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Histopath Flashcards

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1
Q

Modifiable RFs for atherosclerosis

A

T2DM, HTN, Hyperchol, Smoking

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2
Q

Non modifiable RFs for atherosclerosis

A

Gender, age, FHx

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3
Q

Resolving MI

A

0-6 hours - no histological changes
6-24 hours - necrotic cell death, loss of myocyte nuclei, homogenous cytoplasm
1-4 days - acute inflam w/ cellular infiltrate
2 weeks - repair w/ classic young scar

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4
Q

Dressers syndrome

A

Chest pain, fevers + effusion weeks to months after MI

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5
Q

Nutmeg liver

A

RV failure

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6
Q

HoCM mutations

A

Autosomal dominant

BMHC, MYBP-C and Trop-T

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7
Q

Arrhythmogenic RV Cardiomyopathy

A

Myocyte loss w/ fibrous try replacement

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8
Q

Acute Rheumatic fever

A

T2HS - CASES w/ beady (verrucae) vegetation a, Aschoff bodies and Anitschkov myocytes
Tx BenPen

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9
Q

Libman sacks endocarditis

A

Assoc w/ SLE and antiphospholipid

Warty vegetations, sterile and platelet rich

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10
Q

Acute IE

A

Staph aureus - IVDU

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11
Q

Subacute IE

A

Strep viridans - dental caries

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12
Q

Monckeburg arteriosclerosis

A

Focal calcification of media of small-medium arteries

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13
Q

Carcinoid syndrome

A

5 hydroxyindodeacetic acid producing tumours

Episodic flushing, abdo cramps, diarrhoea and Right valve abnormality

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14
Q

3 components of atherosclerotic plaques

A

1 cells - macrophages + other leukocytes
2 ECM incl collagen
3 IC + EC lipid

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15
Q

Stages of atherogenesis

A 
1 endothelial injury
2 LDL enters intima and oxidised
3 macrophages take up - foam cells
4 apoptosis of foam cells - plaque
5 recruit more inflam cells
6 form fibrous cap
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15
Q

Ortner’s syndrome

A

Mitral stenosis
Enlarged LA
Recurrent laryngeal nerve palsy

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16
Q

Asthma histology

A

Churschman spirals
Eosinophils
Charcot-Leyden crystals

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17
Q

Honey comb lung

A

Interstitial lung disease

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18
Q

Small cell lung Ca

A

Oat cells + paraneoplastic syndromes

P53 + RB1 mutations

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19
Q

NSCLC

A

AdenoCa
SCC
Large cell Ca

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20
Q

Adenocarcinoma lung

A

Atypical cells line alveoli and peripheral on CXR
Non smokers
Mucin vacuoles

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21
Q

Squamous cell carcinoma lung

A

Keratinisation and IC prickle desmosomes

Hypercalcaemia

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22
Q

Large cell Ca

A

Undifferentiated form of either adenoCa or SCC

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23
Q

Barrett’s oesophagus

A

Metaplasia

Squamous -> columnar

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24
Plummer Vinson
Dysphagia Oesophageal webs Iron deficiency anaemia Assoc w/ SCC oesophagus
25
Zollinger Ellison
May be part of MEN1 Gastric secreting tumour of pancreatic G cells Multiple peptic ulcers and diarrhoea
26
Menetrier's disease
Gross hyperplasia of gastric pits and increased mucosal thickness
28
MEN1
Hyperparathyroid Pancreatic islet cell tumours eg insulinoma Prolactinoma (pituitary adenoma)
29
MEN2a
Medullary thyroid cancer Phaeo Parathyroid
30
MEN2b
``` Medullary thyroid cancer Phaeo Mucocutaneous Neuroma Marfanoid phenotype GI upset Hypotonia ```
31
Gastric Ca
Progressive dysphagia | Signet ring cells and linnitis plastica
32
H pylori Triple Therapy
PPI, Clarithromycin, Amoxicillin or Metronidazole
33
Gardner's syndrome
FAP + extraintestinal growths (osteomas, epidermoid cysts, desmoid tumours) + dental caries APC gene mutation (same as FAP)
34
Wilson's disease
``` Autosomal recessive Mutation in ATP7B gene Low caeruloplasmin Parkinsonism, seizures, dementia, cirrhosis + Kayser - Fleischer rings Mallory bodies on microscopy Tx Penicillamine ```
35
Haemochromotosis
``` Autosomal recessive Mutation in HFE gene Fe stains with Pearl's Prussian Blue Bronze Diabetes Transferrin saturation>45% Tx venesection + Desferioxamine ```
36
Alpha1 antitrypsin
Autosomal Dominant Hepatitis and Emphysema Intracytoplasmic inclusion stain w/ Periodic acid Schiff Absent alpha globulin band on electrophoresis
37
Crohn's histopath
``` Skip lesions Cobblestone appearance Rosethorn ulcers Non caseating granulomas Transmural ```
38
UC histopath
Pseduopolyps Mucosal only No granulomas
39
Peutz-Jeghers
LKB1 mutation Mucocutaneous hyperpigmentation, oral freckles Multiple polyps
40
CEA
Colorectal Ca
41
Ca19-9
Pancreatic Ca
42
Ca125
Ovarian Ca
43
AFP
HCC
44
Calcitonin
Medullary thyroid Ca Tumour marker
45
Metabolic syndrome
``` Fasting glucose >6 BP >140/90 Central Obesity Dyslipidaemia Microalbuminaemia ```
46
IGETSMASHED - causes of pancreatitis
``` Idiopathic Gallstones EtOH Trauma Steroids Mumps AI Scorpion stings Hyperlipidaemia ERCP Drugs e.g. Thiazides ```
47
Pancreatic Ca - ductal adenoCa
Trousseau syndrome (recurrent superficial phlebitis) Courvoisier's sign (painless, palpable gallbladder + jaundice) Hypercalcaemia
48
PBC
``` Jaundice, xanthelasma + pruritus Intrahepatic bile duct destruction Anti-mitochondrial Abs High ALP and Cholesterol Assoc w/ Sjorgren's ```
49
PSC
Destruction of extra and intrahepatic BD Assoc w/ UC Beading of bile ducts on ERCP Risk of cholangioCa
50
Nephrotic syndrome definition
Proteinuria >3g/24h Hypoalbuminaemia Oedema (Hyperlipidaemia)
51
Amyloidosis
Apple green birefringence w/ Congo red | Macroglossia, HF, Hepatomeg + Nephrotic
52
RPGN Type 1
Anti GBM Ab Goodpasture's Linear stain on IF
53
RPGN Type 2
``` Immune complex IgA nephropathy Lupus nephritis Post Strep GN Granular stain on IF ```
54
RPGN Type 3
Pauci-immune cANCA= Wegener's pANCA= MPA (Chrug-Strauss) Absent/scant stain on IF
55
Alport's syndrome
X linked Mutation in T4 collagen Nephritic + sensorineural deafness + eye disorders
56
Benign familial haematuria
Asymptomatic haemturia Autosomal dominant Mutation in T4 collagen
57
Liddle syndrome
Mutation in ENaC - overactive | HyperNa + HypoK
58
Renal stones
75% Ca Oxaloate (opaque) 10-20% Mg Ammonium phosphate (staghorn opaque) 5% Urate (lucent)
59
Membraneous GN
Thickened GBM Spike/dome protrusions Subepithelial Ig + granular staining
60
HUS E coli strain
O157:H7
61
Urea and Creatinine normal ranges
Creatinine: 60-110 Urea: 2.5-7
62
Renal function interpretation
Raised urea > Creatinine - dehydration | High urea + creatinine - ARF/CRF
63
CRF signs and stages
``` Signs of uraemia (fatigue, itching, anorexia) Stage 1 GFR>90 (normal) Stage 2 GFR 60-89 Stage 3 GFR 30-59 Stage 4 GFR 15-29 Stage 5 GFR ```
64
Adult PKD
Autosomal dominant PKD1 and 2 mutations (polycystin) Large multcystic kidneys + Berry aneurysms
65
Fitz-Hugh-Curtis
RUQ pain due to perihepatitis in PID | Violin string peri hepatic lesions
66
Serous epithelial Ovarian CA
Psammoma bodies | Mimics tubal epithelium
67
Serous mucinous Ovarian Ca
Mimic endocervical or intestinal wall (pseduomyoxma peritonei) Secrete mucin
68
Serous endometroid Ovarian Ca
Mimics endometrium
69
Clear cell Ovarian Ca
IC glycogen | Hobnail appearance
70
Meig's syndrome
Ascites + Pleural effusion | Assoc w/ Sex cord fibroma
71
Granulosa-theca cell tumour
Produce E2
72
Sertoli-Leydig tumour
Produce androgens (can get in F)
73
Duct papilloma
Bloody discharge w/o lump | Dx w/ galactogram
74
Ductal Ca in situ
Unilateral post menopasual w/ focal microcalcification
75
Lobular Ca in situ
Bilateral premenopausal, multifocal w/ no calcification
76
Infiltrating DCIS
Scirrhous look, peau d'orange, Paget's, tethering, Retraction, Ulceration
77
Tamoxifen
ER agonist/antagonist
78
Herceptin/Trastuzumab
HER2 antagonist, must monitor LVEF
79
Non traumatic intraparenchymal haemorrhage
Charcot-Bouchard microaneurysms | Basal ganglia
80
Meningioma
Assoc w/ NF2
81
Ependyoma
Ventricular tumour, hydrocephalus
82
Pilocytic astrocytoma
Childhood, indolent
83
Oligodendroma
Soft, gelatinous, calcified
84
AD
``` Tau and beta-amyloid Presenelins 1+2 in Down's e4 allele of apolipoprotein E predisposes Temporal and frontal lobes Loss of cholinergic neurons ```
85
DLB
``` Alpha-synuclein, ubiquitin PD Sx (TRAP) ```
86
Frontotemporal dementia
Linked to Ch17 | Tau
87
MS
2 lesions separated in space and time Optic neuritis + instability/weakness Myelin basic protein + proteolipid protein Abs
88
MS plaque classification
Acute - minor changes Early chronic active - oedema + macrophages Late chronic active - complete loss of myelin Chronic active - complete loss of myelin w/ NO macrophages Shadow - nearly complete remyelination
89
Multiple system atrophy
Papp-Lentos bodies in glial cells | Similar to PD
90
Huntington's
Autosomal dominant | Cerebral atrophy in caudate nucleus + putamen + NT changes
91
OA X ray findings
Subchondral sclerosis Subchondral cyst formation Joint space narrowing Osteophytes
92
Osteoporosis
T score >2.5 | Ca, PO4, ALP normal
93
Osteomalacia
Vit D def Low Vit D, Low Ca, Low PO4, High ALP, High PTH Soft bones w/ wide epiphyses Pseudofractures (looser zones)
94
Primary Hyperparathyroidism
High Ca, Low/normal PO4, High/normal ALP Moans, Bones, Groans, Stones Brown's tumours (Osteitis fibrosa cystica) Salt and pepper skull
95
Paget's disease of bone
``` Bone pain, n. compression, enlarging head Osteoporosis circumscripta Cotton wool Picture frame and ivory vertebrae V High ALP, normal Ca + PO4 ```
96
Renal Osteodystrophy
2o hyperparathyroidism in RF | Low Ca, High PO4
97
Gout
Needle shaped urate crystals | -vely birefringent
98
Pseduogout
Rhomboid shaped Ca pyrophosphate crystals | +vely birefringent
99
Herberden's nodes
DIPJ
100
Bouchard's nodes
PIPJ
101
Osteosarcoma
Adolescent knee ALP +ve Codman's triangle Sunburst appearance
102
Chondrosarcoma
>40 axial bones | Lytic lesion w/ fluffy calcification
103
Ewing's sarcoma
``` Under 20 long bone ALP-ve CD99 +ve T(11:22) Onion skinning of periosteum ```
104
Giant cell Bone malignancy
20-40 F Knee epiphysis Multinucleate giant cells Spindle/ovoid cells "soap bubble"
105
Osteoid osteoma
Adolescent Tibia/femur | Night pain relieved by Aspirin
106
Osteoma
Bony outgrowths in middle age | Assoc w/ Gardner's
107
Enchondroma
Middle age hands Blue-grey lobules of hyaline Cotton wool calcification
108
Ollier's syndrome
Multiple enchondromas
109
Maffuci's syndrome
Multiple enchondromas + haemangiomas
110
Osteochondroma
Teenage boys long bones | Cartilage capped bony outgrowth
111
Fibrous dysplasia
Middle age F Chinese letters Soap bubble osteolysis Shepherd's crook deformity
112
McClune-Albright syndrome
Fibrous dysplasia, cafe-au-lait spots + precocious puberty
113
Osteoblastoma
Speckled mineralisation
114
Ossifying fibroma
Mandible (adults), Tibia (children) | Benign fibrous tumour w/ reactive bone formation
115
Lichen Planus
Wickham's striae | Saw toothing of Rete ridges
116
Pemphigoid
IgG to hemidesmosomes | Epidermal-dermal junction
117
Pemphigus
IgG Desmoglein 1/3 | IntraEpidermal
118
BCC
Pearly surface w/ telangectasia
119
Lentigo Maligna Melanoma
Slowly growing black lesion on sun exposed areas
120
Superficial spreading Malignant Melanoma
Irregular borders w/ variation in colour
121
Nodular malignant melanoma
Younger age group, any site
122
Acral Lentiginous melanoma
Palms, soles and subungual areas of non Caucasians
123
Pityriasis rosacea
Salmon pink rash (herald patch) followed by oval macules in Christmas tree distribution
124
Dermatomyositis
Heliotrope rash | Gottron's papules
125
Takayasu's arteritis
Large vessel vasculitis | Pulseless disease
126
Temporal arteritis
Large vessel vasculitis Scalp tenderness + temporal headache Assoc w/ polymyalgia rheumatica
127
PAN
Medium vessel vasculitis Assoc w/ Hep B Microaneurysms
128
Kawasaki
Medium vessel vasculitis Fever >5 days Rash, Strawberry tongue, Cervical LN, coronary aneurysms, conjunctivitis
129
Polymyalgia rheumatica
Subacute onset asymmetrical aching, tenderness, morning stiffness in shoulders
130
Buerger's
Corkscrew appearance on Angiogram | Heavy smokers
131
Wegener's
Epistaxis/saddle nose, Haemoptysis +GN (T3 RPGN) cANCA small vessel
132
Churg strauss (eMPA)
Asthma, Eosinophilia | pANCA
133
MPA
Focal necrotizing GN | pANCA
134
Goodpasture's
Cough, Dyspnoea, Haemoptysis + nephrotic T1RPGN Anti GBM Abs
135
HSP
``` Preceding URTI Purpuric rash on buttocks and extensors Colicky abdo pain (risk of intussusception) Arthritis GN ```
136
Behcet's
Recurrent oral and genital ulceration + iritis in absence of Syphilis
137
Osler-Weber-Rendu
Hereditary Haemorrhagic Telangectasia | Epistaxis + GI bleeds

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