Clinical relevance Flashcards
Which of these pathological terms best described the cardiac features seen in this image?
- hypertrophy
- hyperplasia
- metaplasia
- dysplasia
- atrophy
hypertrophy
This man has damage to the median and ulnar nerves supplying the muscles of his hand. Which of these terms best describes the abnormality which is present?
- hypertrophy
- hyperplasia
- metaplasia
- dysplasia
- atrophy
atrophy
A 65 year old patient who has a long history of heartburn has an endoscopy and the gastroenterologist biopsies a velvety area in the lower oesophagus.
Which term best describes the changes which are present in this biopsy?
- Hypertrophy
- Hyperplasia
- Metaplasia
- Dysplasia
- Atrophy
metaplasia
A dermatologist biopsies a scaly patch from the scalp of an elderly farmer and the pathologist states that “The keratinocyte nuclei are enlarged and hyperchromatic with an increased nuclear to cytoplasmic ratio. These cells do not mature”. The image of what the pathologist sees is on the left and there is some normal epithelium on the right for comparison.
Which process best describes what the pathologist is seeing?
- hypertrophy
- hyperplasia
- metaplasia
- dysplasia
- atrophy
dysplasia
A 25 year old woman has given birth to her first child and is now breast feeding. Which term best describes the change which has happened in her breast lobules, photographed in the image on the left? The image on the right shows a non-lactating breast for comparison.
- hypertrophy
- hyperplasia
- metaplasia
- dysplasia
- atrophy
Hyperplasia
The cervical squamous epithelial cells in the left image were seen when a 28 year old woman had a screening test. The pathologist reported that mild dyskaryosis* was present and a subsequent biopsy showed mild dysplasia of the cervix. Compare the cells on the left to those on the right. The cells on the left show enlarged dark nuclei with irregular nuclear outlines and a mildy increased nuclear to cytoplasmic ratio.
Is this change reversible ie. is dysplasia reversible?
yes
A 76-year-old female has been on high dose steroids to suppress an autoimmune disease which she has forgotten the name of. Which of the following cells is most likely to be activated in her bones?
- osteoblasts
- osteoclasts
- fibroblasts
- adipocytes
- osteocytes
Osteoclasts
as high dose of sterioids inhibit osteoblasts while the production of RANK is stimulated
You are walking home one evening when you witness a cyclist falling from his bicycle onto his outstretched arm. 6 hours later an X-ray reveals a fracture of the distal radius. If you looked at the fracture site under the microscope at this point what would you see?
- proliferating blood vessels and fibroblasts forming a mass of granulation tissue
- layers of recently formed woven bone
- large aggregates of plasma cells
- layers of fibrin and red blood cells forming a haematoma
- active endochondral ossification
layers of fibrin and red blood cells forming a haematoma
A 20 year old woman was involved in a road traffic collision where she was the driver. In addition to fracturing her tibia she suffered considerable soft tissue injuries. She tells you that her urine has recently turned a reddish-brown colour. Which of the following conditions is the most likely explanation for her symptoms?
- acute thromboembolism
- fat embolism
- myoglobinuria
- hypernilirubinaema
- bone marrow embolism
myoglobinuria
A 65-year-old man suffers multiple traumatic injuries following a motorcycle collision. Two days after the injury he suddenly becomes short of breath and becomes more irritable, confused and restless. You notice some petechiae (seen in the image) on his trunk and face. Which is the most likely diagnosis in this man?
- acute thromboembolism
- fat embolism
- air embolism
- air embolism
- ammiotic embolis
- acute osteomyelitis with septicaemia
Fat embolism
Fat embolism most commonly occurs as a result of fractures of bones such as the femur or pelvis. Fat embolism syndrome occurs when fat enters the blood stream and results in symptoms, which usually begin within a day of the fracture.
Describe the three main steps by which a fracture is likely to heal normally and for each step describe the normal cellular response
Inflammatory phase :
- bleeding from the torn vessels, clotting cascade activated and inflammatory cells brought into the area
- haematoma forms in fracture gap
- occurs immediately after injury, peaks at 48 hours and subsidises by 1 week
Reparative phase:
- at the fracture site, mesenchymal stem cells become fibroblasts, osteoblasts and chrondroblasts
- a soft callus is formed by chrondogenesis at the periphery
- a hard callus is formed by intramembrous ossification at the cortical bone ends
- endochondral ossification converts callus to woven bone, starting within the first few days and lasting a few weeks
Remodelling phase:
- woven bone is replaced by lamellar bone
- excess callus is resorbed
- begins a few weeks after the injury and lasts years
A 65 year old male fell over and sustained a bimalleolar ankle fracture whilst smoking a cigarette outside the diabetic foot clinic. He has a PMH or diabetes, obesity, hyperthyroidism and hypertension. The fracture was treated non-operatively with a below the knee cast. At his fracture clinic review, 9 weeks following the fracture, the orthopaedic surgeon tells him that radiographs show the fractures are not healing at the rate of which one would expect.
What two risk factors could be responsible for the delayed fracture healing?
- diabetes
- 2) smoking
