March 2017

Question 1

1. Which is not consistent with Wegeners
   a. Upper respiratory tract granulomas
   b. Lower respiratory tract granulomas
   c. Renal artery vasculitis
   d. Pulmonary artery vasculitis
   e. Glomerulonephritis

Answer 1

1. Which is not consistent with Wegeners
   a. Upper respiratory tract granulomas yes
   b. Lower respiratory tract granulomas yes
   c. Renal artery vasculitis no
   d. Pulmonary artery vasculitis yes
   e. Glomerulonephritis yes

Question 2

2. Two questions on Churg strauss
   a. Associated pANCA
   eGPA asthma, eosinophilia

Answer 2

2. Two questions on Churg strauss
   a. Associated pANCA yes
   eGPA asthma, eosinophilia

*LW:
Allergic granulomatosis and angiitis = churn strauss syndrome
- Allergic rhinitis, asthma, peripheral eosinophilia, pANCA
- Lung, heart, spleen, peripheral nerves, skin.
- Coronary arteritis, and myocarditis.
- Infrequent renal disease.

Question 3

3. Which doesn’t cause bowel ischaemia
   a. PAN
   b. Behchets
   c. Atherosclerosis

Answer 3

3. Which doesn’t cause bowel ischaemia
   a. PAN yes
   b. Behchets yes, possible but less likely out of these 3
   c. Atherosclerosis yes

Question 4

4. Most likely cause of acute bowel ischaemia
   a. SMA atherosclerosis
   b. SMV thrombosis
   c. Aortic dissection
   d. SMA embolus

Answer 4

4. Most likely cause of acute bowel ischaemia
   a. SMA atherosclerosis common
   b. SMV thrombosis yes
   c. Aortic dissection yes HTN and dissect into SMA
   d. SMA embolus AF most likely

Question 5

5. Aortic dissection
   a. 5-10% don’t have an intimal tear IMH
   b. Dissection between media and the intima
   c. Most common to have tear at junction of arch and proximal descending aorta

Answer 5

5. Aortic dissection
   a. 5-10% don’t have an intimal tear IMH 10%
   b. Dissection between media and the intima ?maybe not dissection usually outer third of media and can rupture into adventitia (robbins)
   c. Most common to have tear at junction of arch and proximal descending aorta yes aortic ischmus

*LW:
StatDx states Stanford A (I.e. ascending aorta and arch +/- descending) most common at 60%. so C likely less correct.

Question 6

6. What is least associated with BRCA
   a. Pancreas
   b. Prostate
   c. CRC
   d. Ovarian

Answer 6

6. What is least associated with BRCA
   a. Pancreas yes
   b. Prostate yes
   c. CRC yes no
   d. Ovarian yes

Question 7

7. Most likely to cause colon cancer
   a. PJ
   b. UC

Answer 7

7. Most likely to cause colon cancer
   a. PJ less likely but is associated with colon and breast
   b. UC yes

Question 8

8. Least likely to cause gastric cancer
   a. Fundic gland polyp
   b. Hyperplastic polyp
   c. Adenomatous polyp
   d. Partial gastrectomy
   e. H pylori

Answer 8

8. Least likely to cause gastric cancer
   a. Fundic gland polyp no
   b. Hyperplastic polyp can
   c. Adenomatous polyp yes
   d. Partial gastrectomy yes
   e. H pylori yes

Question 9

9. With regard to celiac disease (least likely)
   a. Severely affects the distal small bowel
   b. Increase in number of small bowel folds
   c. Villous atrophy
   d. Autoimmune reaction to ingested to gliadin
   e. Increased risk of MALToma

Answer 9

a. Severely affects the distal small bowel no

9. With regard to celiac disease (least likely)
   a. Severely affects the distal small bowel no
   b. Increase in number of small bowel folds yes distally
   c. Villous atrophy yes
   d. Autoimmune reaction to ingested to gliadin yes
   e. Increased risk of MALToma no MALToma with Hpylori, T lymphoma with celiac disease

Question 10

10. Most common location of small bowel adenocarcinoma
    a. Duodenum
    b. Proximal jejunum
    c. Distal jejunum
    d. Proximal ileum
    e. Distal ileum lymphoma,

Answer 10

a. Duodenum periampullary tumor

10. Most common location of small bowel adenocarcinoma
    a. Duodenum periampullary tumor
    b. Proximal jejunum GIST
    c. Distal jejunum
    d. Proximal ileum
    e. Distal ileum lymphoma, TB, Yersinia, carcinoid from enterochromaffin cells

Question 11

11. Young patient with bicornuate uterus and one kidney
    a. Mesonephric duct
    b. Mullerian duct mullarian anomalies
    c. Wolffian duct
    d. Genital ridge

Answer 11

b. Mullerian duct mullarian anomalies

11. Young patient with bicornuate uterus and one kidney
    a. Mesonephric duct
    b. Mullerian duct mullarian anomalies
    c. Wolffian duct
    d. Genital ridge

Question 12

12. Newborn with dilated colon and unilateral sacral agenesis
    a. Hirschsprungs
    b. Anal atresia
    c. Ileal atresia
    d. Meconium plug

Answer 12

b. Anal atresia VACTERL or curarino ASP triad anorectal malformation, sacral osseus defect, presacral mass

12. Newborn with dilated colon and unilateral sacral agenesis
    a. Hirschsprungs not sacrum
    b. Anal atresia VACTERL or curarino ASP triad anorectal malformation, sacral osseus defect, presacral mass
    c. Ileal atresia no
    d. Meconium plug no

Question 13

13. Which is associated with CF?

a. Hypertrophic pyloric stenosis

Answer 13

*LW:
Stat Dx states there is increased incidence of Pyloric stenosis with CF

13. Which is associated with CF?
    a. Hypertrophic pyloric stenosis articles say maybe, but I would say no

Question 14

14. Which is most suggestive of UC
    a. Pseudopolyps
    b. Uveitis
    c. Fistulas
    d. Sacroiliitis

Answer 14

a. Pseudopolyps yes

14. Which is most suggestive of UC
    a. Pseudopolyps yes
    b. Uveitis IBD
    c. Fistulas no
    d. Sacroiliitis IBD

Question 15

15. Most consistent with reactive arthritis
    a. Symmetrical sacroiliitis
    b. Shoulder arthropathy
    c. Commonly follows GI infection

Answer 15

c. Commonly follows GI infection yes arthritis follow GI or chlamydia is most consistent

15. Most consistent with reactive arthritis
    a. Symmetrical sacroiliitis no asymmetrics
    b. Shoulder arthropathy non specific
    c. Commonly follows GI infection yes arthritis follow GI or chlamydia is most consistent

Question 16

16. Hydroxyapetite deposition disease associated with
    a. Dermatomyositis
    b. Sjogrens
    C. Scleroderma
    d. Dialysis

Answer 16

d. Dialysis yes amyloid b2 microglobulin, CPPD and HADD, osteodystrophy

16. Hydroxyapetite deposition disease associated with
    a. Dermatomyositis no calcinosis universalis
    b. Sjogrens no
    c. Scleroderma no calcinosis circumscripta
    d. Dialysis yes amyloid b2 microglobulin, CPPD and HADD, osteodystrophy

Question 17

17. Least liekly to have changes in CJD
    a. Dentate nuclei
    b. Caudate
    c. Putamin
    d. Thalami

Answer 17

a. Dentate nuclei no

17. Least liekly to have changes in CJD
    a. Dentate nuclei no
    b. Caudate yes BG
    c. Putamin yes BG
    d. Thalami yes hockey stick

Question 18

18. Least likely CADASIL manifestation?
    a. External capsule ischaemia
    b. Basal ganglia ischaemia
    c. Anterior temporal white matter change
    d. Periventricular white matter changes
    e. Skin changes

Answer 18

e. Skin changes no

18. Least likely CADASIL manifestation?
    a. External capsule ischaemia yes classic location
    b. Basal ganglia ischaemia yes
    c. Anterior temporal white matter change yes classic location
    d. Periventricular white matter changes yes leukoencephalopathy
    e. Skin changes no

Question 19

19. Most true regarding HSV?
    a. HSV1
    b. HSV2
    c. Causes haemorrhagic necrosis
    d. Lateral temporal lobe changes

Answer 19

c. Causes haemorrhagic necrosis yes

19. Most true regarding HSV?
    a. HSV1 Most common cause of neonatal encephalitis no HSV2 birth canal
    b. HSV2 most common cause of adult encephalitis no HSV1
    c. Causes haemorrhagic necrosis yes
    d. Lateral temporal lobe changes mesial

Question 20

20. What is the least likely consequence of herniation
    a. DAI
    b. Duret haemorrhage y
    c. ACA infarct
    d. PCA infarct
    e. Kernohans notch

Answer 20

a. DAI false, it is associated but not a consequence

20. What is the least likely consequence of herniation
    a. DAI false, it is associated but not a consequence
    b. Duret haemorrhage yes stretching pontine perforators
    c. ACA infarct yes subfalcine
    d. PCA infarct yes transtentorial, also affects CN3
    e. Kernohans notch yes cerebral peduncle of contralateral side

Question 21

21. One month history of weakness with T2 hyperintensity in supraspinatus, infraspinatus, teres minor. Normal T1
    a. Impingement of the suprascapular nerve in the spinoglenoid notch
    b. Impingement of the suprascapular nerve in the suprascapular notch
    c. Quadralateral space
    d. Brachial neuritis

Answer 21

d. Brachial neuritis yes parsonate turners idiopathic brachial neuritis

21. One month history of weakness with T2 hyperintensity in supraspinatus, infraspinatus, teres minor. Normal T1
    a. Impingement of the suprascapular nerve in the spinoglenoid notch no, isolated infraspinatus
    b. Impingement of the suprascapular nerve in the suprascapular notch no, doesn’t involve teres minor
    c. Quadralateral space no teres minor only from axillary nerve
    d. Brachial neuritis yes parsonate turners idiopathic brachial neuritis

Question 22

22. Least likely to cause thoracic outlet syndrome
    a. Levator clavicular muscle
    b. Anterior scalene hypertrophy
    c. Cervical rib
    d. Pectoralis minor tunnel
    e. Supracalvicular mass

Answer 22

a. Levator clavicular muscle ?yes but super rare, above clavicle

22. Least likely to cause thoracic outlet syndrome
    a. Levator clavicular muscle ?yes but super rare, above clavicle
    b. Anterior scalene hypertrophy yes interscalene triangle
    c. Cervical rib yes C7
    d. Pectoralis minor tunnel yes subpectoral space
    e. Supracalvicular mass yes

Question 23

23. Varicose veins most correct?
    a. Vein thickening
    b. Enlarged vein with competent valves
    c. Venous ulcers that are slow to heal
    d. Cause significant numbers of PE

Answer 23

c. Venous ulcers that are slow to heal yes, usually chronic ulcers

23. Varicose veins most correct?
    a. Vein thickening false thin dilated
    b. Enlarged vein with competent valves false incompentent
    c. Venous ulcers that are slow to heal yes, usually chronic ulcers
    d. Cause significant numbers of PE no usually DVT not superficial

Question 24

24. Least correct regarding causes of pulmonary hypertension?
    a. Primary is progressive and results in death
    b. Partial filling defects associated with primary
    c. Primary is more common than secondary
    d. Can be caused by emphysema

Answer 24

c. Primary is more common than secondary no primary rare

24. Least correct regarding causes of pulmonary hypertension?
    a. Primary is progressive and results in death yes
    b. Partial filling defects associated with primary yes secondary chronic PE
    c. Primary is more common than secondary no primary rare
    d. Can be caused by emphysema yes

Question 25

25. Least true regarding malignant hypertension a. 1-5% of essential hypertension b. Can arise in people with previously normal blood pressure c. Fibrinoid necrosis (or sclerosis) of the arteriole walls d. Greater than 110mmHg diastolic

Answer 25

* LW: 25. Least true regarding malignant hypertension a. 1-5% of essential hypertension: Robbins states about 5% - so probably true b. Can arise in people with previously normal blood pressure yes c. Fibrinoid necrosis (or sclerosis) of the arteriole walls yes d. Greater than 110mmHg diastolic: greater than 120mmHg diastolic - so this is least likely.

Question 26

26. Least true regarding berry aneurysms a. 90 percent internal carotid b. 25% present within the first 24 hours with infarct due to vasospasm c. Can present as an enlarging mass d. 2% of post mortems

Answer 26

b. 25% present within the first 24 hours with infarct due to vasospasm no 26. Least true regarding berry aneurysms a. 90 percent internal carotid ~maybe b. 25% present within the first 24 hours with infarct due to vasospasm no c. Can present as an enlarging mass yes d. 2% of post mortems yes

Question 27

27. Least correct regarding ADEM? a. 20-30 percent mortality 10-20 b. Post viral or vaccination c. Perivenular d. Causes demyelination and axonal degeneration

Answer 27

a. 20-30 percent mortality 10-20 too high *Robbins states upto 20% D. Robbins states causes demyelination but doesnt mention axonal degeneration. 27. Least correct regarding ADEM? a. 20-30 percent mortality 10-20 too high b. Post viral or vaccination yes c. Perivenular yes d. Causes demyelination and axonal degeneration yes

Question 28

28. With regard to pleural solitary fibrous tumour a. Associated with asbestos b. Hypocalcaemia c. Cant remember the correct answer

Answer 28

28. With regard to pleural solitary fibrous tumour a. Associated with asbestos no b. Hypocalcaemia no hypoglycaemia c. Cant remember the correct answer

Question 29

29. Neuroendocrine lung tumour most likely to cause hypercalcaemia a. DIPNET b. Typical carcinoid c. Small cell lung cancer yes

Answer 29

c. Small cell lung cancer yes 29. Neuroendocrine lung tumour most likely to cause hypercalcaemia a. DIPNET b. Typical carcinoid c. Small cell lung cancer yes

Question 30

30. Most likely associated with hypocalcaemia a. Primary hyperparathyrodism b. Secondary hyperparathyroidism c. Tertiary hyperparathyroidism

Answer 30

b. Secondary hyperparathyroidism yes 30. Most likely associated with hypocalcaemia a. Primary hyperparathyrodism no b. Secondary hyperparathyroidism yes c. Tertiary hyperparathyroidism no

Question 31

31. Least likely to cause gynaecomastia a. Cirrhosis b. Adrenal hyperplasia c. Leydig cell tumour d. Sertoli tumour

Answer 31

b. Adrenal hyperplasia no 31. Least likely to cause gynaecomastia a. Cirrhosis yes b. Adrenal hyperplasia no c. Leydig cell tumour yes d. Sertoli tumour yes

Question 32

32. Most true regarding cryptorchidism a. 25% are bilateral b. Orchidopexy corrects increased risk of malignancy c. 10% of 1 year old boys d. Contralateral testis is almost always normal

Answer 32

a. 25% are bilateral - TRUE 25% 32. Most true regarding cryptorchidism a. 25% are bilateral - TRUE 25% b. Orchidopexy corrects increased risk of malignancy controversial c. 10% of 1 year old boys: FALSE 1% of 1year olds. d. Contralateral testis is almost always normal no

Question 33

33. Most common testicular cancer a. Yolk sack b. Teratoma c. Seminoma d. Choriocarcinoma

Answer 33

c. Seminoma yes 33. Most common testicular cancer a. Yolk sack b. Teratoma c. Seminoma yes d. Choriocarcinoma

Question 34

34. Most true regarding placental site tumour? a. Associated with markedly elevated BHCG b. Mostly associated with normal pregnancy

Answer 34

34. Most true regarding placental site tumour? a. Associated with markedly elevated BHCG no mild (*LW agrees, rare form of GGT, with less syncitiotrophblasts hence lower BHCG) b. Mostly associated with normal pregnancy ??no, sometimes (*LW - may occur after normal pregnancy, molar pregnancy or even after a terminated pregnancy.)

Question 35

35. Regarding choriocarcinoma (False) a. Better prognosis with non-gestational choriocarcinoma b. Frequently metastases at presentation c. Can present up to 2 years after pregnancy

Answer 35

a. Better prognosis with non-gestational choriocarcinoma false 35. Regarding choriocarcinoma (False) a. Better prognosis with non-gestational choriocarcinoma false b. Frequently metastases at presentation yes c. Can present up to 2 years after pregnancy yes up to 15

Question 36

36. Not associated with pre-eclampsia a. Placental infarcts b. HELLP c. Neurological symptoms d. Retroplacental bleed

Answer 36

**LJS - pre-eclampsia get headaches and visual disturbance but eclampsia defined by CNS involvement - seizures/coma. Depends on definition of neurological. c. Neurological symptoms no 36. Not associated with pre-eclampsia a. Placental infarcts yes b. HELLP yes c. Neurological symptoms no d. Retroplacental bleed yes

Question 37

37. Not associated with sarcoid a. Membranous glomerulonephritis b. Mickulicz ?

Answer 37

*LW: 37. Not associated with sarcoid a. Membranous glomerulonephritis no b. Mickulicz - gland disease of Sjoggren syndrome, associated with Sarcoidosis.

Question 38

38. True regarding pagets disease of the nipple a. Eczematous reaction on skin b. Occult DCIS involving the nipple ? c. Lactiferous ducts involved in less than 5%

Answer 38

a. Eczematous reaction on skin yes b. Occult DCIS involving the nipple: although Paget cells extend from DCIS within ductal system into nipple skin without crossing BM, so DCIS cells are present but dont arise from nipple. 38. True regarding pagets disease of the nipple a. Eczematous reaction on skin yes b. Occult DCIS involving the nipple ? c. Lactiferous ducts involved in less than 5% no

Question 39

39. Regarding fibrous dysplasia a. >50% polyostotic b. Commonly have café-au-lait spots c. In the skull, facial bones and mandible more commonly involved than the vault

Answer 39

39. Regarding fibrous dysplasia a. >50% polyostotic FALSE - monoostotic >70% b. Commonly have café-au-lait spots FALSE <3% c. In the skull, facial bones and mandible more commonly involved than the vault: depends on wording: - FALSE if referring to monostotic form - Robbins states jawbone and calvaria most commonly affected in monoostotic form out of head bones. - TRUE if polyostotic: Craniofacial involvement is present in 50% of patients who have moderate number of bones affected, and 100% in with extensive skeletal disease.

Question 40

40. Regarding osteosarcoma (false): a. Periosteal has a cleft between the bone and the tumour b. Parosteal has significant cartilage component c. High grade surface osteosarcoma has a similar prognosis to conventional

Answer 40

a. Periosteal has a cleft between the bone and the tumour false 40. Regarding osteosarcoma (false): a. Periosteal has a cleft between the bone and the tumour false b. Parosteal has significant cartilage component yes c. High grade surface osteosarcoma has a similar prognosis to conventional yes

Question 41

41. Most common cause of jaundice in pregnancy a. Cholestasis b. HELLP c. Viral hepatitis d. Choledocolithiasis

Answer 41

*LW preferred answer is viral 41. Most common cause of jaundice in pregnancy a. Cholestasis yes b. HELLP c. Viral hepatitis d. Choledocolithiasis

Question 42

42. Least true with regard to endocarditis: a. Acute causes valve destruction b. Acute affects previously damage valves C. Strep viridans most common cause of subacute

Answer 42

42. Least true with regard to endocarditis: a. Acute causes valve destruction yes b. Acute affects previously damage valves no c. Strep viridans most common cause of subacute yes

Question 43

43. Least likely to with regard to congenital heart disease a. Truncus arteriosus carries a poor prognosis b. Septum primum ASD presents early

Answer 43

**LJS - septum primum ASD is big defect, unlikely to be asx But overall ASD more likely to present in adulthood vs VSD 43. Least likely to with regard to congenital heart disease a. Truncus arteriosus carries a poor prognosis yes b. Septum primum ASD presents early no

Question 44

44. Which is least likely regarding ovarian tumours a. Serous carcinoma more common than borderline b. Serous carcinoma more likely bilateral c. Mucinous more common than serous d. Mucinous more commonly malignant

Answer 44

44. Which is least likely regarding ovarian tumours a. Serous carcinoma more common than borderline: Unsure - Robbins states 75% are benign or borderline, while 25% malignant. b. Serous carcinoma more likely bilateral: TRUE c. Mucinous more common than serous: FALSE (serous most common malignant ovarian neoplasm) d. Mucinous more commonly malignant: FALSE 15% are malignant (compared to 25% of serous).

Question 45

45. Most likely cause of partial hepatic fibrosis a. Budd Chiari b. Alpha-1-antitripsin c. Wilsons d. Haemachromotosis

Answer 45

45. Most likely cause of partial hepatic fibrosis a. Budd Chiari yes b. Alpha-1-antitripsin c. Wilsons d. Haemachromotosis

Question 46

46. Most true with regard to osteopetrosis a. Hepatosplenomegally b. Axial more affected than appendicular c. No increased risk of fracture d. Autosomal recessive form affects the navicular e. Autosomal dominant form…

Answer 46

46. Most true with regard to osteopetrosis a. Hepatosplenomegally yes b. Axial more affected than appendicular no c. No increased risk of fracture no d. Autosomal recessive form affects the navicular no e. Autosomal dominant form… no

Question 47

47. Least likely to cause expansion of the pituitary fossa a. Meningioma b. Germinoma c. Craniopharyngioma d. Lymphocytic hypophysitis e. Macroadenoma

Answer 47

47. Least likely to cause expansion of the pituitary fossa a. Meningioma b. Germinoma c. Craniopharyngioma d. Lymphocytic hypophysitis yes e. Macroadenoma

Question 48

48. Least correct with regard to macroadenoma: a. Commonly non-secretory b. PRL production most common c. Can invade the cavernous sinus d. The correct answer

Answer 48

48. Least correct with regard to macroadenoma: a. Commonly non-secretory yes b. PRL production most common: incorrect if over all most common i.e. non secretary is most common. However Prolactinomas are most common type of hyper functioning adenoma and can range in size including macro adenomas. c. Can invade the cavernous sinus yes d. The correct answer

Question 49

49. Least true with regard to chondrosarcoma a. Low grade lesions can cause reactive cortical thickening b. 15% arise from benign condroid lesions c. Majority high grade d. Most arise in axial skeleton

Answer 49

49. Least true with regard to chondrosarcoma a. Low grade lesions can cause reactive cortical thickening yes b. 15% arise from benign condroid lesions yes c. Majority high grade no d. Most arise in axial skeleton yes

Question 50

50. Woman with history of breast cancer, limp and hip pain 2 weeks, with increased T2 signal surrounding the psoas muscle a. Psoas tear b. Metastasis of the lesser trochanter c. Subtrochanteric fracture d. Subcapital fracture

Answer 50

*LW: Psoas tear is very rare With a HX of breast Cancer I think this is implying the pathological fracture of lesser troch 50. Woman with history of breast cancer, limp and hip pain 2 weeks, with increased T2 signal surrounding the psoas muscle a. Psoas tear yes b. Metastasis of the lesser trochanter c. Subtrochanteric fracture d. Subcapital fracture

Question 51

51. Vitamin most associated with prostate carcinoma risk a. D b. E c. K d. A e. C

Answer 51

51. Vitamin most associated with prostate carcinoma risk a. D yes b. E - protective. c. K d. A - protective e. C

Question 52

52. Least frequent with MEN1 a. Pituitary adenoma b. Adrenal cortical adenoma c. Pancreatic islet cell tumour d. Phaeochromocytoma

Answer 52

52. Least frequent with MEN1 a. Pituitary adenoma b. Adrenal cortical adenoma c. Pancreatic islet cell tumour d. Phaeochromocytoma yes

Question 53

53. Least true regarding Wilsons a. Reduced ceruloplasmin b. Increased excretion of copper into bile c. Autosomal recessive

Answer 53

53. Least true regarding Wilsons a. Reduced ceruloplasmin yes b. Increased excretion of copper into bile: false, has reduced excretion. c. Autosomal recessive yes

Question 54

54. Least likely to cause splenomegaly a. Biliary acarisis b. Cirrhosis c. Schistosomiasis d. Hepatitis B

Answer 54

54. Least likely to cause splenomegaly a. Biliary acarisis no b. Cirrhosis c. Schistosomiasis d. Hepatitis B

Question 55

55. Least likely a result of diabetes a. Calcification of the vas deferans b. Amyloidosis c. Pancreatitis

Answer 55

55. Least likely a result of diabetes a. Calcification of the vas deferans b. Amyloidosis c. Pancreatitis no

Question 56

56. Least true regarding wilms a. Dysplastic kidneys risk factor b. Most <2 years old

Answer 56

56. Least true regarding wilms a. Dysplastic kidneys risk factor yes b. Most <2 years old no

Question 57

57. True regarding neuroblastoma a. Metastases can regress in infants b. Frequently lymph node involvement at diagnosis c. VMA for screening

Answer 57

57. True regarding neuroblastoma a. Metastases can regress in infants yes b. Frequently lymph node involvement at diagnosis yes c. VMA for screening yes

Question 58

58. Least associated with NF2 a. Meningioma b. Ependymoma c. Schwannoma d. Dural calcification e. Optic nerve glioma

Answer 58

58. Least associated with NF2 a. Meningioma b. Ependymoma c. Schwannoma d. Dural calcification e. Optic nerve glioma no

Question 59

59. Most likely diagnosis – 2cm cystic mass in the head of the pancreas in a 50 year old male a. IPMN b. Mucinous c. Serous d. Adenocarcinoma

Answer 59

59. Most likely diagnosis – 2cm cystic mass in the head of the pancreas in a 50 year old male a. IPMN yes b. Mucinous c. Serous d. Adenocarcinoma

Question 60

60. Most likely to have pseudomembranes a. Infectious colitis and pseudomembranous colitis b. Dysentry and ischaemic colitis c. Pseudomebranous colitis and ischaemic colitis

Answer 60

*LW: Pseudomembranous colitis and ischemic colitis Most common cause of pseudo membranes is Pseudomembranous colitis secondary to C. Difficile infection. The only other mention of pseudomembranes in Robbins is Ischaemic colitis, thus B is favoured answer. Less common non-C. difficile causes of pseudomembranous colitis include Behcet’s disease, collagenous colitis, inflammatory bowel disease, ischemic colitis, other infections organisms (e.g. bacteria, parasites, viruses), and a handful of drugs and toxins. Previous answer: 60. Most likely to have pseudomembranes a. Infectious colitis and pseudomembranous colitis yes b. Dysentry and ischaemic colitis c. Pseudomebranous colitis and ischaemic colitis

Question 61

61. True regarding mucinous ovarian carcinoma | a. 70% 5 year survival with peritoneal disease

Answer 61

61. True regarding mucinous ovarian carcinoma a. 70% 5 year survival with peritoneal disease FALSE Robbins refers to serous carcinoma involving peritoneum as 5yr survival of 25%. I would imagine Mucinous is worse.

Question 62

62. Most likely regarding mixed mullerian tumours a. Homologous with endometrial, mesenchymal elements b. Heterologous with epidermal and neural elements c. Combination/collision of two different germ cell lines

Answer 62

62. Most likely regarding mixed mullerian tumours a. Homologous with endometrial, mesenchymal elements yes b. Heterologous with epidermal and neural elements c. Combination/collision of two different germ cell lines

Question 63

63. Diabetic mastopathy least likely a. Painful b. Difficult to distinguish from tumour clinically c. Soft mass d. Thought to be autoimmune

Answer 63

**LJS - painless hard mass (fibrotic), diffc ddx from ca clinically 63. Diabetic mastopathy least likely a. Painful painless b. Difficult to distinguish from tumour clinically c. Soft mass d. Thought to be autoimmune

Question 64

64. Least likely regarding male breast cancer a. Lobular comparatively more common than ductal when compared to females b. Papillary comparatively more common than in females c. 50% have lymph nodes at presentation

Answer 64

a. Lobular comparatively more common than ductal when compared to females no 64. Least likely regarding male breast cancer a. Lobular comparatively more common than ductal when compared to females no b. Papillary comparatively more common than in females c. 50% have lymph nodes at presentation

Question 65

65. Least likely post acute MI a. Pericarditis b. Mitral valve prolapse c. Aortic valve prolapse d. Mural thrombus e. Myocardial rupture

Answer 65

c. Aortic valve prolapse no 65. Least likely post acute MI a. Pericarditis yes b. Mitral valve prolapse yes c. Aortic valve prolapse no d. Mural thrombus yes e. Myocardial rupture yes

Question 66

67. Most commonly associated with renal papillary necrosis a. NSAIDS b. Steroids

Answer 66

67. Most commonly associated with renal papillary necrosis a. NSAIDS yes b. Steroids