Pathology and Inflammation Quiz

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Questions and Answers

What does the term 'pathology' mean?

Pathology is the study of the structural, biochemical, and functional changes in cells, tissues, and organs that underlie disease.

List the four aspects that pathology explains in relation to a disease.

The four aspects are etiology, pathogenesis, morphologic changes, and functional changes.

What distinguishes primary etiology from idiopathic etiology?

Primary etiology refers to known causes of a disease, while idiopathic etiology refers to unknown causes.

How does pathogenesis relate to morphologic changes?

Pathogenesis describes the mechanisms through which the cause of a disease operates, resulting in morphologic changes. Signup and view all the answers

What is the significance of morphological changes in pathology?

Morphological changes influence the normal function of the organ and lead to functional alterations and clinical signs. Signup and view all the answers

What are the two main techniques used in histopathology?

The two main techniques are incisional biopsy and excisional biopsy. Signup and view all the answers

Describe the purpose of cytopathologic techniques.

Cytopathologic techniques aim to study cells for the early detection and diagnosis of cancer. Signup and view all the answers

Why is tissue fixation important following a biopsy?

Tissue fixation is crucial for preserving the sample and inactivating microbes to prevent degradation. Signup and view all the answers

What are pyogenic bacteria, and what condition do they cause?

Pyogenic bacteria cause suppuration, which is characterized by the formation of pus. Signup and view all the answers

Define cellulitis and its primary characteristic.

Cellulitis is the diffuse inflammation of soft tissues. Signup and view all the answers

What is the significance of fever in the context of acute inflammation?

Fever indicates the presence of bacteriaemia, which is often associated with acute inflammatory responses. Signup and view all the answers

What is meant by the term 'ulcer' in the context of acute inflammation?

An ulcer is a local defect on the surface of an organ produced by inflammation. Signup and view all the answers

Explain the process of resolution in acute inflammation.

Resolution refers to the complete return to normal tissue after acute inflammation when changes are minimal and reversible. Signup and view all the answers

What occurs during healing by fibrosis following acute inflammation?

Healing by fibrosis occurs when extensive tissue destruction prevents regeneration, leading to the formation of scar tissue. Signup and view all the answers

Describe the fate of acute inflammation when pyogenic bacteria are involved.

It progresses to suppuration, leading to tissue necrosis and potentially forming abscesses. Signup and view all the answers

List two systemic effects associated with acute inflammation.

Fever and leukocytosis are two systemic effects of acute inflammation. Signup and view all the answers

What is chronic inflammation and how does it differ from acute inflammation?

Chronic inflammation is a prolonged process where tissue destruction and inflammation occur simultaneously, while acute inflammation is a short-term response to injury or infection. Signup and view all the answers

What are the key systemic effects of chronic inflammation?

Key systemic effects include mild fever, anemia, leukocytosis, elevated ESR, and increased levels of C-reactive protein. Signup and view all the answers

How are arteries classified based on their caliber?

Arteries are classified into large (elastic), medium-sized (muscular), and smallest arterioles. Signup and view all the answers

Describe the three histological layers of arteries.

The three layers are the tunica intima (inner lining), tunica media (smooth muscle layer), and tunica adventitia (outer coat). Signup and view all the answers

What is arteriosclerosis and what causes it?

Arteriosclerosis is the thickening and hardening of arterial walls, often caused by aging, hypertension, or calcification. Signup and view all the answers

What are the four morphologic entities included under arteriosclerosis?

The four entities are senile arteriosclerosis, hypertensive arteriosclerosis, Mönckeberg’s arteriosclerosis, and a fourth unnamed type. Signup and view all the answers

What mechanisms can lead to chronic inflammation following acute inflammation?

Chronic inflammation can result from extensive tissue damage or surviving bacteria post-acute inflammation. Signup and view all the answers

What role does amyloidosis play in chronic inflammation?

Amyloidosis occurs when serum amyloid A is produced due to inflammation, leading to protein deposition in tissues. Signup and view all the answers

What does the term 'inflammation' literally mean?

It means 'burning'. Signup and view all the answers

List the five cardinal signs of inflammation.

Rubor (redness), Tumor (swelling), Calor (heat), Dolor (pain), Functio laesa (loss of function). Signup and view all the answers

Differentiate between acute and chronic inflammation.

Acute inflammation lasts less than two weeks, while chronic inflammation has a longer duration and involves chronic inflammatory cells. Signup and view all the answers

What are the main cellular events in acute inflammation?

Exudation of leucocytes and phagocytosis. Signup and view all the answers

Identify two types of chemical mediators involved in acute inflammation.

Vasodilators and agents that increase vascular permeability. Signup and view all the answers

Define pseudomembranous inflammation.

It is an inflammatory response occurring on mucous surfaces like the oral or respiratory tracts. Signup and view all the answers

What characterizes the formation of ulcers in inflammation?

Ulcers are local defects on the surface of an organ caused by inflammatory processes. Signup and view all the answers

Explain what suppuration means in the context of inflammation.

Suppuration refers to the formation of a cavity filled with purulent exudate or pus. Signup and view all the answers

What is the primary characteristic of Buerger’s disease?

It primarily affects men under 35 who are heavy smokers and can lead to gangrene and amputation. Signup and view all the answers

Define a true aneurysm and a false aneurysm.

A true aneurysm has all the layers of the vessel wall, while a false aneurysm (pseudo-aneurysm) is a hematoma outside the artery due to injury. Signup and view all the answers

What is the main cause of ischemic heart disease (IHD)?

The main cause of IHD is the narrowing or obstruction of the coronary arteries. Signup and view all the answers

What are the three layers of the heart wall?

The three layers are the pericardium, myocardium, and endocardium. Signup and view all the answers

Name two types of arteritis mentioned and describe their origin.

Polyarteritis nodosa (PAN) and Wegener’s granulomatosis; both are believed to have an immunologic origin. Signup and view all the answers

What is the hallmark symptom of Takayasu’s arteritis?

The hallmark symptom is pulselessness due to arterial occlusion. Signup and view all the answers

What is the role of the myocardium in the heart?

The myocardium is responsible for the contraction and relaxation of the heart muscles. Signup and view all the answers

Identify the four heart valves and categorize them into atrio-ventricular and semilunar valves.

The mitral and tricuspid valves are atrio-ventricular, while the aortic and pulmonary valves are semilunar. Signup and view all the answers

What is atherosclerosis and what characterizes its primary features?

Atherosclerosis is an inflammatory arterial disease characterized by fibrofatty plaques or atheromas affecting primarily the intima. Signup and view all the answers

Identify two non-modifiable risk factors for atherosclerosis.

Age and genetic factors are two non-modifiable risk factors for atherosclerosis. Signup and view all the answers

What is the initial triggering event in the pathogenesis of atherosclerosis?

Endothelial injury is the initial triggering event in the pathogenesis of atherosclerosis. Signup and view all the answers

List two clinical effects of atherosclerosis.

Slow luminal narrowing causing ischemia and sudden luminal occlusion causing infarction are two clinical effects of atherosclerosis. Signup and view all the answers

What are the major sites of atherosclerosis in order of frequency?

The major sites are the abdominal aorta and iliac arteries, coronary arteries, and internal carotid arteries. Signup and view all the answers

What morphological feature is characterized by the accumulation of lipids in the arterial wall?

Fatty streaks and dots characterize the morphological feature of lipid accumulation in the arterial wall. Signup and view all the answers

What is arteritis and how does it relate to the inflammatory process in blood vessels?

Arteritis is the inflammation of an artery or arteriole and is part of the broader category of vasculitis. Signup and view all the answers

Describe one potential outcome of complicated atherosclerotic lesions.

One potential outcome of complicated atherosclerotic lesions is thrombosis, which can lead to sudden blockage of blood flow. Signup and view all the answers

Study Notes

Pathology

Pathology is the study of structural, biochemical, and functional changes in cells, tissues, and organs that underlie disease.
The term "patho" means disease, and "logy" means study, both from Greek origin.

Aspects of Disease

Pathology examines a disease through four aspects:
- Etiology (cause of the disease)
- Pathogenesis (development of the disease)
- Morphologic changes (structural changes)
- Functional changes (dysfunction) and clinical significance

Etiology

Etiology encompasses two major factors:
- Genetic
- Acquired (infectious, nutritional, chemical, etc.)
If the cause is known, it's called primary etiology.
If the cause is unknown, it's called idiopathic.

Pathogenesis

Pathogenesis describes the mechanisms through which a disease cause operates.
Mechanisms can be evident or latent (during incubation periods).
Pathogenesis leads to morphologic changes.

Morphologic Changes

Morphologic changes are structural alterations in cells or tissues resulting from pathogenic mechanisms.
Changes can be observed with the naked eye (gross) or under a microscope (microscopic).
Morphologic changes lead to functional alterations, visible as clinical signs and symptoms of the disease.

Functional Changes

Morphologic changes affect organ function.
Functional changes define the clinical features (symptoms/signs), disease course, and prognosis (outcome).

Histopathological Techniques

Histopathological techniques study tissues using microscopes.
Tissue samples are obtained via biopsy (incisional or excisional) from a living person (often under anesthesia).
Immediately after removal, the tissue sample is fixed in 10% formaldehyde solution to inactivate microbes for long-term preservation.

Cytopathologic Techniques

Cytopathologic techniques study cells from various body tissues.
Applications include screening for asymptomatic cancer, diagnosing symptomatic cancer, and monitoring patients treated for cancer.
Screening examples include Pap smear testing for cervical cancer.
Diagnostic examples include identifying cancerous cells in physical or radiological exams.
Surveillance examples include monitoring urine samples for recurrence of urinary tract cancers.

Cytopathologic Methods

Fine-needle aspiration cytology (FNAC): obtaining cells from a diseased organ using a thin needle under negative pressure, guided by imaging (ultrasound or CT scans). Used for superficial and deep organs.
Exfoliative cytology: examines cells shed spontaneously into body fluids or secretions (e.g., sputum, cerebrospinal fluid, urine, effusions, nipple or vaginal discharge).
Abrasive cytology: cells are dislodged from body surfaces (e.g., skin) using tools such as spatulas or small brushes; for example, cervical smears.

Hematopathology

Hematopathology examines blood cells and their precursors in the bone marrow (e.g., anemia and leukemia).

Immunohistochemistry

Immunohistochemistry identifies specific antigens in tissue samples (e.g., cancer cell antigens).

Microbiological Examination

Microbiological examination identifies microorganisms in body fluids or tissues using microscopic, cultural, and serological techniques.

Biochemical Examination

Biochemical examination investigates metabolic diseases in blood, urine, and other bodily fluids.

Cytogenetic Test

Cytogenetic tests investigate chromosomal abnormalities (structure and number) using molecular biology techniques.

Molecular Genetic Test

Molecular genetic tests, like fluorescent in situ hybridization (FISH), examine segments and sequences of DNA, identifying genetic diseases.

Autopsy

Autopsy examines the deceased body to determine the cause of death, for forensic or clinical purposes.

The Causes of Disease

Diseases stem from genetic factors, environmental factors, or a combination of both.

Outcome and Consequences of Disease

Disease outcomes vary, ranging from resolution (no lingering effects) to sequelae (lingering effects) to death.

Clinical & Biological Death

Clinical death marks a reversible state between life and biologic death, involving cessation of respiratory, circulatory, and brain functions. Possible recovery with CPR.
Biological death signifies an irreversible state of cellular destruction and cessation of life functions, including the brain stem.

Learning Objectives

Topics for further study, including specific cell types, injury mechanisms, and common disease forms.

Cell Injury and Etiology

Acquired causes include hypoxia/ischemia, physical agents, chemical agents, microbial agents, immunological agents, nutritional derangements, aging, psychogenic disease, iatrogenic factors (medical treatment), and idiopathic disease (unknown cause).

Hypoxia and Ischemia

The most common cause of cell injury.
Cells need oxygen for energy production. Reduced oxygen (hypoxia) or poor blood flow (ischemia) disrupt cellular activities.

Cell Injury and Pathogenesis

Cells respond to injury by adapting, acquiring reversible injury, or suffering irreversible injury, leading to death (necrosis or apoptosis).

Cell Death

Cell death occurs through two processes: necrosis and apoptosis.

Necrosis

Excess fluid entering a cell, causing swelling and membrane rupture.
Intracellular degradative processes occur within a still-living organism.
Necrosis does not occur in dead organisms, as is replaced by autolysis and heterolysis.

Types of Necrosis

Coagulative necrosis: occurs when blood supply to an organ is interrupted, particularly the heart.
Liquefactive necrosis: tissue digestion leading to softening and liquefaction; common in ischemic brain injury and suppurative infections (pus formation).
Fat necrosis: trauma in tissues with high fat content (e.g., breast, acute hemorrhagic pancreatitis).
Caseous necrosis: has a cheese-like appearance, common in tuberculosis.
Gangrenous necrosis: coagulative necrosis, often accompanied by liquefactive necrosis due to a bacterial infection.

Apoptosis

Cell death occurs in individual cells within clusters of other cells.
Characterized by cell shrinkage and increased acidophilia (staining).
Followed by fragmentation into apoptotic bodies for phagocytosis.
Distinct from necrosis, apoptosis is not associated with inflammation or calcification.

Acute Inflammation

Tissue response to injury or infection.
Characterized by cardinal signs: rubor (redness), tumor (swelling), calor (heat), dolor (pain), and functio laesa (loss of function).
Acute inflammation typically lasts less than two weeks and involves the influx of fluid and plasma, activation of platelets, and accumulation/migration of cells.

Types of Inflammation

Acute inflammation (short-term).
Chronic inflammation (long-term).
Subacute inflammation (intermediate state).

Acute Inflammation (Vascular events)

Initial vasoconstriction, followed by vasodilation (redness and warmth).
Increased vascular permeability (fluid into extracellular space, swelling).
Blood flow slows (stasis).

Acute Inflammation (Cellular Events)

Leukocyte margination (mainly neutrophils).
Phagocytosis (engulfment of foreign material).

Chemical Mediators of Acute Inflammation

Chemicals released from cells, plasma, or damaged tissue.
Increase vascular permeability, cause vasodilation, fever, pain, chemotaxis, and tissue damage..

Morphology of Acute Inflammation

Pseudomembranous inflammation (mucous surfaces).
Ulcer (local defects on organ surfaces).
Suppuration (pus-filled cavities; abscess formation).
Cellulitis (diffuse inflammation in soft tissues).
Bacterial infection of the blood (bacteremia, septicemia, pyaemia).

Systemic Effects of Acute Inflammation

Fever.
Leukocytosis (increased white blood cells).
Elevated C-reactive protein (CRP).
Lymphangitis and lymphadenitis (inflammation of lymph vessels/nodes).
Shock (severe cases).

Fate (Prognosis) of Acute Inflammation

Resolution (complete restoration of normal tissue).
Healing by fibrosis (replacement of lost tissue with scar tissue).
Suppuration (Formation of abscesses).
Chronic inflammation.

Chronic Inflammation

Prolonged process where tissue destruction and inflammation coexist.
Causes include ongoing/recurrent acute inflammation, new onset inflammation (no prior acute event), or chronic infection.

Systemic Effects of Chronic Inflammation

Mild fever, weight loss, weakness.
Anemia.
Leukocytosis.
Elevated ESR (erythrocyte sedimentation rate).
Elevated c-reactive protein (CRP).
Amyloidosis (abnormal protein deposition).

Diseases of the Respiratory System

Pediatric lung disease.
Pulmonary vascular disease.
Pulmonary infections.
Chronic obstructive pulmonary disease (COPD).
Chronic restrictive pulmonary disease (CRPD).
Tumors of the lungs.

Pediatric Lung Disease

Congenital anomalies (agenesis, hypoplasia, tracheal/bronchial anomalies, vascular anomalies, cysts, etc.).
Neonatal acquired lung disease (e.g., respiratory distress syndrome, bronchopulmonary dysplasia).

Acute Respiratory Distress Syndrome

(ARDS) or Hyaline Membrane Disease
Either neonatal or in adults.

Atelectasis and Collapse

Primary atelectasis (incomplete lung expansion; often from weak respiratory function/prematurity).
Secondary atelectasis (partial lung collapse; from compression, obstruction, or contraction).

Pulmonary Vascular Disease

Pulmonary arterial hypertension (PH): high-flow, low-pressure system; systolic blood pressure >30 mmHg.
Primary PH (idiopathic - cause unknown) and secondary PH (associated with other diseases).

Pulmonary Infections

Types include pneumonia, lung abscess, and fungal infections.
Classifications for pneumonia include lobar, bronchopneumonia, interstitial, and classified etiologically (bacterial, viral, etc.).
Common bacterial pneumonia etiologies - pneumococci, staphylococci, streptococci, gram-negative aerobic bacteria.

Lung Abscess

Localized tissue necrosis and suppuration (pus).
Etiologies include aspiration, pre-existing infections, bronchial obstruction, septic emboli, or miscellaneous factors.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic airflow limitation.
Chronic bronchitis, emphysema, bronchial asthma, and bronchiectasis are typical forms of COPD.

Chronic Bronchitis

Clinical definition of chronic cough with sputum production.
Etiologies include smoking, pollution, and genetics.
Morphologic features include thickened, hyperemic, edematous bronchial walls with mucus plaques.

Emphysema

Morphologic definition of permanent air space dilation and destruction.
Etiologies include smoking, air pollution, occupational exposures, genetics.

Bronchial Asthma

Increased responsiveness of the tracheobronchial tree leading to spasmodic airway narrowing.
Etiologies include extrinsic (allergic), intrinsic (non-allergic), and mixed types.

Bronchiectasis

Irreversible dilation of the bronchi and bronchioles.
Etiologies include hereditary/congenital factors, endobronchial obstructions, and infections.
Often presents with chronic cough, foul-smelling sputum, hemoptysis, recurrent pneumonia.

Chronic Restrictive Pulmonary Disease (CRPD)

Reduced lung expansion with decreased lung capacity.
Causes include chest wall disorders (kyphoscoliosis, poliomyelitis, obesity), pleural disorders, and interstitial lung diseases.
Other causes: pneumoconiosis and connective tissue disorders.

Tumors of the Lungs

Both benign and malignant tumors occur.
Primary lung cancer (bronchogenic carcinoma) is most common, often related to smoking and other exposures.
Lung is a common site for metastasis.

Bronchogenic Carcinoma

Etiologies include smoking, atmospheric pollution, occupational causes, dietary factors (e.g., Vitamin A deficiency), and chronic scarring (e.g., tuberculosis and asbestosis).
Histological types include squamous cell, adenocarcinoma, large cell, small cell, and combined types.
Therapeutic purposes including small cell, non-small cell, and combined/mixed.

Metastatic Lung Tumors

Secondary lung tumors are more common.
Common sources include cancers of the bowel, breast, thyroid, kidney, pancreas, and liver (ipsilateral or contralateral lung).

Diseases of the Arteries

Arteriosclerosis (hardening and thickening of arteries).
Arteritis/vasculitis (inflammation of arteries).
Aneurysms (abnormal bulges/dilatations in arteries).

Arteriosclerosis

Thickening and hardening of the arterial walls.
Subtypes include senile, hypertensive, and Mönckeberg's (medial calcific sclerosis) arteriosclerosis. Atherosclerosis is also included.

Atherosclerosis

Most common form of arteriosclerosis.
Characterized by fibrofatty plaques (atheromas).
Risk factors, including modifiable (smoking, hypertension, diabetes, dyslipidemia) and non-modifiable (age, sex, genetics).

Pathogenesis of Atherosclerosis

Initial injury to the endothelium, platelet adhesion, and monocyte/macrophage migration, and intimal smooth muscle cell proliferation.

Morphologic Features of Arteriosclerosis

Common features include fatty streaks, intermediate lesions, atheromas, fibrous plaques, complicated lesions, calcification, and aneurysm formation.

Clinical Effects of Atherosclerosis

Slow luminal narrowing causing ischemia and atrophy.
Sudden luminal occlusion causing infarction and necrosis.
Thrombi and emboli formation.
Aneurysm formation (distention and rupture).

Arteritis

Inflammation of the arteries.
Infectious arteritis, with subtypes like endarteritis obliterans.
Non-infectious arteritis, including subtypes like polyarteritis nodosa, Wegener's granulomatosis, temporal arteritis, Takayasu's arteritis, and Kawasaki's disease, as well as miscellaneous vasculitis.
Buerger's disease (thromboangiitis obliterans).

Aneurysms

Abnormal dilatations of blood vessels.
Classification based on aneurysmal composition (true vs. false).

Ischemic Heart Disease

Cardiac disability due to an imbalance between myocardial oxygen supply and demand.
Causes include coronary atherosclerosis (atherosclerotic plaque, hemorrhage, ulceration, thrombosis, and embolism), nonatherosclerotic causes (vasospasm, arteritis, aneurysms) .
Clinical features include asymptomatic stage, angina pectoris, acute myocardial infarction (AMI), chronic ischemic heart disease(CIHD), or sudden cardiac death.

Rheumatic Fever and Rheumatic Heart Disease

Systemic, non-suppurative, post-streptococcal inflammatory disease affecting the heart, joints, central nervous system, skin, and subcutaneous tissues.
Often seen in poor socioeconomic conditions.
Primarily affects the heart valves (endocarditis).

Valvular Diseases

Stenosis (incomplete valve opening, obstructing forward blood flow).
Insufficiency (incomplete valve closure, causing backflow or regurgitation).
Mixed disorders (involving both stenosis and insufficiency).

Mitral Stenosis

RHD is a primary cause, more often in women.
Other etiologies include bacterial endocarditis, endocardial fibroelastosis, and congenital mitral valve abnormalities.
Effects: left atrial enlargement, left ventricular atrophy or normal in size, and pulmonary hypertension.

Mitral Insufficiency

RHD accounts for about 50% of cases, more often in men.
Other causes: calcification of mitral valve annulus; myxomatous transformation of mitral leaflets or chordae tendinae.
Associated with some degree of mitral stenosis.

Aortic Stenosis

Calcific type (more common) or noncalcific.
Etiologies include senility, RHD, bacterial endocarditis, Mönckeberg's calcific aortic stenosis, familial hypercholesterolemic xanthoma.

Aortic Insufficiency

Etiology: RHD (most frequent), congenital bicuspid aorta, Marfan syndrome.
Congenital subaortic stenosis and dissecting aneurysm.

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Description

Test your knowledge on key concepts in pathology, including the meaning of pathology, aspects of disease explanation, and the significance of morphological changes. This quiz also explores acute inflammation, chronic inflammation, and techniques in histopathology. Perfect for students of medical sciences or anyone interested in understanding disease mechanisms.