Patho Robbins
3. A 6-year-old boy is taken to the pediatrician because of generalized facial edema and somnolence. He has been passing dark brown urine. Physical examination reveals hypertension. Urinalysis shows oliguria, hematuria, proteinuria, and red blood cell casts. Which of the following is the most likely diagnosis? a. Nephritic syndrome b. Nephrotic syndrome c. Rapidly progressive acute renal failure d. Chronic uremia e. Nephrolithiasis
A These clinical findings are typical signs and symptoms associated with nephritic syndrome, which is most likely caused by acute glomerulonephritis.
3. Which of the following skin lesions will most likely progress to invasive squamous cell carcinoma? a. Actinic keratosis b. Seborrheic keratosis c. Seborrheic dermatitis d. Epidermal inclusion cyst e. Steatocystoma multiplex
A Actinic keratosis is an intraepithelial malignancy that can progress to invasive squamous cell carcinoma; it is therefore advisable to remove these lesions before they transform into squamous cell carcinoma.
4. Loss of heterozygosity, structural rearrangements, or point mutations of the retinoblastoma tumor suppressor gene (RB) are found in 60%-70% of all sporadic bone tumors. Which of the following is the best classification for this tumor? a. Osteosarcoma b. Osteoblastoma c. Osteoid osteoma d. Chondrosarcoma e. Ewing sarcoma
A Changes involving the retinoblastoma tumor suppressor gene RB are found in 60%-70% of all sporadic osteosarcomas.
6. Comedocarcinoma of the breast is a type of which of the following carcinomas? a. Ductal carcinoma in situ b. Medullary carcinoma c. Invasive ductal carcinoma d. Invasive lobular carcinoma e. Tubular carcinoma
A Comedocarcinoma is a type of ductal carcinoma in situ. This preinvasive type of carcinoma is composed of pleomorphic malignant cells forming solid intraductal sheets with central necrosis. If not removed surgically, comedocarcinoma will progress to invasive ductal carcinoma.
8. Which of the following infectious agents causes condyloma acuminatum of the penis? a. Human papillomavirus types 6 and 11 b. Human papillomavirus types 16 and 18 c. Herpesvirus type 1 d. Herpesvirus type 2 e. Ureaplasma urealyticum
A Condyloma acuminatum is caused by the noncarcinogenic strains of human papillomavirus types 6 and 11. Human papillomaviruses types 16 and 18 are found in squamous cell carcinoma of the penis.
6. Which kidney disease characterized by nephrotic syndrome, microscopic hematuria, and glomerular deposits of C3 complement and properdin is caused by an autoantibody called C3 nephritic factor? a. Membranoproliferative glomerulonephritis type II b. Focal segmental glomerulosclerosis c. Membranous nephropathy d. IgA nephropathy e. Acute postinfectious glomerulonephritis
A Deposits of C3 complement and properdin in the glomerular basement membranes, visible by electron microscopy in the form of ribbon-like densities and associated with low serum complement, are typical of membranoproliferative glomerulonephritis type II. This kidney disease is caused by C3 nephritic factor, an autoantibody binding to the alternative complement pathway regulating enzyme C3 convertase.
11. A 25-year-old woman had a workup for infertility. During the laparoscopic examination, the gynecologist found foci of endometriosis. Such foci are most often seen on which of the following sites? a. Ovary b. Uterine ligaments c. Rectovaginal septum d. Pelvic peritoneum e. Appendix
A Foci of endometriosis are seen most often on the ovaries. Other sites involved are the uterine ligaments, rectovaginal septum, pelvic peritoneum, and appendix, listed in descending order of frequency.
2. Which of the following infectious agents is the most common cause of urinary tract infection? a. Escherichia coli b. Proteus vulgaris c. Klebsiella sp d. Streptococcus faecalis e. Staphylococcus aureus
A More than 85% of all urinary tract infections are caused by gram-negative bacteria. Escherichia coli is the most common pathogen from the group of bacteria listed in the question.
9. Penile carcinomas tend to metastasize first to which of the following nodes? a. Inguinal lymph nodes b. Obturator lymph nodes c. Internal ileac lymph nodes d. External iliac lymph nodes e. Paraortic abdominal lymph nodes
A Penile carcinomas tend to metastasize first to the inguinal lymph nodes. However, only 50% of patients who have penile carcinoma with enlarged inguinal lymph nodes at the time of diagnosis have lymph node metastases; the enlarged lymph nodes in the remaining half histologically show only lymphoid hyperplasia.
1. A nephrectomy specimen reveals a yellow lesion with large amounts of lipids in the kidney of a 63-year-old man. The lesion is most likely related to a. a deletion of von Hippel-Lindau (VHL) tumor suppressor gene b. a mutation of myc oncogene c. an amplification of ras oncogene d. a loss of bcl-2 proapoptotic gene e. an aflatoxin related carcinogen
A The kidney contains a large renal cell carcinoma. These tumors contain large amounts of lipids, which accounts for their yellow color on gross examination and the clear appearance of cells in routine microscopic slides. Deletions of the von Hippel-Lindau mutations are found in most clear renal cell carcinomas.
12. A high level of expression of the tumor suppressor gene PTEN will most likely be found in which of the following? a. Normal proliferative phase endometrium b. Uterine ligaments c. Complex atypical endometrial hyperplasia d. Endometrial intraepithelial neoplasia e. Adenocarcinoma of the endometrium
A The tumor suppressor gene PTEN is normally expressed in the endometrial glands in the proliferative phase of the menstrual cycle, but it is not expressed in the secretory phase. It is also lost in 63% of premalignant complex atypical endometrial hyperplasia (also known as endometrial intraepithelial neoplasia) and in 50%-80% of endometrial adenocarcinomas.
3. Thyroid ophthalmopathy is typically found in patients who have which of the following disorders? a. Graves disease b. Multinodular goiter c. Toxic (hyperfunctioning) adenoma of the thyroid d. Hashimoto thyroiditis e. Riedel thyroiditis
A Thyroid ophthalmopathy, which is characterized by a wide-eyed staring gaze and exophthalmos, is a feature of Graves disease. It is not found in other forms of hyperthyroidism caused by multinodular goiter or toxic adenoma, or in hypothyroidism caused by Hashimoto or Riedel thyroiditis.
5. A 30-year-old heroin addict who is positive for the human immunodeficiency virus (HIV) is hospitalized because of generalized edema. Laboratory studies show proteinuria, hypoalbuminemia, hyperlipidemia, and lipiduria. Which of the following diseases is most likely to be diagnosed by a biopsy of the kidney? a. Lipoid nephrosis b. Focal segmental glomerulosclerosis c. Membranous nephropathy d. IgA nephropathy e. Amyloidosis
B Clinical findings indicate that this patient has nephrotic syndrome. The most likely cause of nephrotic syndrome in a patient who is HIV-positive is focal segmental glomerulosclerosis.
1. The autosomal dominant bone disorder caused by a mutation of fibroblast growth factor receptor 3 (FGFR3) is characterized by short stature, rhizomelic shortening of limbs, frontal bossing of the skull, and midface abnormalities. Which of the following disorders is described by these characteristics? a. Achondrogenesis b. Achondroplasia c. Multiple epiphyseal dysplasia d. Synpolydactyly e. Holt-Oram syndrome
B Dwarfism, characterized by short limbs and relatively large head with midfacial changes involving the nose, is related to the mutation of the fibroblast growth factor receptor 3 (FGFR3) and is called achondroplasia.
1. The best characterized molecular abnormality in pituitary adenomas involves which of the following? a. Cell surface receptors b. G-proteins mediating signal transduction c. Adenylate cyclase related cytoplasmic effectors d. Nuclear receptors e. DNA repair enzymes
B G-protein mutations are the best characterized molecular abnormalities found in pituitary adenomas. G-proteins are involved in the transmission of signals from cell surface receptors stimulated with hypothalamic release factors and intracellular effectors, such as the adenylate cyclase system.
4. The PKD1 gene encoding polycystin-1 is a large integral membrane protein. It is typically found in persons who have which of the following diseases? a. Childhood polycystic kidney disease b. Adult polycystic disease c. Adult onset renal medullary cystic disease d. Glomerulocystic disease e. Acquired renal cystic disease c
B The PKD1 gene encoding polycystin-1 is mutated in most persons who have autosomal dominant polycystic kidney disease (PKD), which is also known as adult PKD. This disease is frequently associated with polycystic liver disease and berry aneurysms of the circle of Willis.
4. A patient who develops cancer later in life shows an increased tendency to develop urogenital congenital anomalies of the lower urinary tract. Which of the following anomalies is this patient most likely to develop? a. Bladder diverticular b. Bladder exstrophy c. Hypospadia d. Congenital urethral stenosis e. Megaureters
B Urinary bladder exstrophy is associated in later life with an increased incidence of adenocarcinoma of the urinary bladder and also with adenocarcinomas of the colon.
5. Vascular endothelial growth factor (VEGF) is implicated in the pathogenesis of which complication of diabetes? a. Cerebral infarcts b. Intraretinal microangiopathy c. Diabetic glomerulosclerosis d. Gangrene of the foot e. Peripheral neuropathy
B Vascular endothelial growth factor (VEGF) stimulates intraretinal angiogenesis and is implicated in the pathogenesis of proliferative intraretinal microangiopathy.
15. A uterus with a luminal lesion was removed from a 58-year-old woman who complained of metrorrhagia. Most likely this lesion is pathogenetically related to a. herpesvirus infection b. human papillomavirus infection c. hyperestrinism d. multiparity e. endometriosis
C A luminal lesion is most likely an endometrial adenocarcinoma. Endometrial adenocarcinoma occurs with increased incidence in many conditions marked by hyperestrinism, and estrogen is considered to have major role in the pathogenesis of these tumors.
13. Elevated 17-ketosteroid excretion, masculinization, and hirsutism are found in a woman who has a tumor of the ovary. The tumor is composed of polygonal cells with abundant eosinophilic cytoplasm and occasional Reinke crystals. Which of the following is the most likely classification of this tumor? a. Thecoma b. Granulosa cell tumor c. Hilar tumor of the ovary d. Sertoli-Leydig cell tumor e. Brenner tumor
C An androgen-producing ovarian tumor composed of cells that resemble Leydig cells is called a hilar tumor. It originates from steroid-secreting cells normally found in the hilum of the ovary.
10. Vaccination for the human papillomavirus in women, it is expected to reduce the incidence of carcinoma at which of the following sites? a. Clitoris b. Vagina c. Cervix d. Endometrium e. Ovary
C Cancers associated with the human papillomavirus (HPV) occur most often on the cervix. Vaccination against HPV is expected to reduce the incidence of all human genital cancers caused by HPV, but most prominently carcinoma of the cervix.
7. Which of the following risk factors is most often encountered in patients with urothelial carcinoma? a. Industrial exposure to arylamines b. Industrial exposure to azo dyes c. Cigarette smoking d. Long-term use of analgesics e. Infection with Schistosoma haematobium
C Cigarette smoking is the most important influence and most commonly encountered risk factor for urinary bladder cancer.
2. Compression fractures of vertebral bodies seen in elderly women are causally related to reduced recruitment of osteoclasts. This process is associated with an increased concentration of which chemical mediators in the bone? a. Prostaglandins b. Leukotrienes c. Cytokines such as interleukin (IL)-1 and IL-6 d. Oncogenes such as c-MYC and K-RAS e. Fibroblast growth factors
C Compression fractures of vertebral bones in postmenopausal women are related to reduced levels of estrogens. Reduced levels of estrogen lead to an increase of cytokines, such as interleukin (IL)-1 and IL-6, which retard the recruitment of monocytes to the bones and inhibit their transformation into osteoclasts (a process known as osteoclast recruitment).
1. Which of the following skin lesions becomes darker and more pigmented upon exposure to sunlight? a. Vitiligo b. Lentigo c. Ephelis d. Congenital melanocytic nevus e. Dysplastic nevus
C Ephelis (freckle) becomes more pigmented upon exposure to sunshine. Freckles differ from nevi (moles) and lentigines, which do not respond to ultraviolet light stimulation. Vitiligo is a depigmentation of the skin that does not respond to sunlight.
2. A 50-year-old man who is showing signs of acromegaly is found to have an elevated concentration of growth hormone and another hormone in blood that was apparently derived from the liver. Which other hormone is most likely increased in this patient's blood? a. Glucagon b. Somatostatin c. Insulin growth factor I d. Cholecystokinin e. Secretin
C Growth hormone stimulates the liver to produce insulin-like growth hormone I (somatomedin C), which causes many of the clinical manifestations seen in patients with growth hormone-secreting pituitary adenomas.
3. Osteoid osteoma is a small benign bone tumor associated with pain that is disproportionate to the size of the lesion. This pain is caused by an excess of which of the following substances? a. Interleukin (IL)-1 and IL-6 b. Leukotrienes c. Prostaglandin E2 d. Complement C3 e. Bradykinin
C It has been known for many years that the severe pain caused by osteoid osteoma can be treated with aspirin. It has been shown that the pain is caused by prostaglandin E2, which is produced by the proliferating osteoblasts in the tumor.
8. Which of the following muscle diseases is classified as an ion channel myopathy (channelopathy)? a. Dysferlin deficiency b. Becker muscular dystrophy c. Malignant hyperpyrexia d. Central core disease e. Myotubular myopathy
C Malignant hyperpyrexia (malignant hyperthermia) is characterized by a hypermetabolic state (tachycardia, tachypnea, muscle spasm, and high fever) that is triggered by induction of anes-thesia. Several mutations have been identified in these patients, including an L-type voltage-dependent ca
7. Membranoproliferative glomerulonephritis caused by mixed cryoglobulinemia is most often secondary to which of the following diseases? a. Diabetes mellitus b. Multiple myeloma c. Membranous nephropathy d. Amyloidosis e. Human immunodeficiency virus infection
C Membranoproliferative glomerulonephritis caused by mixed cryoglobulinemia is most often a complication of viral hepatitis C. The glomeruli contain deposits of IgG-IgM cryoglobulins, which are also found in the small blood vessels of the skin and joints, resulting in cutaneous vasculitis with petechial hemorrhages and synovitis.
7. A biopsy specimen was taken from an excoriated and oozing nipple of a 50-year-old woman. Which diagnosis would be most consistent with these findings. a. eczema b. psoriasis c. Paget disease of the breast d. medullary carcinoma of the breast e. fibrocystic change of the breast
C The epidermis in this breast biopsy contains scattered large atypical cells with clear cytoplasms. These cells represent breast carcinoma cells that have ascended through the ducts into the epidermis and produced the lesions typical of Paget disease of the breast.
3. Which of the following is the most common source of septic thromboemboli in the cerebral arteries? a. Leg veins b. Pulmonary veins c. Heart d. Aorta e. Carotid arteries
C The heart is the most common cause of septic thromboemboli. Such emboli originate from the infected vegetations found on the valves in endocarditis.
5. The primitive neuroectodermal tumor (PNET) of soft tissues has the same histologic features and the same chromosomal translocation as which of the following bone tumors? a. Osteosarcoma b. Chondrosarcoma c. Ewing sarcoma d. Malignant fibrous histiocytoma e. Giant cell tumor of bones
C The primitive neuroectodermal tumor (PNET) is a soft tissue equivalent of Ewing sarcoma. These two tumors resemble one another histologically and have the same chromosomal changes.
17. The solitary nodular lesion in this uterus removed from a 55-year-old woman is most likely composed of a. benign endometrial glandular cells b. malignant endometrial glandular cells c. benign smooth muscle cells d. malignant smooth muscle cells e. foci of adenomyosis
C The solitary white nodule is most likely a leiomyoma, a benign tumor composed of smooth muscle cells.
6. 21-Hydroxylase deficiency, the most common cause of congenital adrenal hyperplasia (CAH), is characterized by a lack of cortisol and another very important steroid hormone.The adrenal gland of the affected children is unable to synthesize which of the following hormones? a. Androstenedione b. Dehydroxyepiandrosterone c. 17-Hydroxyprogesterone d. Aldosterone e. Testosterone
D 21-Hydroxylase deficiency results in a deficiency of glucocorticoids (cortisol) and mineralocorticoids (aldosterone). The synthesis of androstenedione and testosterone actually is increased, resulting in virilization in female infants.
14. Where would a multilocular cystadenoma tumor most likely originated from the a. prostate b. rectum c. urinary bladder d. ovary e. uterus
D A multilocular cystadenoma. Tumors of this type most often arise from the ovary.
5. BRCA1 and BRCA2 genes that are mutated in 25% of all women who have familial breast cancer encode proteins. Which of the following functions do these proteins serve? a. Cell surface receptors for growth factors b. Growth factors c. Cytoplasmic signaling molecules d. DNA repair enzymes e. Nuclear hormone receptors
D BRCA1 and BRCA2 are tumor suppressor genes that encode nuclear proteins promoting DNA damage repair.
1. Fetal alcohol syndrome is most often characterized by which of the following disorders? a. Encephalocele b. Anencephaly c. Macrogyria d. Microencephaly e. Lissencephaly
D Fetal alcohol syndrome is often associated with microencephaly, which accounts for mental retardation in these children.
5. A 60-year-old man is being treated for cancer with several cytotoxic drugs, including cyclophosphamide. He developed hematuria and later died. At autopsy, cystitis is noted. Which specific form of cystitis did this patient most likely develop? a. Interstitial cystitis b. Follicular cystitis c. Emphysematous cystitis d. Hemorrhagic cystitis e. Malakoplakia
D Hemorrhagic cystitis is a well-known complication of anticancer treatment and is most often seen in patients who receive cyclophosphamide.
3. A 50-year-old woman sees her physician because she has noticed a bloody discharge from the left nipple. Upon physical examination, there are no palpable masses in the breast. Which of the following is the most likely cause of this discharge? a. Solitary cyst b. Fibrocystic change c. Acute mastitis d. Intraductal papilloma e. Carcinoma
D Intraductal papilloma is the most likely cause of a bloody discharge from the nipple.
2. Which of the following genital lesions is associated with a greater than expected risk of carcinoma of the vulva? a. Condyloma acuminatum b. Condyloma latum c. Lichen simplex chronicus d. Lichen sclerosus e. Papillary hydradenoma
D Lichen sclerosus is not recognized as a precancerous condition, but it has been associated with genetic alteration and a greater than expected risk of subsequent carcinoma in 1%-4% of all patients. Condyloma acuminatum is caused by human papillomavirus types 6 and 11 and tends to involute spontaneously. Condyloma latum is a manifestation of secondary syphilis and is not associated with cancer. Lichen simplex chronicus is caused by rubbing and scratching and is not related to cancer. Papillary hydradenoma is a benign tumor of the vulvar modified apocrine sweat glands and does not predispose to cancer.
4. Basal cell carcinoma of the skin often contains mutations of the p53 gene and the gene called PTCH (mutated in congenital nevoid basal cell carcinoma syndrome). These mutations are most likely the result of action of which of the following? a. Epidermal growth factor b. G-protein signal transduction system c. Chemical carcinogens from the environment d. Ultraviolet light e. Cosmic radiation
D Mutation of the DNA found in the DNA of basal cell carcinoma carry the so-called "UV signature" and are thought to be related to the action of ultraviolet light in the sunlight.
3. Nephrotic syndrome related to minimal change disease, combined with acute renal failure related to acute interstitial nephritis, is a well-documented adverse reaction to which of the following drugs? a. Methicillin b. Ampicillin c. Rifampin d. Ibuprofen e. Hydrochlorothiazide
D Nonsteroidal anti-inflammatory drugs, such as ibuprofen, can cause several renal syndromes, and one of them is the peculiar association of acute interstitial nephritis and minimal change disease.
10. Seminomas tend to metastasize first to which of the following sites? a. Internal iliac lymph nodes b. External iliac lymph nodes c. Mesenteric lymph nodes d. Retroperitoneal para-aortic lymph nodes e. Urinary bladder
D Seminomas, similar to all other testicular tumors, tend to metastasize to the retroperitoneal para-aortic lymph nodes.
2. The normal glomerular basement membrane is composed of which type of collagen? a. Type I b. Type II c. Type III d. Type IV e. Type V
D Similar to other basement membranes, the glomerular basement membrane is composed of collagen type IV. It is a helical molecule composed of six genetically distinct α chains (α1 to α6). Mutation of the gene for the α5 chain of collagen type IV causes hereditary glomerulopathy of Alport syndrome.
6. A 20-year-old man is being treated for a soft tissue tumor of the lower extremity. The tumor is composed of malignant spindle-shaped cells and epithelial cells that form gland-like structures. Which of the following is the most likely diagnosis? a. Leiomyosarcoma b. Malignant fibrous histiocytoma c. Primitive neuroectodermal tumor d. Synovial sarcoma e. Rhabdomyosarcoma
D Synovial sarcoma is a biphasic soft tissue sarcoma composed of spindle cells and epithelial glandular-like cells.
6. A papillary urinary bladder tumor composed of multilayered hyperchromatic transitional epithelium shows significant nuclear atypia. This type of tumor is best classified as which of the following? a. Urothelial papilloma b. Urothelial neoplasm of low malignant potential c. Papillary urothelial carcinoma, low grade d. Papillary urothelial carcinoma, high grade e. Anaplastic carcinoma
D The World Health Organization
1. An inhumogeneous testis containing cystic lesions was removed from a 30-year-old man. It most likely represents a. an adenocarcinoma b. a squamous cell carcinoma c. a seminoma d. a nonseminomatous germ cell tumor e. a Leydig cell tumor
D The two most common tumors in 30-year-old men are seminomas and nonseminomatous germ cell tumors (NSGCT). In contrast to seminomas, which appear homogeneous on cross section, this tumor is inhomogeneous and contains numerous cystic spaces. Accordingly, it is most likely a nonseminomatous germ cell tumor.
9. A physical examination of a 5-year-old girl shows a grape-like polypoid mass protruding from the vagina. Histologic examination reveals that the mass has a myxoid stroma that contains small oval-shaped cells. Some of these cells have pink cytoplasm and resemble tennis rackets. These cells reacted positively upon immunohistochemical staining with the antibodies to desmin. Which of the following is the most likely diagnosis? a. Squamous cell carcinoma b. Clear cell adenocarcinoma of the cervix c. Leiomyosarcoma d. Rhabdomyosarcoma e. Malignant melanoma
D This grape-like tumor is an embryonal rhabdomyosarcoma, also known as sarcoma botryoides (Greek word for "grape-like").
7. This lymph node was removed from the lateral side of the neck of a 38-year-old woman who had a thyroidectomy. She had an enlarged, painless thyroid but had no signs of altered thyroid function. The lymph node shows signs of a. autoimmune disease b. bacterial infection c. hyperplasia d. neoplasia e. metaplasia
D This lymph node contains foci of papillary carcinoma with calcifications (psammoma bodies). Such tumors are
2. A well-demarcated, coin-like, dark brown lesion appeared on the shoulder of a 59-year-old man. The lesion appears velvety, greasy, and has a "stuck on" appearance so that it can easily be removed. Which of the following is the most likely diagnosis? a. Lentigo b. Ephelis c. Vitiligo d. Seborrheic keratosis e. Actinic keratosis
D This well-demarcated, "stuck on" pigmented lesion, which appears greasy and velvety on palpation, most likely represents seborrheic keratosis. Such benign epithelial tumors are extremely common in middle-aged and elderly persons.
16. These ovaries were removed from an infertile, obese, slightly hirsute 30-year-old woman with persistent menstrual irregularities. The cystic spaces seen in the ovaries represent a. foci of endometriosis b. foci of endosalpingiosis c. corpora lutea d. corpora albicantia e. dilated follicles filled with fluid
E This woman has polycystic ovarian disease. The ovaries contain numerous cysts, which represent follicular cysts formed from dilated, but unruptured Graafian follicles.
4. Which of the following nonneoplastic breast lesions is associated with the highest risk of mammary cancer? a. Apocrine cysts b. Sclerosing adenosis c. Complex sclerosing lesion d. Small duct papillomas e. Atypical ductal hyperplasia
E Atypical ductal hyperplasia is associated with a moderate increase in risk of cancer. Thus, of the five microscopic changes listed here, it has the highest risk of cancer. Nonproliferative breast changes such as cysts, as well as fibrosis and adenosis, do not increase the risk of cancer. Proliferative breast disease without atypia, including sclerosing adenosis, radial scars (complex sclerosing lesion), and small duct papillomas are associated with a mild increase in risk.
1. A 55-year-old woman who has diabetes mellitus complains of genital itching. Examination shows whitish plaques on the mucosa of the vulva and vagina. Which of the following infectious agents most likely caused these changes? a. Human papillomavirus b. Herpes simplex virus type 2 c. Trichomonas vaginalis d. Gardnerella vaginalis e. Candida albicans
E Candida vaginalis infections of the vulva and vagina are the most common genital complications of diabetes mellitus.
4. Calcifications of the basal ganglia are complications associated with parkinsonian-like movement disorders and calcification of the lens with cataract formation. These complications are most often associated with which of the following conditions? a. Parathyroid adenoma b. Secondary parathyroid hyperplasia c. Tertiary hyperparathyroidism d. Parathyroid carcinoma e. Hypoparathyroidism
E Hypothyroidism is associated with calcification of the basal ganglia, causing parkinsonian movement disorders and calcification of the lens. These are complications of hypoparathyroidism.
2. Posttraumatic hydrocephalus is most often caused by which of the following? a. Hypersecretion of cerebrospinal fluid b. Obstruction of the aqueduct c. Obstruction of the foramen of Luschka d. Obstruction of the foramen of Magendie e. Obstruction of cerebrospinal fluid absorption
E Posttraumatic hydrocephalus is caused by an obstruction of cerebrospinal fluid resorption caused by hemorrhage into the subarachnoid spaces.
4. Which of the following is the dominant protein component of neuritic plaques in the brain in Alzheimer disease? a. Apoprotein ε b. Tau protein c. Neurofibrillin d. Microtubules-associated protein 2 (MAP2) e. A derived from amyloid precursor protein (APP)
E The A protein derived from amyloid precursor protein (APP) is the dominant protein in neuritic plaques of Alzheimer disease. lcium channel
7. Trinucleotide CTG repeat expansion plays a role in the pathogenesis of which of the following muscle diseases? a. Duchenne muscular dystrophy b. Becker muscular dystrophy c. Autosomal dominant limb girdle muscular dystrophy d. Autosomal recessive limb girdle muscular dystrophy e. Myotonic dystrophy
E The trinucleotide CTG repeat expansion on chromosome 19q13.2-13.3 affecting the dystrophia myotonia-protein kinase gene is the genetic basis of myotonic dystrophy.
8. What would the findings be in a mucinous carcinoma tumor removed from the breast of a 60 year-old woman a. rubbery and yellow b. white and gritty c. calcified d. necrotic and caseous e. soft and gelatinous
E This tumor is a mucinous carcinoma composed of sparse tumor cells floating in abundant mucus. Such tumors are soft and gelatinous on gross examination.
