March 2018 Flashcards
- Wilsons likely
a. Baby jaundice 3-6months
b. Corona radiata T2 early in disease
c. High ceruloplasmin bound copper
d. Autosomal dominant
e. Fatty liver
- Wilsons likely
a. Baby jaundice 3-6months too young usually teens
b. Corona radiata T2 early in disease usually basal ganglia causing parkinsonism
c. High ceruloplasmin bound copper low ceruloplasmin high copper
d. Autosomal dominant AR
e. Fatty liver true, mix with high density copper in liver may be normal on CT
- SLE part of diagnostic criteria
a. Pericarditis
b. Peripheral neuropathy
c. Erosive arthropathy
- SLE part of diagnostic criteria
a. Pericarditis true
b. Peripheral neuropathy CNS
c. Erosive arthropathy non erosive
d. MD SOAP BRAIN = criteria for SLE = malar rash, discoid rash, serositis, oral ulcers, arthritis, photosensitivity, blood dyscrasias, renal failure, ANA, immunologic, neurologic
- Xlinked
a. Adrenoleukodystrophy
b. Alexanders
c. Canavan
d. MLD
- Xlinked
a. Adrenoleukodystrophy yes
b. Alexanders
c. Canavan
d. MLD
- FMD doesn’t cause
a. Tinnitis
b. PVD
c. Angina
d. Renal
e. Carotid
**LJS - I think PVD least common of those listed. Tinnitus listed on radiopedia, due to carotid/VA involvement. Rest listed in Robbins, PVD is not in either (though some evidence that it occurs - google)
- FMD doesn’t cause
a. Tinnitis yes but rare, I think rarest only in case series
b. PVD yes but rare
c. Angina yes but rare in case series
d. Renal
e. Carotid
- PAN does not affect
a. Lungs
b. Kidneys
c. Mesenteric vessels
- PAN does not affect
a. Lungs PAN spares lungs classically, similar to MPA but medium vessels affected
b. Kidneys
c. Mesenteric vessels
- SCC tongue which doesn’t cause
a. Marijuana
b. Cocaine
c. HPV
d. Syphillis
e. Alcohol
- SCC tongue which doesn’t cause
a. Marijuana smoking
b. Cocaine doesn’t because you snort it, HTN, perforation
c. HPV yes oral sex
d. Syphillis rare syphilitic leukoplakia
e. Alcohol yes
- Not risk factor for RCC
a. Smoking
b. Alcohol
c. Obesity
- Not risk factor for RCC
a. Smoking yes
b. Alcohol no! lower risk
c. Obesity yes
- Precursor to melanoma
a. Blue naevus
b. Dysplastic naevus
c. Congenital naevus
d. Basal naevus
- Precursor to melanoma
a. Blue naevus
b. Dysplastic naevus yes
c. Congenital naevus
d. Basal naevus
- PML
a. JCV
- PML
a. JCV yes
- Jaundice in pregnancy, most common cause of liver disease in pregnancy
a. Cholestasis
b. Hepatitis
c. Preeclampsia
d. HELLP
b. Hepatitis yes most common cause of jaundice in pregnancy
- Jaundice in pregnancy, most common cause of liver disease in pregnancy
a. Cholestasis 1 in 1000
b. Hepatitis yes most common cause of jaundice in pregnancy
c. Preeclampsia HTN and proteinuria
d. HELLP rare but bad
- Least true regarding circumvallate
a. Abruption
b. IUGR
c. Painless bleeding
d. Fetal death
e. Abnormal tocography
- LW:
11. Least true regarding circumvallate: favoured answer painless bleeding.
a. Abruption: known association
b. IUGR: known association
c. Painless bleeding: not by itself, association with abruption which causes painful bleeding.
d. Fetal death: usually of no consequence
e. Abnormal tocography
- Least correct
a. ADEM follow bacterial infection
b. NMO bilateral optic neuritis
c. Relapsing remitting MS on MRI plaque doesn’t have axonal degeneration
*LW: favour option A.
- Least correct
a. ADEM follow bacterial infection: possible but rare, and most resoruces state viral or post vaccination. ONly case report level of bacterial.
b. NMO bilateral optic neuritis: true
c. Relapsing remitting MS on MRI plaque doesn’t have axonal degeneration: RObbins states Axons are relatively preserved but may be reduced in number. Other resources have stated, they do have axonal degeneration.
- Hirschprungs false
a. More common in females
b. Involves whole colon
c. Bowel obstruction and perforation
a. More common in females more common male
- Hirschprungs false
a. More common in females more common male
b. Involves whole colon
c. Bowel obstruction and perforation
- PXA
a. Involves grey matter and overlying meninges
b. Adults frontal
c. Child brainstem and cerebellum
- PXA
a. Involves grey matter and overlying meninges this dural reaction
b. Adults frontal temproal
c. Child brainstem and cerebellum rare
- Which chondroid lesion crosses physes
a. Chondroblastoma
b. Periostial chondroma
c. EnchondromaLeas
d. CMF
e. Osteochondroma
- Which chondroid lesion crosses physes:
*LW:
Wheeles states: only three tumors may invade physis: chondroblastoma, GCT, and clear cell chondrosarcoma
a. Chondroblastoma rarely may cross physis: probably the best answer
b. Periostial chondroma: periosteal based lesion, so unlikely to cross the actual physical bar.
c. Enchondroma: very unlikely to occur in the epiphysis, occurring most commonly in diaphysis.
d. CMF: unlikely
e. Osteochondroma: exophytic so false.
- PVNS and GCT (Giant cell tumour of tendon sheath) which is false
a. PVNS most common knee
b. GCT most common wrist
c. PVNS and GCT erode bone
d. GCT excision likely to recur
e. PVNS characteristically cause inflammation
e. PVNS characteristically cause inflammation probably this characteristically bleed other answers are all more correct, and is a low grade neoplasm rather than an inflammatory process.
16. PVNS and GCT (Giant cell tumour of tendon sheath) which is false
a. PVNS most common knee: TRUE
b. GCT most common wrist: TRUE
c. PVNS and GCT erode bone: Can do in up to 15%
d. GCT excision likely to recur: TRUE
e. PVNS characteristically cause inflammation probably this characteristically bleed other answers are all more correct
- Post partum diabetes insipidus
a. Lymphocytic hypophysitis
b. Sheehans
- Post partum diabetes insipidus
a. Lymphocytic hypophysitis yes, loss of posterior pituitary bright spot and DI
b. Sheehans massive bleed and necrosis
- Most common with tumor marker
a. YS tumor
b. Seminoma
c. Granulosa cell
- Most common with tumor marker
a. YS tumor aFP
b. Seminoma
c. Granulosa cell
- Most common elderly testicular tumor
a. Lymphoma
- Most common elderly testicular tumor
a. Lymphoma yes
- Most common eldertly germ cell testicular tumor
a. Spermatocytic seminoma
- Most common eldertly germ cell testicular tumor
a. Spermatocytic seminoma yes
- Wilms least correct
a. Bilateral almost always germ line
b. Unilateral is 50% genetic
c. Genetic wilms have nephrogenic rests
b. Unilateral is 50% genetic: this is lease correct as approx. 10% is genetic.
- Wilms least correct
a. Bilateral almost always germ line
b. Unilateral is 50% genetic: this is lease correct as approx. 10% is genetic.
c. Genetic wilms have nephrogenic rests
- Breast least likely in post menopausal
a. IDC
b. LCIS
c. Fibroadenoma
d. Phylloides
e. Papillary
c. Fibroadenoma young
- Breast least likely in post menopausal
a. IDC
b. LCIS
c. Fibroadenoma young
d. Phylloides
e. Papillary
- True regarding juvenile papillomatosis
a. Most commonly presents as palpable mass
b. Nipple discharge
c. Solid lesion on US
d. No increased risk of breast cancer
- True regarding juvenile papillomatosis
a. Most commonly presents as palpable mass: correct
b. Nipple discharge: FALSE - adult papilloma bloody discharge
c. Solid lesion on US: FA:LSE - can have small cysts, pathologically swiss cheese appearance
d. No increased risk of breast cancer: FALSE - increased risk
- Regarding thyroid lesions (which is false)
a. Iodine deficiency associated papillary
b. Radiation is associated with papillary
c. Medullary with MEN worse prognosis than medullary without MEN
d. Anaplastic kills by invasion
e. Hashimotos sometimes assoc with hodgkins lymphoma
**LJS - iodine deficiency is ass/w follicular carcinoma (Robbins p 1095)
Hashimotos ass/w marginal zone B cell lymphoma (NHL) and papillary carcinoma
Rest are true
- Regarding thyroid lesions (which is false)
a. Iodine deficiency associated papillary: FALSE
b. Radiation is associated with papillary: TRUE
c. Medullary with MEN worse prognosis than medullary without MEN: TRUE
d. Anaplastic kills by invasion: TRUE
e. Hashimotos sometimes assoc with hodgkins lymphoma: FALSE - associated NHL
- More likely Hodgkins than NHL
a. Single nodal site
b. Extranodal disease
c. Small bowel mesentery
- More likely Hodgkins than NHL
a. Single nodal site true
b. Extranodal disease NHL
- Complex sclerosing lesion on biopsy
a. No further management, benign
b. Hookwire and open biopsy
c. Hookwire WLE and SNB
- Complex sclerosing lesion on biopsy
a. No further management, benign false
b. Hookwire and open biopsy correct
c. Hookwire WLE and SNB false SNB only if invasive cancer, radial scar is not cancer, DCIS is not cancer
- DCIS
a. Prognosis depends on histological microarchitecture
b. High grade worse prognosis
- DCIS
a. Prognosis depends on histological microarchitecture wrong but some what true if comedonecrosis is included, but I think they mean appearance of papillary, micropapillary, cribiform etc.
b. High grade worse prognosis correct grading based on comedonecrosis and pleomorphism
- Antibodies to GBM
a. Goodpastures
b. PAN
c. Wegners
d. MPA
- Antibodies to GBM
a. Goodpastures true
b. PAN
c. Wegners
d. MPA
- Myeloma false
a. IgA
b. IgG
c. Serum light chains
d. BJP
- Myeloma false
a. IgA less common, maybe this answer or the other not recalled one
b. IgG most common
c. Serum light chains yes
d. BJP yes
- Diabetes microangiopathy false
a. Glomerulosclerosis
b. Macula edema
c. Peripheral neuropathy
d. Autonomic neuropathy
- Diabetes microangiopathy false
a. Glomerulosclerosis yes
b. Macula edema yes
c. Peripheral neuropathy yes
d. Autonomic neuropathy not sure
- Cortical calcifications in HIV on US which is true
a. HIVAN
b. CMV
c. EBV
d. PCP
- Cortical calcifications in HIV on US which is true
a. HIVAN no, enlarged echogenic kidney
b. CMV yes, later described also in MAI
c. EBV no
d. PCP yes, first case series described
- Trophoblastic disease
a. PSTT presenting 2 years after normal pregnancy has good prognosis
b. Metastatic disease to lungs in GTD is very chemosensitive
c. Partial mole no risk of choriocarcinoma
- Trophoblastic disease
a. PSTT presenting 2 years after normal pregnancy has good prognosis I think this is false, usually slow growing but if delayed will be metastatic
b. Metastatic disease to lungs in GTD is very chemosensitive true
c. Partial mole no risk of choriocarcinoma: *LW - I think this is false as less but possible but ‘partial’ risk of choriocarcinoma relative to complete [previous answer of: true]
- SPT false
a. Solid and cystic components
b. Middle aged woman
- SPT false
a. Solid and cystic components true
b. Middle aged woman false
- Most likely bilateral
a. Mucinous tumor
b. Endometrioid tumor
c. Brenners
d. Dermoid
- Most likely bilateral
a. Mucinous tumor
b. Endometrioid tumor yes, most likely bilateral serous > endometrioid/clear cell > dermoid
c. Brenners
d. Dermoid
- RCC bilateral most likely
a. Clearcell
b. Papillary
c. Medullary
d. Collecting duct
- RCC bilateral most likely
a. Clearcell
b. Papillary true
c. Medullary
d. Collecting duct
- RCC best prognosis
a. Clear cell
b. Papillary
c. Chromophobe
d. Medullary
- RCC best prognosis
a. Clear cell
b. Papillary
c. Chromophobe true assoc with BHDS, oncocytic
d. Medullary
- Parotid lesion least likely
a. SCC
b. Actinic cell
c. Warthins
d. Adenocystic
e. Mucoepidermoid
*LW: SCC Incidence of parotid lesions: Pleomorphic adenoma - 50% Mucoepidermoid (malignant) - 15% Adenocarcinoma NOS (malignant) - 10% Warthin 5-10% Oncocytoma - 1% Acinic cell carcinoma (malignant) - 5% adenoid cystic carcinoma (malignant) - 5% SCC - 1%
- Parotid lesion least likely
a. SCC either this, does it count mets to parotid node
b. Actinic cell or this
c. Warthins
d. Adenocystic
e. Mucoepidermoid
- Spiculated mass true
a. Complex sclerosing lesion (this was the best option even though usually its no mass centrally)
b. Short spicules in radial scar
- Spiculated mass true
a. Complex sclerosing lesion (this was the best option even though usually its no mass centrally) true
b. Short spicules in radial scar
- Least likely present with spiculated mass
a. Medullary breast
- Least likely present with spiculated mass
a. Medullary breast usually circumscribed
- Coal workers least likely
a. Centrilobular emphysema
b. Nodules and macules
c. PMF lower zone
d. Peripheral calcification in node
c. PMF lower zone false
- Coal workers least likely
a. Centrilobular emphysema
b. Nodules and macules
c. PMF lower zone false
d. Peripheral calcification in node
- Silicosis wrong
a. Causes TB
b. Massive fibrosis upper lobe
c. Nodules in lower zones
d. Honeycombing
c. Nodules in lower zones false
* No hard evidence of UIP association
- Silicosis wrong
a. Causes TB - associated with it
b. Massive fibrosis upper lobe
c. Nodules in lower zones false
d. Honeycombing 10% UIP
- Pleural effusion wrong
a. Renal failure haemorrhagic effusion
b. Simple effusion in low albumin
- Pleural effusion wrong
a. Renal failure haemorrhagic effusion false, transudate
b. Simple effusion in low albumin
- LAM false
a. Chylothorax
b. PTX
c. TS
d. Upper zone distribution of cysts
d. Upper zone distribution of cysts no distribution, LCH is upper lobe
- LAM false
a. Chylothorax
b. PTX
c. TS
d. Upper zone distribution of cysts no distribution, LCH is upper lobe
- Renal papillary necrosis (False)
a. Analgesia
b. Diabetes
c. Obtruction
d. Sickle cell
e. Emboli into segmental vessel
- Renal papillary necrosis:
a. Analgesia: TRUE
b. Diabetes: TRUE
c. Obtruction: TRUE
d. Sickle cell: TRUE
e. Emboli into segmental vessel: FALSE
POSTCARDS: pyelonephritis, obstruction of the urogenital tract, sickle cell disease, tuberculosis, cirrhosis of the liver, analgesia/alcohol abuse, renal vein thrombosis, diabetes mellitus, systemic vasculitis
- Drug associations false
a. MTX pneumatocele
b. Cylophoshamide and mass
c. Phenytoin and pleural effusion
- Drug associations false
a. MTX pneumatocele false
b. Cylophoshamide and mass
c. Phenytoin and pleural effusion
- Lesion without scar
a. Adenoma
b. Haemangioma
c. FLHCC
d. FNH
e. Cholangiocarcinoma
- Lesion without scar
a. Adenoma no scar
b. Haemangioma
c. FLHCC
d. FNH
e. Cholangiocarcinoma
- CM brain (false)
a. Associated DVA
b. Haemosiderin rim
c. Seizure
d. No brain tissue
e. Dilated draining vein
- CM brain
a. Associated DVA: true
b. Haemosiderin rim: true
c. Seizure: true
d. No brain tissue in-between: true
e. Dilated draining vein: false, this occurs in a dAVF
- Psoriatic arthritis true
a. Aortitis
b. Synovial inflammation
c. Plantar fasciitis
**LJS - Plantar fasciitis - yes, form of enthesitis - statDx agrees.
-Aortitis - no (other HLA B27 arthropathies - ank spond, reiters are ass/w aortitis, not psoriatic)
StatDx reports aortic insufficiency.
-Synovial inflammation - no. Seronegative spondyloarthropathies affect the ligamentous attachments, not the synovium (Robbins)
StatDx states generalised synovitis, and is similar to RA - which is synovial inflammation.
- Psoriatic arthritis true
a. Aortitis
b. Synovial inflammation also true, but I think this one
c. Plantar fasciitis
- Lesion false
a. Nodular fasciitis related to trauma
b. Variations of myositis ossificans and nodular fasciits locations features
- *LJS - nodular fasciitis also related to trauma
- LW agree - preceeeding trauma noted in 10-15% cases.
Nodular fascitis: most commonly volar aspect forearm, followed by chest wall and back.
Myositis ossificans:
metaplstic bone.
Commonly follows episode of trauma > 50% cases.
Muscles of proximal limbs, eventually painless hard mass.
Most peripheral zone well formed mineralised trabeculae, while less ossified centre.
- Lesion false
a. Nodular fasciitis related to trauma
b. Variations of myositis ossificans and nodular fasciits locations features
- Lesion in stomach dyspepsia, sessile, 90 degree angle
a. Duplication
b. GIST
c. Lymphoma
**LJS - MALToma complicating H pylori gastritis?
- Lesion in stomach dyspepsia, sessile, 90 degree angle
a. Duplication
b. GIST maybe this?? Don’t know
c. Lymphoma
- OI
a. All have dentogenesis imperfecta
b. Type 1 kyphoscoliosis
c. Type 2 life
d. Type 3 hearing impairment
e. Type 4 blue sclera
OI
a. All have dentogenesis imperfects: false,
Robbins states type one has dentogenesis imperfecta, type 2 DOES NOT, Type 3 and 4 do.
b. Type 1 kyphoscoliosis: false, mild so less likely kyphoscoliosis:
*LW answer:
Type I has kyphoscoliosis: unlikely as near normal stature, with bone deformity minor.
c. Type 2 life: false lethal form
d. Type 3 hearing impairment: Robbins states hearing imparment.
e. Type 4 blue sclera
*LW answer:
Robbins states type 1, type 2, type 3 (intially at birth then become white) has blue sclera.
Type IV has blue sclera: variable
RP states type 1 has blue sclera, while type IV sclerae are often light blue in infancy, but the colour intensity varies - the sclerae may lighten to white later in childhood or early adulthood
**LJS - all but type 2 have dentinogenesis imperfecta
Type 3 hearing impairment - correct. Also has progressive kyphoscoliosis
Type 4 - normal sclera
- PSC
a. Associated with IBD
- PSC
a. Associated with IBD yes
- PBC wrong
a. Smooth muscle antibody
b. Hyperlipaemia
c. Tendon xanthoma
d. Scleroderma
e. IBD
- PBC wrong:
* Wonder if poor recall, incorrectly recalling anti mitochondrial AB.
a. Smooth muscle antibody: FALSE - anti-mitochondrial antibody.
b. Hyperlipaemia: TRUE
c. Tendon xanthoma: TRUE
d. Scleroderma: TRUE
e. IBD: uncommon, but uptodate states multiple case reports of PBC and UC, likely sharing similar genetic trait.
- Biliary atresia which is wrong
a. Involves intra and extrahepatic bile ducts
b. Small GB
c. Associated with CHD
d. Polysplenia
e. TEF
- Biliary atresia which is wrong
a. Involves intra and extrahepatic bile ducts false, extra only
b. Small GB
c. Associated with CHD
d. Polysplenia
e. TEF
- Carcinoid most aggressive
a. Gastric
b. Duodenal
c. Ileum
d. Appendix
e. Rectum
- Carcinoid most aggressive
90% of ileal gastric and colonic carcinoids have penetrated through muscle wall and nodal spread at diagosis.
ILEUM Confirmed as most aggressive.
a. Gastric
b. Duodenal
c. Ileum I think this
d. Appendix relatively benign incidental - almost never metastasize.
e. Rectum relatively benign - almost never metastasize.
- Cancer causing pseudomyxoma most likely
a. Appendix mucocele
b. Appendix mucinous tumor
c. Gastric signet ring
- Cancer causing pseudomyxoma most likely
a. Appendix mucocele false not all tumor may be LN obstruction
b. Appendix mucinous tumor true
c. Gastric signet ring true but less common than appendix
- Cervical cancer true
a. Invading upper 1/3 vagina bad prognosis
b. NET worst prognosis
- Cervical cancer true
a. Invading upper 1/3 vagina bad prognosis false, parametrial bad, lower third bad
b. NET worst prognosis true super aggressive
- Epiphyseal true
a. Clear cell chondrosarc
b. Fibrosarcoma
c. NOF
d. ABC
- Epiphyseal true
a. Clear cell chondrosarc true
b. Fibrosarcoma
c. NOF
d. ABC
- What doesn’t cause aortic regurg
a. Bicuspid
b. Endocarditis
- What doesn’t cause aortic regurg
a. Bicuspid true
b. Endocarditis
- ?endocarditis extend to annulus to cause pericarditis
Valve ring abscess - vegetations erode into underlying myocardium = abscess
- ?endocarditis extend to annulus to cause pericarditis
- What complication not associated with AMI
a. LV thrombus
b. Pericarditis fibrinous
c. MR
d. Tamponade
e. AR
- What complication not associated with AMI
a. LV thrombus yes
b. Pericarditis fibrinous yes
c. MR yes papillary rupture
d. Tamponade yes free wall rupture
e. AR no
- DCM (false)
a. Alcohol
b. Sarcoid
c. HTN
d. Radiation
- DCM
a. Alcohol TRUE
b. Sarcoid TRUE
c. HTN TRUE via IHD
d. Radiation: FALSE no constrictive pericarditis
- Which is upper oesophageal stenosis
a. Zenkers
b. Tumor
c. Shasker A
d. Epiphrenic
e. Achalasia
- Which is upper oesophageal stenosis
a. Zenkers true, a distended Zenker sac may compress the anterior oesophagus resulting in stenosis.
**LJS - Zenker can cause compression of the oesophageal lumen. Counts as a “stenosis”?
Also tumour - SCC in upper oesophagus
b. Tumor: possible but more common mid and lower.
c. Shasker A: false - lower third
d. Epiphrenic: false, lower
e. Achalasia: false lower.
- Renal stones
a. Medullary sponge
b. ADPKD
c. ARPKD
d. MCDK
e. Medullary cystic kidney disease
- Renal stones
a. Medullary sponge true
b. ADPKD
c. ARPKD
d. MCDK
e. Medullary cystic kidney disease
- What is not true about radial scar
a. Fat in centre replaced by fibrous tissue
b. Spiculation long
c. Investigate after biopsy
d. Ischemia
- What is not true about radial scar
a. Fat in centre replaced by fibrous tissue false black star
b. Spiculation long
c. Investigate after biopsy
d. Ischemia
- Haemophilia B (false)
a. Autosomal recessive
b. Ballooning epiphysis
c. Ankle knee destruction
- Haemophilia B
a. Autosomal recessive false, x linked
b. Ballooning epiphysis
c. Ankle knee destruction
Osteomyelitis terms:
- Sequestrum:
- Involucrum:
- Brodie abscess:
- Sclerosing osteomyelitis of Garre:
Osteomyelitis terms:
- Sequestrum: Dead piece of bone / segmental necrosis.
- Involucrum: Reactive new bone deposited as a seeve of living tissue around a segment of devitalised bone.
- Brodie abscess: Small intra osseous abscess, involved cortex commonly, and walled by reactive bone.
- Sclerosing osteomyelitis of Garre: Jaw lesion associated with extensive new bone formation that obscures much of the underlying osseous structures.
