Pathological Processes

Question 1

Why is troponin I/T detectable after a MI?

Answer 1

An area of cardiac muscle has undergone necrosis due to an infarction (lack of blood supply)
Cell membrane becomes leaky so it can be measured in blood

Question 2

How does cirrhosis appear histologically?

Answer 2

Bands of fibrosis surrounding nodules of regenerating hepatocytes

Question 3

What is an opsonin and give some examples?

Answer 3

A substance that coats foreign materials to make them easier to phagocytose
(CRP, IgG/IgM, C3b, C4b)

Question 4

How does exudate form?

Answer 4

1. Tissue injury results in vasodilatory mediators being released
2. Inflammatory mediators cause endothelial cells to contract so vessel walls are leaky
3. Plasma proteins leave the vessel and fluid collects in the interstitial space
4. Fluid collects in extravascular space

Question 5

What is diapedesis?

Answer 5

Passage of blood cells through blood vessel walls

Question 6

What is a chemoattractant and give some examples?

Answer 6

Attracts inflammatory cells
(Endotoxin, thrombin, C3a/C4a/C5a, IL8)

Question 7

Why is granulation tissue so red?

Answer 7

Contains many small blood vessels

Question 8

How does a scar appear a year after and why?

Answer 8

White - small blood vessels regress
Hairless - hair follicles don’t regenerate in damaged skin
Stretched - elastic fibres don’t regenerate

Question 9

What are abdominal adhesions?

Answer 9

Bands of fibrous tissue that form between abdominal tissues and organs

Question 10

Give 2 reasons why pregnancy ^risk of DVT?

Answer 10

1. Blood is hypercoagulable
2. Baby = pelvic mass compressing venous flow

Question 11

Why would you start a patient on LMWH instead of warfarin?

Answer 11

LMWH effective immediately

Question 12

What is a saddle embolus?

Answer 12

A large emboli that straddles the bifurcation of the pulmonary artery

Question 13

Which white cell is required for a histological diagnosis of chronic inflammation?

Answer 13

Epitheloid histiocytes

Question 14

Which blood test is decreased in DIC?

Answer 14

Fibrinogen

Question 15

How does coagulative necrosis appear histologically?

Answer 15

Loss of cell detail but ghost outline of tissue

Question 16

What colour would a cardiac infarct be?

Answer 16

White

Question 17

What are some differences between necrosis and apoptosis?

Answer 17

Inflammation present in N
Always pathological in N
Membrane intact in A

Question 18

What are the functions of the compliment system?

Answer 18

Killing bacteria
Chemotaxins
Opsonisation

Question 19

Features of inherited angio-oedema?

Answer 19

Swelling of face and airway and intestinal mucosa
(fatal in pharynx)

Question 20

Functions of macrophages?

Answer 20

Phagocytosis
Secretion of chemical mediators
Opsonisation
Stimulating angiogenesis
Inducing fever

Question 21

Which tissues always heal with a scar?

Answer 21

Cardiac, skeletal, neural tissue

Question 22

What’s the difference between thrombosis and clotting?

Answer 22

Thrombus is pathological and inside the vessel
Clot is physiological and outside the vessel

Question 23

How can a PE cause death?

Answer 23

1. Ventilation-perfusion mis match
2. ^resistance to flow = acute R HF = cor pulmonale

Question 24

What causes an AAA?

Answer 24

Atherosclerosis weakens the tunica media

Question 25

Why do both alleles of a tumour supressor gene need to be mutated but only one allele of a proto-oncogene?

Answer 25

Proto-oncogene = activating (encourage neoplasia)
Tumour supressor gene = deactivaitng (need both alleles destroyed for cell cycle to continue)

Question 26

What’s cancer progression?

Answer 26

Accumulation of mutations over time.

Question 27

How does HPV cause cancer?

Answer 27

HPV produces two proteins (E6 and E7) that inactivate tumour
suppressor proteins (RB protein and p53)

Question 28

What are the 5 cancers that metastasise to bone?

Answer 28

Breast
Brostate
Bidney
Bhyroid
Bronchus

Question 29

Which glands have ducts?

Answer 29

Exocrine glands have ducts, endocrine glands do not

Question 30

Which is the correct order of events that a neutrophil must follow for phagocytosis?

Answer 30

Chemotaxis, activation, margination, diapedesis, recognition attachment, phagocytosis

Question 31

What are the main cell types in chronic inflammation?

Answer 31

Macrophages and lymphocytes

Question 32

What cells are seen in a foreign body granuloma?

Answer 32

macrophages
epithelioid macrophages
fibroblasts

Question 33

When are Touton giant cell seen?

Answer 33

Fat necrosis and Xanthomas

Question 34

What’s the function of tumour necrosis factor?

Answer 34

Migration and proliferation of fibroblasts

Question 35

What is the main lymphatic drainage?

Answer 35

R lymphatic duct to R subclavian vein
Thoracic duct to L subclavain vein

Question 36

Which part of the lymph node does lymphatic fluid enter?

Answer 36

Convex surface

Question 37

What will the blood tests show for haemophilia A?

Answer 37

APTT is prolonged, but PT and bleeding time are normal

Question 38

What will the blood tests show for a low platelet count?

Answer 38

Bleeding time prolonged, but not APTT or PT

Question 39

From which cells do platelets emerge?

Answer 39

Megakaryocytes

Question 40

What are the different types of plaque?

Answer 40

Fatty streak - flat lesion in the intima
Simple plaque - raised lesion in the arterial wall
Complicated plaque - produces symptoms

Question 41

What are the different types of cells in regards to regeneration?

Answer 41

Stable cells - can replicate if they must e.g. liver
Permanent cells - unable to replicate e.g. heart
Labile cells - replicate constantly e.g. skin

Question 42

Define carcinoma.

Answer 42

Malignant neoplasm of non-glandular epithelium