General Pathology
Study online at https://quizlet.com/_21ft41
1. Causes of cellu- hypoxia, chemical and physical injury, infections, immuno-
lar injury logic reactions, genetic disorders, nutritional or vitamin
deficiencies, aging
2. Hypoxia - lack of oxygen
- can result from loss of blood supply, decrease in oxy-
gen-carrying capacity of the blood due to anemia or car-
bon monoxide poisoning and poisoning of the enzymes of
oxidative phosphorylation by toxins
3. Infections - viruses invade the cells, commander synthetic machin-
ery and may release proteins that are toxic to the host
- bacteria release exotoxins (phospholipase) or produce
endotoxins (lipopolysaccharides) from their cell walls
4. Cellular changes - cloudy swelling from cell membrane disruption, mem-
during injury brane damage, endoplasmic reticulum swelling, mitochon-
drial swelling, lysosomal swelling, nuclear changes, apop-
tosis
5. coagulation - most common form of necrosis in cells without large
necrosis numbers of lysosomes
- occurs after sudden ischemia, thermal injury, or toxin
injury
- heart is most common example
6. Liquefactive - results from cellular destruction by hydrolytic enzymes
necrosis involved in autolysis and heterolysis
- occurs in brain infarcts and pancreatic necrosis
- called suppuration and resulting fluid is pus
7. Caseous necro- - combination of liquefactive and coagulation necrosis
sis - produces issue hat is grossly soft, friable, and cheese
like
- characteristic of TB, some granulomas and fungal infec-
tions
8. Enzymatic fat caused by the action of lipase on fatty tissue
necrosis
1 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
9. Gummatous - seen in the late stage of syphilis
necrosis - has a gelatinous appearance
10. Apoptosis -programmed cell death characterized by chromatin con-
densation, breakdown of DNA into nucleosome sized frag-
ments, RNA and protein synthesis, minimal inflammatory
response
11. Calcification - dystrophic calcification appears in areas of necrosis due
to precipitation of calcium phosphate in low pH
- metastatic calcification caused by hypercalcemia is due
to precipitate of supersaturated solutions of calcium phos-
phate
12. Cell types that nerve, cardiac, skeletal and muscle cells
cannot exhibit
hyperplasia
13. transudate - comparatively protein free fluid into extravascular space
that leaks into the extravascular space
- usually due to pressure differences between the vascu-
lature and intracellular space
14. exudate - fluid containing proteins, cells and plasma that leads into
the extravascular space
- usually due to increased permeability of endothelial cell
barriers and chemotactic factors attracting WBC
15. Vascular -transient vasoconstriction followed by vasodilation
changes in - increased vascular permeability as the result of endothe-
inflammation lial cell, transiently affecting venues
- chemical mediators of increased vascular permeability
include the vasoactive amines, histamine and serotonin
- complement component C3a and C5a are anaphylatox-
ins and cause the release of more vasoactive amines
- slowing of circulation due to increased blood viscosity
from extravasation of fluid allows the leukocytes to mi-
grate, roll and then adhere to endothelium
16. Chemotaxis
2 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
- attracting of cells toward a chemical mediator that is
released in the area of inflammation
- two most important chemotactic factors for neutrophils
are IL-8 and C5a
17. Phagocytosis - neutrophils and macrophages engulf and destroy foreign
material
- particle to be phagocytosed can be coated with serum
opsonins, such as IgG and C3b
- facilitate phagocytosis by allowing the particle to bind to
complement receptor 1 (CR1) and the Fc receptor on the
surface of the cell
- phagocytic vacuole fuses with a lysosome
- lysosome disgorges its content into the fused vacuole
-particle is then broken down via the action of reactive
oxygen species, acid hydrolyses, neutral protease and
lysozymes
18. Cyclooxygenase - leads to prostaglandin formation
pathway - certain prostaglandins mediate vasodilation and pain
- Aspirin and NSAIDs inhibit prostaglandin synthesis
- Corticosteroids prevent the transformation of phospho-
lipid into arachidonic acid by inhibiting the enzyme phos-
pholipase and inhibit both pathways
19. Lipoxygenase - leads to leukotriene synthesis
pathway - certain leukotrienes are involved in chemotaxis and in-
creasing vascular permeability
20. main cellular - acute: neutrophil
component of - chronic: monocyte-macrophage
chronic and
acute inflamma-
tion
21. Mono- - secrete enzymes such as neutral proteases and acid
cyte-macrophage hydrolyses
- activated duo has the capability within a few days of
secreting various plasma proteins, such as complement
components C1- C5, reactive metabolites of oxygen ,
3 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
leukotrienes, prostaglandins, cytokines (IL-1, TNF), as
well as various growth factors
-
22. Chronic inflam- - primarily mononuclear with proliferation and maturation
mation cellular of monocytes into macrophages
infiltrate - fibroblasts are recruited and proliferate, small vessels
proliferate and subsequent collagen deposition results in
fibrosis and scarring
- lymphocytes, plasma cells, and eosinophils are also
present in sites of chronic inflammation
23. Chronic granu- - occurs if a substance cannot be removed (asbestos,
lomatous inflam- silica, tuberculous bacilli)
mation - most frequently seen in tuberculosis, sarcoid, or with
foreign bodies
- granulomas are also seen in Crohn disease, gout,
rheumatoid arthritis and in fungal and parasitic infection
24. labile cells - includes surface epithelial cells (such as those lining the
skin), oral cavity, vagina, cervix, hematopoietic, splenic
and lymphoid cells
- regenerate throughout life
25. stable cells - replicate at low levels throughout life but are dormant
unless stimulated by some event
- liver, pancreas, kidney, vascular endothelium and smooth
muscle
26. Replacement - replacement of a damaged area by CT involves migration
and proliferation of fibroblasts into the damaged area,
deposition of extracellular matrix, formation of new blood
vessels, and reorganization of the connective tissue into a
scar
27. Wound healing - involves collagen synthesis and degradation
- growth factors (such as PDGF, TGF a and B, FGF) and
cytokines (IL-1 and TNF) stimulate collagen synthesis
28.
4 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
Primary union by - little surrounding tissue damage, wound is clean, and
first intention wound edges are closely approximated
- wounds fill with clotted blood, forming a scab
- neutrophils line the wound edge within 24 hours
- thin epithelial cover appears within 24-48 hours
- macrophages replace neutrophils and the granulation
tissue fills in the wound
- by day 5, collagen fibers laid down by fibroblasts cross
the incision following fibrin
- full maturation of a scar requires up to 1 year
29. Secondary union - occurs when the two skin edges are not in contact
by secondary in- - requires larger amounts of granulation tissue to fill in the
tention defect
- mediated by myofibroblasts
30. Causes of edema - increased hydrostatic pressure
- hypoalbuminemia- decreased colloid osmotic pressure
- lymphatic obstruction
- renal retention of salt and water
31. Thrombus facili- - exposure of tissue factor from injured cells activates
tation factor VII
- exposure of thrombogenic sub endothelial collagen acti-
vates factor XII
- platelets deposit and aggregate due to collagen expo-
sure and generation of thrombi
32. Thrombus inhibi- - increased prostacyclin (PGI2) and nitric (NO2) inhibit
tion platelet aggregation
- synthesis of plasminogen activator promotes fibrinolytic
activity
33. Thrombogenesis - endothelial injury exposes sub endothelial collagen
- platelets adhere, requiring von Willebrand factor and
factor VIII; stimulation of the clotting cascade requires
thromboplastin release from the endothelium
- plates degranulate, releasing ADP and fibrinogen
- platelets aggregate forming a temporary hemostatic
plug.
5 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
- Thrombus retracts and organizes with proliferation of
capillaries, fibroblasts and infiltration by neutrophils and
macrophages
- canalization or formation or a new path for blood flow
through the thrombus is accomplished by endothelial
growth over the surface and through the thrombus, result-
ing in incorporation of the thrombus into the vessel
34. Thrombus mor- - head of the thrombus is composed of platelets and fibrin
phology - tail of the thrombus grows downstream and consists of
red blood cells and fibrin
- Lines of Zahn are alternating layers of fibrin, platelets,
and RBCs within the tail of the thrombus
35. mural thrombi adherent to the vessel wall and affect large vessels
36. occlusive throm- restrict blood flow most frequently in coronary, cerebral,
bi femoral, iliac, popliteal and mesenteric vessels
- often overly a plaque
- arterial thrombi are often occlusive
- venous thrombi rarely occlude vessels and tend to em-
bolus
37. Disseminated in- - begins with extensive formation of thrombi in the mi-
travascular coag- crocirculation causing consumption of components nec-
ulation (DIC) essary for hemostasis and activation of the fibrinolytic
pathways, leading to a bleeding diathesis
- associated with amniotic fluid emboli, preeclampsia,
gram negative sepsis, cancer, trauma, surgery and burns
38. embolism - occlusion of a vessel by a mass that are often thrombi
that have dislodged from their site for formation
- pulmonary emboli often come from deep vein trombones
int he lower legs
- systemic emboli are formed in the arterial circulation
- paradoxical emboli cross over from the right side to
the left side of the heart through septal defects and gain
access to the systemic circulation
39. shock
6 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
- characterized by vascular collapse
- greatly decreased perfusion of both cells and tissue due
to reduced blood volume, cardiac output or vascular tone
- cellular injury is initially reversible but can result in cell
death
- cardiogenic shock: results from MI
- hypovolemic shock: results from reduced blood volume
- septic shock: bacteria infection which causes the release
of vasodilatory mediators into the vasculature
- neurogenic shock results from anesthesia or spinal cord
injury
40. Anaplasia loss of cell differentiation and tissue organization
41. Metaplasia replacement of one type of adult cell or tissue by another
not normally present in that site
42. Desmoplasia excessive fibrous tissue formation in tumor stroma
43. Dysplasia abnormal atypical cellular proliferation
44. Carcinoma malignant tumor of epithelium
45. Carcinoma in situ malignant tumor of epithelium which shows no invasion of
underlying tissue
46. Sarcoma non epithelial (mesenchymal) malignant tumor
47. Alpha-fetopro- tumor marker that is expressed in hepatoma, embryonal
tein (AFP) cell tumor of the testis
48. Carcinoembryon- - seen in any tumor derived from the guy epithelium or
ic antigen (CEA) intra-abdominal inflammation
- also elevated in smokers in the absence of a tumor
49. beta human - elevated in choriocarcinoma, hydatidiform mole and ger-
chorionic go- minoma
nadotropin (hCG) - also elevated in pregnancy and is the base of a pregnan-
cy test
7 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
50. prostatic acid elevations seen in prostate tumors extending outside the
phosphatase capsule of the prostate
51. CA-125 elevated in ovarian cancer
52. Carcinoid tumors may produce 5-HIAA, a metabolite of serotonin
53. Oat cell tumors produce ADH or ACTH
of the lung
54. squamous cell sometimes produce hypercalcemia by releasing a
carcinoma of the PTH-like molecule
lung
55. Lymphatic epithelial carcinoma
spread most
common route of
spread for...
56. hematogenous in the lungs
spread causes
metastasis most
often...
57. somatic mutation structural changes at the gene or chromosomal level that
occur spontaneously or in response to carcinogens
58. Aberrent differ- cancer cells occurs in the absence of structural changes,
entiation indicating abnormalities of gene regulation affecting
growth and differentiation
59. Viral infection integration of viral DNA into the host genome may lead to
malignant transformation
60. direct acting mutagens that cause cancer directly, usually by modifying
chemical car- DNA
cinogens
61. procarcinogens - require metabolic conversion to form active carcinogens
- require initiating agent and a promotor
8 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
- exposure to initiator induces an irreversible cellular
change which allows the cells to form a tumor
62. UV radiation - produces pyrimidine dimers in DNA leading to transcrip-
tional errors
63. Ionizing radiation - by x rays and gamma rays causes chain breaks in nucleic
acids
64. RNA oncogenic - produce a viral coded reverse transcriptase allowing
viruses synthesis of DNA from a viral RNA template
- DNA can then be integrated into the host genome
65. DNA oncogenic - papovirus, adenovirus, herpesvirus
viruses
66. Lead poisoning - due to chronic gradual accumulation
(Plumbism) - lead inhibits enzymes involved in hemoglobin synthesis
and inhibits adenyl cyclase activity in the brain and pan-
creas
- features: anemia (hypochromic and microcytic), en-
cephalopathy, peripheral neuropathy, renal lesions, ab-
dominal colic, lead lines)
67. Carbon monox- - combines with hemoglobin to form carboxyhemoglobin
ide poisoning which cannot carry oxygen
- affinity of carbon monoxide for hemoglobin is more than
200 times greater than that of oxygen
- coma and death ensure when 60% of hemoglobin is
carboxyhemoglobin
68. Acetaminophen - accidental childhood poisonings and suicide attempts
toxicity - causes severe centrilobular hepatic necrosis
- hepatic failure is not evident until 2-6 days after ingestion
69. salicylates - initially direct respiratory stimulation produces a respira-
tory alkalosis
- metabolic effects of salicylate cause a metabolic acidosis
- vomiting comlicates fluid and electrolyte disturbances
9 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
and fatalities are most often due to dehydration and hy-
pokalemia
70. Mercury poison- - rare
ing - mercury initiates enzymes and damages cell mem-
branes
- most commonly absorbed as a gas through the lungs
- acute: necrosis of gastric and colonic epithelium acute
renal tubular necrosis and possibly cerebral edema
- chronic: excess salivation, gingivitis, gastritis, renal tubu-
lar basement membrane thickening, and cerebral and
cerebellar atrophy
71. Marfan syn- - CT abnormality
drome - mostly AD
- arachnodactyly (long spider like fingers), tall stature, liga-
mentous laxity, sublimed lens, dissecting aorta aneurysm,
mitral valve prolapse, and a short lfie span often as a result
of ruptured aorta
72. Familial polypo- - thousands of edematous polyps appear starting in the
sis coli (FPC) coloretum and spreading up to the colon
- Gardner syndrome has colonic polyps
73. Adult polycystic renal cysts, increasing with age, causing progressively
kidney disease enlarged kidneys, hypertension, renal failure and anemia
74. Huntington Dis- - progressive neurologic disorder with involuntary choreic
ease movements, cognitive impairment, and changes in behav-
ior
- associated with degeneration of the caudate nucleus
75. Wilm tumor - embryonal tumor, one of the most common solid tumors
in children under age 4, involving one or both kidneys
and characterized by primitive mesenchyme and imma-
ture tubules
76. Glycogen stor- - autosomal recessive
age diseases - Type I (von Gierke disease)- caused by an enzyme defect
in G6P
10 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
- Type II (Pompe Disease)- an enzyme defect in lysosomal
a1-4-glucosidase which affects all organs
- Type III due to an enzyme defect in glycogen debranching
enzymes which affects all organs
- Type IV due to an enzyme defect in branching enzymes
which affects all organs
- Type V (McArdle disease) due to a defect in striated
muscle phosphorylase which specifically affects striated
muscle
- Type VI is due to a defect in liver phosphorylase which
affects only the liver
77. Mucopolysaccha- - lysosomal enzymatic defects lead to the accumulation of
ridoses glycosaminoglycans throughout the body and the brain
78. Sphingolipidos- - Tay Sachs disease
es - Gaucher disease
- Riemann-Pick disease
79. Tay Sachs dis- - Sphingolipidoses disease
ease - due to a deficiency of hexosaminiase A which leads to
an accusation of Gm2 ganglioside, affecting all organs
but predominantly the brain, retina and peripheral nervous
system
- onset begins at 6 months of age and progressive mental,
motor, and visual deterioration leads to death by age 3
- common among Ashkenazic jews
80. Gaucher disease - Sphingolipidoses disease
- due to defects in B-glucocerebrosidase leading to ac-
cumulation of glucoverebroside which affects reticuloen-
dothelial cells and the CNS
81. Riemann-Pick - defect in sphinogmyelinase that leads to an accumulation
disease of sphingomyelin and cholesterol in a variety of organs
82. Phenylketronuria - disorder from an absence of phenylalanine hydroxylase
which halts the conversion of phenylalanine to tyrosine
and there are elevated levels of phenylalanine in the blood
- babies begin to develop an abnormal pattern on EEG
11 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
with seizures and mental retardation
- minimal melanin production with light skin, hair and blue
eyes
- urine has a musty odor
- patients must have a diet free of phenylalanine and must
supplement with tyrosine
83. Galactosemia - results from two enzyme deficiencies
- Galactokinase deficiency- benign disease that results in
cataract formation
- Galactose-1-phosphate uridytransferase deficiency- se-
vere form of galactosemia
84. Albinism - enzyme deficiency that prevents melanin synthesis from
tyrosine
- could be limited to the eye or total body
- causes premature wrinkling and a tendency to develop
solar keratosis, as well as basal cell, squamous cell, and
melanocyte carcinomas
85. Cystic fibrosis - abnormality in chloride channels
- hyperviscous secretions lead to ileum obstruction and
patients suffer from steatorrhea, pulmonary obstruction
and pneumonia
86. Alpha-1- trypsin - progressive emphysema of the lower lobes of the lungs
deficiency - smoking emphysema causes disease in the upper lobes
87. Down syndrome - trisomy 21
- defect increases with maternal age
- severe mental retardation, facies, dysplastic ears, hypo-
tonia, etc.
- increased incidence of ventricular septal defect (VSD),
acute lymphoblastic leukemia (ALL), and neurologic
changes similar to those of Alzheimer disease
88. Edward syn- - trisomy 18
drome - severe mental retardation, VSD, micrognathia, rock-
er-bottom feet, low set ears
- average life span is 2-3 months
12 / 13
General Pathology
Study online at https://quizlet.com/_21ft41
89. Patau syndrome - trisomy 13
- microcephaly, severe mental retardation, cleft lip and
palate, VSD, dextrocardia, and polydactyly
- death typically in the neonatal period
90. Cri du chat syn- - deleting of the short arm of chromosome 5
drome - patient exhibits a cat like cry for up to 1 year of age,
severe mental retardation and microcephaly
- in one four patients have a VSD. May live to adulthood
91. DiGeorge syn- - caused by absence of parathyroids and thymus which
drome results in cardiovascular abnormalities and low set ears
- deletion of chromosome 22q11
92. Klinefelter syn- - most common carotene is 47, XXY
drome - includes testicular atrophy, sterility, a small penis, failure
of development of male secondary sexual characteristics
and gynecomastia
93. Turner syndrome - typically 45, XO
- may be subtle in mosaics
- edema during infancy, web neck, short stature, broad
chest with wide-spaced nipples, low hairline, primary
amenorrhea, infertility, coarctation of the aorta, streak
oversee, abnormal intelligence
13 / 13
