MEDEX Pathophysiology Exam 1

This is the most common malignancy of the eyelid, is locally invasive, and only rarely metastasizes. It is characterized as a pearly papule with or without telangectasia.

A 16 year old female presents with fever, tonsilitis, diffuse lymphadenopathy, splenomegaly and a predominant leukocytosis of CD8+ cells. You suspect:

By far the most important risk factor in malignancies of the skin is:

Deposition of calcium at sites of cell injury and necrosis (as in atheromas of advanced atherosclerosis) is defined as:

Seeding within body cavities is particularly characteristic of cancers of the:

Which of the following are major complications of streptococcal pharyngitis?

(Select all that apply)

The syndrome of acute viral rhinosinusitis includes:

(Additionally, a common complication of viral rhinosinusitis is serous otitis media.)
(Select all that apply)

This is a superficial infection usually caused by Staphylococcus aureus, or less commonly, Streptococcus pyogenes. It typically begins as a small macule on the extremities or face, and evolves rapidly into a larger lesion with a honey-colored crust.

In the Warburg effect, cancer cells utilize aerobic glycolysis instead of the mitochondria for ATP production, even in the face of adequate oxygenation. Tumors that adopt aerobic glycolysis are the fastest growing human cancers (e.g. Burkitt Lymphoma). Because of this "glucose hunger", tumors can be identified on a PET scan by their increased uptake in F-fluorodeoxyglucose, a non-metabolizable derivative of glucose given by injection during the scan.

____ is an infection caused by Haemophilus influenzae which can produce a sudden and complete upper airway obstruction.

This condition is caused by human papilloma virus and presents as gray to white, flat to convex papules with a pebble-like surface. Histologically, there is koilocytosis and papillomatous epidermal hyperplasia.

Open angle glaucoma presents with a ____ pattern of vision loss and pathologic cupping of the physiologic disk on fundoscopy, while macular degeneration presents with a ____ pattern of vision loss and drussen on fundoscopy.

Which of the following is NOT a cancer commonly caused by VIRAL infection?

____ is a bacteria that can cause pneumonia in immunocompromised patients, particularly organ transplant recipients. It is associated with water cooling towers and water heaters.

In contrast to acute inflammation, chronic inflammation is characterized by:
(Select all that apply)

____ is the result of either a germline mutation or somatic mutation of the RB1 gene. It is almost exclusively a malignancy of childhood. Associated exam findings include leukocoria and strabismus.

A 65 year old female presents to your rural emergency department with a complaint of severe pain in her left eye and seeing halos around lights. She states that onset occurred in a darkened movie theater approximately an hour prior. Exam reveals a cloudy cornea, dilated and fixed pupil, with a firm globe. You realize that this is:

This class of inflammatory mediators is responsible for endothelial activation and systemic symptoms of septic shock (fever, hypotension, increased metabolism). It includes TNF, IL-1 and IL-6.

Non-Small Cell Lung Carcinoma responds best to surgical resection and includes:

(Select all that apply)

____ is a complication of chronic otitis media caused by inward migration of the pars flaccida. Otoscopy may reveal an epitympanic retraction pocket that exudes keratin or granulation tissue.

TP53 is an example of a:

A 30 year old female visits your office for an annual physical. She has recently returned from a year-long trip in Namibia. Her PPD skin test is positive. You question her about symptoms and she denies chronic cough, hemoptysis, unexplained weight loss, night sweats, fatigue or dyspnea. You look in her file and discover that her last PPD (before her trip) was negative. A chest X-ray is negative. Your diagnosis is:

Injury to alveoli with activation of macrophages and subsequent release of fibrogenetic cytokines, especially TGF-beta, is the unifying pathogenic factor in:

____ is characterized by caseating granulomas and Ghon complexes, while ____ is characterized by non-caseating granulomas and hilar lymphadenopathy.

In this type of cellular death, the cell swells, the nucleus undergoes karyolysis, cellular contents undergo enzymatic digestion, and an adjacent inflammatory reaction is frequently triggered.

All of the following are major systemic effects of inflammation EXCEPT:

This pathway of apoptosis is triggered by loss of survival signals, DNA damage, or accumulation of misfolded proteins (endoplasmic reticulum stress).

____ is a serious complication of acute otitis media.

A chronic inflammatory condition of the skin resulting from increased epidermal turnover, acanthosis, parakeratosis and loss of the stratum granulosum. Macroscopically it appears as a well-demarcated salmon-colored plaque with a silver scale, most frequently on the extensor surfaces.

In ____, epithelial regeneration is the principal mechanism of repair. Conversely, healing by _____ involves more intense inflammation, granulation tissue and accumulation of extracellular matrix.

____ is more typical of carcinomas, whereas ____ is characteristic of sarcomas.

____ is/are a fungal lung infection endemic in the Ohio and Mississippi river valleys, as well as Appalachia.

(Select all that apply)

This condition is characterized by round, exophytic, coin-like, brown plaques with a "stuck-on" appearance. Most commonly they appear on the trunk, but can also appear on the head, neck and extremities.

_____ is defined as the de-differentiation of cancer cells.

Diffuse restrictive lung disorders are characterized by an increase in the FEV1/FVC ratio (decreased vital capacity, decreased or near-normal FEV1). They include:
(Select all that apply)

This type of extracellular fluid has a low protein content and few cells. It is associated with conditions with decreased oncotic pressure (e.g. nephrotic syndrome) or increased hydrostatic pressure (e.g. congestive heart failure).

On fundoscopy you see microaneurysms, hard exudates and neovascularization. You suspect:

____ attempts to estimate the level of malignancy based on the cytologic differentiation of tumor cells, whereas ____ is based on the size of the primary lesion, spread to regional lymph nodes, and presence or absence of distant metastases.

____ is a fleshy, triangular encroachment of the conjunctiva onto the cornea, whereas ____ is a yellow, elevated nodule in the conjunctiva.

____ is an abscess of either the meibomian gland or glands of Zeis. It is differentiated from a ____ in that the former is acute, tender and edematous, while the latter is chronic, non-tender and granulomatous.

This class of cell-derived inflammatory mediators is responsible for increased vascular permeability, chemotaxis and leukocyte adhesion and activation. It is also an arachadonic acid metabolite released by mast cells and leukocytes.

A 35 year old patient presents with progressive, unilateral sensorineural hearing loss. You suspect:

This dermatologic condition has a tendency to occur on both sun-exposed and unexposed body surfaces. It is characterized by flat to slightly raised plaques with a pebbly surface, variable pigmentation and irregular borders. Lesions are typically >5mm in diameter. It is recognized as a risk marker for the future development of melanoma.

This type of necrosis most commonly occurs in solid organs after an infarction.

In tumors, _____ is the supporting, host-derived, non-neoplastic tissue made up of connective tissue, blood vessels and inflammatory cells.

Bacterial keratitis typically presents with ____ corneal ulcers, while herpetic keratitis presents with ____ corneal ulcers.

Generally speaking, benign neoplasms differ from malignant neoplasms in that they:
(Select all that apply)

Common causes of otitis externa include:

(Select all that apply)

____ are responsible for the major immune defense mechanism against tumors.

Similar to allergic contact dermatitis, the PPD test relies on a ____ reaction that becomes positive 2-4 weeks after TB infection.