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Flashcards in Pathology Deck (63)
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1
Q

What are the two types of healing and what do they result in?

A

Healing by resolution - Normal tissue.

Healing by repair - Scar.

2
Q

What four things are required for healing by resolution to occur?

A

Contain cells capable of mitosis.

Inflammation.

Free of the cause of the damage.

Minimal damage to the ICM.

3
Q

What is the process of scarring called?

A

Fibrosis.

4
Q

What are the components of granulation tissue?

A

Myofibroblasts, Fibroblasts.

Capillaries.

inflammatory cells.

5
Q

What cells form the capillaries in granulation tissue?

A

Endothelial cells.

6
Q

Where are the two locations the endothelial cells in granulation tissue come from?

A

Blood vessels in adjacent tissues

Bone marrow (released into the blood stream where they circulate and then enter the required tissue.

7
Q

What is the useful function of the contraction of myofibroblasts?

A

Contraction reduces the size of the wound or injury.

8
Q

How is repair in bone different from other tissue?

A

Does not result in a fibrous scar. This is because the granulation tissues contains chondroblasts and osteoblasts, this forms new cartilage and bone called a callus which is then remodelled and can be almost the same as the original tissue.

9
Q

What are the stages of healing a bone fracture?

A

haematoma.

Modified granulation tissue.

Bony callus.

Remodelling.

10
Q

Definition of osteoporosis?

A

Decrease in the mass of the skeleton although the bone remains normally mineralised.

11
Q

Definition of osteomalacia?

A

Bone mass is normal but the bone is abnormally mineralised.

12
Q

What is osteomalacia called in children?

A

Rickets.

13
Q

Common problems in osteoporosis?

A

Pathological fractures due to little trauma.

14
Q

Common causes of pathological fractures?

A

Osteomalacia, osteoporosis, Bone metastases and neoplasms also parathyroidism.

15
Q

What hormone stimulates osteoclasts?

A

Parathyroid hormone.

16
Q

What two reasons cause women to be at higher risk of OP than men?

A

lower peak bone mass

Reduction in oestrogen production in Post-menopausal women.

17
Q

Why does the decreased production of oestrogen lead to OP?

A

Increases osteoclast activity.

18
Q

What is a DXA scan?

A

A scan to measure bone density.

19
Q

What’s the name of the non-blanching rash associated with meningitis, why is this present?

A

A purpuric rash - because of bleeding into the skin.

20
Q

Symptoms associated with meningitis?

A

Stiff neck, purpuric rash, confusion, headache.

21
Q

What is a risk associated with performing a lumbar puncture?

A

if blood clotting is not corrected, bleeding into the spinal canal may occur.

22
Q

What three abnormalities may there be in the CSF of a meningitis patient?

A

Increased neutrophil count

Increased protein concentration

Decreased glucose concentration

23
Q

What colour do Gram-negative bacteria stain?

A

Red.

24
Q

What is Disseminated intravascular coagulation (DIC)?

A

Injury of the epithelium (due to endotoxin in Meningitis) causing the formation of innumerable small thrombi.

This can cause haemorrhages into the tissue due to the lack of coagulation factors (all used up in thrombi.

25
Q

Why is glucose concentration reduced in the CSF of a meningitis patient?

A

The bacteria metabolise the glucose in the CSF.

26
Q

Why is protein concentration increased in the CSF of a meningitis patient?

A

Bacteria causes inflammation, which causes the endothelium to become more permeable to proteins which leak into the fluid.

27
Q

What is a notifiable disease?

A

A disease that must be reported to the ‘Proper officer’

28
Q

What drugs are used in osteoporosis therapy?

A

Anti-resorptive, such as bisphosphonates, HRT or Vit D.

Or Formulation stimulating such as PTH or strontium ranelate.

29
Q

How do bisphosponates work?

A

They reduce resorption as they kill osteoclasts.

30
Q

What is MND, what does it affect, and what are it’s features?

A

Motor neurone disease is a progressive degenerative disease with a median survival of 2 yrs.

Presents with weakness, wasting, fasciculations with preserved reflexes and no sensory issues.

31
Q

Features of nerve root compression?

A

It is acute or chronic and presents with pain, sensory symptoms and weakness.

32
Q

What is a good way to remember S1 and S5 dermatomes?

A

S1 - little toe

S5 - Big toe.

33
Q

Four types of neuropathy?

A

Small fibre,

Sensory,

Motor

Mixed

34
Q

Two different neurophysiological types of neuropathy?

A

Axonal or demyelinating.

35
Q

Features of neuropathy?

A

LMN weakness, wasting, hyporeflexia, sensory involvement.

36
Q

Different causes of neuropathy?

A

Diabetes - 50% of cases

Small fibre - alcohol

Demyelinating - genetic, inflammatory.

Acute: Guillian barré, diptheria

25% case unknown.

37
Q

An example of a pre-synaptic and post-synaptic diseases of the NMJ?

A

Pre - Botulism

Post - Myasthenia Gravis

38
Q

What is Lambert eaton syndrome?

A

genetic condition affecting the presynaptic release of ACh. caused by autoantibodies inhibiting calcium channels in the presynaptic neurone.

39
Q

Treatment Of myasthenia?

A

Pyridostigmine is first line treatment.

Prednisone is used for long-term immunosuppression and rapid onset.

40
Q

Features of muscle disease?

A

Presenting symptom is weakness, often symmetrical, often no pain or sensory symptoms.

41
Q

How can Astrocytes and Oligodendrocytes become pathological in dysfunction?

A

Astrocytes can become reactive cells (gliosis)

Oligodendrocytes can degenerate and die.

42
Q

What are some things that can go wrong with a neurone?

A

Disorder of neuronal metabolism.

Demyelination.

Loss of connections.

Axon degeneration.

43
Q

How is the CNS formed from the neural tube in development?

A

Derived from the ectoderm.

Neural plate folds to form neural tube

Brain and spinal cord then develop from this neural tube.

44
Q

What is bacterial meningitis?

A

Spread of bacteria and acute inflammatory cells (cause pus) through the subarachnoid space.

45
Q

What is Herpes encephalitis, and what does it cause when it affects the CNS?

A

A virus, when it infects the CNS it causes necrosis and Inflammation, part of the temporal and insular cortex and brain swelling.

46
Q

What are the primary and secondary problems associated with Head injury? (just some)

A

Primary:

Lacerations of scalp
Skull fracture
Intracranial haemorrhage
Lacerations of the brain 
Diffuse axonal injury

Secondary:

Brain swelling
Ischaemia
Infection
raised intracranial pressure.

47
Q

What is a contusion of the brain?

A

Like bruising of the brain.

48
Q

What is diffuse axonal injury?

A

It is the widespread disruption of axons and axonal transport.

49
Q

What is the main pathological mechanism in Multiple sclerosis?

A

Demyelination.

50
Q

What’s the ‘working hypothesis’ for the cause of multiple sclerosis?

A

Immune mediated demyelination Is triggered in genetically susceptible individuals by a common infective organism.

51
Q

Are primary Brain tumours rare or common?

A

Rare - usually comes from elsewhere.

52
Q

What is a meningioma?

A

Brain tumour arising from the meninges.

53
Q

Three cerebral artery territories?

A

Anterior Cerebral artery

Middle cerebral artery

Posterior cerebral artery

54
Q

What is a Intracerebral haemorrhage?

A

Haemorrhage in the basal ganglia due to rupture of small blood vessels, damaged due to long term hypertension.

55
Q

What is bradykinesia, where might it be seen in a clinical setting?

A

Slowness of movement, e.g. in parkinsons.

56
Q

Definition of dementia?

A

A progressive decline in multiple aspects of cognitive function.

57
Q

3 common causes of dementia?

A

Alzheimers.

Dementia with Lewy bodies.

Vascular dementia.

58
Q

Pathology associated with Alzheimer’s disease?

A

Formation of plaques and tangles, there is also the loss of synapses and neurones.

59
Q

What are the 5 causes/types of abnormal gait?

A

Central

Muscular

Neurological

Deformity

psychological

60
Q

Three types of centrally abnormal gait?

A

Ataxic (cerebellum problems)

Spastic e.g. scissoring or dragging
-causes from infection, trauma, demyelination cerebral palsy.

Shuffling (festinant)
- Parkinsons

61
Q

Two types of muscularly abnormal gait?

A

Myopathic (waddling gait)

  • Muscular dystrophy
  • DDH
  • Muscular disease

Trendelenburg (leg swinging)

  • Hip abductor weakness
  • Superior gluteal nerve injury commonly
62
Q

An example of a neurologically abnormal gait?

A

High stepping

  • Polio
  • MS
63
Q

Examples of deformity caused abnormal gaits?

A

Out-toeing

  • Tibial/femoral torsion
  • Knock kneed

In-toeing

  • Tibial torsion
  • Femoral anteversion