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MRCS-Pathology > Deck 4 > Flashcards

Deck 4 Flashcards

(49 cards)

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1
Q

Acute inflammation def

A

body’s response to tissue injury characterised by red hot swollen pain

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2
Q

Acute inflammation stages

A
  1. vasoconstriction
  2. vasodilation (red/hot)
  3. increased permeability (swelling)
  4. Migration of white cells (neutrophils)
  5. Phagocytosis
  6. Resolution or progression
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3
Q

Complement cascade 3 pathways activation

A

Classic: antigen-antibody complex activation
Alternative: C3 contacting micro-organisms
Lectin: Mannose-binding lectin binds to cell membrane of pathogens

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4
Q

Consequences of complement cascade activation

A
  1. inflammation and activation of leucocytes
  2. Opsonisation of pathogens for macrophages
  3. formation of MAC and destruction of pathogens
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5
Q

Possible outcomes of inflammation

A
  • Resolution
  • Chronic inflammation
  • Scar
  • abscess
  • Death (meningitis)
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6
Q

Possible outcomes of inflammation

A
  • Resolution
  • Chronic inflammation
  • Scar
  • abscess
  • Death (meningitis)
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7
Q

Chronic inflammation

A

Active inflammation, tissue injury and healing occurring at the same time

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8
Q

Examples of chronic inflmmation

A

Infection evading host immune: TB, H pylori

Auto-immune: rheumatoid

Untreated acute inflammation: chronic osteomyelitis

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9
Q

Examples of chronic inflmmation

A

Infection evading host immune: TB, H pylori

Auto-immune: rheumatoid

Untreated acute inflammation: chronic osteomyelitis

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10
Q

BRCA 1 and 2 chromosomes

A 
1 = 17
2 = 13
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11
Q

BRCA 1 ass with which cancers

A

Ovarian

Breast

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12
Q

BRCA 2 associated with which cancers

A

Breast

Pancreatic

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13
Q

Sentinel node biopsy procedure

A
  1. radio-isotope/dye injected into sub-dermal layer around areolar region
  2. During op, sentinel node identified by dye or Geiger counter
  3. if positive that group of nodes are excised
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14
Q

Complications of mastectomy

A

Immediate: haemorrhage

Early:

  • damage to local nerves: thoraco-dorsal, long thoracic
  • infection
  • haematoma/seroma formation

Late:
- recurrance

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15
Q

Breast reconstruction

A

Breast mound:
- flap or implant or both

Nipple areolar complex:

  • areolar region: tattoo
  • nipple: flap or graft from contra-lateral side
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16
Q

Types of flaps in breast reconstruction

A
  • Latissimus dorsi
  • TRAM (transverse rectus abdominis)
  • DIEP (deep inferior epigastric perforator)
  • SGAP or IGAP (Sup/Inf gluteal aretery perforator flaps)
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17
Q

Local complications of radiotherapy

A
  • permenant skin discolouration
  • Lymphoedema
  • Swelling of remaining breast
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18
Q

Oestrogen dependent breast cancer mx

A

Pre-menupause:

  • tamoxifen (SERM)
  • stops production of oestrogen at overies

Post-menupause

  • anastrazole ( aromatase inhibitor)
  • stops peripheral production in fat tissue
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19
Q

Herceptin role in breast cancer

A

Targets cells that over-express HER2 (transmembrane epidermal growth factor)

Reduces recurrence

HER2 over expressed in 15% of breast cancers

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20
Q

Poor prognostic factors for breast cancer

Study These Flashcards
A

HER 2 positive
Young at diagnosis
High grade

21
Q

Naevus definition

Study These Flashcards
A

benign proliferation of cells of skin

22
Q

Types of naevus

Study These Flashcards
A
  1. melanocytic (eg congenital)
  2. vascular (eg port wine stain)
  3. Epidermal (warty naevus)
23
Q

Types of cutaneous melanoma

Study These Flashcards
A
  • Superficial spreading
  • Nodular
  • Acral lentigenous and subungal melanoma
  • lentigo maligna
24
Q

Types of cutaneous melanoma

Study These Flashcards
A
  • Superficial spreading
  • Nodular
  • Acral lentigenous and subungal melanoma
  • lentigo maligna
25
RFs for melanoma
Modifiable: - UV light exposure - CT scan in childhood Non-modifiable: - age - Previous BCC, SCC - Fitz Patrick 1
26
ABCDE rule to examine melanomas
``` Assymetry Border irregularity Colour variation Diameter >7mm Evolution eg shape/size/colour ```
27
Glasgow 7 point checklist for melanoma components
Major fx (2 points) - change in size - irregular shape - irregular colour Minor fx (1 point) - diameter >7mm - inflammation - oozing - change in sensation
28
Glasgow 7 point checklist interpretation
Lesions scoring 3 or more need urgent referral
29
What type of biopsy for melanoma
excision biopsy with 2mm excision margin
30
How are branchial cyst formed
Failed or incomplete involution of pharyngeal cleft during development (mostly 2nd branchial cleft)
31
Where are branchial cysts found
Anterior to SCM upper 1/3 in the anterior triangle
32
When do branchial cysts present
2-3rd decade of life
33
How are branchial cysts diagnosed?
USS +/- FNA (cholesterol rich fluid)
34
Branchial cyst rx
Mostly conservative | Surgical removal if pressure/infection
35
When do thyroglossal cysts present
40% in the first decade, but could present later
36
Where are thyroglossal cysts found
Midline or off midline, | Between chin to 2nd tracheal ring
37
What is a dermoid cyst
Benign tumour of ectoderm Keratinised epithelium with hair and sweat glands
38
Where are dermoid cysts found
- Midline neck and trunk - Midline nose - Medial and lateral eyebrows
39
Dermoid cyst mx
Excision
40
What is a sebaceous cyst
Epidermoid or pilar (hair follicle) cysts that contain keratin
41
What is a sebaceous cyst
Epidermoid or pilar (hair follicle) cysts that contain keratin
42
Common sites for sebaceous cysts
Head Scalp Neck Trunk
43
Rx for sebaceous cyst
Excised with overlying skin as contains a punctum
44
Ludwig's angina
Cellulitis of floor of the mouth and neck Spreads through submandibular space Leads to elevation and posterior displacement of tongue -> aiwary obstruction
45
Cystic hygroma cause
Congenital malformation of lymphatic system
46
Where are cystic hygromas found
posterior triangle of neck
47
When do cystic hygromas present
Majority visible at birth | 90 % by 2yo
48
Rx for cystic hygroma
Aspiration + Injection of sclerosing agent or Resection
49
Ludwig's angina
Cellulitis of floor of the mouth and neck Spreads through submandibular space Leads to elevation and posterior displacement of tongue -> aiwary obstruction

MRCS-Pathology (11 decks)

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