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Matt's Path > Histopath > Flashcards

Histopath Flashcards

1
Q

betaHMC mutation

A

Hypertrophic Cardiomyopathy

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2
Q

Erythema marginatum

Subcutaenous nodules

A

Acute Rheumatic Fever

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3
Q

Acute Rheumatic Fever

A

Strep throat infection

Heart: pancarditis (endocarditis, myocarditis, pericarditis)
Joint: arthritis and synovitis
Skin: Erythema marginatum, subcutaneous nodules
CNS: encephalitis, Sydenham’s chorea

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4
Q

Jones Criteria

A

Diagnosis of Rheumatic Fever = group A strep infection + 2 major OR 1 major + 2 minor

Major (CASES)
Carditis
Arthritis
Sydenham's chorea 
Erythema marginatum 
Subcutaneous nodules 
Minor criteria
Fever
Raised ESR or CRP
Migratory arthralgia 
Prolonged PR interval 
Previous rheumatic fever
Malaise
Tachycardia
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5
Q

Beady fibrous vegetations

A

verrucae

Rheumatic fever

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6
Q

Aschoff bodies

A

Small giant-cell granulomas

Rheumatic fever

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7
Q

Anitschkov myocytes

A

regenerating myocytes

Rheumatic fever

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8
Q

Libman-Sacks

A

Associated with SLE and anti-phospholipid syndrome

small (<2mm) “warty” vegetations

Sterile

Platelet rich

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9
Q

Acute infective endocarditis

A

Staph aureus

Strep pyogenes

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10
Q

Subacute infective endocarditis

A

Strep viridans

Staph. epidemris

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11
Q

Culture negative infective endocarditis

A 
Coxiella
Mycoplasma
Candida
Brucella
Chlamydia
Mycoplasma
Bartonella

HACEK
Haemophilus, Aggregatibacter (previously Actinobacillus), Cardiobacterium, Eikenella, Kingella

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12
Q

Tricuspid infective endocarditis

A

IVDU

Staph aureus

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13
Q

Duke Criteria

A

Diagnosis of Infetcive Endocarditis
2 major
1 major = 3 minor
5 minor

Major:
Positive blood culture growing typical IE organism OR 2 positive culture >12 hours apart
Evidence of vegetation/abscess on echo OR new regurgitant murmur

Minor:
Risk factor (prosthetic valve, IVDU, congenital valve abnormalities)
Fever >38
Thromboembolic phenomena
Immune phenomena
Positive blood culture not meeting major criteria

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14
Q

Treatment of infective endocarditis

A

Acute:
Flucloxacillin for MSSA
Rifampicin AND Vancomycin AND Gentamicin for MRSA

Subacute:
Benzylpenicillin AND Gentammicin OR Vancomycin for 4 weeks

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15
Q

Mid-diastolic click and late systolic murmur

A

Mitral valve prolapse

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16
Q

Pericarditis

A

Types

Fibrinous: MI, Uraemia

Purulent: Staphylococcus aureus

Grenulomatous: TB

Haemorrhagic: Tumour, Tb, Uraemia

Fibrous = constrictive (arises from the above)

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17
Q

Pericardial effusion

A

Chronic heart failure

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18
Q

Pericardial effusion

A

Usual cause: Chronic heart failure

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19
Q

Cardiomyopathy

A

Dilated = systolic dysfunction

Hypertrophic = dialstoilic dysfunction

Restrictive = diastolic dysfunction

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20
Q

Charcot-Leyden crystals

A

Asthma

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21
Q

Curschmann spirals

A

Asthma

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22
Q

Goblet cell hyperplasia, hypertrophy of mucous glands

A

Chronic bronchitis

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23
Q

Yellow nail syndrome

A

Yellow dystrophic nails
Pleural effusions
Lymphoedema
Bronchiectasis

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24
Q

Young’s syndrome

A

Rhinosinusitis
Azoospermia
Bronchiectasis

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25
Q

Keratinisation

Intercellular prickles

A

Squamous cell carcinoma

M>F

Most common

Smoking

p53, c-myc mutations

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26
Q

EGFR mutation

mucin vacuoles

A

Adenocarcinoma

F>M

NON-Smokers

glandular differentiation with mucin production

EGFR –> give TKI (tyrosine kinase inhibitor)

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27
Q

RB1 mutation
Ectoptic ACTH
Lambert-Eaton

A

Small cell carcinoma

Arise from neuroendocrine cells

Smoking

P53 and RB1 mutations

Poor prognosis: mets early to bone, adrenal, liver brain

Ectopic ACTH

Cerebellar degeneration

Lambert Eaton: rare autoimmune disorder that is characterized by muscle weakness of the limbs. It is the result of an autoimmune reaction in which antibodies are formed against presynaptic voltage-gated calcium channels

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28
Q

Poorly differentiated malignant epithelium tumour of the lung

A

Large cell carcinoma

Poor prognosis

Large cells

Large nuclei

No evidence of glandular or squamous differentiation

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29
Q

Carcinoid syndrome

A

Flushing
Diarrhoea
Bronchoconstriction

Ectopic serotonin

Tx: Octreotide

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30
Q

ERCC1

A

Poor response to cisplatin

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31
Q

Linitis plastica and signet ring cell

A

Gastric adenocarcinoma

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32
Q

5-ASA

A

Ulcerative colitis

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33
Q

Watershed areas of gut

A

Splenic flexure (SMA transition to IMA)

Rectosigmoid (IMA transition to internal iliac)

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34
Q

Carcinoid crisis

A 
Life-threatening vasodilation
Hypotenion
Tachycardia
Bronchoconstriction
Hyperglycaemia
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35
Q

Enterochromaffin cell origin

A

Serotonin producing

Lung, bowel, ovaries, testes

Carcinoid syndrome

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36
Q

Urinary 5-HIAA

A

Enterochromaffin cell cancer

Carcinoid syndrome

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37
Q

Hypoproteinaemic Hypokalaemic

A

Villous adenoma

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38
Q

Risk factor for adenoma –> adenocarcinoma

A

1) Size (main factor)
2) dysplasia
3) villous component

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39
Q

Juvenile polyposis

A

Autosomal dominant

In children

Haemartomatous polyp

100s

May require colectomy to stop haemorrhage

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40
Q

Peutz–Jeghers syndrome

A

Autosomal dominant -LKB1

Hamartomatous polyps

Hyperpigmented macules on the lips and oral mucosa (melanosis)

Increased risk of intussusception and malignancy

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41
Q

Hyperplastic polyp

A

Shedding of epithelium, cell build up

50-60 yrs

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42
Q

Pseudo polyp

A

IBD (UC)

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43
Q

Microsatellite instability

A

Hereditary non-polyposis colorectal cancer

HNPCC

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44
Q

Colorectal cancer

A

95% adenocarcinoma

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45
Q

Right-sided bowel tumours

A

Iron deficiency anaemia

Weight loss

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46
Q

Left-sided bowel tumours

A

Change in bowel habit

Crampy LLQ pain

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47
Q

CEA

A

colorectal cancer

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48
Q

Accumulation of fat droplets in hepatocytes

A

Hepatic steatosis (fatty liver)

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49
Q

Ballooning hepaotcytes

Necrosis

Mallory-denk bodies

Fibrosis

Pericellular fibrosis

A

Alcoholic hepatitis

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50
Q

Micronodular cirrhosis

Bands of fibrous tissue

Intra- and extra- hepatic shunting

A

Alcoholic cirrhosis

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51
Q

Neutrophil polymorphs

Mallory-denk

A

Alcoholic hepatitis

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52
Q

Megamitochondria

A

Alcoholic hepatitis

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53
Q

NAFLD

A

Steatosis in non-alcoholics

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54
Q

NASH

A

NAFLD + inflammation

Steatosis + inflammation in non-alcoholics

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55
Q

Interface hepatitis with plasma cells

A

Autoimmune hepatitis

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56
Q

Anti-LKM

A

Type II autoimmune hepatitis

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57
Q

Anti-SMA

A

Type I autoimmune hepatitis

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58
Q

Primary Biliary Cholangitis

A

Autoimmune inflammatory destruction of medium sized INTRAhepatic bile ducts

Slow development of cirrhosis over many years (hence renamed form cirrhosis to cholangitis as can diagnose prior to cirrhosis)

F> M 10:1

Increased serum ALP

Increase cholesterol

Increase IgM (late feature)

Anti-mitochondrial antibodies

NO BILE DUCT DILATATION

Bile duct loss with granulomas

Present with fatigue, pruritis, abdo discomfort

Tx: ursodeoxycholic acid

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59
Q

Primary Scleroisng Cholangitis

A

Inflammation and obliterative fibrosis of EXTRAhepatic and INTRAhepatic bile ducts

Multi-focal stricture formation with dilitation of preserved segments

Onion-skinning fibrosis

M > F

Associated with IBD (Ulcerative colitis)

Increase ALP

p-ANCA

Bile duct dilatation

ERCP: beading of bile duct (multifocal strictures)

Increase in cholangiocarcinoma

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60
Q

Absent aslpha globulin band on electrophoresis

A

A1AT deficiency

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61
Q

Haemorrhagic cystitis

A

Cyclophoshphamide use

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62
Q

Urinary schistosomiasis

A

Squamous cell carcinoma of bladder

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63
Q

Most common bladder tumour

A

Transitional cell (Urothelial) tumour

90% of bladder tumours

Smoker
Aromatic amines

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64
Q

Gleason system

A

Grading of Prostate cancer

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65
Q

Acute bacterial prostatitis

A

E.Coli

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66
Q

Most common germinal tumour

A

Seminoma

95% of testicular tumours are germ cell origin

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67
Q

AFP, HCG and LDH

A

tumour markers for teratoma

  • male peeing on pregnancy test story
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68
Q

Nephrotic syndrome

A

Triad:
>3g/24 hr protein

Hypoalbuminaemia

Oedoema

(+hyperlipidaemia)

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69
Q

Diffuse glomerular basement membrane thickening

A

Membranous glomerular disease

= primary cause of nephrotic syndrome

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70
Q

Primary causes of nephrotic syndrome

A

Minimal change disease

Membranous glomerular disease

Focal segmental glomerulosclerosis

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71
Q

Focal and segmental glomerular consolidation and scarring

A

Focal segmental glomerulosclerosis

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72
Q

Membranous glomerular disease

A

Causes nephrotic syndrome

Common in adults

Diffuse glomerular basement membrane thickening

Loss of podocyte foot processes

Subepithelial spikey depsotis

Can be primary or secondary to SLE, drug, malignancy

Ig and complement in granular deposits along entire GBM

40% ESRF 2-20 yrs

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73
Q

Focal segmental glomerulosclerosis

A

Causes nephrotic syndrome

Common in adults

Focal and segmental glomerular consolidation and scarring

Hyalinosis

Loss of podocyte foot processes

Ig and complement deposited in scarred areas

50% respond to steroids

50% ESFR in 10 years

Primary
Can be due to HIV nephropathy and Obesity

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74
Q

Mesangial matrix nodule = Kimmelstiel Wilson Nodules

A

= Diabetes nephropathy

causes nephrotic syndrome

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75
Q

Apple green birefringence with Congo red stain

A

Amyloidosis

Can cause nephrotic syndrome

Chronic inflammation

TB

RA

Multiple myeloma - AL protein deposition

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76
Q

Nephritic syndrome

A

Manifestation of glomerular inflammation (glomerulonephritis)

Characterised:

Haematuria (coca-cola urine)
Dysmorphic RBCs and red cell casts in urine

May also have:
Oliguria
Increased urea and creatinine
Hypertension
Proteinuria (but sub nephrotic levels)
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77
Q

Causes of Nephritic Syndrome (5)

A

Acute post-infectious glomerulonephritis

IgA nephropathy (Berger Disease)

Rapidly progressive (Cresenteric) Glomerulonephritis (3 types)

Hereditary nephritis (Alport’s syndrome)

Thin basement membrane disease (benign familial haematuria)

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78
Q

HLA-DRB1

A

Goodpasture’s

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79
Q

Acute post-infectious (post-streptococcal) glomerulonephritis

A

Causes Nephritic syndrome

1-3 weeks after Group A alpha-haemolytic strep throat infection

Streptococcus pyogenes

Immune complex deposition

Haematuria, red cell casts, hypertension, proteinuria, oedema,

ASOT titre increased

Decreased C3

LM: increased cellularity
FM: grnaular depsoits of IgG and C3 in GBM
EM: subendothelial humps

80
Q

IgA Nephropathy (Berger Disease)

A

Commonest cause of glomerulonephritis worldwide (causes nephritic syndrome)

Deposition of IgA complexes in glomeruli

1-2 days after URTI –> Frank haematuria

Persistent or recurring frank haematuria

Can be asymptomatic microscopic haematuria

Can progress to ESRF

FM: Granular deposition of IgA and complement in mesangium

81
Q

Rapidly progressive (Crescentic) Glomerulonephritis

A

Most aggressive glomerulonephritis - can cause ESRF in weeks

Nephritic syndrome + oliguria and renal failure

All have crescents on LM

3 Types

Type 1: Anti-GBM antibody (Goodpasture’s –> Type IV collagen alpha 3)
Linear deposition of igG in GBM
+pulmonary haemorrhage

Type 2: immune complexes
SLE, IgA, Post-strep
granular/lumps deposition of IgG in GBM/mesangium

Type 3: pauci-immune (Not anti-GBM or immune complexes)

c-ANCA: Wegner’s
p-ANCA: microscopic polyangiitis
Scanty/lack of immune complex deposition

+Vasculitis

82
Q

Hereditary Nephritis (Alport’s syndrome)

A

Causes Nephritic syndrome
Can be asymptomatic haematuria

x-linked recessive mutation in collagen IV alpha 4 chain

Nephritic syndrome + sensorineural deafness + eye problems (cataracts and lens dislocation)

Presents at 5-20 years and prepossesses to ESRF

83
Q

Thin Basement Membrane Disease (Benign Familial Haematuria)

A

Asymptomatic haematuria (v.rarely nephritic syndrome)

No decline in renal function

Autosomal dominant mutation in collagen IV alpha 4 chain

84
Q

Aysmptomatic haematuria

A

Think basement membrane disease

Alport’s

IgA nephropathy

85
Q

Nephritic syndrome + scanty immune deposition

A

Pauci-immune

Wegners

Microscopic polyangiitis

86
Q

Nephritic syndrome + sensorineural deafness + lens dislocation

A

Alport’s syndrome

87
Q

Frank haematuria 2 days post URTI

A

IgA nephropathy

88
Q

Increased ASOT titre, Low C3 and URTI 3 weeks ago

A

Post-streptococcal GN

89
Q

Causes of Acute Tubular Injury

A

Commonest cause of acute renal failure

Ischaemia –> prolonged pre-renal AKI

Nephrotoxins (CHARM chain)

Cisplatin
Heavy metals
Aminoglycosides (Gentamicin)
Radiocontrast medium
Myoglobin

Chain: light chains in multiple myeloma

Histology: necrosis of short segments of tubules

90
Q

Tubulointerstitial Nephritis

A

A group of renal inflammatory disorders that involve the tubules and interstitium

Acute pyelonephritis = leukocytic casts

Chronic pyelonephritis
Reccurent infections –> scarring of parenchyma

Acute interstitial nephritis
Hypersensitivity reactions to drugs
Fever, skin rash, haematuria, proteinuria, eosinophilia

Chronic interstitial nephritis
Elderly with long-term analgesic consumption (NSAIDs/paracetamol)
Hypertension, anaemia, proteinuria, haematuria

91
Q

Thrombotic microangipathies

A

Thrombosis
+MAHA
+Thrombocytopenia
+renal failure (mostly in HUS)

Causes
TTP - diffuse, esp in CNS
HUS - confined to kidneys

TTP = headache, altered consciousness
HUS= renal failure
92
Q

Pre-renal causes of AKI

A 
Hypovolaemia
Sepsis
Burns
Acute pancreatitis
Renal artery stenosis

Pre-renal = most common cause of AKI

93
Q

Complications of AKI

A 
Metabolic acidosis 
Hyperkalaemia
Fluid overload
HTN
Hypocalcaemia
Uraemia
94
Q

Renal causes of AKI

A

Acute glomerulonephritis

Acute tubular necrosis (most common renal cause)

Thrombotic MAHA

95
Q

Post-renal causes of AKI

A

Stones
Tumours (Primary or Secondary)
Prostatic hypertrophy
Retroperitoneal fibrosis

96
Q

Chronic renal failure stages

A 
GFR 
>90 = stage 1
60-89 = stage 2
30-59 = stage 3
15-29 = stage 4
<15 = stage 5

Start with 15, double, double again, add 30

97
Q

PKD1

A

Autosomal Dominant

Adult Polycystic Kidney Disease

Chromosome 16 (polycystin 1)

Also PKD2
chromosome 4 (polycystin-2)
98
Q

Lupus Nephritis

A

Can progress to chronic renal failure

Stage from I - VI

99
Q

Renal cell carcinoma

A

Clear cell carcinoma - well differentiated

Papillary carcinoma - commonest in dialysis-associated kidney disease

Chromophobe renal carcinoma - pale, eosiophilic cells

Presents: palpable mass, haematuria, costovertebral pain
Paraneoplastic syndrome: polycythaemia, hypercalcaemia, HTN, Cushing’s syndrome, Amyloidosis

100
Q

RUQ and peri-hepatitis

A

Fits High Curtis Syndrome

Also: violin string peri-hepatic adhesions

101
Q

“Powder burns”

A

Endometriosis

102
Q

red-blue to brown nodules

A

Endometriosis

103
Q

Bundles of smooth muscle

A

Fibroids

104
Q

Endometrial Cancer

A

Subdivided:

Endometrioid (80%)
Oestrogen excess

Non-endometrioid (205)
Papillary
Serous 
Clear cell
Unrelated to oestrogen --> more aggressive
105
Q

VIN

A

Graded from I - III

Associated with HPV-16

Usual type: 35-55 years, warty/basaloid SCC

Differentiated type: older women, keratinising SCC (higher rate of malignant transformation)

106
Q

Vulval Carcinoma

A

Mainly squamous cell carcinoma (arise from VIN)

Or from other skin abnormalities (Paget’s disease of the vulva - adenocarcinoma in situ)

107
Q

Ovarian Tumour Types

A 
Epitheloid cell types 
Serous cystadenoma
Mucinous cystadenoma
Endometrioid
Clear cell

Germ cell types
Dysgerminoma
Teratoma
Choriocarcinoma

Sex cord/stroma cell types
Fibroma
Granuloa-theca cell tumour
Sertoli-Leydig cell tumour

108
Q

Ovarian tumour producing androgens

A

Sertoli-Leydig cell tumour

109
Q

Ovarian tumour producing b-hCG

A

Choriocarcinoma

110
Q

Ovarian tumour producing E2

A

Granuloa-theca cell tumour

111
Q

Hobnail appearance

A

Clear cell ovarian tumour

112
Q

Psammoma bodies

A

Serous cystadenoma

113
Q

Clear cytoplasma

A

Clear cell tumour

114
Q

No Psammoma bodies

A

Mucinous cystadenoma

115
Q

Oestrogen secreting tumour

A

Mucinous cystadenoma

116
Q

Causes pseudomyxoma peritonei

A

Mucinous cystadenoma

117
Q

Keratinising squamous epithelium + breast pain

A

Periductal mastitis

Smokers

Not associated with lactation

118
Q

Fat necrosis

A

Inflammatory response to damaged adipose tissue

PAINLESS breast mass / skin thickening / mammographic lesion

119
Q

Fibrocytic Disease

A

Fibrocystic disease (finbroadenosis)

Cystic changes: small cysts form by dilation of lobules
Contain fluid
Often calcified

Fibrosis: inflammation and fibrosis secondary to cyst rupture

Adenosis: increased number of acini per lobule (normally seen in pregnancy)

120
Q

Finger-like projections into ducts

A

Gynaecomastia

121
Q

Duct papilloma

A

Benign papillary tumour arising within duct system of breast

Peripheral: within small terminal ducts
Central: within larger lactiferous ducts

Causes bloody discharge

No LUMP

Not seen on mammogram

Ix: galactogram

122
Q

Stellate pattern of glandular tissue

A

Radial scar

Benign sclerosing lesion

Central scarring surrounded by proliferating glandular tissue in a stellate pattern

Resembles carcinoma on mammogram

123
Q

BRCA1/2

A

Increase risk of:

Breast cacrinoma
Ovarian caner
Prostate cancer
Pancreatic cancer

124
Q

Carcinoma in situ (breast)

A

Proliferation limited ti ducts/lobules by basement membrane

Lobullar (LCIS): no calcification, ALWAYS incidental finding on biopsy

Ductal (DCIS): Microcalcifcation on mammogram, much increased risk of breast carcinoma

125
Q

Invasive breast carcinoma

A

Categorised into ductal, lobular or tubular

Ductal: carcinoma that cannot be subclassified into another group - MOST COMMON

Lobular: cells aloigned in single file chains/ strands

Tubular: Well-formed tubules with low grade nuclei (rarely palpable as <1cm)

Can also be mucinous –> secretes mucin

126
Q

Triple assessment

A

Examination

Mammorgaphy, USS or MRI

FNA & Cytology

127
Q

Breast carcinoma prognosis

A

ER/PR receptor positive –> GOOD

HER 2 positive –> BAD

128
Q

Basal-like carcinoma breast

A

Sheets of atypical cells with lymphocyte infiltration

Stain: CK5/6/14

129
Q

Phyllodes tumour

A

Interlobular stroma

Typically large, fast-growing masses

Mostly low grade, but can be aggressive

Palpable mass >50 yrs

130
Q

Low glucose, high protein and lymphocyte on Lumbar Puncture

A

TB

131
Q

Neurofibromatosis type II (NF2)

A

Meningioma

132
Q

Ventricular tumour, hydrocephalus

A

Ependymoma

133
Q

Indolent, chilhood brain tumour

A

Pilocytic astrocytoma

134
Q

Soft, gelatinous calcified brain tumour

A

Oligodendroma

135
Q

Commonest brain tumour (primary)

A

Astrocytomas

Metastatic is more common tumour in CNS (lung, breast, malignant melanoma)

136
Q

Tau protein Dementias

A

Corticobasal degeneration

Frontotemporal dementia (linked to chromosome 17)

Pick’s disease

Alzheimers (Tau and beta-amyloid)

137
Q

Alpha-synuclein, ubiquitin

A

Dementia awith Lewy Bodies

138
Q

Alzheimers

A

Senile plaques of beta-amyloid

Neurofibrillary tangles of Tau

139
Q

Alpha-synuclein

A

Present in both

Lewy Body Dementia

Parkinson’s disease

140
Q

Multiple Sclerosis Proteins

A

Myelin basic protein

Proteo-lipid protein

MS plaques show sharp margins of myelin loss

141
Q

Multisystem Atrophy

A

Shy Drager: Autonomic dysfunction

Striatonigral: difficulty with movement

Olivopontocerebellar: Difficulty with balance and coordination

Can appear very similar to Parkinson’s BUT show poor response to parkinson medications

142
Q

Loss of cancellous bone

A

Osteoporosis

143
Q

Looser’s zones

A

Pseudo fractures

= osteomalacia

144
Q

Brown’s tumour

A

Primary Hyperparathyroidism

Bone lesion that arises in settings of excess osteoclast activity, such as hyperparathyroidism.

Brown tumours consist of fibrous tissue, woven bone and supporting vasculature, but no matrix.

145
Q

Excess of unmineralised bone

A

Osteomalacia

146
Q

Osteitis fibrosa cystica

A

Osteomalacia

Marrow fibrosis + cysts

147
Q

Mixed lytic and sclerotic bone

A

Paget’s

148
Q

Salt and pepper skull

A

Primary hyperparathyroidism

149
Q

Subperiostal bone resorption in phalanges

A

Primary hyperparathyroidism

150
Q

Mosaic pattern of lamellar bone

A

Paget’s

151
Q

Huge osteoclasts

A

Paget’s

> 100 nuclei

152
Q

Rachitic rosary

A

Prominent knobs of bone at the costochondral joints

= Ricket’s

153
Q

Decrease bone mineralisation

A

Osteomalacia

154
Q

X-ray feature of Paget’s

A

Skull
Osteoporosis circumscripta
Cotton wool

Vertebrae
Picture frame
Ivory vertebrae

Pelvis
Sclerosis and lucency

155
Q

Colchicine

A

Acute treatment of gout

156
Q

Pseudo-gout crystals

A

Calcium pyrophosphate crystals

Rhomboid shaped

157
Q

Osteosarcoma

A

Adolescence

Knee 60%

Malignant mesenchymal cells

ALP+ve

Elevated periosteum (Codman’s triangle)

Sunburst appearance

158
Q

Chondrosarcoma

A

> 40 yrs

Axial skeleton, femur, tibia, pelvis

Malignant chondrocytes

Lytic lesion with fluffy clacification

AXIAL SKELETON

159
Q

Ewing’s Sarcoma

A

<20 yrs

Long bone, pelvis

Sheets of small round cells
CD99 +ve

t(11:22)

Onion skinning of the periosteum

160
Q

Giant cell (borderline malignancy)

A

20-40yrs
F>M

Knee-epiphysis

Osteoclast-type multinucleate giant cells on background of spindle / ovoid cells

Lytic/lucent lesions up to articular surface

161
Q

Codman’s triangle

A

Elevated periosteum

Osteosarcoma

162
Q

Onion skinning of periosteum

A

Ewing’s sarcoma

163
Q

T11:22

A

Ewing’s sarcoma

164
Q

Multinucleate giant cell swith ovoid/spindle

A

Giant cell (borderline)

165
Q

Radiolucent nidus with sclerotic rim

A

Osetoid oesteoma

166
Q

Gardner syndrome

A

multiple osteomas + GI polyps + epidermoid cysts

167
Q

Bony outgrowths attached to normal bone

A

Oesteoma

168
Q

Benign tumours of cartilage

A

Enchondroma

169
Q

Oiler’s syndrome

A

Multiple enchondromas

170
Q

Maffuci’s syndrome

A

Multiple enchondromas + haemangiomas

171
Q

Cotton wool calcification

A

Enchondroma

172
Q

Fibrous dysplasia

A

fibrous tissue in place of bone

173
Q

Albright syndrome

A

Polyostotic dyplasia + cafe au lait spots + precocious puberty

174
Q

Lytic well defined

A

Simple bone cyst

175
Q

Speckled mineralisation

A

Osteoblastoma

176
Q

Auspitz’ sign

A

Rubbing plaques causes pin-point bleeding

Psoriasis

177
Q

“test tubes in racks”

A

Psoriasis

178
Q

Annular target lesion

A

Erythema multiforme

179
Q

IgG to hemidesmosomes + linear IgG at BM

A

Pemphigoid

180
Q

IgG to hemidemosomal and netlike pattern of intercellular IgG

A

Pemphigus

181
Q

Buckshot appearance

A

Malignant melanoma

=pagetoid cells

182
Q

Breslow thickness

A

Most important prognostic factor

183
Q

Malignant melanoma on sun exposed areas

A

Lentigo malignant melanoma

184
Q

SLE

A

Type III hypersensitivity reaction

HLA DR3 (or 2)

Anti-dsDNA
Anti-Sm

(anti-histone if drug induced)

Criteria (4 of 11 ACR)
SOAP BRAIN MD

Serositis
Oral ulcers
Arthritis
Photosensitivty

Blood disorders  (AIHA, ITP, leucopenia)
Renal imvolvement
ANA +ve
Immune phenomena (dsDNA, anti-Sm, Antiphospholipid Ab)
Neuro symptoms

Malar rash
Discoid

185
Q

Limited Scleroderma

A

Anti-centromere

Calcinosis 
Raynaud's
Esophageal dysmotility 
Sclerodactyl
Telangiectasia

Onion skinning around arterioles

Associated with pulmonary hypertension

186
Q

Diffuse Scleroderma

A

Anti-Scl-70

Inflammation within or around muscle fibres

Associated with pulmonary fibrosis

187
Q

Anti-Jo1

A

Dermatomyositis

and polymyositis

188
Q

Herald Patch

A

Pityriasis Rosea

Christmas tree distribution

Post-viral

189
Q

Large vessel vasculitides

A

Takayasu’s arteritis

Temporal arteritis

190
Q

Medium sized vasculitides

A

Polyarteritis nodosa

Kawasaki’s

Buerger’s disease (Thromboangitis obliterans)

191
Q

Small vessel vasculitides

A

Wegner’s (Granulomatosis with polyangiitis)

Churg Strauss (Eosinophilic granulomatosis with polyangiitis)

Microscopic polyangiitis

Henoch Schonlein Purpura

192
Q

Pulseless disease

A

Takayasu’s Arteritis

193
Q

Takayasu’s Arteritis

A

“pulseless”

Increase in Japanese women

Vacular symptoms: Absent pulse, bruits, claudication

194
Q

Scalp tenderness, headache, jaw claudication

A

Temporal arteritis

195
Q

Temporal arteritis

A

Elderly

Scalp tenderness

Jaw claudication

Blurred vision

Increase ESR

Histo: Granulomatous transmural inflammation + giant cell + skip lesion

Matt's Path (18 decks)

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