题目内容

A 40-year-old man has a history of intravenous drug use. Physical examination shows needle tracks in his left antecubital fossa. He has mild scleral icterus. Serologic studies for HBsAg and anti-HCV are positive. He develops hepatocellular carcinoma l5 years later. Which of the following best explains why this patient developed hepatocellular carcinoma. _ _

A. The consistent integration of these viruses in the vicinity of protooncogenes
B. The ability of these viruses to capture protooncogenes from the host DNA
C. Virus-induced injury to liver cells followed by extensive regeneration
D. The ability of viral genes to inactivate RB and p53 expression
E. The ability of these viruses to cause immunosuppression of the host

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A 48-year-old woman notices a lump in her left breast. On physical examination, the physician palpates a firm, nonmovable, 2-cm mass in the upper outer quadrant of the left breast. There are enlarged, firm, nontender lymph nodes in the left axilla. A fine-needle aspiration biopsy is performed, and the cells present are consistent with carcinoma. A mastectomy with axillary lymph node dissection is performed, and carcinoma is present in two of eight axillary nodes. Which of the following factors is most likely responsible for the lymph node metastases. _ _

A. Increased laminin receptors on tumor cells
B. Presence of keratin in tumor cells
C. Diminished apoptosis of tumor cells
D. Tumor cell monoclonality
E. Lymphadenitis

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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
Bilirubin in canaliculi
C. Glycogen in hepatocytes
D. Amyloid in portal triads
E. Hemosiderin in hepatocytes

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A 50-year-old man experienced an episode of chest pain 6 hours before his death. A histologic section of left ventricular myocardium taken at autopsy showed a deeply eosinophilic-staining area with loss of nuclei and cross-striations in myocardial fibers. There was no hemorrhage or inflammation. Which of the following conditions most likely produced these myocardial changes. _ _

A. Viral infection
B. Coronary artery thrombosis
C. Blunt chest trauma
D. Antibodies directed against myocardium
E. Protein-deficient diet

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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. _ _

Apoptosis
B. Dysplasia
C. Fatty change
D. Hyperplasia
E. Hypertrophy
F. Metaplasia

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