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emily pathology > Past Paper Questions > Flashcards

Past Paper Questions Flashcards

1
Q

neutrophils in myelodysplastic syndrome

A

hypogranulation and hyposegmented neutrophils

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2
Q

Smear cells on blood film

A

CLL

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3
Q

neutrophils in megaloblastic anaemia

A

hypersegmented neutrophils

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4
Q

rank cancers as cause of death in men

A

1 lung
2 prostate
3 colon

(breast least likely)

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5
Q

5 stages of eosophageal adenocarcinoma progression

A 
Reactive
metaplasia
low grade dysplasia
high grade dysplasia
adenocarcinoma
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6
Q

Na and K in Conns

A

(high aldosterone) high sodium low patassium (high BP)

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7
Q

Evolocumab

A

PCSK9 antibody reduces LDL

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8
Q

Dry mouth, dry eyes, anti ro, anti la, speckled pattern

A

Sjogrens

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9
Q

JAK2 V617F mutation

A

Polycythaemia Vera

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10
Q

Spherocytes on blood film, coombs +ve

A

Autoimmune haemolytic anaemia

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11
Q

Which coag factor falls most rapidly after starting warfarin

A

(CR) 7 > 9 > 10 > 2

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12
Q

therapeutic anticoagulation during pregnancy

A

LMWH

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13
Q

Imatinib

A

CML - in chronic phase

ALL if 9;22 translocation

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14
Q

kappa and lambda light chains

A

Multiple myeloma

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15
Q

Reed sternberg cells

A

Hodgkins lymphoma

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16
Q

temp for platelet storage

A

room temp

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17
Q

Venetoclax

A

BCL2 inhibitor induces apoptosis (used in CLL)

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18
Q

smear cells CD5 and CD18 +ve

A

B cell CLL

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19
Q

commonest primary tumour of the heart

A

atrial myxoma

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20
Q

most likely cause of mobile mass in breast

A

fibroadenoma

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21
Q

commonest malignant breast cancer

A

invasive ductal carcinoma

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22
Q

What type of emphysema is associated with smoking?

A

centriobular

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23
Q

what type of emphysema is associated with alpha 1 antitrypsin deficiency

A

Panacinar

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24
Q

most common primary cause of nephrotic syndrome in adults

A

Focal segmental glomerulosclerosis

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25
Q

most common secondary cause of nephrotic syndrome in adults

A

diabetes

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26
Q

most common cause of portal vein thrombosis

A

malignancy

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27
Q

organism causing pneumonia with blood sputum in alcoholic and diabetics

A

Klebsiella Pneumoniae

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28
Q

male version of ovarian dysgeminoma

A

Seminoma

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29
Q

most common histological type of oesophageal cancer in UK

A

adenocarcinoma

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30
Q

goblet cells present in barret’s

A

intestinal metaplasia

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31
Q

goblet cells NOT present in barett’s

A

gastric metaplasia

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32
Q

vascular tumour associated with HHV8 infection

A

Kaposi Sarcoma

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33
Q

commonest cause of myocarditis

A

viral infection

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34
Q

raised AMA in what liver disease

A

Primary Biliary Cirrhosis

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35
Q

temporal encephalitis

A

Herpes Simplex Virus

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36
Q

most common cause of hypocalcaemia in community

A

Vit D def

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37
Q

liver enz specifically suggesting obstructive jaundice

A

ALP

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38
Q

liver enz specifically suggesting hepatic jaundice

A

AST and ALT

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39
Q

which adrenal zone produces aldosterone?

A

Zona glomerulosa

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40
Q

which adrenal zone produces cortisol?

A

zona fasciculata

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41
Q

which adrenal zone produces androgens?

A

zona reticularis

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42
Q

which adrenal zone produces noradrenaline

A

medulla

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43
Q

What condition occurs in both MEN1 and MEN2A

A

Parathyroid hyperplasia

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44
Q

What conditions occur in both MEN2A and MEN2B

A

Phaeo

Medullary thyroid carcinoma

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45
Q

Conditions in MEN1

A

PPP

Pituitary adenoma
Parathyroid hyperplasia
Pancreatic tumours

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46
Q

Conditions in MEN2A

A

PPM

Parathyroid hyperplasia
Pheaochromocytoma
Medullary thyroid carcinoma

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47
Q

Conditions in MEN2B

A

PMMM

Pheaochromocytoma
Medullary Thyroid Carcinoma
Marfanoid body
Mucosal neuromas

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48
Q

what enz does allopurinol inhibit?

A

Xanathine oxidase

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49
Q

What vit def causes pellagra?

A

Niacin

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50
Q

What vit def causes anaemia and neuropathy?

A

Vit E

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51
Q

What vit def causes clotting abnormalities=

A

Vit K

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52
Q

What vit def causes dermatitis and anaemia?

A

Vit B6

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53
Q

which hormone increases urinary phosphate excretion?

A

PTH

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54
Q

confirm pancreatitis

A

serum lipase

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55
Q

hypercalcaemia in sarcoidosis

A

1 alpha hydroxylase release by activated macrophages

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56
Q

commonest cause of hypercalcaemia in community

A

Primary hyperparathyroidism

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57
Q

hormone produced by fat cells with receptors in hypothalamus

A

leptin

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58
Q

deficiency of what plasma protein in liver disease and mvmnt disorder

A

Ceruloplasmin

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59
Q

fully differentiated b cell that produces antibodies

A

Plasma cell

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60
Q

what condition invloves upper and lower airways, kidneys, ANCA positive with cytoplasmic staining for proteinase 3?

A

Wegener’s Granulomatosis (GPA)

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61
Q

ANCA positive with perinuclear staining for myeloperoxidase

A

Microscopic Polyangitis

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62
Q

reactivation of human polyoma virus t (john cunningham virus)

A

Progressive Multifocal Leukoencephalopathy

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63
Q

MEFV gene mutation

A

Familial mediteranian fever

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64
Q

measure what before azathioprine use?

A

Thiopurine Methyltransferase (TPMT)

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65
Q

neutrophils fail to oxidise dihydrorhodamine (DHR)

A

Chronic granulomatous disease

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66
Q

antibody isotype for food allergy

A

IgE

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67
Q

antibody isotype in secretions

A

IgA

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68
Q

Antibody isotype in primary response

A

IgM

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69
Q

Antibody isotype in secondary response

A

IgG

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70
Q

IL2RG mutation encoding IL2 common gamma chain

A

X linked SCID

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71
Q

CAR-T cell for what cancer cell type?

A

B cells

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72
Q

Bare lymphocyte syndrome affecting HLA class II - what def?

A

CD4+ T cells (T helper cells)

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73
Q

Bare lymphocyte syndrome affecting HLA class I - what def?

A

CD8+ T cells (cytotoxic T cells)

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74
Q

mutation of CD40 ligand

A

Hyper IgM syndrome

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75
Q

Denosumab

A

monoclonal antibody for RANKL used to treat Osteoporosis

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76
Q

IgA specific for TTG

A

coeliac

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77
Q

class of abx - conc dependent killing

A

aminoglycosides

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78
Q

gram -ve bacilli causing fever and abdo pain after trip to india, Malaria neg, what abx?

A

Salmonella? Ceftriaxone

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79
Q

gram +ve rods in CSF of elderly woman

A

Listeria monocytogenes

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80
Q

which human herpes virus is associated with post transplant lymphoproliferative disorder ?

A

EBV (Human herpes virus 4)

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81
Q

yeasts in CSF of HIV patient

A

cryptococcus neoformans

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82
Q

Rice water stool

A

Vibrio Cholera

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83
Q

which virus in first 20 weeks of pregnancy causes hydrops fetalis

A

Parvovirus B19 (slapped cheek)

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84
Q

mucomycosis antifungal therapy

A

amphotericin B

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85
Q

4 year old with bloody diarrhoea and HUS

A

E coli 0157:H7

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86
Q

what is the cause of beta thalassaemia major

A

decreased production of beta globin chains

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87
Q

auer rods on blood film

A

AML

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88
Q

left shift

A

increase of immature cells

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89
Q

toxic granulation

A

bacterial infection

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90
Q

factors in cryprecipitate

A

8 ,13 and vWF

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91
Q

factos in FFP

A

Fibrinogen and all coag factors

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92
Q

young girl with leg pains, palor, bruising, lymphadenopathy and blood film shows 80% blast cells

A

ALL

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93
Q

smoker with high Hb, normal RBC mass, low plasma volume

A

relative polycythemia

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94
Q

neutropenic sepsis secondary to myelodysplasia presents with pancytopenia, and blood film with numerous large primitive cells

A

Progression to myelofibrosis

95
Q

DOAC monitoring

A

none

96
Q

LMWH monitoring

A

none

97
Q

Warfarin monitoring

A

INR

98
Q

Unfractionated heparin monitoring

A

APTT or Anti Xa assay

99
Q

acute graft v host disease mediated by which cell type

A

donor t cells

100
Q

symptoms of multiple myeloma

A

CRAB

Calcium
Renal failure
Anaemia
Bone lesions

101
Q

therapy for CML with philadelphia translocationin chronic phase

A

imatinib (ABL1 tyrosine kinase inhibitor)

102
Q

which blood stuff decrease in pregnancy

A 
Hb
Hct
Plt
Factor 2
Protein S
103
Q

Ann arbor stage 1

A

hodgkins

one LN region

104
Q

Ann arbor stage 2

A

Hodgkins

2 or more LN on same sid eof diaphragm

105
Q

Ann arbor stage 3

A

hodgkins

2 or more LN on either side of diaphragm

106
Q

Ann arbor stage 4

A

hodgkins

2 or more LN on either side of diaphragm and organ mets

107
Q

what type of necrosis is associated with MI?

A

coagulative necrosis

108
Q

most common ovarian tumour

A

serous cystadenoma

109
Q

most common testicular cancer

A

germ cell testicular cancer (seminoma)

110
Q

extradural haemorrhage blood vessel

A

middle meningeal artery

111
Q

subdural haemorrhage blood vessel

A

bridging veins

112
Q

subarachnoid haemorrhage blood vessel

A

berry aneurysm at carotid bifurcation

113
Q

virus associated with nasopharyngeal carcinoma

A

EBV

114
Q

pulmonary oedema due to liver disease

A

decreased osmotic pressure (low albumin)

115
Q

commonest cause of ARDS in adults

A

sepsis

116
Q

commonest glial cell in CNS

A

astrocytes

117
Q

commonest cause of mitral valve stenosis

A

Rheumatic heart disease

118
Q

inheritance of haemochromatosis

A

autosomal recessive

119
Q

inheritance of Wilsons

A

Autosomal recessive

120
Q

Inheritance of alpha 1 antitrypsin deficicency

A

Autosomal dominant

121
Q

commonest cause of pancreatitis

A

gallstones

122
Q

brain tumor at surface asymptomatic

A

meningioma

123
Q

commonest skin cancer

A

basal cell carcinoma

124
Q

low Na, high K, low bicarb,, lowish glucose

A

addisons –> renal loss of Na causing H retention –> metabolic acidosis

125
Q

AST:ALT alcoholic cirrhosis

A

2:1

126
Q

AST:ALT viral hep

A

1:1

127
Q

Quinine glucose effect

A

hypoglycaemia

128
Q

glucagon

A

release glucose into blood

129
Q

clinical features of hypercalcaemia

A

Stones
Bones
Groans
Moans

130
Q

macro vs micros pit adenoma

A

micro <10mm

Macro >10mm

131
Q

mild prolactin elevation

<1000

A 
stress
recent breast exam
vaginal exam
hypothyroidism
PCOS
132
Q

moderate prolactin elevation >1000 <5000

A 
hypothalamic tumour
non-functioning pituitary adenoma
microprolactinoma
PCOS
drugs
133
Q

extreme prolactin elevation

>5000

A

macroprolactinoma

134
Q

PPH low pit hormones

A

Sheehan syndrome (hypopituitarism)

135
Q

Obstructive jaundice

A

incr conj bili
red urobili
pale stool
dark urine

136
Q

haemolytic jaundice

A

raised LDH
red haptoglobin
raised urobili
raised unconj bili

137
Q

what binds receptors in adrenal and stimulates aldosterone release

A

Ang II

138
Q

what convertes Ang I to ang II

A

ACE produced by lungs

139
Q

what converts angiotensinogen to ang I

A

Renin

140
Q

where is angiotensinogen produced

A

liver

141
Q

in ab mediated rejection of renal allograft where is inflmmatory infiltrate seen?

A

Capilaries

142
Q

cells infected by HIV

A

CD4 t cells

143
Q

HIV gp120

A

initial binding

144
Q

HIV gp41

A

conformational change

145
Q

conjugate vaccines

A

N meningitidis
H influenzae
Strep pneumonia

146
Q

high ANA, +ve dsDNA antibody, low C3 and C4

A

SLE

147
Q

gastric parietl cell abs

A

pernicious anaemia

148
Q

coombs type 1 hypersensitivity rxn

A

igE mediated mast cell histamine release

149
Q

coombs type 2 hypersensitivity rxn

A

igG/IgM to cell/matrix antigen

150
Q

coombs type 3 hypersensitivity rxn

A

igG/IgM to soluble antigen

151
Q

coombs type 4 hypersensitivity rxn

A

T cell mediated

152
Q

failure to regulate cryopyrin driven activation of neutrophils

A

Familial mediteranean fever

153
Q

Pembrolizumab (anti-PD1)

A

Keytruda

enhances T-cell immunity and used in mx of some cancers (NSCLC, melanoma, bladder cancer, Hodgkins lymphoma)

154
Q

Rituximab (anti-CD20)

A

depletes mature B-cells

155
Q

b-DMARD for RA mx

A

Adalimumab (anti-TNFalpha)

156
Q

standard immunosuppressive regimen for transplant pts

A

CNI + MMF/aza +/- steroid

157
Q

CNI

A

Tacrolimus

Cyclosporin

158
Q

MMF

A

Mycophenolate mofetil

blocks T>B cell prolif
via blocking nucleotide synthesis

159
Q

Azathioprine

A

prevents T>Bcell activation/prolif
via blocking purine synthesis

measure TPMT before starting

160
Q

what chemokine receptor promotes dendritic cell migration to LNs

A

CCR7

161
Q

Plasmapheresis

A

severe type 2 disease

Goodpastures (anti GBM)
Myasthenia Gravis (anti AchR)
Vascular rejection
Ab mediated rejection

162
Q

close contact with TB - what is lifetime risk?

A

10%

163
Q

what % of world have TB

A

33%

164
Q

Legionella abx

A

Macrolides (Azithromycin)

Quinolones (ciprofloxacin)

165
Q

hep worse in pregnancy

A

Hep E

166
Q

seroogical test for candida

A

Beta-D-glucan

167
Q

serological test for aspergillus

A

galactomannan

168
Q

serological test for syphilis

A

TPPA (treponema pallidum particle agglutination)

169
Q

Widal test

A

typhoid paratyphoid

170
Q

food poisoning organism in honey or canned beans

A

clostridium botulinim

171
Q

enteric fever constipation and rose spots

A

salmonella typhi

172
Q

undercooked chicken and bloody diarrhoea

A

campylobacter jejuni

173
Q

severe malaria tx

A

IV artesunate

174
Q

mild malaria tx

A

Riamet = artemether + lumefantrine

175
Q

Hep B antiviral

A

tenofovir

176
Q

Rat bite fever

A

Streptobacillis moniliformis

177
Q

Q fever

A

coxiella burnetti

178
Q

syphilis

A

treponema pallidum

179
Q

Lyme disease

A

borrelia birgdoferi

180
Q

bacillary angiomatosis

A

bartonella henselae

181
Q

commonest form of prion disease

A

sporadic CJD

182
Q

refer to coroner if

A

unknown cause of death
not seen by dr in last illness or last 28 days
death in custody
detained under MHA

183
Q

hierarchy of consent (family)

A 
Partner/spouse
Parent/child
Sibling
Grandparent/grandchild
Nephew/neice
step parent
half sibling
friend of long standing
184
Q

p ANCA anti myeloperoxidase

A

Microscopic polyangitis

185
Q

c ANCA anti proteinase 3

A

Granulomatosis with Polyangitis

186
Q

routine test shows raised WCC, Neutrophils and Basophils

A

CML

187
Q

Carbimazole side effect

A

agranulocytosis

188
Q

Spleen in Ann Arbor staging for hodgkins lymphoma

A

= Lymphoid (so if theres mets then still considered stage 3)

189
Q

hypogranular hypolobulated neutrophils

A

myelodysplastic syndrome

190
Q

raised Hb A2

A

Beta thalassaemia

191
Q

globins that make up Ab A2

A

2 alpha and 2 gamma globins

192
Q

pancytopaenia
Tear drop poikilocytes
primitive cells

A

Myelofibrosis

193
Q

liver mass with raised AFP

A

hepatocellular carcinoma

194
Q

lesion with eosinophilic cytoplasm, intercellular bridges, intracellular keratin formation

A

squamous cell carcinoma

195
Q

Pt without ABO grouping need plasma of what group?

A

AB (so no anti A or B abs are present)

196
Q

villous atrophy, lymphocyte infiltrate, crypt hyperplasia

A

coeliac disease

197
Q

haemangioblastomas in cerebellum and retina, renal cell carcinomas, cysts of pancreas and kidneys

A

Von Hippel Lindau

198
Q

giant cell astrocytoma; cortical tuber; supependymal nodules and calcifications on CT

A

Tuberous Sclerosis

199
Q

Sjögrens salivary gland bx

A

CD4 +ve T cells

200
Q

hypoglycaemia tx with no IV access

A

IM/SC glucagon

201
Q

asymptomatic hyperbilirubinaemia

A

Gilberts

202
Q

Positively birefrinent crystals in knee

A

Pseuogout

203
Q

18 yo died with hypertrophy of interventricular septum

A

hypertrophic obstructive cardiomyopathy

204
Q

which WBC has granulers with myeloperoxidase and ALP

A

Neutrophils

205
Q

clear cell carcinoma origin

A

Kidney

206
Q

congo red +ve with apple green birefringence

A

Amyloid

207
Q

mouldy grain + hepatocellular carcinoma

A

Afla toxin from aspergillus flavus

208
Q

ALP > 500 in bone disease

A

Osteomalacia, pagets

209
Q

ALP < 500 in bone disease

A

cancer

210
Q

overdose with respiratory alkalosis

A

Aspirin

211
Q

low calcium, low phosphate, high PTH

A

secondary hyperparathyroidism

212
Q

dihydrorhodamine test

A

chronic granulomatous disease

213
Q

congenital adrenal hyperplasia enz deficiency

A

21 hydroxylase

214
Q

FMF tx

A

Colchicine

215
Q

max number of HLA mismatches in parent to child organ donation

A

3

216
Q

chance of perfect HLA match from sibling donor

A

25%

217
Q

chance of HLA mm of 3 from sibling donor

A

50%

218
Q

chance of HLA mm of 6 from sibling donor

A

25%

219
Q

mutation in hyper IgM

A

CD40L

220
Q

low Cd4+ve cells and no class switching

A

bare lymphocyte syndrome type 2

221
Q

low Cd8+ve cells and normal IgG levels

A

bare lymphocyte syndrome type 1

222
Q

cytokine in ankylosing spondylitis

A

TNF alpha

IL 17

223
Q

linear deposits of ab along glomerular basement membrane

A

goodpastures

224
Q

immune cell type deficient in DiGeorge

A

Tcells

225
Q

CSF test for cryptococcus neoformans

A

India ink stain

226
Q

urinary antigen test

A

legionella

strep pneumoniae

227
Q

cytokine promoting terminal differentiation of eosinphils

A

IL5

228
Q

Meningitis tx with cover

A

Ceftriazone + ampicillin cover for Listeria +/- acyclovir for encephalitis

229
Q

2 day old CSF gram -ve bacilli

A

e coli

230
Q

CoNs causing UTI

A

staph saprophyticus

231
Q

dsDNA virus in transplant pts causing nephritis

A

BK virus

232
Q

fever, abdo pain, constipation, gram -ve rod

A

salmonella typhi

233
Q

helminth

A

strongoloidies

234
Q

fetus exposure -> sensorineural deafness, eye abnormalities, congenital heart disease

A

rubella

emily pathology (6 decks)

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