Deck 1 Flashcards
1
Q
Acquired factor deficiency in patients with systemic amyloidosis?
A
Factor X
2
Q
McCune-Albright Syndrome and mutation?
A
Polyostotic fibrous dysplasia, cutaneous spots, and endocrinopathy. Mutation in GNAS1.
3
Q
Viral cause of hemorrhagic cystitis?
A
Adenovirus type 11
4
Q
Most common cause of traveler’s diarrhea?
A
ETEC
5
Q
Most common cause of bacterial enteritis?
A
Campylobacter jejuni
6
Q
What is a Phase II citation?
A
Requires documented corrective action within 30 days.
7
Q
What is a Phase I citation?
A
Must be corrected by the next internal inspection.
8
Q
What 3 groups of patients qualify for medicare?
A
- Age 65 and older
- Permanently disabled
- ESRD
9
Q
What does medicare part A cover?
A
inpatient care excluding physician services
10
Q
What does medicare part B cover?
A
Outpatient services and inpatient physician services
11
Q
Technical charges for an inpatient are reimbursed under?
A
DRG
12
Q
Causes daisy head orangophillic structures on Pap?
A
Tyrosine crystals of pleomorphic adenoma.
13
Q
IHC profile of GI inflammatory polyps?
A
The spindle-shaped stromal cells are positive for CD34 and vimentin, while they are negative for CD117. A variable number are focally positive for smooth muscle actin and CD68.
14
Q
MUC staining in intestinal adenomas?
A
MUC2 positive
MUC1 and MUC5ac negative
15
Q
MUC staining in pancreatobililary adenocarcinomas?
A
MUC2 negative
MUC1 and MUC5ac positive
16
Q
Recurrence rate for Pleomorphic Adenoma with positive margin?
A
Up to 1/3 of cases (old data), better now.
17
Q
Poorly circumscribed dermal tumors composed of irregularly shaped islands and cords of basaloid cells that fit together like the pieces of a jigsaw puzzle.
A
Cylindromas
18
Q
Adult classic seminomas, nonseminomatous, and mixed germ cell tumors are characterized by these two features?
A
intratubular germ cell neoplasia and i(12p).
19
Q
IHC profile of medullary thyroid carcinoma?
A
- Thyroglobulin negative
- Calcitonin, carcinoembryonic antigen (CEA), chromogranin, synaptophysin, and thyroid transcription factor 1 (TTF-1).
20
Q
What virus causes molluscum contagiousum and what is the inclusion called?
A
Pox-virus (molluscum contagiosum virus)
Henderson-Patterson bodies
21
Q
What is the hallmark alteration in oligodendrogliomas?
A
Concurrent deletion of chromosomal arms 1p and 19q
22
Q
Persistence of amyloid beyond 5 days is suggestive of?
A
Pancreatic Pseudocyst
23
Q
Amylase or lipase is most specific for pancreatitis?
A
Lipase
24
Q
Increased Amylase
Normal CEA
Increased CA 19-9
Indicative of which pancreatic cyst?
A
Pseudocyst
25
Decreased Amylase
Decreased CEA
Decreased CA 19-9
Indicative of which pancreatic cyst?
Serous cystadenoma or Solid pseudo papillary tumor
26
Normal Amylase
Increased CEA
Increased CA 19-9
Indicative of which pancreatic cyst?
Mutinous cystadenoma
27
Increased Amylase
Increased CEA
Normal to increased CA 19-9
Indicative of which pancreatic cyst?
IPMN
28
What are Heinz bodies and what stain is used to observe them?
- Denatured hemoglobin
| - Supravital stains
29
How long must cytology slides retained?
5 years
30
Translocation observed in nodular fasciitis and aneurysmal bone cyst?
t(17;22) - MYH9-USP6
31
What stain is specific for infantile hemangioma?
GLUT-1
32
What is the most common post-radiation sarcoma?
Undifferentiated pleomorphic sarcoma
33
Alicia blue at pH 2.5 stains which cells?
Goblet cells
34
Microscopic colitidies are more prominent in which portions of the colon?
Right and transverse colon
35
Duret hemorrhages result from?
Uncal herniation
36
True or false: MelanA stains the adrenal cortex?
True
37
Characteristics of IgG and IgM in regards to complement fixation and hemolysis pattern?
IgM - readily fixes complement and result in intravascular hemolysis
IgG - doesn't as readily fix complement and results in extravascular hemolysis
38
What proportion of cases of arrhythmogenic cardiomyopathy are inherited in an AD manner?
Approximately half of cases of arrhythmogenic cardiomyopathy are autosomal dominant
39
What is lymphomatoid granulomatosis?
Epstein-Barr virus-positive pulmonary lymphoma of B-cell origin. Lymphomatoid granulomatosis is a nodular pulmonary process characterized by vasculocentric necrotic nodules. The vessels can often show lifting of endothelium by the invading lymphocytes. The skin and CNS can also be involved.
40
What is the most common malignant salivary gland tumor overall?
Mucoepidermoid carcinoma
41
What is the most common malignant salivary gland tumor of the parotid?
Mucoepidermoid carcinoma
42
What is the most common malignant salivary gland tumor of the submandibular and sublingual glands?
Adenoid cystic carcinoma.
43
Name two syndromes associated with fibrothecoma?
Meigs syndrome (fibroma, ascites, and right hydrothorax) and Gorlin (basal cell nevus) syndrome.
44
What are the characteristic histopathologic findings of lupus erythematous skin involvement?
vacuolar (hydropic) alteration of the basal layer of the epidermis, a thickened basement membrane zone, interstitial mucin deposition in the dermis, and a lymphocytic inflammatory infiltrate
45
CD34 staining in DFSP.
Positive
46
CD34 staining in DF?
Negative
47
What is the most common lymphoma of the thyroid?
DLBCL
48
t(15;17) is seen in?
Acute promyelocytic leukemia
49
Age associated with good and poor prognosis in neuroblastoma?
Good <1 yo
| Poor >5 yo
50
MKI index considered intermediate in neuroblastoma?
100-200
51
MKI index considered high in neuroblastoma?
>200
52
Anti–Saccharomyces cerevisiae antibody (ASCA) test is associated with which type of IBD?
Crohn's disease (65% of patients, only 15% in UC)
53
What rheumatologic condition may have organizing pneumonia?
RA
54
When are glycjogenated hepatocytes seen?
Diabetics with poor glucose control.
55
What is the commonest and second most common locations for rhabdomyosarcoma?
1. head and neck (50%)
| 2. GU (30%)
56
The top three locations of GI carcinoid tumor?
1. Small intestine
2. Appendix
3. Rectum
57
IHC profile of carcinoid tumor (and one additional stain in rectal carcinoids)?
positive for synaptophysin, chromogranin, and neuron-specific enolase
Rectal carcinoids are positive for PAP, but not PSA
58
Basophilic stippling can be found in which conditions?
lead intoxication, thalassemias, hemoglobinopathies, myelodysplasias, and megaloblastic anemia.
59
PFA-100 result:
| • ADP normal and EPI normal =
Normal
60
PFA-100 result:
| • ADP normal and EPI abnormal =
aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS)
61
PFA-100 result
| • ADP abnormal and EPI abnormal =
Bernard Soulier (BS) syndrome, Glanzmann thrombasthenia, von Willebrand disease, and so on.
62
In regards to pathophysiology, HSP is considered a systemic form of?
IgA nephropathy
63
HSP symptoms include
Purpura (predominantly involving the lower extremities), arthralgias, abdominal pain, and hematuria.
64
What is the finding in skin in patients with HSP?
Leukocytoclastic vasculitis with IgA deposition.
65
Immunohistochemically, clear cell renal cell carcinoma is positive for?
epithelial membrane antigen (EMA)+, Pan CK/Cam 5.2+, CK7/20 -, Carbonic Anhydrase 9 (CA-9+, Vimentin+, CD10+, RCC+, Pax-2+, and Pax-8+.
66
Loss of short arm of chromosome 3 is seen in?
Clear cell RCC associated with VHL.
67
What molecule is the receptor for EBV entry into the cell?
CD21
68
What are the genes associated with MHC 1
HLA-A, -B, -C
69
What cells have MHC-1 on their surface?
All nucleated cells.
70
MHC-1 presents what peptides?
Internal self-peptides and viral peptides
71
Cytotoxic CD8+ T cells recognize which MHC?
MHC-1
72
What are the genes associated with MHC 2
HLA-DR, -DP, -DQ
73
What cells have MHC-2 on their surface?
APCs
74
MHC-2 presents what peptides?
Exogenous
75
CD4+ T cells recognize which MHC?
MHC-2
76
A differentiating characteristic of A. fumigatus is its ability to grow at XX°C.
45°C
77
Cysticercosis is caused by?
pork tapeworm, Taenia solium
78
Virus most commonly implicated in endocervical neoplasia?
HPV-18
79
Virus most commonly implicated in squamous cervical neoplasia?
HPV-16
80
Fibrous dysplasia does or does not have osteoblast rimming?
Does not have
81
What is Kasabach-Merritt Syndrome?
Angiomatosis resulting in thrombocytopenia and consumptive coagulopathy.
82
What jaw tumor is associated with nevoid basal cell carcinoma syndomre?
Odontogenic keratocyst.
83
How do Erhheim-Chester disease histiocytes stain in regards to S100 and CD1a?
Variable S100 positivity, negative for CD1a.
84
What infection is associated with pulmonary alveolar proteinosis?
Nocardia
85
The most common cause of lymphocytic myocarditis?
Viral myocarditis.
86
Aggregates of large histiocytes with basophilic cytoplasm, vesicular nuclei, and a central bar of chromatin in the myocardium represent a?
Aschoff body
87
What cells make up the Aschoff body?
Anitschow
88
EM finding associated with anthracycline cardiotoxicity?
sarcotubular dilatation
89
Liver findings in AD and AR PKD?
AD: hepatic cysts
AR: congénital hepatic fibrosis
90
Klippel-Trenaunay syndrome is associated with what kidney tumor?
Hemangioma
91
Tuberous sclerosis is characterized by?
AML of the kidney, cardiac rhabdomyoma, and adenoma sebaceum
92
What is the most common germ cell tumor in prepubescent boys?
Yolk sac tumor
93
How much blood is usually collected at a donation and what volume constitutes a short filled unit?
Normal: 450 +/- 50
| Short filled: 300-404
94
A receiving blood bank must complete what testing on blood units?
ABO and Rh typing
95
Anti-B test reagent color
Yellow
96
Anti A test reagent color
Blue
97
How many antigens must be tested on an antibody panel?
at least 18
98
How long can infant blood need not be crossmatched?
4 months
99
What may happen if LR is transfused in the same line as blood products?
Thrombosis
100
What may happen if Dextrose or hypotonic solutions are transfused in the same line as blood products?
hemolysis
101
Most common cause of community acquired pneumonia?
S. pneumoniae
102
Common pathogens causing pneumonia in patients with COPD?
H. influenzae, M. catarrhalis, Legionella
103
Most common cause of croup?
Parainfluenza virus
104
Most common cause of bronchiolitis in children?
RSV
105
Platelet adhesion is mediated by?
GP1b - vWF receptor
| GB1a-IIa - collagen receptor
106
Platelet aggregation mediated by?
GBIIb-IIIa - fibrinogen receptor
107
What activates GBIb in vivo and in vitro?
In vivo - shear forces
| In vitro - ristocetin
108
What do platelet alpha granules contain?
Fibrinogen, PDGF, vWF, P-selectin, PF-4
109
What do platelet dense granules contain?
ADP, ATP, Ca2+, and 5-HT
110
How is the extrinsic coagulation cascade "linked" to the intrinsic cascade?
Factor VIIa is capable of activating IX to IXa
111
What markers are on the lymphoid stem cell?
CD34+, TdT+, HLA-DR+
112
Pro-B cell immunophenotype?
CD34+, TdT+, HLA-DR+
| CD19+, CD10+
113
Pre-B cell immunophontype?
CD34-, TdT-, HLA-DR+
| CD19+, CD10+, CD20+
114
B cell immunophonotype?
CD34-, TdT-, HLA-DR+
| CD19+, CD10+, CD20+, CD21+, CD22+ surface Ig
115
Plasma cell phenotype?
CD34-, TdT-, HLA-DR+
| CD19-, CD10-, CD20-, CD21-, CD22- cytoplasmic Ig
116
Pro-thymocyte immunophyenotype?
CD34+. TdT+, CD7+
117
Immature/common thymocyte immunophenotype?
CD34-, TdT+, CD7+
| CD1+, CD2+, cCD3+, CD3-, CD5+. CD4+. CD8+
118
Mature thymocytre/T cell immunophynotype?
CD34-, TdT-, CD7+
| CD1-, CD2+, CD3+, CD5+. CD4 or CD8+
119
What immunoglobulins are on the surface of B cells?
IgM and IgD
120
What percentage of the peripheral blood lymphocytes are T cells?
65%
121
Normal CD4 to CD8 ratio?
2:1
122
95% of T cells carry this receptor while the other 5% this receptor?
95% - alpha beta
| 5% - gamma delta
123
TCR expressed in association with this CD molecule?
CD3
124
What is the major and minor normal adult hemoglobins?
HbA and HbA2
125
What makes up hemoglobin A?
alpha2 beta2
126
What makes up hemoglobin A2?
alpha2 delta2
127
What makes up hemoglobin F?
alpha2 gamma2
128
What is the incidence of HbS trait in african americans?
10%
129
What is hemoglobin S?
Beta chain allele with encodes valine in place of glutamate at position 6
130
What does hemoglobin SA electrophoresis look like?
35-45% HbS, 50-65% HbA, <3% HbA2
131
How long do red cells survive in HbSS?
17 days
132
What does hemoglobin SS electrophoresis look like?
>80% HbS, 1-20% HbF, 1-4% HbA2, 0% HbA
133
What is hemoglobin C?
Beta chain allele with encodes lysine in place of glutamate at position 6
134
What is the second most common abnormal hemoglobin after S and what is its structure?
Hemoglobin E - beta26 (glu-lys)
135
Which hemoglobins run with S on alkaline gel?
HbD and HbG and Lepore
136
15% hemoglobin S is questionable for?
Hemoglobin Lepore
137
What is Hb Lepore and how does it present clinically?
Fusion of delta and beta genes
| It presents with thallasemic indices
138
What abnormal hemoglobin is characterized by a mutation in the alpha gene which produces an abnormally long transcript?
Hb constant springs
139
What shifts the oxygen dissociation curve to the left?
Alkalosis
Hypothermia
Decreased 2,3 DPG
140
What shifts the oxygen dissociation curve to the right?
Acidosis
Hyperthermia
increased 2,3-DPG
141
What is methemoglobin and how is it treated?
Hemoglobin with Fe3+ instead of Fe2+, cannot bind O2
| Tx: Methylene blue
142
What level of Hi can cause cyanosis?
10%
143
What level of SHb can cause cyanosis?
3-4%
144
What bacterial infection is associated with sulfhemoglobin?
C. perfringens bacteremia
145
What HbCO level is expected in a smoker?
2-6%
146
Symptoms of carboxyhemoglobin start at this level and become fatal at this level?
Symptoms: 10-20%
Fatal: 50%
147
What is DNA methylation and what is its effect?
Methylation affects cysteine moieties location in CpG island which leads to decreased transcription - basis of epigenetic modification
148
Histone acetylation has what effect on DNT?
increased DNA transcription
149
Most common cause of hospital acquired endocarditis?
Enterococcus
150
Most common genetic abnormalities in CMML?
trisomy 8, monosomy 7
151
CD34 and BCL-2 staining in solitary fibrous tumor?
Positive
152
What is the two most common genetic alterations in BE?
- inactivation of the p16 INK4A/CDKN
| - loss or mutations of p53
153
What is the risk of cancer in patients with BE with and without dysplasia?
- without dysplasia, is approximately 2%.
| - high-grade dysplasia ranges from 16% to 59%.
154
How is the anion gap calculated?
Anion gap = Na+–(Cl– + HCO3–)
155
How is the standard deviation index calculated?
SDI = (lab result – peer group mean)/peer group standard deviation.
156
What is accuracy?
How close a value is to the true value?
157
What is precision?
How reproducible is the value?
158
What is the immunophenotype of MF?
CD2+, CD3+, CD4+, CD5+, and CD8− T-cell infiltrate. Lesions often show an absence of CD7
159
MF with CD30+ cells indicates?
Poor Prognosis.
160
Immunophenotype of CLL/SLL
CD19 positive, CD20 positive (dim), CD5 positive, CD23 positive, CD43 positive/negative, FMC7 negative to dim, and dim surface light chain immunoglobulin expression.
161
Howell-Jolly Bodies represent ______ and are seen in patients with _________?
DNA, asplenia
162
AML with in(16) results in this morphology, is associated with this genetic abnormality, and portends a better or worse prognosis?
Prominent eosinophils are seen
CBFB-MYH11 fusion protein
Good prognosis
163
Typical staining of adenoid cystic carcinoma of the breast?
ER, PR, Her2 negative
| CD117+
164
Patients with adenoid cystic carcinoma of the breast have a _______ prognosis?
Good
165
Invasive cribriform carcinoma of the breast has a favorable or unfavorable prognosis?
Favorable
166
The low grade neoplasia pathway in breast pathology is associated with this genetic aberration?
loss of 16q
167
Which one of the following is most commonly associated with transfusion-transmitted sepsis after transfusion of red blood cells (RBCs)?
Yersinia enterocolitica
168
APC gene mutations are associated with these syndrome?
FAP, Gardner Syndrome, Turcot Syndrome
169
Genetic mutation seen in Putz-Jegher Syndrome?
STK11
170
How do you calculate a likelihood ratio?
Sensitivity/(1-specificity)
171
How do you calculate post-test probability?
post-test odds = pretest odds × likelihood ratio
172
How do you calculate pre-test odds?
pretest odds = [pretest probability/(1 – pretest probability)]
or
pretest odds = [disease prevalence/(1 – disease prevalence)]
173
According to the Clinical Laboratory Improvement Amendments of 1988 (CLIA’88), point-of-care testing (POCT) programs must keep their records of all quality control activities for at least ____________.
2 years
174
Hyperleukocytosis has what effect on potassium levels?
Pseduohyper or hypokalemia?
175
What causes primary hyperparathyroidism in 85% of patients?
A single parathyroid adenoma.
176
Postinfantile giant cell transformation (PIGCT) of the liver is seen in?
autoimmune hepatitis, HCV infection with or without HIV confection, drug hepatotoxicity
177
Immunoprofile of HCC?
```
CK7/20 -
HepPar1 +
polyclonal CEA +
Glypican3 +
HSP70+
```
178
Typical IHC profile of chromophobe carcinoma?
CK7+, CK20-
KIT+
PAX2-
Colloidal iron+
179
Typical genetics of chromphobe carcinoma?
Loss of multiple chromosomes
180
Flow cytometric diagnosis of PNH relies on identification of decreased levels of these two red cell surface proteins?
CD55, CD59
181
grading of endometrioid adenocarincoma?
Grade 1: <5% solid
Grade 2: 5-50% solid
Grade 3: >50% solid
182
Fusobacterium nucleatum is ________ for indole reactionn and _________ for lipase reaction?
Positive for both
183
What is the most frequent translocation in Endometrial stromal sarcoma?
t(7;17)(p15;q21) resulting in a JAZF1/SUZ12 fusion product.
184
p16 staining in micro glandular hyperplasia?
negative
185
IgA IF pattern in dermatitis herpetiformis?
Granular
186
Order engraftment time from shortest to longest amounts these HPSC collection techniques: cord-derived, peripheral blood-derived, marrow-derived?
peripheral blood
marrow
cord
187
Order risk of GVHD from greatest to least regarding these HPSC collection techniques: cord-derived, peripheral blood-derived, marrow-derived?
Peripheral blood
marrow
cord
188
Classify these cytogenetic aberrations in CLL/SLL as either good or bad prognostic indicators: del13q, del TP53(17p13), monosomy 13, and deletion ATM (11q22)?
- deletion 13q or monosomy 13 predict a good prognosis.
| - TP53 (17p13) and ATM (11q22) deletions individually, or in combination, predict a poor response to treatment.
189
IHC profile of DSRCT?
variable positivity for several keratins, EMA, desmin, NSE, and vimentin and shows consistent nuclear expression of WT1-C
190
Fusion partners in DSRCT t(11;22)?
EWS and WT-1
191
Neutrophils are activated mostly by this cytokine?
IL-8
192
Eosinophilic inflammation is driven by this cytokine?
IL-5
193
The complement factor acts as an opsonin and leads to phagocytosis of the foreign substance?
C3b
194
These complement members make up the membrane attack complex?
C5-C9 (C5b6789)
195
These two complement proteins promote the release of histamine from basophils and are referred to as anaphylatoxins?
C3a and C5a
196
What is the genetic locus of the MHC?
Chromosome 6p
197
```
What is typical in thalassemia regarding:
Hemoglobin and Hematocrit:
RBC Count:
MCV:
Peripheral Smear:
```
Hemoglobin and Hematocrit: low
RBC Count: normal to elevated
MCV: lower than in IDA
Peripheral Smear: microcytosis, target cells, basophilic stippling
198
The type of antibody in WAIHA is a ______ typically with broad reactivity against ___________
IgG, Rh antigens
199
The type of antibody in CAD/CAIHA is a ______ typically reactivity against ___________
IgM, I antigen
200
CAIHA with anti-I or Anti-i can be caused by these viruses?
Anti-I: mycoplasma pneumonia
| Anti-i: EBV
201
Peripheral blood neutrophils with phagocytosed RBCs is seen in?
Paroxysmal cold hemoglobinuria
202
What is the Donath-Landsteiner Antibody?
IgG biphasic hemolysin with anti-P specificity
203
What are cryoglobulins?
Immunoglobulins that precipitate reversibly at low temperatures
204
What is type 1 cryoglobulinemia?
Monoclonal immunoglobulins seen in multiple myeloma of Waldenstroms macroglobulenemia
205
What is type 2 cryoglobulinemia?
Monoclonal IgM and polyclonal IgG
| IgM has RA activity (anti-IgG)
206
What is type 3 cryoglobulinemia?
Mixture of w polyclonal immunoglobulins
207
Mutations in this gene are associated with PNH?
PIG-A
208
LAP score in PNA?
Low
209
Translocation and fusion partners in PNET/Ewing's sarcoma
t(11;22)(q24;q11) - FLI-1 and EWS
210
translocation in Clear Cell Sarcoma?
t(12;22)
211
translocation in secretory carcinoma of the breast and mammary analog secretary carcinoma of the salivary gland?
t(12;15) ETV6-NTRK3
212
t(11;19) - CRCT1-MAML2 is seen in which head and neck malignancy?
Mucoepidermoid carcinoma.
213
Mutations in this protein lead to hereditary hemochromatosis?
HFE
214
Bacteria commonly found with T. vaginalis infection?
Leptothrix
215
Quad screen results expected in trisomy 18?
All normal or decreased
216
What cell is used to culture C. trachoma's?
McCoy
217
What are Donovan bodies?
Bipolar stained rods in macrophages or monocytes in Donovan's disease
218
Appearance of V. cholerae on TCBS agar and what does that colony color indicate?
Yellow, sucrose fermentation
219
The most common translocation and partners seen in ALCL?
t(2;5) - NPM-ALK
220
ALK rearrangement in lung adenocarincomas is associated with these fusion gene?
ALK/EML4
221
Expected normal platelet aggregometry response to ristocetin 0.8 mg/mL and 1.2 mg/mL?
0. 8 - little response
| 1. 2 - aggregation
222
A poor response to all agonists except ristocetin is indicative of?
Glanzmann thrombasthenia
223
A response to everything but ristocetin is indicative of?
vWD or Bernard-Soulier Syndrome
224
The majority of immunodeficiencies affect ________ as they are typically inherited in this manner?
boys, x-linked
225
Recurrent bacterial infections, especially of the upper aerodigestive tract, as well as chronic G. intestinalis infection may indicate?
And immunoglobulin or B cell defect
226
Increased susceptibility to viral or fungal opportunistic infections can be seen with defects in?
T cells
227
Defects in this system lead to infection with catalase positive organisms?
Phagocyte system
228
Defects in this portion of the innate immune system leads to infection with encapsulated bacteria?
Terminal complement disorders
229
Staining profile of PLGA?
S100 and EMA - strong and diffuse
CEA - variable
CKIT - weak positive
230
Staining profile of adenoid cystic carcinoma of the salivary gland?
S100 - variable
EMA and CEA - luminal cells
CKIT - strongly positive
231
t(8;21) results in this morphology in AML?
Myeloblasts with neurtophillic differentiation
232
What are the fusion partners in t(8;21) AML?
RUNX1-RUNX1T1
233
Myelomonocytic or monocytic differentiation in AML may be due to this translocation?
t(9;11)
234
Gliomas may stain with this cytokeratin?
AE1/AE3 due to cross reactivity with GFAP
235
Desmoplastic melanomas stain for these melanoma markers?
S100 and SOX10
236
These coagulation factors of the intrinsic pathway does not result in clinically significant bleeding when deficient?
prekallikrein, factor XII, and high-molecular-weight kininogen
237
Immunoreactivity of meningiomas?
EMA and vimentin positive
238
T. whippeli gram stain?
gram+, classified as an actinomycete
239
Where do atypical fibroxanthomas occur and who gets them?
atypical fibroxanthomas (AFXs) occur in the dermis of the sun-damaged skin of older individuals
240
IHC profile of atypical fibroxanthoma?
CD34 negative, and express myofibroblastic markers, such as smooth muscle actin (SMA)
241
Number of cells required in a conventional pap?
8,000-12,000
242
Number of cells required in a thin-prep pap?
5000
243
Triad observed in toxoplasma lymphadenitis?
follicular hyperplasia
clusters of epithelioid histiocytes
infiltration of monocytoid B cells
244
FDA irradiation requirements for blood products?
15 Gy to periphery of unit, 25 Gy to center of unit
245
Group A has this added to its carbohydrate moiety to make it group A.
N-acetylgalactosamine
246
Group B has this added to its carbohydrate moiety to make it group B.
Galactose
247
Homocysteine and methymalonic acid levels in B12 and folate deficiency?
B12: elevated MMA and Homocysteine
Folate: normal MMA and elevated homocysteine
248
MEN2B consists of?
medullary thyroid carincoma, pheochromocytoma, and multiple ganlglioneuromas.
249
MEN1 consists of?
pancreatic neuroendocrine tumors
pituitary adenomas
parathyroid hyperplasia
250
MEN2A consists of?
medullary thyroid carincoma, pheochromocytoma, parathyroid hyperplasia
251
What syndrome has multiple colon polyps and brain tumors?
Turcot syndrome
| either associated with FAP or Lynch syndrome
252
What syndrome is characterized by multiple colon polyps, jaw tumors, and fibromatosiss?
Gardner's syndrome
| associated with APC gene
253
The most common malignant sarcoma primary to the heart is?
Angiosarcoma
254
t(x;17) is seen in?
ASPS TFE-ASPL
255
Myelomonocystic leukemia would be positive for these markers?
CD11c CD64, CD33 and CD13.
256
What happens to hepcidin levels when a patient has hemochromatosis.
levels are low
257
• Microcytosis + normal iron studies + normal hemoglobin fractionation pattern (no variants; hemoglobin A, A2, and F within the reference range) is a presumptive diagnosis of?
α-thalassemia trait.
258
• Microcytosis + normal iron studies + elevated hemoglobin A2 is a presumptive diagnosis of?
β-thalassemia trait.
259
Transient abnormal myelopoeisis observed in trisomy 21 is associated with myeloid proliferation typically of this lineage?
Megakaryocytic
260
Mutations in this gene are seen in patient's with trisomy 21 with myeloid neoplasms?
GATA-1
261
cytokeratins expressed in clear cell rcc?
CK8, CK18
262
Thiamine deficiency can lead to this gross finding in the brain?
atrophy of the mammillary bodies
263
Serum ceruloplasmin levels and urinary copper levels in Wilson's disease?
Ceruloplasmin - low, urine Ca2+ elevated
264
Mutations in this gene cause Wilson's disease?
ATP7B
265
Flow cytometric diagnosis of Glanzmann thrombasthenia is done by identifying loss of either of these markers?
GPIIb (CD41) and GPIIIa (CD61)
266
What are the acrocentric chromosomes?
13, 14, 15, 21, and 22
267
Tumor marker of ovarian carcinoma?
CA-125
268
CEA is a tumor marker of?
Pancreatic and gastrointestinal cancers
269
CA-19-9 is a tumor marker of?
Pancreatic adenocarinocma.
270
Salivary duct carcinoma resembles this neoplasm and has this immunoprofile?
```
IDC of the breast
AR+
GCDFP+
HEr2Neu+
PSA (50%)
PR (6%)
ER (1%)
```
271
Renal papillary necrosis occurs in these four settings?
obstructive pyelonephritis, diabetic nephropathy, sickle cell anemia, and analgesic abuse
272
Pilomatrixoma is also known as?
Malherbe calcifying epithelioma
273
Most common Rh-positive Weiner haplotype in whites?
R1
274
Most common Rh-positive haplotype in blacks?
R0
275
The most common Rh-negative Rh haplotype?
r
276
infantile precursor B-cell lymphoblastic leukemia is associated with this gene and translocation.
MLL gene on 11q23
| t(4;11).
277
Immunohistochemical staining for YST?
YST is positive for α-fetoprotein (AFP) and cytokeratin. CEA, vimentin, and PLAP show variable positivity. EMA, CD30, and CD99 are negative.
278
What non-GI tumors are seen in Peutz-Jegher Syndrome?
Women: adenoma malignum and SCTAT
Men: Sertoli cell tumors
279
What GI polyp is associated with hypokalemia?
villous adenoma
280
Genetic alteration seen in hibernoma?
11q13
281
Genetic alteration seen in myxoid liposarcoma?
t(12;16)
282
Genetic alteration seen in well-differentiated liposarcoma?
Ring chromosome 12
283
Genetic alteration seen in lipoblastoma?
8q11-13
284
Genetic alteration seen in spindle/pleomorphic lipoma?
16q13
285
Microglandular adenosine has myoepithelial cells, true or false?
false
286
Describe myxofibrosarcoma?
Grossly MFS is a multinodular neoplasm composed of gelatinous or fibrous nodules. Microscopically the tumor nodules are lined by fibrous septa and are composed of myxoid to fibrous matrix in variable proportions. The myxoid areas contain curvilinear vessels with perivascular tumor cell condensation.
287
Autoantibody seen in primary biliary cirrhosis?
Anti-mitochondrial
288
Enzyme important to the development of HDL?
LCAT
289
HTLV-1 is the causative agent of?
ATLL as well as tropical spastic paraparesis.
290
What is the immunophenotype of ATLL?
CD2+, CD3+, CD5+, CD7–, CD4+, CD25+, ±FoxP3+
291
The diagnosis of CLL requires an absolute lymphocyte count of at least ______ for _______ months?
5 × 109/L, 3 months
292
vWF levels are 25% higher or lower in patients with type ) blood?
lower
293
Which malaria is more common in Asia?
P. vivax
294
What is the most common site of extra skeletal plasmacytoma?
Upper respiratory tract
295
What is the most sensitive marker of mesothelioma and what is the most sensitive marker of adenocarcinoma?
Meso - calretinin
| Adeno - BerEp4
296
What is Stewart-Treves Syndrome?
Angiosarcoma arising in the breast or axilla following mastectomy with axillary dissection.
297
Where is the most common location for gastric leiomyomas?
Cardia
298
Chromogranin or synaptophysin is a better stain for detection of carcinoid tumor?
Chromogranin
299
Which variant of rhabdomyosarcoma is associated with a translocation and what is the translocation?
Alveolar rhabdomyosarcoma, t(2;13)
300
t(12:22)
clear cell sarcoma, EWS-ATF-1 fusion
301
Follicular cervicitis is associated with what infection?
C. trachomatis
302
Number of cells required on liquid-based anal pap?
2,000-3,000
303
Cardiac fibromas are associated with this syndrome?
Ghorlin Syndrom
304
What gene is mutated in Ghorlin's syndrome?
PTC
305
Mucoid intimal edema is a feature of?
Thrombotic microangiopathy
306
What is the new name of Wagner's granulomatosis?
Granulomatosis with polyangiitis
307
What is the new name of Churg-Strauss syndrome?
Eosinophilic granulomatosis with polyangiitis
308
What gene is mutated in Ehler's-Danlose Syndrome?
COL3A1
309
What is the best serologic test for Celiac Disease?
Anti-tissue transglutaminase
310
What HLA halpotypes are associated wit Celiac Disease?
DQ2 (95%) and DQ8 (5%)
311
AFP is primarily elevated in this germ cell tumor?
Yolk sac
312
What is an Askin tumor?
A Ewing sarcoma/PNET of the thoracopulmonary area.
313
What is Munro microabscess?
Collection of neutrophils in the stratum corneum.
314
What or the histology features of psoriasis?
```
Regular elongation of rete ridges
Parakeratosis
Munro microabscesses
Thinning of the Supra papillary plate
Hypogranulosis
Dilated blood vessels in the papillary tips
```
315
Histology of rheumatoid nodule and granuloma annulare?
RN: irregular nodule usually with fibrin in necrobiotic center.
GA: well delineated areas of disintegrated collagen and mucin surrounded by granulomatous inflammation
316
What is Mafucci Syndrome?
Multiple enchondromas and hemagiomas
317
What lymphoma most commonly presents as lymphomatous polyposis?
Mantle cell lymphoma
318
At what temperature is cryoprecipate formed when thawing plasma?
1-6 C
319
What temperature is cryo stored?
-18C
320
This thyroid cancer stains strongly for CK19
PTC
321
Lacrimal gland or orbital marginal zone lymphomas are associated with this bacterium?
Chlamydia psittaci.
322
PAX-8 is positive or negative in the kidney and positive or negative in the urothelium
Kidney: positive
Urothelium: negative
323
What type of schwannoma is associated with Carney Complex?
psammomatous melanotic schwannoma
324
How long can pooled and unpooled cryo be stored and ta what temp?
Pooled - 4 hours
Unpooled - 6 hours
20-24C after thawing at 37C
325
What is analytical specificity?
a laboratory test’s ability to measure a particular analyte in the presence of possible interfering substances.
326
Alveolar soft part sarcoma metastasizes to this location with greater frequency compared to other sarcomas?
Brain
327
Extra-mammary Paget's disease is positive for?
Low molecular weight keratin, CEA, and EMA.
328
What subtypes of Hodgkin Lymphoma has the best and worst prognoses?
Best: Nodular lymphocyte predominant
Worst: Lymphocyte deplete
329
The duffy antigen is the receptor for this microorganism?
P. vivax
330
People of African descent have this duffy phenotype?
a-, b-
331
What are the acceptable platelet transfusion triggers:
- Stable non-bleeding patient
- Bleeding patient, or about to undergo surgical procedure
- Intracerebral, intraocular, and pulmonary bleeding
- 10
- 50
- 100
332
One does of platelets is expected to raise the platelet count by?
30-60 K
333
A pure mutinous tumor of the breast is classified as such when >XX% is mutinous?
90%
334
IHC profile of seminoma?
Keratin - to weak
| OCT3/4, CKIT, PLAP, and PAS +
335
What is a pulmonary sequestration?
Portions of lung that reviews an aberrant blood supply from branches o the aorta rather than the pulmonary artery.
336
What are two other names for de Quervain's thyroiditis?
- Granulomatous thyroiditis
| - giant cell thyroiditis
337
Pattern of thyroid hormone changes seen in de Quervain's thyroiditis?
Hyperthyroidism followed by a return to the euthyroid state.
338
Acid and gastrin levels in patients with autoimmune atrophic gastritis.
Hypochlorhidria and elevated gastrin.
339
Type of adenocarcinoma in patients with H. pylori gastritis?
intestinal type
340
MLH1 loss is due to ________ and results in decreased expression of these proteins by IHC?
Hypermethylation, decreased MLH1 and PMS2
341
Intermediate trophoblasts stain strongly with?
HPL
342
How does medullary thyroid carcinoma metastasize?
Veins and lymphatics
343
What is the Regan isoenzyme?
Placental ALP produced by a malignancy
344
In regards to ALP isoenzymes, liver ______, and bone _______?
Liver lasts and bone burns
345
How can the MCV be calculated?
HCT/RBC
346
Breast tumor marker?
CA-15.3
347
What antigens are diminished by enzyme treatment with ficin or papain?
Duffy, M, and N, Lutheran, Chido, Rodgers
348
How is plasma volume calculated?
Plasma volume is calculated as (1 – hematocrit) × 0.7 dL/kg × body mass (kg)
349
How does one dose cryoglobulin?
: Dose (units) = [post-fibrinogen (mg/dL) – pre-fibrinogen (mg/dL) × plasma volume]/250 mg/unit.
350
Pulmonary malakoplakia can be caused by this organism?
| Urinary tract?
Pulm - Rhodococcus equi
| UT - E. coli
351
Granulocyte yields below this level are considered ineffective when transfused into a neutropenic patient?
1 x 10^10
352
What temperature are granulocytes stored and what is their expiration?
20-24C, 24 hours
353
Temp that RBCs should be stored?
1-10C
354
What renal tumor is associated with polycythemia
Metanephric adenoma
355
Staining of nephrogenic adenoma?
PAX2 and PAX8+
Most negative for PSA
Can be positive for racemase
356
The preferred cardiac biomarker is __________, followed by ____________ if the preferred marker is unavailable.
Troponin T, CK-MB
357
How do you calculate the reticulocyte index and reticulocyte production index?
Reticulocyte index = reticulocytes × HCT/normal HCT
| Reticulocyte production index = (reticulocytes × HCT)/(normal HCT × correction factor).
358
What is the most common cranial neoplasm in tuberous sclerosis?
SEGA
359
Translocation seen in follicular lymphoma?
t(14;18)
360
CD34, bel-2, and CD10 staining in trichoepitheliomas vs basal cell carcinoma.
- Focal positive CD34 staining of the fibroblastic stroma has been seen in trichoepitheliomas, whereas it is negative in basal cell carcinoma.
- Staining of the outermost epithelial layer for bcl-2 has been seen in trichoepithelioma. In contrast, the tumor islands of basal cell carcinoma usually stain diffusely.
- Immunohistochemistry for CD10 stains the stromal cells but not the epithelial cells in trichoepithelioma, whereas it stains the epithelial cells in basal cell carcinoma.
361
The most common CNS lymphoma is ?
| CNS lymphomas are radiosensitive, true or false?
- DLBCL
| - Radiosensitive
362
Members of this mycobacterial group stain for these non-bacterial stains?
Members of Mycobacterium avium complex (MAC), but not M. tuberculosis, may stain positively for desmin, actin, and cytokeratin.
363
What is the carney complex?
abnormal skin pigmentation, cutaneous and cardiac myxomas, and abnormalities of the endocrine system (adrenal, pituitary, thyroid).
364
How do myxomas stain?
Myxoma cells stain positively for endothelial markers CD34 and CD31 and are variably positive for S-100. Calretinin has been reported positive in 74% to 100% of cases and can be useful to distinguish this lesion from a myxoid thrombus. Tumor cells are negative for cytokeratin, but heterologous glands show positivity.
365
CK7 staining in:
- Conventional clear cell RCC
- Chromophobe RCC
- Papillary RCC
Conventional RCC: negative
| Chromophore and papillary: positive
366
What lineage does each of the markers indicate?
- Anti-CD18
- Anti-CD33
- Anti-CD61
- Anti-CD71
- Anti-CD18 monocytic
- Anti-CD33 myeloid
- Anti-CD61 megakaryocytic
- Anti-CD71 erythroid lineage
367
Is CD31 or CD34 more specific and sensitive for vascular tumors?
CD31
368
Translocation seen in DFSP?
t(17;22) translocation or ring chromosomes that contain this fusion - COL1A1–PDGFB
369
Infantile fibrosarcoma and the related cellular congenital mesoblastic nephrona carry which fusion?
ETV6–NTRK3
370
What is the most common enzyme deficiency of the glycolytic pathway?
Pyruvate kinase deficiency.
371
Grade 2 carcinoids (atypical carcinoids) are defined by?
2-10 mitoses/10 HPF
372
What is the Azzopardi effect and where is it seen?
Smudged densely basophilic nucleic acid accretions adjacent to tumoral blood vessels in small cell carcinomas.
373
Describe the EGFR mutation in NSCLC?
Exon 20 mutations are associated with resistance
Exon 18-24 leads to constitutive activation
Exon 19 and 21 are associated with sensitivity to EGFR inhibitors
374
Urease, indole, and ornithine decarboxylase in P. mirabilis and P. vulgaris?
• P. mirabilis and P. vulgaris are both urea positive. Only P. vulgaris is indole positive, and only P. mirabilis is ornithine decarboxylase (ODC) positive.
375
Slide and tube coagulase tests for S. aureus and S. lugdunensis?
S. aureus - slide and tube positive
| S. lugdunensis - slide positive or negative and tube negative
376
```
Indicate shelf life of RBCs:
ACD/CPD/CD2D
CDPA-1
AS
Irradiated units
```
ACD/CPD/CD2D: 21
CDPA-1: 35
AS: 42
Irradiated units: 28 days or original outdate, whichever is sooner
377
How soon after autologous donation can the patient have surgery?
3 days
378
T-PLL is characterized by this molecular event?
in(14) - involving oncogenes TCL1A and TCL1B
379
SDH mutations, including germline mutations, are associated with these 3 neoplasms?
pheochromocytomas, paragangliomas and GIST.
380
Organophosphate poisoning:
- parasympathetic or sympathetic response?
- Due to inactivation of?
- Antidote?``
Parasympathetic response
Inactivation of acetylcholinesterase
Atropine
381
What are the zones of the SPEP from left to right?
The zones in the SPEP from left to right are: Pre-albumin (contains retinol binding protein and transthyretin) Albumin (contains albumin), Alpha-1 (contains alpha-1-antitrypsin, thyroid-binding globulin, HDL, prothrombin, transcortin and alpha-1 acid glycoprotein (orosomucoid)), Alpha-2 (contains alpha-2-macroglobulin, ceruloplasmin and haptoglobin), beta (contains transferrin, LDL, hemopexin, fibrinogen, C3 and IgA) and the gamma zone (contains immunoglobulins and CRP).
382
The sequence of alkaline gel for hemoglobin electrophoresis is:
+(Anode) A F S C (Cathode)-
383
How should FFP be thawed for use?
Water bath at 30-37 C or FDA approved microwave
384
What hepatitis virus is a DNA virus?
Hepatitis B
385
What is Carney's triad and what gene is hypermethylated?
Pulmonary hamartomas, GIST, and paragangliomas
| SDHD
386
How does abciximab work?
Monoclonal antibody against GpIIb/IIIa
387
Xp11 translocation renal cell carcinomas are associated with this IHC stain?
TFE3
388
t(6;11) renal cell carcinoma is associated with this gene and how do you look for these gene?
TFEB, FISH
389
HLRCC is associated with mutations in this gene?
fumarate hydrotase
390
What causes Gaucher's disease?
Glucocerebrocidase deficiency
391
What is the most common worm infection in the US? What about tapeworm?
Hymenolepis nana (“dwarf tapeworm") is the most common tapeworm infection in the U.S. (the most common worm infection in the U.S. is Enterobius vermicularis).
392
Which malaria has a banana shipped gametocyte?
“FA"lciparum - “FAt banana"
393
What is the characteristic features of chondroblastoma?
chicken-wire calcifications
394
What are the types of vWD?
Type 1: quantitative deficiency
Type 2: qualitative deficiency
-2A: inability to form large and intermediate multimers, only short multimers present
-2B: increased affinity of vWF for Gp1b, +/- thrombocytopenia - loss of large monomers
-2M: decreased ability of vWF to bind Gp1b
-2N: vWF cannot hold onto FVIII
Type 3: absence of vWF
Platelet type: increased affinity of Gp1b for vWF, similar to type 2B
395
Staining of a plasmacytoma?
By IHC, plasmacytoma, is positive for CD138, CD38, CD79a, and kappa or lambda light chain restricted. It may stain for EMA, CD117, or CD56.
396
What SPEP pattern is seen in nephrotic syndrome?
Nephrotic syndrome shows hypoproteinemia everywhere except the alpha-2 region, which is increased.
397
Which rRNA is used for rapid identification of fungi?
26S
398
Which blood group systems display dosage?
Rh, MNS, Kidd, Duffy, and Lutheran blood group systems
399
> 90% of non-erythroid cells are myeloblasts, > 3% are positive for MPO or Sudan Black B, < 10% are granulocytes, and myeloblasts are positive for one or more myeloid related antigen including CD13, CD33 or CD117
AML without differentiation
400
Granulocyte transfusion should be given when neutrophils are ??
500/uL
401
Which candida organism(s) are most resistant to fluconazole?
Candida glabrata, Candida krusei
402
Which candida organism is most resistant to amphotericin B?
Candida lusitaniae
403
Staining differences in endometrial and endocervical adenocarincoma?
Endometrioid adenocarcinoma: vimentin, ER and PR; endocervical carcinoma: p16, p53, CEA
404
What are the most common mutations in PTC?
BRAF, RAS, RET/PTC - mutually exclusive
405
What is the most common mutation in FTC?
RET or PAX8/PPARy
406
What happens to blood glucose in POC devices with high and low HCT?
High HCT - underestimates glucose
| Low HCT - overestimates glucose
407
What is a potential consequence of long term administration of low molecular weight heparin?
Osteoporosis
408
Large colony variants of Streptococcus groups C and G were reclassified as? The small colony variants (≤0.5 mm) of groups C and G have been placed in the ______ group.
S. dysgalactiae subsp. equisimilis (SDSE).
| S. anginosus
409
20% of cases of familial ALS are associated with mutations in?
SOD1
410
The largest protozoan and the only ciliate that infects humans?
Balantidium coli
411
A band that migrates between CK MB and CK MM?
MacroCK, seen in asymptomatic elderly women
412
A band that migrates to the right of CK MM?
mitochondrial CK seen in metastatic disease
413
Which aspirgillis is a carcinogen for HCC?
A. flavus
414
Benign epididymal tumor in patients with VHL?
papillary cystadenoma
415
Describe lichen planus?
Lichen planus: thickened layers of the epidermis with apoptosis and Civatte bodies in the basal layer. Sawtooth rete ridges. Band of lymphocytes.
416
Which esterase is specific for granulocytes?
Chloracetate esterase
417
Middlebrook agar shows what when growing mycobacteria?
Chording
418
A breast sentinel node isolated tumor cell is defined as?
malignant cells present no more than 0.2 mm and less than 200 cells.
419
A breast sentinel node micro metastasis is defined as?
tumor cell deposit >0.2 mm and/or >200 cells, but <2 mm.
420
Epithelial cells in micro glandular adenosine are strongly positive for?
S100
421
Invasive apocrine carcinoma of the breast IHC profile?
ER, PR, Her2 negative
| AR+, GCDFP+
422
What is the criteria to call a phyllodes tumor malignant?
stroll overgrowth, >10/10 mits/10 HPF, infiltrative borders, marked stroll atypia, and increased stroll cellularity.
423
Which cytokine is thought to drive castleman's disease?
IL-6
424
What is the one single best test for iron deficiency anemia?
Serum ferritin
425
LD and serum bilirubin in B12 or folate deficiency?
High LD, mild to moderate elevation in bilirubin
426
Fanconi's anemia is considered this type of syndrome and is caused mostly by these 3 genes?
Chromosomal breakage syndrome
| FANCA, FANCC, FANCG
427
Pure red cell aplasia is also known as?
Blackman Diamond Syndrome
428
A high density or over expression of the I antigen on red cells is associated with these 2 anemias?
Congenital dyserythropoietic anemia and Blackman Diamond Syndrome
429
What is the WHO definition of anemia?
```
Men 13
Women 12 (11 if pregnant)
```
430
Increased indirect bilirubin is associated with intra or extravascular hemolysis?
Extravascular
431
In addition to clinical signs and symptoms, these changes in cTnI are associated with myocardial necrosis?
If cTnI initially abnormal - >20% change at 3 or 6 hours
If cTnI initially normal - >50% change at 3 or 6 hours
432
What are the negative acute phase reactants?
Prealbumim
Albumin
Transferritin
433
In patients receiving chemotherapy, what may herald the onset of neutropenia?
Monocytopenia
434
A double spike of albumin denotes?
Bisalbuminemia, no clinical consequence.
435
Balanitis xerotica obliteratans is also know as?
Lichen sclerosis
436
Which malaria causes cerebral malaria?
P. falicparum
437
Carney's Complex?
endocrine neoplasia, atrial myxomas, skin pigmentation and psammomatous melanotic schwannoma.
438
What are the two most frequent types of ectopic epithelium encountered in Meckel's diverticulum?
1. Gastric
| 2. Pancreatic
439
What is the target of HPV viral proteins E6 and E7?
E6: p53 and telomerase
E7: RB - leads to p16 overexpression
440
Which Candida is associated with neonatal and pediatric invasive infections?
C. parapsilosis
441
which meningiomas are grade II?
Chordoid and clear cell
442
Which meningiomas are grade III?
Rhabdoid and papillary
443
cryptococcus on bird seed agar is this color?
Brown
444
IHC profile of chordomas?
S100+, EMA+, CK+
445
Tangier's disease shows absence of?
HDL
446
Hemoglobin H
(-,-), (-,alpha)
447
The most common clonal molecular alteration in PMF is?
Janus kinase 2 V617F (JAK2 V617F)
448
Decomposition will produce this pattern of Na, Cl, and K in vitreous humor?
Decreased Na and Cl, increased K
449
Loeffler's agar shows organisms with metachromatic granules.
C. diphtheria
450
For hemoglobin electrophoresis, the correct sequence on alkaline gel is _________, and the correct sequence on acid gel is _____________?
+(Anode) A F S C (Cathode) -
| +(Anode) C S A F (Cathode)-
451
What cytokine stimulates marrow fibrosis?
TGF-beta1
452
Rh-null phenotype results in this red cell deformity?
Stomatocytosis
453
Which malaria's have Schuffner's dots?
P. ovalae and P. vivax
454
he most common antibodies involved in hemolytic disease of the fetus and newborn are?
anti-D, anti-K, anti-Fya, anti-C and anti-c.
455
Does anti-K cause HDFN?
No, but surpasses fetal erythropoiesis.
456
CLL/PLL is defined as?
11-55% prolymphocytes
457
Most common cytogenetic abnormality in CLL/SLL?
trisomy 12
458
Where do mantle cell lymphomas typically arise?
Waldeyer's run and GI tract
459
Tranlocation in mantle cell lymphoma?
t(11;14)
460
Follicular lymphoma is made up of these two types of cells?
centrocytes (small cleaved cells)
| centroblasts (large noncleaved cells)
461
How is FL graded and what are the grades?
- proportion of centroblasts found in 10 random 40X fields
```
Grade 1: 0-5
Grade 2: 5-15
Grade 3: >15
-3A: some residual centrocytes
-3B: no residual centrocytes
```
462
MALTomas are this type of lymphoma?
MZL
463
In additional to typical B cell markers, Hairy Cell Leukemia is positive for?
CD11c, CD25, CD103, annexin A1, and cyclinD1
464
CD5 and CD23 in PLL?
both negative
465
Lymphoplasmacytic lymphoma IHC:
```
CD19/20 +
CD38 +
sIg bright
cIg positive
negative to weak CD5, CD23, CD10
```
466
Translocation in lymphoplasmacytic lymphoma?
t(9;14)
467
Glomus cells are _____ for SMA, and ______ for CD31?`
positive, negative
468
The spindle cells of PASH are positive for?
SMA and vimentin
469
Hans classification of DLBCL?GC
CD10+ (30% of cells) - GCB type
CD10-, BCL-6-, ABC
CD10-, BCL-6+, MUM1+, ABC
CD10-, BCL-6+, MUM1-, GCB
470
BCL6 and BCL2 in primary DLBCL of the CNS?
BCL6+
| BCL2-
471
Name some of the specific subtypes of DLBCL?
```
Primary CNS lymphoma
TCHRBCL
Primary mediastinal (thyme) large B cell lymphoma
ALK+ large B cell lymphoma
Plasmablastic lymphoma
Intravascular large B cell lymphoma
PEL
Leg type primary cutaneous DLBCL
EBV+ DLBCL of the elderly
Lymphomatous granulomatosis
DLBCL associated with chronic inflammation
```
472
EBV+ PTLD usually occurs in this timeframe post-transplant?
the 1st year
473
What organ transplants are most susceptible to PTLD?
heart-lung and liver-bowel
474
The hallmark of CSF protein electrophoreses is?
pre-albumin band
475
Glomerular proteinuria pattern on UPEP?
strong albumin, alpha1 and beta bands
476
Tubular proteinuria pattern on UPEP?
weak albumin, strong alpha1 and beta bands
477
What must the platelet count be in order to diagnose ET?
A platelet count greater than 450 × 109/L
478
What markers can be used to predict the course of IPMN?
MUC2
479
Antibodies against these are seen in pemphigus vulgaris?
desmoglein III and I
480
Coffin-lid crystals in urine are?
Triple phosphate crystals
481
Hand deformities in trisomy 13 and trisomy 18?
13 - polydactyly
| 18 - overlap
482
Translocation seen in MALTomas?
t(11;18)
483
What is the normal lifespan of a native and transfused platelet?
native: 8-12 days
transfused: 3-4 days
484
What mycobacteria are Runyon group 1 (photochromogens)?
M. kanasii, M. simiae, M. marinum and M. asiaticum
485
Mycobacterium ? is a photochromogen at 24 degrees and a scotochromogen at 37 degrees.
Mycobacterium szulgai is a photochromogen at 24 degrees and a scotochromogen at 37 degrees.
486
In addition to standard B cell markers, BL is positive for?
CD10, bcl-6, and C-myc
487
Difference between LBL and ALL?
lesions involving tissue and sparing bone marrow and PB = LBL
>25% marrow or >20% blasts in PB = ALL
488
SPEP with beta-gamma bridging and decreased albumin indicates?
Liver cirrhosis
489
What is Evan's Syndrome?
ITP and AIHA
490
Hyperglycemia will cause this to happen to sodium?
Physiologic shift out of the cell, causing true hyperglycemia
491
How does one correct sodium for hyperglycemia?
[1.6(serum glucose - 100)]/100
492
What is the significance of Ito cells?
- store vitamin A
| - can differentiate into myofibroblasts and create fibrosis
493
Stem cells in the liver are located in the?
Canal of herring, leads to bile ductule proliferation.
494
Periportal pathologies are?
chronic hepatitis, chronic cholestatis (bile ductular reaction)
495
Steatohepatitis is seen in this zone?
zone III, centrilobular
496
Two places one sees ground glass hepatocytes?
HepB and polypharmacy
497
Portal lymphoid follicles +/- micro vesicular steatosis are seen in?
Chronic HepC
498
How do you stage
chronic hepatitis?
Stage: amount of fibrosis:
1: Increased portal fibrosis
2: Fibrosis extends out away from portal tract
3: Bridging fibrosis between portal tracts or from portal tract to central vein
4: Cirrhosis
499
How do you grade
chronic hepatitis?
Grade: look at 2 factors:
1: Degree of interface activity
2: Degree of lobular activity
Increased grade means increased risk of developing fibrosis
500
supernumerary nipples is also known as?
Polythelia
501
What are the breast myoepithelial markers?
p63, myosin heavy chain, calponin, HMWK (C5/6/14)
502
What are the breast luminal markers?
LMWK (CK7,8,18)
503
What antibodies are present in autoimmune hepatitis types 1, 2 and 3?
Are they IgG or IgM?
Increased IgG
Type 1: +ANA or anti-SMA abs (young adult F>M)
Type 2: Anti-LKM abs (liver kidney microsome)
Often seen in kids
Type 3: anti-SLA ab (Soluble liver antigen)
504
Duct ectasia is also know as?
Periductal mastitis
505
Amnion nodosum is seen with?
Oligohydramnios
506
p62 and ubiquitin stain?
Mallory Bodies
507
Idiopathic granulomatous mastitis can be associated with this microorganism?
Corynebacterium
508
Where is folate absorbed?
Proximal jejunum
509
Ringed sideroblasts form when iron deposits in this organelle?
Mitochondria
510
What tumors are known to make EPO?
hemangioblastoma, RCC, uterine leiomyoma, HCC
511
60:40:20:15:5
Total body water : Intracellular : Extracellular : Interstitial : Plasma
512
Normal A1c
Abnormal A1c
A1c diagnostic of DM
Normal A1c <5.7
Abnormal A1c 5.7-6.4
A1c diagnostic of DM 6.5 or above
513
Granulomatous cholangitis?
Primary biliary cholangitis (cirrhosis)
514
What is the Tenny-Parker effect?
Increased syncytial knots and terminal villous hypoplasia
515
Bile lakes are almost pathognomonic for?
Large duct obstruction
516
loss of interlobular bile ducts and foam cell arteriopathy indicate?
Chronic rejection
517
LGL leukemia IHC profile?
CD2, CD3, CD8, CD16, CD57+
518
LGL leukemia IHC profile?
CD2, CD3, CD8, CD16, CD57+ (will be CD3 and CD8 negative if NK type)
519
Long standing celiac disease can give rise to this lymphoma?
Enteropathy associated T cell lymphoma
520
EATL IHC?
CD3+, CD30+, CD4/8-
521
What is fetal papyraceous?
Incorporation of dead twin into placenta
522
What presents with purport fulminans and DIC?
homozygous protein C deficiency
523
If peripheral access is not feasible, which central line is preferred in regards to less infection risk?
IJ/subclavian over femoral
524
How do you calculate INR?
INR = (PT/PTGeoMean)^ISI
525
Normal BUN:Cr and BUN:Cr in pre-renal azotemia?
Normal: 10:1
| Pre-renal: >20:1, sign of hypoperfusion
526
What is the purpose of the amniotic fluid bilirubin (Delta OD450)?
Determine the amount of fetal hemolysis
527
What is a potential normal site of HCG secretion in the perimenopausal woman?
pituitary gland
528
The alpha chain of b-HCG is the same as these hormones?
TSH, FSH, LH
529
What are the HACEK bugs?
```
Haemophilus
Aggregatibacter
Cardiobacterium
Eikenella
Kingella
```
530
Besides the HACEK group, what intracellular bugs can cause culture negative endocarditis?
Rickettsia, Q-fever, Whipple's disease
531
What is Marantic Endocarditis
Nonbacterial thrombotic endocarditis seen in hyper coagulable states
532
What is Libman-Sacks endocarditis and where are the vegetations found?
Seen in lupus erythmatosus
| Vegetation's on both sides of vavles
533
What are the large vessel vasculitides?
Giant cell arteritis
| Takayasu's arteritis
534
What are the medium vessel vasculitides?
```
Polyarteritis nodosa
Kawasaki disease
Thromboangiitis obliterates (Buerger disease)
```
535
What are the small vessel vasculitities?
HSP (IgA)
SLE (IgG)
cryoglobulinermia (IgG and IgM)
Goodpasture's disease
Wegner's granulomatosis (granulomatosis with polyangiitis)
Churg Strauss Disease (eosinophilic granulomatosis with polyangiitis)
Microscopic polyangitis
536
HCG in pregnancy:
- First detectable:
- Doubles roughly every ? hours until ? weeks?
- Remains detectable for ? after delivery?
- First detectable: 6-8 days following conception
- Doubles roughly every 48 hours until 10 weeks
- Remains detectable for 2 after delivery?
537
Fetal fibronectin has a good _______ predictive value in regards to predicting preterm birth?
The absence of fetal fibronectin in cervicovaginal fluids has a high negative predictive value of preterm birth
538
Dilated sinusoids and hepatic atrophy are indicative of?
Budd Chiari Syndrome (outflow obstruction)
539
Where does the iron accumulate in the liver in Hereditary hemochromatosis?
Periportal hepatocytes first, with progression towards the central vein
540
Glycjogenated nuclei in the liver are associated with?
Wilson's disease
541
Name two copper stains?
Rhodanin and Victoria Blue
542
What causes bread and butter pericarditis?
ARF
Uremia
Myocardial infarction
543
What is the most common congenital heart defect?
VSD, 90% close by 1 year
544
Cardiac rhabdomyoma prognosis, immunostain?
Most will spontaneously regress in the 1st year of life
| HMB45+, desmin+
545
Tetralogy of Fallot
VSD
Overriding aorta
Sub pulmonary fibrosis
Right ventricular hypertrophy
546
EM findings of Amyloidosis?
10 nm non-branching fibrils
547
Histology of bile duct hamartoma/von Meyenburg complex?
Irregular shaped, dilated glands in a fibrous stroma.
| Contains mucin or bile
548
How do you diagnose somatic malignancy in a testicular germ cell tumor?
Must take up at least one 4x field.
549
What is thought to be a possible precursor to NLPHL?
Progressive transformation of germinal centers
550
The most common subtype of CHL?
Nodular sclerosis
551
What is the definition of a ringed sideroblast?
At least 5 siderosomes that surround at least a third of the nucleus
552
Isolated loss of Y, 5q-, or 20q- in MDS, prognosis?
Favorable prognosis
553
3 or more anomalies or chromosome 7 anomalies in MDS, prognosis?
Unfavorable prognosis
554
JMML may be associated with this syndrome?
NF1
555
CML:
- p210
- p230
- p190
- p210: normal
- p230: associated with thrombocytosis and neutrophils
- p190: associated with marked monocytosis and Ph+ ALL
556
Which IgG subclass does not cross the placenta?
IgG2
557
```
IF Patterns, antigens detected and disease associations:
Speckled:
Homogenous:
Nucleolar:
Centromere:
```
```
Speckled:
- SSA, SSB, Smith, U1-RNP, PCNA, Scl-70
- SLE, MCTD, Sjogren, scleroderma
Homogenous:
- DNA, histone, dsDNA, ssDNA
- SLE, drug-induced SLE, RA
Nucleolar:
- RNA polymerase 1, u3RNP, PM-scl
- scleroderma, polymyositis
Centromere:
- CENP-A, B, C
- Scleroderma (with CREST), Raynouds
```
558
Renal tumor seen in Burt-Hogg-Dube syndrome?
Chromophobe
559
What makes up the MELD score?
Bilirubin, INR, Creatinine
560
What is Lhermitte-Duclos?
A rare cerebellar tumor associated with Cowden Syndrome.
561
The most common dermatophyte?
T. rubrum
562
Serous cystadenoma of the pancreas is associated with this syndrome?
VHL
563
What defines microinvasion in DCIS?
<1mm or up to 3 foci of <1mm
| treated clinically like DCIS
564
What are the most common mutations in endometrial endometrioid adenocarcinoma?
PTEN and MSI
565
Winter's formula?
PCO2 = 1.5([HCO3-]) + 8 ???
566
Malaria associated with fever every 72 hours? 24 hours?
72: P. malariae
24: P. knowlesi
567
What are the 4 types of AML?
AML with recurrent genetic translocation
AML following therapy
AML myelodysplasia related changes
AML, NOS
568
What are the AMLs with recurrent genetic translocations?
t(8;21) - abundant gray-blue cyto with Auer rods and large granules (RUNX1)
inv(16) - increased abnormal eos (MYH11/CBFB)
t(15;17) -
t(9;11) - monoblastic differentiation (MLL)
t(6;9) - with basophilia (DEK/NUP214)
t(1;22) - megakaryocytic (RMB15/MKL1)
inv(3) - Thrombocytosis, giant agranular platelets (RPN1/EV11)
569
Formula to calculate MCV?
MCV = Hct x 10/RBC
570
Formula to calculate MCHC?
MCHC = (Hgb/Hct)100
571
A high MCHC may indicate?
spherocytosis, cold agglutinin, or lipemia specimen
572
PAS reliably stains positive in this leukemia?
Acute erythroid leukemia
573
What hepatitis B antibody indicates permanent immunity?1
Anti-HBs
574
How do you t ell the difference between T. sodium and T. saginata?
The eggs of Taenia solium (pork) and Taenia saginata (beef) look the same with radial striations and a thick shell. These two are best distinguished by the lateral striations/ uterine branches per side. Taenia solium has < 13, Taenia saginata has > 13. Mnemonic: 13 is an unlucky number, and getting a tapeworm is unlucky. The pig (solium) tapeworm has less than 13 lateral uterine branches (pigs are smaller than cows), and the beef (saginata) tapeworm has more than 13 lateral uterine branches (cows are bigger than pigs).
575
Features of Medullary Carcinoma of the Breast?
- BRCA1 associated
- Syncytial growth in 75% of the tumor
- no glands
- Lymphoplasmacytic infiltrate at periphery or admixed
- nuclear pleomorphism
- complete circumscribed
- better prognosis, triple negative
576
Invasive micro papillary carcinoma is associated with?
Lymph node mets
577
Grading tubules and mits in breast cancer?
1 - >75%, <5
2 - 10-75%, 5-10
3 - <10%, >10
578
When is a breast cancer determined to be HER2 positive by IHC, FISH?
Positive IHC (3+) = strong membranous staining in >30% of cells at 10X
Positive FISH = HER2/CEP17 >2 or HER2/CEP17 <2 but copy number >6
579
YUPA
YUPA: Yellow Urate Parallel to the Axis.
580
What substance(s) neutralize P1?
Hydatid cyst fluid and pigeon eggs
581
What substance(s) neutralize I?
Breast milk
582
Stain helpful in diagnose of FNH?
Map-like/geographic glutamine synthetase
583
Dolichos bifloris binds to?
A1
584
Alex europaeus bind to?
H
585
What is Caroli disease and Caroli syndrome?
AR conditions associated with ARPCKD
Caroli disease: intrahepatic dilation of bile ducts
Caroli syndrome: above associated with congenital hepatic fibrosis
586
How to calculate number of units needed to test to find antigen negative blood?
1/(antigen negative units in percent) X 100
587
What are 3 potential causes of a D+ patient with an apparent anti-D upon typing?
1. WAIHA
2. Anti-LW
3. Partial D
588
Described the different grades of cellular rejection in the heart?
Grade 1R: interstitial and/or perivascular infiltrate with up to one focus of myocyte damage
Grade 2R: 2+ foci of myocyte damage
Grade 3R: Diffuse inflammation, multiple foci of myocyte damage , hemorrhage, edema, and vasculitis
589
What pattern is represented by all cells in panel and auto control positive at AHG only?
Warm autoantibodies (IgG)
590
What pattern is represented by all cells in panel except auto control positive at AHG only (weak 1-2+)?
HTLA (chido or rodgers)
591
What pattern is represented by all cells in panel and auto control positive at IS only?
Cold autoantibody (IgM)
592
DAT with anti-IgG or anti-IgG and anti-C3 indicates?
Warm autoantibody (IgG)
593
DAT anti-C3 only?
Cold autoantibody (IgM)
594
Where are exophytic and inverted papillomas found in the nasal cavity?
Exophtic: septum
Inverted: lateral walls and sinuses
595
Where are angiofibromas typically located?
posterior nasal cavity
596
What is the most common salivary gland tumor in children?
MEC
597
Which salivary gland tumor typically arises only in the minor salivary glands?
PLGA
598
What is a syringoma?
Syringoma has groups of ducts lined by two layers of epithelium.
599
In which type of HIT is it ok to give platelets?
HIT type 1
600
How do you classify thymomas?
Thymoma classification: A: spindled cells, B1 -> B3 epithelioid cells with decreasing amount of lymphocytes. AB: spindle and epithelioid cells. C: carcinoma.
601
```
What types of epithelium are usually associated with the following:
MUC1
MUC2
MUC5AC
MUC6
```
MUC1: Pancreatobiliary
MUC2: Intestinal
MUC5AC: Gastric
MUC6: pyloric
602
What are the 4 types of hepatic adenomas?
HNF-1a - steaktotoc, loss of LFABP
Inflammatory/Telaniectatic - serum amyloid A/CRP
Beta-catenin mutated - nuclear beta catenin, increased risk of HCC
Unclassified
603
Stain helpful in diagnose of FNH?
Map-like/geographic glutamine synthetase
604
What condition is commonly associated with temporal arteritis?
Polymyalgia rheumatica
605
Polyarteritis is associated with this in about 30% of cases?
HepB infection
606
What is Caroli disease and Caroli syndrome?
AR conditions associated with ARPCKD
Caroli disease: intrahepatic dilation of bile ducts
Caroli syndrome: above associated with congenital hepatic fibrosis
607
What is Alagille Syndrome?
AD paucity of bile ducts with mutations in Jagged 1
608
Describe the QUILTY A and QUILTY B lesions?
QUILTY A: collection of lymphocytes confined to the endocardium with preserved CD21 framework
QUILTY B: As in type A, but with extension in to underlying myocardium
609
Described the different grades of cellular rejection in the heart?
Grade 1R: interstitial and/or perivascular infiltrate with up to one focus of myocyte damage
Grade 2R: 2+ foci of myocyte damage
Grade 3R: Diffuse inflammation, multiple foci of myocyte damage , hemorrhage, edema, and vasculitis
610
Cystic medial degeneration (cystic medial necrosis) is associated with?
Marfan's syndrome
611
How does one grade pancreatic NETs?
NET 1: <2 mits/10HPF, <2% Ki67
NET 2: 2-20 mits/10HPF, 3-20% Ki67
NET3: >20 mits/10HPF, >20% Ki67
612
VMA, urinary metanephrines and catecholamines are seen in?
Paraganglioma and pheochromocytoma
613
VMA and HVA are seen in?
Neuroblastoma
614
When does one expect to see a trough in the cortisol level? When in the peak?
Trough - midnight
| Peak - 8 AM
615
What is the purpose of the low and high does dexamethasone suppression tests?
Low - does the pt have cushings syndrome
| High - does the pt have cushings disease
616
Solid pseudo papillary tumor is always negative for?
Chromogranin and ER
617
What 3 conditions will cause the urine dipstick to turn positive for blood?
Hematuria, hemoglobinuria, and myoglobinuria
618
The urine dipstick is most sensitive to this ketone?
acetoacetic acid
619
What are potential false positives for urine leukocyte esterase?
Trichomonads and eosinophils
620
What urine crystal form envelopes?
Calcium oxalate
621
The majority of kidney stones are made of this crystal?
Calcium oxlate
622
How many red cells are allowed in a unit of granulocytes?
<2 mL
623
Glomus tumor is positive for?
Desmin and SMA
624
EMA and desmin in bening and malignant mesothelium?
Benign: EMA-, desmin+
Malignant: EMA+, desmin-
625
Focal nodular hyperplasia is characterized by these 3 findings?
Nodular architecture
Abnormal vasculature
Bile Duct Proliferation
626
Arginine hydrolysis and positive Voges-Proskaur tests ate seen in?
S. anginosus group
627
In the ideal gaussian distribution how much of the population falls within 1 SD, 2 SD, or 3 SD?
1 SD: 68.2%
2 SD: 95.5%
3 SD: 99.7%
628
What is the hallmark genetic event in the botryoid variant of Embryonal Rhabdomyosarcoma?
LOH 11p15.5
629
What stains will highlight MG bodies of malakoplakia?
PAS, von Kossa, Prussian blue
630
Atypical fibroxanthoma immunostain?
CD10, CD117 and CD68; CD163 is less sensitive but may also be positive.
631
What is another name for Warthin's Tumor?
Papillary cystadenoma lymphomatosum
632
FISH in urothelial carcinoma detects?
Aneuploidy of 3, 7, 17, or loss of 9p21
633
Blood groups in caucasians from highest to lowest prevalence?
0 > A > B > AB
634
Which subtype of basal cell carcinoma is most likely to metastasize?
Basosquamous
635
What is the most common cause of nephrotic syndrome in adults and children?
Adults: FSGS
Children: Minimal change disease
636
Which enteric are H2S producers?
Salmonella, Citrobacter and Proteus
637
What is the relative risk of invasive carcinoma in:
- Cystic/Benign epithelial hyperplasia?
- Atypical hyperplasia?
- DCIS or LCIS?
- 1.5-2X
- 4-5X
- 8-10X
638
What medical treatment can be used to treat infantile hamangiomas?
Propranolol
639
How does the MecA gene confer resistance?
PBP2A protein, a low affinity penicillin binding protein
640
How is LCH classified?
It is classified as unifocal (“eosinophilic granuloma"), multifocal unisystem (Hand-Schuller-Christian disease), multifocal multisystem (Letterer-Siwe disease, poor prognosis), and pulmonary Langerhans cell histiocytosis (strong association with smoking).
641
IHC staining differential of Urothelial carcinoma, reactive atypia, and normal
Carcinoma: full thickness CK20, absent or basal CD44, strong and diffuse p53
Reactive/normal: CK20 in umbrella cells only, paranasal or slightly increased CD44, and p53 negative
642
What is the normal urothelial thickness?
5-7 layer
643
Which variants of urothelial carcinoma are the most aggressive?
Nested and micropapillary
644
Is verrucous carcinoma of the bladder HPV associated?
No, p53+
645
IHC of inflammatory pseudo tumor?
CK+, actin+, vimentin+, 2/3rds ALK+
646
Most common Rh+ genotypes in whites and blacks?
Whites: R1/R1 or R1/r
Blacks: R0/R0 or R0/r
647
What is the rate of sensitization if Rh+ blood is transfused into a Rh- individual?
20-30%
648
Anti-E should prompt a search for?
Anti-c
649
Anti-G looks like?
Antobides to both D and C
650
What is the risk for carcinoma in simple hyperplasia, complex hyperplasia, and CAH?
1%, 3%, or 30%
651
What percentage of patient with CAH have carcinoma?
25-50%
652
>5 mits/HPF gets one to uterine leiomyosarcoma in these variants?
Epihtelioid and myxoid
653
What does GAVE stand for in stomach pathology?
Gastric astral vascular ectasia
654
In the small bowel, how many lymphocytes should be present?
1 for every 5 enterocytes
655
Most sensitive and specific antibodies in celiac disease?
Sensitive celia needs tissues and every measly thing has to be in a specific order
656
How are trophoblastic tumors categorized?
All are CK18/HLAG+
if p63 negative/hPL++
Ki67 <1%: exaggerated placental site
Ki67 >1%: PSTT
if p63++/hPL +/-
Ki67 <10%: PSN
Ki67 >10%: Epitheliod trophoblastic tumor
if p63+ or hCG+: choriocarcioma
657
What can be used to monitor glycemic control in patients with hemolytic disorders?
In hemolytic conditions, fructosamine (glycated albumin) is more useful for the monitoring of longer term glycemic control than HbA1c.
658
Molecular findings in HLH?
PRF1, UNC13D, or STX11
659
What genetic events are usually present in serrated adenomas?
BRAF mutations (80%) and MSI.
660
How often must you verify cesium-137 and cobalt-60 irradiation?
cesium-137 - 12 months
| cobalt-60 - 6 months
661
How is renal cell carcinoma graded?
1. small round nuclei without nucleoli
2. irregular nuclear contours, inconspicuous nucleoli
3. nucleoli visible at 10x
4. large hyper chromatic, pleomorphic nuclei, single or multiple nucleoli
662
Low and high grade serous mutations?
LG: KRAS (50%), BRAF (50%)
HG: p53
663
Gyn clear cell carcinoma mutation?
ARID1A, PIK3CA, PTEN
664
Mutation in granulosa cell tumors?
FOXL2
665
All sex cord stromal tumors are positive for these 2 stains?
Calretinin and inhibiin
666
INI-1 negative tumor?
```
Rhabdoid tumor of the kidney
ATRT
Medullary carcinoma of the kidney
Epithelioid sarcoma
Malignant myoeuithlioma
Epithelioid MPNST
MERT
```
667
Size cutoff for AAH, AID, and invasive adenocarcinoma?
AAH <5 mm
| AIS <3 cm
668
In lung cancer, EGFR and ALK testing should be done on these tumor?
All NSCLC with adenocarcinoma component
669
What characterizes NF2?
```
Multiple
Inherited
Schwannomas
Meningiomas
Ependymomas
```
670
When is the pseudo glandular phase of lung development and what develops?
Development of the large airways to the terminal bronchioles
| 6-16 weeks
671
When is the acinar/canalicular phase of lung development?
16-26 weeks (this phase must be completed in order for any chance of extrauterine lung function
672
When is the saccular phase of lung development
26-36 week
673
when is the alveolar phase of lung development?
36 weeks to 10 years
674
What is Legg-Calve-Perthes disease?
idiopathic hip avascular necrosis in children
675
USP6 rearrangement is seen in?
ABC
Nodular fasciitis
cellular fibromas of the tendon sheath
676
Osteofibrous dysplasia is also know as?
Ossifying fibroma
677
Osteofibrous displasia may progress to?
Adamantinoma
678
Sharpey fibers may be seen in?
Fibrous dysplasia
679
MDM2 mutations are seen in these bone tumors?
Parosteal osteosarcoma
| Well-differentiated intramedullary osteosarcoma
680
What two conditions lead to cholesterol lung effusions?
Rheumatoid arthritis and MTB infection
681
Which type of hodgkin lymphoma is more common in women?
Classic nodular sclerossi
682
Describe the CPAMS?
Type 0: Tracheal bronchial, fatal
Type 1: Bronchial/bronchiolar (1 large cyst with smaller surrounding cysts)
Type 2: bronchiolar (back to back bronchial)
Type 3: bronchiolar/alveolar
Type 4: alveolar large cyst in periphery of lobe
683
Which sarcomas commonly metastasize to lymph nodes?
Epithelial sarcoma
Alveolar rhabdo
Clear cell sarcoma
684
What three features are seen in atypical polypoid adenomyoma?
fascicles of smooth muscle
atypical epithelial glands
squamous metaplasia
685
In what tumors does one see the ETV6-NTRK3 translocation
cellular congenital mesoblastic nephroma
Secretory carcinomas (breast and salivary gland)
Leukemia (AML)
686
INI-1 and BRG-1 are also known as?
INI-1: SMARCB1
| BRG-1: SMARCA4
687
What is the most common HPV seen in veruccus vulgarism?
HPV 2 and 4
688
What HPVs are seen in plantar warts?
HPV 1, 2, 4, 63
689
What can cause a false positive PPD?
BCG vaccine
| Other non-tuberculous mycobacteria
690
EIA for galactomanin is used to diagnose?
Aspergillum species infection
691
IHC difference between classic and spermatohytic seminoma?
Classic: PLAP, OCT3/4, and CD117 +
Spermatohytic: PLAP, OCT3/4 negative, CD117 weak
692
Who makes up the Runyon IV (fast growing) mycobacteria?
```
M. fortuitous
M. abcesses
M mucogenicum
M. thermoresitbile
M. chelonae
```
693
KIA/TIA slants: K/K (red/red)?
not enteric, maybe pseudomonas
694
KIA/TIA slants: K/A (red/yellow)?
lactose non-fermenter
695
KIA/TIA slants: A/A (yellow/yellow)?
glucose and lactose fermenter
696
What 3 haemophylis species requires X and V?
H. influenze
H. haemolyticus
H. aegyptius
697
What are some of the more common reasons to see arterial thromboses?
Atiphospholipid syndrome
Prothrombin 20210
HIT
698
What causes Yaws?
T. pallidum sps. perteneum
699
What causes Bejel?
T. pallidum sps. endemicum
700
What bacteria makeup MTB complex?
```
MTB
M. kansasii
M. africanum
M. Microti
M. bovis
M. canetti
```
701
Which microfilariae are sheathed?
Whucheria
Brugia
Loa loa
702
What is the most common combination in testicular mixed germ cell tumor?
Embryonal and teratoma
703
Which testicular germ cell tumor is the most likely to be bilateral?
Spermatohytic tumor
704
MyoD1 staining in ASPS?
cytoplasmic
705
3 entities that may be seen on the crown of an unerupted tooth?
Dentigerous cyst
OKC
cystic ameloblastoma
706
What is considered a micro satellite high or low tumor?
High - 2 foci of instability
| Low - 1 focus of instability
707
Describe the emphysema of AAT?
panacidar, predominantly basal
708
Poorly differentiated thyroid carcinoma by the Turin Criteria?
```
Solid of trabecular growth
Absence of PTC nuclei
Presence of at least one of the following;
convoluted nuclei (raisinoid)
Mits > or equal to 3/10 HPF
Necrosis
```
709
Low power normal skin pathologies?
Tina
Urticaria
Viral exanthem
Amyloidosis
710
What are the findings in Sweets syndrome?
Papillary dermal edema
| Dense dermal infiltrate of neutrophils
711
What conditions show a vacuolar interface dermatitis?
```
Drug
Dermatomyositis
Erythema multiform
Lichen anything
Lupus
GVHD
```
712
Lichen planus cannot have?
Parakeratosis or eos
713
What is the "red, white. and blue" of lichen sclerosis?
Red: compact epidermis
White: pale dermis
Blue: perivascualr lymphoid infiltrate
714
What is a trichilemmoma and when is it seen?
Smooth lobule of glycjogenated cells hanging from the epidermis
Cowmen's syndrome
715
What is the most common type of melanoma?
Superficial spteading
716
What melanoma has the worst prognosis?
Nodular
717
Lobular panniculitis is most indicative of?
Lupus panniculitis
718
The rash of lyme disease is known as?
Erythema migrans
719
Protein encoded by SMARCA4
BRG1
720
Protein encoded by SMARCB1
INI1
721
How is pulmonary adenocarcinoma defined?
Epithelial malignancy with glandular differentiation with mucin production or pneumocyte maker expression
722
What are the histologic patterns of conventional pulmonary adenocarcinoma?
```
Acinar
Papillary
Micropapillary
Lepidic
Solid
```
723
What are the recognized variants of pulmonary adenocarcinoma?
Invasive mucinous
Colloid
Fetal
Enteric
724
Define minimally invasive pulmonary adenocarcinoma
Tumor 3 cm or less (lepidic) with 5 cm or less invasive component
725
What is the size cutoff for atypical adenomatous hyperplasia?
5 mm or less
726
How is pulmonary adenocarcinoma in situ defined?
Lepdic tumor 3 cm or less is size
727
Pulmonary squamous cell carcinoma is defined as?
Epithelial tumor with keratinization, intracellular bridges, or an undifferentiated neoplasm with squamous markers
728
Which pulmonary carcinoma driver mutations are typically seen in nonsmokers? Smoker?
Non-smoker: ALK or EGFR
| Smokers: KRAS
