Shared Flashcard Set

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case5
Buzzwords
39
Pathology
Professional
04/22/2011

Additional Pathology Flashcards

 


 

Cards

Term
RFs: OCPs, preg, obesity, metabolic s/o, incr lipid, rapid wt loss, gallbladder stasis
Definition
Cholesterol stones
Term

MC in Asia

 

-RFs: chronic hemolytic s/o, biliary infxn (bact, parasites), Ileal dz/resection, CF w/ pancreatic insuff

Definition
Pigment stones
Term
Steps to form cholesterol stone
Definition

1. Supersat of bile w/ cholesterol

2. Gallbladder hypomotility promotes crystal nucleation

3. accelerated nucleation

4. mucus hypersecretion promotes crystal in sonte (w/ GB stasis)

Term
Mix of insoluble oxidized calcium salt of unconjugated bili, along w/ inorganic calcium salts
Definition
Pigment stones
Term

What color of stone:

 

-sterile, sml almost always multiple, surface is spiculated or molded may crumble

 

-Radioopaque (csan be seen on Xray)

Definition
Black
Term

what color of stone:

 

-assoc w/ infxn, lamellated & soft w/ a soap like or greasy consistency

 

-typically radiolucent (can't be seen on Xray)

Definition
Brown stones
Term
Diff btw calcous and acalculous acute cholecystitis
Definition

-Calculous- assoc w/ gallstones

-acalculous- not assoc w/ gallstones

Term
RF for acalculous acute cholescystitis
Definition

-thought to be assoc w/ ischemia

 

RF: sepsis w/ hypotension and multi organ system failure, immunosuppresion, major trauma, DM

Term
complication of acute cholecystitis
Definition
Bacterial superinfxn w/ cholangitis or sepsis, gall bladder perforation, local abscess formation, biliary-enteric fistula w/ possible ileus
Term

-Assoc w/ gallstones

 

-Rokitansky-Aschoff sinuses

Definition
Chronic cholecytitis
Term
Chronic cholecystitis Porcelin GB is assoc w/
Definition
Incr risk of gallbladder adenocarcinoma
Term

-Ascending cholangitis

 

-bugs are

Definition
E coli, Klebsiella, Enterobacter, Enterococcus
Term
assoc w/ calcification
Definition

-Echonicoccal infxn

-Chornic cholecystitis

-Chronic pancreatitis

Term

-present before age 10 w/ nonspecific jaundice

 

-Incr risk of extrahepatic cholangiocarcinoma in older pts

Definition
Choledochol cysts
Term

-In asia assoc w/ infxn

 

-MOST IMPT RF is cholelithiaisis (hint its a cancer)

Definition
Carcinoma of the gallbladder
Term
Infiltrative pattern: more common than exophytic. Diffuse thickening of GB wall, Firm, schirrhous, poss deep ulceration or penetration of gallbladder wall
Definition
Carcinoma of the gallbladder
Term
Carcinoma of the Gallbladder the exophytic pattern is most common in :
Definition
Fundus or neck
Term

Carcinoma of the gallbladder:

which tumors have better px than others?

 

-What is the px? Good or bad

Definition

-Papillary tumors have better px than others

 

-bad- 5yr survival is 5-12% despite surgical intervention :(

Term
RFs for carcinoma of extrahepatic bile ducts (aka cholangiocarcinoma)
Definition

RFs: choledochol cysts, exposure to Thorotrast, HCV infxn, primary sclersoing cholangitis

 

in Asia: major RF is hcornic infxn w/ flukes (Opithorchis sinesin)

Term
Px for carcinoma of extrahepatic bile duct (aka cholangiocarcinoma)
Definition

Px is v poor for all cholangiocarcinomas

 

-esp intrahepatic (medial death is 6mnths)

Term

Carcinoma of bile ducts (cholangiocarcinoma)

 

-Which is more common intraheptaic or extrahepatic

Definition
Extrahepatic
Term

Klatskin tumors usu have slower growth prominant fibrosis and infrequent distal mets

 

They are part of which cancer?

Definition
Carcinoma of the extrahepatic bile ducts (cholangiocarcinoma)
Term

RFs: What is it?

-80% d/t biliary tract dz

-male= alcohol related, women=gallstones

 -Metabolic s/o- HyperTGs, hyperCa

-Ischemia, trauma or inherited

Definition
acute pancreatitis
Term

-middle ages male (assoc w/ long term alcohol abuse)

 

-silent until presents w/ pancreatic insuff (wt loss, hypoalbuminemia) & DM

Definition
chronic pancreatitis
Term

Relative sparing of islets

 

-gross: v firm, hard gland, calcified concretions may be visible even grossly (& on radiograph and CT)

Definition
Chronic pancreatitis
Term
Pseudocysts can be seen in
Definition
acute and chronic pancreatitis
Term

-nonspecific abd pain or palpable mass

 

-benign neoplasm, 60-70yo female

 

histo: well circumscribed mass w/ glycogen rich cuboidal cells surrounding small cyts which contain clear, straw colored fluid

 

-Px- surgical resection if curtaive :)

Definition

Serous cyst

(pancreas)

Term

-painless, slow growing, benign

-FEMALE

Histo: body or tail of pancreas

-cysts filled w/ thick mucin, lined by columnar, mucin producing cells

-assoc dense stroma that resembles ovarain stroma

 

 

-Px: up to 1/3 contain invasive CA- req full path exam after resection

Definition

Mucinous cyst

pancreas

Term

assoc w/ Von Hippel Lindaou dz, ADPKD

 

-Cyts lined by cuboidal epithelium or linning poss flattened if intraluminal  press in cytrs is hi

-surrouned by thin fibrous capsul

Definition
congenital cyst (pancreas)
Term

-localized collection of necrotic & hemmorrahgic material

-Usu solitary, peripancreatic location

-No epithelial lining

 

-may be seen in acute/chornic pancreatitis

Definition
pseudocyts (pancreas)
Term

-Strongest RF is smoking,

 

Other RF: chornic pancreatitis, DM

-painless jaundice,Tousseau sign

 

CEA and CA19-9

Definition
Pancreatic carcinoma
Term
-perineural invasion
Definition
Pancreatic carcinoma
Term
Px for pancreatic carcinoma
Definition

Fewer than 20% resectable at dx

 

-Dismal 5 yr surival (<5%) :(

Term

-MC cause in adult is cholethiasis

-children d/t biliary atresia, CF, choledochal cyts or paucity of bile duct obs

 

-Pruritis, incr Alk pos, GGT

 

-End stage liver w/ yellow-green pigmentatio

Definition
secondary biliary cirrhosis
Term

40-50 yo, pruritis, anti-mitochondrial Abs

 

-may see hyperpigmentation & inflammatory arthropathy in some pts, hepatomegaly, eyelid xanthelesmas

 

-incr risk of hepatocellular carcinoma

-Noncaseating granulomas may be present

Definition
primary biliary cirrhosis
Term

-20-50 yo male, assoc w/ ulcerative coliits

 

-Pruritis, incr alk phos

-autoabs: ANA, anitSMA, atypical pANCA

Definition
primary sclerosing cholangitis
Term

-beaded appearnce when imaging biliary tree d/t irreg strictures and dilations of affected bile ducts

 

-Onio skini fibrosis

Definition
Primary sclerosing cholangitis
Term

Primary sclerosing choloangtis

 

you have in incr risk of what?

Definition

-cholangioCa

-chronic pancreatitis

-Hepatocellular CA

Term
Feathery degeneration of hepatocytes will be seen
Definition

in cholestasis

 

(cholestasis can be seen in SBC, PBC and anything that has cholestasis)

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