diagnostic

Question 1

Enzyme deficient in Gaucher disease.

Answer 1

B- glucosidase and Glucocerebrosidase

B- glucosidase: Fabry disease
Glucocerebrosidase: Krabbe disease

Question 2

Initial vascular event in acute inflammation.

Answer 2

Vasoconstriction of the arterioles.

then:
* Vasodilation
* Increased vascular permeability
* Swelling
* Reduced blood flow

Question 3

After a few minutes of re-anastomosing the vessels in kidney transplant, you noticed the kidney became mottled, cyanotic and flaccid. You suspect rejection of the kidney. What is most likely the histologic finding in the rejected organ?

Answer 3

Extensive interstitial mononuclear cell infiltrate and edema. (hyper acute rejection)

Question 4

What is the type of hypersensitivity demonstrated by the type of rejection the kidney underwent?

Answer 4

type II

- preformed antibodies acting against transplanted tissue.

Question 5

3 month old female CXR revealed interstitial pneumonitis with overaeration, and absence of thymic shadow, with a normal-looking heart silhouette. What is most likely diagnosis?

Answer 5

DiGeorge syndrome

*X-linked and autosomal recessive

Question 6

SAFEST treatment for DiGeorge syndrome.

Answer 6

Fetal thymus transplant

Question 7

Ashoff bodies is seen in?

Answer 7

Acute rheumatic fever
(pancarditis)
* composed of foci of lymphocytes and plump activated macrophages, can be found in all layers of the heart.

Question 8

Element of immune system that plays part in pathogenesis of Type I hypersensitivity.

Answer 8

Th2 cells, IgE antibodies and mast cells.

• Type II: IgG and IgM
• Type III: IgG and IgM-antigen complexes
• Type IV: Sensitized T-cells

Question 9

What is the most common histologic type of lupus nephritis?

Answer 9

Type 4 — MC and worst prognosis

Type 1: no observable renal involvement
Type 2: Mesangial
Type 3: Focal proliferative
Type 4: Diffuse proliferative
Type 5: Membranous

Question 10

Airway remodeling collectively refers to what histologic findings?

Answer 10

• Overall thickening of the airway wall.
• Increase in size of submucosal mucus glands and mucus metaplasia of airway epithelial cells.
• Sub-basement membrane fibrosis.
• Increased vascularity.
• Hypertrophy and hyperplasia of bronchial smooth muscles.

Question 11

55/M presents with chest pain 5hrs PTC,; described as retrosternal in location, radiating to the right shoulder, described as heavy compressing in character, lasting for 30 minutes unrelieved by rest. What is expected histologic findings in the affected tissue at the time of presentation?

Answer 11

Early coagulation necrosis, edema and hemorrhage.

5 hours post MI

Question 12

The patient was subsequently admitted for a week, with unremarkable course in the wards. He followed up with his physician after he was discharged. What is the expected histologic finding in the affected tissue?

Answer 12

Well-established granulation tissue with new blood vessels and collagen deposition.
(14 days post MI)

Question 13

3/F consulted with DOB for the past 2 days. Patient is not cyanotic. Pertinent PE revealed a grade 4/6 holosystolic regurgitant murmur heard loudest at the left lower sternal border. CXR revealed a normal aortic knob size with increased pulmonary vascular markings. 15-lead ECG revealed LVH. What is the diagnosis?

Answer 13

Ventricular Septal defect

Question 14

What is the most common type of VSD?

Answer 14

Perimembranous

MC ASD type: Ostium secundum