Histopathology Flashcards
What is the typical chemotherapy regime used for non-resectable pancreatic cancer?
FOLFIRINOX
A 60 year old man has suffered from atrial fibrillation since his early 30s. He has undergone multiple failed cardioversions, the most recent of which was 10 years ago. Since then his symptoms have been well controlled with bisoprolol 10mg OD. His heart sounds are normal.
He says he has had high blood pressure for “years”.
His ECG is normal other than an irregularly irregular rhythm and large, bifid p waves.
What is the most likely abnormality that will be found on his echocardiogram to explain his permanent atrial fibrillation and poor success at cardioversion?
Dilated left atrium
What liver enzyme may also be found in the heart and may rise in acute myocardial infarction?
Aspartate Aminotransferase
What sign is the name of a palpable lymph node in the left supraclavicular fossa?
Troisier sign
What further imaging is indicated for a confirmed transient ischaemic attack of the anterior circulation when neurological symptoms have resolved?
Carotid Ultrasound (for consideration of a carotid endarterectomy)
Long term prevention of TIA
Clopidogrel 75mg lifelong (replaces aspirin)
High intensity statin
Pattern of AST:ALT in alcoholic hepatitis
AST > 3x ALT - highly specific for alcoholic hepatitis
ALT> 1000 suggests what
toxins, drugs, viruses, ischaemia
Chest pain + raised AST
Myocardial infarction
Chest pain + raised AST
Myocardial infarction
ALP>AST
Biliary Obstruction
ALP>AST
Biliary Obstruction
A CT report for a 74 year old gentleman with shortness of breath and a dry cough mentions the presence of “a honeycomb lung”.
What condition does the gentleman likely have?
Interstitial Lung Disease
A 32 year old breastfeeding woman presents to her GP with a sore, inflamed left breast. She reports symptoms are worsening. She feels unwell.
Her temperature is 38.5c. She is not tachycardic.
On examination there is a diffusely tender left breast with a firm, fluctuant mass located 2cm medial to the nipple. It is approximately 1cm in size. There is no nipple retraction.
What is the diagnosis?
Breast Abscess
A 18 year old university student collapses 1 hour into a game of rugby. He regains consciousness after bystanders perform CPR. There is a family history of sudden cardiac death.
He has an ejection systolic murmur and an ECG shows ST depression in the anterior leads with giant T wave inversion. QRS complexes are noted to be tall.
What diagnostic investigation is most appropriate?
Echocardiogram
A 18 year old man has his urine dipped as part of a pre employment health check.
He has no past medical history and denies any symptoms.
The urine dip shows the presence of microscopic haematuria (+). He says that his father also always has blood in his urine.
What is the likely diagnosis
Benign familial haematuria
What is the minimum random plasma glucose level (in mmol/L) that is required to diagnose diabetes in a symptomatic individual?
11.1
Which class of lupus nephritis on biopsy may show complete sclerosis of nearly all glomeruli?
Class VI
Most common solid organ cancers in men
Prostate (most common in men)
Lung
Bowel
Head and Neck
Other
Most common solid organ cancers in women
Breast (most common cancer overall)
Lung
Bowel
Uterus
Other
Comonest causes cancer mortality men
Lung (most deadly)
Prostate
Bowel
Oesophagus
Other
Most common causes cancer death women
Lung (most deadly)
Breast
Bowel
Cancer of unknown primary
Other
A 30 year old woman is seen in emergency department after an overdose of paracetamol.
Her blood tests reveal: ALT >12x upper limit of normal, AST >7x upper limit of normal, ALP >2x upper limit of normal, Bilirubin >8x upper limit of normal
A VBG shows a pH of 7.23 and a lactate of 10. Her blood sugar is 3.4.
She has been started on N-acetylcysteine, glucose and intravenous fluids by A+E.
What is the next most appropriate treatment for her deranged liver function?
Liver transplant
A 24 year old with Ehlers Danlos syndrome presents to the emergency department with a sudden onset severe headache.
She lost consciousness at the onset of the headache and has vomited twice since.
CT Head non contrast reveals hyperdense enhancement adjacent to the circle of willis.
What is the likely diagnosis?
Subarachnoid haemorrhage
