Beruflich Dokumente
Kultur Dokumente
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
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B. heterophagocytosis
C. liquefactive necrosis
D. hyperplasia
Answer: A
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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
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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
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
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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
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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
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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?
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A. systemic anaphylactic reaction
B. complement-mediated cytotoxicity reaction
C. systemic immune complex reaction
D. delayed type hypersensitivity reaction
Answer: B
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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
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?
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A. organization
B. resolution
C. keloid formation
D. dehiscence
Answer: C
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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
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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
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B. vasoconstriction
C. neutrophil chemotaxis
D. platelet aggregation
Answer: B
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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?
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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
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
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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
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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
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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
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D. history of trauma
Answer: C
27. A 64-year old man has several episodes of hematuria in the past week. On physical
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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
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29. The use of broad-spectrum antibiotics can produce a bleeding diathesis characterized by
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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
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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
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organism. Which of the following is the most likely diagnosis?
A. chromomycosis
B. blastomycosis
C. cryptococcosis
D. cryptosporidiosis
Answer: C
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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.
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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
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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
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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
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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?
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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
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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
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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
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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
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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
79. A 43-year old man presents with increasing fatigue and occasional headaches. He states that
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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
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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
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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
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B. Duchennes muscular dystrophy
C. polymyositis
D. inclusion body myositis
Answer: B
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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
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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
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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
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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
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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
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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
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B. syringomyelia
C. Gullain-Barre syndrome
D. diabetes melitus
Answer: C
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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
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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
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of these findings?
A. thiamine
B. niacin
C. cobalamin
D. riboflavin
Answer: A
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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
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Answer: B
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
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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
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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
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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)
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a. tropicalsprue
b. whipplesdisease
c. celiacsprue
d. disaccharidasedeficiency
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
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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
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CELLINJURYANDADAPTATION
1. Psammomabodiesarefociofdystrophiccalcificationseeninwhichcondition?
A.multiplemyelomaofbone B.papillarythyroidcarcinoma
s.
C.parathyroidadenoma D.Pagetdisease
2. Theseareeosinophiliccytoplasmicinclusionsseeninalcoholicliverdisease.
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A.Amyloid B.Mallorybodies
C. Russelbodies D.Kimurabodies
3. Whichofthefollowingisafeatureofnecrosis?
A.reducedcellsize B.intactcellularcontents
C. intactplasmamembrane D.karyolysis
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4. A40yearoldmalecomplainsofchroniccoughandweightloss.CXRshowsan
illdefinedmassalongtheapexofbothlobes.SputumAFBwaspositive.Biopsy
ofthelungmostlikelyrevealwhichofthefollowing:
A.liquifactivenecrosis B.coagulativenecrosis
C.caseationnecrosis D.tumornecrosis
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5. Whichofthefollowingischaracteristicofapoptosis?
A.absenceofinflammation B.affectsnumerouscellsatatime
C.cellswelling D.leakingofenzymes
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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
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
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
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
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
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
A. Coagulation C. Liquefaction
B. Caseation D. Gangrenous
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
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
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
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
47. This is the second stage in the evolution of the lobar pneumonia:
A. Congestion C. Resolution
Ai
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
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.
A. VSD C. PDA
B. ASD D. TOF
37
MALE REPRODUCTIVE SYSTEMS
61. Most common testicular tumor in infants
A. Yolk sac tumor C. Embryonal carcinoma
B. Teratoma D. Choriocarcinoma
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
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
SKIN
73. Which type of mole is noted for its greatest malignant potential?
A. Melanoma C. Compound nevus
B. Intradermal nevus D. Junctional nevus
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
A 10 year old female presents with generalized edema. Blood pressure is 90/60.
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
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
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
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
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:
_____54.Arighttoleftshuntbestexemplifiedbywhichofthefollowing?
m
_____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
____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
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
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
26. Diffuseeffacementoffootprocessesischaracteristicof:
m
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