Pathology Written Flashcards
Mention the predisposing factors of gastric carcinoma
H.pylori gastritis; as there is sequence of events of atrophy, intestinal metaplasia and dysplasia
Smoked food and canned food have carcinogenic substances
Autoimmune gastritis type A through atrophy
Genetic factors
Mention the microscopic picture of Crohn’s disease
Segmental inflammation and ulceration rich in neutrophils affecting the whole thickness of the wall
Fibrosis
Mention the microscopic picture of ulcerative colitis
Active phase: Mucosal ulcers, diffuse infiltration by inflammatory cells, crypt abscess formation, degenerative changes in the surface epithelium, severe mucosal edema
Chronic phase: mucosal crypt distortion, mucosal atrophy and submucosal fibrosis, epithelial dysplasia
Mention causes of liver abscess
Solitary abscess: amoebic abscess, infected hydatid cyst, cholecystitis, traumatic injury
Multiple abscesses: Amoebic abscess, pyemic abscess, actinomycosis
5 causes of liver cirrhosis
Post hepatitis Cirrhosis
Alcohol/Nutritional cirrhosis
Post- Necrotic Cirrhosis
Primary biliary cirrhosis
Cirrhosis related to circulatory disorders
5 complications of gall bladder stones
Predisposes to cholecystitis
Stones migrate to common bile duct and may cause obstruction
Acute pancreatitis
Distention of gall bladder
Predispose to carcinoma
Five Complications of peptic ulcer disease.
Bleeding from eroded vessels
Penetration into solid viscera as pancreas
Pyloric obstruction in ulcers (they narrow the pylorus)
Perforation of peritoneal cavity
Malignant transformation does not occur
Six causes of acute pancreatitis.
Obstruction of Ampulla of Vater by gall stone
Excess alcohol abuse
Accidental surgical injury
Viral infection
Bacterial infection
Hyperparathyroidism
Six causes of acute intestinal obstruction
Paralytic ileus
Strangulation hernia
Adhesion of healed peritoneal inflammation following surgery
Lumen obstruction
Volvous: completely twisting of bowel loop
embolism of mesenteric artery
Five complications of acute suppurative appendicitis
Rupture with septic peritonitis
Gangrene
Chronicity (Chronic appendicitis)
Pus formation
Mucocele of appendix
Five of the pathological features gross pictures of ulcerative colitis
Rectosigmoid commonly affected by multiple superficial ulcers
Pseudo polyps which are small elevations
Fibrosis in prolonged disease
It involves the rectum and extends proximally retrograde to colon
Three predisposing factors for hepatocellular carcinoma
Cirrhosis
Chronic viral hepatitis C
Hepatocarcinogen alfatoxins
Three types of gall bladder stones
Cholesterol stones: yellowish-white; cannot be seen by X-ray
Pigmented stones: very dark and small; opaque on X-ray
Mixed stones: most common, faceted, different colors
5 causes of hepatomegaly.
Inflammatory diseases
Degenerative diseases
Metabolic disorders as glycogen storage disease
Neoplastic diseases
Some types of Cirrhosis
List Clinco-pathological syndromes of viral hepatitis
Acute asymptomatic infection with recovery
Acute symptomatic infection with recovery
Fulminant hepatitis
Chronic hepatitis
Carrier state
Four non neoplastic colonic polyps
Bilharzial polyps
Hyperplastic polyps
Pseudo polyps
Hamartomas polyps
List the complications of gastric carcinoma
Melena
Hematemesis (bloody vomiting)
Pyloric obstruction
Anemia
Spread: direct, lymphatic spread and blood spread
Discuss pathogenesis and gross picture of chronic duodenal ulcer (Peptic Ulcer Disease)
Pathogenesis: hyperacidity and failure of mucosal defense mechanism
Gross picture: peptic ulcers are four times more common in the duodenum than in the stomach. Are usually solitary, round or oval in shape. The floor is smooth and base is firm
Microscopic features of chronic viral hepatitis
Inflammation: portal inflammation , lobular inflammation
Necrosis: piecemeal necrosis, spotty necrosis, apoptosis necrosis
Fibrosis: portal fibrosis
Other features: steatosis of hepatocytes and hepatocellular dysplasia
Define acute hemorrhagic pancreatitis
a severe and potentially life-threatening inflammation of the pancreas characterized by the presence of hemorrhage, or bleeding, within the pancreatic tissue
Define ulcerative colitis
Ulcerative colitis is a chronic inflammatory bowel disease (IBD) characterized by inflammation and ulcers in the colon and rectum,
Define dysentery
Dysentery is a term used to describe a group of gastrointestinal disorders characterized by inflammation of the intestines, particularly the colon, and accompanied by symptoms such as severe diarrhea, abdominal pain, and the presence of blood and mucus in the stool
Define Liver cirrhosis.
Liver cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions
Mention the causative agent of:
Bacillary dysentery
Traveler’s diarrohea
Amebic dysentery
Entamoeba histolytica
Define cryptorchidism
failure of descent of testis from abdominal cavity to scrotum for unknown cause
What is meant by acute pyelonephritis? Enumerate the predisposing factors.
common suppurative inflammation affecting kidney and pelvis caused by bacterial infection
> Diabetes (++) susceptibility to infection
Immune suppression and immunedeficiency
short UTI
Define Crescentic glomerulonephritis and enumerate the causes
> rapid progressive loss of renal function
histological formation of cresents + Severe oliguria
1- Post infectious: after acute diffuse proliferative GN in adults
2- With systemic diseases as PAN, SLE, good pasture syndrome
3- idiopathic
Define pyonephrosis?
Mention two causes?
Dilatation and distension of renal pelvis and calyces with pus———> progressive atrophy of the kidney due to total complete obstruction of high urinary tract
Hydronephrosis
Chronic pyelonephritis
List Prerenal Causes of Hematuria
- hypertension
- Leukemia, purpura
- vitK,C deficiency
- Anticoagulation drugs
Enumerate six 6 post-renal causes for hematuria
1- Congenital bladder diverticulum
2- Trauma: catheterization
3- Bilharziasis
4- Cystitis, urethritis
5- kidney stones
6- Urinary bladder tumors
Renal causes of hematuria
Renal trauma
Glomerular nephritis
Kidney stones
Renal vascular diseases
Enumerate types of renal calculi
- calcium oxalate: > 75%
- triple phosphate: 10%
- uric acid: 6-9%
- cysteine stone (rare)
Mention complications of cystitis
- Ascending infection -> pyelonephritis
- Stones
- Chronic fibrosed contracted bladder
- Hematuria
Give short account on etiology and pathogenesis of acute diffuse proliferative glomerulonephritis (acute post streptococcal GN)
Exogenous: certain strains of B-hemolytic streptococci or Other infections: as mumps, measles, chickenpox
Endogenous: systemic lupus erythematosus (SLE)
PATHOGENESIS:
During latent period between infection and nephritis, antibodies against streptococcal antigens are formed in serum the Immune complex deposit between GBM and epithelial cells -> subepithelial granular deposits -> complement activation -> glomerular damage
12- CASE
A 70-year-old man complains of increased urgency to void. He could not completely empty his bladder with difficulty in micturition, poor or intermittent stream and dribbling at end of micturition. Rectal digital examination reveals an enlarged nodular prostate. Ultrasonography showed that enlargement affects mainly the transitional zone of the prostate.
A. What is the most likely diagnosis?
B. What are the possible effects and complications?
A. Benign prostatic hyperplasia
B. Hydroureter, residual urine causing cystits. Dilation of bladder
Enumerate: Four causes of endometrial hyperplasia.
Prolonged estrogen stimulation
Estrogen secreting tumors
Prolonged estrogen therapy
Obesity
Four causes of uterine bleeding caused by local organic lesion
Pregnancy disorders: abortion
Benign tumors: endometrial polyp
Malignant tumors: carcinoma of endometrium
Inflammations: endometritis
Causes of dysfunctional uterine bleeding
Anovulatory cycle
Endocrine disorders
Estrogen producing ovarian tumors
Inadequate Luteal phase
Predisposing factors of uterine cervical carcinoma.
- Early age of sexual activity
- Females with multiple sexual partners
- Male partner with multiple previous sexual partners
- Chronic cervicitis
Complications of endometriosis
Dysmenorrhea: Painful menstruation due to intrapelvic bleeding.
Dyspareunia: painful intercourse
Infertility: Adhesions around the tubes
Complications of puerperal sepsis.
severe toxemia and septicemia
Spread of infection to the tubes -> salpingtis.
spread of infection to peritoneum –> peritonitis
Healing of infected tubes–> fibrosis and infertility
Mention differences between partial and complete hydatiform moles.
Complete: diploid, fertilization of empty ovum by two sperm, fetal parts absent and rarely progress to carcinoma
Partial: triploid, fertilization of ovum by two sperms, fetal part present and very rarely progress to carcinoma
Give an account on duct ectasia (periductal mastitis) (definition, etiology, gross and microscopic pictures).
marked dilatation of mammary ducts containing inspissated Secretions
unknown etiology
Gross: firm tender greyish white mass with large dilated ducts
Micro: dilated ducts contain foamy macrophages and are surrounded by granulomatous inflammation
1- Case: A 58-year-old female came to the outpatient clinic, complaining of a breast mass and itchy nipple. She told history that she first noticed this mass since 3 months with rapid increase in size. On examination, the mass was hard fixed and measured 5 cm in diameter. The nipple was red, scaly and ulcerated. The axillary lymph nodes on the same side were enlarged.
a) What’s your diagnosis of breast lump?
b) Mention three common microscopic types of such lesion?
c) What’s the likely cause of the scaly ulcerated nipple and what is the expected microscopic picture of the nipple in such case.
a) breast cancer
b) Non invasive carcinoma (lobar and ductal), Invasive carcinoma (lobar and ductal), special types
7- Case: A 50-year-old woman presents to her doctor with large firm fixed left breast mass with axillary lymph nodes. The nipple was retracted and the skin showed Peau d’orange. Her mammography showed microcalcifications.
a) What’s your diagnosis?
b) Describe the microscopic picture of this lesion?
a) Breast cancer
b) Infiltrating tumor composed of tubules, groups, sheets, trabeculae, single tumor cells.
tumor cells: large and pleomorphic
4- Case: A 57-year-old woman presents to her gynecologist with lower abdominal pain. During her workup, a CT scan of her abdomen shows bilateral large ovarian cysts. Removal of these cysts were done . The both cysts were unilocular with smooth outer surface, filled with serous fluid and showed small papillae on the inner surface.
a) What’s your diagnosis?
b) Mention the types of this lesion and describe their microscopic pictures
a) Serous cystadenoma
b) Serous cystadenoma: cyst lined by cuboidal cells
Mucinous cystadenoma: cyst lined by columnar mucin secreting cells
Chylothorax
Accumulation of milky white fluid
Rhinoscleroma
Granulomatous inflammation of the nose may affect larynx, pharynx
Bronchiectasis
permanent dilation of medium sized bronchi and bronchioles with chronic suppurative infection
Atelectasis.
Failure of expansion Or collapse of previously inflated lung, Affecting part or all of one lung
Mention 4 complications of lobar pneumonia
1 - failure of resolution—–> Carnification
2- Toxemia: on 9th day acute heart failure due to toxic myocarditis
3- Spread: Direct or by blood
4- Post pneumatic lung abscess
Lung abscess complications
Rupture into bronchus: hemoptysis & cough of purulent sputum
■ Rupture into pleural cavity pneumothorax
■ Lung Gangrene
■ Embolization of septic emboli to brain
■ Chronic lung abscess
Chronic bronchitis
The diagnosis is clinical: persistent productive cough for at least 3 consecutive months in 2 consecutive years
Otitis media
Infection of middle ear associated with upper respiratory tract infection
Pneumoconiosis
Lung disease that is caused by Inhalation of dust
Mention four complications of bronchiectasis
Spread
Lung abscess
Lung gangrene
Squamous lung carcinoma
Enumerate four complications of acute tonsilitis
Spread: direct causing Quinzy, lymph causing lymphadenitis, blood causing septicemia
Hypersensitivity to strept—>acute rheumatic fever
Chronic tonsillitis
Mention causes of Epistaxis
Trauma
Tumors
Rhinoscleroma
Vitamin K deficiency
