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Principles 2018 > Pathology part 2 > Flashcards

Pathology part 2 Flashcards

1
Q

What happens after acute inflammation?

A

Dependent on;
1.Site– different organs, different capacity for repair, different vascular supplies

  1. Type of injury – severity, pathogenecity of organism
  2. Duration of injury – can be removed, is it sustained
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2
Q

What is resolution?

A

Complete restoration of the tissue to normal after removal of inflammatory components

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3
Q

What does resolution depend upon?

A

Tissue has the ability to repair

Good vascular supply

Easily removable injurious agent

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4
Q

What is suppuration?

A

Pus- contains living, dead and dying cells. Neutrophils, bacteria, inflammatory debris (fibrin)

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5
Q

What is an empyema?

A

When a space is filled with pus and walled off

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6
Q

When does organisation occur?

A

If injury produces lots of necrosis
If injury produces lots of fibrin that isn’t easily cleared
Poor blood supply
Tissue type

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7
Q

What is organisation?

A

Mucosa where damage goes beyond the basement membrane favour healing by organisation and repair, not resolution

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8
Q

What does organisation provide?

A

A scaffold for resolution to occur around

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9
Q

What are erosions and abrasions?

A

Heal rapidly with complete resolution

Basement membrane is in tact

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10
Q

What is a common healing response in all tissues?

A

Granulation tissue formation

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11
Q

Describe granulation

A

Defect is slowly infiltrated by capillaries and then by myofibroblasts

Deposit collagen and smooth muscle cells.

Given constituents it looks very red

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12
Q

What can scarring and fibrosis cause?

A

Loss of function

Contraction

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13
Q

Can the liver regenerate?

A

Yes but can be overwhelmed

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14
Q

What is scarring and fibrosis of the liver?

A

Cirrhosis

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15
Q

What is the result of cirrhosis?

A

Liver failure- can’t remove toxins or make proteins

Vascular disturbance

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16
Q

What is seen microscopically in liver cirrhosis?

A

Thick bands of fibrous tissue

Nodules of regenerative hepatocytes

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17
Q

What is chronic inflammation?

A

Not related to time
No implication of severity
Can occur without preceding acute

18
Q

When is chronic inflammation favoured?

A

> Suppuration, walled off pus, scarring
Persistence of injury- foreign material, keratin
Infectious agent- virus. persistence of infection (mycobacterium)
Type of injury- autoimmune, transplant rejection

19
Q

What is chronic inflammation characterised by?

A

Lymphocyte

Macrophage

20
Q

What is a granuloma?

A

Aggregate of epitheloid histiocytes

21
Q

What causes the formation of granulomas?

A

Foreign bodies
-endogenous >keratin, bone, crystals

-exogenous> talc, asbestos, suture material, oil

22
Q

What infections cause granuloma infection?

A 
Parasites
Worms
Eggs
Syphilis
Mycobacterium- including TB
23
Q

What is cheesey necrosis?

A

Tuberculous granulomas- caseous necrosis

24
Q

What is infarction?

A

Cell death after loss of O2

25
Q

How does hypoxic injury occur?

A

No O2 > no ATP

26
Q

What happens as a result of no ATP?

A

Na/K ATPase fails – increased K, swelling

Calcium pump fails – increased intracellular calcium

27
Q

What does increased intracellular calcium stimulate?

A
  1. ATPase (makes things worse)
  2. Phospholipase (membrane damage)
  3. Proteases (membrane and cytoskeleton damage)
  4. Endonuclease (DNA damage and breakdown)
  5. Mitochondrial permeability (release pro death factors)
28
Q

What is the window for reversible injury in the myocardium?

A

20 minutes

29
Q

What happens to cells as a result of hypoxia?

A

Cells shrink and Become red

Nucleus shrinks and becomes dark

Marginal contraction bands appear

30
Q

What happens in the 1st 24 hours as a result of hypoxia?

A

Cell contents leaked

Complement cascade initiated

Acute inflammation

31
Q

What vascular changes occur as a result of acute inflammation

A 
Vasodilation
Slowing of flow
White cell margination
Rolling
Pavementing
Diapedesis
Chemotaxis
Phagocytosis
32
Q

What is the function of neutrophils?

A

Phagocytic properties

Cytokine production

33
Q

What are the three types of necrosis?

A

Caseous
Liquefactive
Coagulative

34
Q

Define coagulative necrosis

A

cell death with some structure of cells left as “ghost outline” before complete phagocytosis of materials

35
Q

What is the clinical implication of necrosis?

A

Cardiac rupture risk greatest at 3-7 days

36
Q

What happens after acute inflammation?

A

Resolution
Restitution
Suppuration
Chronic Inflammation

37
Q

What are neutrophils replaces by after acute period?

A

Macrophages

38
Q

What does the presence of macrophages show at post mortem?

A

Yellow appearance

39
Q

When does resolution occur?

A

only if short duration of injury and if injury is mild and blood supply is good

40
Q

What is restitution?

A

Gradual process
Progressive scarring
Macrophages are replaced by fibroblasts

41
Q

What is the role of fibroblasts?

A

Lay down collagen
Occurs progressively after 2 weeks
Complete at 6 weels

Principles 2018 (34 decks)

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