USMLE Pathology 2 — Questions and Answers
Question 1: Virchow's triad describes risk factors for thrombosis. Which factor represents endothelial injury?
- Damaged vessel wall (Correct answer)
- Stasis of blood flow
- Hypercoagulability
- Turbulent blood flow
Correct answer: Damaged vessel wall
Virchow's triad consists of endothelial injury (damaged vessel wall), abnormal blood flow (stasis/turbulence), and hypercoagulability; endothelial damage exposes subendothelial collagen.
Question 2: Which cell type is most prominent in the early neutrophilic phase of acute inflammation?
- Neutrophils (Correct answer)
- Macrophages
- Lymphocytes
- Plasma cells
Correct answer: Neutrophils
Neutrophils are the first responders in acute inflammation, arriving within hours via chemotaxis and phagocytosing bacteria and debris.
Question 3: A biopsy of a cardiac valve shows fibrinous vegetations on both sides of the leaflets in a patient with rheumatic fever. What is the pathological term for these vegetations?
- Aschoff bodies (Correct answer)
- Verrucous vegetations
- Libman-Sacks endocarditis
- Bacterial vegetations
Correct answer: Aschoff bodies
Aschoff bodies are pathognomonic granulomatous lesions of rheumatic fever, containing multinucleated giant cells (Aschoff cells) and Anitschkow cells in the myocardium.
Question 4: Which proto-oncogene, when amplified, is associated with poor prognosis in neuroblastoma?
- N-MYC (Correct answer)
- HER2/neu
- BCR-ABL
- RET
Correct answer: N-MYC
N-MYC (MYCN) amplification in neuroblastoma is associated with rapid tumor progression and poor prognosis, classified as Stage 4S in infants.
Question 5: A patient develops a saddle-shaped nose deformity, perforation of the nasal septum, and granulomatous inflammation. cANCA is positive. What is the diagnosis?
- Granulomatosis with polyangiitis (Wegener's) (Correct answer)
- Polyarteritis nodosa
- Churg-Strauss syndrome
- Goodpasture syndrome
Correct answer: Granulomatosis with polyangiitis (Wegener's)
Granulomatosis with polyangiitis (formerly Wegener's) causes necrotizing granulomatous inflammation of the upper and lower respiratory tract and glomerulonephritis, with positive cANCA (PR3-ANCA).
Question 6: Which form of cell death is characterized by cell shrinkage, nuclear condensation (pyknosis), membrane blebbing, and formation of apoptotic bodies without inflammation?
- Apoptosis (Correct answer)
- Necrosis
- Necroptosis
- Autophagy
Correct answer: Apoptosis
Apoptosis is programmed cell death characterized by cell shrinkage, chromatin condensation, membrane blebbing, and apoptotic body formation without triggering inflammation.
USMLE Pathology 2
Virchow's triad describes risk factors for thrombosis.
Which factor represents endothelial injury?