H yeild Flashcards
Restrictive pericarditis
Hx of systemic disease e.g. amyloidosis,
haemochromatosis, inflammatory bowel disease
○ If pericardial thickening or fluid can’t be demonstrated consider restrictive
cardiomyopathy
Endocrine tumour
rare, normally bod or tail, can be functional (-> Sx due to
hormone secretion) or non functional
○ Acinar cell - enzyme production (e.g. lipase -> fat necrosis), rare, older
adults
Pancreatoblastoma
rare, mainly childhood, presents with abdo pain, emesis,
jaundice
Pseudocyst
usually complication of pancreatitis, or in children after abdo trauma;
presents with abdo discomfort, difficult digestion
Adenocarcinoma
head of pancreas
○ Ductal adenocarcinoma = 85% of pancreatic malignancies; RUQ + back pain,
weight loss, ascites, usual suspects
Type of cancer that doesn’t occur in pancreas
squamous cell
Duct ectasia
inflammation and dilatation of breast ducts, presents with nipple
discharge
○ Inflammation, proteinaceous material, benign + no risk of malignancy
Fibroadenoma
benign, mobile lump, multinodular composed of expanded
intralobular stroma, compressed ‘slit like’ ducts, branching sheets of epithelium
Fibrocystic
hormone responsive, lumpiness, ⅓ of premenopausal women, can be
cysts, apocrine metaplasia, adenosis, epithelial hyperplasia and stromal hyperplasia
○ No increased risk of malignancy
Radial scar
benign sclerosing lesion characterised by a central zone of scarring
surrounded by a radiating zone of proliferating glandular tissue’
○ Stellate mass on mammogram (resembles carcinoma), central elastotic nidus
surrounded by proliferative corona
Mastitis
Red breast, lactating, cracked skin - continue expressing + antibiotics
Duct papilloma
nipple discharge or mass, 40-60, papillary, excision of involved
duct is curative
Fat necrosis
breast lump, may be firm, Hx of breast trauma
Phyllodes tumour
enlarging fibroepithelial mass in woman >50, potentially
aggressive, can arise with pre existing fibroadenoma
○ ‘Proliferation of fibroepithelium and stromal tissue’
DCIS
neoplastic, 85% found on mammography, ducts with atypical epithelial cells
○ Most common so pick this if in doubt
○ Staged into low, intermediate, and high grade
Invasive breast carcinoma
oestrogen factors, 5% inherited, firm breast mass,
atypical epithelial cells
○ Low grade - ER, PR positive and Her2 non amplified
○ High grade - ER, PR negative and Her2 amplified
○ Invasive ductal carcinoma - nipple retraction
○ Invasive lobular - loss of E-cadherin
Gynaecomastia
benign enlargement of male breast around puberty or over 50,
idiopathic or associated with drugs
Normal breast
Branching ducts end in terminal duct lobular units
○ Ductal lobular system lined by inner glandular epithelium and outer
myoepithelium
Diverticulitis
old, rectal bleeding, fever, LIF
Sigmoid volvulus
obstruction
UC + Crohns
UC continuous, superficial, more likely to have blood
Infective colitis
pseudomembrane, Abx in history
Barrett’s oesophagus
metaplasia, columnar epithelium, goblet cells (intestinal)
Squamous cell carcinoma of oesphagus
alcohol, smoking, mid/lower
oesophagus, invasion into submucosa
CF
patients after lung transplant are more likely to get adenocarcinoma of colon
MALT lymphoma
Pernicious anaemia, H pylor
Chronic gastritis:
associated with pernicious anaemia and gastric ulcer
Gastric cancer
5% adenocarcinoma
○ Intestinal - well differentiated
○ Diffuse - poorly differentiated (linitis plastica, signet ring cell)
○ Signet ring cell - contains mucin which pushes nucleus to cell periphery
Lower GI cancer
Adenocarcinoma most common - male with change in bowel habit, weight
loss, bleeding PR
○ AFP -> hyperplastic polyps
○ Polyps not associated with increased cancer risk -> hamartomatous
HIV Tuberculoma
ring enhancing lesion
TIA
<24 hours stroke symptoms
Multiple Sclerosis
relapsing remitting or primary progressive, vision problems
CVS Disease
focal neurology, FAST, >24 hours
Subarachnoid Haemorrhage
thunderclap
Middle meningeal/extradural bleed
Hit on side of head and lucid interval
Variant CJD
Depression then CNS symptoms in young person
Sporadic CJD -
neurosings first and presents later
Alzheimer’s
most common cause of dementia, neurofibrillary tangles (tau), senile plaques
(beta amyloid)
Neurofibromatosis type 1 -
optic nerve tumour excised and now lump on hand
AV malformation
capillary loops surrounded by epithelial cells
Tuberous sclerosis
epileptic with patch on back and lumps in brain
Herniation
raised ICP symptoms for a while then became obtunded
Meningioma
mass under dura mater compressing frontal lobe (usually)
Wilms
massive abdo mass in child, might have high BP, or haematuria
RCC
High EPO, high Hb, renal masses, painless haematuria
Renal Infarct
fat person with CVS risk factors, will hurt
