Clinical Pathology Quiz

15 Questions | By Chachelly | Last updated: Mar 22, 2022 | Total Attempts: 696

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Please choose the correct answers to the following questions and learn about the clinical pathology. Let's check your knowledge on this quiz now!

Questions and Answers

1.

In the oncology unit of a tertiary care hospital, an outbreak of nosocomial infections was observed. Blood stream and urinary tract infections were predominant. The causative agent of the outbreak was a multiple drug resistant (MDR), catalase-negative, Gram- positive coccus that is known to be a major etiological agent of nosocomial infections. As part of infection control measures, surveillance cultures were carried out to detect patients colonized by this nosocomial pathogen. What specimen is ideal for this purpose?
- A.
  
  Nasal swab
- B.
  
  Swab from axilla
- C.
  
  Blood
- D.
  
  Urine
- E.
  
  Rectal swab
2.

A 30-year-old patient came to the ER with severe nausea and vomiting. He just returned from a party 3 hours ago. At the party he enjoyed pudding along with other food. Physical examination revealed normal temperature with mild diffuse tenderness of the abdomen. The organism isolated is Gram-positive cocci that occur in grape-like clusters, are catalase and coagulase positive, and form golden yellow colony on agar. The toxin released by the causative organism responsible for the patient's symptoms is which of the following?
- A.
  
  Toxic shock syndrome toxin (TSST-1)
- B.
  
  Exfoliatin toxin
- C.
  
  Enterotoxin
- D.
  
  Leukocidin
- E.
  
  Alpha toxin
3.

A sample of pus collected from a 4-year-old boy diagnosed with pleural empyema complicating lobar pneumonia was received in the microbiology laboratory. Gram- stained smears of the pus showed intracellular and extracellular small Gram-positive diplococci. Cultures were done on sheep blood agar and incubated at 37 degrees in the presence of 5-10% carbon-dioxide, After overnight incubation, alpha hemolytic small (0.5-1mm) dome-shaped glistening colonies appeared on the blood agar medium. Further study of the colonies showed that the isolate was oxidase and catalase negative, fermented various carbohydrates with acid production, and was bile soluble and sensitive to optochin. The organism was resistant to penicillin with minimum inhibitory concentration (MIC) of >8mcg/ml. It was sensitive to vancomycin and resistant to erythromycin and cephalosporin. The high resistance to penicillin shown by the isolate is most likely to be due to which of the following mechanisms?
- A.
  
  Alteration in the penicillin binding proteins
- B.
  
  Production of chromosomal beta-lactamase
- C.
  
  Efflux pump activity
- D.
  
  Change in porin channels
- E.
  
  Production of plasmid-mediated beta-lactamase
4.

As part of a study on organisms associated with bacterial vaginosis, samples of vaginal discharge collected from women clinically diagnosed with the condition were cultured for aerobic and anaerobic bacteria. About 20% of the isolates belonged to an obligate anaerobic species of small non-motile Gram-negative saccharolytic bacillus. These isolates were resistant to penicillin and produced beta-lactamase. This bacterial species most likely belongs to what genera?
- A.
  
  Mycoplasma
- B.
  
  Prevotella
- C.
  
  Gardnerella
- D.
  
  Lactobacillus
- E.
  
  Propionibacterium
- F.
  
  Mobiluncus
5.

A 24-year-old woman presents to the ER with a dry cough and fever for the past few days. The patient also notes pleuritic, non-radiating chest pain rated at 4/10 in intensity. The patient has a 10-pack year smoking history. She also reports going to New Mexico last week on vacation. Examination reveals a thin woman in no acute distress. Vital signs are T 101.5 F, BP 134/88mm Hg, P92/min, R12/min. A reddish, tender 3 cm nodule is also noted on the anterior aspect of the legs just distal to the knees. What is the most likely pathohistological feature of the causative agent?
- A.
  
  Spherules with endospores
- B.
  
  Broad based budding
- C.
  
  Tuberculate macroconidium
- D.
  
  Gram positive diplococci
- E.
  
  Gram negative rods
6.

As part of a study on bacterial agents associated with non-gonococcal urethritis (NGU), a sample of urethral discharge collected from an adult male was cultured on A8 selective agar medium. After 48 hours of incubation in the presence of carbon dioxide, tiny brown colored colonies measuring 15-20 microns were detected on the medium using stereomicroscope. This isolate is likely to possess what characteristic?
- A.
  
  Growth is inhibited by sterol
- B.
  
  Is susceptible to beta-lactam antibiotics
- C.
  
  Lipopolysaccha ride (LPS) is a virulence factor
- D.
  
  Is genetically related to bacterial L-forms
- E.
  
  Produces urease enzyme
7.

Smooth strains (S) of Streptococcus pneumoniae are encapsulated and are pathogenic. Rough strains (R) are not encapsulated and are generally not pathogenic. When mice are injected with live S strains, they die. When injected with live R strains, the mice survive. Mice also survive when injected with dead S strains. Interestingly, when dead S strains and live R strains are mixed together and then injected into mice, the mice die and colonies of S and R strains can be isolated from the dead mice. What is the most likely explanation for these interesting laboratory results?
- A.
  
  Transportation
- B.
  
  Transformation
- C.
  
  Conjugation
- D.
  
  Transduction
- E.
  
  Transposition
8.

A 20-year-old female comes to the office complaining of a malodorous vaginal discharge. She has had this discharge for approximately two weeks with little respite. She has been sexually inactive for the past year. She does not complain of any itching or abdominal/pelvic pain. Physical examination reveals a homogeneous gray discharge. There appears to be no redness or ulceration of the vulva and surrounding area. Some of the vaginal discharge is obtained and mixed with 10% KOH whereupon a fishy amine odor is produced. A gram stain of the vaginal discharge reveals diagnostic "clue" cells (refer to the image). What is the most likely diagnosis based on the clinical presentation and test results?
- A.
  
  Gonorrhea cervicitis
- B.
  
  Bacterial vaginosis
- C.
  
  Candidiasisivulvovaginitis
- D.
  
  Chlamydial endocervicitis
- E.
  
  Trichomoniasis
9.

A 60-year-old white woman develops an annoying discomfort in her abdomen. She notices that meals seem to make her discomfort worse. She has lost her previously vigorous appetite. Over several weeks, she has unexplained weight loss. She sees her doctor because of these complaints, and he orders an upper GI series. The results of the upper GI series are suggestive of a malignancy. Subsequently, an endoscopy with biopsy is done. After the endoscopy, her doctor tells her that she has adenocarcinoma of the stomach. Her pelvic exam is positive and it is determined that she has metastases to the ovaries. What is this called?
- A.
  
  Krukenberg tumor
- B.
  
  Brenner tumor
- C.
  
  Teratoma
- D.
  
  Arrhenoblastoma
- E.
  
  Hilus cell tumor
10.

A 36-year-old para 3 female presents with severe pain abdomen associated with vaginal bleeding following 4 months amenorrhea. On examination, the patient is in shock. Her abdomen is tender. Subsequent laparotomy reveals perforation of the uterus through which purple fungating growth is visible. Histological examination shows structures of chorionic villi with marked trophoblastic proliferation deep in the myometriunn. What is the most likely diagnosis in this case?
- A.
  
  Complete hydatidiform mole
- B.
  
  Partial hyclatidiform mole
- C.
  
  Invasive mole
- D.
  
  Choriocarcinonna
- E.
  
  Placental site trophoblastic tumor
11.

A 36-year-old para 3 female attends the clinic suffering from discomfort in the lower abdomen. She recently noticed a vague swelling in her lower abdomen. She had regular menstrual cycles and had three normal deliveries. Her youngest child is 3 years old. On examination, a mass is felt in her lower abdomen. Ultrasonography reveals a cystic mass measuring 15 cms in diameter involving the right adnexal region. The uterus is normal in size. Following surgical resection, the mass appears to be cystic with dilated vessels on the surface. The cut surface reveals that the cyst is unilocular and is filled with serous fluid. There are no solid areas. Microscopically, the cyst wall is lined by ciliated tallcolumnar epithelium. These features are diagnostic of what condition?
- A.
  
  Serous cystadenoma
- B.
  
  Mucinous cystadenoma
- C.
  
  Polycystic ovarian disease
- D.
  
  Corpus luteal cyst
- E.
  
  Dermoid cyst
12.

A 20-year-old female visits the gynecologist having noticed a mass in her lower abdomen. On further questioning, she reveals that she has been suffering from pelvic discomfort for some time. Her ultrasonogram reveals a mass occupying the left adnexal region. Surgical excision of the mass is done subsequently. The mass measures 14cm in diameter, is cystic, and is filled with cheesy material with hair tufts with a solid area protruding into the cavity. Microscopically, the cyst wall is lined by stratified squamous epithelium with underlying sebaceous glands. The sections that are taken from the solid area show cartilage. These features are diagnostic of what condition?
- A.
  
  Serous cystadenoma
- B.
  
  Mucinous cystadenoma
- C.
  
  Polycystic ovarian disease
- D.
  
  Corpus luteal cyst
- E.
  
  Dermoid cyst
13.

A 32-year-old female is found to have bilateral ovarian masses during ultrasonography. Both the masses are cystic in nature. Fine needle aspiration done from both the masses do not reveal any malignant cells. Subsequently the masses are excised. The right ovarian mass is 12 cms in size. The left ovarian mass is 16 crns in size. The cut surface of both the masses reveals multilocular cysts filled with gelatinous fluid. There are no solid areas in either one. Multiple sections studied from the masses show fibrocollagenous cyst wall lined by tall columnar epithelium with apical mucin. There is no cellular atypia normulti layering of the epithelium. No invasion is seen in any of the sections studied. These features are diagnostic of what condition?
- A.
  
  Serous cystadenoma
- B.
  
  Mucinous cystadenoma
- C.
  
  Polycystic ovarian disease
- D.
  
  Corpus luteal cyst
- E.
  
  Dermoid cyst
14.

A 43-year-old woman previously in good health starts to notice some abnormal vaginal bleeding. She sees her family doctor about this. A Pap smear is done and the results are positive. Colposcopy is then done and a biopsy is taken at that time. The results come back indicating that she has cervical cancer. She asks her doctor how and why this could have happened to her. Which of the following might have put her at an increased risk for the development of cervical cancer?
- A.
  
  Cigarette smoking
- B.
  
  Young age at menarche
- C.
  
  Never having had children
- D.
  
  Picornavirus infection
- E.
  
  Abstinence
15.

A 32-year-old para 2 female presents with vaginal bleeding following 16 weeks of amenorrhea. It started as watery brownish vaginal discharge and it is associated with lower abdominal pain. On examination, the size of the uterus is more than that expected for the period of amenorrhea. The uterus feels doughy. Ultrasonogram reveals snowstorm appearance. The patient is advised evacuation. Grape like vesicles are seen in the curettage. No fetal parts are seen. What is the most likely diagnosis?
- A.
  
  Complete hydatidiform mole
- B.
  
  Partial hyclatidiform mole
- C.
  
  Invasive mole
- D.
  
  Choriocarcinonna
- E.
  
  Placental site trophoblastic tumor