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Path - HANIN > Histopath > Flashcards

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
Q

Bouchard and Heberden nodes

A

Osteoarthritis

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26
Q

Swan neck, Boutinner’s and Z-thumb

A

Rheumatoid Arthritis

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27
Q

Baker (popliteal) cyst

A

Rheumatoid Arthritis

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28
Q

Non-caseating granulomas, schaumann and asteroid bodies

A

Sarcoidosis

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29
Q

Bilateral Uveitis, parotid enlargement and facial nerve palsy

A

Heerfordt’s Syndrome (sarcoidosis)

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30
Q

Coup de sabre

A

Limited CREST

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31
Q

Heliotrope rash

A

Dermatomyositis

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32
Q

Gottron papules

A

Dermatomyositis

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33
Q

Auspitz sign

A

Psoriasis (pin point bleeding)

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34
Q

Koebner phenonmenon

A

Psoriasis (lesions when trauma or scars)

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35
Q

Test tubes in a rack appearance

A

Clubbing of rete ridges in histo of Psoriasis

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36
Q

Mother of pearl sheen and Wickam’s straie

A

Lichen Planus

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37
Q

Christmas tree and Herald patch

A

Pityrasis Rosea

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38
Q

Nikolsky sign

A

SJS + TEN

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39
Q

Aschoff Bodies and Anitschkov myocytes

A

Rheumatic fever

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40
Q

CASES (Carditis, Arthritis, Sydenham’s chorea, Erythema Marginatum, Subcutaneous nodules)

A

Jone’s Major Criteria - RHEUMATIC FEVER/DISEASE

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41
Q

Fever, raised CRP/ESR, tachycardia, malaise, prolonged PR interval

A

Jone’s minor criteria - Rheumatic fever/disease

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42
Q

Benzylpencillin (10 days)

A

Treatment for Rheumatic fever but also:

  • Bed rest
  • NSAIDS
  • Corticosteriods for 2 weeks
  • Diuretics (if they go into HF)
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43
Q

Libman-Sacks endocarditis

A

SLE and anti-phospholipid syndrome

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44
Q

Roth spots + osler nodes

A

Infective endocarditis

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45
Q

Positive blood culture and evidence of vegetation

A

Major Duke Criteria (IE)

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46
Q

IVDU, fever, immune +/- thromboembolic phenomena

A

Minor Duke criteria

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47
Q

BenPen + Gentamicin / Vancomycin

A

IE (subacute) treatment - 4 weeks

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48
Q

Flucloxacillin

A

MSSA (IE)

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49
Q

Rifampicin + Vancomycin + Gentamicin

A

MRSA (IE)

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50
Q

Aortic stenosis

A

Calcification, congenital bicuspid valve

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51
Q

Aortic regurgitation

A

IE, dissecting aortic aneurysm, ank spond, Marfans

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52
Q

Mitral stenosis

A

Rheumatic fever

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53
Q

Mitral regurgitation

A

IE, post MI, rheumatic fever, connective tissue disease

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54
Q

Fibrinous, Purulent, Haemorrhagic, Fibrous, Granulomatous

A

Types of Pericarditis

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55
Q

Dilation of the airways, goblet cell hyperplasia, hypertrophy of mucous glands

A

Chronic bronchitis histological features

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56
Q

Curschmann spirals, Charcot-Leyden crystals

A

Asthma

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57
Q

Loss of alveolar parenchyma distal to terminal bronchiole

A

Emphysema

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58
Q

Painless breast lump/skin thickening/mammographic lesion

Causes: trauma, surgery, cancer

A

Fat necrosis

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59
Q

Poorly defined palpable periareolar mass with thick white nipple discharge - usually seen in multiparous women aged 40-60.

A

Duct ectasia

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60
Q

Cytology of breast tissue - proteinaceous material, inflammatory cells

A

Duct ectasia

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61
Q

Painful breast in smoker, cytology shows keratinized squamous epithelium deep into nipple duct orifice

A

Periductal ectasia

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62
Q

Painful red breast and fever during lactation (s.aureus)

A

Acute mastitis

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63
Q

Breast tissue - necrotic and infiltrated by neutrophils

A

Acute mastitis

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64
Q

Tx of mastitis

A

Continued expression of milk + antibiotics +/- surgical drainage

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65
Q

Small fluid cysts in the breast that occur due to hormonal changes. Often calcified

A

Fibrocytic disease

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66
Q

Normally seen in pregnancy - increased number of acini per lobule

A

Adenosis (breast)

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67
Q

Epithelial hyperplasia, finger like projection into ducts

A

Gynaecomastia

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68
Q

Common bening tumour (stromal) seen in 20-30 year old women, grows during pregnancy and calcifies during menopause

A

Fibroadenoma

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69
Q

Overgrowth of collagenous mesenchyme

A

Fibroadenoma

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70
Q

Bloody nipple discharge, no lump or changes in mammogram

A

Duct papilloma

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71
Q

Bening sclerosing lesion that looks like carcinoma on mammogram

A

Radial scar

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72
Q

Breast carcinoma in situ

A

Ductal (more invasive) and lobular

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73
Q

Monoclonal Ig to Her2

A

Herceptin

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74
Q

Poor breast cancer prognosis

A

Her2

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75
Q

Palpable breast mass arising from interlobular stroma

A

Phyllodes tumour

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76
Q

Swelling and frothy urine

A

Nephrotic syndrome

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77
Q

Nephrotic syndrome seen in kids which responds to steriods but there are no loss microscopy or immunofluroensce findings

A

Minimal change disease

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78
Q

Loss of podocytes foot processes (electron)

A

Minimal change disease

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79
Q

Nephrotic syndrome caused by thickening of the glomerular basement membrane due to Ig and complement deposits (spikey)

A

Membranous glomerular disaese

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80
Q

Does membraneous glomerular disease respond to steriods?

A

Not really

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81
Q

What do you seen on the electron microscopy of membraneous glomular disease

A

Loss of podocyte foot processes

Subepithelial deposits = spikey

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82
Q

Nephrotic syndrome associated with focal and segmemtal scarring and consolidation of the basement membrane

A

Focal segmental glomerulosclerosis

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83
Q

Kimmelstein wilson nodules seen in histology of kidneys

A

Diabetes (asian)

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84
Q

Big tongue, big heart and big liver

A

Amyloidosis

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85
Q

Features of nephritic syndrome

A 
Haematuria 
Oliguria 
Hypertension 
RBC casts in urine 
Increased urea and creatinine
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86
Q

Raised ASOT titre and reduced C3

A

Post-streptococcal glomerulonephritis

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87
Q

Light microscopy of post-streptococcal glomerulonephritis

A

increased cellularity of glomeruli

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88
Q

Fluoresence microscope of post-strep glomerulonephritis

A

Granular deposits of IgG and C3 in GBM

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89
Q

Electron microscope

A

Subendothelial humps

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90
Q

Frank haematuria in a patient that has just recovered from URTI

A

IgA nephropathy (berger’s syndrome)

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91
Q

Fluoresnce microscope of IgA nephropathy (nephritic)

A

IgA and complement deposits in the mesangium

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92
Q

How does rapidly progressively (crescent) glomerulonephritis present?

A

Oliguria and renal failure more pronounced
Types:

1- Anti-GBM antibody
2- Immune complexes
3. ANCA - associated

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93
Q

What is associated with Anti-GBM antibody RPG? (COLA4)

A

Goodpastures (think additional pulmonary haemorrhage)

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94
Q

What do you see in fluoresence microscopy?

A

Linear deposits of IgG in GBM

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95
Q

What conditions are associated with Type 2 (immune mediated) RPG?

A

SLE
IgA nephropathy
Post strep GN

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96
Q

What do you see in flurosence microscopy?

A

Granular IgG complex deposition in the GBM and mesengium

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97
Q

Associated conditions of Type 3 RPG?

A

c-ANCA : wegeners
p-ANCA: microscopic polyangitis

Vasculitis so pulmonary haemorrhage or rash

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98
Q

Alport’s syndrome

A

Nephritic syndrome and sensorineural deafness
COLA5
X-linked

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99
Q

V.rarely a cause of nephritic syndrome?

A

Thin basement membrane disease

Microscopic haematuria

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100
Q

Differentials of asymptomatic haematuria

A

IgA nephropathy
Alport syndrome
Thin Basement membrane disease

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101
Q

Causes of nephritic syndromes

A 
IgA nephropathy 
Thin basement membrane disease 
Rapidly progressive glomerulonephritis 
Alport's syndrome 
Post streptococcus glomerulonephritis
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102
Q

What are common causes of ATN?

A

Ischaemia - burns, sepsis

Drugs - gentamicin, NSAIDs, radiocontrast

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103
Q

Histopath of ATN

A

necrosis of the short segments of tubules

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104
Q

How does acute pyleonephritis present as?

A

Flank pain, fever, rigors, haematuria, frequency, dysuria

Leukocytic casts seen in urine

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105
Q

Causes of chronic pyleonephritis?

A

Chronic obstruction like a renal stone

Urine reflux

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106
Q

What causes acute interstitial nephritis?

A

Drug hypersensitivity reaction like Abx, diuretics

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107
Q

How does acute interstitial nephritis present?

A 
Fever
Skin rash 
Haematuria 
Proteinuria 
Eosinophilia
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108
Q

Triad in HUS

A

MAHA (microangiopathic haemolytic anaemia)
Thrombocytopenia
Renal failure

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109
Q

HUS

A 
Affects kids 
Renal failure 
E.coli O157:H7 
Associated diarrohea 
Low platelets 
MAHA --> pallor and jaundice 
Raised LDH and reticulocyte count 
Coombs negative
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110
Q

TTP

A

Thrombi everywhere, not just kidney
Can have neuro symptoms
Unlikely to have renal failure

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111
Q

Complications of acute renal failure

A 
Metabolic acidosis 
Hyperkalemia 
HTN 
Hypocalcemia 
Uraemia 
Fluid overload
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112
Q

Causes of pre-renal failure

A

Hypovolemia caused by ischaemia, burns, sepsis

Renal artery stenosis, acute pancreatitis

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113
Q

Causes of renal failure

A

ATN
Acute glomerulonephritis
HUS etc

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114
Q

Causes of post renal failure

A

Obstruction via renal stone, ureter obstruction, tumour and prostate hypertrophy

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115
Q

Causes of chronic renal failure

A

DM
Glomerulonephritis
Hypertension and vascular disease
Polycystic kidney disease

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116
Q

Polycystic kidney disease

A

Mutations in PKD1 on chromosome 16

Can have liver cysts and berry aneurysms

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117
Q

How does someone with polycystic kidney disease present?

A

Haematuria
Flank pain
UTI
Cyst rupture, infection, haemorrhage

118
Q

Types of Renal cell carcinoma

A

Clear cell
Papillary
Chromophobe

119
Q

How does renal cell carcinoma present?

A

Costovertebral pain
Palpable mass
Haematuria
Paraneoplastic syndrome: polycythaemia, hypercalcaemia, HTN, cushing and amyloidosis

120
Q

Carcinogenesis often involves an activating mutation of KRAS

A

Pancreatic Ductal Carcinoma

121
Q

Histopathology shows cells with abundant eosinophilic finely granular cytoplasm. These cells show positive immunoreactivity for lipase.

A

Acinar Cell Carcinoma

122
Q

A 35 year old woman presents with a long history of recurrent duodenal ulcers involving D1 and D2.

A

pancreatic Endocrine Neoplasm

123
Q

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.

A

Zollinger-Ellison

124
Q

What two hormones stimulate the pancreas?

A

Secretin - controls gastric acid secretion and buffering with HCO3-
CCK - responsible for digestion enzymes

125
Q

Alpha cells of islets of langerhans

A

Secrete glucagon

126
Q

Beta cells of islets of langerhans

A

Secrete insulin

127
Q

Delta cells of islet of langerhan

A

Secrete somatastin

128
Q

Acute pancreatitis - I GET SMASHED

A 
Idiopathic 
Gallstones 
Trauma 
Steroids 
Mumps 
Autoimmune 
Scorpion bite 
Hyperlipidiamia 
Ethanol 
Drugs
129
Q

Symptoms of acute pancreatitis

A

Severe epigastric pain that radiates to the back
Relived by sitting forward
Nausea and vomiting

130
Q

Aftermath of acute pancreatitis esp in alcoholics

A

Pseudocyst

131
Q

Histology of acute pancreatitis

A

Coagulative necrosis

132
Q

Causes of chronic pancreatitis

A

Cystic fibrosis
Autoimmune (IgG4 sclerosing)
Alcohol
Pancreatic duct obstruction

133
Q

How does chronic pancreatitis present?

A

Epigastric pain radiating to the back
Malabsorption (foul stools and weight loss)
DM

134
Q

Histology of chronic pancreatitis

A

Fibrosis
Duct dilation
Calcification

135
Q

Pancreatic carcinoma - presentation

A 
Painless jaundice, itching and foul stools 
Weight loss 
Trousseau and couveriser sign + 
Abdo pain 
Abdo mass 
DM 
Virchow's node
136
Q

Ix of pancreatic carcinoma (head)

A 
Low Hb 
Raised bili 
Raised Ca2+ 
CT/MRI/ERCP 
Ca 19.9 > 70
137
Q

Surgery for pancreatic carcinoma

A

Whipple’s procedure

138
Q

Neuroendocrine tumour (body and tail)

A

associated with MEN 1 -PPP
Gastrinoma - Zollinger-Ellison syndrome (think recurrent ulcers)
Insulinoma - hypoglycaemic attacks

139
Q

Pancreatic divisum

A

increased risk of pancreatitis due to failure of fusion of dorsal and ventral buds

140
Q

Annular pancreas

A

Think less than 1 year and apparently associated with down’s

141
Q

A new born was found to have ppersistent jaundice due to absence of glucuronyl transferase activity.

A

Crigler-Najjar syndrome

142
Q

If i stayed on the pill, what liver tumour would i get?

A

Hepatic adenoma (resect if bigger than 5cm or doesnt shrink when you stop taking OCP)

143
Q

Haemangioma

A

Another benign liver tumour

144
Q

what causes hepatocellular carcinoma?

A

Hep B+C
Alcoholic cirrhosis
Haematochromatosis

145
Q

How to investigate hepatocellular carcinoma?

A

Raised AFP

USS

146
Q

Where does cholangiocarcinoma come from?

A

Adenocarcinoma arising from bile ducts

147
Q

Causes of cholangiocarcinoma

A

PSC
Chronic liver disease
Lynch syndrome

148
Q

Most common cause of liver cancer

A

metastases from other cancers/tumours

149
Q

Haematochromatosis

A

HFE gene Chr 6

150
Q

Wilson’s disease

A

ATP7B chr 13

151
Q

If you see micro/macro nodular, what should you think?

A

Liver cirrohosis

152
Q

Child Pugh score

A

To determine prognosis of liver cirrhosis

Less than 7, is CP A
7-9 = B
1O+ = C, bad news

153
Q

prehepatic causes of portal hypertension

A

Portal vein thrombosis

154
Q

hepatic causes of portal hypertension

A

Divided into pre-sinosidual, sinosidual and post-sinsidual

Pre-sinosidual : PBC, schistomsomiasis
Sinosidual: liver cirrhosis
Post-sinosidual: veno-occlusive disease

155
Q

Post hepatic causes of portal hypertension

A

Budd-Chiari syndrome

156
Q

What is budd-chiari syndrome

A

occulsion of the hepatic vein due to thrombophilia, OCP, HCC,

157
Q

Tx of budd chiari syndrome

A

Thrombolytic
Treat underlying cause
TIPS

158
Q

Fatty liver

A

Looks greasy, yellow, pale and large

Steatosis

Fully reversible if alcohol is avoided

159
Q

Alcoholic hepatitis

A

Large, fibrotic liver

160
Q

Mallory bodies

A

Alcoholic hepatitis

161
Q

When do you see micronodular cirrhosis?

A

Small nodules and bands of fibrous tissue

162
Q

How is more at risk of autoimmune hepatitis?

A 
RA 
SLE 
Thyroiditis 
UC 
Coeliac 
Sjorgens 
Females 
HLA-DR3 L6
163
Q

GORD complications

A 
Ulcers 
Haemorrhage 
Strictures 
Barrett's oesphagus 
Oesophageal cancer
164
Q

Barrett’s

A

Metaplasia leading to squamous –> columnar cells in the oesophagus

Upward migration of the SCJ

165
Q

Oesophageal adenocarcinoma

A

Dysplasia usually due to chronic GORD. Seen in the distal 1/3 of the oesphagus

166
Q

Squamous cell carcioma of oesphagus

A

Associated with ETOH, smoking, plummer vinson, alchasia cardia, HPV

Presents with difficulty swallowing, pain, weight loss

167
Q

How do you treat varices?

A

Sclerotherapy/banding via endoscopy

168
Q

Is gastric ulcer worse or better with food?

A

Worse with food

169
Q

What causes gastric lymphoma

A

H.pylori (tx with triple therapy - clarithomycin, PPI + metro?)

170
Q

Is the duodenum ulcer better or worse with food?

A

Better with food. More common too

171
Q

What cancer can coeliac disease progress to? (10%)

A

duodenal t-cell lymphoma

172
Q

Cobblestone appearance

A

Crohn’s

173
Q

Aphthous ulcer/rosethorn ulcers –> serpentine ulcers

A

Crohn’s

174
Q

Non-caseating granuloma

A

Crohn’s

175
Q

Transmural inflammation

A

Crohn’s

176
Q

Backwash ileitis

A

UC

177
Q

Pseudopolyps

A

UC

178
Q

Extra-GI manifestion

A 
Erythema nodosum, clubbing, erythema multiforme
Uveitis 
Conjuctivitis
Arthritis 
Ankylosing spondylitis 
PSC (UC)
179
Q

Watershed areas

A

seen in ischaemic colitis- splenic flexure and rectosigmoid

180
Q

How do you diagnose c.difficile infection

A

Stool culture
Hx of abx exposure (3Cs)

Tx: metro or vanc

181
Q

Origin of carcinoid syndrome

A

Enterochromaffin cells - produce serotonin

182
Q

Features of carcinoid syndrome

A

Bronchoconstriction
Facial flushing
Diarrhoea

183
Q

IX of carcinoid syndrome

A

24 Hr urine 5-HIAA

184
Q

Tx of carcinoid syndrome

A

Ocretide (somastatin analogue)

185
Q

Features of a carcinoid crisis

A

Life threatening vasodilation
Hypotension
Tachycardia
Hyperglycaemia

186
Q

What gene puts you most at risk of colon adenomas? (neoplastic)

A

APC gene (Kras, p53 and LOF)

187
Q

Rectal bleeding in kid under 5 years? DDx

A

Hamaramatous polyp

188
Q

Where else would you see hamaramatous polyp?

A

Peutz-Jeghers syndrome (increased risk of intussception)

189
Q

98% of colorectal cancers are?

A

ADENOCARCINOMA

190
Q

Hereditary causes of colorectal cancer

A

FAP

HNPCC

191
Q

Fitz hugh curtis syndrome

A

RUQ from peri-hepatitis and violin string peri-hepatic adhesions

192
Q

Powder burns + chocolate cysts

A

Endometriosis (macroscopic)

193
Q

Red degeneration of fibroids

A

Seen in pregnancy with severe abdo pain due to haemorrhagic infarction

194
Q

Hobnail appearance

A

Epithelial clear cell ovarian carcinoma

195
Q

Meig syndrome

A

Associated with sex cord fibroma cancer presenting with ascites and pleural effusion

196
Q

3 components of an atherosclerotic plaque

A

Cells like SMC, macrophages and other leukocytes
Intracellular and extracellular lipids
ECM including collagen

197
Q

Which kinda flow is atherogenic?

A

Turbulent flow due to low sheer stress

High lamina flow is protective

198
Q

Complications of MI

A

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
Q

MI histology : 6-24 hours

A

Loss of nuclei
Homogenous cytoplasm
Necrotic cell death

200
Q

MI histology: 1 - 4 days

A

Infiltration of polymorphs and then macrophages

201
Q

MI histology: 1- 2 weeks

A

granulation tissue
collagen synthesis
angiogenesis
myofibroblasts

202
Q

Ix of HF

A

BNP
ECG
ECHO
CXR

203
Q

causes of dilated cardiomyopathy

A 
alcohol 
sarcodosis 
haematochromatosis 
myocarditis 
peripartum 
genetics 
idiopathic
204
Q

What is associated with hypertrophic cardiomyopathy

A

Aortic stenosis

205
Q

Causes of restrictive cardiomyopathy

A 
Amyloidosis
Sarcoidosis 
Fibrosis (radiation)
206
Q

Myocyte disarray

A

HCM

207
Q

Which gene is associated with HCM

A

beta-MHC gene

208
Q

Septal hypertrophy with outflow tract obstruction

A

HOCM

209
Q

features of rheumatic fever

A

Heart: pancarditis
Skin : erythema marginatum, subcutaneous nodules
Joints: arthritis
CNS: sydenhams chorea, encephalopathy

210
Q

What infection is associated with rheumatic fever?

A

Group A strep infection (lancefield)

211
Q

Jones major criteria (CASES)

A 
Carditis 
Arthritis 
Sydenham's chorea 
Erythema marginatum 
Subcutaneous nodules
212
Q

Jones minor criteria

A 
Fever 
Raised ESR/CRP 
Tachycardia 
Previous rheumatic fever 
Prolonged PR interval 
malaise
213
Q

What valve is affected in rheumatic fever

A

mitral valve

214
Q

Histology of rheumatic fever

A

Aschoff bodies
Anitschkov myocytes
Verrucae vegetations

215
Q

Tx of rheumatic fever

A

BenPen

216
Q

Non-bacterial thrombotic endocarditis

A

path: DIC/hypercoaguable states

217
Q

Libman-Sacks endocarditis

A

SLE

sterile warty vegatations that are platelet rich

218
Q

What murmur is associated with IE?

A

MR/AR

219
Q

what is the immune phenonemna in IE

A

Roth spots
Osler nodes
Haematuria due to glomerulonephritis

220
Q

When would you see IE on the right side of the heart?

A

IVDU

221
Q

Duke’s major criteria (IE)

A

Positive blood culture typical IE organisms
Evidence of vegetation on echo
New regurgitant murmur

222
Q

Duke’s minor criteria (IE)

A 
Risk factors 
Fever 
Immune phenonmena 
Thromboembolic phenonmena 
Positive blood culture but not major criteria
223
Q

Mitral valve prolapse

A

Middle age women SOB + chest pain

Mid systolic click + late systolic murmur

224
Q

Histology of chronic bronchitis

A

Hyperplasia of goblet cells and mucous glands

Dilation of airways

225
Q

Young’s syndrome

A

rhinosinusitis, azoospermia, bronchiectasis

226
Q

Yellow nail syndrome

A

yellow nails, lymphoedema, pleural effusions and bronchicetasis

227
Q

Interstital lung disease

A

Fibrosing
Granulomatous
Eosinophilic
Smoking related

228
Q

Hyperplasia of type II pneumocytes (surfactant)

A

Honeycomb fibrosis lung

229
Q

Tx of fibrosis of lung

A

Steriods
Azathioprine
Cyclophosphamide

230
Q

Pneumoconiosis

A

Occupational lung disease
Affect the upper lobe
Asbestosis
Risk of mesothelioma

231
Q

Progressive persistent productive cough, SOB, clubbing, and severe weight loss

A

Extrinsic allergic alveolitis

232
Q

Lung - Squamous cell carcinoma

A

Linked to smoking

p53/c-myc mutation

233
Q

Histo of lung -squamous cell carcinoma

A

Keratinisation

Intercellular prickles

234
Q

Adenocarcinoma - lung

A

More common in women and non-smokers

235
Q

Histo of adenocarcinoma - lung

A

Glandular differentiation

236
Q

Small cell carcinoma - lung

A

Arising from neuroendocrine cells (ACTH secretion)

p53 and RB1 mutations

237
Q

Large cell carcinoma histo

A

no evidence of glandular or squamous differentiation

238
Q

What is pulmonary hypertension?

A

> 25 mmHg at rest (mean pulmonary arterial pressure)

239
Q

Iron laden macrophages

A

Seen in heart failure/pulmonary oedema

240
Q

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.

A

Sarcodosis

241
Q

Increased levels in rickets and osteomalacia

A

alk phos

242
Q

Osteopenia

A

1-2.5 T score

243
Q

Osteoporosis

A

T-score >2.5

244
Q

Colle’s wrist fracture

A

Osteoporosis

245
Q

histo of osteoporosis

A

Loss of cancellous bone

246
Q

Rachitic rosary, frontal bossing, bowed legs, pigeon chest and delayed walking

A

Rickets

247
Q

Looser zones on x-ray

A

Osteomalacia/rickets

248
Q

histo of osteomalacia/rickets

A

excess of unmineralized bone (osteoid)

249
Q

Low Ca2+, low PO4, high ALP

A

Rickets/osteomalacia

250
Q

osteitis fibrosa cystica

A

hyperparathyroidism primary

251
Q

Salt + pepper skull

A

hyperparathyroidism primary

252
Q

Brown’s tumours

A

hyperparathyroidism primary

253
Q

high ca2+, low phopsphate, n/high ALP

A

hyperparathyroidism primary

254
Q

Nerve compression, microfractures, deafness, cardiac failure

A

Paget’s disease

255
Q

Cotton wool skull

A

Paget’s disease

256
Q

Ivory vertebrae

A

Paget’s disease

257
Q

VERY HIGH ALP

A

Paget’s disease

258
Q

low ca2+, high phosphate

A

Secondary PTH

Renal osteodystrophy

259
Q

Gout Ix

A

Negatively bifrigent crystals

260
Q

Tx of Gout

A

Colchicine (Acute)

Allopurinol (chronic)

261
Q

Postively bifrigent crystals

A

Pseudogout

262
Q

Calcium pyrophospahte crystals

A

Pseudogout

263
Q

X-ray changes in osteomyelitis

A

Lytic destruction of bone

10 days post onset

264
Q

Heberden and bouchard nodes

A

osteoarthritis

265
Q

Codman’s triangle

Sunburst appearance

A

Osteosarcoma

266
Q

Which bone is affected by osteosarcoma?

A

Knee

267
Q

Histo of osteosarcoma

A

Malignant mesenchymal cells

ALP+ve

268
Q

Lytic lesion with fluffy calcification

A

Chondrosarcoma

269
Q

What bones are affected by chondrosarcoma?

A

Femur/tibia
Pelvis
Axial skeleton

270
Q

Onion skinning of the periosteum

A

Ewing’s sarcoma

271
Q

Radiolucent nidus

A

Osteoid osteoma

272
Q

Cotton wool calcification and o-ring sign

A

Enchondroma (olliers and maffauci syndrome)

273
Q

Chinese letters, shepherd’s crook deformity and soap bubble osteolysis

A

Fibrous dysplasia

274
Q

A 25 year old woman with ulcerative colitis presents with an ulcerating lesion on her left shin.

A

Pyoderma Gangrenosum

275
Q

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.

A

Psorasis

276
Q

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.

A

Lichen planus

277
Q

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.

A

Pemiphgoid

278
Q

Auspitz sign

A

Pin point bleeding when rubbing PSORIATIC lesions

279
Q

Koebner phenonmenon

A

Lesions form at site of trauma

280
Q

Rain drop plaques seen in kids wks post strep infection

A

Guttate psoriasis

281
Q

nail changes in psoriasis

A

Pitting
Onycholysis
Subungual hyperkeratosis

282
Q

Mother of pearl sheen

A

Lichen planus

283
Q

SNAPP

A 
Drugs that cause erythema multiforme
Sulphomiades 
NSAIDS
Allopurinol 
Pencillin 
Phenytoin
284
Q

Bullae are deep

A

Pemphigoid

285
Q

Bullae are superficial

A

Pemphigus

286
Q

Pearly surface with telangiectasia

A

Basal cell carcinoma

287
Q

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.

A

Psoriastic arthritis

288
Q

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

A

Polyartertis nodosa

289
Q

Churg strauss

A

Asthma
Allergic rhinitis
Eosinophilia
p-ANCA

290
Q

Non-caseating granuloma

A

Sarcoidosis

291
Q

Bilateral hilar lymphadenopathy

A

Sarcoidosis

292
Q

Raised calcium, raised ESR and raised ACE

A

Sarcoidosis

Path - HANIN (5 decks)

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