Pathology PreTestTMSelf-Assessment and Review Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. 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DOI: 10.1036/0071471820 For more information about this title, click here Contents Preface. ix Introduction . x High-Yield Facts High-Yield Facts in Pathology . 1 General Pathology Questions . 41 Answers . 95 Cardiovascular System Questions . 191 Answers . 209 Hematology Questions . 233 Answers . 258 Respiratory System Questions . 293 Answers . 306 Head and Neck Questions . 321 Answers . 326 Gastrointestinal System Questions . 333 Answers . 359 v vi Contents Urinary System Questions . 397 Answers . 409 Reproductive Systems Questions . 427 Answers . 446 Endocrine System Questions . 471 Answers . 484 Skin Questions . 503 Answers . 512 Musculoskeletal System Questions . 523 Answers . 534 Nervous System Questions . 547 Answers . 558 Bibliography . 577 Index . 579 Student Reviewers Amy S.Arrington, PhD Baylor College of Medicine Class of 2007 Silke Heinisch Temple University School of Medicine Class of 2010 Farrant Sakaguchi University of Utah Class of 2008 Dedication To Steve and Luke, who showed me that the race is not always won by the young and swift, but sometimes by those who persevere and keep on running, and to Karen, who reminded me that running fast is so much better than running slowly. vii Copyright © 2007 by The McGraw-Hill Companies, Inc. Click here for terms of use. viii Pathology Laboratory Values Substance Source Normal Albumin Serum 3.2–4.5 g/dL Alkaline phosphatase Serum 20–130 IU/L Bicarbonate Plasma 21–28 mM Bilirubin, direct (conjugated) Serum <0.3 mg/dL Bilirubin, indirect (unconjugated) Serum 0.1–1.0 mg/dL Bilirubin, total Serum 0.1–1.2 mg/dL BUN Serum 8–23 mg/dL Calcium Serum 9.2–11.0 mg/dL (4.6–5.5 meq/L) Chloride Serum 95–103 meq/L Cholesterol Serum 150–250 mg/dL Creatinine Serum 0.6–1.2 mg/dL GGT (γ-glutamyltransferase) Serum 5–40 IU/L Glucose (fasting) Serum 70–110 mg/dL Insulin Plasma 4–24 µIU/mL Iron Serum 60–150 µg/dL Iron saturation Serum 20–55% Osmolality Serum 280–295 mosm/L Phosphorus Serum 2.3–4.7 mg/dL Potassium Plasma 3.8–5.0 meq/L Protein Serum 6.0–7.8 g/dL Sodium Plasma 136–142 meq/L T3 resin uptake Serum 25–38 relative % uptake Thyrotropin (TSH) Serum 0.5–5 µIU/mL Thyroxine, free (FT4) Serum 0.9–2.3 ng/dL Thyroxine, total (T4) Serum 5.5–12.5 µg/dL Triiodothyronine (T3) Serum 80–200 mg/dL Hematology Platelet count 150,000–450,000/µL White cell count 4,440–11,000/µL Lymphocyte count 1,000–4,800/µL (about 34%) Mean corpuscular volume (MCV) 80–96 µm3 Mean corpuscular hemoglobin 27.5–33.2 pg (MCH) Mean corpuscular hemoglobin 33.4–35.5% concentration (MCHC) Hemoglobin Whole blood Female 12–16 g/dL Male 13.5–18 g/dL Preface The study of pathology, a science so basic to clinical medicine, has been abbreviated sadly in many medical schools in recent years, and that too at a time when explosive growth is occurring in the science. Recent advances in immunopathology, diagnosis of bacterial and viral diseases including AIDS, and detection of infectious agents such as papillomavirus in cervical dysplasia are proceeding at a tremendous rate. The eleventh edition of Pathology: PreTestTM Self-Assessment and Review includes such new subject areas as predictive values in the interpretation of laboratory data, the importance of cytokines, the molecular basis of genetic and other disease processes, and molecular biology techniques as these apply to lymphopro- liferative disorders and other tumors. The medical student must feel submerged at times in the flood of information—occasionally instructors may have similar feelings. This edi- tion is not intended to cover all new knowledge in addition to including older anatomic and clinical pathology. It is, rather, a serious attempt to present important facts about many disease processes in the hope that the student will read much further in major textbooks and journals and will receive some assistance in passing medical school, licensure, or board examinations. ix Copyright © 2007 by The McGraw-Hill Companies, Inc. Click here for terms of use. Introduction Each PreTestTM Self-Assessment and Review allows medical students to compre- hensively and conveniently assess and review their knowledge of a particular basic science, in this instance pathology. The 500 questions parallel the for- mat and degree of difficulty of the questions found in the United States Med- ical Licensing Examination (USMLE) Step 1. Practicing physicians who want to hone their skills before USMLE Step 3 or recertification may find this to be a good beginning in their review process. Each question is accompanied by an answer, a paragraph explanation, and a specific page reference to an appropriate textbook or journal article. A bibliography listing sources can be found following the last chapter of this text. Each multiple-choice question in this book contains four or more possible answer options.