BOARD REVIEW

CHOOSE THE BEST ANSWER.

1.

2.

Viruses induce cell injury through:

A. direct cytopathic effect
B. immune mediated reactions

C. both A & B are correct

D. neither A nor B is correct

Process (es) involved in cell necrosis is (are):

A. denaturation of proteins
B. enzymic digestion of cells

C. both A & B are correct

D. neither A nor B is correct

3.

The following statements are TRUE of caseous necrosis:

A. it is a combination of coagulation and liquefaction necrosis
B. it is a characteristic feature of tuberculosis
C. both A & B are correct
D. neither A nor B is correct

4.

Jaundice is due to the accumulation of this pigment:

A. bilirubin
C. lipofuscin
B. hemosiderin
D. melanin

5.

The sequence of cellular events in inflammation is:

A. margination diapedesis chemotaxis phagocytosis
B. diapedesis margination chemotaxis phagocytosis
C. chemotaxis margination diapedesis phagocytosis
D. chemotaxis diapedesis margination phagocytosis

6.

The most effective means of microbial killing is via the:

A. oxygen independent mechanism
B. myeloperozidase independed mechanism
C. hydrogen peroxide, myeloperoxidase and halide system
D. only A & C are correct

7.

The most important cause of delay in wound healing is:

A. infection
C. inadequate blood supply
B. presence of foreign bodies
D. mechanical factors

8.

Keloid is due to excessive:

A. granulation tissue
B. granuloma formation

C. amyloid deposition
D. collagen accumulation

9.

Edema can result from any of the following mechanisms:

A. increased hydrostatic pressure of the blood
B. increased osmotic pressure of interstitial fluid (sodium retention)
C. decreased oncotic pressure of plasma protein
D. all of the above are correct

10.

A patient with CHF has generalized edema. The operative mechanism

involved in edema are the following EXCEPT:
A. increased aldosterone secretion
B. increased central venous pressure
C. diminished CO
D. diminished ADH secretion

11.

Periorbital edema is usually encountered in:

A. filariasis
C. liver cirrhosis
B. nephritic syndrome
D. inflammatory states

12.

Fluid that collects during acute inflammation and that has a protein content in
excess of 3.0 g/L and SG over 1.015 is termed:
A. exudate
C. hydropericardium
B. transudate
D. wheal

13.

A segment of one chromosome transferred to another segment is known as:

A. mutation
C. inversion
B. translocation
D. deletion

14.

The most common cause of the occurrence of Klinefelters syndrome:

A. non-disjunction in meiotic division in oogenesis
B. non-disjunction in meiotic division in spermatogenesis
C. non-disjunction in meiotic division in embryogenesis
D. translocation

15.

The number of Barr bodies in a patient with 48 XXXY karyotype:

A. none
C. two
B. one
D. three

16.

The following clinical manifestations are seen in a patient with Downs

syndrome EXCEPT:
A. dysplastic pelvis and middle phalanx of hand
B. mental retardation
C. microcephaly
D. horizontal palmar crease

17.

Pathologic changes that have been described in AIDS include cell of the
following EXCEPT:
A. hypogammaglobulinemia
B. viral inclusions in histiocytes of lymph nodes
C. T4/T8 ratio is very low
D. Lymphoid depletion of cortical and paracortical areas of lymph nodes

18.

Thymectomy in new born infant will cause:

A. impaired cell-mediated immune response
B. impaired antibody response
C. heavy chain disease
D. no discenible immune dysfunction

19.

Tuberculous lesions are brought about by:

A. release of exotoxin
C. hypersensitivity reaction
B. release of endotoxin
D. activation of lysosomes

20.

Immunoglobulins are produced by:

A. neutrophils
B. basophils

C. eosinophils
D. lymphocytes

21.

The following are malignant conditions EXCEPT:

A. hepatoma
C. melanoma
B. lymphoma
D. adenoma

22.

This tumor belong to the category of blastoma:

A. dermoid cyst
C. squamous cell carcinoma
B. adenocarcinoma
D. Wilms tumor

23.

The following are non-neoplasia EXCEPT:

A. hamartoma
C. dysplasia
B. choristoma
D. fibroma

24.

The following are suppressor genes EXCEPT:

A. p53
C. APC
B. bcl-2
D. NF I

25.

A 6-year-old boy develops abdominal pain and vomiting preceded by a 3-day

period without bowel movements. A diagnosis of intestinal obstruction is
made. Of the following, the most likely reason for the obstruction is a bolus
of:
A. Taenia saginata
C. Strongyloides tercoralis
B. Ascaris lumbricoides
D. Onchocerca volvulus

26.

The following is/are attributed directly or indirectly to schistosomiasis

EXCEPT:
A. solitary liver abscess
B. granulomatous around shcistosoma ova
C. dark (gray) color of the liver and spleen because of a hemoglobin-derived
pigment that accumulate in reticulo-endothelial cells
D. urinary bladder malignancy, predominantly of the squamous cell type

27.

The morphologic changes in typhoid fever include the following EXCEPT:

A. accumulation of mononuclear phagocytes throughout the lymphreticular
system, with some lymphocytes and plasma cells
B. enlargement of the liver with areas of focal necrosis surrounded by
mononuclear cell proliferation (typhoid nodules)
C. oval ulcers in the ileum with their long axis along the long axis of the
bowel

28.

A chronic carrier state of typhoid fever is most likely due to the persistence of
the organism in:
A. the appendix
C. the gall bladder
B. the cortex of the kidney
D. the ileum

29.

Function of thiamine:
A. co-enzyme in oxidative decarboxylation of alpha-ketoacids
B. synthesis of DNA and RNA
C. respiratory enzyme in the cytochrome enzyme
D. all of the above are correct

30.

The metabolism of calcium is closely regulated by:

A. vitamin D
C. thyroid gland
B. parathyroid gland
D. all of the above are correct

31.

The mechanism of clotting is affected by:

A. Vitamin A
C. Thiamine
B. Vitamin K
D. Vitamin E

32.

This/these pollutants is/are dangerous because once released into the

environment they are forever i.e. resistant to natural process of decay.
A. polychlorinated biphenyls
C. carbon monoxide
B. chloroform
D. all of the above are correct

33.

Ethyl alcohol toxicity will cause:

A. venous thrombosis
B. cheery-red discoloration of skin

34.

C. fatty liver
D. gingivitis

Which of the following is the most common adverse effect of smoking?

A. myocardial infarction
C. cancer of the pancreas
B. cancer of the bladder
D. peptic ulcer disease

35.

Exposure to carbon particle in the ambient air will result to:

A. Anthracosis
C. progressive massive fibrosis
B. coal workers pneumoconiosis
D. any of the above

36.

The leading cause of death in children between 5-14 years of age is:
A. malignant neoplasm
C. injuries resulting from accidents
B. congenital anomalies
D. cardiac diseases

37.

The highest at risk period for intrauterine cytomegalovirus infection:

A. 1st trimester of pregnancy
C. 3rd trimester of pregnancy
B. 2nd trimester of pregnancy
D. all of the above

38.

Organogenesis is completed by:

A. 2nd trimester of pregnancy
B. the end of 2nd trimester

C. the end of 1st trimester

D. the middle of 1st trimester

39.

Polyarteritis nodosa frequently affected organs include all of the following

EXCEPT:
A. Kidney
C. Lungs
B. Heart
D. GIT

40.

All of the following are characteristic features of thromboangitis obliterans

(Buergers disease) EXCEPT:
A. lesions are sharply segmental
B. only the lower extremities are affected
C. arteries of small and medium size are affected
D. both upper and lower extremities are affected

41.

All of the listed anatomic changes are considered as important features in

syphilitic aortitis EXCEPT:
A. longitudinal wrinkling (tree barking)
B. dilatation of aortic valve ring
C. obliterative endarteritis of vasa vasorum
D. widening of coronary ostia

42.

The histological hallmarks of temporal or giant cell arteritis are the following
EXCEPT:
A. lymphocytic infiltrate in the intima and inner media
B. disruption of incarnal elastic lamira associated with giant cells
C. patchy necrosis of the media
D. eosinophilic infiltration of all muscular coats

43.

Complicated or advanced atherosclerosis would most likely affect this portion

of the blood vessel:
A. intima only
C. intima and adventitia
B. intima and media
D. adventitia

44.

A biopsy of the femoral artery revealed calcification in the media would be

compatible with:
A. accelerated hypertension
B. young individuals, usually male
C. usual complication of ischemia and gangrene
D. none of the above

45.

A vascular tumor associated with AIDS is:

A. Lymphaniosarcoma
C. Angiosarcoma
B. Kaposis sarcoma
D. Hemangiopericytoma

46.

The following are associated with cor pulmonale EXCEPT:

A. concentric left ventricular hypertrophy
B. congestive heart failure
C. pulmonary valve dilatation
D. pulmonary hypertension

47.

The following are possible morphologic changes in sickle cell disease

EXCEPT:
A. Gamma Gandy bodies in the spleen
B. Papillary necrosis in the kidney due to capillary stasis
C. Micro infarction in the brain
D. Evidences of chronic glumerulonephritis

48.

A decrease in the number of platelets is seen in which condition EXCEPT:

A. polycythemia vera
C. idiopathic thrombocytopenic purpura
B. aplastic anemia
D. acute leukemia

49.

B-thalassemia major shows all of the following features EXCEPT:

A. hypochromic microcytic anemia
B. target cells and anisocytosis in peripheral blood smear
C. diminished synthesis of the alpha chain hemoglobin
D. clinical necessity for multiple blood transfusions

50.

The patterns of chronic lymphadenitis include the following EXCEPT:

A. sinus histiocytosis
C. follicular hyperplasia
B. paracortical hyperplasia
D. suppurative lymphadenitis

51.

Starry sky pattern of lymph node is characteristic of:

A. Burkitts lymphoma
C. Histiocytic lymphoma
B. Hodgkins lymphoma
D. Sezarys syndrome

52.

Lacunar cells are characteristics of this type of Hodgkins disease:

A. lymphocytic predominance
C. mixed cellularity
B. lymphocyte depletion
D. nodular sclerosis

53.

The most common type of Histiocytosis X in infants is:

A. eosinophilic granuloma
C. letterer-siwe syndrome
B. hand-schuller-christian disease
D. unifocal langerhans cell histiocytosis

54.

Sinus histiocytosis are normally seen in nodes draining:

A. infection
C. drug abuse
B. cancers
D. immunologic disorders

55.

A patient presents with hemoptysis and acute renal failure. A diagnosis worth
considering in this clinical picture is:
A. Asbestosis
C. Good pastures syndrome
B. primary atypical pneumonia
D. tuberculosis

56.

Alpha-1 antitrypsin deficiency is associated with:

A. panlobular emphysema
C. Wegeners granulomatosis
B. anthracosis
D. bronchogenic carcinoma

57.

Enlargement of pulmonary alveolar spaces with destruction of septal walls is

seen in:
A. chronic bronchitis
C. pulmonary infarction
B. emphysema
D. alveolar proteinosis

58.

A chest x-ray that shows a shaggy cavity with a thick irregular border and
satellite densities in the right lower lobe is most compatible with:
A. bronchogenic carcinoma
C. abscess
B. tuberculosis
D. histoplasmosis

59.

Which statement about esophageal cancer is false?

A. it is usually of squamous cell type
B. most common in the distal portion
C. primarily a disease of elderly males
D. characterized by dysphagia and painless weight loss

60.

Macrophages with positive periodic acid-schiff-staining material in intestinal

lamina propia and lymph nodes are characteristically found in:
A. Wilsons disease
C. Whipples disease
B. Elevated serum gastrin levels
D. Gardeners syndrome

61.

The Mallory-Weiss syndrome is due to laceration in the mucosa of the:

A. Esophagus
C. Pylorus
B. Stomach
D. Small intestine

62.

Carcinoma of the GIT would be expected to occur with greatest frequency in

patients with:
A. familial polyposis of the colon
C. Crohns disease
B. villous adenoma of the colon
D. gastric ulcer

63.

Chronic obstruction of the cystic duct results to development of:

A. Choledochal cyst
C. Hydrops of the gall bladder
B. Porcelain gall bladder
D. Carcinoma of the gall bladder

64.

Which of the following condition(s) increase(s) the risk of bile duct

carcinoma?
A. Choledochal cyst
C. Hydrops of the gall bladder
B. Porcelain gall bladder
D. Choledocholithiasis

65.

Carcinoma of the pancreas:

A. occurs most often in the body of the pancreas
B. is associated with hypocalcemia
C. arises from the pancreatic ductal cells
D. is usually cured by total pancreatectomy
All of the following pediatric conditions are characterized by unconjugated
hyperbilirubinemia EXCEPT:
A. Hemolytic disease of the newborn
B. Physiologic jaundice of the newborn
C. Intrahepatic biliary atresia
D. Gilberts syndrome

66.

67.

The least common type of gall bladder calculi are:

A. pure calcium bilirubinate
C. pure cholesterol
B. pure calcium carbonate
D. mixed stone

68.

Cholelithiasis is mainly due to:

A. Infection
B. supersaturation of bile with cholesterol

69.

C. bile stasis
D. inflammation

In addition to nephritic injury, the other main cause of acute tubular necrosis is:
A. Sepsis
C. severe hypocomplementemia
B. Ischemia
D. immune complex deposition

70.

Of the complications of acute pyelonephritis enumerated below, one does not

belong:
A. retroperitoneal abscess formation
C. acute episodes of paroxysmal HPN
B. renal papillary necrosis
D. pyonephrosis

71.

Of the risk factors for pyelonephritis enumerated below, one does not belong:
A. diabetes mellitus
B. male sex
C. congenital abnormalities of the urinary tract
D. pregnancy

72.

Chronic renal disease, pheochromocytoma, Conns syndrome, coarctation of

the aorta and acromegaly are all conditions that may lead to:
A. venous thrombosis
C. Wegeners granulomatosis
B. hypersensitivity vasculitis
D. hypertension

73.

Nests of urothelium may be found in the lamina propia of the urinary bladder
representing normal variation in the morphology of the bladder. These nests
of urothelium are called:
A. Brunners nests
C. Brunns nests
B. Burneys nests
D. Burners nests

74.

The following are implicated in the causation of bladder carcinoma,

EXCEPT:
A. Beta naphthylamine
C. Cyclophosphamide
B. S. Haemotobium
D. There is no exception

75.

A newborn baby was noted to pass out urine through a small opening in the
area of the umbilicus. This is most probably due to:
A. Urachal cyst
C. Exstrophy of the bladder
B. Patent urachus
D. Any of the above

76.

Transitional cell tumors that are more likely to behave as malignant are
characterized by the following EXCEPT:
A. Induce angiogenesis
B. Manifest highly abnormal karyotypes
C. Lack blood group antigens on their cell surface
D. There is no exception

77.

The following is caused by human papilloma virus type 6 (HPV-6):

A. Giant condyloma
C. condyloma lata
B. Condyloma acuminatum
D. all of the above

78.

The following are TRUE about hypospadias and epispadias, EXCEPT:

A. Commonly associated with failure of normal descent of the testes and
malformation of the bladder
B. May lead to partial urinary obstruction
C. Possible cause of sterility
D. There is no exception

79.

The majority of ovarian neoplasms arise from:

A. germ cells
C. sex-cord stroma
B. surface epithelial cell
D. metastatic from GIT

80.

The most common site of endometriosis:

A. fallopian tube
C. recto-vaginal septum
B. ovary
D. vagina

81.

Choriocarcinoma is most often preceded by:

A. abortion
C. normal pregnancy
B. ectopic pregnancy
D. H. mole

82.

The most common primary malignant tumor of the ovary:

A. endometrioid carcinoma
C. serous cystadenocarcinoma
B. mucinous cystadenocarcinoma
D. yolk sac tumor

83.

Cord like ducts filled with necrotic and cheesy tumorous tissue that can be
readily extruded upon pressure is seen in:
A. mucinous carcinoma
C. medullary carcinoma
B. comedocarcinoma
D. pagets disease of the breast

84.

Lesions mistaken clinically as malignant are the following EXCEPT:

A. fibroadenoma
C. mammary duct ectasia
B. fat necrosis
D. mastitis

85.

Sites of metastases of cystosarcoma phyllodes are usually:

A. axillary lymph nodes
C. liver
B. lungs and bone
D. brain

86.

The most frequent site of breast cancer is:

A. lower inner quadrant
C. upper outer quadrant
B. upper inner quadrant
D. subareolar

For numbers 87 to 89
87.
A female patient presented with moon facies, truncal obesity and hisrutism.
Plasma cortisol was elevated. These features characterize:
A. Conns syndrome
C. Waterhouse-Friderichsen syndrome
B. Cushings syndrome
D. Only B & C are correct
88.

If you suspect the presence of Cushings syndrome, you should perform a:

A. low dose dexamethasone test
B. high dose dexamethasone suppression test
C. both A & B are correct
D. neither A nor B is correct

89.

If this were Cushings syndrome, one would expect:

A. suppression of cortisol secretion
C. no suppression of cortisol secretion
B. suppression of ACTH secretion
D. only A & B are correct

90.

Suppression of cortisol secretion with high dose dexamethasone suppression

test indicates the presence of:
A. an adrenal neoplasm
C. pituitary ACTH excess
B. ectopic ACTH syndrome
D. all of the above are correct

91.

Which of the following is a secondary lesion?

A. wheal
C. erosion
B. pustule
D. bulla

92.

Psoriatic patients typically develop silvery:

A. excoriations
C. papules
B. scales
D. pustules

93.

A patient presents with vesicles on the left side of his trunk. A simple lab
procedure to do to support a diagnosis of herpes zoster is:
A. gram stain
C. Tzanck smear
B. KOH stain
D. Patch test

94.

One of the etiologic factors in acne is the:

A. Pityrosporum
C. Propionibacterium
B. Staphylococcus
D. Enterococci

95.

The paucibacillary therapy for Hansens disease is:

A. Rifampicin 600 mg; Ofloxacin 400 mg; Minocycline 100mg daily for 6
months
B. Rifampicin 600mg once a month for 6 months; Dapsone 100mg daily
for 6 months
C. Rifampicin 600mg once a month for 2 years; Dapsone 100mg daily for 2
years; Clofazimine 50mg daily for 2 years
D. Rifampicin 600mg once a month for 6 months; Dapsone 100mg daily for 6
months; Clofazimine 50mg daily for 6 months

96.

A child presents with an array of macules, papules, vesicles, and bullae,

reddish, with pale eroded center involving the extremities, lips and oral
mucosa in a symmetric pattern. There was intake of penicillin and
sulfonamides for urinary tract infection. The patient most likely has:
A. erythema multiforme
C. lichen planus
B. psoriasis
D. porphyria

97.

Most common primary malignant brain tumor:

A. Medulloblastoma
C. Ganglioneuroma
B. glioblastoma multiforme
D. ependymoma

98.

Histologic criteria for glioblastoma multiforme:

A. vascular endothelial proliferation
B. anaplasia
C. both A & B are correct
D. neither A nor B is correct

99.

Medulloblastoma most frequently occurs in:

A. age 60 and above
C. children & young adults
B. middle adulthood
D. no age predilection is observed

100.

Tuberculoma in children frequently occurs in:

A. Supratentorial
C. Posterior fossa
B. Infratentorial
D. Transtentorial