United State Medical Licensing Examination (Step 1) Set 18

The bone marrow biopsy depicted in below figure was obtained from an infant with hepatosplenomegaly and mental retardation. The pathologic basis of this disorder is best explained by which of the following?

A 72-year-oldman with a known history of chronic essential hypertension dies unattended at home. The medical examiner determines the cause of death to be hypertensive intracerebral hemorrhage. The most likely site of the hemorrhage is which of the following?

A 10-year-old boy is brought to a pediatric clinic by his mother, who states that he has been voiding brown-colored urine for the past 2 days. The child's history is negative except for a sore throat about 2 weeks ago. Physical examination reveals moderate periorbital edema and mild hypertension. Urinalysis demonstrates red cells, both red and white cell casts, and 2+ protein. If a renal biopsy were obtained, what would be the characteristic light and/or electron microscopic finding in the glomeruli?

A 56-year-old man complains of increasing dyspnea on exertion over the past few days. He is noted to be overweight and cyanotic. He has smoked cigarettes for at least 35 years and has a long-standing history of persistent cough, producing a large amount of thick mucopurulent sputum. Auscultation reveals scattered rhonchi and wheezes. Histological examination of his lung tissue would most likely how which of the following?

A 6-year-old child presents with diarrhea, malabsorption, and steatorrhea. A photomicrograph from a small intestinal mucosal biopsy is displayed in below figure. An appropriate treatment would be which of the following?

A 57-year-old man seeks medical attention for the recent appearance of numerous, large, fluid-filled, cutaneous blisters. These involve the face, scalp, neck, and axillae. Manual pressure to the skin results in epidermal separation. These changes are most likely the result of which of the following?

A 32-year-old male cyclist is struck at night by a hit-and-run motorist. He is unconscious and severely injured and is not discovered until a pedestrian walks by 2 or 3 hours later. When he arrives at the emergency room, he is in shock and his BP is 80/30 mm Hg. He is transfused and a large wound on his right leg is cleaned and sutured. However, by the next day his urine output has decreased to less than 20 mL/h. Which of the following microscopic descriptions best describes his kidneys at this time?

A 76-year-old woman suffers a massive myocardial infarct and dies in cardiogenic shock 20 hours after its onset. Microscopic examination of her infarcted myocardium would be expected to demonstrate which of the following?

A 32-year-old man presents with diarrhea and symptoms of peptic ulcer disease. Endoscopy reveals two ulcers, one in the first portion of the duodenum and one in the midduodenum. However, they do not respond to the usual peptic ulcer treatment programs. The most likely explanation for the findings in this patient is which of the following?

A 47-year-old man has been chronically ill for the past 18 months. He undergoes a lung biopsy and a ection is shown in below figure. Which of the following is the most likely diagnosis?