practice questions for final exam path 1
A 27-year-old woman presents with a sudden onset of right-sided blindness and weakness in her left leg. There is no history of trauma, however she experienced two similar episodes within the previous 8 months. MRI examination reveals periventricular plaques and demyelination in the white matter of CNS. Which of the following is the most likely finding in the CSF? A. Increased immunoglobulins manifested as oligoclonal band in electrophoresis B. Increased neutrophil and protein content with decreased glucose C. Isolation of the causative viral infection D. CSF shows no significant changes from normal
Increased immunoglobulins manifested as oligoclonal band in electrophoresis
Most common benign liver tumor: A. Cavernous hemangioma B. Liver cell adenoma C. Lipoma D. Hamartoma
Cavernous hemangioma
A tumor arising in the arachnoid villi and attached to the dura is the: a. meningioma b. astrocytoma c. medulloblastoma d. neurolemmoma e. none of the above
meningioma
Psammoma bodies are found often in which one of the following cancers? a. meningioma b. neuroblastoma c. glioblastoma d. osteochondroma e. none of the above
meningioma
One of the following is not an etiological factor in acute pancreatitis? A. Cholelithiasis B. Alcohol abuse C. Trauma D. Acute cholecystitis
Acute cholecystitis
Which is the most common pathological process to develop when a gallstone obstructs the cystic duct? A. Ascending cholangitis B. Acute cholecystitis C. Carcinoma of the gallbladder D. Ciliary cirrhosis
Acute cholecystitis
Macrovesicular steatosis is caused by all of the following conditions EXCEPT: a. Acute fatty liver of pregnancy b. Alcohol c. Obesity d. Type II diabetes mellitus e. Wilson disease
Acute fatty liver of pregnancy
Mallory bodies are characteristic of: A. Alcoholic liver disease B. Hemochromatosis C. Hepatitis C infection D. Acute pancreatitis
Alcoholic liver disease
Which of the following statements is about epidural hemorrhage is correct? A. Almost always accompanied by skull fracture B. Bleeding is usually of venous origin C. Occasionally occurs as a result of rupture of berry aneurysm Predisposed to by hypertension
Almost always accompanied by skull fracture
All of the following statements are true regarding carcinoma of head of pancreas, EXCEPT: A- The most common location of cancer of pancreas B- Jaundice is a common presenting symptom C- Severe liver metastases D- Alpha feto protein marker
Alpha feto protein marker
A 15 year old teenage with history of gross hematuria and vision problems is found to have nerve deafness and dislocation of the left ocular lens. Electron microscopy study shows irregular foci of thickening and thinning of the glomerular basement membrane with "basket-weave" appearance of the lamina densa. Which of the following choices best describes this renal condition? a. Alport syndrome b. IgA nephropathy c. Minimal change disease d. Poststreptococcal glomerulonephritis e. Thin basement membrane disease
Alport syndrome
What is the appropriate term for a chronic inflammatory joint disease characterized by stiffness and fusion of the spine and sacroiliac joints? A. Gout B. Rheumatoid arthritis C. Osteoarthritis D. Ankylosing spondylitis
Ankylosing spondylitis
Renal papillary necrosis can result from all of the following conditions EXCEPT: a. Analgesics b. Antibiotics c. Diabetes mellitus d. Sickle cell disease e. Urolithiasis-related obstruction
Antibiotics
ONE of the following statements regarding carcinoma of the head of the pancreas is not true: A. It is the most common location of carcinoma of the pancreas B. Arises from pancreatic Acinar cells C. Jaundice is a common presenting symptom D. Massive metastases to the liver
Arises from pancreatic Acinar cells
Congestive heart failure of Paget's disease of the bone is primarily caused by: A. Anemia B. Arteriovenous shunting C. Hypertension D. Hyperthyroidism
Arteriovenous shunting
Which one of the following statements about diabetes mellitus type I is true? A. Patients are usually obese B. Autoimmune destruction of β -cells C. Insulin resistant D. Adult-onset diabetes
Autoimmune destruction of β -cells
1. Papilledema is an important manifestation associated with: A. Guillian-Barre syndrome B. Friedreich ataxia C. Cerebral infarct D. Amytrophic lateral sclerosis
Cerebral infarct
A 75-year-old woman complains of persistent headache after a head trauma. MRI examination reveals subdural hematoma over the right cerebral hemisphere. Which of the following is a well-known characteristic of this disorder? A. Bleeding from the arteries of Willis B. Etiologically related to hypertension C. Characteristically caused by venous hemorrhage D. Caused by rupture of the middle meningeal artery
Characteristically caused by venous hemorrhage
What is the most common cause of liver cirrhosis in USA? A. Hemochromatosis B. Alpha-1 antitrypsin deficiency C. Hepatitis C virus infection D. Chronic alcohol consumption
Chronic alcohol consumption
Secondary hyperparathyroidism may be caused by: A. Chronic renal failure B. Hashimoto thyroiditis C. Parathyroid adenoma D. Pituitary adenoma
Chronic renal failure
A small bowel resection specimen from a patient suspected to have Crohn's disease would show all of the following features EXCEPT: a. Circumferential ulcers b. Cobblestone appearance of the mucosa c. Fat wrapping d. Fistula formation e. Strictures
Circumferential ulcers
Which inflammatory bowel disease is characterized by segmental involvement (skipped areas), long serpentine ulcers and fistulous tracts? A. Crohn disease B. Diverticulitis C. Malabsorption syndrome D. Ulcerative colitis
Crohn disease
A chronic granulomatous lesion involving all layers of the wall of the terminal ileum or colon is which one of the following clinical entities? a. Crohn's disease b. Ulcerative colitis c. Diverticulitis d. Parasitic infestation e. Granuloma annulare
Crohn's disease
Hepatitis A virus is transmitted by which one of the following? A. Feces of chronic carriers B. Eating raw seafood (oysters) C. Breast feeding D. Transplacental
Eating raw seafood (oysters)
A 3-day-old infant presents with fever (103°F) and convulsions. The infant is given broad-spectrum antibiotics and antiviral medications but he develops coma and dies. At autopsy, the brain shows acute purulent meningitis. What is the most likely cause of suppurative meningitis in this neonate? A. Cryptococcus neoformans B. Hemophilus influenza C. Escherichia coli D. Meningococcus
Escherichia coli
Which of the following forms of glomerular diseases is the MOST common cause of nephrotic syndrome in adults in United States? a. Focal segmental glomerulosclerosis b. Membranoproliferative glomerulonephritis c. Membranous glomerulopathy d. Minimal change disease e. Rapidly progressive glomerulonephritis
Focal segmental glomerulosclerosis
What is the MOST common extranodal site of involvement by diffuse large B cell lymphoma, not otherwise specified? a. Bone b. Gastrointestinal tract c. Skin d. Spleen e. Testis
GI
A 50-year-old man has increasingly severe, almost constant, generalized headaches. An MRI scan of the brain shows an irregular mass of 8 cm in size centered in the right frontal region and extending across the corpus collosum, with areas of hemorrhage and necrosis. A lumbar puncture needle reveals no significant CSF changes. These findings are almost indicative of: A. Tuberculosis meningitis B. Herpes simplex encephalitis C. Glioblastoma multiforme D. Subarachnoid hemorrhage
Glioblastoma multiforme
A 25 year old man presents with acute onset hemoptysis, anemia, azotemia, and diffuse pulmonary infiltrates. A kidney biopsy shows membranoproliferative glomerulonephritis with linear IgG deposits. What is the MOST likely cause of this patient's symptoms? a. Cocaine intoxication b. Drug reaction c. Goodpasture's syndrome d. Heart failure e. Idiopathic pulmonary hypertension
Goodpasture's syndrome
A 2-year-old child presents with fever, headache, and nuchal rigidity. The CSF is turbid with lot of neutrophils, increased protein, and decreased glucose content. The most likely etiologic agent is: A. E. coli B. Hemophilus influenza C. TB D. Viral infection
Hemophilus influenza
The histologic examination of thyroid reveals marked destruction of the thyroid parenchyma with lymphocytic infiltration and germinal centers. These changes are consistent with which of the following: A. Subacute thyroiditis B. Hashimoto's disease C. Papillary carcinoma D. Graves' disease
Hashimoto's disease
All of the following lesions are associated with a circle of Willis berry aneurysm EXCEPT: a. Arterial fibromuscular dysplasia b. Coarctation of aorta c. Hemangioblastoma d. Marfan disease e. Polycystic kidney disease
Hemangioblastoma
What is the MOST common primary tumor of the liver? a. Cholangiocarcinoma b. Focal nodular hyperplasia c. Hemangioma d. Hepatic adenoma e. Hepatocellular carcinoma
Hemangioma
Liver cirrhosis predisposes to all of the following, EXCEPT: A. Hemorrhoids B. Splenomegaly C. Hepatocellular carcinoma D. Hepatolenticular degeneration
Hepatocellular carcinoma
Which one of the following tumors is most commonly associated with elevated serum levels of alpha-feto protein? A. Carcinoma of the head of the pancreas B. Carcinoma of stomach C. Hepatocellular carcinoma D. Colorectal carcinoma
Hepatocellular carcinoma
What is the most important sequence of increased intracranial pressure? A. Hydrocephalus B. Papilledema C. Herniation D. Headache and vomiting
Herniation
The finding of acute encephalitis with hemorrhagic necrosis in the temporal lobe is most typical for which ONE of the following infectious agents? A. Meningococci B. Rabies virus C. Measles D. Herpes simplex virus type I
Herpes simplex virus type I
The percentage of patients who develop chronic hepatitis is: A. Higher in hepatitis C than B B. Higher in hepatitis B than C C. Equal in hepatitis V and C D. No chronic hepatitis in either
Higher in hepatitis C than B
The most significant result of Arnold-Chiari malformation is: A. Hydrocephalus B. Infection C. Infarction D. Hemorrhage
Hydrocephalus
A 30-year-old male has an attack of acute cholecystitis. CT scan reveals distended gallbladder filled with several pigment stones. These findings suggest which of the following underlying conditions? A. Crohn disease B. Hypercholesterolemia C. Chronic hemolysis D. Primary biliary cirrhosis
Hypercholesterolemia
Which is the most common location of Crohn disease? A. Ileum B. Ileum and colon C. Rectum D. Ascending colon
Ileum and colon
A 13 year old girl is diagnosed with type 1 diabetes. Histologic examination of her pancreas would show what pathologic change? a. Acinar atrophy and fibrosis b. Amyloid deposition within the islets c. Dystrophic calcification and fat necrosis d. Increased number of islets e. Infiltration of islet cells by T lymphocytes
Infiltration of islet cells by T lymphocytes
stoma? a. Coarse lace-like osteoid deposition b. Distinct osteoblastic rimming c. Epithelioid osteoblasts d. Infiltrative borders e. Lack of atypical mitoses
Infiltrative borders
One of the following histological features is characteristically present in ulcerative colitis: A. Cobble-stoned mucosa B. Fissures C. Lesions in the small intestine and colon D. Inflammatory pseudopolyps
Inflammatory pseudopolyps
One of the following is NOT a feature of Type II diabetes: A. Adult-onset diabetes B. Obese patients C. Absence of dysfunctional insulin receptors D. Insulin-dependent diabetes
Insulin-dependent diabetes
Most hypertensive cerebral hemorrhage occurs in: A. Medulla B. Internal capsule C. Frontal lobe D. Cerebellum
Internal capsule
Which statement is correct regarding subacute sclerosing pan encephalitis? A. It is characterized by measles virus infection B. It is typically asymptomatic C. It is caused by herpes simplex virus type I D. Intracytoplasmic inclusions are present
It is characterized by measles virus infection
A 40-year-old man presents with inflammation of a single metatarsophalangeal joint. Examination of the joint fluid reveals ureate crystals. Which statement is true of this disorder? A. It is characterized by pannus formation B. It is an autoimmune disease C. It is inherited as x-linked recessive disorder D. It is associated with Heberden's nodes
It is inherited as x-linked recessive disorder
1. Which statement describes herpes simplex virus type I in the central nervous system? A. It forms Intracytoplasmic inclusions B. It is usually limited to the cerebellum C. It shows Cowdry type A inclusion bodies D. It produces microabscesses
It shows Cowdry type A inclusion bodies
In a rectal suction biopsy, which of the following histologic findings supports a diagnosis of Hirschsprung's disease? a. Lack of ganglion cells b. Lack of interstitial cells of Cajal c. Lack of neural plexuses d. Lymphocytic ganglionitis e. Submucosal fibrosis
Lack of ganglion cells
Which of the following is the cause of Hirschsprung's disease? A. Chronic dysentery B. Diverticulosis C. Lack of innervation D. Intestinal ischemia
Lack of innervation
A 30-year-old male suffers transient episodes of abdominal distension and diarrhea that last for a few hours and then subside. He experiences no episodes when he avoids milk products in his diet for a month. What is the possible cause for these findings? A. Crohn disease B. Lactase deficiency C. Celiac disease D. Tropical sprue
Lactase deficiency
Varicose veins in the lower part of the esophagus are a complication of: A. Barrett esophagus B. Achalasia C. Mallory-Weiss syndrome D. Liver cirrhosis
Liver cirrhosis
What are the most common histological findings of Crohn disease? A. Transmural hemorrhagic necrosis B. Ulcers undermining the mucosa C. Absence of ganglionic cells in the myenteric plexus D. Lumen always narrowed by fibrosis (string sign)
Lumen always narrowed by fibrosis (string sign)
Which of the following histologic findings would be very unusual for a diagnosis of Crohn's disease? a. Epithelioid granulomas b. Fissuring ulcers c. Lymphocytic phlebitis d. Transmural lymphoid aggregates e. Neural hypertrophy and thickening of the muscularis mucosae
Lymphocytic phlebitis
All of the following nuclear changes are typically seen in papillary thyroid carcinoma EXCEPT: a. Fine chromatin b. Grooves c. Macronucleoli d. Nuclear enlargement e. Pseudoinclusions
Macronucleoli
Choose the FALSE statement regarding osteoarthritis: A. It is the most common joint disease in USA B. The incidence increases with the age of the population C. Sclerosis of the subchondral bone D. Metacarpophalangeal joints are first involved
Metacarpophalangeal joints are first involved
What is the most common malignant tumor of the liver? A. Metastatic tumors B. Hepatocellular carcinoma C. Choiangiocarcinoma D. Angiosarcoma
Metastatic tumors
A 60-year-old woman with chronic atrial fibrillation develops suddenly cerebral infarct caused by embolization from the left atrium. Which vessel is the most likely site of embolic obstruction? A. Anterior cerebral artery B. Posterior cerebral artery C. Internal carotid artery D. Middle cerebral artery
Middle cerebral artery
Most arteriovenous malformations occur within which of the following vascular distributions? a. Anterior cerebral artery b. Anterior choroidal artery c. Middle cerebral artery d. Posterior cerebral artery e. Superior cerebellar artery
Middle cerebral artery
The most common source of blood in an epidural hematoma associated with skull fracture is ____________________. a. Bridging veins b. Dural sinus c. Middle meningeal artery d. Middle meningeal vein e. None of the above
Middle meningeal artery
Which of the following glomerular diseases is the MOST common cause of nephrotic syndrome in children? a. Focal segmental glomerulosclerosis b. IgA nephropathy c. Membranoproliferative glomerulonephritis d. Membranous glomerulopathy e. Minimal change disease
Minimal change disease
Pheochromocytomas are highly associated with all of the following syndromes EXCEPT: a. Hereditary paraganglioma-pheochromocytoma syndrome b. Multiple endocrine neoplasia 1 (MEN 1) c. Multiple endocrine neoplasia 2a (MEN 2a) d. Multiple endocrine neoplasia 2b (MEN 2b) e. von Hippel-Lindau disease (VHL)
Multiple endocrine neoplasia 1 (MEN 1)
The radiographic description of "permeative" and "moth-eaten" appearance is typically associated with an infiltrative, malignant process. Which of the following tumors is an exception to this rule and shows a well-circumscribed border? a. Chondrosarcoma b. Ewing's sarcoma c. Fibrosarcoma d. Multiple myeloma e. Osteosarcoma
Multiple myeloma
1. Dementia is a feature of the following, EXCEPT: A. Alzheimer disease B. Multiple sclerosis C. Pick disease D. Chronic subdural hematoma
Multiple sclerosis
A patient with fever, headache and a stiff neck demonstrates the presence of gram negative diplococci in the cerebrospinal fluid. The MOST likely organism in the gram stain is: a. Neisseria meningitis b. Neisseria gonorrhea c. listeria d. pneumococci e. staphylococci
Neisseria meningitis
1. Histological features of Parkinson disease include the following, EXCEPT: A. Lewy body B. Neurofibrillary tangles C. Depigmentation of substantia nigra D. Neuronal loss
Neurofibrillary tangles
Which of the following renal diseases is thought to be unique to diabetes mellitus? a. Diffuse glomerulosclerosis b. Nodular glomerulosclerosis c. Pyelonephritis d. All of the above e. Only 1 and 2
Nodular glomerulosclerosis
1. Transtentorial herniation produces one of the following: A. Communicating hydrocephalus B. Respiratory arrest C. One dilated pupil D. Blindness in one eye
One dilated pupil
A 16-year-old teenager presents with a mass in the distal portion of his left femur. Workup finds a cartilage-capped outgrowth of the bone that is connected to the underlying skeleton by a bony stalk. No destruction of the underlying bone is seen. What is the best diagnosis? A. Chondrosarcoma B. Osteochondroma C. Enchondroma D. Osteosarcoma
Osteochondroma
A seven-year-old child has had multiple and frequent bone fractures on multiple bone trauma. He is noticed to have blue coloration of the sclera of both eyes. The most probable diagnosis is: A. Osteogenesis imperfect B. Osteopetrosis C. Achondroplasia D. Osteomalacia
Osteogenesis imperfect
Which of the following tumor is commonly associated with the formation of Codman triangle? a. Aneurysmal bone cyst b. Chondrosarcoma c. Ewing sarcoma d. Fibrous dysplasia e. Osteogenic sarcoma
Osteogenic sarcoma
Which of the following is true of Paget's disease of the bone? a. It usually affects adolescents b. It usually affects the small bones of the hands c. Osteogenic sarcoma may arise in affected bones in about 1% of patients d. It is also known as osteopetrosis e. it is an infectious disease
Osteogenic sarcoma may arise in affected bones in about 1% of patients
Erlenmeyer flask deformity of the bone is associated with which of the following bone conditions? a. Osteitis deformans b. Osteolysis c. Osteopenia d. Osteopetrosis e. Osteoporosis
Osteopetrosis
Which one of the following statements is NOT characteristic for rheumatoid arthritis? A. Genetic predisposition (HLA-DR4) B. Symmetrical polyarthritis C. Osteophyte formation D. Pain and morning stiffness
Osteophyte formation
A patient has enlargement of the skull and bowing of the tibias and femurs. A biopsy shows osteosclerotic bone with mosaic pattern. What is the most likely diagnosis? A. Paget disease B. Osteomalacia C. Osteoporosis D. Osteogenesis imperfect
Paget disease
Which of the following endocrine lesions are LEAST likely to present with hypertension? a. Aldosteronoma b. Congenital adrenal hyperplasia c. Growth hormone secreting pituitary adenoma d. Pancreatic glucagonoma e. Pheochromocytoma
Pancreatic glucagonoma
What is the most common primary malignant neoplasm of the thyroid gland in countries with adequate dietary iodine? a. Follicular adenoma b. Follicular carcinoma c. Medullary thyroid carcinoma d. Papillary thyroid carcinoma e. Primary thyroid lymphoma
Papillary thyroid carcinoma
A 52 year old woman presents with a lytic lesion of the jaw, which on biopsy shows bone resorption and replacement by fibrous tissue and osteoclast-like giant cells. She also has recently been diagnosed with kidney stones and osteopenia. A serum calcium level is 12.4 mg/dL. What is the MOST likely cause of her symptoms? a. Four gland parathyroid hyperplasia b. Hypoparathyroidism c. Osteomalacia (Vitamin D deficiency) d. Parathyroid adenoma e. Renal failure
Parathyroid adenoma
A 32 year old woman presents with amenorrhea and bilateral white breast discharge. No breast lesions are palpated, and a pregnancy test is negative. What is the MOST likely finding on an MRI scan of the brain? a. An empty sella turcica b. Glioblastoma c. Pituitary macroadenoma d. Pituitary microadenoma e. Subarachnoid hemorrhage
Pituitary microadenoma
Which of the following pathologic features is NOT typical for untreated ulcerative colitis? a. Backwash ileitis b. Chronic active colitis c. Crypt rupture associated granulomas d. Patchy and segmental involvement e. Rectal involvement
Patchy and segmental involvement
After a gastric biopsy, a patient shows marked gastric atrophy and the presence of antiparietal cell antibodies in the serum. Which of the following diagnosis is MOST likely? a. Menetrier's disease b. Zollinger-Ellison syndrome c. Giardia infestation d. Pernicious anemia e. Cirrhosis of the liver
Pernicious anemia
All of the following statements concerning cholelithiasis is true, EXCEPT: A. Obesity and pregnancy play a role in formation of gallstones B. Decreased gallbladder motility due to spinal cord injury C. More common in females D. Pigment stone is the most common type of gallstones
Pigment stone is the most common type of gallstones
A 29 year old woman is diagnosed with hepatitis B infection. She is at the greatest risk for developing which of the following? a. Churg-Strauss disease b. Hypersensitivity vasculitis c. Polyarteritis nodosa d. Takayasu arteritis e. Wegner granulomatosis (granulomatosis with polyangiitis)
Polyarteritis nodosa
An acute infarct involving the occipital lobe visual cortex would be MOST likely due to an occlusion in which artery? a. Anterior cerebral artery b. Anterior inferior cerebellar artery c. Middle cerebral artery d. Posterior cerebral artery e. Superior cerebellar artery
Posterior cerebral artery
Which of the following conditions is LEAST likely to progress towards chronic glomerulonephritis? a. Focal segmental glomerulosclerosis b. Membranoproliferative glomerulonephropathy c. Membranous glomerulopathy d. Poststreptococcal glomerulonephritis e. Rapidly progressive glomerulonephritis
Poststreptococcal glomerulonephritis
The feature that most reliably distinguishes Crohn disease from ulcerative colitis is: A. Presence of granulomas and transmural inflammation B. Presence of extra-intestinal complications C. Involvement of colon D. Clinical presentation
Presence of granulomas and transmural inflammation
Which one of the following represents an autoimmune disease? A. Peptic ulcer of the stomach B. Barrett esophagus C. Acute pancreatitis D. Primary biliary cirrhosis
Primary biliary cirrhosis
Asymmetric arthritis involving only the distal interphalangeal joints is a characteristic feature of: A. Psoriatic arthritis B. Rheumatoid arthritis C. Ankylosing spondylitis D. Reiter's syndrome
Psoriatic arthritis
Most carcinomas of the colon occur in: A. Transverse colon B. Rectosigmoid C. Cecum D. Ascending colon
Rectosigmoid
A nodule is removed from a patient with arthritis. The histological appearance includes fibrinoid necrosis, pannus formation, round cell inflammatory infiltration of tissue and synovial hyperplasia. a. Rheumatoid arthritis b. Osteoarthritis c. Gouty arthritis d. Septic arthritis e. Traumatic arthritis
Rheumatoid arthritis
Subcutaneous nodules are most characteristic of patients with which of the following diseases? A. Osteoarthritis B. Psoriatic arthritis C. Colitic arthritis D. Rheumatoid arthritis
Rheumatoid arthritis
Which ONE of the following manifestations is characteristically associated with osteoid osteoma? A. Stiffness in the knee is that is worse in the morning B. Pain in the first toe that occurs after wine drinking C. Numbness and tingling in the 4th and 5th fingers D. Severe pain in the femur that is drastically reduced by aspirin
Severe pain in the femur that is drastically reduced by aspirin
A 37 year old pregnant woman goes through a difficult home labor and delivery, which results in significant postpartum hemorrhage. Two weeks later, she calls her midwife about problems breastfeeding, and reports that her breast milk still has not "come in." What is the MOST likely cause of her inability to breastfeed? a. Cushing syndrome b. Poor hydration c. Prior breast surgery d. Prolactin-secreting pituitary adenoma e. Sheehan syndrome
Sheehan syndrome
Which of the following histologic types of colorectal cancer is more common in patients with long-standing ulcerative colitis? a. Adenosquamous carcinoma b. Medullary carcinoma c. Mucinous carcinoma d. Signet ring cell carcinoma e. Small cell carcinoma
Signet ring cell carcinoma
In radiologic evaluation, giant cell tumor has been described as: A. Onion skin B. Soap bubble C. Sunray appearance D. Codman triangle
Soap bubble
A 30-year-old female recovering from an attack of influenza suddenly developed a painful enlarged thyroid gland. The most likely diagnosis is: A. Thyroid abscess B. Subacute granulomatous thyroiditis C. Hashimoto thyroiditis D. Thyroid adenoma
Subacute granulomatous thyroiditis
Rupture of a berry aneurysm is most commonly associated with which of the following pathological findings? A. Subdural hemorrhage B. Intracerebral hemorrhage C. Extradural hemorrhage D. Subarachnoid hemorrhage
Subarachnoid hemorrhage
A slowly accumulating post-traumatic hematoma is most likely to be located in which anatomical compartment? A. Subdural space B. Epidural space C. Subarachnoid space D. Intracerebral
Subdural space
A 36 year old woman has multiple, small, sterile pink vegetations with a warty appearance on the undersurface of the atrioventricular valves microscopically. The involved heart valves show focal valvulitis with fibrinoid necrosis. The underlying etiology of these vegetations is which of the following? a. Ankylosing spondylitis b. Rheumatic fever c. Sarcoid d. Syphilis e. Systemic lupus erythematosus
Systemic lupus erythematosus
All of the following are causes of malabsorption EXCEPT: a. Crohn's disease b. Ulcerative colitis c. Pancreatic insufficiency d. Celiac sprue e. Whipple's disease
Ulcerative colitis
Which one among the following is a more important risk factor for adenocarcinoma of the colon: A. Crohn disease B. Meckel diverticulum C. Ulcerative colitis D. Volvulus
Ulcerative colitis
A 68 year old man notices that he has been changing the size of his hat rather frequently to fit his enlarging head. Investigations reveal that he has a disorder that leads to an imbalance between activity of osteoclasts and osteoblasts. Which of the following features is LEAST likely to be associated with this condition? a. Giant cell tumor arising in facial bone b. Increased numbers of cement lines c. Markedly elevated serum alkaline phosphatase activity d. Osteoporosis circumscripta affecting the skull e. Usually affects the peripheral skeleton
Usually affects the peripheral skeleton
ONE of the following is not true regarding osteosarcoma: A. May have a sunray appearance on x-ray B. Vertebral body is the most common location C. The most common primary bone cancer in the young D. May be associated with Paget's disease
Vertebral body is the most common location
The patient with complaints of peptic ulcerations and gastric ulcerations and gastric hypersecretion was found to have a tumor of delta cells. Gastrin was demonstrated in the tumor by radioimmunoassay. Which of the following is the most likely diagnosis? a. Adenocarcinoma of the pancreas b. Insulinoma c. Zollinger-Ellison syndrome d. Glucagonoma e. Carcinoma of stomach
Zollinger-Ellison syndrome
Chronic rejection of a renal transplant is characterized histologically by which of the following: a. marked intimal fibrosis of arteries and arterioles ("onion-skinning") b. interstitial fibrosis with tubular atrophy c. extensive coagulative necrosis of renal parenchyma d. a and b e. a, b, and c
a and b
"Strawberry gallbladder" is a clinical term sometimes applied to: a. acute allergic response to strawberries b. acute allergic response to any antigen c. acute cholecystitis with cholesterolosis d. gangrenous cholecystitis e. bile stasis of gallbladder
acute cholecystitis with cholesterolosis
A 50 year old woman was admitted with sudden onset of severe abdominal pain radiating in the upper back. She was mildly jaundiced. She had a large meal prior to the onset of her symptoms. She gave a history of chronic gallbladder disease. The MOST likely diagnosis is: a. ruptured tubal pregnancy b. chronic pancreatitis c. acute pancreatitis d. appendicitis e. ruptured diverticulum of colon
acute pancreatitis
A 50-year-old man presents with slowly progressive jaundice, weight loss, and upper abdominal pain that radiates to his midback. Examination reveals an enlarged gallbladder in the right upper quadrant of his abdomen, and a CT scan shows an irregular mass involving the head of the pancreas. Histologic sections from this mass are most likely to reveal what abnormality?
adenocarcinoma
The renal manifestations of systemic lupus erythematosus include: a. mesangioproliferative glomerulonephritis b. focal proliferative glomerulonephritis c. membranous glomerulonephritis with subendothelial deposits of immune complexes d. diffuse proliferative glomerulonephritis e. all of the above
all of the above
All of the following are true of Crohn's disease EXCEPT: a. characterized histologically by extensive transmural granulomatous inflammation b. may involve colon, terminal ileum and rectum c. pseudopolyps of the colonic mucosa are a major gross feature d. extensive fistula formation with pericolonic abscesses e. increased incidence of intestinal malignancies
c. pseudopolyps of the colonic mucosa are a major gross feature
Primary carcinoma of the gallbladder is most commonly associated with: a. carcinoma of the pancreas b. hepatitis c. cholelithiasis d. carcinoma of the lung e. Laennec's cirrhosis
cholelithiasis
"Thyroid" appearance of renal tubules is considered typical of: a. chronic pyelonephritis b. chronic glomerulonephritis c. arteriolar nephrosclerosis d. malignant hypertension e. diabetic nephropathy
chronic pyelonephritis
An infant who is apparently well during the first week of life experiences onset of regurgitation of food and vomiting during the second and third week. Visible peristaltic contractions on examination of the abdomen are noted and a firm ovoid mass palpated. This is: a. congenital hypertrophic pyloric stenosis b. esophageal webs c. achalasia d. hiatal hernia e. congenital esophageal stenosis
congenital hypertrophic pyloric stenosis
Which one of the following hormones may cause peptic ulcer? A. Thyroid hormone B. Prolactin C. Corticosteroids D. Estrogen
corticosteroids
Lesions of the stomach that are associated with a higher than usual rate of development of gastric cancer include all of the following EXCEPT: a. achlorhydria b. atrophic gastritis c. pernicious anemia d. adenomatous polyps e. duodenal ulcer
duodenal ulcer
Which of the following lesions is MOST frequently associated with Paget's disease of the breast? a. infiltrating intraductal carcinoma b. lobular carcinoma c. fibroadenoma d. squamous cell carcinoma e. sclerosing adenosis
infiltrating intraductal carcinoma
Traumatic fat necrosis of the breast is important because it: a. may lead to gangrene b. may be mistaken for malignant tumor c. is apt to produce a sinus tract d. will become malignant e. may develop into tuberculosis
may be mistaken for malignant tumor
The most serious of the renal lesions in patients with systemic lupus erythematosus producing hematuria, proteinuria and hypertension and occurring in up to 50% of the patients is: a. mesangioproliferative glomerulonephritis b. focal proliferative glomerulonephritis c. diffuse proliferative glomerulonephritis d. membranous glomerulonephritis e. none of the above
membranous glomerulonephritis
The following are true of neurofibromatosis EXCEPT: a. autosomal dominant transmission in approximately 50% of cases b. multiple cutaneous neurofibromas c. 6 or more "café au lait" spots d. neurofibromas never undergo malignant transformation
neurofibromas never undergo malignant transformation
caput medusa is assocatied with
portal hypertension
The majority of carcinomas of the large bowel occur in the: a. right side of the colon b. hepatic flexure c. transverse colon d. descending colon e. rectum, rectosigmoid and sigmoid colon
rectum, rectosigmoid and sigmoid colon
The term ANASARCA means: a. severe, generalized edema b. localized lymphedema of the arm in patients with breast cancer c. collection of fluid in the pleural cavity d. none of the above
severe, generalized edema
The portion of colon that is entirely suspended by mesentery, and therefore prone to volvulus, is _______________________. a. ascending colon b. cecum c. descending colon d. rectum e. sigmoid colon
sigmoid colon
Which of the following is NOT a cause of jaundice? a. overproduction of bilirubin related to intervascular or extravascular hemolysis b. cholestasis c. cirrhosis of the liver d. splenomegaly e. drugs
splenomegaly
The manifestations of chronic renal failure are directly referable to derangement of renal function and include the following EXCEPT: a. electrolyte balance b. volume regulation c. excretion of waste products d. synthesis of specific catecholamine products e. acid-base balance
synthesis of specific catecholamine products
Your patient, a 38 year old female, presents with an erythematous rash in the "butterfly" area of the face associated with fever of 101 degrees F, arthralgias (pain in the joints) and mild proteinuria. Her medications include hydralazine which she has been taking for the past 6 months for hypertension. ANA is positive with homogeneous pattern and the Crithidia lucilia test for ds-DNA is also positive. Biopsies from involved and uninvolved skin show immunofluorescence at the dermal epidermal junction in both. Your diagnosis in this patient is: a. discoid lupus erythematosus b. systemic lupus erythematosus c. dermatomyositis d. hydralazine induced lupus erythematosus e. none of the above
systemic lupus erythematosus
Gallstone and alcohol predispose to acute pancreatitis true or false
true
Painless hematuria is suggestive of: a. hemorrhagic cystitis b. prostatitis c. urethritis d. tumor of the lower urinary tract e. bladder diverticula
tumor of the lower urinary tract
Amyloidosis may be found in: a. uncontrolled chronic inflammatory conditions b. tumors of plasma cells c. hyperplastic scar tissue d. only a and b e. a, b, and c
uncontrolled chronic inflammatory conditions b. tumors of plasma cells
All of the following findings are possible results of portal hypertension for cirrhosis of the liver, EXCEPT: A. Hemorrhoids (piles) B. Ascites C. Splenomegaly D. Vasculitis
vasculitis
Berry aneurysm is associated with: a. syphilis in arch of aorta b. weakness in circle of Willis c. arterial anastomosis in liver d. hemopericardium e. dissecting aneurysm of abdominal aorta
weakness in circle of Willis