Introduction to Pathology
Chapter Exam Questions
Course Introduction
Introduction to Pathology offers students a comprehensive overview of the basic principles and mechanisms underlying disease processes in the human body. The course examines cellular adaptations, injury, inflammation, healing, hemodynamic disorders, and neoplasia, providing a foundation for understanding how normal physiology is disrupted in various pathological conditions. Through lectures, case studies, and laboratory sessions, students will learn to recognize fundamental pathological changes and correlate them with clinical manifestations, laboratory findings, and diagnostic techniques. This course is essential for students pursuing careers in medicine, biomedical sciences, and related health fields, preparing them for advanced study in clinical and systemic pathology.
Recommended Textbook
Basic Pathology 9th Edition by Vinay Kumar
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265 Flashcards
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Chapter 1: Cell Injury, Cell Death, and Adaptations
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Sample Questions
Q1) Continuous expression of the gene for atrial natriuretic factor in the myocardial cells of the left ventricle is typically a consequence of A) myocardial infarction
B) angina pectoris
C) hypertension
D) hypotension
E) ventricular fibrillation
Answer: C
Q2) A 28-year-old man was found to have cirrhosis of the liver and pulmonary emphysema. The liver cells contained globular inclusions in their cytoplasm, which by electron microscopy are shown to be located inside the A) Golgi apparatus
B) smooth endoplasmic reticulum
C) rough endoplasmic reticulum
D) mitochondria
E) peroxisomes
Answer: C
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Chapter 2: Inflammation and Repair
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Sample Questions
Q1) Which of the following mediators of inflammation has chemotactic properties and is increased in persons taking aspirin?
A) Thromboxane A<sub>2</sub>
B) Prostaglandin E<sub>2</sub>
C) Platelet-activating factor
D) Leukotriene B<sub>4</sub>
E) Interleukin-1
Answer: D
Q2) C-reactive protein binds to the surface of microbes in tissues acting as
A) a caspase
B) a peroxidase
C) an opsonin
D) an anaphylatoxin
E) a membrane attack protein
Answer: C
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Chapter 3: Hemodynamic Disorders, Thromboembolism, and Shock
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Sample Questions
Q1) A 60-year-old man who had longstanding congestive heart failure complained of pain under the right costal margin. He died of worsening heart failure. At autopsy, the liver appeared enlarged and congested, showing a "nutmeg pattern" on cross section. Histologically this liver will show
A) atrophy of bile ducts
B) dilatation of bile ducts
C) intralobular cholestasis
D) centrolobular necrosis and loss of hepatocytes
E) fibrosis of the Glisson capsule
Answer: D
Q2) A 60-year-old woman had a mastectomy for advanced cancer in her left breast, followed by chemotherapy and radiation therapy. She developed edema of the left arm. This edema is caused by
A) obstruction of the lymph flow
B) arterial thrombosis
C) venous thrombosis
D) spread of cancer into the soft tissue of the arm
E) hypoalbuminemia secondary to liver injury caused by hepatic metastases
Answer: A
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Chapter 4: Diseases of the Immune System
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Q1) A 40-year-old man presents with hemoptysis and renal failure. A kidney biopsy specimen revealed linear deposits of IgG in glomerular basement membranes and crescents between the glomerular capillary loops and the Bowman capsule. The antibodies causing these pathologic changes react with
A) laminin
B) fibronectin
C) collagen type I
D) collagen type IV
E) podocytes of glomerular epithelial cells
Q2) Antigen-antibody reaction in polyarteritis nodosa is characterized by which form of necrosis of the arterial wall?
A) Coagulative necrosis
B) Fibrinoid necrosis
C) Liquefactive necrosis
D) Fat necrosis
E) Caseous necrosis
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Chapter 5: Neoplasia
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Q1) Pseudomyxoma peritonei is a complication of which tumor?
A) Serous cystadenoma of the ovary
B) Mucinous cystadenoma of the ovary
C) Ovarian fibroma
D) Myxoma of the heart
E) Myxosarcoma of the lower extremity
Q2) In which cell function is BRCA1, a gene mutated in women with familial breast carcinoma, involved?
A) Cell adhesion
B) Growth inhibition
C) Signal transduction
D) Cell surface channel
E) Transcriptional regulation and DNA repair
Q3) Which mechanism affecting the genes or chromosomes accounts for the activation of the c-myc protooncogene in Burkitt lymphoma cells?
A) Overexpression
B) Amplification
C) Point mutation
D) Translocation
E) Inactivation of its promotor
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Chapter 6: Genetic and Pediatric Diseases
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Q1) Chromosome 22q11 deletion is typically associated with A) rocker-bottom feet
B) horseshoe kidneys
C) thymic hypoplasia
D) microphthalmia
E) simian crease on hands
Q2) Which malignancy occurs at a high rate in persons affected with Down syndrome?
A) Acute lymphoblastic leukemia
B) Chronic lymphocytic leukemia
C) Chronic myelogenous leukemia
D) Plasmacytoma
E) Brain tumors
Q3) Neonatal vomiting and diarrhea and failure to thrive, combined with jaundice, hepatomegaly, early development of cataracts, and mental retardation, suggest the diagnosis of
A) Hunter syndrome
B) Hurler syndrome
C) cystic fibrosis
D) Marfan syndrome
E) galactosemia
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Chapter 7: Environmental and Nutritional Diseases
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Q1) Frontal bossing of the cranium that imparts a square appearance to the head, pigeon breast deformity, and bow legs are features of a deficiency of which vitamin?
A) Vitamin A
B) Vitamin B<sub>1</sub>
C) Vitamin C
D) Vitamin D
E) Vitamin K
Q2) Lead absorbed from the environment during infancy and childhood is predominantly deposited in which internal organ or organ system?
A) Brain
B) Liver
C) Lungs
D) Bones
E) Skeletal muscles
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Chapter 8: General Pathology of Infectious Diseases
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Sample Questions
Q1) Mycobacterium tuberculosis phagocytosed by macrophages in granulomas can be killed by endogenous nitric oxide (NO) after these macrophages become activated by T-helper cells. Which biologically active substance stimulates the formation of NO in macrophages?
A) Platelet-activating factor
B) Interferon-
C) Interleukin-1
D) Tumor necrosis factor
E) Prostaglandin E<sub>2</sub>
Q2) Schistosoma mansoni infection causes liver changes that present histologically as A) granulomas that also contain eosinophils
B) abscesses
C) suppurative cholangitis
D) centrolobular necrosis of liver cells
E) centrolobular fibrosis
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Chapter 9: Blood Vessels
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Sample Questions
Q1) "Pulseless disease" associated with giant cell granulomatous inflammation of the aorta and its major branches arising from the arch of the aorta are features of
A) temporal (giant cell) arteritis
B) Takayasu arteritis
C) Kawasaki disease
D) Churg-Strauss syndrome
E) Henoch-Schönlein purpura
Q2) Antineutrophil cytoplasmic antibodies showing widespread cytoplasmic staining of neutrophils in an indirect immunofluorescence test (c-ANCA) are found in high titers in which disease?
A) Microscopic polyangiitis
B) Wegener granulomatosis
C) Churg-Strauss syndrome
D) Goodpasture syndrome
E) Kawasaki syndrome
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Chapter 10: Heart
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Sample Questions
Q1) Bacillary angiomatosis is typically found in AIDS patients and is caused by
A) herpesvirus type 8
B) herpesvirus type 3
C) herpesvirus type 6
D) Bartonella henselae
E) measles virus
Q2) The most common genetic mutation found in congenital hypertrophic cardiomyopathy involves the gene encoding
A) troponin T
B) troponin I
C) -tropomyosin
D) myosin-binding protein C
E) ß-myosin heavy chain
Q3) Stable angina, the most common form of angina pectoris, is caused by A) stenosis of coronary arteries
B) Lipid-rich atheromas
C) ruptured atheromas
D) thrombi overlying partially ruptured atheromas
E) no pathologic changes in the coronary arteries
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Chapter 11: Hematopoietic and Lymphoid Systems
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Q1) Hemolytic uremic syndrome (HUS) shares many features with thrombotic thrombocytopenic purpura (TTP), but in contrast with patients with TTP, those with HUS do NOT have
A) anemia
B) renal failure
C) neurologic deficits
D) fever
E) thrombocytopenia
Q2) Which test is abnormal in hemophilia A?
A) Bleeding
B) Platelet count
C) Prothrombin time
D) Partial thromboplastin time
E) Clot retraction
Q3) Severe hemophilia develops in patients who have factor VIII reduced below A) 1%
B) 5%
C) 10%
D) 20%
E) 25%
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Chapter 12: Lung
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Sample Questions
Q1) The inhalation of which substance is the most common cause of "humidifier" or "air-conditioner" lung?
A) Thermophilic bacteria
B) Cotton fibers
C) Animal proteins
D) Plant proteins
E) Talc
Q2) Pulmonary infection characterized by predominance of macrophages involving predominantly small bronchioli and sparing the large bronchioli is most typical of infection caused by
A) Haemophilus influenzae
B) Staphylococcus aureus
C) Streptococcus pneumoniae
D) Pseudomonas aeruginosa
E) Legionella pneumophila
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Chapter 13: Kidney and Its Collecting System
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Q1) Membranoproliferative glomerulonephritis caused by mixed cryoglobulinemia is most often secondary to which of the following diseases?
A) Diabetes mellitus
B) Multiple myeloma
C) Membranous nephropathy
D) Amyloidosis
E) Human immunodeficiency virus infection
Q2) Which kidney disease characterized by nephrotic syndrome, microscopic hematuria, and glomerular deposits of C3 complement and properdin is caused by an autoantibody called C3 nephritic factor?
A) Membranoproliferative glomerulonephritis type II
B) Focal segmental glomerulosclerosis
C) Membranous nephropathy
D) IgA nephropathy
E) Acute postinfectious glomerulonephritis
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Chapter 14: Oral Cavity and Gastrointestinal Tract
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Sample Questions
Q1) Protein-losing gastroenteropathy will most likely develop in patients who have
A) acute erosive gastritis
B) chronic Helicobacter pylori-related gastritis
C) autoimmune atrophic gastritis
D) hypertrophic gastropathy
E) gastric peptic ulcer
Q2) Primary tumors of the peritoneum are called
A) adenocarcinomatosis peritonei
B) pseudomyxoma peritonei
C) peritoneal sarcoma
D) mesothelioma
E) myxomatosis
Q3) Most gastric polyps are microscopically classified as A) tubular adenomas
B) villous adenomas
C) hyperplastic polyps
D) fundic gland polyps
E) carcinoids
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Chapter 15: Liver, Gallbladder, and Biliary Tract
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Q1) Cryoglobulinemia is found in chronic hepatitis caused by which hepatotropic virus?
A) Hepatitis A virus (HAV)
B) HBV
C) HCV
D) HDV
E) HEV
Q2) Antibodies to mitochondrial dihydrolipoamide acetyltransferase are typically found in 90% of patients who have
A) autoimmune hepatitis
B) lupoid hepatitis
C) primary sclerosing cholangitis
D) primary biliary cirrhosis
E) hepatocellular carcinoma
Q3) Which of the following drugs causes microvesicular fatty change of the liver?
A) Tetracycline
B) Acetaminophen
C) Methyldopa
D) Methotrexate
E) Chlorpromazine
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Chapter 16: Pancreas
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Sample Questions
Q1) A 65-year-old man complains of vague upper abdominal pain, weight loss, and loose fatty stools. Radiographs show visible calcifications within the pancreas. These findings are most consistent with a diagnosis of which of the following disorders?
A) Ductal carcinoma of the pancreas
B) Acinar cell carcinoma of the pancreas
C) Islet cell carcinoma
D) Chronic pancreatitis
E) Pancreatic pseudocyst
Q2) Hereditary pancreatitis is most likely to be found in persons harboring the mutation of which of the following genes?
A) <sub>1</sub>-Antitrypsin
B) Amylase
C) Cationic trypsinogen
D) Enterokinase
E) Alkaline phosphatase
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Chapter 17: Male Genital System and Lower Urinary Tract
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Q1) Seminomas tend to metastasize first to which of the following sites?
A) Internal iliac lymph nodes
B) External iliac lymph nodes
C) Mesenteric lymph nodes
D) Retroperitoneal para-aortic lymph nodes
E) Urinary bladder
Q2) Which of the following infectious agents causes condyloma acuminatum of the penis?
A) Human papillomavirus types 6 and 11
B) Human papillomavirus types 16 and 18
C) Herpesvirus type 1
D) Herpesvirus type 2
E) Ureaplasma urealyticum
Q3) Penile carcinomas tend to metastasize first to which of the following nodes?
A) Inguinal lymph nodes
B) Obturator lymph nodes
C) Internal ileac lymph nodes
D) External iliac lymph nodes
E) Paraortic abdominal lymph nodes
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Chapter 18: Female Genital System and Breast
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Q1) Which of the following nonneoplastic breast lesions is associated with the highest risk of mammary cancer?
A) Apocrine cysts
B) Sclerosing adenosis
C) Complex sclerosing lesion
D) Small duct papillomas
E) Atypical ductal hyperplasia
Q2) BRCA1 and BRCA2 genes that are mutated in 25% of all women who have familial breast cancer encode proteins. Which of the following functions do these proteins serve?
A) Cell surface receptors for growth factors
B) Growth factors
C) Cytoplasmic signaling molecules
D) DNA repair enzymes
E) Nuclear hormone receptors
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Chapter 19: Endocrine System
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Q1) Vascular endothelial growth factor (VEGF) is implicated in the pathogenesis of which complication of diabetes?
A) Cerebral infarcts
B) Intraretinal microangiopathy
C) Diabetic glomerulosclerosis
D) Gangrene of the foot
E) Peripheral neuropathy
Q2) The best characterized molecular abnormality in pituitary adenomas involves which of the following?
A) Cell surface receptors
B) G-proteins mediating signal transduction
C) Adenylate cyclase related cytoplasmic effectors
D) Nuclear receptors
E) DNA repair enzymes
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Chapter 20: Bones, Joints, and Soft Tissue Tumors
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Q1) Which of the following muscle diseases is classified as an ion channel myopathy (channelopathy)?
A) Dysferlin deficiency
B) Becker muscular dystrophy
C) Malignant hyperpyrexia
D) Central core disease
E) Myotubular myopathy
Q2) Osteoid osteoma is a small benign bone tumor associated with pain that is disproportionate to the size of the lesion. This pain is caused by an excess of which of the following substances?
A) Interleukin (IL)-1 and IL-6
B) Leukotrienes
C) Prostaglandin E<sub>2</sub>
D) Complement C<sub>3</sub>
E) Bradykinin
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Chapter 21: Peripheral Nerves and Muscles
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Q1) Guillain-Barré syndrome is mediated by which form of immune hypersensitivity reaction?
A) Atopic IgE-mediated reaction
B) Cytotoxic IgG antibody-mediated reaction
C) Circulating immune complex-mediated reaction
D) T cell-mediated reaction
E) Graft-versus-host reaction
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Chapter 22: Central Nervous System
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Q1) Which of the following is the most common source of septic thromboemboli in the cerebral arteries?
A) Leg veins
B) Pulmonary veins
C) Heart
D) Aorta
E) Carotid arteries
Q2) Fetal alcohol syndrome is most often characterized by which of the following disorders?
A) Encephalocele
B) Anencephaly
C) Macrogyria
D) Microencephaly
E) Lissencephaly
Q3) Posttraumatic hydrocephalus is most often caused by which of the following?
A) Hypersecretion of cerebrospinal fluid
B) Obstruction of the aqueduct
C) Obstruction of the foramen of Luschka
D) Obstruction of the foramen of Magendie
E) Obstruction of cerebrospinal fluid absorption
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Chapter 23: Skin
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Q1) Which of the following skin lesions will most likely progress to invasive squamous cell carcinoma?
A) Actinic keratosis
B) Seborrheic keratosis
C) Seborrheic dermatitis
D) Epidermal inclusion cyst
E) Steatocystoma multiplex
Q2) Which of the following skin lesions becomes darker and more pigmented upon exposure to sunlight?
A) Vitiligo
B) Lentigo
C) Ephelis
D) Congenital melanocytic nevus
E) Dysplastic nevus
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