1.A study is performed to analyze characteristics of malignant neoplasms in biopsy specimens. The biopsies were performed on patients who had palpable mass lesions on digital rectal examination. Of the following microscopic findings, which is most likely to indicate that the neoplasm is malignant?
A:Invasion
B:Atypia
C:Necrosis
D:Increased nuclear/cytoplasmic ratio
E:Pleomorphism
答案:Invasion
2.A 54-year-old previously healthy woman is hospitalized for pneumonia. On the 10th hospital day she is found to have swelling and tenderness of her right leg, which has developed over the past 48 hours. Raising the leg elicits pain. An ultrasound examination reveals findings suggestive of femoral vein thrombosis. Which of the following conditions is most likely to have contributed the most to the appearance of these findings?
A:Protein C deficiency
B:Chronic alcohol abuse
C:Immobilization
D:Trousseau syndrome
E:Pregnancy
答案:Immobilization
3.The main proliferating cells in acute diffuse proliferative glomerulonephritis are
A:Periglomerular fibroblasts
B:Glomerular epithelial cells and parietal epithelial cells
C:Glomerular epithelial cells and mesangial cells
D:Glomerular parietal epithelial cells and capillary endothelial cells
E:Glomerular capillary endothelial cells and mesangial cells
答案:Glomerular capillary endothelial cells and mesangial cells
4.A 66-year-old man has developed a chronic cough over the past 2 months. There are no abnormal physical examination findings. A chest x-ray shows a 3 cm mass in the right upper lobe. After fine needle aspiration biopsy, the mass is resected. Gross and microscopic examination of the mass is performed and it is determined that a neoplasm is present. Which of the following findings regarding this mass is most likely to be irrelevant for determining further therapy and prognosis?
A:Is the neoplasm invading the margin of resection
B:How much inflammation is present in the neoplasm
C:The size of the neoplasm
D:Is the neoplasm primary or metastatic
E:The differentiation of the neoplasm
答案:How much inflammation is present in the neoplasm
5.A 22-year-old woman is discovered to have a nontender thyroid nodule that is found to be a cold nodule on a radioisotope scan. The pathology report from a fine needle aspiration of the nodule describes a follicular neoplasm, the differential of which includes a benign follicular adenoma and a malignant follicular carcinoma. Which is the single best histologic criterion to differentiate between these two neoplasms?
A:Number of mitoses
B:Invasion into vessels
C:Inspissation of colloid
D: Presence of atypia
E:Hyperplasia of follicles
答案:Invasion into vessels
6.In an experiment, Enterobacter cloacae organisms are added to a solution containing leukocytes and blood plasma. Engulfment and phagocytosis of the microbes is observed to occur. Next a substance is added which enhances engulfment, and more bacteria are destroyed. Which of the following substances in the plasma is most likely to produce this effect?
A:Complement C3b
B:P-selectin
C:Immunoglobulin M
D:Glutathione peroxidase
E:NADPH oxidase
答案:Complement C3b
7.A 32-year-old woman has noted dull pelvic pain for the last two months. On physical examination there is a mass palpated in the right lower quadrant. An abdominal ultrasound reveals an 8 cm mass involving the right ovary. The mass is surgically excised. On gross inspection, the surface of the mass is smooth and is not adherent to surrounding pelvic structure. On sectioning it is cystic and filled with hair. On microscopic examination there is squamous epithelium, tall columnar glandular epithelium, cartilage, and fibrous connective tissue. Which of the following neoplasms is she most likely to have?
A:Mesothelioma
B:Myxoma
C:Choristoma
D:Teratoma
E:Hamartoma
答案:Teratoma
8.A 44-year-old African-American man has had elevated blood pressure for years which has not been treated. He now has severe headaches. On physical examination his blood pressure is 275/150 mm Hg. Laboratory studies show Hgb 13.8 g/dL, serum glucose 76 mg/dL, and creatinine 3.5 mg/dL. These findings are most likely to be associated with which of the following pathologic lesions involving his kidneys?
A:Thrombophlebitis
B:Hyperplastic arteriolosclerosis
C:Atherosclerosis
D:Monckeberg medial calcific sclerosis
E:Hyaline arteriolosclerosis
答案:Hyperplastic arteriolosclerosis
9.A 43-year-old man has complained of mild burning substernal pain following meals for the past 3 years. Upper GI endoscopy is performed and biopsies are taken of an erythematous area of the lower esophageal mucosa 3 cm above the gastroesophageal junction. There is no mass lesion, no ulceration, and no hemorrhage noted. The biopsies show the presence of columnar epithelium with goblet cells. Which of the following mucosal alterations is most likely represented by these findings?
A:Hyperplasia
B:Dysplasia
C:Carcinoma
D:Ischemia
E:Metaplasia
答案:Metaplasia
10.An eight year old boy infected with Mycobacterium tuberculosis is most often going to have:
A:Cavitary upper lobe lung lesions on chest radiograph
B:Intestinal ulcerations
C:Miliary spread to the liver and spleen
D:A cough with sputum 4+ positive for acid fast bacilli
E:Enlarged hilar lymph nodes with caseous necrosis
答案:A cough with sputum 4+ positive for acid fast bacilli
11. In an experiment, a glass bead is embolized to a branch of the renal artery. A day later there is a focal area in which the renal parenchymal cells in the distribution of the occluded artery show karyolysis and karyorrhexis. The outlines of the cells are still visible, but the nuclei have lost basophilic staining and the cytoplasm is eosinophilic but pale. Which of the following types of cellular necrosis is most likely present?
A:Coagulative
B:Caseous
C: Fatty
D:Gangrenous
E: Liquefactive
A:Crohn's disease B:Pernicious anemia C:Helicobacter pylori D:Adenocarcinoma E:Gastrinoma (Zollinger-Ellison syndrome) 13.A 3-year-old boy is brought to the clinic because of fever and ‘fussiness’, and he is diagnosed as have acute otitis media. In this acute inflammatory reaction, which of the following cells would have reached the site of inflammation first?
A:Monocytes-macrophages B:Basophils C:Neutrophils D:Lymphocytes E:Plasma cells 14. Seeding metastasis is most common in which of the following malignancies?
A:Osteosarcoma B:Breast carcinoma C:Melanoma D:Gastric signet-ring carcinoma E:Squamous carcinoma of penis 15.The nonpregnant uterus of a 20-year-old woman measures 7×4×3 cm.The woman becomes pregnant and just before delivery of a term infant, the uterus measures 34×18×12 cm. Which of the following cellular processes has contributed most to the increase in uterine size?
A:Vascular endothelial hyperplasia B:Myometrial fibroblast proliferation C:Myometrial smooth muscle hypertrophy D:Endometrial stromal hypertrophy E:Endometrial glandular hyperplasia 16.A 71-year-old woman experiences a transient ischemic attack (TIA). She had an acute myocardial infarction 5 years ago. Which of the following physical examination findings is most likely to be associated with her TIA?
A:Carotid bruit B: Pulsatile abdominal mass C:Leg swelling D:Blood pressure 140/90 mm Hg E:Heart rate of 100/minute 17.A 23-year-old undergoes surgery for fractures of the pelvis and left femur resulting from a high-speed motor vehicle accident. The following day he develops dyspnea, speech difficulties, and a petechial skin rash. Which of the following types of embolism is the likely cause of these findings?
A:Amniotic fluid B:Air C:Fat D:Paradoxical E:Thrombotic 18.A 40-year-old man had undifferentiated carcinoma of the lung. Despite chemotherapy, the man died of widespread metastases. At autopsy, tumors were found in many organs. Histologic examination showed many foci in which individual tumor cells appeared shrunken and deeply eosinophilic. Their nuclei exhibited condensed aggregates of chromatin under the nuclear membrane. The process affecting these shrunken tumor cells was most likely triggered by the release of which of the following substances into the cytosol?
A:Lipofuscin B:Cytochrome c C:Phospholipase D: BCL-2 E:Catalase 19.An underlying disease process that could relate panlobular pulmonary emphysema to cirrhosis of the liver is:
A:Alpha-1-antitrypsin deficiency B:Intravenous drug use C:Alcoholism D:Wilson's disease E:Cystic fibrosis 20.In which of the following diseases, the basement membrane of the glomerulus is normal
A:II membranous proliferative glomerulonephritis B:I membranous proliferative glomerulonephritis C:minimal change glomerulonephritis D:crescent glomerulonephritis E:membranous glomerulonephritis 21.In an experiment, a lung tissue preparation is exposed to Mycobacterium tuberculosis organisms. Over the next week, it is observed that granulomas form in the lung. Within the granuloma are found inflammatory cells expressing class II MHC antigens. These cells elaborate cytokines that promote fibroblastic production of collagen within the granulomas. From which of the following peripheral blood leukocytes are these cells bearing class II antigen most likely to be derived?
A:Monocytes B:B cells C:NK cells D:Neutrophils E:Basophils 22.A 54-year-old man experienced onset of severe substernal chest pain over a period of 3 hours. An ECG showed changes consistent with an acute myocardial infarction. After thrombolytic therapy with tissue plasminogen activator (t-PA), his serum creatine kinase (CK) level increased. Which of the following events most likely occurred following t-PA therapy?
A:Chemical injury B:Reperfusion injury C:Cellular regeneration D: Increased synthesis of CK E:Myofiber atrophy 23.Of the following features, the one that is LEAST likely to be associated with chronic bronchitis is:
A:Severe dyspnea B:Increased airway resistance C:Productive cough for months D:Frequent infections E:Bronchial mucus gland hypertrophy 24.The gross appearance of a liver with macronodular cirrhosis is most consistent with which of the following laboratory findings:
A:Toxic acetaminophen level B:Decreased clot stabilization from factor XIII deficiency C:Elevated alpha-fetoprotein D:Hepatitis C antibody positive E:Hepatitis A antibody positive 25. After two weeks in the hospital following a fall in which she incurred a fracture of her left femoral trochanter, a 76-year-old woman now has a left leg that is swollen, particularly her lower leg below the knee. She experiences pain on movement of this leg, and there is tenderness to palpation. Which of the following complications is most likely to occur next after these events?
A:Hematoma of the thigh B:Soft tissue sarcoma C:Disseminated intravascular coagulation D:Gangrenous necrosis of the foot E:Pulmonary thromboembolism 26.A 54-year-old, previously healthy man sustained an extensive thermal burn injury involving 70% of the total body surface area of his skin. He was hospitalized in stable condition. Three weeks after the initial burn injury, he developed melanotic stools. His blood pressure dropped to 80/ 40 mm Hg, and his hematocrit declined to 18%. Where are gastrointestinal ulcerations most likely to be found in this man?
A:Esophagus B:Ileum C:Colon D:Duodenum E:Stomach 27.An 84-year-old female is found at autopsy to have a cirrhotic liver in which the size of the liver nodules averages 2 to 3 mm. Microscopically, the liver shows regenerative nodules with extensive fibrosis between portal regions, scattered lymphocytes, and bile duct proliferation. Which of the following etiologies best explains the appearance of the cirrhosis in this case:
A:Chronic alcoholism B:Biliary atresia C:Hepatitis B infection D:Alpha-1-antitrypsin deficiency E:Veno-occlusive disease 28.An epidemiologic study is performed to find risk factors for development of malignant neoplasms. A statistical analysis of pre-existing medical conditions is done. Some pre-existing chronic medical conditions are observed to precede development of malignant neoplasms, while others do not. Which of the following conditions is most likely to be statistically related to development of a malignancy?
A: Chronic bronchitis B:Essential hypertension C:Uterine leiomyomas D:Ulcerative colitis E:Coronary artery disease 29.Which of the following features is true in describing malignant neoplasm?
A:The bigger the neoplasm the higher the tumor grade B:The presence of mitoses indicate that a tumor is malignant C:The presence of giant cells indicate that a tumor is malignant D:Lack of differentiation is a hallmark of malignant transformation E:Anaplastic tumors do not differ cytologically from normal counterparts 30.A 44-year-old woman dies as a consequence of a 'stroke'. At autopsy, she is found to have a large right basal ganglia hemorrhage. She has an enlarged 550 gm heart with predominantly left ventricular hypertrophy. Her kidneys are small, about 80 gm each, with cortical scarring, and microscopically they demonstrate small renal arterioles that have luminal narrowing from concentric intimal thickening. Which of the following is the most likely condition associated with her findings?
A:Hypercholesterolemia B:Autosomal dominant polycystic kidney disease C:Hypertensive emergency D:Monckeberg's sclerosis E:Diabetes mellitus, type II 31. A 54-year-old man with a chronic cough has a squamous cell carcinoma diagnosed in his right lung. While performing a pneumonectomy, the thoracic surgeon notes that the hilar lymph nodes are small, 0.5 to 1.0 cm in size, and jet black in colour throughout. Which of the following is the most likely cause for this appearance to the hilar nodes?
A:Anthracotic pigment B:Lipochrome deposits C:Hemosiderosis D:Melanin accumulation E:Metastatic carcinoma 32.A clinical study is performed of patients with pharyngeal infections. The most typical clinical course averages 3 days from the time of onset until the patient sees the physician. Most of these patients experience fever and chills. On physical examination, the most common findings include swelling, erythema, and pharyngeal purulent exudate. Which of the following types of inflammation did these patients most likely have?
A:Gangrenous B:Acute C: Granulomatous D:Resolving E:Chronic 33.During hospitalization, a 40-year-old woman develops thrombophlebitis. She recovers and is discharged. She returns to her job as an electrician. A couple of months later, which of the following terms would best describe the process seen in a femoral vein after recovery from her thrombophlebitis:
A:Propagation B:Rupture C:Acute inflammation D:Organization E:Embolization 34.A 71-year-old woman had the loss of consciousness that persisted for over an hour. When she becomes arousable, she cannot speak nor move her right arm. A cerebral angiogram revealed an occlusion to her left middle cerebral artery. Months later, a computed tomographic (CT) scan shows a large 5 cm cystic area in her left parietal lobe cortex. This CT finding is most likely the consequence of resolution from which of the following cellular events?
A:Atrophy B:Coagulative necrosis C:Liquefactive necrosis D:Apoptosis E: Caseous necrosis 35.A 48-year-old woman has a routine physical examination. A 4 cm diameter non-tender mass is palpated in her right breast. The mass appears fixed to the chest wall. Another 2 cm non-tender mass is palpable in the left axilla. A chest radiograph reveals multiple 0.5 to 2 cm nodules in both lungs. Which of the following TNM classifications best indicates the stage of her disease?
A:T4 N1 M1 B:T1 N1 M0 C:T1 N0 M1 D:T3 N0 M0 E:T2 N1 M0 36.A 54-year-old man sought medical care for low-grade fever, anorexia, fatigue, night sweats, weight loss, and persistent cough with bouts of hemoptysis. A chest x-ray had revealed a right apical infiltrate with beginning cavitation, and examination of the sputum had revealed acid-fast bacilli. This condition is typified by a form of inflammation that invariably includes which of the following?
A:Caseous necrosis B:Clusters of epithelioid cells C:Massive infiltration of lymphocytes and plasma cells D:A morphologically identifiable etiologic agent E:Prominent granulation tissue 37.Which of the following statements about inflammatory cells are INCORRECT?
A:Neutrophils are the most prominent inflammatory cells in acute inflammation B:Mast cells and basophils are sources of histamine C:Lymphocytes, together with plasma cells and eosinophils, are the most prominent inflammaroty cells in chronic inflammation D:Basophils are the predominant inflammatory cells in allergic reactions E:Lymphocytes are the most prominent inflammatory cells in viral infection 38.Which of the following inflammatory cells are the most important phagocytic cells?
A:Eosinophils B:Lymphocytes C:Neutrophils D:Monocytes-macrophages E:Basophils 39.Which of the following descriptions of Hodgkin lymphoma are INCORRECT?
A:Hodgkin lymphoma derives from a single transformed cell and is therefore monoclonal B:According to WHO classification, Hodgkin lymphoma are comprised of two disease entities: Classical Hodgkin Lymphoma (CHL) and Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) C:Hodgkin lymphoma accounts for up to 80% of all lymphomas D:Hodgkin lymphoma is a tumor of T-cell origin E:Hodgkin lymphoma always arises at a single lymph node and spread characteristically in a stepwise fashion to contiguous lymph nodes 40.The tubercle, or tuberculous granuloma, is shown typically by:
A:Lymphocytes B:Epitheloid cell C:Langhans’ giant cells D:Fibrosis E:Caseous necrosis 41.Which of the following statements regarding chronic bronchitis are TRUE:
A:The dominant pathologic features are mucus hypersecretion and persistent inflammation B:Cigarette smoking is the most important risk factor C:Air pollutants contribute to chronic bronchitis D:Histologic examination demonstrates enlargement of mucous-secreting glands, goblet cell hyperplasia, chronic inflammation, and bronchiolar wall fibrosis E:Chronic bronchitis is defined as persistent productive cough for at least 3 consecutive months in at least 2 consecutive years 42.Which of the following complications may occur following a transmural myocardial infarction?
A:Rupture of the heart B:Ventricular aneurysm C:Congestive heart failure D:Acute serofibrinous pericarditis E:Mural thrombosis 43.The main manifestations of nephrotic syndrome include
A:Massive proteinuria B: Severe edema C:Hypertension D:Hypoproteinemia E:Hyperlipidemia 44.Which of the following statements about cirrhosis are INCORRECT:
A:It is potential end stage of chronic liver disease of any cause B:Alcoholic cirrhosis is always in a macronodular pattern C:It is characterized by fibrosis and nodular regeneration D:It is a diffuse and reversible process E:Main causes include alcohol, HBV, HCV, autoimmune liver disease and haemochromatosis 45.Which of the following statements about diabetes are INCORRECT?
A:Type 1 diabetes is caused by peripheral resistance to insulin action B:In type 2 diabetes, insulitis of Langerhans islets is common C:In type 2 diabetes, amyloid deposition can be found in Langerhans islets D:Patients with type 1 diabetes are more likely to suffer from serious metabolic complications, such as ketoacidosis E: Type 2 diabetes comprises 10% of all primary diabetes 46.Which of the following features are true in describing carcinoma in situ?
A:It is preinvasive neoplasm B:It is early stage carcinoma C:It does not metastastasize D:It is intramucosal carcinoma E:Dysplastic changes involve the entire thickness of the epithelium 47.A 57-year-old man has a sudden onset of severe substernal chest pain that radiates to the neck. He has tachycardia, hyperventilation, and hypotension on physical examination. No cardiac murmurs are heard on auscultation. Emergent coronary angiography shows a thrombotic occlusion of the left circumflex artery with areas of 60% to 75% narrowing in the proximal circumflex and anterior descending arteries. Which of the following complications of this disease is likely to occur in the future?
A:ventricular aneurysm B:Thromboembolism C:Pericarditis D:None of above E: Myocardial rupture 48.Which of the following descriptions does not correspond to post-streptococcal glomerulonephritis
A:IgG and C3 deposits on the lateral side of glomerular capillary basement membrane B:Most of them occur in adults C:Mostly had a history of streptococcal infection 2 weeks before onset D:Streptococcus was found in glomeruli E:Mostly turn to chronic 49.Which the following condition is associated with high blood pressure?
A:Muscle disease B:Stroke C:Heart disease D:Kidney disease E:Blindness 50.Which of the following descriptions of thyroid papillary carcinoma are not CORRECT?
A:Functional tumor resulting in thyrotoxicosis B: Calcitonin-producing tumor C:Origin from C cells D:Tumor with amyloid-containing stroma E:Slow-growing lesion with relatively good prognosis 51.Compared with primary healing, secondary healing is different from primary healing
A:Numerous necrotic tissues B:Significant inflammation C:Large scars D:Big wound E: Long healing time 52.Which of the following statements about thyroid carcinoma are CORRECT?
A:Undifferentiated carcinoma is the most aggressive subtype in thyroid carcinomas B:Follicular carcinoma is the second most common thyroid cancer C:Amyloid deposition is commonly seen in papillary carcinoma D:Papillary architecture is the most characteristic histologic change in follicular carcinoma E:Follicular carcinoma derives from parafollicular cells, and therefore can produce calcitonin 53.Which of the following statements regarding Crohn disease are TRUE:
A:Skip lesions are common B:Any site within the gastrointestinal tract can be involved C:Extraintestinal manifestations are uncommon D:Caseating granulomas may occur E:It most commonly affects the rectum and sigmoid colon 54.Atherosclerosis primarily affects which of the following vessels?
A:Small arteries B:Elastic arteries C:Veins D:Arteriole E:Muscular arteries 55.The following cells belong to unstable cells
A:Epidermal cells B:Sweat gland epithelial cells C:Intestinal mucosal epithelial cells D:Lymphoblastic cells E:Epithelium of bronchial mucosa 56.Pathological changes of Goodpasture Syndrome include
A:Local rupture of glomerular capillary basement membrane B:crescent formation in glomerulus C:glomerular capillary endothelial cell proliferation D:glomerular capillary plexus fibrinoid necrosis E:eosinophil infiltration 57.Higher levels of HDL correlate with increased risk of atherosclerosis.
A:对 B:错 58.Bone belongs to tissue composed primarily of nondividing permanent cells.
A:错误 B:正确 59.Cancer cachexia usually occurs at the advanced stages of disease
A:对 B:错 60.In general, benign tumors are composed of well-differentiated cells that closely resemble their normal counterparts.
A:错 B:对 61.Chronic inflammation can occur when the inciting injury is persistent or recurrent or when the inflammatory reaction is insufficient to completely degrade the agent that incites the inflammatory reaction.
A:错 B:对 62. Wilms' tumor is the most common renal pediatric tumor and share no morphologic features with adult Wilms' tumor.
A:对 B:错 63.Hyperplasia with increase in cell number accounts for most of the marked increase in size of the uterus during pregnancy.
A:错误 B:正确 64.Atherosclerosis primarily affects small arteries.
A:错 B:对 65.Myocardial Infarction is caused by transient, reversible myocardial ischemia.
A:正确 B:错误 66.COPD is a group of disorders characterized by airflow obstruction.
A:错误 B:正确 67.Large cell carcinomas of the lung are well differentiated.
A:错 B:对 68.Hepatitis A can result in a carrier state or in chronic liver disease.
A:错误 B:正确
