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PATHOLOGY NBME EXAMS | ALL QUESTIONS AND CORRECT ANSWERS (ALREADY GRADED A+) | LATEST VE, Exams of Nursing

DeVry University-TexasNursing

PATHOLOGY NBME EXAMS | ALL QUESTIONS AND CORRECT ANSWERS (ALREADY GRADED A+) | LATEST VERSION | VERIFIED ANSWERS 2025

Typology: Exams

2024/2025

Available from 06/23/2025

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PATHOLOGY NBME EXAMS | ALL QUESTIONS
AND CORRECT ANSWERS (ALREADY GRADED
A+) | LATEST VERSION | VERIFIED ANSWERS
2025
1. A 65-year-old man has hematuria and a renal mass on imaging.
Histology reveals clear cells. What is the most likely diagnosis?
Clear cell renal cell carcinoma
This is the most common subtype of renal cancer, often associated
with von Hippel–Lindau disease and characterized by clear
cytoplasm due to lipid/glycogen content.
2. A 10-year-old boy presents with fatigue, pallor, and petechiae.
Bone marrow biopsy shows >25% lymphoblasts. Diagnosis?
Acute lymphoblastic leukemia (ALL)
Common in children, ALL presents with bone marrow failure signs
and lymphoblasts.
3. A 40-year-old man has progressive dysphagia and weight loss.
Endoscopy shows esophageal mass; biopsy shows keratin pearls.
Diagnosis?
Squamous cell carcinoma of the esophagus
Keratin pearls are diagnostic for squamous cell carcinoma,
commonly linked to smoking and alcohol.
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Download PATHOLOGY NBME EXAMS | ALL QUESTIONS AND CORRECT ANSWERS (ALREADY GRADED A+) | LATEST VE and more Exams Nursing in PDF only on Docsity!

PATHOLOGY NBME EXAMS | ALL QUESTIONS

AND CORRECT ANSWERS (ALREADY GRADED

A+) | LATEST VERSION | VERIFIED ANSWERS

  1. A 65-year-old man has hematuria and a renal mass on imaging. Histology reveals clear cells. What is the most likely diagnosis? Clear cell renal cell carcinoma This is the most common subtype of renal cancer, often associated with von Hippel–Lindau disease and characterized by clear cytoplasm due to lipid/glycogen content.
  2. A 10-year-old boy presents with fatigue, pallor, and petechiae. Bone marrow biopsy shows >25% lymphoblasts. Diagnosis? Acute lymphoblastic leukemia (ALL) Common in children, ALL presents with bone marrow failure signs and lymphoblasts.
  3. A 40-year-old man has progressive dysphagia and weight loss. Endoscopy shows esophageal mass; biopsy shows keratin pearls. Diagnosis? Squamous cell carcinoma of the esophagus Keratin pearls are diagnostic for squamous cell carcinoma, commonly linked to smoking and alcohol.
  1. A woman presents with sudden onset of chest pain and ST elevation. Autopsy reveals transmural coagulative necrosis. Duration of infarct? 24 - 7 2 hours Coagulative necrosis is prominent in myocardial infarction by 1- 3 days post-event.
  2. A patient has chronic gastritis with intestinal metaplasia. Which organism is implicated? Helicobacter pylori Chronic infection with H. pylori can lead to metaplasia and increase cancer risk.
  3. A 55-year-old smoker has a chronic cough and is diagnosed with squamous metaplasia in bronchi. This change increases the risk for: Carcinoma Metaplasia can progress to dysplasia and then to carcinoma in response to irritants.
  4. Which of the following mediators is primarily responsible for increased vascular permeability during acute inflammation? Histamine Histamine causes endothelial cell contraction, leading to vascular permeability.
  5. A 60-year-old male has liver biopsy showing ground-glass hepatocytes. What virus is likely? Hepatitis B virus

CLL is a B-cell malignancy and smudge cells are fragile B cells on smear.

  1. A 45-year-old woman with difficulty swallowing and Raynaud’s phenomenon. Labs show anti-centromere antibodies. Likely diagnosis? Limited systemic sclerosis (CREST syndrome) Anti-centromere antibodies are seen in limited cutaneous systemic sclerosis.
  2. Which cytokine is most important for granuloma formation? Interferon-gamma (IFN-γ) IFN-γ from Th1 cells activates macrophages, essential in granuloma maintenance.
  3. A woman with hematuria, deafness, and lens dislocation. Diagnosis? Alport syndrome Due to mutation in type IV collagen, affecting kidney, ears, and eyes.
  4. A 25-year-old man presents with urethritis and conjunctivitis after diarrhea. What HLA is likely involved? HLA-B Reactive arthritis is a seronegative spondyloarthropathy associated with HLA-B27.
  5. A patient has anemia and glossitis. Labs show macrocytosis and hypersegmented neutrophils. Diagnosis? Vitamin B12 deficiency

B12 deficiency impairs DNA synthesis, causing megaloblastic anemia and neuro symptoms.

  1. A patient has high PTH and low calcium. Possible cause? Chronic renal failure Secondary hyperparathyroidism due to decreased vitamin D activation and phosphate retention.
  2. A lung biopsy shows glandular structures in an invasive tumor. Diagnosis? Adenocarcinoma Most common primary lung cancer, especially in nonsmokers and females.
  3. A 30-year-old woman with tremor, weight loss, and exophthalmos. Likely antibody? TSI (thyroid-stimulating immunoglobulin) Graves disease is caused by TSI stimulating TSH receptors.
  4. A patient has a thyroid nodule. Biopsy shows orphan Annie nuclei and psammoma bodies. Diagnosis? Papillary thyroid carcinoma Papillary thyroid carcinoma is the most common and has distinct nuclear features.
  5. Which of the following tumors is derived from neural crest cells? Pheochromocytoma Derived from chromaffin cells of adrenal medulla, a neural crest derivative.

Systemic lupus erythematosus RBC casts + lupus serologies suggest lupus nephritis.

  1. A young man with hemoptysis, hematuria, and anti-GBM antibodies. Diagnosis? Goodpasture syndrome Autoantibodies target basement membranes in lungs and kidneys.
  2. A 45-year-old man with hepatomegaly and bronze skin. Likely gene mutation? HFE gene Hereditary hemochromatosis involves iron overload due to HFE mutation.
  3. A female patient with facial rash worsened by sunlight, and mouth ulcers. Best initial test? ANA (antinuclear antibody) ANA is highly sensitive for lupus.
  4. What is the most common cause of fatty change in the liver? Alcohol Alcohol impairs lipid metabolism, leading to steatosis.
  5. A 7-year-old has hematuria following a sore throat. Diagnosis? Poststreptococcal glomerulonephritis Occurs 1–3 weeks after streptococcal infection, with immune complex deposition.
  6. A biopsy shows malignant cells with "salt and pepper" chromatin in a lung mass. Diagnosis?

Small cell carcinoma Neuroendocrine tumor with fine chromatin and rapid growth.

  1. A man develops hematuria 1 day after upper respiratory infection. Diagnosis? IgA nephropathy IgA deposition in mesangium causes rapid-onset hematuria.
  2. A 60-year-old man has fatigue and elevated alkaline phosphatase. Anti-mitochondrial antibodies are present. Diagnosis? Primary biliary cholangitis Autoimmune destruction of intrahepatic bile ducts, mostly in women.
  3. A woman with a breast mass; biopsy shows duct-like structures with desmoplastic stroma. Diagnosis? Invasive ductal carcinoma Most common breast cancer, with firm, fibrous texture.
  4. A patient presents with a thyroid nodule and calcitonin- producing cells. Diagnosis? Medullary thyroid carcinoma Derived from parafollicular C cells, secreting calcitonin.
  5. A child has anemia, jaundice, and increased MCHC. Osmotic fragility test is positive. Diagnosis? Hereditary spherocytosis Defect in spectrin/ankyrin leads to spherocytes and splenomegaly.
  6. A man with testicular mass and elevated AFP. Histology shows Schiller-Duval bodies. Diagnosis?
  1. A man has difficulty swallowing, halitosis, and regurgitation of undigested food. Diagnosis? Zenker diverticulum False diverticulum due to herniation through Killian triangle.
  2. A 50-year-old woman has painful thyroid and low TSH. After 2 weeks, thyroid function returns to normal. Diagnosis? Subacute granulomatous thyroiditis Often post-viral, presents with painful thyroid and transient hyperthyroidism.
  3. A 45-year-old man with hepatocellular carcinoma. What marker is elevated? Alpha-fetoprotein (AFP) AFP is elevated in liver cancer and yolk sac tumors.
  4. A 6-year-old with Down syndrome develops fatigue and pancytopenia. Likely leukemia? Acute megakaryoblastic leukemia Common in Down syndrome children under 5 years.
  5. A 65-year-old man presents with weight loss and painless jaundice. CT shows a pancreatic mass. Marker to assess? CA 19- 9 CA 19-9 is the tumor marker most commonly associated with pancreatic adenocarcinoma.
  6. A 7-year-old boy has a Wilms tumor. Which genetic abnormality is commonly associated?

WT1 gene mutation WT1 is a tumor suppressor gene on chromosome 11p13, commonly mutated in Wilms tumor.

  1. A patient with iron deficiency anemia develops esophageal webs and glossitis. Syndrome? Plummer-Vinson syndrome Triad: iron deficiency anemia, esophageal webs, and glossitis.
  2. A patient with chronic cough and dyspnea. Lung biopsy shows noncaseating granulomas. Diagnosis? Sarcoidosis Sarcoidosis is characterized by noncaseating granulomas, often affecting lungs and hilar lymph nodes.
  3. A 3-year-old has abdominal pain and a palpable "sausage- shaped" mass. Diagnosis? Intussusception Common pediatric emergency caused by telescoping of the bowel, often near ileocecal valve.
  4. A 20-year-old man presents with hematuria and sensorineural deafness. Glomerular EM shows splitting of basement membrane. Diagnosis? Alport syndrome Defective type IV collagen affects kidney, ears, and eyes; shows basket-weave pattern on EM.
  5. A 55-year-old alcoholic male has confusion, ophthalmoplegia, and ataxia. Cause?

Increased estrogen levels Liver cannot degrade estrogens, leading to feminization.

  1. A woman has recurrent oral and genital ulcers with uveitis. Diagnosis? Behçet syndrome Vasculitis involving mucous membranes and eyes.
  2. A newborn has projectile vomiting and an olive-like mass in the abdomen. Diagnosis? Pyloric stenosis Hypertrophy of the pylorus causes gastric outlet obstruction.
  3. A 10-year-old boy with abdominal pain and target lesions on skin. Most likely preceding infection? Mycoplasma pneumoniae Erythema multiforme is often associated with Mycoplasma or HSV.
  4. A 40-year-old female has fatigue, pruritus, and xanthomas. AMA is positive. Diagnosis? Primary biliary cholangitis Autoimmune destruction of intrahepatic bile ducts, primarily in women.
  5. A young adult with nasal polyps and asthma develops hematuria. c-ANCA is positive. Diagnosis? Granulomatosis with polyangiitis (Wegener’s) c-ANCA (PR3-ANCA) is highly specific for GPA.
  6. A man has hematuria and red cell casts 2 days after a URI. Diagnosis?

IgA nephropathy (Berger disease) Presents soon after mucosal infection with IgA deposition in mesangium.

  1. A neonate presents with jaundice and hepatosplenomegaly. Labs show elevated conjugated bilirubin. Diagnosis? Biliary atresia Progressive fibro-obliteration of extrahepatic bile ducts.
  2. A 30-year-old man with Crohn's disease presents with a right lower quadrant mass. Most likely cause? Fibrostenotic stricture Chronic transmural inflammation can cause fibrosis and obstruction.
  3. A woman has chronic pelvic pain and chocolate cysts on ovary. Diagnosis? Endometriosis Ectopic endometrial tissue causes cysts filled with old blood.
  4. A patient with new-onset diabetes and necrolytic migratory erythema. Suspected tumor? Glucagonoma Alpha-cell pancreatic tumor that secretes glucagon.
  5. A 70-year-old woman has right-sided facial droop and difficulty speaking. Brain shows liquefactive necrosis. Cell type removing debris? Microglia
  1. A patient with history of HIV presents with CNS lymphoma. Most likely virus? Epstein-Barr virus (EBV) Primary CNS lymphoma in immunosuppressed patients is often EBV- associated.
  2. A patient with fatigue and pallor has low haptoglobin and schistocytes on smear. Diagnosis? Microangiopathic hemolytic anemia (MAHA) Schistocytes suggest intravascular destruction.
  3. A female with sudden vision loss, jaw claudication, and headache. ESR is elevated. Diagnosis? Temporal arteritis (giant cell arteritis) Granulomatous inflammation of large arteries; can cause blindness if untreated.
  4. A 40-year-old with severe fatigue and splenomegaly. Peripheral smear shows teardrop cells. Bone marrow biopsy is dry tap. Diagnosis? Primary myelofibrosis Fibrosis displaces hematopoietic elements; dry tap and teardrop cells are classic.
  5. A child with hemarthrosis and high PTT but normal PT and bleeding time. Diagnosis? Hemophilia A or B X-linked deficiency of Factor VIII or IX.
  1. A patient with nausea, abdominal pain, and rash after new drug. Labs show eosinophilia and elevated creatinine. Diagnosis? Acute interstitial nephritis Drug-induced hypersensitivity reaction causing renal inflammation.
  2. A 60-year-old man with back pain and lytic bone lesions. Urinalysis positive for Bence Jones proteins. Diagnosis? Multiple myeloma Malignant plasma cells produce monoclonal light chains detectable in urine.
  3. A patient develops pancytopenia after chloramphenicol therapy. Diagnosis? Aplastic anemia Bone marrow failure from drug toxicity.
  4. A 40-year-old man with lung nodules and hematuria. Biopsy shows necrotizing granulomas. Diagnosis? Granulomatosis with polyangiitis Vasculitis of small vessels with granulomas in lung and kidney.
  5. A 20-year-old man with sickle cell disease presents with hip pain. Imaging shows bone infarction. Cause? Avascular necrosis Impaired blood flow due to vaso-occlusion leads to bone ischemia.
  6. A newborn has massive hepatosplenomegaly, jaundice, and nucleated RBCs. Likely cause? Erythroblastosis fetalis Hemolytic disease of the newborn due to Rh incompatibility.

Granulosa cell tumor Estrogen-secreting tumor with coffee-bean nuclei and Call-Exner bodies.

  1. A boy has bruising, recurrent infections, and albinism. Diagnosis? Chediak-Higashi syndrome Defective lysosomal trafficking regulator gene (LYST); impaired phagolysosome fusion.
  2. A 30-year-old IV drug user has tricuspid regurgitation and fever. Most likely pathogen? Staphylococcus aureus Common cause of right-sided endocarditis in IV drug users.
  3. A patient with fatigue, weight loss, and splenomegaly. Labs show Philadelphia chromosome. Diagnosis? Chronic myeloid leukemia (CML) BCR-ABL translocation t(9;22) activates tyrosine kinase.
  4. A patient develops red, itchy wheals after penicillin. What type of hypersensitivity reaction? Type I IgE-mediated immediate hypersensitivity.
  5. A child with anemia, jaundice, and increased osmotic fragility. Defect in which protein? Spectrin Hereditary spherocytosis is due to red cell membrane protein defects.
  1. A patient presents with difficulty breathing, bilateral pleural effusions, and positive ANA and anti-dsDNA. Diagnosis? Systemic lupus erythematosus Serositis is a common manifestation of SLE, and pleural effusion with positive serologies confirms the diagnosis.
  2. A 5-year-old child presents with swelling around the eyes and frothy urine. Most likely diagnosis? Minimal change disease Most common cause of nephrotic syndrome in children, showing effacement of foot processes.
  3. A patient with peptic ulcer disease has a gastrin-secreting tumor. Diagnosis? Zollinger-Ellison syndrome Gastrinomas cause excessive acid secretion and recurrent ulcers.
  4. A newborn with polyhydramnios and inability to pass NG tube. Diagnosis? Esophageal atresia with distal tracheoesophageal fistula Air in stomach and failed NG placement are classic findings.
  5. A woman develops amenorrhea and visual field deficits. MRI shows pituitary mass. Hormone elevated? Prolactin Prolactinomas are the most common pituitary tumors.
  6. A man has coarse facial features, large hands, and elevated IGF-1. Diagnosis? Acromegaly