Introduction to Pathology

Question 1

What is pathology?

Answer 1

The study of the cause and mechanisms of disease

Question 2

Define aetiology, and what it can include (2)

Answer 2

The causes leading to a disease

• genetic factors
• acquired / environmental factors

Question 3

List the 4 processes of pathology

Answer 3

1. Etiology
2. Pathogenesis
3. Structural
4. Clinical Manifestations

Question 4

Cystic Fibrosis is an autosomal _______ disorder?

Answer 4

Cystic Fibrosis is an autosomal recessive disorder.

Question 5

Mutations in what gene leads to Cystic Fibrosis?

Answer 5

The CFTR gene.

Question 6

What are the symptoms of cystic fibrosis? (3)

Answer 6

• Thick mucous secretions
• Recurrent chest infections
• Lung damage

Question 7

Crohn’s disease is a combination of genetic _____ + _____ disease + ______ response

Answer 7

Crohn’s disease is a combination of genetic susceptibility + infectious disease + immune response

Question 8

Give an example of an environmental factor in disease. Name the disease and how it occurs, plus symptoms.

Answer 8

Asbestosis

• work related exposure to asbestos fibres
• lung and pleural fibrosis
• mesothelioma (tumours in covering of lungs)

Question 9

Most diseases are an interaction of multiple ______ and ______ factors

Answer 9

Most diseases are an interaction of multiple genetic and environmental factors

Question 10

Many breast cancers have an overexpressed ______ protein/gene, which is a _______. These genes are present in ____ ____.

Answer 10

Many breast cancers have an overexpressed HER-2 protein/gene, which is a receptor for a growth factor. These genes are present in extra copies.

Question 11

HER-2 codes for

Answer 11

epidermal growth factor receptor in mammary cells

Question 12

HER-2 is a target for the antibody ______

Answer 12

herceptin

Question 13

What is the function of herceptin?

Answer 13

prevents expression, which prevents ability to drive cancer development. It is a competitive inhibitor that replaces EGF (epidermal growth factor)

Question 14

Define Morbid Anatomy

Answer 14

The post-mortem macroscopic examination of disease

Question 15

Molecular pathology describes disease processes in terms of _____ and _____ biological processes.

Answer 15

biochemical and molecular

Question 16

Anatomical Pathology is:

Answer 16

The macroscopic and microscopic study of tissue obtained by biopsy, at surgery or post mortem.

Question 17

Anatomical pathology is an _____ science.

Answer 17

observational

Question 18

General Pathology, aka mechanisms of disease, is:

Answer 18

The investigation of processes underlying disease conditions.

Question 19

General pathology is an _____ science.

Answer 19

experimental

Question 20

Define pathogenesis:

Answer 20

The mechanism of disease development.

Question 21

Inflammatory bowel diseases include: (2)

Answer 21

Crohn’s disease & Ulcerative colitis

Question 22

Crohn’s Disease first appears in: (age group)

Answer 22

adolescents or young adults

Question 23

Crohn’s Disease occurs mainly in the ____ of the _____ intestine, but can occur anywhere in the gut.

Answer 23

Crohn’s Disease occurs mainly in the end of the small intestine (ileum), but can occur anywhere in the gut.

Question 24

Areas affected by Crohn’s Disease become _____

Answer 24

inflammed

Question 25

The epithelial lining in Crohn’s Disease _____.

Answer 25

ulcerates

Question 26

The colon wall in crohn’s disease may undergo extensive damange and ____________.

Answer 26

fibrotic thickening

Question 27

The lumen in crohn’s disease:

Answer 27

narrows/stenosis

Question 28

In Crohn’s Disease, ____ develop throughout the bowel wall, and drain into pus filled cavities known as ______ or form _____ into nearby loops of bowel.

Answer 28

In Crohn’s Disease, fissures develop throughout the bowel wall, and drain into pus filled cavities known as abscesses or form channels/fistulas into nearby loops of bowel.

Question 29

Aggregations of lymphocutes are known as:

Answer 29

follicles

Question 30

Aggregations of macrophages are known as:

Answer 30

granulomas

Question 31

When the immune system is activated in Crohn’s disease, what three things happen as a result?

Answer 31

appearance of lymphocyte follicles, granulomas and enlarged lymph nodes

Question 32

In Crohn’s disease, the probability of developing _____ is increased

Answer 32

cancer

Question 33

Cancer is a ______ disease

Answer 33

neoplastic disease

Question 34

List the 4 aetiological factors involved with Crohn’s Disease, and give an example of each.

Answer 34

1. Genetic - family history - NOD2 gene mutation in 30% of caucasians
2. Environmental - diet, NSAIDs, tobacco, increased hygiene
3. Microbial - pathogenic infections as triggers, altered communicies of commensal bacteria (which alters the ecology of the gut)
4. Uncontrolled immune responses - over-active Th1 Cells which secrete TNF, or underactive Treg cells

Question 35

Outline the pathogenesis of Crohn’s Disease - 4 steps:

Answer 35

1. Environemental trigger (e.g infection, NSAID damage) damages mucosa
2. Damage (with bacterial invasion of the submucosa) induces inflammatory response and healing
3. People with genetic deficiency in innate immunity or barrier function may be unable to repair the damage or eliminate microbes from the submucosa
4. Uncontrolled T cell responses may develop against commensal bacteria, ultimately damaging the colon wall.

Question 36

Investigation of a mass/abnormal tissue includes the use of: (3)

Answer 36

1. Fine needle aspiration
2. Exfoliative cytology
3. Tissue biopsy

Question 37

The three kinds of tissue biopsy and their differences are:

Answer 37

1. Core biopsy - sample taken with hollow needle, includes cells of surrounding tissue
2. Incisional biopsy - sample of abnormal tissue cut out
3. excisional biopsy - entire abnormal mass cut out

Question 38

List the four types of analysis regarding tissue biopsies and what they look at (tools of pathology):

Answer 38

1. cytology and morphology
   - types of cells present, cytology of cells, architecture of tissue
2. Microbiology
   - culture cells, tissue or swabs/scrapings from tissue
3. Immunology
   - antigen expressions
4. Molecular studies
   - chromosome analysis, DNA & RNA analysis