PATHOLOGY EXAM # 4
Feb. 11, 1998
Name:_______________________________
(Plea sign your exam if you wish it returned to you)
Practical Questions:
1. This congenital heart defect reprents:
A. Transposition of the great arteries
B. Truncus arteriosus
C.Coarctation of the aorta - infantile form
D. Coarctation of the aorta - adult form
2. The event depicted in this coronary artery would least likely result in:
A. Sudden cardiac death
B. Unstable angina pectoris
C. Acute myocardial infarction
D.Typical angina pectoris
E. Arrythmia
3. This patient had no evidence of systemic hypertension or valvular obstruction. Which of
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the following is not associated with the depicted heart dia?
A. Sudden death
B. Autosomal dominant pattern of inheritance
C.Amyloidosis
D. Disproportionate thickening of ventricular ptum
E. Myofiber disarray
4. The most likely etiology of the depicted dia of the mitral valve is:
A. Mitral valve prolap
B.Chronic rheumatic heart dia
C. Carcinoid heart dia
D. Mitral annular calcification
E. Nonbacterial thrombotic endocarditis
5. The myocarditis depicted would most likely result from:
A. Viral infection
B. Bite of the reduviid bug
C. Lyme dia
D.Eating raw pork
E. Drug hypernsitivity
6. Which one of the following is true regarding this appendiceal lesion?
(Note: there are 2 slides to this question)
A.It can elaborate vasoactive amines
B. It has a high metastatic rate
C. It aris from glandular goblet cells
D. This will likely lead to carcinoid syndrome刺鸟
7. A 24 year old male who had consumed excess ethanol prented to the emergency room
with hematemesis. This photographs demonstrates the lesion. Diagnosis:
A. Achalasia
B. Plummer Vinson syndrome
C.Mallory Weiss syndrome
D. Barrett’s esophagus
8. Which one of the following is true of this lesion en in the stomach?
A. It occurs most commonly in females
B.Most occur in the stomach and proximal duodenum
C. Usually prents with hematemesis
凯旋门洗车机
D. Endoscopy alone can rule out malignancy
9. The lesion shown on this photomicrograph is most consistent with
A. A malignant lesion arising from the pancreatic duct epithelium
B. A benign lesion arising from the pancreatic duct epithelium
C. A lesion arising from cell of the pancreatic islet
D. A malignant lesion arising from stromal fibroblast of the pancreas
10. The stone shown on this gross photograph is frequently en in:
A.Patients with bile stasis and infection
B. Female native Americans
C. Patients with cirrhosis
D. In patients with hemolytic anemia
11. The medical history of the patient pictured is least likely to include:
A.Autosomal recessive Crigler-Najjar Type I syndrome diagnod in infancy
B. Intravenous drug abu
C. Chronic alcoholism
D. History of exposure to thorotrast
E. Associated renal failure
12. This liver biopsy demonstrates a liver condition which:
A. Is specific for one particular diagnosis
B.Can be reversible
C. Is always associated with hepatomegaly
D. Is always symptomatic
13. This histological finding in a salivary gland tumor is:
A. Incidental and unrelated to diagnosis
B. Irrelevant
C.Significant and helpful in curing the diagnosis
D. Not consistent with any salivary gland tumor histology
14. Your differential bad on the gross appearance of this lung would include all except:
天津经济广播A. Metastatic carcinoma from the colon
B. E. coli pneumonia
C. Adenovirus pneumonitis
D. Tuberculosis
E. Bronchioloalveolar carcinoma
15. A 65 year old man prented with fever, weight loss, hyponatremia, and an area of
radiodensity in his left lower lobe. He has a 40 pack year smoking history and carried a diagnosis of chronic bronchitis. This poor fellow was another victim of the Graham Ambulance Service outside the ER, providing this gross and microscopic specimen. Bad o n your diagnosis, what would have been the best inital treatment of the lesion (if he ) ? (Note: there are 2 slides to this question)
A. Antibiotics
B. Surgery alone
C. Chemotherapy
D. Radiation alone
E. Anticoagulation
16. Identify the histological finding and the dia in a 54 year old woman with veral
metatarsal fractures.
A. Malignant osteoid; osteosarcoma
B. Plasma cells; multiple myeloma
C. Osteoid ams; osteomalacia
D. Sequestrum; osteomyelitis
E. Cartilage; enchondromata
17. A 23 year old man with pain in his buttock. Your diagnosis from this xray and histological ction:
(Note: there are 2 slides to this question)
A. Osteosarcoma
B. Osteochondroma
C. Ewing's sarcoma of bone
D. Osteoid osteoma
E. Enchondroma
18. The most likely diagnosis in a 72 year old man who prented with low back pain and this xray and biopsy:
(Note: there are 2 slides to this question)
A. Enchondroma
B. Metastatic adenocarcinoma, likely from the prostate
C. Non ossifying fibroma
D. Osteosarcoma
E. Chrondrosarcoma
19. A 45 year old man prented with a history of multiple episodes of shortness of breath of
over the past few years. During his workup, he keeled over, lost vital signs and could not be resuscitated. If he had survived, his most appropriate treatment would have been:
A. Antibiotics
B. Surgery alone
C. Chemotherapy
D. Radiation alone
E. Anticoagulation
Written Questions:
20. Trisomy 21 may be associated with:
A. Transposition of the great arteries
B. Coarctation of the aorta
C.Endocardial cushion defect (Arterioventricular ptal defect)
D. Tricuspid atresia
21. Which features are en with Tetrology of Fallot:
A. Ventricular ptal defect
B. Overriding aorta
C. Right ventricular outflow obstruction
D. Right ventricular hypertrophy
E.All of the above
22. The most common cardiac malformation is:
A. Atrial ptal defect
B. Endocardial cushion defect
C.Ventricular ptal defect
D. Aortic stenosis
23. Coarctation of the aorta - adult form is not associated with:
A. Hypertension in arms
B.Hypertension in legs
C. Claudication and cold legs
D. Collateral circulation with rib notching
24. A 42 year old patient was diagnod as having the most common primary tumor of the
adult heart. Where is the most likely location of the tumor?
A. Right atrium
B.Left atrium
C. Right ventricle
D. Left ventricle
E. None of the above
25. A 48 year old patient reported transient chest pains at rest. While significant ST gment
evaluations were en on EKG, there was no evidence of obstructing vascular lesions on cardiac angiography. The most likely diagnosis is:
A. Acute myocardial infarction
B. Ludwig’s angina
C. Typical angina pectoris
D. Crescendo angina地震
E.Prinzmetal’s variant angina
26. A 57 year old patient prented with a large pulsatile abdominal mass confirmed to be an
aortic aneurysm. All of the following statements concerning this lesion are true except:
A. Found between the level of the renal arteries and the bifurcation of tha aorta.
B. Atherosclerosis is a major etiologic factor
C. May prent by compressing a ureter
D.Tho greater than 5 cm are inoperable
E. Rupture is associated with high mortality rate
Matching: The following pertain to questions 27 through 30. You may u an answer once, more than once, or not at all.
A 12 year old patient prented with migratory polyarthritis and subcutaneous nodules
three weeks after a documented ca of group A beta-hemolytic streptcoccal pharyngitis.
A. Mitral stenosis
B. Acute myocarditis
C. Aschoff bodies
D. Sydenham’s chorea
27. Most life threatening complication in childhood. (B)
28. Associated with involuntary purpoless movements. (D)
29. Most common long term quelae without prophylaxis (A)
30. Considered pathognomic of rheumatic fever (C )
31. A 58 year old patient is diagnod as having acute myocardial infarction. When is the risk
highest for ventricular rupture?
A. 1-2 days after ont
B.4-7 days after ont
C. 11-14 days after ont
D. 17-21 days after ont
Matching: The following pertain to questions 32 through 35. You may u an answer once, more than once, or not at all.
A. Associated with pure right-sided heart failure
B. Associated with pure left-sided heart failure
C. Both A and B
D. Neither
32. Ankle edema (A)
33. Pulmonary edema (B)
34. "Nutmeg” liver (chronic passive congestion) (A)
35. Ascites (A)
36. Which of the following is not associated with coronary artery dia?
滚英语怎么说A. Sudden cardiac death
B. Myocardial infarction
C. Angina pectoris
D. Cor pulmonale
E. Chronic ischemic heart dia
Matching: The following pertain to questions 37 through 39. You may u an answer once, more than once, or not at all.
A. Typical angina pectoris
B. Prinzmetal’s variant angina
形容大雨的词语C. Both A and B
D. Neither
37. Paroxysmal substernal chest discomfort or pain (C )
38. Due to coronary artery spasm (B)
39. Related to physical exertion (A)
40. What is the most common rious complication of acute myocardial infarction?我校
A. Thromboembolism
B. Ventricular rupture
C.Cardiac arrhythmias
D. Left ventricular congestive failure
