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Phase 2A: ICS > Pathology > Flashcards

Pathology Flashcards

1
Q

Define pathology

A

features of a disease

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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
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3
Q

Give an example of acute inflammation

A

Acute peritonitis

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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

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5
Q

Give an example of chronic inflammation

A

Rheumatoid arthritis

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6
Q

List the main causes of inflammation

A
  1. ) Trauma
  2. ) Tissue necrosis (tissue death)
  3. ) Irritation (hypersensitivity)
  4. ) Physical/chemical agents e.g. radiotherapy
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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
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8
Q

Give 4 examples of granulomatous diseases

A
  1. ) TB
  2. ) Sarcoidosis
  3. ) Crohn’s
  4. ) Leprosy
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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

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10
Q

Describe and explain the development of fibrosis and scar tissue

A

Add in

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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

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12
Q

What does an atheroma begin as?

A

Begins as a fatty streak

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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
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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
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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
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16
Q

Define thrombosis

A

x

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17
Q

Describe the pathogenesis of thrombosis

A

x

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18
Q

What are the histopathological and clinical features of thrombosis

A

x

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19
Q

Define embolism

A

x

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20
Q

Describe the pathogenesis of embolism

A

x

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21
Q

What are the histopathological and clinical features of embolism?

A

x

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22
Q

Define infarction

A

x

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23
Q

Describe the pathogenesis of embolism

A

x

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24
Q

What are the histopathological and clinical features of infarction

A

x

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25
Q

Define apoptosis

A

This is the programmed cell death of individual cells

26
Q

Describe the main pathological features of apoptosis

A

1.) Changes to cell: get pyknosis, cell shrinkage, bleb formation and karyorrhexis

27
Q

Give examples of apoptosis

A
  • 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
Q

Why does the process of apoptosis happen?

A
  • 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
Q

Describe the process of apoptosis

A
  • 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
Q

Define necrosis

A

This is traumatic cell death

31
Q

Describe the pathological features of necrosis

A
  • Can have liquidative, coagulative or caseous necrosis

- If it is caseous: this implies TB

32
Q

Give examples of necrosis

A
  • Frostbite
  • Cerebral infarction
  • Pancreatitis
  • Avascular necrosis of the bone
33
Q

Define atrophy

A

This is a decrease in the size of tissue

34
Q

Describe the pathological features of atrophy

A

Get a decrease in the number of cells AND a decrease in cell size

35
Q

Give examples of atrophy

A
  • Atrophic brain cerebral atrophy in alzheimer’s
  • Muscular atrophy
  • Optic nerve atrophy
36
Q

Define hypertrophy

A

This is when cells increase in size (they literally expand in size, they do not divide)!

37
Q

Describe the pathological features of hypertrophy

A

Have none noted down

38
Q

Give examples of hypertrophy

A

Organ size increasing e.g. cardiac myopathy

39
Q

Define hyperplasia

A

Increase in size of tissue

40
Q

Describe the pathological features of hyperplasia

A

More cells are produced (they don’t expand in size)

41
Q

Give an example of hyperplasia

A

Benign prostate

42
Q

Define dysplasia

A

This is a change in cells

43
Q

Describe the pathological features of dysplasia

A

This is a change in cells in the progression to becoming cancer

44
Q

Give an example of dysplasia

A

Note: remember that focal cortical dysplasia IS NOT dysplasia. Could be a trick exam q

45
Q

Define metaplasia

A

This is a change in the differention of a cell

46
Q

Describe the pathological features of metaplasia

A

Cell epithelia can change

47
Q

Give examples of metaplasia

A
  1. ) Smoking: causes ciliated columnar epithelium to become squamous
  2. ) Barrett’s oesophagus
48
Q

Describe the classification of tumours

A

add in

49
Q

Define carcinogenesis

A

This is the change from normal cells to cancer cells. The process requires multiple mutations in the gene

50
Q

What are the main 3 mechanisms that carcinogenesis uses

A
  1. ) Environmental
  2. ) Biological
  3. ) Human/genetic
51
Q

Give 4 examples of environmental carcinogenesis

A
  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
Q

Give 4 examples of biological carcinogenesis

A
  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
Q

Give 3 examples of human (genetic) carcinogenesis

A
  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
Q

Describe the process of neoplasm invasion

A
  • 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
Q

What 3 things do neoplasm cells do to evade the host immune defence?

A
  1. ) Aggregate with platelets
  2. ) Shed off surface antigens
  3. ) Adhesion to other tumour cells
56
Q

How do tumours metastasise and remain in the extracellular matrix?

A
  • 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
Q

Name the tumours that commonly metastasis to the liver

A
  • Colon
  • Stomach
  • Pancreas
  • Carcinoid tumours of the intestine
58
Q

Name the tumours that commonly metastasis to bone

A
  • Prostate
  • Breast
  • Thyroid
  • Lung
  • Kidney
59
Q

Describe the two types of autopsies

A
  1. ) Hospital ones (for audit/teaching/research)

2. ) Medico-legal ones (includes coronial and forensic)

60
Q

What deaths are referred to the coroner?

A
  • Natural
  • Iatrogenic: abortion/anaesthetic death
  • Unnatural: suicide/unlawful killing
61
Q

Four questions for the coronial autopsy to answer

A
  1. ) Who was the deceased?
  2. ) When did they die?
  3. ) How did they die?
  4. ) How did they come about their death?
62
Q

Describe the process of autopsy

A
  • History
  • External examination
  • Evisceration
  • Internal examination
  • Reconstruction

Phase 2A: ICS (3 decks)

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