General pathology 2008-2009

Compiled by Bhupinder Bawa

Q1. All of the following tissues have continuous capillaries except?

A. Muscle
B. Brain
C. Spleen
D. Lung
E. Bone

Q2. Glanzman’s thromboasthenia is due to defect in?

A. GPIIb
B. GPIIa
C. GPIIIa
D. A and C only
E. All of the above

Q3. Immediate increase in vascular permeability is induced by all of the following

execpt?

A. Histamine
B. Bradykinin
C. Leukotrine
D. Substance P
E. Tumor necrosis factor

Q4. The major resistance vessels within the circulatory system are
A. Veins
B. Arteries
C. Venuoles
D. Arterioles
E. Capillaries

Q5. Hemorrhage from vessel disruption is not caused by

A. Scurvy
B. Endotoxemia
C. Uremic toxins
D. Canine Adenovirus-1
E. Equine infectious anemia

Q6. Edema caused by which of the following is not due to increased hydrostatic pressure
A. Congestive heart failure
B. Constrictive pericarditis
C. Malnutrition
D. Thrombosis
E. Heat
 General pathology 2008-2009
Compiled by Bhupinder Bawa
Q7. Which of the following is not expected with congestion due to heart failure?
A. Edema
B. Cyanosis
C. Erythema
D. Tissue hypoxia
E. Hemosiderin-laden macrophages

Q8. Besides hydrostatic pressure changes, fluid movement between the intravascular and
extravascular space is mostly influenced by?

A. Urea concentrations
B. Protein concentrations
C. Sodium concentrations
D. Glucose concentrations
E. Chloride concentrations:

Q9. In a healthy animal, on average, which of the following forces is responsible for the
net filtration of fluid from arteriolar end capillaries into the interstitium?

A. Colloid osmotic pressure

B. Vascular permeability
C. Hydrostatic pressure
D. Osmolality
E. None of the above

Q10. Which of the following anti-thrombotic properties are not produced by endothelial
cells?

A. Protein S
B. Protein C receptor
C. Tissue plasminogen activator
D. Tissue factor pathway inhibitor
E. Plasminogen activator inhibitor-1

Q11. All of the following conditions can lead to an edematous state except…
A. Lymphangitis
B. Salt restricted diet
C. Venous thrombosis
D. Acute inflammation
E. Nephrotic syndrome

Q12. Which of the following is false regarding hyperemia and congestion?

A. Affected tissue has a blue-red color with congestion
B. Hyperemia is an active process where congestion is passive
C. Chronic passive congestion of the liver can lead to a “nutmeg” gross appearance
 General pathology 2008-2009
Compiled by Bhupinder Bawa
D. Hyperemia is due to increased inflow of blood, where congestion is due to diminished
outflow
E. Acute pulmonary congestion is characterized by alveolar septal edema and numerous
hemosiderin-laden macrophages

Q13. Which of the following are true regarding fluid distribution and homeostasis?

1. Movement of substances through interendothelial pores and cell

membranes is generally a passive process
2. Oncotic pressure can be influenced significantly by plasma sodium and
chloride concentrations
3. Decreased venous hydrostatic pressure results in net absorption of fluid
4. Decreased plasma oncotic pressure results in net absorption of fluid
5. Absorption may occur across entire length of capillary beds with closed
precapillary sphincters and low blood flow

A. 1,2,3
B. 1,3,5
C. 2,3,4
D. 3,4,5
E. All are true

Q14. Which of the following are true regarding hemorrhage and thrombosis?

1. Hemorrhage by rhexis can be caused by trauma or vascular erosion

2. Diapedesis is hemorrhage through small leaks in otherwise intact blood
vessels
3. The most common cause of increased platelet use is DIC
4. Acquired platelet inhibition and dysfunction is most often associated with
NSAID drugs
5. Petechial hemorrhages occur mainly through diapedesis

A. 1,2,3
B. 1,3,5
C. 2,3,4
D. 3,4,5
E. All are true

Q15. All of the following events are part of primary hemostasis except?

A. Adherence of platelets to extracellular matrix

B. Release of platelets secretary granules
C. Recruitment of additional platelets
D. Activation of platelets
E. Deposition of fibrin
 General pathology 2008-2009
Compiled by Bhupinder Bawa
Q16. Which of the following is present in the dense granules of platelets?

A. Fibronectin
B. Ionized calcium
C. Platelet factor 4
D. Factor V and VIII
E. Platelet derived growth factor

Q17. All of the following factors are directly activated by thrombin except?

A. I
B. V
C. VII
D. VIII
E. XIII

Q18. All of the followings are function of antithrombin III except?

A. Inhibition of plasmin
B. Activation of fibrinolysis
C. Inhibition of kinin formation
D. Inhibition of complement activation
E. Neutralization of thrombin and factor Xa

Q19. Which of the following is not an antithrombotic property of endothelium?

A. Production of prothrombin
B. Acts as a barrier between blood and ECM
C. Membrane bound heparin-like molecules
D. Production of tissue factor pathway inhibitor
E. Production of tissue type plasminogen activator

Q20. Which of the following is not a prothrombotic property of endothelium

A. Plasminogen activator inhibitors

B. Von Willebrand factor
C. Thrombomodulin
D. Tissue factor
E. None of the above

Q21. Which of the following is not an antithrombotic mediator of platelets

A. ATP
B. Protein S
C. Protease Nexin II
D. Thrombospondin
 General pathology 2008-2009
Compiled by Bhupinder Bawa
E. Tissue factor pathway inhibitor

Q22. Which of the following is not a prothrombotic mediator of platelets

A. ADP
B. Protein C
C. Fibrinogen
D. Thromboxane
E. Platelet factor 4

Q23. Which of the following is not a fibrinolytic inhibitor

A. Plasminogen activator inhibitor

B. Antithrombin III
C. α2-antiplasmin
D. α1-antitrypsin
E. None of the above

Q24. Which of the following is required for platelet aggregation via binding to
fibrinogen?

A. Expression of GpIIb-IIIa
B. Release of α-granules
C. Release of δ-granules
D. Production of TxA2
E. Production of NO

Q25. Which of the following is required to activate Protein C?

A. Thrombomodulin
B. Vitamin K
C. Thrombin
D. Plasmin
E. A, B & C

Q26. Thrombin can be involved in the inflammatory response in which of the following
ways?

A. Generates chemotactic molecules

B. Direct activation of mononuclear cells
C. Direct stimulation of leukocyte adhesion molecules
D. Generates fibrin split products from cleavage of fibrinogen
E. All of the above
 General pathology 2008-2009
Compiled by Bhupinder Bawa
Q27. Which of the following properties of endothelium are inhibitory to platelet
activation?
1) Nitric oxide secretion
2) Prostacyclin secretion
3) Secretion of thromboxane A2
4) Expression of adenosine diphosphatase
5) Prevents exposure to subendothelial collagen

A. 1, 2, 5
B. 1, 2, 4, 5
C. 1, 3, 5
D. 1 4, 5
E. 2, 5

Q28. Which of the following does not have inhibitory effects on thrombosis?

A. Protein C
B. Prostacyclin
C. Antithrombin III
D. Adenosine diphosphate
E. Thrombin bound to thrombomodulin

Q29. The platelet surface receptor for von Willebrands factor is?
A. Glycoprotein Ia
B. Glycoprotein Ib
C. Glycoprotein IIb
D. Glycoprotein IIIa
E. Glycoprotein IIb/IIIa

Q30. Which of the following factors does not require activation by thrombin?
A. I
B. V
C. IX
D. VIII
E. XIII

Q31. Which of the following are directly required for the amplification process that
results in the generation of large amounts of active thrombin?

1) Phospholipid surface
2) Calcium ions
3) Va
4) Xa
5) II

A. 1, 2, 5
 General pathology 2008-2009
Compiled by Bhupinder Bawa
B. 1, 2, 3, 5
C. 1, 2, 3, 4, 5
D. 3, 5
E. 3, 4, 5

Q32. Intact endothelial cells inhibit platelet adherence by producing or expressing…

1. NO
2. ADP
3. PGI2
4. TXA2
5. Tissue-type plasminogen activator (t-PA)

A. 1,2
B. 1,3
C. 1,4
D. 1,2,3
E. 1,2,3,4,5

Q33. Which of the following is false regarding platelets?

A. Alpha granules contain ADP and ionized calcium

B. ADP and TXA2 are important for platelet aggregation
C. Bernard-Soulier syndrome is a genetic deficiency of GpIb receptor
D. Platelet adhesion depends primarily on vWF-GpIb receptor associations
E. Platelet aggregation involves linking platelets via fibrinogen bridges bound to the
platelet GpIIb-IIIa receptors

Q34. The major stimulus for coagulation in vivo is…

A. Activation of factor X
B. Platelet adherence to extracellular matrix
C. Binding of HMWK, factor XII, and prekallikrein to altered endothelial surface
D. Exposure of plasma to tissue factor and subsequent extrinsic coagulation activation
E. Both c&d

Q35. The most potent and clinically significant of the coagulation inhibitors is…
A. ATIII
B. PAI-I
C. TFPI
D. Protein C
E. Protein S

Q36. Hyperhomocystenemia leading to hypercoagulable state is a result of mutation in

A. Factor V gene
B. Prothrombin gene
 General pathology 2008-2009
Compiled by Bhupinder Bawa
C. Hemocystene reductase
D. Hemocystene hydroxylase
E. Methyltetrahydrofolate reductase

Q37. Blood stasis promote thrombosis by all of the following methods except?

A. Retard inflow of clotting factors inhibitors

B. Prevent dilution of activated clotting factors
C. Bring platelets into contact with endothelium
D. Disrupt the endothelium and expose subendothelial ECM
E. Promote endothelial cell activation and leukocyte adhesion

Q38. Which of the following will not commonly increase the risk of thrombosis?

A. Vitamin E/ Selenium deficiency

B. Glomerular amyloidosis
C. Vitamin A deficiency
D. Renal insufficiency
E. Diabetes mellitus

Q39. Activation of the extrinsic coagulation pathway can lead to inhibition of coagulation
by which of the following?

1. Production of TF
2. Activation of Protein C
3. Activation of factor V and VIII
4. Converting plasminogen to plasmin
5. Inactivation of thrombin by binding to ATIII

A. 1,2,3,4,5
B. 1,3,5
C. 2,4,5
D. 2,4
E. 3,4

Q40. Dogs with nephrotic syndrome are predisposed to thrombosis due to?
A. Loss of antithrombin III
B. Loss of α-2 macroglobulin
C. Increased circulation of protein C
D. Increased circulating tissue factor
E. Loss of tissue plasminogen activators

Q41. Which of the following is NOT typical of an arterial thrombus?

A. Are red in color

B. Has a firm attachment
 General pathology 2008-2009
Compiled by Bhupinder Bawa
C. Have a laminated appearance
D. Composed predominantly of platelets and fibrin
E. Extends downstream from the point of attachment

Q42. Which of the following is not the fate of a thrombus?

A. Dissolution
B. Propagation
C. Embolization
D. Organization
E. Decanalization

Q43. Which of the following is not an embolus?

A. Fat
B. Tumor
C. Nitrogen
D. Amniotic fluid
E. Digested food

Q44. Which disease causes thrombosis due to hypercoagulability?

A. Vitamin E/Selenium deficiency

B. Purpura hemorrhagica
C. Copper deficiency
D. Diabetes mellitus
E. Bovine pestivirus

Q45. During non-progressive stage of shock all of the following can result in
vasoconstriction except?

A. ADH
B. Heat
C. Endothelin
D. Increased O2
E. Angiotension II

Q46. In an ischemic cell, the breakdown product of ATP is?

A. Urates
B. Hypoxanthine
C. Superoxide anions
D. Hydrogen peroxide
E. All of the above

Q47. At low dose, LPS can serve all the following functions except?
 General pathology 2008-2009
Compiled by Bhupinder Bawa

A. Activation of monocytes and macrophages

B. Activation of intrinsic coagulation cascade
C. Activation of complement
D. Activation of endothelium
E. Systemic vasodilation

Q48. Infarction caused by venous thrombosis is most likely to occur in which of the
following tissues?
A. Heart
B. Lung
C. Testis
D. Liver
E. Skeletal muscle

Q49. Which of the following is not directly associated with endotoxic shock?

A. Il-1 release
B. Activation of factor XII
C. Downregulation of TFPI
D. Increased thrombomodulin expression
E. Upregulation of cell adhesion molecules

Q50. Ischemia due to infarction is not dependant on (Robbins 139)

A. Vascular supply to the organ

B. Oxygen saturation of the blood
C. Reperfusion ability of the organ
D. Rate of development of occlusion
E. Vulnerability of the organ to hypoxia

Q51. Which organ is likely to develop a chronic hemorrhagic infarct (Robbins 138)

A. Lung
B. Brain
C. Heart
D. Kidney
E. Spleen

Q52. Which organ is likely to undergo liquefactive necrosis due to infarction (PBVD 94)

A. Lung
B. Brain
C. Heart
D. Kidney
E. Spleen
 General pathology 2008-2009
Compiled by Bhupinder Bawa
Q53. In which of the following scenarios would an infarct likely lead to the most tissue
damage?

A. Slowly developing infarct in the lung

B. Rapidly developing infarct in the lung
C. Slowly developing infarct in the spleen
D. Rapidly developing infarct in the spleen
E. All would cause similar tissue damage

Q54.Which of the following is false regarding LPS and septic shock?

A. At low doses, LPS predominantly activates monocytes and macrophages

B. Gram negative bacteria and several species of Staphylococcus have LPS in their
cell wall
C. At higher LPS levels, the increased production of IL-1 and TNF leads to the
cascade of events that result in septic shock
D. All of the cellular and hemodynamic effects of septic shock may be reproduced
by injection of LPS alone
E. Mice lacking LPS-binding protein, CD14, or the mammalian TLR-4 are protected
against the effects of LPS

Q55.Which of the following is an example of shock caused by a cytokine independent

pathway?

A. Electrocution
B. Gram negative sepsis
C. Severe fear or emotional distress
D. Vaccine-induced anaphylactic shock
E. Both a and c

Q56.Which of the following is not a characteristic of the non-progressive stage of shock?

A. Increased ADH release

B. Increased cardiac output
C. Increased peripheral resistance
D. Shifting from aerobic to anaerobic metabolism
E. Shifting of fluids from the interstitium into the plasma

Q57. Trisomy is an example of a

A. Chromosome mutation
B. Frameshift mutation
C. Genome mutation
D. Gene mutation
E. Point mutation
 General pathology 2008-2009
Compiled by Bhupinder Bawa
Q58. The loss of a single base in a sequence is an example of a (Robbins 148)

A. Frameshift mutation
B. Gene mutation
C. Point mutation
D. A & B
E. All of the above

1. C; (PBVD 66) spleen and liver has discontinuous capillaries

2. D; (PBVD 83)
3. E; (PBVD 72) TNF is late inducer of vascular permeability by causing cytoskeletal
rearrangement.
4. D (PBVD 63)
5. E(due to platelet destruction) (PBVD 83)
6. C(decreased oncotic pressure from low protein intake D (Robbins pp120)
7. C (Robbins p.122)
8. B – Sodium and chloride concentrations rapidly equilibrate across the endothelium
and therefore do generally do not contribute to net fluid shifts. Urea is an ineffective
osmole because it too rapidly diffuses to reach equilibrium (PBVD p. 67)
9. C (PBVD pp69). In the arteriolar side the hydrostatic pressure overcomes the plasma
colloidal pressure under normal circumstances leading to fluid leaving the capillaries.
Reduced hydrostatic forces and colloid osmotic pressures are responsible for the net
movement of fluid into venous side capillaries.
10. E (PBVDpp 70) PAI-1 is Pro-coagulant by inhibiting the activation of plasmin
resulting in decreased fibrinolysis.
11. B. (Robbins p.120) Excessive sodium intake with renal insufficiency would be
correct
12. E (Robbins p.122)Chronic pulmonary congestion may contain hemosiderin-laden
macrophages (heart failure cells)
13. B (PBVD p.67) Sodium and chloride account for approximately 84% of total plasma
osmolality but contribute minimally to oncotic pressure since they move freely
through interendothelial pores. Increased plasma oncotic pressure results in net
absorption of fluid
14. E (PBVD p.83
15. E; (Robbins pp 124) deposition of fibrin is event during secondary hemostasis
16. B; (Robbins pp 126) the rest are part of alpha granule of platelet
17. C; (PBVD 78)
18. B: (PBVD pp 81) ATIII inhibits fibrinolysis by inhibition of plasmin
19. A(Robbins 125/PBVD 75)
20. C (Robbins 126/PBVD 75)
21. D (PBVD 76)
22. B (PBVD 76)
23. E (PBVD 81)
 General pathology 2008-2009
Compiled by Bhupinder Bawa
24. C (p127 Robbins). ADP is released from δ-granules and causes a conformational
change in GpIIa-IIIb which allows it to bind to fibrinogen.
25. E (p125 Robbins). Thrombomodulin converts thrombin to an anti-coagulent capable
of activating Protein C. Proteins C is vitamin K dependent.
26. E (p127,129,130 Robbins). Through PAR’s (protease-activated receptors) thrombin
prostaglandins and chemokines, and upregulates expression of adhesion molecules
from endothelium. It also directly activates mononuclear cells, and directly stimulats
neutrophil and mononuclear cell adhesion. And by splitting fibrinogen it creates
fibrin split products which are chemotactic.
27. B (Robbins p. 125)
28. D (Robbins p. 126)
29. B (Robbins p. 124)
30. C (Robbins p. 128)
31. C (Robbins p. 129)– the complex of all these components is known as the
prothrombinase complex
32. B (Robbins p.125)
33. A- (Robbins p.126-127) Dense bodies (or δ granules) contain ADP, ATP, ionized Ca,
histamine, serotonin, and epinephrine
34. D (PBVD p. 78-79)
35. A (PBVD p.81)
36. E; (Robbins pp 132)
37. D; (Robbins pp 131)
38. C (p 87 PBVD) (a) causes microangiopathy leading to endothelial damage, (b) leads
to loss of ATIII, (d) causes uremia and injury to endothelium, (e) causes
microangiopathy by causing thickening of capillary BM, and enhanced platelet
activity.
39. C (p91 PBVD)
40. A PBVD p. 87
41. A PBVD p. 87
42. E (Robbins pp 133)
43. E (Robbins pp 136)
44. D (PBVD pp 87) (Vit E deficiency causes microangiopathy, Purpura causes
vasculitis, Copper deficiency causes aneurysm, Bovine pestivirus is epitheliotrophic,
Diabetes enhances platelet activity)
45. B; (PBVD pp 98)
46. B; (PBVD pp 94) The breakdown product is hypoxanthine, which in the absence of
O2 is non reactive but if the tissue is reperfused it is converted by xanthine oxidase by
urates, hydrogen peroxide and superoxide anions.
47. E (Robbins pp140, PBVD pp97)systemic vasodilation takes place with high dose of
LPS
48. C (PBVD 138) – tissues that have a single venous outflow channel (e.g. testis and
ovary) are most susceptible
49. D (PBVD 140)– thrombomodulin expression is downregulated, contributing to the
hypercoagulable state
50. C (Robbins pp 139)
51. A (Robbins pp 138) due to dual blood supply
 General pathology 2008-2009
Compiled by Bhupinder Bawa
52. B (PBVD pp 94)
53. D (Robbins p.139) Dual blood supply is the most important factor in determining
whether occlusion of vessel causes damage. Slowly developing occlusions are less
likely to cause infarction because of developing alternative perfusion pathways.
54. B (Robbins p.140-141) Only gram negative bacteria have LPS in their cell wall.
Staph can produce a group of bacterial superantigens (toxic shock syndrome toxin-1)
that cause syndromes similar to septic shock
55. E (PBVD p.97) - In neurogenic causes of blood maldistribution shock, cytokine
release is not a major factor in the initial peripheral vasodilation (there are autonomic
discharges).
56. D (PBVD p.98) Cellular metabolism becomes less efficient and shifts from aerobic to
anaerobic metabolism in the progressive stage of shock.
57. C (Robbins 147)
58. D (Robbins 148)
59.

PBVD chapter 4
BGC

1. Which of the following cytokines are NOT strongly involved in fibroblast and
myofibroblast proliferation in wounds?

A. TGF-α
B. TGF-β
C. VEGF
D. PDGF
E. IL-13

Answer: A p156 and 166

2. Which of the following chemicals are not produced by dendritic cells to induce a TH1
response?

A. IL-12
B. IL-18
C. IL-23
D. IL-27
E. None of the above

Answer: E p157 The TH1 cells then release IL-2 for proliferation of T lymphocytes that
produce IFN-γ, and TNF-β which activate macrophages.
IFN-γ can inhibit TH2 pathway.

3. Which of the following are most important in directing the TH2 T cell response?
 General pathology 2008-2009
Compiled by Bhupinder Bawa
A. IL-5, IL-10
B. IL-4, IL-10
C. IL-5, IL-13
D. IL-4, IL-5
E. None of the above

Answer: B p158

4. Which of the following can inhibit macrophages?

1) glucocorticoid receptor activation

2) Phagocytosis of apoptotic bodies
3) Acetylcholine
4) IFN-γ
5) IL-10

A) 1,2,3,4,5
B) 1,2,3,5
C) 2,3,4,5
D) 2,3,5
E) 1,2,5

Answer: A p162-163 Vagal release of Ach modulates macrophage activity and TNF-a
release. I think IFN-y is a dose response effect of inhibition.

5. Which of the following cause fibroblast proliferation?

1) TGF-β
2) IL-13
3) PDGF
4) VEGF
5) Proline

A) 1,2,3,4,5
B) 1,2,3,5
C) 2,3,4,5
D) 2,3,4
E) 3,4,5

Answer: A p160

6) A TH1 response typically causes elaboration of which of the following?

1) IL-1
2) IL-12
3) IFN-γ
 General pathology 2008-2009
Compiled by Bhupinder Bawa
4) NOS2
5) TNF-α

A) 1,2,3,4,5
B) 2,3,4,5
C) 2,3,5
D) 2,4,5
E) 3,4,5

Answer: A p161 fig 4-7 Cytokines from a TH1 response induce NOS2 and create NO
and citrulline from arginine which causes less fibrosis

7) A TH2 response typically causes elaboration of which of the following?

1) IL-4
2) IL-10
3) TGF-β
4) GM-CSF
5) Arginase

A) 1,2,3,4,5
B) 1,2,3,4
C) 1,2,4,5
D) 2,3,4,5
E) 2,3,4

Answer: A p161 fig 4-7 MMP9 is also produced and converts latent TGFB to active
TGF-B which acts directly on fibroblasts. Arginase produces L-Ornithine which produces
Polyamine cell proliferation and Proline collagen production.

8) PPAR’s reduce the chronic inflammatory response by which of the following

mechanisms?

A) Inhibit NFκB, STATs, AP-1 and NFAT

B) Decreses iNOS expression
C) Inhibits IL-6, IL-12, and VCAM-1 expression
D) all of the above
E none of the above

Answer: D p163

9) Diffuse granulomatous inflammation occurs with which of the following?

A) Protozoal infections
B) Deep mycoses
C) Nocardia spp
 General pathology 2008-2009
Compiled by Bhupinder Bawa
D) brucella spp
E) All of the above

Answer: E p165

10) Pyogranulomatous inflammation is often seen with which of the following?

A) Blastomyces dermatitidis
B) Protozoal infections
C) Mycobacteria
D) Johnes
E) All of the above

Answer: A p165

11) Granulomas differ from granulomatous inflammation in which of the following

ways?

A) Granulomas are a distinct type of granulomatous inflammation that occurs as a well-

defined area forming a distinct mass
B) Granulomas have a cellular exudate consisting of activated macrophages
C) Granulomas cause diffuse thickening of a mucosal layer
D) Granulomas can be arranged in a haphazard manner
E) All of the above

Answer: A p165

12) Firm adhesion of monocytes to endothelium is mediated by which of the following?

A) LFA-1 (CD11a/CD18)
B) VLA-4 (α4β1 integrin)
C) Mac-1 (CD11a/CD18)
D) VCAM-1/ ICAM-1/2
E) All of the above

Answer: E p167
Only VCAM and ICAM are endothelial molecules the rest are monocyte molecules

13) Transmigration of Monocytes are mediated by all of the following except?

A) PECAM-1
B) ICAM-1
C) JAM A
D) LFA-1
E) None of the above
 General pathology 2008-2009
Compiled by Bhupinder Bawa
Answer: B p167 in addition to those above monocytes and other leukocytes pass
between endothelial cells and separate the tight junctions and VE-cadherins

14) Classic activation of macrophages occurs through which mediators?

A) TH1 responses
B) IL-12
C) IFN-γ
D) all of the above
E) None of the above

Answer: D p167

15) Innate immune activation of macropahges can involve all of the following except?

A) LPS
B) Teichoic acid
C) Oxidized LDL’s
D) Heat shock proteins
E) All of the above

Answer: E p167 Activation by binding all of the above molecules to TLR’s

16) Alternative activation of macrophages can occur through which of the following?

A) TH2 responses
B) IL-13
C) IL-4
D) All of the above
E) None of the above

Answer: D p167

17) Innate activation of macrophages leads to release of which of the following?

A) Reactive Oxygen Species

B) Nitric Oxide
C) IFN-α
D) IFN-β
E) All of the above

Answer: E p168

18) Classic activation with IFN-y leads to which of the following?

1) Expression of MHC II antigen

 General pathology 2008-2009
Compiled by Bhupinder Bawa
2) delayed hypersensitivity
3) Respiratory burst
4) Release of IL-1
5) Release of TNF

A) 1,2,3,4,5
B) 1,2,4,5
C) 2,3,5
D) 2,4,5
E) 4,5

Answer: A p168

19) Alternative activation can lead to which of the following?

A) Enhancing MHC II
B) Expression of mannose receptors
C) Enhancement of humoral immunity and allergic responses
D) All of the above
E) None of the above

Answer: D p 168

20) which of the following can deactivate macrophages?

A) Phagocytosis of apoptotic cells

B) phagocytosis of reduced LDL’s
C) Storage of mannose receptors in lysosomes
D) all of the above
E) None of the above

Answer: A p168- Phagocytosis of apoptotic bodies, and storage of oxidized LDL’s in

lysosomes can deactivate macrophages

21) Canine cutaneous histiocytomas are derived from which of the following?

A) Langhan’s type Macrophages

B) Langerhans’s cells
C) Stem cells
D) Mast cells
E) None of the above

Answer: B p170

22) Which of the following mediate dendritic cell migration to lymph nodes?
 General pathology 2008-2009
Compiled by Bhupinder Bawa
A) CD34
B) CCL21
C) ICAM-1
D) All of the above
E) None of the above

Answer: B p170

23) Dendritic cells that mediate suppression of immune responses are called?

A) Telomeric
B) Tolerogenic
C) Langerhan’s
D) Telomerogenic
E) None of the above

Answer: B p172

24) Which of the following are most likely to be involved in granuloma formation?

A) α/β T Lymphocytes
B) γ/δ T lymphocytes
C) B Lymphocytes
D) Dendritic cells
E) None of the above

Answer: B p172- α/β T lymphocytes are key to regulation of adaptive immunity. These
cells differentiate into effector memory lymphocytes (extra lymphoid) and central
memory lymphoid sites which settle into the blood and lymphoid organs. Memory
lymphocytes can contribute to the persistence of chronic inflammation and granuloma
formation.

25) T regulatory lymphocytes can influence the strength and balance of TH1 and/or TH2
responses through secretion of which of the following?

1. TGF-β
2. IL-12
3. IL-10
4. IL-4
5. IL-3

A. 1,2,3
B. 1,3,4
C. 2,3,4
D. 2,4,5
E. 3,4,5
 General pathology 2008-2009
Compiled by Bhupinder Bawa

Answer: B. P172

26) Natural Killer cells are activated by which of the following?

1. IL-12
2. IFN-γ
3. TNF-β
4. TNF-α
 General pathology 2008-2009
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5. Type 1 interferons

A. 1,3,4
B. 1,4,5
C. 1,5
D. 2,3,4
E. 2,3

Answer: C p173

27) Which of the following is NOT true of myofibroblasts?

A. They form in response to TGF-β

B. They are specialized smooth muscle cells
C. They form in response to tissue plane stress
D. Platelets and macrophages can induce their formation
E. They connect their actin filaments to extracellular proteins

Answer: B p186

Robbins Chapter 4
BGC

1. Severe and generalized edema with profound subcutaneous swelling is called?

A. Anaphylaxis
B. Maledema
C. Anasarca
D. Shock
E. None of the above

Answer: B p120

2. Protein rich edema is usually caused by which of the following?

A. Increased capillary pressure

B. Decreased oncotic pressure
C. Increased oncotic pressure
D. Inflammation
E. All of the above

Answer: D p120

3. Endothelial factors produced during coagulation that INHIBIT platelet aggregation

include?
 General pathology 2008-2009
Compiled by Bhupinder Bawa
1. NO
2. PGI2
3. Protein C
4. thrombomodulin
5. adenosine diphosphatase

A. 1,2,4
B. 1,2,5
C. 1,3,4
D. 2,3,5
E. 2,4,5

Answer: B p125. Platelet inhibitors are NO, PGI2, and ADPase. Protein C and
thrombomodulin interfere with the coagulation cascade.

4. Platelet adhesion to subendothelial collagen involves which fo the following?

1. VWF
2. Gp1b
3. Factor V
4. Factor IX
5. GpIIb-IIIa

A. 1,2,3,4,5
B. 1,2,3,4
C. 1,2,3
D. 1,2
E. 1

Answer: B p127

5. Which of the following will not lead to thrombus formation?

A. Radiation
B. Hypertension
C. Cigarette smoke
D. Turbulent blood flow
E. Hypocholesterolemia

Answer: E p131. Hypercholesterolemia may initiate endothelial injury

6. Laminar blood flow helps prevent thrombus formation by all of the following
mechanisms except?

A. Helps prevent endothelial activation

 General pathology 2008-2009
Compiled by Bhupinder Bawa
B. Helps dilute activated ckotting factors
C. Prevents platelet contact with endothelium
D. Allows the inflow of clotting factor inhibitors
E. Resists the turbulent blood flow caused by atherosclerotic plaques

Answer: E. p131.

7. Reperfusion injury results from all of the following EXCEPT?

A. The addition of oxygen to hypoxanthine and xanthine oxidase

B. Increased fluid accumulation in the interstitium
C. Breakdown of ATP to adenosine
D. Release of tissue factor
E. Additional thrombosis

Answer: C p 94 PBVD Adenosine is produced after a short period of ischemia and is a

potent vasodilator and help to relieve the ischemia.

Robbins 4

Q. Select one best combination

Endothelium prevents platelet aggregation by

1. TNFα
2. Bradykinin
3. Nitric oxide
4. Prostacyclin
5. Adenosine diphosphatase

a. 1,2,3
b. 1,2,4
c. 1,2,5
d. 2,3,4
e. 3,4,5

Answer. e Ref. page 125

All of the following can produce a hypercoaguable state and thus increase thrombosis
except:
A) Protein S deficiency
B) Antithrombin III deficiency
C) Increased PGI2 release by endothelium
D) Altered factor V resistant to protein C cleavage
E) Increased hepatic syntheses of coagulation factors
 General pathology 2008-2009
Compiled by Bhupinder Bawa

Answer: C pages 131-132

The following are potential outcomes of venous thrombosis except:

A) Embolization to lungs
B) Dissolution/Resolution
C) Organization and recanalization
D) Migration into abdominal cavity
E) Organization and incorporation into vessel wall

Answer: D page 134

Q. Antithrombotic effects of endothelium are mediated by all of the followings, except

a. Factor VIIIa
b. Thrombomodulin
c. Heparin-like molecule
d. Tissue factor pathway inhibitor
e. Tissue-type plasminogen activator

Answer. a Ref. page 125

Q. Which of the following reaction in the coagulation cascade involves

phospholipids as a cofactor?

a. Tissue factor activation

b. Prothrombin activation
c. Factor XIII activation
d. Factor XII activation
e. Factor XI activation

A. b ref. Page 128, Fig 4-9

Place the following in the correct order.

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1) Vasoconstriction
2) Endothelial Injury
3) Formation of fibrin clot
4) Aggregation of platelets
5) Adherence of platelets to the extracellular matrix

A) 1, 2, 3, 4, 5
B) 1, 5, 2, 3, 4
C) 2, 1, 4, 5, 3
D) 2, 1, 5, 4, 3
E) 5, 4, 3, 2, 1

Answer: C Page: 124-125

Which of the following is not an antithrombotic property of endothelial cells?

A) Synthesis of nitric oxide

B) Synthesis of prostacyclin
C) Synthesis of tissue factor
D) Expression of thrombomodulin
E) Expression of heparin-like molecules

Answer: C Page: 125-126

A mutation that eliminates the ability of platelets to secrete their granules would result in
which of the following.

A) Inefficient coagulation due to a lack of calcium.

B) Decreased platelet adhesion due to a lack of glycoprotein Ib.
C) The inability to prevent platelet aggregation via prostacyclin.
D) The inability to stimulate platelet aggregation via thromboxane.
E) The inability to initiate the coagulation cascade via tissue factor.

Answer: A Page: 126-127

Which of following does not influence whether or not an organ develops an infarct after
vascular occlusion?
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Compiled by Bhupinder Bawa
A) Occlusion of the arterial blood supply versus the venous drainage
B) The rate of development of the vascular occlusion
C) The nature of the vascular supply to the organ
D) The vulnerability of the tissue to hypoxia
E) The oxygen content of the blood

Answer: A Page #137-139

Which of the following mediators directly causes vasodilation in septic shock?

A) Histamine
B) LKT-B4
C) TNF-α
D) Il-1
E) NO

Answer: E Page #139-143, 74-75

Categories the following as being either characteristic of arterial thrombi (AT) or venous
thrombi (VT) eh!: P132-133

1) Contains more erythrocytes__VT___

2) Creates a long cast in the lumen _VT_____
3) Occlusive__AT___
4) Common site of occurrence in lower extremities__VT___
5) Contain more platelets__AT___
6) Grows in retrograde direction__At or VT__
7) Common sites of occurrence are coronary, cerebral, femoral arteries__AT___
8) Occurs in sites of stasis__VT___
9) Invariably occlusive__VT__
10) Extends in the direction of blood flow__VT___
11) Occurs due to endothelial injury or at sites of turbulence__AT__

The following are characteristics of red infarcts EXCEPT: (Page138)

 General pathology 2008-2009
Compiled by Bhupinder Bawa
1) Occur in previous congested tissues
2) Occur in solid tissues
3) Occur at site of previous arterial occlusion
4) Occur with venous occlusions
5) Occur in tissues with end-arterial circulation

A) 1,3,4
B) 1,4,5
C) 2,3,5
D) 2,5
E) 3,5

The following are antithrombotic properties of endothelial cells except:

A) Tissue factor
B) Heparin-like molecule
C) Thombomodulin receptor
D) Adenosine diphosphatase expression
E) Tissue-type plasminogen activator (t-PA) synthesis

Answer: A , pages 124-125

The following are true regarding thrombin except:

A) Directly induces platelet aggregation
B) Activates mononuclear inflammatory cells
C) Involved in generation of cross-linked fibrin
D) Binds to intrinsic tyrosine kinase activity receptor
E) Activates endothelium to generate leukocyte adhesion molecule

Answer: D , pages 128,129

The following are true regarding LPS except:

A) Causes most cases of septic shock
B) Consists of toxic fatty acid (lipid A) and polysaccharide coat
C) Causes mononuclear cell activation and production of IL-1 and TNF
D) Over time there are successive waves of IL-6/IL-8, TNF and IL-1 respectively
E) LPS binding protein, CD 14 and mammalian TLR-4 are necessary for toxic effects

Answer: D pages 140-141

The following are true regarding heparin-like molecules except:

1) Interacts with anti-thrombin III
2) Present on surface of endothelial cells
 General pathology 2008-2009
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3) Present on surface of activated platelets
4) Cofactor that inactivates tissue factor Va and VIIIa
5) Cofactor that inactivates thrombin, factor Xa, and IXa

A) 1,2
B) 2,3
C) 2,4
D) 3,4
E) 4,5

Answer: D page 125,126

The following contribute to platelet aggregation except:

A) Adenosine diphosphate
B) GP IIb-IIa receptors
C) Thromboxane A2
D) Prostacyclin
E) Fibrinogen

Answer: D page 126

Pulmonary edema most typically occurs with the following except:

A) Renal failure
B) Pulmonary infections
C) Hypersensitivity reactions
D) Left ventricular heart failure
E) Right ventricular heart failure

Answer: E page 122

Petechial hemorrhages are typically associated with the following except:

A) Low platelet counts
B) Clotting factor deficits
C) Defective platelet function
D) Vascular inflammation (vasculitis)
E) Locally increased intravascular pressure

Answer: D page 123

 General pathology 2008-2009
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The following are necessary components for the LPS activation of endothelium and
Leukocytes except:
A) Toll-like receptor protein 4 (TLR-4)
B) Toll-like receptor protein 3 (TLR-3)
C) Bacterial wall lipopolysaccharides
D) LPS binding protein
E) CD14

Answer: B page 140

Turbulence contributes to arterial or cardiac thrombosis by all of the following

mechanisms except:
A) Disruption of laminar flow
B) Promotes endothelial cell activation
C) Retards inflow of clotting factor inhibitors
D) Prevents dilution of activated clotting factors
E) Causes Factor V to be resistant to cleavage by protein C

Answer: E inherited defect in Factor V page 131

Elephantiasis results from

A. Reduced plasma osmotic pressure

B. Increased vascular permeability
C. Increased hydrostatic pressure
D. Lymphatic obstruction
E. Sodium retention

(Answer D ref. page 121)

Robbins Chap. 4 p. 119-124

All of the following are characteristics of iron-deficiency anemia in dogs except: (FVCP
p. 146-151, 108, 172)
A) hypoferremia
B) thrombocytosis
C) hypoferritinemia
D) microcytic hypochromic anemia
E) increased serum total iron binding capacity (TIBC)

Answer: E (increased TIBC is present in other species with Fe deficiency but not dogs)

Which of the following would induce edema due to increased intravascular hydrostatic
pressure?
 General pathology 2008-2009
Compiled by Bhupinder Bawa
A. sporotrichosis
B. polioencephalomalacia
C. Type I hypersensitivity
D. Type III hypersensitivity
E. gastric dilation and volvulus

Answer: E pg 71, Box 2-2, Pathologic Basis of Veterinary Disease

Which of the following statements regarding hyperemia and congestion is false? (pp 122-
123)

F. Hyperemia is an active process.

G. Congestion is a passive process.
H. In both, the cut surfaces of tissues are hemorrhagic and wet.
I.Both indicate a local increased volume of blood in a particular tissue.
J. In both, increased inflow leads to engorgement with oxygenated blood.

Answer: E

Glanzmann thrombasthenia is a congenital bleeding disorder caused by a mutation of

A. von Willebrand factor

B. Glycoprotein IIb-IIIa
C. Antithrombin III
D. Glycoprotein Ib
E. Tissue factor

(Answer B ref. page 127, fig. 4-8. Vet Pathol 2006 (1) page 78-82)

Which of the following inhibits platelet aggregation?

A. Adenine nucleotides
B. Thromboxane A2
C. Prostacyclin
D. Fibrinogen
E. Thrombin

(Answer C ref. page 125,127)

Which of the following statements regarding thrombomodulin is correct? (p 125)

A. It’s a heparin-like molecule.

B. It inhibits platelet aggregation.
 General pathology 2008-2009
Compiled by Bhupinder Bawa
C. It promotes fibrinolytic activity.
D. It interacts with antithrombin III to inactivate thrombin.
E. It converts thrombin to an anticoagulant that can activate protein C.

Answer: E

Which of the following molecules is not secreted by endothelial cells? (p 125-127)

A. Prostaglandin I2 (PGI2)
B. Thromboxane A2 (TxA2)
C. Tissue factor pathway inhibitor
D. Plasminogen activator inhibitors (PAIs)
E. Tissue-type plasminogen activator (t-PA)

Answer: B
All of the following are endothelial mediators with anticoagulant properties except:
A) Thrombomodulin
B) Prostacyclin (PGI2)
C) Heparin-like molecules
D) Tissue plasminogen activator
E) Adenosine triphosphate (ATP)

Answer: E from platelets Tables page 75-76 (Path. basis of vet disease)

All of the following are platelet derived mediators with procoagulant properties except:
A) Calcium
B) Tissue Factor
C) Thrombospondin
D) Thromboxane A2
E) Adenosine triphosphate (ATP)

Answer: B endothelium derived Tables page 75-76 (Path. basis of vet disease)

Which of the following is the single most important factor to thrombus formation?

A. Blood flow turbulence

B. Endothelial integrity
C. Coagulation factor
D. Blood flow stasis
E. Platelet activity

(Answer B ref. page 131, fig 4-14 Virchow triad in thrombosis)

Enhanced platelet activity occurs in all of the following pathologic states EXCEPT:
(McGavin & Zachary, p 78)
A. Antithrombin III deficiency
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Compiled by Bhupinder Bawa
B. Malignant neoplasia
C. Heartworm disease
D. Diabetes mellitus
E. Uremia

Answer: A

Dogs with nephritic syndrome have abnormal levels of which of the following that may
lead to a hypercoagulable state?

A. Factor I
B. thrombin
C. Factor VIII
D. Platelet activity
E. antithrombin III

Answer: E pg 87, PBVD

Which of the following may occur in shock caused by blood maldistribution?

1. generation of C3a & C5a

2. activation of Factor XII by LPS
3. release of platelet activating factor
4. widespread mast cell degranulation
5. peripheral vasodilation resulting from autonomic discharges

A. 1
B. 1,2
C. 1,2,3
D. 1,2,3,4
E. 1,2,3,4,5

Answer: E PBVD pg. 97

Engagement of TLR-4 on endothelial cells by LPS complex directly initiates the

following:
1) Activation of protein C
2) Increased synthesis of TFPI
3) Decreased synthesis of TFPI
4) Increased synthesis of thrombomodulin
5) Decreased synthesis of thrombomodulin

A) 1,2
B) 1,3
C) 2,3
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D) 3,4
E) 3,5

Answer: E page 140

Pro-coagulant effects( thrombomodulin+ thrombin activates protein C with protein S

which inhibits clotting by cleavage of activated factor 5 and 8)
TFPI(Tissue factor pathway inhibitor) activated tissue factor-factor VIIa and Xa

All of the following can revert to normal if an animal survives an episode of shock
except:
A) Hepatocytes
B) Cardiac myocytes
C) Gastrointestinal epithelium
D) Kidney tubular epithelium
E) Adrenal cortical epithelium

Answer: B Page 142

All of the following can directly cause a decrease in plasma oncotic pressure except:
A) Malnutrition
B) Liver cirrhosis
C) Nephrotic syndrome
D) Constrictive pericarditis
E) Protein losing gastroenteropathy

Answer: D page 120

Left ventricular heart failure will directly cause all of the following:
A) Ascites
B) Liver cirrhosis
C) Hemoabdomen
D) Pulmonary edema
E) Chronic passive congestion of liver

Answer: D page 122

Q1. Fenestrated capillaries are present in all of the following tissues except? (PVBD pp
66)
 General pathology 2008-2009
Compiled by Bhupinder Bawa
A. Intestinal villi
B. Choroid plexus
C. Cilliary process of eye
D. Glomerular capillaries of kidney
E. Capillary endothelium in lung alveoli

Q2. Immediate increase in permeability is induced by all of the following mediators

except (PBVD pp 72)
F. Histamine
G. TNF-α
H. Bradykinin
I. Leukotrines
J. Substance P

Q3. Hemorrhage due to thrombocytopenia can take place in all of the following condition
except (PBVD pp 83)
A. Radiation injury
B. Parvovirus infection
C. Systemic lupus erythematosus
D. Equine infectious anemia
E. Chediak-Higashi syndrome

Answers:
1) E. Alveoli capillary endothelium is example of continuous capillary
2) B. TNF increases permeability by cytoskeletal rearrangement of endothelial cells
and endothelial cell retraction and not by endothelial contraction.
3) E. A and B leads to decreased production of platelets, C leads to increased
platelet destruction by direct immune mediated destruction, D is viral induced
immune mediate destruction, E is abnormal synthesis or release of platelet
granules.

1) The defect in Glanzmann’s thrombasthenia is

A) Mutation affecting calcium binding domain of the extracellular portion of GPIIb

B) Deficient release of platelet granule content
C) Deficiency of GPIb on the platelet surface
D) Abnormal synthesis of platelet granules
E) Defective platelet storage of ADP

2) Hemophilia A is a result of deficiency of

A) Factor 1
B) Factor II
C) Factor X
 General pathology 2008-2009
Compiled by Bhupinder Bawa
D) Factor IX
E) Factor VIII

1) Answer: A; PBVD 83; B=storage pool disease; C=Bernard-Soulier syndrome;

D=along with defective release is reported in Simmental cattle, dogs, cats and fawn-
hooded rats.
E= occurs in Chediak-Higashi syndrome
2) Answer E; PBVD 84; Factor IX deficiency = hemophilia B

Which of the following statements about edema is FALSE (p. 120-121)?

A) Increased capillary pressure can result in increased interstitial fluid.
B) Decreased lymphatic drainage can lead to increased interstitial fluid.
C) Decreased intravascular colloid osmotic pressure can result in increased
interstitial fluid.
D) Inflammatory edema is a protein-rich exudate and is usually caused by
increases in vascular permeability.
E) Congestive heart failure leads to decreased cardiac output, decreased renal
vasoconstriction, and induction of sodium and water retention through
stimulation of the renin-angiotensin-aldosterone system.

Answer: E

Which one of the following is not a characteristic of iron-deficiency anemia in dogs?

(FVCP p. 146-151, 108, 172)
F) hypoferremia
G) thrombocytosis
H) hypoferritinemia
I) microcytic hypochromic anemia
J) increased serum total iron binding capacity (TIBC)

Answer: E (increased TIBC is present in other species with Fe deficiency but not dogs)

1) The major resistance vessels within the circulatory system are:

A) Arteries
B) Arterioles
C) Capillaries
D) Veins
E) Venules

Answer: B PBVD p63

2) Regarding endothelial cell bioactive mediators, the following are true except:
 General pathology 2008-2009
Compiled by Bhupinder Bawa

A) Nitric oxide promotes smooth muscle relaxation and vasodilation

B) Endothelin-1 promotes smooth muscle contraction and vasoconstriction
C) Endothelial cells express E-selectin in response to cytokines to promote neutrophil
rolling
D) Tissue factor is released in response to injury to activate the extrinsic coagulation
pathway
E) Prostacyclin promotes the adhesion of platelets to the endothelium and promotes clot
formation

Answer: E PBVD p69

3) Glanzmann’s thrombasthenia occurs due to a deficiency or defective function of:

1) GPIb
2) GPIIa
3) GPIIb
4) GPIIIa
5) GPIIIb

A) 1, 2
B) 2, 4
C) 3, 4
D) 3, 5
E) 4, 5

Answer: C PBVD p83

2) Which of the following is NOT vitamin-K dependent? PBVD p81

A) II
B) IX
C) Protein C
D) XI
E) VII

Answer: E

3) The activity of thrombin includes which of the following? PBVD p82

1) Destruction of V and VIII when the concentration of thrombin is high

2) Activation of V
3) Activation of VIII
4) Activation of XI
5) Platelet activation
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A) 1, 2, 3, 4
B) 1, 2, 3, 4, 5
C) 2, 3, 4, 5
D) 2, 3, 5
E) 2, 3

Answer: B

4) Which of the following is NOT a constituent of dense bodies (δ granules) within

platelets?
Robbins p 126
A) ADP
B) histamine
C) ionized calcium
D) epinephrine
E) platelet-derived growth factor

Answer: E

1) The following contribute to antithrombotic properties of endothelium EXCEPT

A) Intact endothelium
B) Prostacyclin and nitric oxide synthesis
C) Expression of adenosine diphosphatase
D) Interaction of thrombomodulin and thrombin
E) Secretion of inhibitors of plasmingoen activator

1) Answer: E; Page 126; intact endothelium, prostacyclin, nitric oxide and ADPase have
anti-platelet effect; Interaction of thrombomodulin with thrombin converts thrombin from
a procoagulant molecule to anticoagulant molecule which activates protein C. Protein C,
along with protein S, in turn cleaves factors Va and VIIIa . Inhibitor of plasminogen
activator prevents t-PA; thus inhibiting conversion of plasminogen to plasmin which
further prevents lysis of fibrin.

Q1. Prothrombinase complex is formed by? (PVBD pp 77)

1. Xa
2. Va
3. Ca2+
4. IIa
5. VII

F. 1,2,3
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G. 1,2,4
H. 2,3,4
I. 3,4,5
J. 2,3,5

Q2. All of the following are procoagulant except? (PBVD 77)

K. Thrombin
L. Thrombomodulin
M. Thromboxane
N. Thrombospondin
O. Thromboplastin

Answers:
4) A
5) B

1) Dogs with nephrotic syndrome are at risk of venous thrombosis due to: PBVD p87

A) Blood turbulence in injured glomeruli

B) PGI2 depletion
C) ATIII depletion
D) Accumulation of activated coagulation proteins in the blood
E) All of the above

Answer: C

2) Which of the following best describe arterial thrombi? PBVD p 87

1) Pale in color
2) Contain many erythrocytes
3) Firmly attached to the vessel wall
4) Thrombi tails extend upstream (towards the heart)
5) Have a laminated appearance

A) 1, 2, 3, 4, 5
B) 1, 2, 3, 4
C) 1, 3, 4, 5
D) 1, 3, 5
E) 2, 3, 4, 5

Answer: D

1) Which of the following organs are highly susceptible to infarction? PBVD p. 94

1) brain
2) heart
 General pathology 2008-2009
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3) kidney
4) spleen
5) liver

A) 1, 2
B) 1, 2, 3
C) 1, 2, 3, 4
D) 1, 2, 3, 4, 5
E) 2, 3, 4, 5

Answer: C

2) Which of the following mediators are involved in the development of endotoxic

shock?

1) LPS-binding protein
2) TNF
3) Il-1
4) CD14
5) Toll-like receptor 4

A) 1, 2, 3
B) 1, 2, 3, 5
C) 1, 4, 5
D) 1, 2, 3, 4, 5
E) 1, 3, 5

Answer: D

All of the following clinicopathologic abnormalities are commonly present in

consumptive coagulopathies like disseminated intravascular coagulation except: (FVCP
p. 209)
A) increased [FDP]
B) thrombocytopenia
C) hypofibrinogenemia
D) decreased [vWf:Ag]
E) prolonged PTT and PT

Answer: D

Which of the following cytokines are produced by mononuclear phagocytes in response

to bacterial endotoxins? (p. 140)
1) IL-1
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2) IL-6
3) IL-5
4) TNF-α
5) TGF-β

A) 1, 2, 3
B) 1, 2, 4
C) 1, 2, 5
D) 2, 3, 4
E) 3, 4, 5

Answer: B

1) The following is NOT a primary cause of hypercoagulability

A) Mutation in factor V gene

B) Prothrombin gene mutation
C) Inherited protein C deficiency
D) Inherited Antithrombin III deficiency
E) Antiphospholipid antibody syndrome

2) Hyperhomocystenemia leading to hypercoagulable state is a result of mutation in

A) Factor V gene
B) Prothrombin gene
C) Hemocystene reductase
D) Hemocystene convertase
E) Methyltetrahydrofolate reductase

3) The following is NOT true regarding heparin-induced thrombocytopenia syndrome

A) Antibodies that bind heparin and platelet factor 4 complexes

B) Caused by low molecular weight heparin preparations
C) Antibodies that bind endothelium
D) Antibodies that bind platelets
E) Hypercoagulable state

4) The following can result in hypercoagulable state

1) Prolonged immobilization
2) Unfractioned heparin
3) Myocardial infarction
4) Pregnancy
5) Cancer
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A) 1
B) 1, 3
C) 1, 3, 4
D) 1, 2, 3, 4
E) 1, 2, 3, 4, 5

1) Answer: E; 132; table 4.2; it is a secondary cause previously known as lupus

anticoagulant syndrome; mutation in the factor V gene renders Va resistant to
degradation by protein C; prothrombin gene mutation results in elevated levels of
prothrombin; protein C deficiency results in defective degradation of Va and VIIIa;
antithrombin is essential for degradation of IIa, IXa, Xa, XIa and XIIa;
2) Answer: E; 132; C and D are incorrect; A and B are explained in the above question.
3) Answer: B; use of low molecular weight as apposed to high molecular weight
unfractioned heparin prevents this condition
4) Answer: E; Page 131-132;

1) The stimulation of endothelial TLR4 by LPS in septic shock results in

A) Decreased expression of tissue factor pathway inhibitor

B) Decreased expression of thrombomodulin
C) Cytokine production
D) All the above
E) A and C

2) The activation of the following is an important part of superantigen induced toxic

shock syndrome

A) Endothelium
B) Macrophage
C) B-lymphocyte
D) T-lymphocyte
E) Dendritic cell

3) The prognosis depends on the origin of shock; the following has better prognosis

A) Hypovolemic shock
B) Cardiogenic shock
C) Septic shock
D) None
E) All

1) Answer: D; page 140

2) Answer D; page 140
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3) Answer: A; page 143

Q1. Cytokine induced initial peripheral vasodilation is a feature of what type of shock
(PBVD pp 97)

P. Neurogenic shock
Q. Cardiogenic shock
R. Hypovolemic shock
S. Anaphylactic shock
T. Septic shock

a. 1,2,3
b. 2,4
c. 4,5
d. 2,3
e. 1,5

Answer: C

Q2. Lipopolysaccharide can directly activate which of the following (PBVD pp 97)

K. Factor XII
L. TFPI
M. Thrombomodulain
N. TNF
O. IL-1

Answer: A

Q1. Blood stasis promote thrombosis by all of the following methods except (Robbins pp
131)
U. Bring platelets into contact with endothelium
V. Disrupt the endothelium and expose subendothelial ECM
W. Prevent dilution of activated clotting factors
X. Retard inflow of clotting factors inhibitors
Y. Promote endothelial cell activation and leukocyte adhesion

Answer: B

Q2. Elevated levels of homocysteine can lead to atrial and venous thrombosis by
(Robbins pp 131)

6. Inhibition of antithrombin III

7. Activation of antithrombin III
8. Inhibition of thrombomodulin
 General pathology 2008-2009
Compiled by Bhupinder Bawa
9. Inhibition of prothrombin
10. Inhibition of factor 5

P. 1,2,3
Q. 2,3
R. 1, 3
S. 3,4,5
T. 1,5

Answer: C

Q2. Leidan mutation leading to hypercoagulability is due to genetic defect in? (Robbins
ppp 131)

A. Thrombin
B. Prothombin
C. Fibrinogen
D. Factor V
E. Tissue factor

Answer: D