Pathoma Chapter 3C

Question 1

Malignant tumors are classically

Answer 1

poorly differentiated (anaplastic)

Question 2

Characteristics of malignant tumors include

Answer 2

1. Disorganized growth (loss of polarity) 2. Nuclear pleomorphism and hyperchromasia 3. High nuclear to cytoplasmic ratio 4. High mitotic activity with atypical mitosis 5. Invasion (through basement membrane or into local tissue)

Question 3

What is the hallmark of malignancy?

Answer 3

Metastatic potential - benign tumors never metastasize

Question 4

What is the target cell type for the immunohistochemical stain of Keratin?

Answer 4

Epithelium

Question 5

What is the target cell type for the immunohistochemical stain of Vimentin

Answer 5

Mesenchyme

Question 6

What is the target cell type for the immunohistochemical stain of desmin

Answer 6

Muscle

Question 7

What is the target cell type for the immunohistochemical stain of Neurofilament

Answer 7

Neurons

Question 8

What is the target cell type for the immunohistochemical stain of PSA

Answer 8

Prostatic epil helium

Question 9

What is the target cell type for the immunohistochemical stain of ER

Answer 9

Breast epithelium

Question 10

What is the target cell type for the immunohistochemical stain of Thyroglobulin

Answer 10

thyroid follicular cells

Question 11

What is the target cell type for the immunohistochemical stain of chromogranin?

Answer 11

neuroendocrine cells (small cell carcinoma of lung and carcinoid tumors)

Question 12

What is the target cell type for the immunohistochemical stain of S-100?

Answer 12

Melanoma

Question 13

What is used to characterize tumors that are difficult to classify on histology?

Answer 13

Immunohistochemistry

Question 14

What are serum tumor markers?

Answer 14

Proteins released by tumor into serum (e.g PSA)

Question 15

Serum tumor markers are useful for what?

Answer 15

screening, monitoring response to treatment, and monitoring recurrence

Question 16

Elevated levels of serum tissue markers require what?

Answer 16

it requires tissue biopsy for diagnosis of carcinoma (e.g., biopsy of prostate with elevated PSA),

Question 17

What is involved in the grading of cancer?

Answer 17

Microscopic assessment of differentiation (how much a cancer resembles the tissue in which it grows); takes into account architectural and nuclear features

Question 18

What is low grade?

Answer 18

Well differentiated?resembles normal parent tissue

Question 19

What is high grade?

Answer 19

poorly differentiated?does not resemble parent tissue

Question 20

Cancer grading is important for what?

Answer 20

determining prognosis; well-differentiated cancers have better prognosis than poorly-differentiated cancers.

Question 21

What is staging of cancer?

Answer 21

its an assessment of size and spread of a cancer,

Question 22

How does the staging of cancer compare to the grading of cancer?

Answer 22

Key prognostic factor; more important than grading

Question 23

When is the staging of cancer determined?

Answer 23

after final surgical resection of the tumor

Question 24

What is the TNM staging system?

Answer 24

T?tumor (size and/or depth of invasion), N?spread to regional lymph nodes; second most important prognostic factor, M?metastasis; single most important prognostic factor

Question 25

In the TNM staging system what is the most important prognostic factor?

Answer 25

Metastasis

Question 26

At T8, there are two things what are they?

Answer 26

IVC and right phrenic nerve

Question 27

At T10, there are two things what are they?

Answer 27

Esophagus and Vagus (two trunks)

Question 28

At T12, there are three things what are they?

Answer 28

Aorta, Thoracic duct, azygos vein

Question 29

Shoulder pain via the diaphragm, what is it?

Answer 29

Shoulder C5

Question 30

Trapezium ridge pain via the diaphragm, what is it?

Answer 30

Traqezius ridge C3-C4

Question 31

Common carotid bifurcates at what level?

Answer 31

C4

Question 32

Trachea bifurcates at what level?

Answer 32

T4

Question 33

Abdominal Aorta bifurcates at what level?

Answer 33

L4

Question 34

What is the lymph drainage of the ovaries/testes?

Answer 34

Para-aortic lymph nodes

Question 35

What is the lymph drainage of the body of uterus/cervix/superior part of the bladder?

Answer 35

External iliac nodes

Question 36

What is lymph drainage of the vagina/vulva/scrotum/distal anus?

Answer 36

Internal Iliac Nodes

Question 37

What is the lymph drainage of the glans penis?

Answer 37

Deep inguinal nodes

Question 38

What is dysdiadochokinesia?

Answer 38

impaired rapid alternating movements

Question 39

What are the four nuclei, lateral to medial in the deep nucliei in the Cerebellum?

Answer 39

Dentate Emboliform Globose Fastigial

Question 40

What is the only output of the cerebellar cortex?

Answer 40

Purkinje Cells

Question 41

What is the speed of conduction of the different locations in the heart? Name all 5

Answer 41

Purkinje Atria Ventricles Bundle of His AV node

Question 42

Rhabdomyomas are seen in what neuro issue?

Answer 42

Tuberous Sclerosis

Question 43

Testicular non germ cell tumors: Reinke Crystals (eosinophilic cytoplasmic inclusions), makes androgens or estrogens, can cause Gynecomastia in men?

Answer 43

Leydig Cell Tumor

Question 44

Testicular non germ cell tumors: Androblastoma from sex cord stroma?

Answer 44

Sertoli Cell Tumor, high estrogen, and no AFP

Question 45

Testicular non germ cell tumors: Most common testicular cancer in older men, arises from a metastatic lymphoma?

Answer 45

Testicular Lymphoma

Question 46

Ovarian Cysts Distention of unruptured graafian follicle, associated with hyperestrogenism, endometrial hyperplasia, usually young women?

Answer 46

Follicular Cysts

Question 47

Ovarian Cysts Often bilateral/multiple, due to gonadotropin stimulation, associated with choriocarcinoma and hyatidiform moles?

Answer 47

Theca Lutein Cysts

Question 48

Laron syndrome has a defective what?

Answer 48

GH receptor

Question 49

What is sustained, involuntary muscle contractions?

Answer 49

Dystonia

Question 50

What is sudden, jerky, purposeless movements?

Answer 50

Chorea

Question 51

What is slow, snake-like, writhing movements; especially in the fingers?

Answer 51

Athetosis

Question 52

What is restlessness and intense urge to move?

Answer 52

Akathisia