Week 2 - Pathology

Question 1

Define necrosis.

Answer 1

Unprogrammed, uncontrolled cell death due to an external stimuli. it is ALWAYS pathological.

Question 2

Define apoptosis.

Answer 2

Genetically programmed cell death, requiring energy. during e.g. embryogenesis and is usually physiological.

Question 3

Define depositions.

Answer 3

Abnormal accumulation of substances. May be IC or EC.

Question 4

What are AL and AA amyloid?

Answer 4

AL is the light chain of Ig. AA is serum amyloid associated protein, produced in prolonged chronic inflammation,

Question 5

Deposition of Ca may be described as 2 things:

Answer 5

Dystrophic- deposition in abnormal tissue with normal serum Ca.
Metastatic- deposition in normal living tissue with raised serum Ca.

Question 6

What are the types necrosis?

Answer 6

Coagulative (caused by ischaemia and infarction, retains its structure) - Haemorrhagic and gangrenous
Colliquative (liquid like and loses its structure)
Caseous (cheese like)
Fat (lipases on fat tissue)

Question 7

What is the purpose of inflammation?

Answer 7

To destroy or control the harmful stimulus, initiate repair and restore function.

Question 8

What are the 4 clinical features of inflammation?

Answer 8

Increased RR and HR, high or low temperature, low or raised WC count.

Question 9

What are some beneficial effects of acute inflammation?

Answer 9

Dilution of toxin by oedema fluid, delivery of nutrients, increased entry of Ab and drug transport, stimulates immune response, fibrin traps microbes

Question 10

Deine exudate and transudate.

Answer 10

Exudate- EC fluid with high protein and cellular content.

Transudate - EC fluid with low protein and cellular content.

Question 11

What are the outcomes of acute inflammation?

Answer 11

Resolution
Healing by fibrosis
Progression to chronic inflammation

Question 12

What is granulomatous inflammation?

Answer 12

A distinctive pattern of chronic inflammation. Activated Mø with modified appearance (epitheliod mø) and giant cells.

Question 13

What is the defect in Chronic granulomatous disease.

Answer 13

Defect in NADPH oxidase system within the phagocyte. Inability to kill IC organisms by resp burst. Patients have recurrent and repeated infections.

Question 14

What are the phases of healing?

Answer 14

1. Formation of a blood clot.
2. Formation of granulation tissue.
3. Cell proliferation and collagen desposition
4. Scar formation
5. Wound contraction
6. CT remodelling
7. Recovery of tensile strength

Question 15

What are the phases of f# healing?

Answer 15

Inflammation- Haematoma forms. Inflammatory cells recruited. Granulation tissue, ingrowth of vessels, migration of mesenchymal cells. O2 and nutrients to bone.
Repair- Fibroblasts lay down stroma. Osteoid secreted and a soft callus forms which ossifies over 4 weeks.
Remodelling

Question 16

Why are post mortems performed?

Answer 16

Audit of medical care. Revealing diagnosis or explaining unexpected findings (diagnostic tool). Investigating possible failings in surgery (monitor of medical care)

Question 17

How would you know the difference between and arterial and venous thrombosis?

Answer 17

Arterial- ‘White thrombus’ many platelets, small fibrin- high flow rate
Venous- ‘Red thrombus’ lots of fibrin trapping RBCs- low flow rate

Question 18

What makes up Virchows triad in factors contributing to thrombosis.

Answer 18

Blood composition- hyper coagulable state
Blood flow- Circulatory stasis
Vessel wall- vascular wall injury.

Question 19

What are the possible categories of disease?

Answer 19

Developmental, Inflammatory, Neoplastic, Degenerative

Question 20

What does VITAMIN CDEF stand for?

Answer 20

Vascular, Infective/inflammatory, Traumatic, AI, Metabolic, Iatrogenic/idiopathic, Neoplastic, congenital, degenerative, endocrine, functional

Question 21

What makes the spread of infection more likely?

Answer 21

Immunosuppressed
Low protein levels
Poor vascular supply

Question 22

What does D-dimer measure?

Answer 22

A measure of dissolved thrombus

Question 23

Define anaplasia

Answer 23

Lack of differentiation of a tumour (invasive and undifferentiated)

Question 24

Define Ectopia

Answer 24

Abnormal location to position of an organ or tissue, most often occurring congenitally, but can be due to injury

Question 25

What do majority of grade 2 SSC show?

Answer 25

Nuclear atypia (pleomorphic)
Coarse chromatin
Irregular nuclear mem

Question 26

What is the Rovsings test and what might it show?

Answer 26

Deep palpation of left lower quadrant, pain referred to right lower quadrant - acute appendicitis

Question 27

What is Obturator sign and what might it show?

Answer 27

flex patients right hip and knee to 90, internally rotate hip- pain in RLQ - acute appendicitis or pelvic abscess

Question 28

What is the Psoas sign and what might it show?

Answer 28

Patient flex right thigh against examiners resting hand, lower abdominal pain - retrocecal appendicitis or psoas abscess

Question 29

What are some types of exudate?

Answer 29

serous - transudate - pericardial, peritoneal, pleural
fibrinous - fluid rich in fibrin
harmorrhagic - vascular injury or depletion of coagulation factors
suppurative - pus - neutrophil polymorphs
membranous- epithelium coated in fibrin, ep &inflam cells
pseudo-membranous - ulceration - surface exudate
necrotising (gangrenous) - high pressure - vascular occlusion and thrombosis

Question 30

What conditions cause the blood to be in a hyper coagulable state?

Answer 30

Malignancy, sepsis, IBD, trauma

Question 31

What causes bilateral leg swelling?

Answer 31

Heart failure, cirrhosis, malnutrition