MCQs and SEQs of General Pathology for 3rd year Professional exam

Paper 1
1. A lymphnode on cut section shows cheesy material. On microscopy it shows amorphous,
granular, eosinophilic, necrotic center surrounded by granulomatous inflammation. Which of the
following types of necrosis is present in this case?
a. Fibrinoid necrosis
b. Gangrenous necrosis
c. Coagulative necrosis
d. Caseous necrosis*
e. Liquefactive necrosis
2. Which one of the following statement is correct regarding the morphological consequences of
decreased intracellular ATP during cell injury?
a. The activity of the plasma membrane energy- dependent sodium pump is increased
b. Failure of the Ca2+ pump leads to influx of Ca2+ *
c. There is increase in protein synthesis
d. There is increase in Glycogen
e. There is increase in pH
3. An 80 years old man dies from complication of Alzheimer disease. At autopsy his heart shows
dark brown pigment on sectioning. Microscopically there is light brown pigment with H&E staining.
Which of the following substance is most likely to be increased in the myocardial fibers in this case?
a. Hemosidrin
b. Lipofuscin*
c. Glycogen
d. Cholesterol
e. Melanin
4. Which of the following Cellular adaptation is seen after partial resection of liver:
a. Hyperplasia*
b. Hypertrophy
c. Metaplasia
d. Dysplasia
e. Atrophy
5. The two pathways of Apoptosis (Extrinsic and Intrinsic) differ in their induction and regulation,
but both culminate in the activation of:
a. BCL2
b. Cytochrome C
c. Caspase*
d. Endonuclease
e. Catalase

6. Within minutes following a bee sting, a 37-year-old man develops marked respiratory stridor with
dyspnea and wheezing. He also develops swelling and erythema seen in his arms and legs. An injection
of epinephrine helps to reverse these events and he recovers within minutes. Which of the following
chemical mediators is most important in the pathogenesis of this condition?

a. Bradykinin
b. Complement C5a
c. Nitric oxide
d. Tumor necrosis factor
e. Histamine*

7. A 22-year-old man developed marked right lower quadrant abdominal pain over the past day. On
physical examination there was rebound tenderness on palpation over the right iliac fossa. The pain
experienced by this patient was predominantly the result of the formation of which of the following
chemical mediators?

a. Complement C3b and IgG

8. An inflammatory process that had continued for 3 months included the transformation of tissue
macrophages to epithelioid cells. This event is most likely to occur as an inflammatory response to
which of the following infectious agents?

a. Mycobacterium Tuberculous*
b. Pseudomonas aeruginosa
c. Cytomegalovirus
d. Giardia lamblia
e. Treponema pallidum

9. A 37 year old man had nausea and vomiting for 5 weeks. He experienced an episode of hematemesis
one day back. Upper GI endoscopy was performed, and there was a 1.5 cm diameter lesion in the gastric
antrum which on histological examination showed loss of surface epithelium. These findings are most
typical for which of the following pathologic processes?

a. Abscess
b. Serositis
c. Granuloma
d. Gangrene
e. Ulcer*

10. Morphological changes seen in chronic non- specific inflammation include an increase in:
 a. Neutrophils, lymphocytes and fibrosis
b. Neutrophils, lymphocytes and macrophages
c. Lymphocytes, plasma cells and fibrosis*
d. Giant cells, macrophages and coagulative necrosis
e. Lymphocytes, neutrophils and coagulative necrosis

11. The most common mechanism of vascular leakage in inflammation is;

a. Gaps due to endothelial contraction*

12. A 55-year-old woman touches a pot of boiling water. Within 2 hours, she has marked erythema of
the skin of the fingers of her hand, and small blisters appear on the finger pads. This has led to which
one of the following inflammatory responses?

a. Fibrinous inflammation
b. Granulomatous inflammation
c. Purulent inflammation
d. Serous inflammation*
e. Ulceration

13. A 92-year-old woman is brought unconscious to the emergency room. Her blood pressure is 70/30
mm Hg. She is febrile (38°C/100.5°F) and tachypneic. Laboratory studies demonstrate a WBC count of
22,000/μL with 92% neutrophils. Urinalysis reveals numerous Gram-negative organisms. Which of the
following most likely accounts for this patient’s signs and symptoms?

a. Anaphylactic shock
b. Cardiogenic shock
c. Hypovolemic shock
d. Neurogenic shock
e. Septic shock*
14. A 55-year-old woman following major abdominal surgery has had discomfort and swelling
of her left leg for the past week. On physical examination, the leg is slightly difficult to move,
and on palpation there is tenderness. A Doppler sonogram shows thrombosis of deep left leg
veins. Which of the following mechanisms is most likely to contribute to her condition?
a. Hypercalcemia
b. Immobilization*
c. Ingestion of aspirin
d. Nitric oxide release
e. Turbulent blood flow

15. A 32-year-old man is involved in a vehicular accident and sustains fractures of the right
femur and tibia and the left humerus. The fractures are stabilized surgically. He is in stable
 condition for 2 days, but then suddenly becomes severely dyspneic. Which of the following
complications from his injuries is the most likely cause of his sudden respiratory difficulty?
a. Cardiac tamponade
b. Fat embolism*
c. Pulmonary edema
d. Pulmonary infarction
e. Right hemothorax
16. The characteristic that differentiates a thrombus from a clot is:
a. Thrombus is attached to the wall and has layers of fibrin and platelet*
b. Thrombus is friable and gelatinous.
c. Thrombus is red in color and surrounded by film of yellow fat
d. Thrombus is composed of red blood cells, macrophages and neutrophils.
e. Thrombus is mainly composed of gram-negative bacteria
17. Histologic examination of the heart shows extensive growth of fibroblasts,
smooth muscle cells and deposition of collagen in the mural thrombus. Which
of the following terms describes this outcome of thrombosis?
a. Canalization
b. Dissolution
c. Organization*
d. Propagation
e. Embolization
18. Duchenne muscular dystrophy is caused by a sex-linked recessive allele. Its victims
are almost invariably boys, who usually die in younger age. Why is this disorder
almost never seen in girls?
a. Sex-linked traits are never seen in girls
b. The allele is carried on the Y chromosome
c. Nondisjunction occurs in males but not in females
d. In order to express an X-linked recessive, a female must have two copies of the gene*

19. Phenotypic changes including increased height, long tapering fingers and ectopia lentis is
a feature of which of the following?
a. Marfan Syndrome*
b. Ehlers- Danlos Syndrome
c. Turner syndrome
d. Cystic Fibrosis
e. Patau syndrome

20. A male has features of hypogonadism, small atrophic testes along with lack of secondary
male characteristics. He also has developed gynecomastia. Which one of the chromosomal
abnormality is most likely?
a. 47, XX, +13
b. 47, XX, +21
c. 47, XX, +18
d. 45, X
e. 47, XXY*

21. A 45 year male experienced weight loss and easy fatigability with symptoms of polyuria
and polydipsia. Laboratory investigations showed markedly increased blood sugar levels
along with glycosuria. This disorder is an example of which one of the following probable
inheritance pattern?
a. Autosomal dominant
b. X-linked recessive
c. X-linked dominant
d. Multifactorial /polygenic*
e. Autosomal recessive
22. Regarding cutaneous wound healing which of the following statement is correct?
a. Insensate skin has little impact on wound healing rates
b. Complications from wound contraction are most commonly seen on the face and neck
c. Early movement of wounds can stimulate the process of angiogenesis and healing
d. Vitamin C deficiency impairs collagen synthesis in healing tissues*
e. Glucocorticoids promote collagen syenthesis and fibrosis of tissues
23. Which one of the following neoplasms is locally invasive but seldom spreads by
metastasis?
a. Papillomas of the skin
b. Squamous cell carcinomas of the skin
c. Adenocarcinomas of the lungs
d. Basal cell carcinoma of the skin*
e. Osteogenic sarcomas of the limbs
24. Metastasis refers to the spread of neoplastic cells from one part of the body to another.
Which one of the following is true for metastasic neoplasms?
a. The lungs, heart, and brain are considered to be the most common sites for tumor emboli
to lodge
b. There is a tendency for sarcomas to metastasize by way of lymphatics
c. Carcinomas tend to metastasize by implantation
d. It is more common for carcinomas to metastasize by way of lymphatics, whereas
sarcomas tend to metastasize by way of the bloodstream*
e. Benign neoplasms are more likely to metastasize to remote sites in the body than
anaplastic neoplasms.
25. Which of the following tumor marker is of diagnostic value in colorectal carcinoma?
a. CEA*
b. CA-125
c. Neuron specific enolase
d. Alpha fetoprotein
e. HCG
26. Which of the following statements regarding Familial Rb gene is correct?
a. It is a tumor suppressor gene associated with Wilms tumor
b. Has association with Osteosarcoma*
c. Has association with carcinomas of female breast and ovary
d. Has association with Li-Fraumeni syndrome
e. Is associated with colon cancer
27. Workers heavily exposed to aniline dye are at risk of developing which of the following
cancers?
a. Skin cancer
b. Ovarian cancer
c. Breast cancer
d. Bladder cancer*
e. Lung cancer
28. Which of the following chemical carcinogens can cause skin cancers when painted on
skin or can induce sarcomas when injected subcutaneously?
a. Direct acting alkylating agents
b. Aromatic amines and azo dyes
c. Nitrosamines and amides
d. Polycyclic aromatic hydrocarbons*
e. Vinyl chloride
29. Which of the following are most likely radiation induced cancers?
a. Hepatocellular carcinoma and cervical carcinoma
b. Leukemias and thyroid cancer*
c. Mesotheliomas and bladder cancer
d. Bronchogenic carcinoma
e. Sarcomas
30. An 8-year-old boy presents with periorbital edema and dark colored urine. Urinalysis
shows 3+ hematuria. His parents report that the boy had a streptococcal throat infection 2
weeks ago. A renal biopsy shows features of glomerulonephritis. Which of the following best
explains the pathogenesis of glomerulonephritis in this patient?
a. Antineutrophil cytoplasmic autoantibodies
b. Deposition of circulating immune complexes *
c. Directly cytotoxic IgG and IgM antibodies
d. IgE-mediated mast cell degranulation
e. T cell–mediated delayed hypersensitivity reaction
31. Rh- hemolytic disease of the newborn is an example of;
a. Delayed type of hypersensitivity reaction
b. Type 1 hypersensitivity reaction
c. Type 11 hypersensitivity reaction*
d. Type 111 hypersensitivity reaction
e. Autoimmune hemolytic anemia
32. A 35-year-old man consults a physician for seasonal eye itching and runny nose.
Recurrent conjunctivitis in this patient is most likely caused by which of the following
mechanisms of disease?
a. Autoimmunity
b. Bacterial infection
c. Chemical toxicity
d. Hypersensitivity *
e. Viral infection
33. Regarding adaptive immunity which statement is correct?
a. It is present at birth
b. It is the body’s first line of defense
c. It does not develop long term memory for specific antigen
d. Its major components are natural killer cells and proteins of complement system
e. It is stimulated both by microbes and nonmicrobial substances(antigen)*
34. Regarding immunological tolerance which of the following statement is True?
a. Body can’t produce antibodies to antigen
b. Clonal deletion is blocked
c. B lymphocytes are suppressed
d. T lymphocytes are suppressed
e. Clonal deletion of lymphocytes to self antigens occurs*

35. A child has pigeon breast deformity along with lumbar lordosis and bowing of the legs.
What is the most likely diagnosis?
a. Beriberi
 b. Pellagra
c. Rickets*
d. Osteomalacia
e. Scurvy
36. Which of the following is the most common primary renal tumor of childhood?
a. Chromophobe Carcinoma
b. Papillary Carcinoma
c. Wilms tumor*
d. Oncocytoma
e. Clear cell carcinoma.
37. A Widespread disorder due to a defect in epithelial chloride transport affecting
fluid secretion in exocrine glands, epithelial lining of the respiratory, gastrointestinal,
and reproductive tracts is called:
a. Phenylketonuria
b.Galactosemia
c. Cystic Fibrosis*
d. Gaucher’s disease
e. Niemann pick disease

SEQs

1. a. If a patient’s hypertension remains untreated for years, which type of cellular adaptation will
most likely be seen in the myocardium? 1
b. Briefly discuss this type of cellular adaptation 2
c. What are Reactive Oxygen species? Briefly describe their role in cell injury. 2
2. a. Enumerate the diseases characterized by Chronic granulomatous inflammation. Describe the
morphology of Tuberculous Granuloma. 3
b. Briefly discuss the Cellular events of acute inflammation 2
3. a. Define thrombosis and write down the pathogenesis of thrombus formation 3
b. What are the different types of infarcts? Describe each type with examples. 2
4. a. Write down the factors that retard Wound healing 3
b. Write down the salient features of Turner syndrome 2
5. a. Give various pathways of metastasis. Write down the steps involved in hematogenous spread
of tumor. 3
b. Briefly describe the role of p53 in tumor formation. 2
6. What are types of Transplant rejections? Write a note on Hyperacute Transplant rejection 5