Repeated USMLE Questions Step 1 Review-158- Pathology

Q- A 59-year-old man presents with progressive dysphagia. Endoscopy reveals an ulcerated mass in the distal esophagus. Biopsy shows malignant gland-forming cells.
Which risk factor is most strongly associated with this condition?

A- Alcohol consumption

B- Chronic gastroesophageal reflux disease

C- Human papillomavirus infection

D- Iron deficiency anemia

B- Chronic gastroesophageal reflux disease- Esophageal adenocarcinoma arises from Barrett’s esophagus, which develops due to long-standing GERD.

 

Q- A 66-year-old woman presents with bone pain and hearing loss. Laboratory studies show elevated alkaline phosphatase with normal calcium and phosphate levels.
What is the most likely underlying pathology?

A- Osteomalacia

B- Osteoporosis

C- Paget’s disease of bone

D- Primary hyperparathyroidism

C- Paget’s disease of bone- Paget disease involves increased and disorganized bone remodeling, causing bone pain, deformities, and elevated ALP with normal calcium levels.

 

Q- A 35-year-old man presents with hematuria and rapidly worsening renal function. Renal biopsy shows crescent formation in glomeruli.
Which mechanism best explains this pathology?

A- Basement membrane thickening

B- Immune complex deposition

C- Podocyte injury

D- Proliferation of parietal epithelial cells

D- Proliferation of parietal epithelial cells- Crescentic (rapidly progressive) glomerulonephritis is characterized by crescents formed from proliferating parietal epithelial cells and macrophages.

 

Q- A 42-year-old woman presents with fatigue and glossitis. Peripheral smear shows macrocytosis and hypersegmented neutrophils.
Which additional finding is most likely present?

A- Decreased reticulocyte count due to hemolysis

B- Elevated bilirubin due to RBC destruction

C- Increased homocysteine levels

D- Low ferritin levels

C- Increased homocysteine levels- Megaloblastic anemia (B12 or folate deficiency) causes impaired DNA synthesis, leading to macrocytosis and elevated homocysteine.

 

Q- A 70-year-old man presents with memory loss and personality changes. Autopsy of the brain reveals extracellular beta-amyloid plaques and intracellular neurofibrillary tangles.
What protein makes up the neurofibrillary tangles?

A- Alpha-synuclein

B- Beta-amyloid

C- Prion protein

D- Tau protein

D- Tau protein- Neurofibrillary tangles in Alzheimer’s disease consist of hyperphosphorylated tau protein, while plaques are composed of beta-amyloid

 

Read this Pathology MCQs Book

More Repeated USMLE Questions Step 1

Leave a Comment