Path BB questions

Question 1

Differentiation of this is regulated via the RANK gene product.

Answer 1

Osteoclast

Question 2

This type of bone is 80-90% calcified and its function is mainly mechanical and protective.

Answer 2

Cortical

Question 3

This type of bone is immature and usually pathological.

Answer 3

Woven

Question 4

bone cancer in 10-20 year olds

Answer 4

Ewing Sarcoma

Question 5

Bone tumour painless and slow growing, related to previous fracture

Answer 5

Osteochondroma

Question 6

70 year old man presents to his GP with a four day history of haemoptysis. He has noticed he has been loosing weight over the last 4 months and has felt tired and unwell. On examination he has bilateral ptosis and proximal weakness in the limbs which improves on repeated testing

Answer 6

Small cell carcinoma - Causes myasthenia gravis syndrome

Non small cell causes horners (Most commonly adeno)

Question 7

A 35 year old woman presents with weight loss and tiredness. Her GP examines her and finds that she also has a fine tremor and is sweaty. Investigations: TSH <0.01, Free T4 36.0. There is low uptake on a technetium scan. The aetiology could be viral or autoimmune.

Answer 7

Subacute thyroiditis - Could be viral or Autoimmune. Mixed Hyper/hypo picture

Question 8

Neoplasms found in young women as ovarian masses, usually unilateral and most often on the right. They are usually filled with sebaceous secretion and matted hair and may have a nodular projection from which teeth protrude.

Answer 8

Mature - Immature more common in older women and don’t have hair and teeth

Question 9

Squamous epithelium mixed with intestinal epithelium

Answer 9

Mature Cystic - Krukenburg has sigent cells

Question 10

Fibrous tissue containing spindle cells and lipid

Answer 10

Thecoma - contians lipids

Question 11

Very aggressive tumour producing HCG and AFP; neoplastic cells are anaplastic.

Answer 11

Embryonal carcinoma

Question 12

Commonest malignant cause of testicular mass in those aged under 5.

Answer 12

ALL

Question 13

Commonest malignant cause of testicular mass in those aged 60

Answer 13

Diffuse Large B cell lymphoma

Question 14

A pap smear taken from a chronic granulomatous ulcer shows a necrotic centre, periarteritis and endarteritis obliterans and an intense peripheral cellular infiltrate consisting mainly of mononuclear cells and giant cells.

Answer 14

Treponema Pallidum - endarteritis obliterans points to it

Question 15

The metaplasia that occurs in the transformation zone involves which cell-types?

Answer 15

Glandular to Squamous

Question 16

FNA is 100%PPV or 10% false positive rate for cytopathalogical diagnosis?

Answer 16

100% PPV

Question 17

A 45 year old woman with known gallstones presents to A & E with abdominal pain which radiates to her back. The pain is relieved by sitting forward. The pain has been constant for several hours and she has also vomited twice. Which enzyme is most likely to be raised?

Answer 17

Amylase - Due to the acute pancreatitis

Question 18

A 10 year old boy is brought by his mother to your clinic. He is very thin, but has a distended abdomen. What is it that his diet does not contain to cause this?

Answer 18

Protein

Question 19

An 85 year old smoker lady is brought to the GP by concerned relatives. She lives alone and has become increasingly withdrawn. On close questioning it appears that over the past few months she has been smoking more heavily and surviving on little more than tea and toast.

Answer 19

Vitamin C deficiency

Question 20

Which deficiency in CF or pancreatitis?

Answer 20

Vitamin K

Question 21

Testicular cancer raised AFP

Answer 21

Yolk sac tumour, or less commonly embryonal carcinomas

Question 22

32 year old female presented with weight loss and anxiety. The thyroid gland was enlarged, firm, fleshy and pale, infiltrated by lymphocytes. Askanazy cells were noted.

Answer 22

Hashimotos - some present hyperthyroid and Asikanzy cells

Question 23

Neurotoxic product(s) of heme breakdown producing neurovisceral damage in certain porphyrias

Answer 23

5-aminolevulinic acid

Question 24

Extracts of or detoxified exotoxin product by a micro-organism.

Answer 24

Tetanus/Diptheria

Question 25

Vaccine that is made using recombinant DNA technology.

Answer 25

Hepatitis B virus vaccine

Question 26

A freeze dried live attenuated strain of Mycobacterium bovis

Answer 26

BCG

Question 27

This form of immunity is induced by vaccination.

Answer 27

Active Immunity

Question 28

This microbe affects the ileum, appendix and colon. Its peyer patch invasion leads to mesenteric lymph node enlargement with necrotising granulomas.

Answer 28

Yersinia

Question 29

A 34 year old female returned from Indonesia two weeks ago. She complains of diarrhoea, abdominal pain, weight loss, nausea and vomiting for the past few days. She has no fever. Investigation reveals steatorrhoea and stools appear to contain numerous cysts.

Answer 29

Giardiasis - Steatorrhoea and Cysts (Inactive Giardia)

Question 30

Following a barbeque, a 41 year old develops watery diarrhoea and vomiting. On retrospect, he wondered whether he should have had that dodgy looking shish kebab…

Answer 30

Salmonella - If crampy, think campylobacter