铜翱憨混溺毋硕册畅鸿集纬希
匠殊篱据担擅扁撼寿晨仁行剩
（⊙.⊙）
绪论 单元测试
1、单选题：
Techniques used for collecting biopsy sample include: （ ）
A:Local excision
B:Endoscopic forceps
C:Deep organ puncture
D:Scratching
E:All the other options are included
答案: All the other options are included
第一章 单元测试
1、单选题：
A 17-year-old boy infected with hepatitis A experiences mild nausea for about 1 week and develops very mild scleral icterus. On physical examination, he has minimal right upper quadrant tenderness. Laboratory findings include a serum AST of 68U/L, ALT 75U/L, and total bilirubin 5.l mg/dL. The increase in this patient’s serum enzyme levels most likely results from which of the following changes in the hepatocytes?
A:Dispersion of ribosomes
B:Autophagy by lysosomes
C:Swelling of the mitochondria
D:Clumping of nuclear chromatin
E:Defects in the cell membrane
答案: Defects in the cell membrane
2、单选题：
An experiment analyzes cells for enzyme activity associated with sustained cellular proliferation. Which of the following cells is most likely to have the highest telomerase activity?
A:Endothelial cells
B:Germ cells
C:Neurons
D:Neutrophils
E:Erythrocytes
答案: Neurons
3、单选题：
In a clinical trial, a chemotherapeutic agent is given to patients with breast cancer metastases. Samples of the cancer cells are obtained and assessed for the presence of death of tumor cells by apoptosis. Mutational inactivation of which of the following products is most likely to render tumor cells resistant to the effects of such an agent?
A:BCL-2
B:p53
C:NF- kappaB
D:Cytochrome P-450
E:Granzyme B
答案: NF- kappaB
4、单选题：
A 22-year-old woman has a congenital anemia that has required multiple transfusions of RBCs for many years. On physical examination, she now has no significant findings; however, liver function tests show reduced serum albumin. Which of the following findings would most likely appear in a liver biopsy specimen?
A:Steatosis in hepatocytes
B:Bilirubin in canaliculi
C:Glycogen in hepatocytes
D:Amyloid in portal triads
E:Hemosiderin in hepatocytes
答案: Hemosiderin in hepatocytes
5、单选题：
A 69-year-old man has had difficulty with urination, including hesitancy and frequency, for the past 5 years. A digital rectal examination reveals that the prostate gland is palpably enlarged to about twice normal size. A transurethral resection of the prostate is performed, and the microscopic appearance of the prostate “chips” obtained is that of nodules of glands with intervening stroma. Which of the following pathologic processes has most likely occurred in the prostate?
A:Apoptosis
B:Dysplasia
C:Fatty change
D:Hyperplasia
E:Hypertrophy
F:Metaplasia
答案: Hyperplasia
6、单选题：
A 33-year-old woman has had increasing lethargy and decreased urine output for the past week. Laboratory studies show serum creatinine level of 4.3mg/dL and urea nitrogen level of 40mg/dL. A renal biopsy is performed, and the specimen is examined using electron microscopy. Which of the following morphologic changes most likely suggests a diagnosis of acute tubular necrosis?
A:Mitochondrial swelling
B:Plasma membrane blebs
C:Chromatin clumping
D:Nuclear fragmentation
E:Ribosomal disaggregation
答案: Nuclear fragmentation
7、单选题：
A 63-year-old man has a 2-year history of worsening congestive heart failure. An echocardiogram shows mitral stenosis with left atrial dilation. A thrombus is present in the left atrium. One month later, he experiences left flank pain and notes hematuria. Laboratory testing shows elevated serum AST. Which of the following patterns of tissue injury is most likely to be present?
A:Liquefactive necrosis
B:Caseous necrosis
C:Coagulative necrosis
D:Fat necrosis
E:Gangrenous necrosis
答案: Coagulative necrosis
8、多选题：
On a routine visit to the physician, an otherwise healthy 51-year-old man has a blood pressure of 150/95 mm Hg. If the patient’s hypertension remains untreated for years, Which of the following cellular changes is unlikely to occur in myocardium?
A:Atrophy
B:Hyperplasia
C:Metaplasia
D:Hemosiderosis
E:Hypertrophy
答案: Atrophy;Hyperplasia;Metaplasia;Hemosiderosis
9、多选题：
In an experiment, cells are subjected to radiant energy in the form of x-rays. This results in cell injury caused by hydrolysis of water. Which of the following cellular enzymes does not protect cells from this damage?
A:Phospholipase
B:Glutathione peroxidase
C:Endonuclease
D:Lactate dehydrogenase
E:Protease
答案: Phospholipase;Endonuclease;Lactate dehydrogenase;Protease
10、单选题：
A 68-year-old woman suddenly lost consciousness and, on awakening 1 hour later, she could not speak or move her right arm and leg. Two months later, a head CT scan showed a large cystic area in the left parietal lobe. Which of the following pathologic processes has most likely occurred in the brain?
A:Fat necrosis
B:Coagulative necrosis
C:Apoptosis
D:Liquefactive necrosis
E:Karyolysis
答案: Liquefactive necrosis
第二章 单元测试
1、单选题：
A 60-year-old woman developed chest pain that persisted for 4 hours. A radiographic imaging procedure showed an apparent myocardial infarction involving a 3×4 cm area of the posterior left ventricular free wall. Laboratory findings showed serum creatine kinase of 600 U/L. The patient received both anti-arrhythmic and pressor agents to treat the decreased cardiac output while in the hospital. Which of the following pathologic findings would most likely be seen in the left ventricle l month later?
A:Abscess
B:Complete resolution
C:Coagulative necrosis
D:Nodular regeneration
E:Fibrous scar
答案: Fibrous scar
2、单选题：
An experiment infects one group of test animals with viral hepatitis. Two months later, complete recovery of the normal liver architecture is observed when the livers from these animals are examined microscopically. A second test group is infected with bacterial organisms, and after the same period of time, fibrous scars from resolving abscesses are seen microscopically in the livers. Which of the following factors best explains the different outcomes for the two test groups?
A:Nature of the etiologic agent
B: Extent of liver cell injury
C:Injury to the connective tissue framework
D:Location of the lesion
E:Extent of damage to the bile ducts
答案: Injury to the connective tissue framework
3、单选题：
A 23-year-old woman receiving corticosteroid therapy for an autoimmune disease has an abscess on her upper outer right arm. She undergoes minor surgery to incise and drain the abscess, but the wound heals poorly over the next month. Which of the following aspects of wound healing is most likely to be deficient in this patient?
A:Re-epithelization
B:Fibroblast growth factor elaboration
C:Collagen deposition
D:Serine proteinase production
E:Neutrophil infiltration
答案: Collagen deposition
4、单选题：
A cesarean section is performed on a 20-year-old woman to deliver a term infant, and the lower abdominal incision is sutured. The sutures are removed l week later. Which of the following statements best describes the wound site at the time of suture removal?
A:Granulation tissue is still present
B:Collagen degradation exceeds synthesis
C:Wound strength is 80% of normal tissue
D:Type IV collagen predominates
E:No more wound strength will be gained
答案: Granulation tissue is still present
5、单选题：
A 40-year-old man underwent laparotomy for a perforated sigmoid colon diverticulum. A wound infection complicated the postoperative course, and surgical wound dehiscence occurred. Primary closure was no longer possible, and the wound “granulated in.” Six weeks later, the wound is only l0% of its original size. Which of the following processes best accounts for the observed decrease in wound size over the past 6 weeks?
A:Increase in synthesis of collagen
B:Myofibroblast contraction
C:Inhibition of metalloproteinases
D: Resolution of subcutaneous edema
E:Elaboration of adhesive glycoproteins
答案: Myofibroblast contraction
6、单选题：
In an experiment involving observations on wound healing, researchers noted that intracytoplasmic cytoskeletal elements, including actin, interact with the extracellular matrix to promote cell attachment and migration in wound healing. Which of the following substances is most likely responsible for such interaction between the cytoskeleton and the extracellular matrix?
A:Epidermal growth factor
B:Fibronectin
C:Integrin
D:Platelet-derived growth factor
E:Type IV collagen
F:Vascular endothelial growth factor
答案: Integrin
7、单选题：
In an experiment, release of epidermal growth factor into an area of denuded skin causes mitogenic stimulation of the skin epithelial cells. Which of the following proteins is most likely to be involved in transducing the mitogenic signal from the epidermal cell membrane to the nucleus?
A: G proteins
B:RAS proteins
C:Cyclin D
D: Cyclic AMP
E:Cyclin-dependent kinase
答案: RAS proteins
8、单选题：
An experiment analyzes factors involved in the cell cycle during growth factor-induced cellular regeneration in a tissue culture. Cyclin B synthesis is induced; the cyclin B then binds and activates cyclin-dependent kinase 1 (CDK1). The active kinase produced by this process is most likely to control progression in which of the following phases of the cell cycle?
A:G0 to G1
B:G1 to S
C:S to G2
D:G2 to M
E:M to G1
答案: G2 to M
9、单选题：
An experiment is conducted involving cellular aspects of wound healing. Components of the extracellular matrix are analyzed to determine their sites of production and their binding patterns to other tissue components.Which of the following molecules synthesized by fibroblasts can best bind to cellular integrins and extracellular collagen and attach epidermal basal cells to basement membrane?
A:Heparin
B:Dermatan sulfate
C:Procollagen
D:Fibronectin
E:Hyaluronic acid
答案: Fibronectin
10、多选题：
In an experiment, surgical incisions are made in a study group of laboratory rats. Observations about the wounds are recorded over a 2-week period using a variety of chemical mediators. Which of the following steps in the inflammatory-repair response is impossible affected by neutralization of transforming growth factor-β?
A:Leukocyte extravasation
B:Increase in vascular permeability
C:Production of collagen
D:Chemotaxis of lymphocytes
E:Migration of epithelial cells
答案: Leukocyte extravasation;Increase in vascular permeability ;Chemotaxis of lymphocytes;Migration of epithelial cells
第三章 单元测试
1、单选题：
A 52-year-old woman with no major medical problems takes a long airplane flight across the Pacific Ocean. Upon arrival at Sydney’s Kingsford Smith airport following the flight from Los Angeles, she cannot put her shoes back on. There is no pain or tenderness. Which of the following is the most likely explanation for this phenomenon?
A:Activation of Hageman factor has led to bradykinin production.
B:A lot of drinks were served in the first class section.
C:Femoral vein thrombosis developed.
D:A cellulitis developed in her legs.
E:Venous hydrostatic pressure became increased.
答案: Venous hydrostatic pressure became increased.
2、单选题：
A 56-year-old man has had increasing difficulty breathing for the past week. On physical examination he has no fever. Auscultation of his chest reveals diminished breath sounds and dullness to percussion bilaterally. There is 2+ pitting edema present to the level of his thighs. A chest radiograph reveals bilateral pleural effusions. Which of the following laboratory test findings is he most likely to have?
A:Hypoalbuminemia
B:Glucosuria
C:Neutrophilia
D:Anemia
E:Hypernatremia
答案: Hypoalbuminemia
3、单选题：
A study of atherogenesis is performed. There is a propensity for atheromas to form at muscular arterial branch points, such as the carotid and aortic bifurcations. Which of the following events in the arteries at these locations is most likely to initiate atherogenesis?
A:Collagen synthesis
B:Endothelial dysfunction
C:Lactic acidosis
D:Cholesterol breakdown
E:Hypoxemia
答案: Endothelial dysfunction
4、单选题：
A 61-year-old man has the sudden onset of severe chest pain. Vital signs include T 37°C, P 102/minute, RR 20/minute, and BP 80/40 mm Hg. An electrocardiogram demonstrates changes that are consistent with myocardial ischemia involving the left lateral ventricular free wall. He is given thrombolytic therapy with tissue plasminogen activator (tPA) 3 hours after the onset of chest pain. However his serum creatinine kinase is found to be 450 U/L (elevated) 3 hours after this therapy. Which of the following cellular events has most likely occurred?
A:Cellular regeneration
B:Drug-induced necrosis
C:Reperfusion injury
D:Increased synthesis of creatine kinase
E:Myofiber atrophy
答案: Reperfusion injury
5、单选题：
A clinical study is performed with subjects who have thrombocytopenia
A:Adherence to injured vascular walls
B:Conversion of fibrinogen to fibrin
C:Induction of vasoconstriction
D:Increase in surface sites for coagulation
E:Release of substances that neutralize heparin
答案: Conversion of fibrinogen to fibrin
6、单选题：
A 70-year-old man seeks medical attention because of shortness of breath on minimal exertion. A posteroanterior chest radiograph reveals blunting of the right costophrenic sulcus interpreted as a right-sided pleural effusion. The aspirated fluid is straw colored and clear. The protein concentration is low, and the specific gravity is 1.011. Microscopic examination reveals an occasional mesothelial cell. Which of the following is the most likely cause of the effusion?
A:Decreased oncotic pressure
B:Left ventricular heart failure
C:Mesothelioma
D:Pneumonia
E:Tuberculosis
答案: Left ventricular heart failure
7、单选题：
Two days following a cholecystectomy, a 32-year-old hospitalized woman has sudden onset of dyspnea, pleural pain, and cough productive of frothy, blood-tinged sputum. Ventilation-perfusion scintigraphy indicates a perfusion defect. If it were possible to examine a portion of the affected lung, which of the following would most likely have been found?
A:Air embolism
B:Anemic (white or pale) infarction
C:Disseminated intravascular coagulation (DIC)
D:Generalized thrombosis
E:Hemorrhagic (red) infarct
答案: Hemorrhagic (red) infarct
8、单选题：
A 36-year-old man dies during cardiac surgery. He had a history of long-standing rheumatic heart disease with mitral stenosis. At autopsy, the pathologist reports findings consistent with mitral stenosis and noted the presence of ‘heart failure cells’. This finding results from ( ).
A:activation of the coagulation cascade
B:chronic passive congestion of the lungs
C:hypoxic myocardial injury
D:myocardial hyperemia
E:hyperemia of the lungs
答案: chronic passive congestion of the lungs
9、单选题：
During a laboratory exercise on coagulation testing, a 23-year-old medical student is found to have a prolonged bleeding time. She has had a long history of ‘easy bleeding’ with frequent bleeding of the gums, epistaxis, cutaneous bleeding, and menorrhagia. Further testing revealed a deficiency of von Willebrand factor. Which of the following thrombogenic processes involving platelets is most directly impaired?
A:Adhesion
B:Conformational change with activation of phospholipid surface
C:Formation of fibrinogen bridges
D:Release reaction
E:Stabilization of platelet plug
答案: Adhesion
10、多选题：
Fluid is aspirated from the grossly distended abdomen of a 47-year-old chronic alcoholic man. The fluid is straw colored and clear and is found to have a protein content (largely albumin) of 2.5g/dL. Which of the following is not the main cause of the patient’s fluid accumulation?
A:Blockage of lymphatics
B:Decreased oncotic pressure
C:Decreased sodium retention
D:Increased capillary permeability
E:Inflammatory exudation
答案: Blockage of lymphatics;Decreased sodium retention;Increased capillary permeability;Inflammatory exudation
第四章 单元测试
1、单选题：
A 22-year-old man develops marked right lower quadrant abdominal pain over the past day. On physical examination there is rebound tenderness on palpation over the right lower quadrant. Laparoscopic surgery is performed, and the appendix is swollen, erythematous, and partly covered by a yellowish exudate. It is removed, and a microscopic section shows infiltration with numerous neutrophils. The pain experienced by this patient is predominantly the result of which of the following two chemical mediators?
A:Complement C3b and IgG
B:Interleukin-1 and tumor necrosis factor
C:Histamine and serotonin
D:Prostaglandin and bradykinin
E:Leukotriene and HPETE
答案: Prostaglandin and bradykinin
2、单选题：
A 45-year-old man has been working hard all day long carrying loads of bricks to build a wall. He takes a non-steroidal anti-inflammatory drug (ibuprofen). Which of the following processes is this drug most likely to diminish in his arms?
A:Thrombosis
B:Pain
C:Necrosis
D:Fibrinolysis
E:Scar formation
答案: Pain
3、单选题：
Within minutes following a bee sting, a 37-year-old man develops marked respiratory stridor with dyspnea and wheezing. He also develops swelling and erythema seen in his arms and legs. An injection of epinephrine helps to reverse these events and he recovers within minutes. Which of the following chemical mediators is most important in the pathogenesis of this man’s condition?
A:Bradykinin
B:Complement C5a
C:Nitric oxide
D:Tumor necrosis factor
E:Histamine
答案: Histamine
4、单选题：
In an experiment, lymphatic channels are observed in normal soft tissue preparations. Staphylococcus aureus organisms are innoculated into the tissues and the immunologic response is observed over the next 24 hours. Which of the following functions is most likely to be served by these lymphatics to produce a specific immune response to these organisms?
A:Carry lymphocytes to peripheral tissue sites
B:Remove extravascular tissue fluid
C:Transport antigen presenting cells
D:Serve as a route for dissemination of infection
E:Provide an emigration point for neutrophils
答案: Transport antigen presenting cells
5、单选题：
A 65-year-old woman has had a fever for the past day. On physical examination her temperature is 39°C and blood pressure 90/50 mm Hg with heart rate of 106/minute. Laboratory studies show a WBC count of 12,510/microliter and WBC differential count of 78 segs, 8 bands, 11 lymphs, and 3 monos. A blood culture is positive for Escherichia coli. Her central venous pressure falls markedly. She goes into hypovolemic shock as a result of the widespread inappropriate release of a chemical mediator derived from macrophages. She develops multiple organ failure. Which of the following mediators is most likely to produce these findings?
A:Nitric oxide
B:Bradykinin
C:Histamine
D:Prostacyclin
E: Complement C3a
答案: Nitric oxide
6、单选题：
A 56-year-old man has had increasing dyspnea for 6 years. He has no cough or fever. He had chronic exposure to inhalation of silica dust for many years in his job. A chest x-ray now shows increased interstitial markings and parenchymal 1 to 3 cm solid nodules.His pulmonary problems are most likely to be mediated through which of the following inflammatory processes?
A:Neutrophilic infiltrates producing leukotrienes
B:Foreign body giant cell formation
C:Plasma cell synthesis of immunoglobulins
D:Mast cell histamine release
E:Macrophage elaboration of cytokines
答案: Macrophage elaboration of cytokines
7、单选题：
A 40-year-old woman had laparoscopic surgery 3 months ago. Now she has a small 0.5 cm nodule beneath the skin at the incision site that was sutured. Which of the following cell types is most likely to be most characteristic of the inflammatory response in this situation?
A:Mast cell
B:Eosinophil
C:Giant cell
D:Neutrophil
E:Plasma cell
答案: Giant cell
8、单选题：
A 43-year-old woman has had a chronic cough with fever and weight loss for the past month. A chest radiograph reveals multiple nodules from 1 to 4 cm in size, some of which demonstrate cavitation in the upper lobes. A sputum sample reveals the presence of acid fast bacilli.Which of the following cells is the most important in the development of her lung lesions?
A:Macrophage
B:Fibroblast
C:Neutrophil
D:Mast cell
E:Platelet
答案: Macrophage
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