Histopathology Flashcards
(248 cards)
1
Q
Give 4 important components of Cirrhosis
A
- whole liver involved
- fibrosis
- nodules of regenerating hepatocytes
- distortion of vascular architecture: intra/extra hepatic shunting of blood
2
Q
what are the 6 types of liver cell?
A
- hepatocyte
- blood vessels
- kuppfer cells
- stellate cells
- bile ducts
- endothelial cells
3
Q
what are the 3 main complications of liver cirrhosis
A
- portal hypertension
- hepatic encephalopathy
- liver cell cancer
4
Q
What is the histopathology of actute hepatitis?
A
Spotty necrosis
5
Q
Which types of viral hepatiti can cause chronic hepatitis?
A
B, C, D (the chronic viruses)
6
Q
What are the 3 causes of chronic hepatitis
A
viral, drugs, autoimmune
7
Q
What is a classic example of a drug which can cause chronic hepatitis?
A
Isoniazid
8
Q
In chronic hepatitis, what is the difference between grade and stage?
A
GRADE = how much inflammation is there
STAGE = how much fibrosis
9
Q
What is the more recent and accurate name for piecemeal necrosis?
A
interface hepatitis
10
Q
What is interface hepatitis?
A
(aka piecemeal necrosis) is a process of inflammation and erosion of the hepatic parenchyma at its junction with portal tracts or fibrous septa
11
Q
What are the hallmarks of alcoholic hepatitis?
A
Hepathcyte ballooning and necrosis due to accumulation of fat, water and proteins
Mallory-Denk bodies
Large fibrotic liver
12
Q
What is the proper name for accumulation of fat droplets in hepatocytes?
A
Steatosis
13
Q
What are the 2 types of non-alcoholic fatty liver disease?
A
- simple steatosis: fatty infiltration and is fairly benign
- NASH: non-alcoholic steatohepatitis: steatosis and inflammation - can progress to cirrhosis
14
Q
What is the most common cause of chronic liver disease in the west?
A
NAFLD
15
Q
What is the diagnostic feature of primary biliary cholangitis?
A
anti-mitochondrial antibodies
16
Q
What autoimmune condition is primary sclerosing cholangitis associated with?
A
ulcerative colitis
17
Q
what does PSC increase the risk of?
A
cholangiocarcinoma
18
Q
what is the gold standard for diagnosis of PSC?
A
ERCP - endoscopic retrograde cholangiopancreatography - shows beading of bile ducts (multifocl strictures)
19
Q
what condition are Kayser-Fleischer rings associated with?
A
Wilson’s disease (COPPER ACCUMULATION)
20
Q
What genetic condition associated with liver damage, diabetes and skin pigmentation?
A
Haemochromatosis - accumulation of iron due to genetic mutation causing increased gut absorption of iron resulting in build up over the years/ aka bronzed diabetes
21
Q
What is haemosiderosis
A
Accumulation of iron in macrophages due to blood transfusions - not damaging to liver
22
Q
A rhodanine stain of a liver sample comes up positive - what condition does this suggest?
A
Wilson’s disease
23
Q
what is the toxic byprouct of paraceamol
A
Napqui
24
Q
give 2 specific and 2 general causes of hepatic granulomas?
A
specific to the liver: PBC and drugs
general: TB and sarcoid
25
Is alcoholic cirrhosis macro or micronodular
Micronodular
26
is viral liver hepatitis micro or macronodular
macronodular
27
Which of these is the commonest liver cell cancer seen in the west?
a) liver cell carcinoma
b) cholangiocarcinoma
c) metastatic adenocarcinoma
metastatic adeonocarcinoma - metastatic cancers are really common!
28
Which of these is not associated with fatty change in the liver?
a) diabetes
b) Hep B
c) Hep C
d) alcohol
B) Hep B --> because hep C can cause fat in the liver
29
which of these is not associated with genetic haemochromatosis
a) cirrhosis
b) diabetes
c) kayser-fleisher ring
d) myocardial damage
c) kayser-fleisher rings - these are associated with Wilsons disease
30
What are 3 types of benign liver cancers
1. liver cell adenoma
2. bile duct adenoma
3 haemangioma
31
What type of bullous disease is characterised by IgG antibodies and C3 binding to hemidesmosomes of the basement membrane, resulting in subepidermal bull?
Pemphigoid
32
Which type of bullous disease is characterised by IgG antibodies binding to the desmosoml proteins causing intraepidermal bulla?
Pemphigus vulgaris
33
Which type of bullous disease affects both the skin AMD mucous membranes?
Pemphigus
34
which antibodies are involved in the autoimmune pemphigus vulgaris and pemphigoid diseases?
IgG
35
what are the specific antibodies which are produces in pemphigus foliaceus?
Desmoglein-1 (IgA)
36
What are the types of dermatitis?
1. atopic
2. contact
3. seborrheic
37
What is the skin condition which can present in infants with a cradle cap, and is caused by a reaction to the yeast Malassezia?
Seborrheic dermatitis
38
Which surfaces of the body is eczema commonly affecting?
Flexor
39
Which surfaces of the body does psoriasis affect?
Extensor
40
What is the basic histopathological basis of psoriasis?
- parakeratosis (rapid turnover of keratocytes) resulting in loss of the granular layer, causing thickening of the epidermis.
- clubbing of the rete ridges.
- Munro's microabscesses (fill with neutrophils)
41
What type of hypersensitivity reaction is contact dermatitis?
Type IV (delayed hypersensitivity) - cell mediated - activated T cells release cytokines which activate macrophages or Tc cells which cause direct cellular damage
42
What other features other than skin changes are seen in psoriasis
Nails: pitting, onycholysis,
43
What is onycholysis?
Separation of the nail from the nail bed
44
What disease is characterized by itchy reddish-purple polygon-shaped skin lesions on the lower back, wrists, and ankles. It may also present with a burning sensation in the mouth, and a lattice-like network of white lines near sites of erosion
Lichen planus
45
In lichen planus, what is the a lattice-like network of white lines near sites of erosion called?
Wickman's striae
46
In which condition do you see saw-tooth rete ridges and basal cell degeneration?
Lichen planus
47
What is the likely diagnosis: Rapid progression of painful, necrolytic, cutaneous ulcer with an irregular, violaceous and undermined border, biopsy shows abundance of inflammatory cells: neutrophils
Pyoderm gangrenosum
48
What type of hypersensitivity reaction is psoriasis?
Type IV T cell hypersensitivity reaction
49
What is a granuloma
A collection of activated histiocytes(macrophages)
50
What is the likely diagnosis: rough brown plaque, waxy, warty, "stuck on" appearance, in elderly patient - histo describes as proliferation of basal keratinocytes
Seborrhoeic keratosis
51
what is the likely diagnosis - 60 year old who spends a lot of time in spain, pearly white ridge, rolled edge, central ulceration,
BCC - basal cell carcinoma
52
Which of BCCs and SCCs can metastasise?
SCCs
53
The Breslow thickness is used to stage which cancer?
malignant melanoma
54
Which common skin cancer does not metastasise?
Basal cell carcinoma
55
What is the commonest cause of people going into acute renal failure?
Acute tubular injury/necrosis
56
what are 3 causes of crescentic glomerulonephritis?
1. immune complex
2. anti-GBM disease
3. pauci-immune - associated with anti-neutrophil cytoplasm antibodies (ANCA)
57
what disease is diagnosed by immunochemistry showing linear deposition of IgG antibodies on the glomerular basement membrane?
Anti-GBM diease or goodpastures disease
58
What disease is characterised by cresentic glomerulonephritis and lung haemorrhage?
Goodpasture's syndrome
59
what disease is associated with ANCA and glomerular necrosis?
Pauci-immune crescetic GN
60
what antibodies is pauci-immune GN associated with?
Anti neutrophil cytoplasm antibodies (ANCA)
61
What does a Congo-red stain turning green under polarised light indicate?
presence of amyloidosis - causing nephrotic syndrome
62
What 4 things characterise nephrotic syndrome?
1. Hypoalbuminaemia
2. Proteinuria (>3.5g/day)
3. Oedema
4. Hyperlipidaemia
63
what pathogen causes diarrhoea associated haemolytic uraemic syndrome and why?
E. coli - the toxin it makes directly targets the renal endothelium
64
What are 3 examples of systemic diseases that can cause nephrotic syndrome?
1. diabetes mellitus
2. Amyloidosis
3. SLE
65
What are the primary glomerular diseases that case nephrotic syndrome?
1. minimal change disease
2. focal and segmental glomerulosclerosis
3. membranous glomerulonephritis
66
Which primary glomerular disease is seen most commonly in children?
Minimal change disease
67
what is the likely diagnosis and common treatment for a child with nephrotic syndrome
Minimal change disease
| - respond to immunosuppression so a course of corticosteroids - prednisolone
68
What is the antibody responsible for primary membranous glomerulonepritis?
Autoantibodies to phospholipase A2 receptor - found on podocytes
69
what proportion of patients with IgA nephropathy progress to end stage renal disease?
30%
70
what is the most common cause of chronic kieny disease?
diabetes
71
what antibodies are commonly made in SLE?
ANA and anti ds-DNA
72
what cell forms the outer layer of the glomerular filtration barrier?
podocyte
73
to the nearest 10% what percentage of end stage renal disease is due to autosomal dominant polycystic disease?
10%
74
what type of amyloid is formed in patients with multiple myeloma?
AL
75
antibodies to phospholipase A2 receptor are associated with what form of glomerulonephritis?
membranous glomerulonephritis
76
what type of epithelial cells is the oesophagus lines with
squamous
77
what is the Z line
gastro-oesophageal junction - transition from squamous to columnar epithelial cells
78
in the duodenum, what is the normal villous:crypt ratio?
2:1 -- V:C
79
what is the key inflammatory cell involved in acute oesophagitis
neutrophil polymorph
80
what is the key difference between an acute and a chronic ulcer?
chronic ulcers have scarring and fibrosis at the base
81
what changes are seen in Barret's oesophagus?
re-epithelialistion of the oesophagus with columnar epithelium, often with goblet cells
82
what is the key feature differentiating dysplasia from adenocarcinoma in the oesophagus
dysplasia = cytological, histological and genetic features of malignancy but NO INVASION - adenocarcinoma has invasion through the basement membrane
83
what is the commenest type of cancer in the oesophagus?
adenocarcinoma
84
what are the 2 types of cancer of the oesophagus and which is more common?
adenocarcinoma - (glandular - from dysplasia and invasion of columnar cells)
squamous cell carcinoma
85
what is a common infectious cause of acute gastritis?
H. pylori
86
what does a biopsy of the stomach showing the presence of lymphoid follicles indicate?
a current or previous infection with H. pylori
87
what does lymphoid tissue in the stomach increase the risk of?
Lymphomas - MALTomas
88
What is the increased risk of cancer with H pylori infection?
8X
89
what is the most common type of gastric cancer?
adenocarcinoma - either intestinal or diffuse type
90
Apart from H. pylori, which other pathogens must you consider when thinking about inflammation of the duodenum?
Giardia lamblia
CMV
cryptosporidius
Whipples
91
how do you diagnose coeliacs disease
transglutaminase antibodies
endomysial antibodies
duodeal bopsy shoes villous atrophy (only if on a gluten diet at the time)
92
Histologically describe a MALToma
expansion of hte marginal zone with development of sheets of neoplastic small lymphoid cells
93
What kind of cells are involved in coeliac associated MALTomas in the duodenum
T cells (s opposed to B cells in normal gastric MALTomas)
94
True or false - most oesophageal and gastric cancers arise from pre-existing adenomas
False - metaplasia --> dysplasia pathway is most common
95
In a patient with coeliac disease on a diet containing gluten, what is the most likely histology
villous atrophy, with increased intra-epithelial lymphocytes
96
What are 4 complications of GORD
1. haemorrhage
2. stricture
3. perforation
4. Barrett's oesophagus
97
What are 2 mjor examples of cancellous bones
pelvis and vertebrae
98
Which type of mone is more metabolically active: cancellous or cortical
cancellous
99
in suspected metabolic bone disease, where must a bone biopsy be obtained from
iliac crest
100
Re-epithelialisation by metaplastic columnar epithelium with goblet cells is called
intestinal metaplasia
101
what is melena
black tarry stools with an offensive odour caused by an upper GI bleed
102
What does a CLO test for?
H. pylori - "campylobacter like organism test"
103
food and antacids relieve the pain of which type of ulcers?
Duodenal
104
A 65 year old male with a long history of epigastric pain. Endoscopy reveals 3.2cm of columnar metaplasia in the lower oesophagus. Goblet cells are seen.
Barrett's oesophagus
105
what is the urea breath test used to diagnose?
H pylori - works based on how H. pylori converts urea to ammonia and CO2
106
A 66 year old man complaining of epigastric pain undergoes an endoscopy. The mucosa appears reddened in the antrum of the stomach. 13C is detected on a urea breath test.
Gastric ulcer
107
What is a rare diesease of the muscle of the lower esophageal body and the lower esophageal sphincter that prevents relaxation of the sphincter and an absence of contractions, or peristalsis, of the esophagus.
Achalasia
108
A 30-year-old woman presents with haematemesis and diarrhoea. She has recurrent peptic ulceration and is taking omeprazole. Despite this, she has persistently high serum gastrin levels. Endoscopy shows a large 3cm actively bleeding ulcer in the duodenum.
Zollinger-Ellison syndrome
109
A 50-year-old women presents with chest pain associated with regurgitation of solids and liquids equally, both occurring after swallowing. Diagnosis is confirmed by a characteristic ‘beak like’ tapering of the lower oesophagus on barium swallow and manometry shows failure of relaxation of the LOS.
Achalasia
110
A 65-year-old woman presents with a 3 month history of anorexia, weight loss and epigastric pain. Blood tests reveal an iron deficiency anaemia. Endoscopy shows a thickened rigid gastric wall known as ‘leather bottle stomach’ indicating infiltration into all layers of the gastric wall. Numerous signet ring cells on biopsy diffusely infiltrate the mucosa.
Diffuse stomach carcinoma - adenocarcinoma
111
A 45 year old woman presents with large tongue and swelling of the legs. She has a high BP and urine dipstick reveals protein +++.The tissue from renal biopsy stains with Congo red dye and shows apple green birefringence under polarised light
Renal amyloidosis
112
A 28 year old woman presents with malaise, weight loss, an erythematous rash on the face and joint pains. Both antinuclear antibodies (ANA) and double-stranded DNA (dsDNA) antibodies were found in the serum.
SLE
113
A 55 year old woman presents with severe, unremitting headache with scalp tenderness. Her ESR and CRP are raised. A biopsy reveals giant cells.
Temporal arteritis
114
delta-F508 mutation is a specific mutation for what?
Cystic Fibrosis
115
What are the causes of pancreatitis?
GETSMASHED
```
Gallstones
Ethanol (alcohol)
Trauma
Steroids
Mumps
Autoimmune (SLE)
Scorpion sting
Hypercalcaemia
ERCP
Drugs
```
116
What is the commonest cause of acute pancreatitis in the UK?
alcoholism
117
39 year old lady suffers a sharp retrosternal chest pain which is worse on inspiration. The finding on auscultation is typical of this presentation.
pericarditis
118
A 28 year old sportsman presents to A&E with severe chest pain and breathlessness. He has a history of asthma. There is a systolic murmur on examination.
hypertrophic cardiomyopathy
119
A 10 year old boy presents with skin rash and joint pain in his elbows and knees. His mother tells you that he recently had a sore throat. On examination he is found to have an ejection systolic murmur and a friction rub.
Acute rheumatic fever
120
A 68 year old smoker presents with jaundice and worsening abdominal and back pain. Scratch marks are seen on his arms and legs. He has lost 5kg in 2 months. Ultrasound shows dilated intrahepatic bile ducts.
carcinoma head of the pancreas
121
Around 10 % eventually get primary lymphoma (less often, carcinoma) of the gut if not properly treated. HLA B8 is linked with this.
coeliac disease
122
A 66 year old man complaining of epigastric pain undergoes an endoscopy. The mucosa appears reddened in the antrum of the stomach. 13C is detected on a urea breath test.
H Pylori
123
A 58 year old female presents with malnutrition. She complains of abdominal pain, weight loss and arthritis. She has steatorrhoea. A jejunal biopsy showed periodic acid-Schiff (PAS)-positive macrophages
Whipple's disease
124
A 45 year old woman presents with large tongue and swelling of the legs. She has a high BP and urine dipstick reveals protein +++.The tissue from renal biopsy stains with Congo red dye and shows apple green birefringence under polarised light
renal amyloidosis
125
A 70 year old woman is referred to hospital with signs of peripheral oedema and hepatosplenomegaly. Hospital investigations demonstrate a degree of bone erosion and high levels of circulating kappa uniform light chain
Myeloma associated amyloidosis
126
what type of amyloidosis is secondary to inflammatory conditions such as Chron's disease or rheumatoid arthritis?
AA - reactive amyloidosis
127
what is Hirschpring's disease
Absence of ganglion cells in the myenteric plexus, resulting in distal colon failing to dilate - resulting in constipaition, abdo distention, overflow diarrhoea
128
what condition is Hirschprung's disease associated wth
Down's syndrome
129
How do you treat Hirschprung's disease
biopsy to see absence of ganglion cells
| and resection of affected area
130
describe pancrwatic pseudocysts
lines with fibrous tissue (NO EPITHELIAL lining) - contain fluid rich in pancreatic enzymes or necrotic material
connect with pancreatic ducts
131
What is the other common name for IgG4 disease
autoimmune pancreatitis
132
wha tare the most common pancreatic tumours?
ductal carcinomas (85%)
133
give the 4 risk factors for ductal carcinoma
- smoking
- BMI and dietary
- chronic pancreatitis
- DM
134
What does ductal carcinoma arise from?
PANIN - pancreatic intraductal neoplasia
135
what mutations are very common in ductal pancreatic carcinomas?
K-Ras (95%)
136
which end of the pancreas must tumours be to cause jaundice?
The head - obstruct the bile duct
137
what are 90% acute cholecystitis associated with?
gall stones
138
What are Rokitansky-Aschoff sinuses?
Diverticula in the gall bladder (outpouchings) which can be related to chronic cholecystitis
139
Gall bladder cancers are what type?
Adenocarcinomas
140
What is the major disease associated with gall bladder cancer>
gallstones (90%)
141
define pancreatitis
acute inflammation of the pancreas caused by aberrant release of . pancreatic enzymes - autodigestion
142
what is the most common cause of acute pancreatitis? (and what %)
gall stones (50%)
143
How to gallstones lead to pancreatitis?
obstruction leads to reflux of bile up the pancreatic duct, followed by damage to acini with release of proenzymes which then become activated
144
what are the 3 different patterns of injury in acute pancreatitis
1. periductal - necrosis of acinar cells near the ducts
2. perilobular - necrosis at the edges of the lobules (due to poor blood supply)
3. panlobular (develops from 1 and 2)
145
how are pseudocysts structurally different to cysts?
pseudocysts lack an epithelial lining
146
what is the most common cause of chronic pancreatitis?
alcohol (80%)
147
give 4 complications of chronic pancreatitis
- diabetes mellitus
- malabsorption
- pseudocysts
- ? carcinoma of the pancreas
148
Autoimmune pancreatitis is characterised by large numbers of which cells?
IgG4 positive plasma cells
149
Give 5 complications of diverticular disease
1. obstruction
2. inflammation (diverticulitis)
3. pain
4. perforation
5. fistula
150
which organism causes psuedomembranous colitis?
C. diff toxins
151
how do you diagnose pseudomembranous colitis?
- clinical picture (diarrhoea, fever, nausea following recent Ab use. esp. cephalosporins or fluoroquinolones)
- Histology - shows massive inflammation of lower GI tract with sloughing
- Stool assay - C. diff toxin
152
Treatment for pseudomembranous colitis?
Metronidazole or Vancomycin
153
What is dressler's syndrome
Autoimmune reaction weeks-months post-MI, reaction to the damaged myocytes results in inflammation and causes pericarditis
154
Which gene is most commoly mutated in HCM?
beta-MHC gene
| Troponin T also often involved
155
what do you see histologically in hypertrophic cardiomyopathy?>
Myocyte dysarray - which causes arrythmias
156
Which valve is most ommonly affected in Rheumatic fever?
Mitral
157
what is commonly the causative organism in rheumatic fever?
GAS
158
What are the Jones' major criteria for Rheumatic fever?
```
CASES
Carditis
Arthritis
Sydenham's chorea
Erythema marginarum
Subcutaneous nodules
```
159
WHat are examples of diffuse alveolar damage in adults and neonates?
adults: ARDS
neonates: Hyaline membrane disease of the newborn
160
What is the resp condition associated with lack of surfactant in premature neonates?
Hyaline membrane disease of the newborn
161
Which part of the lung does aspestososis tend to affec?
Lower lobes
162
What is pneumoconiosis caused by?
Usually occupational - non-neoplastic lung reaction to inhalation of mineral dust/inorganic particles - often UPPER LOBE e.g. silicosis, coal worker.
163
What histological features do you see in asthma
Curschmann's spirrals and Charcot-Leyden crystals
164
what is the definition of chronic bronchitis
chronic cough and production of sputum most days for 3+ months over 2+ consecutive years
165
causes of amphysema
- smoking
| - alpha1-antitrypsin deficiency
166
what is the definition of bronchiectasis?
permanent abnormal dilation of the bronchi
167
What are congenital causes of bronchiectasis?
CF
primary ciliary dyskinesia
Young's syndrome
168
What triad of features are there in Toung's syndrome?
Azoospermia
Rhinosinusitis
Bronchiectasis `
169
What is the name of an infected pleural effusion?
Empyema
170
What is a granuloma?
Collection of histiocytes / macrophages +/- multinucleate giant cells
171
What is the classic histological sign you see in end stage interstitial disease?
honey comb lung
172
What non-infectious causes of granulomas are there in the lung
Sarcoid
- Foreign body
- occupational lung disease
173
Infectious causes of lunggranulomas
TB
| Fungal - cryptococcus, histo, aspergillus
174
what is the proper name for farmer's lung?
extrinsic allergic alveolitis
175
What is "dusty lung"
Pneumoconiosis - permanent alteration to lung structure due to inhalation of INORGANIC dust, and the tissue reaction to its presence
e.g. coal workers lung, aspestososis, silicosis
176
WHat is asbestososis associated with
- pleural plaques
- fine subpleural basal fibrosis with asbestos bodies in the tissue
- increased risk of lung cancer
177
WHat is nutmeg liver suggestive of?
RIght sided heart failure causing venous congestion of organs like the liver
178
What are the types of non-small cell carcinoma?
- squamous cell
- adenocarcinoma
- large cell carcinoma
179
what is the most common type of lung cancer
Squamous cell carcinoma (35%)
180
In which type of lung cancer would you expect to see keratinisation?
squamous cell
181
which type of lung cancer (adeno or squamous) is more likely to be in a peripheral location and present with mets?
Adenocarcinomas - 80% present with mets
Squamous cell Ca metastasise late and are located centrally
182
which type of lung cancer is most common in women and non smokers?
adenocarcinomas
183
Which type of lung cancer is associated with ACTH secretion
Small cell
184
what mutations are common in small cell lung cancer?
p53 and RB1
185
what drugs do some adenocarcinomas respond well to?
anti-EGFR e.g. Tarceva
186
Which positive marker indicates a poor response to cisplatin chemo in non small cell large cell lung cancer
ERCC1
187
What do kras mutations predict?
non response to EGFR therapy
188
Which types of lung cancer sometime secrete PTH, causing hypercalcaemia?
Squamous cell
189
Which types of lung cancer sometimes secrete ACTH or ADH?
Small cell
190
45 year old woman presents with nipple retraction, pain and thick white nipple discharge. Cytology shows proteinaceous material andinflammatory cells. Diagnosis?
Duct Ectasia
191
What cancers does BRCA1?BRCA2 gene increase risk of
breast
ovarian
pancreatic
prostate
192
What aggroup of women are invited for mammogram screening?
47 to 73 invited every 3 years
193
What are the risk factors for breast cancer?
Genetic susceptibilty- BRCA1/BRCA2 genes
Hormone exposure: early menarche late menopause, OCP, HRT, late childbirth
Age
Obesity
FHx Tobacco and alcohol
194
What is the triple assessment
examintion, radiology (mammogram/uss) and cytology - fine needle aspiration
195
What is the most common invasive breast cancer?
Invasive ductal carcinoma
196
Which carcinoma in situ is associated with calcification
DCIS - ductal -
197
Which receptors are breast neoplastic leasions checked for?
Eostrogen, progesterone and HER2
| ER/PR and HER2
198
What are positive ER and PR receptors indicative of in breast neoplastic?
Good prognosis as it means it is responsive to tamoxifen
199
What is a positive HER2 indicative of?
bad prognosis
| Can use Herceptin immunoglobulin
200
What infection is Vulval intraepithelial carcinoma associated with?
HPV-16
201
Which type of ovarian cancer is associated with psammoma bodies
Serous cystadenoma
202
Ovarian cancer with classic hobnail histological appearance
Clear cell cancer (clear nail varnish on the ovaries)
203
What do choriocarcinomas secrete?
hCG
204
What is the difference between immature and mature ovarian teratomas?
Immature = malignant, solid, contains immature embryonal tissue - secreted AFP
Mature = dermoid cysts, contain mature tissues e.g. hair, teeth. Benign
205
What type of cell are dermoid cysts derived from?
germ cells
206
what types of ovarian tumours are associated with oligomenorrhoea, breast enlargement and breast/endometrial cancer?
Granulosa-Theca cell tumour - secrete oestrogen hence symptoms
Granny Theresa secreting female hormone
207
what do sertoli-leydig ovarian tumours secrete
Androgens
208
Which types of HPV contribute to cervical dysplasia?
HPV 16 + 18
209
What cell type is the most commmon type of cervical cancer
squamous cell carcinoma (70-80%)
210
which surfaces are affected by psoriasis
Extensor (knees, elbows, scalp)
211
what is koebner's phenomenon
seen in derm ondition like psoriasis, vitilligo and molluscum - where lesions appear at sites of trauma e.g. from scrattching
212
What is guttate psoriasis associated with
Weeks post strep throat
213
which drugs can cause erythema multiforme?
```
SNAPP
Sulphonamides
NSAIDS
Allopurinol
Penicillin
Phenytoin
```
214
what is the skin disease linked to coeliac disease
Dermatitis herpetiformis
215
what is the sqamous cell carcinoma in situ called
Bowen's diseas
216
describe a keratoacanthoma
rapidly growing dome shaped nodule which may cave crusty necrotic centre. Looks similr to SCC on histology, but benign and cler sponataneously
217
Which is the most common type of malignant skin cancer that is often called the rodent ulcer?
Basal cell carcinoma (Rodents are common in the basement)
218
Most common benign liver tumour?
Haemangioma
219
Most common malignant liver tumour?
Mets from other prmary tumours
220
most common cause of chronic liver disease in the west:
Non alcoholic fatty liver disease
221
What antibodies are commonly involved in primary biliary cirrhosis (PBC)
anti-mitochondrial
222
which type of cirrhosis do you find mallory bodies in the liver?
Alcoholic hepatitis
223
which type of liver cirrhosis is associated wih IBD, especially UC, and is also linked to cholangiocarcinoma
Primary sclerosing cholangitis
224
which gene is mutated in Wilson's disease
ATP7B
225
In which condition are mallory bodies most commonly seen
Alcoholic hepatitis - but also seen in alcoholic steatosis, alcoholic cirrhosis, Wilsons disease
226
At which 3 points are kidney stones most likely to impact?
1. from kidney to ureter - PUJ
2. crossing brim of pelvic inlet- pelvic brim
3. passage through wall of bladder - vesicoureteric junction
227
what are the 2 most common types of renal calculi?
1. calcium oxalate - 75%
| 2. triple stones (magnesum ammonium phosphate) - 15%
228
which type of kidney stons are known to form large staghorn calculi?
Triple stones -magnesium ammoium phosphate
229
what is the common childhood renal cancer characterised by lots of small round blue cells with areas of more differentiated epithelial and stromal components.
Wilm's tumour - nephroblastoma
230
what is used to estimate the prognosis of prostate cancer?
Gleason score - ranging from 6 (mild) to 10 (severe)
231
what is the commonest cause of nephritic syndrome woldwide?
Berger's disease - IgA nephropathy
232
what is the most common pancreatic cancer
Ductal adenocarcinoma
233
where do the majoirty of subarachnoid haemorrhages occur?
Bifurcation of the internal carotid (80%)
234
what conditions is subarachnoid haemorrhage associated with
Polycystic kidneys
Ehlers danlos
coarctaton aorta
235
signs of dementia
memory impairment
aphasia
apraxia
agnosia
236
Agnosia means....
reduced ability to interpret sensory stimuli e.g. unable to recognise objects, smells, sounds
237
apraxia means
reduced ability to perform learned motor tasks
238
aphasia means
language disorder reduced ability to produce/understand speech (receptive/expressive)
239
what is idiopathic parkinsons caused by
death of dopaminergic neurons in the substantia nigra causing reduced stimulation to the motor cortex
240
what are the classic symptoms you see in parkinsons
```
Tremor
Rigidity
Shuffling gait
Akinesia
Postural instability
```
241
which mutated protein is involved in OD
alpha-synuclein
242
What are the urate crystals like in gout
Needle like and negatively birefringant
243
what are the calcium pyrophosphate crystals like in pseudogout?
rhomboid shaped and positively birefringant
244
where are Heberden's and Bouchard's nodes?
Heberden's = distal inter-phalangeal joint (DIPJ)
Bouchards = (PIPJ)
remember outer hebrides (far away - distal) and local butcher's (proximal)
245
which joint des RA spare?
DIPJ
246
which lymphoma do you see panless lymphadenopathy, weight loss, pain ater drinking alcohol -
Hodgkins
247
What cells can you see in Hodgkins lymphoma
Reed-sternberg
248
clinical features of multiple myeloma
```
CRAB
calcium high
Renal failure
Anaemia
Bones
```
