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Sys Patho Flashcards

1
Q

Nasopharyngeal CA gross?

A

Non-keratinizing.
EBV at young age

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2
Q

Symptoms of NPC?

A

Diplopia
Nasal obstruction
Serous nasal discharge

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3
Q

NPC mets to where?

A

cervical LNs

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4
Q

NPC mets to where?

A

cervical LNs

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5
Q

Nasopharyngeal Papilloma RF?

A

HPV

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6
Q

SCC of larynx symptoms and mets?

A

hoarseness, mets to regional LNs

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7
Q

T2 respi failure cause of death?

A

Hypoxia, CO2 retention acidosis.

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8
Q

Congestive HF shows what in pulmonary edema macrophages?

A

Hemosiderin-laden macrophages

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9
Q

Where is inflammation in atypical pneumonia?

A

Inflammation confined to alveolar septa and lung interstitium

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10
Q

Exposure to what causes hypersensitivity pneumonitis?

A

Bird droppings

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11
Q

What means highly infectious TB?

A

Sputum AFB smear positive

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12
Q

In secondary infection, where is the Assmann focus?

A

Apices of the lung

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13
Q

What does bronchiectasis present with?

A

Haemotypsis and clubbing

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14
Q

Pathology of bronchiectasis?

A

Interference with drainage of secretions
Recurrent and persistent infections

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15
Q

What does COPD present with?

A

hyper-inflation and hyperresonance

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16
Q

in what condition is airflow not fully reversible?

A

COPD.

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17
Q

RF for COPD?

A

Bronchiolitis
Chronic bronchitis
Emphysema

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18
Q

Croup is mostly due to?

A

Upper respi tract infection

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19
Q

Causes of ARDS?

A

Inhalation of toxic fumes
Trauma/burns
Sepsis

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20
Q

Causes of ARDS?

A

Inhalation of toxic fumes
Trauma/burns
Sepsis

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21
Q

2 phases of ARDS?

A

Acute exudative phase
Organization phase

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22
Q

Which lung cancer is not as closely a/w smoking?

A

Adenocarcinoma

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23
Q

Features of small cell CA?

A

Oat cell Carcinoma.

Secrete ACTH and ADH.
Strongly a/w smoking
Poor prognosis.

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24
Q

HPV negative or positive Oral SCC has better prognosis?

A

HPV positive SCC oropharynx has better prognosis. A/w leukoplakia with erythroplakia.

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25
Q

Which oropharyngeal SCC is well differentiated and keratinizing?

A

HPV negative one

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26
Q

Risk factor for HPV related oropharyngeal SCC?

A

Oral sexual contact, not rly alcohol and smoking

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27
Q

Pleomorphic adenoma vs Warthin. Which commoner in men?

A

Warthin

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28
Q

How do pleomorphic adenoma and Warthin present?

A

Painless slow growing mass at parotid

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29
Q

Pathosis of AI gastritis?

A

AutoAb to parietal cells and intrinsic factor
Chief cell destruction
Vit B12 malabsorption in ileum
Endocrine cell hyperplasia
Defective gastric acid secretion

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30
Q

Sequelae of AI gastritis?

A

AdenoCA, atrophy, carcinoid tumour, pernicious anemia

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31
Q

Where does half of Esophageal SCC occur?

A

middle 1/3 of esophagus

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32
Q

2 forms of chronic gastritis

A

H. Pylori associated Gastritis
Autoimmune gastritis

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33
Q

Gross features of chronic gastritis?

A

Mucosal atrophy
Intestinal metaplasia

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34
Q

Peptic ulcers distribution and infiltration?

A

Peptic ulcers usually solitary, penetrating muscularis mucosae or deeper.

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35
Q

Commonest site of peptic ulcers?

A

Duodenum 1st part

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36
Q

Diseases a/w H. Pylori?

A

Chronic gastritis
Gastric AdenoCA
Peptic Ulcer Disease
Gastric Lymphoma (MALT)

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37
Q

What can cause luminal obstruction in appendicitis?

A

Lymphoid hyperplasia
Fecolith
Foreign matter

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38
Q

Which part of stomach is H Pylori infection most common?

A

Antrum

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39
Q

What are the 2 types of ischemic bowel disease?

A

Transmural infarction - major vessel obstruction
Mural infarction - hypoperfusion

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40
Q

What kind of ulcers does amebiasis give in GIT?

A

Flask-shaped ulcers with shaggy edges

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41
Q

How does amebiasis spread to give liver abscess?

A

spread via portal circulation

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42
Q

Which inflammatory bowel disease has skipped lesions?

A

Crohn’s Diease

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43
Q

Where does Crohn’s happen compared to UC?

A

Crohn’s is in terminal ileum
UC in rectum and distal colon.

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44
Q

Where is diverticular disease common?

A

Descending colon, but other parts also can

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45
Q

Fundic gland polyps caused by?

A

Lower acidity and hyper-gastrinemia. Not pre-malignant

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46
Q

Which marker for GIST?

A

CD117 marker

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47
Q

Which pathos show signet ring cells?

A

Krukenberg tumour
Gastric adenoCA

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48
Q

Most important prognostic factor for early gastric CA?

A

Invasion not beyond submucosa. LN mets doesnt matter.

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49
Q

3 possible types of gastric CA?

A

Exophytic
Flat/depressed
Excavated

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50
Q

Describe intestinal type gastric CA?

A

Arise from complete-type metaplasia. Lined by cuboidal to columnar epithelial cells.

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51
Q

Where is gastric CA commonest?

A

Pylorus and antrum > cardia

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52
Q

Diagnostic criteria for MAFLD?

A

Detection of liver steatosis via imaging / liver histo
+ 1/3 of obesity, T2DM, or clinical markers of metabolic dysfunction e.g. waist circumference.

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53
Q

Pathosis of ALD?

A

Steatosis
Hypoxia and oxidative stress
inflammatory response
Dysfunction of mitochondrial and cellular membranes
Low hepatic sinusoidal perfusion

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54
Q

Blood shows AST more than double of ALT. What isit

A

Alcoholic liver disease

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55
Q

Which cancer does hepatolithiasis predispose to?

A

CholangioCA

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56
Q

Which cancer does hepatolithiasis predispose to?

A

CholangioCA

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57
Q

Cause of cholangioCA?

A

Sporadic, unassociated with pre-existing conditions

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58
Q

what does urinalysis of Acute Interstitial Nephritis show?

A

WBC, RBCs, Eosinophils

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59
Q

What is AD polycystic kidney disease associated with?

A

Berry aneurysms in brain

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60
Q

Which renal failure is caused by polycystic kidney disease

A

Chronic Renal failure

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61
Q

What does horseshoe kidney cause?

A

Renal calculi.

62
Q

Which area does urothelial CA affect?

A

Pelvi-calyceal system

63
Q

Micro for Clear cell RCC?

A

Polygonal cells with clear cytoplasm
Delicate branching vasculature
Invasion of renal vein

64
Q

Where does clear cell RCC arise from?

A

Tubular Epithelium

65
Q

How does Chronic RF kidneys look like

A

Bilateral small contracted kidneys

Tubular atrophy and interstitial fibrosis

66
Q

What shows positive staining with Congo red stain?

A

Amyloidosis

67
Q

What is commonest cause of chronic RF?

A

Diabetic nephropathy

68
Q

Commonest benign mesenchymal kidney tumour?

A

Angiomyolipoma. A/w tubular necrosis

69
Q

Can polycystic kidney disease be unilateral?

A

no its bilateral

70
Q

Are oral contraceptives and disseminated cancer RF for Deep vein thrombosis?

A

Yes

71
Q

The 4 Tetralogy of Fallot?

A

pulmonary stenosis
RV hypertrophy
Ventricular Septal Defect
Overriding of aorta

72
Q

What does AMI present as?

A

Left sided chest pain radiating to jaw.

73
Q

What does AMI present as?

A

Left sided chest pain radiating to jaw.

74
Q

Complications of atherosclerosis?

A

Aortic Aneurysms
Cerebral infarction
AMI
Peripheral vascular disease

75
Q

3 factors for ischemic heart disease

A

Reduced coronary flow
Higher myocardial demand
Lower oxygen availability in blood

76
Q

When does classical Hodgkin peak?

A

late adolescence or after 60yo

77
Q

What does high GGP level indicate?

A

Bile duct issues

78
Q

what does high ALP level mean?

A

Issue with liver or bone

79
Q

Which kidney disease is a/w berry aneurysms?

A

Polycystic Kidney Disease

80
Q

What inheritance is polycystic kidney disease?

A

Autosomal Dominant

81
Q

How do cells show in Acute Tubular Necrosis?

A

Swelling
Vacuolation
Sloughing
Flattening
Tubular dilation
Interstitial edema
Necrosis
Loss of PAS-positive brush border

82
Q

Which kidney disease shows eosinophilia with renal failure?

A

Acute Interstitial Nephritis.
Urinalysis shows RBCs, WBCs, Eosinophils

83
Q

Clinicals of Acute pyelonephritis?

A

Fever, chills
Dysuria
Pyuria
Urinary frequency
Flank pain and tenderness

84
Q

What is a/w lower risk of SCC of penis?

A

Circumcision when young

85
Q

Which germ cell tumour of testicles has better prognosis?

A

SGCT.

86
Q

Commonest testicular tumour in infants?

A

Yolk sac tumour

87
Q

What can be first clinical manifestation of gastric adenoCA?

A

Mets to supraclavicular nodes e.g. Virchow’s nodes, Trousseau’s sign

88
Q

What gene hit in FAP?

A

Tumour suppressor gene APC

89
Q

What is primary sclerosing cholangitis associated with?

A

Ulcerative Colitis and CRC

90
Q

What is HCC associated with?

A

Beta catenin activation + p53 inactivation

91
Q

Commonest site of pancreatic CA?

A

Head

92
Q

Risk factors for pancreatic CA?

A

Smoking
High Fat diet
Chronic pancreatitis
DM
Genetics

93
Q

Genes commonly mutated in Pancreatic CA?

A

KRAS, TP53, SMAD4, CDKN2A

94
Q

Clinicals of nephrotic syndrome

A

Proteinuria
Anasarca
Polyuria
Hypoalbuminemia
Lipiduria
Hyperlipidemia

95
Q

Clinicals of nephrotic syndrome

A

Proteinuria
Anasarca
Polyuria
Hyperlipidemia
Lipiduria
Hypoalbuminemia

96
Q

What can nephrotic syndrome urine and body have

A

Large urine volume with frothy urine
Body swelling

97
Q

Clinicals of nephritic syndrome?

A

Proteinuria
Haematuria
Oliguria
Edema
Hypertension
Azotaemia

98
Q

Commonest cause of nephritic syndrome?

A

IgA nephropathy

99
Q

Diffuse large B cell lymphoma

A
100
Q

SCC of vulva related to?

A

30% a/w HPV

101
Q

What do vulvar CAs develop from?

A

From classic Vulvar IN.
Most develop in background of lichen sclerosus

102
Q

Risk factors for Cervical CA?

A

Early first sex
Multiple sex partners
Related HPV infection
Genetic factors
Infections e.g. Chlamydia
Oral contraceptives and smoking

103
Q

Pathosis of Cervical CA?

A

HPV infection -> intraepithelial cervical neoplasia 1, 2, 3 -> Invasion for cancer

104
Q

Testing regime for cervical cancer?

A

Pap smear every 3 years for sexually active 25-29yo
HPV DNA every 5 years afterwards.

105
Q

Gross of cervical CA?

A

Fungating, Ulcerating, Infiltrative

106
Q

What causes endometrial hyperplasia?

A

Unopposed estrogen secretion.

107
Q

What can PID present with?

A

Pelvic pain
Vaginal discharge
Adnexal tenderness

108
Q

Name of most primitive ovarian germ cell tumour?

A

Dysgerminoma

109
Q

What is teratoma of ovarian germ cell tumour?

A

Neoplastic differentiation of embryo

110
Q

What tumour shows Schiller-Duval bodies?

A

Endodermal sinus tumour

111
Q

Which condition is implantation of placenta near internal os?

A

Placenta Previa

112
Q

Which condition is premature separation of placenta from uterine wall during pregnancy?

A

Placenta Abruptio

113
Q

Which condition is adhesion of normal placental villi to uterine wall with failure to separate?

A

Placenta Accreta

114
Q

Rhitinis is usually viral or bacterial?

A

viral!

115
Q

Does BCG prevent infection?

A

No, but help prevent progression to clinical disease and miliary TB

116
Q

SCC of lung commoner in male or female?

A

Male!

117
Q

Common substances of urolithiasis?

A

Calcium oxalate
MgNH4PO4
Urate stones from gout/leukemia
Cysteine stones

118
Q

What test for prostatic CA?

A

Prostate Specific Antigen test.
But not cfm unless super elevated

119
Q

What epithelial ovarian tumour can predispose to ovarian CA?

A

Mucinous cystadenoma

120
Q

Dequervain’s Thyroiditis usually has what in history?

A

URTI, mostly viral

121
Q

What does Paget’s disease present with?

A

Bone overgrowth
Severe secondary OA
AV shunt
Sarcoma
Chalkstick fractures
Nerve compression injury and deafness

122
Q

What is Paget’s Disease?

A

Excessive turnover of bone causing disorganization of its architecture.
Increased activity of both osteoclasts and osteoblasts

123
Q

Complications of Gout

A

Gouty Tophi
Joint deformities and destruction
Uric acid kidney stones

124
Q

What causes inflammatory response in gout?

A

Attempted phagocytosis of urate crystals

125
Q

Malignant bone tumour with primitive tumour cells.
Shows rosettes or pseudorosettes

A

Ewing sarcoma

126
Q

Onion skin appearance. What tumour?

A

Ewing sarcoma.
CD99 expression, usually whites btw 5-20yo

127
Q

Where is leukoplakia commonest?

A

Buccal mucosa

128
Q

Complications of MI

A

LV- congestive HF
Ruptured papillary muscle
Arrhythmia - Cardiac Death
Ruptured myocardium - Cardiac Tamponade
Pericarditis

129
Q

Testicular tumours cause painless enlargement of testis?

A

Yes

130
Q

What markers MAY be raised in testicular tumours?

A

AFP and HCG

131
Q

What can IVDA have in heart?

A

Tricuspid valve rupture
Pericarditis
Myocardial ring abscess

132
Q

Hodgkin LYmphoma positive for what cell markers?

A

CD15 and CD30

133
Q

Which patho gives starry-sky appearance?

A

Burkitt Lymphoma

134
Q

Where do B cells home to in cortex?

A

Cortex of LNs

135
Q

What features of LNs raise concern of malignancy?

A

Matted and Fixed LNs

136
Q

What does diabetic nephropathy predispose to?

A

Pyelonephritis
Chronic RF

137
Q

How does Aortic dissection present?

A

Tearing back pain migrating down from chest

138
Q

What is mitral stenosis a/w?

A

Acute rheumatic fever
Atrial fibrillation
Pulmonary HTN

139
Q

What can cause aortic regurgitation as complication?

A

Tertiary syphilis. It can cause aortic root aneuryms as well.

140
Q

Can emphysema cause airway obstruction?

A

Yes

141
Q

What causes croup in kids?

A

PArtial airway obstruction

142
Q

Micro of osteosarcoma?

A

DEstruction
Sunburst pattern
Codman’s triangle

143
Q

Who gets giant cell tumour of bone more often?

A

Asians.

144
Q

What does positive Direct Coombs TEst mean?

A

Autoimmune hemolytic anemia

145
Q

What cells are meningiomas from? Micro features?

A

Arachnoidal cells.
Show Psammomma bodies and nuclear inclusions

146
Q

Where are medulloblastomas found? What nuclei shape?

A

Found in cerebellum
Carrot shaped nuclei

147
Q

Cause of non-communicating hydrocephalus in kids?

A

Ependymomas

148
Q

What gene mutated in lung AdenoCA?

A

EGFR

149
Q

Can peptic ulcers cause back pain?

A

Yes

150
Q

What do chorioCA of female trophoblasts arise from?

A

Hydatiform moles

151
Q

Where is the commonest site of breast tumours?

A

Upper outer quadrant

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