Pathology Secrets

1. Cell volume depends on function of cell membrane = semipermeable with proper amount of ATP
2. Cell injury increased [Ca2+] in the hyaloplasm (cytosol)
3. Cell death Nuclear changes
   1. Pyknosis: chromatin clumping and shrinking with increased basophilia
   2. Karyolysis: fading of chromatin material
   3. Karyorrhexis: fragmentation of chromatin
4. Necrosis (death of cells/tissues) is most often caused by ischemia or the action of toxic substances and infectious pathogens
5. Apoptosis (programmed cell death) can also be caused by exogenous factors (i.e., viruses, drugs)
6. Hyperplasia: increase in cell # increase in tissue/organ size; Hypertrophy: increase in cell size
7. Inflammation involves the following responses…
   1. Vascular
   2. Cellular
   3. Humoral
8. Mediators of inflammation are produced by endothelial cells & inflammatory cells, and the liver (main source of plasma proteins)
9. Hageman factor (clotting factor XII) activates the following systems…
   1. Kinin
   2. Complement
   3. Clotting
   4. Fibrinolytic system
10. Cytokines: are multifunctional polypeptides that modulate the function of other cells
11. Polymorphonuclear leukocytes: principal cells of ACUTE INFLAMMATION
    1. Lymphocytes, macrophages, & plasma cells are principal cell of CHRONIC INFLAMMATION
12. Edema: accumulation of fluid in the interstitial spaces and body cavities
13. Thrombosis: pathologic coagulation of circulating blood inside intact vascular spaces
14. Virchow Triad: 3 factors that promote thrombosis
    1. Changes in the vessel wall
    2. Changes in bloodflow
    3. Changes in the composition of blood
15. Most common form of embolism = thromboembolism
16. Disseminated Intravascular Coagulation (DIC): a form of thrombosis and small blood vessels associated with uncontrollable bleeding caused by consumption of coagulation factors in the blood
17. Infarct: an area of ischemic necrosis that is usually caused by occlusion of vessels or hypoperfusion of tissues (w/ blood)
18. Shock: a condition caused by hypoperfusion of tissues (w/ blood); can be classified as…
    1. Cardiogenic
    2. Hypovolemic
    3. Distributive (related to vasodilation)
    4. Septic
    5. Neurogenic
19. Hypersensitivity reactions: involve cell and tissue injury caused by antibodies or products of activated T lymphocytes
20. Autoimmune diseases: are based on the immune reaction against self-antigens
21. Acquired immunodeficiency syndrome (AIDS): an infectious disease caused by the human immunodeficiency virus (HIV)
    1. Characterized by profound suppression of the immune system and susceptibility to infections, neurologic disorders, and malignancies
22. Cancer = malignant tumors
23. Main groups of malignant tumors are:
    1. Carcinomas
    2. Sarcomas
    3. Lymphomas
    4. Gliomas
24. Carcinogens: are cancer-inducing factors that include physical forces, chemicals, viruses, and endogenous oncogenes
25. Reactions of the host to the tumor can be LOCAL or SYSTEMIC, and include various inflammatory, and immune, hormonal, circulatory, and neural processes
26. Teratogens: are chemical, physical, or biological agents capable of inducing developmental abnormalities and a fetus
27. Down syndrome: the most common autosomal chromosome abnormality
    1. Characterized by mental deficiency and characteristic facial and somatic features
28. Laws of Mendelian Genetics: states that single gene defects are inherited as…
    1. Autosomal dominant,
    2. Autosomal recessive,
    3. Sex-linked dominant, or
    4. Sex-linked recessive
29. Atherosclerosis: a multi-factorial disease that predominately affects older people, but it can be accelerated by…
    1. Hypertension
    2. Hyperlipidemia
    3. Smoking
30. Arterial hypertension: any mobile factorial disease of unknown etiology, but it can also be secondary to renal, endocrine, vascular, and neurologic diseases
31. Vasculitis: an inflammation of vessels, is most often immunologically mediated
32. Aneurysms: localized dilations of the arteries most often caused by atherosclerosis and hypertension
33. Cardiac failure may be caused by…
    1. Inherited heart disease
    2. Extracardiac causes
       1. Pressure overload (in hypertension)
       2. Volume overload (in renal water retention)
34. Coronary heart disease:
    1. Most common cause of cardiac failure
    2. Most common cause of death in the U.S.
35. Myocardial Infarction (MI): “heart attack” – represents an area of myocardial cell necrosis caused by ischemia
36. Most common complication of an MI = Arrhythmia
37. Most common cause of Endocarditis = bacteria
38. Cardiomyopathy: (3 forms)
    1. Dilated
    2. Hypertrophic
    3. Restrictive
39. Ventricular Septal Defect (VSD): most common noncyanotic congenital heart disease
    1. Characterized by a L R shunt
40. Tetralogy of Fallot: most common cyanotic congenital heart disease
    1. Includes 4 pathologic findings:
       1. VSD
       2. Overriding dextraposed aorta
       3. Pulmonary artery stenosis
       4. Right ventricular hypertrophy
41. Hypochromic microcytic anemia: is most often caused by iron deficiency and chronic blood loss
42. Sickle cell anemia: is a hereditary hemoglobinopathy caused by a mutation of the α-globin gene
43. Lymphomas: malignant tumors of lymphoid cells – are most often of B-cell origin
44. Leukemia: a malignancy of hematopoietic and lymphoid cells
    1. Characterized by the appearance of malignant cells in the circulation
45. Multiple Myeloma: a malignancy of plasma cells
    1. Associated w/ lytic bone lesions and monoclonal gammopathy
46. Hodgkin Disease (HD): a form of lymph node malignancy
    1. Characterized by the presence of REED-STERNBERG CELLS
    2. Several histologic forms of Hodgkin Lymphoma (HL):
       1. Lymphocyte-predominence
       2. Lymphocyte-rich
       3. Mixed cellularity
       4. Lymphocyte depletion (has the worst prognosis of the forms of HLs)
       5. Nodular sclerosis (most common form of HL)
47. Atelectasis: is incomplete expansion of the lungs or collapse of a previously inflated lung parenchyma (“collapsed lung”)
    1. Collapsed lungs: (4 categories of atelectasis)
       1. Resorption – a blockage preventing new air from getting in
       2. Compressive – a potential space in the pleural cavity gets filled and causes compression on the lung (fluid, blood, air)
          1. Pneumothorax
       3. Contraction – the lungs contract generally, not readily curable, a lung that is becoming fibrotic
       4. Microatelectasis – the inability of the lungs to fully expand
          1. Aveolar level
          2. Usually caused by surfactants
          3. Surfactants – keeps the wet thin membranes from sticking to each other
48. Adult Respiratory Distress Syndrome (ARDS): is caused by Diffuse Alveolar Damage (DAD) resulting from injury of endothelial cells or pneumocytes forming the aveolar—capillary units
49. Chronic Obstructive Pulmonary Disease (COPD): includes several diseases, but the most important are EMPHYSEMA and CHRONIC BRONCHITIS
50. Bronchial Asthma: a chronic relapsing inflammatory OBSTRUCTIVE lung disease, presenting w/ hyperreactiviy of airways and periodic bronchospasm
51. Acute pneumonia: an inflammation of lungs usually caused by viruses or bacteria
52. Pneumoconioses: are interstitial lung diseases cuaed by inhaled particles such as coal, silica, or asbestos
53. Most lung cancers originate from the epithelium of the bronchi and are related to smoking
54. Esophagitis is most often caused by Gastroesophageal Reflux Disease (GERD)
55. Atrophic Gastritis: (the most common form of gastritis) is most often caused by Helicobacter pylori
56. Peptic ulcers are prone to bleeding.
57. Carcinomas of the esophagus and stomach = poor prognosis.
58. Diarrhea can be classified as…
    1. Osmotic
    2. Secretory
    3. Exudative
    4. Malabsorptive
    5. Mixed
59. Malabsorption syndrome is characterized by steatorrhea and deficiency of fat-soluble vitamins.
60. Inflammatory bowel disease (Crohn disease and ulcerative colitis) they share some features but differ in many aspects. (see table below)

1. Carcinoma of the large intestine is the third most common form of cancer and the third most common cancer-related cause of death in the U.S.
   1. It occurs most often in the rectosigmoid area.
2. Jaundice can be classified as…
   1. prehepatic (hemolytic)
   2. hepatic
   3. posthepatic (obstructive).
3. Cirrhosis is equivalent to end-stage liver disease
   1. characterized by…
      1. loss of normal hepatic 
architecture
      2. fibrosis
      3. the formation of regenerating nodules
4. Hepatitis is most often caused by viruses, drugs, or immune mechanisms
5. Chronic alcoholism may cause three pathologic changes in the liver:
   1. fatty liver
   2. alcoholic hepatitis
   3. cirrhosis
6. Alcohol and biliary disease account for 80% of all causes of acute pancreatitis.
7. Diabetes mellitus: (a disease characterized by hyperglycemia) is caused by…
   1. Insulin deficiency (TYPE 1)
   2. Tissue resistance to insulin (TYPE 2)
8. Uremia is a set of clinical and laboratory findings found in patients with end-stage kidney disease
9. Glomerulonephritis is immunologically mediated in most instances.
10. Pyelonephritis is a bacterial kidney infection.
11. The most important tumors of the kidneys and the urinary tract are…
    1. Renal cell carcinoma
    2. Transitional cell carcinoma
    3. Wilms tumor
12. Testicular tumors are derived from germ cells in 90% of cases and belong to two groups:
    1. Seminomas (most common testicular tumor)
    2. Nonseminomatous germ cell tumors (NSGCTs)
13. Prostate carcinoma is the most common malignant tumor in males
14. Carcinomas of the vulva, vagina, and cervix are linked to human papillomavirus (HPV) infection
    1. Most common types of HPV related to carcinomas:
       1. HPV 16
       2. HPV 18
    2. Most common type of HPV that cause genital warts (condylomata acuminata)
       1. HPV 6
       2. HPV 11
       3. (and HPV 16)
15. Endometrial adenocarcinoma is linked to hyperestrinism
16. Leiomyomas are the most common benign tumors of the uterus
17. Breast carcinoma is the most common (non-skin) malignant tumor in females
18. Hyperthyroidism may be caused by…
    1. Autoimmune mechanisms (e.g., in Graves disease)
    2. Tumors (e.g., follicular adenomas)
    3. Hyperfunctioning goiters
19. Hyperparathyroidism, most often caused by parathyroid adenoma
    1. Characterized by hypercalcemia
20. Hypofunction of adrenal glands is the cause of Addison disease, whereas hyperfunction causes Cushing syndrome
21. The three most important skin diseases caused by bacteria are…
    1. Impetigo
    2. Folliculitis
    3. Acne
22. Warts are caused by HPV infection.
23. Psoriasis is a common chronic skin disease of unknown etiology affecting 1% to 2% of the population
24. Skin cancer is related to sun exposure
25. Basal cell carcinoma of the skin, the most common malignant tumor, is only locally invasive and 
rarely metastasizes
26. Pigmented skin lesions may be benign (such as freckles, lentigo, and nevus) or malignant (such as malignant melanoma)
27. Osteoporosis is a form of osteopenia characterized by a loss of both calcium salts and organic matrix of the bones (osteoid)
28. The two most important diseases of the joints are rheumatoid arthritis and osteoarthritis
29. Osteosarcoma occurs most often in children and young people, whereas chondrosarcoma has 
its peak incidence in adults
30. Duchenne muscular dystrophy is the most common genetic muscle disease
31. The most important immunologic diseases of the muscle are polymyositis and myasthenia gravis
32. Rhabdomyosarcoma is a malignant tumor of striated muscle
33. The most important forms of intracranial bleeding are…
    1. Intracerebral hemorrhage in 
hypertension
    2. Subdural hematoma
    3. Subarachnoid hematoma
    4. Epidural hematoma
34. Infection of the brain and the meninges can occur through four main routes:
    1. Vascular spread
    2. Direct extension
    3. Ascending neural route
    4. Penetrating wounds
35. Tabes dorsalis is a spinal cord lesion caused by syphilis.
36. Multiple sclerosis is a demyelinating autoimmune disease characterized by a chronic relapsing 
and remitting course
    1. MS is the most common demyelinating disease
37.  Alzheimer’s disease (an old-age neurodegenerative disease of unknown etiology) is the most common cause of dementia
38. Most brain tumors are malignant
39. Gliomas are malignant tumors of the CNS originating from…
    1. Astrocytes
    2. Oligodendroglia cells
    3. Ependymal cells.
40. Diabetic neuropathy is the most common peripheral nerve disease encountered in general practice