general pathology Flashcards
hospital autopsies
<10% of autopsies in the UK
Requires Medical Certificate cause of Death (MCCD)
Audit, teaching, governance, research
medico-legal autopsies
> 90% of autopsies in the UK
Coronial
forensic
presumed natural death
Cause of death not known
not seen by doctor within days of death
presumed iatrogenic deaths
peri/post operative deaths
anaesthetic deaths
abortion
complications of therapy
presumed unnatural deaths
accidents
custody deaths
war/industrial pensions
doctor referral for autopsy
No statutory duty to refer
common law duty
GMC guidance
registrar of BDM referral for autopsy
statutory duty to refer
other referrals for autopsy
Relatives
the police
anatomical pathology technicians
histopathologists
Hospital autopsies
coronial autopsies (Natural deaths, drowning, suicide, accidents, road traffic deaths, fire deaths, industrial deaths, peri/post operative deaths)
forensic pathologists
Coronial autopsies (homicide, death in custody, neglect and any done by histopathologists due to the action of a third party)
inflammation
local and physiological response to tissue injury
not a disease but a manifestation of disease
outcomes and harmful effects of inflammation
Benefits=
resolution
suppuration
organisation
Diseases= Digestion of normal tissue Swelling Compressing brain tissue Fibrosis from chronic inflammation Autoimmunity Over reaction to stimulus
acute inflammation
initial and often transient series of tissue reactions to injury
sudden onset
short duration
usually resolves
cell type= neutrophil polymorphs
chronic inflammation
Subsequent of often prolonged tissue reactions following the initial response
slow onset or sequel to acute
long duration
may never resolve
cell type= macrophages
cells involved in inflammation
neutrophil polymorphs macrophages lymphocytes endothelial cells fibroblasts
neutrophil polymorphs (inflammation)
short lived
first on the scene of acute
cytoplasmic granules full of enzymes that kill bacteria
usually die at the scene of inflammation
release chemicals that attract other inflammatory cells such as macrophages
macrophages (inflammation)
long lived cells- weeks to months
phagocytic properties
ingest bacteria and debris
carry debris away
present antigens to lymphocytes
lymphocytes (inflammation)
long lived cells- years
produce chemicals that attract other inflammatory cells
immunological memory
endothelial cells (inflammation)
line capillaries
become sticky in areas of inflammation so inflammatory cells adhere to them
become porous to allow inflammatory cells to pass into tissues
fibroblasts (inflammation)
long lived cells
form collagen in areas of chronic inflammation
causes of acute inflammation
microbial infections (bacterial, viruses)
hypersensitivity (parasites, allergic reactions)
physical agents (trauma, ionising radiation, heat)
chemicals (corrosives, acids, alkalis)
bacterial toxins
tissue necrosis
microbial infections (inflammation)
most common cause of acute inflammation
viruses lead to death of cells by intracellular multiplication
bacteria release exotoxins
parasitic infections and TB inflammation are examples of where hypersensitivity is important
hypersensitivity inflammation
altered state of immunological responsiveness causes inappropriate or excessive immune reaction
damages tissues
has cellular or chemical mediators
physical agents in inflammation
tissue damage leading to inflammation may occur through physical trauma, UV or other ionising radiation, burns or frostbite