Pathology Minimals 1st Semester

What do hypersensitivity reactions mean? Theyareimmuneresponses. Theyleadtoinflammationandconsecutivetissuedamage. Which cells are the cellular mediators of tissue injury in anaphylactic hypersensitivity? Mast cells. Circulatingbasophilgranulocytes. Which cells of an inflammatory exsudate indicate anaphylactic reaction? Eosinophilgranulocytes. What is the mechanism of tissue injury in type III (immun-complex mediated) hypersensitivity? Activationof complement. Accumlationandactivationofneutrophilgranulocytes. What kind of tissue damage is typical for type III hypersensitivity reaction? Fibrinoidnecrosisinvesselwalls (e.g. necrotising vasculitis). Which cells are the effector cells in delayed (type IV.) hypersensitivity? Epithelioidcellsthat are transformed from macrophages. How long does it take from the antigen exposure (e.g. skin) to develop a delayed type hypersensitivity 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 cytotoxic reactions? Osmotic lysis based on membrane perforation InductionofapoptosisbyFas-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 Whartonsjelly. What is the main cell type in xanthoma? Lipoidstoringhistiocytes. How are benign blood vessel tumors called? Hemangiomas. What are the two major forms of hemangiomas? cavernous haemangioma capillary haemangioma What is a biopsy? Atissuesampletakenfordiagnostichistopathologicalevaluation What is the basic principle of immunohistochemical methods? Specificbindingofantigensbytestantibodies 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. Theremainingscarisdelicate. Give an example of primary wound healing? wound helaing after plastic surgery. What are the characteristics of secondary wound healing? Largetissuedestruction Lotoftissuedebris Infection and inflammatory reaction develops

Explain the sequence of secondary wound healing! thewoundcavityisgraduallyfilledwithgranulationtissue. massivecollagenproduction. Terminateswithalargescar. Give an example of secondary wound healing! Dogbite. Burning. From what source may stem cells be acquired for therapeutical purposes? Bonemarroworperipheralbloodofadults(adultstemcell). from cells of an early embryo (embryonic stem cell). What are the forms of amyloid? AmyloidAA(i.e.amyloidassociated)occurringinpatientswithchronicdiseases associated with pronounced tissue destruction. AmyloidAL(i.e.amyloidlightchain)occurringinpatientswithabnormalproliferation of 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? Preneoplasticcondition. Itoccursprincipallyinepithelia. Earlyrecognitionandsurgicalremovalpreventstumorformation. What are the morphological signs of dysplasia? Nuclearand cellular polymorphism. Thecellnucleiare hyperchromatic. Numberofmitoticfiguresincreases. Disturbedcellpolarity. CIN is the acronym for? CervicalIntraepithelialNeoplasia. What is the meaning of the CIN categories? Theymarkthe severity of the precancerous condition within the squamous epithelium of the cervix

What does CIN III mean? Dysplasiaofthewholethicknessofepithelium. Thebasementmembraneisstillintact,there are no signs of invasive growth Itiscalled 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) lymphnodeinvolvement(N) presence of organ metastases (M) What is the basis of tumor ploidy determination? thequantitation of the amount of DNA-binding stain What is the DNA index? DNAcontentoftumorcells/DNAcontentofnormalcells. What is homeostasis? physiological steady state abilityforadaptation What is the meaning of atrophy? Reductionofthefunctionalcellvolume(atrophiasimplex). Which are the factors leading to atrophy? Reducedactivity Reducedbloodsupply Unsatisfactoryalimentation Lapseofnervestimulation Lackofhormonalstimulation What are the main mechanisms of atrophy? theubiquitin-proteasome system cellularautophagy What is involution? Reductionofthevolumeofthefunctional cells by atrophy (simple atrophy) Reductionofthenumberofthefunctionalcellsbyapoptosis(numerical atrophy) What is hypertrophy? Organor tissue enlagement by the increase of the volume of individual cells What is hyperplasia? Organor tissue enlagement by the increase of the number of cells.

What is the mechanism of hypoxic or toxic cellular swelling? Sodiumandwaterinfluxintothecells. What is cell necrosis? Cellortissuedeathinalivingorganism. Thesumofmorphologicalchangesoccuring within dead cells in a living environment. What are the commonest forms of coagulative necrosis? Infarction Caseousnecrosis(necrosiscaseosa) Zenker-type necrosis (etc. typhus, tetanus) Sloughnecrosis(necrosiscrustosa) Fibrinoidnecrosis(inarterialwalls) 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? escapeofpancreaticlipase Neutralfatisdigestedintofattyacidandglycerol. Formationofcalciumsoapsfromfatty acids. Which are important systems of tumor characterization with respect to prognosis and treatment? Histopathologicalgrading. Pathologicalstaging. What is the pathology-based definition of anaplasia? Lackofcellulardifferentiation. What types of tumor-progression are you aware of? Clinicalprogression(size,dissemination). Biological/histopathologicalprogression(dedifferentiation/anaplasia). What is the main point of molecular cancer screening? detectionofgermlinemutations, thatmaybeassociatedwithgeneticdisorderswhichmaypredisposeforcancer. What are the manifestations of gene amplification in chromosomal preparations? Chromosomallyintegratedhomogeneousstainingregion(HSR). Extrachromosomaldoubleminutes. 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? NottinghamPrognosticIndex(NPI)inbreast cancer. Gleason-score in prostate cancer. What is the basis of different skin colors? Theintensityofmelaninsynthesisinthemelanocytes. Thenumberofmelanocytesintheskindoesnotdiffer. What is a melanocytic naevus? Benigntumorof the melanocytes (neoplasia). Whcih are the forms of the melanocytic naevi? Junctionalnaevus. Compoundnaevus. Intradermalnaevus. What is the precancerous lesion of malignant melanoma? Dysplasticnaevus. What are the risk factors for metastatis in malignant melanoma? Depthofpenetration. Mitoticrate. Epidermalulceration. Epithelioidcelltype. What is congestion? Intravascularstasis What is hyperaemia? Increasedbloodcontent in small vessels of tissues and organs. What is the definition of oedema? Extravascularandinterstitialaccumulationoftransudatefluid. What are the morphologic features of oedema? macroscopically:tissueswelling,increaseinweight microscopically:wideningoftheextracellularspace What kinds of pathomechanisms may lead to oedema? riseinhidrostaticpressure dropofplasmaoncoticpressure increaseofvascularpermeability lymphaticstasis

Name examples of increased hydrostatic pressure! heartfailure venousthrombosis hepatic cirrhosis with vascular decompensation pregnancy Name examples of decreased plasma oncotic pressure! chronicrenalfailure hepaticcirrhosiswithparenchymaldecompensation starvation(inanitio) lowproteinmalnutrition Give examples of oedema caused by lymphatic congestion! excisionofalymphnode(block-dissection) neoplasiaof lymphnodes inflammationandscarringoflymphnodes What is thrombosis? Intravascularcoagulationofbloodinlivingorganisms. What types of thrombi do you know? redthrombus coagulation whitethrombus precipitation (conglutination) mixedorlaminatedthrombus(redandwhitecomponents) hyalinthrombus(fibrinmicrothrombususualyinDIC) complexthrombus What types of thrombosis can be distinguished? arterial venous(phlebothrombosis,deepveinsinthelowerextremities,portalvein) intracavitalthrombusoftheheart(muralthrombusorvegetatioglobulosa) What facilitates the development of thrombosis? endotheliallesion deceleration of the bloodflow (congestion) dilatatedvessels(turbulence) increasedbloodcoagulation(hyperviscositysyndrome,thrombocytosis,activationand accumulation of coagulation factors) What is embolisation? intravascularsolid,liquidorgaseous material that is carried by the blood stream causes obstruction of an artery (emablo = to throw in) What forms of emboli can be differentiated? endogenous exogenous

What are the sources of endogenous emboli? thrombus tissueparticles cells(trauma, tumor) fat (trauma, medical malpractice) amnioticfluid atheroma(cholesterincrystalsintherenalcapillaries) gas-embolisation (Caisson-syndrome or decompression-syndrome) What are the sources of exogenous emboli? airembolisation 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? Discontinuityofthevesselwall.(Haemorrhagiaperrhexim,haemorrhagia per arrosionem) Step-over bleeding (haemorrhagia per diapedesim, occuring at the level of capillaries) What are the causes of haemorrhagia per rhexim? injuryofthevesselwall(cut,puncture,contusion,incision) spontaneousruptureofthevessel 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(malignanttumors) What is haemothorax? Accumulationofbloodin the thorax. What is haemopericardium? Accumulationofbloodinthepericardialcavity. What is the medical expression for the accumulation of blood in the peritoneal cavity? Haemoperitoneumorhaemascos. What is haemocephalusinternus? Accumulation of blood in the cerebral ventricules. What is haemocephalusexternus? Accumulationofbloodinthesubarachnoidealspaces.

What is haematometra? Accumulationofbloodintheuterinecavity. What is haemarthros? Accumulationofbloodin the synovial cavity. What is petechia? Small,spotlike,1-2 mm in diameter bleeding. What is purpura? Multiple,smallbleedingsrangingindiameterfrom3mmto1cm. What is suffusioorsugillatio? Lamellarbleedinginthesubcutaneousconnective tissue. What is haematoma? Extensiveinterstitialbleedingcausingvolumeexpansion. What is ecchymosis? 1-2 cm in diameter or larger patchy, mostly subcutaneous bleeding What is apoplexia? Bleedingcausingtissuedestruction. What isexsanguinatio? Loosingasignificantamount 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? thenatureoftheinducingfactor(physicalandchemical=aseptic,bacterial= infectious/septic) theintensity/thevirulenceoftheinductingfactor thelocationof the inflammation (which organ or tissue) immuneresponses(hypersensitivity,immunocomplexformation) What does pus contain? Tissuedebris Fibrin Neutrophilgranulocytes Bacteria What are the classical signs of the acute inflammation? Rubor Tumor Calor Dolor Functiolaesa How do we categorise acute inflammation regarding the exudate? Serous Fibrinous Purulentorsuppurative Hemorrhagic Gangrenous What is characteristic for serous inflammation? Occursintissueinterstitium and cavities of the body presentsasa serum-like fluid Themildestformofinflammation. What is characteristic for fibrinous inflammation? Startswitha serous exudation. The exudate becomes sero-fibrinous Thicklayeroffibrinmayprecipitate

What is characteristic for purulent inflammation? usually is the results of bacterial infections. Leukodiapedesis Pusproduction What is folliculitis? Purulentinflammationoftheskinshair follicles. What is the name of the deep inflammation affecting sebaceous glands? Furuncule. What is carbuncule? Deepinflammationdevelopedbythefusionoffuruncules. What is pustule? Pusfilledvesiclesofthesuperficialepidermis(e.g. varicella). What is characteristic for a chronic abscess? itislinedwithathickwall. Theinnerlayeristhepyogenicwall(granulationtissueinfiltratedby neutrophiles) Theouterlayeristhehypocellular scar tissue. How do we call pus within an anatomical cavity? Empyema. What is a phlegmone? Inflammatoryexudatespreadingfreelyalongthetissueinterstitium. What is characteristic for hemorrhagic inflammation? Endothelinjury Erythrodiapedesis Bloodstainedexudate Mayfollowserousorpurulentinflammation. What is characteristic for gangrenous inflammation? Exudationand proliferation are less important. Thedominantfeatureisthetissuenecrosis. Theimmuneresponseisdeficient. Theinducing 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? Completehealing(restitutioadintergum). Fibrosisorscar. Abscessformation. Chronicinflammation. What are the types of chronic inflammation? Immun-mediated chronic inflammations. Nonimmun-mediated chronic inflammations. Granulomatousinflammations. What are the steps of tissue regeneration? Productionofgranulationtissue. Remodeling of granulation tissue. Fibrosis. Scar. What are the types of wound healing? Primarywoundhealing(sanatiovulnerisperprimamintentionem). Underscalewoundhealing(forexampleumbilicalcord). Secondarywoundhealing(sanatiovulnerispersecundamintentionem). 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: Chronicorimmunomediatedinflammation (e.g. autoimmune disease) The presence of epitheloid type macrophages indicate that the cause of the inflammation is: TypeIVimmuno-mediated inflammation. What are the main reasons of anemia? Decreaseinredbloodcellproduction. Hemolysis. Bleeding What are the circumstances leading to iron deficiency anemia? Lowironintake. Ironmalabsorption. Incrisediron demands Chronicbloodloss. Malignantdiseases. What are the major features of aplastic anaemia?

What are the major features of aplastic anemia?

Bonemarrowstemcelldisease. Trilinear bone marrow aplasia. Pancytopenia. Which are the chronic myeloproliferative diseases? Chronicmyelogenousleukemia(CML). Essential thrombocytemia. Polycythemiavera. Chronicidiopathicmyelofibrosis. What are the phases of the CML? Chronic phase. Acceleratedphase. Blasticcrisis. What is the characteristic genetic abnormality in CML? Philaderphia-translocation. What are the phases of polycythemia vera and what are their characteristics? Proliferativephase:trilinearproliferation. Postpolycythaemicphase:myelofibrosis. What are the characteristics of essential thrombocytaemia? Isolated bone marrow megakaryocytic proliferation Chronicelevation of platelet count. Increasedtendencyforthrombosis. What are the characteristic signs of myelofibrosis? Collagenfibrosisinthebonemarrow. Extramedullaryhaematopoesis. Leukoerythroblasticbloodsmear. 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? theblastrateinthe bone marrow is higher than 20% How do we classify lymphomas according to the clinical course? Indolent Agressive

How do we classify lymphomas according to the cellular differentiation? Precursor Peripherial What is MGUS? Monoclonalgammopathyofundeterminedsignificance What are the characteristic features of plasma cell myeloma? Monoclonalplasmacellproliferation Monoclonalgammopathy Osteolyticbonelesions Pathologicfractures What are the types of Hodgkin's lymphoma? Nodularlymphocytepredominant Hodgkin's lymphoma ClassicalHodgkin'slymphoma Which cells are typical for Hodgkin's lymphoma? Hodgkincells mirrorimage cells Sternberg-Reed cells Basedonthenatureofpresentation,Burkittslymphomacanbe: Endemic(EBVassociated) Sporadic Immunodeficiencyassociated(HIVassociated) What are the most frequent sites of extranodal lymphomas? GItract Skin Respiratorytracts Mediastinum What does the abbreviation MALT stand for? Mucosaassociatedlymphoidtissue Which microorganism has a causative role in the development of the MALT lymphoma of the stomach? Helicobacterpylori What is mycosis fungoides? Thecommonest cutaneous T-cell lymphoma. What is Sezary syndrome? Leukemicmanifestationofthemycosisfungoides.