Random Flashcards
What causes rat bite fever? tx?
Sterptobacillus monoliformis/spirillum minus
Tx: penicillin
What is a VHF caused by ticks? rats?
Congo-Crimean haemorrhagic fever
Rats: Lassa
What is a snail track ulcer characteristic of?
Secondary syphilis
What cells are usually not seen in stomach?
Goblet = intestinal metaplasia
Layers of mucosa of stomach?
Columnar epithelium
Lamina propria
Muscularis mucosa (erosion stops here)
Layers of oesophagus?
Mucosa
Submucosa
Muscularis propria
2 types of barrett’s(CLO)?
With goblet cells (intestinal type) - higher risk
Without goblet cells (gastric type)
What is SCC of oesophagus linked to?
Alcohol and smoking
Causes of chronic gastritis?
Autoimmune
Bacteria
Chemical
What helps H pylori attach?
cag-A –> chronic (–> cancer)
2 types of gastric adenocarcinoma?
Intestinal - well-diff
Diffuse - poorly diff e.g. linitis plastica, signet ring cell carcinoma
Characteristic feature off H pylori in upper GI?
Lymphoid follicles (but crypts full of neuts = MALToma)
What infection apart from H pylori can cause duodenitis?
Tropheryma whippelii
What infection mimics Coeliac histology?
Tropical sprue
Precursor of Coeliac?
Lymphocytic duodenitis
Where is ankyrin mutation found?
Spherocytosis
Where is protein 4.2 found?
Spherocytosis
Where is alpha spectrin found?
Elliptocytosis
Inheritance of spherocytosis?
Autosomal dominant
Definitive diagnosis for spherocytosis?
Eosin-5-maleimide on flow cytometry = less binding
Cause of gout?
Monosodium urate monohydrate
Cause of pseudogout?
Calcium pyrophosphate dihydrate
Most common RF for brain tumours?
Radiation
Chemo for high grade gliomas?
Temozolomide (or biologics like EGFR, PD-1 i)
Survival with grade 2 vs 3 brain tumours?
2 = >5yrs 3 = <5yrs
NB: no staging, just TYPE + GRADE
Only brain tumour that is staged?
Medulloblastoma
Most common primary CNS tumour?
Glioma
Rosenthal fibres + granular bodies in CNS?
Pilocytic astrocytoma
Well circumscribed enhancing tumours that is cystic and cerebellar on MRI?
Pilocytic astrocytoma
Mutation in pilocytic astrocytomas?
BRAF in 70%
Supratentorial type of glioma in adults?
Diffuse astrocytoma
Positive genetic prognostic in diffuse astrocytoma?
IDH1/2
Diffuse astrocytoma on MRI?
Non-enhancing and low choline:creatinine ratio
NB: glioblastomas are HETEROGENOUS enhancing
CNS tumour with microvascular proliferation, high cellularity and high mitotic activity (+ necrosis)?
Glioblastoma multiforme
Most common CNS tumour in children?
Pilocytic astrocytoma (*not medulloblastoma)
70yo with focal neurologu, MRI with enhancing right frontal lesion?
Glioblastoma
Astrocytomas or oligodendrogliomas, better prognosis?
Oligodendrogliomas
Fried eggs appearance CNS tumours?
Oligodendrogliomas (small cells with clear cytoplasm)
Patchy/no enhancement on MRI CNS tumour?
Oligodendroglioma
IDH1/2 and co-deletion of 1p/19q present in 100% of cases of this tumour
Oligodendroglioma
2nd most common CNS tumour overall?
- Metastatic
- Meningioma
- Glioblastoma
- Astrocytoma
Extraaxial, isodense, enhancing with contrast?
Meningioma
What grade is a tumour with mitotic activity of 3 vs 21 on HPF?
<4 = grade I >20 = grade III
Which tumour shows globules on hx and pseudinvasion in Virchow-Robin space?
Meningioma
Most common sources of CNS mets in order?
Lung (>40%)
Breast (15%)
Melanoma (~9%)
CNS mets location?
Grey-white junction
Homer-Wright rosettes, small blue round cells and synaptophysin expression?
Medulloblastoma - 2nd most common tumour in children
Which CNS tumour is a candidate for resection?
Oligodendroglioma
CNS tumour responsive to steroids?
Diffuse astrocytoma?
Max number of mismatches in HLA class I between mother and child?
2 - because you inherit at least one of HLAA etc from each parent so 1 will always be a match to that parent
Tx for MRSA?
Vancomycin
Reactivation of which virus is common with Rituximab?
Hep B
Which coagulation factor decreased first with warfarin?
FVII
Which coagulation factors are not made in the liver?
III, IV and VIII