1.	ONE KODACHROME.  Skin exhibting:

	A.	actinic keratosis
*	B.	hyperkeratosis
	C.	lichen planus
	D.	psoriasis
	E.	seborrheic keratosis

2.	FOUR KODACHROMES.  Fluorescence photo is for IgG.  Your best diagnosis, please.  

*	A.	bullous pemphigoid
	B.	discoid lupus
	C.	fire ant stings
	D.	herpes simplex
	E.	pemphigus vulgaris

3.	TWO KODACHROMES.  Your best diagnosis?

	A.	Burkitt's lymphoma
	B.	myeloid metaplasia
*	C.	nodular sclerosing Hodgkin's disease
	D.	plasma cell myeloma
	E.	suppurative granulomas consistent with tularemia

4.	ONE KODACHROME.  Ignore the labels.  What is the most likely diagnosis?

	A.	chronic granulocytic leukemia
*	B.	hemoglobin C
	C.	pernicious anemia
	D.	thalassemia major
	E.	thalassemia minor

5.	ONE KODACHROME.  Bone marrow core biopsy.  What is the diagnosis?

*	A.	chronic lymphocytic leukemia
	B.	erythroid hyperplasia
	C.	normal marrow
	D.	plasma cell myeloma
	E.	polycythemia vera rubra

6.	TWO KODACHROMES.  Skin and biopsy.  What is it?

	A.	eczema
*	B.	erythema multiforme
	C.	lichen planus
	D.	psoriasis
	E.	squamous cell carcinoma



7.	ONE KODACHROME.  Skin biopsy.  Give your best diagnosis.

*	A.	compound nevus 
	B.	dermatofibroma
	C.	lentigo
	D.	nodular melanoma
	E.	seborrheic keratosis

8.	ONE KODACHROME.  Patient photo.  Which is most likely?

	A.	bullous pemphigoid
	B.	mycosis fungoides
	C.	psoriasis
*	D.	Stevens-Johnson syndrome
	E.	systemic lupus

9.	ONE KODACHROME.  Peripheral smear.  What is the diagnosis?

	A.	myelofibrosis / leukoerythroblastic smear
	B.	pernicious anemia
*	C.	sickle cell disease
	D.	thalassemia major
	E.	thalassemia minor

10.	ONE KODACHROME.  Peripheral smear. What is the diagnosis?

	A.	acute lymphoblastic leukemia, L3 (Burkitt)
*	B.	acute monocytic leukemia
	C.	chronic lymphocytic leukemia
	D.	chronic myelogenous leukemia
	E.	pernicious anemia

11.	THREE KODACHROMES.  Skin.  Fluorescence is for IgG. What is the diagnosis?

	A.	bullous pemphigoid
	B.	dermatitis herpetiformis
*	C.	discoid lupus
	D.	pemphigus vulgaris
	E.	psoriasis

12.	TWO KODACHROMES.  Silver stains.  Which AIDS opportunist?

	A.	bartonella
*	B.	candida
	C.	cryptosporidium
	D.	histoplasmosis
	E.	pneumocystis



13.	TWO KODACHROMES.  Skin biopsy.  Your best interpretation?

*	A.	actinic keratosis
	B.	basal cell carcinoma
	C.	discoid lupus
	D.	pemphigus
	E.	wart

14.	TWO KODACHROMES.  What is this congneital skin lesion?

	A.	congenital syphilis
	B.	epidermolysis bullosa
*	C.	ichthyosis
	D.	neurofibromatosis
	E.	tuberous sclerosis

15.	THREE KODACHROMES.  What is the diagnosis?

	A.	discoid lupus
	B.	eczema
	C.	impetigo
*	D.	lichen planus
	E.	psoriasis

16.	THREE KODACHROMES.  Give your best diagnosis.

	A.	lichen planus
	B.	lupus
	C.	malignant melanoma, amelanotic
*	D.	mycosis fungoides
	E.	psoriasis

17.	ONE KODACHROME.  Skin biopsy.  What's the diagnosis?

	A.	dermatofibroma
	B.	intradermal nevus
*	C.	Kaposi's sarcoma
	D.	psoriasis
	E.	squamous cell carcinoma

18.	ONE KODACHROME.  Skin lesions.  They are most suggestive of

*	A.	dermatitis herpetiformis
	B.	discoid lupus
	C.	pityriasis rosea
	D.	psoriasis
	E.	scleroderma



19.	ONE KODACHROME.  These skin lesions are most suggestive of:

	A.	eczema
	B.	mycosis fungoides
*	C.	pityriasis rosea
	D.	psoriasis
	E.	tinea versicolor

20.	TWO KODACHROMES.  What's your diagnosis?

*	A.	Burkitt's lymphoma
	B.	chronic lymphocytic leukemia
	C.	chronic myelogenous leukemia
	D.	hairy cell leukemia
 	E.	plasma cell myeloma

21.	TWO KODACHROMES.  Your best diagnosis?

	A.	amyloidosis
	B.	erythema multiforme
	C.	pemphigus
*	D.	polyarteritis nodosa
	E.	thrombotic thrombocytopenic purpura

22.	TWO KODACHROMES.  Hepatocellular carcinoma.  What is the brown pigment?

	A.	alpha-1 antitrypsin
*	B.	bilirubin / biliverdin
	C.	hemosiderin
	D.	lipofuscin
	E.	melanin

23.	THREE KODACHROMES.  Skin lesions.  What is the diagnosis?

	A.	dermatitis herpetiformis
	B.	discoid lupus
*	C.	eczema
	D.	lichen planus
	E.	psoriasis

24.	TWO KODACHORMES.  Spleen.  What is the diagnosis?

*	A.	Hodgkin's disease
	B.	Langerhans cell histiocytosis
C.	lymphoid hyperplasia, nonspecific
	D.	myeloid metaplasia
	E.	non-Hodgkin's lymphoma



25.	ONE KODACHROME.  Peripheral smear.  What is the diagnosis?

	A.	acute leukemia, cannot tell myeloid vs. lymphoid
	B.	acute myelogenous leukemia
*	C.	infectious mononucleosis
	D.	myelofibrosis-type picture
	E.	pernicious anemia

26.	THREE KODACHROMES.  Skin.  What is the diagnosis?

	A.	benign nevus
	B.	lentigo
*	C.	malignant melanoma
	D.	pigmented basal cell carcinoma
	E.	squamous cell carcinoma

27.	TWO KODACHROMES.  Skin.  What is the diagnosis?

	A.	actinic keratosis
 	B.	basal cell carcinoma
*	C.	keratoacanthoma
	D.	squamous cell carcinoma
	E.	wart

28.	ONE KODACHROME. Lymph node, PAS stain.  What is the diagnosis?

	A.	diffuse large-cell lymphoma
	B.	Hodgkin's disease
	C.	plasma cell myeloma
	D.	syphilis
*	E.	Waldenstrom's macroglobulinemia

29.	TWO KODACHROMES.  Ear lesion.  What is it?

	A.	eczema
	B.	actinic keratosis
	C.	melanoma
*	D.	seborrheic keratosis
	E.	squamous cell carcinoma


30.	THREE KODACHROMES.  Your best diagnosis?

*	A.	basal cell carcinoma
	B.	pemphigus vulgaris
	C.	Stevens-Johnson syndrome
	D.	squamous cell carcinoma
	E.	toxic epidermal necrolysis



31.	TWO KODACHROMES. What is the diagnosis?

	A.	benign nevus
*	B.	dermatofibroma	
	C.	lentigo
	D.	malignant melanoma
	E.	seborrheic keratosis

32.	ONE KODACHROME. What is the diagnosis?

A.	acute leukemia, cannot distinguish lymphoid vs myeloid
*	B.	acute myelogenous leukemia
	C.	histoplasmosis
	D.	infectious mononucleosis
	E.	malaria

33.	ONE KODACHROME.  Which AIDS opportunist?

	A.	candida
*	B.	cytomegalovirus
	C.	histoplasmosis
	D.	Kaposi's 
	E.	pneumocystis 

34.	THREE KODACHROMES.  Which AIDS opportunist?

	A.	bacterial infection
	B.	candida
	C.	cytomegalovirus
*	D.	herpes simplex
	E.	syphilis

35.	ONE KODACHROME.  Munro's and Kogoj's lesions in this illness are composed of

	A.	amyloid
	B.	apoptotic cells
	C.	immune complexes
	D.	eosinophils
*	E.	neutrophils

36.	ONE KODACHROME.  The hyaline in this diabetic's kidney is composed primarily of

	A.	altered keratin
	B.	amyloid
*	C.	basement membrane
	D.	fibrinoid
	E.	immunoglobulin




BONUS ITEMS:

37.	ONE KODACHROME.  Lymph node.  Suggest a reasonable diagnosis.

		[Hodgkin's]

38.	ONE KODACHROME.  What is the pigment in the macrophages in this section of lung from a 
patient with congestive heart failure?

		[hemosiderin, accept iron]

39.	ONE KODACHROME.  Silver stain of lung from a patient with AIDS.  What are the intracellular 
organisms?  Be specific.

		[histoplasmosis]

40.	TWO KODACHROMES.  Diagnose the skin lesions.

		[molluscum]

41.	ONE KODACHROME.  Your best diagnosis?

		[Pelger-Huet]

42.	THREE KODACHROMES.  Your best diagnosis?

		[TTP]

43.	ONE KODACHROME.  Your best diagnosis?

		[blue nevus]

44.	TWO KODACHROMES. The Archbishop of Canterbury and your instructor.  Your instructor 
was losing weight.  The second slide, an acid-fast stain, explains why.  What is the diagnosis?

		[tuberculosis]

45.	Is the bleeding time in classic hemophilia normal or prolonged?  Explain.

		[normal, platelets function fine]




46.	What genetic anomaly is today's best predictor that a person with HIV will NOT progress even 
if untreated?

		[CKR5-negative heterozygote]




								NAME: _____________________
											36 points maximum

								Who's sitting near you? ..







UHS PATHOLOGY
SKIN, BLOOD, AND LYMPH
2002-2003

Instructions: You know the routine.  Please do not phonate during the exam.  
We don't think you will need to take a bathroom break.  If you are in the first 
group, please do not leave until we tell you when and where do to so.  Good 
luck.


If medical school were easy,
your degree would be worthless!


 

Victorian-era blood transfusion
Illustration from Dracula