Principles of Disease Final Exam Review Flashcards

100 Practice flashcards for the PATH 3610 Final Exam Review based on the lecture notes on Principles of Disease.

What is the 'compensated state' in tissue degeneration?

A state where inefficient function of a degenerate tissue is sufficient to maintain life due to compensatory mechanisms.

How is lethal cell injury (necrosis) primarily characterized?

By certain recognizable microscopic changes in a living organism, representing local cell death.

What is the most efficient energy source for normal cells?

High-energy phosphate bonds of $ATP$.

Which process requires oxygen to phosphorylate $ADP$ into $ATP$?

Oxidative phosphorylation.

Which condition is defined as insufficient oxygen specifically within cells?

Hypoxia.

What is hypoxemia?

A decreased ability of the blood to carry oxygen, such as in anemia or $CO$ poisoning.

Which energy substrate is the only source for brain neurons in a normal physiological state?

Glucose.

How does the toxin cyanide cause $ATP$ depletion?

It interferes with cytochrome oxidase, the final enzyme in the respiratory chain.

What causes the 'cloudy swelling' appearance in cell degeneration?

Lack of $ATP$ leads to dysfunction of the sodium pump, causing sodium and water to move into the cell.

Why does a switch to anaerobic glycolysis exacerbate cellular injury?

It produces lactic acid, which lowers intracellular $pH$ and damages lysosomal membranes.

Which cells are first affected by defective energy production?

Cells with the highest metabolic rate and oxygen demand, such as brain cells.

What specific pigment represents damaged cell membrane deposited in the cytoplasm?

Lipofuscin.

What is the composition of lipofuscin?

Phospholipid and protein complexes resulting from free-radical peroxidation.

In the liver, fatty degeneration (steatosis) involves the accumulation of which substance?

Triglycerides ($TGs$).

How does the liver appear grossly when affected by fat accumulation?

Pale/beige, enlarged, friable, and greasy in texture.

What is the term for excess iron accumulating in tissues?

Hemosiderin.

Which inherited defect in iron metabolism leads to the accumulation of free ferric iron?

Hemochromatosis.

Which form of bilirubin is water-soluble and conjugated in the liver?

Bilirubin conjugated to glucuronide.

What are the three mechanisms that can result in jaundice (icterus)?

Hemolysis, hepatocellular dysfunction, and bile flow obstruction (cholestasis).

What is the clinical term for neuronal dysfunction caused by bilirubin accumulation in the brain?

Kernicterus.

What is a somatic mutation?

A mutation involving tissue cells that is not passed onto offspring.

What are the two microscopic morphologic changes indicating reversible cell injury?

Cellular swelling and fatty change.

How many hours must pass before changes of necrosis are visible by light microscopy?

$\text{6-8 hours}$.

What is enzymatic fat necrosis typically associated with?

The release of pancreatic lipase into the abdominal mesentery and omentum.

What creates the 'white, chalky' appearance in enzymatic fat necrosis?

Fatty acids complexing with plasma calcium ions to form $Ca^{2+}$ soaps.

Why does necrotic cytoplasm stain more intensely 'pink' with hematoxylin & eosin (H&E) stains?

Due to cytoplasmic protein denaturation and the loss of ribosomes.

What is dystrophic calcification?

Abnormal deposition of calcium salts in dead or dying tissues despite normal serum calcium levels.

What is the 'Suicide Bag Hypothesis'?

The proposition that the release of lysosomal enzymes causes cell death (now known to be a result of death).

What is pyknosis?

The process where nuclear chromatin clumps and the nucleus becomes smaller and more densely staining.

Define karrhyorhexis.

The process where a pyknotic nucleus breaks up into fragments.

Define karrhyolysis.

The complete lysis of a nucleus due to lysosomal enzymes.

What is gangrene?

Cell and tissue death usually following a pattern of blood flow loss, often darkly discoloured and demarcated.

Why are necrotic tissues ideal growth media for secondary infections?

They lack blood flow, making them inaccessible to inflammatory cells and the immune system.

Which specific form of programmed cell death is active and requires energy?

Apoptosis.

Which enzymes mediate the execution phase of apoptosis?

Caspases.

What is autophagy?

A process where a cell recycles its own non-essential organelles to provide energy.

What causes 'rigor mortis' after death?

$ATP$ reduction in muscles.

What is 'putrefaction'?

Post mortem fermentation caused by saprophytic bacteria, often producing gas bubbles.

How is 'autolysis' distinguished from 'necrosis' microscopically?

Autolysis generally lacks the presence of inflammatory cells.

In a normal capillary, what happens at the arteriolar end?

Vascular hydrostatic pressure exceeds vascular oncotic pressure, driving fluid into tissues.

What is the main protein responsible for plasma oncotic pressure?

Albumin.

Which term describes fluid that has moved out of the capillary through endothelial pores?

Ultrafiltrate.

What is 'pitting edema'?

Skin edema where focal pressure leaves a depression or 'pit'.

What is 'ascites'?

A watery effusion specifically in the peritoneal cavity.

What is 'anasarca'?

Massive edema involving the whole body and its cavities.

What causes the edema in right-sided ventricular heart failure?

Venous blood 'backs up' systemically, increasing vascular hydrostatic pressure.

What is 'pulmonary edema'?

Fluid accumulation in the alveolar spaces of the lungs, often due to left-sided heart failure.

In the renin-angiotensin-aldosterone pathway, what is the effect of aldosterone?

It causes sodium and water retention, increasing blood volume and vascular hydrostatic pressure.

What is 'hypoproteinemia'?

Decreased blood protein levels, which leads to decreased plasma oncotic pressure and generalized edema.

Small 'pinpoint' focal hemorrhages are known as what?

Petechiae.

Larger areas of hemorrhage, commonly known as bruises, are called what?

Ecchymoses.

What is a 'hematoma'?

A large 'blood blister' where blood has pooled within a tissue.

What is the term for coughing up blood?

Hemoptysis.

What are the four primary responses in normal hemostasis?

Transient vasoconstriction, primary hemostasis, secondary hemostasis, and permanent plug formation.

Which plasma protein connects platelets to form aggregates during primary hemostasis?

Fibrinogen.

Which vitamin is required for the synthesis of prothrombin and factors $VII$, $IX$, and $X$?

Vitamin $K$.

What is the function of 'plasmin' in the fibrinolytic cascade?

It breaks down fibrin and interferes with its polymerization to dissolve clots.

What is the most common inherited sex-linked coagulation disorder?

Hemophilia $A$ (deficiency in Factor $VIII$).

What are the three factors of Virchow’s Triad?

(1) Endothelial injury, (2) alteration in blood flow, and (3) hypercoagulability.

Which term describes a lack of blood supply to a tissue?

Ischemia.

What is an 'infarct'?

A localized area of necrosis resulting from inadequate blood supply.

Which organs are characterized by a 'dual blood supply'?

The lungs (pulmonary and bronchial) and the liver (hepatic and portal).

What is 'reperfusion injury'?

The exacerbation of tissue injury that occurs when blood flow is restored to an ischemic area.

Define Disseminated Intravascular Coagulation ($DIC$).

A thrombohemorrhagic syndrome resulting from widespread activation of coagulation and subsequent depletion of factors.

What are the five main causes of shock?

Hypovolemia, Septic, Cardiogenic, Neurogenic, and Anaphylactic.

What is the final common path for all types of shock?

A reduction in tissue perfusion.

What are the five cardinal signs of acute inflammation?

Redness, heat, swelling, pain, and loss of function.

Which chemical mediator is released by mast cells to cause capillary dilation?

Histamine.

How do exudates differ from transudates regarding protein content?

Exudates have a higher protein content and higher specific gravity due to increased vascular permeability.

Which large protein, formed from fibrinogen, aids in localizing inflammatory processes?

Fibrin.

Which blood cell type is the first to arrive at a site of acute inflammation?

Neutrophils.

What process describes leukocytes squeezing through endothelial junctions?

Diapedesis (or transmigration).

What is 'chemotaxis'?

The directional migration of inflammatory cells along a chemical concentration gradient.

Define 'opsonization'.

The process of coating a particle with antibodies or complement to enhance phagocytosis.

Which drug family inhibits the conversion of arachidonic acid to prostaglandins?

$NSAIDs$ (non-steroidal anti-inflammatory drugs).

What is a 'left shift' in a $CBC$?

The presence of increased numbers of immature neutrophils in the blood, indicating high demand.

What is 'suppurative' or 'purulent' inflammation?

Inflammation characterized by the formation of pus.

How is chronic inflammation characterized?

By mononuclear cell types (macrophages, lymphocytes, plasma cells), tissue fibrosis, and angiogenesis.

What are the hallmark cells of granulomatous inflammation?

Epithelioid cells (activated macrophages).

A fragment of devitalized bone that persists in chronic osteomyelitis is called what?

A sequestrum.

What is 'amyloid'?

An abnormally folded, insoluble $\beta-pleated$ fibrillary protein deposited in the interstitium.

Which virus is the primary cause of AIDS?

Human Immunodeficiency Virus ($HIV$).

Which immune cell does $HIV$ show a specific tropism for?

$CD4^{+}$ $T$ cells.

What is the difference between Labile, Stable, and Permanent cells?

Labile cells divide constantly; Stable cells divide only if needed; Permanent cells cannot divide after fetal life.

Which tissue type is the 'functional' part of an organ?

Parenchymal cells.

What is 'granulation tissue'?

Pink, soft, vascularized immature connective tissue consisting of fibroblasts and new capillaries.

What is 'Keloid' formation?

The development of abnormal nodular masses of collagen during skin healing.

Which infectious agents are 'obligate intracellular organisms' lacking nucleic acids?

Prions.

Which bacteria lack a cell wall and are known for evading the immune system?

Mycoplasmas.

What is 'Septicemia'?

Disease resulting from the presence of bacteria or their toxins in the bloodstream.

What occurs in 'Hamburger Disease' ($E.\text{ }coli\text{ }O157:H7$)?

Verocytotoxin causes damage to vascular endothelial cells, leading to hemorrhagic colitis and $HUS$.

What are Koch's Postulates used for?

Criteria used to establish an etiologic association between a microorganism and a disease.

Distinguish between a definitive and an intermediate host.

The definitive host harbors the adult/reproducing parasite; the intermediate host harbors immature forms.

What is 'Hyperplasia'?

An increase in tissue size due to an increase in the number of cells.

What is 'Metaplasia'?

A reversible change where one mature cell type is replaced by another mature cell type.

What is the 'guardian of the genome'?

The $TP53$ tumor suppressor gene.

How are benign tumors of epithelial origin named if they originate from glandular tissue?

Adenomas.

What suffix is used for malignant tumors of mesenchymal origin?

-sarcoma.

What does the 'TNM' system stand for in cancer staging?

$T$ (tumor size), $N$ (lymph node involvement), and $M$ (metastases).