USMLE reproductive module Flashcards
A researcher is reviewing a large set of diverse tissue slides for the presence of a new cell surface receptor that is stained by immunofluorescence. The researcher first examines each slide to ensure that the stained tissue is from the correct organ indicated on the label.
Which of the following structures is the researcher most likely to see on a slide containing breast tissue?
Colloid-filled cells surrounded by blood vessels
Myoepithelial ducts surrounded by alveoli
Pyramidal cells containing large secretory organelles
Secretory cells arranged in cords and interspersed with adipose
Tubular glands in a highly vascular stroma lacking ducts
A 54-year-old male presents to his primary care physician due to concern about his “growing breasts.” He has not had any changes in his diet and exercises regularly. He reports no cold intolerance, changes in stool, or skin rashes. Medical history is significant for hypertension, essential tremor, gastroesophageal reflux disease, and alcohol use disorder. Medications include hydrochlorothiazide, propranolol, cimetidine, and a multivitamin. The patient is 167.6 cm (5 ft 6 in) tall and weighs 70.3 kg (155 lb); body mass index is 25 kg/m2. Temperature is 37.2°C (98.9°F), pulse is 72/min, and blood pressure is 134/83 mm Hg. Physical examination reveals a firm, mobile ball of tissue under each of his nipples.
The drug most likely responsible for this patient’s symptoms has which of the following mechanisms of action?
β-Adrenergic receptor antagonism
5-Hydroxytryptamine receptor antagonism
Histamine H2-receptor antagonism
Sodium-chloride cotransporter inhibition
Sodium/potassium/chloride transporter inhibition
A 65-year-old woman comes to a primary care physician’s office for her first physical examination in 20 years. The patient has no history of significant illness and denies a history of alcohol use. However, she gives a history of smoking 10 cigarettes a day for the past 20 years. She has had no recommended cancer screenings. Her father died of prostate cancer when he was 50 years old. On physical examination, there is a 2-cm firm, fixed, and nontender right axillary lymph node. A biopsy of the lymph node is performed, which reveals cancer metastatic to the lymph nodes.
Which of the following is the most likely histopathological description of the biopsied tissue?
Clusters of small basophilic epithelial cells
Ductal proliferation with stromal invasion
Globular myxoma cells
Large germinal centers with numerous mitotic figures and necrotic cells
Proliferation of intralobular stroma distorting the associated epithelium
A 57-year-old man comes to the physician because of a 2-week history of decreased libido. He was recently started on a medication for gastroesophageal reflux disease. He reports that he has been taking higher than the prescribed doses of this medication for persistent symptoms of heartburn.
The drug most likely prescribed for this patient’s reflux also puts him at increased risk for which of the following additional adverse effects?
Constipation
8%
Gynecomastia
76%
Interstitial nephritis
5%
Involuntary movements of the lips and tongue
3%
QT prolongation
A 21-year-old woman comes to her primary care physician for the evaluation of a small, firm mass on her right breast that she has had for the past 3 months. She says the mass increases in size during menstruation. She has no personal or family history of breast cancer. She does not report overlying skin changes or nipple discharge. Physical examination reveals a firm, nontender, and mobile mass in the lower, inner quadrant of her right breast.
Histologic examination of the mass will most likely show which of the following results?
Branching fibrovascular core extending from a dilated duct
Fibrotic stroma around normal glandular tissue
Large cells with clear halos
Parallel arrays of small, monomorphic cells with scant cytoplasm
Sheets of pleomorphic cells infiltrating adjacent stroma
A 27-year-old man presents to his physician with a painless lump that has been growing on his left breast for 1 month. The patient has no family history of malignancy. Physical examination reveals a nontender, fixed, hard mass measuring approximately 1 cm × 1 cm. There is no cervical or axillary lymphadenopathy. An ultrasound-guided biopsy of the mass is performed. Histologic findings from the biopsy are shown in the image.
Which of the following genetic abnormalities significantly increases the risk for this patient’s most likely disease?
47,XYY genotype
CGG trinucleotide repeat
CYP21A2 mutation
Trisomy 21
XXY genotype
A 37-year-old woman comes to the physician because of a left breast lump first noticed a few months ago. The patient does not believe the lump has changed in size even in relation to her cycle. The patient’s aunt died from breast cancer at 45 years of age, which she only recently came to know about. Physical examination reveals no visible lump, but a palpable mass is present just under the skin on the lateral aspect of the left breast. It is a globular lump, soft, nontender, freely mobile, and has a smooth margin.
Which of the following tissues would most likely be observed in this biopsy?
Cuboidal luminal cells and spindle-shaped myoepithelial cells
Irregular network of collagen fibers and fibroblast nuclei
Large, round, empty cells with peripherally displaced nuclei
Lymphocytes and plasma cells
Stratified squamous cells with keratinization
A 24-year-old man recently diagnosed with a testicular seminoma commences high-dose chemotherapy. A week later, he returns to the physician complaining of dry cough and shortness of breath. Cardiopulmonary physical examination is unremarkable. Imaging results are shown.
Among the chemotherapeutic agents used to treat this patient, the one most likely responsible for the patient’s new symptoms has which of the following mechanisms of action?
Alkylation of DNA
29%
Formation of superoxide or hydroxide radicals
47%
Inhibition of microtubule polymerization
10%
Inhibition of topoisomerase II
9%
Stabilization of microtubules against depolymerization
