erythrophagia,is m/c seen in typhoid/crohns :

o Erythrophagocytosis: seen in Typhoid ulcers

m/c malignancy in aids kaposis/cnslymphoma:

o Mx in HIV AIDS: MC Mx is Lymphoma, MC vascular Mx is Kaposi Sarcoma. MC site of Lymphoma

lymphnodes (not CNS). MC brain tumor in HIV AIDS: Primary CNS malignancy

Role of Bradykinin in process of inflammation

a) Increased vascular permeability

b) Pain

o Ans.Increased vascular permeability. Please note although bradykinin causes both but since increased

vascular permeability is Most characteristic feature of inflammation that should be the answer. Also

pain is sequale of inflammation it has no role in inflammation

Tumors in children:

o MC tumor (Neoplasm): ALL, MC Mx: ALL. Mc solid organ tumors: CNS tumors (Astrocytomas). MC

abdominal Mx: Neuroblastoma, MC soft tissue sarcoma (obviously sarcomas means malignant): Rhabdo

Myosarcoma

histological examination of lesion in stomach lipid laden cells..likely cause? ?

lymphoma

post gastrectomy

signet cell ca stomach

atrophic gastritis

o post gastrectomy: these are called lpid islands seen after partial gastrectomy especially after Bilroth I

&II surgery. Etiology: thought to be due to intestinal gastric reflux

CLL SLL: MC pathognomonic and MC pattern in pseudofollicular pattern

MC tumor of infancy: Hemangioma. MC malignancy of infancy will be neuroblastoma

Chloroma or myeloid sarcoma: MC morphology (means MC cause): Myeloblast some of them show

promyelocytes (means M2 followed by M3). Where as> 50% of AML with monoblastic differentiation

(M5 and M4) show myeloid sarcoma. Thats why if Q is which AML is most likely to present as Myelod

sarcoma Ans is M5, M4

Graft rejections: Hyper Acute: Type II HS: biopsy finding: vasculitis and thrombosis

Acute Humoral: type II HS. Biopsy findings: vasculitits and thrombosis (same as hyper acute)

Acute cellular rejection: type IV HS, biopsy finding: tubulitis

Chronic rejection: Fibrotic tissue reaction (some books say it as type IV HS). Biopsy findings: interstitial

fibrosis and tubular atrophy

mcc complication of massive blood transfusion a. hypothermia b.non hemolytic febrile rxn

o Hypothermia. Ref Wintrobes hypothermia is one of the most common complications of massive

blood transfusion

Cold hemagglutinin IgM or Donath landstiener Ab?

o IgM. Remember that cold Ab are of two types cold agglutinins (IgM) and cold hemolysins- DL Ab

(IgG)- DL Ab is not an agglutinin at all

which of the following is not a criteria for making diagnosis of accelerated CML.. a. basophilia 10-19%

b. persistant thrombocytosis > 1000 * 10 ^9/l

o Basophils 10-19% is not criteria. The criteria is basophils >20%

subcellular structure of macrophages responsible for the accumulation of this pigment hemosiderin

??a lysosome b. ER C. ribosome d. golgi apparatus

o lysozome: iron(Hb) when is taken up by macrophages which will be converted into hemosiderin by

lysosomes

Chances of having an affected baby if both parents are affected by autosomal dominant disease??

75% or 50%

o 75%. (dont confuse there will be one homozygous dominant baby will also live it wont die. Death will

depend upon what gene is coding for

cells involved in ards? In ARDS both endothelial cells and epithelial cells can be damaged however

endothelial damage is earliest and most predominant

Anti Tumour Cytokines : IL 2 and IL 15 (Activate NK cells) INF gamma (activates macrophages, TNF

secreted by macrophages which will ultimately kill tumour cells

Atheroma resulting in anginahas following characteristic except

A.Thin fibrous cap

B.Thick fibrous cap

C.Lack of macrophage

D.Lack of smooth muscle cell

Ans :Thick fibrous cap. Angina occurs due to rupture of plaque.

factors increasing chance of ruture of plaque are1. large areas of foam cells and extra cellular lipid, and

2) thin fibrous cap and less smooth muscle.3) more inflammatory cells.

Most specific marker of gist?

A dog 1

B cd117.

Most specific marker for GIST : DOG1 and Most sensitive CD117

Most common tumour of spleen? Hemagioma query Mets

o Ans :Hemagioma

o Exp : MC neoplasm of spleen lymphoma (NHL) .

o MC primary neoplasm of spleen HEMAGIOMA (Cavernous)

o Remember mets to spleen are considered as rare neoplasm so MC neoplasm of Spleen

MC Splenic cysts: Paracytic (Echinococcus). Followed by pseudocyst ( remember pseudocyst is MC non

parasitic cyst of spleen)

Hypertrophy & Hyperplasia in uterus & breast

Endotoxic shock: initial event is cytokine release followed by endothelial injury then release of

secondary cytokines

MC tumor of appendix (Carcinoid- ref Robbins & WHO book)

Biopsy from mass around knee joint, biphasic tumor Mic-2 + likely diagnosis?

Ans: Synovial sarcoma

Exp: Mic-2 positive tumors are: Synovial Sarcoma, Ewings sarcoma, Granulosa cell tumor and

lymphoblastic lymphoma. In these mass around knee joint can be either synivial or ewings. Next hint is

to see (if given) whether a bone tumor or soft tissue tumor: if bone tumor then Ewings if Soft tissue then

Synovial. Or other hint will be histology: Ewings will show rosette while synovial is biphasic tumor.

MC malignancy in small bowel: carcinoid

MC sensitive and specific marker for RS cells: Most sensitive is Cd30: 100% sensitive. CD 15 is more

specific

Hypersensitivity pneumonitis: type IV HS

o Exp:earlier it was thought to be a type III HS but since atleast 2/3 of all HS show granulomas type IV HS

occurs (New hypothesis). If Q is asked mark type IV

Best prognostic lung carcinoma: squamous or BAC

o Exp: squamous better prognostic than adenocarcinoma. But bronchioloalveolar carcinoma (BAC) has

excellent prognosis (with 100% 5 yr survival if resectable growth). No studies compare BAC with

squamous but if they ask then go with BAC

RCC TYPES &PROGNOSIS

Worst to best are: collecting duct ca (or Ca of duct of belini>clear cell>papillary>chromophobe

Chromophobe is clearly the best prognostic RCC of common types

Papillary and clear cell arise from proximal tubule while chromophobe arises from distal tubules and

carcinoma of duct of belini arises from collecting ducts

Gullian Barrie syndrome: Cell mediated hypersensitivity (type IV) however recent studies also show

antibody mediated. Single best ans type IV hS

LE cell phenomena: MC seen in neutrophils (polymorphs) can also be seen in monocytes and

eosinophils

DS associated AML: DS associated leukemias are AML

o in children under 4 yrs ratio of ALL to AML in DS is =1:1.2 in DS ( as compared to 4:1 in non-DS

children) this means obviously incidence of AML increases in DS while ALL remains stagnant thats why

they become almost equal incidene. MC AML type is M7 (70% of AML are M7)

o So if Q is which leukemia is associated with DS :Ans will be AML (ALL is not associated with DS) MC in

DS AML or ALL answer should be AML (1.2 cases for every case of ALL)

o IF q is which is associated with DS? AML M7 or ALL.Ans will be AML M7

o But if the Q is which is more common in DS AML M7 or ALL , then answer better answer will be ALL (

because only 70% of AML are AML M7) and ration ALL: AML is almost same thus ALL will be more than

AML M7 ( dont confuse this )

Myeloid sarcoma markers: frequency of positivity in decreasing order CD68>MPO>CD117>others

Soft Tissue Tumors

MC Soft tissue tumor in adults: Lipoma

MC soft tissue tumor in children: Hemangioma

MC soft tissue sarcoma (Adults): Liposarcoma (earlier MFH- malignant fibrous histiocytoma)

MC soft tissu sarcoma in children : Rhabdomyosarcoma(RMS)

MC site of lipoma: Nape of neck

MC site of liposarcoma: retroperitoneum

MC site of RMS:periorbital

MC type of RMS: Embryonal

Marker for RMS: Desmin, Myogenin, MyoD1

GENETICS OF IMPORTANT SOFT TISSUE TUMORS

Ewing's/ PNET & Desmoplastic small round tumor: t(11;22)

RMS: t(2;13) & t(1;13)

Synovial sarcoma: t(x;18)

clear cell sarcoma: t(12;22)

Extra skeletal myxoid chondrosarcoma: t(9;22)

Dermatofibrosarcoma protuberance: t (17;22)

Well diff liposarcoma: 12q ring

NASH / NAFLD ( NON Alcoholic steato hepatitis/ non alcoholic fatty liver disease)

Incidence M=F

Biopsy: micro & macro vesicular steatosis (triglycerides accumalate), mallory hyaline, balooning

degeneration & apoptosis.

Diagnosis is of exclusion (negative history of excessive alcohol intake)

Autoimmune hepatitis

Female prepondrance (78%)

Young and perimenopausal women

Elevated ANA, SMA and Anti LKM-1 antibodies

Negative AMA (antimitochondrial antibodies)

Biopsy: chronic inflammatory infiltrate consisting of lymphocytes and plasma cells ( plasma cells are

characetristic of autoimmune hepatitis)

Pediatric tumors

MC neoplasm of infancy: hemangioma

MC malignancy of infancy : neuroblastoma

MC malignancy of childhood: 1.Leukemias (ALL) 2. CNS tumors 3.neuroblastoma in order

MC neoplasm of childhood : ALL

MC abdominal tumor in infancy :neuroblastoma ( remember if Q says Infancy & childhood then also the

same answer)

MC abdominal tumor in an older child: wilms tumor

MC CNS tumor : astrocytoma (pilocytic) followed by medulloblastoma

MC malignancy of CNS in children: Medulloblastoma (remember that astrocytoma is benign- WHO grade

I)

MC benign soft tissue tumor: hemangioma

MC malignant soft tissue tumor: rhabdomyosarcoma

1. Cause of abdominal aortic aneurysms: Atherosclerosis

2. Cause of thoracic aneurysms: hypertension

3. Site of AAA: below renal arteries

4. Tumor of BV: hemangioma, capillary

5. Primary Tx of heart in children: rhabdomyoma

6. Primary Tx of heart in adults: myxoma

7. Mx of heart: secondaries (bronchial)

8. Primary Mx of heart: Angiosarcoma

9. Lymphoma: Non Hodgkin

10. Type of HL: Nodular sclerosis> mixed cellularity

11. Site of HL: cervical

12. Age group of HL: 32 years (4th decade)

13. Type of NHL: DLBCL

14. AML: M2

15. AML with DIC: M3

16. Site of Myeloid sarcoma in CML: Skin

17. Inherited Bleeding disorder: vWD

18. Inherited disorder assoc with life threatning bleeding : Hemophelia A

19. Lung ca in men / smokers: SCC

20. Lung ca in Women/ non smokers: Adeno

21. Most aggressive lung tumor: small cell

22. Pleaural tumor: mets

23. Primary pleural Mx: Malignant mesothelioma

24. Tx of Salivary gland: PA

25. Mx of Salivary gland: MECa

26. Site of Meca: parotid

27. Esophageal Ca: SCC

28. Site of esophageal Ca: mid third

29. Site of biopsy in H pylori: antrum

30. Site of biopsy in celiac: D2

31. Type of gastric polyp: hyperplastic

32. Mx of stomach: adenocarcinoma

33. Lymphoma of stomach: MALToma>DLBCL

34. Mesenchymal Tx of abdomen: GIST

35. Site of polyps in GIT: colon

36. Mx of GIT: colon Ad Ca

37. Tx of appendix: carcinoid

38. Benign Tx of liver: cavernous hemangioma

39. Mx of liver: Mets

40. Primary Mx of liver: HCC>cholangio Ca

41. Primary MX of liver in children: Hepatoblastoma

42. Primary in hepatic mets: colon> breast>lung

43. Cyst of pancreas: pseudocyst

44. Cause of NS in children : MCD

45. Cause of NS in adults : FSGS

46. Cause of papillary necrosis : DM

47. Benign Tx of kidney : papillary adenoma

48. Mx of kidney : RCC (adenocarcinomas of kidney)

49. Type of RCC : clear cell

50. Site of RCC mets : lungs>bones

51. Cause of melacoplakia : E.coli>Proteus

52. Mx of bladder : TCC(urothelial carcinoma

53. CA of penis : SCC

54. Benign paratesticular Tx : adenomatoid

55. Mx of paratesticular : RMS

56. Testicular tumour : seminoma

57. Mx of prostrate : adenocarcinoma

58. Secondary in prostrate : urothelial carcinoma

59. Site of Mets in CA prostrate : lumbar spine>femur

60. Site of pituitary adenoma : anterior lobe

61. Type of pituitary adenoma : prolactinoma>GH

62. Type of PA secreting dual hormone : GH & prolactin

63. Thyroid Mx: PTC

64. Variant of PTC: Follicular variant

65. Cause of primary hyper parathyroidism: Adenoma

66. Cause of sec. Hyper parathyroidism: renal failure

67. Pancreatic endocrine neoplasms: insulinoma

68. Cause ACTH independent Cushings: Adrenal adenoma> carcinoma

69. Cause of cushings: glucocorticoids (exogenous)

70. Endogenous Cause of cushings: ACTH pit adenoma

71. Adrenal neoplasm in children: ACC

72. Adrenal neoplasm in adults: Adenoma=carcinoma

73. Common muscular dystrophy: Duchenne (DMD)

74. Most severe muscular dystrophy: DMD

75. Type of intracranial aneurysms: saccular (Berry)

76. Site of berry aneurysms: Ant cerebral A

77. Mx of brain: Mets

78. Primary for mets in brain: Lungs>breast

79. Primary tumor of CNS: Meningioma

80. Primary tumor of brain: Glioblastoma

81. Primary Mx of CNS: Glioblastoma

82. Primary Tx of CNS in childhood: pilocytic astrocytoma

83. Primary Mx of CNS in childhood: medulloblastoma

84. Midline Post fossa tumor in children: medulloblastoma