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Path (hopefully more condensed) > Histo > Flashcards

Histo Flashcards

1
Q

what do neutrophil polymorphs indicate

A

acute inflammation

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2
Q

what do lymphocytes indicate

A

chronic inflammation

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3
Q

lymphocytes + neutrophils =

A

acute on chronic

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4
Q

what is the loss of surface epithelium +/- lamina propria with muscularis in tact

A

erosion

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5
Q

what is the loss of surface epithelium with depth of tissue loss beyond the muscularis mucosae

A

ulcer

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6
Q

ulcer with element of fibrosis

A

chronic ulcer

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7
Q

what is dysplasia

A

cytological and histological features of malignancy, basement membrane in tact

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8
Q

what are the two roads to GI cancer

A

metaplasia-dysplasia pathway (oesophageal)

adeno-carcinoma pathway (colorectal cancer)

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9
Q

features of adenocarcinoma

A

gland forming

mucin secreting

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10
Q

features of squamous cell carcinoma

A

make keratin

inter-cellular bridges

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11
Q

what is the squamo-columnar junction called in oesophagus

A

Z line

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12
Q

what subtype of barrett’s oesophagus carries greater risk

A

goblet cell positive(intestinal type columnar epithelium)

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13
Q

stain to highlight intestinal type columnar epithelium

A

methylene blue

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14
Q

most common oesophageal malignancy worldwide

A

upper/mid oesopahgeal SCC

alcohol/ cigarettes

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15
Q

most common oesophageal malignancy UK

A

distal adenocarcinoma (columnar epithelium transformation)

GORD/ oesophagitis

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16
Q

oesophageal varices cause

A

portal HTN: cirrhosis, portal vein thrombosis, IVC obstruction

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17
Q

oesophageal varices presentation

A

upper gi bleed, melaena

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18
Q

oesophageal varices management

A

fluid resuscitate, terlipressin, scope, PPI infusion

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19
Q

should goblet cells be seen in stomach?

A

NO - indicates intestinal type metaplasia

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20
Q

what do chief cells produce

A

pepsin

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21
Q

what do parietal cells produce

A

intrinsic factor

HCl

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22
Q

causes of acute gastritis

A

alcohol consumption, NSAIDs, H. pylori, stress

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23
Q

causes of chronic gastritis

A

autoimmune (pernicious anaemia), H. pylori, bile reflux, NSAIDs, CMV if immunosuppressed, crohn’s

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24
Q

H. pylori eradication therapy

A

PPI

clarithromycin

amoxicillin or metronidazole

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25
Q

h pylori under microscope

A

gram negative curved rod

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26
Q

what is H pylori associated with

A

MALT, B cell marginal lymphoma

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27
Q

what is the main type of gastric cancer

A

adenocarcinoma (95%)

other 5% are SCC, lymphoma, GIST

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28
Q

what are the two types of gastric adenocarcinoma

A

intestinal - well-differentiated, mucin producing, gland forming

diffuse - sinlge-cell architecture, no gland formation, signet-ring cells

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29
Q

what are signet ring cells associated with

A

diffuse type gastric adenocarcinoma

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30
Q

usual type of stomach cell

A

columnar epithelium

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31
Q

most common cause of duodenal ulcers

A

H pylori

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32
Q

coeliac disease changes on biopsy

A

villous atrophy, crypt hyperplasia

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33
Q

lymphocytic duodenitis villous structure

A

NORMAL

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34
Q

examples of non-neoplastic polyps

A

hyperplastic polyps

inflammatory pseudo-polyps

hamartomatous polyps

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35
Q

examples of neoplastic polyps

A

tubular adenoma

tubulovillous adenoma

villous adenoma

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36
Q

polyps with increased risk of cancer

A

higher villous component, dysplastic features

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37
Q

pathology of liver fibrosis

A

kupferr cells activated

stellate cells activated –> myelofibroblasts

basement membrane secreted

collagen in space of disse

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38
Q

features of liver cirrhosis

A

whole liver fibrosis with nodules of regenerating hepatocytes and distortion of vascular architecture

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39
Q

alcoholic hepatitis features

A

ballooning of cells

mallory denk bodies

apoptosis

pericellular fibrosis

hypoxic zone 3

relatively irreversible

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40
Q

most common cause of liver cancer

A

secondary metastatic disease

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41
Q

primary tumours of the liver

A

hepatocellular carcinoma

hepatoblastoma

cholangiocarcinoma

haemangiosarcoma

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42
Q

peri-ductal injury in acute pancreatitis suggests what cause

A

obstructive cause

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43
Q

peri-lobular injury in acute pancreatitis suggests what cause

A

vascular cause

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44
Q

acute pancreatitis pathology

A

reflux enzymes –> acinar necrosis –> release of more enzymes

release of lipases –> fat necrosis –> soaponification with calcium

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45
Q

acute pancreatitis complications

A

haemorrhagic pancreatitis

hypoglycaemia, hypocalcaemia

pesudocyst, abcess

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46
Q

chronic pancreatitis features

A

fibrosis, duct strictures, loss of paenchyma

main cause = alcohol

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47
Q

main type of pancreatic carcinoma

A

ductal (85%)

other type = acinar

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48
Q

other types of pancreatic cancer

A

cystic neoplasms: - serous cystadenoma
- mucinous cystic neoplasm

neuroendocrine tumours

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49
Q

pancreatic neuroendocrine tumour features

A

associated with MEN1 (pituitary, pancreas and parathyroid)

most commonly in tail

most commonly non-secretory

most common type if secretory = insulinoma

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50
Q

pancreatic ductal carcinoma features

A

95% associated with K-ras mutations

most common in head (60%)

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51
Q

nephrotic syndrome triad

A

hypoalbuminaemia

proteinuria

oedema

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52
Q

primary causes of nephrotic syndrome

A

minimal change disease

membranous glomerular disease

focal segmental glomerulosclerosis

membranoproliferative glomerulonephritis

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53
Q

secondary causes of nephrotic syndrome

A

SLE

diabetes

amyloidosis

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54
Q

minimal change disease on electron microscopy

A

loss of podocyte foot processes

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55
Q

minimal change disease management

A

oral prednisolone

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56
Q

most common cause of adult nephrotic syndrome

A

membranous glomerular disease

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57
Q

membranous glomerular disease auto-antibody

A

anti-phospholipase A2 receptor

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58
Q

membranous glomerular disease light microscopy

A

diffuse GBM thickening

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59
Q

membranous glomerular disease electron microscopy

A

loss of podocyte foot processes

spikey subendothelial deposits

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60
Q

membranous glomerular disease management

A

ACEi/ ARB, Bp control

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61
Q

focal segmental glomerulosclerosis light microscopy

A

focal and segmental scarring, hyalinosis

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62
Q

focal segmental glomerulosclerosis electron microscopy

A

loss of podocyte foot processes

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63
Q

focal segmental glomerulosclerosis management

A

ACEi/ ARB, BP control

50% respond to steroids

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64
Q

nephritic syndrome features

A

proteinuria

haematuria

azootemia (high urea and creatinine)

red cell casts

oliguria

HTN

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65
Q

nephritic syndrome causes

A

acute post-infectious GN

IgA nephropathy (berger’s disease)

rapidly progressive GN (cresentic)

Alport’s syndrome (hereditary nephritis)

thin basement membrane disease (benign familial haematuria)

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66
Q

acute post infectious GN features

A

1-3 weeks after strep throat or impetigo

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67
Q

acute post infectious GN bloods

A

high antistreptlysin O titer (ASOT)

low C3

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68
Q

acute post infectious GN light microscopy

A

increased cellularity of glomeruli/ mesangium

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69
Q

acute post infectious GN electron microscopy

A

subendothelial humps

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70
Q

acute post infectious GN immunofluorescence

A

granular deposition of IgG + C3

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71
Q

acute post infectious GN management

A

supportive

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72
Q

IgA nephropathy features

A

most common cause of GN worldwide, east/ south asian patients

days after URTI/ GI infection

frank haematuria

deposition of IgA immune complexes

can progress to ESRF

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73
Q

IgA nephropathy bloods

A

high igA

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74
Q

IgA nephropathy immunofluorescence

A

granular deposition of IgA and C3 in mesangium

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75
Q

IgA nephropathy rule of thirds

A

1/3 asymptomatic

1/3 CKD

1/3 progressive ckd –> dialysis/ transplantation

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76
Q

rapidly progressive GN features

A

ESRF within weeks, most aggressive GN

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77
Q

rapidly progressive GN type 1 association

A

anti-GBM antibody

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78
Q

rapidly progressive GN type 2 association

A

immune complex mediated

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79
Q

rapidly progressive GN type 3 association

A

ANCA associated, pauci-immune

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80
Q

alport’s syndrome features

A

type 4 collagen mutation

nephritic syndrome

sensorineural deafness

eye disorders (lens dislocation, cataracts, macular retinal flecks)

81
Q

alport’s syndrome inheritance

A

x linked

82
Q

thin basement membrane disease features

A

asymptomatic microscopic haematuria

renal function normal

excellent prognosis

autosomal dominant

83
Q

most common type of ovarian cancer, with columnar epithelium and psammoma bodies on histology

A

serous cystadenoma

84
Q

ovarian cancer with mucin secreting cells, NO psammoma bodies. epithelium may resemble GI or endocervical epithelium

A

mucinous cystadenoma

85
Q

ovarian cancer with tubular glands on histology, with endometriosis as a risk factor

A

endometroid carcinomas

86
Q

ovarian cancer with clear cells, and hobnail appearance on histology. strong association with endometriosis, poor prognosis

A

clear cell carcinomas

87
Q

most common ovarian cancer in young women, usually benign

A

dysgerminoma

88
Q

tumour with differentiation into mature tissues e.g. skin, teeth, hair, bone, cartilage

A

cystic teratoma (aka dermoid cyst)

89
Q

tumour type that secretes hCG and mimics pregnancy

A

choriocarcinoma

90
Q

ovarian sex cord tumour that secretes oestrogen

symptoms include post-menstrual/ intermenstrual bleeding, endometrial/ breast cancer, breast enlargment

A

granulosa/ theca cell tumours

91
Q

ovarian sex cord tumour that secretes androgens

symptoms include virilisation, breast atrophy, hirsuitism, enlarged clitoris

A

sertoli-leydig cell tumours

92
Q

sex cord tumour that doesn’t secrete any hormones

benign, 50% associated with meig’s syndrome (r sided pleural effusion, ascites)

A

fibroma

93
Q

high risk hpv strains

A

16, 18

94
Q

most common type of cervical cancer

A

SCC (80%)

other 20% = adenocarcinoma

95
Q

red painful breast, tender to touch, hot. neutrophils present on cytology

A

acute mastitis

96
Q

multiparous 40-60 y/o smoker with greeny brown nipple discharge. cytology shows proteinaceous material and inflammatory cells, histology shows duct dilation, proteinaceous material inside the duct and periductal inflammation.

A

duct ectasia

97
Q

obese middle aged woman with a painless, firm breast mass after surgery. cytology shows empty fat spaces, histiocytes, multinucleated giant cells. can cause nipple retraction

A

fat necrosis

98
Q

breast cancer that is almost always found incidentally. no microcalcifications, so doesn’t show up on USS or mammography. NO necrosis

A

lobular carcinoma in situ

99
Q

breast cancer with areas of calcification seen on mammography and with necrosis

A

ductal carcinoma in situ

100
Q

features of invasive breast carcinoma

A

peau d’orange, tethering, paget’s disease of breast (eczema on nipple), nipple retraction, lymphadenopathy, ulceration, bloody discharge

101
Q

most important prognostic factor for breast cancer

A

status of axillary lymph nodes

102
Q

ER/PR receptor positive breast cancer prognosis/ treatment

A

good prognosis

tamoxifen

103
Q

HER2 receptor positive breast cancer prognosis/ treatment

A

poor prognosis

herceptin

104
Q

breast lumpiness, cyclical (related to menstruation), very common

A

fibrocystic disease

105
Q

20-30 yo with a freely mobile breast lump, changes in size with menstrual cycle. histology shows stromal and glandular tissue

A

fibroadenoma

106
Q

enlarging fibroepithelial mass in woman >50. Histology shows leaf-like fronds/ artichoke like appearance, glandular and stromal proliferation, overlapping cells

A

phyllodes tumour

107
Q

benign cause of bloody nipple discharge in 40-60 yos. cytology shows branching papillary groups of epithelium. histology shows a papillary mass within a dilated duct, papillary mass tends to have fibrovascular core

A

intraductal papilloma

108
Q

central zone of scarring surrounded by radiating zone of proliferating glandular tissue. stellate mass on mammogram (resembles carcinoma)

A

radial scar

109
Q

benign bone tumour in woman <30 affecting proximal femur/ ribs/ tibia/ skull.

xray shows soap-bubble osteolysis, shepherd’s crook deformity if femur affected.

histology - chinese letters (marrow replaced by fibrous stroma and rounded trabecular bone

A

fibrous dysplasia

110
Q

benign bone tumour in men aged 10-20 at the ends of longs bones

most common benign bone tumour

x ray shows bony protuberance with cartilage cap - ‘mushroom’

A

osteochondroma

111
Q

benign bone tumour with risk of malignant transformation. Affects fingers and hands of middle aged, can cause pathological fractures.

xray shows popcorn/ cotton wool calcification, o ring sign

A

echondroma

112
Q

benign bone tumour causing dull pain at night in tibial diaphysis, proximal femur, adolescent boys. pain relieved by aspirin

A

osteoid osteoma

113
Q

most common primary bone cancer. men aged 10-30 with bone forming at end of long bones, most commonly knee. causes pain and a mass.

xray shows elevated periosteum (Codman’s triangle), mixed sclerotic and lytic lesions, cortical breach, sun-burst appearance

histology shows malignant mesenchymal cells, stain for ALP is positive

A

osteosarcoma

114
Q

malignany bone tumour that is cartilage producing in axial skeleton, proximal femur/tibia, pelvis, pts aged >40

xray shows lytic lesions with fluffy calcification

A

chondrosarcoma

115
Q

malignant bone tumour of under 20s, at the diaphysis/ metaphysis of long bones or pelvis.

xray shows onion skinning of periosteum, lytic lesions +/- sclerosis

histology shows sheets of small round cells, CD99 positive, ALP negative

A

Ewing’s sarcoma

116
Q

malignant bone tumour of 20-40 yo women, at knee epiphyses with extension into metaphysis

xray shows lytic appearance, soap-bubble appearance

histology shows giant multinucleate osteoclasts

A

giant cell tumour

117
Q

RA features

A

periarticular erosions, osteopenia, soft tissue swelling, subluxations

118
Q

osteoarthritis features

A

loss of joint space, osteophytes, subchondral cysts, subchondral sclerosis

119
Q

what condition is associated with bamboo spine

A

ankylosing spondylitis

120
Q

psoriatic arthritis features

A

new fluffy bone

nail changes - onycholysis, nail pitting

121
Q

reactive arthritis features

A

seronegative

HLA-B27 associated

sacroiliac and knee joints

associated keratoderma, blennorrhagica, circinate balanitis, enthesitis of achilles tendon

122
Q

psoriasis features

A

parakeratosis - nuclei within stratum corneum, thick keratin layer, silvery scales

loss of stratum granulosum - auspitz sign

123
Q

purple, pruritic, papules and plaques on inner surface of wrists. white lacy appearance in mouth (wickam striae)

A

lichen planus

124
Q

ulcer due to underlying disease (colitis, leukaemia, sclerosing cholangitis)

A

pyoderma gangrenosum

125
Q

pigmented, cauliflower like lesion with a stuck on appearance. histology shows horn cysts and orderly proliferation of epidermis

A

seborrhoeic keratosis

126
Q

pre-malignant lesion with warty, sandpaper like texture in sun exposed areas. histology shows solar elastosis, parakeratosis, atypia/ dysplasia, inflammation

A

actinic keratosis

127
Q

superficial skin blisters that easily rupture leading to raw red surface. nikolsky’s sign is positive. acantholytic cells on biopsy, mucosal involvement

A

pemphigus vulgaris

128
Q

antibodies associated with pemphigus vulgaris

A

desmoglein 1 and 3

129
Q

elderly patient, with tense bullae on flexor surfaces that do not easily rupture

A

bullous pemphigoid

130
Q

antibodies associated with bullous pemphigoid

A

anti-hemidesmosome

131
Q

excoriated red area (bullae rupture too easily to see intact), less severe course than pemphigus vulgaris

A

pemphigus foliaceus

132
Q

initial salmon pink lesion (herald patch) –> multiple oval macules in fir tree distribution

follows an URTI

A

pityriasis

133
Q

rolled pearly edge with central ulcer and fine telangiectasia in a sun exposed area in an elderly person, does not metastasise

A

BCC

134
Q

most common type of amyloidosis

A

AL amyloidosis

associated with paraproteins (e.g. multiple myeloma)

135
Q

AA amyloidosis

A

associated with chronic infection/ inflammation (RA, crohn’s)

136
Q

sarcoidosis features

A

non-caseating granulomas, lungs most commonly affected, high ACE

associations - erythema nodosum, hypercalcaemia, uveitis

137
Q

fontana stain

A

positive for melanin, melanoma

138
Q

congo red stain with apple green birefringence under polarised light

A

amyloidosis

139
Q

rhodanine stain

A

golden brown against blue background = copper (Wilson’s disease)

140
Q

prussian blue stain

A

blue = iron, haemachromatosis

141
Q

perl’s stain

A

positive = iron, haemachromatosis

142
Q

cytokeratin is used for

A

epithelial marker, carcinoma

143
Q

cd45 is used for

A

lymphoid marker, lymphocyte

144
Q

ziehl-neelson stain

A

red against blue background = TB

145
Q

auramine stain

A

bright yellow fluorescence = TB

146
Q

gomori’s methanamine silver stain

A

flying saucer shaped cysts = pneumocystis jiroveci

147
Q

modified kinyoung acid fast stain

A

cryptosporidium parvum

148
Q

india ink stain

A

yeast cells surrounded by halos = cryptococcus neoformans

149
Q

giemsa stain

A

cytoplasmic inclusions = chlamydia psittaci

150
Q

fite stain

A

mycobacterium leprae

151
Q

what is aflatoxin from aspergillus a risk factor for

A

hepatocellular carcinoma

152
Q

chronic bronchitis histology

A

mucus gland hypertrophy, goblet cell hyperplasia/ metaplasia

153
Q

microscopic polyangitis features

A

small vessel vasculitis, immune complexes

affects skin, heart, brain, kidneys

pANCA association

154
Q

condition with a thickened aortic arch, leading to no palpable pulses, reduced blood pressure in arms and hands

A

takayasu arteritis

155
Q

inclusion bodies deposited in alpha-synuclein neurons

A

parkinsons

156
Q

features of subdural haemorrhage

A

between dura and arachnoid due to tear in bridging vein

caused by trauma

raised ICP

haematoma development takes 48hrs

157
Q

conditions associated with SAH

A

polycystic kidney disease, aortic coarctation, fibromuscular dysplasia, Berry aneurysm, HTN

158
Q

features of an extradural haemorrhage

A

middle meningeal artery rupture from pterion fracture

lucid interval

159
Q

intracerebral haemorrhage

A

HTN –> hyaline arterioscleorsis, charcot-bouchard aneurysms

160
Q

crohn’s disease extra-intestinal manifestations

A

artheritis

ankylosing spondylosis

stomatitis, uveitis

derm lesions (pyoderma gangrenosum, erythema nodosum)

161
Q

crohn’s disease features

A

transmural inflammation, skip lesions, fistulae

non-caseating granulomas

162
Q

haemachromatosis features

A

autsomal recessive

cirrhosis, diabetes, bronzed skin, cardiomyopathy, gondal atrophy, impotence

163
Q

primary biliary cirrhosis features

A

jaundice, xanthelasma, pruritis

raised ALP, GGT, IgM, cholesterol

associated with sjogren’s

164
Q

what is adenocarcinoma of the bile ducts called

A

cholangiocarinoma

165
Q

cholangiocarcinoma risk factors

A

primary sclerosing cholangitis

parasitic liver fluke infection

exposure to imaging contrast media

166
Q

alpha1-antitrypsin deficiency features

A

emphysema

cirrhosis

167
Q

primary sclerosing cholangitis features

A

periductal fibrosis

concentric onion ring fibrosis

168
Q

symptomatic individual with a fasting glucose over what number indicates diabetes

A

7

169
Q

most common type of lung cancer in uk

A

adenocarcinoma

170
Q

hepatobiliary pathology associated with pANCA

A

primary sclerosing cholangitis

171
Q

mallory denk bodies on liver biopsy

A

alcoholic hepatitis

172
Q

chemo for CLL increases risk of which type of kidney stone

A

uric acid

173
Q

keratin pearls in which cancer

A

squamous cell carcinoma

174
Q

what do pancreatic delta cells produce

A

somatostatin

175
Q

positive anti-mitochondrial antibody, hepatobiliary disease with granulomas

A

primary biliary cirrhosis

176
Q

most common cause of chronic renal failure in UK

A

diabetes

177
Q

MODY inheritance

A

autosomal dominant

178
Q

IBD with non-caseating granulomas

A

crohn’s

179
Q

18 year old man with nephritic syndrome, cataracts and sensorineural deafness

A

Alport’s

180
Q

honeycomb lung

A

interstitial lung disease

181
Q

stain for iron

A

prussian blue

182
Q

pancreatic cancer marker

A

ca 19-9

183
Q

stool marker for IBD

A

calprotectin

184
Q

wilson’s disease treatment

A

zinc

trientine

185
Q

ECG leads 2,3 and aVF represent which region of heart

A

inferior wall

186
Q

positive male pregnancy test

A

testicular cancer

187
Q

kimmelstiel wilson nodules on renal biopsy

A

diabetes

188
Q

epigastric pain that worsens after eating is which kind of peptic ulcer

A

gastric

189
Q

renal cancer with neoplastic cells with transparent cytoplasm. cells are arranged in nests with interveneing blood vessles

A

clear cell cancer

190
Q

acute rheumatic fever criteria

A

jones criteria

191
Q

IBD with transmural inflammation

A

crohn’s

192
Q

oat shaped cells on biopsy

A

small cell lung cancer

193
Q

infective endocarditis criteria

A

dukes criteria

194
Q

lucid interval

A

extradural

195
Q

bronchoconstriction, flushing and diarrhoea

A

carcinoid syndrome

196
Q

waxy casts in urine

A

CKD

197
Q

epithelial casts in urine

A

acute tubular necrosis

198
Q

fatty casts in urine

A

nephrotic syndrome

Path (hopefully more condensed) (5 decks)

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