/50

Pathology Test Part 1

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1) A 55 year old presents to clinic due to vulval itch and discolouration. examination reveals pale white discoloured areas to the vulva. A biopsy conforms Lichen Sclerosus (LS). What is the risk of developing squamous cell carcinoma compared to patients with normal vulval biopsy?

2) Which age group has the highest rates of chlamydia infection?

3) Renal cell carcinoma is associated with which type of metastasis

4) A 38 year old women attends clinic follow up. You note pelvic ultrasound shows a 60mm simple cyst. What is the most appropriate course of action regarding this cyst according to the RCOG green top guidelines?

5) Regarding Gestational Diabetes which of the following statements is TRUE?

6) A 30 year old women who is 24 weeks pregnant attends EPU due to suprapubic pain. Ultrasound shows a viable foetus and also a fibroid with a cystic fluid filled centre. What is the likely diagnosis?

7) Paraneoplastic Cushing's syndrome is most commonly associated with which of the following malignancies?

8) Regarding the diagnosis of Gestational Diabetes which of the following tests is recommended by the WHO for diagnosis?

9) A 24 year old who is 32 weeks pregnant presents with a rash to the abdomen. Looking at the picture below what is the diagnosis?

10) You are asked to review a patient. They have attended for a scan at 13 weeks following a positive pregnancy test. The patient has had 2 previous pregnancies for which she opted for termination on both occasions. The scan shows no identifiable fetal tissue or gestational sac and you note the radiologist has reported a 'bunch of grapes sign'. What is the likely diagnosis?

11) Choriocarcinoma is associated with which type of metastasis?

12)

You are reviewing a patient with a scan suggestive of partial molar pregnancy. What is the
typical genotype of a partial molar pregnancy?

13) Regarding Venous Thomboembolism (VTE) in pregnancy which of the following statements are TRUE?

14)

You are assessing a patient with an ovarian mass and are using the Risk of Malignancy Index 1
(RMI) score. Which of the following is used to calculate the RMI?

15)

You are asked to review a 32 year old patient who is 34 weeks pregnant on the early pregnancy unit who has attended due to severe abdominal pain. After sending bloods you are phoned by the lab as the serum amylase has come back raised at 450 U/L. You diagnose acute pancreatitis.
What kind of necrosis is seen in this situation?

16) Endometriosis is an example of which of the following?

17) A 42 year old smoker attends clinic due to vulval soreness and shows you a number of vulval lumps. Biopsy is taken and reported as showing epithelial nuclear atypia, loss of surface differentiation and increased mitosis. What is the diagnosis?

18)

A patient has returned to your clinic. She presented with painful periods 18 months earlier and
laparoscopy confirmed endometriosis. She now gets pain on opening her bowels as well as low
back pain. What structure is likely to be involved?

19)

A 35 year old woman has a pelvic ultrasound scan showing multiple fibroids. What is the most
common form of fibroid degeneration?

20) The increase in number of endometrial cells during pregnancy is an example of

21) A couple have been referred to the infertility clinic. The male partner Is 25 and has CF, his semen analysis shows azoospermia. What is the likely underlying cause?

22) A patient asks you in clinic when she can start trying to conceive again. She has just completed chemotherapy for gestational trophoblastic disease (GTD)?

23) A 77 year old woman undergoes staging investigations for endometrial carcinoma. This shows invasion of the inguinal lymph nodes. What is this patients 5‐year survival?

24)

A 25 year old primigravida carrying a twin male pregnancy presents at 31 weeks gestation. She
is lethargic, clinically jaundiced and complains of abdominal pain with frequent vomiting. You
suspect acute fatty liver of pregnancy (AFLP). What is the the primary cause of AFLP?

25) You see a patient with the rash below:

Which of the following cancer types is this most strongly associated with?

26) Ovarian cancer is associated with which type of metastasis?

27) Hepatocellular carcinoma

28) A patients MSU comes back showing heavy growth of E.Coli that is resistant to trimethoprim, amoxicillin and nitrofurantoin. You decide to prescribe a course of Cefalexin. What is the mechanism of action of Cefalexin?

29) A 74 year old patient undergoes biopsy of an ulcerated vulval lesion. What is the most likely cancer type?

30)

A 28 year old primigravida carrying a twin pregnancy presents at 32 weeks gestation. She is lethargic, clinically jaundiced and complains of abdominal pain with frequent vomiting. Her bloods are as follows:
Bilirubin 62 µmol/l
ALP 640 u/l
ALT 196 u/l
γGT 185 u/l
Albumin 24 g/l
INR 3.2
What is the likely diagnosis?

31)

A 35 year old women attends clinic following laparotomy and unilateral oophorectomy. The
histology shows Psammoma bodies. What type of tumour would this be consistent with?

32) Regarding the rash below which of the following statements is true?

33) Closure of a patent ductus arteriosus in a term infant should be via?

34) You review a patients blood results and find the following:

Na+         123 mmol/l
K+            5.0 mmol/l
Urea 2.5 mmol/l
Creatinine 70 µmol/l
You diagnose SIADH. Which malignancy is most commonly associated with SIADH?

35) During pre‐op assessment for hysterectomy and oophorectomy a patients chest XRAY shows a Ghon focus suggestive of past tuberculosis infection. What kind of necrosis is seen in tuberculosis infection?

36) A patient attends the maternity unit as her waters have broken but she hasn't had contractions. She is 39+6 weeks gestation. Speculum examination confirms prelabour rupture of membranes (PROM). What is the risk of serious neonatal infection with PROM?

37)

A 69 year old lady has a stroke on the ward 4 days after hysterectomy. What type of necrosis
typically occurs in cerebral infarction?

38)

A couple come to see you in clinic. The male partner reveals he has cystic fibrosis and wants to
know what his likelihood of being infertile is. What is the male infertility rate in CF patients?

39) The increase in size of endometrial cells during pregnancy is an example of

40) A 77 year old woman undergoes investigation for postmenopausal bleeding. A lesion is biopsied from t he cervix that is histologically confirmed as endometrial carcinoma. Further staging investigations shows no spread to the serosa or adnexa, no spread to the para‐aortic, pelvic or inguinal lymph nodes and no evidence of distant metastasis. What FIGO stage is this?

41) A 30 year old patient has a cervical smear. The report shows anisocytosis, poikilocytosis and hyperchromatism. What are these features suggestive of?

42) Endometrial tissue found within the myometrium is classed as

43) What percentage of patients with breast cancer have hypercalcaemia

44) What percentage of cervical cancers are HPV related?

45) What is the incidence of hyperthyroidism in complete molar pregnancy?

46)

The change of cervical simple columnar epithelium with stratified squamous epithelium is an
example of

47) The UK childhood vaccination schedule includes vaccination against HPV for girls aged 12 to 13. What HPV subtypes are vaccinated against with the vaccine Gardasil®?

48) A 69 year old patient undergoes staging investigations for endometrial carcinoma. This shows invasion of the vaginal wall but no nodal involvement or distant metastasis. What FIGO stage is this?

49) A 29 year old is diagnosed with stage 1A2 cervical cancer. Which of the following is the most appropriate treatment option?

50) You are asked to review a patient. They have attended for a scan at 13 weeks following a positive pregnancy test. The patient has had 2 previous pregnancies for which she opted for termination on both occasions. The scan shows a large irregular haemorrhagic mass that appears to be invading into the myometrium. What is the likely diagnosis?

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