Pathology Prc Finaledit

PATHOLOGY Instructions:

Choose the BEST answer

1. Acute myelogenous leukemia is: a. most common in females b. most common in adults over 60 years old c. occasionally aleukemic d. associated with massive splenomegaly 1. Answer: C Robbins 6th ed pp. 677

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2. Hodgkin’s lymphoma with the worst prognosis: a. lymphocyte predominance b. nodular sclerosis c. mixed cellularity d. lymphocyte depletion 2. Answer: D Robbins 6th ed pp. 672

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3. The a. b. c. d. 3.

most important difference between a benign reactive lymph node and lymphoma : interstitial fibrosis follicular hyperplasia effacement of normal architecture presence of plasma cells Answer: C Robbins 6th ed pp. 649 MPL 0.33

4. Plasma cells are characterized by a. abundant surface immunoglobulins b. Fc surface receptors c. Abundant cytoplasm immunoglobulins d. Complement surface receptors 4. Answer: C Robbins 6th ed pp. 82

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5. Paroxysmal hypertension is most typically associated with which of the following? a. adrenal adenoma b. thyroid adenoma c. parathyroid adenoma d. pheochromocytoma 5. Answer: D Robbins 6th ed pp. 1166 MPL 1 6. The association of medullary carcinoma of the thyroid with pheochromocytoma with or without parathyroid hyperplasia or adenoma is called: a. Conn’s syndrome b. Cushing’s syndrome c. Sipple’s syndrome d. Waterhouse-Friedricksen’s syndrome 6. Answer: C Robbins 6th ed pp. 1167 MPL 0.25 7. Which of the following is the most common cause of Cushing’s syndrome a. exogenous corticosteroids b. adrenal cortical carcinoma c. oat cell carcinoma of the lungs d. basophilic adenoma of the pituitary 7. Answer: A Robbins 6th ed pp. 1153 MPL 0.33 8. A destructive lesion in this area will result in diabetes insipidus: a. mamillothalamic tract b. adenohypophysis c. subthalamic fasciculus d. supraoptic and paraventricular hypothalamic nuclei 8. Answer: D Robbins 6th ed pp. 1129 MPL 0.25 9. Conn’s syndrome is primarily associated with an excess of : a. glucocorticoids b. mineralocorticoids c. thyroid hormone d. ADH 9. Answer: B Robbins 6th ed pp. 1155 MPL 0.25 10. Primary hyperaldosteronism is associated with:

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a. hyponatremia b. hypotension c. elevation of plasma renin levels d. hypokalemia 10. Answer: D Robbins 6th ed pp. 1155

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11. The single most frequent adrenal lesion producing primary hyperaldosteronism: a. single unilateral adenoma b. multiple unilateral adenomas c. bilateral adenomas d. carcinoma 11. Answer: A Robbins 6th ed pp. 1155 MPL 0.25 12. Truncal obesity, easy bruising and osteoporosis is associated with: a. craniopharyngioma b. adrenal adenoma c. thyroid adenoma d. parathyroid adenoma 12. Answer: B Robbins 6th ed pp. 1154-1155 MPL 1 13 Urinalysis results show proteinuria, red blood cells and casts, and 1-2 pus cells per HPO. These findings are consistent with: a. acute cystitis b. acute pyelonephritis c. chronic pyelonephritis d. acute post-streptococcal glomerulonephritis 13. Answer: D Robbins 6th ed pp. 950 MPL 1 14. Membranous glomerulopathy and poststreptococcal glomerulonephritis are similar in that they both: a. are self-limiting and transient renal diseases b. are commonly associated with nephrotic syndrome c. are most commonly seen in children d. have glomerular immune complex deposits 14. Answer: D Robbins 6th ed pp. 953 MPL 0.5 15. 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. acute post-infectious glomerulonephritis b. membranous nephropathy c. Goodpasture’s syndrome d. Minimal change disease 15. Answer: C Robbins 6th ed pp. 951 MPL 1 16. The most characteristic feature of rapidly progressive glomerulonephritis: a. crescent formation b. hyaline nodules c. subepithelial dense deposits d. thickened capillary loops 16. Answer: A Robbins 6th ed pp. 951 MPL 1 17. Benign nephrosclerosis is best defined as: a. fibrinoid necrosis of afferent arterioles with ischemic atrophy of nephrons b. hyalinization of afferent arterioles with ischemic atrophy of nephrons c. diffuse thickening of glomerular capillary basement membrane leading to glomerulosclerosis d. deposition of basement-like material within the glomerular mesangium leading to glomerulosclerosis 17. Answer: B Robbins 6th ed pp. 981-982 MPL 0.25 18. Ischemic acute tubular necrosis occurs most commonly in association with: a. septic shock b. ruptured aneurysm c. carcinoma of the prostate d. malignant hypertension 18. Answer: A Robbins 6th ed pp. 969 MPL 1

19. The most common appearance of nephrotic syndrome in adults is:

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a. b. c. d.

proliferative glomerulonephritis membranous glomerulonephritis rapidly progressive glomerulonephritis wire-loops

19. Answer: B

Robbins 6th ed pp. 953

20. “Nutmeg liver” is a gross finding seen in: a. petechial hemorrhages b. viral hepatitis c. alcoholism d. chronic passive congestion 20. Answer: D Robbins 6th ed pp. 116-117

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21. Which of the following is associated with high levels of serum alkaline phosphatase? a. hemolytic anemia b. metastatic carcinoma to the liver c. Dubin-Johnson syndrome d. Gilbert’s syndrome 21. Answer: B Robbins 6th ed pp. 891 MPL 1 22. The most common outcome in-patients with acute Hepatitis B is: a. complete recovery without residual dysfunction b. chronic persistent hepatitis c. chronic active hepatitis d. postnecrotic cirrhosis 22. Answer: A Robbins 6th ed pp. 858 MPL 1 23. 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 b. high serum bilirubin c. high serum aspartate transaminases d. high serum alkaline phosphatase 23. Answer: A Robbins 6th ed pp. 867 MPL 1 24. The most important substance in the formation of gallstones is: a. calcium c. bile salts b. bilirubin d. lecithin 24. Answer: C Robbins 6th ed pp. 894 MPL 0.25 25. Cirrhosis produces most of its clinical manifestations by means of: a. hepatic necrosis leading to insufficient number of liver cells to sustain life b. cancerous change in regenerating nodules c. obstruction of large biliary passages d. vascular derangements in the liver 25. Answer: D Robbins 6th ed pp. 853 MPL 0.25 26. The major cause of portal hypertension is: a. Intrahepatic c. prehepatic b. Posthepatic d. cardiac 26. Answer: A Robbins 6th ed pp. 855

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27. The most common factor in the formation of esophageal varices is obstruction at the level of: a. esophageal vein b. hepatic vein c. intrahepatic vessels d. portal vein 27. Answer: C Robbins 6th ed pp. 783 MPL 0.25 28. When a person dies suddenly from a “heart attack” the most likely event causing it will be: a. aortic aneurysm b. coronary artery embolism c. congestive heart failure d. arrhythmia 28. Answer: D Robbins 6th ed pp. 562 MPL 1 29. Acute rheumatic heart disease is associated with: a. arthritis b. emboli to multiple organs

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c. cardiac tamponade d. right to left shunt 29. Answer: A Robbins 6th ed pp. 572

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30. The most frequent and clinically significant residual lesion of acute rheumatic fever is: a. myocardial fibrosis b. aortic stenosis c. mitral stenosis d. pericardial adhesion 30. Answer: D Robbins 6th ed pp. 570-571 MPL 0.25 31. The absolute criterion of cardiomegaly: a. increase in size b. increase wall thickness c. increase in weight d. change in shape 31. Answer: C Robbins 6th ed pp. 544

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32. Myocardial disease gradually producing 4-chamber dilatation: a. viral myocarditis b. hypertrophic cardiomyopathy c. congestive cardiomyopathy d. restrictive cardiomyopathy 32. Answer: C Robbins 6th ed pp. 579-581 MPL 1 33. Necrotizing infection caused by highly virulent organisms seeding a normal valve: a. rheumatic heart disease b. SLE endocarditis c. acute infective endocarditis d. marantic Endocarditis 33. Answer: C Robbins 6th ed pp. 572-573 MPL 1 34. The most common cause of intestinal obstruction is: a. adhesions b. volvulus c. neoplasm d. hernia 34. Answer: A Robbins 6th ed pp. 825 (table)

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35. A two-week old boy has projectile vomiting. The most likely diagnosis is : a. pyloric stenosis b. esophageal atresia c. annular pancreas d. incomplete rotation of the gut 35. Answer: A Robbins 6th ed pp. 789 MPL 0.25 36. An endoscopic gastric biopsy finding of intestinal type epithelia is most likely due to: a. chronic gastritis b. congenital heterotopia c. precancerous dysplasia d. metastatic carcinoma 36. Answer: A Robbins 6th ed pp. 790 MPL 0.25 37. Most characteristic of right sided colon cancer compared to left-sided cancer: a. anemia b. associated with polyposis c. bowel obstruction d. diarrhea 37. Answer: A Robbins 6th ed pp. 834 MPL 0.33

38. Acute erosive gastritis is characterized by: a. superficial and multiple gastric mucosal ulceration b. pus in the gastric mucosa c. deep ulcer with scarred base d. frequent association with gastric cancer

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38. Answer: A

Robbins 6th ed pp. 789-790

39. The most common site of chronic gastric peptic ulcer: a. lesser curvature at the antral-body junction b. anterior wall of the duodenal verge c. greater curvature at the mid-antrum d. esophago-gastric junction 39. Answer: A Robbins 6th ed pp. 795 40. The definitive finding in acute appendicitis: a. obstruction of the lumen by a fecalith b. mucus inspissation in the lumen c. neutrophils in the muscularis d. serosal congestion and margination of polys 40. Answer: C Robbins 6th ed pp. 839

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41. Morphologic appearance favoring benign rather than malignant gastric ulcer: a. large ulcer b. heaped up margin c. antral location d. folds radiating from the ulcer 41. Answer: C Robbins 6th ed pp. 795 MPL 0.25 42. Most frequently found neoplasm in the appendix: a. adenoma b. polyp c. carcinoid d. adenocarcinoma 42. Answer: C Robbins 6th ed pp. 840 43. The most common malignant soft tissue tumor: a. rhabdomyosarcoma b. malignant fibrous histiocytoma c. leiomyosarcoma d. liposarcoma 43. Answer: D Robbins 6th ed pp. 1261

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44. Brown tumors of bone is associated with: a. hyperparathyroidism b. trauma c. metastatic carcinoma d. vitamin deficiency 44. Answer: A Robbins 6th ed pp. 1228

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45. The most frequent site of compression fracture is: a. femur b. radio-ulnar area c. clavicle d. vertebrae 45. Answer: D Robbins 6th ed pp. 1229-1231

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46. Rheumatoid arthritis usually has its origin in: a. ball and socket joints b. lumbo-sacral joints c. small peripheral joints d. major weight-bearing joints 46. Answer: C Robbins 6th ed pp. 1251

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47. Most common primary malignant bone tumor in 15-25 years of age: a. chondrosarcoma b. osteosarcoma c. Ewing’s sarcoma d. Chondroblastoma 47. Answer: B Robbins 6th ed pp. 1236 MPL 1

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48. The most likely malignant bone tumor in a 65 yo man is: a. Giant cell tumor b. Osteosarcoma c. Metastatic prostatic cancer d. Multiple myeloma 48. Answer: C Robbins 6th ed pp. 1245

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49. The most common primary type of bronchogenic carcinoma is: a. metastatic carcinoma b. adenocarcinoma c. squamous cell carcinoma d. small cell carcinoma 49. Answer: C Robbins 6th ed pp. 743-744 MPL 1 50. The source of surfactant is believed to be: a. Type I pneumocyte b. Type II pneumocyte c. Mast cell d. Alveolar mcrophage 50. Answer: B Robbins 6th ed pp. 471

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51. The single most characteristic feature of bronchiectasis is: a. excessive mucus secretion b. immotile cilia c. dilatation of bronchi d. alpha-1 antitrypsin deficiency 51. Answer: C Robbins 6th ed pp. 716 MPL 1 52. Non-communicating hydrocephalus means obstruction: a. between ventricles and subarachnoid space b. at the cisterna ambiens c. at the arachnoid granulations d. at the vein of Galen 52. Answer: B Robbins 6th ed pp. 1298-1299

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53. The most common cause of bacterial meningitis in a patient