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Phase 2a Medicine - Riona COPY > Pathology > Flashcards

Pathology Flashcards

1
Q

What is inflammation?

A

The local physiological response to tissue injury

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2
Q

Give the 5 cardinal signs of inflammation

A
  • ) Rubor/redness
  • ) Calor/heat
  • ) Tumor/swelling
  • ) Dolor/pain
  • ) Function laesa/loss of function
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3
Q

What is rubor due to?

A

Dilation of small blood vessels in area

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4
Q

What is calor due to?

A

Hyperaemia (increased blood flow) and systemic fever

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5
Q

What is tumor due to?

A

Oedema and a mass of inflammatory cells migrating to area

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6
Q

What is dolor due to?

A

Stretch and distortion of tissues from oedema/pus, and chemical mediators such as bradykinin, serotonin and prostaglandins inducing pain

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7
Q

What is functio laesa due to?

A

Movement consciously and reflexively inhibited by pain/tissue and may be immobilised by swelling

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8
Q

Give the 3 main inflammatory cells

A
  • ) Neutrophil polymorphs
  • ) Lymphocytes
  • ) Plasma cells
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9
Q

What does acute inflammation involve?

A
  • ) Tissue macrophages
  • ) Lymphatics
  • ) Neutrophil polymorphs
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10
Q

Give the 3 steps of acute inflammation

A

1) Changes in vessel calibre and flow
2) Increased vascular permeability due to transient chemical mediators and formation of fluid exudate
3) Formation of cellular exudate then emigration of neutrophil polymorphs

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11
Q

Give 2 chemical mediators of inflammation

A
  • ) Histamine
  • ) Bradykinin
  • ) NO
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12
Q

What is fluid exudate?

A

The leakage of protein rich fluid

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13
Q

Give 3 beneficial effects of fluid exudate

A
  • ) Dilution of toxins for removal
  • ) Entry of antibodies due to increased vascular permeability
  • ) Transport of drugs
  • ) Fibrin formation
  • ) Stimulation of immune response
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14
Q

Give 2 harmful effects of fluid exudate

A
  • ) Digestion of normal tissue
  • ) Swelling leading to airway obstruction
  • ) Inappropriate inflammation
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15
Q

Give the 4 outcomes of acute inflammation

A
  • ) Resolution to normal
  • ) Suppuration (pus formation)
  • ) Organisation via replacement by granulation tissue
  • ) Progression to chronic
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16
Q

What is resolution of acute inflammation?

A

Initiating factor is removed, and the tissue is left undamaged or able to regenerate

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17
Q

What is pus a mixture of?

A

Living, dying, dead neutrophils/bacteria with cellular debris

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18
Q

What is the stimulus for suppuration?

A

Fairly persistent, usually infective

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19
Q

What is pus surrounded by once it accumulates?

A

Pyogenic membrane of capillaries, neutrophils and some fibroblasts

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20
Q

What does the pus accumulation eventually become?

A

Granulation tissue and leads to scarring

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21
Q

What is organisation in acute inflammation?

A

The repair of specialised tissue by the formation of a fibrous scar

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22
Q

How do organisation occur?

A

Production of granulation tissue and removal of dead tissue by phagocytosis

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23
Q

What is scar tissue made mainly of?

A

Collagen

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24
Q

Give 3 causes of acute inflammation

A
  • ) Microbial infections
  • ) Hypersensitivity reactions
  • ) Physical agents
  • ) Chemicals
  • ) Tissue necrosis
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25
Q

What is chronic inflammation?

A

A prolonged or persistent inflammation marked by new tissue formation (fibrosis)

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26
Q

What are the 4 main cell types in chronic inflammation?

A
  • ) Plasma cells
  • ) Macrophages
  • ) Lymphocytes
  • ) Eosinophil polymorphs
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27
Q

Give 3 signs of chronic inflammation

A
  • ) Chronic ulcer
  • ) Chronic abscess cavity
  • ) Fibrosis
  • ) Granulomatous inflammation
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28
Q

Give 3 causes of chronic inflammation

A
  • ) Resistance of infective agent to killing
  • ) Necrotic tissue/foreign material
  • ) Autoimmune diseases
  • ) IBD/Crohn’s
  • ) Transplant rejection
  • ) Outcome of acute, usually suppurative
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29
Q

What is granulomatous inflammation?

A

A type of chronic inflammation associated with granulomas

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30
Q

What is a granuloma?

A

Aggregate of epithelioid histiocytes (activated macrophages) surrounded by mature lymphocytes

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31
Q

Give 2 granulomatous diseases

A
  • ) TB
  • ) Crohn’s
  • ) Leprosy
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32
Q

Give a product of epithelioid histiocytes (and thus granulomas)

A

ACE

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33
Q

What is a clot?

A

A solid mass of blood constituents

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34
Q

What is laminar flow?

A

Cells generally travel in the centre of arterial vessels

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35
Q

What is a thrombus?

A

A clot formed within an intact vascular system during life

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36
Q

What is an embolus?

A

A thrombus that breaks loose and travels to another vessel in the body

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37
Q

Give 2 factors which are needed for a thrombus to form

A
  • ) Change in vessel wall
  • ) Change in blood constituents
  • ) Change in blood flow
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38
Q

Give an example of an antiplatelet

A

Aspirin

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39
Q

What do antiplatelets do?

A

Inhibit thromboxane production from platelets to stop new platelet activation and aggregation

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40
Q

Give an example of an anticoagulant

A

Warfarin

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41
Q

What do anticoagulants do?

A

Target clotting factors by competing with vitamin K

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42
Q

What clotting factors do anticoagulants inhibit? (4)

A
  • ) II
  • ) VII
  • ) IX
  • ) X
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43
Q

What does an atherosclerotic plaque consist of?

A
  • ) Lipid
  • ) Necrotic core
  • ) Connective tissue
  • ) Fibrous cap
  • ) Inflammatory cells
  • ) Possible calcification
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44
Q

Which vessels is atherosclerosis most common in?

A

High pressure arteries

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45
Q

Give 3 risk factors for atherosclerosis

A
  • ) Increasing age
  • ) Male sex
  • ) Smoking
  • ) Obesity
  • ) High cholesterol
  • ) Fatty diet
  • ) DM
  • ) High BP
  • ) FHx
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46
Q

Give the 5 steps of atherosclerosis formation

A

1) Fatty streaks
2) Intermediate lesions
3) Fibrous plaque
4) Plaque rupture
5) Plaque erosion

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47
Q

Give 3 complications of atherosclerosis

A
  • ) MI
  • ) Angina
  • ) Thrombosis
  • ) Embolism
  • ) Stroke
  • ) Limb ischaemia
  • ) Organ infarction
  • ) Haemorrhage
  • ) Aneurysm
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48
Q

Give the 3 parts of Virchow’s triad

A
  • ) Hypercoagulability
  • ) Blood stasis
  • ) Endothelial damage
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49
Q

What is a thromboembolism?

A

Formation of a blood clot in a vessel

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50
Q

What is an infarction?

A

When blood flow to a tissue is obstructed, and the tissue dies to a lack of oxygen

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51
Q

Give 3 complications of a MI

A
  • ) Cerebral infarction
  • ) Arrhythmia
  • ) Cardiogenic shock
  • ) Cardiac rupture
52
Q

What is ischaemia?

A

Inadequate blood flow to tissues

53
Q

Define atrophy

A

Decrease in size of tissue due to decrease in number of constituent cells/decrease in cellular size

54
Q

Define hypertrophy

A

Increase in size of tissue due to increase in size of constituent cells

55
Q

Define hyperplasia

A

Increase in size of tissue due to increase in number of constituent cells, or by lack of apoptosis

56
Q

Dedine dysplasia

A

Imprecise term for morphological changes in cells in the progression to becoming cancer

57
Q

Define metaplasia

A

The change in differentiation of a cell from one fully differentiated type to another fully differentiated type

58
Q

Define apoptosis

A

Progreammed cell death occurring in old/damaged cells so that they aren’t replicated

59
Q

What regulates apoptosis?

A

p53

60
Q

Define necrosis

A

Traumatic cell death

61
Q

Give 2 causes of necrosis

A
  • ) Infarction
  • ) Frostbite
  • ) Toxins
62
Q

What is intraepithelial neoplasia?

A

Potentially premalignant dysplasia of cells

63
Q

What is a neoplasm?

A

The formation of abnormal and uncoordinated tissue growth that persists after withdrawal of the initiating cause

64
Q

Give 4 features of benign neoplasia that differentiate it from malignant (brackets are malignant)

A
  • ) Slow growing (fast)
  • ) Infrequent mitoses (frequent)
  • ) Good histological resemblance to normal tissue (poor)
  • ) Near normal nuclear morphology (enlarged irregular)
  • ) No invasion or mets (occur)
  • ) Often well bordered (poorly defined)
  • ) No necrosis or ulceration (common)
  • ) Exophytic/outward growth (endophytic/inward)
65
Q

What are the 2 ways in which we classify tumours?

A
  • ) Behavioural

- ) Histogenetic

66
Q

Give 2 benign epithelial tumours

A
  • ) Papilloma

- ) Adenoma

67
Q

What is a papilloma?

A

Benign tumour of non-glandular and non-secretory epithelium

68
Q

What is an adenoma?

A

Benign tumour of glandular or secretory epithelium

69
Q

What are malignant epithelial tumours called?

A

Carcinomas or adenocarcinomas (glandular)

70
Q

Give 2 benign connective tissue tumours

A
  • ) Lipoma
  • ) Leiomyoma
  • ) Rhabdomyoma
  • ) Chondroma
71
Q

What are malignant connective tissue tumours called?

A

Sarcomas

72
Q

What are lymphoid/haematopoietic malignant tumours called?

A

Lymphomas or leukaemias

73
Q

What is Kaposi’s sarcoma?

A

Malignant neoplasm derived form vascular endothelium

74
Q

What is Kaposi’s sarcoma associated with?

A

AIDS

75
Q

What does the grade of neoplasms correlate with?

A

The amount of histological differentiation (and growing speed)

76
Q

What does T1N1M0 mean?

A

Small tumour, 1 nodal met, no other mets

77
Q

Give the staging/grading system used for colorectal carcinomas

A

Duke’s ABCD

78
Q

Give the 7 steps of the formation of a metastatic tumour

A

1) Detachment from other cells
2) Invasion of basement membrane
3) Intravasation
4) Evasion of host defences
5) Arrest by binding to endothelial ligands for adhesion to endothelium
6) Extravasation by integrins
7) Proliferation and vascularisation of tumour

79
Q

How does detachment from other cells occur in the formation of a metastatic tumour?

A

Loss of adhesion molecules

80
Q

What make invasion of the basement membrane and intravasation occur in the formation of a metastatic tumour?

A

Metalloproteinases

81
Q

Give 3 ways in which malignant tumours cause mortality

A
  • ) Pressure on tissue
  • ) Destruction of tissue
  • ) Mets
  • ) Haemorrhage from ulcerated surfaces
  • ) Obstruction of flow
  • ) Formation production
  • ) Pain
  • ) Weight loss
  • ) Debility
82
Q

Give 3 ways in which benign tumours cause mortality

A
  • ) Pressure on adjacent tissues
  • ) Obstruction of flow
  • ) Hormone production
  • ) Possible transformation into malignant
83
Q

What is a germline mutation?

A

Altered gene in gamete that can be passed on

84
Q

Give an example of a germline mutation

A

BRCA1 mutation

85
Q

What is a somatic mutation?

A

Genetic mutation that will be present in subsequent cell divisions but will not be in gametes

86
Q

Give an example of a somatic mutation

A

Philadelphia chromosome

87
Q

Give 3 things carcinogenesis requires

A
  • ) Expression of telomerase to avoid shortening
  • ) Loss of tumour suppressor genefunction
  • ) Enhanced expression of dominant oncogenes
88
Q

What is Knudson’s 2 hit hypothesis?

A

Cancer is the result of accumulated mutations to a cell’s DNA

89
Q

What are the 2 hits in Knudson’s hypothesis?

A

1) Inheritance of defective allele or acquired mutation

2) Mutational loss of function of normal allele

90
Q

Define carcinogenesis

A

The transformation of normal cells into neoplastic cells through permanent genetic alterations or mutations (malignant)

91
Q

Define oncogenesis

A

The transformation of normal cells into neoplastic cells through permanent genetic alterations or mutations (benign and malignant)

92
Q

Define carcinogen

A

Agents suspected or known to cause tumours

93
Q

Define carcinogenic

A

Cancer causing

94
Q

Define oncogenic

A

Tumour causing

95
Q

Give 2 problems with identifying carcinogens

A
  • ) Long latent interval
  • ) Complexity of environment
  • ) Ethical constraints
96
Q

How is the location of cancer caused by chemical carcinogens related to that chemical?

A

Cancer likely localised to where the enzyme that converts the pro-carcinogen to it’s active form is

97
Q

Give 3 treatment options for treating cancers

A
  • ) Radiotherapy
  • ) Chemotherapy
  • ) Surgery
98
Q

Give 2 ways in which conventional chemotherapy works

A
  • ) Bind to mitotic spindles to stop contraction and thus division of cell
  • ) Bind to DNA so synthesis is inhibited
  • ) Bind to enzymes that are needed for DNA replication
99
Q

What is a problem with conventional chemo?

A

It also affects normal dividing cells

100
Q

Give 2 ways in which targeted chemotherapy works

A
  • ) Create antibodies to receptors to prevent growth factor
  • ) Inhibit receptors inside cells
  • ) Antibodies against growth factors
101
Q

Define histogenesis

A

The specific cell of origin for a tumour

102
Q

Define osteosclerotic

A

New bone growth

103
Q

Define osteolytic

A

Holes in bone

104
Q

What do caretaker genes do?

A

Repair DNA damage

105
Q

What do gatekeeper genes do?

A

Promote damaged cell death

106
Q

What are oncogenes?

A

If expressed, they drive the neoplastic behaviour of cells

107
Q

What is the most frequently mutated gene in cancers?

A

Tumour suppressor gene p53

108
Q

What type of gene is p43?

A

Gatekeeper gene

109
Q

What does germline mutation of p53 lead to?

A

Li-Fraumeni syndrome

110
Q

What is Li-Fraumeni syndrome?

A

Autosomal dominant hereditary disorder that pre-disposes carriers to cancer development

111
Q

What gene gives rise to familiar retinoblastoma when germline mutated?

A

RB1

112
Q

What type of gene is BRCA1/2?

A

Caretaker

113
Q

Give the 8 principles of screening

A
  • ) Important condition
  • ) Recognisable latent/early stage
  • ) Natural course must be understood
  • ) Suitable, acceptable test
  • ) Case finding should be continuous (repeated tests)
  • ) Accepted and available treatment
  • ) Agreed policy on who to treat
  • ) Cost consideration
114
Q

What must screening be? (5)

A

Cheap, reliable, acceptable, sensitive, specific

115
Q

What are the 2 main types of autopsy?

A

Hospital and medico-legal

116
Q

What are the 2 types of pathologists, and what do they each do?

A

Histopathologist (hospital and coronial), forensic pathologist (coronial)

117
Q

Give 3 questions to answer in an autopsy

A
  • ) Who was the deceased?
  • ) When did they die?
  • ) Where did they die?
  • ) How did they come about their death?
118
Q

What is healing by 1st intention?

A

Wound heals back together

119
Q

What is healing by 2nd intention?

A

Wound doesn’t heal back together, is filled in by other tissue

120
Q

Define congenital disorders

A

Present at birth

121
Q

Defined inherited disorders

A

Caused by inherited genetic abnormality

122
Q

Defined acquired disorders

A

Caused by non-genetic environmental factors, can be congenital

123
Q

What is dermal elastosis?

A

Wrinkles in skin due to UV damage

124
Q

Why do cataracts occur?

A

Cross linking of proteins in lenses due to UV

125
Q

What is sarcopenia?

A

Loss of muscles mainly due to decreased growth hormone and testosterone

126
Q

Why does deafness occur?

A

Loss of hair cells in cochlea

Phase 2a Medicine - Riona COPY (17 decks)

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