ZQuPancreasQuiz

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Author:
EssentialPathologyNNMI
ID:
134967
Filename:
ZQuPancreasQuiz
Updated:
2012-09-21 09:57:01
Tags:
pathology ZQu pancreas
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Description:
Review of pancreatic pathology
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  1. 54-year old man presented with a 4-cm solitary mass with possible cystic change in the body of the pancreas. The most likely DDx is:
    A. Pseudocyst
    B. Mucinous cystic neoplasm
    C. Solid cystic pseudopapillary tumor
    D. Benign simple cyst
    E. Intraducatal musinous papillary neoplasm.
    Answer: "E. Intraducatal mucinous papillary neoplasm."
  2. 54-year old woman with a 4-cm solitary cystic in the body of pancreas. The lesion grew to 5.7 cm in 2 years although she remained asymptomatic. What was the most likely diganosis?
    A. Pseudocyst.
    B. Mucinous cystic neoplasm (MCN)
    C. Pancreatic ductal adenocarcinoma.
    D. Benign simple cyst.
    E. Intraducatal mucinous papillary neoplasm (IPMN)
    Answer: "B. Mucinous cystic neoplasm (MCN)."
  3. A gallstone with golden-yellow crystal crush surface is most likely from
    A. A 46-yo slightly overweight woman.
    B. A 13-yo obesed boy with family history of heart disease and stroke.
    C. An 80-yo man with long-standing pulmonary disease.
    D. A 26-yo girl with sickle-cell anemia.
    E. Both A and B.  "
    Amswer: "Both A and B (i.e. cholesterol stone)"
  4. What are the risk factors (5Fs) for gallstones/cholecystitis?
    • Fat.
    • Female.
    • Family history.
    • Fertile.
    • Forty.
  5. The gallbladder from a 42-yo woman showed a vague nodule at the fundus on pathology gross examination. The most likely diagnosis is:
    A. Phrygian hat.
    B. Adenomyoma.
    C. Invasive adenocarcinoma.
    D. Papillary hyperplasia.
    E Incarcerated gall stone
    Answer: "B. Adenomyoma."
  6. Multiple small black rock-hard gallstones are most likely from.
    A 46-year old slightly overweight woman.
    B. A 13-year old boy by the name of Don Giovani
    C. An 80-year old man with long-standing pulmonary disease.
    D. A 26-year girl with sickle-cell anemia.
    E. Both B and D.
    Answer: "Both B and E (hemolytic)"
  7. 52-yo woman with a history of Hashimoto thyroiditis developed signs of biliary obstruction. Malignancy was suspected. Imaging studies showed mild diffuse enlargement of pancreas and segmental dilation of main pancreatic duct. No discreet mass was detected. What additional tests would be valuable in diagnostic workup?
    Answer: "Serum IgG4 level, biopsy of the pancreas, brief steroid challenge."
  8. Which of the following  about autoimmune pancreatitis is INCORRECT?
    A. May occurs in a wide variety of organs and tissues.
    B. Often forms an inflammatory fibroproliferative nodule or mass.
    C. Presence of IgG4 positive plasma cells is diagnostic.
    D. Elevated serum IgG4 level is common.
    E. Swift response to steroid therapy.
    Answer: C. These plasma cells can also be seen in a wide variety of inflammatory processes unrelated to autoimmunity.
  9. A3-yo boy with growth delay was found to have a palpable abdominal mass confirmed by CT scan. A 13-cm solid mass was subsequently resected. The mass was lobulated with broad fibrous bands. A variety of different cell populations were seen microscopically.  Which one additional histological component could be diagnostic for this tumor?
    Answer: "Squamoid corpuscles".
  10. Present of IgG4 positive plasma cells is diagnostic of the IgG4-associated diseases.
    True
    False
    Answer:: False.  High numbers of IgG4-positive plasma cells can also be seen in diverse non-specific inflammatory conditions.
  11. 62-yo woman with intermitantt abdominal discomfort for 2 years was found on CT scan to have a 6.5 cm (well circumscribed) noculated mass in the tail of the pancreas.  What's the most likely pancreatic lesion?
    Answer: Microcystic serous cystadenoma.
  12. 55-yo man was found to have a 2.8-cm nodule in the head of pancreas on imaging study; extrusion of mucoid material from Ampulla of Vater was noted endoscopically. He most likely had
    A. Intraductal papillary mucinous neoplasm.
    B. Mucinous cystadenoma.
    C. Ductal adenocarcinoma.
    D. Solid (cystic) pseudopapillary tumor.
    E. Acinar cell carcinoma
    Answer: "A.Pancreatic Intraductal papillary mucinous neoplasm."
  13. 61-yo man gradually developed skin rashes on the thigh and abdomenthat  in the past two months. A vaguely palpable mass wass noted by PE. CT reveals a 6.8 multinodular in the body-tail of the pancreas. What did she most likely have?
    A. Ductal adenocarcinoma.
    B. Solid pseudopapillary tumor.
    C. Acinar cell carcinoma.
    D. Pancreatic mucinous cystic neoplasm.
    E. Autoimmune pancreatitis
    Answer: "C. Acinar cell carcinoma."
  14. Which adult tumor is immunohistochemically positive for pancreatic enzymes trypsin and chymotrypsin?
    A. Acinar cell carcinoma.
    B. Pancreatic endocrine tumor.
    C. Pancreatoblastoma.
    D. Solid pseudopapillary neoplasm of the pancreas.
    E. Well-differentiated ductal adenocarcinoma.
    Answer: "A. Acinar cell carcinoma."
  15. 25-yo woman presented with stomach discomfort and a possible abdominal mass on physical exam. Imaging studies showed a 11.5-cm well-circumscribed partially cystic pancreatic mass. Which of the following pancreatic tumors did she most likely have?
    A. Acinar cell carcinoma.
    B. Pancreatic endocrine tumor.
    C. Pancreatoblastoma.
    D. Solid cystic pseudopapillary tumor.
    E. Ductal adenocarcinoma
    Answer: "D. Solid cystic pseudopapillary tumor."
  16. Which of the entities below is most commonly seen in children?
    A. Acinar cell carcinoma.
    B. Pancreatic endocrine tumor.
    C. Pancreatoblastoma.
    D. Solid pseudopapillary neoplasm of the pancreas.
    E. Well-differentiated ductal adenocarcinoma "
    Answer: "C. Pancreatoblastoma"

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