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6087 Pathology

A 29-year-old woman has had a fever and sore throat for the past 3 days. On physical examination, her temperature is 38degC. The pharynx is erythematous, with yellowish tonsillar exudate. She is treated with ampicillin and recovers fully in 7 days. Two weeks later, she develops fever and a rash and notices a slight decrease in urinary output. Her temperature is 37.7degC, and there is a diffuse erythematous rash on the trunk and extremities. Urinalysis shows a pH of 6; specific gravity, 1.022; 1+ proteinuria; 1+ hematuria; and no glucose or ketones. Microscopic examination of the urine shows RBCs and WBCs, including eosinophils, but no casts or crystals. What is the most likely cause of her disease?

ADeposition of immune complexes with streptococcal antigens
BFormation of antibodies against glomerular basement membrane
CHematogenous dissemination of septic emboli
DHypersensitivity reaction to ampicillin
Pathology
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6089 Pathology

A 49-year-old male who is a long-term smoker presents with frequency and hematuria. Histologic examination of sections taken from an exophytic lesion of the urinary bladder reveal groups of atypical cells with frequent mitoses forming finger-like projections that have thin, fibrovascular cores. These groups of atypical cells do not extend into the lamina propria and muscularis. No glands or keratin production are found. What is the most accurate diagnosis for this bladder tumor?

AAdenocarcinoma, noninvasive
BInveed papilloma
CTransitional cell carcinoma in situ
DPapillary transitional cell carcinoma (TCC), noninvasive
Pathology
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6091 Pathology

A 36-year-old man presents to his physician complaining of right scrotal swelling. He states that the swelling has been present for 1 week. He initially noticed the swelling sholy after moving furniture for his new living room. He denies any nausea, vomiting, change in bowel habits, abdominal pain, or urinary tract symptoms. He has no other significant medical or surgical history. On examination, he has an enlarged right hemi-scrotum with a mass that appears to be originating at the level of the external inguinal ring. With the patient completely relaxed, the physician is able to reduce the mass by pushing it back through the external inguinal ring. With the mass reduced, the physician instructs the patient to perform a Valsalva maneuver, upon which a protrusion is felt at the external inguinal ring. Once the mass is reduced, the testicle appears normal in size and consistency. Which of the following pathological processes might cause the patient’s underlying condition to occur in an infant?

ADefect in the floor of the inguinal canal
BDefect in the internal inguinal ring
CDefect in the linea semilunaris
DPatent processus vaginalis
Pathology
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