35. Dr. Gustafson punctuated his case presentations with photos of (A) cats (B) dogs (C) flowers (D) his fellow residents (E) the Des Moines DO med school 36. Before his execution, Socrates spoke of the human body as (A) a prison, confining and confusing the soul (B) a river, constantly changing (C) a well-run state, like his ideal "Republic" (D) a wonderful mechanism which arose by chance (E) naturally pure, with disease the result of human sin 37. "Porphyria", Greek for "purple", refers to the color imparted to the (A) eyes (irides) (B) feces (C) hair (D) urine, fresh (E) urine, upon standing 38. What is the cell of origin of a botyroid sarcoma? (A) bone (B) cartilage (C) fibroblast (D) skeletal muscle (E) smooth muscle 39. A hibernoma is a tumor of / recapitulating (A) brown fat (B) hair (bear fur thickens when they hibernate) (C) notochord (D) primitive mesenchyma (E) skeletal muscle 40. If you were to biopsy acanthosis nigricans, it would most closely resemble (A) common freckle (B) common lentigo (C) common nevus (D) lentigo maligna (melanoma in situ) (E) seborrheic keratosis 41. Osgood-Schlatter's will affect which bone? (A) femur (B) first metatarsal (C) patella (D) talus (E) tibia 42. Rheumatoid factor comes from (A) hepatocytes (B) lymphocytes (C) plasma cells (D) synovial cells (E) the pharmacy 43. The physical properties of synovial fluid which account for the "clot" and "string" tests result primarily from the presence of (A) complement components (B) dermatan sulfate (C) hyaluronic acid (D) neutrophils (E) rheumatoid factor 44. Which is LEAST LIKELY to lead to osteoarthritis? (A) alkaptonuria (B) obesity (C) iron overload (D) running with the track team (E) operating a jack hammer 45. Which usually starts in the diaphysis? (A) chondrosarcoma (B) enchondroma (C) osteoclastoma (giant cell tumor) (D) osteoid osteoma (E) osteosarcoma Skin pathology personalities. Use each choice exactly once. (A) Breslow (B) Clark (C) Hutchinson (D) Koebner (E) Spitz 46. described a children's lesion that looks microscopically like melanoma, but isn't 47. described the lentigo maligna freckle 48. noticed that some skin diseases already present elsewhere pop up in sites that are scratched 49. prognosticated melanomas by their actual thickness in millimeters 50. prognosticated melanomas by their depth of invasion Skin histopathology. Use each choice exactly once. A. bacterial infection of the epidermis B. edema and acute inflammation through the epidermis C. groups of polys in both lower epidermis and scale, with elongation of the rete pegs and dermal papillae D. lymphocytes along the basal layer, which shows hydropic change E. lymphocytes attacking epidermis; lymphocytic vasculitis 51. eczema 52. erythema multiforme 53. impetigo 54. lichen planus 55. psoriasis Skin semi-diseases. Use each choice exactly once. (A) common ichthyosis (B) ephelide (C) erythema nodosum (D) pompholyx (E) tinea versicolor 56. Freckle 57. Infectious disease 58. Mutated filaggrin, skin cells shed too late 59. One of a very few diseases of subcutaneous fat 60. Palms and soles Brain tumor. Use each choice exactly once. (A) ependymoma (B) glioblastoma (C) medulloblastoma (D) meningioma (E) oligodendroglioma 61. Calcifications and fried egg cells 62. Highly malignant; palisades and necrosis 63. Rosettes and pseudo-rosettes; on the walls of the ventricles 64. Spreads along the outer surfaces of brain and cord; small blue cells 65. Usually benign 66. ONE KODACHROME. The most likely micro-organism if this were a healthy 19-year-old man (A) E. coli (B) gonococcus (C) meningococcus (D) pneumococcus (E) strep B 67. TWO KODACHROMES. Muscle. The most likely diagnosis is (A) denervation atrophy (B) mitochondrial myopathy (C) muscular dystrophy (D) polymyositis (E) trichinosis 68. ONE KODACHROME. Leg tumor. Your best diagnosis? (A) chondrosarcoma (B) Ewing's sarcoma (C) malignant fibrous histiocytoma (D) osteoid osteoma (E) osteosarcoma 69. ONE KODACHROME. Brain. (A) astrocytoma (B) fresh (few days) ischemic injury (C) multiple sclerosis (D) old ischemic injury (E) tuberous sclerosis 70. ONE KODACHROME. Cauda equina. What's wrong? (A) ependymoma (B) meningitis (C) neurofibromatosis (D) sacrococcygeal teratoma (E) no pathology 71. ONE KODACHROME. He has (A) acne (B) lichen planus (C) pityriasis rosea (D) psoriasis (E) zoster 72. ONE KODACHROME. Skin (A) acanthosis nigricans (B) actinic keratosis (C) melanoma (D) seborrheic keratosis (E) squamous carcinoma 73. ONE KODACHROME. He neglected his (A) basal cell carcinoma (B) glioblastoma (C) melanoma (D) ringworm (E) squamous cell carcinoma 74. ONE KODACHROME. Bone. What is wrong? (A) hyperparathyroidism (B) osteomalacia (C) osteoporosis (D) osteopetrosis (E) osteosarcoma 75. TWO KODACHROMES. Even without checking for Auspitz's sign, there's no mistaking this elbow lesion. What is it? (A) gout (B) pemphigus (C) psoriasis (D) rheumatoid nodule (E) vitiligo 76. ONE KODACHROME. Muscle trichrome. What's your diagnosis? (A) denervation atrophy (B) mitochondrial myopathy (C) muscular dystrophy (D) nemaline myopathy (E) trichinosis 77. ONE KODACHROME. Skin photomicrograph. What's your best diagnosis? (A) basal cell carcinoma (B) dermatofibroma (C) erythema multiforme (D) seborrheic keratosis (E) squamous cell carcinoma 78. ONE KODACHROME. Copper wires mean (A) hypertensive arteriolar sclerosis (B) glaucoma (C) papilledema (D) retinoblastoma (E) Wilson's 79. ONE KODACHROME. Brian. (A) Alzheimer's (B) astrocytoma (C) Huntington's (D) Pick's (E) tuberous sclerosis 80. ONE KODACHROME. Skin (A) dermatofibroma (B) melanoma (C) psoriasis (D) squamous cell carcinoma (E) vasculitis 81. ONE KODACHROME. Brain. One photo. (A) basilar artery atherosclerosis with thrombus (B) berry aneurysm, intact (C) berry aneurysm, ruptured (D) central pontine myelinolysis (E) Duret hemorrhage from herniation 82. ONE KODACHROME. Muscle. (A) denervation atrophy (B) muscular dystrophy (C) nemaline myopathy (D) liposarcoma (E) rhabdomyosarcoma 83. ONE KODACHROME. Substantia nigra. (A) Lafora body (B) Lewy body (C) Marischino body (D) Negri body (E) Pick body 84. ONE KODACHROME. The "cartwheel" (storiform) pattern proclaims this a (A) malignant fibrous histiocytoma (B) nodule of erythema nodosum (C) osteosarcoma (D) spindle cell lipoma (E) synovial sarcoma 85. ONE KODACHROME. The result of bleeding from (A) berry aneurysm (B) little veins (C) lenticulostriate artery (D) middle meningeal artery (E) shigella infection 86. TWO KODACHROMES. Brain. Your best diagnosis? (A) astrocytoma (B) atrophy consistent with Alzheimer's (C) infarct (D) metastases, consistent with lung cancer origin (E) tuberous sclerosis 87. ONE KODACHROME. Look carefully. (A) diffuse hypoxic injury (B) epidural hematoma (C) hemorrhagic infarct (D) meningioma (E) ruptured berry aneurysm 88. TWO KODACHROMES. Brain. What's you diagnosis? (A) Alzheimer's (B) Huntington's (C) Pick's (D) prion disease (E) neurofibromatosis 89. ONE KODACHROME. This strong PAS positivity is characteristic for this (A) dermatofibroma (B) Ewing's sarcoma (C) medullary breast cancer (D) medulloblastoma (E) retinoblastoma 90. TWO KODACHROMES. Patient and muscle biopsy. Probably (A) Down's, with normal muscle (B) muscular dystrophy (C) nemaline myopathy (D) polymyositis (E) Werdnig-Hoffman spinal atrophy 91. ONE KODACHROME. Bone lesion. Your best diagnosis? (A) fibrous dysplasia (B) osteoclastoma / giant cell tumor (C) osteosarcoma (D) Paget's (E) no pathology 92. ONE KODACHROME. What's the name for this pattern of breast cancer? (A) colloid / mucinous carcinoma (B) comedocarcinoma (C) lobular carcinoma in situ (D) medullary carcinoma (E) tubular carcinoma 93. ONE KODACHROME. Eye lesion (A) coloboma (B) detached retina (C) melanoma (D) pterygium (E) retinoblastoma 94. TWO KODACHROMES. Muscle lesions. What's the problem? (A) muscular dystrophy (B) nemaline myopathy (C) nerve disease (D) polymyositis (E) no pathology 95. ONE KODACHROME. Skull lesion. Patient most likely has (A) meningioma (B) osteopetrosis (C) Paget's (D) plasma cell myeloma (E) spherocytosis 96. THREE KODACHROMES. Brain. The last is a Luxol Fast Blue. What's the diagnosis? (A) glioblastoma (B) infarct, old (C) multiple sclerosis (D) neurosyphilis (E) tuberous sclerosis 97. TWO KODACHROMES. Brain. What's the diagnosis? (A) glioblastoma (B) metastatic oat cell carcinoma (C) neurofibroma (D) oligodendroglioma (E) schwannoma 98. ONE KODACHROME. Patient photo (A) ankylosing spondylitis (B) neurofibromatosis (C) osteogenesis imperfecta (D) Paget's (E) rheumatoid arthritis 99. ONE KODACHROME. What's the name given to this growth pattern of breast cancer? (A) comedo (B) medullary (C) mucinous / colloid (D) papillary (E) scirrhous 100. ONE KODACHROME. What's happening in the muscle? (A) Duchenne's dystrophy (B) nerve injury and regeneration (C) nerve injury without reinnervation (D) myotonic dystrophy (E) trichinosis BONUS ITEMS: 101. ONE KODACHROME. Brain. What's wrong? [no corpus callosum] 102. What is a desmoid? [2 of 3 ... fibrous, tumor, non-metastasizing / locally invasive] 103. Where is a pilonidal cyst located? [lower back / over sacrum] 104. A volcano-shaped, very rapidly-erupting squamous lesion, with a central keratin plug, is probably what benign lesion? [keratoacanthoma] 105. What infection produces the infamous "dendritic", tree- branching ulcers on the cornea? Be specific. [herpes simplex; no credit for just herpes] 106. What is pannus? [I need hyperplasia/inflamed, synovium, and rheumatoid arthritis] 107. What is Pott's disease? [TB of the spine] 108. A favorite piece of trivia that might save a life. A calcified pinna should make you think of [Addisonism] 109. What's the big long name for a troublesome epidermoid cyst of the middle ear? [cholesteatoma] 110. ONE KODACHROME. Why is this man smiling? [+1 for any correct answer] Name: _________ UHS PATHOLOGY 1998-1999 Exam V Part I Instructions: Usual rules. When you have finished this exam, hand it in and get out your copy of "The Right Test", or borrow a copy that an instructor has noted to be unmarked. Then take Part II Good Luck!