Pathological Anatomy Exam PDF

What is the difference between pathological anatomy and pathological physiology? ​ Pathological anatomy: studies structural changes in tissues and organs caused by disease. ​ Pathological physiology: examines functional changes in the body during disease. Explain the terms etiology and p...

What is the difference between pathological anatomy and pathological physiology? ​ Pathological anatomy: studies structural changes in tissues and organs caused by disease. ​ Pathological physiology: examines functional changes in the body during disease. Explain the terms etiology and pathogenesis. ​ Etiology: cause of a disease. ​ Pathogenesis: mechanism of disease development. What types of autopsies do you know? Clinical (medical cause analysis), forensic (suspicious death investigation) and anatomical (research and education). What is a biopsy (biopsy examination)? Removal and examination of pathologically altered tissue from a living patient. What is cytology (cytological examination)? Examination of cell shapes from swabs or liquid punctates, excluding blood. What is a molecular pathological examination? Detects genetic changes in tumor cells to diagnose and predict disease progression. What are the two stages of dying? Clinical death (reversible) and biological death (irreversible). How is brain death diagnosed? Confirmed by clinical assessment (absence of brainstem reflexes, breathing, and electrical activity) and instrumental methods (cerebral arteries angiography, brain perfusion scintigraphy). What is adaptation, and what types of adaptive reactions do you know? Is a reversible functional and structural response to increased or decreased demands on the organism. Types: hypertrophy, hyperplasia, atrophy, metaplasia. What is the difference between hypertrophy and hyperplasia? ​ Hypertrophy: increased size cell ​ Hyperplasia: increased cell number What is atrophy, and can you provide some examples? Decrease on the size or the volume of the cell. Ex: brain and testicular atrophy. What is metaplasia? Replacement of differentiated cells by another type of differentiated tissue. What types of cell death do you know, and what are their characteristics? ​ Necrosis: pathological, uncontrolled cell death ​ Apoptosis: regulated, programmed cell death  ​ Necroptosis: regulated, programmed necrosis What is an infarction? Tissue death due to lack of blood supply. Ex: myocardial infarction What is gangrene? Necrosis modified by secondary changes - drying, infection by anaerobic bacteria, or aerobic gas-producing bacteria. What is a pressure ulcer, and where is it typically located? Necrosis of the skin spreading to subcutaneous tissue and muscle, typically in areas subjected to prolonged pressure due to patient immobility. Typically located over bony areas. What is thrombosis, and what factors contribute to its development? Intravital clot formation in heart or blood vessels. Factors include: endothelial injury, blood flow disorder, and hypercoagulable state. What is embolism? Provide examples of what can embolize and identify the most common type of embolism. A substance (an embolus) travels through the bloodstream and lodges in a blood vessel, causing a blockage. Ex: thrombembolism (most common), air embolism, fat embolism, amniotic fluid embolism, tumor embolism. What is edema, and what mechanisms can lead to its formation? Accumulation of fluid in tissues. Mechanisms: venous stasis, hypoproteinemic, sodium and water retention, lymphedema. What are the signs of dehydration? Reduced fluid intake, diarrhea, vomiting, sweating, urine loss, fluid loss from burns. What is Marfan syndrome? Genetic disorder affecting connective tissue (fibrillin gene), leading to tall stature, aortic defects, hypermobility, flat feets and long limbs. What is amyloid/amyloidosis, and in which degenerative disease does it play a key role in pathogenesis? Structural changes of proteins (soluble convert into insoluble) and accumulation in tissues. Amyloid in CNS: key in Alzheimer’s disease pathogenesis. Name three examples of skin pigmentation disorders. Albinism, vitiligo and freckles What is lithiasis, and where does it typically occur? The presence of concrements in the body within the excretory systems of certain organs What is colic? Sudden, intermittent pain from muscle contractions caused by a stone moving through excretory pathways. What is inflammation? Defensive and reparative response to tissue damage, part of innate immune system. What are the local and systemic manifestations of inflammation? ​ Local: rubor, dolor, calor, tumor, functio laesa ​ Systemic: leukocytosis, leukopenia, acute phase proteins, increased coagulation and sedimentation, fever, activation of lymphoid organs. What is the difference between an abscess and phlegmon? ​ Abscess: localized pus-filled cavity ​ Phlegmon: diffuse tissue inflammation What are the characteristics of the two basic types of healing? ​ Regeneration: healing of a lesion with the original tissue maintaining its functionality ​ Reparation: healing of a lesion with functionally inferior tissue - usually a fibrous scar How does a fracture heal? 1.​ hematoma formation in the area of fracture 2.​ granulation tissue connects loose fragments and forms a fibrous callus 3.​ cartilage callus with rest 4.​ bone callus which remodels and transforms into definitive bone What is the principle of our immune system, and what are the two basic types of immunity, and what does each include? Protects against pathogens. Types: innate immunity (general defense, 1st barrier, no memory) and adaptive immunity (specific defense, 2nd barrier, has memory, involves T and B lymphocytes and produces antibodies). Provide several examples of low immune system activity. Low activity: immunodeficiency diseases, immunosupresive treatments, malnutrition, congenital or adquired immune system deficiencies. What are the two most common situations of exaggerated immune system reactions? ​ Allergies (e.g: hay fever) ​ Autoimmune diseases (e.g: rheumatoid arthritis, lupus) What is trisomy? Provide an example. A condition where there are 3 copies of a chromosome instead of 2. E.g: Down syndrome (trisomy 21) What is a teratogen? An external factor that causes developmental disorders. E.g: alcohol, medications. What is screening? A method of testing for disease in people who don't show symptoms, often to detect conditions early. What is a nosocomial infection? An infection acquired in a healthcare setting, often during hospital stays. What is sepsis? A life-threatening condition caused by an infection spreading through the bloodstream, leading to widespread inflammation. What is a tumor, and what characteristics does a tumor-altered cell exhibit? Tissue mass caused by excessive, uncoordinated and irreversible proliferation of transformed cells. Tumor-altered cells exhibit autonomy in growth, unlimited replication, immune evasion, angiogenesis, energy parasitism and ability to metastasize (malignant). How are tumors classified by biological behavior, and what characteristics do the different types have? ​ Benign: slow growth, high degree of differentiation, encapsulated, no metastasizes. ​ Malignant: fast growth, low degree of differentiation, unencapsulated, often metastasizes. How can malignant tumors spread? ​ Local invasion: penetrating and destroying surrounding tissues, complication surgical removal. ​ Metastasis: formation of secondary tumors via lymphatic or blood spread or implantation in adjacent cavities. What are paraneoplastic syndromes? A set of symptoms in patients with advanced cancer not directly related to the tumor mass, often due to: endocrine, autoimmune, coagulation disorders. What are the current national screening programs in the Czech Republic? -cervical cancer (woman > 25) - annually during preventive gynecological exams -breast cancer (woman > 45) - mammography every 2 years -colorectal cancer (men and woman > 50) - fecal occult blood test, colonoscopy -prostate cancer (men > 50) - PSA test What are the three most common tumors in men, women, and children? ​ Men: Prostate, lung, colorectal. ​ Women: Breast, lung, colorectal. ​ Children: Leukemia, brain tumors, lymphomas. What is the mechanism of tumor cell transformation? Tumor cell transformation (oncogenesis) occurs through genetic changes like translocations, mutations, or deletions, altering proliferation, apoptosis, and invasiveness. It involves activation of oncogenes or mutation of tumor suppressor genes (e.g., p53, Rb). How can tumors manifest clinically? List at least 8 different examples. ​ Pain ​ Weight loss ​ Fatigue ​ Bleeding ​ Lump or mass ​ Obstruction ​ Organ dysfunction ​ Cachexia What is the basic terminology for benign and malignant tumors from different tissues (how do their names appear)? Epithelial tumors: ​ Benign: Adenoma, papilloma ​ Malignant: Adenocarcinoma, carcinoma Neuroendocrine tumors: Carcinoid (in GIT or respiratory system) Mesenchymal tumors: ​ Benign: Lipoma, myoma, fibroma ​ Malignant: Sarcomas (e.g., liposarcoma, leiomyosarcoma) Hematological tumors: Leukemias and lymphomas (always malignant) Neuroectodermal tumors: ​ CNS and meninges: Gliomas, glioblastomas ​ Peripheral nerves: Neurilemmomas, neurofibromas ​ Melanocytes: Pigmented nevi (benign), melanoma (malignant) Germinal tumors: Seminoma, dysgerminoma, teratomas Mixed tumors: Fibroadenoma, carcinosarcoma What is a cyst? Cavity with its own epithelial lining How is systemic arterial hypertension defined? Increased blood pressure above 140/90mmHg (repeated measurements at rest, minimum of 2 times across three doctor visits) What is secondary hypertension? Provide examples. High blood pressure caused by another condition, such as renal or endocrine causes, aortic narrowing or hypertension during pregnancy. What factors are involved in the pathogenesis of primary (essential) hypertension? genetics - family history of hypertension  smoking, alcohol consumption diet - salt intake obesity chronic, excessive stress What are the consequences (organ damage) of systemic hypertension? predisposition to premature atherosclerosis left heart failure and IHD, increasing risk of heart failure brain damage: Stroke kidney damage, leading to kidney failure aneurysm and aortic dissection What is atherosclerosis, and why is it problematic? Formation of "atherosclerotic plaques" in arterial walls, composed of fatty substances - gradually narrow the vessel, leading to potential ischemia of the affected organ What are an aneurysm and aortic dissection? ​ Aneurysm: localized enlargement of an artery caused by weakness in the vessel wall ​ Aortic dissection: tear in the layer of the aorta, causing blood to flow between the layers of the vessel wall What are varices? Where can they occur? Abnormally dilated veins, commonly in the legs or esophagus, often caused by increased pressure or liver disease. What is the difference between superficial thrombophlebitis and iliofemoral phlebothrombosis? ​ Superficial thrombophlebitis: inflammation and thrombosis in superficial veins, minimal risk of embolism. ​ Iliofemoral phlebothrombosis: affects deep veins, high risk of embolism. What are the two basic types of valvular disorders? Stenosis (narrowing) and insufficiency (regurgitation). What is coronary heart disease (CHD)? CHD is ischemia caused by atherosclerosis in coronary arteries. What are the clinical forms of CHD? ​ acute (unstable) ○​ Unstable Angina Pectoris ○​ Acute Myocardial Infarction (MI) ○​ Sudden (Coronary) Death ​ chronic (stable) ○​ Post-MI state ○​ Angina Pectoris (exertional, vasospastic) Based on the events in the coronary vessels, explain the difference between angina pectoris and acute myocardial infarction. Angina is reversible ischemia, while infarction is irreversible myocardial necrosis due to prolonged ischemia. What are the risk factors for CHD? ​ Modifiable ○​ hypertension ○​ hyperlipoproteinemia ○​ smoking ○​ diabetes mellitus ○​ inactivity (obesity) ○​ stress ​ Non-modifiable ○​ age ○​ gender ○​ genetics How is acute myocardial infarction treated today? With β-blockers, vasodilators and revascularization via PCI or CABG. What is cardiac tamponade, and how can it occur? Disruption of diastolic filling of the heart due to myocardial rupture, leading to acute heart failure. What is heart failure, and how is it classified? Condition where heart cannot pump blood effectively, leading to inadequate tissue perfusion. ​ Defects with left-to-right shunt ​ Defects with right-to-left shunt ​ Defects without shunt How will the symptoms of left-sided and right-sided heart failure differ? ​ Left sided symptoms: pulmonary symptoms (shortness of breath, coughing, and fluid in the lungs) ​ Right-sided symptoms: systemic symptoms (swelling in the legs, abdomen, and neck veins) What is acute rhinitis, and what is its typical course? Viral infection causing nasal congestion and discharge, often self-limiting. What is angina? Acute infection of the tonsils, commonly caused by streptococci. -Symptoms: fever, sore throat, swollen lymph nodes, purulent tonsils -Treatment: antibiotics What is pulmonary atelectasis? Collapse of previously inflated lung tissue due to air absorption and alveolar collapse. What is pulmonary edema, and why is it so dangerous? Presence of fluid in the pulmonary interstitium, quickly infiltrating alveoli. This fluid is dangerous because limits or even prevents gas exchange (diffusion), causing respiratory failure. How can pulmonary hypertension develop? Can be primary (idiopathic) or secondary (due to overload or damage), leading to right heart failure and vascular remodeling. What is pulmonary embolism? Obstruction of various portions of the pulmonary arterial bed, caused by particles or material traveling through the bloodstream from systemic veins via the right heart into branches of the pulmonary artery. What is ARDS (Acute Respiratory Distress Syndrome)? A form of pulmonary edema characterized by increased permeability of the damaged alveolar-capillary membrane, allowing plasma proteins and water to enter the alveoli. What are the three most important obstructive pulmonary diseases? What causes obstruction in each of them? ​ Bronchial Asthma – caused by bronchial inflammation and narrowing triggered by allergens or irritants. ​ COPD (Chronic Obstructive Pulmonary Disease) – includes chronic bronchitis and emphysema, caused by long-term inflammation and damage to the airways, often due to smoking. ​ Bronchiectasis – caused by chronic infection and damage to the airways. What is cystic fibrosis, and what is the essence of the disease? A genetic disorder located on chromosome 7. It affects the chloride channels in cells, leading to thick and sticky mucus in lungs and other organs, causing respiratory and digestive problems. Provide at least 5 examples of restrictive pulmonary diseases. -Lung cancer -Atelectasis -Pulmonary edema -Pneumonia (infectious lung inflammation) -Interstitial pulmonary fibrosis What is pneumonia? Lung infection causing alveolar inflammation and consolidation. What is pneumothorax? Air in the pleural cavity causing lung collapse due to loss of negative intrapleural pressure. What is the difference between primary and secondary endocrine disorders? Primary: Originates in the gland itself. Secondary: Due to pituitary or hypothalamic dysfunction. What is the difference between gigantism and acromegaly? Are both caused by excess of growth hormone (GH) but they have different symptoms: ​ Gigantism: children, excessive height and overall growth. ​ Acromegaly: adults, enlargement of bones and tissues (hands, feets, face). What is diabetes insipidus, and how does it manifest? A condition of low ADH causing polyuria and polydipsia What is a goiter? Any enlargement of the thyroid gland (regardless of function) List at least 5 symptoms of hypothyroidism and hyperthyroidism. ​ Hypothyroidism: fatigue, weight gain, anemia, dry skin, bradycardia ​ Hyperthyroidism: tachycardia, weight loss, osteoporosis, tremors, diarrhea What is the most common cause of primary hyperparathyroidism, and how will it manifest? Caused by parathyroid adenoma or hyperplasia of parathyroid glands. ​ Manifestations: ○​ hypercalcemia ○​ heart rhythm disorders ○​ muscle weakness ○​ fatigue ○​ nephrolithiasis ○​ osteopenia ○​ nausea ○​ constipation What is Addison's disease, and how can it be life-threatening? Disease caused by autoimmune damage to the adrenal glands, leading to low pressure, electrolyte imbalances and hyperpigmentation. It can be life-threatening causing hypotension, muscle wealness, arrhythmias and hypoglycemia. What is Conn's syndrome? Is a form of hyperaldosteronism that causes hypertension, hypokalemia, alkalosis and general weakness. How can hypercortisolism develop, and how will it manifest? Hypercortisolism can result from adrenal tumors, ACTH hypersecretion, or steroid use. It causes obesity, muscle weakness, osteoporosis, hyperglycemia, skin atrophy, hypertension, and psychological changes. What is diabetes mellitus (DM), how is it classified, and what is the pathogenesis of the two main types? Is a group of metabolic disorders characterized by chronic hyperglycemia due to impaired insulin secretion, insulin action, or both. ​ Type 1: absolute lack of insulin secretion, mostly autoimmune  ​ Type 2: progressive impairment of insulin secretion on the background of insulin resistance ​ Other specific types: ○​ MODY ○​ Secondary diabetes ​ Gestational diabetes What are the acute complications of DM? Hypoglycaemia, diabetic ketoacidosis, hyperosmolar syndrome What are the chronic complications of DM? Neuropathy, nephropathy, retinopathy, atherosclerosis, and foot ulcers What is uremia, and what are its manifestations? Condition caused by renal failure, especially in ESRD ​ Manifestations: cardiac issues, muscle weakness, anemia, immune dysfunction, bleeding, mental changes and bone disease What are the two main types of glomerular filtration disorders? Provide examples. ​ Primary glomerulopathy: originated on the glomeruli (acute, rapidly progressive and chronic glomerulonephritis). ​ Secondary glomerulopathy: glomerular damage due to systemic diseases (diabetic nephropathy, lupus nephritis, amyloidosis). What is nephrotic syndrome? Set of symptoms due to high proteinuria (› 3.5g/ day) What is acute pyelonephritis, and how can it develop? Purulent involvement of the renal pelvis and kidneys caused by bacterial infection What are the mechanisms of acute renal failure, and provide examples. ​ Prerenal (low perfusion): acute MI, hemorrhage, sepsis ​ Renal (tubular damage): alimentary intoxication ​ Postrenal (obstruction): urinary stones, tumors What are the metabolic consequences of acute kidney failure, and how do they threaten the patient's life? ​ Hyperkalemia: cardiac arrest ​ Metabolic acidosis: respiratory/cardiac failure ​ Fluid overload: pulmonary edema ​ Uremia: brain and heart damage Life-threat: multi-organ failure risk What are the most common causes of chronic kidney insufficiency? ​ Glomerulonephritis (GN) – 50%. ​ Diabetic Nephropathy – 20%.  ​ Other Causes (30%) – Interstitial nephritis, nephrosclerosis, irreversible atherosclerosis. What is hydronephrosis? Condition in which the outflow of urine from the renal pelvis is obstructed How does cystitis manifest clinically? Inflammation of bladder ​ manifestations: ○​ acute: dysuria, haematuria, pollakiuria and urgency ○​ chronic: clinical picture less distinct, but symptoms the same What are the risk factors for developing urolithiasis? Dehydration, diet, hypercalcemia, and infections What is vesicoureteral reflux, and why can it be dangerous? Urine backflow from bladder to ureters, risking infection and kidney damage How does dental caries develop? Tooth decay from bacterial acid production on dental surfaces List at least 8 different causes of swallowing disorders (dysphagia). Stroke, GERD, tumors, esophageal motility disorders, neuromuscular diseases, diabetes, infections, or trauma What is gastroesophageal reflux, and why can it be dangerous? Acidic stomach contents flow back into the esophagus due to a weak lower esophageal sphincter. Dangers: Irritation can cause esophagitis, ulcers, strictures, bleeding, Barrett's esophagus (precancerous) or risk of aspiration into the respiratory tract. What is a hiatal hernia? Dislocation of part of the stomach through the esophageal hiatus of the diaphragm into the chest area How does a peptic ulcer form? Erosion in the stomach or duodenum due to acid and H. pylori What is a polyp? Macroscopic term denoting a circumscribed protrusion of the mucosa into the lumina What are the mechanisms of diarrhea? Osmotic, secretory, exudative, or motility disorders What is ileus and what are the mechanisms of its formation? Life-threatening intestinal obstruction. Mechanisms:  ​ Mechanical: blockage (tumors, gallstones) ​ Neurogenic: motility failure (paralytic after surgery) ​ Vascular: blood flow obstruction (thrombosis, embolism) What is diverticulosis? Deviations of the wall of the colon caused by increased intraluminal pressure in motility disorders What is the difference in the pathogenesis of acute and chronic pancreatitis? ​ Acute: enzymatic self-digestion of pancreas ​ Chronic: persistent inflammation with fibrosis What can be dangerous about cholecystitis? Can lead to sepsis (cholecystitis, cholangitis) or obstruction in the bile ducts (cholestasis, obstructive icterus, acute pancreatitis) What are the three basic types (by mechanism of origin) of icterus? ​ Prehepatic (hemolysis) ​ Hepatic (liver dysfunction) ​ Posthepatic (bile obstruction) List at least 8 consequences of hepatic insufficiency (failure). ​ Metabolic disorders: diabetes ​ Nutritional disorders: impaired digestion ​ Internal environmental changes: hypokalemia, metabolic alkalosis ​ Haematological disorders: anemia ​ Ascites ​ Edema ​ Hepatic encephalopathy ​ Hepatorenal syndrome What are steatosis and cirrhosis of the liver? Steatosis: fat accumulation in the liver Cirrhosis: Irreversible liver remodeling with necrosis, vascular overgrowth, disrupted structure, loss of function, and impaired blood flow Give at least 5 examples of causes of malabsorption syndrome. ​ Insufficient secretion of digestive juices: gastritis ​ Lactase deficiency ​ Celiac sprue ​ Idiopathic inflammatory disease: Crohn's ​ Motility disorders: hypothyroidism What is osteoporosis and how is it classified? Bone loss with impaired architecture, increasing fracture risk Classification: ​ Generalized: ○​ Primary: type l (postmenopausal) or type ll (senile)  ○​ Secondary: due to diseases or medications ​ Localized: specific bones (immobilized limbs, rheumatoid arthritis) What is osteonecrosis and give an example Aseptic or avascular necrosis caused by death of bone tissue and bone marrow due to local ischemia (bone infarction). Köhler's disease - navicular bone What is rickets and osteomalacia and what is the difference between them? Disturbance of calcium and phosphate homeostasis in vitamin D deficiency. Rickets occurs in children while osteomalacia in adults. What is osteoarthritis? A degenerative joint disease characterized by cartilage loss, joint pain, stiffness, and reduced mobility, commonly in weight-bearing joints (e.g., knees, hips) What types of arthritis do you know? 4 categories of arthritis: osteoarthritis infectious arthritis immune-mediated inflammation arthritis associated with metabolic defect What is pannus? Inflammation and hyperplasia of the synovial membrane - lingual overgrowth into the joint cavity What is ankylosing spondyloarthritis? Affection of the attachments of the longitudinal ligaments to the vertebral bodies and interverte fibrotization and subsequent ossification of ligaments and intervertebral discs - "bamboo rod" What is gout and how does it manifest itself? Gout is caused by the deposition of uric acid crystals in joints. Manifestations: Sudden, severe joint pain (commonly in the big toe), redness, swelling, and warmth. How are neuropathies classified according to aetiology and give examples. 1.​ Diabetic neuropathy (due to diabetes). 2.​ Toxic neuropathy (caused by alcohol or drugs like chemotherapy). 3.​ Infectious neuropathy (e.g., leprosy, HIV). 4.​ Hereditary neuropathy (e.g., Charcot-Marie-Tooth disease). 5.​ Traumatic neuropathy (e.g., nerve compression or severance). What are the three degrees of peripheral nerve damage? Neuropraxia: Temporary loss of function without structural damage. Axonotmesis: Axonal damage with intact connective tissue; potential for regeneration. Neurotmesis: Complete severance of the nerve; unlikely to regenerate without surgical repair. What is myasthenia gravis? Chronic autoimmune disease causing weakness in skeletal muscles due to antibodies blocking acetylcholine receptors at the neuromuscular junction What are the most common muscular dystrophies and what are their clinical manifestations? Duchenne muscular dystrophy (DMD): Severe, early-onset muscle weakness, pseudohypertrophy of calves, loss of ambulation by adolescence. Becker muscular dystrophy (BMD): Milder and slower progression than DMD. Myotonic dystrophy: Muscle weakness, myotonia, and systemic symptoms (e.g., cataracts, cardiac issues).