ICS Flashcards
What is inflammation?
A reaction to injury or infection involving cells such as neutrophils and macrophages
What does an abscess consist of?
A collection of neutrophils, death tissues (debris) and bacteria
What type of infection it is when the throat and tonsils are red without white pus?
Viral infection
What type of infection it is when the throat and tonsils are white with pus?
Bacterial infection (have to give antibiotics)
What are the 2 conditions when inflammation is good?
Infection, Injury
What are the 2 times when inflammation is bad?
Autoimmunity, over-reaction to stimulus
How is acute inflammation classified? Provide 3 criteria of acute inflammation.
- Sudden Onset
- Short Duration
- Usually Resolves
How is chronic inflammation classified? Provide 3 criteria of chronic inflammation.
- Slowly onset or sequel to acute
- Long duration
- May never resolve
What cells are involved in inflammation?
- Neutrophil polymorphs
- Macrophages
- Lymphocytes
- Endothelial cells
- Fibroblasts
What cells are first seen during acute inflammation?
Neutrophils
Is neutrophil short-lived or long-lived?
Short-lived
When does neutrophil die?
At the scene of inflammation
How does neutrophil work?
Release chemicals that attract other inflammatory cells such as macrophages.
Is macrophage short-lived or long-lived?
Long-lived (weeks to months)
What properties do macrophages have?
Phagocytotic property
What do macrophages work?
- Ingest bacteria and debris
- May carry debris away
- May present antigens to lymphocytes so lymphocytes can perform immune reaction
What cells have irregular polymorph nuclei?
Neutrophils
What cells have big globular nucleus?
Macrophages
Are lymphocytes short-lived or long-lived?
Long-lived (years)
How do lymphocytes work?
- Produce chemicals which attract other inflammatory cells
- Immunological memory for past infections and antigens (B plasma cells- produce antibodies)
What cells line capillary blood vessels in areas of inflammation?
Endothelial cells
What happen to endothelial cells during inflammation?
- Become sticky in areas of inflammation (usually NO prevent stickiness and adhesion), so inflammatory cells adhere to them
- Become porous to allow inflammatory cells to pass into tissues
- Grow into areas of damage to form new capillary vessels
Is the capillary bed close or open most of the time?
close
What chemical substance open up the capillary bed during inflammation?
Histamine
In sepsis, is the capillary bed open or close?
All open
Why you get swelling area during an inflammation?
capillaries are leaky
Are fibroblast short-lived or long-lived?
Long-lived
What does fibroblast form?
Form collagen in areas of chronic inflammation and repair (might lead to “fibrosis”)
What is an example of acute inflammation?
Acute appendicitis
What happen during acute appendicitis?
- unknown cause
- neutrophils appear
- blood vessels dilate
- inflammation of serosal surface occurs
- pain felt
What are the outcomes of acute inflammation?
Roar SOP
1. Resolution
2. Suppuration
3. Organisation
4. Progression to chronic inflammation
Types of chronic inflammation
- Primary onset
- Secondary onset from acute inflammation
Examples of chronic inflammation
TB (no initial acute inflammation)
What happens in TB?
- Mycobacteria ingested by macrophages
- Macrophages often fail to kill the mycobacteria
- Lymphocytes appear
- Macrophages appear
- Fibrosis occurs
What are the particular feature of chronic inflammation?
granulomas
Why do you apply ice when treating inflammation?
- ice reduces swelling etc, cold stops the sphincter from opening up, fluid not leaked, hence stopped inflammatory process
How do you treat mosquito bite?
Antihistamine - damp down inflammation
How does ibuprofen help in treating inflammation?
inhibit prostaglandin synthetase (prostaglandin is a chemical mediator of inflammation)
How does corticosteroids work in skin rashes?
- bind to DNA to upregulate inhibitors on inflammation
- down-regulate chemical mediator for inflammation
in ancient egypt, during mummification, the brain is liquified and removed via ?
cribriform plate
Who dissected both animal and live humans?
Herophilus
What are the 2 main types of autopsy?
- Hospital autopsy (<10%, requires MCCD, audit, teaching, governance and research)
- Medico-legal autopsy (>90%)
2(a) Coronial Autopsy (lawful)
2(b) Forensic Autopsy (unlawful)
What are the type of deaths referred to the coroner
- Presumed natural
- Presumed iatrogenic (medical-related)
- Presumed unnatural
Who makes the referrals?
- Doctors
- Registrar of BDM (Birth, Death, Marriage)
- Referrals also come from (relatives, police, and anatomical pathology technicians)
Which autopsy does doctor perform?
Both hospital autopsy and coronial autopsy
Which autopsy does histopathologist perform?
Hospital autopsy and coronial autopsy
Which autopsy does forensic pathologist perform?
Coronial autopsy
What are the roles of coronial autopsy and coroner?
Who, When, Where, How
What are the 5 autopsy related laws?
- Coroners Act 1988
- Coroners Rules 1984
- Amendment Rules 2005
- Coroners and Justice Act 2009
- Human Tissue Act 2004
What are the 5 steps of autopsy?
- History/Scene
- External examination
- Evisceration
- Internal Examination
- Reconstruction
What are the 3 main investigation purposes of external examination?
- Who? (Identification)
- why? (Disease and Treatment)
- Why me? (Injuries)
What are the 5 steps of Evisceration?
- Y shaped incision
- Open all body cavities
- Examine all organs in situ
- Remove thoracic and abdominal organs
- Remove Brain
What are the 2 factors resolution depend on?
- Initiating factor removed
- Tissue undamaged or able to regenerate
What are the 2 factors repair depend on?
- Initiating factor still present
- Tissue damaged and unable to regenerate
What are the 2 types of healing during wounds injury?
- Healing by first intention (can bring the edges of the skin together)
- Healing by second intention (cant bring the edges of the skin together)
What ends up healing but with the biggest scar?
Granulation tissue
What is “repair”?
The replacement of damaged tissue by fibrous tissue.
(For example those tissue who cant regenerate, i.e. heart after myocardial infarction, brain after cerebral infarction, spinal cord after trauma)
What are fibrosis called in the brain?
Gliosis
What are the cells that regenerate?
-hepatocytes
-pneumocytes
-all blood cells
-gut epithelium
-skin epithelium
-osteocytes
What does blood contain?
- Oxygen carrying red blood cells
- infection fighting/inflammatory white blood cells
- Clotting platelets
- Plasma
What are the 2 reasons blood doesn’t normally form clot?
- Laminar flow
- Endothelial cells that are lining vessels are not sticky when healthy
Define thrombosis.
The formation of solid mass from blood constituents in an intact vessel in a living person
Define thrombosis.
The formation of solid mass from blood constituents in an intact vessel in a living person
What is the first stage of thrombosis?
Platelet aggregation
What do platelets do?
- Release chemicals when they aggregate
- Cause the cascade of clotting proteins in the blood
- Positive feedback loops
- Formation of the fibrin mesh which entrap the RBC.
What are the 3 factors of thrombosis?
- Change in vessels wall
- Change in blood flow
- Change in blood constituents
How to prevent thrombosis on patients?
- early mobilisation after operations
- low dose subcutaneous heparin
What is embolism?
The process of a solid mass in the blood being carried through the circulation to a place where it gets stuck and blocks the vessel.
What usually does the solid mass in embolism form from?
DVT from the leg veins which breaks off and embolises through the large veins and right side of the heart to the lungs
What are the less common causes of ebolism?
air (IVF), cholesterol crystals, tumour, amniotic fluid, fat
What happens when an embolus enters the venous system?
- Travel to the vena cava
- Through the right side of the lung
- lodge somewhere in the pulmonary arteries
Why does the lung act as a filter for any venous emboli?
The blood vessels in the lung split down to capillary size
What happens when an embolus enters the arterial system?
- Travel anywhere downstream of its entry point
What is ischaemia?
A reduction in blood flow to tissue without any other implications
What is infarction?
The reduction in blood flow to a tissue that is so reduced that it cannot even support mere maintenance of the cells in the tissue so they die.
Why are most organs in the human body so susceptible to infarction?
They only have a single artery supplying them (end arterial supply)
Why are most organs in the human body so susceptible to infarction?
They only have a single artery supplying them (end arterial supply)
What organs have dual arterial supply>
- Liver (portal venous and hepatic artery supplies)
- Lung (with pulmonary venous and bronchial artery supplies)
- Brain (circle of Willis)
Why is the blood flow in vein a passive blood flow?
Because the blood flow back with the aid of muscle contractile force
What are the 2 things you can do in hospital to prevent thrombosis?
- elastic stocking
- anticoagulant
What can inhibit platelet aggregation?
aspirin
What is atherosclerosis?
The accumulation of fibrolipid plaques in
systemic (as opposed to pulmonary) arteries.
State the time course of atherosclerosis respectively at “birth”, “late teenage/early 20s”, “30s/40s/50s” and “40s-80s”.
- birth - no atherosclerosis
- late teenage/early 20s - fatty streaks in aorta, may not
progress to established atherosclerosis - 30s/40s/50s - development of established atherosclerotic
plaques - 40s-80s - complications of atherosclerotic plaques e.g.
thrombosis, intraplaque haemorrhage
What are the risk factors of atherosclerosis?
- hypertension
- hyperlipidaemia
- cigarette smoking
- poorly controlled DM
What is the old atherosclerosis theory that wasnt true?
lipid insudation theory
What is the new atherosclerosis theory that is true now?
current endothelial damage theory
State the 3 steps of pathogenesis of atherosclerosis.
- endothelial cells are delicate
- easily damaged by cigarette smoke, shearing forces at
arterial divisions, hyperlipidaemia, glycosylation products - cumulative damage leads to endothelial ulceration, mi-
crothrombi, eventual development of established athero-
sclerotic plaques
What are the main complications of atherosclerosis?
- Infarction
- embolism (if it breaks off)
What are one of the minerals that will commonly present in atherosclerosis plaque?
- calcium
At which year will there be a steep increase of risk of atherosclerosis?
40-50
What type of vessels does atherosclerosis more common to happen in?
High blood pressure athery like aortaWhat
What does an atherosclerosis plaque consist of?
fibrous tissue, lipids which are mainly cholesterol, lymphocytes (chronic inflammation)
At what site in vessels does atherosclerosis usually happen?
Bifurcation side
What are the 2 things that are produced when the DM is poorly controleld?
- superoxide anion
- glycosylation products
What are the 3 main substances in cigarette smoking that are harmful?
- Free radicals
- nicotine
- carbon monoxide
What prevents platelet aggregation?
- low dose of aspirins (usually for UK its 75mg of aspirin)
What is the condition that will happen in aorta when atherosclerosis happens?
Aortic aneurysm, may cause rupture and people die pretty quickly
What is the only similarity between apoptosis and necrosis?
they result in cell death
What is apoptosis?
Programmed cell death
Why is apoptosis important?
important process in normal
cell turnover in the body which prevents cells with accumulated genetic damage from dividing and producing cells which might eventually develop into cancer cells
How does a cell decide when to apoptose?
One of the mechanisms is detecting amount of DNA damage within the cell.
What is the gene that decides cell apoptosis?
p53 is a protein in cells which can detect DNA damage
and can then trigger apoptosis
How does a cell apoptose?
The cell triggers a series of proteins which lead to the release of enzymes within the cell which eventually autodigest the cell.
What is the type of enzyme that lead to a cascade of activated enzyme in apoptosis?
Caspases
What are the 2 big factors that relate with caspases when it comes to apoptosis?
- BCL2/BAX
- Fas receptor and Fas ligand
State 2 situations how apoptosis work in healthy situation
- Development - removal of cells during development e.g. interdigital webs
- Cell turnover - removal of cells during normal turnover
e.g. cells in the intestinal villi at the tips, to be replaced
by cells from below
State 2 situations how apoptosis work in deases?
- Cancer - - cells in tumours often don’t apoptose when
they would have been expected to which results in increase in the tumour size and accumulation of genetic
mutations. Often this is due to mutations in the P53
gene, so the p53 protein can no longer detect DNA
damage and instigate apoptosis. - HIV - the HIV virus can induce apoptosis. It can induce
apoptosis in CD4 helper cells which reduces their num- bers enormously to produce an immunodeficient state.
What is necrosis?
It is the wholesale destruction of large numbers of cells by some
external factor.
State 4 clinical examples of necrosis.
- Infarction due to loss of blood supply e.g. myocardial
infarction, cerebral infarction - Frostbite
- Toxic venom from reptiles and insects
- Pancreatitis
What gene is known as the gatekeeper gene?
P53 Gene
What happened after necrosis?
all the body can do is try to clear up the mess by macrophages phagocytosing dead cells and usually
by replacing the necrotic tissue by fibrous scar tissue (unless the tissue can regenerate).
What is caseous necrosis?
(meaning like soft cheese) because that can
be due to tuberculosis so a pathologist would always order
stains for mycobacteria (e.g. Ziehl-Neelson or more sensi- tive PCR techniques) if she/he saw caseous necrosi
What may cause the avascular necrosis of the head of femur?
fracture at the neck of the femur, thus cutting off the blood supply to the head of the femur
What causes the necrosis of the bone in the wrist?
Scaphoid fracture
What happens in pancreatitis?
Inflammation of the pancreas, it is retroperitoneal, the pancreas is full of enzyme, the pancreas will eat itself, discolouration in the flank, need operation to clear the necrosis
The survicval rate of conception drops to 40 percent around which week?
2-3 weeks
What happens when the zygote after conception is non-viable?
Early miscarriage
What goes wrong in spinal bifida?
Cell migration (neural tube formation)
What is commonly seen in patients with spina bifida?
Lower limb paralysis
What are the three main types of spina bifida?
- Spina bifida occulta
- Meningocele
- Myelomeningocele
What are the disease where cell migration fails?
cleft palate
What happen in VSD?
Left ventricle has high pressure than right, causing systolic murmur
Is clubfoot more commonly seen as environmental causage or genetic causage?
Environmental
Why patient with Trisomy 21 Down syndrome will develop dementia?
Because the amyloid beta protein gene is on the same chromosome 21
Is Mendelian inheritance theory one gene or multiple genes?
One gene
What is the example of autosomal co-dominant?
Blood group
What is the protein that accumulated in Huntington’s disease?
Huntingtin
What do you call when a lot of gene are inherited at once?
Polygenic inheritance
Pituitary adenoma affects what hormone?
Growth Hormone
What disease is acquired disease but can be congenital?
Fetal alcohol syndrome
What disease is acquired disease but can be congenital?
Fetal alcohol syndrome
What are the facial characteristic of patient with fetal alcohol syndrome?
- Small eyes openings
- Smooth philtrum
- Thin upper lip
What is hypertrophy?
- increase in the size of an organ due to an increase in the size of its constituent cells
- occurs in organs where cells cannot divide
- examples - skeletal muscle in athletes/bodybuilders
What is hyperplasia?
- increase in the size of an organ due to increase in the
number of its constituent cells - occurs in organs where cells can divide
- examples - benign prostatic hyperplasia, endometrial
hyperplasia
What is mixed hypertrophyhyperplasia?
- increase in the size of an organ due to increase in size
and number of its constituent cells - occurs in organs where cells can divide
- example - smooth muscle cells of the uterus during
pregnancy
What is atrophy? Example of atrophy?
- decrease in size of an organ due to decrease in size or
number of its constituent cells or both - Alzheimer’s dementia, quadriceps muscle
following knee injuries
What is metaplasia?
- change in cell differentiation from one fully-differentiated type to another fully-differentiated type
- usually caused by a consistent change in the environment of an epithelial surface
What are the examples of metaplasia?
- bronchial epithelium from ciliated columnar
epithelium to squamous epithelium in the face of continued cigarette smoke - oesophageal squamous epithelium to glandular epithelium in continued acid reflux from the stomach (Barrett’s oesophagus)
- the uterine cervix from columnar epithelium to squamous epithelium at puberty when it is exposed to the acidic environment of the vagina
What is dysplasia?
morphological changes that
may be seen in cells (often epithelium) in the progression on to development of cancer (neoplasia)
What is the spectrum of dysplasia?
Mild, Moderate, Severe, Carcinoma in situ, invasive cancer
What are the examples of dysplasia?
- bronchial epithelium in cigarette smokers:
metaplasia from ciliated columnar epithelium to squamous epithelium, then
development of dysplasia in the squamous epithelium
What are the different types of hypertrophy?
- Myofibril hypertrophied muscles
- Sarcoplasmic hypertrophied muscles
Which gene does mutation happen where there is huge muscles in cow?
myostatin gene mutation
What is the upper limit of human life span?
120-130 year olds
What is the name of the limit that determines how many times a cell can divide?
the Hayflick limit
Why Skin cells from older people will divide less times in culture than those from younger people ?
at each cell division the telomere region at the end of chromosomes shortens and eventually becomes so short that it is not possible for the chromosomes to divide and replicate so the cell can no longer divide. Telomere length appears to be paternally-inherited.
What is the name of the condition where ageing is greatly accelerated and these are often due to mutations in cell membrane proteins which make cell division impossible.
progeria
What are the damages that can interfere cell division?
- Damage to mitochondrial DNA
- Loss of DNA repair mechanism
- Peroxidation of membranes
- Free radical generation
- Time-dependent activation of ageing and death genes
- Telomere shortening
- Accumulation of toxic by products by metabolism
- Cross Linking or mutation of DNA
- Cross linking of protein
- Loss of calcium influx controls
What is the only definitive method to slow down ageing?
calorie restriction
What are the specific local measures to reduce ageing to specific body part?
high sun protection factor cream to reduce UV cross-linking of proteins in the dermis.
What are the example effects of ageing to different parts of the bodies?
- Skin - wrinkling of skin (dermal elastosis) is caused by
UV-B light causing cross-linking of the proteins, especially collagen, in the dermis. Can be reduced by avoiding too much sun exposure and using high sun protection factor cream. - Eyes - cataracts are cause by UV-B cross-linking of pro- teins in the lens causing opacity. Can be prevented by
wearing sunglasses that cut out UV light. Can be treated
by replacement of the lens with a plastic implant. - Osteoporosis - loss of bone matrix predominantly in
women after menopause. Can be prevented by hormone replacement therapy at menopause and calcium/
vitamin D supplements. - Dementia - may be Alzheimer’s type or vascular dementia. Alzheimer’s dementia doesn’t as yet have a fully un- derstood pathogenesis but there are genetic factors and lifestyles factors which can prevent it e.g. exercise, not being obese. Vascular dementia has the same risk factors as atherosclerosis in other parts of the body e.g. high blood pressure, hyperlipidaemia, poorly-controlled diabetes
- Loss of muscle (sarcopaenia) - may be the thing that
prevents independent living in older people due to prob- lems such as getting out of chairs and upstairs. May well
be caused by reduced levels of growth hormone and
testosterone in later life. Can be prevented by regular
exercise, including resistance/weight training. - Deafness - the hair cells in the cochlear do not divide so
if they are damaged by high volumes they will die and
not be replaced eventually producing deafness. Prevention = avoidance of high-volume sounds throughout life.
What are the 2 factors that cause age to have a limit?
cell division, telomeres, enable chromosome to replicate, too short to allow cell division sometimes
What are the causes of inflammation?
- Necrosis/infarction/direct trauma
- Infection (bacterial, viruses, fungi, protozoa, parasites)
- Chemical or other physical agents, including radiotherapy
- Autoimmune reactions, particularly hypersensitivity states
What are the features of inflammation?
- Redness
- pain
- swelling (oedema)
- loss of function
- heat
What are the types of inflammation?
Acute
* Polymorph neutrophils with later macrophages
Chronic
* Lymphocytes, plasma cells, macrophages
* Sometimes groups of epithelioid macrophages (granulomas)
What are the types of inflammation?
Acute
* Polymorph neutrophils with later macrophages
Chronic
* Lymphocytes, plasma cells, macrophages
* Sometimes groups of epithelioid macrophages (granulomas)
What most likely causes sarcoid?
mycobacterium
What causes rebound tenderness.
Acute inflammation like acute appendicitis
How to deal with pus?
Drainage of pus using aspiration
Drainage by cutting it open
How to deal with sepsis due to diverticular disease?
Surgery with antibiotic and wash the large bowel
What cancer will not spread to other sites?
Basal cell carcinoma
What cancer will not spread to other sites?
Basal cell carcinoma
How to cure basal cell carcinoma?
Complete excision
What are the common symptoms of leukemia?
Systemic:
Weight loss, fever, frequent infection
Lung: SOB
Muscular Weakness
Bones or joints: Pain or tenderness
Psychological: Fatigues loss of appetite
Swelling lymph node
Enlargement of spleen and liver
Skin: Night sweat, bleeding and bruising, purplish patches of spots
,
Where does carcinoma usually spread to?
Lymph nodes that drain the site of carcinoma
Where does carcinoma usually spread to?
Lymph nodes that drain the site of carcinoma
Carcinoma can spread through what to where?
Spread through blood to bone
What are the cancer that commonly spread to bone?
Breast, prostate, lung, thyroid, kidney
What is required when breast cancer has spread to the axilla?
Axilla node clearance
What could be present even if the tumour is compeltely excised?
Micro metastases
What is adjuvant therapy?
Extra treatment given after surgical excision like radiotherapy
Can basal cell carcinoma kill people?
Yes, but not by metastasis
Where can we take the biopsy when there is leukamia?
bone marrow
What therapy does people with leukamia need?
Systemic chemotherapy
What scan do we use to observe the enlargement of lymph node?
Ultrasound scan
What scan do we use to observe the enlargement of lymph node?
Ultrasound scan
Where does oestrogen receptor live?
In the nucleus of the breast cell
What is the adjuvant anti-oestrogen therapy given to breast cancer patient?
Tamoxifen
What type of cancer metastases quite frequently?
Melanoma
What is the main effector cell in acute inflammation?
Neutrophils
What is the cell that produce collagen in fibrous scarring?
Fibroblast
Which of the following is an example of acute inflammation?
1.Glandular fever
2. Leprosy
3. Appendicitis
4. Tuberculosis
Appendicitis
AppendicitisIn which of the following does granulomatous inflammation occur?
1. Crohn’s disease
2. Appendictis
3. Infectious mononucleosis
4. lobar pneumonia
Crohn;s disease
Which of the following is a chronic inflammatory process from its start?
Infectious mononucleosis
Example of hyperplasia?
Benngn prostate enlargement/hyperplasia (BPHBenign)
Which of the following example is not a type of apoptosis?
a. loss of cell from duodenal villi tips
b. loss of cells during embryogenesis
c. renal infarction
d. graft versus host disease
renal infarction
Which of the following is an example of atrophy?
1. Biceps of a body builder
2. Uterus in pregnancy
3. Brain dementia
4. Prostate in older age
- Brain dementia
What is the pattern of differentiation of the metaplastic lining the bronchi of cigarette smokers
Ciliated pseudostratified columnar epithelial cells > simple squamous epithelial cells
Which of the following is an example of necrosis?
1. loss of cells from duodenal tips
2. loss of individual cells in graft versus host disease
3. loss of individual cells during development
4. renal cells infarction
renal cells infarction
What process is defined by the formation of solid mass of blood constituents within intact vessels druing life?
Thrombosis
Name a drug that inhibits platelet aggregation.
Low-dose aspirin
What is carcinogenesis?
The transformation of normal cells to neoplastic cells through permanent genetic alteration or mutation
What is the difference between carcinoegnesis and oncogenesis?
carcinogenesis is for maligannt neoplasm while oncogenesis is for both benign and malignant neoplasm
How many percentage of cancer risk is environmental?
85%
What is the primary cancer of the liver?
Hepatocellular carcinoma, often common in places with high hepatitis B/C
Where is oesophageal carcinoma popular at?
Japan and china due to linhsien chicken and turkey and iran due to the scaldingly hot coffee
Lung cancer prence and is associated wtih?
35k death annually, smoking
What is bladder cancer associated with?
Aniline dye, rubber indusrty, β-naphthylamine
β-naphthylamine
What is bladder cancer associated with?
Aniline dye, rubber indusrty
Scrotal cancer is associated with?
Chimney sweep, β-naphthylamine
What does chernobyl cause?
Thyroid cancer
What are the classes of carciogenes?
chemical, viral, ionising and non-onising radiation, hormones and parasite and mycotoxin, miscellanous
Most chemical carcinogen require conversion from what to what?
pro-carcinogen to ultimate carcinogen
What can polycyclic aromatic cause?
Lung cancer, skin cancer (due to smaoking and min
What can aromatic amine cause?
Bladder cancer (due to rubber/dye worker)
What can nitrosamine cause?
Gut cancer
What can alkylating agents cause?
Leukaemia
Viruses cause how many percentage of cancer?
10-15%
What does Human Herpes Virus 8
cause?
Kaposi sarcoma
What does Epstein Barr Virus cause?
Burkitt lymphoma,
Nasopharyngeal carcinoma
What does Hepatitis B Virus
cause?
Hepatocellular carcinoma
What does Human papillomavirus
cause?
Squamous cell carcinomas of the cervix, penis, anus, head and neck
What does Merkle cell polyomavirus
cause?
Merkle cell carcinoma
What does Human T-lymphotrophic virus
cause?
Adult T-cell leukaemia
Exposure to UVA, UVB increase the risk of?
basal cell carcinoma, squamous cell carcinoma ( increase risk in xeroderma pigmentosum
What type of cancer will uranium miner usually have ?
lung cancer
What type of cancer will Ukrainian children usually have?
Thyroid cancer
What does high oestrogen cause?
Mammary or endometrial cancer
What does high anabolic steroid cause
Hepatocellular carcinoma
What does aflatoxin B1 cause?
Hepatocellular carcinoma
What does Clonorchis sinesis cause?
cholangiocarcinoma
What does Shistosoma cause?
bladder cancer
Oral cancer is common in which area?
India and SE asia because of reverse smoking
Lower skin cancer in those with?
Draker skin
Excess alcohol use increases risk of cancers of ?
mouth, oesophagus, liver, colon and breast
Obesity increases risk of ?
Breast, colon cancer
Premalignant conditions that cause cancer?
Colonic polyps
Cervical dysplasia (CIN)
Ulcerative colitis
Undescended testis
Relate ECG changes with pericarditis.
ECG changes not because of the pericardium is inflamed, but because its closed to myocardium, we get ECG changes
Do you do echo when patient has acute tamponade?
If theres acute tamponade, we drain it immediately, we dont do echo otherwise the patient will die
Talk about tamponade, calcification and pericarditis.
Tamponade rarely occur at pericaridits, but when it does, constriction happens and calcification happens, surgery has to be done and the calcium needs to be scrap off from the heart manually by the surgeon
