NAME: ___________________ 100 points University of Health Sciences Pathology Exam I -- 1997-8 INSTRUCTIONS: For the multiple choice items, choose the one best answer. There are a few type-K questions from Quizbank. For the matching items, use each choice exactly once. For the fill-in-the-blank items, we're prefer that you use ink. Think before you write. If there is evidence of erasure, we cannot reconsider the scoring of a contested item. If you have a question, raise you hand and I'll get with you. Please do not phonate. The first person finished posts the key. Posting the key does NOT constitute giving you your grade. Write your challenges on it. You are also allowed to follow the standard procedure (see Bryan or me for a challenge form) -- but why wait? This exam is not intended to be especially difficult. Be prepared for somewhat more challenging exams in the future. GOOD LUCK! 36. Most solitary birthmarks probably result, at least in large part, from anti-oncogene deletion syndromes inherited mutations of proto-oncogenes * mutations in one cell of the embryo physical injury to the body-part while in the uterus a transcultural ethic based on moderate realism 37. Which is LEAST LIKELY to happen in apoptosis? * the cell dissolves into liquid the cell is phagocytized the cell's proteins get cross-linked the DNA is severed at the nucleosomes the nucleus undergoes pyknosis 38. Which is LEAST LIKELY to exhibit significant hyperplasia? * a successful aerobic athlete's heart bone marrow during a bad post-surgical bacterial infection bone marrow following a blood donation endocrine cells bearing a mutation promoting cell division thyroid gland in iodine deficiency 39. Which is NOT true of leukotriene B4? arachidonic acid metabolite chemotactic for neutrophils makes vessels permeable to albumin * opsonizes bacteria promotes neutrophil adherence to endothelium 40. You've just been resuscitated from three hours of bad shock. Which is LEAST LIKELY to exist inside of you right now? centrilobular hepatic necrosis contraction bands in your subendocardium lipid-depleted adrenal cortex * shock lung shock kidney Patterns of necrosis A. caseous necrosis B. coagulation necrosis C. fibrinoid necrosis D. liquefaction necrosis E. no necrosis 41. heart attack, day 4 [B] 42. sudden cardiac death [E] 43. polyarteritis, vessel wall [C] 44. pus, gas gangrene, brain infarct [D] 45. tuberculosis [A] The many faces of "hyaline" A. beta-pleated anything B. intranuclear on Tzanck prep C. keloid D. Russell body E. walls of small arteries, hypertension and diabetes 46. amyloid [A] 47. basement membrane [E] 48. collagen [C] 49. herpes virus [B] 50. immunoglobulin [D] A. angioedema B. ataxia-telangiectasia C. Chediak-Higashi D. chronic granulomatous disease E. Wiscott-Aldrich 51. extra sensitivity to x-ray therapy [B] 52. lack of C1 esterase inhibitor [A] 53. lack of CD43 on all leukocytes, eczema and virus infections [E] 54. neutrophils with multi-problem membrane defect [C] 55. neutrophils cannot make peroxide [D] AIDS molecules A. CD4 B. CKR-5 C. gp120 D. gp51 (reverse transcriptase) E. nef 56. binds to T-cells; neurotoxin [C] 57. damaged in the non-progressive strain of HIV [E] 58. people who lack this cannot get AIDS [B] 59. primary receptor for HIV, characteristic of T-cells [A] 60. target for zidovudine (AZT) therapy [D] Those recessive diseases are easy to write questions about.... A. alkaptonuria B. Gaucher's C. McArdle's D. Niemann-Pick E. Tay-Sachs 61. glucocerebroside, adults with pathological fractures [B] 62. ganglioside, red spot in eye, blindness [E] 63. homogentisic acid, black bad cartilages [A] 64. poor athletes, glycogen under sarcolemma [C] 65. sphingomyelin, zebras on electron microscopy [D] And so are those autosomal dominant diseases.... A. acute intermittent porphyria B. familial amyotrophic lateral sclerosis C. familial hypercholesterolemia D. Marfan's E. neurofibromatosis 66. anti-oncogene is deleted once, and a second hit causes tumors [E] 67. mutated protein generates free radicals [B] 68. shortage of fibrillin, an accessory protein for collagen and elastin [D] 69. shortage of a major enzyme [A] 70. shortage of an important receptor [C] 71. Which kind of blot visualizes DNA sequences? A. Eastern B. Northern C. Northwestern (wildcats) * D. Southern E. Western 72. People with multiple severe allergies are likely to have a mutant gene for the A. eosinophil basic protein B. IgE C. interleukin 5 (eosinophil turn-on juice) * D. mast cell IgE receptor E. T-cell hypersensitivity regulator 73. TWO KODACHROMES. The oil red O stain of this teen's aorta showcases the early lesions of atherosclerosis by staining A. collagen B. elastin C. collagen and elastin D. glycogen * E. lipid 74. TWO KODACHROMES. Both photomicrographs exhibit A. anaplasia * B. calcium deposition C. granulation tissue D. granuloma formation E. pus 75. ONE KODACHROME. Two kids with A. Apert's ("Mary Ann") B. Ehlers-Danlos C. Treacher-Collins's * D. Turner's E. Klinefelter's 76. ONE KODACHROME. Photomicrograph of bone. * A. healing fracture with cartilage callus B. hemorrhage C. pus ("osteomyelitis") D. tuberculosis E. vasculitis 77. ONE KODACHROME. Brain with vascular mass. The mass has always been there. It would be best considered to be a(n) A. abscess B. cyst * C. hamartoma D. hemorrhage E. tumor 78. TWO KODACHROMES. Brain. What's the lesion? A. abscess B. cancer C. hemorrhage D. liquefied infarct * E. tuberculosis 79. ONE KODACHROME. Heart. What's the diagnosis? A. atherosclerosis B. fatty change consistent with diphtheria * C. fatty ingrowth D. fat necrosis, either enzymatic or not E. vasculitis 80. ONE KODACHROME. This is probably A. cleft lip (polygenic inheritance) * B. noma C. gas gangrene D. Treacher-Collins E. tuberculosis 81. ONE KODACHROME. Photomicrograph showing A. anaplasia B. acute inflammation without necrosis * C. chronic inflammation D. infarct without inflammation E. pus 82. ONE KODACHROME. Spleen with A. abscesses B. amyloid ("sago spleen") C. amyloid ("lardaceous spleen") D. hemorrhages * E. infarcts 83. TWO KODACHROMES. Brain with A. abscess B. Alzheimer's atrophy C. hemorrhage D. recent infarct (1 day) * E. old infarct (1 year) 84. ONE KODACHROME. Splenic vein with A. amyloid in its wall * B. ante-mortem thrombus C. nearby pancreatic enzymatic fat necrosis D. post-mortem thrombus E. Wegener's granulomatosis 85. ONE KODACHROME. Five year old girl with A. Angelman's * B. McCune-Albright C. Tuberous sclerosis D. Treacher-Collins E. Waardenburg's 86. ONE KODACHROME. Artery with A. atheroembolus B. fibrinoid necrosis * C. intimal hyperplasia D. medial hyperplasia / hypertrophy E. multi-channel recanalized thrombus 87. ONE KODACHROME. Heart from a patient with A. diphtheria B. infarct, fresh (3-10 days) C. infarct, old (1 year) D. iron overload (hemochromatosis) * E. severe anemia 88. TWO KODACHROMES. You suspect... A. Duchenne's * B. Ehlers-Danlos C. Iron overload D. Pompe's E. Shy-Drager 89. ONE KODACHROME. Photograph of pancreas, with A. abscess formation B. amyloid deposition C. atrophy * D. fat necrosis E. hemorrhage (petechial) 90. ONE KODACHROME. Joel showing off his muscular A. anaplasia B. dysplasia C. hyperplasia * D. hypertrophy E. metaplasia 91. ONE KODACHROME. Blood. At the center.... * A. basophil B. eosinophil C. lymphocyte D. monocyte E. neutrophil 92. ONE KODACHROME. Heart with A. abscess B. brown atrophy C. fresh infarct * D. mural thrombus E. vegetations 93. ONE KODACHROME. Heart. Which pigment? A. bilirubin B. carotene C. hemosiderin * D. lipofuscin E. melanin 94. ONE KODACHROME. Why is it particularly difficult to infarct the liver? A. bad things almost never happen to the portal vein * B. it has a dual blood supply C. it needs almost no oxygen D. it is a perfusion priority, even in severe shock E. its name means "the organ that lives" so it cannot be killed 95. ONE KODACHROME. Colon. What's the diagnosis? A. abscess B. melanosis coli * C. pseudomembrane D. transmural infarct E. normal colon, I am so tricky 96. ONE KODACHROME. My best picture of a(n) A. buccal smear from a XXX female B. healthy smear of blood * C. positive LE-cell (lupus) preparation D. positive acid-fast tuberculosis smear E. sarcoid-type (non-caseating) granuloma 97. ONE KODACHROME. Photomicrograph, site unknown. You suspect A. amyloidosis; let's get a Congo Red B. cancer, because of anaplasia C. gonorrhea or another pus-producing infection D. infarct * E. tuberculosis or histoplasmosis 98. ONE KODACHROME. Young adult with probable * A. Klinefelter's B. male pseudohermaphroditism C. mafanism D. Turner's E. XYY 99. ONE KODACHROME. Brain with... * A. atrophy B. fresh infarct (1 day) C. meningitis D. old infarct (1 year) E. trisomy 13 100. ONE KODACHROME. To prove it is melanin, treat it with A. acid-fast stain of your choice * B. peroxide hair bleach C. Prussian blue D. tender loving care E. thioflavin T BONUS ITEMS 101. What does the fas gene product do on a cell's surface? [apoptosis trigger] 102. What does catalase do for us? [turns hydrogen peroxide into oxygen and water] 103. What is rufous albinism? [red hair, red skin / lots and lots of pheomelanin /] [redheads from very dark-skinned families] 104. Giant mitochondria in the liver warn of what pathological disease process condition entity state? [alcohol drinking] 105. What's the usual cause of high serum phosphate levels? [kidney failure] 106. "Chronic granulomatous disease" patients (i.e., those with the hereditary neutrophil defect) have the greatest difficulty handing which bacterium? [staphylococcus] 107. If you've got a "stabbing pain", but you haven't really been stabbed, what part of your body is probably irritated? [serosal membrane / pleura, pericardium, peritoneum] 108. What is a paradoxical embolus? [systemic veins to systemic arteries] 109. Autoantibodies in Lyme disease, an example of molecular mimicry, attack what part of your body? [axon, accept nerve] 110. In historic "serum sickness", what was the antigenic species? [horse] 111. And what's the AUTO-antigen in dermatitis herpetiformis / celiac sprue? [reticulin; "wheat / gluten " is wrong] 112. What's the name of the disease in which the people are light-skinned, have hypogonadism and epicanthic folds, steal and hide jelly donuts, and get very angry when you padlock the refrigerator? [Prader-Willi] 113. What is pus? [must include "neutrophils" and "necrosis"] 114. Autoantibodies against transfer RNA synthetase produces a subtype of which well-characterized disease? [polymyositis / allow dermatomyositis] 115. Hereditary deficiency of C2 most closely resembles which well-characterized disease? [lupus] 116. What is proteinase 3? [anything about neutrophils or Wegener's autoantigen] 117. What is argyria? [silver salt pigmentation] 118. What is riluzone? [drug slows neuron loss from glutamate excitotoxicity] 119. How is lyonization used to establish clonality? [same X inactivated in all of a cell's descendants; when heterozygous, all cells in clone have same phenotype] 120. ONE KODACHROME. Why is this man smiling? [toothless albino banjo player with splenomeg-li-a,] [+1 for any reasonable answer]