1
Q
dystrophic calcification
A
deposit of calcium in damaged tissue (atherosclerosis)
ie normal calcium levels
2
Q
metastatic calcification
A
deposit of calcium in normal tissue
3
Q
necrosis
A
localized death of cells, tissues, or organ
- uncontrolled
- cell membraine breaks down and contents are released
4
Q
coaglative necrosis
A
morphalogic appearance of boiled meet
-most common, due to inactivity of hydrolytic enzymes
5
Q
liquefactive necrosis
A
dissolution of tissue
- soft and filled with fluid
- eg brain infarct
6
Q
caseous necrosis
A
cheese like necrotic tissue
- limited liquifaction
- seen in TB
7
Q
fat necrosis
A
fat deposits that are calcified by enzymes
-white chalky areas
8
Q
apoptosis
A
cells shrink into small components and are absorbed by other clls
no contents are released
no inflammatory reaction
9
Q
function of inflammation
A
- contain and isolate injury
- destroy microorganisms/toxins
- prepare tissue for healing and repair
- coordinated by vascularized living tissue (ie does not happen after death)
10
Q
clinical signs of acute inflammation
A
- redness
- pain
- edema
- loss of function
- heat
11
Q
histamine
A
inc. vessel permiability
- released by mast cells
12
Q
basophils
A
mast cells in tissue
13
Q
bradykinin
A
increases vessal permeability
causes pain
14
Q
compliment
A
plasma proteins that kill bacteria
-activated by classical, alternative, or lectin pathways
15
Q
arachidonic acid derivatives
A
- from phospholipids in cell walls
- metaboized to form inflammatory substances
16
Q
what do NSAIDS block?
A
AA derivative formation
17
Q
presence of fluid in tissue
A
edema
18
Q
transudate
A
protein poor fluid containing few cells
19
Q
exudate
A
protein rich fluid
different types
20
Q
serous inflammation
A
fewer cells, clear exudate
21
Q
fibrinous inflammation
A
sticky, exudate rich in fibrin
22
Q
purulent inflammation
A
pus
rich in neutraphils (due to bacterial infection)
23
Q
ulcerative inflammation
A
loss of epithelial lining
inflammaiton extens to surrounding tissue
24
Q
pseudomembranous inflammation
A
ulceration and fibrinopurulent exidate
-forms pseudomembrane over the ulcer
25
herniation
abscess in brain inc. volume in cranium-->brain moves down into foremen magnum
-medulla is compressed
26
outcomes of inflammation
1. complete resolution
2. abscess formation-lined in fibrous capsule
3. healing by fibrosis and scar formation-normal tissue replaced
4. progression to chronic inflammation
27
chronic inflammation
exudate rich in mononuclear cells (lymphocytes, plasma cells, macrophages present)
28
examples of regeneration abilities
epithelial cells-high
liver cells-can divide but slower
neurons-can't
29
wound healing by first intention
occurs after surgical incision
- scab formation, nutraphils enter and scavenge debris
- formation of granulation tissue
- resorbtion of granulation tissue and replacement by fibrous scar
30
wound healing by second intention
- gaping wound not closed surgically
- granulation tissue forms and is replaced w/fibrous tissue
- wound contracts with time
31
keloid
scar that expands beyond site of wound
32
teratogen
agent that causes fetal abnormality
33
developmental malformation
results in abnormal features
- 75% of the time the cause is unknown
- can be genetic
34
achondroplastic dwarfism mode of inheritance
autosomal dominant
35
examples of teratogens
```
x rays
alcohol
thalidomide
isotretinoin
infectious things: TORCH
toxoplasmosis (parasites), other (bacterias) (STD, unpasturized milk), Rubella,
cytomegaalovirus
herpes simplex
```
36
fetal alcohol syndrome
- intra-uterine growth retardation
- reduced mental processes
- altered physical appearance
37
monosomy
loss of chromosome
-autosomal monosomies are fatal
-Y is fatal
X is not- turner's syndrome
38
trisomy
presence of extra copy of a chromosome
not necessarily fatal
-sex are usually not lethal
39
downs syndrom
1 in 800 neonates affected
- complete copy in most cases (more severe phenotype)
- translocation sometimes
- usually the mother's chromosome, risk is inc. with inc. age
- screen older mothers
- significant morbidity and increased mortality
- intestinal atresia, heart defects, etc.
40
turner's syndrome
monosomy X
1 in 3000 neonates
abnormal segregation of X or Y during meiosis
-female but infertile
-ovaries present but unable to produce eggs
41
klinefelter's syndrome
```
trisomy X
1 in 700 neonates
-abnormal X or Y segregation
-male phenotype (XXY)
-infertile-atrophic testis
```
42
XXX
still compatible with life
| -slowed mental processes
43
q 13 deletion
q means long arm
| known to cause retinoplastonas
44
alleles
genes present on autosomes
- 1 copy form each parent
- one copy of Y genes for males
45
marfans pattern of inheritence
autosomal dominant
46
familial hypercholesterolemia pattern of inheritence
autosomal dominant
47
what is variable penetrance?
| variable expressivity?
the percentage of intividuals with a gene that will actually express it
-degree of expression in the individual with the gene
48
marfan's syndrome
```
defect in fibrillin gene
-tall, thin, loose joints
-cardiovascular abnormalities
-occular abnormalities
-shortened life expentancy
(usually due to rupture of a dissecting aneurysm)
```
49
dissection
blood tracking through vessel vall
50
familial hypercholesterolemia
defect in LDL receptor gene
-insufficient removal
-deposits in tissue as atheroslerosis and xanthomas in skin and soft tissue
worse phenotype if homozygous
-develop ischemic heart disease before age 20
51
cystic fibrosis mode of inheritence
autosomal recessive
| -carrier rate 1 in 25
52
cystic fibrosis
```
defect in Cl transport gene
-->thick exocrine secretions that obstruct ducts and cause infections
meconium ileus (failure to pass meconium)
-pseudomonas nifections
```
53
lysosomal storage diseases
- group of diseases of defects in different enzymes
- results in accumulation of materials in lysosomes
- eg lipidoses, glycogenoses
54
tay sachs
```
autosomal recessive
lysosomal
storage disease
-defective hexosaminidase
-brain, eye changes
-3-5 yr life expectancy
```
55
gaucher disease
lysosomal storage disease
defective glucocerebrosidase
-enlarged spleen, anemia
-normal life expectancy if type 1
56
phenylketonuria
defective phenylalanine hydroxylase gene
- which converts it to Tyr
- accumulation causes toxic effects on cells during development (not adulthood)
- can minimize effects by following phenylalanine deficient diet
57
hemophilia
x-linked recessive-only males are effected
defect in coagulation proteins (clotting factors)
-secondary complications are arthritis, joint malformation
-treatment=factor replacement
58
duchenne and backer's muscular distrophy
due to defective dystrophin protein
- which is involved in attachment of cytoskeleton, especially muscles
- duchenne more severe, earlier onset of muscle wasting
59
fragile x syndrome
affects males (but not classical inheritence pattern)
- portion of X chromosome is fragile due to CGG triplet repeats
- these increase with each generation and mental retardation and enlarged testis are eventually expressed
60
2 examples of multifactorial inheritence disorders
dysraphia
diabetes type 2
5-10% chance of developing disorder b/c of exogenous and endogenous factors contributing to expresion
61
egs of dysraphias
```
=neural tube defects
anencephaly-abscence of brain
spina bifida-defect in vertebral bones (dont fuse properly)
meningocele-defect in vertebre/meninges
folate decreases risk
```
62
chorionic villus sampling
- biopsy of placental villus
- gets fetal cells for analysis
- risky
63
premature baby
delivered b/f 37 wks
64
Intrauterine growth restricted baby
is less than 3200g
65
immature baby
both premature and low weight
66
causes of prematureity
maternal-smoking, substance abuse, malnutrition
- fetal-genetics
- placental-insufficiency
67
neonatal respiratory distress sydrome
shortness of breath
-inadequate surfactant leads to atelectasis and hyaline membrane formation
to treat: release surfactant into amniotic fluid before birth and corticosteroids
68
igA
present in secretions, milk
| as dimer
69
IgE
present in tissue on mast cells
| -mediate alergic responses
70
IgD
on B cells
| activation of lymphocyte
71
IgM
present in blood
first defense against common bacteria
pentamers
neutralize and activate compliment
72
IgG
present in blood but indicates later response (B cells make IgM first)
acts as opsonin
73
type II hypersensitivity
exaggerated immune response from deposition of Ab on cells or tissue
-eg myesthenia gravis
74
hemolytic anemia
type II hypersensitivit
Abs to protein on surface of RBCs
could be b/c of a drug
75
graves disease
=autoimmune thyroiditis
Ab against TSH receptor
-hyperthyroidism
76
myasthenia gravis
Ab against acetycholine receptor on mm
| -muscle weakness
77
type III hypersensitivit
exaggerated immune response from creation of Ag-Ab complexes cauing inflammation in various places
-eg lupus, rheumathoid arthritis
78
one theory of how lupus works
maybe from defective clearance of cells resulting in Abs against cell parts (eg anti-nucleus)
79
type IV hypersensitivity
excessive, prolonged immune reaction by immune cells-Ag complexes
-supermacrophages
-possible granulomas
eg tuberculosis
80
allograft
| xenograft
donor
| different species donor
81
hyperacute rejection
w/in hours
| due to preformed Ab (usually blood type)
82
acute rejection
w/in days
| Ab and cell mediated
83
chronic rejection
w/in monts to years
ab and cell mediated
vascular obstruction and tissue destruction
84
neoplasm
mass of abnormal cells growing autonomously
85
benign neoplasm
```
generally well differentiated
slow growth
no invasion
-smooth boarder, encapsulated
no matestases
```
86
premalignant
likely to become malignant but has not invaded basement membrane
87
benign epithelial neoplasms
adenoma (some are premalignant, but usually not skin ones)
| papilloma
88
malignant epithelial neoplasm
adenocarcinoma
squamous cell carcinoma
transitional cell carcinoma
89
in situ (neoplasm nomenclature)
means premalignant
| needed to distinguish from truly malignant
90
sarcoma
malignant neoplasm
91
carcinogens
substances that produce cancer
92
inherited cancer syndromes
mutant gene that increases risk of cancer developing
| -eg defective DNA repair syndromes
93
example of a benign tumor associated w/increased risk of malignancy
villous adenomas of colon
94
grade of malignant neoplasm
describes degree of differentiation
high grade don't look like cells (poorly differentiated)
low grade are well differentiated
95
stage
amount of malignant neoplasm
- size
- lymph nodes
- distant metastasis
96
example of fatal benign neoplasm
meningioma
97
paraneoplastic syndromes
not explained but happens in cancer patients
- hypercalcemia
- cushing's-prod of ACTH
- inappropriate antidiuretic hormone produced by Tumor (ADH)
98
pro-carcinogen
must be modified in body to become a carcinogen
99
UV radiation
damages DNA
| -xeroderma pigmentosa=genetic defect in DNA repair enzymes, leads to early skin cancer
100
ionizing radiation
leukemias inc. in Japan
| thyroid cancer in patients who received radiation to neck
101
oncogenes
mutated genes whose products are associated with formation of neoplasms
- ie control cell growth
- tumor suppressor genes
102
water distribution in body
2/3 in intracellular fluid compartment
1/3 in extracellular fluid compartment
--3/4 in interstitium, 1/4 in tissue
103
edema
accumulation of fluid
| -exudate if inflammation, transudate if not
104
hydrostatic pressure
forces water out
105
oncotic pressure
pushes water in
106
anasarca
generalized edema
| -fluid accumulates in low areas (ankles or ileosecal region if lying down)
107
hydrocardia
excess fluid in pericardial cavity
108
hyperemia
inc. in volume of blood in tissue
-active=from exercise or inflammation
passive-from dec. venous pressure that occurs w/impaired outflow of blood
109
cyanosis
blue lips and skin due to lack of oxygen
110
purpura
bruise greater than 3mm
111
patechiae
pinpoint hemmorhages from capillary rupture
112
hemoptysis
coughing blood
113
hematemesis
vomitting blood
114
hematochezia
blood in rectum (bright red)
115
melena
dark blood in stool
116
hematuria
blood in urine
117
manorrhagia
excessive blood loss in menses
118
massive blood loss
hypovolemia and shock
119
clot formation predisposing factors
blood not flowing properly
hypercoaguable state
endothelial injury
120
embolus
any circulating material that may cause a problem
121
stenosis
narrowing
122
causes of shock
```
S-septic from bacteria
H-hypovolemic
O-obstructive (eg cardiac tampenade)
C-cardiogenic-heart not contracting
K-anaphalactic shock
S-spinal/neurogenic (lack of or improper innervation)
```
123
which vessels don't have media (smooth muscle)
capillaries and lymphatics
124
which layer is thickened by age in blood vessels?
intima
125
arteriosclerosis
| atherosclerosis
=intima is scarred (typically by hypertension)
| fatty expansion of intima happens
126
media disease
dissection
raynauds disease-abnormal response to cold and blue cold extremities
vasculitis
127
which layers does an aneurism effect and what is it?
dilation of vessel wall that predisposes to clot and rupture
| effects any or all layers
128
ischemic heart disease
- reduced coronary circulation (usully from atherosclerosis)
- variable symptoms including: angina, myocardial infarct (death of heart muscle), can become chronic
- arrythmia from ischemia in conduction system
129
complications of MI
- myocardial rupture-5-7 days after MI, can result in cardiac tampenade
- papillary muscle rupture with mitral regurgitation
- ventricular aneurysm
- arrythmias
- mural thrombus and emboli
130
congestive heart falure
heart unable to pump enough blood to meet tissue demands
- various causes, including chronic ischemic damage
- shortness of breath, tiredness, etc.
- can't get blood out to system so accumulates in lungs
- can't get blood to lungs so it accumulates in veins
131
dilated cardiomyopathy
dilated chambers
| -due to genetics, viral infection, alcohol, late ishemic disease, and chemo
132
hypertrophic cardiomyopathy
thickened walls-genetic
133
restrictive cardiomyopathy
reduced ventricular contractility
- idiopathic primary form forms in kids
- aquired forms in adults (eg amyloidosis)
134
arrythmogenic cardiomyopathy
fibrofatty replacement of myocardium-genetic
135
septal wall defect
simple defect
136
tetraology of fallot
cyanotic defect
137
valvular heart disease
can be stenosis or insufficiency of any valve
| -genetics, infection,, autoimmune, etc.
138
endocarditis
- inflammation of inner heart lining (usually valve)
- sometimes autoimmune or metastises related
- impaired valve function and emboli
139
myocarditis
inflammation of heart muscle
- including lymphocytic mycarditis, sarcoidosis, eosinophilic myocarditis
- can have long term sequalae of heart failure
- can be caused by viruses, toxins, autoimmunity, medication
140
pericarditis
inflammation of epicardium and or pericardium
-pericardial effusion and possible tamponade
-can acute-fibrinous
or chronic-fibrous or a mix
-surgery if causing tampenade
141
cardiac neoplasms
- most commonly metastasis
- typically rapidly fatal
- most common primary cardiac neoplasm is myxoma
142
anthracosis
accumulation of carbon particles in lungs
| -stored as anthracotic pigment
143
diptheria
bacterial infection in throat that forms membrane
| membranes can break off and get inhaled and cause death
144
parainfluenza virus causes
croup in kids younger that 3
145
acute epiglottitis
3-7yr old kids
- may cause swelling/closure of airway
- usually self limiting
- immunization
146
bronchiolitis
kids less than 2 years old
-inflammation due to virus
usually respiratory syncitial virus
147
difference b/t atypical and typical pneumonia
atypical has nonproductive cough
| -infection is in b/t alveoli in interstitial tissue
148
community aquired vs. hospital aquired causes of pneumonia
community usually gram +
| hospital usually gram -
149
complications of pneumonia
pleuritis
pyothorax-puss in pleural cavity
empeyma-localized areas of pus in pleural cavity
abcess
bronchiectasis-continued inflammation and expansion
chronic lung disease
150
where does TB initial infection occur?
in the lung, causing Ghon complex to form w/lung lesion and enlarged hilar nodes
151
common comorbidity of TB
liver disease from antibiotics
152
egs of obstructive diseases
asthma
COPD
bronchiectasis
cystic fibrosis
153
extrinsic asthma
| intrinsic asthma
attacks precipitated by triggering allergens
| attacks precipitated by non-immune mx (eg exercise, stress, temperature)
154
hypersensitivity pneumonitis
=immune reaction to various organic materials (eg pigeon poo)
-can become chronic and cell-mediated, which leads to destruction and dec. compliance
155
pneumoconioses
due to inhalation of inorganic dusts (eg sand, coal)
156
sarcoidosis
multisystemic, unkown etiologies
- non caseating granulomas in various organs
- biopsy to diagnose
- no specific treatment but steroids
157
aletactasis
expansion of alveoli
158
adult respiratory distress syndrome
acute respiratory failure that doesn't respond to oxygen
- ie are still breathing but not oxygenating blood
- injury to lung causes leakage from capillaries
159
pneumothorex
air into pleural cavity with collapse of lung
160
pleural effusion
accumulation of fluid in pleural cavity
Pathology 375
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