Pathology Exam 1 Practice 69 Questions with Verified Answers,100% CORRECT

Pathology Exam 1 Practice 69 Questions with Verified Answers A 39 yo woman presents w/ severe menorrhagia and colicky dysmenorrhea. A hysterectomy including resection of the fallopian tubes and ovaries is performed. Examination by the pathologist finds a right adnexal cyst measuring approx 2.3 cm in diameter and filler with clotted blood. Microscopic examination reveals the presence in the wall of the cyst of endometrial glands, stroma, and hemosiderin pigment. What is the best diagnosis? A) Endometrioid carcinoma B) Krukenberg tumor C) Endometriosis D) HPV type 6 - CORRECT ANSWER C) Endometriosis A Pap smear of a 30 yo woman is found to have atypical cells suggestive of HPV infection. Which of the following abnormalities describes the characteristic cytologic feature caused by HPV infection in Pap smear? A) Hyperkeratosis B) Parakeratosis C) Koilocytosis D) Acanthosis - CORRECT ANSWER C) Koilocytosis A 55 yo woman reports to a physician for progressive fatigue, loss of appetite and malaise for the last 2 months. An upper GI endoscopy reveals an ulcerative mass located along the lesser curvature. CT scan of the abdomen shows bilateral ovarian masses. Which of the following condition this patient is most likely to have? A) Krukenberg tumor B) Ampullary carcinoma C) Serous adenomacarcinoma of the ovary D) Endometrioid carcinoma of the uterine body - CORRECT ANSWER A) Krukenberg tumor A 33 yo female has her yearly PE, which includes a Pap smear. The pathologist interprets the Pap smear as high-grade dysplasia (HSIL), which is confirmed by subsequent cervical bx. Of the following, what is the most likely cause? A) HPV type 6 B) CMV C) HHV6 D) HPV type 16 - CORRECT ANSWER D) HPV type 16 A 41 yo female with chronic pelvic pain undergoes a hysterectomy, the resected uterus is filled with nodules composed of benign smooth muscle cells. Which of the following terms best describes these nodules: A) Fibroma B) Thecoma C) Leiomyoma D) Leimyocarcoma - CORRECT ANSWER C) Leiomyoma A 25 yo, sexually active woman has had a mucopurulent vaginal discharge for 1 wk. On pelvic examination, the cervix appears reddened around the os, but no erosions or mass lesions are present. A Pap smear shows numerous neutrophils, but no dysplastic cells. A cervical bx specimen shows marked follicular cervicitis. Which of the following infectious agents is most likely to produce these findings? A) Herpes simplex virus B) Chlamydia trachomatis C) Candida albicans D) Gardenerlla vaginalis - CORRECT ANSWER B) Chlamydia trachomatis A 74 yo woman recently noticed a pale area of discoloration on the labia. Pelvic examination shows the presence of a 0.8 cm flat, white area on the right labia major. A bx specimen is obtained and on microscopic examination shows dysplastic cells that occupy half the thickness of the squamous epithelium, with minimal underlying chronic inflammation. In situ hybridization shows HPV type 16 DNA in the epithelial cells. What is the most likely diagnosis? A) Vulvar intraepithelial neoplasia B) Squamous hyperplasia C) Chronic vulvitis D) Lichen sclerosis et atrophicus - CORRECT ANSWER A) Vulvar intraepithelial neoplasia A 68 yo postmenopausal woman is concerned about pale areas on her labia that have been slowly enlarging for the past year. The areas cause discomfort and become easily irritated. PE shows pale gray to parchment-like areas of skin that involve most of the labia major, labia minor, and Introits. The Introits is narrowed. A bx specimen is taken and microscopically shows thinning of the squamous epithelium, a dense band of upper dermal hyaline collagen, and scattered upper dermal mononuclear inflammatory cells. What is the most likely diagnosis? A) Extramammary Paget disease B) HPV infection C) Pelvic inflammatory disease D) Lichen sclerosis et atrophicus - CORRECT ANSWER D) Lichen sclerosis et atrophicus After a laparotomy of a 26 yo woman, a mass is removed. Microscopic examination reveals a cystic cavity filled with hair, fat tissue, skin, adnexal organs, and neural tissue. All of the tissues are similar to those normally found without malignant changes. Which of the following is the most likely diagnosis? A) Immature teratoma B) Mature teratoma C) Leiomyoma D) Leiomyosarcoma - CORRECT ANSWER B) Mature teratoma Which of the following describes multiple small mutinous cysts of the endocervix that result from blockage of the endocervical glands by overlying squamous epithelium? A) Chocolate cysts B) Bartholin cysts C) Nabothian cysts D) Follicular cysts - CORRECT ANSWER C) Nabothian cysts A 21 yo sexually active woman has had pelvic pain for 1 wk. A pelvic examination shows mild erythema of the ectocervix and pain on palpation of right adnexa. A Pap smear shows many neutrophils, but no dysplastic cells. A cervical culture grows Neisseria gonorrhoeae. If the infection is not adequately treated, she will be at increased risk for which of the following complications? A) Dysfunctional uterine bleeding B) Ectopic pregnancy C) Endometrial hyperplasia D) Cervical carcinoma - CORRECT ANSWER B) Ectopic pregnancy A 35 yo woman who presents with menometrorrhagia is found to have a 4.0 cm mass within her left ovary. This mass is resected surgically and a histologic section reveals the tumor to be composed of small polygonal cells growing sheets and anastomosing cords. Rare Call-Exner bodies are present. The tumor cells are found to stain positively with an immunoperoxidase stain against inhibit. Which of the following is most likely to be secreted by these tumor cells? A) Estrogen B) Testosterone C) beta-Human chorionic gonadotropin D) alpha-Fetoprotein - CORRECT ANSWER A) Estrogen A 28 yo sexually active woman comes to her PA for a routine health maintenance examination. There are no abnormal findings on PE. She has been taking oral contraceptives for the past 10 yrs. A Pap smear shows HSIL (moderate dysplasia or CIN II). What is the most likely molecular pathogenesis for this finding? A) Inheritance of a tumor suppression gene mutation B) Up-regulation of antiapoptotic genes C) Viral inactivation of the RB1 gene product (pRB) D) Recurrent gonococcal cervicitis - CORRECT ANSWER C) Viral inactivation of the RB1 gene product (pRB) Prolonged, unopposed estrogen stimulation in an adult woman increases the risk of development of endometrial hyperplasia and subsequent carcinoma. Which of the following is the MC histologic appearance for this type of cancer? A) Cervical carcinoma B) Adenocarcinoma C) Leiomyoma D) Ampullary carcinoma - CORRECT ANSWER B) Adenocarcinoma What is the MC type of ovarian tumor? A) Immature teratoma B) Fibroma C) Serous cystadenoma D) Mature teratoma - CORRECT ANSWER C) Serous cystadenoma A 79-year-old man presents to the emergency room with severe right-sided weakness. He has noticed increasing difficulty using his right hand over the past several months and now walks with great difficulty. His past medical history is significant for colon cancer that was resected 5 years ago. He has poorly controlled HTN and admits to smoking two packs of cigarettes a day for the past 50 years. A CT scan of the brain reveals a discrete globoid lesion in the frontal and parietal lobes with a prominent halo of eema. Which of the following is the most likely diagnosis? A) Metastatic cancer B) Craniopharyngioma C) Meningioma D) Glioblastoma multiforme - CORRECT ANSWER A) Metastatic cancer A 45 year-old man with AIDS is admitted to the hospital with a productive cough, fever, and night sweats. X-ray film of the chest shows an ill-defined area of consolidation at the periphery of the right middle lobe and mediastinal lymphadenopathy. A sputum culture grows acid-fast bacilli. The patient develops a severe headache and neck rigidity. Which of the following brain areas is most likely affected by this patient's infection? A) Cerebellum B) Periventricular white matter C) Base of the brain D) Temporal-occipital sulcus - CORRECT ANSWER C) Base of the brain A 26-year-old male is involved in a motorcycle accident and survives, but sustains a subarachnoid hemorrhage and cerebral contusions, most prominently on the right side of the brain, which are diagnosed by a CT scan. Over the next several days, his mental status declines, and on the 3rd day, a PE by his nurse reveals dilation of the right pupil and ophthalmoplegia and contralateral hemiparesis. Which of the following processes is causing this change? A) Herniation of the right uncus B) Herniation of the right cingulate gyrus C) Contusions of the right occipital lobe D) Herniation of the right cerebellar tonsil - CORRECT ANSWER D) Herniation of the right uncus A 14-year-old girl is rushed to the emergency room after receiving a gunshot wound to the head and is pronounced dead on arrival. If this child died due to immediate "blast effect" of the penetrating wound, the autopsy would likely show herniation of the tonsils of the cerebellum into which anatomic shape? A) Central spinal canal B) Posterior fossa C) Foramen magnum D) Aqueduct of Sylvius - CORRECT ANSWER C) Foramen magnum A 45-year-old woman is brought to the emergency room after experiencing a generalized seizure. An MRI shows a dural mass with calcifications. A CBC is normal. A portion of the skill and the adherent mass removed. Microscopic examination shows oval to spindle shaped neoplastic cells with a whorled pattern. What is the appropriate diagnosis? A) Meningioma B) Oligodendroglioma C) Hemangioblastoma D) Medulloblastoma - CORRECT ANSWER A) Meningioma A 59-year-old woman presents with headache and mild fever of 3 days in duration. On physical examination, the patient appears confused and inattentive. On the following day, she is rushed to the emergency room after suffering a generalized seizure. Lumbar puncture shows increased levels of CSF protein, but cultures are negative, and the white cell count is not elevated. PCR analysis of the CSF fluid shows evidence of herpes simplex type 1. This infection most likely involves which of the following anatomic regions of the patient's brain? A) Temporal lobes B) Basal ganglia C) Brainstem nuclei D) Subependymal areas of the cerebral hemispheres - CORRECT ANSWER A) Temporal lobes A 68-year-old woman complains of difficulty getting out of a chair. ON examination, the patient shows reduced facial expression, a resting tremor, cogwheel rigidity, and bradykinesia (slowness of voluntary movements). The patient dies of CHF 10 years later. Microscopic examination of brain tissue at autopsy is shown in the image. The spherical, eosinophilic inclusions, in the cytoplasm of this pigmented neuron are composed of which of the following proteins? A) Polyglutamine B)