Sys Patho Flashcards
1
Q
Nasopharyngeal CA gross?
A
Non-keratinizing.
EBV at young age
2
Q
Symptoms of NPC?
A
Diplopia
Nasal obstruction
Serous nasal discharge
3
Q
NPC mets to where?
A
cervical LNs
4
Q
NPC mets to where?
A
cervical LNs
5
Q
Nasopharyngeal Papilloma RF?
A
HPV
6
Q
SCC of larynx symptoms and mets?
A
hoarseness, mets to regional LNs
7
Q
T2 respi failure cause of death?
A
Hypoxia, CO2 retention acidosis.
8
Q
Congestive HF shows what in pulmonary edema macrophages?
A
Hemosiderin-laden macrophages
9
Q
Where is inflammation in atypical pneumonia?
A
Inflammation confined to alveolar septa and lung interstitium
10
Q
Exposure to what causes hypersensitivity pneumonitis?
A
Bird droppings
11
Q
What means highly infectious TB?
A
Sputum AFB smear positive
12
Q
In secondary infection, where is the Assmann focus?
A
Apices of the lung
13
Q
What does bronchiectasis present with?
A
Haemotypsis and clubbing
14
Q
Pathology of bronchiectasis?
A
Interference with drainage of secretions
Recurrent and persistent infections
15
Q
What does COPD present with?
A
hyper-inflation and hyperresonance
16
Q
in what condition is airflow not fully reversible?
A
COPD.
17
Q
RF for COPD?
A
Bronchiolitis
Chronic bronchitis
Emphysema
18
Q
Croup is mostly due to?
A
Upper respi tract infection
19
Q
Causes of ARDS?
A
Inhalation of toxic fumes
Trauma/burns
Sepsis
20
Q
Causes of ARDS?
A
Inhalation of toxic fumes
Trauma/burns
Sepsis
21
Q
2 phases of ARDS?
A
Acute exudative phase
Organization phase
22
Q
Which lung cancer is not as closely a/w smoking?
A
Adenocarcinoma
23
Q
Features of small cell CA?
A
Oat cell Carcinoma.
Secrete ACTH and ADH.
Strongly a/w smoking
Poor prognosis.
24
Q
HPV negative or positive Oral SCC has better prognosis?
A
HPV positive SCC oropharynx has better prognosis. A/w leukoplakia with erythroplakia.
25
Which oropharyngeal SCC is well differentiated and keratinizing?
HPV negative one
26
Risk factor for HPV related oropharyngeal SCC?
Oral sexual contact, not rly alcohol and smoking
27
Pleomorphic adenoma vs Warthin. Which commoner in men?
Warthin
28
How do pleomorphic adenoma and Warthin present?
Painless slow growing mass at parotid
29
Pathosis of AI gastritis?
AutoAb to parietal cells and intrinsic factor
Chief cell destruction
Vit B12 malabsorption in ileum
Endocrine cell hyperplasia
Defective gastric acid secretion
30
Sequelae of AI gastritis?
AdenoCA, atrophy, carcinoid tumour, pernicious anemia
31
Where does half of Esophageal SCC occur?
middle 1/3 of esophagus
32
2 forms of chronic gastritis
H. Pylori associated Gastritis
Autoimmune gastritis
33
Gross features of chronic gastritis?
Mucosal atrophy
Intestinal metaplasia
34
Peptic ulcers distribution and infiltration?
Peptic ulcers usually solitary, penetrating muscularis mucosae or deeper.
35
Commonest site of peptic ulcers?
Duodenum 1st part
36
Diseases a/w H. Pylori?
Chronic gastritis
Gastric AdenoCA
Peptic Ulcer Disease
Gastric Lymphoma (MALT)
37
What can cause luminal obstruction in appendicitis?
Lymphoid hyperplasia
Fecolith
Foreign matter
38
Which part of stomach is H Pylori infection most common?
Antrum
39
What are the 2 types of ischemic bowel disease?
Transmural infarction - major vessel obstruction
Mural infarction - hypoperfusion
40
What kind of ulcers does amebiasis give in GIT?
Flask-shaped ulcers with shaggy edges
41
How does amebiasis spread to give liver abscess?
spread via portal circulation
42
Which inflammatory bowel disease has skipped lesions?
Crohn's Diease
43
Where does Crohn's happen compared to UC?
Crohn's is in terminal ileum
UC in rectum and distal colon.
44
Where is diverticular disease common?
Descending colon, but other parts also can
45
Fundic gland polyps caused by?
Lower acidity and hyper-gastrinemia. Not pre-malignant
46
Which marker for GIST?
CD117 marker
47
Which pathos show signet ring cells?
Krukenberg tumour
Gastric adenoCA
48
Most important prognostic factor for early gastric CA?
Invasion not beyond submucosa. LN mets doesnt matter.
49
3 possible types of gastric CA?
Exophytic
Flat/depressed
Excavated
50
Describe intestinal type gastric CA?
Arise from complete-type metaplasia. Lined by cuboidal to columnar epithelial cells.
51
Where is gastric CA commonest?
Pylorus and antrum > cardia
52
Diagnostic criteria for MAFLD?
Detection of liver steatosis via imaging / liver histo
+ 1/3 of obesity, T2DM, or clinical markers of metabolic dysfunction e.g. waist circumference.
53
Pathosis of ALD?
Steatosis
Hypoxia and oxidative stress
inflammatory response
Dysfunction of mitochondrial and cellular membranes
Low hepatic sinusoidal perfusion
54
Blood shows AST more than double of ALT. What isit
Alcoholic liver disease
55
Which cancer does hepatolithiasis predispose to?
CholangioCA
56
Which cancer does hepatolithiasis predispose to?
CholangioCA
57
Cause of cholangioCA?
Sporadic, unassociated with pre-existing conditions
58
what does urinalysis of Acute Interstitial Nephritis show?
WBC, RBCs, Eosinophils
59
What is AD polycystic kidney disease associated with?
Berry aneurysms in brain
60
Which renal failure is caused by polycystic kidney disease
Chronic Renal failure
61
What does horseshoe kidney cause?
Renal calculi.
62
Which area does urothelial CA affect?
Pelvi-calyceal system
63
Micro for Clear cell RCC?
Polygonal cells with clear cytoplasm
Delicate branching vasculature
Invasion of renal vein
64
Where does clear cell RCC arise from?
Tubular Epithelium
65
How does Chronic RF kidneys look like
Bilateral small contracted kidneys
Tubular atrophy and interstitial fibrosis
66
What shows positive staining with Congo red stain?
Amyloidosis
67
What is commonest cause of chronic RF?
Diabetic nephropathy
68
Commonest benign mesenchymal kidney tumour?
Angiomyolipoma. A/w tubular necrosis
69
Can polycystic kidney disease be unilateral?
no its bilateral
70
Are oral contraceptives and disseminated cancer RF for Deep vein thrombosis?
Yes
71
The 4 Tetralogy of Fallot?
pulmonary stenosis
RV hypertrophy
Ventricular Septal Defect
Overriding of aorta
72
What does AMI present as?
Left sided chest pain radiating to jaw.
73
What does AMI present as?
Left sided chest pain radiating to jaw.
74
Complications of atherosclerosis?
Aortic Aneurysms
Cerebral infarction
AMI
Peripheral vascular disease
75
3 factors for ischemic heart disease
Reduced coronary flow
Higher myocardial demand
Lower oxygen availability in blood
76
When does classical Hodgkin peak?
late adolescence or after 60yo
77
What does high GGP level indicate?
Bile duct issues
78
what does high ALP level mean?
Issue with liver or bone
79
Which kidney disease is a/w berry aneurysms?
Polycystic Kidney Disease
80
What inheritance is polycystic kidney disease?
Autosomal Dominant
81
How do cells show in Acute Tubular Necrosis?
Swelling
Vacuolation
Sloughing
Flattening
Tubular dilation
Interstitial edema
Necrosis
Loss of PAS-positive brush border
82
Which kidney disease shows eosinophilia with renal failure?
Acute Interstitial Nephritis.
Urinalysis shows RBCs, WBCs, Eosinophils
83
Clinicals of Acute pyelonephritis?
Fever, chills
Dysuria
Pyuria
Urinary frequency
Flank pain and tenderness
84
What is a/w lower risk of SCC of penis?
Circumcision when young
85
Which germ cell tumour of testicles has better prognosis?
SGCT.
86
Commonest testicular tumour in infants?
Yolk sac tumour
87
What can be first clinical manifestation of gastric adenoCA?
Mets to supraclavicular nodes e.g. Virchow's nodes, Trousseau's sign
88
What gene hit in FAP?
Tumour suppressor gene APC
89
What is primary sclerosing cholangitis associated with?
Ulcerative Colitis and CRC
90
What is HCC associated with?
Beta catenin activation + p53 inactivation
91
Commonest site of pancreatic CA?
Head
92
Risk factors for pancreatic CA?
Smoking
High Fat diet
Chronic pancreatitis
DM
Genetics
93
Genes commonly mutated in Pancreatic CA?
KRAS, TP53, SMAD4, CDKN2A
94
Clinicals of nephrotic syndrome
Proteinuria
Anasarca
Polyuria
Hypoalbuminemia
Lipiduria
Hyperlipidemia
95
Clinicals of nephrotic syndrome
Proteinuria
Anasarca
Polyuria
Hyperlipidemia
Lipiduria
Hypoalbuminemia
96
What can nephrotic syndrome urine and body have
Large urine volume with frothy urine
Body swelling
97
Clinicals of nephritic syndrome?
Proteinuria
Haematuria
Oliguria
Edema
Hypertension
Azotaemia
98
Commonest cause of nephritic syndrome?
IgA nephropathy
99
Diffuse large B cell lymphoma
100
SCC of vulva related to?
30% a/w HPV
101
What do vulvar CAs develop from?
From classic Vulvar IN.
Most develop in background of lichen sclerosus
102
Risk factors for Cervical CA?
Early first sex
Multiple sex partners
Related HPV infection
Genetic factors
Infections e.g. Chlamydia
Oral contraceptives and smoking
103
Pathosis of Cervical CA?
HPV infection -> intraepithelial cervical neoplasia 1, 2, 3 -> Invasion for cancer
104
Testing regime for cervical cancer?
Pap smear every 3 years for sexually active 25-29yo
HPV DNA every 5 years afterwards.
105
Gross of cervical CA?
Fungating, Ulcerating, Infiltrative
106
What causes endometrial hyperplasia?
Unopposed estrogen secretion.
107
What can PID present with?
Pelvic pain
Vaginal discharge
Adnexal tenderness
108
Name of most primitive ovarian germ cell tumour?
Dysgerminoma
109
What is teratoma of ovarian germ cell tumour?
Neoplastic differentiation of embryo
110
What tumour shows Schiller-Duval bodies?
Endodermal sinus tumour
111
Which condition is implantation of placenta near internal os?
Placenta Previa
112
Which condition is premature separation of placenta from uterine wall during pregnancy?
Placenta Abruptio
113
Which condition is adhesion of normal placental villi to uterine wall with failure to separate?
Placenta Accreta
114
Rhitinis is usually viral or bacterial?
viral!
115
Does BCG prevent infection?
No, but help prevent progression to clinical disease and miliary TB
116
SCC of lung commoner in male or female?
Male!
117
Common substances of urolithiasis?
Calcium oxalate
MgNH4PO4
Urate stones from gout/leukemia
Cysteine stones
118
What test for prostatic CA?
Prostate Specific Antigen test.
But not cfm unless super elevated
119
What epithelial ovarian tumour can predispose to ovarian CA?
Mucinous cystadenoma
120
Dequervain's Thyroiditis usually has what in history?
URTI, mostly viral
121
What does Paget's disease present with?
Bone overgrowth
Severe secondary OA
AV shunt
Sarcoma
Chalkstick fractures
Nerve compression injury and deafness
122
What is Paget's Disease?
Excessive turnover of bone causing disorganization of its architecture.
Increased activity of both osteoclasts and osteoblasts
123
Complications of Gout
Gouty Tophi
Joint deformities and destruction
Uric acid kidney stones
124
What causes inflammatory response in gout?
Attempted phagocytosis of urate crystals
125
Malignant bone tumour with primitive tumour cells.
Shows rosettes or pseudorosettes
Ewing sarcoma
126
Onion skin appearance. What tumour?
Ewing sarcoma.
CD99 expression, usually whites btw 5-20yo
127
Where is leukoplakia commonest?
Buccal mucosa
128
Complications of MI
LV- congestive HF
Ruptured papillary muscle
Arrhythmia - Cardiac Death
Ruptured myocardium - Cardiac Tamponade
Pericarditis
129
Testicular tumours cause painless enlargement of testis?
Yes
130
What markers MAY be raised in testicular tumours?
AFP and HCG
131
What can IVDA have in heart?
Tricuspid valve rupture
Pericarditis
Myocardial ring abscess
132
Hodgkin LYmphoma positive for what cell markers?
CD15 and CD30
133
Which patho gives starry-sky appearance?
Burkitt Lymphoma
134
Where do B cells home to in cortex?
Cortex of LNs
135
What features of LNs raise concern of malignancy?
Matted and Fixed LNs
136
What does diabetic nephropathy predispose to?
Pyelonephritis
Chronic RF
137
How does Aortic dissection present?
Tearing back pain migrating down from chest
138
What is mitral stenosis a/w?
Acute rheumatic fever
Atrial fibrillation
Pulmonary HTN
139
What can cause aortic regurgitation as complication?
Tertiary syphilis. It can cause aortic root aneuryms as well.
140
Can emphysema cause airway obstruction?
Yes
141
What causes croup in kids?
PArtial airway obstruction
142
Micro of osteosarcoma?
DEstruction
Sunburst pattern
Codman's triangle
143
Who gets giant cell tumour of bone more often?
Asians.
144
What does positive Direct Coombs TEst mean?
Autoimmune hemolytic anemia
145
What cells are meningiomas from? Micro features?
Arachnoidal cells.
Show Psammomma bodies and nuclear inclusions
146
Where are medulloblastomas found? What nuclei shape?
Found in cerebellum
Carrot shaped nuclei
147
Cause of non-communicating hydrocephalus in kids?
Ependymomas
148
What gene mutated in lung AdenoCA?
EGFR
149
Can peptic ulcers cause back pain?
Yes
150
What do chorioCA of female trophoblasts arise from?
Hydatiform moles
151
Where is the commonest site of breast tumours?
Upper outer quadrant
