Anatomical Pathology Flashcards
(218 cards)
1
Q
A
2
Q
A
3
Q
What are the two main types of immunity?
A
Cell mediated and humoral immunity
Cell mediated immunity defends against intracellular microbes, while humoral immunity protects against extracellular microbes and their toxins.
4
Q
List examples of organ specific autoimmune diseases.
A
- Hashimoto’s thyroiditis
- Grave’s disease
- Autoimmune atrophic gastritis
- Goodpasture’s syndrome
- Myasthenia gravis
- Pemphigus vulgaris
- Autoimmune haemolytic anaemia
- Autoimmune thrombocytopenic purpura
These diseases involve an immune response specifically targeting certain organs or tissues.
5
Q
What is the mechanism of Type I hypersensitivity reactions?
A
IgE is produced, leading to immediate release of vasoactive amines from mast cells and recruitment of inflammatory cells
Common diseases associated with Type I hypersensitivity include anaphylaxis, allergies, and asthma.
6
Q
What are the clinical features of systemic lupus erythematosus?
A
Clinical features include a variety of systemic symptoms, but specifics were not listed in the provided text.
Systemic lupus erythematosus is an autoimmune disease characterized by a wide range of symptoms affecting multiple organ systems.
7
Q
What defines innate immunity?
A
Defence mechanisms that are present before infection
Innate immunity includes epithelial barriers, phagocytic cells, natural killer cells, and plasma proteins.
8
Q
What is the role of T-helper cells in adaptive immunity?
A
T-helper cells amplify B cell response
They play a crucial role in coordinating the immune response.
9
Q
What are the four types of hypersensitivity reactions?
A
- Type I (immediate)
- Type II (antibody mediated)
- Type III (immune complex mediated)
- Type IV (cell mediated)
Each type involves different mechanisms and diseases.
10
Q
True or False: Autoimmune diseases can be organ specific or generalized.
A
True
Generalized autoimmune diseases often affect connective tissues and vessels.
11
Q
Fill in the blank: Autoimmune diseases result when the immune system reacts against its own _______.
A
[tissues]
This reaction typically occurs due to loss of self-tolerance.
12
Q
What are the pathological features of generalized autoimmune diseases?
A
- Fibrinoid necrosis
- Inflammation
- Fibrosis
These diseases are often referred to as collagen vascular diseases.
13
Q
What is the primary characteristic of rheumatoid arthritis?
A
Chronic inflammatory synovitis and erosion of the articular cartilage
It primarily affects joints and can lead to significant deformities.
14
Q
What are extra-articular features of rheumatoid arthritis?
A
- Subcutaneous rheumatoid nodules
- Anaemia
- Lymphadenopathy and splenomegaly
- Pericarditis
- Dry eyes and mouth (Sjogren’s syndrome)
- Uveitis and scleritis
- Vasculitis
- Pulmonary nodules and interstitial fibrosis
- Amyloidosis
These features indicate the systemic nature of the disease.
15
Q
Define scleroderma.
A
Systemic disorder characterized by sclerosis (hardening) of connective tissues
It may involve symptoms such as Raynaud’s phenomenon and thickening of skin.
16
Q
What distinguishes polymyositis from dermatomyositis?
A
Polymyositis involves muscle weakness, while dermatomyositis includes skin changes along with muscle weakness
Dermatomyositis features purple (heliotrope) discoloration and swelling of eyelids.
17
Q
What is the significance of HLA antigen B27 in ankylosing spondylitis?
A
90% of patients will have the HLA antigen B27
This antigen is associated with increased susceptibility to the disease.
18
Q
What are the systemic features of ankylosing spondylitis?
A
- Peripheral arthritis (spares hands)
- Uveitis
- Aortic valve incompetence
- Chronic inflammatory bowel disease
These features indicate the systemic impact of the disease.
19
Q
What are common treatment options for generalized autoimmune diseases?
A
- Corticosteroids
- Immunosuppressive drugs
These treatments aim to manage symptoms and reduce immune system activity.
20
Q
What is a common consequence of long-term steroid use in autoimmune disease patients?
A
Predisposition to infections
Long-term steroid use can have various side effects, including hepatotoxicity.
21
Q
A
22
Q
What is the difference between ionizing and non-ionizing radiation?
A
Ionizing radiation is >10V and can remove tightly bound electrons, while non-ionizing radiation is <10V and cannot remove electrons.
Examples of non-ionizing radiation include UV light and microwaves, whereas ionizing radiation includes X-rays and gamma rays.
23
Q
What are the effects of radiation injury on the heart?
A
Increased risk for:
* CAD
* Valvular heart disease
* CHF
* Pericardial disease
* Sudden death
Cardiovascular disease is a common cause of death among Hodgkin lymphoma patients treated with radiation.
24
Q
List the common side effects of chemotherapeutic agents.
A
Common side effects include:
* Myelosuppression
* Nausea
* Vomiting
* Hair loss
* Fatigue
* Risk of infection
Most side effects are temporary but can lead to permanent changes.
25
What are the histopathological features of radiation-induced cell injury?
Features include:
* Cell death
* Atrophy
* Fibrosis
## Footnote
These features can be observed in affected organs, particularly in the lungs, heart, gastrointestinal tract, and liver.
26
Describe the mechanism of radiation-induced injury.
Mechanisms include:
* Direct injury to cell membranes and organelles
* Direct injury to DNA
* Generation of free radicals
* Necrosis or apoptosis of injured cells
## Footnote
Survival of cells with DNA mutations may lead to cancer.
27
How does the rate of delivery of radiation affect biological effects?
A larger ionizing dose correlates with more tissue damage, and continuous radiation causes more injury than periodic radiation.
## Footnote
Field size and rate of cellular proliferation also influence injury risk.
28
What is Radiation Induced Liver Disease (RILD)?
RILD is characterized by:
* Ascites
* Hepatomegaly
* Abnormal liver function tests
## Footnote
It develops 2-4 months after hepatic irradiation.
29
What are the clinical findings of radiation pneumonitis?
Clinical findings include:
* Dyspnea
* Cough
* Low-grade fever
* Chest discomfort
## Footnote
These symptoms typically occur days to weeks after exposure.
30
What are the phases of lung injury due to radiation?
The phases are:
* Acute exudative phase
* Organizing phase
* Chronic fibrotic phase
## Footnote
The first two phases are referred to as radiation pneumonitis, while the third is called radiation fibrosis.
31
What are some effects of chemotherapy on the lungs?
Chemotherapy can lead to:
* Pulmonary reactions
* Drug-induced lung disease
* Abnormal lung function studies
## Footnote
Diagnosis requires differentiation from infection and other lung damage causes.
32
True or False: The heart is considered more vulnerable to chemotherapy toxicity than other tissues.
False
## Footnote
The heart is generally considered less vulnerable than tissues such as bone marrow and the gastrointestinal tract.
33
Fill in the blank: Chemotherapy uses one or more _______ to kill cancer cells.
[medications]
34
What are the effects of chemotherapy on the liver?
Chemotherapy effects include:
* Elevated liver enzymes
* Elevated bilirubin
* Liver damage/injury
## Footnote
Histological features may include cholestasis, steatosis, hepatitis, and hepatocellular necrosis.
35
What is the main cause of cardiovascular disease in patients treated with radiation?
Radiation therapy
## Footnote
Cardiovascular disease is the most common cause of death in Hodgkin lymphoma patients who received radiation.
36
What specific therapeutic agents are associated with myelosuppression?
Agents include:
* Methotrexate
* 5-Fluorouracil
* Doxorubicin
* Tamoxifen
## Footnote
Myelosuppression can vary in reversibility with different agents.
37
What is the conclusion regarding cancer treatment effects?
Cancer treatment may have unwanted side effects that can appear temporally removed from the cancer itself.
## Footnote
These effects should be considered, especially in patients presenting with second neoplasms.
38
39
Define the human endocrine system
An integrated and widely distributed group of organs that orchestrate a state of metabolic equilibrium within the body via molecular signaling of secreted molecules called hormones.
40
What are the two components of the pancreas?
* Exocrine pancreas
* Endocrine pancreas
41
What is diabetes mellitus?
A group of metabolic disorders sharing the common feature of hyperglycemia due to a defect in insulin production or action.
42
List the clinical features of diabetes mellitus.
* Increased thirst
* Frequent urination
* Increased appetite
* Weight loss
43
What is the primary function of insulin?
To lower blood glucose levels in response to high blood glucose levels.
44
What is the primary function of glucagon?
To increase blood glucose levels in response to low blood glucose levels.
45
Define Cushing syndrome
A constellation of bodily responses to excess glucocorticoids.
46
What is Addison disease?
Chronic insufficiency of adrenal cortical hormones due to destruction of the adrenal cortex.
47
What are the two major types of diabetes mellitus?
* Type 1 DM
* Type 2 DM
48
What is the aetiology of Type 1 diabetes mellitus?
An autoimmune disease resulting in destruction of Beta cells.
49
What distinguishes Type 2 diabetes mellitus from Type 1?
Type 2 involves peripheral resistance to insulin action and an inadequate secretory response by the Beta cells.
50
What are the microscopic changes in the pancreas for Type 1 diabetes?
* Lymphocytic infiltrate of the islets
* Reduction in size of islets
* Atrophy
* Fibrosis
51
What are the acute clinical features of diabetes mellitus?
* Polyuria
* Polydipsia
* Polyphagia
* Dizziness
* Weakness
52
What are the chronic complications of diabetes mellitus?
* Macrovascular disease
* Microvascular disease
53
What is the primary cause of Cushing syndrome?
* Administration of excess glucocorticoids
* Excess secretion of ACTH by a pituitary adenoma
54
List the clinical features of Cushing syndrome.
* Central obesity
* Buffalo hump
* Moon face
* Osteoporosis
* Muscle weakness
55
What is the primary cause of Addison disease?
* Autoimmune destruction
* Infections (e.g., tuberculosis, HIV)
* Metastatic neoplasms
56
What are the clinical features of Addison disease?
* Weakness
* Weight loss
* Anorexia
* Nausea and vomiting
* Hypoglycemia
57
Fill in the blank: The endocrine pancreas secretes hormones such as _______ and _______.
[insulin], [glucagon]
58
True or False: Type 1 diabetes mellitus usually occurs in middle-aged or older patients.
False
59
What is the role of ACTH in adrenal gland function?
ACTH stimulates the adrenal gland to produce glucocorticoids.
60
What is glucotoxicity?
The toxic effect of persistent hyperglycemia on blood vessels.
61
What is the difference between primary and secondary adrenal insufficiency?
Primary is due to a defect in the adrenal gland, while secondary is due to decreased stimulation from ACTH.
62
What are the effects of chronic high blood glucose levels?
* Damage to blood vessels
* Increased risk of myocardial infarcts
* Diabetic neuropathy
63
What is the significance of consistent blood glucose level control in diabetes?
To prevent complications related to chronic hyperglycemia.
64
65
What are the objectives of the Renal Pathology course?
• List some causes of proteinuria/nephrotic syndrome
• List some causes of haematuria/nephritic syndrome
• Discuss acute tubular necrosis
• Describe how diabetes affects the kidney
• List the causes of acute and chronic renal failure
• Discuss the pathogenesis of acute pyelonephritis
• Define vesico-ureteric reflux
## Footnote
Course coordinators include Dr Janine van der Linde, Dr Monique Keller, and Eileen du Plooy.
66
What is the normal anatomy of the kidney?
• Bean-shaped retroperitoneal organs
• Weighs 120-150g
• Approximately 11cm in length
• Cortex: outer layer, smooth surface, 1.2 – 1.5cm
• Medulla: cone-shaped pyramids with papillae
## Footnote
Papillae drain into pelvis, which drains into ureter.
67
What are the main functions of the kidney?
• Eliminating metabolic waste
• Regulating fluid and electrolyte balance
• Maintaining acid-base balance
• Secretion of hormones:
* Prostaglandins
* Erythropoietin
* α-1 hydroxylase
* Renin
## Footnote
These hormones play roles in vascular tone and RBC production.
68
What is the functional unit of the kidney?
Nephron
## Footnote
Components include glomerulus with Bowman’s capsule, proximal convoluted tubules, loops of Henle, distal tubules, and collecting ducts.
69
What are clinical features of renal disease?
• Proteinuria/nephrotic syndrome
• Hematuria/nephritic syndrome
• Systemic hypertension
• Acute/chronic renal failure
• Urinary tract infections
• Nephrolithiasis
• Symptoms related to renal tubular defects
## Footnote
These features help in diagnosing renal diseases.
70
What is proteinuria?
Presence of protein within the urine
• Persistent > 30 mg/24 hours in adults
• > 100 mg/m2/24 hours in children
## Footnote
Heavy proteinuria (≥ 3.5 grams/24 hours) characterizes nephrotic syndrome.
71
What are primary renal disease patterns resulting in proteinuria/nephrotic syndrome?
• Minimal change disease
• Focal segmental glomerulosclerosis (FSGS)
• Membranous glomerulonephritis (GN)
• Membranoproliferative GN
## Footnote
These conditions significantly impact kidney function.
72
What is haematuria?
Presence of blood in the urine
• Can be microscopic or macroscopic
• May be intermittent or persistent
## Footnote
Dysmorphic red blood cells indicate glomerular disease.
73
What are primary glomerular disease patterns associated with hematuria/nephritic syndrome?
• Diffuse proliferative GN
• Mesangioproliferative GN
• Thin basement membrane disease
• Anti-GBM disease
• Focal segmental proliferative GN
## Footnote
Understanding these patterns aids in diagnosis.
74
What is nephritic syndrome?
Acute onset hematuria, oliguria, systemic hypertension, +/- peripheral edema, +/- proteinuria
## Footnote
This syndrome indicates significant renal pathology.
75
What systemic diseases can involve the kidney?
• Diabetes mellitus
• Systemic lupus erythematosus
• Amyloidosis
• Infections (e.g., HIV, malaria, Hepatitis)
• Drugs (e.g., Heroin)
## Footnote
Renal involvement can complicate these conditions.
76
What are the renal effects of diabetes mellitus?
• Diabetic nephropathy (glomerulopathy, arteriolar hyalinosis, tubulointerstitial lesions)
• Clinical presentation includes chronic renal failure and proteinuria/nephrotic syndrome
## Footnote
Changes include capillary wall thickening and mesangial expansion.
77
What is acute tubular necrosis (ATN)?
Characterized by destruction of tubular cells and acute suppression of renal function
• Important cause of acute renal failure
• Can recover fully with appropriate support
## Footnote
Patients may present with marked oliguria (<100 ml/24hr).
78
What are the causes of ischemic ATN?
• Trauma
• Burns
• Infections
## Footnote
Pathogenesis involves hypovolemia leading to decreased renal blood flow.
79
What are the causes of toxic ATN?
• Heavy metals (e.g., mercury, gold)
• Organic solvents (e.g., carbon tetrachloride)
• Glycol (e.g., ethylene glycol)
• Iatrogenic agents (e.g., antibiotics)
• Pesticides
## Footnote
Tubular epithelial cells are particularly vulnerable to toxic injury.
80
What are the types of renal failure?
• Acute renal failure (ARF)
• Chronic renal failure (CRF)
## Footnote
Each type has distinct causes and presentations.
81
What are the causes of chronic renal failure?
• Glomerulonephritis
• Diabetic glomerulopathy/glomerulosclerosis
• Chronic pyelonephritis
• Obstructive uropathy
• Hypertensive nephrosclerosis
• Polycystic kidney disease
• Drug or toxin-induced renal damage
## Footnote
Chronic renal failure often results from a gradual loss of renal function.
82
What is vesico-ureteric reflux (VUR)?
Abnormal angle at which the terminal ureteric segment enters the bladder
## Footnote
In VUR, urine can reflux during bladder contraction, increasing the risk of pyelonephritis.
83
What are the clinical features of acute pyelonephritis?
• Acute suppurative inflammation of tubules and interstitium
• Symptoms include fever, malaise, dysuria
• Presence of white cell casts indicates pyelonephritis
## Footnote
Often caused by Gram-negative bacteria such as E. coli.
84
85
What is the causative agent of tuberculosis?
Mycobacterium tuberculosis
## Footnote
Aerobic bacteria that require oxygen and have a unique cell wall containing mycolic acid.
86
What are the two major routes of tuberculosis infection?
* Respiratory
* Oropharyngeal
87
What are the three basic steps in the pathogenesis of tuberculosis?
* Host immune response to pathogen
* Evasion of host immune response by pathogen
* Spread of pathogen through host body
88
What type of immune response is primarily involved in tuberculosis?
Innate immune response and cell-mediated immune response
89
What is the role of macrophages in the innate immune response to TB?
Phagocytosis
90
How does Mycobacterium tuberculosis evade the host immune response?
Prevents lysosome from attaching to phagosome
91
What happens to T-cells during the adaptive immune response to TB?
T-cell becomes activated and releases IFN-γ (interferon-gamma)
92
What are the effects of IFN-γ in TB infection?
* Stimulates maturation of phagolysosome
* Stimulates nitrous oxide production
* Mobilises defensins
* Stimulates autophagy
93
What is a granuloma in the context of tuberculosis?
A consequence of the host immune response characterized by a collection of immune cells
94
What is the difference between primary and secondary TB infection?
Primary TB occurs in previously unexposed hosts, while secondary TB can occur after re-exposure or reactivation.
95
What is the Ghon complex?
Granuloma formation and spread to lymph nodes in primary TB
96
What are common clinical outcomes of primary TB?
* Latency with viable bacilli
* Disease progression (e.g., bronchopneumonia)
* Haematogenous spread
97
What is miliary TB?
A severe form of TB characterized by the spread of bacilli through the bloodstream to multiple organs
98
List major organs affected by miliary TB.
* Brain
* Bones
* Liver
* Spleen
* Intestines
* Bladder
* Heart
* Skin
* Kidney
99
What staining method is used for microscopic identification of Mycobacterium tuberculosis?
Ziehl-Neelsen stain
100
What are the reagents used in the Ziehl-Neelsen stain?
* Carbol fuchsin
* Acid alcohol
* Methylene blue
101
True or False: Tuberculosis has been present in human history for over 9000 years.
True
102
Who discovered the contagious nature of tuberculosis?
Jean Antoine Villemin in 1869
103
What is the significance of Robert Koch in tuberculosis research?
He discovered the tuberculosis bacterium in 1882, known as 'Koch's bacillus'
104
105
Define obesity
A disorder of energy balance where food-derived energy chronically exceeds energy expenditure, leading to excess calorie storage in adipose tissue.
106
What are the BMI categories?
* BMI < 18.5 = underweight
* 18.5 - 24.9 = normal
* 25.0 - 29.9 = overweight
* BMI ≥ 30 = obese
107
What type of obesity is associated with a higher risk of disease?
Central/visceral obesity
108
List the multifactorial causes of obesity
* Genetic
* Psychological
* Environmental
109
What is the impact of obesity on life expectancy?
Reduces life expectancy by increasing the risk of some diseases.
110
Name one gastrointestinal complication associated with obesity
Gallstones
111
What is a respiratory complication associated with obesity?
Sleep apnoea
112
What are the two main forms of protein-energy malnutrition?
* Marasmus
* Kwashiorkor
113
Define marasmus
Severe reduction in calorie intake, resulting in growth retardation and loss of muscle mass.
114
Define kwashiorkor
Protein deprivation greater than calorie reduction, leading to loss of visceral protein, especially in the liver.
115
What are the consequences of vitamin A deficiency?
* Night blindness
* Xerophthalmia
* Mucosal infections
116
What is the main consequence of vitamin B1 deficiency?
Beri beri
117
What does vitamin B12 deficiency lead to?
Megaloblastic anaemia and subacute combined degeneration of the spinal cord.
118
Fill in the blank: Diabetes mellitus is characterized by impaired glucose homeostasis due to an insufficiency of _______.
insulin
119
What are the two types of diabetes mellitus?
* Type I (juvenile onset, insulin-dependent)
* Type II (maturity onset, non-insulin dependent)
120
What is gout a result of?
High blood uric acid levels
121
List one inborn error of metabolism.
Phenylketonuria
122
What impact do metabolic disorders have on motility?
Decreased energy levels.
123
True or False: Timely diagnosis and optimal control of metabolic disorders improve outcomes.
True
124
What is the consequence of vitamin C deficiency?
Scurvy, swollen bleeding gums, bruising and bleeding.
125
What is a common complication of obesity related to the cardiovascular system?
Hypertension
126
What is a gynaecological complication associated with obesity?
Infertility
127
128
What is inflammation?
A physiological response to tissue injury.
## Footnote
Inflammation can be acute or chronic.
129
What are the two types of inflammation?
* Acute
* Chronic
130
What are the physical characteristics of acute inflammation?
* Rubor (redness)
* Calor (heat)
* Tumour (swelling)
* Dolor (pain)
* Functio laesa (loss of function)
131
What are common causes of acute inflammation?
* Microbial infection
* Hypersensitivity reaction
* Physical agent (trauma, heat, cold, radiation)
* Chemicals (corrosives, acids)
* Tissue necrosis (ischemic infarction)
132
What are the possible outcomes of acute inflammation?
* Resolution
* Suppuration
* Organisation
* Progression to chronic inflammation
133
What processes occur during acute inflammation?
* Change in vessel calibre and flow
* Increased vascular permeability
* Formation of fluid exudate
* Emigration of neutrophils
134
List some chemical mediators involved in acute inflammation.
* Histamine
* Prostaglandins
* Serotonin
* Cytokines
* Interleukins
135
What is the role of histamine in acute inflammation?
Causes vasodilation and increased permeability.
## Footnote
Histamine is released from mast cells.
136
What are the main cells involved in acute inflammation?
* Macrophages
* Neutrophils
137
What is the function of neutrophils in acute inflammation?
* Move to the site of inflammation
* Opsonise microbes
* Perform phagocytosis
138
What are some beneficial effects of acute inflammation?
* Dilution of toxins
* Entry of antibodies
* Transport of drugs
139
What are some harmful effects of acute inflammation?
* Digestion of normal tissue
* Swelling causing obstruction
* Inappropriate inflammatory response
140
What is chronic inflammation?
A process that has extended over a long period of time with predominant lymphocytes, plasma cells, and macrophages.
141
What cells predominantly participate in chronic inflammation?
* B lymphocytes
* T lymphocytes
* Plasma cells
* Macrophages
142
What are the main characteristics of chronic inflammation?
* Continuing destruction of tissue
* Granulation and scar tissue formation
* Angiogenesis and fibroblast proliferation
143
What role do T lymphocytes play in chronic inflammation?
* Recruit macrophages
* Produce inflammatory mediators
* Destroy target cells
144
What are systemic effects of inflammation?
* Pyrexia
* Constitutional symptoms (malaise, anorexia, nausea)
* Weight loss
* Reactive hyperplasia of reticulo-endothelial system
* Amyloidosis
145
What haematological changes occur during inflammation?
* Increased erythrocyte sedimentation rate
* Leukocytosis
* Anemia
146
What is the role of macrophages in chronic inflammation?
Phagocytic cells that move in response to chemotactic stimuli and are derived from blood monocytes.
147
What is a granuloma?
A collection of epitheliod histiocytes formed during chronic inflammation.
148
True or False: Acute inflammation is usually associated with systemic symptoms like fever.
True
149
Fill in the blank: Chronic inflammation is associated with _______.
scarring and contractures
150
What is the main cell type involved in the initial response of acute inflammation?
Neutrophils
151
152
What is the estimated number of people living with HIV in South Africa?
7 600 000
## Footnote
This statistic highlights the significant impact of HIV in the region.
153
What percentage of people living with HIV in South Africa are receiving ART?
62%
## Footnote
This reflects the efforts in providing antiretroviral therapy to individuals diagnosed with HIV.
154
What is the percent change in new HIV infections in South Africa since 2010?
-57%
## Footnote
This indicates a significant decline in new infections over a decade.
155
What type of cells does HIV primarily attack?
CD4 cells
## Footnote
CD4 cells are crucial for the immune response.
156
What is encouraged for all persons at risk of HIV?
Testing, consent, confidentiality, counselling, and access to healthcare
## Footnote
These measures are essential for early detection and management.
157
What are the stages of HIV infection?
* Acute retroviral syndrome
* Chronic phase
* Clinical AIDS
## Footnote
Each stage has distinct clinical features and implications.
158
What are common symptoms of acute retroviral syndrome?
* Sore throat
* Myalgia
* Fever
* Fatigue
## Footnote
These symptoms typically appear 3-6 weeks after infection.
159
What happens during the chronic phase of HIV infection?
Lymph nodes and spleen are sites of HIV replication and cell destruction
## Footnote
This phase often has few clinical manifestations.
160
What is a significant consequence of untreated HIV infection over 7-10 years?
Progression to AIDS
## Footnote
Exceptions include rapid progressors and long-term nonprogressors.
161
What are the common causes of death in AIDS patients?
* Opportunistic infections
* Secondary neoplasms
## Footnote
These complications arise due to severely compromised immunity.
162
Name two viral infections associated with HIV/AIDS.
* Cytomegalovirus
* Herpes simplex
## Footnote
These infections can lead to severe complications in HIV-positive individuals.
163
Which opportunistic infection is most commonly associated with AIDS?
Tuberculosis (TB)
## Footnote
TB incidence increases dramatically during the AIDS epidemic.
164
List three fungal infections associated with HIV.
* Histoplasmosis
* Candida
* Pneumocystis jirovecii
## Footnote
These infections can significantly impact the health of HIV-positive individuals.
165
What type of neoplasia is most commonly associated with HIV?
* Kaposi sarcoma
* Lymphomas
## Footnote
These cancers are linked to immunosuppression in HIV patients.
166
What is Kaposi sarcoma associated with?
Human Herpesvirus 8 (HHV-8)
## Footnote
It is a vasoformative tumor and a common manifestation in HIV.
167
What is a common neurological complication in HIV-infected individuals?
HIV-associated neurocognitive disorder
## Footnote
This can range from mild cognitive changes to dementia.
168
What is the role of the JC virus in HIV-related neurological disease?
Causes Progressive Multifocal Leukoencephalopathy (PML)
## Footnote
PML involves demyelination and is a severe complication.
169
What is Immune Reconstitution Inflammatory Syndrome (IRIS)?
Paradoxical worsening of symptoms after ART initiation
## Footnote
This can occur as the immune system begins to recover.
170
Fill in the blank: The most common cause of cutaneous disorders in AIDS is _______.
Fungal, viral, bacterial infections
## Footnote
Various infections can manifest in the skin of HIV-positive individuals.
171
What are some adverse effects of antiretroviral therapy?
* Lipodystrophy
* Elevated lipids
* Insulin resistance
## Footnote
These side effects can complicate the management of HIV.
172
What socioeconomic factors must be considered in HIV management?
* Employment
* Family support
## Footnote
These factors can significantly impact treatment adherence and health outcomes.
173
True or False: HIV treatment can lead to adverse reactions.
True
## Footnote
While lifesaving, treatment can also introduce complications.
174
175
Define atrophy
Acquired decrease in size of an organ or cell by reduction in cell size and/or cell numbers.
## Footnote
Atrophy occurs in both physiological and pathological conditions.
176
What is hyperplasia?
Increase in size of a tissue or organ due to an increase in the NUMBER of its constituent cells (by cell replication / mitosis).
## Footnote
Hyperplasia often co-exists with hypertrophy.
177
Define hypertrophy
Increase in the size of a tissue/organ due to an increase in SIZE of its constituent cells without cell division.
## Footnote
Commonly occurs in permanent cells such as neurons and cardiac myocytes.
178
What is metaplasia?
Reversible transformation of one type of terminally differentiated cell into another type of fully differentiated cell that is usually less specialized.
## Footnote
Represents an adaptive response to environmental stress.
179
Discuss dysplasia
Premalignant condition characterized by abnormal size, number, shape, and orientation of epithelial cells.
## Footnote
Can be caused by longstanding physical or chemical injury.
180
What is the definition of neoplasia?
Neoplasia is 'new growth'; the lesion formed is called a neoplasm or tumor.
## Footnote
Neoplastic cells in malignant tumors can invade and metastasize.
181
List the different classifications for tumors
* Anatomical (macroscopic appearance & site of origin)
* Histogenetic (tissue of origin)
* Histological (degree of differentiation)
* Behavioral (benign vs malignant)
* Aetiological classification
## Footnote
Behavioral classification is the most important.
182
True or False: Malignant neoplasms develop in approximately 25% of the human population.
True
## Footnote
Individual risk increases with age, but tumors can occur even in infancy.
183
What are the characteristics of benign tumors?
* Non-invasive
* Remain localized
* Slow-growing
* Close histological resemblance to parent tissue
## Footnote
This contrasts with malignant tumors.
184
What are the characteristics of malignant tumors?
* Invasive
* Capable of direct and distant spread by metastasis
* Relatively rapid growth rate
* Variable histological resemblance to the parent tissue
## Footnote
This classification is crucial for surgical pathology.
185
Define physiological atrophy
Atrophy that occurs in normal physiological processes such as aging or development.
## Footnote
Examples include the closure of the ductus arteriosus in infants.
186
What causes pathological atrophy?
* Decreased function/disuse
* Denervation
* Loss of blood supply
* Pressure atrophy
* Malnutrition
* Loss of endocrine stimulation
* Hormone-induced atrophy
## Footnote
Each cause can lead to significant tissue loss.
187
What is the significance of dysplasia?
It is a potential precursor to cancer and may be reversible in early stages.
## Footnote
Full thickness dysplasia is known as carcinoma in situ.
188
Fill in the blank: A neoplasm is an _______ tissue mass that persists in an excessive manner.
abnormal
## Footnote
Neoplasms can be benign or malignant.
189
What features distinguish neoplasms from normal tissues?
* Loss of differentiation
* Loss of cellular cohesion
* Nuclear enlargement and pleomorphism
* Increased and abnormal mitotic activity
## Footnote
These features are more pronounced in malignant neoplasms.
190
What is the histogenetic classification of tumors?
Classification by cell of origin determined by histopathological examination.
## Footnote
Major categories include epithelial cells, mesenchymal tissues, and neural tissues.
191
What suffix is commonly used for benign tumors?
'-oma'
## Footnote
Not all '-omas' are neoplasms.
192
True or False: Tumors can be classified based on their macroscopic appearance.
True
## Footnote
For example, polypoid tumors are usually benign.
193
What are the implications of distinguishing between physiological and pathological growth?
It informs treatment and understanding of mechanisms behind growth abnormalities.
## Footnote
This distinction is vital for prognosis and behavior of tumors.
194
195
What is the main purpose of distinguishing between benign and malignant tumours?
Guides treatment, outlook, and prognosis.
196
List the general clinical characteristics of benign tumours.
* Grow by expansion
* Compress surrounding tissues & form a fibrous capsule
* Round, smooth, regular to palpation
* Grow slowly
* Do not recur after removal
* Rarely cause severe problems
197
List the general clinical characteristics of malignant tumours.
* Grow by local invasion & infiltration
* Poorly circumscribed, unencapsulated
* Fixed to surrounding tissues
* Rough & irregular to palpation
* May cause ulceration
* Grow rapidly
* Difficult to remove surgically in entirety
* Tendency to spread locally & by various routes to distant sites
198
What are the histological characteristics of benign tumours?
* Well-differentiated
* Localised and encapsulated
199
What are the histological characteristics of malignant tumours?
* Less differentiated
* Invade and infiltrate surrounding tissues
* Frequent mitoses
* Loss of normal arrangement of cells
200
Describe the cytological characteristics of benign cells.
Multiply regularly, slowly, and in an even fashion, forming a rounded mass.
201
Describe the cytological characteristics of malignant cells.
Multiply rapidly and irregularly; spikes and cords of cells are formed which infiltrate surrounding tissues.
202
What is the defining characteristic of malignant tumours?
Ability to invade and metastasise.
203
What are the four methods of tumour metastasis?
* Haematogenous
* Lymphatic
* Transcoelomic
* Implantation
204
What is the purpose of a frozen section in histological diagnosis?
Provides rapid diagnosis by allowing tissue to be frozen, sectioned, and stained quickly.
205
What types of specimens are suitable for histological examination?
* Excision biopsy
* Incision biopsy
* Trucut/core biopsy
206
What is the significance of tumour markers in diagnosis?
Help monitor clinical progress and detect tumours before they become symptomatic.
207
What is the difference between clinical staging and histological grading of tumours?
Staging refers to the extent of spread, while grading assesses the degree of malignancy.
208
What are the three grades of tumours?
* Well-differentiated
* Moderately-differentiated
* Poorly-differentiated
209
What is tumour cachexia?
A non-specific metabolic effect causing severe weight loss.
210
What is meant by 'carcinomatosis'?
Extensive metastatic disease.
211
True or False: All malignant tumours metastasise.
False.
212
Fill in the blank: The grading of tumours is based on _______.
histological features
213
What are common sites for blood-borne metastasis?
* Lungs
* Liver
* Bone
* Brain
* Adrenals
214
What is the most widely used staging system for tumours?
TNM staging.
215
What are the clinical effects of tumours?
* Compression of adjacent tissues
* Destruction of surrounding tissues
* Metabolic effects
216
What is the role of hormone/enzyme studies in the diagnosis of neoplasms?
Occasionally helpful but not always reliable for diagnosis.
217
What is the significance of mitotic activity in tumour grading?
Indicates the degree of malignancy.
218
What are the characteristics of malignant nuclei?
* Irregular in size
* Irregular in shape
* Hyperchromatic
* Multiple nucleoli
