haroon pathology Flashcards
3 stages of inflammation
- increase in vessel calbire - it gets wider
- fluid exudate
- cellular exudate
neutrophil action in acute inflammation
- margination
- adhesion using selectin protein
- emigration + diapedisis
- chemotaxis - following cytokines to inflammation site
neutrophil action at site of acute inflmaation
- phagocytosis
- phagolysosome formation + bacterial killing
- macrophages clear debris
define granuloma
aggregate of epitheloid histocytes
how to detect granulomatous disease
high ACE because granulomas secrete ACE
3 stages of thrombosis
- vasospasm
- formation of primary platelt plug
- coagulation cascade
how is primary platelet plug formed
VWF binds to exposed collagen
platelts bind to VWF via gp1b
activates platelts
they go from discoid to pseudopoid
platelts bind to each other via gp2a/3b –> aggregation
intrinsic part of coagulation cascade
12
11
9
8
10
extrinsic part of coahulation cascade
3
7
10
common part of coagulation cascade
10
5
2
1
how do arterial thrombi present
cold, pale, loss of pulse
how do venous thrombi present
tender, swollen, red
treatment for arterial thrombi
antiplatelts - aspirin
treatment for veous thrombi
DOAC or warfarin
3 fates of thrombi
- resolution
- organisation
- embolism
where do arterial emboli form
in systemic circulation from left heart
where do venous embol form
in pulmonary circulation from right heart
components of atheroscloertic plauqe
- lipid
- smooth muscke
- macrophages/foam cells
- platelets
- fibroblasts
formation of atherscloeritc plaque
- fatty streak
- lipid accumulation
- plateley aggregation
- fibrin mesh and rbc trapping
- fibrous cap
define apoptosis
non inflammatory controlled cell death
what happens in apoptosis
- cells shrink
- organeless are retained
- cell membrane in tact
- chromatin unaltered so no mutation
- easy process
3 mechancisms of apptosis
- intrinsic
- extrinsic
- cytotoxic
what happens in intrinsic apoptosis
bax protein acts on mitochondiral membrane to promote cytochrome c release
activates caspases –> apoptosis
what happens in extrinsic apoptosis
FasL or TNF-L binds to CSM receptots
activates caspases –> apoptosis
what happens in cytotoxic apoptosis
CD8+ binding releases granzyme B from CD8+ cell
granzyme B –> perforin –> caspases –> apoptosis
define necrosis
inflmmatory traumatic cell death
what happens in necrosis
- cells burst
- organelles splurge out
- cell membranes damaged
- chromatin altered so big mutation risk
which cells can neoplasms arise from
nucleated cells only
cant srise from erythrocytes
define neoplasm
autonomos abnormal persistent new growth
how can benign tumours be patholgicL
- horomone secreting eg prolactinoma
- put pressure on local structures
- obtstruction
- transformation into malignant
impavcts of malignant tumours
- pressure on structurs
- form secondary metastatic tumours
- obstruction
- from paraneoplastc sydnromes
- blood loss
- pain
non glandular benign tumour
papilloma
non glandular malignant tumiur
carcinoma
glandular benign tumur
adenoma
glandular malignant tumour
adenocarcinoma
which tumour never metastatsizes
basal cell carcinoma
what does teratoma mean
cancer of all 3 germ layers
4 characteristucs of neoplastic cell
- autocrine growth stimulation
- evasion of apoptosis
- telomerase
- susatined angiogenesis and ability to invade BM
how do neoplasms have autocrine growth stimulation
- overexpression of growth hormone
- mutation of tumour supressor genes eg p53
- underexpression of growth inhibitors
how does telomerase help neoplastic cells
prevents telomeres shorterning with each replication
pathway of metastasis
- detachment from primary site
- invasion of other tissues
- invasion of blood vessels
- evasion of host defence, adherence to blood vessel wall
- extravasation to distant site
3 methods of spread for metastastes
- haemategenous
- lymphatics
- transolemic - via effusion and fluid
how do sarcomas mostly spread
hameatogenous
most common method of tumur staging
TNM - tumour, node , metastases
except for lymphoma, lakeumea, and CNS cancers
what kind of prevention is cancer screening
secondary
which cancers are screened for in uk
cervical - cervical swab
breast - mammogram
colorectal - foecal occult
what does heel prick test at birth test for
- cystic fibrosis
- sickle cell anemia
- congential hypothyroidism
