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The following samples are available to demonstrate exam question format only.

Anatomic Pathology Written Exam

Directions: Choose the one answer that is best in each case.

Question 1.

A pathologist was asked to assess the margins on a 3 x 1.5 cm skin specimen removed for suspected basal cell carcinoma. Separate frozen sections were performed on each of the four margins. What is the correct CPT coding for this intraoperative consult?

A) 88305 x 4.
B) 88331 x 4.
C) 88331 x 1 and 88332 x 3.
D) 88332 x 4.

Question 2.

Which statement regarding the 100 slide per day screening limit imposed by CLIA is correct?

A) It applies only to gynecologic slides.
B) Previously examined abnormal gynecologic cases are included in the 100-slide limit.
C) Slides prepared by liquid-based techniques with cells dispersed over half the slide count as one-half slide.
D) The CLIA workload limit does not apply to CLIA licensed and CAP accredited laboratories.

Question 3.

The major morphologic manifestation of chronic rejection of a lung allograft is:

A) Bronchiolitis obliterans.
B) Interstitial fibrosis.
C) Nonspecific interstitial pneumonitis.
D) Perivascular mononuclear infiltrates.

Question 4.

Primary hyperparathyroidism is most frequently caused by:

A) Chronic renal disease.
B) Malabsorption syndrome.
C) Parathyroid adenoma.
D) Parathyroid carcinoma.
E) Primary parathyroid hyperplasia.

Question 5.

A melanoma is most likely to arise in a:

A) Blue nevus.
B) Compound nevus in a fair skinned, blue eyed redhead.
C) Giant congenital nevus.
D) Pigmented spindle cell nevus.
E) Spitz nevus.

Anatomic Pathology Practical Exam

Directions: Choose the single best answer.

Question 1.

For this biopsy from an 18-year-old male who had a bone marrow transplant for acute leukemia? What is the most likely diagnosis is:

A) graft-versus-host reaction.
B) junctional nevus.
C) leukemic infiltration.
D) lymphoma cutis. 
E) mycosis fungoides.

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Question 2.

The best interpretation for this cervicovaginal cytology specimen from a 32-year-old patient is:

A) atypical squamous cells of undetermined significance.
B) high grade squamous intraepithelial lesion.
C) low grade squamous intraepithelial lesion.
D) negative for intraepithelial lesion or malignancy.
E) reactive cellular changes associated with inflammation.

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Question 3.

These GMS stained (x400) organisms are:

A) Blastomyces dermatitidis.
B) Cryptococcus neoformans.
C) Pneumocystis carinii cysts.
D) trophozoites of Entamoeba histolytica.
E) yeasts of Candida species.

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Question 4.

The most likely diagnosis for this 4 cm tumor in the neck of a 51-year-old male is:

A) carotid body tumor.
B) granular cell tumor.
C) malignant melanoma.
D) metastatic renal carcinoma.
E) mucoepidermoid carcinoma.

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Question 5.

For this section of normal kidney stained with patient serum for IgG. The most likely diagnosis is:

A) acute post streptococcal glomerulonephritis.
B) Goodpasture syndrome.
C) minimal change disease.
D) systemic lupus erythematosus.
E) granulomatosis with polyangiitis.

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Question 6.

The most likely diagnosis is:

A) arteriovenous malformation.
B) glioblastoma multiforme.
C) infarction.
D) pilocytic astrocytoma.
E) radiation necrosis.

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Question 7.

The most likely diagnosis for this H&E stained section of a 3 cm nodule from the parotid gland of a 45-year-old female is:

A) acinic cell carcinoma.
B) adenoid cystic carcinoma.
C) normal parotid tissue
D) pleomorphic adenoma.
E) Warthin tumor.

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Question 8.

The most likely diagnosis for this core needle biopsy from the breast of a 52-year-old female is:

A) chronic mastitis.
B) fat necrosis.
C) invasive lobular carcinoma.
D) metastatic small cell carcinoma.
E) myeloma.

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Question 9.

This was the driver of a car that overturned and caught fire after a head-on collision.The injuries shown are most likely due to:

A) falling on gravel.
B) postmortem burns caused by gasoline.
C) second degree burns caused by heat.
D) steering wheel impact.
E) the body’s dragging on the ground.

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Clinical Pathology Written Exam

Directions: Choose the one answer that is best in each case.

Question 1.

A 77-year-old male with severe peripheral vascular disease presented at the emergency department with severe abdominal pain of several hours’ duration. There was no history of trauma or chest pain. Laboratory studies included:

Patient Result Reference Interval
Total creatine kinase (CK) 275 IU/L 21–232 IU/L
CK-MB 3 ng/mL 0–5 ng/mL

 

The most likely source of the elevated CK activity is:

A) Hepatic congestion.
B) Infarcted bowel.
C) Myocardial infarction.
D) Renal infarction.
E) Rhabdomyolysis.

Question 2.

Which myelodysplastic syndrome is most likely to transform to acute leukemia?

A) Chronic myelomonocytic leukemia.
B) Refractory anemia.
C) Refractory anemia with excess blasts.
D) Refractory anemia with ringed sideroblasts.
E) Refractory throbocytopenia.

Question 3.

A patient with recurrent episodes of venous and arterial thrombosis was given therapeutic doses of heparin, but the heparin failed to exert an anticoagulant effect. The patient most likely has a deficiency of:

A) Antithrombin.
B) Factor VIII.
C) Plasminogen.
D) Platelets.
E) Protein C.

Question 4.

The most common type of allogeneic transfusion reaction from packed red blood cells is:

A) Acute hemolytic.
B) Allergic. 
C) Delayed hemolytic.
D) Febrile, nonhemolytic. 
E) Transfusion-related acute lung injury.

Question 5.

The most common cause of fatal hemolytic transfusion reactions is:

A) Clerical errors related to misidentification of patients.
B) Failure to premedicate patients with acetaminophen. 
C) Laboratory technical or testing mistakes. 
D) The emergency transfusion of uncrossmatched blood.
E) Transfusing red blood cells too rapidly.

Question 6.

A patient with necrotizing granulomatous inflammation in the lungs, leukocytoclastic angiitis in the dermis, and necrotizing and crescentic glomerulonephritis in the kidneys would most likely test positive for:

A) Anti-neutrophil cytoplasmic antibodies.
B) Antinuclear antibodies.
C) Anti-phospholipid antibodies.
D) Hepatitis C virus antibodies. 
E) IgA fibronectin aggregates.

Question 7.

The oncogene that becomes activated in the t(14;18) that is often associated with follicular lymphoma is:

A) Bcl-2.
B) Bcr/abl.
C) Ets-1.
D) Myc.
E) Mos.

Question 8.

A blood agar plate has small, nonhemolytic colonies isolated from an intra-abdominal abscess. The isolate is catalase negative, bile esculin positive, pyrrolidonyl positive, and grows in 6.5% sodium chloride. The most likely identification is:

A) Enterococcus species.
B) Group B Streptococcus.
C) Pneumococcus.
D) Staphylococcus species.

Clinical Pathology Practical Exam

Question 1.

The acquired B phenomenon is associated with antigens from which organism?

A) Candida albicans.
B) Escherichia coli O 86.  
C) Legionella pneumophila.
D) Mycoplasma pneumoniae.
E) Treponema pallidum.

Question 2.

The concentration of an analyte is measured in nondiseased and diseased populations,and cut-off point Q is chosen. The number of false positives is represented by area:

A) W.
B) X.
C) Y.
D) Z.

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Question 3.

Data obtained during the evaluation of a diagnostic test for a disease with a prevalence of 10% is shown.

Patient Status Positive Result Negative Result Total
Disease 100 0 100
No Disease 200 700 900
Total 300 700 1,000

 

Which statement regarding the data is correct?

A) The diagnostic sensitivity is 100%.
B) The diagnostic specificity is 70%.
C) The efficiency of the test is 43%.
E) The predictive value of a negative test is 70%.
 

Question 4.

This is a flow cytometric dot plot of peripheral blood lymphocytes stained for CD3 and CD8 from a patient with a decreased absolute number of lymphocytes. The most likely diagnosis is:

A) AIDS.
B) cytomegalovirus infection.
C) infectious mononucleosis.
D) large granular lymphocytic
E) no pathologic change.

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Question 5.

The most likely diagnosis for this blood film from a 38-year-old female is:

A) acute myeloid leukemia with maturation.
B) acute myeloid leukemia with inv(16)(p13q22).
C) acute myelomonocytic leukemia.
D) acute promyelocytic leukemia.
E) mast cell leukemia.

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Question 6.

The appearance of the hand suggests that this infant has:

A) a chromosomal abnormality.
B) a cleft lip and palate.
C) a short fourth metacarpal.
D) holoprosencephaly.
E) rocker-bottom feet.

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Question 7.

The best interpretation for this serum electrophoresis and immunofixation data from an 85-year-old female is:

A) acute phase reactant pattern.
B) IgA monoclonal gammopathy.
C) normal study.
D) Waldenström macroglobulinemia.

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Question 8.

The most likely diagnosis for this bile duct brush cytology from a 45-year-old female is:

A) amoebae.
B) Cryptosporidium.
C) degenerated epithelial cells.
D) Giardia.
E) normal epithelial cells.

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Question 9.

The most likely diagnosis for this subcutaneous tissue biopsy from a patient who suffered a firecracker injury is:

A) Aspergillosis. 
B) Botryomycosis.
C) Phaeohyphomycosis.
D) Sporotrichosis.
E) Zygomycosis.

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Virtual Microscopy Practice