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past papers > Pathology 2017-2019 > Flashcards

Pathology 2017-2019 Flashcards

1
Q

HIV man with pneumonia severe dyspnoea and dry cough on exertion (but no FLAWS that indicated TB) and ground glass on imaging.

A

Pneumocystis Pneumonia

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2
Q

Woman with renal transplant and a CXR showing halo sign

A

→ Aspergillus

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3
Q

A man with persistent heartburn has an Endoscopy done, which shows a mass in the oesophagus (at a depth of) 35cm down. Which cancer develops in Barrett’s oesophagus?

A

Adenocarcinoma

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4
Q

Antibodies:

Patient with Sjogren’s (dry mucous membranes)

A

–> anti ro & anti la
Anti-ro more specific

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5
Q

Antibodies:
SLE with recurrent clotting

A

–> anticardiolipin

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6
Q

Publican with diabetes, fatty stools, weight loss, ‘slate grey skin’ and joint pains. What is the underlying diagnosis causing this?

A

Haemochromatosis

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7
Q

MEFV Mutation, what is it?

A

Familial Mediterranean Fever

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8
Q

NOD2/CARD15, what is it found in?

A

Crohn’s disease

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9
Q

Immunodeficiency with common gamma chain problem

A

X-linked SCID

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10
Q

Swollen joint, needle-shaped aspirate with negative birefringence, what is the enzyme responsible

A

xanthine oxidase

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11
Q

Gout - acute treatment

A

Colchine

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12
Q

Gout - non acute treatment

A

Allopurinol

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13
Q

Bacteria causing scarlet fever?

A

Streptococcus pyogenes

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14
Q

Child (was a 15 yo) with brain tumour extends outwards from cerebellum and invading subarachnoid space. Signs of ataxia? What is the most likely type.

A

Astrocytoma

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15
Q

Sacroiliitis, HLA B27 positive

A

Ankylosying spondylitis

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16
Q

HIV +ve patient with v low CD4 + vascular lesions seen on trunk. What virus causes this cancer?

A

HHV8

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17
Q

What enzyme to confirm cardiac failure?

A

BNP

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18
Q

What liver enzyme is raised in MI

A

Aspartate aminotransferase (AST)

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19
Q

Rhabdomyolysis what enzyme will be high?

A

ALP

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20
Q

Lady with Multiple myeloma and restrictive cardiomyopathy. What will you see on heart biopsy

A

Amyloid deposition

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21
Q

Previous IVDU man is given Rituximab - CHOP treatment for Non-Hodgkin’s lymphoma. He later 8 months later develops fulminant liver failure and dies. Why?

A

→ Hep B virus reactivation

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22
Q

Which type of cell does Rituximab target?

A

Mature B cells (CD20)

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23
Q

Cancer with keratin and intercellular bridges

A

squamous cell carcinoma

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24
Q

What type of cancer is gastric

A

adenocarcinoma

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25
Q

cANCA positive man with glomerulonephritis and lung changes, what does he have?

A

Granluomatosis with polyoangiitis

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26
Q

Treatment for CLL with p53 mutation. What is the first-line treatment?

A

Ibrutinib

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27
Q

Athlete’s foot

A

Trichophyton rubrum

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28
Q

What is the usual prophylaxis for allograft rejection

A

Mycophenolate mofetil/azathioprine, pred, tacrolimus (calcineurin inhibitor)

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29
Q

Treatment with Rheumatoid arthritis? Something TNFa? It gave names and mechanisms

Adalimumab TNFalpha

Basiliximab - Anti CD25

Denosumab - anti-RANKL

Secukinumab

A

Adalimumab TNFalpha

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30
Q

HIV - what natural antibody against, which confers protective immunity against HIV? Or something similar
HIV - GAG
HIV - gp120
CXCR4
Protease
Reverse transcriptase

A

HIV - gp120
or CCR5

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31
Q

Which type of embolus is common in cholesterol cleft?

A

Atheromatous

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32
Q

Patient with coeliac. What would you see on biopsy?

A

Intraepithelial Lymphocytes

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33
Q

Acquired MAHA. What do you see?
Dat +ve spherocytes
Dat +ve fragments
Dat -ve spherocytes
Dat -ve fragments
Dat +ve smear cells

A

Dat -ve fragments

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34
Q

HTLV1 Virus lymphoma

A

Adult t cell lymphoma/leukaemia

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35
Q

How does a melanoma spread?

A

Lymphoid

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36
Q

22 year old student with two weeks anorexia, fever and malaise – raised ALT, normal/super mildly raised ALP + GGT

A

Viral hepatitis

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37
Q

Women with colicky abdominal pain.
Elevated mildly elevated ALP, ALT, GGT, & Bilirubin.
GGT + Bilirubin most raised of results provided.

A

Acute cholecystitis

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38
Q

Used for mild CAP (Community acquired pneumonia) caused by Hib (Haemophilus influenza type B)

A

→ amoxicillin

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39
Q

Which/What antibiotic would you use to treat/prescribe someone who has cellulitis with a Methicillin SENSITIVE strain of Staphylococcus aureus?

A

Flucloxacillin

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40
Q

Which/What cancer is associated with (? the presence of?) E cadherins?

A

Invasive ductal

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41
Q

Fibro-epithelial tumour with abundant stromal elements.

A

Phyllodes

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42
Q

What enzyme if low, leads to hyperuricemia/rise in blood uric acid?

A

HGPRT

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43
Q

What enzyme regulates the rate limiting step in haem biosynthesis pathway/of the blood?

A

ALA Synthase

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44
Q

Which/What enzyme is raised in mumps?

A

Amylase S

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45
Q

Woman with dry eyes and parotid swelling?

A

Sjogren syndrome → anti-ro

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46
Q

A 12-year-old boy has recurrent chest infections, and has an ear infection. He doesn’t have any B Cells.

A

Bruton’s

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47
Q

A Girl is found to have no CD4 cells, but CD8 cells and B cells are present.

A

Bare lymphocyte syndrome

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48
Q

A boy’s father has TB. The same boy develops a mycobacterium infection, following their BCG

A

IFN gamma receptor deficiency

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49
Q

In a 19 year old asthmatic. What drug do you use to treat influenza A?

A

Oseltamivir

50
Q

Graft(?-verus host?) disease pathophysiology
- CD4 + activated and assists CD8+ & B cells
- HLA
- Pre-existing antibodies in the recipient
- mast cell degranulation
- ischaemia of the donated organ

A

CD4 + activated and assists CD8+ & B cells

51
Q

HIV RNA forms HIV, via which error-prone enzyme?

A

Reverse transcriptase

52
Q

Person is discharged after surgery, who had a bilateral hemianopia, with removal of pituitary adenoma. Consultant says it is alright to discharge them. What do you prescribe the patient on discharge?

A

DDAVP –> or hydrocortisone if it is an option

53
Q

Which of these is a common finding in someone who has portal hypertension?

A

Splenomegaly

54
Q

What is the most specific marker for Rheumatoid arthritis:

A

Anti-cyclic citrullinated protein

55
Q

The wall of vessels expresses anti-thrombotic factors why is this?

A

Because it secrete Thrombomodulin

56
Q

Cushing disease person – Which is the best investigation to confirm the suspected diagnosis?

A

High dose dexamethasone suppression test

57
Q

What does the number of True positives divided by the total number who have the disease describe?

A

Sensitivity

58
Q

Child/Infant – nephrotic syndrome – (What is the most likely diagnosis)?

A

Minimal change disease

59
Q

50 year old man with Midshaft femur fracture – what would you find at the site of the break/fracture (or rather, which/what type of cancer does he have)?

A

Chondrosarcoma

60
Q

Middle aged lady. Liver biopsy, loss of bile ducts and granulomas present. Which/what disease is consistent with these findings?

A

Primary biliary cholangitis

61
Q

What would be raised in obstructive jaundice due to gallstones?

A

ALP

62
Q

What would be raised in obstructive jaundice due to pancreatic adenocarcinoma?

A

ALP

63
Q

What is a sign that your patient has been taking cocaine?

A

Raised AST

64
Q

Post strep GN - what do you see in the kidneys?

A

– immune complex deposition

65
Q

Malignant HTN, what is the classic finding on renal histology

A

fibrinoid necrosis

66
Q

Multiple myeloma - what would you see in kidneys?

A

amyloid deposition

67
Q

Pityriasis versicolor

A

Malassezia furfur

68
Q

Man in his 60s with poorly controlled diabetes pr\esents with rapidly progressing periorbital swelling, sinus pain, confusion and sinusitis

A

apparently Rhizopus spp. causing mucormycosis

69
Q

Resistant Psoriasis treatment

A

Etanercept (TNF antagonist)

70
Q

Chronic granulomatous disease treatment

A

IFN gamma

71
Q

Osteoporosis treatmenet

A

Denosumab

72
Q

What immune cell detects MHC1 and kills virus infected/cancer cells. Is inhibited by MHC I

A

NK cells

73
Q

What is done to blood donations to reduce GvHD?

A

– Irradiated blood components (leukapheresis)

74
Q

Most common cause of acute pancreatitis?

A

Gallstones

75
Q

Increased calcitonin. Type of cancer?

A

Medullary thyroid cancer

76
Q

MEN2 medullary thyroid adenoma. What hormone would you measure?

A

– calcitonin

77
Q

IPEX affects what type of immune cell?

A
  • T reg
78
Q

low TSH, raised T3/4 following a viral infection

A

– De Quervain’s thyroiditis

79
Q

Most common type of primary thyroid cancer to metastasise to lymph node?

A

Papillary

80
Q

Patient is on low molecular weight heparin, what do you measure to monitor this?

A

anti-Xa

81
Q

16 year old girl has pleuritic chest pain, joint pain, positive ANA and Anti-Sm, no liver enzyme derangement, raised ESR?

A
  • SLE
82
Q

What virus increases risk of nasopharyngeal cancer

A

– EBV

83
Q

Chimeric antigen receptor T-cell therapy against CD19: what type of haematological malignancy does it target?

A

ALL

84
Q

45yo woman with autoimmune diseases, low IgM, IgA and IgE; full blood count is normal?

A

– common variable immune deficiency

85
Q

Young guy has a fall and hits his head, presents two days later and then loses consciousness, where is the bleeding coming from?

A

Cortical vein

86
Q

Ovarian mass in Japanese woman: signet ring cells

A

Krukenburg tumour

87
Q

What is called when you have discontinuation of epithelium

A

Ulcer

88
Q

Which immunoglobulin is found in mucosa

A

IgA

89
Q

Histopathological change that occurs to liver in patients with diabetes?

A

hepatic steatosis

90
Q

Nivolumab is a PD1 inhibitor, what cells does it target?

A
  • T reg cells
91
Q

PCSK9 inhibitor - evolucumab, what does it halve?

A

LDL

92
Q

Which molecule takes cholesterol and moves it to liver and steroidogenesis organs?

A

HDL

93
Q

Which disease do you see in both MEN1 and MEN2a?

A

primary hyperparathyroidism,

94
Q

What type of section is done for urgent diagnosis during surgery?

A

frozen section

95
Q

Tetralogy of Fallot type of shunt

A

Right to left

96
Q

Insulinoma. What would you find? Low cortisol, low FFAs, low pro-insulin, low glucagon, low c-peptide

A

low pro-insulin

97
Q

Bortezomib is a proteasome inhibitor, how does this work?

A

First line for treating multiple myeloma. Accumulation of misfolded protein -> induction of cell death

98
Q

What Type Hypersensitivity causes serum sickness?

A

Type 3

99
Q

Low sodium (124) and specific gravity of 1.000 cause?

A

psychogenic polydipsia

100
Q

Neonate (2 day old) has meningitis and blood cultures isolate gram negative rods, what is the organism?

A

E coli

101
Q

What vaccine preventable organism causes cough, lymph node enlargement and has a potential to occlude the airway?

A

Diptheria

102
Q

What is the effect of the gene mutation in familial mediterranean fever?

A

– reduce pyrin marenostrin -> lack of -ve feedback for neutrophil

103
Q

Man with history of PKD has a cerebral bleed - what type? Subarachnoid (berry aneurysm?)

A

Subarachnoid (berry aneurysm?)

104
Q

What cell type is raised in the blood in schistosomiasis?

A

Eosinophils (because it’s protozoan infection)

105
Q

What is the specific auto-antigen that is the target of the immune system in Goodpastures syndrome?

A

Type IV Collagen

106
Q

Which of these is particularly associated with longstanding bronchiectasis?

A. E-Coli
B. Pseudomonas Aeruginosa
C. Staph aureus
D. Strep pneumoniae
E. Strep pyogenes

A

B. Pseudomonas Aeruginosa

107
Q

Which of these is most likely to CAUSE bronchiectasis?

A. E-coli
B. Pseudomonas Aeruginosa
C. Staph aureus
D. Strep pneumoniae
E. Strep pyogenes

A

C. Staph aureus CORRECT ANSWER

108
Q

Which of these is associated with hyperkalaemia?

A. Addison’s disease
B. Conn’s syndrome
C. Ectopic ACTH
D. Prostate cancer
E. Renal artery stenosis

A

A. Addison’s disease CORRECT ANSWER

109
Q

Antibodies to phospholipase A2 receptor are associated with what form of glomerulonephritis?

A. Crescentic
B. Goodpastures disease
C. Membranous
D. Minimal change
E. Rapidly progressive

A

C. Membranous CORRECT ANSWER

110
Q

Which of the options acts to stimulate 1alpha hydroxylase activity in the kidney to increase the production of vitamin D3.

A. Calcitonin
B. Calcitriol
C. Cholecalciferol
D. Ergocalciferol
E. Parathyroid Hormone

A

E. Parathyroid Hormone

111
Q

Name the form of vitamin D produced following the action of 1alpha hydroxylase on 25-OH D3 in the kidney.

A. Calcitonin
B. Calcitriol
C. Cholecalciferol
D. Ergocalciferol
E. Vitamin D3

A

. Calcitriol CORRECT ANSWER

112
Q

Name the peptide hormone responsible for increasing plasma calcium in response to reduced calcium levels by stimulating osteoclast activity.

A. Calcitonin
B. Calcitriol
C. Cholecalciferol
D. Ergocalciferol
E. Parathyroid Hormone

A

E. Parathyroid Hormone

113
Q

When stained with a Rhodanine stain a liver biopsy reveals a golden brown colour against the blue counterstain. What is the most likely diagnosis?

A

Wilsons Disease

114
Q

A liver biopsy histology is reported as showing “Caseating granulomata”. What is the most likely diagnosis?

A

Tuberculosis

115
Q

A liver biopsy histology is reported as showing “NON Caseating granulomata”. What is the most likely diagnosis?

A

Sarcoidosis

116
Q

A liver biopsy histology is reported as showing “A “nutmeg” appearance”. What is the most likely diagnosis?

A

Hepatic congestion secondary to right heart failure

117
Q

A 70 year old known teetotal patient is noted to have a heart murmur and careful examination reveals splenomegaly with an obvious notch and you can’t get above it. There are no visible veins on the anterior abdominal wall, and there is no ascites, so you conclude that there is no portal hypertension. Dipstick of the urine reveals microscopic haematuria. She is found to have a temperature of between 37.5oC and 38.5oC whenever it is checked.

What is the diagnosis?

A

Endocarditis

118
Q

What is the technical term for a connection between two epithelial surfaces, as occurs in Crohns disease where for example there might be a connection between the bladder and the bowel?

A

Fistula

119
Q

A 32-year old woman is thought to have Graves’ disease. What antibody should you look for?

A

anti TSH receptor antibodies

120
Q

. A patient presents with weakness and is found to have a potassium of 2.4mM (NR 3.5 to 5.0). What is the likely acid-base abnormality if you check the patients arterial blood gas?

A

Metabolic alkalosis

121
Q

Name the drug used for patients with type 2 diabetes which inhibits the enzyme alpha glucosidase in the brush border membrane of the small bowel.

A

Acarbose

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