Past questions - Pathology

Question 1

What is acute inflammation?

Answer 1

Bodys response to tissue injury.
Innate and immediate.

Heat, pain, redness, swelling

Question 2

What are the stages of wound healing?

Answer 2

1. Vasoconstriction
2. Hemostasis - vasodilation, increased vascular permeability, platelet activation
3. Inflammatory - migration of white cells - neutrophils
4. Phagocytosis - macrophages
5. proliferative - fibroblasts
6. resolution or progression

Question 3

Chemical mediators

Answer 3

Platelets - prostaglandins, leukotriene, histamine, serotonin

plasma - plasmin, bradykinin

complement

Question 4

Gastric cancer

Answer 4

CDH mutation

Question 5

Polyp

Answer 5

Abnormal growth of tissue form mucous membrane

Question 6

What is an oncogene

Answer 6

A muted gene that has the potential to cause cancer. Stimulates growth when not required.

Question 7

Adenoma cancer sequence

Answer 7

Stepwise pattern of Mutations of oncogenes and TSG

• APC - tumour supressor gene - mutation
• K-Ras - oncogene
  P53 - TSG - inactivated

Question 8

Dysplasia

Answer 8

Disordered cellular development characterised by increased mitosis and pleomorphism but unable to invade basement membrane

Question 9

What is the APC gene?

Answer 9

Tumour supressor gene
Negatively regulates WNT pathway
degrades beta catenin

mutation - beta catenin not degraded - WNT stimualted - overgrowth

Question 10

RHD pathophysiology

Answer 10

Group A strep - cross reacts with host abs -complement - T cell - recurrent inflmaation - stenosis

Ashcoff bodies

Question 11

Steroids

Answer 11

Opportunisitic bacteria
CIshings - obesity, stria muscle weakness
cardio-fluid retention
DM

Question 12

GCA Eye

Answer 12

Anterior ischeamic optic neuropathy

Question 13

How do steroids cause bone disease

Answer 13

Inhibitiion of GIT calcium
Dircet stimulation of osteoclast
Decrease of renal reabsorption

Question 14

Neutrophils

Answer 14

Margination and rolling
Adhesion
Transmigration
Migration

Bone marrow - HEAMTOPOEITC STEM CELLS

Question 15

Parathyroid hyperplasia

Answer 15

Chief cell - MEN
Water clear cell

Question 16

What is IHC?

Answer 16

lOCALISING SPECIFIC ANITGENS IN TISSUES based on antigen aby

Question 17

How does a malignant tumour survive in LN/ lymphatic spread

Answer 17

Release growth factors such as VGEF - Lymphactic vessel explanison

Question 18

How does cancer spread?

Answer 18

1. Direct or continuous extension
2. Penetrates into lymph, blood or body
3. Transport into circulation
4. ARREST IN THE CAPILLARY BEDS
5. Growth of tumour

Question 18

Carcinoid tumour

Answer 18

Enterchomofin cells

Cutaneous flushing, diarrhoea, malabsorption

Beta catain allows spread

Question 18

Why renal stones in crohns?

Answer 18

Increased intestinal fat -> binds to calcium -> leaving oxalates

Question 19

Chronic changes in IBD

Answer 19

laminia propira
paneth cell meteplasia

Question 20

Role of TNF in IBD

Answer 20

Cytokine involved in systemic inflammation.
Regulates the innate immune response

Increases tight junction epithelia
Increase flux of luminal
Causes acute inflammation

TNF alpha inhibition by monoclonal antibodies

Question 21

Biofilms

Answer 21

Viscous layer of extracellular polysaccharides that adhere to host

Question 22

Why pus yellow

Answer 22

Myeloperoxidase

Question 23

Granuloma

Answer 23

Aggregation of macrophages

Question 24

Heart carcinoid

Answer 24

Libman sacks endocardis (non bacterial endocardis)

Question 25

What to look out for on report

Answer 25

Malignant features - Histological grade and differentiation - Size - Margin status - Immunohistochemistry

Question 26

Grading

Answer 26

Microscopic differentiaiton

Question 27

Staging

Answer 27

extent and spread

Question 28

Lung cancer parneoplastic

Answer 28

- (ADH), inducing hyponatremia due to inappropriate ADH secretion - (ACTH), producing Cushing syndrome - Parathormone, parathyroid hormone-related peptide, prostaglandin E, and somecytokines, all implicated in the hypercalcemia - Calcitonin, causing hypocalcemia - Gonadotropins, causing gynecomastia - Serotonin and bradykinin, associated with the carcinoid syndrome

Question 29

What is amyloid

Answer 29

Fibril protein

Question 30

Why Hyper coagulable

Answer 30

Tumor cells to produce and secrete procoagulant/fibrinolytic substance which activate coagulation cascade stimulation of tissue factor production by host cell.

Question 31

What is an ulcer

Answer 31

local defect of mucus membrane due to loss of surface epithelial cells

Question 32

H.pylori

Answer 32

Spiral heix microareophilic gram negative bacteria

Question 33

What is gangrene

Answer 33

Necoris caused by critically insufficent blodd supply

Question 34

Tb tests

Answer 34

sputum - ziehl neelson mantoux PCR quantiferon FNAC

Question 35

What are giant cells?

Answer 35

Multinucleated cells comprising of macrophages often forming granuloma e.g. Langerhans’ giant cells, Reed sternberg cells

Question 36

Granuloma

Answer 36

Organised collection of macrophages IN REPSOSNE TO CHRONIC INFLAMMATION

Question 37

Cracinoma

Answer 37

Malignat neoplasm of epithelial cells

Question 38

Hamartoma

Answer 38

Disorganised arrangements of different amounts of tissue normally found at that site

Question 39

PMC

Answer 39

abx - disrupt microbe - allow c.diff to colonise - release toxins - eruption of neutrophils - mucopurulent psudeomemrbanes

Question 40

GCA

Answer 40

Tunica media Intimal thickening granulmotosis inflamamtion - lamina destruciton Tcells and macrophages Skip lesions