Introductory Clinical Sciences

Question 1

Define inflammation

Answer 1

Local physiological response to tissue injury (a manifestation of disease as opposed to a disease in itself)

Question 2

In what ways can inflammation be beneficial?

Answer 2

Prevention of spread of disease (eg. destruction of invading microorganisms and walling off of an abscess cavity)

Question 3

In what ways can inflammation be harmful?

Answer 3

Abscess in brain could compress vital structures

Fibrosis from chronic inflammation may distort tissues and alter function permanently

Question 4

Define acute inflammation

Answer 4

Initial and often transient series of tissue reactions to injury

Question 5

Define chronic inflammation

Answer 5

Subsequent and often prolonged tissue reactions following initial response

Question 6

What steps are involved in acute inflammation?

Answer 6

1) Initial reaction to injury
2) vasodilation
3) exudative component (protein-rich)
4) neutrophil polymorph’s present

Question 7

What are the possible outcomes of acute inflammation?

Answer 7

resolution
suppuration
organisation
chronic inflammation

Question 8

What are the causes of acute inflammation?

Answer 8

1) microbial infection
2) hypersensitivity reactions
3) physical agents
4) chemicals
5) bacterial toxins
6) tissue necrosis

Question 9

What are the macroscopic features of acute inflammation?

Answer 9

rubor, calor, tumor, dolor, loss of function

Question 10

Define carcinogenesis

Answer 10

The transformation of normal cells to neoplastic cells through permanent genetic alterations/mutations

Question 11

Define carcinogens

Answer 11

Agents known/suspected to cause tumours
85% environemental
15% genetic

Question 12

Why is it difficult to identify carcinogens?

Answer 12

• Latent interval between exposure and cancer formation
• complexity of environment/mixture of carcinogens
• ethical constraints

Question 13

What epidemiological features is hepatocellular carcinoma associated with?

Answer 13

Areas with high rates of Hep B/C and mycotoxins

Question 14

Give examples of common behavioural/occupational risks

Answer 14

• smoking = lung cancer
• analine dye = bladder cancer
• polycyclic aromatic hydrocarbons = squamous cell carcinoma

Question 15

What is thorotrast?

Answer 15

• radioactive contrast dye used in 20th century
• irreversibly ingested by Kupffer cells
  = angiosarcoma of liver

Question 16

What is irradiation from chernobyl associated with?

Answer 16

Release of I-125 and I-131 = thyroid cancer

Question 17

What are the types of carcinogens?

Answer 17

• Chemical
• Viral
• ionising/non-ionising agents
• hormones, parasites and mycotoxins
• other (asbestos, metals)

Question 18

What are premalignant lesions?

Answer 18

Identifiable local abnormalities associated with increased risk of malignancy at that site

Question 19

Give examples of premalignant lesions

Answer 19

• colonic polyps
• cervical dysplasia
• ulcerative colitis
• undescended testis

Question 20

What tissues can neoplasms arise from?

Answer 20

All tissues except erythrocytes (no nucleus):

• epithelial cells
• connective tissue
• lymphoid/haemopoietic tissues

Question 21

Why is a tumour not the same as a neoplasm?

Answer 21

Tumour = any abnormal swelling (neoplasm, inflammation, hypertrophy, hyperplasia…)

Question 22

Define neoplasm

Answer 22

A lesion (NEW GROWTH) resulting from the AUTONOMOUS, ABNORMAL growth of cells which PERSISTS after the initiating stimulus has been removed

Question 23

Which cancers are the most prevalent?

Answer 23

male = prostate
female = breast

Question 24

Which cancers cause the most deaths?

Answer 24

male = lung
female = lung

Question 25

What are the 2 spectra of neoplasms?

Answer 25

malignant <>benign

fatal <> subclinical