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Year 5 😊✌🏼 > MedEd Histopath > Flashcards

MedEd Histopath Flashcards

1
Q

How does HPV cause cervical cancer/

A

inhibits tumour suppressor genes (check)

E6 inactivates p53
E7 inactivates Rb gene

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2
Q

hypoechoic mass on USS

A

most likely cyst

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3
Q

Hyperplasua

A

increase in number of cells

e.g. parathyroid hyperplasmia

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4
Q

hypertrophy

A

increase in size of cells (HOCM, LVH)

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5
Q

Metaplasia

A

r

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6
Q

Dysplasia

A
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7
Q

Neoplasia

A
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8
Q

Vulval intraepithelial neoplasia

A

squamous epithelium on the outside

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9
Q
A

epithelial thickening
massive proliferation of epithelial cells

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10
Q

VIN types

A

usual and differentiated

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11
Q

VIN - differentiated type

A

derived from lichen sclerosis

more likely to develop into SSCC

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12
Q

hen is it not VIN anymore

A

when it invades the BM

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13
Q

Types of vulval and vaginal carcinoma

A

squamous cell carcinoma (95%)

clear cell carcinoma

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14
Q

What are CIN and VIN?

A

both are types of dysplasia

poorly differentiated cells

not cancer until invades the BM

cervical and vulval

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15
Q

buzz word for fibroids

A

purple bundles of smooth muscle cells

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16
Q

how common are fibroids?

A

common

present in 40% of women above 40 yo

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17
Q

How is endometrial tissue spread in endometriosis?

A

vascular or lymphatic dissemination of endometrial cells

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18
Q

powder burn

A

endometrial tissue is darker hence this appearance

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19
Q

Endometroid vs non-endometrioid carcinoma

A

endometriod more common

Endo: Sarah eats Meat (secretory, endometriosis, mucinous)

Non-endo: Paul Can’t stand (it) - papillary, clear cell, serous

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20
Q

buzz word for Fitz Hugh Curtis sundrome

A

‘violin strings’ peri hepatic lesions

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21
Q

Causes of ascending PID

A

n gonorrhea
c trachmoatic

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22
Q

causes of external contamination e.g. TOP PID

A

staph aureus?

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23
Q

what type of physiological cysts are common in early pregnancy ?

A

common in early pregnancy

corpus luteum may become filled with blood or fluid

most likely to present with intraperitoneal bleeds

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24
Q

Rokitansky protuberances are associated with…

A
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25
Q

How does milk travel through the breast?

A

made in lobules

travels through duct to the nipple

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26
Q

What is the single best prognostic indicator for breast cancer?

A

lymph node involvement

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27
Q

radiological buzzword for DCIS

A

microcalcifications

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28
Q

fibro… radiological finding

A

areas of microcalcifications in multiple areas in both breasts

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29
Q

4 classes of breast histopath

A

inflammatory
benign breast lump
proliferative
malignant breast lump

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30
Q

triple assessment

A

clinical hx and exam

imaging (USS in under 35, Mammography in over 35)

pathology/biospy

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31
Q

FNA vs core biopsy in breast cancer

A

FNA - used if you expect the content of a lump to be liquid, collect cells

CB - used when you expect the content of a lump to be solid and you get a portion of the tissue for histopath

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32
Q

types of mastitis

A

lactational (within 6w PP due to milk stasis, may have a cracked nipple)

non-lactational (not currently breast feeding)

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33
Q

acute mastitis - which cells may be found

A

neutrophils

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34
Q

Mx of mastitis

A

continue breast feeding bilaterally (can be due to obstruction)

analgesia

warm compresses

if unresolved after 12-24h
- medical - oral fluclox because S aureus is most common

abscess: IV abx and incision & drainage

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35
Q

Fat necrosis of the breast causes

A

trauma to the breassts
previous radiotherapy
unilateral masss?

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36
Q

histopath of breast fat necrosis

A

fat ?

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37
Q

fibroadenoma age group

A

20-40

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38
Q

buzzword for fibroadenoma

A

single
breast mouse
moves very mcuh

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39
Q

Mx of fibroadenoma

A

<3m -> convservative mx

> 3 cm -> surgical (or if v symptomatic)

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40
Q

phyllodes tumour

A

extremely rare

aggressive malignant fibroepithelial neoplasms

malignant version of fibroadenoma

2 in every 1 million

> 50 yo

artichoke appearance
frond-like
branching

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41
Q

Fibrocystic disesaseas

A

fluid-filled sacs in the breast
common - 7% of women, pre or perimenopausal

lumpiness of breasts
can be unilateral m bilateral, single or multiple, cyclical pain

well-demarcated, fluctuant, transilluminable, clear nipple discharge

histo: fluid filled cysts

red flags:
FNA is blood stained
core biopsy reveals complex cystic contents

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42
Q

bening duct ectasia - pathogenesis

A

blockage of milk ducts -> dilatation (proteinaceous immaterial inside the duct)

seen in peri-post menopausal women

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43
Q

benign duct ectasia- RFs

A

smokers
mass with yellow green discharge
sub areolar mass, nipple inversion

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44
Q

Intraductal papillome

A

benign
nodule wishin a duct
seen in peri and postmenopausal women

2 types:
1. peripheral -> small ductules affected
2. central -> large ductules affected -> blood or clear nipple discharge

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45
Q

Radial scar

A

bening sclerosing lesion caused by impaired healing post injury

46
Q

radial scar buzz words

A

central, fibrous, stellate area

47
Q

Proliferative breast conditions - pre-malignant

A

usual epithelial hyperplasia (1-2x) - good
flat epithelial atypic (4x) - medium
in situ lobular neoplasia (7-12x) - really baad

48
Q

What is the commonest cancer in the UK

A

breast cancer

49
Q
A

commonest cancer in the UK
affects 1/7 females
rare under 35, increasing with age

50
Q

genetic of breast cancer

A

BRCA 1/2 (AD)
FH (br or ov ca)
Li Fraumeni syndrome

51
Q

2 main types of breast ca

A

non-invasive (DCIS, LCIS)
invasive (IDC, ILC, Paget’s disease)

52
Q

DCIS - how does it present

A

microcalcifications in asymptomatic women

most common non-invasive breast cancer

53
Q

most common breast cancer

A

invasive ductal carcinoma (85%)

54
Q

buzzwords breast cancer

A
55
Q

Nottingham grading system

A

used for breast cancer
graded /3 for following criteria (total /9)

  1. nucelar pleomorphosms
  2. tubule formato
  3. mitotic activity

Grade 1: well diff
Grade 2:
Grade 3

56
Q

grading for breast cancer

A

Nottingham grading system

57
Q

Commonest brain cancer in childer

A

astrocytoma

58
Q

stroke definition

A

focal neurological deficit of presumed vascular origin that lasts more than 24 h

59
Q

Commonest cause of ischemic stroke

A
  1. atherosclerosis
  2. thromboembolic (e.g. AF)
60
Q

commonest RD for hemorrhagic stroke

A

hypertension

61
Q

single best modifiable RF for ALL strokes

A

hypertension

62
Q

types of haemorrhagic strokes

A

traumatic
non-traumatic

63
Q

non-traumatic hemorrhagic strokes

A

intraparenchymal haemorrhage (50% due ot HTN, common site: basal ganglia)

subarachnoid haemorrhage (85% from ruptured berry aneurysm, associated with PCKD = bilateral abdo masses and FH or SASH)

64
Q

buzzword for SAH on CT

A

hyperattenuitaion around the circle of willis

65
Q

xanthochromia

A

LP 12h post CT that was -ve for SAH

blood -> xanthochromia, confirms SAH

66
Q

haemorrhagic strokes - traumatic

A

extradural haemorrhage (lemon shape - you are extra so you have lemon in your drink, rupture of MMA, post RTA or punch to temples)

subdural haemorrhage (prev hx of minor head trauma, banana/crescent shape, rupture of bridging veins)
alcoholics, anti-coal, elderly

67
Q

What is the single largest cause of death in under 45s?

A

traumatic brain injiry

68
Q

RED FLAGS post head injury

A

otorrhoea
rhinorrhoea
straw coloured fluid (CSF) from nose or ears
battle’s sign

69
Q

What are contusions

A

collisions between brain and skull

coup: impact of brain on skull
countercoup: injury to the opposite side of the brain

e.g. whiplash

70
Q

Commonest cells of the brain

A

astrocytes

71
Q

what is the commonest type of brain cancer?

A

mets (lung, skin and breast)

  1. astrocytoma (primary) -> glioblastoma multiforme specifically
72
Q

astrocytomas locations in the brain

A

intra-axial (within the brain parenchyma)
supratentorial

73
Q

Do brain cancers use TNM?

A

no

74
Q

grading vs staging

A

grading: how differentiated the tumour cells are compared with native

staging: how far the tumour has sprad

75
Q

Range of astrocytomas

A

pilocytic ast rocytoma (G1) - 0-20yo, indolent, childhood

diffuse glioma (G2-G3) - 20-40 yo

Glioblastoma multiforme (G4) - 50+ years, most common! aggressive, primary tumour in adults

76
Q

Brain cancer buzzwords slide

A
77
Q

Medulloblastoma

A

mainly affects children
balance issues
squint

78
Q

craaniopharyngioma vs pituitary

A

PT: superior bitemporaal hemianopia

more info here

79
Q

5As of dementai

A

Amnesia
Apraxia
Aphasia
Agnosia
Anomia

80
Q

commonest causes of dementia in order

A
  1. alzheimes
  2. vascular
  3. lewy body
  4. frontotemporal
81
Q

theories for AD

A
  1. accumulate of beta amyloid plaques
  2. hyperphosphorylation of tau proteins
82
Q
A

meidal temporal lobes and hippocampus most commonly affected in AD

global atrophy

83
Q

BRAAK

A

used for staging AD

84
Q

buzzwords for dementias

A
85
Q

syndromes in parkisons

A
86
Q

Flow of CSF

A

produced in choroid plexus within the ventricular system of the brain

drains through the inter ventricular foramen into 3rd ventricle

from 3rd to 4th via cerebral aqueduct

goes into the subarachnoid space

absorbed into sinuses and finally into the superior sagittal sinus

87
Q

Different types of hydrocephalus

A

blockage: non-communicating

increased production/decreased absorption: communicating hydrocephalus

normal pressure hydrocephalus

88
Q

aggregation of which protein in Parkinson’s disease

A

aloha synuclein

89
Q

mccune albright syndroem

A

fibrous dysplasia
cafe au lait spots
precocious puberty

90
Q

commonest bone cancer in adults

A

osteosarcoma

91
Q

histological features of RA

A
92
Q

osteomyelitis consequences

A
93
Q

gout vs pseudogout

A

gout: needle shape -ve birefringent, rat bite erosions

pseudo gout: rhomboid shoe

94
Q

benign bone cancer

A
95
Q

osteisarcoma - commonest locations

A

knee (60%), tibia, femur

in teenagers

96
Q

bone: fibrous dysplasia

A

seen in McCune Albright syndrome
bone is replaced by benign fibrous tissue
benign bone tumours

97
Q

proliferation of which cell type is seen in RA

A

synoviocytes

anti CCP and RF binds to them

through B- and T-cell activation but you often don’t get proliferation of these cells

98
Q

Layers of the epidermis

A
99
Q

bullous pemphigoid

A
100
Q

Pemphigus vulgaris

A
101
Q

theories for eczemma

A
  1. inside out theory - automuune IgE sensitisation leads to skin barrier dysfunction
  2. outside in theory - allergen exposure leads to IgE dysfunction
102
Q

eczema - mmutatiosn

A

filaggrin gene

103
Q

hypersensitivity type - eczema

A

Type 1:

Type 2:

104
Q

hsitpath of eczema

A

thickening of epidermis

spongiosis (fluid collection)

105
Q

Psoriasis

A

t-cell hyperactivity
epidermal thickening

buzzword: parakeratosis (lots of keratin and keratinocytes)

106
Q

Auspitz sign

A

associated with psoriasis

more info

107
Q

types of psoriasis

A
108
Q

bullous pemohigoid vs pemphigus vulgaris

A

bullous pemphigoid: IgG reaction to adhesion molecules

difficult to rub away because covered by epidermis

more in

pemphigus: bullae not that strong

109
Q

pemphigus foliates

A

affects elderly populaation

detachment of superficial keratinocytes

110
Q

commonest skin cancer

A

BCC (70%)
SCC (20%)
melanoma (10%)

111
Q

most common type of melanoma

A

superficial spreading

Year 5 😊✌🏼 (53 decks)

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