Original Pathology Flashcards
1
Q
What are the 4 microscopic characteristics of dysplasia?
A
1) Anisocytosis
2) Poikilocytosis
3) Hyperchromatism
4) Mitotic figures
2
Q
What is anisocytosis?
A
Unequal cell size
3
Q
What is poikilocytosis?
A
Abnormal cell shape
4
Q
What is hyperchromatism?
A
Pigmentation
5
Q
What is hypertrophy due to?
A
Typically a result of increased intracellular protein rather cytosol
6
Q
What is the difference between hypertrophy and hyperplasia?
A
Hypertrophy = increased cell size
Hyperplasia = increased cell number
7
Q
What is metaplasia?
A
Reversible change of one differentiated cell type with another
8
Q
What is dysplasia?
A
Abnormal change to cellular size, shape and/or organisation
Pre-malignant
9
Q
What are the different types of necrosis?
A
1) Coagulative
2) Liquefactive
3) Fat
4) Gangrenous
5) Caseous
10
Q
Where does coagulative necrosis take place?
A
Kidneys; Heart; Adrenals; Hypoxic environment
11
Q
Where does liquefactive necrosis take place?
A
Brain
12
Q
Where does fat necrosis take place?
A
Pancreas
13
Q
Where does gangrenous necrosis take place?
A
GI tract; Peripheral limb
14
Q
Where does caseous necrosis take place?
A
In TB infection (caseous = granulomatous)
15
Q
What cell type is found at the endocervix?
A
Columnar
16
Q
What cell type is found at the ectocervix?
A
Stratified squamous, non-keratinised
17
Q
What is between the endo- and ecto-cervix?
A
The transformation zone
aka. squamo-columnar junction (SCJ)
- where cervical smears are taken from
18
Q
What cell type is found in the ovaries?
A
Cuboidal
19
Q
What cell type is found in the fallopian tubes and endometrium?
A
Columnar
20
Q
What obstetric phenomenon is of increased prevalence in women with bicornuate uterus?
A
Breech presentation
21
Q
What causes bicornate uterus?
A
Incomplete fusion of the Mulllerian (paramesonephric) ducts
22
Q
What outcomes are associated with a bicornate uterus?
A
Recurrent miscarriage
Breech presentation
Preterm delivery
23
Q
What is uterus didelphus?
A
When there are two entirely separate uterine cavities
24
Q
What is the genotype of a complete molar pregnancy?
A
Usually 46XX (as it usually occurs when a single sperm fuses with a single egg devoid of DNA)
25
What is the commonest cause of acute renal failure?
Acute tubular necrosis
26
What are the pathological features of acute tubular necrosis?
Urinary granular and hyaline casts
27
What is diabetic nephropathy otherwise known as?
Nodular glomerulosclerosis
28
What are the defining pathological features of diabetic nephropathy?
Glomerulus basement membrane thickening
Mesangial sclerosis (impact filtration pressure)
Glomerulosclerosis (renal blood vessel hardening)
29
What is the greatest risk factors for the development of bladder cancer?
Smoking
30
What results from polyarteritis nodosa?
A necrotising transmural inflammation of the small and medium sized arteries resulting in associated microaneurysm formation, tissue infarction and necrosis. Can affect the GIT, kidneys, heart or the liver
31
What infection is associated with polyarteritis nodosa?
Hep B
32
Lung cancer and tumours of the CNS are associated with what paraneoplastic syndrome?
SIADH
33
Small cell lung cancers are associated with what paraneoplastic syndrome?
Cushing's
34
Uterine cancer is associated with what paraneoplastic syndrome?
Acanthosis nigricans
35
Breast cancer is associated with what paraneoplastic syndrome?
Dermatomyositis
36
Renal cancer is associated with what paraneoplastic syndrome?
Polycythaemia
37
Hepatocellular and small cell lung cancers are associated with what paraneoplastic syndrome?
Lambert-Eaton myasthenic syndrome
38
What is a class I haemorrhage?
Up to 15% blood volume loss, approx. 750ml
39
What is a class II haemorrhage?
15-30% blood volume loss
40
What is a class III haemorrhage?
30-40% blood volume loss
41
What is a class IV haemorrhage?
>40% blood volume loss
42
What is the most common inherited thrombophilia?
Factor V Leiden
43
How is the ductus arteriosus in preterm infants treated?
Indomethacin
44
What is used to keep the ductus arteriosis open in children with congenital heart defects awaiting surgery?
Prostaglandin infusion
45
What is the term for a malignancy of mesenchymal origin?
Sarcoma
46
By what route do choriocarcinomas metastasise?
Haematogenous route
47
What is the histological appearance of the endometrium soon after ovulation?
Glands with subnuclear vaculoation in oedematous stroma
48
What is pyknosis?
Shrinkage
49
What is karyorrhexis?
Fragmentation
50
What is autolysis?
Cell death occuring postmortem or after having been removed from the body, as in surgery
51
What are the different types of chemical mediators of inflammation?
1. Histamine
2. Serotonin
3. Prostaglandins
4. Cytokines
5. Kinins
52
From what are kinins produced?
Plasma
53
From what are cytokines produced?
Macrophages
Endothelium
54
From what are prostaglandins produced?
Leucocytes
Platelets
Endothelium
55
From what is serotonin produced?
Platelets
Mast cells
56
From what is histamine produced?
Mast cells
Platelets
57
What are the effects of inflammation?
Rubor - redness
Calor - heat
Dolor - pain
Tumour - swelling
Function Laesa - loss of function
58
What are the theories of the causes of endometriosis?
1. Retorgrade menstruation
2. Vascular dissemination theory - theory that endometrium can travel through blood/lymph vessels
3. Metaplastic theory - whereby peritoneal tissue can turn into endometrium
59
What are the favoured metastasis sites of choriocarcinoma?
Lungs
Vagina
Brain
60
What is a placental site nodule?
When hyalinised nodule of indeterminate type, or placental site trophoblast remains in the endometrial lining, often causing persistent bleeding
61
What is the tumour marker of a placental site trophoblastic tumour?
Human placental lactogen
62
What are the characteristic microscopic findings in a uterus of a woman with pre-eclampsia?
Fibrinoid necrosis of uterine spiral arteries with intramural infiltration of foam cells
63
What is a battledore placenta?
When the umbilical cord insertion point is at the edge rather than the centre of the placenta
64
What is a velamentous insertion of the cord?
When the insertion point of the cord is so far to the edge that it is actually into the membranes
65
What is the precursor lesion of cervical squamous cell carcinoma?
CIN
66
What is the precursor lesion of cervical adenocarcinoma?
CGIN - cervical glandular intraepithelial neoplasia
67
What is a Krukemberg tumour?
A metastatic gastrointestinal neoplasia to the ovaries resulting in bilateral enlargement with infiltrating malignant cells containing intracellular mucin
68
What is classical VIN?
Occurs in younger women, associated with high risk HPV, graded into VIN I, 2, 3
69
What is differentiated VIN?
Occurs in older women, associated with lichen sclerosis, no further grading
70
What is sarcoma botyroides?
Embryonal rhabdomyosarcoma, occurring in children <5 years old - a polypoid mass that fills the vagina and resembles a bunch of grapes
71
Which cell types cannot regenerate?
Myocardium and spinal cord
72
What is the histological appearance of the pancreas in T2DM?
The islets have amyloid infiltration.
73
Which HLA antigens are associated with T1DM?
HLA DR3 and DR4
74
What is the order of anaesthetic for LA administration?
Local anaesthetic agents block first to last
unmyelinated:
C fibres (<1 micrometer)
B fibres (1-3 micrometers)
A fibres (1-20 micrometers)
75
Temperature and pain sensation are carried by which nerve fibres?
Temperature and pain sensation are carried by the small C fibres
76
Proprioception is carried by which nerve fibres?
Proprioception is carried by A-alpha fibres
77
What is the histological change seen in benign ectropion?
Metaplasia
78
What is koilocytosis?
Abnormally large and irregularly shaped nuceli
79
What mediators induce vasodilation?
Histamine
NO
80
Which vessels are affected by vasodilation first?
Arterioles
81
What are the causes of atrophy?
1. Decreased workload
2. Loss of innervation
3. Diminished blood supply
4. Inadequate nutrition
82
What are the hallmarks of cell injury?
1. Decreased oxidative phosphorylation
2. Depleted ATP
3. Cellular swelling
83
What are the different types of cell death?
1. Necrosis - traumatic cell death
2. Apoptosis - programmed cell death
3. Autolysis - non-traumatic cell death occurring through action of the cells own enzymes
84
What is cell death characterised by?
1. Pyknosis - condensation of chromatin
2. Karyorrhexis - fragmentation
3. Karyolysis - dissolution of the nucleus
85
What are the stages of wound healing?
1. Inflammatory - ADP cause thrombus aggregation, cytokine attract macrophages and lymphocytes, histamine increase permeability
2. Proliferative - fibroblasts lay down collagen type 3, angiogenesis and re-epithelialization
3. Remodelling - maturation of collagen from type 3 to type 1, and wound contraction
86
When does a scar become devoid of inflammatory cells?
Week 4
87
What is wound strength at week 1 relative to that of un-wounded skin?
10%
88
What is wound strength at 3 months relative to that of un-wounded skin?
80%
89
Over what time period do scars mature?
2 years
90
What are the different types of mature scar?
1. Atrophic
2. Hypertrophic - excessive scar tissue that doesn't pass beyond the boundaries of the original wound
3. Keloid
91
What promotes good wound healing?
Good blood supply
Vitamin C
Zinc
Protein
Insulin
UV light
92
What inhibits good wound healing?
Glucocorticoids
Infection
Extreme temperatures
93
What is a teratoma?
A neoplasm containing more than one germ cell layer
94
Are teratomas malignant or benign?
Ovarian teratoma = benign
Testicular teratoma = malignant
95
At what size is a tumour radiologically detectable?
10mm
96
Which cancers cannot metastasise?
BCC and gliomas
97
What is the lifetime risk of endometrial cancer/ovarian cancer with HNPCC?
Endometrial - 30-50%
Ovarian - 10%
98
What risk does diethylstilbestrol increase?
Risk of vaginal clear cell carcinoma
99
Which tumour marker is increased in breast cancer?
CA 15-3
100
How is Factor V Leiden inherited?
Autosomal dominant
101
How do platelets change in pregnancy?
Physiological drop in serum platelet levels due to haemodilution, despite increased platelet production
102
What are the ONLY coagulant factors that DON'T increase in pregnancy?
XI and XIII
103
What is Virchow's triad?
1. Endothelial injury
2. Stasis
3. Hypercoagulability
104
What are the genetic hypercoagulable states?
Protein C deficiency
Protein S deficiency
Anti-thrombin III deficiency
Factor V Leiden
105
What are the acquired hypercoagulable states?
Pregnancy
COCP
Antiphospholipid antibodies
Nephrotic syndrome
106
What is the presence of antiphospholipid antibodies in recurrent miscarriage?
15%
107
What is the presence of antiphospholipid antibodies in SLE?
30%
108
What is the mortality rate of amniotic fluid embolism?
60%
109
When are symptoms seen in air embolus?
>100ml of air
110
At what platelet count is regional anaesthesia considered safe?
>80
111
What are the complications of transfusions?
Thrombophlebitis
Infections
Air embolism
Allergic reaction
Haemolytic transfusion reaction
Febrile transfusion reaction
Transfusion related acute lung injury
112
How long is the progression to cancer from CIN?
15 years
113
What proportion of women with endometriosis will be infertile?
40%
114
What is Meig's syndrome?
Characterised by an ovarian tumour - a fibroma-thecoma - a hydrothorax (more common on the right side), and ascites
115
What is the most common symptoms of vulval cancer?
Itching
116
What level of proteinuria indicates SEVERE pre-eclampsia?
Proteinuria >500mg/24hours
117
What does Kleihauer's test measure?
Fetal RBCs in the maternal circulation - normally fetal maternal haemorrhage is <4ml at delivery
