RCPA BPS Exam flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Reversible cell injury

ATP depletion causes cell swelling, fatty change and ribosomal detachment; mitochondria and nucleus remain intact, so the cell can recover if the stimulus is removed.

Apoptosis

ATP-dependent, caspase-mediated programmed cell death producing apoptotic bodies without inflammation; initiated by intrinsic (mitochondrial) or extrinsic (death receptor) pathways.

Metaplasia

Reversible change of one mature cell type to another, usually in response to chronic irritation; example is Barrett oesophagus where squamous epithelium becomes columnar.

Desmosome

Intercellular junction linking intermediate filaments (keratin) of adjacent cells; provides mechanical strength in epithelia and is targeted in pemphigus vulgaris.

Acute inflammation

Rapid response to injury with vasodilation, increased vascular permeability and neutrophil recruitment; mediated by histamine, prostaglandins, leukotrienes and cytokines.

Granuloma

Collection of epithelioid macrophages, often with Langhans giant cells and a lymphocyte rim, formed in chronic inflammation from persistent pathogens or foreign bodies.

Primary intention healing

Healing of clean, apposed surgical wound edges with minimal granulation tissue and a thin scar; occurs faster and with less contraction than secondary intention.

Labile cells

Cells that continuously divide and regenerate rapidly, such as epidermis, gastrointestinal epithelium and haematopoietic cells; they are most vulnerable to radiation and chemotherapy.

Tumour suppressor gene

Gene whose loss of function promotes cancer; examples include TP53, RB1, APC and BRCA1/2; usually requires inactivation of both alleles (two-hit hypothesis).

Metastatic cascade

Sequence of local invasion, intravasation, survival in circulation, extravasation and colonisation; organ tropism follows the seed and soil hypothesis.

TNM staging

Anatomical staging system: T describes primary tumour size and invasion, N regional lymph node involvement, M distant metastasis; higher stage generally predicts worse prognosis.

Paraneoplastic syndrome

Clinical effects of cancer not caused by local tumour mass or metastasis, such as ectopic hormone production, hypercalcaemia, cachexia or Trousseau thrombophlebitis.

Virchow's triad

Three factors predisposing to thrombosis: endothelial injury, abnormal blood flow (stasis or turbulence) and hypercoagulability; used to assess venous and arterial thrombosis risk.

Factor V Leiden

Point mutation in factor V making it resistant to activated protein C cleavage; most common inherited thrombophilia, causing recurrent venous thrombosis.

Acute haemolytic transfusion reaction

ABO-incompatible transfusion causing fever, flank pain, haemoglobinuria, hypotension and DIC; complement activation destroys donor red cells intravascularly.

Antithrombin

Serine protease inhibitor that inactivates thrombin and factor Xa; heparin enhances its activity; inherited deficiency causes recurrent venous thrombosis.

Type I hypersensitivity

IgE-mediated immediate allergic reaction; mast cell degranulation releases histamine and leukotrienes, causing urticaria, bronchospasm, and anaphylaxis in severe cases.

Type IV hypersensitivity

Delayed, T-cell-mediated reaction occurring 48-72 hours after antigen exposure; examples include contact dermatitis, tuberculosis granulomas and transplant rejection.

Graft-versus-host disease

Donor T lymphocytes attack recipient tissues after allogeneic bone marrow transplant; affects skin, gastrointestinal tract and liver, causing rash, diarrhoea and jaundice.

Complement membrane attack complex

Assembly of C5b, C6, C7, C8 and C9 forms a pore in target cell membranes, causing osmotic lysis; important in defence against Neisseria species.

Endotoxin

Lipopolysaccharide component of Gram-negative bacterial outer membrane; triggers TLR4 signalling, fever, hypotension and septic shock; heat-stable and not neutralised by antitoxin.

Autoclave sterilisation

Steam under pressure at 121°C and 15 psi for 15 minutes kills all microorganisms including bacterial spores; standard method for surgical instruments and media.

Biofilm

Surface-associated microbial community embedded in extracellular matrix; increases antibiotic resistance and immune evasion, common on catheters, prosthetic valves and dental plaque.

Anion gap

Calculated as Na+ minus (Cl- plus HCO3-); normal 8-12 mmol/L; raised in lactic acidosis, ketoacidosis, renal failure and toxin ingestion (methanol, ethylene glycol).

HbA1c

Glycated haemoglobin reflecting average plasma glucose over preceding 2-3 months; diagnostic of diabetes at ≥6.5% (48 mmol/mol) and used to monitor glycaemic control.

Friedewald formula

Estimates LDL cholesterol as total cholesterol minus HDL minus triglycerides divided by 2.2 (mmol/L); valid only when triglycerides are below 4.5 mmol/L.

Tumour lysis syndrome

Metabolic emergency after rapid cancer cell death, causing hyperkalaemia, hyperphosphataemia, hyperuricaemia and hypocalcaemia; may lead to acute kidney injury and arrhythmias.

Philadelphia chromosome

Reciprocal translocation t(9;22) creating BCR-ABL fusion tyrosine kinase; hallmark of chronic myeloid leukaemia and target of imatinib therapy.

Knudson two-hit hypothesis

Tumour suppressor genes require inactivation of both alleles for cancer; hereditary cases inherit one mutated allele, so a single somatic hit suffices, causing early onset.

Frameshift mutation

Insertion or deletion of nucleotides not a multiple of three, altering the reading frame downstream; usually produces a truncated, non-functional protein.

Atherosclerosis

Chronic arterial disease initiated by endothelial injury, with lipid accumulation, macrophage foam cell formation, smooth muscle proliferation and plaque complications such as rupture and thrombosis.

Nephrotic syndrome

Glomerular disease with proteinuria exceeding 3.5 g/day, hypoalbuminaemia, oedema and hyperlipidaemia; causes include minimal change disease and membranous nephropathy.