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Year 5 😊✌🏼 > MedEd Histopath 2 > Flashcards

MedEd Histopath 2 Flashcards

(85 cards)

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1
Q

Which pneumonia pathogen is associated with erythema multiforme?

A

Mycoplasma pneumonia

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2
Q

AKI - what is it?

A

acute decline in renal function
leads to fall in urine output
measured with Cr and Urea

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3
Q

CKD - what is it?

A

decline in renal function over >3 months
progressive damage
eGFR used to measure/stage it

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4
Q

eGFR - CKD staffing

A

1 - >90
2 60-89 (mild)
3A 45-59
3B 30-44
4 12-29
5 <15 (end stage)

no sx, no CKD

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5
Q

Causes of CKD

A

DM
HTN

ADPKD
untreated AKI (pyelonephritis, ATN, obstruction)

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6
Q

are AKI and CKD reversible?

A

AKI can be

CKD no

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7
Q

Causes of AKI

A

renal
- ischaemia
- nephrotoxins
- glomerulonephritis
- interstitial nephritis
- hepatorenal syndrome
- HUS/TTP

post-renal

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8
Q

Types of intrinsic renal pathology

A

Glomerulus
- nephrotic syndromes (minimal change, membranous, FSGS, secondary causes)
- nephritic syndromes (IgA, post streptococcal, rapidly progressive (crescentic) _>

add

Blood vessels
- HUS
TTP

Tubules
add

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9
Q

Mesangium (kidney)

A

ECM
EC-tissue

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10
Q

which cells do the filtering ?

A

podocytes (check)

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11
Q

nephrotic syndrome triad

A

peripheral oedema
proteinuria (3g/d or PCR >300mg)
low serum albumin

also increased cholesterol and clotting tendencies

issues with podocytes -> protein get out

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12
Q

nephrotic syndrome triad

A

peripheral oedema
proteinuria (3g/d or PCR >300mg)
low serum albumin

also increased cholesterol and clotting tendencies

issues with podocytes -> protein get out

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13
Q

Minimal change disease

A
  • affects children
  • normal on light microscopy
  • electron microscopy shows loss of food processes in podocytes
  • nothing on immunofluorescence
  • responds very well to steroids (90% poeple respond well to pred)
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14
Q

Membranous glomerulopathy

A
  • immune complexes attach evenly to basement membrane
  • responds poorly to steroids
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15
Q

Which antibodies are associated with membranous glomerulopathy?

A
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16
Q

FSGS

A

focal: only some glomeruli are damaged
segmental: only some regions of the glomerulus are damaged
sclerosis: scarring

affects adults

light microscopy shows focal and segmental scarring
EM: loss of foot processes
Responds less well to steroids (but better than)

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17
Q

secondary causes of nephrotic syndrome

A

Diabetes (kimmelstiel Wilson nodules)

Amyloidosis
- AA or AL
AA is chronic inflammation e.g. SLE, RA
AL is light chains -> multiple myeloma

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18
Q

Nephritic syndrome

A

haematuria
HTN
peripheral oedema

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19
Q

red cell casts in urine

A

red cells forced through the sieve
damage to kidney
…

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20
Q

IgA nephropathy

A

causes nephritic syndrome
post group A strep infection (1-2d, IgA = acute)

IgA immune deposits within glomeruli
IgA immune deposits in mesangium seen on IF

33% get better
33% get CKD
33% need dialysis

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21
Q

post strep glomerulonephritis

A

after group A strep infection (1-3w)
thought to be due to antigen mimicry and immune complex deposition

bloods: raised anti-streptolysin O titre, reduced C3

IF: granular IgG deposits in BM

Mx: supportive

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22
Q

Rapidly progressive (crescentic)

A

most aggressive form of glomerulonephritis causing renal failure in weeks

characterised by severity and presence of crescents (macrophages in Bowman’s capsules)

acute onset

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23
Q
A

Anti-GBM - Goodpastures
Immune complex mediated
Pauci immune (ANCA-assocaited)

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24
Q

Goodpastures syndrome

A

anti-GBM disease
presence of anti-glomerular BM Ab

credence seen on LM
IF: linear deposition of IgG in GBM

also see pulmonary haemorrhage

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25
Immune complex mediated - rapidly progressive GN causes
SLE IgAa nephropathy post-infection HSP
26
bumpy deposition of immune complexes in GBM or mesangium
27
Pauci-immune/ANCA associated
cANCA: GPA pANCA: MPA/eGPA vasculitis affecting small micro blood vessels LM; IF: no/scanty immune complexes
28
Alpert's syndrome
hereditary cause of glomerulonephritis X-linked causing problem with type 4 collagen triad: causes progressive end stage renal failure with some extra-renal sx
29
benign familial haematurua - genetic issue
AD gene causing problem with type 4 collagen
30
benignfamilial haematurua
causes
31
ATN
- most common renal cause of AKI - tubules will die and she leading to presence of brown casts in the urine - caused by hypovolaemia - toxins (aaminoglycosdies ee.g. gentamicin, myoglobin (rhabdomyolysis), contrast)
32
commonest cause of renal AKI
ATN
33
Acute interstitial nephritis
interstitial infiltrate of kind of like an allergic rection
34
causes of white and brown cell casts in urine
white: AIN brown: ATN
35
AIN - causese
most often after starting
36
HUS
eColi O157:H7 after petting zoo, after a bout of diarrhoea
37
E coli O157:H7 - what does it cause?
HUS
38
TTP - genetic mutation
ADAMTS13 protease deficiency (it cleared vWF)
39
TTP
40
PKD
AD due to mutation in PKD gene encoding polycystic extra renal - liver cysts - Berry aneurysms (SAH)
41
Lupus nephritis
wire loop capillaries and lumpy immune complex deposotopm
42
6 stages of lupus nephritis
1: minimal early: only connective tissue affected, later on also kidney tissue finally advanced sclerosis(>90%)
43
Portal triad
hepatic artery portal vein bile duct -> central vein in the middle of lobule
44
functional unit of liver
45
Zone 1-3 liver
1: periportal (closest to BV) - affected first in viral hepatitiss and toxic substance ingestion - most oxygenation 2: Mid zone 3: Periventroicular (most functioning hepatocytes) - add
46
rouses transaminases 0 3 main causes
viral hep
47
causes of acute hepatitis
- hep Aa/E (faeco oral route) drugs
48
pattern of infallamtion in acute hepatitis
spotty ///////add
49
Causes of chronic hepatitis
insert
50
pattern inflammation in chronic hep
piecemeal necrosis/interface hepatitis loss of border between the portal tract and the surrounding parenchyma bridging fibrosis check
51
nodule size in cirrhosis
micronodulaar: alcohol macro nodular: everything else
52
high resistance in fibrotic intrahep
53
intrahepatic shunting
bypasses hepatocytes due to .....backflow due to restistance of hepatocytes?
54
F1-F4 fibrosis
55
Mallory denk bodies
seen in alcoholic hepatitis
56
steatosis vs alcoholic hepatitis vs. alcoholic cirrhosis
57
NAFLD
Histologicaally similar to ALD, distinguished via hx Progression 1. 2. 3. cirrhosis
58
PSG
59
PBC
60
r
61
stain in alpha 1 antitr
62
Wilsons
63
haemaachromatosis
64
commonest liver tumours
mets
65
commonest liver tumour
haemangioma (most common, benign)
66
liver cell adenoma
associated with cOCP
67
antibodies in
anti-mitochondrial antibody
68
inheritance pattern of hereditary haemochromatosis
AR
69
WIlson inheritance pattern
AR
70
alpha-1 antitrypsin deficiency inheritance pattern
AD
71
most common examination finding in a patient with portal HTN splenomegaly hepatomegaly spider naevi jaundice liver flap
splenomegaly
72
Which pathogens cause spotty necrosis in
hep A/E (what causes acute hepatitis)
73
which tumours have keratin production of intercellular bridges?
aqueous cell carcinoma
74
which malignant tumours have glands?
adenocarcinomas
75
H&E stain full nam e
haematoxylin and eosin purple: pink:
76
histopath in MI
<6 h: normal histology 6-24h: loss of nuclei, homogenous cytoplasm and necrotic cell death 1-4d" infiltration of polymorphs then macrophages (which clear up debris) 5-10d further removal of debris 1-2w has granulation tissues new BVs, myofibroblasts. add
77
FAP mutation
AD mutation in APC tumour suppressor gene
78
FAP presentation
100s or 1000s of polyps seen in childhood adenoma -> polyp -> carcinoma progression ot cancer is 10)%
79
Garner's syndrome
subtypes of FAP with extra-GI sx more
80
Lynch syndrome mutation
AD mutation in DNA mismatch repair gene
81
What cancers in HNPCC associated with?
endometrial ovarian gastric colon
82
GI polyps higher risk of cancer
- larger - more - higher villous component - dysplastic features
83
Medullary thyroid carcinoma
parafollicular cells measure calcitonin
84
MEN syndrome
MEN 1: 3P 2P 1 P
85
Gleason Score
/10 sum of worst grade seen and the most common grade seen (e.g. 3+5 = 8)

Year 5 😊✌🏼 (53 decks)

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