Tongji Univesity School of Medicine 2014-2015 Academic Year,the 2s semester Final Examination of (Test paper A) Name ID IAtypel question (One point Fach question below contains five suggested answers.Choose the one best response to each question 1.During acute inflammation,histamine-induced increased vascular permeability causes the formation of exudates (inflammatory edema).Which e of the listed cell types is the most likely source of the hista ine? Fibroblasts c.Lymphocytes d.Mast cells e.Neutrophils 2.Histologic sections of lung tissue from a 68-year-old female with congestive heart failure and progressive breathing problems reveal numerous hemosiderin-laden cells within the alveoli.Theses "heart failure cells" originate from alveolar Eosinophils c. Lymphocytes d.Macrophages e.Pneumocytes 3.By definition,granulomas are composed of ( a.Chronic abscess b.Collagen c.Endothelial cells and fibroblasts d.Macrophages or epithelioid cells e.Hemosiderin-laden macrophaes 4.Which one of the listed changes correctly describes the pathophysiology involved in the production of pulmonary edema in patients with congestive
Tongji Univesity School of Medicine 2014-2015 Academic Year, the 2 st semester Final Examination of __________________ (Test paper A) Name ID ⅠA type1 question（40 questions. One point per question） Directions: Each question below contains five suggested answers. Choose the one best response to each question. 1. During acute inflammation, histamine-induced increased vascular permeability causes the formation of exudates (inflammatory edema). Which one of the listed cell types is the most likely source of the histamine? ( ) a. Endothelial cells b. Fibroblasts c. Lymphocytes d. Mast cells e. Neutrophils 2. Histologic sections of lung tissue from a 68-year-old female with congestive heart failure and progressive breathing problems reveal numerous hemosiderin-laden cells within the alveoli. Theses “heart failure cells” originate from alveolar ( ) a. Endothelial cells b. Eosinophils c. Lymphocytes d. Macrophages e. Pneumocytes 3. By definition, granulomas are composed of ( ) a. Chronic abscess b. Collagen c. Endothelial cells and fibroblasts d. Macrophages or epithelioid cells e. Hemosiderin-laden macrophages 4. Which one of the listed changes correctly describes the pathophysiology involved in the production of pulmonary edema in patients with congestive
heart failure? Deer eased plasma oncotic pressure Endothelial damage c.Increased hydrostatic pressure d.Increased vascular permeability e.Lymphatic obstruction 5.A postmortem clo is most likely to ( ) a.Grossly display features of recanalization b.Grossly have lines of Zahn c.Grossly have the appearance of "chicken fat"overlying 'currant jelly" d.Microscopically app pear attached to the wall of the blood vessel e.Microscopically have alternating layers of cells and platelets 6.What is the most common site of origin of thrombotic pulmonary emboli?() a.Deep leg veins b.Lumen of left ventricle c.Lumen of right ventricle d Mesente ic veins e.Superficial leg veins 7.The most serious common complication of lower extremity thrombophlebitis is( Cerebral infarction b.Kidney infarction c.Myocardial infarction d.Pulmonary infarction e.Intestinal infarction 8.What is the most common cause of chronic obstructive pulmonary disease?() a.Pneumoconiosis b.Pneumonia c.Interstitial lung diseases d.Chronie bronchitis e.Pulmonary tuberculosis 9.Of the tumors of the liver listed below,which is the most common?( a.Hepatocellular carcinoma b.Angiosarcoma Cholangio arcinoma d Hamartoma e.Hemangioma 10.Which of the following is the most common type of breast careinoma?()
heart failure? ( ) a. Decreased plasma oncotic pressure b. Endothelial damage c. Increased hydrostatic pressure d. Increased vascular permeability e. Lymphatic obstruction 5. A postmortem clot is most likely to ( ) a. Grossly display features of recanalization b. Grossly have lines of Zahn c. Grossly have the appearance of “chicken fat” overlying ‘currant jelly” d. Microscopically appear attached to the wall of the blood vessel e. Microscopically have alternating layers of cells and platelets 6. What is the most common site of origin of thrombotic pulmonary emboli? ( ) a. Deep leg veins b. Lumen of left ventricle c. Lumen of right ventricle d. Mesenteric veins e. Superficial leg veins 7. The most serious common complication of lower extremity thrombophlebitis is( ) a. Cerebral infarction b. Kidney infarction c. Myocardial infarction d. Pulmonary infarction e. Intestinal infarction 8. What is the most common cause of chronic obstructive pulmonary disease? ( ) a. Pneumoconiosis b. Pneumonia c. Interstitial lung diseases d. Chronic bronchitis e. Pulmonary tuberculosis 9. Of the tumors of the liver listed below, which is the most common? ( ) a. Hepatocellular carcinoma b. Angiosarcoma c. Cholangiocarcinoma d. Hamartoma e. Hemangioma 10. Which of the following is the most common type of breast carcinoma? ( )
a.Intraductal b.Medullary Papillary d.Mucinous e.Infiltrating ductal 11.Fluid that collects during acute inflammation and that has protein content in s of 3.0g/dl and a specific gravity over 1.015 is termed( b.Transudate c.Coagulation d.Lymphokine e.Hemorrhage 12.The most important prognostic factor for human cancer is the( a.Grade b.Stage c.Lymphocytic infiltration d.Va asion e. Mitotic index 13.The classic lesion of rheumatic heart disease is ( a.Mallory's body Aschoff body Psammo a body d.Negri body e.Anitschkow's myocyte 14.Which of the following infections is often the cause of interstitial pneumonia? a.Gram-positive bacterial b.Gram-negative bacterial c.Viral d.Fungal e.Parasitic 15.Gastric carcinoma is most common in which one of the listed site locations(） a.pyloric antrum pyloric antr m and lesser curvature e- lesser curvature d.greater curvature e.fundic
a. Intraductal b. Medullary c. Papillary d. Mucinous e. Infiltrating ductal 11. Fluid that collects during acute inflammation and that has protein content in excess of 3.0g/dl and a specific gravity over 1.015 is termed ( ) a. Exudate b. Transudate c. Coagulation d. Lymphokine e. Hemorrhage 12. The most important prognostic factor for human cancer is the ( ) a. Grade b. Stage c. Lymphocytic infiltration d. Vascular invasion e. Mitotic index 13. The classic lesion of rheumatic heart disease is ( ) a. Mallory’s body b. Aschoff body c. Psammoma body d. Negri body e. Anitschkow’s myocyte 14. Which of the following infections is often the cause of interstitial pneumonia? ( ) a. Gram-positive bacterial b. Gram-negative bacterial c. Viral d. Fungal e. Parasitic 15. Gastric carcinoma is most common in which one of the listed site locations( ) a. pyloric antrum b. pyloric antrum and lesser curvature c. lesser curvature d. greater curvature e. fundic
16.Which of the flowing sites is the most common of chronic gastric ulcer?() pyloric antrum b.pyloric antrum and lesser curvature c.lesser curvature d.greater curvature e.fundic 17.Which one of the listed is the most common complication of chronic peptic ulcer？( a.hemorrhage b.perforation c.pyloric stenosis malignant transformation e.hypertrophic gastritis 18.The most serious complication of chronic peptic ulcer is ( a.hemorrhage perforation pyloric stenosis d.malignant transformation e.hypertrophic gastritis 19.Which one of the listed is the most common pathological type of early gastric carcinoma? a.protruded type,I type b.superficial elevated type,IIa type c. superficial flat type,IIb type superficial depr ssed type,Ile typ e excavated type,III type 20.A factor that stimulates the proliferation of smooth-muscle cells and also relates to the pathogenesis of atherosclerosis is( a.Platelet-derived growth factor gro wth factor B &1necd Interleukin e.Tumor necrosis factor 21.The most characteristic and frequent feature of chronic rheumatic heart disease is the d opm int of a.Vegetations on the endocardium b.Ashoff bodies within the myocardium c.Fibrin deposits within the pericardium d.Stenosis of the mitral valve
16. Which of the flowing sites is the most common of chronic gastric ulcer? ( ) a. pyloric antrum b. pyloric antrum and lesser curvature c. lesser curvature d. greater curvature e. fundic 17. Which one of the listed is the most common complication of chronic peptic ulcer? ( ) a. hemorrhage b. perforation c. pyloric stenosis d. malignant transformation e. hypertrophic gastritis 18. The most serious complication of chronic peptic ulcer is ( ) a. hemorrhage b. perforation c. pyloric stenosis d. malignant transformation e. hypertrophic gastritis 19. Which one of the listed is the most common pathological type of early gastric carcinoma? ( ) a. protruded type, I type b. superficial elevated type, IIa type c. superficial flat type, IIb type d. superficial depressed type, IIc type e. excavated type, III type 20. A factor that stimulates the proliferation of smooth-muscle cells and also relates to the pathogenesis of atherosclerosis is ( ) a. Platelet-derived growth factor b. Transforming growth factor β c. Interleukin 1 d. Interferon α e. Tumor necrosis factor 21. The most characteristic and frequent feature of chronic rheumatic heart disease is the development of ( ) a. Vegetations on the endocardium b. Ashoff bodies within the myocardium c. Fibrin deposits within the pericardium d. Stenosis of the mitral valve
e.Incompetence of the pulmonic valve 22.Histological sections(routine H&E stain)of lung reveal the alveoli to be filled with pale,nongranular pink fluid.Neither leukocytes nor erythrocytes are present within this fluid.What is the most likely(i.e.,most common)cause of this abnormality？( a.Bacterial pne umonia Conge tive hea art failure Lymphatic ob ruction by tumor d.Pulmonary embolus e.Viral pneumonia 23.The Astler-Coller modification of the Duckes classification is used to classify cancers of the a.Colon b.Liver c.Lung d.Pancr e.Stomach 24.Familial polyposis coli is characterized by a.Autosomal recessive pattern of inheritance b.Mutiple hamartomatous polyps throughout the colon 100%risk of carci An association with fibromatosis and mutiple osteomas e.An association with tumors of the central nervous svstem 25.Which of the listed typesofcfound within the liver is the mjor soureof the excess collagen deposited in cirrhosis? Hepatocyte b.Kupffer cells c.Ito cells(hepatic stellate cells) d.Endothelial cells e.Bile duct epithelial cells 26.What is the most likely cause of the combination of generalized edema hypoalbuminemia.hypercholesterolemia,marked proteinuria,and fatty casts and fat bodies in the urine? a.Nephritic syndrome b.Nephrotic Acute renal failure d.Renal tubular defect e.Urinary tract infection
e. Incompetence of the pulmonic valve 22. Histological sections (routine H&E stain) of lung reveal the alveoli to be filled with pale, nongranular pink fluid. Neither leukocytes nor erythrocytes are present within this fluid. What is the most likely (i.e., most common) cause of this abnormality? ( ) a. Bacterial pneumonia b. Congestive heart failure c. Lymphatic obstruction by tumor d. Pulmonary embolus e. Viral pneumonia 23. The Astler-Coller modification of the Duckes classification is used to classify cancers of the ( ) a. Colon b. Liver c. Lung d. Pancreas e. Stomach 24. Familial polyposis coli is characterized by ( ) a. Autosomal recessive pattern of inheritance b. Mutiple hamartomatous polyps throughout the colon c. 100% risk of carcinoma d. An association with fibromatosis and mutiple osteomas e. An association with tumors of the central nervous system 25. Which of the listed types of cells found within the liver is the major source of the excess collagen deposited in cirrhosis? ( ) a. Hepatocytes b. Kupffer cells c. Ito cells (hepatic stellate cells ) d. Endothelial cells e. Bile duct epithelial cells 26. What is the most likely cause of the combination of generalized edema, hypoalbuminemia, hypercholesterolemia, marked proteinuria, and fatty casts and fat bodies in the urine? ( ) a. Nephritic syndrome b. Nephrotic syndrome c. Acute renal failure d. Renal tubular defect e. Urinary tract infection
27.Which one of the listed hepatic diseases has the greatest risk of developing into he pato ellula 0m hepatic steatosis(fatty liver) b.portal cirrhosis c.postnecrotic cirrhosis d.biliary cirrhosis e congestive liver cirrhosis 28.Of the lung tumors listed below,which type belongs to the APUD group of tumors? a.Hamartoma b.Mucoepidermoid carcinoma Aden cys carcinoma Bronchial carcinoid e.Squamons cell carcinoma 29.What is the name that is given to the hyaline masses that are often seen in the cytoplasm of hepa nts with alcoholic hepati tis? an bodies(acidophilic bodies) b.Negri bodies c.Mallory's bodies d.Russel's bodies e.Residual bodies 30.Lipoid nephrosis of the kidneys characteristically produces changes that may be observed by electron microscope (EM)in which of the following renal maio glomerular elements? Epithelial cells c Mesangiun d.Blood vessels e.Basement membrane 31.Which of the following tumor markers has been associated with the hepatocellular carcinoma? a.CEA b.AFP c.Prostae-specific antigen d.Tyrosine enzyme e.Thyroglibu in antigen 32.Of the tumors listed below,which is benign tumor?( a.Leukemia b.Melanoma
27. Which one of the listed hepatic diseases has the greatest risk of developing into hepatocellular carcinoma ? ( ) a. hepatic steatosis (fatty liver) b. portal cirrhosis c. postnecrotic cirrhosis d. biliary cirrhosis e. congestive liver cirrhosis 28. Of the lung tumors listed below, which type belongs to the APUD group of tumors? ( ) a. Hamartoma b. Mucoepidermoid carcinoma c. Adenoid cystic carcinoma d. Bronchial carcinoid e. Squamons cell carcinoma 29. What is the name that is given to the hyaline masses that are often seen in the cytoplasm of hepatocytes in patients with alcoholic hepatitis? ( ) a. Councilman bodies ( acidophilic bodies ) b. Negri bodies c. Mallory’s bodies d. Russel’s bodies e. Residual bodies 30. Lipoid nephrosis of the kidneys characteristically produces changes that may be observed by electron microscope (EM) in which of the following renal glomerular elements? ( ) a. Endothelial cells b. Epithelial cells c. Mesangium d. Blood vessels e. Basement membrane 31. Which of the following tumor markers has been associated with the hepatocellular carcinoma? ( ) a. CEA b. AFP c. Prostae-specific antigen d. Tyrosine enzyme e. Thyroglibulin antigen 32. Of the tumors listed below, which is benign tumor? ( ) a. Leukemia b. Melanoma
c.Teratoma d.Embryonic tumor of kidney e.True aneurysm 33.The most common cause of liver cirrhosis in China is ( a.Drug-induced hepatitis b.Toxin-induced hepatitis Alcoholic h patitis e.Autoimmune hepatitis 34.Complications of lobar pneumonia include each of the following conditions EXCEPT C Pulmonary carnification b.Purulent pleurisy c.Pulmonary abscess d.Septic shock (infective shock) e.Bronchiectasis 35.Which one of the following definitions is correct?( a.Dysplasia is a change from one type of differentiated tissue to another b.Anaplasia is an almost complete lack of differentiation c.Carcinoma is a tumor of epithelial derivation sordere develo pment of cells with loss of organizatior Carcinoma in situ is a carcinoma with stromal invasion 36.Which one of the following statements is correct?( a.Adenoma is a malignant tumor of glandular epithelium Sarcoma is a benign tumor of conective tissu Liposarcon alignant tumor of adipose tissue Aneurysm is a benign tumor of artery e.Lymphoma is a benign tumor of lymphoid cells 37.Which one of the listed statements of common features of benign tumors is Invasion of surrounding stromal tissue b)Cells of uniform size and appearance c)Many mitotic figures d)Ill-defined borders e)Close resemblance to the original tissue 38.Which one of the following inflammatory processes often contain granulomas EXCEPT a.Tuberculosis
c. Teratoma d. Embryonic tumor of kidney e. True aneurysm 33. The most common cause of liver cirrhosis in China is ( ) a. Drug-induced hepatitis b. Toxin-induced hepatitis c. Alcoholic hepatitis d. Viral hepatitis e. Autoimmune hepatitis 34. Complications of lobar pneumonia include each of the following conditions EXCEPT ( ) a. Pulmonary carnification b. Purulent pleurisy c. Pulmonary abscess d. Septic shock ( infective shock ) e. Bronchiectasis 35.Which one of the following definitions is correct? ( ) a. Dysplasia is a change from one type of differentiated tissue to another b. Anaplasia is an almost complete lack of differentiation c. Carcinoma is a tumor of epithelial derivation d. Metaplasia is the disordered development of cells with loss of organization e. Carcinoma in situ is a carcinoma with stromal invasion 36. Which one of the following statements is correct? ( ) a. Adenoma is a malignant tumor of glandular epithelium b. Sarcoma is a benign tumor of connective tissue c. Liposarcoma is a malignant tumor of adipose tissue d. Aneurysm is a benign tumor of artery e. Lymphoma is a benign tumor of lymphoid cells 37.Which one of the listed statements of common features of benign tumors is correct? ( ) a) Invasion of surrounding stromal tissue b) Cells of uniform size and appearance c) Many mitotic figures d) Ill-defined borders e) Close resemblance to the original tissue 38.Which one of the following inflammatory processes often contain granulomas EXCEPT ( ) a. Tuberculosis
b.Typhoid fever Ulcerative colitis d.Syphilis e.Rheumatic myocarditis 39.Which one of the following statements about acute inflammation is correct? The predominant l types b.The inflammation is usually initiated by cell-mediated immunity c.The duration may be for months d.Plasma cells are frequently present e.Lymphocytes are present at the start of the process 40. Benign hypertension is characterized by:() a.Fibrinoid necrosis of arterioles b.Atrophy of the muscular media of the arteries c.Fibroelastic thickening of whole arteriole walls deposition in narteriole walls Su dden and severe increase in blood pressure IIA type2 question (20 questions.Two points per question) Directions:Each question below contains five suggested answers.Choose the one best response to each question 41.On a routine visit to the physician,an otherwise healthy 51 year-old man has an elevated blood pressure of 150/95 mm Hg.If the patient's hypertension remains untreated for years,which of the following cellular alteratio will most likely be se i the myocardium(heart muscle)?( A.Atrophy B.Hemosiderosis C.Hypertrophy D.Metaplasia E.Sclerosis 42.A 72 year-old man died suddenly and unexpectedly from congestive heart failure.At autopsy,the heart was very enlarged and weighed 580 grams.There was marked left ventricular hypertrophy and minimal coronary arterial atheroscle stry panel ered prior to death abnormalities s.Which of the following pathologic processes best accounts for appearance of his aortic valve,which is seen in the figure?() A.Amyloidosis B.Dystrophic calcification C.Fatty Change
b. Typhoid fever c. Ulcerative colitis d. Syphilis e. Rheumatic myocarditis 39.Which one of the following statements about acute inflammation is correct? ( ) a. The predominant cell type is the neutrophil polymorph b. The inflammation is usually initiated by cell-mediated immunity c. The duration may be for months d. Plasma cells are frequently present e. Lymphocytes are present at the start of the process 40. Benign hypertension is characterized by：( ) a．Fibrinoid necrosis of arterioles b．Atrophy of the muscular media of the arteries c．Fibroelastic thickening of whole arteriole walls d．Hyaline deposition in arteriole walls e．Sudden and severe increase in blood pressure ⅡA type2 question（20 questions. Two points per question） Directions: Each question below contains five suggested answers. Choose the one best response to each question. 41. On a routine visit to the physician, an otherwise healthy 51 year-old man has an elevated blood pressure of 150/95 mm Hg. If the patient’s hypertension remains untreated for years, which of the following cellular alterations will most likely be seen in the myocardium (heart muscle)? ( ) A. Atrophy B. Hemosiderosis C. Hypertrophy D. Metaplasia E. Sclerosis 42. A 72 year-old man died suddenly and unexpectedly from congestive heart failure. At autopsy, the heart was very enlarged and weighed 580 grams. There was marked left ventricular hypertrophy and minimal coronary arterial atherosclerosis. A serum chemistry panel ordered prior to death showed no abnormalities. Which of the following pathologic processes best accounts for the appearance of his aortic valve, which is seen in the figure? ( ) A. Amyloidosis B. Dystrophic calcification C. Fatty Change
D.Hemosiderosis E.Lipofuscin deposition 43.A 16 year-old boy sustained blunt trauma to the abdomen when the vehicle he was driving struck a bridge abutment at high speed.Peritoneal lavage(washing the peritoneal cavity with saline)showed a hemoperitoneum (blood in the abdominal cavity),and at laparotomy (surgical exploration of the abdomen),a small port the Several left lobe of the liv was removed be of the later, scan of the abdomen shows that the liver is nearly normal in size again.Which of the following processes best explains this phenomenon?( A.Apoptosis C.Fatty change D.Hydropic change E.Hyperplasia 44.Which of the following statements is correet?( A.Autophagy is a rare process that is alw ciated with dis B.Autophagy is important in cellular defense against microorganisms C.Autophagy is not involved in cellular differentiation. D.The autophagic vacuole fuses with a lysosome to form an autophagolysosome. E.The autophagic vacuole is formed by mitochondria. 45.A63-year-old man develops worsening congestive heart failure I month afte an acute mvocardial infarction.An echocardiogram shows a markedly decreased ejection fraction.He dies six weeks after his acute myocardial infarct.At autopsy, a section of the infarct shows that the necrotic mvocardium has largely been capillaries,fibroblasts,and collager Which of the following natory cell types plays the most important role in the healing process by removing debris?( A.Eosinophils B.Lymphocytes D.Neutrophil E.Plasmacytes 46.While shaving one morning,a 23-year-old man nicks his lip with a razor. Seconds after the injury,the bleeding stops.Which of the following mechanisms is most likely to reduc e blood loss from a small dermal vein?( A.Fibrin poly eriza 10n B.Neutrophil chemotaxis C.Platelet aggregation D.Protein C activation
D. Hemosiderosis E. Lipofuscin deposition 43. A 16 year-old boy sustained blunt trauma to the abdomen when the vehicle he was driving struck a bridge abutment at high speed. Peritoneal lavage (washing the peritoneal cavity with saline) showed a hemoperitoneum (blood in the abdominal cavity), and at laparotomy (surgical exploration of the abdomen), a small portion of the left lobe of the liver was removed because of the injury. Several weeks later, a CT scan of the abdomen shows that the liver is nearly normal in size again. Which of the following processes best explains this phenomenon? ( ) A. Apoptosis B. Dysplasia C. Fatty change D. Hydropic change E. Hyperplasia 44. Which of the following statements is correct? ( ) A. Autophagy is a rare process that is always associated with disease. B. Autophagy is important in cellular defense against microorganisms. C. Autophagy is not involved in cellular differentiation. D. The autophagic vacuole fuses with a lysosome to form an autophagolysosome. E. The autophagic vacuole is formed by mitochondria. 45. A 63-year-old man develops worsening congestive heart failure 1 month after an acute myocardial infarction. An echocardiogram shows a markedly decreased ejection fraction. He dies six weeks after his acute myocardial infarct. At autopsy, a section of the infarct shows that the necrotic myocardium has largely been replaced by capillaries, fibroblasts, and collagen. Which of the following inflammatory cell types plays the most important role in the healing process by removing debris? ( ) A. Eosinophils B. Lymphocytes C. Macrophages D. Neutrophils E. Plasmacytes 46. While shaving one morning, a 23-year-old man nicks his lip with a razor. Seconds after the injury, the bleeding stops. Which of the following mechanisms is most likely to reduce blood loss from a small dermal vein? ( ) A. Fibrin polymerization B. Neutrophil chemotaxis C. Platelet aggregation D. Protein C activation
E.Vasodilation 47.A 50-year-old man has a two-year history of angina pectoris that occurs when he exercises.His blood pressure and pulse are normal.Coronary angiography shows 75%narrowing of the left anterior descending artery.Which of the following cell types was the initial target in the development of this lesion?( A Endothelial cells B.Fibroblasts C.Lymphocytes D.Platelets E.Smooth muscle cells 48.A 56-year-old man with a 120 pack-year smoking history is referred to you for consideration of surgical resection after he is found to have a new 2 cm lung mass on a chest x-ray.After you have reviewed his records,you want to be able to tell him whether surgery will cure his disease.Factors that would influence whether a surgical resection would be curative include:( A.Cell ty of the neoplasm B Locatic of the neoplasm Stage of the neoplasm D.Whether the neoplasm is benign or malignant E.All of the above 49.During a routine health maintenance examination of a 40-year-old man a stool guaiac test result was positive (occult blood in the stool).follow-up sigmoidoscopy showed a 1.5 cm circumscribed,pedunculated mass on a short stalk,located in the upper rectum.Which of the following terms best describes the lesion？( A.Adenom B.Dysplasia C.Hamartoma D.Melanoma E.Sarcoma 50.An epidemiologic study investigates the potential cellular molecular alterations that may contribute to the development of cancers in a population Molecular data from resected colonic lesions show changes involved in the evolution of a sporadic colonic adenoma into an invasive carcinoma.Which of the following best describes the mechanism producing these changes?( A.Extensive regeneration of tissues increases the risk of cancer-causing tations B.Inherited defects in DNA repair genes increase the susceptibility to develop cancer C.Malignant transformation involves accumulation of mutations in
E. Vasodilation 47. A 50-year-old man has a two-year history of angina pectoris that occurs when he exercises. His blood pressure and pulse are normal. Coronary angiography shows 75% narrowing of the left anterior descending artery. Which of the following cell types was the initial target in the development of this lesion? ( ) A. Endothelial cells B. Fibroblasts C. Lymphocytes D. Platelets E. Smooth muscle cells 48. A 56-year-old man with a 120 pack-year smoking history is referred to you for consideration of surgical resection after he is found to have a new 2 cm lung mass on a chest x-ray. After you have reviewed his records, you want to be able to tell him whether surgery will cure his disease. Factors that would influence whether a surgical resection would be curative include: ( ) A. Cell type of the neoplasm B. Location of the neoplasm C. Stage of the neoplasm D. Whether the neoplasm is benign or malignant E. All of the above 49. During a routine health maintenance examination of a 40-year-old man a stool guaiac test result was positive (occult blood in the stool). A follow-up sigmoidoscopy showed a 1.5 cm circumscribed, pedunculated mass on a short stalk, located in the upper rectum. Which of the following terms best describes the lesion? ( ) A. Adenoma B. Dysplasia C. Hamartoma D. Melanoma E. Sarcoma 50. An epidemiologic study investigates the potential cellular molecular alterations that may contribute to the development of cancers in a population. Molecular data from resected colonic lesions show changes involved in the evolution of a sporadic colonic adenoma into an invasive carcinoma. Which of the following best describes the mechanism producing these changes? ( ) A. Extensive regeneration of tissues increases the risk of cancer-causing mutations B. Inherited defects in DNA repair genes increase the susceptibility to develop cancer C. Malignant transformation involves accumulation of mutations in