Pathology Final - Fall 2017

Optimizing nine path final dumps (2015-17)

Made by Dirk -- Cuban 2020

Cardiovascular--
Fibrous cap/plaque/angina:
-Question about angina, what does this describe? Stable plaque
-Described chest pain on exertion- Stable angina- ask what is the stenosis of the coronary was the answer (try to confuse
with vasospasm= Prinzmetal angina, and unstable plaque- Unstable angina)
-Atherosclerotic plaque, what is highest chance of rupture = thin fibrous cap
-Thin fibrous cap….__________ core? Thick Fibrous cap…. ________ ? Thin-> Less stable, bigger core. Thick-> More
stable, smaller core, Core: has lipids, macrophages & T-cells
Cardiomyopathy:
-DIALATED CARDIOMYOPATHY causes?A-alcholism, anemia B - Cocksackie B + BeriBeir (thiamine deficienc), C-
Chagas disease, D - Dystrophin Gene, pregnancy
-Question describing young athlete that died, what did he have? hypertrophic cardiomyopathy
-OLDER GUY PLAYING SPORT and fell over = Hypertrophic cardiomyopathy (cause it said sport)
-WHITE HEART = RESTRICTIVE and asked for cause ( 2 big causes) Fibrosis, chronic ischemic heart disease
-RESTIRCTIVE CARDIOMYOPATHY = Diastolic problem
-Restrictive cardiomyopathy what is a risk factor/leads to? Amyloidosis
-Heart problems from amyloidosis – transthyretin
-Hypertrophic cardiomyopathy, what is the mechanism? Beta-myosin
Arteritis:
-Polyarteriitis nodosa = associated with hepatitis B
-Question describing giant cell arteritis, what is associated with it? Polymyalgia rheumatica
-Giant cell temporal arteriitis = vision loss I think
-Patient with Media and Adventitia fibrosis? How old is she? What does she have? Takayasu Arteritis, <40, 7:1 females
Wegner’s:
-Another question describing wegner’s, asked what will you find on physical exam? Nasal ulceration
-Patient had RPGN type III and said no deposits in IF and also said person had nasalpharyngeal problem?what was the
marker? PR-­­3( Wegners)
-RPGN- type III- pauci immune- Wegner’s sinusitis, lung, and renal - asked what will you see on IF- c-ANCA but they put it
down as PR3 ANCA
-Know that wegeners affects upper respiratory tract (around nose) and that goodpasteurs does not
-Described wegner’s what protein? PR3-anca
-Showed Wegners histological picture and asked question
-Question that someone gets kidney problems AND necrotic abscesses around the face. What else would you find? -
Answer: PR3-ANCA (which is C-ANCA)
-Know hypersensitivities of all the arteriole problems, wegner’s, pan, the PANCA and CANCA markers and shit- high yield
P ANCA and C ANCA Mechanism? Microscopic Polyangitis & Churg- Panca. Wegner- Canca/PR3anca
Aortic dissection/aneursym/calcification/stenosis:
-AORTIC DISSECTION = WHAT WAS THE CAUSE = MARFANS/FIBRILIN GENE Intimal Tear, media weakening
-Risk factor of aortic dissection? HTN
-Risk factor for aortic aneurysm? Atherosclerosis
 -MCC of Aortic calcification… Calcific aortic stenosis in 1) elderly 2) congenital bicuspid
-Old lady with murmur and aortic calcification- what causes = normal aging
-Old man dies from calcification in aorta – wear and tear (aging)
-Abdominal aorta aneurysm- what is main cause = atherosclerosis (hyperlipidemia)
-Know that pain radiating to back is dissection
-Picture of aortic stenosis, where else would you see? Breast
Sudden Death:
-Question about sudden cardiac death, what is the complication? Arrhythmia
-SUDDEN CARDIAC DEATH causes? Arrhythmia, can sudden major emboli also be a cause?
-Described sudden death due to hypertrophic cardiomyopathy and asked cause = beta myosin heavy chain
MI:
-Pt. w/ MI has distended jugular vein, muffled heart sounds, what is the complication? Ventricular rupture
-Muffled heart sounds, elevated JVP, HTN - Free wall has ruptured.. What artery? LAD?
-Showed a picture of Timeline of MI histology: Two weeks
-Picture of MI with scar, what is happening at 12 hours = coagulation necrosis
-Showed picture of an MI and asked you to 'date' it
-Picture of heart with fibrous scar tissue of heart, when do you see this? 2 months
-Described scar formation and asked what are you going to have at two weeks= type 1 collagen I think
-Lady had MI, if see acute abdominal pain- had to come up with ischemia - question was where- splenic flexure, intestinal
angina
-Lady had MI, got ventricular aneurysm- got right cerebral hemorrhage, cause- embolic hemorrhagic stroke
-Patient had MI admitted to hospital and had another MI… What is the Most important Cardiac Marker (in general)? And
in this case what is the most diagnostic marker in this case? Troponin I. Ck-MB (peaks at 24 hrs) for re-infarct diagnosis
-Guy with MI, how do you detect reinfarction? CK-MB
-There was a question about a lady who had an MI, and then a couple weeks later she had a stroke in the supermarket. -
What was the cause. Answer: Mural wall thrombosis that was created during MI, broke free and caused Stroke.
-Described old dude having heart attack = need to know what atherosclerotic emboli is made of
VSD ect...:
-Picture of tetralogy of fallot, what is complication? Polycythemia
-Complication of tetrology of fallot= not sure, I put cerebral thrombosis
-Patient with pansystolic murmur, what does he have? VSD
-Patient is an 18 month old child membranous cardiac defect that resulted in Angiomatoid change? What is the Defect? -
What syndrome can result of the aforementioned shunt reversal? Membranous-VSD (L->R). Eisenmeger (R->L)
-Described post ductal coarctation and had to know complication = not too sure on answer, I put cerebral something
Thrombus/Embolism:
-Showed the picture of the pulmonary embolism and asked where the embolism came from? Popliteal vein
-Asked where mural thrombus will go? Lower limbs
-Talked about Jak 2 mutation and decrease epo: thinking thrombosus
-Picture of marrow embolism and said death after resuscitation attempts = answer was aggressive cardiac resuscitation
-Bone marrow embolism is found in ..- Incidental finding after cardiac resuscitation flat bone breaks (sternum, pelvis, ribs)
- more marrow cells than fat cells
-PATIENT who died INSTANTLY – CPR was performed→ unsuccessful outcome… _________ EMBOLISM? And what type of
finding on autopsy? Bone marrow embolism, small pulmonary vessels with fat and very high content of RBCs (cells>fat)
-How you look for fat embolism? Sputum/urine test for fat globules
-Long bone fractures Hugely associated with…? Fat Embolism (fat>cells)
-Showed picture of an atherosclerotic embolus and asked what the white lines were – cholesterol clefts
-Asked how you know it is a clot vs a thrombus – no lines of Zahn
CLOT VS. THROMBUS? Clot- platelets w/o fibrin, gelatinous, not attached to vessel wall, red Thrombus: platelets+fibrin,
firm, lines of Zahn, inside vessel, arterial (pale) & venous (red), attached to vessel wall
 -Arterial thrombi what color Pale
-Venous Thrombi Red
-Paradoxical DVT that reaches the brain… how’d it get there? VSD, ASD,PFO
-DVT in popliteal- what causes- when do not ambulate
PAN and Hep B:
-PAN, what is associated? Hep B
-TYPE III PAN largely associated with? Hep B, type 3 hsn
-Showed histo of PAN and asked what is associated -> Hep B
HTN/Hypertrophy:
-Described hypertension below 160 = hyaline arteriolosclerosis/// 160-210 = hyperplastic arteriolosclerosis /// above 210
= necrotizing
-Concentric hypertrophy, what do you get? Pulmonary hypertension
-Histo of Hyperplastic malignant htn, what is complication? Stroke
DiGeorge/Turner:
-Described DiGeorge, what was problem? Thymic development
-Notching of ribs, coarctation of aorta Turner syndrome
Heart Failure:
-Left-heart failure, what is a symptom? Orthopnea
-Showed hemosiderin in heart failure- ask where would you see similar pigment- we put Hemochromocytosis (because
iron, be careful do not put lipofuscin)
Pericarditis:
-Guy has MI, leaning forward helps relieves pain, friction rub, what does he have? Fibrinous pericarditis,
-Described jones criteria, described skin modules and joint pain = answer was heart pancarditis
-Pericarditis is caused by rheumatic fever or MI = fibrinoid for a few days and then dresslers autoimmunity after 2 weeks
Aschoff bodies:
-Female presents to the office with a mid-systolic murmur. History reveals a significant childhood illness… Presents with
Fever, Erythema marginatum, Valvular damage, ESR (increased), Red-hot joints (migratory polyarthritis), Subcutaneous
nodules… What is seen on histology? (signs of Acute Rheumatic disease) → Aschoff bodies and Anitschkow cells in
myocardium histology
-Showed picture of aschoff body and asked where to find it= heart myocardium
Rheumatic fever:
-RHEUMATIC FEVER? What are the deposits you see made of… Composition? Sterile, fibrin, small
-Described Rheumatic Fever: antibody against self antigen
-Rheumatic fever – cross reacting antibodies
-RHEUMATIC FEVER CROSS REACTING ANTIBODY with…. M proteins in heart (have cross reactivity with antigens of Group
A streptococci)
Kawasaki:
-Kawasaki, what is complication? MI
-Indication for aspirin in a child? Kawaski
Buerger’s:
-Histo Thromboangitis, what is the mechanism? Tobacco hypersensitivity
-Described Burgers disease and asked what is cause = smoking
-Scenario of guy with weak calves, loss of skin, what is the mechanism? Buerger’s hypersensitivity
Syphilis:
-Picture of tree bark syphilis and what causes the mechanism? Something about vaso vasorum
-Syphilis thoracic aneurysm picture, what is the cause = something to do with vaso vasorum
Marfan’s/Ehler-Danlos:
-Describe a lady with mitral valve prolapse, what is a risk factor? Marfan’s
-22 YEAR OLD WOMAN with MITRAL PROLAPSE = WHAT ELSE WOULD YOU CHECK FOR = MARFANS
 -Mitral valve prolapse in middle aged women = collagen problem so either marfans or erlos danos
-Described Cola1 mutation, Ehler-Danlos- what will you see- blue sclera.
Endocarditis:
-Prosthetic valve infection = staph epidermidis
-ENDOCARDITIS in a non IVDU… Mcc organism? And MCC valve? Who Gets the vegitations on the Aortic valve? strep
viridians is the most common cause of native mitral valve infection. Aortic for an elderly person. staph epi for prosthetic
valve. s. aureus-tricuspid valve (iv-drug)
-Describe infective endocarditis, causes splinter hemorrhages? Peripheral emboli
-Viral myocarditis complication = not too sure I put infectious endocarditis
-Thrombogenic substances released from necrotic tumor cells? Trousseau Syndrome (MARANTIC adenocarcinoma)
Coxasackie B:
-Showed viral myocarditis picture and asked cause – Coxsackie
-COXASACKIE B virus would have _________ infiltrate lymphocytic
Hemangioma:
-An example of Hamartoma that is self resolving…? Hemangioma
-Which vascular tumor resolves on its own? Hemiangioma by age 7*
--Heme
Spherocytosis:
-Talked about hereditary spherocytosis: Defect in membrane
-Hereditary spherocytosis. It asked how you would diagnose it. Answer: Osmotic fragility test.
-Also describe spherocytes, Coomb’s positive- described autoimmune thrombocytopenia - IgG mediated
-Hereditary spherocytosis- osmotic fragility test
-Described hereditary spherocytosis, but said that it was coombs positive – which means that it was Chronic Lymphocytic
Leukemia. What was causing the destruction of th. Answer: Autoimmune destruction. e RBCs
G6PD/Heinz:
-Image of heinz bodies
-G6PD deficiency- patient just had an episode how would you test - detect Heinz bodies (do not pick enzyme assay -
because need to wait until 2 months later to be positive)
-G6PD deficiency- get tired easily (anemia), a peripheral blood smear shows bite cells (heinze bodies removed). How you
would diagnose the disease? Do a G6PD assay to look for the missing enzyme.
-Show a picture of G6PD and asked the cause – fava beans
-G6PD: what was the cause? Infections
Anemia/hypoxia:
-Aplastic Anemia : Irradiation of the body
-Another hypoxia question something with nail spooning but re-phrased 2 times
-Couple questions on iron deficiency anemia. Know it presents with hypochromic, microcytic anemia, and has Koilonychia
(spoon fingers).
-Described iron deficiency anemia - microcytic, micro chromic, no splenomegaly, target cells - koilonykia (nail spooning)
-Showed the picture of the iron deficiency nails and asked what kind of RBCs – microcytic, hypochromic anemia
-Asked what mutation results in sickle cell disease - point mutation
-Sickle cell anemia, kid with dactylitis, failure to thrive, recurrent infections, etc. What would cause the cells to sickle. -
Answer: Dehydration. Other causes they could ask are: Low pH (high ph was a wrong answer on the test), hypoxia,
infection, hypothermia, etc.
-Described Sickle cell trait but in a weird way (nothing about HbS, just said about HbA and HbF), showed the boy with
daktylitis - most common cause of death- infection
-Described some sort of hemolytic anemia: decreased haptoglobin
-Image of megaloblastic anemia and asked etiology - folate/B12 def.
-Question about anemia of chronic disease - the iron is trapped in the macrophages and not released to the erythroid
precursors
 -High ferritin, low TIBC, low serum Fe – anemia of chronic disease
-Described PHN and asked what causes the anemia – hemolysis
B-thalasemia:
-Described B-thal and asked what causes the intravascular hemolysis – congregation of alpha chains
-There were a couple questions about B-thalasemia major. One asked what actually caused the destruction of the red
blood cells. The answer is the formation of tetramers of the alpha chains
-Described Beta-­­thallasemia: complication was secondary hemochromatosis
-Histo of heart failure cells from a guy who died of an MI. What else you would see these cells in. Blood transfusions – like
from Beta Thalassemia major.
Multiple Myeloma:
-Described multiple bone lesions with IgG spike- Multiple Myeloma- tried to confused with Prostate cancer
-Showed a picture of multiple myeloma and described man with back pain, asked what complication is – proteinuria
-Showed picture of Multiple myeloma: light
-Described a person with multiple myeloma? what would be complication: Amyloid
-Image of skull lesions [multiple myeloma sclerosis] -amyloids made up of light chains
-Amyloidosis- needed to know that Bence Jones protein meaning multiple myeloma, what kind of amyloid was it? =
localized amyloidosis
AML/Auer Rods:
-Image of AML - asked translocation
-Describes AML (auer rods) – t(15;17)
-Showed picture of Auer rods: 15-­­17
-Auer Rods- complication DIC, because thrombogenic (they give Waterhouse-Friderichsen too, but no adrenal symptoms)
-Described a leukemia with auer rods (AML), and asked what a complication was. DIC.
-AML - M3 promyelocytic leukemia
-Question about a leukemia (can’t remember which one), answer was that it transforms to AML. So just know which
leukemias go to AML Myeloproliferative disorders [blast crisis], CML (most common), MDS, Essential thrombocytosis
CML:
-CML- BCL-ABL fusion
-Complication of CML ? AML
-Image of CML -­­ask for 9:22
-picture of CML: 9-­­22
-Described CML and asked the mutation – BCR-ABL fusion
-Translocation associated with CML - t[9:22] - ABL-BCR
-Gave you CD 20 and 45 positive and asked what it was – lymphocyte predominant
ALL/CLL:
-Described ALL and asked for worst prognosis – High white blood cell count
-Poor prognosis for ALL : Philadelphia
-Showed B-ALL, 4 year old boy with headache, vision problem, vomiting - asked about translocation (t (12; 21)
-Autoimmune hemolytic anemia- complication of CLL
-Described CLL (smudge cells, etc) and asked about complication? Autoimmune hemolytic anemia
-CLL-­­ Aml
Rh Factor/Factor V-Leiden:
-There was a question about a baby with lots of hemolytic anemia, and shistocytes. It asked for the pathogenesis and I put
“Rh incompatibility”
-Rheumatoid factor, what do you see? IgM against IgG
MOST COMMON MUTATION FOR HYPERCOAGULABILITY? Factor V-Leiden--resistant to protein C inactivation
Hemophilia:
-Question about hemophilia A - factor 8 def.
-Vw, Hemophilia ALL BLOOD DISORDERS from biochem with BT, PT, PTT and all that, including platelet count (like 5qs)
 -Someone had a von willebrand deficiency, and what the problem was? Defect in platelet-to-collagen adhesion
-Kid with bleeding disorder, ONLY PTT was high – Hemophilia A
-Hemophilia A, young BOY who had a clotting problem. Normal BT, PT, elevated PTT. What factor was missing? Factor VIII
-There was a PTT question: hemophilia
Polycythemia vera:
-Complication of polycythemia vera - congestion of blood vessels
-One question on polycythemia vera- with increased platelets and JAK 2 mutation, decreased EPO
-Question about a leukemia, said that it was a JAK2 kinase mutation, and asked what was wrong? Over activation of -
Tyrosine kinase receptor
EBV Burkitt’s/Lymphoma:
-Young child with a huge mass on his jaw [african burkitt's lymphoma] has EBV infection, what else
can EBV cause - hodgkin's lymphoma
-Showed picture of EBV asks what else does it cause- all answers were weird they put Hodgkin lymphoma (ONE OF THE
LEAST COMMON THINGS BUT THEY DID)
-Hodgkin lymphoma- Variant type- mixed cells- CD20, 45
Hodgkin Lymphoma expressed CD 20, CD45, what type? Lymphocyte Predominant. (I was looking for the word “variant”,
but it wasn’t there – the answer was Lymphocyte Predominant)
-Described eosinophilic version of Hodgkins: EBV
-Described Burkitt’s lymphoma and asked what else EBV causes – Hodgkin lymphoma
-Kid with bump on the jaw that is lymphoma, what is the genetic mutation? MYC gene (Heavy chain of IgG – t(8,14))
-EBV causes Burkitts Lymphoma.. what else… nasopharyngeal cancer, hodgkins, lymphoproliferative disease
-Picture of a downy cell from infectious mononucleosis asked which disease caused by same pathogen (EBV). One choice
was hairy cell leukemia (wrong, because EBV causes Oral Hairy Leukoplakia), right answer: Hodgkin’s Lymphoma.
DIC/Shock:
-Complication of APML - DIC
-Complication of septic shock = DIC
-SEPTIC SHOCK/DIC = how would you test D Dimer, Fibrin Degradation Products
-How do you test for septic shock? LPS, O antigen, warm hands
Follicular lymphoma:
-Described follicular lymphoma t (14;18) and asked complication – DLBL
-Lymphoma expressed CD 19,20, and CD10 – what is it? Answer: Follicular Lymphoma.
B cell lymphoma:
-Question where the answer was either precursor B cell neoplasia or hodgkin's lymphoma. I didn’t know the correct
answer.
-Someone with generalized lymphadenopathy with non-­­tender: peripheral B Cell
Hairy Cell Leukemia:
-Picture of Hairy Cell Leukemia and what type of stain to confirm diagnosis. Tartrate-resistant acid phosphatase stain
-Image of Hairy cell leukemia : trap stain
-Image of hairy cell leukemia - TRAP +
-Hairy cell stain – TRAP stain
-Showed a picture of hairy cell and asked the tumor markers – CD 11c and 103
Hemochromatosis:
-Described hemochromatosis and asked a complication – diabetes
-Described hemochromatosis and asked the gene – HFE
-Described hemochromatosis: HFE gene
-C282Y mutation.. what molecular technique do i use? what does it cause? . Hemochromatosis; mutation in HFE gene,
excessive iron absorption & deposition. Real time PCR, RFLP, Electrophoresis
-Complication of blood transfusions - hemochromatosis
Myelofibrosis:
 -Picture of myelofibrosis of bone marrow - tear drop cells
-Picture of myelofibrosis: tear drop cells
-Showed teardrop cells and asked what the disease was – primary myelofibrosis
-Picture of tear drop cells and asked what it could by – primary myelofibrosis
Graft rejection/immunity/arteriolar dilation:
-Graft rejection – donor preformed antibodies against host
-Characteristic of innate immunity – no memory
-Arteriolar DILATION causes? active hyperemia → vasodilation with causes of blushing, exercise

--Renal
Wegner’s/Goodpasteur’s:
-Know the difference between Wegeners and Goodpasteurs for the heart and kidney
-Described Goodpasture’s (hemoptysis, renal problem, anti-GBM Abs) asked what other disorder have the same type of
immune reaction- Myasthenia gravis (answer choices were RA, SLE, PSGN, TB)
-Goodpasteur’s syndrome and asked what else has the same type of hypersensitivity. Answer was Myesthenia Gravis
(both are type 2 hypersensitivity syndromes where antibodies DIRECTLY attack a tissue of the body, causing dysfunction)
Heart and Renal:
-Lady with renal failure- high BUN and Creatinine - pericarditis
-Patient had a MI and then some renal problems, what's the possible etiology - ischemia leading to Acute tubular necrosis
NSAIDS/Drugs/Papillary necrosis:
-Person had taken acetaminophen: papillary necrosis
-Person using NSAIDs for back pain what was the cause of the hematuria? Papillary necrosis
-Kid took his father's painkillers and then developed kidney problems - papillary necrosis
-Question on papillary necrosis
-Older person using antibiotics describing AIN, what would you see? Eosinophilia
PKD:
-Autosomal recessive PKD with hepatic fibrosis, what happens? Die in infancy
-Image of ADPKD: Berry aneurysm
-Described APKD, what do they develop? Subarachnoid hemorrhage berry?
-Subarachnoid hemorrhage- what is the cause ruptured Berry aneurysm, congenital abnormality
-Image - polycystic kidney disease - what else might you see in this patient? Berry aneurysm
-I think there was an image on child polycystic kidney disease, and associations - hepatic cyst
-A question described Polycystic kidney disease and asked what gene was broken. Answer: PKD1
Alport’s/Hypercalcemia:
-Hypercalcemia -­­ Nephrogenic
-Histo of alport’s what is defective? Collage IV Alpha 5
-Image - Alport syndrome - associated with renal/hearing/eye problems
-Alports : sensinoural
GN:
-Described lots of crescents with linear staining, what do they have? Anti-GBM anti-body
-Post-streptococcal GN- showed sup epithelial hump on EM- low complement levels
-Normal C4, low C3 described, hypercellular glomeruli, proliferation of mesangium, thickening of loops, what is it? Post
Strep
-There was a question that said some kid had a “throat infection” (strep) and then 10 days later had kidney problems and
dark urine. It asked for a complication. Answer: Low compliment levels
-Post-strep little boy complete resolution
Pyelonephritis/Abscess:
-Showed picture of WBC cast, what is can cause this? Pyelonephritis
-Acute pyelonephritis complication - perinephric abscess
 -Describe acute pyelonephritis? ask complication :Perinephric abscess
-Candida infection in CD 4<100 what can it cause in Kidney? Abscess
Minimal Change Disease:
-Described minimal change, what is prognosis? Recovery with steroids
-Minimal change disease- effacement of podocytes - will see hyperlipidemia (oval fat smth casts)
-Kid with minimal change disease. EM you see diffuse effacement of foot processes and nothing else. Asked what
associated finding would be. -Hyperlipidemia (lose a lot of albumin protein, liver compensates by putting fat into blood)
Nephritic/Nephrotic:
-Described nephrotic syndrome what do you see, had to narrow down other choices because they were all nephritic?
Thickening of basement membrane
-Know the presentations/descriptions of the different nephrotic/nephritic syndromes. The stem was really clear on which
one they wanted you to think about, then you just had to either know it's etiology [like association with HBV or HCV]-
immune complex depositions, anti GBM, etc.
Atheromatous plaque/Atherosclerosis/HTN:
-Described RENAL ARTERY stenosis with bruit what is risk factor? Atherosclerosis
-Renal Artery stenosis; Atheromatous plaque
-Said patient had renal artery stenosis and asked etiology - atheromatous plaque
-There was a question about some lady who had a renal artery stenosis on the left side that was giving her malignant
hypertension, and asked what was the most likely cause. Answer: Atheromatous Plaque
-Necrotizing vasculitis in the kidney = hypertension
-I think there was a question on benign hypertension and what would you see - hyalinization of the arterioles
-There’s an arteriole from the HTN slide, and asked what caused it. Answer: HTN (NOT atherosclerosis, NOT diabetes)
Hmm similar question as above and asked diagnositic test - renal arteriogram
RCC:
-Behaviour of renal cell carcinoma - invasion of renal vein
-Picture of renal cell-­­ Invade the renal vein
-Another question asked what a risk factor for renal cell carcinoma was. Answer: smoking.
-Few questions on renal cell carcinoma. One question asked about what was associated with it. I thought the answer was
the Von Hippo Lindau syndrome (because it’s the VHL gene that is broken in Renal cell carcinoma. But I don’t know)
-Renal bruit, hypertension in old lady- why - atherosclerosis, if THEY WOULD GIVE YOU YOUNG- PUT FIBROMUSCULAR
DYSPLASIA
-Described renal cell carcinoma, what is associated paraneoplastic syndrome? Polycythemia
-Renal cell carcinoma and asked what was a possible complication. Paraneoplastic syndromes.
IgA Nephropathy:
-Guy had viral bronchitis had hematuria and mild proteinuria, then had it again later. What is this? IgA nephropathy
-IgA nephropathy due to URT- what else gives you the same renal presentation- Celiac disease
-Picture of IgA nephropathy (berger’s disease) and asked what caused it. Answer: Celiacs disease (body produces IgA abs
against the tissue transglutaminase and gliadin, and those abs get filtered at the kidney and cause IgA nephropathy)
SLE:
-Question on SLE
-SLE = type 3 hypersensitivity
-Talked about Lupus ; Anti-­­ DNA
-Described SLE- photosensitivity, rash, renal, joint point- anti dsDNA
-Described lupus (malar rash, etc.) and asked how to diagnose. Answer: Anti-Double Stranded DNA anti-bodies.
-Antibody for SLE = anti dsDNA
-Described SLE with renal abnormalities, what did they most likely have? Mesangial proliferative
Mesangioproliferative/Membranous:
-Mesangioproliferative glomeruloneohropathy
-Mesangioproliferative : IgA
 -Membranoproliferative image : Hep C
-Spike and dome appearance (meaning membranous glomerulopathy), and it asked what would cause it. Hepatitis B.
-Describe spikes and dome: membranoneropathy
FSGS/PSGN/KW nodules:
-FSGS- why? Hyper filtration
-Picture of Focal Segmental Glomerular Scleoris (FSGS), and asked what caused it. Compensatory Hyperfiltration.
-They talked about PSGN with the subepithelal hump
-Showed picture of KW nodules in DM - asked what is the cause of renal damage- NEG of small vessels (non-enzymatic
glycosylation)
Bladder:
-Described papillary carcinoma of bladder, what is risk factor? Smoking
-Schistosoma complication – bladder cancer
-Describe Squamous cell carcinoma in bladder: shistosoma
Acute Tubular Necrosis/Casts:
-When do you see granular casts - Acute Tubular necrosis
-They mentioned muddy brown cast: tubular Acute epithelium
Ascending infection/Stones/Hydronephrosis:
-Etiology of kidney infection - ascending infection
-Question about college guy who had an obstructing kidney stone. Asked for a complication. Answer: Hydronephrosis.
-patient had stone and hydronephrosis and asked how could you relieve this? Alkalizing your urine
-What would help prevent renal stones - alkalinization of the urine
-Renal stone- risk for pyelonephritis (chronic)
-Picture of amyloidosis of kidney, what stain to confirm = congo red

--Male
BPH:
-Picture of enlarged bladder with hydronephrosis risk factor? BPH
-Describe BPH: asked for complication: Hydronephrosis
-There was a question about a guy with Benign Prostatic Hyperplasia, and it asked what a complication would be. Answer:
bilateral hydronephrosis
-Benign prostatic hyperplasia- risk for infection of the kidney (pyelonephritis) DO NOT CHOSE HYDRONEPHROSIS- THEY
SAID UNILATERAL
-Complication of BPH - hydronephrosis
Prostate cancer:
-A question said that someone had an enlarged prostate and it was causing back pain, etc. (adenocarcinoma of the
prostate), and asked what you would see on histology. Answer: a SINGLE layer of cuboidal epithelial cells, with NO BASAL
FLAT CELLS.
-Guy has multiple sexual partners, develops painful urination, what is a risk factor? BPH (other answer choices were
multiple sexual partners, poor sexual hygiene)
-Guy has prostate cancer, increase PSA levels, where is it felt? Peripherally
-Another question was, multiple lesions due to prostate cancer in old guy- his PSA went over 35 (Normal not more than
10) answer was metastasis to the spinal cord via valveless plexus of Batson
Seminoma:
-Described seminoma where else would you see? Medullary carcinoma of breast (invasive ductal, dysgerminoma,
oligodendroma)
-Histo of seminoma, what else would you see? Lymphocytic infiltrates
-Describe fried egg appearance: Seminoma
 -What cancer looks the like fried eggs and lymphocytic infiltrate in ovaries - answer choices invasive lobular carcinoma in a
breast, seminoma, renal cell carcinoma, medullary carcinoma of thyroid, papillary carcinoma of thyroid
-Dysgerminoma in a female – a patient with turners, sheets of cells with dark blue nucleus and lots of cytoplasm (didn’t
use the word “Fried egg appearance” but described it) asked what would be a similar tumor in a man? Seminoma.
Cryptorchidism/hypogonadism/germ cell:
-Described kid with cryptorchidism, what is complication? Germ cell tumor
-One question asked about cryptorchidism and it asked what kind of cancer it could cause. Answer: germ cell tumors.
-It talked about a male child who was tall, but had hypogonadism. What is the genetics of this person? Answer: XXY
-Undescended testicle- 6 months old boy- what is the possible complication - in inguinal canal was the one we had- out of
all answer choices it was one of the testicular germinal cell tumors (distractors were testicular lymphoma and
gynecomastia- NB that Sertoli will get affected not Leydig so testosterone production is not affected, so no man-boobs)
Male genitourinary
-Described tumor in male: germ cell
Gout:
-Question described gout = purine degradation breakdown
-GOUT in the big toe? What birefringerence? Shape of crystals?
-Negative birefringent, needle shaped crystals
-Showed gout crystals and asked make up – monosodium urate
-There was a question about gout. Someone went on a bender and had a toe-ache the next day. What caused it. I think
the answer was HGPRT deficiency or something (but they actually wrote out the name and didn’t just put the letters
HGPRT)
-Guy with a toe problem- hyperuricemia
Circumcision:
-A question said that some guy had a cancerous lesion on the shaft of his penis and asked for an association. Answer:
Circumcision is considered protective against it.

--Breast
BRCA 1&2/CEA/p53/genes:
-Mom had breast cancer, sister had ovarian cancer, she has lump on her breast indicating malignancy. What is best
indicator of malignancy? Family history
-Breast cancer family history – test BRCA 1 and 2
-BRCA 1/2 are a tumor suppressor genes.. what are other tumor suppressor genes? p53, RB, NF1/2, p16, APC, WT1, DPC,
DCC
-Breast cancer marker? CEA
-P53-­­ family history of cancer and breast
-A 23 year old mother of a 2 year old child (yes two year old) weans her little boy of breast feeding. Her husband is
surprised that his wife is no longer wearing the same size bra because her breasts have decreased in size. What is
mechanism of this atrophy? loss of trophic signal-> Atrophy, Necrosis, Chromosome 13 BRCA 2 inheritance
ER/PR:
-There was a question about breast cancer. It asked which was a better prognosis. Answer: ER+/PR+
-Hard, attached, irregular mass- what will give good prognosis- ER and PR positive
-Lady with breast cancer ER/PR (+), cathepsin (+) what is good prognosis? ER/PR (+)
Lobular:
-Picture of lobular carcinoma in-situ and asked what was the problem. Answer: mutation in E-Cadherin.
FCC:
-Described FCC, what is malignancy? Atypical epithelial hyperplasia
-Histo of FCC, what causes it? Overreaction to cyclic changes Too much estrogen
-Described the histology of FCC with apocrine metaplasia and asked how it is malignant: atypical ductal hyperplasia
Fibroadenoma/fibrocystic change:
-Histo of intracanalicular fibroadenoma, what occurs? Regresses during menopause
-Soft, mobile, painful mass in UOQ - what will you say- will regress with menopause
-Someone with fibrocystic change of the breast, has a double layer of cells (simple type), but they were growing weird.
What the likely outcome was. It would naturally regress with menopause (because the estrogen signal would decrease).
Phylloides:
-Phylloides tumor, what characteristic makes it malignant - mitoses >10/HPF
-Phylloides : greater than 10 HPF
DCIS/Paget’s:
-Image of the Invasive ductal : DCIS
-Image - ductal carcinoma of breast - forgot question
-Described paget’s with cells, what is underlying disease? DCIS
-Described paget's and asked what should u look for - underlying ductal carcinoma of the breast
-Image of histological image of Paget’s : Ductal Carcinoma
-Paget’s extramammary with itching and crust and atypical cell- what will you look for- intraductal carcinoma in situ
-Paget’s disease of the nipple, looked like eczyma, and asked what underlying condition you would look for. I thought the
answer was supposed to be Invasive Ductal Carcinoma, but that wasn’t an option. So I put invasive lobular carcinoma.

--Ovary
Fibrothecoma:
-Histo of firbrothecoma, what is associated syndrome? Basal cell nevus Pretty sure this is supposed to be Meigs. (ovarian
fibroma + ascites + pulm. effusion)
-Palpable abdominal mass which was an ovarian tumor. But it said that it caused abdominal ascites and pleural effusion
on the right side, what was the complication? Meig’s syndrome with fibrothecoma. The complication here is torsion.
Pseudomyxoma peritonei:
-Question about pseudomyxoma peritonei - jelly belly, ovarian mass and intestinal mass
-Ovary with mucinous glands (basically describing pseudomyxoma peritonei) where else would you check? Appendix
Krunkenberg:
-Picture of krukenberg where else would you see? Left supraclavicular lymph node
-Most likely mets for krukenberg tumor - from stomach
Ovary Marker:
-Ovary 125 marker, what does it indicate? Response to treatment
PCOD/adnexal mass:
-Described PCOD, what would they have? Insulin resistance
-Described PCOD: increase LH>FSH
-Left adnexal mass, hadn’t had her period for 8 weeks what would you test? Beta hCG
-Polycystic ovarian disease, asked what would be an investigation to confirm diagnosis? Answer: LH>FSH
-Polycystic Ovarian disease. Picture of PCOS from lab and asked what a complication would be. Endometrial hyperplasia
-Patient with polycystic ovaries - LH:FSH ratio inc.
Granulosa theca cell tumor/Call-Exner:
-Describing endometrial carcinoma what would cause this? Granulosa theca cell tumor
-Tumor of the ovary with lipid-leyden cells and spindle cells – which I assume was talking about granulosa theca cell
tumor. Then it asked a complication. The answer was something to do with elevated estrogen.
-Granolas cell-Theca ovarian cancer would give you endometrial hyperplasia
-Gave call-exner description of a tumor. What association - inc estrogen
-Described call-­­exner : granolas theca carcinoma: Complication:endometrial carcinoma
Ovarian cyst:
-Picture of dermoid cyst, what is complication? Squamous cell
 -Described chocolate cyst, what's a complication - infertility
-Described Chocolate cyst: complication: infertility
Teratoma:
-Struma ovarii (girl present with hyperthyroidism and ovarian mass, thyroid is fine)- monodermal teratoma
-Struma ovarii said it was producing thyroid hormone from the ovary, what type of tumor. Cystic Teratoma.
-I think there was a question on teratoma but can’t remember what they asked
-Described teratoma, teeth and hair in ovary = teratoma
-Girl has a tooth in her ovary. What possible complication. Answer: torsion. Another ovarian teratoma question - had -
Teeth on X-ray- what is the most common complication- torsion

--Female
Enlarged clit/ambiguous genitalia:
-Described someone with enlarged clitoris with 17alpha hydroxylase that was elevated? 21 hydroxyls deficiency
-Described clitomegaly and bilateral adrenal hyperplasia- increased 17alphahydroxylase- we put 21 alpha hydroxyls
deficiency
-There was a question about a girl with enlarged clitoris. I think the answer was: 21-alpha-hydroxylase deficiency.
-Girl with ambiguous genitalia with hypotension, what’s the deficiency? 21 hydroxylase
Adenomyosis:
-Described endometrium tissue in myometrium and asked the name of this condition - adenomyosis
-Uterus tissue going into myometrium: Adenomyosis
-Described lady with tissues in fallopian tubes and ovaries (endometriosis) what do you see? Endometrial glands in stroma
Long period:
-Lady had prolonged periods/bleeding, what is cause? Persistent corpus luteum
Endometrial carcinoma:
-Endometrial carcinoma and what was a risk factor for it. Answer: nulliparity or late menopause – I don’t remember, there
were a couple questions that asked the same thing. But the answer is that it is caused by unopposed estrogen.
-Histo of endometrial carcinoma, what causes this? Unopposed estrogen
-Image of endometrial carcinoma: Unapposed estrogen
Genital warts:
-Described condylmoma accunminatum, what are risk factors? HPV 6 and 11
-Was also one which described a wart due to HPV
-Describe someone with genital warts? Hpv 6 or 11
Hydatiform mole/choriocarcinoma:
-Image -choriocarcinoma - and asked something, i forgot
-Choriocarcinoma- what would give you the highest risk- we put molar pregnancy (although better answer would be
ovarian choriocarcinoma)
-Chorioncarcinoma: B-­­hcg
-Empty : Choriocarcinoma
-Lady with Hydatiform mole and asked what a complication would be. Answer: Choriocarcinoma.
-Described hydatiform mole (complete) empty ovum, no fetal parts, what do you see? Completely paternal genes
-Woman was positive for pregnancy, but nothing was seen in the uterus. Umm forgot what
-Lady was passing “grape-like vesicles” from her vagina, and on investigation there were some partially formed fetus parts
too. Asked what the pathogenesis was. Answer: One normal ovum fertilized with 2 sperm.
-Question describing choriocarcinoma- what would give you the highest risk- we put molar pregnancy (better answer
would be ovarian choriocarcinoma)
-Described a complete mole and asked what would u see. Empty ovum with 2 sperm.
Pre-eclampsia:
-Described pre-eclampisa, what is the first step in the pathogenesis? Placental ischemia
 placental ischemia: preeclampsia
-There was a preeclampsia: ask the cause ? Placental ischemia
-Described pre-eclampsia and asked what likely caused it - placental ischemia
-Pregnant lady with pre-eclampsia. When she gave birth her blood pressure went back down. What you would find on
investigation. -Partially Necrotic Placenta (mother makes abs against the placenta for some reason, so it becomes necrotic
ischemia. The placenta can’t get enough blood, so it releases more hormones to raise the mothers blood pressure, which
causes pre-ecclampsia. Baby will usually be born small and early).
CIN/dysplasia:
-Keratin dysplasia on cervix = cervical cancer or too many sex partners etc
-Hyperchromatic nuclei with a clear halo around the nuclei on the cervical surface is found on a woman.. what is the
etiology? CIN I (this is describing koilocytosis)
-Cervical cancer and asked what the risk factor was. Answer: multiple sexual partners (HPV infection causes it)
-Histo of CIN, what is the risk factor? HPV 16, 18
-Picture of CIN 2 and asked etiology
-PAP smear- abnormal what causes weirdly worded- viral proteins stop Rb activity
Leiomyoma (Fibroid):
-Picture of uterine fibroids what is complication? Necrosis and hemorrhage during pregnancy
-Picture of uterine fibroids, what is an aggravating factor? Estrogen
-There was a question that described leiomyoma, and asked what a complication was. Answer: Infertility.
-Described leiomyoma and asked what might you see - red degeneration
-They describe leiomyoma: don’t pick Leoyomasarcoma, answer red degeneration
-Woman with period 6 days ago, and has been heavy way to heavy bleeding, endometrium shows heavy mass, what is
cause of heavy bleeding?
-Description of leiomyoma- menorrhagia, masses in uterus, no atypia, worles of SM pattern - complication- infertility
-Described fibroids (leiomyoma) and asked what is characteristic = slow growing
PID/ectopic pregnancy/Infertility:
-Risk of ectopic pregnancy like fibrosis of tubes, or something like that. I think there were 2 questions similar to this
-Lady who got Gonorrhea and asked what a complication was. Answer was PID or infertility (one of those)
-N.Gonorrhea- complication- ectopic pregnancy
-Endometriosis- complication- ectopic pregnancy
-Picture of an ectopic pregnancy and it asked what caused it. The answer was: Endometriosis.
-Lady with infertility, she gave GnRH, LH went up, estradiol low. What is problem? Ovarian failure
Abdominal striae:
-Fat lady, with abdominal striae, male pattern of hair

--Neuro
Hypoxia/Middle meningeal artery/Injury:
-Most sensitive cells to hypoxia – brain
-Ischemic injury of primary motor and /or sensory cortex –Weakness and /or sensory abnormalities in leg
-Middle meningeal artery with broken temporal bone- epidural
-A guy gets hit in the head and gets a biconvex disc shaped hemorrhage and intermittent lucidity. What artery is
damaged? Answer: Middle Meningeal Artery.
Hypoglycemia:
-Hypoglycemia of the brain so what cells are affected? Pyramidal cells of hippocampus
Prion/myasthenia gravis:
-34 year old farmer had progressive dementia, losing ability to do stuff, died a year later what does he have? Spongiform
degeneration, prion
-Described bovine spongiform encephalopathy - and asked how could he have acquired it - eating bovine meat
 -Myasthenia gravis – autoantibodies against the cell function
Herniation:
-Described a person and they had CN III defect (blown pupil, down and out eye) – uncal herniation
-Transtentorial Herniation? CN defect? Also called uncal herniation. CN III, PNS messes up, see pupil dilation. Duret
hemorrhages in midbrain and pons
-Subfalcine herniation – displacement of cingulate gyrus under the falx cerebri Compression of branches of
anterior cerebral artery
-Tonsillar herniation through the foramen magnum
-Patient is brought in for an autopsy. The examiners report identified that the patient died due to a herniation that passed
through the foramen magnum which compressed the respiratory centers of the brain stem. Identify the type of herniation
that has occurred and another possible sign that would have lead a physician to note that the herniation was occurring
before the patient had died.
-Brain stem compression – respiratory centers in medulla oblongata –Death due to cardio-respiratory arrest
ALS:
-Asked question about ALS- anterior horn destruction- asked what was the cause- inherited mutation
-Anterior horn motor loss, but sensory and intelligence was intact (Amyotrphic lateral sclerosis), and asked what
was the etiology. Answer was that it was genetic (that’s what it said “genetic”, it didn’t even make you pick which
gene it was)
Neuroblastoma:
-Described kid with neuroblastoma, what is the gene? ALK
-Described Neuroblastoma ask for gene: ALK
-One question asked which gene it was: ALK gene
-Question about neuroblastoma, they described a person with a mass on the adrenals [remember that the neuroblastoma
is seen in the sympathetic chain or in the medulla of the adrenals] - asked gene mutation ALK - blueberry muffin baby
-There were a bunch of questions on neuroblastoma
Parkinson’s:
-Described parkinson's, and asked what would u see - atrophy of substantia nigra
-It asked about parkinson's and asked what you would see. Answer: degeneration of the substantia nigra
-Described parkinson’s what is affected? Substantia nigra
-Described Parkinson’s : substantia nigra
-Described something that sounds like parkinson’s and it had corneal deposits
-Parkinson’s presentation- atrophy of substantia nigra
Huntington’s:
-Described huntington’s what the genetic defect? Trinucleotide repeat
-It talked about someone who developed chorea, dementia, motor difficulties, etc. (Huntingtons) and then asked
pathogenesis. Answer: Trinucleotide repeats that get longer in successive generations.
-Described Huntington’s and asked how to diagnose it? genetic testing
-Huntington's disease - atrophy of caudate n putamen
-Huntington’s- CAG trinucleotide repeat
GBM/meningioma:
-Described guy with meningioma, older, not sudden presentation, well circumscribed, calcifications (whorles with
psammoma)
-Picture of glioblastoma multiforme what is prognosis? Resistant to treatment
-There was the picture of glioblastoma multiformes and it asked which cell was the origin. Answer: Astrocytes
Showed glioblastoma multiforme- cells of origin - astrocytes
-GBM, what is good prognosis? (+) p53
-Showed glioblastoma multiforme- cells of origin - astrocytes
Hyrdocephalus:
 -Described guy with memory problems, incontinence, and ataxia (classic triad)- put peritoneal CSF shunt- improved-
normal pressure hydrocephalus
-A guy has dementia, ataxia, and urinary incontinence, and he gets hydrocephalus that is cured with a shunt. What kind is
it? Answer: normal pressure hydrocephalus.
-Described normal pressure hydrocephalus, what else would they have? Urinary incontinence
-Risk factor for developing ex vacuo hydrocephalus - atrophy
-Diffuse brain atrophy- hydrocephalus ex-vacuo
-Diffuse brain atrophy- hydrocephalus ex-vacuo
Subdural hematoma/infarct/HTN:
-CT of subdural hematoma, what is cause? Rupture of bridging veins
-Imaging revealed a subdural hemorrhage and asked which vessel - bridging veins
-Blood pooled out in subdural space = hematoma? (sounded like subdural hemorrhage but that was not an option and
that is irrelevant to this class, hematoma was best answer I thought but could be wrong)
image of the cerebral infarct: hypertension
-Etiology for lacunar infarcts - HTN
-What causes watershed infarct in the brain? HTN or Atherosclerotic plaque
-WATER SHED INFARCT in the BRAIN = Ischemic encepathology
-Showed brain as red infarct, what other organ does red = lung
-Describe an old man and it had crescents shaped hematoma and what was a risk factor: cerebral atrophy
-Guy talked to dad night before, died next morning. Had slit hemorrhages (intraparenchymal hemorrhage). What is risk
factor? Hypertension
-Charcot-Bouchard hemorrhage- HTN
Liquefactive necrosis:
-Described liquefactive necrosis in the brain and asked what other organ you would see it in? Lung
-Infarct in the brain seen leads to liquefactive necrosis (Late stage)? What type of enzymes do the work? MCA and ACA jct
leads to what type of infarct? Coagulative->Liquefactive. Hydrolytic enzymes. Cerebral infarct (Red infarct)
MS:
-Showed picture of MS plaques, what do you see in CSF? Ig clonal bands
-What is the risk factor for MS- vitamin D deficiency
-Described multiple sclerosis, what other symptoms? Urinary incontinence
-Described a patient with Multiple sclerosis, and asked etiology - demyelination
-Described MS: Patchy loss of myelin
Berry aneurysm:
-Guy strained lifting boxes, and then developed headache, what did he have? Berry aneurysm
-Patient had problem with collagen what could be a another problem = berry aneurysm
Neonatal:
-I think there was a question on Neonatal jaundice, and it asked what the problem was. Answer: Absence of UDP-
glucuronyltransferase.
-Etiology of meningitis in a 3 day old - e.coli [remember which bacteria cause it in each age group]
-1 week old baby with meningitis – Group B strep
-Neonatal meningitis what bug? – Strep. agalactiae, Listeria monocytogenes & E. coli
-Neonatal Meningitis? Bug? E. coli or Staph Agalectasia
Waterhouse Friderichson/Meningitidis:
-Showed picture of septic shock, rad rashes everywhere, = Neisseria meningitidis
-GM- diplocooci meningitis… nasty complication? Waterhouse Friderichson, adrenals, teenagers mostly, with N.
meningtides.
-Described bacterial meningitis, stiff neck- = neisseria meningitidis
-Bacterial meningitis, what do you see in the CSF? High PMNs
-Question with a person with bacterial meningitis, what would u see in CSF - dec glucose
 -CSF w/ LOW GLUCOSE? bacterial infection
-Viral Meningitis CSF looks like? Normal glucose, slightly elevated protein. Elevated CD8 Lymphocytes
[No PMNs]
-Kid who has fungal viral and bacterial infection (in the blood), CT scan shows a viral meningitis?
Counter-coup/Hit on head:
-Said that a person was hit on his head and he had damage to the front n back of his brain - Coup n countercoup
-Guy hit in a head- counter-coup
-Described guy hit with frontal and occipital lobe: coupe -­­contracoupe
-A guy gets hit at the base of the skull what do you see? Answer; Racoon eyes.
Abscess:
-Person with an abscess in middle ear complication -- abscess in brain
-Said there was a brain abscess: what can lead to it? Otitis media
Rabies:
-Question on rabies?
-Negri body found in what type of infection? Rabies Virus
-NEGRI BODY PICTURE? What is the reservoir? What indicates a poorer prognosis? dogs outside of U.S., U.S.-bats; the
closer bite is to brainstem location, the poorer prognosis
-Rabies picture, what is predominant cell involved = lymphocytes
Alzheimer's/Amyloid:
-TRANSTHEYRITIN??? Found in Famililal Neuropathies (amylodiosis) and senile Cardiac amylodosis
-Alzhiemers? Where else might you see amyloid Plaques? Pts w/ renal failure
-Showed a picture of Congo red stain and asked what else it can be the stain for? Alzheimers
-Question on alzheimer's, forgot what it was
-Alzheimer : impaired cognition
-Alzheimer’s- presenilin mutation
-Alzheimer’s - amyloid plaques and neurofibrillary, tangles
-There was a question on a guy who developed slowly onset memory loss, and had atrophy of the frontal, temporal, and
parietal lobes. (alzehimers) what protein would you see? Answer: Neurofibrillary tangles.
Wernicke-korsakoff:
-Wernicke-korsakoff question
-Describe Wernicke K: thiamine
-CNS alcoholic- mammary body and Wernike-Korsakoff (2qs)
-There was a question about someone who was an alcoholic, and they had thiamine deficiency, and they couldn’t walk
straight or see well. It asked where you would see problems in the brain. Answer: Destruction of Mamillary Bodies.

Endocrine--
Papillary thyroid carcinoma (orphan annie eyes):
-Image Annie’s eye: Post-­­radiation
-Histo of orphan annie eye, what is this? Papillary thyroid carcinoma
-One question showed a picture of Papillary Carcinoma of the thyroid with orphan annie eye nuclei, and asked what
would cause it. Answer: Long-standing ionizing radiation.
-Image of papillary carcinoma of thyroid - psammoma bodies
-Psamomma body- papillary thyroid carcinoma
Follicular carcinoma/Adenoma:
-Follicular carcinoma of thyroid- invaded Basement membrane what else on histo marks invasiveness- hemorrhages
(actually had it on picture we got this one wrong)
-Lady with mass in thyroid, normal levels of T3, T4, what did she have? Adenoma
Goiter:
 -There was a question about a goiter that secretes T3/T4, and asked what else you would find. Answer: Decreased TSI
(negative feedback).
Medullary thyroid carcinoma/pheochromocytoma:
-Medullary thyroid carcinoma described with amyloid and spindle cells. What is gene mutation? RET oncogene
-High calcitonin: Medullary : pheochromocytoma
-Medullary carcinoma of the thyroid description- calcitonin in blood
-Medullary carcinoma of thyroid histo with pheochromocytoma symptoms (Describing MEN2a), what else would they
have? Hyperparathyroid
-There was a question about pheochromocytoma. I think it asked which cells it came from. Answer: chromaffin cells.
-They described pheochomocytoma, what do you check in urine? VMA
-Described a person with 2 symptoms of MEN2, and asked what else are u most likely to see - pheochromocytoma. [know
the 3 that fall into each category]
Parathyroid/pituitary:
-Said girl had prolactinoma, and gastrinoma- what else will you check for- Parathyroid - MEN1 (MEN1 mutation 3P’s)
-One question asked about someone who had a pituitary adenoma, and said what else would you want to watch out for.
Answer: Parathyroid cancer.
-I think there was a question about having too much phosphate and not enough Calcium. I thought the answer was: Not
enough PTH hormone.
-Question about a pituitary tumor and decreased levels of LH/FSH/GH, and they asked which hormone might be normal
ADH
-Person had low levels from the anterior pituitary:vasopressin
-Pituitary resection, what would effect? Thyroid
Acromegaly/IGF-1:
-There was a question on acromegaly. It asked how you would diagnose it. Answer: Increased IGF-1.
-Described acromegaly what is another diagnostic factor? IGF-1
-Described acromegaly with big jaw: look for IGF-­­1
-Person with GH adenoma, what would you check for -- IGF-1
Hyponatremia:
-Lady was weird, gave IV, then went weird again and she was also hyponatremic what does she have? Rapid treatment of
hyponatremia
-Rapid correction of hyponatremia- Central Pontine
-hyponatremia, low values: ACTH was high: pituitary or adrenal don
-A question on SIADH said that someone had hypertension and hyponatremia, what is the problem? Answer: ADH
secretion despite negative feedback.
Hyperprolactinemia:
-Excessive milk production, she wasn’t pregnant what did she have? Hyperprolactinemia
Addison’s:
-Lady with weakness fatigue, hyperkalemia, hyponatremia, postural hypotension, described addison’s, what would they
present with? Spots on mouth (hyperpigmentation?)
-There was a question about a woman who had hyperpigmentation of limbs, low Aldesterone, Low sex hormones, and low
cortisol. I think it was addisons disease.
-Addison: Hyperpigmentation: we think autoimmune destruction
-Described Addison’s - hyponatremia, hyperkalemia, water loss, increased ACTH- what causes (answer choices were
exogenous steroids, primary adrenal adenoma, pituitary adenoma, paraneoplastic) - answer was Autoimmune destruction
of Adrenal glands
Grave’s:
-Described grave’s disease, what is the antibody? Anti-thyroid stimulating immunoglobulin
-Grave’s- high T3, T4, low TSH, have thyroid-stimulating Abs- what other test- ophthalmopathy
-Graves: Low TSH, HIGH T4
 -There was a question about how you would differentiate graves disease from other types of hyperthyroidism? Answer:
graves has pretibial myxedema and eye problems.
-Lady has Grave’s disease, she started having hemiparesis on one side. Then developed weakness one side. What did she
have? Mural thrombus
Diabetes/dialysis/insulin:
-PATIENT WITH CHRONIC DIALYSIS gets dialysis.. How why? B2 microglobulin?
-Person has low C-peptide, high insulin, passed out. What caused this? Factitious insulin
-Picture of Diabetes type II : amyloid
-Mucormycosis = associated with diabetes
-MUCORMYCOSIS = who is predisposed to it? type 1 ketoacidotic diabetics is #1
-Picture of mucormycosis aneurysm and asked what you would screen for? Diabetes
-Guy had diabetic ketoacidosis, what do you see? Ketones
-Diabetes insipidus: Hypercalemia
-Nephrogenic Diabetes Insipidus- hypercalcemia
-There was a question about Diabetes Insipidus. It said that even after someone was given ADH, they’re kidneys were still
unable to concentrate the urine. What caused it? Answer: I don’t remember. Either Hypercalcemia, Lithium.
-Guy in accident, had hyponatremia, polydipsia, what is the cause of this? Central diabetes insipidus
-Prolonged tracking of diabetes? HbA1c
-Image - diabetes, forgot question
-There was a question that said there was a 10 year old girl with a family history of diabetes. She had an elevated RBS (I
have no idea what that is), and it asked what she had. I don’t know (it was either type 1 diabetes, type 2 diabetes,
insulinoma, etc.)
-Kid with Type I diabetes, what would you see on histo? Decrease islet cells with lymphocytic infiltrate
-Acute complication of diabetes what do you see? Electrolyte imbalance
-Described nephrogenic diabetes insipidus - patient taking lithium. Forgot leading question
-Girl with multiple sex partners, flank pain, burning pee, (describing cystitis) what is risk factor? Diabetes
Hashimoto’s/Lymphoma:
-I think there was a question about hashimotos and it asked for a complication. Answer: Lymphoma.
-There was a question that described someone with hashimotos disease and asked what a possible complication was. -
Answer: Marginal Zone Lymphoma.
-Asked about Hashimoto: anti-­­thyroglobulin
-Gave presentation of Hashimoto’s- what is the complication - B-cell marginal lymphoma “don’t pick anti-­­mitochondrial
! it is suppose to be anti-­­microsomal”
-Histo of hashimoto’s, asked what antibody? Anti-thyroglobulin
-Said that a person has either graves or hashimotos and asked what would you see on measurement of TSH/T3/4 levels.
-Described lady with Hashimoto’s what test is diagnostic for this? Thyroxine levels No. Anti-thyroglobulin Ab’s (if it was an
option that is)
-Describe Hashimoto: Carpal tunnel
-Some guy with a thyroid problem and what is the first test you should do? Thyroid problem first test to do is check TSH in
the BLOOD.
Hypothyroidism/general thyroid questions:
-Complication of hypothyroidism - carpal tunnel syndrome
-Few questions on a person who is cold intolerant and head intolerant, so think of thyroid problems and what can happen
-Described a person with thyroid problems and then asked what would be ur next investigation. TSH levels or imaging,
wasnt sure.
Cushing’s:
-Question on cushings
-Description of Cushings:
 -There was a question about cushings. The person had adrenal atrophy on one side, and decreased ACTH, but they still
had a shit-ton of cortisol. Answer: it was a unilateral adrenal cortical adenoma.
-Small cell carcinoma -­­ Cushings
-Picture of small cell carcinoma n asked a complication- Cushings
--Bone
Multiple myeloma:
-They gave lytic lesions, amyloid, described multiple myeloma. What is complication? Renal failure
-Described multiple myeloma – hypercalcemia
-multiple myeloma (lytic lesions in the spine) asked what else you would see? Hypercalcemia. Wrong answer- AA amyloid
Rheumatoid arthritis:
-Described rheumatoid arthritis, what would you see? Pannus formation
-There was a question about someone who had painful arthritis that got better throughout the day (rheumatoid arthritis),
and asked what you would find. Answer IgG in joint (answer was NOT bouchard’s nodes – that would be osteoarthritis)
-Autoantibodies in rheumatoid arthritis - anti citrulline protein Ab
-Chronic Rheumatoid arthritis, (described iron deficiency anemia – but high levels of ferritin and low TIBC). What caused
the anemia. Elevated Hepcidin – which sequesters iron stores, and causes anemia of chronic disease
-Described Rhematoid Arthritis: but has answer for Anti-­­nuclear antibodies and anti-­­ citrullinated protein( not sure
which one they wanted)
-I think there was a question about the complication of Rhematoid Arthritis being amyloidosis
-RA- amyloidosis, SAA
-Lady with RA on corticosteroid therapy - at risk for osteoporosis
Osteomalacia:
-Osteomalacia picture, what causes this? Defective mineralization
Rickett’s:
-Rickett’s in children, what do you see? Low ca, low phosphate, increased PTH, increased ALP
-There was a question about rickets (bowing of the legs and stuff). Answer was it was caused from inability to mineralize
bone.
-Question about rickettssiae, don’t remember
Osteoporosis:
-Osteoporosis picture of bone, what causes this? Decreased synthetic activity of osteoblastic
-Osteoporosis- increased osteoclast activity
-Described lady with osteoporosis what is lab values? Everything normal
-Old lady felt down- femur fracture do not remember how exactly they asked a question- but answer was osteoporosis
-There was a question about an old lady with thin bones and lower blood pressure. Answer: It’s just a natural part of
aging.
-Osteopetrosis described in kid, what was deficiency? Carbonic anhydrase
Paget’s:
-A question on Pagets disease of bone. Complication: Sensorial hearing loss (pinches cranial nerve VIII)
-Paget’s disease described, high hydroxyproline, what do you see in values? High ALP everything else normal
-Paget’s Complication: High cardic output heart failure
-Picture of Paget’s with lytic lesions. What do they have complication of? Osteogenic sarcoma
-Another question on Paget’s disease of bones. It was a guy with bone problems and warm skin. Asked about
Complications: It leads to osteosarcoma. (it also causes osteo-clastoma though, but that wasn’t a choice)
-Paget's disease - problem with your osteoclasts
-Paget’s- what is the complication - osteosarcoma
-Paget’s in teen- p53 mutation (can also be Rb, elderly- radiation and Paget’s are most common)
Scurvy/osteophytes/Vitamin D:
-Described scurvy, what is defective? Cross-linking
-X-­­ray of osteophytes: Degenerative disease
 -Lady with renal failure, on dialysis, hypocalcemia, (basically renal osteodystrophy) what is the cause? Vitamin D
dehydroxylation
Ankylosing spondylitits:
-Guy with bamboo spine (ankylosing spondylitis), what is associated? HLA-B27
Endochondroma/chondrosarcoma:
-Endochondroma described it as o-ring lesions, asked what is complication? Chondrosarcoma
-There was a question that showed the picture from enchondroma. It asked what it can progress to? Answer:
Chondrosarcoma.
-Showed X-ray of enchondroma- what is the complication- Chondrosarcoma
Osteopenic:
-Etiology for being osteopenic - modeling remodeling?
Achondroplasia:
-Achondroplasia image
-Achondroplasia- impaired chondrocyte proliferation
-There was the picture of the achondroplasia guy and asked pathogenesis. Answer: Fibroblast Growth Factor Receptor is
broken.
-Showed a pic of Achondrialplasia: mesenchymal condensation
Osteogenesis Imperfecta:
-Asked a question about a kid who keeps breaking his bones (osteogenesis imperfecta) and asked what a complication
was. Answer: Blue Sclera
-Osteogenesis imperfecta - collagen problem
-Described Osteogensis imperfect: collagen defect
Osteomyelitis:
-Osteomyelitis question, what would you see? Sequestrum
-Osteomyelitis: Sequestrum
-There was a question about osteomyelitis in sickle cell. What caused it? Answer: Salmonella
Giant cell bone tumor/Ewing’s:
-Giant cell bone tumor- soap bubble on X-ray
-Asked the location for either giant cell/Ewings sarcoma, forgot which 1? Epiphysis and diaphysis respectively
-Showed a picture of ewings of the round blue cells: where was it located?
Osteosarcoma:
-Osteosarcoma - Rb gene
-A child is presented to the clinic when his mother notices whitish reflection when she was at the beach. Doctor examines
and determines that this child has RB gene mutation and performs enucleation. Doctor also advises mother on a
pathology that this child may develop in his teenage years.. what is this pathology? Ulcerative Colitis, Gastric Tumor,
Aortic dissection, Osteosarcoma
-Described osteosarcoma with elevated periosteum : RB
-There was another question about some kid who had a cancer in the knee in the metaphysis, and it asked what you
would see. Answer: Elevated Periosteum.
-RB gene implicated in…. (bone cancer)… What type of pattern would you see on XRAY? Sunburst appearance->
Osteogenic Sarcoma
Osteoarthritis:
-Osteoarthritis - degenerative disease
-Described osteoarthritis- pain worsens with activity and as the day progresses, showed histo slide with “mice”- who
would you see it in - fat guy
-There was a question that showed a picture of osteoarthritis, and asked what a risk factor would be. Answer: Obesity. (if
you’re fat, you put more strain on the joints, and it wears them down)
--Skin
Basal cell carcinoma – UV light
Melanoma BRAF
BRAF -­­ Melanoma
Mutation associated with melanoma
Impetigo described – caused by direct damage to epithelium
27 year old black male seen with large growth behind ear…? What is it? Histologically (collagen type and how does that
differ from normal?) Keloids, Type III-> Type I

--Forensics
Alcohol:
-Girl drank wood alcohol, what is it? Methanol
-There was a question on someone who drank something and had blurry vision or went blind. Answer was methanol
-Guy drank something- got blind- what was it = Methanol
-Methanol: high anion gap and blindness
Cocaine:
-Guy on cocaine, what is complication? Dilated cardiomyopathy
-Cocaine nose caused by = vasoconstriction? Or necrotizing vasculitis?
-I think there was another question on cocaine too. It gives you elevated blood pressure and leads to vasospasm, so you
get a heart attack.
-Patient had dilated eyes - cocaine
-dilated pupils- cocaine, guy with psychosis and hallucinations- cocaine
Heroin:
-Pinpoint pupils - heroin
-Heroin : pinpoint
-Person who has heroin overdose.. what do you also check for? Staph Aureus
Suicide/CO2 Poisoning:
-Hesitation Marks: suicide
-RK couldn’t take the pressure anymore closed the garage and started his car. He play some bruce
springsteen and closed his eyes…. He was saved by a neighbor. What is his Dx? What do you expect
him to look like? CO poisoning, cherry red discoloration
-There was a question about some lady who was saved from a fire, and she had cherry red lips. What
was the pathogenesis? Answer: Formation of carbamohemoglobin (Carbon monoxide poisoning)
-CO poisoning, cherry red- carboxyHb
-Showed globus pallidus of CO poisoning- don’t remember question
Contusion/fracture/Inflammation/shaken baby
-Grab a hot frying pan- serous inflammation
-Basal skull fracture, what is indicator? Hemotympanum
-Basal skull fracture- blood in tympanic membrane
-Person had a contusion and bleeding from ears with hemotypanum and hit in the mastoid process:Basal skull fracture
-Hemotympanum is a sign of ? - basal skull fracture
-Father came in carrying child with retinal hemorrhages, what is cause of death? Shaken baby syndrome
Gun shot:
-Characteristic of entry wound in a gun shot - abrasion ring
-Bullet shot: ring abrasion
Overdose/poisoning:
 -Girl overdosed on acetaminophen – saturates glutathione
-Lead poisoning question what will you get an increase of protoporphyrin IX
-Described lead toxicity and asked what you’ll see on a blood smear – basophilic stippling
-There was a question about someone who had demyelination of nerves in the brain and peripheral nerves and asked
what caused it. I wasn’t sure – I thought it was multiple myeloma, but that wasn’t a choice. So I think I put Lead poisoning.
-Lead toxicity causes.. – Lead lines, demylination in children, peripheral neuropathy in adults. Anemia, Basophilic Stippling,
Colic w/ Diarreahea, foot drop, growth retardation, gum line
MVA/Lightning/Sexual assault:
-C. perfringens and gas gangrene in MVA accident patient
-Forensics- lightning strike- some sort of lesions look like leaf cannot remember the name (Lichtenberg figures)
-Lighting – Tree Lichtenberg
-There was a question about a guy who got struck by lightning. How can you tell it was lightening? Answer: Lichtenberg’s
figure – (which are fern-like burns)
-I think there was a question about sexual assault. Answer: First get informed consent.

--Peds
Infection/hemorrhage/fluid embolism/alcohol:
-Baby gets gonorrhea through the birth canal
-Intraventricular hemorrhage -­­ baby hyaline
-Woman gives birth and has all the symptoms of amniotic fluid embolism. What do you check for? Fetal squames
-Talked about young boy after viral infection: ITP destruction of antibody coated plates
-They described kid with increase epinephrine in lysosomes, what disease is this? Dubin Johnson
-Baby with alcoholic mother, what is complication baby will have? Low IQ
Rubella:
-Baby born with rubella, how did this spread? Hematogenously ?Transplacentally?
-Complication of rubella infection - patent ductus arteriosus
-PDA-­­ Rubella
Prematurity/Fibroplasia?PKU
-Baby had respiratory problem, gave surfactant, what is risk factor? Prematurity
-Complication of oxygen therapy for respiratory distress syndrome of the newborn - retrolental fibroplasia
-Described phenylketonuria, what enzyme defective? Phenylalanine hydroxylase
Necrotizing Enterocolitis/Meconium:
-Baby described with necrotizing enterocolitis, what is complication? DIC, sepsis, etc (Not sure what answer was)
-Low birth weight baby- necrotizing enterocolitis
-Kid with meconeum ileum (CF)- what test- Sweat test
Galactosemia:
-Baby given formula, started throwing up what did they have? Galactosemia
-Complication of galactosemia - cataracts/MR
-Galactosemia: cataracts
Potter’s Sequence:
-Basically described potter sequence, renal agenesis, pulmonary hypoplasia and asked you what
-A question describing polhydramnios, pulmonary hypoplasia: Sequence
-Kind of error in morphogenesis this was - a sequence
Medulloblastoma/Homer-Wright Rosettes:
-Kid with lazy eye, what did he have? Medulloblastoma
-Picture of medulloblastoma: ask for histology : blue cells
-Homer-Wright Rosettes- neuroblastoma, ask what will you see in urine- VMA
-One question asked what you would check in the urine? Answer: VMA
-One question said that you see homer-wright rosetts, what is the disease? Answer: Neuroblastoma.
 -Homer-Wright Rosettes- medulloblastoma
-Showed the picture of medulloblastoma, and said they had homer-wright rosettes. It asked for a complication: Ewing
Sarcoma.
-Described a tumor as having small round blue cells, and u had to pick from the options which tumor is it most likely to be
- medulloblastoma
-Described retinblastoma, needed to know Rb gene = tumor suppressor gene
Retinoblastoma
-Retinoblastoma and osteosarcoma- Rb mutation
-Shows baby with retinoblastoma and asks what is an associated condition: osteosarcoma
-There was a question about a kid who had a cat-eye reflex (retinoblastoma) and asked what associated disease he could
have. Answer: Osteosarcoma.
Hemolytic Uremic Syndrome/High RBC
-Hemolytic uremic syndrome in a kid with bloody diarrhea- E.Coli EHEC
-Idiopathic Thrombocytopenic Purpura / Hemolytic Uremic Syndrome. kid with fever, diarrhea, and then a couple weeks
later had purpura all down their legs. Cause? EHEC
-There was a question about some kid with a high red blood cell turnover rate, and it asked for a complication. I couldn’t
decide between: “it would lead to gallstones” or “it would turn into AML”

--Organisms
Bartonella/Histoplasmosis:
-PRESENCE OF neutrophilic infiltrate in presence of necrotizing granuloma Organism? Bartonella Hensale in Cat Scratch
Disease-- [Note: Buerger also has granulomatous inflammation w/ neutrophils--microabscess]
-HISTOPLASMOSIS = PIC FROM THE LAB describe it? Snow Storm/Buckshot appearance, similar to that of miliary TB
(indistinguishable)
CMV/Diptheria:
-Intra nuclear basophillic and intra cytoplasmic eosinophillic inclusions? CMV
-DIPTHERIA? Bug? Test? Endo/exotoxin?? Tellurite, Eleck, Exotoxin
Herpes:
-HERPES ZOSTER = WHERE DO YOU FIND IT? Where does it establish latency? Dorsal root ganglion
-Description herpes lesion and asked cause - HSV 2 virus
Chronic granulomatous disease/EBV:
-Chronic granulomatous disease – decreased free radicals
-EBV sign of rapid growth- myelin figures
Leprosy:
-Lepromatous leprosy caused by afunctional cell mediated immunity
-LEPROSY PICTURE – what type of response? TH1 Tubercoid (skin erthyematous reaction) vs TH2 Lepromatous (virchow
foamy cell picture)
Crytococcus neoformans:
-Organism with India ink = Cryptococcus neoformans
-Asks how you would definitively know the organism is Cryptococcus neoformans – organism negative stain on India Ink
-Described cryptococcus = had to know that person probably had HIV
HIV:
-Diagnostic for HIV infection… PCR assay. AIDS CD4 <200
Said ^^^ test…. Tests what? nucleic acids
-How do we test for HIV- Western
-What is the cause of lymphoma in the brain- HIV (answer was multiple sexual partners)

Misc:
Mediator of fever -IL-1
IL-­­1: Fever
Brandykinin: Pain
Mediator of pain - bradykinin
What mediates fever = bradykinin maybe? (should have been pain)
What mediates pain= histamine
HISTAMINE Causes a few signs of inflammation? vasodilation, redness, edema (increased vasc permeability)
Chemotactic factors for neutrophils… TELL ME ALL OF THEM? IL8, C5a, Bacterial Products (E. coli, Staph aureus) , LTB4
Person with Conn's test, what test would you do? Oral sodium loading test
Described Conn syndrome with high aldosterone /screening test you do ? oral sodium loading test
Question on CAH 21 hydroxylase deficiency. Said they had elevated 17 alpha hydroxyprogesterone.
Alaplasia picture = not differentiated at all
Nuclear chromatin clumping seen on microscopy? Ischemia, Reversible, lactic acid accumulation
Massive calcium influx due to an intracellular change? Reversible or Irreversible? - Irreversible.
Lipoma described characteristic = benign characteristics, slow growing etc
There was a question about someone who got in a car wreck and cut open their arm, and it ended up getting black, with
crepitous necrosis and puss coming out. It asked for the bacteria. I put Clostridium perfringes (although bacillus
anthracicus was a close second, but the black eschers from that usually only happens with people who are wool-sorters).
Clostridium perforinges what toxin does it release = lectinase
Question about klebsiella, who is most affected? Alcoholics
Described slender pseudohyphae (candida) and asked common etiology = immunocompromised patients
Picture of histology of Actinomycosis in the mouth, caused by = dental work
Actinomyces ISRAELI = what is seen in the wound sulfur like granules
Actinomycoses – caused by ill fitting dentures
Tattooing = dermal macrophage
Need to know paraneoplastic syndrome of adenocarcinoma = hypercalcemia
Granuloma is type 4 hypersensitivity
Non caseating granuloma for sarcoidosis
Described irreversible cell injury, what was hallmark = detachment of ribosome’s from smooth ER (not mitochondrial
swelling)
Asked for irreversible :Vacuolization of mitochondria
Describes mixed cell reaction – fungus
Which is NOT benign – adenoma
Ki67 proliferation marker for? Malignancy - proliferation marker - measures Rate of Growth in general can be for benign
or malignant -thats how you tell whether a tumor has fast or slow growth
Told you cancer cells were CD117 (c-kit) positive, what type of cells – cells of cajal
Kaposi’s sarcoma caused by HHV-8
Cause of cachexia – TNF-alpha
Cachexia is caused by... what cytokines.. TNF-A
Hyperchromatic nuclei and hasn’t invaded basement membrane – dysplasia
Septic shock – insulin resistance
What causes sickling – dehydration
Best way to stage a tumor – size of the primary tumor
Staging = TNM and what is the important factor (generally speaking)? Tumor size, Lymph node spread and Metastasis
involvement
Image of linitis plastic? E-­­cadherin
Test for Q Fever? Immunofluorescence and liver biopsy containing ring granulomas
HEAT STROKE mechanism? Major organs affected? Dry skin, high temp, CVS & Pulmonary
HepC- how would you get it- blood transfusion although very uncommon was the one reasonable answer
HepB question- description of MGN
I thought there was a question about someone who had bleeding gums and their teeth were falling out. It asked
pathogenesis. Answer: defective cross-linking of collagen.