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Pathology > Histopathology > Flashcards

Histopathology Flashcards

1
Q

Name 3 syndromes which predispose to CNS tumours, and their mode of inheritance.

A

Neurofibromatosis 1/2, tuberous sclerosis 1/2, von Hippel lindau, turcot’s syndrome
Autosomal dominant

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2
Q

What category of tumours are most and 2nd most common primary CNS tumours?

A

Gliomas

Meningiomas

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3
Q

Name 2 common glial tumours seen in adults. Are they low or high grade?

A

Astrocytoma, oligodendroglioma.

High grade.

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4
Q

Which mutations are associated with diffuse and compressive gliomas?

A

Diffuse: IDH mutations
Compressive: MAPK pathway (BRAF gene)

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5
Q

What are the features of pilocytic astrocytoma?

A

Compressive glioma
Grade I
1st/2nd decade of life
Hallmark: Piloid ‘hairy’ cell – piloid astrocytes
Often Rosenthal fibres and granular bodies
Half have BRAF mutation

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6
Q

What do astrocytomas eventually transform into?

A

Glioblastomas

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7
Q

Which is the most aggressive and frequent diffuse glioma?

A

De novo glioblastoma (wildtype IDH)

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8
Q

What is the hallmark of oligodendrogliomas?

A

Round cells with clear cytoplasm (fried egg appearance)

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9
Q

What is the most and 2nd most frequent brain tumour in children?

A

Pilocystic astrocytoma

Medulloblastoma

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10
Q

Which CNS tumour originates from neuroepithelial precursors of the cerebellum/dorsal brainstem?

A

Medulloblastoma

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11
Q

Which CNS tumour is responsive to steroids?

A

Glioblastomas

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12
Q

What are the 3 types of cerebral oedema?

A

Vasogenic, cytotoxic hydrocephalic

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13
Q

What is non-communicating and communicating hydrocephalus?

A

Non-communicating: obstruction to CSF flow

Communicating: abnormal reabsorption of CSF into venous sinuses

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14
Q

What are the 3 types of brain herniation?

A

Subfalcine, transtentorial/uncal, tonsillar (coning)

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15
Q

What is the most common cause of haemorrhagic stroke?

A

Hypertension

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16
Q

How does the presentation of bleeding differ between AVMs and cavernous angiomas?

A

AVM: high pressure, massive bleed

Cavernous angioma: low pressure, recurrent bleeds

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17
Q

Most common causes subarachnoid haemorrhage?

A

Berry aneurysm rupture

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18
Q

Most common type of stroke?

A

Ischaemic

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19
Q

What type of trauma most commonly causes comas?

A

Diffuse axonal injury

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20
Q

Name some human prion diseases

A

o Creutzfeldt-Jakob disease
o Gerstmann-Straussler-Sheinker syndrome
o Kuru
o Fatal familial insomnia

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21
Q

Which is the transmissible protein in prion diseases?

A

PrP

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22
Q

How are beta amyloid plaques formed in Alzheimer’s disease?

A

APP (amyloid precursor protein) cleaved but produces intact beta amyloid proteins, which condenses and forms plaques

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23
Q

What are histological features of alzheimers?

A

Beta amyloid plaques, neurofibrillary tangles, hyperphosphorylated tau

24
Q

What is the histological feature of parkinson’s disease?

A

Lewy bodies made of alpha synuclein

25
Q

What are the features of pick’s disease?

A
  • Frontotemporal atrophy
  • Marked gliosis and neuronal loss
  • Balloon neurons
  • Tau positive pick bodies
26
Q

Which type of thyroid carcinoma is most closely associated with ionising radiation?

A

Papillary

27
Q

Which type of thyroid carcinoma typically metastasises to the bone?

A

Follicular

28
Q

Which type of thyroid carcinoma is associated with MEN?

A

Medullary

29
Q

Which type of thyroid carcinoma is the most aggressive?

A

Anaplastic

30
Q

What are the majority of renal calculi made of, and what causes it?

A

Calcium oxalate

Absorptive hypercalciuria, renal hypercalciuria

31
Q

Which 3 compounds are renal calculi most commonly made of?

A

Calcium oxalate, magnesium ammonium phosphate, uric acid

32
Q

What are the common sites for renal calculi impaction?

A

PUJ, pelvic brim, VUJ

33
Q

Benign renal neoplasms:

  1. Mahogany brown, central area of scarring, nests of cells with loose oedematous connective tissue
  2. <5mm epithelial tumours
  3. Composed of fat, smooth muscle and blood vessels
A
  1. Oncocytoma
  2. Papillary adenoma
  3. Angiomyolipoma
34
Q

3 commonest types of malignant renal cell carcinoma?

A

Clear cell, papillary, chromophobe

35
Q

Which grading system is used for renal cell carcinoma?

A

Fuhrman system

36
Q

Which malignant neoplasm has the typical histological appearance of small round blue cells?

A

Nephroblastoma (Wilm’s tumour)

37
Q

What are the management options for benign prostatic hyperplasia?

A

o Alpha blockers – doxazosin
o 5a reductase inhibitor – finasteride, duatseride
o Transurethral resection of the prostate (TURP)

38
Q

What is the strongest prognostic indicator for prostate cancer?

A

Gleason score

39
Q

What is the most important risk factor for testicular germ cell tumours?

A

Cryptorchidism

40
Q

Why do testicular germ cell tumours have such a good prognosis?

A

high sensitivity to modern platinum-based chemotherapy regimes

41
Q

what are the low and high risk strains of HPV?

A

Low: 6, 11
High: 16, 18

42
Q

What is the characteristic cytological feature of HPV infection

A

Koilocytes

43
Q

How does a complete and partial hydatidiform mole form?

A

Complete:
Empty egg + haploid sperm which duplicates, or empty egg + 2 haploid sperm

Incomplete:
Normal egg + 2 haploid sperm, or normal egg + 1 diploid sperm

44
Q

Commonest type of aggressive ovarian carcinoma?

A

Serous

45
Q

Which ovarian cancers are associated with endometriosis?

A

Clear cell

Endometrioid

46
Q

What are krunkenberg tumours and their characteristic features?

A

2ry ovarian tumours
Bilateral metastases
Composed of mucin producing signet ring cells
Commonly gastric or breast origin

47
Q

Which is a cancer that commonly metastasises to the ovaries?

A

Colorectal carcinoma

48
Q

What are 2 important mutations involved in hereditary ovarian cancer?

A

BRCA, HNPCC

49
Q

Which drug causes SLE and what test can be used to determine it?

A

Hydralazine

Anti-histone antibody

50
Q

Which test is used to screen for SLE?

A

ANA

51
Q

Which specific autoantibodies are used to diagnose SLE?

A

Anti-dsDNA, anti-smith, anti-histone

52
Q

Which antibodies are present in diffuse and limited scleroderma?

A

Diffuse: anti-topoisomerase
Limited: anti-centromere

53
Q

What are the immunofluorescence patterns seen with anti-nuclear antibody staining and what conditions do they represent?

A

SLE: whole nucleus
Systemic sclerosis: nucleolus
Mixed connective tissue disease: speckled

54
Q

What are some chemical pathological features of sarcoidosis?

A

Raised ACE
Hypercalcaemia
Hypergammaglobulinaemia

55
Q

What are some features of polyarteritis nodosa and what virus is it associated with?

A 
Medium vessel vasculitis
Necrotizing arteritis
Gut ischaemia, renal impairment
Beaded appearance due to aneurysms on angiogram
Hepatitis B
56
Q

What is the antibody and target associated with

  1. granulomatosis with polyangiitis?
  2. eosinophilic granulomatosis with polyangiitis?
A
  1. C-ANCA against proteinase 3

2. P-ANCA against myeloperoxidase

57
Q

What are the triads associated with:

  1. granulomatosis with polyangiitis?
  2. eosinophilic granulomatosis with polyangiitis?
A
  1. ENT, lungs, kidneys

2. asthma, eosinophilia, vasculitis

Pathology (5 decks)

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