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Biology - Year 2 > Pathology and Medicine > Flashcards

Pathology and Medicine Flashcards

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1
Q

What does acute mean?

What does chronic mean?

A

A rapid onset disease, (but not always followed by rapid resolution)

May follow an acute initial episode and have a prolonged course lasting months or years

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2
Q

What do these prefixes mean?

  • ana
  • dys
  • hyper
  • hypo
  • meta
  • neo
A

Absence

Disordered

Excess over normal

Deficiency below normal

Change from one state to another

New

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3
Q

What do these suffixes mean?

  • itis
  • oma
  • osis
  • oid
  • plasia
  • opathy
A

Inflammatory process

Tumour

Abnormal increase

Bearing resemblance to

Disorder of growth

Abnormal state lacking specific characteristics

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4
Q

What are disease classifications based on?

A

Causes (aetiology) and underlying mechanisms (pathogenesis)

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5
Q

Classification of a disease is commonly based on?
A) The on-set of a disease
B) The reversibility of a disease
C) The name of the doctor who discovered it
D) The mechanism of a disease
E) None of the above

A

D)

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6
Q

What is a congenital disease?

What is the other type of disease classification?

A

Initiated before or during birth, may not manifest until adult life. Can be genetic or non-genetic

Acquired

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7
Q

What is the pathogenesis of a disease?

A

The mechanism through which the aetiology (cause) operates to produce the pathological and clinical manifestations

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8
Q

What is a symptom?

What is a sign?

A

What the patient feels/ complains about

What the doctor is looking for

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9
Q

What is a syndrome?

A

An aggregate of signs and symptoms or a combination of lesions without which the disease cannot be recognised or diagnosed

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10
Q

What is morbidity?

A

The disease state of an individual, or the incidence of illness in a population - the proportion of patients with a particular disease during a given year per given unit of population

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11
Q

What is mortality?

A

The probability death will be the end result of that disease

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12
Q

What is prevalence?

A

The total number of cases of a given disease in a specified population at a designated time (morbidity and incidence refer to new cases)

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13
Q

What is a prospective study?

What is a retrospective study?

What are cross-sectional studies?

A

Subjects are followed over time

Looking back over a period of time

Prevalence between different populations at a particular time

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14
Q

What happens if cytosolic calcium levels increase?

A

It can cause irreversible damage and cells death

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15
Q

What are the four types of necrosis? Describe them.

A

Coagulative necrosis - most common form, occurs in all tissues except brain

Liquefactive/colliquative necrosis - affects cells in the CNS, complete digestion of dead cells results in tansformation of tissue into a liquid viscous mass

Caseous necrosis - found in tuberculosis infection, tissue architecture is completely obliterated

Fat necrosis - occurs during pancreatitis, result of rereleased active pancreatic lipases

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16
Q

What are some of the characteristics of apoptotic cells? (There are 6)

A

Degradation of the cytoskeletal framework

Fragmentation of DNA

Loss of mitochondrial function

Nucleus shrinks (pyknosis) and fragmentation (karyorrhexis)

Cell shrinks but retains intact plasma membrane (which induces phagocytosis)

Apoptotic bodies

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17
Q

Name three components/ processes involved in haemostasis.

A

Vascular wall

Platelets

The coagulation cascade

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18
Q

Name and briefly describe three predisposing factors of thrombosis.

A

Endothelial injury - exposure of underneath ECM, adhesion of platelets and release of tissue factor

Stasis or turbulence of blood flow - turbulence occurs in arteries and stasis occurs in veins

Blood hypercoagulability - in some individuals clotting factors are hyperactive

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19
Q

Name seven risk factors for thrombosis.

A

Prolonged bed rest or immobilisation - causes stasis

Myocardial infarction - activates clotting factors and releases TF

Atrial fibrillation - ventrical can’t pump enough blood causing stasis

Prosthetic cardiac valves - valves different shape so create turbulence

Tissue injury, surgery, fracture, burn - releases tissue factor

Cancer - tumours release TF and cytokines that promote coagulation

Increased age - reduced activity causes stasis

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20
Q

What are the common sites where thrombosis forms?

A

Coronary cerebral and femoral arteries

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21
Q

Venous thrombosis can cause pulmonary infarction true or false?

A

True

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22
Q

In reference to thrombosis what is an embolism?

A

Where part of the thrombus dislodges and travels to other parts in the vasculature

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23
Q

What are the usually consequences of arterial embolisms?

A

Infarction or gangrene

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24
Q

On examination of a heart after autopsy, a myocardial infarct can usually be recognised 2 hours after coronary artery occulsion, true or false?

A

False

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25
Q

How many litres of blood does the healthy 70kg adult male’s body contain?

A

5 litres

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26
Q

What are the four clinical signs of inflammation?

What is the 5th sign added by laesa?

A

Redness, swelling, heat and pain

Loss of function

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27
Q

What is a oedema?

A

An excess of watery fluid collecting in cavities or tissues of the body

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28
Q

What are the main phagocytic cells involved in acute inflammation?

A

Neutrophils

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29
Q

What is hyperplasia?

A

An increase in the number of cells in an organ or tissue (resulting in increased volume of the organ or tissue)

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30
Q

What is hypertrophy?

A

An increase in the size of cells due to synthesis of more structural components (can result in an increase in size of the organ)

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31
Q

What is atrophy?

A

The shrinkage (reduced size) of an organ or tissue from a decrease in cell size or number

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32
Q

What is anaplasia?

A

Lack of differentiation, a hallmark of malignant transformation

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33
Q

What is neoplasia?

A

The process of new growth

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34
Q

The two types of benign epithelial tumours are papillomas and adenoids, where are they found?

A

Papillomas - in skin

Adenomas - in glands

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35
Q

What are malignant epithelial tumours called?

What are malignant connective tissue tumours called?

A

Carcinomas

Sarcomas

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36
Q

What is dysplasia?

A

Disordered growth (loss in uniformity of individual cells)

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37
Q

What are the names of the four valves in the heart?

A

Pulmonary valve

Aortic valve

Tricuspid valve

Mitral valve

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38
Q

What side of the heart does systemic hypertension affect?

What side of the heart does pulmonary hypertension affect?

A

Causes left heart hypertrophy

Causes right heart hypertrophy

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39
Q

What is cardiomyopathy?

When should it be diagnosed?

A

A heart muscle disease of uncertain cause.

Only when all other causes of cardiac failure e.g. hypertension, ischemic heart disease etc have been excluded

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40
Q

Which of the following is a compensatory mechanism for cardiac dysfunction?
A) cardiac hypertrophy
B) release of noradrenaline
C) activation of the renin-angiotensin-aldosterone system
D) release of atrial natriuretic peptide
E) all of the above

A

Answer E

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41
Q

What are the diastolic and systolic pressures that indicate hypertension?

A

A diastolic pressure greater than 89mm Hg

A systolic pressure greater than 139mm Hg

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42
Q

What is the equation for blood pressure?

A

BP = Cardiac output X peripheral resistance

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43
Q

What is an aortic dissection?

A

When blood goes into the media to form a blood-filled channel within the aortic wall

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44
Q

Aortic desiccation, true or false?
A) is a complication of atherosclerosis
B) often commenses distal to the aortic arch
C) is associated with systemic hypertension
D) can occur in patients with inherited connective tissue disorders
E) is usually fatal

A 
A) true
B) false
C) true
D) true
E) true
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45
Q

What is atherosclerosis characterised by?

A

Intimal lesions (atheromatous or fibrofatty plaques) which protrude into and obstruct vascular lumens

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46
Q

What on an ECG indicates a myocardial infarction?

What indicates a past myocardial infarction?

A

ST-elevation

A large q wave

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47
Q

What percentage of blood is made of plasma?

What percentage is composed of cells?

A

55%

40-45%

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48
Q

Where does hematopoesis occur in the first 6wks - 6months of life?

Where does it occur after 6 months?

A

Liver and spleen

Bone marrow

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49
Q

What is the precursor cell of erthrocytes called?

A

Reticulocyte

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50
Q

What are the three essential dietary constituents required for haematopoesis?

A

Iron

Vitamin B12

Folic acid

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51
Q

What is the most common cause of anemia?

A

Iron deficiency

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52
Q

What is megaloblastic anaemia characterised by?

What causes it?

A

Large immature red blood cells (megaloblasts)

Vitamin B12 and folate deficiencies or metabolism problems. Other defects of DNA synthesis

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53
Q 
Which of the following is a cause of anaemia?
A) suppression of red cell proliferation
B) maturation defect in red cells
C) chronic haemorrhage 
D) haemolysis
E) all of the above
A

E

54
Q

What effects do cytokines have on the liver?

How does this impact red cell production?

In what type of disease are cytokines released?

A

Act on the liver to increase hepcidin synthesis

Reduces iron release, inhibits erythropoietin synthesis, causes an overall reduction in RBC synthesis

Chronic inflammatory/neoplastic diseases

55
Q

What are the clinical features of aplastic anaemia?

A

Deficiency in red cells, white cells and platelets, physical findings include bruising, bleeding gums and epistaxis, mouth infections are common

56
Q

What is the cause of thalassemias?

What is the pathogenesis of thalassemias?

How are thalassemias diagnosed?

A

Abnormalities of glob in chain (alpha or beta) synthesis

Imbalanced glob in chain production leads to ineffective erythropoiesis and haemolysis

Hemoglobin electrophoresis can diagnose most specifically, can also use blood count and films

57
Q

In what blood disorder are bite and blister cells found?

A

Glucose-6-phosphate-dehydrogenase-deficiency

58
Q 
Which of the following is a feature of anaemia of chronic diseases?
A) an uncommon anaemia
B) stimulated RBC proliferation
C) impaired Fe utilisation
D) increased haemolysis
E) none of the above
A

C

59
Q 
Clinical presentation of aplastic anaemia includes:
A) anaemia
B) neutropenia
C) thrombocytopenia
D) bone marrow hypocellularity
E) all of the above
A

E

60
Q

What do these definitions of changes in leucocyte counts mean?

  • leucocytosis
  • leucopenia
  • leukaemia
A

Increase in leukocyte cell numbers

Decrease in leukocyte cell numbers

Neoplasia of leucopoietic tissue with a massive increase in total numbers

61
Q

Give at least 5 causes of neutrophilia.

A

Bacterial infection

Inflammation/tissue necrosis

Metabolic disorders

Malignant neoplasia

Drugs (steroids)

62
Q

Give at least 4 causes of neutropenia.

A

Viral infection

Severe bacterial infection

Drug induced e.g. Anti inflammatory agents

Autoimmune e.g. Rheumatoid arthritis

As part of pancytopenia

63
Q

List 4 causes of lymphocytosis.

A

Acute viral infections e.g. glandular fever

Chronic infections e.g. Tuberculosis

Leukaemia

Non-Hodgkin’s lymphoma

64
Q

Of the two types of acute leukaemia which one mostly affects children and which one’s incidence increases with age?

A

Lymphoblastic - mostly in children

Myeloblastic - all age groups, incidence increases with age

65
Q

What are the two types of chronic leukaemia and what age groups do they affect?

A

Myeloid/granulocytic - all age groups

Lymphocytic - >50 years age groups

66
Q 
Lymphocytosis occurs in which of the following conditions?
A) tissue necrosis
B) acute viral infection
C) parasitic infestation 
D) irradiation
E) haemorrhage
A

B

67
Q

One feature of acute leukaemia is:
A) it only affects children
B) blast cells rarely appear in blood films
C) there is no spleen enlargement
D) Reed-Sternberg cells are present in the lymph nodes
E) blast cells are accumulated in the bone marrow

A

E

68
Q

What do these tests of haemostat ice function test for?

  • bleeding time
  • activated partial thromboplastin time (APTT)
  • prothrombin time (PT)
A

Platelet integrity

Test the intrinsic pathway and several factors (12, 11, 9, 8, 10, 5, 2, 1)

Test for the extrinsic pathway and several factors (7, 10, 5, 2, 1)

69
Q

Haemolysis results in what type of bilirubin?

Bile duct blockage results in an increase of what type of bilirubin?

What type of bilirubin is released in liver damage?

A

Unconjugated

Conjugated

Conjugated and unconjugated

70
Q

What sort of test would you use to investigate hepatitis?

A

Serum transferase (which has increased levels in hepatitis)

71
Q

Give at least 4 causes of acute hepatitis.

What is the best test for acute hepatitis?

A

Viruses (hepatitis viruses)

Non-viral infection

Alcohol

Drugs: anti-TB (isoniazid)

Others: pregnancy etc…

Serum ATL

72
Q

What is the mechanism of liver damage for hepatitis A?

A

Cytopathic (virus proliferates in liver cells damaging them) and immunity mediated (by T-cells)

73
Q

What is the mechanism of liver damage by hepatitis B?

A

Immunity mediated (by T-cells)

74
Q

Which type of hepatitis puts you at risk of developing cirrhosis and hepatocellular carcinoma?

A

Hepatitis C

75
Q 
The spread of hepatitis A is mainly by:
A) blood
B) vertical transmission
C) personal contact
D) faecal-oral route
E) all of the above
A

D

76
Q

Give at least 4 causes of cirrhosis.

A

Viral (hep B, hep C and hep D)

Alcohol

Autoimmune hepatitis

Wilson’s disease

Other (e.g. drugs, non-alcoholic fatty liver disease)

77
Q

What type of body is a specific feature for alcohol induced liver damage?

A

Mallory body

78
Q

Which of the following statements is not true about cirrhosis?
A) cirrhosis is a histological diagnosis
B) it is the end result of a variety of chronic liver diseases
C) it is a localised and irreversible process
D) there is fibrosis and distortion of normal structure
E) portal vein hypertension is a complication

A

C (diffuse not localised)

79
Q

Which of the following statements is correct regarding alcoholic liver disease?
A) it is the most common cause of chronic liver disease in the west
B) it is more common in men but also occurs in women
C) alcohol acts as a hepatotoxin
D) alcoholic fatty liver and alcoholic cirrhosis are major pathological lesions
E) all of the above

A

E

80
Q

What are the most frequent diseases in the respiratory tract?

A

Upper respiratory tract infections

81
Q

What is the common cause of community acquired pneumonia?

A

Streptococcus pmeumoniae

82
Q

What age is most affected by bronchopneumonia?

What age is most affected by lobar pneumonia?

A

Old age, infancy and patients with debilitating diseases

Typically healthy adults between 20-50yrs

83
Q

Asthma has the following clinical features except:
A) the patients can be atopic
B) the airways must be hyper-responsive to stimuli
C) occupational exposure to chemicals may play a role
D) the patients may respond to allergens
E) smoking is a aetiological factor

A

E

84
Q

Which of the following is true about emphysema:
A) cigarette smoking and atmospheric pollutants are aetiological factors
B) dilation and distruction of the air sacs distal to the terminal bronchioles
C) there is airway obstruction and airflow limitation
D) an alpha-1 antitrypsin deficiency is responsible for some patients
E) all of the above

A

E

85
Q

What are the three major components of acute inflammation?

A

Vascular dilation - to increase blood flow

Structure changes in the microvasculature to allow plasma proteins and leukocytes to leave the circulation

Emigration of the leukocytes from the microvasculature, their accumulation in the injury site and their activation to eliminate the offending agent

86
Q

What is the dominant cell type activated in acute inflammation?

What is the dominant cell type activated in chronic inflammation?

A

Neutrophils

Macrophages

87
Q

In what type of disease is granuloma formed?

What causes granuloma?

A

Chronic inflammation

Resistance to phagocytosis (macrophage engulfs pathogen but can’t destroy it)

88
Q

Out of the 5 varieties of leucocytes which three are granulocytes?

A

Neutrophils
Eosinophils
Basophils

89
Q

Benign prostatic hyperplasia is
A) a neoplastic enlargement
B) common between 40-60 years old
C) associated with smooth muscle hypertrophy
D) a fibromuscular and glandular hyperplasia
E) mainly a glandular hyperplasia

A

D

90
Q

What are the main symptoms of BPH?

A

Hesitancy in initiation of micturition

Poor stream

Dribbling postmicturition

Frequency and nocturia

91
Q

Can bladder hypertrophy be associated with BPH?

A

Yes

92
Q

Transitional cell carcinomas of the bladder are common in people in their 40s?

A

False, rare in the under 50s

93
Q

Out of these which is a risk factor for transitional cell carcinoma of the bladder?
A) smoking
B) exposure to acryilamides
C) drugs (analgesics and immunosuppressive drugs)
D) radiation
E) all of the above

A

E

94
Q

What type of cirrhosis is found in alcoholic cirrhosis?

A

Micronodular cirrhosis

95
Q

In which type of pneumonia do you find:
A) focal inflammation along airways
B) diffuse inflammation affecting the entire lobe

A

A) Bronchopneumonia

B) lobar pneumonia

96
Q

What is the most common cause of COPD?

What are some of the other causes?

A

Smoking

Atmospheric pollutants and alpha-1-trypsin deficiency

97
Q

What are the three mediators that induce vessel dilation in acute inflammation?

A

Histamine, bradykinin and NO

98
Q

What is extravasation?

A

The movement of leukocytes from the vessel lumen to interstitial tissue in acute inflammation

99
Q

Which vascular mediator (involved in the inflammation reaction) is responsible for pain?

A

Bradykinin

100
Q

Chronic inflammation is characterised by the 5 signs of acute inflammation?

A

False

101
Q

What is the common cause of adenocarcinona in the oesophagus?

A

Barrett’s oesophageal

102
Q

Give 5 factors associated with gastritis in the stomach (inflammation of the gastric mucosa).

A

NSAIDs

Alcohol and tobacco

Bacterial and viral infection

Severe stress

Chemotherapy

103
Q

The chronic infection with which microorganism is linked with gastritis?

A

H. Pylori

104
Q

In people with peptic ulcers what is the most common complication that leads to death?

Name another complication that can lead to death.

A

Perforation, release of acid and gut contents into peritoneum (60% of deaths)

Bleeding (25%) of deaths

105
Q

What are the two types of adenocaecinoma found in gastric cancers? Describe them

A

Intestinal - develops from precursor lesions, mean age 55yrs, moms common

Diffuse, no precursor lesions, mean age 48yrs

106
Q

GI cancers have a genetic component?

A

True

107
Q

People with dermititis herptiformis cannot get Coeliac disease,true or false?

A

False they have a 100% chance of getting coeliac disease

108
Q

What is the name of the protein in gluten that coeliacs are intolerant to?

A

Gliadin

109
Q

What is the only 100% accurate method of diagnosis of coeliac disease?

A

SI biopsy

110
Q

Chrons disease only affects the small intestine true or false?

A

False, it can affect any part of the bowel (mouth to anus) but mostly affects the small and large intestines

111
Q

Which disease of the bowel is characterised by skip lesions? Which disease is characterised by continuous inflammation?

A

Chrons disease

Ulcerative colitis

112
Q

What are the two types of epithelial lesions found in tumours of the GI tract?

A

Adenoma (benign) and adenocarcinoma (malignant)

113
Q

What are the characteristics of nuclear atypia?

A

DNA damage, micro satellite instability, defect in DNA repair throughout the entire GI tract

114
Q

What type of polyp is linked to risk of cancer?

A

Villous polyps, risk of cancer is proportional to proportion of polyp which is villous

115
Q

A mutation in what gene is responsible for familial adenomatous polyposis (FAP)?

A

Adenomatous polyposis coli (APC) gene

116
Q

Which node is the pacemaker of the heart?

A

SA node

117
Q

What is the most important event in the formation of atherosclerosis?

A

Endothelial injury

118
Q

What are the clinical manifestations of ischemic heart disease?

A

Angina

Myocardial infarction

Sudden cardiac death

Heart failure

119
Q

What is
A) anisocytosis
B) poikilocytosis
C) anisochromasia

A

Variation in size

Variation in shape

Variation in Hb (change of colour)

120
Q

What is the pathogenesis of anemia of chronic diseases?

A

Cytokines driven inhibition of RBC production

121
Q

In what condition are bite and blister cells found?

A

Glucose-6-phosphate-dehydrogenase deficiency

122
Q

What type of leukaemia is due to a chromosomal abnormality between chromosomes 22 and 9?

A

Chronic leukaemia

123
Q

What clotting factors require vitamin K for synthesis?

A

2, 7, 9 and 10

124
Q

What is a common cause of glomerulonephritis?

Golmerulonephritis can be chronic or acute true or false?

A

The immune system attacking healthy body tissue

True

125
Q

What happens in nephrotic syndrome?

A

Damage to the glomeruli in the kidney causes large molecular weight proteins such as albumin to be excreted in the urine

126
Q

What are
A) pre-renal
B) intrinsic renal
C) post renal

Causes of acute renal failure?

A

A) shock, hypovolemia
B) acute tubular necrosis
C) obstruction

127
Q

What are some of the major causes of chronic renal failure?

A

Diabetes

Hypertension

Glomerulonephritis

Pyelonephritis

Cystic renal disease

Nephrotoxins

128
Q

Below what glomerular filtration rate does chronic renal failure stop being asymptomatic?

Above what serum urea level are symptoms of CRF common?

A

GFR 40mmol/L

129
Q

Painless heamaturia is a symptom of bladder cancer, true or false?

A

True

130
Q 
Describe these types of urinary incontinence
A) urge incontinence
B) stress incontinence
C) overflow incontinence
D) functional incontinence
A

A) due to detrusor (smooth muscle of bladder) overactivity secondary to infection or central nervous factors

B) occurs when intra-abdominal pressure is increased (e.g. cough, sneeze), common in women after childbirth

C) leakage of urine from full distended bladder, after spinal injury or prostatic obstruction

D) inability to reach a toilet

131
Q

Painless haematuria is a symptom of cystitis, true or false?

A

False

Biology - Year 2 (9 decks)

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