MRCS Part A Pathology Syllabus

Pathology syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Pathology in MRCS Part A, not a summary of it.

1. 1

   Cell Injury and Adaptation

   4 topics

   • Cell Injury
     • Types of Cell Injury
     • Mechanisms of Cell Injury
     • Reversible and Irreversible Injury
     • Cell Death: Necrosis and Apoptosis
   • Cellular Adaptations
     • Hypertrophy
     • Hyperplasia
     • Atrophy
     • Metaplasia
   • Intracellular Accumulations
     • Lipids
     • Proteins
     • Glycogen
     • Pigments
   • Pathologic Calcification
     • Dystrophic Calcification
     • Metastatic Calcification
2. 2

   Inflammation and Repair

   3 topics

   • Acute Inflammation
     • Vascular Changes
     • Cellular Events
     • Chemical Mediators
   • Chronic Inflammation
     • Causes
     • Cellular Components
     • Granulomatous Inflammation
   • Tissue Repair
     • Regeneration
     • Healing by Connective Tissue
     • Factors Affecting Healing
3. 3

   Hemodynamic Disorders

   5 topics

   • Edema
     • Pathophysiology
     • Types of Edema
   • Hemorrhage
     • Causes
     • Clinical Significance
   • Thrombosis
     • Pathogenesis
     • Fate of Thrombus
   • Embolism
     • Types of Emboli
     • Clinical Consequences
   • Shock
     • Types of Shock
     • Pathophysiology
     • Clinical Features
4. 4

   Genetic Disorders

   4 topics

   • Mendelian Disorders
     • Autosomal Dominant Disorders
     • Autosomal Recessive Disorders
     • X-linked Disorders
   • Chromosomal Disorders
     • Numerical Abnormalities
     • Structural Abnormalities
   • Multifactorial Disorders
     • Examples and Mechanisms
   • Molecular Basis of Genetic Diseases
     • Mutations
     • Epigenetics
5. 5

   Neoplasia

   6 topics

   • Fundamentals of Neoplasia
     • Definitions and Nomenclature
     • Benign vs Malignant Tumors
   • Molecular Basis of Cancer
     • Genetic Changes in Cancer
     • Oncogenes and Tumor Suppressor Genes
   • Tumor-Host Interactions
     • Local and Systemic Effects
     • Paraneoplastic Syndromes
   • Carcinogenesis
     • Chemical Carcinogenesis
     • Radiation Carcinogenesis
     • Microbial Carcinogenesis
   • Tumor Progression and Metastasis
     • Invasion and Metastasis
     • Angiogenesis
   • Clinical Aspects of Neoplasia
     • Diagnosis
     • Grading and Staging
     • Treatment
6. 6

   Environmental and Nutritional Pathology

   2 topics

   • Environmental Diseases
     • Toxicology
     • Chemical Injuries
     • Physical Injuries
   • Nutritional Diseases
     • Malnutrition
     • Vitamin Deficiencies
     • Obesity
7. 7

   Infectious Diseases

   5 topics

   • General Principles of Microbial Pathogenesis
     • Host-Pathogen Interactions
     • Mechanisms of Microbial Injury
   • Bacterial Infections
     • Pathogenesis and Examples
   • Viral Infections
     • Pathogenesis and Examples
   • Fungal Infections
     • Pathogenesis and Examples
   • Parasitic Infections
     • Pathogenesis and Examples
8. 8

   Immunopathology

   5 topics

   • Basics of the Immune System
     • Innate Immunity
     • Adaptive Immunity
   • Hypersensitivity Reactions
     • Type I Hypersensitivity
     • Type II Hypersensitivity
     • Type III Hypersensitivity
     • Type IV Hypersensitivity
   • Autoimmune Diseases
     • Mechanisms
     • Examples
   • Immunodeficiency Diseases
     • Primary Immunodeficiencies
     • Secondary Immunodeficiencies
   • Amyloidosis
     • Pathogenesis
     • Classification
     • Clinical Features
9. 9

   Blood Vessels

   1 topic

   • Vascular Disorders
     • Atherosclerosis
     • Hypertension
     • Aneurysms
     • Vasculitis
10. 10

    Heart

    4 topics

    • Ischemic Heart Disease
      • Pathogenesis
      • Clinical Syndromes
    • Hypertensive Heart Disease
      • Left-sided Hypertensive Heart Disease
      • Right-sided Hypertensive Heart Disease
    • Valvular Heart Disease
      • Rheumatic Heart Disease
      • Infective Endocarditis
      • Non-infective Endocarditis
    • Myocardial Diseases
      • Cardiomyopathies
      • Myocarditis
11. 11

    Respiratory System

    4 topics

    • Obstructive Lung Diseases
      • Chronic Obstructive Pulmonary Disease (COPD)
      • Asthma
      • Bronchiectasis
    • Restrictive Lung Diseases
      • Interstitial Lung Diseases
      • Pneumoconiosis
    • Pulmonary Infections
      • Pneumonia
      • Tuberculosis
      • Fungal Infections
    • Lung Tumors
      • Primary Lung Cancer
      • Metastatic Tumors
12. 12

    Gastrointestinal Tract

    6 topics

    • Esophagus
      • Esophagitis
      • Barrett's Esophagus
      • Esophageal Cancer
    • Stomach
      • Gastritis
      • Peptic Ulcer Disease
      • Gastric Cancer
    • Intestines
      • Inflammatory Bowel Disease
      • Infectious Enterocolitis
      • Colorectal Cancer
    • Liver
      • Hepatitis
      • Cirrhosis
      • Hepatocellular Carcinoma
    • Gallbladder and Biliary Tract
      • Cholelithiasis
      • Cholecystitis
      • Gallbladder Cancer
    • Pancreas
      • Pancreatitis
      • Pancreatic Cancer
13. 13

    Urinary Tract

    2 topics

    • Kidneys
      • Glomerular Diseases
      • Tubulointerstitial Diseases
      • Renal Tumors
    • Ureters and Bladder
      • Urolithiasis
      • Bladder Cancer
14. 14

    Reproductive System

    3 topics

    • Male Reproductive System
      • Prostate Diseases
      • Testicular Tumors
    • Female Reproductive System
      • Cervical Diseases
      • Endometrial Diseases
      • Ovarian Tumors
    • Breast
      • Benign Breast Diseases
      • Breast Cancer
15. 15

    Endocrine System

    5 topics

    • Pituitary Gland
      • Hyperpituitarism
      • Hypopituitarism
    • Thyroid Gland
      • Hyperthyroidism
      • Hypothyroidism
      • Thyroid Tumors
    • Parathyroid Gland
      • Hyperparathyroidism
      • Hypoparathyroidism
    • Adrenal Gland
      • Adrenocortical Hyperfunction
      • Adrenocortical Hypofunction
      • Adrenal Tumors
    • Pancreatic Endocrine Tumors
      • Insulinomas
      • Gastrinomas
16. 16

    Nervous System

    4 topics

    • Cerebrovascular Diseases
      • Stroke
      • Aneurysms
    • Infections of the CNS
      • Meningitis
      • Encephalitis
    • Neurodegenerative Diseases
      • Alzheimer's Disease
      • Parkinson's Disease
      • Amyotrophic Lateral Sclerosis
    • CNS Tumors
      • Gliomas
      • Meningiomas
17. 17

    Musculoskeletal System

    3 topics

    • Bone Diseases
      • Osteoporosis
      • Osteomyelitis
      • Bone Tumors
    • Joint Diseases
      • Osteoarthritis
      • Rheumatoid Arthritis
      • Gout
    • Muscle Diseases
      • Muscular Dystrophies
      • Myopathies
18. 18

    Skin

    3 topics

    • Inflammatory Skin Diseases
      • Eczema
      • Psoriasis
      • Acne
    • Blistering Diseases
      • Pemphigus
      • Bullous Pemphigoid
    • Skin Tumors
      • Benign Tumors
      • Malignant Tumors
19. 19

    Pediatric Diseases

    3 topics

    • Congenital Anomalies
      • Types and Examples
    • Perinatal Infections
      • TORCH Infections
    • Pediatric Tumors
      • Neuroblastoma
      • Wilms Tumor

Pathology flashcards for MRCS Part A

24 of 51 cards from the Pathology deck — real questions with worked answers.

1. What are the two principal patterns of cell death, and how do they differ in energy requirement and inflammation?

   Necrosis: passive, ATP-independent, causes membrane rupture with leakage of contents and an inflammatory reaction. Apoptosis: active, ATP-dependent, programmed self-destruction with intact membranes, apoptotic bodies, and no inflammation.

2. List the common biochemical mechanisms of cell injury.

   ATP depletion, mitochondrial damage, increased intracellular calcium, accumulation of reactive oxygen species (oxidative stress), defects in membrane permeability, and damage to DNA/proteins.

3. What is the point of irreversibility in reversible vs irreversible cell injury?

   Irreversibility is marked by severe mitochondrial dysfunction (inability to regenerate ATP) and profound disturbance of membrane function (plasma membrane rupture), leading to death. Reversible injury shows cell swelling and fatty change but intact membranes.

4. Name the six morphologic types of necrosis.

   Coagulative, liquefactive, caseous, fat, fibrinoid, and gangrenous necrosis.

5. Which type of necrosis is characteristic of ischemic infarction of solid organs, and which is characteristic of brain infarction?

   Solid organs (e.g. heart, kidney): coagulative necrosis. Brain (CNS): liquefactive necrosis.

6. What are the three main free radicals (reactive oxygen species) involved in cell injury, and name antioxidant defenses.

   Superoxide anion ($\ce{O2^{.-}}$), hydrogen peroxide ($\ce{H2O2}$), and hydroxyl radical ($\ce{^{.}OH}$). Defenses: superoxide dismutase (SOD), catalase, glutathione peroxidase, and antioxidants such as vitamins E, A, C.

7. Define the four main cellular adaptations to stress.

   Hypertrophy (increased cell size), hyperplasia (increased cell number), atrophy (decreased size/number), and metaplasia (reversible change of one differentiated cell type to another).

8. What is metaplasia and give the classic example seen in Barrett esophagus?

   Metaplasia is the reversible replacement of one differentiated cell type by another. In Barrett esophagus, stratified squamous epithelium is replaced by columnar (glandular) epithelium due to chronic acid reflux.

9. Distinguish physiologic from pathologic hyperplasia with examples.

   Physiologic: hormonal (e.g. pregnant uterus, breast at puberty) or compensatory (liver regeneration). Pathologic: excessive hormonal/growth-factor stimulation, e.g. endometrial hyperplasia, benign prostatic hyperplasia.

10. List the main intracellular accumulations and a disease example for each.

    Lipid (fatty change in liver, atherosclerosis), protein (Mallory bodies, Russell bodies), glycogen (diabetes, glycogen storage diseases), and pigments (lipofuscin, melanin, hemosiderin).

11. What is lipofuscin and what does its presence signify?

    Lipofuscin is an insoluble brown-yellow 'wear-and-tear' pigment composed of lipid-protein complexes from lipid peroxidation. It signifies aging or cellular atrophy (brown atrophy of heart/liver) and is not injurious.

12. Differentiate hemosiderin from hemosiderosis and hemochromatosis.

    Hemosiderin is an iron-storage pigment (aggregated ferritin). Hemosiderosis is localized/systemic iron accumulation without organ damage. Hemochromatosis is iron overload causing tissue injury (cirrhosis, diabetes, cardiac failure, skin pigmentation).

13. Contrast dystrophic and metastatic calcification.

    Dystrophic: calcium deposition in dead/damaged tissue with NORMAL serum calcium (e.g. atheromas, damaged heart valves, caseous foci). Metastatic: deposition in normal tissue due to HYPERCALCEMIA (e.g. hyperparathyroidism, vitamin D excess, bone destruction, renal failure).

14. Name four major causes of hypercalcemia leading to metastatic calcification.

    Increased PTH (primary or ectopic hyperparathyroidism), destruction of bone (tumors, immobilization, Paget disease), vitamin D disorders (intoxication, sarcoidosis), and renal failure (secondary hyperparathyroidism).

15. What are the five cardinal signs of acute inflammation and their Latin names?

    Redness (rubor), heat (calor), swelling (tumor), pain (dolor), and loss of function (functio laesa).

16. Describe the vascular changes in acute inflammation.

    Transient vasoconstriction, then vasodilation (increased blood flow = heat and redness), followed by increased vascular permeability causing exudation of protein-rich fluid, stasis, and margination of leukocytes.

17. List the sequential steps of leukocyte extravasation in acute inflammation.

    Margination and rolling (selectins), adhesion (integrins–ICAM/VCAM), transmigration/diapedesis (PECAM-1/CD31), and chemotaxis toward the injury.

18. Name the key selectins and their ligands in leukocyte rolling.

    E-selectin (endothelium) and P-selectin (endothelium/platelets) bind sialyl-Lewis X on leukocytes; L-selectin (leukocytes) binds GlyCAM-1/CD34 on endothelium.

19. What is the difference between transudate and exudate (including specific gravity and protein)?

    Transudate: low protein, few cells, specific gravity $< 1.012$, due to hydrostatic/osmotic imbalance (ultrafiltrate). Exudate: high protein, many cells, specific gravity $> 1.020$, due to increased vascular permeability in inflammation.

20. List the major chemical mediators of acute inflammation grouped by source.

    Cell-derived: histamine, serotonin, prostaglandins, leukotrienes, PAF, cytokines (TNF, IL-1), nitric oxide, ROS. Plasma-derived: complement (C3a, C5a, MAC), kinins (bradykinin), and coagulation/fibrinolytic factors.

21. Which arachidonic acid metabolites arise from the cyclooxygenase vs lipoxygenase pathways?

    Cyclooxygenase (COX): prostaglandins ($PGE_2$, $PGD_2$, $PGF_2$), prostacyclin ($PGI_2$), thromboxane $A_2$. Lipoxygenase: leukotrienes ($LTB_4$ chemotactic; $LTC_4/D_4/E_4$ vasoconstriction and bronchospasm) and lipoxins.

22. What are the functions of complement fragments C3a, C5a, C3b, and the MAC?

    C3a and C5a: anaphylatoxins (increase vascular permeability, mast cell degranulation); C5a is also chemotactic. C3b: opsonization. Membrane attack complex (C5b-9): cell lysis.

23. What are the possible outcomes of acute inflammation?

    Complete resolution, healing by fibrosis (scarring), abscess formation, or progression to chronic inflammation.

24. What cells characterize chronic inflammation, and what defines it?

    Chronic inflammation is prolonged inflammation with simultaneous tissue destruction and repair. Characterized by mononuclear cells: macrophages, lymphocytes, and plasma cells, with angiogenesis and fibrosis.

See more Pathology flashcards →

Planning Pathology for MRCS Part A

Pathology (MRCS Part A) FAQ