1. Among the following, tuberculosis is most likely to affect the A. ectocervix B. endocervix C. ovary D. oviduct (*) E. vulva 2. The pathologist reports "microglandular hyperplasia" on the endocervical curettings. This effect is usually due to A. chlamydial infestation B. HPV effect, non-tumorigenic strains C. HPV effect, strains 16 or 18 D. progesterone (*) E. tissue repair following a procedure 3. Where do you find a "Nabothian cyst"? A. alongside the oviduct B. endocervix (*) C. Naboth's vineyard D. testicular adnexal structures E. vaginal wall or vestibule 4. Which is most characteristic of the renal lesion in eclampsia? A. basement membrane splitting B. endothelial cell swelling (*) C. foot process fusion D. proximal tubular cell loss E. subepithelial deposits 5. Which is most likely to produce bleeding from the nipple? A. duct ectasia B. fat necrosis C. papilloma (*) D. inflammatory carcinoma E. sclerosing adenosis 6. Which of these cancers is most likely to produce bone metastases that are osteoblastic rather than osteolytic? A. choriocarcinoma in either sex B. endometrial adenocarcinoma C. granulosa cell tumor D. ovarian serous carcinoma E. prostate adenocarcinoma (*) 7. In the Van Nuys system for grading and treating non-infiltrating ductal carcinoma, the WORST grade is assigned to tumors on the basis of A. cribriform growth pattern B. malignant-looking nuclei (*) C. necrosis D. single cell layer E. solid growth pattern 8. TWO KODACHROMES. Uterus. Your best diagnosis? A. adenocarcinoma (*) B. adenomyosis C. cystic ("simple") hyperplasia D. endometrial polyp E. hydatidiform mole 9. ONE KODACHROME. The hyaline globules in this endodermal sinus tumor stain positive for its serum marker, which is A. alpha-fetoprotein (*) B. alpha-lactalbumin C. carcinoembryonic antigen D. chorionic gonadotropin E. inhibin 10. ONE KODACHROME. Lesion from the wall of the uterus. What is the diagnosis? A. adenocarcinoma B. adenomyosis C. choriocarcinoma D. gas gangrene E. invasive mole (*) 11. ONE KODACHROME. Pap smear. Your best diagnosis? A. ASCUS B. candidiasis (*) C. herpes D. severe dysplasia E. trichomonas 12. TWO KODACHROMES. Uterus. What's the lesion? A. adenomyosis B. endometrial stromal sarcoma C. endometrial polyp D. hydatidiform mole E. leiomyoma (*) 13. TWO KODACHROMES. Ovarian tumor. What kind? A. Brenner tumor B. choriocarcinoma * C. clear cell carcinoma D. granulosa cell tumor E. thecoma 14. ONE KODACHROME. Pap smear. Read it? A. herpes B. invasive adenocarcinoma C. invasive squamous cancer (*) D. mild squamous dysplasia E. trichomonas 15. TWO KODACHROMES. Which feature is most helpful in letting us know that this is a leiomyosarcoma rather than a leiomyoma? A. bizarre, large, hyperchromatic nuclei B. calcification C. mitotic figures (*) D. necrosis E. vascular invasion 16. ONE KODACHROME. Read this cervical biopsy. A. adenocarcinoma B. herpes C. mild dysplasia (CIN I) (*) D. severe dysplasia (CIN III) E. venereal wart without dysplasia 17. ONE KODACHROME. Which testicular tumor? A. choriocarcinoma B. seminoma (*) C. Leydig cell adenoma D. this is torsion, not a tumor E. this is normal spermatogenesis 18. ONE KODACHROME. Cervix biopsy. Read it? A. invasive adenocarcinoma B. invasive squamous carcinoma (*) C. squamous carcinoma in situ D. venereal wart E. no pathology 19. THREE KODACHROMES. Breast cancer. Which type? A. comedocarcinoma B. lobular carcinoma in situ C. medullary carcinoma D. osteosarcoma (*) E. scirrhus carcinoma 20. TWO KODACHROMES. Breast lesion. What's the diagnosis? A. comedocarcinoma (*) B. fat necrosis C. fibrocystic change D. mucinous carcinoma E. tubular carcinoma 21. TWO KODACHROMES. Breast lesion. What will you call it? A. comedocarcinoma B. cystic change, benign C. lobular carcinoma in situ D. medullary carcinoma E. mucinous / colloid carcinoma (*) 22. ONE KODACHROME. Vulvar lesion. What's the diagnosis? A. Bartholin's cyst B. carcinoma in situ C. herpes D. lichen sclerosus (*) E. venereal wart 23. TWO KODACHROMES. Uterus. What's the lesion? A. adenocarcinoma B. endometrial polyp (*) C. hydatidiform mole D. missed abortion E. mixed Mullerian tumor 24. TWO KODACHROMES. Ovarian disease. What's the diagnosis? A. choriocarcinoma B. endometriosis C. granulosa cell tumor D. serous cystadenocarcinoma (*) E. Stein-Leventhal polycystic ovaries 25. TWO KODACHROMES. Testicular lesion. Which kind? A. choriocarcinoma B. embryonal cell carcinoma (*) C. Leydig cell adenoma D. seminoma E. torsion 26. ONE KODACHROME. Read this pap smear. A. ASCUS B. candida C. herpes * D. intraepithelial neoplasia, high grade E. trichomonas 27. TWO KODACHROMES. Ovarian tumor. Which one? A. choriocarcinoma B. dermoid cyst C. dysgerminoma D. mucinous cystadenoma (*) E. thecoma 28. TWO KODACHROMES. Which type of breast cancer? A. cribriform intraductal carcinoma B. invasive lobular carcinoma C. lobular carcinoma in situ D. phyllodes tumor, not necessary malignant E. tubular carcinoma (*) 29. ONE KODACHROME. Now read this pap smear. A. adenocarcinoma B. herpes C. mild dysplasia (*) D. severe dysplasia E. trichomonas 30. TWO KODACHROMES. Diagnose this breast lesion. A. fat necrosis B. inflammatory carcinoma (*) C. Paget's disease D. papillary carcinoma E. post-radiation effect BONUS ITEMS: 31. TWO KODACHROMES. Diagnose this breast lesion. [Paget's] 32. TWO KODACHROMES. Diagnose this ovarian lesion. [dermoid / teratoma] 33. ONE KODACHROME. Prostate hyperplasia or prostate cancer? Explain your choice. [cancer; must say glands-within-glands OR loss of second cell layer] 34. THREE KODACHROMES. Diagnose this challenging breast lesion. [(hem-)angiosarcoma; no other answers acceptable] 35. TWO KODACHROME. What's this gynecologic tumor? [rhabdomyosarcoma or sarcoma botryoides] 36. What's "placenta accreta"? [no decidua / attached directly to myometrium or scar] 37. Mention ONE distinctive morphologic features of the uterine arteries in eclampsia? [one has to be "necrosis", the other something about lipid] 38. Mention THE OTHER distinctive morphologic feature of the uterine arteries in eclampsia? [see above] 39. What causes a "chocolate cyst" of an ovary? [endometriosis] 40. What is the histologic feature that will tell the pathologist that a woman with heavy, prolonged menses is actually suffering from "persistent luteal phase"? [decidualization of the menstrual endometrium] 41. What does MIB-1 staining of a breast biopsy tell the pathologist? [proliferation rate] 42. What's a "median bar"? [selective hyperplasia of the median lobe of the prostate] NAME: _______________ 15 points SEAT #: ______________ UHS PATHOLOGY REPRODUCTIVE 2002-2003 INSTRUCTIONS: You know the drill. If you are in the first group. when you are told to leave the building, leave in a group with no delays and no stragglers. If you have a question, please do not phonate. The key will be up by the time that the second group is finished. GOOD LUCK!