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MS 2 - Unit 1 > Pathology Concepts - High Yield > Flashcards

Pathology Concepts - High Yield Flashcards

1
Q

Bartholin Cyst

A

unilateral, painful lesion near vaginal canal

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2
Q

Condyloma

A

HPV 6 and 11 warty neoplasm, not risk for cancer histology - koilocytic change

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3
Q

Lichen Sclerosis

A

Postmenopausal women Benign, slight increased risk for squamous cell carcinoma Leukoplakia on vulva Can be associated with autoimmune disorders painful intercourse

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4
Q

Lichen Simplex Chronicus

A

Thick, leathery vulva hyperplasia of vulvar squamous epithelium benign

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5
Q

Vulvar Carcinoma

A

HPV 16, 18, 31, 33 presents as leukoplakia rare VIN (vulvar intraepithelial neoplasia) cytokeratins - tumor markers can have keratin pearls on histo koilocytic change on histology

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6
Q

Extramammary Paget Disease

A

indicates carcinoma in situ burning sensation malignant epithelial cells in epidermis erythamatous, pruritic, ulcerated vulvar skin PAS +, keratin -, S100-, CEA+

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7
Q

Vaginal Adenosis

A

focal persistence of columnar epithelium in the upper vagina increased in females with DES exposure in utero

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8
Q

Clear Cell Adenocarcinoma of the Vagina

A

complication of DES-associated vaginal adenosis

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9
Q

Embryonal Rhabdomyosarcoma (Sarcoma Botryoides)

A

Bleeding Grape like mass protruding from vagina children

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10
Q

HPV E6 protein

A

increased destruction of p53

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11
Q

HPV E7 protein

A

increased destruction of Rb

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12
Q

Cervical Intraepithelial Neoplasia (CIN)

A

Koilocytic change looks like a mosaic, inlaid woodwork carcinoma in situ is dysplasia involving the full thickness of the epithelium progression from CIN I to CIS is not inevitable

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13
Q

Cervical Carcinoma

A

40-50 yrs post-coital bleeding high risk HPV infection cervical carcinoma is AIDS-defining most is squamous cell carcinoma, but both squamous cell and adenocarcinoma are associated with HPV hydronephrosis w/ postrenal failure is a common cause of mortality CIN to cancer 10-20 years

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14
Q

Quadrivalent HPV vaccine

A

6, 11, 16, 18

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15
Q

Proliferative phase

A

estrogen driven

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16
Q

Secretory phase

A

progesterone driven

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17
Q

Menstrual phase

A

loss of progesterone support

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18
Q

Asherman Syndrome

A

Secondary amenorrhea due to loss of stratum basalis overaggressive D&C cause

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19
Q

Acute Endometritis

A

usually due to retained products of conception, incompete abortion is nidus for inection bacterial infection –> fever, pelvic pain

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20
Q

Chronic Endometritis

A

lymphocytes and plasma cells IUD, TB, chronic PID, retained products of conception abnormal bleeding, pain, infertility

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21
Q

Endometrial Polyp

A

side effect of tamoxifen hyperplastic protrusion of endometrium (hypersensitive to estrogen stimulation) endometrial glands, fibrous endometrial stroma perimenopausal women

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22
Q

Endometriosis

A

ovary most common site chocolate cysts gun-powder nodules increased risk of carcinoma at side of endometriosis (in ovary esp) adenomyosis when uterine myometrium is involved

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23
Q

Endometrial Hyperplasia

A

glands >> stroma consequence of unopposed estrogen (ie PCOS, obesity) atypia is the key word for progression to cancer postmenopausal uterine bleeding

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24
Q

Endometrial Carcinoma

A

most common invasive carcinoma of female genital tract postmenopausal bleeding endometrioid histology - hyperplasia pathway sporadic pathway - papillary serous adenocarcinoma - serous histology (surface epithelium) with psammoma bodies (laminated calcified concretions) p53 mutation common BRCA-1 mutation common

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25
Q

Leiomyoma

A

uterine fibroid whirled masses, come in sets usually without encapsulation benign can cause bleeding (–> anemia)

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26
Q

Leiomyosarcoma

A

arises de novo unilateral, usually one mass, necrosis and hemorrhage postmenopausal women Actin+ 10+ mitosis per HPF or 5+ mitoses per 10 HPF Nuclear atypia, necrosis possible

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27
Q

FSH

A

granulosa cells convert androgen to estrogen

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28
Q

LH surge

A

caused by estradiol surge

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29
Q

Polycystic Ovarian Disease (PCOS, PCOD)

A

LH: FSH > 2 unopposed acyclic estrogen secretion androgen converted to estrone in adipose tissue –> increased risk for endometrial carcinoma T2DM common low FSH - cystic degeneration of follicles common (5% of repro age women) oligomenorrhea, hirsutism aka Stein-Leventhal Syndrome

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30
Q

Surface Epithelial Ovarian tumor

A

most common serous and mucinous BRCA1 mutations increase risk for serous carcinoma of ovary and fallopian tube malignant tumors - cystadenocarcinoma - complex cysts with thick, shaggy lining postmenopausal women poor prognosis (usually caught late) CA-125 serum marker Brenner tumor - benign - bladder-like epithelium

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31
Q

Cystic Teratoma

A

fetal tissue most common germ cell tumor** often bilateral struma ovarii if composed of thyroid tissue

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32
Q

Dysgerminoma

A

tumor of large cells with clear cytoplasm and central nucleii malignant germ cell tumor LDH may be elevated female counterpart to testicular seminoma in males glycogen-filled cells with septa containing lymphocytes

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33
Q

Endometrial sinus tumor

A

malignant tumor that mimics the yolk sac most common germ cell tumor in children AFP elevated Schiller-Duval bodies (like glomeruli) histology

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34
Q

Choriocarcinoma

A

malignant tumor or cytotrophoblasts and syncytiotrophoblasts rapid breast enlargement/precocious puberty in younger patients mimics placental tissue, villi absent small and hemorhhagic tumor with early hematogenous spread b-HCG elevated** due to syncytial cells poor response to chemo

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35
Q

Embryonal Carcinoma

A

malignant, large primitive cells aggressive with early metastases

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36
Q

Granulosa-Theca Cell Tumor

A

Sex-cord stromal tumor precocious puberty, but usually occurs in postmenopausal women malignant but not aggressive

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37
Q

Sertoli-Leydig cell tumor

A

hirsutism virilization sex-cord stromal tumors

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38
Q

Fibroma (of the ovary)

A

benign solid, firm, white tumor of fibroblasts pleural effusion, ascites (Meigs syndrome)

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39
Q

Krukenberg Tumor

A

metastatic mucinous tumor from GI cancer (gastric adenocarcinoma) involves both ovaries “signet ring” cell appearance pseudomyxoma peritonei - massive amounts of mucus in the peritoneum (from tumor of appendix)

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40
Q

Ectopic pregnancy

A

PID is risk for surgical emergency major bleed if bursts

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41
Q

Spontaneous abortion

A

most common is trisomy 16, hypercoagulable state, congenital infection, teratogen exposure usually in first 2 weeks gestation

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42
Q

Placenta Previa

A

implantation of placenta in lower uterus, blocks os 3rd trimester bleeding often requires C-section

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43
Q

Placental Abruption

A

separation of placenta from decidua prior to delivery of fetus reason for stillborn 3rd trimester bleeding, fetal insufficiency

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44
Q

Placenta Accreta

A

improper implantation of placenta into myometrium Difficult delivery of placenta, postpartum bleeding Often requires hysterectomy

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45
Q

Preeclampsia

A

HTN, proteinuria, edema usually arising in 3rd trimester DIC is a major complication - fibrin thrombi in liver, brain, kidneys HELLP (hemolysis, elevated liver enzymes, low platelets) abnormality of maternal-fetal vascular interface in placenta

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46
Q

Hyditaform Mole - Partial Mole

A

normal ovum, 2 sperm 69 chromosomes fetal tissue present snowstorm on ultrasound, fetal HR neg bHCG much higher than expected

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47
Q

Hytidaform Mole - Complete Mole

A

empty ovum, 2 sperm 46 chromosomes absent fetal tissue choriocarcinoma risk snowstorm on ultrasound, fetal HR neg bHCG much higher than expected

48
Q

Acute mastitis

A

staph

49
Q

Periductal mastitis

A

inflammation of subareolar ducts smokers subareolar mass with nipple retraction

50
Q

Fat necrosis

A

trauma calcifications and giant cells

51
Q

Fibrocystic change

A

usually benign, some changes associated with increased risk for invasive carcinoma cystic breasts blue dome gross appearance

52
Q

Intraductal Papilloma

A

bloody nipple discharge in premenopausal woman *subareolar (whereas Paget Disease is areola and nipple) must distinguish from papillary carcinoma fibrovascular projections lined by epithelium WITH myoepithelial cells (cancer has no myoepithelial cells)

53
Q

Fibroadenoma

A

tumor of fibrous tissue and glands (epithelial and stromal elements) surgical removal is curative well-circumscribed, mobile, marble-like mass estrogen sensitive*** lifetime risk for cancer is doubled

54
Q

Phyllodes Tumor

A

fibroadenoma-like tumor leaf-like projections on biopsy (benign growth of ductal structures) sharply circumscribed, glistening stroma has high mitotic activity postmenopausal women sometimes malignant (when they are, they are less sharply circumscribed and much more stromal components as compared with ductal components

55
Q

DCIS

A

does not usually produce a mass calcification on mammography Paget Disease indicates underlying carcinoma

56
Q

Invasive Ductal Carcinoma

A

most common invasive cancer of the breast irregular nests of cells and cords of epithelial cells can be tubular (well-differentiated tubules w/o myoepithelium), mucinous, medullary (large, high grade cells with lymphocytes, plasma cells) or inflammatory increased in BRCA1 carriers

57
Q

Lobular Carcinoma In Situ (LCIS)

A

discohesive cells lacking E-cadherin no mass or calcifications treatment with tamoxifen **LCIS, more than DCIS, serves as a marker for enhanced risk of subsequent invasive carcinoma in both breasts

58
Q

Achondroplasia

A

dwarfism overexpression of FGF3 autosomal dominant failure of normal epiphyseal cartilage formation poor endochondral bone formation - long bones cant grow

59
Q

Osteogenesis Imperfecta

A

blue sclera hearing loss congenital structurally weak bone mutations in the gene for type I collagen (COL1A1 and COL1A2)

60
Q

Osteopetrosis

A

inherited defect of bone resorption abnormally thick, heavy bones marrow can be compromised, tx is bone marrow replacement aka Albers-Shonberg disease disorder of osteoCLASTS (failed resorption)

61
Q

Osteomalacia

A

impaired mineralization of osteoid can be associated with autoimmune disorders (ie Chrons, celiac) pidgeon-breast deformity frontal bossing rachitic rosary low vitamin D in adults, Ca down, phosphate down, PTH up, alk phos up

62
Q

Osteoporosis

A

reduction in trabecular bone mass DIP > PIP involvement porous bone, fracture risk labs normal postmenopausal women –> estrogen withdrawal –> increased # of osteoclasts (type 1) OR, decreased osteoblast activity (type 2)

63
Q

Paget Disease of Bone

A

>60 years imbalance of osteoclast and osteoblast function mosaic pattern (puzzle pieces) of lamellar bone bone pain hearing loss lion-like facies elevated alk phos complication can include high output cardiac failure due to formation of AV shunts in bone increased risk of osteogenic sarcoma more common in people of English descent

64
Q

Osteomyelitis

A

infection can be in children bacterial like staph lytic focus = sequestrum sclerosis around it = involucrum bone pain and fever etc.

65
Q

Avascular Necrosis

A

DCS ischemic necrosis of bone, bone marrow can also be caused by trauma children and adolescents can be affected

66
Q

Osteoma

A

Gardner syndrome benign tumor surface of facial bones

67
Q

Osteoid Osteoma

A

small, painful lesion surrounded by reactive bone formation radiolucent core typically young people (5-25) aspirin resolves pain (osteoblastoma does NOT respond to aspirin) cortex of long bones (diaphysis) ie femur benign tumor of osteoblasts (produce osteoid)

68
Q

Osteochondroma

A

overlying cartilage cap lateral projection of growth plate (metaphysis)

69
Q

Osteosarcoma

A

highly malignant proliferation of osteoblasts mutations in Rb protein (some p53, but mostly Rb) teenagers, elderly lung mets Codman triangle (“sunburst appearance”) arises in metaphysis of long bones or knee region pathologic fracture or bone pain

70
Q

Giant Cell Tumor

A

young adults epiphysis of long bones soap-bubble appearance RANK ligand aggressive

71
Q

Ewing Sarcoma

A

neuroectoderm derivation onion-skin appearance kids small, round blue cells on biopsy diaphysis of long bones t 11;22 translocation

72
Q

Chondroma

A

intermedullary small bones of hands and feet

73
Q

Chrondrosarcoma

A

intermedullary pelvis or central skeleton malignant

74
Q

Chondroblastoma

A

chicken wire appearance adolescents primitive chondroblasts and cartilage matrix

75
Q

Osteoarthritis

A

Progressive disease Herberden nodes - DIP - osteophyte formation Bouchard nodes - PIP - osteophyte formation morning stiffness, worsens during day

76
Q

Rheumatoid Arthritis

A

HLA-DR4 pannus Baker cyst, vasculitis, pleural effusions morning stiffness that improves with movement synovitis progressive IgM autoantibody against Fc portion of IgG (rheumatoid factor)

77
Q

Ankylosing Spondylitis

A

HLA-B27 axial skeleton involvement seronegative spondylarthropathy more common in young men uveitis

78
Q

Reactive arthritis

A

HLA-B27 arthritis, urethritis, conjunctivitis Chlamydia or GI infection

79
Q

Infectious Arthritis

A

DGI or staph warm joint, limited ROM, fever, ESR elevated usually knee

80
Q

Gout

A

MSU crystals negative biferingence hyperuricemia podagra chronic gout –> renal failure, tophi development

81
Q

Dermatomyositis

A

heliotrope rash (upper eyelids) anti-Jo antibody, ANA+ inflammatory, involves skin and skeletal muscle

82
Q

X-linked MD

A

dystrophin deletion replacement of skeletal muscle by adipose tissue

83
Q

Liposarcoma

A

lipoblast is characteristic cell

84
Q

Rhabdomyoma

A

tuberous sclerosis benign tumor of skeletal muscle

85
Q

Rhabdomyosarcoma

A

most common malignant soft tissue tumor in children rhabdomyoblast desmin + head and neck common, vagina in young girls common

86
Q

Caruncle

A

postmenopausal women near urethra ulcerated, bleeding

87
Q

Lymphogranuloma venereum

A

Chlamydia serotype enlarged inguinal lymph nodes genital elephantiasis rectal strictures granulomatous inflammation *with* inclusion bodies**

88
Q

Chancroid

A

vesiculopapular lesion(s) purulence, bleeds, fever, malaise haemophilus ducreyi granulomatous inflammation, acute transmission (~5 days)

89
Q

PTEN tumor suppressor gene

A

hormonally regulated in the normal endometrium biomarker for endometrial carcinogenesis

90
Q

WT-1 tumor suppressor protein

A

loss of fx associated with Wilm’s tumor

91
Q

Endometrial stromal sarcoma

A

usually neoplastic cells surrounding a blood vessel rare

92
Q

Adenomyosis

A

Presence of endometrial glands and stroma in the myometrium 1/5 of uteri have this characteristic can be associated with pelvic pain and bleeding, dyspareunia

93
Q

Carcinosarcoma

A

aggressive mixed mesodermal tumor poor prognosis

94
Q

Granulosa cell tumor

A

sex cord tumor prototypical functional neoplasm of the ovary associated with estrogen secretion usually postmenopausal women (in young girls, precocious puberty is an indicator) Exner bodies (look like flowers) on histology

95
Q

Thecoma

A

postmenopausal women functional ovarian tumor estrogen production yellow on gross exam lipid-laden theca cells endometrial hyperplasia common, can progress to cancer

96
Q

Papillomatosis

A

risk for developing cancer proliferative fibrocystic change ie increased cells lining the dilated terminal ducts (ductal epithelial hyperplasia)

97
Q

Invasive Lobular Carcinoma

A

second most common form of invasive breast cancer can be a discrete firm mass or not single strands or lines of cells with stroma in between

98
Q

Medullary carcinoma (of the breast)

A

nests of cells lymphocytes, dense lymphoid infiltrate fleshy, bulky tumors no calcifications better prognosis than infiltrating ductal or lobular carcinoma

99
Q

Most common breast cancer in men:

A

Invasive ductal carcinoma (still very rare) BRCA2 plays a role

100
Q

Mutations in the lysyl hydroxylase gene

A

Ehlers-Danlos Syndrome

101
Q

Mutations in fibrillin gene

A

Marfan Syndrome

102
Q

Androgenital syndrome

A

congenital 21-hydroxylase deficiency virilization in females a congenital adrenal hyperplasia high levels of androgens lead to premature closure of epiphyses

103
Q

Pseudoarthrosis

A

joint like tissue formation at a site of fracture nonunion healing surgical removal to properly heal fracture

104
Q

Legg-Calve-Perthes disease

A

avascular necrosis in the femoral head of children

105
Q

Sequestrum

A

necrotic bone

106
Q

Involucrum

A

periosteal new bone forms around the sequestrum

107
Q

Osteitis Fibrosa Cystica

A

hyperparathyroidism complication

108
Q

Pseudogout / Chondrocalcinosis

A

aspirate has rhomboid “coffin-like” crystals (CPPD) and neutrophils seen in the elderly gout-like symptoms + biferingence

109
Q

8;14 translocation

A

Burkitt Lymphoma

110
Q

Hand-Schuller-Christian disease

A

young children (2-5) proliferation of Langerhans cells radiolucent bony lesions lesion may produce exopthalmos infiltration of the hypothalamic stalk can lead to DI weepy skin lesions ie at hairline

111
Q

Myositis ossificans

A

young people benign usually from blunt trauma occurs near a bone, often mistaken for a malignant bone thing

112
Q

Synovial sarcoma

A

highly malignant soft tissue tumor spindle-shaped mesenchymal cells and cuboidal, epithelial-like cells keratin +

113
Q

Papillary structures with psammoma bodies would characterize:

A

a cystadenocarcinoma

114
Q

A choriocarcinoma with trophoblastic cells is usually gestational in origin and has a:

A

hemorrhagic appearance

115
Q

α-Fetoprotein is a marker for:

A

some germ cell tumors that contain yolk sac elements

MS 2 - Unit 1 (12 decks)

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