1 Word
1 Word
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2. Metaplasia
a. Is an increase in the number and size of cells in a tissue.
b. Is the process that occurs in Barretts oesophagitis.
c. Is typically an irreversible process.
d. Preserves mucus secretion in the respiratory tract.
4. Deposits of amyloid in whole organs can be diagnosed by histological staining nolan x soju
with a. Congo red
b. PAS
c. Methylviolet
d. Iodine and dilute sulfuric acid
e. Toluidine blue
5. A 3-year-old child has been diagnosed with metabolic disorder and has developed
hepatic failure. The left lobe of an adult donor liver is used as a transplant. A year
later, the size of each liver in donor and recipient is greater than at the time of
transplantation. Which of the following cellular alterations is most likely to explain
this phenomenon? a. Metaplasia
b. Hypoplasia
c. Dysplasia
d. Hyperplasia
6. During acute inflammation: histamine-induced increased vascular permeability
causes the formation of exudates (inflammatory edema). Which one of the listed
cell types is the most likely source of the histamine that causes the increased
vascular permeability?
a. Endothelial cells
b. Fibroblasts
c. Lymphocytes
d. Mast cells
7. Which of the following mediators are involved in the phase of vascular changes
during acute inflammation? a. IL-12
b. Histamine
c. Substance P
d. Thrombin
8. Which of the following best reflects the order of nuclear loss in cell death?
a. Karyopyknosis, Karyiorrhexis, Karyiolysis
b. Kartolysis, Kariorrhexis, Karyopyknosis
c. Kariopyknosis: Kariolysis, Kariorrhexis
d. Kariolysis, Kariopyknosis, Kariorrhexis
13. A 4-year-old boy falls on a rusty nail and punctures his skin. The wound is cleaned
and covered with sterile gauze. Which of the following is the initial event in the
healing process?
a. Accumulation of acute inflammatory cells
b. Deposition of proteoglycans and collagen
c. Formation of a fibrin clot
d. Macrophage-mediated phagocytosis of cellular debris
15. Which of the following cell types belong to stable cell population? nolan x soju
a. Neurons
b. Cardiac cells
c. Surface epithelial cells
d. Hepatocytes
16. Which of the following mediators most likely contributes to giant cell formation?
a. Interferon y
b. Histamine
c. IL-I
d. None of the above
18. An S7-year-oId male develops worsening heart failure. Workup reveals decreased
left ventricular filling due to decreased compliance of the left ventricle. Two
months later the patient dies: and postmortem sections reveal deposits of
eosinophilic, Congo red—positive material in the interstitium of his heart. When
viewed under polarized light, this material displays an apple-green birefringence.
1%at is the correct diagnosis? a. Amyloidosis
b. Glycogenosis
c. Hemochromatosis
d. Sarcoidosis
22. Dysplasia
a. Is a feature of mesenchymal cells.
b. Inevitably progresses to cancer.
c. Is characterised by cellular pleomorphism.
d. Is not associated with tissue architectural abnormalities.
e. Is the same as carcinoma in situ.
24. Which of the following best reflects the order of events in acute inflammation?
a. Adhesion: Chemotaxis, Transmigration: Phagocytosis
b. Margination, Chemotaxis, Phagocytosis: Adhesion
c. Rolling, Chemotaxis, Transmigration, Phagocytosis
d. Rolling, Adhesion, Chemotaxis, phagocytosis
26. Which of the following is a good example of type Ill hypersensitivity reaction? nolan x soju
a. Tuberculosis
b. Serum sickness
c. Asthma
d. None of the above
29. Which of the following cell types differentiates into morphologically distinct cells
capable of immunoglobulin production? a. Neutrophils
b. Basophils
c. B cells
d. T cells
e. Plasma cells
32. A histopathologist reports fat necrosis after examning a slide. Fat necrosis might
be found in which one of the following situations? a. Brain injury
b. Muscle injury
c. Trauma to the breast
d. Trauma to the bowel
33. A woman who is allergic to cats visits a neighbour who has several cats. During the
visit, she inhales cat dander, and within minutes: she develops nasal congestion
with abundant nasal secretions. 1%ich of the following substances is most likely to
produce these findings? a. Histamine
b. Substance P
c. IL-12
d. All of the above
36. Fluid that collects during acute inflammation and that has a protein content
exceeding 3 g/dl and a specific gravity exceeding 1.015 is referred a. Edema
b. An effusion
c. Answer is C or D
nolan x soju
37. Which of the following terms refer to a malignant tumor of the cartilage?
a. Chondroma
b. Fibrosarcoma
c. Chondrosarcoma
d. Osteosarcoma
e. Osteoma
f. Adenocarcinoma
38. Activation of which of the following cytoplasmic enzymes is most likely seen in
apoptosis?
a. Caspases
b. Ribonucleases
c. Telomerases
d. None of the above
39. Which feature in a tumor suggests that it is likely to be a benign neoplasm?
a. Circumscription
b. Lack of nuclear pleomorphism
c. Low mitotic count
d. All of the above
40. Klinefelter's syndrome does not include which of the following conditions?
a. Mental retardation
b. Hypogonadism
c. Infertility
d. Gynecomastia
e. Absence of germ cells
41. Human immunodeficiency virus (HIV) has a special affinity for infecting which type
of cell?
a. A-CD8+ T cell
b. CD4+ T cell
c. Natural killer cell
d. Dendritic cell
47. A 35-year-old woman had a firm nodule palpable on the dome of the uterus six
years ago on routine examination. Then discovered. She is asymptomatic. The
uterine nodule most likely represents a(an): a. Adenocarcinoma
b. Rhabdomyoma
c. Hamartoma
d. Leiomyoma
a.
d. Systemic lupus erythematosus
50. In apoptosis
It involves physiologic and pathologic stimuli
b. Selectins
c. Integrins
d. Immunoglobulins
56. In primary wound healing:
a. Macrophage infiltration occurs at 12hrs
b. Wound strength is 50% of normal at the end of first 2 days
c. Type I collagen is replaced by type Ill collagen
d. None of the above
58. Ten minutes after being stung by a wasp: a 30-year-old male develops multiple
patches of red, irregular skin lesions over his entire body. These lesions (urticaria)
are pruritic: and new crops of lesions occur every day. This response is primarily
the result of liberation of specific vasoactive substances by the action of: a.
Activated T lymphocytes on smooth muscle cells
b. IgA on basophils and mast cells nolan x soju
c. IgA on lymphocytes and eosinophils
d. lgE on basophils and mast cells
59. Each classic term describing acute inflammation is correctly matched with its cause
EXCEPT
a. Rubor — vasodilatation
b. Dolor — inflammatory cells infiltrating blood vessels
c. Color — increased blood flow
d. Tumor — exudation of fluid and cells into extravascular tissues
a.
60. Regarding fatty change, which statement is TRUE:
a. It may result from protein malnutrition
b. It may result from anoxia
c. It may result from systemic sclerosis
d. Fatty deposits are seen in all hepatocytes in alcoholic fatty liver
61. The endogenous pigment (s) NOT derived from hemoglobin is (are) Hemosiderin
b. Lipofuscin
62. Which of the following pigments will accumulate as the result of peroxidation of
cell membranes?
a. Bilirubin
b. Lipochrome
c. Melanin
d. Hemomelanin
e. hemosiderin
a.
a. Increased intravascular hydrostatic pressure
b. Decreased intravascular oncotic pressure
c. Lymphatic Obstruction
d. Inflammation
a.
b. Vitamin A excess
c. Barrett's oesophagitis
68. The inability to distinguish between self-cells and non-self-cells may lead to:
a. Autoimmune diseases
b. Cancer
c. Immunodeficiency syndromes
d. Dysplasia
70. What is the most common site of origin of thrombotic pulmonary emboli?
a. Deep leg veins
b. Lumen of left ventricle
c. Lumen of right ventricle
d. Mesenteric veins nolan x soju
72. . Metastasis
a. Unequivocally proves malignancy.
b. Is proven by lymph node enlargement adjacent to a tumor.
c. Of breast cancer is usually to supraclavicular nodes.
d. Is the most common presentation of melanoma
e. all of the above
73. Severe generalized edema is called:
a. Neoplasia
b. Anasarca
c. Pitting edema
d. Myxoedema
76. . Which of the following terms refer to a malignant tumor of a smooth muscle?
a. Leiomyoma
b. Leiomyosarcoma
c. Adenoma
d. Rhabdomyosarcoma nolan x soju
78. Which of the following terms refer to a benign tumor of a skeletal muscle?
a. Rhabdomyoma
b. Rhabdomyosarcoma
c. Fibroma
d. Fibrosarcoma
79. The first vascular response to Injury is
a. slowing of the circulation
b. Arteriolar vasoconstriction.
c. capillary engorgement
d. recruitment of vascular beds-
e. venular dilation.
81. In the inflammatory response to this infection, which of the following cells removes
the bacteria by phagocytosis? a. Macrophages
b. Mast cells
c. Endothelial cells
d. T regulatory cells
82. All clinical features listed below are usual for Turner's Syndrome: EXCEPT
a. Primary amenorrhea
b. Infertility
c. Most over 6 feet tall
d. Webbing of neck
e. Cubitus valgus
nolan x soju
88. Which of the following is a characteristic feature of benign tumors? nolan x soju
a. Mostly they are undifferentiated
b. They can invade the tissues around
c. They usually resemble the tissue of origin
d. All of the above
93. The term that describes the adherence of neutrophils and monocytes to the
vascular endothelium prior to movement into the extravascular space is a.
Margination
b. Diapedesis
c. Pavementing
d. Emigration
e. Clotting
94. Which of the following viral infections is associated with cervical cancer
development? a. EBV nolan x soju
b. CMV
c. HPV
d. 1--1N
97. Which of the following terms refer to a malignant tumor of a mesenchymal origin?
a. Sarcoma
b. Teratoma
c. Carcinoma
d. Adenoma
99. Hyperplasia
a. Occurs after partial hepatectomy
b. Refers to an increase in the size of the cells
c. Is always pathological
d. Often occurs in cardiac and skeletal muscle
e. Usually progresses to cancerous proliferation
2. A 25-year-old woman breastfed her first baby for almost 1 year with no difficulties and no
complications. Which of the following cellular that occurred in the breast during pregnancy
allowed her to nurse the infant for this period of time?
- Ductal epithelial metaplasia
- Epithelial dysplasia
- Lobular hyperplasia
- Stromal hypertrophy
3. Which of the following substances accumulate in cells during aging and chronic disease?
- Glycogen
- Lipofuscin
- Melanin
- None of the above
7. Metastatic calcification
- Is encountered in areas of necrosis
- Can occur with normal serum level of calcium
- Can be associated with metaplasia
- Is commonly associated with hyperparathyroidism
11. What is the most common site of origin of thrombotic pulmonary emboli?
- Deep leg veins
- Lumen of left ventricle
- Lumen of right ventricle
- Mesenteric veins
14. A 64-year-old male present with symptoms of anemia. On workup you discover that the
patient has been losing blood from the GI tract secondary to a tumor mass in his colon. The
pathology report from a biopsy specimen indicates that this mass is an invasive
adenocarcinoma. Which one of the listed descriptions best describes he most likely
histologic appearance of this tumor?
- A uniform proliferation of fibrous tissue
- A disorganized mass of proliferating fibroblast and blood vessels
- A disorganized mass of smooth muscle
- A disorganized mass of cells forming glandular structures
17. Which one of the listed statements best describes the process called chemotaxis?
- Abnormal fusion of phagosomes to primary lysosomes
- Attachment of chemicals to extracellular material to increase phagocytosis
- Dilation of blood vessels
- Movement of cells toward a certain site or source
18. Which of the following terms refer to a malignant tumor of a mesenchymal origin?
- Sarcoma
- Teratoma
- Carcinoma
- Adenoma
nolan x soju
2. What type of antibody is most abundant in the serum and function as an opsonin?
- IgG
- IgM
- IgD
- IgE
3. Which of the following pigments will accumulate as the result of peroxidation of cell
membranes?
- Bilirubin
- Lipochrome
- Melanin
- Hemomelanin
- Hemosiderin
4. Ten minutes after being stung by a wasp, a 30-year-old male develops multiple patches of
red, irregular skin lesion over his entire body. These lesions are pruritic and new crops nolan x soju
of lesions occur every day. This response is primarily the result of liberation of specific
vasoactive substances by the action of
- Activated T lymphocytes on smooth muscle cells
- IgA on basophils and mast cells
- IgA on lymphocytes and eosinophils
- IgE on basophils and mast cells
5. Metastasis refers to
- Carcinoma in situ
- The spread of cancer cells around the body
- Well-differentiated cells
- An aspect of benign tumors
6. Activation of which of the following cytoplasmic enzymes is most likely seen in apoptosis?
- Caspases
- Ribonucleases
- Telomerases
- None of the above
7. Severe cell injury due to ischemia is characterized by
- Increased cellular capacity for oxidative phosphorylation
- A loss of intracellular calcium
- Shrinkage of mitochondria - Decreased intracellular pH
- Decreased intracellular lactate
11. Dysplasia
- Is a feature of mesenchymal cells
- Inevitably progresses to cancer
- Is characterized by cellular pleomorphism
- Is not associated with tissue architectural abnormalities
- Is the same as carcinoma in situ
-
-
-
15. The inability to distinguish between self-cells and non-self-cells may lead to
- Autoimmune diseases
- Cancer
- Immunodeficiency syndromes
- Dysplasia
-
-
-
20. Which of the following auto-antibodies are diagnostic for Systemic Lupus Erythematosus
(SLE)?
- Antibodies to double-stranded DNA
- Antibodies to tissue transglutaminase
- Antibodies to ribonucleoproteins
- Antibodies to TSH receptor
21. In an experiment bacteria are introduced into a preferred tissue preparation. Leukocytes
leave the vasculature and migrate to the site of bacterial inoculation. The movement of
these leukocytes is most likely to be mediated by which of the following substance?
- IL-12
- Prostaglandins
- Chemokines
- Histamine
22. Which of the following mediators are involved in the phase of vascular changes during acute
inflammation?
- IL-12 nolan x soju
- Histamine
- Substance P
- Thombin
25. In the inflammatory response to this infection, which of the following cells removes the
bacteria by phagocytosis?
Macrophages
Mast cells
Endothelial cells
- T regulatory cells
26. The cellular accumulation in case of fatty change disorder of liver, may result from all of the
following factors EXCEPT
- Increased transport of precursor substance to cell
- Overproduction of accumulated material by cell
- Decreased mobilization of accumulated material by cells
- Decreased utilization of accumulated material by cells
- Irreversible damage to mitochondria
27. A 25-year-old machinist is injured by a metal silver in his left hand. Over the next few days
the wounded area becomes reddened, tender, swollen, and feels warm to the touch.
Redness at the site of injury in this patient is caused by which of the following mechanism?
- Hemorrhage
- Neutrophil margination
- Vasoconstriction
- Vasodilation
29. Which of the following cell types belong to liable cell population?
-
-
-
- Cardiac cells
- Surface epithelial cells
- Neurons
- None of the above
-
-
Caspase activation
- Karyorrhexis
- Chromatin condensation - None of the above
39. Which of the following enzymes degrade basement membranes of vessels during
metastasis?
- Granzymes
- Telomerases
- Collagenases
- All of the above
Antibodies to ribonucleoproteins
- Antibodies to TSH receptor
7. Following coronary artery occlusion, the earliest morphologic finding that closely correspond
to severe loss of membrane integrity and irreversible cell injury is.
- Swelling and vacuolization of mitochondria and the appearance of large mitochondrial
densities
- Cell swelling
- Depletion of cellular glycogen stores (as demonstrated by PAS stain)
- Blebs on cell membranes
- Clumping and condensation of nuclear chromatin
10. Which of the following terms refers to a malignant tumor of the cartilage?
- Chondroma
- Fibrosarcoma
- Chondrosarcoma
- Osteosarcoma
- Osteomia
- Adenocarcinoma
- Hemangioma
- Melanoma
14. The term that describes the adherence of neutrophils and monocytes to the vascular
endothelium prior to movement into the extravascular space is
- Margination
- Diapedesis
- Pavementing
- Clotting
16. All of the following abnormalities may be seen in Marfan’s syndrome EXCEPT
- Ectopia lentis
- Dissecting aneurysm of the aorta
- Mitral valve prolapse
- Sclerodactyly
-
- Aortic valvular insufficiency
13. Which of the following cell types are most closely associated with chronic inflammatory
processes?
- Neutrophils
- Plasma cells
- Eosinophils
- All of the above
14. Fluid that collects during acute inflammation and that has a protein content exceeding 3
g/dl and a specific gravity exceeding 1.015 id referred
- Edema
- An effusion
- A transudate
- Serum
- An exudate
15. All of the following abnormalities may be seen in Marfan’s syndrome EXCEPT
- Ectopia lentis
- Dissecting aneurysm of the aorta
- Mitral valve prolapse
- Sclerodactyly
- Aortic valvular insufficiency
nolan x soju
16. Hyperplasia
- Occurs after partial hepatectomy
- Refers to an increase in the size of the cells
- Is always pathological
- Often occurs in cardiac and skeletal muscle
- Usually progresses to cancerous proliferation
17. Which one of the listed changes correctly describes the pathophysiology involved in the
production of pulmonary edema in patient with congestive heart failure?
- Decreased plasma oncotic pressure
- Endothelial damage
- Increased hydrostatic pressure
- Lymphatic obstruction
21. Each classic term describing acute inflammation is correctly matched with its cause EXCEPT
- Rubor – vasodilation
- Dolor – inflammatory cells infiltrating blood vessels
- Color – increased blood flow
- Tumor – exudation of fluid and cells into extravascular tissue
23. A woman who is allergic to cats visits a neighbour who has several cats. During the visit,
she inhales cat dander, and within minutes, she develops nasal congestion with abundant
nasal secretions. Which of the following substances is most likely to produce these findings?
- Histamine
- Substance P
- IL-12
- All of the above
24. Which of the following chemical mediators act in chemotaxis during acute inflammation? -
Nitric oxide
- IL – 12
- Serotonin
- None of the above
25. Which of the following mediators most likely contributes to giant cell formation?
- Interferon ỿ
- Histamine
38. A 36-year-old female presents with increased trouble swallowing. Physical examination
finds hypertension and sclerodactyly. A skin biopsy reveals dermal fibrosis with an absence
of adnexal structures, while laboratory examination finds an autoantibody against DNA
topossomerase (anti-cl-70). What is the best diagnosis for this individual?
- Systemic sclerosis
- Mixed connective tissue disorder
- Sjogren’s syndrome
- Systemic lupus erythematosus
39. Which of the following terms refer to a benign tumor of a skeletal muscle?
- Rhabdomyoma
- Rhabdomyosarcoma
- Fibroma
- Fibrosarcoma
nolan x soju
41. In reversible cell injury all are true except
- ATP depletion is responsible for acute cellular swelling
- Can cause myocardial cells to cease contraction within 60 seconds
- ATP is generated anaerobically from creatine phosphate
- Mitochondrial swelling and degranulation of ER are hallmarks of irreversible cells injury
- Is associated with myelin figures
42. Which of the following pigments will accumulate as the result of peroxidation of cell
membranes?
- Bilirubin
- Lipochrome
- Melanin
- Hemomelanin
- Hemosiderin
45. Initial rolling interactions in acute inflammation is mediated by which of the following?
- Interleukins
- Selectins - Integrins
- Immunoglobulins
46. Which of the following mediators most likely contributes to giant cell formation?
- Interferon ỿ
- Histamine
- IL – 1
- None of the above
50. Infarction
- The nuclei of malignant cells show
- Variability in size
- Variability to shape
- Hyperchromasia
- All of the above
54. All of the following vascular changes are observed in acute inflammation, except
- Vasodilation
- Stasis of blood
- Increased vascular permeability
- Decreased hydrostatic pressure
55. Which of the following chemical mediators act in chemotaxis during acute inflammation? -
Nitric oxide
- IL 12
- Serotonin
- None of the above
56. Which of the following terms refer to a malignant tumor of a smooth muscle?
- Lesomyoma
- Lesomyosarcoma
- Adenoma
- Rhabdomyosarcoma
64. The cellular accumulation in case of fatty change disorder of liver, may result from all of th
following factors EXCEPT
- Increased transport of precursor substances to cell
- Overproduction of accumulated material
- Decreased mobilization of accumulated material by cells
- Decreased utilization of accumulated material by cells
- Irreversible damage to mitochondria
65. All of the following phrases concerning Down’s syndrome are correct EXCEPT
- Most common chromosomal disorder
- Absence of Barr bodies in female patients
- Mental retardation
- Increased incidence of congenital heart disease and other congenital abnormalities
- Nondisjunction most frequent cause
66. A 4-year-old boy falls on a rusty nail and punctures his skin. The wound is cleaned and
covered with sterile gauze. Which of the following is the initial event in the healing process?
- Accumulation of acute inflammatory cells nolan x soju
- Deposition of proteoglycans and collagen
- Formation of a fibrin clot
- Macrophage-mediated phagocytosis of cellular debris
67. Which of the following terms refer to a malignant tumor of testicular epithelium?
- Seminoma
- Mesothelioma
- Hemangioma
- Lymphoma
2. A 35-year-old woman takes acetylsalicylic acid (aspirin) for arthritis. Although her joint pain
is reduced with this therapy, the inflammatory process continues. The aspirin therapy
alleviates her pain mainly through reduction in the synthesis of which of the following
mediators?
a. Complement C1q
b. Histamine
c. Leukotriene E4
d. Nitric oxide
e. Prostaglandins
3. A 19-year-old woman develops a sore throat and fever during the past day. Physical
examination shows pharyngeal erythema and swelling. Laboratory findings include nolan x soju
leukocytosis. She is given naproxen. Which of the following features of the acute
inflammatory response is most affected by this drug? a. Chemotaxis
b. Emigration
c. Leukocytosis
d. Phagocytosis
e. Vasodilation
4. In an experiment, neutrophils collected from peripheral blood are analyzed for a “burst” of
oxygen consumption. This respiratory burst is an essential step for which of the following
events in an acute inflammatory response? a. Attachment to endothelial cells
b. Generation of microbicidal activity
c. Increased production in bone marrow
d. Opsonization of bacteria Phagocytosis of bacteria
5. A 6-year-old child has a history of recurrent infections with pyogenic bacteria, including
Staphylococcus aureus and Streptococcus pneumoniae. The infections are accompanied by
a neutrophilic leukocytosis. Microscopic examination of a biopsy specimen obtained from
an area of soft tissue necrosis shows microbial organisms, but very few neutrophils. An
analysis of neutrophil function shows a defect in rolling. This child’s increased susceptibility
to infection is most likely caused by a defect involving which of the following molecules?
a. Complement C3b
b. Integrins
c. Leukotriene B4
d. NADPH oxidase
e. Selectins
6. A 36-year-old woman with pneumococcal pneumonia develops a right pleural effusion. The
pleural fluid displays a high specific gravity and contains large numbers of
polymorphonuclear (PMN) leukocytes. Which of the following best characterizes this pleural
effusion?
a. Fibrinous exudate
b. Lymphedema
c. Purulent exudate
d. Serosanguinous exudate
e. Transudate
7. A 68-year-old coal miner with a history of smoking and emphysema develops severe
airflow obstruction and expires. Autopsy reveals a “black lung,” with coal-dust nodules nolan x soju
scattered throughout the parenchyma and a central area of dense fibrosis. The coal
dust entrapped within this miner’s lung was sequestered primarily by which of the
following cells?
a. Endothelial cells
b. Fibroblasts
c. Lymphocytes
d. Macrophages
e. Plasma cells
8. A 25-year-old machinist is injured by a metal sliver in his left hand. Over the next few days,
the wounded area becomes reddened, tender, swollen, and feels warm to the touch.
Redness at the site of injury in this patient is caused primarily by which of the following
mechanisms? a. Hemorrhage
b. Hemostasis
c. Neutrophil margination
d. Vasoconstriction
e. Vasodilation
10. In an experiment, T lymphocytes from peripheral blood are placed in a medium that
preserves their function. The lymphocytes are activated by contact with antigen and
incubated for 4 hours. The supernatant fluid is collected and is found to contain a
substance that is a major stimulator of monocytes and macrophages. Which of the
following substances released into this fluid medium is most likely to stimulate
macrophages? a. Histamine
b. Interferon- γ
c. Leukotriene B4
d. Nitric Oxide
e. Phospholipase C
f. Tumor Necrosis Factor (TNF)
11. A 69-year-old woman has had transient ischemic attacks for the past 3 months. On physical
examination, she has an audible bruit on auscultation of the neck. A right carotid
nolan x soju
endarterectomy is performed. The curetted atheromatous plaque has a grossly yellow-tan,
firm appearance. Microscopically, which of the following materials can be found in
abundance in the form of crystals within cleftlike spaces? a. Cholesterol
b. Glycogen
c. Hemosiderin
d. Immunoglobulin
e. Lipofuscin
13. A 47-year-old man has a lung carcinoma with metastases. He receives chemotherapy. A
month later, histologic examination of a metastatic lesion shows many foci in which
individual tumor cells appear shrunken and deeply eosinophilic. Their nuclei exhibit
condensed aggregates of chromatin under the nuclear membrane. The pathologic process
affecting these shrunken tumor cells is most likely triggered by release of which of the
following substances into the cytosol? a. BCL2
b. Catalase
c. Cytochrome c
d. Lipofuscin
e. Phospholipase
14. A study of aging shows that senescent cells have accumulated damage from toxic
byproducts of metabolism. There is increased intracellular lipofuscin deposition. Prolonged
ingestion of which of the following substances is most likely to counteract this aging
mechanism? a. Antioxidants
b. Analgesics
c. Antimicrobials
d. Antineoplastic agents
e. Glucocorticoids
15. A 16-year-old boy sustained blunt trauma to his abdomen when he struck a bridge
nolan x soju
abutment at high speed while driving a motor vehicle. Peritoneal lavage shows a
hemoperitoneum, and at laparotomy, a small portion of the left lobe of the injured liver is
removed. Two months later, a CT scan of the abdomen shows that the liver has nearly
regained its size before the injury. Which of the following processes best explains this CT
scan finding? a. Apoptosis
b. Dysplasia
c. Hyperplasia
d. Hydropic change
e. Steatosis
17. In an experiment, metabolically active cells are subjected to radiant energy in the form of
xrays. This results in cell injury caused by hydrolysis of water. Which of the following
intracellular enzymes helps to protect the cells from this type of injury?
a. Endonuclease
b. Glutathione peroxidase
c. Lactate dehydrogenase
d. Phospholipase Protease
18. A 72-year-old man died suddenly from congestive heart failure. At autopsy, his heart
weighed 580 g (normal 330 g) and showed marked left ventricular hypertrophy and
minimal coronary arterial atherosclerosis. A serum chemistry panel ordered before death
showed no abnormalities. Which of the following pathologic processes best accounts for
the changes of the aortic valve? a. Amyloidosis
b. Dystrophic calcification
c. Hemosiderosis
d. Hyaline change
e. Lipofuscin deposition
nolan x soju
1. A 30-year-old firefighter suffers extensive third-degree burns over his arms and hands.
This patient is at high-risk for developing which of the following complications of wound
healing?
a. Contracture
b. Dehiscence
c. Incisional hernia Keloid
d. Traumatic neuroma
2. A 29-year-old man with acute appendicitis undergoes surgical removal of the inflamed
appendix. The incision site is sutured. A trichrome-stained section representative of the
site with blue appearing collagen. How long after the surgery would this appearance most
likely be seen?
a. 1 day
b. 2 to 3 days
c. 4 to 5 days
d. 2 weeks 1 month
3. In an experiment, bacteria are inoculated into aliquots of normal human blood that have
been treated with an anticoagulant. It is observed that the bacteria are either
phagocytized by neutrophils or undergo lysis. Which of the following blood plasma
components is most likely to facilitate these effects?
a. Complement nolan x soju
b. Fibrin
c. Kallikrein
d. Plasmin
e. Thrombin
4. A 43-year-old man with a ventricular septal defect has had a cough and fever for the past
2 days. On examination, he has a temperature of 37.6° C and a cardiac murmur. A blood
culture grows Streptococcus, viridans group. His erythrocyte sedimentation rate (ESR) is
increased. Microbial cells are opsonized and cleared. Which of the following chemical
mediators is most important in producing these findings? a. Bradykinin
b. C-reactive protein
c. Interferon-γ
d. Nitric oxide Prostaglandin
e. Tumor necrosis factor (TNF)
5. A 28-year-old woman sustains a deep, open laceration over her right forearm in a
motorcycle accident. The wound is cleaned and sutured. Which of the following cell types
mediates contraction of the wound to facilitate healing? a. Endothelial cells
b. Fibroblasts
c. Macrophages
d. Myofibroblasts
e. Smooth muscle cells
7. A 7-year-old boy falls on a rusty nail and punctures his skin. The wound is cleaned and
covered with sterile gauze. Which of the following is the initial event in the healing
process?
a. Accumulation of acute inflammatory cells
b. Deposition of proteoglycans and collagen
c. Differentiation and migration of myofibroblasts
d. Formation of a fibrin clot
e. Macrophage-mediated phagocytosis of cellular debris nolan x soju
8. A woman who is allergic to cats visits a neighbor who has several cats. During the visit, she
inhales cat dander, and within minutes, she develops nasal congestion with abundant
nasal secretions. Which of the following substances is most likely to produce these
findings?
a. Bradykinin
b. Complement C5a
c. Histamine
d. Interleukin-1 (IL-1)
e. Phospholipase C
f. Tumor necrosis factor (TNF)
9. A 22-year-old woman nursing her newborn develops a tender erythematous area around
the nipple of her left breast. A thick, yellow fluid is observed to drain from an open fissure.
Examination of this breast fluid under the light microscope will most likely reveal an
abundance of which of the following inflammatory cells? a. Blymphocytes
b. Eosinophil
c. Mast cells
d. Neutrophils
e. Plasma cells
10. A 50-year-old man had chest pain persisting for 4 hours. A radiographic imaging procedure
showed an infarction involving a 4-cm area of the posterior left ventricular free wall.
Laboratory findings showed serum creatine kinase of 600 U/L. Which of the following
pathologic findings would most likely be seen in the left ventricular lesion 1 month later?
a. Chronic inflammation
b. Coagulative necrosis
c. Complete regeneration
d. Fibrous scar
e. Nodular regeneration
11. A 9-year-old boy receives a deep laceration over his right eyebrow playing ice hockey. The
wound is cleaned and sutured. Which of the following describes the principal function of
macrophages that are present in the wound 24 to 48 hours after the injury? a. Antibody
production
b. Deposition of collagen
c. Histamine release
d. Phagocytosis
e. Wound contraction
12. A 59-year-old woman tests positive for hepatitis A antibody. Her serum AST level is 275
nolan x soju
U/L, and ALT is 310 U/L. One month later, these enzyme levels have returned to normal.
Which phase of the cell cycle best describes the hepatocytes 1 month after her infection?
a. G0
b. G1
c. S
d. G2
e. M
13. A 29-year-old carpenter receives a traumatic laceration to her left arm. Which of the
following is the most important factor that determines whether this wound will heal by
primary or secondary intention? a. Apposition of edges
b. Depth of wound
c. Metabolic status
d. Skin site affected
e. Vascular supply
14. An 8-year-old girl with asthma presents with respiratory distress. She has a history of
allergies and upper respiratory tract infections. She also has history of wheezes associated
with exercise. Which of the following mediators of inflammation is the most powerful
stimulator of bronchoconstriction and vasoconstriction in this patient? a. Bradykinin
b. Complement proteins
c. Interleukin-1
d. Leukotrienes
e. Tumor necrosis factor-α
15. A 19-year-old woman develops a sore throat and fever during the past day. Physical
examination shows pharyngeal erythema and swelling. Laboratory findings include
leukocytosis. She is given naproxen. Which of the following features of the acute
inflammatory response is most affected by this drug? a. Chemotaxis
b. Emigration
c. Leukocytosis
d. Phagocytosis
e. Vasodilation
16. Which of the following preformed substances is released from mast cells and platelets,
resulting in increased vascular permeability in the lungs of the patient described in
previous question? a. Bradykinin
b. Hageman factor
c. Histamine nolan x soju
d. Leukotrienes (SRS-A)
e. Thromboxane A2
17. Patients with extensive endothelial injury from Escherichia coli sepsis have consumption of
coagulation factors as well as an extensive inflammatory response. Administration of
activated protein C is most likely to decrease this inflammatory response by reducing the
amount of which of the following substances? a. Complement
b. Fibrin
c. Kallikrein
d. Plasmin
e. Thrombin
19. One month after an appendectomy, a 25-year-old woman palpates a small nodule beneath
the skin at the site of the healed right lower quadrant sutured incision. The nodule is
excised, and microscopic examination shows macrophages, collagen deposition, small
lymphocytes, and multinucleated giant cells. Polarizable, refractile material is seen in the
nodule. Which of the following complications of the surgery best accounts for these
findings?
a. Abscess formation
b. Chronic inflammation
c. Exuberant granulation tissue
d. Granuloma formation
e. Healing by second intention
20. A 45-year-old woman with autoimmune hemolytic anemia presents with increasing
fatigue. Which of the following mediators of inflammation is primarily responsible for
antibody-mediated hemolysis in this patient? a. Arachidonic acid metabolites
b. Coagulation proteins
c. Complement proteins nolan x soju
d. Kallikrein and kinins
e. Lysophospholipids
21. A 9-year-old boy has had a chronic cough and fever for the past month. A chest radiograph
shows enlargement of hilar lymph nodes and bilateral pulmonary nodular interstitial
infiltrates. A sputum sample contains acid- fast bacilli. A transbronchial biopsy specimen
shows granulomatous inflammation with epithelioid macrophages and Langhans giant
cells.Which of the following mediators is most likely to contribute to giant cell formation?
a. Complement C3b
b. Interferon-γ
c. Interleukin-1 (IL-1)
d. Leukotriene B4
22. Tum A 36-year-old woman with pneumococcal pneumonia develops a right pleural
effusion. The pleural fluid displays a high specific gravity and contains large numbers of
polymorphonuclear (PMN) leukocytes. Which of the following best characterizes this
pleural effusion?
a. Fibrinous exudate
b. Lymphedema
c. Purulent exudate
d. Serosanguineous exudate
e. Transudate
23. A 35-year-old woman takes acetylsalicylic acid (aspirin) for arthritis. Although her joint pain
is reduced with this therapy, the inflammatory process continues. The aspirin therapy
alleviates her pain mainly through reduction in the synthesis of which of the following
mediators?
a. Complement C1q
b. Histamine
c. Leukotriene E4
d. Nitric oxide
e. Prostaglandins
24. A 54-year-old man undergoes laparoscopic hernia repair. In spite of the small size of the
incisions, he has poor wound healing. Further history reveals that his usual diet has poor
nutritional value and is deficient in vitamin C. Synthesis of which of the following
extracellular matrix components is most affected by this deficiency? a. Collagen
b. Elastin
c. Fibronectin
d. Integrin
e. Laminin
nolan x soju
25. A 41-year-old man has had a severe headache for the past 2 days. On examination, his
temperature is 39.2° C. A lumbar puncture is performed, and the cerebrospinal fluid
obtained has a WBC count of 910/mm3 with 94% neutrophils and 6% lymphocytes. Which
of the following substances is the most likely mediator for the fever observed in this man?
a. Bradykinin
b. Histamine
c. Leukotriene B4
d. Nitric oxide
e. Tumor necrosis factor (TNF)
e. Anti–SS-A
5. A 2-year-old boy is found to have bilateral retinal tumors. Molecular studies demonstrate
a germline mutation in one allele of the Rb gene. Which of the following genetic events
best explains the mechanism of carcinogenesis in this patient? a. Balanced translocation
b. Expansion of trinucleotide repeat
c. Gene amplification
d. Loss of heterozygosity
e. Maternal nondisjunction
7. Persons with sensitivity to body jewelry undergo skin patch testing with nickel nolan x soju
compounds. Within 24 to 48 hours there is focal erythema and induration of their skin,
accompanied by itching and pain. Histologically, there is an accumuation of neutrophils
and monocytes with some CD4 T cells. Which of the following cytokines produced by T
cells is most likely to be involved in mediating this reaction? a. IL-2
b. IL-5
c. IL-10
d. IL-12
e. IL-17
Which of the following types of necrosis is grossly opaque and chalky white
Fat necrosis
Which of the following types of necrosis is most commonly associated with ischemic injury:
Coagulative necrosis
3-5) For each example of necrosis listed on the left select the most suitable description from those
on the right.
Caseous necrosis – Cheese-like material
Coagulative necrosis – Dull, swollen firm area
Colliquative necrosis – Soft, liquefying material
A 28-year-old woman is pinned by falling debris during a hurricane. An x-ray film of the leg reveals
a compound fracture of the right tibia. The leg is immobilized in a cast for 6 weeks. When the cast
is removed, the patient notices that her right leg is weak and visibly smaller in circumference than
the left leg. Which of the following terms best describes this change in the patient's leg muscle?
Atrophy
A 60-year-old man is rushed to the hospital with acute liver failure. He undergoes successful
orthotopic liver transplantation; however, the transplanted liver does not produce much
bile for the first 3 days. Poor graft function in this patient is thought to be the result of
“reperfusion injury.” Which of the following substances was the most likely cause of reperfusion
injury in this patient’s transplanted liver?
Reactive oxygen species
Which one of the following ultrastructural features is believed to allow for the increases
permeability of the vascular endothelium in acutely inflamed tissue? Gaps in
endothelial tight junctions
Which one of the following is not an endogenous mediator of increased vascular permeability?
Prostaglandin E2
A 28-year-old man with a history of radiation/bone marrow transplantation for leukemia presents
with severe diarrhea.
He subsequently develops septic shock and expires. Microscopic examination of the colon
epithelium at autopsy reveals numerous acidophilic bodies and small cells with pyknotic
Nuclei. Which of the following proteins most likely played a key role in triggering
radiationinduced cell death in this patient’s colonic mucosa?
P53
While in a home improvement center warehouse buying paint, a 35- year-old man hears "Look
out below!" and is then struck on the leg by a falling pallet rack, which strikes him on his left leg in
the region of his thigh. The skin is not broken. Within 2 days there is a 5 x 7 cm purple color to the
site of injury. Which of the following substances has most likely accumulated at the site of injury
to produce a yellow-brown color 16 days after the injury?
Hemosiderin
13-15) For each of the cell type listed on the left choose the most appropriate association from
those on the right
nolan x soju
A 59-year-old woman had the loss of consciousness that persisted for over an hour. When she
becomes arousable, she cannot speak nor move her right arm or leg. A cerebral angiogram
revealed an occlusion to her left middle cerebral artery. Months later, a computed
tomographic (CT) scan shows a large 5 cm cystic area in her left parietal lobe cortex. This CT
finding is most likely the consequence of resolution from which of the following cellular
events? Liquefactive necrosis
The growth factor elaborated by macrophages, which recruits macrophages and fibroblasts to
wound site and induces all steps in angiogenesis is:
Fibroblast growth factor
Hyperplasia primarily operative in which of the following growth alterations Galactorrhea
in a c4 a prolactinoma
If the following events were places in their most probable order of occurrence following a
skin wound which would come first? Blood clot formation
Which of the following disorders is an example of metaplasia?
Squamous epithelium in the mainstem bronchus of a smoker
A diabetic patient has an ulcer on their great toe, which statement is false regarding its healing.
Large amounts of granulation tissue grow in from the periphery of the wound
Which of the following pigments will accumulate as the result of peroxidation of cell membranes
Lipochrome
nolan x soju
If the following features were put in chronological order which would come fourth?
Production of mature plasma cells
An infiltrate of which one of the following cells is most characteristic of the early stages of acute
inflammation?
Neutrophils
Which one of the following is not an organ specific auto-immune disease? Rheumatoid
arthritis
A 45-year-old man has had a fever and dry cough for 3 days, and now has difficulty breathing and
a cough productive of sputum. On physical examination his temperature is 38.5 C. diffuse rales
are auscultated over lower lung fields. A chest radiograph shows a right pleural effusion. A right
thoracentesis is performed. The fluid obtained has a cloudy appearance with cell count showing
5500 leukocytes per microliter, 98% of which are neutrophils. Which of the following terms best
describes his pleural process
Purulent inflammation
A 55-year-old woman has had discomfort and swelling of the left leg for the past week. On
physical examination, the leg is slightly difficult to move, but on palpation, there is no pain. A
venogram shows thrombosis of deep leg veins. Which of the following mechanisms is most likely
to cause this condition?
Immobilization
A 39 years old male developed a testicular mass which was removed and sent for pathological
examination, along with the additional studies. Which of the following is the most compelling
evidence that the lesion is malignant
Cells of the mass infiltrate a narrow band of tunica albuginea
Which of the following pair does not correctly match the tumor with its causative agent
Hepatocellular carcinoma – Hepatitis A virus nolan x soju
38-40) from the list on the right select the most appropriate definition for each of the terms on
the left.
For which of the following tumours is there a definite generic basis in a proportion of cases?
Colonic carcinoma
If eosinophils and mast cells are identified in a tissue biopsy from an inflammatory process, which
type of immune reaction is most likely occurring
Type 1
A 62-year-old woman has a 3-month history of weight loss, abdominal pain radiating to the back
and jaundice. The causal lesion show
Neoplasia
nolan x soju
The gross and microscopic characteristics used to differentiate benign from malignant neoplasms
have been proved by testing them for correlation with
Behavior of neoplasms in human subjects
Review of a series of surgical pathology reports indicated that a certain neoplasm is grades as
grade 1 on a scale of 1 to 4. Clinically, some of the patients with this neoplasm are found to be
stage 1. Which of the following is the best interpretation of a neoplasm with stage 1 designation?
Is well-differentiated and localized
A 35-year-old woman had a firm nodule palpable on the dome of the uterus six years ago
recorded on routine physical examination. The nodule has slowly increased in size and now
appears to be about twice the size it was when first discovered. By ultrasound scan it is solid and
circumscribed. She remains asymptomatic. Which of the following neoplasms is she most likely to
have?
Leiomyoma
A 45-year-old healthy woman has a routine check of her health status. She has no chest pain,
cough, or fever. A chest x-ray taken and shows a peripheral 2.5 cm diameter "coin lesion" in the
right mid-lung field. Which of the following biologic characteristics best distinguishes this lesion as
a neoplasm, rather than a granuloma
Uncontrolled ( autonomous ) growth
Alcohol keratin is composed of
Pre keratin
A young man of 20, got a lacerated wound on his left arm, stitched-1 week later sutures were
remained-healing continued but the site became disfigured by prominent raised irregular nodular
scar, in next 2 months which of the following best describes the process :
Keloid formation
Chemotaxis is mediated by
Leukotriene B4 & C5a
Which leukotriene is adhesion factor for the neutrophil on the cell surface to attach to
endothelium
B4
A clinical study is performed of patients with pharyngeal infections. The most typical clinical
course averages 3 days from the time of onset until the patient sees the physician. Most of these
patients experience fever and chills. On physical examination, the most common findings include
swelling, erythema, and pharyngeal purulent exudate. Which of the following types of
inflammation did these patients most likely have?
Acute inflammation
A 22-year-old man develops marked right lower quadrant abdominal pain over the past
day. On physical examination there is rebound tenderness on palpation over the right lower
quadrant. Laparoscopic surgery is performed, and the appendix is swollen, erythematous, and
partly covered by a yellowish exudate. It is removed, and a microscopic section shows infiltration
with numerous neutrophils. The pain experienced by this patient is predominantly the result of
which of the following two chemical mediators?
Prostaglandin and bradykinin
In von Hippel-Lindau disease, the multiple vascular lesions involving several organs are known as
Cavernous hemangiomas
Each type of necrosis is correctly paired with its most likely site of involvement EXCEPT
Liquefaction- spleen or lung
All of the following abnormal clinical manifestations are correctly paired with the appropriate
compound or pigment deposited EXCEPT
Atrophy of hepatic and myocardial cells – lipofuscin
Which of the following types of necrosis is most often caused by sudden ischemia from vascular
occlusion Caseous necrosis
Each classic term describing acute inflammation is correctly matched with its cause EXCEPT
Dolor – inflammatory cells infiltrating blood vessels
Deposits of amyloid in whole organs can be diagnosed by histological staining with Congo
red
nolan x soju
Klinefelter’s syndrome does not include which of the following conditions? Mental
retardation
The endogenous pigment (s) NOT derived from hemoglobin is (are) Lipofuscin
A 40-year-old woman had bilateral silicone breast implants placed two years ago. Since that time,
she has noted increased firmness with slight deformity of the breast on the left. The implants are
removed, and there is evidence for leakage of the implant contents on the left. Which of the
following cell types is most likely to be most characteristic of the inflammatory response in this
situation?
Giant cell
Human immunodeficiency virus (HIV) has a special affinity for infecting which type of cell? CD4+
T cell
A 14-year-old healthy girl has a 0.3 cm reddish, slightly raised nodule on the skin of the upper part
of her chest found on a routine physical examination. She states that this lesion has been present
for years and has not appreciably changed in size or color. Which of the following neoplasms is
this nodule most likely to be?
Hemangioma
If a person has documented anemia but is asymptomatic, the physician can eliminate all of the
following causes EXCEPT
Mismatched blood unit
Which of the following findings provides for a definitive diagnosis of hemolytic anemia?
Red blood cell destruction
A deficiency of the red cell membrane component spectrin causes which of the following
conditions?
Hereditary spherocytosis nolan x soju
Which of the following coagulation factors is reduced or absent in classic hemophilia (hemophilia
A)?
VIII
All of the following statements regarding acute myocardial infarction are true EXCEPT
Histologic evidence is seen first at about 24 hours post infarction
Glomus tumors (glomangiomas) originate in structures that are responsible for which of
the following functions? Temperature regulation
“Cor bovinum” is a latin term that describes the appearance of a heart affected by which of the
1. A 62-year-old man is brought to the emergency room in a disoriented
state. Physical examination reveals jaundice, splenomegaly, and ascites.
Serum level is ALT, AST, alkali phosphatase and bilirubin are all elevated. A
liver biopsy demonstrates alcoholic hepatitis with mallory bodies. These
cytoplasmic structures are composed of interwoven bunnies of which of
the following proteins?
ANS: hypertrophy
ANS: phospholipids
ANS: atrophy
6. A 40 year ld man is pulled from the ocean after a boating accident and
resuscitationed. Six hours later the patient develops acute renal failure.
Kidney biopsy reveals evidence of karyorrhexis and karyolysis in renal
tubular epithelial cells. Which of the following biochemical event
preceded these pathologic changes?
8. A 53 year old man has experienced severe chest pain for the past 6 hours.
On physical examination he is afebrile but has tachycardia. laboratory
studies show a serum troponin 1 of 10 ng/mL. A coronary angiogram is
performed emergently and reveals >90% occlusion of the left anterior
descending artery. In this setting, an irreversible injury to the myocardial
fibres will have occurred when which of the following cellular changes
occurs?
ANS: metaplasia
ANS: Gangrene
ANS: atrophy
ANS: mitcchondria
ANS: nucleus breaks up into smaller fragments scattered around the cytoplasm
ANS: liver
ANS: metaplasia
nolan x soju
23. Increases demand, increased trophic stimulation
31. A 40 year old woman had bilateral silicone breast implants placedtwo
year ago. Since tat time she has noted increase firmness with slight
nolan x soju
deformity of the breast on the left. The implats are removed and there is
evidence for leakage of the implant contents not he left. Which of the
following cell types is most likely to be most characteristic of the
inflammatory response in this situation?
32. Fluid that collects during acute inflammation and that has a
proteincontent exceeding 3 g/dl and a specific gravity exceeding 1.015 is
referred
ANS: an exudate
33. Once damaged a tissue or organ usually attempts to regenerateitself. All
of the following cell type are capable of regenerating tissues except
41. A 2 year old boy healthy for the first six months of life. He then develops
recurrent infections. Serum concentration of complement, phagocytic function
and bactericidal function of neutrophils are normal.
A skin test with candida antigens shows 2 cm of induration at 48 hours. Which
of the following would most likely be abnormal?
ANS: platelets
ANS: tuberculosis
14. Mast cells and blood basophils release Ans. Histamine, serotonin,
anaphilaron
17. ……
18. Which phase of inflammation is started with the reaction of
microcirculation
Ans. Phase of alteration
21. During the acute inflammation within the first 6-24 hours are accumulated
preferably
Ans. Neutrophils
22. The adhesion molecules of endothelial cells are
Ans. ELAM-1, ICAM-1
31. The surface adhesion molecule named E-selectin (also known as ELAM-1)
is located on
Ans. Endothelial cells
33. All the chemical mediators listed increase vascular permeability except
Ans. IL-1
35. All chemical reactants listed are oxygen dependent for bactericidal action
except
Ans. Lactoferina
38. Which of the following are needed for granuloma formation Ans. Cell
mediated immunity to the inciting agent
40. Human immunodeficiency virus (HIV) has a special affinity for infecting
which type of cell? nolan x soju
86. .…………
98. The antibody found in the sera of patients with systemic lupus
erythematosus include all following except
nolan x soju
Ans. Anti-basal membrane
99. When the components of the complement system interact, they do all
following except
Ans. Suppression of T cell activities
2. A 62-year-old man is brought to the emergency room in a disoriented state. Physical examination
reveals jaundice splenomegaly, and ascites. Serum levels of ALT, AST, alkaline phosphatase, and bilirubin
are all elevated. A liv demonstrates alcoholic hepatitis with Mallory bodies. These cytoplasmic structures
are composed of Interwoven bundles of which of the following proteins?
(A) as Antitrypsin
(e) a synuclein
nolan x soju
3. A 32-year-old woman with poorly controlled diabetes mellitus delivers a healthy boy at 38 weeks
of gestation. A of maternal hyperglycemia during pregnancy, pancreatic islets in the neonate would
be expected to show which following morphologic responses to injury?
(A) Atrophy
(B) Dysplasia
(C) Hyperplasia
(D) Metaplasia
(E) Necrosis
4. A 20-year-old man from China is evaluated for persistent cough, night sweats, low-grade fever, and
general A chest X-ray reveals findings "consistent with a Ghon complex.’’ Sputum cultures grow
acidfast bacilli, Exa of hilac lymph nodes In this patient would most likely demonstrate which of the
following pathologic changes?
20. A 43-year-old man has complained of mild burning substernal pain following meals for the past 3
years. Upper GI endoscopy is performed and biopsies are taken of an erythematous area of the lower
esophageal mucosa 3 cm above the gastroesophageal junction. There is no mass lesion, no ulceration,
and no hemorrhage noted. The biopsies show the presence of columnar epithelium with goblet cells.
Which of the following mucosal alterations is most likely represented by these findings?
(A) Dysplasia
(B) Hyperplasia
(C) Carcinoma
(D) Ischemia
(E) Metaplasia
21. A 59-year-old woman had the loss of consciousness that persisted for over an hour. When she nolan x soju
becomes arousable, she cannot speak nor move her right arm or leg. A cerebral angiogram revealed an
occlusion to her left middle cerebral artery. Months later, a computed tomographic (CT) scan shows a
large 5 cm cystic area in her left parietal lobe cortex. This CT finding is most likely the consequence of
resolution from which of the following cellular events?
(B) Atrophy
(E) Apoptosis
22. An 80-year-old man dies from complications of Alzheimer disease. At autopsy, his heart is small
(250 gm) and dark brown on sectioning. Microscopically, there is light brown perinuclear pigment with
H&E staining of the cardiac muscle fibers. Which of the following substances is most likely increased in
the myocardial fibers to produce this appearance of his heart?
30. Malnutrition, Aging and ischaemia are most commonly associated with which of the following
(A) Hypertrophy
(B) Atrophy
31. Which of the following morphological changes is NOT associated with coagulative necrosis?
A) Karyorrhexis
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(B) Abscess
(C) Pyknosis
(D) Karyolysis
(A) Lysosomes
(B) Nucleus
(C) Mitochondria
Cell shrinkage/atrophy
(A) Colliquative
(B) Gangrenous
(C) Caseous
(D) Coagulative
(A) Excess fluid is taken into the cell, resulting in a turgid appearance
(D) Nucleus breaks up into smaller fragments scattered around the cytoplasm
(B) Gangrenous
(C) Fat
(D) Colliquative
(E) complete removal of excess hormone triggers will slow progression but not reverse hyperplastic
changes
42. Chemically Induced cell Injury from carbon tetrachloride (CC4) and acetaminophen (Tylenol) affect
which organ?
nolan x soju
(A) Brain
(B) Kidneys
(C) Pancreas
43. Which of the following pigments will accumulate as the result of peroxidation of cell membranes?
(A) bilirubin
(B) lipochrome
(C) melanin
(D) hemomelanin
(E) hemosiderin
1. All of the following vascular changes are observed in acute inflammation, except: (A) Vasodilation
(B) Stasis of blood.
(C) Increased vascular permeability.
(D) Decreased hydrostatic pressure.Answer is D
2. Grandma falls down the steps leading to the entrance of the house of a relative hosting a family reunion,
who is heard to remark, "I've been meaning to get that loose step fixed." Grandma is hospitalized for
surgery to replace the broken hip she sustains and is then moved to a nursing home, but she is unable to
ambulate until about a month later, when she dies suddenly. Which of the following is most likely to be the
immediate cause of death found at autopsy?
(A) Squamous cell carcinoma of lung
(B) Tuberculosis
(C) Pulmonary embolism
(D) Pneumonia with pneumococcus
(E) Congestive heart failure (C) CORRECT.
Answer is A
4. Each of the following is a characteristic of the plaques seen in multiple sclerosis EXCEPT (A) early
nolan x soju
complete' loss of axons
(B) gliosis
(Q loss of oligodendroglia
(D) mononuclear inflammatory infiltrate
(E) preferential paraventricular distributionAnswer is A
5. During the first two months of life, the microorganism most frequently responsible for meningitis is
(A) Escherichia coli
(B) Hemophilus influenzae
(C) Neisseria meningitidis
(D) Staphylococcus
aureus
(E) Streptococcus pneumonia
Answer is A
6. A study of pathologic findings in the islets of Langerhans is performed. It is observed that insulitis may occur in the islets. The
inflammatory infiltrate is predominantly composed of T lymphocytes. Which of the following is most likely to occur as a consequence of
insulitis? (A) Neoplasia
(B) Malabsorption
(C) Ketoacidosis
(D) Obesity
(E) Sepsis
C is correct
7. A 20-year-old man incurs blunt trauma to his upper outer arm. On physical examination, there is a 2 x 3 cm contusion. The initial soft
tissue bleeding stops in a few minutes and the size of the bruise does not increase. Which of the following chemical mediators is most
important in this episode of hemostasis?
1
(A) Leukotriene
(B) Prostaglandin
(C) Prostacyclin
(D) Plasminogen
(E) Thromboxane
(E) CORRECT.
8. A subdural hematoma is most likely to be associated with a traumatic tear of the (A)
bridging cerebral veins
(B) middle cerebral artery
(C) middle meningeal artery
(D) superficial temporal artery
(E) superior longitudinal sinus
Answer is A
Answer is D
10. A 68-year-old woman has survived multiple episodes of pulmonary thromboembolism during the past three months. Which of the
following is the most likely underlying condition leading to this patient's recurrent pulmonary thromboembolism? (A) Micronodular
cirrhosis of the liver
(B) Adenocarcinoma of the pancreas
(C) Thrombocytopenia
(D) Familial hypercholesterolemia nolan x soju
(E) Mitral valve endocarditis(F) Type II diabetes mellitus (B) CORRECT.
11. A 44-year-old African-American man has had elevated blood pressure for years which has not been treated. He now has severe
headaches. On physical examination his blood pressure is 275/150 mm Hg. Laboratory studies show Hgb 13.8 g/dL, serum glucose 76
mg/dL, and creatinine 3.5 mg/dL. These findings are most likely to be associated with which of the following pathologic lesions involving
his kidneys?
(A) Hyperplastic arteriolosclerosis
(B) Hyaline arteriolosclerosis
(C) Monckeberg medial calcific sclerosis
(D) Atherosclerosis
(E) Thrombophlebitis
(A) CORRECT.
13. A study is performed involving persons who have a history of diabetes mellitus type 1 or type 2. These patients are found to have
cellular injury that results from glycosylation end products and from sorbitol accumulation within cells. The same patients are also
shown to have ischemic tissue damage from accelerated and advanced atherosclerosis. Which of the following complications is most
likely to result from atherosclerosis in these patients?
2
(A) Chronic renal failure
(B) Impotence
(C) Stroke
(D) Cataracts
(E) Retinopathy
C is CORRECT.
14. A 45-year-old woman who has been bedridden for several weeks has the onset of left sided chest pain along with dyspnea. She has
some tenderness in her left leg, which has a slightly greater circumference in the thigh than the right. A ventilation/perfusion scan shows
evidence for a left lower lobe perfusion defect. Which of the following vascular diseases is most likely to cause these findings: (A) Hyaline
arteriolosclerosis
(B) Monckeberg's medial calcific sclerosis
(C) Complex calcified coronary atherosclerosis
(D) Arterial mural thrombosis(E) Phlebothrombosis
E is CORRECT.
15. Some cells demonstrate glucose uptake regardless of the plasma insulin level. In a person who has had persistent hyperglycemia for
years, cellular injury can occur. Which of the following cell types is most likely to show injury from hyperglycemia: (A) Cardiac muscle
cells
(B) Fibroblasts
(C) Steatocytes
(D) Neurons
(E) Smooth muscle cells.
(D) CORRECT.
16. During hospitalization, a 40-year-old woman develops thrombophlebitis. She recovers and is discharged. She returns to her job as an
electrician. A couple of months later, which of the following terms would best describe the process seen in a femoral vein after recovery
from her thrombophlebitis:
(A) Acute inflammation
(B) Rupture
(C) Organization
(D) Embolization(E) Propagation
C is CORRECT.
17. The most common cause of viral pneumonia in infants under 6 months is
(A) ECHO virus
(B) influenza virus, group A
(C) rhinovirus
(D) respiratory syncytial virus
(E) coronavirus nolan x soju
Answer is D
18. Fatty change with “tigroid” appearance in the myocardium is characteristic of (A) Alcoholic cardiac
injury
(B) Diabetes mellitus
(C) Chronic anemia
(D) Hyperthyroidism
(E) Obesity
The answer is C
19. A 32-year-old Rh-negative woman was delivered of her third child. She had not sought medical care during pregnancy. Upon
admission,, her saline agglutinin titer for Rh+ cells was 1:4, and indirect antiglobulin (Coombs) test titer was 1:32. The infant had a
hemoglobin of 10 g/dL and became severely jaundiced, as her second child had been. The greatest hazard for the infant is (A)
cardiac failure secondary to anemia
(B) hypoglycemia secondary to pancreatic islet hyperplasia
(C) jaundice associated with an increased concentration of conjugated (direct) bilirubin
(D) kernicterus associated with an increased concentration of unconjugated (indirect) bilirubin(E) renal failure secondary to
hemolysis
Answer is D
3
(B) Tumor stage
(C) Lymphocytic infiltration
(D) Vascular invasion
(E) The mitotic index
The answer is B
21. A 52-year-old man has an ulcerated area on the sole of his foot that has not healed for 2 months. He is 180 cm tall, weighs 126 kg, and
has continued to gain weight gradually. He has not had any major illnesses. His blood pressure is normal. Which of the following
laboratory tests performed on serum from a blood sample would be most useful in elucidating the underlying cause for his problem: (A)
Antithrombin III
(B) Cortisol
(C) Creatine kinase
(D) Glucose
(E) Carcinoembryonic antigen
D is CORRECT.
24. Which of the following pigments will accumulate as the result of peroxidation of cell membranes?
(A) Bilirubin
(B) Lipochrome
(C) Melanin
(D) Hemozoin
(E) Hemosiderin
Answer is B
25. Cellular regeneration and restoration of normal morphology is possible in each of the following conditions EXCEPT (A)
diphtheritic myocarditis
(B) damage to proximal convoluted renal tubules by mercuric salts nolan x soju
(C) acute erosion of gastric mucosa
(D) viral hepatitis A
(E) squamous metaplasia of the bronchial epithelium
Answer is A
26. A 57-year-old man has had blood pressure measurements in the range of 160/95 to 180/110 mm Hg for many years. He has
taken no medications. A renal scan reveals kidneys of normal size for age. These findings with benign nephrosclerosis are most likely to
occur with which of the following vascular changes:
(A) Hyaline arteriolosclerosis
(B) Monckeberg's medial calcific sclerosis
(C) Complex calcified atherosclerosis
(D) Arterial mural thrombosis
(E) Hyperplastic arteriolosclerosis
A is CORRECT.
27. A deficiency of the red cell membrane component spectrin causes which of the following conditions?
(A) Pernicious anemia
(B) Hereditary spherocytosis
(C) Sickle cell anemia
(D) Thalassemia major
(E) Blackfan-Diamond syndrome
4
The answer is B
28. The pathogenesis of granulomatous reactions includes each of the following EXCEPT
(A) activated macrophages
(B) antibodies
(C) bacterial lipids
(D) insoluble materials
(E) T lymphocyte
Answer is B
29. Development of tensile strength in a healing wound parallels the
(A) appearance of mucopolysaccharides
(B) ingrowth of fibroblasts
(C) appearance of reticulin fibers
(D) appearance of collagen
(E) contraction of the scar
Answer is D
30. The gross and microscopic characteristics used to differentiate benign from malignant neoplasms have been proved by testing them
for correlation with
(A) electron microscopic features of the neoplasms
(B) chemical analyses of neoplasms for DNA content
(C) analyses of chromosome number and configuration
(D) growth of neoplastic cells in tissue culture
(E) behavior of neoplasms in human subjectsAnswer is E
31. In which of the following conditions bilateral contracted kidneys are characteristically seen?
(A). Amyloidosis.
(B). Diabetes mellitus.
(C) . Rapidly progressive (crescentic) glomerulonephritis.
(D). Benign nephrosclerosis.
Answer is D
32. Which one of the following diseases characteristically causes fatty change in liver?
(A) Hepatitis B virus infection.
(B). Wilson’s disease.
(C). Chronic alcoholism.
(D) Hepatitis C virus infection.
Answer is C
Answer is A
35. Factors that contribute to the pathogenesis of amyloidosis include each of the following
EXCEPT(A) chronic infection
(B) deficiency of amylase
(C) inherited susceptibility
(D) malignant plasma cells
(E) rheumatoid arthritisAnswer is B
5
36. Which of the following is most likely to be found in hypogammaglobulinemia (Bruton disease)?
(A) A familial history of similar diseases in females
(B) Thymic agenesis
(C) Infections with Hemophilus influenzae
(D) Inflammatory bowel disease
(E) Leukopenia
Answer is C
37. A 58-year-old man is hospitalized for evaluation of recent intermittent upper abdominal pain. History and physical examination
reveal a 15-lb weight loss over recent months and upper abdominal tenderness without evidence of a mass or ascites. The best diagnostic
approach and most likely preliminary diagnosis would be
(A) Oral cholecystography for the diagnosis of chronic cholecystitis with cholelithiasis
(B) Serum bilirubin measurement for the diagnosis of chronic cholecystitis with cholelithiasis
(C) Endoscopy for the diagnosis of carcinoma of the ampulla of Vater
(D) Celiotomy for the diagnosis of carcinoma of the head of the pancreas
(E) Computed tomography for the diagnosis of carcinoma of the body of the pancreas
The answer is E
40. What is the name given to the hyaline masses often seen in the cytoplasm of hepatocytes in patients with alcoholic hepatitis?
(A) Councilman bodies
(B) Negri bodies
(C) Mallory’s bodies
(D)Michaelis-Gutmann bodies
(E) Rotor’s bodies
The answer is C
41. A 52-year-old recent immigrant from Vietnam complains of abdominal swelling, weight loss, and
upper abdominal pain of 3 weeks in duration. His past medical history includes malaria and infection nolan x soju
with the liver fl uke Clonorchis sinensis. The liver is hard to palpation. An abdominal CT scan shows a
hypoattenuated mass with lobulated margins in the liver. A biopsy discloses well-differentiated
neoplastic glands embedded in a dense fi brous stroma. Which of the following is the most likely
diagnosis?
(A) Carcinoma of the gallbladder
(B) Cholangiocarcinoma
(C) Hemangiosarcoma
(D) Hepatocellular carcinoma
(E) Metastatic colon adenocarcinoma
Answer is B
42. An adolescent presents with lassitude, jaundice, fever, hypersplenism, and Kayser-Fleischer rings. Which of the
following disorders is most likely?
(A) Alpha1- antitrypsin deficiency
(B) Wilson’s disease
(C) Hepatitis B infection
(D) Gilbert’s syndrome
(E) Idiopathic hemochromatosis
6
The answer is B
44. All of the following clinical features are likely to be found in a patient with nephrotic syndrome
EXCEPT(A) Proteinuria
(B) Hypoalbuminemia
(C) Red cell casts
(D) Hyperlipidemia
(E) Edema
The answer is C
45. An increased frequency of acute leukemia is most characteristic in patients with(A) cystic
fibrosis
(B) Down syndrome
(C) Klinefelter syndrome
(D) Tay-Sachs disease
(E) Turner syndromeAnswer is B
47. All of the following statements regarding postinfectious glomerulonephritis are true EXCEPT
(A) The disease follows infection with group A -hemolytic streptococci
(B) Large subepithelial immune-type deposits are seen by electron microscopy
(C) The histologic picture is that of diffuse proliferative glomerulonephritis
(D) The clinical picture is characteristic of acute nephritis
(E) Most affected children progress to chronic renal failure
The answer is E
48. A 58-year-old woman is brought to the emergency department4 hours after vomiting blood and
experiencing bloody stools. The patient was diagnosed with alcoholic cirrhosis 2 years ago.
Endoscopy reveals large esophageal varices, one of which is actively bleeding. Which of the nolan x soju
following best explains the pathogenesis of dilated esophageal veins in this patient?
(A) Decreased intravascular oncotic pressure
(B) Increased capillary permeability
(C) Increased intravascular hydrostatic pressure
(D) Vasoconstriction of arterioles
(E) Vasodilatation of capillaries
The answer is C
49. A kidney biopsy specimen that shows subendothelial granular electron-dense deposits is characteristic of which of
the following disease states?
(A) Rapidly progressive glomerulonephritis
(B) Poststreptococcal glomerulonephritis
(C) Membranous glomerulonephritis
(D) Systemic lupus erythematosus
(E) Goodpasture’s syndrome
The answer is D
7
50. Cor pulmonale is a result of
(A) a healed myocardial infarct
(B) aortic stenosis
(C) emphysema
(D) rheumatic fever
(E) systemic hypertensionAnswer is C
51. In an adult patient, which of the following diseases would most frequently be associated with a smaller than normal spleen? (A)
Myelofibrosis
(B) Sickle cell anemia
(C) Infectious mononucleosis
(D) Chronic myelocytic leukemia
(E) Thalassemia major
Answer is B
52. A clinical study is performed of patients with pharyngeal infections. The most typical clinical course averages 3 days from the time of
onset until the patient sees the physician. Most of these patients experienced fever and chills. On physical examination, the most
common finding is a pharyngeal purulent exudate. Which of the following types of inflammation did these patients most likely have?
(A) Granulomatous inflammation
(B) Acute inflammation
(C) Abscess formation
(D) Resolution of inflammation
(E) Chronic inflammation
The answer is B
53. A 45-year-old man has had a fever and dry cough for 3 days, and now has difficulty breathing and a cough productive of sputum. On
physical examination his temperature is 38.5 C. Diffuse rales are auscultated over lower lung fields. A chest radiograph shows a right
pleural effusion. A right thoracentesis is performed. The fluid obtained has a cloudy appearance with a cell count showing 5500
leukocytes per microliter, 98% of which are neutrophils. Which of the following terms best describes his pleural process? (A) Serous
inflammation
(B) Purulent inflammation
(C) Fibrinous inflammation
(D) Chronic inflammation
(E) Granulomatous inflammation
The answer is B
55. A 40-year-old woman had bilateral silicone breast implants placed two years ago. Since that time, she has noted increased firmness
with slight deformity of the breast on the left. The implants are removed, and there is evidence for leakage of the implant contents on
the left. Which of the following cell types is most likely to be most characteristic of the inflammatory response in nolanthis x soju
situation? (A) mast cell
(B) Eosinophil(C) Neutrophil
(D) Plasma cell
(E) Giant cell
The answer is E
Answer is C
57. Pulmonary infarcts are characterized by each of the following EXCEPT
(A) subpleural location
8
(B) increased frequency in patients with heart failure
(C) pale color
(D) wedge shape
(E) becoming abscesses when infected
Answer is C
58. Surgical therapy is LEAST likely to cure
(A) bronchogenic adenocarcinoma
(B) carcinoid
(C) hamartoma
(D) small-cell (oat-cell) carcinoma
(E) squamous cell carcinoma
9
14
Pathology Exam
Test option - 20124
Directions: Each question below contains five suggested answers. Choose the one best response to each question.
1. A clinical study is performed of patients with pharyngeal infections. The most typical clinical course averages 3 days
from the time of onset until the patient sees the physician. Most of these patients experienced fever and chills. On
physical examination, the most common finding is a pharyngeal purulent exudate. Which of the following types of
inflammation did these patients most likely have?
A. Granulomatous inflammation
B. Abscess formation
C. Resolution of inflammation
D. Acute inflammation
E. Chronic inflammation
The answer is D
The answer is A
The answer is B
a. A 22-year-old man develops marked right lower quadrant abdominal pain over the past day. On physical examination
there is rebound tenderness on palpation over the right lower quadrant. Laparoscopic surgery is performed, and the
appendix is swollen, erythematous, and partly covered by a yellowish exudate. It is removed, and a microscopic
section shows infiltration with numerous neutrophils. The pain experienced by this patient is predominantly the result
of the formation of which of the following two chemical mediators?
A. Complement C3b and lgG
B. Interleukin-1 and tumor necrosis factor
C. Prostaglandin and bradykinin
D. Histamine and serotonin
E. Leukotriene and HPETE
The answer is C
14
30
DIRECTIONS: Each of the numbered items or incomplete statements in this section is followed by answers or by completions of
the statement.
Select the ONE lettered answer or completion that is BEST in each case and fill in the circle c the corresponding letter on the
answer sheet.
1. Which of the following substances is most important in killing bacteria within phagosomes of neutrophils?
(A) Complement
(B) Lactic acid
(C) Opsonin
(D) Oxygen metabolites
(E) Prostaglandins
Answer is D
Answer is C
Answer is A
4. A 48-year-old woman has a malignant lymphoma involving lymph nodes in the para-aortic region. She is treated with a chemotherapeutic agent
nolan
which results in the loss of individual neoplastic cells through fragmentation of individual cell nuclei and cytoplasm. Over the next 2 months, the x soju
lymphoma decreases in size, as documented on abdominal CT scans. By which of the following mechanisms has her neoplasm primarily responded to
therapy?
(A) Coagulative necrosis
(B) Mitochondrial poisoning
(C) Phagocytosis
(D) Acute inflammation
(E) Apoptosis
(E) CORRECT
30
35
Answer is A
Answer is B
35. A 66-year-old woman has the sudden loss of movement on part of the left side of her body. She has smoked a pack of cigarettes
a day for the past 45 years. She has vital signs including T 37.1 C, P 80/minute, RR 16/minute, and BP 160/100 mm Hg. A cerebral
angiogram reveals occlusion of a branch of her middle cerebral artery. Laboratory findings include a hemoglobin A1C of 9%. Which
of the following components of blood lipids is most important in contributing to her disease? (A) Chylomicrons
(B) Lipoprotein lipase
(C) Oxidized LDL
(D) VLDL
(E) HDL cholesterol
(C) CORRECT.
37. An autopsy study reveals that evidence for atheroma formation can begin even in children. The gross appearances of the aortas
are recorded and compared with microscopic findings of atheroma formation. Which of the following is most likely to be the first
visible gross evidence for the formation of an atheroma?
(A) Thrombus
(B) Fatty streak
(C) Calcification
(D) Hemorrhage
(E) Exudate
(F) Ulceration
(B) CORRECT.
38. Among the following, transitional cell carcinoma of the urinary bladder most often is associated with
(A) metastases to bone
(B) metastases to the kidneys
(C) metastases to the lungs
(D) metastases to the central nervous system
(E) local extension to surrounding tissuesAnswer is E
39. Disease or infarction of neurological tissue causes it to be replaced by: (A). Fluid
(B). Neuroglia
(C). Proliferation of adjacent nerve cells
(D). Blood vessel
Answer is B
35
36
Answer is D
Answer is B
42. In von Hippel-Lindau disease, the multiple vascular lesions involving several organs are known as
(A) Necrotizing arteriolitis
(B) Giant cell arteritis
( C) Thromboangitis obliterans
(D) Cavernous hemangiomas
(E) Teleangiectases
The answer is D
43. Flat small vegetations in the cusps of both tricuspid and mitral valves are seen in:
(A). Viral myocarditis
(B). Libmann Sachs endocarditis
(C). Rheumatic carditis
(D). Infective endocarditis nolan x soju
The answer is D
44. A 50-year-old malnourished alcoholic with severe dental caries complains of malaise and right chest
pain of about 2 weeks’ duration. He is febrile and has a cough productive of foul, purulent sputum. A roentgenogram
of the chest shows a fluid-filled cavity, 2 cm in diameter, in the upper lobe of the right lung. The lesion is most likely
(A) an abscess
(B) pulmonary infarct
(C) tuberculosis
(D) bronchiectasis
(E) squamous cell carcinoma
Answer is A
45. A 63-year-old man has had increasing exercise intolerance for the past 5 years so that he now becomes short of breath upon
climbing a single flight of stairs. Laboratory studies have shown fasting blood glucose measurements from 145 to 210 mg/dL for the
past 25 years, but he has not sought medical treatment. If he dies suddenly, which of the following is most likely to be the immediate
cause of death?
(A) Myocardial infarction
(B) Nodular glomerulosclerosis
(C) Cerebral hemorrhage
(D) Hyperosmolar coma
(E) Right lower leg gangrene
(A) CORRECT.
46. Enzyme that protects the brain from free radical injury is:
(A). Myeloperoxidase
(B). Superoxide dismutase
(C). MAO
36
45
Pathology – Exam
Test Option 20123
Directions: Each question below contains five suggested answers. Choose the one best response to each question.
1. A 50-year-old woman with a history of unstable angina suffers an acute myocardial infarction. Thrombolytic
therapy with tissue plasminogen activator (tPA) is administered to restore coronary blood flow early in the course
of this myocardial infarction. In spite of this therapy, the degree of myocardial fiber injury may increase because
of which of the following cellular abnormalities?
A. Cytoskeletal intermediate filament loss
B. A decreased intracellular pH from anaerobic glycolysis
C. An increase in toxic oxygen radicals
D. Mitochondrial swelling
E. Nuclear chromatin clumping and decreased protein synthesisThe answer is C
2. Which of the following pigments will accumulate as the result of peroxidation of cell membranes?
A. bilirubin
B. lipochrome
C. melanin
D. hemomelanin
E. hemosiderinThe answer is B
nolan x soju
3. Severe cell injury due to ischemia is characterized by
A. increased cellular capacity for oxidative phosphorylation
B. a loss of intracellular calcium
C. shrinkage of mitochondria
D. decreased intracellular pH
E. decreased intracellular lactateThe answer is D
4. The earliest histological features of coagulative necrosis of cardiac muscle can be detected by light
microscopyA. 30-40- minutes following vascular occlusion
B. 6 hours following vascular occlusion
C. 12 hours following vascular occlusion
D. 24 hours following vascular occlusion
E. 36 hours following vascular occlusionThe answer is C
5. Following coronary artery occlusion, the earliest morphologic finding that closely corresponds to severe loss of
membrane integrity and irreversible cell injury is
A. swelling and vacuolization of mitochondria and the appearance of large mitochondrial densities
B. cell swelling
C. depletion of cellular glycogen stores (as demonstrated by PAS stain)
D. blebs on cell membranes
E. clumping and condensation of nuclear chromatin
45
7. An Amputated lower limb from a diabetic patient showing black
discoloration of the skin and soft tissues with areas of yellowish exudates is
characterized as: a) Neoplasia
b) Gangrenous Necrosis
c) Coagulopathy
d) Hemosiderosis
e) Gas gangrene
8. Focal fat necrosis, with flecks of chalky tan-white material seen in the
omentum is most often associated with the following: a) Gangrenous
appendicitis
b) Chronic salpingitis
c) Acute pancreatitis
d) Hepatitis
e) Acute gastritis
10. The presence of Columnar Epithelium with Goblet cells in the Lower
Oesophagus is most consistent with:
a) Dysplasia
nolan x soju
b) Hyperplasia
c) Carcinoma
d) Ischaemia
e) Metaplasia
13. Which of the following cellular changes is most likely to present irreversible
cellular injury:
a) Epithelial dysplasia
b) Cytoplasmic fatty metamorphosis
c) Nuclear pyknosis
d) Atrophy
e) Anaerobic Glycolysis
15. Which of the following is the most likely pathologic alteration following
occlusion of the left middle cerebral artery by a sterile thrombus: a)
Cerebral softening from liquefactive necrosis
b) Pale infarction with coagulative necrosis
c) Predominantly the loss of glial cells
d) Recovery of damaged neurons if the vascular supply is re-established
e) Wet gangrene with secondary bacterial infection
17. Which of the following type of necrosis is most commonly associated with
ischaemic injury:
a) Coagulation Necrosis
b) Liquefaction Necrosis
c) Caseous Necrosis
d) Fat Necrosis
e) Gangrenous Necrosis
28. Apoptosis:
a) Massive necrosis
b) Foreign body phagocytosis
c) Lipoprotein synthesis
d) Programmed cell death
e) Wet gangrene
40. Digestion of tissue with soap formation and calcification is characteristic of:
a) Coagulation Necrosis
b) Caseous Necrosis
c) Fibrinoid Necrosis
d) Liquefaction Necrosis
e) Enzymatic Fat Necrosis
41. All of the following findings represent changes seen within cells that
represent reversible cellular injury, except: a) Fatty change in
hepatocytes
b) Neuronal cell swelling
c) Skeletal muscle fiber anaerobic glycolysis
d) Renal tubular cell nuclear pyknosis
e) Kupffer cell iron deposition
42. Which is most likely to happen following a stroke with loss of blood supply
to a lobe of the brain:
a) Cerebral softening from liquefactive necrosis
b) Pale infarction with coagulative necrosis
c) Predominantly the loss of glial cells
d) Recover of damaged neurons if the vascular supply is restablished
e) Wet gangrene with secondary bacterial infection
44. Which of the following cellular changes represents the best evidence for
irreversible cellular injury:
a) Epithelial dysplasia
b) Cytoplasmic fatty metamorphosis
c) Nuclear pyknosis
d) Atrophy
e) Anaerobic glycolysis
45. The presence of differentiated columnar epithelium with goblet cells in lower
esophagus is consistent with:
a) Dysplasia
b) Hyperplasia
c) Carcinoma
d) Ischemia
e) Metaplasia
46. Which of the following will show hypertrophy:
a) The uterine myometrium in pregnancy
b) The female breast at puberty
c) The liver following partial resection
d) The ovary following menopause
e) The cervix with chronic inflammation
49. Which of the following tissues is most likely to be least affected by Ischemia:
a) Skeletal muscle
b) Small intestinal epithelium
c) Retina
d) Myocardium nolan x soju
e) Hippocampus
52. Which of the following types of necrosis is grossly opaque & "chalk" white:
a) Coagulation necrosis
b) Liquefaction
c) Caseous necrosis
d) Fat necrosis
e) Gangrenous necrosis
64. Two days after myocardial infarction, histology of the heart will show:
a) Fibroblasts and Collagen
b) Granulation Tissue
c) Necrotic Muscle & Neutrophils
d) Granulamatous Inflammation
e) Aneurysmal Dilation
78. Which of the following is most likely associated with Caseation Necrosis:
a) Diabetic Gangrene
b) Gas Gangrene
c) Myocardial Infarction
d) Inpissated Pus
e) Splenic Infarction
82. Squamous Metaplasia can occur in all of the following sites except: a)
Nose
b) Salivary Gland Ducts
c) Jejunum
d) Renal Pelvis
e) Gall Bladder
nolan x soju
83. Colliquative Necrosis occurs in:
a) Spleen
b) Liver
c) Heart
d) Brain
e) Kidneys
88. A common manifestation of sublethal cell injury seen in organs such as the
heart and liver is:
a) Glycogen accumulation
b) Fatty change
c) Calcium deposition
d) Apoptosis
e) Deposition of Amyloid
89. In the process of necrosis, a reduction in the size of the nucleus and a
condensation of nuclear material is known as:
a) Karyolysis
b) Pyknophrasia
c) Karyorrhexis
d) Pyknosis nolan x soju
e) Metachromasia
99. Multinucleated Giant Cells of the foreign body type origin from:
a) Nuclear Division of Granulocytes
b) Atypical Regeneration of Epithelium
c) Megakaryocytes
d) Fusion of Macrophages
e) Multiplication of Nuclei Surrounding Fibrocytes
100. Histamine is thought to be the direct cause of: a) Leukocytosis
b) Emigration
c) Phagocytosis
d) Increased Vascular Permeability
e) All of the Above
.
101 An Abscess is best defined as:
a) A local defect in the surface of a tissue
b) An abnormal accumulation between two surfaces
c) Any area of tissue necrosis
d) A localized collection of pus
e) An epithelium-lined sac filled with viscous fluid
108 Which of the following is the most efficient killer of bacteria in neutrophils:
a) Spontaneous dismutation of O2 to H2O
b) Conversion of H2O2 to HOCl by Myeloperoxiase
c) Oxidative metabolism giving rise to OH and O2
d) Hyrolyzing Bacterial Coated with Lysozyme
e) Action of Hydrolytic Enzymes
111. Fever and Leukocytes in which most leukocytes are neutrophils typical
of: a) Acute Bacterial Infection
b) Acute Viral Infection nolan x soju
c) Chronic Viral Infection
d) Parasitemia
e) Foreign Body Giant Cell Reaction
113. Prostaglandins are formed from Arachidonic Acid through the action
of which enzyme pathway? a) Cyclooxygenase
b) Lipoxygenase
c) Myeloperoxidase
d) Phospholipase A
e) Glutathione Reductase
119. The first inflammatory cell to show at the site of acute inflammation is the:
a) Monocyte
b) B-lymphocyte
c) T-lymphocyte
d) Neutrophils
e) Mast cell
120. The following are true about an exudate except: a) It can be present
as edema
b) It has a high protein content
c) It has a specific gravity ≥ 1.020
d) It may contain inflammatory cells
e) It can be due to congestive heart failure
124. Following an attack of chest infection for three days, a patient becomes very
ill and his chest x-rays shows a 3cm rounded density. He is most likely
having: a) Hypertrophic scar
b) Abscess formation
c) Regeneration
d) Bronchogenic carcinoma
e) Progression to chronic inflammation
125. Which of the following cells is the most important in the development of
tuberculous granuloma:
nolan x soju
a) Macrophages
b) Fibroblast
c) Neutrophil
d) Mast Cell
e) Platelet
126. Which of the following inflammatory processes would cause interstitial
fibrosis and nodules in the lungs of a person who inhaled silica dust:
a) Neutrophilic infiltration with release of leukotrienes
b) Foreign body giant cell formation
c) Plasma cell production of immunoglobin
d) Histamine release by mast cells
e) Release of growth factors by macrophages
127. Which of the following mediators are predominantly responsible for pain in
acute inflammation:
a) Complement C3b and IgG
b) Interleukin-1 and tumour necrosis factor
c) Histamine and Serotonin
d) Prostaglandin and Bradykinin
e) Leukotriene and E-selectin
128. Which of the following cell types is most likely to be most characteristic of a
foreign body reaction:
a) Mast cell
b) Eosinophil
c) Giant cell
d) Neutrophils
e) Plasma cell
133. Apoptosis does not induce inflammation because: a) The injury is too
mild to induce inflammation
b) Phagocytic cells secrete cytokines that inhibit inflammation
c) The process occurs only in avascular tissues
d) Apoptosis occurs only in immune deficient tissues
e) The patient is using antibiotics
134. Osponization is the:
a) Formation of free radicals
b) Degradation of bacteria by lysozymes
c) Engulfment of antigen by leukocytes
d) Coating of antigen by antibodies
e) Processing of antigens by antigen presenting cells
142. The high protein content of the inflammatory exudates is mainly due to:
a) Protein released from dead tissue
b) Production of protein by inflammatory cells
c) Increased capillary permeability
d) Increased capillary hydrostatic pressure
e) Increased blood flow in the site of inflammation
148. The following are true of macrophages except: a) They are phagocytic
cells
b) They produce interleukins
c) Are antigen-presenting cells
d) They are derived from blood monocytes
e) They are the main cells in chronic inflammation
149. Which of the following is true about an Exudate: a) Occurs in heart
failure
b) Is due to low plasma oncotic pressure
c) Has a low specific gravity
d) Has a high protein content
e) Is due to lymphatic obstruction
150. The most important factor in the formation of acute inflammatory exudates
is:
a) Increased Hydrostatic Pressure
b) Increased Blood Flow
nolan x soju
c) Chemotaxis
d) Increased Vascular Permeability
e) Lymphatic Obstruction
152. Infertility and short stature in a woman with a 45x karyotype are typical of:
a) Rlinefelter Syndrome
b) Turner Syndrome
c) Down Syndrome
d) Achondroplasia Dwarfism
e) Cystic Fibrosis
166. Repair of which of the following involves regeneration and connective tissue
repair:
a) Bone fracture
b) Renal tubular necrosis
c) Both A and B
d) Neither A nor B
170. Following a hypotensive shock which lasted for hours, which of the
following tissues is most likely to withstand the ischemia: a) Skeletal
muscle
b) Small Intestinal Epithelium
c) Retina
d) Myocardium
e) Hippocampus
173. The following are true about arterial thrombi except: a) Are usually
due to endothelial injury
b) Can be precipitated by atherosclerosis
c) Grow in the direction of blood flow
d) Lead to ischemia and infarction
e) Commonly cause systemic emboli
178. Which one of the following is not a cause of thrombosis: a) Damage nolan x soju
of endothelial lining
b) Aneurysms
c) Polycythenia
d) Dissiminated Carcinomatosis
e) High level of antithrombin III
182. The following are true of Thrombi except: a) Are formed from blood
consitituents
b) Always cause complete vascular occlusion and infarction
c) Are complicated by embolization
d) May undergo dystrophic calcification
187. A detached intravascular solid, liquid or gas carried to a site distant from its
point of origin is most associated with:
a) Ascites
b) Petechiae
c) Infarction
d) Emboli
e) Hematoma
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191. Which of the following is most significant in the diagnosis of early acute
myocardial infarction:
a) ESR
b) ASO titre
c) Troponin
d) LDH
e) Total CK
192. Which of the following is not a major risk factor for atherosclerosis:
a) Family history
b) Hyperlipidemia
c) Physical inactivity
d) Diabetes
e) Hypertension
193. Organs which are less susceptible than others to infarction because of a dual
blood supply include:
a) Liver and Lungs
b) Liver and Kidney
c) Lung and Spleen
d) Spleen and Kidney
e) Pancreas and Lung
194. Which cells are targeted by HIV:
a) CD4 + cells
b) Plasma cells
c) Macrophages
d) Both A & B
e) Both A & C
208. Which of the following will predict a better prognosis for breast
cancer: a) The tumor is small in size
b) No metastasis are found in sampled lymph node
c) Numerous mitosis are seen
d) Tumor shows mild hyperchromatism
e) Tumor cells show marked pleomorphism
215. Which of the following malignant tumors has the best prognosis:
a) Hepatocellular Carcinoma
b) Renal Cell Carcinoma
c) Basal Cell Carcinoma
d) Squamous Cell Carcinoma of Cervix
e) Squamous Cell Carcinoma of Skin
245. One of the following is not true about bilharzial portal hypertension:
a) Splenomegaly is of the congestive type
b) Iron deficiency anemia is a complication
c) Periportal fibrosis is the cause
d) There is an increased incidence of hepatocellular carcinoma nolan x soju
e) Hepatic failure is not an early complication