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Other MRCEM part 1 > Pathology > Flashcards

Pathology Flashcards

(67 cards)

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1
Q

How are the isotopes of immunoglobin determined?

A

By heavy chain….
Gamme / Alpha / Mu / Epsilon / Delta

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2
Q

Two types of immunoglobulin light chains

A

Kappa or Lambda

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3
Q

A deficiency in C1 inhibitors results in…

A

Hereditary angioedema

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4
Q

Deficiency in complement decay - accelerating factor results in

A

Paroxysmal nocturnal haemoglobinuria

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5
Q

Three types of cells

A

Labile, stable and permanent

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6
Q

Labile cells are…

Examples include

A

constantly dividing and have a good capacity for regeneration

Surface epithelia of skin / GI tract / uterus
Blood cells are derived from labile cells of the bone marrow

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7
Q

Stable cells are…

Examples include

A

State of quiescene, cells slowly replicate to maintain tissue size, tissues may rapidly regenerate if stimulated

Liver / renal tubular epithelium, endocrine glands

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8
Q

Permanent tissues consist of…

Examples include

A

Cells that have left the cell cycle and so are incapable of cell division, CANNOT regenerate

Brain wells / myocardial cells / skeletal muscle cells

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9
Q

Which antibodies are capable of transpacental passage?

A

IgG

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10
Q

Which type anti-bodies are Anti-D?

A

IgG

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11
Q

When skeletal muscle is damaged, what are stimulated to divide?

A

Satellite cells, which fuse with existing muscle fibres to regenerate and repair the damaged fibres. Skeletal muscle fibres themseleves cannor divide. However muscle fibres can lay down new protein and hypertroph.

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12
Q

Which muscle cells have the greatest capacity to regenerate?

A

Smooth muscle cells

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13
Q

Where is most dietary iron absorbed?

A

Duodenum

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14
Q

Where is Vit K obtained?

A

Green veg and bacterial synthesis in the gut

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15
Q

Which factors are Vit K dependent?

A

II, VII,IX, X, protein C and protein S

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16
Q

Cytokines involved in granulomatous inflammation?

A

IL-1 - initiates
IL-2 enlarges
TNF-alpha maintains

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17
Q

Which type of organisms are hypoplenic patients at risk of?

A

Encapsulated bacteria

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18
Q

Lab findings in Haemophilia B

A

Prolonged APTT, normal PT and low IX

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19
Q

Tubercilun test is an example of what type of hypersensitivity

A

Delayed, IV, cell mediated

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20
Q

Type of necrosis seen after an MI?

A

Coagulative - loss of cell nuclei, preservation of underlying architecture

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21
Q

Type of necrosis seen after a cerebral infarction?

A

Liquefaction
Complete loss of cellular structure and conversion to soft, semi-solid mass

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22
Q

Type of necrosis seen in TB?

A

Caseous
complete loss of normal tissue architecture, replaced by amorphous, granular and eosinophilic tissue

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23
Q

Which cytokine….

Initiates granuloma formation
Causes granulomas enlarge
Maintains them

A

IL-1
IL-2
TNF-alpha

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24
Q

Causes of eosinophil leucocytosis?

A

Allergic disease
Parasites
Skin disease
Drug sensitivity
Hodgkin’s disease

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25
Type 1 hypersensitivity reactions mediated by?
IgE with immediate degranulation of mast cells and basophils
26
Examples of type 1 hypersensitivity reactions?
Allergic rhinitis Allergic conjunctivits Allergic asthma Systemic anaphylaxis Angioedema Urticaria Penicillin allergy
27
Type 2 hypersensitivity reactions mediated by?
Antibody mediated, IgG or IgM antibodies for specific cell surface antigen (auto or for foreign cells) Cell destruction via complement fixation, antibody cell-mediated cytotoxicity & phagocytosis
28
Examples of type 2 hypersensitivity reactions?
Incompatible blood transfusions Haemolytic disease of the new born Autoimmune haemolytic anaemias Goodpastures Rheumatic heart disease Bullous pemphigoid
29
Type 3 hypersensitivity reactions mediated by?
Immune complex mediated hypersensitivity IgG antibodies react to free soluble antigens, creating a complex Rapid influx of antigens, overwhelms the mechanism (usually taken to the spleen), deposited elsewhere ie small blood vessles, kidneys and joints
30
Examples of type 3 hypersensitivity reactions?
Extrinsic allergic alveolitis SLE Post strep glomerulonephritis Reactive arthritis Rheumatoid arthritis
31
Type 4 hypersensitivity reactions mediated by?
T cell mediated
32
Examples of type 4 hypersensitivity reactions?
Contact dermatitis Hashimoto's thyroiditis Primary biliary cholangitis Tuberculin skin test Chronic transplant rejection Sarcoidosis Crohn's disease
32
Examples of type 4 hypersensitivity reactions?
Contact dermatitis Hashimoto's thyroiditis Primary biliary cholangitis Tuberculin skin test Chronic transplant rejection Sarcoidosis Crohn's disease
33
Most common maligancy of childhood?
Acute lymphoblastic leukeamia
34
FBC in ALL?
Normochromic normocytic anaemia and thrombocytopenia
35
Haemophilia A defect due to absence or low levels of?
Plasma factor VIII
36
Lab findings in Haemophilia A
Prolonged APTT Normal PT Low factor VIII
37
Clotting pathway, extrinsic and intrinsic pathways, blood test used to evaluate them
38
Haemophilia B defect due to absence or low levels of?
Factor IX
39
Lab findings in Haemophilia B
Prolonged APTT Normal PT Low factor IX
40
Lab findings in Von Willebrand disease
Abnormal PFA-100 test Low VIII (due to VWF is a carrier for VIII) Prolonged APTT or normal Normal PT Low VWF Defective platelet aggregation Normal platelet count
41
B cell activation cascade
42
Most common leukaemia in adults?
CLL
43
Define fibrinoid necrosis
Damage of the lining of your blood vessels, occurs in malignant HTN
44
Main hormonal regulator of iron homeostasis
Hepcidin
45
Beta thalasaemia and alpha are more common in which populations respectively?
Mediterranean Far East
46
Vit K dependent clotting factors
II, VII, IX, X, protein C & S
47
Multi-nucleated giant cells are formed from aggregates of?
Macrophages
48
Most common inherited cause of venous thrombosis?
Factor V leiden
49
Typical first presentation of sickle cell disease
Hand foot syndrome - infarcation of metaphyses of small bones
50
Inheritance of sickle cells
Autosomal recessive traint
51
When does fat necrosis take place?
Acute pancreatitis
52
What does APTT measure?
Deficiency in intrinsic and common pathway
53
What does PT measure?
Deficiency in extrinsic and common pathway
54
Actions of hepcidin
Hormonal regulator of iron homeostasis Lowers cell levels of ferroportin (protein that allows iron entry into the portal circulation from duodenal enterocytes and from macrophages)
55
Cholelithiasis =
uncomplicated gallstones
56
Biliary colic =
typically right upper quadrant pain following a fatty meal as gallstones obstruct the cystic duct during contraction of the gallbladder. Not associated with systemic upset
57
Cholecystitis =
inflammation of the gallbladder. Pain is often associated with nausea, vomiting or fever
58
Choledocholithiasis =
gallstone within the common bile duct. Often causes deranged liver function tests.
59
Cholangitis =
infection of the common bile duct often secondary to choledocholithiasis. Typically presents with right upper quadrant pain, fever and jaundice (Charcot’s Triad)
60
What two ducts join to form the common bile duct
Common hepatic duct and cytic duct
61
What ducts join to form the hepatopancreatic ampulla of vater?
CBD + pancreatic duct
62
Which two vessels form the (hepatic) portal vein + where
SMV Splenic vein Posterior to neck of pancreas
63
3 areas of portosystemic anastamoses
Gastroesophageal junction Anus Ant. abdominal wall
64
Which bit of the pancreas is not retroperitoneal ?
Tail
65
Primary arterial supply of the pancreas
Pancreatic branches of the splenic artery
66

Other MRCEM part 1 (5 decks)

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