36. Pathologists detest this colonic lesion, because it is harder to find at autopsy than during life. A. ameboma * B. angiodysplasia C. diverticulitis D. Hirschsprung's E. juvenile polyp 37. "Backwash ileitis" is a notable feature of A. acute appendicitis B. amebiasis C. cancer of the cecum D. Crohn's regional enteritis * E. ulcerative colitis 38. Necrotizing enterocolitis is a life-threatening problem of A. amebiasis patients B. patients on antibiotics * C. premature babies D. poorly nourished people E. ulcerative colitis patients ("toxic megacolon") 39. Hyaline spheres of widely-varying sizes, PAS-positive, and on electron microscopy consisting of protein in dilated endoplasmic reticulum cisterns, indicates: A. alcoholism * B. antitrypsin deficiency C. apoptosis D. primary biliary cirrhosis E. Reye's syndrome 40. Patients with idiopathic sclerosing cholangitis often suffer as well from A. autosomal dominant polycystic kidneys B. Crohn's disease C. primary biliary cirrhosis * D. ulcerative colitis E. the other HLA-B27 family of diseases 41. So often mutated in pancreatic cancer that it's become a signature used in diagnosis... * A. k-ras B. L-myc C. fos D. NF-1 E. jun 42. Most "maturity onset diabetes of the young" patients have mutant A. amylin * B. glucokinase C. glutamic acid decarboxylase D. phosphofructokinase E. transglutaminase 43. Which is least likely to invade veins directly? A. follicular thyroid cancer B. hepatocellular carcinoma * C. papillary thyroid cancer D. renal cell carcinoma E. sarcoma of the perirenal tissue 44. Autoimmunity is NOT much implicated in A. Graves's thyroiditis B. Hashimoto's thyroiditis C. "idiopathic" addisonism D. type I diabetes * E. type II diabetes 45. Microaneurysms of the retina are most typical of A. cryoglobulinemia * B. diabetes C. high blood pressure D. plasma cell myeloma E. Wegener's 46. What causes most diverticula of the bladder? A. birth defects B. constipation / low roughage diet C. longstanding infection * D. obstruction E. stones from any cause 47. Which is NOT a known risk factor for bladder cancer? A. aniline dye worker * B. asbestos exposure C. cigaret smoking D. cyclophosphamide therapy E. phenacetin use 48. Patients with minimal change disease are LEAST LIKELY to have A. edema * B. hematuria C. heavy proteinuria D. high blood cholesterol E. low blood albumin 49. The most common reason that the juxtaglomerular apparatus fails to produce renin as it should is A. anatomic birth defect B. biochemical birth defect * C. diabetes D. nephrotic syndrome E. reninoma (hemangiopericytoma) elsewhere 50. Most metastases to the adrenal gland come from a primary cancer in the A. breast or prostate B. kidney C. liver * D. lung E. opposite adrenal gland 51. The combination of autoimmune addisonism and Hashimoto-type thyroid disease is called: A. Jack Kennedy's disease * B. Schmidt's syndrome C. Simmonds's disease D. Sipple's disease E. Wermer's syndrome 52. Which portion of the nephron is most severely affected by lithium toxicity? A. afferent arteriole * B. collecting duct C. glomerulus D. loop of Henle E. proximal tubule, because it is the most metabolically active 53. What's the normal weight of a young adult man's prostate? A. 5 gm B. 10 gm * C. 20 gm D. 50 gm E. 100 gm 54. At surgery, the testicular lesion proved to be soft, with a pushing border, and homogeneous very-pale-yellow / cream colored. It's probably what? A. choriocarcinoma B. embryonal cell carcinoma C. tuberculosis * D. seminoma E. syphilis 55. Usual infectious agent in Reiter's: * A. chlamydia B. gonococcus C. mycoplasma / ureaplasma D. papillomavirus E. tuberculosis 56. Testicular tumors recapitulating which cell are least likely to be malignant? A. embryonic tissue * B. Leydig cell C. spermatocyte D. trophoblast E. yolk sac 57. ONE KODACHROME. Man's abdomen. Suspect... A. Addisonism B. Crohn's * C. Cushingism D. hyperparathyroidism E. ulcerative colitis 58. ONE KODACHROME. Gallstones made mostly of A. bilirubin * B. cholesterol C. cysteine D. uric acid E. 2,4-dinitrophenol 59. ONE KODACHROME. Pancreas. What's the diagnosis? * A. alcohol effect B. cancer C. cystic fibrosis D. cytomegalovirus E. insulinoma 60. ONE KODACHROME. What nutrient is clearly deficient? A. folic acid B. chromium * C. iodine D. selenium E. vitamin A 61. ONE KODACHROME. Liver. What is the diagnosis? * A. Budd-Chiari B. hepatocellular carcinoma C. cholangiocarcinoma D. liver flukes E. no pathology 62. TWO KODACHROMES. A man and his liver. What's amiss? A. acute hepatitis, probably viral B. acute necrosis * C. alcoholism D. Budd-Chiari E. iron overload 63. ONE KODACHROME. Pancreas. Your best diagnosis? A. acute alcoholic pancreatitis * B. cancer C. chronic pancreatitis with protein plugs D. cystic fibrosis E. normal pancreas 64. TWO KODACHROMES. Thyroid. Your best diagnosis, please A. DeQuervain's B. Graves's * C. Hashimoto's D. Quasimodo's E. Reidel's 65. TWO KODACHROMES. At autopsy, you'd be likely to find a A. adrenal adenoma B. pituitary adenoma * C. parathyroid adenoma D. pheochromocytoma E. thyroid mass 66. ONE KODACHROME. Adrenal. What's the diagnosis? A. cortical adenoma B. hyperplasia from a Cushing's pituitary adenoma * C. neuroblastoma D. metastatic oat cell carcinoma E. pheochromocytoma 67. ONE KODACHROME. Cirrhosis most likely due to A. alcohol abuse * B. old viral disease C. primary biliary cirrhosis D. uh, this is normal liver E. uh, this isn't cirrhosis, it's a liver abscess 68. ONE KODACHROME. The patient has * A. ascariasis B. bowel infarct C. Crohn's regional enteritis D. lupus (wire loops) E. ulcerative colitis 69. ONE KODACHROME. Kidney. The patient has A. acute pyelonephritis B. chronic pyelonephritis with thyroidization * C. nephritic syndrome D. nephrotic syndrome E. plasma cell myeloma 70. ONE KODACHROME. Kidney. Suspicious for... A. diabetes B. reflux and recurrent pyelonephritis C. phenacetin abuse D. polyarteritis nodosa * E. scleroderma or hemolytic-uremic syndrome 71. ONE KODACHROME. Prostate * A. adenocarcinoma B. hyperplasia C. squamous metaplasia D. transitional cell carcinoma E. tuberculosis 72. TWO KODACHROMES. Glomeruli. Probably.... A. diffuse proliferative post-streptococcal disease B. focal-segmental glomerulosclerosis C. high blood pressure D. membranous glomerulopathy * E. Wegener's 73. ONE KODACHROME. Pancreatic island. Your diagnosis? A. type I diabetes * B. type II diabetes C. normal 74. THREE KODACHROMES. Glomerular disease. Which one? A. diffuse proliferative glomerulonephritis B. focal-segmental glomerulosclerosis * C. membranous glomerulopathy D. mesangioproliferative glomerulonephritis, perhaps IgA E. Wegener's 75. ONE KODACHROME. Kaiser-Fleischer rings of A. bacterial endocarditis B. hemochromatosis C. lupus D. tram-track nephropathy * E. Wilson's disease 76. ONE KODACHROME. Thyroid. What is your diagnosis? A. DeQuervain's B. follicular carcinoma C. Graves' D. Hashimoto's * E. uh, this is normal thyroid 77. ONE KODACHROME. IgG immunofluorescence in glomerular disease. Probably this is A. dense deposit disease * B. Goodpasture's disease C. IgA nephropathy D. post-streptococcal glomerulonephritis E. Wegener's 78. ONE KODACHROME. Liver. What's wrong? A. acute viral hepatitis B. angiosarcoma C. cholangiocarcinoma D. hepatocellular carcinoma * E. primary biliary cirrhosis 79. ONE KODACHROME. Bladder. What's your diagnosis? * A. cancer, transitional-cell type B. hypertrophy consistent with prostatism C. interstitial cystitis D. malakoplakia E. schistosomiasis, no cancer 80. TWO KODACHROMES. Abdomen. Your best diagnosis. A. autosomal dominant polycystic kidney disease * B. autosomal recessive polycystic kidney disease C. cystic renal dysplasia D. neuroblastoma E. Wilms tumor 81. ONE KODACHROME. Liver. The most likely choice is A. acute viral hepatitis * B. alcoholic cirrhosis C. chronic active hepatitis D. echinococcus, these are little cysts E. hepatocellular carcinoma 82. TWO KODACHROMES. Thyroid lesion. What's wrong? A. DeQuervain's disease B. Graves' disease C. Hashimoto's disease * D. papillary carcinoma E. radiation effect 83. TWO KODACHROMES. Ovarian tumor. What's your diagnosis? A. dermoid cyst (benign teratoma) B. mucinous cystadenoma C. serous cystadenocarcinoma D. Sertoli-Leydig tumor E. thecoma 84. TWO KODACHROMES. To assess the malignant potential of a uterine smooth muscle tumor, we look mostly at * A. count of mitotic figures B. N/C ratio C. necrosis D. nuclear variability E. vascular invasion 85. ONE KODACHROME. What is the diagnosis? * A. acanthosis nigricans B. HPV infection C. lichen sclerosus D. malignant melanoma E. squamous carcinoma of the vulva 86. TWO KODACHROMES. What did this mass turn out to be? * A. adenocarcinoma B. Crohn's regional enteritis C. hemorrhoid D. squamous cancer E. wart 87. TWO KODACHROMES. Kidney. What's wrong? A. diabetic glomerulosclerosis, diffuse only B. diabetic glomerulosclerosis, nodular * C. membranoproliferative glomerulonephritis D. mesangioproliferative glomerulonephritis, maybe IgA E. uh, these glomeruli are normal 88. TWO KODACHROMES. Just on the histology, the kidney probably has A. diabetes * B. focal-segmental glomerulosclerosis C. membranous glomerulopathy D. minimal-change disease E. post-streptococcal glomerulonephritis 89. ONE KODACHROME. Thyroid. Family history of pheochromocytoma. Your best call? A. benign thyroid adenoma B. follicular carcinoma * C. medullary carcinoma D. papillary carcinoma E. parathyroid adenoma arising within the thyroid gland 90. THREE KODACHROMES. Your best diagnosis? A. acute viral hepatitis * B. chronic active hepatitis C. chronic persistent hepatitis D. hepatocellular carcinoma E. primary biliary cirrhosis 91. ONE KODACHROME. Kidney. A. acute pyelonephritis * B. benign high blood pressure C. malignant hypertension D. polyarteritis nodosa / Henoch-Schonlein E. uh, this is ureter... 92. TWO KODACHROMES. What does he have? A. adenocarcinoma consistent with urethral gland primary B. chlamydia * C. gonorrhea D. papillomavirus infection E. squamous cancer 93. TWO KODACHROMES. Kidney. * A. acute pyelonephritis B. acute tubular necrosis C. lead poisoning D. renal cell carcinoma E. transitional cell carcinoma 94. TWO KODACHROMES. Ovarian tumor. A. arrhenoblastoma (Sertoli-Leydig) B. choriocarcinoma C. dysgerminoma * D. mucinous cystadenocarcinoma E. serous cystadenocarcinoma 95. TWO KODACHROMES. Endometrial biopsy. A. normal * B. atypical hyperplasia C. benign endometrial polyp D. choriocarcinoma E. mixed mullerian tumor 96. ONE KODACHROME. Try your skill at reading this pap smear. A. candida * B. carcinoma C. gardnerella D. trichomonas E. normal 97. ONE KODACHROME. Ovarian tumor. A. Choriocarcinoma B. Dysgerminoma * C. Granulosa cell tumor D. Mucinous cystadenoma E. Serous cystadenocarcinoma 98. THREE KODACHROMES. Ovarian cancer. A. Granulosa cell tumor B. Krukenberg tumor C. Mucinous cystadenocarcinoma * D. Serous cystadenocarcinoma E. Uh, this is just a dermoid cyst, not cancer. 99. TWO KODACHROMES. Genital infections. * A. Candida B. Herpes C. Papilloma virus D. Trichomonas E. Uh, these are both cancer 100. TWO KODACHROMES. Liver. Your best diagnosis, please. A. Acetaminophen overdose with Councilman body * B. Acute viral hepatitis C. Alcoholic hepatitis D. Cholangiocarcinoma E. Hepatocellular carcinoma BONUS: 101. What is the difference between a diverticulum and a pseudodiverticulum? [true has all wall layers] 102. What is a median bar? [big middle prostate lobe] 103. What is "Plummer's disease"? [thyrotoxicosis from a hot adenoma or nodular goiter, either's fine] 104. Gleason's grading system was intended for cancer of what organ? [prostate] 105. What is asterixis? [liver flap] 106. What serious disease has the same locus as Gilbert's? Name either the eponym or the enzyme! [Gilbert's] 107. Why will a patient with acute hemorrhagic pancreatitis be likely to develop hypocalcemia? [fat necrosis, calcium precipitates] 108. What amino acid forms certain kidney stones when the kidney cannot retain it properly? [cysteine] 109. What is "Trousseau's (other) sign" in cancer of the pancreas? [thrombophlebitis is sufficient] 110. What's a "Klatskin tumor"? [at junction of hepatic ducts] 111. Exposure to what industrial poison is a notable cause of prostate cancer? [cadmium] 112. "Pinealoma" is an old name for a pineal tumor which mimics which testicular tumor? [pinealoma] 113. What abnormality are you most likely to see on histologic section of a thyroid gland from a child with trisomy 21? [I need "lymphocytes"] 114. Why does 11-hydroxylase deficiency cause extra male hormones to be produced? [mass action, any sensible explanation] 115. Which drug, from the penicillin family, is an infamous cause of interstitial nephritis? [methicillin] 116. Why do men with prostatism often have some blood in the urine as a result? [stretched veins in distended bladder] 117. What is epispadias? [urethra opens on dorsum of penis] 118. ONE KODACHROME. Colon tumor. Your best diagnosis, please? [carcinoid] 119. TWO KODACHROMES. What is your best diagnosis? [craniopharyngioma] 120. ONE KODACHROME. Why is this man smiling? [6 path lectures in a week, +1 any correct answer]