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PAT 310 > Written Pathology > Flashcards

Written Pathology Flashcards

1
Q

Enumerate complications of acute tonsillitis or acute pharyngitis

A
  1. Chronicity: Chronic tonsillitis or pharyngitis.
  2. Spread of infection:
    a. Direct: otitis media, pharyngitis, or laryngitis.
    b. Lymphatic: Cervical lymph nodes (lymphadenitis).
    c. Blood: Bacteremia, septicemia, pyemia, or toxemia.
  3. Hypersensitivity: Rhematic fever or post-streptococcal glomerulonephritis.
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2
Q

Enumerate complications of Diphtheria:

A
  1. Spread of infection:
    a. Direct, blood and lymphatic
  2. Asphyxia caused by edema. Pseudo membrane & laryngeal spasm.
  3. Cloudy swelling & focal necrosis of parenchymal organs.
  4. Acute supra-renal insufficiency: Hemorrhage & necrosis of suprarenal cortex.
  5. Temporary paralysis of muscles of palate, pharynx, larynx, eye, face
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3
Q

Discuss Rhinoscleroma miscroscope picture

A

Large macrophage with foamy cytoplasm and pyknotic nucleus
Plasma cells and Russel bodies
Fibrosis

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4
Q

Discuss Nasopharyngeal carcinoma microscopic picture

A

a. Keratinizing squamous cell carcinoma.

b. Non-keratinizing squamous cell carcinoma.

c. Undifferentiated carcinoma with excess lymphocytes

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5
Q

Enumerate causes epistaxis

A
  1. Trauma.
  2. Tumor: juvenile angiofibroma.
  3. Inflammatory: nasal polyp & rhinoscleroma.
  4. Foreign bodies.
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6
Q

Discuss stages of lobar pneumonia:

A
  1. Congestion: Lasts for 24 hours. The capillaries show hyperemia & lung alveoli are filled with protein rich exudate. The lung is heavy, edematous & red.
  2. Red hepatization: From 2nd : 4th day. The alveoli show fibrin with massive accumulation of polymorphs with some lymphocytes & macrophages. Many red cells are extravasated. The lung is red, solid & its consistency resembles fresh liver.
  3. Gray hepatization: From 5th : 8th day. Lysis of RBCs occurs. The alveoli show more accumulation of fibrin which shrinks away from alveolar wall. The lung is grey & solid.
  4. Resolution: From 8th : 10th day in untreated cases. Neutrophils die releasing proteolytic enzymes causing liquefaction & absorption of the exudate & enzymatic digestion of inflammatory debris. The lung returns to normal.
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7
Q

Discuss lobar pneumonia (Def, risk factors, site, fate, complication)

A

Acute diffuse fibrinous inflammation of lung tissue

Previously healthy middle aged people

Upper lobe of rt lung

resolution

Failure resolution cornification, toxemia may lead to heart failure, spread, lung abscess

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8
Q

Discuss bronchopneumonia (Def, risk factors, site, fate, complication)

A

Patchy areas of acute suppurative
inflammation affects bronchi

Extremes of age and Debilitating diseases

Bilateral basal

Death

pneumonic lung abscess and gangrene, toxemia, septicemia, fibrosis

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9
Q

Atypical pneumonia (Def, site, fate, complication)

A

Inflammation confined to alveolar
septa & interstitium

Patchy and involves whole lobes

Adult respiratory distress syndrome

Upper respiratory tract infection and respiratory distress

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10
Q

Enumerate types & causes of lung abscesses

A
  1. Aspiration lung abscess (primary lung abscess): It is due to aspiration of:
    a) Blood clots or infected material during oral surgery.
    b) Vomitus during general anesthesia.
  2. Post-pneumonic lung abscess: Multiple in bronchopneumonia or single in lobar pneumonia.
  3. Bronchial obstruction with bronchogenic carcinoma: distal atelectasis & aspiration of blood & tumor fragment contribute to
    the development of lung abscess.
  4. Pyemic lung abscess: septic emboli from septic thrombophlebitis of systemic veins. Yellow spots surrounded by a zone of congestion.
  5. Direct traumatic punctures or spread of infection from adjacent organ.
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11
Q

Discuss complications of lung abscess

A
  1. Resolution: in case of small sized abscess & with proper treatment.
  2. Rupture:
    a. Into a bronchus: results in hemoptysis & coughing of purulent sputum.
    b. In the pleural cavity: results in empyema & pyopneumothorax.
  3. Gangrene: the cavity is irregular with a necrotic lining
  4. Embolization of septic material to the brain results in meningitis & brain abscess.
  5. Chronicity: Chronic lung abscess is well-defined cavity
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12
Q

Discuss bronchial asthma types

A

A. Atopic (allergic) asthma: the most common type caused by type 1 hypersensitivity reaction triggered by
environmental antigen (pollen, dust, certain foods, …) with positive family history.

B. Non-atopic asthma: hyper-reactivity of airways triggered by respiratory tract infections or chemical irritation with no family
history

C. Aspirin-induces asthma: exact mechanism is unknown.

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13
Q

Give the def, etiology, pathogenesis and clinical picture of Emphysema.

A

Permanent dilation of air spaces of bronchioles

Imbalance between pulmonary proteases & their inhibitors

Smoking & air pollutants recruit neutrophils &
macrophages that release proteases (elastases) causing damage of elastic tissue preventing elastic recoil of the lung during expiration

Barrel chest, Coughing & wheezing, Dyspnea, Finger clubbing due to hypoxia

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14
Q

Give the def, etiology, pathogenesis and clinical picture of Bronchiectasis

A

Abnormal permanent dilatation of medium sized bronchi & bronchioles associated with chronic suppurative inflammation of their walls

Congenital or hereditary, Septic bronchopneumonia, Bronchial obstruction by tumor or foreign body

septic pneumonia, septic bronchopneumonia, lung collapse

Persistent severe cough, culture reveals mixed flora, coughing is associated with morning rising and positional changes

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15
Q

Enumerate complications of Emphysema

A
  1. Right sided heart failure & pulmonary hypertension
  2. Respiratory failure from defective ventilation, perfusion & diffusion of gases with cyanosis, respiratory acidosis & death
  3. Rupture bullae containing air into pleura causing pneumothorax
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16
Q

Enumerate types of bronchiectasis dilations

A
  1. Saccular: dilatation of part of circumference of a segment
  2. Fusiform: dilatation of the whole circumference of a segment o
  3. Cylindrical: dilatation of the whole circumference of the whole length of the bronchus
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17
Q

Enumerate complications of Bronchiectasis

A
  1. Spread of infection
  2. Hemoptysis with abundant foul smelling, yellowish, red sputum
  3. Bilateral lung fibrosis, pulmonary hypertension & right sided heart failure
  4. Secondary amyloidosis
  5. Squamous metaplasia may lead to squamous cell carcinoma
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18
Q

Define atelectasis and collapse and its types

A

Atelectasis is failure of lung expansion & collapse is acquired deflation of previously inflated lung affecting part or all of one lung.

Resorption collapse: occurs with complete obstruction by mucus plugs or foreign body

Compression collapse: associated with pneumothorax, hemothorax

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19
Q

Enumerate predisposing factors of lung cancer

A
  1. Smoking.
  2. air pollution
  3. Silicosis .
  4. Bronchiectasis.
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20
Q

Give an account on the types of lung carcinoma

A

Squamous cell carcinoma: in smoker males, centrally located, infiltrative tumor, keratin pearl formation

Adenocarcinoma: in females, peripherally located, early spread to the pleura, glandular

Large cell carcinoma: undifferentiated type with no glandular or keratin pearl formation

Small cell carcinoma: Worst prognosis, early metastasis, centrally located, cells are small neuroendocrine

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21
Q

Enumerate complications of lung carcinoma

A

Spreads: either directly, lymphatically or blood

Obstruction to organs

Paraneoplastic syndrome causing: hypercalcemia, Cushing syndrome,

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22
Q

Discuss causes of pulmonary hypertension

A
  1. Chronic obstructive or interstitial lung diseases.
  2. Recurrent pulmonary emboli.
  3. Mitral stenosis.
  4. Congenital left to right shunt.
  5. Idiopathic or primary pulmonary hypertension.
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23
Q

Enumerate complications of polycystic disease

A

Hematuria
Secondary infections
Hypertension
Chronic renal failure

24
Q

Give the clinical manifestation of Nephritic syndrome

A

Acute onset of gross hematuria hypertension, mild proteinuria, edema

24
Q

Give the clinical manifestation of Nephrotic syndrome

A

heavy proteinuria, severe edema, hyperlipidemia and lipiduria

24
Q

Discuss the etiology of acute diffuse proliferative GN

A

During latent period between infection and nephritis, antibodies are formed against streptococcal antigens. The reaction occurs in the serum and the immune complex deposits between glomerular basement membrane and epithelial cells, leading to injury.

25
Q

Discuss the pathogenesis of glomerular injury

A

Immune mechanism: Antibody mediated injury is the most common type of glomerular injury as glomerular deposits of immunoglobulins and complement are detected in more than 70% of cases

Non immune mechanism: loss of glomerular shape and glomerular hyperfiltration

25
Q

Give the cause of membranous nephropathy

A

may occur association with systemic disease such as infection, carcinoma, drugs and metabolic disorders

26
Q

Define Berger’s disease (IGA Nephropathy)

A

Disease characterized by the presence of prominent IgA deposits in the mesangial region.

27
Q

Enumerate four systemic diseases associated with glomerular lesion

A

Vasculitis
Bacterial endocarditis
Amyloidosis
SLE

28
Q

Give the causes and types of acute tubular necrosis

A

Toxic ATN: due to heavy metals, organic solvents, pesticides, antibiotics

Ischemic ATN: due to trauma, burns, and infections

29
Q

Give the causes of Acute Pyelonephritis

A

gram negative bacilli due to:

ascending infection (through urethra) , or hematogenous infection (through blood)

30
Q

What are the predisposing factors of Acute Pyelonephritis

A

General factors: diabetes mellitus and immunosuppression

Special factors: urethral catherization, female gender, UTI and stasis of urine

31
Q

Define chronic pyelonephritis and give its causes

A

Chronic tubulointerstitial inflammation and scarring associated with deformity

Causes: obstruction and reflux of UTI with congenial vesicoureteral reflux.

32
Q

Enumerate four causes of urinary tract obstruction (Obstructive uropathy)

A

Congenital anomalies
Tumors
Pregnancy
Benign prostatic hypertrophy

33
Q

Define Hydronephrosis and give 3 complications

A

Dilation of the renal pelvis and calyces associated with progressive atrophy of the kidney due to partial obstruction to the outflow of urine

Secondary infection
Chronic renal failure
Hypertension

34
Q

Define pyonephrosis and give 2 causes

A

Dilation and distension of the renal pelvis and calyces with pus associated with progressive atrophy of the kidney due to total or almost complete obstruction of the outflow urine.

Hydronephrosis
Chronic pyelonephritis

35
Q

Enumerate the types of stones

A

Calcium oxalate
Triple phosphate stones
Uric acid stones
Cystine stones

36
Q

Enumerate factors (pathogenesis) that cause calculi formation in urine

A

Increase urinary concentration of the stones constituents: increased urinary concentration of calcium, increased uric acid in urine, dehydration

Change in pH of urine: infection by urea splitting organism and decrease acidity

Lack of substances in urine which inhibit precipitation of crystals

37
Q

Discuss the complications of renal calculi

A

Migration of stones from pelvicalyceal system to ureters resulting in colics and obstructive uropathy

Obstruction produces hydroureter and hydronephrosis

Infection: cystits

Squamous metaplasia, dysplasia. squamous cell carcinoma and carcinoma insitu

38
Q

Enumerate the tumors of the kidney

A

Benign tumors: Renal papillary adenoma, angiomyolipoma, oncocytoma, squamous cell papilloma

Malignant tumors: renal cell carcinoma, Wilm’s tumor, Urothelial carcinoma

39
Q

Give an account on the microscopic features of renal cell carcinoma

A

Clear cell carcinoma, tumor cells grow in solid sheets, and cord like patterns,

40
Q

Define WILM’s Tumor (Nephroblastoma)

A

most common primary renal tumor of childhood

41
Q

Give the causes of acute renal failure

A

Pre-renal causes: hemorrhage

Renal causes: acute diffuse GN, Acute pyelonephritis, acute tubular necrosis

Post renal causes: Sudden complete obstruction of ureter by stone

42
Q

Enumerate the causes of chronic renal failure

A

Chronic glomerulonephritis
Chronic bilateral pyelonephritis
Polycystic kidney disease
Bilateral hydronephrosis
Diabetes mellitus
Essential hypertension

43
Q

Discuss the types of cystitis and their causes

A

Acute cystitis: bacterial suppurative cystitis; caused by E.coli mostly through ascending infections and hemorrhagic cystitis caused by some antitumor drugs

Chronic cystitis: Bilharzial cystitis and chronic tuberculous cystitis.

44
Q

Enumerate the predisposing factors of carcinoma in the bladder

A

Schistosoma haematobium infection
Cigarette smoking
Industrial carcinogens

45
Q

Discuss the types of carcinoma found in the bladder

A

Urothelial carcinoma: are either papillary or non papillary. Papillary are superficial and can be removed while non papillary are more invasive and likely yo infiltrate lamina propria of bladder.

Squamous cell carcinoma: associated with chronic bladder infection and irritation

Adenocarcinoma: fungating mass that invades the bladder wall and ulcerates the mucosa

46
Q

List four renal causes of hematuria

A

Trauma
Tumors of kidney
Nephritic syndrome
Polycystic kidneys

47
Q

List complications of gonorrhea?

A

Spread: to seminal vesicles or prostate
Sexual transmission to female partner
Chronicity
Fibrosis—–> obstructive uropathy

48
Q

List the germ cell tumors of the testis?

A

Seminoma

Non seminomatous: Embryonal carcinoma, yolk sac tumor, teratoma, mixed germ cell tumors

49
Q

Define hydrocele and mention 4 causes for it

A

accumulation of serous fluid in tunica vaginalis

cause: idiopathic, inflammation, torsion of testis, tumors of testis

50
Q

Define hematocele and mention 2 causes for it?

A

Def: collection of blood in tunica vaginalis

Causes: traumatic, malignancy tumors of testis, hemorrhagic blood disease

51
Q

Effects and complications of benign prostatic hyperplasia?

A

Gradual hypertrophy of bladder musculature–> diverticula and dilation of bladder

Hydroureter, hydro nephrosis

Cystic

Bladder calcunli

52
Q
A

PAT 310 (13 decks)

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