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Basic Clinical Science Questions and Answers focuses on “General Pathology”.
1. A Histopathology lab will deal with _________
A. Cells
B. Tissues
C. Organs
D. Organ System
Answer: B
Clarification: Histology stands for the study of tissues while pathology stands for the study of diseases or abnormal conditions. Thus, the histopathology lab will deal with diseased or abnormal tissues.
2. What is the temperature which is maintained by the Freezers in the pathology labs?
A. 10℃ – 15℃
B. 0℃ – 10℃
C. -10℃ – -60℃
D. -100℃
Answer: C
Clarification: When pathological samples are collected, they may have to be stored for further study or for future use. They are stored at a temperature of -10℃ – -60℃. At this temperature, the solution used for preserving freezes without causing damage to the samples.
3. What solution is used to maintain sterility in labs?
A. Sodium Chloride
B. Sodium Hypochlorite
C. Sodium Cyanide
D. Sodium Sulphate
Answer: B
Clarification: Sodium Hypochlorite acts like a bleaching agent. When it is dissolved in water and used to clean the labs, it gives off nascent oxygen. This oxygen is highly reactive and dangerous to microbes. It destroys the microbes that may have grown in the lab. It also helps remove stains due to its reactive nature and thus reduces/destroys the environment for microbes to breed.
4. An electrophoresis machine is used to __________
A. separate DNA
B. separate blood components
C. separate the bone components
D. separate the muscle fibers
Answer: A
Clarification: An electrophoresis machine uses the charge present on the substance and the weight of the substance to separate the various components of the substance. The DNA strand is taken and broken at various places which is detected by markers. These strands all possess individual charges and weights. When a potential difference is developed across the two ends, the strands start moving according to their weight and charges. Thus, the strands of the DNA get separated.
5. Which of the following devices are used to maintain a sterile environment while working with microorganisms?
A. Laminar Airflow
B. Microwave oven
C. Water Bath
D. Incubator
Answer: A
Clarification: A laminar air flow is like a sterile work station. It has a UV lamp and the whole chamber is aerated with sterile air to destroy any unwanted microorganisms. When any work is being done with microorganisms, they are placed in a petridish and placed in the laminar air flow. This allows sufficient aeration to the organisms without posing danger to the scientists. The scientists can work on the organisms by using gloves and accessing the chamber via special small holes which are wide enough for only the arms to pass through. Thus, the body stays out while the work in being done. This allows for isolation and maintains sterility.
6. Which device is used to separate the components of blood?
A. auto analyzer
B. centrifuge
C. hematocrit
D. magnetic stirrer
Answer: B
Clarification: The various components of blood precipitate at various speeds. The centrifuge rotates at high speed and the components depending upon their density separate out. The high speed causes them to clump together and then they either float up or sink down.
7. How are the blood cells and plasma separated?
A. hematocrit
B. hot plate
C. centrifuge
D. water bath
Answer: A
Clarification: The blood is collected, heparin is added to it and then the blood is centrifugated at 10,000 RPM. Then the blood is left to settle down. The cells due to higher weight settle down and the plasma floats up. The RBCs have the highest density so they settle down at the bottom. Then comes a layer of WBCs and then platelets. The plasma is collected above the platelets.
8. The cells related to blood are collectively called as
A. oestoblast cells
B. concdrocyte cells
C. hematopoietic cells
D. megakaryocytes
Answer: C
Clarification: Hemato is a term that related to blood. All the cellular components of the blood originate from the hematopoietic cells. They are found in the bone marrow of the long bones and are self renewing in nature. These are also considered as stem cells as they can give rise to different types of cells.
9. Endocarditis in IV drug abusers typically
A. involves the mitral valve
B. is caused by candida albicans
C. does not cause fever
D. has a better prognosis than other types of endocarditis
E. is caused by staph aureus
Answer: E.is caused by staph aureus
10. The commonest cause of fungal endocarditis is
A. actinomycosis
B. as
C. as
D. candida
E. blatomycosis
Answer: D.candida
11. With regard to MI
A. gross necrotic changes are present within 3-5 hours
B. irreversible cell injury occurs in less than 10 minutes
C. fibrotic scarring is completed in less than 2 weeks
D. death occurs in 20 % of cases in less than 2 hours
E. is most commonly caused by occlusion of the left circumflex coronary artery
Answer: D.death occurs in 20 % of cases in less than 2 hours
12. Regarding pericarditis
A. constrictive pericarditis only rarely follows suppurative pericarditis
B. primary pericarditis is usually bacterial in origin
C. serous pericarditis may be due to ureamia
D. haemorrhagic pericarditis is most commonly due to Klebsiella infection
E. fibrinous pericarditis is due to TB until proven otherwise
Answer: C.serous pericarditis may be due to ureamia
13. Shock results in
Answer: D.decreased capillary hydrostatic pressure
14. Patient who has a normal blood pressure post MI must have
A. increased cardiac output
B. increased systolic filling pressure
C. increased right atrial pressure
Answer: B.increased systolic filling pressure
15. Acute endocarditis
A. has a less than 20 % mortality
B. is caused by virulent micro-organisms
C. 30 % is caused bacteria
Answer: B.is caused by virulent micro-organisms
16. Congestive cardiac failure may be caused by
A. vitamin A deficiency
B. niacin deficiency
C. vitamin D deficiency
D. thiamine deficiency
E. vitamin C deficiency
Answer: D.thiamine deficiency
17. Thromboctopenia
A. occurs commonly in HIV
B. causes spontaneous bleeding at levels of less than 90,000/mm
C. occurs with hyposplenism
D. is related to platelet survival in paroxysmal nocturnal haemoglobinuria
E. is not associated with megaloblastic anaemia
Answer: A.occurs commonly in HIV
18. A young man presents with central chest pain presumed to beassociated with vasoconstriction. The most likely cause of the pain is local
A. hypoxia
B. decreased ATP
C. increased CO2
D. catecholamines acting on alpha 1 receptors
E. acetylcholine stimulation
Answer: A.hypoxia
19. An adult male with an ejection fraction of 80 % could be due to
A. myocardial ischaemia
B. arrhythmia
C. thiamine deficiency
Answer: C.thiamine deficiency
20. Malignant hypertension
A. 75 % recover with no loss of renal function
B. is associated with abnormal renin levels
E. affects 1 to 5 % of sufferers
Answer: E.affects 1 to 5 % of sufferers
21. The cause of fluid retention peripherally with congestive cardiac failureis
A. increased renin
B. increased GFR
C. increased angiotensin 2
D. increased aldosterone
Answer: D.increased aldosterone
22. Rheumatic carditis is associated with
A. Curschmann spirals
B. Ito cells
C. Aschoff bodies
D. Nutmeg cells
E. Reed-sternberg cells
Answer: C.Aschoff bodies
23. Bradykinin
A. causes smooth muscle dilatation
B. kallikrein causes prohormone degredation to produce bradykinin
Answer: B.kallikrein causes prohormone degredation to produce bradykinin
24. Diabetes is associated with
A. carbuncles
B. mucormycosis
E. all of the above
Answer: E.all of the above
25. Pathogenesis of type 1 diabetes is associated with
A. decreased insulin sensitivity
B. abnormal glucokinase activity
C. no antibodies found at diagnosis
D. auto-immune insulitis
E. twin concordance greater than 70 %
Answer: D.auto-immune insulitis
26. In type 1 diabetes
A. associated organ-specific auto-immune disorders are common
B. a genetic susceptibility is not supported by evidence
C. Finnish children have a 70 fold increase compared with Korean children
D. Influenza and varicella viruses are suspected as initiators of the disease
E. Children who ingest cows milk early in life may have a lower incidence
Answer: C.Finnish children have a 70 fold increase compared with Korean children
27. Regarding pancreatitis
A. the second most common cause is infectious agents
B. trypsin is implicated as an activator of the kinin system
C. the chronic form is usually due to gallstones
D. duct obstruction is not the mechanism in alcoholic pancreatitis
E. elastase is the only pancreatic enzyme that acts to limit pancreatitis
Answer: B.trypsin is implicated as an activator of the kinin system
28. In acute pancreatitis
A. fat necrosis occurs in other intra-abdominal fatty deposits
B. trauma is the precipitating cause in 30 % of cases
C. alcohol is directly toxic to the Islets of Langerhans
D. Kallikrein converts trypsin to activate the complement system
E. Erythromycin has been implicated in severe cases
Answer: A.fat necrosis occurs in other intra-abdominal fatty deposits
29. With regards to jaundice
A. Conjugated bilirubin causes kernicterus in adults
B. Unconjugated bilirubin does not colour sclera
C. Unconjugated bilirubin is tightly bound to albumin
D. Unconjugated bilirubin produces bilirubin in urine
E. Conjugated bilirubin is tightly bound to albumin
Answer: C.Unconjugated bilirubin is tightly bound to albumin
30. In cirrhosis
A. fibrosis is confined to the delicate bands around central veins
B. nodularity is uncommon
C. vascular architecture is preserved
D. the Ito cell is a major source of excess collagen
E. the left lobe of the liver is most affected
Answer: D.the Ito cell is a major source of excess collagen
31. Cirrhosis is associated with
Answer: B.reorganised liver vasculature with scarring
32. Oesophageal varices
A. occur in one third of all cirrhosis patients
B. account for more than 50 % of episodes of haematemesis
C. are most often associated with hepatitis C cirrhosis
D. have a 40 % mortality during the first episode of rupture
E. lie primarily in the middle portion of the oesophagus
Answer: D.have a 40 % mortality during the first episode of rupture
33. Concerning acute tubular necrosis
A. cephalosporins are not a causative agent
B. nephrotoxic causes are associated with a poor prognosis
C. casts are found in the loop of Henle
D. rhabdomyolysis is not a cause
E. ischaemic tubular necrosis is uncommon after haemorrhagic shock
Answer: C.casts are found in the loop of Henle
34. Regarding acute tubular necrosis
A. it is associated with hyperkalemia not hypokalemia in recovery
B. non-oliguric has a better recovery
C. it is associated with ischaemic cortical cells
D. 80 % are associated with anuria
Answer: B.non-oliguric has a better recovery
35. Ischaemic tubular necrosis is associated with
A. maintenance stage with polyuria
B. predominantly proximal necrosis
C. intact basement membranes
D. tubular cast obstruction
E. distal necrosis only
Answer: D.tubular cast obstruction
36. Regarding the hepatorenal syndrome
A. it is irreversible
B. one loses the ability to concentrate urine
C. urine has a high sodium concentration
D. the urine is hyperosmolar
E. the favoured theory of it’s generation involves increased renal blood
Answer: D.the urine is hyperosmolar
37. Urolithiasis
A. presence of hypercalcemia implies renal insufficiency
B. a patient with leukemia is likely to make cystine calculi
C. calcium is the major component of 35% of calculi
D. struvite stones are made up of magnesium-ammonium-phosphate
E. the commonest cause of calcium oxalate stones is hypercalciuria
Answer: D.struvite stones are made up of magnesium-ammonium-phosphate
38. In pyelonephritis
A. 85 % of infections are caused by G-ve bacteria
B. uretral obstruction makes haematogenous infection less likely
C. uretral obstruction allows bacteria to ascend the ureter into the pelvis
D. infection is less likely during pregnancy
E. papillary necrosis and perinephric abscess are common seqelae
Answer: A.85 % of infections are caused by G-ve bacteria
39. Cushing syndrome is associated with
A. osteoporosis
B. general obesity
C. hypotension
Answer: A.osteoporosis
40. Macrocytic anaemia is associated with all the following except
A. Hyperthyroidism
B. Neoplasm
C. Folate and B12 deficiency
D. Pregnancy
E. EBV
Answer: E.EBV
41. Myositis ossificans
A. Morphologically resembles osteosarcoma
B. Resembles the repair process following a muscle tear
Answer: A.Morphologically resembles osteosarcoma
42. Hypothyroidism is associated with all of the following EXCEPT
A. cretinism
B. decreased hair growth
C. cold intolerance
Answer: B.decreased hair growth
43. Which of the following reactions is cell mediated
A. SLE
B. Arthus reaction
C. Anaphylaxis
D. Graft rejection
E. Goodpastures
Answer: D.Graft rejection
44. Myelefibrosis
A. causes decreased megakaryocytes
B. stimulates erythropoetin production
C. causes leukoerythroblastic anaemia
Answer: C.causes leukoerythroblastic anaemia
45. The commonest cause of thyroid carcinoma is
A. medullary
B. follicular
C. papillary
D. anaplastic
E. squamous
Answer: C.papillary
46. Stress fractures
A. do not incite a paracortical reaction
B. result from repetitive stresses or abnormal axial loading
Answer: B.result from repetitive stresses or abnormal axial loading
47. A performed mediator of inflammation is
A. Prostaglandin
B. Histamine
C. Leukotriene
D. Nitric oxide
E. Platelet activating factor
Answer: B.Histamine
48. In normal haemostasis
A. Factor V inhibits thrombosis
B. Alpha 2 microglobulin is antithrombotic
C. PGI2 favours platelet aggregation
D. Platelet aggregation is inhibited by von Willebrand factor
E. Tissue plasminogen activator is responsible for prothrombotic events
Answer: B.Alpha 2 microglobulin is antithrombotic
49. Mononuclear phagocytes
A. Are the predominant cells in three day old wounds
B. Are common in liver, spleen and pancreas
C. Produce fibroblast growth factor
D. Secrete interferon Y
E. Have a half life of one day
Answer: C.Produce fibroblast growth factor
50. Normal endothelial cells decrease platelet aggregation by secreting
A. Interleukin 1
B. von Willebrand factor
C. Prostacyclin
D. Factor V
E. Thromboplastin
Answer: C.Prostacyclin
51. Interleukin 1 causes
A. Neutropaenia
B. Decreased sleep
C. Decreased prostaglandin synthesis
D. Increased collagen synthesis
E. Decreased leukocyte adherence
Answer: D.Increased collagen synthesis
52. Thrombosis is potentiated by all of the following except
A. von Willebrand factor deficiency
B. Protein S deficiency
C. Antithrombin III deficiency
D. Thrombotic thrombocytopenia
E. Acute leukaemia
Answer: A.von Willebrand factor deficiency
53. Acute compensatory mechanisms in shock include all of the following except
A. Baroreceptor reflexes
B. Reverse stress-relaxation of vascular smooth muscle
C. The effects of increased aldosterone secretion
D. Activation of the renin-angiotensin system
E. The central nervous system ischaemic response
Answer: C.The effects of increased aldosterone secretion
54. The following are primary mediators of type I hypersensitivity reactions except
A. Adenosine
B. Neutrophil chemotactic factor
C. Heparin
D. Platelet activating factor
E. Acid hydrolases
Answer: D.Platelet activating factor
55. Malignant neoplasms
A. Are independent of hormonal influence
B. Are always composed of homogeneous cell lines
C. Arise from differentiated cells by a process of anaplasia
D. Display abnormal nuclei with pale nucleoli
E. Typically grow more rapidly than benign
Answer: E.Typically grow more rapidly than benign
56. Regarding metastasis
A. All carcinomas have the ability to metastasise
B. Highly invasive carcinomas rarely metastasise
C. Carcinomas typically spread via lymphatics compared with haematogenous spread
D. Tumour cells develop increased cohesiveness of their cell surface in the formation of cancer cell emboli
E. Cells involved in lymphatic dissemination release degradative enzymes
Answer: E.Cells involved in lymphatic dissemination release degradative enzymes
57. HIV infection
A. Is caused by rhinovirus
B. Results in increased CD4 and T cell memory
C. Results in inversion at the CD4-CD8 ratio
D. Increases immature precursors of CD4 and T cells
E. Causes a CD4-CD8 ratio close to 2
Answer: C.Results in inversion at the CD4-CD8 ratio
58. A typical feature of AIDS
A. Decreased delayed type hypersensitivity reaction
B. Lymphocytosis
C. Hypogammaglobulinaemia
D. Increase CD4 and T cells
E. Increase chemotaxis and phagocytosis
Answer: A.Decreased delayed type hypersensitivity reaction
59. In reversible cell injury, all are true except
A. ATP depletion is responsible for acute cellular swelling
B. Can cause myocardial cells to cease contraction within 60 seconds
C. ATP is generated anaerobically from creatine phosphate
D. Mitochondrial swelling and degranulation of ER are the hallmarks of irreversible cellular damage
E. Is associated with myelin figures
Answer: D.Mitochondrial swelling and degranulation of ER are the hallmarks of irreversible cellular damage
60. Metaplasia
A. Is irreversible
B. Is commonly a change from squamous to columnar epithelium
C. An example is the transformation of epithelial cells into chondroblasts to produce cartilage
D. Retinoids may play a role
E. Even if the stimuli is persistent, it is a benign lesion
Answer: D.Retinoids may play a role
61. In apoptosis
A. It involves physiologic and pathologic stimuli
B. Histologically, it involves coagulation necrosis
C. Its DNA breakdown is random and diffuse
D. Its mechanism involves ATP depletion
E. It involves an inflammatory tissue reaction
Answer: A.It involves physiologic and pathologic stimuli
62. Hyperplasia
A. Occurs after partial hepatectomy
B. Refers to an increase in the size of cells
C. Is always a pathologic process
D. Often occurs in cardiac and skeletal muscle
E. Usually progresses to cancerous proliferation
Answer: A.Occurs after partial hepatectomy
63. Metastatic calcification
A. Causes widespread tissue damage
B. Occurs with normal calcium levels
C. Can be caused by systemic sarcoidosis
D. Occurs in hypothyroidism
E. Is caused by drinking large quantities of milk
Answer: C.Can be caused by systemic sarcoidosis
64. Mumps virus is a
A. Adenovirus
B. Herpes virus
C. Paramyxovirus
D. Pox virus
E. Picornavirus
Answer: C.Paramyxovirus
65. Prothrombotic characteristics of endothelium include
A. Plasminogen activator
B. Prostacyclin
C. von Willebrand factor
D. Thrombomodulin
E. Heparin like molecules
Answer: C.von Willebrand factor
66. Regarding giant cell arteritis, which statement is not correct
A. Affects medium arteries
B. Affects small arteries including vertebral
C. Affects small arteries including ophthalmic
D. Has an increased prevalence of HLA-DR4
E. Has no gastrointestinal manifestations
Answer: E.Has no gastrointestinal manifestations
67. All of the following organisms cause a clinical effect via the production of an exotoxin except
A. Clostridium tetani
B. Staphylococcus aureus
C. E. coli
D. Pseudomonas aerugenosa
E. Vibrio cholera
Answer: D.Pseudomonas aerugenosa
68. Select the true statement concerning atherosclerosis
A. Congenital absence of LDL cholesterol leads to premature atherosclerosis
B. Thoracic aorta is more likely to be involved than the abdominal
C. Fatty streaks appear in the aortas of children as young as 1 year
D. Fatty streaks are destined to become atherosclerotic plaques
E. Endothelial disruption always precedes atheroma development
Answer: C.Fatty streaks appear in the aortas of children as young as 1 year
69. Select the false statement concerning atherosclerosis
A. Familial hypercholesterolaemia is associated with inadequate hepatic uptake of LDL
B. CMV has been detected in human atheromatous plaques
C. Fibrous atheromatous plaques are capable of regression
D. Foam cells can be considered to be specialised macrophages
E. Atherosclerosis is associated with medial calcific sclerosis
Answer: E.Atherosclerosis is associated with medial calcific sclerosis
70. An infectious complication of transfusion
A. Is most commonly Hepatitis C
B. Is most commonly Hepatitis B
C. Is rarely transmission of HIV since screening was instituted
D. Never includes gonorrhoea or malaria
E. Can be clinically apparent mononucleosis in about 7% of cases
Answer: A.Is most commonly Hepatitis C
71. Which of the following is true concerning rhabdomyolysis
A. It is caused by injury to smooth muscle
B. Its diagnosis depends on the presence of characteristic physical findings
C. The final common pathway of injury involves damage to the sarcolemma
D. Renal failure is due to acute glomerular nephritis
E. Occurs only in trauma
Answer: C.The final common pathway of injury involves damage to the sarcolemma
72. Neutrophilia is generally caused by all of the following except
A. Inflammatory disease
B. Bacterial infection
C. Viral infection
D. Corticosteroids
E. Stress
Answer: C.Viral infection
73. Which of the following is true of chronic myeloid leukaemia
A. Most common leukaemia
B. Decreased leukocyte alkaline phosphatase level
C. Usually occurs in patients less than 40 years old
D. Increased WBC count with an abnormal differential
E. Rarely associated with the Philadelphia chromosome
Answer: B.Decreased leukocyte alkaline phosphatase level
74. All of the following are cardiac compensatory responses that occur in heart failure except
A. Cardiac muscle fibre stretching
B. Increased adrenergic receptors on cardiac cells
C. Chamber hypertrophy
D. Decreased heart rate
E. Increased vasopressin levels
Answer: D.Decreased heart rate
75. Shock in burn patients is primarily due to
A. Neurogenic factors
B. Hypovolaemia
C. Acute erythrocyte haemolysis
D. Myocardial depression factor
E. All of the above
Answer: E.All of the above
76. The immediate lethal dose of radiation exposure for humans in a non-mass casualty situation is
A. 50 rads
B. 150 rads
C. 250 rads
D. 350 rads
E. 450 rads
Answer: E.450 rads
77. With regard to apoptosis, which of the following is incorrect
A. it may be regarded as a normal physiological process
B. it is characterised by chromatin condensation
C. it often elicits a strong inflammatory response
D. it is the process by which ovaries atrophy in post menopausal women
E. it is characterised by cell shrinkage
Answer: C.it often elicits a strong inflammatory response
78. With regard to the acute inflammatory response, which is the most common mechanism of vascular leakage
A. endothelial cell contraction
B. junctional retraction
C. direct injury
D. leukocyte-dependent leakage
E. regenerating endothelium
Answer: A.endothelial cell contraction
79. With regard to cellular injury, all of the following are reversible except
A. decreased ATP
B. intracellular release of lysosomal enzymes
C. decreased Na pump activity
D. detachment of ribosomes
E. ER swelling
Answer: B.intracellular release of lysosomal enzymes
80. With regard to the role of complement in the acute inflammatory response, which of thefollowing is incorrect
A. C5a is a powerful, chemotactic agent for neutrophils, monocytes and eosinophils
B. C5a increases leukocyte adhesion to endothelium by activating leukocytes
C. C3a and C5a are called anaphylatoxins because they cause mast cell degranulation
D. C3a activates the lipoxygenase pathway in leukocytes
E. C3 and C5 can be activated in inflammatory exudate by lysosomal enzymes
Answer: D.C3a activates the lipoxygenase pathway in leukocytes
81. Coagulative necrosis
A. results from necrosis in which cellular enzymatic digestion predominates over denaturation
B. is characterised by a marked leukocytic infiltrate
C. is uncommon after myocardial infarction
D. usually occurs after irreversible ischaemic cellular damage
E. is not usually seen in association with caseous necrosis
Answer: D.usually occurs after irreversible ischaemic cellular damage
82. Granulomatous inflammation
A. may sometimes be a component of the acute inflammatory response
B. indicates the presence of tuberculosis
C. consists, in part, of microscopic aggregates of transformed lymphocytes
D. is always associated with the presence of giant cells
E. may result from non-immune mechanisms
Answer: E.may result from non-immune mechanisms
83. Removal of sutures from a wound at day 7 coincides with a wound strength of
A. 1% of unwounded skin strength
B. 10% of unwounded skin strength
C. 50% of unwounded skin strength
D. 75% of unwounded skin strength
E. 100%, ie. same as unwounded skin
Answer: B.10% of unwounded skin strength
84. In a healthy individual over the age of 5 years, lymphocytes are mainly found in
A. bone marrow, thymus, spleen
B. liver, thymus, spleen
C. lymph nodes, spleen, thymus
D. bone marrow, spleen, liver
E. liver, spleen, pancreas
Answer: C.lymph nodes, spleen, thymus
85. With regard to natural killer lymphocytes
A. constitute less than 5% of blood lymphocytes
B. require opsonisation to enable their killing of cells
C. have a prime role in defense against parasites
D. require prior sensitisation to be effective
E. have an innate ability to lyse tumour cells and virally affected cells
Answer: E.have an innate ability to lyse tumour cells and virally affected cells
86. With regard to B lymphocytes
A. they constitute 50% of circulating lymphocytes
B. they are found in germinal centres in the red pulp of the spleen
C. they are genetically programmed to recognise specific antigens by means of antigen specific cell surface receptors
D. they release chemical mediators when attached to IgE Type I hypersensitivity reactions
E. they are not affected by HIV infection
Answer: C.they are genetically programmed to recognise specific antigens by means of antigen specific cell surface receptors
87. Transplant rejection involves
A. Type IV hypersensitivity only
B. Type IV and III hypersensitivity only
C. Type IV, III and II hypersensitivity only
D. Type IV and II hypersensitivity only
E. Type II and III hypersensitivity only
Answer: C.Type IV, III and II hypersensitivity only
88. Major immune abnormalities associated with HIV infection include all of the following except
A. hypergammaglobulinaemia
B. inversion of CD4-CD8 ratio
C. decreased delayed hypersensitivity reactions
D. decreased monocyte HLA class II expression
E. decreased IL2 and IFNγ production
Answer: A.hypergammaglobulinaemia
89. Successful immune response to HIV during the acute phase of infection results from
A. increase in the CD4+ lymphocyte numbers
B. appearance of anti-HIV antibodies
C. Type III hypersensitivity reaction
D. lymphoid tissue based destruction of infected cells
E. development of CD8+ virus specific cytotoxic cells
Answer: E.development of CD8+ virus specific cytotoxic cells
90. With respect to macrophages, which of the following is not true
A. they can produce TNF and IL4 both of which cause fever
B. they have direct tissue toxicity due to the ability to release hydrogen peroxide
C. they have oxygen dependent microbicidal activity
D. they have cytotoxicity against tumour cells
E. they process antigens and act as antigen presenting cells to activate lymphocytes
Answer: A.they can produce TNF and IL4 both of which cause fever
91. In viral hepatitis
A. the majority of cases of acute Hepatitis B infection result in a carrier state, without clinical evidence of disease
B. anti HB s appears in the first week of infection
C. anti HCV IgG does not confer immunity to Hepatitis C
D. the major cause of death from Hepatitis B is hepatocellular carcinoma
E. Hepatitis A virus has an outer surface envelope of protein, lipid and carbohydrate
Answer: C.anti HCV IgG does not confer immunity to Hepatitis C
92. The most common cause of pericarditis is
A. SLE
B. drug hypersensitivity
C. trauma
D. post myocardial infarction
E. bacterial
Answer: D.post myocardial infarction
93. All of the following are neoplastic syndromes associated with lung cancer except
A. Cushing’s syndrome
B. syndrome of inappropriate ADH secretion
C. hypocalcaemia
D. carcinoid syndrome
E. hypertrophic osteoarthropathy
Answer: C.hypocalcaemia
94. All of the following are features of rheumatic fever except
A. carditis
B. subcutaneous nodules
C. erythema nodosum
D. elevated antistreptolysin
E. aschoff bodies in the heart
Answer: C.erythema nodosum
95. Mediators of septic shock include all of the following except
A. IL6
B. C5a
C. PAF
D. catecholamines
E. TNF antibodies
Answer: E.TNF antibodies
96. Metaplasia is seen in all of the following except
A. respiratory epithelium of cigarette smokers
B. vitamin A excess
C. Barrett’s oesophagitis
D. epithelium of a pancreatic duct containing stones
E. foci of cell injury
Answer: B.vitamin A excess
97. The commonest site of a Berry aneurysm in the Circle of Willis is
A. junction of anterior cerebral and anterior communicating arteries
B. junction of middle cerebral and internal carotid arteries
C. bifurcation of the basilar artery
D. the middle cerebral artery
E. junction of the posterior cerebral and posterior communicating arteries
Answer: A.junction of anterior cerebral and anterior communicating arteries
98. The virus causing molluscum contagiosum belongs to the following viral family
A. adeno
B. herpes
C. parvo
D. pox
E. picorna
Answer: D.pox
99. Most pulmonary emboli
A. cause centrally located pulmonary haemorrhage
B. cause pulmonary infarction
C. cause acute right heart failure
D. are clinically silent
E. lead to pulmonary hypertension
Answer: D.are clinically silent
100. Acute pancreatitis
A. may be caused by Helminth infection
B. causes hypercalcaemia
C. develops in 50% of patients with gallstones
D. leads to inhibition of elastase
E. involves acinar cell injury as a late event
Answer: A.may be caused by Helminth infection
101. Which of the following is not a para-neoplastic syndrome associated with lung carcinoma
A. ectopic ADH secretion
B. dermatomyositis
C. migratory thrombophlebitis
D. Eaton-Lambert (myasthenic) syndrome
E. thrombocytosis
Answer: E.thrombocytosis
102. Which of the following tumour is benign
A. chondrosarcoma
B. osteochondroma
C. chondroblastoma
D. Ewing’s tumour
E. none of the above
Answer: B.osteochondroma
103. Which of the following is not a feature of acute Crohn’s disease
A. segmental lesions
B. serosal involvement
C. fissures penetrating deep into the wall of affected mucosa
D. inflammatory pseudo-polyps
E. epithelioid granulomata
Answer: D.inflammatory pseudo-polyps
104. A 50-year old woman presents with back pain. X-rays suggest a malignant deposit in the 10th thoracic vertebra. The least likely primary site is
A. breast
B. ovary
C. thyroid
D. kidney
E. colon
Answer: D.kidney
105. Regarding haemorrhagic infarction of the brain, which of the following is not true
A. it usually results from an embolic event
B. it usually contains multiple petechial haemorrhages which may be confluent
C. the distinction between this and non haemorrhagic infarcts is clinically insignificant
D. the haemorrhages are presumed to be secondary to reperfusion injury
E. the size of it will depend in part upon the collateral blood supply to that area
Answer: C.the distinction between this and non haemorrhagic infarcts is clinically insignificant
106. The histological appearance of contraction brands in association with acute myocardialinfarction indicate
A. previous old myocardial infarctions
B. early aneurysmal formation
C. compensatory responses to decreased myocardial contractility
D. a right ventricular infarct
E. recent reperfusion therapy
Answer: E.recent reperfusion therapy
107. After occlusion of a coronary artery
A. the ischaemia is most pronounced in the epicardial region
B. loss of contractility only occurs when ultra structural changes in the myocyte are present
C. reperfusion of the ischaemic area can result in new cellular damage, due to the generation of oxygen free radicals
D. Q waves on the ECG are diagnostic of transmural infarction
E. none of the above are true
Answer: C.reperfusion of the ischaemic area can result in new cellular damage, due to the generation of oxygen free radicals
108. With regard to aortic dissection, which is incorrect
A. it tends to occur in 40-60 year old men
B. approximately 90% of non-traumatic cases occur in patients with antecedent hypertension
C. it is usually associated with marked dilatation of the aorta
D. it is unusual in the presence of substantial atherosclerosis
E. it is usually caused by an intimal tear within 10cm of the aortic valve
Answer: C.it is usually associated with marked dilatation of the aorta
109. The most common site of origin of emboli causing cerebrovascular disease is
A. common carotid artery
B. internal carotid artery
C. the heart
D. either end of basilar artery
E. intracranial vessels
Answer: C.the heart
110. Which of the following is malignant
A. Squamous cell papilloma
B. Hydatidiform mole
C. Chondroma
D. Mature teratoma
E. Bronchial carcinoid
Answer: E.Bronchial carcinoid
111. Anaplasia is not characterised by
A. pleomorphism
B. Abundant nuclear DNA
C. A nuclear-cytoplasmic ratio of 1:6
D. Coarsely clumped chromatin
E. Lack of differentiation
Answer: C.A nuclear-cytoplasmic ratio of 1:6
112. All of the following are precancerous except
A. Chronic gastritis of pernicious anaemia
B. Solar keratosis
C. Crohn’s disease
D. Leukoplakia
E. Chronic ulcerative colitis
Answer: C.Crohn’s disease
113. Prothrombogenic factors include all of the following except
A. Platelet activating factor
B. Von Willebrand factor
C. Nitric oxide
D. Tissue factor
E. tPA inhibitor
Answer: C.Nitric oxide
114. In acute inflammation, all of the following are true except
A. there is contraction of endothelial cells
B. there is a mononuclear infiltrate
C. there is induction of adhesion molecules on endothelium
D. there is production of arachidonic acid metabolites
E. cytokines induce a systemic acute phase response
Answer: B.there is a mononuclear infiltrate
115. Cellular events in acute inflammation include all of the following except
A. redistribution of preformed adhesion molecules to the cell surface of leukocytes
B. adhesion and transmigration of leukocytes to endothelium
C. leukocyte activation
D. margination of macrophages to vessel walls
E. extracellular release of lysosomal enzymes and products of arachidonic acid metabolism
Answer: D.margination of macrophages to vessel walls
116. The factor conferring the most risk in thromboembolic disease is
A. smoking
B. atrial fibrillation
C. oral contraceptives
D. prolonged bed rest
E. late pregnancy / post delivery
Answer: D.prolonged bed rest
117. Systemic lupus erythematosus
A. has a female : male gender ratio of 2:1
B. is characterised by antinuclear antibodies (ANAs)
C. rarely involves the kidney
D. is associated with a seronegative arthropathy causing marked joint erosion
E. is commonly fulminant with death in weeks to months
Answer: B.is characterised by antinuclear antibodies (ANAs)
118. The most common cause of Traveller’s diarrhoea is
A. Rotavirus
B. E.coli
C. Shigella
D. Salmonella
E. Giardia
Answer: B.E.coli
119. Iron deficiency anaemia features
A. a normal haematocrit
B. increased serum ferritin
C. normal mean red cell volume
D. low platelet count
E. none of the above
Answer: E.none of the above
120. Platelets
A. have a normal concentration range in peripheral blood of 80-100 x 103/mm3
B. are important in haemostasis only
C. remain viable in stored blood for 24 hours only
D. normally are removed from the circulation almost entirely by the spleen
E. have an average lifespan of average 20 days
Answer: C.remain viable in stored blood for 24 hours only
121. In compensated heart failure
A. right atrial pressure drops
B. maximum cardiac output is unchanged
C. resting cardiac output is unchanged
D. renin level eventually drops below premorbid level
E. fluid retention plays no role
Answer: C.resting cardiac output is unchanged
122. Infective endocarditis
A. in the acute form, is most commonly caused by streptococci
B. involves abnormal valves in most acute cases
C. is confirmed by positive blood cultures in less than 50% of cases
D. may cause splenic infarction
E. may cause MacCallum’s plaques to form on affected valves
Answer: D.may cause splenic infarction
123. Cor Pulmonale may be caused by
A. congenital heart disease
B. mitral stenosis
C. left ventricular failure
D. primary pulmonary hypertension
E. aortic regurgitation
Answer: D.primary pulmonary hypertension
124. Regarding peptic ulceration
A. it occurs most commonly in the antrum of the stomach
B. it has a strong genetic influence
C. there is H. pylori infection of the mucosa in 50% of patients with duodenal ulceration
D. it is more frequent in patients with chronic obstructive pulmonary disease
E. gastric acid is the only prerequisite for formation of ulcers
Answer: D.it is more frequent in patients with chronic obstructive pulmonary disease
125. The features of bronchogenic carcinoma include
A. the classification of “oat cell” tumour within the large cell type
B. high initial response to chemotherapy for small cell type
C. the strongest correlation with cigarette smoking in the adenocarcinoma type
D. that 50% of small cell type occur in nonsmokers
E. histological features identical in small cell carcinomas and squamous cell types
Answer: B.high initial response to chemotherapy for small cell type
126. The major abnormalities of immune function in AIDS are characterised by
A. Inversion of the CD4-CD8 ratio
B. Increase in the number of memory T cells
C. Hypogammaglobulinaemia and decreased circulating immune complexes
D. Decreased secretion of TNF and IL-1
E. All of the above
Answer: A.Inversion of the CD4-CD8 ratio
127. Regarding hypersensitivity reactions
A. In anaphylaxis, IgE is bound to mast cells by their Fab portions to release vasoactive amines
B. Goodpasture’s syndrome is an example of type III hypersensitivity reaction
C. Farmer’s lung is a type III reaction to micropolyspora species
D. Delayed hypersensitivity is mediated by macrophages
E. The Mantoux reaction is a form of contact hypersensitivity
Answer: C.Farmer’s lung is a type III reaction to micropolyspora species
128. Acute appendicitis
A. In preschool children, it usually presents with the so-called “classic” signs and symptoms
B. It is associated with appendiceal obstruction in 10% of cases
C. Histologically, it shows neutrophilic infiltration of the muscularis layer
D. The clinical diagnosis is falsely positive in about 50% of cases
E. It cannot cause liver abscesses
Answer: C.Histologically, it shows neutrophilic infiltration of the muscularis layer
129. Pneumocystis carinii
A. Produces pneumocystis pneumonia in normal persons
B. Causes a Ghon’s focus in the lung
C. Causes patchy atelectasis
D. Is a fungus
E. Attaches selectively to Type II alveolar cells
Answer: D.Is a fungus
130. Regarding septic shock
A. Endotoxin is the only cause
B. Marked vasoconstriction occurs in the non-infected tissue
C. Cardiac output is low in 75% of patients
D. Endotoxin entering the circulation causes an effect very similar to anaphylaxis
E. Blood viscosity is unchanged
Answer: D.Endotoxin entering the circulation causes an effect very similar to anaphylaxis
131. Acute pancreatitis
A. Is associated with increased serum amylase concentration without elevation in serum lipase concentration
B. Occurs most often in later life
C. Occurs in about 5% of patients with gallstones
D. When associated with alcohol is not usually preceded by chronic pancreatitis
E. Is often associated with hypercalcaemia
Answer: C.Occurs in about 5% of patients with gallstones
132. The acute nephritic syndrome has all of the following features except
A. Proteinuria
B. Haematuria
C. Hypertension
D. Hyaline casts
E. Oliguria
Answer: D.Hyaline casts
133. A young baby presents with jaundice, dark urine and pale stools. He is most likely to have
A. Physiologic jaundice of the newborn
B. Breast milk jaundice
C. Gilbert’s syndrome
D. Biliary atresia
E. None of the above
Answer: D.Biliary atresia
134. With regard to the leukocyte extravasation of the acute inflammatory response, which of the following is incorrect
A. ELAM-1 is a selectin found on endothelium
B. E and P-selectins bind to oligosaccharides found on neutrophils and monocytes
C. L-selectin is found on neutrophils, monocytes and lymphocytes
D. ICAM-1 belongs to the immunoglobulin family of molecules, and is found on leukocytes
E. VCAM-1 binds to integrins
Answer: D.ICAM-1 belongs to the immunoglobulin family of molecules, and is found on leukocytes
135. IgE mediated Type I hypersensitivity reactions require the action of which lymphocyte class
A. B only
B. CD8 T cells and B cells
C. Tµ2 T cells and B cells
D. Tµ1 T cells and B cells
E. Natural Killer cells and B cells
Answer: C.Tµ2 T cells and B cells
136. Smoking is associated with
Answer: D.particle deposition in alveolar macrophages