Revision notes: 7. Pathology Flashcards
1
Q
Two substances responsible for initiating systemic acute phase response
A
Interleukin-1
TNF
2
Q
Caseating granuloma
A
TB
3
Q
Non-caseating granuloma
A
Sarcoidosis
4
Q
Teratoma definition
A
Neoplasm containing more than one germ cell layer
5
Q
HNPCC inheritance
A
Autosomal dominant
6
Q
HNPCC risk of colorectal cancer
A
80% risk colonic cancer
7
Q
What is factor V leiden
A
Variant of factor V that cannot be inactivated by protein C
Causes hypercoagulant state
8
Q
Antiphospholipid triad
A
Recurrent miscarriage
Thrombosis - arterial & venous
Presence of antiphospholipid antibody
9
Q
Ataxia telangiectasia important features
A
Autosomal recessive
Acute leukaemia
Lymphoma
Breast cancer
10
Q
Fanconi anaemia important features
A
Autosomal recessive
Acute leukaemia
11
Q
Xeroderma pigementosa
A
Autosomal recessive
Basal + squamous cell carcinoma
Malignant melanoma
12
Q
Tuberous Sclerosis important features
A
Autosomal dominant
Hamartomas
Glial tumours
13
Q
Neurofibromatosis important features
A
Autosomal dominant Gliomas of brain and optic nerve Acoustic neuromas Meningioma Phaeochromocytoma
14
Q
Aflatoxin associated with which malignancy
A
Hepatocellular carcinoma
15
Q
Nitrosamines and amides associated with which malignancy
A
Gastric CA
16
Q
Arsenic associated with which malignancy
A
Skin cancer
17
Q
aromatic amines and azo dyes which malignancy
A
Liver
18
Q
Beta-naphthylamine which malignancy
A
Bladder
19
Q
Pro-inflammatory mediator not inhibited by NSAIDs
A
Bradykinin
20
Q
Tamm-Horsfall protein
A
glycoprotein secreted by renal tubular epithelial cells
21
Q
Wound healing: re-epithelisation occurs when
A
24-48hrs post injury
22
Q
Non-epithelial ovarian cancer makes up what percentage of ovarian cancer
A
10-15%
23
Q
Brenner’s tumour is composed of
A
Transitional cells
These tumours secrete oestrogen
24
Q
Meig’s syndrome triad
A
Ovarian fibroma
Hydrothorax
Ascites
25
RMI - how to calculate
Risk of malignancy index
CA-125 * USS findings * menopause status
Post-menopausal = 3 points
> 1 worrying ultrasound feature = 3 points
26
Schiller-Duval body
Cellular structure resembling glomerulus
Seen in endodermal sinus (yolk sac) tumours
Secrete AFP and A1-antitrypsin
27
Call-exner body
Fluid filled punched out spaces between granulosa cells
| See in granulosa cell tumours
28
Sex cord stromal tumour presentation
Acute abdominal pain (tendency to rupture)
Iso-sexual precocious puberty
Menorrhagia
Irregular bleeding
29
Mucin-secreting signet-ring cells
Krukenberg tumour
GI cancer metastasing to ovary
Signet rings seen in stomach cancer
30
Inheritance pattern of Lynch syndrome
Autosomal dominant
31
Risk of endometrial cancer if u have lynch
Lifetime risk of endometrial cancer in pt with lynch is 40-60% compared to 3% risk in general population
32
Peutz-jeghers syndrome
Mutation in STK11
Autosomal dominant
Inc risk of sex cord stromal ovarian tumours and adenoma malignum of cervix
33
Serous ovarian cancers cell type
Resemble internal lining of fallopian tube
34
Mucinous ovarian cancer cell type
Resemble lining of endocervix or intestine
35
Clear cell tumours are linked to
endometriosis
36
Psammoma bodies
concentric lamellated calcified structures
Seen in:
papillary thyroid carcinoma
Meningioma
papillary serous cystadenocarcinoma of ovary
37
Endometrial epithelial cells becoming vacuolated, thrown into pseudo-papillary folds giving hyper-secretory impression
Evidence of decidualisation around spiral arteries and under surface of epithelium
Arias-stella reaction
38
Thickened polypoidal endometrium, straight endometrial glands, narrow columnar cells with basophilic cytoplasm, stromal hyperplasia and increase in glands
Ratio of glands to stroma is NORMAL
Hyperplasia without atypia.
Not pre-malignant
Associated wtih unopposed oestrogen stimulation with anovulatory cycles, oestrogen secreting tumours, oestrogen therapy
39
Increased ratio of glands:stroma, crowding of glands, back-to-back appearance
Various degrees of cellular pleomorphism and atypia
Increase in mitotic figures
Atypical hyperplasia
Risk of progression to endometrial carcinoma up to 50%
40
Endometrial SARCOMA - "homologous" vs "heterologous"
homologous if they contain endometrial tissue only (stromal or glandular)
heterologous if they contain extra-uterine tissue such as muscle or cartilage
41
Commonest site for endometriosis
ovary
42
elongated, spindle-shaped, with a cigar-shaped nucleus
FIBROID
Uterine leiomyoma
43
Most common fibroid degeneration type
Hyaline
44
Prevalence of sarcoma in pts undergoing hysterectomy or myomectomy for myometrial mass
1: 500
| 0. 2%
45
Dysgerminoma important facts
Most common malignant germ cell tumour
Female equivalent of seminoma
EXTREMELY RADIOSENSITIVE
Bilateral in 20%
46
Most common SOLID benign tumour of ovary
fibroma
47
Most common benign ovarian neoplasm in children
dermoid cyst
48
theca-lutein cyst features
simple cysts
lined with leutenised granulosa cells
2ndry to excessive gonadotrophic stimulation of ovaries - ovulation inducing drugs, molar pregnancy
49
Which ovarian tumour secretes AFP
endodermal sinus tumour
50
dermoid cyst lining
stratified squamous epithelium
51
serum inhibin is a marker for which ovarian tumour
granulosa cell tumour
52
In women using COCP, endometrium is characterised by
glandular atrophy
53
In women using copper coil, endo characterised by
mononuclear cell infiltrate
54
In women using mirena, endo characterised by
Decidual changes
55
acute endometritis - characterised by
Polymorphonuclear cell infiltration of the endometrial glands and stroma
56
Lymphocytic and plasma cell infiltration of the endometrial glands and stroma
Chronic endometritis
57
Diagnosis of endometriosis
Biopsy identifying haemosiderin-laden macrophages
58
average age of diagnosis of leiomyosarcoma
51 years old
59
ECM-1 antibodies have been detected in 60-80% of women with
Lichen Sclerosus
60
Pale, white atrophic areas on vulva
Fissuring
Stenosis of introitus
Lichen Sclerosus
61
Lichenoid inflammatory infiltrate in dermal-epidermal junction
Hyperkeratosis
Clefting
Lichen Sclerosus
62
Weak circulating basement membrane zone antibodies
Erosive lichen planus
63
Wickham's striae
Lichus Planus
64
if it involves the vagina it cannot be
lichen sclerosus
65
Irregular saw-toothed acanthosis
Increased granular layer
Basal cell liquefaction
Lichen planus
66
Distal urethral prolapse
| Pink exophytic lesion at urethral meatus
Urethral caruncle
67
Endocervical COLUMNAR epithelium visible at ectocervix, undergoes squamous metaplasia
cervical ectropion
68
Cervical intra-epithelial neoplasia associated with
HPV 16, 18, 31, 33
69
CIN I
Dysplastic cells confined to lower third of epithelium
70
CIN II
Dysplastic cells confined to lower two thirds of epithelium
71
CIN III
Entire thickness of epithelium involved
72
Risk factors for SCC cervix
```
Early age first sex
Multiple partners
Smoking
Non-barrier contraception
Immunosuppression
```
73
Risk of invasive vulval cancer in women with lichen sclerosus
4%
74
Diffuse CK20 positivity is suggestive of
secondary vulval paget's disease
| Spread of internal malignancy e.g. anorectal adenocarcinoma / urothelial carcinoma
75
Basaloid carcinoma of vulva
```
Associated with HPV
Younger population (<65)
```
76
DES daughters at risk of
Clear cell adenocarcinoma of vagina
| 0.1% risk
77
Sulphur granules
Actinomycosis
78
Examples of granulomatous inflammation
1) TB and leprosy
2) Syphilis - gumma
3) Cat scratch disease
4) Schistosomiasis
5) Cryptococcus and coccidiodes infections
6) Sarcoidosis
7) Silicosis and berylliosis
79
HPV is a .... virus with ..... within genome
DNA virus
| oncogene
80
MEN 1
Autosomal dominant
| Adenoma of Pituitary, parathyroid, islet cell
81
MEN 2
Autosomal dominant
Medullary carcinoma thyroid
Phaeo
parathyroid
82
Neutrophils appear within .... at the margins of an incision
24 hours
83
Granulation tissue forms when in wound healing
3-5 days
84
Remodelled scar - main collagen
collagen 1
85
Protein involved in apoptosis
BCL-2
86
Granulosa cell tumour is a
Sex cord stromal ovarian cancer
87
Aflatoxin B1 causes
Hepatocellular carcinoma
88
What % of PEs are clinically asymptomatic
60-80%
89
Diffuse renal cortical necrosis
Abruption/septic shock
Irreversible renal failure
Anuria
90
Metastatic calcification occurs in
normal tissues in presence of hypercalcaemia
91
Dystrophic calcification refers to
Calcium deposition in tissues in presence of normal plasma calcium & phosphate
92
How to oncogenic viruses cause cancer
Cause cancer by integrating viral DNA into the host’s DNA
93
Mature cystic teratoma - risk of malignant transformation
1%
