115年 - [無官方正解]115 國立臺灣大學_ 碩士班招生考試試題：應用病理學#137682

1. Which mediator is preformed and stored in mast cell granules for immediate r toL (A) Prostaglandin D2 (B) Leukotriene B4 (C) Histamine release? (D) TNF

2. The rolling of leukocytes on endothelium is primarily mediated by:
(A) Integrins (B) ICAM-1 (C) PECAM-1 (D) Selectins

3. Granulation tissue is composed of which two primary elements? (A) Fibrin and platelets (B) Caseous necrosis and lymphocytes
(C) New capillaries and fibroblasts (D) Collagen and elastic fibers

4. The most common mutation in Marfan syndrome involves the gene for:
(A) Collagen type I (B) Fibrillin-1 (C) Elastin (D) FGFR3

5. Cystic fibrosis is caused by a defect in the transport of which ion?
(A) Sodium (B) Chloride (C) Potassium (D) Calcium

6. Phenylketonuria (PKU) is caused by a deficiency ofwhich enzyme?
(A) Phenylalanine hydroxylase (B) Tyrosinase (C) HGPRT (D) G6PD

7.The most common site of hematogenous metastasis for many carcinomas is:
(A) Heart (B) Bone(C) Lung (D) Spleen

8. The p53 gene is mainly classified as a:(A) Oncogene(B) Tumor suppressor gene
(C) Mismatch repair gene(D) Growth factor

9.Which virus is most strongly associated with Burkitt lymphoma?
(A) HIV(B) HPV (C) HBV (D) EBV

10. "Grade" of a tumor refers to its:
(A) Level of differentiation (B) Extent of spread (C) Lymph node involvement(D) Size

11.Which vasculitis typically affects the temporal artery in elderly patients?
(A) Wilms tumor(B)Giant cell arteritis
(C) Renal cell carcinoma(D)Wegener granulomatosis

12. Kaposi sarcoma is caused by which virus?
(A) EBV (B) HIV (C) HPV(D) HHV8

13. The most common cause of iron deficiency anemia is:
(A) Chronic blood loss (B) Malabsorption (C) Poor intake(D) Pregnancy

14. Multiple myeloma is a malignancy of which cell type?
(A) T lymphocytes (B) Plasma cells (C) Neutrophils(D) Monocytes

15. The most common malignant tumor of the kidney in adults is:
(A) Wilms tumor (B) Angiomyolipoma
(C) Renal cell carcinoma (D) Urothelial carcinoma

16. Which histology is typical for post-streptococcal glomerulonephritis (PSGN)?(A) Kawasaki disease (B) Giant cell arteritis(C) Polyarteritis nodosa (D) Wegener granulomatosis

17. The most common type of gallstone in Taiwan is:
(A) Pigment stones (B) Cholesterol stones (C) Calcium phosphate (D) Gouty tophi

18. Primary Biliary Cholangitis (PBC) is associated with which antibody?
(A) Anti-nuclear antibody (ANA) (B) Anti-mitochondrial antibody (AMA)
(C) Anti-smooth muscle antibody (D) Anti-LKM (Liver Kidney Microsomal) antibody

19. Most prostate cancers arise in which part of the gland?
(A) Transition zone (B) Periurethral zone (C) Central zone
(D) Peripheral zone

20. Which is the most common germ cell tumor of the testis?
(A)Teratoma(B) Seminoma
(C) Acute infection (D) Food poisoning

21. "Orphan Annie eye" nuclei are characteristic of which cancer?

(A) Papillary carcinoma(B) Follicular carcinoma
(C) Medullary carcinoma(D) Anaplastic carcinoma

22. Cushing syndrome is caused by an excess of:
(A) Aldosterone (B) Epinephrine (C) Cortisol (D) Insulin

23. Duchenne muscular dystrophy is caused by a deficiency of: Al Actin (A) Actin (B) Myosin (C) Dystrophin(D) Acetylcholine

24.Guillain-Barré syndrome is typically preceded by:
(A) Trauma (B) Malnutrition(C) Yolk sac tumor (D) Choriocarcinoma

25.Which ofthe following skin diseases has the closest relationship with a specific viral infection?
(A) Urticaria (B) Lichen planus
(C) Pemphigus vulgaris (D) Condyloma acuminatum

26. A 28-year-old man sustains a skin abrasion on his knee. Within 24 hours, the wound is erythematous and edematous, and a neutrophil-rich exudate is present. Which mediator is MOST directly responsible
for the rapid increase in vascular permeability in the first minutes after injury?
(A) Vascular endothelial growth factor (B) Interleukin-1(C) Platelet-activating factor (D) Histamine

27. A 63-year-old woman has a long-standing gastric ulcer that shows a transition from normal mucosa to areas of dysplasia and then to invasive adenocarcinoma. Which concept of carcinogenesis is BEST
illustrated by this sosequence?(A) Paraneoplastic syndrome(C) Tumor progression(B) Field cancerization(D) Grading of tumors

28.A 55-year-old man with a long history of smoking presents with chronic cough and dyspnea. Lung
biopsy shows loss of alveolar walls with enlargement of airspaces rspaces and and minimal fibrosis. Which pathologic mechanism BEST explains this finding?
(A) Diffuse interstitial collagen deposition from chronic inflammation (B) Decreased antiprotease activity leading to elastin destruction
(C) Obliteration of small airways by granulation tissue polyps
(D) Accumulation of surfactant in intra-alveolar spaces

29.A 45-year-old woman is diagnosed with an invasive ductal carcinoma of the breast. The tumor is high an duDEST grade with marked nuclear atypia and numerous mitoses. Which term BESTss describes this histologic
assessment and is most closely associated with proliferation rate and differentiation?(A) Tumor staging (B) Tumor grading (C) Desmoplasia (D) Anaplasia

30. A 65-year-old man presents with stable angina. Coronary angiography shows a fibrofatty plaque with an intact fibrous cap and a small lipid core. Which feature best explains why this lesion is less likely to
cause an acute myocardial infarction than a "vulnerable" plaque?(A) Large lipid core with intraplaque hemorrhage(B) High content of foamy macrophages near the shoulder regions
(C) Thick collagen-rich fibrous cap with few inflammatory cells(D) Marked thinning of the fibrous cap with abundant metalloproteinases

31. A 45-year-old woman presents with a 2-cm firm breast mass. Core biopsy reveals invasive ductal carcinoma that is estrogen receptor ER-positive, progesterone receptor PR-positive, and HER2- t-a- entor ER-nositive provesterone receptor PR-positive, and HER2- sgd hard fire thie arofile and rsis? negative. Which molecular subtype best fits this profile and prognosis?
(A) Luminal A subtypе (B) Luminal B subtype(C) HER2-enriched subtype (D) Basal-like (triple-negative) subtype

32.A 23-year-old man presents with acute onset severe testicular pain. The testis is enlarged, hemorrhagic,
and non-transilluminant. Histology after orchiectomy shows sheets of uniform large cells with clear and pon tamsillt iects of unifo cytonlasm distinct cell ho cytoplasm, distinct cell borders, and prominent nucleoli separated by delicate fibrous septa infiltrated
bycytoplasm, distinet cell borders, ad promne mostlik lymphocytes. Which one (including associated marker) is most likely to be the diagnosis of this tumor?
(A) Teratoma (CK)
(B) Seminoma (Placental alkaline phosphatase, PLAP)(C) Yolk sac tumor (Alpha-fetoprotein, AFP) (D) Choriocarcinoma Human chorionic gonadotropin (hCG)

33.A 58-year-old man with a long history of chronic hepatitis B develops a 4-cm mass in the liver. Biopsy shows of malignant chronic hepatocytes forming trabeculae and pseudoacini.Which mechanism best explains the inflammation in this patient's neoplasm?
(A) Creation of a microenvironment that completely prevents apoptosis (B) Direct viral integration always activating the same proto-oncogene (C) Increased reactive oxygen speciess causing causing DNA damage and promoting genomic instability (D) Exclusive inactivation of tumor suppressor genes without affecting oncogenes

34.A 34-year-old woman presents with a 3-week history of fever, night sweats, and painless cervical lymphadenopathy. Excisional biopsy shows nodular architecture with large Reed-Sternberg cells in a
background of small lymphocytes, histiocytes, and eosinophils. Immunostaining shows CD15-positive, CD30-positive, CD45-negative large cells. Which diagnosis is most likely?
(A) Diffuse large B-cell lymphoma (B) Classical Hodgkin lymphoma, nodular sclerosis or mixed cellularity type (C) Reactive follicular hynernlasis (D) Nodular lymphocyte-predominant Hodgkin lymphoma

35. A 62-year-old man with a history of long-standing ulcerative colitis presents with increasing
bdominal pain and weight loss. Colonoscopy reveals a mass in the sigmoid colon. Compared with sporadic colon adenocarcinoma, which feature is more likely in colitis-associated carcinoma?
(A) invariably right-sided and exophytic (B) Has a negligible risk of synchronous tumors
(C) Arises from flat dysplasia with multifocal lesions
(D) Shows fewer p53 mutations than sporadic cases

36.A 60-year-old man presents with dyspnea and non-productive cough. Imaging reveals a peripheral lung mass. Biopsy shows malignant glands producing mucin with irregular, infiltrative growth and desmoplastic stroma. Which additional finding would most strongly support a primary lung adenocarcinoma rather than a metastasis from the colon?
(A) Presence of signet-ring cells in the tumor (B) Strong, diffuse cytoplasmic CDX2 positivity p(C) Immunoreactivity for thyroid transcription factor-1 (TTF-1) (D) Loss of expression of E-cadherin

37.A 50-year-old oesets man presents with nephrotic syome.Ne syndrome. Renal biopsy shows membranous nephropathy.During evaluation, a 3-cm mass is found in the lung. Which mechanism best explains the association between this tumor and the patient's glomerular disease?
(A) Direct invasion of tumor into the kidney cortex
(B)Paraneoplastic secretion of renin causing glglomerular injury
(C) Obstruction of renal veins by tumor emboli
(D) Deposition of tumor-associated immune complexes in glomerular capillary walls

38.A 72-year-old woman develops a painful, indurated lesion on her lower leg. Biopsy reveals necrotizing inflammation of medium-sized arteries with fibrinoid necrosis, but nono involvement involvement of arterioles, capillaries, or venules. There is no granulomatous inflammation, and the lungs are spared. Which diagnosis best fits these findings?
(A) Leukocytoclastic (hypersensitivity) vasculitis (B) Polyarteritis nodosa
(C) Granulomatosis with polyangiitis (D)Microscopic polyangiitis

39. A 40-year-old woman presents with wlao a chronic non-healing gastric ulcer. Biopsy at the edge of the ulcer reveals dense lymphoid infiltrates infiltrates forming lymphoepithelial lesions. Immunostaining shows a marginal zone B-cell lymphoma. Which underlying condition most likely contributed to the pathogenesis of this tumor?(A) Autoimmune destruction destruction ofof parietal parietal cecells in pernicious anemia (B) Chronic Helicobacter pylori infection(C) Epstein-Barr virus latent infection of B cells(D) Celiac disease with villous atrophy

40. A 55-year-old man with a history of alcohol use presents with acute epigastric pain radiating to the back. Serum amylase and lipase are markedly elevated. Autopsy (ifperformed) would most likely show which early morphologic change in the pancreas?(A) Multiple microabscesses confined to the pancreatic ducts(B) Diffuse pancreatic fibrosis with ductal distortion and acinar atrophy (C) Well-circumscribed encapsulated collection of necrotic ecrotic debris and fluid(D) Acute hemorrhagic necrosis with fat saponification in peripancreatic tissues

41.A 68-year-old man presents with hematuria and urinary frequency. Cystoscopy reveals a papillarytumor in the bladder bladder. Pionillaothри Biopsy shows papillary urothelial carcinoma with invasion into the lamina
propria but not muscularis propria. According to the TNM staging system for bladder cancer, which on this fndi stage best corresponds to this finding?(A) Ta (B) T2 (C) T3 (D) T1

42.A 65-year-old man presents with sudden, painless loss of vision in his right eye. Funduscopic examination shows a pale retina with a cherry-red spot at the fovea. Which vascular event best
explains these findings?(A) Hypertensive rupture of retinal microaneurysms(B) Thrombotic occlusion of the central retinal vein(C) Embolic occlusion of the central retinal artery(D) Diabetic microangiopathy with neovascularization

43.A 4-year-old boy presents with leukocoria (white pupillary reflex) in his right eye. Imaging reveals an
intraocular mass. Histology after enucleation shows small round blue cells forming FlexnerWintersteiner rosettes. Which genetic abnormality is most closely associated with this tumor?
(A) Translocation t(9;22) creating the BCR-ABL fusion gene
(B) Amplification of N-MYC oncogene on chromosome 2p
(C) Isochromosome 17q abnormality
(D) Germline mutation in RB1 tumor suppressor gene on chromosome 13q14

44. A 10-year-old boy with aa history ofof recurrent bacterial infections and aldetaysoot delayed separation of the umbilical cord is found to have markedly decreased neutrophil adesiooe adhesion to endothelium on laboratory testing. Which step ofleukocyte recruitment in acute inflammation is most directly impaired in this patient?
(A) Vasodilation mediated by histamine and nitric oxide
(B) Margination of leukocytes in postcapillary venules
(C) Chemotaxis toward bacterial products (D) Firm adhesion due to defective integrins (LAD type 1)

45.A 54-year-old woman presents with a persistent nonproductive cough and progressive dyspnea. Highresolution CT shows bilateral, predominantly subpleural reticular opacities and honeycomb changes,
greatest at the lung bases. Surgical lung biopsy reveals patchy interstitial fibrosis with areas of normal
lung alternating with dense scarring and fibroblastic foci. Which of the following is the most
appropriate diagnosis?
(A) Hypersensitivity pneumonitis
(B) Nonspecific interstitial pneumonia (NSIP) (C) Cryptogenic organizing pneumonia
(D) Usual interstitial pneumonia (UIP) pattern of idiopathic pulmonary fibrosis

46.A 32-year-old nonsmoking woman presents with a solitary, well-circumscribed peripheral lung nodule
discovered incidentally on imaging. She is asymptomatic. Wedge resection reveals a lesion composed
of disorganized but benign-appearing cartilage, fibrous tissue, and clefts lined by respiratory
epithelium. Which of the following is the most appropriate diagnosis?
(A) Adenocarcinoma carcinoma in situ of the lung
(B) Metastatic lesion lesion from an extrapulmonary primary
(C) Pulmonary hamartoma
(D) Bronchial carcinoid tumor

47.A 58-year-old man with a history of asbestos exposure presents with progressive dyspnea and chest n ing reveale diffse nleural thickeni pain. Imaging reveals diffuse pleural thickening and a mass encasing the lung. Histology shows mass encasine the lung Histolooy she maianantcelle formind hular and nanillar strictres with immunobistochemistry nositive fo malignant cells forming tubular and papillary structures, with immunohistochemistry positive for calratinin and WT1 Which of the following is the most likely diagnoeis? calretinin and WT-1. Which of the following is the most likely diagnosis?
(A) Primary pulmonary adenocarcinoma
(B) Metastatic gastrointestinal adenocarcinoma to the lung
(C) Malignant mesothelioma
(D) Squamous cell carcinoma of the lung

48. A 45-year-old woman discovers a painless, firm, mobile mass in the upper outer quadrant of her right
breast. Mammography shows a well-circumscribed, radiodense lesion. Excisional biopsy reveals a
well-demarcated, biphasic tumor composed of epithelial-lined glandular spaces and aproliferating
cellular stroma. The lesion lacks significant cytologic atypia and mitotic activity. Which of the
following is the most likely diagnosis?
(A) Fibroadenoma (B) Invasive ductal carcinoma of no special type
(C) Intraductal papilloma (D) Phyllodes tumor, high grade

49. A 63-year-old woman presents with a hard, irregular mass in her left breast. Core biopsy shows
malignant ductal cells infiltrating a desmoplastic stroma. Immunohistochemical studies demonstrate
tumor cells that are estrogen receptor (ER)-positive and HER2-negative. Which of the following is the
most likely implication of this receptor profile?
(A) Lack of any predictive value for systemic therapy choices
(B) More aggressive behavior with poor response to hormone therapy
(C) Requirement for anti-HER2 targeted therapy as the main treatment
(D) Favorable prognosis with potential benefit from endocrine therapy

50. A 40-year-old woman is found to have microcalcifications on screening mammography. Stereot
biopsy shows malignant epithelial cells confined within ducts, forming cribriform and comedo patterns
with central necrosis, rosis, but no invasion beyond the basement membrane. Which of the following is the
most appropriate diagnosis?
(A) Invasive lobular carcinoma
(C) Lobular carcinoma in situ (LCIS)
(B) Ductal carcinoma in situ (DCIS)
(D) Fibrocystic changes with epithelial hyperplasia