NursGuru

    Exam Review

    1. A skin biopsy is examined by light microscopy in the Pathology Department. Neutrophils (polys) are seen attached to endothelial cells lining small blood vessels (shown). What is the most likely reason for this pathologic finding?
      A)
      Acute inflammation
      B)
      Granulomatous inflammation
      C)
      Chronic inflammation
      D)
      Immune complex disease
      E)
      Hypersensitivity type I
    2. A 31-year-old woman complains of increased vaginal discharge of 1 month duration. A cervical Pap smear is obtained. Superficial epithelial cells in the smear show condensed pyknotic nuclei (see arrows). Pyknosis is typically associated with which of the following processes?
      A)
      Atrophy
      B)
      Cell death
      C)
      Dysplasia
      D)
      Hypertrophy
      E)
      Neoplasia
    3. Renal cell carcinomas may secrete a hormone (erythropoietin) that stimulates erythrocytosis (increased hematocrit). The bone marrow of such patients contains an increased number of erythrocyte stem cells. Which of the following terms best describes this change in cellularity of the patient's bone marrow?
      A)
      Atrophy
      B)
      Hypertrophy
      C)
      Hyperplasia
      D)
      Metaplasia
      E)
      Dysplasia
    4. Which of the following is an autoimmune blistering skin disease caused by autoantibodies to surface antigens on stratified squamous epithelial cells?
      A)
      Actinic keratosis
      B)
      Pemphigus vulgaris
      C)
      Psoriasis
      D)
      Scleroderma
      E)
      Systemic lupus erythematosus

    Exam Review

    1. Vasodilation of precapillary arterioles during acute inflammation increases blood flow to injured tissue. Which of the following terms best describes this hallmark of inflammation?
      A)
      Anemia
      B)
      Hyperemia
      C)
      Hemostasis
      D)
      Lymphedema
      E)
      Vasoconstriction
    2. A 50-year-old man is found to have blood in his urine (hematuria) during a routine check up. Vital signs are normal. An owing abdominal CT scan reveals a 2-cm right renal mass, and a CT-guided needle biopsy establishes a diagnosis of renal cell carcinoma. You inform the patient that "staging" of his tumor is key to selecting treatment and evaluating prognosis. Which of the following is the most important staging factor for this patient?
      A)
      Chromosomal aneuploidy of the tumor
      B)
      Histologic grade of the tumor
      C)
      Metastases to regional lymph nodes
      D)
      Proliferative capacity of the tumor stem cells
      E)
      Somatic mutations in the p53 tumor suppressor gene
    3. Chest x-ray of a 28-year-old man with a history of alcoholism reveals a pulmonary abscess within the middle lobe of the right lung. Which of the following terms appropriately describes the material filling this cystic lung cavity?
      A)
      Purulent exudate
      B)
      Fibrinous exudate
      C)
      Serous exudate
      D)
      Thrombus
      E)
      Transudate
    4. A 23-year-old pregnant woman asks you for examples of chemical, physical, and biological agents that are risk factors for congenital birth defects. Which of the following terms best describes these agents?
      A)
      Allergens
      B)
      Carcinogens
      C)
      Mutagens
      D)
      Pyrogens
      E)
      Teratogens

    Exam Review

    1. An 80-year-old man dies of metastatic cancer. Histological examination of the liver at autopsy is shown. What is the most likely explanation for the accumulation of intracellular golden granules composed of cross-linked proteins and lipids within hepatocytes in this patient?
      A)
      Autoimmune liver disease
      B)
      Chronic renal failure
      C)
      Congestive heart failure
      D)
      Patient's age
      E)
      Response to chemotherapy
    2. Physical examination of a 48-year-old woman reveals large erythematous and scaly plaques (shown). Which of the following is the most likely diagnosis?
      A)
      Actinic Keratosis
      B)
      Bullous pemphigoid
      C)
      Erythema multiforme
      D)
      Ichthyosis vulgaris
      E)
      Psoriasis
    3. A 68-year-old woman dies of congestive heart failure. A section of the heart at autopsy is examined (shown). Which of the following best describes the morphologic reaction to persistent stress evidenced in this patient's heart?
      A)
      Atrophy
      B)
      Hypertrophy
      C)
      Hyperplasia
      D)
      Dysplasia
      E)
      Metaplasia
    4. Large amounts of brown pigment are noted in a liver biopsy specimen obtained from a man with autoimmune hemolytic anemia. This pigment reacts with Prussian Blue. What is the appropriate name for this intracellular pigment?
      A)
      Ferritin
      B)
      Hemoglobin
      C)
      Hemosiderin
      D)
      Lipofuscin
      E)
      Transferrin

    Exam Review

    1. A 44-year-old man presents with a painful skin rash that developed after working outdoors on a warm summer day (patient shown). Based on the history and distribution of the rash, which of the following is the most likely medical diagnosis?
      A)
      Dermatitis herpetiformis
      B)
      Erythema multiforme
      C)
      Psoriasis
      D)
      Systemic lupus erythematosus
      E)
      Urticaria pigmentosa
    2. A freely-movable nodule measuring 2 cm in diameter was palpated in the right breast of a 25-year-old woman. Biopsy reveals a benign neoplasm of ductal epithelial cell origin, accompanied by an accumulation of fibrous connective tissue. Based on the histopathology report, which of the following is the most likely diagnosis?
      A)
      Adenocarcinoma
      B)
      Fibroma
      C)
      Fibroadenoma
      D)
      Fibrosarcoma
      E)
      Papilloma
    3. During a research conference you are asked to discuss staging and grading of breast cancer. Which of the following clinicopathological findings is most important for grading tumors?
      A)
      Level of epithelial tumor invasion
      B)
      Microscopic evidence of anaplasia and pleomorphism
      C)
      Presence of neoplastic cells within the circulation
      D)
      Presence of tumor metastases
      E)
      Size of the primary tumor
    4. A 58-year-old, obese woman with familial hypercholesterolemia develops progressive right renal artery narrowing (stenosis). Over time, this patient's right kidney is likely to demonstrate which of the following adaptations to reduced blood flow (partial ischemia)?
      A)
      Atrophy
      B)
      Dysplasia
      C)
      Hypertrophy
      D)
      Hyperplasia
      E)
      Metaplasia

    Exam Review

    1. A 28-year-old man presents with abnormal scars on his shoulder and chest (patient shown). These scars are most likely caused by an inherited defect in wound healing that results in excessive deposition of which of the following extracellular matrix glycoproteins?
      A)
      Collagen
      B)
      Elastin
      C)
      Fibrillin
      D)
      Laminin
      E)
      Perlecan
    2. Collagen: The abnormal scars shown are keloids, which result from excessive deposition of collagen in the extracellular matrix during wound healing. Overproduction leads to raised, firm, irregular scars (keloids).
      A)
      Elastin: Provides elasticity to tissues; not the main component of keloid scars.
      B)
      Fibrillin: Structural glycoprotein associated with Marfan syndrome, not keloid formation.
      C)
      Laminin: Important in basement membranes, not excessive scar tissue.
      D)
      Perlecan: A proteoglycan in basement membranes, not involved in keloid pathology.
    3. A 29-year-old carpenter receives a traumatic laceration to her left arm. Which of the following is the most important factor that determines whether this deep wound will heal by primary or secondary intention?
      A)
      Apposition of edges
      B)
      Depth of wound
      C)
      Metabolic status
      D)
      Skin site affected
      E)
      Vascular supply
    4. This young man presented with a three-day history of grouped blisters on his lips and cheek (patient shown). These "fever blisters" were most likely caused by which of the following mechanisms of disease?
      A)
      Autoantibodies to keratinocyte surface antigens
      B)
      Defective synthesis of epidermal cell adhesion molecules
      C)
      Herpes simplex viral infection
      D)
      Familial collagen vascular disease

    Exam Review

    1. A 3-year-old boy skins his knees on a rug at home (carpet burn). This superficial abrasion of the epidermis will heal primarily through which of the following processes?
      A)
      Angiogenesis
      B)
      Fibrosis
      C)
      Granulation
      D)
      Metaplasia
      E)
      Regeneration
    2. A 68-year-old man with chronic renal disease complains of headaches and dizziness. Blood pressure is 220/130 mm Hg (malignant hypertension). While in the emergency room, the patient suffers a massive stroke and expires. Microscopic examination of the kidney at autopsy shows areas of fibrinoid necrosis. This type of necrosis is typically seen in which of the following anatomic structures or locations?
      A)
      Adipose tissue
      B)
      Blood vessels
      C)
      Collecting tubules and ducts
      D)
      Lymphatic tissue
      E)
      Serosal surfaces
    3. A 24-year-old woman with a history of bronchial asthma and seasonal allergies undergoes skin testing to identify potential allergens in her environment. A positive skin reaction to ragweed in this patient would be mediated by which of the following classes of immunoglobulin?
      A)
      IgA
      B)
      IgD
      C)
      IgG
      D)
      IgE
      E)
      IgM
    4. A kidney was affected by inflammation for 2 months. What type of cells would one expect to find in this tissue affected by chronic inflammation?
      A)
      Eosinophils
      B)
      Lymphocytes
      C)
      Mast cells
      D)
      Multinucleated giant cells
      E)
      Segmented neutrophils