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Pathology Department
Independent Medical College, Faisalabad
3 Year MBBS – 3rd Term Examination, 2018
rd

Subject : G.Pathology & Microbiology (MCQ) Total Marks : 50

Topics : Neoplasia,Disorders of Immunity,Genetic disorders Time Allowed : 60 Min

Virology, Enviromental diseases, Actinomycetes

1. Which one is most malignant tumour?

(A) Ewing cell sarcoma (B) Multiple myeloma (C) Chondrosarcoma
(D) Osteosarcoma (E) Rhabdomyosarcoma

2. Which one of the following does not participate as Anti-tumour effector mechanism?
(A) Natural Killer cell (B) Cytotoxic T cell (C) Interleukin
(D) Interferon (E) HLA class 1

3. Which one of the following is not observed as para-neoplastic syndrome in a patient suffering from
cancer?
(A) Myesthenia (B) Anaemia (C) Hypoglycemia
(D) Peptic ulcer (E) Nephrotic syndrome

4. Which of the following factor has major role on the prognosis of cancer?
(A) Nuclear pleomorphism (B) Necrosis (C) Haemorrhage
(D) Invasion (E) Inflammation

5. The survivors of Nagasaki has greatest risk of the following cancer except which one?
(A) Breast (B) Colon (C) Lung9
(D) Thyroid (E) Ovary

6. Which of the following proto-oncogene is involved in signal transduction to cause cancer?

(A) Cmyc (B) K-Ras (C) Erb 1
(D) Cyclin D (E) CDK 4

7. Which one of the following is not a natural product causing cancer?

(A) Safrole (B) Cycasin (C) Benzidine
(D) Aflotoxin (E) Griseofulvin

8. A 60-year-old man works in rubber industry where β nephthylamine is used. Which cancer is most likely
can develop?
(A) Gastric carcinoma (B) Osteosarcoma (C) Bladder carcinoma
(D) Hepatoma (E) Skin cancer

9. Which one of the following tumour frequently metastarise through vascular route?
(A) Melanoma (B) Chordoma (C) Osteosarcoma
(D) Carcinoma lung (E) Lymphoma

10. A man migrated from Africa suffered from Lymphoma in the neck. It is associated with which biological
agent?
(A) E.B Virus (B) Herpes virus (C) Human papilloma virus
(D) Aflatoxin (E) Adenovirus
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11. The Hamartoma is which one of the following?

(A) Teratoma (B) Haemangioma (C) Haematoma
(D) Antibioma (E) Chordoma

12. Alfa fetoprotein is biological marker of which tumour?

(A) Yolk sac tumour (B) Dysgerminoma (C) Ewing sarcoma
(D) Adenocarcinoma (E) Gastric carcinoma

13. Which one of the following is not a suppressor gene?

(A) erb B1 (B) BRCA 1 (C) APC
(D) NF 1 (E) P 53

14. Which one of the following is not a DNA oncogenic virus?

(A) HTLV-1 (B) HPV-16 (C) H.B.V.
(D) EBV (E) Herpes virus

15. The person who take tobacco in any form can develop cancers in the following organs except which
one of the following?
(A) Lung (B) Oesohagus (C) Oral cavity
(D) Urinary bladder (E) Pancreas

16. A 60-year-old male can develop some cancer except in which one of the following industrial exposure
of metal?
(A) Cadmium (B) Nickle (C) Arsenic
(D) Iron (E) Asbestos

17. Pollen would most likely evoke which type of hypersensitivity response:
a. Cytotoxic (Type II) b. Immune complex (Type III) c. Cell Mediated (Type IV)
d. Immediate type (Type I) e. latent (Type V).

18. Which hypersensitivity reaction is T cell mediated?

a. Type I b. Type II c. Type III
d. Type IV e. None of these

19. Which of the following bind to mast cells and cross-link, resulting in de-granulation and release of
histamine ?
a. IgM b. IgA c. IgG
d. Interleukins e. IgE

20. Production of auto-antibodies may be due to:

a. Emergence of mutant clones of B cells
b. Production of antibodies against sequestered (hidden) tissues
c. genetic factors
d. all are possible
e. None of these

21.A positive tuberculin test is an example of

a. Type I hypersensitivity b. Delayed type hypersensitivity c. acute contact dermatitis
d. Eczema e. Pollen allergic response

22. Contact with poison ivy would elicit which type of hypersensitivity reaction?
a. type III b. type I c. type II
d. type IV e. type V
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23 . A tissue graft between two people who are not genetically identical is termed a:
a.Isograft b. Heterograft c. Xenograft
d. Autograft e. Allograft

2 4. An example of a type III immune complex disease is:

a. Contact dermatitis b. Graft rejection c. Serum sickness
d. Atopy e. Allergies

25. Graft versus host disease results when the recipient lacks or has a poor immune system, and the donor
organ and recipient express different:
a. HLA b. T cells c. Antibodies
d. Autoantibodies e. Interleukins

26. Agammaglobulinemia is an immunodeficiency disease due to a deficiency in:

a. T cells b. MHC c. IgE
d. Cytokines e. B cells

27. Human immunodeficiency virus (HIV) binds specifically to which immune cell marker?
a. CD8 b. MHC c. CDC
d. CD4 e. GP120

28.. HIV has a high mutation rate due to the imprecise operation of its:
a. Viral membrane b. CD4 receptor c. Reverse transcriptase
d. protease e. dismutase

29. Which of the following is considered an autoimmune disease?

a. Rheumatoid arthritis b. AIDS c. SCID
d. agammaglobulinemia e. CJD

30.The Mantoux skin test is based on which one of the following ?

a..Type I hyper sensitivity b. Type II hypersensitivity c. Type III hypersensitivity
d..Type IV hypersensitivity e. None of the above

31. HIV infection

a. Is caused by rhinovirus b. Results in increased CD4 and T cell memory
c. Results in inversion of the CD4-CD8 ratio. d. Increases immature precursors of CD4 and T cells
e. Causes a CD4-CD ratio close to 2

32. A typical feature of AIDS

a. Decreased delayed type hypersensitivity reaction b. Lymphocytosis
c. Hypogammaglobulinaemia d. Increased CD4 and Tcells
e. Increase chemotaxis and phagocytosis

33. Mutations that arise in somatic cells are important in the genesis of which of the following diseases?
a) Inherited diseases b) Endocrine disorders c) Metabolic disorders
D) Cancers e) Connective tissue disorders

34: In antosomonal recessive disorders, siblings have

a) One chance in four of having the trait b) One change in two of having the trait
c)..One chance in eight of having the trait d) One chance in sixteen of having the trait
e) One chance in sixty four of having the trait
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35: Martan’s syndrome results from mutations affecting which of the following proteins?
a) Elastin b) Collagen c) Keratin
d) Beta-catenin e) Fibrillin

36: Hunter syndrome, a form of mucopolysaccharidoscs is an:

a) Autosomosoml dominant trait b) Autosomal recessive trait c) X-linked dominant
d) Y-linked recessive trait e) X-linked recessive trait

37. Down syndrome is associated with an extra coy of genes on chromosome

a) 17 b. 21 c.11 d. 19 e. 15

38. Which structure serves as the target for neutralizing antibodies when dealing with an enveloped, (-) ssRNA
virus?
a..RNA b. Capsid c. Lipid bilayer
d. Envelope glycoprotein e. RNA polymerase

39. Virulence factors play an important role in the pathogenesis of viral infections, and some of these factors
alter host defence mechanisms. One such factor is the HCMV (human cytomegalovirus) U56 protein that
inhibits TAP proteins (transporters associated with antigen processing). By inhibiting TAP, which host
defence mechanism is affected by U56?
A. B-cell-mediated antigen presentation to naive CD4 cells
B. CD4+-mediated B-cell activation
C. Dendritic cell-mediated antigen presentation to naive CD4+ cells
D. Somatic cell-mediated antigen presentation to activated CD8+ ceils
CD4+ -mediated CD8+ cell activation
E. xxxxxxxxxxxxxxx

40. What would be the phenotype of cells infected with HIV-1 during the primary stage of the infection?
A..CD4 CXCR4 B. CD8 CCR5 C. CD4 CCR5
D. CD8 / CXCR4 E. xxxxxxxxxx

41. A 32-year old man with AIDS develops symptoms of retinitts. Which enzyme is encoded by the
pathogen most likely responsible for the retinitts?
A.. Integrase B. 5N-methyl capping enzyme C. Neuraminidase
D.RNA-dependent RNA polymerase E. Thymidine kinase

42. You are now aware that there are a number of T cell types associated with specfic immune responses
to particular pathogens. Which type of pathogen would you most associate with TH17 responses?
A..Intracellular bacteria B. Extracellular bacteria C. Metazoan parasites
D. Viruses E. xxxxxxxxxxxxxx

43. The influenza virus is mainly controlled in special "risk" sectors by:
A. Hygien B. Vaccination C. Antiviral drugs
D..Humanized nmonoclonal antibodies E. xxxxxxxxxxxxx
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44. The influenza virus has complicated genetics mainly characterised by which of the following?
A. Genetic reassortment amongst 8 genes. B. High levels of recombination.
C. High fidelity RNA repla D. xxxxxxxxxxxx
E. Rapid adsorption and fusion from without via a hydrophobic peptide

45. Passive immunity is achieved by administering

a. Live virus b. Attenuated virus c. Absorbed toxin
d. Activated T cells e. All of the above

46. The HIV virus

a. Is a retrovirus b. Primarily targets the CNS and haemopoietic systems
c. Binds to the CD4 molecule on T cells d. Binds to the CD4 molecule on macrophages
e. All of the above

47. Major abnormalities of immune function in AIDS is

a. Decreased formation of circulating immune complexes b. Increased CD4:CD8
c. No alteration in macrophage/monocyte function d. Increased MHC II antigen expression
e. Decreased delayed hypersensitivity reactions

48. With regard to immunopathogenesis of HIV

a. Loss of CD4+ cells by direct and indirect mechanisms leads to the inversion
of the CD4-CD8 ratio
b. Infection of monocytes and macrophages is relatively unimportant in the pathogenesis of HIV
c. CD4+ T cells and macrophages contained in blood are major sites of infection and persistence
rather than lymphoid tissue
d. B cell antibody response to antigen is unaffected in AIDS
e. It is predominately CD4- T cells rather than CD4+ cells that are affected

49. The 'Actinomycetes' that causes abscesses in brain and kidney in immunodeficent patients are

a.. Actinomycetes israelii b. Nocardia asteroids c. M. marinum

d.. M. leprae e. None of above

50. The habitat for the 'Actinomycetes israelii' is

a.. Anal canal b. Genital tract c. Oral cavity
d..Skin e. None of above
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Pathology Department
Independent Medical College, Faisalabad
3 Year MBBS – 3rd Term Examination, 2018
rd

Subject : G.Pathology & Microbiology (SEQ) Total Marks : 50

Topics : Neoplasia,Disorders of Immunity,Genetic disorders Time Allowed : 60 Min
Virology, Enviromental diseases, Actinomycetes
1. (a) Enumerate the modes of invasion by cancer. 02
(b) What is the mechanism of invasion by cancer? 03

2. (a) Enumerate the factor involved in cancer formation. 03

(b) Briefly mention 2 characters of malignancy. 02

3. A 10 years old child from a village is bought to hospital with shortness of breath, wheezing, exceptional
dyspnea and occasional urticarial. Fecal specimen is positive for Ascaris eggs.
(a) Name the underlying hypersensitivity mechanism responsible for this child’s lung symptoms. (1)
(b) Give the immunological basis of this type of hypersensitivity. (2)
(c) What is the beneficial role of immunoglobulin E (IgE) (2)

4. (a) Define hypersensitivity. (1)

(b) Give the nechanism of type III hypersensitivity reactions with two examples. (4)

5. (a) Which antibodies are involved in hyperacute rejection and how they are produced ? (2)
(b) Write down the morphology of hyperacute rejection. (3)

6. Describe the role of T-Helper lymphocytes in immune reaction. (5)

7. (a) Write down two differences between viruses and bacteria . (2)
(b) Name four RNA and four DNA viruses with one example of the disease caused by each.(3)

8. A 35 years old male develops high grade fever with severe headache and
retrobulbar pain during an epidemic of Dengue viral infection.
(a) Describe briefly the clinical spectrum of this infection. (3)
(b) How will you confirm the diagnosis in Lab, during first 4 days of illness ? (2)

9. Describe klinefelter syndrome: (5)

10. (a) Give the clinical findings in a patient of Nocardiosis. (2)

(b) Give the lab diagnosis of Actinomycosis. (3)