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NEETMDS- Pathology short notes

NEET MDS Shorts

776926
Pathology

Extensive cellulitis is most accurately described by the term "phlegmon
Phlegm is a thick, viscous substance produced by the respiratory tract,
especially during a respiratory infection, which can be coughed up from the
lungs or expelled from the nose. It is primarily composed of mucus, dead cells,
and other substances.
Phlegmon is a term that is closely related to extensive cellulitis. It refers
to a severe form of cellulitis where the infection has spread deeply into the
subcutaneous tissues and is accompanied by significant inflammation, including
the presence of pus and necrosis. Phlegmon is characterized by intense pain,
swelling, redness, and warmth in the affected area. This condition often
requires aggressive medical management, including intravenous antibiotics and
surgical drainage if an abscess forms. It is an advanced and severe stage of
cellulitis that can lead to systemic infection if not treated properly.

414380
Pathology

Tumour cells have genetic alterations which result in expression of nonself proteins: This is the most accurate statement regarding immune surveillance. Tumor cells often undergo genetic mutations that lead to the expression of abnormal proteins (neoantigens) that are not present in normal cells. These nonself proteins can be recognized by the immune system as foreign, triggering an immune response. This recognition is a key aspect of how immune surveillance functions effectively against tumors.

115498
Pathology

The newly formed collagen in the scar tissue is arranged differently compared to the organized collagen fibers in the unwounded skin, leading to a weaker structure. The 70-80% tensile strength is typically what is seen in well-healed sutured wounds. This remaining deficit is because scar tissue is less elastic and more prone to dehiscence (reopening) under tension compared to normal skin.

763586
Pathology

Gas Gangrene, also known as clostridial myonecrosis or anaerobic cellulitis,
is a severe and rapidly progressing form of necrotizing soft tissue infection
caused by the bacterial genus Clostridium. The condition is characterized by the
production of gas within the tissues due to the fermentation of carbohydrates by
the bacteria. The most common species implicated in gas gangrene is Clostridium
perfringens.

1. Clostridium tetani: This bacterium is the causative agent of tetanus, which
is a neurotoxic disease that leads to muscle spasms and rigidity. It is not
directly associated with gas gangrene, although both are anaerobic infections
that can occur in deep puncture wounds and both produce exotoxins. However, the
primary symptom of tetanus is muscular rigidity and spasms due to the production
of tetanospasmin, not the tissue destruction and gas production seen in gas
gangrene.

2. Clostridium perfringens: This is the most common cause of gas gangrene. C.
perfringens produces alpha toxin, which is a powerful enzyme that can break down
tissue and release gas as a byproduct. The infection typically occurs in the
deep layers of the skin and muscles following a severe trauma, surgery, or
burns, where there is a lack of oxygen, allowing the anaerobic bacteria to
thrive. The rapid spread of infection is due to the bacteria's ability to
produce multiple exotoxins that cause tissue necrosis and vasoconstriction,
leading to ischemia and further tissue damage.

3. Clostridium difficile: Although a member of the Clostridium genus, C.
difficile is mainly associated with antibiotic-associated diarrhea and
pseudomembranous colitis. It is a hospital-acquired infection that affects the
intestinal tract and is not typically involved in causing gas gangrene. While it
is an anaerobic bacterium, its pathogenicity is primarily due to the production
of toxins that damage the colon's mucosal lining rather than invading tissues
outside the gut.

4. Peptostreptococci: These are anaerobic bacteria that can be part of the
normal skin and mucosal flora. They are involved in various infections,
particularly in immunocompromised individuals or those with underlying medical
conditions. Peptostreptococci are more commonly associated with mixed anaerobic
infections such as abscesses, osteomyelitis, and other soft tissue infections,
but they are not typically the sole cause of gas gangrene.

748440
Pathology

Diapedesis is a critical process in the body's immune response, particularly in the context of inflammation.

757861
Pathology

Enlarged hypersegmented neutrophils are typically seen in Megaloblastic
anemia (option 3). Here is a detailed explanation:

1. Leukopenia: Leukopenia is a condition where there is a decrease in the total
number of white blood cells (WBCs) in the bloodstream. It does not directly
refer to the morphological changes in the neutrophils. The presence of enlarged
or hypersegmented neutrophils is not a hallmark feature of leukopenia; rather,
the condition is characterized by a low WBC count.

2. Leukocytosis: Leukocytosis is the medical term for an increase in the number
of white blood cells in the bloodstream. It can occur due to various conditions
like infections, inflammation, or leukemia. However, hypersegmentation of
neutrophils is not a typical finding in leukocytosis. The presence of enlarged
neutrophils is also not characteristic of this condition.

3. Megaloblastic anemia: Megaloblastic anemia is a type of anemia that occurs
due to the lack of vitamin B12 or folic acid. These vitamins are essential for
the maturation of red blood cells in the bone marrow. In the case of vitamin B12
or folic acid deficiency, the red blood cells become large and immature, leading
to their inability to function properly. Additionally, neutrophils, which are a
type of white blood cell, can also become enlarged and hypersegmented in
megaloblastic anemia. The enlarged neutrophils are called "megaloblastic
neutrophils" or "hypersegmented neutrophils." The hypersegmentation occurs due
to the defect in DNA synthesis that results from the vitamin deficiency, causing
the nucleus of the neutrophil to segment more than the normal 2-5 lobes.

4. Acute myeloid leukemia: While acute myeloid leukemia (AML) is characterized
by an overproduction of immature myeloid cells, including neutrophils, enlarged
hypersegmented neutrophils are not a typical feature of this condition. In AML,
the bone marrow is filled with abnormal, immature cells called blasts, which do
not mature properly and function as normal blood cells. However, AML can present
with a variety of morphological changes in neutrophils, such as Auer rods, but
hypersegmentation is not specific to AML.

Enlarged hypersegmented neutrophils are most commonly associated with
Megaloblastic anemia, which is caused by vitamin B12 or folic acid deficiency
and leads to abnormal cell maturation in the bone marrow, affecting both red and
white blood cells.

909424
Pathology

The expansion of the marrow space due to increased hematopoiesis can lead to resorption of the outer cortical bone and the formation of new bone, resulting in the characteristic "crew cut" appearance on X-rays. This appearance is due to the trabecular pattern of the skull becoming more prominent as the outer layer is resorbed.

734447
Pathology


The first vascular reaction in inflammation is Vasodilation.

Explanation:

Inflammation is the body's protective response to tissue injury or infection. It
is characterized by the classical signs of redness (rubor), heat (calor),
swelling (tumor), pain (dolor), and loss of function (functio laesa). The
initial vascular changes in the inflammatory process include:

1. Vasoconstriction: This is a temporary response that occurs immediately after
injury to minimize blood loss. However, it is quickly followed by the more
significant and prolonged phase of vasodilation.

2. Vasodilation: This is the first major vascular reaction in the inflammatory
response. Vasodilation occurs due to the release of substances such as
histamine, bradykinins, and prostaglandins from the damaged tissue cells and
mast cells. These substances are known as vasodilators and they cause the smooth
muscles surrounding the blood vessels to relax, leading to an increase in the
diameter of the blood vessels. This results in increased blood flow to the
injured area, which is essential for delivering white blood cells, nutrients,
and oxygen to the site of inflammation. The increased blood flow is what causes
the characteristic redness and heat of an inflamed area.

3. Increased vascular permeability: Although it is not the first vascular
reaction, increased vascular permeability is a critical component of the
inflammatory process. After vasodilation, the endothelial cells that line the
blood vessels become more permeable, allowing plasma and proteins to leak out of
the vessels into the surrounding tissue. This leads to the formation of an
exudate, which is the accumulation of fluid and proteins that makes up the
swelling (edema) seen in inflammation.

4. Marginisation or Pavementing: This is the process where neutrophils (a type
of white blood cell) move along the walls of blood vessels towards the site of
inflammation. It occurs later in the inflammatory response after the initial
vasodilation and increased vascular permeability. These cells then migrate
through the vessel walls into the tissue to combat pathogens and debris.

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