Pathology

Question 1

What is the normal range of weight for the spleen?

Answer 1

100-250g

Question 2

Where are macrophages and dendritic cells in the spleen located?

Answer 2

In the marginal zone

Question 3

Where is Splenomegaly felt?

Answer 3

Under the left costal margin

Question 4

What are the causes of Splenomegaly?

Answer 4

C- Congestion
H- Haematological ex haemolytic anaemia,sickle cell
I - Infection ex EBV, HIV, malaria
N-Neoplasm -
A- Autoimmune -Rheumatoid arthritis
S- Storage disease

Question 5

True or False? Alkalines increase iron absorption?

Answer 5

FALSE!! Alkalines example ( Antacids,Pancreatic secretions ) REDUCE iron absorption

Question 6

True or False? A reduced hepcidin serum favours iron absorption

Answer 6

TRUE!!

Question 7

What is the cause of Neuropathy in Vitamin B12 deficiency?

Answer 7

This is due to accumulation of S‐adenosyl homocysteine and reduced levels of S‐adenosyl methionine.

Question 8

What is an essential factor in the conversion of Methylmalonyl - CoA to succinyl- CoA?

Answer 8

Vitamin B12

Question 9

True or False? Folate is responsible for the conversion of homocysteine TO methionine?

Answer 9

FALSE!! Vitamin B12 is responsible for the conversion of Homocysteine to Methionine.

“12 is when we need to B @ H&M” H before M !!

Question 10

What is the main disease associated with Thymic Hyperplasia?

Answer 10

Myasthenia Gravis

Question 11

Thymomas are of what origin?

Answer 11

Epithelial origin

Question 12

Why is Thymic hyperplasia associated with Myasthenia Gravis?

Answer 12

MG is a neuromuscular disorder with an auto immune component. The body forms antibodies to acetylcholine receptors ( anti-acetylcholine receptors) . In the body the Thymus produces these antibodies , so more antibodies produced , more cells needed to produce them resulting in Thymic Hyperplasia.

Question 13

Fill in th blanks. “ Developmental thymic pathology are _____ &_____”

Answer 13

Agenesis - Absence of an organ, usually due to non-appearance of its primordium in the embryo.

Hypoplasia- Incomplete development of underdevelopment of an organ or a tissue

Question 14

Fill in the blanks.” Acquired thymic pathology are ______, ________ &________”

Answer 14

Atrophy
Hyperplasia
Neoplasia

Question 15

What type of cells are found in Hassall’s corpuscle?

Answer 15

Squamous cells

Question 16

In what disease can thymic hypoplasia & agenesis be seen?

Answer 16

DiGeorge syndrome accompanied by parathyroid developmental failures.

Question 17

What is Primary Thymic Hypoplasia?

Answer 17

Loss of thymus. Therefore thymus was incompletely formed during embryological development. As a result the individual still has B-cells but not T-cells.

Question 18

What is Secondary Thymic Hypoplasia/Agenesis?

Answer 18

Bone marrow is hypoplastic which results in a more severe immune deficiency state because loss of precursor lymphocytes precludes the formation of both immature B and T cells. Results in SCID

Question 19

What is the emrbryologic origin of the Thymus?

Answer 19

Third pharyngeal pouch

Question 20

What are the contributing factors to Acquired thymic atrophy?

Answer 20

Age
Malnutrition
Stress
Terminal illness
Cytotoxic drugs

Question 21

What other diseases can be seen with thymic hyperplasia?

Answer 21

Grave’s Disease
Addison’s Disease-
Sclerodoma
Rheumatoid Arthritis
Systemic Lupus Erythrmatosus

Question 22

What is another name for Type I thymoma?

Answer 22

Invasive thymoma - cytologically benign but biologically aggressive

Question 23

A Thymic carcinoma is known as?

Answer 23

Type II thymoma - cytologically and biologically malignant.

Question 24

What is the most common location for a Thymoma?

Answer 24

Anterior mediastinal mass

Question 25

What diseases are associated with Thymomas?

Answer 25

Myesthenia Gravis Cytopenias - Pure Red cell applasia, Acquired hypo γ-globulinaemia Auto-immune -Graves/ Pernicious anaemia/ SLE/ Rheumatoid/polymyositis Superior vena cava syndrome Good syndrome

Question 26

What is the main cause of lymphadenopathy?

Answer 26

Acute or Chronic Reactive hyperplasia

Question 27

What cells are found in the Paracortex and medullary sinus of lymph nodes?

Answer 27

Plasma cells and Memory B cells

Question 28

Where are B - cell centroblasts ( small- non cleaved cells) made ?

Answer 28

In the follicles

Question 29

At what locations do localised acute reactive hyperplasia occur?

Answer 29

Tonsils- In tonsilitis lymph hyperplasia occurs in response to pharyngitis. Inguinal- Hyperplasia of these nodes are related to STD’s, cuts and bruises on the lower limbs Enteric- During gastroentiritis lymph nodes in the mesentery are involved.

Question 30

At what location do generalised acute reactive hyperplasia occur?

Answer 30

Thoughought the body. (All lymph nodes are enlarged)

Question 31

What is the characteristic feature of Follicular hyperplasia?

Answer 31

Germinal centre

Question 32

What is the microscopic appearance of Acute reactive hyperplasia?

Answer 32

Red-grey Intact capsule ± perinodal extension

Question 33

What are the patterns associated with Chronic Reactive hyperplasia?

Answer 33

1) Follicular (B cell) -associated with increase antibody production 2) Paracortical/ diffuse (T cell)- associated with viral infections and cytotoxicity 3)Sinus histiocytosis (macrophages)-cytokine effect in lymph nodes draining tumours 4)Combinations

Question 34

What are causes of Chronic reactive hyperplasia -Follicular ?

Answer 34

Rheumatoid arthritis Toxoplasmosis Early HIV infection Castlemans disease

Question 35

What are causes of Chronic reactive hyperplasia -Paracortical / Diffuse ?

Answer 35

Viral infections (such as EBV, mono) Certain vaccinations (e.g., smallpox) Immune reactions induced by drugs (especially phenytoin).

Question 36

True or False? Chronic reactive hyperplasia ( Sinus Histiocytosis) is often is encountered in lymph nodes draining cancers and may represent an immune response to the tumor or its products.

Answer 36

TRUE!!

Question 37

What are the main characteristics of Chronic reactive hyperplasia - Sinus Histiocytosis ?

Answer 37

Hypertrophy of lining endothelial cells and an infiltrate of macrophages (histiocytes).

Question 38

In which pattern of Chronic reactive hyperplasia has the presence of Tingible body macrophages?

Answer 38

Follicular hyperplasia

Question 39

What type of cells are present in reactive follicles in Follicular- Chronic reactive hyperplasia?

Answer 39

Scattered B cells Scattered T cells Phagocytic macrophages containing nuclear debris (tingible body macrophages) A meshwork of antigen-presenting follicular dendritic cells.

Question 40

In Hb C, what substitutions occur?

Answer 40

A structural variant of normal haemoglobin A (Hb A) caused by an amino acid substitution of glutamic acid with lysine

Question 41

Fill in the blanks." In Hb E, structural variant of normal haemoglobin A (Hb A) caused by an amino acid substitution of lysine for glutamic acid at position _______of the beta haemoglobin chain.

Answer 41

Twenty six (26)

Question 42

What are disorders of Heme synthesis known as?

Answer 42

Porphyrias

Question 43

What is the most common porphyria and what is it's etiology?

Answer 43

Porphyria cutanea tarda and it is caused by deficiency in uroporphyrinogen decarboxylase.

Question 44

What is a distinct feature of Porphyria cutanea tarda & Erythropoietic porphyrias ?

Answer 44

They give a red-brown colour in urine

Question 45

What percentage of your body is made of water?

Answer 45

60%

Question 46

What is Hyperaemia?

Answer 46

Arteriolar dilation, increased blood INFLOW. " since you're hyper you can come IN'

Question 47

What is Congestion?

Answer 47

Venous dilation, decreased OUTFLOW. ' you are congested so you have to come OUT'

Question 48

True or False? Hyperaemia is an Active process while Congestion is a Passive process.

Answer 48

TRUE!!

Question 49

What is Oedema?

Answer 49

Accumulation of interstitial fluid within tissues.

Question 50

What is the name of Generalised Oedema ?

Answer 50

Anasarca

Question 51

What are the respective names for localised oedema in the following locations: 1. Lungs 2. Pericardium 3. Abdomen

Answer 51

1. Lungs -HYDROTHORAX (PLEURAL EFFUSION) 2. Pericardium -HYDROPERICARDIUM (PERICARDIAL EFFUSION) 3. Abdomen- ASCITES

Question 52

Which term would best describe internal bleeding from a ruptured liver haemangioma?

Answer 52

Haemoperitoneum

Question 53

A class 4 Haemmorhhage has what percentage of blood loss?

Answer 53

>40%

Question 54

A Class 1 Haemorrhage has what percentage of blood loss?

Answer 54

Up to 15%

Question 55

What is the smallest bleed and what is the size?

Answer 55

Petechiae (1-2 mm)

Question 56

Haemarthrosis is a haemorrhage in which location?

Answer 56

In joint spaces

Question 57

What is the location of a Thrombus?

Answer 57

Intravascular

Question 58

What is the Macroscopic appearance of a Thrombus?

Answer 58

Granular Firm but friable

Question 59

What microscopic characteristic is a distinguished feature of a Thrombus?

Answer 59

Lines of Zahn

Question 60

What are thrombi located in the in heart chambers or in the aortic lumen known as?

Answer 60

Mural thrombi

Question 61

True or False? A chicken fat appearance is seen in all extravascular clots.

Answer 61

TRUE!!

Question 62

True or False? A chicken fat appearance is seen in postmortem clots.

Answer 62

TRUE!!

Question 63

True or False? Postmortem clots are attached to the underlying vessel wall.

Answer 63

FALSE!! They are NOT attached.

Question 64

Fill in the Blanks.Platelets are involved in _______ while platelets are uninvolved in _______.

Answer 64

Platelets are involved in the formation of Thrombus Platelets are uninvolved in the formation of Clots

Question 65

What are the components of Virchow's Triad?

Answer 65

Hypercoagulbility Endothelial Damage Circulatory Stasis

Question 66

Thrombi present on the heart valves are called ?

Answer 66

Vegetations

Question 67

Congenital abnormalities and ex May-Thurner syndrome and Paget- Schrotter syndrome can affect which part of Virchrows triad?

Answer 67

Circulatory Stasis( Abnormal Blood Flow)

Question 68

Oestrogen therapy, Inflammation and Dehydration can affect can affect which part of Virchrows triad?

Answer 68

Hypercoagubility

Question 69

Physical trauma strain and Microtrauma to the blood vessel can affect which part of Virchows triad?

Answer 69

Endothelial Damage

Question 70

Arteriosclerosis and Increase homocysteine levels can affect what part of Virchow's Triad?

Answer 70

Endothelial damage

Question 71

True or False? Oral contraceptive are associated with hypercoagubility.

Answer 71

TRUE!!

Question 72

In what organs are Anemic (White) Infarcts seen ?

Answer 72

Organs with end circulation - Heart - Spleen - Kidney

Question 73

In what organs are Haemorrhagic (red) infarcts seen?

Answer 73

Organs with dual circulation Liver Small Intestine

Question 74

Where was the spleen developed from?

Answer 74

Dorsal mesogastrium

Question 75

When does the spleen begin to develop?

Answer 75

6th week

Question 76

What is the nerve supply of the spleen?

Answer 76

The spleen is supplied from the coeliac plexus with sympathetic fibres only.