Pathology Flashcards
Clinical findings of Primary biliary cholangitis
Middle-age women.
Pruritus before jaundice, fatigue, hepatosplenomegaly, and xanthomatous lesions in eyelids, skin and tendons
Cholestatic pattern of LFTs
Anti mitochondrial antibodies
Associated with other autoimmune conditions
Interstitial pancreatitis macroscopic and microscopic findings
Grossly edematous macroscopically
Focal fat necrosis, calcium deposition and interstitisal edema microscopically
Macroscopic findings of necrotizing (hemorrhagic) pancreatitis
Chalky-white areas of fat necrosis with black areas of hemorrhage
Acute viral hepatitis (HAV) histologic findings
Hepatocyte necrosis: swelling and cytoplasmatic emptying (ballooning degeneration)
Hepatocyte apoptosis: Shrinkage and nuclear eosinophilia (Councilman bodies)
Mononuclear infiltration
Autoimmune hepatitis histologic findings
Immune response vs hepatic antigens: lymphoplasmacytic infiltration in portal and periportal regions.
Anti-smooth muscle antibodies
Hepatitis B histologic findings
Ground-glass hepatocytes, central balloon degeneration, cytotoxic T cells mediated damage
Histologic findings in nonalcoholic fatty liver disease
Lipid accumulation on cytoplasm and ballooning degeneration
Alcoholic cirrhosis histological findings
Swollen and necrotic hepatocytes with neutrophilic infiltration (also seen in acetaminophen overdose). Mallory bodies. Hepatic steatosis
Periductal “onion skin” fibrosis and luminal obliteration of biliary ducts. Associated with CUCI and p-ANCA +
Primary sclerosing cholangitis
Medical findings of Sclerodermal esophageal dysmotility
Smooth muscle atrophy: fibrous replacement of muscularis in lower esophagus; acid reflux → Barrett esophagus. Part of CREST sx
CREST syndrome
Calcinosis, Raynaud phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasia
Immunologic response in HAV infection
CD8 lymphocytic and NK response
Portal vein thrombosis clinical findings
Portal hypertension, splenomegaly, varicosities at portocaval anastomoses. No histologic changes to hepatic parenchyma
Histological findings of Whipple disease.
Infection with Tropheryma whipplei.
PAS +, foamy macrophages in intestinal lamina propria, mesenteric nodes.
Classical findings of Crohn disease.
Skip lesions in many portions of GI with rectal sparing.
Cobblestone mucosa, noncaseating granulomas, fistulas, erythema nodosum, bowel wall (muscularis) thickening. Risk of deficiency of vit B12 due malabsorption.
Clinical difference between right and left sided colorectal cancer
Right side: cecal, ascending colon. Occult bleeding
Left side: rectosigmoid. Hematochezia and obstruction
Diffuse gastric adenocarcinoma histological findings
Diffuse carcinoma infiltrates stomach wall: thickened and leathery (linitis plastica) and displays signet ring cells.
From the colonic polyps, which one has the greatest risk of malignancy
Adenomatous polyps → villous
Serrated polyps
Classical findings of Ulcerative Colitis
Continuous colonic lesions, rectal involvement, mucosal and submucosal inflammation, loss of haustra (lead pipe)
Th2 mediated, pANCA association
Toxic megacolon, perforation
Most common neoplasia found in upper 2/3 portions of esophagus
Squamous cell carcinoma, that presents with keratin pearls and intercellular bridges
Cause of formation of black gallstones
Supersaturation of bilirrubin
- ↑ bilirrubin production (chronic hemolysis)
- Altered enterohepatic circulation (ileal disease)
Gilbert syndrome clinical characteristics
Mildly ↓ UDP-glucuronosyltransferase conjugation and impaired bilirrubin uptake.
Mild jaundice
Triggers: stress, illness, fasting, hemolysis, physical exertion
↑ unconjugated bilirrubin, normal liver function test
Site of the stomach where H. pylori colonizes first
Gastric antrum
Lab markers of biosynthetic capacity of the liver
Albumin and Prothrombin time
Lab marker of transport and metabolic capacity of the liver
Bilirrubin
Vitamin deficiency seen in cystic fibrosis that can lead to hemolytic anemia
Vitamin E
Most common via fot liver metastasis
Portal circulation
Classical findings of Hemochromatosis
AR. HFE hene. HLA-A3 association. ↑ intestinal absorption
Lab: ↑ ferritin, ↑ iron, transferrin saturation, ↓ TIBC
Bx: prussian blue stain
Cirrhosis, diabetes and skin pigmentation, arthropay, hypogonadism, HCC
Difference betweeen Grade and Stage in tumors
Grade: degree of cellular differentiation and mitotic activity
Stage: degree of localization/spread based on site and size of 1° lesion, lymphatic spread and metastases. More prognostic value
Difference between Curling ulcer and Cushing ulcer
Curling ulcer: due trauma/ischemia. Hypovolemia → muchosal ischemia
Cushing ulcer: due brain injury. ↑ vagal stimulation → ↑ ACh → ↑ H+ production
Histological findings of focal nodular hyperplasia
Small, solitary pale nodules composed of cords of normal-appearing hepatocytes and central stellate scar with fibrous septate.
Pathogenic factor for Shigellosis
Invasion of M cells (at Peyer patch through endocytosis
Serum marker for Hepatocellular carcinoma
Alfa fetoprotein
