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Backup Gen > Pathology > Flashcards

Pathology Flashcards

1
Q

Ghon complex -

A

Ghon complex - primary TB and regional nodal involvement
o Macrophage internalisation
o Granulomata – epitheloid histocytes
o T4 hypersensitivity

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2
Q

Cancer most common in non-smokers

A

Peripheral Adenocarcinoma – most common in non-smokers

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3
Q

Organisms for Malignant otitis externa

A

Malignant otitis - Pseudomonas aeruginosa - Severe pain, headaches and granulation tissue

Diabetes (90%) or immunosuppression (illness or treatment related)
Severe, unrelenting, deep-seated otalgia
Temporal headaches
Purulent otorrhea
Possibly dysphagia, hoarseness, and/or facial nerve dysfunction

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4
Q

Malignant hypertension results in

A

Malignant hypertension - Fibrinoid necrosis

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5
Q

Reed Sternberg cells

A

Hodgkins lymphoma - Reed Sternberg cells

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6
Q

Most favourable prognosis for Hodgkins lymphoma

A

Classical lymphocyte predominant

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7
Q

Asteroid Bodies

A

Asteroid Bodies - Sarcoid

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8
Q

% of sarcomas are found in the extremities.

A

40% of sarcomas are found in the extremities.

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9
Q

Most common anal cancer and cause

A

Anal SCC (most common) – HPPV 16 (Less 18)

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10
Q

Granulomas are…

A

Granulomas are organised collections of macrophages, different to giant cells

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11
Q

nose bleed, hearing loss, face/ear pain, soft palate paralysis

A

nasoparyngeal carcinoma – nose bleed, hearing loss, face/ear pain, soft palate paralysis
- EBV risk factor

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12
Q

Concentric ring of epithelial cells seen in the medulla of the thymus (pharyngeal pouch 3+4)

A

Hassall’s corpuscles

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13
Q

Watercress farmer - jaundice - organism?

A

Watercress farmer – fasciola hepatica –

Jaundice and bile duct hyperechoic dilation.

Aka liver fluke, nematode.
Stool or serology, triclabendazole

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14
Q

cartilage, ciliated epithelium

A

Hamartoma: CT,

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15
Q

to kill tubercle bacilli

A

Autoclave to kill tubercle bacilli

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16
Q

laxative abuse

A

Melanosis coli

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17
Q

GVDH

A

Lymphocyte proliferation not neutrophil

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18
Q

Gigantic leg

Mosquito bite in congo, Indian BL

A

Filriasis- gigantic leg Wuchereria bancrofti - nematode– treat with diethylcarbamazepine

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19
Q

Ascending UTI

A

Ascending UTI – E Coli

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20
Q

Fournier’s Gangrene

A

E-coli and bacteroides

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21
Q

To sterilise endoscopic equipment

A

Glutaraldehyde

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22
Q

Fistulae, sulphur granules, poor healing

A

Fistulae, sulphur granules, poor healing

Actinomycosis – Gram +ve anaerobes, long term penicillin

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23
Q

Colon carcinoma + endocarditis

A

Streptoccus Bovis - gram +ve

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24
Q

Work with sheeps and dogs – LFTs + Eosinophilia

A

Echinococcus granulosus

Hydatid cyst – calcified – work with sheeps and dogs – LFTs + Eosinophilia (liver, intestines)

25
Q

Meditarrean, Middle Eastern, Biliary cysts + Urticarial rash

A

Hydatid cysts – Echinococcus Granulosus –

T1 Hypersitivity – cysts are allergens

26
Q

Most common food borne illness
(resistant to cooking)
Onset is hours after eating

A

C. Perfringens

27
Q

Foodborne illness - within minutes of eating

A

Minutes with staph aureus (preformed enterotoxin)

28
Q

Associated with gas grene

A

C. Perfringens

29
Q

Waterhouse - Friderichsen syndrome - adrenal gland bleeding and failure due to severe infection - mostly commonly due to.

A

most commonly Meningococcus - Neisseria meningitidis.

Waterhouse - Friderichsen syndrome - adrenal gland bleeding and failure due to severe infection -

30
Q

Osteomyelitis in Sickle

A

Osteomyelitis in Sickle: E.Coli>Staph Aureus

31
Q

Achalasia - Infective destruction of myenteric plexus ganglia, heart, CNS, spleen.

A

Achalasia – trypanosoma Cruzi destruction of myenteric plexus ganglia, heart, CNS, spleen. Only acute infection curable

32
Q

SEVERE Abdo pain with diarrhoea – more likely to be

A

SEVERE Abdo pain with diarrhoea – more likely campylobacter jejuni

33
Q

Diarrhoea in immune suppressed – renal transplant

A

cryptospirodium - cysts

34
Q

Relative bradycardia in

A

Relative bradycardia in typhoid fever

35
Q

CMV infection most common in

A

CMV infection most common in solid organ transplants

36
Q

Birds touching your milk?!

A

Birds touching your milk?! Compylobacter jejuni!

37
Q

Egypt, swimming pool, diarrhoea

A

Giardia – resistant to chlorination.

First line treatment is with metronidazole

38
Q

Group A Strep add what to flucloxacillin

A

Group A Strep – add penicillin to flucloxacillin

39
Q

Coughing, abdo discomfort, no prurois anii, Indian/Far East

A

orms and eggs on microscopy – Ascaris Lumbricoides

Treatment is with mebendazole

40
Q

Management of hepatitis B

A

Pegylated interferon-alpha

lamivudine, tenofovir and entecavir

41
Q

Complications of hepatitis B infection

A 
Chronic hepatitis (5-10%)
Fulminant liver failure (1%)
Hepatocellular carcinoma
Glomerulonephritis
Polyarteritis nodosa
Cryoglobulinaemia
42
Q

Management of chronic Hep C

A

a combination of pegylated interferon-alpha and ribavirin are used, up to 55% of patients successfully clear the virus

43
Q

Hep C management complications

A

ribavirin - side-effects: haemolytic anaemia, cough. Women should not become pregnant within 6 months of stopping ribavirin as it is teratogenic

interferon alpha - side-effects: flu-like symptoms, depression, fatigue, leukopenia, thrombocytopenia

44
Q

HIV Antigen test

A

p24 antigen test
usually positive from about 1 week to 3 - 4 weeks after infection with HIV
sometimes used as an additional screening test in blood banks

45
Q

The commonest organism in isolated pathogen infection in Necrotising fasciitis

A

Streptococcus

46
Q

A similar principle but the infection is more superficially sited than necrotising fasciitis and often confined to the trunk

A

Meleneys gangrene

47
Q

Who should be screened for MRSA?

A

all patients awaiting elective admissions (exceptions include day patients having terminations of pregnancy and ophthalmic surgery. Patients admitted to mental health trusts are also excluded)
in the UK all emergency admissions are currently screened

48
Q

How should a patient be screened for MRSA?

A

nasal swab and skin lesions or wounds
the swab should be wiped around the inside rim of a patient’s nose for 5 seconds
the microbiology form must be labelled ‘MRSA screen’

49
Q

Suppression of MRSA from a carrier once identified

A

nose: mupirocin 2% in white soft paraffin, tds for 5 days
skin: chlorhexidine gluconate, od for 5 days. Apply all over but particularly to the axilla, groin and perineum

50
Q

The following antibiotics are commonly used in the treatment of MRSA infections:

A

vancomycin
teicoplanin

Some strains may be sensitive to the antibiotics listed below but they should not generally be used alone because resistance may develop:
rifampicin
macrolides
tetracyclines
aminoglycosides
clindamycin
51
Q

Osteomyelitis

A

S aureus and occasionally Enterobacter or Streptococcus species

52
Q

Septic arthritis…
Most common organism overall -
young adults who are sexually active -

A

Most common organism overall is Staphylococcus aureus
In young adults who are sexually active Neisseria gonorrhoeae should also be considered

The BNF currently recommends flucloxacillin or clindamycin if penicillin allergic

53
Q

Alpha haemolytic streptococci

A 
Streptococcus pneumoniae (pneumococcus) - pneumonia, meningitis and otitis media
Streptococcus viridans
54
Q

Beta haemolytic streptococci

A

These can be subdivided into group A and B

Group A
most important organism is Streptococcus pyogenes
responsible for erysipelas, impetigo, cellulitis, type 2 necrotizing fasciitis and pharyngitis/tonsillitis
immunological reactions can cause rheumatic fever or post-streptococcal glomerulonephritis
erythrogenic toxins cause scarlet fever

Group B
Streptococcus agalactiae may lead to neonatal meningitis and septicaemia

55
Q

Staphylococcus aureus

A 
Facultative anaerobe
Gram positive coccus
Exo toxin  -toxic shock syndrome
Enterotoxin - gastroenteritis 
Resistance to methicillin (and other antibiotics) is mediated by the mec operon
56
Q

Streptococcus pyogenes

A

Gram positive, forms chain like colonies, Lancefield Group A Streptococcus
beta haemolysis on blood agar plates
superantigens such as pyogenic exotoxin A which results in scarlet fever

57
Q

Escherichia coli

A

Gram negative rod
Facultative anaerobe, non sporing
Enterotoxigenic E-Coli produces an enterotoxin (ST enterotoxin) that results in large volume fluid secretion into the gut lumen (Via cAMP activation)
Enteropathogenic E-Coli binds to intestinal cells and cause structural damage

58
Q

Campylobacter jejuni

A

Curved, gram negative, non sporulating bacteria
commonest causes of diarrhoea worldwide
Remains a differential for right iliac fossa pain with diarrhoea
Self limiting infection so antibiotics are not usually advised. However, the quinolones are often rapidly effective.

59
Q

Helicobacter pylori

A

Gram negative, helix shaped rod, microaerophillic
Those carrying the cag A gene may cause ulcers
colonises the gastric antrum and irritates resulting in increased gastrin release and higher levels of gastric acid
These patients will develop duodenal ulcers.

In patients who are colonised 10-20% risk of peptic ulcer, 1-2% risk gastric cancer, <1% risk MALT lymphoma.

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