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Pathology 1st Exam
SY 2010-2011
1. Smoking is implicated in any of the following conditions EXCEPT:
A. Lung Carcinoma
C. Myocardial Infarction
B. Bronchial Metaplasia
D. Breast Carcinoma
2. Liver biopsy of a 57-year old executive showed lipid accumulation within the liver cells competing and
displacing the nucleus to the periphery of the cell. There are hyaline inclusions in the cytoplasm. Which of
the following is the most likely cause of the hepatic changes?
A. Alcohol Abuse
C. Malnutrition
B. Carbon Tetrachloride exposure
D. Obesity
3. A 35-year old IV drug abuser is brought to the hospital with high fever, chills and hematuria. The most
common part in the heart affected would be:
A. Aortic Valve
C. Left Ventricle
B. Mitral Valve
D. Tricuspid Valve
4. A 50-year old man working as a stone cutter showed fine nodularity in the upper lobes of the lung. There
are eggshell calcifications in the hilar region. The most likely diagnosis is:
A. Silicosis
C. Asbestosis
B. Anthracosis
D. Siderosis
5. A 5-year old boy with chicken pox accidentally drank an overdose of aspirin. The expected untoward
consequence is:
A. Metabolic Acidosis
C. Both
B. Respiratory Alkalosis
D. Neither
6. An accident in a dry cleaning facility exploded a traumatic amount of carbon tetrachloride in the skin and
by inhalation (hindi clear iyong audio, sorry). Severe damage to what of the following organ is most likely to occur?
A. Kidney
C. Liver
B. Intestine
D. Stomach
7. A degenerative neurologic disorder, amyotropic lateral sclerosis, is produced by the ingestion of:
A. Aflatoxin contaminated food
B. Saxitoxin contaminated dinoflaggelates in mollusks
C. Ciguatoxin contaminated dinoflaggelates in tropical fish and snails
D. Cycasintoxin (Methylazoxymethanol -Glucoside) in cycad flour
8. The category of radiation sickness that manifest after exposure to the highest dose of whole body
radiation is known as:
A. Hematopoetic
C. Central Nervous System
B. Gastrointestinal
D. Musculoskeletal
9. A 40-year old man who recently immigrated from Japan to the US is diagnosed with gastric carcinoma.
The associated risk factor for this is:
A. High animal fat diet
C. Nitrites food preservative
B. Aflatoxin contaminated food
D. –Naphthylamine exposure
10. Which of the following is a fat-soluble vitamin involved in the maintenance of normal vision,
differentiation, and resistance to infection?
A. Vitamin A
C. Vitamin C
B. Vitamin D
D. Vitamin E
11. A burn injury involving the dermis is:
B. Second degree burn
12. Obesity is associated with the following except:
A. Fatty Liver
C. Diabetes insipidus
B. Cholelithiasis
D. Hypertension
13. This heavy metal binds with high affinity to thiol groups and induce CNS and kidney damage.
A. Lead
C. Arsenic
B. Mercury
D. Cadmium
14. Exposure to which of the following causes a mutation in codon 249 of the p53 tumor suppressor gene
which leads to the development of cancer?
A. Sodium Nitrite
B. Artificial Sweeteners (cyclamates, saccharin)
C. Aflatoxin
D. High animal fat intake
15. Which of the following disorders can alter sodium metabolism, causing edema?
A. nephrotic syndrome
C. Reduced renal perfusion
B. hypoaldosteronism
D. Malnutrition
16. When right ventricular failure occurs pooling of blood occurs in all of the following organs EXCEPT:
A. Kidneys
C. Lower extremities
B. Spleen
D. Lungs
17. A 55-year old woman has been hospitalized with pancreatitis. She had swollen legs which are tender to
palpitation but is not warm. (di na tinuloy ni doc na basahin)
A. Venous thrombosis
B. Septic Embolization
C. Infarction
D. Cellulitis
18. The clinical history which BEST describes a patient with a pulmonary thromboembolism is:
A. A 65-year old man chronically bed-ridden in terminal stage of cancer
B. A 24-year old female patient presenting with acute dyspnea an hour after vaginal delivery
C. A normal apparently healthy adult with choking sensation ten minutes after surfacing from diving in
batangas
D. Pedestrian accident victim became comatose ten days after surgery to repair multiple bone fractures
19. Which of the following is correct regarding thrombosis with a patient with adenocarcinoma of the
pancreas?
A. It is likely related to tissue thromboplastin release, decreased circulation and chemical
alterations in the blood secondary to malignant tumor
B. Lines of Zahn are identified in the lesion as a result of tumor deposition with platelet
C. Organization is not a possible outcome
D. Migration of the intravascular material would result in a fat embolism to the lung
20. In liver cirrhosis, this factor does not contribute to ascitis:
A. decreased colloid osmotic pressure of the blood
B. elevated portal venous pressure
C. Hyponatremia
D. Secondary Hyperaldosteronism
21. Which of the listed changes correctly describes the pathophysiology of pulmonary edema in congestive
heart failure?
A. decrease plasma oncotic pressure
B. endothelial damage
C. increase hydrostatic pressure
D. lymphatic obstruction
22. Which of the listed clinical scenarios illustrates the concept of active hyperemia?
A. A 22-year old second year medical student who develops a red face after being asked a question
during a lecture
B. A 37-year old male who develops massive scrotal swelling due to infection by Wucheria bancrofti
C. A 69-year old female who dies progressive secondary heart failure and at autopsy is found to have
“nutmeg liver”
D. A 6-year old boy who develops sudden onset of scrotal pain due to testicular torsion
23. Contribution of platelets in the formation of thrombi include only:
A. generation of von willibrand factor which promotes platelet adhesion
B. thromboxane release which promote platelet aggregation
C. formation of a secondary hemostatic plug
D. All of the above are correct
(for 24 – 27, di nakuha sa picture kaya walang choices)
24. A 30-year old male went for deep sea diving. The expected pathologic findings in the lungs would be:
Entrapped air bubbles
25. A stroke suddenly developed in a patient with aortic valve endocarditis which is a consequence of:
arterial embolization
26. The pathogenesis of septic shock is
C. Bacterial wall lipopolysaccharide
27. Shock as a result of decrease peripheral resistance may result from the following except:
Dehydration
28. Obstruction of the main blood supply will lead to pale anemic infarct in the:
A. Heart
C. Lung
B. Brain
D. GIT
29. All of the following hemodynamic events are correctly matched except:
A. carotid artery thrombosis – cerebral infarct
B. Kwashiorkor-localized edema
C. Deep venous thrombosis – pulmonary infarction
D. Fat embolism – crushing injury
30. Post mortem clot is most likely to:
A. Grossly display features of recanalization
B. Grossly have lines of Zahn
C. Grossly have the appearance of chicken fat or currant jelly
D. Microscopically appear attached to the wall of the blood vessel
31. Which of the following pathologic manifestation is incorrectly matched?
A. anemic infarct – double blood supply
B. active hyperaemia – acute inflammation
C. chronic passive congestion of the liver – right sided heart failure
D. Heart failure cells – left sided heart failure
32. Which of the following listed changes describes the pathophysiology in CHF:
A. Decreased plasma oncotic pressure
B. Endothelial damage
C. Increased hydrostatic pressure
D. Increased vascular permeability
33. A 49 y/o male develops severe abdominal pain taken to ER, taken to surgery, intestines were markedly
hemorrhagic, twisting, abnormality cause hemorrhagic infarction because of:
A. Arterial occlusion
B. The collateral blood supply of the GITs
C. The dual blood supply of the GIT
D. Increased vascular permeability
34. 25 y/o previously healthy construction worker falls..... surgery, develops shortness of breath, shock,
comatose. What are the expected findings?
A. an occluding saddle thrombo-embolus in the left and right main pulmonary artery
B. pale infarct of the left ventricle
C. Bright red material on oil red O or sudan red stains found within the lumina of pulmonary vessels
D. hemothorax
35. On section of an organ from 60 y/o who showed a wedge shaped hemorrhagic lesion in which of the
organs in clinical situation will this lesion most likely occur?
A. Heart with complete coronary artery occlusion
B. lung with pulmonary thrombo-embolism
C. kidney with renal artery thrombosis
D. brain with cerebral artery thrombosis
36. An 8 y/o boy has mental retardation, unusual facial features, large testis. What is the diagnosis?
A. Genetic test for trinucleotide repeat expansion in the fragile X gene
B. Karyotype of the mother’s chromosome
C. Karyotype of the father’s chromosome
D. Measurement of testicular volume
37. Tissue from spontaneous abortion from a dead male fetus with a barr body has a:
A. Down Syndrome
B. Turners Syndrome
C. Klinefelters Syndrome
D. Normal male
38. The ff are trisomies except:
A. Klinefelters Syndrome
B. Turners syndrome
C. Down syndrome
D. Edwards syndrome
39. A pt with a 45X0 karyotype has:
A. Klinefelters Syndrome
B. Turners syndrome
C. Down syndrome
D. Edwards syndrome
40. Deletion of chromosome 22q manifests as:
(sorry di nakuha sa picture yung mga choices)
Di George syndrome
41. For sex linked recessive mode of inheritance, the abnormal changed is:
A. from affected father to affected sons
B. from affected father to carrier daughters
C. from affected mother to affected daughter
D. high rate of transmission if mothers carry the gene
42. Diabetes Mellitus shows a dosage effect therefore that is? Sorry malabo.. di na kasi binabasa ni
Dr.Jacoba ung buong question)
A. it is transmitted thru a single gene disorder
B. the greater the number of inherited deleterious genes the more severe the expression of the
disease
C. the carrier state shows mild manifestations of the disorder
D. high rate of transmission if mothers carry the gene
43. Dr. Jacoba: A 27 y/o male is suspected of having a klinefelter’s syndrome I showed 2 karyotypes
47XXX / 46XY therefore this patient is a mosaic and I told you that it only happens in embryogenesis. It
happens in the baby not in the ova or sperm.     
A. non disjunction in spermatogenesis
B. non disjunction in oogenesis
C. non disjunction in emryogenesis
D. Translocation in gametogenesis
44. A newborn patient in the nursery has a down’s syndrome the ff patient have this features except:
A. Dysplastic middle phalanx of the hand
B. Hypotonic motor response
C. Horizontal palmar crease
D. Cherry red spot
45. Which of the ff. Lab results is correct with a patient who has down syndrome except:
A. FISH with 3 fluorescent dots
B. Karyotype with 47 XXX
C. Three Barr bodies on buccal smear
D. All of the above
46. Which of the following mechanism is possible for the production of Down’s syndrome?
A. Non disjunction involving a pair of autosomes during gametogenesis
B. Anaphase lag involving a pair of autosomes during gametogenesis
C. Both
D. Neither
47. Turners syndrome may be produced by:
A. Non disjunction involving a pair of sex chromosome during gametogenesis
B. Anaphase lag involving a pair of sex chromosome during gametogenesis
C. Both
D. Neither
48. A 5-year-old patient is brought to the clinic frequently complains of muscle cramps when running or
jumping, with mild hepatomegaly upon examination. What lysosomal disorder is this?
A. Pompes
B. Mc Ardles
C. sex linked dominant
D. sex linked recessive
49. A 20-year-old male has been your patient, with an older sister with the manifestation his parents are
normal, sons and daughters of his siblings are nomal. What is the mode of inheritance?
A. autosomal dominant
B. autosomal recessive
C. sex linked dominant
D. sex linked recessive
50. This pedigree for a family that manifest with muscle weakness
What is the mode of inheritance for this?
A. autosomal dominant
B. autosomal recessive
C. sex linked dominant
D. sex linked recessive
50. This is a pedigree for a family that manifest with muscle weakness
What is the mode of inheritance for this?
A. autosomal dominant
B. autosomal recessive
 all generations has it; no sex predilection
51.
What is the mode of inheritance?
A. Mendelian – Autosomal dominant
B. Mendelian – Sex linked dominant
C. Non Mendelian – Mitochondrial nheritance
C. sex linked dominant
D. sex linked recessive
D. Cytogenic
 mitochondrial inheritance - if female has it, all daughters and sons will have it, and if male has it – none
of daughters or sons will have it.
52. Pedigree of family that manifest with bleeding and anemia
What is the mode of inheritance for this?
A. autosomal dominant
C. sex linked dominant
B. autosomal recessive
D. sex linked recessive
 “pag may nakitang predominant to male = sex linked”
53. This disorder is an autosomal dominant…(why didn’t the parent manifest)?
A. Carrier (for recessive)
C. new mutation
B. Incomplete penetrance
D. permutation
 It is an autosomal dominant trait = incomplete penetrance
 new mutation is not possible since the father and sister showed manifestation
54. A 17- year-old male comes in because a… (tall boy, supraorbital prominence, dislocation of the ankle,
thick glasses, long and tapered fingers)?
A. Turners Syndrome
C. Marfans Syndrome
B. Fragile X Syndrome
D. Ehlers Danlos Syndrome
55. Follow up of the cardiovascular status for Marfan’s syndrome is important because they have multiple
cardiac problems such as….except?
A. Mitral valve prolapse
C. Cystic medionecrosis
B. Intimal tear of the aorta
D. Ventricular septal defect
56. The karyotype of a female with Marfan’s Syndrome?
A. 47 XX 15+
C. 46XX i(15)
B. 46 XX 15q-
D. 46XX
 Marfan’s syndrome is mendellian and not cytogenetic. Therefore should be normal
57. A 25 year old male comes to .......your clinic for fertility workout. A buccus smear show 3 barr bodies?
A. 46 XXY
C. 48 XXXY
B. 47 XXX
D. 49 XXXXY
58. A patient with RHD was observed ……..to have mitral valve calcification which of the ff process explain
the calcium deposits?
A. Hypercalcemia
C. Excessive calcium intake
B. Dystrophic calcification
D. Metastatic calcification
 Dystrophic calcification = need to have dead cells and abnormal cells = rhd or valve/s destroyed
 metastatic hypercalcemia = you have hypercalcemia
59. An alcoholic was noted to have…….yellowish discoloration of the ….?
A. Lipochrome
C. Hemosiderin
B. Melanin
D. Bilirubin
For nos. 60 to 63
60. A 40-year-old female suddenly……unconscious ruptured aneurism which of the ff is to be observed?
A. coagulative necrosis
C. liquefactive necrosis
B. caseous necrosis
D. fat necrosis
61. The affected neurons will manifest…….
A. 3 – 5 minutes
A. 30 – 50 minutes
C. 1 – 2 hrs
D. 3- 5 hrs
62. The first to be affected by hpoxia is…
A. anerobic glycolysis
B. mitochondrial oxidative phosphorylation
C. aerobic glycolysis
D. sodium pump
63. Which of the following cellular change…….(irreversible cell injury is due to)?
A. decreased Na influx
C. Swelling of the ER
B. K efflux
D. Cell membrane damage
For nos. 64 & 65
A woman complained of hemoptysis. A chest radiograph done revealed a caitary lesion and a
nodule at the right apex. Sputum sample demonstrates the presence of acid fast bacilli.
 diagnosis is TB
64. Which of the following cells is …….most important component of lung lesion?
A. Fibroblasts
C. modified macrophages
B. Lymphocytes
D. plasma cells
65. Which type of necrosis will ………….?
A. Coagulative
B. Caseous
C. liquefactive
D. gangrenous
66. Which of the following changes …….of the bronchial epithelium of smokers has the highest risk of
malignant transformation?
A. adenomatous hyperplasia
D. osseous metaplasia
B. apocrine metaplasia
E. squamous metaplasia
C. dysplasia
 if you insist on smoking, Metaplasia will progress to dysplasia will progress to anaplasia which is
malignant
For nos. 67-72
67. A 12-year old male complains of……right lower quadrant abdominal pain, nausea, fever, CBC revealed
neutrophilia and toxic granules?
A. bacteria
C. viruses
B. parasites
D. rickettsiae
parasites = eosiniophil, virus and rickettsiae = lymphocytes
68. The pain felt by this patient is attributed to?
A. C3a & C5a
B. Interleukin-1 &tumor necrosis factor
C.Prostaglandin and braykinin
D. Histamine & Serotonin
69. Appendectomy was done. If there were no complication in the healing of the appendectomy wound it
will have the ff features EXCEPT…
A. granulation tissue
C. collagen deposition
B. tissue necrosis
D. wound contraction
 surgical wound therefore heal by primary infection; wound contraction is secondary
70. The most important local factor…..that delays this healing
A. Inadequate blood supply
C. Vitamin C deficiency
B. Infection
D. Protein deficiency
71. Clearance of bacteria from the site …of infection would be achieved most effectively through the
regeneration of your…
A. Major basic protein
B. Bactericidal permeability increasing protein
C. Lysozyme
D. Hypochlorite
hydrogen peroxide = hypochlorite
72. Maximal tensile strength in the healing is seen in?
A. 1 week
B. 3 weeks
C. 1 month
D. 3 months
73. A macrophage-derived factor stimulates neovascularization EXCEPT?
A. Platelet derived growth factor
B. Transforming growth factor-beta
C. Fibroblast growth factor – 2
D. Vascular endothelial growth factor
74. An elderly male complains of difficulty….enlarged prostate what would be the process involved?
A. atrophy
D. hyperplasia
B. dysplasia
E. metaplasia
C. hypertrophy
75. A 52-year old male, a known alcoholic…...increasing abdominal girth liver biopsy shows cyrosis; what
would indicate that this is a transudate?
A. Specific gravity = 1.05
C. Neutrophils present
B. Protein content = 0.8g/dL
D. Large volume of fluid
low protein content
76. If liver biopsy showed extensive intracytoplasmic vacuoles. Which of the following elements would it
contain?
A. Specific gravity
C. Glycogen
B. Fatty acids
D. Triglyceride
77. Which of the following is the most common cause of liver pathology in adults?
A. Viral hepatitis
C. Alcohol abuse
B. Malnutrition
D. hypercholesterolemia
78. Following an injury, neutrophils transmigrate to the extravascular space. Which of the following is
responsible for this?
A. E-selectin
C. Vascular cell adhesion molecule
B. P-selectin
D. Platelet cell adhesion molecule
79. Granulomas are seen in the following except
A. TB
C. Schistosomiasis
B. Streptococcus infection
D. Cat scratch disease
80. Which one of the following mediators is the most important?
A. Interleukins
C. Interferon G
B. Leukotrienes
D. TNF
81. Which of the following is a distinct feature of chronic inflammation?
A. angiogenesis
C. Neutrophilic infiltrates
B. Angioedema
D. Marked capillary permeability
82. An 82 year old male dies from complications of Alzheimer’s disease. What is the histologic change
present?
A. Mitochondrial damage
C. Hypertrophy of the smooth ER
B. Membrane skeleton abnormality
D. Neurofibrillary tangles
83. A 40 year old female developed jaundice with an enlarged liver with a uniform yellow greasy cut
surface. What is the diagnosis with that description?
A. Excessive entry of FFA into the liver C. Low apoprotein synthesis
B. Increased esterification of FA to TG D. Impaired lipoprotein secretion from liver
84. A below the knee amputation was performed extensive on an 85 year old male with extensive black
discoloration and purulent exudation. What type of necrosis is this?
A. Coagulative necrosis
C. Gangrenous necrosis
B. Caseation necrosis
D. Liquefactive necrosis
85. Generation of which of the following will least likely decrease free radicals?
A. Myeloperoxidase
C. Glutathione peroxidase
B. Superoxide dismutase
D. Catalase
86. Which of the following cells is …
A. Endothelial cells
B. Hepatocyte
C. Smooth muscles
D. Skeletal muscles
87. A 45 year old female was diagnosed with viral pneumonia. Which of the following would be present?
A. Neutrophils
C. Lymphocytes
B. Macrophages
D. Eosinophils
88. Features of apoptosis include the following except:
A. There is absence of inflammation
B. Its most characteristic feature is chromatin condensation
C. It is a morphologic pattern of cell necrosis
D. It is responsible for cell death in viral infection
89. If their connective tissue framework is destroyed which will be replaced by fibrosis?
A. Myocardial cells
D. All of the above
B. Gastric mucosal cells
E. Only A & C
C. Bronchial epithelial cells
90. Ab production against Ag is produced by or characteristic of
A. Lymphoctes
C. Neutrophils
B. Mast cells
D. Plasma cells
91. Exudate formation involves increase in
A. It is mediated by histamine and serotonin
B. It is most commonly due to direct endothelial cell injury
C. Both A & B
D. Neither A & B
92. Keloid is a tumorous scar caused by
A. amyloid
B. Collagen
C. Glycogen
D. Keratin
93. Abscess is the result of which process?
A. Autolysis
B. Heterolysis
C. Both A & B
D. Neither A & B
94. Phagocytosis requires the following receptors
A. Mannose receptors
D. All of the above
B. Scavenger receptors
E. Only B & C
C. Receptors for opsonins
95. Phagocytosis is best accomplished by:
A. Neutrophils
B. Macrophages
C. Lymphoctes
D. Plasma cells
96. Features of embryonic stem cells include all except
A. They are isolated from normal blast cysts
B. They are multipotent
C. They are used in therapeutic cloning
D. They can generate all tissues of the body
97. Acute phase responses in inflammation commonly involve
A. Anorexia
C. Leukopenia
B. Fever
D. Increased acute phase proteins
98. Uncomplicated pericardial effusion in congestive heart failure is
A. Fibrinous
C. Serous
B. Membranous
D. Suppurative
99. An important complication of wound healing in 2nd degree burns is
A. Contracture
C. Serous
B. Fibromatosis
D. Wound dehiscence
100. Cellular aging is the result of a progressive decline in cellular function and viability due to which of the
following
A. Telomere shortening
B. Environmental insults with free radical formation
C. DNA repair defects
D. All of the above
E. Only B & C