INSTRUCTIONS: SELECT THE SINGLE BEST ANSWER FOR EACH QUESTION.
___3__1. vonWillebrand factor (vWf):
1 is absent or deficient in classic Hemophilia A.
2. inhibits endothelial tissue plasminogen activator (t-PA).
3. is capable of binding platelets to subintimal tissue.
4. is an anti-thrombotic factor.
5. activates plasminogen.
___4__2. Thrombomodulin:
1. activates prothrombin to promote thrombosis.
2. promotes thrombosis by inactivating anti-thrombin III.
3. is anti-thrombotic by its activation of anti-thrombin III.
4. is anti-thrombotic by its activation of Protein C/S.
5. promotes thrombosis by converting soluble fibrinogen to insoluble fibrin.
___1__3. A genetic defect in the clotting mechanism:
1. involves abnormality of a single clotting factor.
2. involves abnormalities of multiple clotting factors.
3. is found only in males.
4. appears only in adult life.
5. never involves the platelets.
___5__4. Protein C:
1. is secreted into subendothelial tissue space where it serves to bind platelets.
2. requires anti-thrombin III for its activation.
3. forms a complex with heparin which inactivates Factor IIa and Xa.
4. forms a complex with Protein S which inactivates Factors IIa and Va.
5. forms a complex with Protein S which inactivates Factors VIIIa and Va.
___4__5. Endothelial cells produce:
1. Thromboxane A2 which is a potent vasodilator.
2. Prostaglandin I2 (Prostacyclin) which is a potent vasoconstrictor.
3. Nitric oxide and thromboxane A2 which cause vasodilation and inhibit
platelet aggregation.
4. Nitric oxide and Prostaglandin I2 (Prostacyclin) which cause vasodilation
and inhibit platelet aggregation.
5. Nitric oxide and Prostaglandin I2 which cause vasoconstriction and
promote platelet aggregation.
__4__6. A recently discovered occurrence of mutations in Factor V is frequently
associated with increased incidence of thromboses. This is due to:
1. increased binding to Factor VIII.
2. decreased sensitivity to heparin.
3. increased binding to Factor X.
4. decreased sensitivity to Protein C/S.
5. increased binding to Factor IX.
__5__7. Administration of one-half an aspirin per day results in:
1. decreased formation of platelet membrane glycoprotein.
2. increased formation of platelet a (alpha) granules.
3. decreased formation of platelet actomyosin.
4. increased formation of endothelial thromboxane A2.
5. decreased formation of platelet thromboxane A2.
__2__8. Thrombin contributes to clot formation EXCEPT by:
1. inducing platelet aggregation.
2. combining with thrombomodulin.
3. splitting fibrinogen to form fibrin.
4. increasing conversion of Factor XI to XIa.
5. increasing activation of Factors V and VIII.
__2__9. Tissue Factor (TF) initiates clotting by activation of Factors:
1. VIII and IX.
2. IX and X.
3. X and XI.
4. XI and XII.
5. XII and XIII.
__2__10. The activity of Tissue Factor Pathway Inhibitor is relatively unchecked in:
1. Thrombocytopenia.
2. Hemophilia A.
3. Hageman Factor (XII) deficiency.
4. Acquired hypoprothrombinemia.
5. Factor XI deficiency.
__4__11. The Plasminogen-Plasmin system tends to limit thrombosis by:
1. inhibiting the action of thrombin.
2. acting as a protease that breaks down Tissue Factor.
3. acting as a protease that breaks down platelet lipoprotein membranes.
4. acting as a protease that breaks down fibrin.
5. inhibiting action of Tissue Factor Protein Inhibitor.
__1__12. Thrombi that may form on the mitral and aortic valves and on the aorta can
embolize to any of the following EXCEPT:
1. lung. 4. spleen
2. brain. 5. legs
3. kidney.
__1__13. Disseminated Intravascular Coagulation (DIC) is characterized by:
1. decreased fibrinogen - increased plasmin.
2. decreased fibrinogen - decreased plasmin.
3. decreased plasmin - decreased platelets.
4. increased fibrinogen - decreased platelets.
5. increased plasmin - increased platelets.
__3__14. Pulmonary thromboemboli are least likely to be associated with thrombosis of:
1. deep leg veins.
2. pelvic veins.
3. portal vein.
4. inferior vena cava.
5. femoral veins.
__4__15. Granulation tissue is:
1. the histological reaction to tuberculosis.
2. composed of epitheloid cells and lymphocytes.
3. composed of polymorphonuclear leukocytes and monocytes.
4. composed of fibroblasts and endothelial cells.
5. composed of epithelial cells and giant cells.
__1__16. Transforming growth factor-[beta] (beta) (TGF-[beta]) is capable of causing all of the following EXCEPT:
1. increased degradation of extracellular matrix.
2 increased fibroblast migration.
3. increased fibroblast proliferation.
4. increased production of collagen.
5. increased production of fibronectin.
__4__17. Deficiency or abnormality of fibrillin is associated with:
1. cutis laxa.
2. scurvy.
3. keloids.
4. Marfan Syndrome
5. Epidermolysis Bullosa
__4__18. The glomerular defect in Alport Syndrome is due to genetic defect in collagen
type:
1. I 4. IV
2. II 5. V
3. III
__3__19. Strength of a healing wound is best correlated to wound content of:
1. mucopolysaccharide.
2. fibronectin.
3. collagen.
4. laminin.
5. elastin.
__5__20. Repair of myocardial infarction involves all of the following EXCEPT:
1. formation of granulation tissue.
2. phagocytosis of dead muscle by macrophages.
3. proliferation of fibroblasts.
4. formation of collagen.
5. regeneration of myofibers.
A. Clinical Vignette
A 65 year old white male is diagnosed as having colonic adenocarcinoma with metastatic spread to the liver. As part of his treatment regimen, he is given a course of systemic chemotherapy aimed at killing the fast-growing population of tumor cells.
__2__21. Which of the following normal organs/systems will be least likely affected by the systemic chemotherapy.
1. hematopoietic system
2. musculoskeletal system
3. liver
4. endocrine system
5. lungs
__2__22. In question 21, the cells from the organ/system most likely to be affected by the chemotherapy are examples of which of the following cell types:
1. postmitotic cells
2. intermitotic cells
3. interphase cells
4. reverting postmitotic cells
5. non-mitotic cells
__1__23. True or False: In tissues containing intermitotic cells, injuries will heal by complete regeneration.
1. True
2. False
B. Clinical Vignette
A 75 year old White male enters the hospital with dysphagia (pain on swallowing) and is found to have a 2 cm. nodule in the lower esophagus adjacent to the gastroesophogeal junction. He has been treated for chronic reflux esophagitis for many years; and has a long-standing history of cigarette and alcohol abuse. An endoscopy is performed and reveals a mass nearly completely obstructing the gastroesophageal junction. The mass and several flat reddened areas on the esophageal mucosa proximal to the mass are biopsied.
__1__24. The biopsy of the mass reveals an adenocarcinoma. The biopsy of the flat reddened proximal areas show a columnar epithelium with an appearance mimicking intestinal mucosa. The process which has involved the latter columnar mucosa is referred to as:
1. metaplasia
2. hypertrophy
3. hyperplasia
4. atrophy
5. carcinomatosis
__4__25. The progressive development of the adenocarcinoma most probably included all of the factors listed below except:
1. Conversion of squamous to columnar epithelium
2. Genetic defects caused by constant irritation and carcinogen exposure
3. Generation of an abnormal DNA cellular content (aneuploidy)
4. Hyperplasia of gastric columnar cells
5. Dysplasia involving Barrett's esophagus
C. Clinical Vignette
A 75 year old female is brought into the emergency room following a collapse at home. She died shortly thereafter in cardiac arrest. Her physician tells you that she had a long-standing history of hypertension which has been poorly controlled on medication. You perform an autopsy.
__1__26. At postmortem examination, the heart is found to weigh 600 grams. The left ventricular wall is 3 cm. thick. This finding is indicative of:
1. cardiac hypertrophy
2. cardiac hyperplasia
3. cardiac metaplasia
4. cardiac dysplasia
5. cardiac malignancy
__5__27. Which of the following best describes the process of dysplasia?
1. transformation of one cell type to another
2. increase in the size of cells
3. increase in the number of cells
4. increase in cell number due to neoplastic transformation
5. a physiologic response to cellular injury
Clinical Vignette
A 42 year old female is diagnosed as having breast cancer. The lesion is small (less than 1 cm. in diameter) and appears to be localized to the breast with no evidence of regional or systemic spread. As her physician, you want to gather prognostic data regarding the patient's tumor to guide therapeutic options (i.e. to treat or not treat for potential occult systemic disease), so you order a DNA (cell cycle) analysis.
__3__28. Which of the following statements regarding the cell cycle is correct:
1. The S (synthesis) phase consists of cells which are in mitosis.
2. Cells in the G0G1 phase are tetraploid.
3. Most cells are usually found in the G0G1 phase.
4. A DNA ploidy analysis of a tumor showing an abnormal DNA content is diagnostic of malignancy.
5. In a normal resting tissue, most cells are in the G2M phase.
__2__29. When you are analyzing the results of the DNA flow cytometric test you see the following graphical representation of the cells. Based on these results which of the following statements is the best answer regarding this patient's tumor?
1. The patient is in the best prognostic category.
2. The patient is in a group which might benefit from further therapy.
3. The patient has a diploid tumor.
4. The group at channel number 42 are cells in mitotic division.
5. The S-phase of normal cells is found between channel numbers 60 and 84.
GRAPH
A 7 year old boy with recent burn injury presents with complaint of increased tenderness
and swelling of the affected hand. The wound exhibits an erythematous and exudative border with yellowish discharge material.
__2__30. This most likely represents infection by:
1. crytococcus
2. pseudomonas
3. aspergillus
4. listeria
__3__31. The host defense system(s) primarily responsible for resolution of this infection are:
I. Neutrophils
II. NK Cells
III. Cytokines (lymphokines)
IV. Immunoglobulin and Complement
1. I and II
2. II and III
3. I and IV
4. IV only
__1__32. During work-up, it is discovered that the patient had previously been diagnosed with
Kartagener's Syndrome (Immotile Cilia Syndrome). These patients are at increased
risk for:
1. pneumonia.
2. hepatitis.
3. impetigo.
4. encephalitis
__4__33. The risk of infection in leukemic and marrow transplant patients is directly
proportional to the number of circulating:
1. thrombocytes.
2. T-cells.
3. platelets.
4. neutrophils.
__4__34. One of the most common heritable immunodeficiency states is:
1. isolated IgG deficiency.
2. agammaglobulinemia of Bruton.
3. DiGeorge's Syndrome
4. isolated IgA deficiency.
__2__35. A patient presents with localized edema of the left lower extremity. All of the
following are possible explanations EXCEPT:
1. Wuchereria bancrofti.
2. pregnancy.
3. radiation therapy.
4. metastatic melanoma.
__2__36. A 24 year old long distance runner weighs 60 kg and has an intravascular volume
of approximately 4 liters. She is likely to tolerate an acute blood loss of:
1. 1000cc
2. 500cc
3. 700cc
4. 1200cc
5. 900cc
__2__37. Apoptosis is believed to have a key role in all of the following EXCEPT:
1. embryogenesis
2. ischemic necrosis
3. adrenal atrophy due to corticosteroid administration
4. normal cyclic endometrial breakdown
5. cell deletion in normal proliferating intestinal epithelium
__4__38. Which of the following ultrastructural changes is NOT associated with
reversible cell injury?
1. dilation of endoplasmic reticulum
2. detachment of ribosomes from rough endoplasmic reticulum
3. swollen mitochondria
4. disruption of lysosomal membranes
5. plasma membrane blebs
__3__39. Of the following ultrastructural features , which best describes irreversible cell injury?
1. small mitochondrial densities
2. loss of microvilli
3. disruption of the plasma membrane
4. dissociation of polyribosomes
5. myelin figures
__5__40. Which statement about irreversible cell injury is TRUE?
1. The "turning point" from reversible to irreversible cell injury is a well understood and readily characterized biochemical event.
2. Damage to the plasma membrane plays only a minor role.
3. The duration of ischemia needed to induce irreversible injury is independent of cell type.
4. Susceptibility to irreversible cell injury is unrelated to nutritional and hormonal status.
5. ATP depletion due to persistent mitochondrial dysfunction is an important factor in irreversible cell injury.
__2__41. In ischemic cell injury, all of the following biochemical mechanisms may contribute either directly or indirectly to membrane damage EXCEPT:
1. decreased phospholipid synthesis
2. decreased intracellular calcium concentration
3. protease activation
4. lipid peroxidation
5. phospholipase activation
__5__42. Which of the following biochemical events does NOT play a key role in reperfusion injury?
1. massive influx of calcium ions through the damaged membrane
2. formation of oxygen free radicals by polymorphonuclear leukocytes
3. inhibition of enzymes
4. poisoning of the mitochondrial electron transport system
5. sudden shift in pH due to restored blood flow
__1__43. All of the following statements about free radicals are true EXCEPT:
1. Free radicals induce cell injury only in ischemia.
2. Mechanisms of injury include peroxidation of lipids and oxidative modification of proteins.
3. Free radicals may undergo spontaneous decay.
4. Autocatalytic reactions may enhance injury due to free radicals.
5. Antioxidants, such as vitamin E, may block or inactivate free radicals.
SELECT:
(1) if a, b, and c are correct
(2) if a and c are correct
(3) if b and d are correct
(4) if only d is correct
(5) if all are correct
__1__44. The benefits of inflammation include:
a. localization or walling off of site of damage
b. removal of dead cells and debris
c. preparation of area for repair
d. laying foundation for hypersensitivity
__2__45. The acute red discoloration of the skin in the earliest stages of sunburn is
caused by:
1. increased amount of pigment in the basal layers of the blood vessels
2. congestion of the blood vessels of the dermis
3. edema of the dermis
4. lymphangiectasis
5. cyanosis
__5__46. As the circulating blood flows in the capillaries, it can be differentiated into an
axial stream and a peripheral stream. Normally, the peripheral stream contains:
1. white cells
2. erythrocytes
3. white cells and red cells
4. thrombocytes
5. only plasma
__4__47. Which part of the microcirculation is most consistently involved in the permeability
changes and exudation of acute inflammation?
1. small arteries
2. arterioles
3. capillaries
4. venules
5. veins
__2__48. Characteristic morphological features of chronic granulomatous inflammation are:
1. liquefaction necrosis, neutrophilic granulocyte infiltration and scattered
multinucleated giant cells
2. aggregates of mononuclear phagocytes (with or without multinucleated
giant cells and scattered lymphocytes)
3. foci of caseous necrosis surrounded by neutrophilic granulocytes and
multinucleated giant cells
4. aggregates of lymphocytes and plasma cells
__1__49. The chronic inflammation of a delayed hypersensitivity reaction is mediated by:
1. lymphokines
2. histamine
3. bradykinin
4. exotoxin
5. complement
SELECT:
(1) if a, b, and c are correct
(2) if a and c are correct
(3) if b and d are correct
(4) if only d is correct
(5) if all are correct
__3__50. Substances which are chemotactic for neutrophils and/or monocytes include:
a. C3a
b C5a
c. prostaglandins
d. leukotriene B4
SELECT:
(1) if a, b, and c are correct
(2) if a and c are correct
(3) if b and d are correct
(4) if only d is correct
(5) if all are correct
__3__51. Chemically, opsonins may be:
a. IgM
b. IgG
c. C1
d. C3b
__3__52. Which of the following cells has the shortest life span?
1. lymphocyte
2. monocyte
3. neutrophil
4. giant cell
5. epithelioid cell
__4__53. The epithelioid cells of a tubercle are derived from :
1. Langhans' giant cells
2. lymphocytes
3. capillary endothelial cells
4. mononuclear phagocytes
5. polymorphonuclear phagocytes
__1__54. Children with chronic granulomatous disease of childhood have a defect in:
1. neutrophil myeloperoxidase/hydrogen peroxide system
2. neutrophil membrane receptors for the Fc fragment
3. complement activation via the classical pathway
4. neutrophil membrane receptors for C3
5. macrophage activation
__5__55. The feature common to every chronic infectious granulomatous lesion is:
1. Langhans' giant cell
2. exotoxin
3. endotoxin
4. caseation necrosis
5. epithelioid cells
__3__56. Morphological changes seen in chronic non-specific inflammation include an
increase in :
1. neutrophils, lymphocytes and liquefactive necrosis
2. neutrophils, macrophages and fibrosis
3. lymphocytes, plasma cells and fibrosis
4. giant cells, eosinophils and fibrosis
5. giant cells, macrophages and coagulative necrosis
__5__57. A large purulent lesion with multiple draining tracts which frequently occurs on
the back of the neck is called a:
1. boil
2. pustule
3. furuncle
4. bulla
5. carbuncle
__3__58. A boy cuts his hand on a piece of glass. Two days later there is an open sore
surrounded by swelling. His entire forearm is red and hot. Axillary lymph nodes
are enlarged. The best designation for his condition is:
1. ulcer
2. purulent exudate
3. cellulitis
4. abscess
5. caseation
SELECT:
(1) if a, b, and c are correct
(2) if a and c are correct
(3) if b and d are correct
(4) if only d is correct
(5) if all are correct
__2__59. It is sometimes important to determine whether a pleural or peritoneal effusion is
the result of inflammatory or non-inflammatory edema. Which of the following
is/are characteristic of a transudate?
a. specific gravity below 1.012
b. high protein content
c. low content of lymphocytes and neutrophils
d. the presence of fibrin
__2__60. Elevated serum gamma globulins are responsible for elevated erythrocyte
sedimentation rates in:
1. acute inflammation
2. chronic inflammation
3. both
4. neither
__2__61. Acute inflammation is a form of immune response.
1. True
2. False
MATCH the cytokines with their appropriate function during inflammation.
1. IL-4
2. IFN Gamma
3. IL-5
4. IL-9
__2__62. Activates macrophages
__1__63. Inhibits the release of early inflammation cytokines
__3__64. Activates eosinophils
__4__65. Polymorphonuclear leukocytes are by definition part of:
1. granuloma
2. granulation tissue
3. both
4. neither
__4__66. Multinucleated giant cells of the foreign body type originate from:
1. endothelial cells
2. fibroblasts
3. granulocytes
4. macrophages
__3__67. Eosinophilia is seen in:
1. allergic diseases
2. parasitic diseases
3. both
4. neither
__4__68. Which of the following is common to tuberculosis, leprosy and sarcoidosis?
1. mycobacterial infection
2. plasmacytic endarteritis
3. pulmonary disease
4. granulomatous inflammation
SELECT:
(1) if a, b, and c are correct
(2) if a and c are correct
(3) if b and d are correct
(4) if only d is correct
(5) if all are correct
__1__69. The process of suppuration typically involves:
a. necrosis of tissue
b. presence of bacteria
c. presence of many neutrophils
d. accumulation of lymphocytes
__3__70. Causes of fever in inflammation include:
1. macrophages product similar to interleukin I
2. prostaglandins
3. both
4. neither
__4__71. Wound healing is impaired by the experimental elimination of:
1. Eosinophils and basophils.
2. B cells and T cells.
3. neutrophils and eoxinophils
4. monocytes and platelets
5. eosinophils and tissue mast cells
__4__72. You are asked to evaluate a core needle biopsy of liver taken intraoperatively during
a gastric stapling procedure for treatment of obesity. The light microscopic findings
you see most likely reflect:
1. alcohol abuse
2. abnormal cholesterol metabolism
3. a tissue processing artifact
4. triglyceride accumulation
5. surgical trauma
__5__73. You are performing a cholecystectomy on a young black woman with sickle cell
anemia and notice that her liver looks abnormally dark reddish-brown. You take a
liver biopsy and send it to Pathology. You expect the surgical pathologist to find
evidence of:
1. bile lakes
2. primary hemochromatosis
3. steatosis
4. Mallory's hyaline
5. secondary hemochromatosis
__2__74. You are caring for a patient on dialysis for chronic renal failure. Recently, this
patient had a basal cell carcinoma removed from her forehead, and on the surgical
pathology report the presence of calcification around small blood vessels was
noted. The latter finding is an example of:
1. dystrophic calcification
2. metastatic calcification
3. hyaline change
4. heterotopic bone
5. athcrosclerosis
__1__75. A necessary condition for shock is:
1. inadequate perfusion of tissues
2. hypovolemia
3. loss of tone in peripheral vasculature
4. hypotension
5. bleeding.
__3__76. At autopsy a patient is found to have hemosiderin-laden alveolar macrophages, "nutmeg" liver, hydrothorax, and bilateral ankle edema. The patient had:
1. left-sided heart failure
2. right-sided heart failure
3. both
4. neither
__2__77. Widespread (rather than localized) edema is most likely in:
1. lymphatic obstruction
2. hypoalbuminemia
3. capillary damage
4. inflammation
__4__78. Which of the following components of myocardium will first undergo necrosis when subjected to ischemia?
1. endothelial cells
2. fibroblasts
3. macrophages
4. myocytes
__1__79. Which of the following histologic features is most characteristic of coagulative necrosis?
1. loss of cell nuclei with intact cellular outlines
2. infiltration with and replacement by polymorphonuclear leukocytes
3. infiltration with mononuclear cells, histiocytes, and giant cells
4. vacuolar myocytolysis
5. infitration with polymorphonuclear leukocytes and calcification
__3__80. Which of the following features is most characteristic of gummatous necrosis?
1. loss of cell nuclei with intact cellular outlines
2. infiltration with and replacement by polymorphonuclear leukocytes
3. infiltration with mononuclear cells, histiocytes, and giant cells
4. vacuolar myocytolysis
5. infiltration with polymorphonuclear leukocytes and calcification
__5__81. Which of the following histologic features is most characteristic of enzymatic fat necrosis?
1. loss of cell nuclei with intact cellular outlines
2. infiltration with and replacement by polymorphonuclear leukocytes
3. infiltration with mononuclear cells, histiocytes, and giant cells
4. vacuolar myocytolysis
5. infitration with polymorphonuclear leukocytes and calcification
__2__82. Which of the following features is most characteristic of liquefaction necrosis?
1. loss of cell nuclei with intact cellular outlines
2. infiltration with and replacement by polymorphonuclear leukocytes
3. infiltration with mononuclear cells, histiocytes, and giant cells
4. vacuolar myocytolysis
5. infiltration with polymorphonuclear leukocytes and calcification
__2__83. Which of the following is LEAST HELPFUL in distinguishing postmortem autolysis from necrosis?
1. polymorphonuclear leukocyte infiltrate
2. karyorrhexis, karyolysis, and pyknosis
3. a zone of congestion
4. a wedge-shaped lesion
__5__84. Which type of necrosis CANNOT be identified on the basis of gross examination?
1. coagulation necrosis
2. liquefaction necrosis
3. caseous necrosis
4. enzymatic fat necrosis
5. fibrinoid necrosis
6. gangrene
__3__85. Liquefaction necrosis characteristically occurs in:
1. brain infarction
2. kidney abscess
3. both
4. neither
SHOW SLIDES FOR THE FOLLOWING QUESTIONS.
__2__86. .An AIDS patient presents with complaint of fever, weight loss, persistent diarrhea and pneumonia-like symptoms. In this setting, diarrhea is often secondary to the protozoan:
1. pneumocystis carinii
2. cryptosporidium parvum
3. toxoplasma gondii
4. crytococcus neoformans
__1__87. Alternately (in the patient from the previous question), focal ulceration and necrosis in the small and large intestine and this histology are most consistent with infection by:
1. cytomegalovirus
2. Epstein-Barr virus
3. Herpes Simplex Virus I (HSV I)
4. Herpes Simplex Virus II (HSV II)
__4__88. A 40 year old black woman was noted to have hilar adenopathy on chest x-ray as part of a routine physical exam. Otherwise, she was in good health. The slide portrays the hilar lymph node biopsy findings. Notably, special stains for acid fast and fungal organisms were negative as were cultures for mycobacterial and fungal pathogens. This scenario represents a case of:
1. chromoblastomycosis
2. Schistosomiasis
3. Hansen's disease, lepromatous type
4. Sarcoidosis
5. Acquired immunodeficiency
6. Pulmonary tuberculosis
__3__89. This patient represents a case of deficiency of:
1. C5b
2. C3a
3. CD18
4. CD38
5. CD19
__4__90. A 35 year old man presents with a three week history of malaise (feeling unwell) and worsening jaundice. Serum levels of liver enzymes and bilirubin are elevated. After examining his liver biopsy, a more detailed history is obtained which reveals:
1. recent ingestion of undercooked sausage
2. recent ingestion of raw shellfish
3. recent ingestion of raw fish
4. excessive ingestion of alcohol
5. ingestion of water contaminated with barnyard runoff
6. a history of paraproteinemia
__2__91. A 35 year old man presents with a three week history of malaise and worsening jaundice. Serum levels of liver enzymes and bilirubin are elevated. After examining his liver biopsy, a more detailed history is obtained which reveals:
1. recent ingestion of undercooked sausage
2. recent ingestion of raw shellfish
3. recent ingestion of raw fish
4. excessive ingestion of alcohol
5. ingestion of water contaminated with barnyard runoff
6. a history of paraproteinemia
__4__92. A 35 year old man dies after three months of malaise and worsening jaundice. Serum levels of liver enzymes and bilirubin are elevated. After examining his liver at autopsy, a more detailed history is obtained which reveals:
1. recent ingestion of undercooked sausage
2. recent ingestion of raw shellfish
3. recent ingestion of raw fish
4. excessive ingestion of alcohol
5. ingestion of water contaminated with barnyard runoff
6. a history of paraproteinemia
__6__93. A 35 year old man dies after three months of malaise and worsening jaundice. Serum levels of liver enzymes and bilirubin are elevated. After examining his liver at autopsy, a more detailed history is obtained which reveals:
1. recent ingestion of undercooked sausage
2. recent ingestion of raw shellfish
3. recent ingestion of raw fish
4. excessive ingestion of alcohol
5. ingestion of water contaminated with barnyard runoff
6. a history of paraproteinemia
__1__94. A 35 year old man presents with a three day history of malaise severe muscle pain. Serum level of Creatine kinase is elevated, predominantly with the skeletal muscle isoenzyme. After examining his muscle biopsy, a more detailed history is obtained which reveals:
1. recent ingestion of undercooked sausage
2. recent ingestion of raw shellfish
3. recent ingestion of raw fish
4. excessive ingestion of alcohol
5. ingestion of water contaminated with barnyard runoff
6. a history of paraproteinemia
__2__95. You are examining the lung biopsy from a 65 year old alcoholic, who had presented with shortness of breath and unexplained infiltrates on his chest radiograph. The pathology resident proudly proclaims that he has found "giant cells" in the biopsy. After looking at the slide you agree, and point out that in this case the cells are related to:
1. reactivation of Tuberculosis
2. immunosuppression and Cytomegalovirus infection
3. aspiration of food particles
4. lobar pneumonia
5. aspiration of silicon-laden dust
6. recent influenza pneumonia
7. travel to the San Joachin valley of California
8. immunosuppression and Aspergillus infection
9. Sarcoidosis
__5__96. You are examining the lung biopsy from a 65 year old alcoholic, who had presented with shortness of breath and unexplained infiltrates on his chest radiograph. The pathology resident proudly proclaims that he has found "giant cells" in the biopsy. After looking at the slide you agree, and point out that in this case the cells are related to:
1. reactivation of Tuberculosis
2. immunosuppression and Cytomegalovirus infection
3. aspiration of food particles
4. lobar pneumonia
5. aspiration of silicon-laden dust
6. recent influenza pneumonia
7. travel to the San Joachin valley of California
8. immunosuppression and Aspergillus infection
9. Sarcoidosis
__7__97. You are examining the lung biopsy from a 65 year old alcoholic, who had presented with shortness of breath and unexplained infiltrates on his chest radiograph. The pathology resident proudly proclaims that he has found "giant cells" in the biopsy. After looking at the slide you agree, and point out that in this case the cells are related to:
1. reactivation of Tuberculosis
2. immunosuppression and Cytomegalovirus infection
3. aspiration of food particles
4. lobar pneumonia
5. aspiration of silicon-laden dust
6. recent influenza pneumonia
7. travel to the San Joachin valley of California
8. immunosuppression and Aspergillus infection
9. Sarcoidosis
__1__98. You are examining the lung biopsy from a 65 year old alcoholic, who had presented with shortness of breath and unexplained infiltrates on his chest radiograph. The pathology resident proudly proclaims that he has found "giant cells" in the biopsy. After looking at the slide you agree, and point out that in this case the cells are related to:
1. reactivation of Tuberculosis
2. immunosuppression and Cytomegalovirus infection
3. aspiration of food particles
4. lobar pneumonia
5. aspiration of silicon-laden dust
6. recent influenza pneumonia
7. travel to the San Joachin valley of California
8. immunosuppression and Aspergillus infection
9. Sarcoidosis
__3__99. You are examining the lung biopsy from a 65 year old alcoholic, who had presented with shortness of breath and unexplained infiltrates on his chest radiograph. The pathology resident proudly proclaims that he has found "giant cells" in the biopsy. After looking at the slide you agree, and point out that in this case the cells are related to:
1. reactivation of Tuberculosis
2. immunosuppression and Cytomegalovirus infection
3. aspiration of food particles
4. lobar pneumonia
5. aspiration of silicon-laden dust
6. recent influenza pneumonia
7. travel to the San Joachin valley of California
8. immunosuppression and Aspergillus infection
9. Sarcoidosis
Return to Pathology 500 Exams Page
Return to Rochester Pathology Home Page
Return to Pathology Internet Resources Page