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Path 375 Topic 1
| Vocabulary | Definition |
|---|---|
| parenchymal tissue | we have 2 types of tissue: performs function (others) |
| stromal tissue | we have 2 types of tissue: support function (connective) |
| differentiated cell | cell with function |
| undifferentiated cell | cell without specialized function |
| rough ER / smooth ER | protein / catabolism, synthesis |
| autocrine | control of cell - itself |
| paracrine | control of cell - neighbour |
| endocrine | control of cell - distant neighbour |
| CNS | Central Nervous System |
| ANS | Autonomic Nervous System |
| PNS | Peripheral Nervous System |
| Etiology | Cause of disease (defn path1) |
| Pathogenesis | Mechanism of disease (defn path2) |
| Morphology | Appearance of disease (defn path3) |
| Clinical Significance | Consequence of disease (defn path4) |
| Natural History | Progression of disease (defn path5) |
| Cell injury | when cell lose Homeostasis / balance |
| Reversible Cell Injury | type1 cell injury |
| Irreversible Cell Injury | type2 cell injury |
| Lack of Oxygen | An example of cell injury |
| Hypoxia | Decrease oxygen supply |
| Anoxia | Total lack of oxygen (heart1-2hr/brain4min) |
| Heart attack | Heart stops pumping effectively (hypoxia) |
| Atrophy | Adapt to cell injury1: smaller |
| Physiological atrophy (eg) | aging: Brain |
| Pathological atrophy (eg) | muscle denervation: skeletal muscle cells supplied by that nerve |
| Hypertrophy (eg) | adapt to cell injury2: larger |
| Physiologic hypertrophy (eg) | exercise: skeletal muscle |
| Pathologic hypertrophy (eg) | hypertension (systemic pressure): cardiac muscle cells |
| Hyperplasia | adapt to cell injury3: more cells |
| Physiologic hyperplasia (eg) | pregnancy: female breast |
| Pathologic hyperplasia (eg) | endometrial hyperplasia: endometrial cavity |
| Metaplasia (defn) | adapt to cell injury4: change cell type |
| Metaplasia (eg) | chronic smoking: columnar bronchial epithelium to stratified squamous |
| columnar bronchial epithelium | before smoking |
| stratified squamous | after smoking |
| dysplasia | abnormal growth of cells/tissue (any "bad cell") |
| squamous | scaly |
| exogenous | outside cell |
| endogenous | inside cell |
| anthracosis | accumulation of carbon particles (@ lungs) |
| hemosiderosis | accumulation of hemosiderin |
| steatosis | acculmulation of fat |
| Pathologic calcification | (blank) |
| Dystrophic calcification (defn) | Ca2+ deposit in damaged tissue |
| Dystrophic calcification (eg) | Atherosclerosis |
| Metastatic calcification (defn) | Ca2+ in normal tissue (only when hypercalcemia) |
| hypercalcemia | abnormally high Ca2+ in blood |
| hemosiderin | break-down product of Hb |
| Necrosis | MURDERED: death due to external force - change in appearance (morphological) |
| Apoptosis | NORMAL: death due to old age etc (also in viral bacteria) |
| Coagulative necrosis (morph) | SOLID: boiled meat (coagulated proteins), solid internal organs |
| The most common form of necrosis is... | coagulative necrosis |
| Coagulative necrosis (mechm) | inactivation of hydrolytic enzymes |
| if you don't have working hydrolytic enzymes... | coagulative necrosis |
| Liquefactive necrosis (morph) | dissolution of tissue, soft, filled with fluid |
| Liquefactive necrosis (eg) | Brain infarct |
| Caseous necrosis (morph) | cheese, limited liquefaction |
| Caseous necrosis (eg) | TB |
| Fat necrosis (morph) | white chalky |
| Fat necrosis (mechm) | enzyme complex with Ca2+ |
| Inflammation (defn) | A response to injury: non-specific coordinated response by vascularized living tissue to injury |
| Why do tissue inflame? | 1. contain/isolate 2. destroy 3. prepare healing BUT can be harmful |
| 5 Clinical Signs of Inflammation | 1. heat 2. redness 3. edema 4. pain 5. loss of function |
| What are the events in inflammation? | 1spincter relax 2transient vasoconstriction 3v.dilation 4i.permeability 5.WBC arrive (PMN,Plalates,Fibrin,Leukocytes) |
| caliber | diameter |
| transient vasoconstriction | brief vasoconstriction |
| What are the mediators of inflammation? 4x (ie What compounds participate in inflammation?) | 1Histamine 2Bradykinin 3Complement system 4Arachidonic acid derivatives |
| mediators | compounds released by cells to activate WBC |
| Histamine (func) | i. vessel permeability |
| Histamine is released by... | mast cells |
| Bradykinin (func) | 1i. vessel permeability 2pain |
| Bradykinin is from... | derived from plasma proteins |
| plasma proteins | proteins in blood stream |
| Complement system (func) | help to kill bacteria |
| 2 methods to activate Complement | 1. classical pathway 2. alternate pathway |
| Complement activation: classical pathway | Ag-Ab initiated |
| Complement activation: alternate pathway | toxins mediated |
| How many ways can you activate complement system? | 2 |
| Arachidonic acid (AA) derivatives (func) | metabolize to form: 1leukotrienes 2prostaglandins 3prostacyclin 4thromboxane, affect inflammation |
| Arachidonic acid is from... | cell wall phospholipids |
| leukotrienes | from AA |
| prostaglandins | from AA |
| prostacyclin | from AA |
| thromboxane | from AA |
| What cells participate in inflammation? 5x | 1. Neutrophil (PMN) 2. Eosinophils 3. Basophils/mast cells 4. MO 5. Lymphocytes/Plasma cells |
| Look at table for "Cellular components for inflammation" | (blank) |
| PMN also called... | Neutrophil |
| PMN / Neutrophil (func) | 1kill 2engulf bacteria |
| Does PMN produce chemicals? | YES |
| Is PMN long-live/short-live? | short |
| Is PMN mobile? | YES, very. |
| Eosinophils (func) | 1kill bacteria 2parasite 3allergic rxn |
| Is eosinophils mobile? | YES |
| Is eosinophils involve in chronic/acute inflammation? | Present in Chronic |
| What is the difference btw basophil and mast cell? | Basophil - in blood ; Mast cell - in tissue |
| Basophil/Mast cell (func) | release histamine |
| Macrophages (func) | phagocytosis |
| When does MO enters site of infection? | 3-4 days after injury |
| Does MO involve in chronic/acute inflammation? | Chronic |
| Lymphocytes/Plasma cells (func) | adaptive immune response |
| Lymphocytes | Cells in lymph: only T and B |
| Plasma cells | differentiated B cells |
| What are the difference between lymphocytes and plasma cells? | T and B VS differentiated B |
| Does lymphocyte/plasma cell involve in chronic/acute inflammation? | Chronic |
| Inflammatory exudates | oozing-out stuffs during inflammation |
| How many types of inflammatory exudates are there? | 3. 1exudate 2transudate 3pus(purulent) |
| Exudate | Protein+WBC+Fluid, formed only due to inflammation |
| Why does exudate form? | Inflammation |
| Transudate | Fluid only, forms due to disturbance in forces across vessel walls |
| Why does transudate form? | There is a disturbance of balance in forces across vessel walls |
| Pus (purulent) contains... | Neutrophils + dead bacteria |
| Is pus an inflammatory exudate or transudate? | Exudate |
| Purulent | pus |
| What is the difference btw exudate and transudate? | exudate: protein+WBC+fluid ; transudate: fluid only |
| What are the possible outcome of acute inflammation? 4x | 1complete heal 2abscess 3fibrosis&scar 4becomes chronic |
| Abscess | fibrous capsule wall off inflammation |
| Fibrosis | replace usual tissue with fibrous tissue |
| Fibrosis will lead to... | scar |
| How many types of inflammation are there? 7x | 1. Serous 2. Fibrinous 3. Purulent 4. Ulcerative 5. Pseudomembranous 6. Chronic 7. Granulomatous |
| Serous inflammation | A type of inflammatory infiltrate: clear fluid, few cells |
| Fibrinous inflammation | A type of inflammatory infiltrate: exudate rich in fibrin |
| Inflammatory infiltrate | abnormal stuffs that accumulate in cells/tissue |
| Purulent inflammation | A type of inflammatory infiltrate: exudate rich in PMN |
| Ulcerative inflammation | loss of an epithelial lining due to inflammation |
| Ulceration | sloughing of inflammed necrotic tissue, loss of epithelial lining |
| Pseudomembranous inflammation | 2+3+4 (Fibrinous, Purulent, Ulceration) --> pseudomembrane over ulcer |
| Chronic inflammation | +weeks/months ; All at the same time: 1. active inflam 2. tissue destruction 3. healing |
| In chronic inflammation, 3 things occurs at the same time... | All at the same time: 1. active inflam 2. tissue destruction 3. healing |
| Chronic inflammation's exudate | 1lymphocytes 2plasma cells 3MO |
| In chronic inflammation, one type of cell proliferate: | fibroblasts |
| Fibroblasts | a cell that will become connective tissue |
| Granulomatous inflammation | one kind of chronic inflammation: formation of granulomas |
| Granuloma | 1. lymphocytes, 2. MO (chronic inflam cells) 3. +/- multi-nucleated giant cells --- in discrete nodules |
| multi-nucleated giant cells | sometimes found in granulomas |
| Caseating granulomas (eg) | TB |
| Non-caseating granulomas (eg) | sarcoidosis |
| What is the difference: Inflammatory exudate VS Inflammatory infiltrate? | exudate: oozing-out ; infiltrate: accumulation |
| Fibroblast proliferate when... | proliferate in chronic inflammation |
| What are healing and repair? | Cells' mechm to fix damaged tissue |
| Can epithelial cells regenerate (heal/repair)? | YES. Continually diving |
| Can liver cells regenerate (heal/repair)? | YES. If required. |
| Can neurons regenerate (heal/repair)? | NO. |
| What cells can regenerate themselves and what cannot? | YES: epithelial, liver cells NO: neurons |
| granulation tissue | small, bead-like bulge; consist NEW capillaries |
| How many types of wound-healing process are there? | 2. 1st and 2nd intention |
| Wond healing by first intention (defn) | healing occurs after a surgical incision |
| Wound healing by first intention (steps) | 1scab 2PMN 3granulation tissue 4fibrous tissue(scar, collagen) 5contract myofibroblast 6disappear |
| Wound healing by second intention (defn) | HUGE wound, cannot/not closed surgically |
| Wound healing by second intention (steps) | 1granulation tissue 2fibrous tissue 3contracts **disfiguring |
| granulation tissue, fibrous tissue, scar, collagen, fibroblast | wound healing |
| scab | a crust discharged to cover healing wound (*dried up discharge) |
| Abscess, Sinus, Fistula | [Fig 2.15] When abscess gets too large |
| When an abscess gets too large... | rupture --> sinus, fistula |
| sinus (Ch2) | picture like pot (abscess) |
| fistula | 2 pots of abscess connect |
| keloids | disfiguring scar, excess amount of collagen |
| Immune system (defn) | Immune system protects body against harmful substances |
| We have 2 types of immune system: | 1natural 2acquired immunity |
| How can immune system cause disease? (Broad) | 1too active (hypersensitivity, autoimmune) 2underactive (immunodeficiency) 3transfusion, transplants |
| What are our 4 lymphoid organs? | 1lymph nodes 2spleen 3thymus 4mucosa associated lymphoid tissue |
| lymph nodes | lymphoid organs |
| spleen | lymphoid organs |
| thymus | lymphoid organs |
| mucosa associated lymphoid tissue (MALT) | lymphoid organs |
| MALT | mucosa associated lymphoid tissue |
| How many type of adaptive immune cells do we have? | 4. 1T 2B 3Plasma 4NK |
| Receptor of T cells | TCR |
| T helper cells is also called... | CD4 |
| T helper cells / CD4 T cells (func) | help B lymphocyte product Ab |
| T suppressor lymphocytes is also called... | CD8 |
| T suppressor lymphocytes / CD8 (func) | 1suppress Ab production 2kill viral infected cells |
| Natural killer cell (NK) | not B nor T |
| Natural killer cell (NK) | 1.kill viral infected cells 2kill tumor 3kill foreign cells w/out prior exposure |
| MHC is found on... | APC |
| MHC Class I - Ag binds to... (T cell).. | CD8 |
| MHC Class II - Ag binds to... (T cell).. | CD4 |
| How many types of B cell antibodies do we have? | 5x. IgG, M, A, D, E |
| Look at table for Antibodies in notes | (blank) |
| IgG is found in... | Blood |
| IgG | Ab when re-exposure |
| IgG (mechm) | 1Floating in cell 2got bact 3Fc get recog by PMN, lymphocytes, MO, eosinophils, palate |
| opsonin | IgG: Increased phagocytosis by cell |
| IgM is found in... | blood |
| IgM | Ab when first encountered |
| IgM (shape) | pentamer held together by J-chain |
| Pentamer Ig | IgM |
| J-chain | IgM pentamer |
| IgM (func) | 1.Ab 2. neutralize bact 3. complement activation |
| Which Ig activates complement? | IgM |
| IgD is found in... | surface of B cells |
| IgD (func) | Activate B if see Ag |
| IgE is found in... | surface of mast cell (tissue) |
| IgE (func) | mediate allergic Type I response |
| IgA is found in... | secretions, milk |
| IgA looks like... | Dimer |
| Which Ig comes in dimer? | IgA |
| Which Ig is a good oposonin? | IgG |
| How did immune specificity comes about? | 1. TCR & 2. AB gene rearrangment |
| Ab (func) | 1no entry 2complement 3spleen/liver removal 4cytotoxic response |
| How is our immune system activated? From bacteria to Memory | (Refer to notes) |
| previously sensitized B cells | B cells that have seen the Ag before |
| What are the 4 types of Hypersensitive reactions? | T1 Anaphylactic Type T2 Cytotoxic Type T3 Immune Complex Type T4 Cell mediated (Delayed response) |
| Type I Hypersensitive Reaction (defn, step, conseq) | Anaphylactic Type Reaction: Mediated by IgE -- Mechm: IgE on mast cell Conseq: Inflammation |
| Anaphylactic Type Reaction is also called... | Type 1 Hypersensitivity |
| Type 2 Hypersensitive reaction (defn, step, conseq) | Cytotoxin Type Reaction: Mediators IgM/IgG Mech: IgM/G binds to self /hapten Conseq 1complement killing 2PMN,MO,NK killing 3Ab block receptor (death / change in function) |
| hapten | small mol'c adapter (binding's middle person) |
| Cytotoxic type hypersensitivity is also called... | Type 2 Hypersensitive Rxn |
| Type 3 Hypersensitive Reaction (defn, step, conseq) | Immune Complex Type Reaction: Ab-Ag forms large clump, circulate, stuck in membrane, inflamme Conseq: Membrane inflammation (localized or systemic) |
| Immune Complex hypersensitive reaction is also called... | Type 3 Hypersensitive Rxn |
| Type 4 hypersensitive reaction (defn, step, conseq) | Cell mediated (delayed response): Mediated by T,MO Step: Infection drags on for a long time, MO-Epitheloid cells-Granulomas-Giant cell, memory Conseq 1. granuloma (TB) 2. no granuloma (contact dermatitis) |
| Cell mediated (delayed response) hypersensitive reaction is also called... | Type 4 Hypersensitive Rxn |
| epitheloid cells | 1st step of MO transformation in granulomas |
| giant cells | 2nd step of MO transformation after granuloma established |
| Allergic rhinitis (location, Ag, route, symp, treatment, eg) | Type 1: Hay Fever |
| Atopic dermatitis (location, Ag, route, symp, treatment, eg) | Type 1: Childhood rash |
| Asthma (some forms) Ch3 (location, Ag, route, symp, treatment, eg) | Type 1: Children asthma (inhaled, delayed response) |
| Anaphylactic Shock (location, Ag, route, symp, treatment, eg) | Type 1: Peanut Butter Shock, Bee Venom |
| What are the symptoms of an anaphylactic shock? | 1.laryngeal constriction (choking) 2. shock 3. pulmonary edema |
| What is the treatment for anaphylactic shock? | epinephrine 1. i. artery contract 2. i. heart action |
| How many Type 1 hypersensitive reaction examples? | 4 |
| How many types of Type 2 hypersensitive reaction examples? | 3 |
| Hymolytic anemia (Ag, Ab, Consequence) | Type 2: Ag=RBC , hemolysis |
| Grave's Disease (Ag, Ab, Consequence) | Type 2: Ag=TSH receptor, overproduction of thyroid hormone |
| Hyperthyroidism | overproduction of thyroid hormone |
| Myasthenia gravis (Ag, Ab, Consequence) | Type 2: Ag=Acetylcholine receptor @ muscle (muscle weakness) |
| How many examples are there for type 3 hypersensitivity rxn? | 3 |
| Systemic lupus erythemastosus (location, Ag, Consequence, Preceed by) | Type 3: Circulating Ag-Ab |
| Post-streptococcal glomerulonephritis (location, Ag, Consequence, Preceed by) | Type 3: Streptococcal upper respiratory tract infection --> deposit BM (basal membrane) of glomeruli |
| BM (basal membrane of glomeruli) | Post-streptococcus glomerulonephritis (type3) |
| Streptococcal upper respiratory tract infection | Post-streptococcus glomerulonephritis (type3) |
| Polyarteritis nodosa (location, Ag, Consequence, Preceed by) | Type 3: vessel wall, weaken arteries, chronic Hep B |
| How many examples do Type 4 hypersensitive reaction has? | 2 |
| Tuberculosis (ch3) | Type 4 |
| Contact Dermatitis | Type 4: latex gloves, poison ivy, gold rings |
| Tuberculin | Lab test for TB. Inject TB proteins to see if swell. |
| Induration | This is what you look for in TB test: hardening of normally soft tissue due to inflammation etc |
| Transplantation: What are the possible diseases? | 1. Rejection 2. GVHD (Graft versus host disease) |
| Autograft | eg. skin graft, hair transplant |
| Allograft | HLA typing, blood grps (relatives + immunosuppresant) |
| HLA typing | Human leukocyte typing (before transplant) |
| Xenograft | pig heart valves, cornea |
| Transplant: Rejection: How many types are there? | 3 |
| Types of Transplant rejection: | 1hyperacute 2acute 3chronic |
| hyperacute transplant rejection | (hours) preformed Ab |
| acute transplant rejection | (days/wks) develop Ab, CTL |
| chronic transplant rejection | (mths/yrs) develop Ab, CTL -- vascular obstruction, tissue destruction |
| Graft versus host disease (GVHD) | allogenic bone marrow transplants |
| GVHD | Graft versus host disease |
| Blood Transfusion: considerations -- | ABO , Rh+/- |
| Hemolytic transfusion reaction (giving A blood to B person) symptoms: | 1chills 2shivering 3fever 4shock 5DIC 6death |
| DIC | disseminated intravscular coagulation: small clots in blood vessel |
| hydrops fetalis | extensive edema + jaundice in fetus: by Rh incompatibility |
| What are the types of Rh Ag? | C,D,E. but only D important |
| What are the difference btw Rh and ABO incompatibility? | ABO has preformed Ab. Rh has no preformed Ab, wait for 1st child exposure. |
| How to prevent Rh incompatibility? | Immunoprophylaxis: inject Anti-D-Ig right after 1st child Rh+ birth |
| titre | concentration of Ab |
| systemic autoimmune disease | mechm unclear -- use immunosuppresant "dam-down" |
| organ specific autoimmune disease | mechm unclear -- use immunosuppresant "dam-down" |
| What is the hypothesis for etiology for systemic lupus erythematosus? | Malfunction T suppresor cells --> Polycolnal activation of B + Ab |
| What are the screening for lupus? | 1. ANA test + 2. anti dsDNA Ab + 3. Ab against Extractable Nuclear Antigens + |
| ANA test | antinuclear antibodies, test for autoimmune diseases |
| anti dsDNA antibodies | test for lupus |
| Extractable Nuclear Antigens | test for lupus |
| Lupus is what type of hypersensitivity? | Type 3 (major) and 2 (minor) |
| What is the most serious complication for lupus? | Kidney failure |
| congenital | 先天 |
| What are the two types of immunodeficiency? | 1congenital 2acquired |
| SCIDS | Severe combined immunodeficiency |
| Severe combined immunodeficiency | total lack of B and T "boy in bubble" (cause: bad lymphocyte precursors) |
| Isolated IgA deficiency | increase intestinal infections |
| DiGeorge Syndrome | T cell not developed 1.defective devp 2.no thymus |
| AIDS | acquired immunodeficiency |
| HIV infects what cells? | CD4, MO |
| HIV trasmitted by... | 1. IVDA 2. sexual intercourse 3blood transfusion 4mom-fetal |
| IVDA | IV drug abuse |
| How many types of congenital immunodeficiency did we study? | 3 -- SCIDS, Isolated IgA deficiency, DiGeorge Syndrome |
| How many types of acquired immunodeficiency did we study? | 1. AIDS |
| What is the 4 stages of HIV infection? | 1.acute sick 2. asymptomatic 3. lymphadenopathy 4. opportunistic infections/neoplasia etc |
| lymphadenopathy | swelling of lymph nodes, HIV |
| How to diagnosis HIV? | HIV Ab |
| How to monitor HIV patients? | CD4 counts |
| What are some opportunistic pathogens for HIV patients? | 1pneomocystis carinii 2aspergillus 3MAI |
| What are some tumors for HIV patients? | 1kaposi sarcoma 2lymphoma |
| pneomocystis carinii | HIV opp pathogen (fugus) |
| aspergillus | HIV opp pathogen (fugus) |
| MAI | HIV opp pathogen |
| kaposi sarcoma | HIV tumor |
| lymphoma | HIV tumor |
| How to treat HIV patients? | 1antivirals 2treat opp pathogens |
| Amyloidosis | deposition of abnormal protein (amyloid) in various organs |
| Amyloid | Protein + Sugar from dead tissue, deposit in body =( |
| Describe amyloid protein | It's unusal. beta-pleated sheets |
| What are the typs of amyloid? | AL, AA |
| Neoplasm | is a mass of abnormal cells that grows autonomously: benign or malignant |
| Tumor | swelling (greek's 5 signs of inflam) |
| Cancer | malignant neoplasm |
| Benign neoplasms (charc 4x) | 1well differentiated 2slow growth(few mitosis, no necrosis) 3no invasion (expansile growth, smooth border, encapsulated) 4no metastases |
| Malignant neoplasms (charc 4x) | 1less well differentiated (anaplasia) 2grow quick(ischemic necrosis) 3locally invasive (irreg infiltrating border, no capsule, margin) 4metastasize |
| expansile growth | capable of expansion |
| anaplasia | complete lack of cell differentiation "backward, cell" |
| ischemic necrosis | necrosis due to stop of blood supply, in malignant neoplasm |
| infiltrating border | permeating border (malignant neoplasm) |
| margin | when remove malignant tumor, need to remove surround healthy tissue too |
| -oma | epithelial benign, soft tissue benign |
| -carcinomas | epithelial malignant |
| -sarcomas | soft tissue malignant |
| adenoma | gland tumor, epithlial benign |
| papilloma | finger-like projections, epithelial benign |
| adenocarcinoma | gland formation/mucin production, epithelial malignant |
| squamous cell carcinoma | intercellular bridge/keratin prod., epithelial malignant |
| transitional cell carcinoma | transitional cell epithelium, malignant |
| fibroma | fibroblast, soft tissue b |
| lipoma | fat cells, soft tissue b |
| chondroma | cartilage cells, soft tissue b |
| leiomyoma | smooth muscle, soft tissue b |
| fibrosarcoma | fibroblast, soft tissue m |
| liposarcoma | fat cells, soft tissue m |
| chondrosarcoma | cartillage cells, soft tissue m |
| leiomyosarcoma | smooth muscle cells, soft tissue m |
| melanoma | melanocytes: m |
| lymphoma | lymphocytes: m |
| leukemia | hematopoietic cells: m |
| carcinoid | neuroendocrine cells: m |
| Teratoma | Germ cells: m or b |
| Mixed tumor | epithelial & mesenchymal 2 layer tumor |
| mesenchymal | mesoderm origin tissue |
| melanocyte (func) | product melanin (pigment) |
| squamous cell (func) | 1. intercellular bridge 2. keratin production |
| What are the predisposing factors of neoplasm? 6x | 1geographic 2carcinogens 3age 4herditary factors 5clinical pre-conditional 6benign neoplasm transform |
| Predisposing fac: geographic (eg) | Japan gastric cancer |
| If you're exposed to asbestos, you're likely going to get... | mesothelioma of lung |
| mesothelioma | caused by asbestos |
| neoplasms more common in children: | 1leukemias 2neuroblastroma 3Wilm's tumor 4retinoblastoma |
| leukemia (risk group) | children |
| neuroblastoma (risk group) | children |
| Wilm's tumor (risk group) | children |
| retinoblastoma (risk group) | children |
| Why is there familial adenomatous polyposis (FAP) | lots of polyps in colon: inherit a mutant gene =( |
| Pre-medical condition: liver cirrhosis... | liver cancer |
| Pre-medical condition: atrophic gastritis | stomach cancer |
| Pre-medical condition: chronic ulcerative colitis | colon cancer |
| Pre-medical condition of liver cancer | liver cirrhosis |
| Pre-medical condition of stomach cancer | atrophic gastritis |
| Pre-medical condition of colon cancer | chronic ulcerative colitis |
| cirrhosis | chronic inflam of liver, yellow |
| What kind of benign tumor will led to malignant colon cancer? | villous adenomas of colon |
| Pre-medical condition: villous adenomas of colon | colon cancer |
| What are the different grades of cancer? | 2x. High grade: poorly differentiated ; Low grade: well-differentiated |
| Is there grade and stage for both malignant and benign tumor? | NO. Malignant only. |
| What are the different stages of cancer? | TNM system: (1-4) T size N amt in lymph node M metastasis (1 for <2.5cm etc) |
| What is one eg of staging sytem for cancer? | TNM |
| tumor burden | amount of malignant neoplasm in body |
| Meningioma (...result) | There's no space for it to grow. Compression -- fatal |
| What will tumor do to our body? | 1. compression (fatal) 2. systemic (cachexia, weighloss, anorexia) 3. paraneoplastic syndroms (i. Ca2+, Cushing's synd, Syn of inapp ADH) 4Hormone-secreting tumor |
| cachexia | "bad, condition" -- ill health, poor nutrition (cancer) |
| anorexia | "no, appetite" |
| Paraneoplastic syndromes (defn) | sydrome of symptoms of ppl with cancer but not explained but direct tumor effects |
| Paraneoplastic syndromes (list) | 1. Hypercalcemia 2. Cushing's syndrome 3. Syndrome of inappropriate ADH |
| Hypercalcemia | is the most common paraneoplastic syndrome. 1i. blood Ca2+ 2produce PTH-rp protein |
| PTH-rp protein | produced during hypercalcemia (neoplastic syndromes) |
| Cushing's syndrome | Produce ACTH (neoplastic syndromes) |
| ACTH | Produced during Cushing's syndrome (neoplastic syndromes) |
| Syndrome of inappropriate antidiuretic hormone | Production of ADH (cancer paraneoplastic syndromes) |
| Carcinogen | a cancer-producing substance |
| Chemical carinogenesis (steps) | 1Initiation (damage DNA irrev) 2Promotion (tumor form) 3Progression (tumor change, clonal expansion) |
| Pro-carcinogen | chemical that must be modified in body to become a carcinogen |
| Can all chemical carcinogens initiate & promote? | No. Some just initiate. |
| Alkylating agents | eg of chemical carcinogen: used to treat cancer |
| Aflatoxin | eg of chemical carcinogen: fungus, liver carcinogen |
| Polycyclic hydrocarbons | eg of chemical carcinogen: skin, lung carcinogen |
| Aniline dyes | eg of chemical carcinogen: bladder carcinogen |
| Nitrosamines | eg of chemical carcinogen: gastric cancer |
| amides | eg of chemical carcinogen: gastric cancer |
| Incidence (of a cancer) | # of new case / year |
| TOP RANKING CANCER OCCURANCE (female) | 1breast 2lung 3colorectal 4uterine |
| TOP RANKING CANCER OCCURANCE (male) | 1prostate 2lung 3colorectal |
| Mortality (of a cancer) | # of deaths / year |
| TOP RANKING CANCER DEATHS (female) | 1lung 2breast 3colorectal |
| TOP RANKING CANCER DEATHS (male) | 1lung 2prostate 3colorectal |
| Can our immune system fight cancer? | YES. Can eliminate small ones. Spontaneous remissions. |
| Immunotherapy (cancer) | drugs to enhance our immune destruction of cancer |
| spontaneous remissions (cancer) | sudden disappear of cancer |
| Teratogen | agent that cause fetal abnormality |
| How many chromosomes do we have? | 22 autosomes + 1 sex chromosome |
| aneuploidy | "no, normal # chromome" |
| monosomy - fatal? | (chart) NO for X |
| trisomy - fatal? | (chart) NO for 13, 18, 21, X, Y |
| morbidity | # of case in a population |
| p and q arms of chromosome | p = upper q = lower |
| carrier of genetic disease | (blank) |
| exogenous factors (genetic) | inside body |
| endogenous factors (genetic) | outside body |
| dose effect | close relative have this genetic disease, yours is high too |
| epigenetic factours | environmental factors |
| What are the four ways of prenatal diagnosis? | 1. Ultrasound 2. Chronic villus sampling 3. Amniotic fluid 4. Maternal blood (triple screen) |
| Triple screen | prenatal diagnosis (of mother's blood) |
| chorionic villi | placental villus |
| Premature baby | delivered before 37 wks |
| IUGR | Intrauterin Growth Restriction: birth <3200 g |
| Immature baby | < 37wks <1500 g |
| Placental insufficiency | failure of placenta to supply baby with nutrients |
| Dura matter | Membrane covering brain and spinal cord |
| A normal baby (time, weight) | 40wks, 3500g |
| Reasons of developmental malformities 6x | 1. Unknown 75% 2. Genetic 20% 3. Chromosomal 2% 4. Infection 2% 5. Chemical 1% 6. Physical ?% |
| 20% genetic developmental malformities (types) | 1. auto dominant 2. auto recessive 3. x-link 4multifactorial |
| 2% Chromosomal developmental malformities (types) | 1. Number 2. structural |
| 2% Infection developmental malformities (types) | TORCH |
| Autosomal dominant devlp disease | 1.Achondroplastic dwarfism 2. Marfan's syndrome 3. Familial hypercholesterolemia |
| Achodroplastic dwarfism | short arm & leg |
| Marfan's syndrome | fibrillin gene (tall, thin, weak joints, dissecting aneurysms, retinal detachments) |
| Familial Hypercholesterolemia | LDL receptor gene in liver (early atherosclerosis, heart disease, xanthomas) DD > Dd |
| Autosomal recessive developmental malformities 4x | 1. cystic fibrosis 2. Lysosomal storage disease (Tay-Sachs, Gaucher Disease, lipidoses, mucopolysaccharidoses, glycogenoses) 4 PKU |
| meconium ileus | dark green fecal material in fetal ileus (cystic fibrosis) |
| Chloride sweat test | diag of cystic fibrosis |
| Cystic fibrosis | chlorine transport gene (thick mucous, infections, meconium ileus, mucus plugs) Chloridfe sweat test |
| Lipodoses | lysosome can't digest fat dd |
| Mucopolysacchridoses | lysosome can't digest complex sugar dd |
| Glycogenoses | lysosome can't digest glycogen dd |
| Tay-Sachs | Hexosaminidase gene: lysosome can't digest gangliosides dd (3-5 yrs, brain, eye) |
| Gaucher disease | Glucocerebrosidase gene: lysosome can't digest gluccocerebroside (normal life, large spleen, anemia) |
| PKU | phenylketonuria |
| phenylketonuria PKU | phenylalanine hydroxylase gene: can't PheA -> Try (Ashkanazi Jews, psyconeural, heel prick, don't eat PheA) |
| Hexosaminidase gene | Tay-Sach (gangliosides) |
| Gangliosides | digest by hexosaminidase gene |
| Glucocerebrosidase gene | Gaucher disease (glucocerebroside) |
| glucocerebroside | Glucocerebrosidase gene |
| How many types of x-link recessive developmental disorder? | 3x. 1. hemophilia 2. Duchenne and Becker's Muscular Dystrophy 3. Fragile X syndrome |
| Hemophilia | lack coagulation proteins (clotting factors), 2 types A&B, arthritis, factor replacement, Romanovs (Russian royal family) Xd |
| hemophillia type A | Factor VIII gene 8 : more common 1 in 5000 Xd |
| hemophilia type B | Factor IX gene 9 : rare 1 in 30,000 Xd |
| Romanovs | Russian royal family with hemophilia Xd |
| Duchenne and Becker's Muscular Dystrophy | lack dystrophin protein: weak cells, 2 types |
| dystrophin protein | maintains cell structure by binding cytoskeletons (Duchenne and Becker's Muscular Dystrophy) |
| Duchenne type | severe, common Xd |
| Becker's type | less severe, rare Xd |
| Fragile X syndrome | CGG triplet repeat on X-link (mental retard, enlarged testes) - acculmulation over time |
| CGG triplets repeats | Fragile X syndrome Xd |
| Pre-mutation ** | individual who does not have critical number of repeat to cause expression of disorder (Fragile X syndrome) Xd |
| HOw many multifactorial genetic disease? | 5x 1. hare lip 2. dysraphias (anencephaly, spina bifida, meningocele) 3. diabetes melitus type 2 |
| Hare lip / cleft lip / cleft palate | multifactorial genetic |
| Dysraphias | incomplete fusion of midline structures |
| Anencephaly | no brain |
| Spina bifida | vertebral bones (no skin) |
| Meningocele | under skin vertebra protusion |
| How to prevent dysraphias? | folate |
| Diabetes Mellitus Type 2 | multifactorial genetic. lack of insulin |
| HOw many chromosomal number diseases? | 3 1. turner's syndrome 2. down's syndrome 3. klinefelter's syndrome |
| Turner's syndrome | XO monosomy (look female) |
| Down's syndrome (trisomy) | 21, 21, 21 trisomy (retard, short 5th finger, wide gap 1/2 toes, old mom) |
| Down's syndrome (translocation) | 21to14 (t21/14) |
| t21/14 | translocate from 21 to 14 |
| Klinefelter's syndrome | x,x,x trisomy (look male, breast, infertile) |
| How many chromosome structure disorder? | 3x. 1. WARG 2. Retinoblastomas 3. Down's syndrome 4% |
| WARG | Wilm's tumor, Anairidia, Mental retardation, Genital malformation (delete p11) |
| retinoblastomas | eye tumor (delete q13) |
| anairidia | no iris |
| How many Infections (developmental) | 5 TORCH |
| TORCH: Toxoplasmosis | parasite (brain microcalcification, hydrocephaly, skin lesions) |
| TORCH: Others | syphilis, listeria |
| TORCH: Rubella | German measle virus, microcephaly, heart, microphthalmia (small eyes) |
| TORCH: Cytomegalovirus | brain microcalcification, hydrocephaly |
| TORCH: Herpes simplex virus | developmental |
| Fetal alcohol syndrome | chemical, mental retard |
| thalidomide | sleeping pills (chemical developmental teratogen) |
| Isotretinoin | acne drug (chemical developmental teratogen) |
| Radiation | (physical developmental teratogen) nagasaki, hiroshima |
| Neonatal respiratory distress syndrome | inadequate surfactant (lecithin), atelectasis, hyaline membrane, treat by corticosteriods |
| lecithin | surfactant |
| atelectasis | alveoli collapse "not, end, stretching out" |
| hyaline membrane | glassy appearance membrane |
| Birth injury | hurt when giving birth (large, bone fracture, nerve injury) |
| SIDS | Sudden Infant Death syndrome |
| Crib death | Sudden Infant Death syndrome |
| Cot death | Sudden Infant Death syndrome |
| Sudden Infant Death syndrome | apnea, hypothalamus immature, low social status |
| apnea | "no breathing" |
| Corticosteriods | treatment for neonatal respiratory distress syndrome |
| anasarca | (blank) |
| ascites | (blank) |
| hydrothorax | (blank) |
| hydrocardia | (blank) |
| herniation | (blank) |
| congestive heart failure | Na retention |
| Hemoptysis | (blank) |
| hematemesis | (blank) |
| hematochezia | (blank) |
| melena | (blank) |
| hematuria | (blank) |
| metrorrhagia | (blank) |
| hemothorax | (blank) |
| hemoperitoneum | (blank) |
| hemopericardium | (blank) |
| hemotoma | (blank) |
| petechiae | (blank) |
| purpura | (blank) |
| echymoses | (blank) |
| hypovolemia | (blank) |
| Virchow's triad | thrombosis predispose factors 1. stasis of blood 2. hypercoagulable states 3. endothelial injury |
| Why would there be thrombosis? | virchow's triad |
| fibrinolysis | lyse a thrombus |
| infarct | stop blood, necrosis |
| site of impaction | where embolus got stuck |
| saddle embolus | lung embolus, no blood at all , death |
| pulmonary infarct | small localized, ok |
| carotids artery | (blank) |
| ischemia | stop blood |
| Can heart, liver, brain heal infarcts? | yes heart (fibrosis) yes liver (replacement) NO brain |
| Shock | inadequate blood to tissue, memnoic S, H, O, C, K, S |
| arrhythmia | irregular heart beat |
| oliguria | infrequent urination |
| acidosis | (blank) |
| stages of shock: | 1.compensated/nonprograssive 2. decompensated(prograssive) 3.irreversible |
| descending branch | (blank) |
| circumflex branch | (blank) |
| tricuspid valve | (blank) |
| mitral valve | (blank) |
| pericardial sac | (blank) |
| epicardium | (blank) |
| myocardium | (blank) |
| endocardium | (blank) |
| arotic valve | (blank) |
| pulmonic valve | (blank) |
| cardiac conducting system | (blank) |
| endothelium (vessel) | (blank) |
| media | (blank) |
| adventitia | (blank) |
| Ischemic heart disease | narrowing of vessel, not enough supply to heart muscle (atherosclerosis) |
| angina | chest pain |
| troponin | lab test for ischemic heart disease |
| papillary muscle | muslce of heart valve |
| congestive heart failure | heart is no good pump |
| Hypertension | high blood pressure >90 d > 160 s |
| benign hypertension | hyalinization on vessel walls |
| malignant hypertension | onion skin (necrosis) |
| hypertensive encelphalopahy | microinfarcts, strokes |
| congenital heart disease cause: | rubella, alcohol, chromosome |
| 2 types of congenital heart disease | 1septal defect 2tetralogy of fallot |
| tetralogy of fallot | 1pulmonic stenosis 2LV septal defect 3RV hypertrophy 4overriding aorta |
| plumonic stenosis | narrowing (tetralogy of fallot) |
| endocarditis | (blank) |
| myocarditis | (blank) |
| pericarditis | (blank) |
| acute endocarditis | norm valve |
| subacute endocarditis | abnorm valve |
| result of endocarditis | emboli |
| Rheumatic heart disease | bact (streptococcal) + autoimmune inflammation of heart |
| Rheumatic fever | Rheumatic heart disease |
| vegetations | scar |
| hyalinization | deposit of amyloid (harden arteries, lost elasticity, Ca2+ deposit) |
| Dilated cardiomyopathy | alcohol, virus |
| Hypertrophic cardiomyopathy | young male |
| Restrictive cardiomyopathy | infiltration/ amyloid |
| atrial myxoma | benign |
| it's rare to have metastatic tumor in heart, constantly pumping, if yes, from.. | lungs |
| Iatrogenic | doctor-induced heart disease (radiation x-ray, surgery, transplants of heart) |
| cardiotoxic | (blank) |
| atherosclerosis risk factors | 1. constitutional 2. modifiable major 3. modifiable minor |
| lesion | tissue damage |
| atherosclerosis (mechm) | 1. endothelial injury + hyperlipidemia 2. MO + lipid = foam cells (fatty streaks) 3lipid deposit, ulceration (lipid plaque) 4smooth muscle, fibrous tissue in-growth @ plaque (fibrous plaque) 5. calcification/hemorrhage |
| hyperlipidemia | too much fat in blood |
| foam cells | MO + lipid (atherosclerosis) |
| fatty streaks | atherosclerosis |
| liquid plaque | atherosclerosis |
| fibrous plaque | atherosclerosis |
| vasculitis : 2 types | inflam of vessel wall 1. polyarteritis nodosa 2. temporal arteritis |
| polyarteritis nodosa | type 3. autoimmune. multiple organ |
| temporal arteritis | temporal artery @ head, elderly |
| Raynaud's disease | disorder contract of vessels (always cold @ fingers, toes) Treatment: reheating |
| Deep vein thrombosis | to lung =( |
| varicose vein | dilated, twisted (tortuous) veins (bad valves) @ legs (thrombus, stasis dermatitis) |
| tortuous | twisted |
| stasis dermatitis | no vein circulation, scaly legs (varicose vein) |
| lymphangitis | inflam lymph of leg/hands |
| dual blood supply | lung |
| alveolar ducts | (blank) |
| bronchial arteries | (blank) |
| mucocilliary escalator | (blank) |
| alveolar pneumocyte | (blank) |
| basement membrane | (blank) |
| What are the infections of the upper respiratory tract? 4x | 1. cold/flu 2. strep throat 3. mononucleosis 4. diphtheria |
| common cold/sore throat / flu | rhinovirus, parainfluenza virus |
| strep throat | strep A |
| Mononucleosis | EBV (enlarge nodes, sore throat) |
| diphtheria | membrane formation |
| What are the infections of the middle respiratory tract? 3x | 1. croup 2. acute epiglottitis 3. bronchiolitis |
| Croup | barking cough , parainfluenza virus, <3yrs |
| Acute epiglottitis | H. influenzae B (bacteria), immunization, 3-7yrs |
| Bronchiolitis | respiratory syncitial virus |
| parainfluenza virus | flu, croup |
| H. influenzae B | acute epiglottitis |
| respiratory syncitial virus | bronchiolitis |
| interstitial pneumonia | = atypical pneumonia |
| lobar pneumonia | (blank) |
| bronchopneumonia | (blank) |
| Where do you get typical pneumonia? | 1. community 2. hospital 3. travel/exotic |
| Community acquired pneumonia | strep, staph, hemophilus |
| streptococcus | typical pneumonia |
| hemophilus | typical pneumonia |
| staphlococcus | typical pneumonia |
| Hospital acquired pneumonia | gram (-) |
| gram (-) | Hospital acquired pneumonia |
| hematogenous | route of infection: blood |
| Mycoplasma pneumoniae | atypical pneumonia |
| Legionella pneumophilia | atypical pneumonia (standing water) |
| pleuritis | inflam of pleural cavity |
| pyothorax | pus in pleural cavity |
| empyema | loculated pus in pleural cavity |
| bronchiectasis | chronic dilation of bronchi tubes |
| chronic lung disease | unresponsive to drugs |
| CBC | complete blood count |
| differential test | lab test: # WBC |
| arterial blood gas | lab test: hypoxnia? |
| rigors | shiver |
| dyspnea | difficult breathing |
| mucopurulent discharges | pneunomia |
| primary TB | (blank) |
| secondary TB | reinfection / reactivation |
| Ghon complex | lesion + enlarged hilar nodes + granuloma |
| hilar nodes | lymph node in lungs |
| granuloma | TB + MO + WBC |
| caseous necrosis | TB |
| Acid fast stain | TB (Ziehl-Nielsen) lab test |
| Ziehl-Nielsen | TB acid fast stain lab test |
| DNA Probes | TB lab test |
| multi-drug regimen | TB |
| Pneumonary function test | tell you whether it's obstructive or restrictive |
| Asthma (defn) | (blank) |
| reactive airway disease | asthma |
| 2 types of asthma | (blank) |
| eczema | asthma atopic diseases associated |
| smooth muscle contraction | asthma |
| bronchi contriction | asthma |
| status asthmaticus | bronchodilators no use |
| unremitting asthma attack | persistant asthma attack |
| steriods | asthma |
| Chronic obstructive pulmonary diseases | 1. chronic bronchitis 2. emphysema 3. bronchiectasis |
| Chronic bronchitis | smoking. excessive sputum |
| Emphysema | smoking. dilation of distal air space. 2 types |
| 2 types of emphysema | (blank) |
| centrilobular emphysema | center of a lobule dilated |
| panlobular emphysema | all air space in a lobule dilated |
| alpha-1-anti-trypsin deficiency | panlobular emphysema |
| alpha-1-anti-trypsin | inactivate proteases |
| Bronchiectasis | wall damage, so permanent dilation of bronchus |
| Pink puffer | empysema, overexpand chest "barrel chest", use accessory muscle, hyperventilate "puff" |
| Blue bloater | Chronic bronchitis. obesed. cyanosis (hypoxemia) |
| barrel chest | overinflated lungs, pink puffer |
| lung compliance | lung flexibility |
| restrictive lung disease | lost of lung function, honeycomb lung (end stage) |
| types of restrictive lung diseases | 1. organic (hypersensitive pneumonitis) 2. inorganic (pneumoconioses) 3. non-caeseatig granulomas (sarcoidosis) |
| Hypersensitive pneumonitis | restrictive. inhaled organ dust. type 3/4 |
| farmer's lung | inhaled moldy hay (restrictive) |
| pigeon fancier's lung | inhaled pigeon droppings (restrictive) |
| pneumoconioses | restrictive. inhaled inorganic dusts. |
| Coal-worker's lung | coal & silica (miners) |
| silicosis | inhaled silica particles (sand blaster, miners, stone cutters) |
| asbestosis | inhaled asbesto (shipyard, insulation) -- 1. pleural plaques 2. lung cancer 3. mesothelioma |
| sarcoidosis | non-caeseating granuloma, systemic |
| steriod | treat: sarcoidosis, asthma, SRDS |
| Drowning: 2 types | (blank) |
| wet drowning 90% | hypertonic seawater , pulmonary edema |
| hypertonic sea water drowining | pulmonary edema |
| dry drowning 10% | reflex largyngospasm (close glottis) |
| reflex largyngospasm | close glottis (drowning) -- can save |
| ARDS | adult repiratory distress syndrom |
| adult repiratory distress syndrom | high death rate. sudden respiratory failure, even O2 no use. shock... |
| atelectasis | collapse of alveoli (1surfactant, 2compress, 3obstruction by tumor-resorp air stuck) |
| atelectasis (cause) | 1surfactant, 2compress, 3obstruction by tumor-resorp air stuck |
| dyspnea | shortness of breathe |
| laryngeal carcinoma | squamous cell carcinoma, smoking/alcohol, hoarness loss of voice |
| lung cancer (risk factors) | smoke, asbestos, radiation, arsenic/chrmoium metals, genetic |
| arsenic, chrmoium | lung cancer |
| What is a common site for metastatic tumor? | lung |
| adenocarcinoma | lung cancer @ peripheral solitary nodule (most common) |
| squamous cell carcinoma | lung cancer @ more centrally located, difficult to remove |
| small cell carcinoma | lung cancer . over secretion of ADH (hormone) |
| pneumothorax | air in pleural cavity - lung collapse |
| pleural effusion | fluid in pleural cavity |
| secondary pleuritis | from primary pneumonia |
| pleural tumor | mesothelioma (asbesto) |
Created by:
subaru