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Pathology Flashcards

1
Q

What is inflammation?

A

Local physiological response to tissue injury

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2
Q

What are 2 types of inflammation?

A

Acute and Chronic

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3
Q

Features of Acute Inflammation

A
  • Intial Response of tissue to injury
  • Early onset
  • Short Duration
  • Cells involved = Neutrophils and Monocytes
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4
Q

What are the steps of acute inflammation?

A

Vascular Component - Dilation of Vessels
Exudative component - Vascular leakage of protein-rich fluid (Exudate)
Neutrophil Polymorph - Cells type recruited to tissue

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5
Q

Causes of Acute inflammation

A

Microbial Infections
Hypersensitivity reactions - parasites
Physical agents - Trauma
Chemicals - Acids
Bacterial toxins
Tissue necrosis - Ischemic infarction

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6
Q

What are the 5 cardinal signs?

A

Rubor
Dolor
Calor
Tumor
Loss of function

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7
Q

How do you describe the appearance of redness?

A

Rubor (Due to dilation of small vessels)

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8
Q

How do you describe the appearance of heat?

A

Calor (only seen peripherally)

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9
Q

How do you describe the appearance of swelling?

A

Tumor (Results from oedema or physical mass)

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10
Q

How do you describe appearance of pain?

A

Dolor

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11
Q

What is the acute inflammatory response process?

A

Changes in vessel caliber (gets wider) -> Increased vessel flow
Increased vascular permeability -> Formation of fluid exudate
Formation of cellular exudate -> Emigration of neutrophil polymorphs

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12
Q

Steps of Neutrophil Polymorph Emigration

A
  1. Migration of neutrophils
    - Due to increase in plasma viscosity and slowing of flow due to injury, neutrophils migrate to plasmatic zone
  2. Adhesion of neutrophils
    - Adhesion to vascular endothelium occurs in venules called pavementing
  3. Neutrophil emigration
    - Neutrophils pass through endothelial cells, onto basal lamina and then the vessel wall
  4. Diapedesis
    - RBCs may also escape from vessels, this is a passive process and indicates severe vascular injury
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13
Q

Outcomes of acute inflammation

A

Resolution
Suppuration
Organisation
Progression

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14
Q

What happens in resolution of acute inflammation?

A

Complete restoration of tissues to normal

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15
Q

What happens in suppuration of acute inflammation?

A

Formation of pus
Becomes surrounded by a pyogenic membrane, which is start of healing
Leads to scaring

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16
Q

What happens in organisation of acute inflammation?

A

Replacement by granulation tissue

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17
Q

What happends in progression of acute inflammation?

A

Excessive recurrent inflammation -> Becomes chronic and fibrotic tissue

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18
Q

What is chronic inflammation?

A

Subsequent and prolonged response to tissue injury
Cells involved = Lymphocytes, macrophages and plasma cells
Longer onset, long last effects

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19
Q

What are granulomas?

A

Aggregates of epitheloid histocytes
Form granulomatous

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20
Q

what do granuloma and eosinophil indicate?

A

Parasite

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21
Q

What are the causes of primary chronic inflammation?

A
  • Resistance of infective agent (TB)
  • Endogenous materials (Necrotic tissue)
  • Exogenous materials (Asbetos)
  • Autoimmune conditions (Hashimoto)
  • Primary granulomatous diseases (Chron)
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22
Q

How do B lymphocytes cooperate in chronic inflammation?

A

Transform into plasma cells and produce antibodies

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23
Q

How do T lymphocytes cooperate in chronic inflammation?

A

Responsible for cell-mediate immunity

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24
Q

How do macrophages cooperate in chronic inflammation?

A

Responsible for cell-mediated immunity

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25
How do you macrophages respond in chronic inflammation?
Respond to chemotatic stimuli Produce cytokines
26
What is thrombosis?
Mass of blood constituents (mostly platelets) forming in vessels
27
How does thrombosis form?
1. Vasospasm - Narrowing of arteries caused by persistent contraction of blood vessels 2. Primary platelet plug - aggregation, adhesion, activation 3. Coagulation cascade
28
What influences thrombosis?
Virchow's Triad
29
What are the components of Virchows' triad?
Endothelial injury Hypercoagulability Decreased blood flow
30
What is atherosclerosis?
Plaques forming in intima and media of high pressure vessels ARTERIES
31
What is in a plaque?
Lipid Smooth muscle Macrophages Platelets Fibroblasts
32
How does atherosclerosis form?
1. Endothelial cell dysfunction 2. Fatty Streak - Precursor to plaque 3. Platelet aggregation - Plaque protrudes into artery lumen, disrupts laminar flow. THINNING OF MEDIA 4. Fibrin mesh + RBC trapping - Platelet plug forms fibrin mesh over itself causing RBCS to be trapped within 5. Fibrous Cap - Fibroblasts form smooth muscle cap over 2o platelet plug
33
What is the difference between a stable and unstable atheromas?
In an unstable artheroma, the fibrous cap is damaged and there is continuous platelet plug formation over the cap Therefore, NARROWED
34
What are the risk factors of atherosclerosis?
Diabetes Smoking Obesity Increasing age Male Hypertension
35
How do arterial thromobosis occur?
Atherogenesis
36
How does venous thrombosis occur?
Venous stasis
37
What are the fates of thrombi
Resolution - Degrades, returns normal Organisation - Leaves scar tissue Embolism - Fragments of thrombi break off and lodge in distal circulation
38
What is an embolism?
Mass of material in vascular system able to lodge in a vessela and block its lumen
39
Where are arterial emboli lodged?
System circulation (From left heart)
40
Where are venous emboli lodged?
In pulmonary circulation (From right heart)
41
Where does embolus lodge causing ischemic stroke?
In carotid artery
42
Where does embolus lodge causing pulmonary embolism?
Lodges in pulmonary artery
43
What is apoptosis?
Non inflammatory controlled cell death Cells shrink, organelles retained + CSM intact Chromatin unaltered
44
What are the mechanisms of apoptosis?
Intrinsic Extrinsic Cytotoxic
45
What happens in the intrinsic mechanism of apoptosis?
BAX (Protein) acts in mitochondrial membran to promote cytochrome C release Activates CASPASES -> Apoptosis
46
What happens in extrinsic mechanism of apoptosis?
Fas-Ligand or TNF-Ligand binds to CSM receptor which activate caspases -> apoptosis
47
What happens in cytotoxic mechanism of apoptosis?
CD8+ binding releases granzyme B from CD8+ cell; granzyme B -> performin -> caspases -> apoptosis
48
What is necrosis?
Inflammatory traumatic cell death Cells burst, organelles splurge, CSM damaged Chromatin altered; cell is fucked
49
What is Hypertrophy?
Increase in size of tissue caused by increase in number of constituent cells
50
What is hyperplasia?
Number of cells increases via mitosis
51
What is atrophy?
Number or size of cell decrease
52
What is metaplasia?
Change of one cell type to another type
53
What is dysplasia?
Change of differentiated cell type to poorly differentiated cell type
54
What is ischemia?
Decreased perfusion to tissue without infarction
55
Does basal cell carcinoma of skin invade globally or locally?
Locally - Never spreads to other parts of body
56
How do you cure basal cell carcinoma?
Complete local excision
57
What is carcinogenesis?
Transformation of normal cells to neoplastic cells through permanent mutation
58
What are neoplasms?
Autonomous, Abnormal, Persistent New Growth
59
What type of neoplasms do carcinogenesis only apply to?
Malignant
60
What do both carcinogenic and oncogenic act on?
DNA (Mutagenic)
61
What is the difference between carcinogenic and oncogenic?
Carcinogenic is cancer causing and oncogenic is tumour causing
62
What are tumours classified by?
Behaviour Histogenesis
63
What are the 2 behaviours of a tumour?
Benign or Malignant
64
what are the features of a benign tumour?
- localised (No BM invasion) - Slow growing - Exophytic (Outward growth) - Rare ulceration and necrosis - Close resemblance to normal tissue
65
What are the features of malignant tumour?
-BM invading - very fast mitotic growth - Endophytic (Inward growth) - Common necrosis and ulceration - Poorly differentiated (little resemblance to normal tissue)
66
What is histogenesis?
Origin cell of tumour or based on the specific cell
67
What cells form carcinomas?
Epithelial cells
68
What tissues form sarcomas?
Connective tissue
69
What is metastasis?
Process by which a malignant tumour spreads from its primary site to produce secondary tumours at distant sites
70
What is the pathway of metastasis?
1. Detachment (From primary) 2. Invasion of other tissue 3. Intravasation of BV 4. Evasion of host defence, ADHERENCE to BV wall 5. Extravasation to distant site
71
What are the 3 methods of spread in metastasis?
1. Haematogenous 2. Lymphatic 3. Transcoelomic
72
What happens in haematogenous spread?
Spreads to bone via lung, breast, kidney, thyroid, prostate
73
What happens in lymphatic spread?
secondary formation in lymph nodes e.g. lymphoma
74
What happens in Transcoelomic spread?
Via exudative fluid accumulation, spread through pleural, pericardial + peritoneal effusions
75
What method of spread do carcinomas prefer?
Lymphatic spread
76
What method of spread do sarcomas prefer?
Haematogenous spread
77
What are 2 components of neoplams?
Neoplastic cells and Stroma
78
What are the characteristics of neoplastic cell?
- Derived from nucleated cells - Usually monoclonal - Growth pattern related to parent cell - Synthetic activity related to parent cell
79
What are the characteristics of a stroma?
- Connective tissue framework - Mechanical support - Nutrition
80
What is essential for neoplasm growth?
Angiogenesis
81
What does a neoplasm release in order to initiate angiogenesis?
Vascular endothelial growth factor
82
What is a benign tumour of non-glandular, non-secretory epithelium called?
Papilloma
83
What is a benign tumour of glandular or secretory epithelium called?
Adenoma
84
What is a malignant tumour of epithelial cells called?
Carcinoma
85
What are carcinomas of glandular epithelium called?
Adenocarcinomas
86
What is a benign adipocyte tissue neoplasm called?
Lipoma
87
What is a benign cartilage tissue neoplasm called?
Chondroma
88
What is a benign bone tissue neoplasm called?
Osteoma
89
What is a benign vascular tissue neoplasm called?
Angioma
90
What is a benign striated muscle tissue neoplasm called?
Rhabdomyoma
91
What is a benign smooth muscle tissue neoplasm called?
Leiomyoma
92
What is benign nerve tissue neoplasm callled?
Neuroma
93
What is a malignant adipose tissue neoplasm called?
Liposarcoma
94
What is a malignant striated muscle tissue neoplasm called?
Rhabdomyosarcoma
95
What is a malignant smooth muscle tissue neoplasm called?
Leiomyosarcoma
96
What is malignant cartilage tissue neoplasm called?
Chondrosarcoma
97
What is a malignant bone tissue neoplasm called?
Osteosarcoma
98
What is a malignant blood vessel tissue neoplasm called?
Angiosarcoma
99
What do you call a tumour which its cell-type of origin is unknown?
Anaplastic
100
What exceptions are there to nomenclature of neoplasia?
- Not all '-omas' are neoplasms - Not all malignant tumours are carcinoma or sarcoma

phase 2a (2 decks)

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