random

Question 1

morphologic changes in MI

Answer 1

• <1 day: no gross of microscopic changes –> risk of cardiogenic shock, CHF, arrhythmia
• 1 day: coagulative necrosis (dark discoloration grossly) –> risk of arrthymia
• 1 week: inflammation/debris clean up by PMNS then macros (yellow pallor grossly) –> risk of fibrinous pericarditiis; rupture of free ventricular wall, inventricular septum or pap mm
• 1 month: granulation tissue lays down scaffold for scar with fibroblasts, collagen and BVs
• >1 month: white scar (fibrosis) –> risk of ventricular aneurysm, mural thrombus in anuerysm, CHF (fibrotic tissue contracts poorly), Dressler syndrome (fibrinous pericarditis)

Question 2

Lung cancers

1. Small cell carcinoma
2. Squamous cell carcinoma
3. adenocarcinoma
4. large cell carcinoma
5. bronchioloalveolar carcinoma
6. carcinoid
7. mets to lung

Answer 2

1. SmCC: small poorly differentiated cells that stain with neuroendocrine markers, high mitotic activity, cytoplasm not visible; smokers; central location; paraneoplastic syndromes– SIADH, Cushing (ACTH), Eaton-Lambert
2. SqCC: keratin pearls or intercellular bridges; smokers; central; high Ca (via PTHrP)
3. Aden: glands/mucin; associated with lung scarring (ie: hx of pneumonia); peripheral –> pleural puckering
4. LCC: poorly differentiated large cells with cytoplasm easily visible;smoking
5. BA: lepidic growth; non-smokers; peripheral
6. car: chromogranin (+); polyp-like mass in bronchus
7. mets: cannon-ball nodules

Question 3

carcinogenic agents

1. aflatoxins
2. alkylating agents (chemo)
3. alcohol
4. arsenic
5. asbestos

Answer 3

1. afla – hepatocellular carcinoma (from aspergillus)
2. leukemia/lymphoma
3. SCC of oropharynx + upper esoph, hepatocellular carcinoma
4. SCC of skin, lung cancer, angiosarcoma of liver (cigs)
5. lung cancer > mesothelioma

Question 4

carcinogenic agents

1. cigs
2. nitrosamines
3. naphthylamine
4. vinyl chloride
5. nickel, chromium, beryllium, silica

Answer 4

1. carcinoma of oropharynx, esophagus, lung, kidney, bladder, pancreas (polycylicl hydrocarbons)
2. stomach carcinoma (smoked foods – Japan)
3. urothelial carcinoma of bladder (cigs)
4. angiosarcoma of liver (occupational exposure)
5. lung carcinoma (occupational exposure)

Question 5

1. ERBB2 (HER2/neu)
2. RET

Answer 5

1. Epidermal growth factor receptor: amplification –> breast cancer – tx with Trastuzumab (Herceptin)
2. neural growth factor receptor: pt mutation –> MEN2A, MEN2B, sporadic carcinoma of thyroid

Question 6

1. KIT
2. RAS gene family
3. ABL

Answer 6

1. stem cell growth factor receptor: pt mutation –> GIST
2. GTP-binding protein: pt mutation –> carcinomas, melanoma, lymphoma
3. Tyrosine kinase: t(9;22) with BCR –> CML (tx with Imatinib/Gleevec)

Question 7

1. c-MYC
2. N-MYC
3. L-MYC

Answer 7

1. TF: t(8;14) involving IgH –> Burkitt lymphoma
2. TF: amplification –> neuroblastoma
3. TF: amplification —> Lung carcinoma (small cell)

Question 8

IFs

1. Keratin
2. Vimentin
3. Desmin
4. GFAP
5. neurofilament

Answer 8

1. epithelium (carcinoma)
2. mesenchyme (sarcoma)
3. muscle
4. neuroglia (ie: astrocytoma)
5. neurons

Question 9

immunohistochemical markers

1. chromogranin
2. S-100

Answer 9

1. neuroendocrine cells (small cell carcinoma of lung + carcinoid tumors)
2. Melanoma, Schwannoma, Langerhans cell histiocytosis

Question 10

HSV infection of brain

Answer 10

• encephalitis, not meningitis
• hemorrhagic lesions of temporal lobe

Question 11

1. anti-centromere Abs
2. anti-ds DNA
3. anti-Sm

Answer 11

1. Scleroderma (CREST variant)
2. SLE
3. SLE

Question 12

1. anti-ribonucleoprotein
2. anti-DNA topoisomerase I
3. anti-Sm

Answer 12

1. Sjogren
2. Scleroderma
3. Scleroderma