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12574 Pathology

A 50-year-old man has had a chronic cough for the past 18 months. Physical examination shows nasopharyngeal ulcers, and the lungs have diffuse crackles bilaterally on auscultation. Laboratory studies include a serum urea nitrogen level of 75 mg/dL and a creatinine concentration of 6.7 mg/dL. Urinalysis shows 50 RBCs per high-power field and RBC casts. His serologic titer for C-ANCA (proteinase 3) is elevated. A chest radiograph shows multiple, small, bilateral pulmonary nodules. A transbronchial lung biopsy specimen shows a necrotizing inflammatory process involving the small peripheral pulmonary arteries and arterioles. Which of the following is the most likely diagnosis?

AGranulomatosis with polyangiitis
BFibromuscular dysplasia
CGranuloma pyogenicum
DKaposi sarcoma
Pathology
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12576 Pathology

A 21-year-old female presents because her urine has turned a brown color. She states that about 2 months ago her urine turned brown 2 days after a cold and stayed brown for about 3 days. At the current time a urinalysis reveals 2+ blood with red cells and red cell casts. Fuher laboratory tests include a complete blood count (CBC), serum electrolytes, BUN, creatinine, glucose, antinuclear antibodies (ANAs), and serum complement levels (C3 and C4). All of these tests are within normal limits. Immunofluorescence examination of a renal biopsy from this patient reveals the presence of large, irregular deposits of IgA/C3 in the mesangium. A linear staining pattern is not found. What is the most likely diagnosis for this patient?

ABerger's disease
BGoodpasture's disease
CLipoid nephrosis
DMembranoproliferative glomerulonephritis
Pathology
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12578 Pathology

During a routine breast self-examination, a 35-year-old female is concerned because her breasts feel “lumpy.” She consults you as her primary care physician. After performing an examination, you reassure her that no masses are present and that the “lumpiness” is due to fibrocystic changes. Considering this clinical opinion, a pathologic finding that is consistent with the nonproliferative form of fibrocystic change is

AA blue-domed cyst
BA radial scar
CAtypical hyperplasia
DPapillomatosis
Pathology
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12581 Pathology

An elderly man comes to medical attention because of anemia and multiple infections. Physical examination is remarkable for hepatosplenomegaly. An automated blood count demonstrates pancytopenia. Review of the peripheral smear by a hematologist demonstrates rare, distinctive, neoplastic white cells covered by fine, hairlike projections. Which of the following characteristics would likely be associated with these cells?

ABirbeck granules
BElevated leukocyte alkaline phosphatase
CPhiladelphia chromosome
DPositive tarate-resistant acid phosphatase
Pathology
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