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PATHOLOGY (2nd year) > MIDTERMS > Flashcards

MIDTERMS Flashcards

1
Q

Patient presents with mental retardation, long face with large mandible, large everted ears and large testicles. The most likely diagnosis is:

Hunter syndrome
Hurler syndrome
Patau syndrome
Fragile X syndrome
all of the above

A

Fragile X syndrome

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2
Q

Reprogramming of stem cell pathway is the underlying mechanism of which cellular adaptation?
atrophy
Metaplasia
Hyperplasia
Hypertrophy
all of the above

A

Metaplasia

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3
Q

Itai-itai disease is a disease seen in ____________ toxicity.
Cadmium
Mercury
Lead
Arsenic

A

Cadmium

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4
Q

What receptor is expressed on the plasma membrane of dendritic cells that detect fungal glycans and elicit inflammatory reaction against fungi.
Toll like receptor
C-type Lectin Receptors (CLRs)
Rig-Like Receptors (RLR)
G-Protein Coupled Receptors

A

C-type Lectin Receptors (CLRs)
FUNGI

rig like - virus
g protein - bacterial
tlr - transcription factors

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5
Q

Overdose with acetaminophen can be treated by:
N-acetylcysteine
Thiamine
Naloxone
Activated charcoal

A

N-acetylcysteine

Activated charcoal - also correct but universal antidote

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6
Q

The following causes vascular permeability except:
Prostaglandin D2
Prostaglandin E2
Leukotriene D4
None of the above

A

None of the above

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7
Q

DNA structural variations in the genome that involve the deletion, duplication, or rearrangement of large DNA segments.
Single nucleotide polymorphisms
Copy number variation
Tandem repeats
Chromosal aberrations
None of the above

A
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8
Q

The most potent hallucinogen.

MDMA
LSD
PCP
Cocaine

A

LSD

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9
Q

Which of the following T cell subset is involved in immediate hypersensitivity reaction?

T-helper 1
T-helper 2
T-helper 3
T-helper 4

A

T-helper 2

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10
Q

Phenomenon of unresponsiveness to an antigen as a result of lymphocytes to that antigen, describes

Anergy
self tolerance
Autoimmunity
immunologic tolerance

A

immunologic tolerance

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11
Q

Aflatoxin has been associated with the development of this malignancy.
Lung cancer
Acute Myeloid Leukemia
Angiosarcoma
Liver cancer

A

Liver cancer

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12
Q

Phenomenon of unresponsiveness to an antigen as a result of lymphocytes to that antigen, describes

Anerygy
Autoimmunity
self tolerance
immunologic tolerance

A

Anerygy

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13
Q

Tay-Sachs disease is caused by?

Glycogen accumulation within the cells.
Glucocerebrosidase deficiency causing accumulation of glucocerebroside.
Point mutations or deletions in LDL receptors causing abnormal transport.
Deficiency in hexosaminidase A.

A

Deficiency in hexosaminidase A.

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14
Q

37 years old patient came to you with imaging findings stating that the liver has central vein and sinusoidal distension as well as centrilobular necrosis. You remember during discussion of the acinar model of blood flow that the centrilobular hepatocytes is at what zone?
Zone 1
Zone 2
Zone 3
Zone 4

A

ZONE 3

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15
Q

Which of the following is an example of intracellular hyaline?
Pink deposits in walls of arterioles in patients with chronic hypertension
Deposition in the basement membrane of the kidney of a patient with CKD
Presence of Russell bodies
All of the above

A

Presence of Russell bodies

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16
Q

64 years old male was celebrating his birthday with his family when he suddenly clutched his left chest. He was suddenly rushed to the emergency room within minutes. Laboratory shows an elevated Troponin I, and ECG changes were also noted. As he is still within the time of the golden period what is the best emergent therapy than can be administered?

Aspirin
Vitamin K
Tissue plasminogen activator
Heparin

A

Tissue plasminogen activator

clutched his left chest levine sign(MI)

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17
Q

Which of these cytokine has a role in allergies?

Th1
Th2
Th4
Th17
None of the above

A
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18
Q

In which of the following organs is the pathologic finding of a focal, hemorrhagic lesion most likely to be seen?

Lung with pulmonary thromboembolism
Kidney with renal artery thrombus
Heart with complete coronary artery occlusion
Brain with middle cerebral artery thrombus

A

Lung with pulmonary thromboembolism

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19
Q

Which of the following changes best describes the pathophysiology of pulmonary edema in patients with congestive heart failure?

Widespread endothelial damage
Acute lymphatic obstruction
Decreased plasma oncotic pressure
Increased hydrostatic pressure

A

Increased hydrostatic pressure

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20
Q

B cells develop in the bone marrow, now as a step in their maturation, B cells that recognize self antigen will undergo what process after?

Apoptosis
MHC restriction
Receptor Editing
Somatic recombination

A

Receptor Editing

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21
Q

Pathology of myasthenia gravis is due to:

Phagocytosis
Vasoactive release of amines
antibody mediated cellular dysfuction
immune complex deposition

A
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22
Q

Features of acute inflammation except
Mild local and systemic signs
Fast: minutes to hours
Mild tissue injury
Cellular infiltrates are mainly neutrophil

A

Mild local and systemic signs

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23
Q

A part of histone organization which leads to transcriptional silencing
Histone methylation
Histone phosphorylation
Histone Acetylation
DNA methylation

A

D.

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24
Q

A lysosomal storage disease with a mutation in the gene that encodes glucosylceraminidase presents with an accumulation of glucosylceramide in mononuclear phagocytic cells in the liver, spleen and marrow. The pathognomonic cells shows:
zebra bodies
wrinkled tissue paper celled cytoplasm
8 to 20 multinucleated cells
hydrophic cells with peri-nuclear halo
all of the above

A

wrinkled tissue paper celled cytoplasm
GAUCHERS DISEASE

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25
Q

Minamata disease is a disease seen in ____________ toxicity.

Cadmium
Mercury
Lead
Arsenic

A

Mercury

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26
Q

Deposition of immune complex is seen in which hypersensitivity reaction
TYPE I
TYPE II
TYPE III
TYPE IV

A

TYPE III

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27
Q

In tuberculosis, naive T-cells are differentiated into Th1 through:
Granuloma formation
PD-1 blockade
IL-12 stimulation
Caseous necrosis and formation of epithelioid cells.

A

IL-12 stimulation

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28
Q

What is the most common etiologic factor in acute myeloid leukemia?
Benzene
Radiation Exposure
Mercury
Lead
None of the above

A

Benzene

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29
Q

Perforins and granzymes are used by what cell types?
CD8+ T cells, NK cells
NK cells, Macrophages
CD8+ T cells, CD4+ T cells
CD4+ T cells, NK cells

A

CD8+ T cells, NK cells

NK CELLS - PRODUC GRANZYME

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30
Q

A 6 y/o child has a legs appearing “bowed” and a chest xray is notable for excess cartilage at the costochondral junction of the ribs. She is most likely suffering from
Ricketts
Achondroplasia - lack cartilage formation, dwarfs
Osteoid osteoma
Osteoporosis

A

Ricketts

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31
Q

Which cellular change may be reversed when injurious stimuli is removed?
Pyknosis
swelling of endoplasmic reticulum
BOTH
NEITHER

A

swelling of endoplasmic reticulum

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32
Q

65-year-old patient came for consult and presented with fever, weight loss, and cough. Due to gross negligence, the patient expired and autopsy was done revealing, neutrophilic infiltrates with central liquefaction and surrounding granulation and fibrosis in the absence of granuloma. Microorganism was revealed to have distinctive branched chains and thin aerial filaments resembling hyphae. Which microorganism should be considered?
Aspergillus fumigatus - acute branches, thin filaments
Nocardia spp.
Mycobacterium tuberculosis
Rhizopus spp.

A

Nocardia spp.

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33
Q

All of the following are true regarding ethanol consumption, except
Acetaldehyde is the major metabolite of alcohol and is responsible for many of the toxic effects
Acute alcohol intoxication results in primarily CNS depressant effects
aldehyde dehydrogenase is the major enzyme responsible for metabolizing alcohol
all of the choices are true.
none of the choices are false

A

aldehyde dehydrogenase is the major enzyme responsible for metabolizing alcohol

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34
Q

Abundant in liver and gonads where it is used for steroid hormone and lipoprotein synthesis, and modification of hydrophobic compounds into water-soluble molecules
smooth endoplasmic reticulum
rough endoplasmic reticulum
Lysosomes
proteasome

A

smooth endoplasmic reticulum

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35
Q

Ubiquitous mold that microscopically have septate filaments branching at acute angles
Aspergillus
Mucor spp
Blastomyces dermatitidis
Coccidiodes immitis

A

Aspergillus

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36
Q

A nematode that causes patchy interstitial myocarditis characterized by many eosinophil and scattered giant cells.
Tricnella spiralis
T. cruzi - american treponemiasis (bed bug,painless)
S. mansoni - trematode (hematodium x cause scc (urinary bladder), japonicum)
N. gonorrhea

A

Tricnella spiralis
- only nematode
- can only cause myocarditis

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37
Q

The following agents may cause lung cancer except
Berrylium
Asbestos
Radon
Chromium
Cadmium
all can cause lung cancer

A

Chromium

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38
Q

The following are primary granules except:
Elastase
Collagenase
Acid hydrolase
Myeloperoxidase

A

Collagenase

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39
Q

Rocker bottom feet is frequently observed in patients with
TRISOMY 13
TROSOMY 21
TRISOMY 18
NONE OF THE ABOVE

A

TRISOMY 13 - FREQUENTLY

TRISOMY 18 - NOT FREQUENT

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40
Q

Which of the following viruses can enter latency?
HSV
HPV
CMV
JC virus

A

HSV

HSV 1 AND 2
VARICELLA ZOSTER

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41
Q

FLIP is a protein produced by poxvirus and herpes virus which inhibits apoptotic process by blocking what specific molecule?
BCL-XL
Fas Ligand
FADD
TNF-1

A

FADD

42
Q

Type of mutation occur when the insertion or deletion of one or two base pairs alters the reading frame of the DNA strand
silent mutation
frame shift mutation
missense mutation
non-sense mutation
all of the above

A

frame shift mutation

43
Q

Release of this molecule happens as a protective response to deal with hypoxic stress; this molecule promotes new blood vessel formation, stimulates cell survival pathways, and enhances glycolysis.
VEGF-A
Angiostatin
VEGF-D
HIF-1

A
44
Q

A clinicopathologic entity with a triad of dry eyes, dry mouth and arthritis.
Scleroderma
sjogren syndrome
SLE
dermatomyositis

A

sjogren syndrome

45
Q

An alteration within cells or in extracellular space which gives a homogenous glassy pink appearance in routine H&E histologic sections is called:
coagulation necrosis
Steatosis
hyaline change
fibrinoid necrosis

A
46
Q

Receptor protein responsible for the binding of platelets to vwf on ECM?
gpIa
gpIb
GpIIb
GpIIb/IIIa

A

gpIb

47
Q

Good pasture syndrome is what type of hypersensitivity reaction?
TYPE I
TYPE II
TYPE III
TYPE IV

A

TYPE II

48
Q

It is the basic subunit of chromatin which consists of 147 base pairs of DNA wrapped in approximately two turns around an octameric protein core containing two copies each of histones
Histone
Nucleosome
Chromatin
Centromere

A

Nucleosome

49
Q

This vitamin A derivative is used in the treatment of Acute Promyelocytic Leukemia.
13-cis-retinoic acid
Beta-carotene
Isotretinoin
all-trans-retinoic acid

A

all-trans-retinoic acid

50
Q

This complement protein acts as an opsonin when fixed to the microbial cell wall.
C1q
C5a
C3b
C3a

A

C3b

51
Q

An alteration within cells or in extracellular space which gives a homogenous glassy pink appearance in routine H&E histologic sections is called _____.
coagulation necrosis
Steatosis
hyaline change
fibrinoid necrosis
liquefaction necrosis

A

hyaline change

52
Q

Glycogen storage diseases arises with lack of the following enzyme, except

Acid maltase
Muscle phosphorylase
glucose 6 phospatase
ALL OF THE ABOVE
NONE OF THE ABOVE

A

NONE OF THE ABOVE

53
Q

A 68 year old female with multiple myeloma dies of acute renal failure. At autopsy, her kidneys and liver were pale gray, with waxy cut sections, while her spleen showed tapioca-like granules. On histology, these organs show deposits that
have empty vacuoles that uptake Sudan black -AML
are infiltrated by neutrophils and histiocytes
will fluoresce an apple green color when stained with Congo red
are bluish, with concentric laminations -SCWANOMA BODIES

A

will fluoresce an apple green color when stained with Congo red

TAPIOCA LIKE
-amyloid

54
Q

The following categories of pathophysiology of edema and the clinical condition are correct, except:
Nephrotic syndrome- decreased oncotic pressure
Sodium retention- increased hydrostatic pressure
Kwashoirkor- decreased oncotic pressure
Filariasis- lymphatic obstruction
None of the above
All are correct

A
55
Q

Abnormal fusion of primary granules which results in a malfunctioning WBC with a diminished phagocytic capability
Chediak-Higashi syndrome
Leukocyte adhesion defect
Chronic granulomatous disease
Myeloperoxidase deficiency

A

Chediak-Higashi syndrome
-neutropenia
-defectuve granulation
-delayed microbial killing

CGD-OXIDATIVE BURST
MPO-PEROCYTE SYSTEM

56
Q

An example of point mutation wherein a purine base is replaced by another purine base or a pyrimidine base is replaced by another pyrimidine base.
genomic imprinting
Transition
silent mutation
gonadal mosaicism
all of the above

A

Transition

57
Q

Formed by homotypic extracellular interactions between transmembrane glycoproteins that mechanically attach cells and their cytoskeletons to other cells.
Occluding junctions
Anchoring junctions
Gap junctions
Communicating junctions

A
58
Q

Member of the immunoglobulin superfamily, is an adhesion molecule present in the intercellular junction
CD34
CD31
ICAM
VCAM

A

CD31
-PECAM
ENDOTHELIUM TO VASCULAR

59
Q

True about EXUDATE
low protein and little to no cellular debris
it is essentially an ultrafiltrate of the blood
this is an implication that there is increased permeability triggered by some sort of tissue injury.
this is an implication of osmotic or hydrostatic imbalances in the vessels, without an increase in the permeability of the vascular walls.

A

this is an implication that there is increased permeability triggered by some sort of tissue injury.

60
Q

The most common sexually transmitted bacterial disease is
N. gonrrhea
C. trachomatis
Both
none of the above

A
61
Q

Which of the following is NOT TRUE of the effects of alcoholism on cellular processes?
Depletion of NAD impairs fatty acid oxidation leading to steatosis.
Depletion of NAD impairs conversion of lactate to pyruvate leading to acidosis.
Reactive oxygen species derived from alcohol metabolism causes lipid peroxidation of hepatocyte membranes.
Acetaldehyde triggers enterotoxin release from gram-positive bacteria.

A

Acetaldehyde triggers enterotoxin release from gram-positive bacteria.
should be gram negative

62
Q

This is produced by COX-1 which is expressed constitutively by “healthy” endothelium under normal flow conditions.
PGE2
PGF2
PGI2
PGD2

A

PGI2
PROSTACYCLIN

63
Q

Increased number of hemosiderin-laden macrophages is a tell-tale sign of _____.
old hemorrhage
Melanoma
sunburn or radiation injury
formation of myelin figures
all of the above

A
64
Q

What is the second most common cause of mental retardation after trisomy 21?
TURNER’S SYNDROME
FRAGILE X SYDROME
MARFAN SYNDROME
KLIENFELTER’S SYDNROME

A
65
Q

Which of the following does not belong to Adaptive immunity?
Antibodies
Dendritic cell
Epithelial barriers
T-Lymphocyte

A

Epithelial barriers

innate - skin and leukocytes and complement activation
adaptive - acquired (humoral extra, intra-cell med)

66
Q

Alcohol metabolism by the enzyme catalase is seen in which part of the hepatocyte?
Peroxisome
Mitochondria
Microsomes
Cytosol

A

Peroxisome

67
Q

A patient takes aspirin for arthritis. Although her joint pain is reduced with this therapy, the inflammatory process continues. Aspirin therapy alleviates pain via reduction in the synthesis of
Complement C1q
Histamine
Leukotriene E4
Prostaglandins

A

Prostaglandins

68
Q

What do both the skin and gut epithelial cells produce to protect against infectious disease?
IgA antibodies - mucous
IgG antibodies - cross placenta
IgM antibodies - only pentamer, 1st
IgE antibodies - hypersensitivity and parasitis

A

IgA antibodies

69
Q

Which of the following are not involved in the measurement of extrinsic pathway of coagulation cascade?
Factor XII
Factor X
Factor VII
Factor V

A

Factor XII

70
Q

These are selectins found in lymphocytes and monocytes.
L-selectin
P-selectin
E-selectin
CD-31

A

L-selectin

71
Q

These are intracellular proteins expressed from the bile duct epithelia.
Uric acid
Troponin
Alkaline phosphatase
Transaminase

A
72
Q

Which among the following is a feature of irreversible cell injury?
Presence of small clear vacuoles within cytoplasm
Dilation of endoplastic reticulum
Changes in cellular membrane, specifically blebbing
None of the above

A
73
Q

Leukocytes inability to migrate to the site of infection and inflammation due to a mutation in fucosyl transferase
Leukocyte adhesion defect 1
Leukocyte adhesion defect 2
Myeloperoxidase deficiency
Chronic granulomatous disease

A
74
Q

Plasma membrane transport proteins where transport is relatively slow, solute binds and undergo a series of conformational changes to transport the ligand across the membrane
Carrier protein
Channel protein
Facilitated Diffusion proteins
None of the above

A

Carrier protein

75
Q

The increase in heart size in chronic hemodynamic overload due to hypertension is largely due to
fatty change
myocyte intracellular accumulation
muscle hyperplasia
myocyte hypertrophy

A
76
Q

HIV viral surface proteins essential for viral entry into cells.
Gp41
P17
Gp120
p24

A

Gp120
receptor - CXCR

77
Q

Autoimmune haemolytic anemia is an example of this hypersensitivity
TYPE I
TYPE II
TYPE III
TYPE IV

A
78
Q

A patient with prolonged PTT and normal PT likely has a deficiency in which of the following coagulation factors?
Factor VIII
Factor VII
Factor V
Thrombin

A

Factor VIII

79
Q

Along with SLE, Antiphospholipid antibody syndrome (APAS) has this target antibody which is present in endothelial cell walls, platelets, macrophages, and the mitochondria.
Lipooligosaccharide
Lipopolysaccharide
Cardiolipin
M protein

A

Cardiolipin
and betaglycoprotein 1

80
Q

Initial receptor for viral infection of measles virus expressed on activated lymphocytes, dendritic cells and monocytes.
CD46
Nectin 4
SLAMF-1
CD155

A

SLAMF-1

CD155 - POLIO

81
Q

Numerous factors are considered in platelet adhesion defects including loss of factors and glycoprotein deficiencies. One such deficiency is Glanzmann thrombasthenia which primarily involves which of the following complexes?
gpIIb-IIa complex
gpIIa-IIb complex
gpIIb-IIIa complex
gpIIa-IIIb complex

A

gpIIb-IIIa complex

82
Q

This is a basic form of nuclear chromatin which is cytochemically dense and transcriptionally inactive
Telomere
Centromere
Heterochromatin
Euchromatin

A

Heterochromatin

83
Q

Which of the following is responsible for Neutralization of microbe, phagocytosis and complement activation?
Regulatory T-Lymphocyte
Cytotoxic T-Lymphocyte
Helper T-lymphocyte
B-lymphocyte

A

B-lymphocyte
-HELPER ONLY, SUPPORT

84
Q

Which of the following is a stable cell
Epidermis
Cardiac Myocytes
Neuron
Hepatocyte

A

Hepatocyte

85
Q

Indicate type of hypersensitivity reaction: Poststreptococcal glomerulonephritis
TYPE I
TYPE II
TYPE III
TYPE IV

A

TYPE III

1-IgE,th1
2-antibodies
3-antigen and antibody plus depositions
4-chronic clinical features

86
Q

This occurs when a venous embolus passes through an interatrial or intraventricular defect and gains access to the systemic arterial circulation.
air embolism
Caisson’s disease
paradoxical embolism
fat embolism

A

paradoxical embolism

caissons - air emboli

87
Q

Cell death by necrosis due to mitochondrial dysfunction will be preceded by which event?
increased sirtuins
release of cytochrome C
formation of mitochondrial permeability transition pores
imbalance of BCL2 proteins causing outer membrane leakiness

A

formation of mitochondrial permeability transition pores

88
Q

A 14 year-old female suddenly notices enlargement of her breast followed by cramping in the hypogastric area and episodic fatigue. What could be the cause of the changes in her breast?
Physiologic hypertrophy
Pathologic hypertrophy
Physiologic hyperplasia
Metaplasia

A

Physiologic hyperplasia

89
Q

A 26-year- old man has a sudden loss of vision in the right eye. On physical examination, there is a subluxation of the right crystalline lens. On auscultation of the chest, a mid-systolic click is audible. Echocardiogram was requested showing a floppy mitral valve and dilated aortic arch. On interview, patient says his brothers also have similar symptoms. This is caused by a defect in?
Collagen
NF-2
NF-1
Fibrillin-1

A

Fibrillin-1
MARFAN SYNDROME

NF - NEUROFIBROMATOSIS
COLLAGEN - EHLER DANLOS

90
Q

coagulation factors are inhibited by Protein C and S?
Factors VIII and VWF
Va and VIIIa
II and IX
IX and XIII

A
91
Q

What is it called when viral agents have a predilection for certain types of cell to infect?
Tropism
Antigenic variation
Transmission
Virulence

A

Tropism

92
Q

Cell change characterized by fading basophilia, presumably due to enzymatic degradation by endonucleases.
Karyorrhexis
Karyolysis
Karyoptosis
Pyknosis

A

Karyolysis

93
Q

The following are autosomal dominant disorders except:
Huntington disease
Myotonic dystrophy
Duchenne muscular dystrophy
Hereditary spherocytosis

A

Duchenne muscular dystrophy

94
Q

There is progressive fibrosis interstitial and perivascular fibrosis in the skin and multiple organs
Mixed connective tissue disease
SLE
Sjogren
scleroderma

A

scleroderma
- CHRONIC INFLAMMATION

*SJOGREN - DRY EYES, DRY MOUTH, DESTRUCTION LACRIMAL AND SALIVARY GLANDS
*SLE -MULTIPLE ORGANS
*MIXED CT -

95
Q

A 24-year-old male student came for consult due to occasional dysuria. Further PE revealed a red swollen, tender “mass” in the left inguinal area and scanty, clear-to-white penile discharge. He admits to being sexually active with multiple partners. As a medical practitioner, your initial suspect would be infection caused by?
Neisseria gonorrheae
Treponema pallidum
Chlamydia trachomatis
Haemophilus ducreyi

A

Chlamydia trachomatis

DYSURIA - STI-PENILE DISCHARGE

YELLOWISH - GONORRHEA
TREPONEMA - CHUNKER NOT PAINFUL
HAEMOPHLUS - CHUNKROID PAINFUL

96
Q

A 1-year-old child with failure to thrive now exhibits frequent episodes of seizure. Physical examination shows hepatomegaly and ecchymoses of the skin. His blood glucose is abnormally low. Biopsy of his liver was done revealing vacuolated cells positively staining for glycogen. The disease most likely to cause this is?
Tay-Sachs disease
McArdle Disease
von Gierke Disease
Pompe Disease

A

von Gierke Disease
*G6 PHOSPHATASE
SEVERE HYPOGLYCEMIA

97
Q

Surface protein is S. pyogenes responsible for antibodies and T cells cross-reacting with cardiac proteins.
LPS
m protein
c protein
s protein
none of the above

A

m protein

98
Q

A Trinucleotide repeat Mutations are amplifications of a sequence of three nucleotides, they also are associated with an Anticipation-type of inheritance, An example is the second most common cause of Mental retardation with a prominent PE finding of Macro-orchidism. What Nucleotide repeat will be seen in this patient?
CAG
GAA
CGA
GCA
NONE OF THE ABOVE
ALL ARE CORECT

A

NONE OF THE ABOVE
FRAGILE X SYNDROME (FMR-1)
200 OR MORE REPEATS

99
Q

A 19 y/o female develops a sore throat and fever during the past day. Physical Exam shows pharyngeal erythema and congestion. She is given naproxen. Which of the following features of the acute inflammatory response is most affected by the drug
Vasodilation
Emigration
Leukocytosis
Phagocytosis

A

Vasodilation
NSAIDS- NAPROXEN-PROSTAGLANDINS

100
Q

Opportunistic pathogen that causes progressive multifocal leukoencephalopathy
B. burgdorferi - lyme disease
JC Virus
C. difficile -psedomembranous colitis
M. furfur - fungi

A

JC Virus

PATHOLOGY (2nd year) (6 decks)

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