Pathology & Tumors Flashcards

1
Q

epitheliod melanocytes in the superficial epithelium of conjunctival biopsy

A

risk for malignancy

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2
Q

histology of an iris nevus

A

localized proliferation of BRANCHING DENDRITIC melanocytic cells typically oblong or ovoid with indistinct nucleli

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3
Q

polyhedral cells with large round nuclei with clumped chromatin and prominent eosinophilic nucleoli

A

epithelioid melanoma

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4
Q

mortality rate for iris melanoma

A

4%

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5
Q

Diagnosis

Risk factor for poor outcome

A

Iris melanoma

risk for metastatic death is AC angle invasion which may present as poorly controlled glaucoma, mimicking pigmntary glaucoma

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6
Q

enlarged, deeply eosinophilic filaments

A

rosenthal fibers - found in optic nerve glioma in NF1 -> low-grade juvenile pilocytic astrocytoma

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7
Q

Location of periocular lymphoma with lowest risk of systemic lymphoma

A

conjunctiva < orbital < eyelid

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8
Q

clinical feature typically leads to phthisis bulbi

A

low intraocular pressure

phthisical globes demonstrate

Shrinkage

Atrophy

Disorganized

‘SAD’

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9
Q

hemosiderin-laden macrophages

A

hemolytic glaucoma

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10
Q

Diffuse choroidal hemangiomas are a/w this clinical entity

A

Sturge-Weber syndome (SWS)

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11
Q

hypoplastic scleral spur and anomalous insertion of the ciliary muscle

A

primary congenital glaucoma

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12
Q

marks the termination of Descemet membrane on gonioscopy

A

Schwalbe line

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13
Q

MC eye finding in leukemia

A

retinal hemorrhages (white-centered)

typically have anemia and thrombocytopenia

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14
Q

Virus identified as RF for this lesion

A

human papillomavirus 18

HPV 16 and 18 a/w CIN + sessile papilloma

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15
Q

a/w pedunculated papillomas

A

HPV 6 and 11

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16
Q

optic nerve cells involved with support and nutrition

A

astrocytes

note: oligodendrocytes produce and maintain the myelin sheath of the optic nerve

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17
Q

produce and maintain the myelin sheath of the optic nerve

A

oligodendrocytes

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18
Q

phagocytes of the CNS

A

microglial cells

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19
Q

disruption in architecture of the inner and outer segments of the photoreceptors

A

commotio retinae

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20
Q

stain senile calcific plaque

A

alizarin red

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21
Q

retinal blood supply the

A

NFL

ganglion cell layer

IPL

inner 2/3 of inner nuclear layer

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22
Q

choroidal circulation supplies the

A

outer 1/3 inner nuclear layer

outer plexiform

outer nuclear

photoreceptors

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23
Q

inflammation in phacoantigenic uveitis

(AKA phacoanaphylactic endophthalmitis or lens-induced granulomatous endophthalmitis)

A

zonal granulomatous inflammation

lens protein -> IgG against lens protein -> multinucleated giant cells and neutrophils adjacent to lens material -> lymphocytes/histiocytes -> fibrous connective tissue with chronic inflammation

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24
Q

Langhans giant cells

A

sarcoidosis

multinucleated giant cells

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25
Q

this mutation in tumor correlates with increased RF for metastasis in ocular melanoma

A

BAP1

‘BAD’

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26
Q

Good prognostic mutations in ocular melanoma

A

EIF1AX and SF3B1

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27
Q

sign indicates malignant transformation of a choroidal nevus

A

increase in basal dimension

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28
Q

Tx for ciliary body medulloepithelioma

A

enucleation

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29
Q

What cell type would stain positive for hemosiderin

A

microglial cells

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30
Q

IHC stain for neuroectodermal origin

A

S-100

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31
Q

Diagnosis

A

Granular corneal stromal dystrophy

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32
Q

Composed of which material

A

Granular - hyaline - masson trichrome - electron-dense material with rod-shaped bodies in an amorphous mix

keratoepithelin

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33
Q

Diagnosis

A

touton giant cells in iris - juvenile xanthogranuloma

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34
Q

composition of asteroid bodies

A

calcium hydroxyapatite

alcian blue

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35
Q

MOA of glaucoma 2/2 angle recession

A

damage to TM

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36
Q

RF for malignant transformation of choroidal nevus

A

thickness > 3 mm

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37
Q

Carriers of the APC mutation for Gardener syndrome would have this ocular fundus finding

A

congenital HYPERPLASIA of RPE

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38
Q

Any retinal lesion of any size within 3 mm of fovea without focal or diffuse vitreous seeds is this reese-ellsworth classification (for Rb)

A

group B

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39
Q

MC secondary tumor in Rb survivors

A

osteosarcoma

(40% arising within field of radiation and 36% outside field of radiaiton in patients previously treated for Rb)

40
Q

incomplete closure of embryonic fissure result in

A

coloboma

41
Q

COMS large melanoma study

A

pre-enucleation XTR no effect on survival

42
Q

mutation AW congenital aphakia

A

FOXE3

43
Q

Dalen-Fuchs composed of this cell

A

histiocyte

44
Q

morphologic feature of nanophthalmos

A

normal lens (or slightly large)

short AL (15-20 mm)

thickened sclera

RF uveal effusion + glaucoma

45
Q

CB melanoma may reduce vision by this mechanism

A

lenticular astigmatism

46
Q

primary cellular element observed in periretinal membranes excised during vitrectomy for PVR

A

RPE cells

47
Q

Diagnosis

A

Glaukomflecken - elevated IOP causes degeneration of lens epithelial cells leading to irregular white patches just beneath the anterior lens capsule

necrosis of lens epithelial cells with adjacent degeneration of anterior lens cortex

demonstrate damage from previous episodes of ACG

48
Q

MC clinical presentation of primary intraocular lymphoma

A

vitritis

49
Q

Diagnosis

A

subretinal infiltrates (occasional)

more often - vitritis, iritis, reitnal vasculitis

asterisk - overlying retinal gliosis

choroidal inflammation. Subretinal tumor

50
Q

typical presentation of Coats dz

A

unilateral

51
Q

unilateral retinal vasculopathy more commonly in boys younger than 10 yo

A

Coats disease

52
Q

Diagnosis

A

iris nevus

53
Q

pathologic exam of combined hamartoma of the RPE will show what?

A

dysplastic glia

54
Q

Description

A

peripapillary combined hamartoma of the retina and RPE (note radiating lines through the fovea

55
Q

Seen in combined hamartoma of the RPE

A

mass of proliferating RPE cells

dysplastic glia

reitnal blod vessels

56
Q

Description and associations

A

medium-sized combined hamartoma

A/W: NF2, incontinentia pigmenti, XL retinoschisis

57
Q

most prominent cell type in vitritis a/w bacterial endophthalmitis

A

neutrophils (PMLs)

58
Q

ocular finding a/w aniridia

A

corneal pannus

cataract

foveal hypoplasia

59
Q

Gene mutation correlating wih nevi of ota, blue nevi, and uveal melanoma

A

GNAQ

GNA11

60
Q

Sudan black B

A

lipids

61
Q

Diagnosis and systemic dx

A

scleromalacia perforans

long standing RA

62
Q

RPMI media

A

flow cytometry media (or fresh)

63
Q

mechanism of orbital extension of choroidal melanomas

A

growth through scleral emissary canals

64
Q

Translocation implicated in most common orbital malignant tumor in children (rapid proptosis, bony destruction)

A

FOXO1

65
Q

medulloepitheliomas of the ciliary body develop from what tissue?

A

medullary epithelium

66
Q

Diagnosis

A

sebaceous adenocarcinoma

67
Q

polycoria

A

more than one pupillary opening in the iris

68
Q

corectopia and polycoria

A

axenfeld-Rieger syndrome

69
Q

What determines iris color?

A

melanin granules in anterior stromal melanocytes

70
Q

RPE derived from what embryonic layer

A

neuroectoderm, outer layer of optic cup

71
Q

Diagnosis

A

Macular corneal dystrophy

AR

‘limbus to limbus’

Alcian blue and colloidal iron

72
Q

Diagnosis

A

sebaceous gland carcinoma

73
Q

Systemic condition a/w this

A

congenital hypertrophy of the RPE (CHRPE)

a/w hamartomas of the RPE (RPEH) and familial adenomatous polyposis (FAP) which are bilateral, more haphazard, irregular and jagged borders

74
Q

OCP biopsy should be placed in this medium

A

Michel or Zeus transport medium

75
Q

fixative for EM

A

glutaraldehyde

76
Q

fixative for crystals

A

absolute ethanol or methanol

77
Q

fixative for liquid biopsies or smears (eg, vitreous biopsies, FNAs)

A

Saccomanno fixative

78
Q

Diagnosis

Visual field expected

A

Optic disc drusen

enlarged blind spot

arcuate scotomas

79
Q

Diagnosis

A

Choroidal melanoma

80
Q

4 yo boy present since birth. Diagnosis.

Management

A

congenital nevocellular nevus

lesions >20 cm have a 5%-20% risk of malignant transformation

Note: nevus of ota is diffusely pigmented dermal lesion frequently involves the sclera

81
Q

glycosaminoglycan found in normal composition of sclera

A

dematan sulfate

82
Q

glycosaminoglycans found in the cornea

A

Chondroitin sulfate

Keratan sulfate

83
Q

cyst lined by double layer of cuboidal epitehlium with an empty lumen

(translucent cyst)

A

eccrine cyst

(ductal (sweat gland) eccrine cyst)

84
Q

cyst lined with a double layer of cuboidal epithelium a/w decapitation secretion

A

apocrine cyst

(note: brown color related to cellular decapitation secretion containing lipofuscin pigment)

85
Q

Diagnosis

A

ductal eccrine cyst

86
Q

MOA botulinum toxin type A

A

inhibits release of acetylcholine

binds to receptor sites on motor nerve terminals, entering nerve terminals and INHIBITING RELEASE of AcH

contrast to muscarinic antagonists (atropine) which react with postsynaptic muscarinic receptors and block the action of AcH

87
Q

MOA atropine

A

muscarinic antagonists which react with postsynaptic muscarinic receptors and block the action of AcH

88
Q

Organism

A

viridans streptococci (alpha-hemolytic)

infectious pseudocrystalline keratopathy

89
Q

Timeframe after corneal abrasion for epithelial anchoring fibrils to reform

A

4-6 weeks

90
Q

length of time for migrating epithelial cells to cover a defect (K abrasion)

A

24 to 48 hours

91
Q

Which layer of the cornea when incompeltely healed may allow for fibrous ingrowth?

A

Descemet membrane - stromal fibrocytes may continue to proliferate into the AC as fibrous ingrowth

Note: bowman layer is not replaced when incised or destroyed so if a thin layer of anterior stroma is lost, th eipthelium fills the crater forming a facet.

92
Q

pathology of fibrous histiocytoma or fibroxanthoma

A

proliferation of spindle fibroblasts, wounded histiocytes, and occaisional multinucleated giant cells

93
Q

Orbital solitary fibrous tumors are these classes

A

hemangiopericytomas

fibrous histiocytoma

giant cell angiofibroma

94
Q

multinucleated floret-type giant cells and angioectatic spaces

A

giant cell angiofibroma

95
Q

spindle-shaped, plump histiocyte-like cells with a focal stoiform architecture

A

fibrous histiocytoma

96
Q

staghorn sinusoidal blood vessels

A

hemangiopericytoma

97
Q

Pallisading arrangement of epithelioid histiocytes around a central core of necrotic collagen

A

episcleritis