cell pathology case reviews

Question 1

causes of gastritis

Answer 1

oxygen deprivation 
chemical agents - drugs 
infectious agents - helicobacter 
immunological reactions - autoimmune 
genetic defects 
nutritional imbalances 
physical agents 
ageing

Question 2

clinical outcomes of helicobacter pyiori

Answer 2

> 80% asymptomatic/chromic gastritis
15-20% chronic atrophic gastritis/intestinal metaplasia - inf of stomach
AND gastric/duodenal ulcer
<1% gastric cancer/MALT lymphoma (mucosal associated lymphoid tissue)

Question 3

The effects of helicobacter infection on the stomach

Answer 3

Inflammation: 
acute, chronic (including ulcers)
Cell  damage: 
atrophy, metaplasia, dysplasia 
Neoplasia: 
carcinoma, lymphoma

Question 4

What is seen on an endoscopy of acute gastritis

Answer 4

redness, heat, swelling, pain, loss of function

Question 5

The key inflammatory cell of acute inflammation

Answer 5

neutrophil polypmorph

Question 6

histology of acute gastritis

Answer 6

crypt infiltrated by neutrophils

Question 7

describe an acute peptic ulcer

Answer 7

penetrate into pericavity

acid and pepsin reach pericardium

Question 8

definition of ulcer

Answer 8

break in continuity of mucous membrane and covering epithelium

Question 9

official definition of ulcer

Answer 9

“An open sore on an external or internal surface of the body, caused by a break in the skin or mucous membrane which fails to heal.
Ulcers range from small, painful sores in the mouth to bedsores and serious lesions of the stomach or intestine.”

Question 10

chronic gastritis endoscopy

Answer 10

loss of rugal pattern

atrophy

Question 11

chronic gastritis histology

Answer 11

lymphoid follicles - increased lymphocytes in stomach and germinal centre - increased risk of lymphoma

Question 12

granulomatous gastritis histology

Answer 12

subset of chronic inf
granulolmas - activated macrophages - pale cells
Type 4 hypersensitivity response.

Question 13

description of granulomatous inflammation

Answer 13

Particular form of chronic inflammation showing granuloma formation
Cluster of macrophages
Involves specific immune reaction T cells - activates T cells

Question 14

Causes of granulomatous inflammation

Answer 14

Infection – TB, fungi, helicobacter
Foreign material
Reaction to tumours
Immune diseases (sarcoid, Crohn’s)

Question 15

chronic gastric ulcer fibrosis

Answer 15

scarring associated which is not in acute

Question 16

Wound (Ulcer) Healing

Answer 16

Parenchymal cell regeneration and RESOLUTION
= acute gastric ulcer

REPAIR by connective tissue and SCAR TISSUE FORMATION
= chronic gastric ulcer

Question 17

Cellular adaptations seen in association with helicobacter gastritis

Answer 17

hyperplasia
hypertrophy
atrophy 
metaplasia and 
dysplasia.

Question 18

intestinal metaplasia in helicobacter gastritis

Answer 18

goblet cells

gastric mucosa - intestinal mucosa

Question 19

Dysplasia in helicobacter gastritis

Answer 19

nuclei bigger

Question 20

Benign tumours from glandular epithelium

Answer 20

adenomas

Question 21

Malignant tumours from glandular epithelium

Answer 21

adenocarcinomas

Question 22

cancers from lymphocytes

Answer 22

lymphomas

Question 23

Gastric (adeno)carcinoma

Answer 23

form glands

which contain mucin

Question 24

gastric lymphoma

Answer 24

lymphocytes which are destroying crypts

Question 25

fate of early atheroma

Answer 25

Asymptomatic stable plaque - common
Symptomatic stable plaque causing inducible ischaemia.
- gets bigger
Unstable plaque with risk of rupture and acute ischaemic events. - break off

Question 26

what is myocardial fibrosis

Answer 26

chronic cardiac failure

Question 27

describe MI

Answer 27

Acute cardiac failure

Sudden death

Question 28

what is an aneurism

Answer 28

An abnormal blood-filled bulge of a blood vessel and especially an artery resulting from weakening of the vessel wall.

Question 29

fate of coronary artery aneurism

Answer 29

rupture - bust
thrombosis - poor blood flow
blood flow not linear