Path High Yield Flashcards
1
Q
Pneuonia with rusty sputum and gram positive diplococci
A
Strep pnuemoniae
2
Q
Rose spots (on abdomen), malaise, diarrhoea with blood Gram negative rods
A
Salmonella Typhi
3
Q
Spiral flagellated gram negative bacteria
A
Helicobacter Pylori
4
Q
Which tumour is caused by HHV 8
A
Kaposi’s Sarcoma
5
Q
Gold standard for Crohn’s
A
Intestinal Biopsy
6
Q
Recurrent infections, low set ears, cleft palate, murmur
A
Edward’s Syndrome
7
Q
Tight fingers, raynaud’s, dysphagia, telangiectasia
A
CREST Syndrome
Anti-centromere
8
Q
Graves’ Antibody
A
Anti TSHr
Anti-TPO
9
Q
Ann Arbor Staging
A
1 - Single Lymph Node
2 - Multiple nodes on same side of diaphragm
3- Multiple nodes on both sides of the diaphragm
4- Extra-nodal spread
A - Symptomless
B - B symptoms
For Lymphoma
10
Q
Multiple Myeloma urine finding
A
Bence-Jones proteins
11
Q
High reticulocyte count
Cancer Hx
Anaemia
Fragmented RBCs on film
A
Microangiopathic Haemolytic Anaemia
12
Q
Normal calcium
Normal Phosphate
Normal PTH
Very High ALP
A
Paget’s Disease of the bone
13
Q
Alpha Glucosidase Inhibitor
A
T2DM
Brush border membrane of small bowel
Acarbose
14
Q
Hypokalaemia Acid Base balance
A
Metabolic Alkalosis
15
Q
DPP-4 Inhibitors
A
Dipeptidyl Dipeptidase IV
Sitagliptin
16
Q
Malignant Signet ring cells with mucin in ovaries
A
Signet Ring Adenocarcinoma
17
Q
Biopsy = Transural Inflammation, Granulomas
A
Crohn’s Disease
18
Q
Biopsy = Continuous superficial ulceration of the colon
A
Ulcerative Colitis
19
Q
Colonoscopy = Pouches of mucosa protruding through muscle
A
Diverticular Disease
20
Q
Abx
D&V
Biopsy = membrane-like composed of mucin, fibrin, polymorphs, debris of leukocytes/epithelial cells
A
Pseudomembranous Colitis
Likely Clostridium. difficile
21
Q
Meningitis Picture with
CSF = Normal glucose, raised/normal protein, high lymphocytes with no neutrophils/polymorphs
A
Viral Meningitis picture
22
Q
Ring-enhancing Lesions on brain MRI
A
Cerebral Abscess
23
Q
Unpasteurised Cheese
A
Listeria monocytogenes
24
Q
Listeria monocytogenes stain
A
gram positive rods
25
Strep. pneumoniae stain
Gram positive diplococci
26
Neisseria Gonorrhoeae stain
Gram Negative Intracellular diplococci
27
SLE antibodies
Antinuclear Antibodies
| Double-stranded DNA antibodies
28
p-ANCA positive conditions
Microscopic Polyangiitis
PSC
Eosinophilic Granulomatosis with Polyangiitis
29
Primary Biliary Cholangitis antibody
anti-mitochondrial antibody
30
Goodpasture's Antibody
Anti-glomerular basement membrane
31
Defect in the spectrin molecule on molecular studies
| Anaemic
Hereditary Spherocytosis
32
Macrocytic Anaemia
| Hypersegmented Neutrophils
Pernicious Anaemia
| B12 Deficiency/Folate Deficiency
33
Microcytic Anaemia
Iron Deficiency
34
High Calcium
| Inappropriately high/normal PTH
Primary Hyperparathyroidism
| PT Tumour
35
Low Calcium
| Raised PTH
Vitamin D Deficiency
| Secondary Hyperparathyroidism
36
Pigmentation
Low sodium
High potassium
Low Blood pressure
Addison's Disease
37
Pellagra
Niacin (B3) deficiency
38
Podagra
Acute Gout
39
G6PD Deficiency blood film
Heinz Bodies
| Inclusions on edge of RBCs
40
Hyposplenism/splenectomy/sickle cell blood film
Howell-Jolly Bodies
| Basophilic nuclear remnants in RBC
41
Multiple Myeloma blood film
Rouleaux Formation (cells stacked)
42
What can cause schistocytes to be seen on blood film?
DIC
Haemolytic Uraemic Syndrome
Thrombotic Thrombocytopaenic Purpura
All = Microangiopathic anaemia
43
What can cause target cells (codocytes) to be seen on blood film?
Liver Disease
Hyposplenism
Thalassaemia
IDA
44
Which condition are post-cricoid webs found in?
Plummer-Vinson Syndrome
| IDA
45
Why does anaemia of chronic disease occur in renal failure?
EPO deficiency
46
Which iron marker is high in ACD?
Ferritin
47
What can be seen on blood film in patients with Sideroblastic Anaemia?
Ring Sideroblasts
| These are erythroid precursors with iron deposited in mitochondria in a ring around the nucleus
48
People with which condition are susceptible to Parvovirus B19?
Hereditary Spherocytosis (spectrin deficiency)
49
Which form of Hereditary Spherocytosis isn't autosomal dominant?
Hereditary Pyropoikilocytosis
| weakness to heat
50
What can precipitate G6PD deficiency attacks?
Drugs, Broad Beans, acute infection
51
How would you investigate suspected sickle cell disease?
Blood Film -> Sickle cells, target cells
Sickle Solubility test
Hb Electrophoresis
52
What are the clinical features of beta thalassaemia?
Skull Bossing
Maxillary Hypertrophy
Hairs on end skull c-ray
53
What are donath-landsteiner antibodies?
Seen in paroxysmal cold haemoglobinuria, they stick to RBCs when cold, then are haemolysed by complement when patient warms
54
Which antibody types are seen in AI haemolytic anaemis?
```
Warm = IgG
Cold = IgM
```
55
What can cause a coomb's negative haemolytic anaemis?
Paroxysmal Nocturnal Haemoglobinuria
MAHA
Haemolytic Uraemic Syndrome
56
What causes Haemolytic uraemic syndrome?
E. Coli
57
How is heparin therapy monitored?
Activated partial thromboplastin time
58
Which factor starts the intrinsic pathway?
12
| APTT
59
Which factor starts the extrinsic pathway?
7
| PT
60
Which factor starts the common pathway?
5
| TT
61
How is warfarin therapy monitored?
INR hence PT hence Extrinsic pathway
62
What causes Haemophilia A?
Factor VIII deficiency
63
How is Haemophilia A diagnosed?
Raised APTT
Normal PT
Lowered Factor VIII assay
64
What causes Haemophilia B?
Factor IX Deficiency
65
What does Von Willebrand's Factor do physiologically?
Carries Factor VIII for the Intrinsic pathway
66
Which factors require Vitamin K for their synthesis?
II
VII
IX
X
67
Why might warfarin lead to an initial pro-coagulation state?
Vitamin K also aids in the synthesis of protein C/S
68
How does heparin work?
Potentiates antithrombin III, inactivating thrombin and factors 9,10,11
69
When would you use unfractionated heparin over LMWH?
If the patient has renal impairment
Must monitor APTT/anti-Xa/heparin levels
70
Which antibody can cross the placenta?
IgG
71
Auer Rods
AML
72
Blasts with blebs/tails on blood film
ALL
73
Massive splenomegaly
9;22 translocation
BCR-ABL
CML
74
Which treatment is typically used first line for CML?
Imatinib, a BCR-ABL tyrosine Kinase inhibitor
75
Smear cells on blood film
CLL
76
How is CLL staged?
Binet Staging A,B,C
A = High WCC, <3 groups of nodes
B = >3 groups of nodes
C= Anaemia/Thrombocytopaenia
77
Bi-nucleate/multinucleate, owl-eyed cells on a background of lymphocytes and reactive cells
Reed-Sternberg Cells seen in Hodgkin's Lymphoma
78
High grade B-cell lymphoma with a 'starry sky' appearance
Burkitt's
79
'Starry sky' appearance on histology, EBV association, Jaw involvement
Endemic Burkitt's Lymphoma
80
What is the mainline therapy for Burkitt's Lymhpoma?
Rituximab
81
'Sheets of large lymphoid cells' on blood film
Diffuse Large B-Cell Lymphoma
82
Aggressive lymphoma subtype with 'angular/clefted nuclei' on blood film
Mantle Cell Lymphoma
83
'Follicular pattern/nodular appearance' on blood film
Follicular Lymphoma
84
What is MALT?
Mucosal associated lymphoid tissue due to chronic antigen stimulation
```
Gastric = H Pylori
Parotid = Sjogren's
```
85
NHL with 'large epithelioid lymphocytes'
Anaplastic Large Cell T-Lymphoma
86
NHL with 'Large T-Cells'
Peripheral T-Cell Lymphoma
87
Which cancer is associated with HTLV-1 infection?
Adult T cell leukaemia/lymphoma
88
Which cancer is associated with longstanding coeliac disease?
Enteropathy-associated T cell lymphoma
89
Which cancer is associated with mycosis fungoides?
Cutaneous T Cell Lymphoma
90
```
Hypercalcaemia
Renal Failure
Anaemia and pancytopaenia
Bone issues
Bence-Jones proteins in urine
High ESR
```
Multiple Myeloma
91
What happens in Waldenstrom's Macroglobinaemia?
Lymphoplasmacytoid cells produce monoclonal serum IgM which infiltrate lymph nodes/bone marrow
92
How is systemic amyloidosis diagnosed?
Biopsy -> Congo red stain -> apple green birefringence proves presence of misfolded light chains
93
Peripheral Cytopenia
Qualitative abnormalities of cell maturation
AML transfromation
Myelodysplastic syndromes
94
Pure red cell aplasia with normal WCC and platelets
Diamond-Blackfan Syndrome
95
Autosomal recessive neutrophilia with BM failure
Schwachman-Diamond Syndrome
96
Which condition is a JAK2 mutation associated with?
Polycythaemia Rubra Vera
97
How is TB stained for?
3x Sputum Samples
Ziehl-Neelson Stain
Culture on Lowenstein-Jensen Medium for 6wks
Acid-fast bacilli seen
98
How is TB treated?
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
All for 2m
R/I for 2 more
99
Which vaccine is used for TB?
Bacille-Calmette-Guerin
100
Gram negative cocco-bacilli pneumonia
Haemophilus influenzae
101
Gram negative cocci pneumonia
Moraxella catarrhalis
102
Gram positive cocci in 'grape bunch clusters' pneumonia
Staph aureus
103
-ve rod enterobacter seen in pneumonia in alcoholics and the elderly
Klebsiella pneumoniae
104
Ground Glass appearance
Orphan Annie Nuclei
Psammoma bodies (calcified spherical bodies)
Papillary Thyroid Cancer
Most Common
Good prognosis
105
Osteomyelitis causes in Sickle Cell?
Salmonella enteritides > Staph aureus
106
Antibiotic for shigella?
Ciprofloxacin
107
Reheated rice bacteria
Bacillus cereus
108
BV management
Metronidazole
109
Cat scratch disease
Bartonella henselae
110
Dental abscess IE
Strep viridans
111
Pneumocystis jirovecii treatment
Co-trimoxazole
112
Traveller - Sudden onset fever, headache, pain behind eyes, nausea, vomiting, arthralgia.
Maculopapular rash over face and flexors
Low plt, Low WCC, raised alt/ast
Dengue Fever
113
Congo red stain?
Apple green birefringence indicates positive test for amyloid deposits
114
Fontana stain?
Positive test indicates melanin presence
115
Prussian blue stain?
+ve test indicates iron deposition, as seen in haemochromatosis
116
```
Skip Lesions
Cobblestone Appearance
Aphthous Ulcer
Rosethorn Ulcers
Non-caseating granulomas
```
Crohn's Disease
117
Which cells do carcinoid tumours originate from?
Enterochromaffin, hence secrete 5-HT
118
How would you investigate suspected Carcinoid syndrome?
24h Urine 5-HIAA, a main metabolite of serotonin
119
What is Peutz-Jegher's Syndrome?
Autosomal Dominant condition where an LKB1 mutation leads to multiple colon polyps, hyperpigmentation, mouth/palm/sole freckles
120
Which cancer subtype is colorectal cancer most commonly found to be?
Adenocarcinoma
121
What causes Familial Adenomatous Polyposis?
Autosomal dominant mutation in APC gene
Leads to 100s/1000s of polyps that invariably lead to adenocarcinoma formati
on within 30 years.
122
How is Gardner's Syndrome different from FAP?
Also displays extra-intestinal features, such as osteomas and dental caries
123
What can cause acute pancreatitis?
I GET SMASHED
Idiopathic
Gallstones, Ethanol, Trauma
Steroids, Mumps, Autoimmune, Scorpions, Hyperlipidaemia, ERCP, Drugs (Thiazides)
124
What is the tumour marker for pancreatic carcinoma?
CA 19-9
125
What are neuroendocrine tumours?
Islet cell pancreatic tumours, primarily in the body/tail
| May be functional or non-functional
126
What are neuroendocrine tumours?
Islet cell pancreatic tumours, primarily in the body/tail
| May be functional or non-functional
127
What are some examples of functional neuroendocrine tumours?
Insulinoma
Gastrinoma (Zollinger-Ellison = high acid output)
VIPoma - Diarrhoea
Glucagonoma
128
How are neuroendocrine tumours structured?
Cells arranged in nests or trabeculae with granular cytoplasm
129
What are the features of MEN 1?
PPP
Parathyroid Hyperplasia/Adenoma
Pancreatic Endocrine Tumour (can be phaeochromocytoma)
Pituitary Adenoma
130
What are the features of MEN 2A?
Parathyroid hyperplasia/adenoma
Thyroid Tumours
Phaeochromocytoma
131
What are the features of MEN 2B?
Medullary Thyroid Tumour
Phaeochromocytoma
Neuromas
Marfinoid Phenotype
132
Histopathology shows Spotty necrosis?
Acute Hepatitis
| Small foci of inflammation and infiltrates
133
```
Histopathology shows:
Portal Inflammation
Peicemeal necrosis
Lobular Inflammation
Portal to Central vein bridging
```
Chronic Hepatitis
134
What is Peicemeal Necrosis?
Can't see the border between the portal tract and parenchyma
Seen in Chronic Hepatitis
'Interface Hepatitis"
135
Describe the histopathology of a cirrhosed liver
Hepatocyte Necrosis
Fibrosis
Nodules of regenerating hepatocytes
Disturbance of vascular architecture
136
How is prognosis in liver cirrhosis calculated?
Modified Child's Pugh Score
| Takes into account Albumin, Bilirubin, Prothrombin Time, Ascites and Encephalopathy
137
What are the microscopic characteristics of hepatic steatosis?
Steatosis (yellow fat droplets in cells)
| Chronic = Fibrosis
138
What are the microscopic characteristics of alcoholic hepatitis?
Hepatocyte Ballooning and necrosis
Mallory Denk Bodies (inclusion into hepatocyte cytoplasm)
Fibrosis
139
What are the microscopic characteristics of alcoholic cirrhosis?
Micronodular cirrhosis
| Small nodules and bands of fibrous tissues
140
Which immunoglobulins are implicated in Type 1 Autoimmune hepatitis?
Anti-Nuclear
Anti-Smooth Muscle
Anti-actin Ig
Anti-Soluble liver antigen
141
Which immunoglobulins are implicated in type 2 Autoimmune Hepatitis?
Anti-liver-kidney-microsomal
142
Describe the pathophysiology of Primary Biliary Cholangitis
Autoimmune inflammatory destruction of medium sized intrahepatic bile ducts leading to cholestasis and slow development of cirrhosis over years.
143
Which antibodies are seen in PBC?
Anti-mitochondrial
144
Blood test results in PBC
High ALP
High Cholesterol
High IgM
Hyperbilirubinaemia (late)
145
What is Primary Sclerosing Cholangitis?
Inflammation and obliterative fibrosis of extrahepatic and intrahepatic bile ducts leads to multi-focal stricture formation with dilation of preserved segments
Associated with cholangiocarcinoma, p-ANCA
146
PSC Histology?
Onion skinning fibrosis
| Concentric Fibrosis
