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Pathology Exam 4 Quiz Questions

Terms in this set (15)

Following a bar fight, a 22-year-old man is brought unconscious to the emergency department. Several minutes earlier, he had been hit on the head with a heavy iron club and had been briefly unconscious, but had then apparently recovered. One or two minutes later, he had again lost consciousness. Which of the following is the most likely diagnosis?

A. Transient ischemic attack
B. Subdural hematoma
C. Subarachnoid hemorrhage
D. Epidural hematoma
D. Epidural Hematoma
A 19-year-old young woman who emigrated from Taiwan 8 years ago presents with fever, malaise, myalgias, and arthritis and "coldness" in her upper extremities. She has a weak radial pulse bilaterally, and a magnetic resonance angiogram demonstrates nearly 75% stenosis of the main arteries originating from the aorta. She likely has which of the following rheumatologic conditions?

A. Raynaud disease
B. Takayasu arteritis
C. Kawasaki disease
D. Buerger disease
B. Takayasu Arteritis
A 24-year-old female collapses while running with her boyfriend. Although emergency services are called immediately, she is unable to be resuscitated. She has a family history of sudden cardiac death. At autopsy, a patch of fibrosis is identified on the outflow tract of the left ventricle. Which of the following other features is present?

A. Dilation of all four cardiac chambers
B. An intraluminal coronary artery thrombus
C. A thickened interventricular septum
D. Dilation of the right ventricle with fatty infiltration and fibrosis of the posterior wall
C. A thickened interventricular septum
A 14-year-old boy is brought by his family to your clinic in Utah with a long history of recurrent epistaxis. His father also reports such a history. Of the following, which is the most likely condition consistent with these findings?

A. Osler-Weber-Rendu syndrome
B. Hemangioendothelioma
C. Glomangioma
D. Cavernous hemangioma
A. Osler-Weber-Rendu syndrome
A 55-year-old woman presents with complaints of chest pain. She states that the chest pain predictably occurs when she climbs four flights of stairs to reach her apartment or when she has been jogging for more than 10 minutes. She is particularly concerned because her mother died of a myocardial infarction at 50 years of age. Which of the following best describes this patient's state?

A. Prinzmetal angina
B. Stable angina pectoris
C. Myocardial infarction
D. Arrythmia
B. Stable Angina Pectoris
A 43-year-old female with no history of alcoholism or family history of sudden death collapses while grocery shopping. She had been complaining of increased shortness of breath lately to her husband but refused to see a doctor. Autopsy revealed four-chamber dilation of the heart. Which of the following conditions is the cause of her disease process?

A. A past coxsackievirus B infection
B. A past Streptococcus pneumoniae infection
C. A past Group A streptococcus infection
D. A mutation of the fibrillin gene
A. A past coxsackievirus B infection
A 65-year-old man who has a long history of hypertension presents to the emergency department with tearing chest pain that radiates to the back. An electrocardiogram is normal, as are cardiac enzymes. A "stat" chest radiograph demonstrates widening of the mediastinum. Which of the following is the most likely?

A. Berry aneurysm
B. Atherosclerotic aneurysm
C. Dissecting aneurysm
D. Arteriovenous fistula
C. Dissecting aneurysm
A 3-year-old boy is brought by his parents to the emergency department because they are concerned that he has had a high fever for several days. On examination, the boy has conjunctival and oral erythema. He has palpable cervical lymphadenopathy and erythema of his palms and soles. What is a potential life-threatening complication of this disorder?

A. Aneurysm of the coronary arteries
B. Dissection of the thoracic aorta
C. Ischemia and gangrene of the extremities
D. Aneurysm of the abdominal aorta
A. Aneurysm of the coronary arteries
A 70-year-old woman has a long history of metastatic colon cancer, and she donates her body for use in medical school anatomy courses. At death, the body is emaciated and
cachectic, and gross dissection reveals small fibrin deposits arranged around the line of
closure of the leaflets of the mitral valve. The valvular lesions most likely represent

A. Nonbacterial thrombotic endocarditis.
B. Endocarditis of the carcinoid syndrome.
C. Rheumatic endocarditis.
D. Bacterial endocarditis.
A. Nonbacterial thrombotic endocarditis.
A 75-year-old woman appears well after slipping on wet pavement and striking the right side of her head. When questioned, she says that she does not remember the fall. Subsequently she complains of persistent headache and confusion. Magnetic imaging studies reveal a subdural hematoma over the lateral aspect of the right cerebral hemisphere. Which of the following is a well-known association or characteristic of this disorder?

A. Bleeding from arteries of the circle of Willis
B. Rapidly progressive cerebral compression
C. Laceration of branches of middle meningeal artery
D. Characteristically caused by venous hemorrhage
D. Characteristically caused by venous hemorrhage
A 60-year-old-man is discharged after being observed in the hospital for 6 days following a myocardial infarction. He returns to his normal activities, which include sedentary work only. This point in time following a myocardial infarct is noteworthy for the special danger of which of the following?

A. Mural thrombosis
B. Myocardial (pump) failure
C. Myocardial rupture
D. Ventricular aneurysm
C. Myocardial rupture
A 67-year-old male collapses at work. He is autopsied by the medical examiner, who identifies ischemic heart disease. Of the following, what is the most likely cause of this disease process in the heart?

A. Atherosclerotic cardiovascular disease (ASCVD)
B. Polyarteritis nodosa
C. Embolism (from endocarditis) to the left anterior descending coronary artery
D. Sarcoidosis of the heart
A. Atherosclerotic cardiovascular disease (ASCVD)
A 23-year-old male with a family history of sudden death collapses while playing football with old college friends. Despite aggressive resuscitation efforts, he dies. An autopsy reveals a thick interventricular septum. Which findings would be identified microscopically?

A. Myocyte disarray
B. Patches of fibrosis associated with granulomas and giant cells
C. Fatty infiltration and fibrosis
D. Clusters of lymphocytes and associated necrosis of cardiac myocytes
A. Myocyte disarray
A 55-year-old male with a history of systemic hypertension (15 years with an ACE inhibitor) and hypercholesterolemia presents to the emergency room with complaints of crushing chest pain radiating to his jaw and arm. He is noted to be diaphoretic. He has a troponin I concentration of 3.5 ng/mL. He sustains a cardiac arrest while being evaluated. Of the following, which lesion would most likely be identified as a cause of the symptoms?

A. Thrombus overlying a ruptured atherosclerotic plaque resulting in occlusion of the vessel
B. Occlusion of the circumflex coronary artery, with evidence of bone formation in the plaque
C. A ruptured aneurysm of the left anterior descending coronary artery
D. Hemorrhage in the media of the right coronary artery, with compression of the lumen
A. Thrombus overlying a ruptured atherosclerotic plaque resulting in occlusion of the vessel
A newborn child is noticed by his parents, ten days after they left the hospital, to be breathing fast and to be very irritable. They schedule a visit with their pediatrician the next day, and, during the physical examination, the doctor notices that the baby has blue fingernail beds and that with strenuous crying, his lips become more blue. Of the following, what is the most likely diagnosis?

A. Atrial septal defect
B. Ventricular septal defect
C. Coarctation of the aorta
D. Severe congenital aortic stenosis
B. Ventricular septal defect
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