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Histopath Flashcards

1
Q

Modifiable RFs for atherosclerosis

A

T2DM, HTN, Hyperchol, Smoking

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2
Q

Non modifiable RFs for atherosclerosis

A

Gender, age, FHx

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3
Q

Resolving MI

A

0-6 hours - no histological changes
6-24 hours - necrotic cell death, loss of myocyte nuclei, homogenous cytoplasm
1-4 days - acute inflam w/ cellular infiltrate
2 weeks - repair w/ classic young scar

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4
Q

Dressers syndrome

A

Chest pain, fevers + effusion weeks to months after MI

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5
Q

Nutmeg liver

A

RV failure

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6
Q

HoCM mutations

A

Autosomal dominant

BMHC, MYBP-C and Trop-T

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7
Q

Arrhythmogenic RV Cardiomyopathy

A

Myocyte loss w/ fibrous try replacement

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8
Q

Acute Rheumatic fever

A

T2HS - CASES w/ beady (verrucae) vegetation a, Aschoff bodies and Anitschkov myocytes
Tx BenPen

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9
Q

Libman sacks endocarditis

A

Assoc w/ SLE and antiphospholipid

Warty vegetations, sterile and platelet rich

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10
Q

Acute IE

A

Staph aureus - IVDU

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11
Q

Subacute IE

A

Strep viridans - dental caries

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12
Q

Monckeburg arteriosclerosis

A

Focal calcification of media of small-medium arteries

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13
Q

Carcinoid syndrome

A

5 hydroxyindodeacetic acid producing tumours

Episodic flushing, abdo cramps, diarrhoea and Right valve abnormality

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14
Q

3 components of atherosclerotic plaques

A

1 cells - macrophages + other leukocytes
2 ECM incl collagen
3 IC + EC lipid

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15
Q

Stages of atherogenesis

A 
1 endothelial injury
2 LDL enters intima and oxidised
3 macrophages take up - foam cells
4 apoptosis of foam cells - plaque
5 recruit more inflam cells
6 form fibrous cap
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15
Q

Ortner’s syndrome

A

Mitral stenosis
Enlarged LA
Recurrent laryngeal nerve palsy

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16
Q

Asthma histology

A

Churschman spirals
Eosinophils
Charcot-Leyden crystals

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17
Q

Honey comb lung

A

Interstitial lung disease

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18
Q

Small cell lung Ca

A

Oat cells + paraneoplastic syndromes

P53 + RB1 mutations

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19
Q

NSCLC

A

AdenoCa
SCC
Large cell Ca

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20
Q

Adenocarcinoma lung

A

Atypical cells line alveoli and peripheral on CXR
Non smokers
Mucin vacuoles

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21
Q

Squamous cell carcinoma lung

A

Keratinisation and IC prickle desmosomes

Hypercalcaemia

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22
Q

Large cell Ca

A

Undifferentiated form of either adenoCa or SCC

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23
Q

Barrett’s oesophagus

A

Metaplasia

Squamous -> columnar

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24
Q

Plummer Vinson

A

Dysphagia
Oesophageal webs
Iron deficiency anaemia
Assoc w/ SCC oesophagus

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25
Q

Zollinger Ellison

A

May be part of MEN1
Gastric secreting tumour of pancreatic G cells
Multiple peptic ulcers and diarrhoea

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26
Q

Menetrier’s disease

A

Gross hyperplasia of gastric pits and increased mucosal thickness

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28
Q

MEN1

A

Hyperparathyroid
Pancreatic islet cell tumours eg insulinoma
Prolactinoma (pituitary adenoma)

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29
Q

MEN2a

A

Medullary thyroid cancer
Phaeo
Parathyroid

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30
Q

MEN2b

A 
Medullary thyroid cancer
Phaeo
Mucocutaneous Neuroma
Marfanoid phenotype
GI upset
Hypotonia
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31
Q

Gastric Ca

A

Progressive dysphagia

Signet ring cells and linnitis plastica

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32
Q

H pylori Triple Therapy

A

PPI, Clarithromycin, Amoxicillin or Metronidazole

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33
Q

Gardner’s syndrome

A

FAP + extraintestinal growths (osteomas, epidermoid cysts, desmoid tumours) + dental caries
APC gene mutation (same as FAP)

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34
Q

Wilson’s disease

A 
Autosomal recessive
Mutation in ATP7B gene
Low caeruloplasmin
Parkinsonism, seizures, dementia, cirrhosis + Kayser - Fleischer rings
Mallory bodies on microscopy
Tx Penicillamine
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35
Q

Haemochromotosis

A 
Autosomal recessive
Mutation in HFE gene
Fe stains with Pearl's Prussian Blue
Bronze Diabetes
Transferrin saturation>45%
Tx venesection + Desferioxamine
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36
Q

Alpha1 antitrypsin

A

Autosomal Dominant
Hepatitis and Emphysema
Intracytoplasmic inclusion stain w/ Periodic acid Schiff
Absent alpha globulin band on electrophoresis

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37
Q

Crohn’s histopath

A 
Skip lesions
Cobblestone appearance
Rosethorn ulcers
Non caseating granulomas
Transmural
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38
Q

UC histopath

A

Pseduopolyps
Mucosal only
No granulomas

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39
Q

Peutz-Jeghers

A

LKB1 mutation
Mucocutaneous hyperpigmentation, oral freckles
Multiple polyps

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40
Q

CEA

A

Colorectal Ca

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41
Q

Ca19-9

A

Pancreatic Ca

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42
Q

Ca125

A

Ovarian Ca

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43
Q

AFP

A

HCC

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44
Q

Calcitonin

A

Medullary thyroid Ca Tumour marker

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45
Q

Metabolic syndrome

A 
Fasting glucose >6 
BP >140/90
Central Obesity
Dyslipidaemia
Microalbuminaemia
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46
Q

IGETSMASHED - causes of pancreatitis

A 
Idiopathic
Gallstones
EtOH
Trauma
Steroids
Mumps
AI
Scorpion stings
Hyperlipidaemia
ERCP
Drugs e.g. Thiazides
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47
Q

Pancreatic Ca - ductal adenoCa

A

Trousseau syndrome (recurrent superficial phlebitis)
Courvoisier’s sign (painless, palpable gallbladder + jaundice)
Hypercalcaemia

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48
Q

PBC

A 
Jaundice, xanthelasma + pruritus
Intrahepatic bile duct destruction
Anti-mitochondrial Abs
High ALP and Cholesterol
Assoc w/ Sjorgren's
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49
Q

PSC

A

Destruction of extra and intrahepatic BD
Assoc w/ UC
Beading of bile ducts on ERCP
Risk of cholangioCa

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50
Q

Nephrotic syndrome definition

A

Proteinuria >3g/24h
Hypoalbuminaemia
Oedema
(Hyperlipidaemia)

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51
Q

Amyloidosis

A

Apple green birefringence w/ Congo red

Macroglossia, HF, Hepatomeg + Nephrotic

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52
Q

RPGN Type 1

A

Anti GBM Ab
Goodpasture’s
Linear stain on IF

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53
Q

RPGN Type 2

A 
Immune complex
IgA nephropathy
Lupus nephritis
Post Strep GN
Granular stain on IF
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54
Q

RPGN Type 3

A

Pauci-immune
cANCA= Wegener’s
pANCA= MPA (Chrug-Strauss)
Absent/scant stain on IF

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55
Q

Alport’s syndrome

A

X linked
Mutation in T4 collagen
Nephritic + sensorineural deafness + eye disorders

56
Q

Benign familial haematuria

A

Asymptomatic haemturia
Autosomal dominant
Mutation in T4 collagen

57
Q

Liddle syndrome

A

Mutation in ENaC - overactive

HyperNa + HypoK

58
Q

Renal stones

A

75% Ca Oxaloate (opaque)
10-20% Mg Ammonium phosphate (staghorn opaque)
5% Urate (lucent)

59
Q

Membraneous GN

A

Thickened GBM
Spike/dome protrusions
Subepithelial Ig + granular staining

60
Q

HUS E coli strain

61
Q

Urea and Creatinine normal ranges

A

Creatinine: 60-110
Urea: 2.5-7

62
Q

Renal function interpretation

A

Raised urea > Creatinine - dehydration

High urea + creatinine - ARF/CRF

63
Q

CRF signs and stages

A 
Signs of uraemia (fatigue, itching, anorexia)
Stage 1 GFR>90 (normal)
Stage 2 GFR 60-89
Stage 3 GFR 30-59
Stage 4 GFR 15-29
Stage 5 GFR
64
Q

Adult PKD

A

Autosomal dominant
PKD1 and 2 mutations (polycystin)
Large multcystic kidneys + Berry aneurysms

65
Q

Fitz-Hugh-Curtis

A

RUQ pain due to perihepatitis in PID

Violin string peri hepatic lesions

66
Q

Serous epithelial Ovarian CA

A

Psammoma bodies

Mimics tubal epithelium

67
Q

Serous mucinous Ovarian Ca

A

Mimic endocervical or intestinal wall (pseduomyoxma peritonei)
Secrete mucin

68
Q

Serous endometroid Ovarian Ca

A

Mimics endometrium

69
Q

Clear cell Ovarian Ca

A

IC glycogen

Hobnail appearance

70
Q

Meig’s syndrome

A

Ascites + Pleural effusion

Assoc w/ Sex cord fibroma

71
Q

Granulosa-theca cell tumour

A

Produce E2

72
Q

Sertoli-Leydig tumour

A

Produce androgens (can get in F)

73
Q

Duct papilloma

A

Bloody discharge w/o lump

Dx w/ galactogram

74
Q

Ductal Ca in situ

A

Unilateral post menopasual w/ focal microcalcification

75
Q

Lobular Ca in situ

A

Bilateral premenopausal, multifocal w/ no calcification

76
Q

Infiltrating DCIS

A

Scirrhous look, peau d’orange, Paget’s, tethering, Retraction, Ulceration

77
Q

Tamoxifen

A

ER agonist/antagonist

78
Q

Herceptin/Trastuzumab

A

HER2 antagonist, must monitor LVEF

79
Q

Non traumatic intraparenchymal haemorrhage

A

Charcot-Bouchard microaneurysms

Basal ganglia

80
Q

Meningioma

A

Assoc w/ NF2

81
Q

Ependyoma

A

Ventricular tumour, hydrocephalus

82
Q

Pilocytic astrocytoma

A

Childhood, indolent

83
Q

Oligodendroma

A

Soft, gelatinous, calcified

84
Q

AD

A 
Tau and beta-amyloid
Presenelins 1+2 in Down's
e4 allele of apolipoprotein E predisposes
Temporal and frontal lobes
Loss of cholinergic neurons
85
Q

DLB

A 
Alpha-synuclein, ubiquitin
PD Sx (TRAP)
86
Q

Frontotemporal dementia

A

Linked to Ch17

Tau

87
Q

MS

A

2 lesions separated in space and time
Optic neuritis + instability/weakness
Myelin basic protein + proteolipid protein Abs

88
Q

MS plaque classification

A

Acute - minor changes
Early chronic active - oedema + macrophages
Late chronic active - complete loss of myelin
Chronic active - complete loss of myelin w/ NO macrophages
Shadow - nearly complete remyelination

89
Q

Multiple system atrophy

A

Papp-Lentos bodies in glial cells

Similar to PD

90
Q

Huntington’s

A

Autosomal dominant

Cerebral atrophy in caudate nucleus + putamen + NT changes

91
Q

OA X ray findings

A

Subchondral sclerosis
Subchondral cyst formation
Joint space narrowing
Osteophytes

92
Q

Osteoporosis

A

T score >2.5

Ca, PO4, ALP normal

93
Q

Osteomalacia

A

Vit D def
Low Vit D, Low Ca, Low PO4, High ALP, High PTH
Soft bones w/ wide epiphyses
Pseudofractures (looser zones)

94
Q

Primary Hyperparathyroidism

A

High Ca, Low/normal PO4, High/normal ALP
Moans, Bones, Groans, Stones
Brown’s tumours (Osteitis fibrosa cystica)
Salt and pepper skull

95
Q

Paget’s disease of bone

A 
Bone pain, n. compression, enlarging head
Osteoporosis circumscripta
Cotton wool
Picture frame and ivory vertebrae
V High ALP, normal Ca + PO4
96
Q

Renal Osteodystrophy

A

2o hyperparathyroidism in RF

Low Ca, High PO4

97
Q

Gout

A

Needle shaped urate crystals

-vely birefringent

98
Q

Pseduogout

A

Rhomboid shaped Ca pyrophosphate crystals

+vely birefringent

99
Q

Herberden’s nodes

100
Q

Bouchard’s nodes

101
Q

Osteosarcoma

A

Adolescent knee
ALP +ve
Codman’s triangle
Sunburst appearance

102
Q

Chondrosarcoma

A

> 40 axial bones

Lytic lesion w/ fluffy calcification

103
Q

Ewing’s sarcoma

A 
Under 20 long bone
ALP-ve
CD99 +ve
T(11:22)
Onion skinning of periosteum
104
Q

Giant cell Bone malignancy

A

20-40 F Knee epiphysis
Multinucleate giant cells
Spindle/ovoid cells
“soap bubble”

105
Q

Osteoid osteoma

A

Adolescent Tibia/femur

Night pain relieved by Aspirin

106
Q

Osteoma

A

Bony outgrowths in middle age

Assoc w/ Gardner’s

107
Q

Enchondroma

A

Middle age hands
Blue-grey lobules of hyaline
Cotton wool calcification

108
Q

Ollier’s syndrome

A

Multiple enchondromas

109
Q

Maffuci’s syndrome

A

Multiple enchondromas + haemangiomas

110
Q

Osteochondroma

A

Teenage boys long bones

Cartilage capped bony outgrowth

111
Q

Fibrous dysplasia

A

Middle age F
Chinese letters
Soap bubble osteolysis
Shepherd’s crook deformity

112
Q

McClune-Albright syndrome

A

Fibrous dysplasia, cafe-au-lait spots + precocious puberty

113
Q

Osteoblastoma

A

Speckled mineralisation

114
Q

Ossifying fibroma

A

Mandible (adults), Tibia (children)

Benign fibrous tumour w/ reactive bone formation

115
Q

Lichen Planus

A

Wickham’s striae

Saw toothing of Rete ridges

116
Q

Pemphigoid

A

IgG to hemidesmosomes

Epidermal-dermal junction

117
Q

Pemphigus

A

IgG Desmoglein 1/3

IntraEpidermal

118
Q

BCC

A

Pearly surface w/ telangectasia

119
Q

Lentigo Maligna Melanoma

A

Slowly growing black lesion on sun exposed areas

120
Q

Superficial spreading Malignant Melanoma

A

Irregular borders w/ variation in colour

121
Q

Nodular malignant melanoma

A

Younger age group, any site

122
Q

Acral Lentiginous melanoma

A

Palms, soles and subungual areas of non Caucasians

123
Q

Pityriasis rosacea

A

Salmon pink rash (herald patch) followed by oval macules in Christmas tree distribution

124
Q

Dermatomyositis

A

Heliotrope rash

Gottron’s papules

125
Q

Takayasu’s arteritis

A

Large vessel vasculitis

Pulseless disease

126
Q

Temporal arteritis

A

Large vessel vasculitis
Scalp tenderness + temporal headache
Assoc w/ polymyalgia rheumatica

127
Q

PAN

A

Medium vessel vasculitis
Assoc w/ Hep B
Microaneurysms

128
Q

Kawasaki

A

Medium vessel vasculitis
Fever >5 days
Rash, Strawberry tongue, Cervical LN, coronary aneurysms, conjunctivitis

129
Q

Polymyalgia rheumatica

A

Subacute onset asymmetrical aching, tenderness, morning stiffness in shoulders

130
Q

Buerger’s

A

Corkscrew appearance on Angiogram

Heavy smokers

131
Q

Wegener’s

A

Epistaxis/saddle nose, Haemoptysis +GN (T3 RPGN)
cANCA
small vessel

132
Q

Churg strauss (eMPA)

A

Asthma, Eosinophilia

pANCA

133
Q

MPA

A

Focal necrotizing GN

pANCA

134
Q

Goodpasture’s

A

Cough, Dyspnoea, Haemoptysis + nephrotic
T1RPGN
Anti GBM Abs

135
Q

HSP

A 
Preceding URTI
Purpuric rash on buttocks and extensors
Colicky abdo pain (risk of intussusception)
Arthritis
GN
136
Q

Behcet’s

A

Recurrent oral and genital ulceration + iritis in absence of Syphilis

137
Q

Osler-Weber-Rendu

A

Hereditary Haemorrhagic Telangectasia

Epistaxis + GI bleeds

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