Pathology

Question 1

VINDICATE?

Answer 1

Vascular disease 
infection/inflammation
neoplasia 
drugs 
iatrogenic 
congenital 
autoimmune 
trauma 
endocrine/metabolic

Question 2

what is stasis

Answer 2

slowing of blood due to vasodilation

Question 3

what is margination

Answer 3

blood cells moving to periphery of vessels

Question 4

thrombin and histamine increase expression of which adhesion molecules

Answer 4

integrin and selectin

Question 5

increased TNF and IL-1 increase expression of which adhesion molecules

Answer 5

ICAM and VCAM

Question 6

what is rolling

Answer 6

low affinity binding of adhesion molecules along vascular wall until they become higher affinity closer to infection site to allow for white cells to bind

Question 7

what is chemotaxis

Answer 7

exiting of vascular system to follow concn gradient to reach infection site

Question 8

3 stages of phagocytosis

Answer 8

recognition/attachment
engulfment
killing and degradation

Question 9

how do phagocytes recognise bacteria

Answer 9

mannose receptors

opsonins

Question 10

how do phagocytes engulf pathogens

Answer 10

pseudopods trap bacteria
trapped in phagosome
joins with lysosome to form phagolysosome

Question 11

what is resolution and in what conditions is it favoured?

Answer 11

fully healed tissue 
minimal cell death
capacity to repair 
good vascular supply 
removing injurious agent

Question 12

what is suppuration

Answer 12

pus formation

Question 13

what is organisation

Answer 13

formation of scar tissue

Question 14

when is organisation indicated

Answer 14

no tissue capacity to repair
poor blood supply
damage beyond basal lamina

Question 15

how does organisation occur

Answer 15

deposition of granulation tissue (smooth muscle and collagen)
resolution attempted, when impossible myofibroblasts produce collagen to scar

Question 16

what is chronic inflammation characterised by?

Answer 16

presence of lymphocytes and sometimes monocytes

Question 17

causes of chronic inflammation

Answer 17

exogenous/endogenous material

infection

Question 18

when may resolution occur after MI

Answer 18

within 20 min window

Question 19

what happens in first 24 hours post MI without treatment

Answer 19

cell contents leak into ECF

inflammation occurs due to necrosis

Question 20

when is cardiac perforation most likely to occur

Answer 20

3-7 days

Question 21

how long does it take cardiac muscle to fully scar

Answer 21

6 weeks

Question 22

complications of scarring to the heart

Answer 22

structural impairment

arrhythmia

Question 23

true/false - necrosis requires energy input

Answer 23

false

Question 24

coagulative necrosis?

Answer 24

cell outline preservation

most common

Question 25

liquefactive necrosis?

Answer 25

liquid viscous necrosis with no structure

Question 26

caseous necrosis?

Answer 26

cheesy looking | TB until proven otherwise

Question 27

physiological need for apoptosis

Answer 27

``` normal growth (hand/foot) removal of self lymphocytes ```

Question 28

pathological need for apoptosis

Answer 28

``` injury response radiation chemotherapy infection cancer ```

Question 29

describe extrinsic pathway apoptosis

Answer 29

fas binds to fas death ligand | causes caspase release

Question 30

describe intrinsic pathway apoptosis

Answer 30

growth signals promote anti-apoptotic molecules in mitochondrial membrane Bax/Bac release to increase mitochondrial permeability causing release of cytochrome C and other caspases

Question 31

3 things that happen to cell in apoptosis

Answer 31

pyknosis chromatic condensation cytoplasmic blebs

Question 32

define hypertrophy

Answer 32

cells get bigger

Question 33

define hyperplasia

Answer 33

cell number increases

Question 34

what happens in G1 phase of cell cycle and which cyclin is activated

Answer 34

growth

Question 35

what cyclin activates CDK4?

Answer 35

cyclin D

Question 36

how does activated CDK4 allow the cell to progress to the next cell cycle stage

Answer 36

binds to Rb protein to prevent binding to E2F | E2F allows progression to next stage

Question 37

E2F initiates DNA replication and increases cyclin __ levels

Answer 37

A

Question 38

what does cyclin A do?

Answer 38

propagates DNA replication and binds to CDK2 to move cell to G2

Question 39

what happens in G2

Answer 39

second growth phase

Question 40

what is the G2 checkpoint

Answer 40

p53, checks for mistakes or halts cell cycle | if repair unsuccessful then cell will be apoptosed

Question 41

what is the M phase checkpoint

Answer 41

all chromosomes on metaphase plate and attached to spindle

Question 42

what is the hayflick limit and what are the exceptions

Answer 42

cells can only divide so many times - 50-70 | stem cells and potentially cancer cells are exception

Question 43

true/false - hyperplasia will continue in absence of a stimulus

Answer 43

false

Question 44

example of hyperplasia

Answer 44

lymph nodes in infection | endometrial cell lining at pregnancy

Question 45

example of hypertrophy

Answer 45

physiological or pathological hypertrophy of the heart

Question 46

define atrophy

Answer 46

decrease in cell number

Question 47

reasons for atrophy

Answer 47

``` lost innervation lost blood supply lost hormonal status ageing malnutrition ```

Question 48

true/false - insulin promotes atrophy

Answer 48

false - it opposes it

Question 49

what two hormones promote atrophy and degradation?

Answer 49

glucocotricoids and thyroid hormone

Question 50

what is cancer

Answer 50

uncontrolled cell proliferation and growth that can invade other tissues

Question 51

what is a tumour

Answer 51

swelling

Question 52

what is neoplasia

Answer 52

new growth, not in response to a stimulus

Question 53

what is malignancy

Answer 53

metastatic potential of a neoplastic growth

Question 54

what is dysplasia

Answer 54

disordered growth that is non invasive | rated low to high grade

Question 55

what is carcinoma in situ

Answer 55

dysplasia affecting whole epithelium, last stage before malignancy

Question 56

what is metaplasia

Answer 56

reversible change from one mature cell type to another

Question 57

how are obese patients more likely to have certain cancers

Answer 57

cholesterol mimicks steroid hormones and so can promote growth

Question 58

cancer is identified by the ____

Answer 58

weinberg hallmarks

Question 59

autosomal dominant genes predisposing to cancer

Answer 59

Retinoblastoma | FAP

Question 60

how does chronic inflammation lead to cancer

Answer 60

causes lymphomas - constant lymphocyte production leads to production error

Question 61

3 types of infection that may cause cancer

Answer 61

HPV Epstein-barr Schistosomiasis

Question 62

how does HPV cause cancer

Answer 62

E6 - destroys p53 | E7 - binds to Rb to prevent it binding to E2F

Question 63

how does UVB radiation cause damage to DNA

Answer 63

causes pyrimidine dimers in DNA, can be repaired if minimal

Question 64

chemical causes of cancer

Answer 64

``` smoking - aromatic polycyclic hydrocarbons arsenic aflatoxin beta-naphthylamine nitrosamines ```

Question 65

what test establishes if a chemical may cause cancer?

Answer 65

ames' test

Question 66

what is the double hit hypothesis

Answer 66

those with one dysfunctional gene are predisposed to an issue two dysfunctional genes is a functional problem

Question 67

what is an oncogene

Answer 67

gene promoting cancer growth

Question 68

what is a tumour suppressor

Answer 68

gene discouraging cancer growth

Question 69

most common mutation accounting for carcinoma

Answer 69

EGFR

Question 70

common EGFR mutations

Answer 70

Braf Myc PI3K

Question 71

what is Bcl-2

Answer 71

anti-apoptotic molecule | binds Bax/Bac to stop holes getting punched in mitochondria

Question 72

drug target to prevent angiogenesis in cancer

Answer 72

VEGF | vascular endothelial growth factor

Question 73

what cancers does BRCA cause

Answer 73

breast, ovarian, pancreatic

Question 74

true/false - cancer daughter cells are identical to their cancer parent cells

Answer 74

false

Question 75

how would a benign tumour appear?

Answer 75

smooth, homogenous, encapsulated

Question 76

how would a malignant tumour appear

Answer 76

nasty, heterogenous, irregular, destructive

Question 77

cancer cells are well/poorly differentiated

Answer 77

poorly

Question 78

N:C ratio is raised/lowered in cancer

Answer 78

raised

Question 79

epithelial neoplasm

Answer 79

carcinoma

Question 80

glandular neoplams

Answer 80

adenoma - benign | adenocarcinoma

Question 81

squamous neoplasms

Answer 81

papilloma | SCC

Question 82

bladder neoplasm

Answer 82

transitional cell sarcoma

Question 83

what is immunohistochemistry

Answer 83

binding of antibodies to probe and then to specimen. if it goes brown expected chemical is present

Question 84

how is cancer progression/advance recorded

Answer 84

TNM staging

Question 85

what is cahexia

Answer 85

malignancy related weight loss

Question 86

what is paraneoplastic symptoms

Answer 86

hormone production by tumour to result in electrolyte disturbance

Question 87

what is virchow's triad

Answer 87

site of endothelial injury turbulent blood flow hypercoagulable blood secondary causes

Question 88

what may cause endothelial injury

Answer 88

``` toxins infection smoking hypertension autoimmunity ```

Question 89

4 inherited diaorders causing hypercoagulable blood

Answer 89

factor V leiden Antithrombin III deficiency protein C deficiency Protein S deficiency

Question 90

secondary causes of thrombosis

Answer 90

``` immobility MI AF cancer contraceptives smoking cardiomyopathy tissue injury ```

Question 91

causes of air embolus

Answer 91

decompression sickness | IV injection

Question 92

types of embolism

Answer 92

``` thrombotic septic tumour fat air amniotic fluid ```