Gangrene and mesothelioma

Question 1

A 78-year-old man with black discoloration of his great toe.
Q1. What’s the pathology?

Answer 1

Gangrene of big toe

Question 2

Q2. What’re the types of cell death?

Answer 2

Apoptosis and Necrosis

Question 3

Q3. Mention four differences between Necrosis and apoptosis?

Answer 3

Ap; programmed cell death, the cell shrink and die without releasing its content, plasma membrane intact, no inflammation
Nec; pathological cell death , the cell swells and releasing its content, plasma membrane damaged , associated with inflammation

Question 4

Q4. Mention Types of gangrene?

Answer 4

Dry and moist

Question 5

Q5. Mention Four differences between wet and dry gangrene?

Answer 5

Dry;
common in limbs due to arterial occlusion,
well demarcated area between healthy and gangrenous ,
less to be infected,
organs are dry and shrunk
Wet;
common in bowel due to venous stasis and
line of demarcation is not distinguished ,
can be infected with bacteria,
tissue is soft swolled and moist

Question 6

Q6. Gangrene, surrounding area shows redness. What’s the pathological process? **

Answer 6

Reactive hyperemia

Question 7

Q. What’s the pathology of clubbing?

Answer 7

PDGF – > increase vascularity permeability and CT changes and this will be the hallmark for clubbing.
..
The problem in the nail bed is vascular endothelial growth factor potentiated by hypoxia and cellular stromal changes causing clubbing

Question 8

Q7. What are the pathological cells present in an atheroma?

Answer 8

Machrophages (Foam cells) and lymphocytes

Question 9

Q8. Apart from HTN, diabetes and male sex, what’re the other 3 major risk factors for atherosclerosis?

Answer 9

Hyperlipidemia, Smoking, familial predisposiotion

Question 10

Q9. Which size and type of vessels are affected by atherosclerosis?

Answer 10

Large n medium size

Question 11

Q10. Patient shows Xray with pleural plaques. What are pleural plaques?

Answer 11

Well circumscribed collagen collection and it can be calcified – can beseen in pt with asbestosis – incr. risk of mesothelioma

Question 12

Q11. What’s their significance? Pleural plaques

Answer 12

Increase the risk of developing methotheluioma amd bronchogenic carcinoma

Question 13

Q12. Mention classification of lung cancer.

Answer 13

Small cell L.C
Non-small ; adenocarcinoma, Sq. Cell Ca and large cell carcinoma

Question 14

Q13. Order lung cancer types according to prognosis from best to worse?

Answer 14

The worst; small / the better; Sq. CC
large cell , Adeno

Question 15

Q14. He presented with metastasis which was found poorly differentiated. How to identify the tissue of origin?

Answer 15

By IHC

Question 16

Q15. If the umour is epidermal growth factor positive, what chemotherapeutic agent is appropriate to be used?

Answer 16

Tyrosine Kinase inhibitor (imatinib)

Question 17

Q16. Mention types of necrosis.

Answer 17

Coagulative, caseous, Liquafactive, fat, Fibrnoid and gangrenous and tuberculous

Question 18

Q17. What’s adenocarcinoma?

Answer 18

It’s a malign. Tumor of epithelial origin that secreting mucus.

Question 19

Q18. What’s emphysema?

Answer 19

A major subtype of COPD, the alveoli will be damaged and the wall will be weak and rapture creating large air spaces replacing the lung parynchyma

Question 20

Q19. What’s para neoplastic syndrome?

Answer 20

It’s sets of symptoms and signs which develop distant to site of the tumor origin

Question 21

Q20. What hormones are related to lung cancer?

Answer 21

ACTH, ADH from small
PTH related peptide from Sq.CC

Question 22

Q21. What’s TNF? What’s PDGFRA gene?

Answer 22

It’s Proinflammatory cytokine released by macrophages in response to inflammation and it’s acute phase reactant ptn and has anti-tumor effect
.
Its platelet derived growth factor receptor alpha it’s a tyrosine kinase receptor and its presence indicate a good prognosis as tumor is responsive to imatinib (In small CC)
.
In other lung cell tumors we will give immunotherapy like PDL-1 inhibitors

Question 23

Q. Bedside test to coughing?

Answer 23

Suptum cultre

Question 24

Q.What’s FISH

Answer 24

Florecene in situ hyperdization; uses fluorescently labeled DNA probes to detect chromosomal alterations in cells –used in Cytology.