USMLE : ICM And Pathology Questions! Trivia Quiz

25 Questions | Total Attempts: 175

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USMLE : ICM And Pathology Questions! Trivia Quiz

Are you familiar with ICM and pathology, and do you think you can pass this quiz? Pathology focuses on the relationship between the cause and effect of a disease or injury. It also refers to the study of diseases in general. Pathology provides enough information about the condition for it to lead to the certainty of a diagnosis. If you choose to learn more about ICM and pathology, this is the quiz for you.


Questions and Answers
  • 1. 
    A 12-year-old male is investigated for severe headache and is found to have an intraventricular mass by CT scan. The mass is well demarcated with pushing borders. Microscopically, the excised mass shows cells with nuclei showing open chromatin with an inconspicuous nucleus and, well-defined cytoplasm with tapering processes. These cells are arranged in rosette like rests and around the vessels forming pseudorosettes. Also seen are epithelial lined tubules. The delicate processes are positive with PTAH staining and are positive for GFAP. What is the most likely diagnosis in this case?
    • A. 

      Medullobalstoma

    • B. 

      Neuroblastoma

    • C. 

      Cerebellar astrocytoma

    • D. 

      Ependymoma

    • E. 

      Oligodendroglioma

  • 2. 
    A 65-year-old woman has a long-standing dementing disorder characterized by deterioration in personality, neglect of personal hygiene, impaired judgment, and uninhibited behavior. MRI demonstrates severe cortical atrophy limited to the frontal lobes and anterior two thirds of the temporal lobes, while the remaining cortex is preserved. No evidence of recent or remote infarcts is found. Question: What diagnosis is most consistent with these pathologic and clinical features?
    • A. 

      Alzheimers dz

    • B. 

      Creutzfeldt-Jacob dz

    • C. 

      Dementia with Lewy bodies

    • D. 

      Frontotemporal dementia

    • E. 

      Vascular demntia

    • F. 

      Picks

  • 3. 
    A 72-year-old retired nurse with type II diabetes and arthritis, was brought in to see her physician by her two daughters. Although unconcerned herself, her daughters were worried that something may be wrong with her. They informed the doctor that she hadn it been herself for the past 6 months or so. They described their mothers personality as changing drastically. For example, she now laughed inappropriately and seemed utterly unconcerned with things that had previously interested her. After a normal physical examination, her physician referred her to a neurologist. Upon examination, the neurologist detected nothing unusual. All cranial nerves seemed intact and functional. Based on the patiertis symptoms, the neurologist suspected a tumor. An MRI-scan was ordered, which revealed an abnormal intracranial mass. If this tumor was found to be noninvasive and easily susceptible to complete surgical resection, it is MOST likely which of the following types of tumors?
    • A. 

      Glioma

    • B. 

      Astrocytoma

    • C. 

      Meningionna

    • D. 

      Pinealoma

    • E. 

      Acoustic neuronna

  • 4. 
    An 8-year-old male presents with projectile vomiting, severe headache and ataxia. CSF examination shows small cells with hyperchromatic nucleus microscopically. CT scan reveals a 4-cm mass in the cerebellar vermis. The excised mass shows an intensely cellular tumor comprised of small cells with scanty cytoplasm and ill-defined borders. Mitoses are readily observed. The nuclei are hyperchronnatic and have an irregular membrane with an angular to ovoid shape. What is the most likely diagnosis?
    • A. 

      Medulloblastoma

    • B. 

      Neuroblastoma

    • C. 

      Cerebellar Astrocytoma

    • D. 

      Ependymoma

    • E. 

      Oligodendroglioma

  • 5. 
    A 55-year-old male has had emotional changes consisting of sexual disinhibition and emotional apathy. He later has difficulty with expressing himself and doing his usual routine. The Magnetic Resonance Imaging (MR') reveals atrophy of the frontal and temporal lobes, along with swollen neurons in the temporal and frontal areas of the brain, and intraneuronal argentophilic inclusion bodies in these same areas. What type of dementia is this patient exhibiting?
    • A. 

      Alzheimer disease

    • B. 

      Dementia due to Parkinson's disease

    • C. 

      Dementia due to Huntington's disease

    • D. 

      Dementia due to Pick's disease

    • E. 

      Dementia due to HIV disease

  • 6. 
    A 25-year-old white female at 20 weeks gestation with her first pregnancy presents to the physician for a routine visit without any complaints. The patient has no known co- morbidities and denies significant family medical problems. The patient has been compliant with all of her prenatal obstetrical appointments. The patient's vitals are as follows: pulse 68, respirations 12, blood pressure 102/68, and temperature is 98.6°F. A screening ultrasound examination of her infant is performed at this time and demonstrates an infant with hypoplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle, and enlargement of the posterior fossa. Question: What is the most likely diagnosis?
    • A. 

      Chiari II Malformation

    • B. 

      Alobar Holoprosencephaly

    • C. 

      Dandy Walker Malformation

    • D. 

      Hydranencephaly

    • E. 

      Aqueductal Stenosis

  • 7. 
    A 53-year-old caucasian male comes in with a 2-week history of severe headaches mostly occurring during the night. The patient is pacing while he is talking. During the history taking, he states that the symptoms of pain surround 1 eye and last for 30 to 90 minutes in duration. He also states that there is ipsilateral lacrimation, conjunctival injection, and nasal congestion during the attacks. The patient states that he's had these headaches 2 or more times in a day over a period of several weeks. He cannot point to any one thing that causes them. On examination, the patient has features of partial Horner's syndrome. His vital signs are temperature: 97.0 °F, heart rate: 80/mir, respiration: 16/min, and blood pressure: 126/80mmHg. Question: The client's headache is a:
    • A. 

      Common migraine

    • B. 

      Classic migraine

    • C. 

      Cluster Headache

    • D. 

      Stress headache

    • E. 

      Chronic daily Headache

  • 8. 
    A 54-year-old white male presents with gradual onset of mild dementia, ataxic gait, and startle myoclonus. An MRI scan is normal, and an examination of his cerebrospinal fluid reveals no abnormalities, but the patient's EEG is remarkable for recurrent bursts of high -voltage slow waves. Over the next 6 months, the patient's dementia rapidly worsens, accompanied by general hypertonicity and profound dysarthria. The patient dies shortly thereafter. What is the most likely neuropathological finding on autopsy?
    • A. 

      Cerebellar hyperplasia

    • B. 

      Diffuse spongiform change

    • C. 

      Multiple lacunar infarcts

    • D. 

      Negri bodies

    • E. 

      Neurofibrillary tangles

  • 9. 
    A 15-year-old boy has suffered head trauma in a motor vehicle accident. His Glasgow coma scale (GCS) score is 7. Cranial CT scan shows multiple depressed fractures and intraparenchymal bleed. He has signs of raised intracranial pressure, manifesting as bradycarclia, hypertension, and irregular respiration. Question: What is the initial therapeutic intervention of choice for reducing the intracranial pressure in the above patient?
    • A. 

      I.V mannitol

    • B. 

      I.V. Furosemide

    • C. 

      I.V. Dexamethasone

    • D. 

      Hyperventilation

    • E. 

      Hypothermia

  • 10. 
    A 33-year-old female visits a physician complaining of weight loss in spite of a hearty appetite. At first glance the physician notices her large eyes. She gives a history of increased anxiety over the last few months associated with palpitations and diaphoresis. During the examination, the physician notes tachycardia, hypertension, sweaty palms, and trembling outstretched hands. There is a diffuse swelling in the neck with a bruit heard on auscultation. What is the most likely diagnosis?
    • A. 

      Hashimoto's thyroiditis

    • B. 

      Hypothyroidism

    • C. 

      Parathyroid adenoma

    • D. 

      Lateral aberrant thyroid

    • E. 

      Graves disease

    • F. 

      Hyperthyroidism

  • 11. 
    A 32-year-old mother of two children has 6-month history of annenorrhea, galactorrhea, and loss of libido. Her history is otherwise unremarkable and her b-hCG titer is undectable. The MOST likely cause of her symptoms is which of the following?
    • A. 

      Adenoma of acidophils

    • B. 

      Infarct in the pars nervosa

    • C. 

      Head trauma

    • D. 

      Adenoma of basophils

    • E. 

      Adenoma of chromophobes

  • 12. 
    A 49-year-old patient is evaluated for suicidal ideation after he is found laying on train tracks by police. The man is disheveled and malodorous and states that he has "reached the end" and would rather die. He admits to depressed mood, anhedonia, poor energy, and appetite; he feels miserable and regrets what he has done with his life and wants to put an end to it. He states he has felt this way since age 26, after he was discharged from the military. The man indicates that his life was "great" until he increased his drinking, which caused a divorce at age 30. He has had 2 arrests for driving under the influence. He was in jail for 6 months after he had an accident while drunk that resulted in public property damage. He remembers that he initially felt sick in jail, with sweating, vomiting, shaking, and he experienced a seizure. He then improved after a few days and felt better during the rest of his imprisonment without any depression. Question: What criteria most strongly suggests alcohol abuse?
    • A. 

      Desire to cut down

    • B. 

      Recurrent drunk driving

    • C. 

      Seizure after withdrawal

    • D. 

      Suicidal ideation

    • E. 

      Tolerance

  • 13. 
    A 67-year-old woman who has been in very good health is brought to her physician's office by her husband. He states that over the course of the last 5 years, she has had difficulty recognizing her grandchildren; he must do all the planning for their daily activities; she forgets that she has things cooking on the stove; and at night he sometimes finds her wandering through the house with an "absent" look on her face. She is beginning to demonstrate difficulty in recalling the names of common objects, and her speech is limited to simple 2- or 3-word sentences. Question: What is the most likely diagnosis?
    • A. 

      Alzheimer's disease

    • B. 

      Amnestic disorder

    • C. 

      Pseudodementia

    • D. 

      Substance-Induced persisting dementia

    • E. 

      Vascular dementia

  • 14. 
    A 60-year-old male is concerned because he recently noticed a significant decrease in muscle mass and increase in his waist size, despite the fact that he changed neither his diet nor his life style. Both physical examination and laboratory results (including fasting glucose, TSH, and T4) are within normal limits. Question: What could explain those changes?
    • A. 

      Growth hormone deficiency

    • B. 

      Diabetes mellitus type II

    • C. 

      Hypothyroidism

    • D. 

      Paraneoplastic syndrome

    • E. 

      Hypothalamus-pituitary-thyroid disturbance

  • 15. 
    A 40-year-old woman comes to your office presenting with anxiety, difficulty sleeping, rapid heartbeat, and tremor in her hands. You note the presence of bulging eyes and suspect Graves disease. You confirm that she has this disease by determining the blood levels of:
    • A. 

      Thyroid stimulating hormone

    • B. 

      Thyroid peroxidase

    • C. 

      Protein-bound iodine

    • D. 

      Thyroglobulin

    • E. 

      Thyrotropin-releasing hormone

  • 16. 
    A 42-year-old woman has a 2-month history of palpitations, tremors, and insomnia. During this time, she lost 5 pounds and noticed increased nervousness. On physical exam, she has a pulse of 125 bpm, blood pressure of 130/95 mmHg, and tremors. Her right thyroid lobe is enlarged with a 2 cm nodule. Laboratory evaluation shows free T4 of 2.7 ng/dL (normal range 0.7-1.6 ng/dL), free T3 of 601 pg/ml (normal 240-420 pg/ml), and undetectable TSH of <0.01 mIU/ml (0.5-4.5 mIU/ml). A radioiodine scan of the thyroid shows a focal area of intense uptake in the right lobe with suppression of the rest of the gland. What is the most likely diagnosis?
    • A. 

      Hashimoto thyroiditis

    • B. 

      Graves disease

    • C. 

      Toxic multinodular goiter

    • D. 

      Solitary toxic adenoma

    • E. 

      Thyrotoxicosis factitia

  • 17. 
    A 40-year-old Caucasian woman presents to your office with difficulty swallowing and hoarseness. On further questioning, she acknowedges a history of therapeutic radiation to her neck as a child. On physical examination, you detect a solitary thyroid nodule. A thyroid biopsy is done, and the results indicate a malignancy. The pathologist comments on the presence of psammoma bodies. He also comments on the presence of distinctive ground glass nuclei resembling "Orphan Annie eyes." Which of the following is most likely?
    • A. 

      Thyroid adenoma

    • B. 

      Follicular Carcinoma

    • C. 

      Anaplastic carcinoma

    • D. 

      Medullary carcinoma

    • E. 

      Papillary carcinoma

  • 18. 
    A 30-year-old woman sees her doctor because of depression. Upon questioning for the medical history, she denies any significant past medical history or surgeries. On physical examination, she is found to be obese. Her weight is localized to her trunk; her arms and legs are relatively normal. Her abdomen has prominent purple striae. Her face is very round and covered with acne. Her blood pressure is found to be 164/102 mmHg. Her laboratory results are as follows: TEST RESULTS "REFERENCE   "RANGE BUN 14 mg/dL     7 - 18 mg/dL Calcium 9.6 mg/dL     8.4-10.2 mg/dL Potassium 4.1 mEq/L     3.5-5.0 mEq/L Sodium 139 mEq/L     135-145 mEq/L Further work-up is done and she is found to have a pituitary adenoma. Which of the following is most likely?
    • A. 

      Addison's Disease

    • B. 

      Conn's Syndrome

    • C. 

      Cushing syndrome

    • D. 

      Cushing's disease

    • E. 

      Nelson's syndrome

  • 19. 
    A 39-year-old, nulliparous, gravida 0 was referred for subfertility treatment and assisted conception. After appropriate investigations and counseling, she underwent in vitro fertilization. Following protocol regimens, 7 oocytes were recovered, of which 3 were fertilized normally. Transcervical embryo transfer was carried out on the third day following oocyte recovery. The blastomeres were normal: equal in size and shape with no fragmentation. A pregnancy test was carried out on a urine sample on day 17 and was positive. On 25th day of gestation embryo died. Only one endocrine gland was found in embryo. What endocrine organ was most likely found?
    • A. 

      Pineal gland

    • B. 

      Thyroid gland

    • C. 

      Parathyroid gland

    • D. 

      Adrenal gland

    • E. 

      Pancreas

  • 20. 
    A 32-year-old white female comes into your office. In taking a history she relates feeling well up until six months ago, when she started to feel tired all of the time and her hair and skin are dry. She goes on to say that her mother says her face looks puffy all of the time. She complains of vague aches, pairs, and complains of being cold all of the time and of not being able to concentrate. She also notes that she has been eating more because she feels a lack of energy. She states she has gained thirty pounds over the last year. Her medical history is significant for having a hysterectomy nine months ago. She is a G6 P5 SAB1. She also notes that she has been under a lot of stress since her husband has lost his job and has not found another one. Her vital signs are Temperature 97 oral - Pulses is 70 radial - respirations are 12 - blood pressure is 129/75. What is your working diagnosis?
    • A. 

      Hypothyroidism

    • B. 

      Hyperparathyroidism

    • C. 

      Diabetes Mellitus I

    • D. 

      Diabetes Mellitus ll

    • E. 

      Cushing Disease

  • 21. 
    A 65-year-old otherwise healthy male reports that his feet are cold to the touch and his skin often gets a purplish color. Recently his hands become more sensitive to pain as the temperature decreases. Physical examination is within normal limits for the age. His laboratory tests, including TSH and T4, are within normal limits Question: What might be the cause of the intolerance to cold in this patient?
    • A. 

      Hypothyroidism

    • B. 

      Reduced end-organ response

    • C. 

      Paraneoprastic syndrome

    • D. 

      Hypothalamus-pituitary changes

    • E. 

      Systemic vasculitis

  • 22. 
    A 10-year-old female presents with severe headache and ataxia. Neuroradiologic imaging reveals a cystic tumor in the cerebellum. Microscopically, the excised tumor shows a biphasc pattern. There are bipolar fibrillated and elongated cells packed in bundles with perivascular arrangements. There are stellate cells with short processes with a lacy pattern and areas showing microcystic changes. Also seen are Rosenthal fibers, granular hyaline deposits, and eosinophilic intracytoplasmic bodies. What is the most Likely diagnosis?
    • A. 

      Medulloblastoma

    • B. 

      Neuroblastoma

    • C. 

      Cerebellar Astrocytoma

    • D. 

      Ependymoma

    • E. 

      Oligodendroglioma

  • 23. 
    A 36-y/o man complains of excessive thirst for the past few days. He consumes 3 to 4 liters of water per day but is still thirsty. He has also been passing urine very frequently. He has been started on lithium for bipolar disorder a few months back. Blood glucose is normal. Urine specific gravity and osmolality are 1.002 and 180 mOsm/kg, respectively. There is no increase in urine osmolality with exogenous antidiuretic hormone (ADH) administration. What is the probable diagnosis?
    • A. 

      Idiopathic central diabetes insipidus

    • B. 

      Familial central diabetes irsipidus

    • C. 

      Acquired central diabetes insipidus

    • D. 

      Hereditary nephrogenic diabetes insipid us

    • E. 

      Acquired nephrogenic diabetes insipidus

  • 24. 
    A 65-year-old Caucasian man has a 40-pack-year history of cigarette smoking. He is found to have a spot on his lung after a chest X-ray. A biopsy confirms that he has small cell carcinoma of the lung, and he is admitted to the hospital. Over the course of the next few days, he develops lethargy and confusion and then proceeds to have a seizure. His urine output remains normal. Laboratory tests are performed or his blood and his urine. The results are as follows: TEST RESULTS   REFERENCE RANGE i glucose (fasting) 72 mg/dL   65-110 mg/dL sodium 121 mEq/L   135-145 mEq/L potassium 4.0 nnEq/L   3.5-5.0 mEq/L BUN 11.2 mg/dL   10-20 mg/dL urine dipstick blood negative    negative urine dipstick glucose negative    negative urine dipstick ketones negative   negative urine dipstick protein negative 1.055   negative urine specific gravity 1.001 - 1.035   Question: Water restriction is started and his symptoms improve. What is the most likely diagnosis?
    • A. 

      SIADH

    • B. 

      Diabetes Mellitus

    • C. 

      Diabetes Insipidus

    • D. 

      Psychogenic polydipsia

    • E. 

      Oliguria

  • 25. 
    A 64-year-old African American woman presents with complaints of shortness of breath and dry cough. These symptoms, per the patient's statement, had an insidious onset and have been present for the past few weeks. Her physical examination is unremarkable. Her pulse, BP and temperature are as follows: 80/min, 130/90 mm Hg and 98.9°F. The patient's lab results  and lung biopsy are as follows Question: The next step in the patient's management entails:
    • A. 

      Nothing, the disease has a self-limited course and will regress spontaneously

    • B. 

      Performing acid-fast and silver stains on the biopsy

    • C. 

      Treat the patient with antifungal drugs

    • D. 

      Treat the patient with anti-tuberculous drugs

    • E. 

      Treat the patient with steroids and immunosuppressive drugs

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