PATHOLOGY WRITTEN EXAM II

1. A 65-year-old man is found dead in his driveway with a single gunshot wound to the chest. A revolver is lying on the ground next to the body. Pinned to the man's shirt is a handwritten note explaining that he has learned that the lung cancer he was previously treatedfor had spread to his bones, and he chose to end his own life rather than wither away in pain. The handwriting is confirmed to be his own by comparing the note to other documents known to have been written by him.

At autopsy, an entrance gunshot wound is observed in the precordial area. Internally, there is a through-and-through wound to the heart, and the pericardial sac is distended with blood. A bullet is lodged in the body of a thoracic vertebra. The left lung is absent. Histologic sections taken through the vertebrae and ribs show multiple metastatic foci of squamous cell carcinoma.

What is the medical examiner's proper determination of the manner of death?A. Hemopericardium with cardiac tamponadeB. SuicideC. Metastatic lung cancerD. Natural causesE. Gunshot wound to the heart

2. Schwannoma is frequently:A. None of the above.B. Found in infants.C. Malignant.D. Found in olfactory nerves.E. Found at the cerebellopontine angle.

3. Immunoflourescence is utilized by renal pathologists to identify which of the following?A. localize immunoglobulin and complement deposits in the kidneyB. diagnostic changes of polycystic kidney diseaseC. alterations of epithelial foot processesD. grades of renal transplant rejectionE. changes consistent with acute tubular necrosis

4. Hyaline membranes are characteristic of which lung lesion?A. None of the aboveB. Diffuse alveolar damageC. Desquamative interstitial pneumoniaD. Usual interstitial pneumoniaE. Acute silicosis

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5. A pathologist receives a renal biopsy from a 44 year old woman. Which of the followingis NOT routinely performed for evaluation of glomerular disease?A. Cell culturesB. immunoflourescenceC. PAS (Periodic acid Schiff) stainD. light microscopyE. electron microscopy

For each numbered item (column 1), choose the letter of the most closely related itemin column 2. Each answer can be used once, more than once, or not at all.

COLUMN 1 COLUMN 2

6. Lewy body A. Parkinson's disease7. Knife edge" atrophy of frontal and B. Pick's diseasetemporal lobes sparing posterior 2/3 of C. Amyotrophic lateral sclerosissuperior temporal gyrus D. Alzheimer's disease8. Motor neuron degeneration E. Huntington's disease9. Caudate atrophy

10. A 25 year old woman presents with sensorineural deafness, mild proteinuria and mildhematuria. She gives a family history of deafness and renal failure in a brother andseveral other male relatives. Her brother also has had cataracts at an early age. Giventhis history, which of the following is her MOST LIKELY diagnosis?A. Minimal change diseaseB. Thin basement membrane diseaseC. IgA nephropathyD. Alport's syndromeE. Mesangioproliferative lupus nephritis

Match the diagnosis column on the left with the MOST LIKELY SINGLE ANSWER inthe right hand column. Each answer in the right column may be used once, more thanonce, or not at all.

11. Pneumocystis carinii pneumonia A. AIDS patient12. Sclerosing hemangioma B. Woman with lower lobe nodule13. Scrofula C. Traveler to S.W. United States14. Coccidiomycosis D. 2 year old with bronchiolitis15. Respiratory syncytial virus pneumonia E. Tuberculosis patient

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16. A patient presents with mild proteinuria and hematuria and with further work-up is thought to have a glomerulopathy. Which of the following disorders should USUALLY NOT be considered in the differential diagnosis of glomerular diseases with mild clinical abnormalities?

A. Diffuse proliferative glomerulonephritisB. IgA nephropathyC. Thin basement membrane diseaseD. Alport's syndromeE. Mesangioproliferative lupus nephritis

17. Ferruginous bodies are characteristic of which lung lesion?A. Chronic silicosisB. AsbestosisC. Acute silicosisD. Coal worker's pneumoconiosisE. Pulmonary hemosiderosis

18. A patient is worked-up for a glomerulopathy and found to have deposition of IgA in the mesangium by immunoflourescence. Which of the following disorders should NOT be included in the differential diagnosis for this glomerulopathy?

A. Mesangioproliferative lupus nephritisB. cirrhotic glomerulosclerosisC. IgA nephropathyD. Henoch-Schonlein purpuraE. Post-streptococcal glomerulonephritis

19. Hematuria is noted repeatedly by urinalysis on a 40 year old male patient. Which of the following should be considered in the differential diagnosis?

A. renal tumorsB. urolithiasisC. polycystic kidney diseaseD. glomerulonephritidesE. all of the above

20. A 55 year old nonsmoker has a primary lung cancer in the periphery of the lung. The MOST LIKELY tumor type is:

A. Kaposi's sarcomaB. AdenocarcinomaC. LymphomaD. Squamous carcinomaE. Small cell carcinoma

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21. A 10 year old male presents with proteinuria, a serum albumin of 2.0 (normal range>3.5), peripheral edema, and hypercholesterolemia. Measurement of protein in thispatient's urine over a 24-hour period confirms 4.0 grams of protein per 24 hours. Giventhe information provided, what is your diagnosis?A. tubulointerstitial diseaseB. polycystic kidney diseaseC. nephrotic syndromeD. acute tubular necrosisE. nephritic syndrome

22. Silicosis is caused by inhalation of dusts composed of:A. Calcium aluminum silicateB. Magnesium aluminum silicateC. Fibrous silicateD. Silicon dioxideE. All of the above

23. Which of the following diseases is NOT associated with causation of membranousglomerulopathy?A. Wegener's granulomatosisB. viral hepatitisC. malignant diseasesD. malariaE. systemic lupus erythematosus

24. A 30 year old woman presents to you with nephrotic range proteinuria, hypertension,arthralgias, anemia, skin rash and pericarditis. ANA is positive. Renal biopsy confirmsfinely granular positivity for lgG and C3 within glomerular capillary loops. What is theMOST LIKELY diagnosis based on this clinical information and renal biopsy findings?A. Polyarteritis nodosaB. Membranoproliferative glomerulonephritis, type 1C. Lupus nephritis, mesangioproliferative typeD. Henoch-Schonlein purpuraE. Lupus nephritis, membranous type

25. Which of the following tumors is more frequent in women than men?A. Glioblastoma multiforme.B. Meningioma.C. Anaplastic astrocytoma.D. Astrocytoma.E. Malignant oligodendroglioma.

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26. Which disorder is the MOST COMMON cause of nephrotic syndrome in childhood?A. Anti-glomerular basement diseaseB. post-infectious glomerulonephritisC. Henoch-Schonlein purpuraD. Minimal change diseaseE. IgA nephropathy

27. A 7 year old girl presents with a history of pharyngitis approximately 2 weeks prior topresentation. She now exhibits periorbital swelling first noted by her mother, bloodpressure of 150/95, and reports that her urine looks like Coca-Cola. Based on the thesefindings, you advise the mother of which of the following?A. The child will MOST LIKELY achieve complete recoveryB. The child will MOST LIKELY require a renal transplantC. The child will require work-up for occult malignancyD. The child will MOST LIKELY require supportive dialysis with partial recovery of renal functionE. The child will require corticosteroids

28. Pott's disease is involvement of the spine by:A. SarcoidosisB. TuberculosisC. AspergillosisD. HistoplasmosisE. Metastatic adenocarcinoma

29. A 27 year old male presents with hemoptysis gradually increasing over the last week. Upon questioning, he relates that he has experienced progressive dyspnea and a brownish discoloration to his urine. Further work-up confirms red cell casts, proteinuria, and granular casts. Both c-ANCA and p-ANCA are negative. A renal biopsy and lung biopsy are performed and Dr. Verani pages you to triumphantly inform you that the immunoflourescence shows a fine linear pattern positive for lgG and C3 in most glomeruli and along the alveolar basement membranes. You pre-empt her from telling you the diagnosis (because you want to show her how much you've learned-showoff!), and thank her for confirming the diagnosis of :

A. Marchiafava-Bignami diseaseB. Wegener's granulomatosisC. Polyarteritis nodosaD. Goodpasture's syndromeE. Membranous glomerulonephritis

30. Which form of lupus nephritis is MOST COMMON and also associated with the worst5-year survival rate?A. focal proliferative glomerulonephritisB. mesangial proliferative glomerulonephritisC. none of the aboveD. diffuse proliferative glomerulonephritisE. membranous glomerulonephritis

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31. A 70 year old male is seen in your clinic for evaluation of his dementia. Your work-upincludes an MRI scan that confirms cortical gyral thinning and widening of sulci,consistent with cerebral atrophy. His ventricular system is also diffusely dilated, butthere is no evidence of obstruction in the ventricular system or subarachnoid space.What further work-up should be performed to evaluate the hydrocphalus in this patient?A. PET scanB. cerebral angiogramC. lumbar punctureD. brain biopsyE. No further work-up is required

32. Edema caused by leakage of cerebrospinal fluid from the lateral ventricles into thesurrounding brain in a patient with obstructive hydrocephalus is termed:A. Hydrocephalus ex vacuoB. Vasogenic edemaC. Interstitial edemaD. Fungus cerebriE. Cytotoxic edema

33. Which of the following would cause communicating hydrocephalus?A. Putaminal hemorrhage with intraventricular extensionB. Organizing subarachnoid hemorrhageC. Subependymal giant cell astrocytoma compressing the foramen of MonroeD. Medulloblastoma extending into the 4th ventricleE. Colloid cyst of the third ventricle

34. Neurologic complications of alcohol abuse include all of the following, EXCEPT:A. Wernicke-Korsakoff syndromeB. rhabdomyolysisC. peripheral neuropathyD. Nigral depigmentation and neuronal lossE. Degeneration of the anterior/superior vermis

35. A family of four is found dead inside their 900 square foot apartment in the midst of winter. Their bodies are transported to the medical examiner's office and an autopsy performed on each. Their brains are examined and each brain is found to show bilateral necrosis of the globus pallidus. You immediately call the investigator to ask him to inspect which of the following?

A. recently received mail to evaluate for presence of anthraxB. bacterial contamination of food in the family's refrigeratorC. source of lead toxicity in interior paint or water pipesD. arsenic in prepared foods in the homeE. central heating for production of carbon monoxide

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36. A 66 year old man develops dementia, anemia, ataxia, lower extremity weakness, andtingling in lower extremities. MRI of the spine confirms atrophy of both the posterior andlateral columns of the spinal cord (subacute combined degeneration). Which vitamindeficiency is MOST LIKELY in this patient?A. FolateB. Vitamin AC. Vitamin B1D. Vitamin B12E. Vitamin C

37. Which of the following forms of stroke has the highest mortality rate?A. atherothrombotic cerebral infarctionB. subarachnoid hemorrhageC. intracerebral hemorrhageD. embolic strokeE. transient ischemic attack

38. A seventeen year old male attends a party and abuses inhalational nitrous oxide. In attempts to enhance the effect, the young man inflates a plastic bag with nitrous oxide, and places his head inside. With this technique, the young man effectively provides himself with no oxygenation, passes out, and proceeds to cardiopulmonary arrest. Astute friends at the party quickly pull the bag off of his head, initiate CPR, and he is successfully resuscitated. He is taken to a hospital and remains stable. Given the known vulnerability of neurons to ischemia in the CNS, which region is the MOST LIKELY to have been injured?

A. Cortical layers 1, 2, and 4B. T4 region of the spinal cordC. PutamenD. Caudate nucleiE. Sommer's sector of the hippocampus

39. Which of the following is NOT a potential neurologic complication of hypertension?A. Alzheimer type 2 astrocytosisB. intraventricular ruptureC. lacunar infarctsD. intraparenchymal hemorrhageE. formation and rupture of saccular aneurysms

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40. A 28 year old male complains of feeling a "popping" sensation in his head, followed by a headache which he feels is the "worst headache I've ever experienced." He has no family history of headaches, nor migraines. He has experienced no trauma. He is afebrile with a blood pressure of 130190mmHg. Your neurologic exam reveals no focal abnormalities and is normal except for a mild meningismus. You perform a lumbar puncture which reveals a red-rusty colored CSF. Stat examination of the CSF shows numerous red cells, and very rare white blood cells. CBC is normal. Given your evaluation thus far and considering your MOST LIKELY diagnosis, you would proceed with:

A. a cerebral artery angiogram to evaluate for a saccular aneurysmB. Treatment for migraine headachesC. empiric antibiotics for treatment of meningitisD. echocardiogram to evaluate for endocarditisE. a brain biopsy to evaluate for an encephalitis

41. A 23 year old woman presents to the ER with contractions. She is experiencing sharp pain with each contraction and vomits on several occasions. She is placed NPO (not permitted to drink or eat anything) and is in labor for a total of 18 hours. An IV is not started, and she becomes dehydrated. In the final stages of labor, she is asked to push hard with each contraction, and a healthy baby girl is successfully delivered. The mother subsequently vomits more convulses, and quickly becomes comatose. CT scan confirms bilateral, parasagittal wedge-shaped cerebral hemispheric hemorrhages. Your diagnosis is:

A. Hypertensive hemorrhageB. Disseminated intravascular coagulopathyC. Embolic strokeD. Ruptured saccular aneurysmE. Superior sagittal sinus thrombosis

42. A 32 year old male from Brownsville, TX is admitted with multiple cranial nerve deficits, confusion, fever, night sweats, and meningismus. Lumbar puncture confirms numerous mononuclear cells (lymphocytes and macrophages), mild increase in protein and normal glucose. Gram stain on CSF is negative, cryptococcal antigen is negative, and CSF VDRL (for syphilis) is negative. MRI shows enhancement and thickening of basilar meninges, consistent with a basilar meningitis. Because of the basilar meningitis, an early communicating hydrocephalus is also identified. Given this information, which of the following is the MOST LIKELY diagnosis?

A. Progressive multifocal leukoencephalopathyB. Tuberculous meningoencephalitisC. Amoebic meningoencephalitisD. Primary HIV encephalitisE. Herpes simplex encephalitis

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43. In desquamative interstitial pneumonia, the alveolar spaces becomefilled with:A. Transformed lymphocytesB. Type 1 pneumocytesC. Type 2 pneumocytesD. MacrophagesE. Neutrophiis

44. A 58 year old woman develops rapidly progressive dementia. Physical exam confirmsstartle myoclonus. EEG demonstrates high voltage periodic discharges. A brain biopsyis obtained, and the neuropathologist reports cortical spongiosis. Which of the followingdiagnoses is confirmed by this brain biopsy:A. respirator brainB. Alzheimer's diseaseC. Pick's diseaseD. Creutzfeldt-Jacob diseaseE. progressive multifocal leukoencephalopathy

45. Which of the following IS NOT a typical neurologic infection complicating HIV?A. Progressive multifocal leukoencephalopathyB. Cryptococcal meningitisC. Cytomegaloviral encephalitisD. Naegleria fowleriE. Toxoplasma abscesses

46. A 1 year old boy staying at home with his mother's boyfriend is found to be irritable, lethargic, and with episodic vomiting. Upon the mother's arrival home, the boyfriend updates the mother of the child's illness. After she checks on him in his crib, she finds him somnolent. Upon awakening, he convulses. She quickly takes his temperature, which is normal and asks the boyfriend to call for an ambulance. Upon inspection in the emergency room, the child is found to be stuporous. Fundoscopic examination confirms small retinal hemorrhages. An emergency CT scan shows bilateral subdural hematomas and diffuse cerebral edema. No skull fractures are present. What is the MOST LIKELY diagnosis?

A. Herpes simplex encephalitisB. Shaken baby syndromeC. Thrombotic thrombocytopenic purpuraD. Superior sagittal sinus thrombosisE. Haemophilus influenza meningitis

47. A 33 year old woman develops rapid onset of flaccidity and weakness one week after aflu-like illness. You confirm that she is afebrile, has decreased motor strength in allextremities, is areflexic in both lower extremities, and hyporeflexic in both upperextremities. Lumbar puncture confirms a markedly increased CSF protein level, normalglucose, and no cells. Her respiratory effort is severely decreased, as determined byforced expiratory volume at 1 sec (FEV1). The MOST LIKELY diagnosis based onthese clinical findings is:

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A. progressive multifocal leukoencephalopathyB. superior sagittal sinus thrombosisC. Guillain-Barre syndromeD. central pontine myelinolysisE. multiple sclerosis

48. A 10 year old develops visual disturbances. MRI of the brain confirms bilateralsymmetrical regions of demyelination in the parietooccipital white matter sparingsubcortical U-fibers. Lipids contained within urine samples of this patient are stainedwith toluidine blue, and the material turns a brown-black color. The patient's MOSTLIKELY diagnosis is:A. Multiple sclerosisB. Krabbe's diseaseC. Metachromatic leukodystrophyD. Progressive multifocal leukoencephalopathyE. Acute hemorrhagic encephalomyelitis

49. A 10 year old boy exhibits severe proximal muscle weakness, calf pseudohypertrophy,and Gower's sign. Molecular studies confirm the diagnosis of Duchenne's musculardystrophy. Which ONE of the following is true?A. If he has children, hereditary anticipation should be expectedB. His serum CPK will be normalC. Death ensues by 20-30 years of ageD. His muscle biopsy will contain diagnostic "ragged-red" fibersE. He will become wheelchair bound beginning at about 40 years of age.

50. Which set of neuromuscular disorders are NOT USUALLY associated with an elevatedserum CPK?A. RhabdomyolysisB. DystrophinopathiesC. Inflammatory myopathiesD. Mitochondrial myopathiesE. Glycogen storage disorders (Pompe's and McArdte's diseases)

51. Which of the following disorders is associated with malignant hyperpyrexia (neurolepticmalignant syndrome)?A. McArdle's diseaseB. Central core diseaseC. Myotonic dystrophyD. Duchenne's muscular dystrophyE. Mitochondrial myopathy

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52. A 44 year old male develops cardiogenic shock after a large anterolateral wallmyocardial infarction. Shortly after an episode of prolonged hypotension corrected byadministration of dopamine and dobutamine, the patient was stabilized. He thendeveloped mild to moderate oliguria and sharp rise in BUN and creatinine. His renalfunction improves over the course of several weeks with supportive therapy, andoliguria resolves. What is the MOST LIKELY diagnosis?A. Henoch-Schonlein purpuraB. Toxic acute tubular necrosisC. PyelonephritisD. Obstructive uropathyE. lschemic acute tubular necrosis

53. Which of the following clinical manifestations is NOT a characteristic feature ofnephritic syndrome?A. hematuriaB. anuriaC. red cell castsD. fluid overload with hypertensionE. renal insufficiency

54. Which of the following is a cause of prerenal azotemia (prerenal acute renal failure)?A. acute rejectionB. renal artery thrombosisC. prostatic hypertrophyD. crescentic glomerulonephritisE. acute interstitial nephritis

55. A 40 year old woman with chronic low back pain presents to your clinic with complaintsof flank pain, low grade fever, arthralgias in most major joints (knees, shoulders, hips),skin rash of recent onset, and decreased urine output. She has recently been takingnonsteroidal anti-inflammatory agents in markedly increased amounts to counter anexacerbation of back pain. You order a urinalysis which shows proteinuria, eosinophils,granular casts, few red cells, and renal tubular epithelial cells. CBC confirms a mildleukocytosis and blood eosinophilia. Which of the following is the MOST LKELYdiagnosis given this clinical information:A. Cast nephropathyB. Obstructive uropathyC. Acute tubular necrosisD. Crescentic glomerulonephritisE. Acute interstitial nephritis

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56. The acute renal failure that occurs in "myeloma kidney" (cast nephropathy) is mostly aresult of WHICH ONE of the following?A. tubular damage from Bence Jones proteinB. obstructive uropathyC. vasculitis of afferent arteriolesD. renal artery stenosis and thrombosisE. crescentic formation and segmental glomerular necrosis

57. Which disease is considered a form of thrombotic microangiopathy AND IS MOSTCOMMONLY associated with central nervous system abnormalities?A. Polyarteritis nodosaB. disseminated intravascular coagulopathyC. thrombotic thrombocytopenic purpuraD. hemolytic uremic syndromeE. Henoch-Schonlein purpura

58. A 42 year old African-American male presents to the emergency room with confusionand a blood pressure of 2401150mmHg. CT scan confirms a left putaminalhemorrhage, corroborating your physical exam findings. He dies soon after admissiondespite aggressive therapy. An autopsy is requested and consented for by familymembers. You drop by the morgue just as the pathologist is examining the kidneys. Henotes that the kidneys have a granular cortex and small infarcts are scatteredthroughout the cortex. He also notes the presence of tiny cortical hemorrhagesthroughout both kidneys, and describes them as "flea-bitten." What is the MOSTLIKELY diagnosis?A. disseminated intravascular coagulopathyB. diabetes mellitusC. malignant nephrosclerosisD. Polyarteritis nodosaE. Henoch-Schonlein purpura

59, Which of the following are possible manifestations of polycystic kidney disease?A. NephrolithiasisB. Saccular aneurysmsC. HematuriaD. All of the aboveE. Hepatic cysts

60. Alzheimer's disease is more frequent in:A. Men than women.B. Whites than Blacks.C. Blacks than Hispanics.D. Whites than HispanicsE. Women than men.

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61. Which two diseases together account for more than half of cases of end-stage renaldisease?A. polycystic kidney disease and minimal change diseaseB. diabetes mellitus and hypertensionC. crescentic glomerulonephritis and post-streptococcal glomerulonephritisD. analgesic abuse nephropathy and membranous glomerulonephritisE. diabetes mellitus and polyarteritis nodosa

62. The MOST important prognosticator for lung cancer is:A. smoking historyB. the patient's ageC. the histologic type of the tumorD. the stageE. the lobe that is involved

63. A 60 year old male with hypertension, diabetes, gout, and peptic ulcer disease presentsto the emergency room with intraabdominal pain and decreased urinary output. Furtherwork-up and evaluation confirms urolithiasis with obstruction of the left ureter andproximal ureteral dilatation. A radiolucent defect is detected at the site of ureteralobstruction with the intravenous pyelogram. What is the MOST LIKELY cause of thisobstruction?A. Calcium phosphate stoneB. Struvite stoneC. Bladder atonyD. Uric acid stoneE. Prostatric hypertrophy

64. Asbestos exposure can cause which of the following lesions?A. Bronchogenic carcinomaB. All of the aboveC. Benign pleural effusionD. Fibrous plaques of the parietal pleuraE. Peritoneal mesothelioma

65. A 30 year old woman has had recurrent bouts of pyelonephritis. Your work-up forcontributing factors to this infection should include evaluation for all of the followingEXCEPT:A. diabetes insipidusB. lower urinary tract tumor.C. vesicoureteral refluxD. congenital anomalies of the urinary tractE. urolithiasis

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66. Primary glioblastoma multiforme is characterized by:A. A "ring-enhancing" pattern on MRI.B. Median survival of approximately 12 months.C. Necrosis.D. All of the above.E. EGFR amplification

67. All of the following are potential clinical manifestations of urolithiasis, EXCEPT:A. abdominal painB. hematuriaC. oliguriaD. acute tubular necrosisE. urinary tract infection

68. Lymphocytic interstitial pneumonia is MOST accurately classified as:A. A neoplasmB. An idiopathic granulomatous inflammationC. An idiopathic fibrosing inflammationD. A viral infectionE. A bacterial infection

69. A 66 year old male smoker who worked for 20 years with a lawn fertilizer company wasfound to have hematuria on a routine physical exam. Eventual work-up led toperformance of cystoscopy. A 6 x 8 cm papillary bladder tumor was noted andbiopsied. The pathologist reported the diagnosis, but did not give further details. Youcall her up to ask if she is able to provide you with more details to assess prognosis forthis patient, based on the biopsy. What is the most important determinant in assessingprognosis for this patient?A. Determining whether in-situ tumor is present or notB. Determining the size of the tumorC. Determining the depth of invasion in millimetersD. Determining whether the tumor has invaded the inner third or outer two-thirds of the

muscularis propriaE. Determining the amount of necrosis in the tumor

70. Which form of bladder tumor is increased in incidence in association with infection bySchistosoma hematobium?A. Transitional cell carcinomaB. AdenocarcinomaC. Squamous carcinomaD. Transitional papillomaE. Papillary transitional carcinoma

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71. The most frequent form of Alzheimer's disease is:A. Sporadic.B. Caused by mutation of the amyloid precursor protein (APP) gene.C. Caused by mutations of the presenilin 1 gene.D. Caused by mutations of the presenilin 2 gene.E. Caused by mutations of the ApoE ?4 gene.

Match the age group in the left column with the organism on the right MOST LIKELY tocause an acute pyogenic meningitis. Each answer can be used once, more than onceor not at all.

72. neonate A. Listeria monocytogenes73. infant B. Group B streptococci74. young adult C. Neisseria meningitidis75. elderly D. Pneumococcus

E. Flaemophilus influenza

76. In a dead body, all of the following phenomena are typically observed, EXCEPT:A. Bullae of the skinB. Desiccation of mucous membranes exposed to dry airC. Greenish discolorationD. Gaseous distention of body cavitiesE. Adipocere formation

Match the form of traumatic injury in the left column with its associated condition in theright column. Each answer may be used once, more than once, or not at all.

77. diffuse axonal injury A. falls on buttocks78. ring skull fracture B. middle meningeal artery laceration79. epidural hematoma C. angular head acceleration80. spinal cord injury D. mostly males

Match the nutritional deficiency in the left column with the clinical manifestations in theright column. Each answer can be used once, more than once, or not at all.

81. Vitamin A deficiency A. flag and flaky paint signs82. Kwashiorkor B. rickets83. Vitamin D deficiency C. keratomalacia84. Folate deficiency D. neural tube defects

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Match the renal or urinary tract tumor on the left with its most closely associated featureon the right. Each answer may be used once, more than once or not at all.

85. Clear cell renal carcinoma A. Michaelis-Gutmann bodies86. Transitional cell bladder carcinoma B. aniline dyes87. Papillary renal cell carcinoma C. 3p deletion88. Malakoplakia D. trisomy chromosomes 7 and 17

89. Which of the following weapons is MOST LIKELY to cause a laceration?A. StilettoB. Knife with serrated bladeC. Knife with non-serrated bladeD. Butt of a rifleE. Ice pick

90. A 5-year-old boy has an enhancing tumor nodule in the vermis of the cerebellumpartially obstructing the 4th ventricle with consequent obstructive hydrocephalus.Which answer includes the two MOST LIKELY entities that should be included in yourdifferential diagnosis?A. Medulloblastoma and ependymomaB. Anaplastic astrocytoma and schwannomaC. Pilocytic astrocytoma and central neurocytoma.D. Schwannoma and neurofibroma.E. Capillary hemangioblastoma and glioblastoma.

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ANSWERS1. B2. E3. A4. B5. A6. A7. B8. C9. E10. D11. A12. B13. E14. C15. D16. A17. B18. E19. E20. B21. C22. D23. A24. E25. B26. D27. A28. B29. D30. D31. E32. C33. B34. D35. E36. D37. C38. E39. A40. A41. E42. B43. D44. D45. D

46. B47. C48. C49. C50. D51. B52. E53. B54. B55. E56. A57. C58. C59. D60. E61. B62. D63. D64. B65. A66. D67. D68. A69. D70. C71. A72. B73. E74. C75. D76. E77. C78. A79. B80. D81. C82. A83. B84. D85. C86. B87. D88. A89. D90. A

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