Kellen

Question 1

Leydig Cell Tumor

Answer 1

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

Question 2

Sertoli Cell Tumor

Answer 2

clinically silent

trabeculae forming cordlike structures in fibrous stroma

Question 3

Spermatocele

Answer 3

cystic semen in efferent and rete testis ducts

Question 4

DHT rxn?

Answer 4

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

Question 5

How to treat BPH?

Answer 5

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

Question 6

5 alpha reductase

Answer 6

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

Question 7

normal PSA

Answer 7

0-4

Question 8

chronic abacterial prostatitis

Answer 8

painful ejaculations

Question 9

Free PSA

Answer 9

Cancer makes BOUND PSA. decreased free PSA = cancer

Question 10

Adenomatoid Tumor

Answer 10

mesothelial origin benign

Question 11

IHC of prostate cancer

Answer 11

no CK, p63

presence of AMACR

Question 12

AR gene

Answer 12

CAG repeats - shorter = highest sensitivity to androgens, blacks

Question 13

Prostate Cancer Mets

Answer 13

obturator, para-aortic

Hematogenous: axial skeleton (osteoBLASTIC)

Question 14

What does the PSA bind to with cancer?

Answer 14

alpha1- chymotrypsin

Question 15

What cytokine is responsible for T cell differentiation in Tb?

Answer 15

IL-12

Question 16

Sarcoidosis

Answer 16

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

Question 17

Acrocentric chromosomes

Answer 17

13-15, 21-22

Question 18

Tay Sachs

Answer 18

hexosaminosidase A on chrom 15 - buildup of GM2 ganglioside

Question 19

Gaucher

Answer 19

Beta-glucocerebrosidase on chrom 1 - buildup of glucocerebroside

Question 20

Neimann Pick

Answer 20

syphingomyelinase gene on chrom 11

Question 21

Krabbe

Answer 21

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

Question 22

Metachromatic leukodystrophy

Answer 22

AR deficiency in arylsulfatase A – sulfatide accumulation

Question 23

Adrenoleukodystrophy

Answer 23

X linked - mutations in ABCD1 - peroxisome

perivascular lymphocytic infiltrates

Question 24

Neuromyelitis Optica (Devic’s)

Answer 24

bilateral optic neuritis and spinal cord demyelination

Abs against AQP4

Question 25

Concentric Sclerosis of Balo

Answer 25

borderline form of MS - primary progressive with better prognosis

Question 26

Acute Disseminated Encephalomyelitis

Answer 26

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

Question 27

central pontine myelinolysis

Answer 27

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

Question 28

most common places for atherosclerotic plaque?

Answer 28

MCA, basilar

Question 29

hypertension affects?

Answer 29

BG, pons, cerebellum

Question 30

Lipohyalinosis

Answer 30

macrophages invade wall of artery (result of HTN)

Question 31

Hypertensive Vascular changes lead to what?

Answer 31

Charcot Bouchard Aneurysms - intracerebral hemorrhages

Question 32

Saccular Aneurysm

Answer 32

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

Question 33

Fusiform Aneurysm

Answer 33

tortuous BASILAR artery, advanced atherosclerosis, RARELY RUPTURE

Question 34

AV Malformation

Answer 34

posterior branches of MCA | seizures (no capillary in middle)

Question 35

Cerebral Amyloid Angiopathy

Answer 35

hemorrhage into SUBCORTICAL WHITE matter - lobar hemorrhages

Question 36

Embolic Stroke

Answer 36

hemorrhagic

Question 37

Thrombotic STROKE

Answer 37

pale - thrombus keeps reforming

Question 38

reperfusion looks like what?

Answer 38

punctate hemorrhages

Question 39

bone marrow embolization?

Answer 39

widespread white matter hemorrhages

Question 40

loss of chr 22

Answer 40

meningiomas, schwannomas

Question 41

loss of chr 10

Answer 41

glioblastomas

Question 42

endometrial polyp

Answer 42

responds to estrogen, not progesterone - Tamoxifen association

Question 43

endometrial hyperplasia

Answer 43

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

Question 44

most common female genital cancer in USA?

Answer 44

endometrial adenocarcinoma - presents with post-menopausal bleeding

Question 45

endometrial adenocarcinoma type I

Answer 45

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

Question 46

endometrial adenocarcinoma type II

Answer 46

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

Question 47

endometrial stromal sarcoma

Answer 47

stroma in MYOMETRIUM | cleft around tumor

Question 48

Leiomyoma Locations

Answer 48

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

Question 49

leiomyosarcoma mets?

Answer 49

hematogenous - lung, bone, brain

Question 50

vulva SCC

Answer 50

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

Question 51

Paget's

Answer 51

CK CEA EMA PAS

Question 52

Melanoma

Answer 52

melan A | S100

Question 53

Follicular Cyst

Answer 53

lined by GRANULOSA cells - can produce estrogens

Question 54

PCOS

Answer 54

increased risk of endometrial carcinoma and breast cancer | theca interna hyperplasia

Question 55

Call Exner Bodies

Answer 55

coffee bean nuclei in granulosa cell tumors

Question 56

Granulosa Cell Tumor

Answer 56

inhibin positive