Pathology Written Exam IV
1. Low values for hematocrit and hemoglobin (concentration in whole blood) are reliable criteria for the diagnosis of anemia, unless:
A. The patient has been overloaded by intravenous fluids.
B. The patient's anemia is the result of multiple causes.
C. The underlying cause of the anemia is folate deficiency.
D. The patient normally runs low values for hematocrit and hemoglobin.
E. The anemia has developed over a long period of time.
2. If a patient has a normal hematocrit and a markedly decreased mean corpuscular volume (MCV), then which of the following must be true?
A. The patient has iron deficiency.
B. The patient has deficiency of vitamin B12 and/or folate
C. The patient has anemia of chronic disease.
D. The patient is anemic.
E. The patient has a high red blood cell (RBC) count.
3. The body's response to anemia includes all of the following EXCEPT:
A. Increase of blood flow to the kidneys
B. Decreased peripheral vascular resistance
C. Increased levels of 2,3-diphosphoglycerate in red blood cells
D. Decreased binding affinity between hemoglobin and oxygen
E. Increased cardiac output
4. Which of the following clinical signs or symptoms is peculiar to anemia that develops rapidly, as in acute blood loss?
A. Decreased heart rate
B. Systolic ejection murmur
C. Orthostatic hypotension
D. Pallor
E. Dyspnea
5. In a fully developed case of iron deficiency anemia, which of the following lab values is increased?
A. Red cell mean corpuscular volume (MCV)
B. Serum transferrin
C. Serum iron
D. Serum ferritin
E. Red cell mean corpuscular hemoglobin concentration (MCHC)
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6. In managing a case of iron deficiency anemia developing in a 73-year-old woman, the most important thing for the doctor to do is:
A. Send hair clippings to a reference lab to determine if other trace metals are deficient
B. Reassure the patient and give her iron supplements
C. Look for a source of hemorrhage
D. Take a detailed dietary history to determine the cause of insufficient iron intake
E. Perform a quantitative iron assay on a sample of the marrow
7. Which of the following phenomena observed in vitamin B12 deficiency is NOT characteristic of folate deficiency?
A. Megaloblastic changes in red cell precursors in the marrow
B. Anemia
C. Elevated red cell mean corpuscular volume (MCV)
D. Loss of peripheral nerve function
E. Normal red cell mean corpuscular hemoglobin concentration (MCHC)
8. Folate is essential for which physiologic function?
A. Formation of myelin sheaths around neural axons
B. Synthesis of messenger RNA
C. Synthesis of transfer RNA
D. Transfer of methyl groups from one molecule to another
E. Absorption of vitamin B12 in the terminal ileum
9. Pernicious anemia can be caused by:
A. Adherence to a strict vegan diet
B. Competition for vitamin B12 by the fish tapeworm, Diphyllobothrium latum
C. Surgical resection of the distal ileum
D. Autoantibodies directed against gastric parietal cells and intrinsic factor
E. All of the above
10. In a full-blown case of hemolytic anemia with brisk intravascular hemolysis, which of the following is decreased?
A. Urine urobilinogen
B. Reticulocyte count
C. Urine hemoglobin
D. Serum haptoglobin
E. Serum bilirubin
11. All of the following are immunohemolytic anemias, EXCEPT:
A. Pernicious anemia
B. Paroxysmal cold hemoglobinuria
C. Cold agglutinin disease
D. Hemolytic disease of the newborn
E. Hemolytic transfusion reaction
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12. Detoxification of hydrogen peroxide in the red cell requires all of the following, EXCEPT:
A. NADPH
B. Reduced glutathione
C. Enzymes of the Krebs cycle
D. The hexose monophosphate shunt
E. Glucose-6-phosphate dehydrogenase
13. Which of the following hemoglobins tends to be peculiar to Southeast Asian populations?
A. Hemoglobin A2
B. Hemoglobin F
C. Hemoglobin S
D. Hemoglobin E
E. Hemoglobin C
14. Which of the following conditions is characterized by formation of hemoglobin crystals in red cells?
A. Hemoglobin E disease
B. Hemoglobin C disease
C. Beta-thalassemia
D. Sickle cell trait
E. Sickle cell anemia
15. Hemoglobin C disease causes which of the following?
A. Priapism
B. Dactylitis
C. Autosplenectomy
D. Leg ulcers
E. None of the above
16. A 25-year-old woman has significant red blood cell microcytosis (low MCV) and many target cells on her peripheral blood smear, but is only very mildly anemic. Which of the following is the most likely diagnosis?
A. Thalassemia trait
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Folate deficiency
E. Hemoglobin S disease
17. Which of the following has the best-documented etiologic association with viral infection?
A. porphyria cutanea tarda
B. pemphigus vulgaris
C. pemphigoid gestationis
D. dermatitis herpetiformis
E. erythema multiforme
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18. Patients with which disorder develop IgA antibodies against a component of anchoring fibrils at the dermo-epidermal junction?
A. dermatitis herpetiformis
B. porphyria cutanea tarda
C. pemphigus foliaceus
D. bullous pemphigoid
E. dystrophic epidermolysis bullosa
19. You are asked to see a patient with a presumed diagnosis of bullous pemphigoid.
Which of the following features would be MOST compatible with that diagnosis?
A. sudden onset after starting sulfonamide therapy
B. improvement while on gluten-free diet
C. disorder present since early childhood
D. flaccid blisters
E. oral cavity involvement
20. What are you trying to preserve by submitting tissue to pathology in Michel's media?
A. parasites
B. bacterial toxins
C. cholesterol emboli
D. drugs
E. immunoglobulins
21. Under what bioterrorism agent/disease category are smallpox and anthrax classified by the Centers for Disease Control (CDC)?
A. category "critical"
B. category "cutaneous agents"
C. category "A"
D. category "1"
E. category "most severe"
22. Cryoglobulinemia is MOST LIKELY to be associated with what skin biopsy finding(s)?
A. intraepidermal blister cavity containing eosinophils
B. leukocytoclasis and fibrin deposition in vessel walls
C. intranuclear viral inclusions within keratinocytes
D. intravascular fibrosis and inflammation associated with needle-shaped empty spaces
E. basal epidermal vacuolization and dyskeratotic keratinocytes
23. During a well-child exam, you notice a few 3-4 mm smooth, umbilicated papules on the face of your 3-year-old patient. They do not itch or otherwise bother the child. What is the most likely diagnosis and how might the child contract these lesions?
A. scabies, from living in close quarters with infected siblings
B. molluscum contagiosum, from other kids at daycare
C. herpes simplex type I, from contact with a relative's lip lesion
D. verruca vulgaris, from contact with a parent's hands
E. condyloma acuminatum, from sexual abuse
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24. Skin eruption is one component of the classic triad of acute phase graft versus host disease
(GVHD). What is another component?
A. liver dysfunction
B. renal insufficiency
Path Exam IV 2005 - Uthman
C. mental status changes
D. respiratory difficulties
E. cardiac arrhythmias
25. While on your pediatric rotation, the resident asks you to write an order for transfusion of irradiated RBCs. Irradiation is designed to:
A. Extend the period of time the red cells can be kept unrefrigerated.
B. Enhance the expression of the ABO antigens.
C. Maintain 2,3-DPG and ATP levels during storage.
D. Prevent transfusion of platelet fragments in the RBC unit.
E. Prevent transmission of immunocompetent T-Cells.
26. A group O, Rh Positive patient requires RBC transfusion. There are no O Positive RBCs available. Of the following, the substitute component of choice is:
A. Group A Negative RBCs
B. Group AB FFP
C. Group B Positive RBCs
D. Group O cryoprecipitate
E. There are no acceptable choices
27. Which infectious agent can be transmitted by WBCs present in a blood component?
A. Treponema pallidum
B. Hepatitis B virus (HBV)
C. Plasmodium vivax
D. Cytomegalovirus (CMV)
E. Hepatitis C virus (HCV)
28. You write an order for cryoprecipitate for a young man undergoing liver transplantation.
Transfusion of this blood component would be expected to increase circulating levels of:
A. Factor X
B. Immunoglobulins
C. Fibrinogen
D. Factor V
E. Platelets
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29. An A Positive man receives 20 units of RBCs within 8 hours of being involved in a motor vehicle accident. He develops a dilutional coagulopathy and FFP is requested for transfusion. No Group A FFP is available. The substitute component of choice is:
A. Group AB FFP
B. Group B FFP
C. Group AB Positive RBCs
D. Group O FFP
E. Group O Negative RBCs
30. Citrate is the anticoagulant used during blood collection. Therefore, a potential complication of transfusion of large volumes of blood, such as occurs during massive transfusion, would be:
A. Hypercalcemia
B. Hyperphosphatemia
C. Elevated levels of IgG
D. Decreased levels of complement
E. Hypocalcemia
31. As part of your order for transfusion of RBCs, you request an indirect antiglobulin test.
This test detects:
A. The viability of the patient's platelets
B. Immunoglobulins bound to the patient's red cells in vivo
C. Low levels of complement
D. White cell antigens present in the patient
E. Antibodies in the patient directed against red cell antigens
32. While you are obtaining consent for RBC transfusion from a patient (who happens to be an attorney), she asks you which infectious agent is most likely to be transmitted by blood transfusion. Nodding knowingly, you answer:
A. Creutzfeldt-Jacob prions
B. HIV-1
C. Trypanosoma cruzi
D. Gram-negative bacteria
E. HCV
33. Rh Immune Globulin was developed to:
A. Protect Rh Negative infants from becoming jaundiced
B. Prevent antepartum bleeding in Rh Positive women
C. Remove anti-D from the circulation
D. Protect Rh Positive women from placental clots
E. Prevent Rh Negative women from forming anti-D
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34. In which of the following mother-infant pairs would the infant be most likely to develop
HDN?
A. Group B Negative mother - Group O Negative infant
B. Group O Positive mother - Group A Positive infant
C. Group O Positive mother - Group O Negative infant
D. Group A Positive mother - Group O Positive infant
E. Group AB Negative mother - Group A Negative infant
35. You admit a 70-kg adult patient with a hemoglobin of 4 g/dL. If you transfuse 4 units of
RBCs, in the absence of continued bleeding, what would you expect the posttransfusion hemoglobin to be?
A. 10 g/dL
B. 8 g/dL
C. 14 g/dL
D. 6 g/dL
E. 12 g/dL
36. Hemolytic disease of the newborn (HDN) due to anti-A or anti-B:
A. Can be prevented by giving Rh Immune Globulin.
B. Is less often a clinical problem than HDN due to anti-D.
C. Is caused by autoantibodies in the mother.
D. Often requires exchange transfusions following birth.
E. Results in ascites and pleural effusions in the fetus.
MATCHING : For each of the following patients (Column 1), choose the most appropriate blood component for transfusion from the list below (Column 2)
37. A 52-year-old man with angina who is scheduled for hip replacement surgery.
He has a hemoglobin of 6.2 g/dL, a platelet count of 238,000/pi, and a coagulation profile within reference ranges.
38. A 6-year-old girl with ALL, epistaxis
A. Red Blood Cells
B. Fresh Frozen Plasma
C. Platelets
D. Cryoprecipitate
E. Whole Blood and gum bleeding. She has a hemoglobin level of 9.4 g/dL and a platelet count of 12,000/pL.
39. A 62-year-old man scheduled for emergency coronary artery bypass surgery. He is on coumadin and has a hemoglobin of 10.9 g/dL
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40. Mr. Nelson is a 42-year-old man with a compound fracture of his right femur. His hemoglobin is 6.4 g/dL and you elect to transfuse 2 units of RBCs. He is found to be group A
Positive with a negative antibody screen. After approximately 50mL of the 1 st
unit has been transfused, you are called to the bedside when Mr. Nelson develops a temperature of 101 F (pretransfusion T = 97.8F) with concurrent decrease in blood pressure to 90/62 mmHg. You believe this is an acute hemolytic transfusion reaction. Which of the following situations is most likely to have caused this reaction?
A. Failure to give the patient steroids prior to transfusion
B. Transfusion of A Negative RBCs
C. Recipient misidentification
D. Transfusion of O Positive RBCs
E. Incompatible WBCs in the red cell unit
41. An 80-year-old diabetic man was admitted with a perforated ulcer and upper GI bleeding. He had no symptoms of anemia pre-operatively, and following surgery (partial gastrectomy) has no complaints of chest pain or dyspnea. His vital signs are:T 98.6F, BP 130/80 mmHg, HR 86 bpm.
A post-operative battery of tests shows the following:
Hemoglobin
Platelets
PT
PTT
Fibrinogen
9.3 g/dL
104,000/(L
11 sec
32 sec
110 mg/dL
What would you do now?
A. Transfuse 6 units of platelets and 10 units of cryoprecipitate
B. Transfuse 8 units of platelets
C. Transfuse 1 unit of whole blood
D. Transfuse 1 unit of RBCs
E. Continue to monitor his status
42. Choose the correct answer:
A. Osteogenesis imperfecta is caused by deficiencies in Type II collagen
B. Patients with Paget's disease of bone have disordered bone remodeling
C. Osteopetrosis is an hereditary disease of bone due to osteoblast dysfunction
D. Osteoporosis is characterized by a proportional decrease in cartilage and bone formation
E. Achondroplasia is characterized by inadequate mineralization of long bones
43. All of the following are true of Paget's disease of bone EXCEPT:
A. Frequently involves bones of the hands and feet
B. A mosaic pattern can be seen on a histologic section of bone
C. May be associated with development of secondary bone malignancies
D. Viral infection has been implicated in the etiology
E. Causes lytic and sclerotic areas in bone
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44. All of the following are true of osteomyelitis EXCEPT:
A. Typically affects the diaphysis of a bone in children
B. The sequestrum does not contain osteocyte nuclei in the lacunae
C. Organisms reach the bone mainly via the bloodstream
D. Staph. aureus is the most common causative bacterium
E. Patients with Sickle Cell Disease are prone to Salmonella infection
45. All of the following are true of osteoarthritis EXCEPT:
A. Weight bearing joints are commonly affected
B. Heberden's nodes may be found in the fingers
C. Excessive load on joints has been implicated in the pathogenesis
D. Affected joints are warm and tender
E. Is characterized by progressive erosion of articular cartilage
46. All of the following are true of rheumatoid arthritis EXCEPT:
A. Affected joints are warm and tender
B. May be hereditary
C. The synovium of affected joints is thick and inflamed
D. Tophi are seen in patients with rheumatoid nodules of the skin
E. The majority of adult patients have rheumatoid factor in the serum
47. All of the following are true of gout EXCEPT:
A. Patients have hyperuricemia
B. Renal failure is a complication
C. Urate crystals may be found in soft tissues and organs
D. Calcium pyrophosphate crystals are found in the joints
E. Excessive alcohol consumption is a predisposing factor
48. Choose the single best answer:
A. Cavernous hemangiomas regress spontaneously during infancy
B. Fibromatoses frequently metastasize to the lungs
C. Lipomas most frequently arise in the retroperitoneum
D. Prior irradiation predisposes to the development of angiosarcoma
E. Large areas of hemorrhage and necrosis are characteristic of leiomyomas
49. All of the following are true concerning soft tissue tumors EXCEPT:
A. Gastrointestinal stromal tumors are considered a distinct group of lesions because all of these tumors demonstrate CD1 17 (c-kit protein) positivity on immunohistochemical staining
B. Fibromatoses are very bland cytologically but are infiltrative and can recur
C. Stewart-Treves syndrome is angiosarcoma arising in post-mastectomy lymphedema
Exam questions from Ron Rapini MD 2005
D. Liposarcoma is the second most common soft tissue sarcoma in adults
E. Granular cell tumors are malignant neoplasms that characteristically arise in the retroperitoneum
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MATCHING : For each numbered item (column1) choose the letter of the most closely related item in column 2.
50. Syphilitic osteomyelitis
51. Osteomalacia
52. Ankylosing spondylitis
53. Gout
A.Plasma cell-rich inflammation
B.Lead toxicity
C.HLA B27
D. Vitamin D deficiency
MATCHING : For each numbered item (column 1) choose the letter of the most closely related item in column 2.
54. Osteosarcoma
55. Ewing's sarcoma
56. Fibrous dysplasia
57. Osteoid osteoma
A. Developmental defect
B. Limited growth potential
C. Paget's disease
D. Small blue cells
58. A 57-year-old man complains of chest pain, fever, and non-productive cough for the past two days. A CBC reveals:
WBC:
Diff:
20,000/cumm
80% neutrophils
15% lymphocytes
3% monocytes
2% eosinophils
(Normal: 4,800-10,800)
Normal hemoglobin, hematocrit, and platelet count.
Based on this information, which of the following is the most likely explanation for these findings?
A. Mycoplasma infection
B. Bordetella pertussis infection
C. Adenocarcinoma of the lung
D. Pneumococcal pneumonia
E. Acute appendicitis
59. An 8-year-old boy has fever and malaise for about a month. On physical exam, he is found to have splenomegaly and small peticheal hemorrhages on his mucous membranes. A CBC reveals a high WBC count of 30,000/cumm with many large, immature cells, normocytic anemia, and thrombocytopenia. Based on this information, which of the following is the most likely diagnosis?
A. Chronic lymphocytic leukemia
B. Chronic myelogenous leukemia
C. Epstein-Barr viral infection
D. Acute lymphoblastic leukemia
E. Acute viral hepatitis
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60. A 35-year-old man has fatigue for several weeks and is found to have pancytopenia.
An acute leukemia is suspected. Which of the following is required to make a diagnosis of acute leukemia?
A. Proliferation of all stages of myeloid cells in the marrow
B. Presence of blasts on the peripheral blood smear
C. Pancytopenia in the peripheral blood
D. Presence of 20% blasts in the bone marrow
E. Presence of a "packed" bone marrow
61. A 40-year-old woman is diagnosed with acute promyelocytic leukemia. With this type of leukemia, she is at increased risk for which of the following complications?
A. Disseminated intravascular coagulation
B. Monoclonal gammopathy
C. Pleural effusion
D. Gingival infiltration
E. Massive splenomegaly
62. A 65-year-old man has a fatigue, weakness, and an enlarging abdomen. On physical examination, he has splenomegaly and gouty enlargement of two of his toes. A CBC shows:
WBC:
Diff:
68,000/cumm
50% segmented neutrophiis
(Normal: 4,800 - 10,800)
Hemoglobin:
Hematocrit:
MCV:
Platelets:
20% metamyelocytes
15% myelocytes
3% blasts
5% eosinophils
7% basophils
10.0
30.0
89
450,000/cumm (Normal: 132,000 - 332,000)
Which of the following is the most likely diagnosis in this patient?
A. Acute lymphoblastic leukemia
B. Chronic lymphocytic leukemia
C. Chronic myelogenous leukemia
D. Acute myelogenous leukemia
E. Polycythemia rubra vera
63. A patient with chronic myelogenous leukemia is expected to have which of the following findings?
A. t(8;14) chromosomal translocation
B. Decreased LAP (leukocyte alkaline phosphatase) score
C. Diffuse fibrosis of the bone marrow
D. Monoclonal protein in the serum or urine
E. All of the above
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64. A 3-year-old boy is evaluated for fatigue and pallor. A CBC shows:
WBC: 8,000/cumm with normal differential
Hgb:
Hct:
MCV:
Platelets:
7.2
21.6
70.5
420,000/cumm
This patient's thrombocytosisis is most likely secondary to which of the following?
A. Iron deficiency
B. Chronic myelogenous leukemia
C. Epstein-Barr viral infection
D. Acute lymphoblastic leukemia
E. Respiratory syncytial viral infection
65. A 68-year-old woman complains of fatigue and back pain. A CBC shows a normal
WBC count, normocytic anemia with rouleaux formation, and normal platelet count.
Skeletal x-rays show a vertebral compression fracture of L2-3 and multiple lytic skeletal lesions. Additional studies show a monoclonal IgG kappa protein in the serum. Which of the following additional findings would you most likely expect in this patient?
A. Extensive marrow fibrosis
B. Increased susceptibility to infections
C. Auer rods
D. Hypocalcemia
E. t(8;14) chromosomal translocation
66. A 45-year-old woman with a history of Sjogren syndrome seeks attention for an enlargement of her right parotid gland. A biopsy shows a diffuse lymphocytic infiltrate, and lymphoma is suspected. Which type of lymphoma is this patient most likely to have in her salivary gland?
A. MALT lymphoma
B. Burkitt lymphoma
C. Hodgkin lymphoma
D. Adult T-cell lymphoma
E. Sezary syndrome
67. A 60-year-old man complains of scaly patches of skin on his lower extremities for the past few months. A biopsy and immunophenotyping show atypical T lymphocytes infiltrating the upper dermis with extension into the epidermis. These findings most likely represent which of the following?
A. Hairy ceK leukemia
B. Chronic lymphocytic leukemia
C. Mycosis fungoides
D. Burkitt lymphoma
E. Lymphoblastic lymphoma/acute lymphoblastic leukemia
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68. An 18-year-old man has difficulty breathing, fatigue, and weight loss. Imaging studies show a large mediastinal mass extending into the lung parenchyma associated with a pleural effusion. A biopsy shows sheets of monomorphic, large cells, and immunophenotyping demonstrates a T cell origin. The peripheral blood smear contains similar large cells. Which of the following is this patient most likely to have?
A. Mycosis fungoides
B. Lymphoblastic lymphoma
C. Hodgkin lymphoma
D. MALT lymphoma
E. Acute myelogenous leukemia
69. A type of hematologic malignancy consistently associated with viral infection is:
A. Hairy cell leukemia
B. Chronic lymphocytic leukemia
C. Adult T-cell leukemia/lymphoma
D. Mycosis fungoides
E. Plasma cell (multiple) myeloma
70. In making a diagnosis of polycythemia rubra vera:
A. White blood cell and platelet counts in the peripheral blood are usually decreased.
B. Patients' skin and mucous membranes are usually pale
C. Blood oxygen saturation is usually low despite the erythrocytosis
D. The serum erythropoietin level is usually high.
E. Causes of secondary erythrocytosis, such as renal cell carcinoma, must be excluded.
71. A 54-year-old woman has evanescent red papules that move around hour by hour.
Biopsy shows edema in the dermis with sparse eosinophils, lymphocytes and neutrophils. The most likely diagnosis is:
A. allergic necrotizing vasculitis
B. urticaria
C. eczema
D. scabies
E. Well's syndrome
72. A patient has a papulosquamous rash. Biopsy shows lymphocytes and plasma cells in the dermis. The most likely diagnosis is:
A. erythema multiforme
B. urticaria
C. psoriasis
D. eczema
E. scabies
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73. A 45-year-old medical student, having failed year after year, was stressed out about the upcoming exam and developed scaly papules and vesicles only on the sides of the fingers. A biopsy showed spongiosis and lymphocytes. The most likely diagnosis is:
A. pemphigus
B. urticaria
C. dyshidrotic eczema
D. seborrheic dermatitis
E. angioneurotic edema
74. An obese 65-year-old woman developed moist macerated plaques with satellite papules and pustules beneath the breasts. A biopsy showed budding yeast and hyphae in the stratum corneum. The most likely diagnosis is:
A. tinea manuum
B. mycosis fungoides
C. tinea corporis
D. tinea versicolor
E. candidiasis
75. A 50-year-old alcoholic with cirrhosis developed red blanching macules mainly on the trunk. The most likely diagnosis is:
A. Spitz nevi
B. Dyshidrotic eczema
C. erythema multiforme
D. spider angiomas
E. pyogenic granulomas
76. A 30-year-old man with AIDS developed brownish purplish angulated plaques on the trunk. Biopsy showed slit-like vascular spaces. The most likely diagnosis is:
A. strawberry hemangiomas
B. lichen planus
C. Bowen's disease
D. angiosarcomas
E. Kaposi sarcomas
77. An 80-year-old man developed hyperkeratotic whitish papules on the arms. Biopsy showed atypical keratinocytes in the epidermis, solar elastosis, and no evidence of dermal neoplasm. The most likely diagnosis is:
A. seborrheic dermatitis
B. lichen planus
C. basal cell carcinoma
D. squamous cell carcinoma
E. actinic keratosis
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78. A Portuguese airline pilot developed pruritic purplish polygonal planar papules on the wrists with whitish reticulated patches on the buccal mucosa. Biopsy showed a band of lymphocytes in the dermis. The most likely diagnosis is:
A. lupus erythematosus
B. pemphigoid
C. vasculitis
D. lichen planus
E. Bowen's disease
79. A stressed medical student persistently rubbed the posterior neck and scalp throughout the first and second years of medical school, inducing a scaly plaque. A biopsy showed hyperkeratosis, acanthosis, and perivascular lymphocytes. The most likely diagnosis is:
A. mycosis fungoides
B. lichen simplex chronicus
C. pityriasis rosea
D. pityriasis rubra pilaris
E. lichen planus
80. A bluish 20 cm pigmented macule on the sacrum of a newborn black infant is most likely a:
A. nevus flammeus
B. dysplastic nevus
C. Mongolian spot
D. blue nevus
E. cafe-au-lait macule
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ANSWERS:
19. E
20. E
21. C
22. B
23. B
24. A
25. E
26. E
11. A
12. C
13. D
14. B
15. E
16. A
17. E
18. A
1. A
2. E
3. A
4. C
5. B
6. C
7. D
8. D
9. D
10. D
35. B
36. B
37. A
38. C
39. B
40. C
41. E
42. B
27. D
28. C
29. A
30. E
31. E
32. D
33. E
34. B
43. A
44. A
45. D
64. A
65. B
66. A
67. C
68. B
69. C
70. E
71. B
56. A
57. B
58. A
59. D
60. D
61. A
62. C
63. B
46. D
47. D
48. D
49. E
50. A
51. D
52. C
53. B
54. C
55. D
80. C
72. C
73. C
74. C
75. D
76. E
77. E
78. D
79. B
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