Pathology Flashcards
1
Q
What type of cell is being described?
- any organism that lacks a distinct nucleus and other organelles due to the absence of internal membranes
A
prokaryotic cell
2
Q
Which type of cell is being described?
- any cell or organism that possesses a clearly defined nucleus
A
eukaryotic cell
3
Q
Which type of cell is being described?
- first form of life on earth
- simpler and smaller
- no membrane-bound organelles
- eg. bacteria
A
prokaryotic cell
4
Q
Which type of cell is being described?
- larger and more complex
- membrane-bound organelles
- cell nucleus (DNA organised in chromosomes)
- eg. plant, animal, fungi
A
eukaryotic cell
5
Q
Which cell structure is the following?
- lipid bilayer (2 layers of phospholipids) embedded with proteins
- involved in cell signalling
- transports nutrients into the cell and transports toxic substances out of the cell
A
cell membrane
6
Q
Which cell structure is the following?
- predominantly made up of water
- made up of cytosol, the fluid component
- it is the medium for chemical reaction
- provides a platform upon which other organelles can operate within the cell
A
cytoplasm
7
Q
Which cell structure is the following?
- powerhouse of the cell
- where cellular respiration takes place
- supplies energy for the cell (ATP)
A
mitochondria
8
Q
What is the role of the microfilaments and intermediate filaments in a cell?
A
- provide scaffolding for the cell
9
Q
What is the role of the microtubules of a cell?
A
- they participate in the formation of the spindle during cell division (mitosis)
- regulating cell growth and movement as well as key signaling events, which modulate fundamental cellular processes
10
Q
Which cell structure is the following?
- contains genetic material of cell
A
nucleus
11
Q
Which cell structure is the following?
- where RNA is formed
- primary function is ribosomal RNA (rRNA) synthesis and ribosome biogenesis
A
nucleolus
12
Q
Which cell structure is the following?
- site where protein synthesis and protein metabolism will take place
- studded with ribosomes
A
rough endoplasmic reticulum
13
Q
Which cell structure is the following?
- synthesis and storage of lipids, including cholesterol and phospholipids
A
smooth endoplasmic reticulum
14
Q
Which cell structure is being described?
- contains enzymes, breaks down waste products of the cell
A
lysosome
15
Q
What is being described?
- deoxyribonucleic acid
- contains genetic
information that codes for living organisms - nucleobases; cytosine, guanine, adenine, thymine
- 23 pairs of chromosomes in humans
A
DNA
16
Q
Tissue homeostasis
Which type of cells are being described?
- cells that are constantly renewing eg. stratified squamous epithelium of skin
A
labile cells
17
Q
Tissue homeostasis
Which type of cells are being described?
- usually quiescent (in a state or period of inactivity or dormancy) but can be stimulated to divide eg. hepatocytes
A
stable cells
18
Q
Tissue homeostasis
Which type of cells are being described?
- incapable of regeneration in post-natal life eg. neurons, cardiac muscle
A
permanent cells
19
Q
Cell growth
What is the term used for repeated cell division?
A
cell proliferation
20
Q
Cell growth
What is the term used for increase in the the number of cells?
A
hyperplasia
21
Q
Cell growth
What is the term used for an increase in cell size?
A
hypertrophy
22
Q
Which phase of the cell cycle is being described?
- part of interphase
- preparation of cell for division
- cell grows larger
- number of organelles increases
- cells may exit G1 phase to enter G0 phase where cells are inactive or dormant outside of the cell cycle
A
G1 phase
23
Q
Which phase of the cell cycle is being described?
- synthesis phase
- DNA replication
- part of interphase
- cell synthesises complete copy of DNA in nucleus
A
S phase
24
Q
Which phase of the cell cycle is being described?
- part of interphase
- growth and preparation for division
- cell grows more, makes proteins and organelles
- recognises contents in preparation for mitosis
A
G2 phase
25
Which phase of the cell cycle is being described?
- prophase
- prometaphase
- metaphase
- anaphase
- telophase
- cytokinesis
M phase
26
Which stage of the mitotic phase is being described?
- first stage
- chromosomes duplicate, and the copies remain attached to each other
interphase
27
Which stage of the mitotic phase is being described?
- second stage
- in the nucleus, chromosomes condense and become visible. In the cytoplasm, the spindle forms
prophase
28
Which stage of the mitotic phase is being described?
- third stage
- the nuclear membrane breaks apart, and the spindle starts to interact with the chromosomes
prometaphase
29
Which stage of the mitotic phase is being described?
- fourth stage
- the copied chromosomes align in the middle of the spindle
metaphase
30
Which stage of the mitotic phase is being described?
- fifth stage
- chromosomes separate into two genetically identical groups and move to opposite ends of the spindle
anaphase
31
Which stage of the mitotic phase is being described?
- sixth stage
- nuclear membranes form around each of the two sets of chromosomes, the chromosomes begin to spread out, and the spindle begins to break down
telophase
32
Which stage of the mitotic phase is being described?
- final stage
- the cell splits into two daughter cells each with the same number of chromosomes
cytokinesis
33
Cell injury
What is being described?
- pathological (or excess physiological) stressors force cell into new steady state
cell adaptation
34
Cell injury
What is being described?
- level of stress on cell exceeds adaptive capacity and cell dies
cell injury
35
What are 10 causes of cell injury?
1. hypoxia/ischaemia
2. free radicals
3. chemical
4. ionising radiation
5. mechanical trauma
6. ageing
7. infection
8. genetic abnormality
9. nutritional imbalance
10. thermal
36
List the 4 biochemical mechanisms involved in cell injury?
- loss of energy (ATP/O2 depletion)
- oxygen and O2-derived free radicals
- loss of calcium homeostasis
- defects in plasma membrane
37
Which type of cell injury mechanism is being described?
- mitochondria susceptible to injury from oxidants, free radicals, cations and weak acids
- mitochondrial damage leads to: leakage of pro-apoptotic proteins
- decreased ATP
loss of energy
38
What are 4 implications of decreased ATP?
- cellular swelling
- lactic acid accumulation - decreased pH
- disrupted protein synthesis
- depletion of glycogen (altered metabolism)
39
Which type of cell injury mechanism is being described?
- cellular injury caused by; lipid pre oxidation causing membranous damage, protein cross-linking and fragmentation, reacts with thymine causing DNA damage/mutations
free radicals
40
Which type of cell injury mechanism is being described?
Increase in cytosolic Ca2+:
- Ca2+ is pro-apoptotic
therefore - ischaemia, toxins which will break down phospholipids and low ATP
loss of calcium homeostasis
41
What are the two types of cell injury?
reversible and irreversible
42
Describes the 6 changes in cell morphology following reversible injury?
- cell swelling
- fat accumulation
- cell membrane alterations
- mitochondrial swelling
- RER swelling
- ribosomal detachment
43
Describes the 5 changes in cell morphology following irreversible injury?
- loss of RNA
- chromatin clumping
- membrane disruption
- fragmentation
- nuclear changes
44
What is the definition of apoptosis?
programmed cell death
45
What is the definition of necrosis?
pathological early cell death in living tissue
46
What are 4 physiological and pathological causations of cell apoptosis?
- embryonic development
- hormone dependent involution of organs
- cell death in tumours
- cell injury in viral disease
47
What are 3 triggers of apoptosis?
- death promoting signal
- withdrawal of stimulatory signals
- DNA damage
48
What are the 5 distinctive morphological patterns of necrosis? (CCLFG)
- coagulative
- liquefactive
- gangrenous
- caseous
- fat
49
What are the 2 types of gangrenous necrosis?
- dry gangrene
| - wet gangrene
50
Which type of gangrenous necrosis is being described?
- no bacterial superinfection
- mainly coagulative necrosis
dry gangrene
51
Which type of gangrenous necrosis is being described?
- bacterial superinfection
- mainly liquefactive necrosis
wet gangrene
52
What are 4 differences between necrosis and apoptosis?
necrosis
- cellular swelling
- membranes are broken
- ATP is depleted
- whole areas of tissue are affected
apoptosis
- cellular condensation
- membranes remain intact
- requires ATP
- individual cells appear affected
53
What are the 5 cardinal signs of inflammation?
1. pain
2. heat
3. redness
4. swelling
5. loss of function
54
What are the 3 stages of acute inflammation? (VIM)
- vasodilation
- increased vascular permeability
- migration of leukocytes
55
What are the 4 inflammatory mediators in acute inflammation?
- prostaglandins
- leukotrienes
- histamine
- serotonin
56
What are the two main cell types that are present in inflammation?
neutrophils and macrophages
57
What are the 5 cellular events in acute inflammation? (MADCP)
1. margination
2. adhesion
3. diapedesis
4. chemotaxis
5. phagocytosis
58
Which cellular event is being described in acute inflammation?
- leukocytes move to lie against endothelium as blood flow slows
1. margination
59
Which cellular event in acute inflammation is being described?
- adhesion molecules (integrins) on leukocytes bind to corresponding molecules (ICAM-1 & ICAM-2) on endothelium
2. adhesion
60
Which cellular event in acute inflammation is being described?
- adherent leukocytes pass through endothelium into extravascular space
3. diapedesis
61
Which cellular event in acute inflammation is being described?
- migrated leukocytes move along gradient of chemotactic factors
4. chemotaxis
62
Which cellular event in acute inflammation is being described?
- opsonised bacteria are engulfed by neutrophils and macrophages to create phagosome. Phagosome fuses with lysosome and engulfed particles are ingested
5. phagocytosis
63
Which one of the two cellular components of acute inflammation is being described?
- predominant leukocyte in first 24 hours
- predominant cells in pus
neutrophils
64
Which one of the two cellular components of acute inflammation is being described?
- predominant leukocyte after 48 hours
- continue phagocytosis
- secrete cytokines responsible for extracellular matrix production
macrophages
65
What are the 4 plasma chemical mediators in acute inflammation?
- complement system
- kinin system
- coagulation system
- fibrinolytic system
66
What are the 5 cellular chemical mediators in acute inflammation?
- vasoactive amines
- lysosomal enzymes
- arachidonic acid derivatives
- cytokines
- free radicals
67
What are the 4 outcomes of acute Inflammation? (RASC)
1. resolution
2. abscess & pus formation
3. scarring & fibrosis
4. chronic inflammation
68
What are the 3 features of chronic inflammation?
1. infiltration of tissues with mononuclear inflammatory cells
2. ongoing tissue destruction
3. evidence of healing
69
Which example of chronic inflammation is being described?
* persistence of injurious agent
* failure to drain pus/foreign material
* inadequate blood supply
* inadequate drainage of endocrine gland
non-specific chronic inflammation
70
Which example of chronic inflammation is being described?
- characterised by production of antibodies against self
- chronic tissue damage
- necrosis
- antibody complexes
autoimmune chronic inflammation
71
Which example of chronic inflammation is being described?
- presence of granulomas (organised collection of macrophages)
- offending substance 'walled off' in granulomas
- pus-filled cavities common
granulomatous
72
What are 3 examples of chronic inflammation?
- non specific
- autoimmune
- granulomatous
73
What are the predominant cells in common bacteria?
neutrophils
74
What are the predominant cells in viral infections and autoimmune diseases?
lymphocytes
75
What are the predominant cells in spirochaetal disease eg. syphilis?
plasma cells
76
What are the predominant cells in typhoid fever, TB and fungal infections?
macrophages
77
What are the predominant cells in allergic reactions, parasites and gut inflammation?
eosinophils
78
What are 5 macroscopic features of chronic inflammation?
1. chronic uler
2. chronic abscess
3. thickening of hollow viscous wall
4. granuloma
5. fibrosis
79
What are the microscopic features of chronic inflammation?
positive: formation of new blood vessels (angiogenesis), laying down new collagen, release of cytokines (help with immune response)
negative: release toxins
80
What does SIRS stand for?
systemic inflammatory response syndrome
81
What are the 4 signs of SIRS?
1. tachycardia - increased heart rate 90 beats per min
2. resp rate above 20 breaths per min
3. high temp above 38 degrees or below 36 degrees in elderly patients
4. increased levels of white blood cells
82
What are the 3 stages of acute inflammation? (VIL)
1. vasodilation
2. increased vascular permeability
3. leukocyte migration
83
What are the 3 layers of the skin?
1. epidermis - protection
2. dermis - thermal regulation
3. hypodermis
84
What are the 2 types of wounds?
open and closed
85
What type of wounds are the following?
- incision
- laceration
- abrasion
- puncture
- penetration
open wounds
86
What type of wounds are the following?
- contusion (bruising)
- haematoma (swelling/collection of blood)
closed wounds
87
What are the 4 types of surgical wounds?
1. clean
2. clean-contaminated
3. contaminated
4. dirty
88
Which type of surgical wound is being described?
- an incision in which no Inflammation is encountered in a surgical procedure
- no break in sterile technique, and during which the respiratory, gastrointestinal and genitourinary tracts are not entered
- example is excision of a mole from skin
clean surgical wound
89
Which type of surgical wound is being described?
- an incision through which the respiratory, gastrointestinal or genitourinary tract is entered under controlled conditions
- contamination encountered
- example is elective procedure of bowel (planned)
clean-contamined surgical wound
90
Which type of surgical wound is being described?
- an incision undertaken during an operation in which there is a major break in sterile technique or gross spillage from the gastrointestinal tract
- an incision in which acute, non-purulent (no pus) inflammation is encountered
- example is gall bladder removal (bile spillage)
contaminated surgical wound
91
Which type of surgical wound is being described?
- an incision undertaken during an operation in which the viscera are perforated or when acute inflammation with pus is encountered during the operation
- examples are; contamination of open fracture (trauma), bowel perforation during laparoscopy (faecal contamination)
dirty surgical wound
92
What are the 4 types of burns?
- superficial (first degree)
- partial thickness (second degree)
- full thickness (third degree)
- fourth degree
93
What are the 3 types of wound repair? (intention)?
1. primary
2. secondary
3. tertiary
94
Which type of wound repair is being described?
| - clean edges are brought together without tension
primary
95
Which type of wound repair is being described?
| - healing by granulation from base of wound. edges are not re-approximated
secondary
96
Which type of wound repair is being described?
| - delayed primary closure for dirty wounds
tertiary
97
What are the 4 phases of wound healing?
1. haemostasis
2. inflammation
3. proliferation
4. maturation and remodelling
98
Which phase of wound healing is being described?
Following tissue injury...
- immediate vasoconstriction to prevent blood loss
- activated platelets aggregate at site of endothelial injury
- initiation of clotting cascade
- fibrin matrix stabilises wound by forming a 'mesh'
- 0-15 minutes
haemostasis
99
Which phase of wound healing is being described?
- vasodilation and increased vascular permeability
- migration of neutrophils and macrophages
- phagocytosis of debris
- influx of fibroblasts (important in next phase)
- release of cytokines & platelet-derived growth factors
- hours to days
Fibroblasts: produce extracellular matrix and collagen
- ECM; nutrients, moist environment for cells move on
- collagen; provide strength to skin
inflammation
100
Which phase of wound healing is being described?
- formation of granulation tissue, angiogenesis (formation of new blood vessels), epithelialisation and wound contraction
- cells recruited during inflammatory phase are proliferated due to released growth factors
- epithelial cells at edge of wound proliferate & migrate across defect
- fibroblasts synthesise ECM and collagen (type III)
- endothelial cells - development of new blood vessels
- myofibroblasts similar to smooth muscle cells, act to contract the wound
proliferation
101
Which 4 types of cells are involved in proliferation?
- epithelial
- fibroblasts
- endothelial
- myofibroblasts
102
Which phase of wound healing is being described?
- stage lasts for months, takes longer where there is a lot of movement
- scar becomes less vascular
- tensile strength increases as collagen is modified
- type III collagen replaced by type I collagen, multiple molecules orientate to form 'fibril', cross-linkage of fibrils aided by vitamin c
remodelling
103
How long does it take for a wound to be waterproof?
48 hours
104
How long does it take for full maturation of a wound?
up to 12-18 months
105
What are the 2 types of abnormal healing?
- hypertrophic scar
| - keloid scar
106
Which type of abnormal healing is being described?
- excessive amounts of collagen laid down
- scar does not extend beyond original wound edges
- tension on wound increases likelihood; wound not brought together properly, should have sutured
hypertrophic scar
107
Which type of abnormal healing is being described?
- overgrowth of granulation tissue
- scar extends beyond edges of original wound
- more common in afro-caribbean ethnicities
- removal for aesthetics may result in regrowth
- minimal tension, good surgical technique, pressure dressing may reduce granulation tissue
keloid scar
108
What are the following examples of?
- medical optimisation; antibiotics, oxygen, tetanus, control of blood sugar
- wound debridement; irrigation, surgical, enzymatic, biological (maggots)
- topical therapy; antiseptics, antimicrobials
- wound dressing; films, foams, alginates, hydrocolloids
- wound packing; deep wounds, prevents abscess formation
- wound closure; primary, topic negative pressure
- wound coverage; skin grafts, synthetic grafts, flaps
- adjunctive therapy; surgical drains, hyperbaric oxygen
wound management methods
109
What type of cells are the following?
- osteogenic cell > stem cell
- osteoblast cell > matrix synthesising cell responsible for bone growth
- osteocyte cell > mature bone cell that maintains the bone matrix
- osteoclast > bone-resorbing cell
bone cells
110
What are 5 important factors when considering severity of bone fractures?
- open vs closed wound
- mechanism of injury
- pre-morbid bone quality
- anatomical location
- age of patient
111
What are the 2 types of fracture healing?
primary and secondary
112
Which type of fracture healing is being described?
- bring two ends fracture together (surgeons)
- requires stability of fracture
- Haversian remodelling
primary healing
113
Which type of fracture healing is being described?
- does not require rigid fixation (natural way)
- responses from periosteum & surrounding soft tissue
secondary healing
114
What are the 4 phases of fracture healing?
1. haematoma formation
2. soft callus formation
3. hard callus formation
4. bone remodelling
115
Which phase of fracture healing is being described?
- rupture of blood vessels in medullary cavity
- blood fills gap and spills into surrounding tissues forming a haematoma
- formation of fibrin mesh and seals off fracture site
- influx of inflammatory cells
- cytokines activate osteoprogenitor cells to fibroblasts and chondroblasts
haematoma
116
Which phase of fracture healing is being described?
- by end of 1st-2nd week organised haematoma replaced by soft callus
- granulation tissue provides matrix for woven bone to be deposited by osteoblasts
- still damageable by shear forces
- axial traction & pressure promote matrix formation
soft callus formation
117
Which phase of fracture healing is being described?
- organised parallel to axis of bone
- mineralisation of soft callus
- fracture strength increases
- allows weight bearing
- 6 weeks healing time
hard callus formation
118
Which phase of fracture healing is being described?
- occurs over months and years
- initial callus is replaced with lamellar bone through Haversian remodelling
- internal architecture dependent on Wolff's law
bone remodelling
119
What is being described?
Mechanotransduction
- osteocytes send signals via molecules or direct contact when load sensed
- osteoprogenitor cells differentiate into osteoblasts or osteoclasts dependent on load conditions
Wolff's law
120
What type of cell is being described?
| - stem cells located in the bone that play a prodigal role in bone repair and growth
osteoprogenitor cell
121
What are the 4 principles of fracture management?
1. fracture reduction (to restore anatomical relationships)
2. fracture fixation (providing stability)
3. preservation of blood supply (to the soft tissue and bone)
4. early and safe mobilisation
122
What are the two types of impairment of wound healing?
local and systemic
123
What are the following examples, of which type of impairment of wound healing?
- oxygenation
- infection
- foreign body
- venous sufficiency
local impairment of wound healing
124
What are the following examples, of which type of impairment of wound healing?
- age
- sex hormones (females heal better than males)
- stress
- ischaemia (restricted blood flow)
- disease (jaundice, diabetes etc)
- medications
- nutrition
- smoking
- obesity
- immunocompromised conditions
systemic impairment of wound healing
