Pathology Flashcards
How are the isotopes of immunoglobin determined?
By heavy chain….
Gamme / Alpha / Mu / Epsilon / Delta
Two types of immunoglobulin light chains
Kappa or Lambda
A deficiency in C1 inhibitors results in…
Hereditary angioedema
Deficiency in complement decay - accelerating factor results in
Paroxysmal nocturnal haemoglobinuria
Three types of cells
Labile, stable and permanent
Labile cells are…
Examples include
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
Stable cells are…
Examples include
State of quiescene, cells slowly replicate to maintain tissue size, tissues may rapidly regenerate if stimulated
Liver / renal tubular epithelium, endocrine glands
Permanent tissues consist of…
Examples include
Cells that have left the cell cycle and so are incapable of cell division, CANNOT regenerate
Brain wells / myocardial cells / skeletal muscle cells
Which antibodies are capable of transpacental passage?
IgG
Which type anti-bodies are Anti-D?
IgG
When skeletal muscle is damaged, what are stimulated to divide?
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.
Which muscle cells have the greatest capacity to regenerate?
Smooth muscle cells
Where is most dietary iron absorbed?
Duodenum
Where is Vit K obtained?
Green veg and bacterial synthesis in the gut
Which factors are Vit K dependent?
II, VII,IX, X, protein C and protein S
Cytokines involved in granulomatous inflammation?
IL-1 - initiates
IL-2 enlarges
TNF-alpha maintains
Which type of organisms are hypoplenic patients at risk of?
Encapsulated bacteria
Lab findings in Haemophilia B
Prolonged APTT, normal PT and low IX
Tubercilun test is an example of what type of hypersensitivity
Delayed, IV, cell mediated
Type of necrosis seen after an MI?
Coagulative - loss of cell nuclei, preservation of underlying architecture
Type of necrosis seen after a cerebral infarction?
Liquefaction
Complete loss of cellular structure and conversion to soft, semi-solid mass
Type of necrosis seen in TB?
Caseous
complete loss of normal tissue architecture, replaced by amorphous, granular and eosinophilic tissue
Which cytokine….
Initiates granuloma formation
Causes granulomas enlarge
Maintains them
IL-1
IL-2
TNF-alpha
Causes of eosinophil leucocytosis?
Allergic disease
Parasites
Skin disease
Drug sensitivity
Hodgkin’s disease
Type 1 hypersensitivity reactions mediated by?
IgE with immediate degranulation of mast cells and basophils
Examples of type 1 hypersensitivity reactions?
Allergic rhinitis
Allergic conjunctivits
Allergic asthma
Systemic anaphylaxis
Angioedema
Urticaria
Penicillin allergy
Type 2 hypersensitivity reactions mediated by?
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
Examples of type 2 hypersensitivity reactions?
Incompatible blood transfusions
Haemolytic disease of the new born
Autoimmune haemolytic anaemias
Goodpastures
Rheumatic heart disease
Bullous pemphigoid
Type 3 hypersensitivity reactions mediated by?
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
Examples of type 3 hypersensitivity reactions?
Extrinsic allergic alveolitis
SLE
Post strep glomerulonephritis
Reactive arthritis
Rheumatoid arthritis
Type 4 hypersensitivity reactions mediated by?
T cell mediated
Examples of type 4 hypersensitivity reactions?
Contact dermatitis
Hashimoto’s thyroiditis
Primary biliary cholangitis
Tuberculin skin test
Chronic transplant rejection
Sarcoidosis
Crohn’s disease
Examples of type 4 hypersensitivity reactions?
Contact dermatitis
Hashimoto’s thyroiditis
Primary biliary cholangitis
Tuberculin skin test
Chronic transplant rejection
Sarcoidosis
Crohn’s disease
Most common maligancy of childhood?
Acute lymphoblastic leukeamia
FBC in ALL?
Normochromic normocytic anaemia and thrombocytopenia
Haemophilia A defect due to absence or low levels of?
Plasma factor VIII
Lab findings in Haemophilia A
Prolonged APTT
Normal PT
Low factor VIII
Clotting pathway, extrinsic and intrinsic pathways, blood test used to evaluate them
Haemophilia B defect due to absence or low levels of?
Factor IX
Lab findings in Haemophilia B
Prolonged APTT
Normal PT
Low factor IX
Lab findings in Von Willebrand disease
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
B cell activation cascade
Most common leukaemia in adults?
CLL
Define fibrinoid necrosis
Damage of the lining of your blood vessels, occurs in malignant HTN
Main hormonal regulator of iron homeostasis
Hepcidin
Beta thalasaemia and alpha are more common in which populations respectively?
Mediterranean
Far East
Vit K dependent clotting factors
II, VII, IX, X, protein C & S
Multi-nucleated giant cells are formed from aggregates of?
Macrophages
Most common inherited cause of venous thrombosis?
Factor V leiden
Typical first presentation of sickle cell disease
Hand foot syndrome - infarcation of metaphyses of small bones
Inheritance of sickle cells
Autosomal recessive traint
When does fat necrosis take place?
Acute pancreatitis
What does APTT measure?
Deficiency in intrinsic and common pathway
What does PT measure?
Deficiency in extrinsic and common pathway
Actions of hepcidin
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)
Cholelithiasis =
uncomplicated gallstones
Biliary colic =
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
Cholecystitis =
inflammation of the gallbladder. Pain is often associated with nausea, vomiting or fever
Choledocholithiasis =
gallstone within the common bile duct. Often causes deranged liver function tests.
Cholangitis =
infection of the common bile duct often secondary to choledocholithiasis. Typically presents with right upper quadrant pain, fever and jaundice (Charcot’s Triad)
What two ducts join to form the common bile duct
Common hepatic duct and cytic duct
What ducts join to form the hepatopancreatic ampulla of vater?
CBD + pancreatic duct
Which two vessels form the (hepatic) portal vein
+ where
SMV
Splenic vein
Posterior to neck of pancreas
3 areas of portosystemic anastamoses
Gastroesophageal junction
Anus
Ant. abdominal wall
Which bit of the pancreas is not retroperitoneal ?
Tail
Primary arterial supply of the pancreas
Pancreatic branches of the splenic artery
