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77 Cards in this Set
- Front
- Back
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What does pathology mean?
What does the work of pathology consist of? |
Patho = Disease
Ology = Study So study of disease 20% autopsy (now less) 80% biopsy |
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What was the initial thought of pathology before and now?
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First:
- Anatomical study Now: - More microscopical study Both are methods for diagnosis |
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What is the earliest proof of 'autopsies' in the world ?
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The egyptians about 3000years BC
They removed and examined the internal organs, but not the heart since they believed it was needed for afterlife (soul was in the heart) - and thus prepared them for mummification They removed the organs only through tiny slits in the body - since they thought if they opened the body it would keep it from entering the afterlife |
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One of the earliest known autopsies?
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Of Julio Caesar, in 44 BC - after he was stabbed 23 times from rival senators.
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Autopsy mean?
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"To see for oneself" - greek
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When did the period of autopsy examination start?
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At 16th century - in Italy - Before this it was prohibited by from Rome
In christian Europe not so much I think... |
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Who is seen as the first pathologist? When was he born?
What is he most famous for? |
Giovanni Morgagni - italian father of anatomical pathology - born 1682 - dead 1771
Most famous for writing the first book: "The seats and causes of diseases investigated by anatomy" 1769. (De sedibus causis morbutum) - with reference to 640 autopsies |
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What are the 2 other major fathers of pathology?
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Karl Rokitansky and Rudolf Virchow
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Rokitansky, what did he do for patology? Wen was he born? What was his speciality?
When did he die? How many autopsies? |
Born in HK 1804 - moved to Vienna and did medical school there.
He drastically changed the way autopsies were done for future research, by collaborating with clinicians, and this way learned how to prevent or treat many diseases not before able to treat He was a gross pathologist, specialized in congenital heart diseases. Died in Vienna, after becoming the minister of health. Said to have done more than 50 000 autopsies. |
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Who was Rudolf Virchow, when was he born and what is he famous for?
Microscopy Cell theory Autopsy method |
German, born in 1821, who introduced microscopes to pathology.
He also developed the cell theory - omnis cellula e cellula, and first person to observe chromosomes. Got named after him a method of removal the organs, in specific order So: 1. Microscopy --> Pathology 2. Cell theory 3. Autopsy organ removal 4. Staining of amyloid (Lugol's solution) |
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What's the most important thing Rokitansky have got his name on?
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1. Rokitansky nodules on ovarian teratomas (dermoid cysts)
2. Mayer-Rokitansky syndrome - underdevelopment of Müllerian system (vagina, uterus etc) |
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Who was J.E. Purkyne? When was he born & dead?
What has he named after himself? |
He was a extremely famous czech physiologist, born in 1787 - dead in 1869.
He has named after himself: (pathology, he also has some physiology like purkyne shift) - Purkyne cells of brain - Purkyne fibers of heart - terminal fibers of conductive system |
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Who was the most famous pathologists in 19th century? (18-1900)
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Rokitansky
Virchow Purkyne Treitz Lambl Prowasek (late) |
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What is Vaclav Treitz famous for? (called after himself)
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1. Treitz ligament of duodenum - suspending duodenum
2. Treitz hernia (retroperitoneally) |
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What is Lambl most famous for?
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1. Lamblia intestinalis = Giardia lamblia, parasite that colonize and reproduces in small intestine, causing giardiasis (beaver fever)
2. Lamblia excrescences - filiform (threatlike) outgrowths of heart valves |
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What is giardiasis (beaver fever)?
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Diarrhea, vomiting, hematuria - may even cause lactose intolerance!
Caused by giardia parasites infecting cells of duodenum and small intestine. |
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Who was Stanislav Prowasek?
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A czech parasitologist, who discovered the pathogen behind the epidemic typhus, which commonly occur after wars and natural disasters.
- Which he called 'Rickettsiae Prowaseki', which of he died of himself after getting infected in a german prison hospital. The bacteria is transmitted by the human body louse, causing fever, cough, chills, bp drops, delirium (confusion) and death |
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Tell me about Antonin Fingerland? :):)
1. Teacher in HK 2. Cigarettes and cancer 3. Head of pathology |
He was the teacher of Prof. Steiner, and the reason why he became enthusiastic about pathology.
He was a bauta in studying the connection between cigarette smoke and lunc cancer - where he discovered that one need about 200 - 300 000 cigarettes for risk to become relevant, and if one stops, the risk falls down to non-smoker level. He was the first head of pathology (for 40y) and died in 1999, one year before his assistant, Vladimir Vortel. The department is called after him: Fingerland department |
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Who was Vladimir Vortel?
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The assistant of Antonin Fingerland - and the lecture hall is called after him.
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Definition necropsy?
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Examination of organs of a dead body to determine cause of death - or study the pathological changes one can find
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Definition autopsy?
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A complete investigation of cadavers compared with clinical symptoms - to provide cause of death and its correlation to the clinical symptoms
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What is surgical pathology?
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Biopsy specimens
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Definition puncture?
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Aspiration puncture a body cavity, pathological lesion or organ - usually for diagnosis to see if fluid was e.g. blood or content of small intestine
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What is a biopsy?
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Excision of a tissue part, e.g. liver or pancreas, with a thick needle biopsy - to check it's histology
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Definition excision?
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Removing whole part of a tissue
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What is exstirpation?
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Remove whole pathological lesion or its part
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Definition excochleation?
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Scraping out of some cavity or fistula
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Definition ablation?
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Removing part of body; breast, nail or polyp (polypectomy, with endoscope)
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What material are usually sampled and how?
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1. Surgical excision
2. Endoscopical excision 3. Gyneacological curettage or aspiration or cyst 4. Thick needle biopsy 5. Thin needle biopsy 6. Endomyocardial biopsy 7. Bone marrow biopsy |
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Thin needle biopsy is done when?
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When you can aspirate, either liquid cysts, breast lesions, parotid gland, prostate, thyroid, cervical smears
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Thick needle biopsies are done when?
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To obtain a architectural intact column of tissue:
- Liver - Kidney Usually solid organs, or even bone marrow |
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How is endomyocardial biopsy done?
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A catheter with a forceps …
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Preservation of specimen?
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Always put specimen in 10% formaldehyde, or frozen section if you need to see it quickly in surgery
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What needle is used for bone marrow biopsy?
In what disease suspicions do we usually obtain bm biopsy? |
A 'Israeli'- needle.
Which you can adjust the length of, has a T-shape. Do it in: - Leukemias - Malignant lymphomas - Anemias |
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Definition etiology?
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The origin of a disease
- Underlying causes - Modifying factors WHY a disease develop |
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Definition pathogenesis?
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The steps in development of disease
- How etiological factors trigger cellular and molecular changes that give rise to the changes of the disease HOW a disease develop |
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What are the 8 etiological agents - leading to cell injury and molecular changes?
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1. Hypoxia
2. Physical agents 3. Chemical agents 4. Infectious agents 5. Immunological diseases 6. Aging 7. Nutrition 8. Genetic disorders |
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How does hypoxia lead to cell injury?
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1. Oxygen deficiency
2. Ischemia 3. Cells react |
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Definition ischemia?
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Loss of blood supply in a tissue, due to stop or lower arterial circulation or worse venous drainage
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What are most causes of hypoxia of tissues?
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1. Ischemia
2. Inadequate oxygenation of blood 3. Reduction in oxygen-carrying capacity of blood |
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How can chemical agents cause damage of cells and tissues?
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1. Normal substances may be introduced in excess (glucose, salt, water) and interrupt the osmotic environment too much
2. Poisons may alter membrane permeability, osmotic homeostasis, enzymes or cofactors |
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What physical agents may cause cell damage?
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1. Trauma
2. Temperature extremes 3. Radiation 4. Electric shock 5. Sudden changes in atmospheric pressures |
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What are the groups of infectious agents that may cause cell damage?
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1. Viruses
2. Rickettsiae 3. Bacteria 4. Fungi 5. Protozoans 6. Tapeworms |
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Are rickettsiae bacterias or virus?
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They were for a long time thought to be something in between. But now we know they are bacteria since:
1. Has both DNA and RNA 2. Cell walls similar to gram negative bacteria 3. Divide by binary fission 4. Susceptible to most bacteria |
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What immunological disorders is causing cell damage?
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1. Autoimmune disorders
2. Allergic reactions |
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What genetic changes may lead to genetic disorders?
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1. Congenital malformations due to chromosomal abberrations
2. Mutation, translocation or deletion in a single gene |
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How does nutrition play its role in cell damage?
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1. Protein-calory insufficiency
2. Vitamin deficiencies 3. Obesity (DM & atherosclerosis) |
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What is Hayflick limit?
What is limiting the cells? And how is cancer cells using this? |
The number of times a human cell can divide until division stops.
It is usually around 40-60 times, according to Mr. Hayflick's studies. Cells enter a senescense state, since in each mitosis the telomeres are shortened . NB! Some cancers can avoid this, where the enzyme telomerase prevents telomeres from shortening! Here we may use telomere inhibitors to stop developing of cancer |
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In what organelles is it typical to see changes during the pathogenesis of cell damage?
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1. Cell membrane
2. Mitochondrias 3. ER 4. Lysosomes |
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What changes may we see in cell membrane?
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Increased permeability
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Changes seen in mt's?
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Swelling
Rupture Ca2+ release |
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Changes seen in ER?
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Ribosome release
Swells Rupture |
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Changes seen in lysosomes?
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Rupture & disappear
Autolysis? |
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What are the most common reversible changes seen in tissue injury?
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1. Vacuolar degeneration
2. Fatty changes / statosis |
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What is vacuolar degeneration?
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A swelling of cells - as the first manifestation of a nonlethal injury.
The vacuoles seen are small pinched-off segments of ER. |
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What is steatosis?
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Typical change in cells that contribute in fat metabolism - where we see lipid vacuoles in cytoplasm
- Hepatocytes - Cardiomyocytes - Renal cells This is a pre-necrotic stage |
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2 morphological types of steatosis?
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1. Microvacuolar
2. Macrovacuolar (one vacuole fills whole cytoplasm) |
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What may the etiology of steatosis be?
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1. Hypoxia
2. Overnutrition 3. Undernutrition 4. Toxic injury 5. Heart failure 6. Metabolic disease |
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What undernutritional disease do you know that may lead to steatosis of liver?
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Kwashiorkor - deficiency of protein - cause big, fatty liver.
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What is weight and appearance of normal liver and statotic liver?
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Normal
- Liver color 1.5 kg Steatotic - 2-2.5 kg and yellow, due to the fat |
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If heart becomes steatotic - how does it look and what is it called?
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The inner surface of RA - the chordae tendinae - will become brown and yellow - a tiger color
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What is the definition of death?
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Stop of vital functions:
- Respiration - Heartbeat - Brainwork |
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What is definition of clinical death?
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Temporary stop of heart and breathing - with resuscitation started immediately
Brain can survive without oxygen up to 5 minutes - individually and temperature dependent |
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How do we nowadays define true death?
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Stop of blood circulation through brain
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How does the cells successively die?
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From top to bottom: Neurons first.
Same with rigor mortis: Occur from top to bottom, and is released from top to bottom. |
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What procedure is used to determine true death?
Why is it important? |
We use cerebral angiography:
- Inject contrast medium to brain arteries, to see if there is any movement of blood. Important for organ transplantation - since organs can only be transplanted from dead person |
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Definition pallor?
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Pale skin due to contraction of skin arterioles
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What are the post mortem spots?
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Red spots on back or buttocks, since the blood follows gravity to the lower parts of the body
Shifts position if body position is changed |
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Why is dead body cold?
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Due to balancing of temperature to surrounding temperature
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What is the post mortem spasm of muscles?
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A spasm due to maybe chemical reaction in skin tissue (is thought) - and can be mistaken to be rigor mortis.
It is more commonly seen in high emotional deaths under extreme physical circumstances |
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What is rigor mortis?
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Stiffness after death, due to chemical changes in muscles after death
There are no new ATP supplied, so bridges between actin and myosin cannot be released |
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What is autolysis post mortem?
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Digestion of own cells by:
- Pancreas enzymes - Stomach enzymes - Bowels |
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How does body decay after death?
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Bacterias
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What is maceration post mortem?
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Softening of tissue / skin due to the sterile autolysis
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What is fetus maceratus?
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Intrauterine death of fetus
- Skin is peeled off - Cranial deformities - Soft tissue digestion And the baby is soft |
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Why is there no leukocytic reaction in dead person?
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Since organism is already dead..
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What is a Aschoff-Rokitansky sinus?
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Pseudodiverticular in the gall bladder - outpouchings of gall bladder mucosa - often seen in chronic cholecystitis
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