Question

Where does seeding of cancer cells occur?

	a.	In the pleural space surrounding the heart
	b.	In the cerebrospinal fluid around the spinal cord
	c.	In the joints around the synovial fluid
	d.	In the peritoneal space surrounding the abdominal cavity

A 24-year-old man has had increasing malaise for the past week. He now notes a yellowish hue to his skin and sclerae. On physical examination his temperature is 37.3° C (99.1° F). He has right upper quadrant tenderness. Laboratory studies show his serum AST is 520 U/L and ALT 590 U/L, with total bilirubin 5.8 mg/dL. His hepatitis A IgM test is positive. The patient is diagnosed with acute hepatitis A. Which of the following pathologic processes is most likely to be present in his liver?

	a.	Abscess formation
	b.	Apoptosis
	c.	Coagulative necrosis
	d.	Fatty metamorphosis
	e.	Granuloma formation

A 45-year-old healthy woman has a routine check of her health status. She has no chest pain, cough, or fever. A chest x-ray is taken and shows a peripheral 2.5-cm-diameter “coin lesion” in the right mid-lung field. Which of the following biologic characteristics best distinguishes this lesion as a neoplasm, rather than a granuloma?

	a.	Autonomous growth
	b.	Necrosis
	c.	Radiosensitivity
	d.	Rapid increase in size
	e.	Recurrence following excision

A 62-year-old man has noted a slowly enlarging, raised, pearly nodule on his upper eyelid for the past 2 years. On physical examination there is a nontender, 0.5-cm-diameter nodule with central ulceration. This lesion is excised and on microscopic examination is composed of fairly uniform dark blue cells with scant cytoplasm. Nodules of these cells extend down into the dermis. Which of the following is the most likely risk factor for development of this man’s eyelid lesion?

	a.	Hereditary gene mutation
	b.	Herpes simplex virus infection
	c.	Primary open angle glaucoma
	d.	Sjögren syndrome
	e.	Ultraviolet light exposure

A 20 year old patient is diagnosed with urticaria (type I hypersensitivity). The chemical mediator responsible for these lesions is derived from which of the following cells ?

	a.	Neutrophils
	b.	Eosinophils
	c.	Lymphocytes
	d.	Mast cells
	e.	Platelets

Answer 1

Where does seeding of cancer cells occur?

d.	In the peritoneal space surrounding the abdominal cavity.

A 24-year-old man has had increasing malaise for the past week. He now notes a yellowish hue to his skin and sclerae. On physical examination his temperature is 37.3° C (99.1° F). He has right upper quadrant tenderness. Laboratory studies show his serum AST is 520 U/L and ALT 590 U/L, with total bilirubin 5.8 mg/dL. His hepatitis A IgM test is positive. The patient is diagnosed with acute hepatitis A. Which of the following pathologic processes is most likely to be present in his liver?

e.	Granuloma formation.(Yamamoto T et.al 1995) Note: Liver cells may undergo coagulation necrosis as in acute hepatitis. (page 155, Hepatobiliary Diseases,edited by Jesus Prieto, Joan Rodes, David A. Shafritz)

A 45-year-old healthy woman has a routine check of her health status. She has no chest pain, cough, or fever. A chest x-ray is taken and shows a peripheral 2.5-cm-diameter “coin lesion” in the right mid-lung field. Which of the following biologic characteristics best distinguishes this lesion as a neoplasm, rather than a granuloma?

d. Rapid increase in size.

A 62-year-old man has noted a slowly enlarging, raised, pearly nodule on his upper eyelid for the past 2 years. On physical examination there is a nontender, 0.5-cm-diameter nodule with central ulceration. This lesion is excised and on microscopic examination is composed of fairly uniform dark blue cells with scant cytoplasm. Nodules of these cells extend down into the dermis. Which of the following is the most likely risk factor for development of this man’s eyelid lesion?

e.	Ultraviolet light exposure.

A 20 year old patient is diagnosed with urticaria (type I hypersensitivity). The chemical mediator responsible for these lesions is derived from which of the following cells ?

d.	Mast cells.