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ADVANCE PATHOLOGY > 2nd BM Exam > Flashcards

2nd BM Exam Flashcards

1
Q

Most common drug of abuse:

a. ethanol
b. antidepressants
c. NSAID
d. cocaine
e. barbiturates

A

a. ethanol

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2
Q

Arsenic

a. commonly add in herbicides, rodenticide
poisons
b. may be detected in hair, nails and urine
c. Detected from hairs
d. Can cross placenta
e. A, b and c are correct

A

e. A, b and c are correct???

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3
Q

Screening the drugs of abuse usually done in these settings

a. Forensic testing
b. Emergency code
c. Employment
d. Rapid, stat screening
e. All are correct

A

e. All are correct

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4
Q

Manifestation of acute toxicity

a. cardiovascular symptoms, tachypnea,
hypotension, etc
b. hyperpyrexia
c. mental symptoms: delirium, confusion
d. all are correct

A

d. all are correct

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5
Q

Time taken for 1⁄2 of a drug thats was initially present in serum to be excreted

a. half life
b. elimination
c. excretion
d. diffusion factor
e. distribution

A

a. half life

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6
Q

major drug/s of abuse

a. opiates, morphine
b. tranquilizers, diazepam
c. barbiturates
d. cocaine
e. all are correct

A

e. all are correct

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7
Q

The following statement are TRUE about the major drugs of abuse, except:

a. except for cannabinoids and barbiturates, all are basic amino group containing compounds
b. The acidic drugs are separated by extraction in the TLC test and separated from the basic drugs
c. Serum is the best sample for use in the concentration and extraction procedure in the chromatography accessibility and easy extractability of compounds
d. The most abused drug are cannabinoids
e. No exception

A

e. No exception

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8
Q

MATCHING TYPE

Slurred speech, incoordination, stupor, coma

a. Ethanol
b. Iron
c. Carbon monoxide
d. Aspirin
e. cyanide

A

a. Ethanol

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9
Q

MATCHING TYPE

Metabolic acidosis

a. Ethanol
b. Iron
c. Carbon monoxide
d. Aspirin
e. cyanide

A

d. Aspirin

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10
Q

MATCHING TYPE

Odor of bitter almonds, metabolic acidosis

a. Ethanol
b. Iron
c. Carbon monoxide
d. Aspirin
e. cyanide

A

e. cyanide

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11
Q

MATCHING TYPE

dyspnea/respiratory, neurologic, cardiac coma

a. Ethanol
b. Iron
c. Carbon monoxide
d. Aspirin
e. cyanide

A

C. Carbon Monoxide

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12
Q

Analgesia

a. Cocaine
b. Diazepam
c. Morphine
d. Phenobarbital barbiturate
e. cannabis

A

c. Morphine

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13
Q

To induce local anesthesia in nasopharyngeal surgery

a. Cocaine
b. Diazepam
c. Morphine
d. Phenobarbital barbiturate
e. cannabis

A

a. Cocaine

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14
Q

Mind-altering, diminishes anxiety

a. Cocaine
b. Diazepam
c. Morphine
d. Phenobarbital barbiturate
e. cannabis

A

e. cannabis

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15
Q

“Calming effect” tranquilizer

a. Cocaine
b. Diazepam
c. Morphine
d. Phenobarbital barbiturate
e. cannabis

A

b. Diazepam

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16
Q

TRUE OR FALSE

All drugs are eventually excreted, either unchanged or as metabolites

A

TRUE

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17
Q

TRUE OR FALSE

Steady-state-concentration” is the same as the “half-life” of a drug

A

FALSE

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18
Q

TRUE OR FALSE

The chief value of the chromatography method is confirmation of the initial screening methods

A

TRUE

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19
Q

TRUE OR FALSE

Acute poisoning is usually irreversible, thus utilization of the homogenous assays are useless for detection in the ER

A

FALSE

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20
Q

After the donor’s blood had been screened for infectious disease and been found possible candidate for apheresis donation, what are other qualification that must be satisfied?

a. Check the frequency of donation and or apheresis donation
b. Eligibility of the donor for apheresis donation
c. Amount of product allowed to be collected
d. Instruments to be used for the collection
e. All of the above are correct

A

e. All of the above are correct

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21
Q

Extracorporeal photopheresis/extracorporeal chemotherapy:

a. The cells in the buffy coat are incubated and irradiated before reinfused to the patient
b. There is clean separation of WB into plasma and buffy coat
c. Treatment of cutaneous T-cell lymphoma (CTCL)
d. All are correct

A

d. All are correct

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22
Q

fluids that can be used as replacement in therapeutic plasma exchange, except

a. Fresh frozen plasma
b. Whole blood
c. HES and other synthetic colloid fluid
d. Albumin
e. Saline

A

b. Whole blood

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23
Q

Most common reactions to donor apheresis except:

a. Hypocalcemia
b. Vasovagal reactions/syncope
c. Transfusion reaction from replacement fluid
d. tetany/seizures
e. Hematoma or pain in the site

A

c. Transfusion reaction from replacement fluid

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24
Q

risks/complication from repeated therapeutic plasma exchange

a. Bleeding
b. Allergic reactions
c. Immunodeficiency
d. Disease transmission
e. Only a and c are correct

A

e. Only a and c are correct

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25
Q

Substances used to stimulate increase in blood component in the donor (donor stimulation)

a. Steroids
b. Colony stimulating factors (G-CSF,
GM-CSF)
c. Cytokines
d. Growth factors
e. A, b and c are correct

A

e. A, b and c are correct

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26
Q

Mechanisms of action of TPE/Therapeutic plasma exchange

a. Removal of disease-causing substances from the blood
b. Replacement of deficient substances by utilizing plasma from healthy donors as the replacement fluid
c. Removal of coagulation factors and immunoglobulins
d. Removal of platelets from patient with essential thrombocytosis to prevent stroke
e. A and b are correct

A

e. A and b are correct

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27
Q

Benefits of red blood cell exchange by apheresis compared with simple/chronic transfusion

a. Use of fewer units of RBCs to achieve the same percentage of hemoglobin S
b. Decreased contribution to iron overload in chronically transfused patients
c. Treat hyperparasitemia
d. Treat coagulation factor deficiencies
e. A, b, and c are correct

A

e. A, b, and c are correct

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28
Q

patient was admitted for symptoms of hyperleukocytosis and recommended for leukocytapheresis. The following statements are true of leukocytapheresis, except
a. The goal is to lower the WBCs to relieve patient’s symptoms
b. Reduction of WBCs by apheresis is permanent
c. The cause of hyperleukocytosis may be malignant of nonmalignant disease
d. Symptoms of leukostasis and vaso
occlusive disorders
e. No exception

A

b. Reduction of WBCs by apheresis is permanent

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29
Q

A 1 to 1.5 plasma volume exchange will remove

a. 70% of a substance located within the plasma
b. 30% of a substance located within the plasma
c. Additional plasma volumes will remove the same percentage of remaining substance in the blood
d. All are correct
e. All are correct expect b

A

a. 70% of a substance located within the plasma

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30
Q

“Frequent” donor, except

a. Donates more frequently than every 4
weeks
b. Platelet count must be >1,000,000/uL,
determined before each donation
c. Total serum protein of at least 6.0 g/dL, determined before each donation
d. Annual physical examination by a
physician
e. Limited to 2 donations within a 7-day
period with at least 2 days between donations

A

b. Platelet count must be >1,000,000/uL, determined before each donation

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31
Q

Essential thrombocytopenia

a. Red cell exchange
b. Therapeutic plasma exchange (TPE)
c. Platelet apheresis
d. Plasmapheresis
e. Erythrocytapheresis

A

c. Platelet apheresis

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32
Q

Thrombotic thrombocytopenia purpura

a. Red cell exchange
b. Therapeutic plasma exchange (TPE)
c. Platelet apheresis
d. Plasmapheresis
e. Erythrocytapheresis

A

b. Therapeutic plasma exchange (TPE)

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33
Q

Sickle cell disease

a. Red cell exchange
b. Therapeutic plasma exchange (TPE)
c. Platelet apheresis
d. Plasmapheresis
e. Erythrocytapheresis

A

a. Red cell exchange

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34
Q

Prevent tumor lysis syndrome/leucostasis

a. Erythrocytapheresis
b. Leukocytapheresis
c. Red cell exchange
d. Platelet apheresis
e. Therapeutic plasma exchange (TPE)

A

b. Leukocytapheresis

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35
Q

Improved incompatible organ transplants due to removal of pathologic antibodies

a. Erythrocytapheresis
b. Leukocytapheresis
c. Red cell exchange
d. Platelet apheresis
e. Therapeutic plasma exchange (TPE)

A

e. Therapeutic plasma exchange (TPE)

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36
Q

Decreased amount of Hgb S without increasing the hematocrit

a. Erythrocytapheresis
b. Leukocytapheresis
c. Red cell exchange
d. Platelet apheresis
e. Therapeutic plasma exchange (TPE)

A

c. Red cell exchange

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37
Q

Platelet apheresis

a. 4 weeks
b. 2 days
c. 30 weeks
d. 16 weeks
e. 8 weeks

A

b. 2 days

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38
Q

Two-unit red cell collection

a. 4 weeks
b. 2 days
c. 30 weeks
d. 16 weeks
e. 8 weeks

A

d. 16 weeks

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39
Q

Plasma apheresis

a. 4 weeks
b. 2 days
c. 30 weeks
d. 16 weeks
e. 8 weeks

A

a. 4 weeks

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40
Q

TRUE OR FALSE

Cytokines like the G-CSF and GM-CST (granulocyte-monocyte colony stimulating factor) can dramatically increase the presence of HPC (hematopoietic progenitor cells in the peripheral blood)

A

TRUE

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41
Q

TRUE OR FALSE

The maximum amount of blood allowed to be out of the Donor in the tubings, etc is 100 ml/kg of the donor’s body weight

A

FALSE

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42
Q

TRUE OR FALSE

Red cell exchange/therapeutic erythrocytapheresis most commonly used in the treatment of sickle cell disease

A

TRUE

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43
Q

TRUE OR FALSE

Fresh frozen plasma can be used to manufacture derivative products like coagulation factor concentrates

A

TRUE

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44
Q

TRUE OR FALSE

Therapeutic plasma exchange is a highly selective process where only the component/s needed are removed from the donor

A

FALSE

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45
Q

A. TRUE
B. FALSE
C. EITHER
D. CANNOTBEDETERMINED

Frozen section is indicated in patients with a fine needle aspiration biopsy reading of their thyroid mass as SUGGESTIVE OF FOLLICULAR NEOPLASM.

A

True

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46
Q

A. TRUE
B. FALSE
C. EITHER
D. CANNOTBEDETERMINED

In frozen section, the Pathologist is expected to provide a specific diagnosis but this need not be the case. In some instances, telling the surgeon “Widen the surgical margins, “Do a lobectomy”. or “Stop there” may be far more useful than providing a very sophisticated microscopic diagnosis.

A

A. TRUE

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47
Q

Frozen section is indicated in patient with Hirschsprung’s disease to determine the segment of the intestine in which the ganglion cells are present.

A. TRUE
B. FALSE
C. EITHER
D. CANNOTBEDETERMINED

A

True

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48
Q

In breast masses, the frozen section is indicated to confirm the diagnosis of carcinoma if fine needle aspiration biopsy or core needle biopsies are inconclusive prior to major radical surgery.

A. TRUE
B. FALSE
C. EITHER
D. CANNOTBEDETERMINED

A

A. TRUE

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49
Q

Accurate staging is necessary to evaluate the results of treatments and clinical trials, to facilitate the exchange and comparison of information among treatment centers, and to serve as a basis for clinical and translational cancer research.

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

A

A. TRUE

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50
Q

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

In cancer staging, Non-anatomic factors about a cancer and its host do not provide critical prognostic information.

A

B. FALSE

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51
Q

When a patient receives presurgical treatment and has a post therapy nyc- or yp-TNM stage, the stage used for surveillance analysis and for comparison purposes is the clinical stage before the start of therapy.

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

A

A. TRUE

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52
Q

The rTNM classification changes the original clinical or pathologic staging of the case.

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

A

B. FALSE

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53
Q

If there is pathologic evidence of metastases (pM1), it may be used with clinical T and N information to define clinical Stage IV and pathologic Stage IV.

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

A

A. TRUE

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54
Q

Metachronous primary tumors in single organ (not recurrence), Stage based on clinical suspicion of primary tumor (e.g., TO N1 MO Group IIA breast cancer).

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

A

B. FALSE

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55
Q

The classification of pTis cN0 cM0 may be used to define both clinical and pathologic stage for in situ carcinoma

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

A

A. TRUE

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56
Q

The clinical (pretreatment) stage assigned on the basis of information obtained prior to cancer-directed treatment is not changed on the basis of subsequent information obtained from pathologic examination of resected tissue or from information obtained after initiation of definitive therapy

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

A

False

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57
Q

Frozen section is indicated in Mohs’ procedure

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

A

A. TRUE

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58
Q

Clinical M status (M0 or M1) CANNOT be mixed with pathologic T and N information to define pathologic stage

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

A

A. TRUE

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59
Q

Frozen section is indicated to those who do not have palpable breast mass but on mammogram has calcification

A. TRUE
B. FALSE
C. EITHER
D. CANNOT BE DETERMINED

A

B. FALSE???

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60
Q

a. CLINICAL STAGING
b. PATHOLOGICAL STAGING
c. ROBBINS STAGING

includes any information obtained about the extent of cancer before initiation of definitive treatment (surgery, systemic or radiation therapy, active surveillance, or palliative care)

A

a. CLINICAL STAGING

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61
Q

defined by the same diagnostic studies used for clinical staging supplemented by findings from surgical resection and histologic examination of the surgically removed tissues.

a. CLINICAL STAGING
b. PATHOLOGICAL STAGING
c. ROBBINS STAGING

A

b. PATHOLOGICAL STAGING

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62
Q

documents the extent of the disease for patients whose first course of therapy includes systemic or radiation treatment prior to surgical resection or when systemic therapy or radiation is the primary treatment with no surgical resection.

a. CLINICAL STAGING
b. PATHOLOGICAL STAGING
c. ROBBINS STAGING
D. POST THERAPY STAGING

A

D. POST THERAPY STAGING

63
Q

TX
Tis
T0
T1, T2, T3, T4

Primary tumor cannot be assessed

A

TX

64
Q

TX
Tis
T0
T1, T2, T3, T4

No evidence of primary tumor

A

T0

65
Q

TX
Tis
T0
T1, T2, T3, T4

Carcinoma in situ

A

Tis

66
Q

TX
Tis
T0
T1, T2, T3, T4

Increasing size and/or local extension of the primary tumor

A

T1, T2, T3, T4

67
Q

Nx
N0
N1, N2, N3

Increasing number or extent of regional lymph node involvement.

A

N1, N2, N3

68
Q

Nx
N0
N1, N2, N3

No regional lymph node metastases

A

N0

69
Q

Nx
N0
N1, N2, N3

Regional lymph nodes cannot be assessed

A

Nx

70
Q

50% sons, 50% daughters
0% sons, 100% daughters
0% sons, all carrier daughters
50% sons, half carrier daughters
100% sons, 100% daughters

X-linked DOMINANT, affected FATHER

A

0% sons, 100% daughters

71
Q

50% sons, 50% daughters
0% sons, 100% daughters
0% sons, all carrier daughters
50% sons, half carrier daughters
100% sons, 100% daughters

X-LINKED recessive; affected FATHER

A

0% sons, all carrier daughters

72
Q

50% sons, 50% daughters
0% sons, 100% daughters
0% sons, all carrier daughters
50% sons, half carrier daughters
100% sons, 100% daughters

X-linked recessive; carrier MOTHER

A

50% sons, half carrier daughters

73
Q

50% sons, 50% daughters
0% sons, 100% daughters
0% sons, all carrier daughters
50% sons, half carrier daughters
100% sons, 100% daughters

MITOCHONDRIAL INHERITANCE

A

100% sons, 100% daughters

74
Q

50% sons, 50% daughters
0% sons, 100% daughters
0% sons, all carrier daughters
50% sons, half carrier daughters
100% sons, 100% daughters

X-linked DOMINANT; affected MOTHER

A

50% sons, 50% daughters

75
Q

To screen a disease gene for unknown mutations that may lie anywhere within it, the following mutation scanning techniques may be used, EXCEPT:

a. Single-strand conformation polymorphism (SSCP)
b. Denaturing gradient gel electrophoresis (DGGE)
c. Direct gene-mutation analysis
d. Denaturing high-performance liquid chromatography

A

c. Direct gene-mutation analysis

76
Q

The following have to justify the effort and expenditure required to perform Mass Population Screening:

a. The incidence of the disease must be sufficiently high
b. The carrier frequency should be a good deal higher than the prevalence of affected individuals
c. The candidate disease target much be sufficiently severe
d. The candidate disease target should be amenable to medical intervention upon identification
e. All of the above

A

e. All of the above

77
Q

Southern blotting

a. Identification of RNA
b. Identification of proteins
c. Identification of DNA

A

c. Identification of DNA

78
Q

Western blotting

a. Identification of RNA
b. Identification of proteins
c. Identification of DNA

A

b. Identification of proteins

79
Q

Northern blotting

a. Identification of RNA
b. Identification of proteins
c. Identification of DNA

A

a. Identification of RNA

80
Q

Carrier Screening

a. Detection of recessive mutations in healthy individuals for genetic counseling and family planning
b. Detection of inborn errors of metabolism
c. Performed on a symptomatic individual
d. Applied primarily to late-onset dominant
disorders DNA testing
e. The goal is to ascertain affected babies early in life

A

a. Detection of recessive mutations in healthy individuals for genetic counseling and family planning

81
Q

Newborn Screening

a. Detection of recessive mutations in healthy individuals for genetic counseling and family planning
b. Detection of inborn errors of metabolism
c. Performed on a symptomatic individual
d. Applied primarily to late-onset dominant
disorders DNA testing
e. The goal is to ascertain affected babies early in life

A

e. The goal is to ascertain affected babies early in life

82
Q

Diagnostic Screening

a. Detection of recessive mutations in healthy individuals for genetic counseling and family planning
b. Detection of inborn errors of metabolism
c. Performed on a symptomatic individual
d. Applied primarily to late-onset dominant
disorders DNA testing
e. The goal is to ascertain affected babies early in life

A

c. Performed on a symptomatic individual

83
Q

Penetrance

a. Refers to the proportion of individuals who, have inherited a mutant disease gene, will actually display the disease phenotype
b. Refers to the differential expression of a gene in an offspring, depending on whether it was inherited from the mother or the father
c. Refers to a progressive increase in severity and/or decrease in age of onset of a genetic disorder in subsequent generations of family
d. Are heritable but potentially reversible changes in gene expression

A

a. Refers to the proportion of individuals who, have inherited a mutant disease gene, will actually display the disease phenotype

84
Q

Anticipation

a. Refers to the proportion of individuals who, have inherited a mutant disease gene, will actually display the disease phenotype
b. Refers to the differential expression of a gene in an offspring, depending on whether it was inherited from the mother or the father
c. Refers to a progressive increase in severity and/or decrease in age of onset of a genetic disorder in subsequent generations of family
d. Are heritable but potentially reversible changes in gene expression

A

c. Refers to a progressive increase in severity and/or decrease in age of onset of a genetic disorder in subsequent generations of family

85
Q

Epigenetic changes

a. Refers to the proportion of individuals who, have inherited a mutant disease gene, will actually display the disease phenotype
b. Refers to the differential expression of a gene in an offspring, depending on whether it was inherited from the mother or the father
c. Refers to a progressive increase in severity and/or decrease in age of onset of a genetic disorder in subsequent generations of family
d. Are heritable but potentially reversible changes in gene expression

A

d. Are heritable but potentially reversible changes in gene expression

86
Q

Duchenne Muscular Dystrophy

a. Mutation in dystrophin
b. Caused by expansion of a (CTG)n repeat in the 3’ untranslated region of the myotonin protein kinase gene on chromosome 19q13.3
c. Factor V Leiden mutation
d. Most often is caused by deletion of a known gene (UBE3A) exclusively on the maternally inherited chromosome
e. Single missense mutation in HFE, C282Y, with tyrosine substitution for cystine at amino acid 282 in the HFE protein

A

a. Mutation in dystrophin

87
Q

Myotonic dystrophy

a. Mutation in dystrophin
b. Caused by expansion of a (CTG)n repeat in the 3’ untranslated region of the myotonin protein kinase gene on chromosome 19q13.3
c. Factor V Leiden mutation
d. Most often is caused by deletion of a known gene (UBE3A) exclusively on the maternally inherited chromosome
e. Single missense mutation in HFE, C282Y, with tyrosine substitution for cystine at amino acid 282 in the HFE protein

A

b. Caused by expansion of a (CTG)n repeat in the 3’ untranslated region of the myotonin protein kinase gene on chromosome 19q13.3

88
Q

Hereditary Thrombophilias

a. Mutation in dystrophin
b. Caused by expansion of a (CTG)n repeat in the 3’ untranslated region of the myotonin protein kinase gene on chromosome 19q13.3
c. Factor V Leiden mutation
d. Most often is caused by deletion of a known gene (UBE3A) exclusively on the maternally inherited chromosome
e. Single missense mutation in HFE, C282Y, with tyrosine substitution for cystine at amino acid 282 in the HFE protein

A

c. Factor V Leiden mutation

89
Q

Hemochromatosis

a. Mutation in dystrophin
b. Caused by expansion of a (CTG)n repeat in the 3’ untranslated region of the myotonin protein kinase gene on chromosome 19q13.3
c. Factor V Leiden mutation
d. Most often is caused by deletion of a known gene (UBE3A) exclusively on the maternally inherited chromosome
e. Single missense mutation in HFE, C282Y, with tyrosine substitution for cystine at amino acid 282 in the HFE protein

A

e. Single missense mutation in HFE, C282Y, with tyrosine substitution for cystine at amino acid 282 in the HFE protein

90
Q

The greater the heterogeneity, the user-friendly the results reporting and genetic counseling.

a. TRUE
b. FALSE
c. EITHER
d. CANNOT BE DETERMINED

A

b. FALSE

91
Q

The greater the heterogeneity, the more difficult, labor-intensive, and expensive the DNA test becomes

a. TRUE
b. FALSE
c. EITHER
d. CANNOT BE DETERMINED

A

a. TRUE

92
Q

a. TRUE
b. FALSE
c. EITHER
d. CANNOT BE DETERMINED

In newborn screening, the goal of molecular testing is to ascertain affected babies early in life before irreversible damage occurs.

A

a. TRUE

93
Q

Those for which the causative gene has been isolated

a. Polymorphic DNA markers
b. Direct gene/mutation analysis

A

b. Direct gene/mutation analysis

94
Q

Those for which the cause is unknown.

a. Polymorphic DNA markers
b. Direct gene/mutation analysis

A

a. Polymorphic DNA markers

95
Q

Benign liver diseases may be AFP elevations for up to 2 week. Interestingly, a form of liver cancer will have AFP elevations beyond 2 weeks. Thus, a doctor must:

a. Order same test from same laboratory using same kit
b. Be certain that tumor marker is elevated before surgery
c. Never rely on single laboratory test
d. Be aware of the presence of ectopic tumor

A

c. Never rely on single laboratory test

96
Q

For consistency of serial testing,
a. Order same test from same laboratory using same kit
b. Be certain that tumor marker is elevated before surgery
c. Never rely on single laboratory test
d. Be aware of the presence of ectopic
tumor

A

a. Order same test from same
laboratory using same kit

97
Q

A very important point to consider tumor recurrence or success of surgery.

a. Order same test from same laboratory using same kit
b. Be certain that tumor marker is
elevated before surgery
c. Never rely on single laboratory test
d. Be aware of the presence of ectopic
tumor

A

Be certain that tumor marker is
elevated before surgery

98
Q

A 1 year old infant was noted to have an enlarged abdomen. A CT scan was done revealing an 8 x 9 cm suprarenal mass. The attending physician was suspecting neuroblastoma than Wilms tumor. To specifically support the impression, the physician will most likely order the following enzyme to see if it is elevated.

a. Synaptophysin
b. VMA
c. Urinary catecholamines
d. Metanephrines

A

b. VMA

99
Q

A 32 year old was noted to have a 3 cm round hyperdense mass at the level of T8 left lung. Aspirate of the mass shows malignant small round cells that is positive for Bombesin. What is the most likely diagnosis?
a. Metastatic lymphoma
b. Adenocarcinoma
c. Oat-cell carcinoma
d. Granuloma cell tumor

A

c. Oat-cell carcinoma

100
Q

Elevations of AFP is seen in the following common ectopic tumor sites, except:
a. Ovarian
b. Gastrointestinal
c. Thyroid
d. Renal

A

c. Thyroid

101
Q

A 2 year old male was seen in the emergency room due to complaints of increasing pallor, weakness and easy bruising. CBC was generally normal but a note of “atypical blast-like cells” were seen. Bone marrow biopsy reveal a diagnosis of B-cell precursor lymphoblastic leukemia. To genetically confirm for this, patient will most likely exhibit

A. Full staining on reticulocytes and lymphoid cells
B. Abnormality in(8;21)/RUNXI-RUNXITI
C. Mutation on t(12;21)/ETV6-RUNX1
D. NPMI mutation

A

C. Mutation on t(12;21)/ETV6-RUNX1

102
Q

Positive for JAK2 V6l7F mutation except:

A. Primary myelofibrosis
B. Essential thrombocytosis
C. Polycythemia vera
D. Systemic mastocytosis

A

D. Systemic mastocytosis

103
Q

A 42 year old female was complaining of multiple pigmented maculopapular skin lesions all over the body. Biopsy reveals normal mast cells proliferation. A finding that can support this is

A. ElevatedlevelsofmelaninandCRP
B. KIT mutations
C. Bence jones protein in urine and blood
D. Positivity for chromogranin A

A

B. KIT mutations

104
Q

Marker(s) for multiple myeloma

A. Ig heavy and light chain
B. Bence Jones protein
C. B2M
D. All of the above

A

D. All of the above

105
Q

Significant increased alkaline phosphatase would most likely pinpoints defect in

A. Prostate
B. Bone
C. Pancreas
D. Salivarygland

A

B. Bone

106
Q

A 14 year old female was seen to have 4x6 cm left ovarian mass. Levels of inhibin are likewise elevated. The doctor would most likely do

A. Screening test for struma ovarii
B. Screening test for adrenal cortical
humor
C. Work up for Granulosa-cell tumor
D. Work up for Theca lutein cyst

A

C. Work up for Granulosa-cell tumor

107
Q

Thyroid mass with elevated calcitonin levels
A. Papillary thyroid carcinoma’
B. Medullary thyroid carcinoma
C. Lymphoma of thyroid
D. Follicular carcinoma of thyroid

A

B. Medullary thyroid carcinoma

108
Q

CA 125

A. Ovarian carcinoma
B. Pancreatic carcinoma
C. Gastric carcinoma
D. Breast carcinoma

A

A. Ovarian carcinoma

109
Q

CA 19-9

A. Ovarian carcinoma
B. Pancreatic carcinoma
C. Gastric carcinoma
D. Breast carcinoma

A

B. Pancreatic carcinoma

110
Q

Biopsy of a patient with breast cancer is positive for HER2/neu. This means
A. Patient can be given Herceptin to
block cancer growth
B. Patient can be givenT amoxifen
C. Patient must be radiated
D. Patient has ectopic sites

A

A. Patient can be given Herceptin to block cancer growth

111
Q

A 24 year old patient with recurrent gastric ulcer and elevated gastrin would most likely raise suspicion for
A. H.pylori infection
B. Zollinger-Ellison syndrome
C. Pancreatic duct mass
D. Duodenal cancer

A

B. Zollinger-Ellison syndrome

112
Q

A 0.8 cm benign pituitary adenomatous mass will most commonly yield

A. Increased growth hormone level
B. Increased prolactin level
C. Increased TSH
D. Increased cortisol

A

B. Increased prolactin level

113
Q

A 34 year old female presents to the emergency room with vaginal bleeding during sexual activity. Internal examination by the OBGYN revealed no laceration of the cervical os but noted a fungating cauliflower-like mass at the periphery that bleeds continuously. What major disease marker can be ordered for the patient to aid in the diagnosis?

A. CA125
B. SCC
C. HCG
D. Estrogen

A

B. SCC

114
Q

NPM1 Mutations

A. Chronic myeloid leukemia
B. Polycythemia vera
C. Acute promyelocytic leukemia
D. AML with normal karyotype

A

D. AML with normal karyotype

115
Q

Genetic abnormalities in myeloid neoplasms are usually diagnosed thru

A. FISH
B. PCR
C. Both A and B
D. Biopsy

A

C. Both A and B

116
Q

CEA (Carcino Embryonic Antigen)

A. Lung Cancer
B. Colon Cancer
C. Carcinoids
D. Cushing syndrome

A

B. Colon Cancer

117
Q

Serologic tests of an anemic patient reveal the following: LASA-P: INCREASED. Ferritin: INCREASED

A. B cell chronic lymphocytic leukemia
B. Hodgkin disease
C. Waldenstrom’s disease
D. Hairy cell leukemia

A

B. Hodgkin disease

118
Q

Serologic tests of an anemic patient reveal the following result: Increased Ferritin
A. Splenic tumor
B. Multiple myeloma
C. Melanoma
D. None of the above

A

A. Splenic tumor

119
Q

Elevated metanephrine in severely hypertensive patient

A. Cushing’s syndrome
B. Pheochromocytoma
C. Brain infarction
D. None of the above

A

B. Pheochromocytoma

120
Q

At the growth factor receptor level, the following are the mechanisms by which uncontrolled mitogenesis may be initiated:

A. Over expression of the receptor that results in many activation process and continuous signaling to the nucleus
B. The ECD is either absent or cleaved off by intracellular proteases, leading to spontaneous dimerization.
C. A mutation in the growth factor receptor receptor gene results in an amino acid substitution resulting in spontaneous dimerization
D. 2nd & 3rd choices only
E. All of the above

A

E. All of the above

121
Q

Using a cutoff value of 67.9 ng/mL the sensitivity and specificity of serum EGFr is as
high as 93.3% and 98% respectively, for detection of this neoplasm:

A. Glioblastoma multiforme
B. Asbestos-associated mesothelioma
C. Prostate cancer

A

C. Prostate cancer

122
Q

The most frequently mutated tumor suppressor gene in human cancer

A. Suppressor p53 gene
B. Minichromosome maintenance proteins (MCM5)
C. Ras
D. Nuclear matrix proteins (NMPs)
E. Raf

A

A. Suppressor p53 gene

123
Q

The following statements are correct regarding molecular changes in Neoplasia

A. The malfunctioning of mutant proteins is the central cause of human cancers
B. Mutations in proteins result in amino acid substitutions or deletions
C. Mutations in proteins can lead either to its permanent activation or deactivation
D. Protein overexpression can result in continuous mitogenic signaling
E. All of the above

A

E. All of the above

124
Q

A. TRUE
B. FALSE
C. CANNOT BE DETERMINED

The more such mutations occur, the more likely it is that the cell will undergo malignant transformation.

A

TRUE

125
Q

A. TRUE
B. FALSE
C. CANNOT BE DETERMINED

High levels in serum PDGF indicate the presence of malignancy specifically for platelet or megakaryocytes.

A

B. FALSE

126
Q

A. TRUE
B. FALSE
C. CANNOT BE DETERMINED

Higher levels of serum levels of PDGF-Ab correlate with longer survival times.

A

B. FALSE

127
Q

A. TRUE
B. FALSE
C. CANNOT BE DETERMINED

Elevated serum levels of bFGF is a good prognostic factor in patients with non small-cell carcinomas.

A

A. TRUE

128
Q

A. TRUE
B. FALSE
C. CANNOT BE DETERMINED

Low levels of sE-cad in blood circulation can be valid prognostic markers of metastases, late-stage cancer or poor prognosis.

A

B. FALSE

129
Q

A. TRUE
B. FALSE
C. CANNOT BE DETERMINED

Ninety percent of the mutations in Raf result in substitution of glutamic acid for the normally occurring valine at position 600

A

A. TRUE

130
Q

A. TRUE
B. FALSE
C. CANNOT BE DETERMINED

Mutation in p53 (deletions of whole gene or amino acid substitution) inactivate it leading to removal of its vital control over mitogenesis

A

A. TRUE

131
Q

Nuclear oncoproteins

A. Overproduction by cells
B. Overexpression with high concentration of dimers
C. Mutation in anti oncogenic protein
D. Overexpression of normal G protein S protein kinases
E. Overstimulation of s-phase

A

C. Mutation in anti oncogenic protein

132
Q

Growth factors

A. Overproduction by cells
B. Overexpression with high concentration of dimers
C. Mutation in anti oncogenic protein
D. Overexpression of normal G protein S protein kinases
E. Overstimulation of s-phase

A

A. Overproduction by cells

133
Q

Cytosolic proteins

A. Overproduction by cells
B. Overexpression with high concentration of dimers
C. Mutation in anti oncogenic protein
D. Overexpression of normal G protein S protein kinases
E. Overstimulation of s-phase

A

D. Overexpression of normal G protein S protein kinases

134
Q

Growth factor receptors

A. Overproduction by cells
B. Overexpression with high concentration of dimers
C. Mutation in anti oncogenic protein
D. Overexpression of normal G protein S protein kinases
E. Overstimulation of s-phase

A

B. Overexpression with high concentration of dimers

135
Q

A. Hepatocellular carcinoma
B. Bracelets cancer, ovarian cancer/ leukaemia and lymphomas
C. Cholangiocarcinoma
D. Pancreatobiliary malignancy
E. Gastrointestinal stromal tumours

MCM5

A

D. Pancreatobiliary malignancy

136
Q

MCM6

A. Hepatocellular carcinoma
B. Bracelets cancer, ovarian cancer/ leukaemia and lymphomas
C. Cholangiocarcinoma
D. Pancreatobiliary malignancy
E. Gastrointestinal stromal tumours

A

A. Hepatocellular carcinoma

137
Q

PDGF receptor A

A. Hepatocellular carcinoma
B. Bracelets cancer, ovarian cancer/ leukaemia and lymphomas
C. Cholangiocarcinoma
D. Pancreatobiliary malignancy
E. Gastrointestinal stromal tumours

A

E. Gastrointestinal stromal tumours

138
Q

PDGF A

A. Hepatocellular carcinoma
B. Bracelets cancer, ovarian cancer/ leukaemia and lymphomas
C. Cholangiocarcinoma
D. Pancreatobiliary malignancy
E. Gastrointestinal stromal tumours

A

C. Cholangiocarcinoma

139
Q

Anti-c-myc protein antibodies

A. Hepatocellular carcinoma
B. Breast cancer, ovarian cancer/ leukaemia and lymphomas
C. Cholangiocarcinoma
D. Pancreatobiliary malignancy
E. Gastrointestinal stromal tumours

A

B. Breast cancer, ovarian cancer/ leukaemia and lymphomas

140
Q

S100B

A. Colonic cancer
B. Ovarian cancer
C. Melanoma
D. Hairy cell leukaemia
E. Transitional cell carcinoma

A

C. Melanoma

141
Q

NMP22

A. Colonic cancer
B. Ovarian cancer
C. Melanoma
D. Hairy cell leukaemia
E. Transitional cell carcinoma

A

E. Transitional cell carcinoma

142
Q

Ras oncogene in stool

A. Colonic cancer
B. Ovarian cancer
C. Melanoma
D. Hairy cell leukaemia
E. Transitional cell carcinoma

A

A. Colonic cancer

143
Q

Antibodies b-raf V600E

A. Colonic cancer
B. Ovarian cancer
C. Melanoma
D. Hairy cell leukaemia
E. Transitional cell carcinoma

A

D. Hairy cell leukaemia

144
Q

This is an effective predictor of the occurrence of malignancies at an early stage

A. P53
B. Ras-p21
C. TGF-b
D. HER2
E. TGF-a

A

E. TGF-a

145
Q

The following are the requirements needed for the semen collection, EXCEPT

A. Sexual abstinence of 2-7 days before collection
B. all of the ejaculate must be collected
C. specimen container must be sterile
D. semen should be kept between 20 C-37 C during transportation
E. latex condom may be used for collection

A

E. latex condom may be used for collection

146
Q

Which complete liquefaction time is not normal?

A. 15 mins after ejaculation
B. 30 mins after ejaculation
C. 45 mins after ejaculation
D. 60 mins after ejaculation
E. 75 mins after ejaculation

A

E. 75 mins after ejaculation

147
Q

A semen sample that forms a 3.5 cm long gelatinous string from a stirring rod that has been lifted up, is an indicative of a/an ________ specimen.

A. Normal
B. Abnormal
C. Inadequate
D. Hypospermic

A

B. Abnormal

148
Q

Describe the normal appearance of semen

A. grayish less opaque
B. reddish -brown
C. Homogenous,gray-opalescent
D. Yellowish opalescence

A

A. grayish less opaque

149
Q

Normal minimum volume for one ejaculate

A. not less than 1.0ml
B. not less than 1.5ml
C. not less than 3.0 ml
D. not less than 15 ml

A

B. not less than 1.5ml

150
Q

The pH of a normal semen should be

A. not lower than 5.0
B. not lower than 6.5
C. not lower than 7.2
D. not lower than 6.0

A

C. not lower than 7.2

151
Q

In sperm microscopic analysis, which is a more significant phenomenon that could lead to infertility?

A. Aggregation
B. Agglutination
C. both are significant
D. neither is significant

A

C. both are significant

152
Q

A healthy sperm cell should be moving
A. progressively straight forward only
B. progressively 2 steps forward, 1 step backward
C. progressively forward in a circular tumbling motion
D. all are accepted

A

D. all are accepted
??

153
Q

In vitality testing using Eosin staining, which are the correct findings
A. pink head= dead sperms
B. colorless head = alive sperms
C. light pink head= alive sperms
D. red head= dead sperm
E. all are correct

A

E. all are correct
???

154
Q

Cryptozoospermia is defined as

A. very low sperm count in the ejaculate.
B. total absence of sperm in the ejaculate.- azoospermia
C. sperm count in lower than 100,000 sperm per millilitre
D. no sperm cells seen after centrifugation
E. A & Conly

A

E. A & Conly

ADVANCE PATHOLOGY (2 decks)

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