中国大学Pathology期末答案(慕课2023课后作业答案)
86 min read中国大学Pathology期末答案(慕课2023课后作业答案)
unit test (cellular adaptation, injury and death)
1、A 17-year-old boy infected with hepatitis 大学A experiences mild nausea for about 1 week and develops very mild scleral icterus. On physical examination, he has minimal right upper quadrant tenderness. Laboratory findings include a serum AST of 68U/L, ALT 75U/L, and total bilirubin 5.l mg/dL. The increase in this patient's serum enzyme levels most likely results from which of the following changes in the hepatocytes?
A、Dispersion of ribosomes
B、末答Autophagy by lysosomes
C、案慕案Swelling of the mitochondria
D、课课Clumping of nuclear chromatin
E、后作Defects in the cell membrane
2、业答On a routine visit to the physician,中国 an otherwise healthy 51-year-old man has a blood pressure of 150/95 mm Hg. If the patient's hypertension remains untreated for years, which of the following cellular alterations will most likely be seen in the myocardium?
A、Atrophy
B、大学Hyperplasia
C、末答Metaplasia
D、案慕案Hemosiderosis
E、课课Hypertrophy
3、后作In an experiment,业答 cells are subjected to radiant energy in the form of x-rays. This results in cell injury caused by hydrolysis of water. Which of the following cellular enzymes protects the cells from this type of injury?
A、Phospholipase
B、中国Glutathione peroxidase
C、Endonuclease
D、Lactate dehydrogenase
E、Protease
4、A 68-year-old woman suddenly lost consciousness and, on awakening 1 hour later, she could not speak or move her right arm and leg. Two months later, a head CT scan showed a large cystic area in the left parietal lobe. Which of the following pathologic processes has most likely occurred in the brain?
A、Fat necrosis
B、Coagulative necrosis
C、Apoptosis
D、Liquefactive necrosis
E、Karyolysis
5、An experiment analyzes cells for enzyme activity associated with sustained cellular proliferation. Which of the following cells is most likely to have the highest telomerase activity?
A、Endothelial cells
B、Germ cells
C、Neurons
D、Neutrophils
E、Erythrocytes
6、In a clinical trial, a chemotherapeutic agent is given to patients with breast cancer metastases. Samples of the cancer cells are obtained and assessed for the presence of death of tumor cells by apoptosis. Mutational inactivation of which of the following products is most likely to render tumor cells resistant to the effects of such an agent?
A、BCL-2
B、p53
C、NF- kappaB
D、Cytochrome P-450
E、Granzyme B
7、A 22-year-old woman has a congenital anemia that has required multiple transfusions of RBCs for many years. On physical examination, she now has no significant findings; however, liver function tests show reduced serum albumin. Which of the following findings would most likely appear in a liver biopsy specimen?
A、Steatosis in hepatocytes
B、Bilirubin in canaliculi
C、Glycogen in hepatocytes
D、Amyloid in portal triads
E、Hemosiderin in hepatocytes
8、A 69-year-old man has had difficulty with urination, including hesitancy and frequency, for the past 5 years. A digital rectal examination reveals that the prostate gland is palpably enlarged to about twice normal size. A transurethral resection of the prostate is performed, and the microscopic appearance of the prostate “chips” obtained is that of nodules of glands with intervening stroma. Which of the following pathologic processes has most likely occurred in the prostate?
A、Apoptosis
B、Dysplasia
C、Fatty change
D、Hyperplasia
E、Hypertrophy
F、Metaplasia
9、A 33-year-old woman has had increasing lethargy and decreased urine output for the past week. Laboratory studies show serum creatinine level of 4.3mg/dL and urea nitrogen level of 40mg/dL. A renal biopsy is performed, and the specimen is examined using electron microscopy. Which of the following morphologic changes most likely suggests a diagnosis of acute tubular necrosis?
A、Mitochondrial swelling
B、Plasma membrane blebs
C、Chromatin clumping
D、Nuclear fragmentation
E、Ribosomal disaggregation
10、A 63-year-old man has a 2-year history of worsening congestive heart failure. An echocardiogram shows mitral stenosis with left atrial dilation. A thrombus is present in the left atrium. One month later, he experiences left flank pain and notes hematuria. Laboratory testing shows elevated serum AST. Which of the following patterns of tissue injury is most likely to be present?
A、Liquefactive necrosis
B、Caseous necrosis
C、Coagulative necrosis
D、Fat necrosis
E、Gangrenous necrosis
Introduction of Pathology
unit test (introduction of pathology)
1、Techniques used for collecting biopsy sample include
A、Local excision
B、Endoscopic forceps
C、Deep organ puncture
D、Scratching
E、All the options
Regeneration VS Repair with connective tissue
unit test (regeneration vs repair with connective tissue)
1、In an experiment, surgical incisions are made in a study group of laboratory rats. Observations about the wounds are recorded over a 2-week period using a variety of chemical mediators. Which of the following steps in the inflammatory-repair response is most likely affected by neutralization of transforming growth factor-β?
A、Leukocyte extravasation
B、Increase in vascular permeability
C、Production of collagen
D、Chemotaxis of lymphocytes
E、Migration of epithelial cells
2、A 60-year-old woman developed chest pain that persisted for 4 hours. A radiographic imaging procedure showed an apparent myocardial infarction involving a 3×4 cm area of the posterior left ventricular free wall. Laboratory findings showed serum creatine kinase of 600 U/L. The patient received both anti-arrhythmic and pressor agents to treat the decreased cardiac output while in the hospital. Which of the following pathologic findings would most likely be seen in the left ventricle l month later?
A、Abscess
B、Complete resolution
C、Coagulative necrosis
D、Nodular regeneration
E、Fibrous scar
3、An experiment infects one group of test animals with viral hepatitis. Two months later, complete recovery of the normal liver architecture is observed when the livers from these animals are examined microscopically. A second test group is infected with bacterial organisms, and after the same period of time, fibrous scars from resolving abscesses are seen microscopically in the livers. Which of the following factors best explains the different outcomes for the two test groups?
A、Nature of the etiologic agent
B、Extent of liver cell injury
C、Injury to the connective tissue framework
D、Location of the lesion
E、Extent of damage to the bile ducts
4、A 23-year-old woman receiving corticosteroid therapy for an autoimmune disease has an abscess on her upper outer right arm. She undergoes minor surgery to incise and drain the abscess, but the wound heals poorly over the next month. Which of the following aspects of wound healing is most likely to be deficient in this patient?
A、Re-epithelization
B、Fibroblast growth factor elaboration
C、Collagen deposition
D、Serine proteinase production
E、Neutrophil infiltration
5、A cesarean section is performed on a 20-year-old woman to deliver a term infant, and the lower abdominal incision is sutured. The sutures are removed l week later. Which of the following statements best describes the wound site at the time of suture removal?
A、Granulation tissue is still present
B、Collagen degradation exceeds synthesis
C、Wound strength is 80% of normal tissue
D、Type IV collagen predominates
E、No more wound strength will be gained
6、A 40-year-old man underwent laparotomy for a perforated sigmoid colon diverticulum. A wound infection complicated the postoperative course, and surgical wound dehiscence occurred. Primary closure was no longer possible, and the wound "granulated in." Six weeks later, the wound is only l0% of its original size. Which of the following processes best accounts for the observed decrease in wound size over the past 6 weeks?
A、Increase in synthesis of collagen
B、Myofibroblast contraction
C、Inhibition of metalloproteinases
D、Resolution of subcutaneous edema
E、Elaboration of adhesive glycoproteins
7、In an experiment involving observations on wound healing, researchers noted that intracytoplasmic cytoskeletal elements, including actin, interact with the extracellular matrix to promote cell attachment and migration in wound healing. Which of the following substances is most likely responsible for such interaction between the cytoskeleton and the extracellular matrix?
A、Epidermal growth factor
B、Fibronectin
C、Integrin
D、Platelet-derived growth factor
E、Type IV collagen
F、Vascular endothelial growth factor
8、In an experiment, release of epidermal growth factor into an area of denuded skin causes mitogenic stimulation of the skin epithelial cells. Which of the following proteins is most likely to be involved in transducing the mitogenic signal from the epidermal cell membrane to the nucleus?
A、G proteins
B、RAS proteins
C、Cyclin D
D、Cyclic AMP
E、Cyclin-dependent kinase
9、An experiment analyzes factors involved in the cell cycle during growth factor-induced cellular regeneration in a tissue culture. Cyclin B synthesis is induced; the cyclin B then binds and activates cyclin-dependent kinase 1 (CDK1). The active kinase produced by this process is most likely to control progression in which of the following phases of the cell cycle?
A、G0 to G1
B、G1 to S
C、S to G2
D、G2 to M
E、M to G1
10、An experiment is conducted involving cellular aspects of wound healing. Components of the extracellular matrix are analyzed to determine their sites of production and their binding patterns to other tissue components. Which of the following molecules synthesized by fibroblasts can best bind to cellular integrins and extracellular collagen and attach epidermal basal cells to basement membrane?
A、Heparin
B、Dermatan sulfate
C、Procollagen
D、Fibronectin
E、Hyaluronic acid
Hemodynamic disorders
unit test (hemodynamic disorders)
1、A 52-year-old woman with no major medical problems takes a long airplane flight across the Pacific Ocean. Upon arrival at Sydney's Kingsford Smith airport following the flight from Los Angeles, she cannot put her shoes back on. There is no pain or tenderness. Which of the following is the most likely explanation for this phenomenon?
A、Activation of Hageman factor has led to bradykinin production.
B、A lot of drinks were served in the first class section.
C、Femoral vein thrombosis developed.
D、A cellulitis developed in her legs.
E、Venous hydrostatic pressure became increased.
2、A 56-year-old man has had increasing difficulty breathing for the past week. On physical examination he has no fever. Auscultation of his chest reveals diminished breath sounds and dullness to percussion bilaterally. There is 2+ pitting edema present to the level of his thighs. A chest radiograph reveals bilateral pleural effusions. Which of the following laboratory test findings is he most likely to have?
A、Hypoalbuminemia
B、Glucosuria
C、Neutrophilia
D、Anemia
E、Hypernatremia
3、A study of atherogenesis is performed. There is a propensity for atheromas to form at muscular arterial branch points, such as the carotid and aortic bifurcations. Which of the following events in the arteries at these locations is most likely to initiate atherogenesis?
A、Collagen synthesis
B、Endothelial dysfunction
C、Lactic acidosis
D、Cholesterol breakdown
E、Hypoxemia
4、A 61-year-old man has the sudden onset of severe chest pain. Vital signs include T 37°C, P 102/minute, RR 20/minute, and BP 80/40 mm Hg. An electrocardiogram demonstrates changes that are consistent with myocardial ischemia involving the left lateral ventricular free wall. He is given thrombolytic therapy with tissue plasminogen activator (tPA) 3 hours after the onset of chest pain. However his serum creatinine kinase is found to be 450 U/L (elevated) 3 hours after this therapy. Which of the following cellular events has most likely occurred?
A、Cellular regeneration
B、Drug-induced necrosis
C、Reperfusion injury
D、Increased synthesis of creatine kinase
E、Myofiber atrophy
5、A clinical study is performed with subjects who have thrombocytopenia <10,000/microliter. These patients are observed to have defects in coagulation with spontaneous bleeding characterized by multiple petechiae and purpura and stool samples positive for occult blood. Which of the following coagulation functions is most likely to remain largely intact in these patients?
A、Adherence to injured vascular walls
B、Conversion of fibrinogen to fibrin
C、Induction of vasoconstriction
D、Increase in surface sites for coagulation
E、Release of substances that neutralize heparin
6、A 70-year-old man seeks medical attention because of shortness of breath on minimal exertion. A posteroanterior chest radiograph reveals blunting of the right costophrenic sulcus interpreted as a right-sided pleural effusion. The aspirated fluid is straw colored and clear. The protein concentration is low, and the specific gravity is 1.011. Microscopic examination reveals an occasional mesothelial cell. Which of the following is the most likely cause of the effusion?
A、Decreased oncotic pressure
B、Left ventricular heart failure
C、Mesothelioma
D、Pneumonia
E、Tuberculosis
7、Two days following a cholecystectomy, a 32-year-old hospitalized woman has sudden onset of dyspnea, pleural pain, and cough productive of frothy, blood-tinged sputum. Ventilation-perfusion scintigraphy indicates a perfusion defect. If it were possible to examine a portion of the affected lung, which of the following would most likely have been found?
A、Air embolism
B、Anemic (white or pale) infarction
C、Disseminated intravascular coagulation (DIC)
D、Generalized thrombosis
E、Hemorrhagic (red) infarct
8、Fluid is aspirated from the grossly distended abdomen of a 47-year-old chronic alcoholic man. The fluid is straw colored and clear and is found to have a protein content (largely albumin) of 2.5g/dL. Which of the following is a major contributor to the fluid accumulation in this patient?
A、Blockage of lymphatics
B、Decreased oncotic pressure
C、Decreased sodium retention
D、Increased capillary permeability
E、Inflammatory exudation
9、36-year-old man dies during cardiac surgery. He had a history of long-standing rheumatic heart disease with mitral stenosis. At autopsy, the pathologist reports findings consistent with mitral stenosis and noted the presence of ‘heart failure cells’. This finding results from ( ).
A、activation of the coagulation cascade
B、chronic passive congestion of the lungs
C、hypoxic myocardial injury
D、myocardial hyperemia
E、hyperemia of the lungs
10、During a laboratory exercise on coagulation testing, a 23-year-old medical student is found to have a prolonged bleeding time. She has had a long history of ‘easy bleeding’ with frequent bleeding of the gums, epistaxis, cutaneous bleeding, and menorrhagia. Further testing revealed a deficiency of von Willebrand factor. Which of the following thrombogenic processes involving platelets is most directly impaired?
A、Adhesion
B、Conformational change with activation of phospholipid surface
C、Formation of fibrinogen bridges
D、Release reaction
E、Stabilization of platelet plug
Inflammation
unit test (inflammation)
1、A 22-year-old man develops marked right lower quadrant abdominal pain over the past day. On physical examination there is rebound tenderness on palpation over the right lower quadrant. Laparoscopic surgery is performed, and the appendix is swollen, erythematous, and partly covered by a yellowish exudate. It is removed, and a microscopic section shows infiltration with numerous neutrophils. The pain experienced by this patient is predominantly the result of which of the following two chemical mediators?
A、Complement C3b and IgG
B、Interleukin-1 and tumor necrosis factor
C、Histamine and serotonin
D、Prostaglandin and bradykinin
E、Leukotriene and HPETE
2、A 45-year-old man has been working hard all day long carrying loads of bricks to build a wall. He takes a non-steroidal anti-inflammatory drug (ibuprofen). Which of the following processes is this drug most likely to diminish in his arms?
A、Thrombosis
B、Pain
C、Necrosis
D、Fibrinolysis
E、Scar formation
3、Within minutes following a bee sting, a 37-year-old man develops marked respiratory stridor with dyspnea and wheezing. He also develops swelling and erythema seen in his arms and legs. An injection of epinephrine helps to reverse these events and he recovers within minutes. Which of the following chemical mediators is most important in the pathogenesis of this man's condition?
A、Bradykinin
B、Complement C5a
C、Nitric oxide
D、Tumor necrosis factor
E、Histamine
4、In an experiment, lymphatic channels are observed in normal soft tissue preparations. Staphylococcus aureus organisms are innoculated into the tissues and the immunologic response is observed over the next 24 hours. Which of the following functions is most likely to be served by these lymphatics to produce a specific immune response to these organisms?
A、Carry lymphocytes to peripheral tissue sites
B、Remove extravascular tissue fluid
C、Transport antigen presenting cells
D、Serve as a route for dissemination of infection
E、Provide an emigration point for neutrophils
5、A 65-year-old woman has had a fever for the past day. On physical examination her temperature is 39°C and blood pressure 90/50 mm Hg with heart rate of 106/minute. Laboratory studies show a WBC count of 12,510/microliter and WBC differential count of 78 segs, 8 bands, 11 lymphs, and 3 monos. A blood culture is positive for Escherichia coli. Her central venous pressure falls markedly. She goes into hypovolemic shock as a result of the widespread inappropriate release of a chemical mediator derived from macrophages. She develops multiple organ failure. Which of the following mediators is most likely to produce these findings?
A、Nitric oxide
B、Bradykinin
C、Histamine
D、Prostacyclin
E、Complement C3a
6、A 56-year-old man has had increasing dyspnea for 6 years. He has no cough or fever. He had chronic exposure to inhalation of silica dust for many years in his job. A chest x-ray now shows increased interstitial markings and parenchymal 1 to 3 cm solid nodules. His pulmonary problems are most likely to be mediated through which of the following inflammatory processes?
A、Neutrophilic infiltrates producing leukotrienes
B、Foreign body giant cell formation
C、Plasma cell synthesis of immunoglobulins
D、Mast cell histamine release
E、Macrophage elaboration of cytokines
7、A 40-year-old woman had laparoscopic surgery 3 months ago. Now she has a small 0.5 cm nodule beneath the skin at the incision site that was sutured. Which of the following cell types is most likely to be most characteristic of the inflammatory response in this situation?
A、Mast cell
B、Eosinophil
C、Giant cell
D、Neutrophil
E、Plasma cell
8、A 43-year-old woman has had a chronic cough with fever and weight loss for the past month. A chest radiograph reveals multiple nodules from 1 to 4 cm in size, some of which demonstrate cavitation in the upper lobes. A sputum sample reveals the presence of acid fast bacilli. Which of the following cells is the most important in the development of her lung lesions?
A、Macrophage
B、Fibroblast
C、Neutrophil
D、Mast cell
E、Platelet
9、A routine complete blood count performed on a 22-year-old medical student reveals an abnormality in the differential leukocyte count. She has been complaining of frequent sneezing and ‘watery’ eyes during the past several weeks and reports that she frequently had such episodes in the spring and summer. Which of the following cell types is most likely to be increased?
A、Basophils
B、Eosinophils
C、Lymphocytes
D、Monocytes
E、Neutrophils
10、A routine complete blood count performed on a 22-year-old medical student reveals an abnormality in the differential leukocyte count. She has been complaining of frequent sneezing and ‘watery’ eyes during the past several weeks and reports that she frequently had such episodes in the spring and summer. The manifestations of the girl (frequent sneezing and ‘watery’ eyes) are primarily mediated by ( ).
A、the release of histamine from tissue mast cells
B、the release of histamine from eosinophils
C、the release of bradykinin
D、the release of prostaglandins
E、the release of oxygen metabolites from tissue mast cells
Tumor
unit test (tumor)
1、Which one of the following items is most helpful in distinguishing poorly differentiated carcinoma from sarcoma?
A、The growth pattern
B、The manner of spread
C、The age of patient
D、The location of the tumor
E、Reticulum fiber stain
2、The patient survival rate with stage T4N1M1 neoplam 5 years from the time of diagnosis is less than 50%, regardless of therapy. Which of the following clinical findings is most likely to be characteristic of this group of patients?
A、Cachexia
B、Cardiac murmur
C、Icterus
D、Tympany
E、Splenomegaly
3、A healthy 22-year-old woman undergoes a routine physical examination. A discrete, firm, rubbery, movable mass is found in the left breast. She has no axillary lymphadenopathy. The skin overlying the breast and the nipple appear normal. Which of the following neoplasms is most likely to be present in this woman?
A、Lipoma
B、Intraductal carcinoma
C、Malignant lymphoma
D、Fibroadenoma
E、Leiomyoma
4、62-year-old man has complained of pain on urination for the past week. He is afebrile. On cystoscopy, a slightly erythematous 1 cm diameter area is seen on the bladder mucosa. This area is biopsied and on microscopic examination shows cells with marked hyperchromatism and increased nuclear/cytoplasmic ratio involving the full thickness of the epithelium. However, these changes are confined to the epithelium above the basement membrane. Which of the following terms best describes these biopsy findings?
A、Metaplasia
B、Minimal dysplasia
C、Microinvasion
D、Hyperplasia
E、Carcinoma in situ
5、A 60-year-old man who has a 90 pack year history of cigarette smoking has had a chronic cough for the past 10 years. He has begun to lose weight (3 kg) during the past year. No abnormal findings are noted on physical examination. He has a chest radiograph that reveals a right hilar mass. A sputum cytology shows atypical, hyperchromatic squamous cells. What is the most common initial pathway for metastases from this lesion?
A、Bloodstream
B、Pleural cavity
C、Contiguous spread to chest wall
D、Lymphatics
E、Bronchi
6、All neoplasms are collectively referred to as cancers.
7、Papilloma is a benign neoplasm that most often arises from surface epithelium.
8、Poorly differentiated squamous cell carcinomas form intercellular bridges and pink keratinized cytoplasm.
9、Paraneoplastic syndromes can be explained by the anatomic distribution of the tumor.
10、Biopsy of sentinel lymph nodes is often used to assess the presence or absence of metastatic lesions in the lymph nodes.
Diseases of the cardiovascular system
unit test (disease of the cardiovascular system)
1、50-year?old?man?has?blood?pressure?of?150/90?mm?Hg（normal blood?pressure?is?120/90?mm?Hg）.?If?this?person?remains?untreated?for?years, which?of?the?following?alterations?will?be?seen?in?the?myocardium?
A、Atrophy
B、Metaplasia
C、Hypertrophy
D、Dysplasia
E、Necrosis
2、A 65-year-old man was found to have a 5-cm pulsatile mass in his abdomen during a routine physical examination. Angiography reveals a marked dilation in his aorta distal to the renal arteries. Which of the following is the most likely cause of this aneurysm?
A、A congenital defect
B、Hypertension
C、Trauma
D、Rheumatic fever
E、Atherosclerosis
3、A 65-year-old man develops intense crushing substernal, chest pain that is not relieved by nitroglycerin. The ECG shows ST-segment elevation and abnormal Q waves. His condition rapidly worsens and he dies 2 days later. At autopsy a 2.5 cm2 necrotic area is found that involves the anterior left ventricle. What is the most likely cause of this patient's myocardial infarction?
A、Fibrinoid necrosis of main trunk of left coronary artery
B、Severe stenosis of all three main branches of coronary artery without thrombosis
C、Thrombosis of the anterior descending branch of the left coronary artery
D、Complete occlusion of the left circumflex coronary artery
E、Vasospasm of the right coronary artery
4、A 57-year-old man has had blood pressure measurements in the range of 160/95 to 180/110 mm Hg for many years. He has taken no medications. A renal scan reveals kidneys of normal size for age. These findings with benign nephrosclerosis are most likely to occur with which of the following vascular changes?
A、Hyaline arteriolosclerosis
B、Monckeberg's medial calcific sclerosis
C、Complex calcified atherosclerosis
D、Arterial mural thrombosis
E、Hyperplastic arteriolosclerosis
5、A 51-year-old man has the sudden onset of substernal chest pain which radiates to his left arm and neck. He becomes light-headed and diaphoretic over the next 8 hours. He goes to the emergency room. On examination he is afebrile but has a heart rate of 96/minute with an irregular rhythm. Laboratory studies show an increased serum troponin I. Which of the following features would be most prominent by histopathologic examination of his myocardium at this point in time?
A、Macrophage infiltration
B、Coagulative Necrosis
C、Neutrophilic infiltration
D、Capillary proliferation
E、Collagen deposition
6、Peripheral artery disease develops if plaque deposits block blood flow to the arteries that supply the arms, pelvis, or legs.
7、Gross feature of hypertensive heart disease is left ventrical hypertrophy.
8、Family history, age, genetic abnormalities, and diet, these are all called constitutional risk factor.
9、Myocardial rupture is most common 10-14 days after infarction.
10、Fatty streaks are composed of smooth muscle cells.
Diseases of the respiratory system
unit test (diseases of the respiratory system)
1、An asymptomatic 10-year-old child with a chest radiograph showing a subpleural nodule in the right mid-lung field and enlarged mediastinal lymph nodes probably has:
A、Aspergillosis
B、Primary tuberculosis
C、Coccidiodomycosis
D、Secondary tuberculosis
E、Miliary tuberculosis
2、If a person quits smoking, he/she can expect to benefit from all of the following EXCEPT:
A、Diminished risk for lung cancer
B、Reversal of emphysematous changes
C、Abatement of chronic bronchitis
D、Lower risk for lung infections
E、Decreased risk for lung cancer in close family member
3、Which of the following findings is LEAST likely to be diagnosed by bronchoalveolar lavage (BAL) in a 45-year-old male with fever and cough:
A、Pulmonary hamartoma
B、Pneumocystis carinii
C、Mycobacterium tuberculosis
D、Adenocarcinoma
E、Cytomegalovirus
4、Which of the following patients is LEAST likely to have developed an obstructive lung disease:
A、A 30-year-old female with an elevated sweat chloride noted in childhood
B、A 30-year-old female with a diagnosis of alpha-1-antitrypsin deficiency
C、A 50-year-old male who works in demolition of old buildings
D、A 60-year-old female card dealer who smokes
E、A 50-year-old male with a chronic persistent cough productive of excess mucus
5、Pulmonary atherosclerosis is most often associated with which of the following:
A、Generalized atherosclerosis
B、Bronchopneumonia
C、Hypersensitivity pneumonitis
D、Cor pulmonale
E、Diffuse alveolar damage
6、Lobar pneumonia is characterized by a patchy distribution involving one or more lobes, with an inflammatory infiltrate extending from the bronchioles into the adjacent alveoli.
7、Panacinar emphysema is the most common type of emphysema.
8、The clinical definition of chronic bronchitis is a productive cough that occurs during at least two consecutive months over at least three consecutive years.
9、Small cell anaplastic carcinomas are rarely resected because of early metastasis.
10、Adenocarcinomas are often resectable because they are peripheral in location.
Diseases of the digestive system
unit test (diseases of the digestive system)
1、At the time of biopsy, chronic atrophic gastritis of autoimmune etiology (type A) can be associated with each of the following findings EXCEPT:
A、Helicobacter infection
B、Achlorhydria
C、High serum gastrin levels
D、Risk for adenocarcinoma
E、Pernicious anemia
2、Pre-neoplastic conditions of the gastrointestinal tract include all of the following EXCEPT:
A、Barrett's esophagus
B、Ulcerative colitis
C、Crohn's disease
D、Chronic atrophic gastritis
E、Diverticulitis
3、A perirectal fistula is most likely to occur in which of the following patients:
A、A 66-year-old male with colonic adenocarcinoma
B、A 58-year-old female with diverticulosis and diverticulitis
C、A 25-year-old female with chronic ulcerative colitis
D、A 5-year-old girl with shigellosis
E、A 27-year-old male with Crohn's disease
4、A 45-year-old male is found at autopsy to have a 2500 gm liver (normal up to 1800 gm) that microscopically shows most hepatocytes to be filled with large lipid droplets. The probable etiology is:
A、Alpha-1-antitrypsin deficiency
B、Wilson's disease
C、Acute hepatitis C
D、Chronic alcoholism
E、Biliary tract lithiasis
5、A 54-year-old Asian male who is hepatitis B surface antigen positive has a firm, nodular liver. All of the following findings can occur as complications of this condition EXCEPT:
A、Hepatocellular carcinoma
B、Coagulopathy
C、Ascites
D、Splenomegaly
E、Hepatic infarction
6、Chronic gastritis is characterized by chronic mucosal inflammation and atrophy of the mucosal glands.
7、Most often, the gastric ulcer occurs at or near the greater curvature, in the antral and prepyloric regions.
8、The tumor cells of Krukenberg tumors often contain abundant mucin.
9、The transmission of hepatitis A virus is via parenteral, sexual, and vertical routes.
10、HBV and HCV are the most common viral causes of postnecrotic cirrhosis.
Diseases of the urinary tract system
unit test (diseases of the urinary tract system)
1、A 35-year-old man is awakened at night because of severe lower abdominal pain that radiates to the groin. The pain is very intense and comes in waves. The next morning, he notices blood in his urine. On examination, there are no remarkable findings. Which of the following is the most likely diagnosis?
A、Acute cystitis
B、Renal cell carcinoma
C、Ureteral lithiasis
D、Hydronephrosis
E、Autosomal dominant polycystic kidney disease
2、A 3-year-old previously healthy boy has become increasingly lethargic for the past 3 weeks. On physical examination, his temperature 36.9℃，pulse 80/min, respirations 15/min, and blood pressure 140/90 mmHg. Periorbital edema is present. Urinalysis shows 4+ proteinuria, and no blood, ketones, or glucose. Which of the following is the best information to give the boy's parents about his disease?
A、A relative should be found to provide a transplant
B、A course of antibiotic therapy is indicated
C、Rapid onset of renal failure is likely
D、Corticosteroid therapy should alleviate this problem
E、Other family members are at risk for this disease
3、A 25-year-old man has a 5-year history of celiac sprue. Several days after a mild upper respiratory infection, he begins passing dark red-brown urine. The dark urine persists for the next 3days and then becomes clear and yellow, only to become red-brown again l month later. There are no remarkable findings on physical examination. Urinalysis shows a pH of 6.5, specific gravity 1.018, 3+hematuria, l+ proteinuria, and no glucose or ketones. Microscopic examination of the urine shows RBCs and no WBCs, casts, or crystals. A 24-hour urine protein level is 200mg. A renal biopsy specimen from the glomeruli of this patient is most likely to show which of the following alterations?
A、Subepithelial electron-dense deposits
B、Granular staining of the basement membrane by anti-IgG antibodies
C、Mesangial lgA staining by immunofluorescence
D、Diffuse proliferation and basement membrane thickening
E、Thrombosis in the glomerular capillaries
4、A 7-year-old boy is recovering from impetigo. Physical examination shows a few honey-colored crusts on his face. The crusts are removed, and a culture of the lesions grows group A Streptococcus pyogenes. He is treated with a course of antibiotics. One week later, he develops malaise with nausea and a slight fever and passes dark brown urine. Laboratory studies show a serum anti-streptolysin O (ASO) titer of l:1024. Which of the following is the most likely outcome?
A、Development of rheumatic heart disease
B、Chronic renal failure
C、Lower urinary tract infection
D、Complete recovery without treatment
E、Progression to crescentic glomerulonephritis
5、A 15-year-old boy has been passing dark-colored urine for the past month. On physical examination, he has bilateral sensorineural hearting loss and corneal erosins. Urinalysis shows a pH of 6.5, specific gravity 1.015, 1+hematuria, 1+proteinuria, and no ketones, glucose, or leukocytes. The serum creatinine level is 2.5 mg/dL, and the urea nitrogen level is 24 mg/dL. A renal biopsy specimen shows tubular epithelial foam cells by light microscopy. By electron microscopy, the glomerular basement membrane shows areas of attenuation, with splitting and lamination of lamina densa in other thickened areas. Which of the following is the most likely diagnosis?
A、Acute tubular necrosis
B、Berger disease
C、Membranous glomerulonephritis
D、Diabetic nephropathy
E、Alport syndrome
6、After eating a cheeseburger, French fries, and Ice cream for dinner one night, a 6-year-old girl develops nausea, mild abdominal cramping, and a slight fever. Three days later, her parents notice that she is passing dark stools and dark urine and appears fatigued and weak. On physical examination, she has a temperature of 37.9 , pulse 88/min, respirations 18/min, and blood pressure 140/90mmHg. Scattered petechiae are present ℃ on the extremities. Laboratory findings show a serum creatinine level of 2.2mg/dL and urea nitrogen level of 20 mg/dL. Urinalysis shows a pH of 6, specific gravity 1.016, 2+hematuria, and no protein or glucose. A renal biopsy specimen shows small thrombi within glomerular capillary loops. Which of the following diseases is most likely to produce these findings?
A、Postinfectious glomerulonephritis
B、Wegener granulomatosis
C、Hereditary nephritis
D、Hemolytic-uremic syndrome
E、IgA nephropathy
7、A 25-year-old woman experiences sudden onset of fever, malaise, nausea. On physical examination ,her temperature is 38.2 , pulse 85/min, respirations 18/min,and blood pressure 140/90mmHg. A routine ℃ urinalysis shows 1+ proteinuria, 4+ hematuria, and no ketones or glucose. RBC casts are seen on microscopic examination of the urine. A renal biopsy is performed, and light microscopic examination shows marked glomerular hypercellularity with neutrophils in glomerular capillary loops. immunofluorescence microscopy shows granular deposition of IgG and C3 in glomerular capillary basement membranes. Electron microscopy shows electron-dense subepithelial "humps”. Which of the following is the most likely diagnosis?
A、Goodpasture syndrome
B、Systemic amyloidosis
C、Membranous glomerulonephritis
D、Diabetes mellitus
E、Postinfectious glomerulonephritis
8、A 26-year-old man is involved in a motor vehicle accident and sustains acute blood loss. He is hypotensive for several hours before paramedical personnel arrive. They stabilize the bleeding and transport him to a hospital, where he receives a transfusion of 3 units of packed RBCs. Over the next week, the serum urea nitrogen level increases to 48md/dL, the serum creatinine level increases to 5mg/dL, and the urine output decreases. He undergoes hemodialysis for the next 2 weeks and then develops marked polyuria, with urine output of 2 to 3L per day. His recovery is complicated by bronchopneumonia, but renal function gradually returns to normal. Which of the following histological features best characterizes the patient’s transient renal disease?
A、Glomerular crescents in Bowman's space
B、Interstitial lymphocytic infiltrates
C、Arteriolar fibrinoid necrosis
D、Nodular glomerulosclerosis
E、Rupture of the tubular basement membrane
9、A 50-year-old woman has had fever and flank pain for the past 2 days. On physical examination, her temperature is 38.2 , pulse 81/min, respirations 16/min,and blood pressure 130/80 mmHg. Urinalysis shows ℃ no protein, glucose, or ketones. The leukocyte esterase test is positive. Microscopic examination of the urine shows numerous polymorphonuclear leukocytes and occasional WBC casts. Which of the following organisms is most likely to be found in the urine culture?
A、Mycobacterium tuberculosis
B、Mycoplasma hominis
C、Escherichia coli
D、Group A streptococcus
E、Cryptococcus neoformans
10、A 29-year-old woman sees her physician because she has had a fever and sore throat for the past 3 days. On physical examination, her temperature is 38.0. The pharynx is erythematous, with yellowish tonsillar ℃ exudate. Group A Streptococcus pyogenes is cultured. She is treated with ampicillin and recovers fully in 7 days. Two weeks later; she develops fever and a rash and notices a slight decrease in urinary output. Her temperature is 37.7 , and there is a diffuse erythematous rash on the trunk and extremities. Urinalysis shows ℃ a pH of 6, specific gravity 1.022, l+ proteinuria, l+ hematuria, and no glucose or ketones. Microscopic examination of the urine shows RBCs and WBCs, including eosinophils, but no casts or crystals. Which of the following is the most likely cause of her disease?
A、Deposition of immune complexes with streptococcal antigens
B、Hematogenous dissemination of septic emboli
C、Renal tubular cell necrosis caused by bacterial toxins
D、Hypersensitivity reaction to ampicillin
E、Formation of antibodies against glomerular basement membrane
Diseases of the lymphoid system
unit test (diseases of the lymphoid system)
1、A 33-year-old woman has experienced low grade fevers, night sweats, and generalized malaise for the past 2 months. On physical examination she has non-tender cervical and supraclavicular lymphadenopathy. A cervical lymph node biopsy is performed. On microscopic examination at high magnification there are occasional CD15+ and CD30+ Reed-Sternberg cells along with large and small lymphocytes and bands of fibrosis. Which of the following is the most likely diagnosis?
A、Burkitt lymphoma
B、Hodgkin lymphoma
C、Cat scratch disease
D、Mycosis fungoides
Diseases of the endocrine system
unit test-diseases of the endocrine system
1、A 10-year-old previously healthy child has been noted by her parents to be constantly thirsty. She is consuming large amounts of soft drinks. She is urinating often. Her diet and exercise patterns have not changed, except for an increased appetite, yet she appears cachectic and has lost 7 kg over the past 4 months. On physical examination there are no abnormal findings, other than peripheral muscle wasting and weakness. Which of the following laboratory findings would you most strongly suspect is present in this girl?
A、Increased blood insulin
B、Decreased blood glucagon
C、Ketonuria
D、Increased serum osmolality
E、Decreased plasma H+ (alkalosis)
2、A 52-year-old man has an ulcerated area on the sole of his foot that has not healed for 2 months. He is 180 cm tall, weighs 126 kg, and has continued to gain weight gradually. He has not had any major illnesses. His blood pressure is normal. Which of the following laboratory tests performed on serum from a blood sample would be most useful in elucidating the underlying cause for his problem:
A、Antithrombin III
B、Cortisol
C、Creatine kinase
D、Glucose
E、Carcinoembryonic antigen
3、A clinical study is performed with subjects who were diagnosed with hyperthyroidism, compared with a control group of subjects who were euthryoid. The pathologic findings in the thyroid glands of these subjects are analyzed to determine the spectrum of disease processes present. Which of the following pathologic processes is most likely to be found with equal frequency in both the study and the control subjects?
A、Subacute granulomatous thyroiditis
B、Multinodular goiter
C、Medullary carcinoma
D、Hashimoto thyroiditis
E、Follicular adenoma
4、A 47-year-old woman feels a 'lump' in her neck that she didn't notice 5 months before. Her physician palpates a firm nodule about 2 cm in size to the left of midline in the region of the thyroid gland. By scintigraphic scanning this nodule appears 'cold' with normal activity in the surrounding normally sized thyroid gland. Which of the following is the most likely diagnosis?
A、Papillary carcinoma
B、Follicular adenoma
C、Thyroglossal duct cyst
D、Toxic nodular goiter
E、Granulomatous thyroiditis
5、A 50-year-old man has a lump on his neck found at physical examination. A fine needle aspirate of this lump shows a follicular neoplasm of the thyroid. He undergoes a total thyroidectomy. Within a day following surgery, he is noted to have tingling sensations and neuromuscular irritability. Which of the following serum laboratory tests should be ordered immediately to determine further therapy for this man?
A、TSH
B、Parathormone
C、Thyroxine
D、Calcium
E、Calcitonin
6、A 38-year-old woman has had a feeling of fullness in her neck for the past year. She is otherwise asymptomatic. Her physician's assistant palpates an enlarged but nontender thyroid gland. She has no difficulty swallowing. There is no palpable lymphadenopathy. She has no fever. Her serum TSH is 3.5 mU/L (normal) with total thyroxine of 8.2 micrograms/dL (normal). Thyroid peroxidase antibody is not detected. Two years later, her thyroid has not appreciably changed in size. Which of the following conditions is she most likely to have?
A、Graves disease
B、Nodular goiter
C、Hashimoto thyroiditis
D、Anaplastic carcinoma
E、Follicular adenoma
7、A 28-year-old woman has had difficulty concentrating at work for the past month. She is constantly getting up and walking around to visit co-workers. She complains that the work area is too hot. She seems nervous and often spills her coffee. She has been eating more but has lost 5 kg in the past 2 months. On physical examination her temperature is 37.5°C, pulse 101/minute, respiratory rate 22/minute, and blood pressure 145/85 mm Hg. Which of the following laboratory findings is most likely to be present in this woman?
A、Decreased catecholamines
B、Decreased iodine uptake
C、Decreased plasma insulin
D、Decreased TSH
E、Increased ACTH
8、A 47-year-old woman has felt a 'lump' in her neck for the past 2 months. On physical examination there is a firm nodule in the right lobe of her thyroid. Following fine needle aspiration and cytologic diagnosis of a neoplasm, a thyroidectomy is performed. Grossly, there is a 3 cm mass in the right lower pole that on sectioning is cystic and has papillary excrescences. Which of the following microscopic pathologic findings is most typical for this lesion?
A、Giant cells
B、Amyloid stroma
C、Small thyroid follicles
D、Clear nuclear chromatin
E、Pleomorphic spindle cells
final test
final test
1、A clinical study is performed of patients with pharyngeal infections. The most typical clinical course averages 3 days from the time of onset until the patient sees the physician. Most of these patients experience fever and chills. On physical examination, the most common findings include swelling, erythema, and pharyngeal purulent exudate. Which of the following types of inflammation did these patients most likely have?
A、Granulomatous
B、Acute
C、Gangrenous
D、Resolving
E、Chronic
2、A 54-year-old man sought medical care for low-grade fever, anorexia, fatigue, night sweats, weight loss, and persistent cough with bouts of hemoptysis. A chest x-ray had revealed a right apical infiltrate with beginning cavitation, and examination of the sputum had revealed acid-fast bacilli. This condition is typified by a form of inflammation that invariably includes which of the following?
A、A morphologically identifiable etiologic agent
B、Caseous necrosis
C、Clusters of epithelioid cells
D、Massive infiltration of lymphocytes and plasma cells
E、Prominent granulation tissue
3、In an experiment, Enterobacter cloacae organisms are added to a solution containing leukocytes and blood plasma. Engulfment and phagocytosis of the microbes is observed to occur. Next a substance is added which enhances engulfment, and more bacteria are destroyed. Which of the following substances in the plasma is most likely to produce this effect?
A、Complement C3b
B、Glutathione peroxidase
C、Immunoglobulin M
D、P-selectin
E、NADPH oxidase
4、A 72-year-old man presents with a 3-day history of progressively worsening productive cough, fever, chills, and signs of toxicity. Prominent physical findings include signs of consolidation and rales over the right lung base. Sputum culture is positive for Streptococcus pneumoniae. An intra-alveolar exudate filling the alveoli of the involved portion of the lung is present. Which of the following types of inflammatory cells is most likely a prominent feature of this exudate?
A、Basophils
B、Eosinophils
C、Lymphocytes
D、Monocytes-macrophages
E、Neutrophils
5、A 19-year-old woman who works indoors spends a day outside gardening. She does not wear a hat or sunscreen. That evening her partner remarks that her face appears red. Which of the following dermal changes most likely accounts for her red appearance?
A、Neutrophil aggregation
B、Hemorrhage
C、Edema
D、Hemolysis
E、Vasodilation
6、A 23-year-old undergoes surgery for fractures of the pelvis and left femur resulting from a high-speed motor vehicle accident. The following day he develops dyspnea, speech difficulties, and a petechial skin rash. Which of the following types of embolism is the likely cause of these findings?
A、Air
B、Amniotic fluid
C、Fat
D、Paradoxical
E、Thrombotic
7、A 60-year-old woman has noted a dark red-black appearance to her great toe and second and third toes of her left foot for the past month. On physical examination, the toes are cold and have no sensation to touch. The dorsalis pedis and posterior tibial pulses are not palpable on the left. A transmetatarsal amputation is performed. These findings are most typical for a patient with which of the following conditions?
A、Diabetes mellitus
B、Gout
C、Blunt force trauma
D、AIDS
E、Rheumatoid arthritis
8、A 20-year-old woman had Goodpasture syndrome which progressed to chronic renal failure. She is 165 cm tall and weighs 55 kg. She now has blood pressure measurements in the range of 150/90 to 180/110 mm Hg, but does not regularly take medications. Laboratory studies show her blood urea nitrogen is over 100 mg/dL and she requires chronic dialysis. A chest x-ray shows an enlarged heart. The size of her heart is most likely to be the result of which of the following processes involving the myocardial fibers?
A、Hypertrophy
B、Fatty infiltration
C、Hyperplasia
D、Fatty degeneration
E、Edema
9、After the birth of her first child, a 19-year-old woman breast-fed the infant for about 1 year. Which of the following processes that occurred in the breast during pregnancy allowed her to breast-feed the infant?
A、Stromal hypertrophy
B、Lobular hyperplasia
C、Epithelial dysplasia
D、Intracellular accumulation of fat
E、Ductal epithelial metaplasia
10、A 54-year-old man experienced onset of severe substernal chest pain over a period of 3 hours. An ECG showed changes consistent with an acute myocardial infarction. After thrombolytic therapy with tissue plasminogen activator (t-PA), his serum creatine kinase (CK) level increased. Which of the following events most likely occurred following t-PA therapy?
A、Reperfusion injury
B、Cellular regeneration
C、Chemical injury
D、Increased synthesis of CK
E、Myofiber atrophy
11、An experiment introduces a "knockout" gene mutation into a cell line. The frequency of shrunken cells with chromatin clumping and cytoplasmic blebbing is increased, compared with a cell line without the mutation. Overall survival of the mutant cell line is reduced. Which of the following genes is most likely to be affected by this mutation?
A、BAX
B、BCL-2
C、C-MYC
D、FAS
E、p53
12、A 48-year-old woman has a malignant lymphoma involving lymph nodes in the para-aortic region. She is treated with a chemotherapeutic agent which results in the loss of individual neoplastic cells through fragmentation of individual cell nuclei and cytoplasm. Over the next 2 months, the lymphoma decreases in size, as documented on abdominal CT scans. By which of the following mechanisms has her neoplasm primarily responded to therapy?
A、Coagulative necrosis
B、Mitochondrial poisoning
C、Phagocytosis
D、Acute inflammation
E、Apoptosis
13、A 12-year-old boy has had multiple episodes of ear pain accompanied by fever. On examination his right tympanic membrane is red and bulging with yellow exudate. Laboratory studies of the exudate show culture positive for Hemophilus influenzae. A year later he has conductive hearing loss on the right, and a head CT scan shows a mass in the right middle ear. Which of the following materials is most likely to be seen in the tissue curetted from his middle ear?
A、Lipofuscin pigment
B、Russell bodies
C、Neutrophil granules
D、Cholesterol crystals
E、Anthracotic pigment
14、A 66-year-old man with Parkinson disease develops pleuritic chest pain. On exam, he has guarding over the right lower lung with dullness to percussion. A chest CT scan shows a focal, wedge-shaped pleural based area of hemorrhage in the right lower lobe. Which of the following is the most likely cause for his pulmonary lesion?
A、Embolism
B、Atherosclerosis
C、Vasculitis
D、Arteriolosclerosis
E、Thrombosis
15、Seeding metastasis is most common in which of the following malignancies?
A、Melanoma
B、Gastric signet-ring carcinoma
C、Breast carcinoma
D、Osteosarcoma
E、Squamous carcinoma of penis
16、A 66-year-old man has developed a chronic cough over the past 2 months. There are no abnormal physical examination findings. A chest x-ray shows a 3 cm mass in the right upper lobe. After fine needle aspiration biopsy, the mass is resected. Gross and microscopic examination of the mass is performed and it is determined that a neoplasm is present. Which of the following findings regarding this mass is most likely to be irrelevant for determining further therapy and prognosis?
A、The size of the neoplasm
B、The differentiation of the neoplasm
C、Is the neoplasm invading the margin of resection
D、How much inflammation is present in the neoplasm
E、Is the neoplasm primary or metastatic
17、A study is performed to analyze characteristics of malignant neoplasms in biopsy specimens. The biopsies were performed on patients who had palpable mass lesions on digital rectal examination. Of the following microscopic findings, which is most likely to indicate that the neoplasm is malignant?
A、Pleomorphism
B、Atypia
C、Invasion
D、Increased nuclear/cytoplasmic ratio
E、Necrosis
18、A 14-year-old healthy girl has a 0.3 cm reddish, slightly raised nodule on the skin of the upper part of her chest found on a routine physical examination. She states that this lesion has been present for years and has not appreciably changed in size or color. Which of the following neoplasms is this nodule most likely to be?
A、Hemangioma
B、Melanoma
C、Carcinoma
D、Lymphoma
E、Glioma
19、A 62-year-old man with an 80 pack year history of smoking experiences an episode of hemoptysis. On physical examination he has puffiness as well as plethora of the face, pedal edema, bruises of the skin, and a blood pressure of 165/100 mm Hg. A chest radiograph reveals a 5 cm right upper lobe lung mass. A fine needle aspirate of this mass yields cells consistent with small cell anaplastic lung carcinoma. A bone scan shows no metastases. Immunohistochemical staining of the tumor cells is likely to be positive for which of the following hormones?
A、Parathormone related peptide
B、Erythropoietin
C、ACTH
D、Insulin
E、Gastrin
20、A 32-year-old woman has noted dull pelvic pain for the last two months. On physical examination there is a mass palpated in the right lower quadrant. An abdominal ultrasound reveals an 8 cm mass involving the right ovary. The mass is surgically excised. On gross inspection, the surface of the mass is smooth and is not adherent to surrounding pelvic structure. On sectioning it is cystic and filled with hair. On microscopic examination there is squamous epithelium, tall columnar glandular epithelium, cartilage, and fibrous connective tissue. Which of the following neoplasms is she most likely to have?
A、Choristoma
B、Hamartoma
C、Myxoma
D、Teratoma
E、Mesothelioma
21、A 71-year-old woman experiences a transient ischemic attack (TIA). She had an acute myocardial infarction 5 years ago. Which of the following physical examination findings is most likely to be associated with her TIA?
A、Blood pressure 140/90 mm Hg
B、Carotid bruit
C、Heart rate of 100/minute
D、Leg swelling
E、Pulsatile abdominal mass
22、A 60-year-old man had chest pain and was hospitalized. On the first day of admission, his troponin I is elevated. A coronary angiogram revealed 75% stenosis of the anterior interventricular (left anterior descending) artery. Four days later he suddenly becomes worse, with marked hypotension. A pericardiocentesis is performed and returns 150 cc of bloody fluid. Which of the following microscopic findings is most likely to be present in his left ventricular myocardium at the time of this hypotensive episode?
A、Extensive transmural collagen deposition
B、Lymphocytic infiltrates
C、Coronary arterial dissection
D、Necrosis with neutrophils and macrophages
E、Interstitial edema and loss of myofiber cross striations
23、A 60-year-old man has had hypertension for 20 years. His blood pressure has ranged from 150/95 mmHg to 220/110 mmHg. He has diabetes mellitus and has had signs of renal failure since last year. During the workup of her disease, a renal biopsy is performed. Which of the following vascular lesions is most likely to be found in the kidney of this patient?
A、Dystrophic calcification in the tunica media of muscular arteries
B、The lumens of the afferent glomerular arterioles are narrowed by uniform, homogenous, pink deposits within the vessel walls
C、Fibrinoid necrosis of the intima and tunica media of vascular wall with infiltration of monocytes and neutrophilic granulocytes
D、A concentric obliteration of arterioles by an increase in smooth muscle cells and protein deposition in a laminar configuration
E、Chronic granulomatous inflammation with giant cells and breaks in the internal elastic lamina
24、Which of the following sets of findings is most often associated with lobar pneumonia:
A、Community acquired, S. pneumoniae, alcoholism
B、Hospital acquired, S. aureus, AIDS
C、Hospital acquired, Klebsiella, postoperative
D、Congenital, E. coli, premature rupture of membranes
E、Community acquired, Mycoplasma, Hodgkin's disease
25、Of the following features, the one that is LEAST likely to be associated with chronic bronchitis is:
A、Bronchial mucus gland hypertrophy
B、Productive cough for months
C、Severe dyspnea
D、Increased airway resistance
E、Frequent infections
26、A 20-year-old, previously healthy man is jogging one morning when he trips and falls to the ground. He suddenly becomes markedly short of breath. On examination in the emergency room there are no breath sounds audible over the right side of the chest. A chest radiograph shows shift of the mediastinum from right to left. A chest tube is inserted on the right side, and air rushes out. Which of the following underlying diseases is most likely to have produced this complication?
A、Asthma
B、Bronchiectasis
C、Centriacinar emphysema
D、Chronic bronchitis
E、Distal acinar emphysema
27、A 60-year-old man, a heavy smoker, presents for advice to stop smoking. On physical examination, he is thin and has a ruddy complexion. He has a productive cough and a barrel-shaped chest. He sits leaning forward with his lips pursed to facilitate his breathing. A diagnosis of emphysema is made. Which of the following is the most likely histologic finding in the lungs?
A、Bronchial smooth muscle hypertrophy with proliferation of eosinophils
B、Diffuse alveolar damage with leakage of protein-rich fluid into alveolar spaces
C、Dilation of air spaces with destruction of alveolar walls
D、Hyperplasia of bronchial mucus-secreting submucosal glands
E、Permanent bronchial dilation caused by chronic infection, with bronchi filled with mucus and neutrophils
28、A female infant is born prematurely at 28 weeks’ gestation. Shortly after birth, she shows signs of dyspnea, cyanosis, and tachypnea. She is placed on a ventilator for assisted breathing, and a diagnosis of neonatal respiratory distress syndrome (hyaline membrane disease) is made. Which of the following is the cause of this syndrome?
A、Bronchopulmonary dysplasis
B、Intraventricular brain hemorrhage
C、Lack of fetal pulmonary maturity and deficiency of surfactan
D、Necrotizing enterocolitis
E、Patent ductus arteriosus
29、Which of the following statements regarding peptic ulcers is CORRECT:
A、In the stomach, they are usually in the antrum.
B、In the duodenum, they are usually periampullary.
C、Gastric ulcers are associated with increased gastric acid production.
D、Benign ulcers can be reliably distinguished by their smaller size.
E、Duodenal ulcers are prone to malignant transformation.
30、A 39-year-old male with a history of ulcerative colitis for the past 20 years is found to have a positive stool guaiac, and a mass lesion is palpable with digital rectal examination. This lesion is probably a (an):
A、Lymphoma
B、Malignant carcinoid
C、Adenocarcinoma
D、Kaposi's sarcoma
E、Villous adenoma
31、A 42-year-old man experiences malaise and increasing icterus for 2 weeks. Physical examination shows jaundice, but there are no other significant findings. Serologic test results are positive for IgM anti-HAV and negative for anti-HCV, HBsAg, and IgM anti-HBc. Which of the following outcomes is most likely to occur in this man?
A、Chronic active hepatitis
B、Complete recovery
C、Fulminant hepatitis
D、Hepatocellular carcinoma
E、Negative serologic test results
32、All of the following findings are possible consequences of portal hypertension from cirrhosis of the liver in a 49-year-old male EXCEPT:
A、Hemorrhoids
B、Ascites
C、Splenomegaly
D、Vasculitis
E、Hepatic encephalopathy
33、A 60-year-old man presents with a feeling of fullness in his abdomen and a 5kg weight loss over the past 6months. Physical examination is entirely normal. Laboratory studies show hemoglobin 8.2g/dL, hematocrit 24%, and MCV 70μm3. Urinalysis shows 3+ hematuria but no protein, glucose, or leukocytes. An abdominal CT scan shows an 11cm mass in the upper pole of the right kidney. A right nephrectomy is performed and on gross examination the mass invades the renal vein. Microscopic examination of the mass shows cells with abundant clear cytoplasm. Which of the following molecular abnormalities is most iikly to be found in tumor cell DNA?
A、Homozygous loss of the von Hippd Lindau (VHL) gene
B、Mutational activation of the MET protooncogene
C、Tiresome of chromosome 7 associated genes
D、Integration of human papillomavirus-16 (HPV-16)
E、Microsatellite instability
34、The most serious impact of urinary calculi on the body is caused by
A、chronic mucosal inflammation
B、urinary tract obstruction and injury
C、hematuria
D、stimulation of squamous epithelial metaplasia
E、None of the above
35、A 25-year-old man presents because of ‘fullness’ in his neck. Physical examination finds enlargement of the thyroid gland resulting from the presence of several small masses in both thyroid lobes. These nodules are surgically resected, and the pathology report from this surgical specimen diagnoses a papillary carcinoma. Which of the following histologic changes is most characteristic of this type of carcinoma?
A、An amyloid stroma
B、Bland micro-follicles
C、Extracellular Russell bodies
D、Neoplastic C cells
E、Orphan Annie nuclei
36、A 30-year-old woman from Barcelona has noted enlargement of her neck over the past 4 months. On physical examination, she has a diffusely enlarged thyroid that is not painful to palpation. Her TSH level is 0.2 mU/L (decreased). A subtotal thyroidectomy is performed and histologically the tissue shows follicles with papillary infoldings lined by tall columnar cells. Which of the following is the most likely diagnosis?
A、Subacute granulomatous thyroiditis
B、Papillary carcinoma
C、Multinodular goiter
D、Hashimoto thyroiditis
Pathology，即病理学，是医学的一个重要分支，主要研究人体组织和器官的病理变化及其发生机制。在中国大学中，Pathology是医学、临床医学、生物学等专业的重要学科之一。
中国大学Pathology的教学体系
中国大学Pathology的教学体系可以分为本科教育和研究生教育两个层次：
本科教育
本科教育主要包括基础课程和临床课程两部分。
基础课程
基础课程包括病理学、组织学、细胞生物学、分子生物学等。这些课程主要培养学生对病理学基础知识的掌握与理解。
临床课程
临床课程包括肿瘤病理学、外科病理学、内科病理学、妇产科病理学等。这些课程主要培养学生在实践中应用病理学理论知识的能力。
研究生教育
研究生教育主要包括硕士和博士两个层次。研究生专业分为病理学、实验病理学、分子病理学、肝胆胰病理学等。
中国大学Pathology的科研领域
中国大学Pathology在病理生理学、病理学技术、病理诊断与治疗等领域开展了大量的科研工作，取得了许多成果。
病理生理学
病理生理学主要研究人体器官、组织在病理状态下的生理机能变化。其中，心血管病理生理学、呼吸系统病理生理学、肾脏病理生理学等领域取得了许多成果。
病理学技术
病理学技术主要研究使用各种工具和技术，如光学显微镜、电子显微镜、免疫组化、原位杂交等，对组织及其病理变化的诊断与分析。目前病理学技术的精度与效率已经得到了很大的提高。
病理诊断与治疗
病理诊断与治疗主要研究使用病理学知识对各种疾病进行诊断与治疗。目前，各种疾病的病理诊断与治疗已经得到了极大的提高，如肿瘤的早期诊断、新药的研究与开发等。
中国大学Pathology的未来发展趋势
随着生物技术、信息技术的迅速发展，中国大学Pathology未来的发展趋势主要包括以下几个方面：
基础研究
病理学的未来发展需要更多的基础研究，如基因组学、转录组学、蛋白质组学等。这些研究将有助于更深入地了解疾病的发病机制。
生物信息学
生物信息学是病理学未来发展的重要方向之一。随着新一代测序技术的出现，病理学研究需要更多的生物信息学方法和工具，以更准确地分析组织与疾病的关系。
精准医疗
精准医疗将成为病理学未来的重要发展方向。精准医疗将利用基因、组织、病理等信息，为患者提供个性化的预防、诊断和治疗方案。
分子病理学
分子病理学将成为病理学未来的一个重要分支。分子病理学研究将更加深入地了解疾病的分子机制，为治疗提供更有针对性的方法。
结语
中国大学Pathology是中国医学教育和科研领域中不可或缺的一部分。未来，随着科技的进步和学科的发展，Pathology将为人类健康事业做出更大的贡献。
