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Pathology Flashcards

1
Q

Pathogenesis is defined as…

A

The sequence of events from a healthy state to clinical disease

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2
Q

Some sequelae of coronary artery thromobosis are? (5)

A

Myocardial infarction, arrhythmias, ischaemia, angina, heart failure

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3
Q

Causes of acute inflammation…(5)

A

Bacterial and viral infections
Hypersensitivity
Trauma
Chemicals and irritants

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4
Q

Physical characteristics of inflammation include…(5)

A

Redness (RUBOR), heat (CALOR), swelling (TUMOUR), pain (DOLOR), loss of function (GALEN)

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5
Q

Redness and heat assoc with inflammation is due to…

A

Vasodilation within the damaged area, causing increased blood flow and as a result skin temperature

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6
Q

Cellular pathological changes…(5)

A

WBC margination, rolling, activation, adhesion, trans endothelial migration

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7
Q

Necrosis is defined as…

A

(premature) Cell death (ALWAYS PATHOLOGICAL)

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8
Q

Apoptosis is defined as… It is useful because…

A

Programmed cell death

Get rid of damaged, dead cells and debris

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9
Q

Resolution is complete restoration of inflamed tissue. Factors favouring this include…

A

Minimal cell death/damage
Occurrence in an organ/tissue with good regenerative capacity
Short duration/rapid destruction of causal agent

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10
Q

Suppuration is…

An empyema is…

A

The formation of pus, made up of living cells, dying cells, dead neutrophils, debris and bacteria

Pus fills and walls off

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11
Q

Organisation of tissues after inflammation is their replacement by _____ tissue

A

Granulation

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12
Q

Describe how granulation tissue is formed?

A

Capillaries grow into the inflammatory exudate with macrophages and fibroblasts (LOOKS V RED - IMMATURE BVs)
Angiogenesis, fibroblast proliferation and collagen synthesis (forms scars) occurs
Processes regulated by GFs (TNF, EGF)

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13
Q

Permanent cells are more susceptible to mutations. True/False?

A

False

Dividing cells are more susceptible - e.g. skin, gut, bone, hair cells

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14
Q

p53 is important in DNA repair. What does it do?

A

Recognises a base pair sequence alteration and triggers cell death or DNA repair when the DNA is damaged

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15
Q

Free radicals are dangerous to membrane integrity. What do they do?

A

Lipid peroxidation - bind to lipids and reduce their solubility
Broccoli and cabbage have high anti-oxidants that scavenge and destroy free radicals

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16
Q

An example of an area where liquefactive necrosis would occur?

A

Transformation into liquid viscous mass

Brain Liquid myelin sheath of nerve fibres remains after brain substance dies

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17
Q

An example of caseous necrosis?

A

Soft, white, cheese-like tissue

Tuberculosis

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18
Q

An example of an area where fibrinoid necrosis would occur?

A 
Blood vessels (most common in liver) CIRRHOSIS
Walls replaced by fibrin
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19
Q

What is coagulative necrosis? Where is it commonly found?

A

Cell death with structures left as ghost outline — phagocytosis - common in cardiac muscle

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20
Q

The 3 phases of acute inflammation are:

A

Vascular - vasodilation and increased permeability Exudative - fluid and cells escape from venules
Cellular - neurophils etc accumulate

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21
Q

What happens in transendothelial migration?

A

Neutrophils insert part of their cytoplasm into endothelium when they come into contact with ICAM-1

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22
Q

What is the effect of histamine? What is it released by?

A

Vasodilation, increases vascular permeability, bronchoconstriction
Mast cells, eosinophils, basophils

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23
Q

Chronic inflammation is associated with the presence of…

A

Lymphocytes, macrophages, plasma cells

Formation of granulation tissue -> fibrosis

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24
Q

Characteristic appearances of chronic inflammation include…

A

Ulcer formation
Abscess cavities/suppurative inflammation Granulomatous inflammation
Fibrosis

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25
Q

A granuloma is defined as…

A

An aggregate of epitheloid histiocytes (macrophages etc)

Collection of immune cells form when FB walled off but cant be eliminated

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26
Q

Labile cells are cells that only multiply upon receiving a stimulus. True/False?

A

False

Multiply continually - stable cells only multiply after stimulus

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27
Q

First intention healing is when there is an ulcerated surface. True/False?

A

False

Surgical scar is left - minimal granulation tissue and fibrosis

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28
Q

Metabolic disorders are of two types - ?

A

Inherited or acquired

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29
Q

Inherited metabolic disorders are usually autosomal dominant. True/False?

A

False

AR

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30
Q

Type 1 Diabetes Mellitus is insulin dependent. True/False?

A

True

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31
Q

Type 1 Diabetes has no autoimmune assoc. True/False?

A

False Type 2 has no autoimmune assoc.

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32
Q

Hyperplasia is defined as…

A

Enlargement due to increase in cell number

33
Q

Hypertrophy is defined as…

A

Enlargement due to increase in cell size (no increase in cell number)

34
Q

Atrophy is defined as…

A

Reduction in size due to decrease in cell size and number

35
Q

Hypoplasia is defined as…

A

Reduced size of an organ that never fully developed to normal size (failure of organ development)

36
Q

Which out of hyperplasia, hypoplasia, hypertrophy and atrophy are potentially reversible?

A

Hyperplasia, hypertrophy and atrophy

37
Q

Metaplasia is defined as…

A

Altered differentiation, where a mature cell type transforms into another cell type

38
Q

In Barrett’s oesophagus, ____ epithelium is replaced by ____ epithelium

A

Squamous, glandular

39
Q

Stable cells divide upon stimulation. Examples include…(2)

A

Hepatocytes

Fibroblasts

40
Q

Permanent cells are not able to divide further. Examples include…(3)

A

Neurones
Skeletal muscle
Cardiac muscle

41
Q

Senescence is defined as…

A

Deterioration of function of cells - typically with age

42
Q

Some characteristics of benign neoplasms (5)

A 
Resemble normal 
No invasion 
Well differentiated 
Normal mitotic figures 
DO NOT METASTASISE
43
Q

Some characteristics of maligant neoplasms (6)

A 
Invasive (goes beyond basement membrane)
Varied differentiation 
Abnormal mitotic figures 
Necrosis is common
Pleomorphism (varying sizes of nucleus)
Hyperchromasia (dark staining nucleus)
44
Q

What is dysplasia?

A

A pre-malignant process that involves altered differentiation
Carcinoma-in-situ = highest grade dysplasia

45
Q

Carcinomas are derived from mesenchymal cells/tissues. True/False?

A

False

Derived from epithelial tissue

46
Q

Sarcomas are derived from which type of tissue?

A

Mesenchymal tissue

47
Q

Squamous papillomas and adenomas are examples of which neoplasms?

48
Q

Neoplastic cells are monoclonal. What does this mean?

A

All cells in the lesion are derived from a single common ancestor

49
Q

What are Weinberg Hallmarks of cancer cells? (8)

A

Angiogenesis, cellular DNA spell checking, achieve immortality, invasion, avoid apoptosis, avoid spell checking, remove tumour suppressors, increase oncogenes

50
Q

What is angiogenesis?

A

Formation of new blood vessels

51
Q

What happens when angiogenesis becomes pathological?

A

Control of formation is lost - vessels formed are abnormal

52
Q

What are the modulators of angiogenesis? (3) What is the inhibitor? (1)

A

Hypoxia, VEGF, TNFa

Thrombospondin-1 is the inhibitor

53
Q

Sarcomas metastasise by which route?

A

Haematogenous

54
Q

How can radiation cause cancer?

A

Causes oxidative stress, producing free radicals which damage DNA and other cells

55
Q

Name some examples of classical oncogenes (stimulate cell division) (4)

A

VEGF PDGF ras src

56
Q

Name some examples of tumour suppressor genes (3)

A

p53 BRCA-1 p22 (inhibits CDK)

57
Q

A daughter with mother with breast cancer at aged 70 is an example of a medium risk patient. True/False?

A

False

Low risk

58
Q

An individual with a BRCA1 mutation is an example of a high risk patient. True/False?

59
Q

Well differentiated tumours tend to have a better prognosis. True/False?

60
Q

What is microsatellite instability?

A

Regions where it is easy to identify spelling mistakes that shouldn’t be there

61
Q

The main cancers found in children are…(3)

A

Brain
Bone
Blood

62
Q 
What type of tissue are the following tumours derived from....
Liposarcoma/lipoma
Oseosarcoma/osteoma
Enchondroma/chondrosarcoma
Rhabdomyosarcoma/rhabdomyoma
Leiomyosarcoma/leiomyoma
Leukaemia/lymphoma
A 
Fat
Bone
Cartilage
Skeletal muscle
Smooth muscle
Blood
63
Q

Describe the pathogenesis of atheroma? (6)

A
  1. Endothelial injury
  2. Cholesterol accumulates
  3. Oxidise to produce and inflam response using neutrophils
  4. Macrophages attempt to phagocytose cholesterol —-foam cells —- fatty streak
  5. Endothelium ruptures exposing collagen cap and platelets aggregate together = platelet plug
  6. Chemical changes occur: fibrinogen — fibrin = thrombus
64
Q

Complications of atheroma…(5)

A 
Thrombosis
Aneurysm
Dissection
Embolism
Ischaemia
65
Q

What are the components of Virchows triad? (3)

A

Endothelial wall injury
Blood flow stasis/ turbulence
Increased hypercoagubility

66
Q

Layout the basic coagulation cascade…

A

EXTRINSIC (trauma) INTRINSIC (damaged surface)
activation of factors
prothrombin —– thrombin
fibrinogen —– fibrin
CLOT

67
Q

Consequence of increased coagubility….(4)

A

Arterial thrombus (white)
Venous thrombus (red)
DVT
PE

68
Q

Duke’s Stage A means…

A

Cancer is confined to wall

69
Q

Duke’s Stage B means…

A

Cancer penetrates wall

70
Q

Duke’s Stage C means…

A

Lymph node metastasis

71
Q

Duke’s Stage D means…

A

Metastatic disease

72
Q

T1 staging means…

A

Invasion of submucosa

73
Q

T2 staging means…

A

Invasion of muscularis propria

74
Q

T3 staging means…

A

Invasion of tissues

75
Q

T4 staging means…

A

Invasion of nearby organs

76
Q

N0 staging means…

A

No lymph node metastasis

77
Q

N1 staging means…

A

1-3 lymph nodes affected

78
Q

N2 staging means…

A

4+ lymph nodes affected

Y1 PRINCIPLES (10 decks)

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