Pathoma Chapter 3C Flashcards
Malignant tumors are classically
poorly differentiated (anaplastic)
Characteristics of malignant tumors include
- 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)
What is the hallmark of malignancy?
Metastatic potential - benign tumors never metastasize
What is the target cell type for the immunohistochemical stain of Keratin?
Epithelium
What is the target cell type for the immunohistochemical stain of Vimentin
Mesenchyme
What is the target cell type for the immunohistochemical stain of desmin
Muscle
What is the target cell type for the immunohistochemical stain of Neurofilament
Neurons
What is the target cell type for the immunohistochemical stain of PSA
Prostatic epil helium
What is the target cell type for the immunohistochemical stain of ER
Breast epithelium
What is the target cell type for the immunohistochemical stain of Thyroglobulin
thyroid follicular cells
What is the target cell type for the immunohistochemical stain of chromogranin?
neuroendocrine cells (small cell carcinoma of lung and carcinoid tumors)
What is the target cell type for the immunohistochemical stain of S-100?
Melanoma
What is used to characterize tumors that are difficult to classify on histology?
Immunohistochemistry
What are serum tumor markers?
Proteins released by tumor into serum (e.g PSA)
Serum tumor markers are useful for what?
screening, monitoring response to treatment, and monitoring recurrence
Elevated levels of serum tissue markers require what?
it requires tissue biopsy for diagnosis of carcinoma (e.g., biopsy of prostate with elevated PSA),
What is involved in the grading of cancer?
Microscopic assessment of differentiation (how much a cancer resembles the tissue in which it grows); takes into account architectural and nuclear features
What is low grade?
Well differentiated?resembles normal parent tissue
What is high grade?
poorly differentiated?does not resemble parent tissue
Cancer grading is important for what?
determining prognosis; well-differentiated cancers have better prognosis than poorly-differentiated cancers.
What is staging of cancer?
its an assessment of size and spread of a cancer,
How does the staging of cancer compare to the grading of cancer?
Key prognostic factor; more important than grading
When is the staging of cancer determined?
after final surgical resection of the tumor
What is the TNM staging system?
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
In the TNM staging system what is the most important prognostic factor?
Metastasis
At T8, there are two things what are they?
IVC and right phrenic nerve
At T10, there are two things what are they?
Esophagus and Vagus (two trunks)
At T12, there are three things what are they?
Aorta, Thoracic duct, azygos vein
Shoulder pain via the diaphragm, what is it?
Shoulder C5
Trapezium ridge pain via the diaphragm, what is it?
Traqezius ridge C3-C4
Common carotid bifurcates at what level?
C4
Trachea bifurcates at what level?
T4
Abdominal Aorta bifurcates at what level?
L4
What is the lymph drainage of the ovaries/testes?
Para-aortic lymph nodes
What is the lymph drainage of the body of uterus/cervix/superior part of the bladder?
External iliac nodes
What is lymph drainage of the vagina/vulva/scrotum/distal anus?
Internal Iliac Nodes
What is the lymph drainage of the glans penis?
Deep inguinal nodes
What is dysdiadochokinesia?
impaired rapid alternating movements
What are the four nuclei, lateral to medial in the deep nucliei in the Cerebellum?
Dentate Emboliform Globose Fastigial
What is the only output of the cerebellar cortex?
Purkinje Cells
What is the speed of conduction of the different locations in the heart? Name all 5
Purkinje Atria Ventricles Bundle of His AV node
Rhabdomyomas are seen in what neuro issue?
Tuberous Sclerosis
Testicular non germ cell tumors: Reinke Crystals (eosinophilic cytoplasmic inclusions), makes androgens or estrogens, can cause Gynecomastia in men?
Leydig Cell Tumor
Testicular non germ cell tumors: Androblastoma from sex cord stroma?
Sertoli Cell Tumor, high estrogen, and no AFP
Testicular non germ cell tumors: Most common testicular cancer in older men, arises from a metastatic lymphoma?
Testicular Lymphoma
Ovarian Cysts Distention of unruptured graafian follicle, associated with hyperestrogenism, endometrial hyperplasia, usually young women?
Follicular Cysts
Ovarian Cysts Often bilateral/multiple, due to gonadotropin stimulation, associated with choriocarcinoma and hyatidiform moles?
Theca Lutein Cysts
Laron syndrome has a defective what?
GH receptor
What is sustained, involuntary muscle contractions?
Dystonia
What is sudden, jerky, purposeless movements?
Chorea
What is slow, snake-like, writhing movements; especially in the fingers?
Athetosis
What is restlessness and intense urge to move?
Akathisia