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病理期末102

 

卷A

G1
1. A 56-year-old woman has carried a diagnosis of type 1 DM since the age of
   20. She has had increasing difficulty with vision for the past decade.
   Which of the following pathologic findings is most likely?
   A. corneal stromal dystrophy
   B. retrolental fibroplasia
   C. granulomatous uveitis
   D. capillary microaneurysms


2. All of the following statement regarding Wegener granulomatosis are true,
   Expect:
   A.untreated patient usually die within a year
   B.treated with cyclophosphamide
   C.May have renal involvement(necrotizing glomerulitis)
   D.a neoplasm of natural killer cells


3. A 28 year old male suffers a penetrating injury to his left eye. However,
   three weeks later,he has loss of accomodation, photophobia, and blurred
   vision in his right eye, the most likely diagnosis is which of following?
   A.undiagnosed trauma
   B.sympathetic ophthalmia
   C.aspergillosis
   D.fuchs dystrophy


4. Adenoid cystic carcinoma is a tumor of the salivary glands that is
   characterized by:
   A.nerve invasion is the area of the tumor
   B.grossly cystic appearance
   C.circumscribed growth pattern
   D.frequent involvement of the parotid glands


G2
5. EBV infection is associated with:
   A.heroetic stomatitis
   B.osteomyelitis
   C.nasopharyngeal carcinoma
   D.angiofibroma


6. On physical examination of the oral cavity, the left buccal mucosa of a 72
   years old male reveals some discrete white patches with leathery surface.
   The lesion are spread over a 2.5x0.7cm area. A biopsy of the lesion shows
   hyperkeratosis, parakeratosis, and squamous epithelial acanthosis.
   Which of the followings is most likely to be the cause of disease?
   A. Eating chili peppers
   B. Chewing betal nuts
   C. Franch kissing
   D. HIV
B卷◎39. On physical examination of oral cavity, the left buccal mucosa of a
         72 years old male reveals some discrete white patches with leathery
         surface. The biopsy of lesion shows hyperkeratosis,parakeratosis and
         squmaous epitheial acantosis.  Which of followings is most likely
         cause of disease?
   (A)eating chili peppers
   (B)chewing betal nut
   (C)French kissing
   (D)HIV infection


7. All of the following statements regarding  neuroblastoma are true,Except:
   A. neural crest origin involving olfactory mucosa
   B. small round cells resembling neuroblasts
   C. uncommon and highly malignant timor
   D. not tend to metastasize widely
A卷◎42. About olfactory neuroblastoma 選錯的  (複選?)
   (A)neural crest origin
   (B)small round cell
   (C)uncommon highly malignant
   (D)not tend to metastasize


8. Characteristics of Sjogren’s syndrome include all of the following,
   Except:
   A. swelling of the lacrimal and salivary glands
   B. association with rheumatoid arthritis
   C. metastasis to regional lymph nodes
   D. increased risk for development of malignant lymphoma


G3
9. Retinal detachment is most likely to be a complication of which of the
   following?
   A . macular degeneration
   B. glaucoma
   C. cataracts
   D. diabetic retinopathy
A卷◎37.請問下列何者為最常伴隨retinal detachment的病症
     A. Glucoma
     B. Cataract
     C. Microaneurysm
     D. (請幫忙補強)


B 10. 有關neuroblastic tumors 之敘述 何者為非
    A. adrenal gland是最常見之部位
    B. 所有 ganglioneuroblastomas皆為良性
    C. neuroblastoma 可能會自動消失
    D. ganglioneuroma 不含有neuroblasts

NB在薛純P1

(A)對
(B)GN良性、NB惡性為主,GNB介於中間,可良可惡
(C)對,越早被診斷出來,預後越好,甚至會自癒
(D)對,是分化完全的神經


D 11.有關PNET之敘述何者非
    A. 會表現CD99
    B. 多數病人為青少年
    C. chest wall 是最常見之部位之一
    D. 與t(2;13)(p35:q14)有關

ES在薛純P9

(A)對,要注意的是其他腫瘤也有可能表達CD99
(B)對,80%病人小於20歲
(C)對,脊柱兩旁、軀幹、胸壁是好發處
(D)那是alveolar RMS的特徵(P14左上)


A 12. 一個一歲大的女孩有nephrotic syndorme 及 male pseudohermaphrotidism同時發現
     腎臟有腫瘤,最可能的診斷為下列何者?
    A. wilm’s tumor
    B. cystic nephroma
    C. clear cell sarcoma of the kidney
    D. malignant rhabdoid tumor of the kidney

這是跟WT高度相關的疾病之一,被稱為是Denys-Drash syndrome
其他還有WAGR、Beckwith-Wiedemann syndrome、hemihypertrophy、FWT等...

G4

以紙本講義的順序為主

A 13.下列有關malignant rhabdoid tumor of the kidney(RTK) 之敘述何者非?
    A. inactivation of WT-2 gene
    B. inactivation of hSNF/INI-1 gene
    C. 好發於小於兩歲之兒童
    D. 部份病人會同時出現primary brain tumor


(A) 跟這點無關。
(B) 薛純P.29(左上)第四點,hSNF/INI-1 gene在RTK上不會表現,一般器官都有。
(C) 薛純P.26(右下)第二點,大約有85%的RTK都在出生的前兩年被診斷出來。
(D) 薛純P.29(左上)第二點,15%的病人會出現primary brain tumor。
                                         *(在後顱窩的中線部位。)


B 14. Anaplastic Wilms tumor的特性(中文出題)
    A. 好發於嬰兒期
    B. 常有p53 mutation
    C. 占所有Wilms tumor的20%
    D. 化療效果佳

(A) 薛純P.21(左上)第3點,被診斷的年紀是61個月。(5歲確定不是嬰兒期了..)
(B) 薛純P.21(右上)第1點,25%~73%的人有p53 mutation。
(C) 薛純P.21(左上)第2點,大概4~5%的WT是屬於anaplastic WT。
(D) 薛純P.21(右上)第4點,他之所以預後不好,就是因為化療效果不佳。

 

A 15. 下列何者易發生骨骼轉移
    A. clear cell sarcoma of kidney               (CCSK)
    B. anaplastic wilm’s tumor                   (WT)
    C. atypical mesoblastic nephroma              (CMN的subtype)
    D. malignant rhabdoid tumor of kidney         (RTK)


(A)薛純P.23(右下)第5點,有骨頭轉移的傾向(17~70%)
(B)薛純P.21,沒有提到相關的轉移。
(C)薛純P.32(左下)第3點,AMN指的是CMN裡面的cellular type,
   而CMN的轉移很少發生。
(D)薛純P.26(右下)第4點,沒有找到骨頭轉移傾向,所以另外找了一個,
   RTK被診斷出來的時候,通常已經全身都有癌細胞了。


C 16. 有一個八個月大的女孩診斷出neuroblastoma(NB) 臨床檢查發現下列何者知預後最差
    A. bone marrow metastasis
    B. liver metastasis
    C. lung metastasis
    D. skin metastasis

見薛純P.4(左上)的表,這邊主要考的是stage 4跟stage 4S的差別,這題背的不夠詳細
題意應該是"原發腫瘤被斷定為2B以下,並且出現下列何處轉移,預後最差?"
A、B、D都是可以滿足4S的條件
(4S差不多等於stage 2,還算好治)
Lung不是,轉移到Lung就是stage 4 所以選C。

 

G5
17.下列何者是會侵犯鄰近骨骼的腫瘤?(選項順序有點忘記了...抱歉)
   A. oligodendroma
   B. medulloblastoma
   C. meningioma
   D. astrocytoma


B 18. 下列有關Myositis Ossificans何者正確錯誤?(選項記得不太清楚)
    A. A localized, self limiting, reparative lesions composed of reactive
      hypercellular fibrous tissue and metaplastic bone
    B. lamelar bone 被包住
    C. involves muscles of proximal extremeties, dense calcifications in the
      pheriphery of bone
    D. young adulthood
(A)對
(B)錯,因為我看不懂,有關組織上的特徵,見下題(A)註解
(C)對
(D)對

A卷◎39. 下列關於myositis ossificans ,何者有錯?
     (A) 組織上可見 zonal phenomenon of lamellar bone in lesion center.
     (B) 是localized, self-limiting, reparative lesions composed of reactive
         hypercelluar fibrous tissue and metaplastic bone.
     (C) typically arising in the musculature of proximal extremity(不太記得了)
     (D) 多發於老人

(A) MO在組織上有帶狀分區的特性,
        中心是很多梭狀的myofibroblast搭配fibromyxoid的背景
        接著是一些不成熟的osteoid
        最周邊 有一些osteoblast圍繞在woven bone旁邊,或是lamellar bone的形成
(B)對
(C)對
(D)錯,好發年輕的成人


B 19. 下列何者會造成腦櫻桃紅色,點狀出血,兩側蒼白球(globus pallidus)壞死?
    A. 膽紅素
    B. CO
    C. 甲醇
    D. 乙醇


20. 下列有關腦部接受輻射之後期變化之敘述
   A. 一個月內便會出現顱內壓升高之現象
   B. 病裡變化主要在白質
   C. 血管內皮細胞過度增生
   D. 輻射後所引發之腫瘤已腦膜瘤最常見


G6
D 21. 最常發生於腦室及馬尾的腫瘤是
    A. pilocytic astrocytoma
    B. hemangioblastoma
    C. oligodendroglioma
    D. ependymoma                                                      D


22.what is shower emboli?
    (A) tumor cells
    (B) air
    (C) blood clot
    (D) fat


23. 不明原因性parkison式病的病灶中,下列何種細胞減少最多
   A. 色素性神經細胞
   B. 反應性星狀細胞
   C. 內皮細胞
   D. T淋巴球                                                         A


24. 核黃疸(kernicterus)的病變主要出現在?
    (A)大腦皮質 (B)  大腦白質 (C)  基底核 (D)  灰白質交界


25.一名十歲男童在小腦有一囊腫樣之腫瘤最可能之病裡診斷為
   A. pilocytic astrocytoma
   B. fibrillary astrocytoma
   C. gemistocytic astrocytoma
   D. glioblastoma multiforme


G7
26.慢性高血壓引起腦出血之 charcot-bouchard microaneurysms在哪一位置最常見?
   A. 腦幹
   B. 小腦
   C. 基底核
   D. 海馬迴


27.which of the following is wrong?
   A . patient with epidural hematoma can be lucid for hours between the
       moment of trauma and development of neurologic signs
   B. the histopathology of diffuse axonal injury is characterized by axonal
       swellings
   C. the most frequent cause of clincally significant subarachnoid
       hemorrhage is rupture of a berry aneurysm
   D. cerebral autosomal dominant arteriopathy with subcortical infarcts and
       leukoencephalopathy is characterized by recurrent strokes and dementia
       and granulomatous angitis


28. What is the impact of false positive diagnosis of Pap Smears?
   (A)Patient may die
   (B)Possible law suit for failure to diagnosis
   (C)Increase cost for follow up diagnostic test
   (D)A sense of false security for both patient and children


29. In the Bethesda system, all of the following would be considered a
    high-grade squamous intraepithelial lesions(HSIL), EXCEPT:
   (A) Moderate dysplasia
   (B) Keratinizing dysplasia
   (C) Mild dysplasia
   (D) Carcinoma in situ
   (E) HPV and moderate dysplasia


G8
30. which of the following descriptions about psoriasis is wrong
   A. some patients have nail changes
   B. munro microabscess is a diagnostic feature
   C. microscopically, psoriasis is characterized by marked hypergranulosis
   D. erythroderma may occured
B卷◎35. 有關psoriasis下列何者錯誤?
   (A) nail changes
   (B) Munro microabscess
   (C) hypergranulosa
   (D) erythromatus may occur


31. An elevated skin lesion smaller than 5 mm in size is called
   A. patch
   B. plaque
   C. papule
   D. macule


32. Which of the following results from the hyperplasia of melanocyte?
   (A)Lentigo
   (B)Melasma
   (C)Vitiligo
   (D)Freckle


33. A granular pattern of IgA deposits in the dermal papila in direct
    immunofluorescence study is characterisis for?
    (A)Bullous pemphigoid
    (B)Dermatitis herpetiformis
    (C)Lupus erythematosis
    (D)Pemphigus vulgaris


G9
34. 有關fracture的敘述何者正確?
    (A)compound fracture and comminuted fracture易有細菌感染
    (B)formation of bony callus in catilage at the end of the 1st week
    (C)comminuted fractue(後面的忘了...)
    (D)compound fracture是由既有的disease所造成的


35.Regarding juvenile idiopathic arthritis,which of the following statements
   is incorrect?
    A. Oligoarthritis subtype is associated with ANA positivity and
       iriocylitis
    B. Systemic arthritis usually affects 4 or less joints with high spiking
       fever, hepatosplenomegaly and migratory skin rash.
    C. By definition, JIA requires age at presentation<16 years and a minimum
       duration of 6 weeks
    D. Seldom involving small joints at the initial diagnosis


36.Regarding osteosarcoma, which of the following statement is INCORRECT?
   (A) The most common primary pediateic bone sarcoma, following by Ewing
       Sarcoma.
   (B) Occurring mostly in the intramedullary cavity of bone.
   (C) The most common site of distant metastasis is liver.
   (D) It is a malignant mesenchymal tumor producing tumor osteoids,
       irrespective of the amount.


38. regarding primary aneurysmal bone cyst of bone, which of the following is
    incorrect?
    A.  mostly affecting the epiphysis of the long bone
    B . mostly occurring in patients of the 1st and 2nd decades in age
    C. a neoplastic disease characterized by 17p13 translocation with USP6
       gene rearrangement
    D. histologically featuring multiloculated blood-filled cysts surrounded
       by wall contain proliferating fibroblasts, reactive woven bone, and
       osteoclast-like giant cells


G10
40. Which of the followings of gaint cell tumor is right?
    沒背清楚但key word都有
    (A)Local recurrences are uncommon in diffuse type of this tumor
    (B)Foamy histiocytes and osteoclaset-like multinucleated cells are actual
       tumor cells
    (C)tumor-specific gene translocation
    (D)There is female predominace in sex distribution
B卷◎ 19.有關tenosynovial giant cell tumor,何者不正確?
    (A) diffuse-type不常復發
    (B) foamy histiocyte, osteo-like mutinucleated cell 是此tumor的真正
        tumor cell
    (C) 有特定的基因translocation
    (D) 女性稍常發生


41. Regarding chondrosarcoma of bone, which of the following statements is
    correct
    A. typically occurring in the articular cartilage of proximal long bones
       and flat bones, such as pelvic bones
    B. bimodal peaks of age distribution in terms of conventional varient
    C. surgery, instead of chemotherapy, is the mainstay of treatment for
       conventional variant
    D. mitosis typically seen in grade 1 to 2 cases


卷B

單選
容世明老師
2. 下列何者是原因不明型帕金森氏症的肉眼觀察到的特殊精神病理變化?
   (A) 海馬核萎縮
   (B) 黑質變性
   (C) 運動皮質區萎縮
   (D) 尾狀核萎縮


 複 選
1. 關於malignant melanoma何者正確?
   (A) higher risk for lightly pigment individual
   (B) enlargement of pre-existing nevus is clinical warning sign
   (C) variegation of color within a pigmented lesion is warning sign
   (D) melanoma cell is generally than nevus cell

 

 

 

 

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