ICS - Pathology Flashcards
What are the two types of autopsy?
Hospital
Medico-legal
What are the three types of death referred to coroners?
Presumed natural
Presumed iatrogenic
Presumed unnatural
What is the definition of Inflammation?
The local physiological response to tissue injury
Name 5 cells involved in inflammation.
Neutrophil Polymorphs Macrophages Lymphocytes Endothelial Cells Fibroblasts
What is the characteristic cell recruited to the tissue in acute inflammation?
Neutrophil Polymorph
What are the 4 outcomes of acute inflammation?
Resolution
Suppuration (abscess)
Organisation (tissue replacement)
Progression to chronic inflammation
List 3 causes of acute inflammation.
Microbial infections
Hypersensitivity Reactions
Trauma
List 3 causes of chronic inflammation.
Transplant rejection
Progression from acute inflammation
Recurrent episodes of acute inflammation
Name an example of acute inflammation.
Acute appendicitis
Name an example of chronic inflammation.
Tuberculosis
What are granulomas and how do they appear?
Collections of epithelioid histiocytes (macrophages)
They appear with bundles of macrophages (these look like epithelial cells)
Name a drug that can be used to treat inflammation.
Aspirin
What is meant by ‘repair’?
Replacement of damaged tissue by fibrous tissue
Name 3 examples of cells that can regenerate.
Hepatocytes
Osteocytes
Pneumocytes
Name 2 examples of cells that can’t regenerate.
Mycoardial cells
Neurones
What is ‘organisation’?
The process whereby specialise tissues are repaired by the formation of mature fibrovascular connective tissue
What 2 things prevent clots forming (usually)?
Laminar flow - cells travel in the centre of the arterial vessels and don’t touch the sides
Endothelial cells aren’t ‘sticky’ when healthy
Define thrombosis
A solid mass of blood constituents formed within an intact vascular system during life
What are the 3 causes of thrombosis?
Change in vessel wall
Change in blood flow
Change in blood constituents
Define 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
Define embolus
A mass of material in the vascular system able to become lodged within a vessel and block it
Define Ischaemia
The reduction of blood flow to a tissue without any other implications
Defne Infarction
A reduction of blood flow to a tissue that is so reduced that it cannot support even mere maintenance of the cells in that tissue so they die
Define end artery supply
An organ that only receives blood supply from one artery
Give examples of multiple arterial supplies
Pulmonary + Bronchial arteries - lungs
Portal vein + hepatic artery - liver
Circle of willis - brain
Define atheroma
The fatty material which forms deposits in the arteries
Define apoptosis
Programmed cell death
Define necrosis
Death of most or all of the cells in an organ or tissue due to disease, injury or failure of the blood supply
Name 2 clinical examples of necrosis
Cerebral infarction
Avascular necrosis of bone
Give an example of a polygenic gene disorder
Breast Cancer
BRCA1 and BRCA2 have large individual effects on breast cancer
What is the difference between hypertrophy and hyperplasia?
Hypertrophy = increase in size of tissue due to increase in size of cells Hyperplasia = increase in size of tissue due to increase in number of cells
Define atrophy
A decrease in size of a tissue caused by a decrease in number of the constituent cells or a decrease in their size
Define metaplasia
Change in differentiation of a cell from one fully-differentiated type to a different fully-differentiated type
Define dysplasia
Imprecise term for the morphological changes seen in cells in the progression to becoming cancer
Define carcinogenesis
The transformation of normal cells to neoplastic cells through permanent genetic alterations or mutations
How can carcinogens be classified?
Chemical, Viral, Radiation, Hormones, Miscellaneous
Define carcinogens
Agents known or suspected to cause tumours
Define neoplasm
A lesion resulting from the autonomous abnormal growth of cells which persists after the initiating stimulus has been removed (a new growth)
Give an example of a malignant neoplasm
Prostate cancer
Describe the nomenclature of neoplasia
Suffix ‘oma’
Prefix depending on behavioural classification and cell type
Define papilloma
Benign tumour of non-glandular, non-secretory epithelium
Define adenoma
Benign tumour of glandular or secretory epithelium
Define carcinoma
Malignant tumour of epithelial cells
How are benign connective tissue neoplasms named and given an example
Named according to cell of origin with suffix 'oma' Lipoma - adipocytes Chondroma - cartilage Osteoma - bone Angioma - vascular
How are malignant connective tissue neoplasms named and given an example
‘Sarcoma’ prefixed by cell type of origin
Liposarcoma - adipose tissue
Osteosarcoma - bone
Angiosarcoma - blood vessels
Define teratoma
Neoplasms containing tissues from all 3 embryological layers
Define carcinoma in situ
A malignant epithelial neoplasm that has not yet invaded through the original basement membrane
Define invase carcinoma
A carcinoma that has breached the basement membrane - it can now spread elsewhere
Micro-Invasive carcinoma
Has breached the basement membrane but hasn’t invaded very far away from the original carcinoma
Give the 7 steps to the metastatic cascade
Detachment Invasion Intravasation Evasion of host defences Adherence Extravasation Vascularisation
Define angiogenesis
When tumours begins to grow their blood vessels (once they reach 1mm in diameter)
Which tumours commonly metastasise to the lung?
Sarcomas and any common cancers
Which tumours commonly metastasise to the liver?
Colon, stomach, pancreas and carcinoid tumours of intestine
Which tumours commonly metastasise to the bone?
Prostate, breast, thyroid, lung and kidney
What are the 3 components of Virchow’s triangle?
Stasis of blood flow, endothelial injury, hypercoagulability
What class of drug can be used to treat arterial thrombosis?
Anti-platelets e.g. Aspirin/ clopidogrel
What class of drug can be used to treat venous thrombosis?
Anti-coagulants e.g. warfarin, heparin, DOAC
