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Pathology and final year > USMLE questions > Flashcards

USMLE questions Flashcards

1
Q

how is glioblastoma characterised on CT

A

serpentine border and central areas of necrosis

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2
Q

Densely packed cells with halos of cytoplasm surrounding large
round nuclei are characteristic of

A

oligodendrogliomas

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3
Q

Sharply demarcated areas of tumor cells located at the grey-white
matter junction are characteristic of

A

secondary metastatic lesions from a primary tumor elsewhere
in the body, most commonly the breast, lung, thyroid, skin, kidney, and gastrointestinal tract.

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4
Q

CT head: A whorled pattern of concentrically arranged spindle cells with calcified psammoma bodies is characteristic of

A

meningiomas

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5
Q

conditions with psammoma bodies on histology

A

papillary thyroid cancer
serous cystadenoma of ovary
meningioma
mesiothilioma

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6
Q

difinitive test to diagnose parkinsons

A

alpha- synuclein immunostaining

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7
Q

describe huntingtons disease

A

autosomal dominant
anticipation of CAG repeat
atrophy of the caudate nucleus
chorea and dementia are key features

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8
Q

kidney findings and risks in turners

A

horseshoe kidney
pelvic kidney
duplicated collecting systems

increased risk of wilms tumour compared to general population

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9
Q

biggest risk factor for transitional cell carcinoma and squamous cell carcinoma of the kindey respectively

A

TCC –> smoking
SCC –> schistosomiasis infection

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10
Q

macrophages engulfing RBCs on blood film is characteristic of what

A

haemophagocytic lymphoschistocytosis

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11
Q

complication of septic shock in kidney and describe it

A

diffuse cortical necrosis

combination of hypoperfusion, microangiopathic thrombosis, and infarction; thromboses may be present in the arterioles, capillaries, and glomeruli. The areas of necrosis are generally confi ned to the cortex and, on gross examination, are sharply demarcated

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12
Q

extracolonic cancer risks of lynch syndrome

A

endometrial, ovarian, urinary tract, stomach

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13
Q

which chromosomes is the mutation found in the following conditions

adult PCKD
recessive PCKD
von hippen lindau syndrome
tuberous sclerosis

A

adult PCKD - chrom 16
recessive PCKD - chrom 6
von hippen lindau syndrome- chrom 3
tuberous sclerosis- chrom 9

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14
Q

clinical and lab findings in DMD

A

X linked recessive
Symptoms become evident by the age of 5 years and include delayed walking, clumsiness, weakness in the pelvic girdle muscles, and enlargement of the calf muscles

elevated CK
mutation on Xp21 gene encoding dystrophin

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15
Q

what is deficient in phenylketonuria and what are the features?

A

phenylalanine hydroxylase
catalyses the conversion of phenylanaline to tyrosine

characterized by problems with brain development, mental retardation, and seizures.

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16
Q

what does absence of spectrin lead to

A

hereditary sperocytosis

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17
Q

what sort of virus is EBV

A

DNA virus
member of the human herpes virus family (HHV4)

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18
Q

‘owl eyes’
round intranuclear inclusion with perinuclear halo seen in cells affected by

A

CMV

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19
Q

effects of CMV on immunocompromised

A

retinitis
pneumonitis
inflammation of GI tract
polyradiculopathy
transverse myelitis
focal encephalopathy

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20
Q

complications of MI

A

rupture of the ventricular free wall –> tamponade 4-10days (sudden shock with signs of cardiac tamponade, such as the hypotension, distant heart sounds, and elevated jugular venous pressure )

aneurysm due to lack of contractility i infarcted area

arrhythmias - first few days after

fibrinous pericarditis 3-5 days
(chest pain that is relieved when the patient leans forward; often a pericardial friction rub can be auscultated on cardiac examination)

dresslers syndrome- weeks after

papillary muscle rupture 4-10 dys after (acute mitral regurgitation, causing the abrupt onset of heart failure in the setting of a new systolic murmur)

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21
Q

how to differentiate between staphaureus colonisation and staphylococcal colonisation of microflora

A

coagulase test

staph aureus - coagulase positive

staph epidermidis - coagulase negative

22
Q

which infection is associated with honey

A

clostridium botulinum

23
Q

example of a species with a non immunogenic capsule

A

strep pyogenes with a hyaluronic capsule

24
Q

what bacterial species is an unusual obligate intracellular pathogen due to its inability to synthesise ATP

A

chlamydia

25
Q

triad of
cutaneous hemorrhages (“blueberry muffin baby”), deafness, and periventricular CNS calcifications suggestive of…

A

congenital CMV infection

26
Q

what organism can cause potentially fatal granulomas (granulomatis infantiseptica) following in utero infection.

A

listeria monocytogens

27
Q

most common site for aspiration pneumonia

A

apical segment of the lower lobe (typically right)

28
Q

where is the porphyrin ring of haem derived from? (start of haem synthesis)

A

succinyl-CoA and glycine
catalysed by aminolevolinic acid (ALA) synthase to produce ALA

29
Q

accumulation of chylomicron reminants is characteristic of which fmilial cholesterol disorder

A

familial type III hyperlipidaemia (familial dysbetalipoproteinaemia)

30
Q

features of vitamin A deficiency

A

drying of the bulbar conjunctiva (xerosis) and blind spots (small, grey plaques on the conjunctiva)

31
Q

features of vitamin E deficiency

A

areflexia, decreased proprioception and vibration sence, gait disturbances and paresis of gaze

32
Q

what deficiency makes you more susceptable to anaphylactic blood transfusion reaction

A

selective IgA deficiency

33
Q

features classically associated with wiskott aldrich syndrome

A

recurrent infections, eczema and thrombocytopenia

34
Q

which cell surface marker is required for lysis of IgG coated cells by NK cells

A

CD16

35
Q

common causative organism of pneumonia in alcoholics and describe the microbiological features

A

klebsiella pneumonia
gram negative rod

36
Q

which strep species are alpha and beta haemolytic

A

alpha haemolytic - strep viridans, strep pneumoniae

beta haemolytic- strep pyogenes (GAS) , strep agalactiae (GBS)

37
Q

which cocci are catalase neg and which are catalase positive

A

streptococcus- catalase negative
staph- catalase posititve

38
Q

which organisms are coagulase positive and which are negative

A

positive- staph aureus, yersiniapestis

negative- strep pyogenes, staph epidermidis

39
Q

which interleukin has a direct effect on the hypothalamus to induse fever

A

IL-1 produced by macrophages

40
Q

gram positive rod found in the upper respiratory tract and skin

A

diptheria

41
Q

what antibiotic taken by mother causes teeth motteling to baby in utero

A

tetracyclines

42
Q

classic findings on clinical examination in ASD
(atrial septal defect)

A

prominent right ventricular cardiac impulse
systolic ejection murmur heard loudest in pulmonary area, left sternal border
fixed splitting of second heart sound

43
Q

sunburst appearance on xray and codmans triangle is characteristic of what

A

osteosarcoma

44
Q

is bicarbonate usually high or low in hyperaldosteronism and what is the mechanism

A

high

aldosterone stimulates excretion of H+ in distal tubule creating a metabolic alkalosis (high HCO3)

????? needs clarification

45
Q

what is Bernard-Soulier syndrome?

A

autosomal recessive condition of faulty platelet adhesion
prolonged bleeding time in the presence of a normal plt count

dysfunction of gp Ib-IX complex

46
Q

previously fit and well person in 20s develops painful muscle cramps after strenuous exercise. urine turns red

classic clinical picture of what glycogen storage disease

A

McArdle syndrome

red urine casued by myoglobinurea

47
Q

what does a,b and g haemolytic mean

A

refers to how much haemolysis of RBC occur in response to the bacteria

alpha haemolytic- partial haemolysis
beta haemolytic- complete haemolysis
gamma- no haemolysis

48
Q

what are the mutated genes in MEN 1 and MEN2a/b

A

MEN 1- MEN1 gene
MEN2a/b - RET gene

49
Q

If query CAH

Pt has hypertension, hypokalaemia and low sex hormones (ambiguous genitalia, delayed pruberty)

what enzyme deficiency are you thinking

A

17alpha hydroxylase def

50
Q

If query CAH

pt has hypotension/ salt losing crisis and ambiguous genitalia in girls)

what enzyme def are you thinking?

A

21- hydroxylase def

Pathology and final year (21 decks)

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