PATHOLOGY

1. A functional carcinoid tumor metastatic ti the liver leads to endocardial plaque formationin the heart
and results in:
a. Pulmonary valve stenosis
b. Coronary artery occlusion
c. Tricuspid valve stenosis
d. Libman-Sacks endocarditis

2. What is them main cell in chronic inflammation?

a. Lymphocyte
b. Plasma cell
c. Macrophage
d. Fibroblast

3. An extremely undifferentiated neoplasm with carrot-shaped nuclei, scanty cytoplasm, and, Flexner-
Wintersteiner rosettes:
a. Nephroblastoma
b. Neuroblastoma
c. Retinoblastoma
d. Hepatoblastoma

4. What is the usual morphologic pattern of injury for pericarditis after myocardial infarct?
a. Serous inflammation
b. Fibrinous inflammation
c. Suppurative inflammation
d. Ulcer

5. Which of the following pathologic manifestations is incorrectly paired with its clinico-pathologic
correlate?
a. Anemic infarct – double blood supply
b. Hyperemia – acute inflammation
c. Cardiac sclerosis – chronic cor pulmonale
d. Heart failure cells – mitral stenosis

6. Which collagen type predominates in early healing phase of wounds?

a. Type I
b. Type II
c. Type III
d. Type IV

7. A 50 year-old male complained of severe epigastric pain radiating to the back. Serum amylase was
markedly elevated. A diagnosis of acute pancreatitis was made. The following clinical conditions are
associated with pancreatitis, EXCEPT:
a. Chronic alcoholism
b. Hypertension
c. Hyperparathyroidism
d. Viral pneumonia

8. Families giving consent may make limitations to which procedure?

a. Hospital autopsy
b. Forensic autopsy
c. Neither
d. Both

9. The histopathologic diagnosis of a hydatidiform mole is associated with the following statements
EXCEPT:
a. Subsequent development of a choriocarcinoma after a molar evacuation is remote
b. A major histologic feature is trophoblastic proliferation
c. The majority, if not all, the chorionic villi show cystic degeneration
d. Fertilization of an ovum which has no chromosomal content is one of the causes

10. The most immediate next-of-kin expected to give consent to an adult among the following is:
a. Parents
b. Spouse
c. Children
d. Siblings
11. At the height of a rainy week, an elderly resident of a squatter’s colony was brought to the ER with
fever and chills, cough with rusty sputum, and dyspnea. Percussion of the chest showed complete
dullness over the left lobe of the lung. The MOST likely diagnosis is:
a. Lobar pneumonia
b. Tuberculous pneumonia
c. Bronchopneumonia
d. Viral pneumonia

12. Which of the following is irreversible?

a. Hydrophic swelling
b. Liquefactive necrosis
c. Hypertrophy
d. Atrophy

13. A 30 year-old male patient complained of recurrent diarrhea with vague lower abdominal pain. An
upper GI series showed segmental narrowing. The MOST likely diagnosis is:
a. Crohn’s disease
b. Carcinoid
c. Tuberculosis
d. Adenocarcinoma

14. True for atrophy:

a. Decreased number of cells in an organ
b. Results in decrease in function of an organ
c. May result from increased nutritional demand
d. Exemplified by effect of exercise on muscles

15. A 75 year-old man collapsed suddenly. He died shortly after reaching the hospital. A ruptured
abdominal aneurysm was found. The MOST common cause of such an aneurysm is:
a. Atherosclerosis
b. Bacterial infection
c. Developmental defect
d. Trauma

16. Edema is caused by low plasma oncotic pressure in one of the following:
a. Malnutrition
b. Thrombophlebitis
c. Mitral stenosis
d. Portal hypertension

17. A three-month old first born male was brought to the ER for persistent projectile vomiting. A CT Scan
of the abdomen revealed segmental enlargement of pylorus. The MOST likely diagnosis is:
a. Congenital hypertrophic pyloric stenosis
b. Fibrosing benign duodenal ulcer
c. Crohn’s disease
d. Hirschprung’s disease

18. The lungs in mitral stenosis and the nutmeg liver are examples of:
a. Regeneration
b. Exudation
c. Passive congestion
d. Benign neoplasia

19. A bone marrow aspirate was obtained from a 70 year-old who complained of weakness, weight loss,
and recurrent infections. Laboratory findings showed anemia, proteinuria, and an abnormal
component in serum proteins. The bone marrow showed numerous plasma cells. The MOST
probable diagnosis is:
a. Multiple myeloma
b. Monocytic leukemia
c. Non-Hodgkin’s lymphoma
d. Myelomonocytic leukemia

20. The pathway in which coagulation is triggered by direct tissue damage:

a. Intrinsic pathway
b. Extrinsic pathway
c. Kinin system
d. Complement pathway

21. The phenomenon of multiple parasitic cysts in the brain referred to as a cerebral cysticercosis is
produced by the larva of:
 a. Echinococcus granulosus
b. Multiceps multiceps
c. Taenia saginata
d. Taenia solium

22. The most favored site of venous thrombosis is/are the:

a. Deep calf veins
b. Femoral veins
c. Popliteal vein
d. Saphenous vein

23. All of the following hemodynamic events are correctly matched with the associated condition,
EXCEPT:
a. Left atrial thrombosis – cerebral infarct
b. Venous thrombosis – pulmonary infarct
c. Fat embolism – Caisson disease
d. Gas embolism – status post-surgery

24. The basic defect in kwashiorkor is:

a. Lack of total calories
b. Lack of unsaturated fatty acids
c. Excess of lipoproteins
d. Lack of dietary proteins

25. Which of the following malignant neoplasms is correctly paired with the appropriate paraneoplastic
manifestation:
a. Squamous cell carcinoma of the lung – hypercalcemia
b. Glioblastoma multiforme – hyperglycemia
c. Adrenal cortical carcinoma – hyperuricemia
d. Hepatocellular carcinoma – polycythemia

26. Deficiency of this vitamin produces polyneuropathy, cardiovascular syndrome, and the Wernicke-
Korsakoff Syndrome:
a. Pyridoxine
b. Niacin
c. Riboflavin
d. Thiamin

27. Chronic renal disease, pheochromocytoma, Conn’s syndrome, coarctation of the aorta, and
acromegaly are all conditions that may lead to:
a. Venous thrombosis
b. Hypersensitivity angitis
c. Wegener’s granulomatosis
d. Hypertension

28. Rickets in children and osteomalacia in adults are caused by a deficiency of:
a. Vitamin A
b. Vitamin K
c. Vitamin D
d. Vitamin E

29. Which of the following terms is correctly defined?

a. Autolysis – tissue degradation by intracellular enzymes
b. Apoptosis – ballooning of cell cytoplasm from liquid accumulation
c. Heterolysis – changes induced by fixatives used in histopathologic tissue preparation
d. Fibrinoid necrosis – ischemic necrosis resulting from arteriolar occlusion by fibrin clots

30. Of the following tissues, which one is most susceptible to radiation damage
a. Epithelium
b. Smooth muscle
c. Cardiac muscle
d. Fat

31. Small vessel vasculitis due to IgA-dominant immune complex deposit in the vessel wall is seen in:
a. Infectious vasculitis
b. Drug-induced angitis
c. Henoch-Schoenlein purpura
d. Cryoglobulinemic vasculitis

32. Acute massive aspirin overdose is characterized by

 a. Neuronal damage
b. Acute tubular necrosis
c. Hepatocellular necrosis
d. Nonspecific changes

33. A 50 year-old male patient with chronic atrial fibrillation is relatively at risk for the following clinical
situations, EXCEPT:
a. Renal infarction
b. Cerebral infarction
c. Splenic infarction
d. Pulmonary infarction

34. Destruction of the epidermis and dermis with loss of dermal appendages is seen in:
a. First-degree burn
b. Second-degree burn
c. Third-degree burn
d. Partial thickness burn

35. A 50 year-old obese female has a two-year history of cold, bluish lower extremities with trophic skin
changes. She subsequently developed acute dyspnea and tachypnea for which hospitalization was
sought. During her stay in the wards, she suddenly developed right costovertebral angle pain and
hematuria. Which of the following will best explain her latest symptom?
a. Saddle embolism
b. Shower embolism
c. Paradoxical embolism
d. Fibromuscular dysplasia of the renal artery

36. According to CDC Guidelines, any person with CD4+ T cells fewer than the number below is
considered to have AIDS:
a. 100/uL
b. 200/uL
c. 200/L
d. 500/mL

37. An elderly male was found unconscious on a sidewalk. He had fever and neck rigidity. He died on
the way to the hospital. On post-morten examination, the major findings were those of exudates
localizing at the base of the brain, as well as cavitary lesion within the apices of both lungs. Which of
the following would be a MOST pertinent differential diagnosis?
a. E. coli meningitis
b. Viral meningo-encephalitis
c. Cryptococcal meningitis
d. Protozoal meningo-encephalitis

38. It is the state in which the individual is incapable of developing immune response to a specific
antigen.
a. Immunologic tolerance
b. Self-tolerance
c. Central tolerance
d. Peripheral tolerance

39. A higher level of chromosomal material accumulation and mitoses implies a fast-growing neoplasm.
This observation is reflected histologically by:
a. Tumor hemorrhage and necrosis
b. Anaplasia and macronuclei
c. Well-differentiated architecture
d. Absence of lymphocytic infiltrates

40. Type IV hypersensitivity reaction:

a. Granulomatous reaction
b. Production of activated lymphocyte
c. Immediate response
d. All of the above

41. Patients undergoing chemotherapy for malignancies are at risk for developing urinary calculi. These
calculi usually have the following composition:
a. Cystein crystals
b. Uric acid crystals
c. Calcium oxalate precipitates
d. Magnesium ammonium triple phosphate
42. The major amyloid fibril associated with Alzheimer’s disease is:
a. AL
b. AA
c. ß-2 microglobulin
d. A ß

43. The characteristics of a follicular adenoma of the thyroid are enumerated below, EXCEPT:
a. Usually solitary
b. Papillary structures within the lesional area
c. Morphology within and outside the capsule are different
d. Fibrous encapsulation

44. The most significant laboratory test confirming the presence of amyloidosis is:
a. Congo red staining
b. Apple green birefringence by polarized microscopy
c. Electron microscopy
d. Presence of immune complex deposits

45. A 55 year-old male presented with gross hematuria. An endoscopic examination showed a fungating
urinary bladder mass. Biopsy revealed squamous cell carcinoma. The most likely carcinogen
involved in this case is:
a. Tobacco
b. Schistosoma
c. Aflatoxin
d. Asbestos

46. Which of the following disease is caused by a bite of a sandfly?

a. Malaria
b. Filaria
c. Schistosoma
d. Leishmaniasis

47. A 30 year-old male who was a known case of having rheumatic mitral valvulitis in atrial fibrillation,
suddenly developed a right-sided hemiplegia. The clinical impression was cerebral embolism from a
detached left atrial embolus. The cerebral vessel which most likely become occluded was the:
a. Left MCA
b. Basilar artery
c. Right ACA
d. Middle meningeal artery

48. Pathologic findings in malaria:

a. Hepatosplenomegaly
b. Ring hemorrhages
c. Durck’s granuloma
d. All of the above

49. A 60 year-old male patient presented with gradually worsening ptosis of the eyelids and generalized
muscle weakness. A muscle biopsy showed a positive anti-Ach receptor antibody marker by
immunohistochemical staining. The MOST likely diagnosis is:
a. Myasthenia gravis
b. Polymyositis
c. Diabetes mellitus
d. Grave’s disease

50. Patients who died from the respiratory form of anthrax almost always have:
a. Hemorrhagic adrenalitis and thence the Waterhouse-Friedrichsen syndrome
b. Hemorrhagic meningitis
c. Hemorrhagic myocarditis and pericarditis
d. Hemorrhagic mediastinitis and thoracic lymphadenitis

51. Patients which acquire nodular skin lesions containing foamy macrophages that are filled with
numerous acid-fast bacilli could be diagnosed to have:
a. Tuberculoid leprosy
b. Borderline leprosy
c. Lepromatous leprosy
d. Borderline tuberculoid leprosy

52. The chancre is differentiated from herpetic ulcer clinically by:

a. Being relatively painless
b. Being relatively painful
 c. Deeper involvement of the skin and subsutaneous tissue
d. Recurrent at the same site

53. Obstruction is common in:

a. Right-sided carcinoma of the colon
b. Carcinoma anywhere in the colon
c. Left-sided carcinoma of thecolon
d. Hepatic flexure of carcinoma

54. A patient with measles lesions of five days duration was brought to the hospital because of the
continuing high-grade fever and increasing dyspnea. Despite optimal supportive measures, the
patient died. On autopsy, one should be on the lookout for the following:
a. Cowdry Type A inclusion bodies
b. Warthin-Finkeldey Cells
c. Negri Bodies
d. Koilocytosis

55. Because metastases are almost always present by the time the diagnosis is made, which of the
following histologic forms of lung cancer are radiotherapy and chemotherapy the mainstays of
treatment:
a. Adenocarcinoma
b. Small cell carcinoma
c. Squamous cell carcinoma
d. Large cell carcinoma

56. Atherosclerosis is a disease of the following, EXCEPT:

a. Large muscular arteries
b. Medium muscular arteries
c. Arterioles
d. Elastic arteries

57. Identification of myocardial infarction is usually observed:

a. Four hours after the onset of infarction
b. Two hours after the onset of infarction
c. Twelve hours after the onset of infarction
d. One hour after the onset of infarction

58. Consequences of aortic dissection, EXCEPT:

a. End-organ infarction
b. Hemopericardium
c. Hypertension
d. Double-barreled aorta

59. The MOST important factor which can determine whether an encounter with an antigen induces
tolerance of immunity is:
a. Use of high dose of antigen
b. Immaturity of the lymphocytes in the immune system
c. Use of soluble antigen instead of particulate antigen
d. Use of low-dose antigen

60. Components of Tetralogy of Fallot, EXCEPT:

a. Right ventricular hypertrophy
b. Atrial septal defect
c. Overriding of the aorta
d. Subpulmonic stenosis

61. A point of distinction between nasal polyps and a true sino-nasal neoplasm is that:
a. Nasal polyps commonly arise from the middle turbinate
b. Nasal polyps are often bilateral
c. Nasal polyps are often multicentric
d. Nasal polyps often show squamous metaplasia

62. Malignant epithelial tumors, EXCEPT:

a. Melanoma
b. Adenoma
c. Squamous cell carcinoma
d. Transitional cell carcinoma

63. Virtually pathognomonic of diabetic nephropathy:

a. Fibrin caps and wire loops
 b. Diffuse glomerulosclerosis
c. Nodular glomerulosclerosis
d. Focal segmental glomerulosclerosis

64. The most frequent cause of acquired mitral stenosis is:

a. RHD
b. Mycomatous degeneration
c. Calcification
d. Aging

65. The basic lesion of atherosclerosis is the:

a. Fibrofatty plaques within the intima
b. Hyaline thickening if the tunica intima
c. Fibrinoid necrosis of the intima
d. Calcifications of the media

66. Compromise of heart function because the pericardium is stiff:

a. Hypertrophic cardiomyopathy
b. Restrictive cardiomyopathy
c. Cardiac tamponade
d. Constrictive pericarditis

67. A patient with new skin lesions is found to have a gastric carcinoma. The following cutaneous lesions
are consistent with this situation, EXCEPT:
a. Seborrheic keratosis
b. Paget’s disease
c. Acanthosis nigricans
d. Eryhthema nodosum

68. Which of the following will initially present with a left-to-right shunt?
a. Pulmonary valve stenosis
b. Tetralogy of Fallot
c. Atrial Septal Defect
d. Coarctation of Aorta

69. The presence of melanin-laden histiocytes and Langhan’scells in an enlarged lymph node is
characteristic of:
a. malignant melanoma metastatic to lymph node
b. tuberculosis
c. histiocytic lymphoma
d. dermatopathic lymphadenitis
70. Development of primary hepatocellular carcinoma implies that patients have had:
a. Fulminant hepatitis
b. Chronic hepatitis
c. Cirrhosis
d. Fatty liver

71. An elderly individual died of progressive congestive heart failure. Microscopic examination of the
cardiac tissue shows amorphous deposits with “salmon-pink” tinctorial reaction to Congo Red stains.
Which of the following is a meaningful diagnosis for this case?
a. Hypertrophic obstructive cardiomyopathy
b. Dilated cardiomyopathy
c. Restrictive cardiomyopathy
d. Ischemic heart disease

72. In viral hepatitis, the following is considered the histologic is considered the histologic marker of
irreversible injury?
a. Piecemeal necrosis
b. Bridging necrosis
c. Bridging fibrosis
d. Interface hepatitis

73. Histologic feature which clearly differentiates primary from secondary healing is:
a. Wound contraction
b. Mononuclear infiltrates
c. Formation of granulation tissue
d. Fibrosis

74. The most common malignancy of the stomach

a. Squamous cell carcinoma
 b. Adenocarcinoma
c. Lymphoma
d. Sarcoma

75. A 55 year-old hypertensive male suddenly complained of headache followed by loss of

consciousness. Which of the following is the MOST probably diagnosis?
a. Intraparenchymal hemorrhage
b. Epidural hemorrhage
c. Subarachnoid hemorrhage
d. Subdural hemorrhage

76. True of colorectal carcinoma

a. Late obstruction if at right colon
b. Late obstruction if at left colon or rectum
c. Can metastasize if tumor confined in the mucosa
d. Unrelated to diet

77. Which of the following tumors is highly radiosensitive:

a. Melanoma
b. Neuroblastoma
c. Renal cell carcinoma
d. Dysmerginoma

78. Barett’s esophagus:

a. Caused by chronic reflux esophagitis
b. Yellowish mucosa on endoscopy
c. Reversible completely
d. Pressure of the gastric acid-producing cells in esophagus.
79. The first point of attack of hypoxia in the cell is the:
a. Intracellular glycolysis
b. Oxidative phosphorylation by mitochondria
c. Permeability of the cell membrane
d. Intracellular calcium

80. True for cholecystitis

a. Hypertrophy of muscular wall is always present
b. Rokitansky-Aschoff sinuses are prominent if there are no stones
c. Ischemia is a cause
d. Always a surgical indication

81. Characteristic hematologic effect of lead poisoning is:

a. Aplastic anemia
b. Megaloblastic anemia
c. Microcytic, hypochromic, mild hemolytic anemia
d. Leukemia

82. True for small cell CA:

a. Ectopic hormones like ACTH
b. Eaton-Lambert Syndrome
c. Kulchitsky cells
d. All of the above

83. A 50 year-old male was admitted because of headaches and seizures. CT Scan revealed a large
tumor in the cerebral hemisphere. The MOST likely diagnosis is:
a. Fibrillary astrocytoma
b. Medulloblastoma
c. Ependymoma
d. Pilocytic astrocytoma

84. A 65-year old male presents to his physician because of spiking fever and flank pain. His urine
contained white blood cells, white cell casts, and bacteria. Renal biopsy shows extensive infiltrates of
leukocytes in and around renal tubules. The most likely diagnosis is:
a. Analgesic nephropathy
b. Acute tubular necrosis
c. Acute pyelonephritis
d. Benign nephrosclerosis

85. Consumptive thrombocytopenia occurs in the following conditions, EXCEPT:

a. Hemolytic-Uremic syndrome
b. DIC
 c. Megakaryocytic hypoplasia
d. Thrombotic thrombocytopenic purpura

86. Which of the following is ALWAYS a part of hydronephrosis?

a. Dilatation of renal pelvis
b. Ureteral obstruction
c. Urethral obstruction
d. Renal papillary necrosis

87. Characteristic radiologic picture in metastatic bone lesions of prostatic carcinoma:

a. Lytic and osteoblastic lesions
b. Osteoblastic lesions
c. Subperiosteal bone lysis
d. Osteoclastic lesions

88. True of chronic lymphocytic leukemia (CLL) EXCEPT:

a. It’s morphologically and phenotypically distinguishable from small lymphocytic lymphoma
b. It’s the most common leukemia of adults in the western world
c. The tumor cells are fragile producing smudge cells in the process of making the smear
d. Male predominance is noted

89. Helicobacter pylori infection of the pyloric gastric mucosa is am etiopathogenetic factor in:
a. Gastric adenocarcinoma
b. Acute hemorrhagic gastritis
c. Granulomatous gastritis
d. Auto-immune gastritis

90. Which of the following morphologic abnormalities is considered practically pathognomonic of a

Myelodysplastic Syndrome (MDS)?
a. Micromegakaryocytes
b. Hypersegmented neutrophils
c. Basophilic stippling
d. Binucleated erythroblasts

91. The following are true of arterial thrombosis of arterial thrombosis, EXCEPT:
a. Superimposed over an atherosclerotic region
b. Show Lines of Zahn
c. Forms accurate casts of the vessels from which they arise
d. Usually occlusive

92. The following are examples of hemolytic anemia, EXCEPT:

a. Spherocytosis
b. Pyruvate kinase deficiency
c. Thalassemia syndrome

93. Which of the following conditions is characterized by dystrophic calcifications?

a. Hyperparathyroidism
b. Adrenocortical insufficiency
c. Vitamin C intoxication
d. Atherosclerosis

94. Features of Iron deficiency anemia

a. Microcytic, hypochromic anemia
b. Pencil cells, poikilocytes
c. Low MCV, high RDW
d. All of the above

95. The most common cause of subarachnoid hemorrhage:

a. Capillary hemangioma
b. Charcot-Bouchard microaneurysm
c. AV malformation
d. Ruptured berry aneurysm

96. Vertebral metastasis with osteoblastic reaction is seen in:

a. Penile squamous cell carcinoma
b. Seminoma
c. Prostatic adenocarcinoma
d. Non-seminomatous germ cell tumor

97. Which of the following sexually transmitted infectious diseases is caused by Chlamydia?
 a. Condyloma acuminata
b. Lymphogranuloma venereum
c. Granuloma inguinale
d. Chancroid

98. Choriocarcinoma presents with:

a. Increased alpha-fetoprotein levels
b. Increased hCG
c. “bag of worms”
d. sudden painful violaceous testicular mass

99. These are biologically active substances produced by T-cells that have varied anti-viral and anti-
tumoral activities:
a. Interleukins
b. Interferon’s
c. Leukotrienes
d. Slow-reactive substance of anaphylaxis

100. A 25 year-old healthy man has a work-up for infertility and is found to have a low sperm count.
Physical examination revealed the left spermatic cord to be doughy with a feel of a “bag of worms”.
The most likely diagnosis is:
a. Hydrocoele
b. Varicocoele
c. Seminoma
d. Testicular torsion