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A 6l-year-old woman has felt a lump in her breast for the past 2 months. On physical examination, there is a firm 2-cm mass in the right breast. An excisional biopsy specimen of the mass shows carcinoma. Immunoperoxidase stains for protease cathepsin D and matrix metalloproteinase-9 are performed on the microscopic tissue section and show pronounced cytoplasmic staining in the tumor cells. Which of the following characteristics is most likely to be predicted by this marker.__

Angiogenesis
B. Invasiveness
C. Differentiation
D. Heterogeneity
E. Aneuploidy

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A 22-year-old woman, who works as a secretary for an accounting firm, has noted a palpable nodule on the side of her neck for the past 3 months. On physical examination, there is a 2-cm firm, nontender nodule involving the right lobe of the thyroid gland. A fine-needle aspiration biopsy specimen of the nodule shows cells consistent with carcinoma of the thyroid. No other family members are affected by this disorder. Which of the following would be considered most relevant in the woman's past medical history.__

A. Chronic alcoholism
B. Ataxia telangiectasia
C. Radiation therapy in childhood
D. Blunt trauma from a fall
Exposure to arsenic compounds

An epidemiologic study is performed to assess risks for cervical carcinoma. The cells from cervical lesions in a population of women are analyzed. Binding of certain viral proteins to pRB is found in patients in whom dysplastic cells are present. Viral proteins from which of the following are most likely to bind pRB, increasing the risk for dysplasia.__

A. Cytomegalovirus
B. Epstein-Barr virus
C. Herpes simplex virus
D. Hepatitis B virus
E. HIV

A 54-year-old man experienced onset of severe substernal chest pain over a period of 3 hours. An ECG showed changes consistent with an acute myocardial infarction. After thrombolytic therapy with tissue plasminogen activator (t-PA), his serum creatine kinase () level increased. Which of the following events most likely occurred following t-PA therapy. _ _

A. Reperfusion injury
B. Cellular regeneration
Chemical injury
D. Increased synthesis of CK
E. Myofiber atrophy

A 33-year-old woman has had increasing lethargy and decreased urine output for the past week. Laboratory studies show serum creatinine level of 4.3mg/dL and urea nitrogen level of 40mg/dL. A renal biopsy is performed, and the specimen is examined using electron microscopy. Which of the following morphologic changes most likely suggests a diagnosis of acute tubular necrosis. _ _

A. Mitochondrial swelling
B. Plasma membrane blebs
Chromatin clumping
D. Nuclear fragmentation
E. Ribosomal disaggregation

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