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Other MRCEM part 1 > Pathology > Flashcards

Pathology Flashcards

1
Q

How are the isotopes of immunoglobin determined?

A

By heavy chain….
Gamme / Alpha / Mu / Epsilon / Delta

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2
Q

Two types of immunoglobulin light chains

A

Kappa or Lambda

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3
Q

A deficiency in C1 inhibitors results in…

A

Hereditary angioedema

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4
Q

Deficiency in complement decay - accelerating factor results in

A

Paroxysmal nocturnal haemoglobinuria

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5
Q

Three types of cells

A

Labile, stable and permanent

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6
Q

Labile cells are…

Examples include

A

constantly dividing and have a good capacity for regeneration

Surface epithelia of skin / GI tract / uterus
Blood cells are derived from labile cells of the bone marrow

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7
Q

Stable cells are…

Examples include

A

State of quiescene, cells slowly replicate to maintain tissue size, tissues may rapidly regenerate if stimulated

Liver / renal tubular epithelium, endocrine glands

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8
Q

Permanent tissues consist of…

Examples include

A

Cells that have left the cell cycle and so are incapable of cell division, CANNOT regenerate

Brain wells / myocardial cells / skeletal muscle cells

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9
Q

Which antibodies are capable of transpacental passage?

A

IgG

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10
Q

Which type anti-bodies are Anti-D?

A

IgG

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11
Q

When skeletal muscle is damaged, what are stimulated to divide?

A

Satellite cells, which fuse with existing muscle fibres to regenerate and repair the damaged fibres. Skeletal muscle fibres themseleves cannor divide. However muscle fibres can lay down new protein and hypertroph.

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12
Q

Which muscle cells have the greatest capacity to regenerate?

A

Smooth muscle cells

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13
Q

Where is most dietary iron absorbed?

A

Duodenum

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14
Q

Where is Vit K obtained?

A

Green veg and bacterial synthesis in the gut

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15
Q

Which factors are Vit K dependent?

A

II, VII,IX, X, protein C and protein S

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16
Q

Cytokines involved in granulomatous inflammation?

A

IL-1 - initiates
IL-2 enlarges
TNF-alpha maintains

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17
Q

Which type of organisms are hypoplenic patients at risk of?

A

Encapsulated bacteria

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18
Q

Lab findings in Haemophilia B

A

Prolonged APTT, normal PT and low IX

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19
Q

Tubercilun test is an example of what type of hypersensitivity

A

Delayed, IV, cell mediated

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20
Q

Type of necrosis seen after an MI?

A

Coagulative - loss of cell nuclei, preservation of underlying architecture

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21
Q

Type of necrosis seen after a cerebral infarction?

A

Liquefaction
Complete loss of cellular structure and conversion to soft, semi-solid mass

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22
Q

Type of necrosis seen in TB?

A

Caseous
complete loss of normal tissue architecture, replaced by amorphous, granular and eosinophilic tissue

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23
Q

Which cytokine….

Initiates granuloma formation
Causes granulomas enlarge
Maintains them

A

IL-1
IL-2
TNF-alpha

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24
Q

Causes of eosinophil leucocytosis?

A

Allergic disease
Parasites
Skin disease
Drug sensitivity
Hodgkin’s disease

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25
Q

Type 1 hypersensitivity reactions mediated by?

A

IgE with immediate degranulation of mast cells and basophils

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26
Q

Examples of type 1 hypersensitivity reactions?

A

Allergic rhinitis
Allergic conjunctivits
Allergic asthma
Systemic anaphylaxis
Angioedema
Urticaria
Penicillin allergy

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27
Q

Type 2 hypersensitivity reactions mediated by?

A

Antibody mediated, IgG or IgM antibodies for specific cell surface antigen (auto or for foreign cells)

Cell destruction via complement fixation, antibody cell-mediated cytotoxicity & phagocytosis

28
Q

Examples of type 2 hypersensitivity reactions?

A

Incompatible blood transfusions
Haemolytic disease of the new born
Autoimmune haemolytic anaemias
Goodpastures
Rheumatic heart disease
Bullous pemphigoid

29
Q

Type 3 hypersensitivity reactions mediated by?

A

Immune complex mediated hypersensitivity

IgG antibodies react to free soluble antigens, creating a complex

Rapid influx of antigens, overwhelms the mechanism (usually taken to the spleen), deposited elsewhere ie small blood vessles, kidneys and joints

30
Q

Examples of type 3 hypersensitivity reactions?

A

Extrinsic allergic alveolitis
SLE
Post strep glomerulonephritis
Reactive arthritis
Rheumatoid arthritis

31
Q

Type 4 hypersensitivity reactions mediated by?

A

T cell mediated

32
Q

Examples of type 4 hypersensitivity reactions?

A

Contact dermatitis
Hashimoto’s thyroiditis
Primary biliary cholangitis
Tuberculin skin test
Chronic transplant rejection
Sarcoidosis
Crohn’s disease

32
Q

Examples of type 4 hypersensitivity reactions?

A

Contact dermatitis
Hashimoto’s thyroiditis
Primary biliary cholangitis
Tuberculin skin test
Chronic transplant rejection
Sarcoidosis
Crohn’s disease

33
Q

Most common maligancy of childhood?

A

Acute lymphoblastic leukeamia

34
Q

FBC in ALL?

A

Normochromic normocytic anaemia and thrombocytopenia

35
Q

Haemophilia A defect due to absence or low levels of?

A

Plasma factor VIII

36
Q

Lab findings in Haemophilia A

A

Prolonged APTT
Normal PT
Low factor VIII

37
Q

Clotting pathway, extrinsic and intrinsic pathways, blood test used to evaluate them

A
38
Q

Haemophilia B defect due to absence or low levels of?

A

Factor IX

39
Q

Lab findings in Haemophilia B

A

Prolonged APTT
Normal PT
Low factor IX

40
Q

Lab findings in Von Willebrand disease

A

Abnormal PFA-100 test
Low VIII (due to VWF is a carrier for VIII)
Prolonged APTT or normal
Normal PT
Low VWF
Defective platelet aggregation
Normal platelet count

41
Q

B cell activation cascade

A
42
Q

Most common leukaemia in adults?

A

CLL

43
Q

Define fibrinoid necrosis

A

Damage of the lining of your blood vessels, occurs in malignant HTN

44
Q

Main hormonal regulator of iron homeostasis

A

Hepcidin

45
Q

Beta thalasaemia and alpha are more common in which populations respectively?

A

Mediterranean
Far East

46
Q

Vit K dependent clotting factors

A

II, VII, IX, X, protein C & S

47
Q

Multi-nucleated giant cells are formed from aggregates of?

A

Macrophages

48
Q

Most common inherited cause of venous thrombosis?

A

Factor V leiden

49
Q

Typical first presentation of sickle cell disease

A

Hand foot syndrome - infarcation of metaphyses of small bones

50
Q

Inheritance of sickle cells

A

Autosomal recessive traint

51
Q

When does fat necrosis take place?

A

Acute pancreatitis

52
Q

What does APTT measure?

A

Deficiency in intrinsic and common pathway

53
Q

What does PT measure?

A

Deficiency in extrinsic and common pathway

54
Q

Actions of hepcidin

A

Hormonal regulator of iron homeostasis

Lowers cell levels of ferroportin (protein that allows iron entry into the portal circulation from duodenal enterocytes and from macrophages)

55
Q

Cholelithiasis =

A

uncomplicated gallstones

56
Q

Biliary colic =

A

typically right upper quadrant pain following a fatty meal as gallstones obstruct the cystic duct during contraction of the gallbladder. Not associated with systemic upset

57
Q

Cholecystitis =

A

inflammation of the gallbladder. Pain is often associated with nausea, vomiting or fever

58
Q

Choledocholithiasis =

A

gallstone within the common bile duct. Often causes deranged liver function tests.

59
Q

Cholangitis =

A

infection of the common bile duct often secondary to choledocholithiasis. Typically presents with right upper quadrant pain, fever and jaundice (Charcot’s Triad)

60
Q

What two ducts join to form the common bile duct

A

Common hepatic duct and cytic duct

61
Q

What ducts join to form the hepatopancreatic ampulla of vater?

A

CBD + pancreatic duct

62
Q

Which two vessels form the (hepatic) portal vein

+ where

A

SMV

Splenic vein

Posterior to neck of pancreas

63
Q

3 areas of portosystemic anastamoses

A

Gastroesophageal junction

Anus

Ant. abdominal wall

64
Q

Which bit of the pancreas is not retroperitoneal ?

A

Tail

65
Q

Primary arterial supply of the pancreas

A

Pancreatic branches of the splenic artery

66
Q
A

Other MRCEM part 1 (5 decks)

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