.

COMPILATION OF GENERAL PATHOLOGY PAST

QUESTIONS FOR FIRST IA
CHAPTER 1 & 2
(Note: this compilation excludes the questions in the pictures)
Refer to class of 2019 folder for pics

CHAPTER 1 ( CELL
DEATH,CELLULAR ADATION AND
INJURY)
1.The following statements are correctly paired

a. Pathogenesis – direct cause of disease F

b. Idiopathic – cause is unknown T

c. Prognosis – likely outcome of disease T

d. Congenital - present at birth T

e. Aetiology – mechanism of disease production F

2.Genetic abnormalities may cause disease by:

a.Synthesis of shorter than normal peptides T

b.Total lack of transcription of genes T

c.Abnormal mRNA processing T

d.excess synthesis of a normal protein T

e.Trisomy affecting chromosomes T

3.The following statements are correct

a.Atrophy is a reversible process T

b.Metaplasia inevitably leads to neoplasia F

c.Growth factors may inhibit cell growth or division F

d.The myocardium in a hypertensive patient has more cells than normal F

e.The G1 and S phases of the cell cycle make up interphase T

4.Causes of disease excludes

a.Acute inflammation T

b.Chemicals F

c.Mechanical trauma F

d.Avitaminosis F

e.Bacteria and fungi F

6. The following changes are irreversible

a.Karyorrhexis T

b.Swelling of endoplasmic reticulum F

c.disaggregation of ribosomes F

d.cell chromatolysis F

e.Metaplasia F

7.. The latent interval refers to the period between acquiring the causative agent and

a.When clinical symptoms appear T

b.Death occurs F

c.Manifestation of disease T
d.Complications subside F

e.Signs or symptoms disappear F

8.Squamous cell carcinomas are the commonest at which of the following are sites: b
lev 2

a.prostrate and bronchi

b.bronchi and urinary bladder

c.urinary bladder and prostate

d.colon and bronchi

e.oral cavity and prostate

9. Which of the following is correctly matched?

a.anaplastic…………… resembles primitive cells F

b.pleomophism………… good prognosis F

c.Dysplasia …………… deeply staining with haematoxylin F

d.hyperchromasia …… variable size and shape F

e.benign……………… disordered growth F

10. The following changes are irreversible a lev1

a.Karyorrhexis

b.Swelling of endoplasmic reticulum

c.disaggregation of ribosomes

d.cell chromatolysis
e.metaplasia

11.Which of the following is correctly matched? D lev 2

a.malignant ………..ectopic rest of normal tissue

b.Harmatoma……….produces cells from all germ layers

c.Choristoma………. haphazard arrangement of normal cells

d.differentiation ……extent of maturation

e.totipotent…………. poor prognosis

12.Which of the following statements is correct E

a.Atrophy is an irreversible process

b.Metaplasia inevitably leads to neoplasia

c.hypertrophy involves cell division

d.A hypertensive patient has more myocardial cells than normal

e.Permanent cells do not undergo metaplasia RESEARCH. It however happens in

myotitis ossificans

13.Examples of pathogenetic mechanisms of disease include the following except E

A.Neoplasia

b. Chronic inflammation

c. Embolism

d. Carcinogenesis

e. Trematodes
14. Which of the following changes is an example of a reversible cellular change? B

a. Karyolysis

b. Swelling of endoplasmic reticulum

c.dystrophic calcification

d. Karyopyknosis

e. Karyorrhexis

15.The following are true of permanent cells except B

a.Include neurones

b. replicate easily after injury

c. Have left the cell cycle

d. Are capable of hypertrophy

e. Can undergo atrophy

16.Which of the following statements is incorrectly paired A

a. Pathogenesis – polio virus

b. Idiopathic – cause is unknown

c. Prognosis – malignant

d. Congenital - sickle cell disease

e. Aetiology – genetic abnormality

17.The latent interval refers to the period between acquiring the causative agent and
when C

a. the clinical symptoms peak

b. Death occurs
 c. Manifestation of disease appear

d. Complications subside

18. The father of cellular pathology is D

a. Rokitansky

b. Ackermann

c. Hippocrates

d. Virchow

e. Jenner

19. The following statements are correct except B

a. Neoplasia is an irreversible process

b. inflammation inevitably leads to neoplasia

c. chemical mediators cause vascular changes during inflammation

d. Histamine is a vasodilator

e. Serotonin is a vasodilator

20. For frozen sections the tissue should be sent to the laboratory in: E

a. 10% formalin

b. 10% formol-saline

c. 40% formalin

d. 10% saline

e. fresh unfixed
 21. Causes of disease exclude: A

a. Acute inflammation

b. Chemicals

c. Mechanical trauma

d. Avitaminosis

e. Bacteria and fungi

22. The following changes are irreversible except E

a. necrosis

b. neoplasia

c. apoptosis

d. karyorrhexis

e. hyperplasia

23. A tissue or organ usually attempts to regenerate itself after focal destruction. All of
the following cell types are capable of regenerating tissue except:

a. Hepatocytes

b. Gastric mucosal cells

c. Bladder transitional epithelium

d. Myocardial cells

e. Myeloblasts

24. A man brushes his shin against the tip of a rusted nail sustaining a cut. Within a few
days his shin is swollen, red and painful and the sore exudes pus. The underlying process
serves all of the following purpose:

a. Isolation of infected tissues

 b. Inactivation of causative agents

c. Neutralization of toxins

d. Removal of devitalised tissues

e. Healing of the injured tissues

25.Which of the following causes loss of membrane integrity B a is possible; group

assignment
a. Freezing
b. Complement
c. Potassium cyanide
d. Viruses research the ans

26. A 65yr old woman presents with uterine bleeding. Examination reveals a malignant
uterine mass. The biopsy specimen may show:
T A. Dysplasia
T B. Pleomorphism

F C. Aplasia
T D. Necrosis
F E. Tumour giant cells

27.Increase tissue is caused by the following

a. Hyperplasia T

b. Neoplasia T

c. Inflammation F

d. Anaplasia F

e. Hamartoma T

28.At autopsy in 68-year-old woman, you find a liver with foci of liquefactive necrosis
with positive culture for bacteria. The patient most likely has:

a. Hepatic dysplasia
 b. Multiple hepatic adenomas

c. Colonic carcinoma with metastases

d. Hepatocellular carcinoma with local invasion

e. Hepatic abscesses

29.A tissue or organ usually attempts to regenerate itself after focal destruction. All of
the ff. cell types are capable of regenerating tissue except:
a) Gastric mucosal cells
b) Bladder transitional epithelium
c) Myocardial cells
d) Myeloblasts

30. Stable cells

A.Include cardiac muscle cells F

B.Are not capable of regeneration F

C.Cannot replicate after birth F

D.Have left the cell cycle F

E.Can undergo hypertrophy T

31. Which of the following is a type of liquefactive necrosis: B

A.Fat necrosis

B.Skin abscess

C.myocardial infarct

D.renal infarct
E.lung infarct

32.Atrophy that follows nerve transection and polio will be called A

A.neuropathic

B.disuse

C.pressure

D.traumatic

E.inflammatory

34. Pathologic hyperplasia occurs in: C

A.pregnancy

B.puberty

C.HPV infection of skin

D.Following partial hepatectomy

E.Lactation in breast

35.The following are labile cells

A.Keratinocytes T

B.Chondrocytes F

C.Hepatocytes F

D.renal tubular epithelium F

E.Endothelium F

36. Which of the following will not be confirmed by Perl’s Prussian blue reaction E
A.haemosiderin

B.Ferritin

C.Haematin

D.Haemochromatosis

E.Haematoma RESEARCH THE ANS

37.The following statements are correctly paired

A.Pathogenesis – direct cause of disease F

B.Idiopathic – cause is unknown T

C.Prognosis – likely outcome of disease T

D.Congenital - present at birth T

E.Aetiology – mechanism of disease production F

38.The following statements are correct

A.Atrophy is a reversible process T

B.Metaplasia inevitably leads to neoplasia F

C.Growth factors may inhibit cell growth or division T

D.The myocardium in a hypertensive patient has more cells than normal F

E.The G1 and S phases of the cell cycle make up interphase F

39.Genetic abnormalities may cause disease by:

A.Synthesis of shorter than normal peptides T

B.Total lack of transcription of genes T

C.Abnormal mRNA processing T

D.excess synthesis of a normal protein T

ETrisomy affecting chromosomes T

40. The following changes are irreversible a lev1

A.Karyorrhexis T

B.Swelling of endoplasmic reticulum F

C.disaggregation of ribosomes F

D.cell chromatolysis F

E.Metaplasia F

41. The following are true of permanent cells except B

A.Include neurones

B.replicate easily after injury

C.Have left the cell cycle

D.Are capable of hypertrophy

E.Can undergo atrophy

42. Which of the following statements is incorrectly paired A

A.Pathogenesis – polio virus ANS

B.Idiopathic – cause is unknown

C.Prognosis – malignant
D.Congenital - sickle cell disease

E.Aetiology – genetic abnormality

43.Which of the following is a type of liquefactive necrosis: B

a. Fat necrosis

b. Skin abscess

c. myocardial infarct

d. renal infarct

e. lung infarct

44.List and define the types of abnormal calcification.

Dystrophic- in dead or dying tissue eg. Fat necrosis, Psammoma bodies, atherosclerotic
plagues,Monckeberg’s medial calcific sclerosis
Metastatic- in normal tissue due to hypercalcemia eg. Hyperparathyrodism, parathyroid
adenoma, renal failure, Paget’s dx, cancer of the bone

Give examples of lesions in each case

45.In hypertrophy there is:

A. Increase in the size of the organ or tissue T

B. Increase in number of cells F

C. DNA synthesis T

D. Synthesis of more membranes T

E. A low level of aerobic respiration F

46. A young man develops acute pancreatitis with release of lipase. The following may
be seen in his omentum:
A. Increased number of fat cells F

B. Numerous foamy macrophages T

C. Multinucleate giant cells F

D. Necrotic adipocytes T

E. Many neutrophils T

47. The following are true of apoptosis:

A. Cell death in tumours T

B. Coagulation necrosis F

C. Destruction of cells in developmental involution T

D. Cell depletion in atrophy T

E. Autolysis T

48. Atrophy may be caused by:

A. Decreased work load T

B. Loss of innervation T

C. Diminished blood supply T

D. Loss of hormonal stimulation T

E. Ageing T

49. Dystrophic calcification

A. Occurs in the absence of deranged calcium in metabolism T

B. Is seen in areas of necrosis T

C. May occur throughout the body F

D. Can occur in normal tissues F

E. Is a sign of previous injury T

50. In metaplasia:

A. The change is irreversible F

B. Persistence of the stimuli may induce cancer formation T

C. Function may be lost T

D. There is genetic reprogramming of stem cells T

E. The metaplastic tissue is less adapted for survival F

51. A 25 year old woman has chronic vessel shistosomiasis. Her bladder eliumis lined by
squamous epithelium: This

A. Results in enhanced function of the epithelium T

B. Arises from reprogramming of stem cells T

C. Causes a reduction in nuclear DNA content F

D. Involves depression of differentiation genes F

E. Occurs in the presence of growth factors

52. A 65 year old woman presents with uterine bleeding: Examination reveals a
malignant uterine mass. The biopsy specimen may show

A. Dysplasia

B. Pleomorphism

C. Aplasia

D. Necrosis

E. Tumor giant cell

53.Hepatic injury induced by carbon tetrachloride is characterised by all of the following:

A. Lipid peroxidation T CLUE:CCL4 cause free radical injury

B. Influx of calcium into hepatocytes T

C. Mitochondrial damage T

D. Depletio of intracellular lipid T

E. Disaggregation of polyribosome F

54. The histology of an enlarge prostate in a 65 year old man showed enlarged glands
with corrugated epithelium. This represents a process due to:

A. Coagulation necrosis

B. Hypoplasia

C. Failure of membrane boundary function

D. Increased cell number

E. Metaplasia ans already

STUDY GROUP PAST QUESTIONS
COMPILATION FOR PAHTOLOGY 2
(Note: this compilation excludes questions on the pictures)refer to Class of 2018 folder for pics

CHAPTER 2 & 3
ACUTE AND CHRONIC INFLAMMATION AND WOUND
HEALING

1) Increased blood flow in acute inflammation leads to

a) Build up of activated clotting factors
b) Transudation of protein poor fluid
c) Increased inflow of clotting factor inhibitors
d) Hypercoagulability of blood

2) Arachidonic acid metabolites that promote edema formation include:

a) Leucotriene C4
b) Prostaglandin D2
c) Lipoxin A4
d) d)Thromboxane A4

3) The driver of a taxi sustains a simple fracture of the mid left femur following a head
collision with a tro-tro bus. The ff. will be found at the site after 4 months
a) Fibrous tissue
b) Hyaline cartilage
c) Cancellous bone
d) Woven bone

4) A 5yr old girl falls down and sustains a cut on the knee. The ff. will occur within a few
days except:
 a) Regeneration of parenchymal cells
b) Proliferation of connective tissue cells
c) Remodelling of epidermis
d) Synthesis of extracellular matrix

5) The following may characterize or is true of a granuloma except:

a) Presence of epithelial cells
b) Central liquefactive necrosis
c) Healing by fibrosis
d) Proliferating small blood vessels

6) The following are true of Caseating Granuloma EXCEPT:

a) The causative agent is often mycobacteria or fungi
b) Caused by persistence of injurious stimulus
c) Contains multinucleated giant histiocytes
d)The characteristic cell is from lymphocytes

7) All of the ff. are causes of delayed healing after acute inflammation
a) Advanced age
b) Diabetes mellitus
c) Protein deficiency
d) Retention of debris

8) A man brushes his shin against the tip of a rusted nail sustaining a cut. Within a few days
his shin is swollen, red and painful and the sore exudes pus. The underlying process
serves all of the following purposes EXCEPT:
a) Isolation of infected tissues
b) Inactivation of causative agents
c) Removal of devitalized tissues
d)Healing of the injured tissue

9) A 60yr old man who worked in stone quarry for 40yrs developed breathlessness. A chest
X-ray showed multiple pulmonary nodules. A biopsy of this lesion will show all of the
following except:
a) Multiple abscesses
b) Chronic granulomatous inflammation
c) Many epitheloid macrophages
d) Foreign body giant cells

10) A 70yr old man develops acute myocardial infarction and dies 2 weeks later. At post
mortem the infarct is largely replaced by granulation tissue. The ff. cell types are present
in this lesion EXCEPT:
a) Macrophages
b) Fibroblasts
c) Endothelial cells
d) Epithelial cells
11) A 6yr old develops sore throat. Examination shows a red and swollen tonsil and he is
given aspirin and antibiotics. Which of the ff. steps in the underlying process is affected
by aspirin?
a) Vasodilation
b) Chemotaxis
c) Leukocyte emigration
d) Phagocytosis

12) A 28yr old woman underwent Caesarean section to deliver a term baby. The sutures were
removed 1 week later and would healing progressed but the site became disfigured by a
prominent scar over the next 2 months. This development is:
a) Proud flesh
b) Organization
c) Secondary union
d) Keloid

13) At autopsy, in 68yr old woman, you find a liver in a single large focus of liquefactive
necrosis with negative culture for bacteria. The patient most likely has:
a) Hepatic adenoma
b) Metastasis from colonic carcinoma
c) Hepatocellular carcinoma
d) Hepatic abscess

14) The integrin superfamily includes

a) Sialyated Lewis antigen
b) Complement receptor 4
c) Platelet endothelial adhesion molecule
d) Intercellular adhesion molecule 1

15) Giant cells in granulomatous inflammation in the lung are derived from
a) Endothelium
b) Lymphocytes
c) Macrophages
d) Type 2 pneumocytes

16) One of the major diff. between exudates of fibrinous and suppurative inflammation is the
quantity of :
a) Fibroblasts
b) Neutrophils
c) Macrophages
d) Epitheloid cells
e) Plasma cells

17) The local warmth in the area of acute inflammation is primarily due to which of these
a) Vasodilatation
b) Vasoconstriction
 c) Leucocyte emigration
d) Red cell diapedesis

18) A medical student’s finger is cut by a razor blade. What major processes will follow
sequentially within minutes of this event until one month at this site?
a) Congestion, leucocyte margination, chemotaxis, fibrosis
b) Haemorrhage, leucocyte margination, regeneration, fibrosis
c) Vasoconstriction, leucocyte migration, granulation, fibrosis
d) Increased permeability, regeneration, granulation, fibrosis

19) A man inhales toxic fumes and develops pulmonary edema. This change is mainly due to:
a) Increased vascular permeability
b) Increased arteriolar hydrostatic pressure
c) Low plasma oncotic pressure
d) Reduced capillary hydrostatic pressure

20) A male infant with a history of repeated infections is admitted with fever and productive
cough. Gram positive cocci in chains are seen in the sputum. Tests show ability of his
neutrophils to phagocytose and kill the bacteria in the presence of normal serum but not
in his own serum. He has:
a) Deficiency of selectins
b) Neutrophil microtubular defect
c) Inability to form phagosome
d) Complement deficiency

21) All of the ff. are causes of delayed healing fractures EXCEPT:
a) Vit. E deficiency
b) Internal fixation of fracture
c) Interposition of muscle at fracture ends
d) Poor immobilization

22) A tissue or organ usually attempts to regenerate itself after focal destruction. Cells of the
following organs are capable of regenerating except:
a) Thymus
b) Thyroid
c) Pneumocytes
d) Biceps

23) Inflammatory edema is associated with swelling seen in the ff. except:
a) Insect bite
b) Congestive cardiac failure
c) Surgical wounds
D)Burns
24) Chronic inflammation typically result from infection by the following except:
a) Mycobacterium tuberculosis
b) Foreign particles
c) Fungus
d) Hemophilus influenza

25) Giant cells found in granulomatous inflammation excludes

a) Touton giant cell
b) Foreign body giant cell
c) Langhan’s giant cell
d) Langerhan’s cell

26) Delayed union of a fracture may be due to the following except:

a) Tiny bone pieces at fracture ends
b) Infection by pyogenic bacteria
c) Interposed muscle at fracture ends
d) Poor immobilization

27) The following heal by fibrosis except:

a) Typhoid ulcer
b) Peptic ulcer
c) Deep knife wound
d) Drained abscess cavity

28) The following lesions are likely to regenerate except :

a) Bone fracture
b) Acute hepatitis
c) Poliomyelitis
d) Vasculitis

29) The following are correctly paired except:

a) P selectin – rolling
b) PECAM – transmigration
c) E selectin – firm adhesion
d) ICAM – 1 - rolling

30) During acute inflammation, hydrogen peroxide is produced by:

a) Lysozyme
b) Superoxide dismutase
c) Hydrogen peroxidase
d) Peroxide synthetase

31) Acute inflammation is main mechanism in the following except:

a) Asthma
 b) Pneumonia
c) Glomerulonephritis
d) Atherosclerosis

32) A child falls and injures the scalp which then became reddened, and swollen and
edematous. The reason for these findings is a combination of :
a) Vasodilatation and increased permeability
b) Vasoconstriction and increased permeability
c) Vascular stasis and necrosis
d) Vascular necrosis and angiogenesis

34 – 36) For each of the ff. diseases select the most likely deficiency in the following brackets

A – (NADPH oxidase) B – (fucosyl transferase) C – (CD11a/CD18)

D- (Superoxide dismutase) E – (myeloperoxidase)

33) LAD 1
34) LAD 2
35) Chronic granulomatous disease

37 – 39) For each of the ff. diseases, select the most likely leucocyte function defect in the ff.
brackets

A – (chemotaxis) B – (adhesion) C-(intracellular killing)

36) Anaemia
37) Leukemia
38) Malnutrition

39) The following are true of Caseating Granuloma EXCEPT:

d) The causative agent is often mycobacteria or fungi
e) Caused by persistence of injurious stimulus
f) Contains multinucleated giant histiocytes
g) The characteristic cell is from lymphocytes

40)Alterations in normal blood flow:

a. Bring platelets into contact with endothelium

b. Allow activated clotting factors to build up

c. increase inflow of clotting factor inhibitors

d. Promotes endothelial cell activation

e. Cause hypercoagulability of blood

41)The following are true of edema due to right ventricular failure:

a. Due to increased capillary hydrostatic pressure

b. Appears first around the ankles

c. Ascites usually occurs

d. Protein content is usually in excess of 3gm/dl

e. Pulmonary edema is a result

41)The following are consequences of D.I.C.:

a. Widespread fibrin deposition

b. Generalised edema

c. Haemolytic anaemia

d. Bleeding diathesis

e. Multiple foci of infarction

42. The magnitude of leucocyte migration into an area infected by bacteria is governed by:

a. The type of organism

b. Chemotaxis

c. Bacterial products

d. C5a

e. The formation of pus

43.Clear fluid aspirated from the knee in a patient with traumatic arthritis: b lev 2
 a.Is a transudate

b.Contains a fibrin

c.Contains mainly albumin

d.Contains mainly lymphocytes

e.Is purulent

44.Characteristics of a granuloma excludes: d lev 1

a.Altered macrophages

b.Fused macrophages

c.Epitheloid cells

d.Polymorphonuclear leucocytes

e.Central necrosis

45. Open wounds are associated with the following:

a.Formation of granulation tissue

b.Infection

c.Migration of basal epithelial cells

d.Wound contraction

e.Hypertrophic scars

46.Cells usually involved in chronic inflammation include:

a. Endothelial cells

b. Plasma cells

c. Lymphocytes

d. Macrophages
 e. Fibroblasts

47.Increased vascular permeability in Acute inflammation

a. results in oedema

b. is caused by histamine

c. causes leakage of leucocytes from vessels

d. results from endothelial cell contraction

e. affect mainly the medium sized arteries

48.The following cause neutrophil chemotaxis

a. Bradykinin

b. C3a

c. Ag/Ab complexes

d. C5a

e. Bacterial toxin

49.Wound healing is delayed by deficiency of which of the following

a. Corticosteroid

b. Iron

c. Adrenalin

d. testosterone

e. Vitamin C

50.Systemic manifestations of inflammation include

 a. leucocytosis

b. Eosinophilia

c. Ulceration

d. Leucopenia

e. Lymphocytosis

51. If the following five events are placed in order of occurrence in a skin wound

a. acute inflammation comes first

b. growth of granulation tissue will be second

c. wound edges united by collagen will be third

d. Migration of epithelial cells from edges of wound will be

fourth

e. Loss of vascularity of wound will be fifth

52. Harmful effects of acute inflammation include: d lev 1

a. Dilution of Toxins

b. Formation of fibrin

c. Phagocytosis

d. Swelling of tissues

e. Stimulation of tissue response.

53. Clear fluid aspirated from the knee in a patient with traumatic arthritis:

a.Is a transudate

b.Contains a fibrin

c.Contains mainly albumin

d.Contains mainly lymphocytes

e.Is purulent
54. Useful effects of acute inflammation excludes:

a. Dilution of Toxins

b. Stimulation of immune response

c. Formation of fibrin

d. Phagocytosis

e. Swelling of tissues

55. The following will be true of clear fluid aspirated from the thoracic cavity of a patient with lobar pneumonia except:

a. Is likely to be a exudate

b. will contain no fibrin

c. May be similar to burn blister fluid

d. Any cells present will likely be neutrophils

e. Is due to the process of suppuration

56.Open wounds differ from incised wounds due to presence of which of the following: D

a. granulation tissue

b. Infection

c. Migration of basal epithelial cells

d. Wound contraction

e. Remodelling of collagen

57.A granuloma may show the following features except:

a. Histiocytic giant cells

c. Epithelial cells infiltrate

d. lymphocytic cell cuff

e. presence granulation tissue

 f. Central necrosis

58. The following are predisposing factors in venous thrombosis

a. Thrombocytopenias

b. Leucocyte aggregation

c. Hypercoagulability of blood

d. Stasis

e. Inflammation in the vessel

58. Cells that usually proliferate during chronic inflammation exclude: B

a. Endothelial cells

b. Plasma cells

c. Lymphocytes

d. Macrophages

e. Fibroblasts

59. Local factors affecting the duration of skin wound healing exclude: D

a. infection

b. Vascularity

c. nerve supply

d. tensile strength of skin

e. size of wound

60. The following affect leucocyte migration into an area except:

a. The type of organism

b. Chemotactic factors
 c. Bacterial products

d. collagen

e. Adhesion molecules

61. Wound healing is delayed by excess of the following A

a. Corticosteroid

b. vitamin C

c. Adrenalin

d. Testosterone

e. Vitamin D

62.Which of the following is not true of Increased vascular permeability in Acute inflammation

a. results in oedema

b. is caused by histamine

c. causes leakage of leucocytes from vessels

d. results from endothelial cell contraction

e. affect mainly the microcirculation

63. The following cause pain in inflammation except

a. edema fluid

b. Bradykinin

c. Prostacycline

d. IL1, TNF

e. Prostaglandin E2

64. Systemic manifestations of inflammation exclude

a. Leucocytosis

b. Ulceration

c. Eosinophilia
 d. Leucopenia

e. Lymphocytosis

65.The following cause epitheloid cell granulomas except

a. fungi

b. Bacteria

c. Protozoa

d. Lipid

e.

f. ..

g. Hay fever

66.Leucocyte movement into tissue in inflammation involves the following except: E

a. pavementing

c. Rolling

d. Chemotaxis

e. Adhesion

e granulation

67.The following are true of turbid yellow-green fluid aspirated from the knee in a patient with arthritis
except:

a. Is an exudate

b. Contains a lots of fibrin

c. Produced by acute inflammation

d. Contains numerous neutrophils

e. Is purulent

68. Findings in a tuberculous granuloma exclude:

 a. Altered macrophages

b. Fused macrophages

c. Epithelial cells

d. Polymorphonuclear leucocytes

e. Central necrosis

69. Sutured wounds may have the following except:

a. Formation of granulation tissue

b. giant cells

c. Migration of basal epithelial cells

d. Wound contraction

e. Granulomas

70. The following are histiocytic cells except

a. Touton giant cell

b. Kupfer cell

c. astrocyte

d. Microcytic glial cell

e. Osteoclast

71.Wound healing is delayed by the following except

a. Corticosteroids administration

b. Zinc deficiency

c. Sutures in wound

d. Insulin administration

e. Vitamin C deficiency
72.The following are true of Neutrophils except.

a. are bone marrow derived

b. contain myeloperoxidase

c. predominate in allergic reactions

d. are actively phagocytic

e. usually die at the site of inflammation

73.Which of the following will not be confirmed by Perl’s Prussian blue reaction

a. haemosiderin

b. Ferritin

c. Haematin

d. Haemochromatosis

e. Haematoma

74.The following cause acute inflammation except C

a. streptococcus pneumoniae

b. bacillus anthracis

c. mycobacterium tuberculosis

d. neisseria meningitides

e. staphylococcus aureus

75.Which of the following are events does not occur in healing of a surgical skin wound. E

a. acute inflammation

b. Growth of granulation tissue

c. wound edges united by collagen

d. Migration of epithelial cells from edges of wound

e. Increased vascularity after seventh day

76.pyogenic organisms include the following except c lev 1

a. staphylococci

b. neisseria

c. mycoplasma

d. streptococci

e. Bacillus

77.The following is not associated with thrombosis

a. Activation of coagulation system

b. Endothelial cell damage

c. Formation of leucocyte aggregates

d. Thrombocytopaenia

e. Vascular stasis

78. A bland embolus that is arrested in the circulation may result in the following except: e lev2

a. Infarction

b. Haemorrhage

c. Thrombosis of embolised artery

d. No effect

e. Pyaemic abscess

79. Hypovolaemic shock may result from the following except:

a. Burns

b. Myocardiac infarction

c. Peptic ulcer

d. Gun shot injury

e. Diarrhoea
80. The predominant leucocytes in chemical meningitis are

A. Neutrophils

B. Macrophages

C. Eosinophils

D. Lymphocytes

E. Monocytes

81. The following causes vasodilation in acute inflammation

A. Platelet activating factor

B. Thromboxane

C. Prostacycline

D. Tumour necrosis factor

E. Plasmin

82. The main components of pyogenic membrane are :

A. Lymphocytes

B. Capillaries\

C. Fibroblasts

D. Hyaluronidase

E. Polymorphonuclear leukocytes

83.The following are involved in the oxygen dependent pathway of cell killing:

A. Hydrogen peroxide

B. Low pH

C. Cationic proteins

D. Superoxide

E. Hypochlorite
84. During leukocyte migration:

A. Leukocytes leave vessel by pinocytosis of endothelial cells

B. Neutrophils are the first to emigrate

C. There is accompanying active red cell loss

D. Leukocytes develop pseudopods

85. The best characterizes the inflammatory change indicated:

A. Exudates- edema fluid with protein content in excess of 30g/L

B. Purulent exudate- exudates with large amounts of bacteria

C. Abscess- localised collection of pus

D. Catarrhal exudate- has with large amounts of plasma proteins

E. Granuloma- exudates that comprise discrete aggregates of macrophages

86. The following would usually heal by fibrosis:

A. Gaping road traffic accident wound

B. Surgical skin incisional wound

C. Pneumonia

D. A tuberclosis granuloma

E. An ulcer

87. Suppurative inflammation is associated with :

A. Staphylococcal infection

B. Acute appendicitis

C. Treponema pallidum infection

D. Tuberclosis

E. Polymorphonuclear leukocytes
88. Following phagocytosis of a bacterium, the following may be used in the oxygen independent pathway
of killing:

A. Catalase

B. Major basic protein

C. High ph

D. Myeloperoxidase

E. Lysosyme

89. If the following features of acute inflammation are arranged in chronological order

A. Arteriolar vasoconstriction will be first

B. Escape of protein rich fluid from vessels will be SECOND

C. Slowing of blood flow will be THIRD

D. Dilatation of arterioles will be FOURTH

E. Emigration of leukocytes will be FIFTH

90. Useful effects of inflammation include:

A. Dilution of toxins

B. Formation of fibrin

C. Phagocytosis

D. Swelling of tissues

E. Stimulation of tissue response

91. The following events are arranged in the sequence of occurence:

A. Capillary proliferation from bone marrow- FIRST

B. Increased osteoclastic resorption of the bone- SECOND

C. Lamellar bone replace woven bone- THIRD

D. Ossification of the persistent fibrin clot- FOURTH

E. Proliferation of periosteal cells around the fractured bone ends- FIFTH

92. A 65 year old man with heart disease develops painless, swollen feet. A pit forms depressing the skin in
the affected area. Which of the following mechanisms of swelling explain the swelling?

A. Increased transudation of fluid

B. Lymphatic obstruction

C. Chronic venous congestion

D. Acute inflammation

E. Increased venous hydrostatic pressure

93. His liver show the following

A. Chronic inflammation

B. Diffuse fibrosis

C. Periventricular necrosis in histology

D. Nutmeg appearance on gross examination

E. Cholestasis

94. A 50 year old man with hypertension experiences sudden onset of difficult in breathing and is
diagnosed as having acute left ventricular failure. Which of the following mechanisms most likely caused
dyspnoea?

A. Acute inflammation

B. Pulmonary embolism

C. Decreased plasma oncotic pressure

D. Increased hydrostatic pressure

E. Histamine released

95. A 65 year old woman falls and fractures her right femoral neck. Two weeks later her right leg is swollen
especially around the middle part. This is due to:

A. Gangrenous necrosis of the leg

B. Deep vein thrombosis

C. Infection of the right leg

D. Edema of the right leg

E. Hematoma of the right leg

96. The mechanism involve is

A. Obstruction to blood flow

B. Increased hydrostatic pressure

C. Venous stasis

D. Necrosis with bacterial growth

E. Endothelial damage`

97. The following are true of caseating granulomas

A. Caused often by mycobacteria or fungi

B. It is due to the persistence of injurious stimuli

C. Contains multinucleated giant histiocytes

D. The most characteristic cell of the lesion is derived from lymphocytes

E. Shows necrosis

98. 23 year old woman is on corticosteroid for an autoimmune disease. The following are likely to develop

A. Skin atrophy

B. Poor wound healing

C. Reduced prostaglandin synthesis

D. Adrenal cortical atrophy

E. Neutrophil emigration

99.All of the following are causes of delayed healing after acute inflammation

A. Advanced age

B. Ascorbic acid deficiency

C. Diabetes mellitus
D. Protein deficiency

E. Retention of debris

100. The histology of an enlarged prostate gland in a 65 year old man showed large glands with corrugated
epithelium. This represents a process due to:

A . Coagulative necrosis

B. Hypoplasia

C. Failure of membrane bounding function

D. Increased cell number

E. Metaplasia

101. A 6 year old develops sore throat. Examination shows a red and swollen tonsil and he is given aspirin
and antibiotics. Which of the following underlying processes is affected by aspirin?

A. Vasodilation

B. Chemotaxis

C. Leukocyte emigration

D. Phagocytosis

E. Mast cell degranulation

102. A toddler develops recurrent bacterial infection. Examination of peripheral blood leukocytes shows a
deficiency of myeloperoxidase. The likely cause of this child’s problem is

A. Defective neutrophils degranulation

B. Failure to produce hydrogen peroxide

C. Inability to produce hydroxyl halide radical

D. Defective neutrophils

E. Defective bacterial engulfment

103. A male infant with history of repeated infections is admitted with fever and productive cough. Gram
positive cocci in chains are seen in the sputum. Tests show ability of his neutrophils to phagocytose and kill
the bacteria in presence of normal serum but not in his serum. He has:
A. Ca deficiency

B. Deficiency of selectins

C. Neutrophil microtubular defect

D. Inability to form phagosome

104.29. A 70-year old man develops acute myocardial infarction and dies 2 weeks later. At post mortem
there is necrosis of the anterior wall of the left ventricle and histology shows the necrotic tissue to be
largely replaced by granulation tissue. The following cell types are involved in the development of this
appearance?

A.Macrophages.

B.Fibroblasts

C.Endothelial cells

D.Epithelioid cells

E.Platelets

105.At autopsy, in 68yr old woman, you find a liver in a single large focus of liquefactive necrosis with
negative culture for bacteria. The patient most likely has:
e) Hepatic adenoma
f) Metastasis from colonic carcinoma
g) Hepatocellular carcinoma
h) Hepatic abscess

GENERAL PATHOLOGY IA 2013 QUESTIONS AND ANSWERS

1.An athlete develops acute throat infection. In addition to local acute inflammatory changes he develops
fever and malaise. These constitutional symptoms are caused by: Ans: B
A.histamine
B. IL 1 & TNF
C. C3a
D. Prostacyclin
E. Thromboxane

2.After a minor trauma to the big toe, a child develops painful toe which is warm and tender. The swelling
is fluctuant. This focal reaction represents : B
A. An area of chronic inflammation with granuloma
B. A localised collection of transudate
C. A localised collection of granulation tissue
D. A localized collection of pus
E. An area of collagen deposition

3The most potent microbial mechanism in neutrophils ans: D

A. Myeloperoxidase
B. Neutrophil peroxidase
C. Lysosomal enzymes
D. H2O2-MPO-halide system
E. Neutrophil granule enzymes

4.The earliest mechanism for increased vascular permeability in inflammatory response is: ans: E
A. Increased transcytosis
B. Direct endothelial cell damage
C. Leukocyte mediated endothelial injury
D. Cytoskeletal reorganization
E. Endothelial cell contraction

5.A 40 year old man incurs a burn injury to his hands and arms while working in a propane furnace. Over
the next 3 weeks, the burned skin heals without skin grafting. Which of the following is the most critical
factor in determining whether the skin in the region will regenerate? Ans: D
A. Good cardiac output with tissue perfusion
B. Persistence of skin appendages
C. Diminished edema and erythema
D. Maintenance of underlying connective tissue
E. Granulation tissue formation

6.The incorrectly named inflammation of anatomic site: ans: E

A.keratitis......cornea
B.proctitis.....rectum
C.nephritis.....kidney
D.cheilitis.......lips
E.typhilitis....tympanic membrane

7.Non selective inhibition of COX enzyme would likely lead to this effect on the microvasculature ans: B
A. increased vascular permeability
B. Vasoconstriction
C. Vasodilatation
D. Stasis of blood
E. Increased leukocyte chemotaxis

8.Regarding mediators of inflammation ans: C

a. TNF is a chemokine with chemoattractant property
B. TNF contributes to cachexia of disease
C. TNF and IL-1 are produced mainly by activated macrophages
D. The systemic acute phase response is induced by MIP-1 and RAS
E. PAF causes vasodilatation when expressed at high levels

9.Regarding acute inflammation ans:B

a.Initial vasoconstriction is the result of histamine and nitric oxide
B. Stasis occurs due to vasodilatation and the larger caliber of the vessel
C. Increased permeability leads to protein depleted plasma leaking
D. Initial formation of endothelial gaps lasts for only 15-30 minutes
E. Cytokines (IL-1 and TNF) are responsible for the early permeability

10. The class of inflammatory mediators that increase the permeability of the vessels, cause contraction of
smooth muscle and are chemoattractants for neutrophils ans: A
A. Leukotrienes
B. Histamines
C. Bradykinins
D. Chemokines
E. Prostaglandins

11. Which of the following ultrastructural features of cell injury are considered irreversible? Ans: E
A. Myelin figures
B. Swelling of endoplasmic reticulum
C. Mitochondrial densities
D. Cytoplasmic vacuoles
E. Pyknotic nuclei

12. The following are true of apoptosis except: ans : C

A. It results from immunologic injury
B. It is triggered by decreased BCL2/p53 ratio ebe
C. It can be effectively reversed by surviving
D. It occurs as a consequence of activation of caspase 3
E. It is an example of irreversible cell injury

13. Sections of the trachea shows squamous cells lining the mucosa. The following is responsible except a
A. Vitamin A deficiency
B. Mechanical intubation
C. Hypoglycemia ans: C
D. Chronic inflammation
E. Smoking

14.Calcification is a prominent component of which of the following: ans: A

A. Psammoma bodies
B. Sarcoid granuloma
C. Corpora amylacea
D. Gamma-Gandy bodies
E. Kimmestiel- Wilson lesions

15.Accelerated ageing occures in the following except: ans : C

A. Progeria
B. Werner syndrome
C. Bloom syndrome
D.cockayne syndrome
E. Pick’s disease

16. The earliest event in acute inflammation is ans: E

A. Increased vascular permeability
B. Endothelial contraction
C. Leukocyte margination
D. Increased hydrostatic pressure
E. Vasodilatation

17.The most common mechanism involved in increased vascular permeability ans: B

A. Histamine acting on venules
B. Cytokine meditated formation of endothelial gaps
C. VEGF acting on endothelial cells
D. Leukocyte mediated endothelial injury
E. Bacteria mediated endothelial cell necrosis

18.Primary defects in leukocyte phagocytosis and intracellular killing occur in all the following except:
A. Leukocyte adhesion deficiency
B. Chedak Higashi syndrome
C. X linked gp91 phox defiency
D. Myeloperoxidase deficiency
E. Gluthathione reductase deficiency ans: E

19. Serotonin differs from histamine in the fact that serotonin ans: E
A. Stimulates fibrosis via fibroblast
B. Is not released by platelets
C. Causes increased vascular permeability
D. Does not result in arteriolar vasodilation
E. Serotonin is limited to carcinoid syndrome

20. Which of the following is not true of chemokines? Ans: A

A. They are large protein complexes
B. They bind to serpentine receptors
C. They are induced by interleukin-1
D. They are caused by neutrophil chemotaxis
E. They serves as receptors for HIV virus

21. The enzyme catalysing this reaction in the human body 02-+02+2H+=H20 ans: A
A. It is important in the removal of free radicals
B. Forms hydrogen peroxide, which is a natural oxidant
C. Uses an iron molecule as a catalyst
D. Is part of the antioxidant system in the plasma
E. Uses nitric oxide as a substrate

22. FIbroblasts differentiate into myofibroblasts through ans: E

A. Production of a fibronectin coating on the plasma membrane
B. Forming intracytoplasmic bundles of fibres and dense bodies
C. Acquisition of collagen synthesizing enzymes
D. Production of myoDI family of proteins
E. Acquiring receptors for platelet derived growth factors

23. Fibrosis is induced by all the following mediators except: ans: B

A. Platelet derived growth factor
B. Heparin
C. Transforming growth factor
D. Fibronectin
E. Fibroblast growth factor

24.The following are correctly matched with their ligan receptor #missing# except ans: D
A. Growth factors- receptors with intrinsic tyrosine kinase activity
B. Cytokines - receptors without intrinsic tyrosine kinase activity
C. PGDF- receptors with intrinsic tyrosine kinase activity
D. Steroid hormones- receptors with intrinsic tyrosine kinase activity
E. Non steroid hormones- seven spanning receptors

25. The following are correctly matched except: ans: E***

A. Hyaluronic acid - accumulates in patients with thyroid dysfunction
B. Collagen - defective cross-linking leads to homocystinuria
C. Fibrillin- defective synthesis leads to Marfan Syndrome
D. Fibrillin- helps in assembly of elastin
E. Collagen- type 1 is main component of basement membrane

26. Pathogenesis is ans: D

A. The risk factors associated with disease
B. Prevalence of disease in a population
C. Manifestation of disease
D. Mechanism of disease causation
E. Outcome of disease

27. A 48 year old obese woman has had heart burns after eating #missing# specimen of the esophageal
mucosa is obtained to most # misssing# most likely #missing# following changes: ans: D
A. Necrosis
B. Apoptosis
C. Neoplasia
D. Metaplasia
E. Inflammation

28. A 25 year old woman has chronic vesical shistosomiasis #missing# squamous epithelium. Which of the
following is not true: ans: D( most likey)
A. Results in reduced funtion of the epithelium
B. Arises from reprogramming of stem cells
C. Causes a reduction in nuclear DNA content
D. Involves derepression of differentiation genes
E. Ocuurs in the presence of growth factors

29.Which of the following examples of atrophy is not correctly paired with the cause ans: E
A. Atrophic testis......................... Hormonal lack
B. Pressure atrophy ........................... Ischemia
C. Atrophic brain............................... Ischemia
D. Complete bed rest........................ Disuse
E. Short limb post poliomyelitis........ Disuse

30. The skeletal muscles of an athlete in training enlarge. This change does not involve ans: B
A. Involve induction of growth genes
B. Result in increase in autophagic granules
C. Occur due to hypertrophy of the cells
D. Cause an increase in DNA content of myocytes
E. Result in increase in transcription factors

Compiled Adjei Kwadwo Emmanuel on 26th August, 2014