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Pathology > Midterm Problem Areas > Flashcards

Midterm Problem Areas Flashcards

1
Q

Four types of inflammatory lesions of oral cavity

A

Irritation Fibroma
Pyogenic Granuloma
Peripheral Ossifying Fibroma
Peripheral Giant Cell Granuloma

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2
Q

Most common inflammatory lesion of oral cavity

A

Irritation fibroma

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3
Q

Aphthous ulcer cause (2)

A

Stress

Lack of sleep

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4
Q

Most common fungal infection of mouth

A

Oral thrush

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5
Q

Cause of scarlet fever

A

Group A strep

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6
Q

Result in oral cavity of phenytoin/dilantin ingestion

A

Gingival hyperplasia

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7
Q

3 mutations in squamous cell carcinoma in chronological order

A

Inactivation of P16 –> Hyperplasia
Mutation of p53 –> Dysplasia
Activation of cyclin D1 –> Malignancy

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8
Q

3 Odontogenic cysts

A

Dentigerous
Periapical
Keratocyst

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9
Q

Keratocyst location

2 features of the cyst

A

Posterior mandible

Prominent basal layer palisading + corrugated epithelial surface

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10
Q

DM patients get what sinusitis

A

Mucormycosis

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11
Q

If someone is an adolescent male with a tumor of BV’s and fibrous tissue what is it?
What to be careful of

A

Nasopharyngeal angiofibroma

Bleed out during resection

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12
Q

A malignant tumor arising in the cribiform plate with lobular growth pattern

A

Olfactory neuroblastoma

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13
Q

A tumor with HPV 6 and 11 found in the septum of the nose with inverted growth pattern and mucin microcysts.

A

Sinonasal/Schneiderian Papilloma

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14
Q

A singer who smokes presents with progressive hoarseness and has bilateral nodules.

A

Reactive nodules

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15
Q

A child comes in with obstructive symptoms and has a neoplasm on the vocal cord that tests positive for HPV 6 and 11

A

Squamous papilloma

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16
Q

A smoker with persistent hoarseness comes in

A

Carcinoma of larynx

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17
Q

Patient comes in with cyst on anterolateral aspect of neck

A

Branchial cleft cyst

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18
Q

patient comes in with cyst in midline of neck

A

Thyroglossal duct cyst

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19
Q

60 year old patient comes in with tumor at birfurcation of common carotid artery and has zell ballen of eosinophilic cells

A

Paraganglioma

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20
Q

Most common lesion of salivary glands

Most common location

A

Mucoceles

Lower lip

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21
Q

Patient comes in with what looks like a mucocele on floor of the mouth

A

Ranula

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22
Q

Most malignant salivary gland

A

Sublingual

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23
Q

Most common tumor of salivary glands

A

Pleomorphic adenoma

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24
Q

Second most common tumor of salivary glands

Patient at risk

A

Warthin tumor

Smoker

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25
Q

Most common malignant salivary gland tumor

A

Mucoepidermoid carcinoma

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26
Q

Parotid gland tumor with cells with clear or granular cytoplasm

A

Acinic Cell carcinoma

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27
Q

Patient with tumor of minor salivary glands in the palate. Tumor has small blue cells in cribriform pattern and has hyaline membrane between cells. There is perineural invasion seen.

A

Adenoid Cystic Carcinoma

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28
Q

Patient with benign enlargement of lacrimal gland and salivary glands with dry eyes and mouth

A

Mikulicz

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29
Q

Patient with granulomas in the orbit that are negative for fungi and bacteria

A

Sarcoidosis

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30
Q

Most common primary orbital neoplasm

A

Vascular: Hemangiomas

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31
Q

Most common malignant neoplasm of lacrimal gland

A

Adenoid cystic carcinoma

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32
Q

Most common benign neoplasm of lacrimal gland

A

Pleomorphic adenoma

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33
Q

Patient comes in with neoplasm of lower eyelid and medial canthus

A

Basal Cell Carcinoma

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34
Q

Elderly patient comes in with tumor of upper eyelid and in Zeis/Meibomian glands and presents with conjunctivitis and blepharitis

A

Sebaceous carcinoma of eyelids

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35
Q

Most common cause of conjunctival scarring

A

Chronic dry eyes

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36
Q

Patient presents with an actinic tissue that is moving medially towards the cornea. Reports astigmatism and visual changes.

A

Ptyerygium

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37
Q

Patient presents with yellowish subconjunctival lesion

A

Pinguecula

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38
Q

Most common neoplasm of conjunctiva

Associated with what (2)

A

Squamous Cell

HPV 16 and 18

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39
Q

What is the precursor to conjunctival melanomas

A

Primary Acuired melanosis with atypia

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40
Q

Baby presents with a blue sclera at birth.
What is diagnosis
What is the problem

A

Osteogenesis imperfecta

No Type 1 collagen

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41
Q

Membrane where Copper is deposited in Wilson’s disease

A

Descemet

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42
Q

Patient presents with depositing of calcium in Bowman layer

A

Calcific band keratopathy

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43
Q

Patient presents with solar damage to the Bowman layer

A

Actinic band keratopathy

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44
Q

Patient presents with progressive thinning and ectasia of cornea with no inflammation. Now has irregular astigmatism. Patient also has Marfans and Downs syndrome

A

Keratoconus

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45
Q

Patient has an autosomal recessive dystrophy of the corneal stroma. Deposits of keratin sulfate are found.

A

Macular Corneal Dystrophy

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46
Q

Most common cause of cataract

A

Age-related opacification of lens

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47
Q

Patient presents with loss of vision and no pain. Damage is irreversible

A

Open angle glaucoma

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48
Q

Far-sighted Asian patient comes in. What should you be concerned with

A

Angle closure glaucoma

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49
Q

Most common primary intraocular malignancy in adults
Where does it spread
Which form is the worst

A

Melanoma of Uveal Tract
Liver
Epitheloid pattern

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50
Q

Near sighted people with cotton wool spots are at risk for what

A

Retinal detachment

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51
Q

Number one cause of blindness in US?

A

Diabetes Mellitus or ARMD

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52
Q

Premature infant treated with oxygen has delayed angiogenesis in lateral retina

A

Retionopathy of Prematurity

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53
Q

Patient presents with blindness due to deposits in Bruch membrane and loss of retinal pigmented epithelium

A

Atrophic Dry ARMD

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54
Q

Patient presents with hemorrhage of choroid blood vessels.

A

Exudative Wet ARMD

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55
Q

Most common intraocular tumor of kids

A

Retinoblastoma

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56
Q

Most common tumor of retina

A

Retinoblastoma

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57
Q

Patient presents with leukocoria, dilated fixed pupil heterochromia and strabismus

A

Retinoblastoma

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58
Q

Most common tumor of the optic nerve

A

Gliomas

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59
Q

Teenager patient with benign optic nerve tumor comes in. Patient has neurofibromatosis type 1

A

Pilocytic astrocytoma

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60
Q

3 diseases of optic nerve and cause of each

A

AION: Vascular injury
Papilledema: Intracranial pressure incrase
Optic neuritic: Demyelination

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61
Q

End stage Eye

A

Phthisis Bulbi

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62
Q

Newborn has regurgitation of food with first feeding. Aspiration and suffocates.
What is diagnosis
What is it seen with
What form is most common

A

Esophageal atresia
Tracheoesophageal fistula
Type C

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63
Q

Newborn presents with loops of small bowel outside his abdomen but covered by amniotic membrane.

A

Ompholocele

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64
Q

Newborn presents with a defect to right of umbilicus and has free floating small bowel outside of abdomen

A

Gastroschisis

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65
Q

Patient presents with large defect in which bowel is floating in placental membrane

A

Body stalk defect

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66
Q

Newborn presents with respiratory embarassment and hypoplasia of the lung.

A

Diaphragmatic hernia or Bochdalek hernia

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67
Q

Meckel diverticulum
True or acquired
Rule of 2’s

A

True congenital: all 3 walls

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68
Q

First born male presents with muscular vomiting and has a palpable muscular hypertrophy that feels like an olive.

A

Pyloric stenosis

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69
Q

Newborn Male patient fails to pass meconium. He has Down syndrome. There is a colonic dilatation proximally to the rectum. It ruptures and stercoral ulcers are found.

A

Hirschsprung disease

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70
Q

Patient presents with episodic food regurgitation at night.

A

Esophageal Diverticuli

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71
Q

Location of each diverticuli in esophagus

A

Zenker: Proximal
Traction: Mid
Epiphrenic: Distal

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72
Q

Patient has solid food dysphagia. History of GERD and was drinking lye.

A

Stenosis

73
Q

Women presents with iron deficiency anemia, glossitis, and dysphagia.

A

Plummer-Vinson syndrome with esophageal webs

74
Q

Young patient presents with dilation of proximal esophagus and constriction in lower esophagus. Birds beak appearance on barium swallow
What are they also at risk for.

A

Achalasia

Squamous Cell Carcinoma

75
Q

Patient has a hernia with reflux esophagitis

A

Sliding axial (most common)

76
Q

Patient has a hernia with a volvulus

A

Paraesophageal rolling hernia

77
Q

Chronic alcoholic presents with severe retching and has longitudinal lacerations of esophagus at GE junction. They are only superficial.

A

Mallory-Weiss tears

78
Q

A patient with severe bloody vomit presents with deep tears in the distal esophagus.

A

Boerhaave Syndrome

79
Q

Patient with liver cirrhosis presents with massive hematemesis and bleeds out.

A

Esophageal varices

80
Q

Patient presents with tiny punched out ulcers and has intranuclear inclusion cells on histo slide.

A

Herpes simplex esophagitis

81
Q

Patient presents with shallow ulcerations and intranuclear inclusions

A

CMV

82
Q

40 year old adult presents with heartburn, regurgitation and chest pain. You see eosinophils on histo slide of distal esophagus.

A

GERD

83
Q

Male Patient has a histo slide prepared of upper/mid esophagus showing corrugated epithelium and many eosinophils after an allergic reaction to a meal.

A

Eosinophilic Esophagitis

84
Q

Barrett esophagus associated with what cancer

Achalasia associated with what cancer

A

Adenocarcinoma

Squamous cell carcinoma

85
Q

A patient on NSAID’s and Alcohol presents with pinpoint bleeding and hemorrhage and erosions. Curling and Cushing ulcers are also found.

A

Acute Gastritis

86
Q

Patient presents with H. pylori infection with mucosal atrophy and metaplasia. Lymphocytes have infiltrated the lamina propria and glands.

A

Chronic active gastritis

87
Q

Cancer associated with chronic gastritis caused by H. pylori? (2)

A
  1. Gastric adenocarinoma

2. MALToma

88
Q

60 year old Scandinavian presents with pernicious anemia and atrophy of mucosa.

A

Auto-immune gastritis

89
Q

Patient who has been using NSAID’s and alcohol presents with little to no inflammation but there is foveolar hyperchromasia and hyperplasia.

A

Reactive gastropathy

90
Q

Patient presents with epigastric burning pain. A solitary punched out lesion is found in duodenum. Patient has H. pylori infection and uses NSAID’s.

A

Peptic Ulcer disease

91
Q

Patient has a gastrinoma and multiple peptic ulcers. What is cause

A

Zollinger-Ellison

92
Q

Male patient with hyperplasia of mucosa and thickened gastric folds presents.

A

Menetrier Disease

93
Q

Patient has cystic dilation of fundic glands.

A

Fundic polyp

94
Q

Older Patient has pedunculated and sessile polyps. Patient also has Familial adenomatous polyposis.

A

Adenoma

95
Q

Patient has round polyp that looks to be part of repair process

A

Inflammatory/Fibroid polyp

96
Q

Male patient who eats nitrites, smoked foods, and not enough fruits and veggies presents with chronic gastritis. What is he at risk for

A

Intestinal type Adenocarcinoma

97
Q

Patient with poorly differentiated cancer of stomach.

A

Diffuse Adenocarcinoma

98
Q

Patient has a tumor develop from enterchromaffin like cells and is in a hypergastrinemic state. He has the CD markers of CD56, synaptophysin, and chromogranin

A

Carcinoid Tumor

99
Q

Patient has a tumor develop from interstitial cells of Cajal and is CKIT/CD117 and CD34 positive. Tumor responds to Gleevec.

A

GIST

100
Q

Elderly female presents with herniation of jejunum through only two layers.

A

Jejunal Diverticuli

101
Q

Most common cause of bowel obstruction

A

Adhesion

102
Q

Patient presents with cyclic bowel obstruction symptoms.

A

Endometriosis - bowel obstruction

103
Q

Patient presents with pain out of proportion to physical exam. Displays rigid rebound tenderness. Blood levels show lactic acidosis. Patient dies from peritonitis and sepsis.

A

Ischemic bowel disease at splenic flexure or rectum

104
Q

Patient with lower GI bleed and CREST & Osler-Weber-Rendu presents. Venous dilations are seen in right colon and cecum.

A

Angiodysplasia

105
Q

Patient with lower GI bleed has one large solitary venous dilation.

A

Arteriovenous Malformation

106
Q

A pregnant patient who complains of chronic constipation and history of cirrhosis presents with painful bowel movements.

A

External Hemorrhoid

107
Q

Premature newborn started on formula presents with problem with first oral feeding. Radiograph shows pneumatosis intestinalis (gas in bowel).

A

Necrotizing Enterocolitis

108
Q

Scandinavian patient presents with inflammation of small intestine. Histology shows a blunting of villi with lengthening of glands. Patient tests positive for IgA transglutaminase and IgA Endomysial Ab. Also has dermatitis herpetiformis.
What is diagnosis
What are two associated cancers.

A

HLA-DQ2 Celiac disease/Sprue

T cell lymphoma and adenocarcinoma

109
Q

How to test igA tTG in sprue?
How to test IgA EMA in sprue?
What should you do first

A

tTG: Elisa
EMA: Immunofluoresence
IgA serum test

110
Q

Person visits the tropics and comes back with macrophages in their distal small bowel. Treatment with Antibiotics gives full recovery

A

Tropical Sprue

111
Q

Patient with luminal stasis, hypochlorhydria and immunocompromised has diarrhea.

A

Bacterial Overgrowth syndrome

112
Q

Hospitalized Patient comes in with a membrane of neutrophils, fibrin, and necrosis in his colon. He reports using broad-spectrum antibiotics. Patient dies of toxic megacolon.
How to treat

A

Pseudomembranous colitis caused by C. dif

Oral vancomycin

113
Q

Female patient presents with cramping and diarrhea. No inflammation is seen and physical exam is normal. Patient reports diet of fatty foods and sugary foods. Patient reports stress.

A

Irritable bowel syndrome

114
Q

Twenty year old Jewish patient presents with full thickness inflammation, luminal narrowing, skip lesions, and aphthous ulcers. Fistulas and sinus tract formation occurs as well as fat wrapping. Noncaseating granulomas are in bowel wall lymph nodes. Serology shows P-ANCA positive

A

Crohn’s disease

115
Q

Patient presents with ulceration of mucosa and submucosa only. Continuous inflammatory process involving the rectum. Pseudopolyp formation is seen. No granulomas present. Primary sclerosing cholangitis is seen. Serology shows antibodies to Yeast

A

Ulcerative colitis

116
Q

Elderly female with chronic watery diarrhea and thickened subepithelial collagen

A

Collagenous colitis

117
Q

Patient presents with lymphocytosis of mucosa and inflammation. No thickened subepithelial collagen

A

Lymphocytic colitis

118
Q

Patient presents with heavy pigmentation of colon during cholonoscopy. Reports heavy laxative use.

A

Melanosis Coli

119
Q

Patient has a mass in colon from straining during bowel movements

A

Mucosal prolapse

120
Q

Patient presents with a GI tumor of spindle and stellate cells with inflammation. Cells are CD34 positive. inflammation only through submucosa, not transmural.

A

Inflammatory fibroid polyp

121
Q

Toddler presents with rectal bleeding

A

Juvenile polyposis

122
Q

Young kid presents with tree like polyps and pigmentation on lips and oral cavity. Mutation at STK11/LKB1 on choromosome 19

A

Peutz-Jegher syndrome

123
Q

Patient presents with macrocephaly, benign skin and mucosal tumors and dysplastic gangliocytoma of cerebellum. Loss of PTEN gene function and activation of MTOR

A

Cowden

124
Q

Most common polyps of bowel
Location
Size

A

Hyperplastic
Left colon
Less than 5 mm

125
Q

Polyps are found in the right colon. Associated with defective mismatch repair genes

A

Sessile serrated adenoma

126
Q

3 mutations for colorectal carcinoma

A

Loss of APC gene
Turn on KRAS
Lose DCC

127
Q

Most common primary malignancy of Small intestine

A

Carcinoids

128
Q

Most common type of GI lymphoma

A

Large B-cell

129
Q

Patient presents with apple core apearing tumor in the duodenum

A

Small intestine adenocarcinoma

130
Q

Most common neoplasm of appendix

A

Carcinoid

131
Q

Appendix tumor that makes mucin

A

Pseudomyxoma peritonei

132
Q

Most common thing we see in peritoneum

A

Secondary neoplasms

133
Q

Two genetic causes of acute pancreatitis

A

PRSSI: AD
SPINK1: AR

134
Q

Two lab tests for pancreatitis

Which is better

A

Lipase and amylase

Lipase is more specific and sensitive

135
Q

Main thing confused with acute pancreatitis?

How to differentiate

A

Occlusion of mesenteric vessels –> Ischemic bowel

Do blood gases and look for lactic acidosis

136
Q

Primary progression of chronic pancreatitis

A

Secondary diabetes mellitus due to eventual destruction of islet cells

137
Q

Most common cyst in pancreas

A

Pseudocysts

138
Q

Tumor of pancreas in adolescent girls and young women with mild abdominal discomfort.

A

Solid pseudopapillary tumor

139
Q

Female patient with cystic neoplasm. Ovarian-like stroma in cyst wall

A

Mucinous Cystic neoplasm

140
Q

Male patient with cystic neoplasm in pancreatic head

A

Intraductal papillary mucinous neoplasm

141
Q

Most common type of pancreatic malignancy

A

Pancreatic adenocarcinoma

142
Q

Two mutations in pancreatic adenocarcinoma

A

KRAS activated

p16 inactivated

143
Q

Patient presents with obstructive jaundice, weight loss, and migratory thrombophlebitis. Patient dies within a year.

A

Pancreatic adenocarcinoma

144
Q

Best tumor marker for pancreatic cancer

A

CA19-9

145
Q

Young female Northern European presents with hepatitis. Plasma cells are found at portal tract lobule interface. There is an absence of viral markers and it is negative for anti-mitochondrial antibodies. There is an elevation in autoantibodies.
Type 1 of this has what genetic association?

A

Autoimmune Hepatitis

HLA-DR3

146
Q

Child presents with liver disease after taking aspirin during a viral infection.

A

Reye’s syndrome

147
Q

African american woman presents with hepatitis. There are mallory bodies, hepatocyte swelling and necrosis, neutrophilic infiltrates, fibrosis, and steatosis. Elevated liver enzymes and neutrophils are found.

A

Alcoholic hepatitis

148
Q

An obese patient with diabetes mellitus type 2 presents with elevated liver functions and hepatitis.

A

Metabolic liver disease such as NASH

149
Q

Older male patient presents with hepatomegaly, pancreatic pigementation, diabetes mellitus, and skin pigmentation of a bronze color. Cardiomegaly is also present.
What is diagnosis
What is the mutation
What is the chromosome

A

Hereditary hemochromatosis
HFE gene
Chromosome 6

150
Q

Patient presents with liver disease. There is also basal gnaglia atrophy, kayser-fleischer rings.
How to diagnose? (2)
What is diagnosis

A

Check serum ceruloplasmin and urine copper levels

Wilson’s Disease

151
Q

Middle aged woman with celiac disease had her first symptom as pruritis. She developed jaundice, xanthomas, dark urine and light colored stools later. Blood levels show elevated alkaline phosphatase and cholesterol. Antimitochondrial antibodies are found. Duct injury and plasma cells are found on histo slide.

A

Primary Biliary Cirrhosis

152
Q

Middle aged male with ulcerative colitis presents with biliary cirrhosis. Histo shows a segmental fibrous obliteration of bile ducts.
Diagnosis and increased risk of what

A

Primary Sclerosing Cholangitis

Cholangiocarcinoma

153
Q

Tan clusters of dilated bile ducts in a fibrous stroma are found. They are free of bile and are remnant of biliary duct micro hamartomas

A

Von Meyenburg Complex

154
Q

Female with autosomal dominant polycystic kidney disease presents with diffuse cystic lesions in the liver. These lesions do not communicate with biliary tree.

A

Polycystic liver disease

155
Q

Patient presents with irregular fibrous widening of portal tracts. Patient also has autosomal recessive polycystic kidney disease

A

Congenitla hepatis fibrosis

156
Q

Patient presents with dilation of large bile ducts. Stones and stasis is seen. Associated with both forms of polycystic disease.

A

Caroli Disease

157
Q

Three things that increase risk of cholangiocarcinoma

A

Primary sclerosing cholangitis
Caroli’s
Congenital hepatic fibrosis

158
Q

Patient presents with peculiar facies, vertebral anomalies, CV defects. Histo discovers there are no liver bile ducts. Mutation of JAG 1 gene on Chromosome 20

A

Alagille Syndrome

159
Q

Patient comes in with liver failure. They admit to steroid, oral contraceptive, and danazol use. They report a Bartonella infection recently.

A

Peliosis hepatitis

160
Q

Patient presents with hepatomegaly and ascites. Two or more major hepatic veins are obstructed

A

Budd-Chiari Syndrome

161
Q

Jamaican bush tea drinker presents with oblieration of hepatic veins. He recovers spontaneously.

A

Veno-occlusive disease

162
Q

First time Pregnant mother presents with hypertension and proteinuria. Also displays signs of HELLP syndrome.

A

Pre-eclampsia

163
Q

First time pregnant mother prsents with hypertension and proteinuria. Also displays hyperreflexia and convulsions.

A

Eclampsia

164
Q

Pregnant mother in third trimester presents with liver disease. Microvesicular steatosis is seen on the biopsy.

A

Acute fatty liver of pregnancy

165
Q

Pregnant mother presents with pruritis, jaundice, dark urine, light colored stools. Cholestasis but no necrosis. Conjugated bilirubin detected.

A

Intrahepatic cholestasis of pregnancy

166
Q

Middle aged woman comes in with a nodule on her liver. It is well demarcated, and has a central scar. It is lighter colored and contains large arterial vessels.

A

Focal nodular hyperplasia

167
Q

Elderly patient comes in with multiple spherical nodules in absence of fibrosis. Develops portal hypertension after other stressor. Reticular stain used to accentuate the nodules.

A

Nodular regenerative hyperplasia.

168
Q

Number one cause of non-cirrhotic portal hypertension in the world

A

Nodular Regenerative Hyperplasia

169
Q

You find a benign vascular neoplasm less than 2 cm in size on the liver. Should you biopsy?

A

No, hemangiomas can bleed out

170
Q

Young female patient on oral contraceptives presents with a benign proliferation of hepatocytes without portal triads. They are pale and yellow-tan in color. It is 30 cm large.

A

Hepatic adenoma

171
Q

Young child comes in with FAP. He has a liver tumor. There is a mutation in beta-catenin.

A

Hepatoblastoma

172
Q

Patient comes in after exposure to vinyl chloride with an aggressive tumor

A

Angiosarcoma

173
Q

Elderly black patient comes in with cirrhosis after a mass was found. Patient has a history of viral liver infections and alcohol use. Elevated serum alpha-fetoprotein is found. The tumor is paler than surrounding tissue.

A

Hepatocellular carcinoma

174
Q

Younger patient comes in with what is believed to be a hepatocellular carcinoma. However it is solitary and very fibrosed and well demaracated. Patient has no history of cirrhosis or chronic liver disease.

A

Fibrolamellar hepatocellular carcinoma

175
Q

Hispanic patient comes in with PSC. He has a well differentiated tumor of bile duct with no bile within it. It is found at bifurcation of right and left hepatic ducts. Desmoplastic response is seen.

A

Cholangiocarcinoma: Specifically a Klatskin tumor based on location

176
Q

Obese White female presents with biliary colic

A

Cholelithiasis

177
Q

Child comes in with acholic stools, symptoms of cholestasis and eventual biliary cirrhosis. There is an obstruction found above the porta hepatis that is uncorrectable.

A

Biliary atresia

178
Q

Elderly woman presents with long standing stones and chronic cholecystitis.

A

Carcinoma of the gall bladder

179
Q

Elderly man presents with painless jaundice, hepatomegaly and a palpable gall bladder. Bilirubinemia and elevated alkaline phosphatase are also found.

A

Carcinoma of the extrahepatic ducts

Pathology (36 decks)

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