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Tutorial Pathology

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L5: Chronic Inflammation

1. Define chronic inflammation.


- Chronic inflammation is a response to a prolonged duration in which inflammation,
tissue injury, and attempts at repair coexist in varying combinations.

2. What are the causes of chronic inflammation?


- Hypersensitivity diseases.
- Prolonged exposure to potentially toxic agents, either exogenous or endogenous.

3. State the morphological features expected to be seen in chronic inflammatory


conditions.
- Infiltration with mononuclear cells like monocyte and lymphocyte from blood to
site of infection.
- Tissue destruction, induced by the persistent offending agent or by the
inflammatory cells.
- Attempts at healing by connective tissue replacement of damaged tissue,
accomplished by angiogenesis and fibrosis.

4. What are the cells involved in chronic inflammation?


- Monocyte
- Lymphocyte
- Macrophage
- Plasma cells

5. Briefly describe granulomatous inflammation.


- Granulomatous inflammation is a form of chronic inflammation characterized by
collections of activated macrophages often with T lymphocytes, and sometimes
associated with necrosis.
- Granuloma formation is a cellular attempt to contain offending agent that is difficult
to eradicate
- In this attempt, there is often a strong activation of T lymphocytes leading to
macrophage activation which can cause injury to normal tissue.
- The activated macrophage may develop abundant cytoplasm and begin to resemble
epithelial cells and are called epithelioid cells. Some activated macrophages may
fuse, forming multinucleate giant cells.

L7: Cellular Growth Disturbances

1. Give examples of:


a) Physiological hypertrophy and hyperplasia
- Hyperplasia of breast tissue at puberty, during pregnancy and lactation
- Hypertrophy of muscles in athletes
- Hyperplasia of bone marrow cells producing RBC for people at high altitude.
- Growth of uterus during pregnancy.

b) Pathological hypertrophy and hyperplasia


- Hyperplasia of osteoblasts and osteoclasts - Paget’s disease of bone
- Increase in the size of the heart due to aortic stenosis
- Myocardium in hypertension
2. State five causes of pathological atrophy
- Decreased function
- Loss of innervation
- Reduced blood or oxygen supply
- Nutritional impairment
- Hormonal insufficiency

3. Describe how is metaplasia different from dysplasia.

METAPLASIA DYSPLASIA
Transformation of one type of differentiated Presence of abnormal cells within a tissue or
cell into another type of cell organ
Involve epithelial and mesenchymal cells Involve only epithelial cells
Physiological and pathological Pathological
Reversible Irreversible
Occurs due to the alteration of genetic
Occurs due to external stimulus
material

L8: Neoplasia and carcinogenesis

1. List four gross appearance of tumors.


- Sessile
- Pedunculated polyp
- Papillary
- Fungating
- Annular
- Ulcerated

2. What are the two classifications of tumor?


- Benign
- Malignant

3. Tabulate the comparison between benign and malignant tumors.


BENIGN MALIGNANT
Noninvasive of nearby tissue and does Invasive of nearby tissue and may
not spread to other parts of the body spread to other parts of the body
Slow growth rate Rapid growth rate
Less chance to recur Higher chance to recur
The tumor may grow away from the May form a protrusion in early stages
surface but eventually invade underlying tissue
Secrete substances which cause fatigue
Secrete hormones
and weight loss

4. What are the complications that may result from a tumor?


- Compression, invasion, ulceration, or destruction of adjacent structures.
- Metabolic effects due to appropriate or unexpected neoplastic cell products
- Intracranial hypertension
- Pleural effusion
- Intestinal obstruction
- Urinary tract obstruction
L9: Haemodynamic disorders

1. What are the factors that can lead to edema and effusions?
- Edema – net of fluid movement exceeds the rate of lymphatic drainage, fluid
accumulates
- Effusion – serosal surface involved, fluid accumulate within the adjacent body
cavity

2. Differentiate exudates from transudates


EXUDATE TRANSUDATE
Ultra-filtrate of plasma due to
Increased vascular permeability in increased hydrostatic pressure with
inflammatory process normal vascular permeability (non-
inflammatory process)
Congestive cardiac failure Pus
Bacteria present Bacteria absent
High cell count Low cell count
Neutrophils in acute and lymphocyte
Few lymphocytes and mesothelial cells
in chronic inflammation
Non pitting edema Pitting edema

3. List out the causes of hemorrhagic disorders.


- Defect of primary hemostasis
- Defect of secondary hemostasis
- Defect of small blood vessels

4. Differentiate petechiae, purpura, ecchymosis, and hematoma.


- PETECHIAE – pinpoint, round spots that appear on the skin as a result pf bleeding.
Happens due to fungal, viral and bacterial infections.
- PURPURA - red or purple discolored spots on the skin that do not blanch on
applying pressure. Happens when small blood vessel burst causing blood to pool
under the skin.
- ECCHYMOSIS - discoloration of the skin due to rupture of the blood vessels below
the surface of the skin.
- HEMATOMA – collection of blood outside of blood vessels due to injury to the
wall of blood vessel.

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