MCQ-Lung

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Lung MCQ 1 73F. Pleural effusion. ?mass on CXR. Pleural fluid cell block performed. Cells positive for D2-40 and calretinin; negative for MOC31. Possible diagnoses based on IHC include: A. Adenocarcinoma B. Squamous cell carcinoma C. Small cell carcinoma D. Reactive mesothelial cells E. Malignant mesothelioma F. Malignant melanoma

T/F T/F T/F T/F T/F T/F

MCQ 2 Primary lung adenocarcinoma is positive for which of the following markers? T/F A. B. C. E. F. G. H.

CDX2 CK7 CK20 D. MOC31 TTF1 Napsin A P63 AE1/AE3

MCQ 3 Which of the following are epithelial markers that could be used for IHC in a pleural fluid sample in parallel with mesothelial markers? T/F A. B. C. D. E. F. G. H. I. J. K. L.

CDX2 AE1/AE3 Calretinin CK5/6 CK7 CAM5.2 BerEP4 CK20 MOC31 MNF-116 TTF1 34betaE12

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FRCPath Part1 Course MCQ 4 Which of the following are cytokeratins? T/F A. B. C. D. E. F. G. H. I. J. K. L.

CDX2 AE1/AE3 Calretinin CK5/6 CK7 CAM5.2 BerEP4 CK20 MOC31 MNF-116 TTF1 34betaE12

MCQ 5 The following are useful markers to distinguish malignant mesothelioma from adenocarcinoma: A. B. C. D. E. F. G. H. I. J. K. L. M. N.

WT-1 AE1/AE3 Calretinin CK5/6 CK7 CAM5.2 BerEP4 CK20 MOC31 MNF-116 Thrombomodulin E-cadherin CEA EMA

MCQ 6 Which one of the following markers can help to distinguish between malignant mesothelioma and adenocarcinoma by differential subcellular staining: A. B. C. D. E. F. G. H. I. J.

WT-1 AE1/AE3 Calretinin CK5/6 CK7 CAM5.2 BerEP4 CK20 MOC31 MNF-116 www.oxbridgemedica.com

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Thrombomodulin E-cadherin CEA EMA

MCQ 7 Which of the following markers may be useful to distinguish reactive mesothelial cells from malignant mesothelioma? T/F A. B. C. D. E. F. G. H. I. J. K. L.

Calretinin MOC31 AE1/AE3 Desmin p53 CEA D2-40 EMA CK7 p63 SMA vimentin

MCQ 8 Metastasis in lung or primary. Which primary tumours typically have this immunoprofile? a) CK7-,CK20b) CK7+, CK20c) CK7+, CK20d) CK7-, CK20+

CK7+/CK20-

A. B. C. D. E. F. G. H. I. J. K.

CK7+/CK20+

CK7- / CK20+

CK7-/CK20-

Lung adenocarcinoma Colon adenocarcinoma Mesothelioma Pancreatic adenocarcinoma Small intestine adenocarcinoma Breast adenocarcinoma Prostate adenocarcinoma Ovarian mucinous adenocarcinoma Ovarian serous / endometrioid adenocarcinoma Bladder - transitional cell carcinoma Endometrial adenocarcinoma www.oxbridgemedica.com

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EMQ 9 In the subtyping of metastatic lung tumours, please match the tumours with the antigen that could aid diagnosis by IHC. Each tumour can have no antigen, one or more than one corresponding positive antigens. Each antigen can be used once, more than once or not at all.

ANITGEN: 1) ER 2) Ki67 3) CDX2 4) SYTL5 5) Vimentin 6) SMAD4 7) PR 8) PAX8 9) PLAP 10) AR 11) pCEA 12) mCEA 13) PSA 14) EMA 15) PSAP

A. Prostate adenocarcinoma

B. Breast adenocarcinoma

C. Endometrial adenocarcinoma

D. Renal cell carcinoma

E. Gastric adenocarcinoma

F. Colorectal adenocarcinoma

G. Pancreatic adenocarcinoma

H. Seminoma

MCQ 10 Which of the following conditions in the lung have a tendency to cavitate?

A. B. D. E.

Lung adenocarcinoma Tuberculosis C. Sarcoidosis Lung squamous cell carcinoma Lung small cell carcinoma

MCQ 11 Which of the following markers help to distinguish between lung adenocarcinoma and lung squamous cell carcinoma?

E.p63 F. p16 A. TTF1 G. p40 B. MNF-116 H. CK14 C. CK5/6 I. CK8 D. Calretinin www.oxbridgemedica.com

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MCQ 12 Characteristics of small cell lung carcinoma: T/F A. B. C. D. E. F. G. H. I. J. K.

Finely granular chromatin Cytoplasmic vacuolation Dense cytoplasm on Pap staining Positive staining for synaptophysin Is generally treated by surgery Nuclear moulding Accounts for 45% of primary lung cancers Is distinguished from primary lung adenocarcinoma by its lack of staining for TTF1 Is a small round blue cell tumour Is strongly related to cigarette smoking Azzopardi effect

MCQ 13 Which one of the following lung tumours are associated with haemorrhage including potentially fatal haemoptysis when treated with monoclonal antibody therapy (bevacizumab) : T/F A. B. C. D. E.

Squamous cell carcinoma Adenocarcinoma Small cell carcinoma Large cell neuroendocrine carcinoma Atypical carcinoid tumours

MCQ 14 Molecular pathology of lung tumours: Which one technique is favoured / forecasted in pathology to be the principal instrumental technique that will lead lung cancer molecular diagnostics in the future: T/F A. miRNA analysis B. Genomic DNA sequencing C. Whole human genome expression arrays D. High throughput proteomics by MALDI mass spectometry E. Gene expression by multiplex qPCR F. Mitochondrial DNA mutation analysis G. Raman spectroscopy MCQ 15 Which of the following are important genes in lung cancer molecular testing?

T/F A. B. C. D.

MIB1 p63 EGFR TTF1 www.oxbridgemedica.com

FRCPath Part1 Course E. F. G. H. I. J. K. L.

EML7-ALK EML3-ALK EML4-ALK KRAS-ALK KRAS c-MYC MYBL1 BRAF M. p40

MCQ 16 Which of the following is classical of bronchiolitis obliterans organising pneumonia?

A. B. C. D. E. F.

Fibrosis Asbestos fibres Macrophages within alveoli Intrabronchiolar fibroblastic plugs Granulomas Hyaline membranes

MCQ 17 Aspergillus has the following features: A. B. C. D.

45% branching of hyphae Non-septate Invasion of blood vessels Infection in immunocompetent patients

MCQ 18 Pneumocystis pneumonia: A. B. C. D. E. F. G.

jirovecii is the species that causes lung infection carinii is the species that causes lung infection motoso is the species that causes lung infection Is an opportunistic infection Histologically - alveolar spaces filled with eosinophilic foamy material containing fungi.

Is characteristed by non-branching septate hyphae Is characteristed by 4-6micron diameter cupshaped cysts

MCQ 19 In routine diagnostic practice, asbestos fibres can be counted using: A. B. C. D. E. F.

H&E sections Electron microscopy Perls staining Nitric acid digest and light microscopy Autofluorescence Unstained FFPE sections www.oxbridgemedica.com

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MCQ 20 Asbestos bodies: A. B. C. D. E. F.

Are synonomous with feruginous bodies Are diagnostic of asbestosis The asbestos fibre count decreases over time in living patients lung tissue Are not found in hilar lymph nodes Are usually found in mesothelioma tissue Amphiboles are associated more than crysotiles with mesothelioma

MCQ 21 36F. Heavy smoker. Progressive SOB. CXR – bilateral ground glass appearance. Lung biopsy – alveoli filled with histiocytes, hyperplasia or type 2 pneumocytes, lymphoplasmacytic infiltrate. Diagnosis: A. B. C. D. E.

Bronchiolitis obliterans organising pneumonia Usual interstitial pneumonia Desquamative interstitial pneumonia Extrinsic allergic alveolitis Non-specific interstitial pnemonia

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