ANATOMY MCQ 2008 GOLD - EmergencyPedia
Pathology MCQ
Recalled Questions (2008-2010)
1) OA vs RA
a. in RA osteoclast stimulation by inflammatory mediators causes bone resorption
2) Ulcers:
a. H.pylori causes damage by the production of cytokines
b. All gastric ulcers heal
c. H-pylori invades tissue
d. 80% of people with H pylori get peptic ulcers
3) Measels
a. Rah is caused by hypersensitivity
4) Intracranial bleed
a. 50%-60% are in the putamen
5) Ectopic pregnancy
a. In in every 500 pregnancies
b. Most commonly happens in the fallopian tubes
c.
6) Immunological tolerance
a. Thymus is involvd in developing peripheral tolerance
b.
7) Severe acute left heart failure causes peripheral oedema because
a. Reduced pressure in the peripheral capillaries
b. Reduced right atrial pressure
c. Increased CO2
d. Increased aortic pressure
8) an aging heart demonstrates
a. an increase in the size of the left ventricular cavity
b. yellow atrophy
c. reduced myocardial mass
9) Chlamydia
a. Can only survice inside host cells
b. Can produce its own ATP
c. Is a small gram postive bacteria
d.
10) Immunoglobulin
a. IgM has a valency of 5
b. IgG is 40% of total protein
c. Immunoglobulins constitute 50% of total protein
d. Antibody and antigen bnd covalently
e. Immunoglobulin response happens within 12 hrs
11) In chronic renal failure here is
a. Hypokalemia
b. Hypocalcemia
c. Pimary hyperparathyroidism
d. Increased PTH
e. Respiratory acidosis
12) In chronic renal failure there is
a. Increased total glomerular filtration rate
b. Hypertrophy of the glomerulus and dilatation of the vasculature
c. Slowed tubular flow
d.
13) Intracerebral abscess will cause
a. Raised CSF WCC and reduced CSF glucose
b. Signs of raised ICP and focal neurological signs
14) mitochondria
a. are able to self replicate
b. are absent from RBCs
c. have only 1 layer
d. predominate in cells with anaerobic swelling
15) tuberculosis pathogenicity is due to
a. type 4 hypersensitivity
b.
16) ATN secondary to ischaemia
a. Happens mainly in the DCT
b. Caused by tubules being blocked by casts
17) The following do NOT cause diffuse interstitial pulmonary fibrosis
a. Asbestos
b. Beryllium
c. Chloramphenicol
d. Scleroderma
e. Sarcoidosis
18) Massive neutropenia by removal or destruction is caused by
a. Massive fungus infection
b. Erythromycin
19) Cyanotic cardiac defects are caused by
a. PDA
b. Tractus arteriosus
c. Pulmonary vein displacement
d. Tricuspid atresia
20) What is the clearance mechanism for particles less than 5 micrometers in diameter
a. Alveolar macrophage phagocytosis
b. Sneezing
c. Mucociliary clearance
21) With regards to complement
a. C5a stimulates arachidonic acid metabolism
b. C5a is connected to C5b
c. C3b causes negative feedback on C3
22) Bradykinin is
a. Converted from a larger precursor by Kallikrein
b. Relaxes smooth muscle
23) Which of the following is not a DNA virus
a. HIV
24) Regarding HIV
a. T-cells must be activated for pro-viral DNA transcription
25) With regard to metastasis
a. Renal carcinoma can invade the IVC
b. Ovarian carcinoma causes peritoneal polymyxoma by secondary seeding
26) Apoptosis
a. Caused by activation of caspases
b. Extrinsic pathway is activated by BCL-2 “death receptor”
27) Non-atopic asthma caused by
a. Virus
28) Acute pancreatitis
a. Associated with associated with alcohol or gallstones in 40%
b. Caused by biliary reflux
c. Caused by intraductal activation of enzymes
d. Alpha cells secrete trypsin and pepsinongen
29) Chronic pancreatitis
a. 40% is idiopathic
b. 40% have pseudocysts
c. Not connected to pancreatic carcinoma
30) Hepatitis A
a. Does not caue chronic hepatitis
b. Is a DNA virus
c. Causes a chronic carrier state
31) Subacute endocarditis is caused by
a. Strep pyogenes
b. Staph aureus
c. Staph epidermitis
d. Strep viridians
32) In acute MI
a. There is sudden loss of contractility within 60 sec
b. Necrosis occurs after 60 minutes
33) White infarcts
a. Occur in solid organs and end arteries
b. Occur in the intestine
c. Most common in the liver
34) Vesicoureteric reflux
a. Most common cause of UTI
b. Caused by atony secondary to spinal cord injury
c. Is because of the lengthening of the intravesical part of the ureter
35) DIC is
a. Associated with activated fiBrinolysis
b. Caused by extrinsic pathway activation
c. Associated with thrombocytosis
d. Malignancy presents with bleeding diathesis
36) Volume of intravenous air reqired to causes symptoms is
a. 100ml
37) Stress fractures
a. Caused by abnormal repetitive axial loads
b. Cause a periosteal reaction
c. Associated with pagets disease
38) Fat embolism
a. Causes a petechial rash
b. Symptoms obvious within 12 hrs
c. Associated only with trauma
d. Associated with long bone fratures only.
39) Absorption of iron
a. Increased by vitamin C
b. In the body is stored mainly in cytochrome and myoglobin
40) Rickettsia affects
a. Endothelial cells
b. Hepatocytes
41) First event in inflammation
a. Arteriolar vasoconstriction
42) silicosis
a. most common in coal workers
b. causes mesothelioma
c. causes anthracosis
d. can rapidly progress to respiratory failure
43) lead poisoning causes
a. macrocytosis
b. learning difficulties in children
44) irreversible cell death
a. cell swelling
b. mitochondrial dysfunction
c. microvilli and bleb appearance
d. ribosomal detachment from the RER
45) Smooth ER
a. involed in Protein synthesis
b. ribosomes are present
c. lipid synthesis
d. electron transport chain
46) metastatic cancer
a. well-differentiated tumors don’t metastasize
b. malignant tumours can invade surrounding tissues while appearing cohesive
47) urticaria
a. local degranulation of mast cells
b. characterized by pruritic papules
48) Aortic dissection
a. Most commonly associated with hypertension
49) Rh compatibility
a. Erythroblastosis foetalis
b. C, E, D –ve
50) Emphysema in smoking is
a. Centroacinar
51) Post mortem changes in a clot
a. Chicken fat supernatant
52) Macrophages release
a. Oxygen free radicals
53) Pituitary adenoma
a. Acromegaly
b.
54) Nephritic syndrome
a. Caused by post-stretococcal GN
55) cirrhosis
a. causes a distortion of vascular architecture by fibrosis
b. involves inflammation
PATHOLOGY
(2008)
Regarding peptic ulcer disease
Most duodenal ulcers occur in the posterior wall
Most stomach ulcers occur in the posterior wall
Heaping up of the margins of the peptic ulcer is diagnostic of malignancy (true)
The size and location differentiate a benign from a malignany ulcer (does not)
30% of pts have co-existing duodenal and gastric ulcers (10-20%)
Differences btw OA and RA in morphology
inflammatory mediators activate osteoclasts
Erosion of subchondrial surface causes pseudo-articular surface
Decompression sickness does not cause
Intracerebral haemorrhage
confusion
subchondral avascular necrosis femur
vertigo
arthalgia
Mitochondria and ATP
60% ATP is formed in mitochondria
The last step in ATP formation is transport of O2 along the ETC?
Hydrogen ions release passively diffuse out of mitochondria
glycolysis occurs in cytoplasm
Ab-mediated acute transplant rejection – what is characteristic?
vasculitis
cell mediated immunity
Apart from T cells, what is the major component of cell mediated immunity?
NPs
macrophages
B cells
complement
Which cells can directly kill without prior sensitization to Ag?
NK cells
cytotoxic CD8 cells
other wrong ones
Coal causes all but
bronchiogenic carcinoma
Caplan syndrome
pneumoconiosis
pulmonary fibrosis
anthracosis
Black pigment in smokers lungs deposits in (repeat)
Type I pneumocytes
Type II pneumocytes
Alveolar Macrophages
Squamous cell carcinoma (repeat)
occurs commonly in the periphery
occurs more commonly in women
closely a/w smoking
5 year mortality survival is 40%
The pulmonary disorder predisposing you to cor pulmonale
asthma
pulmonary eosinophilia
cystic fibrosis (I thought this one)
streptococcal pneumonia
Severe acute respiratory syndrome
Atherosclerosis – what is in the core? (repeat)
Smooth muscle
T cells
foam cells
macrophages
lymphocytes
Increased destruction/removal of neutrophils causing neutropenia is due to
psoriatic arthritis
Lyme disease
severe fungal infection
erythromycin
Aging effects on the heart include
sigmoid ventricular septum
dilated L atrium
dilated L ventricle
fibrosis of leaflets
calcification of aortic valve
Hep E (repeat)
20% mortality in pregnant women
parenteral transmission
DNA virus
incubation period of days (4-5?)
Rickettsial infection (repeat) – which is not transmitted by arthropods?
Scrub typhus
endemic typhus
Rocky mountain spotted
Q fever
pediculosis
Passive hyperaemia (WTF? – it’s either congestion if its passive or active if its hyperaemic) is due to
exercising muscle
arterial dilatation
blushing
release of vasoactive substances
portal hypertension
Metastatic calcification typically occurs in
interstitial tissue in gastric mucosa
old TB lesion
healed ?
mitral valve
damaged/healed ?? hip joint??
What causes Vit B12 deficiency
Anti-convulsants
autoimmune gastritis
fat malabsorption
Regarding shock
reversible stage is characterized by hypoperfusion of vital organs
arterial pressure may be normal
marked peripheral vasoconstriction is characteristic
Pulse pressure changes
lactic acidosis enhances the vasomotor response
Loss of 1000mL of blood in a 70 kg man - what is correct
Hct decreases immediately
Iron absorption in the gut doesn’t change
35% plasma volume is lost
something about blood pressure that didn’t seem right (? BP drops)
Renal artery stenosis
causes abnormally high renal vein renin?
usu bilateral
more common in women
causes ipsilateral kidney enlargement
commonly caused by fibromuscular dysplasia
Adult PCKD
is rare, causing 1% of CRF
autosomal recessive
causes solitary and multiple cysts in a normal-sized kidney
40% die from ruptured berry aneurysm
causes mitral valve complications
Apoptosis
is activated by caspases
chromatin condensation is not a feature
death receptor pathway is activated by BCl-2 receptors
2 other wrong stems
Regarding neoplasms
pleocytosis causes lack of differentiation
anaplasia is the hallmark of malignancy
mitoses is only seen in malignancy
Well differentiated only occurs in benign tumours
Function of centrioles (repeat): involved with spindles for mitosis
Regarding electrical injuries
Death is usually a/w massive skin burns
Dry skin is a good conductor
All body tissues can conduct electricity
Lightening is … thermal burns? (sth wrong)
Amperage is not important
Insulin
increases mRNAs in lipogenesis (this is the right answer)
inactivates glycolytic enzymes
activates phosphorylases and glucokinase
decreases transport of glucose into cells
What is an example of hypertrophy?
Increase in breast at puberty
Increase in liver size after partial hepatectomy
Uterus growth in pregnancy
increased resp epithelium in Vit A deficiency
After formation of the blood clot in wound healing, what occurs next?
loss of granulation tissue
granulation tissue
formation of blood clot
infiltration of neutrophils and epithelial migration from the wound margin
collagen deposition
What occurs first in fracture healing?
collagen
woven bone /lamellar bone combo
procallus formation (we put this one – there was nothing about NP infiltration)
neovascularisation?
Regarding phagocytosis
opsonisation occurs with C5b
2 stages: engulfment and killing
largely dependent on O2 for killing (this one)
Regarding platelets
concentration normally is 150 x 10^6 – 450 x 10^6 / litre of blood
needs vWF for degranulation
are the main source of thrombin
Regarding tissue macrophages
The half life is 5-8 days
a minority are formed from monocytes
can be activated endotoxin (I put this one)
Regarding the heart
ATP reduction by 50% occurs within 10 mins
first affected is epicardium
60% of occlusive thrombus is due to ulceration/fissure of plaque
Regarding chronic pancreatitis
Up to 40% is idiopathic
equally affects women and men
most commonly caused by cholelithiasis
has no association with pancreatic cancer
causes pseudocysts in 25%
Regarding acute pancreatitis
trypsin activates the kinin system
less than 5% are idiopathic
35% with gallstones develop pancreatic
gallstones are present in 80% of cases
What is a feature of chronic renal failure?
hyperkalaemia
hypocalcaemia
primary hyperparathyroidism
respiratory acidosis
Nephrotic syndrome
causes salt and water retention
usually does not cause raised plasma lipids
usually a/w raised ASOT
causes haematuria
What presents with nephritic syndrome?
Acute post-strep GN
membranous GN
FSGS
proliferative …glomerulopathy ..
Regarding testicular torsion
peak incidence in toddlers
bell clapper deformity is characteristic in neonates
usually unilateral anatomical abnormality
is due to twisting of spermatic cord causing impaired venous drainage
Regarding the pathogenesis of T1 DM
decreased sensitivity of insulin to receptors
it is due to insulinitis from autoimmune process (this one)
Non-thrombocytopaenic purpura occurs in
AIDS
meningococcal
What is not a major risk factor in atherosclerosis?
Hypertension
Diabetes
OCP
hypertriglyceridaemia
smoking
What is not a major criterion of the Jones criteria for rheumatic fever?
Fever
carditis
sydenham’s chorea
erythema marginatum
large migratory polyarthopathy
Regarding chronic hypertension and intracranial haemorrhages
causes haemorrhage in the putamen in 50-60 of cases
saccular aneurysms
30% die from ruptured intracranial haemorrhage ?
the majority of intracranial haemorrages is due to chronic hypertension
What is characteristic of chronic bronchitis?
decreased goblet cell numbers
smooth muscle hypertrophy of bronchial wall
increased size of mucous glands (I put this one)
thickened basement membrane
What causes leaking of vascular membranes in acute inflammation?
gap in endothelium of venules (this one)
gap in basement membrane
few others that seemed wrong
What is the best definition of gangrenous necrosis?
Digestion of dead tissue by bacteria
Digestion of living tissue by bacteria
coagulative necrosis by bacterial toxins
gas production in the tissue
Regarding hyperbilirubinaemia
Unconjugated bilirubin is water soluble
uncongugated bilirubin is tightly bound to albumin (this one)
Causes kernicterus in adult brains
Unconjugated bilirubin is excreted in urine
Lipofuscin pigment
does not damage cell function or cell
is water soluble
The most common cause of acute haemodynamic (cardiac) pulmonary edema is
decreased colloid oncotic pressure
increased hydrostatic pressure (this one)
altered surfactant
..other weird ones
Acute graft rejection is characterized morphologically by
vasculitis
interstitial mononuclear infiltration
fibrosis
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