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mrcog part 1 > Revision notes: 7. Pathology > Flashcards

Revision notes: 7. Pathology Flashcards

1
Q

Two substances responsible for initiating systemic acute phase response

A

Interleukin-1

TNF

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2
Q

Caseating granuloma

A

TB

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3
Q

Non-caseating granuloma

A

Sarcoidosis

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4
Q

Teratoma definition

A

Neoplasm containing more than one germ cell layer

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5
Q

HNPCC inheritance

A

Autosomal dominant

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6
Q

HNPCC risk of colorectal cancer

A

80% risk colonic cancer

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7
Q

What is factor V leiden

A

Variant of factor V that cannot be inactivated by protein C

Causes hypercoagulant state

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8
Q

Antiphospholipid triad

A

Recurrent miscarriage
Thrombosis - arterial & venous
Presence of antiphospholipid antibody

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9
Q

Ataxia telangiectasia important features

A

Autosomal recessive
Acute leukaemia
Lymphoma
Breast cancer

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10
Q

Fanconi anaemia important features

A

Autosomal recessive

Acute leukaemia

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11
Q

Xeroderma pigementosa

A

Autosomal recessive
Basal + squamous cell carcinoma
Malignant melanoma

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12
Q

Tuberous Sclerosis important features

A

Autosomal dominant
Hamartomas
Glial tumours

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13
Q

Neurofibromatosis important features

A 
Autosomal dominant
Gliomas of brain and optic nerve
Acoustic neuromas
Meningioma
Phaeochromocytoma
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14
Q

Aflatoxin associated with which malignancy

A

Hepatocellular carcinoma

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15
Q

Nitrosamines and amides associated with which malignancy

A

Gastric CA

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16
Q

Arsenic associated with which malignancy

A

Skin cancer

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17
Q

aromatic amines and azo dyes which malignancy

A

Liver

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18
Q

Beta-naphthylamine which malignancy

A

Bladder

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19
Q

Pro-inflammatory mediator not inhibited by NSAIDs

A

Bradykinin

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20
Q

Tamm-Horsfall protein

A

glycoprotein secreted by renal tubular epithelial cells

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21
Q

Wound healing: re-epithelisation occurs when

A

24-48hrs post injury

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22
Q

Non-epithelial ovarian cancer makes up what percentage of ovarian cancer

A

10-15%

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23
Q

Brenner’s tumour is composed of

A

Transitional cells

These tumours secrete oestrogen

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24
Q

Meig’s syndrome triad

A

Ovarian fibroma
Hydrothorax
Ascites

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25
Q

RMI - how to calculate

A

Risk of malignancy index

CA-125 * USS findings * menopause status

Post-menopausal = 3 points

> 1 worrying ultrasound feature = 3 points

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26
Q

Schiller-Duval body

A

Cellular structure resembling glomerulus
Seen in endodermal sinus (yolk sac) tumours

Secrete AFP and A1-antitrypsin

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27
Q

Call-exner body

A

Fluid filled punched out spaces between granulosa cells

See in granulosa cell tumours

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28
Q

Sex cord stromal tumour presentation

A

Acute abdominal pain (tendency to rupture)
Iso-sexual precocious puberty
Menorrhagia
Irregular bleeding

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29
Q

Mucin-secreting signet-ring cells

A

Krukenberg tumour
GI cancer metastasing to ovary

Signet rings seen in stomach cancer

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30
Q

Inheritance pattern of Lynch syndrome

A

Autosomal dominant

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31
Q

Risk of endometrial cancer if u have lynch

A

Lifetime risk of endometrial cancer in pt with lynch is 40-60% compared to 3% risk in general population

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32
Q

Peutz-jeghers syndrome

A

Mutation in STK11
Autosomal dominant
Inc risk of sex cord stromal ovarian tumours and adenoma malignum of cervix

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33
Q

Serous ovarian cancers cell type

A

Resemble internal lining of fallopian tube

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34
Q

Mucinous ovarian cancer cell type

A

Resemble lining of endocervix or intestine

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35
Q

Clear cell tumours are linked to

A

endometriosis

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36
Q

Psammoma bodies

A

concentric lamellated calcified structures
Seen in:
papillary thyroid carcinoma
Meningioma
papillary serous cystadenocarcinoma of ovary

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37
Q

Endometrial epithelial cells becoming vacuolated, thrown into pseudo-papillary folds giving hyper-secretory impression
Evidence of decidualisation around spiral arteries and under surface of epithelium

A

Arias-stella reaction

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38
Q

Thickened polypoidal endometrium, straight endometrial glands, narrow columnar cells with basophilic cytoplasm, stromal hyperplasia and increase in glands

Ratio of glands to stroma is NORMAL

A

Hyperplasia without atypia.

Not pre-malignant

Associated wtih unopposed oestrogen stimulation with anovulatory cycles, oestrogen secreting tumours, oestrogen therapy

39
Q

Increased ratio of glands:stroma, crowding of glands, back-to-back appearance
Various degrees of cellular pleomorphism and atypia

Increase in mitotic figures

A

Atypical hyperplasia

Risk of progression to endometrial carcinoma up to 50%

40
Q

Endometrial SARCOMA - “homologous” vs “heterologous”

A

homologous if they contain endometrial tissue only (stromal or glandular)

heterologous if they contain extra-uterine tissue such as muscle or cartilage

41
Q

Commonest site for endometriosis

A

ovary

42
Q

elongated, spindle-shaped, with a cigar-shaped nucleus

A

FIBROID

Uterine leiomyoma

43
Q

Most common fibroid degeneration type

A

Hyaline

44
Q

Prevalence of sarcoma in pts undergoing hysterectomy or myomectomy for myometrial mass

A

1: 500

0. 2%

45
Q

Dysgerminoma important facts

A

Most common malignant germ cell tumour
Female equivalent of seminoma
EXTREMELY RADIOSENSITIVE
Bilateral in 20%

46
Q

Most common SOLID benign tumour of ovary

A

fibroma

47
Q

Most common benign ovarian neoplasm in children

A

dermoid cyst

48
Q

theca-lutein cyst features

A

simple cysts
lined with leutenised granulosa cells
2ndry to excessive gonadotrophic stimulation of ovaries - ovulation inducing drugs, molar pregnancy

49
Q

Which ovarian tumour secretes AFP

A

endodermal sinus tumour

50
Q

dermoid cyst lining

A

stratified squamous epithelium

51
Q

serum inhibin is a marker for which ovarian tumour

A

granulosa cell tumour

52
Q

In women using COCP, endometrium is characterised by

A

glandular atrophy

53
Q

In women using copper coil, endo characterised by

A

mononuclear cell infiltrate

54
Q

In women using mirena, endo characterised by

A

Decidual changes

55
Q

acute endometritis - characterised by

A

Polymorphonuclear cell infiltration of the endometrial glands and stroma

56
Q

Lymphocytic and plasma cell infiltration of the endometrial glands and stroma

A

Chronic endometritis

57
Q

Diagnosis of endometriosis

A

Biopsy identifying haemosiderin-laden macrophages

58
Q

average age of diagnosis of leiomyosarcoma

A

51 years old

59
Q

ECM-1 antibodies have been detected in 60-80% of women with

A

Lichen Sclerosus

60
Q

Pale, white atrophic areas on vulva
Fissuring
Stenosis of introitus

A

Lichen Sclerosus

61
Q

Lichenoid inflammatory infiltrate in dermal-epidermal junction
Hyperkeratosis
Clefting

A

Lichen Sclerosus

62
Q

Weak circulating basement membrane zone antibodies

A

Erosive lichen planus

63
Q

Wickham’s striae

A

Lichus Planus

64
Q

if it involves the vagina it cannot be

A

lichen sclerosus

65
Q

Irregular saw-toothed acanthosis
Increased granular layer
Basal cell liquefaction

A

Lichen planus

66
Q

Distal urethral prolapse

Pink exophytic lesion at urethral meatus

A

Urethral caruncle

67
Q

Endocervical COLUMNAR epithelium visible at ectocervix, undergoes squamous metaplasia

A

cervical ectropion

68
Q

Cervical intra-epithelial neoplasia associated with

A

HPV 16, 18, 31, 33

69
Q

CIN I

A

Dysplastic cells confined to lower third of epithelium

70
Q

CIN II

A

Dysplastic cells confined to lower two thirds of epithelium

71
Q

CIN III

A

Entire thickness of epithelium involved

72
Q

Risk factors for SCC cervix

A 
Early age first sex
Multiple partners
Smoking
Non-barrier contraception
Immunosuppression
73
Q

Risk of invasive vulval cancer in women with lichen sclerosus

A

4%

74
Q

Diffuse CK20 positivity is suggestive of

A

secondary vulval paget’s disease

Spread of internal malignancy e.g. anorectal adenocarcinoma / urothelial carcinoma

75
Q

Basaloid carcinoma of vulva

A 
Associated with HPV
Younger population (<65)
76
Q

DES daughters at risk of

A

Clear cell adenocarcinoma of vagina

0.1% risk

77
Q

Sulphur granules

A

Actinomycosis

78
Q

Examples of granulomatous inflammation

A

1) TB and leprosy
2) Syphilis - gumma
3) Cat scratch disease
4) Schistosomiasis
5) Cryptococcus and coccidiodes infections
6) Sarcoidosis
7) Silicosis and berylliosis

79
Q

HPV is a …. virus with ….. within genome

A

DNA virus

oncogene

80
Q

MEN 1

A

Autosomal dominant

Adenoma of Pituitary, parathyroid, islet cell

81
Q

MEN 2

A

Autosomal dominant
Medullary carcinoma thyroid
Phaeo
parathyroid

82
Q

Neutrophils appear within …. at the margins of an incision

A

24 hours

83
Q

Granulation tissue forms when in wound healing

A

3-5 days

84
Q

Remodelled scar - main collagen

A

collagen 1

85
Q

Protein involved in apoptosis

A

BCL-2

86
Q

Granulosa cell tumour is a

A

Sex cord stromal ovarian cancer

87
Q

Aflatoxin B1 causes

A

Hepatocellular carcinoma

88
Q

What % of PEs are clinically asymptomatic

A

60-80%

89
Q

Diffuse renal cortical necrosis

A

Abruption/septic shock

Irreversible renal failure
Anuria

90
Q

Metastatic calcification occurs in

A

normal tissues in presence of hypercalcaemia

91
Q

Dystrophic calcification refers to

A

Calcium deposition in tissues in presence of normal plasma calcium & phosphate

92
Q

How to oncogenic viruses cause cancer

A

Cause cancer by integrating viral DNA into the host’s DNA

93
Q

Mature cystic teratoma - risk of malignant transformation

A

1%

mrcog part 1 (14 decks)

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