1

A 53-year-old woman with no prior illnesses has a

routine checkup by her physician. On examination she
has a blood pressure of 150/95 mm Hg. If her
hypertension remains untreated for years, which of
the following cellular alterations would most likely be
seen in her myocardium?
A. Dysplasia
B. Fatty change
C. Hyperplasia
D. Hypertrophy
E. Metaplasia
 2
Xanthoma is a kind of:
A. Calcium metabolism
B. Cholesterol metabolism
C. Protein metabolism
D. Glucid metabolism
E. Water metabolism
 3
Psammoma bodies are kind of:
A. Calcium metabolism
B. Cholesterol metabolism
C. Protein metabolism
D. Glucid metabolism
E. Water metabolism
 4
A 34-year-old obese woman has experienced
heartburn from gastric reflux for the past 5 years after
eating large meals. She undergoes upper
gastrointestinal endoscopy, and a biopsy specimen of
the distal esophagus is obtained. Which of the
following microscopic changes, seen in the figure, has
most likely occurred?
• A Columnar metaplasia
• B Goblet cell hyperplasia
• C Lamina propria atrophy
• D Squamous dysplasia
• E Mucosal hypertrophy
 5
A 22-year-old woman becomes pregnant. A fetal
ultrasound examination at 13 weeks’ gestation
shows her uterus measures 7 × 4 × 3 cm. At delivery
of a term infant, her uterus measures 34 × 18 × 12
cm. Which of the following cellular processes has
contributed most to the increase in her uterine size?
• A. Endometrial glandular hyperplasia
• B. Myometrial fibroblast proliferation
• C. Endometrial stromal hypertrophy
• D. Myometrial smooth muscle hypertrophy
• E. Vascular endothelial hyperplasia
 6
A 20-year-old woman breastfeeds her infant.
On examination, her breasts are slightly
increased in size. Milk can be expressed from
both nipples. Which of the following processes
that occurred in her breasts during pregnancy
enables her to breastfeed the infant?
• A Ductal metaplasia
• B Epithelial dysplasia
• C Intracellular lipid deposition
• D Lobular hyperplasia
• E Stromal hypertrophy
 7
A 16-year-old boy sustained blunt trauma to his
abdomen when he struck a bridge abutment at
high speed while driving a motor vehicle.
Peritoneal lavage shows a hemoperitoneum, and
at laparotomy, a small portion of the left lobe of
the injured liver is removed. Two months later, a
CT scan of the abdomen shows that the liver has
nearly regained its size before the injury. Which of
the following processes best explains this CT scan
finding?
• A Apoptosis
• B Dysplasia
• C Hyperplasia
• D Hydropic change
• E Steatosis
 8
A 71-year-old man has had difficulty with urination,
including hesitancy and increased frequency, for the
past 5 years. A digital rectal examination reveals that
his prostate gland is palpably enlarged to twice normal
size. A transurethral resection of the prostate is
performed, and the microscopic appearance of the
prostate “chips” obtained is that of nodules of glands
with intervening stroma. Which of the following
pathologic processes has most likely occurred in his
prostate?
• A Dysplasia
• B Fatty change D Hyperplasia
• C Hypertrophy E Metaplasia
 9
A 29-year-old man sustains a left femoral fracture
in a motorcycle accident. His leg is placed in a
plaster cast. After his left leg has been immobilized
for 6 weeks, the diameter of the left calf has
decreased in size. This change in size is most likely
to result from which of the following alterations in
his calf muscles?
• A Aplasia
• B Atrophy
• C Dystrophy
• D Hyalinosis
• E Hypoplasia
 10
Who is the father of anatomic pathology?
A. Hippocrates
B. Giovani Batista Morgagni
C. Julius Cohnheim
D. Rudolf Virchow
E. Andreas Vesalius
 11
Which is the most important technique?
A. Staining
B. Processing
C. Fixation
D. Embedding
E. Sectioning
 12
Which solution is used common to fix
specimens?
A. Alcohol
B. Formalin
C. Formalin 5%
D. Formalin 10%
E. Formaldehyte
 13
How long need to fix specimens?
A. 3-6h
B. 12-24h
C. 24-36h
D. 36-48h
E. At least 2 days
 14
Which solution is used to dehydrated?
A. Ethanol, increasing concentration
B. Ethanol, decreasing concentration
C. Xylen
D. Paraffin
E. Formalin 10%
 15
What is the most common staining method?
A. Cytokeratin
B. Congo red
C. Alcian blue
D. Hematoxyline & Eosin
E. Alcian blue & Eosin
 16
Which terminology is not indicate a
benign tumor?
A. Adenoma
B. Thymoma
C. Fibroma
D. Papilloma
E. Adenomyoma
 17
Which terminology is not true?
A. Osteosarcoma
B. Squamous cell carcinoma
C. Hepato cellular carcinoma
D. Chondrosarcoma
E. Adenosarcoma
 18
Which features suggest a melanoma
instead of a benign mole?
A. Diameter > 6mm
B. Diameter > 2mm
C. Border is even
D. Ordinary mole
E. Symetrical
 19
Pancreatic tissue is found incidentally in a
stomach biposy. This is called:
A. Harmatoma
B. Hamartoma
C. Choristoma
D. Malformation
E. Transformation
 20
Which substances are found inside atheroma of
atherosclerosis?
A. Protein
B. Cholesterol
C. Lipid
D. A+B right
E. B+C right
 21
Which arteritis is usually found in cigarett
addicted patients?
A. Temporal arteritis
B. Buerger arteritis
C. Takayashu arteritis
D. Thromboangitis obliterans
E. B+D right
 22
Which primary tumor is commonly found in
heart?
A. Myxoma
B. Hemangioma
C. Myoma
D. Myosarcoma
E. Adenofibroma
 23
How long will the cardiac tissue become
coagulative necrosis after myocardiac infarction?
A. 12h
B. 12-24h
C. 24-72h
D. 3 days
E. 1 week
 24
A 40-year-old man has a positive stool guaiac test
during a routine physical examination. A
colonoscopy is performed and a 0.9-cm,
circumscribed, pedunculated mass on a short stalk
is found in the upper rectum. Which of the
following terms best describes this lesion?
• A Adenoma
• B Carcinoma
• C Choristoma
• D Hamartoma
• E Sarcoma
 25
A 32-year-old woman has experienced dull pelvic pain for
the past 2 months. Physical examination shows a right
adnexal mass. An abdominal ultrasound scan shows a 7.5-
cm cystic ovarian mass. The mass is surgically excised. The
surface of the mass is smooth, and it is not adherent to
surrounding pelvic structures. On gross examination, the
cystic mass is filled with hair. Microscopically, squamous
epithelium, tall columnar glandular epithelium, cartilage,
and fibrous connective tissue are present and resemble
normal tissue counterparts. Which of the following is the
most likely diagnosis?
• A Adenocarcinoma
• B Fibroadenoma D Hamartoma
• C Glioma E Teratoma
 26
A 62-year-old man has had several episodes of
hematuria in the past week. He has a 48 pack-year
history of smoking cigarettes. On physical
examination, there are no abnormal findings. A
urinalysis shows 4+ hematuria, and cytologic
examination of the urine shows that atypical cells
are present. A cystoscopy is performed and a 4-cm
sessile mass with a nodular, ulcerated surface is
seen in the dome of the bladder. Which of the
following terms best describes this lesion?
• A Adenoma
• B Carcinoma
• C Fibroma
• D Papilloma
• E Sarcoma
 27
A Pap smear obtained from a 29-year-old woman
during a routine health maintenance examination
is abnormal. She is currently asymptomatic. She
has a history of multiple sexual partners. Cervical
biopsy specimens are obtained and the
microscopic appearance is shown in the figure.
Which of the following is the most likely
diagnosis?
• A Adenocarcinoma
• B Carcinoma in situ
• C Dysplasia
• D Hamartoma
• E Squamous cell carcinoma
 28
A 44-year-old woman feels painless lumps in
her armpit, which were not present a month
ago. On examination, right axillary
lymphadenopathy is present. The nodes are
painless but firm. Which of the following is the
most likely lesion in her right breast?
• A Acute mastitis with abscess
• B Fibroadenoma
• C Infiltrating lobular carcinoma
• D Intraductal carcinoma
• E Leiomyosarcoma
 29
• A malignant neoplasm is found within the
cranial cavity. A biopsy is obtained and
microscopic examination shows malignant
cells within vascular lumina. Which of the
following types of vessels is most likely to be
invaded by this malignancy?
• A Arterioles
• B Capillaries
• C Lymphatics
• D Muscular arteries
• E Veins
 30
A 70-year-old woman is referred to an ophthalmologist
because of difficulty with her right eye. She also has
pain in the right upper chest. The findings on physical
examination include enophthalmos, meiosis, anhidrosis,
and ptosis. A chest radiograph shows right upper lobe
opacification and bony destruction of the right first rib.
Which of the following conditions is most likely to be
present?
• □ (A) Bronchopneumonia
• □ (B) Bronchiectasis
• □ (C) Bronchogenic carcinoma
• □ (D) Sarcoidosis
• □ (E) Tuberculosis
 31
A previously healthy, 20-year-old woman has had a low-
grade fever for the past 2 weeks. On physical
examination, her temperature is 37.7°C; there are no
other remarkable findings. The gross appearance of the
lung shown in the figure is representative of her disease.
Which of the following studies is most likely to report a
positive result?
• □ (A) HIV serologic test
• □ (B) Rapid plasma reagin
• □ (C) Rheumatoid factor
• □ (D) Sweat chloride
• □ (E) Tuberculin skin test
 32
A 46-year-old woman goes to the physician for a routine
health maintenance examination. On physical
examination, there are no remarkable findings. Her body
mass index is 22. She does not smoke. A tuberculin skin
test is positive. A chest radiograph shows a solitary, 3-cm
left upper lobe mass. The mass is removed at
thoracotomy by wedge resection. The microscopic
appearance of this lesion is shown in the figure. Which of
the following is the most likely diagnosis?
• □ (A) Pulmonary hamartoma
• □ (B) Pulmonary infarction
• □ (C) Mycobacterium tuberculosis infection
• □ (D) Lung abscess
• □ (E) Primary adenocarcinoma
 33
A 57-year-old woman comes to her physician because she has had a
cough and pleuritic chest pain for the past 3 weeks. On physical
examination, she is afebrile. Some crackles are audible over the left
lower lung on auscultation. A chest radiograph shows an ill-defined
area of opacification in the left lower lobe. After 1 month of
antibiotic therapy, her condition has not improved, and the lesion is
still visible radiographically. CT-guided needle biopsy of the left
lower lobe of the lung is performed, and the specimen has the
histologic appearance shown in the figure. Which of the following
neoplasms is most likely to be present in this patient?
• □ (A) Adenocarcinoma
• □ (B) Bronchioloalveolar carcinoma
• □ (C) Hamartoma
• □ (D) Squamous cell carcinoma
• □ (E) Metastatic breast carcinoma
 34
What is the basic unit of breast?
A. Lobular
B. Tubular
C. TDLU
D. Terminal ducts
E. Interlobular stroma
 35
Which breast lesions usually turn up from
intralobular stroma?
A. Phyllodes tumor
B. Fat necrosis
C. Lipoma
D. Carcinoma
E. Sarcoma
 36
Breast carcinoma usually turn up from :
A. Intralobular stroma
B. Interlobular stroma
C. Large ducts
D. Lobules and terminal ducts
E. Pectoralis muscle
 37
A 28-year-old woman in the third trimester of her
third pregnancy discovered a lump in her left
breast. The physician palpated a 2-cm, discrete,
freely movable mass beneath the nipple. After the
birth of a term infant, the mass appears to
decrease slightly in size. The infant breastfeeds
without difficulty. What is the most likely
diagnosis?
• □ (A) Intraductal papilloma
• □ (B) Phyllodes tumor
• □ (C) Lobular carcinoma in situ
• □ (D) Fibroadenoma
• □ (E) Medullary carcinoma
 38
A 30-year-old woman sustained a traumatic blow
to her right breast. Initially, there was a 3-cm
contusion that resolved within 3 weeks, but she
then felt a firm lump that persisted below the site
of the bruise 1 month later. What is the most likely
diagnosis for this lump?
• □ (A) Fibroadenoma
• □ (B) Sclerosing adenosis
• □ (C) Fat necrosis
• □ (D) Ductal carcinoma in situ
• □ (E) Mammary duct ectasia
 39
A 44-year-old woman sees her physician because she
felt a lump in her left breast 1 week ago. The physician
palpates a firm, irregular mass in the upper outer
quadrant of the left breast. There are no overlying skin
lesions. The gross appearance of the excisional biopsy
specimen is shown in the figure. Which of the following
additional findings is most likely to be present on
physical examination?
• □ (A) Axillary lymphadenopathy
• □ (B) Bloody discharge from the nipple
• □ (C) Painful breast enlargement
• □ (D) Mass in the opposite breast
• □ (E) Cushingoid face
 40
A 47-year-old woman has noticed a red, scaly area
of skin on her left breast that has grown slightly
larger over the past 4 months. On physical
examination, there is a 1-cm area of eczematous
skin just lateral to the areola. The figure shows the
microscopic appearance of the skin biopsy
specimen. What is the most likely diagnosis?
• □ (A) Apocrine metaplasia
• □ (B) Paget disease of the breast
• □ (C) Inflammatory carcinoma
• □ (D) Lobular carcinoma in situ
• □ (E) Fat necrosis
 41
Three weeks after giving birth to a normal term
infant, a 24-year-old woman is breastfeeding the
infant and notices fissures in the skin around her
left nipple. Over the next 3 days, the region
around the nipple becomes erythematous and
tender. Purulent exudate from a small abscess
drains through a fissure. Which of the following
organisms is most likely to be cultured from the
exudate?
• □ (A) Listeria monocytogenes
• □ (B) Streptococcus viridans
• □ (C) Candida albicans
• □ (D) Staphylococcus aureus
• □ (E) Lactobacillus acidophilus
 42
A 29-year-old woman and her 32-year-old sister
were diagnosed with infiltrating ductal carcinoma
of the breast, and both had bilateral
mastectomies. Which of the following risk factors
is most significant for this type of cancer?
• □ (A) Oral contraceptive use
• □ (B) Inheritance of a mutant p53 allele
• □ (C) Obesity
• □ (D) Multiparity
• □ (E) Smoking cigarettes
 43
List 3 bone tumours most common?
A. Osteosarcoma, Giant bone tumor, Lipoma
B. Osteosarcoma, Osteochondroma, Giant bone
tumor.
C. Osteosarcoma, Osteoblastoma, Osteochondroma
D. Osteosarcoma, Osteoblastoma, Giant bone
tumor.
E. Ewing sarcoma, Fibroma, Chondrosarcoma
 44
Brown tumor is formed by which abnormal
secretion?
A. Calcitonin
B. Vitamin D
C. Calcium
D. PTH
E. Phosphor
 45
A 42-year-old man on vacation is involved in a
skiing accident in which he sustains a right tibial
diaphyseal fracture. The fracture is set with open
reduction and internal fixation for proper
alignment. His vacation is not over, and 1 week
later, he is in the ski lodge, sitting by the fire with
drink in hand. There are now more osteoclasts in
the region of the fracture. What is the most likely
function of these osteoclasts?
• □ (A) Form collagen
• □ (B) Resorb bone
• □ (C) Synthesize osteoid
• □ (D) Elaborate cytokines
• □ (E) Divide
 46
How long to form procallus after fracture?
• □ (A) 3 days
• □ (B) 5 days
• □ (C) 7 days
• □ (D) 2 weeks
• □ (E) 1 month
 47
Which bone is the most common site for
metastatic tumor?
A. Sternum
B. Spine
C. Tibia
D. Pelvis
E. Femur
 48
Which cancer is the most common cancer
metastatic to bone in children?
A. Prostatic adenocarcinoma
B. Lymphoma
C. Melanoma
D. Neuroblastoma
E. Teratoma
 49
Which bone neoplasm exhibit borderline
or intermediate characteristic malignant
behavior?
A. Osteoid osteoma
B. Osteoblastoma
C. Giant cell tumors
D. Osteosarcoma
E. Chondroma
 50
Which bone neoplasm exhibit benign
behavior and do not have malignant
potential?
A. Langerhans cell histiocytosis
B. Osteoblastoma
C. Giant cell tumors
D. Osteosarcoma
E. Chondroma
 51
A 9-year-old boy has had pain in the area of the right
hip for the past 3 weeks. On physical examination, his
temperature is 38.2°C. There is swelling with marked
tenderness to palpation in the area of the right hip,
pain, and reduced range of motion. Radiographs of the
pelvis and legs show areas of osteolysis and cortical
erosion involving the femoral metaphysis, with adjacent
soft-tissue swelling extending from the subperiosteal
region, and apparent abscess formation. Which
organism is most likely to produce these findings?
• □ (A) Staphylococcus aureus
• □ (B) Haemophilus influenzae
• □ (C) Salmonella enteritidis
• □ (D) Group B streptococcus
• □ (E) Neisseria gonorrhoeae
 52
Which site is the most common site on
osteosarcoma patient?
A. Epiphyseal
B. Metaphyseal
C. Diaphyseal
D. A+B right
E. A+C right
 53
Which cells secrete calcitonin?
A. C cells
B. Parafollicular cells
C. Thyroid follicular cells
D. A+B right
E. A+B+C right
 54
Where is usual location of thyroglossal duct
cyst?
A. Hyoid bone
B. Sternum bone
C. Mandible bone
D. Rib bone
E. Tongue
 55
What are other names for de Quervain
thyroiditis?
A. Granulomatous thyroiditis
B. Autoimmune thyroiditis
C. Hashimoto thyroiditis
D. Acute thyroiditis
E. Riedel thyroiditis
 56
A 60-year-old woman has felt a “lump” on the right side
of her neck for several months. A fine-needle aspiration
biopsy is done, and she undergoes a thyroidectomy. The
microscopic is shown in the figure. Which of the
following was most likely to have been present in
the patient's thyroid gland?
• □ (A) Riedel thyroiditis
• □ (B) Follicular carcinoma
• □ (C) De Quervain thyroiditis
• □ (D) Hashimoto thyroiditis
• □ (E) Medullary carcinoma
 57
What are other names for autoimmune
thyroiditis?
A. Granulomatous thyroiditis
B. De Quervain thyroiditis
C. Hashimoto thyroiditis
D. Acute thyroiditis
E. Riedel thyroiditis
 58
Hũrthle cells is specific for which type
thyroiditis?
A. Granulomatous thyroiditis
B. De Quervain thyroiditis
C. Hashimoto thyroiditis
D. Acute thyroiditis
E. Riedel thyroiditis
 59
Which answer is wrong for Goiter disease?
A. Also is called “Diffuse toxic goiter”
B. Exophtalmos
C. Tachycardia
D. Diaphoresis
E. Constipation
 60
Which carcinoma is the most common
cancer in thyroid gland?
• □ (A) Anaplastic carcinoma
• □ (B) Follicular carcinoma
• □ (C) Papillary thyroid carcinoma
• □ (D) Lymphoma
• □ (E) Medullary carcinoma
 61
A 60-year-old woman has felt a “lump” on the right side of her
neck for several months. On physical examination, she has a
firm 3-cm mass in the right lobe of the thyroid gland. There is
no palpable lymphadenopathy. Laboratory studies show a
serum TSH level of 3 mU/L and a T4 level of 8.8 μg/dL. A fine-
needle aspiration biopsy is done, and she undergoes a
thyroidectomy. A 3-cm solid mass is present within the right
thyroid lobe. Six months later, she visits her physician again
because of pain in the right thigh. A radiograph shows a
fracture of the right femur in an area of lytic bone destruction.
A radioiodine scan shows uptake localized to the region of the
fracture. Which of the following was most likely to have been
present in the patient's thyroid gland?
• □ (A) Anaplastic carcinoma
• □ (B) Follicular carcinoma
• □ (C) Granulomatous thyroiditis
• □ (D) Hashimoto thyroiditis
• □ (E) Medullary carcinoma
 62
Psammoma bodies is found commonly in
which type of thyroid cancer?
• □ (A) Anaplastic carcinoma
• □ (B) Follicular carcinoma
• □ (C) Papillary thyroid carcinoma
• □ (D) Lymphoma
• □ (E) Medullary carcinoma
 63
What is malignant behavior of follicular
carcinoma microscopically?
A. Vascular and capsular invasion
B. Abnormal mitosis
C. Lymph node metastasis
D. Large cells with pyknotic nuclei
E. Not have capsular
 64
Which thyroid cancer is composed of C cells?
• □ (A) Anaplastic carcinoma
• □ (B) Follicular carcinoma
• □ (C) Papillary thyroid carcinoma
• □ (D) Lymphoma
• □ (E) Medullary carcinoma
 65
A patient who used to be diagnosed with type 2
diabetes has recently detected a firm, palpable
mass on her left breast. Which lesions suitable for
her condition?
• □ (A) Carcinoma
• □ (B) Fibroadenoma
• □ (C) Lymphotic mastitis
• □ (D) Fat necrosis
• □ (E) Duct ectasia
66