H yeild

Question 1

Restrictive pericarditis

Answer 1

Hx of systemic disease e.g. amyloidosis,
haemochromatosis, inflammatory bowel disease
○ If pericardial thickening or fluid can’t be demonstrated consider restrictive
cardiomyopathy

Question 2

Endocrine tumour

Answer 2

rare, normally bod or tail, can be functional (-> Sx due to
hormone secretion) or non functional
○ Acinar cell - enzyme production (e.g. lipase -> fat necrosis), rare, older
adults

Question 3

Pancreatoblastoma

Answer 3

rare, mainly childhood, presents with abdo pain, emesis,
jaundice

Question 4

Pseudocyst

Answer 4

usually complication of pancreatitis, or in children after abdo trauma;
presents with abdo discomfort, difficult digestion

Question 5

Adenocarcinoma

Answer 5

head of pancreas
○ Ductal adenocarcinoma = 85% of pancreatic malignancies; RUQ + back pain,
weight loss, ascites, usual suspects

Question 6

Type of cancer that doesn’t occur in pancreas

Answer 6

squamous cell

Question 7

Duct ectasia

Answer 7

inflammation and dilatation of breast ducts, presents with nipple
discharge
○ Inflammation, proteinaceous material, benign + no risk of malignancy

Question 8

Fibroadenoma

Answer 8

benign, mobile lump, multinodular composed of expanded
intralobular stroma, compressed ‘slit like’ ducts, branching sheets of epithelium

Question 9

Fibrocystic

Answer 9

hormone responsive, lumpiness, ⅓ of premenopausal women, can be
cysts, apocrine metaplasia, adenosis, epithelial hyperplasia and stromal hyperplasia
○ No increased risk of malignancy

Question 10

Radial scar

Answer 10

benign sclerosing lesion characterised by a central zone of scarring
surrounded by a radiating zone of proliferating glandular tissue’
○ Stellate mass on mammogram (resembles carcinoma), central elastotic nidus
surrounded by proliferative corona

Question 11

Mastitis

Answer 11

Red breast, lactating, cracked skin - continue expressing + antibiotics

Question 12

Duct papilloma

Answer 12

nipple discharge or mass, 40-60, papillary, excision of involved
duct is curative

Question 13

Fat necrosis

Answer 13

breast lump, may be firm, Hx of breast trauma

Question 14

Phyllodes tumour

Answer 14

enlarging fibroepithelial mass in woman >50, potentially
aggressive, can arise with pre existing fibroadenoma
○ ‘Proliferation of fibroepithelium and stromal tissue’

Question 15

DCIS

Answer 15

neoplastic, 85% found on mammography, ducts with atypical epithelial cells
○ Most common so pick this if in doubt
○ Staged into low, intermediate, and high grade

Question 16

Invasive breast carcinoma

Answer 16

oestrogen factors, 5% inherited, firm breast mass,
atypical epithelial cells
○ Low grade - ER, PR positive and Her2 non amplified
○ High grade - ER, PR negative and Her2 amplified
○ Invasive ductal carcinoma - nipple retraction
○ Invasive lobular - loss of E-cadherin

Question 17

Gynaecomastia

Answer 17

benign enlargement of male breast around puberty or over 50,
idiopathic or associated with drugs

Question 18

Normal breast

Answer 18

Branching ducts end in terminal duct lobular units
○ Ductal lobular system lined by inner glandular epithelium and outer
myoepithelium

Question 19

Diverticulitis

Answer 19

old, rectal bleeding, fever, LIF

Question 20

Sigmoid volvulus

Answer 20

obstruction

Question 21

UC + Crohns

Answer 21

UC continuous, superficial, more likely to have blood

Question 22

Infective colitis

Answer 22

pseudomembrane, Abx in history

Question 23

Barrett’s oesophagus

Answer 23

metaplasia, columnar epithelium, goblet cells (intestinal)

Question 24

Squamous cell carcinoma of oesphagus

Answer 24

alcohol, smoking, mid/lower
oesophagus, invasion into submucosa

Question 25

CF

Answer 25

patients after lung transplant are more likely to get adenocarcinoma of colon

Question 26

MALT lymphoma

Answer 26

Pernicious anaemia, H pylor

Question 27

Chronic gastritis:

Answer 27

associated with pernicious anaemia and gastric ulcer

Question 28

Gastric cancer

Answer 28

5% adenocarcinoma
○ Intestinal - well differentiated
○ Diffuse - poorly differentiated (linitis plastica, signet ring cell)
○ Signet ring cell - contains mucin which pushes nucleus to cell periphery

Question 29

Lower GI cancer

Answer 29

Adenocarcinoma most common - male with change in bowel habit, weight
loss, bleeding PR
○ AFP -> hyperplastic polyps
○ Polyps not associated with increased cancer risk -> hamartomatous

Question 30

HIV Tuberculoma

Answer 30

ring enhancing lesion

Question 31

TIA

Answer 31

<24 hours stroke symptoms

Question 32

Multiple Sclerosis

Answer 32

relapsing remitting or primary progressive, vision problems

Question 33

CVS Disease

Answer 33

focal neurology, FAST, >24 hours

Question 34

Subarachnoid Haemorrhage

Answer 34

thunderclap

Question 35

Middle meningeal/extradural bleed

Answer 35

Hit on side of head and lucid interval

Question 36

Variant CJD

Answer 36

Depression then CNS symptoms in young person

Question 37

Sporadic CJD -

Answer 37

neurosings first and presents later

Question 38

Alzheimer’s

Answer 38

most common cause of dementia, neurofibrillary tangles (tau), senile plaques
(beta amyloid)

Question 39

Neurofibromatosis type 1 -

Answer 39

optic nerve tumour excised and now lump on hand

Question 40

AV malformation

Answer 40

capillary loops surrounded by epithelial cells

Question 41

Tuberous sclerosis

Answer 41

epileptic with patch on back and lumps in brain

Question 42

Herniation

Answer 42

raised ICP symptoms for a while then became obtunded

Question 43

Meningioma

Answer 43

mass under dura mater compressing frontal lobe (usually)

Question 44

Wilms

Answer 44

massive abdo mass in child, might have high BP, or haematuria

Question 45

RCC

Answer 45

High EPO, high Hb, renal masses, painless haematuria

Question 46

Renal Infarct

Answer 46

fat person with CVS risk factors, will hurt