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Patho2 > Practice exam > Flashcards

Practice exam Flashcards

1
Q

What are the red flag questions we would ask with someone who has a suspicion of cancer? (7)

A

Nausea, Generally feeling unwell, Night pain, Strong family history of Cancer, Night sweats, Unexplained weight loss, History of cancer in self (1 mark for each point)

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2
Q

List three symptoms of cauda equina? (3)

A

Bilateral symptoms, Erectile dysfunction, Night pain, Numbness, Saddle anaesthesia, Worsening neurology, Loss of anal tone, Retention of urine (Any of the answers up to three points. 1 mark for each right answer)

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3
Q

List the 5 different meniscal tears? (5)

A

Longitudinal, bucket handle, raidial, flap, horizontal, degenerative (1 mark for each correct point)

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4
Q

Explain the pathophysiology of a frozen shoulder (4)

A

The disease process affects the antero-superior joint capsule, axillary recess,and the coracohumeral ligament (1 mark)
Evidence suggests there is synovial inflammation followed by capsular fibrosis, in which type I and III collagen is laid down with subsequent tissue contraction (1 mark)
Elevated levels of serum cytokines have been noted and facilitate tissue repair and remodelling during inflammatory processes (1 mark)
It is proposed that there is an imbalance between aggressive fibrosis and a loss of normal collagenous remodelling, which can lead to stiffening of the capsule and ligamentous structures (1 mark)

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5
Q

Explain the differences between a CAM, pincer and mixed FAI? (6)

A

Cam impingemenet is where the abnormality is located on the femoral side of the hip joint, the deformity is extra bone formation at the anterolateral head neck junction, causing a non- spherical femoral head (1 mark).
So particularly into flexion and internal rotation , the cam deformity can be forced into the acetabulum causing shearing forces at the chondro labral joint (1 mark)
Pincer impingement is where the abnormality of the acetabulum leading to an over coverage of the femoral head (1 mark).
This can either manefest as a deep acetabular or as a retroverted acetabulum which are most commonly seen anteriorly (1 mark).
This type of impingement can also lead to labral and cartilage damage throughout the acetabulum (1 mark).
Both can exist together. This is called a mixed or a combined FAI (1 mark)

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6
Q

What is a hemiarthroplasty and name one indication for this surgery? (3)

A

Surgical procedure that involves replacing half of the hip joint (1 mark)
Replaces only the femoral head portion of the joint (1 mark)
Can be elective or traumatic (1 mark)
Indications; Fractured femoral neck (from a fall / trauma), avascular necrosis, fracture, non-union, OA (1 mark for any of these points).

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7
Q

How is COPD characterised? (2 marks)

A

COPD is characterised by airflow obstruction that is progressive in severity and not fully reversible.

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8
Q

What conditions does COPD cover? (1 mark- for all 3 no half marks)

A

Chronic Bronchitis, Emphysema and Chronic Asthma.

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9
Q

What are the main causes of COPD? (4 marks)

A

Smoking
Occupational exposure
Alpha 1 antitrypsin deficiency
Social deprivation

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10
Q

What are the 3 main signs in Bronchitis? (3 marks)

A

Inflammation
Increased sputum production
Wheezing from narrowed airways

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11
Q

Define Diabetes. (2 marks)

A

A metabolic disorder (1 mark).It is the absence, deficit or resistance to insulin leading to hyperglycaemia (1 mark).

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12
Q

What are the types of diabetes and what are their associated risk factors? (6 marks)

A 
Type 1 (1 mark) 
Type 2 (1 mark)
Type 1 - Family history, viral infection, autoimmune disease and Type 2 – obesity, hypertension, poor lifestyle, diet, age, ethnicity (1/2 mark for any, max of 4 marks total)
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13
Q

How is each type of diabetes managed? (2 marks)

A

Lifestyle changes (type 2) – “HIITS” & “Starvation diets”, Insulin injections (type 1), Insulin tablets (type 2) (max 2 marks for any of these)

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14
Q

Define Pneumonia (3 marks)

A

Is an inflammatory (1 mark) condition of the lung leading to abnormal alveolar filling (1 mark) with consolidation and exudation (1 mark)

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15
Q

Describe the pathology of pneumonia (4 marks)

A

During pulmonary infection, acute inflammation (1 mark) results in the migration of neutrophils out of capillaries and into airspaces (alveoli) (1 mark), these cells phagocytose and release antimicrobial enzymes and inhibitors (1 mark) → more inflammation and oedema (1 mark)

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16
Q

List 3 potential causes of pneumonia (3 marks)

A 
Bacteria e.g. Streptococcus pneumonia, haemophilus influenza type b (Hib)
Fungi
Virus e.g. respiratory syncytial
Parasites 
Chemical
Aspiration
Inhalation (smoke, burns)
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17
Q

Define cancer. (1 mark)

A

Cancer = Highly invasive and destructive neoplasms (1 mark)

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18
Q

Give any 3 characteristics of a benign tumour. (3 marks)

A 
Benign Tumours
Differentiated cells
Similar to normal cells
Mitosis fairly normal
Relatively slow growth
Expanding mass
Frequently encapsulated
Remains localised
Systemic effects-rare
Only life threatening in certain locations (e.g. brain)
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19
Q

Give any 3 characteristics of a malignant tumour. (3 marks)

A 
Malignant Tumours
Cells vary in size & shape, large nuclei
Many undifferentiated cells
Mitosis increased & atypical
Rapid growth
Cells not adhesive, infiltrate tissue
No capsule
Invades nearby tissue or metastatises to distant sites through blood & lymph vessels
Systemic effects-often present
Life threatening by tissue destruction & spread of tumours
20
Q

State the 3 stages associated with the development of cancer. (3 marks)

A

The initiating event causes a mutation in a cell, changes in the cell DNA. This initial change does not create an active neoplasm. The initiating event may eventually be indentified but many times it is not.
The promoting event is an expansion of the mutated cell’s growth and reproduction. Exposure to “promoters” later causes further changes in DNA, resulting in less differentiation and an increased rate of mitosis
The continued growth of the cell depends on continued exposure to the promoter. Dysplasia (presecence of abnormal cells) or anaplasia (cells that have lost their identity) may be evident at this time. This process leads to development of the tumour.
A common cancer promoter is chronic inflammation. Others include hormones and chemicals in the environment.
Progression is an extension of the promoter stage with one exception: now the cancer growth is no longer dependent on exposure to the promoter. The growth now becomes autonomous. The cell is capable of functioning outside of the rules that regulate cell growth, division and death.

21
Q

a. Draw a picture and label the circulation of the brain. (4 marks)

A

You will only need to label: anterior cerebral artery, middle cerebral artery, posterior cerebral artery, vertebral artery, basilar artery and carotid arteries.

22
Q

b. Describe the areas of the brain affected by a large embolus partially blocking the basilar artery. (2 marks)

A

Basilar artery ischaemic stroke – all of the brainstem, cerebellum and cranial nerves

23
Q

c. Explain the resultant clinical features of this embolus. (4 marks)

A

Clinical features – loss of vital functions such as respiratory control, cardiac control, potential mortality because of this. Less severe problems - balance and coordination difficulties due to the impact on the cerebellum. Lack of control of the face (smell, eyes, mouth, auditory and facial muscles) due to impact on the cranial nerves.

24
Q

a. Give a definition of Parkinson’s disease. (1 mark)

A

Parkinson’s Disease is a chronic, progressive neurodegenerative disorder characterised by tremor and disturbance of voluntary movement, posture and balance

25
Q

b. What is the underlying pathophysiology of Parkinson’s disease? (3 marks)

A

PD results from the degeneration of dopamine producing neurones in the substantia nigra of the basal ganglia. The basal ganglia is an important area for storing of motor memories and initiates and plans movement, it also inhibits unwanted movement. Dopamine is a neurotransmitter. Without dopamine the basal ganglia cannot initiate movement, cannot retrieve motor memories and cannot inhibit unwanted movement.

26
Q

c. Discuss briefly the three main cardinal signs of Parkinson’s disease. (6 marks)

A

Cardinal sign – tremor – resting tremor disappears on movement. Often called a pill-rolling tremor. Due to the lack of dopamine the basal ganglia cannot supress these unwanted movements.
Rigidity – can be felt on passive movement and is an increased resistance to movement in all directions of movement. Can be lead-pipe or cogwheel rigidity. Due to a lack of stimulation of movement pathways and a lack of inhibition of the inhibitive pathways.
Bradykinesia – slow movement – can be seen on functional movement - Due to a lack of stimulation of movement pathways and a lack of inhibition of the inhibitive pathways.

27
Q

a. What are the two main types of Acquired Brain Injury and give examples? (2 marks)

A

Acquired Brain Injuries can be nontraumatic eg. stroke or traumatic eg. open head injury.

28
Q

b. Describe the three main types of TBI. (6 marks)

A

TBI – closed head injury - when the brain is rattled or traumatized inside the skull. Can be Diffuse axonal injury – coup-contracoup or Concussion - temporary disruption of brain function or Intracranial haematoma - ruptured blood vessel results in a pool of blood either around the brain or in between the brain and skull or Cerebral contusion – bleeding in brain.
Open-wound injuries: These injuries are often life-threatening and occur when a blow to the head occurs that is forceful enough to penetrate the skull.
Crushing injuries: Much like how they sound, these types of injuries occur when the brain is compressed between two objects.

29
Q

c. List four immediate signs and symptoms of TBI. (2 marks)

A

Immediate signs – changes in consciousness, headaches and dizziness, vomiting and nausea, difficulty breathing

30
Q

Name the most commonly affected lower limb and upper limb tendons? (2)

A

RC and GT (1 point each)

31
Q

What causes insertional tendinopathy to occur? (5)

A

Overload (1) : stress on the tissue with insufficient recovery periods (too much wear insufficient repair) (1) leading to tissue degradation (1). This is primarily influenced by compression(1) against a bony surface or cam (1).

32
Q

What pathophysiological processes are involved in tendinopathy? (3)

A

Chronic/persistent(1) Inflammation (1) (low grade) and degeneration (1)

33
Q

What is “de Quervains tenosynovitis”? (4)

A

A point will be awarded for each tendon potentially involved = EPB (1) and/or APL (1)
And the identification that this condition is an Inflammation (1) of the synovial sheath (1) around the tendon.

34
Q

What is carpal tunnel syndrome and why does it occur? (6)

A

Carpal tunnel syndrome is the compression (1) of the median nerve within the carpal tunnel (1). This causes symptoms in the median nerve distribution (1). CTS occurs due to swelling in the carpal tunnel (1) or changes to the flexor retinaculum (1). This is often related to changes in one of the 9 tendons that pass through the carpal tunnel (1).

35
Q

Describe the pathophysiological process of Osteoarthritis of the spine (7)

A

Marks given for any 7 of the points below
Degenerative spinal condition (1) involving a cell activated response (1) that leads to eventual degradation of cartilage matrix(1). Activation of cells> Changes to ground substance PG/GAG (1) or H2O content increased (1)> Breakdown of articular cartilage (1)>Fibrillation (1)>Fissures (1)>Gross Ulcerations (1)>Disappearance of articular surface (1)>Osteophyte formation (1)>Thickening of subchondral bone (1)>Synovial membrane changes(1)

36
Q

Describe the pathophysiological process for a spondylosisthesis development (3).

A

There are 3 potential causes in relation to a spondylolisthesis development. (marks given for any of the below.

  1. There may be a Developmental/Congential abnormality/malformation or the pars interarticularis. (1)
  2. Overload of normal bone and degradation/stress fracture (1)
  3. Trauma causing a fracture. (1)
37
Q

Which chromosome is affected in the genetic disease Cystic Fibrosis? (1 mark)
Answer:

A

Chromosome 7 (1 mark)

38
Q

Other than the respiratory symptoms, state 5 other symptoms of Cystic Fibrosis (5 marks)

A

• Diabetes
• Sinusitis
• Nasal Polyps (fleshy swellings that grow from the lining of the nose or sinuses)
• Arthritis
• Osteoporosis
• Infertility
• Liver failure (tiny bile ducts get blocked by mucus)
• Urinary incontinence
• Musculoskeletal system:
- Inspiratory muscle atrophy
- weakness/atrophy in anti- gravity muscles such as the gastrocnemius
- Kyphosis of the spine resulting in neck and back pain
• Delayed puberty

39
Q

When considering genetic risk, what are the 3 possible outcomes for the children of CF carrier parents? (3 marks)

A

1-in-4 chance of having CF (1 mark)
1-in-2 chance of being a carrier of the CF gene (1 mark)
1-in-4 chance of not having CF or being a carrier of the gene (1 mark)

40
Q

What type of respiratory disease is Pulmonary Fibrosis? (1 mark)

A
  • Restrictive
41
Q

What are the possible causes of Pulmonary Fibrosis? (5 marks)

A
  • Smoking
  • Occupational exposure
  • Infection or viruses
  • Link with GORD
  • Genetic link
42
Q

What are the main symptoms of Pulmonary Fibrosis? (4 marks)

A
  • Breathlessness
  • Persistent cough
  • Fatigue
  • Clubbing of the fingers and toes
43
Q

Define cardiovascular disease (CVD) and state specifically where the associated damage occurs (2 marks)

A

– “Cardiovascular disease (CVD) is a general term for conditions affecting the heart and blood vessels” (NHS, 2019) (1 mark)
– It is also associated with damage to the arteries of the brain, kidneys and eyes (1 mark)

44
Q

What are the types of CVD (4 marks)

A

– Coronary Heart Disease (CHD) (1 mark)
– Cerebral Vascular Accidents (CVA) & Transient Ischaemic Attacks (TIA’s) (1/2 mark each)
– Peripheral Vascular Disease (PVD) (1 mark)
– Aortic Disease (1 mark)

45
Q

Define Coronary Heart Disease and state which diseases this includes (2 marks)

A 
–	A disease where the coronary arteries are blocked or narrowed (1/2 mark)
–	Includes the following diseases:
–	Angina (1/2 mark)
–	Myocardial infarction (1/2 mark)
–	Heart failure (1/2 mark)
46
Q

What are the other terms for Coronary heart disease (2 marks)

A

– ischaemic heart disease (1 mark)

– coronary artery disease (1 mark)

Patho2 (22 decks)

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