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Pathology Flashcards

7 cards from real NBME practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. An autopsy of a 68-year-old man with dementia shows senile plaques and neurofibrillary tangles. Which protein forms the core of senile plaques?

    Answer: Amyloid-beta (Abeta42)

    Senile (neuritic) plaques in Alzheimer disease are composed of extracellular amyloid-beta peptide (predominantly Abeta42) derived from APP cleavage.

  2. A 4-year-old child has a Wilms tumor. Which embryonic tissue fails to differentiate properly, leading to this tumor?

    Answer: Metanephric blastema (nephrogenic rests)

    Wilms tumor (nephroblastoma) arises from persistence of nephrogenic rests — foci of metanephric blastema that fail to differentiate into normal nephrons.

  3. A 58-year-old woman undergoes a mastectomy. Histology shows invasive carcinoma with Indian file (single-file) growth pattern and absence of cohesion due to loss of which protein?

    Answer: E-cadherin

    Invasive lobular carcinoma is characterized by single-file tumor cells due to loss of E-cadherin expression from CDH1 mutation or promoter methylation.

  4. A 72-year-old man has progressive dyspnea. Spirometry shows FEV1/FVC = 0.55 (reduced) with increased TLC and RV. CT shows panacinar emphysema predominantly in lower lobes. What is the underlying deficiency?

    Answer: Alpha-1 antitrypsin (AAT)

    Alpha-1 antitrypsin deficiency causes panacinar emphysema predominantly in the lung bases because uninhibited neutrophil elastase destroys alveolar walls.

  5. A 33-year-old man with ulcerative colitis for 10 years has cholestatic jaundice and pruritus. ERCP shows 'beaded' intrahepatic and extrahepatic bile ducts. What is the diagnosis?

    Answer: Primary sclerosing cholangitis (PSC)

    PSC causes multifocal biliary strictures producing the 'beaded' appearance on cholangiography and is strongly associated with IBD, especially UC.

  6. A 28-year-old woman has a cervical Pap smear showing koilocytes. High-risk HPV DNA testing is positive. Which viral protein inactivates p53?

    Answer: E6

    HPV E6 protein binds and targets p53 for ubiquitin-mediated degradation, eliminating this tumor suppressor and enabling unchecked cell proliferation.

  7. A 50-year-old man has a renal mass removed. Histology shows clear cells with abundant glycogen and lipid, arranged in nests with delicate vasculature. What is the most common chromosomal abnormality?

    Answer: Deletion of chromosome 3p (VHL gene loss)

    Clear cell renal cell carcinoma is associated with loss of the VHL tumor suppressor gene on chromosome 3p, leading to HIF activation and VEGF overexpression.