[SEM2] PATHO #1 Flashcards by

You decide to do a Fecal Occult Blood Test (FOBT). What is the principle behind this test?
(1 point)
a) Chromogen as an indicator for an oxidation reaction
b) A sandwich test
c) Heme Immunofluorescence
d) Atomic Absorption Spectrophotometry

How well did you know this?

Not at all

Perfectly

The FOBT is positive. What would this look like?
(1 point)
a) A blue to dark blue color change
b) A fluorescent pattern on polarized microscopy
c) Absorption at 713 nm
d) A red color change

How well did you know this?

Not at all

Perfectly

The lab calls you later, informing you of an erroneous potassium result of 9.2 mmol/L. This reporting error is part of which phase?
(1 point)
a) Analytical phase
b) Postanalytical phase
c) Preanalytical phase
d) Metanalytical phase

How well did you know this?

Not at all

Perfectly

You discover that the sample for the test in the previous item had hemolysis due to improper extraction. This error is part of which phase?
(1 point)
a) Analytical phase
b) Metanalytical phase
c) Preanalytical phase
d) Postanalytical phase

How well did you know this?

Not at all

Perfectly

What variable could have caused a false-negative FOBT result in this case?
(1 point)
a) Vitamin C hyperdosing
b) Aspirin
c) Red meat
d) Menstruation

How well did you know this?

Not at all

Perfectly

Imaging subsequently revealed colon cancer. A genetic mutation was found, which is the most frequently found mutation of RAS in human cancers. Which mutation is this?
(1 point)
a) KRAS
b) NRAS
c) HRAS
d) DRAS

How well did you know this?

Not at all

Perfectly

What type of anemia does this patient most likely have?
(1 point)
a) Microcytic, normochromic
b) Normocytic, normochromic
c) Microcytic, hypochromic
d) Normocytic, hypochromic

How well did you know this?

Not at all

Perfectly

Which of the following tumor markers would you expect to be increased in this case?
(1 point)
a) PSA
b) Alkaline phosphatase
c) CA15-5
d) CEA

How well did you know this?

Not at all

Perfectly

If the initial FOBT was negative but your suspicion remains, what should you do next?
(1 point)
a) Do the test two more times to rule out intermittent bleeding
b) Do nothing
c) Follow up after a month
d) Panic

How well did you know this?

Not at all

Perfectly

What other feature in the stool could indicate an ulcerating lesion, such as that produced by colonic carcinoma?
(1 point)
a) Mucus
b) Fibers
c) Monocytes
d) Undigested food

How well did you know this?

Not at all

Perfectly

This person likely has:
(1 point)
a) Hepatic tuberculosis
b) Liver failure
c) Hepatitis A
d) Gastrinoma

How well did you know this?

Not at all

Perfectly

The cause of this patient’s disease is likely:
(1 point)
a) Increased alcohol intake
b) A hepatic parasite
c) A virus
d) Mycobacterium tuberculosis

How well did you know this?

Not at all

Perfectly

This patient has what type of anemia?
(1 point)
a) Macrocytic
b) Microcytic
c) Anisocytic
d) Normocytic

How well did you know this?

Not at all

Perfectly

This patient’s anemia is probably due to what process?
(1 point)
a) Hepatocyte destruction
b) Dietary folate deficiency
c) Viral latency
d) Splenic destruction of red cells

How well did you know this?

Not at all

Perfectly

Hepatitis profile on this patient was subsequently done, which showed: HBsAg negative, Anti-HBc negative, Anti-HBs positive. This patient is:
(1 point)
a) Chronically infected
b) Immune due to past infection
c) Immune due to vaccination
d) A carrier

How well did you know this?

Not at all

Perfectly

Relating the patient’s physical examination to his lab results, which of the following observations can be made?
(1 point)
a) The patient’s edema is due to his high albumin
b) The patient’s bilirubin is not high enough to cause jaundice
c) His GGT indicates a viral illness
d) His total protein is normal

How well did you know this?

Not at all

Perfectly

The most specific liver function test that pinpoints the cause of this patient’s condition is:
(1 point)
a) Troponin-I
b) GGT
c) ALP
d) Albumin

How well did you know this?

Not at all

Perfectly

Considering this patient has liver failure, what kind of urine crystal can only be found in cases of liver failure?
(1 point)
a) Uric acid
b) Oxalate
c) Triple phosphate
d) Leucine

How well did you know this?

Not at all

Perfectly

AST and ALT determination uses what kind of test tube?
(1 point)
a) Red top
b) Violet top
c) Blue top
d) Green top

How well did you know this?

Not at all

Perfectly

The additive of the test tube in the previous item is:
(1 point)
a) Sodium citrate
b) EDTA
c) None
d) Heparin

How well did you know this?

Not at all

Perfectly

This person likely has:
(1 point)
a) Hashimoto’s thyroiditis
b) Addison’s disease
c) Diabetes insipidus
d) Cushing’s syndrome

How well did you know this?

Not at all

Perfectly

If the cause of the oversecreted hormone is due to a pituitary tumor, this is called:
(1 point)
a) Secondary hyperthyroidism
b) Cushing’s disease
c) Nelson’s syndrome
d) Sheehan’s syndrome

How well did you know this?

Not at all

Perfectly

The first thing to be done with this patient test-wise, to confirm the diagnosis, is to determine the level of:
(1 point)
a) T4, T3
b) GGT
c) CRH
d) Cortisol

How well did you know this?

Not at all

Perfectly

A low urinary free cortisol value is suggestive of:
(1 point)
a) Adrenal hyperfunction
b) Adrenal hypofunction
c) Nothing
d) A central problem

How well did you know this?

Not at all

Perfectly

This test reflects unbound circulating cortisol that is freely filtered by the glomerulus: (1 point) a) 24-hour urinary free cortisol b) Serum cortisol c) Plasma cortisol d) CRH determination

This hormone is produced by the pituitary to stimulate cortisol and adrenaline: (1 point) a) Cortical hormone b) CRH c) TRH d) ACTH

In cortisol determination, dexamethasone is given to: (1 point) a) Suppress cortisol b) Stimulate cortisol

Findings reveal that the patient’s ACTH is elevated. Which of the following is a plausible reason for the increased ACTH amount? (1 point) a) An ACTH-secreting tumor, probably in the lungs b) Intracellular fluid shifts increase relative ACTH production c) Adrenal gland destruction by caseous necrosis d) The pancreas secretes ACTH due to hyperglycemia

Glucocorticoids are secreted by the: (1 point) a) Zona glomerulosa b) Zona fasciculata c) Zona reticularis d) Medulla

CRH binding protein is ___________ during pregnancy: (1 point) a) Decreased b) Increased c) Normal d) None of the above

In a bacterial infection, a CBC would likely show the following: (1 point) a) Increased eosinophils b) Blasts c) Neutrophilic leukocytosis d) Giant platelets

The attending suggests a blood culture (CS). The blood for this test should be extracted: (1 point) a) After ionized electrolytes b) Last c) First d) After clotting studies

Bronchial lavage in this patient would most likely reveal which of the following findings? (1 point) a) Acid-fast bacilli (+) b) Cowdry type B cells c) Negri bodies d) Flagella

Suppose there are no findings as seen in the previous item, and the attending suspects a parasitic infection. What is the most likely parasite that mimics these symptoms? (1 point) a) Trichinella spiralis b) Fasciolopsis buski c) Paragonimus westermani d) Taenia solium

Refer to the presumed causative organism in item #33. What other bacterium has a similar cell wall? (1 point) a) Cryptococcus b) Nocardia c) Staphylococcus d) Ureaplasma

The type of hypersensitivity reaction seen in an infection with this organism is: (1 point) a) Type III b) Type IV c) Type I d) Type II

Instead of a blood culture, what specimen could be taken from this patient to help with the initial diagnosis? (1 point) a) Skin scraping b) Feces c) Urine d) Sputum

This patient eventually needed a blood transfusion. Three potential donors arrive: Donor A was imprisoned for 7 days last June 2019, Donor B was involved in a vehicular accident in 2015, and Donor C uses anti-acne medication. Which of the following donors will you accept? (1 point) a) Donor A b) Donor B c) Donor C d) None of them

A suitable donor arrives, and you extract packed RBCs from him. Which of the following preservatives will give the blood a shelf life of 35 days? (1 point) a) CPDA-1 b) ACD c) CP2D d) CPD

Which of the following is NOT involved as a mediator in this patient’s fever? (1 point) a) Prostaglandins b) IL-1 c) TNF d) Nitric Oxide

Which of the following correctly describes Streptococcus? (1 point) a) Gram-positive, catalase-negative rods b) Gram-positive, catalase-positive rods c) Gram-positive, catalase-positive cocci d) Gram-positive, catalase-negative cocci

Partial hemolysis is indicative of: (1 point) a) Streptococcus agalactiae b) Viridans Streptococcus c) Streptococcus pyogenes d) Enterococcus

In group A Beta Hemolytic streptococci, this component is the major virulence factor of the organism: (1 point) a) Fimbriae b) Hyaluronic acid capsule c) M protein d) Flagella

The rash is probably due to: (1 point) a) A dietary allergy b) The bacterial infection c) A reaction to penicillin d) A reaction to his new shirt

The condition behind the rash is a type ___ hypersensitivity reaction mechanism: (1 point) a) I b) II c) III d) IV

Streptococcus species that is bacitracin-resistant is: (1 point) a) S. agalactiae b) S. pyogenes c) Streptococcus pneumoniae d) Viridans Streptococcus

Streptococcus hemolysis determination is done on what kind of agar? (1 point) a) Lowenstein-Jensen b) Potato dextrose c) TCBS d) Blood agar

Erysipelas is caused by: (1 point) a) Staphylococcus aureus b) Staphylococcus epidermidis c) Streptococcus agalactiae d) Streptococcus pyogenes

A positive CAMP test is seen with: (1 point) a) Enterococcus b) Streptococcus agalactiae c) Viridans Streptococcus d) Streptococcus pyogenes

What does a positive CAMP test look like? (1 point) a) A blackish overgrowth in the agar plate b) Swarming inside the tube c) An arrow-shaped zone of hemolysis between two organisms d) A change in color from green to yellow

This condition is called: (1 point) a) Hurler syndrome b) Tay-Sachs disease c) Morquio syndrome d) Gaucher disease

The finding in the previous item is due to: (1 point) a) Accumulation of GM2 ganglioside b) Accumulation of glucocerebroside c) Accumulation of heparan sulfate d) Accumulation of keratan sulfate

What are the treatment options for this disease? (1 point) a) Dialysis to flush out the excess protein b) A bone marrow transplant c) High-dose GABA inhibitors d) No cure exists yet

True regarding this tumor: (1 point) a) Neurofibrillin is affected b) “Strap cells” are a pathognomonic feature c) May arise from Denys-Drash syndrome d) Involves a PKHD1 mutation

Which of the following is true about Wilms tumor? (1 point) a) It is composed of rhabdomyocytes b) It is the most common pediatric renal neoplasm c) It is part of the WAGGL syndrome d) It is transmitted via an X-linked dominant mechanism

Three of the four choices represent WAGR syndrome. Which of these is the odd man out? (1 point) a) Aniridia b) Genitourinary abnormalities c) Mental retardation d) Wasting

Approximately 5% of Wilms tumors develop this cytologic feature, defined as cells with large, hyperchromatic, pleomorphic nuclei and abnormal mitoses: (1 point) a) Anaplasia b) Anisocoria c) Anucleolia d) Anisocytosis

Most patients with Wilms Tumor can expect their malignancy: (1 point) a) To be curable b) To be incurable c) To recur, especially in tumors without anaplasia d) To be none of these outcomes

This tumor is most likely a: (1 point) a) Acinic Cell Carcinoma b) Pleomorphic adenoma c) Low-Grade Adenocarcinoma d) Basal Cell Adenoma

This tumor is a result of an overexpression of: (1 point) a) DCP-8 b) PLAG-1 c) PD-7 d) KRAS

This tumor is likely: (1 point) a) Formerly benign b) Benign c) Malignant d) Intermediate grade

This patient likely has: (1 point) a) Follicular thyroid carcinoma b) Papillary thyroid carcinoma c) Hashimoto thyroiditis d) Graves' disease

These histologic features may also be present in this kind of tumor: (1 point) a) Schiller-Duvall bodies b) Psammoma bodies c) Call-Exner bodies d) Negri bodies

The spread of this particular type of thyroid neoplasm is: (1 point) a) Hematogenous b) Lymphatic c) Direct seeding d) Through a nerve plexus

The patient’s older sister consults with you for an anterior neck mass. Thyroid function tests are low with increased TSH, and thyroidectomy of the sister reveals the thyroid almost completely replaced by lymphoid follicles and Hurthle cells/oncocytes. This patient likely has: (1 point) a) Hashimoto thyroiditis b) Graves' disease c) Riedel thyroiditis d) De Quervain thyroiditis

This tumor is likely a: (1 point) a) Perineurioma b) MPNST c) Neurofibroma d) Schwannoma

These tumors are caused by loss of expression of: (1 point) a) Merlin b) PTCH c) p53 d) KRAS

Verocay bodies are: (1 point) a) Nuclear-free zones between palisading areas in neurilemmoma b) Rhabdomyoblasts in an otherwise neural tumor c) Carrot-shaving like areas in neurofibromas d) Concentrated areas of mitotic activity in MPNST

What hormone should you test for and use to monitor therapy? (1 point) a) Beta-hCG b) LH c) AFP d) PSA

By how much should this hormone be increased/decreased if as yet untreated? (1 point) a) Increased by a huge amount b) Decreased by a huge amount c) Increased/decreased by only a small amount d) Normal

Further studies of this patient show no fetal parts. What is a possible karyotype of this tumor? (1 point) a) 69, XXY b) 46, XXXY c) 46, XX d) 69, XXX

Which of the following is true regarding complete versus partial hydatidiform moles? (1 point) a) The hCG levels are way higher in partial moles. b) Complete hydatidiform moles have a higher chance of malignancy. c) A partial mole is formed after the fusion of 2 sperm and an empty egg. d) Partial moles usually do not have fetal parts.

Two years later, the patient develops a unilocular cystic tumor in the ovary. The resected tumor is found to have watery contents, but no solid areas. Histologically, the cyst wall lining resembles that of the uterine tube epithelium. This tumor is most likely a/an: (1 point) a) Mucinous cystadenoma b) Leydig tumor c) Endometriotic cyst d) Serous cystadenoma

Subsequently, the patient got pregnant again. She gives birth to conjoined twin boys attached to each other's chest. Examination of the placenta would likely reveal which of the following arrangements of the fetal membranes? (1 point) a) Diamniotic, dichorionic b) Diamniotic, monochorionic c) Monoamnionic, dichorionic d) Monoamnionic, monochorionic

The identical twins were healthy until 7 months when they both started to develop repeated bacterial infections. Further investigation finds the receptors in their B-cells to be defective. This is most probably a case of: (1 point) a) Chediak-Higashi Syndrome b) DiGeorge Syndrome c) Bruton Agammaglobulinemia d) Wiskott-Aldrich Syndrome

Of the following choices, what is the most likely diagnosis? (1 point) a) Squamous papilloma b) Sarcoma botryoides c) Melanoma d) Bowen disease

The pigment in this case is probably: (1 point) a) Not clinically significant b) A wear-and-tear pigment c) Derived from hemoglobin d) Derived from tyrosine

Clear cell adenocarcinoma can be traced to: (1 point) a) Women whose mothers took Tegison b) Women whose mothers took Thalidomide c) Women whose mothers had more than ten sexual partners d) Women whose mothers took Diethylstilbestrol

A pathologist receives a uterine mass which reveals multiple bundles of spindle cells on microscopy. The spindle cells are bland with no abnormal mitoses. This tumor is likely a: (1 point) a) Leiomyosarcoma b) Leiomyoma c) Endometrial Stromal Sarcoma d) Malignant mixed Mullerian tumor

Schiller-Duvall bodies are a distinct feature of: (1 point) a) Choriocarcinoma b) Yolk Sac Tumor c) Immature teratoma d) Dysgerminoma

Call Exner bodies are a distinct feature of: (1 point) a) Serous Cystadenocarcinoma b) Granulosa Cell Tumor c) Immature Teratoma d) Embryonal carcinoma

A major risk factor for ectopic pregnancy is: (1 point) a) Exposure to Aniline Dyes b) PID c) Mayer-Rokitansky-Kuster-Hauser Syndrome d) Hematocolpos

The lower urinary tract is mostly composed of this type of epithelium: (1 point) a) Glandular epithelium b) Transitional epithelium c) Tall columnar epithelium d) Pseudostratified keratinizing epithelium

Which of the following is an extrinsic factor for ureteral obstruction? (1 point) a) Pregnancy b) Stones c) Clots d) Neurogenic

An obstruction at any point in the lower urinary tract may lead to: (1 point) a) Dilatation downstream of the obstruction b) No dilatation at all c) Dilatation upstream and downstream of the obstruction d) Dilatation upstream of the obstruction

These tumors are derived from the: (1 point) a) Intralobular stroma b) Areolar stroma c) Myoepithelial cells d) Toker cells

Treatment for most of these kinds of tumors is usually: (1 point) a) Bone marrow transplant b) Lymph node dissection c) Adjuvant chemotherapy d) Complete resection with margins

A smaller tumor with proliferation of interlobular stroma but far less stromal hypercellularity in a younger patient is called a: (1 point) a) Hemangioma b) PASH c) Fibroadenoma d) Lactating adenoma

A patient has breast cancer. Histopathologic examination of her breast reveals signet ring cells arranged in an “Indian file” pattern. This patient most likely has: (1 point) a) Invasive ductal carcinoma b) Mucinous carcinoma of the breast c) Invasive lobular carcinoma d) Medullary carcinoma of the breast

The most common cause of bloody nipple discharge is: (1 point) a) Fibrocystic change b) Fibroadenoma c) Intraductal papilloma d) Paget's disease

What is true regarding invasive lobular carcinoma? (1 point) a) Consists of comedo and non-comedo necrosis patterns b) Can spread to/affect the opposite breast in 20% of cases c) Consists of a leaf-like pattern d) Composed of tumor cell islands in the middle of pools of mucin

This tumor is most probably a/an: (1 point) a) Osteogenic osteosarcoma b) Chondrosarcoma c) Ewing sarcoma d) Aneurysmal bone cyst

These tumors exhibit this kind of translocation: (1 point) a) t(X:18) b) t(14:18) c) t(9:22) d) t(11:22)

What else is true of this lesion? (1 point) a) It contains a Phrygian cap b) The EWS-FL1 fusion gene is pathognomonic for this lesion c) This is the most common bone tumor of childhood d) It is associated with Von Hippel-Lindau syndrome

The most common WBC malignancy in children with the best prognosis is: (1 point) a) CML (Chronic Myelogenous Leukemia) b) AML (Acute Myelogenous Leukemia) c) CLL (Chronic Lymphocytic Leukemia) d) ALL (Acute Lymphoblastic Leukemia)

A relative of this boy consulted with you about a WBC count of 60 x 10^9/L (Normal is less than 10 x 10^9/L). Further workup proved the patient’s condition to be chronic myelogenous leukemia. How was this definitively diagnosed? (1 point) a) C-reactive protein b) Peripheral blood smear c) Decreased neutrophil alkaline phosphatase d) Cytogenetic/molecular techniques

It is the replacement of one type of cell with another type: (1 point) a) Anaplasia b) Dysplasia c) Metaplasia d) Neoplasia

It is characterized by a constellation of changes that include a loss in the uniformity of the individual cells as well as a loss in their architectural orientation. It is reversible if the initial cause is removed: (1 point) a) Anaplasia b) Dysplasia c) Metaplasia d) Neoplasia

The proliferation of eosinophils and mast cell activation occurs in what type of hypersensitivity reaction? (1 point) a) Type I b) Type II c) Type III d) Type IV

Granuloma formation occurs in which type of hypersensitivity reaction? (1 point) a) Type I b) Type II c) Type III d) Type IV

[SEM2] PATHO #1 Flashcards

(100 cards)