Pathology

Question 1

Two types of bone tumours? (in their features)

Answer 1

Lytic (most common) bone broken down

Sclerotic - hardens bone

Question 2

Main presenting features of bone tumours?

Answer 2

Swelling
Pain 
Pathological fracture
Hyper-calcemia
Fever

Question 3

What is osteochondroma?

Answer 3

Common benign growth of epiphyses

Question 4

Types of bone marrow tumours?

Answer 4

Leukaemia

Multiple Myeloma

Question 5

3 most common types of dementia?

Answer 5

Alzheimers

Dementia with lewy bodies

Multiple Infarct dementia

Question 6

Name of acute and reversible cognitive dysfunction

Answer 6

delirium

Question 7

Definition of dementia?

Answer 7

Irreversible decline of cognitive function from an individual that was previously of normal intellectual abilities

Question 8

Histological changes in alzheimers

Answer 8

AB amyloid plaques

Angiopathy due to AB amyloid

Neurofibrillary tangles of Tau

Loss of neurones

Question 9

What stain is used to demonstrate amyloid?

Answer 9

Congo red

Question 10

What are the two proteins that have roles in the pathogenesis of dementia?

What do they do?

Answer 10

APP:

Forms Amyloid Beta when it is not degraded properly
This produces angiopathy and senile plaques

Tau:

Amyloid beta causes it to be hyperpolarised this leads to neurofibrillary tangles of Tau and then neuronal death

Question 11

Discriminative features of lewy body dementia?

Answer 11

Fluctuations in mental state

Visual hallucinations

Features of parkinsons

Question 12

What are lewy bodies?

Answer 12

Aggregates of α-synuclein

Question 13

Risk factors for multi-infarct dementia?

Answer 13

General vascular risks:

Hyperlipidaemia
High Blood Pressure
Smoking
Diabetes

Question 14

What are the spongiform transmissible encephalopathies?

Answer 14

Transmissible forms of rapidly progressive dementia, due to changes in protein structure, (prion proteins)

Question 15

What are the pathological changes that lead to spongiform ecephalopathy in prion proteins?

Answer 15

PrPc is the normal form of the protein, this can spontaneously change or be transmitted at PrPsc, PrPsc causes PrPc to change to PrPsc, producing a positive feedback loop, accumulating PrPsc in the CNS and causing rapid neurodegeneration.

Question 16

What are common effects of rheumatoid arthritis?

Answer 16

Proximal metacarpal joints inflamed

Ulnar deviation

Question 17

Can rheumatoid arthritis predispose to osteoarthritis

Answer 17

Yes

Question 18

Pathogenesis leading to rheumatoid arthritis?

Answer 18

Initial inflammation due to an infection, IgG antibodies released

Body makes anti-idiotype antibodies (antibodies against the IgG antibodies)

Question 19

How is complement activated?

Answer 19

Activated by the Fc portion of the antibody when it is bound to it’s antigen

Question 20

What is rheumatoid factor?

Answer 20

The anti-idiotype antibodies that can be tested for

Question 21

Where else can immune complex deposition in rheumatoid disease?

Answer 21

Lungs - Fibrosis

Blood vessels - vasculitis

Heart - myocarditis

Skin - rheumatoid nodules

Question 22

Whats a granuloma?

Answer 22

Collection of macrophages

Question 23

Why is the SAA protein increased in rheumatoid arthritis patients?

What can it lead to formation of?

Answer 23

It’s concentration is increased as it is produced in the liver as an acute phase protein, and it its production is increased in reaction to circulating cytokines

Can lead to the formation of amyloid

Question 24

Three main types of stroke?

Answer 24

Cerebral infarction (85%)

Intracerebral haemorrhage

Subarachnoid haemorrhage

Question 25

Two mechanisms of cerebral infarction?

Answer 25

Embolic Thrombotic

Question 26

3 common causes of thrombus formation in the heart?

Answer 26

Atrial Fibrillation Following an MI cardiac valve vegetation due to endocarditis

Question 27

2 Gross neuroanatomical changes in alzheimers disease?

Answer 27

Enlargement of the lateral ventricles Enlarged Sulci in temporal region - associated with memory

Question 28

Drugs used in alzheimers disease?

Answer 28

Donzepil - AchEI Memantine - NMDA receptor antagonists

Question 29

genes associated with alzheimers?

Answer 29

Early onset: APP, presinilin 1 and 2 Late onset: APOE

Question 30

What CN does not have a nucleus in the brainstem?

Answer 30

Olfactory

Question 31

Main difference in Nephrotic and Nephritic syndrome?

Answer 31

Nephrotic: Protein Nephritic: Blood

Question 32

What are the pathological changes (grossly) to the brain followoing stroke?

Answer 32

Infarction leads to death of all cells in the necrotic core 3-5 days after macrophages clear debris 1month - 5yrs the debris is removed and a liquid filled cysts remains (liquefactive necrosis0

Question 33

Causes of death due to stroke?

Answer 33

Immediate infarction of the brainstem A few days later due to raised ICP or consequences of immobility (bronchopneumonia)

Question 34

What are watershed infarcts/strokes?

Answer 34

When there is ischaemia due to a systemic decrease in cerebral perfusion e.g. shock, this means the areas that are supplied by two cerebral arteries are at risk and bordering areas between two territories often infarct.

Question 35

Three main types of stroke?

Answer 35

Ischaemic Parenchymal Haemorrhage Subarachnoid Haemorrhage

Question 36

What type of stroke follows the rupture of a berry aneurysm?

Answer 36

Subarachnoid

Question 37

What is a berry aneurysm?

Answer 37

Saccular aneurysm of one of the main arteries of the circle of willis or one of it's branches

Question 38

What disease predisposes particularly to saccular cerebral arteries?

Answer 38

Autosomal dominant polycystic kidney disease

Question 39

Methods to prevent re-bleeding in survivors of a saccular aneurysm rupture?

Answer 39

Insertion of metal coil into aneurysm to induce thrombosis Clipping the neck of the aneurysm

Question 40

Common route of CNS infection?

Answer 40

Haematogenous

Question 41

Problems that survivors of meningitis have?

Answer 41

Adhesions in subarachnoid space Epilepsy Nerve palsy

Question 42

Complications associated with adhesions in the subarachnoid space?

Answer 42

Obstructive hydrocephalus

Question 43

Definition of abscess?

Answer 43

Collection of pus in tissue

Question 44

Three ways that TB can affect the brain?

Answer 44

Tuberculous meningitis, Tuberculous abscess and spinal osteomyelitis

Question 45

What is potts disease?

Answer 45

Infection of the vertebral column by TB followed by collapse of vertebrae associated with the inflammation, resulting in compression of the spinal cord

Question 46

Process of osteoarthritis?

Answer 46

The hyaline cartilage splits and softens, could be due to many things e.g. infection, damage or just wear and tear. The hyaline cartilage is worn down exposing bone and resulting in inflammation when the bone rubs on the opposing surface An effusion may form and the joint may be very swollen

Question 47

What is an effusion?

Answer 47

The Excess amount of synovial fluid in inflamed joints