Repeated USMLE Questions Step 1 Review-164- Pathology

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Q- A 45-year-old woman presents with episodic headaches, sweating, and palpitations. Imaging reveals an adrenal medullary tumor.
Which histologic pattern is most characteristic of this tumor?

A- Keratin pearls

B- Psammoma bodies

C- Sheets of small blue cells

D- Zellballen pattern

D- Zellballen pattern- Pheochromocytomas show nests (zellballen) of chromaffin cells surrounded by sustentacular cells.

 

Q- A 63-year-old man with long-standing diabetes presents with progressive renal failure. Renal biopsy shows nodular glomerulosclerosis with Kimmelstiel–Wilson nodules.
What is the most likely diagnosis?

A- Amyloidosis

B- Diabetic nephropathy

C- Focal segmental glomerulosclerosis

D- Membranoproliferative glomerulonephritis

B- Diabetic nephropathy- Diabetic nephropathy is characterized by mesangial expansion and Kimmelstiel–Wilson nodules due to chronic hyperglycemia.

 

Q- A 70-year-old man presents with hemoptysis and weight loss. Lung biopsy reveals malignant cells that stain positive for neuroendocrine markers and show nuclear molding.
What is the most likely diagnosis?

A- Adenocarcinoma

B- Large cell carcinoma

C- Small cell carcinoma

D- Squamous cell carcinoma

C- Small cell carcinoma- Small cell carcinoma is a neuroendocrine tumor associated with smoking, nuclear molding, and paraneoplastic syndromes.

 

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Dr Ray Makar
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