Histopath Flashcards
Modifiable RFs for atherosclerosis
T2DM, HTN, Hyperchol, Smoking
Non modifiable RFs for atherosclerosis
Gender, age, FHx
Resolving MI
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
Dressers syndrome
Chest pain, fevers + effusion weeks to months after MI
Nutmeg liver
RV failure
HoCM mutations
Autosomal dominant
BMHC, MYBP-C and Trop-T
Arrhythmogenic RV Cardiomyopathy
Myocyte loss w/ fibrous try replacement
Acute Rheumatic fever
T2HS - CASES w/ beady (verrucae) vegetation a, Aschoff bodies and Anitschkov myocytes
Tx BenPen
Libman sacks endocarditis
Assoc w/ SLE and antiphospholipid
Warty vegetations, sterile and platelet rich
Acute IE
Staph aureus - IVDU
Subacute IE
Strep viridans - dental caries
Monckeburg arteriosclerosis
Focal calcification of media of small-medium arteries
Carcinoid syndrome
5 hydroxyindodeacetic acid producing tumours
Episodic flushing, abdo cramps, diarrhoea and Right valve abnormality
3 components of atherosclerotic plaques
1 cells - macrophages + other leukocytes
2 ECM incl collagen
3 IC + EC lipid
Stages of atherogenesis
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
Ortner’s syndrome
Mitral stenosis
Enlarged LA
Recurrent laryngeal nerve palsy
Asthma histology
Churschman spirals
Eosinophils
Charcot-Leyden crystals
Honey comb lung
Interstitial lung disease
Small cell lung Ca
Oat cells + paraneoplastic syndromes
P53 + RB1 mutations
NSCLC
AdenoCa
SCC
Large cell Ca
Adenocarcinoma lung
Atypical cells line alveoli and peripheral on CXR
Non smokers
Mucin vacuoles
Squamous cell carcinoma lung
Keratinisation and IC prickle desmosomes
Hypercalcaemia
Large cell Ca
Undifferentiated form of either adenoCa or SCC
Barrett’s oesophagus
Metaplasia
Squamous -> columnar
Plummer Vinson
Dysphagia
Oesophageal webs
Iron deficiency anaemia
Assoc w/ SCC oesophagus
Zollinger Ellison
May be part of MEN1
Gastric secreting tumour of pancreatic G cells
Multiple peptic ulcers and diarrhoea
Menetrier’s disease
Gross hyperplasia of gastric pits and increased mucosal thickness
MEN1
Hyperparathyroid
Pancreatic islet cell tumours eg insulinoma
Prolactinoma (pituitary adenoma)
MEN2a
Medullary thyroid cancer
Phaeo
Parathyroid
MEN2b
Medullary thyroid cancer Phaeo Mucocutaneous Neuroma Marfanoid phenotype GI upset Hypotonia
Gastric Ca
Progressive dysphagia
Signet ring cells and linnitis plastica
H pylori Triple Therapy
PPI, Clarithromycin, Amoxicillin or Metronidazole
Gardner’s syndrome
FAP + extraintestinal growths (osteomas, epidermoid cysts, desmoid tumours) + dental caries
APC gene mutation (same as FAP)
Wilson’s disease
Autosomal recessive Mutation in ATP7B gene Low caeruloplasmin Parkinsonism, seizures, dementia, cirrhosis + Kayser - Fleischer rings Mallory bodies on microscopy Tx Penicillamine
Haemochromotosis
Autosomal recessive Mutation in HFE gene Fe stains with Pearl's Prussian Blue Bronze Diabetes Transferrin saturation>45% Tx venesection + Desferioxamine
Alpha1 antitrypsin
Autosomal Dominant
Hepatitis and Emphysema
Intracytoplasmic inclusion stain w/ Periodic acid Schiff
Absent alpha globulin band on electrophoresis
Crohn’s histopath
Skip lesions Cobblestone appearance Rosethorn ulcers Non caseating granulomas Transmural
UC histopath
Pseduopolyps
Mucosal only
No granulomas
Peutz-Jeghers
LKB1 mutation
Mucocutaneous hyperpigmentation, oral freckles
Multiple polyps
CEA
Colorectal Ca
Ca19-9
Pancreatic Ca
Ca125
Ovarian Ca
AFP
HCC
Calcitonin
Medullary thyroid Ca Tumour marker
Metabolic syndrome
Fasting glucose >6 BP >140/90 Central Obesity Dyslipidaemia Microalbuminaemia
IGETSMASHED - causes of pancreatitis
Idiopathic Gallstones EtOH Trauma Steroids Mumps AI Scorpion stings Hyperlipidaemia ERCP Drugs e.g. Thiazides
Pancreatic Ca - ductal adenoCa
Trousseau syndrome (recurrent superficial phlebitis)
Courvoisier’s sign (painless, palpable gallbladder + jaundice)
Hypercalcaemia
PBC
Jaundice, xanthelasma + pruritus Intrahepatic bile duct destruction Anti-mitochondrial Abs High ALP and Cholesterol Assoc w/ Sjorgren's
PSC
Destruction of extra and intrahepatic BD
Assoc w/ UC
Beading of bile ducts on ERCP
Risk of cholangioCa
Nephrotic syndrome definition
Proteinuria >3g/24h
Hypoalbuminaemia
Oedema
(Hyperlipidaemia)
Amyloidosis
Apple green birefringence w/ Congo red
Macroglossia, HF, Hepatomeg + Nephrotic
RPGN Type 1
Anti GBM Ab
Goodpasture’s
Linear stain on IF
RPGN Type 2
Immune complex IgA nephropathy Lupus nephritis Post Strep GN Granular stain on IF
RPGN Type 3
Pauci-immune
cANCA= Wegener’s
pANCA= MPA (Chrug-Strauss)
Absent/scant stain on IF