Medex Pathology Mock Exam September 2023

1. The following disease(s) is/are examples of granulomatous inflammation:

2. Compensatory mechanism in shock include

Decrease in sympathetic activity

Depression of respiratory centre

Stimulation of Renin-Angiotensin

Decrease in antidiuretic hormone production

Increase catecholamine secretion

3. The following statement(s) is/are true regarding atherosclerosis:

An unstable plaque has high lipid core content

Histologically, it is characterized by fibrin cap

It involves the arterial tunica adventitia

It rarely occurs in coronary arteries

It rarely occur in menopausal women

4. The complication(s) of atherosclerosis of internal carotid artery include(s):

5. The following statement(s) is/are true regarding ischemic heart disease.

In myocardial infarction, the severity of ischemia is insufficient to cause death of heart muscle.

In unstable angina, the chest pain can be relieved by rest.

Prinzmetal angina is caused by muscle spasm of coronary artery.

Sudden cardiac death is usually caused by a lethal arrhythmia.

Stable angina is typically seen in <75% coronary artery occlusion.

6. The cause(s) of right heart failure is/are:

7. The following is/are true for congenital heart disease:

Atrial septum defect commonly causes cyanosis at birth

Risk for developing infective endocarditis is high

Intrauterine Rubella infection is one of the etiology for congenital heart disease

Paradoxical embolism is a complication of reverse shunt

50% of large ventricular septum defect can close spontaneously

9. Which of the following condition(s) is/are associated with hypochromic red cells?

10. The following statement(s) is/are true regarding megaloblastic anaemia:

Presence of hypersegmented neutrophils

Normochromic macrocytis red cells

Megaloblastic changes seen in bone marrow

Anisopoikilocytosis of red cells

Presence of fragmented red cells

11. In intravascular haemolysis

There is increase polychromatic red cells

The serum haptoglobulin is raised in intravascular haemolysis

The unconjugated bilirubin is raised

There is erythroid hypoplasia of the bone marrow

There is hemosiderinuria

12. In aplastic anaemia

There is leukocytosis

There is thrombocytopenia

Cyclophosphamide therapy is indicated

The bone marrow is replaced by fibrous tissue

Infections are common and can be life threatening

13. The following concern abnormal bleeding due to thrombocytopenia.

Superficial bleeding into the skin cut is typical.

Bleeding from a superficial skin cut is often excessive.

Gastrointestinal haemorrhage can occur.

Bleeding following tooth extraction is difficult to control.

A history of drug ingestion is important.

14. The following characterize the bleeding due to coagulation factor deficiencies.

Epistaxis is a frequent feature.

Bleeding into the knee joint ins one of the commonest presenting features.

Deep spreading haematomas are common.

Acute bleeding after trauma is typical.

A family history is important.

15. The following concern haemophilia (factor VIII deficiency):

If a haemophiliac male marries a normal female, all their daughters will be carriers.

The severity of bleeding is related to the factor VIII concentration.

Chronic arthritis is uncommon.

Haematomas can compress peripheral nerves.

It occurs more commonly than Christmas disease.

16. All of the following statement(s) correctly describe disseminated intravascular coagulation:

Widespread thromboses are characteristic

Widespread haemorrhages are characteristic

It most often presents as a primary (idiopathic condition).

The brain is the organ most often involved.

It is associated with mucin-secreting adenocarcinoma

17. The following statement(s) is/are true of acute leukaemia.

Acute lymphoblastic leukaemia is common in children

Myeloperoxidase stain is positive in some acute myeloid leukaemia.

Disseminated coagulopathy is a common complication.

Neutropenia is common

Hepatitis A is associated with T-cell leukaemia/lymphoma.

18. In chronic myeloid leukaemia (chronic phase)

Marrow aspirate shows increase in blasts.

Myelocytes can be seen in the peripheral blood.

Splenomegaly commonly occurs.

Basophilia is present.

There is dysplastic changes

19. In polycythaemia rubra vera

20. Plasma cell myeloma

Is a malignant plasma cell disease

Is commonly occur in children

Shows presence of paraprotein in the serum

Shows presence of paraprotein in the urine

Causing osteolytic bone lesions.

21. The following statement(s) is/are true of paraproteinaemia:

Bence Jones protein is heavy chain type immunoglobulin

It commonly occurs in benign conditions

Amyloid deposits in glomeruli and cause kidney disease

Paraprotein can be light chain type immunoglobulin.

Paraprotein of IgM class is the commonest type in plasma cell myeloma.

22. The following statement(s) is/are true of Hodgkin of lymphoma:

Bone marrow involvements indicate of stage 4 disease

Extranodal involvement more common compare to non-Hodgkin lymphoma

They have a better prognosis than Non-Hodgkin lymphoma

Lymph node section showed lymphoma cells surrounded by inflammatory cells

It spreads characteristically to the anatomically contiguous nodes

23. Regarding pulmonary embolism:

It is associated with patients with hypocoagulable states

Blood clots in large pulmonary artery is always embolic in origin

Indwelling central venous line is not a predisposing factor to pulmonary embolism

Saddle embolus is a large emboli lodged at the bifurcation of pulmonary artery.

Small pulmonary embolus usually would be lysed by the fibrinolytic system

24. The following are true of pulmonary tuberculosis:

The Ghon focus is a lesion of secondary TB

Fibro-cavitating lesions are seen in severe primary TB

Miliary TB shows massive haematogenous dissemination of TB to involve the liver, spleen and kidneys.

Primary TB usually heals by fibrosis

Secondary TB is usually a reinfection

25. The following are true of pulmonary edema:

Chronic pulmonary congestion is a cause

Patients present with dyspnoea

The alveolar spaces contain a granular pink precipitate

The lungs are wet and heavy

There is presence of interstitial fibrosis

26. The following statements(s) is/are true concerning fluid and electrolytes:

Haemolysed sample is a cause of hyperkalemia

Hyperkalemia is seen in chronic kidney disease

Patient’s total body sodium can be normal in hypernatremia

Hyponatremia is seen in hypothyroidism

Hyperkalaemia occurs in renal tubular acidosis

27. Metabolic acidosis

Is a common feature in ketosis

Commonly accompanies hypokalaemia

May be caused by starvation

Is a common cause of a normal anion gap

Is accompanied by a compensatory fall in PCO2

28. The following statements(s) is/are true regarding familial hypercholestrolaemia:

Hepatomegaly is a feature

It is due to genetic defect of low density lipoprotein receptor gene

Premature coronary artery disease is a complication

Serum total cholesterol level is elevated

Tendon xanthomata is a feature

29. Which of the following are recognised features or complications of acute renal failure in a previously healthy individual?

30. Which of the following statements about chronic kidney disease (CKD) are true?

The prevalence of CKD falls with age

Glomerular filtration rate is always normal

Diabetes mellitus is a major cause of CKD

CKD is associated with an increased risk of vascular disease

Most patients are symptomatic

31. Regarding type 1 diabetes mellitus:

Causes growth retardation in children

Usually presents at an older age

Is an autoimmune disease

Uncontrolled, almost all patients eventually develop retinopathy

Is associated with obesity

32. Gastro-esophageal reflux disease

Causes peptic ulcer of the lower esophagus

Causes reflux esophagitis

Is a complication of hiatus hernia

Is complicated by development of a squamous cell carcinoma of the esophagus

Results in goblet cell metaplasia of the lower esophagus

33. Carcinoma of the esophagus

Is a complication of achalasia

Most commonly affects the middle third of the esophagus

Of the lower third form glandular structures

Presents early with dysphagia

Spreads to the mediastinal lymph nodes

34. Complications of Helicobacter pylori infection include

35. Endometrial carcinoma:

The 5-year survival rate is 70% in stage 2 tumours.

Has an increased incidence in women with oestrogenic ovarian tumors

Has a peak incidence in the sixth decade

Rarely invades the myometrium

Has a higher incidence in multiparous women

36. Uterine leiomyomas:

Are the commonest tumours of the female genital tract

Are associated with high parity

May cause subfertility

May cause abnormal uterine bleeding

May measure up to 200 mm in diameter

37. Mucinous neoplasms of the ovary:

May be lined by intestinal-type epithelium

Are usually unilocular

Occur more frequently than serous neoplasms of the ovary

May give rise to pseudomyxoma peritonei

Are bilateral in 50% of cases

38. Following is/are cause(s) of localised collection of pus in the brain:

39. In hypertension, the following pathologic changes are seen in cerebral blood vessels:

40. Extradural haematoma

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Medex Pathology Mock Exam September 2023

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