pathology_questions.txt

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rontongbai
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pathology_questions.txt
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2013-03-13 22:45:52
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  1. "in the retina, what is the watershed zone between retinal and choroidal circulation"
    inner nuclear layer
  2. what is cavernous optic atrophy of Schnabel
    "typically occurs in glaucoma pts with high IOP, mucopolysaccharides of the vitreous fill the cystic spaces in the optic nerve by penetrating into the parenchyma through the internal limiting membrane from high IOP (stains with alcian blue or colloidal iron)"
  3. what quadrant do you see dermolipoma
    superotemporal
  4. how does insertion of IO help you determine laterality of the eye
    io inserts temporally near the macula
  5. what are morgagnian globules
    accumulation of eosinophilic globules in slit-like spaces between the lens fibers
  6. what tissues do neural crest give rise to
    "corneal stroma, endothelium, iris stroma, TM, sclera"
  7. what tissues do surface ectoderm give rise to
    "corneal epithelium, lacrimal drainage system"
  8. what tissues do neuroectoderm give rise to
    "iris pigmented epithelium, iris sphincter, iris dilator, RPE, neurosensory retina"
  9. what tissues do mesoderm give rise to
    "temporal portion of scelra, EOMS, schlemms' canal"
  10. what is a teratoma
    tumor derived from all 3 germ layers
  11. what stroma dystrophy has highest recurrence in grafts
    lattice
  12. where do neutrophils come from in a central corneal epi defect
    tears
  13. what things portend poor prognosis for conj melanoma
    "orbital involvement, pagetoid spread, involvement of the eyelid, (epibulbar location is good prognosis)"
  14. what is ddx of pannus
    "trachoma, C/L overwear, blepharocojunctivitis, chemical injuries"
  15. what cells' projections form the ILM and ELM
    mueller cells
  16. what are the most common non-ocular tumors outside field of radiation tx in RB survivors
    osteosarcoma and malignant melanoma
  17. what are the most common secondary tumors arising in field of radiation in rb survivors
    osteosarcoma and fibrosarcoma
  18. what is the chacne offspring have tumor if one parent has unilateral RB
    7-15% (15% of sporadic RB have germline mutation)
  19. what is K edema worse at night in FED
    worsened endothelial function which itself is a result of increased hypoxia when eyelids are closed
  20. what stain do you use for mucormycosis and what does stain show
    GMS stain which shows nonseptated hyphae
  21. where does mucormycosis come from?
    direct spread from sinus infection
  22. what is the average age of diagnosis of RB with known family history? Bilateral disease? Unilateral disease?
    4 months; 14 months; 24 months
  23. what are characteristic FA findings of capillary hemangioma
    fills slowly with pooling in upper part of lesion
  24. what is the ddx of break in Descemets membrane which has scrolled in on itself
    "forceps injury, hydrops associated with KC (or pellucid degeneration), congenital gluacoma (haab's striae), terren marginal degeneration"
  25. what are the histological patterns of shwannoma?
    "antoni A (compact groups of spindle cells within the tumor, verocay bodies- stacked arrangements of elongated palisading nuclei alternating with anuclear zones containing cell processes), antoni B (loose meshwork of tissue interspersed with cystic spaces)"
  26. shwannomas are found in what disorder
    NF
  27. what does mucin do?
    "fill spaces between microvilli of epitheial cells to provide uniform surface, lowers surface tension and thus stabilizing tear film, lubricate the eyelid, trap foreign particles, changes K epithelium to hydrophilic layer"
  28. what do you think of when you see eosinophilic pink material lining the anterior part of iris
    descemet's membrane in ICE syndromes
  29. how does ICE syndrome typically present
    middle aged caucasian woman with unilateral glaucoma and irregular pupil
  30. what is trilateral RB and how common is it
    billateral RB with pinealoblastoma (occurs in 5% of patients with germline mutation)
  31. what is pathological hallmark of adenoid cystic carcinoma
    swiss cheese appearance (aka cribriform pattern)
  32. what is the tx for adenoid cystic carcinoma
    exenteration with removal of adjacent bone
  33. what is the typical presentaitno of adenoid cystic carcinoma? Pleomorphic adenoma?
    "1. women, painful (due to invasion of nerves), poor prognosis, proptosis 2. men, painless, proptosis"
  34. what are indications for enuclation for RB
    1. involvement of optic nerve 2. involvement of anterior segment 3. tumor occupying > 50% of the globe
  35. what retinal cells synapse in the lateral geniculate nucleus
    retinal ganglion cells
  36. what are the 3 main groups of retinal ganglion cells and where do they synapse
    "1. tonic cells stimulated by L or M cones that project to parvocellular layer of the LGN, important in high resolution and color 2. phasic cells project to the magnocellular layers of the LGN, detect motion 3. tonic cells simtulated by S cones"
  37. what are risk factors for growth of choroidal melanocytic lesions
    "srf, orange pigment, juxtapapillary location, leakage on FA, larger size (thickness greater than 1 mm), homogeneity on US"
  38. what is the pathological hallmark of sarcoidosis
    noncaseating granulomas
  39. what's the ddx of noncaseating granulomas
    "fb reaction, sarcoidosis, fungal infection, mycobacterium infection"
  40. what do you see pathologically in dermoids
    stratified squamous epithelium and dermal adnexal structures (eg hair shaft and holocrine glands)
  41. what is the hla for vkh syndrome
    hla-dr4
  42. what are the clinical stages of vkh
    "1. prodomal stage (flu like illness, tinnitus, CSF pleocytosis) 2. acute uveitic stage (granulomatous uveitis, serous RDs, dalen-fuch noduels) 3. convalescent stage (depigmentation of choroid- sunset glow fundus, perilimbal vitiligo- sugiura's sign, skin vitiligo, alopecia, poliosis 4. chronic recurrent stage (recurrent granulomatous uveitis, iris nodules/depigmentation/atrophy, glaucoma, subretinal fibrosis, psc)"
  43. what is the pathological hallmark of GCA
    granulomatous inflammation surrounding the interal elastic lamina involving medium to large vessels
  44. what was the main conclusion of the COMS LARGE choroidal melanoma trial
    adjuvant radiotherapy did not improve survival
  45. what was the main conclusion of the COMS MEDIUM choridal melnaoma trial
    "mortailty was similar among brachytherapy and enucleation groups, mets was found in 10% of patients treated with enucleation"
  46. what was the main conclusino of the COMS small CM observation study
    mortailty rate was 1% at 5 years with observation only for small CM
  47. what is PDS associated with?
    myopia and thus RDs
  48. what are the K dystorphies associated with TGFbeta1; what abnormal protein does it produce
    "EBMD (minority of cases), Reis-Buckler, Thiel-Behnke, lattice types 1 and 3, granular types 1 and 2 (avellino); keratoepithelin"
  49. what K findings do you see in Reis Buckler
    confluent and course geographic opacities at Bowman's layer and superficial stroma
  50. what is the inheritance pattern of reis buckler? How does it present?
    "AD, presents with painful recurrent erosions during 1st or 2nd decade"
  51. what is the stain for AK? What color is it?
    Gridley stain; green
  52. what is the chance of getting RB if one parent has germline mutation
    45% (50% of inheritance * 90% penetrance)
  53. what is the most common way RB extends out of the eye
    "optic nerve (other routes include emissary canals, TM, direct penetration through sclera)"
  54. what is the only 2 K structure that is PAS postivie and why
    "descemet's membrane, only true BM composed of type IV collagen; epithelial basement membrane"
  55. what inheritance is macular dstrophy
    AR
  56. what is the slit lamp findings of macular dstrohpy? Granular dystorphy?
    "diffuse haze which involves entire cornea; clear intervening spaces between ""bread crumb"" like lesions"
  57. what are pathological findings of compound nevus
    nests of nevus cells both at the junction of epithelium and substantia propria and substantia propria itself; cystic inclusions of eptihlium (large white spaces)
  58. where are compound nevus rarely found
    palpebral conjunctiva
  59. what are patholoigcal findings of rubella cataracts
    "microspherophakic and contains ""retained lens fiber nuclei"""
  60. what percent of pts with breast cancer mets to the eye had previous tx for breast ca
    90%
  61. what is the stain for band K? what color does it stain
    "van kossa, black"
  62. what is the most common cause of vision loss in chronic uveitis from JIA
    CME
  63. why shouldn't you treat CM with transscleral diathermy
    can cause scleral damage causing tumor cells to escape
  64. what are the typical path findigns of TED
    muscle bundles seperated by fluid and infiltrated by admixture of mononuclear inflammatory cells
  65. what organism causes majority of fungal infections and what part of US
    "fusarium, southern US"
  66. what are A-scan findings of CM
    initial high-amplitude echo followed by low-amplitude internal reflections (low internal reflectivity)
  67. what are FA findings of CM
    not usually helpful; but some say double circulation pattern (both retinal vessels and choroidal vessels are readily seen in the tumro)
  68. what are the grades of CIN
    "grade I (involves lower 1/3 of epithelium), grade II (involves lower 2/3 of epithelium), grade III (involves almost entire epithelium); insitu (involves entire epithelium)"
  69. what is tx of CIN
    "excision, cryotherapy of surgical margins, and antimetabolite"
  70. what are pathologic findings of pterygium
    "solar elastosis (pink-colored elastin like lines), basophilic degeneration (blue tinged area), thickened subepithlium"
  71. what is a retinocytoma
    differentiated retinoblastoma (same genetic implication of RB)

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