Advent of HAART (incl. cART) has resulted in improved morbidity, mortality & life expectancy of patients with AIDS.
As a result, there is declining incidence of AIDS-defining illnesses, incl. AIDS-defining malignancies. However, deaths due to non-AIDS defining cancers are on the rise (3x ↑).
Which of the following malignancies is not an AIDS defining neoplasm?
Acute exanthem of HIV infection is an early manifestation of HIV infection. Patients turn seropositive shortly thereafter. Clinically, it often presents as a morbilliform exanthem.
Skin biopsy in acute exanthem of HIV infection typically shows which pattern of tissue reaction?
Rare variants of melanoma can show areas of divergent differentiation such as schwannian, smooth muscle, skeletal muscle, cartilage, osteoid, neuroendocrine, etc.
The term metaplastic melanoma is aplied to melanomas showing cartilaginous (chondroid melanoma) or osteoid (osteogenic melanoma).
Which of the following is the most common site of occurence of osteogenic melanoma?
Interaction of PD1-Ligand expressed on melanoma cells with PD1 receptor on activated tumor-specifice T cell provides inhibitory signal which supresses T cell activation. This is a critical mechanism of resistance of tumors towards immune response. Blocking of this interaction by anti-PD1 drugs is called immune checkpoint blockade. It is a very promising mechanims targeted by drugs which has shown to result in long-term survival in some patients with advanced melanoma and other malignancies.
Which of the following statement about immune check point blockage and PD1 targeting by anti-cancer drugs is not true?
The term Next-Gen Sequencing refers to massive parallel sequencing of DNA or cDNA This technology allows to sequence each gene many times (up to 500 times) to increase sensitivity. It can detect base pair mutations, insertions, deletions, copy number changes, translocations in one sequencing reaction. Which of the following statements regarding Next Gene Sequencing is true:
The image below show biopsy of parakeratinizing odonotogenic keratocyst.
Which of the following statements regarding this entity is not true?
The number of melanoma cases worldwide is believed to be increasing faster than any cancer other than non-melanoma skin cancer, with estimates suggesting a doubling of melanoma incidence every 10-20 years. It has been estimated that in 2013 there were 76,690 new cases of cutaneous melanoma in the USA, and that 9,480 people in the USA died from cutaneous melanoma.
These findings have led to statements that cutaneous melanoma has become epidemic in Caucasian populations in many parts of the world. Melanoma is often cured if excised at an early/thin stage, but until very recently advanced/metastatic melanoma has had a very high fatality rate, and been considered for the most part to be incurable. Therefore, in the past 30 years great effort has been put into lowering the death rate from cutaneous melanoma by identifying lesions at an early, curable stage, and screening individuals for early lesions.
Which statement about cutaneous melanoma in the USA has been true for the past 30-40 years? (choose one)
Which is the best immunohistochemical marker for demonstrating hepatocellular differentiation?
A biopsy is submitted from the cheek of an 82 year old man. It contains a spindle cell proliferation that you are concerned could be desmoplastic melanoma. Which of the following are most likely to help you identify desmoplastic melanoma?
Muir-Torre syndrome is an autosomal dominant disorder that is due to mutation in mismatch repair genes (MSH-2, MLH-1, MSH-6, PMS-2) with resultant microsatellite instability.
Which of the following is of greatest concern for associated Muir Torre syndrome?
A biopsy is submitted of an ulcerated crusted nodule. It reveals parasitized histiocytes.
Of the following, which is the most likely diagnosis?
Excisional biopsy of a draining sinus reveals a suppurative infiltrate with pigmented grains. Of the following, which is the most likely diagnosis?
Myiasis is infestation of tissue by Diptera larva. Clinical presentations include wound and furuncular myiasis. Furuncular myiasis occurs at the bite of an insect, most commonly due to Dermatobia hominis in warm humid, low land forests of Central and South America. The female glues her eggs to the abdomen of a captured insect. This vector then bites the host. The larvae sense the change in temperature, detach, and burrow into the subcutaneous tissue through the bite or a follicle. The larva grows and matures over 6-8 weeks before emerging. The larva has an undulating thick chitinous wall with 2 to 6 rows of dark pigmented setae that prevent dislodgement.
Myiasis is infestation of tissue by:
Nematodes or round worms contain a “tube within a tube” or a gut. Cestodes (flat worm/tapeworm) have a secretory tegument but no gut. The worm depicted below lacks a gut.
It is which one of the following?
Although the tumor necrosis factor (TNF) inhibitors are sometimes used to treat psoriasis, paradoxical psoriasiform eruptions not uncommonly result from use of these drugs in patients with inflammatory bowel disease or rheumatoid arthritis without a history of psoriasis. It may be due to disruption of the cytokine balance by TNF blockage allowing unopposed IFN-alpha production by plasmacytoid dendritic cells. Which of the following is most likely to cause a psoriasiform eruption?
Lyme disease is caused by the spirochete Borrelia burgdorferi. It is transmitted to humans through the bite of infected black legged ticks (Ixodes), including Ixodes scapularis (deer tick or black legged tick) and Ixodes pacificus (western black legged tick). In contrast, Dermacentor ticks transmit Rocky Mountain Spotted Fever. Amblyomma americanum (lone star tick) transmits human ehrlichiosis and tularemia.
The adult female tick that typically transmits Lyme disease, is characterized by which of the following features?
|Pass rate:||75 %|
Everybody can take the test but only participants of 2015 Course: Common Areas of Interest for Dermatopathologists and Surgical Pathologists: Infectious Diseases, Mucosal (Oral, Genital, Ophthalmic) Pathology, Melanoma and Critical Diagnoses in a Hospital Setting should claim American Board of Pathology Maintainance of Certification Self-Assessment Credits (SAMs).
Participants who only attended Saturday sessions as part of Arizona Society of Pathologist's Spring Meeting should take a different test which is available by clicking on http://www.dermpedia.org/2015-arizona-society-of-pathologists-spring-meeting
SAMs are provided by Community Medical Centers in Fresno, CA.
Community Medical Centers has been approved by the American Board of Pathology to provide Self-Assessment Modules (SAMs). SAMs are a specific form of Category 1 CME required by the ABP as part of its Maintenance of Certification Program.
The test questions cover 10 hours of instruction at the Course, so successful participants can claim 10 SAM Credits.
All questions are based on the presentations delivered at the Course included in Course Materials. If you have not downloaded the Course Materials yet, they are available from www.dermatopathologyconsultations.com/education
75% of questions must be answered correctly in order to claim the credit.
Please review the questions carefully and review your notes and the Course Materials before answering each question as only 5 attempts will be allowed.