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AP/CP > MUST KNOW HIGH YIELD!!!!! > Flashcards

MUST KNOW HIGH YIELD!!!!! Flashcards

1
Q

What is the triad seen in Toxoplasma lymphadenitis?

A
  • Follicular hyperplasia
  • Intrafollicular epithelioid histiocytes
  • Monocytoid B-cells in sinuses (see pic)

PCR confirms

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2
Q

What testicular tumor has the best 10 year survival?

A

Spermatocytic seminoma

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3
Q

Which type of assay involves probe amplification?

I know super vague but just look at answer and know this

A

Invader assay

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4
Q

Name this salivary gland lesion.

A

Canalicular adenoma

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5
Q

Appendix or colon with this organism

A

Schistosomiasis

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6
Q

How do you monitor therapy following anticoagulation with lepirudin?

A

Lepirudin is a direct thrombin inhibitor that is used to treat pts with HIT

Due to its inhibitory effect on thrombin, lepirudin results in prolongation of both aPTT and prothrombin time (PT). The aPTT is generally the current method of choice for monitoring treatment with lepirudin in most situations.

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7
Q

What is shown in this esophageal brushing cytology specimen?

A

Reactive changes/repair

Esophageal squamous mucosa with reactive changes, consisting of uniform cells with nucleomegaly in a predominantly cohesive flat sheet

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8
Q

Gross photo of echinococcal cyst vs HCC

Which is this?

A

Echinococcal cyst

This is HCC

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9
Q

FNA Salivary gland tumor

A

Well differentiated mucoepidermoid carcinoma

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10
Q

FNA of lung lesion

A

Carcinoid

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11
Q

What Taenia spp is this?

A

T solium (armed rostellum)

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12
Q

What is this?

A

Kaposi sarcoma

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13
Q

What is this?

A

Bullous pemphigoid

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14
Q

What is the cell membrane issue with stomatocytes?

A

defect in sodium/potassium permeability of the RBC membrane (confers protection against P vivax)

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15
Q

Tell the difference between T. solium and T. saginata.

A

T solium does more damage (neurocysticercosis) and it has the hooks

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16
Q

Prostate:

adenosis or basal cell hyperplasia?

A

Adenosis

Here is BCH

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17
Q

What is this this lesion associated with?

A

Oral hairy leukoplakia

Almost exclusively occurs in AIDs patients and is associated with EBV. It presents as white plaques at the lateral border of the tongue.

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18
Q

What diagnosis should be considered in a pt with stomatocytes and hemolytic anemia?

A

Rh Null

LACK Lw antigen!!​

*they could phrase it like this on exam (instead of saying Rh null, say lack Lw antigen–this is actually a Rh LIKE antigen but Rh null pts lack this)

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19
Q

What is this?

*one of the branching chain conidia fungi–don’t know how likely to see on test but just in case…..

A

Scopulariopsis

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20
Q

Where are benign papillary mesotheliomas commonly found?

A

Peritoneum, pericardium, and tunica vaginalis

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21
Q

Gross photo of this colon lesion.

A

Villous adenoma

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22
Q

What placental lesion is shown here?

What is seen in the fetus with this?

A

Amnion nodosum

Staghorn plaques on membranes, a condition characterized by yellow nodules of compressed squames and hair on the surface and membranes, is associated with severe, long-standing oligohydramnios

renal abnormalities seen in fetus

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23
Q

What is this lesion in the brain?

A

Progressive multifocal leukoencephalopathy

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24
Q

What is this lesion of the lower jaw?

A

Ameloblastoma

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25
Q

What is being shown in this cell from the lung?

A

Type II pneumocyte showing SURFACTANT (lamellated bodies)

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26
Q

Septal panniculitis is associated with?

A

Erythema nodosum

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27
Q

What is this lung lesion?

A

Sclerosing hemangioma of the lung

This lesion in the lung is seen more commonly in women with an average age in the 40s and shows papillary like projections lined by epithelioid cells with a central proliferation of polygonal mesenchymal appearing cells. Both populations are TTF1 positive indicating type II pneumocyte origin for this tumor.

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28
Q

What are the 3 stop codons?

A

UAG

UAA

UGA

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29
Q

What is this organism in the brain?

A

Naegleria fowleri

*I realize this concept is getting beat to death but be able to recognoize!

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30
Q

Lesion in 32 yo woman with cervical and groin LAD with prominent follicular hyperplasia.

What is this?

A

SLE Lymphadenitis

Architectural preservation, but follicular hyperplasia with variable sized follicles, increased vascularity, interfollicular immunoblasts and plasma cells.

Often well circumscribed areas of paracortical necrosis with necrosis of small vessels.

Occasionally DNA deposition/hematoxylin bodies (hematoxyphilic material) in stroma, sinuses and blood vessel walls.

May have giant follicles, often disarray of follicular dendritic cell network, no/rare granulomas, no/rare neutrophils.

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31
Q

giant cell lesion in patient post renal transplant, present in two jaw sites and in rib

A

Brown Tumor

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32
Q

What is this?

A

Pemphigus vulgaris

don’t forget about Hailey-Hailey (benign familial pemphigus) but that will have a dilapidated brick wall appearance (seen here)

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33
Q

What is this pancreas lesion?

A

Serous cystadenoma

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34
Q

What disease causes spores with organisms inside and squamous hyperplasia?

A

Rhinosporidiosis caused by Rhinosoridium seeberi - India/Sri Lanka endemic

Huge sporangia with endospores DDX includes coccidiodomycosis but is SMALLER

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35
Q

What percentage of LSIL will progress to HSIL?

A

10%

Two thirds of patients with LSIL will regress

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36
Q

What is this pancreatic lesion?

A

IPMN

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37
Q

What is this?

A

Follicular lymphoma

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38
Q

What is this lesion in the brain?

A

Amoebic encephalitis

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39
Q

What is this lung lesion?

A

Lipoid pneumonia

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40
Q

Cytology of urine showing this

A

Ileal conduit

degenerated columnar cells

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41
Q

What is this?

showing pleural lesion with granulation tissue, fibrosis and inflammation

A

Organizing fibrinous pleuritis (benign pleural lesion)

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42
Q

Common lesion posterior mediastiunum in kid

A

Ganglioneuroma

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43
Q

What is this?

A

Cellular Schwannoma

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44
Q

Name this specialized type of BCC found in groin, breast and ears.

A

Fibroepithelioma of pinkus

It is a eccrine duct BCC

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45
Q

What is this thyroid lesion in a 10 year old kid?

A

Medullary thyroid carcinoma

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46
Q

What is the factor VIII activity in female carriers?

A

50%

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47
Q

This is a lymph node from woman with history of endometriosis. What is diagnosis?

A

Endosalpingiosis

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48
Q

What is this pancreas lesion?

A

Nesidioblastosis

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49
Q

What causes sclerosing mediastinitis?

A

Histoplasma!

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50
Q

What is this?

A

Spitz nevus

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51
Q

What is this?

A

Coccidioides

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52
Q

Which is least likely to get HCC – HepB, HepC, Etoh, Hemachromatosis or Wilson’s?

A

Wilson’s

In order of decreasing likelihood: Hep C, hemachrom, Hep B, Etoh, Wilsons.

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53
Q

What is this retreperitoneal mass?

A

Well Differentiated Liposarcoma

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54
Q

Alpha hemolytic colony on blood agar that is bile soluble?

A

S. pneumo!

Bile solubility distinguishes from other alpha hemolytic colonies

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55
Q

What is this pancreas tumor?

A

Acinar cell carcinoma

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56
Q

What is this?

A

Adenomyosis

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57
Q

Most common location of Zollinger Ellison syndrome?

A

Duodenum

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58
Q

Showed this lesion in the bladder –who gets it?

A

Inflammatory pseudotumor

KIDS

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59
Q

Apoptosis causes all of the following except

  1. Councilman bodies
  2. GVHD crypt changes
  3. Tingible body macrophages
  4. Mallory bodies
A

d. Mallory bodies

A councilman body, also known as Councilman hyaline body or apoptotic body, is an acidophilic (eosinophilic / pink-staining on H&E) globule of cells that represents a dying hepatocyte often surrounded by normal parenchyma.

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60
Q

What is the most common malignant paratesticular tumor in children?

A

Spindle cell variant of embryonal rhabdomyosarcoma

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61
Q

What is this lesion?

A

Conventional osteosarcoma

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62
Q

What is this soft tissue lesion?

A

Myxoid liposarcoma

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63
Q

Name this breast lesion.

A

Nipple adenoma

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64
Q

Gross and micro photo of this liver lesion.

A

FNH

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65
Q

What lesion is seen on this pap smear?

A

Follicular cervicitis

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66
Q

What is this lesion?

A

Morton’s neuroma

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67
Q

What is this ovary lesion?

A

Lipid (steroid) cell tumor

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68
Q

What cardiac tumor is being shown?

A

Rhabdomyoma

MOST COMMONLY IN LEFT VENTRICLE

Most common primary cardiac tumor of
infancy and childhood

May be sporadic, but >50% associated with TS
Eosinophilic, polygonal cells with large glycogen-rich cytoplasmic vacuoles with stranding “spider cells”

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69
Q

What is this lesion seen in the lung?

A

Lipoid pneumonia

Exogenous lipoid pneumonia. The microscopic appearance of exogenous lipoid pneumonia is dependent on the composition of the aspirated material. (A) Exogenous lipoid pneumonia with histiocytes containing predominantly fine microvesicles. (B) Exogenous lipoid pneumonia with larger vacuoles and associated fibrosis

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70
Q

Can you tell the difference between Enterobius vermicularis egg and Hymenolepsis egg?

Which is this?

A

Hymenolepsis

This is Enterobius

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71
Q

What is the lesion and what is it associated with?

A

Plexiform neurofibroma

NF1

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72
Q

This finding is from a pregnant woman. What is it?

A

Amniotic fluid embolism

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73
Q

What kind of placenta is this?

A

Circumvallate placenta

This is a circumvallate placenta in which the membranes double back for a short distance over the fetal surface when the chorionic plate is too small.

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74
Q

Immunophenotype of what other lymphoid process does lymphomatoid papulosis most resemble?

A

Anaplastic Large Cell Lymphoma (CD30+)

Lymphomatoid papulosis aka pseudolymphoma is a primary cutaneous CD30+ T cell lymphoproliferative disorder with wedge shaped dermal infiltrate of atypical lymphocytes and a background of polymorphic inflammatory cells

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75
Q

What is this diagnosis of a lymph node?

A

Langerhans histiocytosis

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76
Q

What is this liver lesion?

A

Autoimmune hepatitis

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77
Q

FNA from head and neck area, what is this?

A

Normal parotid

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78
Q

Name this lesion.

A

Proliferating trichilemmal cyst

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79
Q

What is this?

A

Myxoid Chondrosarcoma

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80
Q

Mediastinal mass– a thymoma or nodular sclerosing Hodgkin’s.

Which is this?

A

Thymoma!

NS Hodgkin’s will have Reed Sternberg cells and the classic lacunar cells (spaces around histiocytes seen here)

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81
Q

What is this seen in an ascites fluid of a woman?

A

Papillary serous carcinoma

82
Q

What is this lymph node lesion?

A

Kikuchi

necrosis and debris, no neutrophils

83
Q

FNA breast:

Apocrine metaplasia or granular cell tumor?

A

Granular cell tumor

here is apocrine metaplasia

84
Q

Most common cause of subarachnoid hemorrhage?

A

Trauma is number one

but then saccular aneurysms

85
Q

40yo woman with bile duct brushing

Be abel to distinguish benign or malignant

Here is pic of normal, reactive, atypical, and malignant for reference

86
Q

What is this testicular lesion?

A

Spermatocytic seminoma

87
Q

What is this lesion in the lung?

A

Silicosis

A silicotic nodule within lung parenchyma is seen here. It is composed mainly of bundles of interlacing pink collagen. There is a minimal inflammatory reaction. The greater the degree of exposure to silica and increasing length of exposure determine the amount of silicotic nodule formation and the degree of restrictive lung disease. Silicosis increases the risk for lung carcinoma only about 2-fold.

88
Q

Orbital mass of monotous small lymphs, a B cell lymphoma. DNA amplification performed for Ig heavy chain, and DNA ladder pattern shows no dominant bands – what does this mean?

  1. The rearrangement was present but failed to amplify
  2. Amplification failed to take place entirely
  3. The test was not specific because of polyclonal B cells in the lesion
  4. The soft tissue around the lesion was accidentally sampled
  5. The lesion is benign
A

The rearrangement was present but failed to amplify

Somatic mutations of the immunoglobulin heavy chain gene of some mature B disorders, especially follicular lymphomas and plasma cell malignancies, alter the sequence of the region amplified by the primers so that primer hybridization is suboptimal or does not occur, resulting in false negative PCR results

89
Q

Pap smear

What is this?

A

Cocklebur with hematoidin crystals

Cockleburs are associated with IUD, oral contraceptive use, and second half of pregnancy. They are related to cellular regeneration and composed of nonimmune glycoprotein, lipid, and calcium. Cytologically they are identified as golden refractile orange crystalline rays surrounded by histiocytes. They have no clinical significance.

90
Q

What are these alveolar macrophages with dark black pigment?

A

Dust cells

91
Q

What liver tumor has this appearance?

A

Fibrolamellar variant of HCC

• Tumor cells larger than normal hepatocytes, polyhedral, or rounded
• Deeply eosinophilic, coarsely granular cytoplasm
• Cytoplasmic inclusions
– Ovoid “pale bodies” (ground glass but HBV-PAS-/fibrinogen+)
– Mallory hyalines (rare)

  • Large, hyperchromatic, and vesicular nuclei
  • Prominent nucleoli
  • Mitoses and multinucleation infrequent
92
Q

What is the ovary tumor?

A

Krukenberg tumor (metastatic adenoCA)

93
Q

FNA of neck mass

A

Chemodectoma (cartoid body paraganglioma)

Red granules are helpful

94
Q

Micro of this cervical lesion

A

Mesonephric/Wollifan duct remnants

Dilated tubules of cuboidal cells with eosinophilic secretions, surrounded by endocervical stroma

Can show this architecture as well

95
Q

What are the features of Yersinia enterocolitis?

A

● Elongated ulcerations overlying lymphoid hyperplasia
● Also small aphthoid ulcers overlying colonies of gram negative rods and with neutrophils at ulcer base
● Also necrotizing granulomas (particularly with Y. pseudotuberculosis)
● Mesenteric nodes show follicular hyperplasia with variable scattered microabscesses and epithelioid granulomas

96
Q

What is this bladder tumor?

A

Paraganglioma

97
Q

What organism causes pseudoepitheliomatosis hyperplasia?

A

Blastomycosis

98
Q

This finding in the bone marrow is due to what?

A

Parvovirus B19

99
Q

What is this?

100
Q

What is this testicular lesion?

A

Sclerosing sertoli cell tumor

101
Q

FNA of head and neck mass

A

Nasopharyngeal carcinoma

102
Q

Skin with subcutis that shows this

A

Endometriosis

103
Q

Plasmapheresis decreases drugs with what properties?

A

Low volume of distribution and highly protein bound

104
Q

Tell the difference between Acanthamoeba and Naegleria infxn in brain.

Which is this?

A

Acanthamoeba

Here is Naegleria (smaller)

105
Q

What is this soft tissue lesion?

A

Nodular fasciitis

106
Q

What is this ovarian and/or endometrial lesion?

A

Clear cell carcinoma

107
Q

Gross photo of valve vegetations. Tell between bacterial and Liebman Sacks (SLE)

A

Four major forms of vegetative endocarditis:

  1. RHD – see small warty row of vegetations along line of closure
  2. Infectious – see large irregular masses on valve cusps that extend onto chordae
  3. Non-bac thrombotic endocarditis: small bland scattered vegs attached at line of closure
  4. Libman sacks – small- med sized vegs on either or both sides of valve leaflets!
108
Q

Name this lesion.

A

Cellular Blue Nevus

Here is a regular blue nevus

109
Q

Lesion in kidney

A

Malakoplakia

*have to look really hard to find MG bodies

110
Q

If shown prominent spiral arterioles in endometrium, what day of this cycle is this from?

A

Day 23

Day 23: prominent spiral arterioles (thickened walls, coiling and endothelial proliferation)

111
Q

Gross photo of adrenal lesion.

A

Myelolipoma

here is an adrenal cortical adenoma

112
Q

Gross photo of pancreas tumor.

A

Islet cell tumor

113
Q

FNA of breast lesion in man with a testicular tumor history

A

Gynecomastia

114
Q

What is this lesion in the vulva?

A

Hidradenoma papilliferum

115
Q

What is this entity in spleen and what is IHC stain?

A

Littoral Cell Angioma

Plump endothelial cells with irregular vascular channels

IHC:

Positive: features of both endothelial (Factor VIII, CD31) and histiocytic (CD68, Mac387, Ham56, lysozyme) differentiation and positive CD21, vimentin

Negative: CD8, CD34 (usually)

116
Q

What cell type is involved in placental trophoblastic tumor?

A

Intermediate trophoblast

117
Q

What is this thyroid lesion?

A

DeQuervain’s thyroiditis (subacute) showing granulomatous inflammation

118
Q

What causes mid zonal necrosis?

A

Yellow fever

119
Q

What does a skin burn look like on histology?

120
Q

FNA mediastinal mass

What is staining pattern?

A

Seminoma/dysgerminoma

PLAP, CD117, OCT3/4, SALL4

121
Q

What is the diagnosis of the bi-valved kidney (micro pic on answer side)?

A

Xanthogranulomatous pyelonephritis

122
Q

What is the most common mutation in CLL?

A

Del 13q14

good prognosis

123
Q

Gross Photo:

What is this?

A

Huntington’s Disease

124
Q

What is the sequelae of neonatal respiratory distress syndrome?

A

Bronchopulmonary dysplasia

125
Q

What is this seen in a sputum?

A

Strongyloides

126
Q

What is this gross photo of from retroperitoneum?

A

Ganglioneuroma

127
Q

ABSOLUTELY MUST KNOW!

What percentage but a lab get on proficiency testing to pass based on CLIA ‘88?

A

80% to pass!!

128
Q

What germ cell tumor can cause thyrotoxicosis and why?

A

Choriocarcinoma

Thought to be from cross-reactivity of TSH and hCG

129
Q

Granuloma annulare is distinguished from the other palisaded granulomas by:

A

Mucin in the granuloma

130
Q

What type of blood should you give in emergent situations:

1) Less then 10 min
2) 10-30 min
3) more than 30 min

A

Blood needed NOW (less than 10 min) GIVE: uncrossmatched Group O neg (may give O pos if male or older female)

Blood needed in 10-30 min GIVE: Uncrossmatched ABO group and Rh type

Blood needed in over 30 min GIVE: Crossmatched ABO group and RH type

131
Q

The most common cause of hypercalcemia?

A

Parathyroid adenoma

132
Q

What is seen in this liver FNA?

A

Echinococus

Radially arranged hooklets

133
Q

What is this bladder lesion?

A

Inverted papilloma

134
Q

What genetic disease is due to DELETION of 5p?

A

Cri du chat

135
Q

What immunostain differentiates follicular dendritic cells vs interdigitating cells by IHC?

A

CD21 (+ FDCs)

136
Q

In methemoglobinemia, what state is iron in?

137
Q

According to Osler lecture, the boards like to show a gross photo of this spleen. What is this?

A

CLL/SLL

CLL/SLL and large granular cell lymphomas grow in miliary pattern in spleen (white pulp)

138
Q

What is this lesion in the endometrium called?

A

Papillary syncytial metaplasia

An inaccurate term as it is not a metaplasia but rather a regenerative or degenerative process secondary to tissue breakdown.

Mitotic figures may be present within the papillary proliferations.

It is also seen following surface breakdown associated with nonmenstrual conditions.

On occasions, the micropapillary architecture is particularly striking, and, if associated with mitotic activity, this raises the possibility of a serous carcinoma

Differentiated by – background endometrium shows features of breakdown – p53 staining which is negative here

139
Q

What is seen in this pap smear?

A

Alternaria

140
Q

Young woman with endometrial biopsy followed by hysterectomy

A

Choriocarcinoma

141
Q

osteoblastic prostate cancer metz are associated with what type of anemia?

A

Erythroleukoblastic

142
Q

FNA of liver lesion in patient with cirrhosis with multiple nodules

A

Reactive hepatocytes with prominent nucleoli

143
Q

Xray and micro photo of this bone lesion.

A

Parosteal osteosarcoma

144
Q

FNA of bladder lesion

A

Malakoplakia

shows MB body

145
Q

FNA of lymph node

A

REACTIVE LYMPHADENOPATHY

note polymorphous population

146
Q

What is this lesion and what syndrome is it associated with?

A

Angiokeratoma

Fabry’s

147
Q

What is the difference between Kikuchi’s (shown here) and Kimura’s lymphadenitis?

A

Kimura’s: Shown here Young Asian males

  • Germinal center hyperplasia with polykaryocytes, fibrosis and proteinaceous material in germinal centers
  • Folliculolysis, interfollicular eosinophils and eosinophilic abscesses
  • Increased paracortical plasma cells
  • Variable hyalinized vessels
  • Soft tissue lesions show proliferation of thin-walled vessels with eosinophilia

​Kikuchi’s: Young asian females

  • Paracortical, well-circumscribed necrotic lesions, often with a starry-sky appearance
  • Karryorhexis, fibrin deposits, plasmacytoid monocytes (2-3x size of small lymphocytes, variable cytoplasm, round nuclei with open chromatin, small nucleoli, CD4+) that may resemble lymphoma, phagocytic and foamy histiocytes, T cells (CD8+, cytotoxic phenotype)
  • No/rare plasma cells, no neutrophils, no follicular hyperplasia, no atypia
148
Q

Breast lesion

*hard to tell from this pic but be prepared to diagnose on test

A

DCIS with cancerization of lobules

*will look like LCIS at first glance but on higher power ther cells are too ugly

149
Q

What is this?

A

Histoplasma

150
Q

Name this breast lesion.

A

Gynecomastia

151
Q

What is an Auer rod?

A

Fusion of lysosomal granules

152
Q

Entity in a pap smear.

153
Q

Single most imporant prognostic factor in papillary thyroid carcinoma?

154
Q

What is this lesion showing giant cell in the aorta?

A

Takayasu’s arteritis

this looks histologically exactly the same as giant cell arteritis and the distinction is primarily based on the age of the patient (in Takayasu <40yo)

155
Q

The worst type of penile squamous cancer is?

156
Q

BETTER KNOW!

Can you tell difference between alpha 1 antitrypsin and alcoholic steatohepatits?

Which is this?

A

A1AT

This is mallory’s hyaline in alcoholic steatohepatitis

157
Q

What is this?

A

Renal pelvis urothelial CA

158
Q

Breast lesion

A

Collagenous spherulosis

159
Q

What lesion is this in the breast?

A

Micropapillary carcinoma of the breast

160
Q

What is this structure seen in a pelvic washing?

A

Collagen ball

161
Q

What is not a direct cost?

162
Q

What is this?

A

Pleomorphic adenoma

163
Q

Diagnosis of prostate core.

A

Prostate AdenoCA

164
Q

Cytology of gastric brushing

A

Normal mucinous cells

165
Q

Which mycobacterium is a scotochromogen at 37 degrees?

A

M. szulgai (37 degrees)

It’s a photochromogen at 22-24 degrees

166
Q

What lesion is this in the lung?

A

Plexiform lesion associated with pulmonary hypertension

167
Q

What is it called if a bacteria has this flagellar arrangement?

A

Peritrichous

E coli, Salmonella, etc

168
Q

What is this soft tissue lesion?

A

Round Cell Liposarcoma

169
Q

Is Factor Va a serine protease or enzyme cofactor?

A

Enzyme cofactor

170
Q

What is this prostate lesion?

A

HG Cribiform PIN

171
Q

What is this mandible lesion and what syndrome is it associated with?

A

Odontogenic keratocyst

Gorlin’s syndrome

172
Q

What is this NOT associated with?

A

Papillary renal necrosis

A mnemonic for the causes of renal papillary necrosis is POSTCARDS:

pyelonephritis, obstruction of the urogenital tract, sickle cell disease, tuberculosis, cirrhosis of the liver, analgesia/alcohol abuse, renal vein thrombosis, diabetes mellitus, and systemic vasculitis

NSAIDS (not associated with it)

173
Q

What is this mediastinal lesion?

174
Q

What is this lesion in the prostate?

A

Clear cell cribiform hyperplasia of prostate

central zone, look for basal cell layer - basal cell layer can be seen by the use of the 34 beta E12 anti-HMWK antibody (K-903) that reacts with the basal cells but not with the acinar cells of the prostate. (CA is negative for K903)

175
Q

Name this lesion.

A

Proliferating trichilemmal cyst

176
Q

What helps build tolerance to barbiturates?

177
Q

BQ! Etiology of vaginal adenosis?

A

Exposure to DES

Vaginal adenosis: Upper 1/3 and anterior wall of vagina, 20% have gross congenital malformation of cervix (T shaped uterine cavity)

Benign glandular epithelium with metaplasia

178
Q

What is culprit in poisoning in individual who has horizontal white creases in nail bed?

179
Q

Calculate odds ratio.

A

OR = (AD)/(BC)

See pic

180
Q

What type of cord insertion is this?

A

Velamentous cord insertion of placenta

181
Q

What is this?

A

Nodular Melanoma

182
Q

What is this liver lesion?

A

Hepatic Adenoma

183
Q

What does a positive nitrocefin test indicate?

A

The nitrocefin biochemical test is a sensitive technique for detecting beta-lactamase producing strains of N. gonorrhoeae, H. influenzae, Staphylococcus spp, Enterococcus spp and Moraxella (Branhamella) catarrhalis. Nitrocefin is the only reliable test for detecting beta-lactamase producing Enterococcus spp.

184
Q

What thyroid lesion is this?

A

Hyalinizing trabecular tumor

*remember has peculiar cytoplasmic Ki67 staining

185
Q

Determine how many tests must be performed in a year to justify the cost of a new instrument if the price of the instrument is $70,000 and it should last 5 years. It can do 60 tests per hour. A tech can do 4 tests per hour and is paid $6 per hour.

A

10,000 tests per year

Equipment Evaluation (Straight from Osler Notes)

You have purchased a $70K machine which has a 5 year lifetime. The machine can perform 60 tests/hr. A tech can run the machine at a salary of $6/hr. Currently, with the manual method, a tech can do 4 tests/hr. How many tests need to be done each year to justify the cost of the machine?

$70K/5 = $14K

$6/4 = $1.50 per test (manual method)

$6/60 = $0.10 per test (new method)

Let x = the number of tests.

0.10x + $14,000 = 1.50x

x = 10,000/yr

186
Q

Given the frequency of homozygous recessive, homozygous dominant and heterozygous genes, be able to calculate allele frequency.

Hardy-Weinburg Equation

A

Remember the basic formulas:

p2 + 2pq + q2 = 1 and p + q = 1

p = frequency of the dominant allele in the population
q = frequency of the recessive allele in the population
p2 = percentage of homozygous dominant individuals
q2 = percentage of homozygous recessive individuals
2pq = percentage of heterozygous individuals

EXAMPLE:

You have sampled a population in which you know that the percentage of the homozygous recessive genotype (aa) is 36%. Using that 36%, calculate the following:

  • The frequency of the “aa” genotype. Answer: 36%, as given in the problem itself.
  • The frequency of the “a” allele. Answer: The frequency of aa is 36%, which means that q2 = 0.36, by definition. If q2 = 0.36, then q = 0.6, again by definition. Since q equals the frequency of the a allele, then the frequency is 60%.
  • The frequency of the “A” allele. Answer: Since q = 0.6, and p + q = 1, then p = 0.4; the frequency of A is by definition equal to p, so the answer is 40%.
  • The frequencies of the genotypes “AA” and “Aa.” Answer: The frequency of AA is equal to p2, and the frequency of Aa is equal to 2pq. So, using the information above, the frequency of AA is 16% (i.e. p2 is 0.4 x 0.4 = 0.16) and Aa is 48% (2pq = 2 x 0.4 x 0.6 = 0.48).
  • The frequencies of the two possible phenotypes if “A” is completely dominant over “a.” Answers: Because “A” is totally dominate over “a”, the dominant phenotype will show if either the homozygous “AA” or heterozygous “Aa” genotypes occur. The recessive phenotype is controlled by the homozygous aa genotype. Therefore, the frequency of the dominant phenotype equals the sum of the frequencies of AA and Aa, and the recessive phenotype is simply the frequency of aa. Therefore, the dominant frequency is 64% and, in the first part of this question above, you have already shown that the recessive frequency is 36%.
187
Q

What is the earliest feature of degenerative joint disease?

A

fibrillary degeneration of collagen

188
Q

fibrin thrombi are important to the diagnosis of

  1. angiolipoma
  2. epithelioid hemangioendothelioma
  3. spindle cell hemangioendothelioma
  4. angiosarcoma
A

Angiolipoma

Hyaline/fibrin thrombi are an important diagnostic sign

189
Q

What is this lesion in the bladder?

A

Nephrogenic adenoma

can look a little different so here is another example

RACEMASE POSITIVE!!!

190
Q

KNOW!!!

What is the function of thromboxane and prostacyclin in platelets?

A

Thromboxane​: causes platelet activation and local vasoconstiction

Prostacyclin: It inhibits platelet activation and is also an effective vasodilator.

191
Q

What is this lesion?

A

Craniopharyngioma

192
Q

They can ask you to identify stain in a normal lymph node based on pattern. What stain is this in a normal lymph node?

A

Bcl6

Stains germinal center

193
Q

FNA of lateral neck mass

A

Branchial cleft cyst

194
Q
  1. FNA of fibrocystic changes has all of the following except:
    1. Apocrine metaplasia
    2. Foamy macrophages
    3. Angular glands
    4. Naked bipolar nuclei
A

c. Angular glands

Features include:

  • Low cellularity
  • Flat, honeycomb epithelial sheets, with no loss of polarity and distinct cell borders
  • Uniform small nuclei, low N/C ratio
  • Bipolar naked nuclei
  • Foamy cells and apocrine cells
  • Fat and fibrous stromal tissue fragments
195
Q

What is this?

A

Fracture callus

shows two thin trabeculae of bone with lots and lots of osteoblasts rimmed around them, plus hemorrhage nearby and reactive looking fibroblastic proliferation around them

196
Q

Circumcision specimen with this lesion

A

Lichen sclerosis et atophicus

197
Q

What is this breast lesion?

A

Micropapillary DCIS

198
Q

What is this in a brain?

A

Toxoplasma

199
Q

Gram (-) cocci that does not ferment glucose or maltose?

A

Moraxella catarrhalis

200
Q

What is this?

A

Secretory endometrium

tell between secretory EM carcinoma and complex hyperplasia.

AP/CP (23 decks)

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