Path Recalls 2017 Flashcards
Which is not consistent with Wegeners?
Upper respiratory tract granulomas Lower respiratory tract granulomas Renal artery vasculitis Pulmonary artery vasculitis Glomerulonephritis
Renal artery vasculitis no
Which is not consistent with Wegeners?
Upper respiratory tract granulomas yes Lower respiratory tract granulomas yes Renal artery vasculitis no Pulmonary artery vasculitis yes Glomerulonephritis yes
Two questions on Churg strauss
Associated:
pANCA
eGPA
Two questions on Churg strauss
Associated pANCA yes
eGPA asthma, eosinophilia
Which doesn’t cause bowel ischaemia
PAN
Behchets
Atherosclerosis
Which doesn’t cause bowel ischaemia
PAN yes
Behchets yes
Atherosclerosis yes
Most likely cause of acute bowel ischaemia
SMA atherosclerosis
SMV thrombosis
Aortic dissection
SMA embolus
SMA embolus AF most likely
Most likely cause of acute bowel ischaemia?
SMA atherosclerosis common
SMV thrombosis yes
Aortic dissection yes HTN and dissect into SMA
SMA embolus AF most likely
Aortic dissection
5-10% don’t have an intimal tear
Dissection between media and the intima
Most common to have tear at junction of arch and proximal descending aorta
- *LJS - 5-10% no intimal tear
- LW agrees.
Dissection between media and the intima ?maybe not dissection usually outer third of media and can rupture into adventitia (robbins)
Aortic dissection
5-10% don’t have an intimal tear - IMH 10%
Dissection between media and the intima - ?maybe not dissection usually outer third of media and can rupture into adventitia (robbins)
Most common to have tear at junction of arch and proximal descending aorta - yes aortic ischmus
What is least associated with BRCA
Pancreas
Prostate
CRC
Ovarian
What is least associated with BRCA Pancreas yes Prostate yes CRC yes no Ovarian yes
Most likely to cause colon cancer
PJ
UC
Most likely to cause colon cancer
PJ less likely but is associated with colon and breast
UC yes
Least likely to cause gastric cancer
Fundic gland polyp Hyperplastic polyp Adenomatous polyp Partial gastrectomy H pylori
Hyperplastic polyp - virtually no malignant potential.
Fundic gland polyp - yes, most common polyp
Adenomatous polyp yes
Partial gastrectomy yes
H pylori yes
With regard to celiac disease (least likely)
Severely affects the distal small bowel Increase in number of small bowel folds Villous atrophy Autoimmune reaction to ingested to gliadin Increased risk of MALToma
Severely affects the distal small bowel
With regard to celiac disease (least likely)
Severely affects the distal small bowel -no. Duodenum and jejunum
Increase in number of small bowel folds -yes distally
Villous atrophy -yes
Autoimmune reaction to ingested to gliadin -yes
Increased risk of MALToma -no MALToma with Hpylori, T lymphoma with celiac disease
Most common location of small bowel adenocarcinoma
Duodenum Proximal jejunum Distal jejunum Proximal ileum Distal ileum
Duodenum periampullary tumor
Most common location of small bowel adenocarcinoma
Duodenum -periampullary tumor Proximal jejunum -GIST Distal jejunum Proximal ileum Distal ileum -lymphoma, TB, Yersinia, carcinoid from enterochromaffin cells
Young patient with bicornuate uterus and one kidney
Mesonephric duct
Mullerian duct
Wolffian duct
Genital ridge
Mullerian duct mullarian anomalies
Young patient with bicornuate uterus and one kidney
Mesonephric duct
Mullerian duct mullarian anomalies
Wolffian duct
Genital ridge
Newborn with dilated colon and unilateral sacral agenesis
Hirschsprungs
Anal atresia
Ileal atresia
Meconium plug
Anal atresia VACTERL or curarino ASP triad anorectal malformation, sacral osseus defect, presacral mass
Newborn with dilated colon and unilateral sacral agenesis
Hirschsprungs not sacrum
Anal atresia VACTERL or curarino ASP triad anorectal malformation, sacral osseus defect, presacral mass
Ileal atresia no
Meconium plug no
Which is associated with CF?
Hypertrophic pyloric stenosis
Which is associated with CF?
Hypertrophic pyloric stenosis articles say maybe, but I would say no
Which is most suggestive of UC?
Pseudopolyps
Uveitis
Fistulas
Sacroiliitis
Pseudopolyps yes.
Which is most suggestive of UC?
Pseudopolyps yes
Uveitis IBD
Fistulas no
Sacroiliitis IBD
Most consistent with reactive arthritis?
Symmetrical sacroiliitis
Shoulder arthropathy
Commonly follows GI infection
Commonly follows GI infection yes arthritis follow GI or chlamydia is most consistent
Most consistent with reactive arthritis?
Symmetrical sacroiliitis no asymmetrics
Shoulder arthropathy non specific
Commonly follows GI infection yes arthritis follow GI or chlamydia is most consistent
Hydroxyapetite deposition disease associated with?
Dermatomyositis
Sjogrens
Scleroderma
Dialysis
Dialysis yes amyloid b2 microglobulin, CPPD and HADD, osteodystrophy
Hydroxyapetite deposition disease associated with?
Dermatomyositis no calcinosis universalis
Sjogrens no
Scleroderma no calcinosis circumscripta
Dialysis yes amyloid b2 microglobulin, CPPD and HADD, osteodystrophy
Least liekly to have changes in CJD?
Dentate nuclei
Caudate
Putamin
Thalami
Dentate nuclei no
Least liekly to have changes in CJD?
Dentate nuclei no
Caudate yes BG
Putamin yes BG
Thalami yes hockey stick
Least likely CADASIL manifestation?
External capsule ischaemia Basal ganglia ischaemia Anterior temporal white matter change Periventricular white matter changes Skin changes
Skin changes no
Least likely CADASIL manifestation?
External capsule ischaemia yes classic location
Basal ganglia ischaemia yes
Anterior temporal white matter change yes classic location
Periventricular white matter changes yes leukoencephalopathy
Skin changes no. **LJS - can perform skin bx to dx if no genetic mutation found. But ?no clinically recognisable skin change
Most true regarding HSV?
HSV1 Most common cause of neonatal encephalitis
HSV2 most common cause of adult encephalitis
Causes haemorrhagic necrosis
Causes haemorrhagic necrosis yes
Most true regarding HSV?
HSV1 Most common cause of neonatal encephalitis no HSV2 birth canal
HSV2 most common cause of adult encephalitis no HSV1
Causes haemorrhagic necrosis yes
What is the least likely consequence of herniation?
DAI Duret haemorrhage ACA infarct PCA infarct Kernohans notch
DAI false, it is associated but not a consequence
What is the least likely consequence of herniation?
DAI false, it is associated but not a consequence
Duret haemorrhage yes stretching pontine perforators
ACA infarct yes subfalcine
PCA infarct yes transtentorial, also affects CN3
Kernohans notch yes cerebral peduncle of contralateral side
One month history of weakness with T2 hyperintensity in supraspinatus, infraspinatus, teres minor. Normal T1
Impingement of the suprascapular nerve in the spinoglenoid notch
Impingement of the suprascapular nerve in the suprascapular notch
Quadralateral space
Brachial neuritis
Brachial neuritis - yes parsonate turners idiopathic brachial neuritis
One month history of weakness with T2 hyperintensity in supraspinatus, infraspinatus, teres minor. Normal T1
Impingement of the suprascapular nerve in the spinoglenoid notch -no, isolated infraspinatus
Impingement of the suprascapular nerve in the suprascapular notch -no, doesn’t involve teres minor
Quadralateral space -no teres minor only from axillary nerve
Brachial neuritis -yes parsonate turners idiopathic brachial neuritis
Least likely to cause thoracic outlet syndrome?
Levator clavicular muscle Anterior scalene hypertrophy Cervical rib Pectoralis minor tunnel Supracalvicular mass
**LJS - they all can. ?poor recall
Supraclavicular mass could cause neurogenic TOS (most common type) by compressing supraclavicular brachial plexus. Listed in radiopaedia causes. Google search supports all others as causes too. ?Go by least common cause ?levator claviculae
**LW:
Agree with above, that the least likely is levator clavicular muscle.
anterior scalene hypertrophy - TRUE; interscalene triangle
Cervical rib - TRUE
PEc minor tunnel - TRUE; below clavicle containing brachial plexus nerves and vessels.
Supraclavicular mass - TRUE; lymphadenopathy, pancoast tumours, osteochondromas.
(https://link.springer.com/article/10.1007/s40122-019-0124-2)
*AJL - Supraclavicular mass (neurovascular bundle is largely infraclavicluar)
Least likely to cause thoracic outlet syndrome?
Levator clavicular muscle ?yes but super rare, above clavicle
Anterior scalene hypertrophy yes interscalene triangle
Cervical rib yes C7
Pectoralis minor tunnel yes subpectoral space
Supracalvicular mass NO
Varicose veins most correct?
Vein thickening
Enlarged vein with competent valves
Venous ulcers that are slow to heal
Cause significant numbers of PE
Venous ulcers that are slow to heal yes, usually chronic ulcers
Varicose veins most correct?
Vein thickening false thin dilated
Enlarged vein with competent valves false incompentent
Venous ulcers that are slow to heal yes, usually chronic ulcers
Cause significant numbers of PE no usually DVT not superficial
Least correct regarding causes of pulmonary hypertension?
Primary is progressive and results in death
Partial filling defects associated with primary
Primary is more common than secondary
Can be caused by emphysema
Primary is more common than secondary no primary rare
Least correct regarding causes of pulmonary hypertension?
Primary is progressive and results in death yes
Partial filling defects associated with primary yes secondary chronic PE
Primary is more common than secondary no primary rare
Can be caused by emphysema yes
Least true regarding malignant hypertension
1-5% of essential hypertension
Can arise in people with previously normal blood pressure
Fibrinoid necrosis (or sclerosis) of the arteriole walls
Greater than 110mmHg diastolic
**LJS (Robbins):
Defined as SBP > 200, DBP > 120 mmHg - this is least true
Least true regarding malignant hypertension
1-5% of essential hypertension - no
Can arise in people with previously normal blood pressure yes
Fibrinoid necrosis (or sclerosis) of the arteriole walls yes
Greater than 110mmHg diastolic yes
Least true regarding berry aneurysms
90 percent internal carotid
25% present within the first 24 hours with infarct due to vasospasm
Can present as an enlarging mass
2% of post mortems
Least true regarding berry aneurysms
90 percent internal carotid ~maybe. **LJS - branch point in anterior COW most common (90%)
25% present within the first 24 hours with infarct due to vasospasm -no
Can present as an enlarging mass -yes
2% of post mortems -yes