Patho Compre

8/20/2019 Patho Compre

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FOR YOUR EYES ONLYZ I n d I c a t e

PATHO COMPRE

A 35 y\o man with a hx of familial adenomatous polyposis (FAP), status post colectomy and nowwith duodenal polyps. Biopsy shows an adenoma of low gade dysplasia.

A !. "hich of the ff. statements a#out small #owel manifestations of these polyps ae tue$a. polyps ae usually e%ident at a#out the same age as coloectal polyps#. polyps de%elop pefeentially in the duodenumc. these polyps cay only a slight lifetime is& fo cance d. these polyps ae usually solitay

E '. "hich of the ff. pedisposes is&s fo de%eloping small #owel adenoA$a. heeditay nonpolyposis coloectal cance syndome (*+P)#. ohns dsec. familial adenomatous polyposis (FAP)d. eliac dsee. all

A-/ A 05 y1o lady with a family histoy of colon cance undegoing sceening colonoscopy andwas found to ha%e a !.5 cm nodule in the cecum. Biopsy shows nests of cells, with ound andunifom nuclei, mophologically consistent with low gade neuoendocine neoplasm(cacinoid tumo).

C 3. "hich statement is tue a#out this lesion of the coloectum$a. patients geneally ae diagnosed in the 2th decade#. patients most commonly pesent with symptoms of flushing and diaheac. it is moe commonly found in the ectum than the oute pats of the colond. ectal location is geneally associated with a poo pognosis

A-/ A 05 y1o lady with a#dominal pain. ndoscopy e%ealed gastic eosions and mucosalganulaity.

E 2. Pio to immunohistochemical studies, the diffeential diagnosis includes the ff., P4/

a. follicula lymphoma#. small lymphocytic lymphoma1 chonic lymphocytic leu&emiac. extanodal maginal one Bcell lymphoma (6A74 lymphoma)d. helico#acte gastitise. eacti%e gastopathy

C 5. "hat is the expected immunophenotype of the atypical infiltate in the extanodal maginal one lymphoma (6A74 lymphoma)$

a. 8'9:, 8;<a:, 85, 8!9:, B7':, B70:, 823#. 8'9:, 85:, 8!9, B7':, B70, F6;, 823:c. 8'9:, 8;<a:, 85, 8!9, 8'3, 823:1, 8!!c:1 (wea&)d. 8'9: (wea&), 8;<a:, 85:, 8!9, 8'3:, 823, F6;

B 0. "hich of the ff. is +=4 associated with this diagnosis$a. mucocutaneous pigmentation#. autosomal ecessi%e inheitancec. tumos of the o%ay

d. incease is& fo the de%elopment of #east and panceatic cance e. mutations in the seine theonine &inase (-4>!!) tumo suppesso gene on chomosome !<

A-/ A 0; y1o woman with heme positi%e stool. ndoscopy e%ealed a gastic polyp which isconsistent with an anti inflammatoy fi#oid polyp.

C ;. "hich of the ff. statements egading this lesion is 4?@$a. stomach is the least common site in the 4 fo this lesion#. it esponds to lee%ac teatmentc. it is thought to #e eacti%e in natued. it is associated with peipheal eosinophilia



A- Cs D</ A 5! y1o woman with symptomatic intenal hemohoids. *emohoidectomy waspefomed. n addition to hemohoids, the sugeon felt that thee was an additional mass in theectum. 4he lesion appea histologically as #undles of smooth muscles and collagen extending into

the lamina popia aound the cypts, with focally hypeplastic epithelium #ut no featues of neoplasia ae noted.

A D. 4he patient has hemohoids, and in addition a 'nd diagnosis fo the ectal lesion is made. "hat is the

most li&ely diagnosis fo the ectal lesion$a. mucosal polapse#. tu#ula adenomac. hypeplastic polypd. in%asi%e adenoAe. di%eticulosis

B <. "hich of the ff. is 4?@ of the ectal lesion discussed in the pe%ious Euestion$a. it occus exclusi%ely in the ectum#. it is easily confused clinically with the ulces of ohns dsec. it usually shows ulceation of the mucosad. the epithelium is seldom hypeplastic

A-/ A 55 y1o, ' months status post lung tansplantation, de%eloped a#dominal pain and diahea. -he su#seEuently undewent a segmental esection of the colon.

B !9. "hich of the ff. statements egading pseudomem#anous colitis is FA7-$a. it is most li&ely associated with clostidium defficile#. it is aely associated with anti#iotic usec. clostidium defficile toxins ae the main cause of this dsed. simila histologic changes may#e seen in ischemia

C !!. A 39 y1o woman pesented with chonic watey diahea. olonoscopy showed nomal appeaingcolon and teminal ileum. "hat is the most li&ely diagnosis$

a. acute selflimited colitis#. pseudomem#anous colitisc. collagenous colitisd. ohns dsee. @lceati%e colitis

D !'. A 33 y1o man with intemittent dysphagia and inged esophagusG on endoscopy. Biopsy waspefomed fom the midesophagus showing pominent eosinophils in the esophageal epithelium."hich of the ff. statements is FA7- when eosinophilic esophagitis is compaed to eflux

esophagitis$a. eosinophilic esophagitis esponds to steoid teatment#. the num#e of eosinophils in eosinophilic esophagitis tend to #e highe c. the infiltation of eosinophils tend to in%ol%e #oth epithelium and su#mucosa in eosinophilic

esophagitisd. eosinophilic infiltation tend to #e found in distal esophagus

A !3. "hich of the ff. is +=4 tue egading the infaction of the cotical aea (7ine of ennai in the%isual cotex)$

a. #loc&age of the anteio cee#al ateies#. #loc&age of the posteio cee#al ateiesc. #ilateal infaction will lead to Anton syndomed. A H e. B H

C !2. 4he weight of the #ain at the time of #ith of a full tem #a#y is a#out/a. !'9 gams #. '29 gams c. 309 gams d. D99 gams e. !259 gams

E !5. Bastons plexus is/a. located in chooids plexus#. the %ascula that aises fom the cicle of "illis and supply the deep gay aeac. associated with cicum%enticula ogansd. located in the etinae. a paa%ete#al %enous plexus



D !0. "hich of the ff. is +=4 coect fo aIal?eitus cells$a. they ae the !st neuons to matue#. they ae most pominent duing the !0th'9th wee& of the gestationc. they ae found in the supeficial o the su#pial location in the cee#al cotexd. they ae found exclusi%ely in the spinal cod

E !;. "hich of the ff. is 4?@ a#out the stiae of ennat$a. it is a #and of intacotical myelinated fi#es in #etween lamina H

#. it is a #and of intacotical myelinated fi#es in #etween lamina J H Jc. it is found in neocotexd. A H e. B H

E !D. "hich of the ff. Antigens would #e widely detected in eacti%e and neoplastic astocytes$a. epithelial mem#ane antigens#. *6B25c. -ynatophysind. +euofilament poteinse.yto&eatin A!1A3

B !<. 6edullo#lastoma in a midline location is li&ely to cause which of the ff$a. gait ataxia and intentional temo #. tuncal ataxiac. lim# ataxiad. alien lim#

e. noneC '9. "hich of the ff. is most li&ely to poduce >lu%eBucy syndome$

a. congenital 6J infection#. congenital u#ella infectionc. ?asmussens encephalitisd. hepes simplex encephalitise. poliomyelitis

C '!. ossed cee#ella atophy efes to/a. atophy of the decussation of supeio cee#ella peduncle#. atophy of ! hemisphee that extends and coss to in%ol%e the ipsilateal cee#ella hemispheec. atophy of ! hemisphee associated with cossed atophy of the contalateal cee#ella

hemispheed. cossed atophy of #oth cee#ella hemispheee. all

C ''. "hich of the ff. tact is in%ol%ed in coodinating the moto function of the nucleus of the

occulomoto, tochlea, and a#ducens ne%es/a. cental tegmental tact#. medial lemniscusc. medial longitudinal fascicled. mammalothalamic tacte. decussation of the supeio cee#ella peduncle

B '3. "hich of the ff. is tue egading decotical postue$a. when the comatose patient ecei%es a stimulus, thee is extension of the uppe lim#s and flexion

of the lowe lim#s#. the le%el of impaiment of the #ainstem acti%ity is #etween the le%els of the ostal poles of the

ed nuclei and the %esti#ula nuclei. (su#thalamus to mid pons)c. when the comatose patient ecei%es a stimulus, thee is extension of #oth uppe and lowe lim#sd. the le%el of impaiment of #ainstem acti%ity is usually a#o%e the le%el of ed nucleuse. all ae tue

E '2. "hich of the ff. is1ae 4?@ a#out 6o#ius syndome$a. facial diplegia#. intenal sta#ismusc. conscious and no cental espiatoy depessiond. no s&eletal muscle po#lem in lim#s and espiatoy musclee. all



D '5. "hich of the ff. can cause high output cadiac failue$a. #ey aneuysm#. dolichoectasiac. micoaneuysm of the #aind. aneuismal malfomation of the geat %ein of alene. none

A '0. "hich of the ff. ae poduced #y polonged fixation in fomalin$

a. Buschino #odies #. 7ewy #odies c. *iano #odies d. 7afoa #odies e. 6ainesco #odiesB ';. homatolysis efes to/

a. depigmentation of pigmented neuons in su#stancia niga that is o#se%ed in Pa&insons dse#. loss of +issi su#stance accompanied #y wea& eosinophilic changes and swelling in neuons

unde stessc. degeneation of the pigmented layes of the etinad. loss of pigmented cells in locus ceuleus in Alheimes dsee. failue to demonstate +issi su#stance #y +issi stain due to o%e diffeentiation of +issi stain

D 'D. "hich of the ff. is +=4 tue a#out childhood meningiomas$a. they ae moe li&ely to #eha%e moe aggessi%e and ecu moe feEuently#. they ae associated with neuofi#omatosis ' (+F ')c. they ae moe li&ely to #e found at infatentoial, inta%enticula, o intapaenchymal locationsd. meningiomas ae common tumos in infants and childen

E '<. "hich type of meningioma is most li&ely to #e found in patients unde '9 yeas of age$a. fi#ous meningioma

#. tansitional meningiomac. secetoy meningiomad. psammomatous meningiomae. chodoid meningioma

C 39. "hich of the ff. is +=4 tue a#out optic ne%e glioma$a. optic ne%e gliomas in childen tend to #eha%e in indolent, slowing gowing fashion#. optic ne%e gliomas ae associated with neuofi#omatosis ! (+F !)c. optic ne%e gliomas in adults tend to #e nonfamilial and #eha%e in a #enign fashiond. spontaneous egession has #een desci#ed in childhood cases of optic ne%e gliomase. optic ne%e gliomas tend to gow outside the optic ne%e and expand the su#aachnoid and

su#dual spaceE 3!.8ysplastic gangliocytoma of the cee#ellum (7hemitte8ucios disease) is associated with/

a. ataxiatelangiectasia#. uaino tiadc. 6ec&elu#e syndome

d. Aicadi syndomee. owden syndome

A 3'. "hich of the ff. syndomes ae not associated with inceased is& fo de%eloping malignancy$a. 6ille 8ie&e syndome#. olin syndomec. 4ucot syndomed. Bloom syndomee. 8own syndome

D 33. "hich of the ff. is tue a#out melanotic neuoectodemal tumo of infancy$a. these tumos typically occu as solitay, solid tumo in the #ain#. ecuence is uncommon and metastases is pactically un&nownc. most tumos occu in olde childend. these tumos contain lage, pigmented melanotic cells, and small pimiti%e

neuoectodemal cells. -ynatophysis is positi%e in #oth cell population e. the lage, melanotic cells ae usually positi%e fo *6B25 and -!99 poteinD 32. 4he most common ogan fo extacanial metastatic medullo#lastoma is1ae/

a. lung and lymph node #. li%e c. s&in H soft tissue d. #one e. pleuaA 35. "hich of the ff. is not tue a#out chooids plexus cacinoma$

a. they occu almost exclusi%ely in adults#. immunohistochemisty can demonstate tansthyetinc. #ain in%asion is commond. the tumo cells ae positi%e fo Jimentin, yto&eatin, and -!99 poteine. Iunctional mem#ane complex can #e demonstated #y electon micoscopy



A 30. 4his pimay tumo is o#tained fom a !' y1o #oy, showing mophologically with clea cell tumo suggesti%e of hemangio#lastoma. 4he most li&ely syndome that is associated with this #oy is/

a. Jon *ipppel7indau syndome#. +euofi#omatosis ! (+F !)c. 4ucot syndomed. olin syndomee. +euofi#omatosis ' (+F ')

D 3;. -u#ependymal giant cell astocytoma can #e immunoeacti%e fo$a. lial fi#illay acidic potein (FAP)#. +euofilamentc. Jimentind. alle. none

A 3D. "hich of the ff. is +=4 tue fo endolymphatic sac tumo$a. these tumos ae moe common in childen than adult#. these tumos ae associated with Jon *ippel7indau dsec. these tumos ae mophologically %ey simila to, if not indistinguisha#le fom, chooids plexus

papillomad. these tumos ae of osseous oigin and often in%ade into the cee#ellopontine angle with

possi#le extension into the posteio fossae. these tumos ae positi%e fo cacinoem#yonic antigen, epithelial mem#ane oigin, and

cyto&eatin

A 3<. "hich of the ff. is +=4 tue a#out meningioangiomatosis/a. they ae associated with neuofi#omatosis ! (+F !)#. it is a ae, #enign, focal, hamatomatous, type of lesion of leptomeninges and the undelying

cee#al cotex leptomeningeal and and meningo%ascula polifeationc. a maIoity of them ae found in the fontaltempoal egiond. a schwannian component can #e pesente. mitotic figues ae ae and the >i0; (6B !) la#eling index is low

B 29. 4he most common location fo pimay extaosseous, intapaenchymal (intaaxial) location fo7angehans cells histiocytosis is/

a. Pineal gland #. *ypothalamus c. Basal ganglia d. ee#ellum e. BainstemB 2!. "omen at high is& of heeditay +onpolyposis oloectal ance (*+P) should not only

@ndego colon1ectum sceening, #ut also sceening of thei/a. lungs #. uteusendometium c. &idneys d. heat e. none

D 2'. "hich of the ff. immunohistochemical stains would #e the least helpful in the wo&up to suppot a diagnosis of gestational topho#lastic dse/

a. hP7 #. #eta h c. P7AP d. yto&eatin 5,0 e. 8!20A 23. All of the ff. ae tue egading mola pegnancy, P4/

a. omplete moles consist of hypeplastic topho#lastic dse that is usually associated with fetalde%elopment

#. omplete mole may dei%e fom an o%um fetilied #y a single spemc. omplete mole may dei%e fom an o%um fetilied #y a ' spemd. Patial moles ae often tiploide. omplete moles confe a geate is& of in%asion tan patial moles

A 22. All of the ff. statements egading the goss findings in ealy complete hydatidifom mole ae 4?@, P4/

a. Botyoid clustes ae usually %isi#le in !st timeste a#otuses#. nlaged %illi foming clustes with fuy sufaces ae aely seenc. -pecimen aely eEuies multiple containes fo tanspotd. 8uing cuettage, expanded %illi may collapse ma&ing thei pesence difficult to detecte. *ydopic change may not #e appaent

A 25. 4he lagest cells ae typically found in which of the ff.$a. 7ow gade sEuamous intaepithelial lesion (7-7)#. *igh gade sEuamous intaepithelial lesion (*-7)c. -Euamous cell Ad. AdenoA

A 20. All of the f. ae helpful in diagnosing dysplasia, P4/a. Pominent nucleolus#. nuclea enlagementc. nuclea hypechomasiad. coasening and clumping of chomatin





B 5D. "hich one of the ff. featues would ha%e diffeentiate a lesion of lipoma fom a nomal adiposetissue$

a. Anaplasia c. numeous mitoses e. pominent nucleoli#. Fi#ous capsule d. unifom population of cells

D 5<. An example of cance suppesso gene is/a. a#l #. Bc c. mycd. P53 e. ?as

A 09. An apathetic male infant in an undede%eloped county is found to ha%e peipheal edema, a moonG

face, and an enlaged fatty li%e. "hich of the ff. is one mechanism in%ol%ed in the pathogenesis ofthis childs a#nomalities$a. deceased caloic inta&e leading to hypoal#uminemia#. deceased ca#ohydate inta&e leading to hypoglycemiac. deceased fluid inta&e leading to hypenatemiad. deceased fat a#soption leading to hypo%itaminosis

B 0!. f a mutant gene is not expessed phenotypically in a peson, this is said to epesent/a. %aia#le expessi%ity c. codominance e. nondisIunction#. educed penetance d. genetic heteogeneity

C 0'. A chomosomal a#eation that esults in a distu#ance in the nomal gene #alance is temed/a. nondisIunction #. euploidy c. aneuploidy d. #ea&age e. %aiance

A 03. A ' month old gil pesents with a soft, high pitched, mewing cy and is found to ha%e se%ealcongenital heat defects. 4he most li&ely chomosomal a#nomality poducing these symptoms is/

a. 5p #. !!p c. !3E d. '!E e. ''E

D 02. A !5 y1o phenotypically female patient pesents fo wo&up of pimay amenohea and is found toha%e an N &ayotype. 4he most li&ely diagnosis is/

a. 4une syndome#. 6ixed gonadal dysgenesisc. 4ue hemaphoditismd. 6ale pseudohemaphoditisme. Female pseudohemaphoditism

B 05. ?eaangement of g chains is seen in/a. 4lymphocytes #. Blymphocytes c. 6acophages d. 7angehans cells e. +> cells

D 00. 4hee is a stong association #etween hemochomatosis and/a. *7AB'; #. *7A8?3 c. *7A8?2 d. *7AA3 e. *7AB"2;

C 0;. "hich of the ff. conditions is most li&ely to #e associated with cance$a. -7 d. Autoimmune thyoiditis#. *P+ e. Ateioscleosisc. Polymyositis

D 0D. -ections of tissue infected with Blastomyces would #e expected to show oganisms with/a. non#anching psedohyphae and #lastocysts#. acuteangle #anching, septate hyphaec. wideangle #anching, nonseptate hyphaed. #oad#ased #uddinge. lage sphees with extenal #udding

E 0<. ffects of adiation exposue on tissue includes all of the ff., P4/a. dou#lestanded chomosomal #ea&s#. fomation of fee adicalsc. a#nomal mitotic figuesd. endothelial swellinge. epidemal hypeplasia

B ;9. All of the ff. genetic disodes ae autosomal ecessi%e (A?), P4/a. Al&aptonuia#. Familial hypecholesteolemiac. Phenyl&etonuia (P>@)d. 6yelopeoxidase deficiencye. ystic fi#osis

E ;!. 6echanisms esponsi#le fo 8owns -yndome include all of the ff., P4/a. +ondisIunction duing the !st meiotic di%ision#. 6osaicismc. 4anslocationd. entic fusion (?o#etsonian tanslocation)e. Fomation of sochomosomes



D ;'. haacteistically, B lymphocytes do all the ff. P4/a. onstitute !9!5K of peipheal #lood lymphocytes#. =ccu in lymphoid follicles and the supeficial cotex of lymph nodesc. xpess suface immunoglo#ulin g8 and g6d. xpess suface cluste diffeentiation antigen 8De. Possesses complement component (3) eceptos

C ;3. Paathyoid homone, #y its action on taget ogans, is &nown to cause all of the ff. P4/

a. incease enal tu#ula ea#soption of calcium#. incease intestinal a#soption of calciumc. inceased seum phosphate le%elsd. mo#iliation of calcium fom #onee. deceased enal tu#ula ea#soption of phosphate

C ;2. le%ated le%els of seum ceatinine &inase (>) ae seen in all of the ff.,P4/a. muscula dystophy#. polymotisisc. myasthenia ga%isd. myocadial infactione. hypothyoidism

D ;5. An infant is found to ha%e an extenal male genitalia and intenal female genitalia. P e%ealsdeceased BP, while la# exam e%eals a seum sodium le%el of !3' meE17. Additionally, #ilateal

adenal cotical hypeplasia is pesent. 4he findings in this infant ae most li&ely the esult of thedeficiency of/

a. 3 Mdehydogenase#. !! hydoxylasec. !; hydoxylased. '! hydoxylasee. ! L hydoxylase

B ;0. A 35 y1o male who pesents with a nec& mass is found to ha%e a seum calcium le%el of !!.D mg1dland peiodic ele%ation of his #lood pessue. xtensi%e wo& up e%eals the pesence of medullayA of the thyoid, a pheochomocytoma, and hypeplasia of the paathyoid glands. 4his patientmost li&ely has/

a. 6ultiple endocine neoplasia syndome (6+) type !#. 6+ syndome type ac. 6+ syndome type #d. Polyglandula syndome type e. Polyglandula syndome type

B ;;. A lesion that oiginates within and selecti%ely destoys the %entomedial nucleus of the

hypothalamus would most li&ely esult in/a. deceased appetite#. inceased appetitec. inceased uinationd. paalysis of the =6e. tunnel %ision

B ;D. Follicula A of the thyoid may show all of the ff. featues, P4/a. %ascula in%asion and hematogenous metastases#. multiple foci within the glandc. a clea cell %aiant that esem#le enal Ad. a#sence of goundglass nucleie. an insula type that is aggessi%e in fom

C ;<. omponents of the nomal thymus glands include all of the ff., P4/a. thymocytes#. epithelial cellsc. geminal centesd. neuoendocine cellse. myoid cells

C D9. 6alacopla&ia of the uinay #ladde is consideed to #e associated with/a. 4B#. uothelial Ac. -chistosomiasisd. -taph. nfectione. defects in phagocytosis



C D!. *istologic exam of an excision specimen fom a lesion on the dosal suface of the penis e%eals a papillay lesion with clea %acuoliation of epithelial cells on the suface and extension of the

hypeplastic epithelium into the undelying tissue along a #oad font. 4he most li&ely diagnosis ofthis lesion is/

a. Bowens dse#. -Euamous cell Ac. Jeucous A

d. ondyloma accuminatumC D'. Failue of the uteus to de%elop (agenesis) is diectly elated to the failue of what em#yonic

stuctue to de%elop$a. uogenital idge#. mesonephic ductc. paamesonephic ductd. metanephic ducte. epoophoon

D D3. A '< y1o female pesents with se%ee pain duing menstuation (dysmenohea). 8uing wo& up, anendometial #iopsy is o#tained. 4he pathology epot fom this specimen ma&es the diagnosis ofendometitis. Based on this pathology epot, which one of the ff. was pesent in the #iopsy sampleof the endometium$

a. neutophils#. lymphocytec. lymphoid follicles

d. plasma cellse. decidualied stomal cells

C D2. A 3' y1o female pesents with the ecent onset of oligomenohea followed #y amenohea, and thenthe loss of female seconday chaacteistics. -he also has de%eloped acne, deepening of he %oice,and tempoal #alding. "hich one of the ff. o%aian tumos would most li&ely poduce thesesymptoms$

a. epithelial tumoc. gem cell tumoe. metastasis#. stomal tumo d. suface tumo

D D5. All the ff. enal disodes ae associated with nephitic syndome, P4/a. mem#anous glomeulonephitis#. lipoid nephosisc. acute tu#ula necosisd. mem#anopolifeati%e glomeulonephtitise. focal segmental glomeuloscleosis

B D0. "ithin postatic glands, featues consistent with postatic intaepithelial neoplasia (P+) include all

of the ff., P4/a. cellula cowding#. a#sence of #asal cell laye c. %aiation of nuclea sied. hypechomatisme. nucleoli

D D;. acinoma of the postate tends to do all of the ff. P4/a. #e AdenoA#. aise in the posteio lo#ec. cause ele%ation of the seum acid phosphatased. #eestogen dependente. fom esteo#lastic metastasis

C DD. A pathognomonic featue of dene%ation followed #y einne%ation is the histologic finding of/a. atophic fi#es c. typespecific gouping of fi#es e. taget fi#es#. angula fi#es d. chec&#oad patten of type ! and type ' fi#es

E D<. Featues of the nomal pocess of factue healing include/a. pseudoathosis c. an in%olucum e. a catilagenous callus#. a seEuestum d. a cloaca

E <9. haacteistics o components of nomal #one in the adult s&eleton include all of the ff. P4/a. osteo#last c. type collagen e. wo%en #one#. osteoid d. lamella #one

D <!. uploidy can esult fom/a. in%esions c. deletions e. tisomy#. duplications d. #alanced tanslocation



C <'. Association with the loss of ?# suppesso gene and the de%elopment of etino#lastoma/a. 5p #. !!p c. !3E d. '!E e. ''E

A <3. ?eaangement of 4? gene is seen in/a. 4lymphocytes d. 7angehans cells#. Blymphocytes e. +atual &ille cellsc. 6acophages

C <2. 4hee is a stong association #etween heumatoid athitis and/

a. *7AB'; #. *7A8?3 c. *7A8?2 d. *7AA3 e. *7AB"2;E <5. 6echanism esponsi#le fo 4unes syndome include which of the ff$

a. nondisIunction duing the !st meiotic di%ision#. mosaicismc. tanslocationd. centic fusion (?o#etsonian tanslocation)e. fomation of isochomosomes

C <0. A 3< y1o male who pesents with a nec& mass is found to ha%e multiple mucocutaneous neuomas and ele%ation of BP. xtensi%e wo& up e%eals the pesence of medullay A of the thyoid and

pheochomocytoma of the adenal medulla. 4his patient, most li&ely has/a. 6+ type d. Polyglandula syndome type #. 6+ type a e. Polyglandula syndome type c. 6+ type #

D <;. A featue of a nomal s&eletal muscle is the histologic finding of/a. atophic fi#es d. chec&#oad patten of type and type fi#es

#. angula fi#es e. taget fi#esc. typespecific gouping of fi#es

D <D. Fomed of an iegula aangement of type collagen fi#es and numeous osteocytes, it is fomedapidly and is always pathologic if found in the adult s&eleton.

a. osteo#last #. osteoid c. lamella #one d. wo%en #oneB <<. -ections to #e %iewed unde electon micoscope (ulta thin sections) ae usually cut at what thic&ness$

a. 5!9nm #. 09<9nm c. !<9'29nm d. 9.5!.9um e. noneC !99. 4he paaffin sections fo outine diagnostic sugical pathology ae cut at a thic&ness of/

a. 2Dnm #. 29D9nm c. 2Dum d. 29D9um e. noneB !9!. A 22 y1o woman noted to ha%e a 3 cm fim, iegula, non mo%a#le mass located in the uppe oute

Euadant of he left #east on P. ells o#tained fom the mass ae consistent with infiltating ductalA. "hich of the ff findings will #est pedict a #ette pognosis$

a. the tumo cells ae stongly estogen ?c positi%e#. no metastases ae found in the sampled 7+

c. flow cytometic analysis demonstates aneuploidy and a high -phased. she has one elati%e who had a simila type of #east cance e. the tumo has a high gade

A !9'. A change in #owel ha#its pompt a 53 y1o woman to see he physician. =n P he stool is positi%e fo occult #lood. A colonoscopy e%eals a 0 cm fia#le mass located in the cecum. 6icoscopic

exam shows a modeately diffeentiated adenoA. "hich of the ff. findings is most li&ely to #e pesent$

a. A &as mutation in the neoplastic cells#. an immunopeoxidase stain positi%e fo %imentin in the neoplastic cellsc. A stool cultue positi%e fo -higella flexneid. A plasma *J! ?+A le%el of 29,999 copies1mle. A high tite 8+A topoisomease autoanti#ody

D !93. A 25 y1o healthy woman has a outine ? ta&en and shows a peipheal '.5 cm diamete coinlesionG in the ight mid lung field. "hich of the ff. #iologic chaacteistics #est distinguishes thislesion as a neoplasm, athe than a ganuloma$a. ecuence ff. excision#. apid incease in siec. sensiti%ity to adiation o chemotheapyd. uncontolled (autonomous) gowthe. necosis



D !92. A clinical study is pefomed on #iopsy specimens and shows a neoplasm composed pedominantlyof cells with a spindle shape and a high +1 atio with ma&ed pleomophism. 4hese cells ae%imentin positi%e, cyto&eatin negati%e, and 825 negati%e #y immunohistochemical staining. 4histype of neoplasm is most li&ely to ha%e #een diagnosed in which of the ff. patients$

a. A 35 y1o woman with a left #east mass and enlaged axillay 7+#. A 55 y1o woman with a massi%e ascites and multiple peitoneal metastasesc. A '5 y1o man with an enlaged left testis

d. A !5 y1o man with a mass in the left femu and lung metastasese. A 5 y1o #oy with a ight enal massE !95. A 2D y1o woman has a 2 cm diamete, fixed, nontende mass palpated in he ight #east. Anothe '

cm non tende mass is palpa#le in the left axilla. A chest adiogaph e%eals multiple 9.5'cmnodules in #oth lungs. "hich of the ff. classifications #est indicates the stage of he disease$a. 4! +! 69 #. 4! +9 6! c. 4' +! 69 d. 43 +9 69 e. 42 +! 6!

C !90. ?e%iew of a seies of sugical pathology epots that a cetain type of neoplasm is gaded as gade on a scale of to J. linically some of the patients with this neoplasm ae found to #e stage ."hich of the ff. is the #est intepetation of a neoplasm with this stage designation/a. is unli&ely to #e malignant#. has po#a#ly aisen fom epitheliumc. may spead %ia lymphaticsd. has an in situ componente. is welldiffeentiated and localied

C !9;. A child is #on with a single functional allele of a tumo suppesso gene. At the age of 5 the

emaining nomal allele is lost though a point mutation. As a esult, the a#ility to continue thetansition to ! to the - phase of cell cycle is lost. "hich of the ff. neoplasms is most li&ely to

aise %ia this mechanism$a. infiltating ductal A of #east#. small cell anaplastic A of the lungc. etino#lastoma of eyed. cee#al astocytomae. chonic myeloid leu&emia

B !9D. A '' y1o woman has a papillay A of the thyoid. "hich of the ff. findings would you considemost ele%ant in he past histoy to indicate a is& facto fo this neoplasm/a. chonic alcoholism#. adiation theapy in childhoodc. ataxia telangiectasiad. #lunt tauma fom a falle. exposue to asenic compounds

E !9<. A 59 y1o man has felt %ague a#dominal discomfot fo the past 2 months. *e has nolymphadenopathy, and no a#dominal masses can #e palpated. An a#dominal 4 scan shows a '9

cm etopeitoneal soft tissue mass o#scuing the left psoas muscle. A stool specimen tested fooccult #lood is negati%e. "hich of the ff. neoplasms is this man most li&ely to ha%e$a. melanoma#. hamatomac. adenoAd. lymphomae. liposacoma

E !!9. t is o#se%ed that some neoplasms appea to de%elop fom %ial oncogenesis, with seologicconfimation of past %ial infection. "hich of the ff. neoplasms is most li&ely to aise in this

manne$a. ?etino#lastoma#. -mall cell anaplastic A of lungc. 4 cell leu&emiad. Postatic adenoAe. *epatic angiosacoma

A !!!.



A !!'. A !2 y1o healthy gil has a 9.3 cm eddish, slightly aised nodule on the s&in of the uppe pat ofhe chest found on a outine P. -he states that this lesion has #een pesent fo yeas and has notappecia#ly changed in sie and colo. "hich of the ff. neoplasms is this nodule most li&ely to #e/ a. hemangioma #. melanoma c. "ilms tumo d. lymphoma e. glioma

D !!3. A 09 y1o man who has a <9 pac& yea histoy of cigaette smo&ing has had a chonic cough fo thepast !! yeas. *e has #egun to lose weight (3 &g) duing the past yea. *e has a chest adiogaphthat e%eals a ight hila mass. A sputum cytology shows atypical, hypechomatic sEuamous cells.

"hat is the most common initial pathway of spead of this lesion$a. #lood steam#. pleual ca%ityc. contiguous spead to chest walld. lymphaticse. #onchi

C !!2. A '5 y1o woman has expeienced episodes of myalgias, pleual effusions, peicaditis, and athalgias without Ioint defomity o%e the couse of the past 3 yeas. A B e%eals a mild nomocytic anemia. "hich of the ff. la# sceening tests is most appopiate to #egin the wo& up

fo he condition/a. 82 lymphocyte count#. Blood cultuec. Antinuclea Anti#ody testd. -edimentation atee. eatinine phospho&inase

E !!5. A male infant is #on at tem with no congenital anomalies. A yea late he now has failue to thi%eand has #een getting ! #acteial pneumonia afte anothe with #oth *emophilus influenae and-tep. pneumoniae cultued fom his sputum. "hich of the ff. diseases is he most li&ely to ha%e$

a. 8ieoge -yndome#. -electi%e gA deficiencyc. BJ infectiond. Acute leu&emiae. lin&ed agammaglo#ulinemia

D !!0. t is noted that patients who ecei%ed enal allogafts with matching to the dono #y tissue typingfo *7A8? (lass ) antigens has a low ate of complications. "hich of the ff. immunologica#nomalities is most li&ely to #e diminished #y tissue typing/a. Amyloidosis#. ell lysis #y 8D lymphocytesc. aft %s. host diseased. 82 lymphocyte acti%ation

e. -eum sic&nessE !!;. An appopiate, useful type hypesensiti%ity esponse of the immune system, accompanied #y

eosinophilia, would most li&ely to #e diected against which of the ff$a. Amyloid potein#. -piochetesc. +eoplasmsd. nhaled dustse. 7i%e flu&es

D !!D. !' hous afte going on a hi&e though dense foliage, a 29 y1o man notices a slightly aised andtende iegula eddish ash on one foeam that was co%eed #y clothing. 4his ash gadually

inceases in intensity fo ' days and then fades afte ' wee&s. "hich of the ff. foms ofhypesensiti%ity is most li&ely demonstated in this patient/a. 4ype *ypesensiti%ity#. 4ype *ypesensiti%ityc. 4ype *ypesensiti%ityd. 4ype J *ypesensiti%ity

C !!<. A 29 y1o woman has had inceasing difficulty swallowing fo o%e the past yea and finds it had tomo%e he finges, though the Ioints ae not painful. -he has lost the facial win&les that she was#eginning to de%elop in the middle age. A s&in #iopsy shows extensi%e demal fi#osis #ut almostno inflammatoy cell infiltates. 4hese findings ae most typical fo which of the ff. condition$

a. 6ixed connecti%e tissue disease#. 8iscoid lupus eythematosusc. ?-4 syndomed. 8ematomyositise. Amyloidosis



D !'9. A '9 y1o woman was gi%en J Penicillin to teat infecti%e endocaditis. "ithin minutes of statingthis theapy, she #egins to ha%e se%ee difficulty of #eathing with espiatoy stido andtachypnea. -he suddenly de%elops an eythematous s&in ash o%e most of he #ody. *e

symptoms ae most li&ely to #e poduced #y which of the ff. chemical mediatos$a. 7! #. #ady&inin c. complement 5a d. histamine e. thom#oxaneB !'!. A 'D y1o woman undegoes allogenic #one maow tansplantation fo acute leu&emia. 3 wee&s

late, she has maow engafment and he *g# and "B count ae etuning to nomal. *owe%e,she has an appeaance of a fine, scaling s&in ash o%e he tun& and uppe extemities. 4hesefindings ae most consistent with which of the ff. complications/a. educed num#es of mega&ayocyets#. apoptosis of epidemal &eatinocytesc. dy gangened. contact dematitise. a#asions fom a fight in @

D !''. A #ee sting is suffeed #y a 'D y1o man, and his wife seaches fantically fo the medical &it withthe inIecta#le epinephine. "hich of the ff. immunologic mechanisms ae they tying to pe%ent$a. local immune complex fomation#. 7 elease fom macophages

c. #inding of antiecepto A#d. systemic anaphylaxise. complement acti%ation

A !'3. A 25 y1o man has #een plagued #y mild chonic diahea and inceased num#es of minoespiatoy infections fo most of his life. Ff. a moto %ehicle accident, he has a significant #loodloss eEuiing tansfusion of #lood poducts. 8uing the tansfusion, he is noted to ha%e ananaphylactic tansfusion eaction. "hich of the ff. diseases is he most li&ely to ha%e$a. -electi%e gA deficiency#. Amyloidosisc. -7d. +iemannPic& dsee. aft %s. host dse

D !'2. A 55 y1o woman has had inceasing difficulty with swallowing o%e the past yea. =n P he BP is''91!!9 mm*g. -he has a positi%e antinuclea anti#ody test with a nucleola patten ofimmunoflouescence. *e seum complement le%els wee nomal. "hich of the ff. lesions is most

li&ely to #e seen in he &idneys with enal #iopsy$a. enal cell A#. nodula glomeuloscleosisc. acute glomeulonephitisd. hypeplastic ateioscleosise. polycyctic change

C !'5. A study of immunoflouescence pattens in s&in #iopsies is pefomed. 4he immunoflouescencepatten in the s&in with A# to g, which shows a #and of immunoflouescence at the demal

epidemal Iunction, is most li&ely to #e #ased upon which of the ff. pathologic mechanisms/a. nceased num#es of 82 lymphocytes infiltating the demis#. deganulation of mast cellsc. tapping of AgA# complexesd. macophages ae eleasing cyto&inese. neutophils ae emigating fom capillaies

A !'0. Pathologic findings in idiopathic hypetophic su#aotic stenosis include all of the ff. P4/a. infiltation of eosinophils in myocadium#. myocadial fi#e disoientation in inte%enticula septumc. thic&ening of anteio leaflet of mital %al%ed. small %enticula ca%ities



B !';. nfiltati%e (esticti%e) cadiomyopathy occus in all of the ff., P4a. Amyloidosis#. auches dsec. lycogen stoage dsed. -acoidosis

C !'D. A 09 y1o man who had #een diagnosed 3 days #efoe as ha%ing had an acute myocadial infactsuddenly de%eloped mital insufficiency. 4his was most li&ely due to/

a. oincidental heumatic mital stenosis#. xtension of the infact to a mital %al%e leafletc. ?uptue of an infacted inte%enticula septum

d. ?uptue of an infacted papillay muscles

D !'<. 4he most feEuent cause of an acute myocadial infaction is occlusion of a maIo coonay atey#y/a. Atheoscleosis #. m#olism c. -pasm d. 4hom#osis

C !39. 6alignant neoplasm which most commonly gi%e ise to cadiac metastases include all of the ff.,P4/a. Bonchogenic A#. A of the #eastc. A of the thyoid glandd. 7ymphomas

C !3!. 4he causes of co pulmonale include all of the ff., P4/a. emphysema of the lungs

#. >yphoscoliosisc. lung a#scessd. ecuent pulmonay em#olism

D !3'. A !9 y1o #oy was found to ha%e mild Iaundice, with an ele%ation mainly of unconIugated #iliu#in,and splenomegaly. *is eythocyte count was 2 million1mm3 and the ed cells showed inceasedfagility in hypotonic saline. 4he most li&ely dx is/a. Lthalassemia#. aplastic anemiac. autoimmune hemolytic anemia

d. heeditay spheocytosis

A !33. A 29 y1o AficanAmeican Jietnam %etean de%eloped episodes of hemolysis on using cetaindugs. +umeous *ein #odies wee found in his eythocytes duing these peiods. 4he most li&elydx is/a. 0P8 deficiency

#. 6yelophthisic anemiac. Penicious anemiad. -ideo#lastic anemia

B !32. 4he pesence of *#F in the #lood of childen and adults is a chaacteistic of/a. L thalassemia c. megalo#lastic anemia#. M thalassemia d. sic&le cell anemia

A !35. 4he most distincti%e featue of acute myelo#lastic leu&emia is the pesence of /a. Aue #odies in myelo#lasts#. #last cisesc. Philadelphia chomosomes in neutophilsd. %ius paticles in myelo#lasts

A !30. Featues of chonic myelocytic leu&emia include all of the ff., P4/a. Autoimmune hemolytic anemia#. con%esion to acute leu&emia

c. hype%iscosity of #loodd. low al&aline phosphatase le%el in leu&emic ganulocytes

C !3;. A 09y1o man complained of #one pain, especially in his spine. ays e%ealed lytic lesions in the %ete#ae and s&ull. *e also had anemia and hypecalcemia. 4he most li&ely dx is/

a. Bu&itts lymphoma#. honic lymphocytic lymphomac. 6ultiple myelomad. "aldenstoms macoglo#ulinemia



C !3D. An association with an inceased incidence of lymphomas has #een found with all of the ff., P4/

a. autoimmune disodes #. chomosome a#nomalities c. cigaette smo&ing d. %iusesC !3<. A 29y19 man pesented with weight loss, and painless lymphadenopathy. A node #iopsy showed polifeation of geminal centes in the cotex and medulla. 4he enlaged centes consisted of

pooly diffeentiate lymphocytes. 4he li&eliest dx is/

a. acute lymphadenitis#. Bu&itts lymphomac. Follicula (nodula) lymphocytic lymphomad. diffuse pooly diffeentiated lymphocytic lymphoma

A !29. All of the ff. statements ae tue concening *odg&ins dse, P4/a. Bu&itts lymphoma is a %aiant occuing in Afica#. 7eu&emia and othe malignancies ha%e appeaed in patients successfully teated fo *odg&ins

diseasec. 7ymph nodes and spleen ae commonly in%ol%edd. ?eed-ten#eg cells ae the most impotant diagnostic featue

D !2!. A young #oy had excessi%e #leeding fom mino wounds and e%en spontaneously. *e was found to ha%e a se%ee deficiency of coagulation facto J. Facto le%els wee nomal, as was platelet

adhesi%eness. 4he most li&ely dx is$a. histmas dse #. -tuat facto deficiency c. %on"ille#ands dse d. hemophilia

C !2'. 4he pincipal taget of the ogan specific autoimmune dse penicious anemia is/

a. Acetylcholine ?c c. gastic paietal cells#. panceatic islet cells d. glomeula and lung #asement mem#ane

D !23. Amyloid deposits ae associated with all of the ff., P4/a. Alheimes dse#. chonic osteomyelitisc. multiple myelomad. -yphilis

D !22. 4he ff. ae associated with -7, P4/a. *ematoxylin #odies#. solu#le immune complex deposits in glomeulic. steile %egetations on heat %al%esd. fi#inoid necosis of mediumsied ateies

C !25. All of the ff. ae chaacteistic of 8ieoges syndome, P4/a. hypopaathyoidism#. hypoplasia of 4dependent aeas in lymph nodes

c. inheitance as autosomal ecessi%ed. ecuent %ial and fungal infections

C !20. 7o#a pneumonia micoscopically is most li&ely desci#ed as/a. hyaline mem#anes lining al%eoli with mononuclea leu&ocytic infiltation of al%eola septa#. patchy infiltation of al%eola spaces with neutophils, especially aound #onchiolesc. unifom infiltation of al%eola spaces with neutophils and fi#ind. hyaline infiltation of al%eoli within a lo#e

D !2;. Am !Dy1o male, with a histoy of mala#soption and steatohea since infancy, died afte ha%ing a chonic poducti%e cough, hemoptysis, and ecuent pulmonay infections fo se%eal yeas. 4he

lung at autopsy was found to ha%e dilated #onchial walls. 4he most li&ely dx is$a. Bonchopneumonia #. 4B c. honic pneumonitis d. Bonchiectasis

A !2D. 4he ff. ae chaacteistic of chonic #onchitis, P4/a. #acteia play an impotant ole in its causation#. #onchial walls ae infiltated #y lymphocytes and macophagesc. #onchial walls show smooth muscle hypetophyd. #onchial mucus glands ae hypeplastic

B !2<. L! antitypsin deficiency is most closely elated to/a. centilo#ula emphysema#. panlo#ula emphysemac. lo#a emphysemad. all

A !59. Pogessi%e massi%e fi#osis of the lungs occus in/a. oal wo&es pneumoconiosis#. *ealed tu#eculosisc. -acoidosis



d. ?adiation pneumonitis

♠♣♦♥ LIVERLUVERZ OCCUPATIONAL HAZARDS ♠♣♦♥

an anatomy of the day to day ailments of liverluverz life

by: Mrs. Bean

Let’s-Go Memory Lapse:haacteied #y lapses in memoy that it is time to

lea%e and e%eyone does lastminuteultaimpotant choes o call of natueEuiettimes

alonena&ed$$$, hence, esulting in the next syndome, theO

(to #e contO)

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