Past questions - Pathology Flashcards
What is acute inflammation?
Bodys response to tissue injury.
Innate and immediate.
Heat, pain, redness, swelling
What are the stages of wound healing?
- Vasoconstriction
- Hemostasis - vasodilation, increased vascular permeability, platelet activation
- Inflammatory - migration of white cells - neutrophils
- Phagocytosis - macrophages
- proliferative - fibroblasts
- resolution or progression
Chemical mediators
Platelets - prostaglandins, leukotriene, histamine, serotonin
plasma - plasmin, bradykinin
complement
Gastric cancer
CDH mutation
Polyp
Abnormal growth of tissue form mucous membrane
What is an oncogene
A muted gene that has the potential to cause cancer. Stimulates growth when not required.
Adenoma cancer sequence
Stepwise pattern of Mutations of oncogenes and TSG
- APC - tumour supressor gene - mutation
- K-Ras - oncogene
P53 - TSG - inactivated
Dysplasia
Disordered cellular development characterised by increased mitosis and pleomorphism but unable to invade basement membrane
What is the APC gene?
Tumour supressor gene
Negatively regulates WNT pathway
degrades beta catenin
mutation - beta catenin not degraded - WNT stimualted - overgrowth
RHD pathophysiology
Group A strep - cross reacts with host abs -complement - T cell - recurrent inflmaation - stenosis
Ashcoff bodies
Steroids
Opportunisitic bacteria
CIshings - obesity, stria muscle weakness
cardio-fluid retention
DM
GCA Eye
Anterior ischeamic optic neuropathy
How do steroids cause bone disease
Inhibitiion of GIT calcium
Dircet stimulation of osteoclast
Decrease of renal reabsorption
Neutrophils
Margination and rolling
Adhesion
Transmigration
Migration
Bone marrow - HEAMTOPOEITC STEM CELLS
Parathyroid hyperplasia
Chief cell - MEN
Water clear cell
What is IHC?
lOCALISING SPECIFIC ANITGENS IN TISSUES based on antigen aby
How does a malignant tumour survive in LN/ lymphatic spread
Release growth factors such as VGEF - Lymphactic vessel explanison
How does cancer spread?
- Direct or continuous extension
- Penetrates into lymph, blood or body
- Transport into circulation
- ARREST IN THE CAPILLARY BEDS
- Growth of tumour
Carcinoid tumour
Enterchomofin cells
Cutaneous flushing, diarrhoea, malabsorption
Beta catain allows spread
Why renal stones in crohns?
Increased intestinal fat -> binds to calcium -> leaving oxalates
Chronic changes in IBD
laminia propira
paneth cell meteplasia
Role of TNF in IBD
Cytokine involved in systemic inflammation.
Regulates the innate immune response
Increases tight junction epithelia
Increase flux of luminal
Causes acute inflammation
TNF alpha inhibition by monoclonal antibodies
Biofilms
Viscous layer of extracellular polysaccharides that adhere to host
Why pus yellow
Myeloperoxidase
Granuloma
Aggregation of macrophages
Heart carcinoid
Libman sacks endocardis (non bacterial endocardis)
What to look out for on report
Malignant features
- Histological grade and differentiation
- Size
- Margin status
- Immunohistochemistry
Grading
Microscopic differentiaiton
Staging
extent and spread
Lung cancer parneoplastic
- (ADH), inducing hyponatremia due to inappropriate ADH secretion
- (ACTH), producing Cushing syndrome
- Parathormone, parathyroid hormone-related peptide, prostaglandin E, and somecytokines, all
implicated in the hypercalcemia - Calcitonin, causing hypocalcemia
- Gonadotropins, causing gynecomastia
- Serotonin and bradykinin, associated with the carcinoid syndrome
What is amyloid
Fibril protein
Why Hyper coagulable
Tumor cells to produce and secrete procoagulant/fibrinolytic substance which activate coagulation cascade
stimulation of tissue factor production by host cell.
What is an ulcer
local defect of mucus membrane due to loss of surface epithelial cells
H.pylori
Spiral heix microareophilic gram negative bacteria
What is gangrene
Necoris caused by critically insufficent blodd supply
Tb tests
sputum - ziehl neelson
mantoux
PCR
quantiferon
FNAC
What are giant cells?
Multinucleated cells comprising of macrophages often forming granuloma
e.g. Langerhans’ giant cells, Reed sternberg cells
Granuloma
Organised collection of macrophages IN REPSOSNE TO CHRONIC INFLAMMATION
Cracinoma
Malignat neoplasm of epithelial cells
Hamartoma
Disorganised arrangements of different amounts of tissue normally found at that site
PMC
abx - disrupt microbe - allow c.diff to colonise - release toxins - eruption of neutrophils - mucopurulent psudeomemrbanes
GCA
Tunica media
Intimal thickening
granulmotosis inflamamtion - lamina destruciton
Tcells and macrophages
Skip lesions
