Repeated USMLE Questions Step 1 Review- 133- Pathology

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Q- A 55-year-old man presents with hematuria. Cystoscopy shows a papillary growth in the bladder. Histology reveals malignant transitional cells.

Which of the following is the most significant risk factor for this condition?

A- Chronic cystitis

B- Cigarette smoking

C- Cyclophosphamide therapy

D- Schistosoma haematobium infection

B- Cigarette smoking- Transitional cell carcinoma (urothelial carcinoma) is strongly linked to cigarette smoking, which increases exposure to carcinogens excreted in urine. Schistosoma infection predisposes to squamous cell carcinoma of the bladder, not transitional.

 

Q- A 65-year-old man presents with progressive dyspnea and a nonproductive cough. Chest X-ray reveals bilateral reticular opacities. Lung biopsy shows honeycomb fibrosis.

Which of the following is the most likely diagnosis?

A- Chronic bronchitis

B- Hypersensitivity pneumonitis

C- Idiopathic pulmonary fibrosis

D- Sarcoidosis

C- Idiopathic pulmonary fibrosis- Idiopathic pulmonary fibrosis is characterized by progressive scarring of lung tissue, leading to honeycomb fibrosis. Chronic bronchitis shows mucus hypersecretion, hypersensitivity pneumonitis is immune-mediated with granulomatous inflammation, and sarcoidosis has noncaseating granulomas.

 

Q- A 45-year-old woman presents with painless swelling in her neck. Fine needle aspiration cytology shows “Orphan Annie-eye nuclei” and psammoma bodies.

Which of the following is the most likely diagnosis?

A- Anaplastic carcinoma of thyroid

B- Follicular carcinoma of thyroid

C- Medullary carcinoma of thyroid

D- Papillary carcinoma of thyroid

D-Papillary carcinoma of thyroid- Papillary thyroid carcinoma is the most common thyroid cancer. Classic features include clear nuclei with central clearing, “Orphan Annie-eye nuclei”, and calcified concentric structures, “Psammoma bodies”.

 

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