Week 2 - Pathology Flashcards
Define necrosis.
Unprogrammed, uncontrolled cell death due to an external stimuli. it is ALWAYS pathological.
Define apoptosis.
Genetically programmed cell death, requiring energy. during e.g. embryogenesis and is usually physiological.
Define depositions.
Abnormal accumulation of substances. May be IC or EC.
What are AL and AA amyloid?
AL is the light chain of Ig. AA is serum amyloid associated protein, produced in prolonged chronic inflammation,
Deposition of Ca may be described as 2 things:
Dystrophic- deposition in abnormal tissue with normal serum Ca.
Metastatic- deposition in normal living tissue with raised serum Ca.
What are the types necrosis?
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)
What is the purpose of inflammation?
To destroy or control the harmful stimulus, initiate repair and restore function.
What are the 4 clinical features of inflammation?
Increased RR and HR, high or low temperature, low or raised WC count.
What are some beneficial effects of acute inflammation?
Dilution of toxin by oedema fluid, delivery of nutrients, increased entry of Ab and drug transport, stimulates immune response, fibrin traps microbes
Deine exudate and transudate.
Exudate- EC fluid with high protein and cellular content.
Transudate - EC fluid with low protein and cellular content.
What are the outcomes of acute inflammation?
Resolution
Healing by fibrosis
Progression to chronic inflammation
What is granulomatous inflammation?
A distinctive pattern of chronic inflammation. Activated Mø with modified appearance (epitheliod mø) and giant cells.
What is the defect in Chronic granulomatous disease.
Defect in NADPH oxidase system within the phagocyte. Inability to kill IC organisms by resp burst. Patients have recurrent and repeated infections.
What are the phases of healing?
- Formation of a blood clot.
- Formation of granulation tissue.
- Cell proliferation and collagen desposition
- Scar formation
- Wound contraction
- CT remodelling
- Recovery of tensile strength
What are the phases of f# healing?
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
Why are post mortems performed?
Audit of medical care. Revealing diagnosis or explaining unexpected findings (diagnostic tool). Investigating possible failings in surgery (monitor of medical care)
How would you know the difference between and arterial and venous thrombosis?
Arterial- ‘White thrombus’ many platelets, small fibrin- high flow rate
Venous- ‘Red thrombus’ lots of fibrin trapping RBCs- low flow rate
What makes up Virchows triad in factors contributing to thrombosis.
Blood composition- hyper coagulable state
Blood flow- Circulatory stasis
Vessel wall- vascular wall injury.
What are the possible categories of disease?
Developmental, Inflammatory, Neoplastic, Degenerative
What does VITAMIN CDEF stand for?
Vascular, Infective/inflammatory, Traumatic, AI, Metabolic, Iatrogenic/idiopathic, Neoplastic, congenital, degenerative, endocrine, functional
What makes the spread of infection more likely?
Immunosuppressed
Low protein levels
Poor vascular supply
What does D-dimer measure?
A measure of dissolved thrombus
Define anaplasia
Lack of differentiation of a tumour (invasive and undifferentiated)
Define Ectopia
Abnormal location to position of an organ or tissue, most often occurring congenitally, but can be due to injury
What do majority of grade 2 SSC show?
Nuclear atypia (pleomorphic)
Coarse chromatin
Irregular nuclear mem
What is the Rovsings test and what might it show?
Deep palpation of left lower quadrant, pain referred to right lower quadrant - acute appendicitis
What is Obturator sign and what might it show?
flex patients right hip and knee to 90, internally rotate hip- pain in RLQ - acute appendicitis or pelvic abscess
What is the Psoas sign and what might it show?
Patient flex right thigh against examiners resting hand, lower abdominal pain - retrocecal appendicitis or psoas abscess
What are some types of exudate?
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
What conditions cause the blood to be in a hyper coagulable state?
Malignancy, sepsis, IBD, trauma
What causes bilateral leg swelling?
Heart failure, cirrhosis, malnutrition
