Section 1
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liquefactive necrosis
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Last updated
6 years ago
Date created
Mar 1, 2020
Cards (131)
Section 1
(50 cards)
liquefactive necrosis
brain infarct, bacterial infections, pancreatitis
Ziehl-Nielsen
acid-fast bacteria
Acetaminophen toxicity
produces NAQI reactiva compound which binds to glutathione (depletes it) metabolism by P450 (CYP2E1) zone 3 necrosis/centrilobular necrosis (region with high concentration of P450) present with Jaundice, RUQ pain
Vitamin C deficiency
scurvy, hemorrhagic diathesis, poor wound healing purpura, bleeding, petechiae- collagen production inhibited
Pyridoxine deficiency
peripheral neuropathy, sideroblastic anemia, impaired immune function, weakness, dermatitis medication induced: isoniazid- always give B6 supplement B6
Sideroblastic anemia
defect in mitochondrial heme synthesis producing ringed sideroblasts
Thiamine deficiencies
Heart= Beriberi, dilated cardiomyopathy Brain= Wernicke-Korsakoff syndrome B1- alcoholics
Vitamin D deficiency
Rickets or osteomalacia bone mineralization inhibited Rachitic rosary- cartilage and unmineralized osteoid overgrowth Collagen 1- skin and bone Vitamin D made in the kidney (1-a-hydroxylase) then converted in the skin and increases absorption of calcium from the gut sxs: diet? renal? sun exposure? fat malabsorption?
Vitamin A deficiency
night blindness, dry skin without vitamin A; cells do not mature. Causes metaplasia White spots are squamous cell metaplasia
Cachexia marker for cancer
TNF (tumor necrosis factor)- pro-inflammatory cytokine suppresses appetite and depletes lipids elevated leptin levels
desmin
muscle: cardiac, smooth, skeletal muscle cells
acid fast stain
cryptosporidium oocyst
pyknosis
nuclear condensation "shrinking"
brown granular casts in urine
degenerative, sloughed off renal epithelial cells
timeline of tissue repair
1 day: acute necrosis 1 week: abscess, macrophages, granulation 1 month: wound healing via re-epitheliazation /scar formation *scarring if there is no underlying stem cell/regenerative tissue
cytokeratin stain
epithelial cells
congo red
amyloid
Fat necrosis
Fatty tissue is broken down into fatty acids saponification
Appetite regulation
Ghrelin: growls/grows Leptin: lowers
chromogranin stain
neuroendocrine cell
Karyorrhexis
nuclear fragmentation
cystic fibrosis
pancreatic insufficiency because of mucus plugs-> bile duct obstruction no bile= no fat absorption= no ADEK vitamins absorbed
trichrome stain
collagen (chirrosis of the liver)
gram
bacteria
Mucicarmine
Cryptococcus neoformans Aspergillus- 45 angle Pneumocystis Jirovecii vs. KOH= scrape specimen
india ink
cryptococcus neoformans CSF culture
CD3 stain
T cell (toddlers)
carcinoid tumor
tumor cells use tryptophan to produce serotonin (flushing)- high levels of 5-HTP liver metastasis only affects right side of the heart, broken down in the lungs to 5-HIAA present in the urine depletes all tryptophan-> niacin deficiency
reversible cell injury
decreased ATP synthesis decreased Na/K ATPase function anaerobic glycolysis decreased protein synthesis plasma membrane blebs and myelin figures
Marasmus vs. Kwashiorkor
Marasmus-low in both calories and protein Kwashiorkor-severe protein deficiency edema: due to increased capillary hydrostatic pressure OR decreased plasma oncotic pressure (hypoproteinemia)
Niacin deficiency
pellagra: dermatitis, diarrhea, dementia, death B9 due to inadequate tryptophan, diet primarily of corn (south america, impoverished)
Periodic acid schiff
carbohydrates alpa-1-antitrypsin basement membrane
vinyl chloride
risk for liver angiosarcoma risk: plastics
Collagen types
I = bONE, skin II = carTWOlage III = blood vessels, granulation tissue IV = basement membrane, lens
prussian blue
iron (hemochromatosis)
vimentin stain
mesenchymal cells, endothelial cells, vascular smooth muscle, fibroblasts
Hyper-vitaminosis
A= stored in stellate cells, liver disease, jaundice (eskimos d/t diet of whale, GNC supplements) Vitamin D= irritability, fatigue, muscle weakness, bone resorption, metastatic calcifications
Carbon tetrachloride (CCl4)
cytochrome p450 converts CCL4 to CL3 free radical- leads to membrane peroxidation damage to liver, kidney, brain risk: occupational
Folate deficiency
megaloblastic anemia vitamin B9
Vitamin B12 deficiency
pernicious anemia (cobalamin) neuropathy
irreversible cell injury
severe membrane damage marked mitochondria dysfunction rupture of lysosomes nuclear changes
S100 stain
neuroendocrine cell melanocytes (also neurocrest cell derived) schwannoma
Karyolysis
dissolution of nucleus "ghost nucleus"
Vitamin K deficiencies
bruising Vit K dependent clotting factors 2, 7, 9, 10, Protein S, C Warfarin: affects vitamin K dependent reaction sxs: usually pharmacologic we get Vitamin K from bacteria so if someone had a colonic resection- increased risk neonates get Vit K injection for this reason
Necrosis vs. Apoptosis
necrosis: pyknosis, kryorrhexis, karyolysis apoptosis: pyknosis, karyorrhexis
Silver Stain
H. Pylori Pneumocystis Jirovecii (black stain)
synaptophysin stain
neurons
caseous necrosis
degeneration and death of tissue with a cheese-like appearance seen in TB
CD20 marker
B cell
tryptophan downstream products
Section 2
(50 cards)
ITP types
acute (Child, viral, self-limited) vs. chronic (SLE) immune thrombocytic purpura IVIG given to help survival of the platelets by blocking Fc receptors on macrophages if steroid and IVIG do not work in patient with ITP splenectomy is last and final option
Chediak-Higashi syndrome
impaired phagolysosome formation. Pathophys: Microtubule polymerization disorder means the "tracks" to get around the cell are broken, as such transport of phagosomes is deficient. albinism, peripheral neuropathy, pyogenic infections
Leukocyte adhesion deficiency
Late seperation of umbilical cord, AR loss of CD18 necessary for integrin formation, recurrent infections without pus
Chronic Granulomatous Disease (CGD)
defect in NADPH oxidase → ↑ susceptibility to infections with catalase + organisms (S. aureus, Aspergillus, listeria, enterobacteria.)
Immigrant swimming in nile with hematuria and malignant squamous epithelial cells- cause?
Squamous cell carcinoma in bladder triggered by schistosomiasis haematobium
Crigler-Najar Syndrome
a) Complete deficiency in UDP glucuronyltransferase b) present in childhood unconjugated bilirubin deposits in the brain
PECAM
neutrophil migration
Psammoma bodies
dystrophic calcification of apoptotic neoplastic cells meningioma papillary thyroid serous cystadeno of ovaries mesothelioma
Complement deficiencies
recurrent neisserial infection
Fibrinoid necrosis
HPS type 3 due to vasculitis be careful with these stems; vs: if the patient has amyloidosis it could be amyloid deposition vs: also could be hyaline arteriosclerosis
ristocetin
measures platelet aggregation with the help of von Willebrand factor (vWF) and exogenous antibiotic ristocetin added in a graded fashion.
giant cell arteritis
temporal artery granulomatous vasculitis; ipsilateral blindness (ophthalmic artery) older female, polymyalgia rheumatica increased ESR: giant cells on bx
Hemophilia A
Factor VIII deficiency, sex-linked recessive. Spontaneous hemarthosis. Excessive bleeding especially deep tissue (muscle). Prolonged PTT (normal PT). Treat by replacing factor & fresh frozen plasma. Genetic counseling
Pathologic vs physiologic LVH
Athletes will have a normal end diastolic LV internal diameter (42-60mm) *be careful with these questions
If cryoprecipitate transfusion improves bleeding coagulation
vWB disease cryoprecipitate provides: vWF, fibrinogen, factor 8, factor 13, fibronectin
Crescendo-decrescendo murmur
AORTIC STENOSIS
Histamine
Chemical stored in mast cells that triggers dilation and increased permeability of capillaries.
Dubin-Johnson syndrome
Conjugated hyperbilirubinemia due to defective liver excretion. Grossly black liver. Benign.
Indomethacin MOA
Prostaglandin inhibitor (NSAID) via COX-2 pathway
C3b
opsonization
Thromboxane
potent platelet activator, vasoconstrictor
ICAM
neutrophil adhesion molecule
Polyarteritis nodosa
Hep B +, affects multiple medium-sized arteries EXCEPT PULMONARY Transmural inflammation young adults, skin, GI tract, liver, kidney
Sialyl Lewis X
Found on leukocytes, binds to P and E selectins during Neutrophil Rolling
Heparin-induced thrombocytopenia (HIT)
Development of IgG antibodies against heparin- bound platelet factor 4 (PF4). Antibody-heparin-PF4 complex activates platelets leading to thrombosis and thrombocytopenia. Prolonged PTT
Kawasaki disease
(inflammation of blood vessles, hence the strawberry tongue) causes coronary artery aneurysms. asian child <4yo fever, conjuctiva, rash next steps: ECHO- look for coronary artery aneurysm tx: ASA (only exception to the rule of Reyes)- prevent thrombosis OR IVIG
Councilman bodies
Toxic or viral hepatitis (dying/ apoptotic hepatocytes); small round eosinophilic masses found in dying hepatocytes often containing chromatin remnants
Gangrenous necrosis
death of tissue from severe hypoxic injury torsion, ischemia
Abciximab
Blocks glycoprotein IIa/IIIb receptor to decrease platelet binding to fibrinogen
DIC
causes: acute promeylocytic leukemia AML, M3 Adenocarcinomas- mucin activated extrinsic pathway STOP Making New thrimbi: Sepsis, trauma, Obstetrics, Pancreatitis, Malignancy, Nephrotic syndrome (minimal change disease)
CD11b/CD18
marker for integrin
Abnormal neutrophil respiratory burst activity
NADPH oxidase activity deficient
Glanzmann thrombasthenia
Due to a genetic GPIIb/IIIa deficiency; platelet aggregation is impaired abnormal aggregation with epinephrine, ADP
Which chemical is most responsible for the symptoms of asthma?
Bradykinin other chemicals: IL-1= fever LB4= chemotaxis PGE2= pain, vasodilation TAXA2= vasoconstriction
Hyaline change
nonspecific term used to describe any intracellular or extracellular alteration that has a pink homogenous appearance on H&E stain
mallory body
An irregular red-staining structure in the cytoplasm of injured liver cells, usually resulting from alcohol-induced liver injury
Prostaglandins
vasodilation
Bud Chiari Syndrome
thrombosis of hepatic veins
Leukotriene B4
cause neutrophil migration to sites of inflammation. Other importnat ones to know are C5a and IL-8. chemokine
Von Willebrand Disease
bleeding disorder caused by a deficiency of von Willebrand factor, a "sticky" protein that lines blood vessels and reacts with platelets to form a plug that leads to clot formation Autosomal Dominant vs. Bernard Soulier
CGD and nitroblue Tetrazolium test
negative NBT test in CGD patients (no reduction occurs)
Hypertrophic scar vs. keloid
Hypertrophic scar does not extend beyond the boundary of the wound Keloid wound grows past the boundary of the original injury (see the histology)
Bernard-Soulier syndrome
genetic GPIB deficiency; platelet ADHESION impaired, blood smear shows thrombocytopenia with enlarged platelets. abnormal platelet aggregation with ristocetin enlarged because they are slightly more immature PTT will be normal Autosomal Dominant
Diabetes and chronic cystitis
DM2 are more susceptible to resistant bacteria
Takayasu arteritis
Granulomatous (giant cell) inflammation of media and adventitia of large elastic arteries. Asian women. Female-to-male ratio of 10:1. Most often affects thoracic aorta and its proximal branches and pulmonary arteries.
Unopposed estrogen effect
Can lead to carcinoma in post-menopausal females
scar formation
Myofibroblasts-> type 3 collagen replaced by type 1 collagen (except keloid: collagen 3 remant)
TTP
Pentad: FAT RN Fever Anemia (microangiopathic hemolytic) Thrombocytopenia (petechiae, mucocutaneous bleed) Renal dysfunction / uremia Neuro sxs (HA, CVA, AMS) Primary: MC idiopathic AI --> Ab vs ADAMST13 Secondary: malignancy, HIV Dx: thrombocytopenia, NORMAL coags (same as in HUS; DIC will also have abn coags) hemolytic anemia: incr retic, schistocytes, incr LDH, incr INdirect bili, decr haptoglobin Tx: Plasmapheresis Tx/oC, steroids DON'T do platelet transfusion (more thrombi formation)
Bcl-2 overexpression
follicular lymphoma t(14;18) inhibits apoptosis- lymphoma cells survive
Hageman factor
Factor XII Converts pre-kalikrein to kalikrein Kalikrein is responsible for producing bradykinin
Section 3
(31 cards)