Histopathology MedEd

Question 1

metaplasia

Answer 1

change in one mature cell type for another mature cell type

Question 2

2 ways of cancer development

Answer 2

metaplasia –> dysplasia pathway

Adeno-carcinoma pathway

Question 3

describe an adenocarcinoma

Answer 3

gland forming

mucin secreting

Question 4

squamous cell carcionoma

Answer 4

make keratin - even in non-keratinsed tissue

inter-cellular bridges

Question 5

define necrosis

Answer 5

represents energy failure
non-energy dependent cell death
cell lysis due to loss of electro-ionic pathway

Question 6

z line

Answer 6

squamo-columnar junction

Question 7

stricters of oesophagus

Answer 7

inflammation –> ulceration –> loss of surface epithelium –> repair –> replacement of useful cells with myofibroplasts –> scarring/strictures

Question 8

oesophageal cancer pathway

Answer 8

inflammation –> metaplasia –> metaplasia withe goblet cells –> dysplasia –> cancer

Question 9

two types of barratts

Answer 9

columnar metaplasia
columnar metaplasia + goblet cells = intestinal type columnar --> greater risk of malignant transformation

Question 10

cancers of oesophagus levels and causes

Answer 10

mid-distal - SCC - smoking and drinking

Distal - adenocarcinoma - GORD

Question 11

what can cause oesophageal varices

Answer 11

any cause of portal hypertension

• cirrhosis
• portal vein thrombosis
• IVC obstruction

Question 12

lining of stomach

Answer 12

columnar epithelium

Question 13

specialised cells of the stomach

Answer 13

parietal cells - acid

P cells/chief cells - pepsin

Question 14

causes of acute gastritis

Answer 14

NSAIDs, booze, H.pylori, stress

Question 15

causes of chronic gastritis

Answer 15

autoimmune
bacteria - h.pylori
corrosives. e.g. acid
CMV( renal transplant) and crohns

Question 16

complications of gastritis

Answer 16

cancer
perforation
ulceration

Question 17

what bacteria is H.pylori?

Answer 17

Gram negative curved rod

hydrogenase: produce energy by oxidising molecular H2 +/- Cag pathogenicity island = poorer outcome

Question 18

cancers associated with H.pylori

Answer 18

adenocarcinoma
lymphoma
MALT

Question 19

Two types of adenocarcinoma of the stomach

Answer 19

intestinal - well differentiated, mucin producing, gland forming
diffuse - single-cell architecture, no gland formation, contain signet ring cell

Question 20

Are goblet cells seen in the stomach?

Answer 20

NO

Question 21

common cause of duodenal ulcers

Answer 21

H.pylori

Question 22

anterior ulcers

Answer 22

perforation -> peritonitis

Question 23

posterior ulcers

Answer 23

near gastroduodenal artery –> haemorrrhage

Question 24

coeliac disease - affect malabsorption

Answer 24

villous atrophy
crypt hyperplasia
increased intraepithlial lymphocyes

Question 25

cancer associated with coeliac disease

Answer 25

EATL

Question 26

Lymphocytic duodenitis

Answer 26

increased epithelium lymphocytes | distinct condition from coeliac

Question 27

ischaemic colitis causes

Answer 27

``` arterial occlusion venous occlusion small vessel disease low flow states obstruction ```

Question 28

spotty necrosis with foci of inflammation

Answer 28

acute hepatitis

Question 29

causes of acute hepatitis

Answer 29

drugs | Hep A and E

Question 30

Bronzed diabetes

Answer 30

haemochromatosis

Question 31

rhodanine stain

Answer 31

wilson's disease copper

Question 32

alcoholic hepatitis

Answer 32

``` ballooning of cells mallory denk bodies apoptosis pericellular fibrosis zone 3 - acetaldehyde highest and relatively hypoxic ```

Question 33

NAFLD

Answer 33

metabolic syndrome | same process as alcoholic cirrhosis

Question 34

common cause of liver cancer

Answer 34

metastatic

Question 35

primary tumors of the liver

Answer 35

HCC - alcoholic hepatitis is risk factor | Hepatoblastoma

Question 36

patterns of injury acute pancreatitis

Answer 36

peri-ductal - obstructive - acinar cells adjacent to the ducts undergo necrosis peri-lobular - vascular cause - necrosis at the edges of the lobules Pan-lobular -injury progressing in either

Question 37

acute pancreatitis pathophysiology

Answer 37

reflux of enzymes --> acinar necrosis --> releasd of more enzymes --?> release of lipases --> fat necrosis --> soaponification with calcium

Question 38

complications of acute pancreatitis

Answer 38

haemorrhage metabolic disturbances pseudocysts abscess

Question 39

management of acute pancreatitis

Answer 39

serum lipase fluid - third spacing abx are not needed unless there is sepsis or necrosis of more than 50% electrolyte replacement

Question 40

commonest causes of chronic pancreatitis

Answer 40

alcohol and gallstones

Question 41

tumors of the pancreas

Answer 41

ductal - 85% acinar - acinar ductal metaplasia - causes ductal cancer cystic neoplasma - predispose to adenocarcinomas of the pancreas

Question 42

ductal carcinoma common mutation

Answer 42

k-ras | peri-neural invasion very common

Question 43

where are NETs most common?

Answer 43

tail of the pancreas

Question 44

MEN1

Answer 44

PPP | Pituitary, pancreas and parathyroid

Question 45

commonest secretory NET

Answer 45

insulinoma

Question 46

50% of gallstones are?

Answer 46

CHOLESTEROL