Pathology Prc Finaledit

PATHOLOGY

Instructions: Choose the BEST answer

1. Acute myelogenous leukemia is:a. most common in femalesb. most common in adults over 60 years oldc. occasionally aleukemicd. associated with massive splenomegaly

1. Answer: C Robbins 6th ed pp. 677 MPL 0.25

2. Hodgkin’s lymphoma with the worst prognosis:a. lymphocyte predominanceb. nodular sclerosisc. mixed cellularityd. lymphocyte depletion

2. Answer: D Robbins 6th ed pp. 672 MPL 0.25

3. The most important difference between a benign reactive lymph node and lymphoma :a. interstitial fibrosisb. follicular hyperplasiac. effacement of normal architectured. presence of plasma cells3. Answer: C Robbins 6th ed pp. 649 MPL 0.33

4. Plasma cells are characterized by a. abundant surface immunoglobulinsb. Fc surface receptorsc. Abundant cytoplasm immunoglobulinsd. Complement surface receptors4. Answer: C Robbins 6th ed pp. 82 MPL 1

5. Paroxysmal hypertension is most typically associated with which of the following?a. adrenal adenomab. thyroid adenomac. parathyroid adenomad. pheochromocytoma5. Answer: D Robbins 6th ed pp. 1166 MPL 1

6. The association of medullary carcinoma of the thyroid with pheochromocytoma with or without parathyroid hyperplasia or adenoma is called:

a. Conn’s syndromeb. Cushing’s syndromec. Sipple’s syndromed. Waterhouse-Friedricksen’s syndrome6. Answer: C Robbins 6th ed pp. 1167 MPL 0.25

7. Which of the following is the most common cause of Cushing’s syndromea. exogenous corticosteroidsb. adrenal cortical carcinomac. oat cell carcinoma of the lungsd. basophilic adenoma of the pituitary7. Answer: A Robbins 6th ed pp. 1153 MPL 0.33

8. A destructive lesion in this area will result in diabetes insipidus:a. mamillothalamic tractb. adenohypophysisc. subthalamic fasciculusd. supraoptic and paraventricular hypothalamic nuclei8. Answer: D Robbins 6th ed pp. 1129 MPL 0.25

9. Conn’s syndrome is primarily associated with an excess of :a. glucocorticoidsb. mineralocorticoidsc. thyroid hormoned. ADH9. Answer: B Robbins 6th ed pp. 1155 MPL 0.25

10. Primary hyperaldosteronism is associated with:

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a. hyponatremiab. hypotensionc. elevation of plasma renin levelsd. hypokalemia10. Answer: D Robbins 6th ed pp. 1155 MPL 0.5

11. The single most frequent adrenal lesion producing primary hyperaldosteronism:a. single unilateral adenomab. multiple unilateral adenomasc. bilateral adenomasd. carcinoma11. Answer: A Robbins 6th ed pp. 1155 MPL 0.25

12. Truncal obesity, easy bruising and osteoporosis is associated with:a. craniopharyngiomab. adrenal adenomac. thyroid adenomad. parathyroid adenoma12. Answer: B Robbins 6th ed pp. 1154-1155 MPL 1

13 Urinalysis results show proteinuria, red blood cells and casts, and 1-2 pus cells per HPO. These findings are consistent with:

a. acute cystitisb. acute pyelonephritisc. chronic pyelonephritisd. acute post-streptococcal glomerulonephritis13. Answer: D Robbins 6th ed pp. 950 MPL 1

14. Membranous glomerulopathy and poststreptococcal glomerulonephritis are similar in that they both:

a. are self-limiting and transient renal diseasesb. are commonly associated with nephrotic syndromec. are most commonly seen in childrend. have glomerular immune complex deposits14. Answer: D Robbins 6th ed pp. 953 MPL 0.5

15. A patient with hemoptysis and renal failure has a renal biopsy which reveals crescentic glomerulonephritis, with linear deposits of IgG and C3 on immunofluorescence. Diagnosis?

a. acute post-infectious glomerulonephritisb. membranous nephropathyc. Goodpasture’s syndromed. Minimal change disease15. Answer: C Robbins 6th ed pp. 951 MPL 1

16. The most characteristic feature of rapidly progressive glomerulonephritis:a. crescent formationb. hyaline nodulesc. subepithelial dense depositsd. thickened capillary loops16. Answer: A Robbins 6th ed pp. 951 MPL 1

17. Benign nephrosclerosis is best defined as:a. fibrinoid necrosis of afferent arterioles with ischemic atrophy of nephronsb. hyalinization of afferent arterioles with ischemic atrophy of nephronsc. diffuse thickening of glomerular capillary basement membrane leading to glomerulosclerosisd. deposition of basement-like material within the glomerular mesangium leading to

glomerulosclerosis17. Answer: B Robbins 6th ed pp. 981-982 MPL 0.25

18. Ischemic acute tubular necrosis occurs most commonly in association with:a. septic shockb. ruptured aneurysmc. carcinoma of the prostated. malignant hypertension18. Answer: A Robbins 6th ed pp. 969 MPL 1

19. The most common appearance of nephrotic syndrome in adults is:

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a. proliferative glomerulonephritisb. membranous glomerulonephritisc. rapidly progressive glomerulonephritisd. wire-loops

19. Answer: B Robbins 6th ed pp. 953 MPL 0.25

20. “Nutmeg liver” is a gross finding seen in:a. petechial hemorrhagesb. viral hepatitisc. alcoholismd. chronic passive congestion20. Answer: D Robbins 6th ed pp. 116-117 MPL 1

21. Which of the following is associated with high levels of serum alkaline phosphatase?a. hemolytic anemiab. metastatic carcinoma to the liverc. Dubin-Johnson syndromed. Gilbert’s syndrome21. Answer: B Robbins 6th ed pp. 891 MPL 1

22. The most common outcome in-patients with acute Hepatitis B is:a. complete recovery without residual dysfunctionb. chronic persistent hepatitisc. chronic active hepatitisd. postnecrotic cirrhosis22. Answer: A Robbins 6th ed pp. 858 MPL 1

23. In a patient suspected of having viral hepatitis, which laboratory finding would indicate the most severe and life threatening amount of liver damage?

a. prolonged prothrombin timeb. high serum bilirubinc. high serum aspartate transaminasesd. high serum alkaline phosphatase23. Answer: A Robbins 6th ed pp. 867 MPL 1

24. The most important substance in the formation of gallstones is:a. calcium c. bile saltsb. bilirubin d. lecithin24. Answer: C Robbins 6th ed pp. 894 MPL 0.25

25. Cirrhosis produces most of its clinical manifestations by means of:a. hepatic necrosis leading to insufficient number of liver cells to sustain lifeb. cancerous change in regenerating nodulesc. obstruction of large biliary passagesd. vascular derangements in the liver25. Answer: D Robbins 6th ed pp. 853 MPL 0.25

26. The major cause of portal hypertension is:a. Intrahepatic c. prehepaticb. Posthepatic d. cardiac26. Answer: A Robbins 6th ed pp. 855 MPL 1

27. The most common factor in the formation of esophageal varices is obstruction at the level of:a. esophageal veinb. hepatic veinc. intrahepatic vesselsd. portal vein27. Answer: C Robbins 6th ed pp. 783 MPL 0.25

28. When a person dies suddenly from a “heart attack” the most likely event causing it will be:a. aortic aneurysmb. coronary artery embolismc. congestive heart failured. arrhythmia28. Answer: D Robbins 6th ed pp. 562 MPL 1

29. Acute rheumatic heart disease is associated with:a. arthritisb. emboli to multiple organs

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c. cardiac tamponaded. right to left shunt29. Answer: A Robbins 6th ed pp. 572 MPL 0.5

30. The most frequent and clinically significant residual lesion of acute rheumatic fever is:a. myocardial fibrosisb. aortic stenosisc. mitral stenosisd. pericardial adhesion30. Answer: D Robbins 6th ed pp. 570-571 MPL 0.25

31. The absolute criterion of cardiomegaly: a. increase in sizeb. increase wall thicknessc. increase in weightd. change in shape31. Answer: C Robbins 6th ed pp. 544 MPL 1

32. Myocardial disease gradually producing 4-chamber dilatation: a. viral myocarditisb. hypertrophic cardiomyopathyc. congestive cardiomyopathyd. restrictive cardiomyopathy32. Answer: C Robbins 6th ed pp. 579-581 MPL 1

33. Necrotizing infection caused by highly virulent organisms seeding a normal valve: a. rheumatic heart diseaseb. SLE endocarditisc. acute infective endocarditisd. marantic Endocarditis33. Answer: C Robbins 6th ed pp. 572-573 MPL 1

34. The most common cause of intestinal obstruction is:a. adhesionsb. volvulusc. neoplasmd. hernia34. Answer: A Robbins 6th ed pp. 825 (table) MPL 1

35. A two-week old boy has projectile vomiting. The most likely diagnosis is :a. pyloric stenosisb. esophageal atresiac. annular pancreasd. incomplete rotation of the gut35. Answer: A Robbins 6th ed pp. 789 MPL 0.25

36. An endoscopic gastric biopsy finding of intestinal type epithelia is most likely due to:a. chronic gastritis b. congenital heterotopiac. precancerous dysplasiad. metastatic carcinoma36. Answer: A Robbins 6th ed pp. 790 MPL 0.25

37. Most characteristic of right sided colon cancer compared to left-sided cancer:a. anemiab. associated with polyposisc. bowel obstructiond. diarrhea37. Answer: A Robbins 6th ed pp. 834 MPL 0.33

38. Acute erosive gastritis is characterized by:a. superficial and multiple gastric mucosal ulcerationb. pus in the gastric mucosac. deep ulcer with scarred based. frequent association with gastric cancer

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38. Answer: A Robbins 6th ed pp. 789-790 MPL 0.25

39. The most common site of chronic gastric peptic ulcer:a. lesser curvature at the antral-body junctionb. anterior wall of the duodenal vergec. greater curvature at the mid-antrumd. esophago-gastric junction39. Answer: A Robbins 6th ed pp. 795 MPL 0.25

40. The definitive finding in acute appendicitis:a. obstruction of the lumen by a fecalithb. mucus inspissation in the lumenc. neutrophils in the muscularisd. serosal congestion and margination of polys40. Answer: C Robbins 6th ed pp. 839 MPL 1

41. Morphologic appearance favoring benign rather than malignant gastric ulcer:a. large ulcerb. heaped up marginc. antral locationd. folds radiating from the ulcer41. Answer: C Robbins 6th ed pp. 795 MPL 0.25

42. Most frequently found neoplasm in the appendix:a. adenomab. polypc. carcinoidd. adenocarcinoma42. Answer: C Robbins 6th ed pp. 840 MPL 1

43. The most common malignant soft tissue tumor:a. rhabdomyosarcomab. malignant fibrous histiocytomac. leiomyosarcomad. liposarcoma43. Answer: D Robbins 6th ed pp. 1261 MPL 0.25

44. Brown tumors of bone is associated with:a. hyperparathyroidismb. traumac. metastatic carcinomad. vitamin deficiency44. Answer: A Robbins 6th ed pp. 1228 MPL 1

45. The most frequent site of compression fracture is:a. femurb. radio-ulnar areac. clavicled. vertebrae45. Answer: D Robbins 6th ed pp. 1229-1231 MPL 1

46. Rheumatoid arthritis usually has its origin in:a. ball and socket jointsb. lumbo-sacral jointsc. small peripheral jointsd. major weight-bearing joints46. Answer: C Robbins 6th ed pp. 1251 MPL 1

47. Most common primary malignant bone tumor in 15-25 years of age:a. chondrosarcomab. osteosarcomac. Ewing’s sarcomad. Chondroblastoma47. Answer: B Robbins 6th ed pp. 1236 MPL 1

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48. The most likely malignant bone tumor in a 65 yo man is:a. Giant cell tumorb. Osteosarcomac. Metastatic prostatic cancerd. Multiple myeloma48. Answer: C Robbins 6th ed pp. 1245 MPL 1

49. The most common primary type of bronchogenic carcinoma is:a. metastatic carcinoma b. adenocarcinomac. squamous cell carcinomad. small cell carcinoma49. Answer: C Robbins 6th ed pp. 743-744 MPL 1

50. The source of surfactant is believed to be:a. Type I pneumocyteb. Type II pneumocytec. Mast celld. Alveolar mcrophage50. Answer: B Robbins 6th ed pp. 471 MPL 0.33

51. The single most characteristic feature of bronchiectasis is:a. excessive mucus secretionb. immotile ciliac. dilatation of bronchid. alpha-1 antitrypsin deficiency51. Answer: C Robbins 6th ed pp. 716 MPL 1

52. Non-communicating hydrocephalus means obstruction:a. between ventricles and subarachnoid spaceb. at the cisterna ambiensc. at the arachnoid granulationsd. at the vein of Galen52. Answer: B Robbins 6th ed pp. 1298-1299 MPL 0.33

53. The most common cause of bacterial meningitis in a patient <2 months old is:a. Escherichia colib. Hemophilus influenzac. Streptococcus pneumoniaed. Neisseria meningitides53. Answer: A Robbins 6th ed pp. 1314 MPL 1

54. The most important and consistent site for histologic lesion in parkinsonism is:a. caudate nucleusb. substantia nigrac. red nucleusd. putamen54. Answer: B Robbins 6th ed pp. 1334 MPL 1

55. Increased hormonal stimulation may cause cells to undergo:a. atrophy c. hyperplasiab. metaplasia d. dysplasia

55. Answer: C Robbins 6th ed pp. 32-33 MPL 1

56. A reversible change or alteration in adult cells characterized by variation in size, shape and organization:

a. metaplasia c. dysplasiab. hyperplasia d. atrophy

56. Answer: C Robbins 6th ed pp. 466 MPL 1

57. Type of cellular adaptation where there is marked increase in the number of autophagosomes accompanied by decrease in the number of mitochondria, myofilaments, ad endoplasmic reticulum:

a. hypertrophy c. hyperplasiab. atrophy d. metaplasia

57. Answer: B Robbins 6th ed pp. 36 MPL 1

58. The most common cause of hypoxic injury is;a. ischemia

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b. depletion of oxygen-carrying capacity of bloodc. poisoning of the oxidative enzymes within the cellsd. thrombosis

58. Answer: A Robbins 6th ed pp. 4 MPL 1

59. The sum of all morphologic changes following cell death:a. necrosis c. autolysisb. heterolysis d. autophagy

59. Answer: A Robbins 6th ed pp. 2 MPL 1

60. The characteristic cellular infiltrate in the early phase of acute inflammation:a. lymphocyte c. plasma cellsb. neutrophils d. eosinophil


61. The immediate transient phase of vascular permeability in most types of tissue injury is mediated by:

a. histamine c. complementb. prostaglandins d. bradykinin

61. Answer: A Robbins 6th ed pp. 66 MPL 0.5

62. The characteristic cell of a granuloma:a. Langhan’s type giant cell c. lymphocyteb. epithelioid cell d. plasma cell

62. Answer: B Robbins 6th ed pp. 83-84 Answer: MPL 1

63. The essential features of a granulation tissue:a. fibroblasts and inflammatory cells c. edema & inflammatory cellb. small blood vessels and fibroblasts d. inflammatory cells & vessels

63. Answer: B Robbins 6th ed pp. 102-103 MPL 0.5

64. Acute pancreatitis:a. coagulation necrosis c. liquefaction necrosisb. caseation necrosis d. enzymatic fat necrosis

64. Answer: D Robbins 6th ed pp. 17-18 MPL 1

65. Acute inflammation is characterized by the following:A. relatively long duration C. emigration of macrophagesB. proliferation blood vessels and connective tissue D. exudation

65. Answer: D Robbins 6th ed pp. 51 MPL 1

66. The most common mechanism of vascular leakage elicited by free oxygen radicals: A. endothelial contraction C. leukocyte-dependent leakage

B. direct endothelial cell injury D. regeneration of endothelial cell66. Answer: B Robbins 6th ed pp. 55 / 76 MPL 0.25

67. Leukocyte adhesion, chemotaxis and activation are important inflammatory mediator processes performed by complement factor:

A. C7a C. C5aB. C6a D. C1a

67. Answer: C Robbins 6th ed pp. 61 MPL 0.33

68. Oxygen-derived free radicals are implicated in:A. endothelial cell damage C. tissue regenerationB. release of histamine D. prostaglandin release

68. Answer: A Robbins 6th ed pp. 76 MPL 0.5

69. This inflammatory infiltrate is the prima donna of chronic inflammation because of the great number of biologically active substances it releases:

A. lymphocytes C. neutrophilsB. macrophage D. plasma cells


70. Adaptation has happen:a. if the cell undergoes necrosis c. ..is replaced by another cell typeb. loses its genetic apparatus d. undergoes dystrophic calcification

70. Answer: C Robbins 6th ed pp. 36-37 MPL 1

71. Characteristics of benign tumors:a. invasive c. immortal

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b. cohesive d. escape from regulatory control71. Answer: B Robbins 6th ed pp. 270 MPL 0.33

72. The most reliable feature of malignancy:a. metastasis c. rate of growth

b. differentiation d. invasion72. Answer: A Robbins 6th ed pp. 268 MPL 1

73. The most common route of metastasis of a carcinoma:a. contiguity c. hematogenousb. lymphatic d. iatrogenic


74. The most important prognostic factor for malignancy:a. stage c. invasionb. grade d. localization

74. Answer: A Robbins 6th ed pp. 321-322 MPL 1

75. A 25-year-old man with a history of intravenous drug use has had one bout of Pneumocystis carinii pneumonia which was successfully treated a year ago. He now has a WBC count of 3600/microliter with differential count of 78 segs, 3 bands, 5 lymphs, and 14 monos. He has recently developed painful, progressive visual loss involving both eyes. Which of the following infections is he most likely to have:

A. Klebsiella pneumoniae C. Mycobacterium tuberculosisB. Staphylococcus aures D. Cytomegalovirus

75. Answer: D Robbins 6th ed pp. 1319 MPL 0.25

76. A 65-year-old previously healthy woman has had a non-productive cough increasing in severity over the last 10 days. She has a temperature of 38.0 C. A chest radiograph shows faint interstitial infiltrates but no areas of consolidation. A CBC reveals a WBC count of 8900/microliter with differential count of 60 segs, 3 bands, 25 lymphs, and 12 monos. A sputum gram stain reveals a few gram positive cocci, gram negative cocci, and Candida with few neutrophils. Her condition gradually improves over the next week. Which of the following infectious agents is most likely responsible for her illness:

A. Klebsiella pneumoniae C. Mycobacterium tuberculosisB. Staphylococcus aures D. Influenza A virus

76. Answer: D Robbins 6th ed pp.348 MPL 0.25

77. A 39-year-old man had an acute febrile illness with fever, pharyngitis, lymphadenopathy, and malaise following a trip to a city known for its commercial sex workers. In how many years would you predict that his peripheral blood CD4 lymphocyte count will drop below 200/microliter:

A. one C. ten B. five D. fifteen

77. Answer: C Robbins 6th ed pp.246-248 MPL 0.25

78. A 20-year-old commercial sex worker has lower abdominal pain of 24 hours duration. There is no previous history of pain. She is febrile, her total WBC is 29,000/mm3 with 85% neutrophils. She has a markedly tender lower abdomen on palpation. Laparotomy reveals a distended, fluid-filled reddened left fallopian tube that is about to rupture. The tube is removed. A culture of the fluid from the tube is most likely to grow:

A. TB bacilli C. AIDS virusB. Neisseria gonorrhea D. Human Papilloma virus

78. Answer: B Robbins 6th ed pp.362 MPL 0.25

79. A 10-year-old child has a severe watery diarrhea that causes her to become severely dehydrated over the past two days. The persistent activation of adenylate cyclase by GTP leads to excessive intestinal fluid loss. Which of the following organisms is most likely to produce a toxin that has this effect:

A. Eschericia coli C. Vibrio choleraB. Entamoeba histolytica D. Salmonella enteritidis

79. Answer: C Robbins 6th ed pp.808 MPL 0.5

80. An 18-year-old man is plowing a field on a hillside. He discovers a deep, penetrating puncture wound to his foot. He walks home and washes the soil off the wound site and puts a bandage over it. A week later the wound is healing, and the leg is not swollen, but he begins to experience generalized muscle spasms, with stiffness and pain in his shoulders and back. He has difficulty with eating and

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swallowing, with painful stiff jaw and facial muscles. Which of the following organisms is most likely responsible for these findings :

A. Clostridium tetani C. Staphylococcus aureusB. Clostridium perfringens D. Streptococcus pneumoniae

80. Answer: A Robbins 6th ed pp.368-369 MPL 1

81. A 41-year-old man has a chronic cough and recently experienced an episode of hemoptysis. A chest radiograph shows a cavitary 4 cm nodule in the right upper lung. There are a few adjacent smaller nodules with calcifications. The best diagnosis is:

A. AIDS with cytomegalovirus C. Bronchopneumonia with pseudomonas

B. Secondary tuberculosis D. peripheral organizing pulmonary thromboembolus


82. A 40-year-old man has had a productive cough with yellowish sputum for several days. A complete blood count shows that he has a total WBC count of 15,700/microliter with differential count of 73 segs, 10 bands, 12 lymphs, and 5 monos. He has a fever of 38.9 C. A chest radiograph reveals a nodule in the left upper lobe that has a central cavity with an air-fluid level. Which of the following findings is most likely to be present in his sputum|:

A. +2 acid fast bacilli C. 4+ gram positive cocciB. atypical squamous cells D. hemosiderin-laden macrophages

82. Answer: C Robbins 6th ed pp.367 / 722 MPL 0.33

83. A 78-year-old woman has a history of Alzheimer's disease. She dies after an illness lasting only a two-day history of fever and cough productive of copious amounts of yellowish sputum. Her vital signs on admission included blood pressure 110/75 mm Hg, pulse 105, respirations 26, and temperature 38.1 C. She had dullness to percussion at the right lung base. The microscopic findings from the right lower lobe at autopsy include numerous neutrophils within the alveolar spaces, with minimal destruction of alveolar walls. What was the most likely infectious cause for her pulmonary disease:

A. Influenza A virus C. streptococcus pneumoniaeB. Mycobacterium tuberculosis D. Cytomegalovirus

83. Answer: C Robbins 6th ed pp.719 MPL 0.33

84. A 22-year-old woman has experienced episodes of myalgias, pleural effusions, pericarditis, and arthralgias without joint deformity over the course of several years. She has continued working at her job. A CBC reveals a mild normocytic anemia. The best laboratory screening test to begin the workup for her condition would be a(an):

A. CD4 lymphocyte count C. antinuclear antibody testB. Blood culture D. creatine phosphokinase


85. A male infant was born at term. No congenital anomalies were noted at birth. A year later he now has failure to thrive and has been getting one bacterial pneumonia after another with both Hemophilus influenzae and Streptococcus pneumoniae cultured from his sputum. You should most strongly suspect that he has which of the following diseases

A. Di George Syndrome C. EBV infectionB. Selective IgA deficiency D. X-inked agammaglobulinemia

85. Answer: D Robbins 6th ed pp.232-233 MPL 0.25

86. An appropriate, useful type I hypersensitivity response of the immune system, accompanied by eosinophilia, would be directed against:

A. amyloid protein C. neoplasmsB. pinworm infection D. inhaled dusts

86. Answer: B Robbins 6th ed pp.82 MPL 1

87. A 54-year-old woman is found to have a blood pressure of 170/110 mm Hg. Her fingers become cold and painful upon exposure to cold. She has mild dyspnea, but no wheezing. The antinuclear antibody test is positive with a titer of 1:256 and a nucleolar pattern. Her serum urea nitrogen is 15 mg/dL with creatinine of 1.1 mg/dL. These findings most strongly suggest that she has which of the following autoimmune diseases:

A. discoid lupus erythematosus C. polymyositis-dermatomyositis B. progressive systemic sclerosis D. rheumatoid arthritis

87. Answer: B Robbins 6th ed pp.226-229 MPL 0.25

88. Several hours after going on a hike through dense foliage, a 40-year-old man notices a slightly raised and tender irregular reddish rash on one forearm that was not covered by clothing. This rash gradually increases in intensity for a couple of days and then fades after two weeks. The rash is most indicative of:

A. Type I C. Type IIIB. Type II D. Type IV

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88. Answer: D Robbins 6th ed pp.204-206 MPL 0.2589. The second pregnancy of a 23-year-old woman appears uncomplicated until ultrasound performed at 19 weeks shows hydrops fetalis. The fetal organ development is consistent for 19 weeks, and no congenital anomalies are noted. Her first pregnancy was uncomplicated and resulted in the birth of a normal girl at term. The current pregnancy yields a baby born prematurely at 32 weeks gestation with marked icterus. The baby is also markedly anemic, and an exchange transfusion is performed. Which of the following immunologic mechanisms best explains these findings

A. anti-receptor antibody C. immune complex formationB. complement-mediated cell destruction D. delayed type

hypersentsitivity89. Answer: B Robbins 6th ed pp.199-201 MPL 0.25

90. A man in his mid-30's presents with malar skin rash, polyarthritis with swelling and warmth of his hands, and sensitization to cold. On physical examination he has generalized lymphadenopathy and pale conjunctivae. Laboratory findings include a hemoglobin of 9.5 g/dL, total WBC count of 2100/microliter, total serum protein 8.8 g/dL, albumin 3.6 g/dL, creatinine 1.1 mg/dL, and creatine kinase of 468 U/L. His antinuclear antibody test is positive at 1:256. The best additional serologic test to help determine his underlying disease process is:

A. Anti-centromere C. Rheumatoid FactorB. Anti-RNP D. Serum C1q complement level

90. Answer: B Robbins 6th ed pp.218 MPL 0.25

91. Several weeks following a pharyngitis in which the throat culture grew group A hemolytic streptococcus, a child is noted to have hematuria on urinalysis. An immunofluorescence staining pattern in a renal biopsy shows granular deposition of IgG and complement around glomerular capillary loops. Which of the following immune hypersensitivity mechanisms is most likely responsible for this pattern of findings



92. A 48-year-old man has a chronic cough with fever that have persisted for several months. The chest radiograph reveals a diffuse reticulonodular pattern. Microscopically on transbronchial biopsy there are focal areas of inflammation containing epitheloid macrophages, Langhan's giant cells, and lymphocytes. These findings are most typical for which of the following immunologic responses:


92. Answer: D Robbins 6th ed pp.204-226 MPL 0.25

93. A 31-year-old woman with chest pain for the past week has a chest radiograph that shows modest bilateral pleural effusions. On chest CT scan, the pleural effusions, as well as a pericardial effusion, are observed. A thoracentesis on the left yields clear fluid with a low protein and cell count. She is found to have an anti-double stranded DNA titer of 1:512. If she is later found to have a serum urea nitrogen that is 55 mg/dL, it will probably be the result of which of the following pathologic processes

A. atherosclerosis C. amyloid depositionB. glomerular immune deposits D. Anti-glomerular basement membrane

93. Answer: B Robbins 6th ed pp.216-225 MPL 0.25

94. A 5 cm well-encapsulated mass was excised from the breast of a 21-year-old woman. Histologically, the mass was composed of elongated, ductlike structures surrounded by loose, fibrous connective tissue. Diagnosis

A. fibroadenoma B. intraductal papillomaC Pagets diseaseD. Phyllodes tumor

94. Answer: A Robbins 6th ed pp. 1102-1103 MPL 0.25

95. An 18-year-old medical student complains of poor concentration and easy fatigability. She had heavy menstrual bleeding but was otherwise healthy. Examination of the blood showed a microcytic, hypochromic erythrocytes. Diagnosis?

A. aplastic anemiaB. sickle cell anemiaC. thalassemiaD. iron deficiency anemia

95. Answer: B Robbins 6th ed pp. 627-630 MPL 1

96. A 30-year-old man known to be a heavy smoker developed gangrene of the leg, which had to be amputated. Intraluminal thrombi associated with microabscesses in the wall of medium sized arteries were found in the resected leg. Diagnosis?

A. Henoch-Sholein purpura

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B. SyphilisC. Polyarteritis nodosaD. Buerger disease

96. Answer: D Robbins 6th ed pp.523 MPL 1

97. Ocular muscle weakness and general fatigability were found in a 38-year-old woman who also had antibodies to acetylcholine receptors. Diagnosis?

A. Graves diseaseB. PolymyositisC. Myasthenia gravisD. Wiscott-Aldrich syndrome

97. Answer: C Robbins 6th ed pp.1289 MPL 1

98. Congenital aplasia of the thymus and parathyroid glands was discovered in a neonate that developed spastic contraction on the second postpartum day. Diagnosis?

A. Goodpasture syndromeB. DiGeorge syndromeC. Isolated IgA deficiencyD. Brutons agammaglobulinemia

98. Answer: B Robbins 6th ed pp.235 MPL 1

99. Hemorrhagic cutaneous nodules in a male homosexual with AIDS. Diagnosis?A. hemangiomaB. lentigo malignaC. neurofibromaD. Kaposi sarcoma

99. Answer: D Robbins 6th ed pp535 MPL 0.33

100. Short female with web neck and amenorrhea. Her karyotype was 45,X. Diagnosis?A. Turner syndromeB. Klinefelter syndromeC. Down syndromeD. Fragile-X syndrome

Answer: A Robbins 6th ed pp.174-176 MPL 0.33

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Pathology Prc Finaledit

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