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At autopsy, the heart of a 63-year-old man weighs only 250g and has small right and left ventricles. The myocardium is firm, with a dark chocolate-brown color throughout. The coronary arteries show minimal atherosclerotic changes. An excessive amount of which of the following substances will most likely be found in the myocardial fibers of this heart? _ _

A. Melanin
B. Hemosiderin
C. Glycogen
D. Lipofuscin
E. Bilirubin

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A 69-year-old woman has had a chronic cough for the past year. A chest radiograph shows a 6-cm mass in the left lung, and a needle biopsy specimen of the mass shows carcinoma. A pneumonectomy is performed, and examination of the hilar lymph nodes reveals a uniform, dark-black cut surface. Which of the following factors is most likely to account for the appearance of the lymph nodes? _ _

A. Smoking
Bleeding disorder
C. Liver failure
D. Aging
E. Metastases

A 38-year-old man has had headaches and nausea for the past 2 months. Laboratory findings show hypercalcemia and hypophosphatemia and normal serum albumin. Urine microscopic analysis shows deposition of calcium salts in the renal tubular epithelium. Which of the following processes has most likely produced this change in the kidney? _ _

A. Dystrophic calcification
B. Renal tubular atrophy
C. Autophagocytosis
D. Metastatic calcification
E. Cellular aging

An experiment introduces a "knockout" gene mutation into a cell line. The frequency of shrunken cells with chromatin clumping and cytoplasmic blebbing is increased, compared with a cell line without the mutation. Overall survival of the mutant cell line is reduced. Which of the following genes is most likely to be affected by this mutation? _ _

A. BAX
BCL-2
C-MYC
D. FAS
E. p53

A 53-year-old man has had marked chest pain for the past 3 hours. Laboratory findings include elevated serum creatine kinase-MB (CK-MB). He receives thrombolytic therapy with tissue plasminogen activator. After the therapy, the CK-MB further increases. Which of the following is the most likely biochemical basis for this observed rise in CK-MB? _ _

A. Reduced protein synthesis
B. Increased generation of oxygen-derived free radicals
C. Increased activity of catalase
D. Reduced oxidative phosphorylation
E. Release of calcium from endoplasmic reticulum

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