Arya.Non-neoplastic Disorders ; Neoplasia; Hematology-1 & 2
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- 1.A 15-year-old boy has a positive monospot test. He has a mild pharyngitis followed by generalized lymphadenopathy, malaise, and mild scleral icterus. His spleen tip is also palpable. He recovers in a month. Which of the following is the most likely finding on the peripheral smear?
- A.
Lymphocytopenia
- B.
Atypical lymphocytes
- C.
Neutrophilia
- D.
Eosinophilia
- 2.A 7-year-old boy complains of groin pain since past few days. Painful, swollen lymph nodes in right inguinal region are noted. Lymph node biopsy shows follicular enlargement and hyperemia. Sinuses are filled with neutrophils.. What is the most likely cause of these histological changes?
- A.
Acute lymphadenitis
- B.
Lymphoma
- C.
Leukemia
- D.
Metastatic carcinoma
- E.
Chronic lymphadenitis
- 3.A 12-year-old girl presents with fever and a swollen lymph node of 6 days duration. Biopsy of the lymph node reveals benign follicular hyperplasia. The pathologic finding is interpreted as which of the following?
- A.
Proliferation in B-cell areas
- B.
Proliferation in T-cell areas
- C.
Proliferation of cancer cells
- D.
Proliferation of plasma cells
- 4.A 30-year-old man gives a history of sore throat with fever followed by 6 weeks of malaise. O/E he has mildly tender generalized lymphadenopathy. A cervical lymph node biopsy shows a diffuse paracortical hyperplasia. Which of the following is the most likely diagnosis?
- A.
Lymphoma
- B.
Lymph node draining a cancer
- C.
Infectious mononucleosis
- D.
Acute lymphadenitis
- 5.A 17-year-old adolescent has had malaise for past 3 wks. Physical examination shows mild pharyngitis and tender axillary/inguinal lymphadenopathy. CBC shows Hb 14.0 g/dL, Hct 42.2%, MCV 90 fL, platelets 301,300/µL, WBC count 8120/µL with "atypical lymphocytes" on peripheral blood smear. Monospot test is positive. What is most likely to be seen on a lymph node biopsy?
- A.
Follicular hyperplasia due to proliferation of B cells
- B.
Paracortical hyperplasia due to proliferation of activated T cells
- C.
Sinus hyperplasia of histiocytes
- D.
Necrotizing lymphadenitis
- E.
Granulomatous lymphadenitis
- 6.A 5-year-old girl presents with a 2-3 day history of localized swelling in the right side of her neck. Physical examination shows very tender, firm, slightly enlarged lymph nodes in the right cervical region. CBC shows mild leukocytosis. Which of the following is the most likely diagnosis?
- A.
Chronic lymphadenitis
- B.
Acute bacterial lymphadenitis
- C.
Lymphoma
- D.
Metastatic cancer
- 7.A 10-yr-old boy presents with high fever since 10 days. O/E- Petechial hemorrhages on trunk and extremities. CBC shows normal Hb, normal platelet count; leukopenia with absolute neutropenia. BM biopsy does not show any abnormal cells. Which of the following is the most likely diagnosis?
- A.
Viral infection
- B.
Overwhelming bacterial infection
- C.
Megaloblastic anemia
- D.
Allergic reactions
- E.
Parasitic infestation
- 8.A 27-year-old woman in excellent health has a routine health maintenance examination. A 2-cm rounded mass is palpable beneath the skin of the left forearm. The mass on excision is yellow, soft and shows a benign tumor composed of adipocytes. What is your diagnosis?
- A.
Fibroadenoma
- B.
Melanoma
- C.
Rhabdomyosarcoma
- D.
Lipoma
- E.
Leiomyoma
- 9.A 35-year-old woman had a firm nodule palpable on the dome of the uterus six years ago recorded on routine physical examination. The nodule has slowly increased in size and is now about twice the size when first discovered. She remains asymptomatic. Which of the following neoplasms is she most likely to have?
- A.
Adenocarcinoma
- B.
Rhabdomyoma
- C.
Seminoma
- D.
Leiomyoma
- E.
Hepatocellular carcinoma
- 10.A 14-year-old healthy girl has a 0.3 cm reddish, slightly raised nodule on the skin of the upper part of her chest found on a routine examination. The tumor shows a benign proliferation of blood vessels. Which of the following neoplasms is this nodule most likely to be?
- A.
Hemangioma
- B.
Melanoma
- C.
Mesothelioma
- D.
Lymphoma
- E.
Meningioma
- 11.Which of the following neoplasms is malignant?
- A.
Seminoma
- B.
Adenoma
- C.
Chondroma
- D.
Osteoma
- E.
Leiomyoma
- 12.A 35-year-old woman has had dull pelvic pain for a year. A pelvic CT scan shows a cystic mass involving the left adnexa. She is found at laparotomy to have a well-circumscribed 5 cm cystic mass in the left ovary. On sectioning the mass is filled with yellow-tan material and hair. Microscopy is shown below. What is your diagnosis?
- A.
Choriocarcinoma
- B.
Osteosarcoma
- C.
Teratoma
- D.
Hydatidiform mole
- 13.A 40-year-old woman has had abdominal discomfort for past 8 months. On pelvic examination, there is a right adnexal mass. An abdominal CT scan shows s a 7 cm cystic mass involving right ovary with small areas of calcification. Uterus is normal in size. Right fallopian tube and ovary are removed surgically. Grossly, the mass on sectioning is filled with abundant hair and sebum. M/S reveals a mass with glandular spaces lined by columnar epithelium, squamous epithelium with hair follicles, cartilage, and dense connective tissue. What is your diagnosis?
- A.
Melanoma
- B.
Mesothelioma
- C.
Teratoma
- D.
Hamartoma
- E.
Choristoma
- 14.Histologic examination of a hamartoma would reveal
- A.
Ectopic islands of normal tissue
- B.
Disorganized normal tissue
- C.
Tumor with tissues derived from all 3 germ cell layers
- D.
Tumor originating from one germ cell layer, but having 2 morphological patterns.
- 15.Which of the following is correct regarding classification and nomenclature of neoplasms?
- A.
A hamartoma is a benign tumor of glandular epithelium
- B.
A carcinoma is an epithelial malignancy
- C.
Liposarcoma is a malignant tumor of skeletal muscle
- D.
A choristoma is a benign tumor of adipose tissue
- 16.A 72-year-old man has been feeling tired for the past 8 months. O/E - No abnormal findings. Lab. studies show Hb 10.4 g/dL, Hct 30.3%, MCV 72 fL, platelet count 239,000/uL, WBC count 7500/uL with automated differential count of 70.1% granulocytes, 18.8% lymphocytes, and 11.1% monocytes. His total bilirubin is 1.0 mg/dL. Which of the following morphologic findings is most likely to be seen on his peripheral blood smear?
- A.
Fragmentation
- B.
Schistocytes
- C.
Howell-Jolly bodies
- D.
Microcytic hypochromic RBCs
- E.
Spherocytosis
- 17.A 65-year-old man has increasing shortness of breath on exertion. Physical examination reveals pallor and koilonychia. A complete blood count reveals the following. Hemoglobin – 8 g/dL Mean corpuscular volume – 72 µm3 Peripheral smear examination shows microcytic hypochromic red cells. Which of the following is the most likely cause of the anemia in this patient?
- A.
Iron deficiency
- B.
Folic acid deficiency
- C.
Vitamin B12 deficiency
- D.
Pernicious anemia
- E.
Alcoholism
- 18.A 40-year-old female is diagnosed with Crohn’s disease. She does not respond to medication. She undergoes surgery (partial resection of colon and terminal ileum). Few weeks later, she presents with fatigue. CBC shows Hb-10 gm%, MCV-110 fL; Reticulocyte count is 0.4%. Which of the following is most likely responsible for her anemia?
- A.
Anemia of chronic disease
- B.
Iron deficiency anemia
- C.
Hemolytic anemia
- D.
Vitamin B12 deficiency
- E.
Bone marrow infiltration by a tumor
- 19.A 51-year-old man has become increasingly fatigued for the past 10 months. O/E- No abnormal findings. Labs- Hb 9.2gm%, Hct 27.9%, MCV 132 fL, platelets 242,000/µL, WBC count 7800/µL. Which morphologic finding is most likely to be present on his peripheral blood smear?
- A.
Hyper-segmented neutrophils
- B.
Normocytic RBCs
- C.
Hypochromasia
- D.
Microcytic RBC's
- 20.A 51-year-old woman has been feeling tired for past 7 months. O/E- Decreased sensation to light touch and pin-prick over lower extremities. CBC shows Hb 9.5 g/dL, Hct 29.1%, MCV 124 fL, platelets 250,000/µL, WBC count 8200/µL. Reticulocyte count - 0.5%. Hyper-segmented neutrophils seen on PBS. Which laboratory test is most appropriate to order next on this woman?
- A.
Serum B12 and folate
- B.
Bone marrow biopsy
- C.
Serum ferritin
- D.
Hemoglobin electrophoresis
- 21.A 63-year-old woman has had malaise and nausea for the past 14 months. Her stool is negative for occult blood. Upper GI endoscopy and other investigations reveal findings of a pernicious anemia . Her Hb is 7.9 g/dL. Which of the following laboratory findings is most likely to be present in this woman?
- A.
Decreased serum ferritin
- B.
Increased reticulocyte count
- C.
Decreased serum folate
- D.
Increased neutrophil segmentation
- E.
Decreased red cell MCV
- 22.A 40-yr-old woman presents with chronic fatigue. Labs show a microcytic hypochromic anemia. Endoscopy shows a bleeding peptic ulcer measuring 1 cm in diameter. Which of the following best describes the pathogenesis of anemia in this patient?
- A.
Defective globin chain synthesis
- B.
Impaired heme synthesis
- C.
Poor utilization of iron stores
- D.
Synthesis of structurally abnormal hemoglobin
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