General pathology

Question 1

Hyperplasia

Answer 1

Increase in number

Question 2

Hypertrophy

Answer 2

Increase in size

Question 3

Examples of metaplasia

Answer 3

Barrett’s oesophagus - epithelial cells
Myositis ossificans

Question 4

Evidence of reversible cell injury

Answer 4

Na/K ATPase
Cell swelling and blebbing
Fatty change

Question 5

Evidence of irreversible cell change

Answer 5

Elevated trop/CK
Loss of cell membrane/mitochondrial membrane/nucleus

Question 6

Mechanisms of cell death

Answer 6

Necrosis - NHS - free and messy
Apoptosis - Switzerland

Question 7

Necrosis

Answer 7

Exogenous
Large cell number
Large size
Inflammation
ATP independent
Disrupted cell membrane

Question 8

Apoptosis

Answer 8

Endogenous
Small number
Small size
No inflammation
ATP dependent
E.g. endometrial shedding

Question 9

Examples of apoptosis

Answer 9

Webbed fingers
Endometrial shedding
Viral-infected cells

Question 10

Coagulative necrosis

Answer 10

Most common
Due to structural integrity - DRY

Question 11

Liquefactive necrosis

Answer 11

Infective
In brain is cystic
Abscess - WET
Pancreas

Question 12

Caseous necrosis

Answer 12

TB

Question 13

Fat necrosis

Answer 13

Acute pancreatitis
Trauma to breast

Question 14

Dry gangrene

Answer 14

No arterial blood supply
No venous congestion

Question 15

Wet gangrene

Answer 15

Venous congestion

Question 16

Pale infarcts

Answer 16

Due to arterial occlusion
Happen in heart, kidney

Question 17

Congested infarcts

Answer 17

Due to venous occlusion
Happen in bowel, appendix, testes

Question 18

Acute inflammation

Answer 18

Macrophages
IL-1

Question 19

Chronic inflammation

Answer 19

T-cell
IL-2

Question 20

Resolution of inflammation

Answer 20

IL-10

Question 21

Pain transmitters

Answer 21

BEE
Bradykinin and PgE2

Question 22

Half life of platelets

Answer 22

7-10 days

Question 23

Half life of RBCs

Answer 23

120 days

Question 24

Which Pg cause vasodilatation?

Answer 24

DILATE - I A E
PgI
PgA
PgE

Question 25

How does arachidonic acid become prostaglandin?

Answer 25

Activated by cyclooxygenase (COX1 or COX2)

Question 26

Primary neutrophil granules

Answer 26

Lysozymes

Question 27

Secondary neutrophil granules

Answer 27

Lactoferrin

Question 28

Neutrophil - 5

Answer 28

Multilobar nucleus with granules in cytoplasm 5 hours in blood 5 days in tissue 50% in the lung

Question 29

C3a and C5a

Answer 29

A = anapylaxis = inflammation

Question 30

C3b

Answer 30

B = binding = opsonisation

Question 31

C5b - C9

Answer 31

MAC

Question 32

Excess serum light chains

Answer 32

Multiple myeloma Bence-Jones proteins

Question 33

IgG

Answer 33

Secondary infection

Question 34

IgE

Answer 34

Anaphylaxis

Question 35

IgA

Answer 35

Produced in saliva and terminal ileum (Peyer's patches in anti-mesenteric border) Increased when happy, decreased when sad

Question 36

IgM

Answer 36

Used for primary infection Has most binding sites

Question 37

Specialised macrophages

Answer 37

Epitheloid cells - flat, needed for granuloma formation Multi-nucleated giant cells - linked together

Question 38

Chronic granulomatous inflammation

Answer 38

Type IV reaction -->TB

Question 39

Caseating granuloma

Answer 39

TB, fungi, TNF-alpha, TNF-alpha blockers (reactivate TB)

Question 40

IL1

Answer 40

Neutrophils

Question 41

IL2

Answer 41

Macrophage

Question 42

Labile cells

Answer 42

Always working E.g. bone marrow, basal skin, GI stem cells

Question 43

Stable cells

Answer 43

Can work but not always E.g. liver, proximal renal tubules

Question 44

Permanent cells

Answer 44

Don't work E.g. neurons, striated muscles

Question 45

First stage of wound healing

Answer 45

Haemostasis - fibrin & platelet 1-3 days

Question 46

Second stage of wound healing

Answer 46

Inflammation - fibroblasts & macrophage Vit C and copper 4-7 days

Question 47

Third stage of wound healing

Answer 47

Proliferation - collagen & myofibroblasts Zinc 2-3 weeks

Question 48

Fourth stage of wound healing

Answer 48

Remodelling Weeks to months

Question 49

Proud flesh

Answer 49

Granulation tissue Neovascularisation protruding through epithelium

Question 50

Types of collagen

Answer 50

Type 1 - bONE, keloid scar Type 2 - cartilage Type 3 - blood vessels, pink scars Type 4 - basement membrane - 4 = floor

Question 51

Nutrients required for collagen

Answer 51

Vitamin C Copper

Question 52

Hypertrophic scar

Answer 52

Weeks Type 3 collagen Parallel and confined to borders

Question 53

Keloid

Answer 53

Months Excess type 1 collagen Beyond borders African Steroids - triamcinolone

Question 54

Psammoma bodies

Answer 54

Intra cellular calcification Papillary thyroid cancer, meningioma, mesothelioma

Question 55

Dystrophic calcification

Answer 55

Secondary to necrosis Localised calcification e.g. saponification in pancreatitis Normal calcium E.g. TB, AAA, pancreatitis

Question 56

Metastatic tissue calcification

Answer 56

Normal tissue Widespread calcification Increased calcium

Question 57

Stains used for amyloidosis

Answer 57

Congo red Apple green birefringence

Question 58

Arrangement of proteins in amyloidosis

Answer 58

Beta-pleated - enzyme unable to break down

Question 59

Primary systemic amyloid

Answer 59

Excess light chain produced by B cells Multiple myeloma

Question 60

Protein in restrictive cardiomyopathy

Answer 60

Transthyretin (ATTR)

Question 61

Dialysis related B2 microglobulin accumulation

Answer 61

Carpal tunnel syndrome

Question 62

Localised amyloid in thyroid

Answer 62

Calcitonin Medullary thyroid cancer - homogenous amorphous material

Question 63

Localised amyloid in pancreas

Answer 63

Amylin - T2DM

Question 64

Location of Peyer's patches

Answer 64

Anti-mesenteric border of ileum

Question 65

Location of B cells

Answer 65

Bone marrow

Question 66

Location of T cells

Answer 66

Thymus

Question 67

Thymus

Answer 67

3rd pharyngeal pouch 3rd year involutes 3rd part of inferior mediastinum

Question 68

Thymoma

Answer 68

Myasthenia gravis SVC syndrome Hassall corpuscles - medulla

Question 69

Most common cause of osteomyelitis in sickle cell anaemia

Answer 69

Salmonella

Question 70

Vaccinations needed post-splenectomy

Answer 70

S. Pneumonia N. Meningitidis H. Influenzae

Question 71

Susceptible viruses post-splenectomy

Answer 71

CMV/EBV

Question 72

Post-splenectomy bloods

Answer 72

Thrombocythaemia Howell-Jolly bodies Absence of bite cells Presence of target cells

Question 73

Stain for iron

Answer 73

Prussian blue

Question 74

Pappenheimer bodies

Answer 74

Sideroblastic anaemia

Question 75

Type I hypersensitivity

Answer 75

Allerges/asthma/anaphylaxis IgE on mast cells Increased tryptase

Question 76

Type II hypersensitivity

Answer 76

IgG Transfusion reaction Grave's Myasthenia gravis Goodpastures

Question 77

Type III hypersensitivity

Answer 77

Deposition of Ag/Ab complex SLE PAN PGN

Question 78

Type IV hypersensitivity

Answer 78

Cell-mediated - T cell TB, thyroiditis, transplant rejection, contact dermatitis, coeliac

Question 79

Most important HLA

Answer 79

HLA DR

Question 80

Which kidney is preferable for donation?

Answer 80

L due to longest vein

Question 81

Which vein is transplanted kidney anastomosed to?

Answer 81

External iliac

Question 82

Where are HLA genes found?

Answer 82

Chromosome 6

Question 83

Type of hypersensitivity G vs H

Answer 83

Type IV

Question 84

Cell type involved in graft vs host

Answer 84

T cells

Question 85

Most common viral infection following organ transplant in weeks

Answer 85

CMV

Question 86

Most common viral infection following organ transplant in months

Answer 86

EBV

Question 87

Anaphylaxis to blood transfusion

Answer 87

Type I

Question 88

Acute haemolytic transfusion reaction

Answer 88

Type II Painful - haemolytic

Question 89

Electrolyte abnormality following blood transfusion

Answer 89

High K High citrate Low Ca Low mg

Question 90

ABG following massive blood transfusion

Answer 90

Metabolic acidosis