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Pathology Test 2

Neoplasms to Cancer

QuestionAnswer
what is abrasion? scrape of the skin that occurs when friction denudes part of the epidermis, minimal hemorrhage occurs and blood clots on the skin surface as a thin red brown scab
what is healing of abrasion? healing occurs quickly without scarring by regeneration of the epidermis from persisting basal cells
what is a contusion? bruise caused by rupture of small blood vessels by blunt force
what is a laceration? tear caused by crushing or stretching force sufficient to tear apart tissue
what is an incised wound? cut produced by an object with a sharp edge margins are smooth with minimal damage or marginal tissue
what are the major complications of thermal burns? shock, burn wound infection and smoke inhalation pneumonia
what is shock from thermal burns? caused mainly by the loss of fluid as inflammatory edema into the burn wound
what is burn wound infection from thermal burns? occurs by growth of bacteria and or fungi in and under the eschar of a third degree burn
what is smoke inhalation pneumonia caused by thermal burns? caused by a chemical injury of the lungs by toxic components of inhaled smoke often produces fatal pulmonary edema
what is anoxia or hypoxia? deficiency of oxygen in the tissue
where are first degree burns mostly seen? upper part of epidermis, acute inflammation
what are second degree burns? most of the epidermis
what is the depth of thermal necrosis in third degree burns? entire epidermis (full thickness burn) most the skin appendages and the upper dermis
what are the clinical features of third degree burns? skin surface is converted into a born, dry, leathery dead material known as an eschar
what is anoxic anoxia? characterized by deficient oxygenation of the arterial blood
what are the causes of anoxic anoxia? disease of the respiratory tract such as emphysema, pneumonia and pulmonary edema depression of the respiratory center of the brain caused by drugs, anesthesia lack of oxygen in the environment as with flying or drowning
what is anemic anoxia? caused by a decreased oxygen carrying capacity of the blood as in severe anemia or carbon monoxide poisoning
what is stagnant anoxia? caused by slowing of the rate of blood flow and occurs with cardiac arrest
what are the major effects of anoxia? brain singularly susceptible, neurons of the brain are irreversibly injured within 10 minutes of the onset of severe anoxia
what are the direct effects on many organs and tissues of ethanol? liver injury ranging from potentially reversible fatty degeneration to irreversible cirrhosis, gastritis, pancreatitis, anemia, decreased resistance to bacterial infections and heart damage
what are the tobacco related diseases? chronic periodontitis, stomatitis, carcinoma of mouth, larynx, lung, urinary bladder, esophagus, chronic bronchitis and obstructive emphysema
what is humoral immunity? mediated by B lymphocytes and plasma cells B lymphocytes respond to free molecular antigens and produce reactant protein molecules known as antibodies or immunoglobulins
what is cellular immunity? mediated by T lymphocytes that respond to antigens (peptides) fixed on the surface of cells rather than to free molecular antigens
what are macrophages? assist the lymphoid cells at several steps in both humoral and cellular immunity
what are the characteristics of allergic diseases mediated by humoral immunity? occur promptly after a sensitized person encounters the antigen
what are some examples of humoral immunity? hay fever, bronchial asthma, urticaria
what are the characteristics of hypersensitivity mediated by cellular immunity? develop gradually over several days as T lymphocytes kill cells exhibiting the offending allergen
what is an example of hypersensitivity mediated by cellular immunity? contact hypersensitivity dermatitis like poison ivy
what is systemic lupus? person form autoantibodies against components of their own cell nucli and these antinuclear antibodies combine with nuclear antigens to form complexes that are deposited in many organs or tissues causing cellular injury or inflammation
what population is systemic lupus found most in? more frequent in women than men
what are the major sites of injury for systemic lupus? kidneys with reneal glomerular injury causes protein loss in the urine and eventual glomerular scarring with renal failure most frequent cause of death
what are the treatment methods of systemic lupus? immunosuppressive therapy causes clinical improvement, most treated patients survive more than 10 years
where is staphylococcus aureus found? skin surface, nose
where is streptococcus pyogenes found? nose, pharynx
where is streptococcus viridans found? nose, pharynx
where is streptococcus mutans found? mouth
where is diplococcus (streptococcus) pneumonia found? pharynx
where is hemophilus influenza found? pharynx
where is Escherichia coli found? colon
where is bacteroides fragilis found? colon, vagina
what is the cause of lobar pneumonia? diplococcus (streptococcus) pneumoniae
what are the predisposing factors for lobar pneumonia? influenza, viral upper respiratory infections, and alcoholism
what do the bacteria do when they are aspirated into the lung in the case of lobar pneumonia? proliferate and produce an abundant protein rich inflammatory exudate and spread quickly through an an entire pulmonary lobe by a firbrin rich intraalveolar exudate
what is an acute fibrinous inflammation? lobar pneumonia when bacteria produce fibrin rich intraalveolar exudate
what is the most common complication in an untreated lobar pneumonia patient? collection of pus in the ipsilateral pleural cavity (pleural empyema)
what is the cause of bronchopneumonia? most cases are mixed infections involving streptococci, staphylococci, pneumococci of less virlent types
what are the predisposing factors for bronchopneumonia? loss of the gag reflex, dysphagia, emesis, tracheostomy, endotracheal intubation, use of mechanical ventilators, pulmonary edema, bronchitis, impaired cough
what is the most common complication of bronchopneumonia? progression to one or more lung abscesses
what are the clinical features of bronchopneumonia? moist rales, low fever, cough productive o mucopurulent sputum, lung bases without signs of consolidation
what is the pathogenesis of acute appendicitis? appendix is obstructed by a fecalith in lumen, istention of the appendiceal lumen by mucosal secretions, slowing of circulation with ischemia causes mucosal injury, bacterial invasion
what does an acutely inflamed appendix look like? sections reveal a dilated lumen containing pus (and often a fecalith) and an ulcerated mucosa
what is the major complication of acute appendicitis? perforation of the appendix resulting in acute peritonitis either localized next to the appendix or less often generlized
what is often the most common cause of common cold? rhinovirus
what are the clinical features of acute appendicitis? pain in lower right quadrant with deep tenderness and mild fever and leukocytosis, anorexia, nausea,
how are venereal diseases spread? direct person contact, usually coitus (heterosexual or homosexual) occasionally kissing or other contact
what is the source of infection for venereal diseases? exudate from obvious or concealed (often asymptomatic lesions of the skin and or mucus membrane of infected person transmission via fomites is mythical
what are fungal diseases usually? opportunistic infections with one or more predisposing factors which impair resistance to infection or enhance growth
what is the major lesion in males for a gonococcal infection? acute purulent urethritis, gonorrhea
what is the major lesion in females for a gonococal infection? endocervicitis (often asymptomatic) ascending infection of the genital tract may produce salpingitis with resultant sterility or tubal pregnancy
what is the major lesion in males for a trichomoniasis infection? asymptomatic urethritis
what is the major lesion in females for a trichomoniasis infection? vaginitis with pruritus and a frothy yellow discharge
what is the major lesion in females for a gardnerella infection? vaginitis with pruritus and a milky discharge
what are the predisposing factors fungal infection? AIDS, diabetes mellitus, certain cancers, immunosuppressive therapy and antibiotic therapy especially treatment with multiple or wide spectrum antibiotics which suppress the competing bacterial flora
what is an example of superficial infections of mucosal surfaces? candidosis including thrush of the mouth and vaginitis
what is AIDS? chronic viral infection characterized by selective infection and destruction of a subset of T lymphocytes with resultant severe depression of both cellular and humoral immunity
what is the cause of AIDS? human immune deficiency virus (HIV) an RNA retrovirus
how is AIDS transmitted requires intimate mucosal contact during coitus (homosexual or heterosexual) or parenteral introduction of the virus during drug abuse
what is the most common opportunistic infection for AIDS patients? pneumonia caused by pneumocystic jiroveci and disseminated infections caused by a variety of bacteria, fungi, viruses and protozoa
what are the major clinical features of AIDS? generalized lymphadenopathy,AIDS encephalopathy, opportunistic infections, malignant neoplasms
what is the most common cause of carcinoma of the larynx? smoking cigarettes
where does carcinoma of the larynx usually arise from? usually arises from the anterior part of one vocal cord as a firm gray nodule
what type of microorganism is carcinoma of the larynx? sluggishly growing squamous carcinoma
when does bronchial asthma usually begin? in childhood
what is bronchial asthma mediated by? humor immunity
what are the causative agents of bronchial asthma? inhaled substances such as pollens, animal dander, mold spores, mouse and roach products and house dust
Why do the lumens of bronchi become narrowed in bronchial asthma? lumens of the medium sized bronchi become narrowed by constriction of bronchial smooth muscle, by bronchial mucosal edema and by an intraluminal accumulation of viscid mucin
what is an attack of bronchial asthma characterized by? Severe dyspnea, a sense of suffocation and clearly audible high pitched wheezing, more marked during expiration
what is COPD caused by? obstructive emphysema is caused by chronic bronchitis and the usual cause of chronic bronchitis is chronic or repetitive inhalation of irritant
what is the most important irritant in chronic bronchitis? cigarette smoke
what do the lungs look like in COPD? large, overdistended and fluffy, resembling cotton candy and the delicate alveolar septa that normally separate alveoli are reduced to threadlike remnants. bronchi have thick walls and lumens usually contain viscid mucin pus
what is expiratory bronchiolar collapse? bronchioles lack cartilage and this loss of tractinal support allows expiratory bronchiolar collapse which impedes expiration and renders cough ineffective and predisposes to secondary bacterial infection of bronchi and lungs
what are the clinical features of COPD? persistent cough, productive of mucinous sputum, dyspnea on exertion and recurrent attacks of acute bacterial infection of the bronchi and lungs
where does carcinoma of the lung usually arise from? epithelium lining a large or medium sized bronchus and is often termed bronchial carcinoma
what is the most common cause of bronchial carcinoma? tobacco smoking, especially cigarette smoking with deep inhalation and the great majority of lung cancer patients have been heavy smokers for over 20 years
what are the other causes of bronchial carcinoma? variety of histological types (squamous carcinoma, adenocarcinoma, undifferentiated carcinoma) and some tumors contain a mixture of histologic types
what are the metastases in bronchial carcinoma? develop early and are usually widespread
what is the main cause of carcinoma of the lip? chronic solar irradiation, sunlight damages the vermilion border of the lip and in most cases of lip cancer the entire lower lip shows evidence of chronic solar damage and is dry, scaly, white and opaque (leukoplakia) with microscopic changes of dysplasia
what is the primary lesion of carcinoma of the lip? occurs on the lower lip as firm nodule that slowly enlarges. microscopic study reveals a squamous carcinoma. metastases occur late in the cervical lymph nodes in only a few patients
where does intraoral carcinoma arise from? lateral borders of the tongue arise in the floor of the mouth or from the bucal mucosa
what are the predisposing factors of intraoral carcinoma? chewing tobacco, dipping snuff, smoking tobacco (especially cigars and pipes) and oral infection by human papillomavirus
what is the primary lesion of intraoral carcinoma? firm gray white mass and ulceration
what does microscopic study reveal on intraoral carcinoma? squamous carcinoma metastases occur first in the cervical lymph nodes
what is the primary lesion of esophageal carcinoma? arises most often from the middle third or the distal end of the esophagus and forms a firm gray white mass with esophageal obstruction and variable ulceration
what does microscopic study reveal about carcinoma of the esophagus? squamous carcinoma or adenocarcinoma
what is the clinical feature of esophageal carcinoma? progressive dysphagia, resultant weight loss and final cachexia
where does chronic peptic ulcer occur more often in? duodenum than the stomach
what does typical chronic peptic ulcer look like? solitary ulcer in either the dotal (pyloric) part of the stomach or the first part of the duodenum
what are the major clinical features of a chronic peptic ulcer? gnawing or burning epigastric pain appearing several house after eating and relieved by ingestion of food or antacids
what has happen to the number or carcinoma of the stomach cases? in the US its incidence has markedly decreased since 1940 probably reflecting an increased dietary intake of fresh fruits and vegetables
what increases the incidence of gastric carcinoma? consumption of smoke, cured, and salted meats and fish
what decreases the incidence of gastric carcinoma? fresh fruits and vegetables
what does microscopic study reveal about gastric carcinoma? adenocarcinoma
where does metastases occur from gastric carcinoma? occur early in the regional lymph nodes, liver, and peritoneum
what is the survival rate for gastric carcinoma? overall 5 year survival rate of about 15%
what are the inflammatory bowel diseases and how are they caused? crohn's disease and chronic ulcerative colitis uncertain cause
what is crohn's disease characterized by? segmental lesions with sharply delimited "skip areas" of normal intestine lesions are most frequent and most severe int he distal ileum but may also involve the colon
what is chronic transmural inflammation of the intestine? Crohn's disease, produces firm thick walled segments of bowel "garden hose bowel"
what is chronic ulcerative colitis characterized by? diffuse acute and chronic mucosal inflammation of the large intestine most severe in the rectum and gradually decreasing in incidence and severity proximally skip areas do not occur and small intestine not involved
what are the major clinic features of chronic ulcerative colitis? dysentery with blood and pus int he stool, abdominal cramps, tenesmus, fever, weakness, weight loss and anemia
what is the most common visceral cancer? carcinoma of the large bowel is the most common visceral cancer and is second only to carcinoma of the lung as a cause of death from cancer
what is the cause of carcinoma of the large bowel? uncertain but is closely related to the refined, low residue, high fat diet which accompanies economic development
what do most carcinoma sod the large bowel probably arise from? malignant change of a preexistent adenoma
what are the precursors of carcinoma of the large bowel? polyps
where can carcinoma of the large bowel arise from? any part of the large bowel and the sites of predilection are the rectum, sigmoid colon and cecum
what is jaundice? liver normally excretes bilirubin but if the liver cells are damaged, bilirubin accumulates int he blood and stains the tissues yellow
what are abnormalities of protein metabolism in hepatic failure? liver normally synthesizes plasma albumin and multiple clotting factors and hepatic failure often causes hypoalbuminemia
what is hepatic coma? liver incorporates ammonia into urea which is excreted in the urine and hepatic failure often causes hyperammonemia with resultant hepatic coma
what is hyperestrinism? liver normally catabolizes estrogen and men with hepatic failure may develop signs of hyperestrinism such as testicular atrophy, gynecomastia, spider telangiectases of the skin and pectoral alopecia
what do regenerative cells in cirrhosis cause? produces bulging nodules of regenerating liver cells surrounded by septa of fibrous tissue
what is portal venous hypertension? increased venous pressure in the portal vein and its tributaries
what are the major effects of portal venous hypertension in cirrhosis? chronic passive congestion of the spleen which is enlarged and firm ascites caused by transudation of fluid from congested capillaries into the peritoneal cavity collateral circulation between port vein tributaries and systemic veins
what is the most important collateral channels? large, dilated, thin walled veins which bulge into the lower esophagus and may rupture to cause massive hemorrhage into the alimentary tract with hematemesis
what are the clinic features of cirrhosis? begin insidious, manifestations of the causative condition e.g. alcoholism or chronic viral hepatitis, manifestations of chronic hepatic failure such as jaundice and hepatic coma and manifestations of portal venous hypertension (ascites, hematemesis)
what happens in acute viral hepatitis? only a few scattered liver cells undergo necrosis, most cases resolve spontaneously and regeneration of liver cells reestablishes normal hepatic structure and function often with lifelong immunity to reinfection by the same virus (NOT C)
what hepatitis can you not have lifelong immunity to reinfection by the same virus? NOT C only A &B
what hepatitis can you not get chronic viral hepatitis? NOT A B and C
what is cholelithiasis? presence of gallstones in the gallbladder usually multiple and consists of cholesterol and bile pigments
what is hepatitis A spread by? intestinal oral route lifelong immunity follows recovery
is there a carrier state with hepatitis A? NO
what is the epidemiology of hepatitis B? IV drug abuse acquired immunity usually follows recovery
is there a carrier state with hepatitis B? 10% of all infections
what are the effects of gallstones? irritation of the gallbladder by gallstones obstruction of the biliary tract causes distention of part of the tract proximal to the obstruction acute cholecystitis, obstruction of the common bile duct, obstructive jaundice
what is pancreatitis caused by? escape of large amounts of digestive enzymes of the pancreas from the pancreatic ducts with resultant enzymatic auto digestion of the pancrease
what are the major predisposing fractures for acute pancreatitis? chronic alcoholic, gallstones and obesity
what is chronic pancreas? result of multiple attacks of acute pancreatitis from each of which the patient recovers with additional scarring of the pancreas always caused by chronic alcoholism
has carcinoma of the pancreas increased or decreased? increasing
what does microscopic study reveal about carcinoma of the pancreas? adenocarcinoma
what are the signs of carcinoma of the head of the pancreas? early obstruction of the common bile duct with obstructive hand ice and epigastric or right subchondral pain
what are the signs of carcinoma of the body of the pancreas? dull boring epigastric or left subchondral pain, worse at night profound depression, weight loss and ascities (caused by peritoneal implantation metastases)
what characterizes cystic fibrosis of the pancreas? dysfunction of exocrine gland
how do you get cystic fibrosis of the pancreas? autosomal recessive trait, homozygotes have severe disease and usually die early in life, both sexes are effected
what is the basic metabolic abnormality of cystic fibrosis of the pancreas? defect of chloride and water transport by the epithelium of small exocrine gland ducts and the secretory product of these glands is abnormally scant and viscid
Created by: Chobchi