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Patho II Final

Total questions: 65

Worksheet time: 36mins

Name
Class
Date
1.

Breast cancer can sometimes occur outside of the confines of breast tissue due to which of the following?

a)

There are ducts and lobules extending into the subcutaneous tissue of the chest wall and into the axilla

b)

There is a double-layered epithelium lining the duct system

c)

There are superficial ducts lined with keratinizing squamous epithelium

d)

Following puberty, the duct system expands and proliferates, giving rise to numerous terminal duct

2.

Only with _________________ does the breast completely mature and become fully functional

a)

Menopause

b)

Pregnancy

c)

Puberty

d)

Prolactin production

3.

When considering the breast tissue in response to the production of breast milk, which of the following occur?

a)

The stroma increases in size

b)

The myoepithelial cells become scant

c)

The breast is mostly composed of lobules

d)

Interlobular stroma is converted to radiolucent adipose tissue

4.

The most common benign breast masses are ___________________ . These arise from the terminal duct lobular unit.

a)

Fibroadenomas

b)

Hemangiomas

c)

Angiosarcoma

d)

Ductal carcinoma in situ

5.

A greater percentage of breast cancers are found in which quadrant of the breast?

a)

Upper outer

b)

Upper inner

c)

Lower outer

d)

Lower inner

6.

Which is the most significant risk factor for developing breast cancer (other than gender)?

a)

Alcohol consumption

b)

Obesity

c)

Hormone replacement therapy

d)

Increasing age

7.

The most common site for breast cancer to spread is the -

a)

Lungs

b)

Liver

c)

Brain

d)

Bone

8.

The proto-oncogene, HER-2/neu gene codes for a transmembrane glycoprotein that:

a)

Binds to the surface of cells, leading to alterations in the DNA

b)

Sends more signals to the nucleus, causing cells to grow and divide quickly.

c)

Cleaves DNA within the cell, leading to disruptions in translation

d)

Acts as a marker to notify apoptotic cells

9.

The most common invasive breast cancer is ___________________ .

a)

Fibroadenomas

b)

Hemangiomas

c)

Angiosarcoma

d)

Ductal carcinoma in situ

e)

Invasive Lobular carcinoma

10.

A rare form of breast cancer that beings in the milk passages and spreads to the skin of the nipple and areola is ______. It typically presents as persistent dermatitis and ezcematous skin lesions.

a)

Fibroadenomas

b)

Hemangiomas

c)

Paget's Disease

d)

Ductal carcinoma in situ

e)

Invasive Lobular carcinoma

11.

Breast devemopment is due to the initial release of _________, which causes fat storage in breast tissue.

a)

Estradiol

b)

Progesterone

c)

FSH

d)

LH

12.

Which of the following accurately describes acute mastiitis?

a)

Improves with lactation cessation

b)

A local infection due to cracks and fissures in the nipples

c)

Is mostly due to Staphylococcus aureus

d)

Requires surgical drainage

e)

Fever is often present

13.

Which of the following is characterized by a painful erythematous mass that mimics a bacterial abscess?

a)

Acute Mastitis

b)

Squamous Metaplasia of Lactiferous Ducts

c)

Duct Ectasia

d)

Lymphocytic Mastopathy

14.

Which of the following is associated with masses that are associated with densely collagenized stroma and must be distinguished from breast cancer?

a)

Lymphocytic Mastopathy

b)

Granulomatous Mastitis

c)

Duct Ectasia

d)

Squamous Metaplasia of Lactiferous Ducts

15.

The most aggrssive forms of breast cancer are linked to what types of cells?

a)

Estrogen negative

b)

HER2/Neu negative

c)

Progesterone negative

d)

Triple negative

16.

T/F: Lobular carcinoma is associated with an increased risk of cancer in BOTH breasts

a)

True

b)

False

17.

HER2/neu would likely benefit from which of the following treatments?

a)

Tamoxifen

b)

Anastrozole

c)

Trastuzumab

d)

Hormone replacement therapy

18.

Which of the following cells of the corpus luteum converts androsterone to 17B - Estradiol?

a)

Granulosa cells

b)

Theca cells

c)

Sertoli cells

d)

Leydig cells

19.

A strong surge of ________ at day 14 of the menstrual cycle, triggers ovulation of an egg from a mature follicle.

a)

LH

b)

Progesterone

c)

Testosterone

d)

Estrogen

20.

Why is fertilization less likely during the luteal phase, 16 - 28 days after ovulation?

a)

The uterine glands secrete more mucus

b)

There is an increase in progesterone

c)

The corpus albicans is no longer making hormones

d)

The functional layer of the endometrium is preparing to shed

21.

Which of the following phases of follicular development occurs most rapidly?

a)

First Stage

b)

Sencond Stage

c)

Third Stage

d)

Fourth Stage

22.

A 28 y/o female presents to your clinic for an annual routine checkup. Her BMI is 42 and she complains of scant uterine bleeding every month with her cycle. What other findings suggest PCOS?

a)

Hirsutism

b)

Dark, hyperpigmented rash in her skin folds

c)

Sufficient endometrial lining

d)

Hypoandrogenism

23.

"Basal-like" breast cancers are ER ______ and PR _______, which causes high proliferative rates and poorly differentiated carcinomas.

a)

+ , -

b)

+ , +

c)

- , +

d)

- , -

24.

Which of the following is the most common invasive breast cancer?

a)

Ductal Carcinoma in Situ

b)

Lobular Carcinoma in Situ

c)

Pagets disease

d)

Fibroadenoma

25.

Which of the following is characteristic of colostrum?

a)

Contains an increased citrate content

b)

More protein than mature milk

c)

More fat than mature milk

d)

Contains IgA, lactoferrin, and oligosaccharides

e)

Has a higher specific gravity than mature milk

26.

What hormone inhibits milk production during pregnancy, and drastically decreases with the delivery of the placenta?

a)

Estrogen

b)

Progesterone

c)

FSH

d)

LH

e)

Prolactin

27.

Mature milk is produced ______ days after delivery and in response to __________ levels of prolactin, but also requires ___________ production.

a)

10, high, estrogen

b)

2, low, progesterone

c)

10, high, progesterone

d)

10, low, estrogen

e)

2, low, estrogen

28.

which probiotic is found in mother's milk and feeds on oligosacchrides?

a)

lactobacilli

b)

Bifidobacillus longum (B. infantis)

c)

bactobacilli

d)

staphylococcus

29.

Oxytocin is important for the:

a)

synthesis of milk

b)

release of milk from the alveoli and small ductules

c)

breast tissue development prior to the onset of menses

d)

lactose production

30.

Mature milk is sufficient for all vitamins except for -

a)

K

b)

A

c)

E

d)

D

e)

C

31.

GP120, found on the surface of the HIV, attaches to the _________ receptor on the surface of T cells and further binds with the use of ______________ receptors to enter the cell.

a)

CD4, GCPR2

b)

CD4, CXCR4/CCR5

c)

CD8, GCPR2

d)

CD8, CXCR4/CCR5

32.

Human Placental Lactogen, is a major coponent of individuals that develop gestational diabetes. As it promotes the utilization of ______ and increases the availability of maternal ___________ for the infant

a)

Glucose, free fatty acids

b)

Ketones, free fatty acids

c)

Glucose, ketones

d)

Free fatty acids, glucose

33.

After integration into the host genome, the HIV uses what enzyme to create cDNA?

a)

DNA Polymerase

b)

RNA Polymerase

c)

Reverse Transcriptase

34.

Cryptococcosis occurs in about 10% of AIDS patients. What is the major clinical manisfestation from this infection?

a)

Pneumonia

b)

Meningitis

c)

Encephalitis

d)

Progressive multifocal leukoencephalopathy

35.

Within days to weeks of the initial infection, what antigen can we test for that is present in 95% of HIV patients by day 16?

(a)  

36.

A 54 y/o Female, G4 P4, presents with a palpable periareolar mass, thick white nipple secretions and mild skin retractions. Patient has no pain or erythema. A likely diagnosis is -

a)

Duct Ectasia

b)

Squamous Metaplasia of Lactiferous Ducts

c)

Acute Mastitis

d)

Fat necrosis

37.

HAART Therapy for HIV infections include which of the following?

a)

2 NRTIs + 1 NNRTI or Integrase Inhibitor

b)

2 PI + 1 NRTI

c)

1 NRTI + 1 NRTI

d)

2 NNRTIs + 1 NRTI or PI

38.

During the natural progression of the HIV virus, a patient that is asymptomatic and experiencing little to none opportunistic infections is likely in what phase of the disease?

a)

Acute phase

b)

Chronic phase

c)

Final phase

39.

Which of the following drugs is responsible for blocking the reverse transcriptase enzyme in the cytoplasm of the cell by binding to the genetic material?

a)

NRTI (Stavudine, Lamivudine, Tenofovir)

b)

PI (Ritonavir, Lopinavir, Atazanavir)

c)

NNRTI (Nevirapine, Delavirdine)

d)

Entry Inhibitors (Enfuvirtide)

40.

When considering the anatomy of the eye, what structure contains the ciliary body, which is responsible for creating the vitreous humor?

a)

Anterior chamber

b)

Posterior chamber

c)

Cornea

d)

Lateral border

e)

Lens

41.

Exposure to chronic levels of UV light can lead to which of the following disorders?

a)

Actinic band keratopathy

b)

Calcific band keratopathy

c)

Keratoconus (progressive corneal thinning)

d)

Fuchs endothelial dystrophy

42.

Which of the following disorders is associated with Down Syndrome, Marfan Syndrome, and atopic disorders?

a)

Actinic band keratopathy

b)

Calcific band keratopathy

c)

Keratoconus (progressive corneal thinning)

d)

Fuchs endothelial dystrophy

43.

The second leading cause of blindness is:

a)

Glaucoma

b)

Cataracts

c)

Cytomegalovirus

d)

Temporal Arteritis

44.

Select all of the symptoms that are associated with closed angle glaucoma:

a)

Nausea/ Vomiting

b)

Headache

c)

Severe eye pain

d)

Halos around the eyes

e)

Syncope

45.

Most common worldwide cause of reversible blindness is:

a)

Glaucoma

b)

Cataracts

c)

Cytomegalovirus

d)

Temporal Arteritis

46.

What is the most common risk factor associated with cataracts?

a)

Aging most common reason

b)

Eye trauma

c)

Steroid use

d)

Diabetes

47.

The leading cause of blindness is :

a)

Age-related Macular Degeneration

b)

Open angle glaucoma

c)

Cataracts

d)

Closed angle glaucoma

48.

Which of the following is associated with dry age-related macular degeneration?

a)

Localized deposits that can be hard, soft, crystalline, or calcified

b)

Thinning and loss of tissue in the macula

c)

Pigment epithelial detachments

d)

Areas of blood vessel leakage

e)

Subretinal pigment epithelial clumping

49.

Neovascularization arising from disc or retinal vessels that may lead to preretinal and vitreous hemorrhage describes:

a)

Proliferative Diabetic Retinopathy

b)

Non-proliferative Diabetic Retinopathy

50.

Which of the following is an emergent condition in patients that have hypertensive retinopathy?

a)

AV Nicking

b)

Papilledema

c)

Cotton Wool Spots

d)

Hemorrhages and microaneurysms

51.

Increased expression of the _____ and ____ genes lead to increased oncogensis in HPV

a)

E1

b)

E2

c)

E6

d)

E7

e)

E4

52.

Which of the following are cofactors in the pathogenesis of HPV and cervical cancer?

a)

Cigarette Smoking

b)

HSV/Chlamydia/STI

c)

Long term use of Oral Contraceptives

d)

HIV or chronic immunosuppressive therapy

e)

Nulliparity

53.

True or False: PCOS has androgen and estrogen excess.

a)

True

b)

False

54.

What are the most common types of HPV in Cervical Cancer?

a)

16

b)

18

c)

33

d)

34

55.

1.Which of the following are theories of endometriosis (pick all that apply)

a)

Lymphatic dissemination

b)

Coelomic Metaplasia

c)

Retrograde menstruation

d)

Genetic link

56.

Which of the following is the most common subtype of epithelial ovarian cancers, is aggressive, and often presents as advance disease (Stage III or IV) due to vague symptoms initially (bloating, constipation).

a)

High grade Serous

b)

Mucinous

c)

Clear Cell

d)

Sex-cord stromal tumors

e)

Germ Cell tumors

57.

Which of the following often presents with a large ovarian mass, with elevated CEA labs, and has appendectomies often performed with staging to ensure primary tumor site identification?

a)

High grade Serous

b)

Mucinous

c)

Clear Cell

d)

Sex-cord stromal tumors

e)

Germ Cell tumors

58.

Which of the following tumors is most likely to produce steroid hormones? Labs (AFP, LDH, Inhibin, and Hcg should be checked)

a)

High grade Serous

b)

Mucinous

c)

Clear Cell

d)

Sex-cord stromal tumors

e)

Germ Cell tumors

59.

What is the most common gynecologic malignancy?

a)

Ovarian

b)

Fallopian tube

c)

Endometrial

d)

Cervix

60.

Which of the following is a benign ovarian neoplasm?

a)

Clear cell

b)

Serous

c)

Granulosa Cell

d)

Mature Teratoma

61.

The most common renal cell carcinoma is-

a)

Papillary

b)

Clear cell

c)

Chromophobic

d)

Bellini Duct

62.

Von Hippel Lindau mutations are associated with which of the following carcinomas?

a)

Papillary

b)

Clear cell

c)

Chromophobic

d)

Bellini Duct

63.

Transition cell carcinoma is associated with mutations in:

a)

FGFR3

b)

Retinoblastoma gene

c)

p53

d)

TT47

64.

An established link between the _________ gene and prostate cancer has been established.

a)

BAK1

b)

TMPRSS-ETS Fusion

c)

BRCA 1

d)

BRCA 2

65.

The most common germ cell neoplasm and the least malignant is-

a)

Seminoma

b)

Yolk Sac tumor

c)

Choriocarcinoma

d)

Embryonal