Pathology 1

Question 1

large volume of glandular epithelium with a marked increase in cell number and a low nuclear to cytoplasmic ratio describes what process?

Answer 1

hyperplasia

(increase in cell number but cells are not atypical

Question 2

sign of abnormal glands?

Answer 2

glands are usually round
if there are too many cells squeezing into the lining of the gland the glands are thrown into folds causing a star shaped appearance

Question 3

examples of hyperplastic conditions

Answer 3

prostate hyperplasia
G cell hyperplasia in the stomach (happens in PPI therapy as -ve feedback is turned off stimulating gastrin release)
thyroid hyperplasia (graves disease)

Question 4

hypertrophy is commonly seen in which conditions?

Answer 4

skeletal muscle (body building)
cardiac muscle (LV hypertrophy)

Question 5

what is dysplasia?

Answer 5

benign abnormal growth of cell

basically means that the cell DNA has begun to accumulate mutations but hasnt yet developed the ability to invade

Question 6

what is metaplasia?

Answer 6

reversible change from one mature cell type to another mature cell type in response to a stimulus

Question 7

examples of metaplasia?

Answer 7

squamous metaplasia in resp tract (precursor to squamous cell carcinoma)
barrets oesophagus (change from stratified squamous to columnar epithelium with goblet cells)

Question 8

risk factors for endometrial carcinoma

Answer 8

age
larger lifetime exposure to oestrogen
obesity (adipose tissue produces oestrogen)

Question 9

what is lynch syndrome?

Answer 9

HNPCC
type of microsatellite instability causing abnormalities of DNA mismatch repair proteins
results in increased colorectal, endometrial and TCC (bladder and ureteric) cancer

Question 10

how can lynch syndrome be tested for?

Answer 10

detect microsatellite instability which is a marker for an error in mismatch repair proteins
once detected the genes can then be sequenced and look at the expression of the proteins using immunohistochemistry

Question 11

examples of encoded proteins in lynch syndrome which can be mutated?

Answer 11

MLH1
MLH3
MSH2
PMS1
PMS2

Question 12

what is a leiomyoma?

Answer 12

benign neoplasm of smooth muscle

connective tissue tumour consisting of spindle cells

Question 13

growth of leiomyomas are dependant on what?

Answer 13

oestrogen

therefore most commonly arise between menarche and menopause

Question 14

locations of leiomyosarcoma?

Answer 14

arise submucosally and project into the lumen
often in uterine smooth muscle causing bleeding and infertility
can also be intramural, subserosal and pedunculated

Question 15

what is CGIN?

Answer 15

cervical glandular intraepithelial neoplasia

type of squamous abnormality in the cervix

Question 16

what does koilocytic change indicate on a cervical smear?

Answer 16

HPV infection

koilocytic change = irregular nuclei with binucleate forms and a perinuclear halo

Question 17

CIN 1/2/3?

Answer 17

1 = koilocytosis seen throughout full thickness but genuine dysplasia only in lower 1/3
2 = dysplasia into middle 1/3
3 = dysplasia full thickness

Question 18

most common type of ovarian cyst?

Answer 18

simple cyst (e.g follicular cyst, luteal cyst)

Question 19

categories of ovarian lesion

Answer 19

epithelial (most common)
germ cell (2nd most common)
sex cord/stromal
metastases to ovary (krukenberg)
neuroectodermal

Question 20

types of epithelial ovarian lesion

Answer 20

serous tumour
mucinour tumour
endometroid tumour
cystadenocarcinoma
uncommon types

Question 21

types of germ cell ovarian lesion

Answer 21

teratoma
dysgerminoma
uncommon types

Question 22

types of sex cord/stromal lesion?

Answer 22

fibroma
granulosa-theca cell tumour
sertoli-leydig cell tumour

Question 23

which cancers commonly metastasise to the ovary?

Answer 23

breast
lung
colon
other sites

Question 24

germ cell tumours such as teratomas can develop into what?

Answer 24

endodermal, ectodermal or mesodermal components

Question 25

types of germ cell tumour?

Answer 25

trophoblastic tumours
dysgerminomas
choriocarcinoma
yolk sac tumour

Question 26

which inflammatory cells are most consistent with a reaction to a foreign material?

Answer 26

macrophage

Question 27

name 4 things which can cause high HCG in pregnancy?

Answer 27

twin pregnancy
molar pregnancy
choriocarcinoma
ovarian germ cell tumours