Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 5 > Histopathology > Flashcards

Histopathology Flashcards

1
Q

CT Head non contrast reveals hyperdense enhancement adjacent to the circle of willis.

What is the likely diagnosis?

A

Subarachnoid haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What cancer is associated with the presence of “oat shaped cells” on biopsy?

A

Small cell lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What type of murmurs are heard in hyperdynamic circulations - pregnancy, anaemia or severe blood loss?

A

flow murmur

soft, systolic murmurs heard best at the left lower sternal edge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

blood findings in PBC

A

elevated serum ALP and an elevated anti mitochondrial antibody titre.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Features of Parkinson’s

A

TRAPS

Tremor
Rigidity (Cogwheel)
Akinesia, bradykinesia
Postural instability
Shuffling gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most common solid organ cancer in males

A

prostate (adenocarcinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

treatment of non metastatic prostate cancer

A

Radical prostatectomy
generally first line in people who can tolerate it and have a new diagnosis of low grade disease

Active surveillance (if surgery not desired/low risk of progression) -> Radical radiotherapy + androgen deprivation if progresses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

treatment of metastatic prostate cancer

A

Docetaxel based chemotherapy
Orchidectomy or anti-androgen therapy (bicalutamide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what infection predisposes you to squamous cell carcinoma of the bladder

A

schistosomiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What structures, present in the large bowel, represent weak points in the bowel wall and allow for the formation of diverticula?

A

taenia coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the typical inheritance pattern of Hereditary non-polyposis colorectal cancer/Lynch Syndrome?

A

Autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Kimmelstiel Wilson nodules found in a renal biopsy are associated with what underlying disease?

A

Diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the secondary causes of nephrotic syndrome?

A

diabetes
amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the first line treatment for severe haemachromatosis?

A

therapeutic phlebotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Thickened basement membrane with spike and dome appearance due to electron dense deposits in the subepithelial layer”
with chronic hep B

A

Membranous glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

treatment for Wilsons

A

Trientine
Penicilamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How are Multiple Endocrine Neoplasias inherited

A

autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MEN 1

A

Pituitary adenoma
Parathyroid hyperplasia
Pancreatic tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MEN 2a

A

Parathyroid hyperplasia
Medullary thyroid carcinoma
Phaeochromocytoma

Think all the Cs: Calcitonin (medullary thyroid cancer), Calcium (Parathyroid hyperplasia) and Catecholamines (Phaeo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MEN 2b

A

Medullary thyroid carcinoma
Phaeochromocytoma
Marfanoid body habitus
Mucosal neuromas

Think B is for Big (marfanoid) and Belly problems (mucosal neuromas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the name given to areas of regenerating mucosa which project into the lumen of the bowel, which may be visualised during a colonoscopy of a patient with ulcerative colitis?

A

pseudopolyp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Persistent ST elevation post myocardial infarction in the absence of chest pain or other ischaemic features is suggestive of ….

A

ventricular aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

4 main types of invasive breast cancer

A

Invasive ductal (most common)
Invasive lobular
Mucinous carcinoma
Tubular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Expression of what cell surface receptor may confer a good prognosis in invasive breast carcinoma?

A

oestrogen receptor or progesterone receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Expression of what cell surface receptor may confer a bad prognosis in invasive breast carcinoma?

A

Herceptin 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what can HER2 positive breast cancer be treated with

A

trastuzumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is seen on mammography with ductal carcinoma in situ?

A

microcalcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the most common type of lung cancer in the UK?

A

(non-small cell) adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

which type of lung cancer is associated with women and non smokers

A

adenocarcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what paraneoplastic syndromes arise from small cell lung cancer?

A

ADH → SIADH (Small cell)
ACTH → Cushing’s syndrome (Small cell)
AchR antibodies → myasthenia gravis
Lambert Eaton syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what paraneoplastic syndromes arise from squamous cell lung cancer?

A

PTH/ PTHrP → primary hyperparathyroidism, hypercalcaemia and bone pain (Squamous cell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

inheritance pattern of benign familial haematuria

A

autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

pre-renal causes of AKI

A

Most common cause of acute renal failure

renal hypo-perfusion e.g. hypovolaemia, sepsis, burns, acute pancreatitis, and renal artery stenosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

renal causes of AKI

A

● Acute Tubular Necrosis (ATN): commonest renal cause of ARF.
● Acute glomerulonephritis.
● Thrombotic microangiopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

post renal causes of AKI

A

Obstruction to urine flow as a result of stones, tumours (primary & secondary), prostatic hypertrophy and retroperitoneal fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

First line investigation for pancreatic cancer

A

CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

associated tumour marker for pancreatic cancer

A

CA19-9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

management of pancreatic cancer

A

palliative chemotherapy (FOLFIRINOX ie 5-FU based)

surgical Whipple’s procedure if curative intent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

examples of neuroendocrine tumours arising from the pancreas

A

Insulinomas - Whipple’s triad of symptoms

Gastrinoma - Zollinger-Ellison syndrome + gastric ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

most common cancer in the UK overall

A

breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

most common cancers in men

A

Prostate (most common in men)
Lung
Bowel
Head and Neck
Other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

most common cancers in women

A

Breast (most common cancer overall)
Lung
Bowel
Uterus
Other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

most deadly cancers in men

A

Lung (most deadly)
Prostate
Bowel
Oesophagus
Other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

most deadly cancers in women

A

Lung (most deadly)
Breast
Bowel
Cancer of unknown primary
Othe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Which tumour marker is used in the diagnosis of hepatocellular carcinoma?

A

alpha fetoprotein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

most common cause of acute pyelonephritis

A

E.coli

leukocytic casts in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

pathophysiology of chronic pyelonephritis

A

chronic, recurrent bacterial infections
obstruction: renal calculi, posterior urethral valves
urine reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

pathophysiology of acute interstitial nephritis

A

drugs e.g. NSAIDs, diuretics, aminoglycosides, PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

histological features of acute interstitial nephritis

A

granulomas
eosinophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

pathophysiology of chronic interstitial nephritis

A

seen in the elders due to chronic analgesia use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Infection by what organism classically precipitates acute rheumatic fever?

A

Group A strep (pyogenes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

difference in presentation of post streptococcal glomerulonephritis and IgA nephropathy

A

Occurs 1-3 weeks after streptococcal throat infection

Presents 1-2 days (earlier than Acute postinfectious GN!) after an URTI with frank
haematuria*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Which hepatobilary pathology is classically associated with an elevated p-ANCA?

A

Primary Sclerosing Cholangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

which movement of air is affected in obstructive lung disease

A

exhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

which movement of air in affected in restrictive lung disease

A

inhalation,

therefore fine-end inspiratory crackles heard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

stages of lobar pneumonia

A

1.Consolidation
2. Red Hepatisation (neutrophilia)
3. Grey Hepatisation (Fibrosis)
4. Resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

diagnostic criteria for Acute Rheumatic fever

A

Jones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

diagnostic criteria for infective endocarditis

A

Duke’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

minor Jones criteria

A

Fever
Raised ESR/CRP
Arthralgia (migratory)
Prolonged PR
Previous RF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

histological features of Rheumatic fever

A

Beady fibrous vegetations (verrucae)
Aschoff bodies (small giant-cell granulomas)
Anitschkov myocytes (regenerating myocytes).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

treatment of rheumatic fever

A

benzypencillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

treatment of acute infective endocarditis

A

flucloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

treatment of subacute infective endocarditis

A

benzypenicllin + gent/vanc 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

most commonly affected valve in rheumatic fever

A

mitral

followed by aortic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what are the benign renal tumours

A

papillary adenoma
oncocytoma
angiomyolipoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what are the malignant renal tumours

A

renal cell carcinoma
nephroblastoma/Wilms
transitional cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

ALP > ALT

A

biliary obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

AST > 3x ALT

A

highly specific for alcoholic hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

ALT raised >1000

A

toxins, drugs, viruses, ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

where can AST be found

A

liver
heart
muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Which common medication are hepatic adenomas associated with?

A

oral contraceptive pill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What type of fluid motion produces low sheer stress and is hence protective against the development of atherosclerotic disease?

A

laminar flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

most common cause of CKD in the UK

A

diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What condition is characterised by microangiopathic haemolytic anaemia, thrombocytopenia and stroke-like symptoms in an adult?

A

TTP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

How much glucose is given, in grams, for an oral glucose tolerance test for the diagnosis of diabetes?

A

75

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

most common type of bladder cancer

A

transitional cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

layers of the skin

A

corneum
lucidum
granulosum
spinous
basale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

seborrhoeic dermatitis is a reaction to which yeast

A

Malassezia furfur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

key histology in psoriasis

A

parakeratosis
test tubes in a rack appearance
Munro’s microabscesses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

most common type of psoriasis

A

chronic plaque psoriasis

salmon pink papule, extensor surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

rash distribution in guttate psoriasis

A

rain drop plaque distribution
trunk of child
seen 2 weeks after group A strep infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

emergency in psoriasis

A

erythrodermic/pustular psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Auspitz sign

A

rubbing of psoriatic plaques causes pin point bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what are the two associated features in psoriasis

A

nail changes and arthritis

arthritis multilans ‘telescoping’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

6Ps of lichen planus

A

purple
pruritic
polygonal
papular
plaques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

which skin emergency in erythema multiform seen in

A

TENS and SJS

> 30 TENS
<10 SJS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

which autoimmune disease is dermatitis herpetiformis associated with

A

coeliac disease

IgA binds to basement membrane in extensor surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

IgG Ab against what in bullous pemphigoid

A

hemidesmosomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

IgG Ab against what in pemphigus vulgaris

A

desmoglein 1 and 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

which malignant skin lesion has a pearly surface and telangiectasia

A

BCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

which malignant skin lesion has rolled edges and is ulcerative

A

SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

most important prognostic factor in melanoma

A

Breslow thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

most common subtype of melanoma

A

superficial spreading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

rash description in pityriasis rosea

A

salmon pink rash/herald patch in Christmas tree distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

after what infection does pityriasis rosea occur

A

HHV-6 and HHV-7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is the most common cause of acute interstitial nephritis?

A

drugs

include antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), and proton pump inhibitors (PPIs).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Which common medication are hepatic adenomas associated with?

A

oral contraceptive pill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is the term used to describe small, tube shaped microscopic particles found in urine?

A

urinary casts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

In the setting of a possible false positive PSA test, what should be done?

A

repeat test in 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

In the setting of a possible false positive PSA test, what should be done?

A

repeat test in 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

what is the tetrad of nephrotic syndrome

A

hypoalbuminaemia
proteinuria
oedema
hyperlipidaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

In the emergency department what imaging is required in the initial workup of a suspected stroke?

why is it important to do?

A

CT head non contrast

Prior to the use of thrombolytic therapy, a CT head will exclude the presence of a significant haemorrhagic stroke, which has very different management to that of an ischaemic stroke.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

symptoms of pancreatic cancer

A

nausea
reflex
belching

progresses to:
weight loss
jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What histopathological description is given to cells that have lost their intercellular connections between neighbouring cells?

A

acantholysis

decreased cohesion between keratinocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

spongiosis

A

intercellular oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What monoclonal antibody therapy targets human epidermal growth factor receptor 2 and is used in the treatment of breast cancer?

A

trastazumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What protein is defective in adult polycystic kidney disease?

A

polycystin-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What kind of cancer is associated with keratin pearls?

A

squamous cell carcinoma

(hyperkeratotic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

what is the triad of carcinoid syndrome

A

bronchoconstriction
flushing
diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What surgical procedure may be used to treat pancreatic cancer affecting the head, neck and body of the pancreas?

A

Whipple’s procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What sign describes painless jaundice in the presence of a palpable gallbladder?

A

Courvoisier’s sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

What tumour marker is most commonly used in the diagnosis of colorectal cancer?

A

carcinoembryonic antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What is the most common histochemical stain used to visualise cells for light microscopy, such as that used for diagnosis of cancers?

A

haemotoxylin and eosin stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

coughing up pink, frothy sputum, SOB, raised JVP, pitting oedema

A

pulmonary oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Whipple triad of symptoms: what are they and what condition are they representative of?

A
  1. episodic hypoglycaemia
  2. central nervous system (CNS) dysfunction temporally related to hypoglycaemia (confusion, anxiety, stupor, paralysis, convulsions, coma)
  3. dramatic reversal of CNS abnormalities by glucose administration.

Insulinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

what is the prognosis of a pancreatic adenocarcinoma

A

very poor

25% 1 year survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

point tenderness adjacent to the sternum bilaterally indicated…

A

costochondritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

chest pain + raised AST

A

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

recent fracture +slightly raised ALP

A

normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

markers of hepatic synthetic function

A

PT
albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

what does HER2 stand for

A

human epidermal growth factor receptor 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

What is the typical inheritance pattern of Maturity Onset Diabetes of the Young (MODY)?

A

autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Damage to what muscle within the heart may result in mitral regurgitation?

A

papillary muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

painful fluid filled blisters; When you run your finger over the surface of one of the blisters, the roof of the blister easily comes away; biopsy reveals acantholytic cells, however the basal keratinocytes remain attached to the basement membrane.

A

pemphigus vulgaris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

The ECG leads II, III and aVF represent which region of the heart?

A

inferior wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

A GFR of less than what value is considered reflecting End Stage Renal Failure in chronic kidney disesease?

A

15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

High resolution CT scan reveals bronchial wall thickening with a positive signet ring sign.

A

bronchiectasis

128
Q

What is the typical inheritance pattern of hypertrophic obstructive cardiomyopathy (HOCM)?

A

autosomal dominant

129
Q

Graded using the Gleason system, what does each number represent?

A

First number = most common cell type seen. Second number = second most common cell type seen (highest grade)

130
Q

what constellation of symptoms are seen in infective endocarditis

A

Clinical features:
● Constitutional:
○ Fever
○ Malaise ○ Rigors
○ Anaemia

● Cardiac:
○ New murmur (MR/AR usually)

● Immune phenomena:
○ Roth spots
○ Osler’s nodes
○ Haematuria due to glomerulonephritis

● Thromboembolic phenomena:
○ Janeway lesions
○ Septic abscesses in lungs/brain/spleen/kidney
○ Microemboli
○ Splinter haemorrhages
○ Splenomegaly

131
Q

causes of acute infective endocarditis

A

staph aureus
strep pyogenes

132
Q

An immune response directed against myelin basic protein and proteo-lipoprotein results in what autoimmune condition?

A

multiple sclerosis

133
Q

There is no evidence of glandular or squamous differentiation. The cells are poorly differentiated with large nuclei. Which lung cancer?

A

large cell carcinoma

poor prognosis

134
Q

What is the organism typically implicated in acute postinfectious glomerulonephritis?

A

Group A Streptococcus

i.e. Streptococcus pyogenes

135
Q

two places prostate cancer usually spreads to

A

bladder
bone

136
Q

What sign, which may be visible around the nails, is seen in Graves’ disease and is due to periosteal bone growth in the nail bed?

A

thyroid acropachy

results in clubbing of the digits

137
Q

what do the delta cells of the pancreas secrete?

what is its role?

A

somatostatin

paracrine effect on alpha and beta cells to reduce glucagon and insulin secretion

138
Q

how does Paget’s disease of the breast present

A

eczema of nipple then areola, peau d’orange (oedema + pitting of breast)

139
Q

what is Paget’s disease of the breast associated with

A

breast cancer

140
Q

which condition is characterized by apical akinesis and ventricular dysfunction on echocardiogram.

A

Takotsubo’s Cardiomyopathy

Coronary arteries are usually unobstructed if an angiogram is performed.

141
Q

which nephrotic syndrome does not respond well to steroids

A

membranous glomerular disease

142
Q

A biopsy viewed under light microscopy shows thickening of the glomerular basement membrane.

Immunofluorescence shows the presence of antibody complexes and complement deposits throughout the glomerular basement membrane

A

membranous glomerular disease

143
Q

What condition is the presence of granular (“muddy brown”) casts seen in the urine associated with?

A

Acute Tubular necrosis

144
Q

which two conditions makes up COPD

A

chronic bronchitis
emphysema

145
Q

What type of bladder cancer is associated with chronic cystitis?

A

squamous cell carcinoma

commonly associated with chronic irritation and inflammation of the bladder.

146
Q

features of chronic pancreatitis on exploration

A

destruction of exocrine tissue, associated with fibrosis and calcification

147
Q

biochemical findings in Wilsons disease

A

low caeruloplasmin
low serum copper
high urinary copper

148
Q

how does Wilson’s disease present

A
  • liver disease e.g. liver failure
  • neuro disease e.g. Parkinsonism
  • kayser fleischer rings
149
Q

age range for Wilson

A

young <20

150
Q

What is the most common pattern of disease progression in Multiple Sclerosis?

A

relapsing remitting

151
Q

what does the presence of faecal calprotectin in the stool reflect

A

presence of intraluminal neutrophils

152
Q

in which liver condition will cytoplasmic Mallory Denk Bodies most commonly be found on biopsy

A

alcoholic hepatitis

153
Q

features of acute interstitial nephritis

A

● A hypersensitivity reaction, usually to a drug (abx, NSAIDs, diuretics)

● Usually begins days after drug exposure

● Presents with: fever, skin rash, haematuria, proteinuria, eosinophilia

● Histology: inflammatory infiltrate with tubular injury, eosinophils & granulomas

154
Q

The presence of white cell casts in the urine along with eosinophilia and recent antibiotic use

A

acute interstitial nephritis

155
Q

what is seen in the urine on microscopy in acute pyelonephritis

A

leukocytic casts

156
Q

lung disease pattern in pulmonary fibrosis

A

restrictive

low FEV1
lower FVC
increased FEV1/FVC

157
Q

investigation for pulmonary fibrosis

A

high resolution CT of the lungs

158
Q

Two main types of lung cancer - small cell and non small cell.

Which is more common

A

small cell

159
Q

what are the non small cell cancers

A

adenocarcinoma (40%)
squamous cell (30%)
large cell
other

160
Q

treatment of limited disease small cell cancer (in one lung only)

A

Chemotherapy + Radiotherapy

161
Q

treatment of extensive small cell cancer (metastatic spread in both lungs)

A

palliative

162
Q

most common paraneoplastic syndrome in small cell lung cancers

A

SIADH (15% of patients)

Cushing’s syndrome (5%)
Lambert-Eaton Myasthenic syndrome (3%)
acromegaly

163
Q

treatment of Stage 1 NSCLC (Small solitary tumour):

A

surgery

164
Q

treatment of Stage 2 NSCLC (Large solid tumour or limited local spread):

A

Surgery followed by chemotherapy or immunotherapy

165
Q

treatment of Stage 3 NSCLC (lymph node spread or multilobular disease):

A

Neoadjuvant chemotherapy with surgery

166
Q

treatment of Stage 4 NSCLC (spread to other lung or distant metastasis):

A

palliation

167
Q

3 histological features of sarcoidosis

A

1- non caseating granulomas
2- Schaumann bodies
3- asteroid bodies

168
Q

skin involvement in sarcoidosis

A

erythema nodosum
lupus pernio

169
Q

eye involvement in sarcoidosis

A

anterior and posterior uveitis
uveoparatoid fever
keratoconjunctivitis
lacrimal gland enlargement

170
Q

what is raised in the bloods in sarcoidosis investigation

A

Calcium
ACE

171
Q

what spirometry picture is sarcoidosis

A

restrictive

172
Q

which layer of the large arteries are affected in atherosclerosis

A

tunica intima

173
Q

difference in vessel occlusion in stable and unstable angina

A

stable: ~70% occlusion

unstable: ~90% occlusion

174
Q

Prinzmental angina is not causes by atherosclerosis but by

A

coronary artery spasm

175
Q

is there muscle death in angina

A

no

176
Q

what is the most common cause of sudden death post-MI

A

VF

occurs in the first 24 hours

177
Q

if you want to decrease stroke volume, what must be increased

A

increase the after load

178
Q

how does cardiac damage affect stroke volume and cardiac output?

what respective changes do they cause?

A

cardiac output decreased therefore increase RAS activation to retain salt and water

stroke volume decreased therefore stimulate SNS to increase total peripheral vascular resistance

179
Q

what does the liver become due to stasis of venous blood in it

A

nutmeg liver

180
Q

what type of cardiomyopathy does sarcoidosis or amyloidosis cause

A

restrictive

181
Q

main mechanism causing aortic stenosis

A

calcification due to old age

182
Q

causes of aortic regurgitation

A

infective endocarditis
Marfans
LV dilation

183
Q

cause of mitral stenosis

A

rheumatic fever

184
Q

causes of mitral regurgitation

A

infective endocarditis
post MI

185
Q

which side of the heart does chronic rheumatic fever usually affect

A

left sides especially mitral valve

186
Q

what are the two clinical signs of mitral valve prolapse

A

mid systolic click
late systolic murmur

187
Q

what usually causes pericardial effusion

A

chronic heart failure

188
Q

Mean pulmonary arterial pressure at rest

A

> 25 mmHg

189
Q

class 2 pulmonary hypertension

A

due to left heart disease

190
Q

class 3 pulmonary hypertension

A

due to lung disease (eg. ILD)

191
Q

class 4 pulmonary hypertension

A

due to many clots overtime which cause fibrosis

192
Q

what is the acute histological finding in pulmonary oedema

A

intra-alveolar fluid

193
Q

what is the chronic histological finding in pulmonary oedema

A

iron laden macrophages (heart failure cells)

194
Q

what causes diffuse alveolar damage in adults

A

ARDS

195
Q

what causes diffuse alveolar damage in neonates

A

hyaline membrane disease

insufficient surfactant production in preterm

196
Q

what is the mechanism of Barretts

A

intestinal metaplasia of the squamous mucosa

197
Q

what feature present increases the likelihood of Barrett’s becoming a cancer

A

goblet cells

198
Q

which third of the oesophagus is oesophageal carcinoma seen

A

distal 1/3

as its is associated with Barrett’s

199
Q

which third of the oesophagus is squamous cell oesophageal carcinoma seen

A

mostly middle (50%)

200
Q

what two risk factors are associated with squamous cell oesophageal carcinoma

A

smoking and alcohol

201
Q

what are engorged dilated veins due to portal HTN called

A

varices

202
Q

is a stomach ulcer pain better or worse with food

A

worse

203
Q

is a duodenal ulcer pain better or worse with food

A

better

204
Q

what are the two types of gastric cancer

A

intestinal (well differentiated)

diffuse (poorly differentiated, signet ring cell )

205
Q

what are the two large vessel vasculitides

A

takayasu arteritis

temporal arteritis

206
Q

what structure is affected in Takayasu arteritis

A

branches of the aorta

207
Q

signs of Takaysu arteritis

A

pulseless
claudication
cold hands

208
Q

what is seen on angiography in polyarteritis nodosa

A

microaneurysms (string of pearls/rosary beed appearance)

209
Q

what are the two types of medium vessel vasculitis

A

polyarteritis nodosa
Buerger’s disease

210
Q

what underlying infection is seen in polyarteritis nodosa

A

Hep B

211
Q

what is the classical appearance seen in angiogram in Buergers disease

A

corkscrew appearance

212
Q

which demographic does burgers disease affect mostly

A

heavy smoking males < 35

213
Q

how are microscopic polyangiitis and Wegeners similar but how do they differ

A

both have pulmonary and renal involvement

differ in antibody (pANCA in the former)

214
Q

in the hexagonal hepatic lobule, what is in the centre

A

central vein

215
Q

what is located on the corners of the hepatic lobule

A

portal triad
(portal vein, hepatic artery, bile duct)

216
Q

which zone is closest to the portal triad

A

zone 1

periportal hepatocytes receives the most oxygen

217
Q

which zone is closest to the central vein of the hepatic lobule

A

zone 3

perivenular hepatocytes are the most mature and metabolically active cells

218
Q

which zone of the hepatic lobule is affected first by viral hepatitis

A

zone 1

219
Q

which zone of the hepatic lobule is most sensitive to metabolic toxins

A

zone 3

220
Q

where are stellate cells found

A

Space of Disseminated in between sinusoid and hepatocytes

221
Q

what two things happen to the architecture of the liver in chronic inflammation

A

loss of microvilli

activation of stellate cells

222
Q

what do activated stellate cells produce

A

collagen

223
Q

what do activated stellate cells become

A

myofibroblasts

224
Q

key histological finding in acute hepatitis caused by drugs or viruses

A

spotty necrosis

225
Q

what does the severity of inflammation in chronic hepatitis determine

A

grade

226
Q

what does the severity of fibrosis in chronic hepatitis determine

A

stage

227
Q

4 events that occur when chronic hepatitis becomes cirrhosis

A
  1. portal inflammation
  2. interface hepatitis
  3. lobular inflammation
  4. bridging from the portal vein to central vein
228
Q

what sort of necrosis occurs in interface hepatitis

A

piecemeal necrosis

229
Q

what happens in interface hepatitis

A

cannot see the border between the portal tract and parenchyma

230
Q

which histolopathological stage is critical in the evolution of chronic hepatitis to cirrhosis

A

Bridging from the portal vein to central vein.

This causes blood to bypass hepatocytes and reduces function of liver (intrahepatic shunting)

231
Q

what is bridging from the portal vein to central vein called

A

intrahepatic shunting (fibrotic bridges)

232
Q

top 3 causes of liver cirrhosis

A
  1. alcoholic liver disease
  2. NAFLD
  3. chronic viral hep
233
Q

which metabolic disorders can lead to liver cirrhosis

A

galactosaemia
glycogen storage disease

234
Q

which drug can lead to liver cirrhosis

A

methotrexate

235
Q

how is liver cirrhosis classified

A

by the size of the regenerating nodueles

MICRO <3
MACRO >3 mm

236
Q

Scoring system for prognosis of liver cirrhosis

A

Modified Child’s Pugh Score

237
Q

the elements of the Modified Child’s Pugh Score

A

A- albumin
B- bilirubin
C- Clotting
D (distension) - Ascites
E- encephalopathy

238
Q

Score for Child Pugh A

A

< 7

239
Q

Score for Child Pugh B

A

7-9

240
Q

Score for Child Pugh C

A

> 10

241
Q

which condition do you see hepatocyte ballooning and necrosis

A

alcoholic hepatitis

242
Q

is alcoholic cirrhosis micro or macronodular

A

micro nodular

243
Q

most common cause of chronic liver disease in the West

A

NAFLD

244
Q

when does NAFLD become NASH

A

steatosis + hepatitis
this can become cirrhosis

245
Q

HLA association in autoimune hep

A

HLA-DR3

246
Q

antibodies in Type 1 autoimmune hep

A

ANA (antinuclear Ig)
anti-SMA (anti-smooth muscle Ig)
anti-actin Ig
anti- soluble liver antigen Ig

247
Q

antibodies in Type 2 autoimmune hep

A

Anti-LKM Ig (anti liver-kidney-microsomal Ig)

248
Q

histology in PBC

A

bile duct loss with granuloma

249
Q

histology in PSC

A

onion skinning fibrosis
beading/strictures

250
Q

what cancer increases with PSC

A

cholangiocarcioma

251
Q

histological changes seen in post strep glomerulonephritis

A

Light microscope (LM):↑cellularity of glomeruli

FluorescenceMicroscope(FM): granular deposits of IgG and C3 in GBM

Electron Microscope (EM): Subendothelial humps

252
Q

Malignant HTN, what is the classic renal finding on histology

A

fibrinoid necrosis

253
Q

which two conditions can lead to mucosa associated lymphoid tissue Lymphoma

A
  1. H.pylori
  2. Sjogrens syndrome
254
Q

Women has acute appendicitis, 5mm tumour found in tip when it’s removed, what sort of tumour might it be?

A

neuroendocrine tumour

255
Q

Fibro-epithelial tumour with abundant stromal elements

A

phyllodes tumour

256
Q

classical histological findings in phyllodes tumour

A

“branching”/”leaf-like fronds”/”artichoke appearance”

257
Q

Breast cancer which has a high, medium and low stage to it

A

Ductal carcinoma in situ

258
Q

out of the two breast carcinomas in situ, which one has micro-calcification

A

ductal carcinoma in situ

no calcification in lobular carcinoma in situ

259
Q

which breast disease changes in presentation according to the menstrual cycle

A

fibrocystic disease

260
Q

which intraductal papillomas cause nipple discharge

A

Larger lactiferous ducts → central papillomas

261
Q

A man with AF (Atrial fibrillation) develops fever, nausea, vomiting and pain in his right loin/flank. What is the most likely cause?

A

renal infarct

262
Q

A man presents with the symptoms of a UTI and acute onset costovertebral pain. He is found to have pus cells and blood in his urine. What is the most likely cause?

A

acute pyelonephritis

263
Q

Patient with a pancreatic mass following acute pancreatitis

A

pancreatic pseudocyst

264
Q

Patient with a history of severe abdominal pain; during cholecystectomy the surgeons noticed grey specks around and on the pancreas

A

acinar cell carcinoma

multifocal fat necrosis

265
Q

On doing a patient’s nephrectomy they notice a mass in the kidney that extends into the the renal vessels and into the perinephric fat

A

angiomyolipoma

266
Q

Man goes deaf with bowed legs

A

Paget’s disease

267
Q

which cerebral haemorrhage is characterised by sudden onset thunderclap headache, LoC and vomiting

A

subarachnoid

268
Q

which cerebral haemorrhage is characterised by bridging veins with slow venous bleed

A

subdural

269
Q

which cerebral haemorrhage is characterised by rapid arterial bleed, lucid interval then LoC

A

epidural

270
Q

“lemon” shape haemorrhage

A

epidural

271
Q

“banana” shape haemorrhage

A

subdural

272
Q

most common site of intraparenchymal haemorrhage of the brain

A

basal ganglia

273
Q

where do most subarachnoid haemorrhages occur

A

bifurcation of the carotids

274
Q

Patient with HIV, raised ICP, new onset epilepsy

A

primary CNS lymphoma

275
Q

Low TSH and high T4 following viral infection, what is the diagnosis

A

viral thyroiditis/ De Quervains

276
Q

Which thyroid cancer most commonly metastasises to the lymph nodes

A

papillary

277
Q

What virus increases risk of nasopharyngeal cancer

A

EBV

278
Q

cerebral haemorrhage associated with gradual headache, fluctuating consciousness
and behaviour changes

A

subdural

279
Q

which are the non-traumatic and traumatic cerebral haemorrhages

A

traumatic: epidural and subdural
non-traumatic: intraparenchymal and subarachnoid

280
Q

where has a Krukenberg tumour metastasised from

A

gastric

281
Q

what liver change occurs in diabetics

A

NAFLD or NASH

due to insulin resistance

282
Q

most common brain tumour in children

A

astrocytoma (pilocytic)

indolent childhood tumour

283
Q

2nd most common brain tumour in children

A

medulloblastoma

284
Q

most common brain tumour in adults

A

glioblastoma

285
Q

2nd most common brain tumour in adults

A

meningioma

286
Q

main mutation in pilocytic astrocytoma

A

BRAF

287
Q

main mutation in GBM

A

IDH wildtype

288
Q

what mutation in diffuse glioma is associated with longer survival and better response to chemo and radiotherapy

A

IDH mutation

289
Q

which brain tumours are associated with psammoa bodies

A

meningioma

290
Q

Publican with diabetes, fatty stools, weight loss, ‘slate grey skin’ and joint pains. What is the underlying diagnosis causing this

A

haemochromatosis

291
Q

most common oesophageal carcinoma seen in the uk

A

adenocarcinoma

most common in Caucasians

292
Q

A woman develops signs of hyperthyroidism. Bloods show low TSH and high thyroxine. Does not have good uptake on technetium scan. What is the likely diagnosis?

A

viral thyroiditis

293
Q

which causes of hyperthyroidism have high uptake

A

Graves
Toxic Multinodular Goitre
Toxic adenoma

294
Q

iodine uptake scan pattern in graves

A

diffuse

295
Q

iodine uptake scan pattern in toxic multinodular goitre

A

mulitple hot nodules

296
Q

iodine uptake scan pattern in toxic adenoma

A

solitary hot nodule

297
Q

which causes of hyperthyroidism have a low uptake

A

De Quervains/ viral
Postpartum thyroiditis
ectopic

298
Q

two drugs that can cause hypothyroidism

A

lithium
amiadorone

299
Q

which thyroiditis causes a stony hard thyroid

A

Riedel’s thyroiditis

300
Q

What type of section is done for urgent diagnosis during surgery

A

intra-operative frozen section

301
Q

What type of shunt is seen in Tetralogy of Fallot

A

right to left

302
Q

primary bone tumour affecting the knee commonly

A

osteosarcoma

303
Q

what is raised in osteosarcoma

A

ALP

304
Q

X-ray findings in osteosarcoma

A

Codman triange
sunburst appearance

305
Q

highly malignant bone tumour

A

Ewings

affects <20s

306
Q

malignant bone tumour affecting over 40s

A

chondrosarcomas

(malignant proliferation of chondrocytes)

307
Q

x-ray finding in chondrosarcoma

A

lytic lesions with fluffy calcification

308
Q

most common benign bone tumour

A

osteochondroma

309
Q

x ray sign for enchondroma

A

cotton wool calcification

310
Q

x ray sign for osteiod osteoma

A

bulls eye

311
Q

in which inherited disease is fibrous dysplasia seen

A

McCune Albright Syndrome

312
Q

x ray findings in fibrous dyplasia

A

Soap bubble osteolysis
Shepherd’s crook deformity

313
Q

What is the difference in bullae in pemphigus vulgaris and bullous vulgaris?

A

Bullous: large tense fluid fluid, on flexural surfaces, do not rupture as easily as pemphigus.
Pemphigus: easily ruptured, found on mucosal and skin. Nikolsky sign positive

314
Q

what is bicalutamide and what is it used for

A

androgen antagonist

metastatic prostate cancer

315
Q

neoplastic cells with transparent cytoplasm. Cells are arranged in nests with intervening blood vessels.

which renal cancer?

A

clear cell

316
Q

in what condition are waxy urinary casts seen

A

CKD

Year 5 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions