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10586 Pathology

A 33-year-old woman has had increasing lethargy and decreased urine output for the past week. Laboratory studies show her serum creatinine is 4.3 mg/ dL and urea nitrogen 40 mg/dL. A renal biopsy is performed, and the specimen is examined using electron microscopy. Which of the following morphologic cellular changes most likely suggests a diagnosis of acute tubular necrosis?

AChromatin clumping
BMitochondrial swelling
CNuclear fragmentation
DPlasma membrane blebs
Pathology
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10587 Pathology

A 53-year-old woman has had nausea, vomiting, and mid-epigastric pain for 5 months. On physical examination, there are no significant findings. An abdominal CT scan shows gastric outlet obstruction. Upper gastrointestinal endoscopy shows an ulcerated 2×4 cm bulky mass in the antrum at the pylorus. A urease test is positive. Which of the following neoplasms is most likely to be seen in a biopsy specimen of this mass?

AAdenocarcinoma
BLeiomyosarcoma
CNeuroendocrine carcinoma
DNon-Hodgkin lymphoma
Pathology
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10590 Pathology

A 60-year-old man presents with dizziness, nausea and severe shoness of breath of several months’ duration. Physical examination shows hepatomegaly, ascites and anasarca. His blood pressure is 200/115 mm Hg. An X-ray film of the chest demonstrates cardiomegaly and mild pulmonary edema. Although different mechanisms may have contributed to the pathogenesis of hypeension in this patient, the common end result for all of them is which of the following?

AAerial cystic medial necrosis
BDecreased plasma oncotic pressure
CGeneralized vasodilation
DIncreased peripheral vascular resistance
Pathology
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