Men's problems. Use each choice once. A. chordee B. erythroplasia C. phimosis D. trabeculation E. varicocele 36. accompanies hypospadias in almost all cases [A] (*) 37. intra-epithelial malignancy [B] (*) 38. over-developed, stretched bladder wall detrusor muscle [D] (*) 39. tight foreskins can be a serious problem [C] (*) 40. like a mess of worms in the scrotum [E] (*) 41. Which is NOT notably more common following radiation? A. astrocytomas B. breast cancer C. papillary carcinoma of the thyroid D. primary adrenal insufficiency (*) E. osteogenic sarcoma 42. Which is the MOST COMMON soft-tissue malignancy? A. dermatofibroma B. fibrosarcoma C. liposarcoma (Americans are a nation of overweight folks) D. malignant fibrous histiocytoma (*) E. rhabdomyosarcoma 43. Medullary carcinoma of the thyroid gland usually produces A. calcitonin (*) B. thyroglobulin C. thyroxine D. tri-iodo-thyronine E. none of these 44. Aerobic training is LEAST LIKELY to substantially increase: A. heart size and power B. number of mitochondria in skeletal muscle C. number of sarcomeres in skeletal muscle (*) D. quantity of glycolytic enzymes in skeletal muscle E. size of mitochondria in skeletal muscle 45. Anterior horn cells die off in all of these EXCEPT: A. amyotrophic lateral sclerosis B. Charcot-Marie-Tooth disease (*) C. paralytic poliomyelitis D. spinal cord infarct E. Werdnig-Hoffman MATCHING. Sites of nerve cell damage. Use each choice once. A. globus pallidus B. granular layer of the cerebellum C. retina D. substantia nigra E. temporal lobe 46. carbon monoxide [A] (*) 47. herpes simplex virus I [E] (*) 48. mercury metal [B] (*) 49. methyl alcohol [C] (*) 50. MPTP "Ecstasy" designer drug [D] (*) MATCHING. At least half-way credible causes. Use each once. A. brain hypoxia around the time of birth B. iatrogenic sodium administration C. junk food diet D. silicone breast implants E. tryptophan from the "health food" store (bad lot, sorry) 51. anencephaly and medulloblastoma (both!) [C] (*) 52. central pontine myelinolysis [B] (*) 53. eosinophilia-myalgia [E] (*) 54. schizophrenia [A] (*) 55. scleroderma, once in a while [D] (*) 56. The current anabolic steroids used by some gym rats are LEAST LIKELY to give them: A. bigger muscles B. cholestasis C. higher LDL cholesterol D. lower HDL cholesterol E. testicular enlargement (*) 57. Which of these lab tests would be most helpful in supporting your impression of "syndrome in inappropriate ADH production" in your oat-cell carcinoma patient? A. hyperkalemia B. hypernatremia C. hypokalemia D. hyponatremia (*) E. inability to concentrate the urine despite fluid restriction 58. Which is NOT a feature of Alzheimer's disease? A. granulovacuolar degeneration B. Hirano bodies C. Lewy bodies (*) D. neurofibrillary tangles E. senile plaques MATCHING. White cells do various things in skin diseases. Match each choice once. A. discoid lupus B. erythema multiforme C. mycosis fungoides D. lichen planus E. psoriasis 59. Lymphocytes attacking the epidermis and vessels [B] (*) 60. Lymphocytes clustered around hair stuff and sweat glands [A] (*) 61. Lymphocytes forming "Pautrier microabscesses" in the epidermis [C] (*) 62. Lymphocytes in an even band along a sawtooth dermal-epidermal junction [D] (*) 63. Neutrophil clusters in the lower epidermis and/or dead layer [E] (*) 64. The characteristic feature of sunburned epidermis, which you'd see if you biopsied it, is: A. acantholysis B. acanthosis C. apoptosis (*) D. parakeratosis E. spongiosis 65. The principal publication implicating Doxylamine (Bendectin) as a human teratogen was an article in the: A. Journal of the American Medical Association B. Journal of the American Osteopathic Association C. Lancet D. National Enquirer (a supermarket tabloid) (*) E. New England Journal of Medicine 66. ONE KODACHROME. What's the brain lesion? A. astrocytoma B. berry aneurysm C. craniopharyngioma (*) D. glioblastoma E. infarct 67. ONE KODACHROME. The pink, hyaline gunk in this medullary carcinoma of the thyroid is: A. amyloid (*) B. fibrin C. immunoglobulin D. thyroglobulin E. ubiquitin 68. ONE KODACHROME. Brain. What's the matter? A. ependymoma B. glioblastoma C. polymicrogyria D. tuberous sclerosis (*) E. von Hippel-Lindau (bet you) 69. TWO KODACHROMES. Breast lesion. Look, and think. What is the diagnosis? A. colloid carcinoma B. comedocarcinoma C. fibroadenoma (*) D. inflammatory carcinoma E. scirrhous carcinoma 70. ONE KODACHROME. Breast. Look, and think. What's the diagnosis? A. colloid carcinoma B. comedocarcinoma C. gynecomastia (*) D. scirrhous carcinoma E. sclerosing adenosis 71. ONE KODACHROME. Endocervix. What's the diagnosis? A. nothing wrong B. carcinoma in situ / intraepithelial neoplasia (*) C. invasive cancer D. lymphocytic cervicitis E. squamous metaplasia 72. ONE KODACHROME. Brain. What's wrong? A. acute subdural hematoma B. congenital absence of the corpus callosum C. contrecoup lesions (*) D. glioblastoma E. subarachnoid bleed 73. ONE KODACHROME. Photomicrograph of an ovarian tumor. What kind? A. dermoid teratoma B. granulosa-theca tumor C. mucinous cystadenoma (*) D. serous cystadenocarcinoma E. Stein-Leventhal 74. THREE KODACHROMES. Thyroid lesion. What's the diagnosis? A. anaplastic carcinoma B. DeQuervain's C. lymphoma D. papillary carcinoma (*) E. Reidel's 75. ONE KODACHROME. Muscle stained with trichrome. What's the most likely diagnosis? A. AZT (zidovudine) myopathy (*) B. denervation-reinnervation C. Duchenne's muscular dystrophy D. myotonic dystrophy E. polymyositis 76. TWO KODACHROMES. From the ovary. What's your best diagnosis? A. dermoid teratoma B. granulosa-theca tumor C. mucinous cystadenoma D. serous cystadenocarcinoma (*) E. Stein-Leventhal 77. ONE KODACHROME. Look closely. This muscle fiber suggests: A. amyotrophic lateral sclerosis B. Duchenne's or Becker's C. mitochondrial myopathy D. myotonic dystrophy (*) E. polymyositis 78. TWO KODACHROMES. Patient and thyroid. What's your best diagnosis? A. DeQuervain's B. Graves' (*) C. Hashimoto's D. idiopathic goiter E. this is cancer 79. TWO KODACHROMES. What's wrong with this bone? A. healing fracture B. osteogenesis imperfecta C. osteoporosis D. osteosarcoma E. Paget's osteitis deformans (*) 80. TWO KODACHROMES. Probably the rash of A. Kaposi's sarcoma B. lichen planus C. molluscum D. pityriasis rosea (*) E. psoriasis 81. ONE KODACHROME. What's the lesion? A. acute subdural hematoma (*) B. birth defect C. epidural hematoma D. intraventricular hemorrhage E. glioblastoma 82. ONE KODACHROME. Look closely. This is a(n): A. acute subdural hematoma B. chronic subdural hematoma C. craniopharyngioma D. AV malformation E. berry aneurysm (*) 83. TWO KODACHROMES. Before and after. It's: A. acromegaly (*) B. Addison's C. Cushing's D. hyperthyroidism E. hypothyroidism 84. ONE KODACHROME. Adrenal tumor. What sort? A. adrenal cortical adenoma B. adrenal cortical carcinoma C. ganglioneuroma D. neuroblastoma (*) E. pheochromocytoma 85. THREE KODACHROMES. The problem is probably: A. aluminum in the deodorant B. fulvic acid in the drinking water C. insecticide in the drinking water D. prions (*) E. viruses 86. TWO KODACHROMES. Special views of muscle. What's the pathology? A. denervation-reinnervation (*) B. mitochondrial myopathy C. muscular dystrophy, possibly Duchenne's D. myotonic dystrophy E. polymyositis-dermatomyositis 87. ONE KODACHROME. Ovarian tumor. A. dermoid teratoma (*) B. granulosa-theca tumor C. Leydig cell / Sertoli cell tumor (arrhenoblastoma) D. mucinous cystadenoma E. serous cystadenocarcinoma 88. ONE KODACHROME. Brain. What's the problem? A. Alzheimer's B. herpes of the temporal lobe C. Huntington's D. Parkinson's E. Pick's (*) 89. TWO KODACHROMES. Gross and micro of a bone lesion. What is the diagnosis? A. chondrosarcoma B. Ewing's sarcoma C. healing fracture, somebody's going to court D. osteoid osteoma E. osteosarcoma (*) 90. TWO KODACHROMES. Gross and micro. What is the diagnosis? A. actinic keratosis / squamous cell carcinoma B. basal cell carcinoma C. discoid lupus D. lichen planus E. psoriasis (*) 91. TWO KODACHROMES. Patient and photomicrograph. What is the problem? A. anencephaly B. basal cell carcinoma C. diffuse axonal injury in head trauma D. encephalocele E. malignant melanoma (*) 92. ONE KODACHROME. The most likely etiologic agent is A. bacterium (*) B. herpes virus C. Nowell's law, a series of mutations with clonal selection D. prion E. programmed obsolescence, this is Alzheimer's disease 93. TWO KODACHROMES. Pigmented lesion. What is the diagnosis? A. benign nevus B. dermatofibroma C. malignant melanoma (*) D. pigmented basal cell carcinoma E. seborrheic keratosis 94. TWO KODACHROMES. Brain. What's your best diagnosis? A. astrocytoma B. choroid plexus papilloma C. medulloblastoma (*) D. meningioma E. multiple sclerosis 95. TWO KODACHROMES. Give me your best diagnosis. A. Alzheimer's B. Arnold-Chiari C. astrocytoma D. medulloblastoma E. multiple sclerosis (*) 96. TWO KODACHROMES. Brain. What is the diagnosis? A. AIDS encephalopathy B. Alzheimer's disease C. diffuse axonal injury D. herpes encephalitis E. Parkinson' disease (*) 97. TWO KODACHROMES. "Hey, I can read a pap smear!" A. candida B. carcinoma (*) C. gonorrhea D. trichomonas E. no pathology 98. ONE KODACHROME. Birth defect. What's the diagnosis? A. Arnold-Chiari B. Dandy-Walker C. encephalocele (*) D. tuberous sclerosis E. ulegyria 99. ONE KODACHROME. Based on the gross, the diagnosis is probably A. astrocytomas B. glioblastoma, probably only one C. medulloblastomas D. meningiomas (*) E. sub-ependymomas 100. THREE KODACHROMES. All are silver stains. What is the diagnosis? A. Alzheimer's disease (*) B. diffuse axonal injury C. neurosyphilis D. Parkinson's disease E. Pick's disease BONUS ITEMS: 101. What's "peau d'orange" (orange-peel), the ominous finding in breast cancer? [lymphedema] (*) 102. The kid in the "Lorenzo's oil" movie had what? [adrenal leukodystrophy] (*) 103. A demented patient dies without health care. His brain has lots of "those Langhans giant cells", not very many neurons left, and nothing else you can find that's really abnormal. What's the diagnosis? [AIDS / HIV] (*) 104. What's BRCA1? [usually-deleted antioncogene for breast cancer] (*) 105. A tumor of small blue cells, arising in bone, rich in glycogen, is probably: [Ewing's] (*) 106. What's the rationale for using rilazole in amyotrophic lateral sclerosis? Be specific. [I need something about glutamate excitotoxicity] (*) 107. Dystrophic calcification and iron deposition ("mineralization") of axons suggests that the cause of the neuropathy is: [methotrexate] (*) 108. Homovanillic acid is the primary substance checked in the urine when you are screening for: [neuroblastoma] (*) 109. What hereditary quasi-disease was recently (1994) found to result, in many cases, from a mutation at the fibroblast growth-factor 3 locus? Hint: All dachshund dogs have it. [achondroplasia] (*) 110. From a biochemist's point of view, what is rheumatoid factor? Be specific. ["antibody vs. antibody" is good enough] (*) 111. The gene for hereditary Finnish multiple sclerosis is inherited at the locus for what protein? [myelin basic protein / I'm soft so I'll take "myelin"] (*) 112. Lack of galactocerebrosidase produces a serious disease of the white matter. Give either the eponym or the characteristic cell's name. [Krabb‚ / globoid histiocyte] (*) 113. What's Devic's disease? [MS of eye and spinal cord] (*) 114. Explain in simple language what the T3RU (resin uptake) measures? [inverse of number of unbound sites on thyroxine carriers] (*) 115. What's a Brodie's abscess? [sequestered osteomyelitis] (*) 116. What's "Simmonds's disease"? [generic term for loss of several adenohypophysis hormones] (*) 117. What's "Nelson's syndrome"? [rapid growth of pituitary ACTH-oma after adrenalectomy /] [ hyperpigmentation / blindness] (*) 118. What's that one neuropsychiatric disease with a very strong HLA link (to DR2/DQ1)? [narcolepsy] (*) 119. Pure "fun to know": What's GQ1b? [Guillain-Barr‚ antigen / tetanus & botulism binder] (*) 120. RU486, the anti-progesterone, is being tested for activity against what CNS tumor? [meningioma] (*) 121. Most primary brain lymphomas in the immunosuppressed are caused by what virus? [human herpesvirus 4 (formerly Epstein-Barr which is OK)] (*) 122. ONE KODACHROME. Why is this man smiling? [Because he's Evan. +1 for any correct answer] (*) NAME:________________ 100 points Who's near you? ---> ---> ---> ---> ---> ---> UNIVERSITY OF HEALTH SCIENCES PATHOLOGY EXAM V 1994-1995 INSTRUCTIONS For the multiple-choice items, including the pictures, fill in your answers on the answer sheet provided. For the completion items, put your answers on the exam sheet. Use ink if you have it. Your instructor will only review possible grading errors if there is no evidence of erasure. We have tried to write a fair test, but there will surely be problems with certain items. If you have a question, raise you hand and we'll talk about it QUIETLY (don't phonate!) during the exam. GOOD LUCK!