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JL Principles > Pathology > Flashcards

Pathology Flashcards

0
Q

What occurs when the p53 gene is lost?

A

Cancer

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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

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2
Q

What inactivates free radicals?

A

Dimutase

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3
Q

What protects against free radicals such as superoxide?

A

Anti-oxidants

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4
Q

What is necrosis?

A

Death of tissues

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5
Q

Name 6 patterns of necrosis

A
  1. Coagulative
  2. Colliquative
  3. Caseous
  4. Gangrenous
  5. Fibrinoid
  6. Fat necrosis
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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

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7
Q

Name one inherited metabolic disorder?

A

Phenylketonuria - deficiency of phenylalanine hydroxylase

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8
Q

What test can be used for phenylketonuria?

A

Guthrie test

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9
Q

Name two chronic inflammatory diseases?

A

Crohn’s and Rheumatoid arthritis

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10
Q

What two chemical mediators are known to produce pain?

A

Histamine and bradykinin

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11
Q

What two pressures lead to the formation of fluid exudate?

A

Increased hydrostatic pressure

Decreased osmotic pressure

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12
Q

Name two components of fluid exudate?

A

Proteins including immunoglobulins and fibrinogen

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13
Q

What is neutrophil accumulation in the extracellular space a diagnostic feature of?

A

Acute inflammation

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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

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15
Q

What 3 substances increase leucocyte surface adhesion molecule expression?

A
  1. Complement component C5a
  2. Leukotriene B4
  3. Tumour Necrosis Factor (TNF)
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16
Q

What 3 substances increase endothelial cell expression of adhesion molecules to which neutrophils bind?

A
  1. IL-1
  2. Endotoxins
  3. Tmour Necrosis Factor
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17
Q

What process allows neutrophils to find the inflammatory stimulus?

A

Chemotaxis

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18
Q

What substance which is a vaso dilator is released by mast cells, eosinophils, basophils and platelets?

A

Histamine

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19
Q

What 3 things stimulate the release of histamine?

A

C3a
C5a
Neutrophils

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20
Q

Where is serotonin present in high concentration?

A

Platelets

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21
Q

What does serotonin do to vascular permeability?

A

Increases it

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22
Q

What are leukotrienes synthesised from?

A

Arachidonic acid

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23
Q

What type of hypersensitivity are leukotrienes involved in?

A

Type I hypersensitivity

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24
Q

What substance increases vascular permeability and stimulates platelet aggregation?

A

Prostaglandins

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25
Q

Name 3 major opsonins?

A

Fc fragment of IgG
C3b
Collectins

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26
Q

After ohagocytosis what do neutrophils undergo?

A

Apoptosis

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27
Q

What name is given to a collection of pus surrounded by a membrane of sprouting capillaries, neutrophils and occasional fibroblasts?

A

An abcess

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28
Q

What does repair and organisation of tissues result in?

A

Fibrosis

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29
Q

What does resolution mean?

A

The complete restoration of the tisseus to normal after an episode of acute inflammation

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30
Q

What is an osteomyelitis?

A

A chronic abcess which is extremely difficult to eradicate

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31
Q

What term is given to an inflammatory process in which lymphocytes, plasma cells and macrophages predominate?

A

Chronic inflammation

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32
Q

What does the formation of granulation tissue result in?

A

Fibrosis

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33
Q

Give 3 examples of primary chronic inflammation?

A
  1. Tuberculosis
  2. Leprosy brucellosis
  3. Viral infections
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34
Q

What crystals are important in gout?

A

Urate crystals

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35
Q

What is ulcerative colitis an example of?

A

Primary chronic inflammation

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36
Q

Name a primary granulomatous disease?

A

Sarcoidosis

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37
Q

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?

A

Chronic ulcer

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38
Q

What granulomatous disease has caseous necrosis?

A

Tuberculosis

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39
Q

Macrophages are activated on migration to an area of inflammation by what two factors?

A

Macrophage activation factors (MAF)

Migration inhibition factor (MIF)

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40
Q

What is the name given to an aggregate of epithelial histiocytes?

A

A granuloma

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41
Q

What is a histiocyte?

A

A macrophage present in connective tissue

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42
Q

What might the appearance of granulomas be augmented by?

A

The presence of caseous necrosis or conversion into histiocytic giant cells

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43
Q

What organism can cause TB which is an aerosol spread from infected cattle or from milk?

A

M. bovis

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44
Q

What type of lesions does M.bovis initially cause?

A

Intestinal/tonsillar lesions

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45
Q

What vaccination is given to protect against TB?

A

BCG vaccination, following a negative heaf test

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46
Q

What is suppuration?

A

The formation of pus

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47
Q

What is organisation of tissues?

A

Replacement of tissues by granulation tissue

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48
Q

What are macrophages and fibroblasts characteristic of?

A

Chronic inflamamtion

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49
Q

Name an aquired metabolic disorder?

A

Diabetes

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50
Q

Which type of diabetes mellitus is insulin dependent?

A

Type I

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51
Q

What type of diabetes mellitus can ketoacidosis be present in?

A

Type I

52
Q

What type of diabetes mellitus are no islet antibodies present?

A

Type II

53
Q

Name 4 complications of diabetes mellitus?

A

Ketoacidosis
Non-enzymatic glycosylation
Hypoglycaemia
Lactic acidosis

54
Q

What is morphogical abnormalities in mitochondira, reduced ER and distorted Golgi apparatus a result of?

A

Ageing

55
Q

Give a biochemical change associated with cellular ageing

A

Accumulation of lipfuscin, advanced glycation end products and abnormally folded proteins

56
Q

What three things make up attenuation of capacity to undertake key biochemical processs as a result of cellular ageing?

A

Decreased oxidative phosphorylation
Synthesis of key nucleic acids and proteins/enzymes
Reduced capacity for nutrient uptake

57
Q

What are by-products of oxidative phosphorylation and lead to breaks and covalent modifications of macromolecules?

A

Free radicals (ROS)

58
Q

What does the accumulation of lipofuscin reflect?

A

Episodes of oxidative damage to the cell

59
Q

What is senescence?

A

After a fixed number of divisions all cells enter a non-dividing state - senescence

60
Q

What syndrome is associated with deflective DNA helicase?

A

Werner’s syndrome

61
Q

What is progeria?

A

A rare genetic condition, usually spontaneous where children have a normal mental development but show signs of old age.

62
Q

What do advanced glycation end products affect?

A

Cell matrix and matrix-matrix interactions

63
Q

What do advanced glycation end products bind to?

A

AGE receptors on endothelial cells

64
Q

What are 4 things about the binding of advanced glycation end products to AGE receptors on endothelial cells?

A

Increase permeability
Pro-inflammatory
Pro-coagulant
Increased matrix production

65
Q

What disease has frontal and temporal atrophy and compensatory ventricular dilatation, formation of senile plaques and neurofibrillary tangles and accelerates the normal ageing process?

A

Alzheimer type dementia

66
Q

Name two osteoarticular diseases?

A

Osteoporosis

Osteoarthritis

67
Q

Name 4 vulnerable intracellular mechanisms of cellular injury

A
  1. Cell membrane integrity
  2. Aerobic respiration
  3. Protein synthesis
  4. Genomic integrity
68
Q

Membrane integrity can cause cellular injury - give 4 causes of mechanical disruption of membrane integrity.

A

Physical trauma
Osmotic, freezing
Complement
Cytotoxic Proteins in cytotoxic t cells

69
Q

Functional disruption of membrane integrity can cause cellular injury - give two causes of functional disruption

A
  1. Depletion of ATP

2. Alterations to lipids and protein in the cell e.g. cross-linking induced by free radicals

70
Q

Impaired metabolism can be related to respiration and protein synthesis. Give 2 causes of respiration related impaired metabolism.

A

Lack of oxygen e.g. blood supply

Block mitochondria respiratory chain e.g. cyanide binding to cytochrome oxidase

71
Q

Imparied metabolism can be as a result of respiration or protein synthesis. Give 2 causes of protein synthesis related impaired metabolism.

A
  1. Ricin blocks translation at ribosome

2. Decreased ATP will contribute

72
Q

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?

A

Cell swelling (hyropic change)

73
Q

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?

A

Fatty change

74
Q

Are leakage of enzymes and nuclear changes reversible?

A

No

75
Q

What type of cell death affects scattered cells?

A

Apoptosis

76
Q

Does apoptosis cause inflammation?

A

No

77
Q

Does apoptosis require energy?

A

No

78
Q

What type of cell death is always pathological?

A

Necrosis

79
Q

What type of cell death affects sheets of cells?

A

Necrosis

80
Q

Does necrosis cause inflammation?

A

Yes

81
Q

Does necrosis require energy?

A

No

82
Q

Give three inhibitors of apoptosis

A

Growth factors
Cell matrix components
Viral proteins

83
Q

Give 7 inducers of apoptosis

A
  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
Q

What molecular mediatros and regulators moderate the extrinsic pathway of apoptosis?

A

Death receptors e.g. CD95/Fas ligand

85
Q

What are three factors that modulate the intrinsic pathway of apoptosis?

A
  1. increased mitochondrial permeability
  2. Bcl-2 family
  3. Cytochrome c/Apaf-1
86
Q

3What is p53 a modulator of?

A

Apoptosis

87
Q

In what three cases in apoptosis increased?

A
  1. AIDS
  2. Neuorodegenerative disorders
  3. Reperfusion injury
88
Q

In what two cases is apoptosis decreased?

A

Neoplasia

Auto-immune disease

89
Q

Name two locations of labile cell types?

A

GI tract

Bone marrow

90
Q

What classification of cell types are hepatocytes and endothelium?

A

Stable

91
Q

Name 2 locations of permanent cell types

A

Neurones

Skeletal muscle

92
Q

What is restitution?

A

Complete repair

93
Q

What is restitution like when there is death of permanent cell populations?

A

Return to normal is not possible

94
Q

What does repair with scarring require the formation of?

A

Granulation tissue

95
Q

What happens in granulation tissue?

A

Capillary endothelial cells proliferate, grow into the damaged area and form fragile vascular channels.

96
Q

In granulation tissue what other cells are capillary endothelial cells mixed with?

A

Neutrophils, macrophages, fibroblasts and myofibroblasts

97
Q

What causes wound contraction?

A

The action of myofibroblasts

98
Q

What are the two types of excessive scar formations?

A
  1. Hypertrophic scar

2. Keloid

99
Q

What is blood clotting a defence mechanism against?

A

Haemorrhage

100
Q

What is a thrombus?

A

Solid mass of blood constituents formed within the blood vessel

101
Q

What three things make up Virchow’s triad?

A
  1. Vessel
  2. Flow
  3. Constituents
102
Q

In Virchow’s triad what two factors affect the vessel?

A

Loss of endothelial surface

Inflammation

103
Q

In Virchow’s triad, what two factors affect flow?

A
  1. Stasis

2. Turbulence

104
Q

In Virchow’s triad, what three factors affect constituents?

A
  1. Platelets
  2. Coagulation proteins
  3. Viscosity
105
Q

What properties do platelets have?

A

Adherence properties

106
Q

During the coagulation cascade - what converts fibrin polymer to form the end product of a cross-linked fibrin polymer?

A

factor XIIIa

107
Q

During the coagulation cascade - what converts XIII to XIIIa?

A

Thrombin

108
Q

During the coagulation cascade - what is converted to a fibrin polymer?

A

Fibrin monomer

109
Q

During the coagulation cascade - what converts fibrinogen to a fibrin monomer?

A

Thrombn

110
Q

What does prothrombin change into with the help of Xa and Va?

A

Thrombin

111
Q

In a venous thrombosis - what is the blood stasis like?

A

Imobilised

112
Q

In a venous thrombosis - what three factors could cause hypercoagulability?

A

Inherited
Drugs
Trauma

113
Q

What is an embolism?

A

A mass of material in the vascular system moving from its site of origin to lodge in the vessels in a distant site

114
Q

What are the 7 types of embolism that can occur?

A 
Thromboembolism
Fat embolism
Atheroembolism
Tumour embolism
Infective
Amniotic fluid
Air embolism
115
Q

What three pathologies can thromboembolism occur in?

A

Deep Vein Thrombosis and Pulmonary thromboembolism

Arterial thrombosis and embolism

116
Q

What 3 symptoms can patients with a DVT present with?

A

Unilateral leg swelling
Oedema
Pain

117
Q

What pathology has a: sudden onset, life threatening, haemoptysis, breathlessness, cardiovascular collapse and shock, cardiac arrest?

A

Pulmonary thromboembolism

118
Q

What 4 things can an arterial thrombosis cause?

A

Atheroma
MI
Atrial thrombosis
Vasculitis

119
Q

What is the term for zonal necrosis due to sudden occlusion of blood supply?

A

Infarction

120
Q

What are generated in a re-perfusion injury?

A

Free radicals

121
Q

What leads up to lipid peroxidation?

A

A chain reaction of free radicals

122
Q

What is the diagnosis for: 59 year old man, chest pain and acute collapse, ECG anteriolateral ischaemia, elevated troponin and cardiac enzymes.

A

Myocardial Infarction

123
Q

What 4 things can cause a myocardial infarction?

A

Muscle cell death (left ventricle)
Loss of blood supply
Occlusion of anterior descending branch of left coronary artery
Coronary artery thrombosis

124
Q

What does endothelial injury cause?

A

Atheroma

125
Q

What four things can cause endothelial injury which can lead to an atheroma?

A

Lipids
Pressure
Toxins
Sheer stress

126
Q

What occurs in a complicated atheroma?

A

Plaque rupture and haemorrhage

127
Q

List 5 complications of an atheroma

A
  1. Thrombosis
  2. Aneurysm
  3. Dissection
  4. Embolism
  5. Ischaemia
128
Q

What is the term for a disease process of elastic artery walls and is in response to injury mechanisms?

A

Atheroma

JL Principles (12 decks)

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