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Endo Repro (Phase II) > Pathoma (HIGH YIELD) > Flashcards

Pathoma (HIGH YIELD) Flashcards

1
Q

Vulvar carcinoma etiologies

A

HPV (dysplasia, VIN) and non-HPV (longstanding lichen sclerosis)

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2
Q

Extramammary Paget’s disease vs Melanoma differentiation?

A

Paget’s: PAS+, keratin +, S100-

Melanoma: PAS-, keratin-, S100+

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3
Q

Vaginal carcinomas nodal metastasis pattern

A

Lower 1/3: inguinal nodes

Upper 2/3: iliac nodes

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4
Q

High risk HPV proteins

A

E6 (destruction of p53), E7 (destruction of Rb)

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5
Q

Cervical carcinoma risk factors

A

HPV (no 1), but smoking and immunodeficiency also important

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6
Q

What malignancy is an AIDS-defining illness in a woman with HIV?

A

Cervical cancer

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7
Q

Frequent cause(s) of mortality in Cervical cancer

A

“Local invasion” (e.g. invasion through bladder, hydronephrosis, renal failure)

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8
Q

Limitations of Pap smear screening

A
  • Inadequate sampling of transition zone

- Decr. efficacy in screening adenocarcinoma

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9
Q

Does HPV vaccination preclude the need for routine Pap smears? Why?

A

No; does not offer protection against HPV 31, 33

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10
Q

Asherman syndrome cause

A

Progressive amenorrhea d/t loss of basalis (regenerative layer) and scarring

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11
Q

Risk factor(s) for endometrial polyp(s)

A

Can arise as side effect of Tamoxifen

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12
Q

Define adenomyosis

A

Endometriosis of myometrium

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13
Q

Most important predictor for progression to carcinoma in Endometrial hyperplasia

A

Cellular atypia

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14
Q

Leiomyosarcoma etiology

A

De novo (does not arise from leiomyoma)

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15
Q

Describe normal endocrine regulation of ovulation in the ovary

A

LH acts on theca cells, which produce androgens, which are then converted to estradiol in the granulosa cells under the influence of FSH, eestradiol then causes egg maturation

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16
Q

Most common germ cell tumor in children

A

Endodermal sinus tumor (type of yolk sac tumor)

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17
Q

Endodermal sinus tumor lab findings

A

Elevated AFP

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18
Q

Endodermal sinus tumor lab findings

A

Elevated AFP

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19
Q

Defines Meigs syndrome

A

Ovarian fibroma (benign tumor of fibroblasts) plus pleural effusion, ascites

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20
Q

What mutation incr. risk for serous carcinoma of the ovary and fallopian tube?

A

BRCA1

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21
Q

What ovarian tumor usually contains urothelium?

A

Brenner tumor

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22
Q

Choriocarcinoma response to chemo?

A

Good response for gestational pathway (i.e. from complete mole); poor response if germ cell pathway

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23
Q

Hypospadias cause

A

Failure of urethral folds to close

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24
Q

Penile SCC precursor lesions

A
  • Bowen disease (shaft)
    • Leukoplakia on shaft of penis; has not invaded BM
  • Erythroplasia of Queyrat (glans)
  • Bowenoid papulosis (reddish papules)
    • Not true Bowen’s disease b/c it does not usually progress to invasion
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25
Q

Testicular torsion presentation

A

Adolescents with acute testicular pain and absent cremasteric reflex

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26
Q

Seminoma histopathology

A

No hemorrhage or necrosis

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27
Q

What type of testicular tumor may form glands?

A

Embryonal carcinoma

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28
Q

Most common testicular tumor in children

A

Yolk sac tumor (aka endodermal sinus tumor)

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29
Q

Possible clinical presentation of choriocarcinoma

A

Gynecomastia, hyperthyroidism (both d/t elevated b-HCG)

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30
Q

Leydig cell tumor characteristic histology

A

Reinke crystals

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31
Q

Leydig cell tumor characteristic histology

A

Reinke crystals

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32
Q

Are teratomas benign or malignant?

A

Benign in females; potentially malignant in males

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33
Q

Acute prostatitis on DRE

A

Tender and boggy

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34
Q

BPH occurs in this zone of the prostate (according to Pathoma)

A

What is the periurethral zone

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35
Q

Prostate adenocarcinoma characteristic histology

A

Small glands, nuclei contain dark nucleoli

36
Q

Growth hormone adenoma presentation

A

Secondary diabetes is often present

37
Q

Sheehan syndrome cause and symptoms

A

Pituitary growth during pregnancy d/t more blood flow incr. susceptibility to infarct during delivery; difficulty with lactation, pubic hair loss

38
Q

Thyroglossal duct cyst presentation

A

Anterior neck mass

39
Q

Lingual thyroid presentation

A

Mass at base of tongue

40
Q

Cause of incr. BMR in hyperthyroidism

A

Incr. synthesis of Na+/K+ ATPase

41
Q

Cause of incr. SNS activity in hyperthyroidism

A

Incr. expression of beta adrenergic receptors

42
Q

Hyperthyroidism on a lipid panel

A

Hypocholesterolemia

43
Q

Enzyme most often deficient in dyshormogenetic goiter

A

Thyroid peroxidase (causing pediatric hypothyroidism)

44
Q

Haplotype associated with Hashimoto thyroiditis

A

HLA DR5

45
Q

Histopathologic findings in Hashimoto thyroiditis

A

Abundant chronic inflammation with formation of germinal centers; Hurthle cells

46
Q

Riedel fibrosing thyroiditis presentation

A

Hypothyroidism with “hard as wood” nontender thyroid

47
Q

Subacute (deQuervain) granulomatous thyroiditis presentation

A

Transient hyperthyroidism with tender (particularly unique) thyroid

48
Q

How is a thyroid biopsy usually performed and why?

A

FNA; thyroid is (very) vascular

49
Q

Thyroid follicular adenoma histopathology

A

Benign proliferation of follicles surrounded by a fibrous capsule

50
Q

4 types of thyroid carcinomas

A

Papillary medullary follicular anaplastic

51
Q

Most important risk factor for papillary thyroid carcinoma

A

Exposure to ionizing radiation in childhood

52
Q

Gross appearance of follicular thyroid carcinoma; what significance does this have with respect to thyroid bx?

A

Extension through capsule; cannot differentiate adenoma from follicular ca on FNA

53
Q

Medullary thyroid cancer histopathologic appearance

A

Malignant cells within amyloid stroma

54
Q

Medullary thyroid cancer genetics

A

Mutation in RET oncogene (mutations detected in RET always prompt prophylactic thyroidectomy)

55
Q

PTH effect on bone

A

Incr. osteoblast activity, which in turn incr. osteoclast activity, crushing bone, leading to Ca++ and Phosphate release

56
Q

Primary hyperparathyroidism GI sequelae

A

Acute pancreatitis (most important), PUD, constipation

57
Q

Primary hyperparathyroidism urine labs

A

Incr. cAMP (PTH binds tubular cells of kidney, activates Gs protein thus activating adenylate cyclase, after which incr. cAMP leaks into urine)

58
Q

Primary hyperparathyroidism serum labs

A

Incr. Alk phos, incr. Ca++, incr. Phosphate, incr. PTH

59
Q

Cause of pseudohypoparathyroidism

A

Defect in Gs protein

60
Q

Why is obesity implicated in type II diabetes?

A

Decr. number of insulin receptors

61
Q

Which has a stronger genetic predisposition: type I or type II diabetes?

A

Type II diabetes

62
Q

Pancreatic histopathology in diabetes

A

Amyloid deposition in islets

63
Q

Diabetic neuropathy pathophysiology

A

Schwann cells can absorb glucose independent of insulin, then aldose reductase converts to sorbitol, leading to osmotic damage

64
Q

How can Cushing syndrome lead to HTN?

A

Cortisol upregulates alpha-1 receptors (cortisol is “necessary for life” b/c it maintains vascular tone)

65
Q

Causes of chronic adrenal insufficiency

A
  • Autoimmune (most common in West)
  • TB (most common in developing world)
  • Bilateral metastatic disease (recall unique site of metastasis for lung ca)
66
Q

Adrenal medulla cell composition (incl. embryologic origin)

A

Chromaffin cells (derived from NCCs)

67
Q

Gross appearance of pheochromocytoma

A

Brown

68
Q

Pheochromocytoma diagnostic requirements

A

Serum metanephrines (breakdown product of epinephrine), elevated 24-hr metanephrines and VMA (breakdown product of metanephrines and normetanephrines)

69
Q

What medication is given before pheochromocytoma removal and why?

A

alpha-Phenoxybenzamine (irreversible alpha-1 blocker); intraoperative compression of pheo could release massive amount of catecholamines, causing HTN surge

70
Q

Most common location (and presentation) of pheochromocytoma outside adrenal medulla

A

Bladder wall (hypertensive during urination)

71
Q

Embryologic origin of breast tissue; why is this important?

A

Skin (modified sweat gland); breast tissue (incl. nipples, cancer) can develop anywhere along “milk line” (axilla to vulva)

72
Q

Normal breast tissue epithelial composition

A

Lobules and ducts lined by 2 layers: myoepithelial cell layer and luminal cell layer

73
Q

Highest density of breast tissue is located where?

A

Upper outer quadrant(s)

74
Q

Mammary duct ectasia symptoms

A

Periareolar mass, green-brown nipple discharge

75
Q

2 possible presentations of breast fat necrosis

A

Mass on exam; calcifications on mammogram (higher yield)

76
Q

Fibrocystic breast histopathology that does NOT incr. risk of cancer (in either breast)

A

Fibrosis, cysts, apocrine metaplasia (one of a few metaplasias that do not incr. cancer risk)

77
Q

Fibrocystic breast histopathology that DOES incr. risk fo cancer (in either breast)

A

Ductal hyperplasia, sclerosis adenosis (often calcified), atypical hyperplasia

78
Q

Intraductal papilloma (breast) vs papillary carcinoma differentiation

A

Papillary carcinoma won’t have myoepithelial cells

79
Q

Phyllodes tumor (breast) histopathology

A

Fibroadenoma-like with overgrowth of fibrous component; leaf-like projections

80
Q

Comedo type DCIS histopathology

A

High grade cells, necrosis, dystrophic calcifications (i.e. calcium in dead cells) in ductal lumen

81
Q

Medullary carcinoma (of breast) histopathology

A

High grade malignant cells in background of inflammatory cells (especially plasma cells and lymphocytes)

82
Q

Medullary carcinoma (of breast) genetics

A

BRCA1

83
Q

Which breast neoplasms lack E-cadherin?

A

LCIS; invasive lobular carcinoma

84
Q

Invasive lobular carcinoma (of breast) histopathologic feature

A

Grows in single file pattern

85
Q

Most important part of TNM staging in breast cancer prognosis

A

Metastasis

Endo Repro (Phase II) (3 decks)

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