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Y3 TRANSITION > Pathology > Flashcards

Pathology Flashcards

1
Q

What does VINDICATE stand for?

A 
All problems must fit into one of these:
Vascular
Infectious/inflammatory
Neoplastic
Drugs/toxins
Intervention/iatrogenic
Congenital/developmental
Autoimmune
Trauma
Endocrine/metabolic
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2
Q

Define hypertrophy

A

Increase in cell size e.g. muscle growth

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3
Q

Define hyperplasia

A

Increase in cell number e.g. BPH, thyroid, in response to a stimulus

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4
Q

Define dysplasia. Is it benign or malignant?

A

Presence of abnormal cell growth e.g. cervix, breast

Pre-malignant phase (not reached the basement membrane)

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5
Q

Define metaplasia

A

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

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6
Q

Define anaplasia

A

Poorly differentiated cells

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7
Q

Define neoplasia

A

Presence or formation of new, abnormal growth of tissue in the absence of a stimulus

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8
Q

There is a marked increase in cell number, large volume of glandular epithelium and low nucleus to cytoplasm ratio. What cell process is this?

A

Hyperplasia

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9
Q

Barret’s oesophagus is a metaplastic change. It represents the change from _______ epithelium to _____ epithelium.

A

Squamous cell epithelium

Columnar cell epithelium

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10
Q

What is Lynch syndrome?

A

Hereditary non-polyposis colorectal cancer (HNPCC) is a type of inherited cancer syndrome associated with a genetic predisposition to different cancer types, associated with mismatch repair and microsatellite instability

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11
Q

List clinical features pointing to a diagnosis of Lynch syndrome

A

Family history of endometrial cancer, colorectal cancer (usually right-sided) and bladder cancer

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12
Q

A post-menopausal women with a low BMI is likely to have endometrial hyperplasia. True/False?

A

False

She has low oestrogen which is a stimulus for endometrial hyperplasia

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13
Q

List risk factors for endomerial cancer

A

Age
Obesity
Exposure to unopposed oestrogen (early menarche, late menopause, low pariety, PCOS, HRT)
Lynch syndrome

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14
Q

23 year old female with heavy periods, occasional IMB with non-specific pelvic pain. Histology confirms a leimyoma. They are an example of a metaplastic/dysplastic/neoplastic change

A

Leiomyomas are an example of a neoplastic change.

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15
Q

Leiomyomas can become malignant. True/False?

A

True (but rarely)

Leimyomas can change into leimyosarcomas in 0.1% of case

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16
Q

24 year old female with post-coital bleeding. Smokes 30 a day and drinks regularly at weekends. What is CGIN?

A

Cervical glandular intra-epithelial neoplasia, a high-grade glandular abnormality

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17
Q

CIN 1 is a ___ grade squamous abnormality

A

CIN 1 is a low grade squamous abnormality

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18
Q

CIN 3 is a ___ grade squamous abnormality

A

CIN 3 is a high grade squamous abnormality

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19
Q

What is dyskaryosis?

A

Change of appearance in cells that cover the surface of the cervix

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20
Q

Outline the management of severe dykaryosis

A

Colposcopy

LLETZ (loop diathermy)

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21
Q

What is koilocyte?

A

A squamous epithelial cell that has been infected by HPV

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22
Q

How are CIN 1-3 classified?

A

Invasion of the basement membrane

CIN1 (basal third of epithelium), to CIN3 (full thickness invasion)

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23
Q

27 year old underwent appendectomy where an incidental ovarian cyst was identified, which was removed. What is the likely diagnosis?

A

An epithelial lesion

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24
Q

List types of ovarian tumours

A 
Epithelial (mucinous, serous, endometriod, clear cell, transitional cell)
Germ cell (dysgerminoma, teratoma, yolk sac, embryonal, yolk sac, choriocarcinoma)
Sex cord/stromal (granulosa cell, fibroma, thecoma, leydig cell)
25
Q

What is a trophoblastic tumour?

A

Germ cell tumour, known as a choriocarcinoma

26
Q

A 39 year old female with spotting after insertion of an IUD. What type of inflammatory cell is most likely to be present?

A

Histiocyte (same as macrophage)

The uterus will shed and endometrial cells

27
Q

State the tumour marker for choriocarcinoma

A

bHCG

28
Q

State the tumour marker for yolk sac tumour

A

AFP

29
Q

What is a complete mole?

A

Fertilisation of an empty ovum by a single sperm that undergoes duplication of chromosomes

30
Q

What is a partial mole?

A

Two sperm fertilising a single ovum, forming a triploidy arrangement

31
Q

What type of molar pregnancy is at risk of choriocarcinoma?

A

Complete molar pregnancy

32
Q

57yo man with lump in left supraclavicular fossa. The lump is non-mobile, non-tender and feels irregular. He is a heavy smoker and has lost some weight. What is the most likely diagnosis?

A

Metastatic malignancy

33
Q

The young are affected by neoplasms of…

A

Brain (medullablastoma)
Blood
Bone (osteosarcoma, Ewing’s sarcoma)

34
Q

The old are affected by neoplasms of…

A

Carcinomas (derived from epithelium)

35
Q

57yo man with lump in left supraclavicular fossa. The lump is non-mobile, non-tender and feels irregular. He is a heavy smoker and has lost some weight. What is the best management option for the GP?

A

Urgent referral to secondary care (ENT)

36
Q

What is the lymphatic spread of colorectal carcinoma?

A

Lung
Liver
Brain

37
Q

30yo man presents with a non-tender, irregular lump in the neck. He is a non-smoker and doesn’t drink. What is the likely diagnosis?

A

HPV associated malignancy

38
Q

State the two most common causes of axilla metastases

A

Breast

Cutaneous (melanoma)

39
Q

State the most common cause of paraortic metastases

A

Testes

40
Q

State the most common cause of supraclavicular metastases

A

Gastric (Virchow’s node)

41
Q

List cancers that metastases pretty much everywhere

A

Prostate
Small cell lung cancer
Melanoma

42
Q

Biopsy of the lymph node shows poorly differentiated single cells, with a signet ring morphology and containing abundant intracytoplasmic mucin. What is the most likely histological diagnosis?

A

Adenocarcinoma

Signet cell carcinoma is a rare form of highly malignant adenocarcinoma that produces mucin (YING YANG SIGN)

43
Q

What is a characteristic sign of melanoma on histological biopsy?

A

Brown staining

44
Q

29 year old female with asymmetrical swelling in the mid-line of the neck. It is poorly circumscribed but moves on swallowing. Patient is otherwise aymptomatic. What is the most likely diagnosis?

A

Multinodular goitre

45
Q

29 year old female with asymmetrical swelling in the mid-line of the neck. She has a multinodular goitre. Patient is otherwise aymptomatic. You do some blood tests. She has a high TSH, normal fT4 (low end), low haemoglobin, normal WCC. These results are consistent with?

A

Subclinical hypothyroidism

46
Q

29 year old female with asymmetrical swelling in the mid-line of the neck, diagnosed as subclinical hypothyroidism, following blood tests. What is the next step in investigating the patient?

A

Ultrasound and fine needle aspirate as she has a neck lump

47
Q

A FNA contains abundant colloid and scattered sheet and aggregates of thyroid follicular epithelial cells. Many of the cells exhibit oncocytic change. In the background abundant lymphocytes are present. What are the features in the report most likely to be describing?

A

Thyroiditis

48
Q

What is the most common method of spread in follicular adenoma?

A

Haematological spread

49
Q

What is the most common method of spread in papillary adenoma?

A

Lymphatic spread

50
Q

What is meant by oncocytic change?

A

Abundant eosinophilic granular cytoplasm as a result of accumulation of altered mitochondria

51
Q

List histological features of papillary thyroid carcinoma

A 
Orphan annie nuclei (empty nuclei)
Psammoma bodies (round calcified collection)
52
Q

18 year old male presents with two day history of swelling in left lateral neck. It is soft and mildly tender. He has other small palpable masses on the contralateral side; What is the most likely pathological process?

A

Viral infection

53
Q

18 year old male with two day history of swelling in the neck, presents two weeks later with a sore throat which has been getting worse and he now has difficulty swallowing. He is also jaundices and has some upper quadrant pain. What is the most likely diagnosis?

A

EBV virus causing glandular fever

54
Q

List clinical features of CMV

A 
Common in AIDS
Fever
Malaise
Lymphadenopathy
Diarrhoea
Nausea and vomiting
Visual floaters
55
Q

An 18yo male with swelling in the neck is diagnosed with EBV virus. What would be the most appropriate management now?

A

Check EBV serology
FBC
Pen V
Advise rest

56
Q

List clinical features of glandular fever

A 
Fever
Pharyngitis
Cervical lymphadenopathy
Abdominal pain (splenomegaly, hepatomegaly)
Jaundice
57
Q

What is the characteristic feature of infectious mononucleosis on biopsy?

A

Enlarged atypical lymphocytes

58
Q

18 year old male with two day history of swelling in the neck, presents two weeks later with a sore throat which has been getting worse and he now has difficulty swallowing. He is also jaundices and has some upper quadrant pain. EBV testing comes back negative. What other important test should be done?

A

HIV (most important)
VDRL
Hep C serology
Hep B serology

59
Q

Lymph node biospy contains numerous aggregates of epitheliod histiocytes many of which are forming granulomas. Areas of caseous necrosis are also present. What is the most likely diagnosis?

A

Mycobacterial infection (TB)

Y3 TRANSITION (10 decks)

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