Unit 7: Adaptation and regeneration 1. Identify most frequent cases of compensation hypertrophy in organs with muscle wall. (p=3) -Urinary bladder -Heart -Vessels
2. What is organization? Which processes are observed in it? (p=4) -Organisation is formation of connective tissue, healing around dead tissue or exogenous agents, and replacement of necrosis, exudates, thrombus & hematoma by connective tissue 3. Name local atrophy varieties progressing in pathology. (p=6) -dysfunctional -neurotic atrophy -ischemic -chemical -pressure -physical 4. Name steps of wound healing by secondary intention. (p=3) -Traumatic edema, demarcation of purulent exudative inflammation with necrotic fibrin -Secondary cleaning of the wound, large amounts of granulative tissue are formed -Appearance of regenerative tissue (scar formation 5. Specify manifestations of pathologic repair. (p=3) -Hyper-regeneration -Hypo-regeneration -Metaplasia 6. What is hyperplasia? (p=2) -Increase in number of cells -Increase in structural-functional elements and intracellular structure of cells 7. Define atrophy. (p=3) -Atrophy is an adaptive response, characterized by a decrease in the size and function of cells, tissues and organs -Shrinkage of cellular size is due to loss of cellular substance 8. Define types of hypertrophy according to the mechanism of the beginning and with the signification for organism. (p=4) -Neurohumoral hypertrophy -Repair hypertrophy hypertrophy -Compensatory (working) hypertrophy -Vicar hypertrophy hypertrophy 9. Name types of general atrophy according to etiology. (p=5) -Alimentary -Tumour -Hypophyseal (pituitary) -Cerebral -Chronic infection
10. What is the form of repair named „repair hypertrophy‟? (p=4) -It is the developing process of substitution hypertrophy which consist of special tissues, that can carry out repair with the help of hyperplastic cells or hyperplastic tissue & hypertrophic hypertrophic cells 11. What is metaplasia? (p=2) -Transformation -Transformation of 1 tissue type to another, usually of the same broad class 12. What structural levels are compensation and adaptive processes realized on? (p=3) -Cellular -Subcellular -Tissue 13. Patient died of decompensation of hypertrophied heart (mass of heart is 500g). During postmortem examination “tiger” heart was found. Give an explanation of decompensation mechanisms. (p=3) -Hypertrophy of the heart leads to an imbalance of oxygen demand and supply to it -subsequently, chronic hypoxia of the myocardium, fatty dystrophy, destruction of mitochondria and increase in cytosolic calcium occurs -Eventually the heart decompensates 14. What are the tissues of the heart exposed to hypertrophy and hyperplasia with
enlargement f heart? (p=4) -Myocardium -Connective tissue stroma -Intramural vessels -Neural apparatus
15. What is carnification? (p=3) -Carnification is the appearance of connective tissue in the alveolar space as a result of pneumonia 16. What is regeneration? (p=2) -Regeneration is the replacement of injured cells with new cells and reconstitution of function 17. Name organs with regenerative hypertrophy in primary form of intracellular hyperplasia of ultrastructures and enlargement of cellular sizes. (p=2) -Brain -Myocardium 18. What is brown atrophy of myocard? (p=3) -It is the general atrophy of the heart, with decrease of the size of the myocardium, accumulation accumulation of pigments of lipofuscin in cardiomyocytes cardiomyocytes -developed during cachexia 19. Specify periods (phases) of compensation and adaptive reactions. (p=3) -Beginning -Consolidation -Exhaustion (decompensation) 20. Give the definition of working hypertrophy. (p=2) -It is hypertrophy characterised by increased cell size due to increased functional demand of the organ 21. Specify types of regeneration. (p=3) -physiological -reparative -pathological 22. What is atrophy organs term with deposit of lipofuscin in pigment in its parenchyma? (p=1) -Brown atrophy 23. What is vicar hypertrophy? (p=1) -It is the hypertrophy of twin organs when 1 is removed or becomes nonfunctional 24. Give explanation of the dystrophic and sclerotic processes in hypertrophied myocard. use facts of electronic microscopy in your answer. (p=4) -Hypertrophied cells have increased oxygen demand over supply causing hypoxia: fatty dystrophy -Hypertrophy of the nucleus, increase in ER vesicles and injury to the myocardium with organisation leads to cardiosclerosis 25. Specify stage names of functional states in hypertrophied heart. (p=2) -Tonogenic -Tonogenic dilatation (compensation) -Myogenic -Myogenic dilatation (decompensation) (decompensation) 26. What is the term of liver with the atrophy and lipofuscin accumulation in hepatocytes? (p=1) -Brown atrophy of the liver 27. Name of forms in wound healing. (p=4) -Healing by first intention -Healing by secondary intention -Healing under crust -Healing with epithelisation 28. What is keloid? (p=2) -It is a type of skin scar characterised by and overgrowth of fibrous tissue in the scar Unit8: Exudative Inflammation 1. Name pleura, peritoneum, muscle, skin inflammations. (p=4) -Pleuritis, Peritonitis, Myositis, Dermatitis
2. What is inflammation? [give Davidovsky‟s definition] (p=10) -It is a complex, local, cyclic, vascular, mesenchymal reaction of the organism developed during the process of evolution -This is a response to lesion, leading to the elimination of initial causative agent with regeneration of tissue as the completion phase 3. What is abcess? (p=5) -It is a focal suppurative inflammation with breakdown of tissue and formation of a cavity enclosed by a pyogenic membrane 4. Name types of exuadative inflammation. (p=6) -Serous -Fibrinous -Hemorrhagic -Purulent -Catarrhal -Mixed -Putrid/rotten 5. What is e mpyema? (p=3) -It is a form of suppurative inflammation of the wall of an anatomical cavity (e.g. peritoneal cavity) with accumulation pus in the cavity 6. What is phlegmona? (p=3) -It is a diffuse purulent exudative inflammation inflammation of friable connective tissue 7. In postmortem child examination there was found very increased heart with fluid accumulation in pericardial sac, thick epicardium covered with friable gray colour and spongeous form. Name the process. Give figurative name of the process of this case. Specify diseases and conditions when this process is observed. (p=6) -Name: Fibrinous pericarditis -Figurative name: Heairy heart -Conditions: Uremia, Rheumatism, Complication of TB, Transmural myocardial infarction, fibrinous lobar pneumonia
-Endometritis, -Endometritis, Mediastinitis, Mesaortitis, rhinitis (respectively) (respectively) 16. Name forms of acute catarrh in mucous membrane. (p=3) -Hemorrhagic -Serous -Purulent 17. What is the term for suppuration process? (p=1) -(Purulent) Inflammation 18. Specify biologic etiology of inflammation. (p=5) -Viruses -Bacteria -Fungi -Protozoa -Immune complexes -Animal parasites 19. Name purulent inflammation in the tissue of nail couch. (p=1) -Paronychia 20. What is the name of internal membrane in the abscess? (p=1) -Pyogenic membrane Unit 9: Productive Inflammation and Immunopathological Immunopathological Processes 1. Specify cell taking part in production inflammation. (p=6) -Epithelioid cells -Macrophages -Plasma Cells -Fibroblasts -Lymphoid cells -Histiocytes
2. Identify definition of production inflammation. (p=3) -It is a type of inflammation characterised by infiltration and proliferation of cells from histiogenous and hematogenous origins; with a predominance predominance of the process of proliferation over alteration and exudation
8. What do prefixes „peri‟ & „para‟ mean in terms, designating inflammations? Give 1 example of each. (p=4) -Peri: Inflammation of the serous membrane of an organ (perimetritis) -Para: Inflammation fatty tissue surrounding an organ (paranephritis)
3. What granulomas are named specifically? (p=5) -Granulomas -Granulomas have special concrete morphologic morphologic structure caused by special types of infections agents and often have necrosis in the central part
9. Give the definition of exudative inflammation. (p=4) -It is a form of inflammation, characterised by the predominance of exudation over alteration and proliferation proliferation
4. What morphological sign predominates in the source of productive proliferation? (p=1) -Proliferation -Proliferation of cells
10. Give terms of the inflammation of arterial wall and internal, external and idle arterial membranes. (p=4) -Arterial wall: arteritis -Internal: endarteritis -Middle: Mesarteritis -External Periarteritis
5. In microscopic examination of the heart, in myocardial stroma inflammatory cellular infiltrate are found. They consisted of lymphoid cells, histiocytes, fibroblasts and plasma cells. What diagnosis follows? (p=3) -Interstitial productive myocarditis
11. What is pus? Give its composition. (p=5) -Pus is an inflammatory exudate which contains leukocytes (mostly neutrophils), parenchymal parenchymal cell debris, microorganisms and pus bodies 12. Mucous membrane of child‟s larynx is edematous, hyperemic with removable gray film. Name of the process. Specify the disease with the process observed. What does the process result in? (p=3) -Process: Croupous laryngitis -Disease: Diphtheria -Result: Asphyxia 13. Give terms of the inflammation in liver, stomach mucous, in large intestine and urinary bladder. (p=6) -Liver: Hepatitis -Stomach mucous: Gastritis -Large intestines: Colitis -Urinary bladder: Cystitis 14. During postmortem examination you can see: thigh bone with local destruction of cortical coat, marrow channel filled with green purulent mass with free scraps of the bone. Name process in the bone and these free scraps of the bone. (p=2) -Process: Osteomyelitis -Name of scraps: Sequestra 15. Name the inflammation in mucous membrane of uterus corpus, in cellular fatty tissue of the thorax, in middle membrane of the aorta, mucous membrane of nose. (p=4)
6. Give names of possible consequences of tuberculous granulomas. (p=2) -Total necrosis -Sclerosis -Calcification -Encapsulation 7. Present manifestation form of productive inflammation. (p=4) -Interstitial -With polyp formation -Granuloma -Inflammation -Inflammation around animal parasites 8. What is the nature of autoimmune reaction progress in immunopathologic immunopathologic processes? (p=2) -It is immunity against own tissue(own antigen), and causes rejection of transplantation transplantation and hypersensitivity 9. Which type of immune reaction progress in immunopathologic immunopathologic process? (p=2) -Humoral Immunity -Cellular Immunity Unit 10: Mesenchymal Tumour 1. Name tumors of skeletal and smooth muscles. (p=4) -Skeletal: Rhabdomyoma, rhabdomyosarcoma -Smooth: Leiomyoma, leiomyosarcoma
-It is a malignant tumour derived from mesenchymal tissues 2. During postmortem examination, the tumor is found in the area of left thigh. The tumor looks like “fish flesh”. The tumor grows from thigh bone, with invasion in the surrounding tissue. Diagnose it according to gross evidences. What is the spread pathway of this tumor? Where does primary metastasis localize? What is manifestation of its general influence of organism? -Diagnosis: Osteosarcoma -Spread: Hematogenous pathway -Primary metastasis: lung -Influence: -Influence: Cachexia 3. What is biologic atypism of tumor characterized by? (p=5) -Progressive growth -Autonomous -Infiltrative -Gives metastasis -Able to be transplanted from 1 host to another in experiments examination, the tumor is detected in the uterus. 4. During postmortem examination, The tumor consists of polymorphic atypical smooth muscle cells. Name this tumor, its spread pathways, localization of primary metastases, the cause of death. (p=5) -Diagnosis: Leiomyosarcoma Leiomyosarcoma -Spread: Hematogenous pathway -Metastasis: Lung -Death: Hemorrhage and cachexia 5. Specify pathway of tumour spread. (p=4) -Lymphogenic -Hematogenic -Perineural -Contact 6. Name all possible variants of tumour growth. (p=6) -Expansive -Invasive -Multicentric -Unicentric -Endophytic -Exophytic 7. During histology examination, there are found growth of filaments with collagen fibres and cells of connective tissues with predominance over fiber structures and tissue atypism signs in derma of the skin. There is marked border of the above mentioned changes. What is your diagnosis? Name growth type and malignant analogue. (p=4) -Diagnosis: Fibroma -Growth: Expansive -Malignant analog: Fibrosarcoma 8. What is the capillary hemangioma? Describe its microscopic structure. (p=4) -Hemangioma is a benign tumour of capillary blood vessels -It is lobulated, unencapsulated, aggregated in closely packed thin-wall capillaries, lined with several levels of flattened endothelium -Separated by scant connective tissue stroma 9. Name localisation of leiomyomas according to layers of uterus walls. (p=3) -Submucous -Subserous -Intramural 10. What is fibroma? (p=2) -It is a benign tumour of fibrous connective tissue 11. The patient died of malignant tumor originated from thigh bone. Where first metastasis are to be looked for? (p=1) -Lungs 12. What is fibrosarcoma? Describe its microscopic structure and nature of growth according to surrounding tissues. (p=4) -Fibrosarcoma -Fibrosarcoma is a malignant tumor of connective tumour. -Microscopically: -Microscopically: Constructed from pleomorphic atypical connective tissue with hyperchromatic nuclei -Growth: Invasive 13. Name general tumour groups according to degree of the maturity. (p=2) -Malignant (less mature) -Benign (more mature) 14. What is sarcoma? (p=2)
15. What is anaplasia (cataplasia)? (p=1) -It is the reversion of differentiation of tumours from a higher level to lower level Unit 11: Epithelial Derived Tumours 1. During microscopic examination, the tumour is found in the bronchial biopsy evidence. It is constructed with nest accumulations of atypical squamous cells with features of “pearls”. Name the tumour and explain the possibility of tumour onset in this construction of bronchi. (p=6) -Name: Squamous cell carcinoma of the bronchus (bronchiogenic carcinoma) plus keratinisation -Onset: Metaplasia from chronic bronchitis + chronic inflammation
2. Specify microscopic picture of squamous carcinoma. (p=4) -Multiple nest-like structures consisting of atypical polygonal cells with keratinisation in the structural centre called „keratin pearls‟ 3. Name ovarian malignant tumours. (p=5) -Arrhenoblastoma -Cellular granulation carcinoma -Cystadenocarcinoma -Brener‟s carcinoma carcinoma -Malignant teratoma 4. Name organs from which metastases are in bones. (p=5) -Tumour of lungs, mammilary glands, prostate glands, kidneys, thyroid glands 5. Where are the first hematogenous and lymphogenous metastases of carcinoma in stomach looked for? (p=3) -Hematogenous: -Hematogenous: liver -Lymphogenous: Lymph nodes of small and large curvature of stomach 6. Explain the progress of aspiration pneumonia of the patient with carcinoma of esophagus. (p=3) -Formation of fistula between trachea and esophagus and aspiration of vomitus/food vomitus/food into the lung will cause aspiration pneumonia 7. What is carcinoma? Specify most typical pathway of carcinoma to differ from sarcoma. (p=4) -Carcinoma is a malignant epithelial-derived tumour with cellular and tissue atypism -which gives metastases through lymphogenic and hematogenic pathways, -more commonly lymphogenic 8. Name most typical localisation of esophageal carcinoma. (p=3) -Proximally: -Proximally: Cricoid cartilage -Medially: Crossing of the left principal bronchus -Distally: Where the esophagus penetrates the diaphragm 9. Name gross (macroscopical) types of stomach carcinoma. (p=4) -Polyp-like -Plaque-like -Fungus-like -Diffuse -Flat -Excavated (Ulcer-like) 10. During postmortem examination metastases of the carcinoma in the liver are found. They are considered first hematogenous metastases of tumor. What are organs to be searched for primary tumour? (p=3) -Stomach -Pancreas -Esophagus 11. Specify preinvasive form of endocervical carcinoma in the uterus. (p=1) -Cancer in situ 12. The ovary has been supplied as a biopsy samples. It is presented by gross cyst about 20cm in diameter with a fluid and heavy papillary projection with white cauliflower tissue remainder. Microscopically papillaries of the tumour are covered by columnar epithelium with nuclear hyperchromia and mitosis. On the separate sections adenous complex grows through cystic wall. Specify the tumour. (p=3) -Tumour of papillary cystadenoma 13. What is the term for malignant tumour of epithelial origin? (p=1) -Carcinoma
14. Specify histological variants of esophageal carcinoma. (p=3) -Squamous cell carcinoma (with/without keratinisation) -Adenocarcinoma -Undifferentiated 15. A female with uterus bleeding developed in post climacteric period. Diagnostic scrape is executed from uterus. Atypical adenous structure with marked cellular atypism is observed. Specify your diagnosis. (p=2) -Adenocarcinoma of the uterus 16. Designate the localisation of primary hematogenous metastases from carcinoma of stomach, pancreas, sigmoid colon, uterus. (p=4) -Stomach-> Liver -Pancreas-> Liver -Sigmoid colon-> Liver -Uterus-> Lungs adenocarcinoma. (p=3) 17. Describe microscopic picture of adenocarcinoma. -It is characterised by pleomorphic glandular tumour cells with hyperchromatic hyperchromatic nuclei and cellular atypism. -High mitotic activity and invades the surrounding tissue without a clear border
18. Give the characteristics of fibroadenoma in accordance with following points: tumour histogenesis, degree of the cell maturity, atypical form, 2 histologic types in female breast, its malignant analogous form. (p=6) -Tumour histogenesis: histogenesis: epithelium of ducts of the breast -Degree of cell maturity: Mature -Atypical form: Tissue atypism -Histologic -Histologic forms: Pericanalicular, Intracanalicular Intracanalicular -Malignant analogue: Adenocarcinoma 19. Give the characteristics of papilloma in accordance with tumour histogenesis, degree of cell maturity, atypical form of tumour and its malignant analogous form. (p=5) -Tumour histogenesis: Squamous/transitional Squamous/transitional epithelial cells -Degree of cell maturity: Mature -Atypism: Tissue atypism -Malignant analogue: Squamous epithelial carcinoma 20. Name growth forms of cervix carcinoma. (p=3) -Endophytic -Exophytic -Mixed 21. Name most typical form of endometrial carcinoma according to microscopic assay. (p=2) -Adenocarcinoma -Undifferentiated -Undifferentiated tumour 22. Female breast biopsy sample is sent for urgent pathohistologic examination. A piece of very solid white tissue with infiltrative attachment to the surrounding fatty cellular tissue is presented. Microscopically, the tumour is found with the stroma predominance over parenchyma. Tumor parenchyma consists of small groups with individual non-differentiated epithelial cells. Name tumour histology forms and most typical localization of metastases with the tumours of female breast. (p=6) -Histological forms: Schirrous -Metastases: Axillary nodes, Infraclavicular nodes, Supraclavicular nodes, Parasternal nodes, Nodes in the anterior mediastinum Unit 12: Tumours of the Nervous System 1. Multiple of round nodes are determined in the skin of patient. One of them is extracted and sent for histologic examination. The tumour is detected by microscopic examination. It consists of connective tissue and partially remained nervous fibres. Name this tumour, disease according to multicentric tumour growth. Give the name of the scientist to describe this desease. (p=3) -Tumour: Neurofibroma -According to tumour growth: Neurofibromatosis -Scientist: von Recklinghausen
2. Name malignant tumour developed from pigmented nevus. (p=1) -Melanoma 3. During postmortem examination, the tumour is found in white substance of brain hemispheres. The tumour is of mixed colours without marked border with surrounding tissues. During histology
examination, there are found immature glial cells of various forms in the tumor. There are marked fields of necrosis and hemorrhages. Specify your diagnosis. (p=3) -Glioblastoma -Glioblastoma multiforme
4. Name main immature neuroectodermal tumours of CNS. (p=5) -Medullablastoma -Glioblastoma -Ependymoblastoma -Choroidcarcinoma -Neuroblastoma 5. Name tumours with peripheral nervous system. (p=3) -Neurofibroma -Schwannoma -Neurofibrosarcoma 6. Specify localisation of melanoma. (p=5) -Skin -Mucous membrane -Pigmented membrane of the eyes -Meninges -Esophagus ADDITIONAL QUESTIONS 1. Common benign tumour during childhood. -Hemangioma -Teratoma -Lymphangioma
2. Common malignant tumour during childhood. -Neuroblastoma -William‟s tumour (nephromatoma) -Acute leukemia 3. Close relationship between abnormal development (teratogenesis) and tumour induction (oncogenesis) during childhood. -Prevalence of constitutional genetic abnormalities -Syndromes predisposing to malignant tumours 4. Reversion. -Tendency of malignant tumours to spontaneously regress to benign tumours and improve survival rate and treatment of many childhood tumours 5. Characters of tumours of infancy and childhood. -Reversion -Benign tumour predominance -In malignant tumours, sarcomas are more common -Embryonic tumours predominate Unit 13: Tumours of the Blood System 1. During postmortem examination, pyoid marrow, large spleen(5kg), enlarged liver (4kg) are found. Blood test shows 70 000 leukocytes in 1 ml, general mass of them were consists of promyelocytes, myelocytes, myelocytes, metamyelocytes. What is the disease under review? (p=2) -Chronic Myelocytic Leukemia
2. The deceased has black disintegrated nasopharyngeal glands in leukemia. Name glandular process and specify microflora in the process. Explain initiation of the process with deceased. (p=4) -Name: Necrotic Angina -Microflora: Saprophytic flora -Initiation: Due to infiltration of leukemic cells leading to secondary infection (non-responsive immune system)
3. Why are spleen and lymph nodes enlarged in le ukemias? (p=1) -Due to abundant spread of leukemic cells (metastasis) 4. Give definition of leukemia. (p=3) -It is a tumour of hemopoietic and lymphoreticular system characterised by neoplastic proliferation proliferation of the formed elements of the systems 5. What is leukemic infiltration? (p=2) -It is local metastasis with growth of leukemic cells 6. Name microscopical changes in spleen, lymph nodes and marrow with myeloleukemias. myeloleukemias. (p=3) -Spleen and lymph nodes: Enlarged, and increased leukemic infiltration with predominance of promyelocytes and myelocytes -Bone marrow: pyoid
7. Specify pathway of tumour spread. (p=4) -Lymphogenic -Hematogenic -Perineural -Implantation
ADDITIONAL QUESTIONS : UNIT (8) 1. Phases of inflammation. 1st: alteration nd 2 : exudation 3rd : proliferation 2.
8. Identify common types of chronic leukemias with respect to cytogenesis. (p=4) -Chronic Lymphocytic Leukemia (CLL) -Chronic Myelocytic Leukemia (CML) -Chronic Monocytic Leukemia -Polycythemia -Polycythemia Vera
3.
9. What is the disease with Philadelphia chromosome found? (p=1) -CML 10. Why do infections complication develops easily in leukemias? (p=2) -Due to decreased function of of immune system because to non-responsive WBC 11. During postmortem examination, enlarged lymph-rich nodes and glands are found in various areas of organism. There are 1,100,000 leukocytes/ml in blood test, mainly lymphoblasts. What is the disease? (p=4) -Acute Lymphocytic Leukemia 12. The patient has necrotic gingivitis, tonsillitis with a great number of hemorrhages on the skin. There are 150,000 leukocytes/ml leukocytes/ml in blood test, among them 90% nonmature cells without cytochemical identification. What is the disease described here? (p=2) -Undifferentiated -Undifferentiated Leukemia
4.
5.
17. Designate types of acute leukemias according to cytogenesis. (p=4) -Undifferentiated -Undifferentiated Leukemia -Acute Myeloblastic Leukemia (AML) -Acute Lymphoblastic Leukemia (ALL) -Acute Monoblastic Leukemia
2. Classification of anemia according to pathogenesis. -Posthemorrhagic -Posthemorrhagic anemia -Hemolytic Anemia -Imparied RBC Production 3. What is radiation injury? -It is the injury due to gamma, X-ray and ionising particles (alpha,beta) that causes alteration of cells due to direct/indirect damage of the DNA
Diseases of croupous tracheitis. Diphtheria Uremia
6.
Localization , gross, outcome and deepness of diphtheric inflammation. Localization : squamous, transverse epithelium (multilayer membrane) Deepness : deep necrosis Gross : cover by thick films that difficult to remove Outcome : ulceration & organization with scar of ulcer -
7.
Localization, gross ,outcome and deepness of croupous inflammation. Localization : cuboidal, columnal epithelium (single layer) Deepness : superficial injury Gross : gray friable films that easily removed Outcome : fully recover/ restoration of normal tissue structure
8.
TASK : Uterus enlarge, cavity cavity widened, mucous membrane membrane saturated with yellow green exudates. Name the disease. p=3 Postpartum purulent endometritis -
9.
TASK : Appendix is red, swollen and covered with a fibrinous exudates. The wall may be very thin with pus into lumen of appendix. Name the disease.p=3 Phlegmonous Phlegmonous purulent appendicitis -
10.
* inflammation of : Whole wall of artery : panarteritis panarteri tis Pia mater : leptomeningitis Membrane of brain : meningitis Bile duct : cholangitis Gall bladder : cholecystitis -
18. Specify histological variants of lymphogranulomatosis. lymphogranulomatosis. (p=4) -With lymphocyte predominance -Mixed cellularity -With Lymphocyte depletion -With Nodular sclerosis ADDITIONAL QUESTIONS 1. Factors of acquired hemolytic anemia -Rhesus disease of newborns -Malaria -Systemic Lupus Erythromatosus (SLE) -Thrombotic Thrombocytic Purpura (TTP) -Disseminated Intravascular Coagulation (DIC)
Organs and tissues with serous inflammation. P=4 Meninges Parenchymal organs ( lung ,kidney & heart) Peripheral nerves Peritoneal, pleural & pericardial c avities
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15. What is myeloblastic leukemia? (p=2) -It is a type of a cute leukemia characterised characterised by an i ncrease in myeloblasts
16. Identify two groups of hemoblastosis according to spreading in the hematopoietic system and give concrete terms of each. (p=4) -Leukemia: Systemic disease, charaterised by leukemic infiltration in peripheral blood flow, bone marrow and other hemopoietic organs -Lymphoma: -Lymphoma: Regional tumour of lymphoreticular lymphoreticular tissues i.e. lymph nodes
Outcome of inflammation. Necrosis Regeneration Scar formation Obliteration Organization Calcification -
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13. Why is „tiger heart‟ observed in leukemia? (p=2) -Due to increased destruction of RBCs and hypoxic organ damage 14. What cells have diagnostic significance in granulomatosis? granulomatosis? (p=1) -Reed-Sternberg-Borosovsky cells
Outcome of serous inflammation. P=2 Resolution with complete recovery of structure Progression to fibrinous or purulent inflammation
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ADDITIONAL QUESTIONS : UNIT (9) 1. Diseases of specific granulomatous productive inflammation. P=4 Tuberculosis Syphilis / lues Leprosy Scleroma 2.
Diseases of non-specific inflammation. P=3 Brucellosis Tularemia Sarcoidosis Typhus fever -
granulomatous
productive
3.
Classification according predominant of cell type for granulomatous granulomatous inflammation. Epitheloid granuloma Macrophage granuloma Giant cell granuloma -
4.
Organs of interstitial inflammation. Kidney Lung Heart Liver
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5. 5.
Etiology / causes of proliferative inflammation. Physical factor Chemical factor Biological factor Immune factor -
6.
What process come before granulomatous productive inflammation? P=1 Necrosis -
6.
Classification of productive inflammation according to duration. Acute Chronic -
7.
7.
8.
9.
11.
Definition of exophytic and endophytic tumor. Exophytic : tumor growth into the lumen of hollow organs ( Eg. : leiomyosarcoma in lumen of uterus ) Endophytic : tumor growth in the wall of hollow organ ( Eg. : cervix with carcinoma )
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Syphilis granulomatous Name : gumma Size : 1-2 cm Cell type : plasma cells, epitheloid cells,lymphoid cells(Tlymphocytes) Type of necrosis : caseous necrosis -
Definition of unicentric and multicentric tumor. Unicentric : 1 place of tumor growth Multicentric : 2 or more place of tumor growth
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Types of hemangioma and its malignant analog. Types : Carvenous hemangioma Capillary hemangioma Glomus / venous angioma Malignant analog : hemangiosarcoma hemangiosarcoma -
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8.
Tuberculosis granulomatous 1-2 mm Cell type : epitheloid cells, lymphoid cells, Piragov‟s cells, Langerhan‟s cell Type of necrosis : caseous necrosis -
States the secondary complication ( metastasis ) Hyalinosis Hemorrhage within node Edema within node Calcification Venous hyperemia -
9.
States the secondary changes of malignant tumor Necrosis Hemorrhage Dystrophy Formation of fistula between organs Thromboembolism / thrombosis -
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10.
Infiltrative growth Cellular & tissue atypisms With metastasis With recidives
The function of macrophage in tuberculosis granuloma. P=1 Phagocytosis ( to phagocytose the bacteria) Definition of interstitial inflammation. Diffused inflammation localized / infiltrate in stroma of organ.
of
benign
tumor
12.
13.
14.
11.
TASK : Lung inflate being “ fluffy”. Pleura and tissue consist multiple millet like grey yellow hillocks. Name the disease , define the “hillocks” and its morphological structures. Disesase: millet tuberculosis of lung Define of “ hillocks” hillocks” : tuberculosis granulomas granulomas Morphological structures : center caseous necrosis, surround by epitheloid cells, then giant polynuclear Piragov & Langerhan‟s cells, lastly lymphoid cells outside. of
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3.
4.
12.
5 charactieristics of benign tumor. Mature Expansive growth Tissue atypism Without metastasis Without recidives
5 characteristics of malignant tumor. Immature -
Characteristic of chondrosarcoma. chondrosarcoma. Immature cellular & tissue atypism Invasive growth Give recidives Capable for metastasis -
ADDITIONAL QUESTIONS : UNIT (12) 1. Mature tumor of neuroectodermal of CNS. P=5 Ganglioneuroma Astrocytoma Oligodendroglioma Ependymoma Choroid papilloma 2.
Basic morphological sigms of cellular atypism. Various shape & size of cells and nuclei Atypical mitosis Ratio cytoplasm to nuclei ( nuclei > cytoplasm volume) Hyperchromatic Hyperchromatic nuclei -
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Classification of tumor atypism. Morphologic Antigenic Histochemical Biological
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heart
ADDITIONAL QUESTIONS QUESTIONS : UNIT (10) 1. What is metastasis and mechanism of its basis. P=5 Apprearance of secondary tumor foci in other tissue or organs far away from the primary foci. Mechanism is by the tissue embolism 2.
States the secondary changes of tumor. Necrosis Inflammation Cyst formation Dystrophic Dystrophic changes Hemorrhage
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Classification of granulomas. Etiology : infection Non-infection Unknown Morphology : specific Non-specific
Localization of productive inflammation ( interstitial myocarditis) and its outcome. Localization : myocardial stroma Outcome : diffuse cardiosclerosis -
10.
Juvenile angiofibroma in nasopharynx. P=7 Consistency : solid Maturity : mature Growth : infiltrative growth Recidive : yes Metastasis : no Reversion : yes Location : nasopharynx
3.
TASK: Biopsy 1 st result= ganglioneurofibroma, ganglioneurofibroma, after 2 years, biopsy again and get the result of ganglioneuroma. What is your conclusion. P=2 Reversion, as ability changing from malignant tumor to benign tumor during childhood when cells with high mitotic activities.
4.
5.
6.
Tumor derived from embryonic tissue. P=1 Teratoma Tumor derived from embryonic embryonic cambial cell. Medulloblastoma Retinoblastoma Neuroblastoma -
6.
Classification of lymphomas Non-Hodgkin lymphoma – small lymphocytic, large cell, lymphoblastic, lymphoblastic, Berkitt‟s lymphoma
7.
4 patterns of of leukemia ALL AML CLL CML -
Tumor derived from meninges. P=2 Meningeoma Meningiosarcoma/ Meningiosarcoma/ malignant meningeoma meningeoma
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8. 7.
Name the synonymal melanoma Melanocarcinoma & malignant melanoma -
8.
Tumor predominant in children. P=5 Hemangioma Teratoma Nevus Nephroblastoma ( William‟s tumor ) Acute leukemia Neuroectodermal tumor sources for histogenic examination. P=5 Medulloblast Ganglion nerve cells Glial cells Choroid epithelium Epidermal glial cells -
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9.
10.
Specify types of nevus. P=5 Dermal Epidermal Mixed / epidermal-dermal Blue epitheloid
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State of maturity of leukemic cells
Define acute leukemia Characterized by replacement of bone marrow with immature cells (termed “ blasts” leukemia)
9.
Define chronic leukemia Characterized by replacement of bone marrow with mature cells (termed “ cystic” leukemia)
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10.
What is lymphogranulomatosis? lymphogranulomatosis? Is a malignant tumor of lymphoid tissues with lesion of lymph nodes & other organs characterized by growth of giant cells, Reed- Stenberg-Beresovsky & inflammatory infiltration.
11.
Specify tissue with high radiosensitivity. Bone marrow Hair follicles Thymus Genital organs Lymph nodes Epithelium of mucous membrane -
12.
Name the findings of blood test in acute leukemia. Appearance of numbers of blast cells
11.
TASK: Biopsy skin for ulcer with healing retardation, tumor large atypical cells. Large nuclei with mitosis , with brown pigmwnt melanin cytoplasm.Name the tumor and its precursor. Tumor: melanoma Precursor : nevus -
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14. 12.
13.
Childhood tumor according to ontogenesis Like adult As teratoma Embryonic group TASK : During postmortem examination examination of child ,the tumor in cerebellum. Tumor without border with surrounding tissues. Microscopically, poorly differentiate of neuroectodermal tumor. Give your diagnosis. Describe microscopic picture. Diagnosis : medullablastoma Microscopic : atypical cells, high mitotic activity & hypochromatic hypochromatic cells.
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16.
18.
Character of blood loss Acute ~ trauma Chronic ~ lesion in GIT , gynecologic disturbance -
3.
Classification of hemolytic anemia. Intrinsic RBC abnormalities- acquired & hereditary Extrinsic RBC abnormalitiesabnormalit ies- membrane defect (paroxysmal nocturnal hemoglobinuria )
4.
5.
Classification of impaired RBC production Disturbance in proliferation & maturation of stem cells Disturbance in proliferation & maturation of erythroblasts Classification of leukemia Basic cell types ( cytogenesis)
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Specify cause of death in radiation sickness. Shock Anemia Infectious disease Hemorrhagic syndrome
Name clinical morphological form of acute radiation sickness. P=4 Bone marrow form Cerebral form Intestinal form Toxic form Term foci of leukemia accumulated in organs. Leukemic infiltration / leukemic metastasis
19.
2.
Specify classification of radiation sickness according to disease cause Acute Chronic -
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Specify sarcoma of childhood and infancy tumors. Osteosarcoma Lymphosarcoma -
ADDITIONAL QUESTIONS : UNIT (13) 1. What is anemia? A reduction reducti on below normal limits of total circulatin g RBC mass
Name the primary organ where leukemia begins. Bone marrow
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17. 14.
Specify main infectious complications in l eukemia Pneumonia Sepsis Purulent inflammation
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Low sensitivity tissue to radiation. Cartilage Connective tissue Vessels Peripheral nerves Bone
20.
Method of histological differentiation.
21.
Splenomegaly, hemorrhagic syndrome, blood test normal, sterna puncture review megaloblast bone marrow.Name the disease and type of it according the result of blood test. Disease: Acute myeloblastic leukemia Type : aleukemic variant -
22.
Classification according to number of leukocytes & leukemic cells. P=4 Leukopenic Leukemic Aleukemic Subleukemic -
23.
Causes / factors of leukemia. leukemia. P=5 Physical- ionizing radiation Chemical- drug, toxin Hereditary Medical agents- carcinogens -
24.
Name the necrotic tonsillitis according to pathological change. Name of multidenous hemorrhage and mechanism. P=5 Acute lymphoblastic leukemia. Wet gangrene. Hemorrhagic syndrome . per diapedesin.
25.
Pathway of spread of leukemia. P=2 Hematogenic Lymphogenic
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26.
27.
Spleen in Hodgkin disease.p=4 Neoplastic proliferatio proliferation n site of necrosis & sclerosis. “ porphyric” spleen Most sensitive organ of acute radiation sickness. Bone marrow
28.
Definition of radiation sickness. P=3 Is injury produced by ionizing radiation over limiting permissible dose.
29.
Synonyms of lymphogranulomatosis. lymphogranulomatosis. P=1 Hodgkin disease (lymphoma) -
30.
Bleeding of brain , medulla oblongata 1cm bleeding. Bone marrow grey green color.Name the disease, syndrome and causes of death. Disease : Acute leukemia Syndrome: Causes of death: hemorrhage & infection -
