Pathology

Question 1

What does VINDICATE stand for?

Answer 1

Vascular
Infection
Neoplasia
Drugs/degenerate
Iatrogenic
Congenital
Autoimmune
Trauma
Endocrine/metabolic

Question 2

What are the symptoms of inflammation?

Answer 2

Rubor - redness
Calor - heat
Dolar - pain
Tumor - swelling

Question 3

What is carcinoma in situ?

Answer 3

Dysplasia of the whole epithelium

It is the final stage before cancer

Question 4

What are Weinbergs Hallmarks of cancer?

Answer 4

Sustaining proliferating signalling

Evading growth suppressors

Avoiding immune destruction

Enabling replicative immortality

Tumor-promoting inflammation

Activating invasion and metastasis

Inducing angiogenesis - own blood supply

Genome instability and mutation

Resisting cell death

Deregulating cellular energetics

Question 5

What genes can cause cancer?

Answer 5

APC gene
RB mutations
BRCA

Question 6

What is hyperplasia?

Answer 6

Increase in cell numbers

Question 7

what is hypertrophy?

Answer 7

increase in cell size

Question 8

What are the two method through which a cell can die?

Answer 8

Necrosis and apoptosis

Question 9

what is necrosis?

Answer 9

pathological cell death in the absence of a signal requiring no energy

Question 10

what are the three types of necrosis?

Answer 10

coagulative
liquefactive
caseous

Question 11

give an example of when each type of necrosis is used.

Answer 11

coagulative necrosis of cardiac muscle in MI
Liquefactive necrosis if necrosis in the brain OR pus
Caseous necrosis in TB

Question 12

describe what happens in the types of necrosis.

Answer 12

Coagulative: proteins coagulate, there is preservation of the cell outline.
Liquefactive: necrotic material is softened and liquified, no cell structure remains.
Caseous is cheese like

Question 13

What is gangrenous necrosis?

Answer 13

cell death by necrosis with infection on top

Question 14

what is apoptosis?

Answer 14

programmed cell death which requires energy. It can be pathological or physiological.

Question 15

what is P53, what is its function and why is it important?

Answer 15

P53 is a protein its function is to monitor mistakes in the cell cycle at G1. If found, repair will be attempted, if cant repair then P53 stimulates caspases and signals for apoptosis. If lost it can lead to development of cancer

Question 16

what are telomeres and what are their significance in cancer?

Answer 16

TTAGGG part of a chromosome that enables cell to divide, with divisions will get smaller until gone and cell will die. Cancer reactivates telomerase which adds telomeres onto chromosomes, making cancer cells immortal

Question 17

what is surface adhesion molecules expression on neutrophils increased by?

Answer 17

C5a
Leukotriene B2
TNF

Question 18

What is expression of endothelial adhersion molecules increased by, to aid neutrophil adhesion?

Answer 18

IL-1
Endotoxins
TNF

Question 19

what role does histamine play in acute inflammation?

Answer 19

vasodilator

Question 20

what is histamine released by?

Answer 20

mast cells, eosinophils, basophils, platelets

Question 21

what is histamines release stimulated by?

Answer 21

C3a, C5a and lysosomal proteins

Question 22

What does serotonin do in acute inflammation?

Answer 22

increases vascular permeability

Question 23

What role do chemokines play in acute inflammation?

Answer 23

attract various leucocytes to site of inflammation

Question 24

what do prostaglandins do in acute inflammation?

Answer 24

increase vascular permeability, stimulate platelet aggregation

Question 25

what is suppuration?

Answer 25

the formation of pus, containing neutrophils, bacteria and cellular debris

Question 26

which cells are involved in chronic inflammation?

Answer 26

plasma cells lymphocytes macrophages

Question 27

what signs of chronic inflammation would be seen macroscopically?

Answer 27

``` chronic ulcer chronic abscess cavity thickening of wall by fibrous tissue granulomatous fibrosis ```

Question 28

what is a granuloma?

Answer 28

collection of macrophages, is a characteristic of chronic inflammation

Question 29

define atrophy

Answer 29

reduction in cell size and number

Question 30

define hypoplasia

Answer 30

reduced size of an organ that never fully developed to normal size

Question 31

define metaplasia and give an example

Answer 31

one type of cell becomes another form of cell in response to stress (example Barrett's oesophagus)

Question 32

define neoplasia

Answer 32

new growth. Normally abnormal mass of tissue growth which is uncoordinated

Question 33

Neoplastic cells are monoclonal, what does this mean?

Answer 33

they are derived from a single common ancestor

Question 34

what is carcinoma?

Answer 34

cancer of epithelial cell

Question 35

what is dysplasia?

Answer 35

presence of abnormal cell type within a tissue leading to disordered growth that is a pre-malignant process

Question 36

what is angiogenesis?

Answer 36

formation of new, abnormal blood vessels

Question 37

what is sarcoma?

Answer 37

cancer of mesenchymal cell

Question 38

how does malignancy occur (basic summary)?

Answer 38

Initiation (first mutation) promotion (further mutations are accumulated) persistence (unregulated abnormal growth)

Question 39

describe what happens in the vascular phase of acute inflammation.

Answer 39

1. vasodilation of arterioles 2. stasis (slows, loss of laminar flow) 3. margination 4. rolling 5. pavmenting (endothelials express ICAM and VCAM adhesion molecules, white cells express integrins, selectins etc) 6. migration 7. leaky vessels

Question 40

how do chemotaxis aid migration?

Answer 40

chemical gradient which chemotaxis follow, increasing concentration of complement proteins.

Question 41

what is the problem with suppuration?

Answer 41

it is walled off so antibiotics and immune cells cannot penetrate so must be drained

Question 42

what does coagulative and liquefactive necrosis result in?

Answer 42

``` Coagulative = scarring Liquefactive = hole/cavity ```

Question 43

how do you diagnose TB?

Answer 43

PCR and positive Ziehl Neelson stain

Question 44

what do oncogenes do?

Answer 44

stimulate cell proliferation

Question 45

what do tumour supressors do?

Answer 45

inhibit cell proliferation, stimulate cell death

Question 46

what genetics do inherited metabolic disorders have?

Answer 46

autosomal recessive

Question 47

what is atheroma characterised by?

Answer 47

fatty streak and fibrofatty plaque