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phase 2 > Pathology > Flashcards

Pathology Flashcards

1
Q

Causes of fluctuating cognitive function

A

Subdural haematoma, cerebral abscess, hypoglycaemia, meningioma, acute aortic regurgitation, hypertensive encephalopathy or alcohol intoxication

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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

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3
Q

Inflammation definition

A

Local physiological response to injury

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4
Q

Granuloma definition

A

Aggregate of epitheliod histiocytes

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5
Q

Embolism definition

A

A detached thrombus carried through the circulation that obstructs a smaller vessel

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6
Q

Infarction definition

A

Reduced blood flow that leads to cell death

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7
Q

Ischaemia definition

A

Reduced blood flow

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8
Q

Apoptosis definition

A

Programmed cell death of a single cell

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9
Q

Necrosis definition

A

Unprogrammed cell death of a large number of cells due to an adverse event

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10
Q

Atrophy definition

A

Decrease in tissue size due to loss of cell size and number

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11
Q

Hypertrophy

A

Increase in tissue size due to increase in size of the constituent cells

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12
Q

Hyperplasia

A

Increase in tissue size due to increase in number of constituent cells

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13
Q

Dysplasia definition

A

Morphological changes seen in cells in progression to becoming cancer

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14
Q

Metaplasia definition

A

Conversion of one differentiated cell into another differentiated cell

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15
Q

Acute inflammation 5 signs

A

Rubor, Calor, Dolor, Tumor and loss of function

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16
Q

Acute inflammation causes

A

Microbial, hypersensitivity, physical (trauma, radiation, hot/cold), chemical or tissue necrosis

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17
Q

What is resolution

A

Complete restoration of the tissue to normal after an episode of acute inflammation

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18
Q

What is suppuration

A

Pus formation

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19
Q

What is organisation

A

The replacement of tissues by granulation

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20
Q

What is axial flow?

A

Blood cells flow mainly in the centre of the lumen (occurs in blood vessels larger than capillaries)

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21
Q

What is plasmatic flow

A

In blood vessels plasma is found towards the vessel walls

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22
Q

What is exudation

A

Net escape of protein rich fluid

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23
Q

What is diapedesis

A

Where hydrostatic pressure forces erythrocytes out of the vessels

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24
Q

How do neutrophils emigrate out of blood vessels

A

Active amoeboid transport, project pseudopodia through venule walls between endothelial cells

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25
Q

What are abscesses

A

collections of pus

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26
Q

What is pus

A

Living, dying and dead neutrophils and bacteria, cellular debris and sometimes globules of lipid

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27
Q

What does pyogenic mean

A

Causes the formation of pus

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28
Q

What are examples of hypersensitivity reactions which cause acute inflammation

A

Parasites and tubercle bacilli

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29
Q

What is a key investigative feature of granulomatous disease

A

ACE released by granulomas

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30
Q

How do ibuprofen and paracetamol act as antiinflammatories

A

Act on cyclooxygenase, preventing prostaglandin release and therefore inflammation

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31
Q

What does cirrhotic mean

A

nodules of regenerating liver which are unable to repair due to persistent initiating factor

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32
Q

What is broncho pneumonia

A

Pneumonia which affects the bronchioles all through the lung

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33
Q

What is lobar pneumonia

A

Pneumonia which just affects one lobe

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34
Q

What is an abrasion

A

Where the top layer of the epidermis is removed

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35
Q

What is an implantation dermoid

A

Where epidermal cells grow to form a keratin filled cyst following wound healing by first intention

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36
Q

What are keloid nodules

A

Where there is excessive fibroblast proliferation and collagen production

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37
Q

Why does a wound healing by first intention appear white

A

Due to the collagen deposition

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38
Q

What is repair

A

Replacement of damaged tissue by fibrous tissue

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39
Q

What is a glios

A

A fibrosis in the CNS

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40
Q

Which cells dont regenerate

A

myocardial cells and neurones

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41
Q

Which cells regenerate

A

Hepatocytes, pneumocytes, blood cells, osteocytes, gut and skin epithelium

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42
Q

What is a granuloma

A

An aggregate of epitheloid histiocytes

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43
Q

What happens in sarcoidosis

A

There are immune differences favouring granulomatous inflammation

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44
Q

Which specific chemical causes granulomatous disease

A

beryllium

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45
Q

When do histiocytic giant cells form

A

When a molecule cant be digested by a single macrophage

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46
Q

What is amyloidosis

A

Raised levels of Amyloid A serum protein causes chronic inflammation and can spread

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47
Q

What is fibrosis

A

Thickening and scarring of connective tissue

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48
Q

Thrombosis definition

A

a solid mass of blood constituents formed within intact vascular system during life

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49
Q

Atherosclerosis definition

A

Atheroma causing hardening of the arteries

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50
Q

Which layer of the arteries does lipid build up in, during artheroma

A

intima

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51
Q

What type of atherosclerosis can be present in 20-30 year olds

A

Fatty streaks, these predispose to atherosclerosis

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52
Q

Which elements of cigarette smoke cause atherosclerosis

A

Carbon monoxide, nicotine and free radicals

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53
Q

How does hypertension lead to atherosclerosis

A

Causes increased shearing forces and therefore endothelial cells

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54
Q

What % of coronary artery occlusion leads to symptoms when working hard

A

40-50%

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55
Q

How does aspirin prevent artherosclerosis

A

Inhibits platelet aggregation so reduces the size of the thrombus forming after each endothelial cell injury

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56
Q

What is an aneurysm

A

An abnormal permanent dilation of a blood vessel or part of a heart chamber

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57
Q

Why dont blood clots normally form

A

Laminar flow and healthy endothelial cells arent sticky

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58
Q

What is a blood clot

A

A post mortem thrombus

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59
Q

What is the main cause of thrombosis in veins

A

Stasis of blood

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60
Q

Why cant a thrombus pass from the venous system through the arterial system

A

It would have to pass through the pulmonary capillaries and only RBC can fit

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61
Q

What is a fistula

A

Connects two epithelial surfaces

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62
Q

What is reperfusion injury

A

Where restored oxygen given following ischaemia, causes ROS to form and cell death

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63
Q

What is the purpose of the circle of willis

A

To equalise pressure, to present dizziness when turning your head

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64
Q

What is a watershed area

A

At the boundary of adjacent arterial territories, at risk as long way from supply.

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65
Q

What is syndactyly

A

Webbed fingers

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66
Q

What happens histologically during apoptosis

A

Nuclei go dark and break up

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67
Q

What is p53

A

Protein which monitors DNA damage and switches on apoptosis

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68
Q

Which enzymes carry out apoptosis

A

Caspases

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69
Q

Which genes control apoptosis in development

A

Homeobox genes

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70
Q

Which gene is needed for apoptosis

A

p53

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71
Q

What is an example of a consequence of no apoptosis

A

cancer

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72
Q

What is an example of a consequence of too much apoptosis

A

HIV virus causing apoptosis of T lymphocytes

73
Q

How will necrosis appear histologically

A

Pink, no nuclei, wiped out

74
Q

What are common causes of avascular necrosis

A

Scaphoid fracture or femoral head fracture

75
Q

What is a caseous necrosis

A

It has a soft cheese appearance histologically and is suggestive of tb

76
Q

What does congenital mean

A

present at birth

77
Q

What does inherited mean

A

caused an inherited genetic abnormality

78
Q

What does acquired mean

A

caused by non genetic environmental factors

79
Q

What is spinal bifida

A

Exposed spinal cord, as neural tube hasnt closed

80
Q

Spina bifida occulta

A

Missing posterior vertebra

81
Q

Meningocele

A

Bulging of the meninges outwards, no neural tissue in bulge

82
Q

Myelomeningocele

A

Bulging out of meninges containing neural tissue into external sac, usually causing paralysis of the lower limbs

83
Q

What causes a lot of miscarriages in the first weeks of pregnancy

A

Chromosomal abnormalities

84
Q

Cleft palate

A

failure of cells to migrate and join up properly in the mouth

85
Q

What is an example of a non inherited congenital abnormality

A

Clubbed foot

86
Q

What are autosomal inherited abnormalities

A

Abnormalities inherited are single gene abnormalities on the non sex chromosomes

87
Q

What is an example of an autosomal dominant gene abnormality

A

FAP

88
Q

What is an example of an autosomal recessive gene abnormality

A

Cystic Fibrosis

89
Q

What is an example of codominant gene expression

A

Blood grouping

90
Q

An abnormality in which gene causes huntingtons

A

hungtingtin

91
Q

Which gene controls muscle growth

A

Myostatin

92
Q

What is acromegaly

A

Excess GH causes excess growth of the peripheral parts: jaw, hands and feet. After puberty.

93
Q

Name an example of cells which hypertophy

A

Those which cant divide such as skeletal muscle

94
Q

Where does metaplasia start from

A

From the basement membrane, newly divided cells develop and replace the older cells over time

95
Q

Why do telomeres shorten

A

Because they are used to initiate DNA replication every time the cell divides

96
Q

Name three causes of accumulating no dividing cell damage

A

Cross linking of proteins and DNA, toxic metabolites and peroxidation products

97
Q

What is the only thing seen to prevent ageing

A

Severe calorie restriction

98
Q

What causes dermal elastosis

A

UV-B light causes collagen protein cross linking, causes lack of elasticity

99
Q

What causes osteoporosis

A

Loss of bone matrix. Decreased oestrogen causes increased bone resorption and decreased bone formation

100
Q

What causes cataracts

A

Cross linking of crystallin protein in the lens by UV-B light

101
Q

What causes senile dementia

A

Loss of cells from the brain and cortical atrophy. Plaques and neurofibrillary tangles form over time.

102
Q

What increases chance of dementia

A

Genetic and environmental factors can increase this (oxidative stress)

103
Q

What is sarcopaenia

A

Loss of muscle

104
Q

What causes sarcopaenia with age

A

Decreased levels of GH and testosterone and increased levels of catabolic cytokines

105
Q

What causes deafness with age

A

Hair cells in the cochlear duct don’t regenerate

106
Q

What must something be to be a metaplasia

A

Autonomous, abnormal, persistent, new growth

107
Q

Why does neoplasia incidence drop in the over 80s

A

Increased risk but fewer people are alive, therefore reduced incidence

108
Q

How can the risk of prostate cancer be calculated

A

Age as a %, 60% of 60 year olds, 100% of 100 year olds

109
Q

What is stroma

A

The connective tissue basis of an organ

110
Q

Why classify neoplasms

A

determine appropriate treatment and provide prognostic information

111
Q

How do benign neoplasms cause harm

A

Pressure on adjacent structures, obstruction of flow, production of hormones, transformation to malignant and anxiety

112
Q

What is histogenesis

A

The specific cell of origin of a tumour

113
Q

What are the three factors affecting thrombus formation

A

Endothelial cell injury, abnormal blood flow, hypercoagulability

114
Q

What is stage 1 of atherosclerosis

A

Fatty Streaks

115
Q

What is stage 2 of atherosclerosis

A

Intermediate lesions

116
Q

What is stage 3 of atherosclerosis

A

Fibrous plaques and advanced lesions

117
Q

What is stage 4 of atherosclerosis

A

Plaque rupture

118
Q

What are fatty streaks and intermediate lesions made up of

A

Layers of foam cells, vascular smooth muscle cells, T lymphocytes and platelet aggregations adhered to the vessel wall

119
Q

What causes plaque rupture

A

There is constant growing and receding, if the balance favours inflammation the plaque will weaken and rupture

120
Q

What are the treatments for atheroscelrosis

A

Statins, Anticoagulants or PCI (percutaneous coronary intervention)

121
Q

What is an arterial thrombus made up of

A

white thrombus - mainly made up of platelets

122
Q

What is a venous thrombus made up of

A

red thrombus - made up of RBC and coagulation factors

123
Q

What can an arterial thrombus lead to

A

MI or Stroke

124
Q

What can a venous thrombus lead to

A

DVT or PE

125
Q

Arterial thrombus treatment

A

Antiplatelets

126
Q

Venous thrombus treatment

A

Anticoagulants

127
Q

Adeno

A

Glandular

128
Q

Papillo

A

non glandular

129
Q

Leiomyo

A

Smooth Muscle

130
Q

Neuro

A

Nerves

131
Q

Chondro

A

Cartilage

132
Q

Lipo

A

Adipose tissue

133
Q

Rhabdomyo

A

Striated muscle

134
Q

Osteo

A

Bone

135
Q

Carcinoma

A

Malignant neoplasm of epithelial cells

136
Q

Angio

A

vascular

137
Q

Sarcoma

A

Malignant neoplasm of connective tissue

138
Q

Anaplastic

A

Unknown cell type

139
Q

Name 2 non neoplastic omas

A

granuloma, mycetoma, tuberculoma

140
Q

Melanoma

A

Malignant neoplasm of melanocytes

141
Q

Mesothelioma

A

Malignant neoplasm of melanocytes

142
Q

Lymphoma

A

Malignant neoplasm of lymphoid cells

143
Q

Blastoma

A

Embryonic tumour

144
Q

Teratoma

A

Contains 3 layers of embryonic tissue

145
Q

What is a carcinogen latent interval

A

Time between exposure and development of cancer

146
Q

What is hepatocellular carcinoma

A

Primary malignancy of the liver

147
Q

What is causes increased bladder cancer incidence in rubber workers?

A

Beta naphthylamine

148
Q

What are ultimate carcinogens

A

Carcinogens which have been activated from their precursor (procarcinogen) state

149
Q

Which chemical carcinogen causes lung cancer

A

Polycyclic aromatic hydrocarbons from smoking

150
Q

Which chemical carcinogen causes skin cancer

A

Polycyclic aromatic hydrocarbons from mineral oils

151
Q

Which chemical carcinogen causes bladder cancer

A

Aromatic amines from rubber/dye work

152
Q

Which chemical carcinogen could cause gut cancer

A

Nitrosamines from preserved meats

153
Q

Which chemical carcinogen could cause leukaemia

A

Alkylating agents, from cancer treatment

154
Q

xerodermatic pigmentosum

A

cant repair UV light damage

155
Q

What increases your exposure to oestrogen?

A

Obesity, early puberty and few or no children

156
Q

Cholangiocarcinoma

A

Bile duct cancer

157
Q

Why is some skin darker than others

A

Same number of melanocytes, dark skinned people just produce more

158
Q

What are host factors which may affect carcinogenesis

A

Race, diet, constitutional factors, premalignant lesions and transplacental exposure

159
Q

What is a premalignant condition

A

An identifiable local abnormality associated with increased risk of malignancy

160
Q

Carcinoma in situ

A

When a carcinoma is contained within a basement membrane

161
Q

Invasive carcinoma

A

Carcinoma which breaches the basement membrane and invades surrounding tissue

162
Q

What is needed for invasion of the basement membrane

A

Proteases and cell motility

163
Q

Define metastasis

A

Spread to a site distant from the original carcinoma

164
Q

What prevents DNA mutations turning into cancer

A

DNA repair proteins

165
Q

Name an angiogenesis activator

A

VEGF

166
Q

Which cancers metastasise to the lung

A

Sarcomas and any common cancer

167
Q

Why do certain cancers metastasise to bone

A

The cancer preferentially binds to blood vessels in bone

168
Q

Osteolytic cancer

A

Makes holes in bone

169
Q

Osteosclerotic cancer

A

Induces new bone growth (Prostate often does this)

170
Q

Why are hospital autopsies requested

A

Auditing, governance, teaching and research. They make up <10%

171
Q

What is a presumed natural death

A

Where the cause of death is not known, not seen doctor in last 14 days

172
Q

What is a presumed iatrogenic death

A

Presumed consequence of medical treatment

173
Q

Give examples of presumed unnatural deaths

A

Accidents, custodial deaths, war/industrial, unlawful killing, neglect, suicide

174
Q

What are the four questions that need to be answered by a coronial autopsy

A

Who when where how (referring to the deceased)

175
Q

Body habitus meaning

A

physique or build

176
Q

When is it better to look at a wet brain than CT

A

Only when looking at meningoencephalitis

177
Q

What is a unique fact about basal skin carcinomas

A

They are locally invasive but never spread to other parts of the body (therefore complete excision cures)

178
Q

Why are leukaemia symptoms generalised

A

As WBC circulate around the whole body

179
Q

Causes of thrombus is normal vessles

A

Atherosclerosis, thrombophillia, malginancy

phase 2 (17 decks)

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