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2023 Fall ITE Flashcards

(85 cards)

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1
Q

2 immunostains most useful for diagnosis of CLL/SLL

A

CD5
CD23

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1
Q

Name 1 recurrent chromosomal alteration seen in CLL/SLL

A

del(11q)
del(13q)
del(17p)
trisomy12

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2
Q

Name 2 most common variants of Richter transformation

A

DLBCL
CHL

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3
Q

List 2 molecular biomarkers predictive of poor prognosis in CLL/SLL

A

TP53 mutation
TP53 deletion
del(17p)

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4
Q

Name 3 head and neck sites where SCC should be routinely tested for presence of HPV with p16 immunostain.

A

Adenoids
Vallecula
EBER-negative nasopharyngeal carcinoma
Cervical SCC metastasis of unknown primary

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5
Q

List 3 method to test for the presence of HPV in biopsy material

A

p16 IHC
HPV-DNA ISH
HPV-DNA PCR
HPV-RNA ISH
HPV-RNA PCR

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6
Q

What is the predominant HPV subtype associated with head and neck squamous cell carcinomas?

A

HPV16

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7
Q

In oropharyngeal carcinomas, what is the minimum percentage of cells with cytoplasmic and nuclear reactivity with p16 to classify the tumor as p16-positive?

A

> 70%

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8
Q

List 2 malignancies associated with hereditary diffuse gastric cancer syndrome

A

Diffuse-type gastric cancer
Invasive lobular breast cancer

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9
Q

Pattern of inheritance of HDGC

A

Autosomal dominant

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10
Q

Name gene ad protein implicated in the majority of HDGC cases

A

CDH1, E-cadherin

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11
Q

Outline the T staging criteria for gastric carcinomas

A

T1 - invades lamina propria or muscularis mucosa (1a) or submucosa (1b)
T2 - invades muscular propria
T3 - invades subserosal connective tissue
T4 - invades serosa (4a) or adjacent organs (4b)

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12
Q

3 clinical criteria used for the diagnosis of nephrotic syndrome

A

Proteinuria >3.5 g/d
Hypoalbuminemia <3 g/dl
Edema
Hyperlipidemia
Lipiduria

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13
Q

Three primary renal causes (renal diseases) of nephrotic syndrome

A

Minimal change disease
FSGS
Membranous glomerulopathy
IgA nephropathy
Membrano-proliferative GN

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14
Q

What modality is required for the diagnosis of minimal change diseases

A

Electron microscopy

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15
Q

List 3 subtypes of RPGN

A

Anti-GBM GN
Immune complex-mediated GN
Pauci-immune GN

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16
Q

List 2 most common HFE gene mutations implicated in primary hemochromatosis

A
  1. C282Y
  2. H63D
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17
Q

5 causes of secondary iron overload

A

Blood transfusions
Severe chronic hemolytic anemia
Severe thalasemia
Bone marrow failure
Aplastic anemia
MDS
Bantu siderosis
Alcoholic liver disease
Neonatal hemochromatosis
Porphyria cutanea tarda

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18
Q

List 2 most common liver complications of hemochromatosis

A
  1. Cirrhosis
  2. HCC
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19
Q

2 ancillary tests helpful in establishing diagnosis of primary hemochromatosis

A
  1. iron staining
  2. iron quantification
  3. genetic testing
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20
Q

List 4 histologic criteria for diagnosis of malignant phylloides

A

Marked stromal cellularity
Marked stromal atypia
Stromal overgrowth
>10 mitosis/10 HPF
Infiltrative boarder
Malignant heterologous stromal element

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21
Q

What tumor parameter is used for T staging phyllodes

A

Tumor size

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22
Q

3 clinical features helpful in differentiating phyllodes from fibroadenoma

A

Older age
Large size
Rapid growth
Common recurrence
Imaging findings (round, smooth borders, cystic space on ultrasound)

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23
Q

3 histologic features of complex fibroadenomas

A

Size > 3mm
Sclerosing adenosis
Epithelial calcification
Papillary apocrine metaplasia

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24
List five common organ sites of tobacco associated cancers
NOT BREAST larynx cervix bone marrow liver colon
25
5 non-neoplastic complications of cigarette smoking
Type 2 DM Rheumatoid arthritis Ectopic pregnancy Erectile dysfunction Hip fractures Age-related macular degeneration
26
Major life-threatening complication of e-cigarette smoking
Acute lung injury
27
List 2 additional carcinogens that can act in synergy with tobacco consumption
Alcohol Uranium Asbestos
28
3 histologic features that define WHO grade 2 meningiomas
1. 4-19 mitotic figures in 10 HPF 2. Unequivocal brain invasion 3. Histological subtypes - choroid or clear cell 4. At least 3 of: - Increased cellularity - Small cell with high N:C - Prominent nucleoli - Sheeting
29
4 histologic subtypes of meningioma
Psammomatous Anaplastic Clear cell Rhabdoid Atypical
30
1 prognostic immunostain that can be used for meningiomas
Progesterone
31
2 common tumor metastases that can be found in meninges
Lobular breast carcinoma Lung adenocarcinoma Melanoma
32
List 3 histologic features of hypertrophic cardiomyopathy
Myocyte hypertrophy Myofiber disarray Interstitial fibrosis
33
List 3 gross features of hypertrophic cardiomyopathy
Hypertrophy Bulging ventricular septum Thickening of anterior mitral leaflet
34
Name 1 protein that can be affected in hypertrophic cardiomyopathy
Myosin-binding protein C Beta-myosin heavy chain
35
2 clinical complications of hypertrophic cardiomyopathy
Sudden cardiac death Cardiac arrhythmia Atrial fibrillation
36
Define quality assurance in pathology
System/program that ensures the final result reported is as correct and accurate as possible and standard is met
37
Define quality control in pathology
Tools included in every test to help detect and correct defects in the system and control the quality of the service being output
38
Define proficiency testing
Process of evaluating the results of unknown specimens to a standard test
39
Name 2 indications for p16 IHC testing in cervical biopsies
Differentiate between reactive mimics (e.g. squamous metaplasia) and HSIL Professional disagreement High risk of missing HSIL (previous high-risk cytology) Differential between CIN1 and CIN2
40
3 criteria defining block-positivity in p16 immunostain
Strong nuclear +- cytoplasm Vertically from basal layers upward at least 1/3 of epithelium Extension laterally over significant distance
41
2 immunostains that can distinguish between endocervical adenocarcinoma, usual type, from endometrioid carcinoma, and pattern of expression (+/-) in endocervical adenocarcinoma
ER (negative) p16 (positive)
42
3 HPV-independent subtypes of endocervical adenocarcinoma
Mesonephric Endometrioid Gastric Clear cell
43
3 gross findings in Alzheimer disease
Generalized cortical atrophy Ventricular enlargement Atrophy of the structures of the medial temporal lobe Loss of pigment in the locus ceruleus
44
2 histologic hallmarks of Alzheimer disease
Neurofibrillary tangles Amyloid plaques
45
Form of amyloid implicated in Alzheimer disease? Associated precursor protein?
Beta-amyloid protein Amyloid precursor protein
46
1 gene associated with familial Alzheimer disease and 1 chromosomal disorder associated with familial AD
Trisomy 21 PSEN1 PSEN2
47
Region of long bones constitutes the most common predilection site for Ewing sarcoma
Diaphyseal-metaphyseal portion
48
Classic plain radiograph finding in Ewing sarcoma
Onion-skin appearance
49
Name the most common translocation seen in Ewing sarcoma and the resulting fusion transcript.
EWSR:FLI1 t(11;22)
50
2 specific immunostains that can be used in the diagnosis of Ewing sarcoma
FLI1 NKX2.2
51
2 most commonly used quality assurance indicators for intraoperative consultations
Turnaround time Frozen-permanent discordance rate
52
5 categories of intraoperative consultation-permanent section correlation results as recommended by the Association of Directors of Anatomic and Surgical Pathology (ADASP)
Agreement Deferral - appropriate Deferral - inappropriate Disagreement - minor Disagreement - major
53
Acceptable rate of major intraoperative consultation-permanent section disagreement?
<3%
54
2 most common causes of intraoperative consultation-permanent section discordance
Technical issues Sampling errors Interpretive errors Incomplete/incorrect clinical history
55
2 commonly used scoring systems for assessing PDL-1 IHC and corresponding formula
TPS Tumor proportion score = # PDL1 positive tumor cells/total # of viable tumor cells x 100 CPS Combined positive score = # of PDL1 positive tumor cells and tumor associated immune cells/total # viable tumor cells x 100
56
For each of 2 PDL-1 scoring systems, list 1 organ system where specific scoring system is used
TPS - NSCLC CPS - ENT (head and neck SCC), GU (urothelial), GI (gastric and esophageal ca), Gyne (cervical ca)
57
2 normal tissues that can be used as controls for PDL-1 IHC
Tonsil Placenta
58
Minimum number of cases that would be required for validation of a new PDL-1 antibody within a laboratory?
40 cases
59
Minimum number of cases that would be required for validation of a Class I and Class II antibodies?
Class I - 20 Class II - 40
60
2 acceptable methods for collecting samples for urine cytology
Voided urine Post-instrumentation Catheter Ileal conduit
61
2 principal indications for the use of cytology in disorders of the lower urinary tract
1. Diagnosis of urothelial cancer 2. Follow-up of patients treated for urothelial cancer
62
3 entities in the differential diagnosis of atypical squamous cells in voided urine cytology
Degenerated balloon cells SCC bladder Ureteral contaminant Gyne tract contaminant TCC with squamous differentiation
63
3 entities in the differential diagnosis for the finding of signet ring cells on voided urine cytology
Primary adenocarcinoma of bladder Metastatic adenocarcinoma Histiocytes Degenerated urothelial cells
64
3 risk factors for the development of clear cell RCC
Smoking Obesity Hypertension Long-term dialysis Diabetes mellitus VHL syndrome
65
List the recurrent chromosomal abnormality found in CCRCC and the affected gene
Chromosome 3 loss VHL
66
5 tumors in the differential of eosinophilic variant of CCRCC
Oncocytoma Chromophobe RCC Eosinophilic vacuolated tumor LOT Epithelioid angiomyolipoma Tubulocystic carcinoma
67
5 molecularly defined renal carcinomas
TFE3-rearrange TFEB-altered FH-deficient SDH-deficient ELOC-mutated ALK-rearranged SMARCB1-deficient
68
4 histologic subtypes of endometrial cacinomas
1. Endometrioid 2. Serous 3. Clear cell 4. Mixed 5. Carcinosarcoma 6. Undifferentiated and dedifferentiated
69
4 molecular subtypes of endometrial carcinomas
1. Copy number high 2. Copy number low 3. POLE ultramutated 4. Microsatellite instability hypermutated
70
Precursor lesion of endometrioid endometrial carcinoma
EIN
71
5 factors for endometrioid endometrial carcinomas
1. Endometriosis 2. Lynch 3. Unopposed estrogen 4. Cowden syndrome 5. Smoking 6. Estrogen replacement therapy
72
2 benign/preinvasive mesothelial tumors
Adenomatoid tumor Well-differentiated papillary mesothelial tumor of the pleura Mesothelioma in situ
73
2 malignant mesothelial tumors according to the WHO Classification of Tumors
Localized pleural mesothelioma Diffuse pleural mesothelioma
74
2 immunostains useful in distinguishing a reactive mesothelial proliferation from a mesothelioma
BAP1 MTAP
75
4 IHCs helpful in differentiating mesothelioma vs adenocarcinoma
Mesothelioma BAP1 WT1 D2-40 Calretinin Adenocarcinoma Claudin4 MOC31 BEREP4
76
5 malignancies in the differential diagnosis of epithelioid mesothelioma
Lung adenocarcinoma Lung SCC EHE Intrapleural thymoma Melanoma Lymphoma Monophasic synovial sarcoma
77
5 histologic subtypes of gastritis
Acute Chronic Lymphocytic Collagenous Eosinophilic Granulomatous
78
2 virulence factors employed by H pylori to infect gastric mucosa
Flagella Urease Adhesins Toxins (CagA)
79
Contrast H pylori gastritis to AIG with respect to 1. most common site in stomach 2. intramucosal distribution 3. acid production 4. antibodies detected in serology
1. Antrum for HP, body for AIG 2. Superficial mucosa - HP; Lower for AIG 3. Increase of slightly decreased in HP; decreased in AIG 4. Anti-H. pylori; Anti parietal cell ab in AIG
80
2 neoplastic complications of H pylori gastritis
1. gastric adenocarcinoma 2. mucosal associated lymphoid tumor (MALT)
81
Mode of inheritance of Peutz-Jeghers syndrome?
Autosomal dominant
82
Characteristic molecular defect in Peutz-Jeghers (PJS)?
Germline mutation/loss of heterozygosity (LOH) in serine-threonine kinase STK11/LKB1, chromosome 19p13.3
83
2 other hamartomatous polyposis syndromes of the gut aside from Peutz-Jegher's?
Juvenile polyposis Juvenile polyposis/hereditary hemorrhagic telangiectasia (HHT) syndrome Cronkhite-Canada syndrome Cowden syndrome
84
Excluding the GI tract, list 4 specific body sites at highest risk for the development of carcinoma in patients with Peutz-Jeghers
Breast Pancreas Ovary Lung Uterine cervix Endometrium Testis

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