Path - Histopathology Flashcards
Which of the following is true of bullous pemphigoid?
A. It is indicated by the presence of Wickham’s striae in the buccal cavity
B. Bullae can be found on the extensor serfaces
C. It is an auto-inflammatory condition present in older patients
D. Tense bullae are produced
E. It is a Type III hypersensitivity reaction
D. Tense bullae are produced
Bullous pemphigoid is an autoimmune condition present in elderly patients characterised by the formation of tense bullae formed on the flexural surfaces. It is characterised as a type II hypersensitivity reaction as it is mediated by IgG against desmosomes (as are all pemphigus types). Wickham’s striae are a sign of lichen planus.
there is stereotypically no mucosal involvement (i.e. the mouth is spared)- classic differentiator between pemphigoid and pemphigus
Which of the following conditions would cause mitotically active melanocytes to be seen on histopathology?
A. Squamous cell carcinoma B. Pregnancy C. Basal cell carcinoma D. Psoriasis E. This is a normal finding
B. Pregnancy
Mitotically-active melanocytes are usually a sign of melanoma. A notable exception is when this appearance is noted in a pregnant patient, as this is normal.
In melanoma, upwards migration of melanocytes towards the epidermis will be seen, and melanocytes will fail to decrease in size as they migrate.
Where does damage occur in pemphigus vulgaris?
A. Between the basement membrane and the bottom of the epidermis
B. Between keratinocytes in the epidermis
C. The surface of the epidermis
D. Between the dermis and epidermis
E. Subcorneal layer of epidermis
B. Between keratinocytes in the epidermis
Pemphigus is caused by antibodies against desmosomes. The type of desmosomes targeted determines which type of pemphigus will arise.
‘A’ describes the site of damage and separation in bullous pemphigoid, and’E’ refers to pemphigus foliaceous.
remember pemphigus is more superficial so flaccid blisters that burst easily. Opposite for BP as deeper (sub-epidermal) so tense blisters (+ red, itchy, hives)
Match the appearances on immunofluorescence with the disease they are each most associated with
A. Homogenous
B. Speckled
C. Centromere pattern
D. Nucleolar pattern
- Diffuse cutaneous systemic sclerosis
- Limited cutaneous systemic sclerosis
- Mixed connective tissue disease
- SLE
A. Homogenous - 4. SLE
B. Speckled - 3. Mixed connective tissue disease (mixed and speckled are sort of synonyms)
C. Centromere pattern - 2. Limited cutaneous systemic sclerosis (CREST)-remember Centromere and Crest (C and C)
D. Nucleolar pattern - 1. Diffuse cutaneous systemic sclerosis
NB: None of these patterns are 100% specific e.g. SLE can give almost any of these appearances on immunofluorescence.
Homogenous pattern indicates Anti-dsDNA
Speckled pattern indicates Anti-Ro, La, and Sm
Nucleolar pattern indicates ANti-SCL70 (anti-topoisomerase)
pic shows main anti-nuclear (ANA) patterns on immunofluorescence
Mixed connective tissue disease, commonly abbreviated as MCTD, is an autoimmune disease characterized by the presence of elevated blood levels of a specific autoantibody, now called anti-U1 ribonucleoprotein (RNP) together with a mix of symptoms of systemic lupus erythematosus (SLE), scleroderma, and polymyositis.[2] The idea behind the “mixed” disease is that this specific autoantibody is also present in other autoimmune diseases such as systemic lupus erythematosus, polymyositis, scleroderma, etc.
scleroderma split into- systemic scelrosis (diffuse type- usually ant-Scl-70) and CREST (limited cutaneous)
A kidney biopsy shows thickened glomerular capillary loops (a wire loop appearance)
Which disease is this suggestive of?
A. SLE B. Scleroderma C. Sarcoidosis D. Goodpasture's disease E. GPA
A. SLE
The wire loop appearance is the classic appearance of lupus nephritis, and is caused by immune complex deposition in the glomerular capillary loops causing thickening.
Which vessels are most often affected by polyarteritis nodosa?
A. Coronary arteries B. Temporal and retinal arteries C. The aorta and its branches D. Renal and mesenteric arteries E. Vessels in the kidneys, lungs, and upper respiratory tract
D. Renal and mesenteric arteries
Polyarteritis nodosa is a necrotising arteritis affecting medium vessels. It most often affects the renal and mesenteric arteries, and causes a series of aneurysms in close proximity, creating the ‘rosary beads’ appearance on angiography. It is classically associated with hepatitis B infection.
Polyarteritis nodosa (PAN) is a systemic necrotizing inflammation of blood vessels (vasculitis) affecting medium-sized muscular arteries, typically involving the arteries of the kidneys and other internal organs but generally sparing the lungs’ circulation
rosary baeds appearance is key
What is the most common form of thyroid cancer?
Papillary
Though thyroid carcinomas are rare, within that group papillary thyroid cancer is the most common. They are especially associated with radiation exposure.
What form of thyroid cancer arises from parafollicular ‘C cells’?
Medullary
Medullary carcinoma makes up 5% of thyroid carcinomas. 80% are spontaneous, but 20% are associated with a MEN syndrome.
What is the most common type of pituitary adenoma?
A, Gonadotrophin-secreting B. ACTH-secreting C. Non-functioning D. Prolactinoma E. TSH-secreting
D. Prolactinoma
Prolactinomas make up 20-30% of pituitary adenomas, with the next most common adenoma being a non-functioning one.
Muscle weakness, hypertension, and congestive cardiac failure are all possible complications of adenomas secreting which hormone?
A. Somatotrophin B. Prolactin C. Somatostatin D. Gonadotrophin E. TSH
A. Somatotrophin
Muscle weakness, hypertension, T2DM, and congestive cardiac failure are all potential complications of acromegaly which is caused by excess somatotrophin (a.k.a. growth hormone).
What is the most common cause of goitre worldwide?
A. Iodine deficiency B. Hashimoto's thyroiditis C. Toxic multinodular goitre D. Graves' disease E. Papillary thyroid cancer
A. Iodine deficiency
Although very rare in the west because of iodine-fortified food, iodine deficiency is very common in parts of the developing world and so is still the commonest cause of goitre.
Which of the following statements about thyroid nodules is FALSE?
A. Solitary nodules are more often neoplastic than multiple nodules
B. Solid nodules are more likely to be neoplastic than cystic nodules
C. Nodules in younger patients are more likely to be neoplastic than those in older patients
D. Nodules in females are more likely to be neoplastic than those in males
E. Nodules that don’t take up radio-labelled iodine (cold) are more commonly neoplastic than hot nodules
D. Nodules in females are more likely to be neoplastic than those in males
Medullary part of MEN-2 commonly.
Anaplastic v poor prognosis.
this is false. The key is the rest are true!
What findings on microscopy would suggest a papillary thyroid carcinoma?
Optically clear nuclei, intranuclear inclusions, and psamomma bodies
Diagnosis of papillary carcinoma does not necessarily focus on the overall architecture, as the classic papillary shape may not be present. Instead the cell morphology is analysed.
The nuclei in papillary thyroid carcinomas are visibly empty, hence ‘optically clear nuclei’ is a sign.
Psamomma bodies are round foci of calcification that appear in many cancers, but the only thyroid cancer they appear in is papillary.
Papillary thyroid cancer gets its name from the papillae among its cells, visible on microscopy.
Which of the following is not a complication or sign of primary hyperparathyroidism?
A. Depression B. Pancreatitis C. Osteitis fibrosa cystica D. Paraesthesia E. Tetany
E. Tetany
All the other options are complications of hypercalcaemia, whereas tetany results from hypocalcaemia. Hyperparathyroidism causes hypercalcaemia as the excess PTH increases serum calcium beyond normal limits.In 80-90% of cases, primary hyperparathyroidism is caused by an adenoma, with 10-20% of cases being due to generalised parathyroid hyperplasia (which can be part of a MEN syndrome). Parathyroid carcinoma accounts for <1% of hyperparathyroidism cases.
Hyperparathyroidism may also be secondary, in which case chronic kidney disease is the most common cause, leading to insufficient 25-hydroxycholecalciferol hydroxylation (low active vitamin D).
Osteitis fibrosa cystica is a skeletal disorder resulting in a loss of bone mass, a weakening of the bones as their calcified supporting structures are replaced with fibrous tissue (peritrabecular fibrosis), and the formation of cyst-like brown tumors in and around the bone. It is caused by hyperPTism (due to osteoclast overactivity)
Which pathogens are particularly associated with pelvic inflammatory disease after a woman has undergone a TOP?
A. Stapylococci B. Salmonella C. Gonococci D. Shigella E. Chlamydia
A. Staphylococci
Gram positive cocci (Staphylococci, Streptococci), coliform bacteria (E. coli, Klebsiella, Enterobacter etc.), and C. perfringens are particularly important causes of PID after a TOP.
Which of the following HPV types is most associated with cervical cancer?
A. 6 B. 9 C. 11 D. 18 E. 33
D. 18
16 and 18 are the most common cancer-causing sub-types. They have a strong association with cervical cancer, but may also cause vulval, vaginal, penile, and anal cancer.
6 and 11 are the most common low-risk, wart-causing HPV sub-types.
Describe the Cervical Screening Program for the following age brackets:
25-49
50-64
65+
25-49: 3 yearly
50-64: 5 yearly
65+: only if not screened since age 50 or recent abnormal tests
A woman undergoes surgery for resection of an endometrial carcinoma. During surgery the para-aortic lymph nodes are found to be involved, though not the pelvic. The primary tumour has spread into the fallopian tubes.
What is the correct FIGO staging of this cancer?
A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4 E. Stage 5
C. Stage 3
Stage 1 – confined to uterus
Stage 2 – spread to cervix
Stage 3 – spread to adnexae (fallopian tubes, ovaries, potentially nearby ligaments), vagina, local lymph nodes (pelvic or para-aortic)
Stage 4 – other pelvic organs distant spread inc any other distant lymph node groups
NB: there is no stage 5
Which of the following is false?
A. Endometriosis may be associated with a variety of ovarian tumours especially clear cell carcinoma
B. Epithelial serous ovarian tumours are the most common type and are bilateral in 30-50% of cases
C. Endometriosis may lead to scarring and infertility
D. Most cases of ovarian cancer have a genetic component
E. Some germ cell tumours can grow teeth and hair
D. Most cases of ovarian cancer have a genetic component
A woman attends her GP for a cervical smear, having not been vaccinated against HPV and having not engaged with smear services before. The doctor notices a visible abnormality of the cervix, which is swabbed, and later biopsied. The biopsy shows a neoplasia of the cervical epithelial squamous cells which occupies 3/4 of the thickness of the cervix but has not breached the basement membrane.
Which of the following options best describes the biopsied lesion?
A. Cervical intra-epithelial neoplasia 1 B. Cervical intra-epithelial neoplasia 2 C. Cervical intra-epithelial neoplasia 3 D. Carcinoma E. Metastasis
C. Cervical intra-epithelial neoplasia 3
The staging system for a cervical intra-epithelial neoplasia is as follows:
CIN 1 - neoplasia occupies <1/3 of the thickness of the epithelium
CIN 2 - neoplasia occupies 1/3 - 2/3 of the thickness of the epithelium
CIN 3 - neoplasia occupies >2/3 of the thickness of the epithelium
Carcinoma - neoplasia has invaded the basement membrane
This is clearly not a metastasis as the biopsy shows the cells are from the cervical epithelium
Which of the following statements concerning HPV and cervical cancer is false?
A. 90% of HPV infections are cleared within 2 years
B. Most women over 65 are not invited to cervical screening
C. The HPV virus can inactivate both the p53 and Retinoblastoma tumour suppressor genes
D. Adenocarcinomas occur 4 times less often than squamous cell carcinomas
E. Non-productive infection of cells cannot be identified due to the lack of infective virions
E. Non-productive infection of cells cannot be identified due to the lack of infective virions
It’s true that non-productive infection does not produce infectious virions, and that infected cells do not display the cytological and histological changes associated with HPV infection. However non-productive infection can still be identified using molecular tests (e.g. PCR) as the HPV DNA still resides in the cells and is replicated along with the host cell.
Some of the early genes expressed by HPV, such as E6 and E7, act as oncogenes that promote tumor growth and malignant transformation- E6 protein inactivates p53 (TSG) and E7 inactivates Rb (TSG)
Which of the following is true
A. Mucinous and secretory endometrial carcinomas have better prognoses than serous and clear cell types
B. Leiomyomas (fibroids) affect ~40% of women <35
C. Diabetes, obesity, and multiparity are risk factors for endometrial carcinoma
D. Leiomyosarcomas may result from fibroids, and have a positive prognosis
E. Endometrial cancers are rare among cancers in the developed world
A. Mucinous and secretory endometrial carcinomas have better prognoses than serous and clear cell types
Endometrial cancer can be divided into two types:
Type I - 80-85% of cases, presents younger, oestrogen dependent, low grade, less invasive, usually mucinous or low grade endometrioid/ serous
Type II - 10-15% of cases, presents older, less oestrogen dependent, high grade, more deeply invasive, feature worse mutations e.g. in p53 (serous carcinoma), usually high grade serous
A Leiomyoma is a benign smooth muscle tumour colloquially known as a fibroid. They occur in 20% of women <35, are the commonest type of uterine tumour, and usually occur in multiples.
Leiomyosarcomas are rare malignant smooth muscle tumours, but do not evolve from benign leiomyomas. They occur usually in post-menopausal women, and have a 5 year survival rate of 20-30%.
Endometrial carcinoma is the most common gynaecological malignancy in the developed world. Diabetes and obesity are indeed risk factors, but nulliparity, not multiparity, also increases the risk.
remember obesity is major RF for endometrial ca (also breast) as increases oestrogen exposure (as high aromatase in adipose tissue)
Describe the pathogenesis of atherosclerosis
LDLs are deposited in the subintimal space of arteries and become oxidised by free radicals in the endothelium
Macrophages are recruited to the site of inflammation, take up the LDLs and become foam cells
Foam cells (along with platelets that adhere to the damaged endothelium) release factors that recruit vascular smooth muscle cells and stimulate them to lay down extracellular matrix within the plaque
Smooth muscle cells also form the fibrous cap over the top of the plaque in response to endothelial damage
Macrophages/ foam cells also release proteinases(metalloproteinases) which eventually degrade the fibrous cap of the plaque, and tissue factor which makes the plaque contents thrombogenic
Eventually the foam cells die and contribute to the lipid rich plaque core
Which of the following is the most significant independent risk factor for cardiovascular disease?
A. Hypertension B. Gender C. Age D. Family history E. Smoking
D. Family history
Why are the majority of myocardial infarctions not preceded by symptoms?
Because symptoms of arterial stenosis only occur at around 70% stenosis
Atheromatous plaques may rupture well before this stage, exposing their thrombogenic contents to the bloodstream and causing a coronary artery thrombosis
go from 0-100 really quick (ie not all the way up to 70 first ie when sxs show)
Why is ischaemia less well tolerated by the myocardium than pure hypoxia?
Because of the failure to remove toxic waste products from the myocardium in ischaemia
Give 5 complications of an MI
Arrhythmia Cardiac rupture Cardiogenic shock/ chronic heart failure Dressler syndrome Mural thrombi (e.g. causing bowel infarction)
What would a ‘nutmeg’ appearance of the liver indicate?
Venous congestion of the liver from right/ congestive heart failure
How does a complete hydatidiform mole form?
Either:
One sperm fertilises an empty egg and its DNA replicates to make a 46XX diploid cell
OR
Two sperm fertilise an empty egg to make either a 46XY or 46XX diploid cell
remember complete mole forms as no maternal genetic material present
A molar pregnancy, also known as a hydatidiform mole, is an abnormal form of pregnancy in which a non-viable fertilized egg implants in the uterus. It falls under the category of gestational trophoblastic diseases.[1] During a molar pregnancy, the uterus contains a growing mass characterized by swollen chorionic villi, resembling clusters of grapes.[2] The occurrence of a molar pregnancy can be attributed to the fertilized egg lacking an original maternal nucleus. As a result, the products of conception may or may not contain fetal tissue.
A complete mole is caused by either a single sperm (90% of the time) or two sperm (10% of the time) combining with an egg that has lost its DNA. In the former case, the sperm reduplicates, leading to the formation of a “complete” 46-chromosome set.[3] Typically, the genotype is 46,XX (diploid) due to subsequent mitosis of the fertilizing sperm, but it can also be 46,XY (diploid).[3] However, 46,YY (diploid) is not observed. On the other hand, a partial mole occurs when a normal egg is fertilized by one or two sperm, which then reduplicates itself, resulting in genotypes of 69,XXY (triploid) or 92,XXXY (tetraploid).
How does a partial hydatidiform mole form?
Either:
A normal egg is fertilised by 2 sperm to form a 69XXY, XXX, or XYY cell
OR
A normal egg is fertilised by a 46XY sperm resulting in a 69XXY cell
Remember: 69 isn’t full sex (complete means normal chromosome number), it’s partial
NB: partial moles don’t become malignant (don’t become choriocarcinoma/invasive mole)
while both choriocarcinoma and invasive mole arise from abnormal placental tissue (both trophoblastic origin), choriocarcinoma is more aggressive, has a higher potential for metastasis, and can occur after various types of pregnancies, whereas invasive mole is typically associated with molar pregnancies and has a lower metastatic potential.
a partial mole occurs when a normal egg is fertilized by one or two sperm, which then reduplicates itself, resulting in genotypes of 69,XXY (triploid) or 92,XXXY (tetraploid).[3]
The findings of an OGD + biopsy are: a lesion in the mid-oesophagus, which on histopathology is seen to feature intercellular bridges.
Which of the following would you most expect to find in this patient’s history?
A. Previous episodes of gastritis B. Epigastric or chest pain worse on lying down C. A family history of malignancy D. High alcohol intake and smoking E. Dysphagia to liquids
D. High alcohol intake and smoking
This history suggests squamous cell carcinoma of the oesophagus, which is the commonest oesophageal cancer worldwide and is particularly linked to high alcohol intake (linked to acetaldehyde pathway) and smoking. The most common cause of oesophageal cancer in the UK is adenocarcinoma, which is linked to GORD and progresses from Barrett’s.
NB: High keratin content and intercellular bridges are features of squamous cell carcinoma
Match each histological description to the appropriate disease:
A. PSC B. PBC C. Alcoholic hepatitis D. Acute hepatitis E. Cirrhosis F. Steatosis G. Chronic hepatitis
- Intrahepatic bile duct granulomatous inflammation, damage, and loss associated with anti-mitochondrial antibodies
- Interface hepatitis
- Ballooning of hepatocytes and Mallory-Denk bodies
- Bile duct scarring and concentric fibrosis within the liver
- Fatty pockets within the liver linked to acute alcohol intake or dietary factors
- Nodules of regeneration causing disruption of vascular architecture
- Spotty necrosis
A. PSC - 3. Bile duct scarring and concentric fibrosis (‘onion skinning’) within the liver
B. PBC - 1. Intrahepatic bile duct granulomatous inflammation, damage, and loss associated with anti-mitochondrial antibodies
C. Alcoholic hepatitis - 2. Ballooning of hepatocytes and Mallory-Denk bodies
D. Acute hepatitis - 7. Spotty necrosis (eg viral, AI and drug induced- as all acute)
E. Cirrhosis - 5. Nodules of regeneration cause disruption of vascular architecture
F. Steatosis - 5. Fatty pockets within the liver linked to acute alcohol intake or dietary factors
G. Chronic hepatitis - 2. Interface hepatitis (eg chronic hep B)
Primary biliary cholangitis - the M rule-
IgM
anti-Mitochondrial antibodies, M2 subtype
Middle aged females
Piecemeal necrosis (more currently called “interface hepatitis” [IH]) is a relatively common type of necrosis seen in hepatitis. It is characterized by inflammation extending from the portal tract (PT) into the periportal zone, with necrosis of periportal hepatocytes and disruption of the limiting plate.Basically necrosis at the lobular-portal interface.
Which of the following statements is false?
A. Acute pancreatitis may cause the formation of pseudocysts lined with necrotic and granulated tissue but not epithelium
B. Gallstones are the most common cause of pancreatitis and are usually made of radiolucent cholesterol
C. Cholecystitis is usually associated with gallstones
D. Pancreatic cancer rarely produces secretions
E. The most common form of pancreatic cancer is ductal adenocarcinoma
D. Pancreatic cancer rarely produces secretions
Ductal adenocarcinomas are the most common type of pancreatic cancer (85%), and secrete mucin.
Match each histological finding to the appropriate disease:
- A multinodular mass of expanded intralobular stroma and compressed, slit-like ducts
- A rapid-growing tumour with overlapping cells that have a leaf-like architecture
- Inflamed and dilated ducts filled with secretions
- Cysts and mild epithelial and stromal proliferation
- Polypoid mass with epithelial outside lining and fibrovascular core
- Sclerosing lesion with scarred centre surrounded by proliferating glandular tissue
A. Fibroadenoma B. Duct ectasia C. Phyllodes tumour D. Intraductal papilloma E. Radial scar F. Fibrocystic changes
A. Fibroadenoma - 1. A multinodular mass of expanded intralobular stroma and compressed, slit-like ducts
B. Duct ectasia - 3. Inflamed and dilated ducts filled with secretions (proteinaceous secretions!)
C. Phyllodes tumour - 2. A rapid-growing tumour with overlapping cells that have a leaf-like architecture
D. Intraductal papilloma - 5. Polypoid mass with epithelial outside lining and fibrovascular core
E. Radial scar - 6. Sclerosing lesion with scarred centre surrounded by proliferating glandular tissue
F. Fibrocystic changes - 4. Cysts and mild epithelial and stromal proliferation
Match each histological finding to the appropriate disease:
- Large pleomorphic cells that move from the ducts to the stroma
- Sheets of markedly atypical cells with prominent lymphocytic infiltrate
- Lots of seemingly empty spaces that are actually filled with secretions
- Ducts filled with atypical epithelial cells, but with a regular lumen
- Cells are monomorphic and organised in a linear fashion
A. DCIS B. Basal-like carcinoma C. Invasive ductal carcinoma D. Invasive lobular carcinoma E. Invasive mucinous carcinoma
A. DCIS - 4. Ducts filled with atypical epithelial cells, but with a regular lumen
B. Basal-like carcinoma - 2. Sheets of markedly atypical cells with prominent lymphocytic infiltrate
C. Invasive ductal carcinoma - 1. Large pleomorphic cells that move from the ducts to the stroma
D. Invasive lobular carcinoma - 5. Cells are monomorphic and organised in a linear fashion
E. Invasive mucinous carcinoma - 3. Lots of seemingly empty spaces that are actually filled with secretions
Basal-like tumors have cells that look similar to the epithelial cells of the outermost, basal layer of the breast’s milk ducts. Basal-like breast cancer is a term often used interchangeably with triple negative breast cancer.- filled w. lymphocytes
Mucinous breast cancer is a rare type of breast cancer. It gets its name because the cancer cells are surrounded by a substance called mucin.
A 13-year-old girl has been having a cough and fever for the last four days, and over the last day developed some difficulty breathing. Her parents did not take her to the emergency room, because they knew a cold was going around. In the morning, they found her unresponsive in her bed. An ambulance was called, but she was pronounced dead. An autopsy was performed, and in the left pleural cavity was a thick white-yellow cloudy fluid substance. Microscopic examination of the lungs confirmed a lobar pneumonia. Of the following, which term best describes the substance in the left pleural cavity?
A. A fibrinous transudate B. A purulent exudate C. A purulent transudate D. A serous exudate E. A serous transudate
B. A purulent exudate
NB: This question is replicated from Prof. Rob Goldin’s Path Mock 2020
Transudate squeezed through - hence ‘trans’
A pathologist is reviewing old autopsy slides from the file of the hospital at which he works. One of the slides includes a section of liver and gallbladder from a person who was exposed to carbon tetrachloride at the dry-cleaning store he worked at. At which of the following locations will the pathologist identify the greatest amount of cellular injury?
A. Centrilobular hepatocytes B. Mucosa of the gallbladder C. Muscularis of the gallbladder D. Periportal hepatocytes E. Portal arteries
A. Centrilobular hepatocytes
This is not as niche a questions as it seems, the majority of liver toxins are metabolites: the chemical that enters the liver is not toxic, but is metabolised to a hepatotoxic compound. The most metabolically active area of the liver is the perilobular hepatocytes, hence these toxic metabolites are most concentrated there and they are the most affected.
NB: This question is replicated from Prof. Rob Goldin’s Path Mock 2020
The regions surrounding the hepatic arteries and portal veins are known as periportal (zone 1), while those adjacent to the central vein are called the pericentral areas of the lobule (zone 3), with the cells in between these regions, referred to as mid-lobular hepatocytes (zone 2).
This specialization is reflected histologically; the detoxifying zone III cells have the highest concentration of CYP2E1 and thus are most sensitive to NAPQI production in acetaminophen toxicity.[12]
Other zonal injury patterns include zone I deposition of hemosiderin in hemochromatosis and zone II necrosis in yellow fever
A 4-year-old boy is evaluated by his paediatrician for 1 week of intermittent haematuria. On examination he appears well developed and well nourished, except a right flank mass is palpable. A biopsy of the mass is performed, which reveals primitive looking small blue cells.
What is the diagnosis?
A. Medulloblastoma B. Neuroblastoma C. Polycystic kidney disease D. Rhabdoid tumour E. Wilm's tumour
E. Wilm’s tumour
NB: This question is replicated from Prof. Rob Goldin’s Path Mock 2020
small-round-blue-cell tumor (SRBCT) or a small-round-cell tumour (SRCT), is any one of a group of malignant neoplasms that have a characteristic appearance under the microscope, i.e. consisting of small round cells that stain blue on routine H&E stained sections.
What stage of liver fibrosis is classified as cirrhosis?
F4
Metavir score
Bridging fibrosis – an advanced stage of liver fibrosis, seen in the progressive form of chronic liver diseases. The term bridging refers to the formation of a “bridge” by a band of mature and thick fibrous tissue from the portal area to the central vein. This form of fibrosis leads to the formation of pseudolobules
Which is the most common type of renal cell carcinoma?
A. Clear cell B. Papillary C. Chromophobe D. Oncocytoma E. Adenoma
A. Clear cell
Clear cell renal carcinomas make up around 70% of renal cell carcinomas. Clear cell carcinomas appear on histology as nests of clear cells set within a capillary network. They appear grossly as a golden/ yellow tumour with haemorrhagic areas.
