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2a - ICS > Pathology > Flashcards

Pathology Flashcards

(95 cards)

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1
Q

Define thrombosis

A

The solidification of blood contents (e.g. platelets & RBC) that forms within the vascular system during life

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2
Q

Give 3 outcomes of a thrombi

A

Resolution - degrades
Organisation - leaves scar tissue
Embolism - fragment of thrombus break off into circulation

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3
Q

What is an embolus

A

A mass of material in the vascular system able to become lodged within a vessel and block its lumen

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4
Q

Describe an arterial emboli and give an example of a condition

A

Lodges in systemic circulation e.g. lodges in carotid artery = Ischaemic stroke

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5
Q

Describe a venous emboli and give an example of a condition

A

Lodges in pulmonary circulation. E.g. DVT embolises and lodges in pul A = pulmonary embolism

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6
Q

Define ischaemia

A

Reduction in blood flow to a tissue or part of the body

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7
Q

What is infarction

A

Tissue death due to inadequate blood supply

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8
Q

What makes an organ susceptible to infarction

A

If the organ only has a single artery supplying it

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9
Q

3 factors that may cause thrombosis (Virchow’s triad)

A

Endothelial injury
change in blood flow
increased coagulability

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10
Q

What is atherosclerosis

A

Accumulation of fibrolipid plaques (atheroma) in the intima of systemic arteries
Narrowing and hardening of arteries

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11
Q

Risk factors of atherosclerosis

A

Smoking
Hypertension
Diabetes
male

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12
Q

What is apoptosis

A

Programmed cell death in single cells

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13
Q

What is necrosis

A

Inflammatory traumatic cell death

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14
Q

What is caseous necrosis

A

Soft cheese appearance
TB characterised by this form

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15
Q

What is the purpose of apoptosis

A

Important in normal cell turnover as it prevents cells with accumulated genetic damage from dividing and producing cells which could develop into cancer

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16
Q

What is the basic function of the p53 gene in apoptosis

A

They detect DNA damage and can then trigger apoptosis

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17
Q

What is the basic principal of how apoptosis occurs

A

Cascade of activated enzymes ( mainly caspases)

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18
Q

What cells are involved in acute inflammation

A

Neutrophils and monocytes

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19
Q

Describe the sequence of acute inflammation

A
  • an injury or infection occurs
  • neutrophils arrive - they phagocytose and release enzymes
  • macrophages arrive and phagocytose them
  • outcome: resolution with clearance of inflammation or progression to chronic inflammation
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20
Q

What cells are involved in chronic inflammation

A

lymphocytes, macrophages, plasma cells

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21
Q

What is a granuloma

A

an aggregation of macrophages/ histocytes surrounded by lymphocytes that forms in response to chronic inflammation

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22
Q

Stages of acute inflammation response

A
  • vessel gets wider 🡪 increased vessel flow
  • Increased vascular permeability 🡪 formation of fluid exudate
  • Formation of cellular exudate 🡪 emigration of neutrophil polymorphs
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23
Q

role of fibroblasts in inflammation

A

produce collagenous connective tissue in scarring

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24
Q

How do lifespans differ between neutrophils, macrophages and lymphocytes

A

neutrophils have a very short lifespan of 2-3 days
macrophages live months to years
Lymphocytes are live several years

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25
Give an example of acute inflammation
Appendicitis
26
What does the presence of both granulomas and eosinophils indicate
a parasite
27
What do all granulomas secrete as a blood marker
ACE
28
Give 3 examples of conditions which cause granulomas to develop
No central necrosis: *Leprosy * Crohn’s disease Central necrosis: *Tuberculosis
29
What are the 2 ways chronic inflammation occurs
Progression from acute inflammation Starts chronic e.g. infectious mononucleosis
30
What is hypertrophy
Increase in size of organ due to increase in size of constituent cells Occurs in organs where cells can’t divide
31
Give an example of hypertrophy
Skeletal muscles in athletes
32
What is hyperplasia
Increase in size of organ due to increase in the number of its constituent cells
33
Give an example of mixed hypertrophy/hyperplasia
Smooth muscle cells of the uterus during pregnancy
34
What is metaplasia
The change in cell differentiation from one fully-differentiated cell type to another
35
What usually causes metaplasia
Consistent change in the environment on an epithelial surface
36
Give an example of metaplasia
Squamous epithelium of the oesophagus can become columnar epithelium in response to continued stomach acid reflux (Barrett’s Oesophagus)
37
What is dysplasia
Morphological changes seen in cells in the progression to becoming cancer
38
What is carcinogenesis
The transformation of normal cells into neoplastic cells through permanent genetic alterations or mutations
39
What are carcinogens
Agents known or suspected to cause tumours
40
Carcinogenic vs oncogenic
Oncogenic are tumour causing agents while carcinogenic are cancer causing agents
41
Risk factor of lung cancer
Smoking
42
Risk factor of bladder cancer
Dyes and rubber industry
43
What drug inhibits platelet aggregation
Aspirin
44
Reverse smoking increases the incidence of which cancer?
Oral cancer
45
Which cancer can human papilloma virus cause
Cervical cancer
46
Which cancer can be caused by excess alcohol consumption
Colon cancer
47
What are the 5 Cardinal signs of inflammation
Heat (calor) Redness (rubor; dilation of small vessels ) Tumour (swelling; from oedema/ physical mass ) Pain ( dolor ) Loss of function (functio laesa)
48
What are the 3 stages of inflammation
* Increased vessel permeability - gets wider which increases flow * fluid exudate - leaky vessel * cellular exudate - neutrophils become abundant
49
State the 4 outcomes of acute inflammation
Resolution Suppuration organisation Progression
50
What is suppuration in terms of inflammation
* Formation of pus * This becomes surrounded by a pyogenic membrane * leads to scarring
51
What is organisation in terms of inflammation
* replacement by granulation tissue * New capillaries grow into the inflammatory exudate, macrophages migrate and fibrosis occurs
52
Describe resolution in terms of inflammatory outcome
Complete restoration of tissues to normal Minimal cell death and rapid destruction of causal agent
53
Explain the stages of neutrophil action in acute inflammation
* Margination - migrate to edge of blood vessel * Adhesion - selectins bind neutrophil, cause rolling along BV * Emigration - neutrophils pass through endothelial cells * Diapedesis - RBC may also escape from vessels passively
54
Clinical features pf arterial thrombi
Loss of pulse Area becomes cold, pale and painful
55
Give a condition that arterial thrombus can lead to
stroke
56
Treatment for arterial thrombi
antiplatelets (aspirin)
57
Give a condition that venous thrombosis can lead to
deep vein thrombosis
58
Formation of arterial thrombi
1. Endothelial cell damage 2. VWF binds to exposed collagen and platelets bind to this - aggregation occurs 3. Turbulence in blood flow due to obstruction of lumen 4. Fibrin deposition and platelet clumping occurs - RBCs and platelets clump together and are meshed in fibrin 5. Positive feedback so process continues indefinitely - thrombus formation
59
Common cause of venous thrombosis
Lower blood pressure in veins - stasis This allows for a thrombus to form
60
Clinical features of venous thrombosis
Tender Swollen Red
61
Treatment for venous thrombosis
anticoagulants (aspirin)
62
Give 3 factors that can affect endothelial injury
Trauma Hypertension Invasive procedures
63
Give 3 factors that can increase coagulability
sepsis smoking malignancy
64
Constituents of atherosclerotic plaque
lipid macrophages Platelets smooth muscle cells
65
Formation of an atherosclerotic plaque
* High levels of LDL in the blood accumulate in arterial wall * Macrophages are attracted to the damage site where they take up lipids to form foam cells * A fatty streak forms (earliest stage of plaque) * Foam cells promote smooth muscle cell proliferation around lipid core and formation of a fibrous cap (collagen)
66
State the 3 pathways of apoptosis
Intrinsic, extrinsic and cytotoxic
67
What is a neoplasm
A lesion resulting from the autonomous or relatively autonomous abnormal growth of cells which persists after the initiating stimulus is removed
68
What is a tumour
Any abnormal swelling Can be caused by inflammation, hypertrophy, neoplasms etc
69
Describe the structure of neoplasms
Consist of neoplasticism cells with a surrounding stroma Neoplastic cells are derived from nucleated cells
70
What are the 2 methods of neoplasm classification
Behavioural - benign/malignant Histogenetic - cell of origin
71
Common features of benign neoplasms
* Localised & non-invasive * Slow growth rate * Low mitosis activity * Close resemblance to normal tissue * Normally encapsulated/ circumscribed * Necrosis and ulceration is rare as they don’t tend to outgrow blood supply * Often exophytic ( grows outwards )
72
Common features of malignant neoplasms
* Invasive * Endophytic growth (inwards) * Metastases * Rapid growth rate - high mitosis activities * Necrosis and ulceration is common * Variable resemblance to normal tissue * Poorly circumscribed
73
What is the defining feature of a malignant neoplasm
Invasive
74
What does the term ‘high grade neoplasm’ mean
Low resemblance to normal tissue which means a poorer prognosis is likely
75
Give 3 ways benign neoplasms cause morbidity and mortality
Pressure on adjacent structures Transformation to malignant neoplasms Obstruct flow
76
What are the 3 different origins of a neoplasm
Epithelial cells Connective tissue Lymphoid/ haematopoietic organs
77
state the suffix of all neoplasms
-oma
78
What is the name of a benign tumour of non-glandular/ non- secretory epithelium
Papilloma
79
What is name for a benign tumour of glandular/ secretory epithelium
Adenoma
80
What is the name for a malignant epithelial neoplasm
Carcinoma
81
What is the name for a malignant tumour of glandular epithelium
Adenocarcinomas
82
Give the name for benign connective tissue neoplasms of the following: Adipocytes, cartilage, bone, vascular
Adipocytes - Lipoma Cartilage - Chondroma Bone - Osteoma Vascular - Angioma
83
Give the name for benign connective tissue neoplasms of the following: striated muscle, smooth muscle and nerves
Striated muscle - Rhabdomyoma Smooth muscle - leimyoma Nerves - neuroma
84
Suffix of malignant connective tissue neoplasms
‘Sarcoma’
85
What is the name for a malignant CT neoplasm of striated muscle
Rhabdomyosarcoma
86
What is a malignant neoplasm known as when the cell of origin is unknown
Anaplastic
87
Give 3 examples of ‘-omas’ that aren’t neoplasms
Granuloma Mycetoma Tuberculoma
88
What is the name for a malignant neoplasm of lymphoid cells
Lymphoma
89
Which tumour metastasise to bone ( BLT KP )
Breast Lungs Thyroid Kidney Prostate
90
Which 3 cancers are screened for in the UK
Bowel Breast Cervical
91
Describe the process of metastasis
1. Tumour cells detach from their neighbours 2. Invasion of surrounding connective tissue 3. Intravasation into lumen of vessels 4. Evasion of host immune defence 5. Adherence to endothelium at a remote location 6. Extravasation of the cells from the vessel lumen into the surrounding tissue 7. Tumour cells proliferate in the new environment
92
Give 3 ways in which tumour cells evade host immune defence
* aggregation with platelets * shedding of surface antigens * adhesion to other tumour cells
93
Briefly describe TNM staging of for tumours
T - refers to primary tumour N – Refers to lymph node status M – Refers to metastatic status
94
Give 3 factors that can cause reduced blood flow
Immobility Atrial fibrillation Varicose (swollen) veins
95
Define atrophy
The decrease in the size of an organ or cell be reduction in cell size and/or number

2a - ICS (4 decks)

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