PBL: Jane Burke MCQ

The dermis may be classified as which of the following types of connective tissue?

a. Adipose

b. Modified elastic

c. Reticular connective

d. Dense regular collagenous connective

e. Dense irregular collagenous connective

e. Dense irregular collagenous connective

Connective tissue proper is characterized as having

a. poor vascularization.

b. poor reparative ability.

c. sensitivity as its main function.

d. more intercellular material than cells.

e. mast cells as the predominant cell type.

d. more intercellular material than cells

The most biologically important physicochemical property of connective tissue which is regulated by its mucopolysaccharide molecules is

a. viscosity.

b. buffering capacity.

c. solubility in dilute acids.

d. supersaturation with calcium ions.

a. viscosity.

Which of the following is NOT a type of connective tissue fiber?

a. Chitin

b. Elastin

c. Collagen

d. Reticulin

c. Chitin

Prickle cells are found in:

a. skin dermis

b. sweat glands

c. peripheral nervous system

d. stratified squamous epithelium

d. stratified squamous epithelium

The dermis may be classified as what type of connective tissue?

a. Modified elastic tissue

b. Reticular connective tissue

c. Dense regular connective tissue

d. Dense irregular connective tissue

d. Dense irregular connective tissue

Which of the following statements concerning skin is correct?

a. The dermis contains a wider variety of nerve endings than epidermis

b. The epidermis is derived from mesenchyme

c. Areas without sebaceous glands have no stratum germinativum in the epidermis

d. In thick skin, as on the sole of the foot, the basement membrane is lacking

a. The dermis contains a wider variety of nerve endings than the epidermis

Mucus-secreting cells are found in the: (a) parotid gland; (b) submandibular gland; (c) mucosa of the trachea; (d) mucosa of the ureter; (e) glands of the esophagus.

1. (a) and (c)

2. (a) and (e)

3. (b), (c) and (d)

4. (b), (c) and (e)

5. (b) and (d) only

4. (b), (c) and (e)

The fate of the epithelial rests of Malassez is that they may: (a) undergo calcification; (b) form into cementicles; (c) become fibrous; (d) form cartilaginous nodules.

1. (a) and (b) only

2. (a), (b) and (c)

3. (b) and (c) only

4. (b), (c) and (d)

5. (c) and (d) only

1. (a) and (b) only

Which of the following cells is most capable of mitotic division in the adult?

1. Fibroblast

2. Odontoblast

3. Nerve cell

4. Epithelial cell

5. Smooth muscle cell

4. Epithelial cell

Which layer of the skin forms the epithelial root sheaths of the hair follicle?

1. Stratum corneum

2. Stratum lucidum

3. Stratum granulosum

4. Stratum germinativum

4. Stratum germinativum

Each of the following cell types secretes the substance with which it is paired EXCEPT

1. Sertoli's cells--testosterone.

2. corpus luteum--progesterone.

3. alpha cells of the pancreas--glucagon.

4. chromaffin cells of the adrenal--catecholamine.

1. Sertoli's cells--testosterone.

Mucosa of all parts of the small intestine is characterized by possessing

1. rugae.

2. villi.

3. haustra.

4. teniae coli.

5. appendices epiploicae.

2. villi.

Systemic arteries and veins differ in that

1. veins have more elastic tissue.

2. arteries have a relatively thinner tunica media.

3. valves are often present in veins.

4. arteries have larger endothelial pores.

5. elastic membranes are less pronounced in arteries.

3. valves are often present in veins.

When compared with the diameter of the lumen, the greatest proportion of thickness of smooth muscle is found in

1. large arteries.

2. capillaries.

3. arterioles.

4. veins.

3. arterioles.

Transitional epithelium is characteristic of the lining of the: (a) trachea; (b) ureter; (c) uterus; (d) first part of the prostatic ureter; (e) urinary bladder.

1. (a), (c) and (d)

2. (a), (c) and (e)

3. (b), (c) and (d)

4. (b), (d) and (e)

5. All of the above

4. (b), (d) and (e)

Modifications of the cell membrane for special functions include: (a) microvilli: (b) basement membrane; (c) desmosomes; (d) mucous membrane; (e) brush border.

1. (a) only

2. (a), (b) and (e)

3. (a), (c) and (e)

4. (b) and (d)

5. (c) and (d)

3. (a), (c) and (e)

Which of the following statements indicates a true similarity between skin of the forearm and skin of the palm?

1. Both types contain sebaceous glands.

2. The stratum lucidum is present in each.

3. The stratum germinativum is present in each.

4. The thickness of the epidermis is about the same.

3. The stratum germinativum is present in each.

When stratifed squamous epithelium thickens, which set of conditions usually prevails?

1. The rete pegs increase in size and the intercellular bridges become more evident.

2. The basement membrane becomes more irregular and the dermis acquires an increased Iymphatic supply.

3. The stratum spinosum becomes less evident and the basement membrane thickens.

4. The number of vascular capillaries in the dermis increases and more sweat glands develop.

1. The rete pegs increase in size and the intercellular bridges become more evident.

The histologic feature that most readily distinguishes the aorta is the presence of

1. a clearly visible external elastic membrane.

2. distinct vasa vasorum in the tunica media

3. a relatively wide and distinct tunica adventitia.

4. a tunica media composed primarily of elastic membranes.

4. a tunica media composed primarily of elastic membranes.

The difference between capillaries and sinusoids is that capillaries

1. contain blood whereas sinusoids contain plasma.

2. have a constant lumen and a complete endothelial lining whereas sinusoids are irregular, tortuous tubes.

3. have a muscular wall that can contract and shut off the circulation whereas sinusoids do not.

4. are restricted to muscular tissue only whereas sinusoids are widely distributed in every organ.

2. have a constant lumen and a complete endothelial lining whereas sinusoids are irregular, tortuous tubes.

Prickle cells are found in

1. skin dermis.

2. sweat glands.

3. peripheral nerve tissue.

4. stratified squamous epithelium.

4. stratified squamous epithelium.

Sensory loss in the skin overlying the parotid gland could be caused by damage to the

1. great auricular nerve.

2. greater occipital nerve.

3. zygomaticotemporal nerve.

4. transverse cervical nerve.

1. great auricular nerve.

The primary source of cranial connective tissue cells is the

1. ectoderm.

2. endoderm.

3. ectomesenchyme.

4. primary follicle.

5. None of the above

3. ectomesenchyme.

Which of the following layers is totally lacking in thin skin?

1. Stratum basale

2. Stratum lucidum

3. Stratum spinosum

4. Stratum corneum

5. Stratum granulosum

2. Stratum lucidum

Which of the following describes the manner in which tissue fluid reaches the epithelium of the skin?

1. Arterioles are directly involved in tissue fluid exchange with the epithelium.

2. Capillaries are directly involved in tissue fluid exchange with the epithelium.

3. Tissue fluid is obtained through the ground substance of connective tissue from arterioles.

4. Tissue fluid is obtained through the ground substance of connective tissue from capillaries.

4. Tissue fluid is obtained through the ground substance of connective tissue from capillaries.

The papillary layer of the dermis differs from the reticular layer in that the papillary layer

1. contains larger blood vessels than the reticular layer.

2. has a few elastic fibers, whereas the reticular layer has no elastic fibers.

3. is composed of coarse collagenous fibers, whereas the reticular layer is composed of predominately fine collagenous fibers.

4. is more finely constructed, whereas the reticular layer contains coarser collagenous fibers as a component.

4. is more finely constructed, whereas the reticular layer contains coarser collagenous fibers as a component.

Which of the following epithelial surface variations serve primarily to increase the functional surface area?

1. Cilia

2. Flagella

3. Microvilli

4. All of the above

3. Microvilli

Second third and fourth right posterior intercostal veins drain from the right superior intercostal vein into the

1. azygos vein.

2. hemiazygos vein.

3. accessory hemiazygos vein.

4. left brachiocephalic vein.

5. left internal jugular vein.

1. azygos vein.

The most prominent functional component in the tunica media of small arteries is

1. elastic fibers.

2. smooth muscle.

3. striated muscle.

4. reticular fibers.

5. collagenous fibers.

2. smooth muscle.

The change of a more specialized cell type to a less specialized cell type is

A. dysplasia.

B. neoplasia.

C. metaplasia.

D. hyperplasia.

E. hypoplasia

C. metaplasia.

Epithelial pearls and intercellular bridges observed in an infiltrating malignancy are diagnostic of

A. adenocarcinoma.

B. anaplastic carcinoma.

C. Squamous cell carcinoma.

D. undifferentiated carcinoma.

E. transitional cell carcinoma.

C. Squamous cell carcinoma.

Cytologic and morphologic characteristics of epithelial dysplasia include: (a) normal architectural arrangement; (b) hyperchromatic nuclei; (c) mitoses near the surface layer; (d) pleomorphism of cells; (e) invasion of underlying connective tissue.

A. (a), (b) and (c)

B. (a), (d) and (e)

C. (b), (c) and (d)

D. (b) and (d) only

E. (b) and (e)

C. (b), (c) and (d)

Granulation tissue typically contains: (a) fibroblasts; (b) nerve fibers; (c) endothelial cells; (d) epitheliod cells

A. (e) giant cells

B. (a) and (b)

C. (a) and (c)

D. (b) and (d)

E. (c) and (d)

F. (c) and (e)

B. (a) and (b)

Granulation tissue is comprised of each of the following components EXCEPT one. Which one is this EXCEPTION?

A. Fibroblasts

B. Plasma cells

C. Capillary buds

D. Endothelial cells

E. Newly formed collagen

B. Plasma cells

Each of the following conditions involves changes in numbers of cells in an organ or tissue EXCEPT one. Which one is this EXCEPTION?

A. Aplasia

B. Hyperplasia

C. Hypoplasia

D. Metaplasia

D. Metaplasia

One piece of examined soft tissue contains obvious glandular tissue. Histological examination reveals that it is composed of purely serous acini. This is MOST likely which' of the following glands?

A. Buccal

B. Parotid

C. Sublingual

D. Submandibular

E. Posterior palatal

B. Parotid

Which of the following is surrounded partly by connective tissue and epithelium, contains lymphoid follicles, has no sinuses, and is penetrated by a number of crypts?

A. Spleen

B. Thymus

C. Lymph node

D. Palatine tonsil

E. Bursa of Fabricius

D. Palatine tonsil

Desmosomes function by serving as

A. a means for communication between cells.

B. a means for attachment of adjacent cells.

C. an outlet for secretory products of a cell.

D. a bridge for continuity of cytoplasm between adjacent cells.

E. a means by which tonofibrils can pass from one cell into another.

B. a means for attachment of adjacent cells.

The dentist incises the mucous membrane of the floor of the mouth. This incision extends from the molar region to the sublingual caruncle (papilla). Which of the following structural groups will be exposed first?

A. Sublingual gland, lingual nerves, and submandibular duct

B. Hyoglossus and mylohyoid muscles, and hypoglossal nerve

C. Lingual nerve, lingual artery, and anterior belly of the digastric muscle

D. Lingual nerve, hypoglossal nerve, and submental branch of the facial artery

E. Anterior belly of the digastric muscle, mylohyoid nerve, and submental branch of the facial artery

A. Sublingual gland, lingual nerves, and submandibular duct

Histologically, the osteoclasts of bone resorption are typically

anuclear.

mononuclear.

multinuclear.

polymorphonuclear.

multinuclear.

Which of the following types of epithelium is well adapted for secretory or absorptive functions?

Simple columnar

Simple squamous

Stratified cuboidal

Stratified squamous

Psuedostratified columnar

Simple columnar

It is possible to distinguish histologically between the stomach and the duodenum because of the presence of

A. mucosal glands in the stomach only.

B. submucosal glands in the duodenum only.

C. simple columnar epithelium lining the stomach only.

D. muscularis mucosa in the stomach only.

E. smooth muscle in the external musculature of the duodenum only.

B. submucosal glands in the duodenum only.

Tendons are comprised of which of the following types of collagenous connective tissue?

Areolar

Reticular

Dense regular

Dense irregular

Dense regular

Which of the following strata of the epidermis is the LEAST cytodifferentiated?

Basale

Corneum

Spinosum

Granulosum

Basale

The submucosa is present in each of the following EXCEPT one. Which one is this EXCEPTION?

Colon

Stomach

Jejunum

Gallbladder

Duodenum

Gallbladder

White matter of the spinal cord consists chiefly of which of the following?

Perineurium

Myelinated axons

Unmyelinated axons

Nerve cell bodies

Loose connective tissue

Myelinated axons

Which of the following represent fan-shaped, hypocalcified areas that originate at the dentinoenamel junction and extend into enamel for part of its thickness?

Tufts

Spindles

Lamellae

Hunter-Schreger bands

Contour lines of Owen

Large wound defects heal by

Tufts

A lesion that is characterized microscopically in the tissues by central necrosis surrounded by macrophages, lymphocytes, plasma cells and occasional giant cells is generally classified as.

a cyst.

a phlegmon.

a granuloma.

an acute abscess.

an autoimmune disease.

a granuloma.

Cell proliferation requires a cell to divide. Select the ONE correct statement about the cell undergoing cell division:

1. DNA is replicated during mitosis

2. RNA is transcribed during GI phase

3. Chromosome segregation occurs at M phase

4. G2 phase is the period between M phase and S phase

5. Longest period in the cell cycle is M phase

Chromosome segregation occurs at M phase

Select the ONE correct property of benign neoplasms:

1. unencapsulated

2. cells grow well in vitro

3. degenerative changes evident in tumor

4. functional properties of cell are lost

5. capsulated

capsulated

Metastasis is a biologic property of malignant cells. Select the one cellular event NOT associated with a metastatic cell:

1. invades into blood vessels

2. invades into lymphatic vessels

3. collagenase negative

4. laminin receptor positive

5. fibronectin receptor positive

collagenase negative

Select the one true statement concerning host response to cancer cells:

1. CD 4 cells are cytotoxic

2. A relatively low ratio (1:1) of CD 8 cells effectively kills neoplastic cells

3. TNF beta is a soluble lymphotoxin secreted by activated macrophages

4. NK cells are unique because they possess immunologic memory

5. Humoral antibody plays little or no role in cancer immunosurveillance

TNF beta is a soluble lymphotoxin secreted by activated macrophages

Malignancies of which of the following organs are most commonly found in males?

1. lung

2. colon

3. brain

4. parotid

5. thyroid

lung

Which of the following tumors originates from the smooth muscle of the esophagus?

1. lipoma

2. adenoma

3. squamous papilloma

4. leiomyoma

5. rhabdomyoma

leiomyoma

A tumor which has invaded the local surrounding tissue but which has not spread to distant sites is best described as:

1. a benign neoplasm

2. a metastasis

3. malignant but not metastatic

4. metastatic but not malignant

5. a malignant carcinoma

malignant but not metastatic

The most likely diagnosis for a patient with dysphonia, dysphagia, weight loss and a history of heavy cigarette smoking is:

1. laryngitis

2. tonsillitis

3. laryngeal polyps

4. carcinoma of the lungs

5. carcinoma of the larynx

carcinoma of the larynx

Metastasizing cells that originate in the tip of the tongue follow the paths of the lymphatic vessels of the tongue and arrive first into the

1. submental nodes.

2. submandibular nodes.

3. supraclavicular nodes.

4. superficial parotid nodes.

5. superior deep cervical nodes.

submental nodes.

A benign glandular neoplasm is termed

cyst.

nevus.

adenoma.

papilloma

adenoma.

A neoplasm composed of either blood vessels or lymph vessels is designated as

angioma.

hematoma.

papilloma.

blue nevus.

lymphosarcoma.

angioma

Of the following, squamous metaplasia is most commonly encountered in the

thyroid.

stomach.

oral mucosa.

fallopian tube.

bronchial mucosa

bronchial mucosa.

A malignant tumor which closely resembles its tissue of origin in cellular structure and architecture is described as

anaplastic.

metaplastic.

well-differentiated.

poorly-differentiated

well-differentiated

The role of immunity in human malignancy is manifest by

histologic appearance of certain tumors in which lymphocyte, monocyte and plasma cell infiltrates are prominent.

spontaneous regression or long-term indolence of certain malignancies.

heightened incidence of malignancy in the very young, the very old or immunodeficient persons.

successful induction of remission or prolongation of remission with immunotherapy.

all of the above.

all of the above.

Implantation metastasis would be likely in carcinoma of the: (a) tongue; (b) stomach; (c) ovary; (d) skin; (e) large bowel.

(a), (b) and (c)

(a), (d) and (e)

(b), (c) and (d)

(b), (c) and (e)

(b), (d) and (e)

(b), (c) and (e)

important microscopic features of malignancy include: (a) anaplasia; (b) invasion; (c) encapsulation; (d) mitosis; (e) uniformity of cells.

(a), (b) and (d)

(a), (c) and (e)

(b), (c) and (d)

(b), (d) and (e)

(c), (d) and (e)

(a), (b) and (d)

Which of the following neoplasms is primary in the adrenal medulla?

Pheochromocytoma

Arrhenoblastoma

Eosinophilicadenoma

Hurthle cell tumor

None of the above

Pheochromocytoma

Which of the following malignancies has the best prognosis?

Osteosarcoma

Multiple myeloma

Basal cell carcinoma

Carcinoma of the breast

Carcinoma of the esophagus

Basal cell carcinoma

Squamous cell carcinoma usually metastasizes by way of

A. the venous system.

B. the arterial system.

C. the lymphatic system.

D. aspiration into the lung.

C. the lymphatic system.

A benign neoplasm of the myometrium of the uterus is a

A. myeloma.

B. fibroma.

C. leiomyoma.

D. myoblastoma.

E. rhabdomyoma.

leiomyoma

Epithelial pearls and intercellular bridges observed in an infiltrating malignancy are diagnostic of

A. adenocarcinoma.

B. anaplastic carcinoma.

C. Squamous cell carcinoma (SCC)

D. undifferentiated carcinoma.

E. transitional cell carcinoma.

C. Squamous cell carcinoma (SCC)

Elevation of serum acid phosphatase levels is likely to be seen in patients with carcinoma of the

A. colon.

B. breast.

C. cervix.

D. uterus.

E. stomach.

F. prostate gland.

prostate gland.

The pulmonary neoplasm to which the endocrine effect of hyperparathyroidism is attributed is

A. adenocarcinoma

B. oat cell carcinoma.

C. pheochromocytoma.

D. medullary carcinoma.

E. squamous cell carcinoma

oat cell carcinoma.

Of the following, the most common site of a basal cell carcinoma is the

A. tongue.

B. gingiva.

C. lower lip.

D. upper face.

E. oral mucosa

upper face.

The most common malignancy found in bones of the human skeleton is

A. osteosarcoma.

B. chondrosarcoma.

C. multiple myeloma.

D. giant cell tumor.

E. metastatic carcinoma.

metastatic carcinoma.

Malignant bone tumors likely to be encountered in children or young adults include: (a) myeloma.; (b) metastatic carcinoma; (c) Ewing's sarcoma.; (d) osteogenic sarcoma; (e) liposarcoma.

A. (a), (b) and (c)

B. (a) and (c)only

C. (b), (c) and (d)

D. (b) and (d) only

E. (c) and d) only

F. (c), (d) and (e)

E. (c) and d) only

Which of the following has been shown to have a relationship to carcinoma of the cervix?

A. Papovavirus

B. Varicella-zoster virus

C. Herpesvirus hominis type I

D. Herpesvirus hominis type II

E. None of the above

D. Herpesvirus hominis type II

Which of the following lesions is most common in infants?

A. Chondrosarcoma

B. Neuroblastoma

C. Malignant melanoma

D. Basal cell carcinoma

E. Squamous cell carcinoma

Neuroblastoma

When malignant cells resemble more primitive, undifferentiated cells than those from which they arose, they are said to be

anaplastic.

metastatic.

hypoplastic.

metaplastic.

anaplastic

The most common type of epithelial metaplasia involves

regeneration of epithelium in an area of cutaneous ulceration.

replacement of squamous cells by cuboidal cells.

replacement of cuboidal cells by columnar cells.

replacement of columnar cells by stratified squamous epithelium.

replacement of columnar cells by stratified squamous epithelium.

A benign tumor arising from voluntary muscle is a

leiomyoma.

papilloma.

rhabdomyoma.

leiomyosarcoma.

rhabdomyosarcoma.

rhabdomyoma.

The most characteristic feature of a neoplasm as opposed to an inflammatory overgrowth is

abnormal mitosis.

size of the lesion.

tendency to grow rapidly.

tendency to recur after removal.

progressive growth after removal of causative stimuli.

progressive growth after removal of causative stimuli.

With respect to its histologic appearance, biologic behavior and preinvasive states oral squamous cell carcinoma most closely resembles

breast cancer.

cervical cancer.

Hodgkin's disease.

carcinoma of the lung.

carcinoma of the colon.

cervical cancer.

Of the following, the most common site of a basal cell carcinoma is the

tongue.

gingiva.

lower lip.

upper face.

oral mucosa.

upper face.

Increased serum acid phosphatase is clinically significant and aids in the diagnosis of

Paget's disease of bone.

primary hyperparathyroidism.

secondary hyperparathyroidism.

breast carcinoma with bone metastasis.

prostate carcinoma with bone metastasis.

prostate carcinoma with bone metastasis.

A woman has metastatic carcinoma of the jaws. The primary lesion would most likely be found in the

lung.

colon.

breast.

cervix.

breast.

The most common primary malignant neoplasm of the lung is

adenocarcinoma.

bronchial adenoma.

alveolar cell carcinoma.

squamous cell carcinoma.

undifferentiated carcinoma.

squamous cell carcinoma.

A candidate virus for the induction of cervical carcinoma is

adenovirus.

C-type virus

varicella zoster.

Epstein-Barr virus.

herpes virus hominis Type 2.

herpes virus hominis Type 2.

Each of the following is a histologic feature of malignant growth EXCEPT

aplasia.

anaplasia.

pleomorphism.

hyperchromatism.

abnormal mitosis.

aplasia.

Which of the following is NOT characteristic of carcinoma in situ?

Pleomorphism

Disorderly maturation

Hyperchromatic nuclei

Disruption of the basement membrane

Disruption of the basement membrane

A tumor composed of multiple tissues in which there may be representatives of all three embryonal layers is

a teratoma.

an adenoma.

a carcinoma.

a sarcoma.

a hamartoma.

a teratoma.

A benign neoplasm of the myometrium of the uterus is a

myeloma.

fibroma.

leiomyoma.

myoblastoma.

rhabdomyoma.

leiomyoma.

Growth of which of the following neoplasms is often influenced by hormones? (a) Glioma; (b) Breast carcinoma; (c) Prostatic carcinoma; (d) Renal cell carcinoma

(a) and (b)

(a) and (c)

(a) and (d)

(b) and (c)

(b) and (d)

(c) and (d)

(b) and (c)

Which of the following is a significant effect of pheochromocytoma?

Myxedema

Acromegaly

Glycosuria

Hypertension

Hypertension

Which of the following is the most common skin cancer in man?

Malignant melanoma

Basal cell carcinoma

Squamous cell carcinoma

Sebaceous adenocarcinorna

Transitional cell carcinoma

Basal cell carcinoma

Which of the following factors determines whether a patient develops acromegaly or gigantism?

Sex

Age at onset of the tumor

Amount of available calcium

Degree of function of the tumor

Age at onset of the tumor

Carcinoma of which of the following tissues has been associated with ingestion of food contaminated with Aspergillus?

Lip

Lung

Liver

Colon

Liver

Which of the following is NOT a histologic criterion of malignant growth?

Aplasia

Anaplasia

Pleomorphism

Hyperchromatism

Abnormal mitosis

Aplasia

The epithelial change most predictive of cancer is

acanthosis.

dysplasia.

metaplasia.

parakeratosis.

hyperkeratosis.

dysplasia.

Irreversible pathologic changes include: (a) fatty degeneration; (b) hydropic degeneration; (c) autolysis; (d) coagulative necrosis.

(a) and (c) only

(a), (c) and (d)

(b) and (c)

(b) and (d)

(c) and (d) only

(b) and (d)

Which of the following viruses is suspect in cervical cancer?

HVH-1

HVH-2

EBV

C-type particles

HVH-2