Pathology Flashcards
causes of fluctuating cognitive function
subdural hematoma
cerebral abscesses
meningioma
hypertensive encephalopathy
insulinoma producing hypoglycemia
acute aortic regurgitation
alcohol intoxication
difference between acute and chronic inflammation
acute is sudden onset, short duration, and resolves over time
chronic is slow onset, long duration, stays
Give examples of chronic inflammation that are not a result of acute inflammation
TB, leprosy, Chron’s disease, sarcoidosis
mononucleosis
Chron’s disease -> inflammatory bowel disease
Sarcoidosis -> granulomas all over body because immune system overreacts
which is the first cell at the site of inflammation
neutrophils
what are the two cells that appear at the site of inflammation?
neutrophils and macrophages
give a few characteristics of neutrophils
polylobed nuclei
many lysosomes
1st cells to arrive at site of inflammation
die at the site of inflammation
what is the relationship between macrophages and immunity?
macrophages present an antigen to lymphocytes to produce antibodies and create long-term immunity
which cells produce antibodies
plasma cells
what is the relationship between capillary sphincters and inflammation?
they open so that more blood flows at the site of inflammation –> capillary bed gets more activated –> b.p drops and you get more swollen
how do you treat acute inflammation?
depending on the cause ice, aspirin, ibuprofen, antihistamines, steroid creams, antibiotics
how does ice decrease inflammation?
shuts capillary sphincters so reduces redness and stops swelling
how does ibuprofen reduce inflammation?
inhibits prostaglandin synthase
what is prostaglandin synthase?
chemical mediator for inflammation
how do corticosteroids reduce inflammation?
up-regulate inhibitors of inflammation and downregulate mediators of inflammation
what cells are part of the reticuloendothelial system
alveolar macrophages
histocytes (connective tissue phagocytes)
Kupffer cells
Mesangial cells (macrophages of the renal system - phagocytes products from glomerular b. m.)
microglial cells
what is normal blood flow called
laminar blood flow
what causes clot formation
exposure of platelets to collagen
how does a clot affect blood flow?
creates turbulent flow
what is a thrombus?
solid mass of blood constituents in the vascular system
what are the three causes of thrombosis?
change in vessel wall
change in blood flow
change in blood constituents
what in the cigarette damages endothelial cells
nicotine
what do healthy endothelial cells produce to be less sticky
NO
why is aspirin used for people with a risk of infarction?
inhibits platelet aggregation
what is an embolus
mass of material lodged in the vessel
what is ischemia
reduction in blood flow
what is infarction
reduction in blood flow which leads to subsequent cell death
what are the different types of emboli?
thrombus
cholesterol crystals
air
tumour
amniotic fluid
fat
what organs have 2 blood supplies and identify those blood supplies
lungs (pulmonary art and bronchial art) and some parts of the brain (circle of Willis)
what is heparin
an anticoagulant
resolution vs repair
resolution - tissue can regenerate
repair - tissue can’t regenerate
which organs can regenerate
Liver
GI tract lining
skin
bones
lung pneumocytes
Can alveoli regenerate
no
what organs don’t regenerate
brain
heart
spinal cord
1st intention healing vs 2nd intention
1st - brings ends together
2nd - the wound is too deep so it can’t bring the end. the tissue has to start growing again from below up and blood supply needs to be brought from both sides
what do you call fibrosis in the brain
gliosis
what cells regenerate
hepatocytes
pneumocytes
all blood cells
gut epithelium
skin epithelium
osteocytes
bone marrow
what process plays a massive role in growth and development
apoptosis and cell migration
what is the difference between spina bifida occulta, meningocele, and myelomeningocele
spina bifida –> missing a spinous process
meningocele –> meninges sticking out in a sack
myelomeningocele –> cauda equina sticks out in the meningeal sack
what is a cleft lip
a split in the upper lip or roof of the palate
describe the possible cardiac congenital defects
non-closure of:
- PATENT foramen ovale –> it raises the risk for stroke. Usually symptomless in children. Blood clots can travel from the right atrium to the left atrium and out to blood vessels of the body. If the clot blocks a blood vessel in the brain, it can cause a stroke.
- VENTRICULAR SEPTAL DEFECT –> Ventricular septal defect is a common congenital heart defect. The baby may have no symptoms and the hole can close over time as the wall continues to grow after birth. If the hole is large, too much blood will be pumped to the lungs. This can lead to heart failure.
- PATENT DUCTUS ARTERIOSUS –> The PDA lets oxygen-rich blood (blood high in oxygen) from the aorta mix with oxygen-poor blood (blood low in oxygen) in the pulmonary artery. As a result, too much blood flows into the lungs, which puts a strain on the heart and increases blood pressure in the pulmonary arteries.
what are the facial characteristics of a baby born with fetal alcohol syndrome
small eye openings
thin upper lip
smooth philtrum (no cupid’s bow above mouth - the dip)
what protein is in excess in Down’s syndrome
beta-amyloid –> gene present on chromosome 21
what are homeobox genes
genes that control cell migration
why are children with Down’s syndrome more susceptible to bacterial infections
gene for
what is the most common type of hyperplasia in adult males and where does it take place specifically
prostatic hyperplasia from the core of the prostate –> the core is the one that enlarges
how does a cell decide when to apoptose
-when it detects too much DNA damage in the cell
what is p53 and how can mutations of it affect cancer
protein in cells which detects DNA damage and triggers apoptosis
mutations in p53 lead to problems in detecting DNA damage –> growth of the cancer
what is the pathophysiological mechanism of HIV
induces apoptosis in CD4 T-helper cells –> immunodeficiency
what is the name of enzymes which trigger apoptosis
caspases
Complications of artherosclerosis
Cerberal infarction, Carotid artheroma ,myocardial infarction, Aortic aneurysm, peripheral, vascular disease, gangrene
What type of inflammation is caused by infectious mononucleosis and why
Chronic because it is caused by a virus so triggers lymphocyte response
How do you reduce the risk of NSAID-related gastritis
Prescribe selective COX-2 inhibitors and ppi
How do you reduce the risk of NSAID-related gastritis
Prescribe selective COX-2 inhibitors and ppi
What are the consequences of acute inflammation
redness, swelling, pain, heat and loss of function
Why does chronic inflammation lead to cancer
Inflammation causes cellular changes to repair damaged tissue —> increased cellular proliferation increases risk of developing mutations
Chronic infl cells also generate a lot of ROS and Nitrogen species —> increase chances of mutations
Infl cells also interfere with cell replication
What type of arthritis is a chronic inflammatory disorder
Rheumatoid arthritis
What type of arthritis is a chronic inflammatory disorder
Rheumatoid arthritis
What are carcinomas and sarcomas
Carcinomas - Malignant cancers of epithelium
Sarcomas - Malignant cancers of connective tissue
Where do carcinomas and sarcomas most likely spread to
Carcinomas spread to the lymph nodes that drain their site
In advanced stages carcinomas can also spread through blood to the bone
Sarcomas spread to blood
Which are the most common cancers which spread to the bone
Breast, prostate, lung, thyroid and kidney
Do all tumours show up on a CT scan
Micro metastases do not if they are under 10mm
What is adjuvant therapy
Extra treatment given after surgical excision
Ex.: radiotherapy after breast lumpectomy
What is the HER 2 receptor
A growth factor receptor found in some breast cancer cells which is associated with a more aggressive tumour and resistance to some kinds of chemotherapy and tamoxifen
What type of cancer is asbestos associated with
Mesothelioma
What type of cancer H. Pylori and epsine-barr associated with
Lymphoma
What cancer is HPV associated with
Cervical cancer
what is a carcinoma?
malignant cancer of epithelium
what is a sarcoma?
malignant cancer of connective tissue
What are the carcinogens for lung and skin cancer?
polycyclic aromatic hydrocarbons
(They result from burning coal, oil, gas, wood, garbage, and tobacco.)
what are the carcinogens for bladder cancer and breast cancer?
aromatic amines
(chemicals found in industrial and manufacturing plants, tobacco smoke, commercial hair dyes, and diesel exhaust.)
what are the carcinogens for gut cancer?
nitrosamines
(formed during the fermentation of various foods and tobacco and by the in vivo reaction of nitrite preservatives with amines under the acidic conditions found in the gastrointestinal tract. –> found in meat products, processed fish, cocoa, beer and other alcoholic beverages)
what are the carcinogens for leukaemia?
alkylating agents –> Actual chemotherapy or radiotherapy –> can cause patients to develop leukaemia
(Alkylating agents keep the cell from reproducing (making copies of itself) by damaging its DNA. These drugs work in all phases of the cell cycle and are used to treat many different cancers, including cancers of the lung, breast, and ovary as well as leukemia, lymphoma, Hodgkin disease, multiple myeloma, and sarcoma.)
Kaposi sarcoma viral carcinogen
Human Herpes virus 8
Kaposi sarcoma is a disease in which cancer cells are found in the skin or mucous membranes that line the gastrointestinal (GI) tract, from mouth to anus, including the stomach and intestines
Hepatocellular carcinoma viral carcinogen
Hep B virus
Burkitt lymphoma and Nasopharyngeal carcinoma viral carcinogens
Epstein Barr Virus
Squamous cell carcinomas of the cervix, penis, anus, head and neck viral carcinogen
Human Papillomavirus
Merkle cell carcinoma viral carcinogen
Merkle cell polyomavirus
What cancers are associated with Human T-lymphotropic virus and
Hep C virus and what kind of viruses are they
Adult T-cell leukaemia
and Hepatocellular carcinoma
RNA viruses
Which carcinogens are associated with skin cancer
UV and Arsenic (metal)
Which mycotoxin is associated with hepatocellular carcinoma
Aflatoxin B1
mycotoxin = toxin produced by moulds and fungi in food
What type of cancer is asbestos associated with
mesothelioma
what is an adenoma?
benign neoplasm of glandular tissue or secretory epithelium; looks like small mushrooms with a stalk and have a smooth surface
what are papillomas?
benign neoplasm with a rough surface (think of ivan’s mole on his face which he removed in russia)
are non-glandular and from non-secretory epithelium
what is the 2 hit hypothesis
you already have a mutation that puts you at risk of cancer and if you get a second mutation/hit the cancer is triggered
what are the 2 viral risk factors for lymphoma?
H pylori and Epstein Barr
what are proto-oncogenes
genes which promote cell growth and survival and prevent apoptosis
what are tumour suppressor genes and how are they regulated in cancer
these genes inhibit cell growth and proliferation and in cancer they are down-regulated
small cell carcinoma vs non-small cell carcinoma
small cell –> very aggressive, loads of necrosis and rapid division
non-small cell –> no very aggressive, growth doesn’t generally outdo angiogenisis so little to no necrosis and doesn’t grow as fast.
what is myeloma
plasma cell cancer –> originates from lymphoid progenitor cells
what is a carcinoma in-situ?
carcinoma which hasn’t gone through BM yet
tumour grading vs tumour staging
Grading –> how much the tumour cells resemble the normal tissue –> very different = high grade
Staging –> how much the tumour has spread
explain the TNM tumour staging
T = tumour size, depth and spread
N = nodes –> extent of lymph node metastasis
M = metastases –> extent of spread to other parts of the body
define carcinogenesis
conversion of normal cells to neoplastic cells via genetic alterations/mutations
define oncogenesis
formation of benign or malignant tumours
what is diethylstilboestrol
medication which was used for morning sickness but increased risk of vaginal cancer
micro-invasive carcinoma vs invasive carcinoma
micro-invasive = has breached BM but can still be fully excised
invasive = got through BM and has high potential to invade rest of body
how do cancer cells invade BM
They produce:
- proteases
- collagenases
- cathepsin D
- urokinase-type plasminogen activator –> protease involved in cell migration
They also have cell motility –> invade ECM
outline the steps of metastasis
formation of malignant tumour
breaching of BM
INTRAVASION
breaching of lymphatic vessel or blood vessel (lymphatic vessel more easy to breach than blood vessel cuz only 1 cell layer whereas vs thick muscle layer)
Evasion of host immune defence
the tumour hides from the immune system by aggregating platelets on top of it –> can’t be detected if it hides behind platelets
travelling of tumour cells to new site
EXTRAVASION
tumour has adhesion receptors –> attaches to a place in the vessel and breaches the wall again to exit in new site
growth factors released from tumour:
- VEGF
- fibroblast growth factor
Inhibition of angiogenesis inhibitors:
- angiostatin
-endostatin
-vasculostatin
tumour growth and angiogenesis beyond 1mm
what type of cancers invade venules easily and where do they usually metastasize
sarcomas easily invade venules and they can metastasize to the lungs because they travel up the vena cava to the heart through the pulmonary artery and to the lungs where they can easily get lodged in the capillaries and grow
would you give chemotherapy to someone going into liver failure?
NO
Angiogenesis inhibitors
- angiostatin
-endostatin
-vasculostatin
tumour definition
any abnormal swelling
neoplasm definition
a lesion resulting from abnormal and autonomous growth of cells which persists after the initiating stimulus has been removed
what are borderline neoplasms?
between benign or malignant
what is the relationship between neoplastic cells and the stroma?
stroma supports the neoplastic cells –> mechanical support and nutrition : metastatic cells hijack the stroma
Name the benign and malignant neoplasm of striated muscle
Rhabdomyoma and Rhabdomyosarcoma
