MCQs that rock Austin Flashcards
1
Q
Why is formalin 10% buffered?
A
to prevent acidity (acid = tissue autolysis)
2
Q
What is the ideal fixative to tissue ratio?
A
10 fix : 1 tissue
3
Q
What is the CAP guideline for duration of tissue fixation for optimal IHC results?
A
Min 6hrs, Max 48hrs
4
Q
What color is the epithelium (keratin) in a Masson trichome stain?
A
RED
5
Q
What color is collagen in a Masson trichrome stain?
A
BLUE
6
Q
What color is smooth muscle in a Masson trichrome stain?
A
RED
7
Q
What does a reticulin stain use to demonstrate reticulin fibers?
A
silver
8
Q
What disease is associated with Lewy bodies?
A
Parkinson Dz
9
Q
Which laboratory test is most specific for rheumatoid arthritis?
A
Anti-citrullinated protein antibodies (ACPAs)
10
Q
What are the 4 nuclear descriptors for papillary thyroid carcinoma?
A
- orphan annie eye nuclei 2. intranuclear pseudoinclusions 3. nucelar grooves 4. nuclear enlargement
11
Q
What is the name of bilateral metastatic GI neoplasia to the ovaries?
A
Krukenberg tumor
12
Q
What syndrome results from deletion of paternal 15q12?
A
Prader-Willi Syndrome
13
Q
Which two viral glycoproteins are crtitical for an HIV infection?
A
gp120 and gp41 (both on the HIV-1 viral spike protein used to infect CD4 cells)
14
Q
Which amyloid light chain occurs more freqently in amyloidosis- kappa or lambda?
A
Lambda light chain amyloid occurs more often than kappa (so OPPOSITE of normal, which is in alphabetical order lol)…remember a normal K:L = 2or3:1 in serum
In amyloidosis the ratio of kappa:lambda light chains is 1:3, suggesting that lambda immunoglobulin light chains are predisposed to form the beta-pleated sheet ultrastructure associated with amyloid
15
Q
Which amyloid forms the core of cerebral plaques in Alzheimer dz?
A
Beta-amyloid
16
Q
Which oncoprotein is being described? It acts primarily through p21, it can promote apoptosis, it functions as a tumor suppressor, and its levels are NEGATIVELY regulated by MDM2
A
p53
17
Q
Which stage in the adenoma-carcinoma sequence in colorectal cancer is associated with the loss of p53 on chromosome 17p?
A
Late adenoma —> carcinoma stage
18
Q
What type of virus is Mollescum Contagiosum?
A
poxvirus
19
Q
What is the most common immunoglobulin subtype in multiple myeloma?
A
IgG
20
Q
What are Dutcher bodies associated with?
A
multiple myeloma (intranuclear immunoglobulin inclusion)
21
Q
What is eczema herpeticum associated with?
A
Darier disease ( a form of Kaposi varicelliform eruption caused by viral infection, usually with the herpes simplex virus (HSV), is an extensive cutaneous vesicular eruption that arises from pre-existing skin disease, usually atopic dermatitis (AD) OR DARIER DZ in this case. Children with AD have a higher risk of developing eczema herpeticum, in which HSV type 1 (HSV-1) is the most common pathogen)
22
Q
4 diagnostic criteria for HHT?
A
1.Recurrent epistaxis 2.Telangiectasias of mucosa/skin 3.AV malformations in lungs 4.Family history
23
Q
4 clinical signs of acrodynia
Bonus: what is acrodynia?
A
1.sialorrhea 2.severe sweating 3.HTN 4. ulcerative gingivitis
Chronic mercury exposure in infants and children is
termed acrodynia (pink disease or Swift-Feer disease). An
erythematous and pruritic rash is present, often with desquamation
of the palms and soles.
24
Q
5 EC-Clearinghouse Group 1 entities
A
Group 1 = strongly assoc with HIV infection:
- Candidiasis (erythem, pseudo mem, ang cheil) 2. Hairy leukoplakia 3.KS 4. NHL 5. Peiro Dz (linear ging erythema, NUG, NUP)
25
What are 4 drugs that can have significant interactions with fluconazole?
1. Phenytoin 2. Warfarin 3.Sulfonylureas 4. Cyclosporine
26
Rank least to most potent...and tell me IV or oral route
Ibandronate (Boniva)
Risedronare (Actonel)
Alendronate (Fosamax)
Pamidronate (Aredia)
Zoledronic acid (Zometa)
Alendronate (Fosamax) Oral
Ibandronate (Boniva) Oral
Risedronare (Actonel) Oral (not in order)
Zoledronic acid (Zometa) IV
Pamidronate (Aredia) also IV (not in order)
27
What is the best marker for thyroid follicular epithelial origin?
Thyroglobulin
28
What is the histology of Tangier disease?
Deposition of xanthomatous cells (Tangier dz = inherited disorder characterized by significantly reduced levels of high-density lipoprotein (HDL) in the blood)
29
What are 4 diseases assoc with gingival fibromatosis?
1.Zimmerman-Laband syn 2.Ramon syn 3.Cross syn 4.Murray-Puretic-Drescher syn
30
What syndrome is associated with a parathyroid adenoma?
MEN2A (also hyperparathyroidism-jaw tumor syndrome)
31
What syndrome is associated with an optic glioma?
NF1
32
What syndrome is associated with mucosal neuromas?
MEN2B
33
What syndrome is associated with spinal meningiomas?
NF2
34
What syndrome is associated with bilateral schwannomas of the vestibular nerve?
NF2
35
What is least helpful in distinguishing acinic cell carcinoma from secretory carcinoma?
```
FISH for ETV6-NTRK3 gene fusion
IHC DOG1
IHC p63
IHC mammaglobin
IHC S100
```
p63 (secretory = neg and acc = neg) by the way...
```
Acinic Cell:
DOG1 +
SOX10 +
S100 -
p63 - (not a tumor of myoepithelial origin)
```
Secretory: (many were called acinic cell before)
S100 +
BRST2 +
Mammaglobin +
ETV6-NTRK3 mutation
p63 - (not a tumor of myoepithelial origin)
36
What 2 lesions raise concern for Kasabach-Merritt Phenominion?
1. tufted hemangioma
2. Kaposiform hemangioendothelioma
This disorder is characterized by severe thrombocytopenia and hemorrhage because of platelet trapping within the tumor. The mortality rate is as high as 20% to 30%.
37
What is a dandy-walker malformation?
posterior brain fossa anomalies (PHACES)
38
Whats is a cervical segmental hemangioma associated with?
BONUS: What are the rest of the lesions in this syndrome?
PHACES (its the H = Hemangioma (usually cervical segmental hemangioma)
Posterior fossa brain anomalies (usually Dandy-Walker malformation)
Hemangioma (usually cervical segmental hemangioma)
Arterial anomalies
Cardiac defects and Coarctation of the aorta
Eye anomalies
Sternal cleft or Supraumbilical raphe
39
What is the Hyam grade for olfactory neurobalstoma with Flexner-Wintersteiner rosettes, abundant necrosis, lacking neurofibrillary matrix?
IV
I = Homer Wright rosettes, no mitoses
II = Homer Wright rosettes, mitoses
III = Flexner-Wintersteiner rosettes little necrosis
IV = Flexner-wintersteiner rosettes, lots of necrosis
40
This is boards-y, not really Neville-y but:
What are 4 facts about lymphoepithelial carcinoma?
1. parotid gland = most common site
2. lymphocytoplasmic infiltrate is non-neoplastic
3. Arctic native and southern China predilections
4. EBV usually identified only in endemic populations
41
Which point mutation is most specific for chondroblastoma?
H3F3A
42
Which nuclear feature of papillary thryroid carcinoma is not seen in cytologic preparations?
Nuclear clearing
43
What does a mutation in type I collagen lead to?
osteogenesis imperfecta
(this came from a question stem about RUNX2/cleidocranial dysplasia and how it is NOT involved in Type I collagen folding)
44
Which gene mutation results in the MOST SEVERE enamel alterations in amelogenesis imperfecta?
FAM83H
45
Deficient enzyme in Gaucher
glucocerebrosidase
46
Deficient enzyme in Niemann-Pick
sphingomyelinase
47
Deficient enzyme in Tay-Sachs
β-hexosaminidase A
48
Deficient enzyme in Fabry
α-galactosidase A (α-Gal A). Fabry disease is a LIPID RETICULOENDOTHELIOSES genetic disorder that prevents the body from making an enzyme called alpha-galactosidase A. This enzyme is responsible for breaking down a type of fat called globotriaosylceramide (Gb3 or GL-3) into building blocks that the body's cells can use.
49
Deficient enzyme in Krabbe
galactocerebrosidase (GALC) (very close to Gaucher) another lipid reticuloendothelosis syndrome
50
Dyskeratosis congenita: What is the pattern of hyperpigmentation that develops early in the disease?
reticular
51
Dyskeratosis congenita: What type of change is seen in the nails?
dystrophic OR dysplastic
52
Dyskeratosis congenita: What form of anemia develops in a large majority of patients?
Bonus: what is the other systemic condition associated with this form of anemia?
aplastic anemia...fanconi anemia is also associated with aplastic anemia
53
Dyskeratosis congenita: are oral lesions benign or malignant?
Bonus: What about HMD? Benign or malignant?
DC: malignant oral lesions
HMD (hereditary mucoepithelial dysplasia): benign (so not dysplastic like the name implies lol) (fiery-red erythema of the hard palate)
54
Dyskeratosis congenita: Which inheritance patterns show\ the most severe disease?
Autosomal recessive and X-linked recessive
55
Which glycoprotein is most affected in pemphigus vulgaris?
Desmoglein 3
56
Which condition uses indirect IF with rat bladder mucosa?
Paraneoplastic pemphigus
57
4 facts about familial gigantiform cementoma (gender, race, age, site)
1. no gender predilection
2. white or Asian predilection
3. seen by adolescence
4. multiple quadrants affected, both mand and max
58
What are 4 criteria for diagnosis of Wegner (granulomatosis w polyangiitis)
1. Oral ulcerations or nasal discharge
2. Abnormal chest xray
3. Abdnormal urinary sediment
4. Gran inflam on bx
59
Hamman's crunch
Cervicofacial emphysema
60
Early widspread secondary dentin
progeria
61
What are the thyroxine and TSH levels for a patient with hypothyroid?
low thyroxine, high TSH
62
What is the second most common location for an ameloblastic fibroma?
posterior maxilla (post mand #1) (rare in anterior)...(so similar to an OKC)
63
Auclair grading system (mucoep): How many points for anaplasia
4
64
Auclair grading system (mucoep): How many points for 4+ mitoses / 10hpf
3
65
Auclair grading system (mucoep): How many points for Necrosis
3
66
Auclair grading system (mucoep): How many points for neural invasion
2
67
Auclair grading system (mucoep): How many points for intracystic less than 20%
2
68
TLE1 positive
SynoviaL Sarcoma = tLe1 (SSX-SS18)
You got this confused with ASPL-TFE3 (where TFE3 is positive)
69
Most common site for metastasizing ameloblastoma
lungs (cervial LN are second most common)
70
HRPT2 gene mutation leads to what 3 clinical manifestations?
1. parathyroid adenoma
2. ossifying fibromas of the jaws
3. Wilms tumor
(hyperparathyroidism-jaw tumor syndrome)
71
What are 4 predisposing factors for NOMA?
1. Malnutrition
2. Poor sanitation
3. Proximity to unkempt livestock
4. malignancy
72
What is granulomatous angiits associated with?
Its ischemic stroke from a VZV infection moving from the trigeminal nerve and invading into the internal carotid artery. holy shit.
73
Compound odontoma most common location
anterior maxilla
74
Complex odontoma most common location
molar regions of either jaw
75
What causes botryomycosis?
Staph Aureus (ha, NOT a fungus like the name leads you believe)
76
What are 3 conditions associated with sialadenosis?
Sialadenosis (aka sialosis - enlargment of the salivary glands w/o significant inflammation)
1. Diabetes mellitus
2. Pregnancy
3. Anorexia nervosa and or bulemia
There are many more including
4. Alcholism
5. general malnutrition
6. Hypothyroidism
7. Acromegaly
77
Congenital hypertrophy of the retinal pigment
FAP (aka pigmented lesions of the ocular fundus). Remember Gardner Syn is a variant of FAP. Gardner Syn is used when the extraintestional manifestations are especially prominent
78
4 syndromes associated with Hemihyperplasia
1. NF 2.Beckwith-Wiedemann 3.Proteus 4.Maffuci
many more...
5. ollier
6. SOD
7. McCune-Albright
even more than that
79
Facial trichilemmomas assoc w?
Cowden (multiple hamartoma syndrome, PTEN)
80
5 features of Tuberous Sclerosis (haha there are 14 total)
1. Facial angiofibromas
2. Hypomelanotic macules (ash leaf)
3. Shagreen patches
4. Subependymal giant cell astrocytomas
5. Oral fibromas
81
Mittenlike deformity
Recessive, Dystrophic Epidermolysis Bullosa (RDEB) (generalized gravis type). Wow. That's a mouthful.
82
Ocular gelatinous plaques
HBID
83
Treatment for chronic sclerosing osteomyelitis
debridement + abx
84
All meds are associated with gingval hyperplasia EXCEPT:
```
erythromycin
verapamil
cyclosporine
azathioprine
nifedipine
```
azathioprine IS NOT (immunosuppressive drug for transplant patients)
erythromycin (abx, yes)
verapamil (calcium channel blocker, yes)
cyclosporine (calcineruon inhibitor immunosuppression, yes)
nifedipine (anti-seizure, yes)
85
Failure of tooth eruption may occur in patients which disease?
Hypothyroidism
Graves Dz
Amyloidosis
Langerhans cell disease
Hypothyroidism (cretinism) (tooth formation might not be impaired, but fail to erupt)
86
All the following syndromes are associated with hypodontia EXCEPT:
Hurler (muccopolysaccharidosis)
Sturge-Weber
Ehlers-Danlos
Peutz-Jeghers
Peutz-Jeghers
87
Neutrophile Nitroblue tetrazolium reduction test
chronic granulomatous disease
Nitro blue tetrazolium is used in a diagnostic test,[3] particularly for chronic granulomatous disease and other diseases of phagocyte function. When there is an NADPH oxidase defect, the phagocyte is unable to make reactive oxygen species or radicals required for bacterial killing. As a result, bacteria may thrive within the phagocyte. The higher the blue score, the better the cell is at producing reactive oxygen species
88
Most common malignant salivary gland tumor of the submandibular gland
adenoid cystic carcinoma
89
Hodgkin Lymphoma stage III
LN involvment both sides of diaphragm
90
Serum levels of beta2-microglobulin and albumin
multiple myeloma
91
All have been assoc w premature loss of teeth EXCEPT:
```
LCH
Down
Oxalosis
Ehlers-Danlos
Taurodontism
```
Answer: Taurodontism
LCH
Down
Oxalosis (is a rare metabolic disorder in which the kidneys are unable to eliminate calcium oxalate crystals through the urine. On Nevilles list of 21 entities that cause premature tooth loss)
Ehlers-Danlos
92
What kind of glands are sebaceous glands?
Holocrine
93
Blandin-Nuhn gland found where?
tongue (anterior ventral, mentioned in neville as a place for mucocele formation)
94
Most common location of a palisaded capsulated neuroma
face (nose and cheek)
95
Perivascular deposits of basement membrane material
lipoid proteinosis
96
Psammommatous melanocytic schwannomas assoc with
carney syndrome
Carney complex is a rare genetic disorder characterized by multiple benign tumors (multiple neoplasia) most often affecting the heart, skin and endocrine system and abnormalities in skin coloring (pigment) resulting in a spotty appearance to the skin of affected areas
97
Lymphaniomyomatosis seen exclusively in what age/gender?
women of child bearing age
aka LAM, cant find in Neville, but cystic lung destruction can be assoc with Tuberous Sclerosis.
98
All have been assoc with increased risk for leukemia EXCEPT:
```
Bloom
Fanconi
Down
Prader-Willi
Wiscott-Aldrich
```
Prader-Willi is NOT assoc with increase leukemia risk
99
Second most frequent site for OKC
posterior maxilla
100
Libman-Sacks endocarditis in SLE:
Manifests primarily in the tricuspid valve
is cased by streptococcus
only rarely causes emboli
features small non-caseating granulomas
is the most freqent cardiac manifestation
ONLY RARELY CASUES EMBOLI (Libman–Sacks endocarditis (LSE) is a form of non-bacterial endocarditis that is seen in association with systemic lupus erythematosus (SLE), antiphospholipid syndrome, and malignancies.)
Manifests primarily in the tricuspid valve (both valves)
is cased by streptococcus (nah)
features small non-caseating granulomas (nah)
is the most freqent cardiac manifestation (pericarditis is most freq)
101
Uremic stomatitis can mimic what other oral lesion?
hairy leukoplakia (whatevs)
102
Enlarged LN w necrosis, nuclear debris, histiocytes, agg of lymphocytes, plasmacytoid monocytes, young male pt w fever leukopenia
Kikuchi-Fujimoto Dz (Kikuchi-Fujimoto disease (KFD) is a benign and self-limited disorder, characterized by regional cervical lymphadenopathy with tenderness, usually accompanied with mild fever and night sweats)
Treatment is symptomatic (analgesics-antipyretics, non-steroidal anti-inflammatory drugs and, rarely, corticosteroids). Spontaneous recovery occurs in 1 to 4 months. Patients with Kikuchi-Fujimoto disease should be followed-up for several years to survey the possibility of the development of systemic lupus erythematosus
103
Mycosis fungoides cell origin
CD4+ T cell
104
Mass of the chest of a teenage male w lymphoid cells lobulated nuclei stippled chromatin scant cytoplasm, mitoses, CD1, CD3, CD5
Lymphoblastic lymphoma
105
Jones-Hartsfield syndrome = gingival fibromatosis + ?
sensorineural hearing loss
106
Which has the lowest 5-year survival rate:
```
Oral Cavity SCC
Melanoma
Laryngeal Carcinoma
Cervical Carcinoma
Hodgkin Lymphoma
```
Laryngeal Carcinoma (61%)
SCC (66%)
Melanoma (Skin 93%, Stage 3 63%)
Cervical (66%)
HL (80%
107
Which test is performed for a malignancy in a LN w architecture effaced by small lymphocytes?
Western blot
108
Which is TRUE re: CMV
Etiology HHV6
Transmission is Human-Human contract only
Approx 50% of population has antibodies
Co-infection with other herpes viri rare
Neonatal infec causes cemental defects and exfoliation of teeth
Answer: Approx 50% of population has antibodies
Etiology HHV6 (nope, HHV5)
Transmission is Human-Human contract only (humans and monkeys are hosts)
Co-infection with other herpes viri rare (often with HSV or EBV)
Neonatal infec causes cemental defects and exfoliation of teeth (CMV causes enamel defects (The teeth exhibited diffuse enamel hypoplasia,
significant attrition, enamel hypomaturation, and yellow
coloration from the underlying dentin.)
109
What is the function of p63?
epidermal-mesenchymal interactions during embryologic dev
110
Which is FALSE re Calretinin?
Vit-D dependet calcium binding protein for calcium signaling
Has both cytoplasmic and nuclear staining
Positive in ameloblastoma
Lost in malignancy
Lost in malignancy is FALSE
Positive in ameloblastoma (stains the stellate reticulum)
111
Which is LEAST likely to be seen in a PEDs pt?
```
Ewing Sarc
Rhabdomyosarc
Liposarc
Ameloblastic Fibrosarc
Acinic Cell Carcinoma
```
Liposarcoma
112
Haha YES!
How many new cases of oral cancer were diagnosed in 2008?
34,000
113
1 y/o bilateral facial swelling, fever, leukocytosis, hyperostosis of facial bones. Neg blood cultures
Caffey Dz
114
Fever and rash, swollen extrematies, erythematous bulbar conjunctiva, cervical LAD, red swollen tongue
Kawasaki disease
115
Cherubism + gingival fibromatosis =
Ramon syndrome
116
What growth factor is responsible for promoting angiogenesis in granulation tissue?
VEGF (vascular endothelial growth factor)
117
Collapse of the bridge of the nose is classic for
leprosy (you thought syphilis, didn't you)
118
What has been linked to multiple superficial mucoceles?
tartar control toothpaste
119
What type of candidiasis is Angular cheilitis?
Erythematous candidiasis (and you taught that)
120
What general type of IHC markers stain Perivascular epithelioid cell tumors (PEComas)?
Melanocytic markers
121
Come on Austin. What is the most common type of sinonasal papilloma?
Inverted
122
Atrophy of upper lip, unilateral posterior open bite, coup de sabre, unilarteral hypoplasia of facial bones =
Parry-Romberg syndrome (Progressive Hemifacial Atrophy)...the other coup de sabre condition is limited scleroderma (morphea)...Neville says they have a "close relationship"
123
CD10+, Bcl2+, CD5-, CD43-
Follicular lymphoma
CD10+ (germinal cell marker)
Bcl2+ (this is aberrant expression caused by t(14;18))
CD5- (T cell marker that is aberrant positive in CLL, so this rules out CLL/SLL and mantle cell)
CD43- (pan T cell marker, this result rules out MALT lymphoma)
124
What are 3 causes for regional odontodysplasia?
1. Vascular abnormalities 2.neural disorders 3.Growth abnormalities
125
The lyon affect is typically seen in
women
126
2 causes for Papillon-Lefevre
1. Chemotactic effect
2. Impaired T and B lymphocyte activity
Neville: cathepsin C gene. This gene is important in the structural
growth and development of the skin and is critical for
appropriate immune response of myeloid and lymphoid
cells. Researchers believe that the loss of appropriate function
of the cathepsin C gene results in an altered immune
response to infection. In addition, the altered gene may
affect the integrity
127
Organism w large (20-60um) round spherules containing numerous endospores
blastomycosis
128
Varocay bodies are made of
BOTH reduplicated basement membrane AND cytoplasmic processes
129
Which Behcet association is fatal?
Neurologic and HLA-B4...interesting...Neville says CNS involvment, but no mention of HLA-B4 with Bechets. Ok, couldn't find it any where on the internet, but ok
130
Large cell lymphoma arising in CLL is known as
Richter syndrome
131
Erythema infectosum is also known as? and is caused by?
Fifth dz, parvovirus (B19)
132
Mikulicz cells
Rhinoscleroma
133
translocation for Anaplastic large cell lymphoma
t(2,5)
134
Intracellular glycogen found in all EXCEPT
Leiomyosarcoma
Acinic Cell Carcinoma
Clear Cell Carcinoma (salivary)
Ewing Sarcoma
Acinic Cell (its Zymogen) (1% can have clear cell variant w glycogen)
135
Occlusive subintimal depositis of PAS+ material at arteriolo-capillary junctions seen on gingival biopsy
Thrombotic thrombocytopenia
136
3 syndromes associated with hypertrichosis
1. hemihyperplasia
2. Segmental Odontomaxillary Dysplasia
3. Gingival fibromatosis
137
t(11;22)
Ewing sarcoma
138
Which does NOT present with interface mucositis?
```
Lichen Planus
EM
SLE
Scleroderma
Lichenoid mucositis
```
Scleroderma
139
Auer bodies
aka Auer rods... myeloid leukemia (AML)
140
Diagnose that entitiy:
```
Tongue neoplasm
"glomeruloid" pattern
"orphan annie nuclei"
p63 +
thyroglobulin -
TTF1 -
```
Polymorphous Adenocarcinoma, cribriform
formerly "cribriform adenocarcinoma of the tongue and minor salivary glands (CATMSG)"
141
TFE3 positive
Alveolar soft part sarcoma (remember synovial sarc is TLE1 pos)
142
WTF?!
Wet keratin is not seen in which?
```
Craniopharyngioma
COC
AOT
Trichoep
Complex Odontoma
```
Complex odontoma does not.
What the hell is wet keratin?
Keratin pearls or wet keratin (nodules of plump eosinophilic, keratinized cells with ghost nuclei) are characteristic histologic features; often associated with calcification
Also, a craniopharyngioma is....
-Adamantinomatous craniopharyngioma: suprasellar or sellar epithelial neoplasm resembling ameloblastoma
-Tumor with palisading epithelium, "wet" keratin and stellate reticulum associated with surrounding gliosis and Rosenthal fibers
-Epithelial neoplasm resembling ameloblastoma or keratinizing and calcifying odontogenic cyst
-Age: bimodal with peaks at 5 - 10 years and 50 - 60 years
More common than papillary craniopharyngioma (even in adults)
Higher frequency in Africans and Far East Asians
-Possible origin in remnants of Rathke pouch epithelium
Misplaced odontogenic rests along pituitary stalk
143
What's the best stain for Leishmaniasis?
Giemsa
144
What is the best stain for necrotic fungal organisms?
GMS
145
Which entity should NOT be considered in the ddx for orofacial granulomatosis?
```
Paracoccidiomycosis
Sarcoidosis
Foreign body rxn
Ulcerative colitis
Tuberculosis
```
Answer: Ulcerative colitis
From tables 9-2 and 9-3 in Neville R/O:
Chronic granulomatous disease (Neutrophil nitroblue tetrazolium reduction test)
Crohn disease (heme eval: low albumin, calcium, folate, iron, RBC, high ESR OR leukocyte scintigraphy using Tc-HMPAO, then scope)
Sarcoid (serum ACE and chest X-ray for hilar LAD)
TB (skin test, chest xray...NEGATIVE AFB on histo DOES NOT R/O TB)
Infections: so paracoccidio, candida, etc
allergy
146
Eosinophilic, ring-shaped calcifications with surrounding multinucleated giant cells and lymphoctes
Hyaline bodies
| AKA pulse granuloma, giant-cell hyaline angiopathy...as seen in inflammatory cysts
147
Xerostomia and keratoconjunctivitis sicca are both seen in:
Sarcoidosis
| sialosis threw me off here...
148
What is the typicall pattern for amyloid deposit in salivary glands?
perivascular and periductal
149
Which entity is NOT of perivascular derivation?
```
Glomangiopericytoma
Myofibroma
Myopericytoma
Solitary fibrous tumor
Glomus tumor
```
Myofibroma
150
Which is considered a proto-oncogene?
```
P16
P53
PRb
BCL-2
Ras
```
Ras is considered a proto-oncogene
A proto-oncogene is a normal gene that could become an oncogene due to mutations or increased expression. Upon acquiring an activating mutation, a proto-oncogene becomes a tumor-inducing agent, an oncogene. Examples of proto-oncogenes include RAS, WNT, MYC, ERK, and TRK.
```
p16 = tumor suppressor
p53 = tumor suppressor
PRb = tumor suppressor
BCL-2 = anti-apoptosis
Ras = proto-oncogene
myc = proto-oncogene
```
151
Which is NOT a viral protein?
```
P16
E6
E7
LMP
P24
```
P16 is not a viral protein
Brief mechanisms:
P16 = human tumor suppressor gene
E6/E7 = E6 and E7 are essential HPV E-gene products, they target P53 and retinoblastoma (Rb) tumuor-suppressor proteins, respectively.
LMP = EBV gene assoc w lymphoproliferative disorders
P24 = an HIV core protein
152
What must be ruled out when considering a diagnosis of PFAFA syndrome in children?
cyclic neutropenia (sporatic or AD, ELAINE gene)
(PFAFA syndrome (Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis) is a childhood syndrome that affects both boys and girls. It causes repeated episodes of fever, mouth sores, sore throat, and swollen lymph nodes. PFAPA usually starts in early childhood between ages 2 and 5.
153
What effects can herpes zoster have on bone and teeth?
bone loss and tooth necrosis
154
Reduced counts of which T cell type may indicate poorer outcomes in SCC patients?
CD8 cytotoxic T cells
155
Wow, you guessed and got this right!
How many IgG4+ plasma cells must be seen at high power for a diagnosis of IgG4 disease?
100
156
The hyoid bone separates which of the following lymph node levels?
Tricky question:
The hyoid separates Ia from VI anteriorly, but posteriorly it separates Ia from IIa....
Good to review this - practice this when doing head and neck exams (this should be taught to dental students better)
157
Which of the following is an encapsulated tumor?
```
Neurofibroma
Schwannoma
Oral focal mucinosis
Pyogenic granuloma
fibroma
```
Schwannoma
I got this right, just wanted to cement it
158
Which virus is associated with....
Merkel cell carcinoma
Pityriasis rosea
Shingles
Kaposi's Varicelliform eruption
Merkel cell carcinoma - Merkel cell polyomavirus (MCPyV) in 80% of cases
Pityriasis rosea - herpes family (HHV6,7 suspected, but lack of evidence)
Shingles (aka herpes zoster) - HHV 3 (Vericella-Zoster Virus)
Kaposi's Varicelliform eruption - HSV 2
159
Nice, guessed and got this right:
Multiple enamel pits seen in....
Tuberous sclerosis
160
Pigmented lesions of the gingva may be seen in:
```
Hypoparathyroidism
Hyperparathyroidism
Hypoadrenocorticism
Hyperadrenocorticism
Hyperthryroidism
```
Hypoadrenocorticism (Addison Dz)
You really shouldnt have missed this one.
```
Lets review:
Hypoparathyroidism = no alternate name
Hyperparathyroidism = no alternate name
Hyperadrenocorticism = Cushing Dz
Hypoadrenocotricism = Addison Dz
Hyperthyroidism = Graves Dz
Hypothyroidism = Myxedema (adults), Cretinism (children)
```
161
Wrinkled silk histiocyte
Gaucher
162
"Sea blue" histiocyte
Neimann-Pick
163
Lingual thyroid:
Overall sex predilection?
Which sex has tendency for malignancy?
overall: Female
carcinoma: Male
164
Which is true of incontinentia pigmenti?
Strong male predilection
Hyperdontia
Ocular involvment considered exclusionary in diagnosis
CNS involvment in more than 90% patients
Early stages resemble vesiculobullous lesions
True: Early stages are characterized by vesiculobullous lesions
Predilection: 37:1 FEMALE predilection (X-linked dominant, so lethal for most males unless they are Kleinfelter XXY)
Hyperdontia: Welp, thats true too....Neville says BOTH hypo and hyperdontia, but in paragraph form mostly hypodontia
35% of patients have ocular involvment (strabismus, nystagmus, cataracts, etc)
CNS involment: 30%
165
Which is true of Xeroderma Pigmentosum?
```
Mutations in DNA repair proteins seen
AD inheritance
Frequent dev of Melanomas
Sun exposure no effect on prognosis
No change to life expectancy
```
Mutations in DNA repair proteins seen - TRUE
AD inheritance- False, AR inheritance
Melanomas - False, only 5%, most have SCCs or BCCs
Sun exposure no effect on prognosis - False, biggest effect
No change to life expectancy - False, 30 years less than average
166
Antigen for pemphigus vulgaris
Desmoglein 3
167
Herald patch
Pityriasis rosea (not in Neville): Pityriasis rosea is a rash that usually begins as a large circular or oval spot on your chest, abdomen or back. Called a herald patch, this spot can be up to 4 inches (10 centimeters) across.
The herald patch is typically followed by smaller spots that sweep out from the middle of your body in a shape that resembles drooping pine-tree branches.
Pityriasis (pit-ih-RIE-uh-sis) rosea can affect any age group. It most commonly occurs between the ages of 10 and 35. It usually goes away on its own within 10 weeks. Pityriasis rosea can cause itching. Treatment may help relieve the symptoms.
Again, Herpes family suspected
168
Herpes zoster on the tip of the nose involves which nerve branch?
Nasociliary (guessed and got it right)
169
So dumb:
The term used to describe an extremely even illumination of a sample without the image of the illumination source being visible in the resulting image is termed:
Kohler illumination
170
Name that method of illumination lol:
Yields dark objects on a bright background, is the simplest technique for optical microscopy. The light source is positioned below the sample. Light then propagates through the sample, and is observed by the objective lens and sensor, which are positioned above the sample.
brightfield illumination
171
Name that method of illumination lol:
A contrast-enhancing technique that improves the quality of the image obtained with birefringent materials
Polarizing illumination
172
Name that method of illumination lol:
A technique in optical microscopy that eliminates scattered light from the sample image. This yields an image with a dark background around the specimen, and is essentially the complete opposite of the brightfield illumination technique. The primary imaging goal is to enhance the contrast of an unstained sample, which is incredibly powerful, yet simple, for live cellular analysis or samples that have not gone through the staining process
Darkfield illumination
173
Name that method of illumination lol:
Static illumination
Not a typical term used in microscopy
174
NICE! You guessed and got this right...
Dermatitis, dementia, and diarrhea = which vitamin deficincy?
Niacin deficiency (Vit B3) AKA Pellagra
It'd be beneficial to review your chapter 17 cards for the rest of these deficiencies
175
Blackfoot disease
Arsenic poisoning
176
Virus assoc with plasmablastic (multicentric) Castleman Disease?
HHV8
177
Angiomyolipoma of the kidney assoc with what genetic condition?
Tuberous sclerosis
178
Most common location for plasmablastic lymphoma in HIV patients
oral cavity
179
Hormone-induced atypical endometrial histopathologic changes
Arias-Stella reaction
180
Histologic change most supportive of Barrett esophagus?
columnar cells
181
All are markers for perineurioma EXCEPT
```
EMA
Claudin-1
Glut-1
Type IV Collagen
GFAP
```
GFAP
(A perineurioma is a rare benign tumor within the sheath of a single nerve that grows but typically does not recur or metastasize. These lesions are only composed of perineurial cells, cloned from a single cell. They are distinct from schwannoma and neurofibroma)
182
Which is a common feature of warty dyskeratoma and keratosis follicularis:
```
Histologic appearance
Mode of inheritance
Predilection for males
Hyperpigmentation of skin
Multifocal presentation
```
Histologic appearance
keratosis follicularis: another name for Darier Disease
183
Kernicterus refers to toxic bilirubin accumulation in which organ
Brain
Kernicterus is a type of brain damage that can result from high levels of bilirubin in a baby's blood. It can cause athetoid cerebral palsy and hearing loss.
184
Histoplasmosis typically disseminated via
Aspiration of aerosol contaminated with bird (or bat) droppings
185
FALSE about PTLD:
```
4x higher incidence in peds
20x higher risk in EBV pts
Most commonly GI tract
Polymorphic-type extranodal disease better prognosis than monomorphic with LN involvment
Assoc with DLBCL
```
False: Risk 20x higher in EBV pos patients
186
Ligneous gingivitis assoc with EXCEPT
Predominance in Asian populations
Type 1 plasminogen def
Nodular enlargment with Ulceration
Concomitant cervical, tracheobronchial / skin leisons
Subepithelial eosinophilic fibrin depositis
BONUS: What is the IHC method for determing fibrin in plasminogen def vs amyloid?
EXCEPT: Predominance in Asian populations
BONUS: Fraser-Lendrum histochemical staining method shows fibrin
187
FALSE regarding alkaptonuria:
Result of incomplete metabolism of homogentisic acid, arginine, and tyrosine
AR inheritance
Blue discoloraiton of dentition due to Tyndall effect
Recurrent nephrolithiasis
Dark brown urine
FALSE: Result of incomplete metabolism of homogentisic acid, arginine, and tyrosine
(yes homogentistic acid, couldn't find arginine/tyrosine
Ochronosis: blue-black color in connective tissue, tendons, and cartilage.
188
Billing 3rd party for pathology services all must be submitted EXCEPT:
```
ICD10
CPT
CLIA Lab ID number
Name of referring clinician
Patient's SSN
```
Patients SSN
189
Embryonic odontogenic tissue origin of Squamous Odontogenic Tumor
Rests of Malassez
190
Organism most commonly associated with allergic fungal sinusitis?
Aspergillus fumigatus
191
False about Leukocyte Adhesion Deficiency Type 1:
Results from mutation long arm chromosome 21
Lack of CD11/CD18 expression assoc wors prog
Infections with overabundance of neutrophils
Primary sites are oral cavity and GI
Etiologic factor in juvenile periodontitis
False: Infections with overabundance of neutrophils
192
GCDFP expressed in
BCC (and Secretory carcinoma)
GCDFP (Gross Cystic Disease Fluid Protein)
193
Which receptor mediates adhesion of tumor cells to the BM prior to invasion?
Laminin
194
Cherubism + gingval fibromatosis + seizures =
Ramon syndrome
195
Which is NOT encountered in Sprue?
```
Glossodynia
Ulcers
Petechiae
Atrophy of filiform papillae
Glossitis
```
(Sprue = celiac)
Not encountered: Petechiae
Glossodynia = burning mouth syndrome
196
Hereditary immunodeficiency with thrombocytopenia and eczema
Wiskott-Aldrich syndrome
Wiskott–Aldrich syndrome (WAS) is a rare X-linked recessive disease characterized by eczema, thrombocytopenia (low platelet count), immune deficiency, and bloody diarrhea (secondary to the thrombocytopenia)
197
Most common benign tumor of bone
osteochondroma
198
All have similar histo EXCEPT
```
Small cell carcinoma of Lung
Biphasic synovial sarcoma
Neuroblastoma
Ewing Sarcoma
Alveolar rhabdomyosarcoma
```
biphasic synovial sarcoma
199
Anti-Smith antibody directed against
Nuclear RNA
200
Lipid reticuloendotheliosis assoc w increased risk for multiple myeloma?
Gaucher
201
Ship's Wheel fungus
South American Blasto (AKA paracoccidio. Jesus)
202
Merkel cells feature
Neurosecretory granules
203
Michaelis-Gutmann bodies
malakoplakia
204
Stains for diagnostic lipoblasts and fat on frozen section
Oil Red O or Sudan Black
205
ID liopblasts with all EXCEPT
```
enlarged adipocytes
Hyperchormatic indented or sharply scalloped nucleus
Lipid-rich droplets in cytoplasm
Appropriate histologic background
Staining with oil red o
```
except enlarged adipocytes
206
Rhabdomyosarcoma in adults =
Rhabdomyosarcoma in 10-25 year olds =
Rhabdomyosarcoma in children =
Rhabdomyosarcoma in adults = Pleomorphic (extremities)
Rhabdomyosarcoma in 10-25 year olds = alveolar
Rhabdomyosarcoma in children = Embryonal
207
Normal glomus body regulates
heat
208
True regarding Desmoplastic Melanoma EXCEPT:
```
often located on head and neck
assoc with overlying lentigo maligna
seen 10 years earlier than conventional melanoma
HMB45 neg
S100 pos
```
EXCEPT Often seen 10 years earlier than conventional melanoma
209
t(2,13)
alveolar rhabdomyosarcoma
Two distinct chromosomal translocations have been identified in alveolar rhabdomyosarcoma: PAX3-FKHR (FOXO1) and PAX7-FKHR (FOXO1)
which i guess are on 2,13. Jesus
210
Which does NOT usually stain positive for CKs?
```
Clear cell sarcoma
Elitheliod sarcoma
synovial sarcoma
Extrarenal rhabdoid tumor
Epitheliod hemandioendothelioma
```
clear cell sarcoma
211
Downey cells
infectious mononucleosis
The distinctive cell associated with EBV or CMV is known as a "Downey cell", a reactive lymphocyte
212
In a lymph node:
| reactive follicles, clusters of epithelioid cells, patches of monocytoid cells suggests
toxoplasmosis
213
All are true for periosteal osteosarcoma EXCEPT:
```
occurs on surface
predominantly chondroblastic
freq affects flat bones
mineralization not on imaging
no intramedullary involvment
```
EXCEPT frequently affects flat bones
214
Extragnathic adamantinomas
osteofibrous dysplasia
Osteofibrous dysplasia (OFD) is a rare disease. It is considered a benign non-neoplastic condition of unknown cause, characterized by a fibrovascular defect. Common sites of involvement are the two leg bones, the tibia, and the fibula
OFD can be classified as monostotic, polyostotic, and McCune Albright syndrome. Most cases of monostotic lesions present with no significant symptoms and are often found incidentally on x-ray. The condition mainly affects patients in their third decade
Extragnathic adamantinomas:
Adamantinoma is a bone tumor which is commonly showed in mandible. Its occurrence in long bones constitutes a rare affection and a difficult histological diagnosis This rare malignant tumor of mesenchymal and epithelial origin
Adamantinoma is characterized by a slow clinical development marked by the prevalence of lung metastases and local recurrences.
215
intraepithelial eosinophilic abscesses
inflammatory bowel disease
216
Lupus vulgaris =
Lupus pernio =
Lupus vulgaris = TB
Lupus pernio = Sarcoid
217
Epidermotropism
mycosis fungoides
Epidermotropism refers to the phenomenon of lymphocytes residing in the epidermis. This is in contrast to exocytosis in which lymphocytes move out through the epidermis.
218
Renal osteodystrophy assoc w
enlargment of the jaws
Renal osteodystrophy is a bone disease that occurs when your kidneys fail to maintain the proper levels of calcium and phosphorus in your blood. It's a common problem in people with kidney disease and affects most dialysis patients
219
Wegners all EXCEPT
```
Stawberry gingivitis
Positive IF for cytoplasmic (c-ANCA)
Ulcerative lesions in oral mucosa
Positive IF for perinuclear (p-ANCA)
Necrotizing glomerulonephritis
```
EXCEPT Positive IF for perinuclear (p-ANCA)
MPO-ANCAs (FKA p-ANCA)are detected in several vasculitides that typically do not present in the oral cavity.
220
New term for p-ANCA
New term for c-ANCA
New term for p-ANCA = MPO-ANCA
New term for c-ANCA = PR3-ANCA (*more specific for Wegeners)
221
Pseudoepitheliomatous hyperplasia seen in all EXCEPT
```
Wegener
GCT
Blastomycosis
Congenital epulis
Tertiary syphilis
```
EXCEPT congenital epulis (just thought the others were interesting)
222
Did you know...varicella recurrence is NOT considered to be caused by exposure to
UV light, I guess thats good, or there would be lots of cases of ramsey hunt
223
High urinary VMA assoc w
```
Hereditary fibromatosis
Stuge-Weber
Medullary carcinoma of thyroid
Peutz-Jegher
MEN2B
```
MEN2B
I got thrown off by MTC. MTC does not cause increased VMA (even though its apart of MEN2B). It causes increase in urine calcitonin
224
Most common malignancy involving bone?
Met
225
Systemic sclerosis assoc with all EXCEPT
```
Raynaud
Acro-osteolysis
CREST
Fibrous dysplasia
Diffuse widening of PDL
```
Fibrous dysplasia
226
Clear cells in clear cell odontogenic carcioma share IHC and structural similarities with what cell type?
Glycogen-rich presecretory ameloblasts
227
What is a rare, potentially lethal, oropharyngeal infectious disease occurring in immunocompetent adolescents and young adults that is mainly due to Fusobacterium necrophorum?
Lemierre syndrome
( and that is characterized by septic thrombophlebitis of the internal jugular vein that leads to septic, usually pulmonary, embolism, associated with ENT (ear, nose, and throat) infection that manifests with fever, neck pain, and tonsillopharyngitis.)
228
What is the other name for Goltz-Gorlin Syndrome?
Focal dermal hypoplasia (FDH), also known as Goltz syndrome, is a rare multisystem disorder that principally involves the development of the skin, hands and feet and eyes. It is a type of ECTODERMAL DYSPLASIA, a group of heritable disorders causing the hair, teeth, nails, and glands to develop and function abnormally.
229
What syndromes are these derm lesions associated with?:
Trichelemmomas
Trichoepitheliomas, Spiradenomas, Cylindromas
Facial angiofibromas
Epidermal cysts
Soft tissue angiomas
Trichelemmomas = Cowden
Trichoepitheliomas, Spiradenomas, Cylindromas = Brooke Speigler
Facial angiofibromas = Tuberous Sclerosis
Epidermal cysts = Gardner syndrome
Soft tissue angiomas = Maffuci
