Clinical pathology Flashcards
Autopsy; Autopsy findings; Cancer
Who is the coroner?
Independent judicial officer
Has a statutory duty to investigate circumstances of certain deaths for public protection
What 11 types of cases must be reported?
Unknown cause of death Deceased not seen by doctor before death (within 14 days) Violent, unnatural or suspicious death Occurred during : -operation/before anaesthetic recovery -police detention Death may be due to: -accident -neglect -industrial disease/previous employment -abortion -suicide -poisoning
What are the 5 reasons for a hospital autopsy?
1) Identify extent of disease, treatment and effects
2) Auditing if major discrepancy between stated and actual cause of death
3) Teaching
4) Monitoring effectiveness of new treatments
5) Research
When is consent required?
Only needed for hospital autopsy
What are the 8 causes of unexpected death?
Cardiac problems Vascular ruptures Haemorrhages within CNS Epilepsy Pulmonary embolus GI tract issues Drugs, alcohol Trauma
What classifies a bruise/contusion?
Blunt force trauma
Occurs alone or in association with other injuries
Extraversated collection of blood leaking from small arteries and venules
May not be seen on surface if deep
What classifies an abrasion?
Graze due to blunt trauma injury
Confined to the epidermis
Can occure due to tangenital force or vertical force
What classifies a laceration?
Split to skin due to blunt force overstretching skin
Passes through whole thickness
Deep and will bleed
Ragged margins showing bruising and crushing
More common where skin can be compressed
What classifies a stab?
Depth>width
Caused by sharp object
Clean edges to wound
What classifies a cut?
Length>depth
Caused by sharp object
Clean edges to wound
Define cancer
Malignant growth caused by uncontrolled cell division
Define neoplasm
Autonomous growth of tissue that has escaped normal constraints of cell proliferation
Benign or malignant
Define tumour
Any kind of mass forming lesion
- neoplastic
- inflammatory
- haematomous
Define metastasis
Spread of malignant tumours via blood vessels to other parts of the body
What distinguishes malignant from benign tumours?
Malignant: Can be poorly differentiated Rapid growth Infiltrates basement membrane Can metastasise
Define carcinogen
Any substance that may cause cancer production when exposed to living tissue
What are 3 examples of environmental carcinogens and the cancers they cause?
UV - Basal/squamous cell carcinoma, multiple myeloma
Ionising radiation - Leukaemia
Asbestos - Mesothelioma
What are 5 examples of infectious carcinogens and the cancers they cause?
EBV - Burkitt's lymphoma HPV - cervical cancer Hep B - hepatocellular carcinoma HHV8 - Kaposi sarcoma H.pylori - Gastric cancer and lymphoma
What are 4 examples of chemical carcinogens?
Hydrocarbons
Amines
Nitrosamines
Azo dyes
What are the 10 features of a successful cancer screening programme?
1) Condition an important health problem
2) Possible treatment available
3) Facilities for diagnosis/treatment available
4) Recognisable latent/early symptomatic stage
5) Suitable test/examination
6) Test acceptable to population
7) Natural history understood
8) Agreed policy on which patients to treat
9) Cost effective
10) Case-findings continuous process
What are the 2 pathological features that predict cancer prognosis?
Grading - degree of differentiation
Staging - degree of metastasis (most important determinant of prognosis)
What is the most commonly used system for staging cancer?
TNM
Tumour - size
Nodes - involvement of lymph nodes
Metastasis - happened or not?
