-1.

Patient is an 18 month old child membranous cardiac defect that resulted in

Angiomatoid change? What is the Defect? What syndrome can result of the
aforementioned shunt reversal? Membranous-VSD (L->R). Eisenmeger (R->L)
2.
Thin fibrous cap.__________ core? Thick Fibrous cap. ________ ?
Thin-> Less stable, bigger core. Thick-> More stable, smaller core
Core: has lipids, macrophages & T-cells
3.
Patient acquired a nosocomial form of pneumonia? (Hint: Most of the time
this bug is penicillin resistant) Staphylococcus Aureus
4.
Solid organ infarct results in? List the organs.white infarct in spleen, heart,
& kidney
5.
Infarct in the brain seen leads to liquefactive necrosis (Late stage)? What
type of enzymes do the work? MCA and ACA jct leads to what type of infarct?
Coagulative->Liquefactive. Hydrolytic enzymes. Cerebral infarct (Red infarct)
6.
Cheesy Chalky necrosis you would see high levels of what enzyme? Lipase
7.
MCC of Aortic calcification Calcific aortic stenosis in 1) elderly 2) congenital
bicuspid
8.
Diagnostic for HIV infection PCR assay. AIDS CD4 <200
9.
Said ^^^ test. Tests what? nucleic acids
10.
Paradoxical DVT that reaches the brain howd it get there? VSD, ASD,PFO
11.
Chemotactic factors for neutrophils TELL ME ALL OF THEM? IL8, C5a,
Bacterial Products (E. coli, Staph aureus) , LTB4
12.
Shipbuilders most likely to develop? Asbestos
13.
Ki67 proliferation marker for? Malignancy - proliferation marker - measures
Rate of Growth in general can be for benign or malignant -thats how you tell whether
a tumor has fast or slow growth
14.
An example of Hamartoma that is self resolving? Hemangioma
15.
Female presents to the office with a mid-systolic murmur. History reveals a
significant child hood illness Presents with Fever, Erythema marginatum, Valvular
damage, ESR (increased), Red-hot joints (migratory polyarthritis), Subcutaneous
nodules What is seen on histology? (signs of Acute Rheumatic disease)
Aschoff bodies and Anitschkow cells in myocardium histology
16.
Lung condition refractory to O2 - associated with TGF-B? what are the top
causes? Consider looking at the pathogen. ARDS; tgf-B is associated with the
proliferative phase (chronic) of ARDS which promotes fibrotic changes
17.
Barrel Chest w/ liver accumulations? What type of destruction? Whats the
condition Emphysema (Pan acinar). Destruction of alveolar septa w/o fibrosis.
Destruction of Elastin, genetic a1AT def
18.
Increased A-P diameter w/ septal destruction in an elderly person who has
100000 pack years what type of septal destruction?septal type of emphysema
distal acinar ; assoc with septal destruction pneumothorax compression
atelectasis as complication
19.
Patient had MI admitted to hospital and had another MI What is the Most
important Cardiac Marker (in general)? And in this case what is the most diagnostic
marker in this case?
Troponin I. Ck-MB (peaks at 24 hrs) for re-infarct diagnosis
20.
Patient with Media and Adventitia fibrosis? How old is she? What does she
have? Takayasu Arteritis, <40, 7:1 females
21.
Indication for aspirin in a child? Kawaski
22.
Nuclear chromatin clumping seen on microscopy? Ischemia, Reversible,

Lactic acid accumulation

23.
Massive calcium influx due to an intracellular change? Reversible or
Irreversible? - Irreversible.
24.
Biiiiiiiiigggggg Ol Mucoid plug? What are the implicated Interleukins? IL 4, 5,
10, 13
25.
Pulmonary fibrosis with Temporal and Geographical?? IPF/UIP
26.
Metaplastic change in the respiratory Epithelium is seen where else do we
see such change. Squamous Cell Carcinoma (Metaplasia would be chronic
bronchitis and bronchiectasis) Cervix. Makes sense
27.
Triad of Gohns, lymphatics, and Lns = ? Primary Complex/ Gohns complex
in Primary TB
28.
Lead toxicity causes.. Lead lines, demylination in children, peripheral
neuropathy in adults. Anemia, Basophilic Stippling, Colic w/ Diarreahea, foot drop,
growth retardation, gum line
29.
EBV causes Burkitts Lymphoma.. what else nasopharyngeal cancer,
hodgkins, lymphoproliferative disease
30.
Muffled heart sounds, elevated JVP, HTN - Free wall has ruptured.. What
artery? LAD? CIRCUMFLEX
31.
Neonatal meningitis what bug? Strep. agalactiae, Listeria monocytogenes
& E. coli
32.
Where do you white infarcts? Solid organs, Heart, Kidney, Spleen
33.
How do you test for septic shock? LPS, O antigen, warm hands but where is paradoxical cooling?
34.
Bone marrow embolism is found in ..- Incidental finding after cardiac
resucitation
flat bone breaks (sternum, pelvis, ribs) - more marrow cells than fat cells
35.
Thrombogenic substances released from necrotic tumor cells? Trousseau
Syndrome (MARANTIC adenocarcinoma)
36.
What causes watershed infarct in the brain? HTN or Atherosclerotic plaque
37.
Arterial thrombi what color Pale
38.
Venous Thrombi Red
39.
CD4 200 <Pneumonia what is the organism ? Jiroveci
40.
Candida infection in CD 4<100 what can it cause in Kidney? Abscess
41.
Negri body found in what type of infection Rabies Virus
42.
SEPTIC SHOCK/DIC = how would you test D Dimer, Fibrin Degredation
Products
43.
FIBROTIC lung with HEMOSIDerin laden MACS = Diffuse alveolar
hemorrhage syndrome
44.
WATER SHED INFARCT in the BRAIN = Ischemic encepathology
45.
AORTIC DISSECTION = WHAT WAS THE CAUSE = MARFANS/FIBRILIN
GENE Intimal Tear, media weakening
46.
22 YEAR OLD WOMAN with MITRAL PROLAPSE = WHAT ELSE WOULD
YOU CHECK FOR = MARFANS
47.
RESTIRCTIVE CARDIOMYOPATHY = Diastolic problem
48.
BANANA SHAPED WHAT CAUSED IT? Hypertrophic septum; B-myosin
49.
OLDER GUY PLAYING SPORT and fell over = Hypertrophic cardiomyopathy
(cause it said sport)
50.
WHITE HEART = RESTRICTIVE and asked for cause ( 2 big causes)
Fibrosis, chronic ischemic heart disease
51.
DIALATED CARDIOMYOPATHY causes?A-alcholism, anemia B -

Cocksackie B + BeriBeir (thiamine deficienc), C- Chagas disease, D - Dystrophin

Gene, pregnancy
52.
SUDDEN CARDIAC DEATH causes? Arrhythmia, can sudden major emboli
also be a cause?
53.
CSF w/ LOW GLUCOSE? bacterial infection
54.
GOUT in the big toe? What birefringerence? Shape of crystals?
Negative birefringent, needle shaped crystals
55.
HISTAMINE Causes a few signs of inflammation? vasodilation, redness,
edema (increased vasc permeability)
56.
Arteriolar DIALATION causes? active hyperemia vasodilation with causes
of blushing, exercise then what is passive?
57.
DIPTHERIA? Bug? Test? Endo/exotoxin?? Tellurite, Eleck, Exotoxin
58.
CD 200 What would be the pulmonary infection in AIDS? P. jur?
59.
P ANCA and C ANCA Mechanism? Microscopic Polyangitis & Churg- Panca.
Wegner- Canca/PR3anca
60.
TRANSTHEYRITIN??? Found in Famililal Neuropathies (amylodiosis) and
senile Cardiac amylodosis
61.
BRONCHIACTISIS and chronic INFLAMMMATION leads to Amyloidosis?
What type of deposits? Lung abscess, AA amyloid
62.
Alzhiemers? Where else might you see amyloid Plaques? Pts w/ renal failure
63.
PATIENT WITH CHRONIC DIALYSIS gets dialysis.. How why? B2
microglobulin?
64.
ENDOCARDITIS in a non IVDU Mcc organism? And MCC valve? Who
Gets the vegitations on the Aortic valve? strep viridians is the most common cause
of native mitral valve infection. Aortic for an elderly person. staph epi for prosthetic
valve. s. aureus-tricuspid valve (iv-drug)
65.
RHEUMATIC FEVER? What are the deposits you see made of
Composition? Sterile, fibrin, small
66.
HEAT STROKE mechanism? Major organs affected? Dry skin, high temp,
CVS & Pulmonary
67.
RHEUMATIC FEVER CROSS REACTING ANTIBODY with. M proteins in
heart (have cross reactivity with antigens of Group A streptococci)
68.
TYPE III PAN largely associated with? Hep B, type 3 hsn
69.
HERPES ZOSTER = WHERE DO YOU FIND IT? Where does it establish
latency? Dorsal root ganglion
70.
NEGRI BODY PICTURE? What is the reservoir? What indicates a poorer
prognosis? dogs outside of U.S., U.S.-bats; the closer bite is to brainstem location,
the poorer prognosis
71.
intra nuclear basophillic and intra cytoplasmic eosinophillic inclusions? CMV
72.
COXASACKIE B virus would have _________ infiltrate lymphocytic
73.
Actinomyces ISRAELI = what is seen in the wound sulfur like granules
74.
MUCOR MYCOSIS = who is predisposed to it? type 1 ketoacidotic diabetics
is #1
75.
HISTOPLASMOSIS = PIC FROM THE LAB describe it? Snow
Storm/Buckshot appearance, similar to that of miliary TB (indistinguishable)
76.
LEPROSY PICTURE what type of response? TH1 Tubercoid (skin
erthyematous reaction) vs TH2 Lepromatous (virchow foamy cell picture)
77.
PRESENSCE OF neutrophillic infiltrate in presense of necrotizing granuloma
Organism? Bartonella Hensale in Cat Scratch Diseas-- [Note: Buerger also has

granulomatous inflammation w/ neutrophils--microabscess]

78.
Person who has heroin overdose.. what do you also check for? Staph Aureus
79.
A night after bananas.. a first termer.. presents to the clinic with a pain that is
radiating to the back..lab examination shows.. elevated amylase and LIPASe.. What
are the possible side effects of this acute pancreatitis? elevated amylase and lipase.
ARDS.
80.
C282Y mutation.. what molecular technique do i use? what does it cause? .
Hemochromatosis; mutation in HFE gene, excessive iron absorption & deposition.
Real time PCR, RFLP, Electrophoresis
81.
Egg cell calcificaton makes you susceptible to? TB (egg cell calcification in
silicosis)
82.
BRCA 1/2 are a tumor suppressor genes.. what are other tumor suppressor
genes? p53, RB, NF1/2, p16, APC, WT1, DPC, DCC
83.
Hyperchromatic nuclei with a clear halo around the nuclei on the cervical
surface is found on a woman.. what is the etiology? CIN I (this is describing
koilocytosis)
84.
Cachexia is caused by... what cytokines.. TNF-A
85.
If a person has comes to doctors office with melena and decreased energy.
his Guaiac test is positive. Upon Sigmoidoscopy, physician finds.. numerous polyps
in descending colon... What is the mode of inheritance of APC ? Autosomal
dominant
86.
Which vascular tumor resolves on its own? Hemiangioma by age 7*
87.
A 23 year old mother of a 2 year old child (yes two year old) finally weans her
little boy (of course) of breast feeding. Her husband is dismayed and is surprised
that his wife is no longer wearing the same size bra because her breasts have
decreased in size. What is the mechanism of this atrophy?
A) loss of trophic signal-> Atrophy
B) Necrosis
C) Chromosome 13 BRCA 2 inheritance
D) Chromosome 17 HNPCC mutation.
88.
A child is presented to the clinic when his mother notices whitish reflection
when she was at the beach. Doctor examines and determines that this child has RB
gene mutation and performs enucleation. Doctor also advises mother on a pathology
that this child may develop in his teenage years.. what is this pathology?
A) Ulcerrative Colitis
B) Gastric Tumor
C) Aortic dissection
D) Osteosarcoma
89. Growth on outside of peripheral region that grew into pleural space Causes?
Plaques, Mesothelioma (note: no asbestos body in plaque, plaques contain collagen
& calcium)
90. HAY FARMER w/ alveolitis? What type of hypersensitivity? Hypersensitive
Pneumonia/Extrinsic Allergic Alveolitis Type 3 (acute-immune complex
mediated)...and then if chronic (Type 4-cell mediated)
91. 27 year old black male seen with large growth behind ear? What is
it? Histologically (collagen type and how does that differ from normal?) Keloids,
Type III-> Type I
92. RK couldnt take the pressure anymore closed the garage and started his car. He
play some bruce springsteen and closed his eyes. He was saved by a neighbor.

What is his Dx? What do you expect him to look like? CO poisoning, cherry red
discoloration
93. MOST COMMON MUTATION FOR HYPERCOAGULABILITY? Factor V-Leiden-resistant to protein C inactivation
94. CLOT VS. THROMBUS? Clot- platelets w/o fibrin, gelatinous, not attached to
vessel wall, red Thrombus: platelets+fibrin, firm, lines of Zahn, inside vessel, arterial
(pale) & venous (red), attached to vessel wall
95. PATIENT who died INSTANTLY CPR was performed unsuccessful
outcome _________ EMBOLISM? And what type of finding on autopsy? Bone
marrow embolism, small pulmonary vessels with fat and very high content of RBCs
(cells>fat)
96. Long bone fractures Hugely associated with? Fat Embolism (fat>cells)
97. GUY with bad breath see AIR FLUID LEVEL on xrayAbcess to? Alcohol
108. Pt comes into the emergency clinic complaining of hemoptysis and a pressure
in his chest. The Attending had an x-ray ordered which came back showing a
widened mediastinum? What is the most likely cause of the imaging phenomena?
109cVirchows node
110. Bud Chiari? Acute passive venous congestion due to right heart failure affecting
the liver
Central vein and sinusoids distended with blood Degeneration of central
hepatocytes
111. Nutmeg Liver? Chronic congestion
Central region of hepatic lobule is reddish brown accentuated against the
surrounding zones of uncongested tan liver
112. Transtentorial Herniation? CN defect? Also called uncal herniation. CN III, PNS
messes up, see pupil dilation.
Duret hemorrhages in midbrain and pons
113. Patient w/ COPD in the hospital. COPD exacerbation what is the bug? H.
influenza and S. Agalaticiae. (I thought the other was M. Catarrhalis)
114. Test for Q Fever? Immunofluorescence and liver biopsy containing ring
granulomas
115. Salmonella infection timeline?
Enter the ileal wall (no lesions at this time) enter blood stream bacteremia ( 1st
week).
Liver enlarged - typhoid nodules composed of Kupffer cell hyperplasia,
minute foci of hemorrhagic necrosis, collections of macrophages (II week)

Spleen- enlarged soft spleen with splenitis, typhoid nodules

Organisms now excreted through the gall bladder in the bile in to the lumen of
the gut, re enter gut wall through ileum

Sensitization has occurred during this period contact with organisms

produces lymphoid hypertrophy and necrosis in the mucosa (III week)
No PMNs! See only macrophages.
Widal Test
116. Neonatal Meningitis? Bug? E. coli or Staph Agalectasia
117. GM- diplocooci meningitis nasty complication? Waterhouse Friderichson,
adrenals, teenagers mostly, with N. meningtides.
118. Viral Meningitis CSF looks like?

Normal glucose, slightly elevated protein. Elevated CD8 Lymphocytes [No PMNs]
119. Kid who has fungal viral and bacterial infection (in the blood), CTScan shows a
viral meningitis?
120. Liver Cancer Marker? alpha fetal protein
121. Breast cancer marker? CEA
122. Colon Cancer Marker? CEA
123. RB gene implicated in. (bone cancer) What type of pattern would you see
on XRAY? Sunburst appearance-> Osteogenic Sarcoma
124. Patient is brought in for an autopsy. The examiners report identified that the
patient died due to a herniation that passed through the foramen magnum which
compressed the respiratory centers of the brain stem. Identify the type of herniation
that has occurred and another possible sign that would have lead a physician to note
that the herniation was occurring before the patient had died.
-Tonsillar herniation through the foramen magnum
Brain stem compression respiratory centers in medulla oblongata
Death due to cardio-respiratory arrest
Subfalcine herniation displacement of cingulate gyrus under the falx cerebri
Compression of branches of anterior cerebral artery
Ischemic injury of primary motor and /or sensory cortex
Weakness and /or sensory abnormalities in leg
125. Staging = TNM and what is the important factor (generally speaking)? Tumor
size, Lymph node spread and Metastasis involvement
Showed histo of PAN and asked what is associated -> Hep B