NBME BRS Pathology Comprehensive Latest
Update 2024-2025 145 Questions and 100%
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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. 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. Androblastoma (Sertoli cell tumor), a nongerm cell tumor derived from
the sex cord, is most often benign. These tumors, along with Leydig (interstitial) cell
,tumors, may be hormone-producing, sometimes elaborating estrogens and presenting
in males with gynecomastia and other feminizing effects. - CORRECT ANSWER: A 45-
year-old man presents with breast enlargement, erectile dysfunction, and decreased
libido. On physical examination, an intratesticular mass is palpated. Which of the
following is the most likely diagnosis?
(A) Androblastoma (Sertoli cell tumor)
(B) Endodermal sinus tumor
(C) Mature teratoma
(D) Mixed germ cell tumor
(E) Seminoma
The answer is A. Association with certain human leukocyte antigen (HLA) types,
autoantibodies, and increased incidence in persons with other autoimmune disorders
are frequent occurrences in autoimmune disorders. In addition, Hashimoto thyroiditis is
characterized by dense lymphocytic infiltrates with germinal center formation, striking
morphologic evidence of immune cell (B lymphocyte) participation. - CORRECT
ANSWER: A 43-year-old woman has a recent diagnosis of Hashimoto thyroiditis. This
disease's autoimmune nature is suggested by which of the following features?
(A) Association with human leukocyte antigen (HLA)-DR5 and HLA-B5
(B) Atrophy of thyroid follicles
(C) Palpable thyroid
(D) Presence of Hürthle cells
(E) Signs and symptoms of hypothyroidism
The answer is A. Calcification within a cystic ovarian tumor in a young woman is most
characteristic of mature teratoma of the ovary, a benign lesion and the most frequently
occurring ovarian tumor. - CORRECT ANSWER: A cystic ovarian mass was palpated in
a 23-year-old woman. If X-ray films revealed calcifications in the mass, which of the
following would be most likely?
(A) Teratoma
(B) Brenner tumor
(C) Mucinous cystadenocarcinoma
(D) Krukenberg tumor
,(E) Choriocarcinoma
The answer is A. Carcinoma of the cervix is associated with infection with certain
serotypes of HPV. Other characteristics include a history of early sexual activity,
squamous cell morphology, and frequent origin at the squamocolumnar junction.
Leiomyomas (fibroids) may increase in size during pregnancy and decrease in size
following menopause. Endometrial carcinoma is the most common gynecologic
malignancy and is associated with hyperestrinism from estrogen therapy. Endodermal
sinus (yolk sac) tumors produce α-fetoprotein. - CORRECT ANSWER: A 35-year-old
woman consults a gynecologist because she has postcoital vaginal bleeding. The
Papanicolaou (Pap) smear is abnormal. Colposcopy and cervical biopsy lead to a
diagnosis of carcinoma of the cervix. Which of the following is most characteristic of this
disorder?
(A) Association with human papillomavirus (HPV) infection
(B) History of exogenous estrogen therapy
(C) Most common gynecologic malignancy
(D) Secretion of AFP
(E) Spontaneous regression following menopause
The answer is A. Classic features of lead poisoning include dark precipitates forming a
gingival lead line (composed of precipitated lead sulfide), radiopaque deposits in
epiphyses, basophilic stippling of erythrocytes, increased urinary delta-ALA, and
peripheral neuropathy and other CNS changes. - CORRECT ANSWER: A 3-year-old girl
presents with dark precipitates along gingival margins, radiopaque deposits in the
epiphyses of her bones, and urinary excretion of delta-aminolevulinic acid (delta-ALA).
Her father states that they live in an old house that has chipped paint. The patient is
diagnosed with lead toxicity. The child's blood would likely also have which of the
following?
(A) Basophilic stippling of erythrocytes
(B) Schistocytes and helmet cells
(C) Increased osmotic fragility of erythrocytes
(D) Clumping of erythrocytes at temperatures below 30°C
(E) Macrocytes
, The answer is A. Congenital pyloric stenosis is an obstruction of the gastric outlet
caused by hypertrophy of the pyloric muscularis. The hypertrophic muscle is often
perceived as a palpable mass. The principal manifestation of this condition, more
common in boys, is projectile vomiting, most often occurring in the first 3 to 6 weeks of
life. - CORRECT ANSWER: A 10-day-old boy with projectile vomiting and a palpable
midepigastric mass most likely has
(A) congenital pyloric stenosis.
(B) infantile polycystic kidney.
(C) intussusception.
(D) tracheoesophageal fistula.
(E) Wilms tumor.
The answer is A. Conjugated hyperbilirubinemia and positive urine tests for bilirubin are
indicative of obstructive jaundice. The further finding of the complete absence of urine
and stool urobilinogen indicates total common bile duct obstruction. Additionally, the
palpable gallbladder (Courvoisier sign) strongly suggests that the etiology is a malignant
tumor, such as adenocarcinoma of the head of the pancreas. - CORRECT ANSWER: A
65-year-old man is seen for the recent onset of jaundice, weight loss, and anorexia.
Abdominal examination reveals a distended, palpable gallbladder. Laboratory studies
reveal conjugated hyperbilirubinemia, positive urine tests for bilirubin, and total absence
of urobilinogen in the urine and stools. The probable diagnosis is
(A) adenocarcinoma of the pancreas.
(B) amebic abscess of the liver.
(C) hepatic vein thrombosis.
(D) hepatitis A infection.
(E) hereditary spherocytosis.
The answer is A. GTPase activity, which is required for inactivation, is decreased in
mutant ras (p21) proteins. This change is mediated by reduced responsiveness to
GTPase activating protein. - CORRECT ANSWER: A 48-year-old man with early-stage
colon cancer undergoes a partial resection of the colon. Molecular analysis reveals that
the tumor tissue harbors a mutation in codon 12 of the rasoncogene. The mutant gene
codes for a ras protein product that has
(A) decreased GTPase activity.
