A. Acute eczema B. Discoid lupus C. Erythema multiforme D. Lichen Planus E. Psoriasis 36. Circumscribed, scaly rash, with some hair loss; lymphocytes especially around hairs and sweat glands, vacuolization of the basal layer; increased surface keratin [B] 37. Oozy-crusty rash, maybe with little blisters; edema of the epidermis ("spongiosis"); [A] 38. Purply, pruritic papules; lymphocytes immediately under the dermis; vacuolized basal cells, sawtooth dermal-epidermal junction; hyperkeratosis; apoptotic basal cells in the dermis [D] 39. Silvery-scaled red plaques, Auspitz's sign, Koebner's phenomenon; elongated rete pegs, hyperkeratosis, and little abscesses in the epidermis and rete pegs [E] 40. Target lesions grossly; lots of T-lymphocytes attacking both epidermis and blood vessels [C] A. Actinic keratosis B. Basal cell carcinoma C. Dermatofibroma / fibrous histiocytoma D. Keratoacanthoma E. Seborrheic keratosis 41. Hyperplastic basal cells with flat bottom and little horn "cysts" [E] 42. Locally invasive but unlikely to metastasize [B] 43. Quasi-tumor in the dermis, maybe at an old bug bite [C] 44. Squamous cell carcinoma in situ [A] 45. "Volcano" lesion, central keratin crater, rapid and frightening growth, no malignant potential [D] They're gonna ask you to look at their "moles".... A. Blue nevus B. Dysplastic nevus C. Halo nevus D. Lentigo E. Nevus spilus 46. A common junctional or intradermal nevus under attack by the immune system [C] 47. Darkly-pigmented nevus cells confined to the deep dermis [A] 48. Little hyperpigmented pinpoint-spots in a tight cluster [E] 49. The key is variable color and irregular borders; ask about a family history [B] 50. The one on the list which almost every adult has [D] A. Osteogenesis imperfecta B. Osteomalacia C. Osteopetrosis D. Osteoporosis E. Paget's osteitis deformans 51. Activity of osteoblasts and osteoclasts is increased; "geographic" or "craze lines" in bone; cancer risk [E] 52. Collagen gene is defective; early fractures; [A] 53. Osteoclasts fail to do their work [C] 54. Strict vegetarians at risk; osteoid remains unmineralized [B] 55. Vitamin D receptor gene implicated; not enough osteoid * (i.e., not enough bone substance); [D] A. Exostosis B. Ewing's tumor C. Fibrous dysplasia D. Fibrous cortical defect E. Healing fracture 56. Bony nodule with a fibrous cap; common and banal [A] 57. Fibrous tissue, often with a mix of lipid-laden macrophages, but no osteoid formation [D] 58. Fibrous tissue with a mix of woven-bone osteoid; ask about other signs of McCune-Albright [C] 59. Irregular mix of loose fibrous tissue, cartilage, and woven bone [E] 60. "Small blue cells" lesion [B] A. Comedo carcinoma B. Fibroadenoma C. Papilloma D. Phyllodes tumor E. Scirrhous carcinoma 61. Bloody discharge from the nipple; the pathologist spends a long time studying it [C] 62. Large breast mass; the pathologist says the epithelium looks fine but the stroma looks a little bit nasty [D] 63. Painless breast mass, sharply circumscribed, in a young woman; compressed ducts appear as slits [B] 64. Painless breast mass; the pathologist calls it "a pre-invasive breast cancer" [A] 65. Painless breast mass; the pathologist calls it "infiltrating cancer" [E] A. Ankylosing spondylitis B. Juvenile rheumatoid arthritis C. Osteoarthritis D. Rheumatoid arthritis, classic E. Septic arthritis 66. Marie-Strumpel's "enthesopathy"* [A] 67. Eburnation, loss of cartilage; pollution in Siberia* [C] 68. Pancytopenia; gangrene of the feet; other weird stuff* [D] 69. Sickle cell patients at special risk [E] 70. The other Dr. Still; big lymph nodes* [B] A. Amyotrophic lateral sclerosis B. Anabolic steroid user C. Duchenne's muscular dystrophy D. McArdle's disease E. Myotonic dystrophy 71. Angular fibers, target fibers* [A] 72. Big calves, variably-sized fibers, some necrosis; fat, scar* [C] 73. PAS-positive sub-sarcolemmal masses* [D] 74. Ring fibers, central nuclei, sarcoplasmic masses* [E] 75. Tiny testes, large muscle fibers* [B] A. Alzheimer's disease B. AIDS encephalopathy C. CMV intrauterine infection D. Prion disease E. Rabies 76. Chunks of amyloid within clusters of altered neurites* [A] 77. Calcium around the ventricles* [C] 78. Langhans giant cells in the white matter* [B] 79. Necrosis and big intracytoplasmic inclusion bodies* [E] 80. Vacuoles within and between brain cells* [D] A. Contrecoup contusion B. Diffuse axonal injury C. Diffuse hypoxic injury D. Herniation effect E. Herpes encephalitis 81. Bleeding and softening on the bottoms of the prefrontal lobes* [A] 82. Bleeding and softening on the bottoms of the temporal lobes* [E] 83. Large hemorrhages in the center of the midbrain and pons* [D] 84. Lilac-purple discoloration of the cortex, possibly with petechiae* [C] 85. Petechiae in the corpus callosum and pontine tegmentum* [B] 86. ONE KODACHROME. Just on the morphology.... A. Acne vulgaris B. Hidradenitis suppurativa C. Impetigo * D. Pityriasis rosea E. Reiter's dermatitis 87. ONE KODACHROME. Skeletal muscle. What's your diagnosis? A. Duchenne's muscular dystrophy * B. Infiltrating breast cancer C. Neurogenic change, early, with type grouping D. Polymyositis with lymphocytic infiltrate E. Prednisone effect with type II fiber atrophy 88. FOUR KODACHROMES. Brain. What's the problem? A. Angioid meningioma * B. Congophilic angiopathy C. Glioblastoma multiforme D. Hypertensive hemorrhage E. Ruptured berry aneurysm 89. THREE KODACHROMES. Brain. What is the diagnosis? A. Brain abscess B. Cryptococcal infection penetrating brain C. Glioblastoma multiforme, giant-cell variant D. Infarct with organization * E. Mucormycosis fungal infection 90. THREE KODACHROMES. Brain. What is the diagnosis? A. Alzheimer's B. Creutzfeldt-Jacob * C. Huntington's D. Multi-infarct dementia E. Pick's 91. TWO KODACHROMES. Diagnose this bone tumor. A. Chondrosarcoma B. Enchondroma C. Ewing's * D. Myeloma E. Osteosarcoma 92. THREE KODACHROMES. Diagnose these skin lesions. A. Acne vulgaris B. Impetigo * C. Erythema nodosum D. Scabies E. Xeroderma pigmentosum 93. THREE KODACHROMES. What's the brain lesion? A. Consistent with AIDS encephalopathy B. Cryptococcal disease with brain penetration C. Infarct * D. Metastatic cancer E. Old toxoplasmosis 94. TWO KODACHROMES. What's the bone lesion? A. Enchondroma which has caused a fracture B. Ewing's C. Fracture, poorly-aligned * D. Osteosarcoma E. Paget's with a fracture 95. FIVE KODACHROMES. What's the skin disease? A. Dermatitis herpetiformis B. Erythema multiforme C. Leprosy D. Pemphigoid * E. Pemphigus 96. TWO KODACHROMES. Ovarian tumor! Which one? A. Choriocarcinoma, see the two types of cells B. Mucinous cystadenoma C. Serous cystadenoma * D. Sertoli-Leydig masculinizer E. Yolk-sac tumor. Look how yellow it is. 97. TWO KODACHROMES. This subacute-sclerosing panencephalitis case demonstrates positive immunolocalization for what virus? A. Epstein-Barr * B. measles C. herpes 1 D. herpes 8 E. JC papovavirus 98. THREE KODACHROMES. The second is a fast-blue myelin stain. Give me your best diagnosis. A. acute infarct B. Binswanger's C. cancer, some type or other * D. progressive multifocal leukoencephalopathy E. tuberculosis 99. FOUR KODACHROMES. Muscle. What's the diagnosis? A. Duchenne's muscular dystrophy B. denervation injury C. glycogen storage disease * D. mitochondrial myopathy E. myotonic dystrophy 100. Kuru was transmitted among the Fore people of New Guinea through their practice of * A. cannibalism B. female circumcision C. reading "The National Enquirer" D. taking Bendectin for morning-sickness E. using silicone breast implants BONUS ITEMS: 101. What is alopecia areata? [diffuse scalp and body hair loss] 102. What's the name of the skin disease which is diagnosed best by finding IgA masses in the tips of the dermal papillae? [dermatitis herpetiformis] 103. What kind of cell has turned malignant in urticaria pigmentosum? [mast cell] 104. What virus has just (1995) been identified as a likely etiologic agent in the SQUAMOUS CELL carcinomas of the skin which arise in immunosuppressed renal transplant patients? (HINT: This is NOT HPV wart virus!) [Kaposi virus /herpes 8] 105. What is a pilonidal cyst? [I need something about hair and sacral area] 106. What is an ephelis? [freckle] 107. What is BRCA1? [antioncogene lost in breast cancer families] 108. What's Dupuytren's contracture? [fibrosis of palmar aponeurosis] 109. What part of the body does Osgood-Schlatter's disease affect? Be specific. [knee] 110. What is "rheumatoid lung"? Mention the essential histopathology. [fibrosis] 111. What tumor is often the underlying cause of myasthenia gravis? [thymoma] 112. What's the muscle pain syndrome that often coexists with temporal arteritis? [polymyalgia rheumatica] 113. Sketch a Lewy body, as seen in Parkinsonism, in this neuron. 114. Mutations at the APP ("amyloid precursor protein") locus produce the best-known hereditary form of what disease? [Alzheimer's] 115. A young adult's mild intention tremor vanishes upon consumption of a small amount of ethanol. What is the most likely diagnosis? [benign familial tremor] 116. Tabes in syphilis features loss of myelin, most severe where? Be VERY specific. [posterior columns of cord] 117. What cells die off in Werdnig-Hoffman disease? [anterior horn / lower motor neurons] 118. What is rheumatoid factor? Tell how a biochemist would probably describe it. [antibody against antibody] 119. What artery is typically occluded during uncal herniation? [posterior cerebral] 120. Why is this man smiling? [Got his Bendectin in Canada; +1 for any correct answer] UNIVERSITY OF HEALTH SCIENCES PATHOLOGY EXAM V 1995-1996 INSTRUCTIONS As before. Matching items: As usual, each choice once. Questions? Raise your hand. When the instructor arrives, don't phonate. HERE'S HOPING YOU REALIZE HOW MUCH YOU'VE LEARNED IN TWO SHORT YEARS! HAVE YOU NOTICED THAT YOU CAN READ MOST JOURNAL ARTICLES AND UNDERSTAND THEM NOW? GOOD LUCK!