Pathology Flashcards

1
Q

What non-gynaecological cancer is COCP protective against?

A

Colorectal cancer

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2
Q

What is the type of cells line the labia majora?

A

Keratinized stratified squamous

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3
Q

Cancer seen with presence of endometrioma

A

Clear cell carcinoma

Endometrioma = endometriosis on the ovary
Clear cell is a type of epithelial ovarian Ca

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4
Q

Silicone breast implants became deformed and rigid. What cells are involved in this process?

A

Giant cells

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5
Q

HRT reduces the risk of which cancer?

A

Colorectal cancer

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6
Q

Radiation does not effect which type of cell?

A

Cortical cells of the neuron

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7
Q

the 2 oncogenes HPV 16 and HPV 18 are responsible for this percentage of cervical cancer:

A

70%

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8
Q

This granulated white blood cell has phagocytic action but constitutes only 2-3% of total WBC count:

A

Eosinophils

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9
Q

Spread of choriocarcinoma is

A

Haematogenous

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10
Q

a patient who is BRCA 1 positive has the following risk for breast and ovarian cancer:

A

Lifetime Breast Cancer Risk 70%
Lifetime Ovarian Cancer Risk 40%
(pass medicine)

75/50 (booklet)

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11
Q

Soft tumour. Histology: interstitial haemorrhage and Call–Exner bodies. Dx?

A

Granulosa cell tumour

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12
Q

Inflammation releases all of the following except which:
von willebrand
nitric oxide
prostacyclin
bradykinin
plasminogen activator

A

plasminogen activator

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13
Q

Which of the ovarian cysts is most prone to torsion?

A

Dermoid cyst

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14
Q

most common type of degeneration in fibroid of non pregnant woman?

A

Hyaline degeneration

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15
Q

A pregnant woman presents with abdominal pain. What type of fibroid degeneration is common in pregnant women?

A

Red degeneration

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16
Q

Best word to describe endometrial mitotic division

A

proliferative

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17
Q

Post menopausal women with vulval itching and thin discharge. Histopathology shows keratin pearl

A

??vaginal squamous cell carcinoma

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18
Q

30 yrs, cyst multi-loculated no solid mass, the CA125 is 100, RMI index is 300. Diagnosis (general)

A

Ovarian cancer

RMI >200 high risk for ovarian malignancy

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19
Q

The stroma and endometrial glands protrude into the myometrium and there is symmetrical uterine enlargement. What is the most likely cause?

A

Adenomyosis
= endometrium within myometrium

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20
Q

65-year-old nullip with vaginal spotting. A hysterectomy is performed, and pathologic examination reveals heterologous components of a malignant tumor of the endometrial glands and metaplastic cartilage. Dx?

A

Endometrial carcinosarcoma

(A mixture of carcinoma (i.e. epithelial) and sarcoma; rare)

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21
Q

What is the calculation for RMI?
e.g. premenopausal, Ca125 250, ovarian mass with solid areas and ascites

A

RMI = ultrasound score x menopausal score x CA-125
3 x 1 x 250 = 750

3 for 2+ USS abnormalities
(mets, ascites, loculated cyst, solid areas)
1 for 1 USS abnormality

3 for postmenopausal
1 for premenopausal

(this is ‘RMI 1’ scoring = 3 rather than 4

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22
Q

What is the type of necrosis in acute tubular necrosis of Kidney?

A

Coagulative necrosis (infarct)
For most stuff

Liquefactive - brain
Gangrenous - limb
Fat - pancreas
Caseous - TB

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23
Q

Ultrasound picture of the ovary shows cystic lesion measuring 3.3x 2.5 cm with echogenic septea. What is the most likely finding?

R pelvic pain, 5cm well defined cystic lesion with mixed echoes

A

Benign teratoma

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24
Q

Which is common malignant tumour in newborn?

A

Sacrococcygeal teratoma

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25
Q

A 55 year old presents to clinic due to vulval itch and discolouration. examination reveals pale white discoloured areas to the vulva. A biopsy shows epidermal atrophy with subepidermal hyalinization and deeper inflammatory infiltrate. What is this characteristic of?

A

Lichen sclerosus

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26
Q

Which pattern of endometrium do simple endometrial hyperplasia most likely resemble?

A

Proliferative endometrium

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27
Q

Emergency hysterectomy at CS. The placenta has not invaded the myometrium. Diagnosis?

A

Placenta accreta

Accreta - invades endometrium
Increta - invades myometrium
Percreta - invades serosa

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28
Q

The probability of sarcomatous change occurring in fibroid is

A

0.1%

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29
Q

Which tumours demonstrate Schiller Duval bodies?

A

Endodermal sinus tumour (EST)
aka
Yolk sac tumour

Classically a testicular tumour in children under 3 years old

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30
Q

Transformation Zone is from X to Y cell type

A

Columnar to Squamous metaplasia

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31
Q

Patient post abortion presents with difficulty breathing and haemoptysis, fluffy circular pacifications on CXR - which tumour marker may be elevated?

A

HCG

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32
Q

RIF pain, USS showing fluid collection, LMP 1/52 ago

A

Endometrioma

33
Q

Epithelial lining of cervix exterior to transformation zone is what tissue type?

A

Stratified squamous non-keratinised

34
Q

71 y/o with unilocular cyst measuring 30 mm and a Ca 125 of 25 iu/ml. What is her RMI?

A

zero

USS
0 = No abnormality
1 = 1 abnormality
3 = 2 or more

USS features
multilocular cyst
Solid areas
Ascites
Intra-abdominal mets

1 = Premenopausal
3 = Postmenopausal

Ca125 value

35
Q

What cell type lines the cervix?

A

Columnar epithelium
aka glandular epithelium

36
Q

LDH elevates in which type of ovarian ca ?

A

Dysgerminoma

37
Q

Infection with which one of the following less common human papillomaviruses (HPVs) is associated with an increased risk of cervical cancer?

A

33

38
Q

Postmenopausal patient with PVB, endometrium 1.2mm on USS. What is the management?

A

Ask to return if bleeding recurs

<4mm and no RF discharge
>4mm endometrial sampling +/- hysteroscopy

39
Q

From which organ / system does the Krukenberg tumor of the ovaries originate?

A

GI tract

40
Q

Most common cancer type in fallopian tube?

A

Serous (an epithelial carcinoma)
STIC - serous tubal intraepithelial carcinoma

41
Q

Which cancer most commonly diagnosed in pregnancy and postpartum?

A

Breast cancer

42
Q

What is the most common cause of postmenopausal bleeding?

A

Atrophic vaginitis and endometritis

43
Q

Which Ovarian Ca is associated with mutation of mismatch repair genes?

A

Endometroid Cancer

44
Q

What type of necrosis is seen in the heart after an acute myocardial infarction?

A

Coagulative necrosis

45
Q

Increase in cell size is called?

A

Hypertrophy

46
Q

Patient with ovarian mass plus pleural effusion histopath revealed white, firm, spindle shape cells. Diagnosis?

A

Fibroma

47
Q

A 27-year-old woman after normal vaginal birth develops shortness of birth and seizures. Despite resuscitation she died. At autopsy squamous cells and fetal hair are found in lungs. What is the most likely cause of death?

A

Amniotic fluid embolus

48
Q

Psammoma bodies are a histologic feature of ovarian papillary serous cystadenoma. ‘
Psammoma bodies’ are composed of ?

A

Calcium

49
Q

woman with complete hydatidiform mole has bilateral multiple tiny ovarian cysts, an enlarged uterus at 12/40. β-hCG is 300,000 mIU/mL. What is the most likely type of these ovarian cysts?

A

Theca lutein cyst

Caused by overstimulation and high HCG

50
Q

Placenta had invaded through the full thickness of the myometrium. Diagnosis?

A

Placenta increta

51
Q

In which subsites does vulval cancer most commonly arise?

A

Labia majora

52
Q

Which neoplasm is characteristically associated with paraneoplastic syndrome of inappropriate antidiuretic hormone (SIADH)?

A

SC lung ca

53
Q

Thrombosis in protein C deficiency is due to

A

Factor V and VIIIa

54
Q

Trophoblast cells that invade the lumen of spiral arteries are called

A

Endovascular trophoblast

55
Q

Where can Arias Stella be found?

A

Endometrium - associated with presence of chorionic tissue

56
Q

Type of necrosis found in the brain

A

colliquative necrosis

57
Q

What kind of epithelium covers the ovary?

A

cuboidal

58
Q

Patient with haematuria, biopsy shows a papillary structure, which type of cancer is this?

A

Transitional cell carcinoma

59
Q

What is the most common type of vulval cancer?

A

Squamous carcinoma

60
Q

What causes meig’s syndrome?

A

Fibroma - a benign ovarian tumour

Meig’s is a triad: ascites, pleural effusion, fibroma

61
Q

A 60-year-old with erythematous erosive lichen planus on the vulva. What type of cancer is linked to lichen planus

A

Squamous cell carcinoma

Remember usually it is lichen sclerosus that causes vulval plaques

62
Q

HPV +ive, cytology normal

A

Re-screen in 12 months

63
Q

HPV +ive, cytology abnormal (i.e. borderline or worse)

A

Colposcopy

64
Q

What gene mutation is found in high grade serous adenocarcinoma?

A

P53

65
Q

Commonest uterine sarcoma

A

Leiomyosarcoma

Same tissue origin as leiomyoma (fibroids)
Doesn’t generally evolve from one to the other.

66
Q

What % of hyperplasia without atypia progress to malignancy? (+bonus how is it managed?)

A

<5%
6 monthly surveillance

67
Q

What % of atypical hyperplasia progress to malignancy? (+bonus how is it managed?)

A

25-30%
Hysterectomy

68
Q

Ovarian mismatch repair genes are seen in

A

Clear cell carcinoma vs endometroid?

69
Q

Which element rises in ovarian clear cell carcinoma

A

Calcium

70
Q

Where is factor 8 produced

A

The liver

71
Q

Which cells in the corpus luteum become vascularised and bleed causing a haemorrhage luteal cyst?

A

Granulosa cells

72
Q

What platelet level triggers transfusion in PPH

A

<75

73
Q

Ovarian cyst is 4cm - management?

A

<50mm - reassure no follow up
50-70mm - ultrasound yearly
>70mm - MRI/surgery

74
Q

Which vulval disease is associated with autoimmune disease

A

Lichen sclerosus

75
Q

Why does red degeneration of fibroids occur in pregnancy?

A

Fibroid enlarges, outgrowing blood supply and becomes ischaemic

76
Q

What percentage of Brenner tumours are malignant?

A

<5%

77
Q

Types of subdural fibroid definition
type 0
type 1
type 2

A

type 0 - pedunculated
type 1 - <50% intramural extension
type 2 - >50% intramural extension

78
Q

A neoplasm of the female genital tract occurring in an 18-year-old girl whose mother was treated with diethylstilbestrol during the pregnancy is likely to be a:

A

Clear cell carcinoma of vagina