non neoplastic pathology Flashcards
histology of all CT disease =
diagnose by ___
chronic inflam with lots of plasma cells
autoIgs as commonly they are immune driven
secondary vasculitis is caused by ___
vessels are proximal to source of inflammation and it spreads to the vessels
direct invasion and inflammation of the vessel walls can be caused by __
infection eg syphilis
specific autoIg for Kawasaki’s disease
anti endothelial
cANCA: c stands for ___ and reacts with __
cytoplasmic
PR3
pANCA: p stands for ___ and reacts with __
perinuclear
MPO
large vessel vasculitis = _____ disease
eg.s (2)
granulomatous disease
GCA
Takayasu arteritis
medium vessel vasculitis = ___ eg. __
or ___ eg. ___
immune complex mediated eg. polyarteritis nodosa
anti-endothelial cell Igs eg. Kawasakis
small vessel vasculitis with paucity of immune complexes (3 types)
vasculitis wo granuloma/asthma = microscopic polyangitis
granulomas no asthma = GPA
eosinophilia, asthma, granulomas = EPGA
features = temporal arteritis which is __ and so -ve biopsy doesnt rule out
condition =
segmental
GPA
give ___ prior to temporal artery biopsy in GPA
steroids
polyarteritis nodosa (PAN) is a vasculitis of \_\_ vessels and is ANCA \_\_\_ presumed due to \_\_ as 1/3 are +ve for these
medium
-ve
circulating hep B immune complexes and Ig
polyarteritis nodosa spares __ and has a propensity for __+__ involvement
features of vessels involved = __+__
spares lungs
renal and GI
transmural necrotising inflam + fibrinoid necrosis
immune complex mediated small vessel vasculitis eg.s (4)
SLE vasculitis
Henoch-Schonlein purpura (IgA)
Cryoglobulin vasculitis
Goodpasture’s
uric acid is end product of __
purine (A+G) degradation
causes of gout that are caused by too much uric acid being produced
90% idiopathic with unknown enzyme defect HGPRT defect ( rare = Lysch-Nyhan syndrome) increased cell turnover - malig, psoriasis, chemo
causes of gout due to excrete too little uric acid =
thiazides
renal impairment
uric acid crystals deposit in __ and ___ in gout
joints in lower temp
kidney tubules and interstitium (can also cause renal stones)
uric acid crystal appearance on microscopy of fresh specimen
needle shaped and negative bifringence
-ve bifringence means the orientation of the crystals =
left
apple green bifringence with congo red staining =
amyloid protein
pseudogout aka
caused by ___ crystals
chondrocalcinosis
calcium pyrophosphatase
rhomboid shaped and weakly +ve bifrengence crystals =
calcium pyrophosphate
increased osteoclast activity causing increased osteoblast activity is the underlying problem in
Pagets
genetic elements of Pagets =
SQSTM1/p62
RANKL - osteoclast receptor activator
Pagets can be caused be a ___ infection eg (3) or idiopathic
viral - paromyxovirus, measles ( nucleocapsid protein MVNP seems to stim osteoclasts) + RSV
3 stages of Pagets = __>__>__
osteolytic > mixed > burnt out
leontiasis ossea =
seen in __
overgrowth of facial and cranial bones seen in Pagets
also fibrous dysplasia, hyperparathyroidism and renal osteodystrophy
platybasia =
seen in __
abnormal flattening of the skull base
Pagets
sabre tibia is seen in what condition
Pagets
Pagets causes __ metabolism = __ skin, ____ HF
and increases ___ risk
increased - warm skin, high volume HF
osteosarcoma
rickety rosary =
sign seen =
2 lines in ribs with the abnormal one at the costochondral junction
Rickets
bowed legs, square head, pigeon chest and rickety rosary are signs in
Rickets
>____ (fibrin mesh)> ___ cell influx > ___ release > ___ cells from periosteum and medulla > __ (1wk) = ___ and remodelling at bone ends > 2-3 wk reach ___ -woven bone deposited ___ to cortical bone, some __ deposited which undergoes ___, bridging with ___ > remodelled
hamartoma inflammatory cell cytokine osteoprogenitor callus = organised hamartoma cartilage - endochondral ossification bony callus
kidney lung and breast mets to bone are usually osteo___
osteolytic
osteoclerotic metastasis =
prostate
creeping substitution on histology is a feature of
AVN
AVN is usually a ___ infarct and often __
wedge-shaped infarct
subcortical
bony lesions caused by proliferation of plasma cells
myeloma/plasmacytoma
polished bone in OA other name =
eburnated bone
small cracks in cartilage seen in the early stages of OA =
fibrillations
4 radiological features of OA =
Loss of joint space = cartilage loss
Subchondral sclerosis = eburnation
Subchondral cysts = Synovial fluid accumulation
Osteophytes = disorganised bone remodelling
RA: AI process = ____ and so there are lots of ___
RF IgM - plasma cells that produce this
in RA ___ is destroyed by inflammatory process and ___ is formed = __+__
cartilage destroyed
pannus - inflammatory cells and hyperplastic synovium
