Histopath Flashcards
1
Q
Oesophageal cancer with smoking and alcohol 20 cm down
A
Squamous cell carcinoma
2
Q
Most common breast malignancy
A
Invasive ductal
3
Q
E-cadherin related
A
Invasive Ductal
4
Q
Fibroepithelial tumour with stromal elements (breast)
A
Phylloides
5
Q
Pain at the END of micturition + loin to groin pain
A
Renal calculi
6
Q
Man with AF develops fever, N&V, and pain in right loin
A
Renal infarct (AF-> clots)
7
Q
Cancer with keratin and intercellular bridges (desmosomes)
A
SCC
8
Q
Transitional cancer - which organ?
A
Bladder
9
Q
Ovarian cancer - most common + psammoma bodies
A
Serous cystadenoma
10
Q
Sarcoidosis changes in LNs
A
Granulomas
11
Q
What is deposited in kidneys in MM?
A
AL amyloid or IgG light chains
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
13
Q
What would you see in scar 1 week post op?
A
Granulation tissue (?)
14
Q
54 yo, fever, weakness, hyperCa, painless haematuria
A
Renal Cell Carcinoma
15
Q
Pain at end of micturition and fever
A
UTI
16
Q
Bilateral oedema, oliguria, ,red cell casts
A
Nephritic syndrome
17
Q
Kidney changes in T1DM
A
Renal sclerosis
18
Q
Radiosensitive cancer of the testicle in young man + white/smooth appearance
A
Seminoma
19
Q
Bladder cancer + schistosomiasis
A
SCC
20
Q
Breast: 55yo, bloody nipple discharge, branching fibrovascular cores, bland epithelium
A
Duct papilloma (AKA Intraductal papilloma) - benign
21
Q
Artichoke like breast lump
A
Phyllodes
22
Q
Stellate pattern of glandular tissue surrounding central scar
A
Radial scar (resembles carcinoma on mammogram)
23
Q
Keritanizing squamous epithelium in smokers breast
A
Periductal masitits (not lactation related)
24
Q
Breast mass, aspirate brown fluid, cysts
A
Fibrocystic disease
25
red, roughened, ulcerated nipple
Paget's of the nipple
26
Microcalcifications of mammography
Ductal carcinoma in situ
27
Sheets of atypical cells with lymphocytic infiltrate (breast)
Basal like carcinoma
28
Multiparous, thick white secretions from nipples
Duct ectasia
29
Lung cancer with paraneoplastic syndromes (e.g. ACTH)
Small cell carcinoma
30
Plumber, thickened pleura
mesothelioma
31
ship worker pleural plaques
asbestos
32
red rusty sputum
strep pneumonia
33
Pattern of lung injury in a1at deficiency
emphysema (often in non smokers)
34
Aggressive LCa responds to chemo
Small cell
35
Common in women and non-smokers (Lung ca)
Adenocarcinoma
36
Smokers + SIADH
Small cell lung cancer
37
Mutations in lung cancer: KRAS
adeno or squamous = poor prognosis, do not respond to tyrosine kinase inhibitors
38
Mutations in lung cancer: EML4-ALK
adenocarcinoma
39
Mutations in lung cancer: EGFR
adenocarcinoma
40
Mutations in lung cancer: ERCC1
NSCLC - poorer response to cisplatin
41
Howships lacunae associated with which cell
Osteoclasts
42
20yo with lytic lesion in the diaphsis of his leg - the pain is alleviated by aspirin
Osteoid Osteoma
43
Liver ANA pos with lymphocytic infiltrate
AI hepatitis
44
PBC
AMA+, cirrhosis, high ALP, granulomas, A/W autoimmune conditions
45
PSC
| Symptoms? Histological appearance? Complications?
Beaded appearance, UC, onion skin fibrosis, can progress to cholangiocarcinoma
46
Lower GI polyps not associated with cancer risk
Hamartomatous (also seen in Peutz-Jeghers Syndrome )
47
84yo woman, acute cramp like abdo pain, oedematous thickening of bowel wall, areas of necrotic ulceration confined to mucosal layers, AF
Ischaemic colitis (often in watershed areas i.e. rectosigmoid or splenic flexure)
48
Signet ring cell cancer
Adenocarcinoma in the ovaries--> tends to be from gastric (or lower GI)
49
Krukenberg
Signet ring cell carcinoma from stomach in ovaries
50
Pernicious anaemia associated with what cancer
Gastric cancer (?MALT)
51
Cancer of the pancreatic duct
Ductal adenocarcinoma
52
Pancreatitis and IgG deposition
AI Pancreatits
53
Rare pancreas tumour in children
Pancreatoblastoma
54
Mass following acute pancreatitis
Pseudocyst
55
Chronic pancreatitis macro sign on laparoscopy
White specks around and on pancreas
56
Which Creutzfeld-Jakob disease starts with psychiatric symptoms when younger, then motor symptoms?
Variant Creutzfeld-Jakob disease
57
b-amyloid plaques
Alzheimer's disease
58
Epileptic, freckles, optic nerve tumour, bumps on skin
NF1
59
Mass under dura mater compressing parietal lobe
Meningioma
60
Capillary loops surrounded by epithelial cells
AV malformation
61
HIV, raised ICP, new onset epilepsy
Cryptococcus/toxoplasmosis
62
Raised AFT testicular tumour
Teratoma (germ cell tumours) - are CHEMOsensitive
63
Painless ulcer, snail track ulcers in mouth
Syphilis
64
Thyroid cancer with RET mutation
Medullary
65
Calcitonin staining thyroid
Medullary (+MEN2+Parafollicular C cells)
66
Cystic lesion with papillary architecture/clear cytoplasm in thyroid
Papillary
67
Tumour which secretes oestrogen
Granulosa-theca cell tumour
68
Fibroma (Ovarian) association
Meig's syndrome (ascites and pleural effusion)
69
Thorotrast exposure
Liver or other cancers
Old school carcinogen from past paper
70
Signet ring = What class of cancer?
Adenocarcinoma
71
Neurofibrillary tangles
Alzheimer's (they are aggregates of tau protein)
72
Types of endometrial cancer
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
Nutmeg liver
1. underlying disease
2. other associated sign
R sided heart failure
| Haemosiderin macrophages in lungs
74
What is Dressler syndrome? (+3 signs and timing)
4 weeks post MI
| Fever, pericardial rub, chest pain
75
Oat cell
Small cell carcinoma
76
Non-caseating granulomas in bowel
Crohn's
77
Hamartomatous polyps with extraintestinal features
1. name of syndrome
2. What are some extraintestinal features?
1. Gardner's Syndrome
| 2. Osteomas and skin bumps (epidermoid cysts)
78
Parkinsons and personality changes. Stains with Rhodanine.
Wilson's
79
Aflatoxin
Hepatocellular carcinoma
80
Prussian blue stain
Haemochromatosis
81
Brown-red warty lesion with sandpaper like consistency
Actinic Keratosis
82
Goodpastures on renal microscopy
Crescents
83
rhabdo leads to what in the kidneys?
Acute renal failure by acute tubular necrosis (ATN)
84
Nerve impingement and heart failure with raised ALP
Paget's
85
Lytic lesions, knee, soap bubble appearance
Giant cell tumour
86
Bone pain and looser's zones (pseudofractures)
Osteomalacia
87
McCune Albright Syndrome
Cafe au lait, precocious puberty, fibrous dysplasia
88
Non bacterial thrombotic endocarditis
1. age
2. characteristics
3. Associations
1. Over 40s
2. no inflamm or infection
3. Malignancy and thromboembolism
89
Which part doe h pylori most severely affect?
The pyloric antrum
90
Intrapancreatic calculi and fibrosis
Chronic pancreatitis
91
Enchondroma
Hands and feet (the ends)
Cotton wool calcification
Hyaline cartilage affected
associated with Ollier's and Maffuci's syndromes
92
Osteochondroma
1. other name
2. what is it?
1. exostosis
2. Like osteoma but with cartilagenous cap and in long bones (cause longer name)
Popcorn calcification
93
Periodic acid schiff stain
a1 antitrypsin deficiency
94
Codman's triangle and sunburst appearance
Osteosarcoma
In teenagers around the knee with high ALP
95
Comminuted fracture (other names)
Splintered fracture (or segmental)
96
White cell casts in urine
Pyelonephritis
97
Benign, blood stained nipple discharge
Intraductal papilloma
98
Pauci-immune crescent GN
Does not have anti-GBM or immune complex
Is associated with Wegeners (ANCA) and vasculitis which can cause pulmonary haemorrhage and rash
99
Man with persistent heartburn has endoscopy done which shows mass in oesophagus 35cm down. Which cancer develops in Barrett's oesophagus?
Adenocarcinoma
100
What is the mechanism in the oesophagus as a result of reflux (GORD) that takes place & leads to cancer?
Metaplasia
101
What happens to the body of the stomach in a patient with pernicious anaemia?
Atrophic (gastritis)
102
Which cancer is associated with H. pylori?
Mucosa-associated lymphoid tissue (MALT)/ MALT lymphoma
| t(11;18)
103
Cancer in Coeliac disease if not sticking to gluten-free diet?
Lymphoma/enteropathy-associated T cell lymphoma
104
Which breast cancer is associated with the presence of E cadherins?
Invasive ductal carcinoma
105
Which breast cancer is associated with the absence of E-cadherins?
Invasive lobular carcinoma
106
```
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. Acute aortic aneurysm
B. Left anterior descending artery thrombus
C. Multiple cerebral infarcts
D. Renal thrombus
E. Ventricular rupture
```
107
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. Renal Carcinoma
108
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. Burkitt's lymphoma
109
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. Splenomegaly
110
Which cancer does asbestos cause?
a. Aspergilloma
b. Acute myeloid leukaemia
c. Mesothelioma
d. Chronic lymphocytic leukaemia
e. Renal carcinoma
c. Mesothelioma
111
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
c. Bladder
112
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
c. Serous adenocarcinoma
Serous carcinoma (serous cystadenocarcinoma) is the most common Malignant ovarian tumour. Serous cystadenoma is the most common benign ovarian tumour
113
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
b. Adenocarcinoma
114
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. 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
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
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
42. 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
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
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?
Subdural
118
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?
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
Which vasculitis causes a disease in which a branch of the external carotid is affected
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
A man has multiple myeloma, and get amyloidosis. Which type of amyloidosis would it be?
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
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…
- Acute aortic aneurysm
- Ventricular rupture
- Multiple cerebral infarcts
- Thrombus of the Left Anterior Descending artery
- Left ventricular hypertrophy
122
- 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
- Adenocarcinoma
- B cell lymphoma
- Squamous cell carcinoma
- Neuroendocrine tumour
123
Eczematous nipple rash caused by individual ‘malignant cells’?
Paget's disease of the breast
124
Heart valve abnormality found in Tetralogy of Fallot
Bicuspid pulmonary valve
125
Cancer associated with untreated coeliac disease
Enteropathy-associated T-cell lymphoma
126
Most common cause of acute pancreatitis?
Gallstones
127
Most common type of primary thyroid cancer to metastasise to lymph node?
Papillary carcinoma
128
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
e. Prostate
d. Lung
b. Colon
c. Head and neck
a. Breast
129
Rank the following stages in evolution of oesophageal adenocarcinoma
a. High grade dysplasia
b. Adenocarcinoma
c. Low grade dysplasia
d. Reactive
e. Metaplasia
d. Reactive
e. Metaplasia
c. Low grade dysplasia
a. High grade dysplasia
b. Adenocarcinoma
130
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. Immune complex deposition
B. Fibrinoid necrosis
C. Nodular glomerulosclerosis (Kimmelstiel-Wilson nodules)
D. Amyloid deposition
131
```
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. Adenocarcinoma
B. B cell lymphoma (Gastric MALToma)
C. Squamous cell carcinoma
D. Neuroendocrine tumour
132
```
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. Adenocarcinoma
B. Metaplasia
C. Chronic gastritis & atrophy
D. Gastric MALT lymphoma
E. Enteropathy-associated T-cell lymphoma
```
133
```
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. Invasive ductal carcinoma
B. Invasive ductal carcinoma
C. Ductal carcinoma in situ
D. Phyllodes tumour
134
```
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. Acute pyelonephritis
B. Calculi
C. Renal cell carcinoma
D. Wilm's tumour/nephroblastoma
E. Renal infarct
```
135
55yr old man with a painless mass in head of pancreas and jaundice
Pancreatic cancer
136
Pancreatic mass following acute pancreatitis
Pancreatic pseudocyst
137
Patient with a history of severe abdominal pain; during cholecystectomy the surgeons noticed grey specks around and on the pancreas
Ductal adenocarcinoma
138
Patient with hypoglycaemia and pancreas mass
Insulinoma
139
Patient with a carcinoma in their liver, what was the original carcinoma in their pancreas that caused the metastases?
Ductal adenocarcinoma
140
- 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. Granulomas
B. AL amyloid
C. Inflammation
D. Atheromatous plaque
E. Collagen
```
141
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?
Angiomyolipoma
142
Patient presents with a craggy enlarged uneven prostate - diagnosis?
Adenocarcinoma
143
Radiosensitive cancer of the testicle in a young man with a white/smooth appearance?
Seminoma
144
Patient with a cancer in their bladder following chronic schistosomiasis?
Squamous cell carcinoma
145
Young man, sudden severe pain in testicle following horse riding?
Testicular torsion
146
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. Osteoporosis
B. Osteoid osteoma
C. Paget's disease
D. Mulitple myeloma
E. Rheumatoid arthritis
```
147
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. Subarachnoid haemorrhage
B. Primary CNS lymphoma
C. ITP
D. TIA
148
Which cancer typically causes an increase in calcitonin?
Medullary carcinoma of thyroid
149
What virus increases risk of nasopharyngeal cancer?
Epstein Barr virus
150
Diffuse continuous inflammation from rectum to caecum without granulomas?
Ulcerative colitis
151
Young guy falls & hits head, 2 days later loses consciousness
Subdural haemorrhage
152
Ovarian mass found in a Japanese woman, & histology shows signet ring cells
Krukenberg tumour - gastric metastases
153
What liver change occurs in diabetic patients?
Non-alcoholic fatty liver disease or non-alcoholic steatohepatitis
154
15 year old presents with signs of ataxia. Imaging shows brain tumour extending outwards from cerebellum & invading subarachnoid space. What is most likely type?
Medulloblastoma
155
Publican with diabetes, fatty stools, weight loss, 'slate grey skin', & joint pains. What is underlying diagnosis causing this?
Haemochromatosis
156
Ovarian tumour with hair. No immature cells seen.
Mature teratoma
157
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?
Oesophageal candidiasis
158
What type of oesophageal cancer is most common in the UK?
Adenocarcinoma
159
What type of gastric cancer is most common?
Adenocarcinoma
160
Biopsy of cancerous lesion shows large amounts of keratin and intercellular bridges, what type of cancer is this?
Squamous cell carcinoma
161
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?
Viral thyroiditis
162
42 year old woman has a history of intermenstrual bleeding. On examination, a cervical polyp is found. What do you do next?
Remove it & send for histology
163
Which disease do you see in both MEN1 and MEN2a?
Parathyroid hyperplasia
164
What type of section is done for urgent diagnosis during surgery?
Intra-operative frozen section
165
What type of shunt is seen in Tetralogy of Fallot?
R -> L shunt
166
Insulinoma. What would you find?
- Low cortisol
- Low free fatty acids
- Low pro-insulin
- Low glucagon
- Low c-peptide
Low free fatty acids
167
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
e. Intraepithelial lymphocytes
168
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. Coarctation of the aorta
169
How does a melanoma spread?
a. Lymphoid
b. Haematological
c. Perineural
d. Iatrogenic
e. Transcoelomic
a. Lymphoid
170
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
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
```
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
```
```
C. Squamous metaplasia
B. Mild dysplasia
E. Moderate dysplasia
D. Carcinoma in situ
A. Invasive carcinoma
```
