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Oph Pathology > Rao > Flashcards

Rao Flashcards

1
Q

PAS stains?

good for visualizing?

A

carbohydrates, mucin

visualizing basement membranes

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2
Q

differentiating conjunctivae use what stain? to look for what defining structure?

A

PAS to find mucin-containing goblet cells

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3
Q

autopsy vs enucleation

A

how much conjunctivae is attached

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4
Q

verifying how globe was opened

A

look for how much sclera on each side of nerve

look for macula (GC layer thin)

more cystic changes in ciliary body temporally

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5
Q

H&E clear spaces can be 3 things:

A

mucin, hydropic change, or fat

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6
Q

sebaceous gland carcinoma

A

stain for fat

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7
Q

what stains fat

A

oil red o (ORO)

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8
Q

presence of hair follicle

A

dermoid

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9
Q

dermoid on child

A

Goldenhar syndrome, check ear for preauricular fistula

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10
Q

follicular conjunctivitis

A

blood vessels pushed to periphery so clear follicle at slit lamp

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11
Q

papillary conjunctivitis

A

blood vessel in middle

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12
Q

papillary conjunctivitis

A

blood vessel in middle

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13
Q

ligneous conjunctivitis

A

very photosensitive, tongue-shape conjunctival lesion on child

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14
Q

ligneous conjunctivitis

A

very photosensitive, tongue-shape conjunctival lesion on child

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15
Q

congo red stains

A

amyloid if birefringence (red and green)

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16
Q

pigmented fungus (stains on PAS GMS)

A

aspergillus

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17
Q

fungal stain?

A

GMS

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18
Q

H&E

A

general tissue stain

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19
Q

pterygium changes

A

squamous metaplasia, loss of goblet cells, elastoid changes, focal area of hyperkeratosis, parakeratosis

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20
Q

PAS

A

stains carbohydrates/glycogen and proteoglycans magenta; stains descemet, lens capsule, bruch membrane, goblet cells

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21
Q

vitamin A

A

glandular epithelium transformed into squamous epithelium

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22
Q

alcian blue

A

acid mucopolysaccharide stained blue, cavernous optic atrophy

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23
Q

alcian blue

A

acid mucopolysaccharide stained blue, cavernous optic atrophy

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24
Q

acellular eosinophilic material

A

amyloid

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25
Q

amyloid seen in

A

MM, important to check for proteinuria

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26
Q

if conjunctiva affected with amyloid, typically localized, if in skin, associated with systemic amyloidosis

A

conjunctivae get this from chronic inflammation

27
Q

amyloid in conjunctivae

A

localized. trachoma

28
Q

bitot’s spot, squamous metaplasia without elastatic change (looks like skin so called epidermalization of conjunctival epithelium), keratosis

A

vitamin A deficiency

29
Q

epidermalization of conjunctival epithelium (4 diff dx)

A

vitamin A deficiency or radiation change or post-alkali burn or cicatricial pemphigoid

30
Q

fingerlike projections lined by epithelial with fibrovascular core

A

papilloma

if no stalk, sessile papilloma

31
Q

sessile papilloma

A

bulbar conj

32
Q

peduculated papilloma

A

on cul de sac, lid margin close to caruncle

33
Q

thickening of conjunctival epithelium

A

acanthosis

34
Q

features of malignant squamous lesions (5)

A

acanthosis (thickened epithelium), dysplasia (defective maturation, larger nuclei farther from BM), dyskeratosis (premature keratin), hyperkeratosis, abnormal mitotic figures

35
Q

carcinoma in situ vs carcinoma

A

BM intact if in situ

36
Q

actinic keratosis vs carcinoma in situ

A

actinic keratosis can show all the same features (acanthosis, dyskeratosis, dysplasia, hyperkeratosis, abnormal mitotic figures) but with elastoid degeneration and degree of the above

37
Q

if no keratin changes cannot dx

A

squamous cell carcinoma

38
Q

desmosomes can help differentiate

A

squamous cell carcinoma

39
Q

elastoid degeneration seen in

A

actinic damage (basophilic changes)

40
Q

mucoepidermoid lesion seen most commonly in

A

lacrimal gland (mix of glandular and squamous) or limbal area (where stem cells are)

41
Q

what conjunctival lesion is highly invasive

A

mucoepidermoid carcinoma (worst prognosis)

42
Q

squamous cell carcinomas most commonly metastasize to

A

preauricular lymph nodes

43
Q

spindle cell squamous carcinoma of conjunctiva without melanin could also be

A

amelanotic spindle cell melanoma

44
Q

stain for melanosomes

A

HMB 45

45
Q

HMB 45+, cytokeratin -

A

amelanotic spindle cell melanoma

46
Q

HMB 45 -, cytokeratin +

A

spindle cell carcinoma

47
Q

malignant conjunctival lesions (3)? worst prognosis? most common?

A

squamous cell carcinoma (most common), mucoepidermoid carcinoma (worst prognosis), spindle cell carcinoma

48
Q

if mixture of lymphoid reactive cells (plasma cells)

A

suggests reactive lymphoid hyperplasia
if only one cell type, lymphoma (can stain for clonality to differentiate if unsure by staining for kappa or lambda, + in B cell tumors which is most of ophthalmic tumors)

49
Q

melanocytes arise from what embryonal origin

A

neural crest

50
Q

melanocytes in conjunctiva are in

A

basal epithelium

51
Q

some melanocytes to not migrate all the way to the basal epithelium and are called

A

deep melanocytes (blue in appearance)

52
Q

nevus of ota (blue in appearance)

A

from deep melanocyte in conj or eyelid

53
Q

junctional nevus

A

seen in young/teen, will then become mixed (40s) then sub epithelial with age

54
Q

if junctional lesion in older person

A

c/f melanoma

55
Q

compound conjunctival nevus

A

cystic lesion, benign if can see cysts on slit lamp

56
Q

acquired melanosis

A

precursor to malignant melanoma of conjunctiva (is melanoma if invades stroma)
melanotic cells in basal epithelium extend upwards into superficial epithelium (vs nevus pushes into nevus); if obscures blood vessels (which are in stroma) then melanin is superficial and suspicious for acquired melanosis

57
Q

malignant melanoma of conj depends on

A

thickness, (esp >0.8mm thick)

58
Q

malignant melanoma origin:

A

de novo, arising from acquired melanosis, arising from nevi

if no junctional activity, means is metastatic/invasion

59
Q

most common stromal conjunctival lesions

A

lymphomas (mostly T cell e.g. MALT, HTLV1, mycoses fungicides, Hodgkin’s)

60
Q

capillary hemangioma vs granuloma

A

history of surgery/trauma (suggests granulomatous)

if rapidly growing granuloma

61
Q

Kaposi sarcoma

A

vascular tumor in HIV patient, cryo treatment or excision

62
Q

ophthalmic manifestations of HIV

A

kaposi’s sarcoma, multiple molluscum, multiple dermatomes of zoster, CMV

63
Q

waxing and waning course

A

melanoma?

Oph Pathology (1 decks)

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