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Pathology > Final > Flashcards

Final Flashcards

1
Q

Define Hemostasis

A

Process of stopping blood loss

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2
Q

What is the principle mechanism of hemostasis?

A

Blood Coagulation

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3
Q

Aka for Tissue Factor

A

Tissue Thromboplastin

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4
Q

Fibrinogen represents what percent of blood proteins?

A

5-10%

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5
Q

What Vitamin is needed to help produce clotting factors in the liver?

A

Vitamin K

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6
Q

Clotting Factor I = ?

A

Fibrinogen

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7
Q

Clotting Factor II = ?

A

Prothrombin

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8
Q

Clotting Factor V = ?

A

Preacceleran

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9
Q

Clotting Factor VII = ?

A

Proconvention

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10
Q

Anti Hemophilic Factor = Clotthing Factor ??

A

VIII

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11
Q

Christmas Factor = Clotting Factor ??

A

IX

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12
Q

Clotting Factor X = ?

A

Stuart- Prower Factor

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13
Q

Name the blood factor that is released with injury and that activates Clotting Factor VII which then activates CF X

A

Tissue Thromboplastin

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14
Q

What is the name of the coagulation pathway that can happen outside and inside the blood vessel

A

Extrinsic Pathway

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15
Q

Name the steps in the Extrinsic Pathway

A

Tissue Cut ——> Tissue Thromboplastin —–> VII (proconvertin) ——-> X (Stuart-prower factor) ——> CF II (prothrombin) ——> CF 1 (Fibrinogen) ——-> Fibrin

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16
Q

What is a big difference between the Extrinsic Pathway of Coagulation and the Intrinsic Pathway

A

With Intrinsic there has to be exposure of the collagen fibres of the basement membrane to blood flow.

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17
Q

What ions help to speed the process of coagulation?

A

Calcium ions

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18
Q

What is the CF cascade for Intrinsic Coagulation

A 
Exposure of Collagen to blood flow
Hageman Factor (CF XII) 
CF XI
CF IX
CF X
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19
Q

T or F

To help with coagulation calcium bromate is injected intravenously to a pt who is hemorrhaging

A

False

Calcium Chlorate

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20
Q

Exposure of collagen fibres to blood flow can activate a special factor that will bind them. What is the name of this factor?

A

von Willebrand factor (vWF)

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21
Q

What is the outcome of vWF and the bound platelets to this factor? What is made??

A

Platelet Plug

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22
Q

T or F

Platelet plugs result in complete closure of damaged endothelium

A

False

Only partial

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23
Q

When platelets bind to vWF they become activated. What is the name of this process?

A

Platelet Degranulation

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24
Q

Platelet Degranulation results in the release of certain substances. Please name them

A

ADP
Thromboxane A2
Growth Factors
Serotonin

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25
Q

What is the function of Thromboxane A2?

A

To promote further platelet activation, vasoconstriction and mediates inflammation

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26
Q

Thromboplastin Antecedent = what clotting factor?

A

XI

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27
Q

Hageman Factor = CF?

A

XII

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28
Q

CF XIII = ?

A

Fibrin Stabilizing Factor

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29
Q

What does hemodynamics mean?

A

the movement of blood with different velocities. Blood flows faster in larger and middle sized arteries and flows slow in veins.

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30
Q

What is the approx time blood takes to coagulate?

A

10 mins

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31
Q

Endothelial mediation of the anticoagulation system is carried out by what molecule in the body?

A

PGI2 = prostacyclin

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32
Q

T or F

Larger hemorrhages but still less than 2cm are known as petechiae

A

False

Purpura

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33
Q

What are pinpoint hemorrhages called?

A

Petechiae

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34
Q

T or F

Hemorrhagic Vasculitis is an example of an ecchymoses

A

False

Purpura - larger hemorrhages but still less than 2 cm
Ecchymoses = when hemorrhage are larger than 2cm

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35
Q

T or F

Petechiae can be caused by hypovitaminosis C

A

True

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36
Q

Brain Petechiae can be a result of?

A

Fat embolism

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37
Q

What is a hemorrhage called when it is in the cavities of big tissue masses?

A

Hematoma

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38
Q

What is Thrombocytopenia

A

“Penia” means lack, lack of platelets (thrombocytes) = increase bleeding
- usually doesn’t result in large bleeding but more Petechia & Purpura

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39
Q

Where are clotting factors produced in the body?

A

Liver

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40
Q

Genetic Diseases associated with non-production of some clotting factors is known as? Name the 3 discusses in class

A

Hemophilias

  1. von willebrand disease
  2. hemophilia A - Classic Hemophilia
  3. hemophilia B - Christmas disease
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41
Q

T or F

Classic hemophilia is a genetic non-production of Clotting Factor IX

A

False

Clotting Facotr VIII - antihemophilic clotting factor

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42
Q

Menorrhagia is associated with what Hemophilic disease

A

von willebrand disease

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43
Q

What Hemophilic disease are characterized by hemarthrosis? (hematoma in the joint)

A

Hemophilia A & B

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44
Q

T or F

Hemophilias only develop in women

A

False

Males

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45
Q

Are hemophilias linked to the X or Y chromosome

A

X

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46
Q

T or F

A thrombus can be formed outside and inside

A

False

Blood clot can be formed outside and inside
Thrombus only formed WITHIN a blood vessel.

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47
Q

T or F

A thrombus is more organized than a blood clot

A

True

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48
Q

The process of formation of a Thrombus is called?

A

Thrombosis

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49
Q

What makes up a Thrombus?

A

Fibrin
Platelets
WBC
RBC

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50
Q

Why is a thrombus more difficult to form in the arteries compared to the veins

A

Hemodynamics! Blood flows quicker through the arteries and therefore there is washing away of components of blood coagulation

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51
Q

What are lines of Zahn?

A

Represent special types of thrombi characterized by visible & microscopic laminations produced by alternating pale layers of platelets mixed with fibrin and a darker layer containing red blood cells.

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52
Q

50% of deaths in the USA are caused by?

A

Atherosclerotic plaques formed in arterial walls which causes additional resistance to blood flow and causes turbulent blood flow which promotes platelet activation

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53
Q

Normal wear and tear in vessels is termed?

A

Hemodynamic Stress

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54
Q

Name some constitutional risk factors associated with atherosclerosis

A
  1. Age - 40-60 years = 5- fold increase risk
  2. Gender - men = 5x more vulnerable than women of same age. (70 years chances are =)
  3. Familial Disposition - genes from parents
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55
Q

What is the normal blood cholesterol level

A

160-200 mg/dL

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56
Q

What can happen if we have less than 160 mg/dL of cholesterol in our blood?

A

You need cholesterol to build hormones - if you have less the liver will produce too much and it can cause hypercholesterolemia

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57
Q

The ratio of LDL:HDL should not be more than?

A

4:1

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58
Q

What can lead to blood flow abnormalities in the arteries?

A
  1. Cardiac Damage reducing the heart’s pumping ability
  2. Increased viscosity of blood = blood flows slower
  3. Turbulence of blood flow - could be caused by aneurysm
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59
Q

A bulbous thrombosis can be formed where in the body can be a result of what condition?

A

Heart

Mitral Valve Stenosis

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60
Q

What is polycythemia

A

Blood Cancer

Overproduction of RBC which increases the friction against the vascular wall.

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61
Q

Erythremia aka ?

A

Polycythemia

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62
Q

What are the risk factors for Thrombosis

A

Physical Inactivity
Varicose Veins
Blood hyper coagulation

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63
Q

95% of thrombi are formed where?

A

Deep veins of the legs

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64
Q

This condition is characterized by distention of the width of veins where the valves will no longer be able to close. It is more commonly seen in women than men

A

Varicose Veins

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65
Q

What type of things can cause Turbulence in blood flow

A

Tumor
Anuerysm
Varicose Veins

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66
Q

Name some conditions associated with blood hyper- coagulation

A 
Extensive burns
Kidney Disease - renal failure
Heart failure 
Chronic Infections
Birth Control Pills
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67
Q

What does Sequelae mean?

A

Pathological consequence. One problem creates additional problems (like a sequel)

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68
Q

Name the steps in the Sequela of Thrombosis

A
  1. Resolution
  2. Organization
  3. Recanalization
  4. Propogation
  5. Infarction
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69
Q

In what stage of Sequela of Thrombosis does phagocytic digestions of thrombus occur?

A

Organization - this occurs 2 or 3 days after thrombi form

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70
Q

Where does propagation of a thrombus occur? Why?

A

Takes place only in veins because of hemodynamics (turbulent blood flow)

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71
Q

What stage of the Thrombus Sequela helps restore blood flow?

A

Recanalization

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72
Q

T or F

Infarction and Ischemia mean the same thing

A

False

Infarction is due to lack of OXYGEN compared to Ischemia which is lack of blood flow.

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73
Q

Tissue that replaces brain tissue where and infarct occurred is called?

A

Neuroglia

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74
Q

T or F

Neuroglia undergoes shrinkage after a while, similar to when connective tissue is laid down in the heart after an infarct and the tissue dies.

A

False

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75
Q

What is the # 1 factor leading to an infarct?

A

Arteriole Thrombosis

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76
Q

An autoimmune disorder that is characterized by vascular wall inflammation is known as?

A

Vasculitis

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77
Q

What are 2 akas for Temporal Arteritis?

A

Giant Cell Arteritis

Horton’s Disease

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78
Q

T or F

Temporal Arteritis can occur in the Superficial Temporal arteries, Vertebral artery and the External Carotid

A

False

The first two are correct however the External Carotid is not mentioned. The 3rd artery is Ophthalmic

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79
Q

What is a consequence of Temporal Arteritis?

A

Blindness

80
Q

T or F

NSAIDS are an effective means to manage Polymyalgia Rheumatic

A

FALSE

81
Q

Polymyalgia Rheumatic is similar/associated with what other condition?

A

Temporal Arteritis

82
Q

List some symptoms of Polymyalgia Rheumatic

A

Pn in shoulder
Pn in muscles
Pn in pelvis
Blindness **can start off temporary blindness and lead to permanent

83
Q

What is the name of the pathology that occurs when a portion of the stomach protrudes through the diaphragm

A

Paraesophageal Hernia

84
Q

T or F

Paraesophageal Hernia’s are classified under Artery Infarction

A

False

Venous - blood is still able to flow into herniated portion but the veins get compressed because the pressure is lower in the veins and venous outflow is stopped.

85
Q

Postpartum Syndrome aka ?

A

Sheehan’s Syndrome

86
Q

Sheehan’s Syndrome affects what major endocrine gland in the body?

A

Pituitary

87
Q

Kazimierz Funk was accredited for the discovery of what vitamin?

A

B1

88
Q

B1 =?

A

Thiamine

89
Q

T or F

B1 is a fat soluble vitamin

A

False

90
Q

What substance is a very serious enemy of Thiamine and competes with it…and always wins?

A

Alcohol

91
Q

What is the condition that results from a deficiency in B1?

A

Beriberi

92
Q

Who discovered Beriberi?

A

Christiaan Eijkman

93
Q

T or F

Wrist drop, foot drop and 1st toe drop are associated with Wet Beriberi

A

False

Dry

94
Q

T or F

Dry beriberi is characterized by symmetrical, non specific peripheral polyneuropathy

A

True

95
Q

What are some associated symptoms of Wet Beriberi

A

Enlargement of heart
Flabby myocardium
Peripheral vasodilation
Cardiac Failure - peripheral edema

96
Q

What is a serious condition that results from Thiamine deficiency that can develop if left untreated?

A

Wernicke Encephalopathy

97
Q

List some symptoms of Wernicke Encephalopathy

A

Global confusion
Listlessness
Apathy
Opthalmoplegia

98
Q

What is Ophthalmoplegia?

A

Results from deep brain tissue damage where eyes will go in different directions.

99
Q

T or F

With Korsakoff’s Psychosis the patient will experience only anterograde amnesia. Retrograde is not affected.

A

False

Both

100
Q

What is confabulation?

A

Inventive memory where an individual will create fantasies and constantly talks. Will not stop talking

101
Q

B2 = ?

A

Riboflavin

102
Q

Where in the body can we produce Riboflavin?

A

GI flora

103
Q

What is another term for Araboflavinosis?

A

Cheilosis or Cheilitis

104
Q

What is Cheilosis?

A

Can occur at the angle of the mouth - will begin to crack and be dry.
Glossitis can occur where there is inflammation of the tongue and can lead to a loss of taste.

105
Q

This condition consists of growth of blood vessels from conjunctiva toward the cornea and is very painful. Causes corneal ulcerations

A

Superficial Intersitial Keratitis

106
Q

When there is a deficiency of Riboflavin in can lead to Dermatitis. Where in the body would this commonly be seen?

A

Naso-labial folds

Scrotum in males and vulva in females.

107
Q

B3 = ?

A

Niacin

108
Q

T or F

B2 when deficient has a dramatic impact on the nervous system

A

False

DOESN’T AFFECT THE NERVOUS SYSTEM

109
Q

Why is B3 popularly used in medicine?

A

For its vasodilation ability - nitroglycerine tx

110
Q

What amino acid is a precursor for B3?

A

Tryptophan

111
Q

How does Niacin contribute to privation of arteriosclerosis?

A

Leads to a decreased production of lipoproteins LDLs

112
Q

Deficiency of Niacin can lead to what condition?

A

Pellagra

113
Q

What does Pellagra mean?

A

“pelle agro” = dry skin

114
Q

What are the 4 of Pellagra?

A

Dermatitis
Diarrhea
Dementia
Death

115
Q

What is the pathophysiology associated with Diarrhea and Pellagra?

A

Atrophy of epithelial cells of intestinal mucosa with involvement of submucosal layer

116
Q

T or F

Casal’s necklace is due to a deficiency in Riboflavin

A

False

Niacine - B3

Riboflavin is B2

117
Q

T or F

Glove-and-stocking lesions are associated with a deficiency in Niacin

A

True

118
Q

What neurons are destroyed in Pellagra that can lead to dementia?

A

Cortical neurons

119
Q

Pyridoxine = ?

A

B6

120
Q

T or F

B6 is highly resilient to heat

A

False

Thermolabile - a small amount of heat will destroy it

121
Q

Name 3 medications that compete with B6’s biochemical reactions and can lead to deficiency

A

Izoniazid - antituberculosis
Estrogens
D-penicillamine - tx for Wilson’s disease

122
Q

T or F

B6 and B2 have very similar symptoms of deficiency

A

True

Cheilosis
Glossitis

123
Q

B12 = ?

A

Cobalamin

124
Q

T or F

Plants are not a source of B12

A

True

125
Q

What is the name of the molecule that binds B12 and carries it to the duodenum?

A

R-binder

126
Q

What cells in the GI produce the intrinsic factor required for B12 absorption?

A

Parietal cells of the stomach

127
Q

T or F

Extrinsic factor = B12

A

True

128
Q

T or F

B12 deficiency anemia is irreversible

A

False

Nervous system pathology associated with the deficiency is irreversible.

129
Q

List some causes of B12 deficiency

A 
inadequate dietary intake
surgical removal of stomach or ileum
malnutrition or alcoholism
Celiac Disease, Chron's Disease 
Vegans
Intake of some medications - Ranitidine & Metformin
130
Q

This auto-immune disease is considered malignant, associated with chronic gastritis and parietal canalicular antibodies.

A

Pernicous Anemia

131
Q

T or F

Parietal Canalicular Antibodies = Type 1 antibodies

A

False

Type III

132
Q

Blocking antibodies associated with Pernicious anemia are Type 1 or Type III?

A

Type 1

133
Q

What are some causes of Megaloblastic Anemia?

A

B12 anemia

Folic Acid Deficiency

134
Q

What is the function of B12 in Hematopoiesis?

A

Restoration of inactive tetrahydrofolate

135
Q

What does pancytopenia mean?

A

Total decrease in the number of blood cells (RBCs, WBCs, and platelets)

136
Q

T or F

Adding B12 DOES NOT help in folic acid deficiency

A

True

137
Q

T or F

Adding folic acid helps in folic acid deficiency

A

True

138
Q

T or F

Folic acid deficiency does not affect the nervous system (except for the fetus) but vitamin B12 does

A

True

139
Q

Ascorbic acid = ?

A

Vitamin C

140
Q

T or F

Vitamin C can be produced in the human body

A

False

141
Q

What is the function of vitamin C with proline?

A

Vitamin C hydroxylates proline to become hydroxyproline

Hydroxyproline makes connective tissues strong and increases tensile strength

142
Q

T or F

Vitamin C plays a role in reducing oxidation of HDL and theoretically decreasing atherosclerosis

A

False

LDL

143
Q

T or F

Retrobulbar hematoma’s are associated with a deficiency in Vitamin K

A

False

C

144
Q

What is the condition associated with blood behind the eyeball causing an increased pressure that pushes the eye forward and can lead to loss of vision? What vitamin is associated with this condition?

A

Retrobulbar Hematomas

Vitamin C

145
Q

T or F

Protrusion of the ribs and sternum is associated with a vitamin D deficiency

A

Ture

146
Q

What is the storage and transport form of Vitamin A?

A

Retinol

147
Q

What form of vitamin A is responsible for the lifespan of epithelia?

A

Retinoid Acid

148
Q

What form of Vitamin A is associated with normal vision in dim light

A

Retinal

149
Q

T or F

Retinoids are the natural precursor for retinal

A

False

Carotinoids

150
Q

This form of Vitamin A is responsible for the production of visual pigments in photoreceptors

A

Retinal

151
Q

T or F

A deficiency in Retinol results in night blindness

A

False

Retinal

152
Q

Bitot’s spots are a results of a deficiency in what form of Vitamin A?

A

Retinoid Acid

153
Q

What two vitamins when deficient can result in the formation of a Nidus?

A

Retinoic Acid & Pyridoxine

vitamin A & B6

154
Q

Pulmonary infection, Follicular & papillar dermatosis as well as formation of a Nidus results in a deficiency with Retinal, Retinol, Retinoids, or Retinoic Acid?

A

Retinoic Acid

155
Q

Name the manifestations of a deficiency in Retinoic Acid

A 
Xeropthalmia 
Xerosis
Squamous Metaplasia
Follicular & Papillar Dermatosis
Pulmonary Infection
Nidus
156
Q

What are some problems causes by chronic Hypervitaminosis?

A 
Weight loss
Nausea, vomiting
Dryness of mucosa of lips
Bone and joint pain 
Heptomegaly - liver is storing excess
157
Q

In what form is vitamin A stored in the liver?

A

Retinol Ester

158
Q

Alpha-Tocopherol is another name for?

A

Vitamin E

159
Q

Vitamin E is a collective name for? **what makes up Vitamin E essentially

A

4 tocopherols and 4 tocotrienols

160
Q

Vitamin E is a good antioxidant in concert with what other vitamins?

A

Vitamin C

Selenium

161
Q

What cell membranes are affected in the body with a deficiency in Vitamin E?

A

Neuron membranes

RBC membranes

162
Q

Degenerative changes in the spinocerebellar tract with a Vitamin E deficiency include….

A 
Absent tendon reflexes
Ataxia = loss of balance
Dysarthria 
Loss of position and vibration sense
Loss of pain sensation (DRG)
163
Q

T or F

A deficiency in Vitamin E will usually result in anemia

A

False

164
Q

T or F

Hypervitaminosis E can decrease coagulative ability of the blood due to interference with vitamin K

A

True

165
Q

how does hypervitaminosis E interfere with vitamin K and its clotting abilities?

A

Decreased production of clotting factors.

166
Q

What vitamin stimulates the production of osteocalcin?

A

Vitamin K

167
Q

T or F

B12, B3 and Vitamin K are all produced by GI flora?

A

True

168
Q

Keshan’s Disease is caused from a deficiency in what trace element?

A

Selenium

169
Q

Hypopigmentation can be caused from a deficiency in?

A

Copper

170
Q

Hypogonadism and infertility can be caused by a deficiency in?

A

Zinc

171
Q

Myopathy and congestive cardiomyopathy are a result of a deficiency in what trace element?

A

Selenium

172
Q

T or F

Anemia is a side effect of Marasmus

A

True

173
Q

Marasamus is a conditioned associated with a deficiency in what nutrient(s)

A

Protein and Total Calories

174
Q

The somatic protein compartment is located primarily where in the body?

A

Skeletal muscles of the body

175
Q

T or F

Marasmus is associated with a deficiency the Visceral protein compartment

A

False

Somatic - visceral compartment is spared.

176
Q

Acrodermatitis enteroathica is associated with a deficiency in what trace element?

A

Zinc

177
Q

The majority of the visceral protein compartment is predominantly found where in the body?

A

Liver

178
Q

How can we determine the visceral compartment of protien is used?

A

By checking blood protein level usually albumin

179
Q

T or f

Malnourished is when you are less than 80% of normal weight

A

True

180
Q

T or F

Kwashikor is less than 60% of normal weight

A

False this is Marasmus

Kwashikor = 60-80% of normal weight

181
Q

T or F

The visceral protein compartment in Marasmus is untouched and therefore blood albumin level is close to normal

A

True

182
Q

What are some symptoms of Marasmus

A 
Extremities are emaciated
Head is disproportionally larger
Anemia - lack of nutrient
Multivitamin deficiency 
Decreased immune function
183
Q

“First-second” is associated with what nutrient deficiency disorder?

A

Kwashikor

184
Q

Which condition is considered “worst” Kwashiorkor or Marasmus?

A

Kwashiorkor because it leads to irreversible changes

185
Q

T or F

Kwashiorkor causes depletion of the visceral protein compartment

A

True

186
Q

What causes the generalized edema seen with Kwashiokor

A
  • Depletion of visceral protein compartment = hypoalbunemia
  • Albumin is responsible for maintaining normal capillary oncotic pressure which normally keeps serum in the vessels (keeps blood within the blood vessels)
  • When low serum moves to the tissues resulting in generalized edema.
187
Q

What happens to the hair with Kwashiorkor?

A

Loss of colour - turns grey, alternating band of pale and darker hair
Straightening

188
Q

Describe the affects of Kwashiorkor on the skin

A

Skin lesions

  • zones of hyper pigmentation
  • areas of desquamousation
  • Hypopigmentation - “flaky paint” appearance due to decrease in melanocytes.
189
Q

Anorexia is particularly damaging to what endocrine organs?

A

Pituitary and Thyroid

190
Q

Symptoms of Anorexia?

A 
Amenorrhea
Hypothyroidism
Decreased immune system function 
Hypokalemia 
Low BP
191
Q

T or F

Anorexia does not cause fat loss in the breasts

A

True

192
Q

What % of people suffering from Bulimia experience amenorrhea?

A

50

193
Q

What is Aspiration pneumonia?

A

Inhalation of omitted particles along with digestive enzymes which causes inflammation of the lungs

194
Q

What is Mallory Weiss Syndrome?

A

Destruction of the distal esophagus due to repetitive long term vomitting

195
Q

Define neoplasia

A

Tissue formation, involves overgrowth of a tissue to from a neoplastic mass or neoplasm called a tumor

Pathology (6 decks)

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