Pathology Flashcards
1
Q
Define pathology
A
features of a disease
2
Q
Describe the cellular, histopathological and clinical features of acute inflammation
A
- Cell/Histo:Change in vessel calibre, fluid exudate, cellular exudate/chemotaxis
- Clinical: swelling/heat (due to hyperaemia)/pain/loss of function
3
Q
Give an example of acute inflammation
A
Acute peritonitis
4
Q
Describe the cellular, histopathological and clinical features of chronic inflammation
A
- Cell/Histo: Cellular infiltrate and tissue destruction
- Clinical: mouth sores/rashes/fatigue
5
Q
Give an example of chronic inflammation
A
Rheumatoid arthritis
6
Q
List the main causes of inflammation
A
- ) Trauma
- ) Tissue necrosis (tissue death)
- ) Irritation (hypersensitivity)
- ) Physical/chemical agents e.g. radiotherapy
7
Q
Describe and explain the development of granulomas
A
- Granuloma is a collection of histocytes (histocytes are macrophages)
- They present as a form of chronic inflammation (type IV hypersensitivity
- Can be scanned for mycobacterial PCR in case of TB
8
Q
Give 4 examples of granulomatous diseases
A
- ) TB
- ) Sarcoidosis
- ) Crohn’s
- ) Leprosy
9
Q
What is the name of the specific cell involved in TB
A
Langhans giant cell. These cells are formed by the fusion of macrophages. They can phagocytose foreign material
10
Q
Describe and explain the development of fibrosis and scar tissue
A
Add in
11
Q
What is an atheroma?
A
Atheroma = an abnormal accumulation of material in the inner layer of the wall of an artery (also commonly called plaque). It contains: fibrous tissue, cholesterol and lymphocytes
12
Q
What does an atheroma begin as?
A
Begins as a fatty streak
13
Q
Describe the pathogenesis of an atheroma
A
- Damage to blood vessels takes place due to the endothelial damage theory
- This theory states that delicate endothelial cells are destroyed, which allows for platelet aggregation and thrombosis to happen.
- Haemorrhage can take place in the atheroma too
14
Q
What are the risk factors for an atheroma and where do atheroma’s commonly take place in the body?
A
- Main risk factors: cigarette smoking/diabetes mellitus/hyperlipidaemia
- Process takes place in HIGH pressure systems (aorta + systemic arteries) and NOT low pressure systems
- 5 affected arteries: aorta/cerebral arteries/common iliac arteries/coronary arteries/carotid arteries
15
Q
Describe the cellular and histopathological features of an atheroma
A
- aortic aneurysm
- gangrene
- peripheral vascular disease (w intermittent claudication - which is too little blood flow to arms/legs)
- cerebral infarction
- carotid atheroma
- myocardial infarction
16
Q
Define thrombosis
A
x
17
Q
Describe the pathogenesis of thrombosis
A
x
18
Q
What are the histopathological and clinical features of thrombosis
A
x
19
Q
Define embolism
A
x
20
Q
Describe the pathogenesis of embolism
A
x
21
Q
What are the histopathological and clinical features of embolism?
A
x
22
Q
Define infarction
A
x
23
Q
Describe the pathogenesis of embolism
A
x
24
Q
What are the histopathological and clinical features of infarction
A
x
25
Define apoptosis
This is the programmed cell death of individual cells
26
Describe the main pathological features of apoptosis
1.) Changes to cell: get pyknosis, cell shrinkage, bleb formation and karyorrhexis
27
Give examples of apoptosis
- Embryonic development: formation of fingers
| - Removal of cells that are no longer functioning: e.g. in the gut where there is a high cell turnover
28
Why does the process of apoptosis happen?
- Due to DNA damage in a fully differentiated cell
- E.g. single or double strand break, a base alteration
- E.g. cross linkage due to UV light
- E.g. if a resting cell has a resting cell
- Proteins (P53) will sense DNA damage
29
Describe the process of apoptosis
- Remember: via caspases
- BCL2 inhibits caspase and BAX+ (internal trigger) triggers caspases
- Caspases are effector molecules for apoptosis
- Fas receptor (external trigger): if Fas ligand binds to fas receptor then this will activate caspases in the cell to begin the breakdown
30
Define necrosis
This is traumatic cell death
31
Describe the pathological features of necrosis
- Can have liquidative, coagulative or caseous necrosis
| - If it is caseous: this implies TB
32
Give examples of necrosis
- Frostbite
- Cerebral infarction
- Pancreatitis
- Avascular necrosis of the bone
33
Define atrophy
This is a decrease in the size of tissue
34
Describe the pathological features of atrophy
Get a decrease in the number of cells AND a decrease in cell size
35
Give examples of atrophy
- Atrophic brain cerebral atrophy in alzheimer's
- Muscular atrophy
- Optic nerve atrophy
36
Define hypertrophy
This is when cells increase in size (they literally expand in size, they do not divide)!
37
Describe the pathological features of hypertrophy
Have none noted down
38
Give examples of hypertrophy
Organ size increasing e.g. cardiac myopathy
39
Define hyperplasia
Increase in size of tissue
40
Describe the pathological features of hyperplasia
More cells are produced (they don't expand in size)
41
Give an example of hyperplasia
Benign prostate
42
Define dysplasia
This is a change in cells
43
Describe the pathological features of dysplasia
This is a change in cells in the progression to becoming cancer
44
Give an example of dysplasia
Note: remember that focal cortical dysplasia IS NOT dysplasia. Could be a trick exam q
45
Define metaplasia
This is a change in the differention of a cell
46
Describe the pathological features of metaplasia
Cell epithelia can change
47
Give examples of metaplasia
1. ) Smoking: causes ciliated columnar epithelium to become squamous
2. ) Barrett's oesophagus
48
Describe the classification of tumours
add in
49
Define carcinogenesis
This is the change from normal cells to cancer cells. The process requires multiple mutations in the gene
50
What are the main 3 mechanisms that carcinogenesis uses
1. ) Environmental
2. ) Biological
3. ) Human/genetic
51
Give 4 examples of environmental carcinogenesis
1. ) Smoking: increased rates of lung cancer
2. ) Hepatocellular carcinoma common in areas with high rates of hep B/C
3. ) Oesophageal carcinoma: increased risk in Japan/Iran/Turkey due to diet
4. ) Bladder cancer risk in airline and rubber industries due to exposure of B-napthalene
52
Give 4 examples of biological carcinogenesis
1. ) Hormones: increase in oestrogen increases risk of mammary + endometrial cancer
2. ) Mycotoxins: aflatoxin B leads to increased risk in hepatocellular carcinoma
3. ) Parasites:
- Clonorchis sinensis: can lead to cholangiocarcinoma
- Shistoma: increased risk of bladder cancer
4. ) Viruses: human herpes 9 leads to risk of kaposi sarcoma
53
Give 3 examples of human (genetic) carcinogenesis
1. ) Age: increased incidence with older age. Only exception is transplacental carcinogenesis
2. ) Race: decreased risk of skin cancer in black skin
3. ) Females have 200X bigger risk of breast cancer
54
Describe the process of neoplasm invasion
- When a carinoma breaches a basement membrane it becomes an invasive carcinoma
- How they get through the B.M:
1. ) Produce proteases
2. ) Invade veins
3. ) Invade the extracellular matrix on other side of vein
- Also the neoplasm needs to be motile: is motile via tumour cell derived motility factors
55
What 3 things do neoplasm cells do to evade the host immune defence?
1. ) Aggregate with platelets
2. ) Shed off surface antigens
3. ) Adhesion to other tumour cells
56
How do tumours metastasise and remain in the extracellular matrix?
- They have adhesion receptors and produce collagenases to remain in the ECM
- They undergo angiogenesis via producing vascular endothelial growth factor and basic fibroblast growth factor
57
Name the tumours that commonly metastasis to the liver
- Colon
- Stomach
- Pancreas
- Carcinoid tumours of the intestine
58
Name the tumours that commonly metastasis to bone
- Prostate
- Breast
- Thyroid
- Lung
- Kidney
59
Describe the two types of autopsies
1. ) Hospital ones (for audit/teaching/research)
| 2. ) Medico-legal ones (includes coronial and forensic)
60
What deaths are referred to the coroner?
- Natural
- Iatrogenic: abortion/anaesthetic death
- Unnatural: suicide/unlawful killing
61
Four questions for the coronial autopsy to answer
1. ) Who was the deceased?
2. ) When did they die?
3. ) How did they die?
4. ) How did they come about their death?
62
Describe the process of autopsy
- History
- External examination
- Evisceration
- Internal examination
- Reconstruction
