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2a - ICS > Pathology > Flashcards

Pathology Flashcards

1
Q

Define thrombosis

A

The solidification of blood contents (e.g. platelets & RBC) that forms within the vascular system during life

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2
Q

Give 3 outcomes of a thrombi

A

Resolution - degrades
Organisation - leaves scar tissue
Embolism - fragment of thrombus break off into circulation

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3
Q

What is an embolus

A

A mass of material in the vascular system able to become lodged within a vessel and block its lumen

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4
Q

Describe an arterial emboli and give an example of a condition

A

Lodges in systemic circulation e.g. lodges in carotid artery = Ischaemic stroke

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5
Q

Describe a venous emboli and give an example of a condition

A

Lodges in pulmonary circulation. E.g. DVT embolises and lodges in pul A = pulmonary embolism

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6
Q

Define ischaemia

A

Reduction in blood flow to a tissue or part of the body

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7
Q

What is infarction

A

Tissue death due to inadequate blood supply

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8
Q

What makes an organ susceptible to infarction

A

If the organ only has a single artery supplying it

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9
Q

3 factors that may cause thrombosis (Virchow’s triad)

A

Endothelial injury
change in blood flow
increased coagulability

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10
Q

What is atherosclerosis

A

Accumulation of fibrolipid plaques (atheroma) in the intima of systemic arteries
Narrowing and hardening of arteries

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11
Q

Risk factors of atherosclerosis

A

Smoking
Hypertension
Diabetes
male

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12
Q

What is apoptosis

A

Programmed cell death in single cells

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13
Q

What is necrosis

A

Inflammatory traumatic cell death

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14
Q

What is caseous necrosis

A

Soft cheese appearance
TB characterised by this form

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15
Q

What is the purpose of apoptosis

A

Important in normal cell turnover as it prevents cells with accumulated genetic damage from dividing and producing cells which could develop into cancer

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16
Q

What is the basic function of the p53 gene in apoptosis

A

They detect DNA damage and can then trigger apoptosis

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17
Q

What is the basic principal of how apoptosis occurs

A

Cascade of activated enzymes ( mainly caspases)

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18
Q

What cells are involved in acute inflammation

A

Neutrophils and monocytes

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19
Q

Describe the sequence of acute inflammation

A
  • an injury or infection occurs
  • neutrophils arrive - they phagocytose and release enzymes
  • macrophages arrive and phagocytose them
  • outcome: resolution with clearance of inflammation or progression to chronic inflammation
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20
Q

What cells are involved in chronic inflammation

A

lymphocytes, macrophages, plasma cells

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21
Q

What is a granuloma

A

an aggregation of macrophages/ histocytes surrounded by lymphocytes that forms in response to chronic inflammation

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22
Q

Stages of acute inflammation response

A
  • vessel gets wider 🡪 increased vessel flow
  • Increased vascular permeability 🡪 formation of fluid exudate
  • Formation of cellular exudate 🡪 emigration of neutrophil polymorphs
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23
Q

role of fibroblasts in inflammation

A

produce collagenous connective tissue in scarring

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24
Q

How do lifespans differ between neutrophils, macrophages and lymphocytes

A

neutrophils have a very short lifespan of 2-3 days
macrophages live months to years
Lymphocytes are live several years

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25
Q

Give an example of acute inflammation

A

Appendicitis

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26
Q

What does the presence of both granulomas and eosinophils indicate

A

a parasite

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27
Q

What do all granulomas secrete as a blood marker

A

ACE

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28
Q

Give 3 examples of conditions which cause granulomas to develop

A

No central necrosis:
*Leprosy
* Crohn’s disease
Central necrosis:
*Tuberculosis

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29
Q

What are the 2 ways chronic inflammation occurs

A

Progression from acute inflammation
Starts chronic e.g. infectious mononucleosis

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30
Q

What is hypertrophy

A

Increase in size of organ due to increase in size of constituent cells
Occurs in organs where cells can’t divide

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31
Q

Give an example of hypertrophy

A

Skeletal muscles in athletes

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32
Q

What is hyperplasia

A

Increase in size of organ due to increase in the number of its constituent cells

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33
Q

Give an example of mixed hypertrophy/hyperplasia

A

Smooth muscle cells of the uterus during pregnancy

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34
Q

What is metaplasia

A

The change in cell differentiation from one fully-differentiated cell
type to another

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35
Q

What usually causes metaplasia

A

Consistent change in the environment on an epithelial surface

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36
Q

Give an example of metaplasia

A

Squamous epithelium of the oesophagus can become columnar
epithelium in response to continued stomach acid reflux (Barrett’s Oesophagus)

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37
Q

What is dysplasia

A

Morphological changes seen in cells in the progression to becoming cancer

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38
Q

What is carcinogenesis

A

The transformation of normal cells into neoplastic cells through permanent genetic alterations or mutations

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39
Q

What are carcinogens

A

Agents known or suspected to cause tumours

40
Q

Carcinogenic vs oncogenic

A

Oncogenic are tumour causing agents while carcinogenic are cancer causing agents

41
Q

Risk factor of lung cancer

A

Smoking

42
Q

Risk factor of bladder cancer

A

Dyes and rubber industry

43
Q

What drug inhibits platelet aggregation

A

Aspirin

44
Q

Reverse smoking increases the incidence of which cancer?

A

Oral cancer

45
Q

Which cancer can human papilloma virus cause

A

Cervical cancer

46
Q

Which cancer can be caused by excess alcohol consumption

A

Colon cancer

47
Q

What are the 5 Cardinal signs of inflammation

A

Heat (calor)
Redness (rubor; dilation of small vessels )
Tumour (swelling; from oedema/ physical mass )
Pain ( dolor )
Loss of function (functio laesa)

48
Q

What are the 3 stages of inflammation

A
  • Increased vessel permeability - gets wider which increases flow
  • fluid exudate - leaky vessel
  • cellular exudate - neutrophils become abundant
49
Q

State the 4 outcomes of acute inflammation

A

Resolution
Suppuration
organisation
Progression

50
Q

What is suppuration in terms of inflammation

A
  • Formation of pus
  • This becomes surrounded by a pyogenic membrane
  • leads to scarring
51
Q

What is organisation in terms of inflammation

A
  • replacement by granulation tissue
  • New capillaries grow into the inflammatory exudate, macrophages migrate and fibrosis occurs
52
Q

Describe resolution in terms of inflammatory outcome

A

Complete restoration of tissues to normal
Minimal cell death and rapid destruction of causal agent

53
Q

Explain the stages of neutrophil action in acute inflammation

A
  • Margination - migrate to edge of blood vessel
  • Adhesion - selectins bind neutrophil, cause rolling along BV
  • Emigration - neutrophils pass through endothelial cells
  • Diapedesis - RBC may also escape from vessels passively
54
Q

Clinical features pf arterial thrombi

A

Loss of pulse
Area becomes cold, pale and painful

55
Q

Give a condition that arterial thrombus can lead to

A

stroke

56
Q

Treatment for arterial thrombi

A

antiplatelets (aspirin)

57
Q

Give a condition that venous thrombosis can lead to

A

deep vein thrombosis

58
Q

Formation of arterial thrombi

A
  1. Endothelial cell damage
  2. VWF binds to exposed collagen and platelets bind to this - aggregation occurs
  3. Turbulence in blood flow due to obstruction of lumen
  4. Fibrin deposition and platelet clumping occurs - RBCs and platelets clump together and are meshed in fibrin
  5. Positive feedback so process continues indefinitely - thrombus formation
59
Q

Common cause of venous thrombosis

A

Lower blood pressure in veins - stasis
This allows for a thrombus to form

60
Q

Clinical features of venous thrombosis

A

Tender
Swollen
Red

61
Q

Treatment for venous thrombosis

A

anticoagulants (aspirin)

62
Q

Give 3 factors that can affect endothelial injury

A

Trauma
Hypertension
Invasive procedures

63
Q

Give 3 factors that can increase coagulability

A

sepsis
smoking
malignancy

64
Q

Constituents of atherosclerotic plaque

A

lipid
macrophages
Platelets
smooth muscle cells

65
Q

Formation of an atherosclerotic plaque

A
  • High levels of LDL in the blood accumulate in arterial wall
  • Macrophages are attracted to the damage site where they take up lipids to form foam cells
  • A fatty streak forms (earliest stage of plaque)
  • Foam cells promote smooth muscle cell proliferation around lipid core and formation of a fibrous cap (collagen)
66
Q

State the 3 pathways of apoptosis

A

Intrinsic, extrinsic and cytotoxic

67
Q

What is a neoplasm

A

A lesion resulting from the autonomous or relatively autonomous abnormal growth of cells which persists after the initiating stimulus is removed

68
Q

What is a tumour

A

Any abnormal swelling
Can be caused by inflammation, hypertrophy, neoplasms etc

69
Q

Describe the structure of neoplasms

A

Consist of neoplasticism cells with a surrounding stroma
Neoplastic cells are derived from nucleated cells

70
Q

What are the 2 methods of neoplasm classification

A

Behavioural - benign/malignant
Histogenetic - cell of origin

71
Q

Common features of benign neoplasms

A
  • Localised & non-invasive
  • Slow growth rate
  • Low mitosis activity
  • Close resemblance to normal tissue
  • Normally encapsulated/ circumscribed
  • Necrosis and ulceration is rare as they don’t tend to outgrow blood supply
  • Often exophytic ( grows outwards )
72
Q

Common features of malignant neoplasms

A
  • Invasive
  • Endophytic growth (inwards)
  • Metastases
  • Rapid growth rate - high mitosis activities
  • Necrosis and ulceration is common
  • Variable resemblance to normal tissue
  • Poorly circumscribed
73
Q

What is the defining feature of a malignant neoplasm

A

Invasive

74
Q

What does the term ‘high grade neoplasm’ mean

A

Low resemblance to normal tissue which means a poorer prognosis is likely

75
Q

Give 3 ways benign neoplasms cause morbidity and mortality

A

Pressure on adjacent structures
Transformation to malignant neoplasms
Obstruct flow

76
Q

What are the 3 different origins of a neoplasm

A

Epithelial cells
Connective tissue
Lymphoid/ haematopoietic organs

77
Q

state the suffix of all neoplasms

A

-oma

78
Q

What is the name of a benign tumour of non-glandular/ non- secretory epithelium

A

Papilloma

79
Q

What is name for a benign tumour of glandular/ secretory epithelium

A

Adenoma

80
Q

What is the name for a malignant epithelial neoplasm

A

Carcinoma

81
Q

What is the name for a malignant tumour of glandular epithelium

A

Adenocarcinomas

82
Q

Give the name for benign connective tissue neoplasms of the following: Adipocytes, cartilage, bone, vascular

A

Adipocytes - Lipoma
Cartilage - Chondroma
Bone - Osteoma
Vascular - Angioma

83
Q

Give the name for benign connective tissue neoplasms of the following: striated muscle, smooth muscle and nerves

A

Striated muscle - Rhabdomyoma
Smooth muscle - leimyoma
Nerves - neuroma

84
Q

Suffix of malignant connective tissue neoplasms

A

‘Sarcoma’

85
Q

What is the name for a malignant CT neoplasm of striated muscle

A

Rhabdomyosarcoma

86
Q

What is a malignant neoplasm known as when the cell of origin is unknown

A

Anaplastic

87
Q

Give 3 examples of ‘-omas’ that aren’t neoplasms

A

Granuloma
Mycetoma
Tuberculoma

88
Q

What is the name for a malignant neoplasm of lymphoid cells

A

Lymphoma

89
Q

Which tumour metastasise to bone ( BLT KP )

A

Breast
Lungs
Thyroid
Kidney
Prostate

90
Q

Which 3 cancers are screened for in the UK

A

Bowel
Breast
Cervical

91
Q

Describe the process of metastasis

A
  1. Tumour cells detach from their neighbours
  2. Invasion of surrounding connective tissue
  3. Intravasation into lumen of vessels
  4. Evasion of host immune defence
  5. Adherence to endothelium at a remote location
  6. Extravasation of the cells from the vessel lumen into the surrounding tissue
  7. Tumour cells proliferate in the new environment
92
Q

Give 3 ways in which tumour cells evade host immune defence

A
  • aggregation with platelets
  • shedding of surface antigens
  • adhesion to other tumour cells
93
Q

Briefly describe TNM staging of for tumours

A

T - refers to primary tumour
N – Refers to lymph node status
M – Refers to metastatic status

94
Q

Give 3 factors that can cause reduced blood flow

A

Immobility
Atrial fibrillation
Varicose (swollen) veins

95
Q

Define atrophy

A

The decrease in the size of an organ or cell be reduction in cell size and/or number

2a - ICS (4 decks)

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