Clinical pathology

Question 1

Who is the coroner?

Answer 1

Independent judicial officer

Has a statutory duty to investigate circumstances of certain deaths for public protection

Question 2

What 11 types of cases must be reported?

Answer 2

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

Question 3

What are the 5 reasons for a hospital autopsy?

Answer 3

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

Question 4

When is consent required?

Answer 4

Only needed for hospital autopsy

Question 5

What are the 8 causes of unexpected death?

Answer 5

Cardiac problems
Vascular ruptures
Haemorrhages within CNS
Epilepsy
Pulmonary embolus
GI tract issues
Drugs, alcohol
Trauma

Question 6

What classifies a bruise/contusion?

Answer 6

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

Question 7

What classifies an abrasion?

Answer 7

Graze due to blunt trauma injury
Confined to the epidermis
Can occure due to tangenital force or vertical force

Question 8

What classifies a laceration?

Answer 8

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

Question 9

What classifies a stab?

Answer 9

Depth>width
Caused by sharp object
Clean edges to wound

Question 10

What classifies a cut?

Answer 10

Length>depth
Caused by sharp object
Clean edges to wound

Question 11

Define cancer

Answer 11

Malignant growth caused by uncontrolled cell division

Question 12

Define neoplasm

Answer 12

Autonomous growth of tissue that has escaped normal constraints of cell proliferation
Benign or malignant

Question 13

Define tumour

Answer 13

Any kind of mass forming lesion

• neoplastic
• inflammatory
• haematomous

Question 14

Define metastasis

Answer 14

Spread of malignant tumours via blood vessels to other parts of the body

Question 15

What distinguishes malignant from benign tumours?

Answer 15

Malignant:
Can be poorly differentiated
Rapid growth
Infiltrates basement membrane
Can metastasise

Question 16

Define carcinogen

Answer 16

Any substance that may cause cancer production when exposed to living tissue

Question 17

What are 3 examples of environmental carcinogens and the cancers they cause?

Answer 17

UV - Basal/squamous cell carcinoma, multiple myeloma
Ionising radiation - Leukaemia
Asbestos - Mesothelioma

Question 18

What are 5 examples of infectious carcinogens and the cancers they cause?

Answer 18

EBV - Burkitt's lymphoma
HPV - cervical cancer
Hep B - hepatocellular carcinoma
HHV8 - Kaposi sarcoma
H.pylori - Gastric cancer and lymphoma

Question 19

What are 4 examples of chemical carcinogens?

Answer 19

Hydrocarbons
Amines
Nitrosamines
Azo dyes

Question 20

What are the 10 features of a successful cancer screening programme?

Answer 20

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

Question 21

What are the 2 pathological features that predict cancer prognosis?

Answer 21

Grading - degree of differentiation

Staging - degree of metastasis (most important determinant of prognosis)

Question 22

What is the most commonly used system for staging cancer?

Answer 22

TNM
Tumour - size
Nodes - involvement of lymph nodes
Metastasis - happened or not?