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Pathology
Adenocarcinoma of the Lung
Characteristics
Most Common Lung Cancer
Most Common in Nonsmokers
Peripheral Location
KRAS, EGFR, and ALK Mutations
Diagnosis
Glandular Pattern
Often Stains with Mucin
Clinical Features
Presents with Hemoptysis
Clubbing
Treatment
Surgical Resection
Chemotherapy and Radiation
2 mins
Squamous Cell Carcinoma of the Lung
Characteristics
Strong Correlation with Smoking
More Common in Men
Central Location
Cavitating Lesion Extending to Hilum
PTHrP Causes Hypercalcemia
Diagnosis
Keratin Pearls
Intercellular Bridges
Treatment
Surgical Resection (if Early Stage)
Chemotherapy and Radiation (if Later Stage)
2 mins
Small Cell (Oat Cell) Carcinoma
Characteristics
Aggressively Malignant
Strong Correlation with Smoking
Central Location
Amplification of Myc Oncogenes
Signs and Symptoms
Narrowing of Bronchial Airways
Cushing's Syndrome
Ectopic ACTH
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Lambert-Eaton Syndrome
Diagnosis
Kulchitsky Cells
Neuron-Specific Enolase Positive
Chromogranin A Positive
Treatment
Chemotherapy and Radiation
3 mins
Large Cell Carcinoma
Characteristics
Strong Correlation with Smoking
Poor Prognosis
Peripheral Lesions
Symptoms
Gynecomastia
Galactorrhea
Diagnosis
Anaplastic Cells
Pleomorphic Giant Cells
May Produce Beta hCG
Diagnosis of Exclusion
Treatment
Surgical Resection
Less Responsive to Chemotherapy and Radiation
2 mins
Bronchial Carcinoid Tumor
Characteristics
Excellent Prognosis
Signs and Symptoms
Symptoms of Bronchial Obstruction
Often Asymptomatic
Carcinoid Syndrome
Diarrhea
Wheezing
Flushing
Diagnosis
5-HIAA in Urine
Nests of Neuroendocrine Cells
Chromogranin A Positive
Treatment
Surgical Resection
Octreotide for Symptomatic Relief
2 mins
Nephrotic Syndrome
Signs and Symptoms
Massive Proteinuria > 3.5g per Day
Edema
Increased risk of infection
Thromboembolism
Hyperlipidemia
Fatty casts
1 min
Membranous Glomerulonephritis
Characteristics
Nephrotic
Diagnosis
LM Thickening of Capillary and Glomerular Basement Membrane (GBM)
EM Spike and Dome Appearance with Subepithelial Deposits
IF Granular
Primary
Phospholipase A2 Receptor Autoantibodies
Secondary
NSAIDS
Gold
Solid Tumors
Hepatitis B Virus (HBV)
Lupus
3 mins
Minimal Change Disease
Pathophysiology
Nephrotic
Most Common in Children
May be Triggered by Recent Infection or Immune Stimulus
Diagnosis
On Electron Microscopy (EM) See Foot Process (Podocyte) Effacement
On Light Microscopy (LM) See Normal Glomeruli
Loss of Negative Charge
Selective Loss of Albumin
Treatment
Responds to Corticosteroids
2 mins
Focal Segmental Glomerulosclerosis
Most Common Cause of Nephrotic Syndrome in Hispanic People and African Americans
Associated with Sickle Cell Disease and HIV
Associated Interferon Therapy and Heroin Abuse
Histopathology
LM Segmental Sclerosis and Hyalinosis
EM Focal Damage of Visceral Epithelial Cells
IF Negative
Signs & Symptoms
Microscopic Hematuria
Nonselective Proteinuria
Considerations
Poor Prognosis
2 mins
Membranoproliferative Glomerulonephritis
Nephritic-Nephrotic Syndrome
Type I
Subendothelial Immune Complexes
Hepatitis C Virus
Granular IF
Tram Tracks Caused by Splitting of the GBM
Ingrowth of Mesangium
Type II
Dense Deposit Disease
C3 Nephritic Factor
2 mins
Diabetic Glomerulonephropathy
Pathophysiology
Nonenzymatic Glycosylation of Glomerular Basement Membrane
Nonenzymatic Glycosylation of Arterioles
Hyperfiltration
Increased GFR
Histological Findings
Hyaline Arteriolosclerosis
Mesangial Expansion
Type IV Collagen Deposition
Kimmelstiel Wilson Lesions
Presentation
Nephrotic
2 mins
Amyloidosis
Etiologies
Primary
Multiple Myeloma
Secondary
Tuberculosis (TB)
Rheumatoid Arthritis
Pathology
Congo Red Stain
Apple Green Birefringence
Complications
Nephrotic Syndrome
2 mins
Papillary Thyroid Carcinoma
Characteristics
Most Common Thyroid Cancer
Excellent Prognosis
Lymphatic Spread
Diagnosis
Orphan Annie Nuclei
Empty Nuclei with Central Clearing
Psammoma Bodies
Risk Factors
Head and Neck Radiation
RET and BRAF Mutations
Gardner Syndrome
Cowden Syndrome
2 mins
Medullary Thyroid Carcinoma
Sporadic and Familial Types
Arises from Parafollicular C cells
Produces Calcitonin
Hypocalcemia
May Produce ACTH
Diagnosis
Sheets of Cells With Amyloid Deposition
Increased Calcitonin with Pentagastrin Infusion
Risk Factors
MEN 2A and 2B
2 mins
Follicular Thyroid Carcinoma
Characteristics
Most Common to Present as Solitary Cold Nodule
Hematogenous Spread
Good Prognosis
Histological findings
Uniform Follicles
May Invade Capsule
Risk factors
Head and Neck Radiation
1 min
Anaplastic Thyroid Cancer
Pathophysiology
Rapidly Progressive
Poor Prognosis
Hoarseness
Diagnosis
Invades Local Structures
Mixed Morphology
Risk Factors
Multinodular Goiter
Older Age
History of Thyroid Disease
2 mins
Ischemia and Vulnerable Tissues
Brain
MCA-ACA and MCA-PCA Interface
Heart
Subendocardium of Left Ventricle
Kidney
Proximal Tubule
Thick Ascending Limbs of the Loop of Henle
Liver
Central Vein
Colon
Splenic Flexure
Rectosigmoid Junction
2 mins
Cardinal Signs of Inflammation
Redness (Rubor)
Warmth (Calor)
Swelling (Tumor)
Pain (Dolor)
Loss of Function (Functio laesa)
1 min
Cancer Warning Signs (CAUTION)
CAUTION
Change in Bowel or Bladder Habits
A Sore That Does Not Heal
Unusual Bleeding or Discharge
Thickening or Lump in the Breast or Elsewhere
Dyspepsia (Indigestion)
Obvious Change to Warts or Moles
Nagging Cough
1 min
Right to Left Heart Shunts
The 5 Ts
Truncus Arteriosus
Transposition of the Great Vessels
Tricuspid Atresia
Tetralogy of Fallot
Total Anomalous Pulmonary Venous Return (TAPVR)
Associations
Cyanosis at Birth
May Require PDA
1 min
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