Pathology Flashcards
(140 cards)
1
Q
Definition of risk factor?
A
Social or individual factor which increases the risk of development of a disease
2
Q
Aetiology definition?
A
Causative element in disease
3
Q
Pathogenesis definition?
A
Sequence of events from healthy state to clinical disease
4
Q
Sequelae definition?
A
Range of possible outcomes of disease process
5
Q
Outcome definition?
A
Patient health or illness at a defined time
6
Q
Necrosis requires energy. True or False?
A
FALSE
Requires no energy
7
Q
What is necrosis? And what does it elicit?
A
Death of tissues
Pathological
-Elicits adjacent tissue response
8
Q
Different patterns of necrosis?
A
- Coagulative
- Colliquative
- Caseous
- Gangrenous
- Fibrinoid
- Fat necrosis
9
Q
Coagulative necrosis?
A
Proteins coagulate
Preservation of cell outline
-Eg MI
10
Q
Colliquitive necrosis?
A
Necrotic material becomes softened and liquefied (PUS)
No cell structure remains
-Eg brain
11
Q
Caseous necrosis?
A
Cheese-like
-Eg TB
12
Q
Gangrenous necrosis?
A
Cell death by necrosis then infection on top of it
Anaerobic bacteria may grow
13
Q
Fibrinoid necrosis?
A
Fibre deposition
-Eg damage to blood vessel in malignant hypertension
14
Q
Fat necrosis example?
A
Eg- Acute pancreatitis
15
Q
What process requires energy?
A
Apoptosis
16
Q
What is apoptosis?
A
Programmed cell death
Defence against inherited injury
-Eithe physiological (normal growth) or pathological (injury, infection, chemo)
17
Q
What is P53 and what can it lead to?
A
- Protein
- If lost it can lead to development of cancer, which is more likely resistant to treatment
18
Q
Where does P53 function?
A
Cell cycle at G1 (like a spell checker)
-If mistakes are found cycle is paused and repair is attempted
19
Q
What can occur at G1 checkpoint?
A
Apoptosis
If DNA is damaged
20
Q
G2 checkpoint?
A
Mitosis will not occur if DNA is damaged or not replicated
21
Q
M checkpoint?
A
Mitosis stops if chromosomes are not properly aligned
22
Q
What happens if DNA can’t be repaired?
A
Then P53 stimulates and indices apoptosis
23
Q
What part of the cell is involved in cell aging?
A
Telomere
Shortening
24
Q
How do chromosomes prevent degradation and fusion?
A
They are capped
25
What does cancer reactivate?
Telomerase gets reactivated in cancer and can become immoral
26
What causes loss of membrane integrity?
Failure of ion pumps
Disruption of membrane
Alteration of lipids
Cross-linking of membrane proteins
27
What are free radicals formed by?
- Drugs
- O2 toxicity
- Reperfusion injury
- Inflammation
- Intracellular killing of bacteria
28
What is a metabolic disorder?
Biochemical abnormality which may itself be deleterious, but which also causes target organ damage, usually by accumulation of injurious agent
29
How would you inherit a metabolic disorder?
Autosomal recessive
30
Inherited metabolic disorder causes...?
Loss of function
31
What is phenylketonuria?
Due to accumulation of phenylalanine
Caused by deficiency in enzyme (phenylalanine hydroxylase) which converts phenylalanine to tryosine
Guthrie test - foot prick (PKU)
32
Vascular phase of inflammation?
Dilation and increased permeability of blood vessels
33
Exudative and cellular phase of inflammation?
Fluid and cells escape from permeable venules
34
What is a diagnostic feature for inflammation?
Neutrophil accumulation in extracellular space
35
Beneficial effects of inflammation?
- Toxin dilution
- Entry of ABs
- Fibrin formation
- Drug transport
- Oxygen and nutrient delivery
- Immune response stimulation
36
Harmful effects of inflammation?
- Digestion of normal tissues
- Swelling
- Inappropriate inflammatory response (Type 1 sensitivity)
37
What is chronic inflammation?
Subsequent and often prolonged tissue reactions
38
Characteristics of inflammation?
- Redness
- Heat
- Swelling
- Pain
- Loss of function
39
Why does redness occur in inflammation?
Due to dilation of small blood vessels
40
Why does heat occur in inflammation?
Increased blood flow through region
41
Why does swelling occur in inflammation?
Accumulation of fluid in extravascular space
42
Why does pain occur in inflammation?
Distortion of tissues
43
Why does loss of function occur in inflammation?
Inhibited by pain or swelling
44
What is in fluid exudate?
Proteins including immunoglobins
45
When does fibrinogen turn to fibrin?
On contact with ECM (Extra-cellular matric fibrin), acutely inflammed organ surfaces commonly covered in fibrin
46
What is margination?
Loss of intravascular fluid and increased plasma viscosity allows neutrophils into plasma (only occurs in venules)
47
What do neutrophils stimulate?
Inflammation
48
Adhesion of neutrophils increased by?
Complement C5a
Leukotriene B2
TNF
49
Endothelial expression of adhesion molecules increased by?
IL1
Endotoxins
TNF
50
What is chemotaxis?
Locomotion orientated along a chemical gradient
51
Examples of chemical mediators?
```
Histamine
Seratonin
Chemokines
Leukotrienes
Prostaglandins
```
52
What does histamine do?
-Vascular dilation
53
What are histamines released by?
Mast cells, eosinophils, basophils, platelets
54
Release of histamine is stimulated by?
C3a, C5a and lysosomal proteins (released by neutrophils)
55
What does seratonin cause?
Increased vascular permeability
56
What is another term for seratonin receptors?
5HT
57
Where are 5HT present in high concentration?
Platelets
58
What do chemokines do?
Attract various leukocytes to site of inflammation
59
What type of hypersensitivity are leukotrienes involved in?
Type 1
60
What do prostaglandins do?
Increase vascular permeability
| Stimulate platelet agregation
61
What is necessary for recognition of microorganisms?
They must be coated with opsonin
62
Examples of things acting as opsonins that could coat microorganisms?
Fc fragment of IgG
C3b
Collectins
63
What is suppuration? What cells does it include?
Formation of pus
| Neutrophils, bacteria, cellular debris
64
Resolution?
Complete restoration of tissues to normal after episode of acute inflammation
65
Cells involved in chronic inflammation?
Plasma cells
Lymphocytes
Macrophages
66
Macroscopic appearance of inflammation eg chronic ulcer?
Breach in mucosa
Base lined by granulation tissue
Fibrous tissue extends through muscle layers
67
Appearance of chronic abscess cavity?
Thickening of wall by fibrous tissue
68
When would something appear granulomatous?
Crohn's
| TB
69
On contact with____, __ Lymphocytes become _______ cells?
Antigen
B
Plasma
70
What cell produces cytokines?
T lymphocyte
71
Characteristics of reversible damage?
- Reduced aerobic respiration/increased anaerobic
- Membrane pumps fail
- Cell swelling
- Accumulation of lipids
72
Characteristics of irreversible damage?
- Severe damage to cell membranes and mitochondria
- Leakage of enzymes
- Nuclear changes- ATP changes, cell membrane damage
73
Progression of injury/damage?
Attempted repair
|
Complete= regeneration/restitution
Incomplete= repair/scarring
74
Labile cells. What are they? location?
Cells that multiply constantly throughout their short lives
| -GI tract, Bone marrow
75
Stable cells. What are they? Location?
Cells that multiply only when needed
| -Hepatocytes, endothelium
76
Permanent cells. What are they? Location?
Cells that are unable to replicate in post-natal life
-Skeletal muscle, neurones
REGENERATION of these is not possible
77
Stem cells. What are they?
Pluripotent cells
| Can differentiate into most cell types
78
What becomes a fibrous scar?
Granulation tissues after it has undergone organisation
79
What is a granuloma and when is it normally present?
- Collection of macrophages (in response to foreign bodies eg bone, asbestos, TB, parasites, syphillis, malignancy)
- FOUND in chronic inflammation
80
What is differentiation?
Acquisition of specialized features
81
Hyperplasia?
Increase in cell number
82
What does amlodipine cause?
Gingival hypertrophy (overgrowth of gum tissue around teeth)
83
Hypertrophy?
Increase in cell size
84
Atrophy?
Reduction in cell size and number in an organ that was normal size
85
Hypoplasia?
Reduced size of an organ that never fully developed to normal size
86
Metaplasia?
One type of cell becomes another form of cell in response to stress
87
Example of metaplasia?
Barrett's eosophagus
88
Meaning of neoplasia?
New growth
89
Neoplasia?
Abnormal mass of tissue, growth which exceeds and is uncoordinated with that of normal tissues
90
Describe heritage of neoplastic cells?
Monoclonal
| -Derived from one single common ancestor
91
Benign neoplasia?
- No necrosis
- N:C nucleus to cytoplasm ration normal
- Minimal change in size/shape (pleomorphism)
- Diploid
- Adenoma
- Papilloma
92
Types of benign neoplasia?
Adenoma
| Papilloma
93
Malignant neoplasia?
```
Necrosis common
Metastatic potential
Pleomorphic
N:C ratio increased
Aneuploid
Carcinoma, carcinoma in situ, sarcoma
```
94
Carcinoma is?
Cancer of epithelial cell
95
Carcinoma in situ is?
Not invading other tissues, confined to site of origin
96
Sarcoma is?
Cancer of mesenchymal cell
97
What is meaning of dysplasia?
Disordered growth
98
What is dysplasia?
Pre-malignant process
| Abnormal cell changes
99
Angiogenesis?
Formation of new abnormal blood vessels
| Successfully growing tumors will develop ability to create own blood supply
100
Metastasis?
Formation of tumour implants that are discontinuous with the primary lesion
101
Roues of mets?
- Carcinoma?
- Sarcoma?
```
Lymphatic= carcinoma
Sarcoma= haematogenous
```
102
Stepwise progression of cancer?
Initiation- 1st mutation
Promotion- more mutations
Persistence - Malignant?
103
What is involved in initiation?
Oncogenes
Tumour suppresors
DNA repair
Evasion of apoptosis
104
What is involved in promotion?
Further accumulation of mutations
105
What is involved in persistence?
Unregulated abnormal growth, can become malignant
106
What do classical oncogenes do?
Stimulate cell proliferation (turn up genes that promote growth)
Inhibition
Dominant
107
Examples of oncogenes affected by mutations?
RAS - colon, lung, bladder, melanoma, pancreatic
BRAF -
Myc -Lymphoma. neuroblastoma, small cell carcinoma of lung
P13K - Haematological malignancies
108
What do tumour suppressors do?
Turn of genes that slow growth
- Inhibit cell proliferation
- Stimulate cell death
- Recessive
109
Examples of tumour suppressors affected by mutations?
P53 protein
110
What is P53? What is is activated by?
Transcription factor
| Activated by cell stress
111
Dna repair genes affected by mutations?
BRCA 1 and BRCA2
112
What malignant cells look like?
Usually rough and nasty
113
What benign cells look like?
Usually smooth and round
114
Epithelium cancer?
Carcinomas
115
Glandular cancers?
Adenoma vs adenocarcinoma
116
Squamous cancers?
Papilloma vs squamous cell carcinoma
117
Sarcoma is malignant. True or false?
TRUE
118
Paraneoplastic syndromes?
Clinical syndromes involving non-metastatic systemic effects that accompany malignant disease. They are rare disorders
119
Example of an acquired metabolic disorder?
Diabetes
120
Which diabetes is insulin dependant?
Type 1
121
What is type 2 diabetes?
Non-insulin dependent
122
Biochemical complications of diabetes?
Ketoacidosis
Non-enzymatic glycosylation
Hypoglycaemia
Lactic acidosis
123
Other issues associated with diabetes?
Macroangiopathy
Diabetic nephropathy
Diabetic retinopathy
Cataracts
124
Peripheral obesity?
Around around arms and thighs
125
Pathogenesis of atheroma?
- Fatty streak
- Fibrofatty plaque
- Proliferative atheroma
- Complicated atheroma
126
Aetiology of atheroma?
Endothelial injury
- Response to injury
- Macrophages + platelets
- Lipid accumulation
- Smooth muscle proliferation
127
Complications of atheroma?
```
Thrombosis
Aneurysm
Dissection
Embolism
Ischaemia
```
128
How hypertension and the heart works?
- Left ventricular hypertrophy
- Increased LV load
- Poor perfusion
- Interstitial fibrosis
- Micro-infarcts
- Diastolic dysfunction
129
Thrombus definition?
Solid mass of blood constituents, formed within blood vessels
130
3 parts of Virchow's triad?
Vessel wall
Blood flow
Blood constituents
131
Vessel wall in Virchow's triad?
Loss of endothelial tissues
| Inflammation
132
Blood flow in Virchow's triad?
Stasis
| Turbulence
133
Blood constituents in Virchow's triad?
Platelets
Coagulation proteins
Viscosity
134
What are platelets?
Anucleated cell fragments
135
What constitutes of platelets?
Adherance properties
Procoagulant contents
Growth factors
136
Embolism?
Mass of material in vascular system moving form its site of origin to lodge in the vessels in a distant site
137
DVT possible causes?
```
Post-op
Bed bound
Travel
Involves=
Unilateral leg swelling
Oedema
Pain
```
138
What is a PTE and it's symptoms/risk factors?
Pulmonary thromboembolism
- Sudden onset
- Haemoptysis
- Breathlessness
- CV collapse and shock
- Cardiac arrest
139
What is the pathology of an MI?
Zonal necrosis due to sudden occlusion of blood supply
| -Due to lack of nutrients and oxygen
140
How long does it take neurons in brain to die without oxygen?
3 mins
