The document provides an overview of various topics in histopathology, organized by level of importance. In the "Very Important" section it lists fundamentals of histopathology and diseases of several organ systems. The "Quite Important" section lists several specific pathology topics. The "Worth Learning" section provides a brief list of additional topics. It then provides more detailed information on selected topics like fundamentals of histopathology, liver diseases, gastrointestinal diseases, and skin pathology.
ULCERATIVE COLITIS
DEFINITION
It is an inflammatory condition of rectum & colon of unknown aetiology perhaps related to stress, westernized diet, autoimmune factor, familial tendency, allergic factor.
commonly starts in the rectum, spreads proximally to the colon & often into the ileum as back wash ileitis (5%).
Fun Functional Gallbladder Disorders: Update on Hypo and Hyperkinetic Gallbla...Patricia Raymond
Functional gallbladder disorder is biliary pain from motility disturbance in the absence of gallstones, sludge, or microcrystal disease. In patients with biliary-type pain and a normal US, the prevalence is 8% men and 21% women. We will review the clinical manifestations, diagnosis, and management of patients with suspected functional gallbladder disorder, and also address current evaluation and management of sphincter of Oddi dysfunction.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ULCERATIVE COLITIS
DEFINITION
It is an inflammatory condition of rectum & colon of unknown aetiology perhaps related to stress, westernized diet, autoimmune factor, familial tendency, allergic factor.
commonly starts in the rectum, spreads proximally to the colon & often into the ileum as back wash ileitis (5%).
Fun Functional Gallbladder Disorders: Update on Hypo and Hyperkinetic Gallbla...Patricia Raymond
Functional gallbladder disorder is biliary pain from motility disturbance in the absence of gallstones, sludge, or microcrystal disease. In patients with biliary-type pain and a normal US, the prevalence is 8% men and 21% women. We will review the clinical manifestations, diagnosis, and management of patients with suspected functional gallbladder disorder, and also address current evaluation and management of sphincter of Oddi dysfunction.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
5. Basics
Cell Appearance Significance
Neutrophil
Multilobed nuclei with
granules
Acute inflammation
Lymphocyte
Little cytoplasm with big
nucleus
Chronic inflammation,
lymphoma
Eosinophil
Bi-lobed nucleus with red
granules
Allergic, parasites,
Hodgkin lymphoma
Mast Cell
Large and heavily
granular
Allergy (e.g. urticaria)
Macrophage
Large with lots of
cytoplasm
Late acute inflammation,
chronic inflammation (inc
granuloma)
6. Basics
Type of Cancer Histological Features Sites
Squamous Cell
Carcinoma
Keratin production
Intercellular bridges
Lung, skin, oesophagus
Adenocarcinoma
Mucin production
Glands
Lung, breast, colon,
pancreas, cervix,
stomach
Transitional Cell
Carcinoma
- Bladder, ureter, urethra
Sarcoma
Arises from
mesenchymal cells
Bone, cartilage, fat,
vascular
7. Basics
Stains
Chemical reaction between
stain and tissue
Antibodies bind to specific
antigen
Examples
H&E: everyday stain
Prussian Blue: iron
Congo Red: amyloid
Examples
Cytokeratin antibody: epithelial cells
CD45: lymphoid marker
Immunohistochemical
Histochemical
9. Question 1
A 45-year-old man presents to his GP with a 3-month history of
worsening dysphagia. He is now unable to comfortably swallow
solid foods. He has never suffered from heartburn and takes no
regular medications. He has a 20 pack year smoking history
and drinks in moderation. A barium swallow identifies an apple
core lesion in the middle third of the oesophagus. This is
followed by an OGD and biopsy which reveals abnormal
keratinised cells with intercellular bridges that have invaded the
basement membrane. What is the most likely diagnosis?
A Barrett’s oesophagus
B Transitional cell carcinoma
C Oesophageal lymphoma
D Adenocarcinoma
E Squamous cell carcinoma
10. Question 2
A 16-year-old girl has suffered from diarrhoea for the past 6
months. She describes the diarrhoea as foul-smelling and has
lost 5 kg over this time period. An endoscopy and biopsy
reveals increased intraepithelial lymphocytes with a 2:1 villous
to crypt ratio. What is the most likely diagnosis?
A Lymphocytic duodenitis
B Coeliac disease
C Crohn’s disease
D Duodenal MALToma
E Linitis plastica
11. Oesophagus and Stomach Histology
Oesophagus
• Contains submucosal
glands
• Transitions from
squamous to columnar
epithelium at the z-line
Body and Fundus
• Columnar lining
• Produce acid and
intrinsic factor
Pylorus and Antrum
• Columnar lining
• Produce gastrin
Duodenum
• Columnar epithelium
with goblet cells
• 2:1 villous: crypt ratio
12. Oesophageal Cancer
Adenocarcinoma
Squamous Cell Carcinoma
Associated with Barrett’s oesophagus
Associated with GORD
Lower 1/3 of oesophagus
Associated with smoking and alcohol
Lower 2/3 of oesophagus
Histology: keratinised cells with
intercellular bridges
Histology: glandular epithelium
13. Chronic Gastritis Histology
Abundance of lymphocytes
Gastritis, Ulcers and Cancer
Causes of Gastritis
• Autoimmune
• H. pylori
• Chemical (alcohol, NSAIDs)
Mucosa-Associated Lymphoid Tissue
• Chronic gastritis induces lymphoid
tissue in the stomach
• Strongly associated with H. pylori
• Increased risk of lymphoma
14. Gastric Ulcers and Cancer
Gastric Ulcer
Definition: the depth of loss of tissue goes beyond the mucosa
(i.e. into the submucosa)
Chronic ulcers are characterised by scarring and fibrosis
IMPORTANT: ALL ulcers should be biopsied to exclude
malignancy
Gastric Adenocarcinoma
Intestinal: well-differentiated, mucin-containing glands
Diffuse: poorly differentiated, composed of single cells,
no gland formation
Linitis plastica
Signet ring cell carcinoma
Types
Niche Gastric Cancer (5%)
Squamous cell carcinoma
Lymphoma
Gastrointestinal stromal tumour
Neuroendocrine tumour
15. Malabsorption due to Partial Villous Atrophy
Villous atrophy
Crypt hyperplasia
Increased intraepithelial
lymphocytes
16. Malabsorption due to Partial Villous Atrophy
Lymphocytic Duodenitis: inflammatory changes without architectural changes
i.e. increased intraepithelial lymphocytes but no villous atrophy/crypt
hyperplasia
Coeliac Disease: inflammatory and architectural changes
Many will go on to develop coeliac disease
Investigations
Antibodies: tissue transglutaminase and endomysial
Duodenal Biopsy: showing villous atrophy whilst ingesting gluten
Tropical Sprue: form of malabsorption with similar histology to coeliac disease
18. Pseudomembranous Colitis
Px: explosive watery diarrhoea, usually after a course of antibiotics
Ix: C. difficile stool toxin assay
Rx: Metronidazole Vancomycin Fidaxomicin Faecal Transplant
19. Ischaemic Colitis
Definition: inflammation and injury of the large
intestine caused by an inadequate blood supply
Watershed: area between the supply of
the SMA and IMA
Causes
Arterial (e.g. thrombus)
Venous (e.g. hypercoagulable)
Small vessel disease (e.g. DM)
Low flow (e.g. shock)
Obstruction (e.g. hernia)
20. Polyps and Adenomas
Polyp
Neoplastic
Non-Neoplastic
Tubular adenoma
Tubulovillous adenoma
Villous adenoma
Hyperplastic
Inflammatory (pseudopolyp)
Hamartomatous
FAP
Autosomal dominant
APC tumour suppressor
gene
Large numbers of polyps,
pretty much everyone gets
cancer
Gardner Syndrome
Same features as FAP
Extra-intestinal manifestations:
Osteomas
Desmoid tumours
Dental caries
Supernumerary teeth
HNPCC
Autosomal dominant
DNA mismatch repair
genes
High risk of cancer,
no polyps
21. Answer 1
A 45-year-old man presents to his GP with a 3-month history of
worsening dysphagia. He is now unable to comfortably swallow
solid foods. He has never suffered from heartburn and takes no
regular medications. He has a 20 pack year smoking history
and drinks in moderation. A barium swallow identifies an apple
core lesion in the middle third of the oesophagus. This is
followed by an OGD and biopsy which reveals abnormal
keratinised cells with intercellular bridges that have invaded the
basement membrane. What is the most likely diagnosis?
A Barrett’s oesophagus
B Transitional cell carcinoma
C Oesophageal lymphoma
D Adenocarcinoma
E Squamous cell carcinoma
22. Answer 2
A 16-year-old girl has suffered from diarrhoea for the past 6
months. She describes the diarrhoea as foul-smelling and has
lost 5 kg over this time period. An endoscopy and biopsy
reveals increased intraepithelial lymphocytes with a 2:1 villous
to crypt ratio. What is the most likely diagnosis?
A Lymphocytic duodenitis
B Coeliac disease
C Crohn’s disease
D Duodenal MALToma
E Linitis plastica
24. Question 5
A 36-year-old woman who was identified as having
an abnormal cervical smear, underwent a cervical
excision biopsy which reveals cervical glandular
intraepithelial neoplasia. Which type of cancer
would this have progressed to if left untreated?
A Adenocarcinoma
B Krukenberg tumour
C Squamous cell carcinoma
D Transitional cell carcinoma
E Serous carcinoma
25. Cervical Cancer
Risk Factors
• HPV 16 and 18
• Multiple sexual partners
• Smoking
• Immunosuppression
Tumorigenesis
HPV 16 and 18 encode two
proteins that inactivate tumour
suppressor genes
E6 – p53
E7 – retinoblastoma
Squamous
Columnar
Transformation
26. Cervical Cancer
Cervical Intraepithelial Neoplasia (CIN)
Dysplastic changes within the epithelium with an intact basement membrane.
Squamous cell carcinoma
Progresses to
Histological classification
CGIN: cervical glandular intraepithelial neoplasia progresses to adenocarcinoma (20%)
27. Endometrial Cancer
Risk Factors
• OESTROGEN
• Nulliparity
• Obesity
• Diabetes mellitus
• COCP
• Tamoxifen
• HRT
• Early menarche
• Late menopause
Type 1 (85%) Type 2 (15%)
Endometrioid
Mucinous
Secretory
Types Serous
Clear cell
Types
Younger patients
Oestrogen-dependent
Associated with atypical
endometrial hyperplasia
Usually low grade
Features
Older patients
Less oestrogen-dependent
Arises from atrophic
endometrium
Higher grade, deeper
invasion
Features
28. Gestational Trophoblastic Disease (Molar Pregnancy)
Gestational Trophoblastic Disease: a spectrum of tumours and tumour-like conditions
characterised by proliferation of pregnancy-associated trophoblastic tissue.
Complete
Empty
23X 23X
OR
23X
46XX
Partial
23X 23X
OR
46XY
23X 69XXY
30. Epithelial Ovarian Tumours
Type Features
Serous
MOST COMMON
Arise from bland epithelium
May be benign, borderline or malignant
Mucinous Mucin-secreting epithelium
Endometrioid
10-20% associated with endometriosis
Co-existence of endometrial carcinoma is
common
Better prognosis than mucinous/serous
Clear cell STRONG association with endometriosis
31. Sex Cord Stromal Tumours
Type Features
Fibroma
Benign
No endocrine production
Granulosa cell tumour
Variable behaviour
May produce oestrogen
Thecoma
Benign
May produce oestrogen
Rarely produces androgens
Sertoli-Leydig cell
tumour
Variable behaviour
May be androgenic
32. Germ Cell Tumours and Secondary Tumours
Secondary Tumours
Krukenberg Tumour
• Bilateral metastases
• Mucin-producing signet-
ring cells
• Usually from gastric or
breast cancer
Metastatic Colorectal Cancer
33. Question 5
A 36-year-old woman who was identified as having
an abnormal cervical smear, underwent a cervical
excision biopsy which reveals cervical glandular
intraepithelial neoplasia. Which type of cancer
would this have progressed to if left untreated?
A Adenocarcinoma
B Krukenberg tumour
C Squamous cell carcinoma
D Transitional cell carcinoma
E Serous carcinoma
35. Question 6
A 55-year-old woman has been referred to the dermatology
outpatient clinic by her GP after developing multiple blisters
on her face. On examination, the blisters are flaccid and
extend across her face and shoulders. A biopsy is taken,
and immunofluorescence analysis reveals of IgG deposition
across the middle of the epidermis.
What is the most likely diagnosis?
A Pemphigus Vulgaris
B Pemphigus Foliaceus
C Bullous Pemphigoid
D Erythroderma
E Epidermolysis Bullosa
42. Answer 6
A 55-year-old woman has been referred to the dermatology
outpatient clinic by her GP after developing multiple blisters
on her face. On examination, the blisters are flaccid and
extend across her face and shoulders. A biopsy is taken,
and immunofluorescence analysis reveals of IgG deposition
across the middle of the epidermis.
What is the most likely diagnosis?
A Pemphigus Vulgaris
B Pemphigus Foliaceus
C Bullous Pemphigoid
D Erythroderma
E Epidermolysis Bullosa
44. Question 1
A 35-year-old female patient has developed right upper
quadrant pain with a fever over the past week. On
examination, she is visibly jaundiced with excoriation marks
across her arms and torso and hepatomegaly is noted. She
has a past medical history of ulcerative colitis and asthma. A
biopsy of her liver is taken.
What histological features would you expect to see?
A Regenerating hepatocytes limited by a fibrous cuff
B Bile duct obliterations with surrounding granulomas
C Bile duct fibrosis
D Ballooning with Mallory Denck bodies
E Accumulation of iron-rich macrophages
45. Answer 1
A 35-year-old female patient has developed right upper
quadrant pain with a fever over the past week. On
examination, she is visibly jaundiced with excoriation marks
across her arms and torso and hepatomegaly is noted. She
has a past medical history of ulcerative colitis and asthma. A
biopsy of her liver is taken.
What histological features would you expect to see?
A Regenerating hepatocytes limited by a fibrous cuff
B Bile duct obliterations with surrounding granulomas
C Bile duct fibrosis
D Ballooning with Mallory Denck bodies
E Accumulation of iron-rich macrophages
46. Question 2
A 53-year-old woman has recently undergone a
cholecystectomy after a long-history of biliary cholic and
chronic cholecystitis. Which of the following features would
you expect to see on histological analysis of the gallbladder?
A Predominance of lymphocytes and macrophages with
Rokitansky-Aschoff sinuses
B Predominance of neutrophils with fibrosis
C Glandular to squamous metaplasia
D Cyst formation
E Presence of signet ring cells
47. Answer 2
A 53-year-old woman has recently undergone a
cholecystectomy after a long-history of biliary cholic and
chronic cholecystitis. Which of the following features would
you expect to see on histological analysis of the gallbladder?
A Predominance of lymphocytes and macrophages with
Rokitansky-Aschoff sinuses
B Predominance of neutrophils with fibrosis
C Glandular to squamous metaplasia
D Cyst formation
E Presence of signet ring cells
48. Question 6
A 57-year-old woman was identified as having a
suspicious lesion on mammography. A biopsy is
taken which identifies a central zone of scarring
surrounded by proliferating glandular tissue. What is
the most likely diagnosis?
A Fibroadenoma
B Intraductal papilloma
C Phyllodes tumour
D Invasive ductal carcinoma
E Radial scar
49. Question 6
A 57-year-old woman was identified as having a
suspicious lesion on mammography. A biopsy is
taken which identifies a central zone of scarring
surrounded by proliferating glandular tissue. What is
the most likely diagnosis?
A Fibroadenoma
B Intraductal papilloma
C Phyllodes tumour
D Invasive ductal carcinoma
E Radial scar
