Histopath - Systemic, Endo, CTD, Bone & Soft tissue

Question 1

AA Amyloid type

Answer 1

Serum amyloid A (acute phase protein synthesised by liver)

Long standing inflammatory disease e.g., Crohn’s, Rh arthritis

Question 2

Al amyloid type

Answer 2

Derived from light chains

Seen in Multiple myeloma, B cell lymphoma

Question 3

Hallmark feature of PID

Answer 3

Salpingitis

Question 4

Classical of Cervical intraepithelial neoplasia

Answer 4

CIN 1 = lower third
CIN 2 = lower two thirds
CIN 3 = entire thickness

Question 5

Most common cervical cancer type

Answer 5

Squamous cell carcinoma

Question 6

high risk (of cancer) HPV strains

Answer 6

16, 18, (33)

Question 7

Which HPV viral proteins involved in cancer pathogenesis

Answer 7

E6 - binds p53

E7 - binds Retinoblastoma (Rb)

Question 8

Most common uterine tumour

Answer 8

Leiomyoma (fibroid)

Question 9

Staging of (endometrioid) uterine cancer

Answer 9

Stage 1A = <50% myometrial invasion
Stage 1B = >50% myometrial invasion

Stage 2 = invades cervical stroma

Stage 3A = invades serosa of corpus uteri and/or andexa
3B = vaginal and/or parametrial
3C1 = pelvic LN
3C2 = para-aortic LN

Stage 4A = bladder and/or bowel
Stage 4B = distant mets (intra-abdominal and/or inguinal lymph nodes)

Question 10

Importance of POLE mutation in endometrial cancer?

Answer 10

Better prognosis

tumours often appear high grade histologically

Question 11

What uterine cancers respond to Anti PD-1 mono therapy

Answer 11

EEC with POLE mutation

MSI tumour groups

Question 12

Most common benign ovarian tumour

Answer 12

Serous cystadenoma

Question 13

Syndromes that pre-dispose to ovarian sex cord stromal tumours

Answer 13

DICER 1 syndrome

Peutz-Jeghers syndrome

Question 14

Most common renal cell carcinoma type

Answer 14

Clear cell renal cell carcinoma (70%)

Question 15

Which renal disease has Abs against phospholipase A2

Answer 15

Membranous glomerulonephritis

Question 16

Which renal disease has Abs against (Type IV collagen in) basement membrane

Answer 16

Anti GBM “Goodpasture’s”

Causes acute crescentic glomerulonephritis

Question 17

Stages of diabetic nephropathy

Answer 17

1 = thickening of basement membrane on EM
2 = increase in mesangial matrix, without nodules
3 = nodular lesions / Kimmelstiel-Wilson
4 = advanced glomerulosclerosis

Question 18

Most specific Ab for SLE

Answer 18

Anti smith (against ribonucleoproteins)

but only 30% patients have it

Question 19

Ab seen in drug related SLE

Answer 19

Anti-histone

Question 20

Abs in systemic sclerosis

Answer 20

Limited (CREST) = anti centromere

Diffuse = topoisomerase (Scl70)

Question 21

Ix findings in sarcoidosis

Answer 21

Hypergammaglobulinaemia
Raised ACE
Hypercalcaemia (vit D hydroxylation by activated macrophages)

Histology: (non caseating) granuloma +/- multinucleate giant cells