同济大学：《病理学》课程教学资源（试卷习题，含答案）试题B卷

Tongji Univesity School of Medicine 2014-2015 Academic Year,the 2*semester Final Examination of (Test paper B) Name. ID IA typel question (30 questions.One point per question) Directions:Each question below contains five suggested answers.Choose the one best response to each question 1.By definition,granulomas are composed of( a.Chronic abscess b.Collagen c.Endothelial cells and fibroblasts e.Hemosiderin-laden macrophages 2.The most important prognostic factor for human cancer is the( a.Grade b.Stage c.Lymphocytic infiltration d.Vascular invasion e.Mitotic index 3.Histologic sections of lung tissue froma68-year-old female with congestive heart failure and progressive breathing problems reveal numerous hemosiderin aden cel业s within the alveoli.Theses "heart failure cells"originate from alveolar( a.Endothelial cells b.Eosinophils c.Lymphocytes d.Macrophage e.Pneumocytes 4.During acute inflammation,histamine-induced inereased vascular permeability causes the formation of exudates(inflammatory edema).Which one of the listed cell types is the most eof the histamine? ) Endothelial cells b.Fibroblasts c.Lymphocytes

Tongji Univesity School of Medicine 2014-2015 Academic Year, the 2 st semester Final Examination of __________________ (Test paper B) Name ID ⅠA type1 question（30 questions. One point per question） Directions: Each question below contains five suggested answers. Choose the one best response to each question. 1. By definition, granulomas are composed of ( ) a. Chronic abscess b. Collagen c. Endothelial cells and fibroblasts d. Macrophages or epithelioid cells e. Hemosiderin-laden macrophages 2. The most important prognostic factor for human cancer is the ( ) a. Grade b. Stage c. Lymphocytic infiltration d. Vascular invasion e. Mitotic index 3. Histologic sections of lung tissue from a 68-year-old female with congestive heart failure and progressive breathing problems reveal numerous hemosiderin-laden cells within the alveoli. Theses “heart failure cells” originate from alveolar( ) a. Endothelial cells b. Eosinophils c. Lymphocytes d. Macrophages e. Pneumocytes 4. During acute inflammation, histamine-induced increased vascular permeability causes the formation of exudates (inflammatory edema). Which one of the listed cell types is the most likely source of the histamine?( ) a. Endothelial cells b. Fibroblasts c. Lymphocytes

d.Mast cells e.Neutrophils 5.A postmortem clot is most likely to( a.Grossly display features of recanalization h.Grossly have lines of Zahn Grossly have the appearance of"chicken fat"overlying'curant jelly" Microscopically appear attached to the wall the blood vesse e.Microscopically have alternating layers of cells and platelets 6.What is the most common site of origin of thrombotic pulmonary emboli?( a.Deep leg veins b.Lumen of left ventricle Lumen of right ventricl d.Mesenteric veins e.Superficial leg veins 7.What is the most of chronic obstructive pulmonary disease?( c.Intestitial lung diseases d.Chronie bronchitis e.Pulmonary tuberculosis 8.Fluid that colleets during acute infammation and that has a protein content in excess of 3.0g/dl and a specific gravity over 1.015 is termed( a.Exudate b.Transudate Lymphokin e.Hemorrhage 9.The most characteristic and frequent feature of chronic rheumatic heart disease is the development of Vegeta ns on the e end cardium Ashoff bodies within the myocardium c.Fibrin deposits within the pericardium d.Stenosis of the mitral valve e.Incompetence of the pulmonic valve 10.Which one of the listed is the most common complication of chronic peptic ulcer?( a.hemorrhage b.perforation

d. Mast cells e. Neutrophils 5. A postmortem clot is most likely to( ) a. Grossly display features of recanalization b. Grossly have lines of Zahn c. Grossly have the appearance of “chicken fat” overlying ‘currant jelly” d. Microscopically appear attached to the wall of the blood vessel e. Microscopically have alternating layers of cells and platelets 6. What is the most common site of origin of thrombotic pulmonary emboli?( ) a. Deep leg veins b. Lumen of left ventricle c. Lumen of right ventricle d. Mesenteric veins e. Superficial leg veins 7. What is the most common cause of chronic obstructive pulmonary disease?( ) a. Pneumoconiosis b. Pneumonia c. Intestitial lung diseases d. Chronic bronchitis e. Pulmonary tuberculosis 8. Fluid that collects during acute inflammation and that has a protein content in excess of 3.0g/dl and a specific gravity over 1.015 is termed( ) a. Exudate b. Transudate c. Coagulation d. Lymphokine e. Hemorrhage 9. The most characteristic and frequent feature of chronic rheumatic heart disease is the development of( ) a. Vegetations on the endocardium b. Ashoff bodies within the myocardium c. Fibrin deposits within the pericardium d. Stenosis of the mitral valve e. Incompetence of the pulmonic valve 10. Which one of the listed is the most common complication of chronic peptic ulcer?( ) a. hemorrhage b. perforation

c.pyloric stenosis d. malignant transformation e. hypertrophic gastritis 11.The most common reason of thrombosis is a.endothelial injury b.blood hyper agulability c.blood flo d.stasis of blood fov e.hypertension 12.The most serious common complication of lower extremity thrombophlebitis is( Kidney infa Myocardial infarction d.Pulmonary infarction e.Intestinal infarction 13.Which one of the listed statements is the best histologic definition of an abscess?( a.A circumscribed collection of neutrophils with necrotic cellular debris b.A localizes defect that results from the sloughing of necrotic inflammatory tissue from the surface of an organ c.A localized proliferation of fibroblasts and small blood vessels d.An aggregate of two or more activated macrophage e.The excessive secretion of mucus from a mucosal surface 14.The classic lesion of rheumatic heart disease is( Mallory's body b.Aschoff body c.Psammoma body d.Negri body e.Anitschkow'smyocyte 15.Which of the following infections is often the cause of interstitial pneumonia?( a.Gram-positive bacterial b.Gram-negative bacterial c.Viral d.Fungal e.Parasiti 16.Gastric carcinoma is most common in which one of the listed site locations( a.pyloricantrum b. pyloricantrum and lesser curvatur lesser curvature d.greater curvature

c. pyloric stenosis d. malignant transformation e. hypertrophic gastritis 11. The most common reason of thrombosis is ( ) a. endothelial injury b. blood hypercoagulability c. blood flow slowly d. stasis of blood flow e.hypertension 12. The most serious common complication of lower extremity thrombophlebitis is( ) a. Cerebral infarction b. Kidney infarction c. Myocardial infarction d. Pulmonary infarction e. Intestinal infarction 13. Which one of the listed statements is the best histologic definition of an abscess?( ) a. A circumscribed collection of neutrophils with necrotic cellular debris b.A localizes defect that results from the sloughing of necrotic inflammatory tissue from the surface of an organ c. A localized proliferation of fibroblasts and small blood vessels d. An aggregate of two or more activated macrophage e. The excessive secretion of mucus from a mucosal surface 14. The classic lesion of rheumatic heart disease is( ) a. Mallory’s body b. Aschoff body c. Psammoma body d. Negri body e. Anitschkow’smyocyte 15. Which of the following infections is often the cause of interstitial pneumonia?( ) a. Gram-positive bacterial b. Gram-negative bacterial c. Viral d. Fungal e. Parasitic 16. Gastric carcinoma is most common in which one of the listed site locations( ) a. pyloricantrum b. pyloricantrum and lesser curvature c. lesser curvature d. greater curvature

e.fundue 17.Histological sections(rouin H&E stain)of lung reveal the alveolito be filled with pale nongranular pink fluid.Neither leukocytes nor erythrocytes are present within this fluid. What is the most likely (i.e.,most common)cause of this abnormality?( a Racterial nneumonia b.Congestive heart failure Lymphatic obs ruction by tumor d.Pulmonary embolus e.Viral pneumonia 18.What is the most likely cause of the combination of generalized edema.hypoalbuminemia marked uria, and fat女y casts and fat bodies in the urine?( a.Nephritic syndrome b.Nephrotic syndrome c Acute renal failure d.Renal tubular defect e Urinary tract infection 19.Which one of the listed hepatic diseases has the greatest risk of developing into hepatocellular carcinoma ? a.hepaticsteatosis(fatty liver) b. portal cirrhosis postnecrotic cirrhosis d.biliary cirrhosis e.congestive liver cirrhosis 20.The most common cause of liver cirrhosis in China is( a.Drug-induced hepatiti b.Toxin-induced hepatitis c.Alcoholic hepatitis d.Viral hepatitis e.Autoim mune hepatitis 21.The cardinal sign of inflammation called rubor is mainly the result of( a. Decreased interstitial hydrostatic pressure b. Decreased vascular permeability of capillaries Increased vascular permeability of venules d. Vasoconstriction of muscular arteries e vasodilation of arterioles 22.Which of the following is the most common type of breast carcinoma?( Intraductal Medullary

e. fundue 17. Histological sections (routine H&E stain) of lung reveal the alveoli to be filled with pale, nongranular pink fluid. Neither leukocytes nor erythrocytes are present within this fluid. What is the most likely (i.e., most common) cause of this abnormality?( ) a. Bacterial pneumonia b. Congestive heart failure c. Lymphatic obstruction by tumor d. Pulmonary embolus e. Viral pneumonia 18.What is the most likely cause of the combination of generalized edema, hypoalbuminemia hypercholesterolemia, marked proteinuria, and fatty casts and fat bodies in the urine?( ) a. Nephritic syndrome b. Nephrotic syndrome c. Acute renal failure d. Renal tubular defect e. Urinary tract infection 19. Which one of the listed hepatic diseases has the greatest risk of developing into hepatocellular carcinoma ?( ) a. hepaticsteatosis (fatty liver) b. portal cirrhosis c. postnecrotic cirrhosis d. biliary cirrhosis e. congestive liver cirrhosis 20. The most common cause of liver cirrhosis in China is( ) a. Drug-induced hepatitis b. Toxin-induced hepatitis c. Alcoholic hepatitis d. Viral hepatitis e. Autoimmune hepatitis 21. The cardinal sign of inflammation called rubor is mainly the result of ( ) a. Decreased interstitial hydrostatic pressure b. Decreased vascular permeability of capillaries c. Increased vascular permeability of venules d. Vasoconstriction of muscular arteries e. Vasodilation of arterioles 22. Which of the following is the most common type of breast carcinoma?( ) a. Intraductal b. Medullary

Papillary e. Infiltrating ducta 23.Of the lesions listed below,which one is in accord with the feature of malignant tumor?( a.Anaplasia b.Aplasia s.Hyperplasia plasia 24.Which of the following tumor markers has been associated with the hepatocellula carcinoma?( a.CEA b.AFP c.Prostae-specific antigen d.Tyrosine enzyme e.Thyroglibulin antigen 25.Nutmeg liver is associated with( a.conestive liver cirrhosis b.portal cirrhos e.biliary cirrhosis d.postnecrotic cirrhosis e.pipe stem cirrhosis 26.Benign hypertension is characterized by: ) a.Fibrinoid necrosis of arterioles b.Atrophy of the muscular media of the arteries c.Fibroelastic thickening of whole arteriole walls d.Hyaline deposition in arteriole walls e.Sudden and severe increase in blood pressure 27.Gastric carcinoma:( is usually of s uamous cell typ is commoner in fema les than male occurs most commonly in the body of the stomach d.is commoner in Europe than China e.has a positive association with dysplasia of gastric mucosa 28.Which one of the listed lesion is tumour?( uloma Atheroma

c. Papillary d. Mucinous e. Infiltrating ductal 23. Of the lesions listed below, which one is in accord with the feature of malignant tumor?( ) a. Anaplasia b. Aplasia c. Hyperplasia d. Hypoplasia e. Metaplasia 24. Which of the following tumor markers has been associated with the hepatocellular carcinoma?( ) a. CEA b. AFP c. Prostae-specific antigen d. Tyrosine enzyme e. Thyroglibulin antigen 25. Nutmeg liver is associated with ( ) a. congestive liver cirrhosis b. portal cirrhosis c. biliary cirrhosis d. postnecrotic cirrhosis e. pipe stem cirrhosis 26. Benign hypertension is characterized by：（ ） a．Fibrinoid necrosis of arterioles b．Atrophy of the muscular media of the arteries c．Fibroelastic thickening of whole arteriole walls d．Hyaline deposition in arteriole walls e．Sudden and severe increase in blood pressure 27. Gastric carcinoma：（） a． is usually of squamous cell type b． is commoner in females than males c． occurs most commonly in the body of the stomach d． is commoner in Europe than China e． has a positive association with dysplasia of gastric mucosa 28. Which one of the listed lesion is tumour?( ) a. Granuloma b. Hematoma c. Atheroma

e 29.Lipoid nephrosis(minimal change nephrosis)of the kidneys characteristically produces changes that may be observed by electron microscope(EM)in which of the following renal glomerular elements?( a.Endothelial cells b.Epithelial cells Mesangium d Blood vessels Basement membrane ) Leukemia b. Melanoma c. Teratoma d. Embryonic tumor of kidney True aneurysm IA type2 question (20 questions.Two points per question) Directions:Each question below contains five suggested answers.Choose the one best response to each question. 31.A30 year-old man fractures his left femur in a biking accident,and his leg is placed in a plaster cast.After the leg has been immobilized for several weeks,the diameter of the left calf has decreased.This chang is most likely to result from which of the following alterations in the calf muscles?() A.Aplasia B.Atrophy C.Dystrophy D.Hypoplasia E.Metaplasia 32.On day 28 of her menstrual cycle,a 23 year-old woman experiences onset of menstrual bleeding that lasts for 6 days.She has had regular cyeles for many years.Which of the following processes is most in the endometrium just before the onset of normal me strual bleeding? A.Apoptosis B.Atrophy C.Caseous necrosis D.Heterophagocytosis ecrosis 33.A woman who is allergic to cats visits a neighbor who has several cats.During the visit, she inhales cat dander and within minutes,she develops nasal congestion with abundant

d. Papilloma e. Tuberculoma 29. Lipoid nephrosis(minimal change nephrosis) of the kidneys characteristically produces changes that may be observed by electron microscope (EM) in which of the following renal glomerular elements?( ) a. Endothelial cells b. Epithelial cells c. Mesangium d. Blood vessels e. Basement membrane 30.Of the tumors listed below, which is benign tumor?( ) a. Leukemia b. Melanoma c. Teratoma d. Embryonic tumor of kidney e. True aneurysm ⅡA type2 question（20 questions. Two points per question） Directions: Each question below contains five suggested answers. Choose the one best response to each question. 31. A 30 year-old man fractures his left femur in a biking accident, and his leg is placed in a plaster cast. After the leg has been immobilized for several weeks, the diameter of the left calf has decreased. This change is most likely to result from which of the following alterations in the calf muscles? （ ） A. Aplasia B. Atrophy C. Dystrophy D. Hypoplasia E. Metaplasia 32. On day 28 of her menstrual cycle, a 23 year-old woman experiences onset of menstrual bleeding that lasts for 6 days. She has had regular cycles for many years. Which of the following processes is most likely occurring in the endometrium just before the onset of normal menstrual bleeding? （ ） A. Apoptosis B. Atrophy C. Caseous necrosis D. Heterophagocytosis E. Liquefactive necrosis 33. A woman who is allergic to cats visits a neighbor who has several cats. During the visit, she inhales cat dander and within minutes, she develops nasal congestion with abundant

nasal secretions.Which of the following substance is most likely to produce these symptoms? A.Bradykinin B.Complement C5a C.Histamine D.Interleukin-1 E.Phospholipase C 34.An 80-year-old female falls down the steps leading to the entranee of the house of a relative who is hosting a family reunion.She is hospitalized for surgery to replace a broken hip.She is then moved to a nursing home,but she is unable to ambulate until about a month later.She gets up to bathe with assistance and she experiences the sudden onset of severe dyspnea (shortmess of breath)and goes into cardiac from which she cat be resuscitated.Which of the following is most likely to be the immediate cause of death at autopsy? A.Acute bronchopneumonia B.Acute renal failure C.Complications of alcohol abuse D.Congestive heart failure E.Pulmonary emb 35.A 40-year-old man has a history of intravenous drug use.Physical examination shows needle tracks in his left antecubital fossa.He has mild seleral icterus (yellow eyeballs). Serologic studies for hepatitis HBsAg and antibodies to hepatitis HCVare positive.He oma 15 years later at age 55. Which of the following best explains why this patient developed hepatocellular carcinoma? A.Integration of these viruses in the vicinity of protooncogenes B.The ability of these viruses to capture protooncogenes from the host DNA. C.These viru ses couse in D.Viral genes inactivate RBand p53 expression E.Virus-induced injury to liver cells followed by extensive regeneration of liver cells 36.A 5-year-old child has loss of vision in the right eye.MR imaging shows a mass in the posterior chamber that nearly fills the globe.The child undergoes enucleation of the right Moleular analysis of the neoplastic cel indicates absene of both opies of a tu suppressor gene t controls the tra ition from the G to the S phase of the cell cycle Which of the following genes is most likely to have the mechanism of action that produced this neoplasm?（) A.BCL2 B.hMSH2 C.K-RAS D.NFI E.RB

nasal secretions. Which of the following substance is most likely to produce these symptoms? （ ） A. Bradykinin B. Complement C5a C. Histamine D. Interleukin-1 E. Phospholipase C 34. An 80-year-old female falls down the steps leading to the entrance of the house of a relative who is hosting a family reunion. She is hospitalized for surgery to replace a broken hip. She is then moved to a nursing home, but she is unable to ambulate until about a month later. She gets up to bathe with assistance and she experiences the sudden onset of severe dyspnea (shortness of breath) and goes into cardiac arrest, from which she cannot be resuscitated. Which of the following is most likely to be the immediate cause of death found at autopsy? （ ） A. Acute bronchopneumonia B. Acute renal failure C. Complications of alcohol abuse D. Congestive heart failure E. Pulmonary embolism 35. A 40-year-old man has a history of intravenous drug use. Physical examination shows needle tracks in his left antecubital fossa. He has mild scleral icterus (yellow eyeballs). Serologic studies for hepatitis HBsAg and antibodies to hepatitis HCV are positive. He develops hepatocellular carcinoma 15 years later at age 55. Which of the following best explains why this patient developed hepatocellular carcinoma? （ ） A. Integration of these viruses in the vicinity of protooncogenes B. The ability of these viruses to capture protooncogenes from the host DNA. C. These viruses cause immunosuppression. D. Viral genes inactivate RB and p53 expression E. Virus-induced injury to liver cells followed by extensive regeneration of liver cells 36. A 5-year-old child has loss of vision in the right eye. MR imaging shows a mass in the posterior chamber that nearly fills the globe. The child undergoes enucleation of the right eye. Molecular analysis of the neoplastic cells indicates absence of both copies of a tumor suppressor gene that controls the transition from the G to the S phase of the cell cycle. Which of the following genes is most likely to have the mechanism of action that produced this neoplasm? （ ） A. BCL2 B. hMSH2 C. K-RAS D. NF1 E. RB

37.A clinical study involves patients diagnosed with carcinoma and whose tumor stage is T4NIMI.The patients'survival rate 5y ears from the time of diagnosis is less than regardless of therapy.Which of the lowing clinical findings is most likely to be characteristic of this group of patients?( A.Cachexia B.Cardiac murmur C.Ieterus D.Loss of sensation E.Splenomegaly 38.A previously healthy 20 year old man develops heart failure over a period of several days. He is febrile and complains to his friends that he has chest pain,but he does not seek medical attention.He dies and an autopsy is performed.Examination of the heart shows that both ventricles are dilated but otherwise the myocardium appears normal by gross visua inspection.An H&E-stained histologic section shows numerous inflammatory cells in the myocardium,more than 80%lymphocytes,which expand the interstitial spaces between individual mvocytes and surround mvocytes.Most of the mvocytes are structurally intact and appear viable,although scattered individual myocytes are necrotic.The most likely explan on for this finding is( A.Acute fungal myocarditis B.Acute myocardial infarction C.Acute rheumatic fever D.Marantic endocarditis E.Viral myocarditis 39.A57-year-old woman comes to the physician because she recently noticed a pale area of discoloration on the labia.The area is painful and itchy.Pelvic examination shows the presence of a 0.7-cm flat,white area on the right labia majora.A biopsy specimen shows dysplastie cel that ocupyabout half the thickness of the squam with minimal underlying chronic infammation. In situ hybridization shows uman papill mavirus type 16 DNA in the epithelial cells.Which of the following is the most likely diagnosis？?（ A Contart dermatitis Condylomaacuminatum Sq amous hyperplasi Vulvar intraepithelial neoplasia E.Chronic vulvitis 40.An epidemiologic study of cancer deaths recorded in the last half of the 20th conducted. number of deaths for one type of cancer Which of the following neoplasms was most likely to be identified by this study?( A.Angiosarcoma of the liver B.Carcinoma of the lung

37. A clinical study involves patients diagnosed with carcinoma and whose tumor stage is T4N1M1. The patients’ survival rate 5 years from the time of diagnosis is less than 50%, regardless of therapy. Which of the following clinical findings is most likely to be characteristic of this group of patients? （ ） A. Cachexia B. Cardiac murmur C. Icterus D. Loss of sensation E. Splenomegaly 38. A previously healthy 20 year old man develops heart failure over a period of several days. He is febrile and complains to his friends that he has chest pain, but he does not seek medical attention. He dies and an autopsy is performed. Examination of the heart shows that both ventricles are dilated but otherwise the myocardium appears normal by gross visual inspection. An H&E-stained histologic section shows numerous inflammatory cells in the myocardium, more than 80% lymphocytes, which expand the interstitial spaces between individual myocytes and surround myocytes. Most of the myocytes are structurally intact and appear viable, although scattered individual myocytes are necrotic. The most likely explanation for this finding is（ ） A. Acute fungal myocarditis B. Acute myocardial infarction C. Acute rheumatic fever D. Marantic endocarditis E. Viral myocarditis 39. A 57-year-old woman comes to the physician because she recently noticed a pale area of discoloration on the labia. The area is painful and itchy. Pelvic examination shows the presence of a 0.7-cm flat, white area on the right labia majora. A biopsy specimen shows dysplastic cells that occupy about half the thickness of the squamous epithelium, with minimal underlying chronic inflammation. In situ hybridization shows human papillo￾mavirus type 16 DNA in the epithelial cells. Which of the following is the most likely diagnosis? （ ） A. Contact dermatitis B. Condylomaacuminatum C. Squamous hyperplasia D. Vulvar intraepithelial neoplasia E. Chronic vulvitis 40. An epidemiologic study of cancer deaths recorded in the last half of the 20th century is conducted. The number of deaths for one particular type of cancer has been increasing in developed nations. Which of the following neoplasms was most likely to be identified by this study? （ ） A. Angiosarcoma of the liver B. Carcinoma of the lung

C.Colorectal carcinoma D.Gastric adenocarcinoma E.Leukemia 41.On a routine visit to the physician,an otherwise healthy 51 year-old man has an elevated blood pressure of 150/95 mm Hg.If the patient's hypertension remains untreated for years,which of the following cellular alterations will most likely be seen in the myoca rdium (he art muscle)? A.Atrophy B.Hemosiderosis C.Hypertrophy D.Metaplasia E.Sclerosis 42.A 72 year-old man died suddenly and unexpectedly from congestive heart failure.At autopsy,the heart was very enlarged and weighed 580 grams.There was marked left ventricular hypertrophy and minimal coronary arterial atherosclerosis.A serum chemistry panel ordered prior to death showed no abnormalities.Which of the follo ing pathologi proces counts for the appearance of his aortic valve,which is seen in the figure?( A.Amvloidosis B.Dystrophic calcification C.Fatty Change D.Hemosidero E.Lipofuscin deposition 43.A 16 year-old boy sustained blunt trauma to the abdomen when the vehicle he was driving struck a bridge abutment at high speed.Peritoneal lavage (washing the p oneal cavity with saline)showed a um (blood in the abdominal cavity),and at laparot my (surgical exploratic the men),a small portion of the left lobe of the liver was removed because of the injury. Several weeks later,a CT scan of the abdomen shows that the liver is nearly normal in size again.Which of the following processes best explains this phenomenon？() A.Apoptosis B.Dysplasia C.Fatty change D.Hydropic change E.Hvperplasia 44.Which of the following statements is correct?() A.Autophagy is a rare process that is always associated with disease. B.Autophagy is important in cellular defense against microorganisms. C.Autophagy is not involved in cellular differentiation

C. Colorectal carcinoma D. Gastric adenocarcinoma E. Leukemia 41. On a routine visit to the physician, an otherwise healthy 51 year-old man has an elevated blood pressure of 150/95 mm Hg. If the patient’s hypertension remains untreated for years, which of the following cellular alterations will most likely be seen in the myocardium (heart muscle)? （ ） A. Atrophy B. Hemosiderosis C. Hypertrophy D. Metaplasia E. Sclerosis 42. A 72 year-old man died suddenly and unexpectedly from congestive heart failure. At autopsy, the heart was very enlarged and weighed 580 grams. There was marked left ventricular hypertrophy and minimal coronary arterial atherosclerosis. A serum chemistry panel ordered prior to death showed no abnormalities. Which of the following pathologic processes best accounts for the appearance of his aortic valve, which is seen in the figure? （ ） A. Amyloidosis B. Dystrophic calcification C. Fatty Change D. Hemosiderosis E. Lipofuscin deposition 43. A 16 year-old boy sustained blunt trauma to the abdomen when the vehicle he was driving struck a bridge abutment at high speed. Peritoneal lavage (washing the peritoneal cavity with saline) showed a hemoperitoneum (blood in the abdominal cavity), and at laparotomy (surgical exploration of the abdomen), a small portion of the left lobe of the liver was removed because of the injury. Several weeks later, a CT scan of the abdomen shows that the liver is nearly normal in size again. Which of the following processes best explains this phenomenon? （ ） A. Apoptosis B. Dysplasia C. Fatty change D. Hydropic change E. Hyperplasia 44. Which of the following statements is correct?（ ） A. Autophagy is a rare process that is always associated with disease. B. Autophagy is important in cellular defense against microorganisms. C. Autophagy is not involved in cellular differentiation

D.The autophagic vacuole fuses with a lysosome to form an autophagolysosome E.The autophagic vacuole is formed by mitochondria 45.A 63-year-old man develops worsening congestive heart failure 1 month after an acute myocardial infarction.An echocardiogram shows a markedly decreased eiection fraction.He dies six weeks after his acute myocardial infarct.At autopsy, the infarct shows that the necrotic myoca dium has largely be replaced by capillaries,fibre asts,and collagen Which of the followir inflammatory cell types plays the most important role in the healing process by removing debris?( A.Eosinophils B.Lymphocytes C Macrop D.Neutrophil E.Plasmacytes 46.While shaving one morning,a 23-year-old man nicks his lip with a razor. Seconds after the e ini ury,the bleeding stops.Which of the follo g mechanisms most likely to reduce blood loss from a small dermal vein? A.Fibrin polymerization B.Neutrophil chemotaxis C.Platelet aggregation D.Protein c activation E.Vasodilation 47.A 50-year-old man has a two-year history of angina pectoris that occurs when he exercises.His blood pressure and pulse are normal.Coronary angiography shows 75%narrowing of the left anterior descending artery.Which of the following cell typ was the initial target in the development of this es ion? A.Endothelial cells B.Fibroblasts C.Lymphocytes D.Platelets E.Smooth muscle cells 48.A 56-year-old man with a 120 pack-year smoking history is referred to you for consideration of surgical resection after he is found to have a new 2 cm lung mass on a chest x-ray.After you have reviewed his records,you want to be able to tell him whether surgery will cure his disease.Factors that would influence whether a surgical resectio would be curative include: Cell type of the neoplasm B.Location of the neoplasm C.Stage of the neoplasm D.Whether the neoplasm is benign or malignant

D. The autophagic vacuole fuses with a lysosome to form an autophagolysosome. E. The autophagic vacuole is formed by mitochondria. 45. A 63-year-old man develops worsening congestive heart failure 1 month after an acute myocardial infarction. An echocardiogram shows a markedly decreased ejection fraction. He dies six weeks after his acute myocardial infarct. At autopsy, a section of the infarct shows that the necrotic myocardium has largely been replaced by capillaries, fibroblasts, and collagen. Which of the following inflammatory cell types plays the most important role in the healing process by removing debris?（ ） A. Eosinophils B. Lymphocytes C. Macrophages D. Neutrophils E. Plasmacytes 46. While shaving one morning, a 23-year-old man nicks his lip with a razor. Seconds after the injury, the bleeding stops. Which of the following mechanisms is most likely to reduce blood loss from a small dermal vein?（ ） A. Fibrin polymerization B. Neutrophil chemotaxis C. Platelet aggregation D. Protein C activation E. Vasodilation 47. A 50-year-old man has a two-year history of angina pectoris that occurs when he exercises. His blood pressure and pulse are normal. Coronary angiography shows 75% narrowing of the left anterior descending artery. Which of the following cell types was the initial target in the development of this lesion?（ ） A. Endothelial cells B. Fibroblasts C. Lymphocytes D. Platelets E. Smooth muscle cells 48. A 56-year-old man with a 120 pack-year smoking history is referred to you for consideration of surgical resection after he is found to have a new 2 cm lung mass on a chest x-ray. After you have reviewed his records, you want to be able to tell him whether surgery will cure his disease. Factors that would influence whether a surgical resection would be curative include:（ ） A. Cell type of the neoplasm B. Location of the neoplasm C. Stage of the neoplasm D. Whether the neoplasm is benign or malignant