pathology

Fever = IL-1, IL-6, TNF
No appetite = TNF
Acute phase = IL-6
Positive = CRP, Ferritin, Fibrinogen, SAA, Hepcidin
Negative = Albumin, Transferrin, Transthyretin
Anti-inflammatory = IL-10
Fibrosis = TGF-β
T-cell = IL-7
Eosinophil = IL-5
Neutrophil = IL-8
Ménétrier = TGF-α
Myeloma = IL-6

और सबसे important 3-number trick:

5 → Eosinophil
7 → T-cell
8 → Neutrophil

Nitric oxide , pAF lysosomal enzyme

Dominant negative

Fibrillin elastin in marfan syndrome

• Carcinoma → Lymphatics

  • Exceptions (Blood): RCC, HCC, Follicular thyroid carcinoma, Choriocarcinoma.

• Sarcoma → Blood

  • Exceptions (Lymph nodes): Rhabdomyosarcoma, Synovial sarcoma.

• CSF spread: Medulloblastoma (drop metastasis).

• Pseudomyxoma peritonei: Usually mucinous appendix tumor.

• Blumer shelf: Stomach cancer deposits in the pouch of Douglas/rectovesical pouch.

• Krukenberg tumor: Stomach → bilateral ovaries, signet-ring cells.

⭐ 30-second Revision

• PDGF/PDGFR → Astrocytoma

• HST → Osteosarcoma

• HGF (Scatter factor) → HCC

• EGFR (ERBB1) → Lung adenocarcinoma → Erlotinib

• HER2 (ERBB2) → Breast carcinoma → Trastuzumab

• RET → MEN2 + Medullary thyroid carcinoma

• RET loss → Hirschsprung disease

• KIT = CD117 → GIST, AML, Mastocytosis, Melanoma, Seminoma

Easy (1–10)

Q1. PDGF-β mutation is classically associated with:

• A. Glioblastoma/Astrocytoma

• B. Osteosarcoma

• C. HCC

• D. Breast carcinoma

Q2. PDGFR-β mutation is seen in:

• A. Astrocytoma

• B. Melanoma

• C. Seminoma

• D. AML

Q3. HST gene mutation is associated with:

• A. Osteosarcoma

• B. HCC

• C. Lung adenocarcinoma

• D. MEN2

Q4. HGF is also called:

• A. Stem cell factor

• B. Scatter factor

• C. Colony stimulating factor

• D. VEGF

Q5. HGF mutation is associated with:

• A. HCC

• B. Breast carcinoma

• C. GIST

• D. Astrocytoma

Q6. EGFR (ERBB1) mutation is classically seen in:

• A. Lung adenocarcinoma

• B. Breast carcinoma

• C. Osteosarcoma

• D. Melanoma

Q7. Drug used against EGFR mutation:

• A. Trastuzumab

• B. Erlotinib

• C. Imatinib

• D. Rituximab

Q8. HER2 is also known as:

• A. ERBB1

• B. ERBB2

• C. RET

• D. KIT

Q9. HER2 amplification is classically seen in:

• A. Breast carcinoma

• B. Lung carcinoma

• C. HCC

• D. AML

Q10. Drug used against HER2:

• A. Erlotinib

• B. Trastuzumab

• C. Imatinib

• D. Gefitinib

Moderate (11–18)

Q11. RET proto-oncogene mutation causes:

• A. MEN 2

• B. MEN 1

• C. NF1

• D. VHL

Q12. Medullary carcinoma thyroid is associated with:

• A. KIT

• B. RET

• C. HER2

• D. HGF

Q13. RET mutation is seen in:

• A. MEN 2A

• B. MEN 2B

• C. Familial medullary thyroid carcinoma

• D. All of the above

Q14. Loss of function of RET causes:

• A. Hirschsprung disease

• B. Neurofibromatosis

• C. Li-Fraumeni

• D. Beckwith-Wiedemann

Q15. CD117 is another name for:

• A. HER2

• B. KIT

• C. RET

• D. EGFR

Q16. Which tumor is classically KIT positive?

• A. GIST

• B. Breast carcinoma

• C. Astrocytoma

• D. HCC

Q17. Which leukemia expresses CD117?

• A. AML

• B. CML

• C. ALL

• D. CLL

Q18. Mastocytosis is associated with mutation of:

• A. KIT

• B. HER2

• C. RET

• D. HGF

FMGE Tricky (19–25)

Q19. KIT mutation is also seen in:

• A. Melanoma

• B. Seminoma

• C. GIST

• D. All of the above

Q20. Match correctly:

• A. EGFR → Trastuzumab

• B. HER2 → Erlotinib

• C. HER2 → Trastuzumab

• D. RET → Erlotinib

Q21. Which growth factor is called Scatter factor?

• A. PDGF

• B. HGF

• C. VEGF

• D. FGF

Q22. Which oncogene is mutated in osteosarcoma?

• A. HST

• B. KIT

• C. HER2

• D. RET

Q23. Which one is NOT associated with KIT/CD117?

• A. GIST

• B. AML

• C. Mastocytosis

• D. Breast carcinoma

Q24. Which receptor belongs to the ERBB family?

• A. EGFR

• B. HER2

• C. Both A & B

• D. RET

Q25. Which of the following pair is incorrect?

• A. HER2 → Breast carcinoma

• B. EGFR → Lung adenocarcinoma

• C. RET → MEN2

• D. HGF → Osteosarcoma

⭐ Bonus FMGE One-liners (Very High Yield)

1. EGFR drug = ________

2. HER2 drug = ________

3. KIT = CD ________

4. HGF = ________ factor

5. RET loss of function = ________ disease

1. Which mutation is classically seen in astrocytoma?

2. Which growth factor is also known as Scatter factor?

3. Which mutation is associated with osteosarcoma?

4. Which receptor is ERBB1?

5. Which receptor is ERBB2?

6. Drug used for EGFR-mutated lung adenocarcinoma?

7. Drug used for HER2-positive breast carcinoma?

8. Which proto-oncogene is mutated in MEN2?

9. Loss of function of RET causes which disease?

10. Another name of KIT?

11. Name any four tumors associated with KIT mutation.

12. Which tumor is the classic board exam association with CD117 positivity?

Super High-Yield FMGE Integrated Questions

Q13. A woman has HER2-positive breast cancer. Which targeted drug is preferred?

Q14. A non-smoker has lung adenocarcinoma with EGFR mutation. Best targeted therapy?

Q15. A child has chronic constipation due to absence of enteric ganglion cells. Which gene is mutated?

Q16. Which mutation is common in medullary carcinoma thyroid?

Q17. Which immunohistochemical marker is positive in GIST?

Q18. Which receptor tyrosine kinase mutation is seen in mastocytosis?

Q13. A woman has HER2-positive breast cancer. Which targeted drug is preferred?

✅ Answer: Trastuzumab

Why?

• HER2 = ERBB2

• HER2-positive breast cancer → Trastuzumab (monoclonal antibody)

FMGE Pearl:

HER2 → Breast carcinoma → Trastuzumab

Q14. A non-smoker has lung adenocarcinoma with EGFR mutation. Best targeted therapy?

✅ Answer: Erlotinib

(Other EGFR inhibitors include Gefitinib, Afatinib, Osimertinib, but your notes specifically mention Erlotinib.)

FMGE Pearl:

EGFR (ERBB1) → Lung adenocarcinoma → Erlotinib

Q15. A child has chronic constipation due to absence of enteric ganglion cells. Which gene is mutated?

✅ Answer: RET (Loss-of-function mutation)

Disease: Hirschsprung disease

⚠ Remember:

• RET Gain-of-function → MEN2, Medullary thyroid carcinoma

• RET Loss-of-function → Hirschsprung disease

This is a favorite FMGE concept.

Q16. Which mutation is common in medullary carcinoma thyroid?

✅ Answer: RET proto-oncogene mutation (Gain-of-function)

Associated with:

• MEN 2A

• MEN 2B

• Familial Medullary Thyroid Carcinoma (FMTC)

Q17. Which immunohistochemical marker is positive in GIST?

✅ Answer: CD117 (KIT/c-KIT)

FMGE loves asking this directly.

Remember:

GIST = CD117 positive

Q18. Which receptor tyrosine kinase mutation is seen in mastocytosis?

✅ Answer: KIT (CD117/c-KIT)

KIT mutation is also associated with:

• GIST

• AML

• Mastocytosis

• Melanoma

• Seminoma

Q1. A patient with lung cancer develops hypercalcemia due to PTHrP. Which type of lung cancer?
Answer: Squamous cell carcinoma.

Q2. A patient with lung cancer has severe hyponatremia due to ectopic ADH secretion. Diagnosis?
Answer: Small cell carcinoma.

Q3. Which lung cancer is associated with ectopic ACTH causing Cushing syndrome?
Answer: Small cell carcinoma.

Q4. An elderly patient has sudden velvety hyperpigmentation in the axilla and neck. Which malignancy should be suspected?
Answer: Gastric carcinoma.

Q5. A patient has recurrent migratory superficial thrombophlebitis (Trousseau syndrome). Which cancer is classically associated?
Answer: Pancreatic adenocarcinoma.

Glioblastoma

Adult + Butterfly glioma + Grade IV + Pseudopalisading necrosis + Glomeruloid vessels + IDH wild type + Poor prognosis

Craniopharyngioma

How they can ask

Q1. Child with visual disturbance + headache; suprasellar tumor. Most likely?
👉 Craniopharyngioma

Q2. Craniopharyngioma arises from remnants of:
👉 Rathke’s pouch

Q3. Histological finding characteristic of craniopharyngioma?
👉 Wet keratin ⭐

Q4. Another characteristic histological feature?
👉 Peripheral palisading + stellate reticulum

Q5. Gross appearance of craniopharyngioma containing cystic material?
👉 “Machine-oil” fluid ⭐⭐⭐

Super-short memory

Prion disease

CJD → 14-3-3 + periodic sharp waves + myoclonus + dementia

KURU → cannibalism + kuru plaques

SCRAPIE → sheep/goat

BSE → cow → vCJD

PRION → PrPᶜ → PrPˢᶜ → spongiform brain