Pathology Flashcards
What does VINDICATE stand for?
Vascular Infection Neoplasia Drugs/degenerate Iatrogenic Congenital Autoimmune Trauma Endocrine/metabolic
What are the symptoms of inflammation?
Rubor - redness
Calor - heat
Dolar - pain
Tumor - swelling
What is carcinoma in situ?
Dysplasia of the whole epithelium
It is the final stage before cancer
What are Weinbergs Hallmarks of cancer?
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
What genes can cause cancer?
APC gene
RB mutations
BRCA
What is hyperplasia?
Increase in cell numbers
what is hypertrophy?
increase in cell size
What are the two method through which a cell can die?
Necrosis and apoptosis
what is necrosis?
pathological cell death in the absence of a signal requiring no energy
what are the three types of necrosis?
coagulative
liquefactive
caseous
give an example of when each type of necrosis is used.
coagulative necrosis of cardiac muscle in MI
Liquefactive necrosis if necrosis in the brain OR pus
Caseous necrosis in TB
describe what happens in the types of necrosis.
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
What is gangrenous necrosis?
cell death by necrosis with infection on top
what is apoptosis?
programmed cell death which requires energy. It can be pathological or physiological.
what is P53, what is its function and why is it important?
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
what are telomeres and what are their significance in cancer?
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
what is surface adhesion molecules expression on neutrophils increased by?
C5a
Leukotriene B2
TNF
What is expression of endothelial adhersion molecules increased by, to aid neutrophil adhesion?
IL-1
Endotoxins
TNF
what role does histamine play in acute inflammation?
vasodilator
what is histamine released by?
mast cells, eosinophils, basophils, platelets
what is histamines release stimulated by?
C3a, C5a and lysosomal proteins
What does serotonin do in acute inflammation?
increases vascular permeability
What role do chemokines play in acute inflammation?
attract various leucocytes to site of inflammation
what do prostaglandins do in acute inflammation?
increase vascular permeability, stimulate platelet aggregation
what is suppuration?
the formation of pus, containing neutrophils, bacteria and cellular debris
which cells are involved in chronic inflammation?
plasma cells
lymphocytes
macrophages
what signs of chronic inflammation would be seen macroscopically?
chronic ulcer chronic abscess cavity thickening of wall by fibrous tissue granulomatous fibrosis
what is a granuloma?
collection of macrophages, is a characteristic of chronic inflammation
define atrophy
reduction in cell size and number
define hypoplasia
reduced size of an organ that never fully developed to normal size
define metaplasia and give an example
one type of cell becomes another form of cell in response to stress (example Barrett’s oesophagus)
define neoplasia
new growth. Normally abnormal mass of tissue growth which is uncoordinated
Neoplastic cells are monoclonal, what does this mean?
they are derived from a single common ancestor
what is carcinoma?
cancer of epithelial cell
what is dysplasia?
presence of abnormal cell type within a tissue leading to disordered growth that is a pre-malignant process
what is angiogenesis?
formation of new, abnormal blood vessels
what is sarcoma?
cancer of mesenchymal cell
how does malignancy occur (basic summary)?
Initiation (first mutation)
promotion (further mutations are accumulated)
persistence (unregulated abnormal growth)
describe what happens in the vascular phase of acute inflammation.
- vasodilation of arterioles
- stasis (slows, loss of laminar flow)
- margination
- rolling
- pavmenting (endothelials express ICAM and VCAM adhesion molecules, white cells express integrins, selectins etc)
- migration
- leaky vessels
how do chemotaxis aid migration?
chemical gradient which chemotaxis follow, increasing concentration of complement proteins.
what is the problem with suppuration?
it is walled off so antibiotics and immune cells cannot penetrate so must be drained
what does coagulative and liquefactive necrosis result in?
Coagulative = scarring Liquefactive = hole/cavity
how do you diagnose TB?
PCR and positive Ziehl Neelson stain
what do oncogenes do?
stimulate cell proliferation
what do tumour supressors do?
inhibit cell proliferation, stimulate cell death
what genetics do inherited metabolic disorders have?
autosomal recessive
what is atheroma characterised by?
fatty streak and fibrofatty plaque
