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Flashcards in Kellen Deck (56):
1

Leydig Cell Tumor

2 peaks: kids and adults (80%)
benign - testicular swelling
may produce androgens, estrogens, corticosteroids
gynecomastia or precocious puberty = presenting features
REINKE crystals - lipofuscin, intracytoplasmic

2

Sertoli Cell Tumor

clinically silent
trabeculae forming cordlike structures in fibrous stroma

3

Spermatocele

cystic semen in efferent and rete testis ducts

4

DHT rxn?

T --> DHT via 5 alpha reductase
DHT binds to nulcear androgen receptor -- increased GFs and FBGF 1,2, 7 and TGF beta.
increased stromal proliferation and decreased death of epithelial cells

5

How to treat BPH?

alpha blockers - relaxes bladder neck, decreases prostate SM tone
5 alpha reductase inhibitors - inhibits DHT synthesis

6

5 alpha reductase

located in STROMAL cells - stromal cells responsible for androgen dependent prostatic growth of epithelial cells

7

normal PSA

0-4

8

chronic abacterial prostatitis

painful ejaculations

9

Free PSA

Cancer makes BOUND PSA. decreased free PSA = cancer

10

Adenomatoid Tumor

mesothelial origin benign

11

IHC of prostate cancer

no CK, p63
presence of AMACR

12

AR gene

CAG repeats - shorter = highest sensitivity to androgens, blacks

13

Prostate Cancer Mets

obturator, para-aortic
Hematogenous: axial skeleton (osteoBLASTIC)

14

What does the PSA bind to with cancer?

alpha1- chymotrypsin

15

What cytokine is responsible for T cell differentiation in Tb?

IL-12

16

Sarcoidosis

High CD4 - making IFN-gamma and IL-2 locally
No NK cells
lots and lots of Il-8, TNF
Schaumann bodies & asteroid inclusions
lymph node enlargement, eye involvement, erythema nodosum

17

Acrocentric chromosomes

13-15, 21-22

18

Tay Sachs

hexosaminosidase A on chrom 15 - buildup of GM2 ganglioside

19

Gaucher

Beta-glucocerebrosidase on chrom 1 - buildup of glucocerebroside

20

Neimann Pick

syphingomyelinase gene on chrom 11

21

Krabbe

AR deficiency of galactosylceramidase --> shunted to production of galactosylsphingosine = cytotoxic

22

Metachromatic leukodystrophy

AR deficiency in arylsulfatase A -- sulfatide accumulation

23

Adrenoleukodystrophy

X linked - mutations in ABCD1 - peroxisome
perivascular lymphocytic infiltrates

24

Neuromyelitis Optica (Devic's)

bilateral optic neuritis and spinal cord demyelination
Abs against AQP4

25

Concentric Sclerosis of Balo

borderline form of MS - primary progressive with better prognosis

26

Acute Disseminated Encephalomyelitis

increased lipid-laden macrophages
all lesions are similar - monophonic
1-2 weeks after measles, mumps, flu; post rabies or smallpox vaccine
perivascular lymphocytic infiltrates with demyelination
gray/white junction

27

central pontine myelinolysis

rapid correction of hyponatremia
rapid increase in extracellular tonicity draws water out of cells

28

most common places for atherosclerotic plaque?

MCA, basilar

29

hypertension affects?

BG, pons, cerebellum

30

Lipohyalinosis

macrophages invade wall of artery (result of HTN)

31

Hypertensive Vascular changes lead to what?

Charcot Bouchard Aneurysms - intracerebral hemorrhages

32

Saccular Aneurysm

MCA &ICA, ACommA
most common cause of SA hemorrhage
Absene of SM, IEL

33

Fusiform Aneurysm

tortuous BASILAR artery, advanced atherosclerosis, RARELY RUPTURE

34

AV Malformation

posterior branches of MCA
seizures (no capillary in middle)

35

Cerebral Amyloid Angiopathy

hemorrhage into SUBCORTICAL WHITE matter - lobar hemorrhages

36

Embolic Stroke

hemorrhagic

37

Thrombotic STROKE

pale - thrombus keeps reforming

38

reperfusion looks like what?

punctate hemorrhages

39

bone marrow embolization?

widespread white matter hemorrhages

40

loss of chr 22

meningiomas, schwannomas

41

loss of chr 10

glioblastomas

42

endometrial polyp

responds to estrogen, not progesterone - Tamoxifen association

43

endometrial hyperplasia

increase in glands rleative to storm secondary to estrogen - PTEN tumor suppressor gene

44

most common female genital cancer in USA?

endometrial adenocarcinoma - presents with post-menopausal bleeding

45

endometrial adenocarcinoma type I

60 yo
associated w/ hyperplasia (unopposed estrogen) - well differentiated
more solid = WORSE prognosis
PTEN, KRAS, microsatellite instability
direct extension, lymphatics

46

endometrial adenocarcinoma type II

older
endometrial ATROPHY
serous, clear cell - poorly differentiated
p53 - intraperitoneal metastasis

47

endometrial stromal sarcoma

stroma in MYOMETRIUM
cleft around tumor

48

Leiomyoma Locations

1. Submucosal - bleeding
2. Intramural - asymptomatic
3. Subserosal - may undergo torsion

49

leiomyosarcoma mets?

hematogenous - lung, bone, brain

50

vulva SCC

1. basaloid/warty - HPV - classic VIN
2. keratinizing - HPV NEGATIVE - VIN simplex

51

Paget's

CK
CEA
EMA
PAS

52

Melanoma

melan A
S100

53

Follicular Cyst

lined by GRANULOSA cells - can produce estrogens

54

PCOS

increased risk of endometrial carcinoma and breast cancer
theca interna hyperplasia

55

Call Exner Bodies

coffee bean nuclei in granulosa cell tumors

56

Granulosa Cell Tumor

inhibin positive