Block II - Path II

Question 1

What are risk factors for RCC?

Answer 1

Smoking, cadmium, plastic factory

Question 2

What are risk factors for TCC?

Answer 2

Smoking, beta-naphthylamine

Question 3

What is a risk factor for a young, Middle-Eastern male for squamous cell carcinoma of the bladder?

Answer 3

Schistosoma hematobium

Question 4

What type of growth is TCC?

Answer 4

Papillary, cauliflower like.

Question 5

What is clear cell carcinoma of the kidney associated with, and what subset is it?

Answer 5

VHL, oncogene; induce HIF, Chromosome 3. Subset of RCC

Question 6

What is a risk factor for HCC?

Answer 6

Aflatoxin; found in peanuts, inhibits TP53 (also Hepatitis B, and Hepatitis C)

Question 7

What is the gene associated with cavernous hemangioma?

Answer 7

VHL gene; HIF, Chr 3.

Question 8

What is a risk factor for cholangiocarcinoma; and what is it associated with?

Answer 8

Opisthorcoris, ulcerative colitis and primary sclerosing cholangitis

Question 9

What is the marker for HCC?

Answer 9

Alpha-fetoprotein

Question 10

Mode of transmission of Hep C?

Answer 10

Primarily blood; through IV Drug Use, and post-transfusion

Question 11

Mode of transmission for Hep B?

Answer 11

Parenteral (blood), sexual (baby-making), perinatal (birthing)

Question 12

Acute Hep B markers:

Answer 12

HBsAg, HBeAg, Anti-HBc of IgM

Question 13

Window Hep B markers:

Answer 13

Anti-HBe, Anti-HBc of IgM

Question 14

Chronic HBV (high infectivity):

Answer 14

HBsAg, HBeAg, Anti-HBc of IgG

Question 15

Chronic HBV (low infectivity):

Answer 15

HBsAg, Anti-HBe, Anti-HBc of IgG

Question 16

Recovery Hep B markers:

Answer 16

Anti-HBs, Anti-HBe, Anti-HBc of IgG

Question 17

Immunized Hep B marker:

Answer 17

Anti-HBs

Question 18

What is fibrinous pericarditis composed of?

Answer 18

Exudate; fibrinogen, PMN’s, IL-6.

Question 19

Name 3 things that affect the tubules:

Answer 19

ATN (mainly PCT), Rhabdomyolysis, and Snake Venom

Question 20

Name 2 things that affect the glomerulus:

Answer 20

PSGN and HUS (via MAHA, forms thrombus in glomerulus)

Question 21

What does Renal Papillary Necrosis affect?

Answer 21

The collecting duct

Question 22

If you have Renal Artery Stenosis without complete occlusion, what type of azotemia is it?

Answer 22

Pre-Renal

Question 23

Non-neoplastic causes of hypercalcemia:

Answer 23

Sarcoidosis (due to increased D3), Padget, and Primary Parathyroidism

Question 24

Neoplastic causes of hypercalcemia:

Answer 24

Renal Cell Carcinoma, Breast Carcinoma, and Squamous Cell Carcinoma

Question 25

What does parathyroid hyperplasia occur in ADPKD?

Answer 25

Chronic Renal Failure causing a decreased Vit D3, and secondary parathyroidism

Question 26

What signifies hydronephrosis?

Answer 26

Dilation of calyx system

Question 27

Obstructive bilateral causes: Male (Adult)

Answer 27

BPH

Question 28

Obstructive bilateral causes: Female (Adult)

Answer 28

Invasive cervical carcinoma

Question 29

Obstructive bilateral causes: Child

Answer 29

Obstruction; or posterior urethral valves

Question 30

What is affected in the kidney if the patient just has Diabetes?

Answer 30

The vessels due to hyaline arteriosclerosis; essential HTN, benign nephrosis and DM cause hyaline.

Question 31

Where do drug analgesics affect the kidney?

Answer 31

Tubules and Interstitium

Question 32

Where does tophi affect the kidney?

Answer 32

Mainly interstitium

Question 33

Where does Amyloid affect the kidney?

Answer 33

Vessels

Question 34

Where does pyelonephritis affect the kidney?

Answer 34

Pelvis, Tubules, Interstitium

Question 35

What are two other causes of Renal Papillary Necrosis?

Answer 35

Sickle Cell Disease and Analgesic Abuse

Question 36

What causes septic shock in acute pyelonephritis?

Answer 36

Peripheral vasodilation

Question 37

Fever, Rash, Eosinophilia, and Renal Abnormality:

Answer 37

Drug-Induced Nephritis

Question 38

Fever, Rash, PMN, and Renal Abnormality

Answer 38

Post-Streptococcal Glomerulonephritis

Question 39

Cause of TTP:

Answer 39

ADAMST13 (metalloprotease that cleaves vWF for adhesion) deficiency; microthrombi with low platelets and increased bleeding time (hemolytic anemia, thrombocytopenia, ARF)

Question 40

What type of necrosis is Diffuse Cortical Necrosis and what is it seen in?

Answer 40

Coagulative; abruptio placentae, DIC.

Question 41

What could reticulocytosis be due to?

Answer 41

Juvenile RBCs; could be due to hemolysis or Vit B12 therapy

Question 42

Iron Deficiency Anemia labs:

Answer 42

Decreased ferritin, increased TIBC

Question 43

Anemia of Chronic Disease labs:

Answer 43

Increased ferritin, decreased TIBC

Question 44

Features of B-thalassemia major:

Answer 44

“Crew-cut” appearance on X-ray; none/very low HbA, elevated HbF

Question 45

What can myeloid metaplasia result in?

Answer 45

Hemolysis

Question 46

What can paranoctornal hemoglobinuria lead to?

Answer 46

Gpi-linked complement deficiency (DAF= CD55/59); chronic hemolysis without dramatic hemoglobinuria; intravascular hemolysis; can cause venous thrombosis in hepatic, portal, or cerebral veins

Question 47

What is MAHA caused by?

Answer 47

TTP, HUS, DIC, and hemolysis in a major blood vessel (such as aorta)

Question 48

Where are Howell-Jolly bodies present? And what is this patient at risk for?

Answer 48

Autospleenectomy in sickle-cell; and recurrent infections by Strep Pneumo, Haemophilius, and Neisseria meningitidis

Question 49

What is aplastic criss caused by and where would you see it?

Answer 49

Parvovirus B19; Sickle-Sell and B-thalassemia

Question 50

Asplastic anemia presents how?

Answer 50

Hypoplastic bone marrow; no splenomegaly or reticulocytes; so fatty marrow

Question 51

Feature of lead poisoning:

Answer 51

Basophilic stippling

Question 52

Where is pancytopenia seen?

Answer 52

Pure red cell aplasia, hyperspleenism, and aplastic anemia