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151 Cards in this Set
- Front
- Back
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What do hypersensitivity reactions mean?
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• They are immune responses.
• They lead to inflammation and consecutive tissue damage. |
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Which cells are the cellular mediators of tissue injury in anaphylactic hypersensitivity?
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• Mast cells.
• Circulating basophil granulocytes. |
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Which cells of an inflammatory exsudate indicate anaphylactic reaction?
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• Eosinophil granulocytes.
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What is the mechanism of tissue injury in type III (immun-complex mediated)
hypersensitivity? |
• Activation of complement.
• Accumlation and activation of neutrophil granulocytes. |
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What kind of tissue damage is typical for type III hypersensitivity reaction?
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• Fibrinoid necrosis in vessel walls (e.g. necrotising vasculitis).
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Which cells are the effector cells in delayed (type IV.) hypersensitivity?
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• Epithelioid cells that are transformed from macrophages.
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How long does it take from the antigen exposure (e.g. skin) to develop a delayed type
hypersensitivity reaction? |
• 2-3 days.
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How long does it take from the antigen exposure to develop a granuloma?
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• 2-3 weeks.
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What is the mechanism of killing the target cells in CD8+ T-cell cytotoxic
reactions? |
• Osmotic lysis based on membrane perforation
• Induction of apoptosis by Fas-ligand binding. |
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Which are the three commonest soft tissue tumors?
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• Lipoma.
• Fibroma. • Leiomyoma. |
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What is the commonest site of a leiomyoma?
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• myometrium.
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What are the features of myxoma?
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• it is a tumor composed of gelatinous connective tissue
• its structure is similar to the fetal Wharton’s jelly. |
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What is the main cell type in xanthoma?
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• Lipoid storing histiocytes.
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How are benign blood vessel tumors called?
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• Hemangiomas.
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What are the two major forms of hemangiomas?
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• cavernous haemangioma
• capillary haemangioma |
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What is a biopsy?
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• A tissue sample taken for diagnostic histopathological evaluation
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What is the basic principle of immunohistochemical methods?
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• Specific binding of antigens by test antibodies
• the antibodies are labelled by an enzymatic reaction (e.g. with peroxydase ) or with a fluorescent dye |
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What is telepathology?
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• a histopathological consultation method based on the electronic transmission of images
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What are the conditions of primary wound healing?
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• The wound is caused by a sharp, clean devices
• There is little tissue damage. • There is a good apposition of edges. • There is little bleeding and inflammation. |
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Explain the sequence of primary wound healing!
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• The wound edged are held together by fibrin, than by fibroblasts.
• A small amount of granulation tissue is produced. • A small amount of collagen is synthesised. • The remaining scar is delicate. |
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Give an example of primary wound healing?
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• wound helaing after plastic surgery.
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What are the characteristics of secondary wound healing?
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• Large tissue destruction
• Lot of tissue debris • Infection and inflammatory reaction develops |
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Explain the sequence of secondary wound healing!
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• the wound cavity is gradually filled with granulation tissue.
• massive collagen production. • Terminates with a large scar. |
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Give an example of secondary wound healing!
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• Dog bite.
• Burning. |
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From what source may stem cells be acquired for therapeutical purposes?
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• Bone marrow or peripheral blood of adults (adult stem cell).
• from cells of an early embryo (embryonic stem cell). |
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What are the forms of amyloid?
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• Amyloid AA (i.e. amyloid associated) occurring in patients with chronic diseases associated with pronounced tissue destruction.
• Amyloid AL (i.e. amyloid light chain) occurring in patients with abnormal proliferation of cells of B lymphocytic origin. |
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What is the common feature of the molecular structure of different types of
amyloid? |
• the beta-pleated sheet molecular conformation of the amyloid fibrils
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How can you detect amyloid in a histologically?
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• Congo-red staining.
• Bi-refringance in polarized light. |
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What is dysplasia?
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• Preneoplastic condition.
• It occurs principally in epithelia. • Early recognition and surgical removal prevents tumor formation. |
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What are the morphological signs of dysplasia?
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• Nuclear and cellular polymorphism.
• The cell nuclei are hyperchromatic. • Number of mitotic figures increases. • Disturbed cell polarity. |
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CIN is the acronym for?
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• Cervical Intraepithelial Neoplasia.
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What is the meaning of the CIN categories?
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• They mark the severity of the precancerous condition within the squamous epithelium of the cervix
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What does CIN – III mean?
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• Dysplasia of the whole thickness of epithelium.
• The basement membrane is still intact, there are no signs of invasive growth • It is called in situ carcinoma. |
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What does the stage of tumors mean?
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• the extension of the tumor
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What does TNM classification represent?
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• the local extent of the tumor (T)
• lymph node involvement (N) • presence of organ metastases (M) |
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What is the basis of tumor ploidy determination?
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• the quantitation of the amount of DNA-binding stain
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What is the DNA index?
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• DNA content of tumor cells / DNA content of normal cells.
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What is homeostasis?
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• physiological steady state
• ability for adaptation |
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What is the meaning of atrophy?
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• Reduction of the functional cell volume (atrophia simplex).
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Which are the factors leading to atrophy?
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• Reduced activity
• Reduced blood supply • Unsatisfactory alimentation • Lapse of nerve stimulation • Lack of hormonal stimulation |
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What are the main mechanisms of atrophy?
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• the ubiquitin-proteasome system
• cellular autophagy |
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What is involution?
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• Reduction of the volume of the functional cells by atrophy (simple atrophy)
• Reduction of the number of the functional cells by apoptosis (numerical atrophy) |
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What is hypertrophy?
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• Organ or tissue enlagement by the increase of the volume of individual cells
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What is hyperplasia?
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• Organ or tissue enlagement by the increase of the number of cells.
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What is the mechanism of hypoxic or toxic cellular swelling?
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• Sodium and water influx into the cells.
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What is cell necrosis?
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• Cell or tissue death in a living organism.
• The sum of morphological changes occuring within dead cells in a living environment. |
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What are the commonest forms of coagulative necrosis?
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• Infarction
• Caseous necrosis (necrosis caseosa) • Zenker-type necrosis (etc. typhus, tetanus) • Slough necrosis (necrosis crustosa) • Fibrinoid necrosis (in arterial walls) |
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What is liquefactive necrosis?
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• occurs in tissues rich in fluid and lipoid substances and poor in proteins.
• predominant swelling and liquefaction. |
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What is the pathomechanism of enzymatic fat cell necrosis?
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• escape of pancreatic lipase
• Neutral fat is digested into fatty acid and glycerol. • Formation of calcium soaps from fatty acids. |
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Which are important systems of tumor characterization with respect to prognosis and treatment?
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• Histopathological grading.
• Pathological staging. |
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What is the pathology-based definition of anaplasia?
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• Lack of cellular differentiation.
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What types of tumor-progression are you aware of?
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• Clinical progression (size, dissemination).
• Biological/histopathological progression (dedifferentiation/anaplasia). |
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What is the main point of molecular cancer screening?
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• detection of germ line mutations,
• that may be associated with genetic disorders which may predispose for cancer. |
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What are the manifestations of gene amplification in chromosomal preparations?
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• Chromosomally integrated homogeneous staining region (HSR).
• Extra chromosomal double minutes. |
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Name two gene amplifications with important clinical impact!
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• N-MYC gene amplification in neuroblastomas.
• HER-2/NEU amplification in breast cancer. |
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List two well-known prognostic histopathological systems?
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• Nottingham Prognostic Index (NPI) in breast cancer.
• Gleason-score in prostate cancer. |
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What is the basis of different skin colors?
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• The intensity of melanin synthesis in the melanocytes.
• The number of melanocytes in the skin does not differ. |
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What is a melanocytic naevus?
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• Benign tumor of the melanocytes (neoplasia).
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Whcih are the forms of the melanocytic naevi?
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• Junctional naevus.
• Compound naevus. • Intradermal naevus. |
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What is the precancerous lesion of malignant melanoma?
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Dysplastic naevus.
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What are the risk factors for metastatis in malignant melanoma?
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• Depth of penetration.
• Mitotic rate. • Epidermal ulceration. • Epithelioid cell type. |
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What is congestion?
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• Intravascular stasis
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What is hyperaemia?
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• Increased blood content in small vessels of tissues and organs.
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What is the definition of oedema?
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• Extravascular and interstitial accumulation of transudate fluid.
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What are the morphologic features of oedema?
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• macroscopically: tissue swelling, increase in weight
• microscopically: widening of the extracellular space |
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What kinds of pathomechanisms may lead to oedema?
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• rise in hidrostatic pressure
• drop of plasma oncotic pressure • increase of vascular permeability • lymphatic stasis |
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Name examples of increased hydrostatic pressure!
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• heart failure
• venous thrombosis • hepatic cirrhosis with vascular decompensation • pregnancy |
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Name examples of decreased plasma oncotic pressure!
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• chronic renal failure
• hepatic cirrhosis with parenchymal decompensation • starvation (inanitio) • low protein malnutrition |
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Give examples of oedema caused by lymphatic congestion!
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• excision of a lymphnode (block-dissection)
• neoplasia of lymphnodes • inflammation and scarring of lymphnodes |
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What is thrombosis?
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• Intravascular coagulation of blood in living organisms.
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What types of thrombi do you know?
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• red thrombus – coagulation
• white thrombus – precipitation (conglutination) • mixed or laminated thrombus (red and white components) • hyalin thrombus (fibrin microthrombus usualy in DIC) • complex thrombus |
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What types of thrombosis can be distinguished?
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• arterial
• venous (phlebothrombosis, deep veins in the lower extremities, portal vein) • intracavital thrombus of the heart (mural thrombus or vegetatio globulosa) |
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What facilitates the development of thrombosis?
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• endothelial lesion
• deceleration of the bloodflow (congestion) • dilatated vessels (turbulence) • increased blood coagulation (hyperviscosity syndrome, thrombocytosis, activation and accumulation of coagulation factors) |
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What is embolisation?
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• intravascular solid, liquid or gaseous material that is carried by the blood stream
• causes obstruction of an artery (emablo = to throw in) |
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What forms of emboli can be differentiated?
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• endogenous
• exogenous |
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What are the sources of endogenous emboli?
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• thrombus
• tissue particles • cells (trauma, tumor) • fat (trauma, medical malpractice) • amniotic fluid • atheroma (cholesterin crystals in the renal capillaries) • gas-embolisation (Caisson-syndrome or decompression-syndrome) |
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What are the sources of exogenous emboli?
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• air embolisation
• foreign body (oily injection, catheter, broken needle-tip) |
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What is haemorrhage?
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• extravasation of all of the components of blood in a living organism
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What are the causes of haemorrhage?
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• Discontinuity of the vessel wall. (Haemorrhagia per rhexim, haemorrhagia per
arrosionem) • Step-over bleeding (haemorrhagia per diapedesim, occuring at the level of capillaries) |
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What are the causes of haemorrhagia per rhexim?
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• injury of the vessel wall (cut, puncture, contusion, incision)
• spontaneous rupture of the vessel wall (atherosclerosis, media necrosis, aneurysma, varyx) |
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What are the causes of haemorrhagia per arrosionem?
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• ulcer (gastric or duodenal)
• inflammation (e.g. TBC in lung) • tumor (malignant tumors) |
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What is haemothorax?
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• Accumulation of blood in the thorax.
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What is haemopericardium?
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• Accumulation of blood in the pericardial cavity.
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What is the medical expression for the accumulation of blood in the peritoneal cavity?
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• Haemoperitoneum or haemascos.
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What is „haemocephalus internus”?
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• Accumulation of blood in the cerebral ventricules.
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What is „haemocephalus externus”?
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• Accumulation of blood in the subarachnoideal spaces.
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What is „haematometra”?
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• Accumulation of blood in the uterine cavity.
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What is „haemarthros”?
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• Accumulation of blood in the synovial cavity.
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What is „petechia”?
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Small, spot like, 1-2 mm in diameter bleeding.
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What is „purpura”?
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• Multiple, small bleedings ranging in diameter from 3mm to 1cm.
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What is „suffusio” or „sugillatio”?
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• Lamellar bleeding in the subcutaneous connective tissue.
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What is „haematoma”?
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• Extensive interstitial bleeding causing volume expansion.
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What is „ecchymosis”?
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• 1-2 cm in diameter or larger patchy, mostly subcutaneous bleeding
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What is „apoplexia”?
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• Bleeding causing tissue destruction.
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What is „exsanguinatio”?
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• Loosing a significant amount of blood in a short time; bleeding to death
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What is the medical expression for blood in the urine?
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• Haematuria.
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What is the medical expression for bloody vomit?
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• Haematemesis.
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What is the medical expression for blood in the sputum?
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expression for blood in the sputum?
• Haemoptoe |
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What is the medical expression for nose bleeding?
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• Epistaxis.
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What is the medical expression for the stool containing digested blood?
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• Melaena.
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What is the medical expression for the stool containing fresh blood?
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• Haematocchesia.
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What is the classification of the inflammation according to extension?
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• local (circumscribed)
• generalized (sepsis) |
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What is the classification of the inflammation according to its duration?
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• hyperacute (anaphylactic)
• acute • subacute • chronic |
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What are the factors influencing the outcome of inflammation?
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• the nature of the inducing factor (physical and chemical = aseptic, bacterial = infectious/septic)
• the intensity/the virulence of the inducting factor • the location of the inflammation (which organ or tissue) • immuneresponses (hypersensitivity, immunocomplex formation) |
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What does pus contain?
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• Tissue debris
• Fibrin • Neutrophil granulocytes • Bacteria |
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What are the classical signs of the acute inflammation?
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• Rubor
• Tumor • Calor • Dolor • Functio laesa |
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How do we categorise acute inflammation regarding the exudate?
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• Serous
• Fibrinous • Purulent or suppurative • Hemorrhagic • Gangrenous |
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What is characteristic for serous inflammation?
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• Occurs in tissue interstitium and cavities of the body
• presents as a serum-like fluid • The mildest form of inflammation. |
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What is characteristic for fibrinous inflammation?
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• Starts with a serous exudation.
• The exudate becomes sero-fibrinous • Thick layer of fibrin may precipitate |
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What is characteristic for purulent inflammation?
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• usually is the results of bacterial infections.
• Leukodiapedesis • Pus production |
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What is folliculitis?
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• Purulent inflammation of the skin’s hair follicles.
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What is the name of the deep inflammation affecting sebaceous glands?
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the deep inflammation affecting sebaceous glands?
• Furuncule. |
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What is carbuncule?
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• Deep inflammation developed by the fusion of furuncules.
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What is pustule?
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• Pus filled vesicles of the superficial epidermis (e.g. varicella).
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What is characteristic for a chronic abscess?
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• it is lined with a thick wall.
• The inner layer is the pyogenic wall (granulation tissue infiltrated by neutrophiles) • The outer layer is the hypocellular scar tissue. |
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How do we call pus within an anatomical cavity?
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• Empyema.
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What is a phlegmone?
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• Inflammatory exudate spreading freely along the tissue interstitium.
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What is characteristic for hemorrhagic inflammation?
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• Endothel injury
• Erythrodiapedesis • Blood stained exudate • May follow serous or purulent inflammation. |
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What is characteristic for gangrenous inflammation?
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• Exudation and proliferation are less important.
• The dominant feature is the tissue necrosis. • The immune response is deficient. • The inducing microorganisms are putrifying bacterias (spirochetes, fusiform bacteriae) |
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What are the types of gangrene?
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• Dry (sicca)
• Wet (humida). |
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What could be the outcome of the acute inflammation?
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• Complete healing (restitutio ad intergum).
• Fibrosis or scar. • Abscess formation. • Chronic inflammation. |
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What are the types of chronic inflammation?
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• Immun-mediated chronic inflammations.
• Non immun-mediated chronic inflammations. • Granulomatous inflammations. |
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What are the steps of tissue regeneration?
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• Production of granulation tissue.
• Remodeling of granulation tissue. • Fibrosis. • Scar. |
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What are the types of wound healing?
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• Primary wound healing (sanatio vulneris per primam intentionem).
• Under scale wound healing (for example umbilical cord). • Secondary wound healing (sanatio vulneris per secundam intentionem). |
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A large number of eosinophil granulocytes indicates that cause of the inflammation is:
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• Allergic
• Fungal • Parasitic |
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A large number of lymphocytes and plasma cells indicate that the cause of the inflammation is:
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• Chronic or immunomediated inflammation (e.g. autoimmune disease)
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The presence of epitheloid type macrophages indicate that the cause of the inflammation is:
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• Type IV immuno-mediated inflammation.
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What are the main reasons of anemia?
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• Decrease in red blood cell production.
• Hemolysis. • Bleeding |
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What are the circumstances leading to iron deficiency anemia?
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• Low iron intake.
• Iron malabsorption. • Incrised iron demands • Chronic blood loss. • Malignant diseases. |
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What are the major features of aplastic anaemia?
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• Bone marrow stem cell disease.
• Trilinear bone marrow aplasia. • Pancytopenia. |
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Which are the chronic myeloproliferative diseases?
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• Chronic myelogenous leukemia(CML).
• Essen tial thrombocytemia. • Polycythemia vera. • Chronic idiopathic myelofibrosis. |
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What are the phases of the CML?
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• Chronic phase.
• Accelerated phase. • Blastic crisis. |
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What is the characteristic genetic abnormality in CML?
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• Philaderphia-translocation.
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What are the phases of polycythemia vera and what are their characteristics?
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• Proliferative phase: trilinear proliferation.
• Postpolycythaemic phase: myelofibrosis. |
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What are the characteristics of essential thrombocytaemia?
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• Isolated bone marrow megakaryocytic proliferation
• Chronic elevation of platelet count. • Increased tendency for thrombosis. |
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What are the characteristic signs of myelofibrosis?
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• Collagen fibrosis in the bone marrow.
• Extramedullary haematopoesis. • Leukoerythroblastic blood smear. |
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What is refractory anemia refractory for?
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• vitamin-substitution therapy.
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What are the factors influencing the outcome of myelodysplastic syndromes?
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• insufficient blood cell production (pancytopenia)
• blastic transformation (acute leukemia). |
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What is the basic requirement for the diagnosis of acute myeloid leukemia?
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• the blast rate in the bone marrow is higher than 20%
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How do we classify lymphomas according to the clinical course?
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• Indolent
• Agressive |
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How do we classify lymphomas according to the cellular differentiation?
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• Precursor
• Peripherial |
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What is MGUS?
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• Monoclonal gammopathy of undetermined significance
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What are the characteristic features of plasma cell myeloma?
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• Monoclonal plasma cell proliferation
• Monoclonal gammopathy • Osteolytic bone lesions • Pathologic fractures |
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What are the types of Hodgkin's lymphoma?
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• Nodular lymphocyte predominant Hodgkin's lymphoma
• Classical Hodgkin's lymphoma |
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Which cells are typical for Hodgkin's lymphoma?
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• Hodgkin cells
• mirror image cells • Sternberg-Reed cells |
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Based on the nature of presentation, Burkitt’s lymphoma can be:
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• Endemic (EBV associated)
• Sporadic • Immunodeficiency associated (HIV associated) |
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What are the most frequent sites of extranodal lymphomas?
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• GI tract
• Skin • Respiratory tracts • Mediastinum |
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What does the abbreviation MALT stand for?
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• Mucosa associated lymphoid tissue
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Which microorganism has a causative role in the development of the MALT lymphoma of the stomach?
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stomach?
• Helicobacter pylori |
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What is mycosis fungoides?
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• The commonest cutaneous T-cell lymphoma.
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What is Sezary syndrome?
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• Leukemic manifestation of the mycosis fungoides.
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