36. Tuberculosis of the female reproductive system characteristically affects the (A) endocervix (B) endometrium * (C) fallopian tubes (D) vagina (E) vulva 37. Adenomyosis is best regarded as a (A) benign neoplasm (B) complication of oral contraceptive use * (C) myometrial extension of stratum basalis (D) premalignant uterine lesion (E) sequel of incomplete abortion 38. Risk factors for of endometrial adenocarcinoma: (A) adenomyosis (B) endometriosis (C) both * (D) neither 39. Leiomyomas of the uterus (1) occur in at least 10% of all women (2) tend to enlarge during periods of estrogenic stimulation (3) are a frequent cause of uterine bleeding (4) become malignant in 20% of cases *A=1,2,3 B=1,3 C=2,4 D=4 only E=all are correct 40. A specimen passed spontaneously per vaginum from a 22-year-old woman consists of gray, grape-like structures. Sections contain avascular chorionic villi with marked but regular cytotrophoblastic proliferation. The description is that of (A) chorioadenoma destruens * (B) hydatidiform mole (C) syncytial endometritis (D) choriocarcinoma 41. A neoplasm of the female genital tract occurring in an 18-year-old girl whose mother was treated with diethylstilbestrol during the pregnancy is likely to be a * (A) adenocarcinoma of vagina (B) Brenner cell tumor of ovary (C) sarcoma botryoides of vagina (D) squamous cell carcinoma of vulva (E) teratoma of ovary 42. Leiomyomas of the uterus are characterized microscopically by each of the following EXCEPT (A) abundant stromal collagen in many cases (B) bundles of smooth muscle cells arranged in whorls (C) cells of uniform size and shape * (D) increased mitotic activity (E) spindle-shaped cells with oval nuclei 43. The most frequent cause of death in untreated squamous cell carcinoma of the cervix is (A) brain metastasis (B) intraperitoneal hemorrhage (C) massive ascites (D) pulmonary infarct * (E) renal failure 44. Which of the following is most likely to result in severe maternal hemorrhage? (A) choriocarcinoma (B) hydatidiform mole * (C) ectopic pregnancy (D) septic abortion (E) spontaneous abortion 45. Eclampsia is associated with each of the following EXCEPT (A) convulsions (B) hypertension * (C) onset early in pregnancy (D) proteinuria 46. Which is true of nodular (follicular) lymphomas? * (A) all are of B-cell origin (B) high mitotic rate distinguishes them from benign conditions (C) more common in Afro-American people (D) prognosis equivalent to corresponding diffuse lymphoma (E) relatively common in children 47. Eosinophils are likely to be numerous in the blood in (A) chicken pox * (B) Hodgkin's disease (C) Letterer-Siwe (D) mantle cell lymphoma (E) typhoid fever 48. Which is the most curable? * (A) African Burkitt's (B) follicular small-cleaved (C) lupus lymphadenitis (D) mycosis fungoides (E) true histiocytic lymphoma 49. APTT will be normal in deficiency of factor (A) V * (B) VII (C) VIII (D) IX (E) XII 50. "Tired platelets" (A) aspirin effect (B) Bernard-Soulier's (C) Christmas's * (D) Glanzmann's (E) Hughes's 51. Major known risk factor for stomach lymphoma in the US * (A) helicobacter (B) ionizing radiation (C) nitrates / nitrites (D) smoked meats (E) tobacco smoking 52. Where is the watershed zone between superior and inferior mesenteric arteries? (A) ascending colon (B) ileocecal valve (C) sigmoid colon * (D) splenic flexure of colon (E) two feet proximal to the ileocecal valve 53. Which anti-neoplastic agent is notorious for producing cirrhosis? (A) adriamycin (B) cyclophosphamide (C) melphalan * (D) methotrexate (E) vincristine 54. "Yokoo bodies", or giant mitochondria, indicate liver damage from what substance? * (A) alcohol (B) cryoglobulins (C) hepatitis B specifically (D) mutated mitochondrial genes (E) yellow fever 55. ONE KODACHROME. Peripheral smear. Give me your best diagnosis. (A) acute lymphoblastic leukemia, probably L2 (B) acute lymphoblastic leukemia, L3 (Burkitt's) * (C) acute myelogenous leukemia, M2 (D) chronic myelogenous leukemia (E) erythroleukemia, M6 56. TWO KODACHROMES. Effects on the liver of * (A) alcohol (B) hemochromatosis (C) hepatitis virus (D) ischemia (E) uh... this is a hepatocellular carcinoma. 57. ONE KODACHROME. Peripheral smear. Give me your best diagnosis. (A) acute lymphoblastic leukemia (B) acute myelogenous leukemia * (C) chronic lymphocytic leukemia (D) chronic myelogenous leukemia (E) hairy cell leukemia 58. TWO KODACHROMES. Aorta and surrounding lymphoid tissue. Give your best diagnosis. (A) benign hyperplasia (B) Burkitt's lymphoma (C) diffuse non-Hodgkin's lymphoma * (D) Hodgkin's disease (E) nodular non-Hodgkin's lymphoma 59. THREE KODACHROMES. Facial mass. What is the diagnosis? (A) adenoid cystic carcinoma (B) mucocele (C) mucoepidermoid carcinoma * (D) pleomorphic adenoma (E) undifferentiated carcinoma 60. ONE KODACHROME. Liver. Dreadful effects of (A) acute yellow atrophy from some cause or other (B) alcohol (C) iron overload * (D) tobacco smoking (E) uh... this is a hepatocellular carcinoma 61. THREE KODACHROMES. Colon. Your best diagnosis? * (A) adenocarcinoma (B) diverticulosis (C) Crohn's regional enteritis (D) pseudomembranous colitis (E) ulcerative colitis 62. TWO KODACHROMES. Mouth. Your best diagnosis? (A) adenoid cystic carcinoma (B) Eskimo cancer (C) herpes simplex (D) leukoplakia with atypia * (E) squamous cell carcinoma 63. THREE KODACHROMES. Liver. Your best diagnosis? (A) acute yellow atrophy (B) alcoholism * (C) alpha-1 antitrypsin deficiency (D) hepatitis, probably viral, cannot rule out medication (E) Wilson's disease 64. ONE KODACHROME. The neutrophil exhibits (A) Pelger-Huet * (B) Dohle bodies (C) mucopolysaccharidosis (D) toxic granulations (E) uh... no neutrophil is pictured 65. TWO KODACHROMES. Liver. What's your diagnosis? (A) acute viral hepatitis (B) alcoholic hepatitis * (C) chronic active hepatitis (D) macronodular cirrhosis (E) micronodular cirrhosis 66. ONE KODACHROME. Peripheral smear. What is the diagnosis? (A) acute myelogenous leukemia or blast crisis, M1 (B) acute myelogenous leukemia, erythroleukemia, M6 (C) acute lymphoblastic leukemia * (D) chronic myelogenous leukemia (E) typhoid fever 67. ONE KODACHROME. Liver. Your best diagnosis, just on the gross. (A) Fitz-Hugh-Curtis (B) hemochromatosis (C) hepatitis * (D) hepatocellular carcinoma (E) primary biliary cirrhosis 68. ONE KODACHROME. Peripheral smear. (A) blast, can't tell what kind (B) infectious mononucleosis (C) myeloblast * (D) plasma cell (E) Sezary / mycosis fungoides cell 69. TWO KODACHROMES. Gall bladder. Your best diagnosis? (A) acute cholecystitis * (B) adenocarcinoma (C) chronic cholecystitis (D) liver fluke (E) strawberry gallbladder only 70. ONE KODACHROME. Peripheral blood (A) acute myelogenous leukemia (B) chronic myelogenous leukemia (C) Dohle bodies (D) Pelger-Huet * (E) pernicious anemia 71. ONE KODACHROME. Heart. (A) Chagas's disease (B) Hodgkin's disease (C) non-Hodgkin's lymphoma (D) polyarteritis consistent with hepatitis B * (E) TTP 72. ONE KODACHROME. Liver (A) acute mushroom poisoning (B) hepatocellular carcinoma * (C) Reye's syndrome (D) shock liver (E) yellow fever 73. ONE KODACHROME. Peripheral smear (A) acute lymphoblastic leukemia (B) acute myelogenous leukemia, probably M1 (C) acute myelogenous leukemia, probably M3 (D) acute myelogenous leukemia, probably M5 * (E) infectious mononucleosis 74. ONE KODACHROME. Liver (A) abscesses (B) hepatocellular carcinoma, multifocal (C) metastases * (D) infarcts (E) tuberculosis 75. ONE KODACHROME. Peripheral smear. (A) Alder-Reilley (B) DIC (C) Chediak-Higashi * (D) Pelger-Huet (E) Essential thrombocythemia 76. ONE KODACHROME. Liver. Your best diagnosis? (A) abscesses (B) biliary cirrhosis, probably primary (C) cystic fibrosis (D) hepatocellular carcinoma * (E) polycystic kidney disease 77. ONE KODACHROME. Gut at autopsy. Your best diagnosis? (A) Crohn's regional enteritis * (B) infarct (C) melanosis coli (D) pseudomembranous colitis (E) ulcerative colitis 78. ONE KODACHROME. Esophagus. What is your diagnosis? (A) adenocarcinoma (B) Barrett's without adenocarcinoma (C) herpes or CMV (D) reflux changes * (E) squamous cell carcinoma 79. ONE KODACHROME. Cervical biopsy. What is the diagnosis? (A) adenocarcinoma * (B) dysplasia (C) herpes (D) invasive squamous carcinoma (E) squamous metaplasia 80. ONE KODACHROME. Liver. What's your diagnosis? (A) abscesses (B) macronodular cirrhosis (C) hepatocellular carcinoma (D) infarcts * (E) metastatic carcinoma BONUS ITEMS 81. ONE KODACHROME. Ulcerative colitis. What is a pseudopolyp? [I need that the surrounding tissue is lost, the polyps are remaining more-normal tissue] 82. ONE KODACHROME. What are the gallstones made of? [cholesterol] 83. ONE KODACHROME. Uterus. Give me your best diagnosis. [endometriosis / adenomyosis] 84. THREE KODACHROMES. Head-and-neck lesion. Your best diagnosis? [Warthin's; accept some reasonable variant of "papillary cystadenoma lymphomatosum"] 85. ONE KODACHROME. Oral lesion. What syndrome? [Peutz-Jegher's] 86. What is tenesmus? [painful urge to defecate whether you need to or not] 87. What's the name for those little tennis-racket shaped things in histiocytosis X? [Birbeck granules] 88. What lymphoma features tiny lipid droplets in its cytoplasm? [Burkitt's] 89. According to classic anatomic pathology, what's the cell of origin of the diffuse-infiltrative stomach cancer? [neck cell] 90. What is dysentery? [bloody mucoid diarrhea; I need at least 2 of the 3] 91. What common cause of lower GI bleeding is more easily identified by the angiographer than by the pathologist? [angiodysplasia] 92. What's the histology of hepatitis due to taking outdated tetracycline? [fatty change] 93. What is fetor hepaticus? [liver-failure bad breath] 94. What is Lynch's syndrome? [hereditary non-polyposis colon cancer] 95. ONE KODACHROME. Why is this man smiling? [+1 any good answer]