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Meded Path Lectures > Path High Yield > Flashcards

Path High Yield Flashcards

1
Q

Pneuonia with rusty sputum and gram positive diplococci

A

Strep pnuemoniae

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2
Q 
Rose spots (on abdomen), malaise, diarrhoea with blood
Gram negative rods
A

Salmonella Typhi

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3
Q

Spiral flagellated gram negative bacteria

A

Helicobacter Pylori

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4
Q

Which tumour is caused by HHV 8

A

Kaposi’s Sarcoma

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5
Q

Gold standard for Crohn’s

A

Intestinal Biopsy

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6
Q

Recurrent infections, low set ears, cleft palate, murmur

A

Edward’s Syndrome

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7
Q

Tight fingers, raynaud’s, dysphagia, telangiectasia

A

CREST Syndrome

Anti-centromere

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8
Q

Graves’ Antibody

A

Anti TSHr

Anti-TPO

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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

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10
Q

Multiple Myeloma urine finding

A

Bence-Jones proteins

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11
Q

High reticulocyte count
Cancer Hx
Anaemia
Fragmented RBCs on film

A

Microangiopathic Haemolytic Anaemia

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12
Q

Normal calcium
Normal Phosphate
Normal PTH
Very High ALP

A

Paget’s Disease of the bone

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13
Q

Alpha Glucosidase Inhibitor

A

T2DM
Brush border membrane of small bowel
Acarbose

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14
Q

Hypokalaemia Acid Base balance

A

Metabolic Alkalosis

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15
Q

DPP-4 Inhibitors

A

Dipeptidyl Dipeptidase IV

Sitagliptin

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16
Q

Malignant Signet ring cells with mucin in ovaries

A

Signet Ring Adenocarcinoma

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17
Q

Biopsy = Transural Inflammation, Granulomas

A

Crohn’s Disease

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18
Q

Biopsy = Continuous superficial ulceration of the colon

A

Ulcerative Colitis

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19
Q

Colonoscopy = Pouches of mucosa protruding through muscle

A

Diverticular Disease

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20
Q

Abx
D&V
Biopsy = membrane-like composed of mucin, fibrin, polymorphs, debris of leukocytes/epithelial cells

A

Pseudomembranous Colitis

Likely Clostridium. difficile

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21
Q

Meningitis Picture with

CSF = Normal glucose, raised/normal protein, high lymphocytes with no neutrophils/polymorphs

A

Viral Meningitis picture

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22
Q

Ring-enhancing Lesions on brain MRI

A

Cerebral Abscess

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23
Q

Unpasteurised Cheese

A

Listeria monocytogenes

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24
Q

Listeria monocytogenes stain

A

gram positive rods

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25
Q

Strep. pneumoniae stain

A

Gram positive diplococci

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26
Q

Neisseria Gonorrhoeae stain

A

Gram Negative Intracellular diplococci

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27
Q

SLE antibodies

A

Antinuclear Antibodies

Double-stranded DNA antibodies

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28
Q

p-ANCA positive conditions

A

Microscopic Polyangiitis
PSC
Eosinophilic Granulomatosis with Polyangiitis

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29
Q

Primary Biliary Cholangitis antibody

A

anti-mitochondrial antibody

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30
Q

Goodpasture’s Antibody

A

Anti-glomerular basement membrane

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31
Q

Defect in the spectrin molecule on molecular studies

Anaemic

A

Hereditary Spherocytosis

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32
Q

Macrocytic Anaemia

Hypersegmented Neutrophils

A

Pernicious Anaemia

B12 Deficiency/Folate Deficiency

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33
Q

Microcytic Anaemia

A

Iron Deficiency

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34
Q

High Calcium

Inappropriately high/normal PTH

A

Primary Hyperparathyroidism

PT Tumour

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35
Q

Low Calcium

Raised PTH

A

Vitamin D Deficiency

Secondary Hyperparathyroidism

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36
Q

Pigmentation
Low sodium
High potassium
Low Blood pressure

A

Addison’s Disease

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37
Q

Pellagra

A

Niacin (B3) deficiency

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38
Q

Podagra

A

Acute Gout

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39
Q

G6PD Deficiency blood film

A

Heinz Bodies

Inclusions on edge of RBCs

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40
Q

Hyposplenism/splenectomy/sickle cell blood film

A

Howell-Jolly Bodies

Basophilic nuclear remnants in RBC

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41
Q

Multiple Myeloma blood film

A

Rouleaux Formation (cells stacked)

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42
Q

What can cause schistocytes to be seen on blood film?

A

DIC
Haemolytic Uraemic Syndrome
Thrombotic Thrombocytopaenic Purpura
All = Microangiopathic anaemia

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43
Q

What can cause target cells (codocytes) to be seen on blood film?

A

Liver Disease
Hyposplenism
Thalassaemia
IDA

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44
Q

Which condition are post-cricoid webs found in?

A

Plummer-Vinson Syndrome

IDA

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45
Q

Why does anaemia of chronic disease occur in renal failure?

A

EPO deficiency

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46
Q

Which iron marker is high in ACD?

A

Ferritin

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47
Q

What can be seen on blood film in patients with Sideroblastic Anaemia?

A

Ring Sideroblasts

These are erythroid precursors with iron deposited in mitochondria in a ring around the nucleus

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48
Q

People with which condition are susceptible to Parvovirus B19?

A

Hereditary Spherocytosis (spectrin deficiency)

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49
Q

Which form of Hereditary Spherocytosis isn’t autosomal dominant?

A

Hereditary Pyropoikilocytosis

weakness to heat

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50
Q

What can precipitate G6PD deficiency attacks?

A

Drugs, Broad Beans, acute infection

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51
Q

How would you investigate suspected sickle cell disease?

A

Blood Film -> Sickle cells, target cells

Sickle Solubility test

Hb Electrophoresis

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52
Q

What are the clinical features of beta thalassaemia?

A

Skull Bossing
Maxillary Hypertrophy
Hairs on end skull c-ray

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53
Q

What are donath-landsteiner antibodies?

A

Seen in paroxysmal cold haemoglobinuria, they stick to RBCs when cold, then are haemolysed by complement when patient warms

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54
Q

Which antibody types are seen in AI haemolytic anaemis?

A 
Warm = IgG
Cold = IgM
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55
Q

What can cause a coomb’s negative haemolytic anaemis?

A

Paroxysmal Nocturnal Haemoglobinuria

MAHA

Haemolytic Uraemic Syndrome

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56
Q

What causes Haemolytic uraemic syndrome?

A

E. Coli

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57
Q

How is heparin therapy monitored?

A

Activated partial thromboplastin time

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58
Q

Which factor starts the intrinsic pathway?

A

12

APTT

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59
Q

Which factor starts the extrinsic pathway?

A

7

PT

60
Q

Which factor starts the common pathway?

A

5

TT

61
Q

How is warfarin therapy monitored?

A

INR hence PT hence Extrinsic pathway

62
Q

What causes Haemophilia A?

A

Factor VIII deficiency

63
Q

How is Haemophilia A diagnosed?

A

Raised APTT
Normal PT
Lowered Factor VIII assay

64
Q

What causes Haemophilia B?

A

Factor IX Deficiency

65
Q

What does Von Willebrand’s Factor do physiologically?

A

Carries Factor VIII for the Intrinsic pathway

66
Q

Which factors require Vitamin K for their synthesis?

A

II
VII
IX
X

67
Q

Why might warfarin lead to an initial pro-coagulation state?

A

Vitamin K also aids in the synthesis of protein C/S

68
Q

How does heparin work?

A

Potentiates antithrombin III, inactivating thrombin and factors 9,10,11

69
Q

When would you use unfractionated heparin over LMWH?

A

If the patient has renal impairment

Must monitor APTT/anti-Xa/heparin levels

70
Q

Which antibody can cross the placenta?

A

IgG

71
Q

Auer Rods

A

AML

72
Q

Blasts with blebs/tails on blood film

A

ALL

73
Q

Massive splenomegaly
9;22 translocation
BCR-ABL

A

CML

74
Q

Which treatment is typically used first line for CML?

A

Imatinib, a BCR-ABL tyrosine Kinase inhibitor

75
Q

Smear cells on blood film

A

CLL

76
Q

How is CLL staged?

A

Binet Staging A,B,C

A = High WCC, <3 groups of nodes

B = >3 groups of nodes

C= Anaemia/Thrombocytopaenia

77
Q

Bi-nucleate/multinucleate, owl-eyed cells on a background of lymphocytes and reactive cells

A

Reed-Sternberg Cells seen in Hodgkin’s Lymphoma

78
Q

High grade B-cell lymphoma with a ‘starry sky’ appearance

A

Burkitt’s

79
Q

‘Starry sky’ appearance on histology, EBV association, Jaw involvement

A

Endemic Burkitt’s Lymphoma

80
Q

What is the mainline therapy for Burkitt’s Lymhpoma?

A

Rituximab

81
Q

‘Sheets of large lymphoid cells’ on blood film

A

Diffuse Large B-Cell Lymphoma

82
Q

Aggressive lymphoma subtype with ‘angular/clefted nuclei’ on blood film

A

Mantle Cell Lymphoma

83
Q

‘Follicular pattern/nodular appearance’ on blood film

A

Follicular Lymphoma

84
Q

What is MALT?

A

Mucosal associated lymphoid tissue due to chronic antigen stimulation

Gastric = H Pylori 
Parotid = Sjogren's
85
Q

NHL with ‘large epithelioid lymphocytes’

A

Anaplastic Large Cell T-Lymphoma

86
Q

NHL with ‘Large T-Cells’

A

Peripheral T-Cell Lymphoma

87
Q

Which cancer is associated with HTLV-1 infection?

A

Adult T cell leukaemia/lymphoma

88
Q

Which cancer is associated with longstanding coeliac disease?

A

Enteropathy-associated T cell lymphoma

89
Q

Which cancer is associated with mycosis fungoides?

A

Cutaneous T Cell Lymphoma

90
Q 
Hypercalcaemia 
Renal Failure
Anaemia and pancytopaenia 
Bone issues 
Bence-Jones proteins in urine
High ESR
A

Multiple Myeloma

91
Q

What happens in Waldenstrom’s Macroglobinaemia?

A

Lymphoplasmacytoid cells produce monoclonal serum IgM which infiltrate lymph nodes/bone marrow

92
Q

How is systemic amyloidosis diagnosed?

A

Biopsy -> Congo red stain -> apple green birefringence proves presence of misfolded light chains

93
Q

Peripheral Cytopenia
Qualitative abnormalities of cell maturation
AML transfromation

A

Myelodysplastic syndromes

94
Q

Pure red cell aplasia with normal WCC and platelets

A

Diamond-Blackfan Syndrome

95
Q

Autosomal recessive neutrophilia with BM failure

A

Schwachman-Diamond Syndrome

96
Q

Which condition is a JAK2 mutation associated with?

A

Polycythaemia Rubra Vera

97
Q

How is TB stained for?

A

3x Sputum Samples

Ziehl-Neelson Stain

Culture on Lowenstein-Jensen Medium for 6wks

Acid-fast bacilli seen

98
Q

How is TB treated?

A

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

All for 2m
R/I for 2 more

99
Q

Which vaccine is used for TB?

A

Bacille-Calmette-Guerin

100
Q

Gram negative cocco-bacilli pneumonia

A

Haemophilus influenzae

101
Q

Gram negative cocci pneumonia

A

Moraxella catarrhalis

102
Q

Gram positive cocci in ‘grape bunch clusters’ pneumonia

A

Staph aureus

103
Q

-ve rod enterobacter seen in pneumonia in alcoholics and the elderly

A

Klebsiella pneumoniae

104
Q

Ground Glass appearance
Orphan Annie Nuclei
Psammoma bodies (calcified spherical bodies)

A

Papillary Thyroid Cancer
Most Common
Good prognosis

105
Q

Osteomyelitis causes in Sickle Cell?

A

Salmonella enteritides > Staph aureus

106
Q

Antibiotic for shigella?

A

Ciprofloxacin

107
Q

Reheated rice bacteria

A

Bacillus cereus

108
Q

BV management

A

Metronidazole

109
Q

Cat scratch disease

A

Bartonella henselae

110
Q

Dental abscess IE

A

Strep viridans

111
Q

Pneumocystis jirovecii treatment

A

Co-trimoxazole

112
Q

Traveller - Sudden onset fever, headache, pain behind eyes, nausea, vomiting, arthralgia.

Maculopapular rash over face and flexors

Low plt, Low WCC, raised alt/ast

A

Dengue Fever

113
Q

Congo red stain?

A

Apple green birefringence indicates positive test for amyloid deposits

114
Q

Fontana stain?

A

Positive test indicates melanin presence

115
Q

Prussian blue stain?

A

+ve test indicates iron deposition, as seen in haemochromatosis

116
Q 
Skip Lesions
Cobblestone Appearance 
Aphthous Ulcer
Rosethorn Ulcers
Non-caseating granulomas
A

Crohn’s Disease

117
Q

Which cells do carcinoid tumours originate from?

A

Enterochromaffin, hence secrete 5-HT

118
Q

How would you investigate suspected Carcinoid syndrome?

A

24h Urine 5-HIAA, a main metabolite of serotonin

119
Q

What is Peutz-Jegher’s Syndrome?

A

Autosomal Dominant condition where an LKB1 mutation leads to multiple colon polyps, hyperpigmentation, mouth/palm/sole freckles

120
Q

Which cancer subtype is colorectal cancer most commonly found to be?

A

Adenocarcinoma

121
Q

What causes Familial Adenomatous Polyposis?

A

Autosomal dominant mutation in APC gene
Leads to 100s/1000s of polyps that invariably lead to adenocarcinoma formati
on within 30 years.

122
Q

How is Gardner’s Syndrome different from FAP?

A

Also displays extra-intestinal features, such as osteomas and dental caries

123
Q

What can cause acute pancreatitis?

A

I GET SMASHED
Idiopathic

Gallstones, Ethanol, Trauma

Steroids, Mumps, Autoimmune, Scorpions, Hyperlipidaemia, ERCP, Drugs (Thiazides)

124
Q

What is the tumour marker for pancreatic carcinoma?

A

CA 19-9

125
Q

What are neuroendocrine tumours?

A

Islet cell pancreatic tumours, primarily in the body/tail

May be functional or non-functional

126
Q

What are neuroendocrine tumours?

A

Islet cell pancreatic tumours, primarily in the body/tail

May be functional or non-functional

127
Q

What are some examples of functional neuroendocrine tumours?

A

Insulinoma
Gastrinoma (Zollinger-Ellison = high acid output)
VIPoma - Diarrhoea
Glucagonoma

128
Q

How are neuroendocrine tumours structured?

A

Cells arranged in nests or trabeculae with granular cytoplasm

129
Q

What are the features of MEN 1?

A

PPP
Parathyroid Hyperplasia/Adenoma
Pancreatic Endocrine Tumour (can be phaeochromocytoma)
Pituitary Adenoma

130
Q

What are the features of MEN 2A?

A

Parathyroid hyperplasia/adenoma
Thyroid Tumours
Phaeochromocytoma

131
Q

What are the features of MEN 2B?

A

Medullary Thyroid Tumour
Phaeochromocytoma
Neuromas
Marfinoid Phenotype

132
Q

Histopathology shows Spotty necrosis?

A

Acute Hepatitis

Small foci of inflammation and infiltrates

133
Q 
Histopathology shows: 
Portal Inflammation 
Peicemeal necrosis 
Lobular Inflammation 
Portal to Central vein bridging
A

Chronic Hepatitis

134
Q

What is Peicemeal Necrosis?

A

Can’t see the border between the portal tract and parenchyma

Seen in Chronic Hepatitis

‘Interface Hepatitis”

135
Q

Describe the histopathology of a cirrhosed liver

A

Hepatocyte Necrosis
Fibrosis
Nodules of regenerating hepatocytes
Disturbance of vascular architecture

136
Q

How is prognosis in liver cirrhosis calculated?

A

Modified Child’s Pugh Score

Takes into account Albumin, Bilirubin, Prothrombin Time, Ascites and Encephalopathy

137
Q

What are the microscopic characteristics of hepatic steatosis?

A

Steatosis (yellow fat droplets in cells)

Chronic = Fibrosis

138
Q

What are the microscopic characteristics of alcoholic hepatitis?

A

Hepatocyte Ballooning and necrosis
Mallory Denk Bodies (inclusion into hepatocyte cytoplasm)
Fibrosis

139
Q

What are the microscopic characteristics of alcoholic cirrhosis?

A

Micronodular cirrhosis

Small nodules and bands of fibrous tissues

140
Q

Which immunoglobulins are implicated in Type 1 Autoimmune hepatitis?

A

Anti-Nuclear
Anti-Smooth Muscle
Anti-actin Ig
Anti-Soluble liver antigen

141
Q

Which immunoglobulins are implicated in type 2 Autoimmune Hepatitis?

A

Anti-liver-kidney-microsomal

142
Q

Describe the pathophysiology of Primary Biliary Cholangitis

A

Autoimmune inflammatory destruction of medium sized intrahepatic bile ducts leading to cholestasis and slow development of cirrhosis over years.

143
Q

Which antibodies are seen in PBC?

A

Anti-mitochondrial

144
Q

Blood test results in PBC

A

High ALP
High Cholesterol
High IgM
Hyperbilirubinaemia (late)

145
Q

What is Primary Sclerosing Cholangitis?

A

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
Q

PSC Histology?

A

Onion skinning fibrosis

Concentric Fibrosis

Meded Path Lectures (15 decks)

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