PrepBank · বিষয়ভিত্তিক প্রশ্ন
Pathology
Pathology
PrepBank · পাতা ৪ / ৭ · ৩০১–৪০০ / ৬৭০
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The ultrastructural changes of reversible cell injury, visible by
electron microscopy, include the following:
1. Plasma membrane alterations, such as blebbing, blunting, and loss of microvilli
2. Mitochondrial changes, including swelling and the appearance of small amorphous densities
3. Accumulation of “myelin figures” in the cytosol composed of phospholipids derived from damaged cellular membranes
4. Dilation of the ER, with detachment of polysomes 5. Nuclear alterations, with disaggregation of granular and fibrilar elements.
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• The thick smear is used to screen for the presence of organisms, and the thin smear is used for species identification.
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Common metabolic causes of coma :
Hypoglycemia
Hyperosmolar nonketotic coma
Diabetic ketoacidosis
Hyponatremia
Uremic coma
Hepatic encephalopathy
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Symptoms
Skin reactions, including hives and itching and flushed or pale skin.
Low blood pressure (hypotension)
Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing.
A weak and rapid pulse.
Nausea, vomiting or diarrhea.
Dizziness or fainting.
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Signs of consolidation -
Inspection - Increased respiratory rate
Palpation- Reduced chest expansion,increased vocal fremitus
Percussion - Dull over affected area
Auscultation - Bronchial bredth sound,Increased vocal resonance
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Ischemia reperfusion injury causes cell injury by :
Reactive oxygen species
IgM complement
Intracellular calcium deposition
Cytokine
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Source of serotonin in acute inflammation -
Platelet
Neuroendocrine cell
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Guillain Barre syndrome ( Acute inflammatory demyelinating polyneuropathy)
Causing ascending paralysis
Disease of perpheral nervous system.
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• HTLV-1: adult T-cell leukemia/lymphoma
• HPV: benign warts, cervical cancer, and oropharyngeal cancer
• EBV: Burkitt lymphomas, B-cell lymphomas in patients with T-cell immunosuppression
• Hepatitis B virus and hepatitis C virus: hepatocellular carcinomas
• H. pylori: gastric adenocarcinoma and MALT lymphoma
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Direct coombs test - Haemolytic autoantibody
Indirect coombs test -
Rh antibody.
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Radiographic abnormalities of Rheumatoid arthritis are:
Periarticular osteoporosis
Marginal joint erosions
Joint subluxation
Joint space narrowing
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Physiological giant cell -
Osteoclast
Megakaryocytes
Syncytiotrophoblast of placenta
Pathological giant cell-
Anaplastic tumors
Hodgkin's disease
Choriocarcinoma
Poorly differentiated astrocytoma
Primary billiary cirrhosis
Giant cell of herpes simplex virus
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Most pulmonary emboli (60% to 80%) are clinically silent because they are small. With time they become organized and are incorporated into the vascular wall; in some cases organization of the thromboembolus leaves behind a delicate, bridging fibrous web.
• Sudden death, acute right heart failure (cor pulmonale), or cardiovascular collapse occurs when emboli obstruct 60% or more of the pulmonary circulation( Large emboli).
• Embolic obstruction of medium-sized arteries with subsequent vascular rupture can result in pulmonary hemorrhage but usually does not cause pulmonary infarction.
• Embolic obstruction of small end-arteriolar pulmonary branches often does produce hemorrhage or infarction.
• Multiple emboli over time may cause pulmonary hypertension and right ventricular failure.
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Clinical features of Achalasia:
• Dysphagia for solids and liquids
• Putrid breath
• High LES pressure on esophageal manometry
• 'Bird-beak' sign on barium swallow study
• Increased risk for esophageal squamous cell carcinoma
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Emphysema is a chronic obstructive airway disease characterized by permanent enlargement of air spaces distal to terminal bronchioles.
It is a component of along with chronic bronchitis.
Subtypes include centriacinar (most common, smoking related), panacinar (seen in α1-antitrypsin deficiency), distal acinar and irregular.
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• Hyperplasia is defined as an increase in the number of cells in an organ or tissue in response to a stimulus.
• Hyperplasia is the result of growth factor-driven proliferation of mature cells and, in some cases, by increased output of new cells from tissue stem cells.
• Physiological hyperplasia occurs in – breast during puberty, liver after hepatectomy
• Pathological hyperplasia occurs in – BPH, wart & endometrial tumour
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Features of extrapyramidal lesion -
Corea
Athetosis
Hemibellismus
Bradykinesia
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Necroptosis -is a hybrid that shares aspects of both necrosis and apoptosis. Morphologically, and to some extent biochemically, it resembles necrosis, as both are characterized by loss of ATP, swelling of the cell and organelles, generation of reactive oxygen species (ROS), release of lysosomal enzymes, and ultimately rupture of the plasma membrane.
Mechanistically, it is triggered by signal transduction pathways that culminate in cell death, a feature similar to apoptosis. Because of these overlapping features, necroptosis is sometimes called programmed necrosis to distinguish it from forms of necrosis driven passively by toxic or ischemic injury to the cell.
Can occur both physiology and pathological condition.
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The 4 cardinal features of TOF -
1. VSD
2.Obstruction of the right ventricular outflow tract
3.An aorta that overrides the VSD
4.Right ventricular hypertrophy
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Causes of portal hypertension :
Obstructive thtombosis of portal vein
Cirrhosis
Nodular hyperplasia of liver
Massive fatty change
Diffuse granulomatous disease
Right sided heart failure
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Causes of -
Osteoblastic metastasis following carcinoma :
Prostate
Breast ( Mixed)
Osteolytic metastasis following carcinoma :
Kidney
Thyroid
Lung
Breast
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Class I - Present in all nucleated cell and platelet
Class II - Present in antigen presenting cell ( Macrophage,B- cell,Dendritic cell)
Class III - Remains free in plasma.
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Superantigen -
Enterotoxin of staphylococcus
Toxic shock syndrome toxin of s.aureus
All toxin of steptococcus
Enterotoxin of bacillus
Enterotoxin of clostridium.
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Pneumothorax -
Inspection - Restricted chest movement
Palpation - Trachea and apex beat shifted to opposite side
Percussion - Resonant percussion note
Auscultation -
Breath sound absent
No added sound
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In kala-azar
Symptoms begin with intermittent fever, weakness, and weight loss.
Massive enlargement of the spleen is characteristic.
Hyperpigmentation of the skin is seen in light-skinned patients (kala-azar means black sickness).
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• The reduction-oxidation reactions that occur during normal metabolic processes.
• Absorption of radiant energy (e.g., ultraviolet light, x-rays).
• Rapid bursts of ROS are produced in activated leukocytes during inflammation.
•. Defects in leukocytic
superoxide production lead to chronic granulomatous disease.
• Enzymatic metabolism of exogenous chemicals or drugs can generate free radicals
• Transition metals such as iron and copper donate or accept free electrons during intracellular reactions and catalyze free radical formation
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Organism causes UTI :
E.coli (most common)
Proteus
Staphylococcus saphrophyticus ( Young women)
Staph.epidermidis
Enterococcus
Klebsiella
Pseudomonas
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Oncogenic RNA Viruses:
1. Human T-cell leukemia virus type 1 (HTLV-1)
– Causes adult T-cell leukemia/lymphoma.
2. Hepatitis C virus (HCV)
– Associated with hepatocellular carcinoma (liver cancer).
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• Tinidazole is better tolerated.
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Multifactorial ( polygenic) inheritance disorders -
Cleft lip and or palate
Congenital dialocation of hip
Congenital heart defects
Gout
Hypertension
Diabetes
Neural tube defects
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Common D/D in acute upper abdominal pain :
Peptic ulcer disease ( most common)
Acute pancreatitis
Acute cholecystitis
Acute inferior MI
Diabetic ketoacidosis .
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Hyperacute rejection:
Occurs within minutes to hours
Due to preformed antibody and complement activation (type II hypersensitivity)
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Causes of transudative oedema :
Protein energy malnutrition
Liver cirrhosis
Malnutrition
Protein losing gastroenteropathy
Causes of exudative ascities :
Heart failure
Cirrhosis
Portal vein thrombosis
Tuberculosis
Peritoneal tumor.