Question NO 21
A 49-year-old man develops an acute myocardial infarction because of
the sudden occlusion of the left anterior descending coronary artery. The
areas of myocardial necrosis within the ventricle can best be described as
a. Coagulative necrosis
b. Liquefactive necrosis
c. Fat necrosis
d. Caseous necrosis
e. Fibrinoid necrosis
Showing posts with label USMLE Step 1. Show all posts
Showing posts with label USMLE Step 1. Show all posts
Binding to Fas ligand (CD95L), Fas (CD95) self-associates
Question NO 20
After binding to Fas ligand (CD95L), Fas (CD95) self-associates and
activates Fas-associated death domain protein (FADD), which in turn
induces apoptosis by stimulating
a. bcl-2
b. Caspase 8
c. Cytochrome a3
d. Cytochrome p450
e. Elastase 6
After binding to Fas ligand (CD95L), Fas (CD95) self-associates and
activates Fas-associated death domain protein (FADD), which in turn
induces apoptosis by stimulating
a. bcl-2
b. Caspase 8
c. Cytochrome a3
d. Cytochrome p450
e. Elastase 6
A 38-year-old female presents with intermittent pelvic pain
Question NO 19
A 38-year-old female presents with intermittent pelvic pain. Physical
examination reveals a 3-cm mass in the area of her right ovary. Histologic
sections from this ovarian mass reveal a papillary tumor with multiple,
scattered small, round, laminated calcifications. These structures are most
likely the result of
a. Apoptosis
b. Dystrophic calcification
c. Enzymatic necrosis
d. Hyperparathyroidism
e. Metastatic calcification
A 38-year-old female presents with intermittent pelvic pain. Physical
examination reveals a 3-cm mass in the area of her right ovary. Histologic
sections from this ovarian mass reveal a papillary tumor with multiple,
scattered small, round, laminated calcifications. These structures are most
likely the result of
a. Apoptosis
b. Dystrophic calcification
c. Enzymatic necrosis
d. Hyperparathyroidism
e. Metastatic calcification
A 48-year-old male presents with signs of alcoholic hepatitis
Question NO 18
A 48-year-old male who has a long history of excessive drinking presents
with signs of alcoholic hepatitis. Microscopic examination of a biopsy
of this patient’s liver reveals irregular eosinophilic hyaline inclusions within
the cytoplasm of the hepatocytes. These eosinophilic inclusions are composed
of
a. Immunoglobulin
b. Excess plasma proteins
c. Prekeratin intermediate filaments
d. Basement membrane material
e. Lipofuscin
A 48-year-old male who has a long history of excessive drinking presents
with signs of alcoholic hepatitis. Microscopic examination of a biopsy
of this patient’s liver reveals irregular eosinophilic hyaline inclusions within
the cytoplasm of the hepatocytes. These eosinophilic inclusions are composed
of
a. Immunoglobulin
b. Excess plasma proteins
c. Prekeratin intermediate filaments
d. Basement membrane material
e. Lipofuscin
Microscopic associations concerning hepatocytes
Question NO 17
Which one of the following microscopic associations concerning
hepatocytes is correct?
a. Clear cytoplasmic material that is oil red O–negative but PAS-positive is most
likely to be cholesterol
b. Clear cytoplasmic material that is oil red O–positive but PAS-negative is most
likely to be lipofuscin
c. Clear nuclear material that is Prussian blue–positive is most likely to be hemosiderin
d. Yellow-brown granular cytoplasmic material that is Prussian blue–negative is
most likely to be bile
e. Yellow-brown granular cytoplasmic material that is Prussian blue–positive is
most likely to be melanin
Which one of the following microscopic associations concerning
hepatocytes is correct?
a. Clear cytoplasmic material that is oil red O–negative but PAS-positive is most
likely to be cholesterol
b. Clear cytoplasmic material that is oil red O–positive but PAS-negative is most
likely to be lipofuscin
c. Clear nuclear material that is Prussian blue–positive is most likely to be hemosiderin
d. Yellow-brown granular cytoplasmic material that is Prussian blue–negative is
most likely to be bile
e. Yellow-brown granular cytoplasmic material that is Prussian blue–positive is
most likely to be melanin
A 54-year-old male develops a thrombus in his left anterior descending coronary artery
Question No 16
A 54-year-old male develops a thrombus in his left anterior descending
coronary artery. The area of myocardium supplied by this vessel is irreversibly
injured. The thrombus is destroyed by the infusion of
streptokinase, which is a plasminogen activator, and the injured area is
reperfused. The patient, however, develops an arrhythmia and dies. An
electron microscopic (EM) picture taken of the irreversibly injured
myocardium reveals the presence of large, dark, irregular amorphic densities
within mitochondria, which are referred to as
a. Apoptotic bodies
b. Flocculent densities
c. Myelin figures
d. Psammoma bodies
e. Russell bodies
A 54-year-old male develops a thrombus in his left anterior descending
coronary artery. The area of myocardium supplied by this vessel is irreversibly
injured. The thrombus is destroyed by the infusion of
streptokinase, which is a plasminogen activator, and the injured area is
reperfused. The patient, however, develops an arrhythmia and dies. An
electron microscopic (EM) picture taken of the irreversibly injured
myocardium reveals the presence of large, dark, irregular amorphic densities
within mitochondria, which are referred to as
a. Apoptotic bodies
b. Flocculent densities
c. Myelin figures
d. Psammoma bodies
e. Russell bodies
Use of broad-spectrum antibiotics
Question NO 15
The use of broad-spectrum antibiotics can produce a bleeding diathesis
characterized by hematomas, hematuria, melena, and bleeding from the
gums by decreasing the normal gut flora and inducing a deficiency of
a. Vitamin A
b. Vitamin B1
c. Vitamin B6
d. Vitamin C
e. Vitamin K
The use of broad-spectrum antibiotics can produce a bleeding diathesis
characterized by hematomas, hematuria, melena, and bleeding from the
gums by decreasing the normal gut flora and inducing a deficiency of
a. Vitamin A
b. Vitamin B1
c. Vitamin B6
d. Vitamin C
e. Vitamin K
A 39-year-old female develops shortness of breath and a low-grade fever
Question NO 14
Several days after exploring a cave in eastern Kentucky, a 39-year-old
female develops shortness of breath and a low-grade fever. Chest x-rays
reveal several irregular areas in both upper lung fields along with enlarged
hilar and mediastinal lymph nodes. A biopsy of one of these lymph nodes
reveals granulomatous inflammation. Multiple small yeasts surrounded by
clear zones are seen within macrophages. Which one of the following
organisms is most likely responsible for this individual’s disease?
a. Aspergillus species
b. Blastomyces dermatitidis
c. C. albicans
d. Histoplasma capsulatum
e. Mucor
Several days after exploring a cave in eastern Kentucky, a 39-year-old
female develops shortness of breath and a low-grade fever. Chest x-rays
reveal several irregular areas in both upper lung fields along with enlarged
hilar and mediastinal lymph nodes. A biopsy of one of these lymph nodes
reveals granulomatous inflammation. Multiple small yeasts surrounded by
clear zones are seen within macrophages. Which one of the following
organisms is most likely responsible for this individual’s disease?
a. Aspergillus species
b. Blastomyces dermatitidis
c. C. albicans
d. Histoplasma capsulatum
e. Mucor
A 22-year-old female presents with the sudden onset of a high fever
Question NO 13
A 22-year-old female presents with the sudden onset of a high fever, a
diffuse erythematous skin rash, and shock. She started menstruating at age
13 and for several years has used tampons. Which one of the following is
the most likely diagnosis for this individual’s illness?
a. Erysipelas caused by Streptococcus pyogenes
b. Fifth disease caused by human parvovirus B19
c. Scarlet fever caused by S. pyogenes
d. Secondary syphilis caused by Treponema pallidum
e. Toxic shock syndrome caused by Staphylococcus aureus
A 22-year-old female presents with the sudden onset of a high fever, a
diffuse erythematous skin rash, and shock. She started menstruating at age
13 and for several years has used tampons. Which one of the following is
the most likely diagnosis for this individual’s illness?
a. Erysipelas caused by Streptococcus pyogenes
b. Fifth disease caused by human parvovirus B19
c. Scarlet fever caused by S. pyogenes
d. Secondary syphilis caused by Treponema pallidum
e. Toxic shock syndrome caused by Staphylococcus aureus
A 59-year-old male is diagnosed as a moderately differentiated squamous cell carcinoma
Question NO 12
A 59-year-old male is found to have a 3.5-cm mass in the right upper
lobe of his lung. A biopsy of this mass is diagnosed as a moderately differentiated
squamous cell carcinoma. Workup reveals that no bone metastases
are present, but laboratory examination reveals that the man’s serum calcium
levels are 11.5 mg/dL. This patient’s paraneoplastic syndrome is most
likely the result of ectopic production of
a. Parathyroid hormone
b. Parathyroid hormone–related peptide
c. Calcitonin
d. Calcitonin-related peptide
e. Erythropoietin
A 59-year-old male is found to have a 3.5-cm mass in the right upper
lobe of his lung. A biopsy of this mass is diagnosed as a moderately differentiated
squamous cell carcinoma. Workup reveals that no bone metastases
are present, but laboratory examination reveals that the man’s serum calcium
levels are 11.5 mg/dL. This patient’s paraneoplastic syndrome is most
likely the result of ectopic production of
a. Parathyroid hormone
b. Parathyroid hormone–related peptide
c. Calcitonin
d. Calcitonin-related peptide
e. Erythropoietin
A 35-year-old male presents with increasing abdominal pain and jaundice
Question NO 11
A 35-year-old male living in a southern region of Africa presents with
increasing abdominal pain and jaundice. He has worked as a farmer for
many years, and sometimes his grain has become moldy. Physical examination
reveals a large mass involving the right side of his liver, and a biopsy
specimen from this mass confirms the diagnosis of liver cancer (hepatocellular
carcinoma). The pathogenesis of this tumor involves which of the following
substances?
a. Aflatoxin B1
b. Direct-acting alkylating agents
c. Vinyl chloride
d. Azo dyes
e. β-naphthylamine
A 35-year-old male living in a southern region of Africa presents with
increasing abdominal pain and jaundice. He has worked as a farmer for
many years, and sometimes his grain has become moldy. Physical examination
reveals a large mass involving the right side of his liver, and a biopsy
specimen from this mass confirms the diagnosis of liver cancer (hepatocellular
carcinoma). The pathogenesis of this tumor involves which of the following
substances?
a. Aflatoxin B1
b. Direct-acting alkylating agents
c. Vinyl chloride
d. Azo dyes
e. β-naphthylamine
An 8-month-old male infant with bacterial respiratory infection
Question NO 6
An 8-month-old male infant is admitted to the hospital because of a
bacterial respiratory infection. The infant responds to appropriate antibiotic
therapy, but is readmitted several weeks later because of severe otitis
media. Over the next several months, the infant is admitted to the hospital
multiple times for recurrent bacterial infections. Workup reveals extremely
low serum antibody levels. The infant has no previous history of viral or
fungal infections. The most likely diagnosis for this infant is
a. Isolated IgA deficiency
b. Chronic granulomatous disease
c. DiGeorge’s syndrome
d. Wiskott-Aldrich syndrome
e. X-linked agammaglobulinemia of Bruton
An 8-month-old male infant is admitted to the hospital because of a
bacterial respiratory infection. The infant responds to appropriate antibiotic
therapy, but is readmitted several weeks later because of severe otitis
media. Over the next several months, the infant is admitted to the hospital
multiple times for recurrent bacterial infections. Workup reveals extremely
low serum antibody levels. The infant has no previous history of viral or
fungal infections. The most likely diagnosis for this infant is
a. Isolated IgA deficiency
b. Chronic granulomatous disease
c. DiGeorge’s syndrome
d. Wiskott-Aldrich syndrome
e. X-linked agammaglobulinemia of Bruton
Sjögren’s syndrome
Question NO 5
A biopsy of an enlarged salivary gland from an individual with Sjögren’s
syndrome is most likely to histologically reveal an extensive infiltrate of
a. Basophils
b. Eosinophils
c. Epithelioid cells
d. Lymphocytes
e. Neutrophils
A biopsy of an enlarged salivary gland from an individual with Sjögren’s
syndrome is most likely to histologically reveal an extensive infiltrate of
a. Basophils
b. Eosinophils
c. Epithelioid cells
d. Lymphocytes
e. Neutrophils
Adult individuals with the karyotype 47,XXY
Question NO. 3
Adult individuals with the karyotype 47,XXY would most likely have
which one of the following sets of laboratory serum values?
Testosterone (FSH) (LH) Estradiol
a. Increased Increased Increased Increased
b. Increased Decreased Decreased Decreased
c. Decreased Increased Increased Decreased
d. Decreased Increased Increased Increased
e. Decreased Decreased Decreased Decreased
Adult individuals with the karyotype 47,XXY would most likely have
which one of the following sets of laboratory serum values?
Testosterone (FSH) (LH) Estradiol
a. Increased Increased Increased Increased
b. Increased Decreased Decreased Decreased
c. Decreased Increased Increased Decreased
d. Decreased Increased Increased Increased
e. Decreased Decreased Decreased Decreased
Mental retardation, self-mutilation, and hyperuricemia
Question NO. 2
A 4-year-old male with mental retardation, self-mutilation, and hyperuricemia
is likely to have a deficiency of an enzyme involved in the
a. Conversion of homogentisic acid to methylacetoacetate
b. Degradation of galactocerebroside
c. Breakdown of branched-chain amino acids
d. Recycling of guanine and hypoxanthine
e. Synthesis of UMP and CTP
A 4-year-old male with mental retardation, self-mutilation, and hyperuricemia
is likely to have a deficiency of an enzyme involved in the
a. Conversion of homogentisic acid to methylacetoacetate
b. Degradation of galactocerebroside
c. Breakdown of branched-chain amino acids
d. Recycling of guanine and hypoxanthine
e. Synthesis of UMP and CTP
Bright “cherry red spot” at the macula
Question NO. 1
A 10-month-old baby is being evaluated for visual problems and
motor incoordination. Examination of the child’s fundus reveals a bright
“cherry red spot” at the macula. Talking to the family of this visually
impaired 10-month-old infant, you find that they are Jewish and their
family is from the eastern portion of Europe (Ashkenazi Jews). Based on
this specific family history, which one of the following enzymes is most
likely to be deficient in this infant?
a. Aryl sulfatase
b. β-glucocerebrosidase
c. Hexosaminidase A
d. Hexosaminidase B
e. Sphingomyelinase
A 10-month-old baby is being evaluated for visual problems and
motor incoordination. Examination of the child’s fundus reveals a bright
“cherry red spot” at the macula. Talking to the family of this visually
impaired 10-month-old infant, you find that they are Jewish and their
family is from the eastern portion of Europe (Ashkenazi Jews). Based on
this specific family history, which one of the following enzymes is most
likely to be deficient in this infant?
a. Aryl sulfatase
b. β-glucocerebrosidase
c. Hexosaminidase A
d. Hexosaminidase B
e. Sphingomyelinase
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