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3rd Year > Histopathology > Flashcards

Histopathology Flashcards

1
Q

Features of nephrotic syndrome

A 
Oedema +++
Proteinuria +++
Hyperlipidaemia
More chronic
No haematuria
Hypertension
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2
Q

Features of nephritic syndrome

A 
Haematuria +++
Oedema +
More acute
Variable proteinuria
Azotaemia
Oliguria
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3
Q

MNCS

A

Type of nephrotic syndrome
Damage only visible under electron microscope
Commonest type in children
Responds very well to steroids (despite no inflammatory cells being there…weird)

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4
Q

Membranous glomerulonephropathy

A

Deposition of GBM antibodies
Causes thickened GBM and subendothelial spikes
85% idiopathic
15% causes by malignancy, SLE, drugs, infection

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5
Q

Proliferation glomerulonephritis

A

Nephritic syndrome
Post-group A streptococcal infection
Infection –> over-repair (hence proliferative)
Major cause of acute nephritis in children

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6
Q

Membranoproliferative glomerulonephritis

A

Nephritic syndrome
Deposits in mesangium –> complement activation –> damage
Unlike membranous glomerulonephropathy, the mesangium (as well as the GBM) is thickened
When crescents are present, bad prognosis.

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7
Q

AKI definition in urine output

A

<400ml/day

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8
Q

Pathogenesis of AKI

A

Usually ATN
Desquamation causes blockage –> oliguria
In late stage it is so damaged that the blockage clears and the kidneys basically become useless at reabsorbing –> polyuria + protein etc

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9
Q

Reflux nephropathy infection pattern

A

Segmental

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10
Q

Infection pattern in bacteriaemia

A

Dotting

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11
Q

Inflammation pattern in pyelonephritis

A

Spares the glomeruli

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12
Q

Gross appearance of kidney in chronic pyelonephritis

A

Pseudobulging

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13
Q

Microscopic appearance of kidney in chronic pyelonephritis

A

Thyroidisation due to colloid filled tubules

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14
Q

Nephrosclerosis

A

Benign hypertensive kidney
Focal sclerosis of arterioles –> cortical scarring
Granular appearance
Malignant hypertension causes this to happen rapidly

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15
Q

Multicystic renal dysplasia

A

Congenital cause of cystic kidneys
Multiple cysts separated by dysplastic parenchyma
Most common cause of abdominal mass in newborn

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16
Q

Medullary sponge kidney

A

Cysts in the collecting ducts

Puts patients at increased risk of calculi

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17
Q

Prevalence of ADPKD

A

1 in 500

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18
Q

Prevelance of ARPKD

A

1 in 20,000

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19
Q

Extrarenal manifestations of ADPKD

A 
40% have cysts in either:
Liver
Pancreas
Spleen
Lungs

10-30% have berry aneurysm in circle of Willis

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20
Q

Neonatal syndrome in ARPKD

A

Potter syndrome
‘Facies’ = low set ears, beaked nose, downward slanting eyes, prominent folds
Liver abnormalities
Causes death shortly after birth in severe forms

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21
Q

Stages of CKD

A 
1 - >90 with evidence of kidney damage
2 - 60-90
3a - 45-60
3b - 30-45
4 - 15-30/
5 - <15
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22
Q

Main causes of CKD

A

Diabetes 45%
Hypertension 30%
Glomerulonephritis 20%
Other (chronic pyelonephritis, PCKD) 5%

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23
Q

Acute renal failure definition in urine output

A

<0.5ml/kg/hr

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24
Q

Epidemiology of nephrolithiasis

A

20-30
5% prevalence
50% recurrence rate
M>F

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25
Q

Types of stone and frequency

A 
Calcium oxalate 40%
Calcium phosphate 25%
Mixed calcium 10%
Triple phosphate/struvite 15%
Urate 5%
Cysteine 1%
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26
Q

Molecular name for struvite

A

Magnesium ammonium phosphate

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27
Q

Infection associated with staghorn

A

Proteus, because it splits urea into ammonium

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28
Q

Wilm’s tumour presentation

A

Infants
Haematuria and abdominal mass
Pyrexia 50% of the time
Very responsive to treatment (surgery + radiotherapy)

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29
Q

Renal cell carcinoma origin

A

PTCs

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30
Q

Renal cell carincoma % of renal cancers

A

95%

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31
Q

RCC presentation

A 
Painless haematuria
Mass
Hypertension
Malaise
Paraneoplastic effects (hypercalcaemia, polycythaemia, amyloidosis)
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32
Q

RCC risk factors

A

Smoking
Heavy metals
Von Hippel Lindau syndrome
Hypertension

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33
Q

RCC microscopy

A

Large round cells with clear cytoplasm and a clearly outlines membrane

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34
Q

TCC of renal pelvis presentation

A

Haematuria and backpain

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35
Q

Bladder tumours origin

A

90% TCC

10% SCC secondary to schistosomiasis haematobium

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36
Q

3 types of bladder tumour

A

Benign papillary adenoma
Papillary neoplasm with low malignant potential (PNLMP)
Urothelial carcinoma

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37
Q

RF for TCC bladder

A 
Smoking
Arylamines
Job with chemicals
Long term analgesic
Cyclophosphamide
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38
Q

Survival of bladder cancer

A

98% @ 10 years

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39
Q

Most common benign liver neoplasm

A

Haemangioma = neoplastic proliferation of vessels

Rarely ruptures, incidental pickup

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40
Q

Benign liver neoplasm associated with the pill

A

Liver cell adenoma = benign tumour with glandular epithelial differentiation

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41
Q

Bening liver neoplasm picked up during surgery

A

Bile duct malformations, that look like metastases

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42
Q

HCC blood cell marker

A

AFP

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43
Q

Fibrolamellar HCC

A

A subtype of HCC that occurs in the young with no history of cirrhosis where there is collagen deposition

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44
Q

Most common place for cholangiocarcinoma to occur

A

Bifurcation of biliary tree

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45
Q

RF for cholangiocarcinoma

A

Things that cause chronic inflammation
Parasites
Primary sclerosis cholangitis

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46
Q

RFs for angiosarcoma

A

Arsenic

Anabolic steroids

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47
Q

Hepatoblastoma blood marker

A

Also AFP

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48
Q

Viral hepatitis from travelling

A

A

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49
Q

RF for HEV

A

Indochina

Pregnant women at BBQs

50
Q

Serology of autoimmune hepatitis

A

ANA+
High IgG
High ALT

51
Q

PSC common in what patients

A

UC
Progressive inflammation leads to fibrosis and strictures in the larger ducts. Diagnosed by MRCP/ERCP where you see beaded appearance

52
Q

Primary biliary cholangitis patient group

A

Middle aged females

53
Q

Pathophysiology of primary biliary cholangitis

A

Granuloma formation around smaller bile ducts in liver

54
Q

Serology of primary biliary cholangitis

A

AMA+

55
Q

Wilsons disease presentation

A

Children present with liver disease

Adults tend to present with neurological symptoms

56
Q

Ch mutation in wilsons disease

A

Ch13

57
Q

Haemochromatosis mutation

A

Ch6 AR mutation of HFE gene

Leads to increased absorption of iron

58
Q

A1AT genetics

A

Autosomal codominant mutation of Ch14

59
Q

Boundary between upper and lower respiratory tract

A

Lower larynx

60
Q

Type of immunological reaction to TB

A 
Type IV hypersensitivity
A - allergic
C - complement
I - immune
D - delayed
61
Q

Histological changes in reflux œsophagites

A

Thickening of basal layer
Lymphocytes + eosinophilia infiltration
Vascular papillae come closer to surface

62
Q

Cause of achalasia

A

Autoimmune destruction of myenteric ganglion cells
Leads to failure of smooth muscle fibres to relax
Food builds up in oesophagus –> chronic inflammation

63
Q

Trypanosomiasis Africa

A

Testse fly –> sleeping sickness

64
Q

Trypanosomiasis South America

A

Rejuvid bug –> Chagas disease (megaoesopagus, cardiomyopathy, megacolon)

65
Q

Treatment for trypanosomiasis

A

Arsenic derivatives

66
Q

GIST

A

Cancer of the interstitial cajal cells

Mesenchymal/connective tissue tumours

67
Q

GIST treatment

A

Imatinib or surgery

TKI blocks the mutated KIT gene

68
Q

Intestinal stomach cancer treatment

A

Hence-tin

69
Q

Coealic histological changes

A

Flat mucosa
Crypt hypertrophy
Villous height: crypt ratio goes from 5:1 to <3:1

70
Q

Complications of coealic

A

Refractory sprue (no response to gluten restriction)
Ulcerative jejunitis
Neoplasia (enteropathy associated T-cell lymphona EATL, adenocarcinoma)

71
Q

Rate of perinatal mortality

A

7.4 per 1000

72
Q

Markers for cancer detection in breast

A

cytokeratin 5/6
P63
Smooth muscle myosin

73
Q

Stains for basement membrane

A

Laminin and collagen

74
Q

Lymphocytic lobulitis

A

Middle aged diabetic females
Looks like cancer on radiograph
Lots of lymphocytes in a dense Stromae

75
Q

Idiopathic granulomatous mastitis

A

Do not excise as you will cause a flare

76
Q

Chalky white deposits

A

Fat necrosis

77
Q

Radial scar

A

Sclerosis adenosis = a benign proliferative condition of the terminal duct lobular units. Manifests as multiple small firm tender nodules and microcysts in the breast.

Radial scars are benign but there is a 1% chance of it turning malignant, so you remove them anyways

78
Q

Sarcoma

A

Malignant neoplasm with mesenchymal differentiation (bone, cartilage etc)

79
Q

OI type that kills you

A

Type 2

80
Q

Brittle bone disease

A

OI

81
Q

Achondroplasia mutation

A

FGFR3

82
Q

Incidence of achondroplasia

A

1 in 30,000

83
Q

Symptoms in osteopetrosis

A

Brittle bones –> fractures
No space in medulla –> extramedullary haematopoesis –
> hepatosplenomegaly

84
Q

Mosaic pattern in bone

A

Paget’s

85
Q

Common age group for osteosarcoma

A

<25

86
Q

Prevalence of IBD

A

1 in 250 total

UC = 1 in 400
Crohns = 1 in 630
87
Q

Juvenile polyposis mutation

A

SMAD4 –> hamatomatous polyps

88
Q

Peutz-Jegher’s syndrome mutation

A

AD mutation of STK11

89
Q

Mesenchymal polyp example

A

Leiomyoma

90
Q

Dukes staging and prognosis

A 
A = not through muscularis mucosa 
B = through MM but not to lymph node
C = lymph node spread
D = distant metastasis
At 5 years
A 95%
B 80%
C 50%
D 5%
91
Q

Stage that most people et diagnosed with colon cancer

A

2/3rds get diagnosed in stages C and D

92
Q

Amsterdam criteria

A 
For diagnosing HNPCC Lynch syndrome:
Must have all the following:
3 first line relatives with CRC
2 different generations
1 person under 50
FAP is excluded
93
Q

Inheritance of HNPCC

A

AD mutation of mismatch repair gene

94
Q

FAP inheritance

A

AD APC mutation

95
Q

Blood marker for progress/recurrence of CRC

A

CEA (Carcinoembryopnic antigen)

96
Q

How many tubules are these in each testis

A

4 tubules in each of the 250 lobules

97
Q

Androgen insensitivity is aka

A

Testicular feminisation

98
Q

RFs for GCTs

A

Cryptorchidism
Testicular dysgenesis (Kleinfelter and testicular feminisation)
Changes in chromosome 12

99
Q

Schiller Duval bodies

A

Yolk sac tumours
Present 50% of the time
Pathognemonic

100
Q

Commonest GCT

A

Seminoma

101
Q

Differentials for old man with tumour in testicle

A

Spermatocytes seminoma

Diffuse large B cell lymphoma

102
Q

Lobes in prostate

A

5

103
Q

Weight of prostate

A

20g normal

Up to 60-100g in BPH

104
Q

Racial group susceptibility in prostate cancer

A

Black > white > asian

105
Q

Dietary factors with prostate cancer

A

Fat increases

Tomatoes decrease

106
Q

Sexual differentiation stage in embryo

A

6 weeks

107
Q

Condyloma

A

Genital warts

HPV 6 and 11

108
Q

HPV strains for cervical or anal cancer

A

HPV 16 and 18

109
Q

Histological changes in HPV infection

A

Squamous cells are infected in zone of transformation
Perinuclear halo
Wrinkled nuclei

110
Q

RF for not clearing HPV

A

Smoking

111
Q

Krukenberg tumour

A

A tumour in the ovary from a distant metastasis
Classically a pyloric adenocarcinoma
Usually bilateral

112
Q

Endometrial cancer staging

A 
1 = confined to uterus
2 = into cervix
3 = beyond uterus, not beyond true pelvis
4 = beyond true pelvis
113
Q

Most common type of ovarian tumour

A

Surface epithelial tumour

114
Q

Chronic lymphocytic thyroiditis

A

A.k.a. Hashimotos

115
Q

Types of thyroid cancer

A

Papillary - lymphatics - associated with radiation - 80%
Follicular - blood - 15%
Medullary - calcitonin producing parafollicular C cells - 3%
Anaplastic - 2%

116
Q

Diagnosing medullary thyroid cancer

A

Measure blood calcitonin levels and/or biopsy and stain for C cells

117
Q

3 main causes of primary hyperparathyroidism

A

Adenoma affecting one gland 90%
Hyperplasia affecting all 4 glands 10%
Carcinoma <1%

118
Q

Main causes of secondary hyperparathyroidism

A

CKD
Vit D or calcium deficiency
Malabsorption
Low serum magnesium

119
Q

Branches of LAD

Branches of circumflex

A

Diagonal

Obtuse marginal

120
Q

Average risk fo stroke in someone with AF

A

1% per year

121
Q

CF inheritance

A

AR CFTR gene

3rd Year (9 decks)

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