2nd Sem Midterms Flashcards by Jon Snow

Cause of the most common congenital anomaly of the gastrointestinal tract.
a. Failure of the extraembryonic gut to return to abdominal activity.
b. Incomplete formation of diaphragm
c. Failure of involution of vitelline duct
d. Failure of involution of cloacal membrane

a. Failure of the extraembryonic gut to return to abdominal activity.

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Seen in failed suicide attempts from swallowing strong acids/alkali resulting in caustic injury and eventual reduction of wall caliber due to fibrosis.
A. Stenosis
B. Atresia
C. Fistula formation
D. Duplication
E. Diverticula formation

A. Stenosis

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Nutcracker esophagus is caused by the following:
A. Intense, high amplitude, uncoordinated contractions
B. Squamous dysplasia
C. Intestinal metaplasia
D. Degenerative changes in the extraesophageal vagus nerve
E. Mucosal erosion with basal zone hyperplasia

A. Intense, high amplitude, uncoordinated contractions

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Which of the following contribute to the development of intestinal-type gastric adenocarcinoma?
A. E-cadherin loss
B. Mutation in CDH1
C. Increased signaling in WNT pathway
D. All of the above

C. Increased signaling in WNT pathway

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Which among the following are NOT TRUE in Ménétrien disease?
A. There is irregular enlargement of the gastric rugae in the fundus
B. Cystic dilatation with glandular atrophy is observed
C. There is intraepithelial lymphocytopenia
D. Peripheral edema may be observed

C. There is intraepithelial lymphocytopenia

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Which of the following is NOT TRUE?
A. Stress-related mucosal disease can penetrate the mucosa
B. Patients with intracranial disease are predisposed to developing Cushing ulcers
C. Cushing ulcers can affect the esophagus
D. Curling ulcers can affect the esophagus

D. Curling ulcers can affect the esophagus

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Which of the following is true with Dieulafoy lesions?
A. Usually seen near the GEJ
B. They are self-limiting
C. These are caused by an abnormality in the submucosal arteriole
D. All of the above

D. All of the above

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Which of the ff is true?
A. Autoimmune atrophic gastritis can have hyperplasia of antral G-cells
B. CagA of H. pylori induces proinflammatory cytokine secretion and increases gastric pH
C. There is defective duodenal B12 absorption in autoimmune atrophic gastritis resulting in megaloblastic anemia
D. Gastritis cystica profunda is limited to the submucosa while polyposa is the one mistaken for adenocarcinoma (pseudotumor)

A. Autoimmune atrophic gastritis can have hyperplasia of antral G-cells

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These tumors have a “salt and pepper” chromatin pattern.
A. Neuroendocrine tumors (NETs)
B. MALTomas
C. Burkitt lymphoma
D. GISTs
E. None of the above

A. Neuroendocrine tumors (NETs)

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Which of the following is NOT TRUE?
A. All gastrointestinal adenomas exhibit dysplasia
B. Patients with Zollinger-Ellison Syndrome gastrinomas can be given somatostatin
C. Proton pump inhibitors (PP|s) can cause fundic gland polyps
D. (11:18)(q21;q21) is the most common mutation in lymphomas arising from MALT
E. Linitis plastica is seen in advanced stage intestinal-type gastric carcinoma due to rugal flattening and rigidity

B. Patients with Zollinger-Ellison Syndrome gastrinomas can be given somatostatin

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A gastrointestinal pathology with a failure to pass meconium in the immediate postnatal period.
a. Aganglionic megacolon
b. Meckel diverticulum
c. Pyloric stenosis
d. Ectopia
e. Omphalocele

a. Aganglionic megacolon

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An abdominal viscera herniating ventrally and are covered by amnion and peritoneum is?
a. Gastroschisis
b. Omphalocele
c. Achalasia
d. Infectious esophagitis
e. Barrett Esophagus

b. Omphalocele

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A precursor lesion for esophageal adenocarcinoma.
a. Gastroschisis
b. Omphalocele
c. Achalasia
d. Infectious esophagitis
e. Barrett Esophagus

e. Barrett Esophagus

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An ulcer in the proximal duodenum secondary to severe burns or trauma
a. Stress ulcer
b. Curling ulcer
c. Cushing ulcer
d. GERD
e. Dieulafoy lesion

b. Curling ulcer

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An abnormal submucosal arteriole usually in the lesser gastric curvature and are near the gastroesophageal junction
A. Gastric antral vascular actasia
B. Dieulafoy lesion
C. Barrett esophagus
D. GERD
E. Ectopia

B. Dieulafoy lesion

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Which of the following is an autoimmune gastritis?
a. Located in antrum
b. Increased acid production
c. With inflammatory polyp
d. Associated with poverty
e. Lymphocyte predominant

a. Located in antrum

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The most common mesenchymal tumor of the abdomen.
a. Gastrointestinal stromal tumor
b. Gastric adenocarcinoma
c. Gastric neuroendocrine/neoplasm
d. Maltoma
e. Intussusception

a. Gastrointestinal stromal tumor

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The most common mesenchymal tumor of the abdomen will have a positive IHC with?
a. CK
b. Synaptophysin
c. Chromogranin
d. CD117
e. CD45

d. CD117

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A comma shaped, gram negative bacteria that has been endemic in the Ganges valley of India.
a. E. coli
b. E. histolytica
c. V. cholerae
d. Camplylobacter spp
e. C. difficile

c. V. cholerae

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The principal cause of traveler’s diarrhea and spread via contaminated food or water.
a. ETEC
b. EPEC
с. ЕНЕС
d. ElEC

a. ETEC

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Which of the following statements is true regarding mucoepidermoid carcinoma?
A. It arises from pleomorphic adenoma
B. It is the most common malignant tumor of the salivary gland
C. It is more common in men than women
D. It is locally aggressive but does not metastasize

B. It is the most common malignant tumor of the salivary gland

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A 27-year-old man presents with a small, painless swelling in his neck. Physical examination finds a 7-mm, smooth, nontender, fluctuant mass located in the anterior midline, near the central portion of the hyoid bone. The mass moves up and down as this patient swallows. The mass is excised and histologic sections reveal a cystic lesion lined by pseudostratified columnar epithelium. Lymphoid tissue is not present in the wall of the cyst. Which is the most likely diagnosis?
A. Dentigerous cyst
B. Odontogenic keratocyst
C.Branchial duct cyst
D. Thyroglossal duct cyst

D. Thyroglossal duct cyst

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A 6-year old boy presents with multiple laryngeal squamous papilloma. On obtaining history, this boy has had the same type of lesions removed in the past. Which of the following viruses is most likely associated with the boy’s condition?
A. CMV
B. HPV
C. EBV
D. HSV

B. HPV

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A 63 year old with a 15 year history if diabetes is hospitalized because of end stage kidney disease. His tongue is covered with white soft patches. Which is the most likely diagnosis?
A. Aphthous stomatitis
B. Herpes labialis
C. Pyogenic granuloma
D. Candidiasis

D. Candidiasis

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Which of the ff microorganisms is/are seen in acute otitis media? A. Streptococcus pneumoniae B. Pseudomonas aeruginosa C. Moraxella catarrhalis D. RSV E. All of the above

E. All of the above

A non-neoplastic lesion composed of keratinizing squamous or metaplastic mucus-secreting epithelium containing amorphous, keratinous debris. A. Hamartoma B. Aural polyp C. Paraganglioma D. Cholesteatoma E. Dentigerous cyst

D. Cholesteatoma

Which of the following is true? A. Paravertebral paraganglioma can arise in the bladder B. Aortopulmonary paragangliomas rarely produce catecholamines C. Aortopulmonary paragangliomas are usually parasympathetic D. All of the above

D. All of the above

Which of the following descriptions best fits the description of hairy leukoplakia? A. Hyperparakeratosis and acanthosis and dysplasia B. Thin keratinized stratified squamous epithelium with a prominent basal cell layer and a corrugated epithelial surface C. Presence of interconnecting cords or 1 with little or no keratinization D. Contains pseudostratified columnar with some lymphoid tissues and prominent centers E. All of the above

B. Thin keratinized stratified squamous epithelium with a prominent basal cell layer and a corrugated epithelial surface

This an odontogenic tumor that originates around an unerupted tooth A. Odontogenic keratocyst B. Dentigerous cyst C. Eruption cyst D. Paradental cyst

B. Dentigerous cyst

What is the most common epithelial odontogenic tumor A. Odontoma B. Pinborg tumor C. Ameloblastoma D. Adenomatous odontogenic tumor

A. Odontoma

What is the most common benign salivary gland tumor? A. Warthin Tumor B. Oncocytoma C. Mucoepidermoid carcinoma D. Benign mixed tumor

D. Benign mixed tumor

Which among the tumors of the salivary gland has translocation in PLAG1 gene? A. Warthin tumor B. Pleomorphic adenoma C. Mucoepidermoid carcinoma D. Adenoid cystic carcinoma

B. Pleomorphic adenoma

Which of the following lesions is the histologic manifestation of acute respiratory distress syndrome? A. Usual Interstitial Pneumonia B. Desquamative Interstitial Pneumonia C. Diffuse Alveolar Damage D. Honeycomb Lung

C. Diffuse Alveolar Damage

An increase in the ratio of mucous gland layer thickness to the thickness of the wall between the epithelium and cartilage is a characteristic finding seen in what disorder? A. Chronic Bronchitis B. Asthma C. Emphysema D. Pneumoconiosis

A. Chronic Bronchitis

The end-stage lung seen in the sequelae of interstitial lung disease is characterized by? A. Honeycombing B. Hepatization C. Atelectasis D. Cavitation

A. Honeycombing

An autoimmune disease characterized by the presence of autoantibodies against non-collagenous domains of type IV Collagen. A. Polyarteritis nodosa B. Eosinophilic granulomatosis with polyangiitis C. Systemic lupus erythematosus D. Goodpasture syndrome

D. Goodpasture syndrome

The most common manifestation of chronic asbestos exposure A. Asbestosis B. Mesothelioma C. Diffuse pleural fibrosis D. Pleural plaque

D. Pleural plaque

Airway remodeling, as occurs in repeated bout asthma, consists of the following changes in the br… wall: A. Hypertrophy and hyperplasia of bronchial smooth muscles B. Increased vascularity C. Submucosal gland hypertrophy/hyperplasia D. All of the above

D. All of the above

Source of pulmonary surfactant is: A. Alveolar macrophage B. Type I pneumocytes C. Type II pneumocytes D. Capillary basement membrane

C. Type II pneumocytes

The most common causative organism for lobar pneumonia is? A. Staphylococci B. Pneumococci C. Streptococci D. Haemophilus

B. Pneumococci

Emphysema associated most often with alpha 1 antitrypsin deficiency is: a. Panacinar b. Distal acinar c. Centriacinar d. Irregular

a. Panacinar

The following type of bronchogenic carcinoma have strong association with cigarette smoking except: a. Squamous cell carcinoma b. Large cell carcinoma c. Small cell carcinoma d. Adenocarcinoma

d. Adenocarcinoma

The most important mutation in small cell carcinoma is in the following gene: a. RB b. CDK c. MYC d. RAS

a. RB

Which of the following mutation is being used to develop targeted molecular therapy in non-small cell cancer of the lung? a. EGFR mutation b. KRAS mutation c. P53 mutation d. P16 mutation

a. EGFR mutation

A 43-year-old male with a history of chronic alcoholism and hepatitis C infection is brought to the emergency room by his friends because he has twice vomited large amounts of blood. Other than the two episodes of bleeding, he had not otherwise been vomiting. What is the most likely mechanism of his bleeding? A. Acute alcohol toxicity B. Tear of the esophagus C. Rupture of dilated vein D. Hemorrhage from neoplasm

C. Rupture of dilated vein

A 49-year-old male presents to his family physician with complains of fever, chills and abdominal pain. He reports that he has had past episodes of a similar nature but has not chosen to seek treatment. He has a past medical history of ulcerative colitis and had a colectomy 5 years ago for Stage 1 colonic adenocarcinoma, which has remission. An ERCP reveals strictures in the extrahepatic bile ducts. Which is the most likely Diagnosis? a. Metastatic colonic adenocarcinoma b. Choledocholithiasis c. Primary sclerosing cholangitis d. Budd-Chiari syndrome

c. Primary sclerosing cholangitis

A 38 yr old female presents to her physician with complaints of abdominal pain. She is subsequently diagnosed with chronic cholecystitis and her gallbladder is removed surgically. The pathologist examining the gallbladder identifies multiple small black stones in her gallbladder. Of the following, what underlying condition or factor did she most likely have? a. Hemolytic anemia b. Acute pancreatitis c. Hodgkin’s lymphoma d. Acute hepatitis

a. Hemolytic anemia

A 3 day old neonate born after a 32 week gestation develops jaundice. Physical examination of the infant is unremarkable. Which of the following is most likely to be increased in this neonate’s serum? a. Carotene b. Conjugate bilirubin c. Galactosyltransferase d. Unconjugated bilirubin

d. Unconjugated bilirubin

Which zone of the liver parenchyma is nearest to the portal tract? a. Zone 1 b. Zone 2 c. Zone 3 d. Zone 4

a. Zone 1

Which of the following is the most common cause of liver cirrhosis? a. Hepatitis B b. Hepatitis C c. Alcoholic liver cirrhosis d. Hemochromatosis

c. Alcoholic liver cirrhosis

45 year old man presents for a routine physical examination. The patient has a history of hyperlipidemia and nodular prostatic hyperplasia. Physical examination reveals a large mass on the lateral side of the scrotum, which can be transilluminated. It is found to be composed of dilated blood vessels draining the left testicle. What is the appropriate diagnosis? A. Epididymitis B. Hematocele C. Hydrocele D. Spermatocele E. Varicocele

E. Varicocele

A bladder carcinoma in situ with flat morphology is known to have which of the following initial mutation? A. KRAS B. BRAS C. BRAF D. TP53 E. CMyc

D. TP53

The maximum Gleason score for prostate carcinoma is? A. 5 B. 1 C. 8 D. 10 E. 15

D. 10

Which of the following stimulates telomerase expression leading to penile squamous cell carcinoma immortalization? A. p53 B. RB C. E7 D. p16 E. PSA

C. E7

It is the most common form of prostatitis. A. Acute bacterial prostatitis B. Chronic bacterial prostatitis C. Chronic abacterial prostatitis D. Granulomatous prostatitis

C. Chronic abacterial prostatitis

It is the most common and serious congenital anomaly of the urinary bladder. A. Exstrophy of the bladder B. Vesicoureteral reflux C. Ureteral junction obstruction D. Urachal cyst

B. Vesicoureteral reflux

Which statement is TRUE of urinary bladder carcinoma? A. It is most common in older males B. Cigarette smoking is the most common risk factor C. Most muscle-invasive types develop from urothelial papilloma D. A and B

D. A and B

Which is TRUE about cryptorchidism? A. It is usually bilateral B. The contralateral testis is unremarkable in unilateral C. The most common site is within the abdomen D. None of the above

D. None of the above

Patients with this condition usually experience colicky dysmenorrhea, dyspareunia, pelvic pain and menometorrhagia with histologic findings that show endometrial tissue on myometrium. A. Endometriosis B. Adenomyosis C. Leiomyoma Uteri D. Leiomyosarcoma

B. Adenomyosis

A 58 years old woman presents with abnormal uterine bleeding for 3 weeks. Pertinent history shows that she is obese, diabetic and was previously diagnosed with endometrial hyperplasia 3 years ago. Endometrial biopsy was done and histopathologic report shows atypical pattern that resembles normal endometrial epithelium with more than 50% non squamous solid pattern. Based on the above findings, what is the best possible diagnosis? A. Type I Endometrial Carcinoma B. Type II Endometrial Carcinoma C. Type III Endometrial Carcinoma D. Endometrial Hyperplasia

C. Type III Endometrial Carcinoma

Under what condition can an ovarian carcinooid tumor produce symptoms of carcinoid syndrome? A. Tumor size exceeds 5cm and has signs of metastasis. B. There is bilaterally observed imaging scans C. Hepatic metastases are present D. Tumor size is large (>7cm) and it produces sufficient 5-hydroxytryptamine

D. Tumor size is large (>7cm) and it produces sufficient 5-hydroxytryptamine

Gestational trophoblastic disease that is characterized by proliferation of placental tissue either villous or trophoblastic, the pathology of which is due to an egg fertilized by 2 sperms and has therefore a triploid or tetraploid karyotyoe. A. Complete hydatidiform mole B. Partial hydatidiform mole C. Choriocarcinoma D. Invasive Mole

A. Complete hydatidiform mole

A 39-year-old woman presents with severe menorrhagia and colicky dysmenorrhea. A hysterectomy including resection of the fallopian tubes and ovaries is performed. Examination by the pathologist finds a right adnexal cyst measuring approximately 2-3 cm in diameter and filled with clotted blood. Microscopic examination reveals the presence in the wall of the cyst of endometrial glands, stroma, and hemosiderin pigment. What is the best diagnosis? A. Adenomyosis B. Endometriosis C. Hydatid cyst D. Hydatidiform mole

B. Endometriosis

A 25-year-old woman presents with lower abdominal pain, fever, and a vaginal discharge. Pelvic examination reveals bilateral adnexal tenderness and pain when the cervix is manipulated. Cultures taken from the vaginal discharge grow Neisseria gonorrhoeae. Which is the most likely cause of this patient's adnexal pain? A. Ectopic pregnancy B. Endometriosis C. Luteoma of pregnancy D. Pelvic inflammatory disease

D. Pelvic inflammatory disease

A 20-year old woman delivers a normal 8 lb. baby boy at 40 weeks of gestation. She has no history of drug abuse, and her pregnancy was unremarkable. Examination had revealed the placenta to be located normally, but following delivery the woman fails to deliver the placenta and subsequently develops massive postpartum hemorrhage and shock. Emergency surgery is performed to stop the bleeding. Which of the following is the most likely cause of her postpartum bleeding? A. An abruptio placenta B. Placenta previa C. Placenta accreta D. Hydatidiform mole

C. Placenta accreta

A 25-year-old woman in her 15th week of pregnancy presents with uterine bleeding and passage of a small amount of watery fluid and tissue. She is found to have a uterus that is much larger than estimated by her gestational dates. Her uterus is found to be filled with cystic, avascular, grapelike structures that do not penetrate the uterine wall. No fetal parts are found. Which of the following is the best diagnosis? A. Partial hydatidiform mole B. Complete hydatidiform mole C. Invasive mole D. Placental site trophoblastic tumor

B. Complete hydatidiform mole

A 26-year-old woman in the third trimester of her first pregnancy develops persistent headaches and swelling of her legs and face. Early during her pregnancy a physical examination was unremarkable; however, now her blood pressure is 170/105 mm g and urinalysis reveals slight proteinuria. Which of the following is the most likely diagnosis? A. Eclampsia B. Gestational trophoblastic disease C. Nephritic syndrome D. Preeclampsia

D. Preeclampsia

A 32-year-old female presents with pelvic pain and irregular menstrual cycles. Upon examination, she mentions experiencing dyspareunia and occasional spotting between periods. Further investigations reveal a pelvic mass. What are the possible diagnoses for this patient, and what diagnostic tests would you recommend to confirm the diagnosis? A. Endometriosis - Confirm with laparoscopy B. Ovarian cyst - Confirm with pelvic ultrasound C. Fibroids - Confirm with pelvic MRI D. All of the above E. None of the above

D. All of the above

A 60-year-old postmenopausal woman reports vaginal bleeding. She underwent a total hysterectomy for benign reasons ten years ago. What are the possible causes of postmenopausal bleeding in this patient, and how would you approach the diagnostic workup? A. Endometrial atrophy - Consider hormone replacement therapy B. Endometrial cancer - Perform endometrial biopsy C. Vaginal atrophy - Prescribe topical estrogen therapy D. Both a) and b) E. Both b) and c)

C. Vaginal atrophy - Prescribe topical estrogen therapy

A couple presents with concerns regarding infertility. The 28-year-old female partner has regular menstrual cycles, no history of pelvic inflammatory disease, and normal findings on pelvic examination. What are the potential causes of infertility in this couple, focusing on female factors, and what diagnostic tests would you recommend? A. Ovulatory dysfunction - Recommend serum progesterone level testing B. Tubal factor- Consider hysterosalpingography C. Uterine abnormalities - Perform hysteroscopy D. Both A and B E. Both B and C

E. Both B and C

A 20 year old woman presents with abdominal distention and discomfort. Imaging studies reveal a complex ovarian mass. Discuss the differential diagnosis of ovarian masses in young women, including benign and malignant conditions, and the appropriate management approach. A. Functional ovarian cyst- conservative management with follow-up B. Dermoid cyst- surgical excision C. Ovarian carcinoma- consult gynecologic oncology for staging laparotomy D. Both A and B E. Both B and C

D. Both A and B

The following organs are derived of mullerian duct, EXCEPT: A. Uterus and cervix B. Cervix and upper vagina C. Upper and lower vagina D. Fallopian tubes and uterus

C. Upper and lower vagina

A gestational trophoblastic disease that is characterized by proliferation of placental tissue, either villous or trophoblastic, the pathology of which is due to an egg fertilized by 2 sperm and has therefore a triploid or tetraploid kayotype. A. Complete hydatidiform mole B. Partial hydatidiform mole C. Choriocarcinoma D. Invasive mole

B. Partial hydatidiform mole

Which statement is correct regarding type 1 endometrial carcinoma. A. Tumors are generally poorly differentiated B. Precursor lesions is endometrial hyperplasia C. Typically diagnosed at 65-75 years D. This is common to women with thin physique

B. Precursor lesions is endometrial hyperplasia

All of the following are correct general statements regarding endometrial carcinoma EXCEPT: A. Most common malignancy of the female genital tract B. Serous carcinoma is associated with atypical endometrial hyperplasia C. Stage remains to be the most important factor in outcome D. Four molecular subtypes of endometrioid and serous carcinoma are currently recognized

B. Serous carcinoma is associated with atypical endometrial hyperplasia

Tissues that may be seen in mature teratoma: A. Brain tissue B. Teeth C. Both D. Neither A nor B

C. Both

Which of the tumors below is a sex-cord stromal tumor of the ovary? A. Immature teratoma B. Granulosa cell tumor C. Transitional carcinoma D. Malignant mixed mullerian tumor

B. Granulosa cell tumor

Invasive lobular carcinoma will have a negative of which of the following IHCs: A. CK7 B. mammaglobin C. GCDFP15 D. E cadherin

D. E cadherin

Which of the following is not a Germ Cell Tumor of the ovary? A. Granulosa Cell Tumor B. Mature Teratoma C. Dysgerminoma D. Yolk Sac Tumor

A. Granulosa Cell Tumor

Tubular adenoma of the breast is mainly composed of A. Closely packed ductules B. Ductal epithelial hyperplasia C. Lobular hyperplasia D. Lactational hyperplasia

A. Closely packed ductules

Phyllodes tumor is distinguished from fibroadenoma by having: A. More ductular hyperplasia B. More cellular stroma C. Compressed ducts D. More lobular hyperplasia

B. More cellular stroma

The most common location of breast cancer is? A. Left upper inner quadrant B. Right upper inner quadrant C. Left lower inner quadrant D. Right lower inner quadrant E. Left upper outer quadrant

E. Left upper outer quadrant

Which of the following histological features is commonly associated with benign breast lesions? A. Pleomorphic nuclei B. Cribriform architecture C. High mitotic activity D. Infiltrative growth pattern

B. Cribriform architecture

Which breast cancer subtype is characterized by overexpression of the HER2/neu oncogene A. Luminal A B. Luminal B C. HER-2 enriched D. Basal-like

C. HER-2 enriched

What is the primary role of pathology in breast cancer staging? A. Assessing hormone receptor status B. Evaluating Tumor size and lymph node involvement C. Identifying metastatic spread to distal areas D. Monitoring treatment response

A. Assessing hormone receptor status

Which biomarker is used to identify hormone (___) positive breast cancer? A. Ki-67 proliferation index B. HER2/neu amplification C. Estrogen Receptor (ER) D. Basal cytokeratins

B. HER2/neu amplification

Which of the following breast lesions arise from intralobular stroma? A. Lipoma B. Paget’s disease C. Phylloides tumor D. Sclerosing adenosis

A. Lipoma

What is the relative risk of having cancer if your patient was diagnosed with sclerosing adenosis? A. 1 B. 1.5-2 C. 4-5 D. 8-10

B. 1.5-2

Which of the following molecular subtypes of breast cancer is associated with BRCA 1 mutation? A. ER pos, Her2 neg B. ER pos, Her2 pos C. ER neg, Her2 neg D. None of the above

C. ER neg, Her2 neg