What is the molecular abnormality in inherited angio-oedema?
C1 esterase inhibitor deficiency
Briefly describe the main clinical features of hereditary angio-oedema?
Attacks of non-itchy cutaneous angio-oedema
Abdominal pain due to intestinal oedema
Family history of sudden death
The macrophage is the ‘mastermind’ of chronic inflammation. Give 4 functions of macrophages.
- Phagocytosis of bacteria and other particles
- Secretion of chemical mediators
- Presenting antigens to the immune system and initiation of the immune response
- Stimulating angiogenesis
- Inducing fibrosis
Name the 3 types of multinucleated giant cell that can be found in a granuloma and describe the histological appearance of each.
Langhans - horse-shoe nuclei around periphery
Foreign body- nuclei arranged randomly
Touton - nuclei arranged in a ring towards the centre of
the cell.
What is sarcoidosis?
Sarcoidosis is an inflammatory disease with an unknown cause in which granulomas are formed in organs throughout the body.
Name 2 organs commonly affected by sarcoidosis.
Lungs and lymph nodes.
Give 3 ways in which sarcoidosis can be distinguished from tuberculosis either by microscopy or other laboratory tests.
TB - casseous centre of granulomas with langhans cells present
- Mycobacterial DNA can be identified from tuberculous granulomas using PCR
- Mycobacterium tuberculosis may be cultured from infected tissues
- Serum ACE raised in sarcoidosis
What local factors can impair the healing of a wound?
- Large size of wound
- Poor blood supply
- Local infection
- Presence of foreign bodies
- Large haematoma or large amount of necrotic tissue
- Mechanical stress on the healing tissue
- Poor surgical technique
Where does clotting occur?
OUTSIDE of vessels
Briefly describe the two possible mechanisms of death in pulmonary embolism.
Respiratory compromise – there is a non-perfused but ventilated area of lung
Haemodynamic compromise – there is an increased resistance to pulmonary blood flow due to obstruction of the pulmonary vessels by the embolus. This results in acute right sided heart failure (acute cor pulmonale).
What are the major complications of an aneurysm?
- Rupture and haemorrhage
- Thromboembolism to the legs causing acute ischaemia.
- Aortic dissection causing acute aortic occlusion or aortic rupture.
What are causes of ventricular hypertrophy?
Systemic hypertension Valvular heart disease – aortic stenosis, aortic regurgitation, mitral regurgitation Ischaemic heart disease Hypertrophic cardiomyopathy Exercise
What causes atrophy?
Disuse atrophy Denervation atrophy Inadequate nutrition Inadequate blood supply Ageing Persistant injury
What is the most common type of cervical cancer?
Squamous cell carcinoma
What is the difference between cerival intraepithelial neoplasia (CIN) and cervical cancer ?
In CIN dysplastic cells are confined to the epithelium and no stromal invasion is seen. In cervical cancer malignant cells have invaded through the basement membrane and are present in the sub-epithelial tissue.
Which lung cancer is likely to produce PTHrP?
Bronchial squamous cell carcinoma.
