Patho Week 1 Flashcards
2 fundunmental item of pathological study
- definition
- aetiology
Objective of pathology study
1- ba able to correlate the clinical manifestation with the pathological changes
2- know prognosis of disease
3- realize the role of histopathology in diagnosis and treatment
Mention 4 lab pathological diagnosis
1- clinical suspicion : detailed clinical history
2- early diagnosis : Routine screening of asymptomatic individuals e.g:
- annual cervical smear
- monthly breast screen by mammography
3- cytological diagnosis : diagnosis of disease by examination isolated cells in body fluids e.g :
Exfoliated cells
Fine needle aspiration
4- Histopathological diagnosis : it is the definitive method in diagnosis
6 types of biopsy specimen
1- Excisional biopsy: ectomy
2- tru cut needle biopsy
3- Incisional biopsy “ punch biopsy “ ده الفتحات زي الفم والانف والrectum
4- Endometrial curetting
5- TUR : for urinary bladder and prostatic biopsy
6- Endoscopic biopsy: through GIt
6 techniques used to histopathological diagnosis
1- frozen sections
2- paraffin section: best material
3- immune peroxides ( immnuohistochemisty) : tumor antigens e.g : cytokeratin in epithelial tumor , vimentin in mesenchymal tumor
4- tumor marker ; CEA in GIT and breast tumor…… Alpha fetoprotein in hepatic carcinoma and PAP in prostatic
5- Electron microscopy: diagnosis of difficult types of disease
6- Molecular diagnosis:
PCR for chronic myeloid leukemia
Flow cytometry for measure DNA content
2 functions of fixation of specimen
- preserve it from decay & autolysis
- stabilize its integrity
7 causes of cell injury
1- hypoxia
2- physical agent
3- chemical agent
4- infection
5- immunological reactions
6- genetic derangement
7- nutritional imbalances
4 mechanism of cell injury
1- decrease energy production
2- imparied cell membrane function
3- increase Ca intracellular
4- accumulation of free radicals
2 causes and 2 effect of decrease energy production
Hypoxia , toxins
Failure of Na , K atp pump -> accumulating of water inside the cell
Increases anaerobic pathway -> increase lactic acid-> osmotic pressure
Causes and 2 effects of imapried cell membrane function
Activation of complement and production of free radicals
- loss of structural integrity
- defect in membrane preambility
What maintains Ca at low levels intracellular ?
Membrane energy dependent transport
What is the effect of increased Ca inside the cell
1- activations of phsopholipase lead to degrade membrane phospholipid
2- activation of protease -> break down proteins
3- Activation of Atpase -> depletion of ATP
4- Activation of endonuclease -> chromatin fragmentation
3 causes of production of free radicals and 3 effects
Radiation, chemical, reduction-oxidation reactions
Lipid damage, protein damage, fragmentation of cellular DNA and mitochondrial damage
What is the best evidence of necrosis and what does it include
Nuclear change
Pyknosis -> shrinkage and deeply stained
Karyorrhexis-> fragmentation of nucleus
Karyolysis -> dissolve of nucleus
2.Causes of acidophilia in necrosis
1- denatured protein has high affinity for eoisn
2- destruction of DNA lead to loss of affinity for basophill
5 types of necrosis and its cause and its common site
1- coagulative necrosis: most common due to sudden cutting of blood supply
2-liquefactive necrosis : the necrotic material undergoes softening due to the action of hydrolytic enzymes
e.g : 1- suppurative inflammation
2- lesion of brain and spinal cord
3- caseous necrosis : due to partial and slow liquefaction
E.g in tuberculous lesion caused by allergic reactions to protein of tubercule bacilli
4- fat necrosis
Enzymatic : due to action of lipase enzyme on fat of mesentry , omentum , abdominal fat which cause split the fat to glycerol and fatty acid , glycerol is absorbed in blood and fatty acid deposits with Ca as a small dull opaque white pathches
E.g : acute hemorrhagic pancreatitis
Traumatic ( non enzymatic ) : due to trauma and in ( breast , subcutaneous tissue)
5- fibrinoid necrosis : it affects wall of blood vessels and kidney glomeruli
Seen in 2 : autoimmune diseases, malignant hypertension
4 fate of necrosis
1- healing by regenerating or fibrosis
2- cyst formation
3- dystrophic calcification
4- gangrene
4 physiological and 4 pathological conditions of apoptosis
1- in Embryogenesis : interdigital cleft
2- Hormone dependent involution of tissue : endometrium during menstruation
3- maintains constant cell number ( normal cell turnover)
4- deletion of auto reactive cell
1- in viral infection: hepatitis
2- pathological atrophy after duct obstruction : pancreas
3- cell death in malignant tumor
4- elimination of cells with damaged DNA
5 morphology of apoptosis
1- shrinkage of cells
2- condensation of chromatin
3- formation of apoptotic boides by fragmentation of cells and nuclei
4- phagocytosis by adjacent cells or macrophages
5- not accompanied by inflammatory reactions
3 Mechanisms of intracellular Accumulation
1- Normal cellular substance produced at normal or increased level but the rate of metabolism is inadequate to remove it e.g fatty change
2- Accumulate of endogenous substances due to defect in metabolism: storage disease
3- Exogenous substances Accumulated because the cell can’t degrade or transport it : Carbon particles ( anthracosis)
2 examples of clowdy swelling
1- renal convoluted tubules in nephritis
2- hepatocyte in viral hepatitis
4 examples of hydropic swelling
1- epidermal cell in viral infection or mild burn
2- cell of renal tubules in electrolyte imbalance
3- hepatocyte in viral hepatitis
4- Beta cells of pancreas in DM
Why fatty change ( steatosis) is more common in liver
Because it is the major organ involved in fat metabolism
Mechanism of normal lipid metabolism in liver
FFA from adipose tissue or ingested food are transported to hepatocyte
In liver FFA are converted to TAG or cholesterol or phospholipid
Triglycerides are complexed with apoprotein to form lipoprotein to be released from liver to tissues
