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Clinical Pathology > Pathology > Flashcards

Pathology Flashcards

1
Q

Acute myelogenous leukemia is:

A

occasionally aleukemic

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2
Q

Hodgkin’s lymphoma with the worst prognosis:

A

lymphocyte depletion

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3
Q

The most important difference between a benign reactive lymph node and lymphoma :

A

effacement of normal architecture

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4
Q

Plasma cells are characterized by

A

Abundant cytoplasm immunoglobulins

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5
Q

Paroxysmal hypertension is most typically associated with which of the following?

A

pheochromocytoma

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6
Q

The association of medullary carcinoma of the thyroid with pheochromocytoma with or without parathyroid hyperplasia or adenoma is called:

A

Sipple’s syndrome

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7
Q

Which of the following is the most common cause of Cushing’s syndrome

A

exogenous corticosteroids

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8
Q

A destructive lesion in this area will result in diabetes insipidus:

A

supraoptic and paraventricular hypothalamic nuclei

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9
Q

Conn’s syndrome is primarily associated with an excess of :

A

mineralocorticoids

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10
Q

Primary hyperaldosteronism is associated with:

A

hypokalemia

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11
Q

The single most frequent adrenal lesion producing primary hyperaldosteronism:

A

single unilateral adenoma

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12
Q

Truncal obesity, easy bruising and osteoporosis is associated with:

A

adrenal adenoma

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13
Q

Urinalysis results show proteinuria, red blood cells and casts, and 1-2 pus cells per HPO. These findings are consistent with:

A

acute post-streptococcal glomerulonephritis

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14
Q

Membranous glomerulopathy and poststreptococcal glomerulonephritis are similar in that they both:

A

have glomerular immune complex deposits

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15
Q

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?

A

Goodpasture’s syndrome

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16
Q

The most characteristic feature of rapidly progressive glomerulonephritis:

A

crescent formation

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17
Q

Benign nephrosclerosis is best defined as:

A

hyalinization of afferent arterioles with ischemic atrophy of nephrons

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18
Q

Ischemic acute tubular necrosis occurs most commonly in association with:

A

septic shock

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19
Q

The most common appearance of nephrotic syndrome in adults is:

A

membranous glomerulonephritis

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20
Q

“Nutmeg liver” is a gross finding seen in:

A

chronic passive congestion

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21
Q

Which of the following is associated with high levels of serum alkaline phosphatase?

A

metastatic carcinoma to the liver

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22
Q

The most common outcome in-patients with acute Hepatitis B is:

A

complete recovery without residual dysfunction

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23
Q

In a patient suspected of having viral hepatitis, which laboratory finding would indicate the most severe and life threatening amount of liver damage?

A

prolonged prothrombin time

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24
Q

The most important substance in the formation of gallstones is:

A

bile salts

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25
Q

Cirrhosis produces most of its clinical manifestations by means of:

A

vascular derangements in the liver

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26
Q

The major cause of portal hypertension is:

A

Intrahepatic

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27
Q

The most common factor in the formation of esophageal varices is obstruction at the level of:

A

intrahepatic vessels

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28
Q

When a person dies suddenly from a “heart attack” the most likely event causing it will be:

A

arrhythmia

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29
Q

Acute rheumatic heart disease is associated with:

A

arthritis

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30
Q

The most frequent and clinically significant residual lesion of acute rheumatic fever is:

A

pericardial adhesion

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31
Q

The absolute criterion of cardiomegaly:

A

c. increase in weight

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32
Q

Myocardial disease gradually producing 4-chamber dilatation:

A

congestive cardiomyopathy

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33
Q

Necrotizing infection caused by highly virulent organisms seeding a normal valve:

A

c. acute infective endocarditis

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34
Q

The most common cause of intestinal obstruction is:

A

adhesions

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35
Q

A two-week old boy has projectile vomiting. The most likely diagnosis is :

A

pyloric stenosis

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36
Q

An endoscopic gastric biopsy finding of intestinal type epithelia is most likely due to:

A

chronic gastritis

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37
Q

Most characteristic of right sided colon cancer compared to left-sided cancer:

A

anemia

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38
Q

Acute erosive gastritis is characterized by:

A

superficial and multiple gastric mucosal ulceration

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39
Q

The most common site of chronic gastric peptic ulcer:

A

lesser curvature at the antral-body junction

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40
Q

The definitive finding in acute appendicitis:

A

neutrophils in the muscularis

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41
Q

Morphologic appearance favoring benign rather than malignant gastric ulcer:

A

antral location

42
Q

Most frequently found neoplasm in the appendix:

A

carcinoid

43
Q

The most common malignant soft tissue tumor:

A

liposarcoma

44
Q

Brown tumors of bone is associated with:

A

hyperparathyroidism

45
Q

The most frequent site of compression fracture is:

A

vertebrae

46
Q

Rheumatoid arthritis usually has its origin in:

A

small peripheral joints

47
Q

Most common primary malignant bone tumor in 15-25 years of age:

A

osteosarcoma

48
Q

The most likely malignant bone tumor in a 65 yo man is:

A

Metastatic prostatic cancer

49
Q

The most common primary type of bronchogenic carcinoma is:

A

squamous cell carcinoma

50
Q

The source of surfactant is believed to be:

A

Type II pneumocyte

51
Q

The single most characteristic feature of bronchiectasis is:

A

dilatation of bronchi

52
Q

Non-communicating hydrocephalus means obstruction:

A

at the cisterna ambiens

53
Q

The most common cause of bacterial meningitis in a patient <2 months old is:

A

Escherichia coli

54
Q

The most important and consistent site for histologic lesion in parkinsonism is:

A

substantia nigra

55
Q

Increased hormonal stimulation may cause cells to undergo:

A

hyperplasia

56
Q

A reversible change or alteration in adult cells characterized by variation in size, shape and organization:

A

dysplasia

57
Q

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:

A

atrophy

58
Q

The most common cause of hypoxic injury is;

A

ischemia

59
Q

The sum of all morphologic changes following cell death:

A

necrosis

60
Q

The characteristic cellular infiltrate in the early phase of acute inflammation:

A

neutrophils

61
Q

The immediate transient phase of vascular permeability in most types of tissue injury is mediated by:

A

histamine

62
Q

The characteristic cell of a granuloma:

A

epithelioid cell

63
Q

The essential features of a granulation tissue:

A

small blood vessels and fibroblasts

64
Q

Acute pancreatitis:

A

enzymatic fat necrosis

65
Q

Acute inflammation is characterized by the following:

A

exudation

66
Q

The most common mechanism of vascular leakage elicited by free oxygen radicals:

A

direct endothelial cell injury

67
Q

Leukocyte adhesion, chemotaxis and activation are important inflammatory mediator processes performed by complement factor:

A

C5a

68
Q

Oxygen-derived free radicals are implicated in:

A

endothelial cell damage

69
Q

This inflammatory infiltrate is the prima donna of chronic inflammation because of the great number of biologically active substances it releases:

A

macrophage

70
Q

Adaptation has happen:

A

..is replaced by another cell type

71
Q

Characteristics of benign tumors:

A

cohesive

72
Q

The most reliable feature of malignancy:

A

metastasis

73
Q

The most common route of metastasis of a carcinoma:

A

lymphatic

74
Q

The most important prognostic factor for malignancy:

A

stage

75
Q

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:

A

Cytomegalovirus

76
Q

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:

A

Influenza A virus

77
Q

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:

A

ten

78
Q

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:

A

Neisseria gonorrhea

79
Q

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:

A

Vibrio cholera

80
Q

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 :

A

Clostridium tetani

81
Q

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:

A

Bronchopneumonia with pseudomonas

82
Q

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|:

A

4+ gram positive cocci

83
Q

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:

A

streptococcus pneumoniae

84
Q

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):

A

antinuclear antibody test

85
Q

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

A

X-inked agammaglobulinemia

86
Q

An appropriate, useful type I hypersensitivity response of the immune system, accompanied by eosinophilia, would be directed against:

A

pinworm infection

87
Q

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:

A

progressive systemic sclerosis

88
Q

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:

A

Type IV

89
Q

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

A

complement-mediated cell destruction

90
Q

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:

A

Anti-RNP

91
Q

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

A

Type III

92
Q

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:

A

Type IV

93
Q

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

A

glomerular immune deposits

94
Q

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

A

fibroadenoma

95
Q

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?

A

iron deficiency anemia

96
Q

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?

A

Buerger disease

97
Q

Ocular muscle weakness and general fatigability were found in a 38-year-old woman who also had antibodies to acetylcholine receptors. Diagnosis?

A

Myasthenia gravis

98
Q

Congenital aplasia of the thymus and parathyroid glands was discovered in a neonate that developed spastic contraction on the second postpartum day. Diagnosis?

A

DiGeorge syndrome

99
Q

Hemorrhagic cutaneous nodules in a male homosexual with AIDS. Diagnosis?

A

Kaposi sarcoma

100
Q

Short female with web neck and amenorrhea. Her karyotype was 45,X. Diagnosis?

A

Turner syndrome

Clinical Pathology (24 decks)

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