Pathology 1

Question 1

What are the two types of autopsy?

Answer 1

Hospital (<10%) Medico-legal (>90%)

Question 2

What deaths are referred to the coroner?

Answer 2

Presumed natural (cause of death unknown)
Presumed iatrogenic (caused by medical examination or treatment)
Presumed unnatural

Question 3

Who can make referrals?

Answer 3

Doctors
Relatives
Police

Question 4

Who performs autopsies?

Answer 4

Histopathologists and Forensic pathologists

Question 5

What is an autopsy?

Answer 5

An autopsy is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause and manner of death or to evaluate any disease or injury that may be present for research or educational purposes

Question 6

What is inflammation?

Answer 6

Is the local physiological response to tissue injury. Not in itself a disease, but is usually a manifestation of disease

Question 7

Define acute inflammation

Answer 7

The initial and often transient series of tissue reactions to injury

Question 8

Define chronic inflammation

Answer 8

The subsequent and often prolonged tissue reactions following the initial response

Question 9

Name some causes of inflammation

Answer 9

Microbial infections, hypersensitivity reactions, physical + chemical agents and tissue necrosis

Question 10

Briefly describe the steps of acute inflammation

Answer 10

1) Initial reaction of tissue to injury
2) Dilation of vessels
3) Vascular leakage of protein-rich fluid
4) Neutrophil polymorph is the characteristic cell recruited to the tissue
5) Outcome may be resolution, suppuration (e.g abscess) or progression to chronic inflammation

Question 11

How does microbial infections cause inflammation?

Answer 11

Bacteria release specific exotoxins - chemicals synthesised by them that specifically initiates inflammation

Question 12

How does hypersensitivity reactions cause inflammation?

Answer 12

This reaction occurs when an altered state of immunological responsiveness causes an inappropriate/excessive immune reaction that damages the tissues

Question 13

How does physical agents cause inflammation?

Answer 13

Either through physical trauma, UV, burns or excessive cooling

Question 14

How does chemical agents cause inflammation?

Answer 14

Corrosive chemicals provoke inflammation through gross tissue damage

Question 15

How does tissue necrosis cause inflammation?

Answer 15

Death of tissues from lack of o2 or nutrients resulting from inadequate blood flow is a potent inflammatory stimulus

Question 16

Name 4 essential macroscopic appearances of acute inflammation

Answer 16

Rubor (redness)
Calor (heat)
Tumor (swelling)
Dolor (pain)

Question 17

Rubor

Answer 17

Due to dilation of small blood vessels within the damaged area

Question 18

Calor

Answer 18

Systemic fever which results from some of the chemical mediators of inflamation

Question 19

Tumor

Answer 19

Results from oedema and due to inflammatory cells migrating into the area

Question 20

Dolor

Answer 20

Results partly from stretching and distortion of tissues due to inflammatory oedema. Some chemical mediators e.g bradykinin are known to induce pain

Question 21

Formation of the cellular exudate

Answer 21

The accumulation of neutrophil polymorphs within the extracellular space is the diagnostic histological feature of acute inflammation

Question 22

What do endogenous chemical mediators cause?

Answer 22

Vasodilation, emigration of neutrophils, chemotaxis, increased vascular permeability, itching and pain

Question 23

Causes of increased vascular permeability

Answer 23

Immediate transient chemical mediators and immediate sustained direct vascular injury

Question 24

4 outcomes of acute inflammation

Answer 24

Resolution
Suppuration
Organisation
Progression to chronic inflammation

Question 25

Causes of chronic inflammation

Answer 25

Primary chronic inflammation Transplant rejection Progression from acute inflammation Recurrent episodes of acute inflammation

Question 26

Macroscopic appearances of chronic inflammation

Answer 26

Chronic ulcer Chronic abscess cavity Granulomatous inflammation Fibrosis

Question 27

Microscopic appearances of chronic inflammation

Answer 27

Cellular infiltrate consists of lymphocytes, plasma cells and macrophages. Neutrophil polymorphs are scarce. Tissue necrosis may be a prominent feature, especially in granulomatous conditions. Some of the macrophages may form multi-nucleate giant cells

Question 28

Role of B-lymphocytes in chronic inflammation

Answer 28

On contact with antigen, become progressively transformed into plasma cells, which are cells specially adapted for the production of antibodies

Question 29

Role of T-lymphocytes in chronic inflammation

Answer 29

Responsible for cell mediated immunity. On contact with antigen, T lymphocytes produce a range of soluble factors called cytokines. They recruit and activate other cell types

Question 30

Granuloma

Answer 30

Aggregate of Epithelioid histiocytes, may contain lymphocytes and histiocytic giant cells

Question 31

Cells that regenerate

Answer 31

``` Hepatocytes Pneumocytes All blood cells Gut epithelium Skin epithelium Osteocytes ```

Question 32

Cells that don't regenerate

Answer 32

Myocardial cells | Neurones