Pathology Flashcards
During inflammation, vessels vasodilate. What mediates this?
Histamine and nitric oxide
Binding of …. facilitates white cell rolling on endothelial surface
Integrin and selectin
5 characteristic of inflammation?
Heat (calor) Redness (rubor) Swelling (tumor) Pain (dolor) Loss of function (functiono laesa)
How does swelling occur in inflammation?
Leaky vessels lose proteins
Water follows protein out
What are opsonins?
Complement/IgG coating bacteria to make them targets for phagocytosis
What is resolution?
Complete restoration of the tissue to normal after removal of inflammatory components
What is suppuration?
Pus- living, dying and dead cells
May form abscess
What type of tissue is laid down in the healing process?
Granulation tissue (collagen and smooth muscle cells)
What is a granuloma?
Collection of macrophages that ‘walls off’ foreign body (parasites, worms, eggs, syphilis, TB etc.)
What is ‘cheesy necrosis’ associated with?
Tuberculous granulomas (caseous necrosis)
Characteristic of chronic inflammation
Lymphocytes + some macrophages
NOTHING TO DO WITH TIME/SEVERITY
Weinberg Hallmarks of cancer?
Increase growth signals Remove growth suppression Avoid apoptosis Achieve immortality Become invasive Make your own blood supply (angiogenesis) Loss of spell DNA spell checks Avoid the immune system others
What is Myc?
Nuclear transcription factor that promotes growth – DNA replication
Which is the most commonly mutated kinase in cancer?
PI3K
What is ‘grade’ a measure of?
How well differentiated a tumour is
Most common tumour supressor gene + most commonly mutated protein in cancer?
p53
How does p53 wokr?
Cell cycle arrest – senses DNA abnormalties at G1 and pauses cell cycle.
Induces apoptosis
What is frequently upregulated in cancers in order to make their own blood supply?
VEGF
What is hyperplasia?
Increase in cell number in response to stimulus
e.g. bone marrow in pancytopenia, breast in pregnancy, thyroid in response to hormones, prostate
What is hypertrophia?
Increase in cell size
e.g. cardiac muscle, skeletal muscle in steroids/weight training
What is dysplasia?
Disordered (abnormal) growth- benign, not in response to stimuli
Not cancer until crosses basement membrane
e.g. DCIS, CIS/CIN, adenoma in colon (will become malignant eventually)
What is metaplasia?
Reversible change to one mature to another mature cell type in response to stimulus
e.g. Barrett’s oesophagus, cervical erosion (transition zone), bladder (transitional to squamous)
How does endometrial hyperplasia occur?
In response to oestrogen
therefore uncommon in post-menopausal women-low oestrogen
What is neoplasia?
New growth
Which cell most commonly reacts to foreign bodies?
Macrophages
What’s another name for macrophages?
Histiocytes
3 Bs of neoplasms in kids?
Bones (osteosarcoma, Ewing’s)
Blood (leukaemias)
Brain (neuroblastoma, medullobastoma)
Cancers in older people?
Carcinomas (epithelial malignancy)
Is pain associated with malignancy?
Not often- usually means reactive (inflammatory)
What are potential differentials for a craggy mass in the supraclavicular region?
Lymphoma
Primary gastric adenocarcinoma
Melanoma on scalp
Squamous carcinoma on neck
Where is Vichow’s node?
Supraclavicular region
Classic presentation of HPV related cancer in young, non-smoker?
Lump in the neck
Enlarged para-aortic lymph nodes could be … metastases?
Testicular
Melanoma appearance on histology?
Produce melanin (brown pigment)
Squamous carcinoma appearance on histology?
Lots of red keratin
Signet ring cells on histology?
Widespread adenocarcinoma of stomach- linitis plastica (very aggressive, hard to excise)
Signet ring sign on chest CT?
Bronchiectasis
Orphan Annie nuclei on histology?
Papillary thyroid cancer
CMV classic presentation?
Proctitis- inflammation of rectum
Chorioretinitis
Bacterial vs viral tonsillitis?
Centor criteria- differentiating Bacterial from Viral:
History of fever
Tonsillar exudates
Tender anterior cervical adenopathy
Absence of cough (if cough is likely to be viral)
Treatment of bacterial tonsillitis?
Penicillin V
2 types of hepatitis that are faecal oral spread?
A + E
fAEcal
Hepatitis mneumonic?
A= Acute B= Badass (blood, sex, tattoo etc.) C= Chronic, copycat (similar to A) D= Dependent on B E= Exotic