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2023 Fall ITE Flashcards

1
Q

2 immunostains most useful for diagnosis of CLL/SLL

A

CD5
CD23

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1
Q

Name 1 recurrent chromosomal alteration seen in CLL/SLL

A

del(11q)
del(13q)
del(17p)
trisomy12

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2
Q

Name 2 most common variants of Richter transformation

A

DLBCL
CHL

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3
Q

List 2 molecular biomarkers predictive of poor prognosis in CLL/SLL

A

TP53 mutation
TP53 deletion
del(17p)

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4
Q

Name 3 head and neck sites where SCC should be routinely tested for presence of HPV with p16 immunostain.

A

Adenoids
Vallecula
EBER-negative nasopharyngeal carcinoma
Cervical SCC metastasis of unknown primary

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5
Q

List 3 method to test for the presence of HPV in biopsy material

A

p16 IHC
HPV-DNA ISH
HPV-DNA PCR
HPV-RNA ISH
HPV-RNA PCR

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6
Q

What is the predominant HPV subtype associated with head and neck squamous cell carcinomas?

A

HPV16

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7
Q

In oropharyngeal carcinomas, what is the minimum percentage of cells with cytoplasmic and nuclear reactivity with p16 to classify the tumor as p16-positive?

A

> 70%

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8
Q

List 2 malignancies associated with hereditary diffuse gastric cancer syndrome

A

Diffuse-type gastric cancer
Invasive lobular breast cancer

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9
Q

Pattern of inheritance of HDGC

A

Autosomal dominant

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10
Q

Name gene ad protein implicated in the majority of HDGC cases

A

CDH1, E-cadherin

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11
Q

Outline the T staging criteria for gastric carcinomas

A

T1 - invades lamina propria or muscularis mucosa (1a) or submucosa (1b)
T2 - invades muscular propria
T3 - invades subserosal connective tissue
T4 - invades serosa (4a) or adjacent organs (4b)

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12
Q

3 clinical criteria used for the diagnosis of nephrotic syndrome

A

Proteinuria >3.5 g/d
Hypoalbuminemia <3 g/dl
Edema
Hyperlipidemia
Lipiduria

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13
Q

Three primary renal causes (renal diseases) of nephrotic syndrome

A

Minimal change disease
FSGS
Membranous glomerulopathy
IgA nephropathy
Membrano-proliferative GN

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14
Q

What modality is required for the diagnosis of minimal change diseases

A

Electron microscopy

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15
Q

List 3 subtypes of RPGN

A

Anti-GBM GN
Immune complex-mediated GN
Pauci-immune GN

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16
Q

List 2 most common HFE gene mutations implicated in primary hemochromatosis

A
  1. C282Y
  2. H63D
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17
Q

5 causes of secondary iron overload

A

Blood transfusions
Severe chronic hemolytic anemia
Severe thalasemia
Bone marrow failure
Aplastic anemia
MDS
Bantu siderosis
Alcoholic liver disease
Neonatal hemochromatosis
Porphyria cutanea tarda

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18
Q

List 2 most common liver complications of hemochromatosis

A
  1. Cirrhosis
  2. HCC
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19
Q

2 ancillary tests helpful in establishing diagnosis of primary hemochromatosis

A
  1. iron staining
  2. iron quantification
  3. genetic testing
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20
Q

List 4 histologic criteria for diagnosis of malignant phylloides

A

Marked stromal cellularity
Marked stromal atypia
Stromal overgrowth
>10 mitosis/10 HPF
Infiltrative boarder
Malignant heterologous stromal element

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21
Q

What tumor parameter is used for T staging phyllodes

A

Tumor size

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22
Q

3 clinical features helpful in differentiating phyllodes from fibroadenoma

A

Older age
Large size
Rapid growth
Common recurrence
Imaging findings (round, smooth borders, cystic space on ultrasound)

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23
Q

3 histologic features of complex fibroadenomas

A

Size > 3mm
Sclerosing adenosis
Epithelial calcification
Papillary apocrine metaplasia

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24
Q

List five common organ sites of tobacco associated cancers

A

NOT BREAST

larynx
cervix
bone marrow
liver
colon

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25
Q

5 non-neoplastic complications of cigarette smoking

A

Type 2 DM
Rheumatoid arthritis
Ectopic pregnancy
Erectile dysfunction
Hip fractures
Age-related macular degeneration

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26
Q

Major life-threatening complication of e-cigarette smoking

A

Acute lung injury

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27
Q

List 2 additional carcinogens that can act in synergy with tobacco consumption

A

Alcohol
Uranium
Asbestos

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28
Q

3 histologic features that define WHO grade 2 meningiomas

A
  1. 4-19 mitotic figures in 10 HPF
  2. Unequivocal brain invasion
  3. Histological subtypes - choroid or clear cell
  4. At least 3 of:
    - Increased cellularity
    - Small cell with high N:C
    - Prominent nucleoli
    - Sheeting
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29
Q

4 histologic subtypes of meningioma

A

Psammomatous
Anaplastic
Clear cell
Rhabdoid
Atypical

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30
Q

1 prognostic immunostain that can be used for meningiomas

A

Progesterone

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31
Q

2 common tumor metastases that can be found in meninges

A

Lobular breast carcinoma
Lung adenocarcinoma
Melanoma

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32
Q

List 3 histologic features of hypertrophic cardiomyopathy

A

Myocyte hypertrophy
Myofiber disarray
Interstitial fibrosis

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33
Q

List 3 gross features of hypertrophic cardiomyopathy

A

Hypertrophy
Bulging ventricular septum
Thickening of anterior mitral leaflet

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34
Q

Name 1 protein that can be affected in hypertrophic cardiomyopathy

A

Myosin-binding protein C
Beta-myosin heavy chain

35
Q

2 clinical complications of hypertrophic cardiomyopathy

A

Sudden cardiac death
Cardiac arrhythmia
Atrial fibrillation

36
Q

Define quality assurance in pathology

A

System/program that ensures the final result reported is as correct and accurate as possible and standard is met

37
Q

Define quality control in pathology

A

Tools included in every test to help detect and correct defects in the system and control the quality of the service being output

38
Q

Define proficiency testing

A

Process of evaluating the results of unknown specimens to a standard test

39
Q

Name 2 indications for p16 IHC testing in cervical biopsies

A

Differentiate between reactive mimics (e.g. squamous metaplasia) and HSIL
Professional disagreement
High risk of missing HSIL (previous high-risk cytology)
Differential between CIN1 and CIN2

40
Q

3 criteria defining block-positivity in p16 immunostain

A

Strong nuclear +- cytoplasm
Vertically from basal layers upward at least 1/3 of epithelium
Extension laterally over significant distance

41
Q

2 immunostains that can distinguish between endocervical adenocarcinoma, usual type, from endometrioid carcinoma, and pattern of expression (+/-) in endocervical adenocarcinoma

A

ER (negative)
p16 (positive)

42
Q

3 HPV-independent subtypes of endocervical adenocarcinoma

A

Mesonephric
Endometrioid
Gastric
Clear cell

43
Q

3 gross findings in Alzheimer disease

A

Generalized cortical atrophy
Ventricular enlargement
Atrophy of the structures of the medial temporal lobe
Loss of pigment in the locus ceruleus

44
Q

2 histologic hallmarks of Alzheimer disease

A

Neurofibrillary tangles
Amyloid plaques

45
Q

Form of amyloid implicated in Alzheimer disease?
Associated precursor protein?

A

Beta-amyloid protein
Amyloid precursor protein

46
Q

1 gene associated with familial Alzheimer disease and 1 chromosomal disorder associated with familial AD

A

Trisomy 21
PSEN1
PSEN2

47
Q

Region of long bones constitutes the most common predilection site for Ewing sarcoma

A

Diaphyseal-metaphyseal portion

48
Q

Classic plain radiograph finding in Ewing sarcoma

A

Onion-skin appearance

49
Q

Name the most common translocation seen in Ewing sarcoma and the resulting fusion transcript.

A

EWSR:FLI1
t(11;22)

50
Q

2 specific immunostains that can be used in the diagnosis of Ewing sarcoma

A

FLI1
NKX2.2

51
Q

2 most commonly used quality assurance indicators for intraoperative consultations

A

Turnaround time
Frozen-permanent discordance rate

52
Q

5 categories of intraoperative consultation-permanent section correlation results as recommended by the Association of Directors of Anatomic and Surgical Pathology (ADASP)

A

Agreement
Deferral - appropriate
Deferral - inappropriate
Disagreement - minor
Disagreement - major

53
Q

Acceptable rate of major intraoperative consultation-permanent section disagreement?

54
Q

2 most common causes of intraoperative consultation-permanent section discordance

A

Technical issues
Sampling errors
Interpretive errors
Incomplete/incorrect clinical history

55
Q

2 commonly used scoring systems for assessing PDL-1 IHC and corresponding formula

A

TPS
Tumor proportion score = # PDL1 positive tumor cells/total # of viable tumor cells x 100

CPS
Combined positive score = # of PDL1 positive tumor cells and tumor associated immune cells/total # viable tumor cells x 100

56
Q

For each of 2 PDL-1 scoring systems, list 1 organ system where specific scoring system is used

A

TPS - NSCLC
CPS - ENT (head and neck SCC), GU (urothelial), GI (gastric and esophageal ca), Gyne (cervical ca)

57
Q

2 normal tissues that can be used as controls for PDL-1 IHC

A

Tonsil
Placenta

58
Q

Minimum number of cases that would be required for validation of a new PDL-1 antibody within a laboratory?

59
Q

Minimum number of cases that would be required for validation of a Class I and Class II antibodies?

A

Class I - 20
Class II - 40

60
Q

2 acceptable methods for collecting samples for urine cytology

A

Voided urine
Post-instrumentation
Catheter
Ileal conduit

61
Q

2 principal indications for the use of cytology in disorders of the lower urinary tract

A
  1. Diagnosis of urothelial cancer
  2. Follow-up of patients treated for urothelial cancer
62
Q

3 entities in the differential diagnosis of atypical squamous cells in voided urine cytology

A

Degenerated balloon cells
SCC bladder
Ureteral contaminant
Gyne tract contaminant
TCC with squamous differentiation

63
Q

3 entities in the differential diagnosis for the finding of signet ring cells on voided urine cytology

A

Primary adenocarcinoma of bladder
Metastatic adenocarcinoma
Histiocytes
Degenerated urothelial cells

64
Q

3 risk factors for the development of clear cell RCC

A

Smoking
Obesity
Hypertension
Long-term dialysis
Diabetes mellitus
VHL syndrome

65
Q

List the recurrent chromosomal abnormality found in CCRCC and the affected gene

A

Chromosome 3 loss
VHL

66
Q

5 tumors in the differential of eosinophilic variant of CCRCC

A

Oncocytoma
Chromophobe RCC
Eosinophilic vacuolated tumor
LOT
Epithelioid angiomyolipoma
Tubulocystic carcinoma

67
Q

5 molecularly defined renal carcinomas

A

TFE3-rearrange
TFEB-altered
FH-deficient
SDH-deficient
ELOC-mutated
ALK-rearranged
SMARCB1-deficient

68
Q

4 histologic subtypes of endometrial cacinomas

A
  1. Endometrioid
  2. Serous
  3. Clear cell
  4. Mixed
  5. Carcinosarcoma
  6. Undifferentiated and dedifferentiated
69
Q

4 molecular subtypes of endometrial carcinomas

A
  1. Copy number high
  2. Copy number low
  3. POLE ultramutated
  4. Microsatellite instability hypermutated
70
Q

Precursor lesion of endometrioid endometrial carcinoma

71
Q

5 factors for endometrioid endometrial carcinomas

A
  1. Endometriosis
  2. Lynch
  3. Unopposed estrogen
  4. Cowden syndrome
  5. Smoking
  6. Estrogen replacement therapy
72
Q

2 benign/preinvasive mesothelial tumors

A

Adenomatoid tumor
Well-differentiated papillary mesothelial tumor of the pleura
Mesothelioma in situ

73
Q

2 malignant mesothelial tumors according to the WHO Classification of Tumors

A

Localized pleural mesothelioma
Diffuse pleural mesothelioma

74
Q

2 immunostains useful in distinguishing a reactive mesothelial proliferation from a mesothelioma

75
Q

4 IHCs helpful in differentiating mesothelioma vs adenocarcinoma

A

Mesothelioma
BAP1
WT1
D2-40
Calretinin

Adenocarcinoma
Claudin4
MOC31
BEREP4

76
Q

5 malignancies in the differential diagnosis of epithelioid mesothelioma

A

Lung adenocarcinoma
Lung SCC
EHE
Intrapleural thymoma
Melanoma
Lymphoma
Monophasic synovial sarcoma

77
Q

5 histologic subtypes of gastritis

A

Acute
Chronic
Lymphocytic
Collagenous
Eosinophilic
Granulomatous

78
Q

2 virulence factors employed by H pylori to infect gastric mucosa

A

Flagella
Urease
Adhesins
Toxins (CagA)

79
Q

Contrast H pylori gastritis to AIG with respect to
1. most common site in stomach
2. intramucosal distribution
3. acid production
4. antibodies detected in serology

A
  1. Antrum for HP, body for AIG
  2. Superficial mucosa - HP; Lower for AIG
  3. Increase of slightly decreased in HP; decreased in AIG
  4. Anti-H. pylori; Anti parietal cell ab in AIG
80
Q

2 neoplastic complications of H pylori gastritis

A
  1. gastric adenocarcinoma
  2. mucosal associated lymphoid tumor (MALT)
81
Q

Mode of inheritance of Peutz-Jeghers syndrome?

A

Autosomal dominant

82
Q

Characteristic molecular defect in Peutz-Jeghers (PJS)?

A

Germline mutation/loss of heterozygosity (LOH) in serine-threonine kinase STK11/LKB1, chromosome 19p13.3

83
Q

2 other hamartomatous polyposis syndromes of the gut aside from Peutz-Jegher’s?

A

Juvenile polyposis
Juvenile polyposis/hereditary hemorrhagic telangiectasia (HHT) syndrome
Cronkhite-Canada syndrome
Cowden syndrome

84
Q

Excluding the GI tract, list 4 specific body sites at highest risk for the development of carcinoma in patients with Peutz-Jeghers

A

Breast
Pancreas
Ovary
Lung
Uterine cervix
Endometrium
Testis

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