Pathology Flashcards
0
Q
What occurs when the p53 gene is lost?
A
Cancer
1
Q
Name a type of pathology that is a silent injury in which dividing cells are more susceptible and permanent cells more resistant.
A
Nuclear DNA damage
2
Q
What inactivates free radicals?
A
Dimutase
3
Q
What protects against free radicals such as superoxide?
A
Anti-oxidants
4
Q
What is necrosis?
A
Death of tissues
5
Q
Name 6 patterns of necrosis
A
- Coagulative
- Colliquative
- Caseous
- Gangrenous
- Fibrinoid
- Fat necrosis
6
Q
What disorder involves a loss of function mutation, gene encodes enzyme in a metabolic pathway and is usually autosomal recessive?
A
Inherited metabolic disorders
7
Q
Name one inherited metabolic disorder?
A
Phenylketonuria - deficiency of phenylalanine hydroxylase
8
Q
What test can be used for phenylketonuria?
A
Guthrie test
9
Q
Name two chronic inflammatory diseases?
A
Crohn’s and Rheumatoid arthritis
10
Q
What two chemical mediators are known to produce pain?
A
Histamine and bradykinin
11
Q
What two pressures lead to the formation of fluid exudate?
A
Increased hydrostatic pressure
Decreased osmotic pressure
12
Q
Name two components of fluid exudate?
A
Proteins including immunoglobulins and fibrinogen
13
Q
What is neutrophil accumulation in the extracellular space a diagnostic feature of?
A
Acute inflammation
14
Q
What type of cell: kills organisms, degrades necrotic tissue, ingests offending agents, produces chemical mediators, produces toxic oxygen radicals and produces tissue damaging enzymes?
A
Neutrophils
15
Q
What 3 substances increase leucocyte surface adhesion molecule expression?
A
- Complement component C5a
- Leukotriene B4
- Tumour Necrosis Factor (TNF)
16
Q
What 3 substances increase endothelial cell expression of adhesion molecules to which neutrophils bind?
A
- IL-1
- Endotoxins
- Tmour Necrosis Factor
17
Q
What process allows neutrophils to find the inflammatory stimulus?
A
Chemotaxis
18
Q
What substance which is a vaso dilator is released by mast cells, eosinophils, basophils and platelets?
A
Histamine
19
Q
What 3 things stimulate the release of histamine?
A
C3a
C5a
Neutrophils
20
Q
Where is serotonin present in high concentration?
A
Platelets
21
Q
What does serotonin do to vascular permeability?
A
Increases it
22
Q
What are leukotrienes synthesised from?
A
Arachidonic acid
23
Q
What type of hypersensitivity are leukotrienes involved in?
A
Type I hypersensitivity
24
What substance increases vascular permeability and stimulates platelet aggregation?
Prostaglandins
25
Name 3 major opsonins?
Fc fragment of IgG
C3b
Collectins
26
After ohagocytosis what do neutrophils undergo?
Apoptosis
27
What name is given to a collection of pus surrounded by a membrane of sprouting capillaries, neutrophils and occasional fibroblasts?
An abcess
28
What does repair and organisation of tissues result in?
Fibrosis
29
What does resolution mean?
The complete restoration of the tisseus to normal after an episode of acute inflammation
30
What is an osteomyelitis?
A chronic abcess which is extremely difficult to eradicate
31
What term is given to an inflammatory process in which lymphocytes, plasma cells and macrophages predominate?
Chronic inflammation
32
What does the formation of granulation tissue result in?
Fibrosis
33
Give 3 examples of primary chronic inflammation?
1. Tuberculosis
2. Leprosy brucellosis
3. Viral infections
34
What crystals are important in gout?
Urate crystals
35
What is ulcerative colitis an example of?
Primary chronic inflammation
36
Name a primary granulomatous disease?
Sarcoidosis
37
What macroscopic appearance of chronic inflammation occurs when the mucosa is breahed, the base lined by granulation tissue and fibrous tissue extends through the muscle layers?
Chronic ulcer
38
What granulomatous disease has caseous necrosis?
Tuberculosis
39
Macrophages are activated on migration to an area of inflammation by what two factors?
Macrophage activation factors (MAF)
| Migration inhibition factor (MIF)
40
What is the name given to an aggregate of epithelial histiocytes?
A granuloma
41
What is a histiocyte?
A macrophage present in connective tissue
42
What might the appearance of granulomas be augmented by?
The presence of caseous necrosis or conversion into histiocytic giant cells
43
What organism can cause TB which is an aerosol spread from infected cattle or from milk?
M. bovis
44
What type of lesions does M.bovis initially cause?
Intestinal/tonsillar lesions
45
What vaccination is given to protect against TB?
BCG vaccination, following a negative heaf test
46
What is suppuration?
The formation of pus
47
What is organisation of tissues?
Replacement of tissues by granulation tissue
48
What are macrophages and fibroblasts characteristic of?
Chronic inflamamtion
49
Name an aquired metabolic disorder?
Diabetes
50
Which type of diabetes mellitus is insulin dependent?
Type I
51
What type of diabetes mellitus can ketoacidosis be present in?
Type I
52
What type of diabetes mellitus are no islet antibodies present?
Type II
53
Name 4 complications of diabetes mellitus?
Ketoacidosis
Non-enzymatic glycosylation
Hypoglycaemia
Lactic acidosis
54
What is morphogical abnormalities in mitochondira, reduced ER and distorted Golgi apparatus a result of?
Ageing
55
Give a biochemical change associated with cellular ageing
Accumulation of lipfuscin, advanced glycation end products and abnormally folded proteins
56
What three things make up attenuation of capacity to undertake key biochemical processs as a result of cellular ageing?
Decreased oxidative phosphorylation
Synthesis of key nucleic acids and proteins/enzymes
Reduced capacity for nutrient uptake
57
What are by-products of oxidative phosphorylation and lead to breaks and covalent modifications of macromolecules?
Free radicals (ROS)
58
What does the accumulation of lipofuscin reflect?
Episodes of oxidative damage to the cell
59
What is senescence?
After a fixed number of divisions all cells enter a non-dividing state - senescence
60
What syndrome is associated with deflective DNA helicase?
Werner's syndrome
61
What is progeria?
A rare genetic condition, usually spontaneous where children have a normal mental development but show signs of old age.
62
What do advanced glycation end products affect?
Cell matrix and matrix-matrix interactions
63
What do advanced glycation end products bind to?
AGE receptors on endothelial cells
64
What are 4 things about the binding of advanced glycation end products to AGE receptors on endothelial cells?
Increase permeability
Pro-inflammatory
Pro-coagulant
Increased matrix production
65
What disease has frontal and temporal atrophy and compensatory ventricular dilatation, formation of senile plaques and neurofibrillary tangles and accelerates the normal ageing process?
Alzheimer type dementia
66
Name two osteoarticular diseases?
Osteoporosis
| Osteoarthritis
67
Name 4 vulnerable intracellular mechanisms of cellular injury
1. Cell membrane integrity
2. Aerobic respiration
3. Protein synthesis
4. Genomic integrity
68
Membrane integrity can cause cellular injury - give 4 causes of mechanical disruption of membrane integrity.
Physical trauma
Osmotic, freezing
Complement
Cytotoxic Proteins in cytotoxic t cells
69
Functional disruption of membrane integrity can cause cellular injury - give two causes of functional disruption
1. Depletion of ATP
| 2. Alterations to lipids and protein in the cell e.g. cross-linking induced by free radicals
70
Impaired metabolism can be related to respiration and protein synthesis. Give 2 causes of respiration related impaired metabolism.
Lack of oxygen e.g. blood supply
| Block mitochondria respiratory chain e.g. cyanide binding to cytochrome oxidase
71
Imparied metabolism can be as a result of respiration or protein synthesis. Give 2 causes of protein synthesis related impaired metabolism.
1. Ricin blocks translation at ribosome
| 2. Decreased ATP will contribute
72
What is recognised when the cytoplasm is pale and swollen, accumulation of fluid, function of membranes and membrane pumps are affected and there is hypoxia or chemical poisons?
Cell swelling (hyropic change)
73
What is recognised when there is accumulation of droplets, uncoupling of lipid and protein metabolism, liver commonly affected and may see many small vacuoles or one large vacuole?
Fatty change
74
Are leakage of enzymes and nuclear changes reversible?
No
75
What type of cell death affects scattered cells?
Apoptosis
76
Does apoptosis cause inflammation?
No
77
Does apoptosis require energy?
No
78
What type of cell death is always pathological?
Necrosis
79
What type of cell death affects sheets of cells?
Necrosis
80
Does necrosis cause inflammation?
Yes
81
Does necrosis require energy?
No
82
Give three inhibitors of apoptosis
Growth factors
Cell matrix components
Viral proteins
83
Give 7 inducers of apoptosis
1. Withdrawal of growth factors
2. Loss of matrix attachment
3. Viruses
4. Free radicals
5. Ionising radiation
6. DNA damage
7. Fas ligand/CD95 interaction
84
What molecular mediatros and regulators moderate the extrinsic pathway of apoptosis?
Death receptors e.g. CD95/Fas ligand
85
What are three factors that modulate the intrinsic pathway of apoptosis?
1. increased mitochondrial permeability
2. Bcl-2 family
3. Cytochrome c/Apaf-1
86
3What is p53 a modulator of?
Apoptosis
87
In what three cases in apoptosis increased?
1. AIDS
2. Neuorodegenerative disorders
3. Reperfusion injury
88
In what two cases is apoptosis decreased?
Neoplasia
| Auto-immune disease
89
Name two locations of labile cell types?
GI tract
| Bone marrow
90
What classification of cell types are hepatocytes and endothelium?
Stable
91
Name 2 locations of permanent cell types
Neurones
| Skeletal muscle
92
What is restitution?
Complete repair
93
What is restitution like when there is death of permanent cell populations?
Return to normal is not possible
94
What does repair with scarring require the formation of?
Granulation tissue
95
What happens in granulation tissue?
Capillary endothelial cells proliferate, grow into the damaged area and form fragile vascular channels.
96
In granulation tissue what other cells are capillary endothelial cells mixed with?
Neutrophils, macrophages, fibroblasts and myofibroblasts
97
What causes wound contraction?
The action of myofibroblasts
98
What are the two types of excessive scar formations?
1. Hypertrophic scar
| 2. Keloid
99
What is blood clotting a defence mechanism against?
Haemorrhage
100
What is a thrombus?
Solid mass of blood constituents formed within the blood vessel
101
What three things make up Virchow's triad?
1. Vessel
2. Flow
3. Constituents
102
In Virchow's triad what two factors affect the vessel?
Loss of endothelial surface
| Inflammation
103
In Virchow's triad, what two factors affect flow?
1. Stasis
| 2. Turbulence
104
In Virchow's triad, what three factors affect constituents?
1. Platelets
2. Coagulation proteins
3. Viscosity
105
What properties do platelets have?
Adherence properties
106
During the coagulation cascade - what converts fibrin polymer to form the end product of a cross-linked fibrin polymer?
factor XIIIa
107
During the coagulation cascade - what converts XIII to XIIIa?
Thrombin
108
During the coagulation cascade - what is converted to a fibrin polymer?
Fibrin monomer
109
During the coagulation cascade - what converts fibrinogen to a fibrin monomer?
Thrombn
110
What does prothrombin change into with the help of Xa and Va?
Thrombin
111
In a venous thrombosis - what is the blood stasis like?
Imobilised
112
In a venous thrombosis - what three factors could cause hypercoagulability?
Inherited
Drugs
Trauma
113
What is an embolism?
A mass of material in the vascular system moving from its site of origin to lodge in the vessels in a distant site
114
What are the 7 types of embolism that can occur?
```
Thromboembolism
Fat embolism
Atheroembolism
Tumour embolism
Infective
Amniotic fluid
Air embolism
```
115
What three pathologies can thromboembolism occur in?
Deep Vein Thrombosis and Pulmonary thromboembolism
| Arterial thrombosis and embolism
116
What 3 symptoms can patients with a DVT present with?
Unilateral leg swelling
Oedema
Pain
117
What pathology has a: sudden onset, life threatening, haemoptysis, breathlessness, cardiovascular collapse and shock, cardiac arrest?
Pulmonary thromboembolism
118
What 4 things can an arterial thrombosis cause?
Atheroma
MI
Atrial thrombosis
Vasculitis
119
What is the term for zonal necrosis due to sudden occlusion of blood supply?
Infarction
120
What are generated in a re-perfusion injury?
Free radicals
121
What leads up to lipid peroxidation?
A chain reaction of free radicals
122
What is the diagnosis for: 59 year old man, chest pain and acute collapse, ECG anteriolateral ischaemia, elevated troponin and cardiac enzymes.
Myocardial Infarction
123
What 4 things can cause a myocardial infarction?
Muscle cell death (left ventricle)
Loss of blood supply
Occlusion of anterior descending branch of left coronary artery
Coronary artery thrombosis
124
What does endothelial injury cause?
Atheroma
125
What four things can cause endothelial injury which can lead to an atheroma?
Lipids
Pressure
Toxins
Sheer stress
126
What occurs in a complicated atheroma?
Plaque rupture and haemorrhage
127
List 5 complications of an atheroma
1. Thrombosis
2. Aneurysm
3. Dissection
4. Embolism
5. Ischaemia
128
What is the term for a disease process of elastic artery walls and is in response to injury mechanisms?
Atheroma
