Preseason 4

Question 1

HbH disease

Answer 1

3 mutated genes for alpha thalassemia

Question 2

Remarks on PNH

Answer 2

Flow cytometry: (-) CD55 and CD59 in almost 100% of red cells

Question 3

Iron studies of anemia of chronic inflammation

Answer 3

Low Fe
Low TIBC
High ferritin

Question 4

TTP’s pentad and ddx

Answer 4

Thrombocytopenia
MAHA
Acute renal failure
Fever
Altered mental status

DDX: HUS

Question 5

HUS’ Quartet

Answer 5

Thrombocytopenia
MAHA
Acute renal failure
Bloody diarrhea / dysentery (from EHEC/shigella)

Question 6

Destruction of air spaces mainly involving respiratory bronchioles with sparing of alveoli

Answer 6

Emphysema, centriacinar (pink puffers)

*barrel-chested

Question 7

Lung honeycomb fibrosis

Answer 7

Usual interstitial fibrosis (UIP)

Question 8

Post-CAP-HR

Biopsy: polypoid organizing connective tissue within alveolar spaces

Answer 8

Cryptogenic organizing pneumonia

Characteristic lesion: Masson bodies

Question 9

Carbon-laden macrophages

Answer 9

Simple coal-workers pneumoconiosis (CWP)

Question 10

Dust-laden macrophages

Answer 10

Silicosis

Case may present with TB

Question 11

Pleural plaques

Answer 11

Asbestosis

Case may present with ancestral houses

Question 12

What cells screte IFN-y

Answer 12

TH1 cells

Question 13

If a tb patient has HIV with profoundly depressed CD4, what is expected

Answer 13

Marcophages with acid fast bacilli

Question 14

Lung cancer

IHC: p40, p63 (+)

Answer 14

Squamous cell CA

Question 15

Lung cancer

IHC: TTF-1, napsin A (+)

Answer 15

Invasive non-mucinous adenoCA

Question 16

Lung cancer

IHC: synaptophysin, CD56 (+)

Answer 16

Small cell (Oat cell) carcinoma

Question 17

Lung cancer

IHC: calretinin, CK5,6 (+)

Answer 17

Malignant mesothelioma

Case may present an old ancestral house

Question 18

P16 (+)

Answer 18

HPV-related oropharyngeal SCC

• > 70% of the cellls should show diffuse and strong nuclear staining in order to be called positiv
• *HIV testing is only indicated in oropharyngeal SCC?

Question 19

Soap bubble lesions in a mandibular mass

Answer 19

Ameloblastoma
Biopsy: nests of tumor cells with an outer layer of columnar cells with reverse polarity of nuclei, and an inner layer resembling stellate retinaculum

Question 20

Schneiderian papilloma

Answer 20

Sinonasal papilloma, inverted type
Nasal septum
Biopsy: nests of cytologically benign squamous cellsinvaginating into the stroma of the mass

Question 21

Biopsy findings of cholesteatoma

Answer 21

Stratified cytologically benign squamous cells with keratinous material

Question 22

Remarks on thyroglossal duct cyst

Answer 22

Procedure; sistrunct procedure

Biopsy: unilocular cystic space lined by respiratory epithelium with few islands of thyroid follicles on the cyst wall

Question 23

Mass on the inner side of the upper lip. Dx and biopsy?

Answer 23

Adenoid cystic carcinoma
Biopsy: gland-like structures showing cribriform pattern, lined by small cells with scant cytoplasm and yperchromatic compact nuclei

Question 24

Gastric vs duodenal ulcer

Answer 24

Gastric ulcer
Gastric pH: increased

Duodenal ulcer
Gastric pH: decreased

Question 25

Most common site of h pylori infection in the stomach

Answer 25

Antrum

Question 26

Chromogranin A

Synapthophysin

Answer 26

Neuroendocrine cells

Question 27

Elephant feet glands

Answer 27

Sessile serrated colonic polyp
Case: ascending colon
Biopsy: serrated architecture throughout the entire gland with lateral growth (elephant-feet glands), no dysplasia

Question 28

Serrated architecture limited to the upper third of the gland

Answer 28

Hyperplastic polyp

Case: descending colon

Question 29

Syndromes associated with FAP

Answer 29

GARDNER SYNDROME
Osteomas
Thyroid and desmoid tumors
Skin cysts

TURCOT SYNDROME
Medulloblastoma
Gliobalstoma