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Pathology Final Exam Retake 2006

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Pathology Final Exam Retake 2006 Powered By Docstoc
					GI 2007 credit version A

    1.   Crohn disease
             a. Always involves the small intestine
             b. Always involves the large intestine
             c. May involve small and large intestine
             d. Never involves duodenum
             e. Always begins in the rectal mucosa

    2.   IBD – it’s:
            a. CD
            b. UC
            c. CD and UC
            d. Infectious disease
            e. Not a proper term

    3.   Pleomorphic adenoma of salivary glands
             a. It’s a slowly growing tumor
             b. Accounts for over 90% of salivary gland tumors
             c. Because of the penetration of the tumors’ capsule, may recur after excision
             d. Shows myxoid stroma with cords of myoepithelial cells
             e. Malignant transformation never occurs
                          Which is FALSE?

    4.   Which of the following are correctly matched?
            a. Plummer-Vinson syndrome – esophageal adenocarcinoma
            b. Barret esophagus – esophageal squamous cell
            c. Liver cirrhosis – esophageal varices
            d. Mallory-Weiss syndrome – stricture of the esophagus
            e. Rolling hiatal hernia – early childhood

    5.   Early gastric cancer
             a. Is a lesion confined to the epithelium
             b. Is a lesion confined to the lamina propria of the mucosa
             c. Is a lesion confined to mucosa and submucosa but with no metastasis
             d. Is a lesion confined to mucosa and submucosa, regardless of the presence or absence of perigastric
                  lymph node metastasis
             e. Is synonymous with carcinoma in situ

    6.   Not a cause of upper GI bleeding
             a. Achalasia
             b. Mallory-weiss syndrome
             c. Varices
             d. Sliding hiatal hernia
             e. Severe reflux esophagitis

    7.   Zenker diverticulum
             a. Is a diverticulum of the small intestine
             b. May develop above the lower esophageal sphincter
             c. Develops above the upper esophageal sphincter
             d. Is a diverticulum of the large intestine
             e. Its typical clinical syndrome is dysphagia

    8.   Cushing ulcer
             a. Is a chronic gastric ulcer
             b. Commonly transforms into gastric carcinoma
             c. Arises in patients with intracranial injury
             d. Is connected with helicobacter pylori infection
             e. Is seen in Zollinger-Ellison syndrome
9.   Warthin tumor
        a. Its adenoid cystic carcinoma
        b. Is unusual in the parotid
        c. Is locally malignant
        d. Presents as tumor with cystic spaces lined by oncogenes
        e. Dense fibrotic stroma is a characteristic feature

10. Lauren classification divides gastric neoplasms into
        a. Polypoid, flat and exuclerative
        b. Adenocarcinomas and squamous cell carcinomas
        c. Carcinomas and sarcomas
        d. Intestinal and diffuse variant.
        e. Benign and malignant

11. the characteristic defect in bilirubin metabolism in Gilbert syndrome
         a. absent bilirubin UGT activity
         b. decreased bilirubin UGT activity
         c. Decreased bilirubin uptake and storage
         d. Impaired biliary excretion
         e. Decreased biliary excretion

12. Unconjugated hybilirubinemia is seen in:
       a. Crigler-Najjar syndrome
       b. Gilbert syndrome
       c. Dubin-Johnson syndrome
       d. Rotor syndrome
       e. Neonatal jaundice
                 i. 1,2,5
                ii. 1,2,3
               iii. 1,4,5
               iv. 1,2,4
                v. 3,4,5

13. Hepatorenal syndrome refers to:
       a. Primary renal carcinoma with liver metastasis
       b. Primary hepatocarcinoma with renal metastasis
       c. Acute pyelonephritis in patients with cirrhosis
       d. Acute renal failure in patients with severe liver disease in who there are no morphological or
            functional causes for the renal failure
       e. Chronic glomerulonephritis in patients with liver neoplasm

2007 kidney colloqvium

1. Adenomyosis
    a. Almost always contains functioning endometrium
    b. Occurs in most women about age of 30
    c. Often regress following menopause
    d. Is always asymptomatic
    e. Microscopic examination reveals heavy inflammatory infiltration

2. Choriocarcinoma
    a. May arise in men.
    b. Always follows invasive mole
    c. Is resistant to chemotherapy
    d. Is a proliferation of mesenchymal cells
    e. Is more common in Africa

3. Radial scar
    a. Is a benign epithelial proliferation.
    b. Is well demarcated and encapsulated
    c. Acini are lined with one cell layer
         d. Present severe cellular atypia
         e. has a very scanty fibrotic stroma

    4. Comedocarcinoma is a form of
        a. invasive ductal carcinoma
        b. invasive lobular carcinoma
        c. LCIS
        d. DCIS.
        e. Paget carcinoma

    5. The most common form of breast cancer
        a. lobular ca
        b. intraductal ca NOS.
        c. tubular ca
        d. mucinous ca
        e. medullary

    6. The worse prognosis among breast cancers presents
        a. papillary ca
        b. tubular ca
        c. medullary ca
        d. mucinous ca
        e. ductal NOS ca.

    7. Grading of invasive ductal breast carcinoma was first described by
        a. Clark staging for melanoma
        b. Breslow staging for melanoma
        c. Bloom
        d. ?
        e. Lauren

    -    Duke staging system- colon cancer
    -    Jewett-Whitmore system- prostate cancer
    -    Ann-Arbor system- lymphoma (blood)
    -    Cotswold system or Modified Ann Arbor Staging- Hodgkin’s disease
    -    FIGO, TNM, CIN- cervical cancer
    -    TNM- breast cancers, cervical cancers, colon cancers, kidney cancers, laryngeal cancers, lung cancers,
         melanomas, prostate, non melanoma skin cancers

8. Fibroadenoma
         a. typically occurs in postmenopausal women
         b. is immobile on palpation
         c. is a biphasic tumor.
         d. frequently transforms into carcinoma
         e. most commonly a multiple

9. Ectropion
         a. is a true erosion
         b. squamous epithelium is replaced by columnar epithelium.
         c. healing results in fibrosis
         d. metastasize in endometrium
         e. regress spontaneously after menopause

10. Prostatic adenocarcinoma
         a. is composed of large dilated glands
         b. glands are lined by two layers of the epithelium
         c. affects men in the age about 30
         d. involves perineural spaces
         e. difficulties in urination are the early clinical sign

11. Risk factors for squamous cell carcinoma of the uterine cervix
       1. nulliparity
       2. breast cancer
       3. HPV infection
       4. early and frequent sexual activity
TRUE answers are
       a. 1,2,3
       b. 2,3
       c. 1,3
       d. 3,4.
       e. 1,2,4


12. The commonest histologic type of RCC
        a. papillary ca
        b. clear cell carcinoma.
        c. oncocytic carcinoma
        d. metanephritic ca
        e. fibrosarcoma

13. NOT a germ cell tumor
       a. teratoma
       b. choriocarcinoma
       c. endodermal sinus tumor.
       d. folliculoma
       e. embryonal carcinoma

14. Granulosa cell tumor
        a. usually bilateral
        b. secretes progesterone
        c. contain Call-Exner bodies
        d. is always malignant

15. Brenner tumor involves
        a. female breast
        b. male breast
        c. ovary.
        d. uterine endometrium
        e. testis

16. Ectopic pregnancy is localized most commonly in
         a. oviductus
         b. right ovary
         c. left ovary
         d. abdominal peritoneum
         e. intestinal mesentery

17. Diabetic glomerulonephritis
        a. always leads to chronic renal failure
        b. results in diffuse thickening of the glomerular membrane and matrix expansion
        c. never leads to chronic reanl failure
        d. is related to amyloid deposits in the….
        e. occurs in all diabetic patients

18. In chronic pyelonephritis
         a. small abscesses are present in the….
         b. neutrophilic infiltrate is visible in the lumen of renal tubules
         c. occurs more frequently in men
         d. patient presents with high fever, pain…

19. Acute tubular necrosis
        a. is due to Alport syndrome
         b. presents with rapidly rising serum…
         c. all forms demonstrate polyuria
         d. leads to cortical necrosis
         e. none of the above.

    20. A well circumscribed breast carcinoma composed of poorly differentiated cells with prominent lymphocytic
    infiltrates
          a. tubular ca
          b. papillary ca
          c. medullary ca.
          d. mucinous ca
          e. invasive lobular ca




Cardio Lungs Endocrine 2007 credit version B

    1.   De Quervain thyroiditis
             a. Follows pregnancy
             b. Is called “palpation thyroiditis”
             c. Is characterized by extensive fibrosis
             d. Is typically self-limited, with recovery within few weeks.

    2.   Concentric myocardial hypertrophy is typical of:
            a. Acute ischemic disease
            b. Chronic ischemic disease
            c. Hypertensive heart disease.
            d. Mitral valve prolapse
            e. Angina pectoris

    3.   Which of the following statement is false?
            a. Genetic factors don’t play a role in determining pressure level.
            b. 90-95% of hypertension is idiopathic
            c. most of secondary hypertension is due to renal dysfunction
            d. Malignant hypertension is characterized by diastolic pressure over 120mmHg
            e. Renal artery stenosis induces renin secretion

    4.   The most common primary cardiac tumor in adults
             a. Mesothelioma
             b. Myxoma.
             c. Adenocarcinoma
             d. Lipoma
             e. Myelolipoma

    5.   Which of the following relationships is correct?
            a. Atelectasis – episodic reversible bronchospam
            b. Extrinsic asthma – lung collapse
            c. Bronchiectasis – permanent dilation of bronchi.
            d. Cystic fibrosis – exposure to asbestos
            e. Chronic interstitial lung disease – secretion of abnormal mucus

    6.   Bronchogenic carcinomas are classified into SCLC and NSCLC
             a. For therapeutic reasons .
             b. Because of differences in immunophenotype
             c. Because of localization
             d. All of the above
          e.   None

7.   NOT a feature of hyperparathyroidism
        a. GI disturbances ( constipation )
        b. Hypertension.
        c. Muscular weakness and hypotonia
        d. Depression or seizures
        e. Polyuria

8.   Cough, weight loss, a smoking history and hypercalcemia would be most consistent with a diagnosis of:
        a. Tuberculosis
        b. Metastatic lung disease
        c. Primary adenocarcinoma of the lung
        d. Primary squamous cell carcinoma of the lung.
        e. Bronchioalveaolar carcinoma of the lung

9.   NOT a morphologic feature of chronis ischemic heart disease?
        a. Enlarged heart
        b. Dilation of all cardiac chambers
        c. Multiple areas of myocardial fibrosis
        d. Myocardial hypertrophy
        e. Neutrophilic infiltrate.

10. Giant cell (temporal) arteritis
        a. Is less common of the vasculities
        b. Is a purulent inflammation
        c. Is rare before the age of 50.
        d. Is inherited in autosomal dominant trait

11. Which of the following relationships is correct?
       a. Wegener granulomatosis – Streptococci
       b. Microscopic polyangiitis – Arch of aorta
       c. Polyarteritis nodosa – a systemic vasculitis of small muscular arteries.
       d. Takayasu arteritis – MEN 1
       e. Buerger disease – multiple varicose veins

12. Not a complication of MI
        a. Papillary muscle dysfunction
        b. External rupture of the heart
        c. Mural thrombi and systemic emboli
        d. Ventricular aneurysm
        e. Chronic renal insufficiency.



Kidney, Reproductive system retake 2007


     1.   Not a disease presenting with nephrotic syndrome
              a. Minimal change glomerulopathy
              b. Focal segmental glomeruloscerosis
              c. Membranous glomerulopathy
              d. Diabetic glomerulosclerosis
              e. Hereditary nephritis.

     2.   Phyllodes tumor
              a. Is always malignant
              b. Epithelial component becomes malignant
              c. Is a small, slow growing tumor
              d. Distant metastasis are never seen
              e. Microscopically looks like FA with more stroma.
3.   LCIS
        a.    In 85% is multicentric
        b.    In 30% is bilateral
        c.    Is composed of the acini filled by monomorphic proliferation of small cells
        d.    25-30% of patients develop invasive ca
        e.    all of the above.

4.   Increased risk of breat ca is associated with
         a. Cystic changes
         b. Apocrine metaplasia
         c. Adenosis
         d. Duct ectasia
         e. Atypical epithelial hyperplasia.

5.   Paget disease of the nipple:
         a. Always involves the skin
         b. Is always accompanied with DCIS
         c. Sometimes is associated with invasive ca
         d. All of the above.
         e. None of the above

6.   “Indian File” is a characteristic feature of:
         a. invasive ductal ca NOS
         b. invasive lobular ca.
         c. DCIS
         d. LCIS
         e. Papillary ca

7.   Yolk sac tumor – FALSE?
         a. Is 2nd most common malignant tumor of germ cells.
         b. Is rich in α-fetoprotein
         c. Occurs in children and young women
         d. Grows rapidly and aggressively
         e. Secretes estrogens

8.   Most common renal calculi
        a. Calcium-containing stones.
        b. Struvite stones
        c. Uric acid stones
        d. Cystine stones
        e. Staghorn calculi

9.   Steroid-responsive nephrotic syndrome was diagnosed in a 4 yr old child. Renal biopsy reveals normal
     glomeruli (under the light microscope). What is your diagnosis?
         a. Crescentic glomerulonephritis
         b. Focal segmental glomerulosclerosis
         c. Minimal change disease
         d. Acute pyelonephritis.
         e. Berger disease

10. Most renal cell carcinomas originate from
       a. Glomeruli
       b. Tubules.
       c. Juxtaglomerular cells
       d. Renal calices
       e. Renal papillae

11. Cancer is least common and infection the most common disease in:
       a. Cervix
       b. Endometrium
         c.   Fallopian tube.
         d.   Ovary
         e.   Breast

12. Complete mole
       a. Is triploid
       b. Never gives rise to choriocarcinoma
       c. Contains fetal parts
       d. Involves all villi.
       e. Is more common in African countries

13. Prostatic adenocarcinoma
        a. Is composed of large dilated glands
        b. Glands are lined by two layers of epithelium
        c. Affects men in the age of about 30
        d. Involves perineural spaces.
        e. Difficulties in urination are the early clinical sign

14. The most common malignant tumor of the ovary is:
        a. Serous adenocarcinoma.
        b. Endometrioid carcinoma
        c. Brenner tumor
        d. Mucinous adenocarcinoma
        e. Dygerminoma

15. Pseudomyxoma peritonei is associated with
        a. all ovarian tumors of epithelial origin
        b. endometrioid carcinoma
        c. malignant mucinous tumor.
        d. embryonal carcinoma
        e. Brenner tumor

16. Dermoid cyst
       a. It’s a mature teratoma.
       b. It’s a choristoma
       c. Is of sex cord stromal cells origin
       d. Often transforms into adenocarcinoma
       e. None of the above

17. Spermatocytic seminoma
        a. Is highly malignant
        b. Affects young adults
        c. Histologically presents numerous anaplastic cells
        d. Is the most common variant of seminomas
        e. Has better prognosis than typical seminoma.

18. Thecoma-fibroma group tumors
       a. are stromal ovarian tumors
       b. are mostly benign
       c. produce estrogens
       d. can be associated with Meigs syndrome
       e. all of the above.

19. Hydronephrosis
       a. Can be congenital
       b. May be due to benign prostatic hypertrophy
       c. Leads to the renal parenchyma atrophy
       d. All of the above.
       e. None of the above

20. Acute tubular necrosis
                 a.   Is less common cause of acute renal failure
                 b.   Clinically presents with polyuria
                 c.   Is irreversible
                 d.   All of the above
                 e.   None of the above.

Hemodynamics

   1.   Brain infarct is an example of
            a. Balsera necrosis
            b. Coagulative necrosis
            c. Liquefactive necrosis
            d. Fibrinoid necrosis
            e. None of the above


   2.   Each type of necrosis is correctly paired with its most likely site of involvement EXCEPT
            a. coagulation- heart or kidney
            b. liquefaction- spleen or lung
            c. caseous- granulomatous inflammation
            d. fibrinoid- arterial walls
            e. enzymatic- pancreas

   3.   All of the following are characteristics of gout, EXCEPT
             a. higher incidence in women
             b. hyperuricemia
             c. involvement of great toe
             d. tophi
             e. painful arthritis

   4.   Fat embolism syndrome is characterized by
             a. pulmonary insufficiency
             b. neurologic symptoms
             c. anemia
             d. thrombocytopenia
             e. all of the above

   5. Morphologic manifestations observed in shock
          a. acute tubular necrosis of the kidney
          b. ischemic encephalopathy
          c. focal coagulation necrosis of the heart
          d. patchy mucosal hemorrhages in the gastric and colonic mucosa
          e. all of the above

   6.   Lipid deposition in hepatocytes in the course of passive liver congestion is due to
            a. toxins
            b. ischemia
            c. high fat intake in diet
            d. apoptosis
            e. none

   7.   Brown atrophy of the liver is accumulation of
           a. Melanin
           b. Lipofuscin
           c. Bile
           d. Hemosiderin
           e. Carbon

   8.   Metastatic calcification can occur in the course of
           a. increased secretion of parathyroid hormone
           b. destruction of bone
         c.   renal failure
         d.   none
         e.   all of the above

9.   Each of the following are appropriately matched, EXCEPT
         a. A-beta amyloid- Alzheimer disease
         b. AL- amyloid – multiple myeloma
         c. AA amyloid- rheumatoid arthritis of TBC
         d. ATTR- senile amyloidosis
         e. Involvement of the kidney (only) – localized amyloidosis

10. All the following characteristics are associated with cystic fibrosis, EXCEPT
         a. malabsorption
         b. biliary liver cirrhosis
         c. severe chronic bronchitis
         d. anemia
         e. infertility

11. Pompe disease is an example of
       a. protein degeneration
       b. mineral degeneration
       c. glycogen accumulation
       d. glucocerebroside accumulation
       e. none

12. Which statement is true?
       a. fatty streaks are composed of lipid-filled foam cells
       b. fatty streaks are always precursors or true plaques
       c. fatty streaks occur only in children
       d. fatty streaks don’t exist
       e. fatty streaks appear only in aortas

13. Macrophages in ATH
       a. are not important
       b. sometimes take part in the development of the plaques
       c. play a protective role
       d. adhere in endothelium and produce chemokines
       e. induce thrombosis

14. Dissecting hematoma may be related to
        a. Marfan syndrome
        b. Medial damage (necrosis)
        c. Hypertension
        d. All of the above
        e. None

15. Tissue damage, respomsible for pulmonary emphysema is due mostly to
        a. activation of proteases and free radicals
        b. acute bronchitis
        c. formation of granulomas
        d. activation of fibroblasts in fibrosis
        e. eosinophils


16. In hereditary hemochromatosis, all of the following organs are involved, EXCEPT
         a. liver
         b. pancreas
         c. adrenals
         d. testis
         e. joints
17. Heart failure cells, macrophages containing
        a. melanin
        b. hemosiderin
        c. lipofuscin
        d. bilirubin
        e. cystein

18. Which of the following is NOT a cause of fatty liver:
       a. obesity
       b. alcohol abuse
       c. passive congestion
       d. diabetes mellitus
       e. jaundice

19. Edema may be causes by
       a. decrease of hydrostatic pressure
       b. increase of oncocytic pressure of plasma
       c. decreased rennin-angiotensin-aldosteron secretion
       d. lymphatic obstruction
       e. all of the above


20. Embolic obstruction of middle-sized pulmonary arteries
       a. is always associated with pulmonary infarction
       b. is never associated with pulmonary infarction
       c. results in pulmonary hyperemia and hemorrhage
       d. always leads to sudden death
       e. is called “saddle embolus”


21. Red infarcts are found
        a. in tissue previously congested
        b. in tissues with a double circulation
        c. in tissues with venous occlusion
        d. in the lungs
        e. all of the above are true

22. Fat embolism:
         a. can be identified in patients after fracture of long bones
         b. is always associated with so called- fat embolism syndrome
         c. the diagnosis is confirmed by large number of fat globules in microcirculation of the lung and often
            in the brain and kidney
         d. is often associated with obstruction of large pulmonary arteries
         e. all of the above are true


23. Emboli causing pulmonary thromboembolism may originate from
       a. deep leg veins
       b. large arteries of lower limbs
       c. aorta
       d. left heart
       e. none of the above


24. TXA2, an important stimulus for platelet aggregation is secreted by
       a. endothelial cells
       b. basophils
       c. platelets
       d. macrophages
       e. neutrophils
    25. Which of the following conditions results in hypovolemic shock?
           a. sepsis
           b. severe hemorrhage
           c. head injury
           d. massive left ventricular infarction
           e. spinal cord injury



Pathology Final Exam Retake 2006


    1.   Giant cells may be present in:
             a. Granulation tissue
             b. Tuberculous granulomas
             c. Sarcoidoses
             d. deQuervain thyroiditis
             e. All of the above.

    2.   Deep circumscribed purulent inflammation is called:
            a. Abscess.
            b. Phlegmon
            c. Empyema
            d. Pyorrhea
            e. Ascites

    3.   What is an outcome of acute inflammation:
            a. Suppuration
            b. Resolution
            c. Transition necrotic inflammation
            d. Organization and repair by fibrosis
            e. All of the above.

    4.   Most common locally invasive tumour of the skin:
            a. Squamous cell carcinoma
            b. Keratoacanthoma
            c. Basal cell carcinoma. Infiltration and destruction of adjacent tiss
            d. Capillary hemangioma
            e. Seborrheic keratosis

    5.   Which of the following is not a cause of Fatty Liver:
            a. Obesity.
            b. Alcohol abuse
            c. Passive congestion
            d. Diabetes mellitus
            e. Janudice

    6.   Xanthomas accumulation of macrophages loaded with:
             a. Fat.
             b. Cholesterol
             c. Fibrin
             d. Lipofuscin
             e. Melanin

    7.   The non-inflammatory causes of edema:
             a. Increased hydrostatic pressure
             b. Hypoproteinemia
             c. Lymphatic obstruction
             d. Sodium retention
             e. All of the above
8.   Lacrimal gland destruction, xerostomia, enlargement of the salivary gland and secondary laryngitis are
     symptoms of:
         a. Sceroloderma
         b. CREST syndrome
         c. Sjorgren syndrome
         d. JRA
         e. None of the above

9.   Localized amyloidosis: Which sentence is TRUE:
         a. Is the most common form of the disease
         b. Is usually limited to one kidney
         c. Its another term for senile amylodosis
         d. Does not exist
         e. Involves lung, larynx, tongue or skin

10. All of the diseases listed below are preneoplastic disorders EXCEPT:
         a. Villous colonic adenomas
         b. Ulcerative colitis
         c. Bronchio squamous metaplasia
         d. Chronic atrophic gastritis
         e. Liver fatty change

11. Inflammatory breast carcinoma: Which statement is TRUE:
         a. Does not exist
         b. Shows extremely good prognosis
         c. Shows extremely bad prognosis
         d. Is always mucinous
         e. Involves only the skin of the nipple

12. Brenner tumour involves:
        a. Female breast
        b. Male breast
        c. Endometrium
        d. Ovary
        e. Testes

13. Mature cystic teratomas: Which is FALSE:
       a. Are germ cell tumours
       b. Are most commonly “dermatoid cysts”
       c. Secrete estrogens
       d. Arise in young women
       e. Most of them are unilateral

14. A cancer that is more common in women than in men:
        a. Liver cancer
        b. Urinary bladder cancer
        c. Stomach cancer
        d. Kidney cancer
        e. Thyroid cancer

15. Duodenal ulcers: Which is FALSE:
       a. Are not a cause of GI tract bleeding
       b. Are caused by helicobacter pylori infections
       c. Arise in zollinger-ellison syndrome
       d. Arise mostly in duodenal bulb
       e. Are related to prolonged NSAID

16. all the following are etiologic factors of liver chirrosis EXCEPT:
          a. alcoholic liver disease
          b. reye syndrome
          c. wilsons disease
        d.   viral hepatitis C
        e.   bile duct obstruction

17. Risk factors associated with carcinoma of the stomach include all of the following EXCEPT:
        a. Use of nitrites as food preservatives
        b. Pernicious anemia and (Addison-Biermer)
        c. Colonic metaplasia of gastric mucosa
        d. High intake of animal fat
        e. Chronic atrophic gastritis

18. All of the following statements describing salivary gland tumours are correctly matched except:
         a. Pleomorphic adenoma – most common tumour
         b. Adenolymphoma – warthins tumour
         c. Mucoepidermoid carcinoma – mixed tumour
         d. Adenoidcystic carcinoma – nerve infiltration
         e. Oncocytoma – eosinophilic cells

19. Mallory Weiss Syndrome:
        a. Is a preneoplastic condition
        b. Causes liver cirrhosis
        c. Is due to viral infection
        d. Causes hemorrhage
        e. Is due to hypersecretion of gastrin

20. Hyperthyroidism is caused by all the following except:
       a. Autoimmune diseases
       b. Surgery, radiation therapy or both
       c. Iodine deficiency
       d. Hereditary or developmental abnormalities
       e. Thyroid adenoma

21. Which of the following characteristics is associated with mening
       a. Multiple areas of demylination
       b. Multiple areas of necrosis and hemorrhage within the tu
       c. Psammoma bodies
       d. Peak incidence in early childhood
       e. Tumour cells arranged in rosettes

22. Which sentence is FALSE:
       a. Glomerulonephritis is most commonly caused by infectious agents
       b. Uremia may cause fibrinous pericarditis
       c. Acute renal failure is dominated by oliguria
       d. Nephritic syndrome is characterized by proteinuria
       e. Urinary tract infection runs with pyuria

23. Wilms tumour is a neoplasm of a/an:
       a. Kidney
       b. Ovary
       c. Bone marrow
       d. Salivary glands
       e. Adrenals

24. Oncocytes: Which sentence is TRUE:
       a. Its another term for neoplastic cells
       b. Derived from altered macrophages
       c. Secrete hormones
       d. Derived from mesenchymal tissues
       e. Are metaplastic cells

25. Brown atrophy of the liver is due to accumulation of:
       a. Bile
         b.   Lipofuschin
         c.   Fat
         d.   Hemosiderin
         e.   Melanin

26. Myocardial infarction is mostly:
       a. Enzyjmatic necrosis
       b. Passive congestion
       c. Coagulative necrosis
       d. Liquefactive necrosis
       e. Caseous necrosis

27. Niemann Pick Disease: Accumulation of :
       a. Fat
       b. Sphingomylin
       c. Mucopolysacharrides
       d. Glycogen
       e. Hemosiderin


28. The commonest one of the group of hereditary disorders characterized by the presence of the structurally
    abnormal Hb is a/an:
        a. Hemolytic anemia
        b. Spherocytosis
        c. Pernicious anemia
        d. Aplastic anemia
        e. Sickle cell anemia

29. Multiphocal destructive bone lesion throughout the skeletal system it’s a description of:
        a. Multiple myloma
        b. Hodgkins lymphoma (nodular sclerosis type)
        c. Polycythemia vera
        d. DIC
        e. None

30. Koilocytes (or cells showing koilocytosis):
        a. Cells accumulating glycogen
        b. Cells with perinuclear vacuolization due to a viral cytopathic effect
        c. Cells with intranuclear inclusion
        d. Cells with ground glass nuclei
        e. None

31. Which of the following relationships are correct:
       1. Emphysema – Restrictive lung disease
       2. Lack of surfactant – atelectasis
       3. bacterial pneumonia – carnification

         a.   all the above
         b.   none
         c.   1, 2
         d.   2, 3
         e.   1, 3

32. Fine needle aspiration biopsy of the thyroid shows giant multinucleated cells, granulocytes, histiocytes,
    altered thyrocytes and scanty colloid. Your diagnosis is:
         a. Pleomorphic anaplastic cancer
         b. Hyperthyroidism
         c. Adenoma
         d. Chronic autoimmune thyroiditis
         e. Subacute thyroiditis
33. Adrenocorticotropic hormone (ACTH) secretion may be associated with:
        a. Pheochromocytoma
        b. Islet cell carcinoma of the pancreas
        c. Small cell carcinoma of the lung
        d. Yolk sac tumor
        e. Mucinous gastric cancer

34. Ovarian mature teratomas: Which is FALSE:
       a. Secrete estrogens
       b. Are germ cell tumors
       c. Are most commonly dermatoid cysts
       d. Arise in young women
       e. Are mostly unilateral

35. the most common location of adenomatous polyps and adenocarcinoma in the GI tract is:
        a. esophagus
        b. stomach
        c. duodenum
        d. small intestine
        e. colon

36. Chronic glomerulonephritis, pheocromocytoma, Conn’s syndrome and acromegaly are all condition that may
    lead to:
         a. Hypertension
         b. Vasculitis
         c. Wegeners granulomatosis
         d. Thrombangiitis obliterans
         e. Venuous thrombosis

37. Which of the following term refers to a malignat tumor of mesenchymal tissue:
       a. Carcinoma
       b. Choristoma
       c. Hemartoma
       d. Sarcoma
       e. Teratoma

38. Occupational exposure to asbestos is linked to all of the following except:
       a. Bronchogenic carcinoma
       b. Malignant mesotheliomas
       c. Interstitial pulmonary fibrosis
       d. Tuberculosis
       e. Pleural fibrosis

39. In chronic pylonephritis, kidney parenchymal shows all of the following features except:
         a. Inflammatory infiltrates
         b. Abscess
         c. Dilation of tubules ( thyroidization)
         d. Periglomerular fibrosis
         e. Vascular changes due to associated hypertension

40. The commonest type of renal tumour in adults:
        a. Wilms tumour
        b. Adenoma
        c. Oncocytoma
        d. Clear cell carcinoma (papillary carcinoma, chromophobe carcinoma)
        e. Angiosarcoma

41. The term “medullary carcinoma” refers to:
        a. Bone marrow (medulla ossium)
        b. Thyroid and bone marrow
        c. Breast and 4th ventricle
         d.   Renal medulla and breast
         e.   Thyroid and breast

42. Brain tumour arising within one of the ventricular cavities is called:
        a. Meduloblastoma
        b. Ependymoma
        c. Oligodendroglioma (occurs in cerebral white matter)
        d. Meningioma
        e. Lymphoma

43. Lack of differentiation:
        a. Anaplasia
        b. Metaplasia
        c. Cataplasia
        d. Dysplasia
        e. Aplasia

44. The most common functioning neuroendocrine tumour of the pancreas:
        a. Gastrinoma
        b. VIP oma
        c. Insulinoma
        d. Carcinoid
        e. Somatostatinoma


45. “Nutmeg Liver”:
        a. Liver with multiple metastasis
        b. Liver military tuberculosis
        c. Chronic passive congestion
        d. Fatty change
        e. Hemochromatosis

46. Rheumatic fever: Which is FALSE:
       a. Involves mitral and aortic valves
       b. Causes pancarditis
       c. Causes arthritis
       d. Causes anemia
       e. Sometimes involves CNS

47. The commonest opportunistic infection in patients with AIDS is:
        a. Micobacterial pneumonia
        b. Pneumocystis carinii pneumonia
        c. CMV pneumonia
        d. Toxoplasmosis
        e. Pulmonary aspergillosis

48. Which of the following is characteristic of primary TB:
       a. Cavitation
       b. Ghon focus
       c. Miliary TB
       d. Diffuse caseation
       e. Bone marrow involvement

49. A typical granuloma resulting from infection with Myocbacterium TB is composed of all of the following
    except:
        a. Giant cells
        b. Central caseous necrosis
        c. Epithelioid macrophages
        d. Granulocytes
        e. Lymphocytes
50. Hepatitis B Virus can produce:
       1. Accute hepatitis
       2. Non progressive chronic hepatitis
       3. Progressive chronic hepatitis ending in sclerosis
       4. Fullminant hepatitis
       5. Asymptomatic carrier state

        a.   all of the above
        b.   1,2,3,4
        c.   3,4,5
        d.   1,3,5
        e.   1,2,5

				
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