Libre Pathology talk:Study Group

Michael's thoughts on the exam

• I wrote it and passed it in 2012. I also did the American exam the same year and passed that.
• The pass rate for the FRCPC exam is pretty high.
  • 2009-2011 it was 96+/-3.9% for Canadian medical school grads on their first attempt.

Written

• I though it was picking at details. Some things are very relevant to practise... other less so.
  • The pocketbook version of Robbins covers most of it.

Practical (slide) exam

• You should know the answer almost immediately.
  • If you don't know, write something down and move on.
• It is set to broadly cover everything.
• If it isn't a spot diagnosis... it should not be on.
• Somethings are PGY2/PGY3 stuff. One should not overthink things.
• Anecdotally, the first impression is usually the right one.
  • I think one should stick with the first impression.

Gross exam

• Go with the most probable if you're uncertain.
• I worked through the Atlas of Gross Pathology with Histologic Correlation (see Pathology books for the reference).
  • I am not sure this is necessary... but I thought it was useful.
• Flickr.com/Google images has a lot to offer in this respect.
• Gross spot diagnosis.

Forensic exam

• I thought this was tricky... and I liked forensics.
• Residents that took the exam prior to me said the same.

Cytology exam

• Some of the cases have several images.
• I remember being confused... the first three images were from one case. I remember thinking... I have the same diagnosis three times.
• Like the forensics and gross sections - this section isn't too long. From an exam strategy point-of-view, this makes it less likely that a diagnosis is repeated.

Oral exam

• I think this is to test if you are safe and useful.
  • By "safe" I mean: knowing your limits and consulting with a colleague when appropriate.
  • By "useful" I mean: you don't need to consult on everything.
• The examiners ask a pre-determined list of questions.
  • Questions may depend on one another and, in fairness, they are told to redirect you.
    • Example: You see a lung biopsy with hyaline material... and you go down the fibrosis route-- but it is really amyloidosis.
      • The examiners will say something like "how would one work-up suspected amyloid?" or "lets assume this is amyloid..."
• If you're a Canadian resident, you cannot be examined by someone within your residency program.
• As far as I know, examiners are told to be stone-faced, i.e. show no emotion.
• Some of the cases were very straight forward.
• I didn't think anything was really exotic.

Michael (talk) 23:43, 25 October 2014 (EDT)

Short answer questions on genetics and molecular pathology.

These are some questions I came up with that are plausible to me... let me know if they are out to lunch.

UNIT 1

1. List three differences between DNA and RNA.
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2. What are the three stop codons?
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3. Where does transcription begin?
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4. List three enzymes necessary for transcription and their function.
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5. List and describe four post transcription modifications of RNA.
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6. List three differences between somatic and germline mutations.
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7. What is the difference between a missense and a non-sense mutation?
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8. Define a frameshift mutation.
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9. Why are inversion mutations difficult to detect?
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10. Describe the potential sequelae of a translocation mutation.
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UNIT 2

1. Translate the following: c.1524_1527delCGTA.
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2. List 5 features of SNPs.
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3. Define a regulatory SNP and a synonymous SNP?
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4. What is the difference between a microstalellite and a minisattelite?
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5. Describe Hardy-Weinberg Equilibrium?
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6. What factors can disrupt the H-W equilibrium?
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7. What is linkage disequilibrium?
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UNIT 3

1. What are the three major steps of PCR?
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2. What is the hallmark of PCR?
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3. What factors affect the method of genotyping chosen?
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4. Define sensitivity, specificity, positive predictive value and negative predictive value.
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5. Define reproducibility and accuracy of an analytical test.
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6. Describe briefly Sanger sequencing.
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7. Describe briefly how Taqman automated genotyping is used for allele detection.
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8. How are DNA microarrays used to identify drug disposition or responses?
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UNIT 4

1. Describe the procedure for submitting FFPE slides for KRAS for colorectal cancer.
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2. Compare and contrast uniplex versus multiplex genotyping.
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3. Compare and contrast conventional vs massively parallel sequencing.
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4. What is multiplex ligation-dependent ligation (MLPA)?
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5. What is fragment analysis?
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6. Compare and contrast RT-PCR vs qRTPCR.
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7. What is MSI?
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8. What is methylation analysis?
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UNIT 5

1. What are the four test features required to be documented by the CLIA?
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2. What are "in vitro diagnostics" vs "laboratory developed tests"?
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3. What does validation mean?
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4. What are the four performance characteristics that need to be verified for FDA cleared/approved tests?
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5. What are the six performance characteristics that need to be verified for FDA cleared LDTs or modified FDA cleared/approved tests?
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UNIT 6

1. List the components of a molecular pathology report.
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2. Define analytical sensitivity and clinical sensitivity.
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3. What should be said in a report of a molecular test on a patient for residual disease if no previous positive assay was confirmed?
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4. Define ammended report versus addendum report.
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5. Whose responsibility is it to sythesize the test results with other clinico-pathological information?
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6. How long are cytogenetic reports required to be kept by CAP?
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7, What is the recommended process to use test results if an assay is not yet validated for clinical use?
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8. Give three examples of "grey areas" which warrant discretion of professionals involved to use a non-validated test?
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9. What reference standard is available for gene nomenclature?
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10. Create a table of the most common gene rearrangements associated with heme and soft tissue diseases.
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11. What is a "DNA fingerprint" and what can it be used for?
A method that examines multiple areas of short tandem repeats to identify paternity, mosaicism, chimerism, and identity in forensics cases

Hi Michael, I've started, but mostly just with the questions for now, as I study I will keep working on it. Can you help me, maybe we can make additional discussion pages for each of my "study" exams,e.g. molecular, robbins chapters, cap protocols etc.