patomorph-cycles-2024
patomorph-cycles-2024
patomorph-cycles-2024
-Myocardial infarction
-Myocarditits
-Myocardial degeneration (cardiomyopathy)
-Systemic Hypertension
-Atherosclerosis
-Coaraction of the aorta
-Mitral valve stenosis
-Mitral and Aortic valve diseases —> Rheumatic fever, Bacteria (Endocarditis), LUES
-Hydrothorax
-Peripheral edema of lower limbs
-Anasarca
-Bronchitis —> catarrhal
-Ascites
-Cyanosis
-Gastritis —> catarrhal
-Enteritis —> catarrhal
-Hydropericardium
-Visceral congestion
-Congestion in liver (hepatomegaly), spleen (splenomegaly), kidneys, brain
4) Red infarct
-In tissues that were previously congested because of sluggish venous outflow
-In tissues with dual circulations (lung and small intestine)
-With venous occlusions (ovarian torsion)
-When flow is reestablished after infarction has occurred (after angioplasty of an arterial
obstruction)
- In loose tissues where blood can collect in infarcted zones (lung)
-Lungs, Testis, Ovary, small intestine, liver
White infarcts:
-Spleen
-Heart
-Kidney
-In solid organs, where the solidity of the tissue limits the amount of hemorrhage that can
deep into the area of ischemic necrosis from adjoining capillaries bed
-With arterial thrombosis —> arterial occlusions
-Solid organs with end-arterial circulations
-Where tissue density limits the seepage of blood from adjoining patent vascular beds
5) Gohn Complex
a. Miliary TB - (lungs,liver, spleen, meninges, etc.)
b. Organ isolated TB
c. secondary TB
d. staining is ziehl Nelson suggesting mycobacterium tuberculosis
6) Amyloidosis
a. intracellular deposition of Congo red
b. intracellular deposition of fibrillar protein
c. Extracellular deposition of fibrillar protein
7) Hamartoma of lung
- is a mass of disorganized tissue indigenous to particular site
- mass of mature: disorganized hepatic cells, blood vessels or nodule in lung
containing islands of cartilage, bronchi and blood vessels
- acquired translocation, suggesting neoplastic origin
- benign
- Refers to an excessive but focal overgrowth of cells and tissues native to the organ in
which it occurs
8) Duret Hemorrhage:
a. pons - midline and paramedian regions of the midbrain and pons
b. Parietal lobe
c. Frontal lobe
d. Cerebellum
e. Occipital lobe
M0 - No distant metastases
M1 - Distant metastases present
- Typical results from release of activated pancreatic lipases into the substance of the
pancreas and the peritoneal cavity
- Characterized by chalky white areas on gross examination released —> fatty acids
combine with calcium to produce grossly visible chalky white areas (fat
saponification)
- Characterized by foci of necrosis that contain shadowy outlines of necrotic fat cells
with basophilic calcium deposits, surrounded by an inflammatory reaction
- Occurs in acute pancreatitis
- Alcohol (60-70%)
- Viral hepatitis → HBV 5.10% , HVC >50%, HDV
- Biliary disease
- Primary hemochromatosis
- Wilson disease
- alpha1-antitrypsin deficiency
29) Fainting lady – woke with inability to speak and move right arm – CT scan show
cyst in parietal lobe – what is it?
a. Liquefactive necrosis
b. Gangrene
c. Coagulative necrosis
d. Amyloidosis
31) What caused: subcutaneous nodule, fibrinoid necrosis, fibroblast and histiocyte
in extensor part of forearm:
a. SLE
b. Rheumatoid arthritis
c. Tuberculosis
d. Syphilis
e. Leprosy
32) Metaplasia is a change in which:
A. Glandular epithelium is replaced by squamous epithelium
B. Immature cell type is replaced by adult cell type
C. One immature cell type is replaced by another immature cell type
D. Adult cell type is replaced by immature cell type
E. One adult cell type is replaced by another adult cell type
- Metaplasia is a reversible change in which one adult cell type (epithelial or
mesenchymal) is replaced by another adult cell type.
Chronic left sided heart failure - hemosiderin + macrophages= heart failure cells in brown
induration of lung
-Cardiac arrhythmias
-Left ventricular aneurysm
-Mural thrombosis
-Papillary muscle rupture/dysfunction
-Cardiac rupture
-Anterior free wall myocardial rupture
-Ventricular septal rupture
-Fibrinous Pericarditis
-Cardiogenic shock
-Pulmonary edema
-Mitral valve insufficiency
-Cardiac tamponade
- Hypotension
-Contractile dysfunction, Right ventricular infarction, Myocardial rupture, Chamber dilation,
Ventricular aneurysm, Progressive late heart failure → Ischemic cardiomyopathy,
Progressive heart failure secondary to ischemic myocardial damage, When compensatory
mechanisms fail t.ex hypertrophy
Cycle 2
a. Hepatocytes
b. Sertoli cells
c. Normal prostatic epithelium 20%- 40%of prostatic cancer found in men with “normal”
PSA levels
d. Neoplastic prostatic epithelium Serum PSA level used as the upper limit of normal: 4.0
ng/l
e. Testicular germ cell
Malignant Melanoma cells reveal positive staining for presence of
a) LCA (leukocyte common antigen)
b) S-100
c) HMB-45
d) cytokeratin (negative)
e) vimentin
a. Malignant
b. Associated with EBV
c. Extra-adrenal + bilateral, not hypertension
d. Familial (25%) (congenital)
8. Which of the clinical variants of malignant melanoma begins with the vertical
growth phase without an obvious radial growth phase?
A. lower-grade ER-positive
B. HER2 negative
C. higher-grade ER-positive
D. HER2 positive
E. ER-negative
10. Endometriosis:
a. Is defined by the presence of endometrial glands and stroma in a location outside the
endometrium
b. Occurs in as many as 10% of women in their reproductive years and in nearly half of
women with infertility
c. Frequently is multifocal
d. Often involves pelvic structures (ovaries, pouch of Douglas, uterine ligaments, tubes
and rectovaginal septum)
e. Never produce infertility (can produce discomfort and eventual sterility)
f. Sex cord stromal tumor
1. Seminoma (40-50)
2. Yolk sac tumor (90% of patients have elevated AFP)
3. Teratoma (all ages)
4. Leydig cell tumor (all ages)
5. Embryonal carcinoma (20-30)
65 y/o women with 1 cm fixed mass in left upper outer quadrant breast. Which is most
likely present
A 50-year-old woman sees her physician because she has noticed a bloody
discharge from the left nipple. Upon physical examination, there are no palpable
masses in the breast and no skin lesions in this area. Which of the following is the
most likely cause of this discharge:
5-year-old girl with sexual characteristics like pubic hair, breasts. Which cell
component is common for this type of ovarian tumour
A. 46 XX (complete)
B. 46 XY (complete)
C. 69 XXY
D. 47 XXY
19. Histologic examination revealed cords and islands of malignant cells with hyper
chromatic nuclei, and peripheral tumour cell nuclei palisading, embedded in a fibrotic
or mutinous stroll matrix. The most likely diagnosis is:
20. PAP
a. Cytological examination of tissue from the vaginal portion and the canal of cervix
- screening tool for detection of cervical dysplasia & carcinoma
21.Which of the following are true regarding BRCA1 and BRCA2 genes?
1. lack of pleomorphism
2. increased number of mitotic figures
3. prominent nucleoli
4. melanin in the cytoplasm (both have)
24. Which of following are risk factors for the development of CIN and invasive
cervical carcinoma:
a. Early age at first intercourse
b. Persistent infection by HPV type 16 - high-risk HPV types 16, 18, 31, 33
c. Multiple sexual partners
d. Smoking
e. Oral contraceptive
f. Nulliparity - multiparity
g. Family history
h. HSV-2, HIV - STD
i. 40-45 y - peak incidence at age 45
j. Ovulatory
A. HHV 8 infection
B. Fair skin
C. UV light exposure
D. Exposure to carcinogenic chemicals
E. Chronic skin inflammation and scarring
A. HIV.
B. HPV 6.
C. HPV 11.
D. HPV 16.
E. HPV 18.
A. Neck
B. Leg - Plantaris and verruca Palmaris occur on the soles and palms, respectively
C. Trunk
D. Hand (many warts on hands)
E. Face - Or dorsal surfaces of the hand → Plana
A. Necrosis
B. Capsular invasion
C. KI-67 index (breast cancer)
D. Vascular invasion
E. Cellular atypia
33. BPH
Bladder diverticulum
Hydroureter
Pyelonephritis
Cystitis
34. Proliferative breast disease without atypia includes:
A. epithelial hyperplasia
B. sclerosing adenosis complex
C. sclerosing lesion
D. papilloma
E. fibrosis - Fibroadenoma should be correct
c) are composed of large, uniform cells with distinct cell borders, clear cytoplasm, and
round nuclei with conspicuous nucleoli arrayed in small lobules with intervening fibrous
septa
A. Is self-limited disease
B. May be caused by viral infection
C. Is most common between 30-50 years of age
D. Is more common in women
E. Is characterised by acute onset with neck pain, fever and thyroid enlargement
37. Skin lesions Warning signs
39. Which of the following sentences are true regarding HER2 in breast carcinomas:
A. HER2 is a receptor tyrosine kinase
B. HER2 promotes cell proliferation
C. HER2 promotes apoptosis by stimulating the RAS- and PI3K-AKT signaling
pathways - inhibits apoptosis
D. Cancers that overexpress HER2 are highly proliferative
E. Cancers that overexpress HER2 can be treated by inhibitors of HER2
40. Which of the following sentences are true regarding breast carcinomas:
a. DCIS
b. B. LCIS
c. Invasive ductal
d. Invasive tubular
e. Invasive lobular - carcinoma, cells invade stroma individually
Cycle 3
7. Viral myocarditis
A. Edema
B. Interstitial inflammatory infiltrates (mononuclear cells)
C. Myocyte injury
D. Diffuse lymphocytic infiltrate - is most common
8. What features are seen in Crohn disease that are not seen in ulcerative colitis:
A. Skip lesion
B. Noncaseating granulomas
C. Only mucosal involvement - transmural
D. Continuous colonic involvement - Ulcerative Colitis
9. Classic PAN
12. Pictures → Sacrococcygeal teratoma: Derived from all 3 germ cell layers:
Ectoderm, Endoderm, Mesoderm
15. Which of the following forms of Kaposi sarcoma characteristically occurs in older
men of Eastern European or Mediterranean descent, presents with multiple red to
purple skin plaques, usually in distal lower extremities and is not associated with HIV
infection eastern, Eastern Europe
A. Pheochromocytoma
B. Schwannoma
C. Paraganglioma - aka extra adrenal Pheochromocytoma
D. ParaGanglioblastoma
HCC
hemangioma
Focular nodal hyperplasia
Hepatic Angiosarcoma
Juvenile hemangioma
- Strawberry hemangioma
- Of newborn skin, extremely common (1 in 200 births)
- Can be multiple
- Grow rapidly for few months but fade by age of 1 to 3 years (complete regression by
age 7)
Secretes sodium
Reabsorbs potassium
Esophageal varices
Barret esophagus
PDGFRA - 8%
Neural epithelium
Podocytes
Nephrogenic rests
In which parts of the lungs are coal macules and coal nodules present?
Cycle 4
Which of the following bone tumors is most commonly associated with the presence
of t(11;22) translocation:
A. Chondrosarcoma
B. Giant cell tumor of tendon sheath
C. Ewing sarcoma
D. Metastatic neuroblastoma
E. Osteosarcoma
+
1. Posterior fossa
2. Meninges
3. Ventricles
4. Spinal cord
5. Cerebral hemispheres - Adult CNS tumors (supratentorial)
●
●
A. Hepatosplenomegaly
B. Generalized lymphadenopathy
C. Anemia
D. Hypergammaglobulinemia - Hypo
E. Thrombocytopenia
●
A. Cough
B. Weight loss
C. Difficulty swallowing
D. Persistent hoarseness - more than 3 weeks
E. Sore throat
+
All the following factors increase the risk of laryngeal carcinoma EXCEPT:
A. Lupus nephritis
B. Membranous nephropathy
C. Focal segmental glomerulosclerosis (FSGS) - Adults
D. Diabetic nephropathy
E. Minimal change disease
+ Causes but not MAJOR
Membranous nephropathy
Diabetic nephropathy
Amyloidosis
Systemic lupus erythematous
The microscopic changes of chronic pyelonephritis include all the following EXCEPT:
A. Lymph nodes
B. Lungs - Distant (hematogeneous)
C. Bones
D. Brain
E. Liver
Which of the following is the most common site of IgA deposition in IgA nephropathy:
A. Bowman's capsule
B. Mesangium - of the glomeruli, electron-dense deposits in there
C. Along glomerular basement membrane
D. Wall of the medium sized blood vessels
E. Along tubular basement membrane
A. Smoking
B. Pregnancy
C. Urinary catheterisation
D. Diabetes
E. Immunosuppressive therapy
A. Grade 5
B. Grade 1
C. Grade 2
D. Grade 3
E. Grade 4
A. Paraganglioma
B. Warthin tumor - Cleft-like, papillary
C. Pleomorphic adenoma - Rounded, well- demarcated masses, encapsulated in some
locations (particularly the palate) gray-white and typically contains myxoid and blue
translucent chondroid (cartilage-like) areas
D. Adenoid cystic carcinoma
E. Mucoepidermoid carcinoma - Circumscribed, lack well-defined capsules and often
are infiltrative, pale gray to white small, mucinous cysts, these tumors contain cords,
sheets, or cysts lined by squamous, mucous, or intermediate cells.
Chronic lymphocytic leukemia and small lymphocytic lymphoma differ primarily in the
extent of which involvement:
A. Spleen
B. Liver
C. Peripheral blood - CLL: Significant peripheral blood involvement, SLL: minimal or no
circulating malignant lymphocytes in the peripheral blood
D. Bone marrow
E. Lymph nodes
Giant cell tumor of tendon sheath is composed of all the following EXCEPT:
- Arise from the metaphysis near the growth plate of long tubular bone
A. Meningioma
B. Astrocytoma, IDH-mutant
C. Oligodendroglioma, IDH-mutant
D. Medulloblastoma
E. Glioblastoma, IDH-wild-type
The light microscopic appearance of the intracranial tumor is shown in figure. All the
following are true EXCEPT: → Meningioma
A 30-year-old woman presents with nephrotic syndrome. Renal biopsy shows diffuse
capillary wall thickening and subepithelial “spike” formation. What is the most likely
diagnosis:
1. IgA nephropathy
2. Focal segmental glomerulosclerosis
3. Minimal change disease
4. Membranoproliferative glomerulonephritis
5. Membranous nephropathy
Which laryngeal tumors are likely to metastasize early due to rich lymphatic supply:
A. 40-50 years
B. Over 80 years
C. 20-30 years
D. 30-40 years
E. 50-80 years
Which HPV types are most commonly associated with laryngeal papillomatosis in
children:
1. Types 1 and 2
2. Types 16 and 18
3. Types 45 and 58
4. Types 6 and 11
5. Types 31 and 33
Which of the following is a major risk factor for squamous cell carcinoma of the
bladder in certain regions:
A. Radiation therapy
B. Chronic bladder irritation and schistosomiasis infection - in areas where it is endemic
C. Asbestos exposure
D. Genetic predisposition
E. Smoking
Figure shows the immunohistochemical staining with the antibody against IgG. What
is the most likely diagnosis:
A. Membranous nephropathy -
B. IgA nephropathy
C. Chronic pyelonephritis
D. Crescentic glomerulonephritis
E. Minimal change disease
A. CD5+, CD20+
B. CD45+, CD117+
C. CD15+, CD30+ + PAX5 (+) & posterior cervical, axillary, and groin region
D. CD19+, CD5+
E. CD15+, LCA+
●
A 60-year-old man presents with rapidly progressive renal failure. Renal biopsy shows
crescentic glomerulonephritis. Immunofluorescence (or immunohistochemistry)
reveals no immune complex deposition. What is the most likely diagnosis:
A. Pauci-immune glomerulonephritis
B. Minimal change disease
C. Focal segmental glomerulosclerosis
D. IgA nephropathy
E. Membranoproliferative glomerulonephritis
On histologic examination, the affected joints in rheumatoid arthritis show all the
following EXCEPT:
Dense inflammatory cell infiltrates (may form lymphoid follicles) in the synovium
What is the most common type of M protein found in multiple myeloma patients:
A. IgE
B. IgD
C. IgA
D. IgG -Monoclonal protein
E. IgM
A. Endosteum
B. Diaphysis
C. Epiphysis
D. Metaphysis
E. Periosteum