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NEET MDS Shorts

75369
Pathology

The principal chemical mediator of the immediate phase of acute inflammation is Histamine. Here's a detailed explanation of the options given:

1. Serotonin: While serotonin is a vasoactive substance that can cause blood vessels to constrict or dilate, it is not the primary mediator of the immediate phase of acute inflammation. It is mainly associated with the regulation of mood, appetite, and sleep. In the context of inflammation, it plays a minor role compared to histamine.

2. Histamine: Histamine is indeed the correct answer. It is a potent chemical mediator released from mast cells and basophils in response to injury or antigenic stimulation. Upon release, histamine acts on blood vessels to cause vasodilation, increased permeability, and increased blood flow to the injured area, which are hallmark features of the immediate phase of acute inflammation. This results in the cardinal signs of inflammation: redness (rubor), heat (calor), swelling (tumor), and pain (dolor).

3. Kinin-Kallikrein system: The kinin-kallikrein system is another important mediator of inflammation, but it is more involved in the later phases. When activated, it results in the formation of kinins, such as bradykinin, which contribute to increased vascular permeability and pain. However, it is not the first line mediator in the immediate phase.

4. Complement system: The complement system is a group of proteins in the blood that work with antibodies to destroy pathogens and trigger inflammation. It is a key component of the innate immune response, but its activation and role are more pronounced in the later stages of inflammation rather than the immediate phase. The complement system is involved in the opsonization of pathogens, recruitment of phagocytes, and the formation of the membrane attack complex, which can lyse certain bacteria and cells.

The immediate phase of acute inflammation is characterized by the rapid response to tissue injury, which includes vasoactive changes and increased vascular permeability to allow fluid, cells, and proteins to move into the interstitial space. Histamine is quickly released from mast cells and basophils and acts on H1 receptors of blood vessels to induce vasodilation and increased permeability. This leads to the early symptoms of inflammation, such as swelling, redness, heat, and pain, and is crucial for the initiation of the inflammatory response to protect the body from harm.

81312
Pathology

Head and Neck: The head and neck region includes various structures such as the oral cavity, nasal cavity, pharynx, larynx, and the salivary glands. This region is highly susceptible to carcinomas due to the presence of mucosal surfaces exposed to potential carcinogens. Common types of head and neck carcinomas include:

- Oral Squamous Cell Carcinoma: This is the most common form of head and neck cancer, typically occurring on the tongue, lips, oral cavity, and oropharynx. Risk factors include tobacco use (smoking and smokeless), alcohol consumption, and human papillomavirus (HPV) infection.
- Nasopharyngeal Carcinoma: This cancer arises from the nasopharynx and is often associated with environmental factors such as the Epstein-Barr virus (EBV) infection and dietary habits.
- Laryngeal Carcinoma: Cancer of the larynx (voice box) is often linked to smoking and excessive alcohol intake.

51229
Pathology

Cells die by one of two mechanisms necrosis or apoptosis Two physiologically different processes Necrosis death by injury Apoptosis death by suicide Appoptosis: Disintegration of cells into membrane-bound particles that are then eliminated by phagocytosis or by shedding.

83305
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.

49048
Pathology

All of the listed conditions (leukoplakia, solar keratosis, and margins of long-standing draining sinuses) are known precursors to squamous cell carcinoma.

83683
Pathology

The correct answer is: 1. Progression vascularization invasion detachment embolization.

Explanation of the stages for a malignant tumor cell:

1. Progression: This is the initial stage of tumor development where the cells acquire the ability to proliferate in an uncontrolled manner. This can be due to genetic mutations that alter the normal regulatory mechanisms that control cell division. The tumor grows locally within the tissue or organ of origin.

2. Vascularization: Also known as angiogenesis, this stage involves the formation of new blood vessels that supply the tumor with nutrients and oxygen, which is essential for its continued growth and progression. The tumor cells secrete factors that stimulate the growth of blood vessels into the tumor mass.

3. Invasion: The malignant tumor cells develop the capability to invade surrounding tissues. They secrete enzymes that degrade the extracellular matrix and basement membrane, allowing them to move through these barriers and invade neighboring tissues and organs.

4. Detachment: During this stage, tumor cells detach from the primary tumor site. This is facilitated by the loss of cell-to-cell adhesion molecules and the degradation of the extracellular matrix by proteolytic enzymes.

5. Embolization: Detached tumor cells can then enter the lymphatic system or bloodstream. This process is known as intravasation. They travel through these vessels as emboli and can potentially form new tumors at distant sites, which is the process of metastasis.

10764
Pathology

Enlargement of interendothelial junctions: This option refers to the widening of the spaces between endothelial cells, which can occur during inflammation. This enlargement allows leukocytes to pass through the endothelium more easily. This is a significant mechanism in the process of leukocyte transmigration.

92926
Pathology

1. Noduloulcerative Basal Cell Carcinoma: This is the most common subtype of BCC, making up about 60-70% of all cases. It typically appears as a slowly growing, round to oval, pearly or translucent nodule with a central ulceration that may bleed or ooze. The borders of the lesion are often not well-defined and may have a rolled, pearly edge with telangiectasias (small, dilated blood vessels).

2. Cystic Basal Cell Carcinoma: This subtype presents as a round, dome-shaped lesion with a cystic or fluid-filled center. It is less common than the noduloulcerative type, and it may be mistaken for a benign cyst or epidermoid cyst.

3. Morphoeic Basal Cell Carcinoma: Also known as sclerosing or morpheaform BCC, this type is characterized by a slowly growing, ill-defined, firm, plaque-like lesion that can infiltrate deeply into the skin. It may have a whitish, waxy appearance with a scar-like texture. Morphoeic BCC tends to be more aggressive and can be challenging to diagnose due to its subtlety.

4. Pigmented Basal Cell Carcinoma: This is a less common variant of BCC, accounting for approximately 6-15% of cases. It presents with pigmentation in the lesion, which can be brown, blue, or black. The presence of pigment can make it look similar to melanoma, another type of skin cancer, so a biopsy is often necessary to confirm the diagnosis.

61993
Pathology

Opsonins are molecules that enhance the phagocytosis of antigens by binding to their surfaces and acting as markers or labels that make them more recognizable to phagocytes.
1. lgG (Fc fragment): Immunoglobulin G (IgG) is the most common antibody isotype in human serum. It plays a crucial role in the secondary immune response. The Fc region of IgG is the fragment that interacts with Fc receptors present on the membrane of phagocytic cells. When an antigen is coated with IgG, the Fc fragments of these antibodies can bind to the Fc receptors, leading to the activation of the phagocytic process. This is known as antibody-dependent phagocytosis, where the antibody acts as an opsonin to facilitate the recognition and engulfment of the antigen by phagocytic cells.

2. C3b of complement cascade: The complement system is a cascade of proteins that can be activated in response to an infection or the presence of foreign substances. C3 is a central protein in this system, and when it is cleaved into C3a and C3b, the latter can bind directly to antigens. C3b acts as an opsonin by coating the surface of pathogens. The presence of C3b on a microbial surface allows it to be recognized by complement receptors on phagocytic cells, such as macrophages. This interaction enhances the efficiency of phagocytosis, as the receptors can recognize the bound C3b and engulf the antigen more readily.

3. IgM (Fc fragment) and C5b of complement cascade: While IgM is the first antibody isotype produced in response to an infection and can also opsonize antigens, it is less efficient than IgG due to its pentameric structure and lower affinity for phagocytic receptors. However, it is not as commonly associated with phagocytosis as IgG. Regarding C5b, it is part of the membrane attack complex (MAC) and is involved in the direct destruction of pathogens rather than acting as a classical opsonin that leads to phagocytosis. The MAC assembles on the surface of the antigen and creates pores, leading to osmotic lysis and destruction of the cell membrane.

61858
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.

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