Pathology Lecture Fundamentals

Comprehensive practice flashcards covering general pathology, cellular adaptations, inflammation, hemodynamics, and neoplasia based on lecture transcripts.

How is Pathology defined based on its etymology?

It comes from 'pathos' (suffering or damage/disease) and is the study of structural and functional changes in cells, tissues, and organs that underlie disease.

What are the four pillars or aspects of a pathological process described in the notes?

Etiology, Pathogenesis, Morphological changes, and Functional disorders (clinical manifestations).

What is the difference between signs and symptoms?

Signs are objective findings observed by the clinician, while symptoms are subjective experiences reported by the patient.

What is cellular atrophy?

A mechanism of cellular adaptation characterized by a decrease in cell size due to loss of cellular substance, leading to a reduction in the size of the tissue or organ.

What acronym is used to remember the causes of pathological atrophy?

MIA PAPA (Disuse, Denervation, Ischemia, Insufficient nutrition/Marasmus, Loss of endocrine stimulation, Senile atrophy, and Pressure/Tumor).

What are the two primary biochemical pathways of pathogenesis in atrophy?

Autophagy (cathepsin G) and the Ubiquitin-proteasome pathway (stimulated by TNF, glucocorticoids, and thyroid hormone).

How is hypertrophy defined?

An increase in cell size due to increased synthesis of structural components, resulting in an increase in the size of the organ, typically occurring in cells that do not divide.

What is the difference between concentric and eccentric myocardial hypertrophy?

Concentric hypertrophy is caused by pressure overload (e.g., hypertension), resulting in thickened walls and reduced lumen; eccentric hypertrophy is caused by volume overload (e.g., valve insufficiency), resulting in lumen dilation and normal wall thickness.

What is hyperplasia?

A mechanism of cellular adaptation involving an increase in the number of cells in an organ or tissue through mitosis.

What characterizes pathological endometrial hyperplasia?

It is an increase in endometrial glands caused by an imbalance with high estrogen levels and low progesterone, often associated with the inactivation of $PTEN$.

What is metaplasia?

A mechanism of cellular adaptation where one adult cell type is replaced by another adult cell type (e.g., columnar to squamous in smokers).

How does Vitamin A influence metaplasia?

Deficiency ($↓$ Vit A) causes squamous metaplasia in the respiratory tract and glands, while excess ($↑$ Vit A) causes dekeratinization.

Which pathogen is responsible for 40% of cervical squamous metaplasia cases?

Chlamydia trachomatis.

What are the two main morphological hallmarks of reversible cell injury?

Cellular swelling (tumefaction) and fatty change (degeneracion grasa).

What are the three nuclear changes characteristic of necrosis?

Pyknosis (nuclear condensation/basophilia), Karyorrhexis (fragmentation), and Karyolysis (loss of basophilia/fading chromatin).

What is coagulative necrosis?

A type of necrosis where the basic tissue architecture is preserved for several days, typically caused by ischemia (infarction), except in the brain.

What characterizes caseous necrosis, and what disease is it characteristic of?

It has a 'cheese-like' (white-yellowish, soft) appearance and is characteristic of Tuberculosis.

What is apoptosis?

A regulated pathway of cell death where cells activate enzymes to degrade their own DNA and proteins while keeping the cell membrane intact.

What are Councilman bodies?

Apoptotic bodies found in the liver.

What is steatosis (fatty change)?

An abnormal accumulation of triglycerides within parenchymal cells, most commonly the liver.

What are Russell bodies?

Accumulations of newly synthesized immunoglobulins (proteins) within the cisternae of the rough endoplasmic reticulum of plasma cells.

How is a 'vulnerable' atherosclerotic plaque defined?

A plaque with a large lipid/foam cell core and a thin fibrous cap with few smooth muscle cells and many inflammatory cells, prone to rupture.

Which arteries are typically NOT affected by atherosclerosis according to the notes?

Upper extremity arteries, mesenteric arteries, and renal arteries.

What is Caplan syndrome?

The coexistence of rheumatoid arthritis with pneumoconiosis (such as asbestosis or silicosis), resulting in rapid-growing lung nodules.

What are the Five Cardinal Signs of Inflammation?

Heat (Calor), Redness (Rubor), Swelling (Tumor), Pain (Dolor), and Loss of function (Functio laesa).

What are the differences between Exudate and Transudate?

Exudate is protein-rich with cellular debris and high density ( > 1020 ), typical of inflammation; Transudate is protein-poor, an ultrafiltrate of blood with low density ( < 1012 ).

What is the Ghon focus and Ghon complex in Tuberculosis?

A Ghon focus is a $1-1.5,cm$ white-grayish area of consolidation in the lung; the Ghon complex is the Ghon focus plus involved caseating regional lymph nodes.

What is Pott's disease (Mal de Pott)?

Isolated tuberculosis affecting the vertebrae.

How do Tuberculoid and Lepromatous leprosy differ microscopically?

Tuberculoid leprosy is paucibacillary (few bacilli) with immune granulomas; Lepromatous leprosy is multibacillary (many bacilli) with lipid-laden 'lepra cells' and 'globi cells'.

What is the diagnostic serum threshold for hyperuricemia in Gout?

Superior to $7,mg/dl$.

What are Schaumann and Asteroid bodies?

Inclusions found within giant cells in Sarcoidosis; Schaumann bodies are laminated calcium/protein concretions, and Asteroid bodies are star-shaped inclusions.

What is 'Nutmeg Liver'?

Macroscopic appearance of the liver in chronic passive congestion (often due to right heart failure), showing red-brown depressed central areas and tan normal areas.

What is the difference between a Red Infarct and a White Infarct?

Red (hemorrhagic) infarcts occur in venous occlusions, loose tissues (lung), or double-circulation organs (intestine); White (anemic) infarcts occur in arterial occlusions in solid organs with terminal circulation (heart, spleen, kidney).

What are the two main components of a neoplasm?

The Parenchyma (neoplastic cells that determine the type) and the Stroma (supporting connective tissue, blood vessels, and nerves).

What is Desmoplasia?

The capacity of neoplastic cells to stimulate the formation of an abundant collagenous stroma.

What are the characteristics of anaplasia?

Pleomorphism, loss of nuclear-to-cytoplasm ratio (approaching $1:1$), atypical mitoses, hyperchromatism, and loss of polarity.

What is a Sentinel Lymph Node?

The first node to receive lymphatic drainage from a primary tumor.

What is Meigs Syndrome?

An ovarian tumor (typically a fibroma > 6,cm ) associated with ascites and right-sided hydrothorax.

How is von Recklinghausen disease (Neurofibromatosis type 1) genetically defined?

An autosomal dominant disorder linked to chromosome $17q$ affecting the neurofibromin gene.

What are Lisch nodules?

Pigmented hamartomatous nodules in the iris found in Neurofibromatosis type 1.

What is the most common tumor type in women according to the notes?

Leiomyoma (uterine fibroids).

Which human papillomavirus (HPV) types are considered high-risk for cervical cancer?

Types $16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68$.

What is the diagnostic cell for Rhabdomyosarcoma?

The rhabdomyoblast, which can be tadpole-shaped (renacuajo) or racquet-shaped (tachuela) with granular eosinophilic cytoplasm.

What is an Acrocordon (fibroepithelial polyp)?

A common benign epithelial neoplasm, often seen in the neck or axilla, appearing as a soft, skin-colored bag-like tumor attached by a thin pedicle.

What are the features used in the clinical ABCDE assessment of Melanoma?

Asymmetry, Border irregularity, Color variegation, Diameter ( > 10,mm ), and Evolution (rapid growth).