Ap - Details From Review Questions

Front 1

Depth of invasion of melanoma

vs.

Depth of invasion of SCC

Back 1

Breslow thickness
Surface of the epithelium (discounting the keratin layer)


SCC: adjacent basement membrane of the closest dermal papilla

Front 2

Cervix from prolapsed uterus

Back 2

Endocervical tunnel clusters!
Benign mimic of adeno
Bland
Lobular architecture

Front 3

Give the classic locations for the following cysts:
Bartholin
Skene
Gartner

Back 3

Bartholin: 4 & 8:00 introitus, mucinous
Skene: paraurethral
Gartner: lateral vag wall, simple columnar

Front 4

BerEp4 & B72.3

Back 4

+ in adeno, - in mesothelioma

Front 5

nuclear beta-catenin in a pancreatic neoplasm

Back 5

abnormal Wnt signaling pathway
SOLID PSEUDOPAPILLARY NEOPLASM

(endocrine and ductal neoplasms will have membranous staining)

Front 6

IHC to PCP detects what forms?

Back 6

Cysts AND trophs

Front 7

Skin nodule
+ PAX5, CD99, chromo/synapto
+ punctate perinuclear CK20
- CK7

Back 7

Merkel cell carcinoma

Front 8

another name for AMACR

Back 8

p504s. + in prostatic neoplasms

Front 9

+ CK, p63 lesional cells
+ CD3, CD1a, TdT, CD99 lymphs

What if also CD5 & ckit+?

Back 9

thymoma


CD5 & ckit are markers for thymic carcinoma

Front 10

CK7-
CK20-
CAM5.2+
PAX2+
TTF1-
CDX2-
CEA-

variations?

Back 10

RCC

(PAX2 does not stain chromophobe)
(chromophobe & papillary RCC are CK7+)

Front 11

Primary HCC stains how:
CK7, CK20, AE1/AE3, Cam5.2, pCEA, HepPar1

How is fibrolamellar variant different?

Back 11

CK7-
CK20-
focal AE1/AE3
Cam5.2+
pCEA + canalicular
HepPar1+

(fibrolamellar variant is CK7+)

Front 12

Phenotype of PEComas?

CK
S100
SMA
MelanA
HMB45
tyrosinase
?

Back 12

CK -
S100 -
SMA +
MelanA +
HMB45 +
tyrosinase + (50%)

Front 13

What are the limitations of using AEC as a chromogen?

Back 13

It is alcohol soluble and must have an aqueous medium for cover slipping

DAB is preferred, it is alcohol insoluble and forms a brown pigment, but may be a carcinogen

Front 14

Most sensitive IHC in MPNST?

Back 14

Collagen IV

Front 15

IHC nephrogenic adenoma

Back 15

AMACR, PAX2

Front 16

Patient population and tumor type of lung cancers with activating EGFR mutations

Back 16

Female
Non-smoker
Adenocarcinoma

Front 17

prognostic groups in neuroblastoma

Back 17

Good px:
Hyperdiploidy, no structural chromosomal abnormalities, expression of Trka neurotrophin receptor

Unfavorable:
Diploid, -1p, -11q, +17q, MYCN amplification

Kids < 1 better px unless MYCN amplification

Front 18

ASPL-TFE3 gene fusion see in what 2 tumors?

Back 18

Alveolar soft part sarcoma
Xp11.2 renal cortical tumors

t(x;17)

Front 19

Fli1 chromosome

Back 19

11

Front 20

Name 5 tumors with t(11;22)

Back 20

Ewings/PNET
Desmoplastic small round cell tumor
Clear cell sarcoma of soft parts
Extraskeletal myxoid chondrosarcoma
Myxoid liposarcoma (rarely)

Front 21

Genes involved in alveolar RMS?

Back 21

t(2;13)
PAX3-FOXOA1 (FKHR)
high risk subgroup
55%

t(1:13)
PAX7-FOXOA1 (FKHR)
Favorable group
22%
can be amplified as double minutes

Front 22

name the cardiomyopathy:
1. dilation of all 4 chambers

2. Hypertrophic septum

3. Thin RV replaced by fat

4. bilateral dilation of atria

Back 22

1. dilated CM
- large, flabby heart, viral/EtOH/pp/drug

2. hypertrophic CM
- sudden death; haphazard array of myocytes; loose ground substance

3. Arrhythmogenic RV dysplasia
- young adults sudden death; familial

4. Restrictive CM
- #1 ww: endomyocardial fibrosis (kids, tropics)
- US: amyloid, hemochromatosis

Front 23

2 syndromes with cardiac myxomas

Back 23

Carney syndrome
TS

Front 24

cardiac section

Back 24

aschoff nodule

Anitschkow cell: caterpillar nucleus!

Front 25

Libman sacks endocarditis

Back 25

BOTH sides of valve
fibrinoid necrosis with lots of POLYS

SLE

Front 26

Cardiac myxomas usually occur in the ______ unless associated with a familial syndrome in which case they more commonly occur in the ________

Back 26

LA

RA

Front 27

DDx eos in the heart

Back 27

Toxo
CMV
drug

Front 28

Diseases that recur after cardiac transplant

Back 28

sarcoid
chagas
giant cell myocarditis
amyloid
Fabry

Front 29

Best stain for cardiac myxoma vs sarcoma?

Back 29

calretinin (+ in myxoma)

Front 30

ignore the glands. what is the name for these bodies, and where are they seen?

Back 30

Gamna Gandy bodies

formed by calcific elastic fiber degeneration with hemosiderosis

Seen in atrial myxomas, and spleen, associated with cardiac congestion and sickle cell anemia.

Front 31

What cardiac tumor is associated with extramedullary hematopoiesis?

Back 31

myxoma, 10%

Front 32

most sensitive marker for angiosarc

Back 32

CD31

Front 33

small vessel vasculitides

Back 33

HSP
Wegeners
Churg Strauss
MPA
Cutaneous leukocytoclastic vasculitis

Front 34

name the classic association in these medium-vessel vasculitides
Giant cell arteritis
Polyarteritis nodosa
Thromboangiitis obliterans
Takayasu

Back 34

Giant cell arteritis - polymyalgia rheumatica
Polyarteritis nodosa - HBV
Thromboangiitis obliterans - smoking
Takayasu - aortic root dilation

Front 35

Which vasculitis is treated with intravenous gamma globulin?

Back 35

Kawasaki disease is an inflammatory disease of the large, medium, and small arteries and affects children younger than 4 years of age. The major risk is the development of coronary artery aneurysm formation with subsequent rupture or thrombosis and possible sudden death. Intravenous gamma globulin is the treatment of choice for preventing coronary artery aneurysm formation and is used in conjunction with aspirin.

Front 36

Most common primary cardiac sarcoma?

cardiac sarcoma most likely to involve valve?

Back 36

Angiosarcoma; RA; TP53 mut

rhabdomyosarcoma; KRAS mutation

Front 37

#1 cause of pulmonary-renal syndrome?

Back 37

ANCA disease (55%)

(anti-GBM disease 5%

Front 38

What type of steatosis is seen in Reyes syndrome, and what is the causative agent?

Back 38

Microvesicular. Also classically seen in HAART therapy

Aspirin

Front 39

What drug classically shows hepatocellular necrosis with inflammation? Antidote?

Back 39

Acetaminophen

N-acetylcysteine

Front 40

Ring granuloma

Back 40

Q fever (rickettsial illness with coxiella)

Front 41

Name the gene:
HCC
Cholangiocarcinoma
Liver cell adenoma
Alagille

Back 41

HCC: p53

Cholangioca: Kras, c-myc

LCA: HNF-1a

Alagille: Jagged-1

Front 42

Victoria blue or rhodamine stain of liver

Back 42

Excess copper in liver cells:

Wilson's disease
Chronic biliary diseases such as PSC, late state PBC

Also HBV

Front 43

What are Mallory bodies composed of?

Back 43

constitutively ubiquitinated cytokeratins 8&18 & other byproducts of cellular stress

can be seen in ASH, NASH, Wilson's....

Front 44

What liver cell makes fibrosis

Back 44

stellate cell, aka Ito cell, lipocyte

Major vitamin A storage; located in space of disse.
Transform to activated myofibroblast cells that make collagen, and then they stain for SMA

Front 45

Megamitochondria are seen in?

Back 45

alcoholic liver disease

Front 46

what condition has string of beads on radiology and has 10% risk of cholangiocarcinoma?

Back 46

PSC

Front 47

name 2 syndromes that can have pancreatoblastoma

Back 47

Beckwith Weidemann
FAP

Front 48

Ranson criteria at presentation

48h

Back 48

Age, WBC, glucose, LDH, AST

hct, BUN, Ca, base deficit, edema, O2 sat

Front 49

what forms of PCP can be seen on slides?

virulence?

Back 49

Cysts - classically
Can see trophs on Diff-Quik with oil immersion

Trops attach to type 1 pneumocytes

Front 50

What cell type covers most of the surface area of the lung?

What cell type can replicate in lung injury?

What cell type makes surfactant and therefore has lamellar bodies on EM?

Back 50

Type 1 pneumocytes cover 97% surface area of the lung, though they are less in number overall

Type 2 pneumocytes are rounded and larger, and can replicate into Type 1 pneumocytes. They make up 60% alveolar cells. Type 2 secretes surfactant, and has lamellar bodies on EM. MUC1 stains Type 2.

Front 51

Associations with avascular necrosis

Back 51

long term steroid use
deep sea diving
hemoglobinopathies
EtOH
Gaucher

Front 52

cytokeratins expressed in synovial sarcoma?

adamantinoma?

Back 52

CK8 & 18

CK14 & 19

Front 53

What GYN tumor is associated with enchondromatosis?

Back 53

Juvenile granulosa cell

Front 54

Vulvar lesion
Painless
+ vimentin, desmin, ER, PR, CD34

Back 54

Angiomyofibroblastoma

Tumor cells are concentrated around vessels
Mast cells common

Front 55

10cm vulvar lesion

+SMA, ER, PR, CD34. desmin

Back 55

Aggressive angiomyxoma

Stellate cells, loose matrix, prominent vasculature

Front 56

what cytokine is responsible for causing pulmonary fibrosis?

Back 56

TGF-B

Front 57

muscle biopsy

Back 57

Polymyositis

ENDOMYSIAL inflammation with CD8+ Tcells

Front 58

muscle biopsy

what to worry about?

Back 58

Dermatomyositis
PERIMYSIAL inflammation with CD4+ Tcells
also has perfascicular atrophy

40% associated with paraneoplastic syndrome!

Front 59

muscle biopsy

Back 59

inclusion body myositis
~ polymyositis in many ways

Front 60

Major difference between myositis and muscular dystrophies?

Back 60

In muscular dystrophy, inflammation is associated with NECROTIC FIBERS

Front 61

Muscle biopsy

Back 61

Duchenne Muscular Dystrophy

Endo & perimysial fibrosis
Atrophy & hypertrophy = size var
Necrotic fibers
“Hyaline fibers”: large, dark, glassy
Increased internal nuc

Front 62

Muscle biopsy

Back 62

Ragged red fibers of mitochondrial myopathy

MERRF (myoclonus epilepsy with RR fibers)
MELAS (mitochondrial encephalomyopathy with lactic acidosis & stroke)
Kearns-Sayre syndrome