Quick Facts 2 Flashcards

1
Q

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

A

calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What cell type are mature neutrophils derived from?

A. Lymphoblasts
B. Macrophages
C. Mast cells
D. Monoblasts
E. Myeloblasts

A

Myeloblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What cell type are mature mast cells derived from?
A. Lymphoblasts
B. Macrophages
C. Myeloid progenitor cell
D. Monoblasts
E. Myeloblasts

A

Myeloid progenitor cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What cell type are mature monocytes derived from?

G. Lymphoblasts
H. Macrophages
I. Monoblast
J. Megakaryocyte
K. Myeloblasts

A

Monoblast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

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

A

60-100ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

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

A

LDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

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

A

Left ventricular failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

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

A

Ipatropium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

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

A

right ventricular failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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

A

Infectious mononucleosis (glandular fever)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

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

A

Late erythoblast / normoblast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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

A

Mitochondria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The gene EPO, which encodes the protein erythropoietin, is found on which chromosome?

A 1
B 22
C 7
D 16
E 11

A

7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which of the following is considered a polymorphonuclear leucocyte?

A T lymphocyte
B B lymphocyte
C Natural killer cell
D Neutrophil
E Monocyte

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Approximately, what proportion of blood is composed of haematocrit?

A 15%
B 25%
C 45%
D 65%
E 85%

A

45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

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

A

NK cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

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%

A

1-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Label A-G

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

2 List three classes of drug which can be used for rate control in atrial fibrillation. (3 marks)

A

Beta blockers, calcium channel blockers, amiodarone, cardiac glycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which dermatomes does angina commonly spread to? [3]

A

left C3, 4 or 5 dermatomes (1 mark).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List two ECG changes that are commonly be seen during episodes of angina. (2 marks)

A

Transient ST-segment elevations
Dynamic T-wave changes:
ST depressions
(any two )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

6 Explain why the immune system has a particular problem when dealing with tuberculosis infection. (3 marks)

A

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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What aspect of cell wall makes M. tuberculosis difficult t break down by lymphocytes? [1]

A

Mycolic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

9 Where in the body are structures that a) measure blood volume b) measure blood osmolarity. [2 marks]

A

a) atria (1 mark)
b) hypothalamus (1 mark)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

10 List FOUR stages in haemostasis involving platelets that do not involve
the coagulation cascade. [Total 4 marks]

A

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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

11 Explain how a blood clot in a damaged blood vessel is removed when the vessel is healed. [2 marks]

A
  • 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).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

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

A

WPW syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

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

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which testicular cancers are filled with lymphocytes? [1]

A

seminoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is this? [1]
Explain?

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Define pancytopenia [1]

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

State two things that would suggest have AML from a blood smear? [2]

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What pathology would be indicated from this blood film? [1]

A

Acute myeloid leukaemia auer rods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How would determine a patient has acute lymphoblastic leukaemia? [1]

A

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 well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How would Chronic Lymphoid Leukemia present on a blood film? [1]

A

PBS: high nuclear:cytoplasm ratio, nuclei of different cells look granular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How would Chronic Lymphoid Leukemia present on a blood film? [1]

A

PBS: high nuclear:cytoplasm ratio, nuclei of different cells look granular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Name a cause of pencil cells in a blood film [1]

A

IDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the arrow pointing to? [1]

A

Reticulocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Teardrop cell is a sign of what type of anaemia? [1]

A

Macrocytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

On a granuloma, describe the location of lymphocytes compared to macrophages [1]

A

Macrophage inside; lymphocytes outside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is this cell histology? [1]

A

Lepidic tumor cells proliferating along the surface of intact alveolar walls without stromal or vascular invasion pathologically

42
Q

Name 4 reasons why get non-obstructive canalicular cholestasis? [4]

A
  • no inflammation – so called ‘bland’ cholestasis, which can occur due to:
  • Pregnancy,
  • Drugs or toxins,
  • Acute hepatitis or
  • Sepsis
43
Q
A
44
Q

Which is nromal and which is pathological and why?

A

LHS – normal
RHS – hepatocellular carcinoma
* Bigger cells
* Bigger nucli
* Lack of structure
* Looks more aggressive

45
Q

What is cholangiocarcinoma? [1]

A

cholangiocarcinoma: Bile duct cancer

46
Q

What is pancarditis? [1]

A

Pericarditis + endocarditis + myocarditis

47
Q

Renal Artery
Proximal Tubule
Interlobar Artery
Arcuate Artery
Interlobular Artery
Collecting Duct

A

Arcuate Artery

48
Q

Usually liver adenocarcinoma metastastis from where? [1]

A

Usually adenocarcinoma metastasises from the rectum/intestines via the hepatic portal vein. The presence of glands containing simple columnar epithelium is easily noticeable.

49
Q

Normal Liver
Cirrhosis
Hepatitis
Hepatocellular
Carcinoma
e) Metastatic Adenocarcinoma

A

Normal Liver
Cirrhosis
Hepatitis
Hepatocellular
Carcinoma
e) Metastatic Adenocarcinoma

50
Q

Normal Liver
Cirrhosis
Hepatitis
Hepatocellular
Carcinoma
Metastatic Adenocarcinoma

A

Hepatitis
Inflammatory cell invasion into the hepatic tissue, especially within the sinusoids. Inflammation of the liver = hepatitis.
Arrow is indicating a lymphocyte.

51
Q

Intracellular oedema occurs after how many hours in MI? [1]

A

12-24 hours:

also get: hypereosinophilia and coagulative necrosis of cardiomyocytes

52
Q

How long ago did an MI occur based off this histology? [1]

A

0-12 hrs

53
Q

How long after an MI do the green and yellow arrows represent? [2]

A

green: 12 to 24 hours
yellow: 10 to 14 days.

54
Q

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?

A
55
Q

formation of microvessels occurs during which stage post-MI? [1]

A

formation of microvessels: 7-10 days during granulation process

56
Q

Describe the difference in the degeneration between these two slides of hepatic injury [2]

A
57
Q

Foamy cells in hepatic cells would indicate damage from what mechansim? [1]

A

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.

58
Q

State the difference between the aroows to the side and to thr top in these hepatocytes [2]

A
59
Q

What do the arrows point to in these injured hepatocytes? [1]

A

Councilman Bodies: Eosinophilic globule with often fragmented nucleus. It represents a hepatocyte that is undergoing apoptosis

60
Q

What are the Councilman bodies and which cells do you find them in? [1]

A

Formation of Councilman Bodies- Eosinophilic globule with often fragmented nucleus. It represents a hepatocyte that is undergoing apoptosis

61
Q

Injury to the liver which associate with an influx of acute or chronic inflammatory cells is called []

A

Injury to the liver which associate with an influx of acute or chronic inflammatory cells is called hepatitis

62
Q

Describe the histological differences between acute and chronic viral hepatitis [2]

A
63
Q

Spotty necrosis is a sign of what damage to hepatocytes? [1]

A

acute viral infection

64
Q

This liver histology shows cirrhosis. State what the top arrow is [1]

A

regenerative nodules

65
Q

Describe the pathology shown in this hepatocyte slide [1]

A

Cholestatic Syndrome (Jaundice)

66
Q

What is this histological pathology of the liver? [1]

A

** Hepatocellular carcinoma** – this time on cut-surface (After slicing the liver). Histology (right hand side) shows disordered growth of hepatocytes with thick hepatic plates.

67
Q

A form of chronic immune [] induced by antibodies reacting in situ to endogenous or planted glomerular antigens refers to what pathology? [1]

A

A form of chronic immune complex glomerulonephritis induced by antibodies reacting in situ to endogenous or planted glomerular antigens.

68
Q

Glomerulonephritis: describe the biopsy features [2]

What is the primary cause of this in 80% of the time? [1]

A
  • Podocytes show effacement of foot processes
  • progressive thickening, glomeruli may become sclerosed

caused by autoantibodies against podocyte antigens.

69
Q

What pathology does this indicate? [1]

A

Membranous glomerulonephritis characterised by thickening of glomerular basement membrane due to presence of subepithelial immune deposits

70
Q

The staining of which antibody would indicate glomerulonephritis? [1]

A
71
Q

One of the causes of glomerulonephritis is the autoimmune disease []

A

One of the causes of glomerulonephritis is the autoimmune disease systemic lupus erythematosus (SLE)

72
Q

What is highlighted in this biopsy of glomerulonephritis? [1]

A

Dense deposits along Basement membrane

73
Q

What is this disease ? [1]

A

Diabetic nephropathy: Note the thickening of the mesangial basement membrane and matrix

74
Q

What is does this histological slide indicate of the renal system? [1]

A

(2) renal vascular lesions, principally arteriolosclerosis;

75
Q

Renal cell carcinoma predominately arised from which kidney tissue? [1]

A

Tubular epithelial cells: clear cell carcinoma is most common form and arises from PCT

76
Q

What type of cancer is referred to as ‘small round blue cell tumour’ [1]

A

Wilms tumour

77
Q

What type of cancer is referred to as ‘small round blue cell tumour’ [1]

A

Wilms tumour

78
Q

What are the most common type of renal cell carcinoma? [1]

A

Clear cell carcinoma

79
Q

This shows clear cell carcinoma. What organ does it arise from and which gene is implicated in this cancer? [1]

A

Renal cells; PCT

  • VHL gene also is involved in the majority of sporadic clear cell carcinomas (von Hippel-Lindau disease)
80
Q

What does the arrow show that indicates this person has Graves disease? [1]

A

scalloping

81
Q

Is this Gaves disease or Hashimotos thyroiditis? [1]

A

Hashimotos thyroiditis

82
Q

State the hormone produce by the cells that are scattered in the islets. what function does it have? [2]

A

somatostatin: inhibits insulin and glucagon secretion

83
Q

Which one shows type 1 and type 2 diabetes? [2]

A

type 1: right - get insulitis (lympohcytic Th17 infiltrate)

type 2: left. Amyloid-like hyalinization

84
Q

The presence of [] cells in cervicological smear is regarded as evidence for HPV infection? [1]

A
85
Q

The presence of [] cells in cervicological smear is regarded as evidence for HPV infection? [1]

A

Koilocyte

86
Q

What do the cells indicate in this cervical smear? [1]

A

koilocyte

87
Q

Which organ is the most common site for metatstatic carcinoma arising from the gut or other parts of the reproductive system? [1]

A

ovary

88
Q

What are the three types of ovarian tumours? [3]

A
89
Q

Describe the three types of epithelial ovarian tumours [3]

A
  • 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)
90
Q

What type of ovarian tumour is this?

Epithelial - endometrioid
Epithelial - mucinous
Epithelial - serous
Germ - teratoma

A

Epithelial - endometrioid

predominantly solid, formation of tubular glands, similar to endometrium, usually malignant

91
Q

What type of ovarian tumour is this?

Epithelial - endometrioid
Epithelial - mucinous
Epithelial - serous
Germ - teratoma

A

Epithelial - serous

tall, columnar, ciliated epithelial cells, resembling fallopian tube, with clear serous fluid, carcinomas frequently have psammoma bodies (concentric calcifications) (left)

92
Q

What type of ovarian tumour is this?

Epithelial - endometrioid
Epithelial - mucinous
Epithelial - serous
Germ - teratoma

A

Epithelial - serous

93
Q

What type of ovarian tumour is this?

Epithelial - endometrioid
Epithelial - mucinous
Epithelial - serous
Germ - teratoma

A

mucinous

larger and polycystic, lined by mucin-producing epithelial cells, and larger areas of necrosis and haemorrhage

94
Q

What type of ovarian tumour is this?

Epithelial - endometrioid
Epithelial - mucinous
Epithelial - serous
Germ - teratoma

A
  • The most common form contains well differentiated ectodermal elements (skin, hair, glands, neural tissue, cartilage, bone etc)
95
Q

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

A

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
96
Q

How can you distinguish BPE from adenocarcinoma? [1]

A

Glands are lined by light stained columnar epithelium and peripheral layer of flattened basal cells and they form papillae

97
Q

What is this pathology of the male reproductive system? [1]

A

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.

98
Q

The majority of germ cell tumours in men are what type of tumour? [1]

A

seminomas

99
Q

Seminoma tumours are characteised infiltration by which cell type? [1]

A
  • Lymphocytic infiltrate
100
Q

Name two types of non-seminoma germ cell tumour in men [2]

A

Teratomas

Choriocarcinoma

101
Q
A
102
Q

Which factors do platelets secrete which promote clot formation? [4]

A

secrete ADP, thromboxane A2 calcium ion and serotonin