pathology

Question 1

apoptosis

Answer 1

• DNA laddering is a sensitive indicator of apoptosis - 180bp fragments
• radiation therapy causes apoptosis via free radical formation and dsDNA breakage

Question 2

intrinsic pathway

Answer 2

• inc mitochondrial permeability and cytochorome c release
• Bcl decreased, BAX and BAK increase
• Bcl-2 is anti-apoptotic and inhibts Apaf-1 activation of caspases

Question 3

extrinsic pathway

Answer 3

• via FasL-Fas (CD95) or immune cell release of perforin and granzyme B
• FasL used in thymic negative selection
• FADD binds caspases and activates them
• defects in FasL are responsible for auto-immune diseases

Question 4

chromatolysis

Answer 4

• after axonal injury, inc protein synthesis to repair axon
• round cellular swelling, displacement of the nucleus to the periphery, and dispersion of Nissl throughout the cytoplasm

Question 5

margination and rolling of neutrophils depends on which factors?

Answer 5

• vascular - E and P selectin, GlyCAM-1, CD34

- leukocyte - Sialyl Lewis and L selectin

Question 6

tight binding of neutrophils depends on which factors?

Answer 6

• vasculature - ICAM and VCAM

- leukocyte - CD11/18 integrins, VLA-4 integrin

Question 7

transmigration/diapedesis of leukocyte depends on which factors?

Answer 7

• vasculature - PECAM-1

- leukocyte - PECAM-1 (CD31)

Question 8

chemotactic factors

Answer 8

C5a, IL8 LTB4, kallikrein, platelet activating factor

Question 9

PDGF

Answer 9

secreted by activated platelets and macrophages, induces vascular remodeling and smooth muscle cell migration
- stimulates fibroblast growth for collagen synthesis

Question 10

FGF

Answer 10

• stimulates all aspects of angiogenesis

Question 11

EGF

Answer 11

• stimulates cell growth via tyrosine kinases (EGFR, ERBB2)

Question 12

TGFbeta

Answer 12

angiogenesis, fibrosis, cell cycle arrest

Question 13

metalloproteinases

Answer 13

tissue remodeling - secreted by macrophages - important for instability of atherosclerotic plaques

Question 14

granulomatous diseases

Answer 14

bartonella, berylliosis, Churg-strauss, crohns, fanciesella tularensis, fungal infections (histo, blastomycosis), Wegeners, listeria, M leprae, M tuberculosis, treponema pallidum, sarcoidosis, schistosomiasis

Question 15

granuloma formation

Answer 15

• macrophages secrete IL 12 that induces Th1 cells
• Th1 cells secrete gamma-interferon, activating macrophages
• TNFa from macrophages induce and maintain granuloma formation (check for TB before starting anti-TNFa)

Question 16

deceased ESR

Answer 16

sickle cell, polycythemia, CHF

Question 17

AL amyloidosis

Answer 17

• deposition of Ig Light chains, associated with MM

- nephrotic syndrome, restrictive cardiomyopathy, easy bruising, neuropathy, tongue enlargement

Question 18

AA amyloidosis

Answer 18

• secondary amyloidosis
• seen with chronic conditions (RA, IBD, protracted infection)
• fibrils composed of serum Amyloid A, often multisystem

Question 19

dialysis related amyloidosis

Answer 19

• B2 microglobulin deposits, may present as carpal tunnel

- B2 microglobulin provides structural support for MHC1 and is not filtered by dialysate

Question 20

heritable amyloidosis

Answer 20

• ex: ATTR neuro/cardiac amyloidosis due to transthyretin gene mutation

Question 21

senile systemic amyloidosis

Answer 21

• deposition of normal TTR in myocardium and other sites

- slow progression to dysfunction, usually asymptomatic

Question 22

organ-specific amyloidosis

Answer 22

• alzheimers deposition of amyloid beta
• islet amyloid polypeptide (IAPP) in DM
• natriuretic peptide in atrial myocytes

Question 23

lipofuscin

Answer 23

yellow-brown pigment associated with normal aging formed by oxidation and polymerization of autophagocytosed organellar membranes
- in the heart, liver, kidney, eye and other organs of old people

Question 24

P glycoprotein

Answer 24

aka multidrug resistant protein (MDR1)

• expressed by some cancer cells to pump out toxins, including chemo
• is an ATP dep efflux pump that esp removes hydrophobic agents like antracyclines

Question 25

cachexia

Answer 25

- mediated by TNFalpha, IFN gamma and IL 6

Question 26

BCR-ABL

Answer 26

- oncogene (tyrosine kinase) associated with CML, ALL

Question 27

bcl-2

Answer 27

- oncogene (anti-apoptotic) associated with follicular and undifferentiated lymphoma

Question 28

BRAF

Answer 28

- oncogene (serine/threonine kinase) associated with melanoma

Question 29

c-kit

Answer 29

oncogene (cytokine receptor) associated with GIST

Question 30

c-myc

Answer 30

oncogene (transcription factor) associated with Burkitt lymphoma

Question 31

Her2/neu

Answer 31

oncogene (tyrosine kinase) associated with breast, ovarian and gastric carcinomas

Question 32

L-myc

Answer 32

oncogene (transcription factor) associated with lung cancer

Question 33

N-myc

Answer 33

oncogene (transcription factor) associated with neuroblastoma

Question 34

ras

Answer 34

oncogene (GTPase) associated with colon, lung and pancreatic cancer

Question 35

ret

Answer 35

oncogene (tyrosine kinase) associated with MEN 2A and 2B

Question 36

CPD4/SMAD4

Answer 36

tumor suppressor gene associated with pancreatic cancer

Question 37

DCC

Answer 37

tumor suppressor gene associated with colon cancer

Question 38

p16

Answer 38

tumor suppressor gene associated with melanoma

Question 39

p53

Answer 39

tumor suppressor gene associated with most human cancers, Li Fraumeni syndrome

Question 40

PTEN

Answer 40

tumor suppressor gene associated with breast, prostate and endometrial cancer

Question 41

Rb

Answer 41

tumor suppressor gene associated with retinoblastoma and osteosarcoma

Question 42

CA 15-3/CA 27-29

Answer 42

marker for breast cancer

Question 43

CEA

Answer 43

marker for colon and pancreatic cancer

Question 44

S-100

Answer 44

marker for neural crest tumors

Question 45

TRAP

Answer 45

marker for hairy cell leukemia

Question 46

paraneoplastic polycythemia

Answer 46

RCC, thymoma, hemangioblastoma, HCC, leiomyoma, pheo

Question 47

paraneoplastic PTHrP

Answer 47

squamous cell carcinoma (lung), RCC, breast cancer

Question 48

paraneoplastic hypercalcemia

Answer 48

Hodgkin lymphoma, some non-hodgkin lymphoma

Question 49

Psammoma bodies seen in

Answer 49

PSaMMoma - Papillary carcinoma of the the thyroid - Serous papillary cystadenocarinoma of ovary - Meningioma - Malignant mesothelioma

Question 50

what metastasizes to the brain?

Answer 50

lung > breast > GU > osteosarcoma > melanoma > GI

Question 51

what metastasizes to the liver?

Answer 51

colon >> stomach > pancreas

Question 52

what metastasizes to bone?

Answer 52

prostate, breast > lung > thyroid