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MRCS-Pathology > Deck 6 > Flashcards

Deck 6 Flashcards

1
Q

Categories of polyps

A

Non-neoplastic

Neoplastic

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2
Q

Non-neoplastic polyps

A

Metaplastic
Hamartomatous
Pseudopolyp

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3
Q

Neoplastic polyp types

A

Tubular
Tubulo-villous
Villous

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4
Q

What is the most frequent neoplastic polyp

A

Tubular then tubulo-villous, then villous

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5
Q

Which neoplastic polyp has the most malignant potential

A

Villous

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6
Q

FAP genetics

A

autosomal dominant

Loss of APC tumour supressor gene

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7
Q

FAP sx

A

100-1000s of polyps in 20s

100% risk of GI malignancy by 40yo

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8
Q

Two FAP syndromes

A

Gardner syndrome

Turcot syndrome

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9
Q

Gardner syndrome sx

A

Polyps+ :

  • Thyroid ca
  • Osteomas
  • Dental numeracy
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10
Q

Turcot syndrome

A

Polyps +

CNS neoplasm : esp medulloblastomas

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10
Q

When to do OGD+colonoscopy for FAP FHx

A

Colonoscopy:

  • 12-13 yo
  • Every 1-3 years

OGD
- 25 yo

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11
Q

Prophylactic op for FAP

A

Total colectomy + ileorectal pouch
or
panproctocolectomy and end lieostomy

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12
Q

What is the function of PSA (prostate specific antigen)

A

Produced by epithelial cells of prostate gland

Liquifies semen allowing sperm to move freely dissolving the cervical mucous

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13
Q

Difference between grading and staging

A

Stage: size and degree of spread

Grade: how well differentiated a tumour is

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14
Q

When to check PSA after prostectomy

A

6 wks after op
Then every 6 months for 2 years
Then every year

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15
Q

Hormone therapy for prostate cancer

A

Bicalumetide (antagonist to androgen receptors)

Stops testosterone binding to cancer cells inhibiting their growth

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16
Q

Voiding sx

A

Incomplete emptying
Hesitancy
Terminal dribble
Poor flow

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17
Q

Filling sx

A

Nocturia
Frequency
Urgency

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18
Q

Aetiology of BPH

A

Unclear, increased ratio of dihydrotestesterone to oestrogen has been suggested

19
Q

Ix of BPH

A

Bedside: urine dip
Bloods: PSA
Imaging: Transrectal USS or IVU
Special tests: uroflowmetry

20
Q

TURP complications

A

Early: bleeding, infection, TUR syndrome
Late: stricture, retrograde ejaculation

21
Q

How does proteus lead to struvite stone formatio

A

Alkalinses the urine (urea ->ammonia)

Reduces solubility of phosphate

22
Q

RIFlE classification

A

R: cr *1.5 or UO< 0.5 6hrs

I: cr * 2 or UO < 0.5 12hrs

F: cr *3 or UO <0.3 ml/kg 24hrs or anuric for 12hrs

Loss: failure for >4 wks
End stage: failure > 3months

22
Q

RIFlE classification

A

R: cr *1.5 or UO< 0.5 6hrs

I: cr * 2 or UO < 0.5 12hrs

F: cr *3 or UO <0.3 ml/kg 24hrs or anuric for 12hrs

Loss: failure for >4 wks
End stage: failure > 3months

23
Q

Warm ischaemic time

A

Start: circulation to donor kidney stops
End: perfusion solution starts flowing

24
Q

Cold ischaemic time

A

Start: cold solution starts flowing
End: organ transplanted in recipient

Max between 24-48hrs

25
Q

What is perfusion solution for organ transplant made off

A

Ice cold solution:

  • impermeable solutes (minimise swelling)
  • pH buffer
  • free radical scavengers
  • membrane stabilisers
  • adenosine for ATP synthesis
26
Q

RFs for undescended testicles

A

Preterm
Low birth weight
FH

27
Q

Teratoma age

A

20-30

28
Q

Seminoma age

A

30-40

29
Q

Where do testicular tumours mets to

A

Lung
Colon
Bladder
Pancreas

30
Q

Where does acral lentigenous affect

A

Palms and soles, under finger nails

31
Q

Where is Breslow thickness measured from

A

From glandular cells of epidermis to deepest point of invasion

32
Q

Features of BCC

A

Sun exposed area
Slow growing, never metastasise

Pearly papule with a rolled edge

33
Q

Treatment of BCC

A

Excision
or
5 FU cream

34
Q

What is Bowens skin disease

A

SSC in situ
Could progress to become invasive SSC

slow enlarging, red, well demarcated plaque

35
Q

Cytological signs of malignancy

A
  1. increased mitotic rate
  2. hyperchromatism (darkened nuclei due to increased DNA concentration)
  3. Pleomorphism (varied size and shape of cell)
  4. Increased nuclear to cytoplasmic ratio
36
Q

What are features of malignancy on histology

A

Neovascularisation
Necrosis
Haemorrhage

37
Q

Negative prognostic markers for melanoma

A

Nodular

High Breslow thickness

38
Q

Functions of spleen

A
  1. immune
  2. circulatory filteration
  3. platelet storage
  4. haemopoiesis until birth
  5. iron re-utilisation
38
Q

Functions of spleen

A
  1. immune
  2. circulatory filteration
  3. platelet storage
  4. haemopoiesis until birth
  5. iron re-utilisation
39
Q

Complications of splenectomy

A

Immediate: haemorrhage

Early:

  • gastric necrosis,
  • pancreatitis

Late:

  • thrombocytosis
  • OPSI (overwhelming post splenectomy infection)
40
Q

Abx post splenectomy

A

Pen V or erythromycin (pen allergic) in:

  • the first 2 yrs
  • <16 yo or >55yo
  • immunocompromised
40
Q

Abx post splenectomy

A

Pen V or erythromycin (pen allergic) in:

  • the first 2 yrs
  • <16 yo or >55yo
  • immunocompromised
41
Q

Splenectomy vaccination procedure

A

Either 2 wks before or 2 wks after op

  1. Haemphilis influenza
  2. Pneumococous
  3. Men B, C
  4. annual flu jan
42
Q

Post splenectomy blood film

A

Increased platelets
Howel jolley bodies (RBC with remnants of nuclei which otherwise should have been removed)
Pappenheimer bodies (siderocytes containing iron)
Target cells

43
Q

Causes of splenomegally

A

Infective: EBV, CMV
Haematological: leukaemia, lymphoma
Systemic: sarcoid, amyloid

MRCS-Pathology (11 decks)

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