Pathology

Question 1

Pathogenesis is defined as…

Answer 1

The sequence of events from a healthy state to clinical disease

Question 2

Some sequelae of coronary artery thromobosis are?

Answer 2

Myocardial infarction, arrhythmias, ischaemia, angina, heart failure

Question 3

Physical characteristics of inflammation include…

Answer 3

Redness, heat, swelling, pain, loss of function

Question 4

Redness and heat assoc with inflammation is due to…

Answer 4

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

Question 5

Necrosis is defined as…

Answer 5

(premature) Cell death

Question 6

Apoptosis is defined as…

It is useful because…

Answer 6

Programmed cell death

Get rid of damaged, dead cells and debris

Question 7

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

Answer 7

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

Question 8

Suppuration is…

Answer 8

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

Question 9

Organisation of tissues after inflammation is their replacement by _____ tissue

Answer 9

Granulation

Question 10

Describe how granulation tissue is formed?

Answer 10

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

Question 11

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

Answer 11

False

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

Question 12

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

Answer 12

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

Question 13

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

Answer 13

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

Question 14

An example of an area where liquifactive/colliquative necrosis would occur?

Answer 14

Brain

Liquid myelin sheath of nerve fibres remains after brain substance dies

Question 15

An example of caseous necrosis?

Answer 15

Tuberculosis

Question 16

An example of an area where fibrinoid necrosis would occur?

Answer 16

Blood vessels (most common in liver)
Walls replaced by fibrin

Question 17

Principle causes of acute inflammation include…

Answer 17

Bacterial and viral infections
Hypersensitivity
Trauma
Chemicals and irritants

Question 18

The 3 phases of acute inflammation are:

Answer 18

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

Question 19

What happens in transendothelial migration?

Answer 19

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

Question 20

What is the effect of histamine?

What is it released by?

Answer 20

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

Question 21

Chronic inflammation is associated with the presence of…

Answer 21

Lymphocytes, macrophages, plasma cells

Formation of granulation tissue -> fibrosis

Question 22

Characteristic appearances of chronic inflammation include…

Answer 22

Ulcer formation
Abscess cavities/suppurative inflammation
Granulomatous inflammation
Fibrosis

Question 23

A granuloma is defined as…

Answer 23

An aggregate of epitheloid histiocytes (macrophages etc)

Question 24

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

Answer 24

False

Multiply continually - stable cells only multiply after stimulus

Question 25

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

Answer 25

False | Surgical scar is left - minimal granulation tissue and fibrosis

Question 26

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

Answer 26

False | Autosomal recessive!

Question 27

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

Answer 27

True

Question 28

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

Answer 28

False | Type 2 has no autoimmune assoc.

Question 29

Hyperplasia is defined as...

Answer 29

Enlargement due to increase in cell number

Question 30

Hypertrophy is defined as...

Answer 30

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

Question 31

Atrophy is defined as...

Answer 31

Reduction in size due to decrease in cell size and number

Question 32

Hypoplasia is defined as...

Answer 32

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

Question 33

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

Answer 33

Hyperplasia, hypertrophy and atrophy

Question 34

Metaplasia is defined as...

Answer 34

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

Question 35

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

Answer 35

Squamous, glandular

Question 36

Stable cells divide upon stimulation. Examples include...

Answer 36

Hepatocytes | Fibroblasts

Question 37

Permanent cells are not able to divide further. Examples include...

Answer 37

Neurones Skeletal muscle Cardiac muscle

Question 38

Senescence is defined as...

Answer 38

Deterioration of function of cells

Question 39

Some characteristics of benign neoplasms

Answer 39

``` Resemble normal No invasion Well differentiated Normal mitotic figures DO NOT METASTASISE ```

Question 40

Some characteristics of maligant neoplasms

Answer 40

Invasive Varied differentiation Abnormal mitotic figures Necrosis is common

Question 41

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

Answer 41

False | Derived from epithelial tissue

Question 42

Sarcomas are derived from which type of tissue?

Answer 42

Mesenchymal tissue

Question 43

Squamous papillomas and adenomas are examples of which neoplasms?

Answer 43

Benign

Question 44

Neoplastic cells are monoclonal. What does this mean?

Answer 44

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

Question 45

What is dysplasia?

Answer 45

Disordered Growth - A pre-malignant process that involves altered differentiation

Question 46

What is angiogenesis?

Answer 46

Formation of new blood vessels Angiogenesis signal: VEGF

Question 47

What happens when angiogenesis becomes pathological?

Answer 47

Control of formation is lost - vessels formed are abnormal (i.e. leaky)

Question 48

What are the modulators of angiogenesis? What is the inhibitor?

Answer 48

Hypoxia, VEGF, TNFa | Thrombospondin-1 is the inhibitor

Question 49

Sarcomas metastasise by which route?

Answer 49

Haematogenous

Question 50

How can radiation cause cancer?

Answer 50

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

Question 51

Name some examples of classical proto-oncogenes (stimulate cell division)

Answer 51

PDGF ras src

Question 52

Name some examples of tumour suppressor genes

Answer 52

p53 | BRCA-1

Question 53

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

Answer 53

False | Low risk

Question 54

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

Answer 54

True

Question 55

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

Answer 55

True

Question 56

Duke's Stage A means...

Answer 56

Cancer is confined to wall

Question 57

Duke's Stage B means...

Answer 57

Cancer penetrates wall

Question 58

Duke's Stage C means...

Answer 58

Lymph node metastasis

Question 59

Duke's Stage D means...

Answer 59

Metastatic disease

Question 60

T1 staging means...

Answer 60

Invasion of submucosa

Question 61

T2 staging means...

Answer 61

Invasion of muscularis propria

Question 62

T3 staging means...

Answer 62

Invasion of tissues

Question 63

T4 staging means...

Answer 63

Invasion of nearby organs

Question 64

N0 staging means...

Answer 64

No lymph node metastasis

Question 65

N1 staging means...

Answer 65

1-3 lymph nodes affected

Question 66

N2 staging means...

Answer 66

4+ lymph nodes affected

Question 67

Which type of emboli are associated with significant injury?

Answer 67

Fat

Question 68

How large does an air/gas embolus have to be to cause a functional effect?

Answer 68

100ml

Question 69

Which type of embolus is a rate complication of child birth?

Answer 69

Amniotic

Question 70

What fungus associated with peanuts are carcinogenic?

Answer 70

Aflatoxin

Question 71

What chemical associated with dyes are carcinogenic? What type of cancer is it commonly associated with?

Answer 71

Beta-napthylamine | Bladder cancer

Question 72

What is the common mechanism used by cancer sells to resist cell death?

Answer 72

BCL-2 upregulation which binds Bax/Bak

Question 73

What is the common mechanism used by cancer sells avoid immune destruction?

Answer 73

Upregulation of Programmed Death - Ligand 1 (PD-L1) to inhibit T cell proliferation

Question 74

Describe the extrinsic apoptotic pathway.

Answer 74

Death receptor activated (i.e. via TNF, Fas) which activates Caspase 8, which in turn activates Caspase 3

Question 75

Describe the intrinsic apoptotic pathway.

Answer 75

Mitochondrial Pathway (i.e. via Bax/Bak) which increases mitochondrial permeability releasing proteins (Cytochome C) that stimulate Caspase 3

Question 76

How does hypoxic injury affect cellular biochemistry?

Answer 76

Failure of Na+/K+ ATPase -> increased intracellular K+ leading to swelling Failure of Ca2+ pump -> increased intracellular Ca2+

Question 77

What is the difference between a blood clot and a thrombosis?

Answer 77

Clot - extravascular | Thrombosis - intravascular

Question 78

What role does PTEN have in the cell cycle?

Answer 78

Tumour Suppressor - increases p27 transcription; P27 then blocks CDKs and cell cycle progression

Question 79

What is a telomere?

Answer 79

TTAGGG repeats that protect chromosome ends and dictate the replication number for a cell (AKA Hayflick Limit)