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Questions and Answers

What is the pathogenesis (origin or cause) of cholesteatoma?

  • Common superficial skin bacterial infection (S. Aureus) that is highly contagious and frequently seen in healthy children. The bacteria in the epidermis evoke an innate immune response that causes epidermal injury with serous exudate and formation of scale crusts (scabs).
  • A fleshly overgrowth of the conjunctiva, which is the thin clear membrane on the surface of the eye.
  • One of the most common causes of irreversible vision loss in patients over 65 years old; results in central vision loss due to damage to the macula.
  • Chronic inflammation and perforation of the eardrum, with ingrowth of the squamous epithelium or metaplasia of the secretory epithelial lining of the middle ear, promote the formation of a squamous cell nest that becomes cystic. (correct)

    • What are the main risk factors for the development of a pterygium?

  • Spending a lot of time outdoors without eye protection. It is also more common in older adults and people who live near the equator. (correct)
  • The most common causes of irreversible vision loss in patients over 65 years old, results in central vision loss due to damage to the macula.
  • Common superficial skin bacterial infection (S. Aureus) that is highly contagious and frequently seen in healthy children. The bacteria in the epidermis evoke an innate immune response that causes epidermal injury with serous exudate and formation of scale crusts (scabs).
  • Chronic inflammation and perforation of the eardrum, with ingrowth of the squamous epithelium or metaplasia of the secretory epithelial lining of the middle ear, promote the formation of a squamous cell nest that becomes cystic.

    • What is the pathogenesis (origin or cause) of macular degeneration?

  • The most common causes of irreversible vision loss in patients over 65 years old, results in central vision loss due to damage to the macula. (correct)
  • Common superficial skin bacterial infection (S. Aureus) that is highly contagious and frequently seen in healthy children. The bacteria in the epidermis evoke an innate immune response that causes epidermal injury with serous exudate and formation of scale crusts (scabs).
  • A fleshly overgrowth of the conjunctiva, which is the thin clear membrane on the surface of the eye.
  • Chronic inflammation and perforation of the eardrum, with ingrowth of the squamous epithelium or metaplasia of the secretory epithelial lining of the middle ear, promote the formation of a squamous cell nest that becomes cystic.

    • What is the primary pathogenic mechanism in allergic rhinitis (hay fever)?

    <p>IgE-mediated immune reaction with an early- and late-phase response, characterized by mucosal edema, erythema, and mucus secretion accompanied by eosinophil-rich leukocytic infiltrates.</p> Signup and view all the answers

    What is the most common cause of purulent (suppurative) inflammation?

    <p>Infection with bacteria that cause liquefactive tissue necrosis, such as staphylococci, These pathogens are referred to as pyogenic (pus-producing) bacteria.</p> Signup and view all the answers

    What are the two major factors that contribute to the clinical features of Klinefelter syndrome?

    <p>Aneuploidy and the impact of increased gene dosage by the supernumerary X and the presence of hypogonadism.</p> Signup and view all the answers

    What is the primary cause of familial hypercholesterolemia?

    <p>Mutations in the LDL receptor (LDLR) gene, encoding for the LDL receptor.</p> Signup and view all the answers

    What is the most common serious complication of thrombocytopenia?

    <p>Bleeding within the brain.</p> Signup and view all the answers

    What is the most common cause of acute tubular necrosis (ATN)?

    <p>Sepsis.</p> Signup and view all the answers

    What is the primary pathogenic mechanism that contributes to the development of atherosclerosis?

    <p>Endothelial injury and dysfunction, which causes increased vascular permeability, leukocyte adhesion, and thrombosis. It is the cornerstone of the response-to-injury hypothesis.</p> Signup and view all the answers

    What is the most important modifiable risk factor for the development of atherosclerosis?

    <p>Hyperlipidemia, increased LDL, HTN, smoking, DM, inflammation.</p> Signup and view all the answers

    What are the two primary types of shock?

    <p>Cardiogenic and hypovolemic</p> Signup and view all the answers

    What are the two primary types of heart block?

    <p>First-degree and third-degree</p> Signup and view all the answers

    What is the primary pathologic mechanism in myocarditis?

    <p>Necrosis and degeneration of myocytes</p> Signup and view all the answers

    What is the primary pathologic mechanism in thrombosis?

    <p>Endothelial injury, stasis or turbulent blood flow, and hypercoagulability</p> Signup and view all the answers

    What is the most common cause of a true aneurysm, and how is it characterized?

    <p>Atherosclerosis; a localized abnormal dilation of a blood vessel or the heart, either congenital or acquired. It can be characterized by a weakening of an intact arterial or ventricular wall, due to the underlying cause.</p> Signup and view all the answers

    What is an example of a single-gene disorder that can cause secondary hypertension?

    <p>Liddle syndrome</p> Signup and view all the answers

    What is the most common cause of primary hyperaldosteronism?

    <p>Bilateral Idiopathic Hyperaldosteronism</p> Signup and view all the answers

    What is the most common cause of acute kidney injury?

    <p>Acute tubular ischemia or necrosis</p> Signup and view all the answers

    What is the pathogenesis of vesicoureteral reflux (VUR)?

    <p>Incompetence of the valvular mechanism at the ureter-bladder junction</p> Signup and view all the answers

    What is the most common cause of intrinsic/intrarenal acute kidney injury?

    <p>Acute tubular necrosis</p> Signup and view all the answers

    What is the most common cause of glomerulonephritis in adults?

    <p>Diabetes mellitus</p> Signup and view all the answers

    What is the most common cause of benign prostatic hyperplasia (BPH) and what is one of its key risk factors?

    <p>The most common cause of BPH is related to aging; one of its key risk factors is DHT.</p> Signup and view all the answers

    What is the most common type of cervical cancer and which HPV types are most implicated?

    <p>Squamous cell carcinoma; HPV-16 and HPV-18</p> Signup and view all the answers

    What is the name of the pre-malignant lesion characterized by the presence of atypical cells confined to the epithelial layer of the vagina?

    <p>Vaginal Intraepithelial Neoplasia (VaIN)</p> Signup and view all the answers

    What is the name of the benign breast tumor that is considered to be hormone-sensitive and often increases in size during pregnancy?

    <p>Fibroadenoma</p> Signup and view all the answers

    What disease is most often characterized by pelvic pain, adnexal tenderness, fever, and vaginal discharge?

    <p>Pelvic inflammatory disease (PID)</p> Signup and view all the answers

    What is the most common cause of PID, and what other microorganisms may contribute to the infection?

    <p>Neisseria gonorrhoeae and Chlamydia trachomatis with other microorganisms such as staphylococci, streptococci, coliforms, and Clostridium perfringens.</p> Signup and view all the answers

    What is the most common cause of dementia in older adults?

    <p>Alzheimer's disease</p> Signup and view all the answers

    What are the two key pathological hallmarks of Alzheimer’s disease?

    <p>Amyloid plaques and neurofibrillary tangles.</p> Signup and view all the answers

    What is the most common cause of myasthenia gravis?

    <p>Anti-ACh receptor antibodies</p> Signup and view all the answers

    What is the most common cause of Bell’s palsy?

    <p>A virus</p> Signup and view all the answers

    What is the most common type of generalized seizure?

    <p>Tonic-clonic seizure</p> Signup and view all the answers

    What is the hallmark of trigeminal neuralgia?

    <p>Sudden, brief, and excruciating facial pain attacks</p> Signup and view all the answers

    What is the most common cause of Huntington's disease?

    <p>A genetic mutation</p> Signup and view all the answers

    What is the pathogenesis of osteomyelitis?

    <p>It tends to occlude local blood vessels which causes bone necrosis and local spread of infection.</p> Signup and view all the answers

    What is the most common cause of gout?

    <p>Hyperuricemia</p> Signup and view all the answers

    What are the four main phases of gout?

    <p>Asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout, chronic tophaceous gout</p> Signup and view all the answers

    What is the most common type of joint disease and what is its primary pathogenic mechanism?

    <p>Osteoarthritis, cartilage degeneration</p> Signup and view all the answers

    What is the most common type of osteoporosis?

    <p>Senile and postmenopausal</p> Signup and view all the answers

    What is the pathogenesis of rheumatoid arthritis?

    <p>A chronic autoimmune disorder that principally attacks the joints, producing a nonsuppurative proliferative and inflammatory synovitis.</p> Signup and view all the answers

    What is the primary cause of osteomalacia?

    <p>Inadequate concentration of vitamin D, calcium, or phosphorus.</p> Signup and view all the answers

    What is the most common cause of fractures, and what are the five stages of bone healing?

    <p>Trauma; Hematoma formation, fibrocartilage formation, callus formation, ossification, consolidation/remodeling</p> Signup and view all the answers

    What is the main function of vitamin D?

    <p>To maintain adequate plasma levels of calcium and phosphorus to support metabolic functions, bone mineralization, and neuromuscular transmission.</p> Signup and view all the answers

    What are the most common causes of Cushing syndrome?

    <p>Exogenous or endogenous factors</p> Signup and view all the answers

    What is the primary pathologic mechanism of type 1 diabetes?

    <p>The body’s immune system attacks the pancreas’ insulin-producing cells.</p> Signup and view all the answers

    Study Notes

    Necrosis

    • Coagulative Necrosis: Dead cells are preserved for a few days, enzymes are blocked, and the cells are eventually removed by phagocytosis. Ischemia causes this in most organs except the brain.
    • Example: Infarct
    • Liquefactive Necrosis: Digestion of dead cells transforms tissue into a viscous liquid (pus). Caused in the brain (and CNS) during ischemia as opposed to other organs.
    • Example: Ischemic CVA
    • Fat Necrosis: Focal areas of fat destruction, often from enzyme release (e.g., pancreatitis) and in breast tissue injury.
    • Example: Breast indentation, pancreatitis
    • Gangrenous Necrosis: A limb with lost blood supply, more liquefactive necrosis when bacterial enzymes work along with the body's inflammatory response.
    • Example: Wet gangrene
    • Caseous Necrosis: Often seen in TB infections; a friable white "cheeselike" area with granulomas.
    • Example: Tuberculosis
    • Fibrinoid Necrosis: Vascular damage from immune reactions, antibody-antigen complexes causing a pink appearance on H&E stain.
    • Example: Malignant HTN

    Cellular Adaptation

    • Hypertrophy: Increased cell size leading to enlarged organs, like cardiomyopathy, uterine enlargement during pregnancy.
    • Atrophy: Reduced size of an organ caused by decreased cell size and number due to loss of blood supply, innervation or lack of workload (skeletal muscle).
    • Hyperplasia: Increased cell number in an organ or tissue, such as during menstruation or liver regeneration (hormonal hyperplasia), PCOS, Hepatic Regeneration.
    • Metaplasia: Reversible cell change where one cell type is replaced by another.
    • Example: Smokers losing cilia
    • Dysplasia: Disordered growth; irreversible changes in cell type (Example: HPV causing epithelial cells into cancerous cells)

    Cellular Damage

    • Necrosis: Severe injury, breakdown of cellular proteins, leakage, inflammation, and enzymatic digestion.
      • Biomarkers are specific enzyme releases to help the body diagnose it.
        • Troponin(cardiac), alkaline phosphatase (bile duct), transaminases (hepatocytes)
      • Cellular swelling, nuclear changes (pyknosis, karyorrhexis, karyolysis), Disrupted plasma membrane, enzymatic digestion, often adjacent inflammation
      • Pathologic and irreversible
    • Apoptosis: Cellular suicide; programmed cell death to prevent replication of damaged cells; no collateral damage.
      • Intrinsic Pathway(Mitochondrial): most common; loss of survival signal, DNA damage, and misfolded proteins trigger release of caspases
      • Extrinsic Pathway(death receptor-initiated): Activated by plasma membrane death receptors
      • Execution Pathway: The intrinsic and extrinsic pathways combine for final apoptosis process
      • Cellular shrinkage, nuclear fragmentation, intact membrane with disoriented structures, and intact cellular contents, no inflammation, often physiologic (DNA damage then pathological).
    • Autophagy: A cell "eating" its own contents due to age, dysfunction, repair needs, nutrient deprivation or need for energy. Fusion of autosomes and lysosomes.
      • Dysregulation in many diseases (cancer, IBS, neurodegenerative disorders)

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