Pathology Flashcards
1
Q
Causes of fluctuating cognitive function
A
Subdural haematoma, cerebral abscess, hypoglycaemia, meningioma, acute aortic regurgitation, hypertensive encephalopathy or alcohol intoxication
2
Q
Which grade cancer has a worse 10 year survival rate
A
Grade 1, although less severe than grade 3 it is more likely to have developing mets
3
Q
Inflammation definition
A
Local physiological response to injury
4
Q
Granuloma definition
A
Aggregate of epitheliod histiocytes
5
Q
Embolism definition
A
A detached thrombus carried through the circulation that obstructs a smaller vessel
6
Q
Infarction definition
A
Reduced blood flow that leads to cell death
7
Q
Ischaemia definition
A
Reduced blood flow
8
Q
Apoptosis definition
A
Programmed cell death of a single cell
9
Q
Necrosis definition
A
Unprogrammed cell death of a large number of cells due to an adverse event
10
Q
Atrophy definition
A
Decrease in tissue size due to loss of cell size and number
11
Q
Hypertrophy
A
Increase in tissue size due to increase in size of the constituent cells
12
Q
Hyperplasia
A
Increase in tissue size due to increase in number of constituent cells
13
Q
Dysplasia definition
A
Morphological changes seen in cells in progression to becoming cancer
14
Q
Metaplasia definition
A
Conversion of one differentiated cell into another differentiated cell
15
Q
Acute inflammation 5 signs
A
Rubor, Calor, Dolor, Tumor and loss of function
16
Q
Acute inflammation causes
A
Microbial, hypersensitivity, physical (trauma, radiation, hot/cold), chemical or tissue necrosis
17
Q
What is resolution
A
Complete restoration of the tissue to normal after an episode of acute inflammation
18
Q
What is suppuration
A
Pus formation
19
Q
What is organisation
A
The replacement of tissues by granulation
20
Q
What is axial flow?
A
Blood cells flow mainly in the centre of the lumen (occurs in blood vessels larger than capillaries)
21
Q
What is plasmatic flow
A
In blood vessels plasma is found towards the vessel walls
22
Q
What is exudation
A
Net escape of protein rich fluid
23
Q
What is diapedesis
A
Where hydrostatic pressure forces erythrocytes out of the vessels
24
Q
How do neutrophils emigrate out of blood vessels
A
Active amoeboid transport, project pseudopodia through venule walls between endothelial cells
25
What are abscesses
collections of pus
26
What is pus
Living, dying and dead neutrophils and bacteria, cellular debris and sometimes globules of lipid
27
What does pyogenic mean
Causes the formation of pus
28
What are examples of hypersensitivity reactions which cause acute inflammation
Parasites and tubercle bacilli
29
What is a key investigative feature of granulomatous disease
ACE released by granulomas
30
How do ibuprofen and paracetamol act as antiinflammatories
Act on cyclooxygenase, preventing prostaglandin release and therefore inflammation
31
What does cirrhotic mean
nodules of regenerating liver which are unable to repair due to persistent initiating factor
32
What is broncho pneumonia
Pneumonia which affects the bronchioles all through the lung
33
What is lobar pneumonia
Pneumonia which just affects one lobe
34
What is an abrasion
Where the top layer of the epidermis is removed
35
What is an implantation dermoid
Where epidermal cells grow to form a keratin filled cyst following wound healing by first intention
36
What are keloid nodules
Where there is excessive fibroblast proliferation and collagen production
37
Why does a wound healing by first intention appear white
Due to the collagen deposition
38
What is repair
Replacement of damaged tissue by fibrous tissue
39
What is a glios
A fibrosis in the CNS
40
Which cells dont regenerate
myocardial cells and neurones
41
Which cells regenerate
Hepatocytes, pneumocytes, blood cells, osteocytes, gut and skin epithelium
42
What is a granuloma
An aggregate of epitheloid histiocytes
43
What happens in sarcoidosis
There are immune differences favouring granulomatous inflammation
44
Which specific chemical causes granulomatous disease
beryllium
45
When do histiocytic giant cells form
When a molecule cant be digested by a single macrophage
46
What is amyloidosis
Raised levels of Amyloid A serum protein causes chronic inflammation and can spread
47
What is fibrosis
Thickening and scarring of connective tissue
48
Thrombosis definition
a solid mass of blood constituents formed within intact vascular system during life
49
Atherosclerosis definition
Atheroma causing hardening of the arteries
50
Which layer of the arteries does lipid build up in, during artheroma
intima
51
What type of atherosclerosis can be present in 20-30 year olds
Fatty streaks, these predispose to atherosclerosis
52
Which elements of cigarette smoke cause atherosclerosis
Carbon monoxide, nicotine and free radicals
53
How does hypertension lead to atherosclerosis
Causes increased shearing forces and therefore endothelial cells
54
What % of coronary artery occlusion leads to symptoms when working hard
40-50%
55
How does aspirin prevent artherosclerosis
Inhibits platelet aggregation so reduces the size of the thrombus forming after each endothelial cell injury
56
What is an aneurysm
An abnormal permanent dilation of a blood vessel or part of a heart chamber
57
Why dont blood clots normally form
Laminar flow and healthy endothelial cells arent sticky
58
What is a blood clot
A post mortem thrombus
59
What is the main cause of thrombosis in veins
Stasis of blood
60
Why cant a thrombus pass from the venous system through the arterial system
It would have to pass through the pulmonary capillaries and only RBC can fit
61
What is a fistula
Connects two epithelial surfaces
62
What is reperfusion injury
Where restored oxygen given following ischaemia, causes ROS to form and cell death
63
What is the purpose of the circle of willis
To equalise pressure, to present dizziness when turning your head
64
What is a watershed area
At the boundary of adjacent arterial territories, at risk as long way from supply.
65
What is syndactyly
Webbed fingers
66
What happens histologically during apoptosis
Nuclei go dark and break up
67
What is p53
Protein which monitors DNA damage and switches on apoptosis
68
Which enzymes carry out apoptosis
Caspases
69
Which genes control apoptosis in development
Homeobox genes
70
Which gene is needed for apoptosis
p53
71
What is an example of a consequence of no apoptosis
cancer
72
What is an example of a consequence of too much apoptosis
HIV virus causing apoptosis of T lymphocytes
73
How will necrosis appear histologically
Pink, no nuclei, wiped out
74
What are common causes of avascular necrosis
Scaphoid fracture or femoral head fracture
75
What is a caseous necrosis
It has a soft cheese appearance histologically and is suggestive of tb
76
What does congenital mean
present at birth
77
What does inherited mean
caused an inherited genetic abnormality
78
What does acquired mean
caused by non genetic environmental factors
79
What is spinal bifida
Exposed spinal cord, as neural tube hasnt closed
80
Spina bifida occulta
Missing posterior vertebra
81
Meningocele
Bulging of the meninges outwards, no neural tissue in bulge
82
Myelomeningocele
Bulging out of meninges containing neural tissue into external sac, usually causing paralysis of the lower limbs
83
What causes a lot of miscarriages in the first weeks of pregnancy
Chromosomal abnormalities
84
Cleft palate
failure of cells to migrate and join up properly in the mouth
85
What is an example of a non inherited congenital abnormality
Clubbed foot
86
What are autosomal inherited abnormalities
Abnormalities inherited are single gene abnormalities on the non sex chromosomes
87
What is an example of an autosomal dominant gene abnormality
FAP
88
What is an example of an autosomal recessive gene abnormality
Cystic Fibrosis
89
What is an example of codominant gene expression
Blood grouping
90
An abnormality in which gene causes huntingtons
hungtingtin
91
Which gene controls muscle growth
Myostatin
92
What is acromegaly
Excess GH causes excess growth of the peripheral parts: jaw, hands and feet. After puberty.
93
Name an example of cells which hypertophy
Those which cant divide such as skeletal muscle
94
Where does metaplasia start from
From the basement membrane, newly divided cells develop and replace the older cells over time
95
Why do telomeres shorten
Because they are used to initiate DNA replication every time the cell divides
96
Name three causes of accumulating no dividing cell damage
Cross linking of proteins and DNA, toxic metabolites and peroxidation products
97
What is the only thing seen to prevent ageing
Severe calorie restriction
98
What causes dermal elastosis
UV-B light causes collagen protein cross linking, causes lack of elasticity
99
What causes osteoporosis
Loss of bone matrix. Decreased oestrogen causes increased bone resorption and decreased bone formation
100
What causes cataracts
Cross linking of crystallin protein in the lens by UV-B light
101
What causes senile dementia
Loss of cells from the brain and cortical atrophy. Plaques and neurofibrillary tangles form over time.
102
What increases chance of dementia
Genetic and environmental factors can increase this (oxidative stress)
103
What is sarcopaenia
Loss of muscle
104
What causes sarcopaenia with age
Decreased levels of GH and testosterone and increased levels of catabolic cytokines
105
What causes deafness with age
Hair cells in the cochlear duct don't regenerate
106
What must something be to be a metaplasia
Autonomous, abnormal, persistent, new growth
107
Why does neoplasia incidence drop in the over 80s
Increased risk but fewer people are alive, therefore reduced incidence
108
How can the risk of prostate cancer be calculated
Age as a %, 60% of 60 year olds, 100% of 100 year olds
109
What is stroma
The connective tissue basis of an organ
110
Why classify neoplasms
determine appropriate treatment and provide prognostic information
111
How do benign neoplasms cause harm
Pressure on adjacent structures, obstruction of flow, production of hormones, transformation to malignant and anxiety
112
What is histogenesis
The specific cell of origin of a tumour
113
What are the three factors affecting thrombus formation
Endothelial cell injury, abnormal blood flow, hypercoagulability
114
What is stage 1 of atherosclerosis
Fatty Streaks
115
What is stage 2 of atherosclerosis
Intermediate lesions
116
What is stage 3 of atherosclerosis
Fibrous plaques and advanced lesions
117
What is stage 4 of atherosclerosis
Plaque rupture
118
What are fatty streaks and intermediate lesions made up of
Layers of foam cells, vascular smooth muscle cells, T lymphocytes and platelet aggregations adhered to the vessel wall
119
What causes plaque rupture
There is constant growing and receding, if the balance favours inflammation the plaque will weaken and rupture
120
What are the treatments for atheroscelrosis
Statins, Anticoagulants or PCI (percutaneous coronary intervention)
121
What is an arterial thrombus made up of
white thrombus - mainly made up of platelets
122
What is a venous thrombus made up of
red thrombus - made up of RBC and coagulation factors
123
What can an arterial thrombus lead to
MI or Stroke
124
What can a venous thrombus lead to
DVT or PE
125
Arterial thrombus treatment
Antiplatelets
126
Venous thrombus treatment
Anticoagulants
127
Adeno
Glandular
128
Papillo
non glandular
129
Leiomyo
Smooth Muscle
130
Neuro
Nerves
131
Chondro
Cartilage
132
Lipo
Adipose tissue
133
Rhabdomyo
Striated muscle
134
Osteo
Bone
135
Carcinoma
Malignant neoplasm of epithelial cells
136
Angio
vascular
137
Sarcoma
Malignant neoplasm of connective tissue
138
Anaplastic
Unknown cell type
139
Name 2 non neoplastic omas
granuloma, mycetoma, tuberculoma
140
Melanoma
Malignant neoplasm of melanocytes
141
Mesothelioma
Malignant neoplasm of melanocytes
142
Lymphoma
Malignant neoplasm of lymphoid cells
143
Blastoma
Embryonic tumour
144
Teratoma
Contains 3 layers of embryonic tissue
145
What is a carcinogen latent interval
Time between exposure and development of cancer
146
What is hepatocellular carcinoma
Primary malignancy of the liver
147
What is causes increased bladder cancer incidence in rubber workers?
Beta naphthylamine
148
What are ultimate carcinogens
Carcinogens which have been activated from their precursor (procarcinogen) state
149
Which chemical carcinogen causes lung cancer
Polycyclic aromatic hydrocarbons from smoking
150
Which chemical carcinogen causes skin cancer
Polycyclic aromatic hydrocarbons from mineral oils
151
Which chemical carcinogen causes bladder cancer
Aromatic amines from rubber/dye work
152
Which chemical carcinogen could cause gut cancer
Nitrosamines from preserved meats
153
Which chemical carcinogen could cause leukaemia
Alkylating agents, from cancer treatment
154
xerodermatic pigmentosum
cant repair UV light damage
155
What increases your exposure to oestrogen?
Obesity, early puberty and few or no children
156
Cholangiocarcinoma
Bile duct cancer
157
Why is some skin darker than others
Same number of melanocytes, dark skinned people just produce more
158
What are host factors which may affect carcinogenesis
Race, diet, constitutional factors, premalignant lesions and transplacental exposure
159
What is a premalignant condition
An identifiable local abnormality associated with increased risk of malignancy
160
Carcinoma in situ
When a carcinoma is contained within a basement membrane
161
Invasive carcinoma
Carcinoma which breaches the basement membrane and invades surrounding tissue
162
What is needed for invasion of the basement membrane
Proteases and cell motility
163
Define metastasis
Spread to a site distant from the original carcinoma
164
What prevents DNA mutations turning into cancer
DNA repair proteins
165
Name an angiogenesis activator
VEGF
166
Which cancers metastasise to the lung
Sarcomas and any common cancer
167
Why do certain cancers metastasise to bone
The cancer preferentially binds to blood vessels in bone
168
Osteolytic cancer
Makes holes in bone
169
Osteosclerotic cancer
Induces new bone growth (Prostate often does this)
170
Why are hospital autopsies requested
Auditing, governance, teaching and research. They make up <10%
171
What is a presumed natural death
Where the cause of death is not known, not seen doctor in last 14 days
172
What is a presumed iatrogenic death
Presumed consequence of medical treatment
173
Give examples of presumed unnatural deaths
Accidents, custodial deaths, war/industrial, unlawful killing, neglect, suicide
174
What are the four questions that need to be answered by a coronial autopsy
Who when where how (referring to the deceased)
175
Body habitus meaning
physique or build
176
When is it better to look at a wet brain than CT
Only when looking at meningoencephalitis
177
What is a unique fact about basal skin carcinomas
They are locally invasive but never spread to other parts of the body (therefore complete excision cures)
178
Why are leukaemia symptoms generalised
As WBC circulate around the whole body
179
Causes of thrombus is normal vessles
Atherosclerosis, thrombophillia, malginancy
