MUST KNOW HIGH YIELD!!!!! Flashcards

Question

What is being shown in this cell from the lung?

Answer 1

Type II pneumocyte showing SURFACTANT (lamellated bodies)

Answer 2

Erythema nodosum

Answer 3

Sclerosing hemangioma of the lung ## Footnote This lesion in the lung is seen more commonly in women with an average age in the 40s and shows papillary like projections lined by epithelioid cells with a central proliferation of polygonal mesenchymal appearing cells. Both populations are TTF1 positive indicating type II pneumocyte origin for this tumor.

Answer 4

UAG UAA UGA

Answer 5

Naegleria fowleri \*I realize this concept is getting beat to death but be able to recognoize!

Answer 6

SLE Lymphadenitis ## Footnote Architectural preservation, but follicular hyperplasia with variable sized follicles, increased vascularity, interfollicular immunoblasts and plasma cells. Often well circumscribed areas of paracortical necrosis with necrosis of small vessels. Occasionally DNA deposition/hematoxylin bodies (hematoxyphilic material) in stroma, sinuses and blood vessel walls. May have giant follicles, often disarray of follicular dendritic cell network, no/rare granulomas, no/rare neutrophils.

Answer 7

Brown Tumor

Answer 8

Pemphigus vulgaris ## Footnote don't forget about Hailey-Hailey (benign familial pemphigus) but that will have a dilapidated brick wall appearance (seen here)

Answer 9

Serous cystadenoma

Answer 10

Rhinosporidiosis caused by Rhinosoridium seeberi - India/Sri Lanka endemic Huge sporangia with endospores DDX includes coccidiodomycosis but is SMALLER

Answer 11

10% Two thirds of patients with LSIL will regress

Answer 12

Follicular lymphoma

Answer 13

Amoebic encephalitis

Answer 14

Lipoid pneumonia

Answer 15

Ileal conduit **degenerated columnar cells**

Answer 16

Organizing fibrinous pleuritis (benign pleural lesion)

Answer 17

Ganglioneuroma

Answer 18

Cellular Schwannoma

Answer 19

Fibroepithelioma of pinkus It is a **eccrine duct BCC**

Answer 20

Medullary thyroid carcinoma

Answer 21

Endosalpingiosis

Answer 22

Nesidioblastosis

Answer 23

Histoplasma!

Answer 24

Spitz nevus

Answer 25

Coccidioides

Answer 26

**Wilson's** In order of decreasing likelihood: Hep C, hemachrom, Hep B, Etoh, Wilsons.

Answer 27

Well Differentiated Liposarcoma

Answer 28

S. pneumo! Bile solubility distinguishes from other alpha hemolytic colonies

Answer 29

Acinar cell carcinoma

Answer 30

Adenomyosis

Answer 31

Inflammatory pseudotumor KIDS

Answer 32

d. Mallory bodies ## Footnote A councilman body, also known as Councilman hyaline body or **apoptotic body**, is an acidophilic (eosinophilic / pink-staining on H&E) globule of cells that represents a dying hepatocyte often surrounded by normal parenchyma.

Answer 33

Spindle cell variant of embryonal rhabdomyosarcoma

Answer 34

Conventional osteosarcoma

Answer 35

Myxoid liposarcoma

Answer 36

Nipple adenoma

Answer 37

Follicular cervicitis

Answer 38

Morton's neuroma

Answer 39

Lipid (steroid) cell tumor

Answer 40

Rhabdomyoma MOST COMMONLY IN LEFT VENTRICLE Most common primary cardiac tumor of infancy and childhood May be sporadic, but \>50% associated with TS Eosinophilic, polygonal cells with large glycogen-rich cytoplasmic vacuoles with stranding “spider cells”

Answer 41

**Lipoid pneumonia** ## Footnote Exogenous lipoid pneumonia. The microscopic appearance of exogenous lipoid pneumonia is dependent on the composition of the aspirated material. (A) Exogenous lipoid pneumonia with histiocytes containing predominantly fine microvesicles. (B) Exogenous lipoid pneumonia with larger vacuoles and associated fibrosis

Answer 42

Hymenolepsis This is Enterobius

Answer 43

Plexiform neurofibroma NF1

Answer 44

Amniotic fluid embolism

Answer 45

Circumvallate placenta This is a circumvallate placenta in which the membranes double back for a short distance over the fetal surface when the chorionic plate is too small.

Answer 46

Anaplastic Large Cell Lymphoma (CD30+) ## Footnote Lymphomatoid papulosis aka pseudolymphoma is a primary cutaneous CD30+ T cell lymphoproliferative disorder with wedge shaped dermal infiltrate of atypical lymphocytes and a background of polymorphic inflammatory cells

Answer 47

Langerhans histiocytosis

Answer 48

Autoimmune hepatitis

Answer 49

Normal parotid

Answer 50

Proliferating trichilemmal cyst

Answer 51

Myxoid Chondrosarcoma

Answer 52

Thymoma! NS Hodgkin's will have Reed Sternberg cells and the classic lacunar cells (spaces around histiocytes seen here)

Answer 53

Papillary serous carcinoma

Answer 54

Kikuchi necrosis and debris, no neutrophils

Answer 55

Granular cell tumor here is apocrine metaplasia

Answer 56

Trauma is number one but then **saccular** aneurysms

Answer 57

Spermatocytic seminoma

Answer 58

**Silicosis** ## Footnote A silicotic nodule within lung parenchyma is seen here. It is composed mainly of bundles of interlacing pink collagen. There is a minimal inflammatory reaction. The greater the degree of exposure to silica and increasing length of exposure determine the amount of silicotic nodule formation and the degree of restrictive lung disease. Silicosis increases the risk for lung carcinoma only about 2-fold.

Answer 59

**_The rearrangement was present but failed to amplify_** ## Footnote Somatic mutations of the immunoglobulin heavy chain gene of some mature B disorders, especially follicular lymphomas and plasma cell malignancies, _alter the sequence of the region amplified by the primers so that primer hybridization is suboptimal or does not occur, resulting in false negative PCR results_

Answer 60

Cocklebur with hematoidin crystals ## Footnote Cockleburs are associated with IUD, oral contraceptive use, and second half of pregnancy. They are related to cellular regeneration and composed of nonimmune glycoprotein, lipid, and calcium. Cytologically they are identified as golden refractile orange crystalline rays surrounded by histiocytes. They have no clinical significance.

Answer 61

Dust cells

Answer 62

Fibrolamellar variant of HCC ## Footnote • Tumor cells larger than normal hepatocytes, polyhedral, or rounded • Deeply eosinophilic, coarsely granular cytoplasm • Cytoplasmic inclusions – Ovoid “pale bodies” (ground glass but HBV-PAS-/fibrinogen+) – Mallory hyalines (rare) * Large, hyperchromatic, and vesicular nuclei * Prominent nucleoli * Mitoses and multinucleation infrequent

Answer 63

Krukenberg tumor (metastatic adenoCA)

Answer 64

Chemodectoma (cartoid body paraganglioma) Red granules are helpful

Answer 65

Mesonephric/Wollifan duct remnants ## Footnote Dilated tubules of cuboidal cells with eosinophilic secretions, surrounded by endocervical stroma Can show this architecture as well

Answer 66

● Elongated ulcerations overlying lymphoid hyperplasia ● Also small aphthoid ulcers overlying colonies of gram negative rods and with neutrophils at ulcer base ● Also necrotizing granulomas (particularly with Y. pseudotuberculosis) ● Mesenteric nodes show follicular hyperplasia with variable scattered microabscesses and epithelioid granulomas

Answer 67

Paraganglioma

Answer 68

Blastomycosis

Answer 69

Parvovirus B19

Answer 70

Sclerosing sertoli cell tumor

Answer 71

Nasopharyngeal carcinoma

Answer 72

Endometriosis

Answer 73

Low volume of distribution and highly protein bound

Answer 74

Acanthamoeba Here is Naegleria (smaller)

Answer 75

Nodular fasciitis

Answer 76

Clear cell carcinoma

Answer 77

Four major forms of vegetative endocarditis: 1. RHD – see small warty row of vegetations along line of closure 2. Infectious – see large irregular masses on valve cusps that extend onto chordae 3. Non-bac thrombotic endocarditis: small bland scattered vegs attached at line of closure 4. Libman sacks – small- med sized vegs **on either or both sides of valve leaflets!**

Answer 78

Cellular Blue Nevus Here is a regular blue nevus

Answer 79

Malakoplakia \*have to look really hard to find MG bodies

Answer 80

Day 23 ## Footnote Day 23: prominent spiral arterioles (thickened walls, coiling and endothelial proliferation)

Answer 81

Myelolipoma here is an adrenal cortical adenoma

Answer 82

Islet cell tumor

Answer 83

Gynecomastia

Answer 84

Hidradenoma papilliferum

Answer 85

**Littoral Cell Angioma** ## Footnote Plump endothelial cells with irregular vascular channels IHC: _Positive_: features of both endothelial (Factor VIII, CD31) and histiocytic (CD68, Mac387, Ham56, lysozyme) differentiation and positive CD21, vimentin _Negative_: CD8, CD34 (usually)

Answer 86

Intermediate trophoblast

Answer 87

DeQuervain's thyroiditis (subacute) showing granulomatous inflammation

Answer 88

Yellow fever

Answer 89

Seminoma/dysgerminoma PLAP, CD117, OCT3/4, SALL4

Answer 90

Xanthogranulomatous pyelonephritis

Answer 91

Del 13q14 good prognosis

Answer 92

Huntington's Disease

Answer 93

Bronchopulmonary dysplasia

Answer 94

Strongyloides

Answer 95

Ganglioneuroma

Answer 96

80% to pass!!

Answer 97

Choriocarcinoma Thought to be from cross-reactivity of TSH and hCG

Answer 98

Mucin in the granuloma

Answer 99

**_Blood needed NOW (less than 10 min)_** GIVE: uncrossmatched Group O neg (may give O pos if male or older female) **_Blood needed in 10-30 min_** GIVE: Uncrossmatched ABO group and Rh type **_Blood needed in over 30 min_** GIVE: Crossmatched ABO group and RH type

Answer 100

Parathyroid adenoma

Answer 101

Echinococus Radially arranged hooklets

Answer 102

Inverted papilloma

Answer 103

Cri du chat

Answer 104

CD21 (+ FDCs)

Answer 105

CLL/SLL CLL/SLL and large granular cell lymphomas grow in miliary pattern in spleen (white pulp)

Answer 106

**Papillary syncytial metaplasia** ## Footnote An inaccurate term as it is not a metaplasia but rather a regenerative or degenerative process secondary to tissue breakdown. Mitotic figures may be present within the papillary proliferations. It is also seen following surface breakdown associated with nonmenstrual conditions. On occasions, the micropapillary architecture is particularly striking, and, if associated with mitotic activity, this raises the possibility of a serous carcinoma Differentiated by – background endometrium shows features of breakdown – p53 staining which is negative here

Answer 107

Alternaria

Answer 108

Choriocarcinoma

Answer 109

Erythroleukoblastic

Answer 110

Reactive hepatocytes with prominent nucleoli

Answer 111

Parosteal osteosarcoma

Answer 112

Malakoplakia shows MB body

Answer 113

REACTIVE LYMPHADENOPATHY note polymorphous population

Answer 114

Angiokeratoma Fabry's

Answer 115

_Kimura's_: Shown here Young Asian males * Germinal center hyperplasia with polykaryocytes, fibrosis and proteinaceous material in germinal centers * Folliculolysis, interfollicular **eosinophils and eosinophilic abscesses** * Increased paracortical plasma cells * Variable hyalinized vessels * Soft tissue lesions show proliferation of thin-walled vessels with eosinophilia _Kikuchi's_: Young asian females * Paracortical, well-circumscribed necrotic lesions, often with a starry-sky appearance * Karryorhexis, fibrin deposits, plasmacytoid monocytes (2-3x size of small lymphocytes, variable cytoplasm, round nuclei with open chromatin, small nucleoli, CD4+) that may resemble lymphoma, phagocytic and foamy histiocytes, T cells (CD8+, cytotoxic phenotype) * No/rare plasma cells, no neutrophils, no follicular hyperplasia, no atypia

Answer 116

DCIS with cancerization of lobules \*will look like LCIS at first glance but on higher power ther cells are too ugly

Answer 117

Histoplasma

Answer 118

Gynecomastia

Answer 119

Fusion of **lysosomal** granules

Answer 120

Takayasu's arteritis ## Footnote this looks histologically exactly the same as giant cell arteritis and the distinction is primarily based on the age of the patient (in Takayasu \<40yo)

Answer 121

A1AT This is mallory's hyaline in alcoholic steatohepatitis

Answer 122

Renal pelvis urothelial CA

Answer 123

Collagenous spherulosis

Answer 124

Micropapillary carcinoma of the breast

Answer 125

Collagen ball

Answer 126

Pleomorphic adenoma

Answer 127

Prostate AdenoCA

Answer 128

Normal mucinous cells

Answer 129

M. szulgai (37 degrees) It's a photochromogen at 22-24 degrees

Answer 130

Plexiform lesion associated with pulmonary hypertension

Answer 131

Peritrichous E coli, Salmonella, etc

Answer 132

Round Cell Liposarcoma

Answer 133

**Enzyme cofactor**

Answer 134

HG Cribiform PIN

Answer 135

Odontogenic keratocyst Gorlin's syndrome

Answer 136

Papillary renal necrosis A mnemonic for the causes of renal papillary necrosis is POSTCARDS: pyelonephritis, obstruction of the urogenital tract, sickle cell disease, tuberculosis, cirrhosis of the liver, analgesia/alcohol abuse, renal vein thrombosis, diabetes mellitus, and systemic vasculitis **NSAIDS (not associated with it)**

Answer 137

**Clear cell cribiform** **hyperplasia of prostate** central zone, look for basal cell layer - basal cell layer can be seen by the use of the 34 beta E12 anti-HMWK antibody (K-903) that reacts with the basal cells but not with the acinar cells of the prostate. (CA is negative for K903)

Answer 138

Proliferating trichilemmal cyst

Answer 139

Exposure to DES _Vaginal adenosis_: Upper 1/3 and anterior wall of vagina, 20% have gross congenital malformation of cervix (T shaped uterine cavity) Benign glandular epithelium with metaplasia

Answer 140

OR = (AD)/(BC) See pic

Answer 141

Velamentous cord insertion of placenta

Answer 142

Nodular Melanoma

Answer 143

Hepatic Adenoma

Answer 144

The nitrocefin biochemical test is a sensitive technique for detecting beta-lactamase producing strains of N. gonorrhoeae, H. influenzae, Staphylococcus spp, Enterococcus spp and Moraxella (Branhamella) catarrhalis. Nitrocefin is the only reliable test for detecting beta-lactamase producing Enterococcus spp.

Answer 145

**Hyalinizing trabecular tumor** \*remember has peculiar cytoplasmic Ki67 staining

Answer 146

**10,000 tests per year** ## Footnote **_Equipment Evaluation_** (Straight from Osler Notes) You have purchased a $70K machine which has a 5 year lifetime. The machine can perform 60 tests/hr. A tech can run the machine at a salary of $6/hr. Currently, with the manual method, a tech can do 4 tests/hr. How many tests need to be done each year to justify the cost of the machine? $70K/5 = $14K $6/4 = $1.50 per test (manual method) $6/60 = $0.10 per test (new method) Let x = the number of tests. 0.10x + $14,000 = 1.50x **x = 10,000/yr**

Answer 147

Remember the basic formulas: **p² + 2pq + q² = 1 and p + q = 1** p = frequency of the dominant allele in the population q = frequency of the recessive allele in the population p² = percentage of homozygous dominant individuals q²= percentage of homozygous recessive individuals 2pq = percentage of heterozygous individuals EXAMPLE: You have sampled a population in which you know that the percentage of the homozygous recessive genotype (aa) is 36%. Using that 36%, calculate the following: * The frequency of the "aa" genotype. Answer: 36%, as given in the problem itself. * The frequency of the "a" allele. Answer: The frequency of aa is 36%, which means that q² = 0.36, by definition. If q² = 0.36, then q = 0.6, again by definition. Since q equals the frequency of the a allele, then the frequency is 60%. * The frequency of the "A" allele. Answer: Since q = 0.6, and p + q = 1, then p = 0.4; the frequency of A is by definition equal to p, so the answer is 40%. * The frequencies of the genotypes "AA" and "Aa." Answer: The frequency of AA is equal to p², and the frequency of Aa is equal to 2pq. So, using the information above, the frequency of AA is 16% (i.e. p² is 0.4 x 0.4 = 0.16) and Aa is 48% (2pq = 2 x 0.4 x 0.6 = 0.48). * The frequencies of the two possible phenotypes if "A" is completely dominant over "a." Answers: Because "A" is totally dominate over "a", the dominant phenotype will show if either the homozygous "AA" or heterozygous "Aa" genotypes occur. The recessive phenotype is controlled by the homozygous aa genotype. Therefore, the frequency of the dominant phenotype equals the sum of the frequencies of AA and Aa, and the recessive phenotype is simply the frequency of aa. Therefore, the dominant frequency is 64% and, in the first part of this question above, you have already shown that the recessive frequency is 36%.

Answer 148

fibrillary degeneration of collagen

Answer 149

Angiolipoma ## Footnote Hyaline/fibrin thrombi are an important diagnostic sign

Answer 150

Nephrogenic adenoma can look a little different so here is another example RACEMASE POSITIVE!!!

Answer 151

_Thromboxane_: causes platelet activation and local vasoconstiction _Prostacyclin_: It inhibits platelet activation and is also an effective vasodilator.

Answer 152

Craniopharyngioma

Answer 153

Bcl6 Stains germinal center

Answer 154

Branchial cleft cyst

Answer 155

**c. Angular glands** _Features include:_ * Low cellularity * Flat, honeycomb epithelial sheets, with no loss of polarity and distinct cell borders * Uniform small nuclei, low N/C ratio * Bipolar naked nuclei * Foamy cells and apocrine cells * Fat and fibrous stromal tissue fragments

Answer 156

Fracture callus ## Footnote shows two thin trabeculae of bone with lots and lots of osteoblasts rimmed around them, plus hemorrhage nearby and reactive looking fibroblastic proliferation around them

Answer 157

Lichen sclerosis et atophicus

Answer 158

Micropapillary DCIS

Answer 159

Toxoplasma

Answer 160

Moraxella catarrhalis

Answer 161

Secretory endometrium ## Footnote tell between secretory EM carcinoma and complex hyperplasia.