AP Questions Part 2 Flashcards
1
Q
Basal cell carcinomas, OKCs, medulloblastoma, ovarian fibromas, and skeletal deformities - what syndrome? What mutation?
A
Gorlin syndrome, PTCH gene
(Think Head + skin/st)
2
Q
Lynch syndrome (GI, endometrial, ovarian ca) + sebaceous adenomas and carcinomas and keratoacanthomas, what syndrome + mutations?
A
Muir-Torre syndrome, MLH1 and MSH2
(TORRid = fat = sebaceous, eat a KERAT)
3
Q
Fibrous dysplasia, skin pigmentation, endocrine abnormalities, think what syndrome? Mutation?
A
McCune Albright syndrome
GNAS1 (GNASh your teeth)
4
Q
Hamartomas, soft tissue and skin tumors, trichilemmomas, breast cancer, what syndrome? Mutation?
A
Cowden syndrome (tricheleMOOmas: Cowden, plus basal edges look like udders of a cow)
PTEN
5
Q
Enchondromas dedifferentiating into chondrosarcomas, hemangiomas dedifferentiating into angiosarcomas, what syndrome?
A
Maffucci’s syndrome
6
Q
Enchondromas dedifferentiating into chondrosarcoma, what syndrome?
A
Ollier’s syndrome
7
Q
What do each of the colors of a health hazard Diamond on safety lab labels indicate? A) blue B) red C) yellow D) white
A
A) health hazard
B) flammability hazard
C) instability hazard
D) special hazards (ie alkalinity, oxidation, radioactivity, rxn with water etc)
8
Q
What is the most common mutation of adenoid cystic carcinoma? Within what body part is it the most common tumor?
A
MYB-NFIB fusion (the B’s are gloBules)
The palate
9
Q
What is the most common EXTRAcranial solid tumor in kids? What 2 places does it metastasize?
A
Neuroblastoma, to bone marrow and skin
10
Q
What do you see on cytology with pulmonary alveolar proteinosis?
A
Little to no inflammation, irregular clumps of PASD+ granular material, necrotic debris, foamy macrophages
11
Q
What mutation is associated with lymphoplasmacytic lymphoma? What immunoglobulin is elevated?
A
MYD88
IgM (causes inclusions in nuclei/cytoplasm)
12
Q
Hairy cell leukemia, what do you see on bone marrow aspirate? what is +IHC?
A
Aspirate: NOTHING (dry tap!)
CD11c, CD25, CD103, annexin-1
13
Q
What tumors is INI-1 / SMARCB1 lost in?(6 groups)
A
Rhabdoid tumors, peripheral nerve sheath tumors, undifferentiated portions of neoplasms, *epithelioid sarcoma, renal medullary carcinoma, SMARCB1 deficient Sinonasal carcinoma
14
Q
What disease involves mutation of a cAMP activated ATP-gated anion channel?
A
Cystic fibrosis
15
Q
What is the difference between Diamond Blackman anemia and Fanconi anemia:
a) clinically
b) genetic inheritance
c) peripheral blood findings
d) marrow findings
A
a) Diamond:abnormal thumbs, Fanconi:cafe au lait spots
b) Diamond: AD or de novo, Fanconi: aut rec
c) Diamond: elevated HbgF and increased erythrocyte adenosine deaminase (both have macrocytic anemia)
d) Diamond: increased lymphoid precursors and decreased erythroblasts (bc it’s a red cell aplasia), Fanconi: AML, myelodysplasia
16
Q
Under CLIA, certificate of waiver allows an office or lab to perform what kinds of tests?
A
Low error prone tests, ie U/A, fingerstick glucose, H pylori, cholesterol, etc
17
Q
Under CLIA, what is the difference between Certificate of Accreditation and Certificate of Compliance?
A
Accreditation: issued if another accrediting agency of equal or more stringent requirement as CLIA (ie CAP, Joint Commission) are met
Compliance: issued if inspection by CLIA itself meets requirements by CLIA
18
Q
What 2 disorders is Alport’s syndrome associated with?
A
- Hematologic: megathrombocytopenia and granulocyte abnormalities
- Diffuse leiomyomatosis
19
Q
What mutation is associated with neuroblastoma? Small cell lung carcinoma?
A
Neuro: N-myc
SCLC: n-myc and L-myc
20
Q
Good prognosis factors for neuroblastoma?
a) age
b) mutation
c) location
A
a) <1 year
2) NO n-myc nut or 1q36 del
3) extra-adrenal
21
Q
Turcot syndrome - what 2 groups of tumors and what mutation?
A
Polyposis and CNS tumors
PMS2
22
Q
Kasabach-Merritt syndrome, think what tumor and what symptoms
A
Vascular (hemangioendothelioma or tufted angioma)
- Infant with thrombocytopenia, hemolytic anemia, consumptive coagulopathy
23
Q
What is the difference between smoldering MM and active MM?
A
Smoldering: no organ impairment
Active: organ impairment (hypercalcemia, anemia, renal impairment, bone lesions)
- both need M protein >3 and BM plasma cells >10%
24
Q
What is the most common site for granular cell tumor? What are 4 stains to remember?
A
Oral cavity
S100+, NSE+, Sudan black+, PAS-D+ granules
25
Disorder of alpha-galactosidase A that causes accumulation of sphingolipids and peripheral neuropathy? Inheritance?
Fabry disease, X-linked (all other lysosomal storage diseases are aut rec)
26
What disorder with mutation of galactosylceramidase results in accumulation of sphingolipids with fevers, failure to thrive?
Krabbe disease
27
Translocation (1;13) or (2;13) is seen commonly in what solid tumor?
Alveolar rhabdomyosarcoma
28
Birt-Hogg-Dube syndrome - what is the mutation and what 3 lesions should you think of?
FLCN (folliculin)
1) chromophobe carcinoma
2) pulmonary cysts
3) skin tumors (fibrofolliculoma, acrochordon, etc)
29
What kidney tumor is associated with sickle cell anemia?
Renal medullary carcinoma
30
What renal tumors are a) associated with trisomy 7 and 17 or loss of chromosome Y, and b) associated with loss of 3p/VHL gene?
A) papillary RCC
B) clear cell RCC
31
What is the cutoff size for papillary adenomas vs papillary RCC
1.5 cm
32
What 3 findings support diagnosis of adrenal cortical carcinoma over adenoma?
1) High serum DHEA-S
2) size >6 cm
3) 3 points of 7 including <25% clear cytoplasm and other typical malignant features ie invasion
33
Hirschprung’s disease: what is the mutation? What happens to ganglion and nerve fibers on IHC?
RET mutation
Absent ganglion cells: calretinin-, NSE-, RET-
Increased nerve fibers: Acetylcholinesterase+
34
Causes of methemoglobinemia?
Antibiotics ie sulfonamides, nitrates, quinones
35
a) What mutations are SSA associated with? b) where are they predominantly located?
A) BRAF, KRAS, microsatellite instability
B) right colon
36
ASC/SIL ratio should not exceed what ratio to maintain quality assurance?
3:1
37
What stain differentiates Langerhans cell sarcoma from LCH?
CD56+ (the rest like cd1a, s100, langerin are same)
38
How is positive amplification of HER2 defined in a) single probe? b) dual probe?
a) >6 signals/cell
b) copy number >=6 OR >=4 + HER2/CEP17 >=2
39
Tyrosine crystals are seen most commonly in what salivary gland tumor?
Pleomorphic adenoma
40
What mutation is seen in Hailey Hailey disease and what is it?
ATP2C1 (encodes calcium protein pump causing defect in keratinocyte adhesion)
Benign familial pemphigus
41
Angiomyolipoma is associated with what condition and mutation?
Tuberous sclerosis, TSC2 mutation
42
What are the 2 most common causes of eosinophilic pleural effusion?
Malignancy and idiopathic
43
How does desmoplastic melanoma differ from conventional melanoma on IHC?
Desmoplastic is negative for HMB-45 and melan-A (is positive for S100 and SOX10)
(deSmoplastic)
44
How long should the following be stored for forensic autopsy vs non-forensic autopsy:
a) wet stock tissue
b) slides, blocks, reports
C) body fluids and tissues for tox
D) tissue for DNA analysis
a) forensics 1 year, non-forensics 3 months
b) forensics indefinitely, non-forensics 10 years
C) 1 year (forensics only)
D) indefinitely (forensics only)
45
What 2 stains highlight microglandular adenosis?
PAS for globules, S100 for epithelial lining
46
What is the mutation and main histo findings for autoimmune lymphoproliferative syndrome?
FAS mutation
CD4/8 lymphocyte increase, paracortical hyperplasia, polyclonal plasmacytosis
47
Endometriosis is associated with what two cancers?
Clear cell adenocarcinoma and endometrioid carcinoma
48
What is most common site of plasmacytoma outside bone marrow (extramedullary)?
Nasopharynx and oropharynx
49
How to differentiate partial and complete mole by IHC?
Partial mole: positive p57
Complete mole: negative p57 in villi (fetal tissue)
50
What happens in primary polycythemia Vera to 1) EPO 2) LAP 3) iron? 4) platelet studies?
1) decreased
2) increased
3) decreased
4) abnormal with thrombosis
(Opposite in secondary)
51
What disease are Mikulicz cells (large vacuolated macrophages) seen in?
Rhinoscleroma (chronic granulomatous bacterial disease of nose caused by Klebsiella rhinoscleromatis)
52
What disease are Michaelis-Gutmann bodies (concentric targetoid lamellations) and von Hansemann cells (histiocytes with granular eosinophilic cytoplasm) seen in?
Malakoplakia
53
What increases grade II (classic oligodendroglioma) to a grade III (anaplastic oligodendroglioma)
Mitosis index and microvascular proliferation
54
What is the most common benign tumor of the extrahepatic biliary tree?
Granular cell tumor
55
What does type I, II, and III paroxysmal nocturnal hemoglobinuria show for CD59 expression?
Type I: normal
Type II: partial expression/deficiency
Type III: complete deficiency
56
What is the most common location of NUT midline carcinomas?
Mediastinum
57
What salivary duct neoplasms have a) abundant mitochondria? B) antimitochondrial antibodies? C) amylase and anti-chymotrypsin?
A) Oncocytoma and warthin tumor
B) mucoepidermoid carcinoma
C) Acinic cell carcinoma
58
What is embryonal carcinoma positive for? Name 5 IHCs
CD30, PLAP, OCT3/4, SALL4, SOC2
59
What is the difference between Carney triad and Carney complex syndrome?
Carney triad: GIST, extra-adrenal paraganglioma, pulmonary chordoma
Carney complex: aut dom multiple endocrine neoplasia with myxomas, endocrine hyperactivity, blue nevus, and schwannoma
60
What tumors are associated with Garner syndrome?
Osteomas, fibromas, colon adenomas, Desmoid tumor
61
Essential thrombocytopenia- what are the two most common mutations?
#1: JAK2 V617F
#2: CALR (calreticulin)
62
What are the two most malignant vascular tumors?
Angiosarcoma and epithelioid hemangioendothelioma
63
What is the mutation seen in Hemoglobin C trait and disease? What do you see on peripheral smear?
Glutamate to lysine mutation at position 6 of beta chain (lySIne like “C”, while sickle cell is valine)
RBC crystals, microcytic anemia
64
What are the mutations for a) posterior fossa ependymoma, group A b) supratentorial ependymoma, and b) spinal cord ependymoma?
a) loss of H3K27me3 expression, EZHIP overexpression (remember K27 is bad and so this has poor prognosis in infants with cerebellar invasion)
b) ZFTA or YAP-1 (Zinger Tatyana YAPs off the top of her head)
c) presence or absence of MYCN amplification
65
What diseases in the mother commonly cause a) villous hyper maturity and b) villous immaturity in the placenta?
A) hypertension (ie eclampsia)
B) diabetes
66
What autoantibodies (and to what) do you see in a) pemphigus foliaceus b) pemphigus vulgaris c) paraneoplastic pemphigus d) bulbous pemphigoid?
a) IgG and C3 to desmoglein 1 (chicken wire, intercellular bridges)
b) “ to demoglein 1 and 3 (“)
c) IgG to multiple antibodies (intercellular bridges AND basement membrane)
d) IgG and C3 to BP-Ag1 (desmoplakin: hemidesmosome) and BP-Ag2 (collagen 17) (linear basement membrane)
67
What’s the difference between type I and type II papillary RCC?
Type I: small hyperchromatic nuclei with pale cytoplasm, inconspicuous nucleoli
Type II: large pseudostratified nuclei with abundant eosinophilic cytoplasm, prominent nucleoli
68
What virus is associated with: a) Angioimmunoblastic T-cell lymphoma b) Adult T cell lymphoma?
A) EBV (Blastic)
B) HTLV-1 (adulT)
69
What IHC is associated with a) Angioimmunoblastic t-cell lymphoma, b) Anaplastic large cell lymphoma, including breast implant associated, c) Sezary syndrome?
A) CD10+
B) CD30+ for all, ALK+ for some (but breast implant is ALK-)
C) cd7-, cd26-
70
What lab finding does T cell large granular lymphocytic leukemia typically present with?
Neutropenia
71
What mutation is associated with juvenile myelomonocytic leukemia?
NF-1
72
What 4 cancers besides retinoblastoma is the mutation Rb associated with?
Osteosarcoma, breast, lung, and colon carcinomas
73
What mutation is seen in Wilson disease? What lab finding and what stain can you use to diagnose?
ATP7B (copper transporting ATPase)
Low ceruloplasmin; rhodanine/orcein/Victoria blue stain
74
What is the most common cause of angiosarcoma?
Radiation therapy
75
How to tell apart endometrial endometrioid from serous from clear cell carcinoma by IHC?
Endometrioid: PAX8, ER, PR, vimentin, CK7
Serous: p17, p53
Clear cell: AMACR, CK7, napsin-A, HNF1-B
76
What is the differentiating size for diagnosing metaphyseal fibrous defect vs non-ossifying fibroma? What is on the radiology and histology for both?
3 cm
Surrounding sclerotic scalloped edges on imaging, metaphysis. Spindled stroma cells in storiform pattern, foamy macrophages, giant cells (but not as many giant cells as in giant cell tumor which is also on epiphysis not metaphysis and is in older not younger patients)
77
What are MOC31 and Ber-EP4 useful for distinguishing?
Adenocarcinoma (positive) vs mesothelioma (negative)
78
What 3 stains stain for plasma cells?
CD138, CD38, and CD79a (other B cell markers are negative)
79
What 3 stains stain for histiocytes?
CD163, CD63, CD68
80
What 3 stains stain for erythrocytes?
CD43, CD245, CD35
81
What are the requirements for satisfactory sample for a) liquid based cytology smears and b) conventional smears?
a) 5000+ squamous cells, <75% obscured
b) 8000+ squamous cells, <75% obscured
82
What is the mutation for Dermatofibrosarcoma protuberans (DFSP)?
COL1A1 and PDGFB (collagen and platelet derived growth factor)
83
Stomatocytosis is caused by what 4 causes?
Drugs, alcohol/liver disease, Rh null phenotype, or inherited aut dom Na+/K+ permeability with increased sodium which increases MCV
84
What 3 things besides CD1a, S100 does Langerhan Cell Histiocytosis stain?
CD207 (Langerin), fascin, CD68
85
IDH mutant astrocytoma shows what by IHC? IDH wild type shows what by IHC?
Mutant: ATRX loss
Wild type: EGFR, c7 gain/c10 loss, TERT
86
What is the genetic syndrome which has cyanotic heart disease, abnormal facies, thymus aplasia, cleft palates, and hypoparathyroidism(decreased calcium)?
22q11 syndrome (aplasia of 3rd and 4th brachial pouches >thymus and parathyroid aplasia)
87
What mutation is present in polymorphous adenocarcinoma of salivary glands?
PRKD
88
What is the common cytogenetic findings in myelolipoma?
X-chromosome inactivation (so, more common in females)
89
What is the difference between perineuroma and neurofibroma?
Same histologically, but perineuroma is S100-, EMA+
90
What are the differences between NF1 and NF2?
NF 1: neurofibromin mut on c17, pigmented hamartomas (Lisch nodules) on iris, cafe au lait spots
NF2: merlin mut on c22, vestibular schwannomas, meningiomas, gliomas, cataracts
91
In lab proficiency testing, a) how many times per year does it need to be done b) how many challenges performed per analyte c) what percent of results need to fall within limits?
a) 3
b) 5
c) 80%
92
How to distinguish CLL and mantle cell lymphoma by IHC?
CD23 (positive in CLL, negative in mantle), cyclinD1 (positive in mantle, negative in CLL)
93
What genetic conditions is HbF elevated in and which is it not?
From list: alpha-thalassemia trait, beta-thalassemia, HbH disease
Increased HbF in beta thalassemia (>50%)
Deceased in alpha-thalassemia (“trait”: 2 alpha chains missing, “HbH”: 1 alpha chain missing)
94
What are the 4 criteria specific for prostatic carcinoma?
Glomeruloid intraglandular projections, perineural invasion, collagenous micronodules (mucinous fibroplasia), LVI
95
What is the difference between real time PCR and touchdown PCR?
Real time: QUANTITATIVE - measures amount of DNA/RNA via fluorescence at beginning of synthesis
Touchdown: higher annealing temperature used earlier in the process and lower annealing temperature used later in the process
96
What age group and treatment for each of the following:
A) osteosarcoma
B) chondrosarcoma
A) younger; radiation and chemo (following amount of necrosis)
B) older; resection only
97
Young patient with bone tumor with pain that is responsive to aspirin and NSAIDs, what’s the diagnosis?
Osteoid osteoma
98
How to tell apart adenoid cystic carcinoma and invasive cribriform carcinoma of breast?
ACC: Triple negative; myoepithelial markers outline all lumina
Cribriform: usually ER/PR/Her2+; myoepithelial markers only outline periphery of nests
99
What is the mutation for adenoid cystic carcinoma of breast?
MYB and MYBL1 (“MYoepithelial Basal cells”)
100
What do tissues look like from minoxycline antibiotic therapy, and what organs/tissues?
Black discoloration of skin, bones, teeth, and thyroid
101
What is the most common breast carcinoma in young people?
Secretory carcinoma (aka “juvenile carcinoma”)
102
What type of melanoma are KIT mutations more common in?
Acral-lentiginous / mucosal
103
What type of gene alteration is most common in BRAF wild type melanoma?
NRAS
104
What is the most common HPV subtype associated with A) small cell carcinoma of cervix and B) HSIL, SCC, AC of cervix?
A) 18
B) 16
105
How is a) superficially invasive carcinoma of cervix defined(depth and width)? b) superficially invasive SCC of vulva(depth)?
A)<5 mm depth or <7 mm width
B)<1 mm from uppermost dermal papillae
106
What is the difference between Kimura’s disease and Kikuchi’s syndrome?
Kimura’s disease: young Asian men, increased IgE, lymph nodes with hyperplastic germinal centers and interfollicular eosinophilia
Kikuchi’s syndrome: young women, lymph nodes with necrosis and apoptotic debri, crescent shaped histiocytes
107
Autoimmune lymphoproliferative syndrome is associated with what mutation?
FAS
108
What syndrome is associated with overgrowth of nearly every tissue type and increased thrombosis? What mutation?
Proteus syndrome, AKT1
109
What grade is tanycytic ependymoma and what is the histologic pattern?
Grade II, spindle cells
110
What type of ependymoma is most common in cauda equina of young adult males? What grade?
Myxopapillary ependymoma
Grade I
111
What type of glomerular disease has subepithelial “spike and dome” deposits and PLA2R1+?
Membranous glomerulonephritis
112
What mutation is associated with focal segmental glomerulosclerosis?
APOL1
113
What do each of the following pancreatic enzymes elevated mean/in what neoplasms are they elevated?
A) amylase
B) CEA
C) CA19-9
A) pancreatic duct blockage (ie pseudocyst, IPMN)
B) mucinous (ie IPMN, mucinous cystadenoma)
C) mucinous (ie IPMN, mucinous cystadenoma)
114
how many peripheral blood blasts and how many bone marrow blasts are in 1) MDS with excess blasts 1, and 2) MDS with excess blasts 2?
1) PB: 2-4%, BM: 5-9%
2) PB: 5-9%, BM: 10-19%, or Auer rods
*both have excess blasts that don’t meet the criteria for leukemia (20%)
115
Thymic carcinoma - what 3 stains to remember are positive?
CD5+
CD117+
p40+ if squamous differention
116
What tumor is associated with Kasabach-Merritt syndrome, and what mechanism does this syndrome entail?
Kaposiform hemangioendothelioma
Platelets trapped by tumor -> thrombocytopenia, hemolytic anemia
117
What nephropathy is associated with a) solid tumors? B) Hodgkin’s lymphoma?
A) membranous nephropathy
B) minimal change disease
118
What is the mutation for Acute Promyelocytic Leukemia and what is the treatment?
t(15;17) PML-RARA
All Trans-Retinoic Acid
119
What is the difference in IHC staining between clear cell renal cell carcinoma and endometrial clear cell carcinoma?
CD10+, PAX2+ in clear cell renal cell (but both are PAX8+)
120
What is the histologic difference between atypical lipomatous tumor and pleomorphic / spindle cell lipoma?
Pleomorphic / spindle cell lipoma has more ropy collagen in the fibrous parts
121
What are the two standard risk mutations in multiple myeloma?
1) hyperploidy with gain of odd number chromosomes
2) IgH mutation including c6;14
122
What is the difference between AA and AL amyloidosis?
AA: most common worldwid, w/ autoimmune / chronic inflammatory states, so IHC will show protein amyloid A
AL: most common in US, w/ plasma cell dyscrasias /LPLs, so w/ kappa or lambda light chains
123
Name 5 cancers associated with EBV in the head/neck
Oral hairy leukoplakia, nasopharyngeal carcinoma, extranodal NK/T cell lymphoma, Burkitt’s lymphoma, lymphoepithelial carcinoma
124
Autoimmune hepatitis - what antibodies are positive in type 1 and type 2?
Type I: ANA, anti-SMA+
Type II: anti-LKM, anti-LC1
125
What 3 cancers are associated with SMARCA4 mutations?
1) Small cell carcinoma of ovary, hypercalcemic type
2) SMARCA4 deficient undifferentiated uterine sarcoma
3) SMARCA4 deficient thoracic sarcoma
126
Name 3 cancers associated with SMARCB1 loss
SMARCB1 = INI1
1) teratoid/rhabdoid tumor
2) renal medullary carcinoma
3) epithelioid sarcoma
127
Name 4 cancers associated with ETV6-NTRK3 mutation
1) infantile fibrosarcoma
2) cellular congenital mesoblastic nephroma
3) secretory carcinoma of breast
4) secretory carcinoma of salivary gland
128
What is the only neuroblastoma without MYC amplification?
Olfactory neuroblastoma
129
What tumor has IL6ST mutation?
Inflammatory adenoma
(Think IL as in interleukin)
130
What two IHC stains help differentiate neurofibroma and schwannoma?
CD34 (positive in NF, neg in Schwannoma)
S100 (positive in both but diffusely in Schwannoma)
131
What does adenomatoid tumor stain positive for? Where is it the most common benign tumor?
D2-40, calretinin, WT-1, thrombomodulin (think: it’s a tumor of mesothelial origin)
Fallopian tube
132
What are germinal centers positive for in reactive germinal centers of benign lymph node vs follicular lymphoma?
Reactive: BCL-6
Follicular: BCL-2
(Both: HGAL)
133
What sex and age group is Langerhans cell histiocytosis common in?
Males, 5-15 (young)
134
What is furcate insertion on the umbilical cord?
When Wharton’s jelly is absent at insertion of the umbilical vessels so they’re unprotected
135
What is the maximum depth for calling something micro invasive for the following carcinomas: a) ovary b) salivary carcinoma ex PA c) pulmonary ACA
a) 3 mm (and <10 mm area)
b) 1.5 mm
c) 5 mm D (and <3 cm size, lepidic growth)
136
What is the mutation and findings for hereditary pyropoikilocytosis?
Spectrin (it’s a type of elliptocytosis)
Autosomal recessive
Heat sensitive (“pyro”) poikilocytes (microspherocytes: “poika dots”) and *elliptocytes*
137
What is the relationship between gonadoblastoma and dysgerminoma?
Dysgerminoma = Seminoma, so is the malignant transformation of gonadoblastoma (in situ lesion)
138
What lab findings and what IHC (One of the CD markers) would you find in hemophagocytic lymphocytosis?
Cytopenia, increased ferritin and triglycerides, decreased fibrinogen and NK cell activity (therefore increased CD25)
139
What mutation is seen in hereditary spherocytosis? What test should you do?
Ankyrin
(Autosomal dominant)
Osmotic fragility test (will be positive)
140
What 4 test markers are different in thalassemia and iron deficiency anemia?
RBC count(low in IDA, normal in thalassemia)
RDW (high in IDA, normal in thalassemia)
Iron(low in IDA, normal in thalassemia)
Ferritin (low in IDA, normal in thalassemia)
141
What 3 diseases are associated with cryoglobulinemia?
SLE, chronic hep C, SLE
(Associated with anti-IgG Ab Rh)
142
Paroxysmal nocturnal hemoglobinuria: a) what is the associated gene expression b) what are the findings c) what are 3 flow cytometry findings to remember?
A) decreased PIGA
B) decreased LAP score, intravascular hemolytic anemia, sometimes progresses to aplastic anemia/AML
C) decreased CD55, CD59, FLAER
143
What is the autoantibody and what are the diseases associated with paroxysmal COLD hemoglobinuria?
igG anti-P
Viral and syphilis infections
144
Each class of of fire extinguishers (A, B, C, D) are used to eliminate what type of fires?
A: pAper fires (paper, wood, cloth)
B: BBQ (flammable liquid, ie gasoline)
C: eleCtriCal
D: combustible meDal/metals (Na, K, Mg, etc)
145
Dark mucocutaneous lesions, hamartomatous polyps, sex cord tumor(female), large calcifying Sertoli tumor(male), and adenoma malignum of cervix - what syndrome?
Peutz-Jeghers
146
What is the most specific test for lead poisoning?
Serum erythrocyte zinc protoporphyrin (elevated)
147
Monoclonal IgM serum paraproteinemia and hyperviscosity syndrome, think what disease? What is it associated with?
Waldenstrom macroglobulinemia
Lymphoplasmacytic lymphoma
148
What is a) Carney syndrome/complex and b) Carney’s triad?(what are their mutations and associated tumors/disease)
a) PRKAR1A
Myxomas, pigmented lentiginosis, blue nevi, schwannomas, pituitary adenomas
b) SDHC hypermethylation
GIST, pulmonary chordoma, extra-adrenal paraganglioma
149
How to differentiate Merkel cell carcinoma from neuroendocrine tumors (IHC)?
Both will have synapto, chromo; but Merkel cell carcinoma will be NF+ and PERINUCLEAR CK20+
150
What is the difference between leukocytoclastic vasculitis and Sweet’s syndrome?
both have perivascular and dermal neutrophilic inflammation, but LCV has fibrinoid necrosis of vessels as well
