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Pathology Flashcards

1
Q

State the 2 types of inflammation

A
  1. Acute
  2. Chronic
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2
Q

What is the onset and duration of acute inflammation?

A

Early onset - seconds to minutes
Short duration - hours to days

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3
Q

Which cells are involved in acute inflammation?

A
  1. Neutrophils
  2. Monocytes
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4
Q

What is the function of acute inflammation?

A

Initial response of tissue to injury

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5
Q

What are the 3 steps of acute inflammation?

A
  1. Vascular component - dilation of vessels
  2. Exudative component - vascular leakage of protein-rich fluid
  3. Neutrophil polymorph - cells type recruited to tissue
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6
Q

State the 6 causes of acute inflammation

A
  1. Microbial infection - bacteria, viruses, etc
  2. Hypersensitivity reactions - parasites
  3. Physical agents - trauma, heat, cold
  4. Chemicals - corrosive, acid
  5. Bacterial toxins
  6. Tissue necrosis - ischemic infarction
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7
Q

What is the vascular component of acute inflammation?

A

Dilation of vessels

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8
Q

What is the exudative component of acute inflammation?

A

Vascular leakage of protein rich fluid

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9
Q

What is the neutrophil polymorph component of acute inflammation?

A

Cells type recruited to tissue

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10
Q

What are the 5 ways of characterising the appearance of acute inflammation?

A
  1. Rubor - redness
  2. Calor - heat
  3. Tumor - swelling
  4. Dolor - pain
  5. Loss of function
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11
Q

What are the 4 stages of neutrophil polymorph emigration in acute inflammation?

A
  1. Migration (margination) of neutrophils
  2. Adhesion of neutrophils
  3. Neutrophil emigration
  4. Diapedesis
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12
Q

What happens during the migration of neutrophils stage of neutrophil polymorph emigration in acute inflammation?

A
  1. Plasma viscosity increases
  2. Flow slows due to injury
  3. Neutrophils migrate to plasmatic zone
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13
Q

What happens during the adhesion of neutrophils stage of neutrophil polymorph emigration in acute inflammation?

A

Adhesion of the neutrophils to the vascular endothelium in the venules

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14
Q

What is the term for the adhesion of neutrophils to the vascular endothelium during the neutrophil polymorph migration stage of acute inflammation?

A

Pavementing

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15
Q

What happens during the neutrophil emigration stage of neutrophil polymorph emigration in acute inflammation?

A

Neutrophils pass through endothelial cells onto basal lamina and then the vessel wall

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16
Q

What happens during the diapedesis stage of neutrophil polymorph emigration in acute inflammation?

A

RBCs escape from vessels as a passive process; indicates severe vascular injury

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17
Q

What are the outcomes of acute inflammation?

A
  1. Resolution
  2. Suppuration
  3. Organisation
  4. Progression
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17
Q

Describe resolution as an outcome of acute inflammation

A
  1. Complete restoration of tissues to normal
  2. Minimal cell death
  3. Rapid destruction of causal agent
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18
Q

Describe supporation as an outcome of acute inflammation

A
  1. Formation of pus
  2. Becomes surrounded by pyogenic membrane (start of healing process)
  3. Leads to scarring
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19
Q

Describe organisation as an outcome of acute inflammation

A
  1. Replacement of granulation tissue
  2. New capillaries grow into inflammatory exudate
  3. Macrophages migrate
  4. Fibrosis occurs
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20
Q

Describe progression as an outcome of acute inflammation

A
  1. Causative agent agent not removed
  2. Progression to chronic inflammation
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21
Q

What are the 2 possible outcomes of healing?

A
  1. Resolution
  2. Repair
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22
Q

What circumstances lead to repair as an outcome of healing?

A

When resolution impossible

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23
Q

What are the cells involved in chronic inflammation?

A
  1. Lymphocytes
  2. Macrophages
  3. Plasma cells
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24
Q

What are the 2 major causes of chronic inflammation?

A
  1. Primary chronic Inflammation
  2. Transplant rejection
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25
Q

What are the 5 subtypes of primary chronic inflammation?

A
  1. Resistance of infective agent
  2. Endogenous materials
  3. Exogenous materials
  4. Autoimmune conditions
  5. Primary granulomatous diseases
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26
Q

Give examples of resistance of infective agent as a cause of primary chronic Inflammation

A

1.TB
2. Leprosy

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27
Q

Give examples of endogenous materials as a cause of primary chronic Inflammation

A

Necrotic tissue

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28
Q

Give examples of exogenous materials as a cause of primary chronic Inflammation

A
  1. Asbestos
  2. Silica
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29
Q

Give examples of autoimmune conditions as a cause of primary chronic Inflammation

A
  1. Hashimoto’s
  2. Rheumatoid arthirtis
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30
Q

Give examples of primary granulomatous diseases as a cause of primary chronic Inflammation

A
  1. Chron’s
  2. Sarcoidosis
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31
Q

State the macroscopic appearance of chronic inflammation

A
  1. Chronic ulcer
  2. Chronic abscess cavity
  3. Granulomatous inflammation
  4. Fibrosis
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32
Q

State the microscopic appearances of chronic inflammation

A
  1. Presence of lymphocytes, plasma cells and macrophages
  2. Exudation NOT a common feature
  3. Evidence of continuing destruction
  4. Possible tissue necrosis
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33
Q

What is the function of B lymphocytes in chronic inflammation?

A

Transform into plasma cells and produce antibodies

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34
Q

What is the function of T lymphocytes in chronic inflammation?

A

Responsible for cell mediated immunity

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35
Q

What is the function of macrophages in chronic inflammation?

A
  1. Respond to chemotactic stimuli
  2. Produce cytokines
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36
Q

Which stain can be used to identify TB granulomas?

A

Ziehl-Neelsen stain

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37
Q

What does the presence of granulomas and eosinophil indicate?

A

Parasite

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38
Q

Define thrombosis

A

The solidification of blood contents that forms within the vascular system during life

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39
Q

Describe platelets

A
  1. Derived from megakaryocytes
  2. Contains alpha granules and dense granules
  3. When platelets activated, granules released when they come into contact with collagen
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40
Q

What is the function of alpha granules

A

Platelet adhesion

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41
Q

What is the function of dense granules

A

Platelet aggregation

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42
Q

What is the trigger for thrombosis formation?

A

First stage - platelet aggregation
Next stage - clotting cascade

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43
Q

What type of feedback loop do platelet aggregation and clotting cascade have?

A

Positive loop

44
Q

What are the 3 corners of Virchow’s Triad

A
  1. Reduced blood flow
  2. Increased coagulability
  3. Blood vessel injury
45
Q

What are 6 factors that cause reduced blood flow?

A
  1. Atrial fibriliation
  2. Long distance travel
  3. Varicose veins
  4. Venous obstruction (e.g. pregnancy)
  5. Immobility
  6. Ventricular/venous insufficiency
46
Q

What are 4 that increase coagulation?

A
  1. Sepsis
  2. Smoking
  3. Coagulation disorders
  4. Malignancy (e.g. cancer)
47
Q

What can venous thrombus lead to?

48
Q

What is treatment for arterial thrombus?

A

Anti-platelets (aspirin)

49
Q

What is treatment for venous thrombus?

A

Anti-coagulants (warfarin)

50
Q

What is an embolism?

A

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

51
Q

Describe arterial embolism

A
  1. Systemic embolism
  2. Arterial emboli can travel anywhere downstream of entry point
  3. Mural thrombi in left ventricle can go anywhere
  4. Cholesterol crystals from atheromatous plaque in descending aorta can go to any lower limb or renal artery
52
Q

Describe venous embolism

A
  1. Pulmonary embolism
  2. Emboli travels to vena cava and lodge in pulmonary arteries
  3. Results in PE
53
Q

What are the 3 types of emboli?

A
  1. Small
  2. Large
  3. Massive
54
Q

What are the characteristics of a small venous emboli?

A
  1. May occur unnoticed
  2. Can cause idiopathic pulmonary hypertension
55
Q

What are characteristics of a large venous emboli?

A
  1. Can result in acute respiratory/ cardiac problems
  2. Resolves slowly
  3. Chest pain
  4. Shortness of breath
56
Q

What are characteristics of a massive venous emboli?

A
  1. Sudden death
  2. Long thrombi derived from leg veins
  3. Often impacted across the bifurcation of one of the pulmonary arteries
57
Q

Define ischaemia

A

ischaemia is the reduction in blood flow to a tissue or part of the body caused by constriction or blockage of blood vessels supplying it

58
Q

Define infarction

A

Infarction is the necrosis of part or whole of an organ that occurs when the artery supplying it becomes obstructed

59
Q

Describe ischaemia

A
  1. Effects can be reversible
  2. Duration of ischaemia attack is brief
  3. Cardiomyocytes and cerebral neurone most vulnerable
60
Q

Describe infarction

A
  1. Usually macroscopic event
  2. Most organs have single artery supply therefore susceptible to infarcts
  3. Liver, brain and lungs have dual supply –> less susceptible
  4. Repercussion injury = damage to tissue during re-oxygenation
61
Q

Define atherosclerosis

A

Disease characterised by formation of atherosclerotic plaques in the intimate of large and medium sized arteries

62
Q

Describe atherosclerosis

A
  1. Often asymptomatic
  2. Accumulation of lipids, macrophages and smooth muscle cells in intimal plaques
  3. Can cause life-threatening damage if thrombus forms on disrupted plaque
63
Q

State the risk factors of atherosclerosis

A
  1. Hypercholesterolaemia (most important risk factor)
  2. Smoking
  3. Hypertension
  4. Diabetes
  5. Male sex
  6. Increasing age
64
Q

What drugs help in atherosclerosis prevention?

A
  1. Low dose aspirin –> inhibits aggregation of platelets
  2. Statins –> cholesterol reducing drug
65
Q

Define apoptosis

A

Apoptosis is a cellular process in which a defined and programmed sequence of intracellular events leads to the removal of a cell without the release of products harmful to surrounding cells

66
Q

What are the inhibitory regulators of apoptosis?

A
  1. Growth factors
  2. Extracellular cell matrix
  3. Sex steroids
67
Q

What are inductive regulators of apoptosis?

A
  1. Glucocorticoids
  2. Free radicals
  3. Ionising radiation
  4. DNA damage
68
Q

What are the 2 pathways to apoptosis?

A
  1. Intrinsic
  2. Extrinsic
69
Q

Which receptors are involved in extrinsic apoptosis?

A
  1. TNFR1
  2. CD95
70
Q

Define necrosis

A
  1. A traumatic cell death which induces inflammation and repair
  2. Characterised by bioenergetic failure and loss of plasma membrane integrity
71
Q

State the 4 types oof necrosis

A
  1. Coagulative
  2. Liquefactive
  3. Caseous
  4. Gangrene
72
Q

Describe coagulative necrosis

A
  1. Most common type
  2. Can occur in most organs
  3. Cause by ischaemia
73
Q

Describe liquefactive necrosis

A

Occurs in brain due to lack of substantial supporting stroma

74
Q

Describe caseous necrosis

A
  1. Causes a ‘cheese’ pattern
  2. TB characterised by this form of necrosis
75
Q

Describe gangrene as a type of necrosis

A
  1. Necrosis with rotting of tissue
  2. Affected tissue appears black due to deposition of iron sulphide (from degradation of haemoglobin)
76
Q

Describe hypertrophy

A
  1. Increase in cell size without cell division
  2. Uterine hypertrophy observed in pregnancy
77
Q

Describe hyperplasia

A
  1. Increase in cell number by mitosis
  2. Only occurs in dividing cells
  3. Hyperplasia of bone marrow cells observed at high altitude
78
Q

What cells cannot undergo hyperplasia?

A
  1. Myocardial cells
  2. Nerve cells
79
Q

Describe atrophy

A
  1. Decrease in size of an organ or cell and/or reduction in cell size/ number
  2. Natural occurrence during GI tract development
  3. Occurs in disease
80
Q

Describe metaplasia

A
  1. Change in differentiation of a cell from one fully-differentiated cell type to another
  2. Response to alterations in cellular environment
81
Q

Describe dysplasia

A

Morphological changes seen in cells in the progression to becoming cancer

82
Q

Define carcinogenesis

A

Transformation of normal cells into neoplastic cells through permanent genetic alterations or mutations

83
Q

Define neoplasm

A

Lesion resulting from autonomous abnormal growth of cells

84
Q

Define tumour

A

Any abnormal swelling

85
Q

Why can neoplasm not occur in erythrocytes?

86
Q

Which cancer can be caused by B-naphthylamine?

A

Bladder cancer

87
Q

What cancer can be caused by polycyclic aromatic hydrocarbons?

A

scrotal carcinoma

88
Q

What cancer is linked to Epstein-Barr Virus (EBV)?

A

Burkett’s lymphoma (cancer of lymphatic system)

89
Q

What cancer is linked to HPV?

A

Cervical cancer

90
Q

What cancer are aflatoxins linked to?

A

hepatocellular carcinoma

91
Q

What is mesothelioma linked to?

A

Exposure to asbestos- Cancer of mesothelium; covering of many organs

92
Q

What are the properties of a benign neoplasm?

A
  1. Does not invade basement membrane
  2. Exophytic (grows outwards)
  3. Low mitotic activity
  4. Circumscribed
  5. Necrosis and ulceration rare
93
Q

What are the properties of a malignant neoplasm?

A
  1. Invades basement membrane
  2. Endophytic (grows inwards)
  3. High mitotic activity
  4. Poorly circumscribed
  5. Necrosis and ulceration common
94
Q

What are the 2 aspects that neoplasm classification is based on?

A
  1. Behaviour (benign vs malignant)
  2. Histogenesis
95
Q

What is histogenesis classification based on?

A

Specific cell or origin of the tumour

96
Q

What do neoplasms in epethelial cells form?

A

Carcinomas

97
Q

What do neoplasms in connective tissue form?

98
Q

What do neoplasms in lymphoid form?

A

Lymphomas or leukemia

99
Q

State and define the histological grading of neoplasms

A

Based on extent to which neoplasm resembles original parent cell histology
Grade 1 - Well differentiated (close resemblance to parent cell)
Grade 2 - Moderately differentiated
Grade 3 - Poorly differentiated

100
Q

What is adenocarcinoma?

A

Malignant tumour of glandular epithelium

101
Q

State the 2 benign epithelial neoplasms and their location

A
  1. Papilloma - non glandular tissue
  2. Adenoma - secretory tissue
102
Q

State the 5 types of connective tissue neoplasms

A
  1. Lipoma - adipocytes
  2. Rhabdomyoma - striated muscle
  3. Leiomyoma - smooth muscle cells
  4. Chondroma - cartilage
  5. Osteoma - bone
103
Q

Define metastasis

A

Process of malignant neoplasms spreading from site of origin to form neoplasms at distant sites

104
Q

Which is the only neoplasm that does not metastasise?

A

Basal cell carcinoma

105
Q

State some routes of metastasis

A
  1. Bone metastasises from cancer originating from - lung, breast, kidney, thyroid, prostate
  2. Lymphatic metastasis common
  3. Carcinomas prefer lymphatic spread
  4. Sarcomas prefer haematogenous spread
106
Q

What is tumour staging?

A
  1. Staging = extent of tumour spread
  2. Determined by histopathological examination and clinical examination
107
Q

How is tumour staging classified?

A

-T - Primary tumour size
-N - Lymph node status
-M - Metastatic status

SJ Phase 2a (13 decks)

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