.

A-) CARCINOMA

1-)Definition :1ry malignant neoplasm arising from(name of organ)

2-)Aetiology :the exact aetiology is unknown however the following

are predsposing factors:
age>40 except : see below **
sex more in males except carcinoma of: gall bladder,thyroid
,pancreas&postcricoid type of esophagyal carcinoma: more in females.

3-)Pathology:
a-)Site:
Irritation

b-)Macro: malignant ulcer raised everted edge,rough necrotic floor,

indurated base
annular stricture....

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 fungating polypoid cawliflower hemorrhagic necrotic friable mass with
broad base.....

:
a-)if it is surface : we start by :malignant ulcer
b-) if it is capacious site : we start by: fungating cawliflower.
c-) if it is tube we start by : annular stricture

If it is asolid organ as LIVER we write ONLY IN GROSS:

Infiltrative hemorrhagic necrotic friable mass.

c-)Micro : according to type of epithelium

4-)Spread:
a-)direct(to near by organs)
b-) lymphatic early by embolization or permiation to regional lymph
nodes.
c-)blood late to LBLB(lung-bone-brain-liver)...

N,B. Spread is early by blood in :

thyroid,breast,lung,kidney,prostate&plascenta

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 5-)complication

:HIDM(Hemorrhage -secondary Infection-Distal Metastasis)+loss of

function.

B-)Metastasis

1-)Definition: secondary malignant neoplasm reaching (the organ)

from other sites.

2-)Aetiology:

- Direct spread
- Blood spread
-Lymphatic spread

3-) Pathology:

Site : multiple

Macro : infiltrative , round ,hemorrhagic ,necrotic ,variable size masses /nodules +

umblication .

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N.B : the nodules may be very large (cannon ball effect) if tumor origin is :
osteosarcoma,seminoma or renal carcinoma.

Micro : resembles the primary

4-) complication: Hemorrhage , secondary infection , loss of function

C-)Bleeding
1-)Definition: bleeding from (name of the organ)

2-)Aetiology General & Local causes

i-)General: HPL & 2 vitamins

a-) Hyper Tension

b-) Hemophilia
c-)Purpura
d-)Lymphoma &Leukemia
e-) Vitamins: C&K deficiency

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ii-)Local:

a-)Congenital diseases
b-)Traumatic diseases
c-)Inflammatory diseases
d-)Neoplastic diseases
e-) Others

D-)Acute Inflammation:
1-)Definition:

Acute (suppurative /catarrhal) inflammation of (mucosa) of (name of the organ)

2-)Aetiology:

a-)CO Causative Organism :Staph,Strept,Pnemococci,Gonococci,E-coli

("
b-)MT Mode of Transmission
c-)PF Predisposing Factors

3-)Pathology

a-)Site: Mucosa of the organ.

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b-)Macro: Mucosa is :hyperemic ,edematous, swollen &thickened covered with
(mucous:if catarrhal OR pus :if suppurative OR pseudomembrane: if
pseudomembranous inflammation as in diphtheria)

c-)Micro: There is : VD , acute inflammatory edema, acute inflammatory

cells(polymorph,macrophages) with( mucin intracellularly &extracellulary
:if catarrhal OR pus cells and necrotic debris :if suppurative OR fibrin
&necrotic epithelium if :pseudomembranous inf. )

4-)Complication:

a-)Chronicity.
b-) Spread
c-) others

E-) chronic nonspecific inflammation:

1-)Definition:-

Chronic non specific inflammation of (name of organ)

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2-)Aetiology:-

Repeated attacks of acute.

3-)Pathology:-

a-) site: mucosa of (name of organ)

b-)macro: Less hyperemicendarteritis obliteransless swollenfibrosis

b-)micro: chronic inflammatory cells plasma cells ,lymphocytes &macrophages

and fibrosis.

4-)complications:-

a-)fibrosis
b-)spread

, ,

And always remember NO GAIN WITHOUT PAIN

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F-)LIVER Cirrhosis:
Any type oF liver cirrhosis we should write:

1-) Definition : 3 characterized by 3

chronic diffuse irreversible liver disease characterized by :

1-)progressive diffuse necrosis of liver cells,associated with frame work

destrucation .
2-)repair by both regeneration nodules and fibrosis ,i.e the normal hepatic
architecture and lobular pattern cannot be restored.
3-)Restoration of normal liver function doesnot occur since the regeneration
nodules have no regular relation to portal tracts, NO central veins OR
presence of eccentric veins and irregular sinusoids.
More over ,hepatocytes in these regeneration nodules are commonly degenerated.

2-) Gross:
-size.
-surface & cut section.
-consistency.
-colour.
3-) Microscopy

4-)Effects.

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G-)STONES of GALL STONES OR URINARY
STONES:
1-)Definition:
Presence of stone in .common in the widest part e.g gall bladder in biliary
tract.

2-)Aetiology:
1-) Change in composition .
2-)Stasis.
3-) Infection
3-)Complications: MIMO
1-)Migration.
2-)Infection.
3-) Metaplasia.
4-)Obstruction.
N.B: . MIXED STONE :THE MOST COMMON GALL STONE
OXALATE STONE :THE MOST COMMON URINATY STONE

H-)Factors Irritate respiratory tract:

Smoking
S moke in air air pollution
Silicosis
ASbestosis
Radioactive Substance

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I-)Factors Irritate GIT:
Spicy food
Smoking
Spiritalcohol
Syphilis
Sharp tooth

J-)Diseases of Gall bladeer is more common

in :
-Female
-Fatty
-Fertile
-Fair
-Above Fourty
-Filty

K-)complications of the ulcer :

1-)Above: hemorrhage.

2-)Below: perforation.

3-)On the same line: fibrosis.

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L-)Aetiology of Viral Hepatitis
Type HAV HEV HBV HCV HDV
Name Infectious ---------- Serum Non A Non B Defective
hepatitis
Incubation 2-6 2-6 2-6 months. 2-6 years. 2-6 months.
Period weeks. weeks.
Mode of Feco oral Feco oral -Blood
transmission. transfusion.
-Sexual
transmission
-Contaminated
syringes
-Hemodialaysis = =
-Hemophilics
-Contaminated
instruments
-Organ
transplantation
-Congenital

Acute < 1% 1-3% . 1-4% 2-5% On top of HBV

Fulminant N.B: in
pregnants
hepatitis
women:
20-50%
Chronicity -No No Yes Yes The Most Yes
Common
cause in
EGYPT
Carrier state No. No. Yes Yes Yes

Oncogenic No. No. Yes Yes Yes

Liver No. No. Yes Yes Yes

cirrhosis

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 IMPORTANT NOTES

The most common causes of acute abdomen:

APC
Acute appendicitis
Perforated ulcer
Acute Cholecystitis

Carcinomas are more in males except:

Thyroid
Gall bladder
Pancreas
Carcinoma of oesophaguspost-cricoid type
MORE IN FEMLAES
Components of BILE: BBCC
Bile salts
Bile pigment
Cholesterol
Caco3

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Autoimmune diseases are nore common in
females except
Polyaretritis nedosa
Ankylosing spondylitis
MORE IN MALES

The most common cancer in :

Females: cancer breast
People live in villagesIN EGYPT: bladder carcinoma
Children: leukemia
Prostitutes: cervix
In humans: colon

Suppurative lung diseases: ABC

1-)Abcess
2-) Bronchecteasis
3-)Infected Cyst empyema /septic broncho pneumonia

Carcinomas start painful: PPPB

1-)Parotid
2-)Prostate
3-)Pancreas
4-)Bone

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The most common cause of :

-Nephritic syndrome is: acute proliferative diffuse G.N

-Nephrotic syndrome in children is: mild changes G.N.

-Nephrotic syndrome in adults is : Membranous G.N

-Renal failure in developed countries is: Glomerulonephritis.

-Renal failure in SUBdeveloped countries is :Pyelonephritis.

End stage of :
-Glomerular diseases : Chronic diffuse G.N
-Liver diseases: Liver cirrhosis

TAKE CARE

DONT forget to write causes of prolonged estrogen stimulation

in 4 diseases which are :
-Endometrial hyperplasia.
-Endometrial carcinoma.
-Mammary HyperplasiaFibro cystic disease

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-Carcinoma of the Breast
Causes of prolonged estrogen stimulation are:
1-)Repeated anovulatory cyclescommon at premenopause
2-)Oestrogen secreting tumorsGranulosa and/or theca cell
tumors
3-) prolonged estrogen therrapy
4-)Polycystic disease of ovary and adrenal hyper function.

---------------------------------------

Age of individuals at which tumors arise:**

1-)Crcinoma :mainly above 40 years except:

Naso pharyngeal carcinoma:
-Young individuals :15-25 years
-Old individuals :60-70 years
Carcinoma of Large intestine:
-Usually above 45 years
-May in younger agesaround or below 30 years on top of
familial polyposis.

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Renal cell carcinoma:
-Sixth decade
Non bilharzial carcinoma above 50"
Prostatic carcinoma :above 50
Chorio carcinoma :below 40
Breast carcinoma : children may be affectedjuvenila
carcinoma=>rare
Thyroid carcinoma :-
-mainly: above 50
- pappilary carcinoma may arise in children &young adults
below 20.

2-)Bone tumors usually below 20 except:

Giant cell tumor:-above 20
osteosarcoma may in the elderlyon top of Pagets disease.
Chondro sarcoma : 4th decade.
plasma cell neoplasms : above 40
Ewings sarcoma: 5-20 or in older age groupsPNET

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