2022 Fall ITE Flashcards
3 Risk factors for thrombosis
- endothelial injury
- hypercoagulability
- stasis
4 possible fates of thrombus
- propagation
- embolization
- dissolution
- organization
3 steps in acute inflammation
- Vasodilation
- Increase permeability
- Emigration of leukocytes
3 features of chronic inflammation
- Mononuclear cells
- Tissue destruction
- Attempts at healing
Non-infectious causes of granulomatous inflammation
Sarcoidosis
Foreign body reaction
Inflammatory bowel disease
Granulomatosis with polyangiitis
Molecular subgroups of endometrial carcinoma
POLE ultramutated
microsatellite instability hypermutated
copy number low
copy number high
Histologic subtypes of endometrial carcinoma
- Endometrioid carcinoma
- Serous carcinoma
- Clear cell carcinoma
- Carcinosarcoma
- Mixed carcinoma
- Undifferentiated
- Dedifferentiated
Precursor lesions of endometrial carcinoma
- Endometrial hyperplasia without atypia
- Endometrioid intraepithelial neoplasia (EIN)
- Serous endometrial intraepithelial carcinoma (SEIC)
Molecular alterations in low grade and high grade endometrial stromal sarcoma
LG-ESS - JAZF1-SUZ12
HG-ESS - YWHAE and BCOR fusions
Subtypes of aggressive oral SCC
- acantholytic
- adenosquamous
- spindle cell SCC
Risk factors for oral SCC
- HPV, particularly HPV-16
- Smoked tobacco
- Alcohol
- Betel quid
- Radiation
Risk factors for nasopharyngeal carcinoma
- EBV
- Alcohol
- Smoking
- Salted fermented foods
4 types of blunt force injury
- Abrasion
- Laceration
- Avulsion
- Bruise
Entrance wound gunshot signs
- Round
- Regular
- May have stippling
- May have soot
- May have internal beveling
Signs of child abuse
- Different ages of lesions
- Delay in seeking medical help
- Vague explanations from parents
- Lesions in unusual sites for accidents
Amsterdam criteria for HNPCC screening
- ≥ relatives with HNPCC-associated Ca (CRC, SB endometrial, urothelial)
- CRC ≥2 successive generations
- 1 FDR to other two
- 1 Ca diagnosis <50 years
Tumors in tuberous sclerosis
PEComas (LAM)
Cortical tubers
Cardiac rhabdomyoma
Angiofibroma
Connective tissue nevi (shagreen patches)
Eosinophilic solid and cystic RCC
Features of VHL
Clear cell RCC
Kidney, liver, and pancreas cysts
Hemangioblastoma (retina, cerebellum)
Pheochromocytoma
Pancreatic NET
Papillary cystadenoma of epididymis
Endolymphatic sac tumor of the ear
Molecular subtypes of breast carcinoma
Luminal A - + ER, ≥20% PR, <14% Ki-67, Grade 1 or 2
Luminal B - + ER, <20% PR, Ki67 ≥ 14%, Grade 3
HER-2 enriched - HER2+, Grade 3
Basal - Grade 3, triple negative
Pre-analytic recommendations for breast biomarker testing from ASCO/CAP
- 10% formalin 6-72 hours
- Sliced at 5 mm intervals
- Record cold ischemia time, fixative type, and time sample placed in formalin
- Use of unstained slides cut > 6 weeks before analysis is NOT RECOMMENDED.
Causes of intrinsic urethral obstruction
- Calculi
- Strictures
- Tumors
- Blood clots
- Neurogenic
Causes of extrinsic urethral obstruction
- Pregnancy
- Periureteral inflammation
- Tumors
- Endometriosis
Gene mutation in low grade urothelial carcinoma
FGFR3
RAS
Gene mutation in high grade urothelial carcinoma
p53, Rb
Common chromosomal aberration in urothelial carcinoma
Chromosome 9p deletion
Indications for radical cystectomy
- muscle invasive bladder carcinoma
- CIS or high-grade papillary cancer refractory to BCG and other intravesical therapies
- CIS extending into prostatic urethra and ducts, where instilled BCG does not come into contact with neoplastic cells
- multifocal lesions too large and extensive to completely eradicate by transurethral resection
- aggressive variant, micropapillary
Stages of mycosis fungoides
patch, plaque, tumor
Markers in mycosis fungoides
CD2+ CD3+ TCR beta + CD5+ CD4+ CD8-
CD7 dim/partially lost
Loss of pan T cell antigen
Demonstration of clonal TCR gene rearrangements
Describe histology of epidermal cyst
Cyst lined by stratified squamous epithelium filled with flaky keratin plaque
Differentiate dermoid from epidermal cyst
Dermoid cyst wall has adnexal tissue (hair follicle and sebaceous glands)
How does pilar/trichilemmal cyst differ histologically from epidermal cyst?
Pilar cyst has densely packed eosinophilic keration (wet keratin)
“Vanishing” cancer reasons
- False positive biopsy
- Specimen mix-up
- Floater on cell block
- Cancer in remaining blocks: levels, re-embed, flip blocks
- Cancer lost by trimming blocks
- Therapeutic biopsy
- Cancer altered by neoadjuvant treatment effects, inflammation
QA monitors in gynecologic cytology
- Interpretive rates of all TBS diagnostic categories
- ASC rate
- ASC:SIL ratio
- Positivity rate of hrHPV in ASC-US cases
- Cytotechnologist-pathologist discrepancy logs
- Cyto-histologic correlation
- Monitoring of screening performance or sensitivity (prospective rescreening, retrospective rescreening)
Critical values in GYN/NON-GYN cytology
- Any unusual or unexpected cytology result
- Involving a critical site (e.g. causing SVC syndrome or paralysis)
- Pathogenic organisms in an immunosuppressed patient or in any orbital or CSF sample
- Identification of HSV changes in cervical/vaginal sample of near-term pregnant patient
- Any corrected report, where the diagnosis if significantly changed and will result in different patient management
2 causes of genetic hypercoagulability
Antithrombin III deficiency
Protein C deficiency
Protein S deficiency
2 most common causes of fat and marrow emboli
Hip fracture
Orthopedic trauma
CPR
