Introduction to Clinical Sciences

Question 1

What does congenital mean?

Answer 1

A condition that is present at birth.

Question 2

Which cells are present in acute inflammation?

Answer 2

Neutrophil polymorph cells

Question 3

Which cells are present in chronic inflammation

Answer 3

Lymphocytes

Macrophages

Question 4

Features of chemical carcinogens

Answer 4

No common structural features
Some act directly
Most require metabolic conversion (pro-carcinogens –> ultimate carcinogens)
Enzyme required may be ubiquitous or confined to certain organs

Question 5

Classes of carcinogens

Answer 5

Chemical
Viral
Ionising and non-ionising radiation
Hormones, parasites and mycotoxins
Miscellaneous

Question 6

Four features of neoplasms

Answer 6

Autonomous
Abnormal
Persistent
New growth

Question 7

Definition of neoplasm

Answer 7

A lesion resulting from autonomous, or relatively autonomous, abnormal growth of cells which persists after the initiating stimulus has been removed. A new growth.

Question 8

Which cancer causes most cancer deaths

Answer 8

Lung cancer

Question 9

What are neoplasms formed of?

Answer 9

Neoplastic cells within a stroma of supportive tissue

Question 10

At what point is angiogenesis essential for neoplasms?

Answer 10

When diameter >2mm

Diffusion not possible at this thickness

Question 11

Common features of benign neoplasms

Answer 11

Localised
Non-invasive
Slow growth rate
Low mitotic activity
Close resemblance to normal tissue
Circumscribed or encapsulated
Nuclear morphometry often normal
Necrosis rare
Ulceration rare
Growth on mucosal surfaces often exophytic

Question 12

Common features of malignant neoplasms

Answer 12

Invasive (defining feature)
Metastases possible 
Rapid growth rate
Variable resemblance to normal tissue
Poorly defined or irregular border
Hyperchromatic nuclei
Pleomorphic nuclei
Increased mitotic activity
Necrosis common
Ulceration common
Growth on mucosal surfaces and skin often endophytic

Question 13

What does suffix -oma indicate?

Answer 13

Neoplasm

Question 14

What does suffix -itis indicate?

Answer 14

Inflammation

Question 15

What is a papilloma?

Answer 15

Benign tumour
Non-glandular, non-secretory epithelium
Prefixed with cell type of origin

Question 16

What is an adenoma?

Answer 16

Benign tumour
Glandular or secretory epithelium
Prefixed with cell type of origin

Question 17

What is a carcinoma?

Answer 17

Malignant epithelial neoplasm

Prefixed by name of epithelial cell type (npt just squamous cells)

Question 18

What is an adenocarcinoma?

Answer 18

Malignant epithelial neoplasm

Epithelial tissue = glandular

Question 19

Common benign connective tissue neoplasms and tissues that they resemble

Answer 19

Lipoma - adipocytes
Chondroma - cartilage
Osteoma - bone
Angioma - vascular
Angiolipoma - blood vessels and fat cells are neoplastic
Rhabdomyoma - striated muscle
Leiomyoma - smooth muscle
Neuroma - nerves

Question 20

What is benign neoplasm of nerves called?

Answer 20

Neuroma

Question 21

Name of malignant connective tissue neoplasms

Answer 21

Sarcoma

Prefixed by cell type of origin

Question 22

Origin of liposarcoma

Answer 22

Adipose tissue

Question 23

Origin of rhabdoymyosarcoma

Answer 23

Striated muscle

Question 24

Origin of leiomyosarcoma

Answer 24

Smooth muscle

Question 25

Origin of osteosarcoma

Answer 25

Bone

Question 26

Origin of angiosarcoma

Answer 26

Blood vessels

Question 27

Origin of chondrosarcoma

Answer 27

Cartilage

Question 28

What are anaplastic carcinomas?

Answer 28

Neoplasms where the cell-type of origin is unknown as bears no resemblance to normal tissue

Question 29

Which -omas are not neoplasms?

Answer 29

Granuloma Mycetoma Tuberculoma

Question 30

Malignant tumours that are not carcinoma or sarcoma...

Answer 30

``` Melanoma = malignant neoplasm of melanocytes Mesothelioma = malignant tumour of mesothelial cells Lymphoma = malignant neoplasm of lymphoid cells ```

Question 31

Eponymously named tumours

Answer 31

Burkitt's lymphoma Ewing's sarcoma Grawitz tumour Kaposi's sarcoma = form of angiosarcoma

Question 32

Extra exceptions to classification of neoplasms

Answer 32

``` Teratoma Embryonal tumours (blastoma) Mixed tumours APUDomas Carcinosarcomas ```

Question 33

Common causes of acute inflammation

Answer 33

``` Microbial infections Hypersensitivity reactions Physical agents Chemicals Tissue necrosis ```

Question 34

Macroscopic appearance of inflammation

Answer 34

``` Rubor - redness Calor - heat Tumor - swelling Dolor - pain Loss of function ```

Question 35

Explain rubor and give examples

Answer 35

Dilatation of small blood vessels gives a red appearance to the inflamed area e.g. sunburn, cellulitis, acute conjunctivitis

Question 36

Explain calor

Answer 36

Due to increased blood flow (hyperaemia) | Only seen in peripheral parts of body e.g. skin

Question 37

Explain tumor

Answer 37

Results from oedema Also from mass of inflammatory cells migrating into the area Formation of new connective tissue as inflammation progresses also contributes

Question 38

Explain dolor

Answer 38

Partly due to stretching and distorting of tissues from oedema Pus under pressure in abscess cavity Chemical mediators may also induce pain

Question 39

Explain loss of function

Answer 39

Movement consciously and reflexively inhibited by pain | Severe swelling may cause immobilisation of tissues

Question 40

What is innate immunity?

Answer 40

Instinctive, non-specific Does not depend on lymphocytes Present from birth

Question 41

What is adaptive immunity?

Answer 41

Specific 'Acquired/learned' immunity Requires lymphocytes and antibodies

Question 42

What is in the upper layer of a centrifuged blood sample?

Answer 42

``` Upper fluid = plasma 90% water Electolytes Lipids Sugars etc. ```

Question 43

What is in the middle layer of a centrifuged blood sample?

Answer 43

White fluffy layer | Buffy coat - leukocytes

Question 44

What is in the lower layer of a centrifuged blood sample?

Answer 44

Erythrocytes Platelets (haematocrit)

Question 45

What is serum?

Answer 45

Plasma without fibrinogen and other clotting factors

Question 46

What is inflammation?

Answer 46

A series of reactions that brings cells and molecules of the immune system to the sites of infection or damage

Question 47

Main outcomes of complement and pathways

Answer 47

Lyse microbes directly (MAC) Chemotaxis (C3a and C5a) Opsonisation (C3b)