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PPQ PATH > histopathology > Flashcards

histopathology Flashcards

1
Q

pain relived by sitting forward, raised amylase. Inflammatory condition resulting in injury of the acinar cells to the pancreas

A

Pancreatitis

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2
Q

rare, mainly childhood, presents with abdo pain, emesis, jaundice

A

Pancreatoblastoma.

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3
Q

Cyst with the epithelial layer

A

cystadenoma

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4
Q

diarrhoea A 39 year old Nepalese man presents with severe watery diarrhoea.He is found to have hypokalaemia and, surprisingly, a metabolic acidosis. A RUQ mass is detected by contrast-enhanced spiral CT scanning. Stool bicarb is high and urine anion gap is negative.

A

vipoma

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5
Q

associatted with necrolytic migrating erythema

A

Glucaoma

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6
Q

recurrent ulceration, hematemesis, diarrhoea, multiple gastro duodenal ulcers, diarrhoea, non-responsive to omeprazole

A

zollinger ellison syndrome

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7
Q

Dilatation of the large breast ducts, menopause, tender lump around the areola +/- Thick, white nipple a green nipple discharge. secretions. Mimics mammographic appearance of cancer

A

Duct ectasia.

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8
Q

Mostly in smokers and not associated with lactation. Histologically, keratinizing squamous epithelium extends deep into nipple duct orifices.

A

Periductal mastitis

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9
Q

red breast, lactating, cracked skin - continue expressing + antibiotics

A

Mastitis

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10
Q

Very common. Group of changes caused by exaggerated normal response to hormones

A

Fibrocystic:

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11
Q

Local areas of epithelial proliferation in large mammary ducts, Hyperplastic lesions rather than malignant or premalignant. May present with blood stained discharge.

A

Duct papilloma

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12
Q

Proliferation of fibroepithelium and stromal tissue’ can arise with pre-existing fibroadenoma.
>50, potentially aggressive
○ Artichoke like tumor.

A

Phyllodes tumour

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13
Q

Incidence increased dramatically since development of mammography. Appear as areas of CALCIFICATIONS. 10% present with clinical symptoms. Much increased risk of progressing to invasive breast Ca. Cancer staged into low grade, intermediate, high grade

A

Ductal Carcinoma in Situ

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14
Q

loss of E-cadherin:

A

Invasive lobular

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15
Q

ALWAYS incidental finding on biopsy as no calcification 20-40% bilateral

A

LCIS

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16
Q

Most common type of invasive cancer:

A

DCIS

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17
Q

Woman with known breast cancer has a red and rough nipple:

A

Paget’s disease

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18
Q

Woman with breast lump, FNA shows C5 grading.

A

Invasive breast carcinoma

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19
Q

old, rectal bleeding, fever, LIF

A

Diverticulitis

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20
Q

left sided abdominal pain relived by defecation

A

diverticular disease

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21
Q

left sided abdominal pain relived by defecation plus fever

A

Diverticulitis

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22
Q

obstruction, constipation, vomiting

A

Sigmoid volvulus

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23
Q

patients after lung transplant are more likely to get adenocarcinoma of colon

A

CF

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24
Q

Pernicious anaemia, H pylori associated

A

Maltoma

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25
Q

Cancer due to Coeliac disease HLA B8 associated 10% would get primary lymphoma a of the gut if not properly treated

A

Enteropathy Associated T-cell Lymphoma

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26
Q

associated with pernicious anemia and gastric ulcer

A

Chronic gastritis

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27
Q

single episode of melana, erosion through the gastric wall and infiltrate

A

Acute Gastritis

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28
Q

well differentiated, progression from athropic gastritis to chronic, eldery male, same as Berret but in oesophagus

A

intestinal gastric cancer

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29
Q

Young women, associated with poor prognosis and lints plastic a and signet ring cells

A

diffuse gastric cancer

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30
Q

male with change in bowel habit, weight loss, bleeding PR

A

adenocarcinoma of the colon

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31
Q

hyperplastic polyps associated mutation

A

AFP

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32
Q

Seen at 50-60s years old, caused by shedding of the epithelium Polyps not associated with increased cancer risk

A

Hyperplastic

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33
Q

type of polyps associated with mucocutenous hyper pigmentation, freckles around the mouth. Focal malformation of mucosa and lamina proporoiat

A

Hamartomas Polyp

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34
Q

What mutation is associated with hamartomous polyps

A

AD - LKB1

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35
Q

Fe def, anaemia, weight loss

A

Right sided tumor

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36
Q

> 100 polyps seen, name the condition, and the mutaiton

A

70% Autosomal Dominant mutation in APC gene (Anaphase promoting Complex).

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37
Q

Change in bowel habit, crampy LLQ pain

A

Left sided bowel tumor

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38
Q

Bilateral pigmentation of the retina, bleeding per rectum, teenager, family history of colorectal cancer:

A

FAP

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39
Q

Associated with bilateral pigmentation on the retina, osteomas and dental carries:

A

Gardener Syndrome

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40
Q

Carcinoma in the right colon (Fe, anemia, weight loss), few polyps, fast progression to malignancy, AD mutations in mismatch repair genes

A

Hereditary non-polyposis colorectal cancer (Lynch syndrome)

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41
Q

What on surveillance would be an indication for colectomy in UC?

A

Dysplastic polyps

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42
Q

What would you see on histology in Crohn’s?

A

Non-Cesaiting Granulomas, Cobblestone

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43
Q

Intermittent diarrhea, pain and fever

A

diverticulitis

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44
Q

ring enhancing lesion HIV person

A

HIV Tuberculoma but I would say toxoplasmosis or brain abscess.

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45
Q

CSF shows. Oligoclonal Bands of IgG on, Electrophoresis.

A

Multiple Sclerosis

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46
Q

elderly person with insidious onset of neuro problems, ‘collapse at home’

A

Subdural

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47
Q

hit on side of head and lucid interval, car traffic accident

A

Middle meningeal/extradural bleed

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48
Q

Psychiatry symptoms first with young age of onset. Depression then CNS symptoms in young person.
young omnivore who had psychiatric symptoms then motor symptoms

A

Chorea-ataxia follow it x. Variant CJD

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49
Q

Neurosign’s first and presents later. Rapid progressive dementia with myoclonus.

A

Sporadic CJD

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50
Q

Optic nerve tumour excised and now lump on hand.

A

Neurofibromatosis type 1

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51
Q

1:5000 condition, mutation on Ch 17 which encodes neurofibrin. Associated with phaochromocytomas

A

Neurofibroblasotma

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52
Q

Epileptic with patch on back and lumps in brain

A

Tuberous sclerosis

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53
Q

adenoma sebaceum (angiofibromas):

A

Tuberous sclerosis

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54
Q

Capillary loops surrounded by epithelial cells, anywhere in the CNS, presenting between 2nd and 5th decade. Associated with headaches, seizures, focal neurological signs, rapid loss of consciousness.

A

AV Malformation

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55
Q

Presents from birth, anywhere in the CNS, usually 50+ of age. Well-defined malformation pf closely packed abnormal vessels with no parenchyma – vascular spaces that can leak, look like rasbery

A

Cavernous angioma

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56
Q

raised ICP symptoms for a while then became obtunded.

A

Herniation

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57
Q

Mass under dura mater compressing frontal lobe (usually). Check notes from David, also NF2.
Commonest brain tumour:

A

Meningioma

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58
Q

Highly vascular tumors and have a tendency to infiltrate. They have extensive areas of necrosis and hypoxia. As a rule, high-grade gliomas almost always grow back even after complete surgical excision, so are commonly called recurrent cancer of the brain

A

Gliomas

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59
Q

Patient with HIV, raised ICP, new onset epilepsy.

A

Cryptococcus: most common fungal infection of CNS.

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60
Q

Headache, fever, malaise, nausea/vomiting, seizures, focal neurological deficit.

A

Tuberculoma

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61
Q

Someone on dialysis with bone pain –

A

Renal osteodystrophy

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62
Q

Thin trabeculae, normal osteoid

A

Osteoporosis

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63
Q

The cell associated with howships lacunae, stimulated by IL-6 in myloma

A

Osteoclast

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64
Q

wide seams of osteoid and increased volume of osteoid

A

osteomalacia

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65
Q

where would you see fibrous osteodystrophy, Brown’s Tumor:

A

In primary hyperparathyroidism, renal osteodystophy

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66
Q

Unmerlised bone (osteoid) can be seen in

A

osteomalcia

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67
Q

Massive osteoclast are seen in which condition?

A

(Paget’s)

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68
Q

Mosaic pattern of lamellar bone

A

Pagets

69
Q

Inferior cerebral artery – where does it rupture, what is the presentation

A

berry aneurysm, thunderclap headache

70
Q

hit on side of head and lucid interval, car traffic accident

A

Middle meningea

71
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, von Hippel Laudau mutation VHL gene

A

Clear cell carcinoma – the most common renal problem

72
Q

high EPO, high Hb,

A

renal masses, painless haematuria RCC

73
Q

vomiting, white cell casts in the urine

A

pyelonephritis

74
Q

Immensive pain, haematuria

A

Calculus

75
Q

drug associated with focal glomerulonephritis

A

heroin

76
Q

Patient with a cancer in their bladder following chronic schistosomiasis

A

squamous cell bladder cancer

77
Q

Painless haematuria, frequency, urgency, pyelonephritis or hydronephrosis if ureteral orifice involved

A

Transitional Cell (Urothelial) Tumours

78
Q

rare bladder cancer, arising from extensive intestinal metaplasia or from urachal Remnants

A

Adenocarcinoma

79
Q

● The commonest cause of the– the most common cause of acute kidney injury, nephrotoxic drugs, RTA, hypovoloemia –

A

acute tubular necrosis

80
Q

. If the patients has RTA there is myoglobin in his urine – generally rhabdomlylosis and muddy casts

A

acute tubular nephritis

81
Q

All have loss of podocyte foot process

A

Nephrotic Syndrome

82
Q

Adults, infection, malignant SLE non-responsive to steroids, membrane thickening, granular deposits (all SLE):

A

Membranous proliferative glomerulonephritis. PLA2 associated in 70% according to Meeran

83
Q

Afro, Caribbean, scarring hylianosis, IgG complement in scarred areas. HIV drug users

A

Focal segmental glomerulonephritis

84
Q

Somebody with bilateral oedema, oliguria and then we were given this insert (red cell casts).

A

Mixed Nepfritic/Nephrotic syndrome

85
Q

may present as nephrotic syndrome, haematuria or proteinuria, Type 1 accounts for 90% of cases, subendothelial immune deposits of electron dense material resulting in a ‘tram-track’ appearance, cause: cryoglobulinaemia, hepatitis C

A

Mixed Essential Cryoglobuinaemia

86
Q

(1-3) weeks post strep –infection coca-cola in the urine

A

Post-strep Glomerulonephritis

87
Q

Frank haematuria, (1-2 days) following throat infection

A

IgA nephropathy (Berger Disease) proliferation of mesangial cells

88
Q

Asian with slight change in renal function, sensorineural deafness + eye disorders

A

Alport syndrome

89
Q

asymptomatic haematuria running in the families, Thin basement membrane disease

A

Thin basement membrane disease (benign familial hematuria )

90
Q

RAPIDLY PROGRESSIVE Glomerulonephritis. What would you see on the electron microscopy?

A

CRESENTSS!!!! Like sailor moooon!!!

91
Q

Q) What are three types of rapidly progressive glomerulonephritis?

A

Type 1: Anti-GBM antibody (Pulmonary-Renal syndrome) Goodpasture Collagen type IV. Linear deposition of complexes in the basement membrane
o LM: CRESCENT Type 2: Immune complex SLE, IgA nephropathy, post infectious GN, granular
o LM: CRESCENT Type 3: Lack of immune complex deposition, Pauci-immune / ANCA-associated (c-ANCA Wegner, p-Anca microscopic polyangitis). VASCULITIS

92
Q

oncogene, poor prognosis, squamous and small cell

A

K-RaSS

93
Q

Peripheral lesion of the lung plus non-small cell

A

Adenocarcinoma

94
Q

peripheral lesion, Asian non-smokers, glandular, women. EGFR - good prognosis extremely good fucking response.

A

Adenocarcinoma

95
Q

prickles, keratinisation, PTHrp secretion, smokers, central but not so much anymore

A

p53, c-myc mutation, most common, proximal bronchi

96
Q

aggressive, responds to chemo, oat cells: p53 RB1

A

Small cell

97
Q

not typical, hypertension, hyperglycaemia, Hypokalaemia, alkalosis and muscle weakness are more common than buffalo hump etc

A

ACTH

98
Q

pre-synaptic voltage gated calcium channel in the peripheral nervous system: Features: repeated muscle contractions lead to increased muscle strength* (in contrast to myasthenia gravis)

A

Lambert-Eaton syndrome:

99
Q

PTH is secreted by which cancers?

A

squamous and small cells

100
Q

Thickened pleura on CT, extensive pleural effusion, chest pain, weight loss, dyspnoea

A

MesoThelioma

101
Q

ship worker with pleural plaques

A

Asbestosis

102
Q

⅓ due to infection, also CF, immunodeficiency, ABPA, aspiration

A

Bronchiectasis

103
Q

A common cause of bronchiectasis

A

CF

104
Q

pattern of lung injury associated with asthma

A

Eosinophilic inflammation

105
Q

28 year old man with multiple fractures, on ward develops SOB and hypoxia:

A

fat embolism

106
Q

occupational problem, finger clubbing, persistent weight loss (type IV)

A

EAA chronic

107
Q

Inhalation of the dust in sensitized individual (type III, bird fancier lung). Cough after working on farm with mouldy hay

A

EEA acute

108
Q

Patient who is a non-smoker, medically well has rusty coloured sputum cough

A

urine streptococcal antigen).

109
Q

Homeless patient presents with dry cough and weight loss→ TB (in the question the options for this are either that you do induced sputum

A
  • Sputum Fast Acid Bacilli (Ziehl-Nelson staining)

- NAAT test

110
Q

c. Patient who is known to be an IVDU presents with dry cough. Chest X-ray shows bihilar interstitial shadowing,

A

silver stain PCP
CXR: typically shows bilateral interstitial pulmonary infiltrates but can present with other x-ray findings e.g. lobar consolidation. May be normal
 exercise-induced desaturation
 bronchoalveolar lavage (BAL) often needed to demonstrate PCP (silver stain shows characteristic cysts)

111
Q

perimenopausal, oestrogen sensitive, good prognosis

A

Endometroid

112
Q

papillary serous. clear cell, older, bad, hobnail 80 year old lady which tumour

A

non-endometroid

113
Q

most common, psammoma bodies

A

Serous

114
Q

mucin secreting cells, pseudomyxoma peritonei(metastasis from appendix)

A

Mucinous

115
Q

hobnail, malignant with poor prognosis

A

Clear cell

116
Q

■ convert androgens to Oestrogen

Irregular menstrual cycles, breast enlarge, breast cancer.

A

Granulosa-theca cells (& therefore tumours)

117
Q

defeminsation and virilsation (hirustuism, deepened voice, enlarged clitoris)

A

Sertoli-Leydig – androgen

118
Q

Meig’s syndrome (ascites + pleural effusion)

A

Ovarian fibroma

119
Q

○ (the most common in young females) radiotherapy sensitive

A

Dysgerminoma

120
Q

Three germ layers (ecto, endo, meso)

A

teratoma (immature – AFP).

121
Q
  • secretes AFP
A

yolk sac tumors

122
Q

(peripheral oedema and hepatosplenomegaly)

A

ALight chain in myeloma

123
Q

Man undergoing treatment for chronic renal failure undergoes treatment and describes tingling in the hands

A

carpal tunnel syndrome) Dialysis associaciated amyloidosis = beta2 micorglobulin

124
Q

Rash below the ankles, constipation followed by diarrhoea, pain in the joints- fever that is cyclical, IL-1

A

Familial Medeterian Fever

125
Q

Cystic lesion with papillary architecture and clear cytoplasm, enlarged thyroid+ lymphadenopathy. Young females. The most common. Excellent prognosis.

A

Papillary carcinoma.

126
Q

solitary nodule

A

Follicular

127
Q

5% originates in par follicular cells – linked to MEN2 and Ret mutation!!!!!. Produce calcitonin

A

Medullary

128
Q

Produced by par follicular cells in the thyroid:

A

calcitonin

129
Q

calcitonin - what does it do?

A

lowers Ca by the action, opposes PTH

130
Q

Rare. Elderly. Poor response to any treatment.

A

Anaplastic

131
Q

Associated with vitiligo, type I diabetes mellitus:

A

Grave’s Disease. TSH, TPO antibodies. Treatment carbimozole SE=agranulocytosis

132
Q

HIGH UPTAKE – 30% - 50%

A

toxic multinodular goitre.

133
Q

HOT NODULE on isotope scan:

A

Toxic adenoma

134
Q

Self-Limiting post-viral painful Goitre

A

Subacute DeQuervain’s thyroiditis

135
Q

diffuse lymphocytic infiltration and atrophy – no goitre

A

no goitre Autoimmune

136
Q

Amiodorane, Lithium: hypothyroidism

A

Drug Induced

137
Q

20 year old with a lytic lesion in the diaphysis of his leg - pain alleviated by aspirin:

A

osteoid osteoma

138
Q

Man goes deaf with bowed legs –

A

Pagets diseas, high ALP

139
Q

Vertebral fracture, high paraprotein

A

Multiple Myloma

140
Q

Young woman with symmetrical joint pain

A

Rheumatoid Arthritis

141
Q

Rheumatoid arthritis + hepatosplenomegaly + low white cell count

A

Felty’s

142
Q

radiolucent nidius with scleriotic rim

A

osteoid osteoma

143
Q

Associated with Gardner syndrome and FAP

A

osteoma

144
Q

Muliple swellings in the hands, cotton wool calcification

A

Enchodroma

145
Q

Most common neoplasm in the skeleton, cartilage capped bony outgrowth

A

Osteochondroma

146
Q

Bone replaced by the fibrous tissue, soap bubble osteolysis and shepards crook deformitiy.

A

Fibrous dysplasia

147
Q

lytic, well defined lesions

A

Simple bone cysts

148
Q

Sunburst apperence

Coldman Triangle

A

Osteosarcoma

149
Q

Presents with fatigue, pruritus and abdominal discomfort. Progressive cholestasis, autoimmune associated with Sjorgen.

A

PBC

150
Q

Features, cholestasis: jaundice and pruritus, RUQ fatigue. Intra and extrahepatic bile ducts

A

PSC

151
Q

non-caseating granulomas; also get Schaumann and asteroid bodies, (inclusions of protein and calcium), lymphadenopathy, painless and rubbery

A

Sarcoidosis changes in the lymph nodes

152
Q

Enzyme elevated in the sarcoidosis:

A

ACE, also 1 alpha hydroxolase

153
Q

Patient had an appendectomy 1 week ago. What would you see in their scar collagen

A

Granulation tissue, fibrocytes and capillaries, primary wound healing

154
Q

what enzyme is increased in acute MI?

A

AST

155
Q

Alkaline phosphatese is secreated by?

A

osteoblasts

156
Q

which one is increased in viral hepatitis?

A

ALT (marker of inflamttion)

157
Q

which one is increased in viral hepatitis? (Hep A, Hep B)

A

ALT (marker of inflamttion)

158
Q

Prostate cancer the most increased

A

acid phosphatase

159
Q

Patient with funny tibia and a bit of bone pain. What tests are you going to order?

A
  • ALP, liver function
160
Q

What scan would you order for patient with Pagets?

A

TC biphosphonate scan

161
Q

What are the complications of Paget’s?

A

Bone pain, osteosarcoma, fractures, deafness

162
Q

Whats the treatmet for asyymptomatic patients with Pagets disease

A
  • Asymptomatic (do nothing)

- Symptomatic biphosphonates

163
Q

Whats the treatment for asymptomatic patients with Page’s disease

A
  • Asymptomatic (do nothing)

- Symptomatic biphosphonates

164
Q

Which enzyme is elevated in osteomalcia?

A

ALP because of the increased bone turnover and osteomalci, leading to increased ALP (secondary parathyroidism)

165
Q

which one is low in primary hyperparathyroidism?

A

vitamin D

166
Q

which enzymes rises in acute renal failure?

A

urea

167
Q

which one is the marker of the chronic renal failure caused by a fall in GFR?

A

creatinine

168
Q

which one is the marker of glucose control over the last three weeks?

A

fructosamine, has shorter life-time than Hba1c

169
Q

what sort of information you would get from anion gap?

A

If there are any poisons sitting around the table , any lactate, any bicorbante

PPQ PATH (5 decks)

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