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Pathology 2006

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					Pathology 2006

1. A child arrived to the E.R. with pain in his right lower abdomen. During surgery a
red inflamed appendix was taken out, it had a white brittle cover. What is the main
cell type in the tissue infiltrate?
    a) Eosinophil
    b) Macrophage
    c) Lymphocyte
    d) Neutrophil

2. A man arrived to the E.R. with severe abdominal pain and a fever. An inflamed
Gall Bladder with exudate, neutrophils and debris was taken out. This is:
    a) Abscess
    b) Empiyema

3. An open question: a man working in an electronic factory comes to the doctor and
complains about chest pains, having difficulties in breathing, coughing and more…
what is he suffering from and what are the pulmonary findings?

4. A man working in a nuclear reactor is exposed to 200 rad. radiation. What will be
the first symptom to appear?
    a) Diarrhea
    b) Pulmonary edema
    c) Leukemia
    d) Neutropenia

Match the virus and the cancer it causes ( a virus may appear a few times or not at
all):
5. Burkitt's lymphoma
6. Nasopharyngeal carcinoma
7. Cervix cancer
8. T-Cell lymphoma

   a)   HIV
   b)   EBV
   c)   HPV
   d)   HBV
   e)   ATLV (adult T-cell lymphotropic virus)

9. Anaplasia is:
   a) A malignancy in an advanced stage
   b) A malignancy restricted to the mucosa
   c) A malignancy with poor differentiation
   d) A malignancy that most of it is necrotic
   e) A malignancy from a non known origin

10. What are the risk factors for the development of cancer in a state of ulcerative
colitis?
    a) Cytokines
    b) Radicals (ROS)
   c) An increase in the tissue stem cell pool
   d) All answers are correct
   e) Non of the answers are correct

11. In which stage during cancer are the Chemokine receptors expressed?
    a) Angiogenesis
    b) Metastasis
    c) Stromal invasion
    d) Stromal migration
    e) Dismantling the basement membrane

12. Which Amyloid sediment will appear as a complication of Ulcerative colitis?
    a) AL amyloid
    b) AA amyloid
    c) Transthyretin
    d) β amyloid
    e) procalcitonin

13. Which is NOT a complication caused by over radiation?
    a) Cataract
    b) Ulcerative colitis
    c) Esophageal stenosis
    d) Emphysema
    e) Angiosarcoma

14. Which of the sentences is NOT correct regarding amyloid?
    a) All amyloid have the same crystal structure
    b) In familial amyloid polyneuropathy there's a residue of transthyretin
    c) AL patients suffer from multiple myeloma
    d) All amyloid have the same fiber structure
    e) In chronic dialysis patients there's ß2 microglobulin sediment

15. Which of the sentences is NOT correct regarding Glycogenosis?
    a) There are 3 groups (liver, muscle, mixed)
    b) Most of them are lysosomal storage diseases
    c) The heart is involved
    d) In Von-Gierke disease there's a glucose-6-phosphatase deficiency

16. Which of these proteins is NOT involved in preventing tissue damage caused by
free radicals?
    a) α1 antitrypsin
    b) catalase
    c) ceruloplasmin
    d) superoxid dismutase
    e) glutathione peroxidase

17. Which of the sentences is NOT correct regarding pulmonary embolism?
    a) Blocking small arteries for a long period of time may result in pulmonary
       hypertension and right-sided hear failure
    b) A common complication in hospitalized patients
   c) Blocking major branches of the pulmonary artery causes an infraction
   d) Only an occlusion of over 60% may lead to major complications, including
      death
   e) In most cases it is a small asymptomatic emboli

18. What is an asymmetric replication?
   a) Differentiation and proliferation at the same time

19. Which is the most common paraneoplastic syndrome?
    a) Hypercalcaemia

20. What is the paraneoplastic syndrome in pancreatic cancer?
    a) DVT

21. What is the pathognomonic finding for silicosis?
    a) Collagen nodule, turquoise in fluorescence techniques

22. In Down syndrome there is:
    a) Duodenal atresia in high frequency

23. The first stage of ischemic damage is:
    a) Sodium and water entry
    b) After 15 seconds – disturbance in contraction

24. In Salmonella there isn't any:
    a) Granulomas

25. Knock out to casapase 3:
    a) Is compensated by other caspases

26. Wound infection:
    a) Most times is not viral

27. In Pap Smear we can find:
    a) Koilocytes

28. Hyaline membrane disease:
    a) Normal placenta

29. The Complement system does NOT play a role in:
    a) Vasodilatation


Pictures to be recognized:

30. micro-organisms in Kupffer cells, skin hyperpigmentation, splenomegaly,
pancytopenia = leishmaniasis donovani
31. Ameba
32. Mucicarmine = Cryptococcus, silver stain = PCP
33. CMV
34. HSV in cervix
35. Molluscum Contagiosum
36. Fibrous nodule in the liver = Schistosoma
37. Schistosoma egg
38. Pulmonary infarction
39. Nutmeg Liver


Slides:

40. A 30 years old AIDS patient = skin with Kapossi Sarcoma
41. Lung – Tuberculosis
42. Adrenal – Neuroblastoma
43. Thyroid – Follicular Adenoma
44. Skin – Venous thrombosis
45. Lung – Aspergillosis
46. Kidney – Clear Cell Carcinoma
47. A 40 years old woman, dyspnea and cough. In the chest X-Ray there is an
expansion of the mediastinum - A lymph node = Sarcoidosis, Granuloma
48. Breast – Fibro-Adenoma
49. Breast - Carcinoma




Possible answers 2006:


1. d                                       15.   c
2. b                                       16.   a
3. Berilosis, granuloma                    17.   c
4.  b
5.  b
6.  b
7.  c
8.  e
9.  c
10. d
11. b
12. b
13. d
14. d
Pathology 2004

Part A – MCQ:
(71 MCQ)

1. Activating P53 will cause:
    a) Increase in Bcl2
    b) Increase in P21
    c) Increase GADD45
    d) Prevention of the Rb phosphorylation
    e) G1 arrest

2. Granulation tissue may contain all the following, except:
    a) Capillaries
    b) Inflammation cells
    c) Young fibroblasts
    d) Many dense collagen fibers
    e) Exudate

3. Who is NOT responsible for leukocytosis during an inflammation?
    a) NO
    b) TNF

4. Matrix-Metalloproteinase plays a role in:
    a) Destroying tissue cells
    b) Phagocytosis
    c) Angiogenesis
    d) All is correct
    e) All is incorrect

5. Which of the following sentences is wrong about histochemistry:
    a) Giemsa for identifying leishmania + malaria
    b) PAS for identifying Helicobacter Pylori
    c) Silver stain for identifying PCP (Pneumocystis carinii)
    d) PAS for identifying fungi
    e) ZN for identifying Mycobacterium Tuberculosis and leprosy

6. Which of the following does NOT have a distinct diagnostic histological image?
    a) Moluscum contagiosum
    b) Staphylococcal infection
    c) Cryptomegalovirus
    d) Leishmania
    e) Herpes Simplex virus

7. The adaptor molecule in both of the Apoptosis pathways:.
    a) APAF1 and DED
    b) APAF1 and FADD

8. Which one of the following changes is NOT specific for cancer cells?
    a) A large nucleolus
   b)   High NCR
   c)   Mitosis
   d)   Irregular nuclear membrane
   e)   Uneven chromatin distribution

9. Where can we find metaplastic cells?
    a) Endocervix
    b) Exocervix
    c) T-zone (transition)
    d) Endometrium

10. Which of the following is NOT typical of normal mucus?
    a) Macrophages
    b) Columnar epithelial cells
    c) Squamous epithelial cells
    d) Eosinophiles
    e) Neutrophiles

11. During the proliferation process (healing, cancer), what is incorrect?
    a) Increase in P16, P27
    b) Decrease in pRb
    c) Increase in cyclinD
    d) All answers are incorrect

12. The Apoptosome is made up of __________

13. EBV is involved in the development of:
    a) Burkitt's lymphoma
    b) Primary brain lymphoma
    c) Gastric lymphoma
    d) Gastric carcinoma
    e) Kaposi sarcoma

14. The damage to the tissue during an inflammation is mainly caused because of the
release of:
    a) Acid proteases
    b) Neutral proteases
    c) Integrins
    d) C5a and C3a
    e) All of the above

15. What is Endostatin?
    a) An angiogenesis inhibitor
    b)

16. Which of the following serves as a DNA repair gene?
    a) BRCA1
    b) BRCA2
    c) ATM
    d) All of the above
   e) Non of the above

17. Schistosoma may cause all of the following, except:
    a) Hepato carcinoma
    b) Urinary bladder Squamous cell carcinoma
    c) Fistula
    d) Hepatic fibrosis
    e) Granuloma

18. Which of the following sentences is correct regarding P53?
    a) Tumor suppressor
    b) It is called "The gene keeper"
    c) It is involved in many tumors
    d) All answers are correct
    e) All answers are incorrect

19. Which of the following causes granulomatotic inflammation?
    a) Salmonella
    b) Mycobacterium
    c) Fungi
    d) Schistosoma
    e) Leishmania

20. A 45 years old man suffers from stomach aches after eating. Gastroscopy
discovered redness in the Ileum and an acute chronic inflammation. What can be the
cause of all these findings?
     a) Staph. Gastroenteritis
     b) Gastrointestinal tuberculosis
     c) H.pylori
     d) Salmonella
     e) Adenovirus

21. Which are the violent genes of HPV?
    a) 16, 18
    b) 33, 54
    c) 6, 11
    d) All answers are correct
    e) All answers are incorrect

22. A diagnostic finding for Asbestosis is:
    a) Mesothelioma
    b) Asbestos bodies
    c) Calcifications

23. Which of the following cells is NOT a target cell for HIV?
    a) CD4 cells
    b) Microglia
    c) Macrophages and monocytes
    d) Neurons
24. What CAN'T be found with chromosome XXY people?
    a) Burr bodies in the oral mucosa
    b) _____ of a testicle + ovary
    c) A man's phenotype
    d) Height
    e) Minor retardation

25. A diagnostic finding of silicosis is:
    a)
    b)
    c) Fibroid layers in the pleura
    d) Honeycombs
    e) Pleural fluid

26. What is incorrect regarding NFM?
    a) AR heredity
    b) A defect in the NF


Part B – open questions:
9 open questions:

27. How are NSAID's responsible for lowering fever during an inflammation?
28. Recognizing a picture from the slides – Actinomycis
29. Recognizing a picture from the slides – candida
30. Recognizing a picture from the slides – mucormycosis


Part C – slides:
10 slides: 0.5 points for recognizing the organ, 1.5 points for the diagnosis.

31. Adenocarcinoma of colon
32. Pulmonary Tuberculosis
33. Sarcoidosis in lymph node
34. Pyelonephritis or DIC in kidney (not determined)
35. Hemoragic infarction in kidney
36. Echinococcal cyst
37. Metastases in lymph node
38. Gucher in liver
39. Clear cell carcinoma in kidney
40. Thromboemboli in lung
Possible answers 2004:


1.    a                                15.   a
2.    d                                16.   d
3.    a                                17.   ?
4.    c                                18.   d
5.    b                                19.   a
6.    b                                20.   c?
7.    b                                21.   a
8.    a                                22.   ?
9.    c                                23.   d
10.   e                                24.   b?
11.   a                                25.   ?
12.   Cytochrome C, APAF1, caspase 9   26.   a
13.   a
14.   b
Pathology 2003

The exam is made up from:     73 MCQ
                              15 short open questions
                              10 slides. 0.5 points for recognizing the organ, 2
                              points for the diagnosis.

1. Mark the right answer: Pulmonary edema appears as a result of:
    a) Left-sided heart failure
    b) Vein blockage
    c) Pressure applied on veins by a tumor or a foreign body
    d) Liver cirrhosis
    e) a+b are correct

2. In case of an acute myocardial infarction, what produces free radicals of oxygen?
    a) Macrophage
    b) Poly-nuclear cells
    c) Myocardium cells
    d) Endothel
    e) Granulocytes
    f) d+e

3. The main component of the basement membrane is:
    a. Thrombospondin
    b. Type IV collagen
    c. Fibrin
    d. Elastin
    e. Non of the above

4. The staging of a tumor is made up by:
    a. Counting the number of the tumor mitosis
    b. The tumor maximal size
    c. The spread range of the tumor
    d. The level of differentiation
    e. Counting the number of the tumor apoptosis

5. Which of the following serves as a DNA repair gene?
    a) BRCA1
    b) BRCA2
    c) P53
    d) All of the above
    e) Non of the above

6. CA125 is a marker for:
    a) Lung cancer
    b) Ovarian cancer
    c) Colon cancer
    d) Breast cancer
    e) Brain cancer
   7. When doing a FNA exam prominent nucleolus are shown, what could be
   possible?
       a) This is after a radiation treatment
       b) Atypical lymphocytes
       c) Reactive cells
       d) Invading carcinoma
       e) a+b+c+d are all correct

8. What is the right sentence regarding endostatin?
    a) Methastatic suppressor
    b) Angiogenesis inhibitor
    c) Metalloproteinase inhibitor
    d) Motility suppressor
    e) Apoptosis inducer

9. DVT is a paraneoplastic syndrome that usually appears in patients suffering from:
    a) Leukemia
    b) Skin cancer
    c) Bone cancer
    d) Pancreatic cancer
    e) Mesothelioma

10. The relation between age of pregnancy (in weeks) and the weight at birth is:
    a) ⅓ of all premature newborns are SGA
    b) All the newborns that were born AGA are mature
    c) ⅓ of all mature newborns are SGA
    d) The older the pregnancy is, the lower SGA percentage will appear
    e) All answers are incorrect

11. Mark the right answer:
    a) Renal failure causes an edema mostly in legs (dependent edema)
    b) Pulmonary edema is a dangerous complication of right sided heart failure
    c) Brain edema may cause cerebellum herniation
    d) Ascites – an extensive edema at the subcutaneous fat
    e) High hydrostatic pressure in blood vessels is a common reason for edema
       during a malnutrition state

12. Tumor cells manage to avoid immunological destruction by:
    a) Making a mass of tumor cells and platelets
    b) Inhibiting HLA class I antigens
    c) Developing FAS ligand and causing T cells to go through apoptosis
    d) All answers are correct
    e) All answers are incorrect

13. All of the following are lysosomal proteins, except:
    a) NOS
    b) Collagenase
    c) Myeloperoxidase
    d) Acid protease
    e) Cathepsin
14. Activated macrophages secrete all of the following, except:
    a) NO
    b) INF-γ
    c) PDGF
    d) IL-1
    e) Protease

15. Anaplasia means:
    a) A good differentiated tumor
    b) A tumor with a similar morphology such as the original tissue
    c) A tumor made up of atypical cells with pleomorphism and polynuclear giant
       cells
    d) An extensive invasive tumor in the body
    e) Pre-melignant lesion

16. A child that is born in a state of Hydrops fetalis:
    a) In most cases he is SGA
    b) Most common reasons today (90%) are with no immunological background
    c) In most cases he will suffer from anemia and/or jaundice
    d) In most cases he is part of the type O blood group
    e) Is always stillborn

17. Which of the following findings is NOT a characteristic of Duchen muscular
dystrophy?
    a) AR heritance
    b) Non neurogenic muscular dystrophy
    c) A dystrophyn deficiency in myocytes
    d) Most patients die in their 20’s
    e) Sometimes you can notice an enlargement of the calf diameter (like
       hypertrophy)

18. What can be identified using silver stain methods in HIV patients?
   a) Histoplasma
   b) Cryptococcus
   c) Coccidiodomycosis
   d) pneumocystic carinii
   e) toxoplasma

19. Which of the following diseases is NOT a risk factor for Amyloidosis?
    a) Tuberculosis
    b) Bronchiectasis
    c) Ulcerative colitis
    d) Plasmacytoma
    e) Mesothelioma

20. Which organ or tissue are the least sensitive to the effect of radioactive radiation?
    a) Small intestine
    b) Lungs
    c) Kidneys
   d) Bone marrow
   e) Lymph nodes

Match the following sentences:

21. Silicosis                                 a) Fibroid layers in the pleura
22. Asbestosis                                b) Granuloma
23. Berylliosis                               c) Aβ protein
24. Alzheimer                                 d) “snow storm” chest X-ray
25. Chronic hemodialysis                      e) β2 micro globulin

26. Mark the correct answer: Karyotype 47 XXY is a characteristic of:
    a) Down syndrome
    b) Gonadal dysgusia (??)
    c) Kleinfelter syndrome
    d) Turner syndrome
    e) Non of the above

27. Which of the following sentences is correct regarding Blastoma?
    a) It is more common with children
    b) It is more common with women
    c) It is made up of different types of embryonic tissues
    d) It is normally benign
    e) It is made up of a mature tissue that is located in an organ where it doesn’t
       normally belong to

28. Which one of the following sentences is correct regarding tumors in children?
    a) Benign tumors in blood vessels are more rare that Blastoma
    b) Carcinoma is not the most common tumor
    c) There are more malignant tumors than benign

29. What does NOT exist in an adult type of Gaucher?
    a) Enlargement of the spleen
    b) Anemia
    c) The involvement of the CNS
    d) Glucocerebrosidase deficiency
    e) Is the most common of all types

30. Which one is NOT related to systemic fever?
    APR
    IL-1
    IL-6
    PG-E2
    TGF-β
    TNF

In questions 31-35 please mark as following
    If 1+2+3 are correct
    If 1+3 are correct
    If 2+4 are correct
   Only if 4 is correct
   If all are correct

31. Echinococcal cyst:
    Humans become infected by a dog feces
    Humans become infected by eating a contaminated mutton meat
    The most common organs that get infected are the liver, spleen and lungs
    The helminth is a saprophyte in the human small intestine

32. In a necrotizing granuloma inflammation biopsy- what is the differential
diagnosis?
    a) Mycobacteria
    b) Herpes
    c) Histoplasma
    d) Staphylococcus

33. Which viral infection can be diagnosed histologically?
    a) HSV
    b) CMV
    c) molluscum contagiosum
    d) rhinovirus

34. Helicobacter pylori:
    a) Is a negative rod, size = 0.5-3.5μ
    b) Causes an infection in the stomach mucosa
    c) Can be identified only by culture
    d) Is a risk factor for the stomach carcinoma

35. Apoptosis:
    a) Cutting the DNA to 180bp fragments
    b) Activating caspases
    c) Inversion of the membrane so the phospholipids will turn outwards
    d) The cell inflation

Other questions that appeared on the exam (without the distractors):

36. Which disease shows hyperplasia of the Peyer`s patches?
37. What is anisocytosis?
38. What is adenoma?
39. What is damaged in cystic fibrosis?
40. What type of epithelial cells are located at the outer layer of the cervix?
41. What is a mutation?
42. Can an obstruction of an artery cause a hemorrhagic infarction?
43. Know the definition of anasarca
44. A question about fat embolism that caused blindness in a short time
45. Is it true that in embolism caused by amniotic fluid there is 80% mortality rate?
46. Is it possible for an air embolism to be caused during birth?
47. What are the antigens on the surface of the HIV virus used for?
48. Which protein is related to the prevention of metastasis?
49. What role plays the TIMPs?
50. NF1 – is it GAP?


Open questions:

51. What are the 2 apoptotic pathways?
52. Which of the 2 apoptotic pathways is the DISC related to?
53. Which 2 types of caspases exist?
54. Which cells makes up the granuloma?
55. What is the cell factor that is activated in case of DNA damage?
56. What is keloid?
57. Aspirin and NSAID’s inhibits _________
58. Caspases consists of the amino acid ________ at its active part and cuts after the
amino acid ______.
59. What causes the flask shaped ulcer inside the colon?
60. Where can u find sequestrum?
61. Which brain cells get damaged in HIV patients that suffer from PML?
62. What is the most common tumor originating from mesenchymal cells in HIV
patients?
63. Which type of Plasmodium infects all types of erythrocytes?
64. Which 2 types of Malaria can stay latent in the liver?
65. A question about HPV


Slides:

           1. Skin - Molluscum contageosum
           2. Uterus - glandular hyperplasia
           3. Rectum – schistosomiasis
           4. (No need to identify the organ) - leishmaniasis (Kala Azar)
           5. Uterus – leiomyoma
           6. Skin - subcutaneus scar
           7. Breast - breast carcinoma
           8. Pancreas - acute pancreatitis (fat necrosis)
           9. Duodenum - chronic peptic ulcer
           10. Lung - fibrino-purulent pneumonia (some say it was
               aspergillosis)
Possible answers 2003:

1.        a              34.         e
2.                       35.         a/e
3.        b              36.         Typhoid
4.        b              37.
5.        d              38.
6.        b              39.
7.        e              40.
8.        b              41.
9.                       42.
10.                      43.
11.       c              44.
12.       d              45.
13.       a              46.
14.       b              47.         diagnosis with ELISA
15.       c              48.         NM23
16.       b              49.
17.       a              50.
18.       d              51.
19.       e              52.
20.       c              53.
21.       d              54.    epithelioid macrophages
                               (histiocytes)
22.       a              55.   P53
23.       b              56.   excessive production of collagen
                               in scar tissue
24.       c              57.   cyclo-oxigenase
25.       e              58.   cysteine, aspartic acid
26.       c              59.   Entamoeba hystolitica
27.       a              60.   Osteomyelitis
28.                      61.   Oligodendrocytes
29.       c              62.   Kaposi` sarcoma
30.       b              63.   Falciparum
31.                      64.   Vivax, ovale
32.       b              65.
33.       a

				
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