NBME BRS Pathology ALL QUESTIONS Latest
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The answer is A. A diet low in fiber and high in fat is believed to be a risk factor for the
development of colon cancer. Both aflatoxin B1 ingestion and hepatitis B infection are
risk factors for hepatocellular carcinoma. Helicobacter pyloriinfection is associated with
stomach cancer. Cancers of the mouth, tongue, and esophagus have a marked
association with the combined abuse of tobacco and alcohol, as well as HPV infection in
a subset of cases - CORRECT ANSWER: A 56-year-old man was recently diagnosed
with early-stage colon cancer. He has no known family history of colon cancer. Which of
the following known risk factors is most likely to have contributed to the development of
this form of cancer?
(A) A diet low in fiber and high in fat
(B) Aflatoxin B1 ingestion
(C) Helicobacter pyloriinfection
(D) Hepatitis B infection
(E) Tobacco and alcohol abuse
The answer is A. A leiomyoma (fibroid) is a benign tumor of the smooth muscle of the
uterus and thus is an example of a benign tumor of mesenchymal origin. Profuse,
painful menses and infertility are major complications of this most common tumor of the
female genital tract. A leiomyosarcoma is the malignant counterpart. Malignant tumors
of epithelial cells are carcinomas, and these are known as adenocarcinomas if they
involve glandular epithelium. Benign tumors of surface epithelium are termed
papillomas. - CORRECT ANSWER: A 24-year-old woman with a history of heavy and
painful menstrual periods has been having difficulty conceiving despite months of trying
to become pregnant. Further workup includes a bimanual pelvic examination and an
ultrasound, which demonstrates a mass in the uterus that is presumed to be a
leiomyoma. This mass is a
(A) benign tumor of mesenchymal tissue.
(B) benign tumor of surface epithelium.
(C) malignant tumor of epithelial tissue.
,(D) malignant tumor of glandular epithelium.
(E) malignant tumor of mesenchymal tissue.
The answer is A. A melanocytic nevus (common mole) is a benign tumor. Nevus cells
are derived from melanocytes and ordinarily occur in clusters or nests. A dysplastic
nevus is an atypical, irregularly pigmented lesion with disorderly proliferation of
melanocytes, dermal fibrosis, and lymphocytic infiltration. Dysplastic nevi may transform
into malignant melanoma. Lentigo maligna is characterized by atypical melanocytes at
the epidermal-dermal junction and is a precursor to lentigo maligna melanoma. -
CORRECT ANSWER: A 25-year-old woman presents with concern about a mole on her
abdomen. The mole is small, round, symmetric, and darkcolored, and has sharply
defined borders. It is diagnosed as a common mole. This lesion is properly termed a
(A) nevocellular nevus.
(B) blue nevus.
(C) Spitz nevus.
(D) dysplastic nevus.
(E) lentigo maligna.
The answer is A. A total lack of glucuronyl transferase results in Crigler-Najjar syndrome
I, which is invariably fatal by 18 months secondary to kernicterus. Gilbert syndrome is
typically mild and usually not detected until later in life. Hemolytic disease of the
newborn is due to blood group incompatibility between mother and child, and the
bilirubinemia is secondary to the inherently decreased glucuronyl transferase with
superimposed hemolytic anemia in the child, further overwhelming the conjugation
machinery. Neonatal glucuronyl transferase is relatively deficient, although present, in
normal infants, contributing to the transient condition termed physiologic jaundice of the
newborn. Rotor syndrome is a relatively benign condition resulting in conjugated
hyperbilirubinemia. - CORRECT ANSWER: A neonate has been persistently jaundiced
from birth despite aggressive phototherapy and exchange transfusions. Laboratory
studies demonstrate significantly elevated unconjugated bilirubin. Tests from an outside
laboratory confirm the total absence of glucuronyl transferase activity. The neonate most
likely has which of the following condition?
(A) Crigler-Najjar syndrome
(B) Gilbert syndrome
(C) Hemolytic disease of the newborn
(D) Physiologic jaundice of the newborn
,(E) Rotor syndrome
The answer is A. Acute cold agglutinin disease is a form of hemolytic anemia due to
autoantibodies to blood group antigens and is sometimes a complication of Mycoplasma
pneumoniaeinfection. Aplastic anemia is associated with a variety of toxic exposures,
including, among others, the antibiotic chloramphenicol, not azithromycin. Aplastic
crises can occur as acute events in the course of hemolytic anemias, such as hereditary
spherocytosis or sickle cell anemia. Paroxysmal nocturnal hemoglobinuria is an
acquired defect that renders red blood cells sensitive to complement-induced lysis.
Warm antibody autoimmune hemolytic anemia can be idiopathic or secondary to
autoimmune disorders or lymphoid neoplasms. - CORRECT ANSWER: A 23-year-old
man presented to his primary care physician 2 weeks ago with a nonproductive cough
and malaise. He was treated with the antibiotic azithromycin for "walking pneumonia"
due to Mycoplasma pneumoniae. He now returns with fatigue and pallor. Laboratory
studies demonstrate a decreased red blood cell count with polychromatophilia and an
increase in indirect (unconjugated) bilirubin. The laboratory findings are most likely due
to
(A) acute cold agglutinin disease.
(B) aplastic anemia.
(C) aplastic crisis.
(D) paroxysmal nocturnal hemoglobinuria.
(E) warm antibody autoimmune hemolytic anemia.
The answer is A. Adult polycystic kidney is frequently associated with berry aneurysm of
the circle of Willis, often in association with cysts in the liver or pancreas. - CORRECT
ANSWER: A 19-year-old boy is seen because of bilateral enlargement of the kidneys.
His father, paternal uncle, and several other family members have similar abnormalities.
Which of the following aneurysms is frequently associated with this disorder?
(A) Berry aneurysm of the circle of Willis
(B) Dissecting aneurysm
(C) Fusiform aneurysm of the abdominal aorta
(D) Saccular aneurysm of the thoracic aorta
The answer is A. Aflatoxin B1 is a fungal metabolite found on moldy nuts and grain
commonly found in southern Africa. It is a cocarcinogen with hepatitis B, which is nearly
, endemic to this region of the world. Together they greatly increase the incidence of
hepatocellular carcinoma, the most prevalent cancer worldwide. C. sinensisis a parasite
associated with the development of cholangiocarcinoma. Hepatitis A has no association
with malignancy. Polyvinyl chloride is associated with angiosarcoma of the liver.
Tetracyclines can cause microvesicular fatty change in the liver. - CORRECT ANSWER:
A 36-year-old man from sub-Saharan Africa presents to the clinic with jaundice and right
upper quadrant pain. On examination, the liver is palpably enlarged. Laboratory studies
demonstrate an increase in liver enzymes. Computed tomography demonstrates a
single large mass in the right lobe of the liver, and serum -fetoprotein is markedly
elevated. Which of the following is likely to have contributed to the patient's condition?
(A) Aflatoxin B1
(B) C. sinensis
(C) Hepatitis A
(D) Polyvinyl chloride
(E) Tetracycline
The answer is A. ALL is the most common malignancy in children and is the form of
acute leukemia that is most responsive to therapy. ALL is characterized by a
predominance of lymphoblasts in the circulating blood and in the bone marrow. Other
progenitor cells do not mature normally, resulting in neutropenia and thrombocytopenia.
CD10-positive ALL is the most frequently occurring form of ALL and is the most
amenable to therapy. Thus CD10 is a favorable prognostic marker of this disease. -
CORRECT ANSWER: A 3-year-old boy presents with epistaxis and fever. Multiple
cutaneous petechiae are evident, and there is generalized enlargement of lymph nodes,
as well as palpable splenomegaly. The hemoglobin and platelet count are markedly
decreased, and the white blood cell count is elevated to 40,000 cells/µL, with a
preponderance of lymphoblasts. Which of the following statements best characterizes
this disorder?
(A) It is the form of acute leukemia that is most responsive to therapy.
(B) It occurs most often in adults but can occur in children.
(C) Lymphoblastic cells cause damage to normal blood cells, resulting in low cell
counts.
(D) The presence of the CD10 marker is indicative of a poorer prognosis.
The answer is A. Alzheimer disease is a major cause of dementia and is characterized
by relatively slow, progressive memory loss followed in later stages by motor problems,
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