GP MIDTERM TERM EXAM Flashcards
Which of the following thyroid carcinoma has been associated with amyloid deposition and multiple endocrine neoplastic syndromes?
Medullary carcinoma
The characteristics of a follicular adenoma of the thyroid include the following, except:
Papillary structures within the capsule
An eosinophilic pituitary adenoma occurring before the closure of epiphyseal line result in:
Gigantism
The most frequent type of hyperfunctioning pituitary adenoma is:
Lactotroph adenomas
Which of the following thyroid carcinoma has a good prognosis of 90% survival rate at 20 years?
Papillary carcinoma
Pituitary cell type associated with Cushing syndrome
Corticotroph
A form of chronic thyroiditis with an autoimmune origin is:
Hashimoto thyroiditis
Compact, lamellar keratin formation (wet keratin)
Adamantinomatous craniopharyngioma
Antidiuretic hormone is stored in the:
Posterior pituitary
True of Sheehan syndrome, except:
Ischemic necrosis of posterior pituitary
A clinical study is performed on postmenopausal women living in Paris, France, who are between the ages of 45 and 70 years. All have been diagnosed with infiltrating ductal carcinoma positive for estrogen receptor (ER) and progesterone receptor (PR), but negative for HER2 expression, which has been confirmed by biopsy and microscopic examination of
tissue. None has the BRCA1 or BRCA2 mutation. Which of the following is most likely to indicate the highest relative risk of developing the carcinomas seen in this group of women?
First-degree relative with breast cancer
What is a feature of comedo DCIS?
High grade nuclei
A 45-year-old woman has felt a poorly defined lump in her right breast for the past year. On examination, she has a nontender, firm, 16-cm mass in the upper inner quadrant of her right breast. There are no lesions of the overlying skin and no axillary lymphadenopathy. A biopsy is performed, and microscopic examination of the specimen shows the findings of stromal hypercellularity with areas of leaf like projections, nuclear pleomorphism and infiltrative borders are observed. The mass is excised with a wide margin, but recurs 1 year later. After further excision, the lesion does not recur. What is the most likely diagnosis?
Phyllodes tumor
A 24-year-old woman notes a lump in her right breast for the past month. She is concerned because her sister was diagnosed with a poorly differentiated triple negative breast cancer at age 31. Ultrasonography of the breast shows a solid mass. Fine needle aspiration is attempted but no diagnostic cells are obtained. Mammography is performed and there is a single 1-cm density with small clustered calcifications in the right breast but no lesions of the opposite breast. Which of the following is the best course of action for this patient?
Biopsy to obtain tissue from the lesion
A 60-year-old nulliparous woman received hormone re- placement therapy for 7 years following menopause at age 53 years. Her BMI is 33. She now undergoes screening mammography, and an irregular mass is identified in the right breast. An excisional biopsy yields a 1.5-cm mass that microscopically has invasive cells that are positive for estrogen receptor but negative for HER2, with low proliferation markers and mutated PIK3CA gene. Following surgical removal of the mass, which of the following clinical courses will most likely occur over the next year?
Very low likelihood of recurrence
A study of women with breast carcinoma is done to determine the presence and amount of estrogen receptor (ER) and progesterone receptor (PR) in the carcinoma cells. Large amounts of ER and PR are found in the carcinoma cells of some patients. These receptors are not present in the cells of other patients. The patients with positivity for ER and PR are likely to exhibit which of the following traits?
Higher response to therapy
A 48-year-old woman has noticed an area of swelling with tenderness in her right breast that has worsened over the past 2 months. On physical examination, the 7-cm area of erythematous skin is tender with a rough, firm surface resembling an orange peel. There is swelling of the right breast, nipple retraction, and right axillary nontender lymphadenopathy. Excisional biopsy of skin and breast is most likely to show which of the following lesions?
Infiltrating duct carcinoma
Which is TRUE about ductal carcinoma in situ?
a. Presence of mucin-positive signet ring cells
b. E-cadherin mutation
c. Both choices are correct
d. Both choices are wrong
Both choices are wrong
A 30-year-old woman has noticed a bloody discharge from the nipple of her left breast for the past 3 days. On physical examination, the skin of the breasts appears normal, and no masses are palpable. There is no axillary lymphadenopathy. She has regular menstrual
cycles and is using oral contraceptives. Excisional biopsy is most likely to show which of the following lesions in her left breast?
Intraductal papilloma
A 25-year-old woman feels a lump in her right breast. She has normal menstrual cycles, she is G3, P3, and her last child was born 5 years ago. On examination a 2-cm, irregular, firm area is palpated beneath the lateral edge of the areola. This lumpy area is not painful
and is movable. There are no lesions of the overlying skin and no axillary lymphadenopathy. A biopsy specimen shows microscopic evidence of an increased number of dilated ducts surrounded by fibrous connective tissue. Fluid-filled ducts with apocrine metaplasia also are present. What is the most likely diagnosis?
Fibrocystic changes
A 68-year-old woman sees her naturopathic health care provider for a routine health examination. There are no remarkable findings on physical examination. A screening mammogram shows a 0.5-cm irregular area of increased density with scattered microcalcifications in the upper outer quad- rant of the left breast. Excisional biopsy shows atypical lobular hyperplasia. She has been on postmenopausal estrogen-progesterone therapy for the past 10 years. She has smoked 1 pack of cigarettes per day for the past 35
years. Which of the following is the most significant risk factor for the development of lobular carcinoma in patients with such lesions?
Atypical cytologic changes
A 20-year-old woman in the third trimester of her third pregnancy discovers a lump in her left breast. On physical examination, a 2-cm, discrete, freely movable mass beneath the nipple is palpable. After the birth of a term infant, the mass appears to decrease in size. The infant is breastfed without difficulty. What is the most likely diagnosis?
Fibroadenoma
A 40-year-old woman has noticed an enlarging mass in her left breast for the past 2 years. The physician palpates a 4-cm firm mass. Following biopsy, a simple mastectomy is performed with axillary lymph node sampling. On gross sectioning, the mass has a soft, tan, fleshy surface. Histologically, the mass is composed of large cells with vesicular nuclei and prominent nucleoli. There is a marked lymphocytic infiltrate within the tumor, and the tumor has a discrete, non-infiltrative border. No axillary node metastases are present. The tumor cells are triple negative, for HER2, estrogen receptor (ER), and progesterone receptor (PR). What is the most likely diagnosis?
Medullary carcinoma
Which is a feature of medullary carcinoma?
Pushing border
A 35-year-old woman sustained a traumatic blow to her right breast. Initially, there was a 3-cm contusion beneath the skin that resolved within 3 weeks, but she then felt a firm, painless lump that persisted below the site of the bruise 1 month later. What is the most likely diagnosis for this lump?
Fat necrosis
TRUE OF THIS CYSTIC DISEASE (REFER TO THE PICTURE).
May present with congenital hepatic fibrosis
Dialysis associated cystic disease is associated with which of the ff conditions as its long term complication?
Renal cell carcinoma
TRUE OF THIS RENAL STONE (REFER TO THE PICTURE)
Formed in alkaline urine
Clinical manifestation of acute kidney infarct
Hematuria
What is the initiating event in the pathogenesis of thrombotic thrombocytopenic purpura?
Platelet aggregration
Which renal condition is associated with loss of functional mutation in TSC1 and TSC2 tumor suppressor genes?
Angiomyolipoma
Name the pathology (REFER TO THE PICTURE).
[Hydronephrosis]
Obstructive uropathy
Name the pathology (REFER TO THE PICTURE).
[Chronic urate nephropathy]
Urate nephropathy
TRUE OF VON HIPPEL LINDAU SYNDROME
a. may develop bilateral renal cell carcinomas
b. may develop multiple renal cysts
c. BOTH
d. NEITHER
Both
Leukemic patients will most likely have this microscopic finding in the urine.
Uric acid crystals
Which of the following vascular disease may clinically present with hypertension?
Nephrosclerosis
Pattern of tubular necrosis in acute ischemic injury
Patchy necrosis along the straight segments of proximal tubules
PAPILLARY RENAL CELL CARCINOMA is associated with which of the following genetic alteration
Trisomy 7
The following are features of chronic pyelonephritis EXCEPT
Papillary necrosis
Pagetoid spread
CIS where malignant cells are scattered in an otherwise normal urothelium
Developmental failure in the anterior abdominal wall and the bladder leading to the bladder communicating directly with the surface of the body through a large defect
Exstrophy of the bladder
Results from implantation of shed renal tubular cells at sites of injured urothelium
Nephrogenic adenoma
Intrinsic cause of ureteral obstruction
Interruption of neural pathway to bladder
Tumor staging in prostatic adenocarcinoma with seminal vesicle invasion
T3b
Associated with seminoma
KIT activating mutations
Common presenting symptom of bladder cancer
Painless hematuria
Endodermal sinus tumor
Yolk sac tumor
Abnormally small orifice of the prepuce
Phimosis
Associated with peyronie disease except:
Small preputial opening
Gross ovarian cyst with brown colored fluid. Microscopic Presence of endometrial glands and stroma within the parenchyma. What is your diagnosis?
Endometriosis
Which histology best describes the endometrium during secretory phase?
Stromal edema, increased cytoplasmic eosinophilia and prominent spiral arterioles
Defect in bicornuate uterus
All of the choices:
a. Failure of wolffian duct fusion
b. Incomplete fusion of the mesonephric duct
c. Incomplete fusion of the paramesonephric duct
False regarding PID
Infection begins in the ovary and spreads downward to involve the vulva and vagina
A theory stating that endometrial lining cells travel backwards through fallopian tubes during menses to reach peritoneal cavity, proliferate and cause chronic inflammation with formation of adhesions
Regurgitation theory
56 year old female with history of early menarche, noted an endometrial mass upon consult, molecular study showed PTEN gene mutation. What is the expected biopsy findings of this mass?
Atypical glandular structures exhibiting cytologic atypia admixed with malignant sarcomatous elements
Vulvar malignancy not associated with HPV infection
Keratinizing SCCA
Which is NOT a function of the HPV E7 gene?
Inhibition of apoptosis
Cervical cancer stage wherein carcinoma has involved the mucosa of the bladder or rectum already
Stage IV
In the CIN classification, CIN III corresponds to the following classification systems EXCEPT:
a. High grade SIL
b. Carcinoma in situ
c. Severe dysplasia
d. None of the choices
None of the choices
TRUE ABOUT BILATERAL MUCINOUS TUMORS OF THE OVARY
a. SOURCE IS MOST LIKELY EXTRAOVARIAN
b. SYNCHRONOUS HIGH GRADE PRIMARY MUCINOUS MALIGNANCY
c. BOTH CHOICES ARE TRUE
d. BOTH CHOICES ARE FALSE
d. BOTH CHOICES ARE FALSE
MUTATION OF THE KRAS PROTO-ONCOGENE IS A CONSISTENT GENETIC ALTERATION IN WHICH OVARIAN TUMOR?
MUCINOUS CYSTADENOCARCINOMA
WHICH OF THE FACTORS IS MOST LIKELY TO RESULT IN EARLY SPONTANEOUS ABORTION?
FETAL ANEUPLOIDY
NULLIPARITY IS SAID TO BE A RISK FACTOR FOR WHICH OVARIAN MALIGNANT TUMOR?
a. ENDOMETRIOID CARCINOMA
b. SEROUS PAPILLARY CYSTADENOCARCINOMA
c. CLEAR CELL CARCINOMA
d. ALL CHOICES
e. NONE OF THE CHOICES
e. NONE OF THE CHOICES
THE FOLLOWING CONDITION OFTEN OVERLAPS WITH POLYCYSTIC OVARY SYNDROME IN YOUNGER WOMEN
STROMAL HYPERTHECOSIS
WHICH OF THE FOLLOWING EPITHELIAL TUMORS OF THE OVARY IS THOUGHT TO ARISE IN ASSOCIATION WITH ENDOMETRIOSIS
a. MUCINOUS CYSTADENOCARCINOMA
b. HIGH GRADE SEROUS PAPILLARY CYSTADENOCARCINOMA
c. BOTH CHOICES ARE CORRECT
d. NONE OF THE CHOICES IS CORRECT
d. NONE OF THE CHOICES IS CORRECT
RESPONSIBLE FOR THE MAJORITY OF SUPPURATIVE FORM OF SALPINGITIS
GONOCOCCI
PRESENCE OF FETAL PARTS IN A HYDATIDIFORM MOLE IS MOST LIKELY ASSOCIATED WITH WHICH KARYOTYPE?
46XX
TRUE ABOUT BRENNER TUMOR OF THE OVARY, EXCEPT
ALL CHOICES ARE TRUE:
a. MOST TUMORS OF THIS TYPE ARE BORDERLINE
b. MORPHOLOGICALLY OFTEN ASSOCIATED WITH MUCINOUS GLANDS IN THE
CENTER OF THE WELL DEMARCATED NESTS
c. CELLULAR COMPONENTS RESEMBLE TRANSITIONAL EPITHELIUM
Which finding will not point to the diagnosis of Minimal Change disease?
EM/GBM thickening
Tuft cells proliferating in endocapillary proliferation are the following EXCEPT
Fibroblasts
Which statement is FALSE regarding Focal Segmental Glomerulosclerosis?
Not associated with HIV, heroin use
Which medical condition increases the risk of a person in developing IgA nephropathy?
Celiac disease
Autoantibodies are directed against which protein in membranous nephropathy?
PLA2R
Endocapillary proliferation characterizes this tissue response
Hypercellularity
Electron microscopy finding in Membranous Nephropathy
Spike and dome appearance
Antibodies are produced in Goodpasture syndrome directed against which component of the glomerular filtration barrier?
Basement membrane
FALSE of Collapsing glomerulopathy
Tubules are spared from injury
Glomerular biopsy findings in Nephritic syndrome
Hypercellular and inflamed glomeruli
