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MRCS-Pathology > Deck 4 > Flashcards

Deck 4 Flashcards

1
Q

Acute inflammation def

A

body’s response to tissue injury characterised by red hot swollen pain

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2
Q

Acute inflammation stages

A
  1. vasoconstriction
  2. vasodilation (red/hot)
  3. increased permeability (swelling)
  4. Migration of white cells (neutrophils)
  5. Phagocytosis
  6. Resolution or progression
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3
Q

Complement cascade 3 pathways activation

A

Classic: antigen-antibody complex activation
Alternative: C3 contacting micro-organisms
Lectin: Mannose-binding lectin binds to cell membrane of pathogens

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4
Q

Consequences of complement cascade activation

A
  1. inflammation and activation of leucocytes
  2. Opsonisation of pathogens for macrophages
  3. formation of MAC and destruction of pathogens
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5
Q

Possible outcomes of inflammation

A
  • Resolution
  • Chronic inflammation
  • Scar
  • abscess
  • Death (meningitis)
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6
Q

Possible outcomes of inflammation

A
  • Resolution
  • Chronic inflammation
  • Scar
  • abscess
  • Death (meningitis)
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7
Q

Chronic inflammation

A

Active inflammation, tissue injury and healing occurring at the same time

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8
Q

Examples of chronic inflmmation

A

Infection evading host immune: TB, H pylori

Auto-immune: rheumatoid

Untreated acute inflammation: chronic osteomyelitis

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9
Q

Examples of chronic inflmmation

A

Infection evading host immune: TB, H pylori

Auto-immune: rheumatoid

Untreated acute inflammation: chronic osteomyelitis

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10
Q

BRCA 1 and 2 chromosomes

A 
1 = 17
2 = 13
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11
Q

BRCA 1 ass with which cancers

A

Ovarian

Breast

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12
Q

BRCA 2 associated with which cancers

A

Breast

Pancreatic

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13
Q

Sentinel node biopsy procedure

A
  1. radio-isotope/dye injected into sub-dermal layer around areolar region
  2. During op, sentinel node identified by dye or Geiger counter
  3. if positive that group of nodes are excised
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14
Q

Complications of mastectomy

A

Immediate: haemorrhage

Early:

  • damage to local nerves: thoraco-dorsal, long thoracic
  • infection
  • haematoma/seroma formation

Late:
- recurrance

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15
Q

Breast reconstruction

A

Breast mound:
- flap or implant or both

Nipple areolar complex:

  • areolar region: tattoo
  • nipple: flap or graft from contra-lateral side
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16
Q

Types of flaps in breast reconstruction

A
  • Latissimus dorsi
  • TRAM (transverse rectus abdominis)
  • DIEP (deep inferior epigastric perforator)
  • SGAP or IGAP (Sup/Inf gluteal aretery perforator flaps)
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17
Q

Local complications of radiotherapy

A
  • permenant skin discolouration
  • Lymphoedema
  • Swelling of remaining breast
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18
Q

Oestrogen dependent breast cancer mx

A

Pre-menupause:

  • tamoxifen (SERM)
  • stops production of oestrogen at overies

Post-menupause

  • anastrazole ( aromatase inhibitor)
  • stops peripheral production in fat tissue
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19
Q

Herceptin role in breast cancer

A

Targets cells that over-express HER2 (transmembrane epidermal growth factor)

Reduces recurrence

HER2 over expressed in 15% of breast cancers

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20
Q

Poor prognostic factors for breast cancer

A

HER 2 positive
Young at diagnosis
High grade

21
Q

Naevus definition

A

benign proliferation of cells of skin

22
Q

Types of naevus

A
  1. melanocytic (eg congenital)
  2. vascular (eg port wine stain)
  3. Epidermal (warty naevus)
23
Q

Types of cutaneous melanoma

A
  • Superficial spreading
  • Nodular
  • Acral lentigenous and subungal melanoma
  • lentigo maligna
24
Q

Types of cutaneous melanoma

A
  • Superficial spreading
  • Nodular
  • Acral lentigenous and subungal melanoma
  • lentigo maligna
25
Q

RFs for melanoma

A

Modifiable:

  • UV light exposure
  • CT scan in childhood

Non-modifiable:

  • age
  • Previous BCC, SCC
  • Fitz Patrick 1
26
Q

ABCDE rule to examine melanomas

A 
Assymetry 
Border irregularity 
Colour variation 
Diameter >7mm
Evolution eg shape/size/colour
27
Q

Glasgow 7 point checklist for melanoma components

A

Major fx (2 points)

  • change in size
  • irregular shape
  • irregular colour

Minor fx (1 point)

  • diameter >7mm
  • inflammation
  • oozing
  • change in sensation
28
Q

Glasgow 7 point checklist interpretation

A

Lesions scoring 3 or more need urgent referral

29
Q

What type of biopsy for melanoma

A

excision biopsy with 2mm excision margin

30
Q

How are branchial cyst formed

A

Failed or incomplete involution of pharyngeal cleft during development (mostly 2nd branchial cleft)

31
Q

Where are branchial cysts found

A

Anterior to SCM upper 1/3 in the anterior triangle

32
Q

When do branchial cysts present

A

2-3rd decade of life

33
Q

How are branchial cysts diagnosed?

A

USS +/- FNA (cholesterol rich fluid)

34
Q

Branchial cyst rx

A

Mostly conservative

Surgical removal if pressure/infection

35
Q

When do thyroglossal cysts present

A

40% in the first decade, but could present later

36
Q

Where are thyroglossal cysts found

A

Midline or off midline,

Between chin to 2nd tracheal ring

37
Q

What is a dermoid cyst

A

Benign tumour of ectoderm

Keratinised epithelium with hair and sweat glands

38
Q

Where are dermoid cysts found

A
  • Midline neck and trunk
  • Midline nose
  • Medial and lateral eyebrows
39
Q

Dermoid cyst mx

A

Excision

40
Q

What is a sebaceous cyst

A

Epidermoid or pilar (hair follicle) cysts that contain keratin

41
Q

What is a sebaceous cyst

A

Epidermoid or pilar (hair follicle) cysts that contain keratin

42
Q

Common sites for sebaceous cysts

A

Head
Scalp
Neck
Trunk

43
Q

Rx for sebaceous cyst

A

Excised with overlying skin as contains a punctum

44
Q

Ludwig’s angina

A

Cellulitis of floor of the mouth and neck
Spreads through submandibular space
Leads to elevation and posterior displacement of tongue
-> aiwary obstruction

45
Q

Cystic hygroma cause

A

Congenital malformation of lymphatic system

46
Q

Where are cystic hygromas found

A

posterior triangle of neck

47
Q

When do cystic hygromas present

A

Majority visible at birth

90 % by 2yo

48
Q

Rx for cystic hygroma

A

Aspiration + Injection of sclerosing agent

or

Resection

49
Q

Ludwig’s angina

A

Cellulitis of floor of the mouth and neck
Spreads through submandibular space
Leads to elevation and posterior displacement of tongue
-> aiwary obstruction

MRCS-Pathology (11 decks)

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