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Pathology
Questions
INFLAMMATION
1. Describe the fundamental differences between the intrinsic and extrinsic pathways of apoptosis.
Name two important similarities between the pathways. (p. 220) ___________________________
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2. What are the six types of necrosis? List an example of each. (p. 220) _______________________
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3. Name three organs that manifest irreversible ischemia with red infarcts. Name three that show pale
infarcts. (p. 221) _________________________________________________________________
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4. What are the five signs and symptoms of inflammation? (p. 221) ___________________________
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5. In the chart below, compare and contrast the ligand-receptor interactions required for each step of
leukocyte extravasation. (p. 222)
Ligand-Receptor
Endothelial Cells Leukocytes
Interaction
Rolling
Tight binding
Diapedesis
Migration
6. What are the three ways that free radicals can be eliminated? (p. 222) ______________________
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7. In the chart below, compare and contrast the characteristics of transudates and exudates. (p. 223)
Transudate Exudate
Causes
Cellularity
Protein level
Specific gravity
8. What three conditions are associated with a low erythrocyte sedimentation rate? (p. 223) _______
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9. In the chart below, compare and contrast the characteristics of hypovolemic/cardiogenic shock vs.
septic shock. (p. 224)
Hypovolemic/
Septic Shock
Cardiogenic Shock
Cardiac output
Clinical appearance
Total peripheral
resistance
NEOPLASIA
10. Define the following terms and provide an example of each. (pp. 225-226)
A. Anaplaia __________________________________________________________________
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B. Dysplasia _________________________________________________________________
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C. Hyperplasia ________________________________________________________________
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D. Hypertrophy ________________________________________________________________
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E. Metaplasia ________________________________________________________________
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F. Neoplasia _________________________________________________________________
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11. Describe the differences between tumor grade and tumor stage. (p. 226) ____________________
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12. Compare and contrast the characteristics of benign vs. malignant tumors. (p. 226)
Differentiated?
Growth
Distinct boundaries?
Metastatic potential?
13. Match the neoplasm(s) to the condition(s) with which it is most commonly associated. (p. 227)
_____ A. Acute lymphoblastic leukemia 1. Acanthosis nigricans
_____ B. Astrocytoma, angiomyolipoma, cardiac 2. Actinic keratosis
rhabdomyoma 3. AIDS
_____ C. Colonic adenocarcinoma 4. Autoimmune diseases
_____ D. Gastric adenocarcinoma 5. Barretts esophagus
_____ E. Esophageal adenocarcinoma 6. Chronic atrophic gastritis, pernicious
_____ F. Hepatocellular carcinoma anemia, postsurgical gastric
_____ G. Lymphoma remnants
_____ H. Malignant lymphoma 7. Cirrhosis
_____ I. Malignant melanoma 8. Down syndrome
_____ J. Melanoma, basal cell carcinoma, and 9. Dysplastic nevus
squamous cell carcinoma of skin 10. Immunodeficiencies
_____ K. Non-Hodgkins lymphoma and Kaposis 11. Pagets disease of bone
sarcoma 12. Plummer-Vinson syndrome
_____ L. Sarcoma and papillary thyroid cancer 13. Radiation exposure
_____ M. Secondary osteosarcoma and fibrosarcoma 14. Tuberous sclerosis
_____ N. Squamous cell carcinoma of esophagus 15. Ulcerative colitis
_____ O. Squamous cell carcinoma of skin 16. Xeroderma pigmentosum, albinism
_____ P. Visceral malignancy
14. Oncogenes are associated with a ______ (gain/loss) of function and require damage to ______
(one/both) allele(s); examples include _________________________. In contrast, tumor
suppressor genes are associated with a ______ (gain/loss) of function and require damage to
______ (one/both) allele(s); examples include _________________________. (pp. 227-228)
15. How are tumor markers best used? (p. 228) ___________________________________________
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16. A 40-year-old otherwise healthy man is diagnosed with nasopharyngeal carcinoma. He does not
smoke or drink. What is the most likely cause of his cancer? (p. 229) ________________________
17. An IV drug abuser who is being monitored for cirrhosis shows a sudden increase in his -
fetoprotein level. For which disease is he at increased risk? (p. 229) ________________________
18. The vaccine Gardasil protects against which viruses that can cause which cancer? (p. 229) ____
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19. A 70-year-old recent immigrant from Japan presents with right upper quadrant pain and loss of
appetite. Which diagnosis should be high on the differential? (p. 229) _______________________
20. A 55-year-old woman with a 40-pack-year history of cigarette smoking presents with new-onset
cough, hemoptysis, and polyuria. What diagnosis should be high on the differential? (p. 229) ____
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21. Which cancers are most common in men? In women? (p. 230) ____________________________
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22. In the chart below, checkmark which primary tumors can metastasize to which organ(s). (p. 230)
Breast
Colon
Gastrointestinal
Kidney
Lung
Pancreas
Prostate
Skin
Stomach
Testes
Thyroid
Answers
INFLAMMATION
1. The intrinsic pathway begins with changes in the levels of anti- and pro-apoptotic factors, leading to
increased mitochondrial permeability. The extrinsic pathway begins with ligand-receptor
interactions or perforin/granzyme release. Similarities: both require ATP, and both ultimately
activate caspases.
2. Caseous (e.g., due to systemic fungal infection), coagulative (as occurs in the heart), fatty
(saponification of liver), fibrinoid (as occurs in blood vessels), gangrenous (limb gangrene), and
liquefactive (bacterial abscess).
3. Red infarct: liver, lungs, and intestine. Pale infarcts: heart, kidney, and spleen.
4. Rubor (redness), dolor (pain), calor (heat), tumor (swelling), and functio laesa (loss of function).
5.
Ligand-Receptor
Endothelial Cells Leukocytes
Interaction
E-selection
Rolling Sialyl Lewis
P-selectin
C5a
IL-8
Migration Various
LTB4
Kallikrein
7.
Transudate Exudate
9.
Hypovolemic/
Septic Shock
Cardiogenic Shock
Total peripheral
Increased Decreased
resistance
NEOPLASIA
10. A. Anaplasia: lacking differentiation. Examples: anaplastic oligodendroglioma, anaplastic thyroid
tumors, many other subtypes of tumors.
D. Hypertrophy: increase in the size of the cell. Examples: increased muscle bulk after weight
lifting, myocardial hypertrophy, myometrium during pregnancy.
F. Neoplasia: new growth, either benign or malignant. Examples: uterine fibroids, nevi,
malignant cancers.
11.
May be poorly
Differentiated? Well-differentiated
differentiated
Growth Slow Erratic
12. Tumor grade is the degree of cellular differentiation within the tumor, and is a characteristic of the
tumor itself. In contrast, tumor stage describes the extent of tumor spread within a patient, and thus
is a better indication of a patients prognosis than tumor grade.
13. A-8, B-14, C-15, D-6, E-5, F-7, G-4, H-10, I-9, J-16, K-3, L-13, M-11, N-12, O-2, P-1.
14. Oncogenes are associated with a gain of function and require damage to only one allele for
expression; examples include c-myc (Burkitts lymphoma) and ras (colon carcinoma). Tumor
suppressor genes are associated with a loss of function and require damage to both alleles for
expression; examples include NF1 (neurofibromatosis type 1) and BRCA2 (breast cancer).
15. To confirm a diagnosis, to check for tumor recurrent, and to monitor response to therapy.
17. Hepatocellular carcinoma. IV drug use and cirrhosis are associated with HCV, and HCV is
associated with hepatocellular carcinoma.
18. HPV 6, 11, 16, and 18. HPV 16 and 18 have been associated with cervical cancer.
19. Gastric cancer. The Japanese diet is high in smoked foods, which contain nitrosamine.
21. Prostate, lung, and colon/rectal cancers are the most common cancers in men; breast, lung, and
colon/rectal cancers are the most common in men.
22.
Breast
Colon
Gastrointestinal
Kidney
Lung
Pancreas
Prostate
Skin
Stomach
Testes
Thyroid
Notes
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