Integrative pathophysiology

Question 1

What are the components of melanoma tumour stage (TNM)?

Answer 1

Breslow thickness
ulceration
microsatellites

Question 2

What are the 4 layers of the epidermis?

Answer 2

stratum corneum
stratum granulosum
stratum spinosum
stratum basale

Question 3

Where is Breslow thickness measured to and from?

Answer 3

measured from stratum granulosum layer to deepest invasive melanocyte

Question 4

What is regression in melanoma?

Answer 4

depigmented area
patient mounted effective immune response to malignant melanocytes causing destruction

Question 5

How does regression show under a microscope?

Answer 5

absence of melanocytes in dermis
scar tissue formation + deposition of pink collagen fibres
blood vessel proliferation
scattered melanophages

Question 6

What causes erythema?

Answer 6

dilated blood vessels
lymphocytic inflammation around blood vessels (perivascular inflammation)

Question 7

What causes surface scale?

Answer 7

hyperkeratosis

Question 8

What is the only epithelial type that produces keratin?

Answer 8

squamous epithelium

Question 9

What is the Lesser-Trelat sign?

Answer 9

abrupt appearance of multiple seborrhoeic keratoses can be a sign of internal malignancy

Question 10

What is parakeratosis and what is it associated with?

Answer 10

nuclei present in thickened keratin layer
increased rate epidermal turnover

Question 11

What epidermal layer do scabies mites burrow through?

Answer 11

stratum corneum

Question 12

What is raised number of eosinophils associated with?

Answer 12

hypersensitivity reaction in skin

Question 13

What causes a pustule?

Answer 13

accumulation of neutrophils + bacteria in follicular infundibulum

Question 14

What causes an abscess?

Answer 14

collection of neutrophils with surrounding fibrosis

Question 15

Stages of neutrophil emigration

Answer 15

margination
rolling
adhesion
diapedesis
phagocytosis

Question 16

What sign is associated with Reed-Sternberg cells and what condition are they seen in?

Answer 16

Owl’s eye nuclei
Hodgkin Lymphoma

Question 17

What are Pel-Ebstein fevers?

Answer 17

cyclical fever with periods of both high + normal temperature

Question 18

List the 3 B symptoms

Answer 18

fever
weight loss
night sweats

Question 19

Follicular lymphoma genetic abnormality

Answer 19

t(14;18)
links BCL2 gene on chromosome 18 with the immunoglobulin heavy chain gene on chromosome 14

Question 20

Burkitt lymphoma genetic abnormality

Answer 20

t(8;14) [most commonly]
links myc gene on chromosome 8 with immunoglobulin heavy chain gene on chromosome 14

Question 21

Mantle cell lymphoma genetic abnormality

Answer 21

t(11;14)
links cyclin D1 gene on chromosome 11 with the immunoglobulin heavy chain gene on chromosome 14

Question 22

CML genetic abnormality

Answer 22

t(9;22)
links proto-oncogene tyrosine protein kinase ABL 1 gene on chromosome 9 with the breakpoint cluster (BCR)gene on chromosome 22

Question 23

Which cells are CD4, CD3, CD8, CD30 and CD20 expressed on?

Answer 23

CD4 = helper T-cell
CD3 = T-cell
CD8 = cytotoxic T-cell
CD30 = Reed-sternberg cell
CD20 = B-cell

Question 24

Microcytic anaemia causes (TAILS)

Answer 24

Thalassaemia
Anaemia of chronic disease
Iron deficiency anaemia
Lead poisoning
Sideroblastic anaemia

Question 25

What would a raised protein level but a normal albumin suggest?

Answer 25

paraprotein present

Question 26

What do plasma cells produce in myeloma and what does this cause?

Answer 26

plasma cells produce RANKL which binds to RANK on cell membrane of osteoclasts, causing their activation, resulting in osteolytic lesions

Question 27

Define dysplasia

Answer 27

disordered growth

Question 28

Define hyperplasia

Answer 28

increase in cell number

Question 29

Define atrophy

Answer 29

reduction in size of a cell or organ

Question 30

Define metaplasia

Answer 30

replacement of a mature cell type with a different mature cell type

Question 31

Define hypertrophy

Answer 31

increase in size of cell or organ

Question 32

What can smoking cause (in terms of cells changes)?

Answer 32

metaplasia columnar epithelium --> squamous epithelium

Question 33

Where does SCC of lung arise from?

Answer 33

arise from bronchi cause central masses

Question 34

Where do adenocarcinomas of lung generally present?

Answer 34

often seen peripherally

Question 35

What are the 5 layers of the epidermis (from top to bottom)?

Answer 35

Stratum corneum Stratum lucidum Stratum granulosum Stratum spinosum Stratum basale

Question 36

What type of epithelium is the epidermis?

Answer 36

stratified squamous epithelium

Question 37

What is the main cell found in the epithelium?

Answer 37

keratinocytes

Question 38

How do keratinocytes mature in the epidermis?

Answer 38

they mature upwards from stratum basale to stratum corneum

Question 39

What is the epidermis derived from? (embryology)

Answer 39

ectoderm

Question 40

What is the dermis derived from? (embryology)

Answer 40

mesoderm

Question 41

What cells can be found in smaller numbers than keratinocytes in the epidermis?

Answer 41

melanocytes langerhans cells