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Pathology mcq review nbme
1 A 77-year-old woman has chronic renal failure. Her serum urea nitrogen is 40 mg/dL. She is given a
diuretic medication and loses 2 kg (4.4 lb). She reduces the protein in her diet and her serum urea nitrogen
decreases to 30 mg/dL. Which of the following terms best describes cellular responses to disease and
treatment in this woman?
A Adaptation
B Apoptosis
C Necroptosis
D Irreversible injury
E Metabolic derangement
2 A 53-year-old woman with no prior illnesses has a routine checkup by her physician. On examination
she has a blood pressure of 150/95 mm Hg. If her hypertension remains untreated for years, which of the
following cellular alterations would most likely be seen in her myocardium?
A Apoptosis
B Dysplasia
C Fatty change
D Hemosiderosis
E Hyperplasia
F Hypertrophy
G Metaplasia
3 A 22-year-old woman becomes pregnant. A fetal ultrasound examination at 13 weeks’ gestation shows
her uterus measures 7 × 4 × 3 cm. At delivery of a term infant, her uterus measures 34 × 18 × 12 cm. Which
of the following cellular processes has contributed most to the increase in her uterine size?
A Endometrial glandular hyperplasia
B Myometrial fibroblast proliferation
C Endometrial stromal hypertrophy
D Myometrial smooth muscle hypertrophy
E Vascular endothelial hyperplasia
4 A 20-year-old woman breastfeeds her infant. On examination, her breasts are slightly increased in size.
Milk can be expressed from both nipples. Which of the following processes that occurred in her breasts
during pregnancy enables her to breastfeed the infant?
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A Ductal metaplasia
B Epithelial dysplasia
C Intracellular lipid deposition
D Lobular hyperplasia
E Stromal hypertrophy
5 A 16-year-old boy sustained blunt trauma to his abdomen when he struck a bridge abutment at high
speed while driving a motor vehicle. Peritoneal lavage shows a hemoperitoneum, and at laparotomy, a
small portion of the left lobe of the injured liver is removed. Two months later, a CT scan of the abdomen
shows that the liver has nearly regained its size before the injury. Which of the following processes best
explains this CT scan finding?
A Apoptosis
B Dysplasia
C Hyperplasia
D Hydropic change
E Steatosis
6 A 71-year-old man has had difficulty with urination, including hesitancy and increased frequency, for
the past 5 years. A digital rectal examination reveals that his prostate gland is palpably enlarged to twice
normal size. A transurethral resection of the prostate is performed, and the microscopic appearance of
the prostate “chips” obtained is that of nodules of glands with intervening stroma. Which of the following
pathologic processes has most likely occurred in his prostate?
A Apoptosis
B Dysplasia
C Fatty change
D Hyperplasia
E Hypertrophy
F Metaplasia
7. A 29-year-old man sustains a left femoral fracture in a motorcycle accident. His leg is placed in a plaster
cast. After his left leg has been immobilized for 6 weeks, the diameter of the left calf has decreased in
size. This change in size is most likely to result from which of the following alterations in his calf muscles?
A Aplasia
B Atrophy
C Dystrophy
,MEDSTUDY.COM
D Hyalinosis
E Hypoplasia
9. An 11-year-old girl becomes infected with hepatitis A and experiences mild nausea for 1 week. On
physical examination, she has minimal right upper quadrant tenderness and scleral icterus. Laboratory
findings include a serum AST of 68 U/L, ALT of 75 U/L, and total bilirubin of 5.1 mg/dL. Her laboratory
findings most likely result from which of the following changes in her hepatocytes?
A Cell membrane defects
B Lysosomal autophagy
C Mitochondrial swelling
D Nuclear chromatin clumping
E Ribosomal dispersion
10 A 33-year-old woman has had increasing lethargy and decreased urine output for the past week.
Laboratory studies show her serum creatinine is 4.3 mg/dL and urea nitrogen 40 mg/dL. A renal biopsy is
performed, and the specimen is examined using electron microscopy. Which of the following morphologic
cellular changes most likely suggests a diagnosis of acute tubular necrosis?
A Chromatin clumping
B Mitochondrial swelling
C Nuclear fragmentation
D Plasma membrane blebs
E Ribosomal disaggregation
13. A 68-year-old woman suddenly lost consciousness and on awakening 1 hour later, she could not speak
or move her right arm. Two months later, a head CT scan showed a large cystic area in the left parietal
lobe. Which of the following pathologic processes has most likely occurred in her brain?
A Apoptosis
B Coagulative necrosis
C Fat necrosis
D Karyolysis
E Liquefactive necrosis
15. An experimental drug administered to a tissue preparation is found to inhibit cellular oxidative
phosphorylation when given in high doses, and ATP production drops to 5% of normal. Cell membrane
, MEDSTUDY.COM
function is diminished. Which of the following substances is most likely to be present at increased
concentration in culture fluid bathing the tissue?
A Calcium
B Glucose
C Ketones
D Potassium
E Sodium
16 A 47-year-old woman has poorly controlled diabetes mellitus and develops coronary artery disease.
She now has decreasing cardiac output with blood pressure of 80/40 mm Hg and ejection fraction of 18%.
An increase in which of the following substances in her blood is most indicative of reversible cell injury
from decreased systemic arterial perfusion of multiple organs and tissues?
A Carbon dioxide
B Creatinine
C Glucose
D Lactic acid
E Troponin I
17. A tissue preparation is experimentally subjected to a hypoxic environment. The cells in this tissue
begin to swell, and chromatin begins to clump in cell nuclei. ATPases are activated, and ATP production
decreases. Which of the following ions accumulating in mitochondria and the cytosol contributes most to
these findings and to eventual cell death?
A Ca2+
B Cl−
C HCO3−
D K+
E Na+
F PO43−
18 In an experiment, a large amount of a drug is administered to experimental organisms and is converted
by cytochrome P-450 to a toxic metabolite. Accumulation of this metabolite leads to increased
intracellular lipid peroxidation. Depletion of which of the following intracellular substances within the
cytosol exacerbates this form of cellular injury by this mechanism?
A ADP
Pathology mcq review nbme
1 A 77-year-old woman has chronic renal failure. Her serum urea nitrogen is 40 mg/dL. She is given a
diuretic medication and loses 2 kg (4.4 lb). She reduces the protein in her diet and her serum urea nitrogen
decreases to 30 mg/dL. Which of the following terms best describes cellular responses to disease and
treatment in this woman?
A Adaptation
B Apoptosis
C Necroptosis
D Irreversible injury
E Metabolic derangement
2 A 53-year-old woman with no prior illnesses has a routine checkup by her physician. On examination
she has a blood pressure of 150/95 mm Hg. If her hypertension remains untreated for years, which of the
following cellular alterations would most likely be seen in her myocardium?
A Apoptosis
B Dysplasia
C Fatty change
D Hemosiderosis
E Hyperplasia
F Hypertrophy
G Metaplasia
3 A 22-year-old woman becomes pregnant. A fetal ultrasound examination at 13 weeks’ gestation shows
her uterus measures 7 × 4 × 3 cm. At delivery of a term infant, her uterus measures 34 × 18 × 12 cm. Which
of the following cellular processes has contributed most to the increase in her uterine size?
A Endometrial glandular hyperplasia
B Myometrial fibroblast proliferation
C Endometrial stromal hypertrophy
D Myometrial smooth muscle hypertrophy
E Vascular endothelial hyperplasia
4 A 20-year-old woman breastfeeds her infant. On examination, her breasts are slightly increased in size.
Milk can be expressed from both nipples. Which of the following processes that occurred in her breasts
during pregnancy enables her to breastfeed the infant?
,MEDSTUDY.COM
A Ductal metaplasia
B Epithelial dysplasia
C Intracellular lipid deposition
D Lobular hyperplasia
E Stromal hypertrophy
5 A 16-year-old boy sustained blunt trauma to his abdomen when he struck a bridge abutment at high
speed while driving a motor vehicle. Peritoneal lavage shows a hemoperitoneum, and at laparotomy, a
small portion of the left lobe of the injured liver is removed. Two months later, a CT scan of the abdomen
shows that the liver has nearly regained its size before the injury. Which of the following processes best
explains this CT scan finding?
A Apoptosis
B Dysplasia
C Hyperplasia
D Hydropic change
E Steatosis
6 A 71-year-old man has had difficulty with urination, including hesitancy and increased frequency, for
the past 5 years. A digital rectal examination reveals that his prostate gland is palpably enlarged to twice
normal size. A transurethral resection of the prostate is performed, and the microscopic appearance of
the prostate “chips” obtained is that of nodules of glands with intervening stroma. Which of the following
pathologic processes has most likely occurred in his prostate?
A Apoptosis
B Dysplasia
C Fatty change
D Hyperplasia
E Hypertrophy
F Metaplasia
7. A 29-year-old man sustains a left femoral fracture in a motorcycle accident. His leg is placed in a plaster
cast. After his left leg has been immobilized for 6 weeks, the diameter of the left calf has decreased in
size. This change in size is most likely to result from which of the following alterations in his calf muscles?
A Aplasia
B Atrophy
C Dystrophy
,MEDSTUDY.COM
D Hyalinosis
E Hypoplasia
9. An 11-year-old girl becomes infected with hepatitis A and experiences mild nausea for 1 week. On
physical examination, she has minimal right upper quadrant tenderness and scleral icterus. Laboratory
findings include a serum AST of 68 U/L, ALT of 75 U/L, and total bilirubin of 5.1 mg/dL. Her laboratory
findings most likely result from which of the following changes in her hepatocytes?
A Cell membrane defects
B Lysosomal autophagy
C Mitochondrial swelling
D Nuclear chromatin clumping
E Ribosomal dispersion
10 A 33-year-old woman has had increasing lethargy and decreased urine output for the past week.
Laboratory studies show her serum creatinine is 4.3 mg/dL and urea nitrogen 40 mg/dL. A renal biopsy is
performed, and the specimen is examined using electron microscopy. Which of the following morphologic
cellular changes most likely suggests a diagnosis of acute tubular necrosis?
A Chromatin clumping
B Mitochondrial swelling
C Nuclear fragmentation
D Plasma membrane blebs
E Ribosomal disaggregation
13. A 68-year-old woman suddenly lost consciousness and on awakening 1 hour later, she could not speak
or move her right arm. Two months later, a head CT scan showed a large cystic area in the left parietal
lobe. Which of the following pathologic processes has most likely occurred in her brain?
A Apoptosis
B Coagulative necrosis
C Fat necrosis
D Karyolysis
E Liquefactive necrosis
15. An experimental drug administered to a tissue preparation is found to inhibit cellular oxidative
phosphorylation when given in high doses, and ATP production drops to 5% of normal. Cell membrane
, MEDSTUDY.COM
function is diminished. Which of the following substances is most likely to be present at increased
concentration in culture fluid bathing the tissue?
A Calcium
B Glucose
C Ketones
D Potassium
E Sodium
16 A 47-year-old woman has poorly controlled diabetes mellitus and develops coronary artery disease.
She now has decreasing cardiac output with blood pressure of 80/40 mm Hg and ejection fraction of 18%.
An increase in which of the following substances in her blood is most indicative of reversible cell injury
from decreased systemic arterial perfusion of multiple organs and tissues?
A Carbon dioxide
B Creatinine
C Glucose
D Lactic acid
E Troponin I
17. A tissue preparation is experimentally subjected to a hypoxic environment. The cells in this tissue
begin to swell, and chromatin begins to clump in cell nuclei. ATPases are activated, and ATP production
decreases. Which of the following ions accumulating in mitochondria and the cytosol contributes most to
these findings and to eventual cell death?
A Ca2+
B Cl−
C HCO3−
D K+
E Na+
F PO43−
18 In an experiment, a large amount of a drug is administered to experimental organisms and is converted
by cytochrome P-450 to a toxic metabolite. Accumulation of this metabolite leads to increased
intracellular lipid peroxidation. Depletion of which of the following intracellular substances within the
cytosol exacerbates this form of cellular injury by this mechanism?
A ADP
