case study assessment

case study assessment



Case Study Assignment General Instructions: · Word limit: NO more than 600 words, excluding references and tables. · Font Arial or Times New Roman Size 12. · Bullet points are recommended for listing. · Refer to Rubric in Canvas for marking scheme. · Minimum of three (3) references recommended. · Vancouver reference style is required. PART 1 INSTRUCTIONS: Read Scenario (Part 1) given below and answer questions 1A, 1B &1C SCENARIO (Part 1): Mrs Perl is a 62-year old lady who is being investigated for a lung mass and a right breast lesion. She has a history of malignant melanoma diagnosed about 2 years ago. The treating doctors initially decide to perform sputum cytology. Representative images from the sputum specimen are shown below. Refer to Figure 1A & 1B. Figure 1A. Sputum, Pap stain (x400) Figure 1B. Sputum, Pap stain (x400) The results of the sputum cytology instigate further investigations of the lung mass, so the patient subsequently has a core biopsy taken of the lung mass. The pathologist performs an initial limited immunohistochemistry panel of S100 (Figure 2) and HMB-45 (Figure 3) The results are depicted below. Figure 2. S100 (x200) Figure 3. HMB-45 (x400) QUESTIONS (3 parts to question) Question 1A: Explain the rationale for the use of this initial immunohistochemistry panel and describe the results. (5 marks) Question 1B: Propose a further immunohistochemistry panel of at least 5 (five) immunohistochemistry markers that can contribute to a final diagnosis and provide a justification of the panel that has been proposed. (10 marks) Question 1C: Provide a diagnosis for Mrs Perl. (5 marks) PART 2 INSTRUCTIONS: Read Scenario (Part 2) given below and answer questions 2A & 2B SCENARIO (Part 2): The treating clinicians, now with a diagnosis for Mrs Perl, wish to pursue molecular testing to optimise treatment. QUESTIONS (2 parts to question) Question 2A: Briefly discuss the genetic mutation(s) that is (are) worthwhile investigating for Mrs Perl’s diagnosis, including treatment options. (10 marks) Question 2B: Examine the method(s) and underlying principles behind the testing for mutation(s) described in Question 2A. (10 marks) THE END 2