Pathology

Question 1

What are the potential causes for a disease?

Answer 1

VINDICATE
Vascular
Infection/Inflammation
Neoplasm
Drugs/toxins
Iatrogenic
Congenital
Autoimmune
Trauma
Endocrine/metabolic

Question 2

What mediators cause vasodilation?

Answer 2

Histamine and NO

Question 3

What is margination?

Answer 3

As the rate of blood flow slows in vasodilation WBCs move to the edges of vessels

Question 4

What do pro-inflammatory mediators cause?

Answer 4

Increased expression of ICAM and Selectin on endothelial cells which bind glycoproteins and integrins respectively on WBC surface

Question 5

What is rolling?

Answer 5

When bonds between endothelial vessel wall cells and WBCs are initially weak and WBCs can move along the walls of the vessels

Question 6

What is the function of chemokines?

Answer 6

They are released from site of injury and bind endothelial cells, then increase the affinity of their binding

Question 7

What is pavementing?

Answer 7

WBCs flatten against the vessel wall

Question 8

What is migration/diapedisis?

Answer 8

WBCs extend pseudopods through gaps in endothelial wall and move out of the vessel

Question 9

What is chemotaxis?

Answer 9

Once outside vessels, WBCs follow concentration gradient towards to site of injury established by chemokines

Question 10

What are examples of chemokines?

Answer 10

C5a
Interleukins
Leukotrines

Question 11

What is the main WBC?

Answer 11

Neutrophil

Question 12

What are the features of neutrophils?

Answer 12

Multilobed (polymorph)

Granulocytes int he cytoplasm

Question 13

What is the function of neutrophils?

Answer 13

Phagocytosis

Question 14

What are the possible outcomes of inflammation?

Answer 14

Resolution
Suppuration
Organisation
Chronic inflammation

Question 15

When will restoration occur?

Answer 15

The site can renew well
Good blood supply
Source of injury removed easily and quickly

Question 16

What is suppuration?

Answer 16

Formation of pus - collection of dead cells

Question 17

When will organisation happen?

Answer 17

Poor blood supply
Extensive cell death and necrosis
Lots of fibrin produced
Tissue type has limited regenerative capacity

Question 18

What can organisation result in?

Answer 18

Granulation tissue

Fibrosis and scarring

Question 19

What is granulation tissue?

Answer 19

Tissue formed to facilitate healing if damage goes beyond basement membrane
Capillaries formed and myofibroblasts lay down collagen and smooth muscle

Question 20

How is fibrosis and scarring formed, and what is the problem with it?

Answer 20

Neutrophils, then macrophages, then fibroblasts lat down collagen
Loss of function

Question 21

What is the predominant cell of chronic inflammation?

Answer 21

Lymphocyte

Question 22

When is chronic inflammation likely?

Answer 22

Suppuration produced walled areas of pus (called abscess or empyema)
Infection is caused by virus or is persistent
Autoimmune cause

Question 23

What can chronic inflammation produce?

Answer 23

Granulomas

Caseous necrosis

Question 24

What are granulomas, why are they formed, and what is a condition that classically causes them?

Answer 24

Aggregate of epithelioid histiocytes or organised collection of macrophages
Formed when immune system cannot eliminate percieved foreign material
Sarcoidosis

Question 25

What are the two causes of cell death?

Answer 25

Necrosis | Apoptosis

Question 26

What are the types of necrosis?

Answer 26

Coagulative - preserved cell outline filled with fibrosis Liquefactive no structure remains Caseous - area of necrosis surrounded by granulomatous inflammation

Question 27

What is apoptosis?

Answer 27

Programmed cell death

Question 28

When is apoptosis physiological?

Answer 28

Normal growth Loss of self-reactive lymphocytes Hormonally resulted processes

Question 29

How does apoptosis occur?

Answer 29

Via caspases that cleave DNA

Question 30

What is the extrinsic pathway of apoptosis?

Answer 30

Loss of growth signals - replacement of anti-apoptotic molecules with Bak and Bax increase permeability of the mitochondria, release proteins that stimulate caspases

Question 31

What is the intrinsic pathway of apoptosis?

Answer 31

Cell membrane receptors bind and activate caspases

Question 32

What is hyperplasia?

Answer 32

Increase in cell number in response to stimulus

Question 33

What is hypertrophy?

Answer 33

Increase in cell size

Question 34

What is atrophy?

Answer 34

Reduction in cell size

Question 35

What is neoplasia?

Answer 35

Any new growth

Question 36

What is a malignant growth?

Answer 36

Growth that has spread path basement membrane the can metastasise - cancer

Question 37

What is a precursor lesion?

Answer 37

A stage where a cell is at high risk of becoming malignant

Question 38

What is metaplasia?

Answer 38

Reversible change from one mature cell type to another

Question 39

What is dysplasia?

Answer 39

Disordered cell growth but no invasion past basement membrane

Question 40

What is carcinoma in situ?

Answer 40

Dysplasia affecting the whole basement membrane - the last stage before malignancy

Question 41

What are features of a benign tumour?

Answer 41

Symmetrical Encapsulated Homogenous Well differentiated

Question 42

What are features of a malignant tumour?

Answer 42

``` Poorly defined and irregular edges Hetrogenous Pleomorphism (all cells look different) High nucleus to cytoplasm ratio Purple when stained Poorly differentiated ```

Question 43

What are the names of benign and malignant squamous epithelium tumours?

Answer 43

Benign - papilloma | Malignant - carcinoma

Question 44

What are the names of benign and malignant glandular epithelium tumours?

Answer 44

Benign - adenoma | Malignant - adenocarcinoma

Question 45

What are the names of benign and malignant mesenchymal tumours?

Answer 45

Benign - _oma | Malignant - _sarcoma

Question 46

What is the grading of a tumour?

Answer 46

How well differentiated

Question 47

What is the staging of a tumour?

Answer 47

How far has it spread - TNM

Question 48

What are the hallmarks of cancer?

Answer 48

``` Sustains proliferative signalling Evading growth suppressors Avoid immune destruction Enabling replicative immortality Tumour promoting inflammation Activating invasion and metastasis Inducing angiogenesis Genome instability and mutation Resisting cell death Deregulating cellular energetics ```

Question 49

What are oncogenes?

Answer 49

Genes that when activated will cause cancer

Question 50

What are porto-oncogenes?

Answer 50

Normal genes involved in cell growth and division which if mutated can cause cancer

Question 51

What are tumour suppressors?

Answer 51

Genes that try to prevent cancer formation

Question 52

What is an example of a tumour suppressor?

Answer 52

p53

Question 53

What is thrombosis?

Answer 53

Intravascular activation of coagulation

Question 54

When is thrombosis more likely?

Answer 54

If Virchow's triad present

Question 55

What is embolism?

Answer 55

Part of thrombosis has dislodges from site of formation and travels until lodges

Question 56

What is ischaemia?

Answer 56

Insufficient blood flow to tissue

Question 57

What is infarction?

Answer 57

Death of tissue due to lack of blood supply and hypoxic cell injury