Section B (Targeted, examples) Practice exam questions Flashcards
List the key histological differences between in-situ and invasive ductal carcinoma of the breast.
Containment by basement membrane in DCIS.
Architectural and cytological features.
Role of immunohistochemistry.
Clinical significance for treatment decisions.
Describe three common causes of benign lymphadenopathy and how they may be distinguished histologically.
Reactive hyperplasia vs. granulomatous lymphadenitis vs. dermatopathic lymphadenopathy.
Key cellular and architectural clues.
Associated clinical settings.
Diagnostic approach.
What are the key histological and molecular features of high-grade serous carcinoma of the ovary?
p53 mutation and WT1 positivity.
Tubal origin and STIC lesion.
Morphological appearance.
Relevance for targeted therapy (e.g., PARP inhibitors).
Explain the rationale for performing perinatal post-mortem and the information it can provide to families.
Determination of cause of death.
Identification of congenital anomalies or infections.
Role in genetic counselling.
Contribution to audit and quality control.
Outline how clinical genomic testing can assist in diagnosing rare cancers or cancer predisposition syndromes.
Use of panel or whole genome sequencing.
Example: detection of BRCA1/2 or TP53 mutations.
Application to undifferentiated tumours.
Implications for family screening and management.
What are the histopathological features and clinical consequences of membranous glomerulopathy?
Thickened glomerular basement membrane on light microscopy.
Subepithelial immune complex deposits visible on EM.
Common cause of nephrotic syndrome (proteinuria, oedema).
May be idiopathic or secondary (e.g., lupus, cancer, infection).
Describe how genomic testing aids in the diagnosis and management of soft tissue sarcomas.
Identifies characteristic gene fusions (e.g., EWSR1-FLI1 in Ewing sarcoma).
Confirms diagnosis in morphologically ambiguous cases.
May guide targeted therapy (e.g., imatinib in PDGFRA-mutant tumours).
Supports prognostic stratification and surveillance planning.
How can the presence of BRAF mutations influence the treatment plan for a patient with malignant melanoma?
BRAF V600E mutation found in ~50% of melanomas.
Enables use of BRAF inhibitors (e.g., vemurafenib) ± MEK inhibitors.
Molecular testing essential for treatment planning.
Helps avoid immunotherapy in select cases where targeted agents are superior.
Explain the common histological and molecular features of hepatocellular carcinoma (HCC), and how these guide clinical management.
Histology: trabecular growth, bile production, pseudoacinar structures.
Common mutations: TERT promoter, TP53, CTNNB1.
Imaging + AFP levels aid diagnosis; biopsy when unclear.
Molecular features influence trial eligibility and targeted treatment.
What are the major steps in conducting a perinatal post-mortem and what information can it provide for parents and clinicians?
External examination, imaging, internal organ dissection.
Sampling for histology, microbiology, cytogenetics.
Helps determine cause of death or detect malformations/genetic syndromes.
Aids in counselling about recurrence risks and planning future pregnancies.
