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131 Flashcards

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1
Q

Name the 5 Pathological processes

A

Adaptation - may result in abnormal cell growth
Abnormal cell growth - such as dysplasia or neoplastic growth
Cell death – may occur due to lack of adaptation
Healing - stimulated by a pathological stress such as physical injury, collagen deposition in scar tissue
Genetic and immune factors - affect a cell/organ ability to adapt to environmental stresses leading to different susceptibilities to disease

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2
Q

What is Hyperplasia

A

Increase in number of tissue cells due to increased cell division

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3
Q

Hypertrophy

A

Increase in size of existing cells, matched by increase in functional capacity

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4
Q

What is this image an example of and why

A

Colonic Epithelial Hyperplasia - increases the number of cells present resulting in deeper crypts

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5
Q

What are the four stages of Apoptosis

A

1) Induction/signalling – limit anti-apoptotic proteins e.g. Bcl-2
2) Effector - ‘point of no return’  mitochondrial permeability
3) Degradation - proteases (caspases)  morphology
4) Phagocytic - cell fragments are engulfed and removed

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6
Q

Differences between Apoptosis and Necrosis

A
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7
Q

How does a ultrasound, CT and MRI work and there disadvantages

A

Ultrasound - high frequency sound waves resulting in low resolution
CT - X-rays resulting in less detail
MRI - strong magnetic fields and radio waves resulting in more detail but slower

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8
Q

What is this a normal histological appearance of

A

Colon

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9
Q

What is this a histological appearance of

A

Testis

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10
Q

What is this a histological appearance of

A

Skin

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11
Q

Features of loss of differentiation

A

Variation in shape and size (pleomorphism) - cells (cellular pleomorphism) and nuclei (nuclear pleomorphism)
Increase in nuclear staining - nuclear hyperchromatism
Increase in size of nucleus relative to cytoplasm

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12
Q

What is Epidemiology

A

The study of factors, implicated in disease progression, that determines its frequency, distribution and severity in cohorts of individuals

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13
Q

What is the epidemiological triangle of causal factors

A

Susceptible host - Genetics etc
External agent - Pathogens, smoking etc
Environment that brings host and agent together - Radiation, diet, carbon combustion etc
DISEASE IS THE INTERACTION OF ALL OF THESE

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14
Q

What is the causal pie model

A

Factors that contribute to a disease are pieces of a pie and all pieces must be present for the disease to occur. Useful for diseases like cancer where there are multiple causative factors

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15
Q

What 4 things are viruses classified by

A

-type of nucleic acid (DNA or RNA)
-mode of replication
-symmetry of virus particle - icosahedral, helical or complex
-presence or absence of external envelope

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16
Q

What are bacteria classified by

A

Size, shape (cocci, bacilli, spiral), colour, respiration, reproduction, immunologic, staining properties (eg gram stain)

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17
Q

4 aims of a microbiology lab

A

Identify microorganisms in specimen
Identify antimicrobial susceptibility
Detect microbial products
Analyse patients response

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18
Q

How does pneumonia infection occur

A

-inhalation of aerosols
-aspiration of normal flora
-via the blood

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19
Q

What causes tuberculosis

A

Inhalation of mycobacterium tuberculosis

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20
Q

Four cardinal effects of acute inflammation

A

-Rubor (redness) - vessel dilatation/increased blood flow to site
-Calor (heat) - vessel dilatation/increased blood flow to site
-Dolor (pain) - pressure on nerve endings/ chemical factors
-Tumor (swelling)

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21
Q

What is acute inflammatory response

A
  1. Release of chemical mediators that stimulate the production of acute inflammatory exudate
  2. Exudate is fluid, proteins and blood cells that mobilise local defences
  3. Infective agents destroyed and eliminated by components of the exudate
  4. Damaged tissue broken down, partly liquefied and the debris is removed from the site of damage
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22
Q

Transmigration of leucocytes during inflammation

A
  1. Mediated by selectins on endothelial cells and integrins on leukocytes
  2. Leukocytes attracted by chemokines and cytokines released by tissue macrophages
  3. Diapedesis – leukocyte forms pseudopodia and produces proteases to help move between endothelial cells of veins and migrate into the tissue
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23
Q

How does acute exudate leave the tissue

A

Mostly re-enter circulation via lymphatic system and stimulate adaptive immune response in lymph nodes.
However neutrophils do not re-circulate (pus buildup)

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24
Q

Microscopy vs Flow Cytometry

25
Innate vs Adapative
Refers to the mediators Innate is usually more rapid as there is particularly no memory cell clones Adaptive involved generation of antigen-specific antibodies and T cells to give long-lasting immunity Innate includes phagocytes, cytokine production and complement cascade
26
6 steps of histology
-Specimen dissected -Fixation: arrests biological activity and prevents tissue degradation -Dehydration: remove water to prevent tissue damage -Embedding: embed into a hard medium such as paraffin wax, freezing or plastic resin (can produce artefacts) -Sectioning: immobilised tissues are held in place and sectioned thinly using a sharp blade (cryostat, microtome, vibratome) -Staining: eg haematoxylin (stains acidic purple/blue) and eosin (stains basic red/pink) (nucleus is blue and cytoplasm pink
27
What function does this cell structure and morphology indicate
Simple columnar epithelium: absorptive/secretory surfaces
28
What function does this cell structure and morphology indicate
Stratified epithelia: protective function eg skin
29
What function does this cell structure and morphology indicate
Brain tissue: thin axon for rapid cell-cell communication
30
What function does this cell structure and morphology indicate
Smooth muscle tissue: elongated cells to maximise contractile properties
31
Human Tissue Act 2004
-Regulates activities - removal, storage, use and disposal of human tissue. -Consent - fundamental principle of the legislation and underpins the lawful removal, storage and use of body parts, organs and tissue.  -DNA - unlawful to have human tissue with the intention of its DNA being analysed, without the consent of the person from whom the tissue came. -Tissue removed and stored for diagnosis does not fall under the Act
32
How to prepare serum from blood vs plasma
Serum: centrifuge a blood clot and then remove the top layer Plasma: add a anticoagulant and centrifuge and remove the top layer
33
What is the difference between precision and accuracy
Precision is the reproducibility Accuracy is how close the value is to the actual value
34
Difference between sensitivity and specificity
Sensitivity – how little of the analyte can be detected by the assay? Specificity – how good is the assay at discriminating between the requested analyte and other interfering substances.
35
What does the Kidney do
-Regulates extracellular fluid volume and electrolyte balance -Excretion of waste products -Selective reabsorption -Secondary endocrine function
36
Important quote about the nature of sodium and water
Where sodium goes, water follows
37
What is the range for normal sodium in a sample
135-145 mmol/l
38
Hypernatremia
Hypernatremia -High Na -Due to water depletion/renal failure/excessive intake -Signs of low BP, low urine output and dry mucous membranes. -Treated by water/ IV 5% dextrose
39
Hyponatraemia via water retention
Too low Na Oedematous causes: heart failure/ decrease effective blood volume/ ADH secretion/ salt and water retention Oedematous treatment: diuretic and restrict fluid (and treat condition) Non-oedematous causes: ADH released all the time (SIAD), too much reabsorption at the kidney Non-oedematous treatment: restrict fluid
40
Hyponatraemia via sodium loss
Too low Na Causes: vomiting/diarrhoea/ Lack of Na intake/ lack of aldosterone (Na lost in urine) Signs: Tachycardia/ hypotension Treatment: Oral correction of sodium loss
41
Normal range for potassium
3.4-4.9 mmol/l
42
Hyperkalaemia
Too high K Causes: renal failure/ adrenal failure/ potassium ions release from damaged cells Treatment: calcium gluconate/ insulin + glucose/ dialysis
43
Hypokalaemia
Too low K Causes: Vomiting/ diarrhoae/ diuretics Treatment: Oral or IV potassium with ECG monitoring
44
Acute Renal Failure causes, treatment and biochemical findings
Biochemical findings: Concentrated urine Serum urea and creatinine increase Hyperkalaemia -nephron can’t excrete K when GFR decreases. Causes: Pre-renal – blood supply to kidney failure Renal – damage to kidney tissue Post-renal –Obstruction blocks urinary drainage Treatment – treat underlying disease; dialysis if severe
45
Chronic renal failure biochemical findings and management
Slow onset (months, years) - IRREVERSIBLE Biochemical findings: Hyperkalaemia -nephron can’t excrete K when GFR decreases. Danger Serum urea and creatinine high Management: sodium restriction diuretics dietary restriction of protein oral ion exchange resin (K removal) Longer term: dialysis or transplant
46
Label the artery structure
47
Development of atheroma in the coronary ateries
1. Macrophages release lipid (and chemical signals) into intima. 2. Cells of intima release collagen in response to signals. 3. Formation of a raised yellow smooth area = LIPID PLAQUE 4. Fibrolipid cap forms 5. Endothelium fragile and often ulcerates 6. Platelets aggregate on plaque which stimulates thrombus formation
48
What are the 4 consequences of atheroma
1. Artery narrowing 2. Thrombus formation 3. Bleeding into the plaque 4. Aneurysm
49
What is arterioslerosis
Thickening and hardening of artery walle
50
What is atherosclerosis
Thickening and hardening of high pressure artery wall caused by atheroma
51
What are troponins and what do the three types do
Troponins exist as a complex of actin and myosin and regulate the contraction of striated muscle Troponin C: binds to calcium and regulated the action of the filaments during contraction Troponin I: inhibitory subunit that prevents contraction in the absence of calcium and troponin C Troponin T: binds the complex to tropomyosin
52
What is red bone marrow
Haematopoietic cells of varying lineage and maturity packed between bony trabeculae of spongy bone.
53
Structure and function of erthrocytes
-Biconcave – mean diameter 7.8 mm and 2.5 mm at the circumferential border -Large surface area –oxygen diffusion -No nucleus (initially had nucleus) -120 day lifespan = 300 miles -Oxygen transport -Carbon dioxide transport -Each rbc contains haemoglobin and enzymes
54
What (blood wise) causes sickle cell anaemia
Abnormal beta chain in haemoglobin Haemoglobin chains stick when deoxygenated Erythrocyte deformed and stuck in capillaries Tissues starved of oxygen
55
Blood type and there compatible and incompatible bloods
56
3 complications of blood transfusion
Wrong blood given Iron overload Infection
57
The Health Act 2006 states
Patients must be cared for in a clean environment Keep risk of HAI as low as possible
58

131/133/134/135/143 - AI (4 decks)

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