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MRCS-Pathology > QNA 2 > Flashcards

QNA 2 Flashcards

1
Q

Hypothalamo-pituitary-adrenal axis for corticosteroids

A

CRH -> ACTH -> cortisol

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2
Q

Hypothalamus hormones

A

GnRH
GHRH
CRH
TRH
PRH

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3
Q

Anterior pituitary hormones

A

FSH/LH
TSH
Prolactin
ACTH
GH

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4
Q

Posterior pituitary hormones

A

ADH
Oxytocin

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5
Q

How does adenosian crisis affect glucose levels

A

too little cortisol
Hypoglycaemia (insulin sensitivity)

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6
Q

Where to check for melanoma

A

Back of legs and back
Soles of hand and feet
Nailbeds

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7
Q

How to identify what phenotype of cancer cells

A

immunohystochemistry/immunocystochemistry

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8
Q

How does immunohistochemistry work

A

adding various antibodies and visualising antibody-antigen formation

Visualisation either by an enzyme like peroxidase attached to antibody changing colour of the solution or immunofluorescence where antibody tagged by fluorecine

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9
Q

How does immunohistochemistry work

A

adding various antibodies and visualising antibody-antigen formation

Visualisation either by an enzyme like peroxidase attached to antibody changing colour of the solution or immunofluorescence where antibody tagged by fluorecine

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10
Q

Differential for foreing traveller with lymph node in neck

A

Lymphoma (hodgkin vs non hodgkin)

TB

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11
Q

What to do if suspected TB

A

Put in a category 3 biohazard bag

Inform public health england

Contact tracing

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12
Q

Adult polycystic kidney disease genetics

A

Autosomal dominant
PKD1 and PKD2 mutations

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13
Q

APKD cyst formation pathophysiology

A

Tubular cells relentlessy divide, lead to formation of outpouching that slowly cuts itself off the main tubule, but keeps filling with the secretions of other tubules

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14
Q

Complications of APKD

A

Renal failure
Infection
HTN
Associated with cerebral aneurysm

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15
Q

How does CLO test work

A

Based on H pylori producing urease urea- >ammonia

Biopsy placed in urea medium

Add an indicator eg phenol red

If H pylori present, produces ammonia, increasing pH changing colour to red

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16
Q

Causes of PUD

A

H pylori
Smoking
High calcium (hyperparathyroid)

17
Q

How to investigate parathyroid issues

A

PTH assay

Sestamibi scan (giving radionucleotide sestamibi and image with gamma camera to identify hyperfunctioning parathyroid adenoma)

18
Q

Commonest histology of gallbladder carcinoma

A

Adenocarcinoma

19
Q

Commonest cause of gallbladder cancer

A

Chronic inflammation from cholecystitis

20
Q

Where does gallbladder cancer spread to first

A

Segment V of liver

Lymphatic spread to cystic and pericholedochal lymph nodes

20
Q

Where does gallbladder cancer spread to first

A

Segment V of liver

Lymphatic spread to cystic and pericholedochal lymph nodes

21
Q

Patient treated for nec fascitis. Develops bloody diarrhoea. What’s the cause

A

Pseudomembranous colitis
Ischaemic colitis
Infective enterocolitis
Stress ulcer

22
Q

Pathophysiology of Pseudomembranes caused by c diff

A

Exudative fibrin deposition as bacteria secrete proteases to damage the bowel mucosa

23
Q

Antibiotic treatment for abscess drainage

A

Recent evidence has shown that antibiotics reduce the risk of recurrence by 5% at 1 month and 8% at 3 months

23
Q

Antibiotic treatment for abscess drainage

A

Recent evidence has shown that antibiotics reduce the risk of recurrence by 5% at 1 month and 8% at 3 months

24
Q

What is sickle cell disease

A

Hereditary haemoglobinopathy
Mutation in B globin leading to HbS formation

Forms abnormally shaped RBC, less flexible, more likely to be broken down

25
Q

Surgical complications of sickle cell

A

Gallstones
Autosplenectomy -> immunosuppression
AVN of bone

26
Q

Most common brain tumour

A

High grade:
Glioblastomas

Low grade:
Meningioma

Metastatic disease

27
Q

Common bacteria causing skin infection

A

Staph aureus
Group A strep (pyogenes)

28
Q

Pheochromocytoma testing

A

Urine: Vanillyl mandelic acid (metabolite of catecholamines)

Plama: catecholamines and metanephrine

29
Q

What malignancy occurs in immunosupressed patients

A

SCC, BCC
Lymphoma
Kaposi sarcoma

30
Q

How do neutrophils migrate towards site of infection

A

Marginisation and rolling along the vessel wall
Transfer between endothelial cells
Migrate towards chemostatic stimulus

31
Q

How does endometriosis migrate to colon?

A

3 theories

Regurgitation: retrograde flow of menstrual endometrium

Vascular/lymphatic

Metaplastic: arises directly from coelomic epithelium of pelvis

32
Q

Which thyroid cancer will not show response to iodine uptake (not picked up by dionuclide scan)

A

Parafollicular C cells (medullary carcinoma)

Dont pick of up iodine

32
Q

Which thyroid cancer will not show response to iodine uptake (not picked up by dionuclide scan)

A

Parafollicular C cells (medullary carcinoma)

Dont pick of up iodine

33
Q

Classification of lung cancer

A

Small cell
Non small cell (adeno, SCC, large cell)

34
Q

Which lung cancer in smoker/nonsmoker

A

Smoker: squamous (male)
Non smoker: adeno (female)

MRCS-Pathology (11 decks)

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