1. Ascites is an effusion in the

A.   biliary system
B.   intestinal tract
C.   pericardial cavity
D.   peritoneal cavity (*)
E.   pleural cavity

2.   Which mechanism is LEAST LIKELY to produce edema?

A.   any obstruction of venous drainage
B.   dilated arterioles (*)
C.   extra-permeable microvasculature
D.   low plasma protein
E.   plugged lymphatic vessels

3.   About how much of your blood do you need to lose in order to
go into hypovolemic shock?

A.   5%
B.   10%
C.   25%
D.   40% (*)
E.   60%

4.   Widespread venous thrombosis is a notorious paraneoplastic
effect of the common primary 
cancer arising in which organ?

A.   lung ("oat cell carcinoma")
B.   colon
C.   liver
D.   pancreas (*)
E.   prostate

5.   Watershed infarcts are LEAST LIKELY to occur in the

A.   brain
B.   heart
C.   large intestine
D.   spleen (*)
E.   they are common in all these locations

6.   Which is LEAST LIKELY to render the blood more viscous,
i.e., harder to pump through narrow 
vessels?

A.   abundant marginally-soluble protein ("cryoglobulinemia")
B.   excessive IgM ("macroglobulinemia")
C.   lead poisoning (*)
D.   polycythemia (excess number of red cells)
E.   sickle cell disease


7.   Which are you LEAST LIKELY to see in tissue from a joint
with rheumatoid arthritis?

A.   fibrin
B.   lymphocytes
C.   plasma cells
D.   pus (*)
E.   scar tissue

8.   Which form of arthritis often causes fibrosis of the lungs
in addition to the joint troubles?

A.   ankylosing spondylitis
B.   Lyme arthritis
C.   osteoarthritis
D.   Reiter's syndrome
E.   rheumatoid arthritis (*)

9.   Kashin-Beck, the crippling arthritis which is prevalent in
central Asia, results from

A.   a virus, possibly parvo B19
B.   environmental pollution and malnutrition (*)
C.   lack of sunlight in women who must stay hidden
D.   mutation of a gene for a cartilage protein
E.   mutation of a gene involving immune response


10.  What's the cell of origin of a hibernoma?

A.   brown fat (*)
B.   hibernating fibroblast
C.   mast cell
D.   skeletal muscle
E.   smooth muscle

11.  Which cell apparently isn't doing its job in osteopetrosis?

A.   marrow fibroblast
B.   marrow macrophage
C.   osteoblast
D.   osteoclast (*)
E.   osteocyte

12.  People with myasthenia gravis very often already have a
tumor of the

A.   lung
B.   skeletal muscle
C.   stomach
D.   thymus (*)
E.   thyroid



13.  Susceptibility to malignant hyperthermia results from 

A.   injury or disease in the hypothalamus
B.   depletion of body sodium stores
C.   mutated calcium channels (*)
D.   overproduction of endogenous pyrogens / cytokines
E.   use of anabolic steroids from the gym

14.  ONE KODACHROME.  Lung.  What is your diagnosis?

A.   ante-mortem thrombus (*)
B.   atherosclerotic lesion
C.   fat embolus
D.   post-mortem thrombus
E.   pulmonary edema

15.  TWO KODACHROMES.  Bone.  What is your diagnosis?

A.   ankylosing spondylitis
B.   osteoporosis (*)
C.   lipoma
D.   metastatic cancer
E.   Paget's osteitis deformans

16.  TWO KODACHROMES.  Muscle.  Your diagnosis?

A.   glycogen storage disease
B.   muscular dystrophy
C.   nerve disease (*)
D.   polymyositis
E.   trichinosis

17.  ONE KODACHROME.  Which is most likely?

A.   Dupuytren's contracture
B.   gonorrhea (*)
C.   Ollier's multiple enchondromatosis
D.   osteoarthritis
E.   rheumatoid arthritis

18.  ONE KODACHROME.  Muscle.  Your best diagnosis?

A.   denervation / reinnervation
B.   mitochondrial myopathy (*)
C.   muscular dystrophy
D.   polymyositis
E.   trichinosis



19.  ONE KODACHROME.  Muscle.  Which is the best choice?

A.   glucocorticoid-induced atrophy without necrosis
B.   glycogen storage disease
C.   muscular dystrophy
D.   myasthenia gravis
E.   Werdnig-Hoffman / spinal motor atrophy (*)

20.  ONE KODACHROME.  Soft tissue mass.  Your best diagnosis?

A.   angiosarcoma
B.   chondrosarcoma
C.   liposarcoma (*)
D.   malignant fibrous histiocytoma
E.   osteosarcoma

21.  TWO KODACHROMES.  Lung.  What's the diagnosis?

A.   edema
B.   fat embolus
C.   infarct (*)
D.   "shock lung"
E.   thromboembolus without apparent infarct

22.  ONE KODACHROME.  Which kind of sarcoma?

A.   fibrosarcoma or malignant fibrous histiocytoma
B.   liposarcoma
C.   osteosarcoma
D.   synovial sarcoma (*)
E.   uh... this is pannus

23.  ONE KODACHROME.  Vertebral column.  Your best diagnosis?

A.   ankylosing spondylitis (*)
B.   osteoarthritis
C.   osteomalacia
D.   osteomyelitis
E.   metastatic cancer

24.  ONE KODACHROME.  Your best diagnosis?

A.   osteogenesis imperfecta
B.   osteitis fibrosa cystica (von Recklinghausen's of bone)
C.   osteoporosis
D.   osteomalacia
E.   Paget's osteitis deformans (*)



25.  TWO KODACHROMES.  What kind of necrosis in these spleen
infarcts?

A.   caseous
B.   coagulation (*)
C.   enzymatic fat
D.   liquefaction
E.   I brain-flushed that stuff after the last exam block

26.  ONE KODACHROME.  Lung.  What's your diagnosis?

A.   red infarct
B.   postmortem thrombus
C.   pulmonary edema (*)
D.   thromboembolus
E.   white infarct

27.  THREE KODACHROMES.  Bone.  What's your diagnosis?

A.   chondrosarcoma
B.   healing fracture
C.   osteitis fibrosa cystica (parathyroid bone disease)
D.   osteosarcoma (*)
E.   Paget's osteitis deformans

28.  ONE KODACHROME.  Muscle.  What's the diagnosis?

A.   glucocorticoid-induced atrophy (*)
B.   nerve disease or injury
C.   mitochondrial myopathy
D.   muscular dystrophy
E.   polymyositis / dermatomyositis

29.  ONE KODACHROME.  What has embolized?

A.   amniotic fluid
B.   bone marrow (*)
C.   some kind of fat with oil globules
D.   talc
E.   thrombus

30.  ONE KODACHROMES.  What kind of bone tumor?

A.   Ewing's sarcoma
B.   osteoclastoma (*)
C.   osteoid osteoma
D.   osteosarcoma
E.   uh... this is tuberculosis



31.  TWO KODACHROMES.  What's wrong with this leg?

A.   chronic lymphatic obstruction
B.   deep vein thrombosis
C.   gangrene from diabetic vascular disease
D.   osteomyelitis
E.   squamous cell carcinoma (*)

32.  TWO KODACHROMES.  What kind of bone tumor?

A.   chondrosarcoma
B.   enchondroma
C.   Ewing's sarcoma (*)
D.   osteoid osteoma
E.   osteosarcoma

33.  ONE KODACHROME.  Muscle.  What is your best choice?

A.   Duchenne's muscular dystrophy (*)
B.   glycogen storage disease
C.   mitochondrial myopathy
D.   nerve damage
E.   polymyositis / dermatomyositis

34.  TWO KODACHROMES.  What is your best diagnosis?

A.   bacterial infection
B.   gout (*)
C.   osteoarthritis
D.   osteomyelitis
E.   rheumatoid arthritis

35.  TWO KODACHROMES.  Look close.  What is your diagnosis?

A.   facioscapulohumoral dystrophy
B.   dermatomyositis
C.   mitochondrial myopathy
D.   myasthenia gravis
E.   myotonic dystrophy (*)

36.  TWO KODACHROMES.  This one's intended to be tough.  What's
the cause of the black 
flecks on the skin?

A.   anthrax, with bacteria visible on microscopy
B.   cancer invading the lymphatics
C.   diabetic microvascular disease
D.   disseminated intravascular coagulation
E.   inflamed small vessels with thrombosis (*)



BONUS ITEMS

37.  TWO KODACHROMES.  Name the disease.

[Ehlers-Danlos]


38.  THREE KODACHROMES.  Name either the systemic disease or the
bony lesion.

[McCune-Albright / fibrous dysplasia]


39.  TWO KODACHROMES.  Name the systemic disease.

[dermatomyositis]


40.  ONE KODACHROME.  Skeletal muscle.  Your best diagnosis,
please.

[neurogenic atrophy]


41.  ONE KODACHROME.  What is the non-staining material which
appears here as needle-like 
spaces?

[cholesterol]


42.  ONE KODACHROME.  What has embolized in this section of
heart?

[cancer]



NAME: ___________________________
36 points maximum


UHS Pathology
Musculoskeletal System Exam
2001-2002




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