2nd Professional Pathology Examination

23 February 2005

MCQ

Time allowed: 1 Hour 40 min

 Questions 1-35: Choose the one best response from several for each set of answers

1. Which one of the following best describes emphysema?

A. Paroxysmal vasoconstriction
B. Destruction of bronchial walls
C. Destruction of alveolar walls
D. Excess mucus production
E. Collapse of alveolar air spaces

2. Rheumatic fever is due to infection with which type of organism?

A. Staphlococci
B. Streptococci
C. Enteric organisms
D. Meningococci
E. E. coli

3. Metaplasia is which one of the following?

A. The growth of a metastasis
B. Transformation of a mature cell into an immature cell
C. Transformation of a benign cell into a malignant cell
D. Transformation of a mature cell into a mature cell of another type
E. Commonly premalignant

4. Which one of the following best describes a granuloma?

A. An important stage in wound healing
B. Composed predominantly of blood vessels and macrophages
C. A collection of transformed macrophages
D. A manifestation of a type 3 hypersensitivity reaction
E. A major type of necrosis

5. Phaeochromocytoma produces which one of the following?

A. Serotonin
B. Norepinephrine
C. Histamine
D. Cortisol
E. Aldosterone

6. Which one of the following is not a feature of tuberculosis?

A. Caseating granulomas
B. The Gohn focus
C. Positive Ziehl-Nielsen stain
D. Positive Kveim test
E. Positive Mantoux test
7. Which of the following pathologies would you most likely see in a patient with
unstable angina?
A. Coronary vasospasm
B. Complete venous occlusion
C. Acute plaque expansion
D. Fixed coronary artery stenosis
E. Complete arterial occlusion

8. Which one of the following is not a feature of hyperthyroidism?

A. Palpitations
B. Exophthalmos
C. Pretibial myxoedema
D. Heat intolerance
E. Constipation

9. Which one of the following best describes coeliac disease?

A. A degenerative disease of the small intestine
B. An infectious disease of the small intestine
C. A congenital disease of the small intestine
D. An immune-mediated disease of the small intestine
E. A neoplastic disease of the small intestine

10. Which one of the following is a potentially premalignant condition?

A. Bronchiectasis
B. Syringomyelia
C. Rheumatoid arthritis
D. Atrophic gastritis
E. Chronic endometritis

11 Which one of the following statements is not correct?

A. E. Coli is an important cause of neonatal meningitis
B Haemophilus influenzae meningitis is commoner in adults than children
C Staphylococcal meningitis may follow penetrating head injuries
D. Neisseria meningitidis meningitis may result in the Waterhouse-
Friederichsen syndrome
E Splenectomised patients are at particular risk from pneumococcal
meningitis.

12. Which one of the following is not a risk factor for urinary tract infection?
A. Spinal cord injury
B. Pregnancy
C. Diabetes insipidus
D. Urinary tract calculi
E. Instrumentation
13. Which one of these best describes the Budd-Chiari syndrome?
A. Thrombosis of the portal vein
B. Occlusion of the central vein
C. Thrombosis of the hepatic artery
D. Thrombosis of the hepatic vein
E. Invasion of the portal vein by schistosomiasis

14. Which one of the following tests is the most useful in the diagnosis of primary
biliary cirrhosis?
A. Antimitochondrial antibody
B Antimicrosomal antibody
C. Antihepatocyte antibody
D. Anti-intrinsic factor antibody
E. AntiDNA antibody

15. Which one of the following best describes Paget’s disease of bone?
A. Diffuse inadequate mineralisation of bone
B. Diffuse bone density decrease
C. Imbalance between osteoblast and osteoclast activity
D. Thinning of bone due to increased parathyroid hormone
E. Bone erosion due to localised inflammation

16. Which one of the following is not associated with hyponatraemia?

A. Diabetes insipidus
B. Addison’s disease
C. Excess water intake
D. Syndrome of inappropriate ADH secretion
E. Persistent vomiting

17. Which one of the following is not an expected feature in obstructive jaundice?
A. Pale stools
B. Large bile duct obstruction
C. Dark urine
D. Elevated alkaline phosphatase
E Predominantly unconjugated hyperbilirubinaemia

18. Which one of these is not a cause of secondary diabetes mellitus?

A Acromegaly
B Chronic pancreatitis
C Thyrotoxicosis
D Tumour of the adrenal cortex
E Marked obesity
19. Which one of the following is not correct with regard to benign prostatic
hyperplasia?
A. Is commonly treated by TURP (transurethral resection of prostate)
B. Can cause bladder wall hypertrophy
C. Predisposes to stone formation in the urinary tract
D. Glandular and stromal tissue can be increased
E. Involves the peripheral part of the gland

20. A gallbladder filled with pus is known as which one of the following?
A. Mucocoele
B Hydrocoele
C Empyema
D Cholangitis
E Cholesterolosis

21. Anti-GBM disease is one component of which clinical syndrome?

A Henoch-Schonlein purpura
B Wegener’s granulomatosis.
C Polyarteritis nodosa
D Goodpasture’s syndrome
E Systemic lupus erythematosus

22. Multiple sclerosis is characterised by:

A Axonal loss and gliosis with tract degeneration in the early stages of the
disease.
B Myelin loss and oligodendrocyte inclusion body formation.
C A fatal outcome early in the disease process.
D Relapsing remitting course followed by secondary progression
E Benign clinical course in majority of patients

23 Which one of the following is not a vasculitis?

A Takayasu’s disease
B Polyarteritis nodosa
C Thromboangiitis obliterans
D Raynaud’s disease
E Kawasaki disease

24. Which one of the following is seen in minimal change nephropathy?

A Increased glomerular size
B Fusion of podocytes
C Glomerular crescents
D Increase in glomerular cellularity
E None of the above
25. Which one of the following is not correct with regard to bone tumours?
A The commonest malignant tumour in adults is a metastatic deposit
B Radiation is a risk factor for osteosarcoma
C Giant cell tumour is also known as osteoclastoma
D Ewing’s tumour is commonest in children
E The vertebrae are the commonest site for osteosarcoma

26. Which one of the following statements is not correct?

A Pyloric stenosis causes a metabolic alkalosis
B High dose insulin can cause hyperkalaemia
C Plasma bicarbonate concentration is increased in a compensated respiratory
acidosis
D Severe diarrhoea causes a metabolic acidosis
E Phosphate is the principal buffer in urine

27. Pituitary adenomas are typically associated with:

A Raised intracranial pressure
B Malignant transformation
C Olfactory symptoms
D Epilepsy
E Visual field defect

28 With regard to Hirschprung’s disease which one of the following is least correct?
A Is also known as megacolon
B Most commonly affects distal segments of the large intestine
C Is more common in individuals with trisomy 21
D Is characterised by abnormally functioning ganglion cells
E Predisposes to enterocolitis

29 With regard to achalasia which one of the following is least correct?

A May predispose to oesophageal carcinoma
B Causes an irregular stricture in the most distal part of the oesophagus
C May result in aspiration pneumonia
D Can be assessed by manometry studies
E There is an increased tone in the lower oesophageal sphincter

30 Which one of the following tumours would be least likely in someone under 25
years of age?
A Nephroblastoma
B Testicular teratoma
C Osteosarcoma
D Chondrosarcoma
E Ewing’s tumour
31 Which one of the following is the best description of a choledocho-enteric fistula?
A Obstruction of the ileum by a gallstone
B A connection between the gallbladder and the small intestine
C A connection between the gallbladder and the large intestine
D A connection between the bile duct and the small intestine
E A connection between the bile duct and the large intestine

32 Which one of the following is not characteristic of carcinoid syndrome?

A Episodic hypertension
B Wheezing
C Flushing
D Fibrosis of the pulmonary and aortic valves
E Diarrhoea

33 Which one of the following is not a cancer-staging system?

A Astler-Collin’s for colonic carcinoma
B TNM for bronchogenic carcinoma
C Ann-Arbor for lymphoma
D Gleason for prostatic carcinoma
E FIGO for cervical carcinoma

34 Which one of the following is not considered a myeloproliferative disorder?

A Essential thrombocythaemia
B Refractory anaemia with excess blasts
C Polycythaemia rubra vera
D Agnogenic myeloid metaplasia
E Myelofibrosis

35 Which one of the following is not true with regard to Peutz-Jeghers syndrome?
A Predisposes to intussussception
B Is associated with ovarian tumour
C Is autosomal recessive
D Gastric polyps may be seen
E Show abnormal mucosal pigmentation
Questions 36 -100: Match the numbered question to the best lettered response for
each set of questions. Each response may be used once, more than once or not at all.

36. Hepatitis B virus A. Hepatocellular carcinoma

37. Oral contraceptive pill B. Cholangiocarcinoma
38. Clonorchis sinensis C. Angiosarcoma
39. Radiation D. Hepatic adenoma
40. Cirrhosis E. None of the above

41. Primary hyperparathyroidism A. Hypocalcaemia

42. Osteomalacia B. Normal alkaline phosphatase
43. Secondary hyperparathyroidism C. Hypophosphaturia
44. Paget’s disease of bone D. Hypercalcaemia
45. Osteoporosis E. None of the above

46. Barrett’s disease A. Pituitary

47. Wilson’s disease B. Adrenal
48. Cushing’s disease C. Joints
49. Still’s disease D. Oesophagus
50. Addison’s disease E. None of the above

51. Giardia A. Small bowel

52. Crohn’s disease B. Large bowel
53. Ulcerative colitis C. Both
54. Pernicious anaemia D. Neither
55. Hirschprung’s disease

56. Asbestos A. Liver cancer

57. Aflatoxin B. Skin cancer
58. Aromatic amines C. Bladder cancer
59. Vinyl chloride D. Lung cancer
60. Arsenic E. Angiosarcoma

61. Weil’s disease A. Protozoan

62. Malaria B. Bacteria
63. Schistosomiasis C. Spirochaete
64. Syphilis D. Mycobacterium
65. Tuberculosis E. Helminth

66. Bladder tumour A. Unilateral hydronephrosis

67. Ureteric stone B. Bilateral hydronephrosis
68. Urethral stricture C. Both
69. Benign prostatic hyperplasia D. Neither
70. Retroperitoneal fibrosis
71. Burkitt’s lymphoma
72. Nasopharyngeal carcinoma
73. Kaposi’s sarcoma
74. Laryngeal carcinoma
75. Cervical carcinoma
A. Epstein-Barr virus
B. Human papilloma virus
C. Herpes simplex virus
D. Cytomegalovirus
E. None of the above

76. Minimal change nephropathy A. Crescent formation

77. Focal segmental glomerulosclerosis B. Immune complex deposition
78. IgA nephropathy C. Both
79. Anti-GBM disease D. Neither
80. Membranous nephropathy

81. Mesothelioma A. Asbestos

82. Pulmonary fibrosis B. Coal dust
83. Bronchogenic carcinoma C. Both
84. Caplan’s syndrome D. Neither
85. Occupational lung disease

86. Uveitis A. Crohn’s disease

87. Regional enteritis B. Ulcerative colitis
88. Increased risk of cancer C. Both
89. Granulomas D. Neither
90. Backwash ileitis

91. Paget’s tumour A. Parotid gland

92. Craniopharyngioma B. Thyroid
93. Warthin’s tumour C. Pharynx
94. Brown tumour D. Bone
95. Ewing’s tumour E. None of the above

96. Gastric inflammation A. Megaloblastic anaemia

97. Koilonychias B. Iron deficiency anaemia
98. Crohn’s disease C. Both
99. Haemochromatosis D. Neither
100. Sensory disturbance
MCQ ANSWER KEY

1 C
2 B
3 D
4 C
5 B
6 D
7 C
8 E
9 D
10 D
11 B
12 C
13 D
14 A
15 C
16 A
17 E
18 E
19 E
20 C
21 D
22 D
23 D
24 B
25 E
26 B
27 E
28 D
29 B
30 D
31 D
32 D
33 D
34 B
35 C
36 A
37 D
38 B
39 C
40 A
41 D
42 A
43 D
44 E
45 B
46 D
47 E
48 A
49 C
50 B
51 A
52 C
53 B
54 D
55 B
56 D
57 A
58 C
59 E
60 B
61 C
62 A
63 E
64 C
65 D
66 C
67 A
68 B
69 B
70 B
71 A
72 A
73 E
74 B
75 B
76 D
77 D
78 C
79 C
80 B
81 A
82 C
83 C
84 B
85 C
86 C
87 A
88 C
89 A
90 B
91 E
92 E
93 A
94 D
95 D
96 C
97 B
98 C
99 D
100 A