Ayad's Gen Path MT2
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| What cells normally divide throughout life to replace the continually lost cells? | Labile cells
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| Surface epithelial cells, crypt cells of gut mucosa, hematopoietic stem cells? | Labile cells
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| Following injury, surviving cells proliferate rapidly to replace lost ones? | Labile cells
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| Long-life span, very slow rate of division? | Stable cells
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| They remain in intermitotic phase for long periods, retain capacity to enter the mitotic cycle when needed (replacement of damaged cells)? | Stable cells
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| What are the two types of stable cells? | Parenchymal cells of solid organs, Mesenchymal cells
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| No capacity for mitotic division in post-natal life? | Permanent cells
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| Neurons, Myocardial cells, skeletal muscle cells are what type of cells? | Permanent cells
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| Injury to tissue w/ permanent cells is always followed by a scar formation (no regeneration is possible, irreversible)? | Permanent cells
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| What type of necrosis happens following myocardial infarction? | Coagulative necrosis
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| Fibroblasts are stimulated by? | Chemical mediators
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| Fibroblasts are stimulated to do what? | Proliferate, and secrete: collagen, elastic/reticular fibers, extracellular matrix, actin/myosin filaments (myofibroblasts)
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| What is fibronectin? | Glycoprotein
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| What does fibronectin do? | Promotes angiogenesis, and is chemotactic to fibroblasts and promotes organization
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| What is a glycoprotein derived from plasma? | Fibronectin
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| Initial scar formation is laid down by what type of cells? | Myofibroblasts
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| Essential for angiogenesis and chemo tactic (direction)? | Capillaries, fibroblasts
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| Early contraction is due to? | Myofibroblast
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| Late contraction is due to? | Collagen
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| What are the 3 types of skin wounds? | Abrasion, Incision/laceration (1st intention), wounds w/ epidermal defect (2nd intention)
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| How long does a scar take to increase tensile strength of a scar to 40%? | 4 weeks
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| How long does a scar take to increase tensile strength of a scar to 80%? | 4 months
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| Secondary wounds are characterized by? | Extensive necrosis, large wounds, secondary infection, inflammation, foreign body
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| Causes of defective wound healing? | Fail of synthesis of collagen fibers, excessive collagen production, local factors, diabetes mellitus, and excessive levels of corticosteroids
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| What causes failure of synthesis of collagen fibers? | Deficiency of vitamin C, Ehlers-Danlos syndrome
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| What is Ehlers-Danlos syndrome? | Deficiency of enzymes involved in collagen synthesis (rubber man)
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| List 2 local factors of defective wound healing? | Foreign body, necrotic tissue, infection, abscess formation, abnormal blood supply
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| What is the problem with high levels of corticosteroids? | Interfere w/ phagocytosis, decrease arachidonic acid metabolites, decrease collage formation
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| Growth factors involved in wound healing? | Platelet-derived Growth factor, Epithelial growth factor, IL-1 and TNF, Thrombin
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| PDGF does what? | Proliferation of fibroblasts, enhances wound healing
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| EGF does what? | Proliferation of epithelial cells and fibroblasts
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| IL-1 and TNF do what? | Chemotactic for fibroblasts, increased collagen synthesis (fibrogenic cytokines)
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| Thrombin does what? | Fibroblast mitosis
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| Edema in the pleural cavity is known as what? | Hydrothorax
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| Edema in the peritoneal cavity is known as what? | Ascites
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| Edema in the pericardial cavity is known as what? | Hydropericardium
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| What force takes fluid out? | Hydrostatic pressure
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| What force brings it back? | Osmotic pressure
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| Increase of blood due to active arterial dilation is known as? | Hyperemia
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| What are two types of Hyperemia? | Physiologic (muscles during exercise), Pathologic (inflammation)
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| Passive increase of blood due to impaired venous drainage? | Congestion
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| Localized congestion is due to? | Venous obstruction
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| Generalized congestion is seen in? | Right heart failure
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| Alveolar macrophages engulf hemosiderin in lung congestion? | Heart failure cells
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| Heart failure cells are seen in which organ? | Lungs
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| Liver congestion is a result of? | Right side heart failure
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| Nutmeg liver is seen in what problem? | Liver congestion, fatty change
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| Splenic congestion is due to what? | Liver cirrhosis, portal hypertension
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| Secretion of ADP leads to platelet aggregation is known as what reaction? | Platelet release reaction
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| ADP is what? | Platelet aggregator
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| 2 steps in platelet plug? | Adhesion, aggregation
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| 3 important factors in hemostasis? | Endothelial cell, blood platelet, coagulation factors
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| What causes platelet adhesion? | Von Willebrand’s factor
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| What causes platelet aggregation? | ADP, Thromboxane
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| Injured endothelial cells initiate thrombosis by? | Von willebrand’s factor, Tissue factor (thromboplastin)
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| Virchow’s Triad? | Endothelial injury (most important), Alteration of normal blood flow, hyper-coagulability of blood
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| What is the most important factor of Virchow’s triad? | Endotherlial injury
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| Arterial thrombi, grey Red mass w/ apparent laminations? | Lines of Zahn
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| Types of arterial thrombi? | Non-occlusive (mural), Occlusive (most common), Vegetative (occur on cardiac valves)
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| What is the most common type of arterial thrombi? | Occlusive
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| What are the lines of Zahn? | Red layer of RBC’s
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| Lines of Zahn are seen where? | Arterial thrombi
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| Venous thrombi commonly occur where? | Lower limbs
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| Venous thrombi can result in what type of emboli? | Pulmonary
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| Almost always occlusive? | Venous thrombi
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| Fragmented or detached thrombi? | Thromboembolism
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| Pulmonary embolism is due to? | Venous embolism
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| Systemic embolism is due to? | Arteriol embolism
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| What causes pulmonary embolism? | Thrombi of systemic veins (usually deep veins of leg)
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| Systemic embolisms are derived from what type of thrombi? | Mural thrombi
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| What is the most common embolism? | Thromboembolism
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| What is the 2nd most common embolism? | Fat embolism
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| Fat embolisms are due to? | Fracture, burn, or surgery
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| Gas embolism is seen in? | Caisson disease, Decompression sickness
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| What gas is involved in gas embolism? | Nitrogen
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| What type of necrosis is infarction? | Coagulative necrosis
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| What are types of infarcts? | Pale, white anemic and Red, hemorrhagic
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| Pale, white anemic infarct is due to what type of obstruction? | Arterial obstruction
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| Red, hemorrhagic infarct is due to what type of obstruction? | Venous obstruction
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| Hemorrhagic infarcts occur in which organs? | Lung, liver, small intestine, ovary, testis
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| White, anemic infarcts occur in which organs? | Spleen, heart, kidney, brain
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| Types of shock? | Cardiogenic, hypovolemic, peripheral sequestration of blood volume
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| Decreased cardiac output due to heart failure? | Cardiogenic shock
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| Decreased cardiac output due to decrease blood volume? | Hypovolemic shock
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| 3 types of shock due to peripheral sequestration of blood volume? | Septic shock, anaphylactic shock, neurogenic shock
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| What type of shock involves endotoxin of gram negative bacteria? | Septic shock
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| What type of shock involves chemical mediators of allergy? | Anaphylactic shock
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| What type of shock involves anesthesia, spinal cord injury? | Neurogenic shock
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| What are 5 causes of shock? | Cardiogenic, neurogenic, hypovolemic, anaphylactic, septic
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| Stages of shock? | Compensation, impaired tissue perfusion (decompensation), irreversible stage
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| Stage of compensation is associated with? | Mild hypotension
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| Stage of impaired tissue perfusion (decompenstion) is associated with? | Lactic acidosis
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| Irreversible stage is associated with? | Failure of peripheral vasoconstriction
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| Polypoid tumors are usually what? | Benign
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| Ulcerated tumors are usually what? | Aggressive
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| Carcinomas are from what? | Epithelial cells
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| Sarcomas are from what? | Mesenchymal tissue
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| Carcinomas are named by what? | Type of epithelium
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| Sarcomas are named by what? | Cell component of tumor
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| Mixed tumors are composed of what? | Epithelial and Mesenchymal tissue
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| Tumor from hepatocytes? | Hepatoma
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| Are hepatomas benign or malignant? | Malignant
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| Tumors from melanocytes? | Melanoma
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| Are melanoma tumors benign or malignant? | Highly malignant
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| A mass of mature disorganized tissue? | Hamartoma
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| What 2 tumors are non-encapsulated but benign? | Leiomyoma of uterus and Hemangioma
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| Why do malignant cells invade? | Physical pressure, secretion of enzymes, low adhesiveness of cells, loss of contact inhibition, vulnerability of adjacent tissue
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| How are carcinomas graded? | Numerically
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| How are sarcomas graded? | Descriptively
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| 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
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| Extent of regional spread of lymph nodes is graded how? | N0- not involved, N1- involved, mobile, N2- involved, fixed
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| Presence or absence of distal metastasis is graded how? | M0-absent, M1- present (one organ), M2- present (more than one organ)
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| 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
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| Second leading cause of death in the USA? | Lung cancer
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| Deadliest cancer for males? | Prostate
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| Deadliest cancer for females? | Breast
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| 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
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| 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
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| Biopsies were performed on patients who had palpable mass lesion on distal rectal exam of the following microscopic findings, which is most likely? | Invasion
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| Type 1 hypersensitivity is known as what? | Immediate (Anaphylactic) reaction
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| IgE is seen in what type of hypersensitivity? | Immediate (Anaphylactic) reaction
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| Bronchial asthma is seen in what type of hypersensitivity? | Immediate (Anaphylactic) reaction
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| IgG and IgM are seen in what type of hypersensitivity? | Type2: Cytotoxic reaction and Type3: Immune complex reaction
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| What type of necrosis occurs in blood vessels? | Fibrinoid necrosis
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| What type of hypersensitivity is mediated by T cells? | Type 4: Cell mediated hypersensitivity
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| What T cell is involved in DTH? | CD4
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| What T cell is involved in T cell mediated cytotoxicity? | CD8
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| Genetic factors of systemic lupus erythematosus? | HLA-DR2 and DR3
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| SLE is hypersensitivity type what? | Type 1
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| ANA react with what? | Nuclei of damaged cells
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| Most common cause of SLE death? | Kidney failure
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| SLE in the skin is seen as what? | Maculopapular rash
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| What are LE cells? | Nuclei of damaged cells
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| Heliotrope rash is characteristic of what autoimmune disease? | Polymyositis/Dermatomyositis
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| Extracellular accumulation of fibrillar proteins? | Amyloidosis
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| Type AL proteins accumulate in the tissue and pass in urine in what disease? | Primary amyloidosis
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| AL proteins passed in the urine are known as what? | Bence Jones protein
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| Type AA protein accumulation is seen in what disease? | Secondary (reactive) amyloidosis
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| Accumulation of B2-microglobulin in joints and synovium? | Hemodialysis-related amyloidosis
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| What type of protein is associated with hemodialysis and renal failure? | B2-microglobulin
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| Familial Mediterranean Fever is seen in what disease? | Hereditary amyloidosis
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| X-linked recessive disorder, absence of B lymphocytes? | Congenital agammaglobulinemia (Bruton’s)
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| Normal total lymphocyte count, serum immunoglobulins are markedly decreased, deficient humoral immunity are common in what immune deficiency? | Congenital agammaglobulinemia (Bruton’s)
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