Lecture | Midterms Review Flashcards
An 80-year old man died of longstanding congestive heart failure. At autopsy, all the following organs would likely manifest congestive changes EXCEPT?
A. Liver
B. Lungs
C. Lower extremities
D. Heart
C. Lower extremities
A previously healthy 42-year-old man has a skin nodule on his right forearm that has become larger and darker with more irregular outlines over the past three months. On physical examination, there is a 2.0 cm diameter darkly pigmented and slightly raises nodule on the dorsum of his right hand. No other skin lesions are noted. Several nontender enlarged lymph nodes are palpable in the right axilla. The lesion is excised and microscopic examination shows a neoplasm composed of darkly pigmented polygonal and spindle cells. Which of the following risk factors is more important for development of this neoplasm?
A. Chronic exposure to ultraviolet light
B. Inheritance of a proto-oncogene
C. Diet filled with nitrosamines
D. Cigarette smoking
A. Chronic exposure to ultraviolet light
A biopsy specimen was obtained from a patient who had a malignant neoplasm. The tumor is mass in spindle shaped cells with increased cellularity and a high N/C ratio with marked pleomorphism in presence of several mitosis. These cells are vimentin positive, cytokeratin negative, and CD45 negative by immunohistochemical stain. this type of neoplasm is most likely seen in which of the following patient?
A. 42 year old female with a right breast mass and palpable axillary nodes
B. 35 year old male with an enlarged testicular mass
C. 58 year old male with a large thigh mass
D. 21 year old female with a thyroid mass and several enlarged neck nodes
C. 58 year old male with a large thigh mass
A change in bowel habits prompts for 63 year old woman to see her physician. On physical examination, there are no lesions noted on digital rectal examination, but her stool is positive for occult blood. A colonoscopy is performed and show presence of colonic adenocarcinoma. An intestinal resection reveals a large 7.0 friable mass located in the sigmoid colon. Which of the following serum marker is most likely helpful for monitoring of possible recurrence?
A. Alpha-feto protein
B. CA-119
C. CA-125
D. Carcinoembryonic antigen
D. Carcinoembryonic antigen
40 year old farmer sought consult due to a markedly edematous right leg. Further work up reveals presence of filarial worm in the blood. Diagnosis of elephantiasis was given. Which of the following most likely explains abnormality in his leg?
A. Muscular hemorrhage
B. Lymphatic obstruction
C. Venous congestion
D. Deep venous thrombosis
B. Lymphatic obstruction
A clinical study on oncogenesis in human neoplasms was done. It is observed that some neoplasms appear to develop from viral oncogenesis with serological confirmation of past viral infection. Which of the following neoplasms is most likely to arise in this manner?
A. HSV and squamous cell carcinoma of the oral cavity
B. CMV and anal carcinoma
C. HBV and hepatic carcinoma
D. EBV and salivary gland carcinoma
C. HBV and hepatic carcinoma
A 54 year old previously healthy woman is hospitalized for pneumonia. On the 10th hospital day, she is found to have a swelling and tenderness of her right leg, which has developed over the past 48 hours. Raising the leg elicits pain. An ultrasound examination reveals findings suggestive of femoral vein thrombosis. Which of the following conditions is most likely to have contributed to the most of the appearance of these findings?
A. Hypertension
B. Pregnancy
C. Vitamin K deficiency
D. Immobilization
A 27 year old soldier fell after he was hit by sniper fire, nearly severing his femoral artery. He developed cold, clammy skin upon his immediate transport to a medical facility. On the way to the hospital, he became obtunded. He died before they reach their destination, which is most likely attributed to which of the following?
A. Brain edema
B. Heart failure
C. Pulmonary embolism
D. Hypovolemic shock due to massive blood loss
D.
The child is born with a single functional allele of a tumor suppressor gene. At the age of five, the remaining normal allele is lost through a point mutation. As a result, the ability to continue the transition from G1 to the S phase of cell cycle is lost. Which of the following neoplasm is most likely to arise via this mechanism?
A. Infiltrating ductal carcinoma of the breast
B. Chronic myelogenous leukemia
C. Retinoblastoma of the eye
D. Cerebral astrocytoma
C / D (?)
Patient admitted for abdominal surgery was inverted given an antibiotic for which she had a previous allergic reaction. Her clinical condition suddenly deteriorated with signs of multiple organ failure? What type of shock would she likely encountered?
A. Septic
B. Cardiogenic
C. Anaphylactic
D. Neurogenic
C.
Deep-sea divers are instructed not to ascend quickly to the surface of the ocean to prevent Caisson disease. This is done to prevent what type of hemodynamic abnormality?
A. Air embolus
B. Nasopharyngeal hemorrhage
C. Cerebral edema
D. Pulmonary congestion
A soft tissue mass in the umbilicus was excised with adequate surgical margins. On the subsequent follow up, the surgeon told the patient that the lesion is grade 1 on the scale of 1 to 4. And it is also stage one. Which of the following statements, best interpreted the patient’s tumor condition?
A. The lesion is unlikely malignant
B. Prognosis is poor due to presence of distant metastasis
C. Tumor is small and localized and also appear well-differentiated
D. carcinoma in suitu
A.
A 30 year old apparently healthy factory worker was admitted to the medical facility due to severe burns which left him bedridden for 1 month. Which of the ff. Will potentially cause a death id the condition is not properly addressed?
A. Thromboembolism
B. myocardial infarction
C. Dehydration
D. neurogenic shock
A
A 5 year old child had propensity to develop easy bruisability in seemingly slight physical activity. He later develops hemarthrosis. 2 male cousins of his also had similar fates. This type of bleeding is most likely attributed to which of the following?
A. Coagulation disorder
B. Abnormality in platelet function
C. Thrombocytopenia
D. Hemolytic anemia
A.
A 4.0 cm diameter superficial mass just beneath the skin was taken from the right gluteal area in a 30 year old female. She recounted that it was dradually enlarging since she first noted it 10 years ago. She had it removed because it causes discomfort on prolonged sitting. Microscopic examination of the surgical specimen reveals the lesion to be composed of mature adipocytes. Which of the following statements is correct?
A. A benign behavior is expected
B. Excision biopsy is curative
C. The neoplastic growth is lipoma
D. All alf the above
D.
A 51 year old male diagnosed with liver cirrhosis due to a 30 year history of chronic alcoholism manifested an increased abdominal girth as fluid accumulation in the peritoneal cavity. Which of the following would likely explain his current condition?
A. Kidney failure
B. Cardiogenic shock
C. Portal hypertension and decrease production of plasma proteins by the liver
D. Lymphatic obstruction
C.
A 30 year old woman with a history of multiple sexual partners over the last 15 years has a routine physical examination with no abnormal findings. On pelvic examination, the cervix shows no abnormalities, but a Pap smear is taken and dysplastic cells are reported to be present. Cervical biopsy is performed and shows microscopic features of a minimal dysplasia involving the cervical squamous epithelium. Which of the following is the most appropriate statement to make to the patient regarding this finding?
A. No further treatment is indicated
B. HPV does not have a role in the pathogenesis
C. Antibiotic therapy is most appropriate
D. Removal of the lesion ensures a good prognosis
D.
A 45 year old asymptomatic woman has a routine check of her health status. She has no chest pain, cough, or a fever. A chest x-ray was taken and shows a peripheral 2.5 cm diameter “coin Lucian” in the right mid-lung field. Which of the following biology characteristics best distinguishes this condition as a neoplasm, rather than a granuloma?
A. Presence of necrosis
B. Rapid uncontrolled growth
C. Recurrence after therapy
D. Absence of a capsule
B.
The frozen section was done on a uterine mass of 40 year old woman who complained of abnormal vaginal bleeding . Which of the following characteristics would best indicate that this neoplastic growth is malignant?
A. Presence of mitosis
B. Cellular atypia
C. Invasion to adjacent structures
D. Nuclear pleomorphism
C.
A 29 year old woman is involved in a motor vehicle accident that results in severe lacerations to her lower extremities, along with blundt, abdominal trauma. The emergency room, she is noted to have cool, pallid skin. She has vital signs showing T 36.9°C, P 110/minute, RR 26/minute, and BP 70/30mmHg. She has decreased urine output. Which of the following laboratory findings on a blood sample from this patient that supports the assertion that she is in progressive shock?
A. Hematocrit of 54%
B. Partial pressure of oxygen at 20mmHg
C. Lactic acidosis
D. Hyponatremia
C.
Septic shock is most commonly due to infections with what type of microbial agents?
A. Pyogenic bacteria
B. Tuberculosis bacteria
C. Gram-negative bacteria
D. Encapsulated bacteria
C.
The term “carcinoma in-situ” means
A. Tumor is confined within the basement membrane
B. No local invasion
C. No involvement of blood vessels and lymphatic channels.
D. All of the above
D.
Which of the following is common in all forms of shock?
A. Activation of chemical mediators of inflammation
B. Hypovolemia
C. Vasodilatation
D. Impaired tissue perfusion
D.
Active hyperemia is observed in which of the following circumstances?
A. All of the above
B. Muscles during strenuous exercise
C. Blushing during an embarrassing moment
D. Acute inflammatory response
A.
The term benign or malignant in the context of neoplastic growth refers to which of the following?
A. The origin of the tumor
B. The biologic behavior of the tumor
C. The degree of differentiation of the tumor
D. The morphologic features of the tumor
. B.
Sarcoma is defined as
A. Localized disordered differentiation of normal tissues
B. Malignant mesenchymal tumor
C. Ectopic islands of normal tissues
D. Malignant tumor of epithelial origin
B.
An infarct is best described as
A. Localized anemia as a result of narrowing of arterial lumen
B. Extracellular release of enzymes resulting in death of several cells
C. Area of necrosis due to sudden insufficiency of blood supply
D. Loss of tissue function in the aftermath of an acute inflammatory response
C.
Which of the following terms refer to accumulation of fluid in body cavities?
A. Anasarca
B. Ascites
C. Effusion
D. Hydrops
C.
Sodium, the principal determinant of extracellular fluid, is primarily regulated by which of the following organ?
A. Adrenal glands
B. Gastrointestinal tract
C. Kidney
D. Parathyroid glands
D.
A 14 year old young female had an enlarging abdominal girth and a positive pregnancy test. Which of the following may explain her condition?
A. There is a possibility of an ovarian malignancy
B. She may be suffering from a trophoblastic disease
C. A fetus is growing in her uterus
D. Any of the above
D.
Epstein-Barr virus is implicated in the etiology of which of the following malignancy?
A. Kaposi sarcoma
B. Burkitt’s lymphoma and Nasopharyngeal carcinoma
C. Cholangiocarcinoma
D. Hepatocellular carcinoma
B.
Which of the following steps in chemical carcinogenesis wherein the transformed cells acquire the ability to invade and metastasize?
A. Initiation
B. Progression
C. Cancer
D. Promotion
C.
The so-called “heart failure cells” are hemosiderin-laden macrophages usually found in which of the following?
A. Myocardial fibers of the ventricular wall of heart
B. Alveoli spaces of the lung
C. Portal triad of the liver
D. Renal tubules of the kidney
D.
An “anaplastic tumor” is likely to be?
A. Tend to have an aggressive behavior
B. Undifferentiated and composed of primitive-looking cells
C. Usually have poor prognosis
D. All of the above
B.
A 59 year old man suddenly become obtunded due to a ruptured aneurysm in the abdominal aorta. Unless corrected, this life-threatening condition is an example of what type of shock?
A. Neurogenic
B. Hypovolemic
C. Anaphylactic
D. Cardiogenic
B.
In tumor pathology, the unequivocal sign of malignancy is:
A. Local invasion
B. Increased mitotic activity
C. Abnormal nuclear morphology and loss of polarity
D. Metastasis
D.
Which of the following is considered a benign tumor?
A. Lymphoma
B. Seminoma
C. Hepatoma
D. None of the above
D.
Infarcts are least likely to be seen in which of the following organs?
A. Kidney
B. Liver and lung
C. Heart
D. Brain
B.
TRUE of hemorrhage
A. Always an abnormal condition
B. Mostly due to trauma
C. Called hematoma when it behaves as a space occupying lesion
D. All of the above
D.
Which of the following is the primary descriptor of a tumor?
A. Biologic behavior
B. Cell or tissue of origin
C. Morphologic features
D. Functional characteristics
B.
If the tissue fluid is an exudate, the likely cause of the edema is inflammation. T/F
T
A poorly differentiated malignant tumor is composed of primitive-looking cells, tends to have an aggressive clinical behavior; hence, a likely poorer prognosis. T/F
True
The hemostatic plug is mostly composed of red blood cells. T/F
False
Hemorrhage is usually a result of a pathologic process. T/F
False
Hyperviscosity of blood increases the chance of thrombus formation. T/F
True
Aside from vascular vessels and lymphatic channels, tumor metastasis is also possible through the neural pathways. T/F
False
Anaplasia, like dysplasia, is also reversible upon removal of the instigating stimulus. T/F
False
Anaphylactic shock is caused by the entry of microbial agents in the supposedly sterile environment of blood. T/F
False
Ames test is a short-term test for identification of carcinogens using mutagenicity in Salmonella typhimurium bacteria as an end point. T/F
True
Blood acidosis is a distinctive manifestation of the compensatory stage of shock. T/F
False
Heart failure can lead to carcinogenic shock. T/F
True
The transformation of a cell into a cancerous one is a one-step process involving mutations of the cell’s genome. T/F
True
Oncotic pressure within the intravascular volume is mainly exerted by albumin. T/F
True
A malignant tumor arises from a single transformed cells. T/F
True
Lung cancer accounts for the greatest number if deaths attributed to a malignancy. T/F
True
The most common mutation in a patient with an inheritable hypercoagulable state involves factor V. T/F
True
In general, carcinomas tend to spread via lymphatic channels while sarcomas spread mainly via the bloodstream. T/F
True
Most of the mutations relating to human cancer occurs during DNA replication and repair. T/F
True
Air bubbles can act as an embolus. T/F
True
The terms “benign” and “malignant” primarily refers to the morphologic features of the neoplastic lesion. T/F
False
Ascites is a term used for the accumulation of fluid in which of the following?
A. Subcutaneous tissues
B. Thoracic cavity
C. Brain
D. Peritoneal cavity
D.
Which of the following best describes a hematoma?
A. Blood oozing out from a cut done by a knife in your left index finger
B. Accumulation of blood in the subdural space from a blunt trauma
C. Blood filling the joint spaces of the knee in a hemophiliac patient
D. “Black eye” sustained from the boxing match
B.
An inflammatory response to the presence of filarial worms may produce enlargement of the scrotum and elephantiasis of the lower extremities is an example of edema caused by which of the following?
A. Increased hydrostatic pressure
B. Decreased oncotic pressure
C. Lymphatic obstruction
D. Sodium retention
C.
What is the fate of the thrombus when it is incorporated into the blood vessel wall?
A. Propagation
B. Embolization
C. Organization
D. Dissolution
C.
Which of the following is the most precise definition of shock?
A. Hypoxemia
B. Disturbance in blood flow
C. Low blood pressure
D. A manifestation of circulatory failure
D.
A disorder in the platelets would likely present in which of the following hemorrhagic manifestations?
A. Hemarthrosis
B. Petechiae
C. Ecchymosis
D. Hematoma
B.
Most cases of pulmonary embolus arise from which of the following sites?
A. Heart valves
B. Mesenteric valves
C. Jugular veins of the neck
D. Deep veins of the lower extremities
D.
Which is the most common inherited hypercoagulability disorder?
A. Protein C deficiency
B. Antithrombin III deficiency
C. Factor V deficiency
D. von Willebrand disease
C.
Blushing as a result of an embarrassing moment is an example of which of the following?
A. Active hyperemia
B. Passive hyperemia
A.
All of the following factors predispose to thrombus formation EXCEPT?
A. Hypercoagulability states
B. Injury to the endothelial lining
C. Disturbances in the flow of blood
D. Severe anemia
D.
Edema is usually manifested when there is increase water content in which of the following compartment?
A. Intracellular
B. Intravascular
C. Interstitial
D. None of the above
C.
Aside form clotted blood, which of the following can behave as an embolus?
A. Amniotic fluid
B. Bubbles of air
C. Fat goobules
D. All of the above
D.
Edema can be seen in the following clinical conditions EXCEPT?
A. Congestive heart failure
B. Hypoalbuminemia
C. Lymphatic obstruction
D. Very low platelet count
D.
A 65 year old woman underwent modified radical mastectomy due to a stage III cancer of the right breast. She eventually followed this treatment regimen with chemotherapy and radiation therapy. Few months later, she developed edema on the right arm. Which of the following is the most likely cause of the edema?
A. Lymphatic obstruction as a result of extensive surgery and subsequent radiation
B. Sodium attention secondary to renal insufficiency
C. Thrombosis due to hypercoagulability state
D. Decrease liver production of albumin due to metastatic disease
A.
Which of the following statements is correct regarding hyperemia?
A. Due to increased in blood volume
B. Mechanism involved is arteriolar dilatation
C. Manifested as erythema
D. All of the above
D.
True of congestion?
A. All of the above
B. May result to either hypoxia or hemorrhage
C. Results from a reduced outflow of blood from a tissue or organ
D. Manifested a cyanosis due to accumulation of deoxygenated blood
C.
A 45 year old obese man with a BMI over 35 suffered chest pains minutes before collapsing in his home. He subsequently died a day later while admitted in the hospital. Autopsy done show significant blockage on both right and left coronary arteries by atherosclerosis. Which of the following would have occurred?
A. The blockage results in ischemic necrosis of the cardiac cells
B. Both A and B
C. The sudden death was due to an embolus
D. Infarction would likely be documented upon examination of the heart
A.
Most of the water content in the human body is found inside the intravascular compartment. T/F
False,
Interstitial compartment
The best majority of cases of septic shock are caused by pyogenic bacteria. T/F
False
(Gram-negative bacteria)
Hypovolemic shock occurs when there is an inadequate volume of blood in the circulatory system. T/F
True
Diarrhea and vomiting me cause dehydration. T/F
True
The pathologic counterpart of hemostasis is thrombosis. T/F
True
The most common source of pulmonary embolism is a thrombus in the deep veins of the legs that have detached, and carried into the bloodstream. T/F
True
Anaphylactic shock denotes systemic vasodilation and increased vascular permeability caused by microbial invasion of the bloodstream. T/F
False
(septic shock is caused by microbial invasion of the bloodstream)
Shock is irreversible even in the early stages. T/F
False
(Reversible)
Circulatory collapse resulting in inadequate perfusion of tissues and organs
Shock
Increased fluid in the extracellular compartment
Edema
Clotting of blood in adherence to vascular wall
Thrombosis
Increase blood flow to an area
Hyperemia
Clot travels a distance from its origin
Embolism
Extravasation of RBCs beyond the confines of blood vessel
Hemorrhage
Increase backflow to an area
Congestion
Keeping blood as a fluid
Hemostasis
Death of tissues without blood
Infarction
In Chemical carcinogenesis, which step is characterized by colonial expansion of the transformed cell?
A. Cancer
B. Progression
C. Promotion
D. Initiation
C.
TRUE of a benign tumor
A. Not characterized by cohesive growth
B. Synonymous with carcinoma in situ
C. Composed of abnormal looking cells
D. One that does not spread to other parts of the body
D.
Carcinoma in situ means
A. Carcinoma is confined to the epithelial layer
B. There is microinvasion into the stroma but no involvement of lymphatic and vascular vessels
C. Size of tumor is less than 2.0 cm in diameter
D. Tumor has already gone beyond the basement membrane
A.
Which of the following malignancy is most likely attributed to exposure of UV light?
A. Skin cancer
B. Cancer of the colon
C. Cancer of the urinary bladder
D. Lung cancer
A.
A high grade malignant tumor located in the nasopharynx of a 56 year old male in which the neoplastic cells show positivity to psycho keratin and negative for leukocyte common antigen is mostly likely diagnosed as?
A. Malignant lymphoma
B. Immature teratoma
C. Undifferentiated carcinoma
D. A soft tissue sarcoma
C.
All of the following malignancy is associated with a strong family history, EXCEPT?
A. Ovarian carcinoma
B. Carcinoma of the pancreas
C. Carcinoma of the cervix
D. Breast carcinoma
D.
The TM and scheme for cancer staging includes all of the following, except?
A. Size of the primary tumor
B. Degree of tumor differentiation
C. Percent of regional lymph node involvement
D. Distant metastasis
B.
Which of the following more is benign?
A. Fibroma
B. Lymphoma
C. Hepatoma
D. Seminoma
A.
The her2/c-erb gene in breast and ovarian cancers is an example of activation of a Proto oncogene, through which of the following mechanism?
A. Gene amplification
B. Chromosomal translocation
C. Insertional mutagenesis
D. Point mutation
A.
Which of the following is a characteristic of a malignant neoplasm?
A. Able to metastasize
B. Display anaplasia
C. Invades surrounding areas
D. All of the above.
D.
A 72 year old male suffering from hepatocellular carcinoma, may give elevated levels of which tumor marker in the blood?
A. Alpha-fetoprotein
B. Human chorionic gonadotrophin
C. CA – 119
D. Carcinoembryonic antigen
A.
Epstein-Barr virus is implicated as an etiology of which of the following malignancy?
A. Nasopharyngeal carcinoma
B. Colonic carcinoma
C. Pancreatic carcinoma
D. Carcinoma of the cervix
A.
Aside from carcinogens and genetic predisposition, which of the following factors tend to influence the likelihood of having cancer?
A. Age
B. Sites of chronic inflammation
C. Infectious agents
D. All of the above
D.
Which of the following is malignant?
A. Melanoma
B. Hemangioma
C. Leiomyoma
D. Lipoma
A.
Cancer grading includes which of the following parameters into consideration?
A. Nuclear pleomorphism
B. All of the above
C. Mitotic activity
D. Cellularity and atypia
B.
Malignant tumors are racing from epithelial cells are called sarcomas. T/F
False
(Carcinoma)
Spread through the lymphatics is the primary pathway in the initial dissemination of carcinomas. T/F
True
The genomics material is the primary and most important target of chemical carcinogens; thus chemical carcinogens are also mutagens. T/F
True
A tumor is formed by the colonial expansion of a single precursor cell that have incurred genetic damage (the so-called transformed cell). T/F
True
Hydrocarbons present in cigarette smoke needs to be metabolized to epoxides to exert its carcinogenic effects. T/F
Trye
Benign tumors are generally more differentiated than their malignant counterparts. T/F
True
The ability to metastasize is the single most important feature distinguishing a benign from a malignant tumor. T/F
True
The appearance of malignant tumor cells in blood is synonymous with metastasis. T/F
False
The development of cancer is a single step process. T/F
False
In neoplastic proliferations, the growth of tumor is virtually autonomous and persists after cessation of the stimuli that initiated the change. T/F
True
