Quick Facts 2 Flashcards
Deposition of which of the following material in an atheroma decreases the compliance of the tissue and makes local formation of a thrombus more likely?
A. Calcium
B. Cholesterol
C. Collagen
D. Fibrin
E. Free fatty acids
calcium
What cell type are mature neutrophils derived from?
A. Lymphoblasts
B. Macrophages
C. Mast cells
D. Monoblasts
E. Myeloblasts
Myeloblasts
What cell type are mature mast cells derived from?
A. Lymphoblasts
B. Macrophages
C. Myeloid progenitor cell
D. Monoblasts
E. Myeloblasts
Myeloid progenitor cells
What cell type are mature monocytes derived from?
G. Lymphoblasts
H. Macrophages
I. Monoblast
J. Megakaryocyte
K. Myeloblasts
Monoblast
What should the range of the QRS duration be in a normal ECG?
A. 20 ms
B. 20-30 ms
C. 30-60 ms
D. 60-100 ms
E. 100-150 ms
60-100ms
What is the main lipid component of an atheroma?
A. Cholesterol
B. Free fatty acid
C. High density lipoprotein
D. Low density lipoprotein
E. Unsaturated fatty acids
LDL
Symptoms of this condition include orthopnea and paroxysmal nocturnal dyspnea. It is associated with an elevated B-type natriuretic peptide (BNP) level.
A. aortic stenosis
B. congestive heart failure
C. left ventricular failure
D. mitral stenosis
E. right ventricular failure
Left ventricular failure
5 Which of these drugs block the muscarinic cholinergic receptors in the smooth muscles of the bronchi in the lungs?
A. Aminophylline
B. Atenolol
C. Beclomethasone
D. Ipratropium
E. Nifedipine
Ipatropium
9 As a consequence of chronic insufficient alveolar ventilation, which cardiac condition presents as breathlessness together with a raised jugular venous pressure and peripheral oedema?
A. Aortic stenosis
B. Endocarditis
C. Left ventricular failure
D. Mitral stenosis
E. Right ventricular failure
right ventricular failure
11 A 19 year old woman was seen by her general practitioner with general malaise and a sore throat. On examination she had a temperature of 39oC, an inflamed throat and generalised lymphadenopathy. Her blood count was normal apart from a lymphocytosis. Many of the lymphocytes appeared reactive. What is the diagnosis?
A. Bacterial pneumonia
B. Human immunodeficiency virus (HIV)
C. Infectious mononucleosis (glandular fever)
D. Pertussis
E. Viral pneumonia
Infectious mononucleosis (glandular fever)
12 At what stage in erythrocyte development does haemoglobin mainly accumulate in the cell?
A. Early erythroblast
B. Haemocytoblast
C. Late erythroblast/normoblast
D. Proerythroblast
E. Reticulocyte
Late erythoblast / normoblast
In the developing erythrocyte, where is the predominant site of haem production?
A Endoplasmic reticulum
B Golgi apparatus
C Mitochondria
D Nucleus
E Cell membrane
Mitochondria
The gene EPO, which encodes the protein erythropoietin, is found on which chromosome?
A 1
B 22
C 7
D 16
E 11
7
Which of the following is considered a polymorphonuclear leucocyte?
A T lymphocyte
B B lymphocyte
C Natural killer cell
D Neutrophil
E Monocyte
Neutrophils:
Polymorphonuclear leucocytes (PMLs) are considered types of white blood cells that contain granules. Granules are secretory vesicles contained within some leucocytes that are released in response to different stimuli including infections and allergic reactions. Consequently, PMLs may also be referred to as granulocytes.
Approximately, what proportion of blood is composed of haematocrit?
A 15%
B 25%
C 45%
D 65%
E 85%
45
Which of the following cell types develops from the lymphoid cell line?
A Natural killer (NK) cells
B Monocytes
C Basophils
D Neutrophils
E Erythrocytes
NK cells
Which of the following is considered the normal percentage of reticulocytes on the full blood count?
A 1-2%
B 5-6%
C 8-10%
D 12-15%
E <0.5%
1-2%
Label A-G
2 List three classes of drug which can be used for rate control in atrial fibrillation. (3 marks)
Beta blockers, calcium channel blockers, amiodarone, cardiac glycosides
Which dermatomes does angina commonly spread to? [3]
left C3, 4 or 5 dermatomes (1 mark).
List two ECG changes that are commonly be seen during episodes of angina. (2 marks)
Transient ST-segment elevations
Dynamic T-wave changes:
ST depressions
(any two )
6 Explain why the immune system has a particular problem when dealing with tuberculosis infection. (3 marks)
Macrophages ingest the bacteria (1 mark) but find it difficult to destroy them as they have a thick waxy cell wall (1 mark) rich in mycolic acid (1 mark) which resists breakdown in lysosomes (1 mark) ( any marks up to 3)
What aspect of cell wall makes M. tuberculosis difficult t break down by lymphocytes? [1]
Mycolic acid
9 Where in the body are structures that a) measure blood volume b) measure blood osmolarity. [2 marks]
a) atria (1 mark)
b) hypothalamus (1 mark)
10 List FOUR stages in haemostasis involving platelets that do not involve
the coagulation cascade. [Total 4 marks]
1) Platelets adhere to collagen (1/2 mark) in vessel wall exposed by damage (1/2 mark)
2) von Willebrand factor binds to exposed collagen and platelets, increasing platelet adherence (1 mark)
3) Adherent platelets secrete ADP, thromboxane A2 calcium ion and serotonin (1/2 mark each up to 1 mark) (1/2 mark for “platelets secrete factors which promote plug formation”)
4) Platelets change shape (1/2 mark) due to the release of calcium to form extensions which lock the platelets together and form a platelet plug (1/2 mark)
11 Explain how a blood clot in a damaged blood vessel is removed when the vessel is healed. [2 marks]
- Plasminogen is a plasma protein which is converted to the active form plasmin (1/2 mark) by tissue plasminogen activator (TPA) (1/2 mark).
- Plasmin breaks down fibrin in clots (1/2 mark) and they then break up.
- TPA is released from intact endothelium but is suppressed by injured tissue (½ mark).
- When the wound has healed TPA is released to activate plasmin (1/2 mark).
Which of the following is not associated with an irregularly irregular pulse?
A Atrial fibrillation
B Atrial flutter with variable block
C Ventricular ectopics
D Atrial ectopics
E Wolff-Parkinson-White syndrome
WPW syndrome
The results of this test demonstrate intermittent episodes of atrial fibrillation.
What the most appropriate management option for this patient?
A Warfarin and metoprolol
B Dabigatran monotherapy
C Amiodarone
D Digoxin
E Flecainide
Flecainide: Flecainide is a class 1c anti-arrhythmic agent. This type of regime is typically described as “pill-in-the-pocket”. When patients start to experience symptoms they are meant to take the medication, which should cease the abnormal rhythm. Flecainide is generally reserved for patients without underlying structural heart disease, who have infrequent episodes that last < 24 hours.
Which testicular cancers are filled with lymphocytes? [1]
seminoma
What is this? [1]
Explain?
Acute Myeloid Leukaemia:
Auer rodsare red staining, needle-like bodies seen in the cytoplasm of myeloblasts, and/or progranulocytes in certain leukemias.Auer rods(see arrow in image) are cytoplasmic inclusions which result from an abnormal fusion of the primary (azurophilic) granules.
Define pancytopenia [1]
Pancytopeniais a condition that occurs when a person has low counts for all three types of blood cells: red blood cells, white blood cells, and platelets.
State two things that would suggest have AML from a blood smear? [2]
pancytopenia
Auer rodsare red staining, needle-like bodies seen in the cytoplasm of myeloblasts, and/or progranulocytes in certain leukemias.Auer rods(see arrow in image) are cytoplasmic inclusions which result from an abnormal fusion of the primary (azurophilic) granules.
What pathology would be indicated from this blood film? [1]
Acute myeloid leukaemia auer rods
How would determine a patient has acute lymphoblastic leukaemia? [1]
In acute lymphoblastic leukemia (ALL), too many immature lymphocytes are present in the bone marrow and the blood. Normally, these cells are relatively rare, but in ALL, they continuously multiply and are overproduced by the bone marrow, causing fatigue, anemia, fever, and bone pain due to the spread of these cells into the bone and joint surfaces
How would Chronic Lymphoid Leukemia present on a blood film? [1]
PBS: high nuclear:cytoplasm ratio, nuclei of different cells look granular
How would Chronic Lymphoid Leukemia present on a blood film? [1]
PBS: high nuclear:cytoplasm ratio, nuclei of different cells look granular
Name a cause of pencil cells in a blood film [1]
IDA
What is the arrow pointing to? [1]
Reticulocyte
Teardrop cell is a sign of what type of anaemia? [1]
Macrocytic
On a granuloma, describe the location of lymphocytes compared to macrophages [1]
Macrophage inside; lymphocytes outside
What is this cell histology? [1]
Lepidic tumor cells proliferating along the surface of intact alveolar walls without stromal or vascular invasion pathologically
Name 4 reasons why get non-obstructive canalicular cholestasis? [4]
- no inflammation – so called ‘bland’ cholestasis, which can occur due to:
- Pregnancy,
- Drugs or toxins,
- Acute hepatitis or
- Sepsis
Which is nromal and which is pathological and why?
LHS – normal
RHS – hepatocellular carcinoma
* Bigger cells
* Bigger nucli
* Lack of structure
* Looks more aggressive
What is cholangiocarcinoma? [1]
cholangiocarcinoma: Bile duct cancer
What is pancarditis? [1]
Pericarditis + endocarditis + myocarditis
Renal Artery
Proximal Tubule
Interlobar Artery
Arcuate Artery
Interlobular Artery
Collecting Duct
Arcuate Artery
Usually liver adenocarcinoma metastastis from where? [1]
Usually adenocarcinoma metastasises from the rectum/intestines via the hepatic portal vein. The presence of glands containing simple columnar epithelium is easily noticeable.
Normal Liver
Cirrhosis
Hepatitis
Hepatocellular
Carcinoma
e) Metastatic Adenocarcinoma
Normal Liver
Cirrhosis
Hepatitis
Hepatocellular
Carcinoma
e) Metastatic Adenocarcinoma
Normal Liver
Cirrhosis
Hepatitis
Hepatocellular
Carcinoma
Metastatic Adenocarcinoma
Hepatitis
Inflammatory cell invasion into the hepatic tissue, especially within the sinusoids. Inflammation of the liver = hepatitis.
Arrow is indicating a lymphocyte.
Intracellular oedema occurs after how many hours in MI? [1]
12-24 hours:
also get: hypereosinophilia and coagulative necrosis of cardiomyocytes
How long ago did an MI occur based off this histology? [1]
0-12 hrs
How long after an MI do the green and yellow arrows represent? [2]
green: 12 to 24 hours
yellow: 10 to 14 days.
Which photo represents neutrophil inflammation after 3-4days and which represents macrophages and lymphocyte infiltration with early removal of necrotic debris after 7-10 days?
formation of microvessels occurs during which stage post-MI? [1]
formation of microvessels: 7-10 days during granulation process
Describe the difference in the degeneration between these two slides of hepatic injury [2]
Foamy cells in hepatic cells would indicate damage from what mechansim? [1]
Biliary deposits cause a foamy, swollen appearance of the hepatocytes
The degenerated hepatocytes shown here are from a case of biliary obstruction. Retained bile salts cause enlargement of and gives a foamy appearance to hepatocytes.
Bile is toxic to hepatocytes. With time these hepatocytes would die and be phagocytized by Kupffer cells.
State the difference between the aroows to the side and to thr top in these hepatocytes [2]
What do the arrows point to in these injured hepatocytes? [1]
Councilman Bodies: Eosinophilic globule with often fragmented nucleus. It represents a hepatocyte that is undergoing apoptosis
What are the Councilman bodies and which cells do you find them in? [1]
Formation of Councilman Bodies- Eosinophilic globule with often fragmented nucleus. It represents a hepatocyte that is undergoing apoptosis
Injury to the liver which associate with an influx of acute or chronic inflammatory cells is called []
Injury to the liver which associate with an influx of acute or chronic inflammatory cells is called hepatitis
Describe the histological differences between acute and chronic viral hepatitis [2]
Spotty necrosis is a sign of what damage to hepatocytes? [1]
acute viral infection
This liver histology shows cirrhosis. State what the top arrow is [1]
regenerative nodules
Describe the pathology shown in this hepatocyte slide [1]
Cholestatic Syndrome (Jaundice)
What is this histological pathology of the liver? [1]
** Hepatocellular carcinoma** – this time on cut-surface (After slicing the liver). Histology (right hand side) shows disordered growth of hepatocytes with thick hepatic plates.
A form of chronic immune [] induced by antibodies reacting in situ to endogenous or planted glomerular antigens refers to what pathology? [1]
A form of chronic immune complex glomerulonephritis induced by antibodies reacting in situ to endogenous or planted glomerular antigens.
Glomerulonephritis: describe the biopsy features [2]
What is the primary cause of this in 80% of the time? [1]
- Podocytes show effacement of foot processes
- progressive thickening, glomeruli may become sclerosed
caused by autoantibodies against podocyte antigens.
What pathology does this indicate? [1]
Membranous glomerulonephritis characterised by thickening of glomerular basement membrane due to presence of subepithelial immune deposits
The staining of which antibody would indicate glomerulonephritis? [1]
One of the causes of glomerulonephritis is the autoimmune disease []
One of the causes of glomerulonephritis is the autoimmune disease systemic lupus erythematosus (SLE)
What is highlighted in this biopsy of glomerulonephritis? [1]
Dense deposits along Basement membrane
What is this disease ? [1]
Diabetic nephropathy: Note the thickening of the mesangial basement membrane and matrix
What is does this histological slide indicate of the renal system? [1]
(2) renal vascular lesions, principally arteriolosclerosis;
Renal cell carcinoma predominately arised from which kidney tissue? [1]
Tubular epithelial cells: clear cell carcinoma is most common form and arises from PCT
What type of cancer is referred to as ‘small round blue cell tumour’ [1]
Wilms tumour
What type of cancer is referred to as ‘small round blue cell tumour’ [1]
Wilms tumour
What are the most common type of renal cell carcinoma? [1]
Clear cell carcinoma
This shows clear cell carcinoma. What organ does it arise from and which gene is implicated in this cancer? [1]
Renal cells; PCT
- VHL gene also is involved in the majority of sporadic clear cell carcinomas (von Hippel-Lindau disease)
What does the arrow show that indicates this person has Graves disease? [1]
scalloping
Is this Gaves disease or Hashimotos thyroiditis? [1]
Hashimotos thyroiditis
State the hormone produce by the cells that are scattered in the islets. what function does it have? [2]
somatostatin: inhibits insulin and glucagon secretion
Which one shows type 1 and type 2 diabetes? [2]
type 1: right - get insulitis (lympohcytic Th17 infiltrate)
type 2: left. Amyloid-like hyalinization
The presence of [] cells in cervicological smear is regarded as evidence for HPV infection? [1]
The presence of [] cells in cervicological smear is regarded as evidence for HPV infection? [1]
Koilocyte
What do the cells indicate in this cervical smear? [1]
koilocyte
Which organ is the most common site for metatstatic carcinoma arising from the gut or other parts of the reproductive system? [1]
ovary
What are the three types of ovarian tumours? [3]
Describe the three types of epithelial ovarian tumours [3]
- Endometrioid tumors: cystic or predominantly solid, formation of tubular glands, similar to endometrium, usually malignant
- Mucinous tumours: larger and polycystic, lined by mucin-producing epithelial cells, and larger areas of necrosis and haemorrhage
- Serous tumours: tall, columnar, ciliated epithelial cells, resembling fallopian tube, with clear serous fluid, carcinomas frequently have psammoma bodies (concentric calcifications) (left)
What type of ovarian tumour is this?
Epithelial - endometrioid
Epithelial - mucinous
Epithelial - serous
Germ - teratoma
Epithelial - endometrioid
predominantly solid, formation of tubular glands, similar to endometrium, usually malignant
What type of ovarian tumour is this?
Epithelial - endometrioid
Epithelial - mucinous
Epithelial - serous
Germ - teratoma
Epithelial - serous
tall, columnar, ciliated epithelial cells, resembling fallopian tube, with clear serous fluid, carcinomas frequently have psammoma bodies (concentric calcifications) (left)
What type of ovarian tumour is this?
Epithelial - endometrioid
Epithelial - mucinous
Epithelial - serous
Germ - teratoma
Epithelial - serous
What type of ovarian tumour is this?
Epithelial - endometrioid
Epithelial - mucinous
Epithelial - serous
Germ - teratoma
mucinous
larger and polycystic, lined by mucin-producing epithelial cells, and larger areas of necrosis and haemorrhage
What type of ovarian tumour is this?
Epithelial - endometrioid
Epithelial - mucinous
Epithelial - serous
Germ - teratoma
- The most common form contains well differentiated ectodermal elements (skin, hair, glands, neural tissue, cartilage, bone etc)
What type of ovarian tumour is this?
Germ - dysgerminoma
Germ - teratoma
Granulosa-theca cell
Thecoma-fibroma
Sertoli-Leydig cell
often referred to as dermoid cysts
Germ - dysgerminoma
- Histomorphology identical to that of testicular seminoma, its ovarian counterpart
- Account roughly 50% of malignant ovarian germ cell tumours
- Sheets or nests of large, uniform cells with clear or eosinophilic cytoplasm and distinct cell membranes
- May also grow as cords, microcysts, tubules, pseudoglandular spaces or trabeculae
- Fibrous septae containing lymphocytes
How can you distinguish BPE from adenocarcinoma? [1]
Glands are lined by light stained columnar epithelium and peripheral layer of flattened basal cells and they form papillae
What is this pathology of the male reproductive system? [1]
Atrophic Testis
In this image of an atrophic testis, observe the cells present in the tissue. The seminiferous tubules contain Sertoli cells, but none of the characteristic cells of spermatogenesis.
The majority of germ cell tumours in men are what type of tumour? [1]
seminomas
Seminoma tumours are characteised infiltration by which cell type? [1]
- Lymphocytic infiltrate
Name two types of non-seminoma germ cell tumour in men [2]
Teratomas
Choriocarcinoma
Which factors do platelets secrete which promote clot formation? [4]
secrete ADP, thromboxane A2 calcium ion and serotonin
