors are usually what?	Aggressive
Carcinomas are from what?	Epithelial cells
Sarcomas are from what?	Mesenchymal tissue
Carcinomas are named by what?	Type of epithelium
Sarcomas are named by what?	Cell component of tumor
Mixed tumors are composed of what?	Epithelial and Mesenchymal tissue
Tumor from hepatocytes?	Hepatoma
Are hepatomas benign or malignant?	Malignant
Tumors from melanocytes?	Melanoma
Are melanoma tumors benign or malignant?	Highly malignant
A mass of mature disorganized tissue?	Hamartoma
What 2 tumors are non-encapsulated but benign?	Leiomyoma of uterus and Hemangioma
Why do malignant cells invade?	Physical pressure, secretion of enzymes, low adhesiveness of cells, loss of contact inhibition, vulnerability of adjacent tissue
How are carcinomas graded?	Numerically
How are sarcomas graded?	Descriptively
Why is grading imperfect?	Different parts of the same tumor may display different degrees of differentiation, grade of tumor may change as the tumor grow
Extent of regional spread of lymph nodes is graded how?	N0- not involved, N1- involved, mobile, N2- involved, fixed
Presence or absence of distal metastasis is graded how?	M0-absent, M1- present (one organ), M2- present (more than one organ)
Size of primary lesion is graded how?	T1- less than 2cm, T2- 2-5cm, T3- more than 5cm (movable), T4- infiltrating adjacent structures (any size), not movable
Second leading cause of death in the USA?	Lung cancer
Deadliest cancer for males?	Prostate
Deadliest cancer for females?	Breast
45 yr. old women, 6 cm diameter non-tender mass in lt. breast, appears fixed to the chest wall, another 2 cm movable non-tender mass is palpable in the lt. axilla. Radiograph reveals multiple .5-2 cm nodules in the lt. lung which of the following classifi	T4, N1, M1
45 yr. old women, no chest pain, cough or fever, x-ray shows a 2.5 cm coin lesion in rt. Mid-lung field. Which of the following biologic characteristics best distinguishes this lesion as a malignant neoplasm. Rather than a granuloma?	Uncontrolled (autonomous) growth
Biopsies were performed on patients who had palpable mass lesion on distal rectal exam of the following microscopic findings, which is most likely?	Invasion
Type 1 hypersensitivity is known as what?	Immediate (Anaphylactic) reaction
IgE is seen in what type of hypersensitivity?	Immediate (Anaphylactic) reaction
Bronchial asthma is seen in what type of hypersensitivity?	Immediate (Anaphylactic) reaction
IgG and IgM are seen in what type of hypersensitivity?	Type2: Cytotoxic reaction and Type3: Immune complex reaction
What type of necrosis occurs in blood vessels?	Fibrinoid necrosis
What type of hypersensitivity is mediated by T cells?	Type 4: Cell mediated hypersensitivity
What T cell is involved in DTH?	CD4
What T cell is involved in T cell mediated cytotoxicity?	CD8
Genetic factors of systemic lupus erythematosus?	HLA-DR2 and DR3
SLE is hypersensitivity type what?	Type 1
ANA react with what?	Nuclei of damaged cells
Most common cause of SLE death?	Kidney failure
SLE in the skin is seen as what?	Maculopapular rash
What are LE cells?	Nuclei of damaged cells
Heliotrope rash is characteristic of what autoimmune disease?	Polymyositis/Dermatomyositis
Extracellular accumulation of fibrillar proteins?	Amyloidosis
Type AL proteins accumulate in the tissue and pass in urine in what disease?	Primary amyloidosis
AL proteins passed in the urine are known as what?	Bence Jones protein
Type AA protein accumulation is seen in what disease?	Secondary (reactive) amyloidosis
Accumulation of B2-microglobulin in joints and synovium?	Hemodialysis-related amyloidosis
What type of protein is associated with hemodialysis and renal failure?	B2-microglobulin
Familial Mediterranean Fever is seen in what disease?	Hereditary amyloidosis
X-linked recessive disorder, absence of B lymphocytes?	Congenital agammaglobulinemia (Bruton’s)
Normal total lymphocyte count, serum immunoglobulins are markedly decreased, deficient humoral immunity are common in what immune deficiency?	Congenital agammaglobulinemia (Bruton’s)