March 2017 Flashcards

1
Q
  1. Which is not consistent with Wegeners
    a. Upper respiratory tract granulomas
    b. Lower respiratory tract granulomas
    c. Renal artery vasculitis
    d. Pulmonary artery vasculitis
    e. Glomerulonephritis
A
  1. Which is not consistent with Wegeners
    a. Upper respiratory tract granulomas yes
    b. Lower respiratory tract granulomas yes
    c. Renal artery vasculitis no
    d. Pulmonary artery vasculitis yes
    e. Glomerulonephritis yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  1. Two questions on Churg strauss
    a. Associated pANCA
    eGPA asthma, eosinophilia
A
  1. Two questions on Churg strauss
    a. Associated pANCA yes
    eGPA asthma, eosinophilia

*LW:
Allergic granulomatosis and angiitis = churn strauss syndrome
- Allergic rhinitis, asthma, peripheral eosinophilia, pANCA
- Lung, heart, spleen, peripheral nerves, skin.
- Coronary arteritis, and myocarditis.
- Infrequent renal disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. Which doesn’t cause bowel ischaemia
    a. PAN
    b. Behchets
    c. Atherosclerosis
A
  1. Which doesn’t cause bowel ischaemia
    a. PAN yes
    b. Behchets yes, possible but less likely out of these 3
    c. Atherosclerosis yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. Most likely cause of acute bowel ischaemia
    a. SMA atherosclerosis
    b. SMV thrombosis
    c. Aortic dissection
    d. SMA embolus
A
  1. Most likely cause of acute bowel ischaemia
    a. SMA atherosclerosis common
    b. SMV thrombosis yes
    c. Aortic dissection yes HTN and dissect into SMA
    d. SMA embolus AF most likely
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. Aortic dissection
    a. 5-10% don’t have an intimal tear IMH
    b. Dissection between media and the intima
    c. Most common to have tear at junction of arch and proximal descending aorta
A
  1. Aortic dissection
    a. 5-10% don’t have an intimal tear IMH 10%
    b. Dissection between media and the intima ?maybe not dissection usually outer third of media and can rupture into adventitia (robbins)
    c. Most common to have tear at junction of arch and proximal descending aorta yes aortic ischmus

*LW:
StatDx states Stanford A (I.e. ascending aorta and arch +/- descending) most common at 60%. so C likely less correct.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  1. What is least associated with BRCA
    a. Pancreas
    b. Prostate
    c. CRC
    d. Ovarian
A
  1. What is least associated with BRCA
    a. Pancreas yes
    b. Prostate yes
    c. CRC yes no
    d. Ovarian yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  1. Most likely to cause colon cancer
    a. PJ
    b. UC
A
  1. Most likely to cause colon cancer
    a. PJ less likely but is associated with colon and breast
    b. UC yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. Least likely to cause gastric cancer
    a. Fundic gland polyp
    b. Hyperplastic polyp
    c. Adenomatous polyp
    d. Partial gastrectomy
    e. H pylori
A
  1. Least likely to cause gastric cancer
    a. Fundic gland polyp no
    b. Hyperplastic polyp can
    c. Adenomatous polyp yes
    d. Partial gastrectomy yes
    e. H pylori yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  1. With regard to celiac disease (least likely)
    a. Severely affects the distal small bowel
    b. Increase in number of small bowel folds
    c. Villous atrophy
    d. Autoimmune reaction to ingested to gliadin
    e. Increased risk of MALToma
A

a. Severely affects the distal small bowel no

  1. With regard to celiac disease (least likely)
    a. Severely affects the distal small bowel no
    b. Increase in number of small bowel folds yes distally
    c. Villous atrophy yes
    d. Autoimmune reaction to ingested to gliadin yes
    e. Increased risk of MALToma no MALToma with Hpylori, T lymphoma with celiac disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  1. Most common location of small bowel adenocarcinoma
    a. Duodenum
    b. Proximal jejunum
    c. Distal jejunum
    d. Proximal ileum
    e. Distal ileum lymphoma,
A

a. Duodenum periampullary tumor

  1. Most common location of small bowel adenocarcinoma
    a. Duodenum periampullary tumor
    b. Proximal jejunum GIST
    c. Distal jejunum
    d. Proximal ileum
    e. Distal ileum lymphoma, TB, Yersinia, carcinoid from enterochromaffin cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. Young patient with bicornuate uterus and one kidney
    a. Mesonephric duct
    b. Mullerian duct mullarian anomalies
    c. Wolffian duct
    d. Genital ridge
A

b. Mullerian duct mullarian anomalies

  1. Young patient with bicornuate uterus and one kidney
    a. Mesonephric duct
    b. Mullerian duct mullarian anomalies
    c. Wolffian duct
    d. Genital ridge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. Newborn with dilated colon and unilateral sacral agenesis
    a. Hirschsprungs
    b. Anal atresia
    c. Ileal atresia
    d. Meconium plug
A

b. Anal atresia VACTERL or curarino ASP triad anorectal malformation, sacral osseus defect, presacral mass

  1. Newborn with dilated colon and unilateral sacral agenesis
    a. Hirschsprungs not sacrum
    b. Anal atresia VACTERL or curarino ASP triad anorectal malformation, sacral osseus defect, presacral mass
    c. Ileal atresia no
    d. Meconium plug no
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. Which is associated with CF?

a. Hypertrophic pyloric stenosis

A

*LW:
Stat Dx states there is increased incidence of Pyloric stenosis with CF

  1. Which is associated with CF?
    a. Hypertrophic pyloric stenosis articles say maybe, but I would say no
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. Which is most suggestive of UC
    a. Pseudopolyps
    b. Uveitis
    c. Fistulas
    d. Sacroiliitis
A

a. Pseudopolyps yes

  1. Which is most suggestive of UC
    a. Pseudopolyps yes
    b. Uveitis IBD
    c. Fistulas no
    d. Sacroiliitis IBD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. Most consistent with reactive arthritis
    a. Symmetrical sacroiliitis
    b. Shoulder arthropathy
    c. Commonly follows GI infection
A

c. Commonly follows GI infection yes arthritis follow GI or chlamydia is most consistent

  1. Most consistent with reactive arthritis
    a. Symmetrical sacroiliitis no asymmetrics
    b. Shoulder arthropathy non specific
    c. Commonly follows GI infection yes arthritis follow GI or chlamydia is most consistent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. Hydroxyapetite deposition disease associated with
    a. Dermatomyositis
    b. Sjogrens
    C. Scleroderma
    d. Dialysis
A

d. Dialysis yes amyloid b2 microglobulin, CPPD and HADD, osteodystrophy

  1. Hydroxyapetite deposition disease associated with
    a. Dermatomyositis no calcinosis universalis
    b. Sjogrens no
    c. Scleroderma no calcinosis circumscripta
    d. Dialysis yes amyloid b2 microglobulin, CPPD and HADD, osteodystrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  1. Least liekly to have changes in CJD
    a. Dentate nuclei
    b. Caudate
    c. Putamin
    d. Thalami
A

a. Dentate nuclei no

  1. Least liekly to have changes in CJD
    a. Dentate nuclei no
    b. Caudate yes BG
    c. Putamin yes BG
    d. Thalami yes hockey stick
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
  1. Least likely CADASIL manifestation?
    a. External capsule ischaemia
    b. Basal ganglia ischaemia
    c. Anterior temporal white matter change
    d. Periventricular white matter changes
    e. Skin changes
A

e. Skin changes no

  1. Least likely CADASIL manifestation?
    a. External capsule ischaemia yes classic location
    b. Basal ganglia ischaemia yes
    c. Anterior temporal white matter change yes classic location
    d. Periventricular white matter changes yes leukoencephalopathy
    e. Skin changes no
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
  1. Most true regarding HSV?
    a. HSV1
    b. HSV2
    c. Causes haemorrhagic necrosis
    d. Lateral temporal lobe changes
A

c. Causes haemorrhagic necrosis yes

  1. Most true regarding HSV?
    a. HSV1 Most common cause of neonatal encephalitis no HSV2 birth canal
    b. HSV2 most common cause of adult encephalitis no HSV1
    c. Causes haemorrhagic necrosis yes
    d. Lateral temporal lobe changes mesial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
  1. What is the least likely consequence of herniation
    a. DAI
    b. Duret haemorrhage y
    c. ACA infarct
    d. PCA infarct
    e. Kernohans notch
A

a. DAI false, it is associated but not a consequence

  1. What is the least likely consequence of herniation
    a. DAI false, it is associated but not a consequence
    b. Duret haemorrhage yes stretching pontine perforators
    c. ACA infarct yes subfalcine
    d. PCA infarct yes transtentorial, also affects CN3
    e. Kernohans notch yes cerebral peduncle of contralateral side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
  1. One month history of weakness with T2 hyperintensity in supraspinatus, infraspinatus, teres minor. Normal T1
    a. Impingement of the suprascapular nerve in the spinoglenoid notch
    b. Impingement of the suprascapular nerve in the suprascapular notch
    c. Quadralateral space
    d. Brachial neuritis
A

d. Brachial neuritis yes parsonate turners idiopathic brachial neuritis

  1. One month history of weakness with T2 hyperintensity in supraspinatus, infraspinatus, teres minor. Normal T1
    a. Impingement of the suprascapular nerve in the spinoglenoid notch no, isolated infraspinatus
    b. Impingement of the suprascapular nerve in the suprascapular notch no, doesn’t involve teres minor
    c. Quadralateral space no teres minor only from axillary nerve
    d. Brachial neuritis yes parsonate turners idiopathic brachial neuritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
  1. Least likely to cause thoracic outlet syndrome
    a. Levator clavicular muscle
    b. Anterior scalene hypertrophy
    c. Cervical rib
    d. Pectoralis minor tunnel
    e. Supracalvicular mass
A

a. Levator clavicular muscle ?yes but super rare, above clavicle

  1. Least likely to cause thoracic outlet syndrome
    a. Levator clavicular muscle ?yes but super rare, above clavicle
    b. Anterior scalene hypertrophy yes interscalene triangle
    c. Cervical rib yes C7
    d. Pectoralis minor tunnel yes subpectoral space
    e. Supracalvicular mass yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q
  1. Varicose veins most correct?
    a. Vein thickening
    b. Enlarged vein with competent valves
    c. Venous ulcers that are slow to heal
    d. Cause significant numbers of PE
A

c. Venous ulcers that are slow to heal yes, usually chronic ulcers

  1. Varicose veins most correct?
    a. Vein thickening false thin dilated
    b. Enlarged vein with competent valves false incompentent
    c. Venous ulcers that are slow to heal yes, usually chronic ulcers
    d. Cause significant numbers of PE no usually DVT not superficial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q
  1. Least correct regarding causes of pulmonary hypertension?
    a. Primary is progressive and results in death
    b. Partial filling defects associated with primary
    c. Primary is more common than secondary
    d. Can be caused by emphysema
A

c. Primary is more common than secondary no primary rare

  1. Least correct regarding causes of pulmonary hypertension?
    a. Primary is progressive and results in death yes
    b. Partial filling defects associated with primary yes secondary chronic PE
    c. Primary is more common than secondary no primary rare
    d. Can be caused by emphysema yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q
  1. Least true regarding malignant hypertension
    a. 1-5% of essential hypertension
    b. Can arise in people with previously normal blood pressure
    c. Fibrinoid necrosis (or sclerosis) of the arteriole walls
    d. Greater than 110mmHg diastolic
A
  • LW:
    25. Least true regarding malignant hypertension
    a. 1-5% of essential hypertension: Robbins states about 5% - so probably true

b. Can arise in people with previously normal blood pressure yes
c. Fibrinoid necrosis (or sclerosis) of the arteriole walls yes
d. Greater than 110mmHg diastolic: greater than 120mmHg diastolic - so this is least likely.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q
  1. Least true regarding berry aneurysms
    a. 90 percent internal carotid
    b. 25% present within the first 24 hours with infarct due to vasospasm
    c. Can present as an enlarging mass
    d. 2% of post mortems
A

b. 25% present within the first 24 hours with infarct due to vasospasm no

  1. Least true regarding berry aneurysms
    a. 90 percent internal carotid ~maybe
    b. 25% present within the first 24 hours with infarct due to vasospasm no
    c. Can present as an enlarging mass yes
    d. 2% of post mortems yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q
  1. Least correct regarding ADEM?
    a. 20-30 percent mortality 10-20
    b. Post viral or vaccination
    c. Perivenular
    d. Causes demyelination and axonal degeneration
A

a. 20-30 percent mortality 10-20 too high
*Robbins states upto 20%
D. Robbins states causes demyelination but doesnt mention axonal degeneration.

  1. Least correct regarding ADEM?
    a. 20-30 percent mortality 10-20 too high
    b. Post viral or vaccination yes
    c. Perivenular yes
    d. Causes demyelination and axonal degeneration yes
28
Q
  1. With regard to pleural solitary fibrous tumour
    a. Associated with asbestos
    b. Hypocalcaemia
    c. Cant remember the correct answer
A
  1. With regard to pleural solitary fibrous tumour
    a. Associated with asbestos no
    b. Hypocalcaemia no hypoglycaemia
    c. Cant remember the correct answer
29
Q
  1. Neuroendocrine lung tumour most likely to cause hypercalcaemia
    a. DIPNET
    b. Typical carcinoid
    c. Small cell lung cancer yes
A

c. Small cell lung cancer yes

  1. Neuroendocrine lung tumour most likely to cause hypercalcaemia
    a. DIPNET
    b. Typical carcinoid
    c. Small cell lung cancer yes
30
Q
  1. Most likely associated with hypocalcaemia
    a. Primary hyperparathyrodism
    b. Secondary hyperparathyroidism
    c. Tertiary hyperparathyroidism
A

b. Secondary hyperparathyroidism yes

  1. Most likely associated with hypocalcaemia
    a. Primary hyperparathyrodism no
    b. Secondary hyperparathyroidism yes
    c. Tertiary hyperparathyroidism no
31
Q
  1. Least likely to cause gynaecomastia
    a. Cirrhosis
    b. Adrenal hyperplasia
    c. Leydig cell tumour
    d. Sertoli tumour
A

b. Adrenal hyperplasia no

  1. Least likely to cause gynaecomastia
    a. Cirrhosis yes
    b. Adrenal hyperplasia no
    c. Leydig cell tumour yes
    d. Sertoli tumour yes
32
Q
  1. Most true regarding cryptorchidism
    a. 25% are bilateral
    b. Orchidopexy corrects increased risk of malignancy
    c. 10% of 1 year old boys
    d. Contralateral testis is almost always normal
A

a. 25% are bilateral - TRUE 25%

  1. Most true regarding cryptorchidism
    a. 25% are bilateral - TRUE 25%
    b. Orchidopexy corrects increased risk of malignancy controversial
    c. 10% of 1 year old boys: FALSE 1% of 1year olds.
    d. Contralateral testis is almost always normal no
33
Q
  1. Most common testicular cancer
    a. Yolk sack
    b. Teratoma
    c. Seminoma
    d. Choriocarcinoma
A

c. Seminoma yes

  1. Most common testicular cancer
    a. Yolk sack
    b. Teratoma
    c. Seminoma yes
    d. Choriocarcinoma
34
Q
  1. Most true regarding placental site tumour?
    a. Associated with markedly elevated BHCG
    b. Mostly associated with normal pregnancy
A
  1. Most true regarding placental site tumour?
    a. Associated with markedly elevated BHCG no mild (*LW agrees, rare form of GGT, with less syncitiotrophblasts hence lower BHCG)

b. Mostly associated with normal pregnancy ??no, sometimes (*LW - may occur after normal pregnancy, molar pregnancy or even after a terminated pregnancy.)

35
Q
  1. Regarding choriocarcinoma (False)
    a. Better prognosis with non-gestational choriocarcinoma
    b. Frequently metastases at presentation
    c. Can present up to 2 years after pregnancy
A

a. Better prognosis with non-gestational choriocarcinoma false

  1. Regarding choriocarcinoma (False)
    a. Better prognosis with non-gestational choriocarcinoma false
    b. Frequently metastases at presentation yes
    c. Can present up to 2 years after pregnancy yes up to 15
36
Q
  1. Not associated with pre-eclampsia
    a. Placental infarcts
    b. HELLP
    c. Neurological symptoms
    d. Retroplacental bleed
A

**LJS - pre-eclampsia get headaches and visual disturbance but eclampsia defined by CNS involvement - seizures/coma.
Depends on definition of neurological.

c. Neurological symptoms no

  1. Not associated with pre-eclampsia
    a. Placental infarcts yes
    b. HELLP yes
    c. Neurological symptoms no
    d. Retroplacental bleed yes
37
Q
  1. Not associated with sarcoid
    a. Membranous glomerulonephritis
    b. Mickulicz ?
A

*LW:

  1. Not associated with sarcoid
    a. Membranous glomerulonephritis no
    b. Mickulicz - gland disease of Sjoggren syndrome, associated with Sarcoidosis.
38
Q
  1. True regarding pagets disease of the nipple
    a. Eczematous reaction on skin
    b. Occult DCIS involving the nipple ?
    c. Lactiferous ducts involved in less than 5%
A

a. Eczematous reaction on skin yes
b. Occult DCIS involving the nipple: although Paget cells extend from DCIS within ductal system into nipple skin without crossing BM, so DCIS cells are present but dont arise from nipple.

  1. True regarding pagets disease of the nipple
    a. Eczematous reaction on skin yes
    b. Occult DCIS involving the nipple ?
    c. Lactiferous ducts involved in less than 5% no
39
Q
  1. Regarding fibrous dysplasia
    a. >50% polyostotic
    b. Commonly have café-au-lait spots
    c. In the skull, facial bones and mandible more commonly involved than the vault
A
  1. Regarding fibrous dysplasia
    a. >50% polyostotic FALSE - monoostotic >70%
    b. Commonly have café-au-lait spots FALSE <3%

c. In the skull, facial bones and mandible more commonly involved than the vault: depends on wording:
- FALSE if referring to monostotic form - Robbins states jawbone and calvaria most commonly affected in monoostotic form out of head bones.
- TRUE if polyostotic: Craniofacial involvement is present in 50% of patients who have moderate number of bones affected, and 100% in with extensive skeletal disease.

40
Q
  1. Regarding osteosarcoma (false):
    a. Periosteal has a cleft between the bone and the tumour
    b. Parosteal has significant cartilage component
    c. High grade surface osteosarcoma has a similar prognosis to conventional
A

a. Periosteal has a cleft between the bone and the tumour false

  1. Regarding osteosarcoma (false):
    a. Periosteal has a cleft between the bone and the tumour false
    b. Parosteal has significant cartilage component yes
    c. High grade surface osteosarcoma has a similar prognosis to conventional yes
41
Q
  1. Most common cause of jaundice in pregnancy
    a. Cholestasis
    b. HELLP
    c. Viral hepatitis
    d. Choledocolithiasis
A

*LW preferred answer is viral

  1. Most common cause of jaundice in pregnancy
    a. Cholestasis yes
    b. HELLP
    c. Viral hepatitis
    d. Choledocolithiasis
42
Q
  1. Least true with regard to endocarditis:
    a. Acute causes valve destruction
    b. Acute affects previously damage valves
    C. Strep viridans most common cause of subacute
A
  1. Least true with regard to endocarditis:
    a. Acute causes valve destruction yes
    b. Acute affects previously damage valves no
    c. Strep viridans most common cause of subacute yes
43
Q
  1. Least likely to with regard to congenital heart disease
    a. Truncus arteriosus carries a poor prognosis
    b. Septum primum ASD presents early
A

**LJS - septum primum ASD is big defect, unlikely to be asx
But overall ASD more likely to present in adulthood vs VSD

  1. Least likely to with regard to congenital heart disease
    a. Truncus arteriosus carries a poor prognosis yes
    b. Septum primum ASD presents early no
44
Q
  1. Which is least likely regarding ovarian tumours
    a. Serous carcinoma more common than borderline
    b. Serous carcinoma more likely bilateral
    c. Mucinous more common than serous
    d. Mucinous more commonly malignant
A
  1. Which is least likely regarding ovarian tumours
    a. Serous carcinoma more common than borderline: Unsure - Robbins states 75% are benign or borderline, while 25% malignant.
    b. Serous carcinoma more likely bilateral: TRUE
    c. Mucinous more common than serous: FALSE (serous most common malignant ovarian neoplasm)
    d. Mucinous more commonly malignant: FALSE 15% are malignant (compared to 25% of serous).
45
Q
  1. Most likely cause of partial hepatic fibrosis
    a. Budd Chiari
    b. Alpha-1-antitripsin
    c. Wilsons
    d. Haemachromotosis
A
  1. Most likely cause of partial hepatic fibrosis
    a. Budd Chiari yes
    b. Alpha-1-antitripsin
    c. Wilsons
    d. Haemachromotosis
46
Q
  1. Most true with regard to osteopetrosis
    a. Hepatosplenomegally
    b. Axial more affected than appendicular
    c. No increased risk of fracture
    d. Autosomal recessive form affects the navicular
    e. Autosomal dominant form…
A
  1. Most true with regard to osteopetrosis
    a. Hepatosplenomegally yes
    b. Axial more affected than appendicular no
    c. No increased risk of fracture no
    d. Autosomal recessive form affects the navicular no
    e. Autosomal dominant form… no
47
Q
  1. Least likely to cause expansion of the pituitary fossa
    a. Meningioma
    b. Germinoma
    c. Craniopharyngioma
    d. Lymphocytic hypophysitis
    e. Macroadenoma
A
  1. Least likely to cause expansion of the pituitary fossa
    a. Meningioma
    b. Germinoma
    c. Craniopharyngioma
    d. Lymphocytic hypophysitis yes
    e. Macroadenoma
48
Q
  1. Least correct with regard to macroadenoma:
    a. Commonly non-secretory
    b. PRL production most common
    c. Can invade the cavernous sinus
    d. The correct answer
A
  1. Least correct with regard to macroadenoma:
    a. Commonly non-secretory yes

b. PRL production most common: incorrect if over all most common i.e. non secretary is most common. However Prolactinomas are most common type of hyper functioning adenoma and can range in size including macro adenomas.
c. Can invade the cavernous sinus yes
d. The correct answer

49
Q
  1. Least true with regard to chondrosarcoma
    a. Low grade lesions can cause reactive cortical thickening
    b. 15% arise from benign condroid lesions
    c. Majority high grade
    d. Most arise in axial skeleton
A
  1. Least true with regard to chondrosarcoma
    a. Low grade lesions can cause reactive cortical thickening yes
    b. 15% arise from benign condroid lesions yes
    c. Majority high grade no
    d. Most arise in axial skeleton yes
50
Q
  1. Woman with history of breast cancer, limp and hip pain 2 weeks, with increased T2 signal surrounding the psoas muscle
    a. Psoas tear
    b. Metastasis of the lesser trochanter
    c. Subtrochanteric fracture
    d. Subcapital fracture
A

*LW:
Psoas tear is very rare
With a HX of breast Cancer I think this is implying the pathological fracture of lesser troch

  1. Woman with history of breast cancer, limp and hip pain 2 weeks, with increased T2 signal surrounding the psoas muscle
    a. Psoas tear yes
    b. Metastasis of the lesser trochanter
    c. Subtrochanteric fracture
    d. Subcapital fracture
51
Q
  1. Vitamin most associated with prostate carcinoma risk
    a. D
    b. E
    c. K
    d. A
    e. C
A
  1. Vitamin most associated with prostate carcinoma risk
    a. D yes
    b. E - protective.
    c. K
    d. A - protective
    e. C
52
Q
  1. Least frequent with MEN1
    a. Pituitary adenoma
    b. Adrenal cortical adenoma
    c. Pancreatic islet cell tumour
    d. Phaeochromocytoma
A
  1. Least frequent with MEN1
    a. Pituitary adenoma
    b. Adrenal cortical adenoma
    c. Pancreatic islet cell tumour
    d. Phaeochromocytoma yes
53
Q
  1. Least true regarding Wilsons
    a. Reduced ceruloplasmin
    b. Increased excretion of copper into bile
    c. Autosomal recessive
A
  1. Least true regarding Wilsons
    a. Reduced ceruloplasmin yes
    b. Increased excretion of copper into bile: false, has reduced excretion.
    c. Autosomal recessive yes
54
Q
  1. Least likely to cause splenomegaly
    a. Biliary acarisis
    b. Cirrhosis
    c. Schistosomiasis
    d. Hepatitis B
A
  1. Least likely to cause splenomegaly
    a. Biliary acarisis no
    b. Cirrhosis
    c. Schistosomiasis
    d. Hepatitis B
55
Q
  1. Least likely a result of diabetes
    a. Calcification of the vas deferans
    b. Amyloidosis
    c. Pancreatitis
A
  1. Least likely a result of diabetes
    a. Calcification of the vas deferans
    b. Amyloidosis
    c. Pancreatitis no
56
Q
  1. Least true regarding wilms
    a. Dysplastic kidneys risk factor
    b. Most <2 years old
A
  1. Least true regarding wilms
    a. Dysplastic kidneys risk factor yes
    b. Most <2 years old no
57
Q
  1. True regarding neuroblastoma
    a. Metastases can regress in infants
    b. Frequently lymph node involvement at diagnosis
    c. VMA for screening
A
  1. True regarding neuroblastoma
    a. Metastases can regress in infants yes
    b. Frequently lymph node involvement at diagnosis yes
    c. VMA for screening yes
58
Q
  1. Least associated with NF2
    a. Meningioma
    b. Ependymoma
    c. Schwannoma
    d. Dural calcification
    e. Optic nerve glioma
A
  1. Least associated with NF2
    a. Meningioma
    b. Ependymoma
    c. Schwannoma
    d. Dural calcification
    e. Optic nerve glioma no
59
Q
  1. Most likely diagnosis – 2cm cystic mass in the head of the pancreas in a 50 year old male
    a. IPMN
    b. Mucinous
    c. Serous
    d. Adenocarcinoma
A
  1. Most likely diagnosis – 2cm cystic mass in the head of the pancreas in a 50 year old male
    a. IPMN yes
    b. Mucinous
    c. Serous
    d. Adenocarcinoma
60
Q
  1. Most likely to have pseudomembranes
    a. Infectious colitis and pseudomembranous colitis
    b. Dysentry and ischaemic colitis
    c. Pseudomebranous colitis and ischaemic colitis
A

*LW:
Pseudomembranous colitis and ischemic colitis

Most common cause of pseudo membranes is Pseudomembranous colitis secondary to C. Difficile infection. The only other mention of pseudomembranes in Robbins is Ischaemic colitis, thus B is favoured answer.

Less common non-C. difficile causes of pseudomembranous colitis include Behcet’s disease, collagenous colitis, inflammatory bowel disease, ischemic colitis, other infections organisms (e.g. bacteria, parasites, viruses), and a handful of drugs and toxins.

Previous answer:

  1. Most likely to have pseudomembranes
    a. Infectious colitis and pseudomembranous colitis yes
    b. Dysentry and ischaemic colitis
    c. Pseudomebranous colitis and ischaemic colitis
61
Q
  1. True regarding mucinous ovarian carcinoma

a. 70% 5 year survival with peritoneal disease

A
  1. True regarding mucinous ovarian carcinoma
    a. 70% 5 year survival with peritoneal disease FALSE

Robbins refers to serous carcinoma involving peritoneum as 5yr survival of 25%. I would imagine Mucinous is worse.

62
Q
  1. Most likely regarding mixed mullerian tumours
    a. Homologous with endometrial, mesenchymal elements
    b. Heterologous with epidermal and neural elements
    c. Combination/collision of two different germ cell lines
A
  1. Most likely regarding mixed mullerian tumours
    a. Homologous with endometrial, mesenchymal elements yes
    b. Heterologous with epidermal and neural elements
    c. Combination/collision of two different germ cell lines
63
Q
  1. Diabetic mastopathy least likely
    a. Painful
    b. Difficult to distinguish from tumour clinically
    c. Soft mass
    d. Thought to be autoimmune
A

**LJS - painless hard mass (fibrotic), diffc ddx from ca clinically

  1. Diabetic mastopathy least likely
    a. Painful painless
    b. Difficult to distinguish from tumour clinically
    c. Soft mass
    d. Thought to be autoimmune
64
Q
  1. Least likely regarding male breast cancer
    a. Lobular comparatively more common than ductal when compared to females
    b. Papillary comparatively more common than in females
    c. 50% have lymph nodes at presentation
A

a. Lobular comparatively more common than ductal when compared to females no

  1. Least likely regarding male breast cancer
    a. Lobular comparatively more common than ductal when compared to females no
    b. Papillary comparatively more common than in females
    c. 50% have lymph nodes at presentation
65
Q
  1. Least likely post acute MI
    a. Pericarditis
    b. Mitral valve prolapse
    c. Aortic valve prolapse
    d. Mural thrombus
    e. Myocardial rupture
A

c. Aortic valve prolapse no

  1. Least likely post acute MI
    a. Pericarditis yes
    b. Mitral valve prolapse yes
    c. Aortic valve prolapse no
    d. Mural thrombus yes
    e. Myocardial rupture yes
66
Q
  1. Most commonly associated with renal papillary necrosis
    a. NSAIDS
    b. Steroids
A
  1. Most commonly associated with renal papillary necrosis
    a. NSAIDS yes
    b. Steroids