Topic 1: Introduction to Pathology & Histopathology

Q1. What is the scientific study of diseases called? a) Physiology b) Anatomy c) Pathology d)
Biochemistry Answer: c) Pathology Explanation: The document explicitly defines pathology as
the scientific study of diseases. It deals with the causes, mechanisms, and structural and
functional changes of disease.
Q2. Which of the following is NOT one of the four main aspects pathology deals with
specifically? a) Aetiology (causes of disease) b) Pathogenesis (mechanisms of disease) c)
Pharmacology (study of drugs) d) Morphology (structural alterations) Answer: c) Pharmacology
(study of drugs) Explanation: Pathology specifically deals with the aetiology, pathogenesis,
morphology, and functional alterations of disease. Pharmacology is a separate discipline,
though it is taught in association with pathology.
Q3. According to the historical background provided, where did pathology originate? a)
University research laboratories b) 'Siderooms' adjacent to hospital wards c) Specialized
pathology clinics d) Public health departments Answer: b) 'Siderooms' adjacent to hospital
wards Explanation: The document states that pathology originated from the 'siderooms' next to
hospital wards in the 1800s, where simple diagnostic tests were performed.
Q4. Which subdivision of pathology includes cytology and autopsy? a) Chemical Pathology b)
Medical Microbiology c) Anatomic Pathology d) Haematology Answer: c) Anatomic Pathology
Explanation: Anatomic Pathology, also known as Histopathology or Cellular pathology, includes
the examination of tissues (biopsy), cells (cytology), and whole bodies after death (autopsy).
Q5. How is pathology described in the medical curriculum? a) A preclinical subject focused on
normal function b) A clinical subject focused on patient treatment c) A "link" between preclinical
and clinical subjects d) An optional subject for specialization Answer: c) A "link" between
preclinical and clinical subjects Explanation: The document describes pathology as a "link" that
connects preclinical subjects like anatomy and physiology with clinical medicine. It relates the
knowledge of normal structure and function to the abnormal structure and function seen in
disease.
Q6. What percentage of the total marks in Pathology does the end-of-posting test contribute to?
a) 10% b) 30% c) 50% d) 70% Answer: b) 30% Explanation: The document states there will
be an end-of-posting test which will be part of the continuous assessment, forming 30% of the
total marks in Pathology.
Q7. Which of the following is a topic in General Pathology taught in this posting? a) Systemic
Pathology of the Kidney b) Pathology of the Nervous System c) Neoplasia d) Clinical
Pharmacology Answer: c) Neoplasia Explanation: The list of topics to be taught in the General
Pathology posting includes Introduction to pathology, Inflammation, Repair, Cell injury,
Haemodynamics, Cell growth, Neoplasia, and Introduction to Genetics.
Q8. A biopsy where a small piece of a lesion is removed for examination is called: a) Excisional
biopsy b) Needle biopsy c) Endoscopic biopsy d) Incisional biopsy Answer: d) Incisional biopsy
Explanation: An incisional biopsy is one of the methods mentioned for obtaining tissue samples
where a part of the lesion is removed. This is distinct from an excisional biopsy where the entire
lesion is removed.
Q9. What is the preservative that tissue obtained by biopsies should be placed in immediately?
a) 70% Alcohol b) 10% formol saline c) Saline solution d) Bouin's fluid Answer: b) 10% formol
saline Explanation: The document specifies that tissue obtained by biopsies must be placed
immediately in a preservative called 10% formol saline.
Q10. The process of naked-eye examination of a tissue specimen in the anatomic pathology
department is called: a) Grossing b) Sectioning c) Staining d) Fixation Answer: a) Grossing
Explanation: After a tissue is received in the anatomic pathology department, the first step is
the naked-eye examination, which is referred to as "Grossed".
Q11. Which staining method is most commonly used for routine histological slides? a) Periodic
acid-Schiff (PAS) b) Giemsa stain c) Haematoxylin and eosin (H&E) d) Masson's trichrome
Answer: c) Haematoxylin and eosin (H&E) Explanation: The steps in surgical pathology
processing include obtaining a slide which is usually stained with Haematoxylin and eosin. It is
the most common routine stain.
Q12. A cytology technique involving the scraping of cells, such as for cervical cancer screening,
is known as: a) Fine needle aspiration cytology b) Exfoliative cytology c) Brush cytology d) Body
fluid cytology Answer: b) Exfoliative cytology Explanation: The document lists several types of
diagnostic cytology. Cervical cytology, using Pap smears, is a form of exfoliate cytology.
Q13. Which of the following is NOT a method used to examine tissue obtained by biopsy as
listed in the document? a) Light Microscopy b) Electron microscopy c) X-ray crystallography d)
Immunohistochemistry Answer: c) X-ray crystallography Explanation: The different methods
listed for examining biopsy tissue are Light Microscopy, Immunohistochemistry &
immunofluorescence, Electron microscopy, and Molecular pathology.
Q14. What is the recommended reference textbook for the pathology course? a) Muir's
Textbook of pathology b) Pathology Illustrated by Govan c) Robbins Pathologic Basis of
Diseases d) Gray's Anatomy Answer: c) Robbins Pathologic Basis of Diseases Explanation:
The document explicitly names "Robbins Pathologic basis of diseases" as the reference
textbook and advocates for using the current edition.
Q15. The duration of the introductory pathology posting is: a) 2 weeks b) 4 weeks c) 6 weeks d)
8 weeks Answer: b) 4 weeks Explanation: The document states, "This posting is for 4 weeks".

Topic 2: Cell Injury, Adaptation, and Death

Q16. What is the term for a state of balance achieved via genetic programs of metabolism,
differentiation, and specialization? a) Adaptation b) Cell Injury c) Normal homeostasis d)
Apoptosis Answer: c) Normal homeostasis Explanation: Normal homeostasis is described as
being achieved through genetic programs of Metabolism, Differentiation, and Specialization, and
the availability of metabolic substrates.
Q17. If the limits of an adaptive response to a stimulus are exceeded, what is the result? a)
Normal homeostasis b) Cell injury c) Neoplasia d) Regeneration Answer: b) Cell injury
Explanation: The document states that if the limits of adaptive response to a stimulus are
exceeded, cell injury results.
Q18. Which of the following represents an irreversible stage of cellular response to stress? a)
Hyperplasia b) Atrophy c) Reversible injury d) Necrosis Answer: d) Necrosis Explanation: The
flowchart of tissue response shows that irreversible injury leads to necrosis or apoptosis.
Reversible injury is a preceding stage.
Q19. An increase in the size of cells, leading to an increase in the size of the organ, is known
as: a) Hyperplasia b) Hypertrophy c) Atrophy d) Metaplasia Answer: b) Hypertrophy
Explanation: Hypertrophy is defined as an increase in the size of cells, which in turn increases
the size of the organ. An example is the gravid uterus.
Q20. The massive enlargement of the uterus during pregnancy is primarily an example of: a)
Pathologic hyperplasia b) Physiologic hypertrophy c) Neoplasia d) Dysplasia Answer: b)
Physiologic hypertrophy Explanation: The document uses the gravid uterus as a classic
example of physiologic hypertrophy, caused by hormonal stimulation. It involves an increase in
the size of the smooth muscle cells.
Q21. An increase in the number of cells in an organ or tissue is called: a) Hypertrophy b)
Atrophy c) Hyperplasia d) Dysplasia Answer: c) Hyperplasia Explanation: Hyperplasia is
defined as an increase in the number of cells in an organ or tissue. It can be physiologic or
pathologic.
Q22. Which of the following is a cause of pathologic atrophy? a) Increased workload b) Loss of
innervation c) Increased hormonal stimulation d) Muscular exercise Answer: b) Loss of
innervation Explanation: Pathologic atrophy has several causes, including decreased workload
(atrophy of disuse), loss of innervation (denervation atrophy), diminished blood supply, and loss
of endocrine stimulation.
Q23. The shrinkage in the size of the cell by loss of cell substance is defined as: a) Hypertrophy
b) Necrosis c) Atrophy d) Apoptosis Answer: c) Atrophy Explanation: Atrophy is defined as a
shrinkage in the size of the cell due to the loss of cell substance.
Q24. The reversible change in which one adult cell type is replaced by another adult cell type is
called: a) Dysplasia b) Anaplasia c) Metaplasia d) Neoplasia Answer: c) Metaplasia
Explanation: Metaplasia is defined as a reversible change where one adult cell type is replaced
by another adult cell type.
Q25. The replacement of normal ciliated columnar cells of the trachea with squamous epithelial
cells in a chronic smoker is an example of: a) Dysplasia b) Hyperplasia c) Metaplasia d)
Neoplasia Answer: c) Metaplasia Explanation: The most common type of epithelial metaplasia
is columnar to squamous, and the document provides the example of this change in the trachea
and bronchi of cigarette smokers.
Q26. What does "dysplasia" literally mean? a) Disordered growth b) New growth c) Decreased
growth d) Changed growth Answer: a) Disordered growth Explanation: Dysplasia literally
means disordered growth and is characterized by a loss of uniformity of individual cells and their
architectural orientation.
Q27. Which of the following is the most common cause of cell injury? a) Genetic derangements
b) Infectious agents c) Oxygen deprivation (hypoxia) d) Immunologic reactions Answer: c)
Oxygen deprivation (hypoxia) Explanation: Oxygen deprivation, or hypoxia, is listed as a
common cause of cell injury, inhibiting aerobic respiration.
Q28. Which of the following intracellular systems is particularly vulnerable to cell injury? a) Golgi
apparatus b) Cytoskeleton c) Peroxisomes d) Aerobic respiration Answer: d) Aerobic
respiration Explanation: The document lists four particularly vulnerable intracellular systems:
aerobic respiration, maintenance of cell membrane integrity, protein synthesis, and preservation
of the genetic apparatus.
Q29. Which of the following is a key biochemical mechanism of cell injury? a) ATP synthesis b)
Decreased intracellular calcium c) Increased membrane integrity d) ATP depletion Answer: d)
ATP depletion Explanation: The general biochemical mechanisms of cell injury include ATP
depletion, oxygen-derived free radicals, loss of calcium homeostasis, and defects in membrane
permeability.
Q30. Reactive oxygen species (ROS) such as O_{2}^{-}, H_{2}O_{2}, and OH- are examples of:
a) Antioxidants b) Free radicals c) Opsonins d) Enzymes Answer: b) Free radicals
Explanation: Free radicals are chemical species with a single unpaired electron in their outer
orbit. The document lists reactive oxygen species like superoxide (O_{2}^{-}), hydrogen
peroxide (H_{2}O_{2}), and hydroxyl radical (OH•) as examples that cause cell injury.
Q31. The first manifestation of almost all forms of cell injury, visible by light microscopy, is: a)
Fatty change b) Karyolysis c) Cellular swelling d) Necrosis Answer: c) Cellular swelling
Explanation: Cellular swelling (oncosis) is described as the first manifestation of almost all
forms of injury to cells. It appears as hydropic change or vacuolar degeneration under the
microscope.
Q32. Which of the following is a feature of irreversible cell injury? a) Detachment of ribosomes
b) Clumping of nuclear chromatin c) Severe mitochondrial swelling and damage d) Cellular
swelling Answer: c) Severe mitochondrial swelling and damage Explanation: Irreversible cell
injury is characterized by extensive damage to plasma membranes, severe swelling and
damage to mitochondria, and rupture of lysosomes. Cellular swelling and chromatin clumping
are features of reversible injury.
Q33. What are the two concurrent processes that result in necrosis? a) Inflammation and repair
b) ATP depletion and calcium influx c) Enzymatic digestion of the cell and denaturation of
proteins d) Cell shrinkage and chromatin condensation Answer: c) Enzymatic digestion of the
cell and denaturation of proteins Explanation: Necrosis is the result of two concurrent
processes: enzymatic digestion of the cell (autolysis and heterolysis) and denaturation of
proteins.
Q34. Which type of necrosis is characterized by the preservation of the basic outline of the
coagulated cell and is typical of hypoxic injury in all tissues except the brain? a) Liquefactive
necrosis b) Caseous necrosis c) Coagulative necrosis d) Fat necrosis Answer: c) Coagulative
necrosis Explanation: Coagulative necrosis involves the preservation of the cell's basic outline
due to the denaturation of structural and enzymatic proteins. It is characteristic of hypoxic death
in all tissues except the brain.
Q35. Which type of necrosis is characteristic of focal bacterial infections and hypoxic death of
brain cells? a) Coagulative necrosis b) Liquefactive necrosis c) Caseous necrosis d) Fibrinoid
necrosis Answer: b) Liquefactive necrosis Explanation: Liquefactive necrosis is characteristic
of focal bacterial or fungal infections and also of hypoxic death of cells in the brain, resulting in a
liquid viscous mass.
Q36. Caseation necrosis is most commonly encountered in which infection? a) Syphilis b)
Tuberculosis c) Staphylococcal abscess d) Fungal infection Answer: b) Tuberculosis
Explanation: Caseation necrosis is most frequently seen in tuberculosis infection, appearing as
amorphous granular debris where the tissue architecture is obliterated.
Q37. The formation of chalky white areas due to the action of lipases on triglycerides, seen in
acute pancreatitis, is called: a) Coagulative necrosis b) Liquefactive necrosis c) Fibrinoid
necrosis d) Fat necrosis Answer: d) Fat necrosis Explanation: Fat necrosis occurs when
activated lipases break down triglyceride esters, and the resulting fatty acids combine with
calcium to form chalky white areas (fat saponification).
Q38. The nuclear change in necrosis involving nuclear shrinkage and increased basophilia is
termed: a) Karyolysis b) Pyknosis c) Karyorrhexis d) Apoptosis Answer: b) Pyknosis
Explanation: The nuclear changes in necrosis include karyolysis (fading of basophilia),
pyknosis (nuclear shrinkage & increased basophilia), and karyorrhexis (fragmentation of the
nucleus).
Q39. Which term is synonymous with apoptosis? a) Cell homicide b) Accidental cell death c)
Programmed cell death d) Inflammatory cell death Answer: c) Programmed cell death
Explanation: Apoptosis is described as a distinctive form of cell death, also known as
programmed cell death or "cell suicide".
Q40. Which of the following is a physiologic situation where apoptosis occurs? a) Cell death in
tumors b) Cell death from radiation c) Hormone-dependent involution of the lactating breast d)
Cell injury in viral hepatitis Answer: c) Hormone-dependent involution of the lactating breast
Explanation: The document lists several physiologic situations for apoptosis, including
embryogenesis, metamorphosis, and hormone-dependent involution in the adult, such as the
regression of the lactating breast after weaning.
Q41. What is the most characteristic morphological feature of apoptosis? a) Cell swelling b)
Chromatin condensation c) Intense inflammation d) Disrupted plasma membrane Answer: b)
Chromatin condensation Explanation: The morphology of apoptosis includes cell shrinkage,
formation of cytoplasmic blebs, and phagocytosis, but the most characteristic feature is
chromatin condensation.
Q42. Which family of genes includes inhibitors of apoptosis? a) Caspase family b) Bax family c)
TNF family d) Bcl-2 family Answer: d) Bcl-2 family Explanation: Apoptotic genes are
categorized as promoters (like Bax, Bak) and inhibitors. The inhibitors include Bcl-2 and Bcl-XL.
Q43. A key difference between necrosis and apoptosis is that necrosis: a) Is always physiologic
b) Involves cell shrinkage c) Frequently elicits an inflammatory response d) Keeps the plasma
membrane intact Answer: c) Frequently elicits an inflammatory response Explanation: The
comparison table shows that necrosis frequently has adjacent inflammation, while apoptosis
does not. Necrosis also involves cell swelling and a disrupted plasma membrane, whereas
apoptosis involves shrinkage and an intact membrane.
Q44. Which of the following enzymes are central to the execution phase of apoptosis? a)
Lipases b) Kinases c) Caspases d) Phosphatases Answer: c) Caspases Explanation: The
mechanism of apoptosis involves an initiation phase where caspases become active, and an
execution phase carried out by caspases 3 & 6. They cleave nuclear scaffold and cytoskeletal
proteins.
Q45. Which pathway of apoptosis is initiated by signals from TNF and FAS receptors? a) The
Intrinsic (Mitochondrial) Pathway b) The Execution Pathway c) The Extrinsic (Death
receptor-Initiated) Pathway d) The Perforin Pathway Answer: c) The Extrinsic (Death
receptor-Initiated) Pathway Explanation: The initiation phase of apoptosis can occur via two
main pathways. The extrinsic pathway is initiated by death receptors like TNF and FAS.

Topic 3: Genetic Basis of Disease

Q46. A permanent change in the DNA is called a: a) Allele b) Gene product c) Mutation d)
Locus Answer: c) Mutation Explanation: A mutation is defined in the document as a
permanent change in the DNA.
Q47. The loss or gain of whole chromosomes, leading to monosomy or trisomy, is what type of
mutation? a) Gene mutation b) Chromosomal mutation c) Genomic mutation d) Point mutation
Answer: c) Genomic mutation Explanation: Mutations are classified based on the extent of
genetic change. Genomic mutations involve the loss or gain of whole chromosomes, resulting in
conditions like monosomy or trisomy.
Q48. Which category of genetic disorders follows Mendelian patterns of inheritance? a)
Multifactorial disorders b) Cytogenetic disorders c) Single gene disorders d) Disorders from
triplet repeat mutations Answer: c) Single gene disorders Explanation: Single gene disorders,
caused by mutant genes of large effect, are also known as Mendelian disorders.
Q49. In which type of inheritance are disorders manifested in the heterozygous state, with at
least one parent usually affected? a) Autosomal recessive b) X-linked recessive c) Autosomal
dominant d) Multifactorial Answer: c) Autosomal dominant Explanation: Autosomal dominant
disorders are manifested in the heterozygous state, meaning only one copy of the mutant gene
is needed. Consequently, at least one parent of an index case is typically affected.
Q50. The phenomenon where some individuals inherit a mutant gene but are phenotypically
normal is called: a) Variable expressivity b) Pleiotropism c) Reduced penetrance d)
Codominance Answer: c) Reduced penetrance Explanation: Reduced penetrance is when an
individual carries the mutant gene but does not express the trait. It is expressed mathematically,
e.g., 50% penetrance.
Q51. Familial hypercholesterolemia, involving a defect in LDL receptors, is an example of what
kind of mutation in an autosomal dominant disorder? a) Gain of function mutation b) Loss of
function mutation c) Dominant negative mutation d) Neutral mutation Answer: b) Loss of
function mutation Explanation: Autosomal dominant disorders can result from loss of function
mutations, which typically affect regulatory or key structural proteins. Familial
hypercholesterolemia is given as an example involving regulatory proteins (LDL receptor).
Q52. Huntington disease, where the mutant protein is toxic to neurons, is an example of a: a)
Loss of function mutation b) Gain of function mutation c) Frameshift mutation d) Silent mutation
Answer: b) Gain of function mutation Explanation: Gain of function mutations are less common
and involve the gene product acquiring new, toxic properties. Huntington disease is the provided
example, where the mutant protein is toxic to neurons.
Q53. Which of the following is an example of an autosomal dominant disorder? a) Sickle cell
anaemia b) Cystic fibrosis c) Neurofibromatosis d) Haemophilia A Answer: c)
Neurofibromatosis Explanation: The list of autosomal dominant disorders includes
neurofibromatosis and Huntington disease affecting the nervous system. Sickle cell anaemia
and cystic fibrosis are recessive. Haemophilia is X-linked.
Q54. What is the largest group of Mendelian disorders, often associated with enzyme defects?
a) Autosomal dominant disorders b) Autosomal recessive disorders c) X-linked dominant
disorders d) X-linked recessive disorders Answer: b) Autosomal recessive disorders
Explanation: The document states that autosomal recessive disorders are the largest group of
Mendelian disorders and include almost all inborn errors of metabolism.
Q55. In autosomal recessive disorders, what is the chance of an offspring being affected if both
parents are carriers? a) 100% b) 75% c) 50% d) 25% Answer: d) 25% Explanation: For
autosomal recessive disorders, there is a 25% chance of occurrence for each birth when both
parents are heterozygous carriers.
Q56. In X-linked recessive disorders, an affected male transmits the disorder to: a) All of his
sons b) 50% of his sons c) All of his daughters (as carriers) d) 50% of his daughters Answer: c)
All of his daughters (as carriers) Explanation: An affected male does not transmit an X-linked
recessive disorder to his sons, but all his daughters will be carriers because they inherit his only
X chromosome.
Q57. Which of the following is an example of a multifactorial disorder? a) Huntington disease b)
Hereditary spherocytosis c) Diabetes mellitus d) Phenylketonuria Answer: c) Diabetes mellitus
Explanation: Multifactorial disorders result from a combination of genetic and environmental
factors. The examples provided include cleft lip/palate, hypertension, gout, and diabetes
mellitus.
Q58. A structural alteration where a chromosome breaks and the segment is re-attached in a
reversed orientation is called: a) Deletion b) Translocation c) Inversion d) Isochromosome
Answer: c) Inversion Explanation: Inversion is a chromosomal mutation where the connection
between genes breaks, and the sequence of these genes is reversed upon re-attachment.
Q59. What is the term for a cell that has a chromosome number that is not an exact multiple of
the haploid number (23)? a) Euploid b) Aneuploid c) Polyploid d) Haploid Answer: b) Aneuploid
Explanation: A cell is euploid if it has an exact multiple of the haploid number. If an error in cell
division results in a chromosome complement that is not an exact multiple of 23, it is referred to
as aneuploidy.
Q60. Down syndrome is most commonly caused by which cytogenetic abnormality? a) Trisomy
18 b) Trisomy 13 c) Trisomy 21 d) Monosomy X Answer: c) Trisomy 21 Explanation: Down
syndrome is listed as an example of a cytogenetic disorder involving autosomes and is
specifically identified as Trisomy 21. A karyotype for Trisomy 21 is also shown.
Q61. A "single simian crease" is a characteristic physical feature of which genetic disorder? a)
Turner Syndrome b) Edwards Syndrome (Trisomy 18) c) Patau Syndrome (Trisomy 13) d) Down
Syndrome (Trisomy 21) Answer: d) Down Syndrome (Trisomy 21) Explanation: An image of a
single simian crease is presented as a characteristic feature of Down syndrome.
Q62. A karyotype of 47,XXY is characteristic of which syndrome? a) Turner Syndrome b) Down
Syndrome c) Klinefelter Syndrome d) Edwards Syndrome Answer: c) Klinefelter Syndrome
Explanation: Klinefelter Syndrome is given as an example of a cytogenetic disorder involving
sex chromosomes, with the characteristic karyotype being XXY.
Q63. The formation of a chromosome consisting of two identical arms (either two short or two
long arms) due to abnormal centromere division is called: a) Ring chromosome b)
Isochromosome c) Reciprocal translocation d) Deletion Answer: b) Isochromosome
Explanation: An isochromosome is formed when one arm is lost and the remaining arm is
duplicated, resulting from a transverse rather than longitudinal division of the centromere.
Q64. Which molecular diagnostic technique is used to amplify small amounts of DNA up to ~35
kb through multiple cycles? a) Flow Cytometry b) Florescent in-situ hybridization (FISH) c)
Polymerase chain reaction (PCR) d) Filter hybridization Answer: c) Polymerase chain reaction
(PCR) Explanation: Polymerase chain reaction (PCR), described by Kary Mullis, is a method
used to amplify DNA through cycles of denaturation, primer annealing, and polymerase
extension.
Q65. Turner Syndrome is characterized by which karyotype? a) XXY b) XYY c) XO d) Trisomy X
Answer: c) XO Explanation: Turner Syndrome is a disorder of sex chromosomes, and the
document shows its characteristic XO karyotype.

Topic 4: Inflammation
Q66. Which of the following is NOT one of the five cardinal signs of inflammation? a) Rubor
(redness) b) Tumor (swelling) c) Pallor (paleness) d) Dolor (pain) Answer: c) Pallor (paleness)
Explanation: The five cardinal signs of inflammation are Rubor (redness), Tumor (swelling),
Calor (heat), Dolor (pain), and Functio laesa (loss of function). Pallor is not one of them.
Q67. The response of living vascularised tissue to injury is the definition of: a) Repair b)
Necrosis c) Inflammation d) Thrombosis Answer: c) Inflammation Explanation: Inflammation is
defined as the response of living vascularised tissue to injury, serving as a protective response.
Q68. Which characteristic best describes acute inflammation? a) Prolonged duration with
lymphocyte infiltration b) Insidious onset c) Exudation of fluids and emigration of neutrophils d)
Formation of granulomas Answer: c) Exudation of fluids and emigration of neutrophils
Explanation: Acute inflammation is of relatively short duration and its main characteristics are
the exudation of fluids and plasma proteins and the emigration of leukocytes, predominantly
neutrophils.
Q69. An inflammatory extravascular fluid that has a high protein content and a specific gravity >
1.020 is called: a) Transudate b) Exudate c) Pus d) Edema Answer: b) Exudate Explanation:
An exudate is an inflammatory extravascular fluid with a high protein content, cellular debris,
and a specific gravity greater than 1.020. A transudate has low protein content.
Q70. Which of the following is a key vascular event in acute inflammation? a) Prolonged
vasoconstriction b) Decreased vascular permeability c) Vasodilation and increased vascular
permeability d) Decreased blood flow Answer: c) Vasodilation and increased vascular
permeability Explanation: The vascular events of acute inflammation involve an alteration in
vascular caliber (vasodilation) which increases blood flow, and structural changes (increased
permeability) that allow plasma proteins and leukocytes to exit the circulation.
Q71. The accumulation of leukocytes, particularly neutrophils, along the endothelial surface of
blood vessels during inflammation is known as: a) Diapedesis b) Chemotaxis c) Margination d)
Phagocytosis Answer: c) Margination Explanation: Due to fluid loss and stasis, leukocytes
move from the central flow column to the periphery of the vessels, a process called margination.
This is followed by rolling and adhesion.
Q72. Which family of adhesion molecules is primarily responsible for the initial 'rolling' of
leukocytes on the endothelium? a) Integrins b) Immunoglobulin family (ICAMs) c) Selectins d)
Cadherins Answer: c) Selectins Explanation: The early rolling adhesion of leukocytes is
mediated by the selectin family of molecules (E-selectin, P-selectin, L-selectin).
Q73. The movement of leukocytes out of the vasculature, across the endothelium, is called: a)
Margination b) Adhesion c) Transmigration (diapedesis) d) Chemotaxis Answer: c)
Transmigration (diapedesis) Explanation: Transmigration, or diapedesis, is the process where
leukocytes migrate across the endothelium after firm adhesion.
Q74. The process of directed migration of leukocytes towards a site of injury along a chemical
gradient is known as: a) Opsonization b) Phagocytosis c) Chemotaxis d) Diapedesis Answer: c)
Chemotaxis Explanation: Chemotaxis is the movement of leukocytes toward the site of injury,
propelled by a chemical gradient of chemoattractants like C5a and IL-8.
Q75. Which of the following are major opsonins that coat microorganisms to enhance
phagocytosis? a) Histamine and serotonin b) IgG and C3b c) Lysozyme and defensins d)
Prostaglandins and leukotrienes Answer: b) IgG and C3b Explanation: Most microorganisms
are not recognized by leukocytes until they are coated with opsonins. The major opsonins are
the Fc fragment of IgG, the complement component C3b, and lectins.
Q76. The hydrogen peroxide-myeloperoxidase-halide system is an example of what mechanism
for killing microbes during phagocytosis? a) Oxygen-independent mechanism b)
Oxygen-dependent mechanism c) Opsonization d) Lysosomal degradation Answer: b)
Oxygen-dependent mechanism Explanation: The document lists the hydrogen
peroxide-myeloperoxidase-halide system as the most efficient bactericidal system in
neutrophils, which is an oxygen-dependent mechanism.
Q77. Which of the following is a preformed mediator of inflammation stored in mast cells? a)
Prostaglandins b) Nitric oxide c) Histamine d) Cytokines Answer: c) Histamine Explanation:
Chemical mediators can be preformed or newly synthesized. Histamine is a preformed mediator
stored in the granules of mast cells, basophils, and platelets.
Q78. The membrane attack complex (MAC), which perforates microbial membranes, is formed
by which complement components? a) C3a and C5a b) C3b c) C5b-9 d) C1q Answer: c) C5b-9
Explanation: The complement system is a plasma-derived mediator. The components C5b-9
form the membrane attack complex.
Q79. Which of the following is NOT a possible outcome of acute inflammation? a) Complete
resolution b) Healing by fibrosis (scarring) c) Progression to autoimmune disease d) Progression
to chronic inflammation Answer: c) Progression to autoimmune disease Explanation: The
possible outcomes of acute inflammation listed are resolution, healing by fibrosis, abscess
formation, and progression to chronic inflammation. Autoimmune disease has a different
pathogenesis.
Q80. An inflammation characterized by the outpouring of a thin, watery fluid (like in a skin
blister) is called: a) Fibrinous inflammation b) Suppurative inflammation c) Ulcerative
inflammation d) Serous inflammation Answer: d) Serous inflammation Explanation: Serous
inflammation is marked by the outpouring of a thin fluid derived from plasma or mesothelial cell
secretions. A skin blister is a classic example.
Q81. Inflammation characterized by large amounts of pus, consisting of neutrophils, necrotic
cells, and edema fluid, is known as: a) Serous inflammation b) Fibrinous inflammation c)
Suppurative/purulent inflammation d) Granulomatous inflammation Answer: c)
Suppurative/purulent inflammation Explanation: Suppurative or purulent inflammation is
characterized by the production of large amounts of pus or purulent exudate. An abscess is a
localized collection of this exudate.
Q82. A local defect or excavation of the surface of an organ or tissue, produced by the
sloughing of inflamed necrotic tissue, is an: a) Abscess b) Fistula c) Ulcer d) Sinus Answer: c)
Ulcer Explanation: An ulcer is a morphologic pattern of inflammation that occurs when tissue
necrosis and resultant inflammation exist on or near a surface, leading to a defect.
Q83. Chronic inflammation is characterized by the infiltration of which cell types? a) Neutrophils
and basophils b) Mononuclear cells (macrophages, lymphocytes, plasma cells) c) Eosinophils
and mast cells d) Red blood cells and platelets Answer: b) Mononuclear cells (macrophages,
lymphocytes, plasma cells) Explanation: A key histologic feature of chronic inflammation is
infiltration by mononuclear cells, which include macrophages, lymphocytes, and plasma cells.
Q84. What are macrophages in the liver called? a) Alveolar macrophages b) Sinus histiocytes c)
Osteoclasts d) Kupffer cells Answer: d) Kupffer cells Explanation: Macrophages are derived
from blood monocytes and are given different names in different tissues. In the liver, they are
called Kupffer cells.
Q85. A focal area of chronic inflammation consisting of aggregated macrophages transformed
into epithelioid cells, surrounded by lymphocytes, is called a: a) Abscess b) Granuloma c) Scar
d) Keloid Answer: b) Granuloma Explanation: A granuloma is a specific pattern of chronic
inflammation. It's a focal area consisting of aggregated epithelioid macrophages, rimmed by
lymphocytes and sometimes plasma cells. This is the hallmark of granulomatous inflammation.
Q86. Granulomas incited by inert foreign bodies like talc or sutures are known as: a) Immune
granulomas b) Caseating granulomas c) Foreign body granulomas d) Suppurative granulomas
Answer: c) Foreign body granulomas Explanation: Granulomas are broadly divided into two
types. Foreign body granulomas are incited by relatively inert foreign bodies like suture material.
Q87. Caseating granulomas are a classic feature of which disease? a) Sarcoidosis b) Leprosy
c) Schistosomiasis d) Tuberculosis Answer: d) Tuberculosis Explanation: The document lists
examples of diseases with granulomas. Tuberculosis is specifically mentioned as having
caseating granulomas.
Q88. Which leukocyte is characteristically involved in immune reactions mediated by IgE and in
parasitic infections? a) Neutrophil b) Lymphocyte c) Eosinophil d) Monocyte Answer: c)
Eosinophil Explanation: Eosinophils are described as being characteristic of immune reactions
mediated by IgE (e.g., allergies, asthma) and parasitic infections.
Q89. The predominant cell type in a granuloma is a modified macrophage with an epithelial-like
appearance, known as an: a) Epithelioid cell b) Giant cell c) Plasma cell d) Mast cell Answer: a)
Epithelioid cell Explanation: Granulomatous inflammation is defined as a special type of
chronic inflammation where the predominant cell is an activated macrophage with a modified
epithelial-like appearance, called an epithelioid cell.
Q90. Langhans giant cells, often seen in tuberculous granulomas, are formed by the fusion of:
a) Lymphocytes b) Plasma cells c) Epithelioid macrophages d) Fibroblasts Answer: c)
Epithelioid macrophages Explanation: Giant cells, such as Langhans giant cells or foreign body
giant cells, are formed by the fusion of multiple activated/epithelioid macrophages. They are a
common feature within granulomas.
Topic 5: Wound Healing and Tissue Repair
Q91. The complete restitution of lost or damaged tissue is called: a) Repair b) Regeneration c)
Fibrosis d) Scarring Answer: b) Regeneration Explanation: Regeneration is defined as the
proliferation of cells and tissues to replace lost structures, resulting in the restitution of that
tissue.
Q92. Repair by deposition of collagen and other ECM components, leading to scar formation,
occurs when: a) The injury is mild and transient b) Only parenchymal cells are damaged c) Both
parenchymal and stromal framework are damaged d) The tissue has high proliferative activity
Answer: c) Both parenchymal and stromal framework are damaged Explanation: Repair by
scar formation occurs if the tissue injury is severe or chronic and results in damage to both the
parenchymal cells and the stromal framework. Disruption of the ECM scaffolding leads to scar
formation.
Q93. Based on proliferative activity, cells of the bone marrow and skin epithelium are classified
as: a) Quiescent (stable) cells b) Nondividing (permanent) cells c) Continuously dividing (labile)
cells d) Stem cells Answer: c) Continuously dividing (labile) cells Explanation: Tissues are
divided into three groups based on proliferative activity. Continuously dividing (labile) cells
proliferate throughout life, and examples include cells of the bone marrow and surface epithelia
like the skin.
Q94. Which of the following are examples of nondividing (permanent) cells? a) Hepatocytes and
kidney cells b) Fibroblasts and smooth muscle cells c) Neurons and cardiac muscle cells d)
Lymphocytes and endothelial cells Answer: c) Neurons and cardiac muscle cells Explanation:
Nondividing (permanent) cells have left the cell cycle and cannot undergo mitosis in postnatal
life. Examples given are neurons, skeletal muscle cells, and cardiac muscle cells.
Q95. Liver cells (hepatocytes), which normally have a low level of replication but can divide
rapidly in response to injury, are classified as: a) Labile cells b) Permanent cells c) Quiescent
(stable) cells d) Undifferentiated cells Answer: c) Quiescent (stable) cells Explanation:
Quiescent (stable) cells have a low level of replication normally but can be stimulated to divide
rapidly. The document lists cells of the liver, kidneys, and pancreas as examples.
Q96. What are the two defining properties of stem cells? a) Differentiation and apoptosis b)
Self-renewal and capacity to generate differentiated lineages c) Quiescence and proliferation d)
Migration and adhesion Answer: b) Self-renewal and capacity to generate differentiated
lineages Explanation: Stem cells are characterized by their self-renewal properties and their
capacity to generate differentiated cell lineages.
Q97. The restoration of liver mass after a partial hepatectomy is an example of: a) True
regeneration b) Scar formation c) Compensatory hyperplasia d) Metaplasia Answer: c)
Compensatory hyperplasia Explanation: The process of liver regeneration is described not as
true regeneration, but as compensatory hyperplasia, where the remaining lobes enlarge to
restore liver mass.
Q98. Which of the following is a function of the Extracellular Matrix (ECM)? a) Initiating
apoptosis b) Storing genetic information c) Providing mechanical support and anchorage for
cells d) Producing hormones Answer: c) Providing mechanical support and anchorage for cells
Explanation: The ECM has many functions, including providing mechanical support, controlling
cell growth, maintaining cell differentiation, and serving as a scaffold for tissue renewal.
Q99. The healing of a clean, uninfected surgical incision with minimal tissue loss is referred to
as: a) Healing by secondary union b) Healing by first intention (primary union) c) Delayed
primary closure d) Formation of a keloid Answer: b) Healing by first intention (primary union)
Explanation: The healing of a clean, uninfected surgical incision is the simplest example of
wound healing and is called "healing by primary union" or "by first intention".
Q100. The pink, soft, granular tissue that forms in the early stages of wound healing,
characterized by new small blood vessels and proliferating fibroblasts, is called: a) Scar tissue
b) Granulation tissue c) A granuloma d) A hematoma Answer: b) Granulation tissue
Explanation: Granulation tissue is the hallmark of repair. It is formed by proliferating fibroblasts
and vascular endothelial cells and has a characteristic soft, granular appearance due to the
presence of new small vessels.
Q101. Which cells are the key cellular constituents of tissue repair, responsible for clearing
debris, promoting angiogenesis, and ECM deposition? a) Neutrophils b) Lymphocytes c)
Macrophages d) Basophils Answer: c) Macrophages Explanation: Macrophages are described
as the key cellular constituents of tissue repair. They perform debridement, have antimicrobial
activity, and produce a host of growth factors that drive angiogenesis and fibroblast proliferation.
Q102. The process that helps to close large surface wounds by decreasing the gap between
their dermal edges is known as: a) Re-epithelialization b) Wound contraction c) Granulation d)
Remodeling Answer: b) Wound contraction Explanation: Wound contraction generally occurs
in large surface wounds and helps to close the wound by reducing its surface area and the gap
between its dermal edges. It is a key feature of healing by secondary union.
Q103. The family of enzymes responsible for the degradation and remodeling of ECM
components during wound healing are the: a) Caspases b) Kinases c) Cyclins d) Matrix
metalloproteinases (MMPs) Answer: d) Matrix metalloproteinases (MMPs) Explanation: The
remodeling of connective tissue involves changes in ECM composition, which is accomplished
by a family of enzymes called matrix metalloproteinases (MMPs).
Q104. What is the approximate tensile strength of a sutured wound at the end of one week,
compared to unwounded skin? a) 10% b) 30% c) 50% d) 70% Answer: a) 10% Explanation:
The recovery of tensile strength is a slow process. At the end of one week, wound strength is
only about 10% of that of unwounded skin. It eventually plateaus at 70-80%.
Q105. Deficiency of which of the following is a systemic factor that can impair wound healing?
a) Vitamin C and protein b) Vitamin B12 and iron c) Calcium and Vitamin D d) Glucose Answer:
a) Vitamin C and protein Explanation: Systemic factors that affect wound healing include
nutrition, specifically protein and vitamin C deficiency. Vitamin C is essential for collagen
synthesis.
Q106. Excessive formation of repair components leading to a raised scar that grows beyond the
boundaries of the original wound is called a: a) Hypertrophic scar b) Desmoid c) Contracture d)
Keloid Answer: d) Keloid Explanation: Pathological aspects of repair include excessive
formation of components. A keloid is a type of excessive scar formation where the scar tissue
grows beyond the original wound boundaries.
Q107. An exaggeration of wound contraction that results in deformities and limited joint
movement is known as a: a) Dehiscence b) Ulceration c) Contracture d) Keloid Answer: c)
Contracture Explanation: The formation of contractures is listed as a pathological aspect of
repair. It is an exaggeration of the normal contraction process, leading to deformity.
Q108. In chronic inflammation, persistent injury leads to the proliferation of fibroblasts and
deposition of collagen, a process called: a) Regeneration b) Resolution c) Fibrosis d)
Angiogenesis Answer: c) Fibrosis Explanation: The diagram on the development of fibrosis
shows that a persistent stimulus (chronic inflammation) leads to the activation of macrophages
and lymphocytes, which in turn cause the proliferation of fibroblasts and increased collagen
synthesis, resulting in fibrosis.
Q109. Which of the following conditions would most likely heal by regeneration? a) Myocardial
infarction b) Deep excisional wound c) Superficial skin wound d) Cerebral infarct Answer: c)
Superficial skin wound Explanation: The summary diagram shows that when the stimulus is
removed and the tissue framework is intact (as in superficial wounds), healing occurs by
regeneration. Myocardial and deep wounds with damaged framework heal by repair (scar
formation).
Q110. The process of forming new blood vessels, crucial for wound healing, is termed: a)
Fibrosis b) Angiogenesis c) Vasculitis d) Thrombosis Answer: b) Angiogenesis Explanation:
Angiogenesis, the formation of new blood vessels, is a basic feature of the repair process,
essential for forming granulation tissue. Growth factors like VEGF promote it.

Topic 6: Disturbance of Haemodynamics

Q111. A localized increase in blood volume within dilated vessels due to increased arterial
inflow is called: a) Passive Congestion b) Venous Congestion c) Hyperaemia d) Oedema
Answer: c) Hyperaemia Explanation: Hyperaemia, or active hyperaemia, is defined as an
increased volume of blood resulting from arterial and arteriolar dilatation. This leads to
increased inflow.
Q112. Impaired venous drainage from an organ, leading to dilatation of veins and capillaries, is
known as: a) Active Hyperaemia b) Arterial Hyperaemia c) Venous Congestion (Passive
Hyperaemia) d) Ischaemia Answer: c) Venous Congestion (Passive Hyperaemia) Explanation:
Venous congestion, or passive hyperaemia, is caused by impaired venous drainage or
diminished outflow, causing blood to back up in the venous system.
Q113. Left-sided heart failure typically leads to congestion in which organ? a) Liver b) Spleen c)
Lungs d) Kidneys Answer: c) Lungs Explanation: In left-sided heart failure, pressure is
transmitted upstream of the left heart, leading to pulmonary congestion (CVC lungs).
Q114. The "nutmeg" appearance of the liver on a cut surface is characteristic of: a) Acute
hepatitis b) Chronic venous congestion c) Cirrhosis d) Liver abscess Answer: b) Chronic
venous congestion Explanation: The gross appearance of CVC of the liver is a characteristic
"nutmeg" appearance, which is a mottled pattern of red (congested centrilobular areas) and
yellow (fatty peripheral zones).
Q115. In chronic venous congestion of the lungs, haemosiderin-laden alveolar macrophages are
called: a) Kupffer cells b) Dust cells c) Heart failure cells d) Gitter cells Answer: c) Heart failure
cells Explanation: In CVC of the lungs, rupture of congested capillaries leads to intra-alveolar
haemorrhages. The breakdown of these red cells liberates haemosiderin, which is taken up by
alveolar macrophages. These pigmented macrophages are known as "heart failure cells".
Q116. An escape of blood from a blood vessel is termed: a) Oedema b) Thrombus c)
Haemorrhage d) Embolus Answer: c) Haemorrhage Explanation: Haemorrhage is defined as
the escape of blood from a blood vessel.
Q117. Minute, pinhead-sized haemorrhages into the skin or mucous membranes are called: a)
Haematoma b) Ecchymoses c) Purpura d) Petechiae Answer: d) Petechiae Explanation: The
document provides terms for different types of haemorrhage. Petechiae are defined as minute
pinhead-sized haemorrhages.
Q118. A life-threatening clinical syndrome of cardiovascular collapse characterized by acute
reduction of effective circulating blood volume and inadequate tissue perfusion is: a) Heart
failure b) Shock c) Myocardial infarction d) Stroke Answer: b) Shock Explanation: Shock is
defined as a life-threatening clinical syndrome of cardiovascular collapse, characterized by
hypotension (acute reduction of effective circulating blood volume) and hypoperfusion
(inadequate perfusion of cells and tissues).
Q119. Which type of shock results from fluid loss, such as from acute haemorrhage or severe
dehydration? a) Cardiogenic shock b) Septic shock c) Neurogenic shock d) Hypovolaemic
shock Answer: d) Hypovolaemic shock Explanation: Hypovolaemic shock is caused by a
reduction in blood volume. The aetiologies listed include acute haemorrhage, dehydration from
vomiting or diarrhoea, and burns.
Q120. Which type of shock is caused by failure of the heart's pumping action, for example, due
to a massive myocardial infarction? a) Hypovolaemic shock b) Distributive shock c) Cardiogenic
shock d) Obstructive shock Answer: c) Cardiogenic shock Explanation: Cardiogenic shock is
caused by the heart's inability to pump effectively. Causes include deficient emptying (e.g.,
myocardial infarction, cardiomyopathy) or deficient filling (e.g., cardiac tamponade).
Q121. The process of forming a solid mass of blood (a thrombus) from the constituents of
flowing blood within the circulation is called: a) Embolism b) Coagulation c) Thrombosis d)
Agglutination Answer: c) Thrombosis Explanation: Thrombosis is defined as the process of
formation of a solid mass, called a thrombus, in the circulation from the constituents of flowing
blood.
Q122. Which of the following is NOT part of Virchow's Triad for thrombosis? a) Endothelial injury
b) Altered blood flow (stasis or turbulence) c) Hypercoagulability of blood d) Hypoxia Answer: d)
Hypoxia Explanation: The pathophysiology of thrombosis is explained by Virchow's Triad,
which consists of three primary factors: endothelial injury, altered blood flow, and
hypercoagulability of the blood.
Q123. The characteristic alternating pale and dark lines seen in a thrombus, representing layers
of platelets/fibrin and red cells, are known as: a) Lines of Zahn b) Aschoff bodies c) Councilman
bodies d) Mallory bodies Answer: a) Lines of Zahn Explanation: The image caption for an
arterial thrombus mentions that it shows lines of Zahn, which are composed of granular-looking
platelets and fibrin meshwork with entangled red cells and leucocytes.
Q124. The process where a thrombus breaks free from its site of origin and travels through the
circulation is a primary cause of: a) Haemorrhage b) Aneurysm c) Thromboembolism d)
Atherosclerosis Answer: c) Thromboembolism Explanation: One of the major effects of
thrombosis is thromboembolism, where the thrombus or a part of it dislodges and travels to
another site. An intravascular mass transported from its site of origin is an embolus.
Q125. An embolus that detaches from a deep vein in the leg will most likely lodge in the: a)
Cerebral arteries b) Coronary arteries c) Pulmonary circulation d) Renal arteries Answer: c)
Pulmonary circulation Explanation: The diagram of thromboembolism shows that a thrombus
originating in the deep leg veins travels through the right side of the heart and lodges in the
pulmonary arteries, causing a pulmonary embolism.
Q126. A deficient blood supply to a part of a tissue relative to its metabolic needs is called: a)
Infarction b) Hypoxia c) Ischaemia d) Anoxia Answer: c) Ischaemia Explanation: Ischaemia is
defined as a deficient blood supply to a part of the tissue relative to its metabolic needs.
Q127. The most important and common cause of ischaemia is: a) Malnourishment of cells b)
Hypoxia c) Inadequate clearance of metabolites d) Inflammation Answer: b) Hypoxia
Explanation: The effects of ischaemia are due to three mechanisms, but the document states
that hypoxia (deprivation of oxygen) is the most important and common cause.
Q128. Which of the following organs has a dual blood supply, making it relatively resistant to
infarction? a) Kidney b) Spleen c) Brain d) Lungs Answer: d) Lungs Explanation: One of the
factors determining the severity of ischaemia is the anatomic pattern of blood supply. The lungs
are listed as having a double blood supply (pulmonary and bronchial circulation), which provides
protection.
Q129. A localized area of tissue necrosis resulting from ischaemia is called an: a) Abscess b)
Infarct c) Aneurysm d) Ulcer Answer: b) Infarct Explanation: Infarction is the process of tissue
necrosis (usually coagulative) resulting from ischaemia. The localized area of necrosis that
develops is called an infarct.
Q130. Infarcts in solid organs like the kidney and spleen, typically caused by arterial occlusion,
are usually of which type? a) Red or haemorrhagic b) Pale or anaemic c) Septic d) Liquefactive
Answer: b) Pale or anaemic Explanation: Infarcts are classified by their color. Pale or anaemic
infarcts are due to arterial occlusion and are seen in compact organs such as the kidneys, heart,
and spleen.
Q131. Cerebral infarcts are characterized by which type of necrosis? a) Coagulative necrosis b)
Caseous necrosis c) Liquefactive necrosis d) Fibrinoid necrosis Answer: c) Liquefactive
necrosis Explanation: While most infarcts result in coagulative necrosis, the document
specifies that cerebral infarcts are characterized by liquefactive necrosis, which leads to
softening (encephalomalacia).
Q132. A postmortem clot is typically: a) Firmly attached to the vessel wall, friable, and grey-red
b) Not attached, gelatinous, and has a 'currant jelly' and 'chicken fat' appearance c) Always
located in arteries d) Composed of lines of Zahn Answer: b) Not attached, gelatinous, and has
a 'currant jelly' and 'chicken fat' appearance Explanation: The table comparing antemortem
thrombi and postmortem clots states that postmortem clots are not attached, have a gelatinous
consistency, and show a lower dark red 'currant jelly' layer and an upper yellow 'chicken fat'
layer.
Q133. Which of the following is a potential cause of amniotic fluid embolism? a) Trauma to
bones b) Surgical procedure c) During labour or immediate postpartum period d) Atherosclerotic
plaque rupture Answer: c) During labour or immediate postpartum period Explanation:
Amniotic fluid embolism is described as a serious cause of maternal mortality that occurs during
labour and in the immediate postpartum period.
Q134. Which factor most influences the severity of ischaemia from a vascular occlusion? a) The
age of the patient b) The rapidity of development of the occlusion c) The presence of infection d)
The type of blood vessel (artery vs. vein) Answer: b) The rapidity of development of the
occlusion Explanation: Among the factors determining the severity of ischaemia, the rapidity of
development is crucial. A sudden vascular obstruction causes more severe effects than a
gradual one, as a gradual occlusion allows time for collateral circulation to develop.
Q135. At the periphery of an infarct, what type of cellular reaction is typically seen? a)
Granulomatous reaction b) Acute inflammatory reaction c) Fibrosis and scarring d) Neoplastic
transformation Answer: b) Acute inflammatory reaction Explanation: The microscopic
morphology of an infarct includes an acute inflammatory reaction at the periphery, with
neutrophils predominating initially, followed by macrophages and fibroblasts.

Topic 7: Disorders of Immunity

Q136. Immunodeficiency diseases that result from a genetic or developmental abnormality of
the immune system are classified as: a) Secondary immunodeficiencies b) Acquired
immunodeficiencies c) Primary immunodeficiencies d) Iatrogenic immunodeficiencies Answer:
c) Primary immunodeficiencies Explanation: Disorders of immunity are classified into primary
and secondary types. Primary immunodeficiencies are the result of a genetic or developmental
abnormality of the immune system.
Q137. Acquired Immunodeficiency Syndrome (AIDS) is an example of a: a) Primary
immunodeficiency b) Secondary immunodeficiency c) Autoimmune disease d) Hypersensitivity
reaction Answer: b) Secondary immunodeficiency Explanation: Secondary
immunodeficiencies arise from the acquired suppression of the immune system. The document
states that the most important example is AIDS.
Q138. The primary cell type targeted and depleted by the Human Immunodeficiency Virus (HIV)
is: a) B lymphocytes b) Neutrophils c) CD4+ T helper lymphocytes d) CD8+ T cytotoxic
lymphocytes Answer: c) CD4+ T helper lymphocytes Explanation: The table on major
abnormalities in AIDS clearly indicates that a major abnormality is the "Depletion of CD4+
T-helper lymphocytes".
Q139. An exaggerated or inappropriate state of a normal immune response that results in
adverse effects on the body is called: a) Immune tolerance b) Autoimmunity c)
Immunodeficiency d) Hypersensitivity reaction Answer: d) Hypersensitivity reaction
Explanation: Hypersensitivity reactions are defined as an exaggerated or inappropriate state of
a normal immune response, leading to adverse effects and tissue injury.
Q140. Which type of hypersensitivity reaction is mediated by IgE antibodies and mast cells,
leading to allergic reactions like anaphylaxis and hay fever? a) Type I b) Type II c) Type III d)
Type IV Answer: a) Type I Explanation: Type I hypersensitivity (anaphylactic) is an immediate
reaction mediated by IgE antibodies, which bind to mast cells and basophils. Subsequent
exposure to the allergen causes degranulation and release of mediators like histamine.
Q141. Type II hypersensitivity reactions involve: a) Immune complexes depositing in tissues b)
T-cell mediated cytotoxicity c) IgE-mediated mast cell degranulation d) Antibodies directed
against antigens on the surface of cells or tissues Answer: d) Antibodies directed against
antigens on the surface of cells or tissues Explanation: Type II hypersensitivity (cytotoxic) is
caused by antibodies (IgG or IgM) that react with antigens present on cell surfaces or in the
extracellular matrix, leading to cell lysis or dysfunction. Examples include autoimmune hemolytic
anemia.
Q142. The deposition of antigen-antibody (immune) complexes in tissues, which then activate
complement and cause inflammation, is the mechanism of which hypersensitivity type? a) Type I
b) Type II c) Type III d) Type IV Answer: c) Type III Explanation: Type III hypersensitivity
(immune complex) is caused by the deposition of circulating antigen-antibody complexes in
vessel walls or other tissues. This deposition triggers complement activation and an
inflammatory response.
Q143. A tuberculin skin test (Mantoux test) is a classic example of which type of hypersensitivity
reaction? a) Type I (Anaphylactic) b) Type II (Cytotoxic) c) Type III (Immune Complex) d) Type
IV (Cell-Mediated) Answer: d) Type IV (Cell-Mediated) Explanation: Type IV hypersensitivity is
a delayed-type reaction mediated by T-lymphocytes (specifically T-helper cells and cytotoxic
T-cells), not antibodies. The tuberculin reaction is a prime example.
Q144. The state in which the body’s immune system fails to distinguish between ‘self’ and
‘non-self’ and forms autoantibodies against its own tissues is called: a) Immunodeficiency b)
Anaphylaxis c) Autoimmunity d) Immune tolerance Answer: c) Autoimmunity Explanation:
Autoimmune diseases are defined as a state where the body's immune system loses its ability
to distinguish 'self' from 'non-self' and subsequently reacts against its own tissue antigens by
forming autoantibodies.
Q145. The normal phenomenon, present since fetal life, where an individual recognizes their
own tissues and antigens as 'self' is called: a) Autoimmunity b) Hypersensitivity c) Immune
tolerance d) Anergy Answer: c) Immune tolerance Explanation: Immune tolerance is the
opposite of autoimmunity and is defined as the normal ability of an individual to recognize
self-tissues and antigens.
Q146. Which of the following is considered a systemic (non-organ-specific) autoimmune
disease? a) Hashimoto's thyroiditis b) Myasthenia gravis c) Systemic Lupus Erythematosus
(SLE) d) Goodpasture's syndrome Answer: c) Systemic Lupus Erythematosus (SLE)
Explanation: Autoimmune diseases are classified as organ-specific or systemic. Systemic
Lupus Erythematosus (SLE) is listed as the classical example of a systemic autoimmune
disease, affecting multiple organ systems.
Q147. Which of the following is an example of an organ-specific autoimmune disease primarily
affecting the thyroid? a) Rheumatoid arthritis b) Scleroderma c) Hashimoto's thyroiditis d)
Myasthenia gravis Answer: c) Hashimoto's thyroiditis Explanation: The classification table lists
several organ-specific autoimmune diseases. Hashimoto's thyroiditis is one that targets the
thyroid gland.
Q148. Autoantibodies against nuclear components (ANAs), such as anti-ds-DNA and anti-Sm,
are characteristic of which disease? a) Myasthenia gravis b) Systemic Lupus Erythematosus
(SLE) c) Multiple sclerosis d) Type 1 diabetes Answer: b) Systemic Lupus Erythematosus (SLE)
Explanation: SLE is a multisystem disease where autoantibodies against nuclear (ANAs) and
cytoplasmic components are demonstrable in the plasma. Specific examples given are ANA,
anti-ds-DNA, and anti-Sm.
Q149. The LE cell, which can be found in about 70% of SLE cases, is a: a) Plasma cell
producing autoantibodies b) Neutrophil or macrophage that has phagocytosed the denatured
nucleus of another cell c) Cytotoxic T-lymphocyte attacking a host cell d) Basophil with IgE on its
surface Answer: b) Neutrophil or macrophage that has phagocytosed the denatured nucleus of
another cell Explanation: The LE cell test is mentioned as being positive in 70% of SLE cases.
An LE cell is a phagocytic leukocyte (like a neutrophil) that has engulfed the antibody-coated
(opsonized) nucleus of a damaged cell.
Q150. According to the CDC classification for HIV/AIDS, an individual with a CD4+ cell count of
150 cells/µL is in which clinical category? a) Category 1 (>500 cells/µL) b) Category 2 (200-499
cells/µL) c) Category 3 (<200 cells/µL) d) Category A (Asymptomatic) Answer: c) Category 3
(<200 cells/µL) Explanation: The Revised CDC HIV/AIDS Classification table shows three
CD4+ T-cell categories. Category 3 is defined by a cell count of <200 cells/µL, which is an
indicator for AIDS.

Topic 8: Diagnostic Techniques in Anatomical Pathology

Q151. Surgical pathology concerns the examination of which type of specimens? a) Autopsy
tissues from deceased patients b) Biopsy specimens from living patients c) Blood and urine
samples d) Environmental samples Answer: b) Biopsy specimens from living patients
Explanation: The introduction states that surgical pathology concerns the examination of
biopsy specimens from living patients to assist in diagnosis, therapy choice, and prognosis.
Q152. In what percentage of routine cases is Haematoxylin and Eosin (H&E) staining sufficient
for histological diagnosis? a) 50% b) 75% c) 85% d) 95% Answer: d) 95% Explanation: The
document states that in up to 95% of routine cases, Haematoxylin and eosin staining alone is
sufficient for making a histological diagnosis.
Q153. A histochemical stain like Ziehl-Neelsen is used to demonstrate which of the following? a)
Fungi b) Collagen c) Mycobacteria d) Melanin Answer: c) Mycobacteria Explanation:
Histochemical (special) stains are used for various purposes. The document lists the
demonstration of organisms as one application, with the Ziehl-Neelsen stain being used for
mycobacteria (the causative agent of tuberculosis).
Q154. Perls’ Prussian blue stain is used to identify which pigment in tissues? a) Melanin b)
Lipofuscin c) Haemosiderin d) Bilirubin Answer: c) Haemosiderin Explanation: One application
of histochemical stains is the identification of pigments. Perls’ Prussian blue stain is specifically
used to demonstrate haemosiderin, an iron-containing pigment.
Q155. What is the primary advantage of monoclonal antibodies over polyclonal antibodies in
immunohistochemistry? a) They are cheaper to produce b) They react with a broad range of
antigens c) They are directed against a single epitope of a specific antigen d) They do not
require a secondary antibody Answer: c) They are directed against a single epitope of a
specific antigen Explanation: Polyclonal antibodies could react with a range of similar but not
identical epitopes. In contrast, monoclonal antibodies, developed using the hybridoma
technique, are highly specific as they are directed against a single epitope of a specific antigen.
Q156. In breast cancer, the detection of oestrogen and progesterone receptors by
immunohistochemistry is important for what reason? a) To confirm the diagnosis of cancer b) To
determine the patient's age c) It has prognostic and therapeutic value d) To identify the primary
site of the tumor Answer: c) It has prognostic and therapeutic value Explanation: Detecting
hormone receptors in breast cancer cells is of prognostic and therapeutic value because
cancers that are positive for these receptors are susceptible to anti-oestrogen therapy.
Q157. Which diagnostic technique involves passing disaggregated cells in a fluid suspension
through a laser beam to analyze their characteristics? a) Electron Microscopy b) Flow Cytometry
c) In situ hybridization d) Polymerase Chain Reaction Answer: b) Flow Cytometry Explanation:
Flow cytometry is a technique where disaggregated cells in a fluid suspension pass one by one
through a laser beam. The scattered light provides information about cell size, shape, DNA
content, and surface molecule expression.
Q158. Determining the CD4 cell count in HIV patients is a key application of which technique?
a) Immunohistochemistry b) Electron Microscopy c) Flow Cytometry d) Karyotyping Answer: c)
Flow Cytometry Explanation: The document lists several applications for flow cytometry in
haematology, including its use to determine CD4 cell counts in HIV patients.
Q159. Which diagnostic method offers the highest resolution, allowing for the visualization of
subcellular organelles like mitochondria and melanosomes? a) Light Microscopy b)
Immunohistochemistry c) Flow Cytometry d) Electron Microscopy (EM) Answer: d) Electron
Microscopy (EM) Explanation: Electron microscopy can achieve a resolution of 1-2nm, far
greater than the 250nm of light microscopy. This extremely high magnification permits the
visualization of ultrastructural features and cytoplasmic organelles.
Q160. In which of the following areas is electron microscopy often the definitive diagnostic
procedure? a) Routine cancer screening b) Blood typing c) Glomerular diseases of the kidney d)
Identifying bacterial infections Answer: c) Glomerular diseases of the kidney Explanation:
While its use has been limited by other techniques, EM remains crucial in certain areas. The
document highlights that glomerular diseases are best categorized using a combination of
stains, immunofluorescence, and EM, with EM often being the definitive diagnostic procedure
(e.g., in minimal change disease).
Q161. The laboratory process of arranging chromosomes from a cell preparation in a standard
format to analyze their number and structure is called: a) Polymerase chain reaction (PCR) b)
Karyotyping c) Flow cytometry d) DNA sequencing Answer: b) Karyotyping Explanation:
Cytogenetic studies involve creating a chromosome spread, staining it (e.g., with Giemsa), and
photographing it. The karyotype is then constructed from the photograph, arranging the 22
autosomes and 2 sex chromosomes by size and banding pattern.
Q162. What substance is used in cytogenetic studies to arrest cell division in metaphase? a)
Phytohaemagglutinin b) Colchicine c) Formalin d) Giemsa Answer: b) Colchicine Explanation:
In preparing a chromosome spread, the cell preparation is stimulated to divide, and then mitosis
is arrested in metaphase using colchicine.
Q163. Which molecular technique uses fluorochrome-labeled probes to demonstrate whole
chromosomes or specific gene loci in tissue sections or chromosome spreads? a) Standard
PCR b) Flow Cytometry c) Fluorescence in situ hybridization (FISH) d) Electron Microscopy
Answer: c) Fluorescence in situ hybridization (FISH) Explanation: Fluorescence in situ
hybridization (FISH) is described as the use of fluorochrome-labeled probes to demonstrate
whole chromosomes or chromosomal loci in chromosome spreads or archival tissue specimens.
Q164. Which of the following is NOT one of the three main steps in a single cycle of the
Polymerase Chain Reaction (PCR)? a) DNA denaturation b) Primer annealing c) Polymerase
extension d) DNA sequencing Answer: d) DNA sequencing Explanation: PCR amplifies DNA
through multiple cycles. Each cycle consists of three steps: i. DNA denaturation, ii. Primer
annealing, and iii. Polymerase extension. DNA sequencing is a separate technique used to
determine the exact order of nucleotides.
Q165. A technique that allows for the measurement of the expression of thousands of genes
simultaneously in a single tissue sample is: a) Electron Microscopy b) Flow Cytometry c)
Karyotyping d) DNA microarray technology (DNA chip) Answer: d) DNA microarray technology
(DNA chip) Explanation: DNA microarray technology, or the DNA chip, is the latest technique
mentioned that can be applied to measure the expression of thousands of genes at once to
generate an expression profile for a given tissue sample.
Remaining 35 MCQs to reach 200
Q166. The final step in surgical pathology processing before a pathologist makes a diagnosis is:
a) Grossing the tissue b) Generating a surgical pathology report c) Obtaining and staining a
slide d) Tissue processing in the laboratory Answer: c) Obtaining and staining a slide
Explanation: The sequence of events is: grossing, tissue processing to get a block, sectioning
the block to get a slide, staining the slide (usually H&E), and then the pathologist looks at the
slide to make a diagnosis. The report is generated after the diagnosis is made.
Q167. Pathologic hyperplasia can constitute a "fertile soil" for what subsequent development? a)
Atrophy b) Regeneration c) Cancerous growth d) Physiologic adaptation Answer: c) Cancerous
growth Explanation: Pathologic hyperplasia, often caused by excessive hormonal stimulation,
is described as constituting a fertile soil in which cancerous growth may eventually arise.
Q168. The change from squamous to columnar epithelium in the esophagus (Barrett's
esophagus) due to acid reflux is an example of: a) Atrophy b) Hyperplasia c) Metaplasia d)
Dysplasia Answer: c) Metaplasia Explanation: While the most common epithelial metaplasia is
columnar to squamous, the document also notes that metaplasia from squamous to columnar
type can occur, providing Barrette oesophagitis as an example.
Q169. Which antioxidant enzyme is responsible for neutralizing the superoxide radical
(O_{2}^{-})? a) Catalase b) Glutathione peroxidase c) Superoxide dismutase (SOD) d) Ferritin
Answer: c) Superoxide dismutase (SOD) Explanation: The document lists enzymatic
antioxidants that protect against free radical injury. Superoxide dismutase (SOD) specifically
acts on the superoxide radical (O_{2}^{-}).
Q170. How does carbon tetrachloride (CCl4) cause chemical injury to liver cells? a) It directly
binds to and damages mitochondria b) It is converted to the toxic free radical CCl3 by P-450
oxidases c) It inhibits the sodium pump, causing cellular swelling d) It causes an autoimmune
reaction against hepatocytes Answer: b) It is converted to the toxic free radical CCl3 by P-450
oxidases Explanation: CCl4 is given as an example of a chemical that causes indirect injury. It
is converted to the highly reactive free radical CCl3 in the smooth endoplasmic reticulum by
P-450 mixed-function oxidases, which then causes injury.
Q171. "Dry gangrene" is a form of which type of necrosis? a) Liquefactive necrosis b)
Coagulative necrosis c) Caseous necrosis d) Fat necrosis Answer: b) Coagulative necrosis
Explanation: Gangrenous necrosis is described as a modified form of coagulative necrosis.
"Dry gangrene" occurs when it is modified by exposure to air.
Q172. Fibrinoid necrosis is typically seen in the walls of which structures? a) Alveoli b)
Hepatocytes c) Neurons d) Arterioles Answer: d) Arterioles Explanation: Fibrinoid necrosis is a
specific type of necrosis seen, for example, in the arterioles in malignant hypertension. It
appears as an eosinophilic granular change in the blood vessel wall.
Q173. In the pathogenesis of apoptosis, initiator caspases like caspase-8 and caspase-9 are
responsible for activating: a) Death receptors b) Bcl-2 family proteins c) Executioner caspases
like caspase-3 and caspase-6 d) DNA repair enzymes Answer: c) Executioner caspases like
caspase-3 and caspase-6 Explanation: The mechanism of apoptosis involves initiator
caspases (e.g., caspase-8 and -9) activating the executioner caspases (e.g., caspase-3 and -6),
which then carry out the degradation of cellular components.
Q174. The presence of two or more populations of cells with different genotypes in one
individual, arising from mitotic error, is known as: a) Aneuploidy b) Mosaicism c) Pleiotropism d)
Heterogeneity Answer: b) Mosaicism Explanation: Mosaicism is defined as the situation where
mitotic division errors in early development give rise to two or more populations of cells in the
same individual.
Q175. Polydactyly (extra fingers or toes) is a characteristic feature of which trisomy? a) Trisomy
21 (Down syndrome) b) Trisomy 18 (Edwards syndrome) c) Trisomy 13 (Patau syndrome) d)
Klinefelter syndrome (XXY) Answer: c) Trisomy 13 (Patau syndrome) Explanation: The
document includes an image of polydactyly as a feature of Trisomy 13 (Patau syndrome).
Q176. Which factor, activated during the coagulation cascade, also plays a role in initiating the
kinin, complement, and fibrinolytic systems? a) Factor VIII (Antihemophilic factor) b) Factor X
(Stuart-Prower factor) c) Factor XII (Hageman factor) d) Factor I (Fibrinogen) Answer: c) Factor
XII (Hageman factor) Explanation: Factor XII (Hageman factor) is a key initiator of the intrinsic
clotting pathway, and the document also lists it as a chemical mediator of inflammation, linking
the clotting system to other inflammatory cascades.
Q177. The immediate transient response in vascular leakage during acute inflammation, caused
by histamine, lasts for approximately: a) 1-5 minutes b) 15-30 minutes c) 4-6 hours d) 24 hours
or more Answer: b) 15-30 minutes Explanation: The document explains that mediators like
histamine cause an early, brief (15-30 min) immediate transient response, leading to endothelial
cell contraction in venules.
Q178. Which cytokine mediators are responsible for the delayed (4-6 hours post-injury) vascular
leakage due to endothelial cell junction retraction? a) Histamine and Bradykinin b) Leukotrienes
and Prostaglandins c) TNF and IL-1 d) C3a and C5a Answer: c) TNF and IL-1 Explanation:
Cytokine mediators such as Tumor Necrosis Factor (TNF) and Interleukin-1 (IL-1) induce a
more prolonged form of vascular leakage by causing endothelial cell junction retraction. This
response starts 4-6 hours after injury and can last for 24 hours or more.
Q179. In cutaneous wound healing, when do neutrophils typically appear at the margins of the
incision? a) Immediately b) Within 24 hours c) Between 3 to 7 days d) After one week Answer:
b) Within 24 hours Explanation: Following the formation of the blood clot, neutrophils appear at
the margins of the incision within 24 hours to help clean the wound area.
Q180. Which growth factor is a potent inducer of angiogenesis? a) Epidermal Growth Factor
(EGF) b) Transforming Growth Factor-beta (TGF-β) c) Platelet-Derived Growth Factor (PDGF)
d) Vascular Endothelial Growth Factor (VEGF) Answer: d) Vascular Endothelial Growth Factor
(VEGF) Explanation: The tables listing growth factors and their functions consistently show
Vascular Endothelial Growth Factor (VEGF) as a primary driver of angiogenesis.
Q181. What is the primary component that gives a scar its tensile strength? a) Elastin b) Fibrin
c) Collagen d) Proteoglycans Answer: c) Collagen Explanation: The process of scar formation
is described as the deposition of collagen and other ECM components. The recovery of tensile
strength is directly related to the net accumulation and structural modification of collagen fibers
within the wound.
Q182. A deficiency in which factor is a common cause of haemorrhagic disorders? a) Red blood
cells b) Platelets or coagulation factors c) White blood cells d) Albumin Answer: b) Platelets or
coagulation factors Explanation: Spontaneous haemorrhage can occur in a variety of clinical
disorders collectively known as haemorrhagic diatheses, which are caused by deficiencies in
platelets or coagulation factors like in haemophilia.
Q183. What are the microscopic channels of blood escape into loose tissues following marked
congestion called? a) Petechiae b) Diapedesis c) Purpura d) Ecchymosis Answer: b)
Diapedesis Explanation: Diapedesis is defined as the microscopic escape of erythrocytes into
loose tissues, which may occur after significant congestion.
Q184. In CVC of the liver, which zone of the hepatic lobule is most severely affected by hypoxic
injury? a) Periportal zone (zone 1) b) Mid-zonal area (zone 2) c) Centrilobular zone (zone 3) d)
The entire lobule is affected equally Answer: c) Centrilobular zone (zone 3) Explanation: In
CVC of the liver, the changes are most marked in the centrilobular zone (zone 3) because it is
the farthest from the arterial blood supply and thus bears the brunt of the hypoxic injury.
Q185. Which of the following is a characteristic of an antemortem thrombus? a) Gelatinous and
shiny b) Not attached to the vessel wall c) Friable and firmly attached d) Uniformly red-purple in
color Answer: c) Friable and firmly attached Explanation: The comparison table indicates that
an antemortem thrombus is typically friable, granular, and firmly attached to the underlying
vessel wall.
Q186. A thrombus that forms in the heart or a large artery and travels to obstruct a distant
vessel is known as a(n): a) Venous thromboembolism b) Systemic (arterial) thromboembolism c)
Paradoxical embolism d) Fat embolism Answer: b) Systemic (arterial) thromboembolism
Explanation: The diagram of thromboembolism shows that systemic thromboembolism
originates in the arterial system (e.g., from the heart or aortic aneurysms) and travels to lodge in
organs like the brain, kidneys, or lower extremities.
Q187. Which type of hypoxia is caused by a low level of haemoglobin in the blood? a) Hypoxic
Hypoxia b) Anaemic Hypoxia c) Stagnant Hypoxia d) Histotoxic Hypoxia Answer: b) Anaemic
Hypoxia Explanation: Ischaemia is primarily caused by hypoxia. The document lists four types
of hypoxia, with Anaemic Hypoxia being defined as that due to a low level of haemoglobin in the
blood.
Q188. What is the term for the replacement of necrotic brain tissue by fatty, distended microglial
cells? a) Fibrosis b) Scarring c) Gliosis d) Calcification Answer: c) Gliosis Explanation: In the
brain, liquefactive necrosis is not replaced by a fibrous scar. Instead, the process is followed by
gliosis, which is replacement by microglial cells (gitter cells) that have phagocytosed the lipid
debris.
Q189. In Type I hypersensitivity, the cross-linking of IgE on the surface of mast cells by an
antigen triggers the release of: a) Cytotoxic enzymes b) Pro-inflammatory cytokines like TNF c)
Preformed mediators like histamine d) Complement proteins Answer: c) Preformed mediators
like histamine Explanation: The mechanism of Type I hypersensitivity involves an antigen
cross-linking IgE antibodies on mast cells, causing them to degranulate and release preformed
mediators, most notably histamine.
Q190. Post-streptococcal glomerulonephritis, where immune deposits are seen in the capillary
loops, is an example of which type of hypersensitivity? a) Type I b) Type II c) Type III d) Type IV
Answer: c) Type III Explanation: Post-streptococcal glomerulonephritis is a classic example of
a Type III (immune complex-mediated) hypersensitivity reaction. The image caption explains
that immune deposits are distributed in the capillary loops.
Q191. What is the role of an 'adapter protein' in the extrinsic pathway of apoptosis? a) To repair
damaged DNA b) To directly cleave cytoskeletal proteins c) To link the activated death receptor
to initiator caspases d) To inhibit the Bcl-2 family proteins Answer: c) To link the activated death
receptor to initiator caspases Explanation: The diagram of apoptosis mechanisms shows that
in the extrinsic pathway, receptor-ligand interactions (e.g., FAS, TNF) lead to the recruitment of
adapter proteins, which in turn recruit and activate initiator caspases.
Q192. Which of the following is NOT listed as a cause of pathologic atrophy? a) Pressure b)
Aging (senile atrophy) c) Inadequate nutrition d) Increased blood supply Answer: d) Increased
blood supply Explanation: The causes of pathologic atrophy include decreased workload, loss
of innervation, diminished blood supply, inadequate nutrition, loss of endocrine stimulation,
aging, and pressure. Increased blood supply would not cause atrophy.
Q193. The process of forming cartilage or bone in tissues that do not normally contain these
elements is an example of: a) Hyperplasia b) Dysplasia c) Neoplasia d) Connective tissue
metaplasia Answer: d) Connective tissue metaplasia Explanation: The document describes
connective (mesenchymal) tissue metaplasia as the formation of cartilage (chondroid), bone
(osseous), or adipose tissue in tissues where they are not normally found.
Q194. Which diagnostic technique would be most appropriate for detecting a chromosomal
translocation, like the Philadelphia chromosome in CML? a) Standard H&E staining b) Electron
Microscopy c) Cytogenetic studies (Karyotyping) or FISH d) Routine blood count Answer: c)
Cytogenetic studies (Karyotyping) or FISH Explanation: Cytogenetic studies are used to detect
structural chromosomal disorders, including rearrangements like translocations. FISH is also
highly effective for detecting specific translocations.
Q195. The 'brown induration' seen on the cut surface of a lung with chronic venous congestion
is due to: a) Accumulation of carbon pigment b) Deposition of collagen only c) A combination of
haemosiderin pigmentation and fibrosis d) Proliferation of smooth muscle Answer: c) A
combination of haemosiderin pigmentation and fibrosis Explanation: The term "brown
induration" is used to describe the gross appearance of CVC lungs. The brown color comes
from haemosiderin pigment (from "heart failure cells"), and the induration (firmness) comes from
the associated fibrosis in the alveolar septa.
Q196. The first step in leukocyte extravasation, where leukocytes settle out of the central flow
column, is: a) Adhesion b) Rolling c) Diapedesis d) Margination Answer: d) Margination
Explanation: The sequence of events in leukocyte extravasation begins with margination,
where leukocytes move to the periphery of the vessel, followed by rolling, adhesion, and finally
transmigration (diapedesis).
Q197. Which term describes a mutant gene leading to many end effects, such as the varied
clinical manifestations of sickle cell disease? a) Genetic heterogeneity b) Variable expressivity c)
Pleiotropism d) Reduced penetrance Answer: c) Pleiotropism Explanation: Pleiotropism is
when a single mutant gene leads to many different end effects. The document provides sickle
cell disease as a classic example.
Q198. Which of the following is an example of a cell surface marker used in
immunohistochemistry to identify endothelial cells? a) Cytokeratin b) Desmin c) Chromogranin
d) von Willebrand Factor (Factor VIII related antigen) Answer: d) von Willebrand Factor (Factor
VIII related antigen) Explanation: Immunohistochemistry can categorize undifferentiated
neoplasms by demonstrating specific markers. The document lists von Willebrand Factor
(Factor VIII related antigen) as a marker for endothelial cells.
Q199. In the pathology laboratory, what is the purpose of a frozen section? a) For long-term
archival of tissue b) To provide a rapid intraoperative diagnosis c) For routine H&E staining d)
For electron microscopy Answer: b) To provide a rapid intraoperative diagnosis Explanation:
Frozen section is listed as a basic technique and is primarily used for intraoperative
consultations, where a surgeon needs a rapid diagnosis while the patient is still in surgery to
guide the extent of the operation. Enzyme histochemistry also often requires frozen sections.
Q200. Which of the following is a characteristic feature of an 'old' or 'healed' infarct? a) Elevated
over the organ surface and haemorrhagic b) Contains a dense neutrophilic infiltrate c) Replaced
by normal parenchymal tissue d) Shrunken, depressed, and replaced by a fibrous scar Answer:
d) Shrunken, depressed, and replaced by a fibrous scar Explanation: A recent infarct is
generally slightly elevated. An old infarct is described as being shrunken and depressed under
the surface of the organ because the necrotic area is eventually replaced by fibrous scar tissue,
which contracts over time.

AI generated by Folarin Samuel MBBS2K25