Download pathology written and practical exam 1

PATHOLOGY WRITTEN EXAM III
1. A 20 year old is found to have buccal and lip melanosis and hamartornatous polyps of the
colon. Which of the following is the MOST LIKELY diagnosis based on these clinical
findings?
A. Lynch syndrome
B. Gardner syndrome
C. Peutz-Jegners syndrome
D. juvenile polyposis
E. Familial polyposis
2. Which of the following is NOT associated with increased risk for developing ovarian
carcinoma:
A. Mutation in BRCA2 gene
B. Nulliparity
C. Family history
D. History of oral contraceptive use.
E. Mutation in BRCA1 gene
3. The primary lesion of Lyme disease is:
A. Erythema annulare
B. Erythema migrans
C. Erythema multiforme
D. Erythema dyschromicum perstans
E. Erythema auricularis
4. A child presents to their physician with a rash on the face, trunk and extremities. Ulcerated
oral lesions are also noted. A biopsy of an enlarged lymph node reveals reticuloendothelial giant
cells "Warthin-Finkeldey cells." Your diagnosis would be with an infection:
A. Rubella virus
B. Rubeola (measles)
C. Secondary Syphilis
D. Parvovirus Big
E. Varicella Zoster
5. Dizygotic twin pregnancy may occur with which configuration of the placental dividing
membrane?
A. Monoamnionic - monochorionic
B. Diamnionic - dichorionic
C. Diamnionic - monochorionic
D. Monoamnionic - dichorionic
E. None of the above
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6. Which of the following regarding cervical (PAP) smears is/are true
A. The slide containing the specimen should be allowed to air-dry
B. Endometrial cells are normally found in smears from post-menopausal females
C. The best time to perform the smear is during menstruation
D. Is an effective screening test for cervical cancer and its precursor lesions
E. All of the above
7. Which of the following is NOT considered a predisposing condition to development of colon
adenocarcinorna?
A. Familial polyposis
B. Inflammatory bowel disease
C. Adenomatous polyps
D. Booerhaave's syndrome
E. High fat diet
8. A 60-year-old woman notices scaling and crusting of the skin of her right nipple and areola.
There is no nipple discharge or nipple retraction. A palpable mass is not detected on physical
examination. A biopsy of the nipple shows very large cells surrounded by a clear zone within the
epidermis. The cytoplasm of the Dells stains positively with a mucin stain. Which of the
following statements is correct?
A. The patient most likely has a fibroadenoma.
B. The patient most likely has fat necrosis of the breast and nipple:
C. The patient most likely has ductal carcinoma of the breast.
D. The patient most likely has colon cancer which has metastasized to the breast.
E. The patient most likely has malignant melanoma involving the breast.
9. Which statement regarding fine needle aspiration is true? This technique:
A. Can be used to diagnose tumors
B. Cannot be performed by pathologists
C. Cannot be used to diagnose infections
D. Is usually associated with significant risk to the patient
E. Requires overnight hospital stay
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10. A 7 year old uncircumcised male presents with a chief complaint of recurrent episodes of
reddening and irritation of the penile foreskin. His father indicates that similar episodes started
two years ago, but now seem to be more frequent. Your physical examination shows a phimotic
foreskin with obvious circumferential scarring and narrowing of the preputial orifice; even with
moderate effort the patient cannot retract the foreskin. The foreskin and glans are hyperemic, and
debris and retained urine are visible in the balanopreputial sulcus (cul-de-sac). Which ONE of
the following should you do?
A. Assure the father that there are no long term sequelae to phimosis.
B. Dimiss the fathers concerns, tell him his son will "grow out of it" and recommend no
treatment.
C. Recommend circumcision.
D. Prescribe anti-virals taken by mouth; no follow-up visit is needed.
E. Inform the father that in spite of intense ongoing research, there is still no known
treatment for his son's condition.
11. A 35-year-old woman notices a small amount of bloody nipple discharge from her right
nipple. On physical examination, she has a 1 cm subareolar mass. The excised mass shows
delicate papillary fronds covered by a single layer of cuboidal epithelium overlying a connective
tissue stalk. Which of the following is the MOST LIKELY diagnosis?
A. lntraductial papilloma
B. Invasive ductal carcinoma
C. Lobular hyperplasia
D. Fibrocystic change
E. Fibroadenoma
12. A patient presents to the E.R. with a genital draining ulcer and painful swollen inguinal
lymph nodes. A darkfield exam is negative, however Gram stain of the lesion reveals Gram
negative bacilli. What Is the MOST LIKELY diagnosis?
A. Lymphogranulom venerum
B. Herpes
C. Chancroid
C. Syphilis
D. Papillomavirus
13. A 40 year old woman presents with a mass of the right parotid. A biopsy of the freely mobile
mass confirms the diagnosis of pleomorphic adenoma (benign mixed tumor). Which form of
therapy is MOST LIKELY to be recommended?
A. enucleation of the mass
B. local neck irradiation
C. complete excision including a thin rim of normal parotid
D. chemotheraphy
E. radical neck dissection and lymph node dissection
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14. Which of the following IS NOT a cause of adrenal insufficiency?
A. polyglandular autoimmune endocrinopathy
B. Conn's syndrome
C. rapid withdrawal of exogenous corticosteroids
D. autoimmune adrenalitis
E. tuberculous adrenalitis
15. An 18 year old girl presents with right sided abdominal pain. Ultrasonography reveals a 5 cm
cystic ovarian mass which is subsequently removed. During perioperative inspection sebaceous
material, hair and teeth are found within the cyst. The MOST LIKELY diagnosis in this case is
A. Dysgerminoma
B. Lymphoma
C: Benign teratoma
D. Metastatic carcinoma
E. Malignant teratoma
16. A 25 year old male presents with complaints of pain on urination. You forget to ask him how
long he has had this problem (shame on you). Before you examine hire you collect a urine
specimen. During the digital prostate exam he remarks that the procedure is slightly
uncomfortable but not painful. You procede with prostate massage and then milk the prostatic
secretions from the urethra into a specimen cup. Finally, you ask the patient to provide a postmassage urine specimen. All 3 specimens are sent to the lab for routine bacterial culture and
white blood cell (WBC) count. The results are as follows:
Pre-massage urine = 1 WBC per high power field; bacterial culture no growth.
Prostatic secretions = 100 WBC per high power field; bacterial culture no growth.
Post-massage urine = 40 WBC per high power field; bacterial culture no growth.
The MOST LIKELY diagnosis is;
A. Chronic bacterial prostatitis.
B. Sepsis of uncertain origin.
C. Acute bacterial prostatitis.
D. Chronic non-bacterial prostatitis.
E. Urinary tract infection.
17. A 38 year old woman with bitemporal hemianopsia is evaluated with an MRI. A large sellar
mass is identified. SerunVplasma hormone levels are obtained and prolactln is determined to be
moderately elevated, but the remainder of the hormone levels are normal. The tumor is resected
and does not stain for any of the pituitary hormones with immunohistochemical stains. Given
this history, pathologic and clinical findings, which of the following is the MOST LIKELY
diagnosis?
A. somatotroptmic adenoma
B. syndrome of inappropriate ADH secretion (SIADH)
C. prolactinoma
D. gonadotrophic adenoma
E. null cell adenoma with stalk effect
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18. An umbilical cord configuration associated with an increased incidence of fetal
malformations?
A. Single umbilical artery
B. Single umbilical vein
C. Single veramentous insertion
D. Single true knot
19. A highly communicable respiratory disease which initially presents with an incubation period
or catarrhal phase foil owed by a period of severe coughing with an inspiratory gasp is MOST
LIKELY due to
A. Rubella
B. Bordetella pertussis
C. Corynebacterium diphtheriae
D. Respiratory Syncytial virus
E. Human Herpes Virus 6
20. A 66 year old male smoker with a chronic clinical history of reflux esophagilis is seen by you
for an annual physical. He relates a history of continuing reflux symptoms, particularly after
large meals. Endoscopy is performed and confirms intestinal metaplasis of the squamous mucosa
from biopsies obtained from the distal esophagus. Which is the MOST LIKELY diagnosis?
A. Normal esophagus
B. Diffuse esophageal spasm
C. Primary esophageal adenocarcinoma
D. scleroderma
E. Barren's esophagus
21. An elderly gentleman presents with a white plaque on his tongue. He has a long history of
smoking. The biopsy is MOST LIKELY to show:
A. Squamous dysplasia
B. Mucocele
C. Oral hairy leukoplalda
D. Peripheral giant cell granuloma
E. Herpes infection
22. Which of the following is the MOST LIKELY karyotype to be present in complete molar
pregnancies:
A. 46, XX
B. 46, YY
C. 69, XXY
D. 69, XXX
E. 46, XY
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23. Which of these malformations accompanies systemic hypertension and left ventricular
hypertrophy?
A. Anomalous pulmonary venous drainage to the right atrium
B. Aortic valve atresia
C. Coarclation of the aorta
D. Truncus arteriosus
E. intramuscular ventricular septal defect
24. A 63 year old Caucasian male presents to your office complaining of mild stomach
discomfort and dyspepsia. He occasionally takes antacids and Pepcid AC for relief. Endoscopy
is performed and shows no discernible alterations. Biopsies of the stomach antrum, body and
fundus are obtained and submitted to surgical pathology for examination. A report from Dr.
Farhood confirms chronic active gastritis in the antrum, but normal fundus and body biopsies.
Helicobacter organisms are identified along the mucosal surface with special stains. No intestinal
metaplasia or atrophy is present. Which of the following diagnoses is MOST CONSISTENT
with the clinical findings and pathologic diagnoses?
A. acute erosive gastropathy
B. acute peptic ulcer
C. diffuse antral gastritis (type B)
D. multifocal atrophic gastitis (type C)
E. diffuse corporal atrophic gastritis (type A)
25. A Tzanck smear from a rash noted to be in a dermatomal pattern is positive showing
multinucleated giant cells. What would be the MOST LIKELY etiology?
A. Varicella Zoster Virus
B. Rubeola (measles) virus
C. Mumps virus
D. Cylomrgalovirus
E. Rubella virus
26. Which of the following is a maternal gestational infection with a potential for teratogenicity?
A. Pneumococcus
B. Rubella
C. Herpes simplex
O. Group B beta hemolytic streptococcus
E. Hemophilus influenza
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27. A 26 year old male presents with chief complaints of recent burning/tingling pains of his
penis. He admits to having new sexual partners in the past months. On physical exam you note a
group of small vesicles with erythematous bases on his glans. Some of the vesicles have ruptured
and ulcerated or have crusts. There is moderate inguinal lymphadenopathy. What are you
suspicious of and which ONE of the following should you do to confirm your clinical
suspicions?
A. Check for bubos to confirm the diagnosis of syphilis.
B. Aspirate the fluid from one vesicle with a syringe and send for the anti-chiamydia
antibody assay to confirm the diagnosis of syphilis.
C. Use a scalpel to open an intact vesicle and scrape it's base and perform a Tzanck smear
to look under the microscope for multinucleated giant cells and viral inclusions to
confirm the diagnosis of herpes simplex.
D. Scrape one of the crusted lesions and do a Tzanck smear to look for Donovan bodies.
E. Obtain vesicle fluid and send it for Treponema pallidum cultures to rule out granuloma
inguinale.
28. A 58 year old man Is evaluated for dysphagia and reflux in the evenings. He explains that on
one occasion he found some of his evening meal undigested on his pillow at midnight, after
retiring at 10 PM. He has been hospitalized previously for suspected aspiration pneumonia.
Motility and Manometric studies confirm relative aperistalsis of the body of the esophagus,
markedly increased baseline tone of the lower esophageal sphincter and incomplete relaxation of
the lower esophageal sphincter. Barium swallow also confirms a dilated body of the esophagus.
Endoscopy with biopsy of the lower esophagus confirms squamous mucosa with mild chronic
inflammation. Based on the available clinical findings, what is the MOST LIKELY diagnosis?
A. Barrett's esophagus
B. achalasia
C. scleroderma
D. Diffuse esophageal spasm
E. polymyositis
29. Gas gangrene is caused by which of the following bacteria?
A. Escherichia coli
B. Clostridium perfringens
C. Pseudomonas aeruginosa
D. Aerobacter aerogenes
E. All of the above
30. Which of the following is a maternal infection with little potential for transplacental infection
of the fetus?
A. Cytomegalovirus
B. Toxoplasmosis
C. Group B beta hemolytic streptococcus
D. Rubella
E. Syphilis
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31. A 70 year woman with chronic constipation, requiring disimpaction in the emergency room
on several recent occasions, presents again to the ER with complaints of moderate hematochezia.
She exhibits out orthostatic hypotension on physical exam, pulse is 100, and reclining blood
pressure is 90/60. She has a temperature of 100.8 degrees F. Abdominal exam confirms moderate
tenderness of the left lower quadrant. Gynecologic exam is normal and the left adnexa are
normal. Rectal exam confirms bright red blood intermixed with firm stool, but no palpable
masses. Which ONE of the following is the MOST LIKELY diagnosis based on these findings?
A. Mallory-Weiss injury
B. Acute appendicitis
C. Villous adenoma of the rectum
D. Anorectal Crohn's disease
E. Colonic diverticular disease
32. A 2 year old child presents with an abdominal mass and hematuria. CT of abdomen shows a
5cm mass arising from the right kidney. Plasma renin levels were elevated. The mass is resected
and histology reveals areas with sheets of small blue cells, structures resembling primitive
glomeruli and tubules, and areas wish spindle cells. The MOST LIKELY diagnosis in this case
is:
A. Renal cell carcinoma
B. Wilms tumor
C. Metastatic carcinoma
D. Neuroblasloma
E. Ganglioneuroma
33. A 30-year-old woman has surgery for resection of thyroid cancer. Post-operatively, she
develops paresthesias In her hands, numbness around her mouth, and mental status changes.
Which is likely?
A. She may develop cardiac valvular insufficiency
B. Suddenly low T3 and T4 levels are responsible for her symptoms
C. Massive amounts of parathyroid hormone-related protein were released from the
tumor in surgery
D. She will have a positive Chvostek sign
E. She Is at risk for developing osteitis fibrosa cystica
34. A 53 year old man presents with cutaneous flushing, episodic diarrhea, bronchospasm, and
tricuspid Insufficiency with right heart failure. 24-hour urine is obtained for 5-HIAA levels (5hydroxy indole acetic acid) and determined to be severely elevated. Which of the following is
MOST LIKELY?
A. Autoimmune adrenalitis
B. Carcinoid syndrome
C. pheochromocytoma arising in the adrenal medulla
D. Cushing's syndrome
E. Addisonian crisis
-8-
35. Which factors have a rate in the pathogenesis of congenital atresia of the ileum?
A. Intrauterine damage to the gut wall.
B. Chromosomal abnormality
C. Defective canalization of the embryonal gut lumen.
D. Absent ganglion cells in the Auerbach plexus
36. Several days after neurosugery for removal of a prolactinoma, a 28 year old male develops
polyuria, polydipsia, and excessive thirst. Which of the following is the MOST LIKELY
diagnosis?
A. pituitary apoplexy
B. persistent prolaciinoma with stalk effect
C. psychogenic polydipsla
D. syndrome of inappropriate AD H release
E. diabetes insipidus
37. Which of the following treponernatoses affects the skin only?
A. Bejel
B. Syphilis
C. Lyme disease
D. Pinta
E. Yaws
38. A congenital abnormality indicates presence at birth. Which of the following qualify for that
designation?
A. Cystic adanomatoid malformation
B. Hyaline membrane disease
C. Necrotizing enteropathy
D. Kernicterus
For each numbered item (Column 1) choose the letter of the MOST CLOSELY related item in
Column 2.
39. 40-year-old woman with an enlarged
and nodular uterus.
40. 61-year-old woman with an enlarged
uterus and postmenopausal bleeding.
41. 25-year-old woman with an ovarian
mass and virilization.
A. Endometrioid adenocarcinorna
B. Sertoli-Leydig cell tumor.
C. Leiomyomas.
42. Which one of the following is TRUE for condyloma acuminatum.
A. it can only be treated by intravenous anti-viral drugs, usually given for 6 months.
B. It is associated with HPV (human papilloma virus)
C. it is found exclusively on the penis in males.
D. It is typically a deeply invasive neoplasm.
E. It is not transmitted through sexual contact.
-9-
43. A 55 year old woman has linilis plastica and bilateral, solid masses of the ovaries. She is also
found to have an enlarged left supraclavicular node. What is the MOST LIKELY cause of the
ovarian masses?
A. mucinous cysladenomas
B. Brenner's tumors
C. Malignant lymphoma
D. serous papillary carcinomas
E. Krukenberg tumors
44. The MOST important finding to confirm the diagnosis of cystic renal dysplasia in a child
with bilateral cystic renal disease is:
A. Liver biopsy showing portal fibrosis and bite duct proliferation
B. Microscopic examination of the kidney showing immature mesenchyme, primitive
tubules, and cartilage
C. Positive family history of cystic renal disease
D. Presence of cysts in the renal medulla
E. Microscopic examination of the kidney with confirmation of the collecting duct origin
of the cysts
45. Which of the following rickettsioses is transmitted by aerosols?
A. Typhus
B. Rickettsialpox
C. Erlichiosis
D. Q fever
E. Rocky Mountain spotted fever
46. What are the pathologic effects of a cardiac ventricular septa) detect with an unobstructed
pulmonary valve?
A. Pulmonary hypertension
B. Splanchnic hypoperfusion
C. Systemic arterial oxygen unsaturation and cyanosis
D. Diminished pulse pressures in the lower extremities
E. Diminished pulmonary blood flow
47. Potters syndrome (with oligohydramnios and pulmonary hypoplasia) can occur in association
with:
A. Acquired cystic renal disease
B. Posterior urethral valve
C. Simple cysts
D. Non-uremic medullary cystic disease
E. All of the above
- 10 -
48. Oligohydrarnnios, a diminution in volume of amniotic fluid, has a high association with what
fetal anomaly?
A. Tetralogy of Fallot
B. Urinary tract obstruction
C. Germinal matrix hemorrhage
D. Congenital cystic adenomatoid malformation
E. None of the above
49. A 30 year old woman presents with bloody diarrhea, arthritis, and weight loss, with
occasional unexplained fever and fatigue. CBC confirms a microcytic anemia and irondeficiency. Ova and parasite stool examination is negative, and routine bacteriologic cultures of
the stool are also negative. Endoscopic exam shows cobblestoning of the terminal ileum,
intervening, uninvolved “skip" regions, and fissuring and cobblestoning of the descending colon.
Which of the o owing is the MOST LIKELY diagnosis?
A. Colonic adenocarcinoma
B. Amoebic colitis
C. Ulcerative colitis
D. Crohn's disease
E. Diverticulosis
50. A 45-year-old woman undergoes a left breast biopsy for what is thought to MOST LIKELY
be fibrocystic disease. Lobular carcinoma-in-situ is discovered along with the fibrocystic change.
Which of the following is true of these findings?
A. She has an increased risk of developing invasive carcinoma.
B. if she develops invasive carcinoma, the cancer may be ductal or lobular.
C. If she develops invasive carcinoma, the tumor is as likely to involve her right breast as
it is her left.
D. Lobular carcinoma-in-situ is less common than ductal carcinoma-in-situ.
E. All of the above
51. Circumstance that makes an infant particularly vulnerable to respiratory distress syndrome
with hyaline membrane disease?
A. Transplacental rubella
B. Aspiration of amniotic sac content
C. Deficient surfactant
D. Single umbilical artery
E. Inspissated meconium
- 11 -
52. A 15 year old presents with hematochezia and colonoscopy confirms multiple adenomatous
polyps throughout the colon. Further physical examination of the patient reveals mandibular
osteomas and numerous keratinous cysts (epidermal inclusion cysts) of the skin. Which is the
MOST LIKELY DIAGNOSIS?
A. Familial polyposis
B. Lynch syndrome
C. Gardner syndrome
D. juvenile polyposis
E. Peutz-Jeghers syndrome
53. Which of the following ovarian tumors is MOST LIKELY to be associated with
endometriosis:
A. Dermold cyst.
B. Clear cell carolnoma.
C. Dysgerminoma.
D. Serous carcinoma.
E. Brenner tumor.
54. A 45-year-old woman has hypercalcemia discovered on routine bloodwork. She has no
symptoms of hypercalcemia and no other known medical conditions. Which of the following is
the MOST LIKELY etiology?
A. Secondary hyperparathyroidism
B. Vitamin D intoxication
C. Parathyroid adenoma
D. Squamous cell carcinoma of the lung
E. Parathyroid carcinoma
55. Which of the following clinical findings may be seen in cases of bacterial sepsis?
A. Diffuse alveolar damage
B. Fever
C. Leukopenla
D. Disseminated intravascular coagulopathy
E. All of the above
For each numbered item (Column 1) choose the letter of the MOST CLOSELY related item in
Column 2 (GSD = glycogen storage disease).
56. Pompe's disease ((-glucosidase
A. hepatic-hypoglycemic GSD
deficiency) Infantile form presents with
B. muscle-energy GSD
enlarged heart, liver, tongue.
C. lysosomal storage disease involving
57. von Glerke disease (GSD Type la;
glycogen
glucose-6-phosphatase deficiency)
Enlarged liver, lactic acidosis, poor
growth.
58. McArdle disease (GSD Type V: muscle
phosphorylase deficiency) Muscle pain
and cramps, myoglobinuria.
- 12 -
59. A time during gestation when the embryo or fetus has maximum susceptibility to
malformation or disruption by exogenous stimuli.
A. First trimester
B. 30th week gestational age
C. Third trimester
D. Second trimester
For each numbered item (Column 1) choose the letter of the MOST CLOSELY related item in
Column 2. Answers may be used more than once.
60. Brenner tumor
A. Sex cord stromal tumor
61. Ovarian fibroma
B. Germ cell tumor
62. Clear cell carcinoma
C. Epithelial tumor
63. Endometriosis
D. Congenital anomaly
64. Struma ovari
E. None of the above
65. A 52 year old alcoholic male presents vomiting large amounts of bright red blood. You place
an IV and stabilize his blood pressure. Emergency endoscopy is performed and shows linear,
longitudinal mucosal tears of the lower esophagus. What is the MOST LIKELY diagnosis?
A. Barrett's esophagus
B. Traction diverticuli
C. Severe erosive gastroesophageal reflux
D. Mallory-Weiss Injury
E. Herpes esophagitis
66. A 25-year-old woman has a tender right breast mass. She is 3 months post-parturn and has
been breast feeding her infant. On physical examination, she has a 1 cm subareolar mass and
fissuring of the right nipple. Which of the following is the MOST LIKELY diagnosis?
A. Inflammatory carcinoma
B. Fibroadenoma
C. Fat necrosis
D. Abscess caused by Staphylococcus
E. Granulomatous inflammation caused by Mycobacterium
67. Which of the following anatomic structures would be, expected in a normal infant born at 40
weeks gestation?
A. Germinal centers in the lymph nodes
B. Germinal centers in the thymic medulla
C. Valve competent foremen ovate
D. Nephrogenic zone in the kidney
- 13 -
68. A 58-year-old woman presented with postmenopausal bleeding. An endometrlal biopsy
showed increase in endometrial glands relative to stroma with cystically dilated glands and no
nuclear alypia. What is the diagnosis?
A. Complex endometrial hyperplasia.
B. Serous carcinoma.
C. Endometrioid adenocarcinoma.
D. Simple endometrial hyperplasia.
E. Atypical endometrial hyperplasia.
69. A 30 year old woman is found to have multiple, shallow and fresh erosions scattered
throughout the stomach. Which of the following entities should NOT be included in the
differential diagnosis of etiologic agents In this patient's acute erosive gastritis?
A. ethanol
B. burns
C. carbonated beverages
D. shock
E. nonsteroidal anti-inflammatory drugs
70. Which of the following is INCORRECT with reference to acute bacterial prostatitis (ABP)?
A. The bacteria responsible for ABP are often the same as those found in urinary tract
infections, such as E. coli.
B. ABP usually presents with back or perineal pain, but is more often asymptomatic,
C. ABP can be caused by the introduction of bacteria into the prostate during a surgical
procedure.
D. If ABP is clinically suspected, start empiric anti-bacterials without prostate massage.
E. ABP can result in abscess formation in the prostate parenchyma.
71. Erysipeloid is caused by which of the following bacteria?
A. Erysipelothrix rhusiopathiae
B. Streptococcus pyogenes
C. Streptococcus agalactiae
D. Staphylococcus aureus
E. None of the above
72. Which of the following is the MOST COMMON malignancy of the thyroid?
A. anaplastic carcinoma
S. lymphoma
C. medullary carcinoma
D. follicular carcinoma
E. papillary carcinoma
- 14 -
73. A patient presents to the ER with a painful genital vesicular lesion. A scraping of the lesion is
collected and multinucleated syncylia are observed microscopically. What is the MOST
LIKELY etiology?
A. Syphilis
B. Chancroid
C. Herpes
D. Papillomavirus
E. Lymphogranuloma venerum
74. An 18 year old girl presents to the emergency room with right lower quadrant pain. Which of
the following SHOULD NOT be included in your differential diagnosis as the etiology for her
abdominal pain?
A. mesenteric lymphadenitis
B. acute pelvic inflammatory disease
C. "milteishmerz'"
D. acute appendicitis
E. diverticulosis
75. In which of the following conditions does the aorta receive blood from the right ventricle?
A. Coarctation of the aorta with a ligamemurn arteriosum
B. Infracristal ventricular septal defect
C. Pulmonic valve stenosis
D. Foramen secundurn atrial septal defect
E. Tetralogy of Fallot
76. Which one of the following is INCORRECT concerning infection/inflammation in the
testes:
A. Bilateral orchitis (inflammation of the testis) is seen in nearly all 8-12 year old boys
with mumps.
B. Gonorrhea can spread from the urethra to the prostate and eventually to the
epididymis.
C. Syphilitic orchitis is characterized by a lymphoplasmacytic infiltrate and obliterative
endarteritis.
D. Granulomatous inflammation is present in tuberculosis of the testis.
E. Non-specific infections often result from spread of a microbe from a urinary tract
infection.
- 15 -
Match the clinical situation with the MOST LIKELY organism.
77. A 20-year-old renal transplant
A. Histoplasma
patient develops a lymphoproliferative
B. Eptein-Barr Virus
disorder 2 months after transplant,
C. Parvovinis B19
78. A 10-year-old girl with sickle cell
D. Coccidiomyces
disease develops a more severe ,
E. Sporothrix
anemia than usual, and her bone
marrow does not respond with the
production of raticulocytes.(early red
cells).
79. 3. A 30-year-old previously healthy
man develops fever, cough, and
pulmonary lesions on chest x-ray after
a vacation in Santa Fe and the
surrounding area.
80. 4. A 45-year-old man who works for a
landscape company develops several
ulcerated nodular lesions along the
inner aspect of his right arm.
81. What are the TYPICAL anatomic features of Hirschsprung disease?
A. Absent myenteric ganglion cells in the distal colon.
B. Absent myenteric ganglion cells in the proximal colon.
C. Constriction of the proximal colon
D. Dilatation of the distal colon
82. A 43-year-old woman presents with vulvar itching. Examination showed multiple vulvar and
perineal papule and macules. Some of the lesions were gray: some were white, while others were
erythematous. A punch biopsy of one of the lesion was performed. Which of the following is the
biopsy is MOST LIKELY to show:
A. Chlamydia trachomatis infection.
B. Vulvar intraepithelial neoplasia.
C. Lymphogranuloma venereum.
D. Granuloma inguinale.
E. Primary syphilis.
83. Causes of Cushing's disease or syndrome include all of the following, EXCEPT:
A. Pituitary adenoma
B. Adrenal cortical adenoma
C. Autoimmune adrenalitis
D. exogenous corticosteroids
E. Small cell carcinoma
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ANSWERS:
C
D
B
B
B
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E
C
A
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A
C
C
B
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D
E
A
B
E
A
A
C
C
A
B
C
B
B
C
E
B
D
B
A
E
D
A
C
A
B
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
- 17 -
B
E
B
D
A
B
B
D
E
C
C
B
C
E
C
A
B
A
C
A
C
E
B
D
D
C
D
C
B
A
E
C
E
E
A
B
C
D
E
A
B
C
- 18 -