arog Study SSStack Free Unfinished Flashcards about pathology MRCS: ‘Seas Allis patholo MRS pathology MRCS part a pathology MRCS [Question [9.38 year ol lady presents witha recent episode of renal cole As part lofher investigations the following results are obtained: Corrected \Calelum’ 3.84 mmol/, PTH: Bapinl increased) Her serum urea and electrolytes are normal, IAGNOSI? [Anewer PRIMARY HYPERPARATHYROIDISM which type of hyperparathyoroidism have INCREASED caldum and PTHparemeter? PRIMARY AND TERTIARY howto differentiate between primary andertian Iyperparatiyroidsm Y {typical clinical feature of primary hyperparathyroidism? tertiary have abnormal urea and electrolyte ‘increase PTI Dye dery Female Slunquencheable Uirswi7 4}bones, stones, abdominal groans anc psychic moans’ Polyps, polyuria: Peptic causes of primary hyperparathyroidsm? 80% solitary adenoma/i/ 15% hyperplasialI/ 9G muBIe adenoma 16 carcinoma MCC of primary hypersaratiyroidism? solitary adenoma association of primary hyperparathyroiaism? HT NIT? MEN Tana evel of caleium oth and phosphate in primary Rypersarathyrolism [andother investigation! Inerease caleluni/increasa PTHIII DECREASE Phosphateliiiiililiechetiam MIBI subtraction scan treatment of primary hyper parathyroidism parathyroidectomy [A60 year old Tibetan immigrant is reerred to the surgical dinicwitha ainlessreck sweling, OFF is located on eft side immediately [anterior to the sternocledomastold muscle There are no ther Carotia body tumour Roca ater nest Erectors al res panic erty uaor night compress which noe ago pos arotdbonerafetoegle Wrenn Tih de fal nes SER Be ST Ova avoren reser ih atlas ander nga cn tometer ernest Woes |sumansblr gd cake eee ines ane Teatconrensi fran SSRN CNS salvar calcul symptom Patients wil usually complain of pain, which I worse on eating (A 73 year old male smoker i referred ta the clinieby his GP.On ‘examination fe nasa dem soft mass immediately anterior to fis er. as boon present forthe pas: five years ands otherwise associated with no symptoms. DIAGNOSIS, |Warthins tumours aka. adenolymphora) are commoner in men |Adenolymphoma ofthe parotid smoker older men [second commenest benign tumour of the parotid gland Warthins tumours Pleomerahic adenoma common in which ender and age? the most common cause of neck swellings. Pleomorphic adenomas typically present in females aged between 40 Ovears Reactive lymphadenopathy [what is the history of Reactive lymphadenopathy? localinfection ora generalised viral Tiness Rubbery. painless lymphadenopathy Iymphoma lymohoma symptom Iymphadenopathy. night sweats and splenomegaly which sweling moves upwards on swallowing thyroid swelling thyroglossaleyst common inwhich age tinyoslossal cyst location More common in palents «20 years old Usually miline, between the isthmus ofthe thyraid and the hyeld bane: hitpsswww studyslack comMasheard-2628913, wrarpa Free Unfinished Flashcards about pathology MRCS: which sweling moves upward with protrutulon of tongue? Thyroglossalcyst Infected THYROGLOSSAL CYST symptom? pals Pharyngeal pouch common in which age and gender? older men what is pharyngeal p0uc? Represents a porteromedialberiation between thyropharyngeus and crcopharyngeus muscles [which midline lump in the neck gureles on palpation? symptom of pharyngeal pouch? Pharyngeal pouch dysphagia, regurgitation, aspiration and chvonie cough [congenital Iyphatc lesion (ymphangioma) typically foundin the neck DIAGNOSIS? Cystic hygroma [eystic hygroma affects which side normally cystic hygroma common in which age and gender? re evident at birt Taroundl 90% present before 2 years of age Branchial est brachial eyst develops due to? oval, mabile cystic mass that develops between the sternocleldomasioid muscle and te pharynx Develop dus to fallure of obliteration ofthe second branchialeleftin lembryoniedevelooment brachaleyst develops in which age group? Usually presentin early adulthood cereal i devlprinwich gener un? foo soaiston fees Iocan cog areca Pabst rs nek ssw dcr Ta an avrg etd aean ayer caiealiciolis tga tay olen aa jpmeicertentpan Cnpanretonte dd gteare (veer sherocions eet het at gat ey io canon duro race aan ao Inheriditary spherocytosis abnormally shaped erythrocyses are prone jtowhat? abnormally shaped erythrocytes are prone to splenic sequestration and aestruction [symptom of heriltary spherocytosis? Inolder patients with herditary spherocytosis anintercurrentliness may lefease the rate of? hyperilrubinaerla, Jaundice ard splenomegaly re cel destruction resulting inmore acute symptoms. severe case of Hertitary spherocytosis may Benefit From? solenectomy [a2 ay old bby i noted to have voiding ifules and on dower oeeante ck to ave rypotpaoe Wh sbnotmelly kro commonly acoclated wth te conaton? what ishypospadiasis? Cryptorchidism Tr hypospadiass tne oretival meatus opens onthe ventral surface of he en i/TAso tere Is ventral deficiency ofthe foreskin [wathral meatus opens proximally ar dstally in hypospadiais? 75%of the openings are distally located feature ot hypospadias, treatment of hypospadiass Alsen en agery 2 veal opened dane Tn eheng > plate retira. calm of spongiosum tase distal fo themasiue Seton teteretn veka No outine cultural creumesions:Urethroplasty: Penile reconstruction ‘The foreskin often ullsed in the recanstructive process. Inboys with very distal diseaseno treatment may be needed [A38 year old Indy presents with RUQ pain and nausea Her medical {therapy is OCP for many years Her LFT are normal, AnUSG. \demonstrates ahypercenoic well defined lesion nthe letlabe ofthe Tier which measures Ie em in iameter Diagnosis? Incavernous hemangioma LFTs? (Cavernaushaemangioma Normal InUSG cavernous hemangioma looks ke? esions are typically well defined and HYPERECHOIC on ultrasound Trkage between cavernous hemangioma and ls possible (oc 37 year old lady presents with RUQ pain and nausea. Medical therapy is ihe OCB Her LE? and serum AFPare normal An UsG demonstrates» |4eminon eneapsulatediesionin theright lobe ofthe iver which has 2 mined echolty and heterogeneous texture, Liver cell adenoma Liver celladenomas are inked 1 Se (oc 90% of patients with ver cell adenomas have... use USG of Iver cell adenoma (oc The lesions wiltypically havea mined echolty and heterogeneous texture [Shephard comes with a3 month history of malaise and RUQ pain hes mildly sundicea, His FT show mile elevation in oirupin ard transaminases, his CBC shows an elevated eosinopi level xray Hydatid erst abdomen shows caleined Tesi In RUQ. DIAGNOSIS? Hyatid cease fs mare common in those who work with. sheeps or dogs Most common benign tumours of mesenchymal origin HydatideystLFT shows what? increase bileubin and irasaminases Hydatid cyst CBC shows what? eosinophilia soften present. Xray of hydati cyst shows what? may reveal calcined cyst wal Hemangioma st benign fiver lesions hitpsswww studyslack comMasheard-2628913, Hemangiomai ver cell adenerall/ Mesanchymal hamartoma ver abscess Amoedi abscess yea dcyt i payee ei! ‘ystadenoma anarpa Free Unfinished Flashcards about pathology MRCS: [cnically eavernous hemangioma appear as. [cavernous hemangioma seperated from normal ver by redsh purple hypervascular lesions ingot fibrous tise {which benign lesion of liver locks ibrous capsule? iveradenoma In patients with haemorrhage or symptoms of iver adenoma treatment? major predisposing facto for Iver abscess removal ofthe adenoma maybe required Bly sepals isa major predisposing factor TIM Strocares aired by the portal venous pte farm the seond actor [symatom ofliver abscess fever right upper quadrant pain, Jaundice [US of iver abscess shows? isthe most common extra intestinal manifestation of amoebiasis Aid filled cavity, hyperechoic walls may beseen in chronic abscesses Liver abscess amoebic Liver abscess occurs majorlyinwhich abe? right [USG of ameobic iver abscess shown? Aspiration of amoebic liver abscess shows? show afluid filed structure with poorly defined boundaries. Aspiatin vel sterile ouress Wis which hasan anchow paste consistency [vestment ofamoebic liver ab5ce55 [Treatments with metronigarale Hydatid eyst sen in which infection? characteristic of eystin hydatid cyst? Seenin cases of Ecrinococeus infection Po epithelial liningifunlocular and may erow to 20cm 10 ‘Sefifieyst walls thick ane hasan external aminatedtnar membrane and an Internat enucleated germinal layer [Symptom of hydatid evs? [Typically presents with malaise and right upper quadrant pai LEFT and CBC in hydatid est USG in hydatid eyst abnormalLFT and eosinophilia Ultrasound may show septa and hyatid sand or daughter evs [nani contraindicated in hydatid cyst percutaneous aspiration treatment of hydatid est sterlisaion ofthe cyst with mebendazole and may be fallowed by Surgical reseet'on Hypertonic swabs ae packed around the cyst during surnery polycystic iver disease is which type of dsroder. autosomal dominant disorder ‘symptom of palyystic liver disease is because of — capsular stretch Rare lesions with malignant potentialinliver ystadenomay USG of Cystadenoma shows Ultrasonography typically shows a large anechoi, uid filed areawith irregular margins. In-eyetadenoma internal echos may reult from = 'A72,year oldman presents wth symptoms and signs of ben ostatic hyperplasia Which of te falovingstrutureste most kel to enlarged on igtairecal examination? septa Medianlobe ofthe prostate [Carcinoma of the prostate typically occursin which lobe? posterior lobe mecian abe of prostates usualy enlargedin... |nBPH the pathology that seen is... jePH Increase in both stromal and glandular components /Miliohanges are most notable inthe central ad perurethral region ofthe land. symptom of BPH present with lower urinary tact symptoms, These wil typically be: Poor ow Nocturia Hesitaney, Incomplete ana doublevoiding, Terminal sriobing, Urgency Incontinence Invurolawmetry a flaw rate of >2Smilsecond helps ta exclude Bladder pressure studies may help ently. [B00 detrusor fare Bladder scanning to demonstrate... resical volumes Medical therapy for BPH aloha blockers work on. alpha blockers and’ alpha reductase Inhibitors work quiely on receptor zones|ocated atthe bladder neck 5 alpha reductase inhibitor work on, [estosterone metabolising enzymes surgical therapy of BPH ransurethval resection of the prostate [complications that may occur after TURP? RETROGRADE EJACULATION "A58 year old man has been sufering from mechanical Back pain for {Several years. One morning he avaves rom sleep and feels sudden [onset of pain in his back radiating downs let lee. DIAGNOSIS propalee of nucleus pulposus Indisk prolapse... the structure which usually hernates, uleus pulposus Intervertebral discs: Consstof annulus Rbrosus and an ner nucleus pulposus [anuls fbrosus consists of several layers fa ibrocartage "The nucleus pulposus contains. a comin the consistency of ely suspended loose fibresiiiimacaproten ge! [developed a small mass, O/E 2 smal smooth cysts dentfed which hitpsswww studyslack comMasheard-2628913, nucleus ofthe asc acisas shockabsonver Pressure onthe dis causes. Posterior protrusion ofthe nucleus pulposus. discs ae seperated by hyaline carton [one disc between esch pair of vertebrae, eceptfor (C1/2 andthe sacrococcygeal vertebrae [A2 year aldboyisbrovghtby his mother who has naticed that hehas [Dermoid cyst a7arpa located above the hyoid bore. On USG lesion appearsto be a heterogenous nd multloculsted mass. DIAGNOSIS? Free Unfinished Flashcards about pathology MRCS: Dermoid cysts are usualy. loculated and location of dermoid yst muliloalated and heterogeneous located above the void "A22month old baby is brought athe clinic by her mother whois Iconcernes that she has developed a swelling Inher neck On [anterior triangle, near tothe angleof the mandible. On USG it has a ud filed, anechole, appearance, DIAGNOSIS? [examination she har 3 tof lesion located Inthe posterior tangle that_[©YS#¢HYEFOm= {ransluminates, DIAGNOSIS? soft and transiluminate and In posterior tangle of neck Cyatichvaromas [A.3 year old boy's brought by mother who has noticed a massin his neck Ofehehasa smooth masslocatedon the teal aspect ots lyrachailoyst Branchial cysts are usualy located latraly and derived from secondbranchialdef lusgfinding of BRACHAIL yt — anechole appearance on ultrasound thyroglossal cyst location? anterior triangle, usually inthe midline and below the hyoid (65% eases [hyroglossal cysts derived rom? Derived fram remnants of the thyroglossal duct throplossal eyst USG appeareance Thin walled and anechoic on USS [Sbcbrancrial arches separated by rachailcleft Incomplete obliteration ofthe branchial apparatus may resulin cysts, sinuses oF fistulae 75% of branchial cysts originate from 2nd brachal cleft location brachalleyst Usually located anterior to the stemocleldomastold near the angle of the mandible USG appeareance of Brachial eyst [dermoid derived from Auld ofthe cyst has a snilar consistency to water and is anechalcon uss Derived from sleuripotent stem cells [dermoid lcationin neck located in the midline///Most commonly na suprahyd location =n fesulefrom occlusion of lymphatic channels Cystic hygroma Infantile hemangioma plainx ray shows mass lesion, usually containing calcified phlebolths| [An unvsualy tall 43 year od lady presents to the surgical clinic with DBateralinguinal nerias. She develops chest pain and collapses As part lother investigations achest xray shows evidence of mediastinal ‘widening DIAGNOSIS? Aorticcissection Marfans syndrome may present with assoction of. sorder Marfan syndrome patient are at high risk of connective tssue disoder such as Glateralinguinalheria eric dlssection |_% patient of Aortc cssection patients ele within 24h and edie within 4@hre not treated 20% and 50% marfan syndrome associated with Features (not symptom) of aortic section: Fypertension| tea inthe intimal layer followed by formation and propagation ofa Subintimat hematoma/iiCystic medial necrosis (Marans), Most common sit of aortic darection '90% occuring within 10 centimetres ofthe aortic valve [classification of Aortic dsssection Stanford Classifcation///DeBakey classification standord classification of Aortic dissection [Type A: Ascending aorta/ aortic root: Surgery=aortc root replacement ae Descending sorta: Medal therapy with antihypertensive DeBakey classificationof Aorticdssecton DeBakey classifation: Type EAscanding aorta aortic arch descending s0rta//type I Ascending aorta only Type Il: Descencirg aorta cstal eo let subelvian artery. clnicalfeature of aortic dissection Tearing sudden onset chest pain (panless 20%. Hypertension or Hypotension A blood oressure difference greater than 20 mm Hg Netrlogie defies (208) Investigation of Aortic dissection ‘CXR widened mediastinum abnormal aortic knob, ng sign, deviation pereloconhogsfct baal Rl Argowahy 830" patents agnose {treatment f Aortic dissection (872 ear oldman a st undertone renal for ruptured AAA Pre loperatvely he was taking aspirin clopdagrel and wartarn. Intra vely he received 8000 unis of uniracionated heparin prior to [application ofthe sori cross clamp. Betz-blockers: aim HR 60. bp and systolic BP 100-120 mmHg Urgent surgicalintervention: type Atssectons. is blood results on admission tothe critical care unit areas follows: Full blood count: Hb: 8 gid Platelets 40" 10974 WAC: 7.1" 109/1 His fibrin deedation produ are messed an ound tobemarkealy elevated AGNOSISS-DIc* "The combination of ow platelet counts and ralsed FOP in Surgical setting, DIAGNOSISLIKELY. pic [activation ofthe coagulation cascade yields. thrombin that converts fibrinogen to brn final product of hemostatic pathway sable fibrin clot Read coagulation cascade and mechanism of DIC development (Q 16) P7,PTT,BT and Patel count in disorder of warfarin administration PT,PTT, BT and Platelet count in dlsorder of aspirin administration PT: PROLONGED///aPT- Normall/ Blending tne- Normal Patel count- Norma PT Normal/aPTT- Normal Bleeding tme- PROLONGED felatelet counts Normal hitpsswww studyslack comMasheard-2628913, anarpa PT.PTT,BT and Platelet count in disorder of Heparin administration Free Unfinished Flashcards about pathology MRCS: PT- Normal (or PROLONGED) PTF PROLONGEDIIi/ Bleeding fime- Normal //Pateletcount-Normal PT,PTT,BT and Pateletcount in DIC 'A53 year old man from Hong Kong presents with symptoms of fatigue, weight loss and recurrent epstans. Exam reveals ft sced cervical Imohadenopathy and oropharyngeal examination reveals ukerated mass nasa pharynn which uss responsible? PROLONGED//aPTF- PROLONGED/// Bleeding tine PROLONGED //Pltelet count: LOW Epstein Barr ius (clinica scenarios of nasopharyngeal carcino) [Nasopharyngeal carcinoma common in which par of world? china clnicafeature of Nasopharyngeal carcinoma (Cervical ymphadenopathy, Olalgla, Unilateral serous otis media Nasal obstruction, dlscharge and/or epistax's, Cranial nerve palsies eg lv Treatment of Nasopharyngeal carcinoma radiotherapy "An 48 year old male presents with lethargy, nightsweats and on ‘examination s found to have et supraclavicular Iymphedenopathy ltt [Supratavicularlymh node biopsy cemonstates Reed. Sternberg cols [onthe subsequent Nstology sections. DIAGNOSIS? Hocgkins lymphoma Reed-Sternbere cells are characteristic histological cell type found in Iymphadenopathy in HODKINS LYMPHOMA, odkin diseave ymphagenopathy inthe neck, alae: grins and abdomen, Need to note: solitaryimultiple, dehned/naitinl, hardrubberysot, enderipainess (Causes of ymphadenopathy (pnemaricHODKINS DISEASE) H | sematologal Nodgkins ymproma, NHL, Leukaemia: O neolgica: metastases: D ermatopathiclympadenits: G aucher’s disease; K [Batak diseace | fectons: Ya, glandular fever, Syphilis, Niemann Pik disease S erumicknessD rug reaction (phenytoin Immunological (SLE), §arceldosis € ndocr nological (}ypertnyroiism) Rngloimmangplastic ympnadenopathy SLE: osinaphiic grarulomatoss [Which ofthe following lesions is least ely io occur inthe presence of \seyereatophic gastritis? A Duodenal ulcer 8, Gastriccancer C- Gastric elyp. ron deficiency anaemia t. Pernicious anaemia gastriccancer most commonin.. country A) Duodenal ulcer [IAPAN Uapanese migrants retain ther increased risk decreased Subsequent generations) familial cause of Gastric cancer occursin.—. HNPCC families risk factor of gastriccancer gastric cancer cistribution ofthe disease in western countries s ‘Changing towards a more proximaligcaion duet smoking and smoked or preserved foods increase the ak obesity stepwise pathology of gastric carcinoma Intestinal metaplasia progressing to atrophic gastritis and subsequent dysplasia, through to cancer Humours ofthe astro-oesoohageal junction ae cles 2s (gastric Caytype £ radocsophageal ances ond sociated win Bae sesoshaaue “Type 2:Caof the cardia, aris rom cardiac ype eptheliom shore setments wah ntesinal metaplasia at the OG Janeton ype Sub Staal cancers tht spree across he junction. vole ifr node Siatorstogasiiecaneer |Groups for close endoscopic monitoring in gastric cancer Intestinal metaplosia of clurnnar type, Atrophi gastritis Low to medium grade dysplasia. Patents wo have previously undergone esections for benign peptcueer disease except highly selective vagotomy) treatment for proximally sited cisease of gastric cancer eeatment fr type 2 junctional tumours (extending into oesophagus) of gastriecancer Proximally sited disease greater than 510m from the OG junction may be ented by otal gastrectomy ioral gastrectomy tumour 5 Sem from OG junetion. esophagogastrectomy is widely advocated by the Japanese in gastic cancer [D2 imphadenectomy Prognss:(UX Data by percentage 5 yea survival: All RO resections: nll Early gasiriccancer: if Stage. Stage 2! Stage [Al RO resections: 54% Early gastric cancer: 91M Stage 17% Stage 2 65% Stage 3: 18% ‘operative procedure for gastric cancer (Operative procedure: Total Gastrectomy, ymphadenectomy and Roux enV anastomosis [A28 year old man develops an acute paronychia and subsequent Spending sep The sive enuateha a aher poe canten than normal tissue because? Caplary walls ae more permeable Increased permeabity allows (eadationst plasmaprotein Presence of nevrophilpolymorphsis istolgieal gnostic feature acute inflammation ‘sequal of acute inflammation Fesolution>>organizatton>»suppuration>> progression to chronic rmarnmation| [n= occurs and persis throughout the inflammatory phase vasodilation | [Asa busy surgical trainee onthe colorectal unit youare given the lunenviable task of reviewing the unit's histopathology results for {colonic polyos Which of the polytypes described below has the Igreatestrisk of malgnaney? Vilous adenoma In Familial Adenomatous Polypsis greater than present polyps are typically 100 how to folowup low isk calorie palye how to followup moderate risk colonicpolvo [Tor adenomas em. NoTollow up or re-colonoscopy at 5 year '.or4 small adenomas or Tadenoma >em Re-scope at 3 years how to followup high risk colonic polyp 5 small adenomas or »Swith 1 of them>em. Re scope at 1 year Segmental resection or complete colectomy shouldbe considered when hitpsswww studyslack comMasheard-2628913, 7. Incomplete excision of malignant plyo//2. Malignant sessile palypi/3 Malignant pedunculated plypwith submucosal invasion 4 87arpa Free Unfinished Flashcards about pathology MRCS: Polyps with poorly differentiated carcinomal/S. Familial polyposis col screening colonoscopy duration by age? [A 23 year old man presents with an inguinal hernia. O/Ehe has a small ‘directheria.he has pigmented spots around hs mouth nis pals landsoles 0 recuctlon of anintussusception at aged 12 years what jesionsis sented? Screening rom teenager up to40 years by 2 yearly sigmoidoscopyicolonoscopy Hamartoma (Hes most likely to have Peutz-Jeghers syndrome which is sssoclated wth Hamartoma} hat is Peutr-Jeghers syncrome? ‘actasamal dominant condition characterised by numerous berign| Ramartomatous polyps nthe gastroltestinal act Peutz-leghers syndrome associated with? associated with pigmented freckles onthe lip, face palms and sles Prognosis of peutzjeghers syndrome ‘Around 50% of patients will have died from agastrointestnal act cancer by the age of 60 yrs [Genetics of Peutz-Jeghers syndrome Autosomal dominant. Responsible gene encodes seine threonine Kinase teen orstkad Feature of Peutz-Jeghers syndrome Harartomstous polyps in Gack manly smal bowel, Pigmented lesions on lips orl mucosa, face, pals and soles, Intestinal obstruction leg intussusception (which may lad to dlagnosis) Gastrantestinal bleeding. treatment of pueutz jephers syndrome Conservative unless complications develop [A56 year old surgeon has been successfully operating or many years [Over the past few weeks she has begun to notice that her hand are becoming bistering and weepy A latex allergy is dlagnosed. what Secounts for scenario? [Type 4 hypersensitivity reaction Hypersensitivity reactions types ACID: ype 1 -Anaphylactiell/iype 2 -Cytotodeliiype3 Immune characteristicof type hypersensitivity comple il tyae 4 Delayed hypersensitvity [Contact dermaits ofa dvonic nature isan example of. ‘4 hypersensitivity "Type 4 hypersensitnityreacions are .._.mediated cal “Anaphyaeil| aE mediated Cxogenous antigen! response Une Siete asthe Ry fest . characteristic type hypersensitivity (CYTOTOXICI/ IgM and ig mediated call surface antigen response fime-hours/ Autoimmune haemolytic anaemia, Pemphigus, [Goodpasture's characteristic of type Il hypersensitivity Immune complou IgG and lg mediated/ SOLUBLE antigen! response tme-hours!/ Serum sickness, SLE, Aspergillosis \characteristicoftypeV hypersensitivity Delayed type// T cell tissue antigen response te- 2-8 daysi/ Graft versushost disease, Contacl dermatitis, [956 year old motorcyclists involved na RTA and sustains a dlsplaced {femoral shat fracture. Not other injures areidentited onthe primary lor secondary surveys, The fracture streatedwith closed, antegrade nvramedullary naltng..CONTINUED ollowing day the patient becomes increasingly agitated and confused [OVE he's pyrexia hypoxic S302 903% on tres 02, tacyeardic and ormotensive system exam demonstrates. anon blanching petecal Fash present over the torso, Cause? FAT EMBOLISM nat usually associated with hypaxia inital Meningococcal sepsis [CLINICAL FEATURE OF FAT EMBOLISM: \Cardiothoracie:Early persistent tachycaréia. Tachyanoea, dyspnoea, Fypowa usually 72 hours following injury. Pyrexia CONT. [Dermatological Red! brown impalpable petechial rash usually onlyn 25'503),Subconjunetval nd oal haemorrhage’ petechae, CNS! Confusion and aptation, Retinal haemorrhages and intra-arterial fat lobules on funeoscopy, Which tumour markers s mast helpful in ientiying an individual with hepatocelar carcinoma? SERUM AFP Hepatocellular carcinomais commonly agnosed with [The most common primary liver tumours are imaging and-an elevated alpha fetoprotein cholangiocarcinoma and hepatocellular carcinoma [Overal metastatic esease accounts for... ofall iver malignancies 95% [second most common typeof primaryliver malignancy... diannosis if cholangiocarcionma cholangiocarcinoma [CA19-9, CEA and CA 125 are ten elevated Created by sarthaknepalt Dent May naa bated Now i hitpsswww studyslack comMasheard-2628913, SAN FRANCISCO 7) or