Pathology | Set 2

1. Which of the following is not a para-neoplastic syndrome associated with lung carcinoma

A. ectopic ADH secretion

B. dermatomyositis

C. migratory thrombophlebitis

D. Eaton-Lambert (myasthenic) syndrome

E. thrombocytosis

Correct : E. thrombocytosis

2. Which of the following tumour is benign

3. Which of the following is not a feature of acute Crohn’s disease

A. segmental lesions

B. serosal involvement

C. fissures penetrating deep into the wall of affected mucosa

D. inflammatory pseudo-polyps

E. epithelioid granulomata

Correct : D. inflammatory pseudo-polyps

4. A 50-year old woman presents with back pain. X-rays suggest a malignant deposit in the 10th thoracic vertebra. The least likely primary site is

5. Regarding haemorrhagic infarction of the brain, which of the following is not true

A. it usually results from an embolic event

B. it usually contains multiple petechial haemorrhages which may be confluent

C. the distinction between this and non haemorrhagic infarcts is clinically insignificant

D. the haemorrhages are presumed to be secondary to reperfusion injury

E. the size of it will depend in part upon the collateral blood supply to that area

Correct : C. the distinction between this and non haemorrhagic infarcts is clinically insignificant

6. The histological appearance of contraction brands in association with acute myocardial infarction indicate

A. previous old myocardial infarctions

B. early aneurysmal formation

C. compensatory responses to decreased myocardial contractility

D. a right ventricular infarct

E. recent reperfusion therapy

Correct : E. recent reperfusion therapy

7. After occlusion of a coronary artery

A. the ischaemia is most pronounced in the epicardial region

B. loss of contractility only occurs when ultra structural changes in the myocyte are present

C. reperfusion of the ischaemic area can result in new cellular damage, due to the generation of oxygen free radicals

D. Q waves on the ECG are diagnostic of transmural infarction

E. none of the above are true

Correct : C. reperfusion of the ischaemic area can result in new cellular damage, due to the generation of oxygen free radicals

8. With regard to aortic dissection, which is incorrect

A. it tends to occur in 40-60 year old men

B. approximately 90% of non-traumatic cases occur in patients with antecedent hypertension

C. it is usually associated with marked dilatation of the aorta

D. it is unusual in the presence of substantial atherosclerosis

E. it is usually caused by an intimal tear within 10cm of the aortic valve

Correct : C. it is usually associated with marked dilatation of the aorta

9. The most common site of origin of emboli causing cerebrovascular disease is

10. Which of the following is malignant

11. Anaplasia is not characterised by

A. pleomorphism

B. Abundant nuclear DNA

C. A nuclear-cytoplasmic ratio of 1:6

D. Coarsely clumped chromatin

E. Lack of differentiation

Correct : C. A nuclear-cytoplasmic ratio of 1:6

12. All of the following are precancerous except

A. Chronic gastritis of pernicious anaemia

B. Solar keratosis

C. Crohn’s disease

D. Leukoplakia

E. Chronic ulcerative colitis

Correct : C. Crohn’s disease

13. Prothrombogenic factors include all of the following except

14. In acute inflammation, all of the following are true except

A. there is contraction of endothelial cells

B. there is a mononuclear infiltrate

C. there is induction of adhesion molecules on endothelium

D. there is production of arachidonic acid metabolites

E. cytokines induce a systemic acute phase response

Correct : B. there is a mononuclear infiltrate

15. Cellular events in acute inflammation include all of the following except

A. redistribution of preformed adhesion molecules to the cell surface of leukocytes

B. adhesion and transmigration of leukocytes to endothelium

C. leukocyte activation

D. margination of macrophages to vessel walls

E. extracellular release of lysosomal enzymes and products of arachidonic acid metabolism

Correct : D. margination of macrophages to vessel walls

16. The factor conferring the most risk in thromboembolic disease is

17. Systemic lupus erythematosus

A. has a female : male gender ratio of 2:1

B. is characterised by antinuclear antibodies (ANAs)

C. rarely involves the kidney

D. is associated with a seronegative arthropathy causing marked joint erosion

E. is commonly fulminant with death in weeks to months

Correct : B. is characterised by antinuclear antibodies (ANAs)

19. Iron deficiency anaemia features

A. a normal haematocrit

B. increased serum ferritin

C. normal mean red cell volume

D. low platelet count

E. none of the above

Correct : E. none of the above

20. Platelets

A. have a normal concentration range in peripheral blood of 80-100 x 103/mm3

B. are important in haemostasis only

C. remain viable in stored blood for 24 hours only

D. normally are removed from the circulation almost entirely by the spleen

E. have an average lifespan of average 20 days

Correct : C. remain viable in stored blood for 24 hours only

21. In compensated heart failure

A. right atrial pressure drops

B. maximum cardiac output is unchanged

C. resting cardiac output is unchanged

D. renin level eventually drops below premorbid level

E. fluid retention plays no role

Correct : C. resting cardiac output is unchanged

22. Infective endocarditis

A. in the acute form, is most commonly caused by streptococci

B. involves abnormal valves in most acute cases

C. is confirmed by positive blood cultures in less than 50% of cases

D. may cause splenic infarction

E. may cause MacCallum’s plaques to form on affected valves

Correct : D. may cause splenic infarction

23. Cor Pulmonale may be caused by

A. congenital heart disease

B. mitral stenosis

C. left ventricular failure

D. primary pulmonary hypertension

E. aortic regurgitation

Correct : D. primary pulmonary hypertension

24. Regarding peptic ulceration

A. it occurs most commonly in the antrum of the stomach

B. it has a strong genetic influence

C. there is H. pylori infection of the mucosa in 50% of patients with duodenal ulceration

D. it is more frequent in patients with chronic obstructive pulmonary disease

E. gastric acid is the only prerequisite for formation of ulcers

Correct : D. it is more frequent in patients with chronic obstructive pulmonary disease

25. The features of bronchogenic carcinoma include

A. the classification of “oat cell” tumour within the large cell type

B. high initial response to chemotherapy for small cell type

C. the strongest correlation with cigarette smoking in the adenocarcinoma type

D. that 50% of small cell type occur in nonsmokers

E. histological features identical in small cell carcinomas and squamous cell types

Correct : B. high initial response to chemotherapy for small cell type

26. The major abnormalities of immune function in AIDS are characterised by

A. Inversion of the CD4-CD8 ratio

B. Increase in the number of memory T cells

C. Hypogammaglobulinaemia and decreased circulating immune complexes

D. Decreased secretion of TNF and IL-1

E. All of the above

Correct : A. Inversion of the CD4-CD8 ratio

27. Regarding hypersensitivity reactions

A. In anaphylaxis, IgE is bound to mast cells by their Fab portions to release vasoactive amines

B. Goodpasture’s syndrome is an example of type III hypersensitivity reaction

C. Farmer’s lung is a type III reaction to micropolyspora species

D. Delayed hypersensitivity is mediated by macrophages

E. The Mantoux reaction is a form of contact hypersensitivity

Correct : C. Farmer’s lung is a type III reaction to micropolyspora species

28. Acute appendicitis

A. In preschool children, it usually presents with the so-called “classic” signs and symptoms

B. It is associated with appendiceal obstruction in 10% of cases

C. Histologically, it shows neutrophilic infiltration of the muscularis layer

D. The clinical diagnosis is falsely positive in about 50% of cases

E. It cannot cause liver abscesses

Correct : C. Histologically, it shows neutrophilic infiltration of the muscularis layer

29. Pneumocystis carinii

A. Produces pneumocystis pneumonia in normal persons

B. Causes a Ghon’s focus in the lung

C. Causes patchy atelectasis

D. Is a fungus

E. Attaches selectively to Type II alveolar cells

Correct : D. Is a fungus

30. Regarding septic shock

A. Endotoxin is the only cause

B. Marked vasoconstriction occurs in the non-infected tissue

C. Cardiac output is low in 75% of patients

D. Endotoxin entering the circulation causes an effect very similar to anaphylaxis

E. Blood viscosity is unchanged

Correct : D. Endotoxin entering the circulation causes an effect very similar to anaphylaxis

31. Acute pancreatitis

A. Is associated with increased serum amylase concentration without elevation in serum lipase concentration

B. Occurs most often in later life

C. Occurs in about 5% of patients with gallstones

D. When associated with alcohol is not usually preceded by chronic pancreatitis

E. Is often associated with hypercalcaemia

Correct : C. Occurs in about 5% of patients with gallstones

32. The acute nephritic syndrome has all of the following features except

33. A young baby presents with jaundice, dark urine and pale stools. He is most likely to have

A. Physiologic jaundice of the newborn

B. Breast milk jaundice

C. Gilbert’s syndrome

D. Biliary atresia

E. None of the above

Correct : D. Biliary atresia

34. With regard to the leukocyte extravasation of the acute inflammatory response, which of the following is incorrect

A. ELAM-1 is a selectin found on endothelium

B. E and P-selectins bind to oligosaccharides found on neutrophils and monocytes

C. L-selectin is found on neutrophils, monocytes and lymphocytes

D. ICAM-1 belongs to the immunoglobulin family of molecules, and is found on leukocytes

E. VCAM-1 binds to integrins

Correct : D. ICAM-1 belongs to the immunoglobulin family of molecules, and is found on leukocytes

35. IgE mediated Type I hypersensitivity reactions require the action of which lymphocyte class

A. B only

B. CD8 T cells and B cells

C. Tµ2 T cells and B cells

D. Tµ1 T cells and B cells

E. Natural Killer cells and B cells

Correct : C. Tµ2 T cells and B cells

36. Thrombus formation is inhibited by

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