Cell injury, apoptosis and death I Flashcards
what are the steps in diagnosing a patient
1) take clinical history and document symptoms
2) examine for clinical signs
3) perform investigations (eg lab test)
what are the 2 different types of diagnostic lab test
give examples of both
1) QUANTITATIVE measurement: interpreted in relationship to “normal” range
eg ELISA for serum insulin level test
2) SUBJECTIVE assessment: based on pathologist assessment
eg cervical epithelial cells on slide
whata re the aims of epidemiology
- provide aetiological clues to cause of disease
- plan preventative measures
- provision of adequate medical facilites
- population screening for early diagnosis
epidemiology establishes the ASSOCIATION between a risk factor and occurence NOT CAUSAL RELATIONSHIP
what is a prospective study
- subjects followed over time
- monitor risk factors
- determine their relative risk
what is a retrospective study
- looking back over a period of time
- PAST exposure to suspected aetiological factors examined
- odds ratio determined
what is a cross sectional study
- prevalence bwteen DIFFERENT POPULATIONS at a particular time
- for public health planning
- assess the association between risk factor and disease (limited though)
what is the purpose of an autopsy
- for legal/medical purpose
- determine cause of death
- collect evidence for prosecution
- info gained used for CLINICAL AUDIT, EDUCATION, MEDICAL RESEARCH
- diagnostic discrepancies are found in ~30% of cases
what is a clinical autopsy
it is non-medicolegal
- on patients who die in hospital with UNCLEAR DIAGNOSIS/ other reasons
who is the only type of person allowed to perform medico-legal autopsies
Home Office pathologists
what underpins cell injury
what are the 2 types
if a new challenge is too great, or for too long, cells may FAIL to MEET this demand and /show signs of injury, change/loss of function, change in morphology
Types: 1) reversible 2) irreversible
what happens to irreversibly injured cells
cell death
1) apoptosis
or
2) necrosis
what are the signs of reversible cell injury
- ER and mitochondrial swelling
- chromatin clumping
what are the 7 general causes of cell injury
give examples
1) oxygen deprivation (hypoxia, ischaemia)
2) physical agents (mechanical trauma, extreme temperature)
3) chemical agents and drugs (Cyanide, CO, alcohol)
4) infectious agents (viruses, bacteria)
5) immunological reactions (anaphylactic reaction to protein)
6) nutritional imbalances (vitamin deficiency, under/overnutrition)
7) genetic derangements (sickle cell anaemia)
what are the mechanisms of cell injury
complex and unknown in many cases
what is cellular response to injury/stimuli dependant on
type, severity and duration of injury
