Pathology Flashcards
Coomb’s test: direct vs indirect (how it works)
Direct: detects antibodies bound to RBC surface antigens, indicating immune mediated attack on RBC
Indirect: detects antibodies against RBCs present in patient’s serum (used for antibody screening)
Either is positive if agglutination occurs
Trichomonas: how many flagellum and where?
4 anterior, 1 posterior
First line treatment for HMB
LNG IUS (mirena) levonorgestrel releasing intrauterine system
Percentage of those who get VZV that develop pneumonitis?
<1%
Percentage risk of endometrial cancer with Lynch syndrome
40-60%
Type of ovarian cancer that is associated with mismatch repair deficiency (MMRD)
Clear cell carcinoma of ovary (rare subtype of epithelial ovarian ca.)
Post CS- absorbable sutures, nodule in stitch line, type of cell for inflammation here
Giant cell (Langerhan)
Management of HIV in pregnancy re: medications/ timing of commencing based on viral load/ CD4 counts
All women not on HAART (highly active anti-retroviral therapy) should commence:
* As soon as they are able to do so in the second trimester where the baseline viral load ≤30,000 HIV RNA copies/mL;
* At the start of the second trimester, or as soon as possible thereafter, in women with a baseline viral load of 30,000–100,000 HIV RNA copies/mL;
* Within the first trimester if viral load >100,000 HIV RNA copies/mL and/or CD4 cell count is less than 200 cells/mm3.
All women should have commenced cART by week 24 of pregnancy.
Subtype of lichen planus that causes painful ulceration
Erosive lichen Planus
Cells of Brenner Tumour
Epithelial stromal tumour; transitional epithelial cells with longitudinal nuclear grooves (coffee bean nuclei), lying in abundant fibrous storm
Most common type of Fallopian tube cancer
Epithelial (serous adenocarcinoma)
What is a keratin pearl in a vulval ulcer suggestive of?
Squamous cell carcinoma (vulval cancer)
Pathophysiology of bacterial vaginosis (bacteria)
Variable degrees of depletion of protective Lactobacillus species. Marked increase in other organisms especially anaerobes: Gardnella vaginalis, Mobincullus, Atopobium vaginale, mycoplasma, bacteroides
General risks of anti-epileptic drugs during pregnancy?
Increased risk of teratogenicity 3x.
Associated with NTDs, cleft lip/ palate, cardiac defects, urogenital defects, neonatal coagulopathies
Which AED has the worst teratogenic profile?
Valproate
Which AEDs are in the FDA pregnancy category D?
Valproate, carbamazepine, phenytoin
Which AEDs are in the FDA pregnancy category C?
Lamotrigine, topiramate, vigabatrin
Which AEDs are in the FDA pregnancy category B?
Levetiracetam, gabapentin
Organism causing gonorrhoea (name and appearance)
Neisseria gonorrhoeae: gram negative intracellular diplococci
Most common tumour of female urethra
TCC
Pathophysiology of Grave’s disease
Autoantibodies to the thyrotropin receptor (TRAb) that activate the receptor, thereby stimulating thyroid hormone synthesis and secretion as well as thyroid growth
Most common cause of hyperprolactinaemia
Pituitary microadenoma
Fevers, headache, lymphadenopathy, CMV IgG positive, IgM negative
Previous CMV infection.
IgM antibodies are produced by the body first in response to a CMV infection. They can be detected in the blood within a week or two after the initial exposure. IgM levels (titers) rise for a short time, then decline and usually fall below detectable levels after a few months. IgM antibody levels rise again when latent CMV is reactivated.
IgG antibodies are produced several weeks after the initial CMV infection. IgG levels rise during the active infection, then stabilize as the CMV infection resolves and the virus becomes inactive. Once exposed to CMV, you will have some measurable amount of CMV IgG antibody in your blood for the rest of your life, which provides protection from getting another primary infection (immunity).
Lung cancer, abdo pain, polyuria & hypercalcaemia
PTHrp produced by squamous cell lung cancer
Risk of miscarriage with amniocentesis
1%
Abe for UTI contraindicated in 3rd trimester/ close to term
Nitrofurantoin (risk of neonatal haemolysis)
Arias Stella reaction
An Arias-Stella reaction is a common gynaecological histological finding in curettage specimens of gestational endometrium describing a non-neoplastic lesion that is easily confused with uterine malignancy.
An Arias-Stella reaction is due to hormonal hyperstimulation causing atypical endometrial glandular cells associated with the presence of viable chorionic tissue
It can present in normal physiologic conditions including pregnancy, postpartum and uterine abortion but is also associated with ectopic pregnancy, gestational trophoblastic disease, and uterine disease affecting the myometrium.
RMI
Combines ultrasound, menopausal status and ca125
RMI = (U) x (M) x Ca125
U- scores 1 point for each of the following characteristics: multilocular cysts, solid areas, metastases, ascites, bilateral lesions.
U = 0 (for an ultrasound score of 0), U = 1 (for an ultrasound score of 1), U = 3 (for an ultrasound score of 2 to 5)
M- premenopausal = 1, post-menopausal = 3 (women without period for 1 year or age >50 and hysterectomy)
If >200, discuss with gynaecological oncologist
How is melanoma prognosis assessed?
Breslow thickness (depth of lesion)
Which malaria parasite is the most dangerous?
P. falciparum
And most prevalent on African continent
PCOS biochemical markers
Increased insulin, decreased SHBG, high testosterone, high LH/oestrogen/ FSH, high prolactin (in 40% -caused by high estradiol)
Features of neonatal herpes
Localized skin infection
Encephalitis
Disseminated herpes infection— the most dangerous type. The virus is spread throughout the body and can affect multiple organs, including the liver, brain, lungs, and kidney.
Pregnant woman contracted CMV in 2nd trimester. Risk of neonatal congenital infection?
30-40% in 1st/2nd trimester
40-70% in 3rd
