Pathology

Question 1

List three examples where a death must be reported to the coroner

Answer 1

1. Suicide
2. Death may be due to neglect either by someone else of by self
3. The cause of death is unknown

Question 2

In a coroners autopsy, any material can be taken from the body- True or false?

Answer 2

False - a coroner may only take material if it bares upon the cause of death

Question 3

On a death certificate, what information is filled in in (2) 
i.e. 
1a
1b
1c
2

Answer 3

2 = Other factors contributing to but not directly involved in death

Question 4

List 2 reasons for conducting a hospital autopsy

Answer 4

1. Audit purposes - often the cause of death is not accurate
2. Teaching

Question 5

List 4 causes of sudden unexpected death in the community

Answer 5

1. Ruptured aortic aneurysm
2. Pulmonary embolism
3. Non traumatic subarachiniod haemorrhage
4. Coronary artery disease

Question 6

What is a bruise?

Answer 6

Extravasated collection of blood from venules/veins/small arteries but not capillaries

Question 7

What is an abrasion?

Answer 7

A graze or a scratch. The most superficial of blunt trauma injuries

Question 8

What is a laceration?

Answer 8

A split to the skin as a result of blunt trauma. Often jagged edges and usually pass through full thickness of the skin

Question 9

List the causes of cell injury

Answer 9

Oxygen deprivation, chemical agents, physical agents, infectious agents, ageing, immunological agents, genetic changes, nutritional imbalances

Question 10

What 4 intracellular systems are particularly vulnerable to cell injury?

Answer 10

ATP generation, protein synthesis, membrane integrity, integrity of genetic apparatus

Question 11

What is atrophy and give one example?

Answer 11

Atrophy =shrinkage in the size of the cell by loss of cell substance e.g. Dementia

Question 12

What is hypertrophy and give one example?

Answer 12

Hypertrophy = increase in the size of the cell . It can be physiological or pathological and either caused by increased functional demand or specific hormonal stimulation
Physiological: Uterus during pregnancy
Pathological: Atherosclerotic plaque leading to heart disease

Question 13

What is hyperplasia and give one example?

Answer 13

Hyperplasia = an increase in the number of cells in an organ. It can be physiological (hormonal or compensatory) or pathological (excessive hormone or growth factor stimulation).
Physiological: endometrium
Pathological: Carcinoma

Question 14

List 3 ways in which cells can adapt to cellular injury?

Answer 14

Hyperplasia, Atrophy, Hypertrophy

Question 15

What is metaplasia?

Answer 15

A reversible change in which one adult cell type is replaced by another. Physiological or pathological.
Physiological: the cervix during pregnancy - the acidic environment causes the cells to change from columnar to squamous.
Pathological: Barrets syndrome- squamous change to columner dur to acid from oesophagus

Question 16

What is dysplasia?

Answer 16

Precancerous cells which show the genetic and cytological features of malignancy but not invading the underlying tissue.
Example: Barret’s syndrome

Question 17

What are the light microscopic changes associated with reversible cell injury?

Answer 17

Fatty change, cellular swelling

Question 18

Define necrosis? And list the 4 different types

Answer 18

Cellular death associated with inflammation

1. Liquefactive (often associated with fungal/bacterial infections. e.g. old cerebral infarct)
2. Caseous (pulmonary TB)
3. Fat (lipase release fatty acids from triaglycerides e.g. pancreatitis)
4. Coagulative (often caused by ischemia or infarction e.g. MI. Architecture of tissue is preserved for a couple of days)

Question 19

List three causes of apoptosis

Answer 19

1. Embryogenesis
2. Stimulus causing irreparable DNA damage
3. Deletion of cells in proliferating populations

Question 20

List 3 differences between apoptosis and necrosis

Answer 20

1. Necrosis is associated with inflammation
2. Apoptosis requires energy (ATP)
3. Apoptosis may be physiological

Question 21

What is necroptosis?

Answer 21

Programmed cell death associated with inflammation

Question 22

Give three examples of diseases processes that involve inflammation

Answer 22

1. Allergy e.g. asthma
2. Infection e.g. TB or the common cold
3. Autoimmune e.g. RA

Question 23

What are the components of an inflammatory reaction?

Answer 23

Cells, Soluble factors, extracellular matrix and vasculature

Question 24

What are the cardinal signs of acute inflammation?

Answer 24

Rubor, Tumour, Calor, Dolor and loss of function

Question 25

List three differences between exudate and transudate?

Answer 25

1. Exudate has leaked out from vessels whereas transudate is the fluid within vessels 2. Exudate has a much higher protein concentration 3. Exudate is cell rich whereas transudate is cell poor

Question 26

List the three different types of exudate and give an example of each

Answer 26

1. Serous= fluid e.g. blister 2. Fibrinous = fibrin e.g. viral pericarditis 3. Purulent = inflammatory cells, fibrin, debris, fluid e.g. peritonitis following bowl perforation

Question 27

Regarding the movement of neutrophils from the blood vessel and into the tissue, put the following words in the correct order: Diapedesis, Rolling and adhesion, margination, chemotaxis

Answer 27

1. Margination 2. Rolling and adhesion 3. Diapedesis 4. Chemotaxis

Question 28

List three causes of chronic inflammation

Answer 28

1. Persistant infection 2. Prolonged exposure to toxic agent 3. Foreign body

Question 29

Exudate is seen in chronic inflammation - true or false?

Answer 29

FALSE - there is NO exudate involved in chronic inflammation

Question 30

Necrosis is more prominent in acute inflammation or chronic inflammation?

Answer 30

Necrosis is more prominent in acute inflammation

Question 31

Give a classic example of tissue resolution

Answer 31

Pneumococcal lobar pneumonia

Question 32

List 5 things that can hinder tissue repair

Answer 32

1. Poor nutrition 2. Persistent foreign body 3. Mineral deficiency 4. Poor blood supply 5. Suppressed inflammation

Question 33

List three complications of tissue repair

Answer 33

1. Keloid formation 2. Contractures 3. Impaired organ function

Question 34

Cytokines are more prominent in chronic inflammation as opposed to acute inflammation - true of false?

Answer 34

True - cytokines predominant in chronic inflammation whereas histamine is seen in acute

Question 35

Name 3 classes of carcinogens

Answer 35

1. Parasites, bacteria and fungi 2. Hormones e.g estrogen in breast cancer 3. Ionising/non-ionising radiation Others: chemicals, viruses

Question 36

Which of the following is an RNA carcinogenic virus: a) HPV b) HTLV-1 c) EBV d) HBV e) HHV8

Answer 36

b) HTLV-1 | All the others are DNA viruses which can cause cancer

Question 37

Helicobactor pylori is a viral carcinogen - true of false?

Answer 37

False, it is a bacterial carcinogen

Question 38

What are the four classes of regulatory genes involved in cancer?

Answer 38

1. Pro-apoptotic genes 2. DNA repair genes 3. Proto-oncogenes 4. Anti-oncogenes/Tumor suppressor genes

Question 39

Name 4 clinical affects of a tumour

Answer 39

1. Anxiety 2. Related to location - pressure, infection, bleeding etc. 3. Metabolic cancer cachexia 4. Paraneoplastic syndromes

Question 40

What is oedema and which two pressure are unbalanced for it to occur?

Answer 40

Oedema is an abnormal increase in interstitial fluid. Hydrostatic forces and osmotic forces become unbalanced for it to occur

Question 41

List 3 common causes of generalised oedema

Answer 41

1. Left ventricular failure 2. Hepatic failure 3. Nephrotic syndrome

Question 42

Define thrombosis and list the three main factors that cause thrombosis

Answer 42

Thrombosis is the formation of a solid mass of blood constituents within the circulatory system 1. Statis 2. Hypercoagulability 3. Vessel wall injury

Question 43

Define an embolism

Answer 43

An embolism is a detached intravascular solid, liquid or gaseous mass that is carried by the blood to a site distant to its origin

Question 44

An emboli lodging in one of the following is most likely to cause instantaneous death: a) Small pulmonary artery b) Medium sized pulmonary artery c) Major pulmonary artery

Answer 44

c) Major pulmonary artery

Question 45

Define a haemorrhage

Answer 45

A haemorrhage is escape of blood from a ruptured vessel

Question 46

Define shock and list the different types

Answer 46

Shock is when tissue perfusion is insufficient to meet metabolic requirements. 1. Anaphylactic 2. Hypovolaemic 3. Septic 4. Cardiogenic 5. Neurogenic

Question 47

What is an infarction?

Answer 47

An infarction is tissue necrosis due to ischaemia

Question 48

What size vessels down athersclerosis affect?

Answer 48

Large and medium arteries

Question 49

Which of the following is associated with a stable plaque: a) More inflammation b) Lipid rich necrotic core c) Thin fibrous cap d) A thick fibrous cap

Answer 49

d) A thick fibrous cap | All the other options are associated with an unstable plaque that is more likely to rupture

Question 50

Which of the following is true about the clinical outcomes of helicobactor pylori infection? a) >80% develop into gastric cancer b) 15-20% develop into gastric cancer c)

Answer 50

c) less the 1%

Question 51

Define an ulcer

Answer 51

An ulcer is an open sore on an external or internal surface of the body, caused by a break in the skin or mucous membrane which fails to heal