Cell Pathology Flashcards
What is resolution
Regeneration of normal, functional, parenchymal cells
Where is resolution possible
Cells that are capable of regeneration e.g. liver
Where there is little structural damage
Define inflammation
Reactions of living vascularated tissue to sub-lethal cellular injury
Give the features of acute inflammation
Transient and early response to injury. Histamine release Necrosis Neutrophils involved Mast cells and eosinophils also involved
Give the features of chronic inflammation
Inflammation of a prolonged duration
Cytokines
Granulation tissue
Macrophages, lymphocytes and plasma cells involved.
Give the features of granulomatous inflammation
Specialised form of chronic inflammation
Granuloma formation (ball of activated lymphocytes)
Giant cells that are fused macrophages - multi-nucleated and horse-shoe shaped nucleus
What are the positives of inflammation
Removal of causative agent
Cessation of inflammatory agent
Healing of tissue
What are the negatives of inflammation
Local tissue is damaged which leads to scarring
Systemic inflammatory reaction
Multi-organ failure
How does resolution relate to lobar pneumonia
exudation
Red hepatisation (RBCs go to alveoli)
Break down (grey hepatisation)
Resolution
Describe repair in relation to inflammation
Scar tissue formation
When may repair occur
Tissue loss is too great
Cells are unable to regenerate
Give the process of repair
Fibroblasts lay down collagen
Collagen is remodelled for maximum tensile strength
Normal tissue is replaced by non-functional scar tissue
Define tumour
Mass forming lesion
Define neoplasm
Autonomous growth of tissue which have escape normal constraints
Define malignant
Invasion of localised and/or spread to other tissue
Define benign
Localised
Define cancer
Malignant neoplasm
Define hamartoma
Localised benign overgrowth of one or more mature cell types
Define hererotopias
Normal tissue found in parts of the body where they are not usually found
Compare benign to malignant
Well differentiated vs poorly differentiated
Slow vs rapid
Does not infiltrate BM vs does infiltrate BM
No metastasis vs metastasis
Define teratoma§
Tumour from germ cell
How may a tumour be spread
Direct extension Haematogenous Lymphatic Transcoelomic Perineural
Describe TNM
T = tumour size and invasion N = Nodes (no. of lymph involved) M = Metastases
What is staging
The spreading
What is grade
Differentiation stage
What is more important, staging or grade?
stage
Give examples of carcninogens
Environmental = UV, ionising radiation, asbestos Infection = EBV, HPV, Hep B, HHV8, H. Pylori Chemical = Hydrocarbons, Amines, Nitrosamines, Azo dyes
What are the types of cell injury
Genetic defects Infectious agents Nutritional imbalance Chemical agents Hypoxia Ageing Physical agents Immunological reactions
Give examples of vulnerable mechanisms
Cell membrane integrity
ATP generation
Protein synthesis
Genetic apparatus
Define atrophy and give an example
A decrease in size of cell or organ by cell substance loss e.g. cortical atrophy in Alzheimers
Define hypertrophy and give an example
Increase in size of cells, leading to an increase in organ or tissue size e.g. hypertension in the left ventricle
Define hyperplasia and give an example
Increase in number of cells in an organ, increasing organ size e.g. oestrogen induced benign prostatic
DefineMetaplasia and give an example
Reversible change where one cell type becomes another cell type e.g. Barrett’s oesophagus.
Define Dysplasia and give and example
Pre cancerous cells which show genetic and cytological features of malignancy e.g. cervical intraepithelial neoplasia
Give examples of reversible injury/ change
Fatty change
Cellular swelling
Describe apoptosis
Programmed cell death of single cells. Active and energy-dependent.
Describe necrosis
Confluent cell death associated with inflammation.
Give the 4 types of necrosis
Coagulative - substance and not the shape
Liquefactive - tissue broken down
Caseous - granulatomous inflammation
Fat - break down of fat cells
What is an ulcer
Local defect or excavation of the surface of an organ or tissue, produced by sloughing of necrotic inflammatory tissue
What does degenerative mean
Change of a tissue to a lower or less functionally active form
sub-lethal injury
An injury that does not kill the cell/organism
Who is the coroner
independent judicial officer that has a duty to investigate the circumstance of death for protection of the public
Give the types of death that must be reported to the coroner
Cause of death is unkown Deceased has not been seen after death Death was violent, unnatural or suspicious Death may be due to an accident Death may be due to neglect Due to industrial disease Abortion Operation or recovery from anaesthetic Suicide Police or prison custody Poisoning
What is a hospital autopsy
Allows thorough examination of the disease, the extent of their disease, treatment and effects
Why may a hospital autopsy be conducted
Audit - major discrepancies between stated and actual cause of death
Monitoring treatment effectiveness
Teaching
Research
What is the consent needed for hospital autopsies
Consent require from relatives but once taken, any material may be used
What is the consent required for a coroner’s autopsy
No consent required by material may only be taken from the area related to cause of death
Give the sub sections of a death certificate
1a - immediate cause of death
1b - predisposing factor
1c - predisposing factor
2 - other factors contributing to but not directly leading to death
Give an example of a death certificate
1a- haemopericardium
1b-myocardial infarction
1c- ischaemic heart disease
2- hypertension
Give natural causes of sudden unexpected death
Cardiovascular disease (cardiac arrhythmia) Berry aneurysm Haemorrhage Pulmonary embolus Asthma bleeding ulcer
Give non-natural causes of sudden unexpected death
Drugs
Alcohol
Trauma
Define a bruise
A blunt trauma injury that causes bleeding to subcutaneous tissue
Define an abrasion
A graze or scratch (superficial blunt trauma injury) which is confined to the epidermis, but may extend to the superficial dermis. Due to tangenital force e.g. friction burn, whip, stamp
Define a laceration
A split in the skin as a result of blunt force trauma overstitching it. They are deep and bleed with a ragged margin. Common where skin is compressed between force and underlying bone, rarely over fleshy areas.
Compare cut and stab
Cut = length > depth Stab = depth> length
Give the key features of Helicobacter pylori
Gram -ve
Asymptomatic
Associated with lymphoma
Give the mechanism of H pylori infection of the stomach
Infection Inflammation Metaplasia and atrophy Dysplasia Adenocarcinoma
What are the 3 things an atheroma can lead to
Slow occlusion of the artery
Sudden occlusion of the artery
Weakening of the artery wall
What can slow occlusion of the artery lead to
Angina
Claudication
Vascular dementia
What can sudden occlusion of the artery lead to
Thrombosis
Embolism
What can weakening of the artery wall lead do
Aneurysms
What is oedema
An abnormal increase in interstitial fluid
What physical changes are seen with oedema
Pitting = fluid in subcutaneous tissue
Fluid in serous cavity
What are the causes of oedema
increase in hydrostatic pressure Decrease in oncotic pressure Lymphatic obstruction Inflammation Water and salt retention
What are the two types of oedema
Generalised and localised
Summarise generalised oedema
Peritoneal, pleural, pericardial serous cavities
Left heart failure leads to right heart failure
Inflammation
Hypertenstion
Lymphatic obstruction
Summarise localised oedema
Pulmonary or cerebral
decrease in oncotic (albumin) pressure often due to hypoproteinaemia or congestive heart failure
How does pulmonary localised oedema occur
Left heart failure leads to hydrostatic pressure being greater than oncotic pressure so fluid enters the interstitial spaces. Fluid then enter the alveoli. Leads to pneumonia, dyspnoea and orthopnoea
How can you identify pulmonary oedema on an X ray
Fluid shows as thin white lines with no clear spaces on the lungs
Describe cerebral localised oedema
Vasogenic so increased capillary and venule permeability. Cytotoxic as Na-K pumps do not work
Define thrombosis
Abnormal blood clot formation in the circulatory system
What is Virchow’s triad
Causes of thrombosis
Endothelial injury
Stasis or turbulent blood flow (pulmonary embolus)
Hypercoagulation
When will thrombosis come into attention
Embolisation
Artery obstruction
What are the thrombosis fates
Propagation (get bigger)
Embolisation (breaks off)
Dissolves / dissolution
Organisation / restore capillary flow
Give features of arterial thrombosis
Vessel wall injury
Narrowing
Occlusion leads to infarction
Give features of venous thrombosis
Stasis or hyper coagulability
deep leg veins
Pulmonary embolus
What is an embolus
Abnormal material in circulation carried away from the origin
Give the features of an embolus
Most are thromboemboli (fragments from the thrombus)
Could also be air, fat, tumour
Can block blood vessels
What are the risk factors for embolus
Age
Pregnancy
Trauma
What is an infarct
Area of ischemic necrosis from occlusion
Compare white and red infarct
White = arterial occlusion in firm/dense organs Red = venous occlusion in double circulatory organs
What is atherosclerosis
Chronic disease caused by focal accumulation of lipids, fibrous tissue and smooth muscle cells
What is haemorrhage
Extravasion of blood due to vessel rupture
What are the causes of haemorrhage
Trauma to vessel
Amyloid
Collagen vascular diseases
What are the types of shock
cardiogenic
Hypovolaemia
Septic
Neurogenic
Compare stable to unstable atherosclerosis
Stable - less inflammation with a thick fibrous cap. Slow growing with a low rupture risk
unstable - more inflammation with a lipid core and a thin fibrous cap and a high rupture risk
What is stable atherosclerosis related to
stable angina and chronic limb ischaemia
What is unstable atherosclerosis related to
unstable angina and myocardial infarction
