Histopath

Question 1

What histological finding will be seen in the kidneys in cases of post-Streptococcal glomerulonephritis?

Answer 1

Immune complex deposition

Question 2

Malignant HTN, what is the classic renal finding on histology

Answer 2

fibrinoid necrosis

Question 3

What finding may be present in the kidneys in a patient with Multiple Myeloma?

Answer 3

Amyloid deposition

Question 4

A man is found to have a tumour in head of his pancreas that has invaded into portal vein, and there is a palpable mass in the liver - cancer type?

Answer 4

Adenocarcinoma

Question 5

Man with H pylori, abnormal area in antrum, mitotic figures and cells with raised nuclear to cytoplasmic ratio, not invading the basement membrane

Answer 5

MALT (Mucosal associated lymphoid tissue) B cell lymphoma

Question 6

Tumour with keratin and intercellular bridges

Answer 6

Squamous cell carcinoma

Question 7

Most common tumour of the appendix

Answer 7

Neuroendocrine tumour

Question 8

Which cancer develops in Barrett’s oesophagus?

Answer 8

Adenocarcinoma

Question 9

Which process takes place in the oesophagus in response to exposure to stomach acid?

Answer 9

Metaplasia

Question 10

What happens to the body of the stomach in a patient with pernicious anaemia?

Answer 10

Chronic gastritis and atrophy

Question 11

Which cancer is associated with H.Pylori infection?

Answer 11

MALT (B cell lymphoma)

Question 12

Which cancer is associated with Coeliac disease patients, particularly if they do not control
their diet

Answer 12

Enteropathy-associated T-cell lymphoma

Question 13

Most common type of malignancy in the breast?

Answer 13

Invasive ductal carcinoma

Question 14

What breast cancer is also known as non-specific type?

Answer 14

Invasive ductal carcinoma

Question 15

Cancer which has a high, medium and low stage to it (breast)

Answer 15

Ductal carcinoma in situ

Question 16

Fibro-epithelial tumour with abundant stromal elements

Answer 16

Phyllodes tumour

Question 17

A man presents with the symptoms of a UTI and acute onset costovertebral pain. He is found to have pus cells and blood in his urine. What is the most likely cause?

Answer 17

Acute pylonephritis

Question 18

A lady with loin-to-groin pain, haematuria and pain at the end of micturition. What is the most likely cause?

Answer 18

Renal calculi

Question 19

A lady has frank painless haematuria and a mass palpable on one side. What is the most likely cause?

Answer 19

Renal cell carcinoma

Question 20

Patient with a pancreatic mass following acute pancreatitis

Answer 20

Pancreatic pseudocyst

Question 21

Patient with a history of severe abdominal pain; during cholecystectomy the surgeons noticed grey specks around and on the pancreas

Answer 21

Ductal adenocarcinoma

Question 22

Patient with hypoglycaemia and pancreas mass

Answer 22

Insulinoma

Question 23

Patient with a carcinoma in their liver, what was the original carcinoma in their pancreas that caused the metastases?

Answer 23

Ductal adenocarcinoma

Question 24

The presence of what in the lymph nodes would support a diagnosis of sarcoidosis

Answer 24

granuloma

Question 25

What is deposited in the kidneys in Multiple Myeloma?

Answer 25

AL Amyloids

Question 26

Radiosensitive cancer of the testicle in a young man with a white/smooth appearance?

Answer 26

Seminoma

Question 27

Patient with a cancer in their bladder following chronic schistosomiasis

Answer 27

Squamous cell carcimoma

Question 28

Most common bladder cancer

Answer 28

Transitional cell carcinoma

Question 29

Man goes deaf with bowed legs

Answer 29

Paget's disease

Question 30

Vertebral fracture, high paraprotein

Answer 30

MM

Question 31

Eczematous nipple rash caused by individual ‘malignant cells’?

Answer 31

Paget's breast

Question 32

Which thyroid cancer most commonly metastasises to the lymph nodes?

Answer 32

Papillary

Question 33

Calcitonin secreting tumour?

Answer 33

Medullary thyroid

Question 34

What virus increases risk of nasopharyngeal cancer?

Answer 34

EBV

Question 35

Young guy falls and hits head, two days later loses consciousness

Answer 35

subdural haemorrhage

Question 36

An ovarian mass is found in a Japanese woman, and histology shows signet ring cells

Answer 36

Kruckenberg tumour – gastric metastasis

Question 37

What liver change occurs in diabetic patients

Answer 37

Non-alcoholic fatty liver disease or Non-alcoholic steatohepatitis

Question 38

A 15 year old presents with signs of ataxia. Imaging shows a brain tumour extending outwards from cerebellum and invading subarachnoid space. What is the most likely type?

Answer 38

Medulloblastoma

Question 39

Most common oesophagal cancer in the UK

Answer 39

Adenocarcinoma

Question 40

What type of gastric cancer is most common?

Answer 40

Adenocarcinoma

Question 41

Which disease do you see in both MEN1 and MEN2a?

Answer 41

Parathyroid hyperplasia

Question 42

What type of shunt is seen in Tetralogy of Fallot?

Answer 42

R to L

Question 43

Insulinoma. What would you find? Low cortisol, low free fatty acids, low pro-insulin, low glucagon, low c-peptide

Answer 43

Low free fatty acids

Question 44

Woman, non-smoker, peripheral lung tumour, which type is it most likely to be?

Answer 44

Adenocarcinoma

Question 45

Most common lung cancer

Answer 45

Squamous cell carcinoma

Question 46

Squamous cell lung cancer - which paraneoplastic syndrome?

Answer 46

PTH secretion

Question 47

Small cell lung cancer - which paraneoplastic syndrome?

Answer 47

ADH (SIADH), ACTH secretion

Question 48

How does a melanoma spread? a. Lymphoid b. Haematological c. Perineural d. Iatrogenic e. Transcoelomic

Answer 48

Lymphoid

Question 49

What is a common finding in someone who has portal hypertension?

Answer 49

Splenomegaly

Question 50

Which cancer is associated with asbestos?

Answer 50

Mesothelioma

Question 51

50 year old man with Midshaft femur fracture – What type of cancer?

Answer 51

Chondrosarcoma (most common above 40yo)

Question 52

Most common cause of constrictive pericarditis in the developing world

Answer 52

TB

Question 53

Commonest cause of portal vein thrombosis

Answer 53

liver cirrhosis

Question 54

Intestinal metaplasia in Barrett’s (columnar-lined) oesophagus is most commonly due to the presence of which cell?

Answer 54

goblet cells

Question 55

Which type of necrosis is associated with a MI?

Answer 55

Coagulative necrosis

Question 56

Most common ovarian tumour

Answer 56

serous cystadenoma

Question 57

Pulmonary oedema due to liver disease is an example of which type of cause of pulmonary oedema? a) Lymphatic obstruction b) Indirect injury to alveolar wall c) Increased hydrostatic pressure d) Direct injury to alveolar wall e) Decreased osmotic pressure

Answer 57

increased hydrostatic pressure

Question 58

What is the most common cause of mitral valve stenosis? a) Systemic lupus b) Rheumatic heart disease c) Pulmonary hypertension d) Infective endocarditis e) Congenital

Answer 58

Rheumatic heart disease

Question 59

Genetic haemochromatosis inheritance

Answer 59

AR

Question 60

Brain tumour which most commonly occurs near the surface of the brain and is frequently asymptomatic is most likely to be? a) GBM b) Haemangioma c) Meningioma d) Schwannoma e) Oligodendroglioma

Answer 60

Meningioma

Question 61

In IVDU, which valve is characteristically associated with infectious endocarditis?

Answer 61

Tricuspid

Question 62

Non IVDU infectious endocarditis affected valve?

Answer 62

Mitral

Question 63

Most common skin cancer

Answer 63

BCC

Question 64

A 50 year old female presents to the ENT clinic following a recent admission of hypercalcaemia. Primary hyperparathyroidism secondary to adenoma is suspected. Which of the following investigations is most appropriate? Neck US CT Neck MRI neck Technetium 99m scan US guided fine needle aspiration cytology (FNAC)

Answer 64

Technetium 99m scan - used for thyroid and parathyroid

Question 65

A patient presenting with SIADH (Syndrome of Inappropriate ADH secretion) is diagnosed with Craniopharyngioma. Which of the following visual defects is most likely to be seen? Homonymous hemianopia Bitemporal superior quandrantanopia Bitemporal inferior quandrantanopia Complete visual field loss Central visual field defect

Answer 65

Bitemporal inferior quandrantanopia / hemianopia - both have come up so i’m not sure which one is more correct (pituitary tumour would be superior)

Question 66

Which of the following statements is true regarding astrocytomas? Diffuse astrocytomas do not progress to IDH-mutant glioblastoma Among IDH wildtype tumours, a genotype of 7q gain and 10q loss have a favorable outcome IDH mutant astrocytomas have better prognosis compared with IDH wildtype Pilocytic astrocytoma are more common in adults compared with children Glioblastoma multiforme is considered a benign version with favorable prognosis

Answer 66

IDH mutant astrocytomas have better prognosis compared with IDH wildtype this is from meded mock so not sure how high yield this is

Question 67

What is most likely seen on biopsy of a patient with Hashimoto’s thyroiditis?

Answer 67

Hurthle cells

Question 68

Alpha-fetoprotein

Answer 68

hepatocellular carcinoma or yolk sac tumour

Question 69

What is the most common histologic type of carcinoma involving the oral cavity?

Answer 69

squamous cell carcinoma

Question 70

Hemangioblastomas of cerebellum, brainstem, spinal cord and retina, with renal cysts and phaeochromocytoma

Answer 70

Von-Hippel Lindau syndrome

Question 71

Optic glioma - which neurocutaneous syndrome?

Answer 71

Neurofibromatosis 1

Question 72

Vestibular schwannoma, meningioma - which neurocutaneous disease

Answer 72

NF 2

Question 73

What is the most likely primary site of origin for clear cell carcinoma in the lung?

Answer 73

Kidneys

Question 74

A 39 year old male farmer from Southern Africa has been exposed to mouldy grain during his working life. He has worsening abdominal pain and jaundice. There is a large mass in the right lobe of his liver. Biopsy of the mass reveals hepatocellular carcinoma. What extrinsic agent is likely to have played a role in the development of this tumour?

Answer 74

Aflatoxin (produced by aspergillus)

Question 75

A young man presents with episodes of fever, pleurisy and peritonitis. Investigations confirm a mutation a of the MEFV gene encoding pyrin. Which drug inhibiting neutrophil function is regarded as the agent of choice for prophylaxis against acute febrile illness and prevention of amyloidosis?

Answer 75

Colchicine

Question 76

Name the most common cause of cancer death in males.

Answer 76

Lung

Question 77

MI histology findings under 6 hours

Answer 77

Normal

Question 78

MI histology findings 6-24h

Answer 78

Loss of nuclei, homogenous cytoplasm, necrotic cell death

Question 79

A man who smokes and drinks alcohol has cancer in the middle third of his oesophagus, what is the likely histopathology?

Answer 79

Squamous cell carcinoma - Smoking, drinking, middle third all point to this (altho smoking is also associated with adeno)

Question 80

Hirschprung's histology

Answer 80

Absence of ganglion cells in the myenteric plexus

Question 81

What bone cancer is most likely to develop in someone with Paget's disease?

Answer 81

Osteosarcoma

Question 82

Most common brain cancer

Answer 82

Secondary mets

Question 83

Most common child brain cancer (primary)

Answer 83

pilocytic astrocytoma

Question 84

Most common primary adult brain cancer

Answer 84

Glioblastoma multiforme

Question 85

Raised AFP, ovarian tumour

Answer 85

Yolk sac tumour

Question 86

Most common melanoma?

Answer 86

Superficial spread, followed by nodular

Question 87

Hyperlipidaemia associated with acute pancreatitis?

Answer 87

high triglycerides

Question 88

Amyloid cardiomyopathy, what kind?

Answer 88

Restrictive

Question 89

Cortical veins in the brain, which type of haemorrhage does it cause?

Answer 89

Subarachnoid haemorrhage

Question 90

Pseudomyxoma peritonei, which cancer is it linked to?

Answer 90

Mucinous ovary tumour

Question 91

A 42 year old male with alcoholism and portal HTN presents with haematemesis and severe hypotension. He dies during attempted resuscitation. At post- mortem examination of the lower oesophagus, which is the most likely finding? Acute inflammation Colummar epithelium (Barrett metaplasia) Decreased ganglion cells in the myenteric plexus Dilated blood vessels in the submucosa Mucosal outpouchings (diverticulae)

Answer 91

Dilated blood vessels in submucosa (varices)

Question 92

A 42 year old male with alcoholism. presents with signs of alcoholic hepatitis, A liver biopsy shows cytoplasmic regular eosinophilic hyaline bodies in the hepatocytes. From which substance are these inclusions formed? Basement membrane material Excess plasma proteins Immunoglobulin Lipofuscin Pre-keratin intermediate filaments

Answer 92

Pre-keratin intermediate filaments

Question 93

Rubor is one of the cardinal signs of inflammation. Rubor is mainly due to which process? Arterial vasoconstriction Arteriolar vasodilatation Decreased capillary permeability Decreased interstitial hydrostatic pressure Increased venular permeability

Answer 93

Vasodilation

Question 94

A 29 year old male presents with bloody diarrhoea. Barium examination reveals a characteristic “string sign.” At colonoscopy, the rectum and sigmoid colon appear normal. Biopsy from the terminal ileum reveals numerous acute and chronic inflammatory cells within the lamina propria. The distal ileum is resected and examination shows a thickened wall with long mucosal fissures extending deep into the wall. Which is the correct diagnosis? Crohn's disease. Eosinophilic colitis Infectious colitis Lymphocytic colitis Ulcerative colitis

Answer 94

Crohn's

Question 95

Fibrovascular cores - what histopathological type of cancer?

Answer 95

Papillary