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