Pathology

Question 1

AAA- organism that causes it?

Answer 1

Mycotic aneurysm- Staph, Strep, salmonella

Question 2

Marjolin’s ulcer?

Answer 2

chronic venous ulcer under gone malignant change

Question 3

Suprachiasmatic nucleus of the hypothalmus?

Answer 3

SCN- regulates circadian rhythm
VMN- loss of satiety
spur-optic nucleus- loss of ADH regulation

Question 4

Signs of UMN and LMN lesions

Answer 4

LMN Lesions
 Anterior horn cells to peripheral nerves
 Wasting
 Fasciculation
 Flaccidity: ↓ tone
 Hyporeflexia
 Down-going plantars 

UMN Lesions
 Motor cells in pre-central gyrus to anterior horn cells
in the cord
 Pyramidal weakness: extensors in UL, flexors in LL
 No wasting
 Spasticity: ↑ tone ± clonus
 Hyperreflexia
 Up-going plantars

Question 5

Effects of raised ICP?

Answer 5

hypertension
bradycardia
low RR
gastric ulceration (cushing’s ulcer)

Question 6

Action of CCK?

Answer 6

Released by I cells in duodenum and jejenum
increased contraction of gallbladder
relaxation of sphincter of Oddi

Question 7

Action of Gastrin?

Answer 7

Released from G-cells in stomach

to increased production of gastric acid from parietal cells in stomach

Question 8

action of Secretin?

Answer 8

Released from duodenum

to regulate water homeostasis throughout the body

Question 9

Action of Somatostatin?

Answer 9

Released from delta cells of Islet of Langherans in pancreas

to inhibit growth hormone release from somatotrope cells

Question 10

What is harmatoma?

Answer 10

tissues that are normal to an area but growing in a disorganised manner

Question 11

What is dumping syndrome?

Answer 11

There are two types of dumping syndromes resulting from rapid gastric emptying:

• early dumping which manifests by dizziness, sweating and palpitations within 5-45 min after eating
• late dumping occurs 2-4 h after eating and is due to rebound hypoglycaemia, small meals and glucose help to improve symptoms.

Question 12

Barrett’s oesophagus cell change?

Answer 12

squamous epithelium—> columnar epithelium

Metaplasia

Question 13

Where do most prostate cancers arise from?

Answer 13

Peripheral zone- 75%

Question 14

how may a left sided renal tumour present?

Answer 14

A renal tumour may present with a left varicocele as the left testicular vein drains into the left renal vein which may be occluded by tumour.

Question 15

What is schistosomiasis related to

Answer 15

SCC of bladder
Deletion of chromosome 9 is the most common chromosomal abnormality, along with alterations in the tumour suppressor genes p53 and Rb

Question 16

Most common germ-cell tumour of testes?

Answer 16

Seminoma

Question 17

Cause of Chagas disease?

Answer 17

The causative organism is Trypanosoma brucei

Chagas disease is caused by the parasite Trypanosoma cruzi which is found in South America. The parasite Trypanosoma bruce (along with Trypanosoma gambiense causes sleeping sickness and is found in Africa. It can cause symptoms similar to achalasia

Question 18

Likely to see on a blood film for splenectomy pt?

Answer 18

Howell–Jolly bodies
One of the functions of the spleen is the sequestration and phagocytosis of old or abnormal red cells. Therefore, in a post-splenectomy patient, red cell inclusion bodies may be present, producing target cells, Howell-Jolly bodies and sideroblasts. Howell-Jolly bodies are nuclear remnants that are removed by the spleen, and are seen in the blood post splenectomy.

Question 19

Cells in Hodgkin’s lymphoma?

Answer 19

Reed-Sternberg cells

Risk factors for HL: EBV, HIV, transplant, reduced exposure to childhood infections

Question 20

Causes of splenomegaly?

Answer 20

Lymphoma
Sarcoidosis
RA
Felty’s symdrome- low WCC, splenomegaly, RA

Question 21

Stages of fracture healing?

Answer 21

Fracture haematoma, vascular granulation tissue, sub-periosteal osteoblast stimulation, bone matrix deposition, endochondral formation, callous formation, remodelling

The fracture line releases blood which creates a fracture haematoma, resulting in a sequence of events that ends in soft then hard callous formation. Remodelling due to on-going forces on the bone continues, sometimes for years after the original fracture

Question 22

Features of Ewing’s

Answer 22

Small round blue cell tumours are a group of tumours characterised by the presence of undifferentiated cells that stain blue at histology. In Ewing sarcoma, plain X-rays do not usually reveal the full extent of bone involvement. Computed tomography scan and magnetic resonance imaging are better for defining the extent of disease and can help guide treatment. Many other benign and malignant tumours can have identical appearances, so diagnosis is made by biopsy. Ewing sarcoma is commonly seen at this age.(15) It is malignant. Most tumours develop in the extremities, but any bone can be involved. Ewing tumour tends to be extensive, sometimes involving the entire bone shaft. Pain and swelling are the most common symptoms. Lytic destruction is the most common X-ray finding, but multiple layers of subperiosteal reactive new bone formation may produce an onion skin appearance.