PATHOLOGY BOARD EXAMINATION

Instructions: Choose the best answer.

1. A 50-year old man has blood pressure of 150/90 mm Hg. If this person remains untreated for
years, which of the following cellular alterations will be seen in the myocardium?
A. atrophy
B. metaplasia
C. hypertrophy
D. dysplasia
Answer: C

2. On day 28 of her menstrual cycle, a 26-year old woman experiences menstrual bleeding
which lasts for 5 days. She has had regular cycles for many years. Which of the following
processes is most likely occurring in the endometrium just before onset of bleeding?
A. apoptosis

in
B. heterophagocytosis
C. liquefactive necrosis
D. hyperplasia
Answer: A

s.
3. At autopsy, a 60-year old man has an enlarged (2500 g) liver with yellow cut surface. Before
death, his total serum cholesterol and triglyceride levels were normal, but he had decreased
serum albumin concentration and prolonged prothrombin time. Which of the following
activities most likely lead to these findings?
A. playing golf
iim
B. cigarette smoking
C. drinking gin
D. aspirin ingestion
Answer: C

4. A 70-year old woman suddenly lost consciousness and on awakening one hour later, she
could not speak nor move her right arm and leg. Two months later, a head MRI showed a
large cystic area in the left parietal lobe. Which of the following pathologic processes has
4a

most likely occurred in the brain?

A. karyolysis
B. fat necrosis
C. apoptosis
D. liquefactive necrosis
Answer: D
m

6. A 21-year old woman complains of pain during menses (dysmenorrhea). To treat this
symptom, she was advised to take indomethacin. This drug may help reduce her pain
because it interferes with the production of which one of the following substances?
A. bradykinin
B. histamine
Ai

C. leukotrienes
D. estrogen
Answer: A

7. What type of leukocyte actively participates in acute inflammatory processes and contains
myeloperoxidase within its primary (azurophilic) granules and alkaline phosphates in its
secondary (specific) granules?
A. lymphocytes
B. neutrophils
C. eosinophils
D. monocytes
Answer: B

1
 8. A 3-year old child touches a lit candle. Within several hours, there is marked erythema of the
skin of the fingers on the childs left hand, and small blisters appear on the finger pads.
Which of the following terms best describe the process?
A. fibrinous inflammation
B. ulceration
C. abscess formation
D. serous inflammation
Answer: D

9. A woman who is allergic to cats visits a friend who keeps several pet cats. During the visit,
she inhales cat dander and within minutes, she develops nasal congestion and abundant
nasal secretions. Which of the following substances is most likely to produce these findings?
A. tumor necrosis factor
B. bradykinin
C. histamine
D. complement C5a

in
Answer: C

10. After receiving incompatible blood, a patient develops a transfusion reaction in the form of
back pain, fever, shortness of breath and hematuria. Which of the following statements
best classifies this type of immunologic reaction?

s.
A. systemic anaphylactic reaction
B. complement-mediated cytotoxicity reaction
C. systemic immune complex reaction
D. delayed type hypersensitivity reaction
Answer: B
iim
12. A patient presents with a large wound on the left leg as a result of a vehicular accident.
Initially his wound is filled with granulation tissue, which is composed of proliferating
fibroblasts and new blood vessels (angiogenesis). Which of the following is a growth
factor that is capable of inducing all the steps necessary for angiogenesis?
A. vascular endothelial growth factor
B. platelet-derived growth factor
C. epidermal growth factor
4a

D. transforming growth factor

Answer: A

13. A 16-year old patient has lacerations on his hand which required sutures. The sutures
were removed after 10 days. Wound healing continued but the site was disfigured by a
prominent, raised nodular scar which developed over the next 2 months. Which of the
following terms best describes the process that occurred within this 2-month period?
m

A. organization
B. resolution
C. keloid formation
D. dehiscence
Answer: C
Ai

14. A 17-year old woman receiving corticosteroid therapy for an autoimmune disease has an
abscess on her upper outer left arm. She undergoes a drainage procedure but the wound
heals poorly over the next month. Which of the following aspects of wound healing is most
likely to be deficient in this patient?
A. neutrophil infiltration
B. collagen deposition
C. re-epithelialization
D. fibroblast elaboration
Answer: B

15. Which of the following changes best describes the pathophysiology involved in the
production of pulmonary edema in patients with congestive heart failure?
A. widespread endothelial damage
B. decreased plasma oncotic pressure
C. acute lymphatic obstruction

2
 D. increased hydrostatic pressure
Answer: D

16. A 23-year old medical student develops a red face after being asked a question during a
lecture. Which of the following statements best describes the vascular reaction?
A. active hyperemia
B. petechial hemorrhage
C. allergic reaction
D. passive congestion
Answer: A

17. While preparing her lunch, a housewife nicks her finger with a knife. Seconds after the
injury, the bleeding stops. Which of the following mechanisms is most likely to reduce
blood loss from a small dermal arteriole?
A. protein C activation

in
B. vasoconstriction
C. neutrophil chemotaxis
D. platelet aggregation
Answer: B

s.
18. A 26-year old rock climber fractures his left femur after falling from a height of 20 meters.
He was hospitalized and over the next several days develops progressive respiratory
problems. He died three days later. At the time of autopsy, oil red-O positive material is
seen in the small blood vessels of the lungs and brain. Which of the following is the most
likely diagnosis?
iim
A. air emboli
B. padoxical emboli
C. fat emboli
D. saddle emboli
Answer: C

19. A 23 year old who had a myocardial infarction 1 year a year ago now has chest pain when
exercising. His underlying disease is due to an absence of LDL receptors on liver cells,
4a

inherited as an autosomal dominant condition. Which of the following laboratory findings is

most likely to be present in this patient?
A. ketonuria
B. hypercholesterolemia
C. hypoglycemia
D. abetalipoprotenemia
Answer: B
m

20. A 20-year old woman of average intelligence and short stature is being evaluated for
primary amenorrhea. Physical examination reveals a shield-shaped chest and her elbows
turn outward when her arms are at her sides. She has a thick neck and you notice the
absence of secondary female sex characteristics. Serum estrogen levels are found to be
decreased, while FSH and LH levels are increased. Which of the following is the most
Ai

likely diagnosis?
A. Turners syndrome
B. fragile X syndrome
C. Klinefelters syndrome
D. XYY syndrome
Answer: A

23. A 26-year old woman presents with increasing fatigue, arthritis, shortness of breath, and a
bimalar, photosensitive erythematous rash. Biopsies from this rash reveal liquefactive
degeneration of the basal layer of the epidermis with a perivascular lymphoid infiltrate.
Physical examination shows bilateral pleural effusions, the fluid from which when examined
histologically reveals multiple erythrocytes phogocytized by phagocytic leukocytes. Which of
the following is the most likely diagnosis?
A. dermatomyositis
B. systemic lupus erythematosus
C. Sjogrens syndrome

3
 D. rheumatoid arthritis
Answer: B

25. A 36-year old man presents with a new onset of a bulge in his right inguinal area. This
was diagnosed as an inguinal hernia. The resected hernial sac contained some adipose
. adipose tissue was sent to the laboratory for examination. Which of the following features
should be present to make a diagnosis of lipoma rather than normal adipose tissue?
A. anaplasia
B. fibrous capsule
C. prominent nucleoli
D. uniform population of cells
Answer: B

26. A 23-year old woman has noted a palpable nodule on her neck for the past 3 months.
On physical examination, there is a 2-cm firm nontender nodule on the left lobe of the

in
thyroid gland. A fine needle biopsy of the nodule reveals cells consistent with thyroid
carcinoma. No other family members are affected by this disorder. Which of the following
is most relevant in the womans past medical history?
A. exposure to polyvinyl compounds
B. chronic alcoholism
C. radiation exposure in childhood

s.
D. history of trauma
Answer: C

27. A 64-year old man has several episodes of hematuria in the past week. On physical
iim
examination, there are no abnormal findings. A urinalysis shows 4+ hematuria and
cytologic examination of the urine shows that atypical cells are present. A urologist
performs a cystoscopy and observes a 4 cm mass with a nodular, ulcerated surface in the
dome of the bladder. Which of the following terms best describes this lesion?
A. sarcoma
B. carcinoma
C. fibroma
D. papilloma
Answer: B
4a

28. A 33-year old woman undergoes an annual physical examination and there are no abnormal
findings. A Pap smear was done as part of the pelvic examination. Cytologically, the cells
obtained from the cervical smear show severe epithelial dysplasia. Which of the following
statements best explains the significance of these findings?
A. The lesion could progress to invasive cervical carcinoma
B. An ovarian teratoma is present
m

C. There has been a regression of cervical carcinoma

D. Antibiotic therapy will cure the lesion
Answer: A

29. The use of broad-spectrum antibiotics can produce a bleeding diathesis characterized by
Ai

hematomas, melena and bleeding gums by decreasing the normal gut flora and inducing a
deficiency of which one of the following vitamins?
A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin K
Answer: D

33. An apathetic male infant from the slums is found to have peripheral edema, a moon face,
and an enlarged fatty liver. Which of the following is the basic defect causing this change
in the liver?
A. Decreased fluid intake leads to hypernatremia
B. Decreased carbohydrate intake leads to hypoglycemia
C. Decreased caloric intake leads to hypoalbuminemia
D. Decreased protein intake leads to decreased lipoproteins
Answer: D

4
 38. A 5-year old girl developed a rash over her chest that began as 0.5 cm reddish macule.
Within 2 days, the macules became vesicle. A few days later, the vesicles ruptured and
crusted over. Over the next 2 weeks, crops of the lesion spread to the face and extremities.
Which of the following clinical manifestations of this infection is most likely to appear
decades later?
A. shingles
B. paralysis
C. congestive heart failure
D. infertility
Answer: A

39. A 36-year old man with AIDS presents with deteriorating mental status. A spinal tap was done.
The cerebrospinal fluid was stained with mucicarmine and India ink. The mucicarmine stain
reveals numerous yeasts that stain bright red. The India ink demonstrates the capsule of the

in
organism. Which of the following is the most likely diagnosis?
A. chromomycosis
B. blastomycosis
C. cryptococcosis
D. cryptosporidiosis
Answer: C

s.
40. A 38-year old man presents with cough, fever, night sweats and weight loss. A chest x-ray
reveals irregular densities in the upper lobe of the right lung. Histologic sections reveal caseous
necrosis surrounded by acid fast bacilli and few scattered giant cells. These giant cell are a
iim
result of fusion together of what type of cell?
A. activated macrophages
B. atypical lymphocytes
C. reactive fibroblasts
D. epithelial cells
Answer: A

41. A 21-year old woman gives birth at term to an infant weighing 1859 g. On physical
4a

examination, the infants head size is normal, but the crown-heel length and foot length are
reduced. There are no external malformations. Throughout infancy, developmental milestones
are delayed. Which of the following conditions occurring during gestation would most likely
produce these findings?
A. maternal diabetes mellitus
B. pregnancy induced hypertension
C. congenital cytomegalovirus
D. erythroblastosis fetalis
m

Answer: B

44. A 40-year old obese man presents signs and symptoms of hyperglycemia. After appropriate
work-up, he is diagnosed as having type II diabetes mellitus, which is due in part to insulin
resistance, Laboratory evaluation of his serum also discloses hypertriglyceridemia, which is due
Ai

to his diabetes. The most common type of secondary hyperlipidemia associated with diabetes
mellitus is characterized by elevated serum levels of which of the following substances?
A. low density lipoproteins
B. very low density lipoproteins
C. chylomicrons
D. intermediate density lipoproteins
Answer: B

45. A 40-year old woman presents with recurrent severe headaches and increasing visual problems.
Physical examination reveals her blood pressure to be 220/150. Her symptoms are most likely to
be associated with which one of the following abnormalities?
A. medial calcific sclerosis
B. hyaline arteriolosclerosis
C. giant cell arteritis
D. Takayasus arteritis
Answer: C

5
 46. A 61-year old man presents with the sudden onset of excruciating pain. He describes the pain as
beginning in the anterior chest, radiating to the back, then moving downward into the abdomen.
His blood pressure is found to be 160/115. Myocardial infarction is suspected but was ruled out
due to normal ECG. An x-ray of the patients abdomen shows a double-barrel aorta. Which of
the following is the cause of the abnormality?
A. loss of elastic tissue in the media
B. congenital defect in the aorta wall
C. abnormal collagen synthesis
D. a microbial infection
Answer: A
R

50. A 62-year old woman presents with increasing fatigue and is found to have hypochromic
normocytic red cells in her peripheral smear. Physical examination finds her heart rate and
respiratory rate to be increased in frequency. Laboratory examination finds decreased serum

in
ferritin, the levels of which are inversely proportional to the serum levels of which one of the
following substances?
A. haptoglobulin
B. bilirubin
C. hemosiderin
D. transferring

s.
Answer: D

52. A 21-yearold woman presents with fever, weight loss, night sweats, and painless enlargement
of several supraclavicular lymph nodes. A biopsy from one of the enlarged lymph nodes shows
iim
binucleate giant cell with prominent acidophilic owl-eye nucleoli. Also present are atypical
mononuclear cells that are surrounded by clear spaces (lacunar cells). Which of the following
is the most likely diagnosis?
A. Hodgkins disease
B. reactive hyperplasia
C. cat-scratch disease
D. non-Hodgkins lymphoma
Answer: A
4a

54. A 6-year old girl accidentally inhales a plastic bead, which lodges in one of her bronchi. A
chest x-ray reveals the mediastinum to be shifted toward the side of the obstruction. Which
of the following pulmonary abnormalities is most likely present in this girl?
A. resorption atelectasis
B. compression atelectasis
C. contraction atelectasis
D. patchy atelectasis
m

Answer: A

56. While recovering in bed 1 week after an abdominal hysterectomy, a 43-year old woman develops
acute shortness of breath with hemoptysis. Physical examination finds the patient to be afebrile
with moderate respiratory distress, calf tenderness, and a widely split S2. Which of the following
Ai

is the most likely diagnosis?

A. atelectasis
B. viral pneumonia
C. congestive heart failure
D. pulmonary embolus
Answer: D

64. A 35-year old man noticed an increased feeling of heaviness in his scrotum for the past 10
months. On physical examination, the left testis is three times the size of the right testis and
is firm on palpation. Laboratory studies include an elevated alpha fetoprotein level. Which of
the following cellular components is most likely to be present in this mass?
A. yolk sac cells
B. Leydig cells
C. seminoma cells
D. cytotrophoblasts
Answer: A

6
 65. A 47-year old man presents with increasing heartburn especially after eating or when lying
down. Biopsies taken approximately 4 cm proximal to the gastroesophageal junction reveal
metaplastic columnar epithelium. Which of the following is the most likely diagnosis?
A. hamartomatous polyp
B. Barretts esophagus
C. Reflux esophagitis
D. Mallory Weiss syndrome
Answer: B

66. A 20-year old woman with abdominal pain localized to the right lower quadrant, nausea and
vomiting, mild fever and an elevation of peripheral leukocyte count. An appendectomy is
performed. Which of the following is the expected microscopic appearance of this appendix?
A. normal appearing appendix
B. dilated lumen filled with mucus

in
C. yellow tumor at the tip of the appendix
D. neutrophils within the muscular wall
Answer: D

67. A 60-year old man presents with increasing fatigue. His past medical history is unremarkable.

s.
Physical examination is also unremarkable except for positive occult blood in stool and
microcytic hypochromic anemia. Barium enema study shows a 4 cm mass in the left side of
his colon having an apple core appearance. Which of the following is the most likely
histologic diagnosis for this colonic mass?
A. leiomyosarcoma
iim
B. adenocarcinoma
C. carcinoid tumor
D. squamous cell carcinoma
Answer: B

68. A 48-year old woman with increasing fatigue and is found to have elevated liver enzymes
(AST and ALT). Over the next year, her liver enzymes have remained elevated and all
serological tests for viral markers remain negative. A liver biopsy reveals chronic inflammation
4a

in the portal triads that focally destroys the limiting plate and spills over into the adjacent
hepatocytes. Anti smooth muscle and antinuclear antibodies are present. An LE test is also
positive. Which of the following is the most likely diagnosis?
A. autoimmune hepatitis
B. primary biliary cirrhosis
C. systemic lupus erythematosus
D. chronic persistent hepatitis
Answer: A
m

69. A 57-year old male alcoholic with a history of chronic liver disease presents with increasing weight
loss and ascites. Physical examination is unremarkable and fecal occult blood is negative. CT scan
of the abdomen reveals a single mass in the left lobe of the liver. Work-up reveals elevated levels
of alpha fetoprotein in this patients blood. Which of the following is the most likely diagnosis?
Ai

A. angiosarcoma
B. hepatoblastoma
C. cholangiocarcinoma
D. hepatocellular carcinoma
Answer: D

70. According to Courvoisiers law, a pancreatic cancer located in the head of the pancreas
should be suspected in an individual with which one of the following clinical signs?
A. migratory thrombophlebitis
B. obstructive jaundice and a dilated gallbladder
C. steatorrhea and a tender gallbladder
D. obstructive jaundice and a nonpalpable gallbladder
Answer: B

7
 72. A 24-year old woman for a fertility work-up gives a history of severe pain during menses. A
previous physician told her that she may have chocolate in her cysts. Which of the following
will most likely be present in this patient?
A. acute pelvic inflammatory disease
B. metastatic ovarian carcinoma
C. endometriosis
D. subserosal leiomyoma
Answer: C

73. A 22-year old woman presents with pelvic pain and is found to have an ovarian mass that
measures 3 cm in diameter. Grossly, the mass consists of multiple cystic spaces. Histologically,
these cysts are lined by tall columnar epithelium, with some of the cells being ciliated. Which
of the following is the correct diagnosis for this ovarian tumor?
A. serous tumor
B. mucinous tumor
C. endometrioid tumor

in
D. clear cell tumor
Answer: A

74. A 30-year old woman in the third trimester of her first pregnancy develops persistent headaches
and swelling of her legs and face. Early during her pregnancy her prenatal consultations were

s.
unremarkable, however, now her blood pressure is 170/105 mmHg and urinalysis reveals slight
proteinuria. Which of the following is the most likely diagnosis?
A. nephrotic syndrome
B. gestational trophoblastic disease
C. preeclampsia
iim
D. ectopic pregnancy
Answer: C

77. A 41-year old woman presents with the new onset of bloody discharge from her left nipple.
Physical examination reveals a 1 cm freely moveable mass that is located directly beneath the
nipple. Sections from the mass reveal multiple fibrovascular cores lined by several layers of
epithelial cells. Atypia is minimal. The lesion is completely contained within the duct and no
invasion into underlying tissue is seen. Which of the following is the most likely diagnosis?
4a

A. benign phyllodes tumor

B. Pagets disease
C. intraductal carcinoma
D. ductal papilloma
Answer: D

79. A 43-year old man presents with increasing fatigue and occasional headaches. He states that
m

recently he has had to change his shoe size from 8 to 9, and he also thinks that his hand and
jaw are now slightly larger. Physical examination reveals a prominent forehead and lower jaw,
enlarged tongue, and large hands and feet. Initial laboratory tests reveals increased serum
glucose. Which of the following is the most likely explanation for this group of findings?
A. acromegaly
B. diabetes
Ai

C. gigantism
D. apoplexy
Answer: A

82. A 20-year old woman presents with the acute onset of perioral tingling and muscle cramps
involving both of her hands. Physical examination finds an anxious woman with increased
respiratory rate , while laboratory examination reveals decreased arterial pCO2, decreased
bicarbonate, and an increased blood pH. The respiratory alkalosis in this individual caused
tetany by decreasing the ionized serum levels of what substance?
A. calcium
B. sodium
C. magnesium
D. potassium
Answer: A

8
 83. A 56-year old woman presents with increasing muscle weakness and fatigue. Physical
examination finds an obese adult woman with purple abdominal stria and increase facial
hair. The excess adipose tissue is mainly distributed in her face, neck and trunk. Laboratory
evaluation finds increased plasma levels of cortisol and glucose. Which of the following is
the most likely diagnosis?
A. Addisons disease
B. Bartterrs disease
C. Cushings syndrome
D. Conns syndrome
Answer: C

86. A 6-year old boy presents with clumsiness, a waddling gait, and difficulty climbing steps. Physical
examination reveals that the boy uses his arms and shoulders to rise from the floor or a chair.
Additionally, his calves appear to be somewhat larger than normal. Which of the following is the
most likely diagnosis?
A. myotonic dystrophy

in
B. Duchennes muscular dystrophy
C. polymyositis
D. inclusion body myositis
Answer: B

s.
87. A 61-year old woman presents with difficulty swallowing, ptosis, and diplopia. Which of the
following is the most likely cause of this womans disease:
A. Rhabdomyolysis
B. Lack of lactate production during ischemic exercise
C. Antibodies to the acetylcholine receptor
iim
D. Corticosteroid therapy
Answer: C

89. A 74-year old man with a slowly growing, ulcerated lesion located on the pinna of his left ear.
The lesion is excised, and histologic sections reveal infiltrating groups of cells in the dermis.
These cells have eosinophilic cytoplasm, intercellular bridges, and intracellular keratin formation.
Which of the following is the most likely diagnosis?
A. dermatofibrosarcoma protuberans
4a

B. Merkel cell carcinoma

C. basal cell carcinoma
D. squamous cell carcinoma
Answer: D

92. A 62-year old woman notices a lump on the left side of her face that has become larger
over the past year. On physical examination, a 4 to 5 cm firm, mobile, painless mass is
m

palpable in he region of the left parotid gland, The oral mucosa appears normal. The
patient does not complain of difficulty in chewing food or talking. Which of the following
conditions is most likely to account or these findings?
A. pleomorphic adenoma
B. Sjogren syndrome
C. sialolithiasis
Ai

D. mucoepidermoid carcinoma
Answer: A

95. A 22-year old male gets hit on the head by a hard object in the temporal area. He does not
lose consciousness but afterwards develops a slight headache. He is not taken to the hospital.
By evening he develops severe headache with vomiting and confusion. He was then brought to
the hospital and was assessed as having an epidural hematoma. Which of the following is most
likely present in this individual?
A. Transection of a branch of the middle meningeal artery
B. Bleeding from torn bridging veins
C. Rupture of a preexisting berry aneurysm
D. Cortical bleeding opposite point of traumatic injury
Answer: A

9
 96. A 47-year old man presents with weakness and cramping that involves both hands. Physical
examination reveals atrophy of the muscles of both hands, hyperactive reflexes and muscle
fasciculations involving the arms and legs and positive Babinski reflex. Sensation appears
to be normal in both arms and legs. Which of the following is the most likely diagnosis?
A. Guillain-Barre syndrome
B. Amyotrophic lateral sclerosis
C. Huntingtons disease
D. Metachromatic leukodystrophy
Answer: B

97. After recovering from a viral respiratory infection, a 22-year old woman presents with weakness
in her distal extremities that rapidly ascends to involve proximal muscles. Physical examination
examination reveals absent deep tendon reflexes, and a lumbar puncture the CSF protein to be
increased, but very few cells are present. A biopsy of a peripheral nerve reveals inflammation and
demyelination. Which of the following is the most likely diagnosis?
A. Brown-Sequard syndrome

in
B. syringomyelia
C. Gullain-Barre syndrome
D. diabetes melitus
Answer: C

s.
98. A 22-year old man has a mild pharyngitis followed a few days later by sudden onset of a severe
headache. Physical examination shows nuchal rigidity. His temperature is 38.8C. The gross
appearance of his brain shows extensive purulent exudate covering the brain convexities. Which
of the following is most likely to be the etiologic agent?
A. Cryptococcus neoformans
iim
B. Neisseria meningitidis
C. Poliovirus
D. Toxoplasma gondii
Answer: B

99. A 51-year old man with acute psychosis has a long history of alcoholism. He keeps on
talking nonsense and is unable to follow simple commands. There is also paralysis of
the lateral rectus muscle. A deficiency of which of these nutrients is most likely the cause
4a

of these findings?
A. thiamine
B. niacin
C. cobalamin
D. riboflavin
Answer: A
m

100. Carpal tunnel syndrome, produced by damage to or pressure on the median nerve deep to
the flexor retinaculum, is best characterized by which one of the following clinical signs?
A. Numbness in the fifth finger and medial portion of the ring finger
B. Pain in thumb, index finger, middle finger and lateral half of ring finger
C. Adduction, extension and internal rotation of upper limb
D. Weakness of extensors of wrist and fingers
Ai

Answer: B

Reference: Robbins Pathologic Basis of Disease 7th Edition

1. A5yearoldmalechildpresentedwithstrabismus,poorvisionandwhitishhueto
the pupil of the left eye. Enucleation was done and biopsy revealed Flexner
Wintersteinerrosettes.Whatisthediagnosis?
(Robbins5theditionp461)
a. retinoblastoma
b. paraganglioma
c. melanoma
d. immatureteratoma

10
 2. A 54year old male was brought to the emergency room due to massive
hemoptysis. CXR showed apical lesion in the right lung. The following are
histologicfeaturesofthisdiseaseentityEXCEPT:(Robbins5theditionp81)
a. centralcaseousnecrosis
b. langhanstypegiantcells
c. concentriccalcificconcretion
d. noneoftheabove

3. A 70year old male died of myocardial infarction. Autopsy was done and
microscopicfindingsofthemyocardiumrevealedcoagulativenecrosiswithloss
ofnucleiandstriationsofthecells.Howoldisthelesion?(Robbins5thedp536)
a. 1824hrs
b. 412hrs
c. 2472hrs
d. 37days

in
4. Histologicsectionsoftheperipherallungmassofa60yearoldfemaleshowed
distinctive, tall, columnar to cuboidal epithelial cells that line up along alveolar
septa and project into the alveolar spaces in numerous branching papillary
projections.Whatisthediagnosis?(Robbins5thedp726)

s.
a. smallcellcarcinoma
b. squamouscellcarcinoma
c. bronchioalveolarcarcinoma
d. largecellcarcinoma
iim
5. A35yearoldmalehadbeenhavingonandoffupperabdominaldiscomfortand
vomiting for 1 year. EGD showed red gastric mucosa. Biopsy was done which
revealed inflammatory cells within the lamina propria and beginning atrophy of
the glandular structures. The following are major etiologic associations of this
diseaseexcept:(Robbins5thed.p771)
a. alcoholconsumptionandcigarettesmoking
b. immunologic
c. chronicinfection
4a

d. noneoftheabove

6. A50yearoldfemalepresentedwithdiarrheaandweightlossfor5years.Punch
biopsyofthesmallintestineshowedmucosaladenwithdistendedmacrophages
inthelaminapropria.ThemacrophagescontainPAS(+)granulesandrodshaped
bacillibyelectronmicroscopy.Whatisthediagnosis:(Robbins5thedp799)
m

a. tropicalsprue
b. whipplesdisease
c. celiacsprue
d. disaccharidasedeficiency

7. A 4year old male with nonhodgkins lymphoma presented with paraaotic

Ai

lymphadenopathyandsplenicmass.Whatisthestageofthedisease?(Robbins5th
edp643)
a. stageI
b. stageII
c. stageIII
d. stageIV

8. A 40year old female presented with a 4 cm fixed right breast mass associated
withmovableaxillarynodes.Whatisthestageofthedisease?(Robbins5thedp
1107)
a. stageI
b. stageII
c. stageIII
d. stageIV

11
 9. A 45 y/o female has a history of regular oral contraceptive intake. She has a
higher risk of developing this tumor compared to nonusers. ( Robbins 5th ed
p.416)
a. Hepaticadenoma
b. Ovariancarcinoma
c. Endometrialcarcinoma
d. Pancreaticadenoma

10. A27y/omalewithfeverandleokocytosisexpiredandwassentforautopsy.One
of the gross finding included multiple pale, wedgeshaped infarcts all over the
spleen.Themostlikelydiagnosisis:(p.572576).
a. Metastaticcarcinoma
b. Disseminatedhistoplasmosis
c. Infectiveendocarditis
d. Hodgkinslymphoma

in
CELLINJURYANDADAPTATION

1. Psammomabodiesarefociofdystrophiccalcificationseeninwhichcondition?
A.multiplemyelomaofbone B.papillarythyroidcarcinoma

s.
C.parathyroidadenoma D.Pagetdisease

2. Theseareeosinophiliccytoplasmicinclusionsseeninalcoholicliverdisease.
iim
A.Amyloid B.Mallorybodies
C. Russelbodies D.Kimurabodies

3. Whichofthefollowingisafeatureofnecrosis?
A.reducedcellsize B.intactcellularcontents
C. intactplasmamembrane D.karyolysis
4a

4. A40yearoldmalecomplainsofchroniccoughandweightloss.CXRshowsan
illdefinedmassalongtheapexofbothlobes.SputumAFBwaspositive.Biopsy
ofthelungmostlikelyrevealwhichofthefollowing:
A.liquifactivenecrosis B.coagulativenecrosis
C.caseationnecrosis D.tumornecrosis
m

5. Whichofthefollowingischaracteristicofapoptosis?
A.absenceofinflammation B.affectsnumerouscellsatatime
C.cellswelling D.leakingofenzymes
Ai

6. Whichischaracteristicofirreversibleinjury?
A.cellswelling B.fattychange
C.surfaceblebs D.cellmembranedefects

ACUTEANDCHRONICINFLAMMATION

7. Whichofthefollowingsubstancesmaycauseedemaduringinflammation?
A.histamine B.C5a
C.interleukine1 D.TNF

12
 8. Thisisknownasthemembraneattackcomplex.
A.C3b B.C67
C.C5b9 D.C1b3

9. Whichofthefollowingwhitebloodcellspredominatewithin6to24hrsafter
tissueinjury?
A.macrophage B.basophils
C.neutrophils D.lymphocytes

10. Typeofinflammationinducedbyindigestibleforeignbodies.
A.serous B.granulomatous
C.suppurative D.fibrinous

in
11. Centralactorsinchronicinflammation.
A.neutrophils B.lymphocytes
C.macrophages D.eosinophils

s.
12. Thehallmarkofacuteinflammationis:
transientvasoconstriction B.vasodilation
iim
C. increasedvascularpermeability D.slowingofcirculation

WOUNDHEALINGANDTISSUEREPAIR

13. Whichofthefollowingisanexampleofwoundhealingbyprimaryintention?
A.compoundfracturefixation B.fistularepair
4a

C.endoscopicsurgery D.abscessdrainage

14. Awoundwillattainmaximumstrengthatwhattime?
A.2weeks B.1month
C.3months D.6months
m

15. Reductioninsizeoflargewoundsisattributedtowhichofthefollowing?
A.fibrosis B.tissueremodeling
C.contraction D.reepithelialization

16. Inadequateformationofgranulationtissueorscarcanleadtowhichofthe
Ai

following?
A.ulcer B.keloid
C.contracture D.granuloma

17. Thisisthemostabundantglycoproteininbasementmembrane.
A.elastin B.laminin
C.proteoglycan D.fibronectin

18. Thisisapotentangiogenicgrowthfactor.
A.Epidermalgrowthfactor B.plateletderivedgrowthfactor
C.fibroblastgrowthfactor D.transforminggrowthfactor

13
 FLUIDANDHEMODYNAMICDISORDERS

19. A40yearoldchronicalcoholiccomplainsofeasyfatigabilityandorthopneaat
night.CXRshowedbilateralpleuraleffusionwhileabdominalultrasoundshowed
asciteswithsmallliver.Whatisthemechanismofeffusion?
A.increasedhydrostaticpressure B.decreasedplasmaoncoticpressure
C.lymphaticobstruction D.inflammationofmembranes

20. A70yearoldmaleafterspendingamonthinthehospitalconfinedtoawheel
chairduetoarthritis,suddenlyexperiencesdifficultyofbreathingafterwalking
onhisown.Whatisthemostlikelydiagnosis?
A.pulmonaryembolism B.oldage
C.sepsis D.bronchopneumonia

in
21. Anarterialthromboemboliismostlikelytoproduceahemorrhagicinfarctinwhich
organ?
A.kidney B.liver
C.lungs D.bone

s.
22. TheserumAST&ALTareobservedtobeincreasingina61y/omanoverthe
pastwk.Healsohasincreasinglowerlegswellingw/grade2+pittingedema
totheknees.Hehasprominentjugularvenousdistentioninneckveinstothe
levelofthemandible.W/coftheff.,underlyingconditionsishemostlikelyto
have,ifthegrossappearanceofthelivershows"nutmeg"pattern?
iim
A.portalveinthrombosis B.chronichepatitis
C.congestiveheartfailure D.bileductobstruction

23. Virchowstriad(factorsfavoringthrombosis)includesw/coftheff.?
A. leukocytosis,thrombocytosis,&erythrocytosis
B. occultcancer,heartfailure,&jaundice
C. hyperglycemia,hyperlipidemia,&hypertension
4a

D. stasis,vascularinjury,&hypercoagulability

24. A32yearoldmaleexperienceddifficultyofbreathingandedemaofthelungs
afterbeinginjectedwithanewantibioticdrug.Helaterlostconsciousnessand
hisBPrapidlydeclined,andlaterwentintoshock.Thisisduetowhichofthe
following?
A.hemorrhage B.anaphylactic
m

C.idiopathic D.sepsis
IMMUNESYSTEM

25. Thisantibodymediateshypersensitivityreactionsandismostcommonlyfound
Ai

onsurfaceofmastcells.
A.IgA B.IgG
C.IgM D.IgE

26. SystemicLupusErythematosuscanbeconfirmedbytestingforwhich
antibodies?
A.SSA B.dsDNA
C.centromere D.antiGBM

27. Thesecellscanlysetumorcellsorvirusinfectedcellswithoutpriorsensitization.
A.Bcells B.Tcells
C.NKcells D.macrophages

14
 28. Apatientwithmyastheniagravisdevelopedprogressivemuscleweakness.This
iswhattypeofhypersensitivityreaction?
A.typeI B.typeII
C.typeIII D.typeIV
GENETICDISORDERS

29. Deficiencyinhomogentisicoxidaseresultsinthisconditionwhichmanifestswith
blackdiscolorationoftheurine.
A.albinism B.phenylketonuria
C.ochronosis D.galactosemia

30. Thisisthemostcommongeneticcauseofmentalretardation.
A.trisomy18 B.trisomy21

in
C.chromosome5p D.Turnersyndrome

31. A10yearoldfemaleconsultedduetomultipleneurofibromas,cutaneouscafau
laitmaculesandpigmentedirishamartomas.Thisconditioniscalled
A.tuberoussclerosis B.VonRecklinghausensdisease

s.
C.Marfanssyndrome D.VonHippelLindausyndrome

NEOPLASIA
32. Chemicalcarcinogenimplicatedinthecausationofmesothelioma.
iim
A.arsenic B.vinylchloride
C.asbestos D.nickel

33. Humanpapillomavirustyperesponsibleforcervicalcarcinoma.
A.2and4 B.16and18
C.20and40 D.6and11
4a

34. Mostcommonparaneoplasticsyndromeassociatedwithsquamouscell
carcinomaofthelung.
A.hypercalcemia B.Cushingsyndrome
C.SIADH D.carcinoidsyndrome

35. Extremelyradiosensitivetesticulartumorthattendstospreadtolymphnodes
m

alongtheiliacarteriesandaorta.
A.teratoma B.seminoma
C.embryonalcarcinoma D.adenocarcinoma

36. Whichofthefollowingischaracteristicofamalignanttumor.
Ai

A.welldifferentiated B.slowgrowing
C.cohesiveandwelldemarcated D.metastasis

37. Tumormarkerforbreastcancer.
A.CA125 B.CA199
C.CA153 D.CA201

ENVIRONMENTAL
38. Thisnutrientdeficiencypresentswithmicrocyticandhypochromicanemia.
A.zinc B.iron
C.iodine D.copper

15
 39. Vitamindeficiencyresultsinnightblindnessandxeropthalmia.
A.VitaminA B.VitaminC
C.VitaminD D.VitaminB1

40. Injurycausedbyabluntforcethatdamagessmallbloodvessels,usuallywithout
disruptionofthecontinuityoftissues.
A.abrasion B.contusion
C.laceration D.incision

41. Chronicingestionofthissubstancebymothersmaycausegrowthretardation
andmicrocephalyininfants.
A.iron B.lactose
C.ethanol D.caffeine

in
DISEASEOFINFANCYANDCHILDHOOD
42. Mostcommoncauseofrespiratorydistressinthenewborn.
A.headinjury B.hyalinemembranedisease
C.cordcoiling D.amnioticfluidaspiration

s.
43. Inbornerrorofmetabolismassociatedwithseverementalretardationandstrong
mousyodortotheaffectedinfant.
A.phenylketonuria B.galactosemia
iim
C.cysticfibrosis D.tyrosinemia

44. Thisisthemostfrequentchildhoodtumorcausingdeathinchildrenyoungerthan
15yearsold.
A.astrocytoma B.leukemia
C.neuroblastoma D.melanoma
4a

INFECTIOUSDISEASES
45. Specialstainusedindiagnosingmycobacteriaandnocardiaeinfections.
A.gramstain B.silverstain
C.Giemsa D.acidfaststain

46. Whichofthefollowingorganismscausenecrotizinginflammation.
m

A.Mycobacteriumtuberculosis B.measlesvirus
B.Clostridiumperfringens D.Staphylococcusaureus

47. Pulmonarydiseasecausedbymycobacteriacharacterizedbysmallvisible(2
mm)fociofyellowwhiteconsolidationscatteredthroughthelungparenchyma.
Ai

A.cavitating B.miliary
C.primaryfocus D.Pottsdisease

48. ThesenodularlesionsarerelatedtodelayedhypersensitivitytoTreponema
pallidum,andaremostcommonlyseeninthebone,skinandmucous
membranesofthemouth.
A.chancre B.scrofula
C.gumma D.warts

49. Thisobligateintracellulargramnegativebacteriumisthemostcommon
bacteriallysexuallytransmitteddiseaseintheworld.
A.N.gonorrhea B.C.trachomatis
C.T.pallidum D.H.ducreyi

16
 CARDIOVASCULARSYSTEM

50. Mostcommoncauseofdeathaftermyocardialinfarction.
A.congestiveheartfailure B.hypotension
C.arrhythmia D.myocardialrupture

51. A20yearoldmalewithrheumaticheartdiseasesuddenlycollapsedaftera
basketballgame.Whichofthefollowingmayhavecausedhissymptoms?
A.mitralstenosis B.myocarditis
C.calcifiedaorta D.mitralvalveprolapse

52. Thisisthemostcommonprimarycardiactumorinadults
A.lipoma B.myxoma

in
C.angiosarcoma D.papilloma

HEMATOPOIETICANDLYMPHOIDDISEASES

s.
53. Hemolysisandvasoocclusivecrisisarecommoninthisformofanemiacaused
bymutationofglutamicacidtovalineataminoacid6ofbetachain.
A.thalassemia B.hemoglobinC
C.sicklecellanemia D.hereditaryspherocytosis
iim
54. Noncaseatinggranulomatousinflammationinthelymphnodesandskinistypical
inwhatcondition?
A.sarcoidosis B.tuberculosis
C.histoplasmosis D.chroniclymphadenitis

55. MostcommontypeofHodgkinsLymphomacharacterizedbybroadcollagen
4a

bandsseparatinglymphoidtissueintowelldefinednodules.
A.Nodularsclerosis B.Mixedcellularity
C.Lymphocytepredominant D.Lymphocytedepleted

56. WhichofthefollowingisacommonfeatureofallHodgkinsLymphomas.
A.helperTcells B.RScells
C.Bcells D.Langhansgiantcells
m

RESPIRATORYSYSTEM
57. Thistypeofpneumoniaischaracterizedbypatchyconsolidationofthelungwith
fociofacutesuppurativeinflammationthatarepoorlydefinedgrossly.
Ai

A.lobarpneumonia B.lipoidpneumonia
C.bronchopneumonia D.tuberculous

58. Whichofthefollowingischaracteristicofemphysema?
A.increasednumberofgobletcells B.mucousplugscontainingeosinophils
C.destructionofalveolarwalls D.chronicnecrotizinginflammation

59. Pulmonaryembolimostoftenoriginatefromwhichsite?
A.rightatrium B.leg
C.aorta D.leftventricle

17
 60. ThisisthemostfrequentprimarylungtumorinmenandassociatedwithPTH
secretion.
A.adenocarcinoma B.carcinoid
C.squamouscellcarcinoma D.smallcellcarcinoma

61. Atheroscleroticchangesinthepulmonaryarteriesaregenerallyindicativeofthis
condition.
A.drugabuse B.hypertension
C.embolism D.amyloidosis
KIDNEYANDURINARY

SYSTEM

62. MostcommonWHOclassofLupusNephritis.
A.nolesions B.mesangial

in
C.focalsegmental D.diffuseproliferative

63. A2yearoldboypresentedwithalargewellcircumscribedabdominalmass
involvingbothkidneys.Microscopicexaminationrevealsepithelialtissues,
blastemaandmesenchymaltissues.Thesearediagnosticofwhichofthe

s.
following?
A.Oncocytoma B.WilmsTumor
C.mesoblasticnephroma D.Neuroblastoma
iim
64. A55yearoldmalepresentingwithhematuria,flankpainandabdominalmass.
Grossfindingsshowagoldenyellowtumorwithhemorrhageandnecrosis.
Microscopically,thetumorcellsarelarge,withopticallyclearcytoplasm.Whatis
themostlikelydiagnosis?
A.Renalcellcarcinoma B.Wilmstumor
C.Pheochromocytoma D.Adenoma
4a

65. WhichofthefollowingtestsismostvaluableinconfirmingGoodpastures
syndrome?
A.diffuselinearstainingofGBMwithIgG
B.granularlumpybumpydepositsofIgG
C.urinecultureforresistantE.coli
D.diffusethickeningofGBMonelectronmicroscopy
GIT,LIVER,PANCREAS
m

66. Thesearelinearlacerationsoccurringalongthegastroesophagealjunctiondue
tofitsofvomitinginalcoholics.
A.esophagealvarices B.MalloryWeisstears
C.Shatzkisrings D.Zenkersdiverticula
Ai

67. Thesearegastriculcersassociatedwithextensiveburns.
A.decubitusulcers B.pepticulcers
C.Curlingsulcers D.steroidulcers

68. Thisisasolitarycongenitalmalformationinthesmallbowelduetopersistenceof
theomphalomesentericduct.
A.Meckelsdiverticula B.intussusception
C.omphalocele D.duplication

69. A30yearoldScandinavianoftenexperiencesintermittentattacksofdiarrhea,
feverandabdominalpainduringemotionalstress.ExaminationoftheGItract
reveallongitudinalmucosalulcerationsandfistulaswithinterveningunaffected

18
 segments.Biopsyshowedtransmuralinflammationandnoncaseating
granulomas.Whatisthemostlikelydiagnosis?
A.Typhoidileitis B.Tropicalsprue
C.Crohnsdisease D.Ulcerativecolitis

70. Mostcommoncauseoftransfusionrelatedhepatitis.
A.HepatitisA B.HepatitisB
C.HepatitisC D.HepatitisD

71. Whichofthefollowingisoneofthemostfrequentcausesofacutepancreatitis?
A.periampullarytumors B.thiazideuse
C.trauma D.alcoholism

MALEANDFEMALEREPRODUCTIVESYSTEM

in
72. Mostcommontypeofgermcelltumorinmenof3rddecade.
A.seminoma B.embryonalcarcinoma
C.teratoma D.yolksactumor

s.
73. Whichofthefollowingconditionsarecharacterizedbypresenceofendometrial
glandsandstromaoutsidetheuterus?
A.adenomyosis B.endometriosis
C.atrophicendometrium D.endometrialhyperplasia
iim
74. Thisisahighlymalignantneoplasmcomposedofadualcellpopulationof
cytotrophoblastsandsyncytiotrophoblasts.
A.seminoma B.completemole
C.choriocarcinoma D.invasivemole
BREAST
4a

75. Thisisthemostcommonbenigntumorofthebreast.
A.fibrocysticdisease B.fibroadenoma
C.bluntductadenosis D.intraductalpapilloma
m

76. Thesecomprisemajorityofallinvasiveductalcarcinomas.
A.classic B.tubular
C.cribriform D.mucinous

ENDOCRINESYSTEM
Ai

77. A20yearoldfemalepresentedwithmuscleweakness,weightlossandpretibial
myxedema.Examinationofthethyroidshowa3foldincreaseinsize.AntiTSH
receptorswerepositive.Whatisthediagnosis?
A.Acutethyroiditis B.Hashimotosthyroiditis
C.DeQuervainsthyroiditis C.Gravesdisease

78. Fineneedleaspiratesofa40yearoldfemaleshowedatypicalcellswithnuclear
groovesandinclusions,papillaeandpsammomabodies.Whatisthemostlikely
diagnosis?
A.papillarycarcinoma B.follicularcarcinoma
C.medullarycarcinoma D.diffusehyperplasia

19
 79. Thisisthemostcommonthyroidmalignancy.
A.medullarycarcinoma B.papillarycarcinoma
C.Follicularadenoma D.follicularcarcinoma

80. Theseareadrenalmasseswhichinducesmarkhypertensionsecondaryto
catecholamineproduction.
A.neuroblastomaB.adenocarcinoma
C.pheochromocytomaD.myelolipoma

81. Thisconditionfollowssuddeninfarctionofthepituitaryglandafterobstetric
hemorrhageorshock.

in
A.emptysellasyndromeB.craniopharyngioma
C.SheehanssyndromeD.lymphocytichypophysitis

82. Thisisthemostcommonsecretingtumorofthepituitarygland.
A.prolactinomaB.growthhormone

s.
C.ACTHD.TSH

MUSCULOSKELETAL

SYSTEM
iim
83. Thisisthemostcommonsofttissuetumorofadulthood.
A.hibernomaB.lipoblastoma
C.lipomaD.histiocytoma

84. Myastheniagravisisanautoimmunediseasewithincreasingmusclefatiguewith
4a

useandocularmuscleinvolvement.Whatistargetedbytheantibodydetected?
A.acetylcholinereceptorsB.glomerularbasementmembranes
C.thyroidstimulatinghormoneD.smoothmusclereceptors

SKIN
m

85. Thisisaskinlesionpresentingaspearlypapulesoftencontainingprominent
dilatedsubepidermalbloodvessels.Microscopically,theyarecharacterizedby
peripheralpalisadingoftumorcells,withseparationartifactsandstromalmucin.
Whatisthemostprobablediagnosis?
A.squamouscellcarcinoma B.Pagetsdisease
C.basalcellcarcinoma D.trichilemmoma
Ai

86. Mostcommonformofmalignantmelanoma.
A.lentigomaligna B.superficialspreading
C.nodular D.acrallentigenous

87. Severeformoferythemamultiformewithmucosalinvolvement,conjunctivitisand
highfever.
A.Urticaria B.StevensJohnsonsyndrome
C.xerodermapigmentosum D.Lupuserythematosus

20
 HEAD,NECKANDEYE

88. Thisisthemostcommonsalivaryglandneoplasm.
A.Warthintumor B.Oncocytoma
C.Basalcelladenoma D.Pleomorphicadenoma

89. Thisisthemostcommonprimarymalignantsalivaryglandtumor.
A.Adenoidcysticcarcinoma B.Mucoepidermoidcarcinoma
C.Warthintumor D.Aciniccelltumor

90. WhichofthefollowingischaracteristicofaWarthintumor?
A.chondromyxoidmatrix

in
B.sheetsofcellswithclearcytoplasm
C.epithelialandlymphoidelements
D.hyalinematerialinbetweenspaces

NERVOUSSYSTEM

s.
91. ThisisthemostcommonCNStumor.
A.astrocytoma B.glioblastomamultiforme
C.oligodendroglioma D.ependymoma
iim
100.Whichofthefollowingisthemostcommoncauseofcerebrovascular
accidents?
A.atherosclerosisB.embolic
C.intracerebralhemorrhageD.subarachnoidhemorrhage
4a

CELLINJURYANDADAPTATION

2. Anincreaseoftissuevolumeduetotheadditionofnewcellsis:
A.anaplasia D.metaplasia
B.hyperplasia C.hypertrophy
m

Answer:B
Category:Recall

3. Tissuenecrosisfollowingocclusionofitsbloodsupplyiscalled:
Ai

A.passivecongestion C.infarction
B.inflammation D.thrombosis
Answer:C
Category:Recall

4. Thetypeofnecrosisseenintissueinjuryassociatedwithacutepancreatitisis:
A.traumaticnecrosis D.enzymaticfatnecrosis
B.coagulationnecrosis E.cellmediatednecrosis
C.caseationnecrosis
Answer:D
Category:Recall

ACUTEANDCHRONICINFLAMMATION

21
 5. Macrophages are invariably found in abundance in inflammatory reactions. These
are
derivedfromthe:
A.neutrophils D.endothelialcells
B.monocytes E.noneoftheabove
C.lymphocytes
Answer:B
Category:Recall

6. Thehallmarkofgranulomatousinflammationisthe:
A.epithelioidcell D.fibroblast
B.plasmacell E.giantcell
C.neutrophil
Answer:A
Category:Recall

in
7. Thetypeofcellthatisfirsttomigrateintofociofacuteinflammationisthe:
A. plasma cell D. polymorphonuclear
leukocyte
B.monocyte E.fibroblast
C.lymphocyte
Answer:D

s.
Category:Recall

8. Chronicinflammationmostoftencontains:
A.eosinophils D.lymphocytes
B.neutrophils E.endothelialcells
iim
C.basophils
Answer:D
Category:Recall

TISSUEREPAIR

9. Inthecourseofcellularrepair,thereofteniscollagendeposition.Thislargelyisa
functionof:
4a

A.epithelialcells D.malignantlymphocytes
B.astrocytes E.plasmacells
C.fibroblasts
Answer:C
Category:Recall

10. Oneofthefollowingisincapableofpostnatalmitosis:
A.myocardium D.fibroblast
m

B.bone E.liverparenchyma
C.skinepithelium
Answer: A
Category:Recall
Ai

11. Thehallmarkoftissuehealingis:
A.granulationtissue C.granuloma
B.exudation D.lymphocyteinfiltration
Answer:A
Category:Recall

HEMODYNAMICDISORDERS

12. Themainpathogeneticmechanismofedemaininflammatorydiseasesis:
A.increaseosmoticpressure
B.decreasehydrostaticintravascularpressure
C.lowserumalbumin
D.increasevascularpermeability
E.decreasevascularpermeability
Answer:D
Category:Recall
22
 13. Suddendeathinpulmonaryembolismisdueto:
A.acuterightheartfailure D.superiorvenacavasyndrome
B.cardiactamponade E.respiratorydistresssyndrome
C.pulmonaryedema
Answer:A
Category:Application

15. Localizededemaisbestexemplifiedby:
A.lowserumprotein D.lymphaticobstruction
B.nephriticsyndrome E.congestiveheartfailure
C.portalhypertension
Answer:D
Category:Recall

DISEASESOFIMMUNITY

in
16. TumormostcommonlyassociatedwithAIDS:
A.adenocarcinoma D.melanoma
B.hepatoma E.lymphoma
C.Kaposissarcoma
Answer:C

s.
Category:Recall

17. SystemicLupusErythematosusisavariablemultiorgandisease,butin100%of
caseslesionsalwaysoccurinthe:
A.brain C.spleen
iim
B.liver D.kidney
Answer:D
Category:Application

18. Pneumoniacausedbythisorganismisfrequentlythefirstdiagnosedinfectionin
HIVinfectedpersons:
A. Pneumocytstis carinii C. Cryptococcus
neoformans
4a

B.Aspergilussp. D.Histoplasmacapsulatum
Answer: A
Category:Recall

PRINCIPLESOFNEOPLASIA
m

21. Themostfrequentformofcancerinfemales:
A.gastric D.breast
B.uterine E.lung
C.colonic
Answer:D.
Ai

Category:Recall

22. Themostcommoncauseofdeathduetocancerinbothmenandwomenis:
A.malignantlymphoma C.lungcarcinoma
B.colorectalcarcinoma D.hepatocellularcarcinoma
Answer:C
Category:Recall

INFECTIOUSDISEASES

29. TBandSchistosomacanproduce:
A.ulceration D.cavitation
B.caseation E.granuloma
C.meningitis
Answer:E

23
 Category:Recall

MULTIPLECHOICE:

1. Thehallmarkofacuteinflammationis:
A. Increasedbloodflow
B. Rubor,calor,dolorincreasedpermeabilityofmicrocirculation
C. Increasedvascularpermeability
D. Vascularstasis

in
2. Themostefficientbactericidalcompoundpresentinneutrophilsisthe:
A. Arachidonicacidmetabolites C.Lysosomalenzymes
B. H202MPOHalidesystem D.Hydrogenperoxide

3. Leukotrienesarederivedfromarachidonicacidthroughthehelpofthisenzyme:
A. Phospholipase C.Cyclooxygenase

s.
B. Lipooxygenase D.Lipoxins

4. Thehallmarkofchronicinflammationis:
A. Increasedpermeabilityofmicrocirculation
B. Migrationofmacrophagesatsiteofinjury
iim
C. Tissuedestruction
D. Mononuclearcellinfiltration

5. Anexampleoftumorsuppressorgene:
A. p53 C.ras
B. Cmyc D.bcr

6. Alymphnodebiopsywasdiagnosedastuberculosis.Thistypeofnecrosisis
4a

characteristicof:
A. Coagulative C.Caseous
B. Liquefactive D.Gangrenous

7. Whichofthefollowingsubstancesaccumulatesinatheroscleroticbloodvessels?
A. Fattyacids C.Tryglicerides
B. Cholesterolesters D.Phospholipids
m

8. "Heartfailurecells"foundinthelungsinChronicPassiveCongestionareactually.
A. Lymphocytes C.Neutrophils
B. Eosinophils D.Macrophages

9. TheoutcomeofthrombosiswhereinthethrombitendstoGROWduetodepositionof
additionalplatelets,fibrinandredbloodcells:
Ai

A. Resolution C.Propagation
B. Organization D.Recanalization

10. Mostcommoncauseofdeathinburnpatientswhogotintoshockis:
A. Sepsis C.Dehydration
B. CHF D.Hemorrhage
11. ThistypeofhypersensitivityreactionismediatedbyIgE:
A. TypeI C.TypeIII
B. TypeII D.TypeIV

12. Oneofthethreemajorcomponentsofacuteinflammationinclude:
A. Alterationinvascularcaliberthatleadstoadecreaseinbloodflow
B. Structurechangesinthemicrovasculaturepermittingplasmaproteinsand
leukocytestoleavethecirculation
C. Tissuedestruction
D. Healingbyconnectivetissue

24
 13. Heatandrednessinacuteinflammationisduetothefollowingpathogenetic
mechanism:
A. Increasedvascularpermeability C.Stasis
B. Increasedbloodflow D.Leukocyticmargination

14. Theuterineendometrialliningthickensduringtheproliferativephaseofthe
menstrualcycle.Thisisdueto:
A. Hypertrophy C.Hyperplasia
B. Dysplasia D.Metaplasia

15. Whichofthefollowingdisordersismostlikelytobeassociatedwithanexudates
ratherthanatransudate?
A. Congestiveheartfailure C.Suppurativeinflammation
B. Nephroticsyndrome D.Peritonitis

in
17. Theroleofhistamineinacuteinflammatoryresponseinclude:
A. Plateletreleaseandaggregation
B. Increasedvascularpermeabilityofthevenules
C. Increasedvascularpermeabilityofthearterioles
D. Membranelysis

s.
18. ThecentralfigureinchronicinflammationistheMacrophagebecauseofitsrolein:
A. Breakdownofcollagenandfibronectin
B. Productionof02andNitricoxidemetabolites
C. Emigrationfromthebloodstreamtositeofinjury
iim
D. Inhibitionbycytokinesandoxidizedlipids

19. Abiopsyofthestomachrevealanareaofmalignantchangecharacterizedby
varisized,compactlyarrangedneoplasticglandslinedbymoderatelydifferentiated
cells.Whichofthefollowingtermsrefertomalignanttumorofglandularepithelium?
A. Sarcoma C.Teratoma
B. Choristoma D.Adenocarcinoma
4a

20. WhichofthefollowingstatementsinNOTtrueofredinfarcts?
A. Itoccursinorganswithdoublebloodsupply
B. Commonlyfoundintheheartandkidneys
C. Seeninvenousocclusionwithinfarction
D. Seeninorganswithwelldevelopedanastomosis

21. Whichofthefollowingconditionsisacomplicationofbothdirectinjuriestothelungs
andsystemicdisorders?
m

A. Atelectasis C.Diffusealveolardamage
B. Pulmonaryedema D.Pulmonarycongestion

22. Whichofthefollowingconditionsofthelungischaracterizedbyabnormalpermanent
enlargementoftheairspacedistaltotheterminalbronchioleaccompaniedby
destructionoftheirwallswithoutobviousfibrosis?
Ai

A. Emphysema C.Chronicbronchitis
B. Bronchialasthma D.Bronchiectasis

23. Aspectrumofimmunologicallymediatedpredominantlyinterstitiallungdisorders
causedbyintenseoftenprolongedexposuretoinhaledorganicdustsand
occupationalantigensis:
A. Pulmonaryalveolarproteinosis
B. Bronchiolisobliteransorganizingpneumonia
C. Desquamativeinterstitialpneumonitis
D. Hypersensitivitypneumonitis

24. Anacutefebrilerespiratorydiseasecharacterizedbypatchyinflammatorychanges
inthelungsconfinedtothealveolarseptaandpulmonaryinterstitium:
A. Primaryatypicalpneumonia C.Bronchopneumonia
B. Lobarpneumonia D.Lobularbronchopneumonia

25
 25. Asystemicdiseaseofunknowncausecharacterizedbynoncaseatinggranulomain
manytissuesandorgansparticularlyinthehilarlymphnodes,lungs,eye,andskin
is:
A. Silicosis C.Idiopathicpulmonaryfibrosis
B. Sarcoidosis D.Asbestosis

26. Mostcommonbenigntumorofthelungdiscoveredincidentallyasacoinlesionon
routineXRayexaminationis:
A. Bronchialcarcinoids C.Hamartoma
B. Thymoma D.Bronchogeniccyst

27. Mostcommoncauseofaspirationpneumoniaishospitalizedpatients:
A. Streptococcuspneumonia C.Haemophilusinfluenzae
B. Staphylococcusaureus D.Pseudomonasaeroginosa

28. Mostcommontypeofasthmathatbeginsinchildhoodandtriggeredby

in
environmentalantigenssuchasdust,pollensandfoodis:
A. Nonatopicasthma C.Atopicasthma
B. Druginducedasthma d. OccupationalAsthma

29. Mostcommonmanifestationofasbestosexposureoftencontainingcalciumseenon

s.
theanteriorandposterioraspectoftheparietalpleura:
A. Asbestosbody C.Ferruginousbodies
B. Plaques D.Amphibole

30. Whichofthefollowingsyndromeischaracterizedbytheappearanceofproliferative
iim
glomerulonephritisandnecrotizinghemorrhagicinterstitialpneumonitis?
A. Goodpasturesyndrome C.Karteagnersyndrome
B. Paraneoplasticsyndrome D.LambertEatonmyasthenicsyndrome

31. Mostcommonlocationofsecondarytuberculosisinthelung:
A. Hilararea C.Peripheral
B. Base D.Apex
4a

32. Afatalcomplicationofrupturedaorticaneurysmandvasculartrauma:
A. Chylothorax C.Hydrothorax
B. Hemothorax D.Empyema

33. MangJuanito,60yearoldman,hasbeensmokingformanyyears,heexperienced
chroniccoughandweightlossforthepast6months,nofevernonauseaand
vomiting.HehadoneboutofhemoptysisandwenttotheERforconsultation.Xray
showsa6cmmassonthemedialupperlobe.Bronchoscopyshowsamassonthe
m

segmentalbronchus.Whichofthefollowingcytologicfindingsislikelytobefoundin
thispatient?
A. Presenceofacidfastorganismonsputumexam
B. Presenceofmalignantsquamouscellsinsputum
C. Presenceofnumerousnecroticdebrisandinflammatorycellsinsputum
D. Presenceofreactivemesothelialcellsinpleuralfluidexam
Ai

35. MangTony,55yearoldmanhasnomajormedicalproblemsinthepastyear,4
monthspriortoconsultationthepatientexperiencemalaiseandweightlossof10kg.
Thepatientisanonsmoker,nofever,nodifficultyofbreathing.ChestXrayshowsa
multiplesolidnodulesscatteredthroughoutthelungfields.Whatisthemostlikely
diagnosis?
A. Bronchogeniccarcinoma C.Malignantmesothelioma
B. Metastaticcarcinoma D.Bronchioalveolarcarcinoma

36. MangTomas,45yearoldmanhadanepisodeofmyocardialinfarctionhewas
broughttotheemergencyroomandwasintubated.Uponintubationhesuffers
aspirationofgastriccontents.Forthenext5dayshedevelopsnonreproductive
coughandfever.ChestXrayshowsa3cmmassintherightlungwithelevatedair
fluidlevel.Whatisthemostlikelydiagnosis?
A. Bronchopulmonarysequestration C.Atelectasis
B. Bronchiectasis D.Lungabscess

26
 37. Hemodynamicpulmonaryedemaseenincongestiveheartfailureisdueto:
A. Increasedoncoticpressure C.Increasedhydrostaticpressure
B. Decreasedinterstitialosmoticpressure D.Increasedalbumin

38. Suddendeathinpatientswithpulmonaryembolismiscausedby:
A. Blockageofbloodflowthroughthelungs
B. Atelectasis
C. Developmentofchronicobstructivepulmonarydisease
D. Developmentofpulmonaryhypertension

39. Alymphohematogenousdisseminationofpulmonarytuberculosiswouldgiveriseto:
A. Vacitaryfibrocaseoustuberculosis C.Tuberculousbronchopneumonia
B. Pottsdisease D.Miliarytuberculosis

40. Theplausiblemechanisminthedevelopmentofemphysemais:

in
A. Increasereleaseofelastaseinneutrophilsandmacrophages
B. Increasealpha1antitrypsinenzyme
C. Presenceofobstructionofatumorofforeignbodywithconcomitantinfection
D. Increaseresponsivenessofthebronchialtree

41. Themajorcauseofceliacsprueis:

s.
A. Bacterialinfection
B. DeficiencyofVitaminB12
C. Hypersensitivitytogliadinfractionofwheatgluten
D. Lymphaticobstruction
iim
43. Thehistologiccriterionforthediagnosisofacuteappendicitisisbasedonfindingthis
typeofcellinfiltratingthemuscularispropia:
A. Histiocytes C.Lymphocytes
B. Monocytes D.Neutrophils

45. Disaccharidasedeficiencyisclassifiedunderwhichofthefollowingmajorcausesof
malabsorptionsyndrome:
A. DefectiveIntraluminaldigestion
4a

B. Lymphaticobstruction
C. Primarymucosalcellabnormalities
D. Reducedsmallintestinalsurfacearea

46. Inulcerativecolitis,inflammationislimitedtothe:
A. Mucosa C.Serosa
B. Submucosa D.Transmurallayer
Answer:mucosaandsubmucosaonly
m

47. Largeareasofhemorrhagicgreenulcerationofthemucosaandgreenblack
necrosisthroughthewall,extendingtotheserosaoftheappendixismostlikely
associatedtowhichofthefollowingstagesofacuteappendicitis?
A. Acutegangrenousappendicitis C.Acutesuppurativeappendicitis
B. Earlyacuteappendicitis D.Rupturedacuteappendicitis
Ai

48. Leon,25yearoldmalecomplainedofintermittentdiarrheaandlowerabdominal
pain.AnupperGIseriesshowedsegmentalnarrowingintheileum.Microscopic
findingsofthelesionshowedinflammationfromthemucosatotheserosawiththe
presenceofnoncaseatinggranulomas.Themostlikelydiagnosisis:
A. Celiacsprue C.Crohn'sdisease
B. Tropicalsprue D.Whipple'sdisease

49. Henry,45yearold,malesuffersfromepisodicabdominalbloatingwithflatulence
andexplosivediarrheaafterattendingaweeklongcommunitycelebrationofthe
dairyindustryduringtherestoftheyear,hedoesnotconsumemilkshakesorice
creamandisnotsymptomatic.Whichofthefollowingconditionsbestaccountsfor
thesefindings?
A. Celiacsprue C.Disaccharidasedeficiency
B. Ulcerativecolitis D.Whipple'sdisease

50. Josie,40yearoldfemale,hasatotalserumbilirubinconcentrationof8.9mg/dland

27
 adirectbilirubinlevelof6.8mg/dl.TheserumAlanineaminotrasferase(ALT)levelis
125U/L,andtheaspartateaminotransferase(AST)levelis108U/L.Aliverbiopsy
showshistologicfindingscharacteristicforSclerosingcholangitis.Whichofthe
followinggastrointestinaltractdiseaseismostlikelytocoexistinthispatient?
A. Celiacsprue C.Tropicalsprue
B. Ulcerativecolitis D.Whipple'sdisease

51. Amiddleagedmalecomplainsoffoodstickingsomewherebetweenmouthand
stomach.Monometryrevealsaperistalsis.Themostpossiblediagnosisis:
A. Stenosisduetoseveregastroesophagealreflux
B. Paraesophagealhiatalhernia
C. Achalasia
D. Zenker'sdiverticulum

52. Joshua,25yearold,medicalstudentdevelopedsharpepigastricpainrelievedby
eating.AnupperG.I.seriesdemonstrateda1cmgastriculcer.Whichofthe

in
followingfeaturesisnotcompatiblewiththeclinicalfindings?
A. Thesizeoftheulcerdoesnotdifferentiateabenignfrommalignantulcer.
B. Heapingupmarginisrareinthebenignulcerbutcharacteristicofmalignant
lesion
C. Thebaseofthepepticulcerissmoothandclean
D. Ulcerativelesioninthegreatercurvatureismorelikelytobeclassicpepticulcer

s.
53. Joan,25yearold,female,developeddiarrhea,abdominalpain,andrectalbleeding.
Sigmoidoscopyshowednumerousulcers.Idiopathicinflammatoryboweldisease
wasconsidered.WhichofthefollowingfindingsismorecompatibletoCrohn's
Diseasethantoulcerativecolitis?
iim
A. Cryptabscessformationdeepinmucosa
B. Increaseincidenceofadenocarcinomaofcolon
C. Pseudopolypformationbetweenulcers
D. Presenceofgranulomasinthecolonicwall

54. Cesar,35yearoldmalehadahistoryofheartburn,regurgitationofsourbrash,
dyspnea,burningesophagealpainandslowlybutprogressivedysphagia.Hewas
admittedtotheemergencyroombecauseoflobarpneumonia.Themostpossible
4a

causeofhispneumoniaisduetoaspirationandcanbeattributedtowhichofthe
followingconditions?
A. Esophagealatresia C.Slidinghiatalhernia
B. Refluxesophagitis D.Esophagealdiverticulum

55. Imelda,6yearold,girl,hadablocky,reddishbrownrashandwastreatedwith
aspirin,shedevelopedfattychangeoftheliver.Themostlikelydiagnosisis:
A. SubacuteSclerosingpanencephalitis
m

B. VaricellaZosterinfection
C. Reye'ssyndrome
D. Poliomyelitis

56. Ronnie,45yearold,alcoholicwentonabingefor2weeks.Hewasfoundcomatose
andinliverfailure.Hisliveratautopsyshowedseveralhepatocyteswithhyaline
Ai

Mallorybodiesinthecytoplasm.Thisfindingismosttypicalof:
A. Alcoholichepatitis C.Hepaticsteatosis
B. Alcoholiccirrhosis D.Hepatocellulartumor

57. Fely,18yearold,female,presentswithabdominalpainlocalizedtotherightlower
quadrant,nauseaandvomiting,mildfever,andanelevationoftheperipheral
leukocytecountto17x109/L.Examinationofthesurgicallyresectedappendixismost
likelytoreveal:
A. Anappendixwithnormalappearance
B. Neutrophilswithinthemuscularwall
C. Lymphoidhyperplasiaandmultinucleatedgiantcellswithinthemuscularwall
D. Adilatedlumenfilledwithmucus

58. Nelia,38yearold,female,complainsoffatigueandpruritus.Sheisfoundtohave
highserumalkalinephosphataseandslightlyelevatedserumbilirubinlevels,and
serumantimitochondrialautobodiesarepresent.Aliverbiopsyrevealsamarked

28
 Lymphocyticinfiltrateintheportaltracts.Occasionalgranulomasarealsoseen.The
mostlikelydiagnosisis:
A. PrimarySclerosingcholangitis C.ViralhepatitisBinfection
B. Primarybiliarycirrhosis D.Impactedgallstone

59. Thefindingsofmultiple,pale,yellow,hardroundstoneswithinthegallbladderis
NOTassociatedwithwhichofthefollowing?
A. Oralcontraceptive C.Obesity
B. Biliaryinfection D.Hyperlipidemiasyndromes

60. Dilatedsinusoidsandirregularcysticspacesfilledwithbloodwithintheliverwhich
mayruptureleadingtomassiveintraabdominalhemorrhage,aremostcommonly
associatedwith:
A. Salicylates C.Estrogen
B. Anabolicsteroids D.Acetaminophen

in
61. Transmuralinfarctscommonlyinvolvethesethreearterialvesselsoftheheart.The
LEASTaffectedoneisthe:
A. Leftanteriordescending C.Rightcoronary
B. Leftcircumflex D.Rightcircumflex
62. Theheatfailurecellsarebynature:
A. Alveolarliningcells C.Polymorphonuclearcells

s.
B. Macrophages D.Eosinophils

63. Anginathatisunstableisclinicallydescribedas:
A. Transient C.Precipitatedbyphysicalstress
B. Relievedbyrest D.Progressive
iim
64. Thisorganisnotprominentaffectedinrightsidedfailure:
A. Liver C.Kidneys
B. Lungs D.Brain

65. Acardiacmassformaninfantonmicroscopicexaminationrevealed"spidercells".
Whattypeoftumoristhis?
A. Leiomyoma C.Rhabdomyoma
4a

B. Myxoma D.Fibroma

66. Casesofpatentductusarteriosusthatarenotisolatedarecommonlyassociated
withthefollowingconditions,Except:
A. VSD C.Coarctation
B. ASD D.Pulmonarystenosis

67. HistopathologyexaminationoftheheartofapatientwhodiedofAMIshowed
m

coagulativenecrosis,edema,hemorrhageandneutrophilicinfiltrates.Howoldisthe
infarct?
A. 30minutes C.1day
B. 12hours D.1week

68. Noli,15yearold,student,hadsorethroatandaweeklaterdevelopedswollenjoints
Ai

andamurmurintheaorticvalvearea.Whatisthediagnosis?
A. Infectiveendocarditis C.SLE
B. Rheumaticheartdisease D.Diphtheria

69. Daniel,35yearoldman,whorecentlyhadaninfarctdevelopedaloudpericardial
frictionrub.Thisisdueto:
A. Anotherinfarct C.Serouspericarditis
B. Purulentpericarditis D.Fibrinouspericarditis

70. George,40yearoldmale,diedofsepsiswithDIC.Uponautopsy,smallmassesof
fibrinthrombiwereseenintheheartvalves.Howdoyouinterpretthis?
A. Patienthadinfectiveendocarditis C.PatienthadNBTE
B. Patienthadrheumaticheartdisease D.Itisnormalfinding

71. Thebilesaltsaidintheemulsificationofdietaryfatsintheintestines.Theyare
composedofbileacidsthathavebeenconjugatedwith:

29
 A. Albumin C.Glucoronicacid
B. Aminoacid D.Glucose

72. Themilkyappearanceofserumafterfatingestioniscalledpostprandiallipemia.The
lipemicappearanceiscausedbythepresenceof:
A. Cholesterol C.Fattyacids
B. Chylomicrons D.Phospholipids

73. Whichofthefollowingapolipoproteins,whenpresentinanincreasedconcentration,
wouldbeassociatedwithadecreasedriskofcoronaryarterydisease?
A. ApoAI C.ApoB100
B. ApoB48 D.ApoCII

74. Whichtypeofinflammationismostcharacteristicofacuterheumaticfever?
A. Myocarditis C.Pancarditis
B. Pericarditis D.Endocarditis

in
75. Thisdiseaseoftheheartpresentsonearlycyanosis:
A. Atrialseptaldefect C.Patentductusarteriosus
B. Truncusarteriosus D.Atrioventricularseptaldefect

76. Whichofthefollowingstatementsaboutheartfailureistrue?

s.
A. Rightsidedfailuremayresultinhepatomegaly
B. Corpulmonaleusuallyisduetoseverepulmonicstenosis
C. Theclinicalmanifestationofheartfailuremostcommonlyreflectrightsided
failure
D. Dyspneaisaresultofbloodstasisintheextremities
iim
77. Whichofthefollowingdiseasesresultsfromafamilialabsenceofhighdensity
lipoprotein?
A. Krabbe's C.Gaucher's
B. Tangier D.TaySachs

78. Theenzymethatexistschieflyinskeletalmuscle,heartandbrainisgrosslyactive
musculardystrophyandrisesearlyinmyocardialinfarctionis:
4a

A. Lipase C.Transminase
B. Lactatedehydrogenase D.Creatinekinase

79. Juanito,34yearoldwasfoundtohavetotalcholesterolof225mg/dlandanHDL
cholesterolof83mg/dl.Basedontheseresults,thisindividual:
A. Isaborderlinehighriskofcoronaryheartdisease
B. Shouldbecounseledtomodifyhisdiettoreducehistotalcholesterol
C. Shouldbeconsultedtoseehisphysicianimmediatetofollowuptesting
m

D. Isprobablynotborderlinehighriskforcoronaryheartdisease.

80. Abloodspecimenisdrawnforlipoproteinphenotyping.Thetestresultsobtainedare:
1. Triglycerides235mg/dl(NV40164mg/dl)
2. Totalcholesterol190mg/dl(NVlessthan200mg/dl)
3. Prebetalipoproteinfractionincreased
Ai

4. Betalipoproteinfractionnormal
5. Chylomicronspresent
6. Serumappearancemilky
Thebestexplanationfortheseresultswouldbethattheindividualexhibited
characteristicof:
A. Anormalindividual C.TypeIIhyperlipoproteinemia
B. Anonfastingserumprotein D.TypeIVhyperlipoproteinemia

81. HemoglobinBart'siscomposedof:
A. Fouralphachains C.Fourgammachains
B. Fourbetachains D.Twoalpha,twobetachains

82. HowellJollybodiesarecomposedof:
A. DNA C.Iron
B. RNA D.Mitochondria

30
 83. Themostmaturecellthatcanundergomitosisisthe:
A. Myeloblast C.Metamyelocyte
B. Promyelocyte D.Myelocyte

84. Vasodilationandbronchoconstrictionwouldbeassociatedwithwhichbloodcell:
A. Eosinophilic C.Basophils
B. Neutrophils D.Monocytes

85. Lymphocytesthatproduceimmunoglobulinsinresponsetoantigenicstimulationare
designated:
A. BLymphocytes C.Plasmacells
B. Tlymphocytes D.Thymocytes

86. ToxicgranulationismostcommonlyobservedasaCytoplasmicinclusionof:
A. Lymphocytes C.Monocytes

in
B. Eosinophils D.Neutrophils

87. WhichofthefollowingorgansisNOTasiteforhematopoiesisinthefetus?
A. Liver C.Spleen
B. Bonemarrow D.Kidney

s.
88. Inearlyinfancythemostnumerouscellsofthebonemarroware:
A. Erythroblasts C.Granulocyticprecursors
B. Lymphocytes D.Histiocytesmonocytes

89. Whichcellclassificationisdescribedbythefollowing:Secondmostnumerouscellin
iim
thebloodusuallysmallandroundintenselybluecytoplasmandnucleuswith
clumpeddarkpurplechromatin?
A. Monocyte C.Lymphocyte
B. Nullcell D.Plasmacyte

90. Whichofthefollowingismostvariableinnormalmarrow?
A. Differentialcountof500cells C.M:Eratio
B. Cellularity D.Ironstage
4a

91. WhichofthefollowingisnotacrucialareaofRBCsurvivalandfunction?
A. IntegrityofRBCcellularmembrane C.Cellmetabolism
B. Intravascularhemolysis D.hemoglobinstructure

92. Whichofthefollowinggroupsofabnormalhemoglobinsareunabletotransportor
deliveroxygen?
A. Carboxyhemoglobinandmethemoglobin
m

B. Methemoglobinandfetalhemoglobin
C. Carboxyhemoglobin,sulfhemoglobin,andfetalhemoglobin
D. Carboxyhemoglobin,methemoglobinandsulfhemoglobin

93. Productionofprimarygranulesceasesandproductionofsecondarygranules
commenceswithwhatcellstage?
Ai

A. Myelocyte C.Myeloblast
B. Promyelocyte D.Metamyelocyte

94. AdecreasedinwhichofthefollowinglaboratoryresultsisNOTausualdiagnostic
criterionforanemia?
A. Hemoglobin C.hematocrit
B. Plateletcount D.RBCcount

95. Whatisdiagnosticvalueofreticulocytecountintheevaluationofanemia?
A. Determinesresponseandpotentialofthebonemarrow
B. Determinescompensationmechanismsforanemia
C. DeterminesthecorrectedRBCcountafterthecalculation
D. DeterminesthepotentialsamplingerrorforRBCcount

96. Abonemarrowhaslargecellsthathaveeccentricpyknoticnuclei.Thecytoplasmof
thesecellstainsverypaleandhasastriatedappearance:

31
 A. Megakaryoblasts C.Gaucher'scells
B. ReedSternbergcells D.Largemyeloblasts

97. WhichofthefollowingisNOTafactortobeevaluatedintheinterpretationofabone
marrowaspiratesmear?
A. Maturationofredandwhitebloodcellsseries
B. M:Eratio
C. Typeandamountofhemoglobin
D. Estimateofbonemarrowactivity

98. Lito27yearoldhasatotalWBCcountof4x109/L.Thedifferentialcountisas
follows: Neutrophils28(NV.56)
Lypmhocytes65(NV.34)
Band.02(NV.2)
Monocytes.5(NV.4)
Whichofthefollowingstatementsistrue?

in
A. Thepercentageoflymphocytesisnormal
B. Theabsolutenumberoflymphocytesislow
C. Thereisanabsolutelymphocytosis
D. Thereisarelativelymphocytosis

100.Theprincipaldefectinchronicgranulomatousdiseaseisin:

s.
A. Chemotaxis C.Phagocytosis
B. Lysosomalfunction D.Productionofoxygenandradical
iim
SIMPLE MULTIPLE CHOICE. CHOOSE THE BEST ANSWER.

ENDOCRINE PATHOLOGY
1. A patient with tremors and with exopthalmos has enlarged thyroid gland. If
thyroidectomy is done the thyroid would exhibit this type of cellular adaptation.
A. Hyperplasia C. Metaplasia
B. Hypertrophy D. Dysplasia
4a

2. This is characterized by hard, fixed thyroid gland associated with extensive

fibrosis that is contiguous with adjacent neck structures
A. Hashimotos thyroiditis C. Granulomatous thyroidis
B. Riedels thyroiditis D. Graves disease
m

3. A medical student who suddenly developed marked tetany and parasthesia and
later on was found out that she was suffering from a parathyroid problem. Your
diagnosis would be:
A. hypoparathyroidism C. parathyroid carcinoma
B. parathyroid adenoma D. parathyroid hypoplasia
Ai

4. Microscopic sections of a 3 cm solitary thyroid nodule show proliferating fetal

type of thyroid follicles with a focus a transcapsular invasion. Your diagnosis
would be:
A. Papillary carcinoma C. Medullar thyroid
carcinoma
B. Follicular carcinoma D. Anaplastic thyroid
carcinoma

5. Which of the following thyroid malignancy has the highest mortality?

A. Papillary carcinoma C. Medullary carcinoma
B. Follicular carcinoma D. Anaplastic thyroid
carcinoma

32
 6. Orphan- Annie nuclei is a characteristic nuclear feature of this thyroid malignancy
A. Papillary carcinoma C. Medullary carcinoma
B. Follicular carcinoma D. Anaplstic carcinoma

GIT, LIVER, AND HBT

7. Barretts esophagus shows this adoptive cellular change
A. Hyperplasia C. Metaplasia
B. Hypertrophy D. Dysplasia

8. The hallmark of irreversible liver injury

A. fatty change C. fibrosis
B. cellular swelling D. bridging necrosis

in
9. The usual site of pancreatic malignancy is:
A. Head C. tail
B. Body D. accessory pancreas

s.
10. Alpha feto protein is requested for the detection of this liver neoplasm
A. Hepatoma C. Metastatic carcinoma
B. Cholangiocarcinoma D. Klatskin tumor
iim
11. An enlarged axillary lymph node excised from a 53 year old female presenting
with an ill defined, fixed palpable firm mass at the right upper outer quadrant
would probably show
A. Metastatic tumor C. Primary malignant tumor
B. Benign tumor D. Hamartomatous tumor

12. This lesion is grossly seen as linear laceration in the gastroesophageal area
4a

A. Barretts esophagus C. Esophageal varices

B. Mallory weiss D. Severe esophagitis

13. This is an premalignant colonic polyp

A. Hamartomatous polyp C. Puetz Jegher polyp
B. Adenomatous polyp D. Inflammatory polyp
m

14. Which is true of chronic gastritis?

A. H. pylori organisms aggregates along metaplastic epithelium
B. It is grossly seen as multiple ulceration
C. It is a common cause of gastric malignancy
Ai

D. It commonly presents as bleeding

15. The type of ulcer produced by this organism is flask shaped

A. M. tuberculosis C. Samonella
B. E. histolytica D. Crohns disease

16. Malignant transformation is a common complication of this lesion

A. Achalasia C. Peptic ulcer
B. Mallory weiss D. Fraction diverticulum

17. You would think of a malignant ulcer if this gross feature is seen
A. converging mucosal fold C. edematous border

33
 B. uneven borders D. mucosa overhungs the
edge of the ulcer

18. Most common malignancy of the appendix is:

A. Carcinoid C. Squamous cell carcinoma
B. Lymphoma D. Seminoma

19. A gastric carcinoma that metastasize in the periumbillical area is called:

A. Virchows nodule C. Krukenberg tumor
B. Sister Mary Joseph nodule D. Linitis plastica

20. Stercoral ulcer are associated with this disease:

A. Meckels diverticulum C. Gastric malignancy
B. Chronic gastritis D. Congenital megacolon

in
21. Most common location of gastric carcinoma
A. Fundus C. Cardia
B. Body D. Antrum

s.
22. Nutmeg liver is the gross appearance of the liver in:
A. acute left ventricular failure C. malnutrition
B. portal vein thrombosis D. chronic right ventricular
iim
failure

CELLULAR REACTION TO INJURY (CRI)

23. Atrophy of myocardial fibers would show this cellular accumulation
A. Hemosiderophage C. Councilman bodies
B. Lipofuscin D. Bilirubin pigments
4a

24. The deepest layer of an ulcer is made up of which of these?

A. vessel proliferation C. fibrosis
B. necrotic tissues D. mixed inflammatory cells

25. Mycobacterium tuberculosis infection would show this type of necrosis.

m

A. Coagulation C. Liquefaction
B. Caseation D. Gangrenous

26. Which of the following is an irreversible form of cellular injury?

Ai

A. Nuclear pyknosis C. Mitochondrial swelling

B. Dilatation of ER D. Plasma membrane blebs

NEOPLASIA
27. Cervical biopsy of a 32 year old female with cervical erosion shows squamous
epithelium that exhibits some atypia and loss of polarity. This adoptive response
is:
A. Hyperpalsia C. Metaplasia
B. Hypertrophy D. Dysplasia

28. This is the most activated oncogene in adenomas and colon cancers:
A. Bax gene C. K-ras
B. APC D. p-53

34
 29. Absolute lymphocytosis, lymphoblasts, many small mature lymphocytes in the
peripheral smears is a characteristic of this type of leukemia:
A. ALL C. CLL
B. AML D. CML

30. This is not a common complication of leukemia:

A. gout C. diabetes
B. infection D. anemia

31. Identification of Reed-Sternberg cells will lead you to think of this tumor:
A. Non-hodgkins lymphoma C. Burkitts lymphoma
B. Hodgkins lymphoma D. hairy cell leukemia

in
32. A malignant epithelial tumor is referred to as:
A. carcinoma C. sarcoma
B. adenoma D. lymphoma

s.
33. Loss of organizational, structural and functional differentiation of cell is known
as:
A. Neoplasia C. hyperchromaticity
B. Anaplasia D. dysplasia
iim
34. A well differentiated tumor means:
A. The tumor is severely anaplastic
B. The tumor still looks like the tissue where it originates
C. The tumor would be very pleomorphic
D. The tumor is benign
4a

35. Which of the following is a benign tumor ?

A. Hepatoma C. Hemangioma
B. Retinoblast D. Sarcoma

36. Which of the following is the pre-cancerous lesion

m

A. CIN C. Fibroepithelial polyp

B. Adenomatous polyp D. Ulcerative colitis

37. Aniline dye and rubber can cause malignancy to this organ
Ai

A. Cervix C. Skin
B. Liver D. Urinary bladder

INFLAMMATION
38. A hypertrophied scar would show this feature.
A. Angiogenesis
B. Lymphoid follicle formation
C. Presence of harphazardly arranged bundles of collagen
D. Aggregates of epitheloid histiocytes

39. The main difference between healing by primary intention and secondary
intention is:
A. Leukocyte migration C. Fibrosis
B. Amount of Granulation tissue D. Contraction

35
 40. This process is always seen in chronic inflammation:
A. Proliferation of blood vessels C. Emigration of neutrophils
B. Increase in edema fluid D. Incerase premeability of
blood vessels

RESPIRATORY SYSTEM
41. Pulmonary embolism could lead to this type of shock
A. Neurogenic shock C. Hypovolemic shock
B. Cardiogenic shock D. Septic shock

42. The mechanism of adult respiratory distress syndrome is:

A. deficiency in pulmonary surfactant C. diffuse damage to the

in
alveolar capillary wall
B. increased hydrostatic pressure D. inflammatory reaction to
microorganisms

s.
43. Posterior mediastinal rest of the lungs tissue with no connection to the air way
system is known as:
A. Bronchiectasis C. teratoma
B. pulmonary sequestration D. hamartoma
iim
44. This syndrome is characterized by bronchiectasis, sinusitis and sinus inversus
caused by defect in ciliary motility
A. Kartagener C. Pulmonary sequestration
B. Cystic fibrosis D. Mesothelioma

45. Viral pneumonias typically presents in the lungs as:

4a

A. lymphoplasmacytic infiltrates within the alveolar sacs

B. mononuclear cells within the septa
C. accumulation of neutrophils in one lobar segment
D. neutrophils in the peribronchiolar area

46. Most common cause of community acquired pneumonia is:

m

A. Klebsiella C. Strep pneumonia

B. Haemophilus influenza D. Staph aureus

47. This is the second stage in the evolution of the lobar pneumonia:
A. Congestion C. Resolution
Ai

B. Gray hepatization D. Red hepatization

48. This type of malignancy is commonly seen in the periphery of the lungs
A. Oat cell carcinoma C. Adenocarcinoma
B. Squamous cell carcinoma D. Small cell carcinoma

49. Collapse of lung secondary to air in the pleural cavity is an example of:
A. Compression atelectasis C. Patchy atelectasis
B. Resorption atelectasis D. Contraction atelectasis

50. This lung disease exhibits smooth muscle hyperplasia of the bronchial walls
A. Emphysema C. Asthma

36
 B. Bronchitis D. Bronchiectasis

51. This finding in the pulmonary vessel would indicate advance pulmonary
hypertension
A. Medial hypertrophy C. Plexogenic arteriopathy
B. Internal hyperplasia D. Pulmonary embolus

52. The usual source of pulmonary embolism is:

A. Bronchus C. mitral valve
B. Deep leg veins D. left atrium

53. Squamous cell carcinoma would normally spread via

A. Lymphatic route C. Direct extension

in
B. Hematogenous route D. It does not metastasize

THE HEART
For question number 58 59

s.
A 25 year old female presents with a history of recurrent fever and arthralgia
accompanied by ECG changes and increased ASO titer in the past 2 years. The physical
examination reveals a cardiac murmur.

54. What is the clinical impression?

iim
A. Acute Rheumatic Fever C. Infective Endocarditis
B. Chronic Rheumatic Heart Disease D. Aortic Calcific Stenosis

55. The murmur is caused by;

A. Anemia C. Contraction deformity
B. Valve deformity D. Change in consistency of
blood
4a

56. Hemorrhagic infarct is the expected lesion in thromboembolism to:

A. Renal artery C. Mesenteric artery
B. Coronary artery D. Splenic artery
m

57. The earliest microscopic sign of myocardial infarction is:

A. neutrophilic infiltration C. coagulation necrosis
B. congestion D. fiber waviness

58. This congenital heart disease has cyanosis at birth:

Ai

A. VSD C. PDA
B. ASD D. TOF

59. Chronic mitral stenosis will show this lung finding:

A. rupture of alveolar septa C. thickening of the septa
B. neutrophilic infiltrates in septa D. hyaline membrane
coating the septa

60. Maximal neutrophilic infiltration in a postinfarct heart is:

A. 8 hours C. 5-7 days
B. 1-3 days D. 2 weeks

37
 MALE REPRODUCTIVE SYSTEMS
61. Most common testicular tumor in infants
A. Yolk sac tumor C. Embryonal carcinoma
B. Teratoma D. Choriocarcinoma

FEMALE REPRODUCTIVE SYSTEMS AND BREAST

62. This breast malignancy has the best prognosis
A. Papillary carcinoma C. Colloid carcinoma
B. Invasive ductal carcinoma D. Intraductal carcinoma

63. Usefullness of the Paps smear is seen in the following except:

A. Hormonal cytology
B. Identifying etiology of infection
C. Diagnosis of endocervical polyp

in
D. Screening of cervical malignancies and its early precursors

64. The surgery of choice in a patient with palpable axillary lymph nodes in the
presence of proven primary breast carcinoma

s.
A. Simple mastectomy C. Modified Radical
mastectomy
B. Excision biopsy D. MRM with frozen section

65. If you are suspecting an ovarian cancer, you would request for what tumor
iim
marker?
A. CEA C. Alpha feto protein
B. CA 125 D. HCG

IMMUNE DYSFUNCTION
66. The following are antigen presenting cells, EXCEPT:
A. dendritic cells C. langerhans cells
4a

B. macrophages D. natural killer cells

Robbins 7th Edition Chapter 6, Page 210

67. Which of the following cells contain CD3, CD4, and CD 8 molecule
A. T lymphocytes C. Interferon
B. B lymphocytes D. Natural Killer cells
m

68. A localized area of tissue necrosis resulting from an acute immune complex is an
example of this type of hypersensitivity reaction
A. Type I C. Type III
B. Type II D. Type IV
Robbins 7 Edition Chapter 6, Page 210
th
Ai

NERVOUS SYSTEM
69. Subarachnoid hemmorhage is associated with this lession
A. Charcot Bouchard microaneurysm C. Degenerative
B. AV malformation D. Berry aneurysm
Robbins 7 Edition Chapter 28, Page 1366
th

70. This is the most common cause of acute bacterial meningitis in children:
A. E. Coli C. Tuberculosis
B. H. Influenza D. Klebsiella
Robbins 7th Edition Chapter 28, Page 1369

71. Histologic lesion that is not present in glioblastoma multiforme

A. Necrosis C. rosette formation
B. Proliferating blood vessels D. anaplastic cells
Robbins 7th Edition Chapter 28, Page 1410
38
 72. The most common cause of intracerebral hemmorhage is:
A. berry aneurysm C. A-V malformation
B. microaneurysm D. infection

SKIN
73. Which type of mole is noted for its greatest malignant potential?
A. Melanoma C. Compound nevus
B. Intradermal nevus D. Junctional nevus

74. Which among these is not a common malignancy of the skin?

A. Adenocarcinoma C. Squamous cell carcinoma
B. Melanoma D. Basal cell carcinoma

in
75. Which among these is considered a premalignant tumor?
A. Keratoacanthoma C. Actinic keratosis
B. Seborrheic keratosis D. Acanthosis nigricans

s.
ENVIRONMENTAL PATHOLOGY
76. This substance has been implicated in mesothelioma
A. asbestos C. X ray
B. mercury D. formaldehyde
iim
77. This is the major source of oil spill
A. Big spills C. Off shore drilling
B. Down the drain D. Up in smoke

78. Caisson disease is associated with this physical injury

A. Blast injury C. Decompression disease
4a

B. Electrical injury D. High altitude sickness

KIDNEY AND URINARY TRACT

79. Crescent formation is produced by the proliferation of which component of the
glomerulus?
A. endothelial cells C. parietal epithelia
B. mesangial epithelia D. podocytes
m

For question number 80 to 83

Ai

A 10 year old female presents with generalized edema. Blood pressure is 90/60.

80. What is the most likely clinical diagnosis?

A. Acute renal failure C. Nephritic syndrome
B. Chronic renal failure D. Nephrotic syndrome

Urinalysis showed the following findings: specific gravity = 1.10 (1.015 1.022)
Protein = 3+
Oval fat bodies = 3+
81. Considering the clinical data, what is the most likely light microscopic pattern?
A. Acute glomerulonephritis (GN) C. Membranoproliferative GN
B. Membranous GN D. Normal glumerulous

39
 82. What is the expected immunofluorescence pattern in this case?
A. Linear C. Negative
immunoflourescene
B. Granular D. Variably linear granular

83. What is the expected electron microscopic (EM) findings?

A. Subepithelial deposits C. Loss of podocyte foot
process
B. Subendothelial deposits D. No pathologic EM findings

For question number 84 to 85

A 65 years old man sought consult due to decreased vigor urinary stream and increased
urinary frequency. Digital rectal examination revealed an enlarged prostate gland.

in
84. An elevated serum prostatic specific antigen (PSA) together with an elevated
alkaline phosphatase level is consistent with which of the following mechanisms?
A. Benign prostatic hyperplasia C. Prostatic malignancy
B. Cystitis D. Prostatitis

s.
Robbins 7th Edition Chapter 21, Page 1053

85. The clinical symptoms of this patient are referable to which of the following
mechanisms?
A. Increased urine output C. Urethral fibrosis &
iim
stricture
B. Prostatic irritation and inflammation D. Urinary bladder outlet
obstruction
Robbins 7th Edition Chapter 21, Page 1033

NUTRITIONAL DISORDERS
For question number 86 to 93
A 35 year old female came in for consultation due to increased amount and frequent
4a

menstruation for the past 6 months. CBC was done revealing low hemoglobin,
hematocrit and red blood cell (RBC) count.

86. The mechanism for the abnormal RBC parameter is due to.
A. Anemia due to hemolysis C. Anemia due to chronic
blood loss
B. Anemia due to hemoglobinopathy D. Anemia due to decreased
m

RBC production
Robbins 7th Edition Chapter 13, Page 624

87. The red cell morphology of the peripheral smear is expected to be

A. Normocytic normochromic C. Macrocytic hyperchromic
B. Normocytic hypochronic D. Microcytic hypochromic
Ai

Robbins 7th Edition Chapter 13, Page 624

88. The most likely RBC disorder present in this patient would be:
A. Megaloblastic anemia C. Iron deficiency anemia
B. Thalassemia D. Sickle Cell Disease
Robbins 7 Edition Chapter 13, Page 643
th

89. Macrocytic, hypochromic type of anemia is seen in which of the following

conditions?
A. Folic Acid Deficiency C. RBC destruction due to
antibodies
B. Lack of dietary iron D. RBC membrane defect
Robbins 7 Edition Chapter 13, Page 642
th

MUSCULOSKELETAL SYSTEM

40
 90. Most common primary malignant tumor of the bone
A. Osteosarcoma C. Chondrosarcoma
B. Metastatic tumor D. Giant cell tumor

91. On x-ray of the skull, lytic punched out lesion are seen. This tumor is probably
made up of
A. giant cells C. bone forming tumor cells
D. plasma cells

92. This lesion has the oldest age group of predilection

A. Osteosarcoma C. Chondrosarcoma
D. Giant cell tumor

93. This soft tissue tumor has biphasic feature of tumor cells

in
A. Fibrosarcoma C. Osteosarcoma
B. Synovial sarcoma D. Malignant fibrous
histiocytoma
CHOOSETHEBESTANSWER.

s.
CellularInjuryandAdaptation
1. Virusesinducecellinjurythrough:
A. directcytopathiceffect C.bothA&Barecorrect
iim
B. immunemediatedreactions D.neitherAnorBiscorrect

2. Process(es)involvedincellnecrosisis(are):
A. denaturationofproteins C.bothA&Barecorrect
B. enzymicdigestionofcells D.neitherAnorBiscorrect
4a

3. ThefollowingstatementsareTRUEofcaseousnecrosis:
A. itisacombinationofcoagulationandliquefactionnecrosis
B. itisacharacteristicfeatureoftuberculosis
C. bothA&Barecorrect
D. neitherAnorBiscorrect
m

4. Jaundiceisduetotheaccumulationofthispigment:
A. bilirubin C.lipofuscin
B. hemosiderin D.melanin
Ai

InflammationandRepair
5. Thesequenceofcellulareventsininflammationis:
A. marginationdiapedesischemotaxisphagocytosis
B. diapedesismarginationchemotaxisphagocytosis
C. chemotaxismarginationdiapedesisphagocytosis
D. chemotaxisdiapedesismarginationphagocytosis

6. Themosteffectivemeansofmicrobialkillingisviathe:
A. oxygenindependentmechanism
B. myeloperozidaseindependedmechanism
C. hydrogenperoxide,myeloperoxidaseandhalidesystem
D. onlyA&Carecorrect

41
 7. Themostimportantcauseofdelayinwoundhealingis:
A. infection C.inadequatebloodsupply
B. presenceofforeignbodies D.mechanicalfactors

8. Keloidisduetoexcessive:
A. granulationtissue C.amyloiddeposition
B. granulomaformation D.collagenaccumulation

FluidandHemodynamics
9. Edemacanresultfromanyofthefollowingmechanisms:
A. increasedhydrostaticpressureoftheblood
B. increasedosmoticpressureofinterstitialfluid(sodiumretention)
C. decreasedoncoticpressureofplasmaprotein

in
D. alloftheabovearecorrect

10. Periorbitaledemaisusuallyencounteredin:
A. filariasis C.livercirrhosis
B. nephriticsyndrome D.inflammatorystates

s.
11. Fluidthatcollectsduringacuteinflammationandthathasaproteincontentin
excessof3.0g/LandSGover1.015istermed:
A. exudate C.hydropericardium
iim
B. transudate D.wheal

GeneticsDisorders
12. Asegmentofonechromosometransferredtoanothersegmentisknownas:
A. mutation C.inversion
B. translocation D.deletion
4a

13. ThemostcommoncauseoftheoccurrenceofKlinefelterssyndrome:
A. nondisjunctioninmeioticdivisioninoogenesis
B. nondisjunctioninmeioticdivisioninspermatogenesis
C. nondisjunctioninmeioticdivisioninembryogenesis
D. translocation
m

14. ThenumberofBarrbodiesinapatientwith48XXXYkaryotype:
A. none C.two
B. one D.three
Ai

15. ThefollowingaresuppressorgenesEXCEPT:
A. p53 C.APC
B. bcl2 D.NFI

InfectiousDisease
16. A6yearoldboydevelopsabdominalpainandvomitingprecededbya3day
periodwithoutbowelmovements.Adiagnosisofintestinalobstructionis
made.Ofthefollowing,themostlikelyreasonfortheobstructionisabolus
of:
A. Taeniasaginata C.Strongyloidestercoralis
B. Ascarislumbricoides D.Onchocercavolvulus

42
 17. Achroniccarrierstateoftyphoidfeverismostlikelyduetothepersistenceof
theorganismin:
A. theappendix C.thegallbladder
B. thecortexofthekidney D.theileum

NutritionalDisease
18. Functionofthiamine:
A. coenzymeinoxidativedecarboxylationofalphaketoacids
B. synthesisofDNAandRNA
C. respiratoryenzymeinthecytochromeenzyme
D. alloftheabovearecorrect

19. Themetabolismofcalciumiscloselyregulatedby:

in
A. vitaminD C.thyroidgland
B. parathyroidgland D.alloftheabovearecorrect

20. Themechanismofclottingisaffectedby:

s.
A. VitaminA C.Thiamine
B. VitaminK D.VitaminE

EnvironmentalPathology
iim
21. This/thesepollutantsis/aredangerousbecauseoncereleasedintothe
environmenttheyareforeveri.e.resistanttonaturalprocessofdecay.
A. polychlorinatedbiphenyls C.carbonmonoxide
B. chloroform D.alloftheabovearecorrect

22. Ethylalcoholtoxicitywillcause:
A. venousthrombosis C.fattyliver
4a

B. cheeryreddiscolorationofskin D.gingivitis

23. Whichofthefollowingisthemostcommonadverseeffectofsmoking?
A. myocardialinfarction C.cancerofthepancreas
B. cancerofthebladder D.pepticulcerdisease
m

24. Exposuretocarbonparticleintheambientairwillresultto:
A. Anthracosis C.progressivemassivefibrosis
B. coalworkerspneumoconiosis D.anyoftheabove
Ai

DiseasesofInfancy&Childhood
25. Theleadingcauseofdeathinchildrenbetween514yearsofageis:
A. malignantneoplasm C.injuriesresultingfromaccidents
D.cardiacdiseases

26. Thehighestatriskperiodforintrauterinecytomegalovirusinfection:
A. 1sttrimesterofpregnancy C.3rdtrimesterofpregnancy
B. 2 trimesterofpregnancy
nd
D.alloftheabove

27. Organogenesisiscompletedby:
A. 2ndtrimesterofpregnancy C.theendof1sttrimester
B. theendof2ndtrimester D.themiddleof1sttrimester
43
 28. Complicatedoradvancedatherosclerosiswouldmostlikelyaffectthisportion
ofthebloodvessel:
A. intimaonly C.intimaandadventitia
B. intimaandmedia D.adventitia

29. Abiopsyofthefemoralarteryrevealedcalcificationinthemediawouldbe
compatiblewith:
A. acceleratedhypertension
B. youngindividuals,usuallymale
C. usualcomplicationofischemiaandgangrene
D. noneoftheabove

in
30. AvasculartumorassociatedwithAIDSis:
A. Lymphaniosarcoma C.Angiosarcoma
B. Kaposissarcoma D.Hemangiopericytoma

s.
WBC,LymphnodesandSpleen
31. Starryskypatternoflymphnodeischaracteristicof:
A. Burkittslymphoma C.Histiocyticlymphoma
iim
D.Sezaryssyndrome

32. LacunarcellsarecharacteristicsofthistypeofHodgkinsdisease:
A. lymphocyticpredominance C.mixedcellularity
B. lymphocytedepletion D.nodularsclerosis
4a

33. ThemostcommontypeofHistiocytosisXininfantsis:
A. eosinophilicgranuloma C.letterersiwesyndrome
B. handschullerchristiandisease D.unifocallangerhanscellhistiocytosis

34. Sinushistiocytosisarenormallyseeninnodesdraining:
m

A. infection C.drugabuse
B. cancers D.immunologicdisorders

35. Apatientpresentswithhemoptysisandacuterenalfailure.Adiagnosisworth
consideringinthisclinicalpictureis:
Ai

A. Asbestosis C.Goodpasturessyndrome
B. primaryatypicalpneumonia D.tuberculosis

RespiratorySystem
36. Alpha1antitrypsindeficiencyisassociatedwith:
A. panlobularemphysema C.Wegenersgranulomatosis
B. anthracosis D.bronchogeniccarcinoma

37. Enlargementofpulmonaryalveolarspaceswithdestructionofseptalwallsis
seenin:
A. chronicbronchitis C.pulmonaryinfarction
B. emphysema D.alveolarproteinosis

44
 38. Achestxraythatshowsashaggycavitywithathickirregularborderand
satellitedensitiesintherightlowerlobeismostcompatiblewith:
A. bronchogeniccarcinoma C.abscess
B. tuberculosis D.histoplasmosis

GIT

39. Whichstatementaboutesophagealcancerisfalse?
A. itisusuallyofsquamouscelltype
B. mostcommoninthedistalportion
C. primarilyadiseaseofelderlymales
D. characterizedbydysphagiaandpainlessweightloss

in
40. Macrophageswithpositiveperiodicacidschiffstainingmaterialinintestinal
laminapropiaandlymphnodesarecharacteristicallyfoundin:
A. Wilsonsdisease C.Whipplesdisease
B. Elevatedserumgastrinlevels D.Gardenerssyndrome

s.
41. TheMalloryWeisssyndromeisduetolacerationinthemucosaofthe:
A. Esophagus C.Pylorus
B. Stomach D.Smallintestine
iim
42. CarcinomaoftheGITwouldbeexpectedtooccurwithgreatestfrequencyin
patientswith:
A. familialpolyposisofthecolon C.Crohnsdisease
B. villousadenomaofthecolon D.gastriculcer

Liver,Biliary&Pancreas
4a

43. Chronicobstructionofthecysticductresultstodevelopmentof:
A. Choledochalcyst C.Hydropsofthegallbladder
B. Porcelaingallbladder D.Carcinomaofthegallbladder

44. Whichofthefollowingcondition(s)increase(s)theriskofbileduct
m

carcinoma?
A. Choledochalcyst C.Hydropsofthegallbladder
B. Porcelaingallbladder D.Choledocholithiasis

45. Carcinomaofthepancreas:
Ai

A. occursmostofteninthebodyofthepancreas
B. isassociatedwithhypocalcemia
C. arisesfromthepancreaticductalcells
D. isusuallycuredbytotalpancreatectomy

46. Theleastcommontypeofgallbladdercalculiare:
A. purecalciumbilirubinate C.purecholesterol
B. purecalciumcarbonate D.mixedstone

47. Cholelithiasisismainlydueto:
A. Infection C.bilestasis
B. supersaturationofbilewithcholesterol D.inflammation

45
 Kidney
48. Inadditiontonephriticinjury,theothermaincauseofacutetubularnecrosisis:
A. Sepsis C.severehypocomplementemia
B. Ischemia D.immunecomplexdeposition

49. Ofthecomplicationsofacutepyelonephritisenumeratedbelow,onedoesnot
belong:
A. retroperitonealabscessformation C.acuteepisodesofparoxysmalHPN
B. renalpapillarynecrosis D.pyonephrosis

50. Oftheriskfactorsforpyelonephritisenumeratedbelow,onedoesnotbelong:
A. diabetesmellitus

in
B. malesex
C. congenitalabnormalitiesoftheurinarytract
D. pregnancy

s.
51. Chronicrenaldisease,pheochromocytoma,Connssyndrome,coarctationof
theaortaandacromegalyareallconditionsthatmayleadto:
A. venousthrombosis C.Wegenersgranulomatosis
B. hypersensitivityvasculitis D.hypertension
iim
LowerUrinaryTract&MaleGenitalSystem
52. Nestsofurotheliummaybefoundinthelaminapropiaoftheurinarybladder
representingnormalvariationinthemorphologyofthebladder.Thesenests
ofurotheliumarecalled:
A. Brunnersnests C.Brunnsnests
B. Burneysnests D.Burnersnests
4a

53. Anewbornbabywasnotedtopassouturinethroughasmallopeninginthe
areaoftheumbilicus.Thisismostprobablydueto:
A. Urachalcyst C.Exstrophyofthebladder
B. Patenturachus D.Anyoftheabove
m

54. Thefollowingiscausedbyhumanpapillomavirustype6(HPV6):
A. Giantcondyloma C.condylomalata
B. Condylomaacuminatum D.alloftheabove
Ai

FemaleGenitalTract
55. Themajorityofovarianneoplasmsarisefrom:
A. germcells C.sexcordstroma
B. surfaceepithelialcell D.metastaticfromGIT

56. Themostcommonsiteofendometriosis:
A. fallopiantube C.rectovaginalseptum
B. ovary D.vagina

57. Choriocarcinomaismostoftenprecededby:
A. abortion C.normalpregnancy
B. ectopicpregnancy D.H.mole

46
 58. Themostcommonprimarymalignanttumoroftheovary:
A. endometrioidcarcinoma C.serouscystadenocarcinoma
B. mucinouscystadenocarcinoma D.yolksactumor

Breast
59. Cordlikeductsfilledwithnecroticandcheesytumoroustissuethatcanbe
readilyextrudeduponpressureisseenin:
A. mucinouscarcinoma C.medullarycarcinoma
B. comedocarcinoma D.pagetsdiseaseofthebreast

60. Sitesofmetastasesofcystosarcomaphyllodesareusually:
A. axillarylymphnodes C.liver

in
B. lungsandbone D.brain

61. Themostfrequentsiteofbreastcanceris:
A. lowerinnerquadrant C.upperouterquadrant

s.
B. upperinnerquadrant D.subareolar

Endocrine
Fornumbers87to89
iim
62. Afemalepatientpresentedwithmoonfacies,truncalobesityandhisrutism.
Plasmacortisolwaselevated.Thesefeaturescharacterize:
A. Connssyndrome C.WaterhouseFriderichsensyndrome
B. Cushingssyndrome D.OnlyB&Carecorrect

63. IfyoususpectthepresenceofCushingssyndrome,youshouldperforma:
A. lowdosedexamethasonetest
4a

B. highdosedexamethasonesuppressiontest
C. bothA&Barecorrect
D. neitherAnorBiscorrect

64. IfthiswereCushingssyndrome,onewouldexpect:
m

A. suppressionofcortisolsecretion C.nosuppressionofcortisolsecretion
B. suppressionofACTHsecretion D.onlyA&Barecorrect

65. Suppressionofcortisolsecretionwithhighdosedexamethasonesuppression
testindicatesthepresenceof:
Ai

A. anadrenalneoplasm C.pituitaryACTHexcess
B. ectopicACTHsyndrome D.alloftheabovearecorrect

Skin&Musculoskeletal
66. Whichofthefollowingisasecondarylesion?
A. wheal C.erosion
D.bulla

67. Psoriaticpatientstypicallydevelopsilvery:
A. excoriations C.papules
B. scales D.pustules

47
 68. Apatientpresentswithvesiclesontheleftsideofhistrunk.Asimplelab
proceduretodotosupportadiagnosisofherpeszosteris:
A. gramstain C.Tzancksmear
B. KOHstain D.Patchtest

69. Oneoftheetiologicfactorsinacneisthe:
A. Pityrosporum C.Propionibacterium
B. Staphylococcus D.Enterococci

70. ThepaucibacillarytherapyforHansensdiseaseis:
A. Rifampicin600mgOfloxacin400mgMinocycline100mgdailyfor6
months
B. Rifampicin600mgonceamonthfor6monthsDapsone100mgdaily

in
for6months
C. Rifampicin600mgonceamonthfor2yearsDapsone100mgdailyfor2
yearsClofazimine50mgdailyfor2years
D. Rifampicin600mgonceamonthfor6monthsDapsone100mgdailyfor6
monthsClofazimine50mgdailyfor6months

s.
71. Achildpresentswithanarrayofmacules,papules,vesicles,andbullae,
reddish,withpaleerodedcenterinvolvingtheextremities,lipsandoral
mucosainasymmetricpattern.Therewasintakeofpenicillinand
iim
sulfonamidesforurinarytractinfection.Thepatientmostlikelyhas:
A. erythemamultiforme C.lichenplanus
B. psoriasis D.porphyria

NervousSystem
72. Mostcommonprimarymalignantbraintumor:
A. Medulloblastoma C.Ganglioneuroma
4a

B. glioblastomamultiforme D.ependymoma

73. Histologiccriteriaforglioblastomamultiforme:
A. vascularendothelialproliferation
B. anaplasia
m

C. bothA&Barecorrect
D. neither AnorBiscorrect

74. Medulloblastomamostfrequentlyoccursin:
A. age60andabove C.children&youngadults
Ai

B. middleadulthood D.noagepredilectionisobserved

75. Tuberculomainchildrenfrequentlyoccursin:
A. Supratentorial C.Posteriorfossa
B. Infratentorial D.Transtentorial

CHOOSETHEBESTANSWER:

_____1.Whichcelladaptationisachievedbydecreasingcellularactivityandreducing
numberandsizeofcellularorganelles?
A. Atrophy B.Hyperplasia C.Hypertrophy D.Metaplasia

_____2.Inhypertrophy,atwhatpointofthecellcycleisblocked?

48
 A.StoG0 B.S C.G0toG1 D.MtoG0

_____3.Whichmechanismexplainstheinitialreductioninsizeofanorganundergoing
atrophy?
A.Apoptosis B.AutolysisC.AutophagyoforganellesD.Extrusionof
organelles

_____4.Inhyperplasiaoftheskin,whichstratumentersthecellcycle?
A.Basale B.Granulosum C.Lucidum D.Spinosum

_____5.Whichofthefollowingsubstancesdisruptthesteadystateandcausescell
swelling?
A.Calcium B.Chloride C.Potassium D.Sodium

_____ 6. Accumulation of lactic acid due to anoxia stops the synthesis of proteins by
disruptingwhichcellularstructure?

in
A. Cellmembrane C.MitochondrialDNA
B. Endoplasmicreticulum D.NuclearDNA

_____7.Abscessoftheliverisaformofwhichtypeofnecrosis?
A.Caseous B.Coagulative C.Gangrenous D.
Liquefactive

s.
_____8.Whichfacilitatesthedegradationofdenaturedproteinthatisbeyondrepairto
preventfurtherinjurytothecell?
A.Caspases B.Chaperones C.Laminin D.Ubiquitin
iim
_____9.Transplantationoforgansbetweentwoidenticaltwinsiscalled:
A. Allograft B.Autograft C.Isograft D.Xenograft

____10.Whichofthefollowingisanessentialcomponentofneoplasia?
A. Autonomicgrowth C.Largemass
B. Excessiveproliferationofcells D.Rapidgrowth

_____ 11. The deposition of calcium salts and other mineral salts in vital tissue that
4a

reflectsderangementincalciummetabolismandhypercalcemiaiscalled:
A. Apoptoticcalcification C.Gangrenouscalcification
B. Dystrophiccalcification D.Metastaticcalcification

_____12.Morphologically,amalignanttumorispoorlydifferentiatedwhenthereis:
A. Markedlyhyperchromaticnuclei C.Totallostofnormalfunctionof
cells
B. Poorresemblancetocelloforigin D.Veryhighnucleocytoplasmic
m

ratio

_____13.Whichofthefollowingisadefinitesignofmalignancy?
A. Compressionofadjacentstructures C.Metastasis
B. Infiltrativegrowth D.Vascularinvasion
Ai

_____14.Rasoncogenequalitativelychangesfunctionofprotooncogenethrough
whichformofmutation?
A.Deletion B.Geneamplification C.Pointmutation D.
Translocation

_____15.IntheTNMstagingsystem,Mstandsforwhichofthefollowing?
A. Metastasistodistantsites C.Probablemortality
B. Probablemorbidity D.Regionallymphnodemetastasis

_____ 16. Which of the following increases the cells ability to adapt and survive
prolongedenvironmentalchanges?
A. Anaerobicrespiration C.Subdivisionandmultiplication
B. Enteringthecellcycle D.Synthesisofgrowthfactorreceptors

49
 _____17.Whichistheuniquecharacteristicofinnateimmuneresponse?
A. Macrophagesplayadominantrole
B. MaincellularcomponentsaretheTlymphocytes
C. Mainhumoralcomponentsaretheinterferons
D. Memorycellsareproduced

_____18.Therepaircomponentofhealinginvolvesprincipallywhichofthefollowing?
A. Formationofsupportingconnectivetissue C.Removalofcellulardebris
B. Regenerationofparenchymalcells D.Synthesisofbasement
membrane

_____19.Inacuteinflammation,scarformationisprimarilyduetothepresenceof:
A. Antigenthatisnotreadilydigested
B. Infection
C. Largeareasofnecrosisandexudateformation
D. Oxygendeprivation

in
_____20.Theformationofgiantcellsinagranulomatousinflammationisforthe
purposeof:
A. Acquiringfasteramoeboidmovementtorunaftertheoffendingagent
B. Acquiringgreatercapabilityforphagocytosis
C. Formingabarrieraroundtheoffendingagent

s.
D. PresentingmoreefficientlytheantigenMHCcomplex

_____21.Whichstatementbestexpressestheconceptofchronicinflammation?
A. Acquiredimmuneresponse
B. Inflammatoryresponsefollowingacuteinflammation
iim
C. Persistenceofstimuluswithprolongedinflammationandrepair
D. Resultofafailedacuteinflammatoryresponse

_____22.Ininnateimmuneresponse,theantiviralactivityofinterferonreducesthe
synthesisof:
A. HostandviralDNA C.Hostproteinsintheribosomes
B. HostandviralmRNA D.Viralcellmembraneproteins
4a

_____23.Theultimategoalofhomeostasisinapersistentlychanginginterstitialmilieu
isto:
A. Inducecelldivision
B. Limitentryandexitofsubstancesintothecytosol
C. Maintainconstancyinthecytosoltoensurephysiologicfunction
D. Removecellsthatcannotadapt

______24.Agingcausescelldamageanddeaththroughwhichmechanism?
m

A. Accumulationofintracellularcalcium
B. IncreasingligandsforFasordeathreceptor
C. MutationofnuclearDNA
D. Productionofoxygenderivedfreeradicals

_____25.Thepathogenesisofcoagulationnecrosisis:
Ai

A. Actionofpowerfulproteolyticenzymesfromlysosomesandinflammatorycells
B. ActivationoftheFasordeathreceptor
C. Inactivationofautolyticorintracellularenzymesanddehydrationwithoutcell
decomposition
D. Rapidentryofwaterandcalciumwithsaponificationofcellularcontents

_____26.Whichofthefollowingbestdescribesdysplasiainthecontextofbiological
growth?
A. CellsthatlostabilitytoentertheG0phaseofcellcycleandareperpetuallyinthe
cycle
B. Lossofdifferentiationand/ormaturationofincreasingnumberofcells
C. Lossoffunctionofincreasingnumberoffullydifferentiatedcells
D. Malignantcellsthatalreadypossessinvasivecapabilitiesbutarestillintheresting
phaseofthecellcycle

50
 _____27.Gravesdiseaseiscausebywhichofthefollowingimmunologicreactions?
A. Activationofnaturalkillercellsduetocomplimentfixationonthefollicular
cells
B. Destructionoffolliclesbyautoantibodiesagainstthyroglobulin
C. DestructionoffolliclesbyTclymphocytesandsubsequentexcessivereleaseof
thyroidhormones
D. ExcessiveproductionofIgGthyroidstimulatingantibodiesduetodefectintheTs
lymphocytes

_____28.Whichistheinitialstepintransudateformation?
A. Decreasedplasmaoncoticpressure C.Increasedinterstitialosmotic
pressure
B. Increasedhydrostaticpressure D.Increasedvascular
permeability

_____29.Thekeymechanismofapoptosisis:

in
A. CessationofmRNAsynthesis
B. CoilingofDNAchromatin
C. DNAfragmentationbyendonucleaseactivation
D. Nonspecificdegradation&randomDNAcleavage

_____30.Whichofthefollowingmakeshomeostasispossibleinthebodysystems?

s.
A. Internalenvironmentalwaysconstant
B. Physiologicfeedbackmechanism
C. Tendencyofbodysystemtobeinequilibrium
D. Tendencyofbodysystemtobeinsteadystate
iim
_____31.Whichisthemechanismbywhichaninfectiousagentmaytriggeran
autoimmunedisease?
A.Infectiousagenthasasimilarantigenicstructureasselfantigenandthe
resultingimmuneresponsecrossreactswithselfantigen.
B.InfectiousagenttriggersprematurereleaseofTlymphocytesfromthethymusstill
possessingreceptorstoselfantigens
C.InfectiousagenttriggersmacrophagestorandomlypresentantigenstotheT
lymphocytesandbychancepresentanantigenthatissimilartoselfantigen.
4a

D.InfectiousagentsuppressesthesuppressorTlymphocytesthusgivingtheThelper
lymphocytethefreedomtoreacttoanyantigenincludingselfantigen.

_____32.ATypeIhypersensitivityreactionduetotheintakeofanantibioticcan
immediatelykillapersonbecauseof:
A. Cellularswellingoftheliningepitheliumwithparalysisofthecilia
B. Constrictionduetoedemaoftheinterstitialtissue
C. Necrosisanddesquamationoftheliningepithelium
m

D. Spasmofthesmoothmusclesandincreasedmucusglandsecretion

_____33.Thepointofirreversibilityofcelldamageisevidentultrastructurallybythe
presenceofwhichofthefollowing?
A. MarkedswellingofmitochondriaandclumpingofmitochondrialDNA
B. Numerousfracturesandbreakupsofmembranesofcellandsaccular
Ai

organelles
C. Polyribosomecomplexesdispersedintosingleribosome
D. TightcoilingofnuclearDNAthreads

_____34.Inaninjuredliver,growthfactorsultimatelycauselivercellsto:
A. Deactivatethecyclindependentkinasecomplexesthusshorteningthecellcycleso
thatmorecellsareproducedwithinashortertime
B. Deactivaethep53suppressorgenesotatnodelayinDNAsynthesisoccurs
C. Enterandcompletethecellcycle
D. Growinsizedbyincreasingthecytoplasmicorganelles
_____35.Solublefactor(e.g.TNF)releasedbyinflammatoryandtumorcellsare
believedtocausecancercachexiathroughwhichofthefollowingmechanisms?
A. DivertTPofnormalcellstomeetincreasedenergyneedsoftumorcells
B. Increasetumorneedsforessentialnutrientsattheexpenseofnormalcells
C. Interferewithnormalcellmetabolismandmetabolismofessentialnutrients
D. Suppressdesireforfoodbyactingonthepituitary

51
 _____36.Inthevascularphaseofacuteinflammation,theinterstitialosmoticpressure
progressivelyincreasesduetotheincreasingamountof:
A. Lymphaticflowresultinginreducedinterstitialfluid
B. Neutrophils
C. Plasmaproteins
D. Proteinaceousdebrisfromdeadbacteria

_____37.Inanacquiredimmuneresponsetoaspecificantigen,thereactiontoa
secondexposureusuallytakesamuchshortertimecomparedtothefirstexposure
becauseofwhichofthefollowing?
A. Afterinitialexposure,allTlymphocytesdevelopreceptorstotheantigenandare
readytoreacttoasecondexposure
B. MemoryTlymphocytescommittedtothatantigenarealreadypresent
C. MemoryTlymphocytescontinuetorecruituncommittedTlymphocyteseveninthe
absenceoftheantigen

in
D. RecruitmentofuncommittedTlymphocytesisfasterinthesecondexposure

_____38.ThedifficultyinproducinganeffectivevaccineagainstHIVisduetowhichof
thefollowing?
A. Thefrequentenzymaticerrorsintranscription,whichmakecopiesifthevirus
RNA,resultsindifferentstains

s.
B. TheexactstructureoftheHIVhasnotbeendeterminedyet
E. Forsomeunknownreasons,Thlymphocytesdonothavethereceptorsforthisvirus,
andso,cannotbeactivatedtoinitiateanimmureresponse
F. ItisdifficulttoisolatetheantigenofanRNAvirus
iim
_____39.Patientsonanticancerchemotherapyarehighlysusceptibletoinfections
becauseof:
A. Markeddiminutioninthenumberofcellsoftheinnateandacquiredimmune
response
B. Susceptibilityoflivertodruginjuryresultingindiminishedcomplementproduction
C. Toxicityofthedrugscausestheneutrophilstoloseitsphagocyticactivity
D. ToxicityofthedrugsimpairstheproductionofMHCbymacrophages
4a

_____40.Coagulationnecrosiscanbeseeninsometypesofbacterialandfungal
infectionwhenthereis:
A. Growthandmultiplicationoftheorganisminthebloodresultinginobstruction
tobloodflow
B. Markededemaformationresultinginthecompressionofarterioles
C. Productionoflargeamountoftoxinsandenzymesbythemicroorganismresultingin
denaturationofintracellularproteins
D. Suppurationresultinginthedestructionofbloodvessels
m

_____ 41. The basal cell changes seen in reflux esophagitis is an example of this
adaptivechange:
A.Atrophy B.Hyperplasia C.Hypertrophy D.Metaplasia

_____42.Theformationofesophagealvaricessecondarytocirrhosisisprimarilydue
Ai

to:
A.Activecongestion B.Passivecongestion C.Thrombosis D.
Embolism

_____43.Inmegacolon,theaganglionicsegmentisinwhichportion:
A. Transversecolon
B. Distendedportion
C. Nondistendeddistalsegment
D. Nondistendedsegmentproximaltothedistension

_____44.Thelesionofcholeraisatmostwhichofthefollowing:
A.Congestionandedema B.Erosions C.Hemorrhage D.Suppurative
inflammation

_____45.Thereasonthetyphoidlesionisusuallyseenintheileumisthat:
A.Absorptionisgreatestinthissegment

52
 B.Intestinalcontentsislessliquidandalkaline,thusfavoringbacterialgrowth
C.Itisthelongestsegment
D.Largeramountoflymphoidtissueorganizedintonodules

_____46.Theinflammatoryreactionseenintyphoidileitisiscomposedmostlyof:
A. Eosinophils B. Mononuclear cells C. Neutrophils D. Plasma
cells

_____47.Theulcersofamebiasisareinitiallyflaskshapedbecause:
A. Fibrosis causes the upper portion of the mucosa adjacent to the ulcer to slowly
approximateeachotherovertheulcer
B. Ischemiacausesthelowerthirdofthemucosatodiefirst
C. Trophozoites penetrate the mucosa but do not penetrate the muscularis
propria
D. Upperthirdofthemucosaadjacenttotheulcerregeneratesabovetheulcer

in
_____48.Theessenceofadenomasofthegastrointestinaltractis:
A.Disorganizedbenignglands C.Hamartomatousgrowth
B.Dysplasticglandularepithelium D.Polypoidmucosaloutgrowth

_____49.Coloniccarcinomaismostcommonatthisportion:
A. Cecum B.Ascending C.Descending D.Rectosigmoid

s.
_____50.Theprognosisofcoloniccarcinomaismoredependenton:
A.Ageofpatient B.Gradeoftumor C.Location D.Stage

_____51.Theinflammatorylesionseeninacuteappendicitisisusuallyinitiatedby:
iim
A. Bacterialinfection C.Ischemia
B.Fecalmaterialwithinthelumen D.Luminalobstruction

_____ 52. The thrombosis seen in the veins of hemorrhoids is primarily due to this
mechanism:
A.Accumulationofclottingfactors C.Endothelialinjury
B.Deficiencyofplasmin D.LocalizeddeficiencyofProteinCandS
4a

_____53.Ininfectiveendocarditis,organismsoflowvirulencethatcauseinfectionina

previouslyabnormal,deformedvalvesisclassifiedas:

A.Acute B.Chronic C.Necrotizing D.Subacute

_____54.Arighttoleftshuntbestexemplifiedbywhichofthefollowing?
m

A.ASD B.PDA C.TOF D.VSD

_____55.Basalcellcarcinomaischaracterizedbywhichofthefollowing?
A. Aggressivetumor
B. Earlymetastasishematogenousspread
C. Locallyinvasiveandrarelymetastasizingtumor
Ai

D. Presenceofintercellularbridgesandkeratohyalin

_____56.Themostcommonprimarycanceroftheboneis:
A. Chondrosarcoma C.Metastaticadneocarcinoma
B. Ewingssarcoma D.Osteosarcoma

_____57.A10montholdinfantpresentedwithavaginalmass.Whatisthemostlikely
diagnosis?
A. Fibrosarcoma C.Rhabdomyosarcoma
B. Liposarcoma D.Synovialcarcinoma

_____58.Allsofttissuetumorsarepositivefor:
A.Cytokeratin B.Desmin C.S100 D.Vimentin
_____59.Whichisacharacteristicfindinginalcoholicliverdisease?
A. Alphafetoprotein C.HbsAg

53
 B. Groundglasshepatocytes D.Mallorybodies

_____60.A24yroldmale,hoursafterexcessivefoodandalcoholintake,was
broughttotheER.Hewasmoaning,writhinginpain,andholdinghisabdomen.Serum
amylaseiselevated.Ifautopsyisdone,whichorganwillmostlikelyshownecrosis?
A.Liver B.Pancreas C.Spleen D.Stomach

_____61.Redistributionofbodyfat,moonface,dorsalbuffalohumpandthin
extremitiessuggests:
A. Addisonsdisease C.Cushingssyndrome
B. Connssyndrome D.Sipplessyndrome

_____62.Crescentsformationseeninrenalbiopsystronglysuggests:
A. Membranousglomerulonephritis C.Poststreptococcalglomerulomephritis
B. Minimalchangedisease D.Rapidlyprogressive
glomerulonephritis

in
_____63.A28y/owomanpreentedwithfever,dysuria,urinaryfrequencyandflank
tenderness.UrinalysisshowedabundantWBCandbacteria.Themostlikelyetiologyis:
A.E.coli B.H.influenzae C.N.gonorrhea D.Proteus
vulgaris

s.
_____64.Coarseasymmetricrenalcorticomedullaryscarring,deformityoftherenal
pelvisandcalyces,atrophictubuleswitheosinophiliccastsallsuggest:
A. Acutepyelonephritis C.Nephriticsyndrome
B. Chronicpyelonephritis D.Nephroticsyndrome
iim
_____65.A19yr.oldfemalestudentdevelopedacutepharyngitis.Throatculture
revealedS.pyogenes.Whichofthefollowingislikelytobeelevated?
A.Basophils B.Eosinophils C.Lymphocytes D.
Neutrophils

_____66.Intestinalintussusceptioninolderchildrenandinadultsismostlikely
associatedwith:
A.Adenomatouspolyp B.CholeraC.Crohnsdisease D.
4a

Typhoidileitis
_____67.Whichofthefollowinghashighestriskofdevelopingcolorectalcarcinoma?
A. Familialadenomatouspolyposis C.PeutzJegherssyndrome
B. Hirschprungsdisease D.Ulcerativecolitis

_____ 68. The erosions associated with acute gastritis is seen in this layer/s of the
stomach:
A.Mucosa C.Mucosa,submucosa,andinnersmoothmuscle
m

layer
B. Mucosa and submucosa D. All layers including the outer smooth muscle
layer

_____69.ThemostcommontypeofcarcinomaassociatedwithBarrettsesophagusis:
A.Adenocarcinoma C.Leiomyosarcoma
Ai

B.Gastrointestinalstromaltumor D.Squamouscarcinoma

_____70.Whichofthefollowingisanautosomaldeletiondisorder?
A. Criduchatsyndrome C.Edward'ssyndrome
B.Down'ssyndrome D.Patau'ssyndrome

_____71.Thelikelihoodthataclinicalconditionwilloccurwhenaparticulargenotype
ispresent:
A.Heterozygosity B.Mosaicism C.Penetrance D.Polymorphism

____72.Inliquefactivenecrosis,destructionofthetissuemorphologyismainlydueto:
A. Bacterialtoxins C.Inflammatorycells
B. Digestiveproteases D.Pancreaticlipases

____73.Whichofthefollowingmorphologicchangesisirreversible?
54
 A. Dysplasia B. Hyperplasia C. Metaplasia D.
Neoplasia

___74.Inwhichconditionwillcaseationnecrosismostlikelyoccur?
A. Arterialbloodsupplyinterruptedbythrombus
B. InfectedwithMycobacteriumtuberculosis
C. InfectedwithPseudomonasaeruginosa
D. Lostinnervation

____75.DegradationofDNAtonucleosomesizedfragmentsischaracterisitcof:
A. Apoptosis B.Dysplasia C.Liquefactivenecrosis D.Metaplasia

____76.Invasiveductalcarcinomaintheupperouterquadrantoftherightbreastwill
likelymetastasizeto:

in
A.Brain B.Contralateralbreast C.Ipsilateralaxillarylymphnode D.
Lungs

____77.Infemales,mostcancerdeathsarecausedbymalignancyinthe:

s.
A.Breast B.Colorectalsegment C.Lung D.Uterus

____78.Mostlikelyconditionthatahistologicallybenignneoplasmsmaybefatal:
A. Causeextensivebleeding C.Failtoinvokeimmuneresponse
B.Multifocallesions D.Transformintocancer
iim
____79.InthePhilippines,themostcommonformofimmunodeficiencyis:
A. AtaxiaTelangiectasia C.Severecombined
immunodeficiency
B. Chronicgranulomatousdisease D.Xlinkedagammaglobulinemia

____80.Anestheticaccidentresultinginlossofvasculartoneandperipheralpoolingof
bloodleadstowhichtypeofshock:
4a

A.CardiogenicB.Hypovolemic C.Neurogenic D.Septic

____81.Whichistheinitialmechanismoftransudateformation?
A. Decreasedplasmaoncoticpressure C.Increasedinterstitialosmotic
m

pressure
B.Increasedhydrostaticpressure D.Increasedvascular
permeability

____82.Inacutecongestiveheartfailure,edemaofthelowerextremitiesisdueto:
A. Decreasedoncoticpressure C.Na+accumulation
Ai

B.Increasedhydrostaticpressure D.Pumpfailure

____83.Whichofthefollowingisareflectionofleftheartfailure?
A. Hepatomegaly C.Pulmonaryedema
B. Pittingedema D.Splenomegaly

____84.Ischemicinjurytothemyocardiumlastingfor15minutesleadsto:
A.Coagulativenecrosis B.FatnecrosisC.GangreneD.Liquefactive
necrosis

____85.Theerosionofprogressivepulmonarytuberculouscavitarylesionsintonearby
pulmonarybloodvesselswouldpresentclinicallyas:
A.dyspneaB.hematemesisC.hemoptysisD.highgradefever

____86.Themechanismofadultrespiratorydistresssyndromeis:

55
 A.Deficiencyinpulmonarysurfactant C.Inflammatoryreactionto
microorganisms
B.Diffusedamagetoalveolarcapillarywall D.Increasedhydrostaticpressure

____87.InthePhilippines,themostcommonsourceofinfectionwithpulmonary
tuberculosis:
A.Childrenwithundiagnosedprimaryinfection
B.Patientswithmiliarytuberculosis
C.Patientswithundiagnosedcavitarypulmonarytuberculosis(PTB)
D.PatientswithdiagnosedcavitaryPTB

____88.Whichtypeofradiationwouldbemostharmful?
A. Alphaparticles B.Betaparticles C.Gammarays D.Xrays

____89.Exposuretoultravioletlightismostimportantindevelopmentof:
A. Basalcellcarcinomaoftheskin C.Papillarycarcinomaofthethyroid

in
B. Squamouscellcarcinomaofthelung D.Acutemyelogenous
leukemia

____90.Typeoflungcarcinomathatstronglycorrelateswithsmoking:
A. Adenocarcinoma C.Mucinoustumor
B. Bronchoaleveolarcarcinoma D.Squamouscellcarcinoma

s.
____91.Whichofthefollowingbestdescribesinvasiveductalcarcinomaofthebreast?
A. Aggressive,highlymetastasizing
B. Gelatinousconsistency
C. Mostcommoncanceramongmalesandfemales
iim
D. Predominantlyhematogenousspread

____92.Whichcontributestothepathogensisofmalignantmelanoma,basalcell
carcinomaandsquamouscellcarcinomaoftheskin?
A. Previousirradiation C.Prolongedcosmeticuse
B. Previoustrauma D.Sunexposure

____93.Innephroticsyndrome,theedemaislikelydueto:
4a

A.Inappropriatesodiumandwaterabsorption
A. Increasedsoluteresultinginwaterretention
B. Renalinsufficiencywithfluidaccumulation
C. Urinaryproteinlossduetoglomerularinjury

____94.WhichofthefollowingrelationshipsisaMISMATCHEDPAIR?
A.Colonicadenocarcinoma:Carcinoembryonicantigen
B.Prostaticadenocarcinoma:Humanchorionicgonadotropin
m

C.Puretesticularseminoma:Placentalalkalinephosphatase
D.Smallcellcanceroflung:Neuronspecificenolase(NSE)

____95.Inseverehepaticdisease,edemaresultsprimarilyfrom:
A. Hypocalcemia C.Hypoproteinemia
B. Hyponatremia D.Hypergammaglobulinemia
Ai

____96.Themostcommonpathologyinthegallbladderis:
A. Adenoma B.Chronicinflammation C.Fataccumulation D.Stone
formation

____97.Mostcommoncauseofsubarachnoidbleed?
A.AVmalformation B.Berryaneurysm C.Hemangiona D.
Microaneurysm

____98.Sarcomasusuallymetastasizevia:
A.BloodstreamB.LocalextensionC.Lymphatics D.Perineural
invasion

____99.Inrabiesinfection,whereinthebrainisNegribodylocated?
A.BloodvesselB.Dura C.Glialcells D.Neuron

56
 ____100.Physiologicatrophyofthebraininan82yearoldmaleismainlydueto:
A.Denervationatrophy C.Lossofendocrinestimulation
B.Disuseatrophy D.Senileatrophy

answer # Question page

B 1 Thecentralfactorinthepathogenesisofirrevsiblecellinjurywouldbe 9
A.mitochondrialdysfunction
B.membranedamage
C.cytoskeletalabnormalities
D.freeradicalformation

C 2 Whichwouldbetheconsequence(s)oftheoccuranceofmitochondrial 12
permeabilitytransition?
A.promotesATPproduction
B.increaseinthenumberofmitochondria

in
C.celldeath
D.A,B,C

B 3 Thepresenceofchalky,whiteareasintheadiposetissueinthe 18
abdominalcavitywouldbeinterpretedtobeassociatedwith:

s.
A.activationofpancreaticamylasesintotheperitonealcavity
B.combinationoffattyacidsreleasedwithcalcium
C.histologicreactionofnumerouslipophages
D.A,B,C
iim
A 4 Theultimatemechanismofsuddencardiacdeathis: 564
A.lethalarrhythmia
B.ischemiccardiomyopathy
C.dilatedcardiomyopathy
D.aorticvalvestenosis

D 5 Myxomatousdegenerationofthemitralvalveisassociatedwith: 564
A.prolapseofthemitralvalveintotheleftventricle
B.ischemicareasintheleftatrialseptum
4a

C.fussionofthemitralcommissures
D.complicationofmitralinsufficiency

A 8 Inperipartumcardiomyopathy,thesystolicdysfunctionofthepatientis 580
associatedorexplainedby:
A.largeandflabbyheart
B.massiveventricularhypertrophywithoutdilatation
m

C.impairedventricularfillingduringdiastole
D.asymmetricseptalhypertrophy

C 9 Themostcharacteristichistologiclesionofacutepancreatitis 905
A.Neutrophilicinfiltration
B.Hemorrhage
Ai

C.Fatnecrosis
D.Necrosisofparenchyma

A 10 Mostimportantenvironmentalfactorforpancreaticcancer 910
A.Smoking
B.Hyperlipoprotenemia
C.Alcoholism
D.Viralinfection

C 11 Ritterdiseaseisalsoknownas 367
A.gasgangrene
B.Hidradenitissuppurativa
C.Staphylococcalscaldedskinsyndrome
D.Quinsysorethroat

B 12 Elephantiasisisassociatedwith 398

57
 A.Onchocercavolvulus
B.Wuchereriabancrofti
C.Ancylostomaduodenale
D.Anyoftheabove

D 13 FungiwithinsmallcystsintheVirchowRobinperivascularspaceis 380
characteristicof
A.Mucor
B.Aspergillus
C.Pneumocystiscarinii
D.Cryptococcusneoformans

D 14 Differentialdiagnosisofachildwhopresentswithfever
A.malaria 389
B.dengue 383
C.poliovirusinfection 373

in
D.Anyoftheabove

A 15 Consequenceofleadexposure 422
A.memoryloss
B.lungfibrosis
C.asthma

s.
D.cancerofnasalcavity

A 16 Indoorairpollutant 418
A.carbonmonoxide
B.sulfurdioxide
iim
C.ozone
D.acidaerosol

D 17 Apatientwithhypochromic,microcyticanemiaisdeficientin 452
A.zinc
B.copper
C.selenium
D.iron
4a

C 18 Achildcameinattheoutpatientdepartmentbecauseofgeneralized 438
edemaaccompaniedbyeasilypluckablehair,listlessness,andloss
ofappetite.Mostlikelysheissufferingfrom
A.anorexia
B.marasmus
C.kwashiorkor
D.bulimia
m

C 19 Traveler'sdiarrheaisassociatedwithwhatorganism 808
A.Salmonellatyphi
B.Campylobacterjejuni
C.Escherichiacoli
Ai

D.Shigella

A 20 AstlerCollerclassificationwhenthemalignantglandsinthecolonare 835
limitedtothemucosa
A.A1
B.A2
C.B
D.Noneoftheabove

B 21 Grosslyappearsasablindpouchontheantimesentericsideofthe 805
smallbowel
A.Hirschprungdisease
B.Meckeldiverticulum
C.Celiacsprue
D.Noneoftheabove

C 22 Informationtoelicitintheclinicalhistoryofapatientwith 799
58
 gastriccarcinoma
A.fondnessforbarbecuedfoods
B.alcoholism
C.presenceofrelativeswithgastriccarcinoma
D.Anyoftheabove

D 23 Alcoholicpatientsmaymanifest
A.longitudinaltearsintheesophagogastricjunction 779
B.assquamouscellcarcinomaoftheesophagus 783
C.asacutegastritis 789
D.Anyoftheabove

C 24 SchillerDuvalbodyisassociated 1076
A.thecomafibroma
B.dysgerminoma
C.yolksactumor

in
D.granulosathecatumor

D 25 Whichisanovariancyst?
A.serouscyst 1069
B.follicularcyst 1066

s.
C.lutealcyst 1066
D.Anyoftheabove

B 26 Differentialdiagnosisofapatientwithsessilemassesprojectinginto 1058
theendometrialcavity
A.papillaryhidradenoma
iim
B.polyp
C.lichensclerosus
D.Anyoftheabove

B 27 A30yearoldfemalecomplainedoflossofconsciousness.Historyrevealed 926
thattheepisodeswereprecipitatedbyfasting.Laboratoryexamatthetime
ofattackshowedglucoselevelatlessthan50mg/dl.Thisisusuallyasso
ciatedwith
4a

A.Gastrinoma
B.Insulinoma
C.Glucagonoma
D.Somatostatinoma

D 29 AnewborninfantwasbornwithahemolyticdiseaseduetoRHincompa 474
tibility.Whatisthemostseriousthreatinthisdisorder.
A.Anasarca
m

B.LiverCirrhosis
C.Pancreaticinsufficiency
D.Kernicterus

B 30 Themostcharacteristicrenalfindingindiabetesmellitus 923
Ai

A.Hyalinearteriolosclerosis
B.Nodularglomerulosclerosis
C.Acutepyelonephritis
D.Diffuseglomerulosclerosis

A 31 Mostfrequenttypeofhyperfunctioningpituitaryadenoma 1125
A.Lactotrophadenoma
B.Corticotrophadenoma
C.Somatotrophadenoma
D.Gonadotrophadenoma

C 32 A23yearoldfemalecomplainedofsorethroat,feverandmalaise.PE 1135
revealedtender,enlargedthyroidgland.LabexamshowedincreasedT4and
T3,decreasedTSH.Themostlikelydiagnosisis
A.Gravesdisease
B.Hashimotothyroiditis

59
 C.DeQuervainthyroiditis
D.Reidelthyroiditis

B 33 ThemostcharacteristicmicroscopicfindingofRetinoblastomais: 1373
A.HomerWrightrosettes
B.FlexnerWintersteinerrosette
C.Blastemacells
D.Rosenthalfibers

A 34 Microscopicfeaturesofthislesionintheurinarybladderrevealed 1002
infiltrationwithlargefoamymacrophageswithmultinucleatedgiantcells
interspersedwithlymphocytes.MichaelisGutmannbodiesarepresent
A.Malakoplakia
B.Tuberculosis
C.Cystitisglandularis
D.Acutesuppurativecystitis

in
B 35 WhichofthefollowingisTRUEofPleomorphicadenoma 770
A.ThesearealsocalledAdenolymphomas
B.Therearethemostcommontumorsofthesalivarygland
C.Thesearehighlymalignanttumors
D.Occursmuchmoreofteninmales

s.
C 36 Thisisahighlyvasculartumorofthenasopharyngealareathatoccur 877
almostexclusivelyinadolescentmales.Ithasabenignnaturebuthas
tendencytobleedprofuselyduringsurgery.
A.Neuroblastoma
iim
B.Squamouscellcarcinoma
C.Angiofibroma
D.Invertedpapilloma

A 37 Step/sinphagocytosisenhancedbyopsonins: 62
A.Recognition&attachment
B.Engulfment
C.Killingordegradation
4a

D.A&Bonly

D 38 Abnormalacquiredleukocytechemotaxisis/areseenin: 65
A.Anemia
B.Sepsis
C.Diabetesmellitus
D.B&Conly
m

C 39 Distinctivepatternofinflammationseenintuberculosis 83
A.Serous
B.Suppurative
C.Fibrinous
D.Chronicgranulomatous
Ai

B 40 Thebiologicbehaviourofmalignantmelanomaisdeterminedby: 1179
A.Radialgrowthphase
B.Nature&extentofverticalgrowthphase
C.Degreeofpigmentation
D.All

A 41 Themostcommonlyacceptedcauseofsquamouscellcarcinomaofthe 1185
skinis:
A.Exposuretoultravioletlight
B.Exposuretoarsenic
C.Cutaneousscars
D.PUVA

B 42 Thedetectionofthisantibodyisspecificforsystemicsclerosis: 227
A.Anticentromereantibody
B.AntiScl70
60
 C.AntiDsDNA
D.AntiSm

C 43 ThereceptorusedbytheHIVstrainthatiseffectiveintransmittingthe 240
infection:
A.CCR4
B.CXCR4
C.CCR5
D.CXCR5

B 44 Bloodtransfusionreactionisanexampleofwhichmechanismof 199200
hypersensitivityreaction?
A.TypeIVdelayedhypersensitivity
B.TypeIIcomplementdependent
C.TypeIIAbmediatedcellulardysfunction
D.TypeIIIimmunecomplexmediated

in
C 45 Trueofclonalanergy: 213214
A.FasFasLengagementleadingtoapoptosisofactivatedTcells
B.clonaldeletionofselfreactiveTcellsduringmaturation
C.Agispresentedbycellsnotbearingtheproperligandresultingtoa

s.
negativesignal
D.suppressorTcellsdownregulatingtheotherTcells

C 46 A53y/oG10P10(100010)femaleunderwenttransplantationoftheright 207208
kidney.Thedonorkidneywastakenfromherhusband.Fifteenminutes
aftertransplantation,thetransplantedkidneybecomecyanotic,mottled
iim
andflaccid.Whatisthemechanismofrejection?
A.directcellmediatedreaction
B.indirectcellmediatedreaction
C.Abmediatedreaction
D.thereisnograftrejection

D 47 ThetrueneoplasticelementinHodgkindisease: 670
A.eosinophil
4a

B.smudgecells
C.plasmacells
D.Reedsternbergcells

C 48 Leftenlargedaxillarylymphnodefroma45y/ofemalewithleftbreast 649650
carcinomawouldlikelyshow:
A.paracorticalhyperplasia
B.follicularhyperplasia
m

C.sinushistiocytosis
D.histologicallynormal

A 49 Incisionbiopsyofasubmandibularmassofa6y/oAfricanboyrevealed 662
diffuseinfiltratesofintermediatesizedlymphoidcellswith"starrysky"
Ai

pattern.TumorcellsexpressCD19,CD10andsurfaceIgM.Givethe
probablediagnosis:
A.Burkitt'slymphoma
B.smalllymphocyticlymphoma
C.acutelymphoblasticlymphoma
D.follicularlymphoma

B 50 HypochromicMicrocyticRBCisseenin: H619
A.VitaminB12deficiency
B.Irondeficiencyanemia
C.Sicklecelldisease
D.Hereditaryspherocytosis

D 51 Sucrosehemolysistestresultinapatientwithparoxysmalnocturnal H635
hemoglobinuria:
A.nohemolysis

61
 B.<5%hemolysis
C.510%hemolysis
D.>10%hemolysis

A 52 Astillborninfantwithsevereedema,markedanemiaandhepatospleno H647
megalyshowslargequantitiesofHbBart's.Trueofthiscondition:
A.completeabsenceofalphachains
B.completeabsenceofbetachains
C.lagrequantitiesofHbA
D.smallquantitiesofHbF

B 53 Angioblastsareinvolvedin: 103
A.angiogenesis
B.vasculogenesis
C.granulationtissueformation
D.tissueremodeling

in
C 54 VitaminCdeficiencyretardswoundhealingbecause: 110
A.infectionpersists
B.woundcontractionisinhibited
C.collagensynthesisisinhibited
D.exuberantgranulationoccurs

s.
A 55 Increasedapoptoticactivitywill: 90
A.decreasethecellpopulation
B.increasecelldifferentiation
C.decreasecellproliferation
iim
D.decreasecelldeath

D 56 Grossly,abreasttumorissoftwithanappearanceofpalegraybluegelatin. 1112
Microscopically,largelobesoflightlystainingmucinwithfloatingneoplastic
cellsareseen.Whatisyourdiagnosis?
A.Schirouscarcinoma
B.Tubularcarcinoma
C.Medullarycarcinoma
4a

D.Colloidcarcinoma

B 57 Whichisacommonbenignlesioninmalebreast? 1117
A.fibroadenoma
B.gynecomastia
C.fibrocysticchange
D.tubularadenoma
m

B 58 WhichisTRUEinapatientdiagnosedwithinvasivelobularcarcinoma? 1111
A.thetumorisalwaysunilateral
B.tumorfrequentlymetastasizetotheCSF
C.tumorcellsareconfinedtothelobule
D.prominentlymphoplasmacyticinfiltration
Ai

C 59 Whatisthemostcommoncomplaintsoflungcancerpatients? 745
A.weightloss
B.chestpain
C.cough
D.dyspnea

B 60 Afemalepatientwithnoprevioussmokinghistoryisdiagnosedtohave 745
bronchogeniccarcinoma,whatisthemostprobablehistologictype?
A.oatcellcarcinoma
B.adenocarcinoma
C.squamouscellcarcinoma
D.largecellcaricnoma

C 61 Apatientpresentedwithenophthalmos,ptosis,&miosis.Hewaspreviously 747
diagnosedwithlungcancer.Whereisthemostprobablesiteofthetumor?
A.lowerlobe
62
 B.middlelobe
C.apex
D.wholelung

C 62 Amalignantlungtumoris3cminsizewithoutpleuralinvolvement&hasipsi 745
lateralhilarnodeinvolvement,whatisthestageofthetumor?
A.Ia
B.Ib
C.IIa
D.IIb

D 63 Patchyconsolidationofthelungs&thepresenceofsuppurativeexudate 721
fillingupthebronchi,bronchioles,&adjacentalveolarspacesarecharacte
risticsseenin:
A.tuberculosis
B.lobarpneumonia

in
C.primaryatypicalpneumonia
D.bronchopneumonia

B 64 Theassociatedmolecularchangeintheevolutionofcolorectaltumorfrom 296
late
adenomatocarcinomaislossof

s.
A.APCgenechromosome5q
B.p53chromosome17p
C.tumorsuppressorgenechromosome18q
D.rasgenechromosome12p
iim
B 65 Migrationoftumorcellsininvasionofextracellularmatrixisfacilitatedby 302
A.metalloproteinases
B.thymosinB15
c. cadherin
D.betacatenin

A 66 HighriskHPVinvolveincervicalcarcinoma 311
A.HPV16
4a

B.HPV6
C.HPV11
D.HPV4

D 67 Tumorsuppressorgeneinvolvedinbreastcarcinoma 286
A.p53
B.WT1
CAPC
m

D.BRCA1

C 68 Tumorcomposedofmorethanoneneoplasticcellstypefrommorethanone 261
germlayer
A.pleomorphicadenoma
Ai

B.fibroadenoma
C.Maturecysticteratoma
D.leiomyoma

A 69 EnzymedeficiencyinTaySacch'sdisease 155
A.HexosaminidaseA
B.Sphingomyelinase
C.Glucocerebrosidase
D.alpha1iduronidase

D 70 CharacteristicclinicalmanifestationofVonGierke'sdisease 160
A.painfulcramps
B.massivecardiomegaly
C.cafaulaitspots
D.hypoglycemia

C 71 MostthreateningfeatureofMarfan'ssyndrome 149
63
 A.skeletalabnormality
B.ocularfindings
C.cardiovascularlesion
D.hyperextensibleskin

C 72 ClassIIImutationinFamilialhypercholesterolemiaisadefectin 152
A.transport
B.recycling
C.binding
D.synthesis

B 75 WhatisthemostcharacteristiccellfoundinRhabdomyoma? 591
A.EpithelioidHistiocyte
B.SpiderCell
C.MalloryCell
D.Langhan'sGiantCell

in
D 76 Associatedwithlittleornoproductionofthe427kDproteincalledDystrophin: 1281
1283
A.DuchenneMuscularDystrophy
B.MyotonicDystrophy
C.BeckerMuscularDystrophy

s.
D.AandConly

A 77 Awhiteinfarct,incontrasttoredinfarct,isusuallyseeninorganswhichare: 132
A.solid
B.withdoublebloodsupply
iim
C.infected
D.previouslycongested.

B 78 Patientswithleftsidedheartfailuremaydeveloppulmonaryedemabecause 114116
of
whichofthefollowingmechanisms?
A.increaseoncoticpressure
B.increaseosmoticpressure
C.vascularpermeability
4a

D.sodiumretention.

C 79 A24yearsoldmaledrugabuserdevelopedSubacutebacterialendocarditis 130
involvingthemitralvalve.Thepatientlaterdevelopedasepticpulmonary
infarc.
throughaprocessknownas:
A.systemicthromboembolisation
m

B.pulmonarythromboembolisation
C.paradoxicalthromboembolisation
D.bacterialdissemination.

D 83 A57yearoldseamanwasadmittedbecauseofdysphagia,sternalpain, 526
dyspnea,andchroniccoughof6monthsduration.Hewastreatedforapenile
Ai

chancrefollowedbyfever,rashes,andlymphadenpathy30yearsago.
Mostpatientswiththislesiondieof:
A.cardiogenicshock
B.hypovolemicshock
C.sepsis
D.congestiveheartfailure

C 84 Themostcharacteristichistologiclesionintheglomeruliofpatientswith 951952
Rapidlyprogressiveglomerulonephritisis:
A.focalhyalinosis
B.basementmembranethickening
C.crescentformation
D.hypercellularity.

C 86 A28yearoldprimigravidahadhypotensiveshockbecauseofpostpartum 969971
hemorrhage.Herurineoutputrangedfrom80200ml/24hours.The

64
 basickidneylesiontoexplainthisdecreasedurineoutputamongthese
patientsis:
A.Hemolyticuremicsyndrome
B.Obstructiveuropathy
C.Acutetubularnecrosis
D.Acutetubulointerstitialnephritis.

A 88 Histologicfindingsofmarkedlyenlargedhyperchromaticnuclei,arrangedin 1013
disorderlyfashionwithincreasdmitosis,andconfinedwithinthebasement
membraneofthepenileskinisconsistentwith:
A.Bowen'sdisease
B.ErythroplasiaofQueyrat
C.Bowenoidpapulosis
D.Squamouscellcarcinoma.

B 89 An8yearoldmalechildwasbroughttothehospitalfortesticular 1024

in
enlargement.
Pertinentphysicalexaminationfindingsrevealedgynecomastia,withpubic
andaxillaryhairandhuskyvoice.Themostprobabletesticularlesionis:
A.Seminoma
B.Leydigcelltumor
C.Sertolicelltumor

s.
D.Embryonalcellcarcinoma

D 90 Foundinthehippocampusandpurkinjecellsofthecerebellumofpatients 1331
with
Alziemer'sDisease
iim
A.Cowdrybodies
B.Negribodies
C.Lewybodies
D.Hiranobodies

C 91 CharacteristicofCNSneoplasia 1343
A.metastasizeearly
B.majorityariseformneurons
C.siteismoreimportantthangrade
4a

D.metastaticcancersareuncommon

D 92 Hydrocephalusmayresultfrom 12989
A.tuberculousmeningitis
B.decreasedbrainparenchyma
C.spaceoccupyinglesioninthebrain
D.allofthese
m

C 96 Livercancerseeninyoungadultswithoutpredisposingfactors 8901
A.cholangiocarcinoma
B.angiosarcoma
C.fibrolamellarHCC
D.hepaticadenoma
Ai

C 98 Mechanismoftriglycerideaccumulationinmalnutrition 39
A.excessiveproduction
B.exogenousaccumulation
C.defectivetransport
D.decreasedenzyme

C 99 Proteinaccumulationincell 41
A.brownatrophy
B.Psammomabodies
C.Russellbodies
D.steatosis

C 100 MostcommoninitialoutcomeofacuteinflammationinPepticulcer: 79
A.Abscessformation
B.Healingthroughfibrosis

65
 C.Progressiontochronicinflammation
D.Resolution

1. Whichofthefollowingaccumulatesinthecytoplasmoflivercellsinsteatosis:
a. Sphingolipids ans.d p. 25
b. phospholipids
c. cholesterol/cholesterolesters

in
d. triglycerides
2. Chalkywhiteappearanceofnecrotictissuesisseeninwhichofthefollowing:
a. caseationnecrosis ans.c p. 1092
b. coagulationnecrosis
c. enzymaticfatnecrosis

s.
d. liquefactionnecrosis
3. Obstructionofthebloodsupplytothebrainwouldleadtowhichtypeof
necrosis:
a. Caseation ans.C p. 138
b. coagulation
iim
c. liquefaction
d. enzymaticfatnecrosis
4. WhatisthecelloforiginoftheepitheloidcellandtheLanghansgiantcellseen
intuberculouslesion:
a. Neutrophils ans.B p. 216
b. monocyte
c. lymphocyte
4a

d. plasmacell
5. Adenocarcinomaoftheprostatetendstoinvolveinitiallywhichofthefollowing
lobesoftheprostategland:
a. Anterior ans.B p. 1054
b. posterior
c. lateral
d. median
m

6. A60yearoldwomanpresentedwithpostmenopausalbleeding.DandCshowed
endometrialhyperplasia.Pelvicultrasoundshowedasolidmasssintheleft
overy.Totalabdominalhysterectomyandbilateralsalpingooophorectomywas
done.Thehistopathologicexaminationoftheleftovarywouldmostlikelyshow
whichofthefollowing:
Ai

a. Granulosecelltumor ans.A p. 1102

b. Matureteratoma
c. Mucinouscystadenoma
d. Fibroma
7. MarkedthrombocytopeniaandaDIClikephenomenonareresponsibleforthe
unusuallyseverebleedingtendencyinwhichofthefollowing:
a. Acutelymphocyticleukemia ans.C p. 693
b. Acutemonocyticleukemia
c. Acutemyelocyticleukemia
d. Acutepromyelocyticleukemia
8. Lacunarcellsareseeninwhichofthefollowing:
a. Hodgkinslymphoma ans.a p. 646
b. NonHodgkinslymphoma
c. Plasmacelldyscrasia
d. Langerhanscellhistiocytosis

66
 9. ThemostcommoncauseofdeathinMultipleMyelomais:
a. renalfailure ans.c p. 664
b. widespreadmetastases
c. infection
d. bleeding
10. Plasmacellsarepredominantcellularinfiltratesinlesionsassociatedwithwhich
ofthefollowing::
a. Herpesvirus ans.C p. 388
b. N.gonorrheae
c. .T.pallidum
d. HepatitisBvirus

11. KimmelstielWilsonslesionsindiabetesmellitusareseeninwhichofthe
following:
a. Eyes ans.D p. 991

in
b. pancreas
c. liver
d. kidney
12. Diffuseinfiltrationoftheadrenalglandisapathologiclesionmostcommonly
associatedwithwhichofthefollowing:

s.
a. Cushingssyndrome ans.C p. 1215
b. WaterhouseFriederischensyndrome
c. Addisonsdisease
d. Connssyndrome
13. Thecellortissueoforiginofmostbreastcarcinomasisthe:
iim
a. Stroma ans.B p. 1130
b. Duct
c. Lobule
d. Acini
14. Incervicalcarcinoma,involvementofthelowerthirdofthevaginaiswhatstage.
a. I ans.C p. 1077
b. II
c. III
4a

d. IV
15. Whichofthefollowingisthemostlikelymediatorofpain:
a. Histamine ans.B p. 68
b. Prostaglandin
c. Cytokine
d. Oxygenmetabolites
m

16. Inhealingbysecondaryintention,theresultantscarismuchsmallerthanthe
originalwoundbecauseofwhichofthefollowing:
a. Lessfibrinformation ans.D p. 113
b. Removalofexudates
c. Moregranulationtissue
Ai

d. Woundretraction

17. ThefinalcommonpathwayofARDSiswhichofthefollowing:
a. Diffusedamagetoalveolarcapillarywalls ans.D p. 715
b. Deficientpulmonarysurfactant
c. Fibrinexudation
d. Formationofhyalinemembranes
18. Whichofthefollowingisthemostcommonpathwayfortheinitialrouteof
metastasisofcarcinomas:
a. directextension ans.Dp. 279
b. seeding
c. hematogenous
d. lymphatics
19. Whichofthefollowingarecharacteristicsofantemortemclots:
a. linesofZahn ans.Ap. 133
67
 b. currantjellyclots
c. both
d. neither
20. Emboliofmajorveinsofthelegswilleventuallyplugsmallvesselsofwhichof
thefollowing:
a. pulmonarycirculation ans.Ap. 136
b. coronarycirculation
c. cerebralcirculation
d. systemiccirculation
21. Whichofthefollowingisthemostimportantfactorinthedevelopmentof
thrombosis:
a. Stasis ans.C p. 130
b. turbulence
c. endothelialinjury
d. hypercoagulabilityofblood

in
22. Whichofthefollowingisthesubstancethatisresponsibleformassiveperipheral
vasodilatationinsepsis:
a. Cytokines ans.D p. 72
b. oxygenderivedfreeradicals
c. fibrindegradationproducts

s.
d. nitricoxide
23. Movementofleukocytestowardsthesiteofinjuryis:
a. Opsonization ans.Bp. 56
b. Chemotaxis
c. Diapedesis
iim
d. Transmigration
24. Secondaryunionischaracterizedby:
a. Woundcontration ans.Ap. 113
b. Minimaltissueloss
c. Deathoflimitedcells
d. Smalldefect

25. CellswhichactasvehiclesinthetransportofHIVtotheotherpartsofthebody:
4a

a. Monocytes ans.Ap. 248

b. Neutrophils
c. Lymphocytes
d. Plasmacells

26. Diffuseeffacementoffootprocessesischaracteristicof:
m

a. Idiopathicrapidlyprogressiveglomerulonephritis ans.B p.981

b. Lipoidnephrosis
c. IgAnephropathy
d. Lupusnephritis
27. Accumulationofcells,intheformofcrescents,inthebowmansspaceis
characteristicofwhichofthefollowing:
Ai

a. Focalsegmentalglomerulosclerosis ans.C p.976

b. Membranousglomerulonephritis
c. Rapidlyprogressiveglomerulonephritis
d. Nephriticsyndrome

28. Hematuria,oliguriaandhypertensionindicateinvolvementofthe:
a. Glomeruli ans.A p. 974
b. Tubules
c. Interstitium
d. Bloodvessels
29. Primarilyunconjugatedhyperbilirubinemiaisseeninwhichofthefollowing:
a. Viralhepatitis ans.D p. 888
b. DubinHohnsonsyndrome
c. Biliarytractobstruction
d. Gilbertssyndrome
68
 30. Theclassicdiagnosticfeaturesofcostovertebralpain,palpablemassand
hematuriasuggestthepresenceofwhichofthefollowing:
a. Renalcellcarcinoma ans.A p. 1018
b. Wilmstumor
c. UrethelialCAoftherenalpelvis
d. UrinarybladderCA
31. ThemostimportanthistopathologicindicationofCNSinjuryis:
a. Rosenthalfibers ans.B p. 1351
b. Gliosis
c. Neuronophagia
d. Corporaamylacea

32. Whichofthefollowingmarkersconferprotectionandformsthebasisforcurrent
vaccinationstrategies:
a. AntiHBe ans.D p. 894

in
b. IgMantiHBe
c. IgGantiHBe
d. AntiHBsAg

33. Persistentinfectionandchronichepatitisarehallmarksofwhichofthefollowing:

s.
a. HBV ans.A p. 891892
b. HCV
c. CoinfectionwithHDVandHBV
d. HEV
34. H.pyloriisassociatedwithwhichofthefollowingconditions:
iim
a. Barrettesophagus ans.B p. 817
b. Pepticulcer
c. Refluxesophagitis
d. Curlingsulcer
35. Varicealdilatationoftheanalandperianalplexusesiscalled:
a. Angiodysplasia ans.B p. 854
b. Hemorrhoids
c. Hemangioma
4a

d. Arteriovenousmalformation
36. Whichofthefollowingisassociatedwithearlycyanosis:
a. Patentduotusarteriosus ans.b p. 575
b. TetralogyofFallot
c. Ventricularseptaldefect
d. Atrialseptaldefect
m

37. Mostdeathsthatoccurduringacuterheumaticfeverarecausedbywhichofthe
following:
a. Streptococcalsepsis ans.c p. 549
b. Pericarditis
c. Myocarditis
Ai

d. Endocarditis

38. Thefollowingareeffectsofagingintheheart,EXCEPT:
a. Brownatrophy ans.b p. 519
b. bootshapedheart
c. sigmoidseptum
d. Lamblsexcrecences

39. Whichofthefollowingprimarilyaffectsthecerebralcortex:
a. Parkinsonism ans.b p. 1329
b. Alzheimersdisease
c. Huntingtonsdisease
d. Friedrichataxia
40. Mostcasesofesophagealcarcinomasarelocatedinthe:
a. Upperthird ans.b p. 765
69
 b. Middlethird
c. Lowerthird
d. Gastroesophagealjunction
41. Gastrichypersecretion,pancreaticislettumor,pepticulcerdiseaseunresponsive
totreatmentandseverediarrheacharacterizewhichofthefollowing:
a. Insulinoma ans.b p. 923
b. Gastrinoma
c. Multipleendocrineneoplasia
d. Glucagenoma

42. Hirschsprungsdiseaseusuallyinvolveswhichsegmentoftheintestine:
a. jejunum ans.c p. 786
b. ileum
c. cecum
d. rectum

in
43. Thisiselevatedupto2weeksinacutepancreatitis:
a. Serumamylase ans.c p. 901
b. Serumlipase
c. Urineamylase

s.
d. Serumcalcium
44. Themostcommoncauseofdeathinpatientswithadvancedcervicalcarcinomais:
a. Uremia ans.a p. 1053
b. Infection
c. Widespreadmetastasis
iim
d. Bleeding

45. Strumaovariiisavariantofwhichofthefollowing:
a. Granulosacelltumor ans.b p. 1072
b. Teratoma
c. Endodermalsinustumor
d. Dysgerminoma
46. Chronicnecrotizinginfectionofthebronchiandbronchiolesassociatedwith
4a

abnormaldilationoftheairwaysis:
a. Bronchitis ans.c p. 692
b. Emphysema
c. Bronchiectasis
d. Lungabscess
m

47. Themostfrequentmechanisminthedevelopmentoflungabscessis:
a. septicembolism ans.b p. 699
b. aspirationofinfectedmaterial
c. postpneumoniccomplication
d. directtrauma
Ai

48. Whichofthefollowingistheclassicphysiologicfeatureofdiffuseinterstitial
lungdisease:
a. Increasedlungvolume ans.a
b. Decreasedpulmonaryresistance
c. Limitedexpiratoryflowrates
d. Reductioninoxygendiffusingcapacity,lungvolumeorcompliance

49. Themostcommoncauseofhydrothoraxis:
a. Renalfailure ans.b p. 729
b. Congestiveheartfailure
c. Nephriticsyndrome
d. Cirrhosis

50. Whichofthefollowingisseeninrickets:
a. Bowingofthebones ans.a p. 417
70
 b. Osteosclerosis
c. Normalgrowthzonesinmetaphysic
d. Pectusexcavatum

51. Theinvolucrumofosteomyelitisconsstsofwhichofthefollowing:
a. Necroticbone ans.d p. 1230
b. Fromafocusinthepelvis
c. Drainingsinuses
d. Reactivebonearoundasequestrum

52. WhichofthefollowingiscorrectregardinghowTuberculousosteomyelitisarise:
a. spontaneously ans.d p. 1231
b. fromafocusinthepelvis
c. fromafocusinthespinalcord
d. fromahematogenousdissemination

in
53. Whichofthefollowingisassociatedwithosteoporosis:
a. reducedphysicalactivity ans.c p. 12201221
b. increasedparathyroidhormone
c. both

s.
d. neither

54. Coupandcontrecoupinjuriesarecharacterizedbywhichofthefollowing:
a. infarctionofbraintissue ans.d p. 1305
b. hemorrhageofbraintissue
iim
c. lacerationofbraintissue
d. contusionofbrain
55. Inrabies,Negribodiesarefoundinwhichofthefollowing:
a. Hippocampus ans.a p. 1320
b. temporallobes
c. hypothalamus
d. pons
4a

56. Themostcommonsiteinvolvedinhypertensiveintracranialhemorrhageiswhich
ofthefollowing:
a. Thalamus ans.c p. 1311
b. pons
c. putamen
d. cerebellum
m

57. Whatisthemostcommonrouteofentryofinfectiousorganismsinthecentral
nervoussystem:
a. directimplantation ans.b p. 1314
b. peripheralnervoussystem
c. localextension
Ai

d. hematogenous

58. Theanteriorhornmotorneuronsofthespinalcordareprimarilyaffectedinwhich
ofthefollowingconditions:
a. cytomegalovirusinfection ans.b p. 1320
b. poliomyelitis
c. toxoplasmosis
d. herpessimplexencephalitis

59. Scirrhouscarcinomasofthebreastareusually:
a. medullarycarcinomas ans.b p. 1103
b. ductalcarcinomas
c. mucinouscarcinomas
d. lobularcarcinomas

71
 60. Whichofthefollowingis/arecharacteristicmammographiccalcificationsin
breastcarcinomas:
a. Smaller ans.d p. 1106
b. moretightlyclustered
c. morenumerous
d. alloftheabove

61. Whichofthefollowingisthemostcommoncauseoflumpinthebreast:
a. nodisease ans.d p. 1091
b. cancer
c. fibroadenoma
d. fibrocysticdisease

62. Thecharacteristicflaskshapedulcersinamebiasisaremostfrequentlyseenin
whichofthefollowing:

in
a. ascendingcolon ans.a p. 333
b. transversecolon
c. descendingcolon
d. rectum

s.
63. WhatkindoforganismisPneumocystiscarinii:
a. Bacterium ans.c p. 228
b. virus
c. protozoa
d. fungus
iim
64. Pipestemfibrosisoftheliverisseeninwhichofthefollowing:
a. Syphilis ans.c p. 372
b. tuberculosis
c. schistosomiasis
d. malaria
4a
m
Ai

72