Pathology Flashcards
Acute myelogenous leukemia is:
occasionally aleukemic
Hodgkin’s lymphoma with the worst prognosis:
lymphocyte depletion
The most important difference between a benign reactive lymph node and lymphoma :
effacement of normal architecture
Plasma cells are characterized by
Abundant cytoplasm immunoglobulins
Paroxysmal hypertension is most typically associated with which of the following?
pheochromocytoma
The association of medullary carcinoma of the thyroid with pheochromocytoma with or without parathyroid hyperplasia or adenoma is called:
Sipple’s syndrome
Which of the following is the most common cause of Cushing’s syndrome
exogenous corticosteroids
A destructive lesion in this area will result in diabetes insipidus:
supraoptic and paraventricular hypothalamic nuclei
Conn’s syndrome is primarily associated with an excess of :
mineralocorticoids
Primary hyperaldosteronism is associated with:
hypokalemia
The single most frequent adrenal lesion producing primary hyperaldosteronism:
single unilateral adenoma
Truncal obesity, easy bruising and osteoporosis is associated with:
adrenal adenoma
Urinalysis results show proteinuria, red blood cells and casts, and 1-2 pus cells per HPO. These findings are consistent with:
acute post-streptococcal glomerulonephritis
Membranous glomerulopathy and poststreptococcal glomerulonephritis are similar in that they both:
have glomerular immune complex deposits
A patient with hemoptysis and renal failure has a renal biopsy which reveals crescentic glomerulonephritis, with linear deposits of IgG and C3 on immunofluorescence. Diagnosis?
Goodpasture’s syndrome
The most characteristic feature of rapidly progressive glomerulonephritis:
crescent formation
Benign nephrosclerosis is best defined as:
hyalinization of afferent arterioles with ischemic atrophy of nephrons
Ischemic acute tubular necrosis occurs most commonly in association with:
septic shock
The most common appearance of nephrotic syndrome in adults is:
membranous glomerulonephritis
“Nutmeg liver” is a gross finding seen in:
chronic passive congestion
Which of the following is associated with high levels of serum alkaline phosphatase?
metastatic carcinoma to the liver
The most common outcome in-patients with acute Hepatitis B is:
complete recovery without residual dysfunction
In a patient suspected of having viral hepatitis, which laboratory finding would indicate the most severe and life threatening amount of liver damage?
prolonged prothrombin time
The most important substance in the formation of gallstones is:
bile salts
Cirrhosis produces most of its clinical manifestations by means of:
vascular derangements in the liver
The major cause of portal hypertension is:
Intrahepatic
The most common factor in the formation of esophageal varices is obstruction at the level of:
intrahepatic vessels
When a person dies suddenly from a “heart attack” the most likely event causing it will be:
arrhythmia
Acute rheumatic heart disease is associated with:
arthritis
The most frequent and clinically significant residual lesion of acute rheumatic fever is:
pericardial adhesion
The absolute criterion of cardiomegaly:
c. increase in weight
Myocardial disease gradually producing 4-chamber dilatation:
congestive cardiomyopathy
Necrotizing infection caused by highly virulent organisms seeding a normal valve:
c. acute infective endocarditis
The most common cause of intestinal obstruction is:
adhesions
A two-week old boy has projectile vomiting. The most likely diagnosis is :
pyloric stenosis
An endoscopic gastric biopsy finding of intestinal type epithelia is most likely due to:
chronic gastritis
Most characteristic of right sided colon cancer compared to left-sided cancer:
anemia
Acute erosive gastritis is characterized by:
superficial and multiple gastric mucosal ulceration
The most common site of chronic gastric peptic ulcer:
lesser curvature at the antral-body junction
The definitive finding in acute appendicitis:
neutrophils in the muscularis
Morphologic appearance favoring benign rather than malignant gastric ulcer:
antral location
Most frequently found neoplasm in the appendix:
carcinoid
The most common malignant soft tissue tumor:
liposarcoma
Brown tumors of bone is associated with:
hyperparathyroidism
The most frequent site of compression fracture is:
vertebrae
Rheumatoid arthritis usually has its origin in:
small peripheral joints
Most common primary malignant bone tumor in 15-25 years of age:
osteosarcoma
The most likely malignant bone tumor in a 65 yo man is:
Metastatic prostatic cancer
The most common primary type of bronchogenic carcinoma is:
squamous cell carcinoma
The source of surfactant is believed to be:
Type II pneumocyte
The single most characteristic feature of bronchiectasis is:
dilatation of bronchi
Non-communicating hydrocephalus means obstruction:
at the cisterna ambiens
The most common cause of bacterial meningitis in a patient <2 months old is:
Escherichia coli
The most important and consistent site for histologic lesion in parkinsonism is:
substantia nigra
Increased hormonal stimulation may cause cells to undergo:
hyperplasia
A reversible change or alteration in adult cells characterized by variation in size, shape and organization:
dysplasia
Type of cellular adaptation where there is marked increase in the number of autophagosomes accompanied by decrease in the number of mitochondria, myofilaments, ad endoplasmic reticulum:
atrophy
The most common cause of hypoxic injury is;
ischemia
The sum of all morphologic changes following cell death:
necrosis
The characteristic cellular infiltrate in the early phase of acute inflammation:
neutrophils
The immediate transient phase of vascular permeability in most types of tissue injury is mediated by:
histamine
The characteristic cell of a granuloma:
epithelioid cell
The essential features of a granulation tissue:
small blood vessels and fibroblasts
Acute pancreatitis:
enzymatic fat necrosis
Acute inflammation is characterized by the following:
exudation
The most common mechanism of vascular leakage elicited by free oxygen radicals:
direct endothelial cell injury
Leukocyte adhesion, chemotaxis and activation are important inflammatory mediator processes performed by complement factor:
C5a
Oxygen-derived free radicals are implicated in:
endothelial cell damage
This inflammatory infiltrate is the prima donna of chronic inflammation because of the great number of biologically active substances it releases:
macrophage
Adaptation has happen:
..is replaced by another cell type
Characteristics of benign tumors:
cohesive
The most reliable feature of malignancy:
metastasis
The most common route of metastasis of a carcinoma:
lymphatic
The most important prognostic factor for malignancy:
stage
A 25-year-old man with a history of intravenous drug use has had one bout of Pneumocystis carinii pneumonia which was successfully treated a year ago. He now has a WBC count of 3600/microliter with differential count of 78 segs, 3 bands, 5 lymphs, and 14 monos. He has recently developed painful, progressive visual loss involving both eyes. Which of the following infections is he most likely to have:
Cytomegalovirus
A 65-year-old previously healthy woman has had a non-productive cough increasing in severity over the last 10 days. She has a temperature of 38.0 C. A chest radiograph shows faint interstitial infiltrates but no areas of consolidation. A CBC reveals a WBC count of 8900/microliter with differential count of 60 segs, 3 bands, 25 lymphs, and 12 monos. A sputum gram stain reveals a few gram positive cocci, gram negative cocci, and Candida with few neutrophils. Her condition gradually improves over the next week. Which of the following infectious agents is most likely responsible for her illness:
Influenza A virus
A 39-year-old man had an acute febrile illness with fever, pharyngitis, lymphadenopathy, and malaise following a trip to a city known for its commercial sex workers. In how many years would you predict that his peripheral blood CD4 lymphocyte count will drop below 200/microliter:
ten
A 20-year-old commercial sex worker has lower abdominal pain of 24 hours duration. There is no previous history of pain. She is febrile, her total WBC is 29,000/mm3 with 85% neutrophils. She has a markedly tender lower abdomen on palpation. Laparotomy reveals a distended, fluid-filled reddened left fallopian tube that is about to rupture. The tube is removed. A culture of the fluid from the tube is most likely to grow:
Neisseria gonorrhea
A 10-year-old child has a severe watery diarrhea that causes her to become severely dehydrated over the past two days. The persistent activation of adenylate cyclase by GTP leads to excessive intestinal fluid loss. Which of the following organisms is most likely to produce a toxin that has this effect:
Vibrio cholera
An 18-year-old man is plowing a field on a hillside. He discovers a deep, penetrating puncture wound to his foot. He walks home and washes the soil off the wound site and puts a bandage over it. A week later the wound is healing, and the leg is not swollen, but he begins to experience generalized muscle spasms, with stiffness and pain in his shoulders and back. He has difficulty with eating and swallowing, with painful stiff jaw and facial muscles. Which of the following organisms is most likely responsible for these findings :
Clostridium tetani
A 41-year-old man has a chronic cough and recently experienced an episode of hemoptysis. A chest radiograph shows a cavitary 4 cm nodule in the right upper lung. There are a few adjacent smaller nodules with calcifications. The best diagnosis is:
Bronchopneumonia with pseudomonas
A 40-year-old man has had a productive cough with yellowish sputum for several days. A complete blood count shows that he has a total WBC count of 15,700/microliter with differential count of 73 segs, 10 bands, 12 lymphs, and 5 monos. He has a fever of 38.9 C. A chest radiograph reveals a nodule in the left upper lobe that has a central cavity with an air-fluid level. Which of the following findings is most likely to be present in his sputum|:
4+ gram positive cocci
A 78-year-old woman has a history of Alzheimer’s disease. She dies after an illness lasting only a two-day history of fever and cough productive of copious amounts of yellowish sputum. Her vital signs on admission included blood pressure 110/75 mm Hg, pulse 105, respirations 26, and temperature 38.1 C. She had dullness to percussion at the right lung base. The microscopic findings from the right lower lobe at autopsy include numerous neutrophils within the alveolar spaces, with minimal destruction of alveolar walls. What was the most likely infectious cause for her pulmonary disease:
streptococcus pneumoniae
A 22-year-old woman has experienced episodes of myalgias, pleural effusions, pericarditis, and arthralgias without joint deformity over the course of several years. She has continued working at her job. A CBC reveals a mild normocytic anemia. The best laboratory screening test to begin the workup for her condition would be a(an):
antinuclear antibody test
A male infant was born at term. No congenital anomalies were noted at birth. A year later he now has failure to thrive and has been getting one bacterial pneumonia after another with both Hemophilus influenzae and Streptococcus pneumoniae cultured from his sputum. You should most strongly suspect that he has which of the following diseases
X-inked agammaglobulinemia
An appropriate, useful type I hypersensitivity response of the immune system, accompanied by eosinophilia, would be directed against:
pinworm infection
A 54-year-old woman is found to have a blood pressure of 170/110 mm Hg. Her fingers become cold and painful upon exposure to cold. She has mild dyspnea, but no wheezing. The antinuclear antibody test is positive with a titer of 1:256 and a nucleolar pattern. Her serum urea nitrogen is 15 mg/dL with creatinine of 1.1 mg/dL. These findings most strongly suggest that she has which of the following autoimmune diseases:
progressive systemic sclerosis
Several hours after going on a hike through dense foliage, a 40-year-old man notices a slightly raised and tender irregular reddish rash on one forearm that was not covered by clothing. This rash gradually increases in intensity for a couple of days and then fades after two weeks. The rash is most indicative of:
Type IV
The second pregnancy of a 23-year-old woman appears uncomplicated until ultrasound performed at 19 weeks shows hydrops fetalis. The fetal organ development is consistent for 19 weeks, and no congenital anomalies are noted. Her first pregnancy was uncomplicated and resulted in the birth of a normal girl at term. The current pregnancy yields a baby born prematurely at 32 weeks gestation with marked icterus. The baby is also markedly anemic, and an exchange transfusion is performed. Which of the following immunologic mechanisms best explains these findings
complement-mediated cell destruction
A man in his mid-30’s presents with malar skin rash, polyarthritis with swelling and warmth of his hands, and sensitization to cold. On physical examination he has generalized lymphadenopathy and pale conjunctivae. Laboratory findings include a hemoglobin of 9.5 g/dL, total WBC count of 2100/microliter, total serum protein 8.8 g/dL, albumin 3.6 g/dL, creatinine 1.1 mg/dL, and creatine kinase of 468 U/L. His antinuclear antibody test is positive at 1:256. The best additional serologic test to help determine his underlying disease process is:
Anti-RNP
Several weeks following a pharyngitis in which the throat culture grew group A hemolytic streptococcus, a child is noted to have hematuria on urinalysis. An immunofluorescence staining pattern in a renal biopsy shows granular deposition of IgG and complement around glomerular capillary loops. Which of the following immune hypersensitivity mechanisms is most likely responsible for this pattern of findings
Type III
A 48-year-old man has a chronic cough with fever that have persisted for several months. The chest radiograph reveals a diffuse reticulonodular pattern. Microscopically on transbronchial biopsy there are focal areas of inflammation containing epitheloid macrophages, Langhan’s giant cells, and lymphocytes. These findings are most typical for which of the following immunologic responses:
Type IV
A 31-year-old woman with chest pain for the past week has a chest radiograph that shows modest bilateral pleural effusions. On chest CT scan, the pleural effusions, as well as a pericardial effusion, are observed. A thoracentesis on the left yields clear fluid with a low protein and cell count. She is found to have an anti-double stranded DNA titer of 1:512. If she is later found to have a serum urea nitrogen that is 55 mg/dL, it will probably be the result of which of the following pathologic processes
glomerular immune deposits
A 5 cm well-encapsulated mass was excised from the breast of a 21-year-old woman.Histologically, the mass was composed of elongated, ductlike structures surrounded by loose, fibrous connective tissue. Diagnosis
fibroadenoma
An 18-year-old medical student complains of poor concentration and easy fatigability. She had heavy menstrual bleeding but was otherwise healthy. Examination of the blood showed a microcytic, hypochromic erythrocytes. Diagnosis?
iron deficiency anemia
A 30-year-old man known to be a heavy smoker developed gangrene of the leg, which had to be amputated. Intraluminal thrombi associated with microabscesses in the wall of medium sized arteries were found in the resected leg. Diagnosis?
Buerger disease
Ocular muscle weakness and general fatigability were found in a 38-year-old woman who also had antibodies to acetylcholine receptors. Diagnosis?
Myasthenia gravis
Congenital aplasia of the thymus and parathyroid glands was discovered in a neonate that developed spastic contraction on the second postpartum day. Diagnosis?
DiGeorge syndrome
Hemorrhagic cutaneous nodules in a male homosexual with AIDS. Diagnosis?
Kaposi sarcoma
Short female with web neck and amenorrhea. Her karyotype was 45,X. Diagnosis?
Turner syndrome
