biochem + pathology

Question 1

tendon xanthomata

Answer 1

specific to familial hypercholesterolaemia
- if detected, pathopneumonic

Question 2

the efficacy of antidopaminergic antipsychotic drugs correlates with the degree of prolactin elevation - true or false

Answer 2

true

Question 3

why does Separated plasma and serum give different potassium results in patients with clotting disorders

Answer 3

plasma – specimen hasn’t clotted – all you’ve done is spin down the cells

serum – specimen HAS clotted before you spin down the cells

Question 4

investigation pseudokalaemia

Answer 4

multiple blood samples hould be taken simultaneously in hospital + spun down at different times post collection

Question 4

investigation pseudokalaemia

Answer 4

multiple blood samples hould be taken simultaneously in hospital + spun down at different times post collection

Question 5

hyperplasia

Answer 5

increase in cell number
- Prostatic hyperplasia
- Thyroid hyperplasia - Graves
- G cell hyperplasia in stomach – occurs with PPIs as the negative feedback loop is turned off stimulating gastrin release
o –> G cells = the pale white fried egg cells lining the gastric crypts

Question 6

dysplasia

Answer 6

benign, abnormal growth

->  Essentially means the cellular DNA has begun to accumulate mutatations but hasn’t yet developed ability to invade

Question 7

metaplasia

Answer 7

= a reversible change from one mature cell type to another in response to a stimulus

• Barretts oesophagus -> squamous epithelium replaced by columnar epithelium
• Squamous metaplasia of respiratory tree, not normally any squamous epithelium there
  o SCC occurs on a background of metaplasia first

Question 8

microsatellite instability

Answer 8

Microsatellite instability = number of repeated DNA bases in a microsatellites (a short, repeated sequence of DNA) is different from what it was when the microsatellite was inherited
- Surrogate marker for an error in mismatch repair proteins
- Once MSI is detected, genes can be sequenced

• Microsatellite instability occurs in most HNPCC

Question 9

leiomyomas

Answer 9

benign neoplasms of smooth muscle

• Connective tissue tumour so consist of spindle cells
• Super common
• Oestrogen dependent – between menarche + menopause
• Can arise submucosally + project into lumen – bleeding, can occasionally as as IUD with infertility

Question 10

CIN + CGIN

Answer 10

CIN = cervical intraepithelial neoplasia  relates to squamous abnormality

CGIN = cervical glandular intraepithelial neoplasia

Question 11

HPV positive smear down the microscope

Answer 11

Shows “koilocytic” change
- Irregular nuclei with binucleate forms + strange perinuclear halo
- Darker than normal staining pattern in nucleus - hyperchromasia

Koilocytosis = cellular events caused by infection with HPV

Question 12

ovarian surface epithelial tumours

Answer 12

commonest ovarian tumour

serous
mucinous
endometriod
cystadenocarcinoma

Question 13

ovarian germ cell tumour

Answer 13

teratoma
dysgerminoma

age >25yrs

Question 14

ovarian sex cord, stroma cell tumours

Answer 14

all ages

fibroma
granulosa-theca cell
sertoli-leydig cell tumour

Question 15

what type of tumour is leydig cell tumours

Answer 15

stroma cells
- assoc with testes where they are incolved in testosterone conversion + stimulation of sertoli cells

Question 16

which inflammatory cell do we assoc most with a reaction to foreign material

Answer 16

macrophages

Question 17

granuloma

Answer 17

• A coalescence of macrophages with surrounding lymphocytes

Lots of disease that cause it
o On often forgotten is in relation to exogenous material

Question 18

what type of tumour is choriocarcinoma

Answer 18

type of germ cell tumour

50% occur after molar pregnancies

Question 19

“signet ring cells”

Answer 19

adenocarcinoma
- cos contain so much mucin

Question 19

“signet ring cells”

Answer 19

adenocarcinoma
- cos contain so much mucin

Question 20

subclinical hypothyroidism

Answer 20

TSH is high but still manage to stimulate enough T4 productions

Question 21

“FNA contains abundant colloid + scattered sheet + aggregate of thyroid follicular epithelial cells. Many of the cells exhibit oncocytic change. In the background, abundant lymphocytes are present.”

Answer 21

thyroiditis

Epithelial cells should be there
- Oncocytic change is not uncommon in thyroiditis – Hurthle cells

o Lymphocytes = inflammation

Question 22

histology of papillary carcinoma

Answer 22

black broken substnce = calcium
–> psammomatous calcification

nucleic appear very pale with central clearing –> commonly called orphan annie nuclei
- nuclear grooves + inclusions

Question 23

tender lymph nodes is an indication of …

Answer 23

infection

Question 24

antibiotics for glandular fever

Answer 24

penicillin V