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OD2 Semester 2 - Applied Clinical Training > wk2: AED - Lumps+Bumps 1 > Flashcards

wk2: AED - Lumps+Bumps 1 Flashcards

1
Q

Name some situations that could result in increased cellular/extracellular mass (name 7 for example)

A

Cellular mass: Hyperplasia, Hypertrophy, Dysplasia, Metaplasia, Neoplasia,
Extracellular mass: Inflammation, FB, Oedema, Haemorrhage, Cellular product depostion, Vesicle, Cyst, Duct/Vesicle Blockage, Microorganism prolfieration

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2
Q

What is Neoplasia?

A

A tumour. Can be benign or malignant

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3
Q

How is benign vs malignancy determined for a tumour? (6)

A

Based on appearance: e.g. degree of differentiation, rate of growth, invasiveness, tendency to metastasise, blood supply, cellular origin, etc.

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4
Q

What do benign tumours result from? (4)

A

Hyperplasia, Metaplasia, Dysplasia, or Hypertrophy

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5
Q

When is a tumour considered cancer? (2)

A

When the cells show uncontrolled growth and spread, which leads to a malignant tumour

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6
Q

What is Pterygium?

A

A fleshy overgrowth (hyperplastic tumour) of the conjunctiva occurring in response to excessive UV exposure and subsequent damage

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7
Q

In terms of ocular surface lesions, how common is pterygium?

A

Common

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8
Q

Where does pterygium originate from?

A

limbal stem cells exposed to chronic UV irritation

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9
Q

What 3 histology characteristics does Pterygium present with?

A

Epithelial proliferation
Goblet cell hyperplasia
Angiogenesis

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10
Q

What causes the defect in cancer cells?

A

Genetic mutations - sometimes caused by infectious viruses or env. factors (e.g. sunlight)

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11
Q

What does the defect in cancer cells allow them to do? (3)

A

Divide uncontrollably
Invade surrounding tissue
Metastasise

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12
Q

How do cancer cells metastasise? (2)

A

They spread via the vascular and/or lymphatic systems

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13
Q

Name 5 risk factors for cancer

A 
Genetics
Smoking
Diet (saturated fat, food preservatives)
Occupation/environment (sunlight, UV)
Infectious agents (viruses after DNA)
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14
Q

Name the 6 major histological classes of cancers

A 
Carcinoma 
Sarcoma 
Myeloma
Leukemia
Lymphoma
Mixed
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15
Q

Which histological classes of cancer can affect the eyes/eyelids? (3)

A

Carcinoma
Sarcoma
Lymphoma

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16
Q

What does carcinoma affect? (2)

A

Epithelial tissues: internal or external linings

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17
Q

What proportion of cancers are carcinomas? Why is this?

A

80-90%. It’s common because epithelial tissue is common throughout the body

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18
Q

Where do Sarcomas occur? (5)

A

Cancers of supportive or connective tissues: bones, tendons, cartilage, muscle and fat

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19
Q

Where do Myelomas occur? (1)

A

cancers of plasma cells of bone marrow

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20
Q

Where does Leukemia occur? (2)

A

cancers of bone marrow that affects WBCs or RBCs

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21
Q

What do lymphomas affect? (2)

A

cancers of glands or nodes of lymphatic system (solid masses)

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22
Q

Where do lymphomas commonly occur? (3)

A

Stomach
Breast
Brain

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23
Q

What are the 2 potential causes of a lump/bump?

A

Increased cellular or extracellular mass (e.g. fluid in cyst)
Tissue enlargement/displacement due to unregulated growth/invasion

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24
Q

How does the general public classify cancer?

A

Based on the primary site of cancer (e.g. skin, breast)

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25
Q

Do primary brain tumours metastasise?

A

No. However, the brain is a common site for metastasis

26
Q

Describe the following characteristics for benign tumours:
A: Are they encapsulated?
B: How fast is their growth rate

A

A: Yes. They are encapsulated
B: Slow growth rate

27
Q

Describe cellular differentiation in the context of biopsy

A

the extent to which cells resemble their forebears

28
Q

How do malignant cells vary under biopsy? (2)

A

vary in size and shape

irregular cells called pleomorphism &/or anaplasia

29
Q

What histological cellular change is an early sign of cancer?

A

pleomorphism

30
Q

Define anaplasia

A

loss of the mature or specialised features of a cell or tissue, as in malignant tumours

31
Q

Describe 4 features of cells that have undergone anaplasia

A

cells become immature
large nuclei
unusual shapes
little cytoplasm (immaturity)

32
Q

What does the presence of feeder blood vessels going towards a lump indicate? (2)

A

active + fast growth suggesting it’s a neoplastic growth (the feeder vessels are needed to facilitate this)

33
Q

How do Benign tumours and Malignant tumours differ in appearance? (2)

A

Benign: localised to single tissue (e.g. conjunctiva); show well demarcated edges
Malignant: invade surrounding tissue; show irregular borders

34
Q

What proportion of tumours with irregular borders are metastatic at time of diagnosis?

A

20%

35
Q

Do all malignancies metastasize?

A

No

36
Q

What does a halo around a malignant tumour represent?

A

area of invasion (invasion zone)

37
Q

When looking at the eye, how do we know whether a neoplastic growth is superficial or deeper in the eye?

A

Get a cotton bud and rub the area: if it moves, it’s superficial

38
Q

Which is worse? A neoplastic growth superficial on the eye or deeper in the eye?

A

Deeper is worse

39
Q

What tests can we use to determine the rate of growth/spread of a neoplastic growth? (2)

A

FAT - Family Album Test

Photo and watch - 6/12months

40
Q

if a tumour grows fast does that mean it’s malignant?

A

Not always

41
Q

If a tumour grows fast, is pleomorphic, highly vascularised and invasive, does that mean it’s malignant?

A

Most likely

42
Q

As a clinician, what should we do if we see any unusual/unexpected lesion inside the eye? (in addition to a tumour) (3)

A

DFE + CFP + OCT or ultrasound
Consider possibility that this is secondary
Vision + Visual function, esp. Visual Field Test

43
Q

Does lymphatic spread happen in the CNS?

A

No

44
Q

Name the 4 most frequent secondary sites for tumour metastasis

A

Eye
Breast
Liver
Lungs

45
Q

How do cysts arise?

A

from secreting epithelium that becomes trapped at a deeper location

46
Q

Define Vesicle

A

a container of fluid within a natural cleavage of skin layers

47
Q

Are cysts hard or soft on palpation?

A

Hard b/c of internal pressure

48
Q

Which enlarges over time? Cysts or Vesicles?

A

Cysts

vesicles do not enlarge over time

49
Q

In regards to dermoid cysts:
A) When do they form?
B) Where do they form?

A

A) Form at birth from entrapped dermis in orbit, lid, limbus

B) can form around and contain lashes (also forms elsewhere presumably)

50
Q

How would you describe the cyst lining?

A

normal skin surface

51
Q

What do cysts contain and how does this affect their structure?

A

Keratin - so hard, slow, growing lump

52
Q

When might you consider referral for a cyst? (3)

A

When:
Becomes painful + inflamed
Grows rapidly or changes colour
Removal is desired for cosmetic reasons

53
Q

What is Lymphangiectasia?

A

focal blockage of conjunctival lymphatic vessels (= multiple bubbles on the conj)

54
Q

How does Lymphangiectasia present? (1)

A

Bubbles on conjunctiva

55
Q

Name 2 potential causes of lymphatic vessel blockage?

A

Trauma

Inflammation

56
Q

What is a Chalazion?

A

A blocked duct causing local swelling of a gland

57
Q

How is a chalazion associated with inflammation?

A

Leakage of oils into surrounding tissues cause inflammation here

58
Q

Describe the nature of the inflammation associated with chalazion? (1)

A

Granulomatous

59
Q

How do you manage chalazion? (3)

A

Warm compresses + massage
Steroid injection
Surgical removal

60
Q

Are chalazions painful?

A

No

61
Q

What is a papilloma?

A

A benign overgrowth of epithelial cells (non-invasive with modest blood vessel growth (surface pink like strawberry))

OD2 Semester 2 - Applied Clinical Training (63 decks)

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