Pathology One-Liners for Medical Students

Patho

• Necrosis in solid organs like the kidney, liver, & heart is coagulative necrosis. 
• Ghost cells are all associated with coagulative necrosis. 
• Necrosis that is seen in the CNS and pancreas is liquefactive necrosis. 
• Necrosis in PAN, RHD, SLE, and mHTN is fibrinogen necrosis. 
• Caspase numbers for apoptosis are 8, 9, and 10 in the case of initiators and 3, 6, and 7 in the case of executors. 
• Necroptosis is caspase-independent programmed cell death. 
• Caspase numbers for pyroptosis are 1, 4, 5, 11. 
• Fever is caused by Interleukin 1, and caspase-1 will activate 1LT (Interleukin 1). 
• The most common metaplasia is squamous metaplasia. 
• An example of mesenchymal metaplasia is myositis (muscle) + ossificans (calcium/bone).
• Sirtuin proteins are the histone deacetylases. 
• Role of sirtuins are anti-aging, promote cell repair, and being used in cancer treatment and diabetes treatment. Sirtuins increase insulin sensitivity. 
• Werner syndrome defect DHA helicase defect. 
• Werner syndrome is also called adult progeria syndrome. 
• Hutchinson-Gilford syndrome-LMNA gene defect where that nucleus is not developed properly.

Pneumonic for Cellular Events of Inflammation are MRATCOP.

• M –Margination 
• R –Rolling 
• A – Adhesion 
• T – Transmigration/Diapedesis 
• C – Chemotaxis 
• O – Opsonization 
• P – Phagocytosis 
• Rolling is carried out by molecules called selectins.
• Adhesion is caused by integrins. 
• Integrins are of 2 types ie βₗ and β₂
• Transmigration/Diapedesis is caused by PECAM 1/CD₃₁ 
• Chemotactic agent that we make are LTB₄, IL₈ & C₅ₐ 
• IgG (Most Important opsonin)
• The most impatient complement opsonin C3b
• LAD1: Integrin (β₂ integrin defect) 
• They show delayed separation of umbilical cord stumps. 
• LAD2: Sialyl lesions defect 
• The patient's blood group is the Bombay Blood group 
• Broton's hypogammaglobulinemia is most commonly seen in boys. It is a B cell defect. The genetic defect is in BTK Gene 
• Chediak Higashi Syndrome is a LYST gene defect (lysosomal trafficking gene defect), Silvery Gray Hair. 
• Chronic Granulomatous Disease There is a defect in NADPH oxidase. The patient suffers a lost infection (Catalase Positive Organism). 
• Diagnosis includes → Screening = NBT test (Nitroblue Tetrazolium). 
• Confirmatory/Diagnostic = DHR (dihydrorhodamine done by flow cytometry). 
• Langhan's giant cell is present in TB and is different from Langerhans. 
• Touton giant cells are seen in Xanthoma or any lipid-related disorder. 
• Warthin Finkeldey giant cells are seen in measles. 
• Types of granulomas are → Durck granuloma, doughnut granuloma, & stellate granuloma. 
• Durk granuloma is seen in cerebral malaria caused by plasmodium falciparum/PF; we have field stain. 
• Doughnut granuloma is seen in Q fever, caused by Coxiella and seen with allopurinol. 
• Stellate granuloma is seen in cat scratch disease and lymphogranuloma venerum. 
• Granulation tissue begins at day 3 and becomes maximum at day 5. 
• Collagen formation begins at 3 and becomes maximum at day 21 or (week3) 
• Collagen formed at the beginning of repair is type III and converts to type 1 by the end of repair. 
• 100% wound strength is never achieved. 
• In Prader-Willi syndrome, maternal imprinting is done and paternal deletion happens. Body will be with obesity and hyperphagia (because ↑ghrelin) 
• In Angelman Syndrome, paternal imprinting is done and maternal deletion happens. It is known as happy puppets. Inappropriate laughter in kids.
• Fragile X syndrome (CGG repeats) > 200 repeats. 
• Myotonic dystrophy is (CTG repeats); patients have “Hatchet facies” 
• Friedreich's Ataxia (GAA repeats) 
• Huntington disease (CAG repeats) 
• Steps of PCR are Denaturation, Annealing and extension 
• Single-base primer extension PCR is used to detect BRAFV600E (Hairy cell Leukemia) 
• Pyrosequencing: when dealing with a contaminant sample (low tumor yield sample) 
• Quantitative assessment/real-time PCR and dealing with cancer CML. 
• Phase for karyotyping is metaphase. fixative used is the Carnoy fixative (Methanol: Glacial acetic acid 3:1) 
• G banding (Giemsa stain) with a light microscope (Most Common Banding)
• Q banding (Quinacrine banding) using Quinacrine stain and fluorescent microscope (fluorescent pigmentation) 
• RET gene Causes medullary carcinoma thyroid 
• RET gene present in Chromosome 10. 
• RET gene associated with Men 2a, Men 2b syndrome 
• If RET is lost, ganglion cells are also lost which causes Hirschsprung disease. 
• CKIT mutation is shown in GIST, AML, Leukemia, melanoma, Mastocytosis and seminoma 
• BRAF (BRAFV006E) mutation can cause HCL, LCH, Papillary carcinoma thyroid,JPA, pilocytic astrocytoma melanoma, and colon cancer. 

Also read: Chronic Myeloproliferative Diseases: Types and Symptoms

Tumor Markers

• AFP (Alpha fetoprotein) indicate yolk sac tumor, hepatocellular carcinoma (HCC) and Hepatoblastoma 
• CEA – Carcino embryonic antigen indicate colon cancer, pancreatic cancer and lung cancer. 
• CA125 → indicating cancer is surface epithelial tumors 
• CA 19 -9 → indicating cancer is Pancreatic cancer 
• CA 15 – 3 indicating cancer is breast cancer 
• CD markers for the natural killer cells are C16, CD56 and CD94 
• CD94 is a new marker 
• CD Markers for T cells are CD1-8, CD28 
• The Pan T cell marker is CD3 
• CD3 is going to fake signal transduction molecules. 
• CD markers of B-cells are CD10, CD19, CD20, CD21, CD22, CD23, CD40 and CD 79a & 79b 
• Pan B cell marker is CD19 
• Signal transduction molecule is CD79ab 
• Epstein Bar virus enter to body through B cells by CD 21/CR 2 marker 
• CD Markers for Myeloid lineage is CD13 and CD33 
• CD marker CD64 for Monocytoid lineage is CD11, CD14 
• CD marker for Megakaryocytes lineage is CD41, 61 & 42 

Antibodies 

• Most sensitive antibodies are antinuclear antibodies. 
• Most specific is the Antismith antibody. 
• Both sensitive and specific is an anti-dsDNA antibody. 
• Neonatal lupus—antiRo antibody 
• SLE resulting in psychosis—anti-ribosomal antibody. 

Also read: FMGE Previous Year Questions for Pathology

Sjogren Syndrome 

• Antibodies for Sjogren's syndrome are anti SS – A and B. 
• Anti SSA is referred to as RO (most sensitive). 
• Anti SSB is referred to as LA (most specific). 

Scleroderma – Limited scleroderma is caused by Anticentromeric Antibody. 

• Diffuse scleroderma is caused by anti-topoisomerase antibody/Anti SCL 70 (most specific). 

Vasculitis 

• Most common vasculitis in adults: giant cell arteritis. 
• Most common artery: Superficial temporal artery 
• Most Common Symptoms: Unilateral Throbbing Headache. 
• Most specific symptoms: Jaw claudication (Jaw Pain) 
• Most dangerous symptoms: loss of vision. 
• Will start steroids immediately. 
• Vasculitis with a weak pulse is Takayasu Arteritis. 
• The most commonly affected artery is the subclavian artery. 
• It occurs in adults below 50 years of age. 
• Vasculitis that occur in HBsAg patients is polyarteritis nodosa. 
• Vessels affect pulmonary circulation. 
• Vasculitis in kids with strawberry tongue is Kawasaki disease. 
• Antibodies for Kawasaki disease are anti endothelial cell antibodies. 
• Vasculitis in smokers is Berger's Disease. 
• Also called as Thromboangiitis Obliterans. 

ANCA 

• C – ANCA is also known as C/PR3 ANCA 
• P – ANCA is also known as MPO ANCA 
• Disease with C-ANCA is Wegener's Granule exocytosis 
• Disease with P-ANCA is microscopic polyangiitis drug straws syndrome, ulcerative colitis & primary sclerosing cholangitis 
• Clinical features of Henoch Schonlein Purpura or non-thrombocytopenic purpura are Purpuric rash, arthritis, Abdominal pain and Hematuria. 
• Antibody associated with Henoch Schonlein Purpura is IgA antibody 

Also read: Types Of Hypersensitivity Reactions

Cardiomyopathy 

• Takotsubo cardiomyopathy is associated with severe emotional stress. It dilates left vertically (maximum receptor for catecholamine present in left vertical)
• Dilated cardiomyopathy dilates four chambers of the heart. 
• Caused in cases of chronic alcoholism and titin mutation. 
• Ninja star nucleus—usually associated with TITIN gene mutation DCM. 
• Hypertrophic obstructive cardiomyopathy causes sudden collapse and death in young athletes.
• Patients will experience obstruction to the blood flow, which ultimately leads to sudden death or collapse. 
• Mutation in hypertrophic obstructive cardiomyopathy is a defect in the beta myosin heavy chain. 
• The heart is banana-shaped. 
• It is only hypertrophy of IVS (Interventricular Septum)

Cardiac Tumors 

• Cardiac tumor with Lepidic cell is myxoma (most common tumor). 
• It occurs in left atrium 
• Cardiac tumors with spider cell is Rhabdomyoma 
• It occurs in the left vertical.

Markers of Lung Tumors 

• Markers of squamous cell carcinoma is keratin pearls (P40 and P63) 
• Markers of adenocarcinoma are TTF1, MUC1 & NAPSINA. 
• Markers of small cell carcinoma are synaptophysin, chromogranin, and bombesin; MSE; CD56; and CD57. 
• Markers of mesothelioma is calretinin; chemical exposure will be asbestosis. 

Also read: How to Prepare Pathology for FMGE

Identify the Disease 

• When Lung shows hemoptysis and kidney shows hematuria it is called good pasture syndrome. 
• Good pasture is RPGN Type 1, Hypersensitivity type – 2, α3 chain of type 4 collagen. 
• Kimmelstiel Wilson lesions are also called nodular glomerulosclerosis and the stain is PAS +ve.

Identify the Intestinal Diseases

• Longitudinal ulcer is seen in typhoid, and transverse ulcer is seen in the TB. 
• Entamoeba histolytica has a flasklike shape. 
• Lead disease with serpiginous ulcer is Crohn's disease. 
• Rectal disease with superficial ulcers and pseudopolyps in ulcerative colitis.

Identify the Brain Tumor 

• Juvenile pilocytic Astrocytoma → child with cerebellar lesion (cystic lesion). 
• Rosenthal fiber-like structure – non specific injury- Alexander's disease. 
• Butterfly glioma with serpentine necrosis is Glioblastoma. It is Grade IV carcinoma and the prognosis is bad. 
• Fried egg appearance with chicken wire blood vessels is oligodendroglioma. 
• The most common mutation is IDH mutation and codeletion 1p/19q has a good response to chemotherapy

Also read: Important One-Liners in Public Health & Community Medicine (PSM)

Meningioma 

• It is most common in females. 
• It is a dural-based tumor (whirling of the tumor cells) 
• Psammoma bodies present. 
• It is progesterone receptor positive (more in pregnancy). 
• CD99/Mic2 marker is in Ewing's sarcoma 
• Salah and Klima needle is used for bone marrow aspiration. 
• Neurological manifestations associated with B12 deficiency. 
• Neurological manifestation is subacute combined degeneration. 
• Another deficiency is hyperpigmentation (mainly in the knuckles). 
• The RBC protein responsible for biconcave shape is spectrin (α, β). 
• The most common mutation in hereditary spherocytosis is the Ankyrin mutation. 
• The most common mutation in autosomal recessive hereditary spherocytosis is the spectrin mutation. 
• Screening test for Hereditary spherocytosis is pink's osmotic fragility test. 
• The diagnostic test (confirmatory test for HS) is EMA (Eosin 5, Maleimide test). 
• EMA is a dye, which binds to brand 3. 

Guess the Leukemia 

• Acute Lymphoblastic leukemia. 
• It is the most common leukemia in children. 
• Blast >20% 
• Shows PAS positivity + Dot, blot, or block positivity. 
• Acute Myeloid Leukemia, Blast is ≥ 20% with Auer rods 
• Auer rods are made up of lysosomes. 
• AML M3 is the only leukemia associated with DIC (Disseminated Intravascular) 
• Name of the cell which shows Auer rods are faggot cell. 
• CLL (Chronic Lymphocytic Leukemia). 
• This is the only Leukemia which is not associated with radiation. 
• Syndrome related to the CLL is Evan's syndrome and Richter syndrome. 
• Evan's syndrome – Autoimmune hemolytic anemia + chronic lymphocytic leukemia + ITP (platelet).
• Richter syndrome – Chronic lymphocytic leukemia + Small lymphocytic lymphoma hanging to diffuse large B cell lymphoma

Also read: Ulnar Nerve Injuries Anatomy & Functions Explained

LAP Score/ NAP Score 

• Normal value of the LAP score is 40-100. 
• LAP score decreased in PNH & CML and increased in Leukemoid reaction, Pregnancy, OCP, neutrophilia/sepsis, & Down syndrome. 

Temperature & Shelf life 

• For whole blood/PRBC, temperature is 2-6 degrees. 
• Can keep it for 21 days if we are using (ACD/CPD) as an anticoagulant. 
• Can keep it for 35 days if anticoagulant is CPDA. 
• Can keep it for 42 days if anticoagulant is SAGM. 
• For platelets rich plasma temperature is 20-24 degree Celsius. 
• Shelf life is 5 days with agitation. 
• For fresh frozen plasma the temperature is <-30°. 
• Shelf life is 1 year.

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