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NEETMDS- Pathology short notes

NEET MDS Shorts

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.

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.

495883
Pathology

Debulking the tumor by surgery makes the tumor cells re-enter the cell cycle and thus become susceptible to drug therapy: This statement is the most accurate. Surgical removal of a tumor (debulking) can indeed lead to the release of tumor cells into the circulation and may also alter the tumor microenvironment. This can make residual tumor cells more susceptible to chemotherapy, as they may re-enter the cell cycle and become more actively dividing, which is when many chemotherapy agents are most effective.

378536
Pathology

Fat Embolism is diagnosed by -
1. Fluffy Exudates in Retina
2. Fat Droplets in Sputum
3. Fat droplets in Urine

406416
Pathology

Sarcoidosis is a systemic granulomatous disorder of unknown etiology that can
affect any organ in the body. It is characterized by the formation of non-caseating
granulomas, which are clumps of inflammatory cells that cluster together in
response to an unidentified antigen. The lungs and lymph nodes are most commonly
involved. Here's a detailed explanation for each of the options:

1. Dry cough: This is a common symptom of pulmonary sarcoidosis. The cough is
usually persistent and non-productive, meaning it does not bring up mucus or
phlegm. The presence of a dry cough is not contradicted in the statement "All
are true regarding Sarcoidosis except," so this option is not the correct
answer.

2. Exertional dyspnoea: Shortness of breath on exertion can occur in individuals
with pulmonary sarcoidosis due to the inflammation and granuloma formation in
the lungs. This symptom can be a result of the impaired lung function and
decreased lung capacity caused by the disease. Therefore, this is also a true
statement regarding sarcoidosis.

3. Wheezing: Wheezing is a high-pitched whistling sound that occurs during
breathing, typically heard when airways become narrowed or blocked. It can be a
symptom of pulmonary sarcoidosis, particularly if the disease involves the
bronchi and bronchioles, leading to bronchial obstruction and airflow
limitation. However, it is not the primary symptom and may be less common than
the other respiratory symptoms mentioned.

4. Hemoptysis: While hemoptysis, or coughing up blood, is not a hallmark symptom
of sarcoidosis, it can occur in some cases, particularly when the granulomas are
located in the lungs. It is usually mild and self-limited, but severe cases can
lead to significant bleeding. This is a true statement regarding sarcoidosis, as
it is a possible, although less common, respiratory symptom of the disease.

Since all the options (1, 2, and 4) are true regarding Sarcoidosis

214133
Pathology


Chicken pox presents with multiple dermal lesions characteristically with vesicles, pustules which may secondarily ulcerate

388981
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.

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.

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