NEWEST ACTUAL EXAM COMPREHENSIVE
QUESTIONS AND VERIFIED ANSWERS
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Exceptions to the rule of how carcinomas spread: -CORRECT ANS>>Renal cell
carcinoma (spreads via invasion of renal vein) hepatocellular carcinoma
(invades hepatic vein), follicular carcinoma of the thyroid, choriocarcinoma,
which both spread hematogenously also.
A benign tumor of the epithelium is a: -CORRECT ANS>>
adenoma, papilloma
Necrosis: -CORRECT ANS>>Exogenous injury causes enzymatic degradation and
protein denaturation of a cell. IC components extravasate. **There's an
inflammatory process unlike apoptosis**
Coagulative necrosis occurs in the: -CORRECT ANS>>Caused by ischemia or
infarction typically. heart, liver, kidney. Occurs in tissues supplied by end
arteries. High cytoplasmic binding of acidophilic dye.
Proteins denature first followed by enzymatic degradation.
Liquefactive necrosis occurs in the: -CORRECT ANS>>brain, bacterial abscess and
pleural effusion. Occurs in CNS because of high fat content there. Unlike coag
necrosis, enzymatic degradation due to release of lysosomal enzymes occurs
first.
A malignant tumor of epithelium is: -CORRECT ANS>>
adenocarcinoma, papillary carcinoma
A benign tumor of the blood vessels: -CORRECT ANS>>
hemangioma
Basic characteristics of a benign tumor: -CORRECT ANS>>well-differentiated, no
necrosis, well demarcated, no metastases, low mitotic activity
Basic characteristics of a malignant tumor: -CORRECT ANS>>may be poorly
differentiated, erratic growth, locally invasive / diffuse, may metastasize, low
apoptosis
,What's the mechanism behind low apoptosis in malignancies? -CORRECT
ANS>>upregulation of telomerase prevents shortening of the telomeres and
thus cell death.
Cachexia: -CORRECT ANS>>weight loss, muscle atrophy and fatigue that occur in
the setting of chronic disease (AIDS, cancer, heart failure, TB). Mediated by TNF-
alpha (called cachectic) IFN-gamma and IL-6.
DISEASE -- CANCER Associations: Acanthosis nigricans (hyperpigmentation and
epithelial thickening) -CORRECT ANS>>visceral malignany (esp stomach)
A malignant tumor of blood vessels: -CORRECT ANS>>
angiosarcoma
CEA: -CORRECT ANS>>CarcinoEmbryonic Antigen. Very nonspecific but produced
by 70% of colorectal and pancreatic cancers; also produced by gastric, breast
and medullary thyroid carcinomas
PSA: -CORRECT ANS>>prostate-specific antigen. Used to follow prostate
adenocarcinoma. Can also be elevated in BPH (benign prostatic hyperplasia) and
prostatitis. Questionable risk / benefit for screening.
S-100: -CORRECT ANS>>neural crest origin, ie melanomas, neural tumors,
schwannomas, langerhan's cell histiocytosis.
TRAP: -CORRECT ANS>>Tatrate-resistant acid phosphatase. Hairy cell leukemia--
a B cell neoplasm.
A malignant tumor of blood: -CORRECT ANS>>leukemia, lymphoma
A benign tumor of smooth muscle: -CORRECT ANS>> Leiomyoma
A malignant tumor of smooth muscle: -CORRECT ANS>> leiomyosarcoma
A benign tumor of striated muscle: -CORRECT ANS>> rhabdomyoma
A malignant tumor of striated muscle: -CORRECT ANS>> rhabdomyosarcoma
A benign tumor of connective tissue: -CORRECT ANS>> fibroma
, A malignant tumor of connective tissue: -CORRECT ANS>> fibrosarcoma