Pathoma Chapters 1-3

Hypertrophy vs Hyperplasia:

These processes happen in response to an increased or decreased stress/stimulus?

Increased

Hypertrophy vs Hyperplasia:

Which involves protein synthesis and production of organelles?

Hypertrophy

Hypertrophy vs Hyperplasia:

Which involves activation of Stem Cells?

Hyperplasia

Hypertrophy vs Hyperplasia:

What are the 3 permanent tissues?

1. CNS

2. Cardiac Muscle

3. Skeletal Muscle

Hypertrophy vs Hyperplasia:

What defines a Permanent tissue?

No Stem Cells

Hypertrophy vs Hyperplasia:

What is the only Hyperplasia that doesn't have an increased risk for cancer?

BPH

Benign Prostatic Hyperplasia

Hypertrophy vs Hyperplasia:

Which can progress to dysplasia?

Hyperplasia

Atrophy:

This response happens due to an increase or decrease in stimulus/stress?

Decrease

Atrophy:

Is a decrease in cell size, number or both?

Both

Decrease in Size and Number

Atrophy:

Decrease in cell number occurs via apoptosis or necrosis?

Apoptosis

Atrophy:

Decrease in cell size occurs via which pathway?

Ubiquitinization

Metaplasia:

What are the 3 kinds of Epithelium?

1. Squamous

2. Transitional

3. Columnar

Metaplasia:

What disease is a classic example of this process?

Barret's Esophagus

Metaplasia:

Barret's Esophagus is a change of epithelium from what type to what type?

Squamous to Columnar

Metaplasia:

Occurs via reprogramming of what cells?

Stem Cells

Metaplasia:

Does this process increase risk of CA?

Yes

Metaplasia:

What is the only metaplasia that does not increase risk of CA?

Apocrine Metaplasia of Breast

i.e. Fibrocystic Changes

What is the difference between Aplasia and Hypoplasia?

Aplasia = Failure of Cell production during embryogenesis

Hypoplasia = Decreased Cell production during embryogenesis

Oxygen Delivery:

Hypoxia is an inability to get Oxygen to what?

Tissue

Oxygen Delivery:

Hypoxemia is an inability to get Oxygen to what?

Blood

Oxygen Delivery:

What is FiO2?

Percent of O2 in Air we breath

Oxygen Delivery:

What are the 3 Important components of FiO2?

1. Oxygen

2. CO2

3. Nitrogen

Oxygen Delivery:

What is PAO2?

Percent of O2 in Alveolus

Oxygen Delivery:

What are the 2 important components of PAO2?

1. Oxygen

2. CO2

Oxygen Delivery:

What is the relationship between Oxygen and CO2 in Alveolus?

Oxygen = 1/CO2

Oxygen Delivery:

What is the relationship between CO2 and Ventilation in Alveolus?

Ventilation = 1/CO2

Oxygen Delivery:

What is PaO2?

Oxygen dissolved in blood

Oxygen Delivery:

FiO2 → PAO2 → PaO2 → SaO2;

What do the 3 arrows represent?

1st Arrow = Airway

2nd Arrow = O2 transfer from Lung to Blood i.e. Diffusion

3rd Arrow = O2 transfer from Blood to Hb

Oxygen Delivery:

FiO2 → PAO2 → PaO2 → SaO2;

What parts above represent Hypoxemia?

FiO2 → PAO2 →

Oxygen Delivery:

FiO2 → PAO2 → PaO2 → SaO2;

What parts above represent Hypoxia?

PaO2 → SaO2

Oxygen Delivery:

What is a classic description in Methemoglobinemia?

Chocolate-Colored Blood

Ischemia can be caused by a decrease of what 2 things?

1. Arterial Perfusion

2. Venous Drainage

What is a classic example of Ischemia via venous drainage?

Budd-Chiari (Thrombus of Hepatic vein)

Necrosis:

What is the only necrosis that becomes liquefied?

Liquefactive

Necrosis:

Ischemia leads to what kind of necrosis?

Coagulative

Necrosis:

What is the only tissue that becomes Liquefactive with ischemia?

Brain Tissue

Necrosis:

What is the classic macroscopic shape of Coagulative necrosis?

Wedge Shaped

Necrosis:

What kind of necrosis happens in Red Infarction?

Coagulative

Blood RE-ENTERS through tissue

Necrosis:

What are 2 areas that suffer Red Infaction?

1. Testes

2. Lungs

Necrosis:

What are 3 examples of Liquefactive necrosis?

1. Brain Infarct

2. Abcess

3. Pancreatitis

Necrosis:

What are the 2 types of Gangrenous Necrosis?

1. Dry

2. Wet

Necrosis:

Gangrenous Necrosis is a type of Coagulative necrosis that happens in what 2 areas?

1. Lower Limb

2. GI

Necrosis:

Wet Gangrenous necrosis is a mix of what 2 kinds of necrosis?

Coagulative and Liquefactive

Necrosis:

What causes Wet Gangrenous Necrosis?

Infection of Gangrenous Tissue

Necrosis:

What is the classic macro description of Fat Necrosis?

Chalky-White

Necrosis:

What causes Fat necrosis to look Chalky-White?

Calcium Deposition

Necrosis:

What are 2 kinds of Calcium deposition?

1. Dystrophic Calcification

2. Metastatic Calcification

Necrosis:

Ca++ deposits in _____1___ tissue and has ______1_____ serum Ca++ in ______1______ Calcification.

Ca++ deposits in necrotic tissue and has normal serum Ca++ in Dystrophic Calcification

Necrosis:

Ca++ deposits in ___2_____ tissue and has ______2_____ serum Ca++ in ______2______ Calcification.

Ca++ deposits in normal tissue and has high serum Ca++ in Metastatic Calcification

"Ca++ is high so it spreads"

Necrosis:

Fibrinoid necrosis is found where?

Blood Vessel Wall

Necrosis:

What are 2 causes of Fibrinoid Necrosis?

1. Vasculitis

2. HTN

Necrosis:

Preeclampsia causes what kind of necrosis in placenta?

Fibrinoid

Due to HTN

Apoptosis:

What are the 3 pathways for apoptosis?

1. Intrinsic Mitochondrial

2. Extrinsic Receptor Ligand

3. CD8+

Apoptosis:

All apoptosis pathways are dependent on what enzyme type?

Caspases

Apoptosis:

What is the function of BCL2?

Maintains Cytochrome C in Mitochondria

Apoptosis:

What does Cytochrome C do in Cytoplasm?

Activates Caspases

Apoptosis:

Damage→↓BCL2→↑Cytoplasmic Cytochrome C→↑Caspase

What apoptotic pathway is this?

Intrinsic Mitochondrial

Apoptosis:

What are the 2 triggers for Extrinsic Receptor Pathway?

1. FAS Ligand → FAS Receptor aka CD 95

2. TNF → TNF Receptor

Apoptosis:

What do CD8+ cells secrete to activate caspases?

Granzyme

Apoptosis:

How does granzyme, secreted by CD8+, get into the other cells cytoplasm?

Perforins

Free Radicals:

What is the most damaging free radical?

Hydroxyl Free Radical

Free Radicals:

What are 2 MCC of Hydroxyl Free Radicals?

1. Ionizing Radiation

2. Metals

Free Radicals:

How does your body remove Hydroxyl Free Radicals?

Glutathione Peroxidase

Amyloidosis:

What are 2 characteristics shared by amyloid?

1. Beta Pleated Sheet Configuration

2. Congo Red or Apple Green Birefringence

Amyloidosis:

Gene for Beta Amyloid is found on what chromosome?

21

Amyloidosis:

B2-Microglobulin Amyloidosis is specific to what kind of patient?

Dialysis

Amyloidosis:

Calcitonin Amylodosis happens in what CA?

Medullary Thyroid

Inflammation:

Allows what 3 things into Interstitial Space?

1. Inflammatory Cells

2. Plasma Protein (Complement)

3. Fluid

Inflammation:

Vasoconstriction usually refers to what kind of vessel?

Arteriole

Inflammation:

Vasodilation usually refers to what kind of vessel?

Post-Capillary Venule

Inflammation:

Increased Vascular Permeability usually refers to what kind of vessel?

Post-Capillary Venule

Inflammation:

What is the function of TLR (Toll Like Receptor) in inflamation?

Increases NF-KB

Inflammation:

What is a classic TLR?

CD 14 on Macrophage recognizes LPS

Inflammation:

What is NF-KB?

Transcription Factor

Inflammation:

What arachadonic acid derivative activates Neutrophils?

LTB4

Inflammation:

What are the 4 neutrophil chemotactic substances?

1. Bacterial Products

2. IL 8

3. C5a

4. LTB4

Inflammation:

What are the 3 ways to activate a MAST Cell?

1. Tissue Trauma

2. C3a or C5a

3. Crosslinking of Cell Surface IgE by Antigen

Inflammation:

What coagulation factor activates Inflamation?

Factor XII aka Hageman Factor

Inflammation:

Hageman Factor activates what 3 systems?

1. Kinin i.e. Inflammation

2. Complement

3. Coagulation and Fibinolysis

Inflammation:

What state Classically activates Hageman Factor?

Gram - Sepsis + DIC

Inflammation:

What are the 2 substances that mediate pain?

1. Bradykinin

2. PGE2

Inflammation:

IL1 and TNF-a act on what cells in the hypothalamus in order to cause fever?

Perivascular Cells

Inflammation:

What enzyme is activated in Perivascular Cells of the Hypothalamus in the presence of IL1 and TNF-a?

COX

Inflammation:

What is the product of COX when activated by IL1 and TNF-a in the Perivascular Cells of the Hypothalamus?

PGE2

Inflammation:

What is the function of PGE2 in the Perivascular Cells of the Hypothalamus?

Raise the Temperature set point (cause fever)

Inflammation:

What are the 4 steps taken for a Neutrophil to arrive where needed?

1. Margination

2. Rolling

3. Adhesion

4. Transmigration

Inflammation:

Margination occurs in what part of the blood vessely?

Post-Capillary Venule

Inflammation:

What substance is expressed by endothelial cells in Rolling?

Selectin

Inflammation:

What 2 selectins are expressed by endothelial cells in Rolling?

1. P Selectin

2. E Selectin

Inflammation:

Where are P selectins Stored?

Weible-Palade Bodies

Inflammation:

Which selectin is mediated via histamine?

P Selectin

Inflammation:

Which selectin is mediated via TNF and IL1?

E Selectin

Inflammation:

What substance is expressed by leukocytes in rolling?

Sialy Lewis X

Inflammation:

What 2 molecules are expressed by the endothelium in adhesion?

1. ICAM

2. VCAM

Inflammation:

What molecule is expressed by the leukocyte in adhesion?

Integrin

Inflammation:

What disease has a deficiency of Integrins or CD 18?

Leukocyte adhesion deficiency

Inflammation:

Chediak-Higashi is an autosomal recessive deficiency that causes what?

Microtubule Dysfunction

Inflammation:

O2 is converted into Radical O2 via what enzyme?

NADPH Oxidase

Inflammation:

Radical O2 is converted into H2O2 via what enzyme?

Superoxide Dismutase

Inflammation:

H2O2 is converted to bleach (HOCl) via what enzyme?

Myeloperoxidase