UNIVERSITY OF SANTO TOMAS FACULTY OF MEDICINE AND SURGERY DEPARTMENT OF PATHOLOGY MEDICAL BOARD REVIEW 2016 PATHOLOGY MOCK EXAMINATION 2016 Name: Lach Date. INSTRUCTIONS; ? CS 1. Check if you have 100 different questions in your questionnaire once you get it and immediately inform your proctor if you are missing a page 2. Transfer all answers to the computerized answer sheet. 3. DO NOT FORGET TO WRITE AND MARK DOWN THE LETTERS OF YOUR NAME IN ‘THE COMPUTERIZED ANSWER SHEET. CHOOSE THE BEST ANSWER: Shade the letters corresponding to your answers. her answer sheet. ~ 4. The pleura that surrounds the lung tissue with long standing exposure to asbestos may develop a malignancy composed of: SS AA Mesotheliai cells C. Mesenchymatgells Endothelial cells D. Hematopoietic cells ~ 2 2 Women exposed tof Smokelcommonly RaveioA ie type of malignancy? A. Squamous cells carcinoma ‘\. ©, Adgndtarcinoma B. Hamartoma 2. Sarcoma \\k PxOiaawn ef wegotiobal coils oy} 3 _Poeural fd eytology resulting from a patonyaith severe ARDS will show Polymorphonuclear inflammatory cells adntfked with alveolar epithelial cells in fibrin 8. Mononuclear inflammatory cells admixed with some mesothelial cells in fibrin C. Lymphocytes and red blood ceils imfimexudates AQ Aceliuiar transudate 7 8 4 Mycobacterium tuberculosis may mafifest as an infection or disease. A patient is yeled as having the dis means: a zg He has a + culture mae 6 4S He has a + culture for MTB plus signs and symptoms C. Hehas a+ 3t but not symptomatic D. Hehasa+ with coryza : > juckos ld B85, Agraini mph nodes showing esa mace and giant cells on histology i: ‘A. Granulation tissue C. Scleroderma r. Scrofuloderma D. Sentine! node 7 fA__ 8. 2a year old medical was rushed to the emergency room because o! dyspnea. nary PE revealed patient in respiratory distress with marked expiratory wheezes Which is the likely clinical impression? AC Bronchial asthma CARDS ‘B. Bacterial pneumonia D. Pneumothorax Ben, ‘A2 year old boy was admitted to the hospital because of dyspnea. The mother says that the child had high grade fever and cough since 3 days ago, unable to eat and very irritable. PPE revealed a child in respiratory distress, highly fibrile with chills. Auscultation shows crepitantrales on both lungs. Which is the likely diagnosis” A. Bronchial asthma C. Neoplasm BC Pneumonia D. Pneumothorax4 A 8 A22yearol (ually active male was ted because of respiratory distre He has productive gough and is seropositive fox HIV dnd culture = fOrNQTEY Direct microscopy of submitted expectorates infection. Identify the pathogen. Pneumocystis carinii C. Escherichia coli B. Entamoebahistolytica D. Giardia lamblia bans I Thy 9 A30year ing executive came down with high grade i) productive Gough) and severe dfspnea warranting admi he _Chest radio-graph show Confluent in the upper lobe. [ Differential diagnosis jwould include which of the following? S K. Lobar pneumonia et B. Pulmonary tuberculosis, C. Small cell malignancy consider oat cell carcinoma : Ml Re aoe, ft i) 10. Cardiac damage may be seen intreptococcal infection of the throat due to which mechanism? AY A. Direct cytopathic change induced by the microorganism B. Fibrin deposited in the cardiac interstitium due to healing is chemotactic for neutrophils \ C. Non-specific immunoglobulins attach to the tissues and induce antibodylependent cell-mediated cytotoxicity . Specific antibodies developed in the imrgune response stig Sic aniacieaves forthe bacterial antigens Tugs L ftyerceacitainy” Xp c (C.11.1n congestive heart failure chronic phase, which celliof evidence is found in the lung? A. Neutrophil 2-Macrophage a/reeiae. B. Red Blood Cells D.Pheumocyte — ‘ 7 O12. Failure of which side of the heart is congested abdominal viscera (early phase) a prominent feature of? Bites Ser A. Lateral ” C. Left B. Medial DB Right 13. The central grumous (ere atndraacteroti plaque is rich in which of these? RP) neo! avg, A. Necrotic debris \ C. Smooth muscle cells B. Fibrous tissue D_Lipids vA D 14. The typical clinical presbaayjon patients with congenital heart defect is which of these? A. Cyanosis . Murmur B. Dyspnea i (D Fever yj fA 15.4 600%ram hear with dilatation ofall four chambers with no other clinical findings is with which pathology of the heart? eae ©. Viral myocardit:, No fire y ‘ B heart disease Wo. (chend, D. Congestive heart failure r the lesion in he heart caused by vascular occlusion of up te 63 and shows interstitial infitrates of the ischemic area? A. Stable Angina ~ 75? C. Prinzmetal Angina B. Unstable Angina Br Acute Myocardial Infarction | month old girl infant was brought to the ER due to luchypnea and here was no weight gain noted since birth On auscultation she | wur. The child is most likely suffering from -& Patent Ducts Arterios.AE 18. Which most common congenital heart disease can sustain non-detection up to adulthood due to small size of the lesion? A. Atrial septal defect C. Patent ductus arteriosus B. Ventricular septal defect D. Transportation of great vessels 19. Shock is associated with which condition? Ne ec tubular necrosis ~ “tal if» sche B. Acute pancreatitis C. Diffuse proliferative glomerulonephritis D. Pulmonary edema 5 20. After falling in a bathtub a female becomes somnolent. A day later CT scans show accumulation of fluid beneath the dura compressing the left brain hemisphere What is this fluid collection called? AV malformation ©. Charcoal Bourchard analirysm Hematoma D. Hemorrhagic necrosis 8 c 21.4 54 ylo man has sudden onset of chest pain. He is found to have a serum 1of SrngimL. A year later he has reduced exercise tolerance. An echocardiogramiteveals an akinetic segment of left ventricle, and he has reduced cardiac output, with an ejection fraction of 25%. He then experiences a transient ischemic attack. ild stroke. His serum troponin 1 is now <0.5 ng/mL. Thrombus formation involving which of the following locations is most likely to have put him at greatest risk for the TIA? A. Cerebral vein c ve ery B. Coronary artery BL a C22. Patients with liver diseases develop edema because of which statement? A. The damaged liver causes venous obstructio! .\Bading to damming back of blood to the inferior vena cava ; B. Excessive protein is lost in the urine £. The diseased liver synthesizes inadeduala protein D. Hormonal secretion increases (23 Anasarca among congestive heart failure patients is noted because of which mechanism? \, A. Decreased colloid oncoti¢ pressure B. Increased ity 2. Increased hydrostati ure 3 D. Obstruction atic channel B24. The comme sm between extensive hemorrhage and myocardial infarction in the evol ‘shock is which of these? A volume C. Internal fluid los: B. Decreased cardiac output D. Vasoconstriction ¢ B ‘Which of the following are characteristic of antemortem clots? purrant jelly clots C. Black tarry features of Zahn, D. Mostly red blond cells © histologically 26. Virchow's triad (factors favoring thrombosis) includes which ofthe foilowing? céle te ei 97B 28. Onatrip to the Caribbean, a 29 y/o man takes a scuba diving course. He goes oo i tle wreck dive to a depth of 50 meters (170 feet). His diving partner signals to him that It's time to ascend but he continues to explore the wreck, noticing some time later than he i unning low on air. He panics and ascends to the surface quickly. Within 2 hours he then develops a headache, tightness in his chest, and difficulty breathing. He experiences generalized pain in all extremities. Which of the following injuries is the most likely cause for his findings? A. DIC C. Hypothermia B. Nitrogen bubble formation D. Free radical cellular injury C28. 446 year old man has had increased sputum production and a chronic cough for the past 5 months. On physical examination there are expiratory wheezes heard over the right lung anteriorly. A chest x-ray demonstrates a 6 cm. right perihilar mass. Laboratory studies include sputum cytology, with the report that “Atypical cells are present suggestive of squamous cell carcinoma.” Which of the following risk factors is most likely to be associated with these findings? A. Exposure to silica & Cigarette smoking B. Exposure to bird dust D. AIDS, Y a 8 30.31 year old man is working on the ungrounded electrical wiring in his house. He has Not flipped the circuit breaker switch to the ‘off position. He accidentally touches the bare black wire of a 110 volt 20 ampere circuit. Which of the following is most likely to be the major life-threatening problem associated with this ‘A. Thermal burns . Vastular thrombosis B. Cardiac arrhythmia D. Hypertfiermia 7D 3t-Anelderly man is found dead in his bed at home jie paramedics are called by his Neighbor, who noticed that the man was out working i his garden as he usually did, but collapsed. When paramedics arrive, the mamis noted to have marked salivation with lacrimation. His pupils are pinpoint. He is incertinent of urine. On the way to the hospital he vorits. Which of the foliaWing environmental exposures best explains these findings? A. Insect sting Ozone B. Asbestos . z Br Organophosphate ‘ B32, Polymerase chain reaction is Used to determine A. Seropositivity .C. Survival time TB Viral toad~ aR ® Genetic sequence a 33, Bacteria are as: A. Gram: or negative ©. Aerobic or anaerobic B. Coccior BrAllof the above ta C34, Thermat@imorphism is seen among which of these? ri (& Fungi 3. Virus D Bacteria af A 35. Flask— like colonic ulcers inducing blood mucoid diarrhea is caused by A. Entamoebahystolitica Salmonella typhi B. Shigella D. Escherichia coli @ < with large dark nuctei of irregularA 38. If the large solitary mass is within the myometrium and has a white whorled cut surface, v with no necrosis, it is grossly which of these? Leiomyoma ©. Leiomyosarcoma B. Endometrial polyp D. Fibroma a (39. Which of the following ovarian age pal is most likely to,be associated with endometrial hyperplasia or carcinoma? Eg prac ye A. Immature teratoma 2: Granulosa cell tumor B. Dysgeminoma’ pounsng D. Mucinous cystadenoma / (40 Ifthe solitary mass were an ovarian mass that turned out to be a cyst with chocolate brown granular inner surface, the most likely diagnosis is ‘A. Dermoid cyst & Endometrial cyst B. Mucinous cystadenoma D.Serous cyst f A 41. The first marker to appear in the serum of patients with acute-hepatitis Bes, © Ae HBsAg ©. Anti-HBe HBeAg D. Anti-HBs > 74, 42-The most common cause of acute hepatitis is A. Hepatitis A © Hepatitis C B. Hepatitis B 7 43:Has greatest risk of progressing to chronic hepatitis. A. Hepatitis A Pitan atts © 8. Hepatitis B D Hepatitis D co 8 44, Spider angiomas in cirrhosis are due to ‘A. Hypercholesterolemia ex > Steatosis B. Hyperestrogenism \ D. Hypogammagiobulinemia X 0 4 ‘Most conmonigenigh neoplasm o of he lver ‘A. Bile duct adenoma © Cavemous hemangioma B Hepaticadenoma «© D Focal nodular neoplasia Z rfp.of cellular adaptation? |G Metaplasia D. Cloudy Swelling Za sign of cellular injury? C. Breaks in cytoplasmic membrane B Loss of microvili rae cree tissues is composed of permanent cell population? a muscle +haron’s C. Bone marrow D. Lymph node a cause of muscle atropy in poliomyelitis is: A. Decreased workload C. Diminished bivod supply 8. Loss of innervations = D. Loss of endorrine stimulation7a 2 52. Which of the foll is a good example of apoptosis’ u A. Negri body einabred ? & Councilman-like body B. Mallory body atte ko) D. Guamier bodies x ® 53 totrautecine gcowth retardation refers to infants who: Weigh less than 2,000 gm born at term B. Weigh less than 2,500 gm bom at term C. Preterm infants who weigh less than 2,500 gm D. Post term infants who weighs less than 2,000 gm / O° 54. Autopsy of a stilborn shows sold, liverike lungs with pink fibrin-ike materials along the alveolar wall. The most probable diagnosis is: A. Viral pneumonia B. TORCH infection ©, Bacterial pneumonia Hyaline membrane disease of the newborn \ Ae ies Y A B. "Respiratory distress syndrome of the newborn ‘C. Pneumonia D. Congenital malformation, deformations and chromosomal anomalies co 1) _ 56. Which of the following is included in the Philippine newborn screening program? A. Cystic fibrosis C. Sigle cell anemia B. Congenital hypoparathyroidism ._ @. Galactosemia © B _87Which of the following is the EM finding in acute fost ‘A. Mesangial deposits sy. B. Subepithelial humps ) treptococcal glomerulonephritis? Intramembranous deposits D. Subendothelial deposits 7 B58. The most common clinical manifestation 6f,IgA nephropathy is: A, Proteinuria , ©. Nephnitic syndrome &. Hematuria D. Nephrotic syndrome 7 _Q _ 58. The morphologic lesion of, A. Segmental sclerosis \ ily progressive glomerulonephritis is i & Epithelial crescents D. Wire loop lesions of diabetic nephropathy is ©. Capsular drops is D: Thickening of basement Kirnmel seq wheter) x A 61,.ctinically mesangial lesions in the glomeruli are usually manifested as Proteinuria. & Nephritic syndrome ria D. Nephrotic syndiome vA 82. Proteinuria is usually manifested as: A. Fruity urine C. Ammoniacal iwine 2% Bubbly urine —B. Teacolored urine© 65. Which of the following GN usually present as nephritic syndrome? a ‘A. Minimal change disease B. Focal segmental glomeruloneptyitis C, Membranous glomerulopathy B® Acute post streptococcal glomerulonephritis D 66. Neoplasm is a distinct dreaded disease the most important aspect of which compared to pseudo-tumors is its characteristic? AX Spread pattern C. Encapsulation B. Association with necrosis D. Uncoordinated growth 7 4 67. Wich of the following reactive chariges is often confused histopathologically with juamous cell carcinoma? ‘Squamous metaplasia C. Hyperplasia B. Hypertrophy D. Atrophy ¢ B68. Necrosia in cancer is most significantly due to which of the following? > A TNF C. Cytokines ~ y B. Ischemia D. Infection 7D 68. Which of the following is the most reliable local ign of cancer? A. Atypia of cells eg B. Presence of necrosis 4 , C. Presence of mitosis A ®. Destruction of basement membrane 2: © —_D 70. which of the foliowing growth pattern of cancer is most eniinous biologically speaking? A. Polypoid CA C. Fungating CA B. Ulcerating CA B® Infiltrating CA % B71. whichis the most common and spreads fost,commonly thru Xe ymphato®) ma ke eal aur Lyn that ycatens A. Carcinoma — hence swgieal Areicon erator 0 & Liposarcoma D Blastoma Hewal ngceeti x ~ © _ 72. Which tumor shows elemerits derived from the different germ cell layers? A. Carcinoma \ & Teraioma B. Liposarcoma . D Blastoma X 8 73. Which tumor ominously spréads most frequently thru théthematogenouS youte? Ae Carcino C Teratoma 8. Uporercan arta fustned D. Blastoma rkers are important in which of the following =~ and follow up of tumors ©. Staging of tume's \ -_D Histologic grading of tumors the most significant and iost reliable 5 © Doubling time : Tumor stage Zif A 78. This is the most common unwanted complication of chronic skin disorder. Fibrosis C. Erythema B. Abscess formation D. Edema BF Oe nae sie even nstony eon mass with history of previous trauma 2 months earlier. Which is tha besh di ‘ic procedure? A. Excision biopsy ©. Core needle biopsy . B. Incisional biopsy D. FNAB /n 8 80 Most common tumor in this patient's age bracket (30-40) is which of the following? A e & Fibrocystic change C. Ductal papilloma. key teyolo —_B. Fibroadenoma D. Benign Phylioides tumor 81. Which of these{spindle celltumors of the breast irony malignant? 4 D A. Fibroma thabdomyoma B. Lipoma B Phylioides tumor % x C 82. Th lalignant breast cancer is most commonly due to which’ folk 4 Calcification ~Cait patpate Aino Tad Fibrosis ~clezmog losin B. Osseous metaplasia Gales D. Hyaline chahge. 7 0 83! This benign breast lesion often associated with history of trauma is crically hard and irregular is often confused with breast cancer A. Fibroadenoma Cc. ectasia 8B. Ductal papilloma &. Fi Osis Z . ~A. 84. Which of tne folowing breast malignancies is most equently associated with central rosis? BP ictarin-siur — Conteclo type ©. Lobular CA . Invasive ductal CA “yD. Mucinous CA 7 — © 65. Mirror-image biopsy of tha contralateraPbreast in a patient with breast cancer is often undertaken in which of the above type'of cancer? \ A. Ductalin-situ ‘ 2 Lobutar CA B. Invasive ductal CA S D. Mucinous CA a 0 86. In staging of cancef'(the mo&t important parameter) under the TNM system, the T represents whi following? A Time C Translocation index B. Doubling time © Tumor size s 7 0 87. The determination of Estrogen Receptor Assay (ERA) Progesterone Receptor Assay (PRA), and Her2neu is important for breast cancer patients for which ot the following objectives? “A. Diagnosis of the breast cancer gnosis of the tumor in terms of 5 years survival C.~Prognosis of the tumor in terms of 10 years survival ®. Assists in the decision to include chemotherapy and choice of dust ag 88.Met common complcaton of Gabi ur . 8 & Bleeding D. Intractable p.un aie ay mee D 89, Which pot has the greatest malignant poten? ‘A. Tubular adenoma C. Hyperplasti: poly i Peutz-jeg! Spe 292 Moun adenoce K va & e 91. Soft tissue tumor with spindle cell in 45° angle insertion is likely which of these tumors? A. Leiomyosarcoma &. Fibrosarcoma B. Malignant fibrous histiocytoma . Synovial sarcoma (1 y 92. Which part of the musculoskeletal system is the most common site of tuberculous infection? 4 Vertebral body Hit?-Raro . [C. Joints| B. Vertebral spine D—tong bones D 6 93. A patient is found unconscious and rushed to the ER. The duty physician detects severe hypotension and notes extensive urticaria and multiple insect bites. Emergency ‘measures included administration of IV fluids and epinephrine, The condtion is mainly due to systemic release of A. Serotonin C. Leukotriene B. Cytokine ®. Histamine 94. In the development of tolerance, the deletion (death or inactivation) of pee cell clones occurs in the: a A. Thymus C. Lymph nodes B. Bone marrow D. Spleen \ 95. A 15 y/0 boy who was a foot taller than his professional Beskett@yconier father may be suffering from: eo 2 Gigantism ©. Kili ’s syndrome B. Acromegaly fan Syndrome 96. A single 1.0 cm thyroid nodule in a 35 y/o female by radionucleotide scan. The lobectomy specimen showed a well-encapsulatéd mass which microscopically showed folicles confined to the ee apsule with the rest of the thyroid having a normal histology. What would this gr6Wvth most probably be? A Follicular adenoma a © Follicular carcinoma B. Adenomatous nodule way D Medullary carcinoma Ww 97. Demyelination is seen in which of these? ‘A. Parkinson's Disease ~ C. Crutzfeld-Jacob Disease B. Alzheimer's ~~ ©. Multiple sclerosis * 96. Which is the most cominB tumor tat metastasizes to the brain? AX Lung C Kidney B. Breast D. Gastrointestinal tract 99. The process olewng a particle to target it for ingestion is called: A cytosis C. Enguifment zB D. Adhesion is clasified as a quiescent cell with 2 low evel of replication but can rg0 rapid division in response to stimuli: —werval organs] A.Squamous epithelium, skin C. Neurons ® Liver i D. Hematopoieti: tissues