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sbcp Flashcards

1
Q

pseudostratified ciliated columnar epithelium

A

respiratory epithelium

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2
Q

silver stain

A

pneumocystis carinii

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3
Q

Pontiac fever

A

legionella pneumoniae

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4
Q

pink puffer

A

emphysema

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5
Q

blue bloater

A

chronic bronchitis

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6
Q

alpha 1 antitrypsin deficiency

A

early onset emphysema and cirrhosis

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7
Q

Charcot-Leden crystals
Curshmann spirals
Creda bodies

A

asthma

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8
Q 
acid and alcohol fast rods
ziehl-neelsen stain
ghon focus/complex
caseating granulomatous inflammation
epitheliod histiocytes
Longhand giant cells and lymphocytes
A

TB

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9
Q

Masson bodies

A

cryptogenic organising fibrosis

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10
Q

crocidolite

A

nasty asbestos type

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11
Q

Caplan lesions

A

coal workers pneumoconiosis

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12
Q

erythema nodosum
granuloma
ACE
hypercalcaemia

A

sarcoidosis

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13
Q

Kerley B lines
beads on a string (congested capillaries along alveolar septa)
heart failure cells (macrophages containing yellow brown haemosiderin granules)

A

pulmonary oedema

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14
Q

smoker
older
nipple discharge

A

duct ectasia

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15
Q

blood stained discharge

obstruction of single duct

A

intraductal papilloma (can become papillary carcinoma)

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16
Q

clinical examination
mammography/USS
FNA/core biopsy

A

triple assessment

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17
Q

exaggeration in normal physiological changes

A

fibroadenosis

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18
Q

breast mouse

solid firm well circumscribed

A

fibroadenoma (phyllodes tumour - malignant counterpart)

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19
Q

fibroblasts
histiocytes
adipocytes

A

fat necrosis

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20
Q

lactating women

A

abscess

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21
Q

eczema around nipple

A

pagets disease of the great (large round malignant epithelial cells invading squamous epithelium of nipple - underlying DCIS)

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22
Q

calcification picked up on mammography

A

DCIS

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23
Q

no necrosis or micro calcification
premenopausal
bilateral

A

lobular carcinoma in situ

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24
Q

tubule formation

cells in nests/sheets/cords/islands

A

invasive ductal carcinoma (mucinous, tubular, medullary and papillary

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25
Q

indian file

A

infiltrating lobular carcinoma

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26
Q

red infarct

A

venous occlusions
lung
dual circulation

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27
Q

pale infarct

A

solid organs with single blood supply eg heart, spleen, kidney

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28
Q

distal tissues - pale painful pulseless cold

A

arterial thrombus

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29
Q

distal tissues swollen red tender

A

venous thrombus

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30
Q

Charcot Bouchard brain aneurysm
retinopathy
papilloedema
benign nephrosclerosis

A

hypertension

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31
Q

malignant arteriosclerosis
fibrinoid necrosis of arterioles
hyperplastic arteriolitis/onion skinning (concentric lamellae

A

malignant hypertension

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32
Q

Aschoff body (pale focus on eosinophilic hyaline material surrounded by lymphocytes and macrophages

A

rheumatic fever

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33
Q

squamous epithelium

A

ectocervix

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34
Q

mucin secreting glandular epithelium

A

endocervix

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35
Q

junction of endo and ectocervix

A

transformation zone

LLETZ - large loop excision of transformation zone

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36
Q

dysplasia of bottom 1/3 cervical epithelium

A

mild cervical intraepithelial neoplasia (CIN I)

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37
Q

dysplasia of bottom 2/3 cervical epithelium

A

moderate cervical intraepithelial neoplasia (CIN II)

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38
Q

full thickness dysplasia of cervical epithelium

A

severe cervical intraepithelial neoplasia (CIN III)

progresses to squamous carcinoma

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39
Q

koliocytosis

large and irregular nuclei

A

HPV infection

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40
Q

lots of mucin
nuclei heaping on top of each other
apoptotic bodies
mitotic figures

A

cervical glandular intraepithelial neoplasia (CGIN)
low/high grade
progresses to adenocarcinoma

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41
Q

HPV 6 + 11

A

low risk cervical cancer

anal warts - condyloma accuminatum

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42
Q

HPV 16 + 18

A

high risk cervical cancer

anal intraepithelial neoplasia (AIN)

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43
Q

polypoid/friable mass arising in transformation zone

cells invading stroma

A

squamous cell carcinoma

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44
Q

endocervix

not visible at colposcopy

A

adenocarcinoma

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45
Q

squamous and adenocarcinoma components

A

adenosquamous carcinoma

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46
Q

keratinising stratified squamous epithelium

A

normal vulva

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47
Q

white itchy vulval dystrophy

A

lichen sclerosis

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48
Q

squamous cell hyperplasia

A

vulval dystrophy

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49
Q

younger patient
HPV link
multifocal
low invasion risk

A

bowenoid/undifferentiated vulval intraepithelial neoplasia (VIN I-III)
preinvasive
progress to vulval squamous carcinoma

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50
Q 
older patient
no HPV link
associated dystrophies
unifocal
high invasion risk
A

simplex/differentiated vulval intraepithelial neoplasia (VIN I-III)
preinvasive
progress to vulval squamous carcinoma

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51
Q

intraepithelial adenocarcinoma

A

pagets disease

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52
Q

circumscribed tumour
white whorled cut surface
spindle shaped cells
lack atypical features

A

fibroids/leiomyoma

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53
Q

endometrial tissue in myometrium

A

adenomyosis

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54
Q

endometrial tissue in site distant from uterus

A

endometriosis

small risk of malignant change

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55
Q

precursor - endometrial hyperplasia
perimenopausal
high BMI, HTN, DM
unopposed oestrogens

A

type 1 endometrial cancer - endometrioid type adenocarcinoma

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56
Q 
older patient without normal risk factors
atrophic endometrium
aggressive 
advanced stage and poor prognosis
p53 mutation 
infiltrates myometrium
hobnail appearance 
papillary structures
A

type 2 endometrial cancer - serous carcinoma

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57
Q

spindle shaped cells
nuclear pleomorphism
areas of necrosis

A

leiomyosarcoma (malignant counterpart to fibroid)

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58
Q

small blue cells invading myometrium
very bland
few mitotic figures

A

endometrial stroma sarcoma

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59
Q

adenocarcinoma and sarcomatous elements

A

carcinosarcoma/malignant mixed mullein tumour (MMMT)

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60
Q

multiple cysts

follicular derivation

A

PCOS

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61
Q

mucinous cystadenoma

A

benign

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62
Q

thin walled cyst with some papillary growths

A

borderline

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63
Q

solid or complicated cystic

A

malignant - subtypes; mucinous, serous, endometrioid, clear cell, transitional

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64
Q

risk of malignancy index

A

menopausal status
CA125 level
USS findings

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65
Q

mature teratoma (dermoid cyst) with skin appendages, hair, gut etc

A

benign germ cell tumour

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66
Q 
immature teratoma 
teratoma with malignant transformation
yolk sac tumour (check serum AFP)
dysgerminoma 
choriocarcinoma (check serum hCG)
A

malignant germ cell tumours

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67
Q

fibroma/fibrothecoma

ascites and plural effusions

A

benign sex cord stromal tumour

Mengs syndrome

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68
Q

granulosa cell tumour

nuclear grooves

A

malignant sex cord stromal tumours

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69
Q

large multinucleated cells

A

osteoclasts

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70
Q

mononuclear cells on bone surface

A

osteoblasts

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71
Q

osteoblasts surrounded by osteoid

A

osteocytes

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72
Q 
haematoma and acute inflammation
organisation of haematoma (granulation tissue)
primary callus response
external bridging callus
remodelling several months later
A

fracture healing

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73
Q 
staph aureus
e coli
pneumococcus 
group a strep
mycobacterium tuberculosis
A

organisms of osteomyelitis

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74
Q

fibrous stroma containing plasma cells and lymphocytes

A

chronic osteomyelitis

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75
Q

synovial hyperplasia
chronic inflammation
lymphoid aggregates
lymphoid follicles

A

rheumatoid arthritis

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76
Q

fixed hyper extension of PIP and flexion of DIP

A

swan neck deformity

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77
Q

fixed hyper flexion of PIP and extension of DIP

A

boutonnieres deformity

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78
Q 
reduced amount of normally mineralised bone
loss of microarchitecture
thinning of cortical bone
trabecular bone poorly defined 
no interconnections
A

osteoporosis

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79
Q

increased seams of unmineralised osteoid

A

osteomalacia

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80
Q

bone thickened
increased osteoblasts
disorganised

A

pagets disease

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81
Q

long bones
central nidus of irregular trabecular / woven bone and osteoid in highly vascular stroma surrounded by mass o sclerotic bone

A

osteoid osteoma - benign

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82
Q

cartilage capped bony projection

A

osteochondroma - benign

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83
Q

cartilaginous lesion in medullary cavity

A

enchondroma - benign

hard to tell apart from a low grade chondroscarcoma - malignant

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84
Q

locally aggressive
in epiphysis
may produce osteoid

A

giant cell tumour - benign

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85
Q

produces malignant osteoid
intramedullary
high grade

A

osteogenic sarcoma - malignant

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86
Q

small round blue cell tumour
poorly differentiated
affects shaft of long bones

A

ewings sarcoma - malignant

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87
Q 
thyroid
breast
prostate
lung
kidney
A

common primary sites of bone metastases

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88
Q

follicles and germinal centres
B cells
(macrophages between follicles)

A

lymph node cortex

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89
Q

lymph sinuses (containing macrophages)
blood vessels
some b cells

A

lymph node medulla

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90
Q

T cells

A

lymph node paracortex

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91
Q

granulomatous inflammation

A 
sarcoidosis 
TB
fungal infection 
hodgkins
crohns
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92
Q

non caseating granulomata
eptheloid cells
langhans giant cells and lymphocytes
increased calcium and ACE

A

sarcoidosis

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93
Q

indolent - lymphocytic / follicular
aggressive - lymphoblastic, burrkits, diffuse large B cell, mantle cell
85% B cell

A

Non Hodgkins Lymphoma

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94
Q

small lymphocytes
prolymphocytes
most common leukaemia

A

chronic lymphocytic leukaemia (CLL)

NHL

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95
Q

centroblasts and centrocytes

A 
follicular lymphoma (NHL)
progresses to diffuse large B cell lymphoma (NHL)
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96
Q 
lymphatoid polyposis (extra nodal in small bowel) 
monotonous proliferation of small lymphoid cells
A

mantle cell (NHL)

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97
Q

jaw / ileocaecal mass
intermediate cells
starry sky appearance
diffuse growth

A

burrkits (NHL)

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98
Q

worse than b cell
cell size varies
sezary syndrome - spreads to blood
mycosis fungicides - primary cutaneous

A

T cell lymphoma (NHL)

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99
Q

Reed Sternberg cells

A

Hodgkins lymphoma (HL)

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100
Q

nodular sclerosis - lacunar cells and sclerotic bands

mixed cellularity - Reed Sternberg!

A

classical Hodgkins lymphoma

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101
Q

Philadelphia chromosome

A

chronic myeloid leukaemia (CML)

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102
Q

blast seen
merges with lymph node disease
children

A

acute lymphoblastic leukaemia

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103
Q

plasma cell neoplasm
bence jones protein in urine
monoclonal Ab band on plasma electrophoresis

A

myeloma

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104
Q

stratified squamous to columnar epithelium
premalignant
red on endoscopy

A

barretts metaplasia of oesophagus

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105
Q

periodic acid schiff (PAS) positive
hyphae stained red
white plaques on endoscopy

A

candida

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106
Q

linear punched out ulcers

multinucleated giant cells with ground glass inclusions

A

hERPES

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107
Q

exophytic polypoid luminal mass / necrotising malignant ulcer eroding wall / adjacent structure
diffuse infiltrating neoplasm causing stricture

A

squamous carcinoma of oesophagus

most common type

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108
Q

oesophageal cancer
obese middle aged white men
barretts risk factor

A

adenocarcinoma

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109
Q

petechial/flea bitten haemorrhage in stomach mucosa

A

acute / erosive gastritis

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110
Q

autoimmune lymphocytic pernicious anaemia

A

type a chronic gastritis

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111
Q

h pylori infection

A

type b chronic active gastritis

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112
Q

mucosal injury and regenerative change eg reflux, drugs, chemicals

A

type c chronic gastritis

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113
Q

defect in epithelial lining where it undergoes necrosis due to direct toxic insult and inflammatory response

A

peptic ulcer

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114
Q

gland forming tumour in body/antrum/cardia

A

intestinal type gastric carcinoma

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115
Q

infiltrate of mucin containing signet ring cells
extensive invasion stomach walls ‘linitis plastic’
early age
e cadherin gene mutation

A

diffuse type gastric carcinoma

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116
Q

confined to mucosa / submucosa without involving muscularis propria

A

early gastric carcinoma

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117
Q

bilateral ovarian tumours

A

krunkenberg

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118
Q

left supraclavicular node

A

virchows node - gastric carcinoma

119
Q

long-standing h pylori infection

antigen dependent polyclonal lymphoid proliferation

A

gastric lymphoma

low grade

120
Q

antigen dependent monoclonal neoplastic lymphoid proliferation

A

MALToma / marginal zone lymphoma

high grade if antigen INdependent monoclonal malignant growth

121
Q

mesenchymal spindle cell tumour
c-kit/CD117 expression
treat with Gilvec (tyrosine kinase inhibitor

A

GI stromal tumour (GIST)

122
Q

uncommon tumour jejunum
napkin ring structure
complication of coeliac or crohns

A

adenocarcinoma

123
Q

neuroendocrine
produce serotonin / 5-HT, 5-HIAA, and vasoactive fibrogenic factors
liver mets leading to carcinoid syndrome
insular/trabecular pattern

A

carcinoid tumour

124
Q

tumour in duodenum

Zollinger Ellison syndrome

A

gastrin cell tumour

125
Q

high grade and aggressive lymphoma

A

enteropathy associated T cell lymphoma

other lymphomas include post transplant lymphoproliferative disorder, MALToma, Burkitts, mantle cell (polyps)

126
Q

common hyperplastic/metaplastic
little malignant potential
adenomatous - tubular/villous/tubulovillous

A

polyps

127
Q

autosomal dominant mutation in APC gene
hundreds of adenomatous polyps
prophylactic panproctocolectomy

A

familial adenomatous polyposis (FAP)

128
Q

micro satellite unstable pathway

mutation in DNA repair genes

A

hereditary non polyposis colon cancer (HNPCC) - Lynch syndrome

129
Q

micro satellite unstable pathway

mutation in DNA repair genes

A

hereditary non polyposis colon cancer (HNPCC) - Lynch syndrome

130
Q

psuedomyoma peritonei

mucinous ovarian tumours

A

mucocele of appendix

131
Q

aggressive

conventional carcinoid with insular/nested growth pattern or goblet cell/crypt cell carcinoid (mucin secreting cells)

A

carcinoid of appendix

132
Q

anal canal carcinoma (basaloid/keratinisng squamous cell carcinoma)
malignant melanoma
pagets disease

A

anal cancers

133
Q

H pylori infection in duodenum

A

duodenitis

134
Q 
gluten intolerance 
anti gliadin (AGA)
anti endomysial (EMA)
anti transglutaminase (TGA)
villous atrophy
crypt hyperplasia
A

coeliac disease

135
Q

tropheryma whippeli

PAS positive macrophages

A

whipples disease - gastroenteritis

136
Q

remnant of vitello intestinal duct

A

meckels diverticulum

137
Q 
granular mucosa
crypt abscesses and destruction
chronic inflammation 
polyps
goblet cell depletion
ulceration
A

ulcerative colitis

138
Q

cobblestone/ulcerated mucosa
aphthous/fissuring ulceration
focal ulceration and transmural lymphoid aggregates and granuloma
skip lesions

A

crohns disease

139
Q

portal vein
hepatic artery
bile duct

A

portal triad

140
Q

anatomical division
hexagonal
central vein at centre
portal tracts at periphery

A

lobule

141
Q

functional division
central axial vessels
central veins at periphery
zones 1-3

A

acinus

142
Q

increased AST and ALT

A

hepatic picture

143
Q

increased ALP and GGT

increased bilirubin

A

cholestatic picture

144
Q

bilirubin >35 mol/L

A

VISIBLE jaundice

145
Q

fatty change and feathery degeneration

A

reversible acute liver injury

146
Q

necrosis
apoptotic bodies - spotty necrosis
confluent necrosis

A

irreversible liver damage

147
Q 
autoimmune
anti mitochondrial antibodies (AMA)
portal tract lymphocytic infiltrate 
ductopenia
granulomas
A

primary sclerosing cholangitis

148
Q

ssRNA enterovirus
faecal oral spread
no carrier state / chronic infection

A

hepatitis a

149
Q 
dsDNA hepadnavirus 
parenteral eg iv drugs, sex, blood
acute - hepatitis and recovery
asymptomatic carrier phase
chronic - hepatitis and cirrhosis / hepatocellular carcinoma
A

hepatitis b

150
Q

ssRNA flavivirus
parenteral transmission
carrier state and risk of chronic

A

hepatitis c

151
Q

diffuse irreversible disruption of entire liver architecture
structurally abnormal regenerative nodules
separated by interconnecting bridging bands of fibrous tissue
collagenous tissue
scattered lymphocytes
proliferation of bile ductules

A

cirrhosis

small shrunken liver with nodular surface

152
Q

steatohepatitis - steatosis, hepatocyte balloon swelling, Mallory’s hyaline (eosinophillic extracytoplasmic globules - tangles of filaments)

A

alcoholic liver disease

153
Q

autosomal recessive HFE gene mutation - C282Y
excessive iron absorption in small intestine
Perls Prussian blue iron stain - blue granules of haemosiderin in hepatocytes

A

haemochromatosis

154
Q

autosomal recessive mutation in copper transporting ATPase

kayser fleischer rings in eyes - peripheral iris brown

A

Wilsons disease

155
Q

rounded eosinophilic lobules within hepatocytes

A

alpha 1 antitrypsin globules

156
Q

acinar cell injury
necrosis
inflammation

A

acute pancreatitis

157
Q

inspissation of secretions
ductal plugs
loss of pancreatic parenchyma and fibrosis
dystrophic calcification

A

chronic pancreatitis

158
Q

insulinoma - hypos
gastronoma - Zollinger Ellison
MEN-1 - pit and parathyroid tumours

A

pancreatic endocrine neoplasms (PENs)

159
Q

dendritic antigen presenting cells

A

langerhans cells

160
Q 
spongiosis 
inflammatory infiltrate in dermis 
lymphocytes in epidermis
parakeratosis
pomphylx - intraepithelial water accumulation forming vesicles
A

eczema

161
Q

parakeratosis
neutrophil polymorphs (munro micro abscesses)
thickening and elongation of epithelial rete processes
no granulomas

A

psoriasis

162
Q

sawtooth rete processes
lymphohistiocytic infiltrate
basal cell liquefaction degeneration
colloid/civatte bodies (apoptotic keratinocytes)

A

cutaneous lichen planus

163
Q

relatively uniform basaloid cells
cell islands surrounded by palisade
hair follicle differentiation

A

basal cell carcinoma

164
Q

squamous cell carcinoma in situ

A

Bowens disease

165
Q

S100 protein
HMB45
Melan A

A

stains for malignant melanoma

166
Q

malignant melanoma in situ

A

Hutchinson’s melanotic freckle / lentigo maligna

167
Q

flattening of calyces
renal parenchymal thinning
cystic thin walled fibrous sac

A

hydronephrosis

168
Q

polar scar involving calyx

thyroidisation of tubules -dilation with pink material resembling thyroid colloid

A

chronic pyelonephritis

169
Q

bilateral renal agenesis leading to oligohydramnios
reduced room for foetus
characteristic facial features and posture
pulmonary hyperplasia
not compatible with life

A

potters syndrome

170
Q

PKD 1

A

autosomal dominant

chromosome 16

171
Q

PKD 2

A

autosomal dominant

chromosome 4

172
Q

Childhood PKD

A

autosomal recessive

chromosome 6

173
Q

calcium oxalate / phosphate

radio opaque

A

renal calculi

174
Q

firm well demarcated white nodule in medulla

A

fibroma/harmartoma

benign renal neoplasm

175
Q

from renal tubular epithelium

low malignant potential

A

cortical adenoma

benign renal neoplasm

176
Q

from distal tubule
enlarged cells
granular esoinophillic cytoplasm

A

oncocytoma

benign renal neoplasm

177
Q

medulla/cortex

blood vessels, smooth muscle, and fat

A

angiomyolipoma

benign renal neoplasm

178
Q 
most common
3p deletion
polyhedral cells with abundant clear cytoplasm
vacuolated cytoplasm 
pyknotic nuclei
A

clear cell carcinoma

malignant renal neoplasm

179
Q 
trisomy 7 and 17
papillary structures
esoinophillic cytoplasm
friable 
often bilateral
A

papillary carcinoma

malignant renal neoplasm

180
Q 
large cells
well defined - good prognosis 
granular cytoplasm
thick cell membrane 
perinuclear halo
A

chromophobe carcinoma

malignant renal neoplasm

181
Q

children <4 yrs
large solid mass of firm white tissue
small round blue cell tumour

A 
Wilms tumour (nephroblastoma)
malignant renal neoplasm
182
Q

rare autosomal dominant condition

chromosome 3

A

von hippel lindau disease

183
Q 
non proliferative glomerulonephritis
proteinuria 
hypoalbuminaemia 
oedema 
hyperlipidaemia
A

nephrotic syndrome

184
Q 
proliferative glomerulonephritis 
oliguria 
hypertension
haematuria
mild oedema 
mild proteinuria
A

nephritic syndrome

185
Q

aniline dyes
analgesic misuse
early haematuria and obstruction

A

transitional cell carcinoma

186
Q

full thickness cytological atypic confined to epithelium
loss of umbrella cells
red patches
treat with BCG therapy

A

TCC in situ

187
Q

warty / cauliflower like papillomatous projections from mucosa

A

papillary TCC

188
Q 
schistosomiasis
areas of squamous metaplasia
solid ulcerative fun gating mass
poor prognosis
TURBT and BCG therapy
A

squamous carcinoma of bladder

189
Q

urachal remand

transitional epithelium metaplasia

A

adenocarcinoma of bladder

190
Q

bowenoid papulosis (HPV)
erythroplasia de queyrat (CIS of glans/foreskin)
Bowens disease

A

pre neoplastic penile conditions

191
Q

squamous cell carcinoma
spindle cell carcinoma
adenosquamous carcinoma
malignant melanoma

A

malignant penile tumours

192
Q

fluid in tunic vaginalis (patent)

A

primary hydrocele

193
Q

well defined
unilateral
large cells with clear cytoplasm
aggregates separated by fibrovascular lymphoid stroma

A

seminoma

germ cell tumour of teste

194
Q

leydig/sertoli cell tumours

almost always benign

A

sex cord stromal tumours

195
Q

increased glandular and stromal elements

glands still in lobules

A

benign prostatic hypertrophy

196
Q

AFP secreting germ cell tumours

note all germ cell tumours can produce hCG by syncytiotrophblasts

A

embryonal carcinoma
yolk sac tumour
teratoma

NOT
seminoma
choriocarcinoma

197
Q

oligodendrocytes

A

form myelin

198
Q

ependymal cells

A

line ventricular system

199
Q

increased CSF

A

hydrocephalus

200
Q

> 15 mgHg
spatial compensation (older patients better bc brain atrophy)
cerebral percussion falls

A

increased ICP

201
Q

increased bp to maintain perfusion (widened pulse pressure)

bradycardia

A

cushings response

202
Q

CN III palsy
PCA compression
midbrain and pons haemorrhage

A

uncal herniation

coning = tonsillar herniation

203
Q

gross - no change

microscopic - red neurons and oedema

A

0-6 hrs post stroke

204
Q

gross - pale swollen loss of grey/white matter margin

microscopic - neutrophil polymorphs

A

onset to 48hrs post stroke

205
Q

gross - gelatinous and friable

microscopic - nil

A

2-10 days post stroke

206
Q

gross - liquefying necrosis leaving cavity

microscopic - macrophages

A

10 days - 3 weeks post stroke

207
Q

no gross or microscopic changes

A

first 24 hrs post MI

208
Q

pale with inflammatory reaction at edges

loss of striations

A

> 24 hrs post MI

209
Q

macrophages (removing dead myocytes)

healing by repair, reorganisation, and progressive fibrosis - scar tissue

A

days - weeks post MI

210
Q

akinetic mature fibrous scar
no contraction
may be weak

A

months post MI

211
Q

venous bleed

A

subdural

212
Q

middle meningeal artery bleed

A

extradural

213
Q

grade IV

poorly defined

A

astrocytoma

214
Q

more sharply defined

calcification

A

oligodendrocytoma

215
Q 
meningeal gliomatosis (CSF dissemination)
children
A

ependymoma

216
Q

benign
neurofibromatosis type 2
oestrogen drive increases size
associated with breast and endometrial cancer

A

meningioma

217
Q

breast
lung
GIT

A

common primary sites of brain metastases

218
Q

e coli
group b strep
listeria monocytogenes

A

neonatal meningitis

219
Q

h influenzae

A

meningitis in children

220
Q

neisseria meningitides

A

adolescent meningitis

221
Q

strep pneumoniae

listeria monocytogenes

A

meningitis in elderly

222
Q

swollen brain with flattened gyral pattern, thick purulent exudate on base of brain, brainstem, and cerebellum

neutrophils and necrotic debris

A

meningitis

223
Q

cloudy / turbid
increased protein and neutrophils
decreased glucose

A

bacterial meningitis

224
Q

clear / turbid
mild increased protein
increased lymphocytes
normal glucose

A

viral meningitis

225
Q

large necrotic brain abscesses

A

toxoplasmosis (HIV)

226
Q

global atrophy
neuritic plaques
amyloid angiopathy (beta A4 stained with silver/congo red and apple green under polarised light)
Tau2 positive neurofibrillary tangles

A

Alzheimers

227
Q

pick cells

neuronal swelling

A

picks disease

228
Q

spongiosis / vacuoles in grey matter

A

CJD

229
Q 
substantia nigra involvement (pallor)
decreased dopamine
Lewy bodies (intracytoplasmic inclusions formed by protein deposition)
A

Parkinsons

230
Q 
autosomal dominant 
CAG repeat sequence 
short arm chromosome 4 
cerebral atrophy
loss of striatal neurons
reactive astrocytosis
A

Huntingtons

231
Q 
myelin sheath destruction
plaque formation 
perivascular invasion 
macrohage action 
decreased oligodendrocytes
A

MS

232
Q

petechial haemorrhage of axillary bodies

alcohol associated

A

wernickes disease

233
Q

alpha - glucagon
beta - insulin
gamma - pancreatic polypeptide
omega - somatosatin

A

produce of pancreas islet cells

234
Q

insulin deficiency
autoimmune destruction of beta cells
HLA DR3/4 haplotype

A

type 1 DM

235
Q

insulin insensitivity

obesity - adiponectin levels

A

type 2 DM

236
Q

elevated blood lipids
reduced HDL
increased thromboxane A2
hyaline atherosclerosis

A

accelerated atherosclerosis

237
Q

nodular glomerulosclerosis in DM

A

kimmelstein wilson lesion

238
Q 
masses of lymphoid tissue 
lymphocytes
germinal follicles
eosinophilic pink appearance 
autoimmune
ashkenazi / hurtle cell change
A

hashimotos thyroiditis

239
Q

hyper functional diffuse thyroid enlargement
infiltrative opthalmopathy
auto anti TSH receptor antibodies
TSH binding Ig

A

Graves disease

240
Q

papillary structure
central fibrovacular core covered by columnar epithelium
orphan Annie eyes

A

papillary thyroid carcinoma

241
Q

worse prognosis
functional nodules
invasion of fibrous capsule

A

follicular thyroid carcinoma

242
Q 
neuroendocrine
from parafollicular/c cells
secrete calcitonin
amyloid stroma
MEN and paraneoplastic syndromes
A

medullary thyroid carcinoma

243
Q

poorly differentiated
poor prognosis
spindly tumour cells
no follicle formation

A

anaplastic thyroid carcinoma

244
Q

B cell
low grade
complicating thyroiditis

A

thyroid lymphoma - rare

245
Q 
liver mets/hepatomegaly
elevated serotonin and 5-HIAA
facial flushing
apparent cyanosis
gi upset 
cough/wheeze/sob
systemic fibrosis
A

carcinoid syndrome

246
Q

catecholamine producing tumour of adrenaline medulla (chromaffin cells)

A

pheochromocytoma

247
Q

parathyroid hyperplasia/adenoma
pancreas endocrine tumour
pituitary prolactinoma
chromosome 11 TSG gene mutation

A

MEN 1

248
Q

medullary thyroid carcinoma
pheochromocytoma
parathyroid hyperplasia
autosomal dominant mutation in RET proto oncogene on chromosome 10

A

MEN 2A

249
Q

same as 2A minus hyperparathyroidism
plus mucosal neuromas ad marfanoid appearance
RET proto oncogene mutation

A

MEN 2B

250
Q

neutrophil polymorphs

small studded abscesses through renal parenchyma

A

acute pyelonephritis

251
Q

bad prognosis
aggressive
gland forming
renal medulla

A

collecting duct carcinoma

malignant renal neoplasm

252
Q

renal cancer grading system

A

Fuhrman

based on nuclear size

253
Q

lymphoma staging

A

Ann Arbor

254
Q

autoimmune bile duct destruction elevated ALP
elevated cholesterol
AMA positive

A

primary biliary cirrhosis / cholangitis

255
Q

chronic inflammation of hepatic bile ducts
associated with ulcerative colitis
MRCP diagnosis ‘beading’
periductal onion skinning fibrosis pattern

A

primary sclerosing cholangitis

256
Q 
non caseating granuloma 
epithelioid cells
langhans giant cells
lymphocytes 
asteroid / schaumann bodies
raised calcium and ACE
A

sarcoidosis

257
Q

young women neck lymph nodes
lacunar cells
sclerotic bands
excellent prognosis

A

classical Hodgkin’s lymphoma - nodular sclerosis

258
Q

intra epidermal blistering of skin and mucous membranes

anti desmosome antibodies

A

pemphigus vulgaris

259
Q

sub epidermal blisters of skin

anti basement membrane antibodies

A

bullous pemphigoid

260
Q

lamivudine

A

hep b suppression

261
Q

interferon

A

hep b cure of high grade infection

262
Q

interferon and ribavirin

A

cure high grade hep c infection

263
Q

nucleoside reverse transcriptase inhibitor
non nucleotide reverse transcriptase inhibitors
protease inhibitors

A

anti retro viral triple therapy

264
Q

gram positive sporing anaerobic rod

A

C. Diff

265
Q

c diff treatment

A

mild - metronidazole
severe - vancomycin
refractory - colectomy

266
Q

gram neg anaerobic rod

undercooked meat

A

salmonella

antibiotics only if immunocomp.

267
Q

gram neg anaerobic rod

contaminated food / water

A

E. coli
Fluids and electrolytes
Cephalosporins, quinolones, doxycycline

268
Q

gram neg spiral bacteria

A

h pylori

triple therapy with ranitidine, tetracycline, and clarithromycin

269
Q

vomiting and watery diarrhoea

A

norovirus
anti motility and emetics
IV fluids

270
Q

yeast like fungus

A

pneumocystis jirovecii
trimethoprim- sulfamethoxazole
resp support

271
Q

double stranded dna herpes virus

A

CMV

HAART

272
Q

invasive budding yeast

A

Candida albicans
Oral / topical nystatin
Oral fluconazole

273
Q

gram positive coccus

A

Staph aureus - fluclox
MSSA - methicillin
MRSA - vancomycin / teicoplanin

274
Q

impetigo (staph aureus / strep pyogenes infection of epidermis)

A

topical Abx
Penicillin
Trimethoprim- MRSA

275
Q

infection of dermis and subcut fat

A

cellulitis
Flucloxacillin
Cephalosporin
Vancomycin

276
Q

necrotising fasciitis

A

IV carbapenem, beta lactamase inhibitor, vancomycin, clindamycin
Surgical debridement

277
Q

encephalitis

A

viruses - aciclovir

listeria monocytogenes, mycobacteria - empirical then target

278
Q

brain abscess

A

staph aureus
streptococcus
enterobacteriacae
pseudonymas aeruginosa

279
Q

CAP

A

strep pneumoniae - amoxicillin

280
Q

day 1-2 CAP

A

congestion - alveoli fill with fluid

281
Q

day 3-4 CAP

A

red hepatisation - exudate (rbcs and fibrin) fill airspace

282
Q

Day 5-7 CAP

A

grey hepatisation - rbcs break down and become grey

283
Q

mycobacterium tuberculosis

A

prophylactic - bcg vaccine
latent - 9 months isoniazid
active - isoniazid, rifampicin, pyrazinamide, ethambutol for 2 months

284
Q

penicillin

A

inhibitor of bacterial penicillin binding protein preventing cross linking of peptide chains in cell wall

resp infections
UTI
otitis media 
bacterial meningitis - benzoyl penicillin
severe infection - piperacillin
285
Q

cephalosporins (cef-)

A

inhibitor of bacterial penicillin binding protein preventing cross linking of peptide chains in cell wall

meningitis
sepsis
pneumonia

286
Q

carbapenems

A

inhibitor of bacterial penicillin binding protein preventing cross linking of peptide chains in cell wall

pseudomonas aeruginosa
pneumonia
intra abdo
complicated UTI

287
Q

tetracycline

A

bind to 30s bacterial ribosomal subunit inhibiting RNA formation - bacterial protein synthesis

chlamydia
mixed RTI
acne vulgaris
pneumonia

288
Q

aminoglycosides (gentamicin)

A

bind to 30s subunit inducing mRNA misreading stopping polypeptide forming - cell death

AEROBIC ONLY 
meningitis 
sepis
pyelonephritis 
endocarditis 
pseudomonas aeruginosa
289
Q

macrolides (-mycin)

A

binds 50s subunit stopping tRNA transfer stopping polypeptide elongation

LRTIs
cellulitis 
acne
h pylori
chlamydia
290
Q

vancomycin

A

binds to terminal chains of NAMA and NAG blocking polypeptide elongation - no cell wall - cell death

endocarditis
MRSA
c diff

291
Q

trimethoprim

A

inhibits bacterial dihydrofolate reductase stopping bacterial DNA synthesis

uncomplicated UTI
pneumocystis carinii

292
Q

amphotericin

A

binds ergosterol in fungal cell membrane forming pore - leakage - death

systemic fungal infection
candidiasis

293
Q

fluconazole

A

inhibits fungal cytochrome P450 3A depleting ergosterol altering membrane fluidity and preventing mitosis

candidiasis
fungal infection in immunocomp.
derm fungal infection
systemic fungal infection

294
Q

aciclovir

A

competitively inhibits viral DNA polymerase - nuclear chain terminator - preventing viral DNA replication

herpes simplex
varicella zoster

SBCP (1 decks)

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