Sept Resit (2021 Qs) Flashcards
Sept (2021)
Main Risk Factors for Developing Atherosclerosis
Major Controllable
- Hyperlipidemia
- Arterial Hypertension
- Cigarette Smoking
- Diabetes Mellitus
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Major Un-controllable
- Age, as RF’s INCREASE with Risk
- Males
- Genetic Predisposition = Familial Hypercholesterolemia
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Minor
- LACK of Exercise
- Type A Personality (STRESS)
- Obesity
- Oral Contraceptives
- Gout
- HIGH Carbohydrate Intake
Cause of Rheumatism - Mechanism & List of Diagnosis of the Main Organ Lesions
RHEUMATISM = is a SYSTEMIC, RECURRENT, NON-SUPPURATIVE Allergic Inflammatory COMPLICATION of UNTREATED Pharyngeal Infection.
MECHANISM:
1) T-Cell Mediated Disease - Type II / III Hypersensitivity Reactions
2) Antibodies IgG / IgM are produced by the body against Group A Strepto M Protein + Carbs
3) There’s a CROSS-REACTION between Body Cells + Strep ANTIGENS
MAIN ORGAN LESIONS
a) HEART = Carditis / Pancarditis
b) JOINTS = Polyarthritis
- multiple, large asymmetrical joints that’s swollen, red, warm + painful
c) BASAL GANGLIA / BRAIN = Chorea Minor
- random INVOLUNTARY movements, that develop 6 months AFTER
d) ERYTHEMA MARGINATIUM & NODOSUM:
- EM = CIRCULAR red RING surrounding NORMAL Skin
- EN = NODULAR red TENDER RASH OVER ANTERIOR Tibia
e) SUBCUTANEOUS NODULES = Pea-Sized, NON-TENDER OVER BONY Prominences
- INDICATES Cardiac involvement
- GRANULOMATOUS Reaction W/ “Picket-like Organisation” of histocytes, SURROUNDING the foci of fibrinoid necrosis
Interstitial Pneumonia - Most Common Causes & Typical Microscopic Findings
CAUSES:
- Respiratory Syncytial Virus, RSV
- Mycoplasma Pneumoniae
- Influenzae & Parainfluenza
- Adenoviruses
- Rhinoviruses
- Coxsackie Viruses
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MACROSCOPY :
- Heavy Lungs
- Congested
- Patchy
- Consolidated
- Subcrepitant
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MICROSCOPIC = INTERSTITIAL Inflammation
- THICKENED Alveolar Walls
- MONONUCLEAR Infiltration w/ Lymph, MFs, Plasma Cells OR LEUCOCYTE Infiltration IF bacterial
- MULTINUCLEATED Giant Cells + Syncytia in bronchiole AND alveoli walls
- RESEMBLE Squamous Epithelium
- VIRAL Inclusions that are INTRANUCLEAR + CYTOPLASMIC
Early Gastric Carcinoma - Definition, Macroscopic, Morphology, Can it Metastasize?
DEFINITION = ADENOCARCINOMA that’s LIMITED to the Mucosa + Submucosa OF the GASTRIC Epithelium
MACROSCOPIC FORMS:
1) PROTRUDED - Cauliflower Appearance
2) SUPERFICIAL (Intra-mucosal)
0 ELEVATED - the height is NO MORE than the THICKNESS of the Mucosa
0 FLAT - the lesion is on the SAME LEVEL as the ADJACENT Mucosa
0 DEPRESSED - UNDER the LEVEL of Adjacent Mucosa
METASTASIS IS POSSIBLE as the Adenocarcinoma can INFILTRATE into the SUBMUCOSA, but it happens RARELY!
Cholecystitis - Main Morphological Types & Complications
Cholecystitis is the ACUTE / CHRONIC Inflammation of the GALL BLADDER
MORHOLOGICAL TYPES
1) Acute = CALCULOUS / ACALCULOUS
a. EMPYEMA
0 DISTENDED & TENSE Gall Bladder w/ SEROSA covered in FIBRINOUS Exudate w/ Congestion + Haemorrhage
0 BRIGHT RED Mucosa
0 Lumen filled with Purulent Exudate AND Bile
0 Gall Bladder Wall w/ INFLAMMATORY Cells, Oedema, Congestion + Neutrophilic Exudate
b. GANGRENOUS
0 ABOVE + ABSCESSES in Wall
2) Chronic
0 HYPERTROPHIC
- Contracted, THICK, FIRM wall, that’s CALCIFIED with THICK MUCOSAL Folds;
- Lumen filled with GALLSTONES
- INTACT Epithelium, but BLUNT Villi
- Wall Contains - Lymph, Plasma Cells, Eosinophils + Adhesions
0 ATROPHIC
- Long standing OBSTRUCTION of Cystic Duct
- THIN Grey Wall, FLAT Mucosa, STONE-BLOCKING Cystic Duct
- TINY MUCOSAL Villi, ABSENT Muscularis, THIN Fibrous Wall containing inflammatory Cells
COMPLICATIONS
- Mucocele = IMPACTED Cystic Duct
- Empyema / Mirizzi Syndrome
- Jaundice
- Fistula
- Malignisation
- Ileus WITH Perforation
- ACUTE Pancreatitis
Hashimoto’s Lymphocytic Thyroiditis - Typical Microscopical Changes
Hashimoto’s Thyroiditis = AUTO-IMMUNE Diffuse Lymphocytic Thyroiditis
3 MAIN FEATURES:
1) Diffuse Goitre
2) Lymphocyte Infiltrates INTO Thyroid
3) Thyroid Antibodies
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2 Forms
1. CLASSIC FORM
0 GROSS = Diffuse, Symmetric, Firm, Rubbery Enlarged Thyroid with FLESHY Cut Surface
0 HISTO:
- INCREASED Lymph Infiltration, Plasma Cells + MFs
- LESS Follicles, ATROPHIC, NO Colloid
- Follicular EPITHELIAL Cells turns into HURTEL CELLS / ONCOCYTES (INCREASED Eosinophilic + Granular Cytoplasm DUE to INCREASED Mitochondria + LARGE BIZARRE Nuclei)
- FIBROSING FORM
0 GROSS = Firm, ENLARGED Thyroid that COMPRESSES the surrounding tissue
0 HISTO:
- Thyroid PARENCHYMA are REPLACED BY Fibrosis
- LESS Infiltration «_space;Classic Form
Clear Cell Carcinoma of Kidney - Macroscopic & Microscopic
Clear Cell Carcinoma of Kidney IS ADENOCARCINOMA from the TUBULAR EPITHELIUM
GROSS:
- UPPER POLE of the Kidney is SOLITARY, UNILATERAL, LARGE, GOLDEN-YELLOW + CIRCUMSCRIBED
- On a CUT-SURFACE, there are LARGE AREAS of Ischaemic Necrosis, Cystic Change + Haemorrhages
- The TUMOUR THROMBUS in the RENAL VEIN, can EXTEND INTO –> VENA CAVA
HISTO:
- LARGE Tumour Cells
- CLEAR Cytoplasm that’s OPTICALLY EMPTY
- Arranged in PAPILLAE / TUBULES
- SMALL Amount of Stroma, BV’s + Lymphocytes
- Tumour Cells INVADE VENOUS Walls
- Has a THICK PSEUDOCAPSULE, showing PARTIAL TUMOUR Infiltration
Abortion - 3 Main Pathognomonic Microscopic Structures
Abortion = Is TERMINATION of Pregnancy, BEFORE 28th WEEK of Gestation, with EXPULSION of an embryo / foetus that’s INCAPABLE of survival
3 Main Pathognomonic Microscopic Structures:
1) TROPHOBLASTIC Cells
2) DECIDUAL Endometrium, which have HYPERSECRETORY Changes, and are RICH in GLYCOGEN
3) IMMATURE Placental CHORIONIC VILLI with NECROTIC Tissue / PHANTOM Villi
List the Forms of Secondary TB
1) FIBROCASEOUS Tuberculosis:
- ORIGINAL AREA of TB, which HEALS at the PERIPHERY WITH a MASSIVE CENTRAL CASEOUS Necrosis Cavity
a) CAVITARY / OPEN = It can BREAK thru BRONCHUS + FORM a CAVITY - Showing a THICK FIBROUS Wall, with YELLOW NECROTIC Material and WIDESPREAD TUBERCLES
b) CHRONIC = Remains a SOFT CASEOUS Lesion , WITHOUT DRAINAGE into –> Bronchus
2) TB CASEOUS PNEUMONIA:
- TB that spreads to REST OF LUNG, where there’s an EXUDATIVE REACTION - Fibri, Polymporphs, Monocyhtes + Tubercle Bacilli
3) MILITARY TB
- TB Infection that LYMPHOHEMATOGENOUSLY SPREADS, either PULMONARY / EXTRAPULMONARY,
- Forming MILLET-SIZED Tubercles
4) TB PLEURITIS & EMPYEMA
- COMPLICATION of Secondary TB
- SEROUS / FIBRIN Exudate is HEALED VIA FIBROSIS
- There’s OBLITERATED Pleural Cavity WITH CASEOUS Material
- Develop EMPYEMA
What do we call, Hiatus Leukemicus?
- They are MOSTLY FOUND in Acute Myeloid Leukemia, AML
- It’s the ABUNDANCE of MYELOBLASTS + MATURE NEUTROPHILS in a PERIPHERAL Blood Smear
- With NO Intermediate Forms
