General Pathology Questions
1. Polymorphonuclear neutrophil granulocytes:
A are important cells in bacterial diseases. B play a role in inflammation by releasing histamine. C Are important cells in parasitic diseases. D None of above
Correct Answer: A are important cells in bacterial diseases.
Explanation: Neutrophils are the first line of defense in acute inflammation. Their primary role is the phagocytosis and killing of bacteria through the release of enzymes and reactive oxygen species. Histamine is primarily released by mast cells and basophils, while parasites are typically combated by eosinophils.
2. An old bitch has a malignant lymphoma… By which of the following mechanisms has her neoplasm primarily responded to therapy:
A Coagulative necrosis B Mitochondrial poisoning C Apoptosis D all of above
Correct Answer: C Apoptosis
Explanation: Chemotherapeutic agents often induce apoptosis (programmed cell death) in neoplastic cells. This is characterized by nuclear fragmentation (karyorrhexis) and the formation of apoptotic bodies without an extensive inflammatory response, leading to a gradual decrease in tumor size.
3. Which of the following would typically result in liquefactive necrosis?
A cerebral infarction from middle cerebral artery thrombosis B liberation of pancreatic enzymes into peritoneum due to acute pancreatitis C myocardial infarction from coronary thrombosis D all of above
Correct Answer: A cerebral infarction from middle cerebral artery thrombosis
Explanation: Liquefactive necrosis is characteristic of focal bacterial or fungal infections and, uniquely, hypoxic death of cells within the central nervous system (brain). Myocardial infarction results in coagulative necrosis, and pancreatitis results in enzymatic fat necrosis.
4. Frozen section evaluation… granulomatous inflammation with large areas of necrosis. Which of the following would be most important to do?
A cell surface markers for lymphocyte phenotyping B chromosomal analysis by karyotyping C cultures for acid fast bacilli and fungi D None of above
Correct Answer: C cultures for acid fast bacilli and fungi
Explanation: Granulomatous inflammation with necrosis (caseous necrosis) is highly suggestive of specific infectious agents, most notably Mycobacterium (acid-fast bacilli) or certain fungal infections. Culturing is essential for definitive diagnosis.
5. A buffalo with immunodeficiency… Chest x-ray shows pulmonary infiltrates. A tuberculin skin test shows no reaction. Which of the following interpretations is most correct?
A she does not now have and never has had tuberculosis B she does not now have tuberculosis, but may have in the past C she may or may not have tuberculosis D none of above
Correct Answer: C she may or may not have tuberculosis
Explanation: In states of immunodeficiency, the body may fail to mount a delayed-type hypersensitivity reaction to the tuberculin test even if an active infection is present. This is known as anergy. Therefore, a negative test does not rule out the disease.
6. Amyloid consists of:
A extracellular deposits of altered protein in a Beta-pleated sheet pattern B extracellular accumulations of damaged collagen fibrils C denatured proteins D all of above
Correct Answer: A extracellular deposits of altered protein in a Beta-pleated sheet pattern
Explanation: Amyloid is a pathological proteinaceous substance deposited between cells. Its defining physical characteristic is that the polypeptide chains are folded into a cross-beta-pleated sheet conformation, which gives it its characteristic staining properties with Congo red.
7. Each of the following may contribute to formation of edema EXCEPT:
A decreased plasma oncotic pressure B increased intravascular hydrostatic pressure C increased serum albumin D all of above
Correct Answer: C increased serum albumin
Explanation: Albumin is the primary protein responsible for plasma oncotic pressure, which keeps fluid inside the vessels. Increased serum albumin would increase oncotic pressure and help prevent edema, rather than cause it.
8. Unconjugated bilirubin is derived principally from:
A glucuronyl transferase activity B toxic liver injury C intravascular haemolysis D bile duct obstruction
Correct Answer: C intravascular haemolysis
Explanation: Unconjugated bilirubin is the byproduct of heme breakdown from red blood cells. Intravascular hemolysis increases the load of heme released into the plasma, leading to high levels of unconjugated bilirubin before it ever reaches the liver for conjugation.
9. Markedly increased concentration responsible for kernicterus in hemolytic disease of the newborn.
A Unconjugated bilirubin B Conjugated bilirubin C hemosiderin D none of above
Correct Answer: A Unconjugated bilirubin
Explanation: Unconjugated bilirubin is lipid-soluble and can cross the blood-brain barrier in neonates. When levels are markedly high, it deposits in the brain (basal ganglia), a toxic condition known as kernicterus.
10. The main feature of a healing wound is:
A Lymphocyte accumulation B Fibrin deposition C Granulation tissue formation D tissue destruction
Correct Answer: C Granulation tissue formation
Explanation: Granulation tissue is the hallmark of early wound healing and tissue repair. it consists of new thin-walled capillaries (angiogenesis), fibroblasts, and an edematous extracellular matrix.
11. In addition to pulmonary stenosis and ventricular septal defect, Tetralogy of Fallot includes:
A Dextroposition of aorta and right ventricular hypertrophy B Dextroposition of aorta and left ventricular hypertrophy C Right ventricular hypertrophy and left atrial dilatation D all of above
Correct Answer: A Dextroposition of aorta and right ventricular hypertrophy
Explanation: The four components of Tetralogy of Fallot are: 1. Ventricular Septal Defect (VSD), 2. Pulmonary Stenosis, 3. Overriding aorta (dextroposition), and 4. Right Ventricular Hypertrophy.
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12. Which of the following is most likely to result in cyanosis?
A Anemia B Polycythemia C Left to right cardiac shunt D bilirubinaemia
Correct Answer: B Polycythemia
Explanation: Cyanosis occurs when there is a high absolute concentration of deoxygenated hemoglobin (usually >5g/dL). Patients with polycythemia (high RBC count) reach this threshold more easily than anemic patients, even if their oxygen saturation is only moderately reduced.
13. Clinical manifestations of right heart failure include each of the following EXCEPT:
A dependent edema B Ascites C Pulmonary edema D nutmeg liver
Correct Answer: C Pulmonary edema
Explanation: Pulmonary edema is a classic sign of left-sided heart failure (due to back-pressure into the lungs). Right-sided failure causes systemic congestion, leading to peripheral edema, ascites, and “nutmeg liver” (congestive hepatopathy).
14. Left-sided heart failure is characterized by:
A Hepatomegaly B Dyspnea (shortness of breath) C Varices D nutmeg liver
Correct Answer: B Dyspnea (shortness of breath)
Explanation: In left-sided heart failure, the left ventricle cannot pump blood efficiently, leading to pulmonary congestion and fluid in the alveoli. This results in dyspnea, orthopnea, and cough.
15. The edema of nephrotic syndrome is best classified as
A Hypovolemic B Obstructive C Oncotic D none of above
Correct Answer: C Oncotic
Explanation: Nephrotic syndrome is characterized by massive proteinuria (loss of albumin in urine). The resulting hypoalbuminemia causes a drop in plasma oncotic pressure, allowing fluid to leak into the interstitium.
16. Which one of the following is may be a malignant neoplasm?
A Seminoma B Trichoepithelioma C Chondroma D hepatoma
Correct Answer: A Seminoma
Explanation: A seminoma is a malignant germ cell tumor of the testis. While it ends in “-oma” (which usually denotes benign tumors), it is an exception to that rule, along with melanoma and lymphoma. “Hepatoma” is an outdated term for Hepatocellular Carcinoma (malignant), but Seminoma is the more standard “exception” taught in general pathology.
17. Proto-oncogenes are:
A Cellular sequences that are not oncogenes themselves, but are strong promoter sequences that flank the true oncogene B Cellular copies of oncogenes that were first found in retroviruses C DNA viral sequences that are known to infect human cells and have been implicated in neoplasia D none of above
Correct Answer: B Cellular copies of oncogenes that were first found in retroviruses
Explanation: Proto-oncogenes are normal cellular genes that regulate cell growth and differentiation. When mutated or overexpressed, they become oncogenes, which promote cancer.
18. Which of the following findings is most useful for the staging of a tumor?
A Presence of necrosis B Presence of abnormal mitoses C Presence of metastases D presence of apoptosis
Correct Answer: C Presence of metastases
Explanation: Staging (e.g., TNM system) refers to the extent of spread of a tumor. The presence of metastases (M) is the most critical factor in determining the stage. Necrosis and mitoses are used for grading (microscopic appearance).
19. Benign tumors arising from the salivary gland epithelium are called:
A Transitional cell epitheliomas B Adenomas C Fibromas D adenocarcinoma
Correct Answer: B Adenomas
Explanation: A benign tumor of glandular epithelium is called an adenoma. “Adenocarcinoma” is the malignant counterpart.
20. Which of the following finding is most important for the grading of tumors?
A Presence of tumor cells in the vascular spaces B Level of invasion C Microscopic pleomorphism of nuclei and the number of mitoses D degree of metastasis
Correct Answer: C Microscopic pleomorphism of nuclei and the number of mitoses
Explanation: Grading is an assessment of the degree of differentiation and the rate of growth of tumor cells under the microscope. This includes evaluating nuclear pleomorphism and the mitotic index.
21. Which of the following activates Hageman factor in blood clotting?
A Kinins B Negatively charged surfaces C Complement C5a D positively charged collagen
Correct Answer: B Negatively charged surfaces
Explanation: Hageman factor (Factor XII) is activated when it comes into contact with negatively charged surfaces, such as exposed subendothelial collagen, basement membranes, or even activated platelets.
22. Epithelioid cells within granulomas are derived from which of the following?
A Plasma cells B Macrophages C Lymphocytes D Eosinophils
Correct Answer: B Macrophages
Explanation: Epithelioid cells are specialized, activated macrophages that have developed an abundant cytoplasm and look somewhat like epithelial cells. They are a hallmark of granulomatous inflammation.
23. Biologically active metabolites of arachidonic acid include all of the following EXCEPT:
A Leukotrienes (SRS) B Thyromboxane A2 C Complement D Antibodies
Correct Answer: C Complement
Explanation: Arachidonic acid metabolites (eicosanoids) include prostaglandins, thromboxanes, and leukotrienes. Complement and Antibodies are proteins, not lipid metabolites of arachidonic acid.
24. Bacterial opsonization is mediated by which one of the following?
A Hageman factor B Prostaglandin C Antibodies D Tumor Necrosis Factor
Correct Answer: C Antibodies
Explanation: Opsonization is the process of coating a particle (like a bacterium) to enhance phagocytosis. The primary opsonins are Antibodies (IgG) and complement fragments (C3b).
25. Predominant cell types in typical chronic inflammatory reactions include all of the following EXCEPT:
A Polymorphonuclear leukocytes B Macrophages C T helper lymphocytes D Epitheloid cells
Correct Answer: A Polymorphonuclear leukocytes
Explanation: Polymorphonuclear leukocytes (neutrophils) are the hallmark of acute inflammation. Chronic inflammation is characterized by mononuclear cells, such as macrophages, lymphocytes, and plasma cells.