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Cell Pathology Flashcards

1
Q

What is resolution

A

Regeneration of normal, functional, parenchymal cells

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2
Q

Where is resolution possible

A

Cells that are capable of regeneration e.g. liver

Where there is little structural damage

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3
Q

Define inflammation

A

Reactions of living vascularated tissue to sub-lethal cellular injury

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4
Q

Give the features of acute inflammation

A 
Transient and early response to injury. 
Histamine release 
Necrosis
Neutrophils involved
Mast cells and eosinophils also involved
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5
Q

Give the features of chronic inflammation

A

Inflammation of a prolonged duration
Cytokines
Granulation tissue
Macrophages, lymphocytes and plasma cells involved.

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6
Q

Give the features of granulomatous inflammation

A

Specialised form of chronic inflammation
Granuloma formation (ball of activated lymphocytes)
Giant cells that are fused macrophages - multi-nucleated and horse-shoe shaped nucleus

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7
Q

What are the positives of inflammation

A

Removal of causative agent
Cessation of inflammatory agent
Healing of tissue

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8
Q

What are the negatives of inflammation

A

Local tissue is damaged which leads to scarring
Systemic inflammatory reaction
Multi-organ failure

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9
Q

How does resolution relate to lobar pneumonia

A

exudation
Red hepatisation (RBCs go to alveoli)
Break down (grey hepatisation)
Resolution

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10
Q

Describe repair in relation to inflammation

A

Scar tissue formation

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11
Q

When may repair occur

A

Tissue loss is too great

Cells are unable to regenerate

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12
Q

Give the process of repair

A

Fibroblasts lay down collagen
Collagen is remodelled for maximum tensile strength
Normal tissue is replaced by non-functional scar tissue

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13
Q

Define tumour

A

Mass forming lesion

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14
Q

Define neoplasm

A

Autonomous growth of tissue which have escape normal constraints

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15
Q

Define malignant

A

Invasion of localised and/or spread to other tissue

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16
Q

Define benign

A

Localised

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17
Q

Define cancer

A

Malignant neoplasm

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18
Q

Define hamartoma

A

Localised benign overgrowth of one or more mature cell types

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19
Q

Define hererotopias

A

Normal tissue found in parts of the body where they are not usually found

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20
Q

Compare benign to malignant

A

Well differentiated vs poorly differentiated
Slow vs rapid
Does not infiltrate BM vs does infiltrate BM
No metastasis vs metastasis

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21
Q

Define teratoma§

A

Tumour from germ cell

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22
Q

How may a tumour be spread

A 
Direct extension
Haematogenous
Lymphatic
Transcoelomic 
Perineural
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23
Q

Describe TNM

A 
T = tumour size and invasion
N = Nodes (no. of lymph involved)
M = Metastases
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24
Q

What is staging

A

The spreading

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25
Q

What is grade

A

Differentiation stage

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26
Q

What is more important, staging or grade?

A

stage

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27
Q

Give examples of carcninogens

A 
Environmental = UV, ionising radiation, asbestos
Infection = EBV, HPV, Hep B, HHV8, H. Pylori
Chemical = Hydrocarbons, Amines, Nitrosamines, Azo dyes
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28
Q

What are the types of cell injury

A 
Genetic defects
Infectious agents
Nutritional imbalance
Chemical agents
Hypoxia 
Ageing 
Physical agents
Immunological reactions
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29
Q

Give examples of vulnerable mechanisms

A

Cell membrane integrity
ATP generation
Protein synthesis
Genetic apparatus

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30
Q

Define atrophy and give an example

A

A decrease in size of cell or organ by cell substance loss e.g. cortical atrophy in Alzheimers

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31
Q

Define hypertrophy and give an example

A

Increase in size of cells, leading to an increase in organ or tissue size e.g. hypertension in the left ventricle

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32
Q

Define hyperplasia and give an example

A

Increase in number of cells in an organ, increasing organ size e.g. oestrogen induced benign prostatic

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33
Q

DefineMetaplasia and give an example

A

Reversible change where one cell type becomes another cell type e.g. Barrett’s oesophagus.

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34
Q

Define Dysplasia and give and example

A

Pre cancerous cells which show genetic and cytological features of malignancy e.g. cervical intraepithelial neoplasia

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35
Q

Give examples of reversible injury/ change

A

Fatty change

Cellular swelling

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36
Q

Describe apoptosis

A

Programmed cell death of single cells. Active and energy-dependent.

37
Q

Describe necrosis

A

Confluent cell death associated with inflammation.

38
Q

Give the 4 types of necrosis

A

Coagulative - substance and not the shape
Liquefactive - tissue broken down
Caseous - granulatomous inflammation
Fat - break down of fat cells

39
Q

What is an ulcer

A

Local defect or excavation of the surface of an organ or tissue, produced by sloughing of necrotic inflammatory tissue

40
Q

What does degenerative mean

A

Change of a tissue to a lower or less functionally active form

41
Q

sub-lethal injury

A

An injury that does not kill the cell/organism

42
Q

Who is the coroner

A

independent judicial officer that has a duty to investigate the circumstance of death for protection of the public

43
Q

Give the types of death that must be reported to the coroner

A 
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
44
Q

What is a hospital autopsy

A

Allows thorough examination of the disease, the extent of their disease, treatment and effects

45
Q

Why may a hospital autopsy be conducted

A

Audit - major discrepancies between stated and actual cause of death
Monitoring treatment effectiveness
Teaching
Research

46
Q

What is the consent needed for hospital autopsies

A

Consent require from relatives but once taken, any material may be used

47
Q

What is the consent required for a coroner’s autopsy

A

No consent required by material may only be taken from the area related to cause of death

48
Q

Give the sub sections of a death certificate

A

1a - immediate cause of death
1b - predisposing factor
1c - predisposing factor
2 - other factors contributing to but not directly leading to death

49
Q

Give an example of a death certificate

A

1a- haemopericardium
1b-myocardial infarction
1c- ischaemic heart disease
2- hypertension

50
Q

Give natural causes of sudden unexpected death

A 
Cardiovascular disease (cardiac arrhythmia)
Berry aneurysm 
Haemorrhage
Pulmonary embolus
Asthma
bleeding ulcer
51
Q

Give non-natural causes of sudden unexpected death

A

Drugs
Alcohol
Trauma

52
Q

Define a bruise

A

A blunt trauma injury that causes bleeding to subcutaneous tissue

53
Q

Define an abrasion

A

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

54
Q

Define a laceration

A

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.

55
Q

Compare cut and stab

A 
Cut = length > depth
Stab = depth> length
56
Q

Give the key features of Helicobacter pylori

A

Gram -ve
Asymptomatic
Associated with lymphoma

57
Q

Give the mechanism of H pylori infection of the stomach

A 
Infection
Inflammation
Metaplasia and atrophy
Dysplasia
Adenocarcinoma
58
Q

What are the 3 things an atheroma can lead to

A

Slow occlusion of the artery
Sudden occlusion of the artery
Weakening of the artery wall

59
Q

What can slow occlusion of the artery lead to

A

Angina
Claudication
Vascular dementia

60
Q

What can sudden occlusion of the artery lead to

A

Thrombosis

Embolism

61
Q

What can weakening of the artery wall lead do

A

Aneurysms

62
Q

What is oedema

A

An abnormal increase in interstitial fluid

63
Q

What physical changes are seen with oedema

A

Pitting = fluid in subcutaneous tissue

Fluid in serous cavity

64
Q

What are the causes of oedema

A 
increase in hydrostatic pressure
Decrease in oncotic pressure 
Lymphatic obstruction
Inflammation
Water and salt retention
65
Q

What are the two types of oedema

A

Generalised and localised

66
Q

Summarise generalised oedema

A

Peritoneal, pleural, pericardial serous cavities
Left heart failure leads to right heart failure
Inflammation
Hypertenstion
Lymphatic obstruction

67
Q

Summarise localised oedema

A

Pulmonary or cerebral

decrease in oncotic (albumin) pressure often due to hypoproteinaemia or congestive heart failure

68
Q

How does pulmonary localised oedema occur

A

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

69
Q

How can you identify pulmonary oedema on an X ray

A

Fluid shows as thin white lines with no clear spaces on the lungs

70
Q

Describe cerebral localised oedema

A

Vasogenic so increased capillary and venule permeability. Cytotoxic as Na-K pumps do not work

71
Q

Define thrombosis

A

Abnormal blood clot formation in the circulatory system

72
Q

What is Virchow’s triad

A

Causes of thrombosis
Endothelial injury
Stasis or turbulent blood flow (pulmonary embolus)
Hypercoagulation

73
Q

When will thrombosis come into attention

A

Embolisation

Artery obstruction

74
Q

What are the thrombosis fates

A

Propagation (get bigger)
Embolisation (breaks off)
Dissolves / dissolution
Organisation / restore capillary flow

75
Q

Give features of arterial thrombosis

A

Vessel wall injury
Narrowing
Occlusion leads to infarction

76
Q

Give features of venous thrombosis

A

Stasis or hyper coagulability
deep leg veins
Pulmonary embolus

77
Q

What is an embolus

A

Abnormal material in circulation carried away from the origin

78
Q

Give the features of an embolus

A

Most are thromboemboli (fragments from the thrombus)
Could also be air, fat, tumour
Can block blood vessels

79
Q

What are the risk factors for embolus

A

Age
Pregnancy
Trauma

80
Q

What is an infarct

A

Area of ischemic necrosis from occlusion

81
Q

Compare white and red infarct

A 
White = arterial occlusion in firm/dense organs
Red = venous occlusion in double circulatory organs
82
Q

What is atherosclerosis

A

Chronic disease caused by focal accumulation of lipids, fibrous tissue and smooth muscle cells

83
Q

What is haemorrhage

A

Extravasion of blood due to vessel rupture

84
Q

What are the causes of haemorrhage

A

Trauma to vessel
Amyloid
Collagen vascular diseases

85
Q

What are the types of shock

A

cardiogenic
Hypovolaemia
Septic
Neurogenic

86
Q

Compare stable to unstable atherosclerosis

A

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

87
Q

What is stable atherosclerosis related to

A

stable angina and chronic limb ischaemia

88
Q

What is unstable atherosclerosis related to

A

unstable angina and myocardial infarction

?? (14 decks)

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