Pathology

Question 1

Glands have ________ and _______ layers

Answer 1

Stomal and epithelial

Question 2

Define hypertrophy

Answer 2

Increase in cell size

Question 3

Define anaplastic

Answer 3

Poorly differentiated malignancy → does not resemble original cell type

Question 4

Define hyperplasia

Answer 4

Increase in cell number

Question 5

Cardiac hypertrophy can be seen physiologically in pregnancy due to……

Answer 5

Increase in blood volume

Question 6

Define dysplasia

Answer 6

Pre-malignant change in which cellular DNA has begun to accumulate but has not developed the ability to invade

Question 7

Define Metaplasia

Answer 7

A reversible change from one mature cell type to another mature cell type in response to a stimulus

Question 8

Outline metaplasia in Barret’s oesophagus

Answer 8

Squamous epithelium to intestinal type columnar epithelium (mucin rich goblet cells) indicating intestinal metaplasia

Question 9

Outline metaplasia that can occur in lungs of smokers, etc

Answer 9

Columnar epithelial cells to squamous epithelial cells

Question 10

Greatest source of oestrogen comes from…

Answer 10

Adipose tissue

Question 11

Lynch syndrome is also known as…

Answer 11

Hereditary non-polyposis colorectal carcinoma

Question 12

Lynch syndrome is a….

Answer 12

Autosomal dominant mutation in DNA mismatch repair genes (micro satellite instability)

Question 13

Lynch syndrome increases risk of which cancers?

Answer 13

Colorectal, Endometrial, Transitional cell carcinoma (TCC) (bladder and ureteric cancers)

Question 14

________ is used to look for expression in tumour, MSI and mutation in Lynch syndrome

Answer 14

Immunohistochemistry

Question 15

Which encoded proteins are related to Lynch syndrome?

Answer 15

MLH1, MLH3, MSH2, PMS1 and PMS2

Question 16

Define Neoplasms

Answer 16

A new and abnormal growth of tissue in a part of the body

Question 17

T or F: Leiomyomas are neoplastic

Answer 17

True

Question 18

Leiomyomas arise from ___________ cells

Answer 18

Smooth muscle

Question 19

As a connective tissue tumour, Leiomyosarcomas consist of _________

Answer 19

spindle cells

Question 20

Leiomyomas tend to arise between ________ and ________ as they are ________ dependent

Answer 20

Menarche
Menopause
Oestrogen

Question 21

T or F: Leiomyosarcoma (malignant) are really common

Answer 21

False

Question 22

CGIN is a……

Answer 22

High grade glandular abnormality

Question 23

CIN is…..

Answer 23

Squamous abnormality

Question 24

Features of PAP smear consistent with HPV infection

Answer 24

Irregular nuclei with binucleate forms and a strange perinuclear halo

Question 25

How to differentiate between CIN 1, 2 and 3

Answer 25

CIN 1 → genuine dysplasia and atypia in cells up to lower 1/3rd CIN 2 → genuine dysplasia and atypia in cells up to 2/3rd CIN 3 → genuine dysplasia and atypia in cells present throughout the full thickness

Question 26

Give examples of epithelial surface tumours

Answer 26

Serous tumour Mutinous tumour Endometrioid tumour Cystadenocarcinoma

Question 27

Give examples of germ cell tumours

Answer 27

Teratoma Dysgerminoma

Question 28

Give examples of Sex cord stromal cell tumours

Answer 28

Fibroma Granulosa-theca cell tumours Sertoli-Leydig cell tumour

Question 29

Which cancers can metastasise to ovaries

Answer 29

Breast Colon Lung Other sites

Question 30

________________ are the cell type most associated with a reaction to foreign non-organic material

Answer 30

Histiocytes (macrophages)

Question 31

What does this image show

Answer 31

Neutrophil

Question 32

What does this image show

Answer 32

Lymphocyte

Question 33

What does this image show

Answer 33

Basophil

Question 34

What does this image show

Answer 34

Macrophage

Question 35

Twin pregnancy Molar pregnancy Choriocarcinoma Ovarian germ cell tumours Placental abruption Placenta praevia Which of the following will not result in high serum HCG?

Answer 35

Placenta praevia

Question 36

For choriocarcinoma, what is seen on US?

Answer 36

Mass/lesion with necrosis and vascularity

Question 37

Complete moles most commonly arise from __________________ and less commonly from __________________

Answer 37

Fertilisation of an empty ovum by a single sperm that undergoes duplication of its chromosomes Dispermy in which two sperms fertilise and empty ovum

Question 38

Partial moles arise from....

Answer 38

Two sperm fertilising a single ovum

Question 39

T or F: Complete moles can progress to become choriocarcinomas

Answer 39

True

Question 40

Most common cancers in kids are...

Answer 40

Blood, brain, bone

Question 41

If on pathology report cells contain mucin it is most likely a...

Answer 41

Adenocarcinoma as adecarcinoma are glandular and glands contain mucin

Question 42

Define... Chondrosarcoma Osteosarcoma Rhabdomyosarcoma Angiosarcoma Leiomyosarcoma

Answer 42

Chondrosarcoma – malignancy of cartilage Osteosarcoma – malignancy of bone Rhabdomyosarcoma – malignancy of skeletal muscle Angiosarcoma – malignancy of blood vessel Leiomyosarcoma – malignancy of smooth muscle

Question 43

Signet ring sign is a feature that a cell....

Answer 43

Contains musin → so likely glandular

Question 44

If a neck mass moves on swallowing it is related to the...

Answer 44

Thyroid

Question 45

______________________ are usually lateral in the neck at the angle of the mandible and as a congenital lesion

Answer 45

Branchial cleft cysts

Question 46

______________ are mobile and present in midline, they also protrude on tongue protrusion

Answer 46

Thyroglossal duct cyst

Question 47

___________________ is when fT4 is in normal range while TSH is raised and and in ___________________ fT4 is in normal range while TSH is low

Answer 47

Subclinical hypothyroidism Subclinical hyperthyroidism

Question 48

Oncocytic change is....

Answer 48

Cellular enlargement characterized by an abundant eosinophilic granular cytoplasm

Question 49

T or F: Oncocytic change is normal in thyroiditis

Answer 49

True → sometimes referred to as Hurthle cells

Question 50

Classification of thyroid lumps via FNA

Answer 50

Thy 1 – inadequate Thy 2 – Benign Thy 3 – Atypia or follicular lesion - Thy 3A – atypia of unknown significance - Thy 3F – could be adenoma or carcinoma Thy 4 – Atypia suspicious of malignancy Thy 5 - Malignant (?type)

Question 51

What is a granuloma

Answer 51

An organised collection of activated macrophages and lymphocytes

Question 52

Formation of granuloma: Non-specific inflammatory response triggered by _____________________ or by _______________________ resulting in activation of ____________. Failure of removal of the stimulus results in _______________________. The end results is an ______________________

Answer 52

Diverse antigenic agents Inert foreign materials T lymphocytes and macrophages Persistent production of activated cytokines Organised collection of persistently activated cells

Question 53

Weinberg's Hallmarks of Cancer

Answer 53

Resisting apoptosis Sustained proliferative signaling Evading growth suppressors Activating invasion and metastasis Inducing angiogenesis

Question 54

Features of benign tumours

Answer 54

Macro (round) Symmetrical, organised Homogenous (cut surface is uniform) Encapsulated (lesion is slow growing) Normal N:C (nucleus: cytoplasm) ratio

Question 55

Features of malignant tumours

Answer 55

Look nasty/not natural Irregular Infiltrative Destructive Heterogenous Pleomorphism Hyperchromatia

Question 56

Define Pleomorphism

Answer 56

Cells grow in multiple shapes and sizes

Question 57

Define Hyperchromatia

Answer 57

Darkly stained nuclei, usually due to increased DNA content

Question 58

Why do malignant tumours cause weight loss?

Answer 58

They are very metabolic active, divide frequently thus requiring lots of energy They also increase metabolism through TNF

Question 59

T or F: A strong immune response to a tumour indicates poor prognosis

Answer 59

False → indicates good prognosis

Question 60

T or F: Cancer patients often get unusual reactions to infections

Answer 60

True