Pathology

Question 1

What are hyperplasia and hypertrophy?

Answer 1

Hyperplasia is an increase in cell number

Hypertrophy is an increase in cell size

Question 2

In what kind of structures is hyperplasia most likely to occur?

Answer 2

Hyperplasia occurs in structures which are under hormonal influence

(it is a process which occurs in response to a stimulus)

Question 3

Give some examples of sites in the body where hyperplasia occurs

Answer 3

Endometrium

Bone marrow

Thyroid

Prostate

Stomach

Question 4

Why might G cell hyperplasia in the stomach occur?

Answer 4

May occur in response to long-term PPI use

Question 5

Give some examples of sites in the body where hypertrophy occurs

Answer 5

Muscles

Heart

Question 6

What is dysplasia?

Answer 6

Abnormal cell growth that hasn’t reached the basement membrane

Question 7

Give some examples of dysplasia

Answer 7

DCIS

CIN (cervical intraepithelial neoplasia)

Adenomas (pre-malignant precursors to adenocarcinoma)

Question 8

What is metaplasia?

Answer 8

Change from one mature cell type to another

Question 9

Give some examples of metaplasia

Answer 9

Barrett’s oesophagus

Cervical transition zone (glandular to epithelial)

Bladder (transitional to squamous - occurs in response to infection and inflammation)

Squamous cell carcinoma in the lung

Question 10

What does CGIN stand for?

Answer 10

Cervical glandular intraepithelial neoplasia

Question 11

What is CIN I?

Answer 11

Low grade squamous abnormality of the cervix

Question 12

What is CN III?

Answer 12

High grade squamous abnormality of the cervix

Question 13

What are koilocytes?

Answer 13

Squamous cells which have been infected with HIV

Question 14

Who gets ovarian cancer?

Answer 14

Older women - usually postmenopausal

Question 15

What is the other term for trophoblastic tumours?

Answer 15

Choriocarcinomas

germ cell tumour of the ovary

Question 16

What are histiocytes?

Answer 16

Macrophages which respond to foreign material

Question 17

What conditions cause a high HCG?

Answer 17

Choriocarcionoma

Twin pregnancies

Molar pregnancies

Placental abruption

Question 18

Which type of ovarian tumour may cause a high HCG level?

Answer 18

Choriocarcinoma

*this may even lead to a falsely positive pregnancy test

Question 19

Molar pregnancy is associated with an increased risk of which cancer?

Answer 19

Choriocarcinoma

Question 20

What is the treatment for molar pregnancy?

Answer 20

Removal

Methotrexate

Question 21

Why is methotrexate used to managed molar pregnancy?

Answer 21

It is a folate antagonist. Folate is needed to make cells so it stops the molar pregnancy from developing further.

Question 22

What are the 3 main groups of tumours which occur in children?

Answer 22

BONE

BLOOD

BRAIN

(e.g osteosarcoma, leukaemia and medulloblastoma)

Question 23

Carcinomas are the most common tumours in older people. What type of malignancy are these?

Answer 23

Epithelial malignancy

Question 24

How does HPV malignancy present?

Answer 24

Young non-smokers

Lump in the neck

Question 25

Which lymph nodes do testicular malignancies spread to?

Answer 25

Para-aortic

Question 26

What cancers spread to the axillary lymph nodes?

Answer 26

Breast cancer Cutaneous cancers (e.g cancers on the skin of the arm)

Question 27

Which cancers can spread pretty much anywhere and should therefore never be ruled out too early?

Answer 27

Melanoma Prostate Small cell lung cancer

Question 28

Signet rings on pathology are indicative of which type of malignancy?

Answer 28

Adenocarcinoma

Question 29

Which conditions may present with an asymmetrical swelling in the midline of the neck that moves on swallowing?

Answer 29

Thyroglossal cyst Multinodular goitre

Question 30

Thyroid cancers most commonly affect which sex and age range?

Answer 30

Women Ages 20-40 (quite young)

Question 31

A patient presents with a neck lump. On the pathology report there are follicular cells, colloid and lymphocytes. What is the most likely diagnosis?

Answer 31

Inflammatory process (e.g thyroiditis) Follicular cells and colloid are normal findings in the thyroid! Lymphocytes indicate an inflammatory process!

Question 32

What is oncocytic change?

Answer 32

Cellular enlargement due to accumulation of altered mitochondria It indicates an inflammatory process Doesn't = malignancy

Question 33

Psammona bodies seen microscopically may be seen with which conditions?

Answer 33

Serous cystadenocarcinoma ovarian tumours Papillary thyroid carcinoma Papillary renal cell carcinoma Endometrial adenocarcinomas

Question 34

How does CMV present?

Answer 34

It is mostly subclinical/ asymptomatic In people with immunosuppression or HIV it presents with chorioretinitis and proctitis It can mimic EBV but typically doesn't have the sore throat that EBV does

Question 35

Who presents with symptoms due to CMV?

Answer 35

People who are immunosuppressed E.g Crohn's and UC patients on immunosuppressive drugs E.g HIV patients with a low CD4 count

Question 36

Why is it important to advise bed rest with EBV and to avoid sports?

Answer 36

There is a risk of splenic rupture

Question 37

What medication is given for EBV?

Answer 37

Penicillin V

Question 38

Why is EBV treated with antibiotics even though it is a viral condition?

Answer 38

Although EBV (glandular fever) may be the most likely diagnosis, there is a risk that the patient could have something like bacterial tonsillitis Antibiotics are given to cover other possibilities

Question 39

Why is a amoxicillin avoided in EMV?

Answer 39

It can cause a rash

Question 40

In patients with vague IBD like symptoms, which condition is now often screened for?

Answer 40

Syphilis