Special Pathology Questions (Part 3/4) with correct Answers 2023

Special Pathology Questions (Part 3/4) with correct Answers 2023 Atelectasis may be due to all of the following EXCEPT: a. bronchiectasis b. inhaled foreign body in bronchus c. mucus plugs in bronchi d. pleural effusion e. spontaneous pneumothorax a. bronchiectasis A 30-year old women complains of recent easy fatigability, bruising, and recurrent throat infection. Physical examination reveals numerous petechiae over her body and mouth. Abnormal laboratory findings include hemoglobin of 6g/dL, WBC of 1500/µL, and platelets of 20,000/µL. The bone marrow is hypocellular and displays increased fat. What is the appropriate diagnosis? (A) Aplastic anemia (B) Iron-deficiency (C) Megaloblastic anemia (D) Myelofibrosis with myeloid metaplasia (E) Pure red cell aplasia (A) Aplastic anemia A 60-year old man present with headaches and pruritus, Physical examination reveals splenomegaly but no lymphadenopathy. A CBC demonstrates elevated hemoglobin of 19.5 g/dL, WBC of 12,800/µL, and platelets of 550,000 /µL. The bone marrow displays hypercellularity of all lineages and depletion of marrow iron stores. Which of the following is the most likely diagnosis? (A) Acute myeloid leukemia (B) Essential thrombocytemia (C) Idiopathic myelofibrosis (D) Occult infection (E) Polycytemia vera (E) Polycytemia vera A 55-year-old man complains of pain in his back, fatigue and occasional confusion. He admits to polyuria and polydipsia. X-ray examination reveals numerous lytic lesions in the lumbal vertebral bodies. Laboratory studies disclose hypoalbuminaemia, mild anemia, and thrombocytopenia. A monoclonal Igk peak is demonstrated by serum electrophoresis. Urinalysis shows 4+ proteinuria. A bone marrow biopsy discloses foci of plasma cells, which account for 18% of all hematopoetic cells. Which is the appropriate diagnosis? (A) Acute lymphoblastic lymphoma (B) Chronic lymphoblastic lymphoma (C) Extramedulary plasmocytoma (D) Multiple myeloma (E) Waldenstöm macroglobulinemia (D) Multiple myeloma A 24-year old woman presents with an earache of 4 days in duration. She also reports increased urine production, skin rash and bone pain on her scalp. Physical examination reveals otitis media, dermatitis and exophtalmus. An X-ray of the scalp shows calvarial bone defects. A fine-needle aspirate displays numerous eosinophils. Which is the most likely diagnosis? (A) Hodgkin lymphoma (B) Langerhans cell histiocytosis (C) Malignant melanoma (D) Metastatic breast carcinoma (E) Multiple myeloma (B) Langerhans cell histiocytosis A 67-year old woman with a prosthetic aortic valve develops progressive anemia. Examination of peripheral blood smear reveals retoculocytosis and schistiocytes. What is the appropriate diagnosis? (A) Acanthosis (B) Henoch-Schönlein purpura (C) Idiopathic thrombpcytopenic purpura (D) Macronagiopathic hemolytic anemia (E) Microangiopathic hemolytic anemia (E) Microangiopathic hemolytic anemia A 4-year old boy develops severe bleeding into the knee joint. Laboratory studies show that serum levels of factor IX are reduced but levels of factor VII is normal. What is the appropriate diagnosis? (A) Hemophilia A (B) Hemophilia B (C) Henoch-Schönlein purpura (D) Idiopathic thrombocytopenic purpura (E) von Willebrand disease (B) Hemophilia B A 20-year old carpenter with a wound infection on his left thumb presents with an enlarged and tender lymph node in the axilla. Lymph node biopsy shows follicular enlargement and hyperemia. The sinuses are filled with neutrophils. Which of the following is the most likely diagnosis? (A) Castelman disease (B) Histiocytosis X (C) Interfollicular hyperplasia (D) Sinus histiocytosis (E) Suppurative lymphadenitis (E) Suppurative lymphadenitis A 56-year-old man with 3-year history of B-cell chronic lymphocytic leukemia complains of the recent onset of fever, weight loss, abdominal pain, and enlargement of lymph nodes. Physical examination reveals hepatosplenomegaly and generalized lymphadenopathy. A lymph node biopsy shows a high-grade, large-cell lymphoma. This patient has which of the following diseases? (A) Carcinoid tumor (B) Hodgkin lymphoma (C) Lymphocytic lymphoma (D) Squamous cell carcinoma (E) Thymoma (C) Lymphocytic lymphoma wrong answers A 60-year-old woman complains of weakness and hematuria. Physical examination shows marked pallor, hepatosplenomegaly, and numerous ecchymoses of the upper and lower extremities. A CBC reveals a normocytic normochromic anemia, thrombocytopenia, neutropenia, and a marked leukocytosis, which is composed mainly of myeloblasts. The major clinical problems associated with this patient's condition are most directly related to which of the following? (A) Avascular necrosis of bone (B) Disseminated intravascular coagulation (C) Hypersplenism (D) Microangiopathic hemolytic anemia (E) Suppression of hematopoesis (C) Hypersplenism A 60-year-old woman with small cell carcinoma of the lung notes rounding of her face, upper truncal obesity, and muscle weakness. Physical examination reveals thin, wrinkled skin, abdominal striae, and multiple purpuric skin lesions. The patient's blood pressure is 175/95 mm Hg. Laboratory studies will likely show elevated serum levels of which of the following hormones? (A) Aldosterone (B) Corticotrophin (C) Epinephrine (D) Prolactin (E) Thyreotropin (B) Corticotrophin A 21-year-old woman experiences abruptio placentae with severe bleeding during the delivery of a term fetus. Five months later, she presents with profound lethargy, pallor, muscle weakness, failure of lactation, and amenorrhea. Which of the following pathologic findings is expected in this patient? (A) Atrophy of the endocrine pancreas (B) Autoimmune destruction of the adrenal cortex (C) Infarction of the pituitary (D) Pituitary prolactinoma (E) Polycystic ovaries (C) Infarction of the pituitary A 65-year-old woman with a history of multinodular goiter complains of increasing nervousness, insomnia, and heart palpitations. She has lost 9 kg (20 lb) over the past 6 months. Physical examination reveals a diffusely enlarged thyroid. There is no evidence of exophthalmus. Laboratory studies show elevated serum levels of T3 and T4. Serologic tests for antithyroid antibodies are negative. Which of the following is an important complication of this patient's endocrinopathy? (A) Autoimmune hepatitis (B) Cardiac arrhythmia (C) Follicular carcinoma of the thyroid (D) Medullary carcinoma of the thyroid (E) Myxedema madness (B) Cardiac arrhythmia A 29-year-old woman complains of nervousness and muscle weakness of 6 months in duration. She is intolerant of heat and sweats excessively. She has lost 9 kg (20 lb) pounds over the past 6 months, despite increased caloric intake. She frequently finds her heart racing and can feel it pounding in her chest. She also states that she has missed several menstrual periods over the past few months. Physical examination reveals warm and moist skin and bulging eyes (exophthalmus). Laboratory studies will likely reveal which of the following endocrine abnormalities in this patient? (A) Anti-thyroid DNA antibodies (B) Anti-TSH receptor antibodies (C) Decreased uptake of radioactive iodine in the thyroid (D) Increased serum TSH (E) Low serum T3 (B) Anti-TSH receptor antibodies A 42-year-old woman presents with amenorrhea and emotional disturbances. You note upper truncal obesity and suspect Cushing syndrome. Laboratory studies reveal elevated serum levels of corticosteroids that can be lowered by administration of dexamethasone. Which of the following is the most likely cause of hypercortisolism in this patient? (A) Adrenal cortical adenoma (B) Adrenal cortical carcinoma (C) Adrenal cortical hyperplasia (D) Pheochromocytoma (E) Pituitary adenoma (E) Pituitary adenoma A 40-year-old man complains of nausea, vomiting, diarrhea, and cramping abdominal pain. His temperature is 38°C (101°F), blood pressure 90/60 mm Hg, and pulse rate 90 per minute. On physical examination, the patient appears dehydrated, with sunken eyeballs, dry tongue, and poor skin turgor. Hyperpigmentation is noted in the palmar creases and the gingival margins. Laboratory results include fasting serum glucose of 62 mg/dL (normal = 70 to 115 mg/dL), BUN of 27 mg/dL (normal = 11 to 23 mg/dL), Na of 122 mEq/L (normal = 136 to 145 mEq/L), and K of 6.5 mEq/L (normal = 3.5 to 5.0 mEq/L). Which of the following is the most likely cause of this patient's symptoms? (A) Amyloidosis (B) Autoimmunity (C) Metastatic cancer (D) Sarcoidosis (E) Tuberculosis (B) Autoimmunity A 46-year-old woman with severe asthma presents with increasing weight and back pain for 9 months. The patient is taking corticosteroids for her asthma. An X-ray of the vertebrae will likely reveal which of the following pathologic findings? (A) Bone infarct (B) Dislocation (C) Osteomalacia (D) Osteomyelitis (E) Osteoporosis (E) Osteoporosis