non neoplastic pathology

Question 1

histology of all CT disease =

diagnose by ___

Answer 1

chronic inflam with lots of plasma cells

autoIgs as commonly they are immune driven

Question 2

secondary vasculitis is caused by ___

Answer 2

vessels are proximal to source of inflammation and it spreads to the vessels

Question 3

direct invasion and inflammation of the vessel walls can be caused by __

Answer 3

infection eg syphilis

Question 4

specific autoIg for Kawasaki’s disease

Answer 4

anti endothelial

Question 5

cANCA: c stands for ___ and reacts with __

Answer 5

cytoplasmic

PR3

Question 6

pANCA: p stands for ___ and reacts with __

Answer 6

perinuclear

MPO

Question 7

large vessel vasculitis = _____ disease

eg.s (2)

Answer 7

granulomatous disease
GCA
Takayasu arteritis

Question 8

medium vessel vasculitis = ___ eg. __

or ___ eg. ___

Answer 8

immune complex mediated eg. polyarteritis nodosa

anti-endothelial cell Igs eg. Kawasakis

Question 9

small vessel vasculitis with paucity of immune complexes (3 types)

Answer 9

vasculitis wo granuloma/asthma = microscopic polyangitis
granulomas no asthma = GPA
eosinophilia, asthma, granulomas = EPGA

Question 10

features = temporal arteritis which is __ and so -ve biopsy doesnt rule out
condition =

Answer 10

segmental

GPA

Question 11

give ___ prior to temporal artery biopsy in GPA

Answer 11

steroids

Question 12

polyarteritis nodosa (PAN) is a vasculitis of \_\_ vessels and is ANCA \_\_\_
presumed due to \_\_ as 1/3 are +ve for these

Answer 12

medium
-ve
circulating hep B immune complexes and Ig

Question 13

polyarteritis nodosa spares __ and has a propensity for __+__ involvement
features of vessels involved = __+__

Answer 13

spares lungs
renal and GI
transmural necrotising inflam + fibrinoid necrosis

Question 14

immune complex mediated small vessel vasculitis eg.s (4)

Answer 14

SLE vasculitis
Henoch-Schonlein purpura (IgA)
Cryoglobulin vasculitis
Goodpasture’s

Question 15

uric acid is end product of __

Answer 15

purine (A+G) degradation

Question 16

causes of gout that are caused by too much uric acid being produced

Answer 16

90% idiopathic with unknown enzyme defect
HGPRT defect ( rare = Lysch-Nyhan syndrome)
increased cell turnover - malig, psoriasis, chemo

Question 17

causes of gout due to excrete too little uric acid =

Answer 17

thiazides

renal impairment

Question 18

uric acid crystals deposit in __ and ___ in gout

Answer 18

joints in lower temp

kidney tubules and interstitium (can also cause renal stones)

Question 19

uric acid crystal appearance on microscopy of fresh specimen

Answer 19

needle shaped and negative bifringence

Question 20

-ve bifringence means the orientation of the crystals =

Answer 20

left

Question 21

apple green bifringence with congo red staining =

Answer 21

amyloid protein

Question 22

pseudogout aka

caused by ___ crystals

Answer 22

chondrocalcinosis

calcium pyrophosphatase

Question 23

rhomboid shaped and weakly +ve bifrengence crystals =

Answer 23

calcium pyrophosphate

Question 24

increased osteoclast activity causing increased osteoblast activity is the underlying problem in

Answer 24

Pagets

Question 25

genetic elements of Pagets =

Answer 25

SQSTM1/p62 | RANKL - osteoclast receptor activator

Question 26

Pagets can be caused be a ___ infection eg (3) or idiopathic

Answer 26

viral - paromyxovirus, measles ( nucleocapsid protein MVNP seems to stim osteoclasts) + RSV

Question 27

3 stages of Pagets = __>__>__

Answer 27

osteolytic > mixed > burnt out

Question 28

leontiasis ossea = | seen in __

Answer 28

overgrowth of facial and cranial bones seen in Pagets | also fibrous dysplasia, hyperparathyroidism and renal osteodystrophy

Question 29

platybasia = | seen in __

Answer 29

abnormal flattening of the skull base | Pagets

Question 30

sabre tibia is seen in what condition

Answer 30

Pagets

Question 31

Pagets causes __ metabolism = __ skin, ____ HF | and increases ___ risk

Answer 31

increased - warm skin, high volume HF | osteosarcoma

Question 32

rickety rosary = | sign seen =

Answer 32

2 lines in ribs with the abnormal one at the costochondral junction Rickets

Question 33

bowed legs, square head, pigeon chest and rickety rosary are signs in

Answer 33

Rickets

Question 34

#>____ (fibrin mesh)> ___ cell influx > ___ release > ___ cells from periosteum and medulla > __ (1wk) = ___ and remodelling at bone ends > 2-3 wk reach ___ -woven bone deposited ___ to cortical bone, some __ deposited which undergoes ___, bridging with ___ > remodelled

Answer 34

``` hamartoma inflammatory cell cytokine osteoprogenitor callus = organised hamartoma cartilage - endochondral ossification bony callus ```

Question 35

kidney lung and breast mets to bone are usually osteo___

Answer 35

osteolytic

Question 36

osteoclerotic metastasis =

Answer 36

prostate

Question 37

creeping substitution on histology is a feature of

Answer 37

AVN

Question 38

AVN is usually a ___ infarct and often __

Answer 38

wedge-shaped infarct | subcortical

Question 39

bony lesions caused by proliferation of plasma cells

Answer 39

myeloma/plasmacytoma

Question 40

polished bone in OA other name =

Answer 40

eburnated bone

Question 41

small cracks in cartilage seen in the early stages of OA =

Answer 41

fibrillations

Question 42

4 radiological features of OA =

Answer 42

Loss of joint space = cartilage loss Subchondral sclerosis = eburnation Subchondral cysts = Synovial fluid accumulation Osteophytes = disorganised bone remodelling

Question 43

RA: AI process = ____ and so there are lots of ___

Answer 43

RF IgM - plasma cells that produce this

Question 44

in RA ___ is destroyed by inflammatory process and ___ is formed = __+__

Answer 44

cartilage destroyed | pannus - inflammatory cells and hyperplastic synovium