(1) Final Exam - Don't Knows Flashcards
which two stains help to differentiate squamous cell carcinoma
p63 and CK34
what are pautrier microabscesses and in which condition are they seen
-CD4 cells accumulate in dermis around langerhans cells
-seen in mycosis fungoides
what is the histologic hallmark of mycosis fungoides
epidermotropism
what is lamellar ichthyosis
recessive, X-linked type of ichthyosis that is most severe
what is dermatitis herpetiformis
inflammatory blistering disorder caused by autoantibodies to IgG
what is the most common type of cutaneous T-cell lymphoma
mycosis fungoides
in which condition can spongiotic dermatosis (edema that seeps into the intercellular spaces of the epidermis) be seen
acute eczematous dermatitis
what is ichthyosis vulgaris
dominant type of ichthyosis that may be associated with lymphoid and visceral malignancies
what is the most common type of mastocytosis
cutaenous
what is parakeratosis
rapid thickening of stratum corneum with retained nuclei
where are verruca plana most often found
face or dorsal surfaces of the hands
dermatitis herpetiformis is associated with which condition
celiac disease
which types of HPV cause anogenital warts
6 and 11
psoriasis is often associated with which condition
arthritis
what is the staging system for squamous cell carcinoma
clarks
what are the four stages of rosacea
flushing (pre-rosacea)
persistent erythema and telangiectasia
pustules and papules
rhinopehyma (thickening of nasal skin)
what does an adrenocorticotrophic hormone producing pituitary adenoma (chromophobe) present with
Cushing syndrome and hyperpigmentation
where does the adenohypophysis (anterior pituitary) arise from
rathke’s pouch
what are thyrotrophs and what do they produce
anterior pituitary basophilic cells that produce TSH
what are the 6 hormones produced by the anterior pituitary
TSH
ACTH
LH
FSH
HGH (human growth hormone)
prolactin
what is the other name for a growth hormone producing pituitary adenoma
somatotroph adenoma
what are the 3 key microscopic features of an adamantinomatous craniopharyngioma
1.) squamous cells with peripheral palisading
2.) stellate reticulum
3.) wet keratin
what are the three cell types of the posterior pituitary gland (neurohypophysis)
pituicytes (glial cells)
axon processes from hypothalamus
herring bodies
what do the parafollicular cells of the thyroid gland do
make calcitonin
what are the four main types of thyroid carcinomas
papillary
follicular
anaplastic
medullary
what is pituitary cachexia (Simmonds disease)
destruction or physiological exhaustion of pituitary
can be caused by things like syphilis, TB, tumor, etc.
affects the thyroid, adrenals, and gonads
what is Zollinger-Ellison syndrome
having one or more gastrinomas
which hormone inhibits growth hormone
somatostatin
patients with which mutations will get a prophylactic thyroidectomy to protect them from medullary carcinoma
RET mutations
which stain is used to differentiate for an adrenocorticotrophic hormone producing pituitary adenoma (chromophobe)
PAS
what are the two types of parathyroid cells
chief and oxyphil cells
what two things do atypical pituitary adenomas have
TP53 mutation and brisk mitotic activity
what is subacute granulomatous thyroiditis (De Quervian)
enlarged thyroid that mostly affects women with a history of upper respiratory infections
microscopy shows granulomas
what is a critical feature of a hyperfunctioning toxic adenoma
intact capsule
what is Conn Syndrome
hypertension caused by overproduction of aldosterone
can present with an aldosterone secreting carcinoma
what are the three cells types of the pineal gland
pinealocytes
astrocytes
corpora arenacea
what is froehlich syndrome (adiposogenital dystrophy)
damage to the hypothalamus leads to obesity, atrophy of gonads, etc.
which two types of anterior pituitary cells are acidophilic
somatotrophs and lactotrophs
which condition has papillary infoldings and peripheral scalloping on microscopy
Graves disease
what are the two categories of WHO classifications for serous cystic neoplasms
serous cystadenoma (benign)
serous cystadenocarcinoma (malignant)
what is the macroscopic presentation of acute pancreatitis
fat necrosis
pancreatoblastomas are associated with which condition
beckwith-weidmann syndrome
what is the macroscopic presentation of chronic pancreatitis
parenchymal fibrosis with proteinaceous plugs
what is the most important diagnostic feature of a mucinous cystic neoplasm
ovarian-type stroma beneath the epithelium
what is the most common neoplastic cyst of the pancreas
intraductal papillary neoplasia
which two viruses can cause acute pancreatitis
mumps
coxsackievirus
what is the most common cause of acute pancreatitis
impaction of stones within the common bile duct (choledocholithiasis)
what are the two conditions associated with pancreatic cysts
polycystic kidney disease
von Hippel-Lindau Syndrome
what could you see under the microscope in the pancreas of a patient with diabetes mellitus
amyloid deposits
what are the two types of mucin producing cystic neoplasms
mucinous cystic neoplasm (MCN)
intraductal papillary mucinous neoplasm (IPMN)
what is the most common type of pancreatic neuroendocrine tumor
insulinoma
what are the three types of cystic exocrine pancreatic neoplasms
serous cystic
mucinous cystic
intraductal papillairy
what do the small pancreatic ducts release
biocarbonate fluid
85-90% of all pancreatic neoplasms are what
ductal adenocarcinoma
what are the three types of non-cystic exocrine pancreatic neoplasms
pancreatic intraepithelial neoplasia
ductal adenocarcinoma
acinar cell carcinoma
onion-skin is seen in which condition
primary sclerosing cholangitis
what is the most common form of liver disease
hepatic steatosis
what is the most common benign liver tumor
cavernous hemangioma
what are the two distinguishing microscopic features of autoimmune hepatitis
hepatic rosettes
plasma cells
in which condition would you see feathery degeneration
advanced cholestasis
what is the second most common primary liver tumor
cholangiocarcinoma
what are the two most common causes of multi-lobulated necrosis of the liver
acetaminophen toxicity and acute viral hepatitis
which condition is associated with primary biliary cholangitis
sjogren syndrome
what is the most common cause of cholestasis
sepsis
what is the most common cause of hepatocellular carcinoma
chronic liver disease
what can fully developed cases of hemochromatosis lead to
diabetes mellitus and abnormal skin pigmentation
what is primary biliary cholangitis
inflammation and destruction of intrahepatic bile ducts which leads to fibrosis
who is most affected by type 1 autoimmune hepatitis
middle-age/older individuals
which condition of the liver often shows a central scar
focal nodular hyperplasia
what are pigment stones made out of
bilirubin calcium salts
what is the cause of chronic passive congestion of the liver “nutmeg liver”
right-sided heart failure
define acute liver failure
liver disease that produces hepatic encephalopathy within 6 months of the initial diagnosis
what are three causes of sinusoidal obstruction syndrome
Jamaican bush tea
stem cell transplantation
chemotherapy
what are the two main types of gallstones
cholesterol and pigment stones
what are the three main mechanisms of liver injury
cholestasis
necrosis
apoptotic death
what is the most common cause of focal nodular hyperplasia
alterations in hepatic parenchymal blood supply
ex. arteriovenous malformations
a hepatoblastoma is associated with which two conditions
FAP (familial adenomatous polyposis) and Beckwith-Wiedmann syndrome
what are the two most common causes of neonatal cholestasis
primary biliary atresia (stricture) and neonatal hepatitis
what are the three causes of bile duct obstruction in adults
extrahepatic cholelithiasis (gallstones)
malignant obstructions
post surgical strictures
what are the two major risk factors of hepatic venous outflow obstructions
pregnancy and oral contraceptives
wilms tumors are made of which three things
blastema
stromal
epithelial cells
renal agenesis is most commonly associated with which genetic condition
trisomy 13 (Downs syndrome)
what is minimal change disease
thinning of the podocytes only seen by electron microscopy
which condition is often caused by polycystic disease
hypertension
40% of patients with polycystic kidney disease also have which disease
polycystic liver disease
what are the two main types of hereditary nephritis
alport syndrome
thin basement membrane
which tumor can be described as mahogany
oncocytoma
what is urate nephropathy
uric acid crystals in the renal tubules (collective ducts) which causes obstructions and can lead to acute renal failure
a T1 kidney tumor is how big in size
7 cm or less
acquired cystic disease increases your risk of which disease at a 100-fold increase
renal cell carcinoma
what is the most common origin of pyelonephritis
ascending infection
what are the four types of calculi
calcium oxalate
struvite
uric acid
cystine
what is the most common cause of nephrotic syndrome in adults in the US
focal segmental glomerulosclerosis
what is seen in type 2 membranoproliferative glomerulonephritis
intramembranous dense deposits due to compliment cascade activation
what is hyalinosis
deposition of eosinophilic protein material
what is Alport syndrome
type 4 collagen causes irregular basement membrane thickening
what are two secondary causes of focal segmental glomerulosclerosis
HIV and obesity
what is seen in light chain cast nephropathy (myeloma kidney)
bence jones proteins
what are the four basic pathological responses to glomerular injury
sclerosis
hyalinosis
hypercellularity
basement membrane thickening
renal cell carcinoma is associated with which condition
von-Hippel Lindau
what is HIV-associated nephropathy
collapsing variant of focal segmental glomerulosclerosis
shows collapsing of tuft
sickle cell nephropathy causes what three clinical manifestations
hematuria
proteinuria
diminished concentrating ability
wilms tumor (nephroblastoma) is associated with which three conditions
WAGR
Denys-drash
beckwith-wiedman syndrome
what is the second most common cause of renal artery stenosis
fibromuscular displasia
what is the most important microscopic feature of chronic pyelonephritis
tubular thyroidization
what does the EM of focal segmental glomerulosclerosis show
loss of podocyte foot processes
which variant of renal cell carcinoma has the worst prognosis
medullary
what is the leading cause of renal failure in the US
diabetic nephropathy
what are the two main things seen in the glomerulus of someone with diabetic nephropathy
basement membrane thickening
kimmelstiel wilson nodules
which portion of the glomerulus is affected by focal segmental glomerulosclerosis
capillary tuft
what are the two most common gross features of acute pyelonephritis
papillary necrosis and micro-abscesses
in which condition would you see perinuclear halos and nuclear pleomorphism
chromophobe carcinoma
minimal change disease is a common occurrence with what
corticosteroid therapy
what is xanthogranulomatous pyelonephritis
rare form of chronic pyelonephritis that can produce stag horn calculi
what is another name for bile cast nephropathy
cholemic necrosis
which condition of the bladder is most common in renal transplant recipients
nephrogenic adenoma
embryonal carcinoma most commonly affects males of which age range
20-30 years old
what is malakoplakia of the bladder
chronic inflammatory reaction of the bladder
common in renal transplant cases and immunocompromised patients
what would be seen on a touch prep for a leydig cell tumor
crystalloids of Reinke
Sertoli cell tumors are associated with which three syndromes
carney complex
peutz-jeghers syndrome
FAP
leydig cell tumors most commonly affect males of which age range
20-60
what is the gross appearance of a leydig cell tumor
homogenous, golden-brown and lobulated
what is an important microscopic feature of a Sertoli cell tumor
cord-like structures
which two infections most commonly affect the epididymis
gonorrhea and TB
what is the most common cause of hydronephrosis in infants and children
ureteropelvic junction obstruction
germ cell tumors of the testicle most commonly affects males of which age range
15-45 years old
which two cells types are common in a choriocarcinoma
trophoblastic cells and syncytiotrophoblasts
what is the most common benign paratesticular (adnexal) tumor
adenomatoid tumor
what are the two main categories of bladder malignancy
epithelial and mesenchymal
which stain is used to look for Michaelis-Gutmann bodies
van kossa stain
condyloma acuminatum is most commonly caused by which strains of HPV
6+11
what is a common microscopic feature of a seminoma
polyhedral cells
a pT3 testicular tumor involves what
spermatic cord
what are the two main types of mesenchymal bladder tumors
benign (leiomyomas) and sarcomas
what is the gross appearance of interstitial cystitis
mucosal fissures and petechial hemorrhage
which stain cause be used to differentiate yolk sac tumors
AFP
what is another name for a yolk sac tumor
endodermal sinus tumor
what are the four main types of bladder malignancy
urothelial (transitional)
SCC
mixed
adenocarcinoma
koilocytosis is seen in which condition
condyloma acuminatum
what are the two main types of sex cord stromal tumors
leydig and Sertoli cell tumors
what is the most malignant paratesticular tumor in adults
liposarcoma
what is the most common testicular tumor in infants and children up to 3 years of age
yolk sac tumor
which two genes mutations can lead to carcinoma in situ of the bladder
TP53 and RB
which gene mutation causes a seminoma
C-KIT
in which condition would you see Michaelis-Gutmann bodies
malakoplakia
which two gene mutations can lead to papillary urothelial neoplasms
RAS and RGRF3
what is a Schiller-duval body
glomerulus like structure composed of a central blood vessel enveloped by tumor cells
anovulation is less commonly associated with which three things
endocrine disorders
ovarian lesions
metabolic disturbances
what is the most common malignancy of the ovary
serous tumor
what are the two groups of vulvar squamous cell carcinoma
basaloid and warty carcinoma
keratinizing squamous cell carcinoma
what are the three main types of type 2 endometrial carcinoma
serous
clear cell
malignant mixed mullerian
what is squamous cell hyperplasia of the vulva
condition caused from rubbing or scratching of the skin
presents as leukoplakia
benign - not premalignant
myometrial leiomyosarcomas metastasize most commonly to which four locations
lungs
bone
brain
abdominal cavity
what are three microscopic features of lichen sclerosus of the vulva
thinning of the epidermis
degeneration of basal epithelial cells
hyperkeratosis
urogenital sinus becomes what in females
lower vagina
external genitalia
which three things cause contribute to preeclampsia
1.) abnormal placental vasculature
2.) endothelial dysfunction
3.) coagulation abnormalities
what is the risk percentage for developing choriocarcinoma from a complete hydatidiform mole
2.5%
what is the main microscopic feature of molluscum contagiosum
handerson-patterson bodies
what is type 2 endometrial carcinoma
two main varients: serous and clear cell
arise in atropic uteri
poorly differentiated
fast growing
which gene is mutated in 20% of endometrial hyperplasia cases
PTEN
what is the second and third most common sites for endometriosis
uterine ligaments and rectovaginal septum respectively
dysgerminomas are most commonly seen in which age range of women
20-30 years of age
mucinous epithelial ovarian tumors often have which gene mutation
KRAS
how are leiomyosarcomas differentiated from leiomyomas
nuclear atypia
mitotic index
tumor necrosis
what are vaginal intraepithelial neoplasia and squamous cell carcinoma associated with
high risk HPV infections
what are the two types of vuvlar glandular neoplastic lesions
papillary hidradenoma
extramammary Paget disease
what is the most common histological subtype of cervical carcinoma
SCC
who is most likely to be affected by preeclampsia
primipara women (those pregnant for the first time)
which three organisms can cause pelvic inflammatory disease (PID)
neisseria gonorrhoeae
chlamydia
infections spread through lymphatics after delivery (ex. strep/staph)
what are the two infections of pre-term labor
ureaplasma urealyticum and mycoplasma hominis
what are the four types of endothelial malignant mixed mullerian tumors (carcinosarcomas)
stromal sarcoma
leiomyosarcoma
rhabdomyosarcoma
chondrosarcoma
which condition would you see “worm-like plugs”
endometrial stromal sarcoma - caused by myometrial veins
at which week is preeclampsia most common
34
what is papillary hidradenoma
a type of vulvar glandular neoplastic lesion
mostly found on labia majora or interlabial folds
ulcerates
endometriosis increases your risk for which two types of ovarian cancer by 3x
endometroid and clear cell
what are Gartner duct cysts
cysts from wolffian (mesonephric) ducts on the lateral walls of the vagina
what differentiates an endometrioid epithelial ovarian tumor from a mucinous or serous one
presence of tubular glands resembling benign or malignant endometrium
what is an ovarian polyembryoma
a malignant germ cell tumor containing embryoid bodies
the most common extra mullerian tumors metastatic to the ovary are
breast and GI
what are the four main types of benign exophytic vulva lesions
condyloma acuminatum
syphillitic condyloma latum
fibroepithelial polyps
vulvar squamous papillomas
which three types of gene mutations are seen in malignant mixed mullerian tumors
PTEN
TP53
PIK3CA
what is ovarian pseudomyxoma peritonei
type of mucinous ovarian cancer
characterized by: mucinous ascites, cystic peritoneal surfaces and adhesions
typically arises from the appendix but can start in the ovaries
which viral protein interferes with the tumor suppressor protein RB and can contribute to cervical cancer
E7
what three main things does endometriosis cause
bleeding
fibrous adhesions
cystic ovaries (chocolate cysts)
what are the two most common types of ovarian germ cell tumors
struma ovarii and carcinoid
chronic endometritis is associated with which four conditions
chronic pelvic inflammatory disease
retained gestational tissue
IUDs
tuberculosis
what is the most common type of type 2 endometrial carcinoma
serous
what is the most common invasive cancer of the female genital tract
endometrial carcinoma
Schiller-duval bodies are seen in which condition
yolk sac tumors
which three infections commonly cause discomfort of the reproductive tract
candida (yeast)
trichomonas (parasite)
gardnerella
what are some features of vulvular keratinizing squamous cell carcinoma
a more common type of squamous cell carcinoma
70% not HPV related
most common in older patients
which strain of HPV accounts for 10% of cervical cancer cases
HPV 18
what is the most common type of ovarian cancer
serous cystadenocarcinoma
which gene mutation is unique to uterine smooth muscle tumors
MED12
which gene mutation is most common in serous (type 2) endometrial carcinoma
TP53
which four conditions are associated with fungal infections of the female genital tract
diabetes mellitus
antibiotics
pregnancy
being immunocompromised
endometerial stromal sarcomas are associated with which type of mutations
translocations
what are the two types of pure stroma neoplasms of the endometrium
benign stromal nodules
endometrial stromal sarcomas
PCOS can often overlap with which condition
stromal hyperthecosis
what are the three other names for squamous metaplasia of lactiferous ducts (SMOLD)
recurrent subareolar abscess
periductal mastitis
zuska disease
what is the other name for large cell ductal carcinoma in-situ
comedocarcinoma
what is the radiologic appearance of Paget disease
rod-like microcalcs
what is squamous metaplasia of lactiferous ducts (SMOLD)
keratin plug in duct causes abscess
which syndrome can be associated with male breast cancer
kleinfelter
what are the 7 variants of invasive (infiltrating) breast carcinoma
mucinous (colloid)
papillary
inflammatory
metaplastic
tubular
apocrine
lobular
what is the main grading system for invasive (infiltrating) breast carcinoma
(scarff) Bloom-Richard grading system
what is an apocrine breast carcinoma
variant of invasive (infiltrating) carcinoma
shows punctate nucleoli
what is one of the biggest risks of developing breast cancer
estrogen exposure
which gene mutation is most common in lobular carcinoma in-situ
E-cadherin (CDH1) mutation
what is epithelial hyperplasia of the breast
a type of proliferative breast disease without atypia
increased numbers of luminal and myoepithelial cells within the ducts
what is the least common type of breast cancer in terms of hormone receptors
HER2+
how do ER-, HER2- cancers develop
because of BRCA1 mutations
what is duct ectasia
white nipple secretions that present as a palpable periareolar mass
the most common metastatic tumors of the breast are from which two locations
skin (melanoma)
ovarian cancer
what are the two types of metaplastic breast carcinoma
matrix producing carcinoma
spindle cell carcinoma
complex sclerosing lesions have components of what
sclerosing adenosis
papillomas
epithelial hyperplasia
what is unique about lobular carcinoma in-situ
no calcifications
where is the BRCA2 gene mutation located
13q12-13 chromosome
what is important to note about the papillary projections in papillary and micropapillary non-comedo ductal carcinoma in-situ
the projections lack fibrovascular cores
what is sclerosing adenosis
a type of proliferative breast disease without atypia
increased number of acini
having a first-degree relative with breast cancer increases your risk by which percentage
15-20%
what is the hallmark of the lobular variant of invasive (infiltrating) breast carcinoma
dyscohesive infiltration tumor cells with no tubular formation
what is the histologic appearance of cribriform non-comedo ductal carcinoma in-situ
rounded (cookie cutter like) spaces filled with calcified material
which two conditions are associated with lymphocytic mastopathy (sclerosing lymphocytic lobulitis)
type 1 diabetes and autoimmune thyroid disease
what are the four major known susceptible genes for familiar breast cancer
BRCA1
BRCA2
TP53
CHEK2
what is the most common gross and microscopic feature of a breast fibroadenoma
slit-like spaces
which two types of ductal carcinoma in-situ can produced nipple discharge
micropapillary and papillary
how do HER2+ cancers develop
due to TP53 mutations
what are the four types of non-comedo ductal carcinoma in-situ
micropapillary
papillary
solid
cribriform
what is the most common sarcoma in the breast
angiosarcoma
what is the most common type of breast cancer
adenocarcinoma
what are the two main microscopic features of comedo ductal carcinoma in-situ
pleomorphic, high grade nuclei
central necrosis
how big is a typical non-ossifying fibroma
5-6 cm
what are the 5 subclassifications of lipomas
1.) conventional
2.) fibrolipoma
3.) angiolipoma
4.) spindle cell
5.) myelolipoma
reactive arthritis can be associated with which three conditions
1.) HIV
2.) chlamydia
3.) GI tract infections
what is an osteoblastoma
benign bone tumor
greater than 2 cm
mostly affects the spine
causes deformation
pseudogout crystals are made of what
calcium pyrophosphate
superficial fibromatoses mostly affects men or women
men
which five conditions are associated with metastatic bone tumors in children
1.) neuroblastoma
2.) Wilms tumor
3.) osteosarcoma
4.) Ewing sarcoma
5.) rhabdomyosarcoma
which class of drugs is used to treat osteoporosis
bisphosphonates - reduce osteoclast activity
what are the two main types of complex soft tissue tumors
leiomyosarcomas
undifferentiated sarcomas
which four conditions are associated with soft tissue tumors
1.) neurofibromatosis 1
2.) gardner syndrome
3.) Li-Fraumeni syndrome
4.) Olser-Weber Rendu syndrome
flat bones develop through this process
intramembranous ossification
what are the two main types of chondromas
enchondroma and juxtacortical chondroma
what is fibrillation
characteristic of osteoarthritis
granular fissures and clefts in the cartilage
what are the four histologic classifications of chondrosarcomas
1.) hyaline cartilage producing (conventional tumor)
2.) clear cell
3.) differentiated
4.) mesenchymal variants
what are Heberden nodes
prominent osteophytes at the distal interphalangeal joints that are common in women
what are the three phases of Paget disease (osteitis deformans)
1.) initial - osteolytic phase (breakdown)
2.) mixed osteoclastic and osteoblastic stage (build up)
3.) final - osteosclerotic stage (bone doesn’t solidify)
what is psoriatic arthritis
chronic inflammatory arthropathy associated with psoriasis
rheumatoid arthritic lesions are most commonly found in which four locations
1.) skin
2.) heart
3.) blood vessels
4.) lungs
what role does the organic bone matrix play
collagen fibers gives bone its tensile strength
which gene mutation is most responsible for osteosarcomas
TP53
what are the two main types of benign bone forming tumors
osteoid osteoma
osteoblastoma
what are the three most common forms of dyostosis
1.) absence of bone or digit (aplasia)
2.) extra bones or digits (supernumerary digit)
3.) abnormal fusion of bones (syndactyly)
what is the most common form of osteochondroma (exostosis)
solitary
how is a giant cell tumor of the bone treated
curettage
what are the four subtypes of a rhabdomyosarcoma
1.) alveolar
2.) embryonal
3.) pleomorphic
4.) spindle cell/sclerosing
what is the histologic appearance of pseudogout
rhomboid crystals
a leiomyosarcoma is most commonly found in which two areas
extremities and retroperitoneum
what are rheumatoid subcutaneous nodules
nodules that form in the case of RA in areas subjected to pressure
what are three examples of exogenous crystals
1.) corticosteroid ester crystals
2.) talcum
3.) silicone
what are the 4 things seen grossly in osteoarthritis
1.) fibrillation
2.) bone eburnation
3.) subchondral cysts
4.) osteophytes
nodular fasciitis mostly affects which area of the body
upper extremities
what is the important histologic feature of a primitive neuroectodermal tumor
Homer-Wright rosettes
what is congenital syphilis
syphilis acquired from birth
spirochetes gather in areas of active ossification which leads to bowing of bone (saber shin)
which two conditions are associated with enchondromas
Ollier disease and Maffucci syndrome
what is the most common form of dwarfism
thanatophoric dysplasia
osteoarthritis most commonly affects what in women
hands and knees
what is osteopetrosis (marble bone disease)
reduced bone resorption due to issues with osteoclasts
leads to increased bone density as new, poor bone is being put down
what are the three histologic subtypes of liposarcomas
1.) well differentiated
2.) myxoid
3.) pleomorphic
what are the three metastatic ways of spread to the bone
1.) direct extension
2.) lymphatic/hematogenous
3.) intraspinal seeding (CSF)
metastatic bone tumors in adults mostly come from which four location
1.) prostate
2.) breast
3.) kidney
4.) lung
where is the gene mutation for Ewing sarcoma located
translocation of the EWSR1 gene on chromosome 22
what are the two other names for osteopetrosis
marble bone disease
albers-schonberg
what is a juxtacortical chondroma
benign tumor of hyaline cartilage which arises on the surface (cortex) of the bone
what is the most common cause of achondroplasia
sporadic mutations in the paternal allele (90%)
what is the histologic appearance of a pleomorphic liposarcoma
anaplastic cells and lipoblasts
what is an aneurysmal bone cyst (ABC)
benign tumor that develops in the metaphysis of long bones and in the vertebral bodies
what is Paget disease (osteitis deformans)
increased bone mass due to new bone that is abnormally shaped, weak, and brittle
leads to a thickened cortex
what is an important feature of rheumatoid arthritis
pannus production
which two conditions can increase your risk of a bone neoplasm
chronic osteomyelitis
Paget disease
viral arthritis is associated with which 4 conditions
1.) rubella
2.) EBV
3.) HVB and HVC
4.) HIV
what is seen histologically in an embryonal rhabdomyosarcoma
spindle cells and myxoid stroma
what is a bone eburnation
characteristic of osteoarthritis
exposed subchondral bone that appears like polished ivory due to friction
those with Maffucci syndrome are at risk for developing which two types of malignancies
ovarian carcinomas and brain gliomas
which subtype of rhabdomyosarcoma is most common
embryonal
what is an osteoid osteoma
benign bone tumor
less than 2 cm
common in men
causes thickening of cortex
mostly affects femur or tibia
what is a common sign of osteogenesis imperfecta (brittle bone disease)
blue sclera
what are the three main consequences of the bone due to hyperparathyroidism
1.) osteoporosis
2.) osteitis
3.) brown tumor
what is seen histologically in a non-ossifying fibroma
storiform pattern due to benign spindle cells
osteoporosis mostly affects which three parts of the body
1.) phalanges
2.) vertebrae
3.) proximal femur
what is multiple hereditary exostosis syndrome
multiple osteochondromas that occur closer to the growth plate
which two joints are most commonly affected by ankylosing spondylitis
sacroiliac and apophyseal joints
what are the two main sites of chondrosarcomas and which is most common
central (intramedullary) and peripheral (juxtacortical)
gout is associated with which four conditions
1.) alcohol
2.) obesity
3.) renal failure
4.) drugs
what is seen histologically in fibrous dysplasia
lack of osteoblastic rimming
what are the three main types of superficial fibromatoses
1.) palmar (dupuytren contracture)
2.) plantar
3.) penile (peyronie disease)
osteoarthritis most commonly affects what in men
hips
what is the pathognomonic feature of gout
tan-white chalky deposits
what is osteogenesis imperfecta (brittle bone disease)
a type 1 collagen deficiency disease
affects bone, joints, eyes, ears, skin, and teeth
higher grade chondrosarcomas have which histologic feature
binucleation (dividing nuclei) of chondrocytes
Homer-Wright rosettes are commonly seen in which condition
primitive neuroectodermal tumors
where do osteosarcomas most commonly arise from
metaphysis region of long bones of the extremities - knee specifically
Ewing sarcoma is grouped with which other condition into a single category
primitive neuroectodermal tumor (PNET)
in which condition would you see a mosaic pattern of lamellar bone
Paget disease
what are the two main types of simple bone soft tissue tumors
Ewing sarcoma
synovial sarcoma
what is a common feature of osteosarcomas
codman triangle
what are the five zones of a growth plate starting from the exterior
1.) reserve zone
2.) zone of proliferation
3.) zone of hypertrophy
4.) zone of mineralization
5.) primary spongiosa
what are two examples of endogenous crystals
monosodium urate (gout)
calcium pyrophosphate dehydrate (pseudogout)
what is a common sign of osteopetrosis
Erlenmeyer flask bone deformity
psoriatic arthritis mostly affects which three things
sacroiliac joint, hands, and feet
what is the most common benign bone tumor
osteochondroma
suppurative arthritis is seen often in which demographic of people
drug users
what is osteopontin
extracellular structural protein that helps with bone formation
what are the four main histologic features of rheumatoid arthritis
1.) synovial cell hyperplasia
2.) angiogenesis
3.) exudate
4.) osteoclastic activity
what is an important feature of psoriatic arthritis
pencil in cup deformity
suppurative arthritis is often associated with which condition
osteomyelitis
what is a verocay body
nuclear-free zones within a schwannoma
what is seen histologically in dermatomyositis
myofiber atrophy at the edges of the fascicles (perifascicular atrophy)
50% of those with Lamber-Eaton Myasthenic Syndrome also have what
an underlying malignancy like small cell neuroendocrine tumor of the lung
what additional condition is associated with Myasthenia gravis
thymic abnormalities (enlarged)
what are plexiform neurofibromas
associated with nerve roots or large nerves
resemble a bag of worms as they grow and entrap axons
what is seen histologically in polymyositis
necrotic, regenerating, and atrophic myofibers in a patchy distribution
which two nerves are most commonly involved in the Varicella-Zoster Virus (shingles)
thoracic and trigeminal
what is the most common cause of a drug myopathy
cholesterol lowering drugs like statins
what is a subfalcine herniation
asymmetric expansion of cerebral hemisphere that displaces the cingulate gyrus under the falx
can cause compression of anterior cerebral artery
what are three causes of cerebral infarcts caused by “other” things
1.) hypercoagulation states
2.) dissecting aneurysm of arteries in the neck
3.) drug abuse
CSF tap of multiple sclerosis would show which two things
1.) mildly elevated protein
2.) elevated IgG levels
cervical lesions above C4 can often causes what
respiratory compromise and paralysis of the diaphragm
what does a microglial cell do
act as a phagocyte
what is craniorachischisis
combination of ancenphaly and boney spinal defect
which stain is used for the hairlike processes seen in a pilocytic astrocytoma
GFAP+
what are the two hallmarks of gliosis
Rosenthal fibers and corpora amylacea
what is seen histologically in a meningioma
psamomma bodies
which two things can cause a hemorrhagic stroke
1.) hypertension
2.) vascular anomalies like aneurysms
which two conditions can cause lacunar infarcts
1.) diabetes
2.) hypertension
which stain is used to diagnose multiple sclerosis
Luxol fast blue periodic acid-Schiff stain
fungal infections most often cause which three forms of CNS injury
1.) chronic meningitis
2.) vasculitis
3.) parenchymal invasion
what are the three most common locations of a cerebral infarct caused by thrombus
1.) bifurcation of carotid arteries
2.) origin of middle cerebral artery
3.) end of basilar artery
what is seen histologically in the beginning stages of acute ischemic injury of the brain
diffuse eosinophilia of shrinking neurons
what is the gross appearance of an oligodendroglioma
gelatinous with cysts, focal hemorrhage, and calcification
cerebral infarct caused by thrombus is often associated with which two conditions
1.) hypertension
2.) diabetes
CMV affects the brain in which three ways
1.) periventricular necrosis
2.) microcephaly
3.) periventricular calcification
which area of the brain is at most risk for watershed infarct
area between anterior and middle cerebral artery
what are two examples of protozoal diseases that can affect the nervous system
1.) malaria
2.) toxoplasmosis
what is the main cause of Huntington disease
degeneration of striatal neurons in basal ganglia
what is Chiari type 1 malformation
low-lying cerebellar tonsils that extent into the vertebral canal
what is the best indicator of neuronal injury
reactive glial cell changes
what is a transtentorial herniation
compression of medial temporal lobe against free margin of tentorium
can cause compression of third cranial nerve (oculomotor) or the posterior cerebral artery which would affect the eyes
what is cytotoxic edema
injury to cells causes secondary increase in intraceullar fluid
common in cases of obesity and diabetes
affects white and gray matter
chicken wire appearance is associated with which condition
oligodendroglioma
which condition can cause ependymal injury with viral inclusions
cytomegalovirus (CMV)
what is the histologic appearance of an oligodendroglioma
anastomosing capillaries resembling chicken wire and granular chromatin
what is the most common location of a diffusely infiltrating astrocytoma
cerebral hemispheres
what usually causes a subdural empyema
bacterial infections of skull or air sinuses like sinusitis or osteomyelitis
which syndrome is associated with acute pyogenic meningitis
Waterhouse-Friderichsen syndrome
an extradural abscess is most commonly associated with which condition
osteomyelitis
what are the three main causes of non-infectious vasculitis
1.) polyarteritis nodosa
2.) primary angitis of the CNS
3.) granulomatous angitis
which three organisms most commonly cause chronic bacterial meningoencephalitis
1.) TB
2.) syphilis (treponema)
3.) borrelia (Lyme disease)
what are pathognomonic to rabies
Negri bodies - inclusions found in pyramidal neurons of hippocampus and Purkinje cells of cerebellum
what is seen grossly in the brain of someone with ethanol poisoning (chronic alcoholism)
1.) cerebral dysfunction
2.) atrophy and loss of granule cells in vermis
what are the two main causes of infectious vasculitis
1.) syphilis
2.) TB
what is a cavernous malformation
tightly packed, low flow vessels not associated with arteriovenous shunting
what are the three steps to the breakdown of a subdural hematoma
1.) lysis of clot (1 week)
2.) growth of fibroblasts into hematoma (2 weeks)
3.) development of hyalinized connective tissue (1-3 months)
what is Arnold-Chiari (type 2) malformation
abnormally small posterior fossa and misshapen midline extensions of vermis through foramen magnum
causes hydrocephalus and lumbar myelomeningocele
what is seen grossly in someone with Huntington disease
atrophy of caudate nucleus and putamen
what is a risk factor for the development of a meningioma
radiation therapy to head and neck
what is the histologic hallmark of Parkinson disease
alpha-synuclein that forms Lewy bodies and Lewy inclusions
which three types of neurons are most sensitive to hypoxia
1.) pyramidal cells of hippocampus
2.) purkinje cells of cerebral cortex
3.) pyramidal neurons in cerebral cortex
what are the three main histologic features of a pilocytic astrocytoma
1.) hairline processes
2.) Rosenthal fibers
3.) mulberry like granular bodies
what is the most common site of an arterivenous malformation
middle cerebral artery
what can be seen histologically in oligodendrocyte injury
nuclear viral inclusions or cytoplasmic inclusions
what is the most common type of embryonal neoplasm of the brain
medulloblastoma within the cerebellum
a meningoencephalocele is associated with which condition
Meckel-Gruber syndrome
which types of glial tumor has the best prognosis
oligodendroglioma
what are the three main causes of macrocephaly and microcephaly
1.) chromosome abnormalities
2.) fetal alcohol syndrome
3.) HIV infection in utero
Arnold-Chiari (type 2) malformation is associated with what
spina bifida
which three locations have the least amount of collateral flow within the brain
1.) thalamus
2.) basal ganglia
3.) deep white matter
what is the most common location for capillary telangiectasis
pons
what are duret hemorrhages
secondary hemorrhagic lesions in the midbrain and pons due to progression herniation
what is seen histologically in primary CNS lymphoma
malignant cells around vessels and necrosis
what is the most common primary glioma
astrocytoma
what is the most common genetic abnormality to cause a meningioma
loss of chromosome 22
what does an astrocyte do
maintain blood brain barrier
what are the 5 changes seen in acute neural injury (red neurons)
1.) shrinkage of cell body
2.) pyknosis of nucleus
3.) lack of nucleolus
4.) loss of Nissl substance
5.) eosinophilia of cytoplasm
what is the main consequence of agenesis of the corpus callousum
prevents both sides of brain from communicating
what is the microscopic feature of an ependymoma
perivascular pseudorosettes
what is gliosis
injury of astrocytes that leads to hypertrophy and hyperplasia
what are the three main causes of a paradoxical emboli
1.) cardiac anomalies in children
2.) cardiac surgery
3.) tumor, fat, or air
what is hydrocephalus ex vacuo
compensatory increase in ventricular volume secondary to loss of brain parenchyma
ex. Alzheimer’s
what is seen histologically 10 days after an acute cerebral infarct
foamy macrophages and reactive gliosis with neovascularization
what are the two main things seen histologically in aseptic meningitis
1.) perivascular cuffs of lymphocytes
2.) microglial nodules
who is most affected by cytomegalovirus (CMV)
immunosuppressed individuals (HIV) and fetuses
what are the three most common locations for a cavernous malformation
1.) cerebellum
2.) pons
3.) subcortical region
which two organisms most commonly cause acute pyogenic meningitis in older adults
1.) strep. pneumo
2.) listeria
what is Heubner arteritis
thickening and lymphocytic infiltration of intima seen in neurosyphilis
what is Fuchs Endothelial Dystrophy
loss of endothelial cells of the cornea which results in stromal edema and bulbous keratopathy
treated with a corneal transplant
which condition can cause significant conjunctival scarring
long standing, untreated chlamydia trachomamtic (trachoma)
what is a common complication of uveitis
sarcoidosis
keratoconus is associated with which two conditions
1.) Downs Syndrome
2.) Marfan Syndrome
what it the most common intraocular malignancy of adults
metastasis (typically choroid) to the uvea (uveal melanoma)
what is the most common cause of glaucoma
increase in ocular pressure
what is the most common malignancy of the eyelid
basal cell carcinoma
cataracts are associated with which four conditions
1.) diabetes mellitus
2.) Wilson disease
3.) radiation
4.) trauma
what are the two histologic hallmarks of a retinoblastoma
1.) flexner-wintersteiner rossettes
2.) homer wright rosettes
what is the most common conjunctival lesion
conjunctival nevus
which two infections are known to cause corneal ulceration
HSV and zoster
what is actinic band keratopathy
aggregates on eyeball due to chronic high level UV exposure
the sclera may appear blue in which three conditions:
1.) high intraocular pressure
2.) osteogenesis imperfecta
3.) recurrent scleritis
what are the three most common types of primary, vascular tumors of the orbit
1.) capillary hemangioma
2.) lymphangioma
3.) cavernous hemangioma