Path- Test 1

increase in size of cells, not in number of cells

• wasting of tissues
• lessened function

increase in number of cells

incomplete development of an organ/tissue

reversible replacement of one cell type with another

type of metaplasia

change in the structure of cells and orientation to eachother

defective development or absence of an organ/tissue

• Abnormal tissue growth wtih loss of cell orientation, shape, and size
• BAD!!!- pre-cancerous

• when the limits of adaptive resonse are exceeded
• reversible- stress/stimuli persist for a short time
• irreversible- stress/stimuli persist or is severe

• cell swelling
• blebs
• ribosome detachment from ER
• swelling of mitochondria
• nuclear chromatin clumping
• fatty change

• plasma membrane damage
• Ca influx
• nuclear condensation, fragmentation, and nucleus dissolution
• lysosome swelling and rupture
• calcification

• cell death
• cells swell and then burst
• common after ischemia

• cell death
• programmed
• cell shrinkage

• type of cell necrosis
• leakage of cell content

• enlarged cell
• nuclear condensation
• plasma membrane disruption
• cell contents enzymatically digested
• inflammation is frequent
• pathologic

• smaller cell
• nucleosome fragments
• cell contents intact
• no inflammation
• physiological

• O2 deprivation (hypoxia, Ischemia)
• Physical agents
• Chemical agents/drugs
• Infectious agents
• Immunologic agents
• Genetic derangements
• Nutritional imbalances

• ATP depletion
• Mitochondrial damage (mitochondrial permiability transition)
• high intracellular Ca+2
• O2 deprivation and O2 derived free radicals
• defects in membrane permiability

leakage of cytochrome C into cytosol

• initiated by many things
• induces cell injury
• free radical degredation
• reperfusion after anoxia induces free radicals

• hydrogen peroxide
• superoxide ion
• hydroxyl radical
• nitric oxide

• something that you ingest that is directly bad for you
• ex: heavy metals

• something ingested that the body turns into something bad
• ex: CCl4

drugs which are toxic if taken in large amounts

• induction of SER- hypertrophy
• lysosomal catabolism
• mitochondrial alterations
• cytoskeletal abnormalities
• heat shock proteins

• heterophagy- taking things in
• autophagy- damage from within

• hypertrophy
• atrophy
• increase size
• abnormal cristae

• tranport
• cell architecture
• cell-cell signaling
• cell strength
• cell mobility
• phagocytosis

• protein folding
• disaggregation
• chaperones

• heart, liver, kideny
• caused by protein denaturation
• hypoxic death
• maintains cells architecture

• brain
• caused by enzymatic digestion
• bacterial infection
• stroke
• no cell architecture

• limbs, GI tract
• loss of blood, coagulative necrosis
• wet gangrene
• coagulative + liquifactive bacterial action
• dry gangrene
• frost bite

• tuberculosis
• form of coagulative necrosis
• cheesey-white appearence
• no tissue architecture

• area of fat destrution
• pancreas
• fat soaponification- chalky

• embryogenesis
• hormone induction
• cell mediated death
• regulation of cells
• atrophy

• apoptosis shows laddered
• necrosis shows smeared

cytochrome C come loose becuase of mitochondrial permiability transmission, cytochromes activate caspase and apoptosis

• FAS ligand causes grouping of death domains
• activates caspases

• abnormal metabolism
• mutations causing alterations in protein folding and transport
• deficiency in enzymes
• inability to degregade phagocytosed particles

• exogenous- outside
• endogenous- inside

• steatosis (fatty change)- abnormal triglyceride accumulation
• liver heart kidney

• alcoholdehydrogenase
• alcohols -> ketones

• foamy
• macrophage eating

• reabsorption droplets- kidenys
• russell bodies- excess protein synthesis
• amyloidosis- aggregation of abnormal proteins

• transparent
• not specific pattern

clear vaccules in cytoplasm

• exogenous- coal, tattoos
• endogenous- lipofusion, melanin, hemosiderin

• occurs in dying tissues
• normal serum calcium
• no calcium metabolism pathology

• in normal tissues
• elecated serum calcium -> hyperparathyroidism

• increased PTH
• bone destruction
• vitamin D
• renal failure

• lucencies in bone
• especially in long bones

reaction of blood vessels causing accumulation of fluid and leukocytes in extravascular tissues

• eliminates microbes
• eleiminates narcotic cells
• prepares for tissue repair

• ~50%
• first responder
• acute inflammation
• forms pus

• ~30%
• chronic inflammation
• cell mediated responders

• ~5%
• long lived
• macrophage in tissue

• ~3%
• parasites and allergies

• <1%
• allergy and antigen
• histamine released

Never Let Monkeys Eat Bananas

• rapid, short lived
• edema
• mainly neutrophils

• slow onset, long lived
• new blood vessels
• fibrosis
• tissue necrosis
• macrophages and lymphocytes

• vasodilation
• edema
• leukocyte accumulation

• rouleaux formation of RBCs
• pushes WBCs to periphery
• adhesion
• pavementing

• margination to periphery
• pavementing
• -rolling
• -p- selectin and e-selectin
• -tight binding by integrins (ICAM-1) and adhesion (TNF and IL-1)
• extravascular migration-cytokines

• recognition and attachment of microbe
• engulfment
• fuses with lysosome (secondary phagolysosome)
• killing and degredation

• cytoplasmic oxidase
• active oxidase
• membrane oxidase

• plasma derived
• cell derived
• biochemically diverse
• multifunctional

• cell derived mediator
• biogenic amine
• stimulates retraction of endothelial cells of venules ( increased permeability)
• short action
• inactivated by histaminase
• (vit C stabalizes mast cells)

• plasma protein
• increases permiability of venous system
• produces pain

• seratonin
• prostaglandins
• leukotrienes
• nitric oxide
• cytokines
• complement

• plasma proteins from the liver
• circulate in inactive form
• activation thru pathway (C3b)
• forms active fragments, intermediate complexes, terminal membrane attack complex

• opsonization
• anaphylaxis
• chemotaxis
• cell lysis

• attachement to neutrophil (FC and C3b r/cs)
• engulf bacteria
• form phagocytic vaccule
• degranulation of granules

• derived from phospholipids
• 2 pathways- lipoxygenase and cyclooxygenase

• arachadonic acid derivative
• chemotaxis, vascular permeability
• bronchospasm

• arachadonic acid derivative
• vasodilation, inhibits monocyte chemotaxis

• arachadonic acid derivative
• platelet aggregation
• thrombosis

• arachadonic acid derivative
• oppses thromboxane

• arachadonic acid derivative
• smooth muscle contractions

• acute- fever, increased sleep, decreased apettite, increased neutrophils
• endothelial effects- increased leukocyte adherence and procoagulent and IL-1, decreased anticoagulent
• fibroblast- increased proliferation, collagen synthesis, PGE
• Leukocyte effects- increased cytokines

• macrophage eat bacteria
• TNF and IL-1 to hypothalamus
• increase temperature

• causes platelet adhesion
• reduced leukocyte adhesion
• smooth muscle vasculature relaxation- vasodilation
• activated by Ca influx

• activated by cytokines and TNF
• acts in macrophage
• to microbe or endothelium of nearby vasculature

• secondary
• smaller

• primary
• larger

• resolution
• pus formation
• fibrosis
• chronif inflammation = FIBROSIS!!!

• return to normal vascular permiability
• drain edema thru lymphatics and macrophages (pinocytosis)
• phagocytosis of apoptotic neutorphils and necrotic debris
• disposal of macrophages
• macrophage secrete growth factor

• early stage fluid build-up (usually under skin)
• jt swelliung
• eczema
• skin burn
• infection of skin vesicles
• effusion- if secreted from peritoneal, pleural, pericardial linings

fibrin deposits

pus build-up

neutrophil apoptosis not cleaned up by macrophages

encapsulated pus

connection to surface

opening/connection without infectious material

• lymphocytes
• macrophages
• multinucleated giant cells
• scar tissue formation

bone marrow -> blood (monocyte) -> tissue (macrophage)

• fibrosis
• growth factor
• tissue injury- nitric oxides

• recruited via chemotaxis
• division
• immobilization by cytokines and oxidized lipids
• CAUSES AGGREGATION

• activation of INF-gama
• presents to T cells
• recruits other cells
• activated T cell recruitment

• area of organ removed
• remaining organ hypertrophies to make up for removed portion

• priming- cytokines, TNF
• proliferation- growth factors
• growth inhibition

• translation
• helix formation
• propeptide cleavage
• collagen!

2 glycoprotein chains held together by disulfide bonds

• endothelial precursor cells from bone marrow
• angiogenesis from pre-existing vessels

• zinc dependent
• regulate growth factors
• inhibit steroids
• activation of zymogens

• edges next to each other
• little tissue loss
• minimal scaring
• closure at initial evaluation

• wound granulates!
• wound is packed
• broad scarslow healing

• delayed primary intention
• cleaned and observed
• left open

excess collagen deposition causing a raised scar

• NOT equal to a tumor
• new growth

• equal to neoplasia
• swelling/mass formation

tissue invation/crab-like

swelling

• hyperplasia
• metaplasia
• dysplasia

• anaplasia
• neoplasia
• desmoplasia

• slow
• expansive/encapsulated
• no metastases
• smooth
• no necrosis or hemorrhage
• looks like normal tissue
• normal nuclei
• few mitosis

• fast
• invasive/metastases
• no capsule
• necrosis and hemorrhage
• does not look like normal tissue
• pleomorphic nuclei
• many, irregular mitoses

• invading other tissues
• thru: lymphatics, blood, body cavities, intraepithelial

• hematogenous
• primary tumor creates a clone
• clone proliferates and transportates in blood
• clot= embolization
• invasion into new tissue
• makes new tumor

• transcoelomic spread
• direct seeding of cavity by cells in that cavity already

tumor cells infiltrate between epithelial cells

10mm

• chemotactis
• fibroblast growth factor

• benigh= cell origin + oma
• malignant = cell origin + sarcoma

• benign= name + oma
• malignant= name + carcinoma

named after the person that found them

lymph node tumor

bone tumor

skin, AIDS

• clinical assessment
• extent of spread
• better rating than grading

histological assessment

• quantitative
• cancer cell less differentiated, require less oxygen, fewer mitochondria and sepecialized enzymes

• aquiring embryonic/fetal features
• fetal protein- liver cells make alpha-fetoprotein
• embryogenic glycoproteins- carcinoembryonic antigen- large intestines

• lack of contact inhibition
• anchorage independant growth
• can be passaged indefinitely

• exogenous: chemical, physical, and biological
• endogenous: oncogenes, tumor suppressor cells

• local action
• site of digestion/absorption
• metabolic action- excretion

• BAD!
• residual smoke particles left around after smoking, linger forever!

• 1. initiation/absorption (irreversible changes)
• 2. promotion (proliferates by promoters)
• 3. conversion (new cell type, self-proliferates)
• 4. progression (new genetic feature)
• 5. colonal expansion

• UV light
• x rays
• radioactive isotopes
• atomoic bomb

• integration of viral DNA
• transduction (acute transforming RNA viruses- FORM ONCOGENES!!)
• insertion (slow transforming RNA, insert into genome- ACTIVATE ONCOGENES!)

• Human viral carcinogenes
• invasive
• cervical carcinoma 16, 18!!!!
• penile, anal carcinomas

• Human viral carcinogenes
• burkitt's lymphoma
• nasopharyngeal carcinoma (sun)

• Human viral carcinogenes
• liver cancer

• Human viral carcinogenes
• associated with herpesvirus
• skin cancer
• AIDS

• Human viral carcinogenes
• lymphoma virus
• HIV
• adult
• RNA virus

• viral oncogenes
• cellular oncogenes
• proto-oncogenes (inactive)
• ongogene is active form, cancer-inducing
• only needs damage to 1 allele to cause cancer

• point mutation
• gene amplification
• chromosomal rearrangement
• insertion of viral oncogene

• protective against oncogenes
• if BOTH alleles are lost, can not protect = CaNcEr!!!

• neurofibromastosis 1
• familial adenomatous polyposis coli
• wilms tumor
• xeoderma pigmentosum
• chromosomal fragility

• thumors involute spontaneously to normal
• BCG for bladder cancer
• tumor vaccines- for melanoas, renal cells

NOT primary diagnostic tool

• local- diminished funtion, space occupying
• systemic- cachexia, anorexia, paraneoplastic syndromes

neoplaias mimicing nearby normal cells

• Change in bowel habits
• A sore that doesnt heal
• Unusual bleeding/discharge
• Thickening/lump
• Indigestion/difficulty swallowing
• Obvious change in wart or mole
• Nagging cough/hoarsness of voice

• type
• location
• grade
• stage
• host immune status
• sensitivity to therapy

• papillary adenocarcinoma of the thyroid
• ovary papillary cystadenocarcinoma
• menigngioma
• malignant mesothelioma

• laminated concentric calcific spheres
• form infarct/calcification of papillae tips
• calcification of intralymphatic tumor thrombi

# of new cases in a population over a time

# of cases in a population over a given time

# of deaths in a population over time

# of people having a disease

• causes lung cancer
• Sx: cough

• breast cancer
• sx: lump

• colon cancer
• sx: blood in stool

• cervical cancer
• sx: vaginal bleeding

• uterine cancer
• sx: vaginal bleeding

• skin cancer
• sx: skin lesion

• prostate cancer
• sx: dysuria

• breast
• lung/bronchi
• colorectal

• prostate
• long/bronchi
• colorectal

• lung/bronchi
• breast
• colorectal

• lung/bronchi
• prostate
• colorectal

liver, lungs, brain, bone

colon, somtach, pancreas, breast, lung

breat, GI, kidney, melanoma, lymphoma, leukemia

lung, breast, kidney, skin, GI

breast, prostate

• righ in cells
• inflammation

• few cells
• ultra-filtrate
• specific gravity < 1.012

• increased hydrostatic pressure and wall permiabilitydecreased oncotic pressure
• lymphatic obstrution

• increased permeability
• hyperemia

• hypertension
• increased venous back pressure

• proteinuria
• decreased protein synthesis

• b/c tumor/chronic inflammation
• elephatitis

• active: dilation of arterioles
• passive: venous back pressure

• edema
• RBC extravasation into alveoli
• anoxia
• pulmonary fibrosis
• hemosiderin accumolatino b/c of macrophages

• blood loss
• hypovolemic shock
• exsanguination
• death!!

• hematoma-compression of tissue from blood
• intracerebral hemorrhage- stroke/death
• chronic hemorrhage- slow blood loss, iron defiency anemia

• <500 ml- homeostatic compensation
• 1000-1500ml- circulatory shock
• >1500- death

• clotting!!
• mass of RBCs and fibrin

• coagulation factors
• platelets
• endothelial cells

• wall defect covered with fibrin and platelets
• fibrin anchors RBCs - nascent thrombosis
• full thromus of RBCs and fibrin

• intramural heart thrombi
• valvular heart thrombi
• arterial thrombi
• venous thrombi
• microvascular thrombi

• virchows tirad
• 1. stasis
• 2. hypercoagulability
• 3. endothelial damage
• can lead to pulmonary embolism

• infarct
• lysis and reperfusion
• organization (rerouting blood vessles)
• recanalization- emobolization -> infarct

• blockage!!
• thromboemboli
• liquid emboli
• gaseous emboli
• solid particle emboli
• amniotic fluid emboli