Written Pathology Flashcards
Enumerate complications of acute tonsillitis or acute pharyngitis
- Chronicity: Chronic tonsillitis or pharyngitis.
- Spread of infection:
a. Direct: otitis media, pharyngitis, or laryngitis.
b. Lymphatic: Cervical lymph nodes (lymphadenitis).
c. Blood: Bacteremia, septicemia, pyemia, or toxemia. - Hypersensitivity: Rhematic fever or post-streptococcal glomerulonephritis.
Enumerate complications of Diphtheria:
- Spread of infection:
a. Direct, blood and lymphatic - Asphyxia caused by edema. Pseudo membrane & laryngeal spasm.
- Cloudy swelling & focal necrosis of parenchymal organs.
- Acute supra-renal insufficiency: Hemorrhage & necrosis of suprarenal cortex.
- Temporary paralysis of muscles of palate, pharynx, larynx, eye, face
Discuss Rhinoscleroma miscroscope picture
Large macrophage with foamy cytoplasm and pyknotic nucleus
Plasma cells and Russel bodies
Fibrosis
Discuss Nasopharyngeal carcinoma microscopic picture
a. Keratinizing squamous cell carcinoma.
b. Non-keratinizing squamous cell carcinoma.
c. Undifferentiated carcinoma with excess lymphocytes
Enumerate causes epistaxis
- Trauma.
- Tumor: juvenile angiofibroma.
- Inflammatory: nasal polyp & rhinoscleroma.
- Foreign bodies.
Discuss stages of lobar pneumonia:
- Congestion: Lasts for 24 hours. The capillaries show hyperemia & lung alveoli are filled with protein rich exudate. The lung is heavy, edematous & red.
- 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.
- 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.
- 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.
Discuss lobar pneumonia (Def, risk factors, site, fate, complication)
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
Discuss bronchopneumonia (Def, risk factors, site, fate, complication)
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
Atypical pneumonia (Def, site, fate, complication)
Inflammation confined to alveolar
septa & interstitium
Patchy and involves whole lobes
Adult respiratory distress syndrome
Upper respiratory tract infection and respiratory distress
Enumerate types & causes of lung abscesses
- 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. - Post-pneumonic lung abscess: Multiple in bronchopneumonia or single in lobar pneumonia.
- Bronchial obstruction with bronchogenic carcinoma: distal atelectasis & aspiration of blood & tumor fragment contribute to
the development of lung abscess. - Pyemic lung abscess: septic emboli from septic thrombophlebitis of systemic veins. Yellow spots surrounded by a zone of congestion.
- Direct traumatic punctures or spread of infection from adjacent organ.
Discuss complications of lung abscess
- Resolution: in case of small sized abscess & with proper treatment.
- Rupture:
a. Into a bronchus: results in hemoptysis & coughing of purulent sputum.
b. In the pleural cavity: results in empyema & pyopneumothorax. - Gangrene: the cavity is irregular with a necrotic lining
- Embolization of septic material to the brain results in meningitis & brain abscess.
- Chronicity: Chronic lung abscess is well-defined cavity
Discuss bronchial asthma types
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.
Give the def, etiology, pathogenesis and clinical picture of Emphysema.
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
Give the def, etiology, pathogenesis and clinical picture of Bronchiectasis
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
Enumerate complications of Emphysema
- Right sided heart failure & pulmonary hypertension
- Respiratory failure from defective ventilation, perfusion & diffusion of gases with cyanosis, respiratory acidosis & death
- Rupture bullae containing air into pleura causing pneumothorax
Enumerate types of bronchiectasis dilations
- Saccular: dilatation of part of circumference of a segment
- Fusiform: dilatation of the whole circumference of a segment o
- Cylindrical: dilatation of the whole circumference of the whole length of the bronchus
Enumerate complications of Bronchiectasis
- Spread of infection
- Hemoptysis with abundant foul smelling, yellowish, red sputum
- Bilateral lung fibrosis, pulmonary hypertension & right sided heart failure
- Secondary amyloidosis
- Squamous metaplasia may lead to squamous cell carcinoma
Define atelectasis and collapse and its types
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
Enumerate predisposing factors of lung cancer
- Smoking.
- air pollution
- Silicosis .
- Bronchiectasis.
Give an account on the types of lung carcinoma
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
Enumerate complications of lung carcinoma
Spreads: either directly, lymphatically or blood
Obstruction to organs
Paraneoplastic syndrome causing: hypercalcemia, Cushing syndrome,
Discuss causes of pulmonary hypertension
- Chronic obstructive or interstitial lung diseases.
- Recurrent pulmonary emboli.
- Mitral stenosis.
- Congenital left to right shunt.
- Idiopathic or primary pulmonary hypertension.
Enumerate complications of polycystic disease
Hematuria
Secondary infections
Hypertension
Chronic renal failure
Give the clinical manifestation of Nephritic syndrome
Acute onset of gross hematuria hypertension, mild proteinuria, edema
Give the clinical manifestation of Nephrotic syndrome
heavy proteinuria, severe edema, hyperlipidemia and lipiduria
Discuss the etiology of acute diffuse proliferative GN
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.
Discuss the pathogenesis of glomerular injury
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
Give the cause of membranous nephropathy
may occur association with systemic disease such as infection, carcinoma, drugs and metabolic disorders
Define Berger’s disease (IGA Nephropathy)
Disease characterized by the presence of prominent IgA deposits in the mesangial region.
Enumerate four systemic diseases associated with glomerular lesion
Vasculitis
Bacterial endocarditis
Amyloidosis
SLE
Give the causes and types of acute tubular necrosis
Toxic ATN: due to heavy metals, organic solvents, pesticides, antibiotics
Ischemic ATN: due to trauma, burns, and infections
Give the causes of Acute Pyelonephritis
gram negative bacilli due to:
ascending infection (through urethra) , or hematogenous infection (through blood)
What are the predisposing factors of Acute Pyelonephritis
General factors: diabetes mellitus and immunosuppression
Special factors: urethral catherization, female gender, UTI and stasis of urine
Define chronic pyelonephritis and give its causes
Chronic tubulointerstitial inflammation and scarring associated with deformity
Causes: obstruction and reflux of UTI with congenial vesicoureteral reflux.
Enumerate four causes of urinary tract obstruction (Obstructive uropathy)
Congenital anomalies
Tumors
Pregnancy
Benign prostatic hypertrophy
Define Hydronephrosis and give 3 complications
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
Define pyonephrosis and give 2 causes
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
Enumerate the types of stones
Calcium oxalate
Triple phosphate stones
Uric acid stones
Cystine stones
Enumerate factors (pathogenesis) that cause calculi formation in urine
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
Discuss the complications of renal calculi
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
Enumerate the tumors of the kidney
Benign tumors: Renal papillary adenoma, angiomyolipoma, oncocytoma, squamous cell papilloma
Malignant tumors: renal cell carcinoma, Wilm’s tumor, Urothelial carcinoma
Give an account on the microscopic features of renal cell carcinoma
Clear cell carcinoma, tumor cells grow in solid sheets, and cord like patterns,
Define WILM’s Tumor (Nephroblastoma)
most common primary renal tumor of childhood
Give the causes of acute renal failure
Pre-renal causes: hemorrhage
Renal causes: acute diffuse GN, Acute pyelonephritis, acute tubular necrosis
Post renal causes: Sudden complete obstruction of ureter by stone
Enumerate the causes of chronic renal failure
Chronic glomerulonephritis
Chronic bilateral pyelonephritis
Polycystic kidney disease
Bilateral hydronephrosis
Diabetes mellitus
Essential hypertension
Discuss the types of cystitis and their causes
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.
Enumerate the predisposing factors of carcinoma in the bladder
Schistosoma haematobium infection
Cigarette smoking
Industrial carcinogens
Discuss the types of carcinoma found in the bladder
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
List four renal causes of hematuria
Trauma
Tumors of kidney
Nephritic syndrome
Polycystic kidneys
List complications of gonorrhea?
Spread: to seminal vesicles or prostate
Sexual transmission to female partner
Chronicity
Fibrosis—–> obstructive uropathy
List the germ cell tumors of the testis?
Seminoma
Non seminomatous: Embryonal carcinoma, yolk sac tumor, teratoma, mixed germ cell tumors
Define hydrocele and mention 4 causes for it
accumulation of serous fluid in tunica vaginalis
cause: idiopathic, inflammation, torsion of testis, tumors of testis
Define hematocele and mention 2 causes for it?
Def: collection of blood in tunica vaginalis
Causes: traumatic, malignancy tumors of testis, hemorrhagic blood disease
Effects and complications of benign prostatic hyperplasia?
Gradual hypertrophy of bladder musculature–> diverticula and dilation of bladder
Hydroureter, hydro nephrosis
Cystic
Bladder calcunli
