Deck 1 Flashcards
Acquired factor deficiency in patients with systemic amyloidosis?
Factor X
McCune-Albright Syndrome and mutation?
Polyostotic fibrous dysplasia, cutaneous spots, and endocrinopathy. Mutation in GNAS1.
Viral cause of hemorrhagic cystitis?
Adenovirus type 11
Most common cause of traveler’s diarrhea?
ETEC
Most common cause of bacterial enteritis?
Campylobacter jejuni
What is a Phase II citation?
Requires documented corrective action within 30 days.
What is a Phase I citation?
Must be corrected by the next internal inspection.
What 3 groups of patients qualify for medicare?
- Age 65 and older
- Permanently disabled
- ESRD
What does medicare part A cover?
inpatient care excluding physician services
What does medicare part B cover?
Outpatient services and inpatient physician services
Technical charges for an inpatient are reimbursed under?
DRG
Causes daisy head orangophillic structures on Pap?
Tyrosine crystals of pleomorphic adenoma.
IHC profile of GI inflammatory polyps?
The spindle-shaped stromal cells are positive for CD34 and vimentin, while they are negative for CD117. A variable number are focally positive for smooth muscle actin and CD68.
MUC staining in intestinal adenomas?
MUC2 positive
MUC1 and MUC5ac negative
MUC staining in pancreatobililary adenocarcinomas?
MUC2 negative
MUC1 and MUC5ac positive
Recurrence rate for Pleomorphic Adenoma with positive margin?
Up to 1/3 of cases (old data), better now.
Poorly circumscribed dermal tumors composed of irregularly shaped islands and cords of basaloid cells that fit together like the pieces of a jigsaw puzzle.
Cylindromas
Adult classic seminomas, nonseminomatous, and mixed germ cell tumors are characterized by these two features?
intratubular germ cell neoplasia and i(12p).
IHC profile of medullary thyroid carcinoma?
- Thyroglobulin negative
- Calcitonin, carcinoembryonic antigen (CEA), chromogranin, synaptophysin, and thyroid transcription factor 1 (TTF-1).
What virus causes molluscum contagiousum and what is the inclusion called?
Pox-virus (molluscum contagiosum virus)
Henderson-Patterson bodies
What is the hallmark alteration in oligodendrogliomas?
Concurrent deletion of chromosomal arms 1p and 19q
Persistence of amyloid beyond 5 days is suggestive of?
Pancreatic Pseudocyst
Amylase or lipase is most specific for pancreatitis?
Lipase
Increased Amylase
Normal CEA
Increased CA 19-9
Indicative of which pancreatic cyst?
Pseudocyst
Decreased Amylase
Decreased CEA
Decreased CA 19-9
Indicative of which pancreatic cyst?
Serous cystadenoma or Solid pseudo papillary tumor
Normal Amylase
Increased CEA
Increased CA 19-9
Indicative of which pancreatic cyst?
Mutinous cystadenoma
Increased Amylase
Increased CEA
Normal to increased CA 19-9
Indicative of which pancreatic cyst?
IPMN
What are Heinz bodies and what stain is used to observe them?
- Denatured hemoglobin
- Supravital stains
How long must cytology slides retained?
5 years
Translocation observed in nodular fasciitis and aneurysmal bone cyst?
t(17;22) - MYH9-USP6
What stain is specific for infantile hemangioma?
GLUT-1
What is the most common post-radiation sarcoma?
Undifferentiated pleomorphic sarcoma
Alicia blue at pH 2.5 stains which cells?
Goblet cells
Microscopic colitidies are more prominent in which portions of the colon?
Right and transverse colon
Duret hemorrhages result from?
Uncal herniation
True or false: MelanA stains the adrenal cortex?
True
Characteristics of IgG and IgM in regards to complement fixation and hemolysis pattern?
IgM - readily fixes complement and result in intravascular hemolysis
IgG - doesn’t as readily fix complement and results in extravascular hemolysis
What proportion of cases of arrhythmogenic cardiomyopathy are inherited in an AD manner?
Approximately half of cases of arrhythmogenic cardiomyopathy are autosomal dominant
What is lymphomatoid granulomatosis?
Epstein-Barr virus-positive pulmonary lymphoma of B-cell origin. Lymphomatoid granulomatosis is a nodular pulmonary process characterized by vasculocentric necrotic nodules. The vessels can often show lifting of endothelium by the invading lymphocytes. The skin and CNS can also be involved.
What is the most common malignant salivary gland tumor overall?
Mucoepidermoid carcinoma
What is the most common malignant salivary gland tumor of the parotid?
Mucoepidermoid carcinoma
What is the most common malignant salivary gland tumor of the submandibular and sublingual glands?
Adenoid cystic carcinoma.
Name two syndromes associated with fibrothecoma?
Meigs syndrome (fibroma, ascites, and right hydrothorax) and Gorlin (basal cell nevus) syndrome.
What are the characteristic histopathologic findings of lupus erythematous skin involvement?
vacuolar (hydropic) alteration of the basal layer of the epidermis, a thickened basement membrane zone, interstitial mucin deposition in the dermis, and a lymphocytic inflammatory infiltrate
CD34 staining in DFSP.
Positive
CD34 staining in DF?
Negative
What is the most common lymphoma of the thyroid?
DLBCL
t(15;17) is seen in?
Acute promyelocytic leukemia
Age associated with good and poor prognosis in neuroblastoma?
Good <1 yo
Poor >5 yo
MKI index considered intermediate in neuroblastoma?
100-200
MKI index considered high in neuroblastoma?
> 200
Anti–Saccharomyces cerevisiae antibody (ASCA) test is associated with which type of IBD?
Crohn’s disease (65% of patients, only 15% in UC)
What rheumatologic condition may have organizing pneumonia?
RA
When are glycjogenated hepatocytes seen?
Diabetics with poor glucose control.
What is the commonest and second most common locations for rhabdomyosarcoma?
- head and neck (50%)
2. GU (30%)
The top three locations of GI carcinoid tumor?
- Small intestine
- Appendix
- Rectum
IHC profile of carcinoid tumor (and one additional stain in rectal carcinoids)?
positive for synaptophysin, chromogranin, and neuron-specific enolase
Rectal carcinoids are positive for PAP, but not PSA
Basophilic stippling can be found in which conditions?
lead intoxication, thalassemias, hemoglobinopathies, myelodysplasias, and megaloblastic anemia.
PFA-100 result:
• ADP normal and EPI normal =
Normal
PFA-100 result:
• ADP normal and EPI abnormal =
aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS)
PFA-100 result
• ADP abnormal and EPI abnormal =
Bernard Soulier (BS) syndrome, Glanzmann thrombasthenia, von Willebrand disease, and so on.
In regards to pathophysiology, HSP is considered a systemic form of?
IgA nephropathy
HSP symptoms include
Purpura (predominantly involving the lower extremities), arthralgias, abdominal pain, and hematuria.
What is the finding in skin in patients with HSP?
Leukocytoclastic vasculitis with IgA deposition.
Immunohistochemically, clear cell renal cell carcinoma is positive for?
epithelial membrane antigen (EMA)+, Pan CK/Cam 5.2+, CK7/20 -, Carbonic Anhydrase 9 (CA-9+, Vimentin+, CD10+, RCC+, Pax-2+, and Pax-8+.
Loss of short arm of chromosome 3 is seen in?
Clear cell RCC associated with VHL.
What molecule is the receptor for EBV entry into the cell?
CD21
What are the genes associated with MHC 1
HLA-A, -B, -C
What cells have MHC-1 on their surface?
All nucleated cells.
MHC-1 presents what peptides?
Internal self-peptides and viral peptides
Cytotoxic CD8+ T cells recognize which MHC?
MHC-1
What are the genes associated with MHC 2
HLA-DR, -DP, -DQ
What cells have MHC-2 on their surface?
APCs
MHC-2 presents what peptides?
Exogenous
CD4+ T cells recognize which MHC?
MHC-2
A differentiating characteristic of A. fumigatus is its ability to grow at XX°C.
45°C
Cysticercosis is caused by?
pork tapeworm, Taenia solium
Virus most commonly implicated in endocervical neoplasia?
HPV-18
Virus most commonly implicated in squamous cervical neoplasia?
HPV-16
Fibrous dysplasia does or does not have osteoblast rimming?
Does not have
What is Kasabach-Merritt Syndrome?
Angiomatosis resulting in thrombocytopenia and consumptive coagulopathy.
What jaw tumor is associated with nevoid basal cell carcinoma syndomre?
Odontogenic keratocyst.
How do Erhheim-Chester disease histiocytes stain in regards to S100 and CD1a?
Variable S100 positivity, negative for CD1a.
What infection is associated with pulmonary alveolar proteinosis?
Nocardia
The most common cause of lymphocytic myocarditis?
Viral myocarditis.
Aggregates of large histiocytes with basophilic cytoplasm, vesicular nuclei, and a central bar of chromatin in the myocardium represent a?
Aschoff body
What cells make up the Aschoff body?
Anitschow
EM finding associated with anthracycline cardiotoxicity?
sarcotubular dilatation
Liver findings in AD and AR PKD?
AD: hepatic cysts
AR: congénital hepatic fibrosis
Klippel-Trenaunay syndrome is associated with what kidney tumor?
Hemangioma
Tuberous sclerosis is characterized by?
AML of the kidney, cardiac rhabdomyoma, and adenoma sebaceum
What is the most common germ cell tumor in prepubescent boys?
Yolk sac tumor
How much blood is usually collected at a donation and what volume constitutes a short filled unit?
Normal: 450 +/- 50
Short filled: 300-404
A receiving blood bank must complete what testing on blood units?
ABO and Rh typing
Anti-B test reagent color
Yellow
Anti A test reagent color
Blue
How many antigens must be tested on an antibody panel?
at least 18
How long can infant blood need not be crossmatched?
4 months
What may happen if LR is transfused in the same line as blood products?
Thrombosis
What may happen if Dextrose or hypotonic solutions are transfused in the same line as blood products?
hemolysis
Most common cause of community acquired pneumonia?
S. pneumoniae
Common pathogens causing pneumonia in patients with COPD?
H. influenzae, M. catarrhalis, Legionella
Most common cause of croup?
Parainfluenza virus
Most common cause of bronchiolitis in children?
RSV
Platelet adhesion is mediated by?
GP1b - vWF receptor
GB1a-IIa - collagen receptor
Platelet aggregation mediated by?
GBIIb-IIIa - fibrinogen receptor
What activates GBIb in vivo and in vitro?
In vivo - shear forces
In vitro - ristocetin
What do platelet alpha granules contain?
Fibrinogen, PDGF, vWF, P-selectin, PF-4
What do platelet dense granules contain?
ADP, ATP, Ca2+, and 5-HT
How is the extrinsic coagulation cascade “linked” to the intrinsic cascade?
Factor VIIa is capable of activating IX to IXa
What markers are on the lymphoid stem cell?
CD34+, TdT+, HLA-DR+
Pro-B cell immunophenotype?
CD34+, TdT+, HLA-DR+
CD19+, CD10+
Pre-B cell immunophontype?
CD34-, TdT-, HLA-DR+
CD19+, CD10+, CD20+
B cell immunophonotype?
CD34-, TdT-, HLA-DR+
CD19+, CD10+, CD20+, CD21+, CD22+ surface Ig
Plasma cell phenotype?
CD34-, TdT-, HLA-DR+
CD19-, CD10-, CD20-, CD21-, CD22- cytoplasmic Ig
Pro-thymocyte immunophyenotype?
CD34+. TdT+, CD7+
Immature/common thymocyte immunophenotype?
CD34-, TdT+, CD7+
CD1+, CD2+, cCD3+, CD3-, CD5+. CD4+. CD8+
Mature thymocytre/T cell immunophynotype?
CD34-, TdT-, CD7+
CD1-, CD2+, CD3+, CD5+. CD4 or CD8+
What immunoglobulins are on the surface of B cells?
IgM and IgD
What percentage of the peripheral blood lymphocytes are T cells?
65%
Normal CD4 to CD8 ratio?
2:1
95% of T cells carry this receptor while the other 5% this receptor?
95% - alpha beta
5% - gamma delta
TCR expressed in association with this CD molecule?
CD3
What is the major and minor normal adult hemoglobins?
HbA and HbA2
What makes up hemoglobin A?
alpha2 beta2
What makes up hemoglobin A2?
alpha2 delta2
What makes up hemoglobin F?
alpha2 gamma2
What is the incidence of HbS trait in african americans?
10%
What is hemoglobin S?
Beta chain allele with encodes valine in place of glutamate at position 6
What does hemoglobin SA electrophoresis look like?
35-45% HbS, 50-65% HbA, <3% HbA2
How long do red cells survive in HbSS?
17 days
What does hemoglobin SS electrophoresis look like?
> 80% HbS, 1-20% HbF, 1-4% HbA2, 0% HbA
What is hemoglobin C?
Beta chain allele with encodes lysine in place of glutamate at position 6
What is the second most common abnormal hemoglobin after S and what is its structure?
Hemoglobin E - beta26 (glu-lys)
Which hemoglobins run with S on alkaline gel?
HbD and HbG and Lepore
15% hemoglobin S is questionable for?
Hemoglobin Lepore
What is Hb Lepore and how does it present clinically?
Fusion of delta and beta genes
It presents with thallasemic indices
What abnormal hemoglobin is characterized by a mutation in the alpha gene which produces an abnormally long transcript?
Hb constant springs
What shifts the oxygen dissociation curve to the left?
Alkalosis
Hypothermia
Decreased 2,3 DPG
What shifts the oxygen dissociation curve to the right?
Acidosis
Hyperthermia
increased 2,3-DPG
What is methemoglobin and how is it treated?
Hemoglobin with Fe3+ instead of Fe2+, cannot bind O2
Tx: Methylene blue
What level of Hi can cause cyanosis?
10%
What level of SHb can cause cyanosis?
3-4%
What bacterial infection is associated with sulfhemoglobin?
C. perfringens bacteremia
What HbCO level is expected in a smoker?
2-6%
Symptoms of carboxyhemoglobin start at this level and become fatal at this level?
Symptoms: 10-20%
Fatal: 50%
What is DNA methylation and what is its effect?
Methylation affects cysteine moieties location in CpG island which leads to decreased transcription - basis of epigenetic modification
Histone acetylation has what effect on DNT?
increased DNA transcription
Most common cause of hospital acquired endocarditis?
Enterococcus
Most common genetic abnormalities in CMML?
trisomy 8, monosomy 7
CD34 and BCL-2 staining in solitary fibrous tumor?
Positive
What is the two most common genetic alterations in BE?
- inactivation of the p16 INK4A/CDKN
- loss or mutations of p53
What is the risk of cancer in patients with BE with and without dysplasia?
- without dysplasia, is approximately 2%.
- high-grade dysplasia ranges from 16% to 59%.
How is the anion gap calculated?
Anion gap = Na+–(Cl– + HCO3–)
How is the standard deviation index calculated?
SDI = (lab result – peer group mean)/peer group standard deviation.
What is accuracy?
How close a value is to the true value?
What is precision?
How reproducible is the value?
What is the immunophenotype of MF?
CD2+, CD3+, CD4+, CD5+, and CD8− T-cell infiltrate. Lesions often show an absence of CD7
MF with CD30+ cells indicates?
Poor Prognosis.
Immunophenotype of CLL/SLL
CD19 positive, CD20 positive (dim), CD5 positive, CD23 positive, CD43 positive/negative, FMC7 negative to dim, and dim surface light chain immunoglobulin expression.
Howell-Jolly Bodies represent ______ and are seen in patients with _________?
DNA, asplenia
AML with in(16) results in this morphology, is associated with this genetic abnormality, and portends a better or worse prognosis?
Prominent eosinophils are seen
CBFB-MYH11 fusion protein
Good prognosis
Typical staining of adenoid cystic carcinoma of the breast?
ER, PR, Her2 negative
CD117+
Patients with adenoid cystic carcinoma of the breast have a _______ prognosis?
Good
Invasive cribriform carcinoma of the breast has a favorable or unfavorable prognosis?
Favorable
The low grade neoplasia pathway in breast pathology is associated with this genetic aberration?
loss of 16q
Which one of the following is most commonly associated with transfusion-transmitted sepsis after transfusion of red blood cells (RBCs)?
Yersinia enterocolitica
APC gene mutations are associated with these syndrome?
FAP, Gardner Syndrome, Turcot Syndrome
Genetic mutation seen in Putz-Jegher Syndrome?
STK11
How do you calculate a likelihood ratio?
Sensitivity/(1-specificity)
How do you calculate post-test probability?
post-test odds = pretest odds × likelihood ratio
How do you calculate pre-test odds?
pretest odds = [pretest probability/(1 – pretest probability)]
or
pretest odds = [disease prevalence/(1 – disease prevalence)]
According to the Clinical Laboratory Improvement Amendments of 1988 (CLIA’88), point-of-care testing (POCT) programs must keep their records of all quality control activities for at least ____________.
2 years
Hyperleukocytosis has what effect on potassium levels?
Pseduohyper or hypokalemia?
What causes primary hyperparathyroidism in 85% of patients?
A single parathyroid adenoma.
Postinfantile giant cell transformation (PIGCT) of the liver is seen in?
autoimmune hepatitis, HCV infection with or without HIV confection, drug hepatotoxicity
Immunoprofile of HCC?
CK7/20 - HepPar1 + polyclonal CEA + Glypican3 + HSP70+
Typical IHC profile of chromophobe carcinoma?
CK7+, CK20-
KIT+
PAX2-
Colloidal iron+
Typical genetics of chromphobe carcinoma?
Loss of multiple chromosomes
Flow cytometric diagnosis of PNH relies on identification of decreased levels of these two red cell surface proteins?
CD55, CD59
grading of endometrioid adenocarincoma?
Grade 1: <5% solid
Grade 2: 5-50% solid
Grade 3: >50% solid
Fusobacterium nucleatum is ________ for indole reactionn and _________ for lipase reaction?
Positive for both
What is the most frequent translocation in Endometrial stromal sarcoma?
t(7;17)(p15;q21) resulting in a JAZF1/SUZ12 fusion product.
p16 staining in micro glandular hyperplasia?
negative
IgA IF pattern in dermatitis herpetiformis?
Granular
Order engraftment time from shortest to longest amounts these HPSC collection techniques: cord-derived, peripheral blood-derived, marrow-derived?
peripheral blood
marrow
cord
Order risk of GVHD from greatest to least regarding these HPSC collection techniques: cord-derived, peripheral blood-derived, marrow-derived?
Peripheral blood
marrow
cord
Classify these cytogenetic aberrations in CLL/SLL as either good or bad prognostic indicators: del13q, del TP53(17p13), monosomy 13, and deletion ATM (11q22)?
- deletion 13q or monosomy 13 predict a good prognosis.
- TP53 (17p13) and ATM (11q22) deletions individually, or in combination, predict a poor response to treatment.
IHC profile of DSRCT?
variable positivity for several keratins, EMA, desmin, NSE, and vimentin and shows consistent nuclear expression of WT1-C
Fusion partners in DSRCT t(11;22)?
EWS and WT-1
Neutrophils are activated mostly by this cytokine?
IL-8
Eosinophilic inflammation is driven by this cytokine?
IL-5
The complement factor acts as an opsonin and leads to phagocytosis of the foreign substance?
C3b
These complement members make up the membrane attack complex?
C5-C9 (C5b6789)
These two complement proteins promote the release of histamine from basophils and are referred to as anaphylatoxins?
C3a and C5a
What is the genetic locus of the MHC?
Chromosome 6p
What is typical in thalassemia regarding: Hemoglobin and Hematocrit: RBC Count: MCV: Peripheral Smear:
Hemoglobin and Hematocrit: low
RBC Count: normal to elevated
MCV: lower than in IDA
Peripheral Smear: microcytosis, target cells, basophilic stippling
The type of antibody in WAIHA is a ______ typically with broad reactivity against ___________
IgG, Rh antigens
The type of antibody in CAD/CAIHA is a ______ typically reactivity against ___________
IgM, I antigen
CAIHA with anti-I or Anti-i can be caused by these viruses?
Anti-I: mycoplasma pneumonia
Anti-i: EBV
Peripheral blood neutrophils with phagocytosed RBCs is seen in?
Paroxysmal cold hemoglobinuria
What is the Donath-Landsteiner Antibody?
IgG biphasic hemolysin with anti-P specificity
What are cryoglobulins?
Immunoglobulins that precipitate reversibly at low temperatures
What is type 1 cryoglobulinemia?
Monoclonal immunoglobulins seen in multiple myeloma of Waldenstroms macroglobulenemia
What is type 2 cryoglobulinemia?
Monoclonal IgM and polyclonal IgG
IgM has RA activity (anti-IgG)
What is type 3 cryoglobulinemia?
Mixture of w polyclonal immunoglobulins
Mutations in this gene are associated with PNH?
PIG-A
LAP score in PNA?
Low
Translocation and fusion partners in PNET/Ewing’s sarcoma
t(11;22)(q24;q11) - FLI-1 and EWS
translocation in Clear Cell Sarcoma?
t(12;22)
translocation in secretory carcinoma of the breast and mammary analog secretary carcinoma of the salivary gland?
t(12;15) ETV6-NTRK3
t(11;19) - CRCT1-MAML2 is seen in which head and neck malignancy?
Mucoepidermoid carcinoma.
Mutations in this protein lead to hereditary hemochromatosis?
HFE
Bacteria commonly found with T. vaginalis infection?
Leptothrix
Quad screen results expected in trisomy 18?
All normal or decreased
What cell is used to culture C. trachoma’s?
McCoy
What are Donovan bodies?
Bipolar stained rods in macrophages or monocytes in Donovan’s disease
Appearance of V. cholerae on TCBS agar and what does that colony color indicate?
Yellow, sucrose fermentation
The most common translocation and partners seen in ALCL?
t(2;5) - NPM-ALK
ALK rearrangement in lung adenocarincomas is associated with these fusion gene?
ALK/EML4
Expected normal platelet aggregometry response to ristocetin 0.8 mg/mL and 1.2 mg/mL?
- 8 - little response
1. 2 - aggregation
A poor response to all agonists except ristocetin is indicative of?
Glanzmann thrombasthenia
A response to everything but ristocetin is indicative of?
vWD or Bernard-Soulier Syndrome
The majority of immunodeficiencies affect ________ as they are typically inherited in this manner?
boys, x-linked
Recurrent bacterial infections, especially of the upper aerodigestive tract, as well as chronic G. intestinalis infection may indicate?
And immunoglobulin or B cell defect
Increased susceptibility to viral or fungal opportunistic infections can be seen with defects in?
T cells
Defects in this system lead to infection with catalase positive organisms?
Phagocyte system
Defects in this portion of the innate immune system leads to infection with encapsulated bacteria?
Terminal complement disorders
Staining profile of PLGA?
S100 and EMA - strong and diffuse
CEA - variable
CKIT - weak positive
Staining profile of adenoid cystic carcinoma of the salivary gland?
S100 - variable
EMA and CEA - luminal cells
CKIT - strongly positive
t(8;21) results in this morphology in AML?
Myeloblasts with neurtophillic differentiation
What are the fusion partners in t(8;21) AML?
RUNX1-RUNX1T1
Myelomonocytic or monocytic differentiation in AML may be due to this translocation?
t(9;11)
Gliomas may stain with this cytokeratin?
AE1/AE3 due to cross reactivity with GFAP
Desmoplastic melanomas stain for these melanoma markers?
S100 and SOX10
These coagulation factors of the intrinsic pathway does not result in clinically significant bleeding when deficient?
prekallikrein, factor XII, and high-molecular-weight kininogen
Immunoreactivity of meningiomas?
EMA and vimentin positive
T. whippeli gram stain?
gram+, classified as an actinomycete
Where do atypical fibroxanthomas occur and who gets them?
atypical fibroxanthomas (AFXs) occur in the dermis of the sun-damaged skin of older individuals
IHC profile of atypical fibroxanthoma?
CD34 negative, and express myofibroblastic markers, such as smooth muscle actin (SMA)
Number of cells required in a conventional pap?
8,000-12,000
Number of cells required in a thin-prep pap?
5000
Triad observed in toxoplasma lymphadenitis?
follicular hyperplasia
clusters of epithelioid histiocytes
infiltration of monocytoid B cells
FDA irradiation requirements for blood products?
15 Gy to periphery of unit, 25 Gy to center of unit
Group A has this added to its carbohydrate moiety to make it group A.
N-acetylgalactosamine
Group B has this added to its carbohydrate moiety to make it group B.
Galactose
Homocysteine and methymalonic acid levels in B12 and folate deficiency?
B12: elevated MMA and Homocysteine
Folate: normal MMA and elevated homocysteine
MEN2B consists of?
medullary thyroid carincoma, pheochromocytoma, and multiple ganlglioneuromas.
MEN1 consists of?
pancreatic neuroendocrine tumors
pituitary adenomas
parathyroid hyperplasia
MEN2A consists of?
medullary thyroid carincoma, pheochromocytoma, parathyroid hyperplasia
What syndrome has multiple colon polyps and brain tumors?
Turcot syndrome
either associated with FAP or Lynch syndrome
What syndrome is characterized by multiple colon polyps, jaw tumors, and fibromatosiss?
Gardner’s syndrome
associated with APC gene
The most common malignant sarcoma primary to the heart is?
Angiosarcoma
t(x;17) is seen in?
ASPS TFE-ASPL
Myelomonocystic leukemia would be positive for these markers?
CD11c CD64, CD33 and CD13.
What happens to hepcidin levels when a patient has hemochromatosis.
levels are low
• Microcytosis + normal iron studies + normal hemoglobin fractionation pattern (no variants; hemoglobin A, A2, and F within the reference range) is a presumptive diagnosis of?
α-thalassemia trait.
• Microcytosis + normal iron studies + elevated hemoglobin A2 is a presumptive diagnosis of?
β-thalassemia trait.
Transient abnormal myelopoeisis observed in trisomy 21 is associated with myeloid proliferation typically of this lineage?
Megakaryocytic
Mutations in this gene are seen in patient’s with trisomy 21 with myeloid neoplasms?
GATA-1
cytokeratins expressed in clear cell rcc?
CK8, CK18
Thiamine deficiency can lead to this gross finding in the brain?
atrophy of the mammillary bodies
Serum ceruloplasmin levels and urinary copper levels in Wilson’s disease?
Ceruloplasmin - low, urine Ca2+ elevated
Mutations in this gene cause Wilson’s disease?
ATP7B
Flow cytometric diagnosis of Glanzmann thrombasthenia is done by identifying loss of either of these markers?
GPIIb (CD41) and GPIIIa (CD61)
What are the acrocentric chromosomes?
13, 14, 15, 21, and 22
Tumor marker of ovarian carcinoma?
CA-125
CEA is a tumor marker of?
Pancreatic and gastrointestinal cancers
CA-19-9 is a tumor marker of?
Pancreatic adenocarinocma.
Salivary duct carcinoma resembles this neoplasm and has this immunoprofile?
IDC of the breast AR+ GCDFP+ HEr2Neu+ PSA (50%) PR (6%) ER (1%)
Renal papillary necrosis occurs in these four settings?
obstructive pyelonephritis, diabetic nephropathy, sickle cell anemia, and analgesic abuse
Pilomatrixoma is also known as?
Malherbe calcifying epithelioma
Most common Rh-positive Weiner haplotype in whites?
R1
Most common Rh-positive haplotype in blacks?
R0
The most common Rh-negative Rh haplotype?
r
infantile precursor B-cell lymphoblastic leukemia is associated with this gene and translocation.
MLL gene on 11q23
t(4;11).
Immunohistochemical staining for YST?
YST is positive for α-fetoprotein (AFP) and cytokeratin. CEA, vimentin, and PLAP show variable positivity. EMA, CD30, and CD99 are negative.
What non-GI tumors are seen in Peutz-Jegher Syndrome?
Women: adenoma malignum and SCTAT
Men: Sertoli cell tumors
What GI polyp is associated with hypokalemia?
villous adenoma
Genetic alteration seen in hibernoma?
11q13
Genetic alteration seen in myxoid liposarcoma?
t(12;16)
Genetic alteration seen in well-differentiated liposarcoma?
Ring chromosome 12
Genetic alteration seen in lipoblastoma?
8q11-13
Genetic alteration seen in spindle/pleomorphic lipoma?
16q13
Microglandular adenosine has myoepithelial cells, true or false?
false
Describe myxofibrosarcoma?
Grossly MFS is a multinodular neoplasm composed of gelatinous or fibrous nodules. Microscopically the tumor nodules are lined by fibrous septa and are composed of myxoid to fibrous matrix in variable proportions. The myxoid areas contain curvilinear vessels with perivascular tumor cell condensation.
Autoantibody seen in primary biliary cirrhosis?
Anti-mitochondrial
Enzyme important to the development of HDL?
LCAT
HTLV-1 is the causative agent of?
ATLL as well as tropical spastic paraparesis.
What is the immunophenotype of ATLL?
CD2+, CD3+, CD5+, CD7–, CD4+, CD25+, ±FoxP3+
The diagnosis of CLL requires an absolute lymphocyte count of at least ______ for _______ months?
5 × 109/L, 3 months
vWF levels are 25% higher or lower in patients with type ) blood?
lower
Which malaria is more common in Asia?
P. vivax
What is the most common site of extra skeletal plasmacytoma?
Upper respiratory tract
What is the most sensitive marker of mesothelioma and what is the most sensitive marker of adenocarcinoma?
Meso - calretinin
Adeno - BerEp4
What is Stewart-Treves Syndrome?
Angiosarcoma arising in the breast or axilla following mastectomy with axillary dissection.
Where is the most common location for gastric leiomyomas?
Cardia
Chromogranin or synaptophysin is a better stain for detection of carcinoid tumor?
Chromogranin
Which variant of rhabdomyosarcoma is associated with a translocation and what is the translocation?
Alveolar rhabdomyosarcoma, t(2;13)
t(12:22)
clear cell sarcoma, EWS-ATF-1 fusion
Follicular cervicitis is associated with what infection?
C. trachomatis
Number of cells required on liquid-based anal pap?
2,000-3,000
Cardiac fibromas are associated with this syndrome?
Ghorlin Syndrom
What gene is mutated in Ghorlin’s syndrome?
PTC
Mucoid intimal edema is a feature of?
Thrombotic microangiopathy
What is the new name of Wagner’s granulomatosis?
Granulomatosis with polyangiitis
What is the new name of Churg-Strauss syndrome?
Eosinophilic granulomatosis with polyangiitis
What gene is mutated in Ehler’s-Danlose Syndrome?
COL3A1
What is the best serologic test for Celiac Disease?
Anti-tissue transglutaminase
What HLA halpotypes are associated wit Celiac Disease?
DQ2 (95%) and DQ8 (5%)
AFP is primarily elevated in this germ cell tumor?
Yolk sac
What is an Askin tumor?
A Ewing sarcoma/PNET of the thoracopulmonary area.
What is Munro microabscess?
Collection of neutrophils in the stratum corneum.
What or the histology features of psoriasis?
Regular elongation of rete ridges Parakeratosis Munro microabscesses Thinning of the Supra papillary plate Hypogranulosis Dilated blood vessels in the papillary tips
Histology of rheumatoid nodule and granuloma annulare?
RN: irregular nodule usually with fibrin in necrobiotic center.
GA: well delineated areas of disintegrated collagen and mucin surrounded by granulomatous inflammation
What is Mafucci Syndrome?
Multiple enchondromas and hemagiomas
What lymphoma most commonly presents as lymphomatous polyposis?
Mantle cell lymphoma
At what temperature is cryoprecipate formed when thawing plasma?
1-6 C
What temperature is cryo stored?
-18C
This thyroid cancer stains strongly for CK19
PTC
Lacrimal gland or orbital marginal zone lymphomas are associated with this bacterium?
Chlamydia psittaci.
PAX-8 is positive or negative in the kidney and positive or negative in the urothelium
Kidney: positive
Urothelium: negative
What type of schwannoma is associated with Carney Complex?
psammomatous melanotic schwannoma
How long can pooled and unpooled cryo be stored and ta what temp?
Pooled - 4 hours
Unpooled - 6 hours
20-24C after thawing at 37C
What is analytical specificity?
a laboratory test’s ability to measure a particular analyte in the presence of possible interfering substances.
Alveolar soft part sarcoma metastasizes to this location with greater frequency compared to other sarcomas?
Brain
Extra-mammary Paget’s disease is positive for?
Low molecular weight keratin, CEA, and EMA.
What subtypes of Hodgkin Lymphoma has the best and worst prognoses?
Best: Nodular lymphocyte predominant
Worst: Lymphocyte deplete
The duffy antigen is the receptor for this microorganism?
P. vivax
People of African descent have this duffy phenotype?
a-, b-
What are the acceptable platelet transfusion triggers:
- Stable non-bleeding patient
- Bleeding patient, or about to undergo surgical procedure
- Intracerebral, intraocular, and pulmonary bleeding
- 10
- 50
- 100
One does of platelets is expected to raise the platelet count by?
30-60 K
A pure mutinous tumor of the breast is classified as such when >XX% is mutinous?
90%
IHC profile of seminoma?
Keratin - to weak
OCT3/4, CKIT, PLAP, and PAS +
What is a pulmonary sequestration?
Portions of lung that reviews an aberrant blood supply from branches o the aorta rather than the pulmonary artery.
What are two other names for de Quervain’s thyroiditis?
- Granulomatous thyroiditis
- giant cell thyroiditis
Pattern of thyroid hormone changes seen in de Quervain’s thyroiditis?
Hyperthyroidism followed by a return to the euthyroid state.
Acid and gastrin levels in patients with autoimmune atrophic gastritis.
Hypochlorhidria and elevated gastrin.
Type of adenocarcinoma in patients with H. pylori gastritis?
intestinal type
MLH1 loss is due to ________ and results in decreased expression of these proteins by IHC?
Hypermethylation, decreased MLH1 and PMS2
Intermediate trophoblasts stain strongly with?
HPL
How does medullary thyroid carcinoma metastasize?
Veins and lymphatics
What is the Regan isoenzyme?
Placental ALP produced by a malignancy
In regards to ALP isoenzymes, liver ______, and bone _______?
Liver lasts and bone burns
How can the MCV be calculated?
HCT/RBC
Breast tumor marker?
CA-15.3
What antigens are diminished by enzyme treatment with ficin or papain?
Duffy, M, and N, Lutheran, Chido, Rodgers
How is plasma volume calculated?
Plasma volume is calculated as (1 – hematocrit) × 0.7 dL/kg × body mass (kg)
How does one dose cryoglobulin?
: Dose (units) = [post-fibrinogen (mg/dL) – pre-fibrinogen (mg/dL) × plasma volume]/250 mg/unit.
Pulmonary malakoplakia can be caused by this organism?
Urinary tract?
Pulm - Rhodococcus equi
UT - E. coli
Granulocyte yields below this level are considered ineffective when transfused into a neutropenic patient?
1 x 10^10
What temperature are granulocytes stored and what is their expiration?
20-24C, 24 hours
Temp that RBCs should be stored?
1-10C
What renal tumor is associated with polycythemia
Metanephric adenoma
Staining of nephrogenic adenoma?
PAX2 and PAX8+
Most negative for PSA
Can be positive for racemase
The preferred cardiac biomarker is __________, followed by ____________ if the preferred marker is unavailable.
Troponin T, CK-MB
How do you calculate the reticulocyte index and reticulocyte production index?
Reticulocyte index = reticulocytes × HCT/normal HCT
Reticulocyte production index = (reticulocytes × HCT)/(normal HCT × correction factor).
What is the most common cranial neoplasm in tuberous sclerosis?
SEGA
Translocation seen in follicular lymphoma?
t(14;18)
CD34, bel-2, and CD10 staining in trichoepitheliomas vs basal cell carcinoma.
- Focal positive CD34 staining of the fibroblastic stroma has been seen in trichoepitheliomas, whereas it is negative in basal cell carcinoma.
- Staining of the outermost epithelial layer for bcl-2 has been seen in trichoepithelioma. In contrast, the tumor islands of basal cell carcinoma usually stain diffusely.
- Immunohistochemistry for CD10 stains the stromal cells but not the epithelial cells in trichoepithelioma, whereas it stains the epithelial cells in basal cell carcinoma.
The most common CNS lymphoma is ?
CNS lymphomas are radiosensitive, true or false?
- DLBCL
- Radiosensitive
Members of this mycobacterial group stain for these non-bacterial stains?
Members of Mycobacterium avium complex (MAC), but not M. tuberculosis, may stain positively for desmin, actin, and cytokeratin.
What is the carney complex?
abnormal skin pigmentation, cutaneous and cardiac myxomas, and abnormalities of the endocrine system (adrenal, pituitary, thyroid).
How do myxomas stain?
Myxoma cells stain positively for endothelial markers CD34 and CD31 and are variably positive for S-100. Calretinin has been reported positive in 74% to 100% of cases and can be useful to distinguish this lesion from a myxoid thrombus. Tumor cells are negative for cytokeratin, but heterologous glands show positivity.
CK7 staining in:
- Conventional clear cell RCC
- Chromophobe RCC
- Papillary RCC
Conventional RCC: negative
Chromophore and papillary: positive
What lineage does each of the markers indicate?
- Anti-CD18
- Anti-CD33
- Anti-CD61
- Anti-CD71
- Anti-CD18 monocytic
- Anti-CD33 myeloid
- Anti-CD61 megakaryocytic
- Anti-CD71 erythroid lineage
Is CD31 or CD34 more specific and sensitive for vascular tumors?
CD31
Translocation seen in DFSP?
t(17;22) translocation or ring chromosomes that contain this fusion - COL1A1–PDGFB
Infantile fibrosarcoma and the related cellular congenital mesoblastic nephrona carry which fusion?
ETV6–NTRK3
What is the most common enzyme deficiency of the glycolytic pathway?
Pyruvate kinase deficiency.
Grade 2 carcinoids (atypical carcinoids) are defined by?
2-10 mitoses/10 HPF
What is the Azzopardi effect and where is it seen?
Smudged densely basophilic nucleic acid accretions adjacent to tumoral blood vessels in small cell carcinomas.
Describe the EGFR mutation in NSCLC?
Exon 20 mutations are associated with resistance
Exon 18-24 leads to constitutive activation
Exon 19 and 21 are associated with sensitivity to EGFR inhibitors
Urease, indole, and ornithine decarboxylase in P. mirabilis and P. vulgaris?
• P. mirabilis and P. vulgaris are both urea positive. Only P. vulgaris is indole positive, and only P. mirabilis is ornithine decarboxylase (ODC) positive.
Slide and tube coagulase tests for S. aureus and S. lugdunensis?
S. aureus - slide and tube positive
S. lugdunensis - slide positive or negative and tube negative
Indicate shelf life of RBCs: ACD/CPD/CD2D CDPA-1 AS Irradiated units
ACD/CPD/CD2D: 21
CDPA-1: 35
AS: 42
Irradiated units: 28 days or original outdate, whichever is sooner
How soon after autologous donation can the patient have surgery?
3 days
T-PLL is characterized by this molecular event?
in(14) - involving oncogenes TCL1A and TCL1B
SDH mutations, including germline mutations, are associated with these 3 neoplasms?
pheochromocytomas, paragangliomas and GIST.
Organophosphate poisoning:
- parasympathetic or sympathetic response?
- Due to inactivation of?
- Antidote?``
Parasympathetic response
Inactivation of acetylcholinesterase
Atropine
What are the zones of the SPEP from left to right?
The zones in the SPEP from left to right are: Pre-albumin (contains retinol binding protein and transthyretin) Albumin (contains albumin), Alpha-1 (contains alpha-1-antitrypsin, thyroid-binding globulin, HDL, prothrombin, transcortin and alpha-1 acid glycoprotein (orosomucoid)), Alpha-2 (contains alpha-2-macroglobulin, ceruloplasmin and haptoglobin), beta (contains transferrin, LDL, hemopexin, fibrinogen, C3 and IgA) and the gamma zone (contains immunoglobulins and CRP).
The sequence of alkaline gel for hemoglobin electrophoresis is:
+(Anode) A F S C (Cathode)-
How should FFP be thawed for use?
Water bath at 30-37 C or FDA approved microwave
What hepatitis virus is a DNA virus?
Hepatitis B
What is Carney’s triad and what gene is hypermethylated?
Pulmonary hamartomas, GIST, and paragangliomas
SDHD
How does abciximab work?
Monoclonal antibody against GpIIb/IIIa
Xp11 translocation renal cell carcinomas are associated with this IHC stain?
TFE3
t(6;11) renal cell carcinoma is associated with this gene and how do you look for these gene?
TFEB, FISH
HLRCC is associated with mutations in this gene?
fumarate hydrotase
What causes Gaucher’s disease?
Glucocerebrocidase deficiency
What is the most common worm infection in the US? What about tapeworm?
Hymenolepis nana (“dwarf tapeworm”) is the most common tapeworm infection in the U.S. (the most common worm infection in the U.S. is Enterobius vermicularis).
Which malaria has a banana shipped gametocyte?
“FA”lciparum - “FAt banana”
What is the characteristic features of chondroblastoma?
chicken-wire calcifications
What are the types of vWD?
Type 1: quantitative deficiency
Type 2: qualitative deficiency
-2A: inability to form large and intermediate multimers, only short multimers present
-2B: increased affinity of vWF for Gp1b, +/- thrombocytopenia - loss of large monomers
-2M: decreased ability of vWF to bind Gp1b
-2N: vWF cannot hold onto FVIII
Type 3: absence of vWF
Platelet type: increased affinity of Gp1b for vWF, similar to type 2B
Staining of a plasmacytoma?
By IHC, plasmacytoma, is positive for CD138, CD38, CD79a, and kappa or lambda light chain restricted. It may stain for EMA, CD117, or CD56.
What SPEP pattern is seen in nephrotic syndrome?
Nephrotic syndrome shows hypoproteinemia everywhere except the alpha-2 region, which is increased.
Which rRNA is used for rapid identification of fungi?
26S
Which blood group systems display dosage?
Rh, MNS, Kidd, Duffy, and Lutheran blood group systems
> 90% of non-erythroid cells are myeloblasts, > 3% are positive for MPO or Sudan Black B, < 10% are granulocytes, and myeloblasts are positive for one or more myeloid related antigen including CD13, CD33 or CD117
AML without differentiation
Granulocyte transfusion should be given when neutrophils are ??
500/uL
Which candida organism(s) are most resistant to fluconazole?
Candida glabrata, Candida krusei
Which candida organism is most resistant to amphotericin B?
Candida lusitaniae
Staining differences in endometrial and endocervical adenocarincoma?
Endometrioid adenocarcinoma: vimentin, ER and PR; endocervical carcinoma: p16, p53, CEA
What are the most common mutations in PTC?
BRAF, RAS, RET/PTC - mutually exclusive
What is the most common mutation in FTC?
RET or PAX8/PPARy
What happens to blood glucose in POC devices with high and low HCT?
High HCT - underestimates glucose
Low HCT - overestimates glucose
What is a potential consequence of long term administration of low molecular weight heparin?
Osteoporosis
Large colony variants of Streptococcus groups C and G were reclassified as? The small colony variants (≤0.5 mm) of groups C and G have been placed in the ______ group.
S. dysgalactiae subsp. equisimilis (SDSE).
S. anginosus
20% of cases of familial ALS are associated with mutations in?
SOD1
The largest protozoan and the only ciliate that infects humans?
Balantidium coli
A band that migrates between CK MB and CK MM?
MacroCK, seen in asymptomatic elderly women
A band that migrates to the right of CK MM?
mitochondrial CK seen in metastatic disease
Which aspirgillis is a carcinogen for HCC?
A. flavus
Benign epididymal tumor in patients with VHL?
papillary cystadenoma
Describe lichen planus?
Lichen planus: thickened layers of the epidermis with apoptosis and Civatte bodies in the basal layer. Sawtooth rete ridges. Band of lymphocytes.
Which esterase is specific for granulocytes?
Chloracetate esterase
Middlebrook agar shows what when growing mycobacteria?
Chording
A breast sentinel node isolated tumor cell is defined as?
malignant cells present no more than 0.2 mm and less than 200 cells.
A breast sentinel node micro metastasis is defined as?
tumor cell deposit >0.2 mm and/or >200 cells, but <2 mm.
Epithelial cells in micro glandular adenosine are strongly positive for?
S100
Invasive apocrine carcinoma of the breast IHC profile?
ER, PR, Her2 negative
AR+, GCDFP+
What is the criteria to call a phyllodes tumor malignant?
stroll overgrowth, >10/10 mits/10 HPF, infiltrative borders, marked stroll atypia, and increased stroll cellularity.
Which cytokine is thought to drive castleman’s disease?
IL-6
What is the one single best test for iron deficiency anemia?
Serum ferritin
LD and serum bilirubin in B12 or folate deficiency?
High LD, mild to moderate elevation in bilirubin
Fanconi’s anemia is considered this type of syndrome and is caused mostly by these 3 genes?
Chromosomal breakage syndrome
FANCA, FANCC, FANCG
Pure red cell aplasia is also known as?
Blackman Diamond Syndrome
A high density or over expression of the I antigen on red cells is associated with these 2 anemias?
Congenital dyserythropoietic anemia and Blackman Diamond Syndrome
What is the WHO definition of anemia?
Men 13 Women 12 (11 if pregnant)
Increased indirect bilirubin is associated with intra or extravascular hemolysis?
Extravascular
In addition to clinical signs and symptoms, these changes in cTnI are associated with myocardial necrosis?
If cTnI initially abnormal - >20% change at 3 or 6 hours
If cTnI initially normal - >50% change at 3 or 6 hours
What are the negative acute phase reactants?
Prealbumim
Albumin
Transferritin
In patients receiving chemotherapy, what may herald the onset of neutropenia?
Monocytopenia
A double spike of albumin denotes?
Bisalbuminemia, no clinical consequence.
Balanitis xerotica obliteratans is also know as?
Lichen sclerosis
Which malaria causes cerebral malaria?
P. falicparum
Carney’s Complex?
endocrine neoplasia, atrial myxomas, skin pigmentation and psammomatous melanotic schwannoma.
What are the two most frequent types of ectopic epithelium encountered in Meckel’s diverticulum?
- Gastric
2. Pancreatic
What is the target of HPV viral proteins E6 and E7?
E6: p53 and telomerase
E7: RB - leads to p16 overexpression
Which Candida is associated with neonatal and pediatric invasive infections?
C. parapsilosis
which meningiomas are grade II?
Chordoid and clear cell
Which meningiomas are grade III?
Rhabdoid and papillary
cryptococcus on bird seed agar is this color?
Brown
IHC profile of chordomas?
S100+, EMA+, CK+
Tangier’s disease shows absence of?
HDL
Hemoglobin H
(-,-), (-,alpha)
The most common clonal molecular alteration in PMF is?
Janus kinase 2 V617F (JAK2 V617F)
Decomposition will produce this pattern of Na, Cl, and K in vitreous humor?
Decreased Na and Cl, increased K
Loeffler’s agar shows organisms with metachromatic granules.
C. diphtheria
For hemoglobin electrophoresis, the correct sequence on alkaline gel is _________, and the correct sequence on acid gel is _____________?
+(Anode) A F S C (Cathode) -
+(Anode) C S A F (Cathode)-
What cytokine stimulates marrow fibrosis?
TGF-beta1
Rh-null phenotype results in this red cell deformity?
Stomatocytosis
Which malaria’s have Schuffner’s dots?
P. ovalae and P. vivax
he most common antibodies involved in hemolytic disease of the fetus and newborn are?
anti-D, anti-K, anti-Fya, anti-C and anti-c.
Does anti-K cause HDFN?
No, but surpasses fetal erythropoiesis.
CLL/PLL is defined as?
11-55% prolymphocytes
Most common cytogenetic abnormality in CLL/SLL?
trisomy 12
Where do mantle cell lymphomas typically arise?
Waldeyer’s run and GI tract
Tranlocation in mantle cell lymphoma?
t(11;14)
Follicular lymphoma is made up of these two types of cells?
centrocytes (small cleaved cells)
centroblasts (large noncleaved cells)
How is FL graded and what are the grades?
- proportion of centroblasts found in 10 random 40X fields
Grade 1: 0-5
Grade 2: 5-15
Grade 3: >15
-3A: some residual centrocytes
-3B: no residual centrocytes
MALTomas are this type of lymphoma?
MZL
In additional to typical B cell markers, Hairy Cell Leukemia is positive for?
CD11c, CD25, CD103, annexin A1, and cyclinD1
CD5 and CD23 in PLL?
both negative
Lymphoplasmacytic lymphoma IHC:
CD19/20 + CD38 + sIg bright cIg positive negative to weak CD5, CD23, CD10
Translocation in lymphoplasmacytic lymphoma?
t(9;14)
Glomus cells are _____ for SMA, and ______ for CD31?`
positive, negative
The spindle cells of PASH are positive for?
SMA and vimentin
Hans classification of DLBCL?GC
CD10+ (30% of cells) - GCB type
CD10-, BCL-6-, ABC
CD10-, BCL-6+, MUM1+, ABC
CD10-, BCL-6+, MUM1-, GCB
BCL6 and BCL2 in primary DLBCL of the CNS?
BCL6+
BCL2-
Name some of the specific subtypes of DLBCL?
Primary CNS lymphoma TCHRBCL Primary mediastinal (thyme) large B cell lymphoma ALK+ large B cell lymphoma Plasmablastic lymphoma Intravascular large B cell lymphoma PEL Leg type primary cutaneous DLBCL EBV+ DLBCL of the elderly Lymphomatous granulomatosis DLBCL associated with chronic inflammation
EBV+ PTLD usually occurs in this timeframe post-transplant?
the 1st year
What organ transplants are most susceptible to PTLD?
heart-lung and liver-bowel
The hallmark of CSF protein electrophoreses is?
pre-albumin band
Glomerular proteinuria pattern on UPEP?
strong albumin, alpha1 and beta bands
Tubular proteinuria pattern on UPEP?
weak albumin, strong alpha1 and beta bands
What must the platelet count be in order to diagnose ET?
A platelet count greater than 450 × 109/L
What markers can be used to predict the course of IPMN?
MUC2
Antibodies against these are seen in pemphigus vulgaris?
desmoglein III and I
Coffin-lid crystals in urine are?
Triple phosphate crystals
Hand deformities in trisomy 13 and trisomy 18?
13 - polydactyly
18 - overlap
Translocation seen in MALTomas?
t(11;18)
What is the normal lifespan of a native and transfused platelet?
native: 8-12 days
transfused: 3-4 days
What mycobacteria are Runyon group 1 (photochromogens)?
M. kanasii, M. simiae, M. marinum and M. asiaticum
Mycobacterium ? is a photochromogen at 24 degrees and a scotochromogen at 37 degrees.
Mycobacterium szulgai is a photochromogen at 24 degrees and a scotochromogen at 37 degrees.
In addition to standard B cell markers, BL is positive for?
CD10, bcl-6, and C-myc
Difference between LBL and ALL?
lesions involving tissue and sparing bone marrow and PB = LBL
>25% marrow or >20% blasts in PB = ALL
SPEP with beta-gamma bridging and decreased albumin indicates?
Liver cirrhosis
What is Evan’s Syndrome?
ITP and AIHA
Hyperglycemia will cause this to happen to sodium?
Physiologic shift out of the cell, causing true hyperglycemia
How does one correct sodium for hyperglycemia?
[1.6(serum glucose - 100)]/100
What is the significance of Ito cells?
- store vitamin A
- can differentiate into myofibroblasts and create fibrosis
Stem cells in the liver are located in the?
Canal of herring, leads to bile ductule proliferation.
Periportal pathologies are?
chronic hepatitis, chronic cholestatis (bile ductular reaction)
Steatohepatitis is seen in this zone?
zone III, centrilobular
Two places one sees ground glass hepatocytes?
HepB and polypharmacy
Portal lymphoid follicles +/- micro vesicular steatosis are seen in?
Chronic HepC
How do you stage chronic hepatitis?
Stage: amount of fibrosis:
1: Increased portal fibrosis
2: Fibrosis extends out away from portal tract
3: Bridging fibrosis between portal tracts or from portal tract to central vein
4: Cirrhosis
How do you grade chronic hepatitis?
Grade: look at 2 factors:
1: Degree of interface activity
2: Degree of lobular activity
Increased grade means increased risk of developing fibrosis
supernumerary nipples is also known as?
Polythelia
What are the breast myoepithelial markers?
p63, myosin heavy chain, calponin, HMWK (C5/6/14)
What are the breast luminal markers?
LMWK (CK7,8,18)
What antibodies are present in autoimmune hepatitis types 1, 2 and 3? Are they IgG or IgM?
Increased IgG
Type 1: +ANA or anti-SMA abs (young adult F>M)
Type 2: Anti-LKM abs (liver kidney microsome)
Often seen in kids
Type 3: anti-SLA ab (Soluble liver antigen)
Duct ectasia is also know as?
Periductal mastitis
Amnion nodosum is seen with?
Oligohydramnios
p62 and ubiquitin stain?
Mallory Bodies
Idiopathic granulomatous mastitis can be associated with this microorganism?
Corynebacterium
Where is folate absorbed?
Proximal jejunum
Ringed sideroblasts form when iron deposits in this organelle?
Mitochondria
What tumors are known to make EPO?
hemangioblastoma, RCC, uterine leiomyoma, HCC
60:40:20:15:5
Total body water : Intracellular : Extracellular : Interstitial : Plasma
Normal A1c
Abnormal A1c
A1c diagnostic of DM
Normal A1c <5.7
Abnormal A1c 5.7-6.4
A1c diagnostic of DM 6.5 or above
Granulomatous cholangitis?
Primary biliary cholangitis (cirrhosis)
What is the Tenny-Parker effect?
Increased syncytial knots and terminal villous hypoplasia
Bile lakes are almost pathognomonic for?
Large duct obstruction
loss of interlobular bile ducts and foam cell arteriopathy indicate?
Chronic rejection
LGL leukemia IHC profile?
CD2, CD3, CD8, CD16, CD57+
LGL leukemia IHC profile?
CD2, CD3, CD8, CD16, CD57+ (will be CD3 and CD8 negative if NK type)
Long standing celiac disease can give rise to this lymphoma?
Enteropathy associated T cell lymphoma
EATL IHC?
CD3+, CD30+, CD4/8-
What is fetal papyraceous?
Incorporation of dead twin into placenta
What presents with purport fulminans and DIC?
homozygous protein C deficiency
If peripheral access is not feasible, which central line is preferred in regards to less infection risk?
IJ/subclavian over femoral
How do you calculate INR?
INR = (PT/PTGeoMean)^ISI
Normal BUN:Cr and BUN:Cr in pre-renal azotemia?
Normal: 10:1
Pre-renal: >20:1, sign of hypoperfusion
What is the purpose of the amniotic fluid bilirubin (Delta OD450)?
Determine the amount of fetal hemolysis
What is a potential normal site of HCG secretion in the perimenopausal woman?
pituitary gland
The alpha chain of b-HCG is the same as these hormones?
TSH, FSH, LH
What are the HACEK bugs?
Haemophilus Aggregatibacter Cardiobacterium Eikenella Kingella
Besides the HACEK group, what intracellular bugs can cause culture negative endocarditis?
Rickettsia, Q-fever, Whipple’s disease
What is Marantic Endocarditis
Nonbacterial thrombotic endocarditis seen in hyper coagulable states
What is Libman-Sacks endocarditis and where are the vegetations found?
Seen in lupus erythmatosus
Vegetation’s on both sides of vavles
What are the large vessel vasculitides?
Giant cell arteritis
Takayasu’s arteritis
What are the medium vessel vasculitides?
Polyarteritis nodosa Kawasaki disease Thromboangiitis obliterates (Buerger disease)
What are the small vessel vasculitities?
HSP (IgA)
SLE (IgG)
cryoglobulinermia (IgG and IgM)
Goodpasture’s disease
Wegner’s granulomatosis (granulomatosis with polyangiitis)
Churg Strauss Disease (eosinophilic granulomatosis with polyangiitis)
Microscopic polyangitis
HCG in pregnancy:
- First detectable:
- Doubles roughly every ? hours until ? weeks?
- Remains detectable for ? after delivery?
- First detectable: 6-8 days following conception
- Doubles roughly every 48 hours until 10 weeks
- Remains detectable for 2 after delivery?
Fetal fibronectin has a good _______ predictive value in regards to predicting preterm birth?
The absence of fetal fibronectin in cervicovaginal fluids has a high negative predictive value of preterm birth
Dilated sinusoids and hepatic atrophy are indicative of?
Budd Chiari Syndrome (outflow obstruction)
Where does the iron accumulate in the liver in Hereditary hemochromatosis?
Periportal hepatocytes first, with progression towards the central vein
Glycjogenated nuclei in the liver are associated with?
Wilson’s disease
Name two copper stains?
Rhodanin and Victoria Blue
What causes bread and butter pericarditis?
ARF
Uremia
Myocardial infarction
What is the most common congenital heart defect?
VSD, 90% close by 1 year
Cardiac rhabdomyoma prognosis, immunostain?
Most will spontaneously regress in the 1st year of life
HMB45+, desmin+
Tetralogy of Fallot
VSD
Overriding aorta
Sub pulmonary fibrosis
Right ventricular hypertrophy
EM findings of Amyloidosis?
10 nm non-branching fibrils
Histology of bile duct hamartoma/von Meyenburg complex?
Irregular shaped, dilated glands in a fibrous stroma.
Contains mucin or bile
How do you diagnose somatic malignancy in a testicular germ cell tumor?
Must take up at least one 4x field.
What is thought to be a possible precursor to NLPHL?
Progressive transformation of germinal centers
The most common subtype of CHL?
Nodular sclerosis
What is the definition of a ringed sideroblast?
At least 5 siderosomes that surround at least a third of the nucleus
Isolated loss of Y, 5q-, or 20q- in MDS, prognosis?
Favorable prognosis
3 or more anomalies or chromosome 7 anomalies in MDS, prognosis?
Unfavorable prognosis
JMML may be associated with this syndrome?
NF1
CML:
- p210
- p230
- p190
- p210: normal
- p230: associated with thrombocytosis and neutrophils
- p190: associated with marked monocytosis and Ph+ ALL
Which IgG subclass does not cross the placenta?
IgG2
IF Patterns, antigens detected and disease associations: Speckled: Homogenous: Nucleolar: Centromere:
Speckled:
- SSA, SSB, Smith, U1-RNP, PCNA, Scl-70
- SLE, MCTD, Sjogren, scleroderma
Homogenous:
- DNA, histone, dsDNA, ssDNA
- SLE, drug-induced SLE, RA
Nucleolar:
- RNA polymerase 1, u3RNP, PM-scl
- scleroderma, polymyositis
Centromere:
- CENP-A, B, C
- Scleroderma (with CREST), RaynoudsRenal tumor seen in Burt-Hogg-Dube syndrome?
Chromophobe
What makes up the MELD score?
Bilirubin, INR, Creatinine
What is Lhermitte-Duclos?
A rare cerebellar tumor associated with Cowden Syndrome.
The most common dermatophyte?
T. rubrum
Serous cystadenoma of the pancreas is associated with this syndrome?
VHL
What defines microinvasion in DCIS?
<1mm or up to 3 foci of <1mm
treated clinically like DCIS
What are the most common mutations in endometrial endometrioid adenocarcinoma?
PTEN and MSI
Winter’s formula?
PCO2 = 1.5([HCO3-]) + 8 ???
Malaria associated with fever every 72 hours? 24 hours?
72: P. malariae
24: P. knowlesi
What are the 4 types of AML?
AML with recurrent genetic translocation
AML following therapy
AML myelodysplasia related changes
AML, NOS
What are the AMLs with recurrent genetic translocations?
t(8;21) - abundant gray-blue cyto with Auer rods and large granules (RUNX1)
inv(16) - increased abnormal eos (MYH11/CBFB)
t(15;17) -
t(9;11) - monoblastic differentiation (MLL)
t(6;9) - with basophilia (DEK/NUP214)
t(1;22) - megakaryocytic (RMB15/MKL1)
inv(3) - Thrombocytosis, giant agranular platelets (RPN1/EV11)
Formula to calculate MCV?
MCV = Hct x 10/RBC
Formula to calculate MCHC?
MCHC = (Hgb/Hct)100
A high MCHC may indicate?
spherocytosis, cold agglutinin, or lipemia specimen
PAS reliably stains positive in this leukemia?
Acute erythroid leukemia
What hepatitis B antibody indicates permanent immunity?1
Anti-HBs
How do you t ell the difference between T. sodium and T. saginata?
The eggs of Taenia solium (pork) and Taenia saginata (beef) look the same with radial striations and a thick shell. These two are best distinguished by the lateral striations/ uterine branches per side. Taenia solium has < 13, Taenia saginata has > 13. Mnemonic: 13 is an unlucky number, and getting a tapeworm is unlucky. The pig (solium) tapeworm has less than 13 lateral uterine branches (pigs are smaller than cows), and the beef (saginata) tapeworm has more than 13 lateral uterine branches (cows are bigger than pigs).
Features of Medullary Carcinoma of the Breast?
- BRCA1 associated
- Syncytial growth in 75% of the tumor
- no glands
- Lymphoplasmacytic infiltrate at periphery or admixed
- nuclear pleomorphism
- complete circumscribed
- better prognosis, triple negative
Invasive micro papillary carcinoma is associated with?
Lymph node mets
Grading tubules and mits in breast cancer?
1 - >75%, <5
2 - 10-75%, 5-10
3 - <10%, >10
When is a breast cancer determined to be HER2 positive by IHC, FISH?
Positive IHC (3+) = strong membranous staining in >30% of cells at 10X
Positive FISH = HER2/CEP17 >2 or HER2/CEP17 <2 but copy number >6
YUPA
YUPA: Yellow Urate Parallel to the Axis.
What substance(s) neutralize P1?
Hydatid cyst fluid and pigeon eggs
What substance(s) neutralize I?
Breast milk
Stain helpful in diagnose of FNH?
Map-like/geographic glutamine synthetase
Dolichos bifloris binds to?
A1
Alex europaeus bind to?
H
What is Caroli disease and Caroli syndrome?
AR conditions associated with ARPCKD
Caroli disease: intrahepatic dilation of bile ducts
Caroli syndrome: above associated with congenital hepatic fibrosis
How to calculate number of units needed to test to find antigen negative blood?
1/(antigen negative units in percent) X 100
What are 3 potential causes of a D+ patient with an apparent anti-D upon typing?
- WAIHA
- Anti-LW
- Partial D
Described the different grades of cellular rejection in the heart?
Grade 1R: interstitial and/or perivascular infiltrate with up to one focus of myocyte damage
Grade 2R: 2+ foci of myocyte damage
Grade 3R: Diffuse inflammation, multiple foci of myocyte damage , hemorrhage, edema, and vasculitis
What pattern is represented by all cells in panel and auto control positive at AHG only?
Warm autoantibodies (IgG)
What pattern is represented by all cells in panel except auto control positive at AHG only (weak 1-2+)?
HTLA (chido or rodgers)
What pattern is represented by all cells in panel and auto control positive at IS only?
Cold autoantibody (IgM)
DAT with anti-IgG or anti-IgG and anti-C3 indicates?
Warm autoantibody (IgG)
DAT anti-C3 only?
Cold autoantibody (IgM)
Where are exophytic and inverted papillomas found in the nasal cavity?
Exophtic: septum
Inverted: lateral walls and sinuses
Where are angiofibromas typically located?
posterior nasal cavity
What is the most common salivary gland tumor in children?
MEC
Which salivary gland tumor typically arises only in the minor salivary glands?
PLGA
What is a syringoma?
Syringoma has groups of ducts lined by two layers of epithelium.
In which type of HIT is it ok to give platelets?
HIT type 1
How do you classify thymomas?
Thymoma classification: A: spindled cells, B1 -> B3 epithelioid cells with decreasing amount of lymphocytes. AB: spindle and epithelioid cells. C: carcinoma.
What types of epithelium are usually associated with the following: MUC1 MUC2 MUC5AC MUC6
MUC1: Pancreatobiliary
MUC2: Intestinal
MUC5AC: Gastric
MUC6: pyloric
What are the 4 types of hepatic adenomas?
HNF-1a - steaktotoc, loss of LFABP
Inflammatory/Telaniectatic - serum amyloid A/CRP
Beta-catenin mutated - nuclear beta catenin, increased risk of HCC
Unclassified
Stain helpful in diagnose of FNH?
Map-like/geographic glutamine synthetase
What condition is commonly associated with temporal arteritis?
Polymyalgia rheumatica
Polyarteritis is associated with this in about 30% of cases?
HepB infection
What is Caroli disease and Caroli syndrome?
AR conditions associated with ARPCKD
Caroli disease: intrahepatic dilation of bile ducts
Caroli syndrome: above associated with congenital hepatic fibrosis
What is Alagille Syndrome?
AD paucity of bile ducts with mutations in Jagged 1
Describe the QUILTY A and QUILTY B lesions?
QUILTY A: collection of lymphocytes confined to the endocardium with preserved CD21 framework
QUILTY B: As in type A, but with extension in to underlying myocardium
Described the different grades of cellular rejection in the heart?
Grade 1R: interstitial and/or perivascular infiltrate with up to one focus of myocyte damage
Grade 2R: 2+ foci of myocyte damage
Grade 3R: Diffuse inflammation, multiple foci of myocyte damage , hemorrhage, edema, and vasculitis
Cystic medial degeneration (cystic medial necrosis) is associated with?
Marfan’s syndrome
How does one grade pancreatic NETs?
NET 1: <2 mits/10HPF, <2% Ki67
NET 2: 2-20 mits/10HPF, 3-20% Ki67
NET3: >20 mits/10HPF, >20% Ki67
VMA, urinary metanephrines and catecholamines are seen in?
Paraganglioma and pheochromocytoma
VMA and HVA are seen in?
Neuroblastoma
When does one expect to see a trough in the cortisol level? When in the peak?
Trough - midnight
Peak - 8 AM
What is the purpose of the low and high does dexamethasone suppression tests?
Low - does the pt have cushings syndrome
High - does the pt have cushings disease
Solid pseudo papillary tumor is always negative for?
Chromogranin and ER
What 3 conditions will cause the urine dipstick to turn positive for blood?
Hematuria, hemoglobinuria, and myoglobinuria
The urine dipstick is most sensitive to this ketone?
acetoacetic acid
What are potential false positives for urine leukocyte esterase?
Trichomonads and eosinophils
What urine crystal form envelopes?
Calcium oxalate
The majority of kidney stones are made of this crystal?
Calcium oxlate
How many red cells are allowed in a unit of granulocytes?
<2 mL
Glomus tumor is positive for?
Desmin and SMA
EMA and desmin in bening and malignant mesothelium?
Benign: EMA-, desmin+
Malignant: EMA+, desmin-
Focal nodular hyperplasia is characterized by these 3 findings?
Nodular architecture
Abnormal vasculature
Bile Duct Proliferation
Arginine hydrolysis and positive Voges-Proskaur tests ate seen in?
S. anginosus group
In the ideal gaussian distribution how much of the population falls within 1 SD, 2 SD, or 3 SD?
1 SD: 68.2%
2 SD: 95.5%
3 SD: 99.7%
What is the hallmark genetic event in the botryoid variant of Embryonal Rhabdomyosarcoma?
LOH 11p15.5
What stains will highlight MG bodies of malakoplakia?
PAS, von Kossa, Prussian blue
Atypical fibroxanthoma immunostain?
CD10, CD117 and CD68; CD163 is less sensitive but may also be positive.
What is another name for Warthin’s Tumor?
Papillary cystadenoma lymphomatosum
FISH in urothelial carcinoma detects?
Aneuploidy of 3, 7, 17, or loss of 9p21
Blood groups in caucasians from highest to lowest prevalence?
0 > A > B > AB
Which subtype of basal cell carcinoma is most likely to metastasize?
Basosquamous
What is the most common cause of nephrotic syndrome in adults and children?
Adults: FSGS
Children: Minimal change disease
Which enteric are H2S producers?
Salmonella, Citrobacter and Proteus
What is the relative risk of invasive carcinoma in:
- Cystic/Benign epithelial hyperplasia?
- Atypical hyperplasia?
- DCIS or LCIS?
- 1.5-2X
- 4-5X
- 8-10X
What medical treatment can be used to treat infantile hamangiomas?
Propranolol
How does the MecA gene confer resistance?
PBP2A protein, a low affinity penicillin binding protein
How is LCH classified?
It is classified as unifocal (“eosinophilic granuloma”), multifocal unisystem (Hand-Schuller-Christian disease), multifocal multisystem (Letterer-Siwe disease, poor prognosis), and pulmonary Langerhans cell histiocytosis (strong association with smoking).
IHC staining differential of Urothelial carcinoma, reactive atypia, and normal
Carcinoma: full thickness CK20, absent or basal CD44, strong and diffuse p53
Reactive/normal: CK20 in umbrella cells only, paranasal or slightly increased CD44, and p53 negative
What is the normal urothelial thickness?
5-7 layer
Which variants of urothelial carcinoma are the most aggressive?
Nested and micropapillary
Is verrucous carcinoma of the bladder HPV associated?
No, p53+
IHC of inflammatory pseudo tumor?
CK+, actin+, vimentin+, 2/3rds ALK+
Most common Rh+ genotypes in whites and blacks?
Whites: R1/R1 or R1/r
Blacks: R0/R0 or R0/r
What is the rate of sensitization if Rh+ blood is transfused into a Rh- individual?
20-30%
Anti-E should prompt a search for?
Anti-c
Anti-G looks like?
Antobides to both D and C
What is the risk for carcinoma in simple hyperplasia, complex hyperplasia, and CAH?
1%, 3%, or 30%
What percentage of patient with CAH have carcinoma?
25-50%
> 5 mits/HPF gets one to uterine leiomyosarcoma in these variants?
Epihtelioid and myxoid
What does GAVE stand for in stomach pathology?
Gastric astral vascular ectasia
In the small bowel, how many lymphocytes should be present?
1 for every 5 enterocytes
Most sensitive and specific antibodies in celiac disease?
Sensitive celia needs tissues and every measly thing has to be in a specific order
How are trophoblastic tumors categorized?
All are CK18/HLAG+
if p63 negative/hPL++
Ki67 <1%: exaggerated placental site
Ki67 >1%: PSTT
if p63++/hPL +/-
Ki67 <10%: PSN
Ki67 >10%: Epitheliod trophoblastic tumor
if p63+ or hCG+: choriocarcioma
What can be used to monitor glycemic control in patients with hemolytic disorders?
In hemolytic conditions, fructosamine (glycated albumin) is more useful for the monitoring of longer term glycemic control than HbA1c.
Molecular findings in HLH?
PRF1, UNC13D, or STX11
What genetic events are usually present in serrated adenomas?
BRAF mutations (80%) and MSI.
How often must you verify cesium-137 and cobalt-60 irradiation?
cesium-137 - 12 months
cobalt-60 - 6 months
How is renal cell carcinoma graded?
- small round nuclei without nucleoli
- irregular nuclear contours, inconspicuous nucleoli
- nucleoli visible at 10x
- large hyper chromatic, pleomorphic nuclei, single or multiple nucleoli
Low and high grade serous mutations?
LG: KRAS (50%), BRAF (50%)
HG: p53
Gyn clear cell carcinoma mutation?
ARID1A, PIK3CA, PTEN
Mutation in granulosa cell tumors?
FOXL2
All sex cord stromal tumors are positive for these 2 stains?
Calretinin and inhibiin
INI-1 negative tumor?
Rhabdoid tumor of the kidney ATRT Medullary carcinoma of the kidney Epithelioid sarcoma Malignant myoeuithlioma Epithelioid MPNST MERT
Size cutoff for AAH, AID, and invasive adenocarcinoma?
AAH <5 mm
AIS <3 cm
In lung cancer, EGFR and ALK testing should be done on these tumor?
All NSCLC with adenocarcinoma component
What characterizes NF2?
Multiple Inherited Schwannomas Meningiomas Ependymomas
When is the pseudo glandular phase of lung development and what develops?
Development of the large airways to the terminal bronchioles
6-16 weeks
When is the acinar/canalicular phase of lung development?
16-26 weeks (this phase must be completed in order for any chance of extrauterine lung function
When is the saccular phase of lung development
26-36 week
when is the alveolar phase of lung development?
36 weeks to 10 years
What is Legg-Calve-Perthes disease?
idiopathic hip avascular necrosis in children
USP6 rearrangement is seen in?
ABC
Nodular fasciitis
cellular fibromas of the tendon sheath
Osteofibrous dysplasia is also know as?
Ossifying fibroma
Osteofibrous displasia may progress to?
Adamantinoma
Sharpey fibers may be seen in?
Fibrous dysplasia
MDM2 mutations are seen in these bone tumors?
Parosteal osteosarcoma
Well-differentiated intramedullary osteosarcoma
What two conditions lead to cholesterol lung effusions?
Rheumatoid arthritis and MTB infection
Which type of hodgkin lymphoma is more common in women?
Classic nodular sclerossi
Describe the CPAMS?
Type 0: Tracheal bronchial, fatal
Type 1: Bronchial/bronchiolar (1 large cyst with smaller surrounding cysts)
Type 2: bronchiolar (back to back bronchial)
Type 3: bronchiolar/alveolar
Type 4: alveolar large cyst in periphery of lobe
Which sarcomas commonly metastasize to lymph nodes?
Epithelial sarcoma
Alveolar rhabdo
Clear cell sarcoma
What three features are seen in atypical polypoid adenomyoma?
fascicles of smooth muscle
atypical epithelial glands
squamous metaplasia
In what tumors does one see the ETV6-NTRK3 translocation
cellular congenital mesoblastic nephroma
Secretory carcinomas (breast and salivary gland)
Leukemia (AML)
INI-1 and BRG-1 are also known as?
INI-1: SMARCB1
BRG-1: SMARCA4
What is the most common HPV seen in veruccus vulgarism?
HPV 2 and 4
What HPVs are seen in plantar warts?
HPV 1, 2, 4, 63
What can cause a false positive PPD?
BCG vaccine
Other non-tuberculous mycobacteria
EIA for galactomanin is used to diagnose?
Aspergillum species infection
IHC difference between classic and spermatohytic seminoma?
Classic: PLAP, OCT3/4, and CD117 +
Spermatohytic: PLAP, OCT3/4 negative, CD117 weak
Who makes up the Runyon IV (fast growing) mycobacteria?
M. fortuitous M. abcesses M mucogenicum M. thermoresitbile M. chelonae
KIA/TIA slants: K/K (red/red)?
not enteric, maybe pseudomonas
KIA/TIA slants: K/A (red/yellow)?
lactose non-fermenter
KIA/TIA slants: A/A (yellow/yellow)?
glucose and lactose fermenter
What 3 haemophylis species requires X and V?
H. influenze
H. haemolyticus
H. aegyptius
What are some of the more common reasons to see arterial thromboses?
Atiphospholipid syndrome
Prothrombin 20210
HIT
What causes Yaws?
T. pallidum sps. perteneum
What causes Bejel?
T. pallidum sps. endemicum
What bacteria makeup MTB complex?
MTB M. kansasii M. africanum M. Microti M. bovis M. canetti
Which microfilariae are sheathed?
Whucheria
Brugia
Loa loa
What is the most common combination in testicular mixed germ cell tumor?
Embryonal and teratoma
Which testicular germ cell tumor is the most likely to be bilateral?
Spermatohytic tumor
MyoD1 staining in ASPS?
cytoplasmic
3 entities that may be seen on the crown of an unerupted tooth?
Dentigerous cyst
OKC
cystic ameloblastoma
What is considered a micro satellite high or low tumor?
High - 2 foci of instability
Low - 1 focus of instability
Describe the emphysema of AAT?
panacidar, predominantly basal
Poorly differentiated thyroid carcinoma by the Turin Criteria?
Solid of trabecular growth
Absence of PTC nuclei
Presence of at least one of the following;
convoluted nuclei (raisinoid)
Mits > or equal to 3/10 HPF
NecrosisLow power normal skin pathologies?
Tina
Urticaria
Viral exanthem
Amyloidosis
What are the findings in Sweets syndrome?
Papillary dermal edema
Dense dermal infiltrate of neutrophils
What conditions show a vacuolar interface dermatitis?
Drug Dermatomyositis Erythema multiform Lichen anything Lupus GVHD
Lichen planus cannot have?
Parakeratosis or eos
What is the “red, white. and blue” of lichen sclerosis?
Red: compact epidermis
White: pale dermis
Blue: perivascualr lymphoid infiltrate
What is a trichilemmoma and when is it seen?
Smooth lobule of glycjogenated cells hanging from the epidermis
Cowmen’s syndrome
What is the most common type of melanoma?
Superficial spteading
What melanoma has the worst prognosis?
Nodular
Lobular panniculitis is most indicative of?
Lupus panniculitis
The rash of lyme disease is known as?
Erythema migrans
Protein encoded by SMARCA4
BRG1
Protein encoded by SMARCB1
INI1
How is pulmonary adenocarcinoma defined?
Epithelial malignancy with glandular differentiation with mucin production or pneumocyte maker expression
What are the histologic patterns of conventional pulmonary adenocarcinoma?
Acinar Papillary Micropapillary Lepidic Solid
What are the recognized variants of pulmonary adenocarcinoma?
Invasive mucinous
Colloid
Fetal
Enteric
Define minimally invasive pulmonary adenocarcinoma
Tumor 3 cm or less (lepidic) with 5 cm or less invasive component
What is the size cutoff for atypical adenomatous hyperplasia?
5 mm or less
How is pulmonary adenocarcinoma in situ defined?
Lepdic tumor 3 cm or less is size
Pulmonary squamous cell carcinoma is defined as?
Epithelial tumor with keratinization, intracellular bridges, or an undifferentiated neoplasm with squamous markers
Which pulmonary carcinoma driver mutations are typically seen in nonsmokers? Smoker?
Non-smoker: ALK or EGFR
Smokers: KRAS
