PATHOLOGY WRITTEN EXAM II
1. A 65-year-old man is found dead in his driveway with a single gunshot wound to the chest. A
revolver is lying on the ground next to the body. Pinned to the man's shirt is a handwritten note
explaining that he has learned that the lung cancer he was previously treated
for had spread to his bones, and he chose to end his own life rather than wither away in pain. The
handwriting is confirmed to be his own by comparing the note to other documents known to have
been written by him.
At autopsy, an entrance gunshot wound is observed in the precordial area. Internally, there is a
through-and-through wound to the heart, and the pericardial sac is distended with blood. A bullet
is lodged in the body of a thoracic vertebra. The left lung is absent. Histologic sections taken
through the vertebrae and ribs show multiple metastatic foci of squamous cell carcinoma.
What is the medical examiner's proper determination of the manner of death?
A. Hemopericardium with cardiac tamponade
B. Suicide
C. Metastatic lung cancer
D. Natural causes
E. Gunshot wound to the heart
2. Schwannoma is frequently:
A. None of the above.
B. Found in infants.
C. Malignant.
D. Found in olfactory nerves.
E. Found at the cerebellopontine angle.
3. Immunoflourescence is utilized by renal pathologists to identify which of the following?
A. localize immunoglobulin and complement deposits in the kidney
B. diagnostic changes of polycystic kidney disease
C. alterations of epithelial foot processes
D. grades of renal transplant rejection
E. changes consistent with acute tubular necrosis
4. Hyaline membranes are characteristic of which lung lesion?
A. None of the above
B. Diffuse alveolar damage
C. Desquamative interstitial pneumonia
D. Usual interstitial pneumonia
E. Acute silicosis
-1-
5. A pathologist receives a renal biopsy from a 44 year old woman. Which of the following
is NOT routinely performed for evaluation of glomerular disease?
A. Cell cultures
B. immunoflourescence
C. PAS (Periodic acid Schiff) stain
D. light microscopy
E. electron microscopy
For each numbered item (column 1), choose the letter of the most closely related item
in column 2. Each answer can be used once, more than once, or not at all.
COLUMN 1
6. Lewy body
7. Knife edge" atrophy of frontal and
temporal lobes sparing posterior 2/3 of
superior temporal gyrus
8. Motor neuron degeneration
9. Caudate atrophy
COLUMN 2
A. Parkinson's disease
B. Pick's disease
C. Amyotrophic lateral sclerosis
D. Alzheimer's disease
E. Huntington's disease
10. A 25 year old woman presents with sensorineural deafness, mild proteinuria and mild
hematuria. She gives a family history of deafness and renal failure in a brother and
several other male relatives. Her brother also has had cataracts at an early age. Given
this history, which of the following is her MOST LIKELY diagnosis?
A. Minimal change disease
B. Thin basement membrane disease
C. IgA nephropathy
D. Alport's syndrome
E. Mesangioproliferative lupus nephritis
Match the diagnosis column on the left with the MOST LIKELY SINGLE ANSWER in
the right hand column. Each answer in the right column may be used once, more than
once, or not at all.
11. Pneumocystis carinii pneumonia
12. Sclerosing hemangioma
13. Scrofula
14. Coccidiomycosis
15. Respiratory syncytial virus pneumonia
A. AIDS patient
B. Woman with lower lobe nodule
C. Traveler to S.W. United States
D. 2 year old with bronchiolitis
E. Tuberculosis patient
-2-
16. A patient presents with mild proteinuria and hematuria and with further work-up is thought to
have a glomerulopathy. Which of the following disorders should USUALLY NOT be considered
in the differential diagnosis of glomerular diseases with mild clinical abnormalities?
A. Diffuse proliferative glomerulonephritis
B. IgA nephropathy
C. Thin basement membrane disease
D. Alport's syndrome
E. Mesangioproliferative lupus nephritis
17. Ferruginous bodies are characteristic of which lung lesion?
A. Chronic silicosis
B. Asbestosis
C. Acute silicosis
D. Coal worker's pneumoconiosis
E. Pulmonary hemosiderosis
18. A patient is worked-up for a glomerulopathy and found to have deposition of IgA in the
mesangium by immunoflourescence. Which of the following disorders should NOT be included
in the differential diagnosis for this glomerulopathy?
A. Mesangioproliferative lupus nephritis
B. cirrhotic glomerulosclerosis
C. IgA nephropathy
D. Henoch-Schonlein purpura
E. Post-streptococcal glomerulonephritis
19. Hematuria is noted repeatedly by urinalysis on a 40 year old male patient. Which of the
following should be considered in the differential diagnosis?
A. renal tumors
B. urolithiasis
C. polycystic kidney disease
D. glomerulonephritides
E. all of the above
20. A 55 year old nonsmoker has a primary lung cancer in the periphery of the lung. The MOST
LIKELY tumor type is:
A. Kaposi's sarcoma
B. Adenocarcinoma
C. Lymphoma
D. Squamous carcinoma
E. Small cell carcinoma
-3-
21. A 10 year old male presents with proteinuria, a serum albumin of 2.0 (normal range
>3.5), peripheral edema, and hypercholesterolemia. Measurement of protein in this
patient's urine over a 24-hour period confirms 4.0 grams of protein per 24 hours. Given
the information provided, what is your diagnosis?
A. tubulointerstitial disease
B. polycystic kidney disease
C. nephrotic syndrome
D. acute tubular necrosis
E. nephritic syndrome
22. Silicosis is caused by inhalation of dusts composed of:
A. Calcium aluminum silicate
B. Magnesium aluminum silicate
C. Fibrous silicate
D. Silicon dioxide
E. All of the above
23. Which of the following diseases is NOT associated with causation of membranous
glomerulopathy?
A. Wegener's granulomatosis
B. viral hepatitis
C. malignant diseases
D. malaria
E. systemic lupus erythematosus
24. A 30 year old woman presents to you with nephrotic range proteinuria, hypertension,
arthralgias, anemia, skin rash and pericarditis. ANA is positive. Renal biopsy confirms
finely granular positivity for lgG and C3 within glomerular capillary loops. What is the
MOST LIKELY diagnosis based on this clinical information and renal biopsy findings?
A. Polyarteritis nodosa
B. Membranoproliferative glomerulonephritis, type 1
C. Lupus nephritis, mesangioproliferative type
D. Henoch-Schonlein purpura
E. Lupus nephritis, membranous type
25. Which of the following tumors is more frequent in women than men?
A. Glioblastoma multiforme.
B. Meningioma.
C. Anaplastic astrocytoma.
D. Astrocytoma.
E. Malignant oligodendroglioma.
-4-
26. Which disorder is the MOST COMMON cause of nephrotic syndrome in childhood?
A. Anti-glomerular basement disease
B. post-infectious glomerulonephritis
C. Henoch-Schonlein purpura
D. Minimal change disease
E. IgA nephropathy
27. A 7 year old girl presents with a history of pharyngitis approximately 2 weeks prior to
presentation. She now exhibits periorbital swelling first noted by her mother, blood
pressure of 150/95, and reports that her urine looks like Coca-Cola. Based on the these
findings, you advise the mother of which of the following?
A. The child will MOST LIKELY achieve complete recovery
B. The child will MOST LIKELY require a renal transplant
C. The child will require work-up for occult malignancy
D. The child will MOST LIKELY require supportive dialysis with partial recovery of
renal function
E. The child will require corticosteroids
28. Pott's disease is involvement of the spine by:
A. Sarcoidosis
B. Tuberculosis
C. Aspergillosis
D. Histoplasmosis
E. Metastatic adenocarcinoma
29. A 27 year old male presents with hemoptysis gradually increasing over the last week. Upon
questioning, he relates that he has experienced progressive dyspnea and a brownish discoloration
to his urine. Further work-up confirms red cell casts, proteinuria, and granular casts. Both cANCA and p-ANCA are negative. A renal biopsy and lung biopsy are performed and Dr. Verani
pages you to triumphantly inform you that the immunoflourescence shows a fine linear pattern
positive for lgG and C3 in most glomeruli and along the alveolar basement membranes. You preempt her from telling you the diagnosis (because you want to show her how much you've
learned-showoff!), and thank her for confirming the diagnosis of :
A. Marchiafava-Bignami disease
B. Wegener's granulomatosis
C. Polyarteritis nodosa
D. Goodpasture's syndrome
E. Membranous glomerulonephritis
30. Which form of lupus nephritis is MOST COMMON and also associated with the worst
5-year survival rate?
A. focal proliferative glomerulonephritis
B. mesangial proliferative glomerulonephritis
C. none of the above
D. diffuse proliferative glomerulonephritis
E. membranous glomerulonephritis
-5-
31. A 70 year old male is seen in your clinic for evaluation of his dementia. Your work-up
includes an MRI scan that confirms cortical gyral thinning and widening of sulci,
consistent with cerebral atrophy. His ventricular system is also diffusely dilated, but
there is no evidence of obstruction in the ventricular system or subarachnoid space.
What further work-up should be performed to evaluate the hydrocphalus in this patient?
A. PET scan
B. cerebral angiogram
C. lumbar puncture
D. brain biopsy
E. No further work-up is required
32. Edema caused by leakage of cerebrospinal fluid from the lateral ventricles into the
surrounding brain in a patient with obstructive hydrocephalus is termed:
A. Hydrocephalus ex vacuo
B. Vasogenic edema
C. Interstitial edema
D. Fungus cerebri
E. Cytotoxic edema
33. Which of the following would cause communicating hydrocephalus?
A. Putaminal hemorrhage with intraventricular extension
B. Organizing subarachnoid hemorrhage
C. Subependymal giant cell astrocytoma compressing the foramen of Monroe
D. Medulloblastoma extending into the 4th ventricle
E. Colloid cyst of the third ventricle
34. Neurologic complications of alcohol abuse include all of the following, EXCEPT:
A. Wernicke-Korsakoff syndrome
B. rhabdomyolysis
C. peripheral neuropathy
D. Nigral depigmentation and neuronal loss
E. Degeneration of the anterior/superior vermis
35. A family of four is found dead inside their 900 square foot apartment in the midst of winter.
Their bodies are transported to the medical examiner's office and an autopsy performed on each.
Their brains are examined and each brain is found to show bilateral necrosis of the globus
pallidus. You immediately call the investigator to ask him to inspect which of the following?
A. recently received mail to evaluate for presence of anthrax
B. bacterial contamination of food in the family's refrigerator
C. source of lead toxicity in interior paint or water pipes
D. arsenic in prepared foods in the home
E. central heating for production of carbon monoxide
-6-
36. A 66 year old man develops dementia, anemia, ataxia, lower extremity weakness, and
tingling in lower extremities. MRI of the spine confirms atrophy of both the posterior and
lateral columns of the spinal cord (subacute combined degeneration). Which vitamin
deficiency is MOST LIKELY in this patient?
A. Folate
B. Vitamin A
C. Vitamin B1
D. Vitamin B12
E. Vitamin C
37. Which of the following forms of stroke has the highest mortality rate?
A. atherothrombotic cerebral infarction
B. subarachnoid hemorrhage
C. intracerebral hemorrhage
D. embolic stroke
E. transient ischemic attack
38. A seventeen year old male attends a party and abuses inhalational nitrous oxide. In attempts
to enhance the effect, the young man inflates a plastic bag with nitrous oxide, and places his head
inside. With this technique, the young man effectively provides himself with no oxygenation,
passes out, and proceeds to cardiopulmonary arrest. Astute friends at the party quickly pull the
bag off of his head, initiate CPR, and he is successfully resuscitated. He is taken to a hospital and
remains stable. Given the known vulnerability of neurons to ischemia in the CNS, which region
is the MOST LIKELY to have been injured?
A. Cortical layers 1, 2, and 4
B. T4 region of the spinal cord
C. Putamen
D. Caudate nuclei
E. Sommer's sector of the hippocampus
39. Which of the following is NOT a potential neurologic complication of hypertension?
A. Alzheimer type 2 astrocytosis
B. intraventricular rupture
C. lacunar infarcts
D. intraparenchymal hemorrhage
E. formation and rupture of saccular aneurysms
-7-
40. A 28 year old male complains of feeling a "popping" sensation in his head, followed by a
headache which he feels is the "worst headache I've ever experienced." He has no family history
of headaches, nor migraines. He has experienced no trauma. He is afebrile with a blood pressure
of 130190mmHg. Your neurologic exam reveals no focal abnormalities and is normal except for
a mild meningismus. You perform a lumbar puncture which reveals a red-rusty colored CSF. Stat
examination of the CSF shows numerous red cells, and very rare white blood cells. CBC is
normal. Given your evaluation thus far and considering your MOST LIKELY diagnosis, you
would proceed with:
A. a cerebral artery angiogram to evaluate for a saccular aneurysm
B. Treatment for migraine headaches
C. empiric antibiotics for treatment of meningitis
D. echocardiogram to evaluate for endocarditis
E. a brain biopsy to evaluate for an encephalitis
41. A 23 year old woman presents to the ER with contractions. She is experiencing sharp pain
with each contraction and vomits on several occasions. She is placed NPO (not permitted to
drink or eat anything) and is in labor for a total of 18 hours. An IV is not started, and she
becomes dehydrated. In the final stages of labor, she is asked to push hard with each contraction,
and a healthy baby girl is successfully delivered. The mother subsequently vomits more
convulses, and quickly becomes comatose. CT scan confirms bilateral, parasagittal wedgeshaped cerebral hemispheric hemorrhages. Your diagnosis is:
A. Hypertensive hemorrhage
B. Disseminated intravascular coagulopathy
C. Embolic stroke
D. Ruptured saccular aneurysm
E. Superior sagittal sinus thrombosis
42. A 32 year old male from Brownsville, TX is admitted with multiple cranial nerve deficits,
confusion, fever, night sweats, and meningismus. Lumbar puncture confirms numerous
mononuclear cells (lymphocytes and macrophages), mild increase in protein and normal glucose.
Gram stain on CSF is negative, cryptococcal antigen is negative, and CSF VDRL (for syphilis) is
negative. MRI shows enhancement and thickening of basilar meninges, consistent with a basilar
meningitis. Because of the basilar meningitis, an early communicating hydrocephalus is also
identified. Given this information, which of the following is the MOST LIKELY diagnosis?
A. Progressive multifocal leukoencephalopathy
B. Tuberculous meningoencephalitis
C. Amoebic meningoencephalitis
D. Primary HIV encephalitis
E. Herpes simplex encephalitis
-8-
43. In desquamative interstitial pneumonia, the alveolar spaces become
filled with:
A. Transformed lymphocytes
B. Type 1 pneumocytes
C. Type 2 pneumocytes
D. Macrophages
E. Neutrophiis
44. A 58 year old woman develops rapidly progressive dementia. Physical exam confirms
startle myoclonus. EEG demonstrates high voltage periodic discharges. A brain biopsy
is obtained, and the neuropathologist reports cortical spongiosis. Which of the following
diagnoses is confirmed by this brain biopsy:
A. respirator brain
B. Alzheimer's disease
C. Pick's disease
D. Creutzfeldt-Jacob disease
E. progressive multifocal leukoencephalopathy
45. Which of the following IS NOT a typical neurologic infection complicating HIV?
A. Progressive multifocal leukoencephalopathy
B. Cryptococcal meningitis
C. Cytomegaloviral encephalitis
D. Naegleria fowleri
E. Toxoplasma abscesses
46. A 1 year old boy staying at home with his mother's boyfriend is found to be irritable,
lethargic, and with episodic vomiting. Upon the mother's arrival home, the boyfriend updates the
mother of the child's illness. After she checks on him in his crib, she finds him somnolent. Upon
awakening, he convulses. She quickly takes his temperature, which is normal and asks the
boyfriend to call for an ambulance. Upon inspection in the emergency room, the child is found to
be stuporous. Fundoscopic examination confirms small retinal hemorrhages. An emergency CT
scan shows bilateral subdural hematomas and diffuse cerebral edema. No skull fractures are
present. What is the MOST LIKELY diagnosis?
A. Herpes simplex encephalitis
B. Shaken baby syndrome
C. Thrombotic thrombocytopenic purpura
D. Superior sagittal sinus thrombosis
E. Haemophilus influenza meningitis
47. A 33 year old woman develops rapid onset of flaccidity and weakness one week after a
flu-like illness. You confirm that she is afebrile, has decreased motor strength in all
extremities, is areflexic in both lower extremities, and hyporeflexic in both upper
extremities. Lumbar puncture confirms a markedly increased CSF protein level, normal
glucose, and no cells. Her respiratory effort is severely decreased, as determined by
forced expiratory volume at 1 sec (FEV1). The MOST LIKELY diagnosis based on
these clinical findings is:
-9-
A. progressive multifocal leukoencephalopathy
B. superior sagittal sinus thrombosis
C. Guillain-Barre syndrome
D. central pontine myelinolysis
E. multiple sclerosis
48. A 10 year old develops visual disturbances. MRI of the brain confirms bilateral
symmetrical regions of demyelination in the parietooccipital white matter sparing
subcortical U-fibers. Lipids contained within urine samples of this patient are stained
with toluidine blue, and the material turns a brown-black color. The patient's MOST
LIKELY diagnosis is:
A. Multiple sclerosis
B. Krabbe's disease
C. Metachromatic leukodystrophy
D. Progressive multifocal leukoencephalopathy
E. Acute hemorrhagic encephalomyelitis
49. A 10 year old boy exhibits severe proximal muscle weakness, calf pseudohypertrophy,
and Gower's sign. Molecular studies confirm the diagnosis of Duchenne's muscular
dystrophy. Which ONE of the following is true?
A. If he has children, hereditary anticipation should be expected
B. His serum CPK will be normal
C. Death ensues by 20-30 years of age
D. His muscle biopsy will contain diagnostic "ragged-red" fibers
E. He will become wheelchair bound beginning at about 40 years of age.
50. Which set of neuromuscular disorders are NOT USUALLY associated with an elevated
serum CPK?
A. Rhabdomyolysis
B. Dystrophinopathies
C. Inflammatory myopathies
D. Mitochondrial myopathies
E. Glycogen storage disorders (Pompe's and McArdte's diseases)
51. Which of the following disorders is associated with malignant hyperpyrexia (neuroleptic
malignant syndrome)?
A. McArdle's disease
B. Central core disease
C. Myotonic dystrophy
D. Duchenne's muscular dystrophy
E. Mitochondrial myopathy
- 10 -
52. A 44 year old male develops cardiogenic shock after a large anterolateral wall
myocardial infarction. Shortly after an episode of prolonged hypotension corrected by
administration of dopamine and dobutamine, the patient was stabilized. He then
developed mild to moderate oliguria and sharp rise in BUN and creatinine. His renal
function improves over the course of several weeks with supportive therapy, and
oliguria resolves. What is the MOST LIKELY diagnosis?
A. Henoch-Schonlein purpura
B. Toxic acute tubular necrosis
C. Pyelonephritis
D. Obstructive uropathy
E. lschemic acute tubular necrosis
53. Which of the following clinical manifestations is NOT a characteristic feature of
nephritic syndrome?
A. hematuria
B. anuria
C. red cell casts
D. fluid overload with hypertension
E. renal insufficiency
54. Which of the following is a cause of prerenal azotemia (prerenal acute renal failure)?
A. acute rejection
B. renal artery thrombosis
C. prostatic hypertrophy
D. crescentic glomerulonephritis
E. acute interstitial nephritis
55. A 40 year old woman with chronic low back pain presents to your clinic with complaints
of flank pain, low grade fever, arthralgias in most major joints (knees, shoulders, hips),
skin rash of recent onset, and decreased urine output. She has recently been taking
nonsteroidal anti-inflammatory agents in markedly increased amounts to counter an
exacerbation of back pain. You order a urinalysis which shows proteinuria, eosinophils,
granular casts, few red cells, and renal tubular epithelial cells. CBC confirms a mild
leukocytosis and blood eosinophilia. Which of the following is the MOST LKELY
diagnosis given this clinical information:
A. Cast nephropathy
B. Obstructive uropathy
C. Acute tubular necrosis
D. Crescentic glomerulonephritis
E. Acute interstitial nephritis
- 11 -
56. The acute renal failure that occurs in "myeloma kidney" (cast nephropathy) is mostly a
result of WHICH ONE of the following?
A. tubular damage from Bence Jones protein
B. obstructive uropathy
C. vasculitis of afferent arterioles
D. renal artery stenosis and thrombosis
E. crescentic formation and segmental glomerular necrosis
57. Which disease is considered a form of thrombotic microangiopathy AND IS MOST
COMMONLY associated with central nervous system abnormalities?
A. Polyarteritis nodosa
B. disseminated intravascular coagulopathy
C. thrombotic thrombocytopenic purpura
D. hemolytic uremic syndrome
E. Henoch-Schonlein purpura
58. A 42 year old African-American male presents to the emergency room with confusion
and a blood pressure of 2401150mmHg. CT scan confirms a left putaminal
hemorrhage, corroborating your physical exam findings. He dies soon after admission
despite aggressive therapy. An autopsy is requested and consented for by family
members. You drop by the morgue just as the pathologist is examining the kidneys. He
notes that the kidneys have a granular cortex and small infarcts are scattered
throughout the cortex. He also notes the presence of tiny cortical hemorrhages
throughout both kidneys, and describes them as "flea-bitten." What is the MOST
LIKELY diagnosis?
A. disseminated intravascular coagulopathy
B. diabetes mellitus
C. malignant nephrosclerosis
D. Polyarteritis nodosa
E. Henoch-Schonlein purpura
59, Which of the following are possible manifestations of polycystic kidney disease?
A. Nephrolithiasis
B. Saccular aneurysms
C. Hematuria
D. All of the above
E. Hepatic cysts
60. Alzheimer's disease is more frequent in:
A. Men than women.
B. Whites than Blacks.
C. Blacks than Hispanics.
D. Whites than Hispanics
E. Women than men.
- 12 -
61. Which two diseases together account for more than half of cases of end-stage renal
disease?
A. polycystic kidney disease and minimal change disease
B. diabetes mellitus and hypertension
C. crescentic glomerulonephritis and post-streptococcal glomerulonephritis
D. analgesic abuse nephropathy and membranous glomerulonephritis
E. diabetes mellitus and polyarteritis nodosa
62. The MOST important prognosticator for lung cancer is:
A. smoking history
B. the patient's age
C. the histologic type of the tumor
D. the stage
E. the lobe that is involved
63. A 60 year old male with hypertension, diabetes, gout, and peptic ulcer disease presents
to the emergency room with intraabdominal pain and decreased urinary output. Further
work-up and evaluation confirms urolithiasis with obstruction of the left ureter and
proximal ureteral dilatation. A radiolucent defect is detected at the site of ureteral
obstruction with the intravenous pyelogram. What is the MOST LIKELY cause of this
obstruction?
A. Calcium phosphate stone
B. Struvite stone
C. Bladder atony
D. Uric acid stone
E. Prostatric hypertrophy
64. Asbestos exposure can cause which of the following lesions?
A. Bronchogenic carcinoma
B. All of the above
C. Benign pleural effusion
D. Fibrous plaques of the parietal pleura
E. Peritoneal mesothelioma
65. A 30 year old woman has had recurrent bouts of pyelonephritis. Your work-up for
contributing factors to this infection should include evaluation for all of the following
EXCEPT:
A. diabetes insipidus
B. lower urinary tract tumor.
C. vesicoureteral reflux
D. congenital anomalies of the urinary tract
E. urolithiasis
- 13 -
66. Primary glioblastoma multiforme is characterized by:
A. A "ring-enhancing" pattern on MRI.
B. Median survival of approximately 12 months.
C. Necrosis.
D. All of the above.
E. EGFR amplification
67. All of the following are potential clinical manifestations of urolithiasis, EXCEPT:
A. abdominal pain
B. hematuria
C. oliguria
D. acute tubular necrosis
E. urinary tract infection
68. Lymphocytic interstitial pneumonia is MOST accurately classified as:
A. A neoplasm
B. An idiopathic granulomatous inflammation
C. An idiopathic fibrosing inflammation
D. A viral infection
E. A bacterial infection
69. A 66 year old male smoker who worked for 20 years with a lawn fertilizer company was
found to have hematuria on a routine physical exam. Eventual work-up led to
performance of cystoscopy. A 6 x 8 cm papillary bladder tumor was noted and
biopsied. The pathologist reported the diagnosis, but did not give further details. You
call her up to ask if she is able to provide you with more details to assess prognosis for
this patient, based on the biopsy. What is the most important determinant in assessing
prognosis for this patient?
A. Determining whether in-situ tumor is present or not
B. Determining the size of the tumor
C. Determining the depth of invasion in millimeters
D. Determining whether the tumor has invaded the inner third or outer two-thirds of the
muscularis propria
E. Determining the amount of necrosis in the tumor
70. Which form of bladder tumor is increased in incidence in association with infection by
Schistosoma hematobium?
A. Transitional cell carcinoma
B. Adenocarcinoma
C. Squamous carcinoma
D. Transitional papilloma
E. Papillary transitional carcinoma
- 14 -
71. The most frequent form of Alzheimer's disease is:
A. Sporadic.
B. Caused by mutation of the amyloid precursor protein (APP) gene.
C. Caused by mutations of the presenilin 1 gene.
D. Caused by mutations of the presenilin 2 gene.
E. Caused by mutations of the ApoE ?4 gene.
Match the age group in the left column with the organism on the right MOST LIKELY to
cause an acute pyogenic meningitis. Each answer can be used once, more than once
or not at all.
72. neonate
73. infant
74. young adult
75. elderly
A. Listeria monocytogenes
B. Group B streptococci
C. Neisseria meningitidis
D. Pneumococcus
E. Flaemophilus influenza
76. In a dead body, all of the following phenomena are typically observed, EXCEPT:
A. Bullae of the skin
B. Desiccation of mucous membranes exposed to dry air
C. Greenish discoloration
D. Gaseous distention of body cavities
E. Adipocere formation
Match the form of traumatic injury in the left column with its associated condition in the
right column. Each answer may be used once, more than once, or not at all.
77. diffuse axonal injury
78. ring skull fracture
79. epidural hematoma
80. spinal cord injury
A. falls on buttocks
B. middle meningeal artery laceration
C. angular head acceleration
D. mostly males
Match the nutritional deficiency in the left column with the clinical manifestations in the
right column. Each answer can be used once, more than once, or not at all.
81. Vitamin A deficiency
82. Kwashiorkor
83. Vitamin D deficiency
84. Folate deficiency
A. flag and flaky paint signs
B. rickets
C. keratomalacia
D. neural tube defects
- 15 -
Match the renal or urinary tract tumor on the left with its most closely associated feature
on the right. Each answer may be used once, more than once or not at all.
85. Clear cell renal carcinoma
86. Transitional cell bladder carcinoma
87. Papillary renal cell carcinoma
88. Malakoplakia
A. Michaelis-Gutmann bodies
B. aniline dyes
C. 3p deletion
D. trisomy chromosomes 7 and 17
89. Which of the following weapons is MOST LIKELY to cause a laceration?
A. Stiletto
B. Knife with serrated blade
C. Knife with non-serrated blade
D. Butt of a rifle
E. Ice pick
90. A 5-year-old boy has an enhancing tumor nodule in the vermis of the cerebellum
partially obstructing the 4th ventricle with consequent obstructive hydrocephalus.
Which answer includes the two MOST LIKELY entities that should be included in your
differential diagnosis?
A. Medulloblastoma and ependymoma
B. Anaplastic astrocytoma and schwannoma
C. Pilocytic astrocytoma and central neurocytoma.
D. Schwannoma and neurofibroma.
E. Capillary hemangioblastoma and glioblastoma.
- 16 -
ANSWERS
1. B
2. E
3. A
4. B
5. A
6. A
7. B
8. C
9. E
10. D
11. A
12. B
13. E
14. C
15. D
16. A
17. B
18. E
19. E
20. B
21. C
22. D
23. A
24. E
25. B
26. D
27. A
28. B
29. D
30. D
31. E
32. C
33. B
34. D
35. E
36. D
37. C
38. E
39. A
40. A
41. E
42. B
43. D
44. D
45. D
46. B
47. C
48. C
49. C
50. D
51. B
52. E
53. B
54. B
55. E
56. A
57. C
58. C
59. D
60. E
61. B
62. D
63. D
64. B
65. A
66. D
67. D
68. A
69. D
70. C
71. A
72. B
73. E
74. C
75. D
76. E
77. C
78. A
79. B
80. D
81. C
82. A
83. B
84. D
85. C
86. B
87. D
88. A
89. D
90. A
- 17 -
- 18 -