Integrative pathophysiology Flashcards
What are the components of melanoma tumour stage (TNM)?
Breslow thickness
ulceration
microsatellites
What are the 4 layers of the epidermis?
stratum corneum
stratum granulosum
stratum spinosum
stratum basale
Where is Breslow thickness measured to and from?
measured from stratum granulosum layer to deepest invasive melanocyte
What is regression in melanoma?
depigmented area
patient mounted effective immune response to malignant melanocytes causing destruction
How does regression show under a microscope?
absence of melanocytes in dermis
scar tissue formation + deposition of pink collagen fibres
blood vessel proliferation
scattered melanophages
What causes erythema?
dilated blood vessels
lymphocytic inflammation around blood vessels (perivascular inflammation)
What causes surface scale?
hyperkeratosis
What is the only epithelial type that produces keratin?
squamous epithelium
What is the Lesser-Trelat sign?
abrupt appearance of multiple seborrhoeic keratoses can be a sign of internal malignancy
What is parakeratosis and what is it associated with?
nuclei present in thickened keratin layer
increased rate epidermal turnover
What epidermal layer do scabies mites burrow through?
stratum corneum
What is raised number of eosinophils associated with?
hypersensitivity reaction in skin
What causes a pustule?
accumulation of neutrophils + bacteria in follicular infundibulum
What causes an abscess?
collection of neutrophils with surrounding fibrosis
Stages of neutrophil emigration
margination
rolling
adhesion
diapedesis
phagocytosis
What sign is associated with Reed-Sternberg cells and what condition are they seen in?
Owl’s eye nuclei
Hodgkin Lymphoma
What are Pel-Ebstein fevers?
cyclical fever with periods of both high + normal temperature
List the 3 B symptoms
fever
weight loss
night sweats
Follicular lymphoma genetic abnormality
t(14;18)
links BCL2 gene on chromosome 18 with the immunoglobulin heavy chain gene on chromosome 14
Burkitt lymphoma genetic abnormality
t(8;14) [most commonly]
links myc gene on chromosome 8 with immunoglobulin heavy chain gene on chromosome 14
Mantle cell lymphoma genetic abnormality
t(11;14)
links cyclin D1 gene on chromosome 11 with the immunoglobulin heavy chain gene on chromosome 14
CML genetic abnormality
t(9;22)
links proto-oncogene tyrosine protein kinase ABL 1 gene on chromosome 9 with the breakpoint cluster (BCR)gene on chromosome 22
Which cells are CD4, CD3, CD8, CD30 and CD20 expressed on?
CD4 = helper T-cell
CD3 = T-cell
CD8 = cytotoxic T-cell
CD30 = Reed-sternberg cell
CD20 = B-cell
Microcytic anaemia causes (TAILS)
Thalassaemia
Anaemia of chronic disease
Iron deficiency anaemia
Lead poisoning
Sideroblastic anaemia
What would a raised protein level but a normal albumin suggest?
paraprotein present
What do plasma cells produce in myeloma and what does this cause?
plasma cells produce RANKL which binds to RANK on cell membrane of osteoclasts, causing their activation, resulting in osteolytic lesions
Define dysplasia
disordered growth
Define hyperplasia
increase in cell number
Define atrophy
reduction in size of a cell or organ
Define metaplasia
replacement of a mature cell type with a different mature cell type
Define hypertrophy
increase in size of cell or organ
What can smoking cause (in terms of cells changes)?
metaplasia
columnar epithelium –> squamous epithelium
Where does SCC of lung arise from?
arise from bronchi
cause central masses
Where do adenocarcinomas of lung generally present?
often seen peripherally
What are the 5 layers of the epidermis (from top to bottom)?
Stratum corneum
Stratum lucidum
Stratum granulosum
Stratum spinosum
Stratum basale
What type of epithelium is the epidermis?
stratified squamous epithelium
What is the main cell found in the epithelium?
keratinocytes
How do keratinocytes mature in the epidermis?
they mature upwards from stratum basale to stratum corneum
What is the epidermis derived from? (embryology)
ectoderm
What is the dermis derived from? (embryology)
mesoderm
What cells can be found in smaller numbers than keratinocytes in the epidermis?
melanocytes
langerhans cells
