|Pass rate:||75 %|
This test is only for those who participated in Saturday Sessions only and offers 6.5 hours of SAM credits. The members of the Arizona Society of Pathologists who participated in the entire Course are eligible for 10 credits and should take 2015 Dermpedia Course: Common Areas of Interest for Dermatopathologists and Surgical Pathologists SAM
Everybody can take the test but only member of Arizona Society of Pathologists who participanted in 2015 Spring Meeting held jointly with Dermpedia 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). 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.
All questions are based on the presentations delivered at the Course included in Course Materials. If you have not downloaded the Course Materials yet, the 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.
According to the most comprehensive study summarizing follow-up data on sentinel lymph node sampling in melanoma, which statement is not true?
The main sourse of false-positive results in melanoma FISH is tetraploidy. In tetraploid cells increased number of intact chromosomes leads to increased signals with all FISH probes. In contrast, selective amplifications or deletions of genetic material is the most characteristic for melanoma. Importantly, not all the signals can be visible in a nucleus from a nevus cells as some FISH probe binding sites may not be in the plane of section. Keeping this in mind answer the question which FISH result from the options bellow is most compatible with malignant melanoma?
Fluorescent in situ hybridization techniques have been used as an adjunct tool in the diagnosis of melanoma. It can be done either on formalin fixed, paraffin-embedded sections or on fresh-frozen tissue. A 4-probe multicolor melanoma FISH is the most commonly used and targets chromosomes 6 and 11. Each fluorescently labeled fragment of DNA that hybridizes to a tumor cell nucleus will appear as a distinct fluorescent dot. Each dot identifies a single copy of the chromosomal locus with a homologous DNA. Knowing that melanomas are characterized by chromosomal copy number aberrations, what is the best interpretation for the figure below?
Aqua: Cen 6
Acrodermatitis enteropathica can be an autosomal recessive inherited disorder or acquired, especially in patients with eating disorders or chronic malabsorption conditions. The clinical syndrome is characterizd by a triad of acral dermatitis, alopecia, and diarrhea. What are the most common features found in the biopsy?
Macular arteritis is a recently described clinicopathological entity. It is characterized clinically by asymptomatic erythematous and hyperpigmented macules and/or livido reticularis on the lower limbs. Which is true about biopsy findings in macular arteritis?
Drug reactions can happen at any time after commencement of the treatment with a drug. Knowing the time-course of different drug eruptions can be helpful in identifying the offending drug. Which is not true about time-course of different types of drug eruptions?
Endocrine mucin producing carcinoma of the eyelid is a recently described lesion which is precursors to mucinous carcinoma of the eyelid. Which is not true about this tumor?
Sebaceous carcinomas of the eyelid is an aggressive tumor which is often misdiagnosed. Key histological features for the diagnosis includes: pagetoid spread, involvement of hair follicles, infiltrative growth, nests with comedo necrosis, and epithelioid cells with vesicular nuclei and bubbly vacuolated cytoplasm. In some cases it may extremely difficult to distinguish ocular sebaceous carcinoma from basal cell carcinoma or squamous cell carcinoma.
Which is not true about ocular sebaceous carcinoma?
Pseudobowenoid changes of the vulva is an HPV-induced lesion described on the vulva which has similar histologic changes to those seen in oral Heck’s disease (focal epithelial hyperplasia). Both conditions are induced by rare HPV variants. Histological feature characteristic for these entities include epithelial hyperplasia with broad rete ridges, koilocytes, and presence of mitosoid bodies.
Mitosoid figures from a representative case from the vulva are shown below.
Which types of HPV have been associated with this disease?
Lyme disease is caused by a spiroquete Borrelia burgdorferi. It is transmitted by the Ixodes tick. Histologically, erythema chronicum migrans is characterized by a non-specific lymphocytic perivascular and perineural inflammatory infiltrate, usually associated with plasma cells. What other condition can be also associated with Lyme disease?
Which form of leprosy is characterized by well formed perineural granulomas and absent bacilli?
Leprosy is caused by Mycobacterium leprae, which is an obligate intracellular gram-positive, weakly acid fast organism. The disease can present in many different forms, depending on the immune response of the patient. Which form of leprosy has the highest number of organisms found in the biopsy specimen?
Erythrasma is caused by an actinobacteria of the genus Corynebacterium (C. minutissimum). Which of the folling statements about skin biopsies in erythrasma is not true?
Erythrasma is a bacterial infection of the skin, which occurs symmetrically in intertriginous areas, and is one of the differential diagnoses for “normal skin” histology on H&E stain. Knowing that it is caused by an actinobacteria of the genus Corynebacterium, which species causes erythrasma?
The PD-L1/PD-1 immune “checkpoint” may be co-opted by tumors to turn off the anti-tumor host immune response. New anti-PD-1 or anti-PD-1 immunotherapies block this interaction, effectively “releasing the brakes” on the host immune system and allowing it to fight tumor. The expression of PD-L1 as detected by immunohistochemistry has been studied as a marker of response to anti-PD-1/PD-L1 immunotherapy.
Complete the following statement:
Patients whose tumors are negative for PD-L1....
Which domains to the p40 and p63 antibodies recognize, respectively?
The “gold standard” for the diagnosis of cutaneous vasculitis is:
The slide below shows a biopsy from a purpuric lesion on the leg of a 18 y/o man who recently recovered from an upper respiratory tract infection. The biopsy showed classic features of leukocytoclastic vasculitis. However, in some cases the biopsy of leukocytoclasitc vasculitis can be false-negative because it is taken too early or two late in the cycle of lesion development. The timing of biopsy is critical for highest diagnostic yield.
The lesion represented in this specimen was most likely biopsied within what time frame after appearance of the lesion?
81 y/o woman with history of lichen sclerosus presented with raised plaque on the vulva. A biopsy was performed. It showed so called differentiated vulvar intraepithelial neoplasia (VIN).
Which of the following is true about this entity?