breast IOD Flashcards
which tumour under microscopy has cell in a single file and a dysfunction in the E-cadherin-catenin system
lobular carcinoma
which tumour describes: a well circumscribed with well differentiated glands embedded into well differentiated connective tissue stroma
breast fibroadenoma
breast cancer that express ER
ER positive is less aggressive and more likely to respond to hormone therapy
breast cancer that over express HER
poorer prognosis but more likely to respond to herceptin
what is associated with microcalcifcations
DCIS can be seen in mammogram
how does DCIS and ductal carcinoma present
ductal carcinoma presents as a mass, DCIS: confined within basement membrane
What are the six different prognostic factors for breast cancer
tumor stage, tumour grade, histological subtype, vascular invasion, excision margins, oestrogen and HER2
what is the most prognostic factor in breast cancer
tumour stage and in particular the lymph nodes
What are the three compensation mechanisms for acid
buffering, compensation and treatment
What are the three mechanisms for buffering
bicarbonate in the serum and phosphate in the urine, skeleton and intracellular loss of H+
Characteristics of compensation of acid
diametric opposite, never overcompensates and delayed and limited
how do we treat to compensate acid
precipitating solution
iron requirment for men and women aged 11-18
men: 11 and women: 15
iron requirement for men and women aged 19-50
men: 8 and women: 18
iron requirement for men and women aged 7-12 months
11 for both
What is the most common cancer in the UK
breast cancer
lifetime risk of breast cancer in the UK
1-8 women
in which ages in breast cancer most likely
40-70 yr
Before what age is breast cancer less likely to develop
25 years
three major risk factors for breast cancers
family history, prolonged oestrogen exposure and alcohol consumption
Which genes can lead to increased risk of breast cancer
BRACA 1 and BRACA 2
under which inheritance pattern is BRCA gene inherited
autosomal dominant
by what percentage does each additional alcoholic drink increase the risk of developing breast cancer
10%
apart from breast cancer, what other cancer is at a higher risk of having BRACA
ovarian cancer and do a bilateral masectomy
What are the four characteristics of a malignant cell
pleomorphism, hyperchromasia, increased nuclear:cytoplasmic ratio and mitotic actvity
in which ages would you consider a mammogram
age over 35
in which ages would you consider an ultrasound
age under 35
why would you do a mammogram in older patients
you can see microcalcifications more clearly
why would you do a ultrasound in younger patients
you can see more dense tissue and identify solid and cystic lesions
What does C1/B1 refer to
inadequate sample
what does C2/B2 refer to
benign
what does C3/B3 refer to
equivocal favour benign
what does C4/B4 refer to
equivocal favour malignant
what does C5/B5 refer to
malignant
Which C/B stage does DCIS refer to
C5/B5
what does a increased urea/creatinine ration refer to
there is a problem with the kidneys
Define fibrocystic change
minor aberrations to cyclical hormonal chnage
painful lump in breast during second half of cycle
fibrocystic change
In which age is fibrocystic age common
25-45
treatment of fibrocystic change
reassurance, analgesia, aspiration or excision
Which three factors reduce the release of ADH
decreased plasma osmolality, increase in plasma volume and ethanol
What is the ages for the NHS breast screening program
47-73 years every 3 years before 50-70
Where do all breast cancers arise from
from epithelial cells lining the terminal duct lobular unit
what type are 75% of breast cancers
ductal carcinoma
What part of the lung does mesothelioma affect
lining of the pleura
latency period of mesothelioma
40 years
what do fibroblasts secrete in the interstitium during DLPD
collagen
three organisms that causes severe CAP
strep pneumoniae, legionella, Stpah auerus
which organism is the main cause of infective excacerbation of COPD and then pneumonia
1)h. influenzae and 2)s.pneumoniae
What are the other three types of breast cancer apart from lobular and ductal
tubular, cribriform and mucinous
most common organisms that cause HAP
gram negative, klebsiella, e-coli and pseudomonas aeruginosa
What are the three risk factors for lung cancer in non-smokers
industrial hazards, epidermal growth factor and environmental hazards like radon gas
What is main demographic in patients with sjorgens syndrome
50 year old women
sensitivity and specificity of ANA testing
high sensitivity but low specificity
A negative ANA will rule out which diseases
SLE, sjorgens syndrome, systemic sclerosis
Which drugs can increase the risk of a positive ANA
hydralazine, isonazid and procainamide
Which infections can you see a positive ANA
TB, mononucleosis, hepatits c, subacute bacterial endocarditis
When should the three serum tryptase samples be taken
15min-3 hr, 3-6hr 24-48hr
when should serum tryptase levels return to normal after an allergic reaction
12-14
What does a persistently raised serum tryptase suggest
mastocytosis
rules for antihistamines when doing a skin prick test
stop 5-7 days before
2 preformed and 2 synthesised inflammatory mediators
preformed: histamine and tryptase, synthesised: prostaglandin and leukotrienes
in which region is beta thalassemia present in higher levels
pakistan
IgA endomysial antibodies, IgA tTG antibodies
coeliac disease
Anti-gastric parietal cell antibodies
atrophic gastritis, pernicious anaemia
anti-intrinsic factor antibodies
pernicious anaemia
anti-mitochondrial antibodies,anti-PDH antibodies
primary biliary cirrhosis
anti-smooth muscle antibodies
autoimmune hepatitis
anti-glomerular basement membrane antibodies
good-pastures syndrome
anti-PR3, cANCA
Granulomatosis with polyangitis, Eosinophilic granulomatosis with polyangiitis
pANCA
granulomatosis with polyangitis, eosinophilic granulomatosis with polyangitis and UC
anti-cardiolipin antibodies
antiphospholipid syndrome
anti-skin antibodies
phemphigus and phemphigold
anti-adrenocortical antibodies
addisons disease
anti-SSA (Ro) and anti-SSB (La)
sjorgens
anti- cyclic citrullinated peptide antibodies
rheumatoid arthritis
anti-acetylcholine receptor antibodies
myasthenia gravis
define chronic spontaneous urticaria
spontaneous hives or angioedema or both daily or almost daily for atleast 6 weeks
6 steps of management for chronic spontaneous urticaria
1) stop exacerbating factors
2) anti-histamines
3) short courses of steroids for 10 days for acute exacerbations
4) h2 receptor blocker- rantidine
5) leukotriene receptor- montelukast
6) IgE antiboidy: ozliumab
increased risk of breast cancer thriugh family history
Breast cancer in a first-degree male relative of any age
Breast cancer in a first-degree relative under the age of 40
Bilateral breast cancer in a first-degree relative under the age of 50
Breast cancer in two first-degree relatives
