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Path Past Papers > Histopath > Flashcards

Histopath Flashcards

1
Q

Oesophageal cancer with smoking and alcohol 20 cm down

A

Squamous cell carcinoma

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2
Q

Most common breast malignancy

A

Invasive ductal

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3
Q

E-cadherin related

A

Invasive Ductal

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4
Q

Fibroepithelial tumour with stromal elements (breast)

A

Phylloides

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5
Q

Pain at the END of micturition + loin to groin pain

A

Renal calculi

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6
Q

Man with AF develops fever, N&V, and pain in right loin

A

Renal infarct (AF-> clots)

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7
Q

Cancer with keratin and intercellular bridges (desmosomes)

A

SCC

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8
Q

Transitional cancer - which organ?

A

Bladder

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9
Q

Ovarian cancer - most common + psammoma bodies

A

Serous cystadenoma

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10
Q

Sarcoidosis changes in LNs

A

Granulomas

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11
Q

What is deposited in kidneys in MM?

A

AL amyloid or IgG light chains

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12
Q

What material is seen in the vessel of a paitent with an MI due to burst atheroma? (embolus/thrombus/atheromatous plaque)

A

Thrombus

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13
Q

What would you see in scar 1 week post op?

A

Granulation tissue (?)

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14
Q

54 yo, fever, weakness, hyperCa, painless haematuria

A

Renal Cell Carcinoma

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15
Q

Pain at end of micturition and fever

A

UTI

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16
Q

Bilateral oedema, oliguria, ,red cell casts

A

Nephritic syndrome

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17
Q

Kidney changes in T1DM

A

Renal sclerosis

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18
Q

Radiosensitive cancer of the testicle in young man + white/smooth appearance

A

Seminoma

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19
Q

Bladder cancer + schistosomiasis

A

SCC

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20
Q

Breast: 55yo, bloody nipple discharge, branching fibrovascular cores, bland epithelium

A

Duct papilloma (AKA Intraductal papilloma) - benign

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21
Q

Artichoke like breast lump

A

Phyllodes

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22
Q

Stellate pattern of glandular tissue surrounding central scar

A

Radial scar (resembles carcinoma on mammogram)

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23
Q

Keritanizing squamous epithelium in smokers breast

A

Periductal masitits (not lactation related)

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24
Q

Breast mass, aspirate brown fluid, cysts

A

Fibrocystic disease

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25
Q

red, roughened, ulcerated nipple

A

Paget’s of the nipple

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26
Q

Microcalcifications of mammography

A

Ductal carcinoma in situ

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27
Q

Sheets of atypical cells with lymphocytic infiltrate (breast)

A

Basal like carcinoma

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28
Q

Multiparous, thick white secretions from nipples

A

Duct ectasia

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29
Q

Lung cancer with paraneoplastic syndromes (e.g. ACTH)

A

Small cell carcinoma

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30
Q

Plumber, thickened pleura

A

mesothelioma

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31
Q

ship worker pleural plaques

A

asbestos

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32
Q

red rusty sputum

A

strep pneumonia

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33
Q

Pattern of lung injury in a1at deficiency

A

emphysema (often in non smokers)

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34
Q

Aggressive LCa responds to chemo

A

Small cell

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35
Q

Common in women and non-smokers (Lung ca)

A

Adenocarcinoma

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36
Q

Smokers + SIADH

A

Small cell lung cancer

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37
Q

Mutations in lung cancer: KRAS

A

adeno or squamous = poor prognosis, do not respond to tyrosine kinase inhibitors

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38
Q

Mutations in lung cancer: EML4-ALK

A

adenocarcinoma

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39
Q

Mutations in lung cancer: EGFR

A

adenocarcinoma

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40
Q

Mutations in lung cancer: ERCC1

A

NSCLC - poorer response to cisplatin

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41
Q

Howships lacunae associated with which cell

A

Osteoclasts

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42
Q

20yo with lytic lesion in the diaphsis of his leg - the pain is alleviated by aspirin

A

Osteoid Osteoma

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43
Q

Liver ANA pos with lymphocytic infiltrate

A

AI hepatitis

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44
Q

PBC

A

AMA+, cirrhosis, high ALP, granulomas, A/W autoimmune conditions

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45
Q

PSC

Symptoms? Histological appearance? Complications?

A

Beaded appearance, UC, onion skin fibrosis, can progress to cholangiocarcinoma

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46
Q

Lower GI polyps not associated with cancer risk

A

Hamartomatous (also seen in Peutz-Jeghers Syndrome )

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47
Q

84yo woman, acute cramp like abdo pain, oedematous thickening of bowel wall, areas of necrotic ulceration confined to mucosal layers, AF

A

Ischaemic colitis (often in watershed areas i.e. rectosigmoid or splenic flexure)

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48
Q

Signet ring cell cancer

A

Adenocarcinoma in the ovaries–> tends to be from gastric (or lower GI)

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49
Q

Krukenberg

A

Signet ring cell carcinoma from stomach in ovaries

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50
Q

Pernicious anaemia associated with what cancer

A

Gastric cancer (?MALT)

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51
Q

Cancer of the pancreatic duct

A

Ductal adenocarcinoma

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52
Q

Pancreatitis and IgG deposition

A

AI Pancreatits

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53
Q

Rare pancreas tumour in children

A

Pancreatoblastoma

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54
Q

Mass following acute pancreatitis

A

Pseudocyst

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55
Q

Chronic pancreatitis macro sign on laparoscopy

A

White specks around and on pancreas

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56
Q

Which Creutzfeld-Jakob disease starts with psychiatric symptoms when younger, then motor symptoms?

A

Variant Creutzfeld-Jakob disease

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57
Q

b-amyloid plaques

A

Alzheimer’s disease

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58
Q

Epileptic, freckles, optic nerve tumour, bumps on skin

A

NF1

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59
Q

Mass under dura mater compressing parietal lobe

A

Meningioma

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60
Q

Capillary loops surrounded by epithelial cells

A

AV malformation

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61
Q

HIV, raised ICP, new onset epilepsy

A

Cryptococcus/toxoplasmosis

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62
Q

Raised AFT testicular tumour

A

Teratoma (germ cell tumours) - are CHEMOsensitive

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63
Q

Painless ulcer, snail track ulcers in mouth

A

Syphilis

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64
Q

Thyroid cancer with RET mutation

A

Medullary

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65
Q

Calcitonin staining thyroid

A

Medullary (+MEN2+Parafollicular C cells)

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66
Q

Cystic lesion with papillary architecture/clear cytoplasm in thyroid

A

Papillary

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67
Q

Tumour which secretes oestrogen

A

Granulosa-theca cell tumour

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68
Q

Fibroma (Ovarian) association

A

Meig’s syndrome (ascites and pleural effusion)

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69
Q

Thorotrast exposure

A

Liver or other cancers

Old school carcinogen from past paper

70
Q

Signet ring = What class of cancer?

A

Adenocarcinoma

71
Q

Neurofibrillary tangles

A

Alzheimer’s (they are aggregates of tau protein)

72
Q

Types of endometrial cancer

A

Endometrioid (80%)
- the classic one related to oestrogen excess

Non-endometrioid (20%)

  • papillary/serous/clear cell
  • more aggressive than endometrioid
  • unrelated to estrogen, usually in elderly women with endometrial atrophy
73
Q

Nutmeg liver

  1. underlying disease
  2. other associated sign
A

R sided heart failure

Haemosiderin macrophages in lungs

74
Q

What is Dressler syndrome? (+3 signs and timing)

A

4 weeks post MI

Fever, pericardial rub, chest pain

75
Q

Oat cell

A

Small cell carcinoma

76
Q

Non-caseating granulomas in bowel

A

Crohn’s

77
Q

Hamartomatous polyps with extraintestinal features

  1. name of syndrome
  2. What are some extraintestinal features?
A
  1. Gardner’s Syndrome

2. Osteomas and skin bumps (epidermoid cysts)

78
Q

Parkinsons and personality changes. Stains with Rhodanine.

A

Wilson’s

79
Q

Aflatoxin

A

Hepatocellular carcinoma

80
Q

Prussian blue stain

A

Haemochromatosis

81
Q

Brown-red warty lesion with sandpaper like consistency

A

Actinic Keratosis

82
Q

Goodpastures on renal microscopy

A

Crescents

83
Q

rhabdo leads to what in the kidneys?

A

Acute renal failure by acute tubular necrosis (ATN)

84
Q

Nerve impingement and heart failure with raised ALP

A

Paget’s

85
Q

Lytic lesions, knee, soap bubble appearance

A

Giant cell tumour

86
Q

Bone pain and looser’s zones (pseudofractures)

A

Osteomalacia

87
Q

McCune Albright Syndrome

A

Cafe au lait, precocious puberty, fibrous dysplasia

88
Q

Non bacterial thrombotic endocarditis

  1. age
  2. characteristics
  3. Associations
A
  1. Over 40s
  2. no inflamm or infection
  3. Malignancy and thromboembolism
89
Q

Which part doe h pylori most severely affect?

A

The pyloric antrum

90
Q

Intrapancreatic calculi and fibrosis

A

Chronic pancreatitis

91
Q

Enchondroma

A

Hands and feet (the ends)
Cotton wool calcification
Hyaline cartilage affected

associated with Ollier’s and Maffuci’s syndromes

92
Q

Osteochondroma

  1. other name
  2. what is it?
A
  1. exostosis
  2. Like osteoma but with cartilagenous cap and in long bones (cause longer name)
    Popcorn calcification
93
Q

Periodic acid schiff stain

A

a1 antitrypsin deficiency

94
Q

Codman’s triangle and sunburst appearance

A

Osteosarcoma

In teenagers around the knee with high ALP

95
Q

Comminuted fracture (other names)

A

Splintered fracture (or segmental)

96
Q

White cell casts in urine

A

Pyelonephritis

97
Q

Benign, blood stained nipple discharge

A

Intraductal papilloma

98
Q

Pauci-immune crescent GN

A

Does not have anti-GBM or immune complex

Is associated with Wegeners (ANCA) and vasculitis which can cause pulmonary haemorrhage and rash

99
Q

Man with persistent heartburn has endoscopy done which shows mass in oesophagus 35cm down. Which cancer develops in Barrett’s oesophagus?

A

Adenocarcinoma

100
Q

What is the mechanism in the oesophagus as a result of reflux (GORD) that takes place & leads to cancer?

A

Metaplasia

101
Q

What happens to the body of the stomach in a patient with pernicious anaemia?

A

Atrophic (gastritis)

102
Q

Which cancer is associated with H. pylori?

A

Mucosa-associated lymphoid tissue (MALT)/ MALT lymphoma

t(11;18)

103
Q

Cancer in Coeliac disease if not sticking to gluten-free diet?

A

Lymphoma/enteropathy-associated T cell lymphoma

104
Q

Which breast cancer is associated with the presence of E cadherins?

A

Invasive ductal carcinoma

105
Q

Which breast cancer is associated with the absence of E-cadherins?

A

Invasive lobular carcinoma

106
Q 
Cardio
•	Acute aortic aneurysm
•	Rupture of embolus in the popliteal fossa
•	Multiple cerebral infarcts
•	Ventricular rupture
•	Left ventricular hypertrophy
•	Left anterior descending artery thrombus
•	Renal thrombus
•	Renal artery stenosis
•	Carotid artery stenosis

A. 60 year old man with abdominal pain radiating to back, collapses, & dies - diagnosis?
B. Ex-smoker with history of hypertension & myocardial ischaemia has sudden chest pain which radiates to neck - diagnosis?
C. A 60 year old lady with a background of stepwise memory loss and hypertension is hospitalised with bronchopneumonia
D. An elderly man with atrial fibrillation develops new right flank pain
E. Man has an MI 3 years ago. Now comes into hospital feeling very unwell. Is having a sample taken from their pericardial layer and you find blood is aspirated from the pericardium

A 
A. Acute aortic aneurysm
B. Left anterior descending artery thrombus
C. Multiple cerebral infarcts
D. Renal thrombus
E. Ventricular rupture
107
Q

Man has large mass on right side of abdomen and has blood in the urine

a. Renal Carcinoma
b. Wilm’s tumour
c. Renal infarct
d. Bladder carcinoma
e. Renal calculi

A

a. Renal Carcinoma

108
Q

10 year old Nigerian boy with a neck swelling. At a missionary so only have rudimentary staining kit. Stained with haemotoxylin and eosin (H&E). Starry Sky appearance.

a. Burkitt’s lymphoma
b. Mantle cell lymphoma
c. Hodgkin’s lymphoma
d. Follicular cell lymphoma
e. Medullary thryoid carcinoma

A

a. Burkitt’s lymphoma

109
Q

Which of these is a common finding in someone who has portal hypertension?

a. Splenomegaly
b. Hepatomegaly
c. Spider Naevi in distribution of Superior vena cava (SVC)
d. Hand flapping
e. Jaundice

A

a. Splenomegaly

110
Q

Which cancer does asbestos cause?

a. Aspergilloma
b. Acute myeloid leukaemia
c. Mesothelioma
d. Chronic lymphocytic leukaemia
e. Renal carcinoma

A

c. Mesothelioma

111
Q

A lady is found to have cancer, and investigations show it is a ‘transitional cell’ cancer. Where has it metastasised from?

a. Colon
b. Liver
c. Bladder
d. Breast
e. Thyroid

A

c. Bladder

112
Q

Woman over 25 years of age. In theatres you overhear a surgeon who says they have just found one of the most common ovarian tumours:

a. Psammoma bodies
b. Teratoma
c. Serous adenocarcinoma
d. Mucous adenocarcinoma

A

c. Serous adenocarcinoma

Serous carcinoma (serous cystadenocarcinoma) is the most common Malignant ovarian tumour. Serous cystadenoma is the most common benign ovarian tumour

113
Q

Which lung cancer is most likely in a person who is a non-smoker?

a. Small cell carcinoma
b. Adenocarcinoma
c. Mesothelioma
d. Squamous cell carcinoma
e. Large cell carcinoma

A

b. Adenocarcinoma

114
Q

Child/Infant – nephrotic syndrome – (What is the most likely cause)?

a. Minimal change disease
b. Membranous glomerulonephritis
c. Focal Segmental glomerulosclerosis
d. Wilm’s tumour
e. Goodpasture’s disease

A

a. Minimal change disease

Had this question been talking about individuals of an African American or Hispanic ethnicity the answer would have been Focal segmental glomerulo-sclerosis.

115
Q

50 year old man with Midshaft femur fracture – what would you find at the site of the break/fracture (or rather, which/what type of cancer does he have)?

a. Neuroblastoma,
b. Osteosarcoma
c. Ewing’s sarcoma
d. Chondrosarcoma
e. Adenocarcinoma

A

d. Chondrosarcoma

Osteosarcoma (bone-connectivetissue-abnormalmass) is the most common form of primary (notcausedbyanythingelse) bone cancer. And is most common in teenagers and young adults.

Ewing’s is a malignant cancer which is most common in teenagers and young adults.

Neuroblastoma (nerve-production-abnormalmass) is a cancer of nerves which can metastasise to bones.

Chondrosarcomas (cartillage-connectivetissue-abnormalmasses) mostly affect individuals above the age of 40. Common sites are the thigh bone (Femur), pelvis and upper arm.

116
Q
  1. Middle aged lady. Liver biopsy, loss of bile ducts and granulomas present. Which/what disease is consistent with these findings?
    a. Mucinous carcinoma
    b. Primary biliary cholangitis
    c. Primary sclerosing cholangitis
    d. Hepatocellular carcinoma
    e. Autoimmune hepatitis
A

b. Primary biliary cholangitis

Primary biliary cholangitis (primary biliary cirrhosis) – “Liver biopsy reveals portal hepatitis and granulomatous destruction of bile ducts”

Jaundice + Ulcerative colitis = PSC suspicion, S in PSC for Suspicious Ulcerative colitis. Of if you want to think of it another way, think of Sclerosing (abnormal-hardening-of-tissue-process) as a rough changes inside a vessel, which is a bit like the rough, bloody, damaged lining of the lumen of the gut in UC

Granulomas present / loss of bile ducts = PBC, B in PBC for BILE duct-destruction

117
Q

An elderly man has a fall, and doesn’t become unconscious/lose consciousness, and presents two days later with a confusion, where is the likely site of bleeding?

A

Subdural

118
Q

Both mother and grandmother had medullary thyroid carcinoma, and have tested positive for MEN2. What [biomarker/protein] would be raised in the blood to confirm medullary thyroid cancer?

A

Calcitonin (Carcinoembryonic antigen (CEA) can also be used but is less sensitive)

Papillary & Follicular thyroid carcinoma = Thyroglobulin. HBME-1 staining is positive in Papillary thyroid carcinoma. (Also reduced expression of ATP5E is significantly associated with the diagnosis of papillary thyroid carcinoma).

Medullary thyroid carcinoma = Calcitonin (Carcinoembryonic antigen (CEA) can also be used but is less sensitive).

Papillary is the most common thyroid cancer. Follicular is the second most common. Medullary is the third most common. Pa(y) > Fo(r) > Me. Or Pa(y) > Fo(r) > Me(eran).

119
Q

Which vasculitis causes a disease in which a branch of the external carotid is affected

A

Giant cell arteritis

Giant Cell Arter-itis (Giant cell artery-inflammation)(or read backwards ‘inflammation-of-arteries of large cells’ (hence it is a large vessel vasculitis (vessel-inflammation) affecting large arterial vessels, such as the external carotid, the ascending aorta and its branches)

120
Q

A man has multiple myeloma, and get amyloidosis. Which type of amyloidosis would it be?

A

Amyloid-light chain amyloidosis (AL amyloidosis)

Extra amyloid info that may be useful and was in the PathPastPapers document is:
Beta amyloid plaques – Alzheimer’s
AA (or serum amyloid A protein, or SAA) – Inflammatory
Amyelin – iselt amyloid polypeptide – T2DM

121
Q

Cardio diagnoses

  • Man with sudden onset abdo pain radiates to the back and dies
  • 4 years ago had a heart attack, now you aspirate blood from the pericardium
  • Woman with progressive memory loss and bronchopneumonia
  • Chest pain, radiates to neck
  • “Man with uncontrolled hypertension and angina” This was actually the whole question…
A
  • Acute aortic aneurysm
  • Ventricular rupture
  • Multiple cerebral infarcts
  • Thrombus of the Left Anterior Descending artery
  • Left ventricular hypertrophy
122
Q
  • Tumour in head of pancreas, invading into portal vein, mass in liver
  • Man with H pylori, abnormal area in antrum, mitotic figures and cells with raised nuclear to cytoplasmic ratio, not invading the basement membrane
  • Tumour in oesophagus with keratin and intercellular bridges
  • Women has acute appendicitis, 5mm tumour found in tip when it’s removed
A
  • Adenocarcinoma
  • B cell lymphoma
  • Squamous cell carcinoma
  • Neuroendocrine tumour
123
Q

Eczematous nipple rash caused by individual ‘malignant cells’?

A

Paget’s disease of the breast

124
Q

Heart valve abnormality found in Tetralogy of Fallot

A

Bicuspid pulmonary valve

125
Q

Cancer associated with untreated coeliac disease

A

Enteropathy-associated T-cell lymphoma

126
Q

Most common cause of acute pancreatitis?

A

Gallstones

127
Q

Most common type of primary thyroid cancer to metastasise to lymph node?

A

Papillary carcinoma

128
Q

Rank the cancers below from most to frequent as a cause of death of men in the UK

a. Breast
b. Colon
c. Head and neck
d. Lung
e. Prostate

A

e. Prostate
d. Lung
b. Colon
c. Head and neck
a. Breast

129
Q

Rank the following stages in evolution of oesophageal adenocarcinoma

a. High grade dysplasia
b. Adenocarcinoma
c. Low grade dysplasia
d. Reactive
e. Metaplasia

A

d. Reactive
e. Metaplasia
c. Low grade dysplasia
a. High grade dysplasia
b. Adenocarcinoma

130
Q

Renal:
- Membranous glomerulonephritis
- Minimal change glomerulonephritis
- Granulomatous changes to vessel
- Amyloid deposition
- Fibrinoid necrosis
- Immune complex deposition
- Nodular glomerulosclerosis
A. What histological finding will be seen in the kidneys in cases of post-Streptococcal glomerulonephritis?
B. Malignant HTN, what is the classic renal finding on histology
C. Severe UTI in the kidney in Diabetes, what do you see on biopsy
D. What finding may be present in the kidneys in a patient with Multiple Myeloma?

A

A. Immune complex deposition
B. Fibrinoid necrosis
C. Nodular glomerulosclerosis (Kimmelstiel-Wilson nodules)
D. Amyloid deposition

131
Q 
Gallbladder & pancreas
•	Adenocarcinoma
•	Squamous cell carcinoma
•	Cholangiocarcinoma
•	Active gastritis
•	B cell lymphoma
•	T cell lymphoma
•	Glandular dysplasia
•	Neuroendocrine tumour
•	Other types of dysplasia/metaplasia?
•	None of the above

A. A man is found to have a tumour in head of his pancreas that has invaded into portal vein, and there is a palpable mass in the liver
B. Man with H pylori, abnormal area in antrum, mitotic figures and cells with raised nuclear to cytoplasmic ratio, not invading the basement membrane
C. Tumour in oesophagus with keratin and intercellular bridges
D. Women has acute appendicitis, 5mm tumour found in tip when it’s removed

A

A. Adenocarcinoma
B. B cell lymphoma (Gastric MALToma)
C. Squamous cell carcinoma
D. Neuroendocrine tumour

132
Q 
Upper GI
•	Adenocarcinoma
•	Small cell cancer
•	Squamous cell carcinoma
•	Lymphoma
•	Enteropathy-associated T-cell lymphoma
•	Atrophy
•	Metaplasia
•	Dysplasia
•	Hodgkin’s lymphoma
•	Gastric MALT lymphoma

A. A man with persistent heartburn has an Endoscopy done, which shows a mass in the oesophagus at a depth of 25cm. Which cancer develops in Barrett’s oesophagus?
B. Which process takes place in the oesophagus in response to exposure to stomach acid?
C. What happens to the body of the stomach in a patient with pernicious anaemia?
D. Which cancer is associated with H.Pylori infection?
E. Which cancer is associated with Coeliac disease patients, particularly if they do not control their diet

A 
A. Adenocarcinoma
B. Metaplasia
C. Chronic gastritis & atrophy
D. Gastric MALT lymphoma
E. Enteropathy-associated T-cell lymphoma
133
Q 
Breast
•	Phyllodes tumour
•	Adenocarcinoma
•	Invasive ductal carcinoma
•	Invasive lobular carcinoma
•	Ductal carcinoma in situ
•	Squamous Cell Carcinoma
•	Angiosarcoma

A. Most common type of malignancy in the breast?
B. Which/What cancer is also known as non-specific type?
C. Cancer which has a high, medium and low stage to it
D. Fibro-epithelial tumour with abundant stromal elements

A

A. Invasive ductal carcinoma
B. Invasive ductal carcinoma
C. Ductal carcinoma in situ
D. Phyllodes tumour

134
Q 
Renal
•	Acute pyelonephritis
•	Calculi
•	Renal cell carcinoma
•	Wilm’s tumour/ Nephroblastoma 
•	Bladder Cancer
•	TB
•	Renal infarct

A. A man presents with the symptoms of a UTI and acute onset costovertebral pain. He is found to have pus cells and blood in his urine. What is the most likely cause?
B. A lady with loin-to-groin pain, haematuria and pain at the end of micturition. What is the most likely cause?
C. A lady has frank painless haematuria and a mass palpable on one side. What is the most likely cause?
D. A 2 year old has a palpable abdominal mass when his mother picks him up. What is the most likely cause?
E. A man with AF (Atrial fibrillation) develops fever, nausea, vomiting and pain in his right loin/flank. What is the most likely cause?

A 
A. Acute pyelonephritis
B. Calculi
C. Renal cell carcinoma
D. Wilm's tumour/nephroblastoma
E. Renal infarct
135
Q

55yr old man with a painless mass in head of pancreas and jaundice

A

Pancreatic cancer

136
Q

Pancreatic mass following acute pancreatitis

A

Pancreatic pseudocyst

137
Q

Patient with a history of severe abdominal pain; during cholecystectomy the surgeons noticed grey specks around and on the pancreas

A

Ductal adenocarcinoma

138
Q

Patient with hypoglycaemia and pancreas mass

A

Insulinoma

139
Q

Patient with a carcinoma in their liver, what was the original carcinoma in their pancreas that caused the metastases?

A

Ductal adenocarcinoma

140
Q
  • AA amyloid
  • AL amyloid
  • Inflammation
  • Collagen
  • Granulomas
  • Granulation tissue
  • Atheromatous plaque
  • Thrombus
  • Emboli
    A. The presence of what in the lymph nodes would support a diagnosis of sarcoidosis?
    B. What is deposited in the kidneys in Multiple Myeloma?
    C. Appendix that is full of neutrophils and is enlarged touching the peritoneum
    D. What material is seen in the vessel of a patient with an MI due to burst atheroma
    E. Patient had an appendectomy 1 week ago. What would you see in their scar?
A 
A. Granulomas
B. AL amyloid
C. Inflammation
D. Atheromatous plaque
E. Collagen
141
Q

On doing a patient’s nephrectomy they notice a mass in the kidney that extends into the the renal vessels and into the perinephric fat - diagnosis?

A

Angiomyolipoma

142
Q

Patient presents with a craggy enlarged uneven prostate - diagnosis?

A

Adenocarcinoma

143
Q

Radiosensitive cancer of the testicle in a young man with a white/smooth appearance?

A

Seminoma

144
Q

Patient with a cancer in their bladder following chronic schistosomiasis?

A

Squamous cell carcinoma

145
Q

Young man, sudden severe pain in testicle following horse riding?

A

Testicular torsion

146
Q

Bones and Joints
A. Old woman falls and breaks her hip
B. 20 year old with a lytic lesion in the diaphysis of his leg, pain alleviated by aspirin
C. Man goes deaf with bowed legs
D. Vertebral fracture, high paraprotein
E. Young woman with symmetrical joint pain

A 
A. Osteoporosis
B. Osteoid osteoma
C. Paget's disease
D. Mulitple myeloma
E. Rheumatoid arthritis
147
Q

Cerebrovascular
A. Sudden headache, loss of consciousness, meningism
B. Patient with HIV, raised ICP, new onset epilepsy
C. Young man with fever, leucocytosis, and a petechial rash after URTI
D. Woman with recurrent episodes of weakness and paraesthesia that spontaneously resolve

A

A. Subarachnoid haemorrhage
B. Primary CNS lymphoma
C. ITP
D. TIA

148
Q

Which cancer typically causes an increase in calcitonin?

A

Medullary carcinoma of thyroid

149
Q

What virus increases risk of nasopharyngeal cancer?

A

Epstein Barr virus

150
Q

Diffuse continuous inflammation from rectum to caecum without granulomas?

A

Ulcerative colitis

151
Q

Young guy falls & hits head, 2 days later loses consciousness

A

Subdural haemorrhage

152
Q

Ovarian mass found in a Japanese woman, & histology shows signet ring cells

A

Krukenberg tumour - gastric metastases

153
Q

What liver change occurs in diabetic patients?

A

Non-alcoholic fatty liver disease or non-alcoholic steatohepatitis

154
Q

15 year old presents with signs of ataxia. Imaging shows brain tumour extending outwards from cerebellum & invading subarachnoid space. What is most likely type?

A

Medulloblastoma

155
Q

Publican with diabetes, fatty stools, weight loss, ‘slate grey skin’, & joint pains. What is underlying diagnosis causing this?

A

Haemochromatosis

156
Q

Ovarian tumour with hair. No immature cells seen.

A

Mature teratoma

157
Q

White plaques are seen lining the oesophagus of an OGD of an alcoholic man with recurrent bleeding varices, what are they most likely to be?

A

Oesophageal candidiasis

158
Q

What type of oesophageal cancer is most common in the UK?

A

Adenocarcinoma

159
Q

What type of gastric cancer is most common?

A

Adenocarcinoma

160
Q

Biopsy of cancerous lesion shows large amounts of keratin and intercellular bridges, what type of cancer is this?

A

Squamous cell carcinoma

161
Q

A woman develops signs of hyperthyroidism. Bloods show low TSH and high thyroxine. Does not have good uptake on technetium scan. What is the likely diagnosis?

A

Viral thyroiditis

162
Q

42 year old woman has a history of intermenstrual bleeding. On examination, a cervical polyp is found. What do you do next?

A

Remove it & send for histology

163
Q

Which disease do you see in both MEN1 and MEN2a?

A

Parathyroid hyperplasia

164
Q

What type of section is done for urgent diagnosis during surgery?

A

Intra-operative frozen section

165
Q

What type of shunt is seen in Tetralogy of Fallot?

A

R -> L shunt

166
Q

Insulinoma. What would you find?

  • Low cortisol
  • Low free fatty acids
  • Low pro-insulin
  • Low glucagon
  • Low c-peptide
A

Low free fatty acids

167
Q

What would you see on a duodenal biopsy of a patient with Coeliac disease?

a. Intraepithelial leukocytes
b. Intraepithelial eosinophils
c. Intraepithelial macrophages
d. Intraepithelial neutrophils
e. Intraepithelial lymphocytes

A

e. Intraepithelial lymphocytes

168
Q

What causes hypertension in upper half of body?

a. Coarctation of the aorta
b. Renal parenchymal disease
c. Renal vascular hypertension
d. Adrenal hypertension

A

a. Coarctation of the aorta

169
Q

How does a melanoma spread?

a. Lymphoid
b. Haematological
c. Perineural
d. Iatrogenic
e. Transcoelomic

A

a. Lymphoid

170
Q

Healing of an acute myocardial infarction follows an ordered sequence of events. Rank the following events in chronological order starting from earliest (1) to latest (5).
A. Granulation tissue begins to form
B. Neutrophils begin to arrive at the area of coagulative necrosis
C. Collagen is deposited, forming a fibrous scar
D. Macrophages begin to arrive at the area of coagulative necrosis
E. Flocculent densities form within mitochondria

A

B. Neutrophils begin to arrive at the area of coagulative necrosis
D. Macrophages begin to arrive at the area of coagulative necrosis
A. Granulation tissue begins to form
E. Flocculent densities form within mitochondria
C. Collagen is deposited, forming a fibrous scar

171
Q 
Regarding the uterine cervix, the process of transformation from normal tissue to a malignant tumour passes through several histologically recognisable stages. Rank the following stages in chronological order starting from earliest (1) to latest (5).
A. Invasive carcinoma
B. Mild dysplasia
C. Squamous metaplasia
D. Carcinoma in situ
E. Moderate dysplasia
A 
C. Squamous metaplasia
B. Mild dysplasia
E. Moderate dysplasia
D. Carcinoma in situ
A. Invasive carcinoma

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