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