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Histopath Flashcards

1
Q

Kimmelsteil-Wilson Nodules

A

Diabetic Nephropathy causes mesengial cells to deposit disordered matrix nodules

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2
Q

Congo Red Stain/Apple Green Bifrigence

A

Amyloidosis (fat pad biopsy)

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3
Q

Subendothelial humps

A

Seen in EM of glomerulus in Nephritic syndrome

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4
Q

Woven basket lamina dense

A

EM - Alport syndrome

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5
Q

Nutmeg liver

A

Congenital heart failure

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6
Q

Mallory bodies

A

Alcoholic hepatitis

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7
Q

Regenerative nodule

A

Seen in cirrohosis with bands of protein (fibrosis)

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8
Q

Mallory-Denk bodies

A

Non-alcoholic steatohepatitis

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9
Q

Onion skin fibrosis

A

PSC (think UC + Crohns)

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10
Q

Brown spots

A

Haematochromatosis

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11
Q

Prussian blue stain

A

Haematochromatosis

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12
Q

Periodic acid schiff

A

Alpha-1 antityrpsin deficiency liver biospy

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13
Q

Chocolate cysts

A

Endometrosis

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14
Q

Powder burns

A

Endometrosis

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15
Q

Psammoma body

A

Serous ovarian cancer (epithelial)

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16
Q

Sister mary joseph nodule

A

Epithelial ovarian cancer that metastasizes to the umbilicus

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17
Q

Schiller Duval Bodies

A

Yolk sac tumours

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18
Q

Call Exner Bodies

A

Granulosa-theca cell tumours

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19
Q

Reinke crystals

A

Sertoli-leydig cell tumours

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20
Q

Looser’s zone

A

Rickets (X-ray finding)

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21
Q

Brown tumour

A

Seen in hyperparathyroidism (X-ray finding which shows marrow fibrosis and cyst)

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22
Q

Salt and pepper skull

A

Seen in hyperparathyroidism (X-ray)

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23
Q

Negatively bifrigent crystals

A

Gout (urate)

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24
Q

Postively bifrigent crystal

A

Pseudogout (calcium pyrophosphate)

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25
Bouchard and Heberden nodes
Osteoarthritis
26
Swan neck, Boutinner's and Z-thumb
Rheumatoid Arthritis
27
Baker (popliteal) cyst
Rheumatoid Arthritis
28
Non-caseating granulomas, schaumann and asteroid bodies
Sarcoidosis
29
Bilateral Uveitis, parotid enlargement and facial nerve palsy
Heerfordt's Syndrome (sarcoidosis)
30
Coup de sabre
Limited CREST
31
Heliotrope rash
Dermatomyositis
32
Gottron papules
Dermatomyositis
33
Auspitz sign
Psoriasis (pin point bleeding)
34
Koebner phenonmenon
Psoriasis (lesions when trauma or scars)
35
Test tubes in a rack appearance
Clubbing of rete ridges in histo of Psoriasis
36
Mother of pearl sheen and Wickam's straie
Lichen Planus
37
Christmas tree and Herald patch
Pityrasis Rosea
38
Nikolsky sign
SJS + TEN
39
Aschoff Bodies and Anitschkov myocytes
Rheumatic fever
40
CASES (Carditis, Arthritis, Sydenham's chorea, Erythema Marginatum, Subcutaneous nodules)
Jone's Major Criteria - RHEUMATIC FEVER/DISEASE
41
Fever, raised CRP/ESR, tachycardia, malaise, prolonged PR interval
Jone's minor criteria - Rheumatic fever/disease
42
Benzylpencillin (10 days)
Treatment for Rheumatic fever but also: - Bed rest - NSAIDS - Corticosteriods for 2 weeks - Diuretics (if they go into HF)
43
Libman-Sacks endocarditis
SLE and anti-phospholipid syndrome
44
Roth spots + osler nodes
Infective endocarditis
45
Positive blood culture and evidence of vegetation
Major Duke Criteria (IE)
46
IVDU, fever, immune +/- thromboembolic phenomena
Minor Duke criteria
47
BenPen + Gentamicin / Vancomycin
IE (subacute) treatment - 4 weeks
48
Flucloxacillin
MSSA (IE)
49
Rifampicin + Vancomycin + Gentamicin
MRSA (IE)
50
Aortic stenosis
Calcification, congenital bicuspid valve
51
Aortic regurgitation
IE, dissecting aortic aneurysm, ank spond, Marfans
52
Mitral stenosis
Rheumatic fever
53
Mitral regurgitation
IE, post MI, rheumatic fever, connective tissue disease
54
Fibrinous, Purulent, Haemorrhagic, Fibrous, Granulomatous
Types of Pericarditis
55
Dilation of the airways, goblet cell hyperplasia, hypertrophy of mucous glands
Chronic bronchitis histological features
56
Curschmann spirals, Charcot-Leyden crystals
Asthma
57
Loss of alveolar parenchyma distal to terminal bronchiole
Emphysema
58
Painless breast lump/skin thickening/mammographic lesion Causes: trauma, surgery, cancer
Fat necrosis
59
Poorly defined palpable periareolar mass with thick white nipple discharge - usually seen in multiparous women aged 40-60.
Duct ectasia
60
Cytology of breast tissue - proteinaceous material, inflammatory cells
Duct ectasia
61
Painful breast in smoker, cytology shows keratinized squamous epithelium deep into nipple duct orifice
Periductal ectasia
62
Painful red breast and fever during lactation (s.aureus)
Acute mastitis
63
Breast tissue - necrotic and infiltrated by neutrophils
Acute mastitis
64
Tx of mastitis
Continued expression of milk + antibiotics +/- surgical drainage
65
Small fluid cysts in the breast that occur due to hormonal changes. Often calcified
Fibrocytic disease
66
Normally seen in pregnancy - increased number of acini per lobule
Adenosis (breast)
67
Epithelial hyperplasia, finger like projection into ducts
Gynaecomastia
68
Common bening tumour (stromal) seen in 20-30 year old women, grows during pregnancy and calcifies during menopause
Fibroadenoma
69
Overgrowth of collagenous mesenchyme
Fibroadenoma
70
Bloody nipple discharge, no lump or changes in mammogram
Duct papilloma
71
Bening sclerosing lesion that looks like carcinoma on mammogram
Radial scar
72
Breast carcinoma in situ
Ductal (more invasive) and lobular
73
Monoclonal Ig to Her2
Herceptin
74
Poor breast cancer prognosis
Her2
75
Palpable breast mass arising from interlobular stroma
Phyllodes tumour
76
Swelling and frothy urine
Nephrotic syndrome
77
Nephrotic syndrome seen in kids which responds to steriods but there are no loss microscopy or immunofluroensce findings
Minimal change disease
78
Loss of podocytes foot processes (electron)
Minimal change disease
79
Nephrotic syndrome caused by thickening of the glomerular basement membrane due to Ig and complement deposits (spikey)
Membranous glomerular disaese
80
Does membraneous glomerular disease respond to steriods?
Not really
81
What do you seen on the electron microscopy of membraneous glomular disease
Loss of podocyte foot processes | Subepithelial deposits = spikey
82
Nephrotic syndrome associated with focal and segmemtal scarring and consolidation of the basement membrane
Focal segmental glomerulosclerosis
83
Kimmelstein wilson nodules seen in histology of kidneys
Diabetes (asian)
84
Big tongue, big heart and big liver
Amyloidosis
85
Features of nephritic syndrome
``` Haematuria Oliguria Hypertension RBC casts in urine Increased urea and creatinine ```
86
Raised ASOT titre and reduced C3
Post-streptococcal glomerulonephritis
87
Light microscopy of post-streptococcal glomerulonephritis
increased cellularity of glomeruli
88
Fluoresence microscope of post-strep glomerulonephritis
Granular deposits of IgG and C3 in GBM
89
Electron microscope
Subendothelial humps
90
Frank haematuria in a patient that has just recovered from URTI
IgA nephropathy (berger's syndrome)
91
Fluoresnce microscope of IgA nephropathy (nephritic)
IgA and complement deposits in the mesangium
92
How does rapidly progressively (crescent) glomerulonephritis present?
Oliguria and renal failure more pronounced Types: 1- Anti-GBM antibody 2- Immune complexes 3. ANCA - associated
93
What is associated with Anti-GBM antibody RPG? (COLA4)
Goodpastures (think additional pulmonary haemorrhage)
94
What do you see in fluoresence microscopy?
Linear deposits of IgG in GBM
95
What conditions are associated with Type 2 (immune mediated) RPG?
SLE IgA nephropathy Post strep GN
96
What do you see in flurosence microscopy?
Granular IgG complex deposition in the GBM and mesengium
97
Associated conditions of Type 3 RPG?
c-ANCA : wegeners p-ANCA: microscopic polyangitis Vasculitis so pulmonary haemorrhage or rash
98
Alport's syndrome
Nephritic syndrome and sensorineural deafness COLA5 X-linked
99
V.rarely a cause of nephritic syndrome?
Thin basement membrane disease | Microscopic haematuria
100
Differentials of asymptomatic haematuria
IgA nephropathy Alport syndrome Thin Basement membrane disease
101
Causes of nephritic syndromes
``` IgA nephropathy Thin basement membrane disease Rapidly progressive glomerulonephritis Alport's syndrome Post streptococcus glomerulonephritis ```
102
What are common causes of ATN?
Ischaemia - burns, sepsis | Drugs - gentamicin, NSAIDs, radiocontrast
103
Histopath of ATN
necrosis of the short segments of tubules
104
How does acute pyleonephritis present as?
Flank pain, fever, rigors, haematuria, frequency, dysuria | Leukocytic casts seen in urine
105
Causes of chronic pyleonephritis?
Chronic obstruction like a renal stone | Urine reflux
106
What causes acute interstitial nephritis?
Drug hypersensitivity reaction like Abx, diuretics
107
How does acute interstitial nephritis present?
``` Fever Skin rash Haematuria Proteinuria Eosinophilia ```
108
Triad in HUS
MAHA (microangiopathic haemolytic anaemia) Thrombocytopenia Renal failure
109
HUS
``` Affects kids Renal failure E.coli O157:H7 Associated diarrohea Low platelets MAHA --> pallor and jaundice Raised LDH and reticulocyte count Coombs negative ```
110
TTP
Thrombi everywhere, not just kidney Can have neuro symptoms Unlikely to have renal failure
111
Complications of acute renal failure
``` Metabolic acidosis Hyperkalemia HTN Hypocalcemia Uraemia Fluid overload ```
112
Causes of pre-renal failure
Hypovolemia caused by ischaemia, burns, sepsis | Renal artery stenosis, acute pancreatitis
113
Causes of renal failure
ATN Acute glomerulonephritis HUS etc
114
Causes of post renal failure
Obstruction via renal stone, ureter obstruction, tumour and prostate hypertrophy
115
Causes of chronic renal failure
DM Glomerulonephritis Hypertension and vascular disease Polycystic kidney disease
116
Polycystic kidney disease
Mutations in PKD1 on chromosome 16 | Can have liver cysts and berry aneurysms
117
How does someone with polycystic kidney disease present?
Haematuria Flank pain UTI Cyst rupture, infection, haemorrhage
118
Types of Renal cell carcinoma
Clear cell Papillary Chromophobe
119
How does renal cell carcinoma present?
Costovertebral pain Palpable mass Haematuria Paraneoplastic syndrome: polycythaemia, hypercalcaemia, HTN, cushing and amyloidosis
120
Carcinogenesis often involves an activating mutation of KRAS
Pancreatic Ductal Carcinoma
121
Histopathology shows cells with abundant eosinophilic finely granular cytoplasm. These cells show positive immunoreactivity for lipase.
Acinar Cell Carcinoma
122
A 35 year old woman presents with a long history of recurrent duodenal ulcers involving D1 and D2.
pancreatic Endocrine Neoplasm
123
A 27-year-old woman presents with abdominal pain and haematemesis. She reports a 1-year history of recurrent peptic ulceration. A CT scan shows a 2-cm mass in the pancreas.
Zollinger-Ellison
124
What two hormones stimulate the pancreas?
Secretin - controls gastric acid secretion and buffering with HCO3- CCK - responsible for digestion enzymes
125
Alpha cells of islets of langerhans
Secrete glucagon
126
Beta cells of islets of langerhans
Secrete insulin
127
Delta cells of islet of langerhan
Secrete somatastin
128
Acute pancreatitis - I GET SMASHED
``` Idiopathic Gallstones Trauma Steroids Mumps Autoimmune Scorpion bite Hyperlipidiamia Ethanol Drugs ```
129
Symptoms of acute pancreatitis
Severe epigastric pain that radiates to the back Relived by sitting forward Nausea and vomiting
130
Aftermath of acute pancreatitis esp in alcoholics
Pseudocyst
131
Histology of acute pancreatitis
Coagulative necrosis
132
Causes of chronic pancreatitis
Cystic fibrosis Autoimmune (IgG4 sclerosing) Alcohol Pancreatic duct obstruction
133
How does chronic pancreatitis present?
Epigastric pain radiating to the back Malabsorption (foul stools and weight loss) DM
134
Histology of chronic pancreatitis
Fibrosis Duct dilation Calcification
135
Pancreatic carcinoma - presentation
``` Painless jaundice, itching and foul stools Weight loss Trousseau and couveriser sign + Abdo pain Abdo mass DM Virchow's node ```
136
Ix of pancreatic carcinoma (head)
``` Low Hb Raised bili Raised Ca2+ CT/MRI/ERCP Ca 19.9 > 70 ```
137
Surgery for pancreatic carcinoma
Whipple's procedure
138
Neuroendocrine tumour (body and tail)
associated with MEN 1 -PPP Gastrinoma - Zollinger-Ellison syndrome (think recurrent ulcers) Insulinoma - hypoglycaemic attacks
139
Pancreatic divisum
increased risk of pancreatitis due to failure of fusion of dorsal and ventral buds
140
Annular pancreas
Think less than 1 year and apparently associated with down's
141
A new born was found to have ppersistent jaundice due to absence of glucuronyl transferase activity.
Crigler-Najjar syndrome
142
If i stayed on the pill, what liver tumour would i get?
Hepatic adenoma (resect if bigger than 5cm or doesnt shrink when you stop taking OCP)
143
Haemangioma
Another benign liver tumour
144
what causes hepatocellular carcinoma?
Hep B+C Alcoholic cirrhosis Haematochromatosis
145
How to investigate hepatocellular carcinoma?
Raised AFP | USS
146
Where does cholangiocarcinoma come from?
Adenocarcinoma arising from bile ducts
147
Causes of cholangiocarcinoma
PSC Chronic liver disease Lynch syndrome
148
Most common cause of liver cancer
metastases from other cancers/tumours
149
Haematochromatosis
HFE gene Chr 6
150
Wilson's disease
ATP7B chr 13
151
If you see micro/macro nodular, what should you think?
Liver cirrohosis
152
Child Pugh score
To determine prognosis of liver cirrhosis Less than 7, is CP A 7-9 = B 1O+ = C, bad news
153
prehepatic causes of portal hypertension
Portal vein thrombosis
154
hepatic causes of portal hypertension
Divided into pre-sinosidual, sinosidual and post-sinsidual Pre-sinosidual : PBC, schistomsomiasis Sinosidual: liver cirrhosis Post-sinosidual: veno-occlusive disease
155
Post hepatic causes of portal hypertension
Budd-Chiari syndrome
156
What is budd-chiari syndrome
occulsion of the hepatic vein due to thrombophilia, OCP, HCC,
157
Tx of budd chiari syndrome
Thrombolytic Treat underlying cause TIPS
158
Fatty liver
Looks greasy, yellow, pale and large Steatosis Fully reversible if alcohol is avoided
159
Alcoholic hepatitis
Large, fibrotic liver
160
Mallory bodies
Alcoholic hepatitis
161
When do you see micronodular cirrhosis?
Small nodules and bands of fibrous tissue
162
How is more at risk of autoimmune hepatitis?
``` RA SLE Thyroiditis UC Coeliac Sjorgens Females HLA-DR3 L6 ```
163
GORD complications
``` Ulcers Haemorrhage Strictures Barrett's oesphagus Oesophageal cancer ```
164
Barrett's
Metaplasia leading to squamous --> columnar cells in the oesophagus Upward migration of the SCJ
165
Oesophageal adenocarcinoma
Dysplasia usually due to chronic GORD. Seen in the distal 1/3 of the oesphagus
166
Squamous cell carcioma of oesphagus
Associated with ETOH, smoking, plummer vinson, alchasia cardia, HPV Presents with difficulty swallowing, pain, weight loss
167
How do you treat varices?
Sclerotherapy/banding via endoscopy
168
Is gastric ulcer worse or better with food?
Worse with food
169
What causes gastric lymphoma
H.pylori (tx with triple therapy - clarithomycin, PPI + metro?)
170
Is the duodenum ulcer better or worse with food?
Better with food. More common too
171
What cancer can coeliac disease progress to? (10%)
duodenal t-cell lymphoma
172
Cobblestone appearance
Crohn's
173
Aphthous ulcer/rosethorn ulcers --> serpentine ulcers
Crohn's
174
Non-caseating granuloma
Crohn's
175
Transmural inflammation
Crohn's
176
Backwash ileitis
UC
177
Pseudopolyps
UC
178
Extra-GI manifestion
``` Erythema nodosum, clubbing, erythema multiforme Uveitis Conjuctivitis Arthritis Ankylosing spondylitis PSC (UC) ```
179
Watershed areas
seen in ischaemic colitis- splenic flexure and rectosigmoid
180
How do you diagnose c.difficile infection
Stool culture Hx of abx exposure (3Cs) Tx: metro or vanc
181
Origin of carcinoid syndrome
Enterochromaffin cells - produce serotonin
182
Features of carcinoid syndrome
Bronchoconstriction Facial flushing Diarrhoea
183
IX of carcinoid syndrome
24 Hr urine 5-HIAA
184
Tx of carcinoid syndrome
Ocretide (somastatin analogue)
185
Features of a carcinoid crisis
Life threatening vasodilation Hypotension Tachycardia Hyperglycaemia
186
What gene puts you most at risk of colon adenomas? (neoplastic)
APC gene (Kras, p53 and LOF)
187
Rectal bleeding in kid under 5 years? DDx
Hamaramatous polyp
188
Where else would you see hamaramatous polyp?
Peutz-Jeghers syndrome (increased risk of intussception)
189
98% of colorectal cancers are?
ADENOCARCINOMA
190
Hereditary causes of colorectal cancer
FAP | HNPCC
191
Fitz hugh curtis syndrome
RUQ from peri-hepatitis and violin string peri-hepatic adhesions
192
Powder burns + chocolate cysts
Endometriosis (macroscopic)
193
Red degeneration of fibroids
Seen in pregnancy with severe abdo pain due to haemorrhagic infarction
194
Hobnail appearance
Epithelial clear cell ovarian carcinoma
195
Meig syndrome
Associated with sex cord fibroma cancer presenting with ascites and pleural effusion
196
3 components of an atherosclerotic plaque
Cells like SMC, macrophages and other leukocytes Intracellular and extracellular lipids ECM including collagen
197
Which kinda flow is atherogenic?
Turbulent flow due to low sheer stress | High lamina flow is protective
198
Complications of MI
Arrhythmia - VF in first 24 hrs HF due to ventricular dysfunction Mitral valve regurg due to papillary muscle necrosis Haemopericardium due to ventricular rupture VSD due to septal rupture Ventricular anyeursm - > 4wks post MI causes persistent ST elevation Pericarditis - dusky haemorrhagic tissue Pericardial effusion Dressler's syndrome (chest pain, fever and effusion weeks/months post MI) Emboli
199
MI histology : 6-24 hours
Loss of nuclei Homogenous cytoplasm Necrotic cell death
200
MI histology: 1 - 4 days
Infiltration of polymorphs and then macrophages
201
MI histology: 1- 2 weeks
granulation tissue collagen synthesis angiogenesis myofibroblasts
202
Ix of HF
BNP ECG ECHO CXR
203
causes of dilated cardiomyopathy
``` alcohol sarcodosis haematochromatosis myocarditis peripartum genetics idiopathic ```
204
What is associated with hypertrophic cardiomyopathy
Aortic stenosis
205
Causes of restrictive cardiomyopathy
``` Amyloidosis Sarcoidosis Fibrosis (radiation) ```
206
Myocyte disarray
HCM
207
Which gene is associated with HCM
beta-MHC gene
208
Septal hypertrophy with outflow tract obstruction
HOCM
209
features of rheumatic fever
Heart: pancarditis Skin : erythema marginatum, subcutaneous nodules Joints: arthritis CNS: sydenhams chorea, encephalopathy
210
What infection is associated with rheumatic fever?
Group A strep infection (lancefield)
211
Jones major criteria (CASES)
``` Carditis Arthritis Sydenham's chorea Erythema marginatum Subcutaneous nodules ```
212
Jones minor criteria
``` Fever Raised ESR/CRP Tachycardia Previous rheumatic fever Prolonged PR interval malaise ```
213
What valve is affected in rheumatic fever
mitral valve
214
Histology of rheumatic fever
Aschoff bodies Anitschkov myocytes Verrucae vegetations
215
Tx of rheumatic fever
BenPen
216
Non-bacterial thrombotic endocarditis
path: DIC/hypercoaguable states
217
Libman-Sacks endocarditis
SLE | sterile warty vegatations that are platelet rich
218
What murmur is associated with IE?
MR/AR
219
what is the immune phenonemna in IE
Roth spots Osler nodes Haematuria due to glomerulonephritis
220
When would you see IE on the right side of the heart?
IVDU
221
Duke's major criteria (IE)
Positive blood culture typical IE organisms Evidence of vegetation on echo New regurgitant murmur
222
Duke's minor criteria (IE)
``` Risk factors Fever Immune phenonmena Thromboembolic phenonmena Positive blood culture but not major criteria ```
223
Mitral valve prolapse
Middle age women SOB + chest pain | Mid systolic click + late systolic murmur
224
Histology of chronic bronchitis
Hyperplasia of goblet cells and mucous glands | Dilation of airways
225
Young's syndrome
rhinosinusitis, azoospermia, bronchiectasis
226
Yellow nail syndrome
yellow nails, lymphoedema, pleural effusions and bronchicetasis
227
Interstital lung disease
Fibrosing Granulomatous Eosinophilic Smoking related
228
Hyperplasia of type II pneumocytes (surfactant)
Honeycomb fibrosis lung
229
Tx of fibrosis of lung
Steriods Azathioprine Cyclophosphamide
230
Pneumoconiosis
Occupational lung disease Affect the upper lobe Asbestosis Risk of mesothelioma
231
Progressive persistent productive cough, SOB, clubbing, and severe weight loss
Extrinsic allergic alveolitis
232
Lung - Squamous cell carcinoma
Linked to smoking | p53/c-myc mutation
233
Histo of lung -squamous cell carcinoma
Keratinisation | Intercellular prickles
234
Adenocarcinoma - lung
More common in women and non-smokers
235
Histo of adenocarcinoma - lung
Glandular differentiation
236
Small cell carcinoma - lung
Arising from neuroendocrine cells (ACTH secretion) | p53 and RB1 mutations
237
Large cell carcinoma histo
no evidence of glandular or squamous differentiation
238
What is pulmonary hypertension?
>25 mmHg at rest (mean pulmonary arterial pressure)
239
Iron laden macrophages
Seen in heart failure/pulmonary oedema
240
A 33 year old female is referred from haematology, where she was found to have leukopenia and a mild anaemia. She is reported to have a mild longstanding cough, although this is of little concern to the patient. She does not smoke and denies weight loss. Physical examination reveals painless cervical and axillary lymphadenopathy. A chest x-ray confirms the diagnosis.
Sarcodosis
241
Increased levels in rickets and osteomalacia
alk phos
242
Osteopenia
1-2.5 T score
243
Osteoporosis
T-score >2.5
244
Colle's wrist fracture
Osteoporosis
245
histo of osteoporosis
Loss of cancellous bone
246
Rachitic rosary, frontal bossing, bowed legs, pigeon chest and delayed walking
Rickets
247
Looser zones on x-ray
Osteomalacia/rickets
248
histo of osteomalacia/rickets
excess of unmineralized bone (osteoid)
249
Low Ca2+, low PO4, high ALP
Rickets/osteomalacia
250
osteitis fibrosa cystica
hyperparathyroidism primary
251
Salt + pepper skull
hyperparathyroidism primary
252
Brown's tumours
hyperparathyroidism primary
253
high ca2+, low phopsphate, n/high ALP
hyperparathyroidism primary
254
Nerve compression, microfractures, deafness, cardiac failure
Paget's disease
255
Cotton wool skull
Paget's disease
256
Ivory vertebrae
Paget's disease
257
VERY HIGH ALP
Paget's disease
258
low ca2+, high phosphate
Secondary PTH | Renal osteodystrophy
259
Gout Ix
Negatively bifrigent crystals
260
Tx of Gout
Colchicine (Acute) | Allopurinol (chronic)
261
Postively bifrigent crystals
Pseudogout
262
Calcium pyrophospahte crystals
Pseudogout
263
X-ray changes in osteomyelitis
Lytic destruction of bone | 10 days post onset
264
Heberden and bouchard nodes
osteoarthritis
265
Codman's triangle | Sunburst appearance
Osteosarcoma
266
Which bone is affected by osteosarcoma?
Knee
267
Histo of osteosarcoma
Malignant mesenchymal cells | ALP+ve
268
Lytic lesion with fluffy calcification
Chondrosarcoma
269
What bones are affected by chondrosarcoma?
Femur/tibia Pelvis Axial skeleton
270
Onion skinning of the periosteum
Ewing's sarcoma
271
Radiolucent nidus
Osteoid osteoma
272
Cotton wool calcification and o-ring sign
Enchondroma (olliers and maffauci syndrome)
273
Chinese letters, shepherd's crook deformity and soap bubble osteolysis
Fibrous dysplasia
274
A 25 year old woman with ulcerative colitis presents with an ulcerating lesion on her left shin.
Pyoderma Gangrenosum
275
A 32 year old woman presents with red and silver scaly lesions on her scalp and extensor surfaces. She claims that the condition is exacerbated by alcohol but improved by sun exposure. Your patient-centred approach to history-taking reveals increased stress at work and a recent acrimonious divorce.
Psorasis
276
A 43 year old woman complains of small, purple bumps on the inside of her wrist, which she describes as “intensely itchy”. On inspection, the papules have a ‘mother of pearl’ sheen. She also has white streaks on her tongue.
Lichen planus
277
A 70 year old woman presents with large, itchy blisters on her arms and legs. Histology reveals that they are subepidermal bullae and shows eosinophilic infiltration.
Pemiphgoid
278
Auspitz sign
Pin point bleeding when rubbing PSORIATIC lesions
279
Koebner phenonmenon
Lesions form at site of trauma
280
Rain drop plaques seen in kids wks post strep infection
Guttate psoriasis
281
nail changes in psoriasis
Pitting Onycholysis Subungual hyperkeratosis
282
Mother of pearl sheen
Lichen planus
283
SNAPP
``` Drugs that cause erythema multiforme Sulphomiades NSAIDS Allopurinol Pencillin Phenytoin ```
284
Bullae are deep
Pemphigoid
285
Bullae are superficial
Pemphigus
286
Pearly surface with telangiectasia
Basal cell carcinoma
287
A 26 year old female presents with two swollen toes on the right foot, a swollen ankle and wrist. She has also suffered from episodes of iritis in the past and has been diagnosed with colitis following a recent colonoscopy.
Psoriastic arthritis
288
A man presents with PUO. Although this may not have been your first investigation a biopsy reveals a necrotising arteritis with inflammation. There are many polymorphs, lymphocytes and eosinophils visible. There are also fibrotic areas. He is successfully treated with corticosteroids and cyclophosphamide
Polyartertis nodosa
289
Churg strauss
Asthma Allergic rhinitis Eosinophilia p-ANCA
290
Non-caseating granuloma
Sarcoidosis
291
Bilateral hilar lymphadenopathy
Sarcoidosis
292
Raised calcium, raised ESR and raised ACE
Sarcoidosis

Path - HANIN (5 decks)

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