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Pathology Examination (Final/ 3hours)

I- Define each of the following (20 marks):
1- Unstable angina ________________________________________
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2- Aneurysm : ___________________________________________
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3- Emphysema:___________________________________________
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4- Atheroma:_____________________________________________
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5- Varicocele:_____________________________________________
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6- Celiac disease: ____________________________________
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7- Chronic hepatitis: _______________________________________
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8- Paraneoplastic syndrome:________________________________
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9- Occult carcinoma:______________________________________
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10- Carcinoid syndrome: _______________________________
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II- Choose the most appropriate answer (100 marks):

1- Histologically, amyloid deposits always begin:
a. Between the cells c. Intranuclear e. Intraglandular
b. Intracytoplasmic d. Intravascular
2- Chronic anemia can induce all except:
a. Fatty change in myocardium
b. Dilated cardiomyopathy
c. Hypertrophic cardiomyopathy
d. Congestive heart failure
3- Aschoff body is the pathologic lesion in:
a. Infective endocarditis c. Rheumatic fever
b. SLE endocarditis d. Tuberculous myocarditis
4- In autoimmune hemolytic anemia, which of the following types of
immunological injury happens is:
a. Type I (anaphylactic) c- Type III (immune complex)
b. d- type IV (cell mediated) d- Type II (cytotoxic)
5- Hematoma is:
a. A benign tumor of blood c- Malignant tumor of blood
b. A granuloma d- Type of hemorrhage
6- Grave's disease is a type of:
a. Type I reaction c- Type III reaction
b. Type II reaction d- Type IV reaction
7- Male infant suffering from recurrent bacterial infection (pneumonia). He most
likely to have:
a. DiGeorge syndrome c- Acute leukemia
b. Epstein-Barr virus (EBV) infection d- X-linked agammaglobulinemia
8- A 23 year old male eats sunfish and develops itching and diarrhea after an
hour. The condition continues for 3 hours then disappeared. Which of the
following immunologic abnormalities is she most likely to have?
a. Anaphylaxis d- Immune complex deposition
b. Release of complement C3b e- Hypergammaglobulinemia
c. Cell-mediated hypersensitivity
9- Cut surface of the lung shows diffuse brown induration in case of:
a. Lobar pneumonia c- bronchopneumonia
b. Mitral stenosis d- viral pneumonia
10- The most common source of brain thromboembolism is:
a. Aortic atherosclerosis c- malignant hypertension
b. Cardiac thrombi d- DVT
11- The infarct of the following organ is invariably hemorrhagic
a. Kidney infarct c- Lung infarct
b. Cardiac infarct d- Spleen infarct
12- Tubercle bacilli cause lesions by the following mechanisms:
a. Elaboration of exotoxin c- Elaboration of endotoxin

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b. Type IV hypersensitivity d- Direct cytotoxicity

13- Hamartoma refers to:
a. Tumor arising from totipotential cells
b. Mass of disorganized but mature cells indigenous to the part
c. Tumor differentiating towards more than one cell line
d. Mass of ectopic rests of normal tissue
14- Hepar lobatum is seen in:
a. Primary syphilis c. Secondary syphilis
b. Tertiary syphilis d. Congenital syphilis
15- Nephroblastoma (Wilms' tumor), which is true:
a. The most common presentation is a mass
b. Usually presented by hematuria
c. The peak incidence is between 2-4 years
d. It is a benign pediatric tumor.
16- Aortic aneurysm is a manifestation of:
a. Primary syphilis c. Secondary syphilis
b. Tertiary syphilis d. Congenital syphilis
17- Atherosclerosis is predominantly a disease of:
a. Intima c. Media
b. Adventitia d. Entire vessel wall
18- The following lipids has highest association with atherosclerosis:
a. Triglycerides (TG) d. Low density lipoprotein (LDL)
b. Very low density lipoprotein (VLDL)
c. High density lipoprotein (HDL)
19- Right heart failure is predominantly characterized by the following except:
a. Congestion of liver c. Congestion of spleen
b. Congestion of kidneys d. Congestion of lungs
20- Features of Fallot's tetralogy are all except:
a. VSD c. Overriding aorta over the VSD
b. Left ventricular hypertrophy d. Stenosis of pulmonary artery
21- The most common complication of coronary atheromatous plaque is:
a. Calcification c. Thrombosis
b. Aneurysm d. Ulceration
22- Myocardial infarction most common in:
a. Right atrium c. Right ventricle
b. Left atrium d. Left ventricle
23- Chronic ischemic heart diseases is most often due to:
a. Coronary atherosclerosis c. Repeated coronary vasospasm
b. Embolisation of coronary branches d. Stenosis of coronary ostia
24- MacCallum's patche is seen in:
a. Right atrium c. Right ventricle
b. Left atrium d. Left ventricle
25- Vegetations of the following types of endocarditis are generally not friable
except that of:

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a. Rheumatic endocarditis
b. Libman-Sacks endocarditis
c. Subacute bacterial endocarditis
d. Non-bacterial thrombotic endocarditis
26- Death of a patient with myocardial infarction after 24 hours of the attack is
most likely due to:
a. Arrhythmias
b. Rupture of papillary muscle
c. Cardiac tamponade
d. Ball thrombus
27- Pathogenesis of stable angina pectoris is:
a. Thrombosis of coronary arteries
b. Rheumatic heart disease
c. Systemic hypertension
d. Fibrous (hard) atheromatous plaque
28- A healthy young male develops acute heart failure in few days. Myocardial
biopsy revealed mononuclear inflammatory infiltrate in the interstitium with
minimal myocyte injury. This patient suffers from:
a. Toxic myocarditis c. Cardiomyopathy
b. Myocardial infarction d. Viral myocarditis
29- Which is not true about the following tumors of the circulatory system:
a. Cardiac myxoma occurs in left atrium
b. Mesothelioma affects the endocardium
c. Most hemangiomas are considered as hamartomas rather than true
tumors.
d. Kaposi sarcoma is the commonest AIDS related vascular tumor.
30- Parotid cystic swelling; fine needle aspiration (FNA) shows epithelial cells
that have eosinophilic cytoplasm and lymphocytes most likely:
a. Lymph node d. Mucoepidermoid carcinoma
b. Warthin’s tumor e. Pleomorphic adenoma
31- The typical carcinoma that develops in Barrett's esophagus is:
a. Epidermoid carcinoma d. Mucoepidermoid carcinoma
b. Small cell carcinoma e. Adenocarcinoma
c. Squamous cell carcinoma
32- The development of peptic ulcer disease has been associated with all except:
a. Mallory-Weiss syndrome d. Caffeine
b. Alcohol e. Zollinger-Ellison syndrome
33- Which of the following tumors of small intestine have malignant potential:
a. Adenomatous polyps d. Hamartomatous polyps
b. Juvenile (retention) polyps e. Leiomyomas
c. Fibromas

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34- A patient has had years of intermittent diarrhea and abdominal pain, but has
never consulted a physician. Eventually he begins to pass fecal material in his
urine and he seeks medical attention. Which one of the following diseases is
most likely to cause this complication?
a. Celiac disease d.. Crohn's diease
b. Diverticulitis e. Ulcerative colitis
35- In pure hepatointestinal bilharziasis which of the following is correctly
ordered:
a. Hepatomegaly, hepatosplenomegaly, splenomegaly with shrunken
liver, ascites
b. Splenomegaly, hepatosplenomegally, splenomegaly with shrunken
liver, ascites
c. Hepatomegaly, ascites, splenomegaly, shrunken liver
d. Splenomegaly, ascites, hepatosplenomegaly, shrunken liver
36- Examples of immune complex glomerulonephritis include the following
except:
a. Acute diffuse glomerulonephritis
b. Membranous glomerulonephritis
c. Membranoproliferative glomerulonephritis
d. Goodpasture's glomerulonephritis
37- Tuberculosis of male genital tract is most commonly involves:
a. Testis c. Epididymis
b. Scrotum d. Prostate
38- Bilharziasis of the male genital tract mostly involves:
a. Epididymis and testis c. Seminal vesicles
b. Spermatic cord d. Prostate
39- All are true about urinary bilharziasis except:
a. Bilharzial polyps are more common than sandy patches
b. The affection mostly affect the trigone and lower ureter
c. Bilharzial ulcers are fissuring ulcers
d. Squamous cell carcinoma is a complication of urinary bilharziasis
40- Tuberculosis of the urinary system which is not true:
a. Urinary bladder usually affects trigone
b. Urinary bladder is more commonly affected than kidney and renal
pelvis
c. TB cystitis should be suggested in patients with negative urine culture
for bacteria
d. Bilateral renal affection is usual
41- Renal amyloidosis, all are true except:
a. Usually unilateral
b. Presenting by nephrotic syndrome
c. The amyloid deposition occurs in glomerular basement membrane as
well as tubular basement membrane
d. A common complication in multiple myeloma

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42- Regarding RCC which of the following least correct:

a. Strong association with VHL gene mutation
b. Grossly it is a golden yellow soft tumor with hemorrhage and necrosis.
c. Clear cell carcinoma is the most common
d. It is benign if less than 5 cm.
43- Which of the following is not derived from renal tubules:
a. Clear cell carcinoma d. Oncocytoma
b. Angiomyolipoma e. Renal tubular adenoma
c. Papillary renal cell carcinoma
44- The most common cause of nephrotic syndrome in adults is:
a. Minimal change disease c. Membranous GN
b. Membranoproliferative GN d. Acute diffuse GN
45- Which of the following is not true about mesothelioma?
a. It is associated with smoking
b. It is a form of lung cancer
c. It affects the pleura of the lungs
d. It is associated with poor outcome
46- Which of the following is not an obstructive condition?
a. Fibrosis of lungs c. Asthma
b. COPD d. emphysema
47- What virus is nasopharyngeal carcinoma associated?
a. CMV c. EBV
b. HPV6 and 11 d. HSV
48- What is the correct order for the gross phases of lobar pneumonia?
a. Congestion, red hepatization, gray hepatization, resolution
b. Gray hepatization, red hepatization, congestion, resolution
c. Red hepatization, congestion, gray hepatization, resolution
d. Resolution, gray hepatization, red hepatization, congestion
49- What type of lung cancer fits this description? The tumor cells originate from
neuroendocrine (Kulchisky) cells. It is associated with smoking, centrally
located along bronchial airways. The tumor is high grade and tends to be at
high stage at time of diagnosis. It is treated with chemotherapy as it is usually
not amenable for surgery. Usually associated with paraneoplastic syndromes.
a. Squamous cell carcinoma c. Adenocarcinoma d. Pancost tumor
b. Carcinoid tumor d. Small cell carcinoma
50- Cigarette smoke contributes in the pathogenesis of emphysema by all except:
a. Attracts neutrophils into the lung
b. Stimulates the release of neutrophil elastase
c. Inhibits the ability of pulmonary neutrophils to clear bacteria
d. Directly increase alpha-1 antiyrypsin
e. Stimulates macrophage elastase activity

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III- Answer only three out of the following questions (30 marks):
a. Hodgkin's and non-Hodgkin's lymphoma
b. Benign and malignant hypertension
c. Discuss TB of the urinary tract
d. Pathology of hepatointestinal schistosomiasis

Dr. Fayed Al-Yousofy