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Evie Pathology > Histopathology > Flashcards

Histopathology Flashcards

1
Q

Takayasus arteritis

A

Large vessel vasculitis

Pulseless, bruits and claudication

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2
Q

Temporal arteritis

A

Tender scalp and headache

Large vessel vasculitis

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3
Q

Granulomatosis transmural inflammation, giant calls and skip lesions on biopsy of a large vessel

A

Temporal arteritis

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4
Q

Corkscrew appearance on angiogram

A

Beurger’s disease

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5
Q

Polyarteritis nodosa

A

Renal involvement and micro-aneurysm

Medium vessel vasculitis

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6
Q

Pulmonary haemorrhage and cresenteric glomerulonephritis

A

Wegener’s granulomatosis

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7
Q

CANCA

A

Wegener’s granulomatosis

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8
Q

Asthma and eosinophilia with pANCA

A

Churg Strauss

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9
Q

Microscopic polyangitis

A

Pulmonary renal syndrome = pulmonary haemorrhage and glomerulonephritis

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10
Q

pANCA (2)

A

Churg Strauss

Microscopic polyangitis

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11
Q

Abdominal pain, glomerulonephritis and a purpuric rash

A

Hennoch-Schonlein Purpura

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12
Q

Antibody type mediating HSP

A

IgA

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13
Q

Nephrotic syndrome, cardiomegaly and hepatosplenomegaly

A

Amyloidosis

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14
Q

Test for amyloidosis

A

Congo red stain showing apple green birefringence (due to the beta pleated sheet conformation)

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15
Q

Non-caseating granulomas

A

Sarcoidosis

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16
Q

Cause of the non-caseating granulomas in sarcoidosis

A

Schauman and asteroid bodies

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17
Q

Fine nodular shadowing and bilateral hilar lymphadenopathy is indicative of what disease process

A

Sarcoidosis (pulmonary infiltrates cause the fine nodular shadowing)

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18
Q

Painless rubbery lymphadenopathy with high Ca, high ESR and raised ACE levels

A

Sarcoidosis

NB: is a diagnosis of exclusion

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19
Q

Basal ganglia stroke in a patient with known hypertension and Charcot-Bouchard microaneurysms

A

Intraparenchymal haemorrhage

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20
Q

Thunderclap headache

A

Subdural haemorrhage

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21
Q

What do polycystic kidneys put you at increased risk of?

A

Berry aneurysms and therefore subarachnoid haemorrhage

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22
Q

Lucid interval before a LoC

A

Extradural haemorrhage

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23
Q

An elderly, alcoholic with a fall and a blow to the head is at increased risk of what?

A

Subdural haemorrhage

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24
Q

CSF showing - high lymphocytes, low glucose and high protein. Fibrin webs are also visualised

A

Tb meningitis

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25
Q

Causes of bacterial meningitis in a neonate (3)

A

E. coli
Listeria
Group B strep

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26
Q

Causes of bacterial meningitis in a young adult (2)

A

Strep. Pneumoniae

N. Meningitidis

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27
Q

Causes of viral meningitis in a neonate (4)

A

HIV
Mumps
Coxsackie
Echovirus

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28
Q

Causes of viral encephalitis (2)

A

HSV1

Rabies

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29
Q

Brain tumour type seen in neurofibromatosis II

A

Meningioma

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30
Q

Ventricular tumour and hydrocephalus

A

Ependymoma

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31
Q

Indolent brain tumour in a child

A

Pilocytic astrocytoma

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32
Q

Soft, gelatinous and calcified brain tumour

A

Oligodendroma

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33
Q

CT shows generalised brain atrophy - widened sulci, narrowed gyri and enlarged ventricles

A

Alzheimer’s Disease

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34
Q

Treatments for Alzheimer’s disease (3)

A

Anti-cholinesterases
nAChR agonists
Glutamate antagonists

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35
Q

Pathological protein in Lewy body dementia (2)

A

Alpha synuclein and ubiquitin

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36
Q

What is a Lewy body

A

Alpha synuclein inclusions

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37
Q

Myelin Basic Protein and proteo-lipid protein as markers for what?

A

Multiple Sclerosis

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38
Q

Shy Drager

A

Autonomic dysfunction

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39
Q

Three features of multi-system atrophy

A

Autonomic dysfunction
Striatonigral involvement –> movement difficulty
Olivopontocerebellar –> balance and co-ordination difficulty

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40
Q

Three types of pathology underlying nephrotic syndrome

A

Minimal change disease
Membranous glomerular disease
Focal segmental glomerulosclerosis

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41
Q

Three features of nephrotic syndrome

A

Oedema
Hypoalbuminaemia
Proteinuria >3g/24h

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42
Q

Child with nephrotic syndrome. Electron microscopy shows loss of podocyte foot processes

A

Minimal change disease

43
Q

What treatment do you give to children with minimal change disease and what percent respond?

A

90% respond to steroids

44
Q

Nephrotic syndrome with diffuse GBM thickening and spiked subepithelial deposits of Ig and complement along the entire GBM.

A

Membranous glomerular disease

45
Q

What percent of membranous glomerular disease progress to ESRF

A

40%

46
Q

Nephrotic syndrome with segmental glomerular consolidation, hyalinosis and scars containing Ig and complement

A

Focal segmental glomerulosclerosis

47
Q

What % of focal segmental glomerulosclerosis respond to steroids

A

50%

48
Q

Kimmelsteil Wilson nodules (mesangial matrix) and diffuse GBM thickening is seen in what?

A

Diabetes

49
Q

Features of nephritic syndrome (5)

A 
Haematuria
RBC casts in urine
Hypertension 
High urea and creatinine 
Oliguria
50
Q

Five types of nephritic syndrome

A 
Acute post infectious GN
IgA nephropathy
Cresenteric (rapidly progressive) GN
Alports syndrome 
Thin basement membrane disease
51
Q

Granular IgG and C3 deposits in GBM with subendothelial humps in nephritic syndrome

A

Acute post infectious GN

52
Q

High ASOT titre, low C3, nephritic syndrome and increased cellularity of glomeruli

A

Acute post infectious GN

53
Q

What causes acute post-infectious GN

A

Post strep throat/impetigo

Damage is caused by immune complex deposition

54
Q

Frank haematuria 2 days after URTI

A

IgA nephropathy

55
Q

granular IgA deposition and complement in the mesangium

A

IgA nephropathy - nephritic syndrome

56
Q

Three types of cresenteric GN

A

Goodpastures - antiGBM antibody
Immune complex mediated - SLE/IgA
ANCA associated - Wegener’s

57
Q

Cresenteric glomerulonephritis with linear IgG deposition and lung involvement

A

Goodpastures

58
Q

Cresenteric glomerulonephritis with granular deposition

A

Immune complex mediated ie SLE

59
Q

Cresenteric glomerulonephritis with a lack of immune complex deposition visualised, vasculitis +/- pulmonary haemorrhage

A

ANCA associated - wegener’s granulomatosis

60
Q

Nephritic syndrome, sensorineural deafness and lens dislocation

A

Alports syndrome

61
Q

Inheritance of alports syndrome

A

X linked

62
Q

Deficit in Alports syndrome

A

IV collagen 5a chain

63
Q

Microscopic haematuria and a mutation in IV collagen as a rare cause of nephritic syndrome

A

Thin basement membrane disease - common as autosomal dominant but rare cause of nephritic syndrome

64
Q

Necrosis of short segments of the kidney tubules shortly after commencing gentamicin

A

Acute tubular necrosis

65
Q

Four causes of tubulointerstitial nephritis

A

Acute pyelonephritis
Chronic pyelonephritis
Acute interstitial nephritis
Chronic interstitial nephritis

66
Q

Fever, chills and renal angle tenderness with leukocytic casts in the urine.

A

Acute pyelonephritis

67
Q

Most common causative agent for acute pyelonephritis

A

E. coli

68
Q

Features of chronic pyelonephritis

A

Parenchyma scars due to recurrent infection

Often on a picture of chronic obstruction ie posterior urethral valves/reflux nephropathy

69
Q

What is the cause of acute interstitial nephritis

A

Hypersensitivity reaction often to drugs

70
Q

How does someone with acute interstitial nephritis present?

A

Fever, rash, haematuria, eosinophilia and proteinuria

71
Q

Elderly lady with long term analgesic use presents with anaemia, proteinuria and haematuria.

A

Chronic interstitial nephritis

72
Q

What is the pathogenesis of thrombotic microangiopathies?

A

Widespread fibrin deposition in vessels –> platelet-fibrin thrombus –> platelet and RBC destruction –> thrombocytopenia and MAHA

73
Q

Child with diarrhoea presents with pallor, jaundice and signs of deranged renal function

A

HUS - E coli caused

74
Q

Low Hb, raised bilirubin, low platelets and raised reticulocytes with high LDH. Fragmented RBCs on blood smear and Coombs negative

A

TTP

75
Q

Increased serum creatinine and urea, high potassium, low calcium and metabolic acidosis.

A

Acute renal failure

76
Q

Define chronic renal failure

A

Progressive and irreversible loss of renal function

77
Q

What are the different stages of kidney failure

A

1 Kidney damage but normal renal function
>90 GFR

2 Mildly impaired
60-89 GFR

3 Moderately impaired
30-59 GFR

4 Severely impaired
15-29 GFR

5 Renal failure <15 GFR

78
Q

Inheritance of adult polycystic kidney disease

A

Autosomal dominant

85% PKD1 mutation - liver cysts

79
Q

Six types of lupus nephritis

A 
Minimal mesangial LN 
Mesangial proliferative LN
Focal LN
Diffuse LN 
Membranous LN
Advanced sclerosing LN
80
Q

Minimal mesangial lupus nephritis

A

Immune complex deposition but no structural changes

81
Q

Mesangial proliferative lupus nephritis

A

Increased mesangial matrix and increased cellularity

82
Q

Focal Lupus Nephritis

A

Active swelling and proliferation of under 1/2 the glomeruli

83
Q

Diffuse lupus nephritis

A

Over 1/2 the glomeruli involved with immune complex deposition

84
Q

Membranous lupus nephritis

A

Subepithelial immune complex deposition

85
Q

Advanced sclerosing lupus nephritis

A

Over 90%glomeruli sclerosed

86
Q

Costovertebral pain

A

Renal cell carcinoma

87
Q

“Powder burns” and “chocolate cysts”

A

Endometriosis

88
Q

Adenomyosis

A

Ectopic endometrial tissue in the myometrium

Globular uterus

89
Q

Staging for endometrial carcinoma

A

FIGO staging

90
Q

What type of carcinoma are the majority of endometrial carcinomas?

A

Endometriod in 80% due to oestrogen excess of which 85% are adenocarcinomas

91
Q

Elderly lady with endometrial atrophy and multiple metastases

A

Non-endometriod endometrial carcinoma - papillary, serous or clear cell.

92
Q

HPV 16

A

Vulval intraepithelial neoplasia

93
Q

Vulval intraepithelial neoplasia in a younger women is associated with what?

A

Warty/basiloid SCC

94
Q

Vulval intraepithelial neoplasia in an older woman is associated with what?

A

Keratinising SCC with a increased risk of malignant transformation

95
Q

Four types of epithelial ovarian carcinoma

A

Serous cystadenoma
Mucinous cystadenoma
Endometroid
Clear cell

96
Q

What percentage of ovarian carcinomas are
A) epithelial
B) Germ cell
C) sex cord/stroma

A

A) 70%
B) 20%
C) 10%

97
Q

Ovarian carcinoma in a woman of 35 which mimics tubal columnar epithelium and contains Psammoma bodies

A

Serous cystadenoma

98
Q

Ovarian carcinoma which secretes both mucin and oestrogen

A

Mucinous cystadenoma

99
Q

Ovarian carcinoma with histology showing clear cytoplasm and a hobnail appearance

A

Clear cell carcinoma

100
Q

Ovarian cancer containing all three germ layers which secretes AFP

A

Teratoma

101
Q

Three types of germ cell ovarian carcinoma

A

Dysgerminoma - testicular seminoma
Teratoma
Choriocarcinoma

102
Q

Three types of sex cord/stromal ovarian carcinoma

A

Fibroma (Meir association)
Granulosa (E2 secreting = big breasts and irregular menstruation)
Sertoli-Leydig cell (androgen secretion = small breasts and virilisation)

103
Q

HPV 16 and 18

A

CIN - cervical intraepithelial neoplasia

Evie Pathology (5 decks)

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